Comparison of conjunctival and corneal surface areas in rabbit and human

Arginine vasopressin transport and metabolism in the pigmented rabbit conjunctiva

The purpose of this study was to evaluate the transepithelial transport and metabolism of arginine vasopressin (AVP) in the pigmented rabbit conjunctiva, both in the absence and presence of protease inhibitors. The apparent permeability coefficient, P(app), for 3H-AVP was determined in the modified Ussing chamber, and AVP metabolites were monitored by reversed phase HPLC using a C18 column. At 50 nM donor 3H-AVP, the P(app) in the mucosal-to-serosal (ms) direction was about five times higher than that in the opposite direction. Excess (0.1 mM) AVP decreased the P(app) for labelled AVP in the mucosal-to-serosal (ms) direction by about 50%. However, intact AVP transport showed neither concentration nor direction dependence. HPLC analysis revealed two subspecies of 3H-AVP in the receiver fluid and virtually no degradation products in the donor fluid following 3 h flux experiments. 3H-AVP transported in the ms direction underwent extensive hydrolysis (73%), which was decreased by 33% with mucosal application of 2 mM camostat mesylate (an aminopeptidase inhibitor) or by 27% with 0.5 mM leupeptin (a serine protease inhibitor). By contrast, 3H-AVP transported in the serosal-to-mucosal (sm) direction resulted in only 37% hydrolysis, and mucosal application of either inhibitor did not significantly affect the P(app) for intact AVP. These data suggest that intact AVP transport in the conjunctiva may be mediated mostly by passive diffusion and enzymatic degradation of AVP may be mediated by proteolytic enzymes present on the mucosal side of the conjunctiva.

Features of the partially expanded human inferior conjunctival sac

Space in the inferior conjunctival sac has not been studied in sufficient detail to allow optimal physical design of conjunctival inserts. We analyzed shape and volume of partially expanded, anesthetized, left inferior conjunctival sacs in 10 young adult subjects by injection of a liquid polysiloxane molding compound. Mean volume, greatest thickness, central thickness, horizontal width, and vertical height of 60 molds were 125.7 microliters (SD = 55), 1.56 mm (SD = 0.69), 1.46 mm (SD = 0.62), 20.7 mm (SD = 2.2), and 8.9 mm (SD = 0.8), respectively. Volumetric and linear dimensions varied between subjects, but certain features were common to all molds: 1) a crescent shape horizontally; 2) a thick inferior horizontal ridge; and 3) a wedge-like shape sagittally. We postulate several advantages of conjunctival inserts with features representative of our molds of conjunctival sacs, e.g. such inserts may be more comfortable, less expelled, larger in volume, and contact more tissue area.

Active sodium and chloride transport across the isolated rabbit conjunctiva

The bulbar-palpebral conjunctiva from albino rabbits was dissected as a cylinder and cut longitudinally to convert it to a flat epithelium that was mounted as a partition between Using-type chambers, exposing 0.38 cm2 of cross-sectional area. The tissue was bathed with a modified Tyrode's solution at 37 degrees C, pH 7.5. The tear-facing side (apical) was 14.6 +/- 1.5 mV negative relative to the basolateral side. Transepithelial resistance was 1.23 +/- 0.01 K omega.cm2 and the short-circuit current (Isc) was 14.4 +/- 1.3, microA/cm2. Sixty percent of the Isc could be accounted for by a Na(+)-dependent, bumetanide-inhibitable Cl- transport directed towards the apical side. The remainder of the Isc reflected a Na+ absorptive process at the apical surface that was amiloride resistant. Evidence was obtained that a likely contributor to this activity is an electrogenic Na(+)-glucose co-carrier. The Cl-dependent Isc was stimulated by forskolin and epinephrine. Permeabilization of the apical membrane with amphotericin B evinced a current carried by a basolateral Na+:K+ pump. An effect by heptanol suggested that part of the Isc traverse the epithelium via gap junctions. Our results imply that transport processes at the conjunctiva could influence the composition of the tear film.

