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Kanclerz P, Bazylczyk N, Radomski SA. Tear film stability in patients with symptoms of dry eye after instillation of dual polymer hydroxypropyl guar/sodium hyaluronate vs single polymer sodium hyaluronate. Int Ophthalmol 2024; 44:193. [PMID: 38653918 DOI: 10.1007/s10792-024-03061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/16/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE This study evaluated the tear film stability in patients with symptoms of dry eye after installation of dual polymer hydroxypropyl guar/sodium hyaluronate (DPHG/SH) vs single polymer SH. METHODS Patients with recently diagnosed mild to moderate dry eye disease (OSDI score 23-32 points) were included. For each patient, the right eye was randomized to receive DPHG/SH or 0.15% SH. Just after the administration of the drop to the right eye, the fellow eye received the other eye drop. The first non-invasive Keratograph first break-up time (NIKBUT), average NIKBUT and tear meniscus height (TMH) were measured before administration of the eye drops, at 1-min, 15 min, 30 min, 60 min, 90 min, and 120 min after instillation. RESULTS A total of 29 patients aged 22.8 ± 2.2 years participated in the study (21 women). No differences between the eye receiving DPHG/SH and single polymer SH were observed for the first NIKBUT (p = 0.45) and average NIKBUT (p = 0.24) variables at any time point. Both DPHG/SH and single polymer SH increased the TMH (p of time effect < 0.001), but with no difference between groups (p = 0.95). CONCLUSION Both DPHG/SH and single polymer SH solutions provide lubrication of the eye surface, however, with no difference in NIKBUT and TMH evaluations for up to two hours following administration.
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Affiliation(s)
- Piotr Kanclerz
- Department of Ophthalmology, Hygeia Clinic, ul. Jaśkowa Dolina 57, 80-286, Gdańsk, Poland.
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland.
| | - Natasza Bazylczyk
- Department of Ophthalmology, Hygeia Clinic, ul. Jaśkowa Dolina 57, 80-286, Gdańsk, Poland
| | - Szymon Adam Radomski
- Department of Ophthalmology, Hygeia Clinic, ul. Jaśkowa Dolina 57, 80-286, Gdańsk, Poland
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López-Cano JJ, González-Cela-Casamayor MA, Andrés-Guerrero V, Vicario-de-la-Torre M, Benítez-Del-Castillo JM, Herrero-Vanrell R, Molina-Martínez IT. New trends towards glaucoma treatment: Topical osmoprotective microemulsions loaded with latanoprost. Ocul Surf 2023; 29:314-330. [PMID: 37295473 DOI: 10.1016/j.jtos.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
The chronic use of hypotensive agents eventually leads to ocular surface damage and poor patient compliance during glaucoma management. Thus, new sustained drug delivery systems are needed. This work aimed to develop osmoprotective latanoprost-loaded microemulsion formulations as new potential glaucoma treatments with ocular surface protective properties. The microemulsions were characterized and latanoprost encapsulation efficacy determined. In-vitro tolerance, osmoprotective efficacy, cell internalization as well as cell-microemulsion interactions and distribution were performed. In vivo hypotensive activity was conducted in rabbits to assess intraocular pressure reduction and relative ocular bioavailability. Physicochemical characterization showed nanodroplet sizes within 20-30 nm, being in vitro tolerance within 80 and 100% viability in corneal and conjunctival cells. Besides, microemulsions exhibited higher protection under hypertonic conditions than untreated cells. Cell fluorescence lasted for 11 days after short exposure to coumarin-loaded microemulsions (5 min) showing extensive internalization in different cell compartments by electronic microscopy. In vivo studies exhibited that a single instillation of latanoprost-loaded microemulsions reduced the intraocular pressure for several days (4-6 days without polymer and 9-13 days with polymers). Relative ocular bioavailability was 4.5 and 19 times higher than the marketed formulation. These findings suggest the use of these microemulsions as potential combined strategies for extended surface protection and glaucoma treatment.
