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Ongoren B, Kara A, Casettari L, Tiboni M, Lalatsa A, Sanz-Perez A, Gonzalez-Burgos E, Romero A, Juberías A, Torrado JJ, Serrano DR. Leveraging 3D-printed microfluidic micromixers for the continuous manufacture of melatonin loaded SNEDDS with enhanced antioxidant activity and skin permeability. Int J Pharm 2024; 663:124536. [PMID: 39074648 DOI: 10.1016/j.ijpharm.2024.124536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 07/31/2024]
Abstract
Vesicants are chemical warfare agents (CWAs) capable of causing severe skin damage and systemic toxicity. Melatonin, known for its anti-inflammatory and antioxidant properties, can mitigate the effects of these agents. Self-nano-emulsifying drug delivery systems (SNEDDS) containing a high melatonin concentration (5 %, 50 mg/g) were optimized using a quality-by-design approach from biocompatible, non-irritant excipients with a particle size of about 100 nm. The melatonin-loaded SNEDDS showed a 43-fold greater permeability than a conventional melatonin cream. Chemical stability at ambient temperature (25 °C) was maintained for one year. The preparation of optimised melatonin-loaded SNEDDS using a simple mixing method was compared to microfluidic micromixers. Mixing was successfully achieved using a 3D-printed (fused deposition modeling or stereolithography) T-shaped toroidal microfluidic chip (with a channel geometry optimized by computational fluid dynamics), resulting in a scalable, continuous process for the first time with a substantial reduction in preparation time compared to other conventional mixing approaches. No statistically significant differences were observed in the key quality attributes, such as particle size and melatonin loading, between mixing method till kinetic equilibrium solubility is reached and mixing using the 3D-printed micromixers. This scalable, continuous, cost-effective approach improves the overall efficiency of SNEDDS production, reduces the cost of quality control for multiple batches, and demonstrates the potential of continuous microfluidic manufacture with readily customizable 3D-printed micromixers at points of care, such as military bases.
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Affiliation(s)
- Baris Ongoren
- Department of Pharmaceutics and Food Technology, School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Aytug Kara
- Department of Pharmaceutics and Food Technology, School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Luca Casettari
- Department of Biomolecular Sciences, School of Pharmacy, University of Urbino Carlo Bo, Piazza del Rinascimento 6, 61029 Urbino, Italy
| | - Mattia Tiboni
- Department of Biomolecular Sciences, School of Pharmacy, University of Urbino Carlo Bo, Piazza del Rinascimento 6, 61029 Urbino, Italy
| | - Aikaterini Lalatsa
- Cancer Research UK Formulation Unit, School of Pharmacy and Biomedical Sciences, Robertson Wing, University of Strathclyde, 161, Cathedral Street, Glasgow G4 0RE, Scotland, UK
| | - Amadeo Sanz-Perez
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - Elena Gonzalez-Burgos
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - Alejandro Romero
- Department of Pharmacology and Toxicology, School of Veterinary, Complutense University of Madrid, 28040 Madrid, Spain
| | - Antonio Juberías
- Dirección de Sanidad del Ejército del Aire, Princesa 87, 28008 Madrid, Spain
| | - Juan J Torrado
- Department of Pharmaceutics and Food Technology, School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Industrial Pharmacy Complutense University of Madrid, 28040 Madrid, Spain.
| | - Dolores R Serrano
- Department of Pharmaceutics and Food Technology, School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Industrial Pharmacy Complutense University of Madrid, 28040 Madrid, Spain.
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Memon H, Ong J, Waisberg E, Panzo N, Sarker P, Zaman N, Tavakkoli A, Lee AG. Biophysics of ophthalmic medications during spaceflight: Principles of ocular fluid dynamics and pharmacokinetics in microgravity. LIFE SCIENCES IN SPACE RESEARCH 2024; 42:53-61. [PMID: 39067991 DOI: 10.1016/j.lssr.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/11/2024] [Accepted: 04/29/2024] [Indexed: 07/30/2024]
Abstract
As spaceflight becomes increasingly accessible and expansive to humanity, it is becoming ever more essential to consider the treatment of various eye diseases in these challenging environments. This paper delves into the increasing fascination with interplanetary travel and its implications for health management in varying environments. It specifically discusses the pharmacological management of ocular diseases, focusing on two key delivery methods: topical eye drops and intravitreal injections. The paper explores how microgravity impacts the administration of these treatments, a vital aspect in understanding drug delivery in space. An extensive analysis is presented on the pharmacokinetics of eye medications, examining the interaction between pharmaceuticals and ocular tissues in zero gravity. The goal of the paper is to bridge the understanding of fluid dynamics, microgravity and the human physiological systems to pave the way for innovative solutions faced by individuals in microgravity.
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Affiliation(s)
- Hamza Memon
- Texas A&M School of Medicine, Bryan, TX, United States
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan, United States
| | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, United Kingdom
| | | | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada, United States
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada, United States
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, Nevada, United States
| | - Andrew G Lee
- Texas A&M School of Medicine, Bryan, TX, United States; Center for Space Medicine, Baylor College of Medicine, Houston, Texas, United States; Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, United States; The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, United States; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York, United States; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas, United States; University of Texas MD Anderson Cancer Center, Houston, Texas, United States; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States.
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Ushida H, Suzumura A, Yamada K, Shimizu H, Suzuki A, Ishikawa Y, Kikuchi R, Nishiguchi KM, Kaneko H. Decrease in electrolyte after vitrectomy surgery may affect the results of forensic investigations using vitreous humor. BMC Ophthalmol 2024; 24:219. [PMID: 38783230 PMCID: PMC11118106 DOI: 10.1186/s12886-024-03445-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 04/10/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE Vitreous humor (VH) is used for postmortem biochemical studies because it is well protected in an uncontaminated state even after death. The goal of this research was to investigate electrolyte concentrations in the VH from human eyes with and without a history of vitrectomy surgery. METHODS We analyzed the sodium (Na), potassium (K), chloride (Cl) and magnesium (Mg) concentrations from 34 VH samples from 34 patients. Eleven samples were from eyes with a history of vitrectomy, and the remaining 23 eyes had no history of vitrectomy. The correlations of Na, K, Cl and Mg concentrations with patient age, interval between first and second vitrectomy, and lens status (history of cataract surgery) were also evaluated. RESULTS The Na, K, Cl and Mg concentrations in VH from vitrectomized eyes were 134.1 ± 7.9 mmol/L, 3.7 ± 0.2 mmol/L, 99.7 ± 6.7 mmol/L and 0.59 ± 0.09 mmol/L, respectively; all were significantly lower than the corresponding concentrations in VH from control eyes (lower by 5.0%, 11.0%, 11.7%, and 22.6%, respectively). Na, K, Cl and Mg concentrations in VH from vitrectomized eyes did not show significant correlations with patient ages or the interval between their first and second vitrectomies. There were no significant differences in Na, K, Cl and Mg concentrations in VH between phakic eyes and intraocular lens-implanted eyes. CONCLUSIONS With the increasing number of vitrectomies being performed, it is necessary to consider the history of vitrectomy when using a subject's VH in forensic examination.
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Affiliation(s)
- Hiroaki Ushida
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, 466-8550, Nagoya, Japan
| | - Ayana Suzumura
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, 466-8550, Nagoya, Japan
| | - Kazuhisa Yamada
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, 466-8550, Nagoya, Japan
| | - Hideyuki Shimizu
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, 466-8550, Nagoya, Japan
| | - Atsuo Suzuki
- Department of Clinical Laboratory, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, 466-8550, Nagoya, Japan
| | - Yusuke Ishikawa
- Department of Clinical Laboratory, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, 466-8550, Nagoya, Japan
| | - Ryosuke Kikuchi
- Division of Clinical Laboratory, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu City, Japan
| | - Koji M Nishiguchi
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, 466-8550, Nagoya, Japan
| | - Hiroki Kaneko
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, 466-8550, Nagoya, Japan.
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Abu Arif J, Knecht VA, Rübsam A, Lussac V, Jami Z, Pohlmann D, Müller B, Pleyer U. Fluocinolone Acetonide Implant for Uveitis: Dissecting Responder and Non-Responder Outcomes at a Tertiary Center. Biomedicines 2024; 12:1106. [PMID: 38791073 PMCID: PMC11117563 DOI: 10.3390/biomedicines12051106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Macular edema (ME) remains a primary cause of visual deterioration in uveitis. Visual acuity (VA) can often be maintained using corticosteroid depot systems. This study evaluated the efficacy of a fluocinolone acetonide (FAc) intravitreal implant (ILUVIEN®) in treating non-infectious uveitis using real-world data. This retrospective analysis included 135 eyes subdivided into responders and non-responders. Central retinal thickness (CRT), VA, and intraocular pressure (IOP) were followed over time. A significant decrease in CRT and an increase in VA were observed in all eyes throughout the follow-up period (p < 0.01). An IOP increase (p = 0.028) necessitated treatment in 43% of eyes by Month 6. Non-responders were older (p = 0.004) and had been treated with more dexamethasone (DEX) implants (p = 0.04); 89.3% had a defect in the external limiting membrane (ELM) and inner/outer segment (IS/OS) zone (p < 0.001). Immunomodulatory therapy had no impact on treatment response. Pars plana vitrectomy (PPV) patients had a mean CRT reduction of 47.55 µm and a reduced effect by Month 24 (p = 0.046) versus non-PPV patients. We conclude that the FAc implant achieves long-term control of CRT and improves VA. Increases in IOP were manageable. Eyes with a previous PPV showed milder results. Data showed a correlation between older age, a damaged ELM and IS/OS zone, frequent DEX inserts, and poorer outcome measures.
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Affiliation(s)
- Jasmin Abu Arif
- Department of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany; (J.A.A.); (V.A.K.); (A.R.); (Z.J.); (D.P.); (B.M.)
| | - Vitus André Knecht
- Department of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany; (J.A.A.); (V.A.K.); (A.R.); (Z.J.); (D.P.); (B.M.)
| | - Anne Rübsam
- Department of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany; (J.A.A.); (V.A.K.); (A.R.); (Z.J.); (D.P.); (B.M.)
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Charité Platz 1, 10117 Berlin, Germany
| | - Vanessa Lussac
- Department of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany; (J.A.A.); (V.A.K.); (A.R.); (Z.J.); (D.P.); (B.M.)
| | - Zohreh Jami
- Department of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany; (J.A.A.); (V.A.K.); (A.R.); (Z.J.); (D.P.); (B.M.)
| | - Dominika Pohlmann
- Department of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany; (J.A.A.); (V.A.K.); (A.R.); (Z.J.); (D.P.); (B.M.)
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Charité Platz 1, 10117 Berlin, Germany
| | - Bert Müller
- Department of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany; (J.A.A.); (V.A.K.); (A.R.); (Z.J.); (D.P.); (B.M.)
| | - Uwe Pleyer
- Department of Ophthalmology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 10117 Berlin, Germany; (J.A.A.); (V.A.K.); (A.R.); (Z.J.); (D.P.); (B.M.)
