Preparation, characterization, and in vivo evaluation of triamcinolone acetonide microspheres after intravitreal administration

Long-term corticosteroid-induced chronic glaucoma model produced by intracameral injection of dexamethasone-loaded PLGA microspheres

PURPOSE

To evaluate a new chronic glaucoma model produced by intracameral injection of dexamethasone-loaded poly lactic-co-glycolic acid microspheres (Dex-PLGA-Ms) over six months.

METHODS

Healthy rats received two injections (at baseline and Week 4) of Dex-PLGA-Ms into the anterior chamber of the right eye. Clinical signs and intraocular pressure (IOP) were weekly recorded. The structure of the retina and optic nerve was in vivo evaluated using optical coherence tomography (OCT) every two weeks and functionally using dark- and light-adapted electroretinography at 0-12-24 weeks. Histological studies were also performed.

RESULTS

IOP progressively increased up to hypertension (23.22 ± 3.63 mmHg) in both eyes but did so later in left eyes. OCT quantified a decrease in full-thickness retina posterior pole (R), retinal-nerve-fiber layer (RNFL), and ganglion-cell layer (GCL) thickness up to 24 weeks. Right eyes showed higher neuroretinal thickness loss up to week 8. RNFL experienced the highest percentage thickness loss at the inferior-superior axis, while in GCL the inner sectors of the horizontal axis (Nasal-Temporal) suffered the greatest decrease in thickness. Retinal ganglion cell, photoreceptor, and intermediate cell functionality decreased over time. Increased deposition of collagen IV was also found in zonular fibers and the ciliary body.

CONCLUSIONS

This work shows the usefulness of drug delivery systems, not to treat pathology but to induce it. Only two injections of Dex-PLGA-Ms in the anterior chamber of rat eyes were enough to progressively create ocular hypertension and subsequent functional and structural neuroretinal degeneration, at least over 6 months.

Microspheres as intraocular therapeutic tools in chronic diseases of the optic nerve and retina

Pathologies affecting the optic nerve and the retina are one of the major causes of blindness. These diseases include age-related macular degeneration (AMD), diabetic retinopathy (DR) and glaucoma, among others. Also, there are genetic disorders that affect the retina causing visual impairment. The prevalence of neurodegenerative diseases of the posterior segment is increased as most of them are related with the elderly. Even with the access to different treatments, there are some challenges in managing patients suffering retinal diseases. One of them is the need for frequent interventions. Also, an unpredictable response to therapy has suggested that different pathways may be playing a role in the development of these diseases. The management of these pathologies requires the development of controlled drug delivery systems able to slow the progression of the disease without the need of frequent invasive interventions, typically related with endophthalmitis, retinal detachment, ocular hypertension, cataract, inflammation, and floaters, among other. Biodegradable microspheres are able to encapsulate low molecular weight substances and large molecules such as biotechnological products. Over the last years, a large variety of active substances has been encapsulated in microspheres with the intention of providing neuroprotection of the optic nerve and the retina. The purpose of the present review is to describe the use of microspheres in chronic neurodegenerative diseases affecting the retina and the optic nerve. The advantage of microencapsulation of low molecular weight drugs as well as therapeutic peptides and proteins to be used as neuroprotective strategy is discussed. Also, a new use of the microspheres in the development of animal models of neurodegeneration of the posterior segment is described.

Experimental circumferential canaloplasty with a new Schlemm canal microcatheter

AIM

To present a new, simple, inexpensive Schlemm canal microcatheter for circumferential canaloplasty in a rabbit model.

METHODS

A rabbit glaucoma animal model was established by intravitreal injection of triamcinolone acetonide. Circumferential canaloplasty with a new Schlemm canal microcatheter (patent license number: 201220029850.0) was performed. The Schlemm canal microcatheter was composed of microcatheter wall and lumen. The wall was made of high refractive index plastic optical fiber that could be attached to an illuminant so that the whole lighted microcatheter was visible during circumferential canaloplasty. The lumen could be attached to an injector for injection of viscoelastic during catheterization. Rabbits were divided randomly into the control, model and treatment groups. Intraocular pressure (IOP) was measured with a Tono-pen tonometer pre-operation and 3, 7, 14, 21 and 28d post-operation. Ultrasound biomicroscopy was performed to visualize the Schlemm canal microcatheter in the Schlemm canal and the sclera pool.

RESULTS

The Schlemm canal microcatheter could be used to perform circumferential canaloplasty in the rabbit glaucoma animal model. IOP was lower in the treatment group than that in the model group 3, 7, 14 and 28d after operation. There were no significant differences in IOP between the control group and treatment group. The differences among the three groups were statistically significant (3d: F=41.985, P<0.001; 7d: F=65.696, P<0.001; 14d: F=114.599, P<0.001; 28d: F=55.006, P<0.001).

CONCLUSION

Circumferential canaloplasty is safe and effective in control of experimental glaucoma model in rabbits.