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Affiliation(s)
- J J López-Cano
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, School of Pharmacy (UCM), Plaza Ramón y Cajal s/n, Madrid, 28040, Spain; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, 28040, Spain
| | - M A González-Cela-Casamayor
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, School of Pharmacy (UCM), Plaza Ramón y Cajal s/n, Madrid, 28040, Spain; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, 28040, Spain
| | - V Andrés-Guerrero
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, School of Pharmacy (UCM), Plaza Ramón y Cajal s/n, Madrid, 28040, Spain; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, 28040, Spain
| | - M Vicario-de-la-Torre
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, School of Pharmacy (UCM), Plaza Ramón y Cajal s/n, Madrid, 28040, Spain; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, 28040, Spain
| | - J M Benítez-Del-Castillo
- Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, 28040, Spain; Ocular Surface and Inflammation Unit, Ophthalmology Department, Sanitary Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, 28040, Spain
| | - R Herrero-Vanrell
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, School of Pharmacy (UCM), Plaza Ramón y Cajal s/n, Madrid, 28040, Spain; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, 28040, Spain.
| | - I T Molina-Martínez
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, School of Pharmacy (UCM), Plaza Ramón y Cajal s/n, Madrid, 28040, Spain; Ocular Pathology National Net (OFTARED) of the Institute of Health Carlos III, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, 28040, Spain.
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Bedos L, Allbaugh RA, Roy M, Kubai MA, Sebbag L. Precorneal retention time of ocular lubricants measured with fluorophotometry in healthy dogs. Vet Ophthalmol 2023; 26 Suppl 1:81-88. [PMID: 36749146 DOI: 10.1111/vop.13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/18/2022] [Accepted: 01/20/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Determine the precorneal retention time of five different ocular lubricants commonly used in dogs. ANIMALS STUDIED Six healthy Beagle dogs (n = 12 eyes). PROCEDURES Five ocular lubricants were studied: Artificial Tears Solution® (1.4% polyvinyl alcohol), I-Drop® Vet Plus (0.25% hyaluronate), Optixcare® Eye Lube Plus (0.25% hyaluronate), Systane® Ultra (0.4% polyethylene glycol 400 and 0.3% propylene glycol), and Artificial Tears Ointment® (mineral oil/white petrolatum). Each lubricant was mixed with 10% sodium fluorescein to achieve 1% fluorescein formulations. Following topical administration of 35 mg in each eye, tear fluid was collected with capillary tubes at selected times (0, 1, 5, 10, 20, 30, 40, 50, 60, 90, 120, 180 min) and fluorescein concentrations were measured with a computerized scanning ocular fluorophotometer. RESULTS Tear fluorescence was significantly greater with Artificial Tears Ointment® compared with other lubricant formulations from 1 to 20 min post-administration. Median (range) precorneal retention times were significantly different among the 5 lubricants, ranging from 40 minutes (20-90 min) for Artificial Tears Ointment®, 35 min (20-90 min) for Systane® Ultra, 30 min (10-60 min) for I-Drop® Vet Plus, 25 min (10-60 min) for Optixcare® Eye Lube Plus, and 10 min (10-20 min) for Artificial Tears Solution®. Precorneal retention time was significantly lower for Artificial Tears Solution® compared with the other 4 formulations. CONCLUSIONS This study established normative data for the retention time of common lubricants on the ocular surface of dogs, which may be used to guide clinicians with their choice of lubricant and frequency of administration.
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Affiliation(s)
- L Bedos
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa, USA
| | - R A Allbaugh
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa, USA
| | - M Roy
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa, USA
| | - M A Kubai
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa, USA
| | - L Sebbag
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa, USA.,Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Choudhari M, Nayak K, Nagai N, Nakazawa Y, Khunt D, Misra M. Role of mucoadhesive agent in ocular delivery of ganciclovir microemulsion: cytotoxicity evaluation in vitro and ex vivo. Int Ophthalmol 2022; 43:1153-1167. [PMID: 36156180 DOI: 10.1007/s10792-022-02514-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of the present study was to investigate increase in delivery of drug upon formulation as mucoadhesive microemulsion system and further to investigate possibility of any cytotoxic effects using such formulation. MATERIAL AND METHODS Considering hydrophilic and small molecular nature of the drug, it was attempted to be formulated as microemulsion, by using pseudo ternary phase diagram method. Thus, three types of microemulsions were prepared; oil in water, water in oil type and chitosan-coated microemulsion. These microemulsions were characterized for several physicochemical properties like size, zeta potential, Polydispersity index, and compared for in vitro cell viability and ex vivo corneal irritation study. RESULTS All three microemulsions were quite stable, transparent and homogenous systems. They showed similar drug release pattern, but highest ex vivo goat corneal permeation was observed with Chitosan coated microemulsion when compared with ganciclovir solution. CONCLUSION All microemulsions were found to be non-irritant in in vitro cell viability assay and ex vivo corneal irritation study, indicating the potential of using such systems for delivery of drug to eye.
