Dr. Mali's top 5 predictions in ophthalmology for 2022

In light of an unprecedented year filled with technological advancements and continued challenges, Joshua Mali, MD, offers his top 5 predictions in ophthalmology for 2022.

1. COVID-19 and its variants will continue to dominate the headlines in 2022, but potential game-changing progress will be made in the realm of therapeutics.

It is obvious that COVID-19 and its variants will likely continue to be the dominant story into 2022. Whether it is identifying new variants, such as Omicron, or battling regional case surges, it seems this virus will continue to

Joshua Mali, MD

invade nearly every facet of our society. However, I am confident that 2022 will deliver game-changing therapeutics to combat this virus, specifically from an unsuspecting pharmaceutical company. In particular, I have my eye on Sorrento Therapeutics, a small biotech company, as it has rapidly developed a tremendous pipeline of promising COVID-19 antibody treatments, vaccine candidates with unique mechanism of action, and diagnostic tests that could hold the key to next generational management and potential cure of this disease.

2. Susvimo will be the biggest innovation in wet age-related macular degeneration management since 2006.

Since the approval of ranibizumab (Lucentis) in 2006, we have not had such an impressive innovation in exudative age-related macular degeneration (AMD) management and sustained drug delivery until now, with the recent FDA approval of Susvimo (formerly known as port delivery system with ranibizumab). Genentech delivers significant optimism by providing a revolutionary sustained drug delivery system to relieve patient intravitreal injection burden through unprecedented durability with the potential of 6-month in-office refills while providing robust visual gains.1 Additionally, don’t forget about faricimab, the first bispecific antibody designed for intraocular use. Faricimab can simultaneously bind and neutralize Ang2 and VEGF-A, which appears to be a very effective treatment for wet AMD and diabetic macular edema, with the potential of 16-week dosing. Genentech has been an incredibly dynamic company that has produced unique innovations that will likely be game-changers in the retina therapeutic space not only for 2022 but also for many years to come.

3. Retinal gene therapy for inherited retinal diseases will make a leap forward.

I believe 2022 will be a critical year for data readouts in ophthalmological clinical trials, especially the ocular gene therapy space, where there are several exciting therapeutic agents on the horizon. One of the biotech companies I believe will achieve tremendous success in 2022 is Applied Genetic Technologies Corporation (AGTC). Their retinal gene therapy candidates for both achromatopsia and X-linked retinitis pigmentosa are impressive and will likely yield additional positive data in 2022, eventually leading to FDA approval of their first-in-class treatments for these debilitating inherited retinal diseases. AGTC is a company to watch in 2022 and is showing it is a leader in the field of ophthalmic gene therapy.

4. Geographic atrophy will have an approved treatment in 2022.

Geographic atrophy (GA) has been the final frontier in retina medicine. Although there are currently no FDA-approved treatments for GA/dry AMD that will change in 2022, Apellis Pharmaceuticals’ FDA-submitted C3-targeted therapy, pegcetacoplan (Empaveli), has been designed to regulate excessive activation of the complement cascade, which can lead to the onset and progression of many serious diseases, including GA. Despite mixed results, with only 1 of their phase 3 clinical trials achieving their primary end point, the pooled analysis was solid, and I strongly believe the data support eventual FDA approval. Not too far behind is Iveric Bio and its C5 inhibitor, avacincaptad pegol (Zimura), which appears to be very promising, and I predict it will have extremely positive interim data in 2022 from their current clinical trial. These 2 agents will usher in a new era in the treatment of GA, giving hope and optimism to patients who desperately need it.  

5. Ophthalmic media platforms will continue to diversify and demonstrate importance.

The power of knowledge and the ability to distribute information across multiple diverse platforms cannot be understated, especially in medicine. Ophthalmology has seen an incredible evolution of media platforms, originating with a limited number of scientific journals, giving way to regular periodicals with fascinating articles about cutting-edge ophthalmic technology and practical treatments, and further supplemented more recently by online/social media channels, such as podcasts, to discuss current topics and advance the field of ophthalmology in real time. The constant exchange and flow of ideas and knowledge is the lifeblood of our profession and will continue to thrive successfully through both traditional media methods and modern modes of delivery. 2022 will likely see continued expansion of these platforms, and I am truly honored to be a part of this renaissance age in medical media as a regular author and contributor to these periodicals, serving on multiple editorial boards, being featured as the medical expert in television and films, and even hosting my own podcast, Eye Care Insider. 

2022 is shaping up to be an amazing year, and I look forward to keeping you updated throughout 2022 and beyond.

Joshua Mali, MD

E: malienterprisesglobal@gmail.com

Mali is a board-certified ophthalmologist and award-winning vitreoretinal surgeon at The Eye Associates, a private multispecialty ophthalmology practice in Sarasota, Florida. He is also the founder and CEO of Mali Enterprises. Mali’s relevant financial disclosures include the following: Genentech/Roche (consultant, speaker), Sorrento Therapeutics (Nasdaq: SRNE) equity stock shareholder, and Applied Genetic Technologies Corporation (Nasdaq: AGTC) equity stock shareholder.