A history of discovery: Why we focus on challenging eye care diseases

Patrice Keegan has lived with a progressive, hereditary eye disease for 20 years, one that affects millions of people around the globe and is the second-leading cause of blindness.

Yet, the New York resident finds that many people don’t understand glaucoma and how it affects her daily life.

A narrow field of vision, balance issues and frequent falls have limited Keegan’s independence and ability to do what she loves, like travel and cook.

“I don't want my family members, my grandchildren to have to experience the symptoms and the loss of vision that I have,” she says. “That's why raising the standard is important.”

People like Patrice help motivate AbbVie’s eye care scientists to push forward with leading-edge translational research. The company is using new, innovative approaches to investigate some of the major causes of vision loss and impairment, from various stages of glaucoma to age-related macular degeneration and refractive errors (e.g., nearsightedness and astigmatism), according to Mayssa Attar, Ph.D., AbbVie’s vice president, research, nonclinical and translational sciences.

With over two decades of experience researching eye diseases, Attar leads the team of scientists responsible for the discovery of potential new treatments and translation of those compounds to clinical trials.

Attar and team are driven by two goals: Bring forward medicines for patients with best-in-class outcomes and reduce the treatment burden. Pursuing these goals is enabled by an eye care journey that began as Allergan over 70 years ago, bolstered today by AbbVie’s legacy in complex diseases and global scale.

A key area of research with great unmet need is retinal disease, driven by degenerative diseases in an aging population, Attar says. This includes age-related macular degeneration (AMD), which causes blurred straight-ahead vision and occurs when aging causes damage to the macula tissue within the retina.

AMD is the leading cause of vision loss for older adults and an important area of research for Attar and team. However, working on AMD and other retinal diseases presents unique challenges because of the barriers to drug delivery to the retina at the back of the eye. Additionally, researchers are limited in their ability to collect a sample for analysis, like you would with a blood or tumor sample for a person taking a cancer medication.

“These challenges actually speak to how our group is structured and the interdisciplinary approach we take to drug discovery,” Attar says. “Our scientists have become very skilled at using in vitro models and in silico models to close the gap between what we can measure in the lab versus what is operationally feasible in the clinic, which allows us to advance research and test a hypothesis.”

Differentiators like having the same state-of-the-art imaging modalities found in an ophthalmologist's office, along with modeling and other digital technologies, accelerate the translation of science to new medicine that serve the goal of improving patient outcomes and reducing burden to patients. Modeling can help scientists explore other medications aimed at reducing treatment burden through improved efficacy, longer-acting and optimal methods of delivery.

Strategic collaborations, both inside and out of AbbVie’s walls, are critical to drive new areas of science, according to Mike Robinson, M.D., AbbVie’s vice president, clinical development, ophthalmology.

With a background in academia and many years as a practicing ophthalmologist, Robinson has seen firsthand the great need to elevate the standard of care and continuously improve existing options. While many products exist to treat dry eye, a common condition, there’s still an opportunity to target the inflammation that’s the likely culprit, Robinson says. Another focus is advancing research in sustained-released medications and investigating ways to improve vision outcomes over time.

Perhaps most exciting is the emerging area of gene therapy for approaching retinal diseases such as wet AMD, which currently involves frequent injections into patients’ eyes. Gene therapy involves introducing a new gene into retinal cells that produces a protein to reduce or potentially eliminate the need for injections while also helping address the disease.

“These approaches are all potential game changers for patients,” Robinson says. “While there’s no playbook for being a pioneer, we must continue targeting unmet needs and going deep on these diseases.”

With glaucoma as the second-leading cause of blindness globally, there continues to be much opportunity and hope for the next breakthrough, Keegan says.

“I understand there are a lot of failures in science,” she says. “What should keep (scientists) motivated is what keeps me motivated, the fact that you do come upon (ways for people to) have improved quality of life and feel more in control.”