Subretinal injection techniques for retinal disease: A review
Open accessAbstract
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.
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The subretinal space is thought to be anatomically more closed and immune-privileged than the intravitreal space.
“The subretinal space is thought to be anatomically more closed and immune-privileged than the intravitreal space (Irigoyen et al., 2022).”
From AAV2 and AAV9 tropism and transgene expression in the mouse eye and major tissues after intravitreal and subretinal delivery (2023) · cites this paper as Irigoyen et al., 2022
Delivery to subretinal space allows direct contact of the vector with photoreceptors and the RPE layers.
“IVT injection potentially exposes the entire retina to gene therapy (Koponen et al., 2021; Puranen et al., 2022), whereas delivery to subretinal space allows direct contact of the vector with photoreceptors and the RPE layers (Irigoyen et al., 2022).”
From AAV2 and AAV9 tropism and transgene expression in the mouse eye and major tissues after intravitreal and subretinal delivery (2023) · cites this paper as Irigoyen et al., 2022
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Overview of Recent Advances in Nano-Based Ocular Drug Delivery
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Vargas, L. D. R., Ruozzi, V., Ross, A. K. M., Dehghani, S., Sommersperger, M., Faridpooya, K., Nasseri, M. A., Fairhurst, M., Navab, N., & Matinfar, S. (2026) · Lecture notes in computer science · doi:10.1007/978-3-032-38236-8_31
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- Authors
- Irigoyen, C., Amenabar Alonso, A., Sanchez-Molina, J., Rodríguez-Hidalgo, M., Lara-López, A., & Ruiz-Ederra, J.
- Affiliations
- University of the Basque Country (ES)
- Department of Ophthalmology, Donostia University Hospital (HUD), 20014 Donostia San-Sebastián, Spain
- Biogipuzkoa Health Research Institute (ES)
- Miramoon Pharma S.L., Avenida de Tolosa, 72, 20018 San Sebastián, Spain
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2022-08-12
- Volume
- 11
- Issue
- 16
- Pages
- 4717
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC9409835
- OpenAlex
- W4291465575
- Cited by
- 106
- References
- 88
- Citations by year
- 2026: 28 · 2025: 45 · 2024: 17 · 2023: 16
- FWCI
- 2.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Health Carlos III (PI20/01186, PTQ2019-010412, DIN2020-011302)
- European Regional Development Fund (Institute of Health Carlos III/ISCIII) (PI20/01186, PTQ2019-010412, DIN2020-011302)
- Retinitis Pigmentosa Patients of Gipuzkoa Foundation (BEGISARE) (PI20/01186, PTQ2019-010412, DIN2020-011302)
- Spanish Ministry of Science and Innovation (PI20/01186, PTQ2019-010412, DIN2020-011302)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advanced Drug Delivery Systems
- Keywords
- subretinal injection, retinal gene therapy, inherited retinal disease, RPE65, voretigene neparvovec, viral vectors, photoreceptors, retinal pigment epithelium
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