DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for macular holes — screening already-approved drugs against its 39-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleMacular holes maps to a 39-gene Open Targets module — the target space DeCure's AI scientist screens approved drugs against.
DeCure.ai methodSignature reversal (LINCS) plus network proximity (STRING) rank already-approved drugs likely to perturb this module — the same engine that produces DeCure.ai's repurposing hypotheses.
Repurposing thesisScreening approved medicines against this disease module, then publishing the evidence for the strongest candidate. Known pharmacology and human exposure data make the first question sharper — they do not establish safety or efficacy in a new indication.
Research record
01
ResearchComing soon
Candidate research + dossier — target rationale, drug-repurposing thesis and evidence pack.proof: Published dossier + on-chain hash
02
ValidationComing soon
In-vitro biological validation at a contract research org (CRO).proof: CRO contract + in-vitro report
03
Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Current lead
No approved-drug candidate for macular holes is corroborated in the literature DeepSearch retrieved. Some conditions are managed with non-pharmacological care — a device, surgery or physical therapy — rather than a medicine; that may be the case here, or the literature we found may simply be too sparse yet to support a drug-repurposing angle.
Molecular view
RAP2A, member of RAS oncogene family (RAP2A) — RAP2A is one of the genes genetically linked to this disease in Open Targets — shown as context, not as a drug target we're pursuing: no approved-drug candidate for this disease is yet corroborated in the literature we found.
Loading structure…
helix sheet gdpdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 1KAO · 1.7 Å · ligand GUANOSINE-5'-DIPHOSPHATE (GDP). Experimental structure, not a prediction.
What the evidence adds up to
In a 1994 retrospective study of 48 eyes with recent-onset full-thickness idiopathic macular holes (symptoms six months or less) and 20 eyes with older holes (symptoms longer than six months), surgery consisted of vitrectomy, separation of the posterior hyaloid, gas tamponade, and one week of face-down positioning; most patients also had epiretinal membrane dissection. Median postoperative visual acuity in the early group was 20/40 at 3, 6, and 12 months. Fifteen of 27 patients (56%) gained at least three lines of vision at 12 months. Anatomic success with one operation was 75% (36/48), rising to 87.5% (42/48) with a second operation. Stage 2 holes had a final anatomic success rate of 94.4%. In an informal survey, 63.4% (26/41) of respondents believed vision was greatly improved, and 70.3% (26/37) said they would definitely choose surgery again. In the late group, median postoperative visual acuity was 20/100 at six months, compared with 20/142 preoperatively, and hole closure with one operation was 60% (12/20). The authors concluded that surgery for recent holes had a better visual prognosis than for older holes.
A 1998 study of 83 consecutive patients (85 eyes) undergoing macular hole surgery with a systematic search for epiretinal membranes (ERMs) around the hole found that an ERM was removed from 26 of 85 eyes (30.6%). ERMs were more frequent in stage 4 than stage 3 holes (76.9% versus 24.6%; P < 0.01). Holes had been present longer in eyes with an ERM than in those without (14.7 versus 8.6 months; P = 0.05). Fewer stage 3 holes with an ERM had an operculum than those without (P = 0.01). Outcome and complication rates were similar whether an ERM was removed or not. The authors supported the hypothesis that ERMs surrounding idiopathic macular holes are secondary to hole formation.
A 2014 review noted that macular hole surgery, first presented in 1991, has progressed to the point where some surgeons report no failures in three years, but the review also stated that everything can be improved upon and that the technique can be refined.