Solid Lipid Nanoparticles Improve the Diclofenac Availability in Vitreous after Intraocular Injection

Purpose. In order to improve the drug availability after intravitreal administration, solid lipid nanoparticles (SLNs) containing diclofenac were prepared. Methods. In this experimental study, 18 albino rabbits were included. In right and left eyes of all rabbits, SLNs containing diclofenac and commercial form of diclofenac (0.3 mg drug) were intravitreally injected, respectively. One, four, twelve, twenty-four, and forty-eight hours after injection, vitreous and aqueous humor samples were obtained in all cases. Then, the concentration of diclofenac sodium was evaluated in all samples. Results. Size of nanoparticles was around 170 nm after preparation. Drug concentration in eyes injected with SLNs was significantly higher than left eyes injected with commercial formulation up to 4 hours after intravitreal injection (p < 0.05). Diclofenac was quantified in samples up to 48 hours after intraocular injection. Four hours after intravitreal injection, the concentration of diclofenac in vitreous and aqueous humor of eyes receiving SLNs was, respectively, 2.5 and 6.5 times higher than eyes injected with commercial form of drug. Conclusions. Here, we demonstrate the potential of SLNs as a carrier of diclofenac for intraocular injection in order to prevent the systemic effects of the drug, increase the injection intervals, and improve the patient compliance.

Animal models of glucocorticoid-induced glaucoma

Glucocorticoid (GC) therapy is widely used to treat a variety of inflammatory diseases and conditions. While unmatched in their anti-inflammatory and immunosuppressive activities, GC therapy is often associated with the significant ocular side effect of GC-induced ocular hypertension (OHT) and iatrogenic open-angle glaucoma. Investigators have generated GC-induced OHT and glaucoma in at least 8 different species besides man. These models mimic many features of this condition in man and provide morphologic and molecular insights into the pathogenesis of GC-OHT. In addition, there are many clinical, morphological, and molecular similarities between GC-induced glaucoma and primary open-angle glaucoma (POAG), making animals models of GC-induced OHT and glaucoma attractive models in which to study specific aspects of POAG.

Sustained delivery of latanoprost by thermosensitive chitosan-gelatin-based hydrogel for controlling ocular hypertension

Glaucoma is an irreversible ocular disease that may lead to progressive visual field loss and eventually to blindness with inadequately controlled intraocular pressure (IOP). Latanoprost is one of the most potent ocular hypotensive compounds, the current first-line therapy in glaucoma. However, the daily instillation required for efficacy and undesirable side-effects are major causes of treatment adherence failure and persistence in glaucoma therapy. In the present study, we developed an injectable thermosensitive chitosan/gelatin/glycerol phosphate (C/G/GP) hydrogel as a sustained-release system of latanoprost for glaucoma treatment. The latanoprost-loaded C/G/GP hydrogel can gel within 1min at 37°C. The results show a sustained release of latanoprost from C/G/GP hydrogel in vitro and in vivo. The latanoprost-loaded C/G/GP hydrogel showed a good in vitro and in vivo biocompatibility. A rabbit model of glaucoma was established by intravitreal injection of triamcinolone acetonide. After a single subconjunctival injection of latanoprost-loaded C/G/GP hydrogel, IOP was significantly decreased within 8days and then remained at a normal level. The results of the study suggest that latanoprost-loaded C/G/GP hydrogel may have a potential application in glaucoma therapy.

Evaluations of therapeutic efficacy of intravitreal injected polylactic-glycolic acid microspheres loaded with triamcinolone acetonide on a rabbit model of uveitis

Conventional treatments of uveitis are not ideal because of the short period of therapeutic efficacy. In the present study, biodegradable polylactic-glycolic acid microspheres loaded with triamcinolone acetonide (TA) were prepared to achieve sustained drug release and their therapeutic efficacy was investigated on a rabbit model of uveitis. TA-loaded microspheres (TA-MS) were prepared by the solvent evaporation method and characterized for encapsulation efficiency, particle size, morphology and in vitro release. The therapeutic efficacy was studied on the rabbit experimental uveitis model based on scoring of the inflammation, aqueous leukocyte counting, aqueous protein determination and histological examination. The TA-MS exhibited smooth and intact surfaces with an average diameter of 50.87 μm. The drug-loading coefficient and encapsulation efficiency were 15.2 ± 0.6 % and 91.24 ± 3.77 %, respectively. The drug release from TA-MS lasted up to 87 days, but only 46 days for TA suspension. The change in surface morphology also showed sustained drug release from TA-MS. TA-MS exhibited improved therapeutic efficacy in lipopolysaccharide -induced uveitis compared to TA suspension, especially in regard to the inhibition of inflammation. The TA-MS had a longer-term therapeutic effect on intraocular inflammation in LPS-induced uveitis in rabbits compared to TA suspension. The results suggested that TA-MS can be developed as a potential sustained-release system for the treatment of uveitis.