A review of implantable intravitreal drug delivery technologies for the treatment of posterior segment eye diseases.
Intravitreal implantable device technology utilizes engineered materials or devices that could revolutionize the treatment of posterior segment eye diseases by affording localized drug delivery, responding to and interacting with target sites to induce physiological responses while minimizing side-effects. Conventional ophthalmic drug delivery systems such as topical eye-drops, systemic drug administration or direct intravitreal injections do not provide adequate therapeutic drug concentrations that are essential for efficient recovery in posterior segment eye disease, due to limitations posed by the restrictive blood-ocular barriers. This review focuses on various aspects of intravitreal drug delivery such as the impediment of the blood-ocular barriers, the potential sites or intraocular drug delivery device implantation, the various approaches employed for ophthalmic drug delivery and includes a concise critical incursion into specialized intravitreal implantable technologies for the treatment of anterior and posterior segment eye disease. In addition, pertinent future challenges and opportunities in the development of intravitreal implantable devices is discussed and explores their application in clinical ophthalmic science to develop innovative therapeutic modalities for the treatment of various posterior segment eye diseases. The inherent structural and functional properties, the potential for providing rate-modulated drug delivery to the posterior segment of the eye and specific development issues relating to various intravitreal implantable drug delivery devices are also expressed in this review.
Choonara
Yahya E
YE
Department of Pharmacy and Pharmacology, University of the Witwatersrand, 7 York Road, Parktown, 2193, Johannesburg, Gauteng, South Africa.
Pillay
Viness
V
Danckwerts
Michael P
MP
Carmichael
Trevor R
TR
du Toit
Lisa C
LC
D000818:Animals; D018916:Blood-Aqueous Barrier; D001813:Blood-Retinal Barrier; D016572:Cyclosporine / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D004337:Drug Carriers / Q000737:chemistry; D016503:Drug Delivery Systems / Q000295:instrumentation / Q000379:methods*; D005128:Eye Diseases / Q000188:drug therapy*; D006801:Humans; D015918:Infusion Pumps, Implantable; D007328:Insulin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D008855:Microscopy, Electron, Scanning; D008863:Microspheres; D008954:Models, Biological; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000493:pharmacokinetics; D013499:Surface Properties; D014822:Vitreous Body / Q000187:drug effects* / Q000378:metabolism
D004337:Drug Carriers; D007328:Insulin; D009883:Ophthalmic Solutions; D016572:Cyclosporine