{"id":239394,"date":"2026-06-22T14:46:11","date_gmt":"2026-06-22T18:46:11","guid":{"rendered":"https:\/\/ziliahealth.com\/blog\/next-generation-ophthalmic-therapeutics\/"},"modified":"2026-06-23T11:23:58","modified_gmt":"2026-06-23T15:23:58","slug":"therapies-ophtalmiques-nouvelle-generation","status":"publish","type":"post","link":"https:\/\/ziliahealth.com\/fr\/blog\/therapies-ophtalmiques-nouvelle-generation\/","title":{"rendered":"L\u2019\u00e9mergence des th\u00e9rapies oculaires de nouvelle g\u00e9n\u00e9ration"},"content":{"rendered":"

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Pendant des d\u00e9cennies, l\u2019ophtalmologie s\u2019est largement appuy\u00e9e sur l\u2019imagerie structurelle et le suivi de l\u2019\u00e9volution des maladies. <\/span>Des technologies telles que la tomographie par coh\u00e9rence optique (OCT) et la photographie du fond d\u2019\u0153il ont permis aux cliniciens de visualiser l\u2019anatomie r\u00e9tinienne, tandis que les examens du champ visuel ont fourni des informations pr\u00e9cieuses sur la fonction visuelle. Ensemble, ces outils ont permis de suivre la progression des maladies avec une pr\u00e9cision remarquable et demeurent des piliers fondamentaux des soins oculaires modernes.<\/p>\n

Cependant, un nombre croissant de donn\u00e9es scientifiques sugg\u00e8re que de nombreuses maladies oculaires d\u00e9butent bien avant que des dommages structurels ne deviennent visibles.<\/p>\n

Dans le glaucome, la r\u00e9tinopathie diab\u00e9tique, la d\u00e9g\u00e9n\u00e9rescence maculaire li\u00e9e \u00e0 l\u2019\u00e2ge (DMLA), les maladies vasculaires r\u00e9tiniennes et les neuropathies optiques, les donn\u00e9es accumul\u00e9es mettent en \u00e9vidence l\u2019importance de la dysfonction m\u00e9tabolique, de l\u2019alt\u00e9ration mitochondriale, de la dysr\u00e9gulation vasculaire, de l\u2019hypoxie tissulaire et du stress neuronal aux stades pr\u00e9coces de la maladie. (1-12)<\/p>\n

Par cons\u00e9quent, les soins oculaires amorcent une transition progressive vers une compr\u00e9hension plus fonctionnelle et m\u00e9tabolique des maladies oculaires, en coh\u00e9rence avec ces observations.<\/p>\n

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Un nouveau paysage th\u00e9rapeutique<\/h3>\n

Cette \u00e9volution est particuli\u00e8rement visible dans la nouvelle g\u00e9n\u00e9ration de th\u00e9rapies oculaires.<\/p>\n

Les traitements \u00e9mergents ciblent de plus en plus la physiologie r\u00e9tinienne, par des approches visant \u00e0 soutenir la neuroprotection, la fonction mitochondriale, l\u2019oxyg\u00e9nation tissulaire, la r\u00e9gulation vasculaire, le m\u00e9tabolisme cellulaire et la survie neuronale.<\/p>\n

Ces th\u00e9rapies couvrent de nombreuses modalit\u00e9s, notamment les agents pharmacologiques, la photobiomodulation, la neurostimulation, les interventions ciblant l\u2019isch\u00e9mie et les approches ax\u00e9es sur le m\u00e9tabolisme. Bien que ces technologies diff\u00e8rent par leur mode d\u2019action, elles poursuivent souvent un objectif commun : pr\u00e9server ou restaurer la fonction cellulaire r\u00e9tinienne avant qu\u2019une d\u00e9g\u00e9n\u00e9rescence irr\u00e9versible ne survienne.<\/p>\n

