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Emixustat is an orally available, synthetic small molecule that acts as a non-retinoid inhibitor of the retinal pigment epithelium-specific 65 kDa protein (RPE65), also known as retinoid isomerohydrolase. By inhibiting RPE65, emixustat modulates the visual cycle and reduces the formation of 11-cis-retinal, thereby decreasing the production of toxic bis-retinoids such as A2E that accumulate in retinal diseases. This mechanism is intended to protect against retinal damage in conditions like Stargardt disease and age-related macular degeneration. Emixustat has been developed primarily for Stargardt disease (with orphan drug status) and has also been investigated for diabetic retinopathy and dry age-related macular degeneration[1][3][4][5][7].
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