Pearce William, Hsu Jason, Yeh Steven
aEmory Eye Center, Emory University School of Medicine, Atlanta, Georgia bRetina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania, USA.
Curr Opin Ophthalmol. 2015 May;26(3):233-9. doi: 10.1097/ICU.0000000000000143.
Emerging developments and research for drug delivery to the posterior segment offer a promising future for the treatment of vitreoretinal disease. As new technologies enter the market, clinicians should be aware of new indications and ongoing clinical trials.
This review summarizes the advantages and shortcomings of the most commonly used drug delivery methods, including vitreous dynamics, physician sustainability and patient preferences. Currently available, intravitreal, corticosteroid-release devices offer surgical and in-office management of retinal vascular disease and posterior uveitis. The suprachoroidal space offers a new anatomic location for the delivery of lower dose medications directly to the target tissue. Implantable drug reservoirs would potentially allow for less frequent intravitreal injections reducing treatment burdens and associated risks. Newer innovations in encapsulated cell technology offer promising results in early clinical trials.
Although pars plana intravitreal injection remains the mainstay of therapy for many vitreoretinal diseases, targeted delivery and implantable eluting devices are rapidly demonstrating safety and efficacy. These therapeutic modalities offer promising options for the vitreoretinal therapeutic landscape.
后段给药的新兴发展和研究为玻璃体视网膜疾病的治疗带来了光明的前景。随着新技术进入市场，临床医生应了解新的适应症和正在进行的临床试验。
本综述总结了最常用药物递送方法的优缺点，包括玻璃体动力学、医生的可持续性和患者偏好。目前可用的玻璃体内皮质类固醇释放装置可用于视网膜血管疾病和后葡萄膜炎的手术和门诊治疗。脉络膜上腔为将低剂量药物直接递送至靶组织提供了一个新的解剖位置。可植入药物储库可能会减少玻璃体内注射的频率，降低治疗负担和相关风险。封装细胞技术的更新创新在早期临床试验中显示出了有前景的结果。
尽管玻璃体腔注射仍然是许多玻璃体视网膜疾病治疗的主要手段，但靶向递送和可植入洗脱装置正在迅速证明其安全性和有效性。这些治疗方式为玻璃体视网膜治疗领域提供了有前景的选择。