Parmi les exemples notables figurent les programmes th\u00e9rapeutiques d\u00e9velopp\u00e9s par des entreprises telles que Perfuse Therapeutics<\/a><\/span> (d\u00e9sormais int\u00e9gr\u00e9e \u00e0<\/span>\u00a0Bayer<\/span>), Mighty Therapeutics<\/a><\/span>, Annexin Pharmaceuticals<\/a><\/span>, et Tavo Biotherapeutics<\/span><\/a><\/span>, ainsi que des approches fond\u00e9es sur des stimuli physiques, notamment les plateformes de photobiomodulation<\/span> Valeda<\/a><\/span> (LumiThera, d\u00e9sormais int\u00e9gr\u00e9e \u00e0<\/span> Alcon) et eye-light (Espansione<\/span><\/a><\/span>, d\u00e9sormais int\u00e9gr\u00e9e \u00e0<\/span> EssilorLuxottica<\/span>), ainsi que des plateformes de neurostimulation telles que<\/span> MacuMira<\/a><\/span> et Eyetronic<\/a><\/span>.<\/p>\n

\u00c0 bien des \u00e9gards, l\u2019ophtalmologie suit aujourd\u2019hui une tendance d\u00e9j\u00e0 observ\u00e9e dans l\u2019ensemble du domaine m\u00e9dical: le passage d\u2019une gestion r\u00e9active des maladies \u00e0 une intervention physiologique plus pr\u00e9coce et \u00e0 une m\u00e9decine de pr\u00e9cision.<\/p>\n

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Les limites de l\u2019imagerie structurelle<\/h3>\n

Cette \u00e9volution met \u00e9galement en lumi\u00e8re une limite importante des outils cliniques actuels.<\/p>\n

La plupart des crit\u00e8res d\u2019\u00e9valuation utilis\u00e9s en ophtalmologie demeurent des cons\u00e9quences structurelles ou fonctionnelles tardives de dommages d\u00e9j\u00e0 accumul\u00e9s, notamment l\u2019atrophie, l\u2019amincissement r\u00e9tinien, la perte du champ visuel et la diminution de l\u2019acuit\u00e9 visuelle.<\/p>\n

Or, de nombreuses th\u00e9rapies \u00e9mergentes visent \u00e0 modifier des m\u00e9canismes biologiques situ\u00e9s en amont du processus pathologique, bien avant l\u2019apparition de ces manifestations.<\/p>\n

Il en r\u00e9sulte un d\u00e9calage croissant entre ce que les th\u00e9rapies de nouvelle g\u00e9n\u00e9ration cherchent \u00e0 influencer et ce que les outils cliniques actuels peuvent mesurer.<\/p>\n

\u00c0 mesure que l\u2019innovation th\u00e9rapeutique cible davantage la physiologie et le m\u00e9tabolisme r\u00e9tiniens, le besoin de modalit\u00e9s capables de fournir des biomarqueurs fonctionnels et objectifs devient de plus en plus important pour le diagnostic, la stratification des patients, le suivi th\u00e9rapeutique et le d\u00e9veloppement des essais cliniques.<\/p>\n

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De nombreuses th\u00e9rapies \u00e9mergentes visent \u00e0 modifier des m\u00e9canismes biologiques situ\u00e9s en amont du processus pathologique, bien avant l\u2019apparition de ces manifestations<\/p>\n<\/blockquote>\n

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L\u2019essor des biomarqueurs fonctionnels et m\u00e9taboliques<\/h3>\n

La r\u00e9tine figure parmi les tissus les plus m\u00e9taboliquement actifs du corps humain. Son taux de consommation d\u2019oxyg\u00e8ne est l\u2019un des plus \u00e9lev\u00e9s parmi tous les tissus, d\u00e9passant m\u00eame celui du cerveau. (13) Son fonctionnement repose sur des m\u00e9canismes de r\u00e9gulation extr\u00eamement fins qui assurent en permanence l\u2019\u00e9quilibre entre l\u2019apport et l\u2019utilisation de l\u2019oxyg\u00e8ne.<\/p>\n

Ces processus physiologiques sont fondamentaux pour la sant\u00e9 r\u00e9tinienne, mais ils ne peuvent \u00eatre \u00e9valu\u00e9s que de mani\u00e8re indirecte par l\u2019imagerie structurelle seule. C\u2019est pr\u00e9cis\u00e9ment l\u00e0 que les biomarqueurs fonctionnels et m\u00e9taboliques peuvent jouer un r\u00f4le d\u00e9terminant.<\/p>\n