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Charité Platz 1, 10117 Berlin, Germany
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Liu Y, Li J, Xiao Z, Wu T, Zhou C, Zhou J. Microstructure-Driven Self-Transport and Convection of Water on Membrane Surface for Ultra-Fast, Highly Sensitive, Low-Cost Lateral-Flow Assays. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2309956. [PMID: 38145329 DOI: 10.1002/smll.202309956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/02/2023] [Indexed: 12/26/2023]
Abstract
Lateral-flow assay (LFA) is one of the most commonly used detection technologies, in which the chromatographic membranes are currently used as the lateral-flow membrane (e.g., nitrocellulose membrane, NC Mem). However, several disadvantages of existing chromatographic membranes limit the performance of LFA, including relatively low flow velocity of sample solution and relatively more residuals of sample on membrane, which increase detection time and detection noise. Herein, a surface structure membrane (SS Mem) is proposed, which enables fast self-transport of water with a convection manner and realizes low residuals of sample on membrane surface after the flow. On SS Mem, the flow velocity of water is 7.1-fold higher, and the residuals of sample are decreased by 60-67%, comparing those in NC Mem. SS Mem is used as lateral-flow membrane to prepare lateral-flow strips of nanogold LFA and fluorescence LFA for rapid detection of SARS CoV-2 nucleocapsid protein. These LFAs require 210 s per detection, with limits of detection of 3.98 pg mL-1 and 53.3 fg mL-1, sensitivity of 96.5%, and specificity of 90%. The results suggest that SS Mem enables ultrafast, highly sensitive lateral-flow immunoassays and shows great potential as a new type of lateral-flow membrane to broaden the application of LFA.
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Affiliation(s)
- Yiren Liu
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
- Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, China
| | - Juanhua Li
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
- Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, China
| | - Zihan Xiao
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
| | - Tianyu Wu
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
| | - Cuiping Zhou
- Department of Emergency, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jianhua Zhou
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, 518107, China
- Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510275, China
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Luduvico KP, Radünz M, Hackbart HCDS, Bona NP, Pedra NS, Chitolina Schetinger MR, Zavareze EDR, Spanevello RM, Stefanello FM. Electrospraying and electrospinning of tannic acid-loaded zein: Characterization and antioxidant effects in astrocyte culture exposed to E. coli lipopolysaccharide. Int J Biol Macromol 2024; 267:131433. [PMID: 38583846 DOI: 10.1016/j.ijbiomac.2024.131433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 03/06/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
Tannic acid (TA) exhibits low bioavailability in the gastrointestinal tract, limiting its benefits due to small amounts reaching the CNS. Thus, the objective of this study was to develop zein capsules and fibers by electrospraying/electrospinning for encapsulation of TA. Polymeric solutions were evaluated by electrical conductivity, density, and viscosity. In zein capsules, up to 2 % TA was added, and in fibers, up to 1 % TA was added. Zein capsule and fiber with TA were evaluated by morphology, size distribution, encapsulation efficiency, thermal and thermogravimetric properties, and functional groups. Zein capsule with 1.5 % TA was evaluated in astrocyte culture for cytotoxicity and antioxidant activity. TA zein capsules and fibers exhibited high encapsulation efficiency and homogeneous morphology. TA encapsulated in zein presented higher thermal stability than free TA. TA zein capsule did not present toxicity and elicited antioxidant action in lipopolysaccharide-induced astrocyte culture. Capsules and fibers were successfully produced by electrospraying/electrospinning techniques.
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Affiliation(s)
- Karina Pereira Luduvico
- Postgraduate Program in Biochemistry and Bioprospecting - Biomarkers Laboratory, Center of Chemical, Pharmaceutical and Food Sciences, Federal University of Pelotas, University Campus s/n, Pelotas, RS, Brazil.
| | - Marjana Radünz
- Postgraduate Program in Food Science and Technology - Biopolymers and Nanotechnology in Food Laboratory, Department of Food Science and Technology, Federal University of Pelotas, University Campus s/n, Pelotas, RS, Brazil
| | - Helen Cristina Dos Santos Hackbart
- Postgraduate Program in Food Science and Technology - Biopolymers and Nanotechnology in Food Laboratory, Department of Food Science and Technology, Federal University of Pelotas, University Campus s/n, Pelotas, RS, Brazil
| | - Natália Pontes Bona
- Postgraduate Program in Biochemistry and Bioprospecting - Biomarkers Laboratory, Center of Chemical, Pharmaceutical and Food Sciences, Federal University of Pelotas, University Campus s/n, Pelotas, RS, Brazil
| | - Nathalia Stark Pedra
- Postgraduate Program in Biochemistry and Bioprospecting - Neurochemistry, Inflammation and Cancer Laboratory, Center of Chemical, Pharmaceutical and Food Sciences, Federal University of Pelotas, University Campus s/n, Pelotas, RS, Brazil
| | - Maria Rosa Chitolina Schetinger
- Postgraduate Program in Biological Sciences: Toxicological Biochemistry, Department of Biochemistry and Molecular Biology, Center of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Elessandra da Rosa Zavareze
- Postgraduate Program in Food Science and Technology - Biopolymers and Nanotechnology in Food Laboratory, Department of Food Science and Technology, Federal University of Pelotas, University Campus s/n, Pelotas, RS, Brazil
| | - Roselia Maria Spanevello
- Postgraduate Program in Biochemistry and Bioprospecting - Neurochemistry, Inflammation and Cancer Laboratory, Center of Chemical, Pharmaceutical and Food Sciences, Federal University of Pelotas, University Campus s/n, Pelotas, RS, Brazil
| | - Francieli Moro Stefanello
- Postgraduate Program in Biochemistry and Bioprospecting - Biomarkers Laboratory, Center of Chemical, Pharmaceutical and Food Sciences, Federal University of Pelotas, University Campus s/n, Pelotas, RS, Brazil.
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Taloni A, Coco G, Rastelli D, Buffon G, Scorcia V, Giannaccare G. Safety and Efficacy of Dexamethasone Intravitreal Implant Given Either First-Line or Second-Line in Diabetic Macular Edema. Patient Prefer Adherence 2023; 17:3307-3329. [PMID: 38106365 PMCID: PMC10725633 DOI: 10.2147/ppa.s427209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023] Open
Abstract
Diabetic macular edema (DME) is a common sight-threatening complication of diabetic retinopathy (DR) and the leading cause of severe visual impairment among the working-age population. Several therapeutic options are available for the management of DME, including intravitreal corticosteroids. They have been traditionally used as second-line treatment, due to the risk of intraocular pressure increase and cataract-related adverse events. However, attention has recently been focused on the primary or early use of intravitreal corticosteroids, due to growing evidence of the crucial role of inflammation in the pathogenesis of DME. Furthermore, intravitreal steroid implants offer the additional advantage of a longer duration of action compared to anti-vascular endothelial growth factor agents (anti-VEGF). This review aims to summarize the available evidence on the efficacy and safety profile of dexamethasone (DEX) intravitreal implant, with a specific focus on clinical scenarios in which it might be considered or even preferred as first-line treatment option by adequate selection of patients, considering both advantages and possible adverse events. Patients with contraindications to anti-VEGF, DME with high inflammatory OCT biomarkers, pseudophakic patients and phakic patients' candidates to cataract surgery as well as vitrectomized eyes may all benefit from first-line DEX implant. Additionally, DME not responders to anti-VEGF should be considered for a switch to DEX implant and a combination therapy of DEX implant and anti-VEGF could be a valid option in severe and persistent DME.
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Affiliation(s)
- Andrea Taloni
- Department of Ophthalmology, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Giulia Coco
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Davide Rastelli
- Department of Ophthalmology, Policlinico Casilino, Rome, Italy
| | - Giacinta Buffon
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Giuseppe Giannaccare
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
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Sun X, Wang X, Guo X, Wang M, Liu H. Combined Use of Anti-VEGF Drugs Before and During Pars Plana Vitrectomy for Severe Proliferative Diabetic Retinopathy. Ophthalmol Ther 2023; 12:3133-3142. [PMID: 37713065 PMCID: PMC10640465 DOI: 10.1007/s40123-023-00803-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate the combined administration of anti-vascular endothelial growth factor (anti-VEGF) drugs before and during pars plana vitrectomy (PPV) and to explore its efficacy and safety in the treatment of patients with severe proliferative diabetic retinopathy (PDR). METHODS This retrospective case series included consecutive patients who underwent PPV. Patients were categorized into two groups: the preoperative group was injected with anti-VEGF drugs before PPV, and the combination group was injected with anti-VEGF drugs before and during PPV. Preoperative, intraoperative, and postoperative clinical data were collected for analysis. The main outcome measures were changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) and occurrence of postoperative vitreous cavity haemorrhage (POVCH). RESULTS In total, 63 eyes of 60 patients with severe PDR were analysed. The operative duration and occurrence of intraoperative haemorrhage, iatrogenic retinal breaks, and silicone oil tamponade were similar between the two groups. The benefits on BCVA, and CRT after 1 week postoperatively, were more obvious in the combination group (P < 0.01). Combination therapy had the potential to reduce the incidence of POVCH. No ocular or systemic adverse events occurred in either group. CONCLUSIONS The combined use of anti-VEGF drugs before and during PPV in patients with severe PDR not only includes the advantages of preoperative injection, but also has more significant prognostic benefits and favourable safety profiles.
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Affiliation(s)
- Xincheng Sun
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
- Department of Ophthalmology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Xianhuai Wang
- Department of Ophthalmology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Xinyu Guo
- Department of Ophthalmology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Mengjiao Wang
- Department of Ophthalmology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China.
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Zhang C, Wu M, Hu S, Shi S, Duan Y, Hu W, Li Y. Label-Free, High-Throughput, Sensitive, and Logical Analysis Using Biomimetic Array Based on Stable Luminescent Copper Nanoclusters and Entropy-Driven Nanomachine. Anal Chem 2023; 95:11978-11987. [PMID: 37494597 DOI: 10.1021/acs.analchem.3c01650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
The development of an array for high-throughput and logical analysis of biomarkers is significant for disease diagnosis. DNA-templated copper nanoclusters (CuNCs) have a strong potential to serve as a label-free photoluminescence source in array platforms, but their luminescent stability and sensitivity need to be improved. Herein, we report a facile, sensitive, and robust biomimetic array assay by integrating with stable luminescent CuNCs and entropy-driven nanomachine (EDN). In this strategy, the luminescent stability of CuNCs was improved by adding fructose in CuNCs synthesis to offer a reliable label-free signal. Meanwhile, the DNA template for CuNCs synthesis was introduced into EDN with excellent signal amplification ability, in which the reaction triggered by target miRNA would cause the blunt/protruding conformation change of 3'-terminus accompanied by the production or loss of luminescence. In addition, a biomimetic array fabricated by photonic crystals (PCs) physically enhanced the emitted luminescent signal of CuNCs and achieved high-throughput signal readout by a microplate reader. The proposed assay can isothermally detect as low as 4.5 pM of miR-21. Moreover, the logical EDN was constructed to achieve logical analysis of multiple miRNAs by "AND" or "OR" logic gate operation. Therefore, the proposed assay has the advantages of label-free property, high sensitivity, flexible design, and high-throughput analysis, which provides ideas for developing a new generation of facile and smart platforms in the fields of biological analysis and clinical application.
