Suprachoroidally injected pharmacological agents for the treatment of chorio-retinal diseases: a targeted approach
| Autor: | Charles C. Wykoff, Zohar Habot-Wilner, Glenn Noronha |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Intraocular pressure
medicine.medical_specialty Triamcinolone acetonide genetic structures Anti-Inflammatory Agents Retina 03 medical and health sciences 0302 clinical medicine Retinal Diseases Ophthalmology medicine Humans Glucocorticoids Retinal pigment epithelium Injection Procedure business.industry Choroid General Medicine Choroid Diseases medicine.disease eye diseases Sclera Posterior segment of eyeball Vitreous Body medicine.anatomical_structure Treatment Outcome 030221 ophthalmology & optometry sense organs Injections Intraocular business 030217 neurology & neurosurgery Uveitis Tomography Optical Coherence medicine.drug |
| Zdroj: | Acta ophthalmologica. 97(5) |
| ISSN: | 1755-3768 |
| Popis: | Delivery of pharmaceuticals to the posterior segment presents challenges that arise from the anatomy and clearance pharmacokinetics of the eye. Systemic and several local administration options [topical, periocular, intravitreal (IVT) and subretinal] are in clinical use, each with a unique benefit to risk profile shaped by factors including the administered agent, frequency of dosing, achievable pharmaceutical concentrations within posterior segment structures versus elsewhere in the eye or the body, invasiveness of the procedure and the inherent challenges with some administration methods. The use of the suprachoroidal space (SCS), which is the region between the sclera and the choroid, is being explored as a potential approach to target pharmacotherapies to the posterior segment via a minimally invasive injection procedure. Preclinical data on agents such as vascular endothelial growth factor inhibitors and triamcinolone acetonide (TA) indicate that administration via suprachoroidal injection results in more posterior distribution of the pharmacologic agent, with higher exposure to the sclera, choroid, retinal pigment epithelium cells and retina, and lesser exposure to the anterior segment, than observed with IVT administration. Based in part on these findings, clinical trials have explored the efficacy and safety of suprachoroidal administration of pharmacologic therapies in conditions affecting the posterior segment. Data on a proprietary formulation of TA administered by suprachoroidal injection show improvement in anatomic and visual outcomes in subjects with noninfectious uveitis, with the potential to mitigate the known risks of cataract and increased intraocular pressure (IOP) associated with the use of intraocular corticosteroids. Suprachoroidal administration appears to be a promising treatment modality and is also in the early stages of investigation for other possible applications, such as injection of antiglaucoma agents into the anterior SCS for long-lasting control of elevated IOP, and as a mode of delivery for gene- or cell-based therapies for retinal disorders. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text