Parmi ces approches \u00e9mergentes, l\u2019oxym\u00e9trie oculaire permet d\u2019\u00e9valuer quantitativement la saturation en oxyg\u00e8ne des tissus r\u00e9tiniens (StO\u2082), un biomarqueur du m\u00e9tabolisme r\u00e9tinien et de la physiologie tissulaire.<\/p>\n

En ajoutant une dimension fonctionnelle et m\u00e9tabolique \u00e0 l\u2019\u00e9valuation de la r\u00e9tine, l\u2019oxym\u00e9trie oculaire pourrait favoriser une d\u00e9tection physiologique plus pr\u00e9coce, un meilleur suivi th\u00e9rapeutique, une \u00e9valuation longitudinale de la r\u00e9ponse aux traitements et, \u00e0 terme, l\u2019int\u00e9gration de nouvelles approches de m\u00e9decine de pr\u00e9cision.<\/p>\n

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Au-del\u00e0 de l\u2019imagerie : vers une ophtalmologie m\u00e9tabolique<\/h3>\n

Ces avanc\u00e9es ouvrent la voie \u00e0 la transformation la plus importante qu\u2019ait connue l\u2019ophtalmologie depuis plusieurs d\u00e9cennies : une \u00e9volution qui d\u00e9passe l\u2019imagerie structurelle pour tendre vers une compr\u00e9hension plus approfondie de la physiologie et du m\u00e9tabolisme r\u00e9tiniens.<\/p>\n

Cette nouvelle approche pourrait consid\u00e9rablement am\u00e9liorer les r\u00e9sultats cliniques en favorisant une prise en charge plus pr\u00e9dictive, plus personnalis\u00e9e et davantage fond\u00e9e sur les m\u00e9canismes biologiques sous-jacents \u00e0 la maladie.<\/p>\n

