At this point, the phrase retina pipeline feels like a bit of a misnomer. It certainly hasn’t been a smooth—or straightforward—path for many of our hopeful therapeutic candidates. But it has been long, that’s for sure. This issue’s cover, perhaps, better visualizes the retina pipeline of today: a constant work in progress with lots of heavy lifting by our researchers.

This year has been full of victories, failures, setbacks, and surprises. The era of geographic atrophy therapy is here with the approval of pegcetacoplan (Syfovre, Apellis Pharmaceuticals) and avacincaptad pegol (Izervay, Iveric Bio/Astellas Pharma), but we hit a speed bump right out of the gate with cases of retinal vasculitis.1 High-dose aflibercept (Eylea HD, Regeneron) gained FDA approval, but not before the company had to address the FDA’s complete response letter (CRL).2 Outlook Therapeutics also received a CRL for ONS-5010 (Lytenava), prompting the company to pursue another pivotal trial.3 Kodiak Sciences paused its tarcocimab program in July after the phase 3 GLEAM and GLIMMER trials failed to meet their primary endpoints, but by early November, the program was up and running again, fueled by positive topline data from the phase 3 GLOW trial.4 Aflibercept (Eylea, Regeneron) and faricimab (Vabysmo, Genentech/Roche) each received new indications of retinopathy of prematurity and retinal vein occlusion, respectively.5,6

Everyone involved in these programs deserves our heartfelt thanks—and a vacation—for pushing our field forward and improving patient care.

Beyond these well-publicized ups and downs, myriad other trials are moving along, slowly churning out data to support the viability of various novel therapies and delivery methods. The pipeline articles within this issue highlight approximately 75 clinical trials evaluating treatments for wet AMD, geographic atrophy, diabetic eye disease, and proliferative vitreoretinopathy—and this doesn’t even touch the booming inherited retinal disease pipeline (see, The Latest in Gene Therapy Clinical Trials for Inherited Retinal Disease). It’s nearly impossible to keep track of it all, and we hope these summaries (with very useful charts) help you stay on top of the data—at least until the next round of interim findings rolls out.

Like all construction projects, our pipeline is rife with delays and unexpected complications; however, Rome wasn’t built in a day, and neither can we establish a full armamentarium of treatments for our varied retinal diseases without facing obstacles. We must trust the process, celebrate every victory, and learn from every failure and setback. Then we roll up our sleeves and get back to work. That’s when we truly grow.

1. Apellis provides updates on injection kits and rare safety events with GA drug Syfovre [press release]. Eyewire+. August 23, 2023. Accessed November 8, 2023. bit.ly/3MFvnhF

2. FDA approves Regeneron’s high-dose aflibercept, Eylea HD [press release]. Eyewire+. August 19, 2023. Accessed November 8, 2023. bit.ly/49BTlnC

3. Outlook Therapeutics Provides Update on Type A Meetings with FDA [press release]. Outlook Therapeutics. November 2, 2023. Accessed November 8, 2023. bit.ly/3FYpGHM

4. Kodiak reboots tarcocimab tedromer development program following strong positive phase 3 diabetic retinopathy results [press release]. Eyewire+. November 6, 2023. Accessed November 8, 2023. bit.ly/49r1WcK

5. Eylea approved as first pharmacologic treatment of preterm infants with ROP [press release]. Eyewire+. February 9, 2023. Accessed November 8, 2023. bit.ly/40xYmJX

6. FDA approves Genentech’s Vabysmo for the treatment of retinal vein occlusion (RVO) [press release]. Eyewire+. October 27, 2023. Accessed November 8, 2023. bit.ly/3svnggA