As of 2023, there is still no official cure for Retinitis Pigmentosa (RP). However, several vision therapy and other interventions have shown promising results in slowing down the degeneration of the retina. There is more interesting research in this field with breakthroughs being made regularly. In this blog, we will discuss some of the most promising research and treatment options for retinitis pigmentosa. While the condition may still be incurable as of now, with these treatment options, you can slow down the progression of RP and protect your vision from degeneration for as long as you live. So, let’s take a look at the different researches and therapies currently being developed for treating RP.
Gene Therapies and Genetic Approaches
Retinitis Pigmentosa is an inherited genetic condition. It is transferred to you from your parents and mutations in up to 60 different genes can cause RP. So, given the nature of the condition, experts have been studying the genes that cause RP. Due to technological limitations, in the past, you could only find out what type of gene mutation caused your RP, but it couldn’t be fixed.
Even though curing it is still not possible, there are active studies being done on actual RP patients to study different gene therapies. If the studies are successful, it could be a breakthrough for the condition and offer a legitimate treatment option for all RP patients around the world. Currently, these studies are being conducted in the US and if you are from there, you can opt to be a part of the studies to be a test subject for various treatment options that are currently being developed.
The exciting matter is that all these treatments are being developed with the aim to cure RP and the vision loss that comes from it. Gene therapies attempt to alter properties of living cells and in the process offer therapeutic relief for patients with various genetic disorders. Now that you know about gene therapies and the promising new future that may offer a treatment for conditions like RP, let’s explore the different gene therapy options that are currently being developed right now.
CRISPR-Cas9 Technology in Gene Editing
Gene editing as the name suggests allows professionals to edit your genes by adding, removing, or altering your genes in particular locations of your genome. Each of these functions have the potential to alter the DNA of any living organism. Altering DNA helps reverse conditions that are caused on a genetic level and can cure conditions that are as of yet thought to be incurable. One of the most popular gene editing techniques used by scientists today is the CRISPR-Cas9 technology.
The CRISPR-Cas9 gene editing technique, which is short for clustered regularly interspaced short palindromic repeats and CRISPR-associated protein 9 is revolutionary and highly talked about in the scientific and medical world due to various factors. Firstly, it is cost-effective compared to other gene editing techniques, making it easily available for a wider range of patients. Second, it is a faster process compared to other gene editing techniques. It is also more accurate and efficient compared to other techniques.
This genome editing technique was developed by scientists who studied a similar technique used by bacteria as a part of their immune defence. When bacterias are affected by viruses, the bacteria capture small parts of the virus and add it to its own DNA to create CRISPR arrays. These arrays are created to remember the virus or its lookalikes by the bacteria. If there are new attacks from similar viruses in the future, the CRISPR arrays create new RNA sequences that attach to the virus’s DNA and using the Cas9 or similar proteins, it disintegrates the virus from the inside, stopping it from affecting the bacteria.
Currently, CRISPR Cas9 gene editing is being used to try and prevent and treat difficult illnesses. It is currently being tested on animal models to understand how different illnesses work and if this treatment is safe for use in humans or not. As with any type of gene editing technique, there are ethical concerns attached to it. With the advent of new technology it could one day be possible to alter genetic traits in human beings to improve genetic things like intelligence and height. This raises a lot of ethical questions and for that matter germline gene editing which would help parents with RP stop it from being passed down to their next generation has been banned in several countries.
Currently, CRISPR Cas9 is not actively used to treat RP, however, it may be able to offer cure for RP to humans in the future. A study in mice has shown CRISPR gene editing was able to restore vision in rats, which makes it a promising treatment option for human beings with RP in the future.
Now that you know about gene editing and CRISPR Cas9, let’s explore other treatment options like Optogenetics.
