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- Xy31Prefilled syringes for intravitreal drug delivery. [Review]
- COClin Ophthalmol 2019; 13:701-706
- Intravitreal injections of anti-vascular endothelial growth factor (VEGF) medications play an increasingly critical role in numerous retinal vascular diseases. Initially, anti-VEGF medications came i…
Intravitreal injections of anti-vascular endothelial growth factor (VEGF) medications play an increasingly critical role in numerous retinal vascular diseases. Initially, anti-VEGF medications came in vials that had to be drawn up by the physician into a syringe for administration. In 2018, the US Food and Drug Administration (US FDA) approved the ranibizumab 0.3 mg prefilled syringe (PFS), and in October 2016, the US FDA approved the ranibizumab 0.5 mg PFS. This article discusses the advantages of the PFS, including reduced injection time, possible reduced risk of endophthalmitis, reduction in intraocular air bubbles and silicone oil droplets, and improved precision in the volume and dose of intravitreal ranibizumab administered, along with possible disadvantages. Implications of the innovation of the PFS on intravitreal injection technique and clinical practice pattern are discussed and reviewed.
- Long-term outcomes of intravitreous bevacizumab or tissue plasminogen activator or vitrectomy for macular edema due to branch retinal vein occlusion. [Journal Article]
- COClin Ophthalmol 2019; 13:617-626
- CONCLUSIONS: The three groups led to similar long-term good visual outcomes. However, additional surgeries were performed in more than 30% of patients in the IVB and tPA groups.
- Optimization by design of etoposide loaded solid lipid nanoparticles for ocular delivery: Characterization, pharmacokinetic and deposition study. [Journal Article]
- MSMater Sci Eng C Mater Biol Appl 2019; 100:959-970
- The present study was to develop etoposide loaded solid lipid nanoparticles (SLN) and optimize it for effective ocular delivery to the posterior eye. SLN were prepared by melt-emulsification and ultr…
The present study was to develop etoposide loaded solid lipid nanoparticles (SLN) and optimize it for effective ocular delivery to the posterior eye. SLN were prepared by melt-emulsification and ultrasonication technique. Etoposide loaded SLN were optimized by using three-factor three levels Box-Behnken design to establish the functional relationships between variables on responses of particle size, polydispersity index (PDI) and entrapment efficiency (EE). SLN were characterized for size & surface morphology, entrapment efficiency and in vitro release. Further the pharmacokinetic study of optimized formulation after intravitreal administration was evaluated in Wister rats. The deposition in the ocular tissues was checked by scintigraphic analysis in Albino rabbits. Histology was also done to evaluate morphological changes if any occur after treatment. The particle size, PDI and EE obtained for the optimized formulation (Z15) were 239.43 ± 2.35 nm, 0.261 ± 0.001 and 80.96 ± 2.21% respectively. Single intravitreal administrations of SLN were able to give sustained etoposide concentration in the vitreous for 7 consecutive days which was also supported by the results of Gamma scintigraphic study. Histology of posterior ocular tissues do not showed any serious toxic effect. Therefore it can concluded that etoposide loaded SLN was able to maintain vitreous concentration of drug without any serious toxic effect to the surrounding ocular tissues after an intravitreous administration in rat eye.
- Anti-vascular endothelial growth factor for neovascular age-related macular degeneration. [Meta-Analysis]
- CDCochrane Database Syst Rev 2019 03 04; 3:CD005139
- CONCLUSIONS: Results of this review show the effectiveness of anti-VEGF agents (pegaptanib, ranibizumab, and bevacizumab) in terms of maintaining visual acuity; studies show that ranibizumab and bevacizumab improved visual acuity in some eyes that received these agents and were equally effective. Available information on the adverse effects of each medication does not suggest a higher incidence of potentially vision-threatening complications with intravitreous injection of anti-VEGF agents compared with control interventions; however, clinical trial sample sizes were not sufficient to estimate differences in rare safety outcomes. Future Cochrane Reviews should incorporate research evaluating variable dosing regimens of anti-VEGF agents, effects of long-term use, use of combination therapies (e.g. anti-VEGF treatment plus photodynamic therapy), and other methods of delivering these agents.
- Prospective randomised clinical trial of intravitreal bevacizumab versus triamcinolone in eyes with diabetic macular oedema undergoing cataract surgery: 6-month results. [Journal Article]
- BJBr J Ophthalmol 2019 Feb 28
- CONCLUSIONS: When given as an adjunct to cataract surgery, both TA and BVB improved visual outcomes at 6 months postoperatively. However, only TA resulted in sustained improvement in CMT, with the majority not requiring any further treatment postoperatively.