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Affiliation(s)
- Manisha Choudhari
- Department of Pharmaceutics, NIPER-Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Kritika Nayak
- Department of Pharmaceutics, NIPER-Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Noriaki Nagai
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka, 577-8502, Japan
| | - Yosuke Nakazawa
- Faculty of Pharmacy, Keio University, 1-5-30, Shibakoen, Minato-ku, Tokyo, 105-8512, Japan
| | - Dignesh Khunt
- Department of Pharmaceutics, NIPER-Ahmedabad, Gandhinagar, Gujarat, 382355, India.,Department of Pharmaceutics, Graduate School of Pharmacy, Gujarat Technical University, Gandhinagar Campus, Gandhinagar, Gujarat, 382028, India
| | - Manju Misra
- Department of Pharmaceutics, NIPER-Ahmedabad, Gandhinagar, Gujarat, 382355, India. .,Department of Pharmaceutics, Graduate School of Pharmacy, Gujarat Technical University, Gandhinagar Campus, Gandhinagar, Gujarat, 382028, India.
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Kim HJ, Youn HC, Hyun JJ, Kim SW. Efficacy of Autologous Serum Gel in Neurotrophic Persistent Corneal Epithelial Defects Combined with Lagophthalmos. Ophthalmol Ther 2022; 11:2129-2139. [PMID: 36152214 DOI: 10.1007/s40123-022-00575-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION To investigate the efficacy of autologous serum gel in patients with lagophthalmos combined with neurotrophic persistent corneal epithelial defects (PEDs). METHODS This is retrospective, case-series study enrolled 15 patients with lagophthalmos complicated by neurotrophic PEDs refractory to medical treatment including autologous serum eye drops. They were treated with autologous serum gel in conjunction with conservative treatment. The following information was collected from medical records: demographics, underlying diseases, and past ocular history. PEDs healing time was evaluated with visual acuity, visual analog scale (VAS) scores, esthesiometer scores, and the areas of the epithelial defects. RESULTS Six men and nine women with a mean age of 63.3 ± 9.9 years were included. The most common cause of the neurotrophic PEDs and lagophthalmos in this group was postherpetic infection (46.7%) and cerebral hemorrhage (26.7%) each. Two months following treatment with autologous serum gel, there was a reduction in the area of the epithelial defects (from 19.2 ± 9.9 to 0.6 ± 1.5 mm2) and a significant improvement in best-corrected visual acuity (BCVA) (from 0.8 ± 0.5 to 0.5 ± 0.4 logMAR) and VAS scores (from 5.1 ± 1.1 to 2.1 ± 0.6) in 13 eyes (87%). Among the 11 completely healed eyes, the mean epithelial healing time was 3.2 ± 1.8 weeks. CONCLUSIONS Autologous serum gel reduces symptoms and promotes corneal epithelialization of refractory neurotrophic PEDs in patients with lagophthalmos. Therefore, it may be well tolerated and a beneficial addition in the management of neurotrophic PEDs in patients with lagophthalmos.
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Affiliation(s)
- Hyeong Ju Kim
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, South Korea
| | - Hyun Chul Youn
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, South Korea
| | - Jeong Jae Hyun
- Department of Chemical Engineering, Soongsil University, Seoul, South Korea
| | - Sang Woo Kim
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, South Korea.
