INTRAOPERATIVE BLEB BEHAVIOR IN SUBRETINAL GENE AUGMENTATION THERAPY FOR INHERITED RETINAL DISEASES.

Area of Science:

• Ophthalmology
• Retinal Diseases
• Gene Therapy

Background:

• Subretinal gene therapy is a promising treatment for inherited retinal diseases (IRDs).
• Predictable bleb propagation is crucial for effective subretinal fluid delivery during these procedures.
• Current methods face challenges with unpredictable bleb behavior.

Purpose of the Study:

• To evaluate factors influencing bleb propagation direction in subretinal gene therapy for various IRDs.
• To identify predictors of bleb behavior and intraoperative foveal detachment.

Main Methods:

• Retrospective review of 70 subretinal gene therapy procedures for IRDs.
• Analysis of factors including patient age, IRD indication, retinotomy location, and injection technique.
• Outcome measures: bleb propagation bias and foveal detachment.

Main Results:

• Successful delivery was achieved in all cases.
• Posterior bleb bias and foveal detachment correlated with closer retinotomy, larger bleb volumes.
• Bleb direction was influenced by disease indication and patient age.
• Retinotomy within two disk diameters of the fovea increased foveal detachment risk.

Conclusions:

• Bleb formation and propagation in subretinal gene therapy are predictable.
• Key influencing factors include patient age, retinotomy site, disease indication, and fluid injection angle.
• This predictability aids in optimizing surgical outcomes for IRDs.