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Affiliation(s)
- Chuyan Zhang
- State Key Laboratory of Respiratory Health and Multimorbidity, Precision Medicine Center, Medical Equipment Innovation Research Center, Med-X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Mengfan Wu
- Research Center of Analytical Instrumentation, School of Mechanical Engineering, Sichuan University, Chengdu, Sichuan 610065, P.R. China
| | - Shunming Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Shaorui Shi
- State Key Laboratory of Respiratory Health and Multimorbidity, Department of Laboratory Medicine, Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yixiang Duan
- Research Center of Analytical Instrumentation, School of Mechanical Engineering, Sichuan University, Chengdu, Sichuan 610065, P.R. China
| | - Wenchuang Hu
- State Key Laboratory of Respiratory Health and Multimorbidity, Precision Medicine Center, Medical Equipment Innovation Research Center, Med-X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yongxin Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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10
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Enhancement of stability and dermal delivery of Carissa carandas Linn. leaf extract by liquid crystals. J Drug Deliv Sci Technol 2023. [DOI: 10.1016/j.jddst.2023.104258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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11
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Iglicki M, Busch C, Lanzetta P, Sarao V, Veritti D, Rassu N, Lupidi M, Cebeci Z, Fraser-Bell S, Bernal-Morales C, Sala-Puigdollers A, Zarranz-Ventura J, Gallego-Pinazo R, Maiti A, D'Amico Ricci G, Udaondo P, Loewenstein A, Chhablani J, Zur D. Vitrectomized vs non-vitrectomized eyes in DEX implant treatment for DMO-Is there any difference? the VITDEX study. Eye (Lond) 2023; 37:280-284. [PMID: 35043004 PMCID: PMC9873723 DOI: 10.1038/s41433-022-01931-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE We aimed to compare visual and anatomical outcome in vitrectomized and non-vitrectomized eyes treated with dexamethasone (DEX) implant due to diabetic macular oedema (DMO). DESIGN Multicenter, retrospective, interventional study. PARTICIPANTS 236 eyes from 234 patients with DMO with or without previous vitrectomy performed with follow-up of 12 months. METHODS Records were reviewed for cases of DMO treated with DEX implant in vitrectomized and not vitrectomized eyes. Best corrected visual acuity (BCVA), central subfoveal thickness (CST), and intraocular pressure (IOP) were recorded at baseline and 12 months after treatment with DEX implants. Correlations between vitreous status and visual and anatomical outcome, as well as safety profile were analysed. MAIN OUTCOME MEASURES BCVA and CST over follow-up period. SECONDARY OUTCOMES cataract rate formation, intraocular pressure increase, number of implants needed. RESULTS The non-vitrectomized group included 130 eyes (55.1%), the vitrectomized group included 106 eyes (44.9%). The groups were well balanced for age and gender (p = 0.540, and p = 0.053, respectively). Both groups showed statistically significant improvement in BCVA and CST (for all groups: p < 0.001). There was no significant difference between the groups in terms of change in vision (p = 0.89) and anatomy (p = 0.65). The mean number of DEX implants given during follow-up was 3.5 in both groups, and there was no significant difference between the groups (p = 0.81). CONCLUSION We demonstrated similar anatomical and functional efficacy of DEX implant in non-vitrectomized and vitrectomized eyes. Its efficacy was not influenced by full vitrectomy for diabetic retinopathy complications. Safety profile was well balanced between groups.
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Affiliation(s)
- Matias Iglicki
- Private Retina Office, University of Buenos Aires, Buenos Aires, Argentina.
| | - Catharina Busch
- Department of Ophthalmology, University of Leipzig, Leipzig, Germany
| | - Paolo Lanzetta
- Department of Medicine-Ophthalmology, University of Udine, Piazzale S. Maria della Misericordia, 33100, Udine, Italy
| | - Valentina Sarao
- Department of Medicine-Ophthalmology, University of Udine, Piazzale S. Maria della Misericordia, 33100, Udine, Italy
| | - Daniele Veritti
- Department of Medicine-Ophthalmology, University of Udine, Piazzale S. Maria della Misericordia, 33100, Udine, Italy
| | - Nicolò Rassu
- Department of Medicine-Ophthalmology, University of Udine, Piazzale S. Maria della Misericordia, 33100, Udine, Italy
| | - Marco Lupidi
- Department of Medicine and Surgery, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, 06156, Perugia, Italy
- Fondazione per la Macula Onlus, Di.N.O.G.Mi., University Eye Clinic, Viale Benedetto XV, 16132, Genova, Italy
- Centre de l'Odéon, 113 Boulevard St Germain, 75006, Paris, France
| | - Zafer Cebeci
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Samantha Fraser-Bell
- Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, NSW, Australia
| | | | | | | | | | - Aniruddha Maiti
- Susrut Eye Foundation & Research Centre Kolkata, Kolkata, India
| | | | | | - Anat Loewenstein
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jay Chhablani
- University of Pittsburgh, UPMC Eye Center, Pittsburgh, PA, USA
| | - Dinah Zur
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Nawrocka ZA, Nawrocki J. Vitrectomy in Diabetic Macular Edema:: A Swept-source OCT Angiography Study. OPHTHALMOLOGY SCIENCE 2022; 2:100207. [PMID: 36385773 PMCID: PMC9647227 DOI: 10.1016/j.xops.2022.100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 12/01/2022]
Abstract
Purpose The foveal avascular zone (FAZ) has been reported to decrease after anti-VEGF injections in diabetic macular edema (DME) in the long term. This study aimed to present the changes in swept-source OCT angiography after vitrectomy in patients with DME. Design Retrospective interventional study. Participants Thirty-five eyes were included (mean age: 62 years). Methods Patients were followed for 12 months after vitrectomy with internal limiting membrane peeling for DME. Main Outcome Measures The following parameters were measured: central retinal thickness (CRT), central choroidal thickness, superficial FAZ, deep FAZ (dFAZ), and vessel density in the superficial and deep retinal layers (dVD). Results The CRT and superficial FAZ significantly decreased after surgery (401 μm-338 μm; P < 0.00, 401 μm-293 μm; P < 0.001, respectively). Initial visual acuity (VA) improved from 20/160 (0.97 logarithm of the minimum angle of resolution [LogMAR]) to 20/80 (0.62 LogMAR) (P < 0.001). The vessel density in the superficial retinal layers rate was 42.3% and decreased after surgery, reaching 41.6% at the end of the follow-up. The dVD rate 1 week after surgery was 28.9% and remained stable throughout the observation period. The most important prognostic factors for the final VA were preoperative VA and preoperative CRT, while the dFAZ and dVD at the time of edema resolution also correlated with the final VA. Conclusions The superficial FAZ decreases after vitrectomy, which might indicate that vitrectomy has a protective effect on DME, similar to anti-VEGF injections. Prognostic factors for better final functional results are better initial VA and lower CRT before vitrectomy, in addition to a lower dFAZ diameter and a higher dVD at the moment of edema resolution. Financial Disclosures The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Key Words
- ANOVA, analysis of variance
- Anti-VEGF injections
- BSS, balanced salt solution
- CCT, central choroidal thickness
- CRT, central retinal thickness
- DME
- DME, diabetic macular edema
- Diabetic macular edema
- FAZ, foveal avascular zone
- ILM, internal limiting membrane
- SD, standard deviation
- SS-OCTA, swept-source OCT angiography
- Swept-source OCT angiography
- VA, visual acuity
- Vitrectomy
- dFAZ, deep FAZ
- dvD, vessel density in the deep retinal layers
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Affiliation(s)
- Zofia Anna Nawrocka
- Correspondence: Zofia Anna Nawrocka, MD, PhD, Ophthalmic Clinic “Jasne Blonia”, Rojna 90, Lodz, Poland.
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13
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Yuan Q, Liu Y, Gou Y, Xu H, Gao Y, Liu Y, Chen Y, Zhang M. Efficacy and safety of the dexamethasone implant in vitrectomized and nonvitrectomized eyes with diabetic macular edema: A systematic review and meta-analysis. Front Pharmacol 2022; 13:1029584. [DOI: 10.3389/fphar.2022.1029584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/21/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose: To compare the efficacy and safety of the intravitreal dexamethasone (DEX) implant for the treatment of diabetic macular edema (DME) in vitrectomized and nonvitrectomized eyes.Methods: We performed a literature search in four electronic databases (PubMed, EMBASE, MEDLINE, and Cochrane Library) from inception to 22 May 2022. Studies comparing the efficacy of the DEX implant in vitrectomized and nonvitrectomized eyes with DME with at least 3 months of follow-up were included. The main outcomes included comparison of the mean change in the best-corrected visual acuity (BCVA) and central macular thickness (CMT) from baseline to different follow-up endpoints between the vitrectomized and nonvitrectomized groups. The secondary outcomes were the mean duration of action for the first DEX implantation and the number of required injections throughout the follow-up period. Safety data were collected and compared.Results: The final analysis included 7 studies involving 582 eyes, 208 vitrectomized eyes and 374 nonvitrectomized eyes. The mean between-group differences in BCVA improvement were not significant at any endpoint, with averages difference of −0.07 logarithm of the minimum angle of resolution (logMAR) (p = 0.088) at 1 month, −0.03 logMAR (p = 0.472) 3 months, −0.07 logMAR (p = 0.066) 6 months, and −0.04 logMAR (p = 0.486) 12 months. The mean between-group differences in CMT reduction were not statistically significant, with mean differences of 7.17 μm (p = 0.685) at 1 month, 20.03 μm (p = 0.632) 3 months, −1.80 μm (p = 0.935) 6 months, and −25.65 μm (p = 0.542) 12 months. However, the vitrectomized group had a significantly shorter duration of action during the first DEX implantation than the nonvitrectomized group, with a mean difference of 0.8 months (p = 0.005). No significant between-group differences were detected for the number of required injections or safety profile.Conclusion: This meta-analysis showed similar efficacy and safety of the sustained-release DEX intravitreal implant for vitrectomized and nonvitrectomized eyes with DME. The intravitreal DEX implant could be considered an effective choice for DME treatment in eyes with prior vitrectomy.
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Kim S, Lee ES, Cha BS, Park KS. High Fructose Concentration Increases the Fluorescence Stability of DNA-Templated Copper Nanoclusters by Several Thousand Times. NANO LETTERS 2022; 22:6121-6127. [PMID: 35895973 DOI: 10.1021/acs.nanolett.2c01287] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
DNA-templated copper nanoclusters (CuNCs) have limited applications because of their low fluorescence stability (several tens of minutes). In this study, we prepared CuNCs with improved temporal fluorescence stability by introducing fructose into the CuNC synthesis process and optimizing the reaction conditions. The inclusion of fructose increased the operating lifetime of CuNCs by approximately 5200-fold from 30 min to 108 days and improved their stability against heat, acids, and bases compared to CuNCs synthesized under original conditions. In addition, the fluorescence signal of CuNCs was maintained for a significantly longer time when stored at refrigeration (4 °C) and freezing (-20 °C) temperatures. Importantly, this method did not require the addition of substances other than fructose or any additional physicochemical treatment to maintain the fluorescence of DNA-templated CuNCs for more than several tens of days. As such, this study could serve as a basis to improve the stability of CuNCs for various applications.
