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1.
Invest Ophthalmol Vis Sci ; 58(1): 555-564, 2017 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-28125842

RESUMEN

Purpose: To determine the effect of injection volume and formulation of a microneedle injection into the suprachoroidal space (SCS) on SCS thickness and closure kinetics. Methods: Microneedle injections containing 25 to 150 µL Hanks' balanced salt solution (HBSS) were performed in the rabbit SCS ex vivo. Distribution of SCS thickness was measured by ultrasonography and three-dimensional (3D) cryo-reconstruction. Microneedle injections were performed in the rabbit SCS in vivo using HBSS, Discovisc, and 1% to 5% carboxymethyl cellulose (CMC) in HBSS. Ultrasonography was used to track SCS thickness over time. Results: Increasing HBSS injection volume increased the area of expanded SCS, but did not increase SCS thickness ex vivo. With SCS injections in vivo, the SCS initially expanded to thicknesses of 0.43 ± 0.06 mm with HBSS, 1.5 ± 0.4 mm with Discovisc, and 0.69 to 2.1 mm with 1% to 5% CMC. After injection with HBSS, Discovisc, and 1% CMC solution, the SCS collapsed to baseline with time constants of 19 minutes, 6 hours, and 2.4 days, respectively. In contrast, injections with 3% to 5% CMC solution resulted in SCS expansion to 2.3 to 2.8 mm over the course of 2.8 to 9.1 hours, after which the SCS collapsed to baseline with time constants of 4.5 to 9.2 days. Conclusions: With low-viscosity formulations, SCS expands to a thickness that remains roughly constant, independent of the volume of fluid injected. Increasing injection fluid viscosity significantly increased SCS thickness. Expansion of the SCS is hypothesized to be controlled by a balance between the viscous forces of the liquid formulation and the resistive biomechanical forces of the tissue.


Asunto(s)
Coroides/metabolismo , Presión Intraocular/fisiología , Agujas , Poliestirenos/farmacocinética , Animales , Coroides/diagnóstico por imagen , Diseño de Equipo , Imagenología Tridimensional , Inyecciones Intraoculares , Miniaturización , Modelos Animales , Poliestirenos/administración & dosificación , Conejos , Distribución Tisular , Cuerpo Vítreo/metabolismo
2.
Exp Eye Res ; 153: 101-109, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27742547

RESUMEN

The purpose of this work was to determine the effect of injection volume, formulation composition, and time on circumferential spread of particles, small molecules, and polymeric formulation excipients in the suprachoroidal space (SCS) after microneedle injection into New Zealand White rabbit eyes ex vivo and in vivo. Microneedle injections of 25-150 µL Hank's Balanced Salt Solution (HBSS) containing 0.2 µm red-fluorescent particles and a model small molecule (fluorescein) were performed in rabbit eyes ex vivo, and visualized via flat mount. Particles with diameters of 0.02-2 µm were co-injected into SCS in vivo with fluorescein or a polymeric formulation excipient: fluorescein isothiocyanate (FITC)-labeled Discovisc or FITC-labeled carboxymethyl cellulose (CMC). Fluorescent fundus images were acquired over time to determine area of particle, fluorescein, and polymeric formulation excipient spread, as well as their co-localization. We found that fluorescein covered a significantly larger area than co-injected particles when suspended in HBSS, and that this difference was present from 3 min post-injection onwards. We further showed that there was no difference in initial area covered by FITC-Discovisc and particles; the transport time (i.e., the time until the FITC-Discovisc and particle area began dissociating) was 2 d. There was also no difference in initial area covered by FITC-CMC and particles; the transport time in FITC-CMC was 4 d. We also found that particle size (20 nm-2 µm) had no effect on spreading area when delivered in HBSS or Discovisc. We conclude that (i) the area of particle spread in SCS during injection generally increased with increasing injection volume, was unaffected by particle size, and was significantly less than the area of fluorescein spread, (ii) particles suspended in low-viscosity HBSS formulation were entrapped in the SCS after injection, whereas fluorescein was not and (iii) particles co-injected with viscous polymeric formulation excipients co-localized near the site of injection in the SCS, continued to co-localize while spreading over larger areas for 2-4 days, and then no longer co-localized as the polymeric formulation excipients were cleared within 1-3 weeks and the particles remained largely in place. These data suggest that particles encounter greater barriers to flow in SCS compared to molecules and that co-localization of particles and polymeric formulation excipients allows spreading over larger areas of the SCS until the particles and excipients dissociate.


