Kang-Mieler Jennifer J, Osswald Christian R, Mieler William F
Illinois Institute of Technology, Department of Biomedical Engineering , Chicago, IL 60616 , USA
Expert Opin Drug Deliv. 2014 Oct;11(10):1647-60. doi: 10.1517/17425247.2014.935338. Epub 2014 Jun 30.
Recent advances in pharmacological therapies to treat ocular diseases such as glaucoma, age-related macular degeneration, diabetic macular edema and retinal vascular occlusions have greatly improved the prognosis for these diseases. Due to these advances in pharmacological therapy, there is a great deal of interest in minimally invasive delivery methods, which has generated rapid developments in the field of ocular drug delivery.
This review will summarize currently available and recent developments for ocular drug delivery to both the anterior and posterior segments. Modes of delivery, including topical, systemic, transcleral/periocular and intravitreal, will be discussed and corresponding examples will be given. This review will highlight the advantages and disadvantages of each mode of delivery and discuss strategies to address these issues.
An ideal therapy should maintain effective levels of drug for the intended duration of treatment following a single application, yet a significant number of months of therapy may be required. There are numerous approaches under investigation to improve treatment options. From the use of novel biomaterial implants and depots for sustained release, to prodrug formations, to iontophoresis to improve drug delivery, the main emphasis will continue to be placed on less invasive, longer acting, sustained release formulations in the treatment of numerous ocular disorders.
治疗青光眼、年龄相关性黄斑变性、糖尿病性黄斑水肿和视网膜血管阻塞等眼部疾病的药物疗法的最新进展极大地改善了这些疾病的预后。由于药物治疗的这些进展,人们对微创给药方法产生了浓厚兴趣,这推动了眼部药物递送领域的快速发展。
本综述将总结目前用于眼部前段和后段药物递送的可用方法及最新进展。将讨论包括局部、全身、经巩膜/眼周和玻璃体内给药等给药方式,并给出相应示例。本综述将突出每种给药方式的优缺点,并讨论解决这些问题的策略。
理想的治疗方法应在单次给药后在预期治疗期间维持有效的药物水平,但可能需要数月的治疗。目前正在研究多种方法来改善治疗选择。从使用新型生物材料植入物和储库进行持续释放,到前药形成,再到离子电渗疗法以改善药物递送,主要重点将继续放在治疗多种眼部疾病时采用侵入性较小、作用时间更长的持续释放制剂上。