Depthwise-controlled scleral insertion of microneedles for drug delivery to the back of the eye

A mosquito proboscis-inspired cambered microneedle patch for ophthalmic regional anaesthesia

INTRODUCTION

One of the methods for pain management involves the use of local anesthesia, which numbs sensations in specific body regions while maintaining consciousness.

OBJECTIVES

Considering the certain limitations (e.g., pain, the requirement of skilled professionals, or slow passive diffusion) of conventional delivery methods of local anesthetics, developing alternative strategies that offer minimally invasive yet therapeutically effective delivery systems is of great concern for ophthalmic regional anesthesia.

METHODS AND RESULTS

In this study, a rapidly dissolving cambered microneedle (MNs) patch, composed of poly(vinylpyrrolidone) (PVP) and hyaluronic acid (HA) and served as a delivery system for lidocaine (Lido) in local anesthesia, was developed taking inspiration from the mosquito proboscis's ability to extract blood unnoticed. The lidocaine-containing MNs patch (MNs@Lido) consisted of 25 microneedles with a four-pronged cone structure (height: 500 μm, base width: 275 μm), arranged in a concentric circle pattern on the patch, and displays excellent dissolubility for effective drug delivery of Lido. After confirming good cytocompatibility, MNs@Lido was found to possess adequate rigidity to penetrate the cornea without causing any subsequent injury, and the created corneal pinhole channels completely self-healed within 24 h. Interestingly, MNs@Lido exhibited effective analgesic effects for local anesthesia on both heel skin and eyeball, with the sustained anesthetic effect lasting for at least 30 min.

CONCLUSIONS

These findings indicate that the mosquito proboscis-inspired cambered MNs patch provides rapid and painless local anesthesia, overcoming the limitations of conventional delivery methods of local anesthetics, thus opening up new possibilities in the treatment of ophthalmic diseases.

Beacon of Hope for Age-Related Retinopathy: Antioxidative Mechanisms and Pre-Clinical Trials of Quercetin Therapy

Age-related retinopathy is one of the leading causes of visual impairment and irreversible blindness, characterized by progressive neuronal and myelin loss. The damages caused by oxidation contributes to the hallmarks of aging and represents fundamental components in pathological pathways that are thought to drive multiple age-related retinopathies. Quercetin (Que), a natural polyphenol abundant in vegetables, herbs, and fruits, has been extensively studied for its long-term antioxidative effects mediated through diverse mechanisms. Additionally, Que and its derivatives exhibit a broad spectrum of pharmacological characteristics in the cellular responses of age-related retinopathy induced by oxidative stress, including anti-inflammatory, anti-neovascularization, regulatory, and neuroprotective effects in autophagy and apoptosis processes. This review mainly focuses on the antioxidative mechanisms and curative effects of Que treatment for various age-related retinopathies, such as retinitis pigmentosa, diabetic retinopathy, age-related macular degeneration, and glaucoma. Furthermore, we discuss emerging technologies and methods involving Que and its derivatives in the therapeutic strategies for age-related retinopathies, highlighting their promise for clinical translation.

Responsive Microneedles for Diagnostic and Therapeutic Applications of Ocular Diseases

Traditional ophthalmic formulations are characterized by low bioavailability, short intraocular retention time, strong irritation, and failure to achieve the expected therapeutic effect due to the special physiological structure of the eye and the existence of many barriers. Microneedle drug delivery is a novel transdermal drug delivery modality. Responsive microneedles are defined as controllably releasing the drug payloads in response to physiological stimuli, including pH levels, temperature, enzymes, and reactive oxygen species (ROS), as well as external stimuli such as magnetic fields and light. In addition to inheriting the advantages of traditional microneedles, which include enhanced targeting and permeability, non-invasiveness, and painless application, the integration with stimulus-responsive materials enables responsive microneedles to achieve a personalized precision drug delivery process, which further increases the accuracy and efficiency of ocular treatments, making on-demand drug delivery possible. This article systematically reviews the classification, mechanisms, and characteristics of responsive microneedles and provides a detailed introduction to their diagnostic and therapeutic applications as well as real-time monitoring potential in ocular diseases, aiming to offer insights for the precision treatment of ocular diseases in the future.

