Bromodomain Inhibitors in Degenerative Eye Disease; An Alternative to VEGF Inhibitors in Macular Degeneration?

For over a decade VEGF (Vascular Endothelial Growth Factor) inhibitors have been the definitive treatment of choroidal neovascularization associated with adult onset macular degeneration. While the induction of “wet macular degeneration” treatment requires 2-3 intravitreal injections, over 2-3 months, the maintenance phase for sustained good visual acuity may be 6 injections or more per year, protracted over 6-8 years. Unfortunately, this treatment, even if the extended number and time of intravitreal injections could be packaged in a sustained delivery device, would still not represent a cure. Alternatively, if the treatment could be targeted to genetic, oxidative stress, inflammatory and immune modification from Bromodomain inhibitors (BRD I), (which would work through these transcription factors from an early stage to correct these macular problems), then patients might be given a more direct and shorter intervention with perhaps oral maintenance as necessary. Similar consideration for BRD I may be developed for uveitis, corneal scarring and retinal ganglion cell protection.

Keywords: Macular degeneration; VEGF Inhibitors; Bromodomain inhibitors; Uveitis; Corneal scarring; RGC (Retinal Fanglion Cell) protection