An update on intravitreal implants in use for eye disorders.
Advanced biotechnological techniques and new polymers have led to the development of many innovative intravitreal drug delivery systems. Some designs are still in an experimental phase while others have gained widespread acceptance and are commercially available. Since steroids are a mainstay of therapy for uveitis and macular edema, new intravitreal implants have been developed to provide continuous release of corticosteroids over prolonged spans of time with reduced systemic adverse effects. Today, three long-acting corticosteroid implants are commercially available: the fluocinolone acetonide implants Retisert® and Iluvien® and the dexamethasone drug delivery system Ozurdex®. They offer an alternative route in the management of macular edema due to uveitis, retinal vein occlusion, diabetes and pseudophakia. Their advantage over treatment with steroid injections and the anti-vascular endothelial growth factor ranibizumab is the long-term control of inflammation and macular edema with a reduced frequency of administration. Their potential side effects are cataract and glaucoma, therefore, careful patient selection and monitoring is essential. Further studies are warranted to define the relative efficacy and indications for each treatment option. The development of new devices is a future challenge in the strive to improve drug delivery systems.
Organi di Senso Department, Faculty of Medicine and Psychology, NESMOS Department, Ophthalmology Unit, University of Rome "Sapienza", Rome, Italy.
A
A
Lambiase
Azienda Policlinico Umberto I, DAI Testa/Collo, Faculty of Medicine and Psychology, NESMOS Department, Ophthalmology Unit, University of Rome "Sapienza", Rome, Italy.
S
S
Abdolrahimzadeh
Sant'Andrea Hospital, Faculty of Medicine and Psychology, NESMOS Department, Ophthalmology Unit, University of Rome "Sapienza", Rome, Italy. santi.recupero@uniroma1.it.
S M
SM
Recupero
D000818:Animals; D003692:Delayed-Action Preparations; D016503:Drug Delivery Systems; D015195:Drug Design; D004343:Drug Implants; D016903:Drug Monitoring / Q000379:methods; D005128:Eye Diseases / Q000188:drug therapy* / Q000503:physiopathology; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D018579:Patient Selection; D011108:Polymers / Q000737:chemistry; D013997:Time Factors
D003692:Delayed-Action Preparations; D004343:Drug Implants; D005938:Glucocorticoids; D011108:Polymers
Dexamethasone; Eye disorders; Fluocinolone acetonide; Intravitreal