Advances in Polysaccharide-Based Microneedle Systems for the Treatment of Ocular Diseases

The eye, a complex organ isolated from the systemic circulation, presents significant drug delivery challenges owing to its protective mechanisms, such as the blood-retinal barrier and corneal impermeability. Conventional drug administration methods often fail to sustain therapeutic levels and may compromise patient safety and compliance. Polysaccharide-based microneedles (PSMNs) have emerged as a transformative solution for ophthalmic drug delivery. However, a comprehensive review of PSMNs in ophthalmology has not been published to date. In this review, we critically examine the synergy between polysaccharide chemistry and microneedle technology for enhancing ocular drug delivery. We provide a thorough analysis of PSMNs, summarizing the design principles, fabrication processes, and challenges addressed during fabrication, including improving patient comfort and compliance. We also describe recent advances and the performance of various PSMNs in both research and clinical scenarios. Finally, we review the current regulatory frameworks and market barriers that are relevant to the clinical and commercial advancement of PSMNs and provide a final perspective on this research area.

Polymeric microneedles for the eye: An overview of advances and ocular applications for minimally invasive drug delivery

Ocular drug delivery is challenging due to the presence of tissue barriers and clearance mechanisms. Most widely used topical formulations need frequent application because of poor permeability, short retention, and low bioavailability. Invasive intraocular injections and implants that deliver drugs at the target site are associated with infections, inflammation, and even vision loss post-use. These gaps can be addressed by a delivery platform that can efficiently deliver drug with minimal tissue damage. Microneedles were introduced as a delivery platform for overcoming dermal barriers with minimal tissue damage. After the successful clinical transition of microneedles in the transdermal drug delivery, they are now being extensively studied for ocular applications. The attributes of minimally invasive application and the capability to deliver a wide range of therapeutics make microneedles an attractive candidate for ocular drug delivery. The current manuscript provides a detailed overview of the recent advancements in the field of microneedles for ocular use. This paper reviews research focusing on polymeric microneedles and their pharmaceutical and biopharmaceutical properties. A brief discussion about their clinical translation and regulatory concerns is also covered. The multitude of research articles supports the fact that microneedles are a potential, minimally invasive drug delivery platform for ophthalmic use.

Matrix hyaluronic acid and bilayer poly-hydroxyethyl methacrylate-hyaluronic acid films as potential ocular drug delivery platforms

This study aimed to design hydrogel based films comprising hyaluronic acid (HA) to overcome limitations of currently used eye drops. Timolol-loaded crosslinked (X2) HA-based and bilayer (B2) (pHEMA/PVP-HA-based layers) films were designed and characterized. The films were transparent (UV, visual observation) with crosslinked (<80 %) films showing lower light transmittance than bilayer (>80 %) films. X2 showed significantly higher swelling capacity, tensile strength and elastic modulus (5491.6 %, 1539.8 Nmm-2, 1777.2 mPa) than B2 (1905.0 %, 170.0N mm-2, 67.3 mPa) respectively. However, X2 showed lower cumulative drug released and adhesive force (27.3 %, 6.2 N) than B2 (57.5 %, 8.6 N). UV sterilization did not significantly alter physical properties, while SEM and IR microscopy showed smooth surface morphology and homogeneous drug distribution. Timolol permeation (EpiCorneal™/porcine cornea) depended on the film matrix with erodible films showing similar permeation to commercial eyedrops. Drug permeation for porcine cornea (X2 = 549.0.2, B2 = 312.1 μgcm-2 h-1) was significantly faster than EpiCorneal™ (X2 = 55.2, B2 = 37.6 μgcm-2 h-1), but with a linear correlation between them. All the selected optimized films showed acceptable compatibility (MTT assay) with both HeLa cells and EpiCorneal™. In conclusion, crosslinked and bilayer HA based films showed ideal characteristics suitable for potential ocular drug delivery, though further work is required to further optimize these properties and confirm their efficacy including in vivo tests.

