用于治疗眼部疾病的医疗设备。
Medical devices for the treatment of eye diseases.
作者信息
Yasukawa Tsutomu, Ogura Yuichiro
机构信息
Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
出版信息
Handb Exp Pharmacol. 2010(197):469-89. doi: 10.1007/978-3-642-00477-3_16.
Development of intraocular drug delivery systems (DDSs) is urgently required for the treatment of eye diseases, especially in the posterior segment of the eye (the vitreous cavity, retina, and choroid), most of which are refractory to conventional pharmacologic approaches; eye drops and systemically administered drugs cannot achieve therapeutic drug concentrations in the posterior segment of the eye. Repeated intravitreal injections of anti-angiogenic agents are effective in the treatment of age-related macular degeneration, but there remain risks of serious side effects such as endophthalmitis associated with repeated injections. Intraocular DDSs may address these problems. Intraocular sustained drug release from implantable or injectable devices has been investigated to treat vitreoretinal diseases. A reservoir-type nonbiodegradable implant was first launched in the market in 1996 for the treatment of cytomegalovirus retinitis secondary to the acquired immunodeficiency syndrome, followed by clinical trials for a variety of potent devices to treat other challenging eye diseases. An injectable rod-shaped insert releasing a steroid is presently being assessed in a phase III trial to treat macular edema secondary to diabetic retinopathy or retinal vein occlusion. Thus various types of intraocular DDSs will be commercially available to treat vision-threatening intraocular diseases in the near future.
治疗眼部疾病迫切需要开发眼内给药系统(DDS),尤其是在眼后段(玻璃体腔、视网膜和脉络膜),其中大多数疾病对传统药物治疗方法难治;眼药水和全身给药的药物无法在眼后段达到治疗药物浓度。反复玻璃体内注射抗血管生成药物在治疗年龄相关性黄斑变性方面有效,但反复注射仍存在严重副作用的风险,如眼内炎。眼内DDS可能解决这些问题。为治疗玻璃体视网膜疾病,已对可植入或可注射装置的眼内持续药物释放进行了研究。一种储库型不可生物降解植入物于1996年首次投放市场,用于治疗获得性免疫缺陷综合征继发的巨细胞病毒性视网膜炎,随后对各种用于治疗其他具有挑战性眼病的有效装置进行了临床试验。一种释放类固醇的可注射棒状插入物目前正在进行III期试验,以治疗糖尿病性视网膜病变或视网膜静脉阻塞继发的黄斑水肿。因此,在不久的将来,各种类型的眼内DDS将可用于治疗威胁视力的眼内疾病。