Active chloride transport in the pigmented rabbit conjunctiva

The present study demonstrates, for the first time, that the excised pigmented rabbit conjunctiva is a tight barrier capable of active Cl- transport. The transepithelial potential difference was 17.7 +/- 0.8 mV (tear-side negative), the short-circuit current was 14.5 +/- 0.7 microA/cm2, and the transconjunctival resistance was 1.3 +/- 0.1 k omega.cm2 for n = 45 tissues. Various inhibitors including ouabain (a Na+/K(+)-ATPase inhibitor), amiloride (a Na+ transport blocker), N-phenylanthranilic acid (a chloride transport inhibitor), bumetanide (an inhibitor of Na(+)-(K+)-Cl- cotransport process), and BaCl2 (a K+ channel blocker) were used on the mucosal and serosal sides of the tissue mounted in Ussing chambers to determine the involvement of the respective ion transport processes in the observed short-circuit current across the conjunctiva. The results suggest that a Cl- conductive pathway is present on the mucosal side of the conjunctiva, whereas Na+/K(+)-ATPase, Na(+)-(K+)-Cl- cotransport process, and K+ conductive pathways are present on its serosal side. Amiloride-sensitive Na(+)-conductive pathways do not appear to be present on either side of the pigmented rabbit conjunctiva.

Plasma concentrations and ocular effects of cyclopentolate after ocular application of three formulations

1. Eight volunteers received in randomized order two 30 microliters drops of either 1% w/v cyclopentolate hydrochloride or a corresponding amount of cyclopentolate polygalacturonate in saline or in acetate buffer in one eye. Cyclopentolate concentrations in plasma were measured by a radioreceptor assay. 2. Peak plasma drug concentrations of about 3 ng ml-1 occurred within 30 min after all formulations. Occasionally, a second concentration peak in plasma, probably reflecting drug absorption from the gastrointestinal tract, was seen after 2 h. The mean elimination half-life of cyclopentolate was 111 min when all subjects and formulations were considered together. There were no statistically significant differences between the formulations with respect to the time-course of plasma drug concentration. 3. The maximal mydriatic effect was reached within about 15 min and was maintained for several hours, often being 1/3 of its peak value after 30 h. Similarly, an intense cycloplegic response was achieved within a few minutes, the peak changes in the near-point of vision being 9 to 10 dioptres. The cycloplegic response was more intense after one of the polygalacturonate complexes, especially at later time points.

Minimizing systemic absorption of topically administered ophthalmic drugs

Due to absorption several ocularly applied medications give rise to systemic side-effects. The problem of systemic drug absorption should be taken into account in designing ocular drug and dosage forms so that oculospecificity of the medications is optimized. In this review we summarize the current knowledge about the systemic absorption of ocularly applied topical drugs. Special emphasis is directed to the methods that can be used to minimize systemic absorption and increase the oculospecificity of drugs, e.g., reducing volume and increasing viscosity of eyedrops, controlling drug release from depot preparations, prodrug-derivatization, and addition of vasoconstrictive agents.

Formulation influence on conjunctival penetration of four beta blockers in the pigmented rabbit: a comparison with corneal penetration

The objective of this study was to compare the influence of pH, tonicity, benzalkonium chloride, and EDTA on the conjunctival and corneal penetration of four beta blockers--atenolol, timolol, levobunolol, and betaxolol. Drug penetration was evaluated using the isolated pigmented rabbit conjunctiva and cornea in the modified Ussing chamber. The conjunctiva was more permeable than the cornea to all four beta blockers. Formulation changes caused larger changes in corneal than in conjunctival drug penetration, especially for the hydrophilic beta blockers, atenolol and timolol. Raising the solution pH to 8.4 caused the largest increase in corneal penetration for all drugs except atenolol. This increase was greater than that obtained by removing the corneal epithelium. The same formulation also increased conjunctival drug penetration, although to a lesser extent. In the case of timolol, the formulation changes evaluated brought about similar changes in its ocular and systemic absorption with good in vitro-in vivo correlations. The above findings indicate that in making formulation changes to maximize corneal drug penetration, it is necessary to evaluate possible changes in conjunctival drug penetration, hence systemic absorption. Moreover, because the conjunctiva plays an active role in the noncorneal route of ocular drug absorption, the relative contribution of the noncorneal to the corneal routes to ocular drug absorption may also be altered by formulation changes.