No drug treatment is mentioned in any of these abstracts. What is still missing is prospective, randomised data comparing surgical techniques and patient stratification by hole duration and stage, as well as standardised, long-term functional outcome measures beyond the informal surveys and retrospective chart reviews reported here.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Archives of Ophthalmology · 1994 · 171 citations
Results of Surgical Treatment of Recent-Onset Full-Thickness Idiopathic Macular Holes
AbstractOBJECTIVE: To investigate whether the visual prognosis after macular hole surgery was different between recent and older holes and to evaluate preoperative characteristics and variations in surgical technique that may influence outcome. DESIGN: The medical charts of all our patients who underwent surgery for a full-thickness macular hole were retrospectively reviewed. PATIENTS: Forty-eight eyes of 48 patients in the "early" group (symptoms < or = 6 months), and 20 eyes of 19 patients in the "late" group (symptoms > 6 months). INTERVENTION: Vitrectomy, separation of the posterior hyaloid, gas tamponade, and instructions to be face down for 1 week. Most patients had epiretinal membrane dissection. MAIN OUTCOME MEASURES: The early and late groups were compared regarding anatomic and visual outcomes. In the early group we evaluated the effect on outcome of the stage of the hole, intraocular tamponade, membrane dissection, and travel distance. RESULTS: Median postoperative visual acuity in the early group was 20/40 at 3, 6, and 12 months. Fifteen (56%) of 27 patients gained at least three lines of vision at 12 months. Anatomic success was seen with one operation in 75% (36/48), and with two operations in 87.5% (42/48). Stage 2 holes had a final anatomic success rate of 94.4%. Of respondents to an informal survey, 63.4% (26/41) believed that vision was greatly improved, and 70.3% (26/37) said that they would definitely choose surgery again. In the late group, median postoperative visual acuity was 20/100 at 6 months, compared with 20/142 preoperatively. Closure of the hole with one operation was seen in 60% (12/20) of the patients in the late group. CONCLUSIONS: Surgery in patients with recent macular holes has a better prognosis for visual rehabilitation than with older holes and appears to be considered beneficial by most patients.
AbstractPURPOSE: To describe the features of the epiretinal membranes (ERMs) surrounding idiopathic macular holes. METHODS: The charts of 83 consecutive patients (85 eyes) who underwent macular hole surgery with a systematic search for an ERM around the hole were reviewed. Visual acuity testing, fundus biomicroscopy, red free and blue filter fundus photographs, and fluorescein angiograms were performed before and after surgery. Eyes with and without ERM removal were compared. RESULTS: An ERM was removed from 26 of 85 eyes (30.6%). ERMs were found more frequently in stage 4 than in stage 3 macular holes (76.9% versus 24.6%; P < 0.01). Holes had been present for longer in eyes with ERM than in those without (14.7 versus 8.6 months; P = 0.05). Fewer stage 3 holes with an ERM had an operculum than those without (P = 0.01). The outcome and complication rates were similar in eyes with an ERM and those without. Of the 24 ERMs detectable on blue filter fundus photographs, only 11 (45.6%) were visible on red free photographs. CONCLUSION: We support the hypothesis that the presence of ERMs surrounding idiopathic macular holes is secondary to hole formation.
Expert Review of Ophthalmology · 2014 · 6 citations
Macular hole surgery: a review of past, present and latest treatments for macular hole
AbstractMacular holes are now a treatable condition. In the 21 years since the concept of macular hole surgery was introduced at the American Academy of Ophthalmology meeting in New Orleans, and the presenter (Neil Kelly) was laughed off the stage, the technique has progressed to the point that the authors have heard busy surgeons stand up in meetings and say ‘I have not had a failure in 3 years’. Everything can be improved upon, and macular hole surgery can be refined as the authors are sure many of those reading this review will do.
Partial thickness macular holes and pharmacological treatment
AbstractAbstract Partial thickness macular holes and lamellar macular holes have a different pathophysiological mechanism compare to the full thickness macular holes as well as different management. Surgery is not always an option. This is the case for a group of full thickness macular holes as well, where pharmacological treatment appears to be a very successful option.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works (targeted per-candidate search), resolved on OpenAlex.
DeCure is a research and publication project, not medical advice and not a treatment. "DeCure for X" describes a research goal, not a claim that a cure exists. Backing a cure is a contribution to fund the research — it is not an investment, and confers no yield, royalty, equity or IP ownership. Papers are published open-access by the DeCure.ai DAO.