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Affiliation(s)
- Seokjoon Kim
- Department of Biological Engineering, College of Engineering, Konkuk University, Seoul 05029, Republic of Korea
| | - Eun Sung Lee
- Department of Biological Engineering, College of Engineering, Konkuk University, Seoul 05029, Republic of Korea
| | - Byung Seok Cha
- Department of Biological Engineering, College of Engineering, Konkuk University, Seoul 05029, Republic of Korea
| | - Ki Soo Park
- Department of Biological Engineering, College of Engineering, Konkuk University, Seoul 05029, Republic of Korea
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15
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Velentza-Almpani A, Ibeanu N, Liu T, Redhead C, Tee Khaw P, Brocchini S, Awwad S, Bouremel Y. Effects of Flow Hydrodynamics and Eye Movements on Intraocular Drug Clearance. Pharmaceutics 2022; 14:pharmaceutics14061267. [PMID: 35745839 PMCID: PMC9229170 DOI: 10.3390/pharmaceutics14061267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/09/2022] [Accepted: 06/12/2022] [Indexed: 02/06/2023] Open
Abstract
New in vitro prototypes (PK-Eye™) were tested with and without eye movement to understand diffusion and convection effects on intraocular clearance. Port placement in front ((i) ciliary inflow model) and behind the model lens ((ii) posterior inflow model) was used to study bevacizumab (1.25 mg/50 µL) and dexamethasone (0.1 mg/100 µL) in phosphate-buffered saline (PBS, pH 7.4) and simulated vitreal fluid (SVF). Dexamethasone was studied in a (iii) retinal-choroid-sclera (RCS) outflow model (with ciliary inflow and two outflow pathways). Ciliary vs. posterior inflow placement did not affect the half-life for dexamethasone at 2.0 µL/min using PBS (4.7 days vs. 4.8 days) and SVF (4.9 days with ciliary inflow), but it did decrease the half-life for bevacizumab in PBS (20.4 days vs. 2.4 days) and SVF (19.2 days vs. 10.8 days). Eye movement only affected the half-life of dexamethasone in both media. Dexamethasone in the RCS model showed approximately 20% and 75% clearance from the RCS and anterior outflows, respectively. The half-life of the protein was comparable to human data in the posterior inflow model. Shorter half-life values for a protein in a ciliary inflow model can be achieved with other eye movements. The RCS flow model with eye movement was comparable to human half-life data for dexamethasone.
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Affiliation(s)
- Angeliki Velentza-Almpani
- Optceutics Ltd., 28a Menelik Road, London NW2 3RP, UK; (A.V.-A.); (N.I.); (T.L.); (C.R.); (P.T.K.); (S.B.)
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Nkiruka Ibeanu
- Optceutics Ltd., 28a Menelik Road, London NW2 3RP, UK; (A.V.-A.); (N.I.); (T.L.); (C.R.); (P.T.K.); (S.B.)
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London EC1V 9EL, UK
| | - Tianyang Liu
- Optceutics Ltd., 28a Menelik Road, London NW2 3RP, UK; (A.V.-A.); (N.I.); (T.L.); (C.R.); (P.T.K.); (S.B.)
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
| | - Christopher Redhead
- Optceutics Ltd., 28a Menelik Road, London NW2 3RP, UK; (A.V.-A.); (N.I.); (T.L.); (C.R.); (P.T.K.); (S.B.)
| | - Peng Tee Khaw
- Optceutics Ltd., 28a Menelik Road, London NW2 3RP, UK; (A.V.-A.); (N.I.); (T.L.); (C.R.); (P.T.K.); (S.B.)
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London EC1V 9EL, UK
| | - Steve Brocchini
- Optceutics Ltd., 28a Menelik Road, London NW2 3RP, UK; (A.V.-A.); (N.I.); (T.L.); (C.R.); (P.T.K.); (S.B.)
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London EC1V 9EL, UK
| | - Sahar Awwad
- Optceutics Ltd., 28a Menelik Road, London NW2 3RP, UK; (A.V.-A.); (N.I.); (T.L.); (C.R.); (P.T.K.); (S.B.)
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London EC1V 9EL, UK
- Correspondence: (S.A.); (Y.B.); Tel.: +44-207-753-5802 (S.A.)
| | - Yann Bouremel
- Optceutics Ltd., 28a Menelik Road, London NW2 3RP, UK; (A.V.-A.); (N.I.); (T.L.); (C.R.); (P.T.K.); (S.B.)
- Department of Pharmaceutics, UCL School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London EC1V 9EL, UK
- Correspondence: (S.A.); (Y.B.); Tel.: +44-207-753-5802 (S.A.)
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16
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Yin S, Cui Y, Jiao W, Zhao B. Potential Prognostic Indicators for Patients With Retinal Vein Occlusion. Front Med (Lausanne) 2022; 9:839082. [PMID: 35692537 PMCID: PMC9174432 DOI: 10.3389/fmed.2022.839082] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
The second most prevalent cause of retinal vascular disease is retinal vein occlusion (RVO). RVO raises intravascular pressure in the capillary and veins, triggering vessel barrier collapse and subsequent leaking of blood or plasma components into the tissue (edema). Macular edema (ME) is a major complication of RVO that results in significant visual impairment. Laser therapy, intravitreal steroid injections, and vascular endothelial growth factor (VEGF) inhibitors are the major therapeutic techniques. Different therapies reduce ME of RVO and improve visual activity. However, some people have no impact on the resolution of ME, while others have a poor visual prognosis despite full ME cure. There are many investigators who studied the relationship between indicators of various instruments with visual activity. However, a summary of those findings is currently lacking. Therefore, we will focus on the predictive factors of different studies associated with positive visual activity outcomes, which would be very useful and important to help address both treatment expectations and methods for patients with RVO.
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Affiliation(s)
- Shan Yin
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yanyan Cui
- Department of Ophthalmology, Liaocheng People’s Hospital, Liaocheng, China
| | - Wanzhen Jiao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Bojun Zhao
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Bojun Zhao,
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Yeast-produced fructosamine-3-kinase retains mobility after ex vivo intravitreal injection in human and bovine eyes as determined by Fluorescence Correlation Spectroscopy. Int J Pharm 2022; 621:121772. [PMID: 35487399 DOI: 10.1016/j.ijpharm.2022.121772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 11/20/2022]
Abstract
Globally, over 2 billion people suffer from vision impairment. Despite complex multifactorial etiology, advanced glycation end products are involved in the pathogenesis of many causative age- and diabetes-related eye diseases. Deglycating enzyme fructosamine-3-kinase (FN3K) was recently proposed as a potential therapeutic, but for further biopharmaceutical development, knowledge on its manufacturability and stability and mobility in the vitreous fluid of the eye is indispensable. We evaluated recombinant production of FN3K in two host systems, and its diffusion behavior in both bovine and human vitreous. Compared to Escherichia coli, intracellular production in Pichia pastoris yielded more and higher purity FN3K. The yeast-produced enzyme was used in a first attempt to use fluorescence correlation spectroscopy to study protein mobility in non-sonicated bovine vitreous, human vitreous, and intact bovine eyes. It was demonstrated that FN3K retained mobility upon intravitreal injection, although a certain delay in diffusion was observed. Alkylation of free cysteines was tolerated both in terms of enzymatic activity and vitreous diffusion. Ex vivo diffusion data gathered and the availability of yeast-produced high purity enzyme now clear the path for in vivo pharmacokinetics studies of FN3K.
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18
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Kwon JW, Park YG. CLINICAL FEATURES OF INTRAVITREAL DEXAMETHASONE IMPLANTATION IN VITRECTOMIZED EYES OF PATIENTS WITH DIABETIC MACULAR EDEMA. Retina 2022; 42:782-788. [PMID: 34907121 DOI: 10.1097/iae.0000000000003380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To identify the clinical outcomes of intravitreal dexamethasone implantation (IVD) in previously vitrectomized eyes of patients with diabetic macular edema. METHOD We performed a retrospective observational study. We recorded central subfield thickness, best-corrected visual acuity, and intraocular pressure up to 12 months after IVD implant placement. We compared the duration of IVD action, intraocular pressure trends, and the prevalence of ocular hypertension after the first IVD treatment of nonvitrectomized and vitrectomized eyes. We also compared the central subfield thickness, best-corrected visual acuity, number of IVD treatments, and prevalence of ocular hypertension between the 2 groups after 12 months. RESULTS We found no significant between-group differences in the central subfield thickness, best-corrected visual acuity, or the prevalence of ocular hypertension during treatment. However, the duration of action of the first IVD treatment was significantly shorter in vitrectomized eyes, and these eyes required more IVD treatments during the 12-month follow-up period. The maximal average intraocular pressure was observed at 2 months after the first IVD treatment in the nonvitrectomized group, but 1 month after the first IVD treatment in the vitrectomized group. CONCLUSION These findings suggest that the IVD pharmacokinetics and pharmacodynamics differ between vitrectomized and nonvitrectomized eyes. Nevertheless, given the relatively long-lasting effectiveness of the treatment and the good clinical results, consecutive IVD treatments may be beneficial for patients with diabetic macular edema with previously vitrectomized eyes.
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Affiliation(s)
- Jin-Woo Kwon
- Department of Ophthalmology, St. Vincent's Hospital, College of Medicine, the Catholic University of Korea, Seoul, Korea; and
| | - Young-Gun Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
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19
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Srikantha N, Teijeiro-Gonzalez Y, Simpson A, Elsaid N, Somavarapu S, Suhling K, Jackson TL. Determining vitreous viscosity using fluorescence recovery after photobleaching. PLoS One 2022; 17:e0261925. [PMID: 35143514 PMCID: PMC8830689 DOI: 10.1371/journal.pone.0261925] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 12/14/2021] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Vitreous humor is a complex biofluid whose composition determines its structure and function. Vitreous viscosity will affect the delivery, distribution, and half-life of intraocular drugs, and key physiological molecules. The central pig vitreous is thought to closely match human vitreous viscosity. Diffusion is inversely related to viscosity, and diffusion is of fundamental importance for all biochemical reactions. Fluorescence Recovery After Photobleaching (FRAP) may provide a novel means of measuring intravitreal diffusion that could be applied to drugs and physiological macromolecules. It would also provide information about vitreous viscosity, which is relevant to drug elimination, and delivery. METHODS Vitreous viscosity and intravitreal macromolecular diffusion of fluorescently labelled macromolecules were investigated in porcine eyes using fluorescence recovery after photobleaching (FRAP). Fluorescein isothiocyanate conjugated (FITC) dextrans and ficolls of varying molecular weights (MWs), and FITC-bovine serum albumin (BSA) were employed using FRAP bleach areas of different diameters. RESULTS The mean (±standard deviation) viscosity of porcine vitreous using dextran, ficoll and BSA were 3.54 ± 1.40, 2.86 ± 1.13 and 4.54 ± 0.13 cP respectively, with an average of 3.65 ± 0.60 cP. CONCLUSIONS FRAP is a feasible and practical optical method to quantify the diffusion of macromolecules through vitreous.