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R\u00e9f\u00e9rences<\/h3>\n
    \n
  1. Casson RJ, Chidlow G, Crowston JG, Williams PA, Wood JPM.<\/b> Retinal energy metabolism in health and glaucoma. Prog Retin Eye Res.<\/i> 2021 Mar;81:100881. doi: 10.1016\/j.preteyeres.2020.100881. Epub 2020 Jul 23. PMID: 32712136.<\/span><\/li>\n
  2. Mozaffarieh M, Grieshaber MC, Flammer J.<\/b> Oxygen and blood flow: players in the pathogenesis of glaucoma. Mol Vis.<\/i> 2008 Jan 31;14:224-33. PMID: 18334938; PMCID: PMC2267728.<\/span><\/li>\n
  3. Liu H, Prokosch V.<\/b> Energy Metabolism in the Inner Retina in Health and Glaucoma. Int J Mol Sci.<\/i> 2021 Apr 1;22(7):3689. doi: 10.3390\/ijms22073689. PMID: 33916246; PMCID: PMC8036449.<\/span><\/li>\n
  4. Weinreb RN, Aung T, Medeiros FA.<\/b> The pathophysiology and treatment of glaucoma: a review. JAMA.<\/i> 2014 May 14;311(18):1901-11. doi: 10.1001\/jama.2014.3192. PMID: 24825645; PMCID: PMC4523637.<\/span><\/li>\n
  5. Kowluru RA.<\/b> Mitochondrial Stability in Diabetic Retinopathy: Lessons Learned From Epigenetics. Diabetes.<\/i> 2019 Feb;68(2):241-247. doi: 10.2337\/dbi18-0016. PMID: 30665952; PMCID: PMC6341304.<\/span><\/li>\n
  6. Smith JD, Sapoznik KA, Bisignano K, Benoit J, Harrison WW.<\/b> Evaluation of macular retinal oximetry across different levels of diabetic retinopathy: a cross-sectional study. BMC Ophthalmol.<\/i> 2025 Jan 17;25(1):24. doi: 10.1186\/s12886-025-03850-1. PMID: 39825268; PMCID: PMC11740494.<\/span><\/li>\n
  7. Arjamaa O, Nikinmaa M.<\/b> Oxygen-dependent diseases in the retina: role of hypoxia-inducible factors. Exp Eye Res.<\/i> 2006 Sep;83(3):473-83. doi: 10.1016\/j.exer.2006.01.016. Epub 2006 Jun 5. PMID: 16750526.<\/span><\/li>\n
  8. Kaarniranta K, Uusitalo H, Blasiak J, Felszeghy S, Kannan R, Kauppinen A, Salminen A, Sinha D, Ferrington D.<\/b> Mechanisms of mitochondrial dysfunction and their impact on age-related macular degeneration. Prog Retin Eye Res.<\/i> 2020 Nov;79:100858. doi: 10.1016\/j.preteyeres.2020.100858. Epub 2020 Apr 13. PMID: 32298788; PMCID: PMC7650008.<\/span><\/li>\n
  9. Lefevere E, Toft-Kehler AK, Vohra R, Kolko M, Moons L, Van Hove I.<\/b> Mitochondrial dysfunction underlying outer retinal diseases. Mitochondrion.<\/i> 2017;36:66-76. doi:10.1016\/j.mito.2017.03.006.<\/span><\/li>\n
  10. Mitchell P, Liew G, Gopinath B et al.<\/b> Age-related macular degeneration. The Lancet,<\/i> 392, 1147-1159.<\/span><\/li>\n
  11. Campochiaro PA.<\/b> Molecular pathogenesis of retinal and choroidal vascular diseases. Prog Retin Eye Res.<\/i> 2015 Nov;49:67-81. doi: 10.1016\/j.preteyeres.2015.06.002. Epub 2015 Jun 23. PMID: 26113211; PMCID: PMC4651818.<\/span><\/li>\n
  12. Miller NR, Arnold AC.<\/b> Current concepts in the diagnosis, pathogenesis, and management of non-arteritic anterior ischaemic optic neuropathy. Eye (Lond).<\/i> 2015 Jan;29(1):65-79. doi: 10.1038\/eye.2014.144. Epub 2014 Jul 4. PMID: 24993324; PMCID: PMC4289822.<\/span><\/li>\n
  13. Joyal JS, Gantner ML, Smith LEH.<\/b> Retinal energy demands control vascular supply of the retina in development and disease: The role of neuronal lipid and glucose metabolism. Prog Retin Eye Res.<\/i> 2018 May;64:131-156. doi: 10.1016\/j.preteyeres.2017.11.002. Epub 2017 Nov 22. PMID: 29175509; PMCID: PMC5963988.<\/span><\/li>\n<\/ol>\n

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    Written by the Zilia Team on June 22, 2026<\/p>\n

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    Lecture additionnelle<\/h2>\n

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border_style=\u00a0\u00bbsolid\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb custom_css_main_element_last_edited=\u00a0\u00bbon|tablet\u00a0\u00bb]<\/p>\n