A wireless battery-free eye modulation patch for high myopia therapy

The proper axial length of the eye is crucial for achieving emmetropia. In this study, we present a wireless battery-free eye modulation patch designed to correct high myopia and prevent relapse. The patch consists of piezoelectric transducers, an electrochemical micro-actuator, a drug microneedle array, μ-LEDs, a flexible circuit, and biocompatible encapsulation. The system can be wirelessly powered and controlled using external ultrasound. The electrochemical micro-actuator plays a key role in precisely shortening the axial length by driving the posterior sclera inward. This ensures accurate scene imaging on the retina for myopia eye. The drug microneedle array delivers riboflavin to the posterior sclera, and μ-LEDs' blue light induces collagen cross-linking, reinforcing sclera strength. In vivo experiments demonstrate that the patch successfully reduces the rabbit eye's axial length by ~1217 μm and increases sclera strength by 387%. The system operates effectively within the body without the need for batteries. Here, we show that the patch offers a promising avenue for clinically treating high myopia.

Progress in the Application of Microneedles in Eye Disorders and the Proposal of the Upgraded Microneedle with Spinule

PURPOSE

In the local administration methods for treating eye diseases, the application of microneedles has great potential due to the shortcomings of low efficacy and significant side effects of local administration preparations. This article provides ideas for the research on the application of ophthalmic microneedle in the treatment of eye diseases.

RESULTS

This article analyzes the physiological structures of the eyes, ocular diseases and its existing ocular preparations in sequence. Finally, this article reviews the development and trends of ocular microneedles in recent years, and summarizes and discusses the drugs of ocular microneedles as well as the future directions of development. At the same time, according to the inspiration of previous work, the concept of "microneedle with spinule" is proposed for the first time, and its advantages and limitations are discussed in the article.

CONCLUSIONS

At present, the application of ocular microneedles still faces multiple challenges. The aspects of auxiliary devices, appearance, the properties of the matrix materials, and preparation technology of ophthalmic microneedle are crucial for their application in the treatment of eye diseases.

Trends in Formulation Approaches for Sustained Drug Delivery to the Posterior Segment of the Eye

The eye, an intricate organ comprising physical and physiological barriers, poses a significant challenge for ophthalmic physicians seeking to treat serious ocular diseases affecting the posterior segment, such as age-related macular degeneration (AMD) and diabetic retinopathy (DR). Despite extensive efforts, the delivery of therapeutic drugs to the rear part of the eye remains an unresolved issue. This comprehensive review delves into conventional and innovative formulation strategies for drug delivery to the posterior segment of the eye. By utilizing alternative nanoformulation approaches such as liposomes, nanoparticles, and microneedle patches, researchers and clinicians can overcome the limitations of conventional eye drops and achieve more effective drug delivery to the posterior segment of the eye. These innovative strategies offer improved drug penetration, prolonged residence time, and controlled release, enhancing therapeutic outcomes for ocular diseases. Moreover, this article explores recently approved delivery systems that leverage diverse polymer technologies, such as chitosan and hyaluronic acid, to regulate drug-controlled release over an extended period. By offering a comprehensive understanding of the available formulation strategies, this review aims to empower researchers and clinicians in their pursuit of developing highly effective treatments for posterior-segment ocular diseases.

