Exosomes for Ophthalmic Therapeutics

Exosomes, as key mediators of cell-to-cell communication, are emerging as promising therapeutic agents in ophthalmology, particularly for conditions with diagnostic and treatment challenges such as age-related macular degeneration, glaucoma, infectious endophthalmitis, diabetic retinopathy, and autoimmune uveitis. These challenges include delayed symptom onset, difficulties in microbial identification, and the complexities of masquerade syndromes. This chapter reviews the roles of exosomes in treating various ophthalmic conditions, highlighting their potential as novel vectors for drug and gene therapy delivery. It explores recent advancements in exosome-based therapies and other innovative therapeutic delivery approaches, including small drug molecules, gene therapy, nanomedicine, stem cells, and trophic factors. These techniques demonstrated to be promising in preclinical animal models for conditions such as corneal scar/haze, inflammation, and angiogenesis are on the cusp of human clinical application. This discussion emphasizes the potential of exosomal and bioengineering approaches in revolutionizing ocular disease treatment, moving toward more effective, targeted, and less invasive therapies.