“Innovations in the ophthalmic field” “Present and future of ophthalmic treatment” series

This series will focus on topics related to the current status and future vision of ophthalmic treatment, the field of our work at Santen. This time, under the theme “Innovations in the ophthalmic field,” we will look at past innovations and emerging technologies as the seeds of future innovations in the ophthalmic field.

What do you associate the word “innovation” with? The word means the action or process of making changes to something established, especially by introducing new methods, ideas or products. Its current common use emphasizes the implication of “creation of a new world through technology.”

We live in a world that is becoming more and more convenient through innovation. For example, a few decades ago, if you wanted to call someone while you were out and about, you had to look for a public phone, but the emergence of mobile phones allowed you to make phone calls wherever you were. Now the development of smartphones enables you to carry in your hand a device that functions as a phone, a personal computer, a digital camera, a portable media player, and more. Innovation also has an aspect of creative destruction. This means that the emergence of a new product or feature that delivers more desirable benefits to consumers can involve a kind of paradigm shift, such as the creation of a new market or the elimination of existing businesses.

The ophthalmic field in which Santen is involved has also so far seen some significant technological innovations, so we may experience destructive innovation in the near future. Here is an introduction to past innovations and emerging technologies, with prospects for bringing about future innovations in the ophthalmic field.

There used to be various premodern equivalents to cataract surgery methods, including dropping the crystalline lens into the vitreous body by needling the eyeball, or removing the crystalline lens. However, despite the severe pain and risks that such treatments entailed, these methods were unable to help restore patients’ vision in a satisfactory way. Thanks to the invention of intraocular lenses and the development of safe and minimally invasive surgical methods, however, today many patients can restore their vision by undergoing cataract surgery.

Conventional fundus examination techniques only used to help examine the retinal surface. However, the invention of optical coherence tomography (OCT) has enabled retina cross-section imaging, and consequently early detection of age-related macular degeneration, retinal vein occlusion and diabetic retinopathy, as well as more accurate follow-up of glaucoma, leading to the development of anti-VEGF agents.

Research on applications of iPS cells to ophthalmic treatment is under way, including transplantation of retinal pigment epithelial cells for treating age-related macular degeneration, and transplantation of retinal tissues for treating retinitis pigmentosa or corneal epithelial cells. There are high public expectations for progress in clinical applications of these emerging technologies.

Research on gene therapy for retinitis pigmentosa has made progress. The development of regenerative medicine and gene therapy is expected to turn retinitis pigmentosa as a hereditary disease without currently effective treatments into a treatable disease.

3D bioprinting is a technology that reproduces what tissue structures with a three-dimensional arrangement of cells look like in an organism. Research is under way on regenerative medicine of corneas as relatively simple tissues that do not include blood vessels or nerves. It is expected that practical use of autologous cell-derived artificial corneas will help solve issues concerning corneal transplantation, such as donor shortage or immunological rejection.

Artificial retinas are being researched as tools for patients who have lost their vision due to retinitis pigmentosa to restore their vision. There are various types of artificial retinas, such as electronic devices whereby electrodes implanted near the retina provide stimulus based on image data sent from a tiny camera attached to eyeglasses worn by the user, and thin membrane-like artificial retinas to be implanted into the fundus.

AI technology-based support tools have also been evolving. For example, tools such as a lightweight AI camera device that gives information about objects to the user through audio feedback, text-to-speech apps for mobile devices, and walking supports including electronic white canes, are dramatically changing the lives of people with visual impairments.

In the healthcare field, the scope of focus has recently broadened to include not only evidence-based treatment effects and functional aspects, such as vision and the visual field, but also comfort perceived as adequate for patients’ individual lifestyles. Santen, as a specialized ophthalmic company, aims to orchestrate and mobilize key technologies and players around the world, in order to deliver happiness through vision.