Microneedles for advanced ocular drug delivery

In the field of ocular drug delivery, topical delivery remains the most common treatment option for managing anterior segment diseases, whileintraocular injectionsare the current gold standard treatment option for treating posterior segment diseases. Nonetheless, topical eye drops are associated with low bioavailability (<5%), and theintravitreal administration procedure is highly invasive, yielding poor patient acceptability. In both cases, frequent administration is currently required. As a result, there is a clear unmet need for sustained drug delivery to the eye, particularly in a manner that can be localised. Microneedles, which are patches containing an array of micron-scale needles (<1 mm), have the potential to meet this need. These platforms can enable localised drug delivery to the eye while enhancing penetration of drug molecules through key ocular barriers, thereby improving overall therapeutic outcomes. Moreover, the minimally invasive manner in which microneedles are applied could provide significant advantages over traditional intravitreal injections regarding patient acceptability. Considering the benefitsofthis novel ocular delivery system, this review provides an in-depth overviewofthe microneedle systems for ocular drug delivery, including the types of microneedles used and therapeutics delivered. Notably, we outline and discuss the current challenges associated with the clinical translation of these platforms and offer opinions on factors which should be considered to improve such transition from lab to clinic.

Biodegradable Polymer-Based Drug-Delivery Systems for Ocular Diseases

Ocular drug delivery is a challenging field due to the unique anatomical and physiological barriers of the eye. Biodegradable polymers have emerged as promising tools for efficient and controlled drug delivery in ocular diseases. This review provides an overview of biodegradable polymer-based drug-delivery systems for ocular diseases with emphasis on the potential for biodegradable polymers to overcome the limitations of conventional methods, allowing for sustained drug release, improved bioavailability, and targeted therapy. Natural and synthetic polymers are both discussed, highlighting their biodegradability and biocompatibility. Various formulation strategies, such as nanoparticles, hydrogels, and microemulsions, among others, are investigated, detailing preparation methods, drug encapsulation, and clinical applications. The focus is on anterior and posterior segment drug delivery, covering glaucoma, corneal disorders, ocular inflammation, retinal diseases, age-related macular degeneration, and diabetic retinopathy. Safety considerations, such as biocompatibility evaluations, in vivo toxicity studies, and clinical safety, are addressed. Future perspectives encompass advancements, regulatory considerations, and clinical translation challenges. In conclusion, biodegradable polymers offer potential for efficient and targeted ocular drug delivery, improving therapeutic outcomes while reducing side effects. Further research is needed to optimize formulation strategies and address regulatory requirements for successful clinical implementation.

Eyedrop-based macromolecular ophthalmic drug delivery for ocular fundus disease treatment

Therapeutic antibodies are extensively used to treat fundus diseases by intravitreal injection, as eyedrop formulation has been rather challenging due to the presence of ocular barriers. Here, an innovative penetrating carrier was developed for antibody delivery in eyedrop formulations. We found that fluorocarbon-modified chitosan (FCS) would self-assemble with proteins to form nanocomplexes, which could effectively pass across the complicated ocular structure to reach the posterior eye segments in both mice and rabbits. In a choroidal melanoma-bearing mouse model, eyedrops containing FCS/anti-PDL1 could induce stronger antitumor immune responses than those triggered by intravenous injection of anti-PDL1. Moreover, in choroidal neovascularization-bearing mouse and rabbit models, FCS/anti-VEGFA eyedrops effectively inhibited vascular proliferation, achieving comparable therapeutic responses to those observed with intravitreal injection of anti-VEGFA. Our work presents an effective delivery carrier to treat fundus diseases using eyedrop of therapeutic proteins, which may enable at-home treatment of many eye diseases with great patient compliance.

Research progress on detachable microneedles for advanced applications

INTRODUCTION

Microneedles (MNs) have undergone great advances in transdermal drug delivery, and commercialized MN applications are currently available in vaccination and cosmetic products. Despite the development of MN technologies, common limitations of MN products still exist. Typical MN patches are applied to target tissues, where the substrate of an MN patch must remain until the drug is delivered, which reduces patients' compliance and hinders the applicability of the MN technique to many diseases in various tissues. MN research is ongoing to solve this issue.

AREAS COVERED

Most recent MNs developed by combining various biomaterials with appropriate fabrication processes are detachable MNs (DeMNs). Because of advances in biomaterials and fabrication techniques, various DeMNs have been rapidly developed. In this review, we discuss four types of DeMN: substrate-separable, multi-layered, crack-inducing, and shell DeMN. These DeMNs deliver various therapeutic agents ranging from small- and large-molecular-weight drugs to proteins and even stem cells for regeneration therapy. Furthermore, DeMNs are applied to skin as well as non-transdermal tissues.

