AAO Subday 2025 – Hope for IRDs: From Optogenetics to Oral Therapies in Late-Breaking Data

Lyna Azzouz, MD
PGY4 Resident
Byers Eye Institute, Stanford University

Late-breaking data presented at AAO 2025 highlighted emerging gene-independent treatment strategies for inherited retinal diseases.

Allen C. Ho, MD (Wills Eye Hospital, Philadelphia) presented the three-year extension results from the RESTORE trial evaluating MCO-010, an investigational intravitreal optogenetic therapy for severe retinitis pigmentosa. The treatment delivers a light-sensitive protein to surviving retinal bipolar cells, aiming to restore light responsiveness even in the absence of functional photoreceptors. In long-term follow-up, a meaningful proportion of treated eyes demonstrated sustained functional improvement over the three year follow up period. There was a good safety profile and no serious inflammatory events. As a mutation-agnostic approach, MCO-010 may hold a potential across a broad range of retinal degenerations.

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In a complementary strategy targeting Stargardt disease, Michel Michaelides, MD (Moorfields Eye Hospital, London) presented the interim analysis of the Phase 3 DRAGON trial investigating Tinlarebant, an oral RBP4 antagonist designed to reduce accumulation of toxic bisretinoids associated with ABCA4 dysfunction. Visual function remained stable through the first treatment year, and treatment-related effects such as delayed dark adaptation were consistent with the drug’s mechanism and generally manageable. Tinlarebant has received FDA Breakthrough Therapy designation, and global regulatory discussions are ongoing.

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While long-term outcomes and real-world applicability will require further study, both presentations sought to advance the broader goal of developing mutation-independent therapies for patients who currently have limited or no treatment options.