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Rapidly dissolving bilayer microneedles enabling minimally invasive and efficient protein delivery to the posterior segment of the eye. Drug Deliv Transl Res 2022:10.1007/s13346-022-01190-x. [PMID: 35713782 DOI: 10.1007/s13346-022-01190-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Abstract
The discovery of proteins that neutralise vascular endothelial growth factors, such as pegaptanib, ranibizumab and aflibercept, can inhibit the process of angiogenesis, thereby restoring eyesight in individuals with retinal vascular disorders. However, due to the posterior location and chronic nature of retinal diseases, a safe and effective intraocular protein delivery system is currently lacking. Thus, dissolving bilayer microneedles (MNs) with the potential to deliver proteins to the back of the eye in an efficient and minimally invasive manner were developed in this study. A model protein, ovalbumin (OVA), was incorporated into MNs fabricated from different polymers, including hyaluronic acid (HA), polyvinyl alcohol (PVA) and polyvinylpyrrolidone (PVP). Optimised PVA/PVP MNs were demonstrated to be robust enough to pierce porcine sclera with > 75% of the needle length penetrating the sclera and dissolving within 150 s. SDS-PAGE and OVA-specific ELISA revealed that the bioactivity of the model protein was maintained during the manufacture of MNs. In hen's egg-chorioallantoic membrane test, MNs fabricated from all chosen polymers were classified as non-irritants. Furthermore, ex vivo permeation studies showed that optimised MNs could permeate 86.99 ± 7.37% of OVA through the sclera, twice that of the needle-free patch (42.16 ± 3.95%), highlighting the capability of MNs to circumvent physical barriers and promote protein delivery to the posterior segment of the eye. In this work, a novel, efficient and safe intraocular protein delivery system was successfully established.
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Rheological Behavior Patterns in Artificial Tears. Optom Vis Sci 2022; 99:455-462. [DOI: 10.1097/opx.0000000000001885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Reduced Posology of an Ophthalmic Hydrogel Containing Dexamethasone/Netilmicin to Prevent and Treat Ocular Inflammation After Cataract Surgery: Efficacy and Tolerability. Adv Ther 2022; 39:5474-5486. [PMID: 36203046 PMCID: PMC9618540 DOI: 10.1007/s12325-022-02295-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/03/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION To demonstrate efficacy and safety of an ophthalmic hydrogel formulation of netilmicin/dexamethasone, containing xanthan gum twice a day (b.i.d.) versus netilmicin/dexamethasone eye drops four times a day (q.i.d) to treat inflammation and prevention of infection after cataract surgery. METHODS Patients undergoing phacoemulsification with intraocular lens implantation (IOL) were randomised in two groups: group 1, twice daily (b.i.d.) dexamethasone 0.1%/netilmicin 0.3% (Netildex) ophthalmic gel; group 2, four times daily (q.i.d.) dexamethasone 0.1%/netilmicin 0.3% (Netildex) eye drops. Both treatments were administered for 14 days after surgery. Patients were evaluated before surgery, on the day of surgery and at 1, 7, 15 and 60 postoperative days. The primary efficacy endpoint was evaluation of cellularity and flare in the anterior chamber through slit-lamp biomicroscopy 7 days after surgery. Secondary endpoints included: presence of signs/symptoms of postoperative ocular inflammation and incidence of infection. RESULTS One hundred seventy-three patients were randomised and 168 were evaluable. Flare and cellularity were resolved at day 7 in 92.5% of patients and almost completely by day 15. In both intent to treat (ITT) and per-protocol (PP) populations, the efficacy analysis demonstrated that the gel formulation administered twice a day was non-inferior to the eye drops administered four times a day. For ITT analysis, the lower limit of the 97.5% confidence interval (- 0.0535) was greater than the non-inferiority limit of -0.10. For the PP analysis, the lower limit of the 97.5% confidence interval (- 0.0526) was greater than the non-inferiority limit of - 0.10. The patient's global tolerability and reported symptoms were similar between treatment groups. No microbial load and no safety events were observed. CONCLUSIONS Efficacy of the gel reduced posology (twice a day) is not inferior to four times a day eye drops. Both treatments were well tolerated and efficacious. The new reduced posology hydrogel formulation may improve patient compliance and quality of life. TRIAL REGISTRATION Eudract: 2016-0021138-63; ClinicalTrial.gov: NCT029738880.
