A Fantastic Voyage: Suprachoroidal Treatment for MD

Remember the 1966 movie "Fantastic Voyage"? That was the sci-fi thriller in which they shrunk a submarine and its five-man crew down to microscopic proportions. They then injected the sub into an injured scientific genius so they could repair his brain damage.

What made it a thriller was the miniaturization effect would only last an hour. After that, the genius would have a rather large submarine in his head, or at least what was left of his head. (Did they make it? What do you think?)

Developments in ophthalmology

What made me think about "Fantastic Voyage" is the fantastic voyage we are going on with developments in ophthalmology. Doctors are already navigating through our eyeballs just like like they navigated in the movie!

Ok. Not exactly. No one is miniaturing submarines and people to navigate through our eyes. However, they are using tools to navigate through the suprachoroidal space to deliver all sorts of good, healing things to our eyes.

What is the suprachoroidal space?

The suprachoroidal space is between the sclera – the tough, outer shell of your eye – and the other layers of the eye. It is “supra choroidal.” In other words, above the choroid.¹

The suprachoroidal space gets a little “roomier” as we age – and quite frankly, everything sags. Doctors can expand the space by injecting it with a sterile solution. Once the suprachoroidal space is expanded, it can become a superhighway for treatments.¹

My search for newer treatment options

One thing that is super good about this superhighway is it can eliminate the need for a vitrectomy for many procedures. When I first started looking at stem cell replacement for my retinal pigment epithelium (RPE), the process was to do a vitrectomy, a type of eye surgery where doctors pretty much drain your eyeball dry so they can get to the macula.

While I am describing the procedure in a much more gruesome way than it deserves, this procedure can open up the interior of the orb to more infection than would normally occur.^1-3

Be that as it may, with the advent of suprachoroidal navigation for treatment delivery, I am planning on finding a process and a clinical trial that will deliver the RPE stem cells to my macula in that fashion instead. Seems like a lot less muss and fuss.

The suprachoroidal superhighway

And there is so much more they are using or planning to use the suprachoroidal superhighway to deliver.

Back in 2014 – the olden times when it comes to ophthalmology – there was a piece in the "Retina Times" entitled, "Achieving Drug Delivery Via the Suprachoroidal Space." That article mentioned the delivery of corticosteroids to the site of macular edema and the swifter uptake of anti-VEGF medications as compared to injections into the vitreous (ie eye shots).⁴

The article also mentioned the possibility of using the roomier suprachoroidal space as a reservoir for storing anti-VEGF medication and increase the time between treatments. But the sentence in the "Retina Today" piece I liked best was this one:⁴

“...delivery via the suprachoroidal space occurred primarily at the level of the choroid, retinal pigment epithelials and photoreceptors outer segments – anatomic regions that are more relevant to the pathophysiology of age-related macular degeneration.”

The voyage

That’s us, guys. We AMD folks are the perfect candidates to reap the rewards of suprachoroidal space delivery systems. This fantastic voyage is for us.