The Asia-Pacific (APAC) region, with its vast and diverse population, presents a complex healthcare landscape. This diversity—encompassing cultural differences, varying healthcare systems and regulatory frameworks—poses unique challenges in managing vision-related diseases. Vision impairment has a profound impact not only on those affected but also on their caregivers and society at large, underscoring the urgent need for effective solutions.
To address the pressing needs of the APAC region, collaborations between industry and research institutions are crucial. An example of this, is the decade-long partnership between Roche and the Singapore Eye Research Institute (SERI), which has played a pivotal role in the development of innovative therapies for retinal diseases like diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD), which impact an increasing number of people in the APAC region.
In Singapore alone, approximately 10% of diabetic patients may require treatment for diabetic eye complications, while 0.5% of the adult population could be affected by nAMD, according to Professor Gemmy Cheung, head of retina research at SERI and head of the medical retina department at the Singapore National Eye Centre (SNEC).
Through the development of innovative treatments which provide advanced eye care for people in APAC, partners like Roche and SERI aim to enhance patient outcomes and alleviate the burden of vision loss across the region. “Looking at innovative therapies specifically designed for DME and nAMD, they have the potential to positively impact on the outcome of eye care in the APAC region. By reducing the frequency of required clinical visits, these therapies can significantly alleviate the burden on both patients and healthcare systems,” remarked Prof. Cheung.
In addition to pioneering new treatments, fostering collaboration and advancing knowledge in eye care are integral to overcoming challenges facing healthcare systems in the region. Recently, in this spirit of collaboration, Roche brought together over 220 ophthalmologists from countries in the APAC region during the APAC Roche Ophtha Week 2024 in Taipei, Taiwan. This significant event focused on addressing the region’s disproportionate burden of visionrelated diseases. Over two days, experts led discussions on current patient challenges, the latest treatment innovations and the essential role of partnerships in advancing ophthalmology.
Diana Liu, General Manager, Roche Hong Kong & Macau, explained, “APAC Roche Ophtha Week 2024 was an illuminating experience, featuring distinguished clinicians from around the globe who explored a broad range of critical ophthalmology topics. The event united minds dedicated to advancing our shared mission—shaping the future of vision.”
“The theme of this year’s event was ‘Light Up for New Hope’ and you felt that hope throughout the sessions. It was inspiring to see real-life case studies presented by some of the top minds in ophthalmology from around the region showing the impact of innovative treatment on patient outcomes. But one of the high points of the event was hearing directly from a patient and their caregiver about what these outcomes mean to them in terms of the real and notable difference to their everyday lives. After all, the work we all do every day is to help people live longer, better lives.”
Vision for everyone by 2030
Dr. Ahmed Elhusseiny, Area Head APAC, Roche Pharmaceuticals, discussed how Roche’s strategic collaborations and commitment to developing innovative therapies align with its broader ambition of ‘vision for everyone by 2030’. “Roche is focused on preserving sight from the leading causes of vision loss through pioneering therapies. Our innovation in scientific discovery—including new potential drug targets, personalized healthcare, molecular engineering, biomarkers and continuous drug delivery—aims to design the right therapies for the right patients,” he explained.
“Our medicines are making a significant impact on patients with ophthalmic conditions,” he added.
“In fact, we have the broadest retina pipeline in diseases. Our pipeline includes innovative treatments across various modalities, such as antibodies, and gene and cell therapies, targeting multiple visionthreatening conditions. These include retinal vascular and diabetic eye diseases, geographic atrophy, and autoimmune conditions like thyroid eye disease and uveitic macular edema.”
Real-life issues facing patients in APAC
The APAC region presents a complex mosaic of healthcare systems, resource distribution and patient needs. Dr. Elhusseiny noted, “The APAC region is very diverse, which includes heterogeneities that are important to understand, such as reimbursement systems, regulatory issues, resource distribution and patient culture. Understanding these issues is crucial for determining how care is delivered.” These variations mean that patients across the region encounter different barriers to accessing care and solutions effective in one country may not be suitable in another.
The demographic change in APAC was also highlighted by Dr. Elhusseiny, stating that “Another common factor across Asia is the aging population. As people live longer, age-related diseases become more prevalent, particularly those affecting the elderly.”
Dr. Elhusseiny emphasized that vision loss, especially when untreated, has a profound effect on individuals and their families. “The inability to see clearly impacts daily activities, mobility and overall quality of life, leading to a loss of independence and increased reliance on caregivers,” he said.
Eyecare policy in APAC: A call for urgent reform
In the APAC region, there is an increasing recognition of the need to revise eye care policies, with a significant focus on accessibility and affordability. The current system often leaves patients struggling with delayed or inadequate care, an issue compounded by the logistical challenges of frequent hospital visits. “The burden extends beyond the individual,” said Dr. Elhusseiny. “It affects family dynamics, economic productivity and healthcare systems.
Despite the growing demand for eye care, vision-related issues are still not a priority for many governments across the APAC region. One of the biggest challenges in the region is getting it on the agenda.
One solution lies in collaboration and integration. “Our operating model is based on partnership, with alliances being integrated into the healthcare system,” he explained. Such a strategy could help bridge the gaps in care, which is becoming increasingly urgent given that nearly two-thirds of those with moderate to severe visual impairment live in East, South and Central Asia.