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Abusharha A. Assessment of a Cationic Emulsion to Control the Tear Film Evaporation Rate. CLINICAL OPTOMETRY 2021; 13:243-248. [PMID: 34408523 PMCID: PMC8364913 DOI: 10.2147/opto.s328787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE To investigate the effect of a single application of cationic emulsion in controlling tear film evaporation and improving tear quality and quantity. MATERIALS A METHODS Twenty male subjects diagnosed with DE were enrolled in the study with an average age of 45.8 ± 6.37 years. The tear film parameters were observed at several time points post-instillation of the cationic emulsion (10, 20, 30, and 60 min). The tear evaporation rate (TER) was measured with a VapoMeter. Noninvasive tear break-up time and meniscus height were assessed using OCULUS Keratograph. RESULTS TER decreased by more than 20% at 20, 30, and 60 minutes time points after instillation of single drop of cationic emulsion. Also, a significant improvement in tear film stability was found at all time points following the instillation of cationic emulsion eye drops. The mean tear break-up time increased from 5.55 ± 2.87 to 6.6 ± 4.2 sec at 60 minutes. The maximum increase in tear break-up time occurred at 30 minutes time point. The TMH was also significantly higher post-instillation of oil emulsion eye drops. There was a significant increase in the TMH post-therapy with oil drop at all time points. CONCLUSION The overall study findings of this study illustrate that the single application of a cationic emulsion effectively controls tear film evaporation in patients with mild to moderate DEs. The cationic emulsion efficiently enhanced both the tear film stability and the tear meniscus volume.
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Affiliation(s)
- Ali Abusharha
- Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia
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Wang L, Zhou MB, Zhang H. The Emerging Role of Topical Ocular Drugs to Target the Posterior Eye. Ophthalmol Ther 2021; 10:465-494. [PMID: 34218424 PMCID: PMC8319259 DOI: 10.1007/s40123-021-00365-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/16/2021] [Indexed: 02/06/2023] Open
Abstract
The prevalence of chronic fundus diseases is increasing with the aging of the general population. The treatment of these intraocular diseases relies on invasive drug delivery because of the globular structure and multiple barriers of the eye. Frequent intraocular injections bring heavy burdens to the medical care system and patients. The use of topical drugs to treat retinal diseases has always been an attractive solution. The fast development of new materials and technologies brings the possibility to develop innovative topical formulations. This article reviews anatomical and physiological barriers of the eye which affect the bioavailability of topical drugs. In addition, we summarize innovative topical formulations which enhance the permeability of drugs through the ocular surface and/or extend the drug retention time in the eye. This article also reviews the differences of eyes between different laboratory animals to address the translational challenges of preclinical models. The fast development of in vitro eye models may provide more tools to increase the clinical translationality of topical formulations for intraocular diseases. Clinical successes of topical formulations rely on continuous and collaborative efforts between different disciplines.
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Affiliation(s)
- Lixiang Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | | | - Hui Zhang
- Yuanpu Eye Biopharmaceutical Co. Ltd., Chengdu, China.
- , No. 14 Jiuxing Avenue, Gaoxin District, Chengdu, China.
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Badr MY, Abdulrahman NS, Schatzlein AG, Uchegbu IF. A polymeric aqueous tacrolimus formulation for topical ocular delivery. Int J Pharm 2021; 599:120364. [DOI: 10.1016/j.ijpharm.2021.120364] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 01/02/2023]
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12
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Preparation of Ophthalmic Microemulsions Containing Lithuanian Royal Jelly and Their Biopharmaceutical Evaluation. Processes (Basel) 2021. [DOI: 10.3390/pr9040616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Royal jelly is a natural substance secreted by worker honeybees that possesses antioxidant, anti-inflammatory, and other biological activities. The purpose of this study was to formulate microemulsions with incorporated Lithuanian royal jelly for possible ophthalmic delivery and to evaluate the quality of the microemulsions in vitro. The oil in water type microemulsions were prepared by the oil titration method, incorporating royal jelly, surfactant, co-surfactant, oil, and water. Physicochemical characteristics of the microemulsions and the quantity of 10-hydroxy-2-decenoic acid released in vitro were assessed. The in vitro assessment of prepared microemulsions formulations was performed with the Statens Seruminstitut rabbit cornea (SIRC) cell culture model. The results revealed that the droplet size of all microemulsion formulations was 67.88–124.2 nm and the polydispersity index was lower than 0.180. In the in vitro release study, the release of 10-hydroxy-2-decenoic acid depended on the amount of royal jelly incorporated and on the ratio of surfactant and co-surfactant in formulations. The in vitro tests with the SIRC cell culture line have shown that all formulations were found non-irritating.