EXPERT OPINION

It has become increasingly evident that novel MN technologies can be expected in terms of designs, fabrication methods, materials, and even possible application sites given the recent advances in DeMNs.

Polymeric Drug Delivery Devices: Role in Cornea and External Disease

ABSTRACT

The field of ophthalmic drug delivery is undergoing rapid changes not only in the evolution of pharmacologic agents but also in the novel drug delivery vehicles. The ocular surface has limitations to drug penetration because of the presence of tight junctions between basal epithelial cells, which limits the amount of drug that can be absorbed after topical instillation. In addition, nasolacrimal drainage reduces the precorneal residence time significantly. Contact lenses (CLs) have been considered as possible carriers for topical medications because they reside on the ocular surface for a sufficient length of time, and pharmacologic agents may be copolymerized with hydrogels allowing controlled drug diffusion. This strategy reduces the frequency of dosage while improving compliance. Modification of drug delivery vehicles is essential to allow sustained release of the drug from a polymeric complex, facilitate stability and residence time of the drug on the precorneal tear film, and improve penetration into biologic membranes. This review focuses on updates in CL-based and non-CL-based strategies in ophthalmic drug delivery.

Self-Plugging Microneedle (SPM) for Intravitreal Drug Delivery

Intravitreal injection (IVI) is a common technology which is used to treat ophthalmic diseases inside eyeballs by delivering various drugs into the vitreous cavity using hypodermic needles. However, in some cases, there are possible side effects such as ocular tissue damage due to repeated injection or eyeball infection through the hole created during the needle retraction process. The best scenario of IVI is a one-time injection of drugs without needle retraction, keeping the system of the eyeball closed. Microneedles (MNs) have been applied to ocular tissues over 10 years, and no serious side effects on ocular tissue due to MN injection have been reported. Therefore, a self-plugging MN (SPM) is developed to perform intraocular drug delivery and to seal the scleral puncture simultaneously. The SPMs are fabricated by a thermal drawing process and then coated with a polymeric carrier of drugs and a hydrogel-based scleral plugging component. Each coated functional layer is characterized and demonstrated by in vitro and ex vivo experiments. Finally, in vivo tests using a porcine model confirms prompt sealing of SPM and sustained intraocular drug delivery.

Microneedle-mediated transdermal nanodelivery systems: a review

The greatest limitation in the development of transdermal drug delivery systems is that only a few drugs can permeate the skin due to the barrier function of the stratum corneum. Active and passive methods are generally available for improving the ability of drug transdermal delivery. However, nanoparticles, as a passive approach, exhibit capacity-constrained permeation enhancement. Thus, microneedle-mediated nanoparticles possess enormous potential and broad prospects. Microneedles promote the penetration of macromolecules by creating microchannels on the skin surface. In this review, the prevailing subknowledge on microneedles (mechanism, classification, and applications of microneedles combined with nanoparticles) is discussed to provide a guideline for readers and a basic reference for further in-depth studies of this novel drug delivery system.

Highly flexible and porous silk fibroin microneedle wraps for perivascular drug delivery

Various perivascular drug delivery techniques have been demonstrated for localized post-treatment of intimal hyperplasia: a vascular inflammatory response caused by endothelial damages. Although most perivascular devices have focused on controlling the delivery duration of anti-proliferation drug, the confined and unidirectional delivery of the drug to the target tissue has become increasingly important. In addition, careful attention should also be paid to the luminal stability and the adequate exchange of vascular protein or cell between the blood vessel and extravascular tissue to avoid any side effect from the long-term application of any perivascular device. Here, a highly flexible and porous silk fibroin microneedle wrap (Silk MN wrap) is proposed to directly inject antiproliferative drug to the anastomosis sites while ensuring sufficient vascular exchanges. Drug-embedded silk MNs were transfer-molded on a highly flexible and porous silk wrap. The enhanced cell compatibility, molecular permeability, and flexibility of silk MN wrap guaranteed the structural integrity of blood vessels. Silk wrap successfully supported the silk MNs and induced multiple MN penetration to the target tissue. Over 28 days, silk MN wrap significantly inhibited intimal hyperplasia with a 62.1% reduction in neointimal formation.

