Lee Susan S, Robinson Michael R
Department of Biomedical Engineering, University of Southern California, Los Angeles, Calif, USA.
Ophthalmic Res. 2009;41(3):124-35. doi: 10.1159/000209665. Epub 2009 Mar 26.
Retinal diseases, such as macular edema from diabetic retinopathy and neovascular age-related macular degeneration, are important causes of visual impairment. Pharmacologic intervention has been employed, since laser can have limited success with improving vision. Topical eye drops and systemic therapy deliver low drug levels to the retina and the potential for systemic drug absorption and the accompanying side effects are high. As a result, transscleral and intravitreal drug delivery systems have had increasing importance in treating retinal diseases to deliver therapeutic drug concentrations and to limit the systemic drug exposure. Herein, we will review the novel drug delivery approaches for treating diabetic macular edema and neovascular age-related macular degeneration.
A Medline search was performed to identify articles that described novel drug delivery systems for treating diabetic macular edema and neovascular age-related macular degeneration. Our review was limited to intravitreal drug delivery systems that have recently completed phase II/III clinical trials and/or have been approved by the US Food and Drug Administration.
Journal articles were identified from the literature search and reviewed.
Local administration of drugs using primarily intravitreal delivery systems is important in treating retinal diseases. Novel drug delivery approaches for treating diabetic macular edema currently are focused on sustained-release corticosteroids. For neovascular age-related macular degeneration, frequent intravitreal injections of anti-vascular endothelial growth factor compounds are the standard of care. Unmet needs in this population are therapies that reduce the treatment burden and improve visual acuity in a greater proportion of patients.
视网膜疾病,如糖尿病视网膜病变引起的黄斑水肿和新生血管性年龄相关性黄斑变性,是视力损害的重要原因。由于激光改善视力的效果有限,药物干预已被采用。局部滴眼液和全身治疗使视网膜的药物水平较低,且全身药物吸收的可能性和随之而来的副作用较高。因此,经巩膜和玻璃体内给药系统在治疗视网膜疾病以提供治疗药物浓度并限制全身药物暴露方面的重要性日益增加。在此,我们将综述治疗糖尿病性黄斑水肿和新生血管性年龄相关性黄斑变性的新型给药方法。
进行了Medline检索,以识别描述治疗糖尿病性黄斑水肿和新生血管性年龄相关性黄斑变性的新型给药系统的文章。我们的综述仅限于最近完成II/III期临床试验和/或已获得美国食品药品监督管理局批准的玻璃体内给药系统。
从文献检索中识别并综述了期刊文章。
主要使用玻璃体内给药系统进行药物局部给药在治疗视网膜疾病中很重要。目前治疗糖尿病性黄斑水肿的新型给药方法主要集中在缓释皮质类固醇。对于新生血管性年龄相关性黄斑变性,频繁玻璃体内注射抗血管内皮生长因子化合物是标准治疗方法。该人群未满足的需求是减少治疗负担并在更大比例的患者中提高视力的疗法。