Gene therapy in glaucoma: Will it replace drugs and surgery?

We have been investigating the use of gene therapy to alter aqueous humor dynamics in the eye with the ultimate goal of producing an alternative glaucoma therapy that would minimize issues of patient compliance. We have demonstrated expression of reporter gene proteins delivered by herpes and adenoviral vectors into the monkey eye in vivo. Tissues expressing these proteins have included the trabecular meshwork (TM), ciliary body, and retinal ganglion cells. Adenoviral vector delivery of genes encoding cytoskeleton modulating proteins altered the shape and cell adhesions of TM and ciliary muscle (CM) cells in vitro and increased outflow facility (OF) in anterior segments in organ culture. Delivery of genes encoding a cell cycle modulating protein to a trabeculectomy site prevented wound healing allowing improved filtration.