[PERSPECTIVES] A Systematic Review of Optogenetic Vision Restoration: History, Challenges, and New Inventions from Bench to Bedside

Antonia Stefanov1 and John G. Flannery1,2 1Helen Wills Neuroscience Institute, University of California, Berkeley, California 94720, USA 2Department of Molecular and Cell Biology, University of California, Berkeley, California 94720, USA Corresponding author: flanneryberkeley.edu

Blindness due to rod-cone dystrophies is a significant comorbidity and cause of reduced quality of life worldwide. Optogenetics uses adeno-associated viral (AAV) vectors to bypass lost photoreceptors and transfect remnant cell populations of the degenerated retina aiming to restore vision via the ectopic expression of opsins. The optogenetic targeting of retinal ganglion cells (RGCs) has been remarkably successful and several studies have advanced to clinical trials over the recent years. The inner retina and specifically ON bipolar cells represent even more appealing targets due to their intrinsically coded tasks in parallel processing and fine-tuning of visual signals before reaching the output: RGCs. However, present success with pursuing inner and outer retinal cells for optogenetic vision restoration is limited by multiple factors, including AAV tropism, promoter specificity, and retinal morphofunctional remodeling. Here we provide a review of the evolution of optogenetics, its greatest challenges, and solutions from bench to bedside.

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