Subretinal Injection Techniques for Retinal Disease: A Review

J Clin Med. 2022 Aug 12;11(16):4717. doi: 10.3390/jcm11164717.

Abstract

Inherited retinal dystrophies (IRDs) affect an estimated 1 in every 2000 people, this corresponding to nearly 2 million cases worldwide. Currently, 270 genes have been associated with IRDs, most of them altering the function of photoreceptors and retinal pigment epithelium. Gene therapy has been proposed as a potential tool for improving visual function in these patients. Clinical trials in animal models and humans have been successful in various types of IRDs. Recently, voretigene neparvovec (Luxturna®) has been approved by the US Food and Drug Administration for the treatment of biallelic mutations in the RPE65 gene. The current state of the art in gene therapy involves the delivery of various types of viral vectors into the subretinal space to effectively transduce diseased photoreceptors and retinal pigment epithelium. For this, subretinal injection is becoming increasingly popular among researchers and clinicians. To date, several approaches for subretinal injection have been described in the scientific literature, all of them effective in accessing the subretinal space. The growth and development of gene therapy give rise to the need for a standardized procedure for subretinal injection that ensures the efficacy and safety of this new approach to drug delivery. The goal of this review is to offer an insight into the current subretinal injection techniques and understand the key factors in the success of this procedure.

Keywords: retinal gene therapy; subretinal injection; subretinal injection technique; vitreoretinal surgery.

Publication types

  • Review

Grants and funding

This research was funded by grants from the National Institute of Health Carlos III and the European Regional Development Fund (Institute of Health Carlos III/ISCIII) PI20/01186 to CI, and support from the Retinitis Pigmentosa Patients of Gipuzkoa Foundation (BEGISARE). JR-E holds a Torres Quevedo Research Fellowship (PTQ2019-010412) from the Spanish Ministry of Science and Innovation. ALL holds an Industrial Doctorate Fellowship (DIN2020-011302) from the Spanish Ministry of Science and Innovation.