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Affiliation(s)
- Nishanthan Srikantha
- School of Medicine, King’s College London, London, United Kingdom
- Department of Ophthalmology, King’s College Hospital, London, United Kingdom
- * E-mail:
| | | | - Andrew Simpson
- School of Medicine, King’s College London, London, United Kingdom
- Department of Ophthalmology, King’s College Hospital, London, United Kingdom
| | - Naba Elsaid
- Anglia Ruskin University, Bishop Hall Lane, Chelmsford, United Kingdom
| | - Satyanarayana Somavarapu
- Department of Pharmaceutics, University College London School of Pharmacy, London, United Kingdom
| | - Klaus Suhling
- Department of Physics, King’s College London, Strand, London, United Kingdom
| | - Timothy L. Jackson
- School of Medicine, King’s College London, London, United Kingdom
- Department of Ophthalmology, King’s College Hospital, London, United Kingdom
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Comparison of Intravitreal Dexamethasone Implant and Ranibizumab in Vitrectomized Eyes with Diabetic Macular Edema. J Ophthalmol 2021; 2021:8882539. [PMID: 34540287 PMCID: PMC8448602 DOI: 10.1155/2021/8882539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 08/26/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose This retrospective study aimed to compare the efficacy of intravitreal ranibizumab (IVR) and intravitreal dexamethasone implant (IDI) for pseudophakic vitrectomized eyes with diabetic macular edema (DME) in a single institution. Methods Pseudophakic vitrectomized eyes with treatment-naïve center-involved DME were enrolled, with one eye in each patient. They were divided into two groups: one group receiving IDI every 3 to 4 months and another group receiving IVR using 3 monthly plus treat-and-extend injections, all with monthly follow-up for 6 months. Switch of intravitreal drugs or deferred macular laser was not allowed. Primary outcome measures included change in central foveal thickness (CFT) in 1 mm by spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA) at Month 6. Results Twenty-two eyes were included in the IDI group and 26 eyes in the IVR group. The baseline demographics, glycosylated hemoglobin level, intraocular pressure (IOP), BCVA, and CFT did not significantly differ (p > 0.05). Compared to baseline data, CFT decreased and BCVA improved significantly after either IDI or IVR at Month 6 (p < 0.05). Significantly better mean final BCVA (0.38 logMAR vs. 0.62 logMAR, p=0.04), more mean visual gain (−0.30 logMAR vs. −0.15 logMAR, p=0.02), lower mean final CFT (310.9 μm vs. 384.2 μm, p=0.04), and larger mean CFT decrease (−150.0 μm vs. −60.1 μm, p=0.03) were found in the IDI group compared to those in the IVR group. A smaller mean treatment number (2.6 vs. 5.6, p < 0.001) and higher rate of postinjection ocular hypertension requiring topical hypotensive agent therapy (27.3% vs. 0%, p=0.0002) were demonstrated in the IDI group than those in the IVR group. Conclusion We concluded that IDI and IVR can both effectively treat vitrectomized eyes with DME. Dexamethasone implants had significantly better visual/anatomical improvement, smaller treatment number, and higher rate of elevated IOP after injection than IVR in pseudophakic vitrectomized eyes with DME in a 6-month period.
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Rimpelä AK, Cui Y, Sauer A. Mechanistic Model for the Prediction of Small-Molecule Vitreal Clearance Combining Diffusion-Limited and Permeability-Limited Clearance. Mol Pharm 2021; 18:2703-2713. [PMID: 34151575 DOI: 10.1021/acs.molpharmaceut.1c00236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The discovery of new small-molecule drugs for intravitreal administration would benefit from simple models to predict vitreal clearance (CL). The current models available have limitations in their applicability to small-molecule drugs and translatability to humans. We developed a mechanistic model combining the diffusion rate of the molecule in the vitreous and permeability across posterior segment tissues and applied it to 30 small molecules with observed CL available mostly from literature. We used Caco-2 permeability as a surrogate for ocular tissue permeability. The model predicted rabbit vitreal CL well, with 80% of the predictions being within a 2-fold range of the observed CL. For an accurate prediction, it was crucial to consider the anterior diffusion CL from the vitreous to the aqueous and a limiting diffusion CL for the whole eye. We observed no major differences in model accuracy when using literature permeability values from retinal pigment epithelial cell models. Importantly, by adopting the specific dimensions of the human eye, the model was able to accurately predict vitreal CL of four compounds for which human vitreal CL data are available. In summary, this mechanistic model enables a simple, accurate, and translatable estimation of small-molecule vitreal CL.
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Affiliation(s)
- Anna-Kaisa Rimpelä
- Department of Drug Discovery Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach, Germany
| | - Yunhai Cui
- Department of Drug Discovery Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach, Germany
| | - Achim Sauer
- Department of Drug Discovery Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach, Germany
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Zhang S, Penkova A, Humayun MS, Martinez-Camarillo JC, Tadle AC, Galesic A, Thompson ME, Pratt M, Gonzales-Calle A, Sadhal SS. In Vivo Experimental and Analytical Studies for Bevacizumab Diffusion Coefficient Measurement in the Rabbit Vitreous Humor. JOURNAL OF HEAT TRANSFER 2021; 143:032101. [PMID: 33612856 PMCID: PMC7871997 DOI: 10.1115/1.4049033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/21/2020] [Indexed: 05/30/2023]
Abstract
In order to measure the effective diffusion coefficient D of Bevacizumab (Avastin, Genentech) in the vitreous humor, a new technique is developed based on the "contour method" and in vivo optical coherence tomography measurements. After injection of Bevacizumab-fluorescein conjugated compound solution into the rabbit eye, the contours of drug concentration distribution at the subsurface of injection were tracked over time. The 2D contours were extrapolated to 3D contours using reasonable assumptions and a numerically integrated analytical model was developed for the theoretical contours for the irregularly shaped drug distribution in the experimental result. By floating the diffusion coefficient, different theoretical contours were constructed and the least-squares best fit to the experimental contours was performed at each time point to get the best fit solution. The approach generated consistent diffusion coefficient values based on the experiments on four rabbit eyes over a period of 3 h each, which gave D = 1.2 ± 0.6 × 10 - 6 cm 2 / s , and the corresponding theoretical contours matched well with the experimental contours. The quantitative measurement of concentration using optical coherence tomography and fluorescein labeling gives a new approach for the "noncontact" in vivo drug distribution measurement within vitreous.
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Affiliation(s)
- Shuqi Zhang
- Department of Aerospace & Mechanical Engineering, University of Southern California, USC Viterbi School of Engineering, Los Angeles, CA 90089-1453
| | - Anita Penkova
- Department of Aerospace & Mechanical Engineering, University of Southern California, USC Viterbi School of Engineering, Los Angeles, CA 90089-1453; Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA 90027
| | - Mark S. Humayun
- Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, CA 90033-4682; Department of Integrative Anatomical Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033-4682; Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089-1111; USC Ginsburg Institute for Biomedical Therapeutics, Department of Ophthalmology, University of Southern California, Los Angeles, CA 90033
| | - Juan Carlos Martinez-Camarillo
- Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, CA 90033-4682; Department of Integrative Anatomical Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033-4682; USC Ginsburg Institute for Biomedical Therapeutics, Department of Ophthalmology, University of Southern California, Los Angeles, CA 90033
| | - Abegail C. Tadle
- Department of Chemistry, University of Southern California, Los Angeles, CA 90089-1062
| | - Ana Galesic
- Department of Chemistry, University of Southern California, Los Angeles, CA 90089-1062
| | - Mark E. Thompson
- Department of Chemistry, University of Southern California, Los Angeles, CA 90089-1062; Mork Family Department of Chemical Engineering & Materials Science, University of Southern California, Los Angeles, CA 90089-1211
| | - Matthew Pratt
- Department of Chemistry, University of Southern California, Los Angeles, CA 90089-1062; Department of Biological Sciences, University of Southern California, Los Angeles, CA 90089-0371
| | - Alejandra Gonzales-Calle
- USC Ginsburg Institute for Biomedical Therapeutics, Department of Ophthalmology, University of Southern California, Los Angeles, CA 90033
| | - Satwindar Singh Sadhal
- Department of Aerospace & Mechanical Engineering, University of Southern California, USC Viterbi School of Engineering, Los Angeles, CA 90089-1453; Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA 90027; Department of Ophthalmology, USC Roski Eye Institute, University of Southern California, Los Angeles, CA 90033-4682; Department of Integrative Anatomical Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033-4682
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Jia H, Huang W, Han Y, Wang Q, He J, Song J, Dai J, Yan H, Liu D. Investigation on the effects of SiO2 nanoparticles with different surface affinity on the viscoelasticity of wormlike micelles. J Mol Liq 2021. [DOI: 10.1016/j.molliq.2020.114675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Yao T, Yang Y, Jin X, Wang Y, Zhou Y, Xu A, He F, Wang Z. Intraocular pharmacokinetics of anti-vascular endothelial growth factor agents by intraoperative subretinal versus intravitreal injection in silicone oil-filled eyes of proliferative diabetic retinopathy: a randomized controlled pilot study. Acta Ophthalmol 2020; 98:e795-e800. [PMID: 32114709 DOI: 10.1111/aos.14386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 02/05/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Intraoperative subretinal anti-vascular endothelial growth factor (VEGF) injections have been used clinically in some case, but the pharmacokinetic characteristics have not yet been determined. In this pilot study, we investigate the pharmacokinetic parameters of anti-VEGF agents by intraoperative subretinal or intravitreal injection in silicone oil (SiO)-filled eyes of patients with proliferative diabetic retinopathy (PDR). METHODS Randomized controlled trial including 13 patients (16 eyes) with PDR underwent pars plana vitrectomy (PPV) with SiO tamponade and randomly received a subretinal (8 eyes) or intravitreal (8 eyes) conbercept injection (0.5 mg/0.05 ml) intraoperatively. Aqueous humour (AH) was obtained on the 1st, 3rd, 7th, 10th, 14th, 21st and 28th day after the injection. Drug concentrations in the AH were determined by enzyme-linked immunosorbent assay (ELISA). The last best-corrected visual acuity (BCVA) was examined 6 months postoperatively. RESULTS The clearance rate of anti-VEGF agents by subretinal injection was reduced in vitrectomized eyes with SiO tamponade (p < 0.05). With the same drug dose, subretinal injection (5.49 ± 6.11 μg/ml) resulted in higher drug concentrations in the AH when compared with intravitreal injection (0.42 ± 0.46 μg/ml, p = 0.001) 4 weeks after the treatment. The mean residence time last (MRT0-t ) by subretinal injection (11.57 ± 0.83 days) was significantly longer than the mean MRT0-t by intravitreal injection (7.10 ± 1.00 days, p < 0.001). A self-paired analysis showed that subretinal injection led to the BCVA improvement by +28.59 letters 6 months postoperatively (p = 0.028) while the BCVA did not improve significantly by intravitreal injection (p = 0.715). CONCLUSIONS The drug maintenance phase was prolonged by intraoperative subretinal injection in SiO-filled eyes of PDR. The results suggest that subretinal injection might be a valuable treatment option for the management of PDR.
