1
|
Samoilă L, Voștinaru O, Dinte E, Bodoki AE, Iacob BC, Bodoki E, Samoilă O. Topical Treatment for Retinal Degenerative Pathologies: A Systematic Review. Int J Mol Sci 2023; 24:ijms24098045. [PMID: 37175752 PMCID: PMC10178888 DOI: 10.3390/ijms24098045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/12/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
The topical administration of medicines is the preferred route in ocular therapy, at least for the anterior segment of the eye. However, the eye's inherent functional and biological barriers all work against the active pharmaceutical ingredient (API) to efficiently reach the targeted retinal structures. The main objective of this article is to offer a systematic review of the scientific literature in recent years, focusing on the latest developments of topical treatment intended for retinal degenerative diseases. Database search returned 102 clinical studies, focused on topical treatment for age macular degeneration, macular edemas (in diabetic retinopathy, surgery related or in retinal dystrophies) or glaucoma. After the exclusion of low-powered studies and those combining vitreo-retinal surgery, 35 articles remained for analysis. Currently, the topical treatment of retinal degenerative diseases is limited by the difficulty to deliver effective drug concentrations to the posterior eye structures. However, in the case of drug classes like NSAIDs, the presence of certain molecular and metabolic features for specific representatives makes the topical administration currently feasible in several clinical contexts. For other drug classes, either a fine-tuning of the API's pharmacokinetic profile or the use of more advanced formulation strategies, such as rationally designed nanostructured drugs and vehicles, crystalline polymorphs or supramolecular complexes, could bring the much awaited breakthrough for a more predictable and controlled delivery towards the retinal structures and could eventually be employed in the future for the development of more effective ways of delivering drugs to the posterior eye, with the ultimate goal of improving their clinical efficacy.
Collapse
Affiliation(s)
- Lăcrămioara Samoilă
- Department of Physiology, "Iuliu Hatieganu" University of Medicine & Pharmacy, 400006 Cluj-Napoca, Romania
| | - Oliviu Voștinaru
- Department of Pharmacology, Physiology and Physiopathology, "Iuliu Hatieganu" University of Medicine & Pharmacy, 400349 Cluj-Napoca, Romania
| | - Elena Dinte
- Department of Pharmaceutical Technology and Biopharmaceutics, "Iuliu Hatieganu" University of Medicine & Pharmacy, 400012 Cluj-Napoca, Romania
| | - Andreea Elena Bodoki
- Department of General and Inorganic Chemistry, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400010 Cluj-Napoca, Romania
| | - Bogdan-Cezar Iacob
- Department of Analytical Chemistry, "Iuliu Hatieganu" University of Medicine & Pharmacy, 400349 Cluj-Napoca, Romania
| | - Ede Bodoki
- Department of Analytical Chemistry, "Iuliu Hatieganu" University of Medicine & Pharmacy, 400349 Cluj-Napoca, Romania
| | - Ovidiu Samoilă
- Department of Ophthalmology, "Iuliu Hatieganu" University of Medicine & Pharmacy, 400006 Cluj-Napoca, Romania
| |
Collapse
|
2
|
Zhang JS, Wang JD, Yusufu M, Cao K, Jin SS, Xiong Y, Li J, Sun XL, Chen SY, Liu ZY, Fu J, Li L, You QS, Wan XH. The effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4-8 years. BMC Ophthalmol 2021; 21:332. [PMID: 34511057 PMCID: PMC8436493 DOI: 10.1186/s12886-021-02098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background The present study sought to observe the effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4–8 years. Methods This is a retrospective case control study. Seventy-seven children (130 eyes) aged from 4 to 8 years who underwent cataract surgery were divided into two groups. In Group A, 50 eyes underwent phacoemulsification, intraocular lens implantation and posterior capsule capsulotomy combined with anterior vitrectomy. In Group B, 80 eyes underwent cataract phacoemulsification and intraocular lens implantation. The postoperative visual acuity and the rate of complications were compared. Results In all patients, cataract surgeries were performed evenly without intraoperative complications. The follow-up time ranged from 6 months to 42 months. No apparent visual axis opacity was detected in group A during the follow-up. By the last visit, apparent visual axis opacity was detected in 31 eyes (38.75%) in group B. Among them, 9 eyes (29.03%) with mild posterior capsule opacification (PCO) were treated with Nd:YAG laser, 3 eyes (9.68%) with thick proliferative membranes were treated with posterior capsule capsulotomy combined with anterior vitrectomy and proliferative membranes in 19 eyes (61.29%) were completely aspired and the posterior capsule was retained. During follow-up, only 2 (6.45%) eyes had PCO recurrence and were treated with Nd:YAG laser. The visual acuity was significantly higher than that before surgery in all patients. Conclusions For older children, the incidence of PCO will be low even if intact posterior capsule is retained. Either Nd:YAG laser or surgical treatment for PCO will be able to maintain good vision.
Collapse
Affiliation(s)
- Jing Shang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Jin Da Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Shan Shan Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Ying Xiong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Jing Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Xiu Li Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Shu Ying Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Zhen Yu Liu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Li Li
- National Key Discipline of Pediatrics, Ministry of Education, Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Qi Sheng You
- Casey Eye Institute, Oregon Health Science University, Oregon, USA
| | - Xiu Hua Wan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, 100005, China.
| |
Collapse
|
3
|
Fakhrutdinova AF, Siplivy VI, Fedoruk NA, Bolshunov AV, Gamidov AA. [Retinal changes after laser interventions on anterior segment of the eyeball]. Vestn Oftalmol 2019; 135:122-129. [PMID: 31215543 DOI: 10.17116/oftalma2019135021122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Laser surgery of the cornea, iris, angle of the anterior chamber and other parts of anterior segment of the eye sees wide application in clinical practice. The adverse effects it can cause in the anterior segment are well known and understood. At the same time, changes the treatment method can cause in the posterior segment of the eye - primarily, in macular area of the cornea, which is of great importance, have not been studied sufficiently. Purpose of the review - to consolidate previously published data on changes in the retina after laser intervention on the anterior segment of the eye.
Collapse
Affiliation(s)
- A F Fakhrutdinova
- Moscow Municipal Polyclinic #219, 47 Jana Rainisa Blvd., Moscow, Russian Federation, 125373
| | - V I Siplivy
- I.M. Sechenov First Moscow State Medical University, Department of Ophthalmology, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991
| | - N A Fedoruk
- Research Institute of Eye Diseases, 11, A, Rossolimo St., Moscow, Russian Federation, 119021
| | - A V Bolshunov
- Research Institute of Eye Diseases, 11, A, Rossolimo St., Moscow, Russian Federation, 119021
| | - A A Gamidov
- Research Institute of Eye Diseases, 11, A, Rossolimo St., Moscow, Russian Federation, 119021
| |
Collapse
|