Voretigene neparvovec in RPE65-related inherited retinal dystrophy: the 1-year real-world study LIGHT.

IF 2.8 3区 医学 Q1 OPHTHALMOLOGY Eye Pub Date : 2025-03-14 DOI:10.1038/s41433-025-03691-8
Isabelle Audo, Pierre-Olivier Barale, Céline Devisme, Saddek Mohand-Said, Isabelle Meunier, Vasily M Smirnov, Claire-Marie Dhaenens, Camille Andrieu, Christina Zeitz, Chloé Pagot, Pascaline Barbier, Malka Tindel, Perrine Chapon, Jose-Alain Sahel
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Abstract

Background: This retrospective real-world study evaluated the effectiveness and safety of subretinal voretigene neparvovec (VN) in French patients (six children, six adults) with inherited retinal dystrophies.

Methods: Data were collected from medical records for the year following bilateral treatment with subretinal VN. Functional vision was assessed using the Streetlab mobility course with obstacles. The main outcome was Percentage of Preferred Walking Speed (PPWS) 1 month after treatment (the average speed to navigate the obstacle course as a percentage of the speed to walk straight for 4 m without obstacles at 500 lux).

Results: PPWS median relative improvement to month 1 was 63.9% (interquartile range 47.8%; 88.5%) at 2 lux. Gains were sustained to month 6, were comparable in children and adults, with similar patterns at 7.5 and 50 lux. Course completion time and the number of collisions improved at month 1 at 2 lux. Median full-field stimulus test (FST) improved at month 1 (-33.2 [interquartile range -33.7; -19.8] dB), with improvements sustained to month 24. Over the study, best corrected visual acuity (BCVA) appeared stable, and kinetic visual field had no discernible pattern. All patients experienced at least one ocular AE related to surgery, VN, or both. One serious AE occurred (retinal detachment in a child), and was considered related to surgery. Chorioretinal atrophies occurred in four adults and one child, with no impact on FST.

Conclusions: Functional vision, measured in the Streetlab mobility course, demonstrated rapid, sustainable improvements in lower light intensities. Safety data were in line with current knowledge for VN.

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背景:这项回顾性真实世界研究评估了视网膜下voretigene neparvovec(VN)在法国遗传性视网膜营养不良症患者(6名儿童,6名成人)中的有效性和安全性:方法:从医疗记录中收集视网膜下VN双侧治疗后一年的数据。采用Streetlab带障碍物移动课程对功能性视力进行评估。主要结果是治疗后1个月的首选步行速度百分比(PPWS)(在500勒克斯条件下,通过障碍物的平均速度占无障碍直行4米速度的百分比):在 2 勒克斯条件下,PPWS 相对于第 1 个月的中位改善率为 63.9%(四分位数范围为 47.8%; 88.5%)。儿童和成人的进步持续到第 6 个月,在 7.5 勒克斯和 50 勒克斯条件下的模式相似。在 2 勒克斯条件下,课程完成时间和碰撞次数在第 1 个月有所改善。全视野刺激测试(FST)的中位数在第1个月有所改善(-33.2[四分位间范围-33.7; -19.8]dB),这种改善持续到第24个月。在整个研究期间,最佳矫正视力 (BCVA) 保持稳定,动态视野没有明显的模式。所有患者都经历了至少一次与手术、VN 或两者相关的眼部 AE。发生了一起严重的 AE(一名儿童视网膜脱离),被认为与手术有关。四名成人和一名儿童发生了脉络膜视网膜萎缩,但对 FST 没有影响:结论:在 Streetlab 移动课程中测量的功能性视力在较低光照强度下表现出快速、可持续的改善。安全性数据符合目前对 VN 的认识。
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来源期刊
Eye
Eye 医学-眼科学
CiteScore
6.40
自引率
5.10%
发文量
481
审稿时长
3-6 weeks
期刊介绍: Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists. Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.
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Comparison of uveitis manifestations in patients with active systemic tuberculosis and those with positive interferon-gamma release assay without active disease. Patients' perspective on the environmental impact of the severe dry eye disease healthcare pathway. Bilateral peripheral retinoschisis with vitreous retinal traction. Correlation between complete polypoidal regression and visual outcomes in polypoidal choroidal vasculopathy eyes receiving intravitreal aflibercept. Voretigene neparvovec in RPE65-related inherited retinal dystrophy: the 1-year real-world study LIGHT.
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