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Affiliation(s)
- Teng‐teng Yao
- Department of Ophthalmology Shanghai Ninth People's Hospital Shanghai Jiaotong University School of Medicine Shanghai China
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology Shanghai China
| | - Yuan Yang
- Department of Ophthalmology Shanghai Ninth People's Hospital Shanghai Jiaotong University School of Medicine Shanghai China
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology Shanghai China
| | - Xiao‐liang Jin
- Department of Ophthalmology Shanghai Ninth People's Hospital Shanghai Jiaotong University School of Medicine Shanghai China
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology Shanghai China
| | - Yi‐xiao Wang
- Department of Ophthalmology Shanghai Ninth People's Hospital Shanghai Jiaotong University School of Medicine Shanghai China
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology Shanghai China
| | - Ya‐li Zhou
- Department of Ophthalmology Shanghai Ninth People's Hospital Shanghai Jiaotong University School of Medicine Shanghai China
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology Shanghai China
| | - A‐jing Xu
- Department of Pharmacy Xinhua Hospital School of Medicine Shanghai Jiaotong University School of Medicine Shanghai China
| | - Fang‐lin He
- Department of Ophthalmology Shanghai Ninth People's Hospital Shanghai Jiaotong University School of Medicine Shanghai China
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology Shanghai China
| | - Zhao‐yang Wang
- Department of Ophthalmology Shanghai Ninth People's Hospital Shanghai Jiaotong University School of Medicine Shanghai China
- Shanghai Key Laboratory of Orbital Disease and Ocular Oncology Shanghai China
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Thakur SS, Pan X, Kumarasinghe GL, Yin N, Pontré BP, Vaghefi E, Rupenthal ID. Relationship between rheological properties and transverse relaxation time (T2) of artificial and porcine vitreous humour. Exp Eye Res 2020; 194:108006. [DOI: 10.1016/j.exer.2020.108006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 12/20/2022]
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Thakur SS, Shenoy SK, Suk JS, Hanes JS, Rupenthal ID. Validation of hyaluronic acid-agar-based hydrogels as vitreous humor mimetics for in vitro drug and particle migration evaluations. Eur J Pharm Biopharm 2020; 148:118-125. [PMID: 31981693 DOI: 10.1016/j.ejpb.2020.01.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/16/2020] [Accepted: 01/19/2020] [Indexed: 12/26/2022]
Abstract
Artificial vitreous humor holds immense potential for use in in vitro intravitreal drug delivery assays. In this study, we investigated rheological properties and drug or nanoparticle migration in hyaluronic acid (HA) - agar based hydrogels and compared these characteristics with bovine vitreous humor. Gel compositions identified in literature containing HA (0.7-5.0 mg/ml) and agar (0.95-4.0 mg/ml) were classified as either high (VH), medium (VM) or low (VL) polymer load. Viscoelastic behavior was evaluated using oscillatory rheology, and migration of differently sized and charged polystyrene nanoparticles (NPs) through the different gels was determined via multiple particle tracking. Comparable rheological behaviour was observed between VL and bovine vitreous. Tracking evaluations revealed that increasing particle size and gel viscosity slowed NP migration. Additionally, 100 nm anionic NPs migrated slower than neutral NPs in VL and VM, while cationic NPs were immobile in all gels. Finally, distribution and clearance of sodium fluorescein was used to model drug mobility through the gels using a custom-built eye model. Flow and angular movement only influenced drug migration in VL and VM, but not VH. Finally, VL and VM demonstrated to have the most similar sodium fluorescein clearance to that of bovine vitreous humor. Together, these evaluations demonstrate that low viscosity HA-agar gels can be used to approximate nanoparticle and drug migration through biological vitreous humor.
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Affiliation(s)
- Sachin S Thakur
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Siddharth K Shenoy
- Center for Nanomedicine, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Jung Soo Suk
- Center for Nanomedicine, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA; Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Justin S Hanes
- Center for Nanomedicine, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA; Department of Pharmacology & Molecular Sciences, Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA; Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD 21218, USA; Department of Ophthalmology, Johns Hopkins University School of Medicine, 400 North Broadway, Baltimore, MD 21231, USA
| | - Ilva D Rupenthal
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
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Flikier S, Wu A, Wu L. Revisiting pars plana vitrectomy in the primary treatment of diabetic macular edema in the era of pharmacological treatment. Taiwan J Ophthalmol 2020; 9:224-232. [PMID: 31942427 PMCID: PMC6947753 DOI: 10.4103/tjo.tjo_61_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/02/2019] [Indexed: 11/16/2022] Open
Abstract
Diabetic macular edema (DME) is the most common cause of moderate visual loss in diabetic patients. The current treatment of choice for center-involved DME is anti-vascular endothelial growth factor (VEGF) treatment. Most patients that undergo pharmacological inhibition with anti-VEGF agents need multiple monitoring visits that include optical coherence tomography imaging and multiple injections. Despite this intensive treatment, up to 60% of eyes will have persistent DME after six consecutive monthly injections of an anti-VEGF. Its sustainability over the long term has been questioned. Pars plana vitrectomy (PPV) by increasing the vitreous cavity oxygenation, relieving vitreomacular traction, and removing cytokines from the vitreous cavity may cause long-term resolution of DME without the aforementioned concerns in selected cases. Eyes with vitreomacular traction clearly benefit from PPV as the primary treatment. The role of PPV for eyes with DME without tractional elements is less clear and needs to be explored further.
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Affiliation(s)
| | - Andres Wu
- Macula, Vitreous and Retina Associates of Costa RIca, San José, Costa Rica
| | - Lihteh Wu
- Macula, Vitreous and Retina Associates of Costa RIca, San José, Costa Rica
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28
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A New Slip Length Model for Enhanced Water Flow Coupling Molecular Interaction, Pore Dimension, Wall Roughness, and Temperature. ADVANCES IN POLYMER TECHNOLOGY 2019. [DOI: 10.1155/2019/6424012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this paper, a slip length model is proposed to analyze the enhanced flow based on the Hagen–Poiseuille equation. The model considers the multimechanisms including wall-water molecular interactions, pore dimensions, fractal roughness, and temperature. The increasing wall-water interactions result in the greater slip length and flow enhancement factor. The increased temperature enhances the kinetic energy of water molecules that leads to great surface diffusion coefficient and small work of adhesion. The wall roughness can decrease the slip length and flow enhancement factor in hydrophilic nanopores. This work studies the effects of multimechanisms on slip length and flow enhancement factor theoretically, which can accurately describe the liquid flow in nanopores.
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Crowell SR, Wang K, Famili A, Shatz W, Loyet KM, Chang V, Liu Y, Prabhu S, Kamath AV, Kelley RF. Influence of Charge, Hydrophobicity, and Size on Vitreous Pharmacokinetics of Large Molecules. Transl Vis Sci Technol 2019; 8:1. [PMID: 31695962 PMCID: PMC6827426 DOI: 10.1167/tvst.8.6.1] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/24/2019] [Indexed: 01/04/2023] Open
Abstract
Purpose Development of therapeutics for retinal disease with improved durability is hampered by inadequate understanding of pharmacokinetic (PK) drivers following intravitreal injection. Previous work shows that hydrodynamic radius is correlated with vitreal half-life over the range of 3 to 7 nm, and that charge and hydrophobicity influence systemic clearance. Better understanding the molecular attributes affecting vitreal elimination half-life enables improved design of therapeutics and enhances clinical translatability. Methods Impacts of charge and hydrophobicity on vitreal PK in the rabbit were systematically assessed using antibody and antibody fragment (Fab) variant series, including ranibizumab, altered through amino acid changes in hypervariable regions of the light chain. The impact of molecule size on vitreal PK was assessed in the rabbit, nonhuman primate, and human for a range of molecules (1–45 nm, net charge −1324 to +22.9 in rabbit), including published and internal data. Results No correlation was observed between vitreal PK and charge or hydrophobicity. Equivalent rabbit vitreal PK was observed for ranibizumab and its variants with isoelectric points (pI) in the range of 6.8 to 10.2, and hydrophobicities of the variable domain unit (FvHI) between 1009 and 1296; additional variant series had vitreal PK similarly unaffected by pI (5.4–10.2) and FvHI (1004–1358). Strong correlations were observed between vitreal half-life and hydrodynamic radius for preclinical species (R2 = 0.8794–0.9366). Conclusions Diffusive properties of soluble large molecules, as quantified by hydrodynamic radius, make a key contribution to vitreal elimination, whereas differences in charge or hydrophobicity make minor or negligible contributions. Translational Relevance These results support estimation of vitreal elimination rates based on molecular size in relevant preclinical species and humans.
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Affiliation(s)
- Susan R Crowell
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech, South San Francisco, CA, USA
| | - Kathryn Wang
- Drug Delivery, Genentech, South San Francisco, CA, USA
| | - Amin Famili
- Drug Delivery, Genentech, South San Francisco, CA, USA
| | - Whitney Shatz
- Protein Chemistry, Genentech, South San Francisco, CA, USA
| | - Kelly M Loyet
- Biochemical and Cellular Pharmacology, Genentech, South San Francisco, CA, USA
| | - Vincent Chang
- Bioanalytical Sciences, Genentech, South San Francisco, CA, USA
| | - Yanqiu Liu
- Bioanalytical Sciences, Genentech, South San Francisco, CA, USA
| | - Saileta Prabhu
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech, South San Francisco, CA, USA
| | - Amrita V Kamath
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech, South San Francisco, CA, USA
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Preoperative Intravitreal Conbercept Facilitates Vitrectomy in Proliferative Diabetic Retinopathy: Is Attention Required for the Fellow Eye? J Ophthalmol 2019; 2019:2923950. [PMID: 31467691 PMCID: PMC6701355 DOI: 10.1155/2019/2923950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 06/16/2019] [Accepted: 07/25/2019] [Indexed: 01/01/2023] Open
Abstract
Purpose To evaluate the effect of preoperative intravitreal conbercept (IVC) injection on patients with proliferative diabetic retinopathy (PDR). Methods Medical records of patients who underwent vitrectomy due to complications of PDR were retrospectively reviewed. Patients were grouped as the IVC group and non-IVC group according to preoperative IVC. Preoperative, intraoperative, and postoperative data of both eyes were collected. The main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), central retinal thickness (CRT), and incidence of tractional retinal detachment (TRD). Results A total of 37 cases were included, 16 in the IVC group and 21 in the non-IVC group. Preoperative IVC significantly reduced surgical duration (IVC vs. non-IVC, 88.9 ± 11.9 min vs. 97.8 ± 12.8 min, p < 0.05). In the vitrectomized eye, no significant difference existed between the IVC group and non-IVC group regarding postoperative BCVA (logMAR, 1.20 ± 0.53 vs. 1.27 ± 0.54, p = 0.68), IOP (16.5 ± 2.9 mmHg vs. 15.6 ± 3.7 mmHg, p = 0.44), and CRT (330.1 ± 35.2 μm vs. 319.2 ± 32.5 μm, p=0.34). In the fellow eye, 6 cases in the IVC group were diagnosed with TRD during postoperative follow-up, while only 2 cases were diagnosed in the non-IVC group (p < 0.05). Conclusion Preoperative intravitreal injection of conbercept has effectively facilitated vitrectomy in PDR patients, but it potentially promotes tractional retinal detachment in the fellow eye following preoperative injection.
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Sırakaya E, Küçük B, Ağadayı A. Aflibercept Treatment for Macular Edema following Branch Retinal Vein Occlusion: Age-Based Responses. Ophthalmologica 2019; 243:94-101. [DOI: 10.1159/000502042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/10/2019] [Indexed: 11/19/2022]
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García-Quintanilla L, Luaces-Rodríguez A, Gil-Martínez M, Mondelo-García C, Maroñas O, Mangas-Sanjuan V, González-Barcia M, Zarra-Ferro I, Aguiar P, Otero-Espinar FJ, Fernández-Ferreiro A. Pharmacokinetics of Intravitreal Anti-VEGF Drugs in Age-Related Macular Degeneration. Pharmaceutics 2019; 11:pharmaceutics11080365. [PMID: 31370346 PMCID: PMC6723750 DOI: 10.3390/pharmaceutics11080365] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/27/2022] Open
Abstract
Intravitreal administration of anti-vascular endothelial growth factor (VEGF) antibodies has become the standard treatment for Age-Related Macular Degeneration; however, the knowledge of their pharmacokinetics is limited. A comprehensive review of the preclinical and clinical pharmacokinetic data that were obtained in different studies with intravitreal bevacizumab, ranibizumab, and aflibercept has been conducted. Moreover, the factors that can influence the vitreous pharmacokinetics of these drugs, as well as the methods that were used in the studies for analytical determination, have been exposed. These anti-VEGF drugs present different charge and molecular weights, which play an important role in vitreous distribution and elimination. The pharmacokinetic parameters that were collected differ depending on the species that were involved in the studies and on physiological and pathological conditions, such as vitrectomy and lensectomy. Knowledge of the intravitreal pharmacokinetics of the anti-VEGF drugs that were used in clinical practice is of vital importance.