Ocular pharmacokinetics of calcium, chloride and sulphate ions after instillation in the rabbit

The ionic environment of the eye is involved in major biochemical processes which are essential for preserving the integrity of cornea and lens. The purpose of the present study was to determine the intra-ocular penetration and the pharmacokinetic parameters of calcium, chloride and sulphate ions in the cornea, iris-ciliary body (ICB) and lens, after administration by instillation in the rabbit eye. In order to extrapolate our results to the processes occurring in man, we followed a precise instillation protocol using a low volume (5 microliters) of 45Calcium, 36Chloride and 35Sulphate, which is less than the lacrimal volume determined during the palpebral closing and performing manual blinking at a frequency of 2 min-1. The results indicate an immediate trans-corneal permeability and a rapid ocular distribution of these ions. We observe that, relative to dose, an important percentage of calcium (67.20 per cent) was entrapped in the cornea; this parameter was less important for chloride (10.19 per cent) and for sulphate ions (3.25 per cent). These values are in agreement with those predicted theoretically for trans-corneal penetration by such compounds. On the other hand, the total degrees of penetration by chloride and sulphate ions in ICB (1.40 per cent and 0.90 per cent, respectively) and lens (0.35 per cent and 0.41 per cent, respectively) are quite similar. Calcium retention is much higher in these tissues (25.39 per cent in ICB and 16.03 per cent in lens).(ABSTRACT TRUNCATED AT 250 WORDS)

Effect on mydriasis of modifying the volume of phenylephrine drops

The cardiovascular effects of topically administered phenylephrine 10% are well known and can be minimised by reducing the concentration of drops administered. By modifying the dimensions of the dropper tip we reduced the volume of the drops administered, and therefore the total dose of phenylephrine, without altering the concentration. No difference in the mydriasis produced by drops of small and normal volume could be detected. Since a smaller dose of phenylephrine is administered with smaller drops, the risk of systemic side effects could be reduced by modifying the tips of eyedroppers.

Limits on optimizing ocular drug delivery

The problem of optimizing ocular bioavailability of topically applied ophthalmic drugs is discussed. A formula for drug concentration in the tear film is derived using well-known pharmacokinetic relationships and a first-order drug decay model for the tear film. The time integral of the tear film concentration is then related to ocular bioavailability. The results of this analysis show that: (1) high corneal permeability (corresponding to lipophilic compounds) produces the highest bioavailability; (2) the bioavailability of drugs with high corneal permeability is relatively unaffected by drug volume; and (3) by making the dosage volume sufficiently small, a bioavailability improvement factor of approximately 4 can be obtained for drugs with low corneal permeability.

L-662,583 is a topically effective ocular hypotensive carbonic anhydrase inhibitor in experimental animals

