“Build a better mousetrap, and the world will beat a path to your door.” This metaphor, credited to Ralph Waldo Emerson,1 embodies the power of innovation. Indeed, mousetraps are the most frequently invented device in U.S. history, with more than 4,400 patents issued since the U.S. Patent Office opened in 1838­—and an estimated 10 times that many submissions rejected.

For exudative and inflammatory retinal diseases, current therapeutics are remarkably effective. Yet, thankfully, the ethos of innovation that defines the retina space continues to lead to the development of next-generation mousetraps. 

Mark Barakat, MD, discusses suprachoroidal drug delivery and Xipere (Clearside Biomedical), projected to launch commercially in the United States in early 2020 (page 18). Differentiating our toolbox beyond intravitreal and sub-Tenon’s injections, clinicians will, for the first time, have an approved mousetrap to readily access the suprachoroidal space in clinic. 

Repeated intravitreal anti-VEGF injections are incredibly safe and effective for the management of neovascular age-related macular degeneration. Nevertheless, efficacy and durability limitations of current anti-VEGF formulations afford ample room for new mousetraps. Arshad Khanani, MD, and colleagues describe the ongoing Phase III trial of the Port Delivery System with ranibizumab (Genentech) and the underlying Phase II data, which aim to bring a hardware-based surgical solution to the management of nAMD (page 20). 

Nicolas Yannuzzi, MD, and
Audina Berrocal, MD, describe their experience, both technical and personal, with Luxturna (voretigene neparvovec, Spark Therapeutics), the first FDA-approved gene therapy for a genetic disease (page 22). The tremendous time and resources invested in this vanguard treatment appear poised to usher in an extraordinary wave of new investigational products into clinical trials targeting diseases ranging from the rare to the commonplace, shepherded by companies including Adverum, Clearside, IVERIC Bio, REGENXBIO and Roche, among many others.

Among thousands of patented mousetraps, fewer than two dozen have made a profit in the marketplace. Newer isn’t always better. The road to commercial viability in retina is cluttered with failed products. Yet, as there remains tremendous opportunity to deliver improved outcomes for our patients, our field of visionaries will certainly continue to refine and innovate in search of the perfect mousetrap. RS













REFERENCE

1. Hope J. A Better Mousetrap. American Heritage Magazine. 1996;47(6). https://www.americanheritage.com/better-mousetrap. Accessed May 8, 2019.