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Affiliation(s)
- Laura García-Quintanilla
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Andrea Luaces-Rodríguez
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
| | - María Gil-Martínez
- Ophthalmology Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
| | - Cristina Mondelo-García
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Olalla Maroñas
- Genomic Medicine Group, Galician Public Foundation of Genomic Medicine, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Víctor Mangas-Sanjuan
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, 46100 Valencia, Spain
- Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia, 46100 Valencia, Spain
| | - Miguel González-Barcia
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Irene Zarra-Ferro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Pablo Aguiar
- Nuclear Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain
- Molecular Imaging Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute of Santiago de Compostela (FIDIS), 15706 Santiago de Compostela, Spain.
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain.
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Development of innovative medical devices by dispersing fatty acid eutectic blend on gauzes using supercritical particle generation processes. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 99:599-610. [DOI: 10.1016/j.msec.2019.02.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/26/2018] [Accepted: 02/03/2019] [Indexed: 11/23/2022]
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Castro-Balado A, Mondelo-García C, González-Barcia M, Zarra-Ferro I, Otero-Espinar FJ, Ruibal-Morell Á, Aguiar-Fernández P, Fernández-Ferreiro A. Ocular Biodistribution Studies using Molecular Imaging. Pharmaceutics 2019; 11:pharmaceutics11050237. [PMID: 31100961 PMCID: PMC6572242 DOI: 10.3390/pharmaceutics11050237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/05/2019] [Accepted: 05/07/2019] [Indexed: 02/07/2023] Open
Abstract
Classical methodologies used in ocular pharmacokinetics studies have difficulties to obtain information about topical and intraocular distribution and clearance of drugs and formulations. This is associated with multiple factors related to ophthalmic physiology, as well as the complexity and invasiveness intrinsic to the sampling. Molecular imaging is a new diagnostic discipline for in vivo imaging, which is emerging and spreading rapidly. Recent developments in molecular imaging techniques, such as positron emission tomography (PET), single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI), allow obtaining reliable pharmacokinetic data, which can be translated into improving the permanence of the ophthalmic drugs in its action site, leading to dosage optimisation. They can be used to study either topical or intraocular administration. With these techniques it is possible to obtain real-time visualisation, localisation, characterisation and quantification of the compounds after their administration, all in a reliable, safe and non-invasive way. None of these novel techniques presents simultaneously high sensitivity and specificity, but it is possible to study biological procedures with the information provided when the techniques are combined. With the results obtained, it is possible to assume that molecular imaging techniques are postulated as a resource with great potential for the research and development of new drugs and ophthalmic delivery systems.
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Affiliation(s)
- Ana Castro-Balado
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Cristina Mondelo-García
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Miguel González-Barcia
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Irene Zarra-Ferro
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Francisco J Otero-Espinar
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.
| | - Álvaro Ruibal-Morell
- Nuclear Medicine Department, University Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela, 15706 Santiago de Compostela, Spain.
- Molecular Imaging Group. Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Pablo Aguiar-Fernández
- Nuclear Medicine Department, University Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela, 15706 Santiago de Compostela, Spain.
- Molecular Imaging Group. Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
| | - Anxo Fernández-Ferreiro
- Pharmacy Department, University Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, Spain.
- Pharmacology Group, Health Research Institute Santiago Compostela (IDIS), 15706 Santiago de Compostela, Spain.
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology and Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), 15706 Santiago de Compostela, Spain.
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Penkova A, Moats R, Humayun MS, Fraser S, Sadhal SS. Diffusive Transport in the Vitreous Humor: Experimental and Analytical Studies. JOURNAL OF HEAT TRANSFER 2019; 141:050801. [PMID: 35832509 PMCID: PMC9201755 DOI: 10.1115/1.4042297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/11/2018] [Indexed: 06/01/2023]
Abstract
In relation to intravitreal drug delivery, predictive mathematical models for drug transport are being developed, and to effectively implement these for retinal delivery, the information on biophysical properties of various ocular tissues is fundamentally important. It is therefore necessary to accurately measure the diffusion coefficient of drugs and drug surrogates in the vitreous humor. In this review, we present the studies conducted by various researchers on such measurements over the last several decades. These include imaging techniques (fluorescence and magnetic resonance imaging (MRI)) that make use of introducing a contrast agent or a labeled drug into the vitreous and tracking its diffusive movement at various time points. A predictive model for the same initial conditions when matched with the experimental measurements provides the diffusion coefficient, leading to results for various molecules ranging in size from approximately 0.1 to 160 kDa. For real drugs, the effectiveness of this system depends on the successful labeling of the drugs with suitable contrast agents such as fluorescein and gadolinium or manganese so that fluorescence or MR imagining could be conducted. Besides this technique, some work has been carried out using the diffusion apparatus for measuring permeation of a drug across an excised vitreous body from a donor chamber to the receptor by sampling assays from the chambers at various time intervals. This has the advantage of not requiring labeling but is otherwise more disruptive to the vitreous. Some success with nanoparticles has been achieved using dynamic light scattering (DLS), and presently, radioactive labeling is being explored.
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Affiliation(s)
- Anita Penkova
- Department of Aerospace & Mechanical Engineering, University of Southern California, Los Angeles, CA 90089-1453
| | - Rex Moats
- Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA 90027
| | - Mark S Humayun
- Department of Ophthalmology, USC Roski Eye Institute, Department of Integrative Anatomical Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033-4682; Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089-1111
| | - Scott Fraser
- Departments of Molecular and Computational Biology, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089-0371
| | - Satwindar Singh Sadhal
- Department of Aerospace & Mechanical Engineering, University of Southern California, Los Angeles, CA 90089-1453
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Retinal oximetry: Metabolic imaging for diseases of the retina and brain. Prog Retin Eye Res 2019; 70:1-22. [DOI: 10.1016/j.preteyeres.2019.04.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/27/2019] [Accepted: 04/10/2019] [Indexed: 12/20/2022]
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Nikfar Z, Shariatinia Z. The RGD tripeptide anticancer drug carrier: DFT computations and molecular dynamics simulations. J Mol Liq 2019. [DOI: 10.1016/j.molliq.2019.02.114] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Houben I, De Zaeytijd J, Deghislage C, Frost NA, Nijs I, Van Calster J. Efficacy of Multiple Dexamethasone Intravitreal Implants for Refractory Retinal Vein Occlusion-Related Macular Edema and Effect of Prior Vitrectomy. J Ocul Pharmacol Ther 2018; 34:710-719. [PMID: 30403557 DOI: 10.1089/jop.2018.0012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose: To evaluate the efficacy of dexamethasone intravitreal implants (DEX implant) in patients with treatment-resistant macular edema (ME) owing to branch and central retinal vein occlusion (BRVO/CRVO), and the influence of prior vitrectomy on this treatment. Methods: Multicenter retrospective chart review was performed on 40 CRVO and 32 BRVO eyes with persistent ME despite intravitreal anti-vascular endothelial growth factor agents and/or intravitreal triamcinolone, and/or laser therapy. Each patient received ≥1 dexamethasone 700 μg implant between March 2011 and December 2015. Thirteen patients underwent prior vitrectomy. Data were collected on best-corrected visual acuity (BCVA), central macular thickness (CMT), time to relapse, and adverse events. Results: At the end of follow-up, BRVO eyes had a lesser CMT reduction from baseline compared to CRVO eyes (-122.50 ± 152.47 μm and -202.26 ± 194.09 μm, respectively). Neither BRVO nor CRVO eyes had a sustained BCVA benefit (P = 0.7041 and P = 0.7027, respectively). Vitrectomized and nonvitrectomized eyes overall had a sustained significant CMT reduction throughout the study with -192.46 ± 172.62 μm and -164.02 ± 180.36 μm, respectively, at final follow-up. Similar time to relapse of 24.4 ± 6.5 and 23.3 ± 13.5 weeks, respectively, was observed. By the end of follow-up, BCVA had only improved in vitrectomized eyes. However, multivariable regression analyses showed no significant association between vitrectomy status and CMT or BCVA change after the first and last injection. Cataract formation and ocular hypertension occurred in 25% and 17%, respectively. Conclusions: Multiple DEX implant are effective in reducing CMT in patients resistant to previous treatments and appear to be similarly effective in vitrectomized and nonvitrectomized eyes.
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Affiliation(s)
- Isabeau Houben
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.,Faculty of Medicine, Master of Specialist Studies in Medicine: Ophthalmology, Catholic University of Leuven, Leuven, Belgium
| | - Julie De Zaeytijd
- Medical Retina and Visual Electrophysiology Division, Department of Ophthalmology, University Hospital Ghent, Gent, Belgium
| | - Catherine Deghislage
- Vitreoretinal Division, Department of Ophthalmology, East Limburg Hospital, Genk, Belgium.,Oogartsen Associatie Maasmechelen, Maasmechelen, Belgium
| | - N Andrew Frost
- Department of Ophthalmology, Torbay Hospital, Lowes Bridge, Torquay, Devon, United Kingdom
| | - Ivo Nijs
- Oogartsen Associatie Maasmechelen, Maasmechelen, Belgium.,Department of Ophthalmology, East Limburg Hospital, Genk, Belgium
| | - Joachim Van Calster
- Vitreoretinal Division, Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
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Modified Vitrectomy Technique for Phakic Rhegmatogenous Retinal Detachment with Intermediate Break. J Ophthalmol 2018; 2018:6127932. [PMID: 30425854 PMCID: PMC6218725 DOI: 10.1155/2018/6127932] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/06/2018] [Accepted: 10/01/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the effects of a modification of the traditional 25-gauge pars plana vitrectomy technique in the treatment of uncomplicated macula-on rhegmatogenous retinal detachment (RRD) with intermediate retinal break(s) and marked vitreous traction in the phakic eye. Methods Prospective, noncomparative, and interventional case series. All consecutive phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, with at least 1 year of postoperative follow-up, were enrolled. In all eyes, "localized 25-gauge vitrectomy" under air infusion with localized removal of the vitreous surrounding the retinal break(s), in association with laser photocoagulation and air tamponade, was performed. The primary end point was the rate of primary retinal attachment. Secondary end points were cataract progression and assessed by digital Scheimpflug lens photography (mean change of nuclear density units) and the rate of complications. Results Thirty-two phakic eyes were included in the final analysis. At 12 months, the primary outcome of anatomical success was achieved in 94% of eyes. The mean nuclear density units did not change significantly at any time point during the follow-up. After localized vitrectomy, one eye developed an epiretinal membrane, and one eye developed cystoid macular edema; no other significant complications were reported. Conclusions "Localized vitrectomy" has a high anatomical success rate in phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, without causing progression of cataract.
