Hunter Rebecca S, Lobo Ann-Marie
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
Clin Ophthalmol. 2011;5:1613-21. doi: 10.2147/OPTH.S17419. Epub 2011 Nov 11.
Uveitis can be a sight-threatening eye disease with significant morbidity. Corticosteroids remain the mainstay of treatment of uveitis and provide an effective treatment against ocular inflammation. However, the various modes available for corticosteroid drug delivery can carry significant ocular and systemic side effects which can limit their use in the treatment of uveitis. In an effort to avoid the damage to ocular structures that can ensue with recurrent episodes of ocular inflammation, the side effects associated with systemic steroids, and the need for repeated administration of both topical and locally injected corticosteroids, sustained-release intraocular corticosteroid implants have been developed. The dexamethasone (DEX) drug delivery system (Ozurdex(®); Allergan Inc, Irvine, CA), is a biodegradable intravitreal implant. This implant has been shown to be effective in the treatment of macular edema and noninfectious posterior uveitis and has been approved by the FDA for these entities. This review will highlight the current methods available for corticosteroid delivery to the eye with a particular emphasis on the DEX intravitreal implant and the evidence currently available for its use in noninfectious uveitis.
葡萄膜炎可能是一种威胁视力的眼部疾病,发病率很高。皮质类固醇仍然是葡萄膜炎治疗的主要手段,能有效对抗眼部炎症。然而,皮质类固醇药物递送的各种方式可能会带来显著的眼部和全身副作用,这可能会限制它们在葡萄膜炎治疗中的应用。为了避免因眼部炎症反复发作、全身使用类固醇相关的副作用以及局部和局部注射皮质类固醇需要重复给药而导致的眼部结构损伤,已开发出缓释眼内皮质类固醇植入物。地塞米松(DEX)药物递送系统(Ozurdex®;Allergan公司,加利福尼亚州欧文市)是一种可生物降解的玻璃体内植入物。这种植入物已被证明对治疗黄斑水肿和非感染性后葡萄膜炎有效,并已获得美国食品药品监督管理局(FDA)对这些病症的批准。本综述将重点介绍目前可用于向眼部递送皮质类固醇的方法,特别强调DEX玻璃体内植入物以及目前可用于其在非感染性葡萄膜炎中使用的证据。