Centre of Reproduction, Development and Aging, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau.
Centre of Reproduction, Development and Aging, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau.
Adv Drug Deliv Rev. 2021 Jun;173:439-460. doi: 10.1016/j.addr.2021.04.007. Epub 2021 Apr 20.
Diabetic retinopathy is a frequent microvascular complication of diabetes and a major cause of visual impairment. In advanced stages, the abnormal neovascularization can lead to fibrosis and subsequent tractional retinal detachment and blindness. The low bioavailability of the drugs at the target site imposed by the anatomic and physiologic barriers within the eye, requires long term treatments with frequent injections that often compromise patient's compliance and increase the risk of developing more complications. In recent years, much effort has been put towards the development of new drug delivery platforms aiming to enhance their permeation, to prolong their retention time at the target site and to provide a sustained release with reduced toxicity and improved efficacy. This review provides an overview of the etiology and pathophysiology of diabetic retinopathy and current treatments. It addresses the specific challenges associated to the different ocular delivery routes and provides a critical review of the most recent developments made in the drug delivery field.
糖尿病性视网膜病变是糖尿病常见的微血管并发症,也是视力损害的主要原因。在晚期,异常的新生血管形成可导致纤维化,随后发生牵引性视网膜脱离和失明。眼部的解剖和生理屏障导致药物在靶部位的生物利用度低,需要长期治疗,频繁注射,这往往会影响患者的依从性,并增加发生更多并发症的风险。近年来,人们致力于开发新的药物输送平台,旨在提高药物的渗透性,延长药物在靶部位的滞留时间,并提供减少毒性和提高疗效的持续释放。本文综述了糖尿病性视网膜病变的病因和发病机制以及目前的治疗方法。本文讨论了与不同眼部给药途径相关的特殊挑战,并对药物输送领域的最新进展进行了批判性评价。