Presbyopia

Presbyopia is caused by the gradual hardening of the lens and decrease in the function of the ciliary muscles. This results in a decline of the eye's adjustment function, and the inability to focus the image of near objects on the retina, leading to a decline in near vision. 

Presbyopia is a physiological phenomenon that is inevitable with age. Studies have shown that the onset of presbyopia occurs around the age of 38, with a prevalence rate of nearly 100 percent at the age of 52. It is estimated that more than 400 million people in China suffer from presbyopia. 

Currently, the treatment options for presbyopia are very limited, relying mainly on spectacles or surgery. Wearing glasses requires frequent removal and insertion, causing many inconveniences in work and life. Surgery, as an irreversible invasive operation, has a very limited acceptance. There are no approved drugs for the treatment of presbyopia in China and the medical need for non-invasive, safe, efficient and reversible treatments for presbyopia remains unsolved until now.

LNZ100 (aceclidine) eye drops are being developed by LENZ Therapeutics. Aceclidine is a small molecule acetylcholine receptor agonist that causes pupil contraction, or miosis, creating a pinhole effect that improves near vision. Studies have shown that aceclidine’s mechanism of action (MOA) is ideally positioned to create a pinhole pupil effect while avoiding the impairment of distance vision called myopic shift. Aceclidine’s unique pupil selective MOA, in which miosis is decoupled from myopic shift, is expected to allow it to target a broad patient population.

CORXEL acquired the Greater China rights for the development and commercialization of the products in April 2022. In August 2024, CORXEL announced that the investigational ophthalmic products, LNZ100 (aceclidine) eye drops, have completed patient enrollment in a Phase 3 clinical study in China for the treatment of presbyopia. 

Reference:

• Mordi J.A., Ciuffreda K.J. Dynamic aspects of accommodation: age and presbyopia. Vision Research (2004);44(6) 591–601.

• Han X, Lee PY, Keel S, et al. Prevalence and incidence of presbyopia in urban Southern China. Br J Ophthalmol (2018);102(11):1538-1542.

• Lu Q, He W, Murthy G.V.S., et al. Presbyopia and Near-Vision Impairment in Rural Northern China.Invest Ophthalmol Vis Sci (2011);52:2300 –2305.

• He M, Abdou A, Naidoo K.S., et al. Prevalence and Correction of Near Vision Impairment at Seven Sites in China, India, Nepal, Niger, South Africa, and the United States. Am J Ophthalmol ( 2012);154: 107–116.

• Refractive Surgery Group of the Society of Ophthalmologists, Chinese Physicians Association, Expert consensus on laser corneal refractive surgery for Chinese patients with age-related under-adjusted refractive error, （2021）[J]. Chinese Journal of Ophthalmology ,2021,57(9): 651-657.DOI:10.3760/cma.j.cn112142-20210523-00246.

• 2023 China Presbyopia Population Insight Report, The 23rd National Symposium on Cataract and Refractive Surgery of the Chinese Medical Association