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Diffusion through the ex vivo vitreal body – Bovine, porcine, and ovine models are poor surrogates for the human vitreous. Int J Pharm 2018; 550:207-215. [DOI: 10.1016/j.ijpharm.2018.07.070] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 11/21/2022]
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Rezkallah A, Malclès A, Dot C, Voirin N, Agard É, Vié AL, Denis P, Mathis T, Kodjikian L. Evaluation of Efficacy and Safety of Dexamethasone Intravitreal Implants of Vitrectomized and Nonvitrectomized Eyes in a Real-World Study. J Ocul Pharmacol Ther 2018; 34:596-602. [DOI: 10.1089/jop.2018.0007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Amina Rezkallah
- Department of Ophthalmology, Croix-Rousse university Hospital, Hospices Civils de Lyon, Lyon, France
| | - Ariane Malclès
- Department of Ophthalmology, Croix-Rousse university Hospital, Hospices Civils de Lyon, Lyon, France
| | - Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France. French Military Health Service Academy, Val de Grâce, Paris, France
| | - Nicolas Voirin
- EPIMOD, Epidemiology and Modelling, Dompierre sur Veyle, France
| | - Émilie Agard
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France. French Military Health Service Academy, Val de Grâce, Paris, France
| | - Anne-Laure Vié
- Department of Ophthalmology, Croix-Rousse university Hospital, Hospices Civils de Lyon, Lyon, France
| | - Philippe Denis
- Department of Ophthalmology, Croix-Rousse university Hospital, Hospices Civils de Lyon, Lyon, France
| | - Thibaud Mathis
- Department of Ophthalmology, Croix-Rousse university Hospital, Hospices Civils de Lyon, Lyon, France
- UMR-CNRS 5510 Matéis, University of Medicine Lyon 1, Lyon, France
| | - Laurent Kodjikian
- Department of Ophthalmology, Croix-Rousse university Hospital, Hospices Civils de Lyon, Lyon, France
- UMR-CNRS 5510 Matéis, University of Medicine Lyon 1, Lyon, France
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Rezkallah A, Malclès A, Dot C, Voirin N, Agard É, Vié AL, Denis P, Mathis T, Kodjikian L. Evaluation of efficacy and safety of dexamethasone intravitreal implants before and after vitrectomy in a real-life study. Acta Ophthalmol 2018; 96:e544-e546. [PMID: 29214742 DOI: 10.1111/aos.13608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Amina Rezkallah
- Department of Ophthalmology; Croix-Rousse Teaching Hospital; Hospices Civils de Lyon; UMR-CNRS 5510 Matéis; University of Medicine Lyon 1; Lyon France
| | - Ariane Malclès
- Department of Ophthalmology; Croix-Rousse Teaching Hospital; Hospices Civils de Lyon; UMR-CNRS 5510 Matéis; University of Medicine Lyon 1; Lyon France
| | - Corinne Dot
- Department of Ophthalmology; Desgenettes Military Hospital; Lyon France
- French Military Health Service Academy; Val de Grâce; Paris France
| | - Nicolas Voirin
- Department of Ophthalmology; Croix-Rousse Teaching Hospital; Hospices Civils de Lyon; UMR-CNRS 5510 Matéis; University of Medicine Lyon 1; Lyon France
| | - Émilie Agard
- Department of Ophthalmology; Desgenettes Military Hospital; Lyon France
- French Military Health Service Academy; Val de Grâce; Paris France
| | - Anne-Laure Vié
- Department of Ophthalmology; Croix-Rousse Teaching Hospital; Hospices Civils de Lyon; UMR-CNRS 5510 Matéis; University of Medicine Lyon 1; Lyon France
| | - Philippe Denis
- Department of Ophthalmology; Croix-Rousse Teaching Hospital; Hospices Civils de Lyon; UMR-CNRS 5510 Matéis; University of Medicine Lyon 1; Lyon France
| | - Thibaud Mathis
- Department of Ophthalmology; Croix-Rousse Teaching Hospital; Hospices Civils de Lyon; UMR-CNRS 5510 Matéis; University of Medicine Lyon 1; Lyon France
| | - Laurent Kodjikian
- Department of Ophthalmology; Croix-Rousse Teaching Hospital; Hospices Civils de Lyon; UMR-CNRS 5510 Matéis; University of Medicine Lyon 1; Lyon France
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Comparison of the Effect of Intravitreal Dexamethasone Implant in Vitrectomized and Nonvitrectomized Eyes for the Treatment of Diabetic Macular Edema. J Ophthalmol 2018; 2018:1757494. [PMID: 29850199 PMCID: PMC5937369 DOI: 10.1155/2018/1757494] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 03/22/2018] [Accepted: 04/03/2018] [Indexed: 12/25/2022] Open
Abstract
Purpose To compare the effectiveness of sustained-release dexamethasone (DEX) intravitreal implant in nonvitrectomized eyes and vitrectomized eyes with diabetic macular edema (DME). Methods A retrospective review of the medical records of 40 eyes of 30 consecutive patients with diabetic macular edema who underwent intravitreal DEX implant injection. Patients were divided into 2 subgroups: 31 eyes that were nonvitrectomized (group 1) and 9 eyes that had previously undergone standard pars plana vitrectomy (group 2). The main outcome measures were BCVA and foveal thickness (FT). Results A significant improvement was seen in BCVA in both group 1 and group 2 at the 1st, 2nd, and 6th months after treatment with DEX implant (p < 0.05). In group 1, a significant reduction in FT was observed at the 1st, 2nd, and 6th months (p < 0.05). In group 2, a significant reduction in FT was seen at the 1st and 2nd months (p < 0.05), but the reduction rate at the 6th month after the injection was not statistically significant (p = 0.06). Conclusion DEX implant is effective for the treatment of diabetic macular edema, and the effectiveness of the drug is similar in vitrectomized and nonvitrectomized eyes.
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Michalewska Z, Stewart MW, Landers MB, Bednarski M, Adelman RA, Nawrocki J. Vitrectomy in the management of diabetic macular edema in treatment-naïve patients. Can J Ophthalmol 2017; 53:402-407. [PMID: 30119796 DOI: 10.1016/j.jcjo.2017.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/22/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To determine the efficacy of vitrectomy in eyes with treatment-naïve diabetic macular edema (DME). METHODS Consecutive patients with treatment-naïve DME who underwent pars plana vitrectomy with internal limiting membrane peeling at a single institution were identified from the electronic medical records. Morphologic and visual acuity changes from baseline were analyzed at both the primary temporal endpoint (6 months) and the final examination with the investigators. The primary outcome measures included changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT). RESULTS Forty-four eyes of 44 patients were included in this retrospective study. The mean BCVA improved significantly from baseline until the 6-month primary endpoint (1.35 logMAR vs 0.83 logMAR, p < 0.001) and stabilized through the final examination (0.77 logMAR). The BCVA improved by at least 0.1, 0.3, and 0.6 logMAR in 26 (60%), 24 (55%), and 14 (32%) of eyes, respectively, whereas it worsened by 0.3 logMAR in only 1 (2%) eye. Final BCVA correlated inversely with duration of diabetes (p = 0.01), presence of an epiretinal membrane (p = 0.02), and initial visual acuity (p = 0.03). Mean CRT decreased significantly from baseline through 6 months (595 µm vs 266 µm; p < 0.001), and edema recurred in only 3 eyes (6%), one of which was subsequently treated with intravitreal bevacizumab. CONCLUSIONS Pars plana vitrectomy significantly improves macular edema and visual acuity in eyes with treatment-naïve DME. Prospective randomized trials are needed to better determine the efficacy of early vitrectomy.
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Stewart MW. The study of intravitreal drug pharmacokinetics: does it matter? and if so, how? Expert Opin Drug Metab Toxicol 2017; 14:5-7. [PMID: 29221430 DOI: 10.1080/17425255.2018.1416098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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LONG-TERM INTRAOCULAR PRESSURE AFTER UNCOMPLICATED PARS PLANA VITRECTOMY FOR IDIOPATHIC EPIRETINAL MEMBRANE. Retina 2017; 39:163-171. [PMID: 29160783 DOI: 10.1097/iae.0000000000001933] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate long-term intraocular pressure trends after uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane. METHODS Three hundred and sixty-eight eyes of 368 consecutive patients were enrolled. Changes in intraocular pressure 1, 3, 6, and 12 months after surgery and during the final follow-up visit were evaluated in vitrectomized eyes and nonvitrectomized fellow eyes. RESULTS The median follow-up period was 36 months (range 12-92 months). Longitudinal data analysis evidenced a 2.5-mmHg (2.2 mmHg; 2.7 mmHg, 95% confidence interval) statistically significant difference in intraocular pressure 30 days after surgery between treated and fellow untreated eyes, gradually recovering to a not significant 0.2-mmHg (-0.1 mmHg; 0.4 mmHg, 95% confidence interval) difference within 26 months. The incidence of late-onset ocular hypertension was 5.7% (21 over 347, 2%; 12%, 95% confidence interval) without difference between the treated eyes and the group control. No significant difference in the incidence of late-onset ocular hypertension and sex, lens status, or gauge of vitrectomy instruments was detected. Only patient's age was significantly higher (mean difference 4.2 years; 0.1-8.0 years, Monte Carlo, 95% confidence interval) in those who developed late-onset ocular hypertension in the vitrectomized eye. CONCLUSION Uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane seems not to increase the risk of late-onset ocular hypertension or open-angle glaucoma development.
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Edington M, Connolly J, Chong NV. Pharmacokinetics of intravitreal anti-VEGF drugs in vitrectomized versus non-vitrectomized eyes. Expert Opin Drug Metab Toxicol 2017; 13:1217-1224. [DOI: 10.1080/17425255.2017.1404987] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Magdalena Edington
- Department of Ophthalmology, University of Oxford, Oxford, UK
- Department of Ophthalmology, Tennent Institute of Ophthalmology, Glasgow, UK
| | - Julie Connolly
- Department of Ophthalmology, Tennent Institute of Ophthalmology, Glasgow, UK
| | - Ngaihang Victor Chong
- Department of Ophthalmology, University of Oxford, Oxford, UK
- Department of Ophthalmology, Royal Free Hospital, London, UK
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Intraoperative Injection of Intravitreal Dexamethasone Implant Using a Vitrectomy Trocar-Assisted Technique. Retina 2017; 39 Suppl 1:S123-S124. [PMID: 28991865 DOI: 10.1097/iae.0000000000001853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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49
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Munoz SZ, Zhadan R, Acosta E. Design of nonionic micelle-laden polysaccharide hydrogels for controlled delivery of hydrophobic drugs. Int J Pharm 2017; 526:455-465. [DOI: 10.1016/j.ijpharm.2017.04.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 10/19/2022]
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50
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Mulder VC, Kluft C, van Etten PG, La Heij EC, van Meurs JC. Higher vitreous concentrations of dabigatran after repeated oral administration. Acta Ophthalmol 2017; 95:e345-e346. [PMID: 28128536 DOI: 10.1111/aos.13348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Verena C. Mulder
- Rotterdam Ophthalmic Institute; Rotterdam Eye Hospital; Rotterdam The Netherlands
| | | | - Peter G. van Etten
- Vitreoretinal Surgery; The Rotterdam Eye Hospital; Rotterdam The Netherlands
| | - Ellen C. La Heij
- Vitreoretinal Surgery; The Rotterdam Eye Hospital; Rotterdam The Netherlands
| | - Jan C. van Meurs
- Rotterdam Ophthalmic Institute; Rotterdam Eye Hospital; Rotterdam The Netherlands
- Vitreoretinal Surgery; The Rotterdam Eye Hospital; Rotterdam The Netherlands
- Erasmus Medical Centre; Rotterdam The Netherlands
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