Optogenetics and Restoring Light Sensitivity
Retinal conditions like retinitis pigmentosa cause irreversible photoreceptor death while not harming the inner retina to a great extent. Optogenetic light sensitive gene therapy now offers a feasible treatment option that can even restore lost vision by rendering surviving retinal neurons. Even at late disease stages this treatment has the potential to restore lost vision regardless of the cause of retinal degeneration.
The concept of optogenetics was published almost 15 years ago with its proof of concept. Since then the field has improved significantly and just recently this gene editing method was successfully used on a human subject to help them restore their vision. You can check out medical journals to learn more about the particular case study or ask your doctor to learn more about optogenetics and if your case is appropriate to use it as a treatment option.
While it is true that optogenetics have been able to restore vision in human patients for the first time, the challenge is still to improve the restorative effects of this treatment. Currently it is only able to offer patients restoration to a rudimentary form of vision and the goal is to offer restoration to a vision that offers the space and time resolution necessary. More research is required in the field to develop more effective tools that would help with better vision repair in the future.
Clinical Trials and Potential Benefits
Gene editing has an untethered potential as a treatment option which has the potential to cure a lot of incurable diseases. However, with treatments like gene editing, there are a lot of ethical and regulatory questions that come up, starting with its safety and long term effects on the human body.
It is safe to say that in the future with a better understanding of the subject, human beings will finally be able to cure conditions like RP, but as of now, it is in a very initial stage where only very specific cases can be treated using these treatment options. Even with very specific treatment cases, these treatments can be costly and can’t guarantee results to the extent one might believe.
So, it is crucial that you discuss the probabilities with your healthcare provider to understand the treatments better and then take an informed decision regarding if this type of treatment is right for you or not.
It is important to note, that participating in these clinical trials is crucial for the future of these treatments and them becoming easily available for more patients in the future. With that being said, let’s take a look at other treatment options namely stem cell and regenerative medicine and how it can help patients with RP.
Stem Cell and Regenerative Medicine
Stem cell and regenerative medicine is another new frontier medical treatment in the development of becoming a widely available treatment option for patients with RP. Given the genetic nature of RP, stem cells can be beneficial in aiding the symptoms of RP. Currently the treatments offered under stem cell and regenerative medicine for RP are aided to stop disease progression and improve the patient’s life quality as much as possible without the need for surgical intervention.
Studies have shown that stem cell therapy is a viable treatment option for visual rehabilitation among patients with retinitis pigmentosa. Autologous stem cells are used from the patient’s own bone marrow and adipose tissues. Both adipose derived stem cells and bone marrow derived stem cells are used to ensure a safe treatment with maximum retrieval. Further details on how the treatment can be effective for you depends on the initial diagnosis of medical professionals.
Stem cell therapy and regenerative medicine can be a great option for your case if your doctors approve the treatment to be effective for you. Let’s take a look into more treatment options that have the potential to help you reverse your condition or at the least aid your symptoms.
Induced Pluripotent Stem Cells (iPSCs) in Retinal Regeneration
Retinal regeneration using pluripotent stem cells is another modern treatment option for RP that has proven to be effective. Stem cell treatments have grown in popularity over the years and are also available quite readily nowadays. This treatment revolves around reprogramming animal and human differentiated cells to create a new type of pluripotent cell that can replicate tissue affected by disease. For patients with RP, this type of treatment can help regenerate the retinal cells and help regain lost vision.
Induced pluripotent stem cells are a type of stem cell derived from adult somatic cells. These somatic cells have been genetically reprogrammed to an embryonic stem cell like state. It is done through processes like forced expression of genes. Other processes used for generating induced pluripotent stem cells include using retroviral or lentiviral transduction of reprogramming factors.
Even though stem cell therapy is readily available using it to treat conditions like retinitis pigmentosa is not offered in most places. The main reason for that is because the offered treatment is still in development and can only offer rudimentary reversal of lost vision. Even for that, patients are vetted to check if they are rightly suited for the treatment or not. And if they pass the evaluation these treatments can be highly expensive.
