title: Personalized Medicine in Ophthalmology: From Pharmacogenetic Biomarkers to Therapeutic and Dosage Optimization.
abstract: Rapid progress in genomics and nanotechnology continue to advance our approach to patient care, from diagnosis and prognosis, to targeting and personalization of therapeutics. However, the clinical application of molecular diagnostics in ophthalmology has been limited even though there have been demonstrations of disease risk and pharmacogenetic associations. There is a high clinical need for therapeutic personalization and dosage optimization in ophthalmology and may be the focus of individualized medicine in this specialty. In several retinal conditions, such as age-related macular degeneration, diabetic macular edema, retinal vein occlusion and pre-threshold retinopathy of prematurity, anti-vascular endothelial growth factor therapeutics have resulted in enhanced outcomes. In glaucoma, recent advances in cytoskeletal agents and prostaglandin molecules that affect outflow and remodel the trabecular meshwork have demonstrated improved intraocular pressure control. Application of recent developments in nanoemulsion and polymeric micelle for targeted delivery and drug release are models of dosage optimization, increasing efficacy and improving outcomes in these major eye diseases.
authors.affiliation: Illumina Inc., San Diego, CA 92122, USA.
authors.forename: Frank S
authors.initials: FS
authors.lastname: Ong
authors.affiliation: Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA ; Department of Ophthalmology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Jane Z
authors.initials: JZ
authors.lastname: Kuo
authors.affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Wei-Chi
authors.initials: WC
authors.lastname: Wu
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore ; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, 119074, Singapore.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
authors.affiliation: Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Wendell-Lamar B
authors.initials: WL
authors.lastname: Blackwell
authors.affiliation: Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Taylor
authors.affiliation: Departments of Pathology and Laboratory Medicine, Pediatrics and Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
authors.forename: Wayne W
authors.initials: WW
authors.lastname: Grody
authors.affiliation: Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA ; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA ; Department of Pediatrics and Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
authors.forename: Jerome I
authors.initials: JI
authors.lastname: Rotter
authors.affiliation: Department of Ophthalmology, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Chi-Chun
authors.initials: CC
authors.lastname: Lai
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, 168751, Singapore ; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, 119074, Singapore.
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
keywords: VEGF; age-related macular degeneration; clinical utility; drug delivery; glaucoma; nanotechnology; ophthalmology; personalized medicine; pharmacogenetics; retinopathy