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Grassiri B, Zambito Y, Bernkop-Schnürch A. Strategies to prolong the residence time of drug delivery systems on ocular surface. Adv Colloid Interface Sci 2021; 288:102342. [PMID: 33444845 DOI: 10.1016/j.cis.2020.102342] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022]
Abstract
Ocular diseases may be treated via different routes of administration, such as topical, intracameral, intravitreal, oral and parenteral. Among them the topical route is most accepted by patients, although it provides in many cases the lowest bioavailability. Indeed, when a topical formulation reaches the precorneal area, i.e., the drug absorption and/or action site, it is rapidly eliminated due to eye protection mechanisms such as blinking, basal and reflex tearing, and naso-lacrimal draining. To avoid this and to reduce the frequency of dosing, various strategies have been developed to prolong drug residence time after topical administration. These strategies include the use of viscosity increasing and mucoadhesive excipients as well as combinations thereof. From the drug delivery system point of view, liquid and semisolid formulations are preferred over solid formulations such as ocular inserts and contact lenses. Furthermore, liquid and semisolid formulations can contain nano- and microcarrier systems that contribute to a prolonged residence time. Within this review an overview about the different types of excipients and formulations as well as their performance in valid animal models and clinical trials is provided.
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Affiliation(s)
- Brunella Grassiri
- Department of Pharmacy, University of Pisa, Via Bonanno 33, 56126 Pisa, Italy
| | - Ylenia Zambito
- Department of Pharmacy, University of Pisa, Via Bonanno 33, 56126 Pisa, Italy; Department of Pharmacy, University of Pisa, Via Bonanno 33, 56126 Pisa, Italy; Interdepartmental Research Center "Nutraceuticals and Food for Health", University of Pisa, Pisa 56100, Italy
| | - Andreas Bernkop-Schnürch
- Institute of Pharmacy/Dep. of Pharmaceutical Technology, Center for Chemistry and Biomedicine, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria.
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Rapisarda A, Arpa P, Fantaguzzi PM, Faraldi F, Ratiglia R, Rizzo S, Vaona P, Iannacone C, Papa V. Dexamethasone/Netilmicin Eye Drops and Eye Gel for the Treatment of Ocular Inflammation After Micro-Incisional Vitreoretinal Surgery. Clin Ophthalmol 2020; 14:3297-3303. [PMID: 33116381 PMCID: PMC7569042 DOI: 10.2147/opth.s257541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/08/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To evaluate the effect of dexamethasone/netilmicin (dexa/net) fixed combination in the treatment of ocular inflammation after sutureless micro-incisional vitreoretinal surgery (MIVS). PATIENTS AND METHODS This multicenter, open, randomized, active-controlled, parallel-group, clinical trial was run in 6 sites in Italy. Treatment started the day of surgery and continued 4 times daily for 14 days. Patients were 1:1 randomized to dexa/net (eyedrops solution and eye gel) or dexamethasone/tobramycin (dexa/tobra) eyedrops suspension and ointment. Viscous formulations (gel or ointment) were used alone during the early post-operative phase; afterwards, a combination of eye drops during daytime and viscous formulations at bedtime was adopted. The primary efficacy parameter evaluated was bulbar conjunctival hyperemia. Additional efficacy and safety parameters (palpebral conjunctival hyperemia, anterior chamber flare and cells, symptoms of ocular discomfort and ocular tolerance, adverse events and intraocular pressure) were also evaluated. Control visits were performed at day 1, day 4 and day 14 after surgery; the endpoint of the study was set at 14±2 days after surgery. RESULTS A complete resolution of bulbar conjunctiva hyperaemia at the study end point was reached in 92.9% of patients treated with dexa/net and 75.0% of those treated with dexa/tobra (p=0.02, Fisher's exact test). No differences were observed between treatments for other efficacy parameters. Statistically significant differences in favour of dexa/net (p< 0.0001, ANOVA) were observed for most of subjective tolerance variables examined (blurred vision, foreign body sensation, stickiness, burning) starting day 1 after surgery when only the viscous formulations were used. No increase in intraocular pressure or adverse events was observed during the study. CONCLUSION The combination dexa/net is safe and effective in the treatment of post-operative inflammation following sutureless MIVS. In particular, the use of eye gel formulation is characterized by a great tolerability.