Intravitreal hydrogels for sustained release of therapeutic proteins

This review highlights how hydrogel formulations can improve intravitreal protein delivery to the posterior segment of the eye in order to increase therapeutic outcome and patient compliance. Several therapeutic proteins have shown excellent clinical successes for the treatment of various intraocular diseases. However, drug delivery to the posterior segment of the eye faces significant challenges due to multiple physiological barriers preventing drugs from reaching the retina, among which intravitreal protein instability and rapid clearance from the site of injection. Hence, frequent injections are required to maintain therapeutic levels. Moreover, because the world population ages, the number of patients suffering from ocular diseases, such as age-related macular degeneration (AMD) and diabetic retinopathy (DR) is increasing and causing increased health care costs. Therefore, there is a growing need for suitable delivery systems able to tackle the current limitations in retinal protein delivery, which also may reduce costs. Hydrogels have shown to be promising delivery systems capable of sustaining release of therapeutic proteins and thus extending their local presence. Here, an extensive overview of preclinically developed intravitreal hydrogels is provided with attention to the rational design of clinically useful intravitreal systems. The currently used polymers, crosslinking mechanisms, in vitro/in vivo models and advancements are discussed together with the limitations and future perspective of these biomaterials.

A two-dimensional MXene potentiates a therapeutic microneedle patch for photonic implantable medicine in the second NIR biowindow

Due to the refractory nature and recurrence of cancer, the related treatments are continuously updated and improved. Here, we designed a soluble polyvinylpyrrolidone (PVP) microneedle system loaded with a two-dimensional (2D) MXene (Nb2C nanosheets) for medical implantation and photothermal ablation of superficial tumors in the second near infrared biological window (NIR-II). In this system, 2D Nb2C nanosheets acted as high-performance photothermal nanoagents, and biocompatible PVP functioned as matrix material to maintain the structure of the needles. The microneedle system exhibited sufficient skin-penetration ability and distinctive dissolution behavior. After being inserted into the skin of the tumor site, it can be dissolved within a short period to release the loaded 2D Nb2C nanosheets. The temperature of the tumor site increased rapidly to almost 70 °C under the irradiation of a 1064 nm laser at a power density of 1 W cm-2, and this could provide sufficient conditions for photonic tumor ablation. After two weeks of treatment, the tumor growth was significantly suppressed, compared to that of the control group, and the survival rate of mice was clearly improved. In addition, the biocompatibility of the microneedle system was tested on mice, in which no significant toxicity or side effects were observed. Therefore, this kind of microneedle system with minimally invasive, safe and effective features is expected to be developed as an intriguing strategy for localized superficial cancer treatment.

Non-transdermal microneedles for advanced drug delivery

Microneedles (MNs) have been used to deliver drugs for over two decades. These platforms have been proven to increase transdermal drug delivery efficiency dramatically by penetrating restrictive tissue barriers in a minimally invasive manner. While much of the early development of MNs focused on transdermal drug delivery, this technology can be applied to a variety of other non-transdermal biomedical applications. Several variations, such as multi-layer or hollow MNs, have been developed to cater to the needs of specific applications. The heterogeneity in the design of MNs has demanded similar variety in their fabrication methods; the most common methods include micromolding and drawing lithography. Numerous materials have been explored for MN fabrication which range from biocompatible ceramics and metals to natural and synthetic biodegradable polymers. Recent advances in MN engineering have diversified MNs to include unique shapes, materials, and mechanical properties that can be tailored for organ-specific applications. In this review, we discuss the design and creation of modern MNs that aim to surpass the biological barriers of non-transdermal drug delivery in ocular, vascular, oral, and mucosal tissue.