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Nanoparticle delivery for diabetic macular edema
Author(s) -
Stefansson E.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.02613
Subject(s) - medicine , ophthalmology , eye drop , macular edema , dexamethasone , posterior segment of eyeball , edema , visual acuity , retinal , surgery
Summary Nanotechnology solves the main obstacles in topical drug delivery and delivers drugs by eye drop to posterior segment of the eye. Cyclodextrin nanoparticles containing dexamethasone increase solubility of dexamethasone in tear fluid 30 fold and the drug stays in tear film for 6 hours compared with minutes for conventional eye drops. The high concentration gradient from tear film into eye wall creates a flux which is active for many hours following eye drop application. This delivers approximately 10 times more drug into the eye and reaches the posterior segment in significant concentration. At the same time relatively less drug is absorbed systemically. Several clinical trials have demonstrated the efficacy of the cyclodextrin nanoparticle platform both for posterior and anterior segment use. Two clinical trials in 41 patients have shown significant improvement in visual acuity and retinal structure in diabetic macular edema. The clinical effect of the eye drops is similar to that of intravitreal anti‐ VEGF injections and steroid implants. Two reports show compelling effect on intermediate/posterior uveitis with cystoid macular edema. Nanotechnology has broken the age old dogma that eye drops cannot reach the retina.