As modern medicine progresses, more research in this field will soon make this treatment more efficient in reversing vision loss from conditions like RP. It will also make the treatment affordable and easily available for all patients across the globe.
Retinal Cell Transplantation and Replacement
Transplantation is one of the most popular treatment ideas for conditions like RP that have just recently become a reality at least to some extent. In clinical trials experts were able to grow retinal cells that were destroyed from stem cells and use that to replace damaged retinal cells with the new healthy transplants. To make this idea into a reality, stem cell research, retinal imaging techniques, tissue engineering, and transplantation techniques have all worked together to realise the common goal.
Human embryonic stem cells, induced pluripotent stem cells, and retinal organoids provide an adequate number of cells at a desired developmental stage which maximises integration of the graft to the host retina. While this treatment is possible and clinical trials have proven it to be effective, there are still a few challenges that need to be met to make this treatment readily and safely available for all patients of serious retinal conditions like RP.
Currently one of the primary concerns regarding the success of this treatment type lies in the fact that stem cells may not integrate with the host retina properly. While it is unfortunate it can at least slow down the progression of retinal degeneration if not reverse the loss of vision. Another major problem with this treatment is immune compatibility. Let’s discuss more about immune compatibility and the challenges of stem cell and regenerative medicine in the next section.
Challenges and Future Prospects
Stem cell therapy is a promising new treatment option for conditions like Retinitis Pigmentosa, however, a lot of research is still required for it to become readily available and safe for all patients. One of the main hurdles for this treatment is immune compatibility among patients. The manufacturing process and ensuring that strict guidelines are followed throughout the entire process to ensure manufacturing consistency is another challenge faced in stem cell therapy.
Contamination issues are also rampant with stem cell therapy research as even the slightest contamination can have adverse effects on the patient. These challenges will be understood thoroughly through more research and with technological advancements. With research and technological advancements scientists will be able to eliminate the problems regarding manufacturing consistency and contamination in the future.
Stem cell therapy is currently a viable treatment option for a variety of conditions including cancer. There is a good chance that with further research it can safely reverse vision loss caused due to conditions like RP. With prospective proof of concepts being developed and submitted, there is no doubt that people in the future may have an opportunity to reverse their vision loss. So, if your medical professionals recommend this treatment option for you, it is in your best interest to try it out.
Retinal Prostheses and Bionic Vision
Bionic vision may seem like stuff from superhero movies, but it is actually possible at least in theory. While the treatment can only be offered in specific cases, it can, however, simulate vision sensation in patients with significant retinal conditions like RP. The catch is that the patient must have an unaffected visual cortex and optic nerve to ensure that the treatment works for them.
The technology works by receiving and processing the light coming into a person’s eye and then transmitting that information as electrical impulses to the inner retinal layers of the eye. Even for patients with conditions like RP, the inner retinal layers are usually unaffected and if that combined with an unaffected visual cortex and optic nerve, it can effectively bring back lost vision with the help of prostheses.
While the real life application of this technology has not been done yet, it still has tremendous potential in becoming highly beneficial for patients with RP and other conditions that cause retinal degeneration. Clinical trials will soon start for this technology to be used in human beings to treat vision loss. So if you are interested, you can read up more about this technology and apply to be a part of the trials.
Retinal Implants and Visual Restoration
Visual restoration using retinal implants is possible and even though it will take decades for the technology to become properly biocompatible. A similar timeline is expected for the technology to develop enough that it can offer feasible results. Current studies are quite preliminary and even though some implants have gone through clinical trials, they are not at a place to offer long-term treatment for patients. The available options that are currently in trials and being produced by several tech companies around the world are namely the Argus II, Boston Retinal Implant Project, Epi-Ret 3, Intelligent Medical Implants (IMI) and Alpha-IMS (Retina Implant AG). Let’s take a closer look at Argus II and Alpha IMS. These are the two devices that are currently at the forefront of devices among the retinal implant researchers and there are some interesting reasons as to why they are at the top.