- Safety, pharmacokinetics, and prevention effect of intraocular crocetin in proliferative vitreoretinopathy. [Journal Article]
- BPBiomed Pharmacother 2019; 109:1211-1220
- The study was designed to determine the safety and pharmacokinetics of intraocular crocetin and examine whether crocetin inhibits the development of proliferative vitreoretinopathy (PVR) in a rabbit …
The study was designed to determine the safety and pharmacokinetics of intraocular crocetin and examine whether crocetin inhibits the development of proliferative vitreoretinopathy (PVR) in a rabbit model. In the toxicity study, the right eyes of rabbits were injected with 0.2 μmol or 0.4 μmol crocetin. The left eyes were injected with 0.1 ml phosphate buffered saline (PBS) containing the same concentration of DMSO. Fundus photography, optical coherence tomography (OCT), and electroretinogram (ERG) were obtained at baseline and 14 days. Afterward, the eyes were enucleated for histopathological analysis and terminal deoxynucleotidyl transferasemediated dUTP nick end labeling (TUNEL) assay. In the pharmacokinetic study, the eyes received an intravitreous injection of 0.4 μmol crocetin to detect vitreous drug levels with HPLC at specific time points. In the efficacy study, PVR was induced with an intravitreal injection of ARPE-19 cells in rabbits. Then ten eyes were injected with 0.4 μmol crocetin, and the other 10 eyes received 0.1 ml PBS. Fundus photography, OCT and ERG were performed at days 3 and 7 and weekly for a total of 4 weeks after injection. Afterward, the eyes were enucleated and subjected to histological analysis and TUNEL staining. The results demonstrated no signs of retinal toxicity. Intravitreal injection of 0.4 μmol crocetin had a half-life of 4.231 h. Treatment with crocetin significantly inhibited the progression of PVR in parallel with a reduced expression of α-SMA, collagen fibers and Ki67. These results indicate that crocetin is an effective and safe inhibitor of PVR in rabbit models.
- One-year effectiveness study of intravitreous bevacizumab in neovascular age-related macular degeneration: a population-based retrospective cohort study. [Journal Article]
- CJCan J Ophthalmol 2018; 53(6):627-631
- CONCLUSIONS: Intravitreous bevacizumab is effective in treating nAMD, especially for eyes with poor baseline VA. Gains in VA were greatest by month 3 and were generally maintained thereafter.
- Periocular triamcinolone acetonide injection for treating polypoidal choroidal vasculopathy concurrent with hemorrhagic retinal detachment. [Journal Article]
- MMedicine (Baltimore) 2018; 97(39):e12464
- To investigate the clinical efficiency of periocular triamcinolone acetonide (TA) injection for treating polypoidal choroidal vasculopathy (PCV) concurrent with hemorrhagic retinal detachment (HRD).T…
To investigate the clinical efficiency of periocular triamcinolone acetonide (TA) injection for treating polypoidal choroidal vasculopathy (PCV) concurrent with hemorrhagic retinal detachment (HRD).Twenty-two cases confirmed with PCV concurrent with HRD characterized by massive subretinal hemorrhage and exudation presented to our department from January 2015 to May 2017 were included in this study. The initial vision varied from counting finger to 0.2. All cases were randomly divided into TA group (n = 12), which received periocular TA injection per month, and anti-VEGF group (n = 10), which were treated by anti-VEGF intravitreous injection per month. The patients were followed up for 6 months, in which fundus examination and visual acuity along with optical coherence tomography (OCT) were carried out.The treatment effect is divided into the following categories. Cure was defined as the elimination of subretinal hemorrhage and exudation accompanied by retinal edema and choroidal neovascularization (CNV) extinction and rise of visual acuity. Improvement was characterized by alleviation of subretinal hemorrhage and exudation accompanied by retinal edema and CNV reduction and rise of visual acuity. Ineffective means remained subretinal hemorrhage and exudation in fundus and no improvement of visual acuity, and polypoid lesions in OCT images. Among the 12 cases in TA group, 1 case was treated by periocular injection of TA twice, and 11 cases were treated by 3 times injection. After that, 3 cases (25%) were cured, 8 cases (66.7%) got improvement, and only 1 case (8.3%) showed no response. Although among 10 cases in the anti-VEGF group, 3 cases were treated by anti-VEGF intravitreous injection twice. Seven cases were treated by 3 times injection. After that, 4 cases (40%) got improvement, and the other 6 case (60%) showed no response. All patients showed no recurrence in the 6-month follow-up. No complications were noticed under periocular injection or intravitreous injection.Periocular TA injection is effective for treating PCV concurrent with HRD.
- Interleukin 4 Leads to Sustained Phosphorylation of the STAT6 and ERK Pathways in the Retina and Disrupts Subcortical Visual Circuitry in Rodents. [Journal Article]
- NNeuroimmunomodulation 2018; 25(2):96-102
- CONCLUSIONS: These data suggest that a single in vivo treatment with IL-4 during the early stages of development modulates signaling pathways in the retina, resulting in altered binocular subcortical visual connectivity.
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- Intravitreous Delivery of Αb-Crystallin Ameliorates N-Methyl-N-Nitrosourea Induced Photoreceptor Degeneration in Mice: An in vivo and ex vivo Study. [Journal Article]
- CPCell Physiol Biochem 2018; 48(5):2147-2160
- CONCLUSIONS: Intravitreal delivery of αBC could alleviate MNU induced photoreceptor degeneration and visual impairment. Further refinement of the αBC induced protection would afford a novel therapeutic strategy for retinitis pigmentosa.