视网膜药物递送的眼周途径。
Periocular routes for retinal drug delivery.
作者信息
Raghava Swita, Hammond Makena, Kompella Uday B
机构信息
University of Nebraska Medical Centre, Department of Pharmaceutical Sciences, Omaha, NE 68198-5840, USA.
出版信息
Expert Opin Drug Deliv. 2004 Nov;1(1):99-114. doi: 10.1517/17425247.1.1.99.
Despite numerous scientific efforts, delivery of therapeutic amounts of a drug to the retina remains a challenge. This challenge is compounded if chronic therapy is desired. The inability or inefficiency of topical and systemic routes for retinal delivery of existing drugs is now widely accepted. Although the intravitreal route offers high local concentrations in the vitreous and, hence, retina, these advantages are offset by side effects, such as cataracts, endophthalmitis and retinal detachment, following repeated intravitreal injections, or intravitreal placement of sustained-release implants. As discussed in this review, periocular routes, including subconjunctival, sub-tenon, retrobulbar, peribulbar and posterior juxtascleral routes, potentially offer a more promising alternative for enhanced drug delivery to the retina compared with topical and systemic routes. Periocular routes exploit the permeability of sclera for retinal drug delivery, and they are particularly useful for administering sustained-release systems of potent drugs. This review discusses the various periocular routes with respect to their anatomical location, pharmacokinetics, safety and mechanisms of drug delivery. In the coming years, several innovations in absorption enhancement, drug delivery systems and drug administration devices are anticipated for improving retinal drug delivery via periocular routes.
尽管进行了大量科学研究,但将治疗剂量的药物输送到视网膜仍然是一项挑战。如果需要长期治疗,这一挑战会更加复杂。现有药物通过局部和全身途径进行视网膜给药的能力不足或效率低下,这一点现在已被广泛认可。尽管玻璃体内途径可在玻璃体以及视网膜中实现高局部浓度,但在反复进行玻璃体内注射或植入缓释植入物后,这些优势会被诸如白内障、眼内炎和视网膜脱离等副作用所抵消。如本综述中所讨论的,眼周途径,包括结膜下、Tenon囊下、球后、球周和巩膜后途径,与局部和全身途径相比,可能为增强药物向视网膜的递送提供更有前景的替代方案。眼周途径利用巩膜的通透性进行视网膜药物递送,并且它们对于施用强效药物的缓释系统特别有用。本综述讨论了各种眼周途径在解剖位置、药代动力学、安全性和药物递送机制方面的情况。在未来几年,预计在吸收增强、药物递送系统和药物给药装置方面会有多项创新,以改善通过眼周途径进行的视网膜药物递送。
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