Has Biotechnology Forgotten the Eye?

For over two decades, the biotechnology industry has been developing therapeutic products based on large molecules. The majority of these products are proteins, from the first trailblazers such as insulin and growth hormone, to the blockbusters like EPO, and subsequently wider classes of molecules such as cytokines, enzymes and antibodies. Yet in all this time, there have been few chronic clinical studies of proteins in eye disease. This is not because the markets are unattractive. Millions of patients suffer from poorly treated diseases in ophthalmology - such as age-related macular degeneration (AMD), or diabetic retinopathy - yet there are still very few medical treatments available. The exception that clearly demonstrates the attractive nature of the ophthalmology market is Visudyne’, developed by QLT Therapeutics Inc. and Novartis. The product transformed QLT from a small Canadian cancer company into a significantly capitalised, internationally known biotech company. This change occurred when the QLT concept of photodynamic therapy, which had previously been applied for several years to cancer with limited success, was applied to AMD. So given this success, why is biotech activity so limited in the eye?