    \u00c0 propos<\/p>\n

    [\/et_pb_text][et_pb_text disabled_on=\u00a0\u00bboff|off|off\u00a0\u00bb _builder_version=\u00a0\u00bb4.21.2″ text_font_size=\u00a0\u00bb0.9rem\u00a0\u00bb text_line_height=\u00a0\u00bb2.5em\u00a0\u00bb text_font_size_tablet=\u00a0\u00bb0.8rem\u00a0\u00bb text_font_size_phone=\u00a0\u00bb0.8rem\u00a0\u00bb text_orientation_tablet=\u00a0\u00bb\u00a0\u00bb text_orientation_phone=\u00a0\u00bbcenter\u00a0\u00bb text_orientation_last_edited=\u00a0\u00bbon|phone\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]Histoire<\/a>
    \n    \u00c9quipe<\/a>
    \n    Blogue
    <\/a>    Nouvelles<\/a>
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    [\/et_pb_text][\/et_pb_column][et_pb_column type=\u00a0\u00bb1_5″ _builder_version=\u00a0\u00bb4.16″ global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_text disabled_on=\u00a0\u00bboff|off|off\u00a0\u00bb admin_label=\u00a0\u00bbText\u00a0\u00bb _builder_version=\u00a0\u00bb4.16″ text_font=\u00a0\u00bbMontserrat||||||||\u00a0\u00bb text_font_size=\u00a0\u00bb1.1rem\u00a0\u00bb text_line_height=\u00a0\u00bb1.2em\u00a0\u00bb background_size=\u00a0\u00bbinitial\u00a0\u00bb background_position=\u00a0\u00bbtop_left\u00a0\u00bb background_repeat=\u00a0\u00bbrepeat\u00a0\u00bb custom_margin=\u00a0\u00bb||8px|\u00a0\u00bb text_font_size_tablet=\u00a0\u00bb1rem\u00a0\u00bb text_font_size_phone=\u00a0\u00bb1rem\u00a0\u00bb text_orientation_tablet=\u00a0\u00bb\u00a0\u00bb text_orientation_phone=\u00a0\u00bbcenter\u00a0\u00bb text_orientation_last_edited=\u00a0\u00bbon|phone\u00a0\u00bb use_border_color=\u00a0\u00bboff\u00a0\u00bb border_color=\u00a0\u00bb#ffffff\u00a0\u00bb border_style=\u00a0\u00bbsolid\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]<\/p>\n

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    Technology<\/a>
    Zilia Ocular
    <\/a>    Vision Loss<\/a><\/p>\n

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    Technologie<\/a>
    Zilia Ocular
    <\/a>    Soins oculaires<\/a><\/p>\n

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    Cookies<\/a>
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border_style=\u00a0\u00bbsolid\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]Certifications[\/et_pb_text][et_pb_image src=\u00a0\u00bbhttps:\/\/ziliahealth.com\/wp-content\/uploads\/2019\/11\/Thumb_mark-of-trust-certified-ISO-13485-quality-management-for-medical-devices-black-logo-En-GB-1019.jpg\u00a0\u00bb title_text=\u00a0\u00bbThumb_mark-of-trust-certified-ISO-13485-quality-management-for-medical-devices-black-logo-En-GB-1019″ _builder_version=\u00a0\u00bb4.27.5″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb width=\u00a0\u00bb75%\u00a0\u00bb max_width=\u00a0\u00bb100%\u00a0\u00bb max_width_tablet=\u00a0\u00bb33%\u00a0\u00bb max_width_phone=\u00a0\u00bb33%\u00a0\u00bb max_width_last_edited=\u00a0\u00bbon|phone\u00a0\u00bb module_alignment=\u00a0\u00bbcenter\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][\/et_pb_image][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=\u00a0\u00bb1_3,1_3,1_3″ module_class=\u00a0\u00bbthree-columns\u00a0\u00bb 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text_font_size_tablet=\u00a0\u00bb0.8rem\u00a0\u00bb text_font_size_phone=\u00a0\u00bb0.8rem\u00a0\u00bb text_font_size_last_edited=\u00a0\u00bbon|tablet\u00a0\u00bb text_orientation_tablet=\u00a0\u00bb\u00a0\u00bb text_orientation_phone=\u00a0\u00bbcenter\u00a0\u00bb text_orientation_last_edited=\u00a0\u00bbon|phone\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb custom_css_main_element_last_edited=\u00a0\u00bbon|tablet\u00a0\u00bb]<\/p>\n

    EN<\/a><\/p>\n

    [\/et_pb_text][\/et_pb_column][et_pb_column type=\u00a0\u00bb1_3″ _builder_version=\u00a0\u00bb4.16″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb custom_css_main_element=\u00a0\u00bbmargin:auto\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_text content_tablet=\u00a0\u00bb<\/p>\n

    Zilia Inc. \u00a9 2023<\/p>\n

    \u00a0\u00bb content_phone=\u00a0\u00bb<\/p>\n

    Zilia Inc. \u00a9 2026<\/p>\n

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    Zilia Inc. \u00a9 2026<\/p>\n

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    Pendant des d\u00e9cennies, l\u2019ophtalmologie s\u2019est largement appuy\u00e9e sur l\u2019imagerie structurelle et le suivi de l\u2019\u00e9volution des maladies. 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