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Affiliation(s)
- Antonio Rapisarda
- Department of Ophthalmology, Azienda Ospedaliera Garibaldi, Catania, Italy
| | - Paolo Arpa
- Department of Ophthalmology, Ospedale San Gerardo, Monza, Italy
| | | | - Francesco Faraldi
- Department of Ophthalmology, Presidio Ospedaliero Oftalmico, Torino, Italy
| | - Roberto Ratiglia
- Department of Ophthalmology, Policlinico Mangiagalli Regina Elena, Milano, Italy
| | - Stanislao Rizzo
- Department of Ophthalmology, Azienda Ospedaliera Pisana, Pisa, Italy
| | - Paola Vaona
- Department of Ophthalmology, Presidio Ospedaliero Oftalmico, Torino, Italy
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Schmidl D, Schlatter A, Chua J, Tan B, Garhöfer G, Schmetterer L. Novel Approaches for Imaging-Based Diagnosis of Ocular Surface Disease. Diagnostics (Basel) 2020; 10:diagnostics10080589. [PMID: 32823769 PMCID: PMC7460546 DOI: 10.3390/diagnostics10080589] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/28/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023] Open
Abstract
Imaging has become indispensable in the diagnosis and management of diseases in the posterior part of the eye. In recent years, imaging techniques for the anterior segment are also gaining importance and are nowadays routinely used in clinical practice. Ocular surface disease is often synonymous with dry eye disease, but also refers to other conditions of the ocular surface, such as Meibomian gland dysfunction or keratitis and conjunctivitis with different underlying causes, i.e., allergies or infections. Therefore, correct differential diagnosis and treatment of ocular surface diseases is crucial, for which imaging can be a helpful tool. A variety of imaging techniques have been introduced to study the ocular surface, such as anterior segment optical coherence tomography, in vivo confocal microscopy, or non-contact meibography. The present review provides an overview on how these techniques can be used in the diagnosis and management of ocular surface disease and compares them to clinical standard methods such as slit lamp examination or staining of the cornea or conjunctiva. Although being more cost-intensive in the short term, in the long term, the use of ocular imaging can lead to more individualized diagnoses and treatment decisions, which in turn are beneficial for affected patients as well as for the healthcare system. In addition, imaging is more objective and provides good documentation, leading to an improvement in patient follow-up and education.
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Affiliation(s)
- Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (A.S.); (G.G.)
| | - Andreas Schlatter
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (A.S.); (G.G.)
- Department of Ophthalmology, Vienna Institute for Research in Ocular Surgery-Karl Landsteiner Institute, Hanusch Hospital, 1140 Vienna, Austria
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore; (J.C.); (B.T.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Nanyang Technological University, Singapore 639798, Singapore
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore; (J.C.); (B.T.)
- SERI-NTU Advanced Ocular Engineering (STANCE), Nanyang Technological University, Singapore 639798, Singapore
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (A.S.); (G.G.)
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria; (D.S.); (A.S.); (G.G.)
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 169856, Singapore; (J.C.); (B.T.)
