Jiang Sibo, Franco Yesenia L, Zhou Yan, Chen Jianjun
Department of Pharmaceutics, University of Florida, Orlando, FL 32827, USA.
Department of Pharmaceutics, University of Minnesota, Minneapolis, MN 55455, USA.
Int J Ophthalmol. 2018 Jun 18;11(6):1038-1044. doi: 10.18240/ijo.2018.06.23. eCollection 2018.
Retinal diseases, including age-related macular degeneration (AMD) and diabetic retinopathy (DR) are the leading causes of blindness in adults over the age of 50 years in the US. While most of those conditions do not have a cure, currently available treatment options attempt to prevent further vision loss. For many ophthalmic drugs, an efficient delivery system to provide maximum therapeutic efficacy and promote patient compliance remains an unmet medical need. An exploration of literature PubMed spanning from 2007 to 2017 was conducted to identify studies that have evaluated nanotechnology as platforms for delivering therapeutic agents to the posterior segment of the eye where the retina is located. Until now, four routes that have been utilized for retinal drug delivery are the intravitreal, periocular, subretinal, and systemic routes. Intravitreal injections are now widely used in clinical practice due to their ability to directly target the back of the eye but are highly invasive procedures that may cause several complications, particularly with repeated uses over a short timespan. Nanotechnology shows great promise to revolutionize retinal drug delivery, offering many advantages such as a targeted delivery system towards the specific site of the retina as well as sustained delivery of therapeutic agents. In this review, specific eye anatomy and constraints on ocular drug administration are illustrated. Further, we list and highlight several examples of nanosystems, such as hydrogels, liposomes, dendrimers, and micelles, used different drug delivery routes to treat various retinal diseases.
视网膜疾病,包括年龄相关性黄斑变性(AMD)和糖尿病性视网膜病变(DR),是美国50岁以上成年人失明的主要原因。虽然这些病症大多无法治愈,但目前可用的治疗方案旨在防止视力进一步丧失。对于许多眼科药物而言,提供最大治疗效果并提高患者依从性的高效递送系统仍是未满足的医疗需求。我们对2007年至2017年期间的PubMed文献进行了检索,以确定那些评估了纳米技术作为将治疗剂递送至视网膜所在的眼后段平台的研究。到目前为止,用于视网膜药物递送的四种途径是玻璃体内、眼周、视网膜下和全身途径。玻璃体内注射因其能够直接靶向眼后部而在临床实践中广泛使用,但它是侵入性很强的操作,可能会引起多种并发症,尤其是在短时间内重复使用时。纳米技术在彻底改变视网膜药物递送方面显示出巨大潜力,具有许多优势,例如针对视网膜特定部位的靶向递送系统以及治疗剂的持续递送。在这篇综述中,阐述了特定的眼部解剖结构以及眼部药物给药的限制因素。此外,我们列举并重点介绍了几种纳米系统的实例,如水凝胶、脂质体、树枝状大分子和胶束,它们通过不同的药物递送途径用于治疗各种视网膜疾病。