To address these challenges, Dr. Elhusseiny emphasized the importance of making vision a critical topic for policymakers, encouraging governments to place greater priority on vision health. With the right approach, eyecare could receive the attention it desperately needs, improving outcomes for millions across the region
The role of innovation in eye health
Despite these challenges, innovation in eye health presents promising avenues for improving the lives of patients with vision impairment. Technological advancements and new therapies are reshaping the care landscape. Prof. Cheung explained, “Nowadays, there are many areas of innovation, including new therapies and technology-driven modalities such as AI that are applicable to patient screening and early detection. These modalities are transforming the landscape of clinical trials and personalized therapy.”
A critical area of innovation is reducing the treatment burden for patients, particularly for retinal vascular diseases, which often require frequent injections to maintain vision. Longer-lasting treatments can significantly improve patients’ quality of life by reducing the number of hospital visits and injections. This is especially important in the APAC region, where logistical challenges and financial constraints can make frequent treatment visits difficult. Prof. Cheung said, “Globally, the emphasis on treatment must be based on durability, reduced treatment burden and increasing intervals between injections to improve patients’ quality of life. This is particularly crucial in the Asia-Pacific region due to challenges such as patient logistics and the financial impact of treatment.”
Advancements in treatment options, such as anti-VEGF therapies, have shown great promise in controlling disease progression in retinal vascular diseases such as nAMD and PCV. These therapies not only improve visual outcomes but also have the potential to alleviate the broader burden on healthcare systems by preventing severe complications associated with untreated vision loss. As Prof.Cheung highlighted, innovations like these could help mitigate the societal impact of vision impairment by allowing patients to maintain their independence for longer and reducing the strain on caregivers and healthcare providers.
Tackling conditions disproportionately affecting APAC: nAMD and PCV
Among the vision-related conditions prevalent in APAC, nAMD and its clinical subtype, PCV, are of particular concern. PCV, which is more common in Asian populations, was historically under-recognized and treated as a subtype of nAMD rather than as a distinct clinical entity. However, recent research and clinical trials have begun to address this oversight, with significant implications for patient care in the region.
Prof. Cheung remarked, “I’ve been thrilled to see the progress and increased interest by industry partners in these regional epidemiological differences. For many years, PCV was not recognized as an independent clinical entity and was considered a subtype of neovascular AMD, so we lacked PCV-specific clinical trial data. But now, in recent TENAYA and LUCERNE trials, we have seen specific Asian subgroup analyses, and the SALWEEN study now aims to assess outcomes for PCV.”
The SALWEEN study, presented at the Asia-Pacific Vitreo-retina Society (APVRS) Congress in late 2024, represents a crucial step forward in understanding the unique aspects of PCV in Asian populations. By focusing on this specific condition, researchers hope to develop more tailored treatment approaches that better address the needs of patients in the region. Prof. Cheung emphasized, “These data are essential for us in the Asia-Pacific region because there may be important differences in treatment outcomes based on subgroups that do not always reflect outcomes in the overall trial population.”
Unmet needs and future directions
Despite progress in understanding and treating nAMD and PCV, significant unmet needs remain. One of the critical challenges is developing treatments that not only control exudation but also address underlying issues that can lead to further complications, such as fibrosis, atrophy and progressive cell loss.
Prof. Cheung summarized the most important aspects of treatment as functional and structural: “Functional aspects refer to visual acuity outcomes, while structural aspects are related to controlling disease activity, reducing fibrosis and cell loss, restoring the structure of the healthy retina and reducing the treatment burden.”
“We’ve seen injectables showing increasing potency in controlling exudation over the past decades. However, closure of the polypoidal lesions remains a critical factor because, if left perfused, these lesions can cause unpredictable hemorrhage. Therefore, newer agents are needed to effectively control the polypoidal lesions and mitigate the risk of bleeding,” Prof. Cheung explained further.
In addition to improving the efficacy of treatments, there is an urgent need for therapies that can be administered less frequently, reducing the overall burden on patients and healthcare systems.
As Prof. Cheung pointed out, “Treatments that have significantly longer durability and are more affordable are urgently needed. Such advancements would improve patient outcomes and help address the broader societal and economic impacts of vision loss in the region.” Looking ahead, the focus of treatment for nAMD and PCV in APAC will likely continue to evolve towards approaches that combine efficacy with a reduced treatment burden and it will take partnership between the medical community and industry partners to ensure that there is continued momentum in development of innovative solutions to the most urgent challenges.
“Given the rapidly aging population in Asia, the need for more real-world evidence in eye health in Asia, the importance of Asian populations in clinical trials such as in SALWEEN, and how that can help to inform the way forward for innovation are becoming increasingly critical,” emphasized Dr. Elhusseiny. “There have been great strides made in innovation in the last decade, which have resulted in improved patient outcomes for those living with vision loss, however it is critical that we come together to ensure that we are tackling the most pressing issues, from clinical innovation, health literacy and policy, for the benefit of people living with vision impairment in APAC. ”
Editor’s Note: A version of this article will appear in the upcoming PIE magazine Issue 32.
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