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Nanyang Technological University, Singapore 639798, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Institute of Molecular and Clinical Ophthalmology, CH-4031 Basel, Switzerland
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40400-29810; Fax: +43-1-40400-29990
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16
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The prominence of the dosage form design to treat ocular diseases. Int J Pharm 2020; 586:119577. [PMID: 32622806 DOI: 10.1016/j.ijpharm.2020.119577] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/16/2020] [Accepted: 06/21/2020] [Indexed: 12/13/2022]
Abstract
The eye is susceptible to various diseases commonly difficult to treat. To overcome the barriers imposed by this organ for required drugs penetration, technological strategies have been implemented to ocular formulations. Among them are the use of temperature or electric stimuli and the development of nanoparticles. The objective of this review is to present the main barriers to ocular drug delivery and to discuss strategies used in the development of ocular dosage forms, primarily for topical delivery, to increase the local bioavailability of drugs, target their delivery and increase patient compliance. Results obtained in the last years related to the topical administration of liposomes, dendrimers, iontophoresis, among other nanoparticulate systems focused on ophthalmic delivery, will be addressed. Finally, some clinical trials and marketed formulations that use nanotechnology to topically treat eye diseases will be presented.
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Ross AE, Bengani LC, Tulsan R, Maidana DE, Salvador-Culla B, Kobashi H, Kolovou PE, Zhai H, Taghizadeh K, Kuang L, Mehta M, Vavvas DG, Kohane DS, Ciolino JB. Topical sustained drug delivery to the retina with a drug-eluting contact lens. Biomaterials 2019; 217:119285. [DOI: 10.1016/j.biomaterials.2019.119285] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/07/2019] [Accepted: 06/13/2019] [Indexed: 02/01/2023]
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18
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Walsh K, Jones L. The use of preservatives in dry eye drops. Clin Ophthalmol 2019; 13:1409-1425. [PMID: 31447543 PMCID: PMC6682755 DOI: 10.2147/opth.s211611] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/03/2019] [Indexed: 12/14/2022] Open
Abstract
Topical ocular preparations are widely recommended by health care professionals, or chosen by patients, to help manage dry eye disease (DED). The chronic and progressive nature of DED may result in the administration of topical products several times a day, over a period of many years. Given DED is a condition that by definition affects the ocular surface, it is important to understand how the repeated use of eye drops may impact the ocular surface, influence clinical signs, affect symptoms, and impact the overall disease process of dry eye. The component in topical preparations with the greatest potential to adversely affect the ocular surface is the preservative. This paper reviews the literature in relation to the use of preservatives in formulations for dry eye. The ocular effects of benzalkonium chloride (BAK) are summarised and compared to the performance of alternative preservatives and preservative-free formulations. Use of preserved and preservative-free drops in relation to the management of varying stages of DED is discussed.
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Affiliation(s)
- Karen Walsh
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, N2L 3G1, Canada
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, N2L 3G1, Canada
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Updates on thermosensitive hydrogel for nasal, ocular and cutaneous delivery. Int J Pharm 2019; 559:86-101. [PMID: 30677480 DOI: 10.1016/j.ijpharm.2019.01.030] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/02/2019] [Accepted: 01/10/2019] [Indexed: 12/15/2022]
Abstract
Thermosensitive hydrogels are in situ gelling systems composed of hydrophilic homopolymers or block copolymers which remain as solutions at room temperature and form gels after administration into the body. Its application in advanced drug delivery has gained significant attention in recent years. The tunable characteristics of thermosensitive hydrogels make them versatile and capable of incorporating both hydrophilic and lipophilic compounds and macromolecules. The drug molecules can be included as free molecules or preformulated into nano- or micro-particles or liposomes. Although there were several reviews on the materials of thermosensitive hydrogels, the compatibility between the drug and thermosensitive material as well as its in vitro release mechanisms and in vivo performance have barely been investigated. The current review is proposed aiming to not only provide an update on the recent development in thermosensitive hydrogel formulations for nasal, ocular and cutaneous deliveries, but also identify the relationship between the drug characteristics and the loading strategies, and their impacts on the release mechanisms and the in vivo performance. Our current update for the first time highlights the essential features for successful development of in situ thermosensitive hydrogels to facilitate nasal, ocular or cutaneous drug deliveries.
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