Current Devices: Argus II and Alpha IMS
Argus II
The Argus II is a retinal prostheses system developed by the USC eye institute headed by Dr Mark Humayun. The Argus II is one of the most popular retinal prostheses devices available currently and it has huge potential to become one of the first bionic devices to restore eyesight in patients with RP. The device is placed inside the eye through surgery and then the patient is required to wear a camera and a video processing device combined together in the form of glasses.
The camera’s pick up the visuals around the patient which is then processed and sent to the implant as electrical signals by the video processing unit. The implant stimulates the remaining retinal cells that are alive and the brain interprets these patterns as light. With time and practise the patients are able to learn how to see objects that are close to them and even read large print text. This is the extent of the research so far.
While the device is revolutionary it still has a long way to go mainly because the restored vision from this device is black and white and doesn’t allow the patients to see fine details. Additionally, patients are vetted carefully before they are offered this device as treatment. Currently this treatment is only offered to patients who are completely blind or who have lost a majority of their vision due to advanced stages of retinitis pigmentosa.
However, even with the limitations it is currently the only retinal prostheses implant that has been approved by the FDA as a humanitarian use device.
Alpha IMS
Alpha IMS has been developed by Retina Implant AG. This device is also a popular retinal prostheses device that has just recently received the CE Mark, which is an European regulatory certification. The Alpha IMS is interesting because it has more electrodes than any other device used in humans. What does that mean?
The electrodes are implanted into the eye and it helps develop better vision. The correlation with the current technology is simple, the more electrodes the better the more detailed vision the patients gets once the device is implanted in their eyes. Till date over 30 patients have received this chip and with the 2nd clinical studies that were published recently it was announced that patients with the Alpha IMS implants were able to see and recognise faces and read signs on doors.
While it is not the equivalent of perfect human vision it is important to note that these devices have been able to restore vision in people who have already lost it. With more clinical trials underway there is hope that the Alpha IMS too has potential to become better and more advanced as time goes. At the moment its proprietary technology is definitely one of the best in the industry and hopefully it will be able to help more patients in the future.
If you are interested, you can check them out online and check to see if you are eligible to be a part of their clinical trials. It can help you learn more about their technology and be a part of the development process.
Advancements and Next-Generation Technologies
Advancements in these technologies will take time to process because it involves developing more efficient devices that are bio-compatible. With new technology and AI becoming more readily used in various industries, it is interesting to see how it may affect retinal implants in the future. As for now, clinical trials are being used to optimise the device and understand how it can better help patients restore their vision to a higher degree.
The next generation of technologies might also see different industries collaborating together to optimise these devices further and definitively create implants that offer a complete range of function. Another retinal implant that you should check out and be aware of is the Boston Retinal Implant Project. They were founded back in the 80s and have since been at work developing novel technologies to offer a better quality of life to the visually impaired.
They are also developing retinal implants and with their years of experience, they too are among the top contenders in the industry who can offer the next technological breakthrough for retinal prostheses implants.
Ending Note
With all these optimistic and inspiring tech research, it feels that Retinitis Pigmentosa may be curable in the future. However, it is important to understand what is meant by “cure” here. With technologies like genetic engineering/modification, it may be possible to cure the disease as in stop it from existing in your body for patients who haven’t lost all their vision yet. For patients in advanced stages of the condition who have lost their vision completely or almost completely can get back vision with technologies like retinal implants and bionic eyes.
The future is certainly promising and at the rate technologies seem to be developing, it may be a reality sooner than later where patients will be able to restore lost vision and protect their eyes from further degeneration. Currently, the best retinitis pigmentosa treatment are vision therapy, and you can avail it at Sanjeevan for perfect eyesight. We also offer other treatment options alongside vision therapy to help restore vision in the best case scenarios. To learn more about our treatment options or to book an appointment today, feel free to check out our website.