1. L-662,583 was a potent inhibitor in vitro of purified, human erythrocyte carbonic anhydrase II, possessing an IC50 of 0.7 nM. The IC50 values for MK-927, acetazolamide and methazolamide were 13.0 nM, 10.8 nM and 21.2 nM, respectively. 2. A 1 h pretreatment with one 50 microliters drop of a 0.1% solution of L-662,583 blocked carbonic anhydrase activity in a homogenate of the iris + ciliary body of albino rabbits by 63%. Similar treatment with 0.1% suspensions of acetazolamide and methazolamide elicited inhibitions of 30% and 20%, respectively. This ex vivo model indirectly assesses the ability of an agent to enter the rabbit eye. 3. Concentrations of L-662,583 in the cornea, aqueous humour and iris + ciliary body of albino rabbits were determined by h.p.l.c. at predetermined times after the instillation (one drop of 50 microliters) of a 2% solution of L-662,583. Peak levels for cornea (47.4 micrograms g-1), aqueous humour (4.51 micrograms ml-1) and iris + ciliary body (9.61 micrograms g-1) occurred at 0.5, 2 and 1 h after instillation, respectively. 4. The experimentally elevated intraocular pressure of the right eye of rabbits, induced by prior intraocular injection of alpha-chymotrypsin, was maximally decreased by 4.5 mmHg, 6.2 mmHg and 9.8 mmHg after the instillation (one drop of 50 microliters) of 0.01%, 0.1% and 0.5% solutions of L-662,583, respectively. All three concentrations lowered intraocular pressure at all time points from 1 h up to and including 5 h, the last recorded time point. The unilateral instillation of L-662,583 (0.5%) into the contralateral, left eye failed to lower the elevated intraocular pressure of the untreated, right eye. This finding indicates that the site of action of topically applied L-662,583 in this paradigm is local. The ocular normotensive, albino rabbit was much less susceptible than the ocular hypertensive rabbit to the intraocular pressure lowering effect of topically applied L-662,583, with a 2% solution maximally decreasing intraocular pressure by 2.3 mmHg. 5. Unilateral ocular hypertension was elicited in the right eye of sedated, cynomolgus monkeys by argon laser-induced photocoagulation of the trabecular meshwork. The instillation (one drop of 50 microL) of L-662, 583 (2%) significantly lowered the elevated intraocular pressure of the right eye at all time points from 1 h up to and including 5 h. The maximum decline was 8.3 mmHg at 3 h and this represented a reduction of 23% from the corresponding baseline value of 36.8 mmHg. The intraocular pressure of the hypertensive, right eye was maximally decreased by 4.1 mmHg and 4.8 mmHg after the instillation of 0.5% and 1% solutions of L-662,583, respectively. Like the rabbit, the normotensive eye of cynomolgus monkeys was more resistant than the hypertensive eye to the ocular hypotensive action of L-662, 583, as indicated by the inability of 0.5% and 1% solutions of the agent to lower intraocular pressure. L-662,583 (2%) maximally reduced the intraocular pressure of normotensive monkey eyes by 2.4 mmHg at 2 h. 6. L-662,583 is structurally different from MK-927, a carbonic anhydrase inhibitor that lowers the intraocular pressure of glaucoma patients following the instillation of a 2% solution. These preclinical observations indicate that L-662,583, like MK-927, is a water-soluble carbonic anhydrase inhibitor which, on topical administration, lowers intraocular pressure by virtue of an action confined to within the eye.

Ocular hypotensive activity and disposition of the topical carbonic anhydrase inhibitor 6-hydroxy-benzo[b]thiophene-2-sulfonamide, L-650,719, in the rabbit

The carbonic anhydrase (C.A.) inhibitor, L-650,719 (6-hydroxy-benzo[b]thiophene-2-sulfonamide) is an advance over the corresponding 6-OH benzothiazole-2-sulfonamide in increased water solubility (4 mM) and CHCl3/buffer partition (0.05). KI vs CA is 10(-8) M. Topical treatment with 1 drop of 0.15-8% suspensions (in hydroxyethylcellulose-HEC) lowered intraocular pressure (IOP) up to 2.6 mmHg, with a plateau at 2%. Two hours after 2% treatment ocular drug distribution showed (microM or mumole/kg): cornea, 115, anterior aqueous 27, posterior aqueous 4, ciliary processes 15. Calculated inhibition of C.A. is 99.7%. IOP lowering effect disappeared at 6 hrs. L-650,719 was also given in solution (17 mM, pH 9.3). One drop every 5 min x 5 or 10 min residence on cornea of this solution produced an IOP lowering and drug distribution similar to that of the 2% suspension. Increasing HEC concentration in the single drop solution from 0 to 1%, led to a 3-fold increase in anterior aqueous drug levels and an improved delta IOP. The pressure lowering is somewhat less than achieved with parenteral sulfonamides in the rabbit. Clinical trials showed modest activity, so L-650,719 is not being developed further. It is evident, however, that sulfonamides with a variety of chemical and pharmacological properties are conducive to development for topical treatment of glaucoma.