Saif Hamdan, MD
Vanderbilt Eye Institute, Nashville, TN
Grace Baldwin, MD
Mass Eye and Ear, Boston, MA
On the final day of the 2026 ASRS Annual meeting, the late-breaking abstracts highlighted emerging therapeutics and potential shifts in treatment paradigms in advanced aged related macular degeneration. The session, moderated by Drs. Sunir Garg, MD, FACS, FASRS and Timothy Murray, MD, MBA, FASRS, included five presentations, each addressing different therapeutic pathways.
First, Dr. David Brown, MD of Retina Consultants of Texas presented a longitudinal comparative analysis of retinal nerve fiber layer (RNFL) changes with anti-complement inhibitors for geographic atrophy (GA). Interestingly, eyes treated with avincaptad pegol or pegcetocoplan demonstrated a significant and consistent thickening of the RNFL on average over a > 2 year follow up period compared with untreated eyes and those receiving anti-VEGF therapy alone. The investigators proposed a complement-inhibitor class-effect or PEGylation-related mechanism of both agents. While the clinical significance remains unclear, Dr. Brown warned against the risk of possible ischemic optic neuropathy and importance of longitudinal RNFL monitoring.
Next, Dr. Vivienne Hau, MD, PhD of Kaiser Permanente shared preliminary safety and efficacy results of ASP7317, a stem-cell derived retinal pigment epithelium (RPE) replacement therapy, for advanced GA. The ongoing phase 1b trial showed a favorable safety profile in 14 patients with early signs of visual improvement and anatomic stabilization. BCVA improved out to week 26 in all three cohorts while fellow eyes decreased. However, they were not baseline matched controls. In a subjective questionnaire, patients report improved or stable vision following treatment. Dr. Hau highlighted ASP7317 as a potential regenerative therapy for advanced GA with plans for continued evaluation through next phases of clinical trials.
Shifting to the treatment of neovascular AMD (nAMD), Dr. Szilárd Kiss, MD, FASRS reported 5-year OPTIC trial outcomes for ixoberogene soroparvovec (ixo-vec), an intravitreal AAV vector designed to encode aflibercept. A single intravitreal injection provided a durable treatment effect, including sustained ocular aflibercept concentrations, preserved visual acuity and anatomic control, and significant reduction in anti-VEGF injections, with a favorable long-term safety profile. There were durable aflibercept levels up to 5 years and stable visual acuity and central subfield thickness. Two phase 3 trials, ARTEMIS and AQUARIUS, are currently underway.
The fourth talk of the session was by Robert Avery, MD of California Retina Consultants discussing subretinal delivery of Sura-vec gene therapy for wet AMD, a longterm follow up of phase 1/2a patients. In this study vision was maintained at 5 years with a significant reduction in treamtent burden. Pigmentary retinopathy has been a known side effect, demonstrated in 2-year results, but otherwise there were no new adverse effects. ATMOSPHERE and ASCENT are ongoing Phase III trials investigating the Sura-vec gene therapy.
Lastly, Dr. Carl Awh, MD, FASRS of Tennessee Retina presented 2-year PRISM trial results for 4D-150 gene therapy, an AAV gene therapy encoding aflibercept and an miRNA that inhibits VEGF-C production. Among 30 participants with varying nAMD severity, the therapy showed no serious adverse events with consistent and sustained treatment burden reduction. He noted that 66% of recently diagnosed eyes were injection free for up to 2 years.
The session concluded with discussion on optimizing patient selection and understanding long-term safety. Multiple presenters highlighted that the goal for many of these therapeutics is to stabilize vision while reducing injection burden for patients, which is an important goal.