Asunto(s)
Excipientes/administración & dosificación , Fluoresceína/administración & dosificación , Polímeros/administración & dosificación , Segmento Posterior del Ojo/metabolismo , Animales , Coroides/metabolismo , Sistemas de Liberación de Medicamentos , Excipientes/farmacología , Fluoresceína/farmacocinética , Colorantes Fluorescentes/administración & dosificación , Colorantes Fluorescentes/farmacocinética , Inyecciones Intraoculares , Modelos Animales , Agujas , Tamaño de la Partícula , Polímeros/farmacocinética , Conejos , Esclerótica/metabolismo , Distribución Tisular/efectos de los fármacos
3.
Exp Eye Res ; 145: 424-431, 2016 04.
Artículo en Inglés | MEDLINE | ID: mdl-26976663

RESUMEN

Microneedle injection into the suprachoroidal space (SCS) enables targeted drug delivery for treatment of posterior segment diseases. This study sought to identify and characterize anatomical barriers to circumferential spread of particles in the SCS of rabbit and human cadaver eyes. These barriers could make targeting specific regions within the SCS challenging. A hollow microneedle (33-gauge, 750 µm long) was used to inject fluorescent particles into albino New Zealand White rabbit eyes ex vivo at six different positions around the limbus and a limited number of conditions in vivo. SCS injections were also performed in human cadaver eyes 8 mm and 2 mm from the optic nerve (ON). Eyes were dissected and particle distribution was quantified. In rabbit eyes, injections made in the superior or inferior hemispheres (even when injected temporally immediately adjacent to the long posterior ciliary artery (LPCA)) did not significantly cross into the other hemisphere, apparently due to a barrier formed by the LPCA. The vortex veins had a minor effect on particle deposition, limited to only around the vortex vein root. In human eyes, the short posterior ciliary arteries (SPCAs) prevented circumferential spread towards the macula and ON. In conclusion, the rabbit LPCA and the human SPCA were anatomical barriers to particle spread within the SCS. Therefore, design of drug delivery protocols targeting the SCS need to account for barriers formed by anatomical structures in order for injected drug to reach target tissues.


Asunto(s)
Coroides/metabolismo , Arterias Ciliares/metabolismo , Sistemas de Liberación de Medicamentos/métodos , Inyecciones Intraoculares/métodos , Soluciones Oftálmicas/metabolismo , Análisis de Varianza , Animales , Cadáver , Fluoresceína/análisis , Humanos , Inyecciones Intraoculares/instrumentación , Microinyecciones/instrumentación , Microesferas , Modelos Animales , Soluciones Oftálmicas/administración & dosificación , Tamaño de la Partícula , Conejos
4.
Eur J Pharm Biopharm ; 95(Pt B): 398-406, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26036448

RESUMEN

In this work, we tested the hypothesis that particles injected into the suprachoroidal space can be localized at the site of injection or broadly distributed throughout the suprachoroidal space by controlling polymeric formulation properties. Single hollow microneedles were inserted into the sclera of New Zealand White rabbits and injected non-biodegradable fluorescently tagged nanoparticles and microparticles suspended in polymeric formulations into the suprachoroidal space of the eye. When formulated in saline, the particles were distributed over 29-42% of the suprachoroidal space immediately after injection. To spread particles over larger areas of the choroidal surface, addition of hyaluronic acid to make moderately non-Newtonian solutions increased particle spread to up to 100% of the suprachoroidal space. To localize particles at the site of injection adjacent to the ciliary body, strongly non-Newtonian polymer solutions localized particles to 8.3-20% of the suprachoroidal space, which exhibited a small increase in area over the course of two months. This study demonstrates targeted particle delivery within the suprachoroidal space using polymer formulations that spread particles over the whole choroidal surface or localized them adjacent to the ciliary body after injection.


Asunto(s)
Coroides/metabolismo , Cuerpo Ciliar/metabolismo , Sistemas de Liberación de Medicamentos , Polímeros/química , Animales , Química Farmacéutica/métodos , Ácido Hialurónico/química , Microesferas , Nanopartículas , Agujas , Conejos , Esclerótica/metabolismo , Factores de Tiempo
5.
Invest Ophthalmol Vis Sci ; 55(11): 7376-86, 2014 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-25212779

RESUMEN

PURPOSE: This study tested the hypothesis that highly targeted intrastromal delivery of bevacizumab using coated microneedles allows dramatic dose sparing compared with subconjunctival and topical delivery for treatment of corneal neovascularization. METHODS: Stainless steel microneedles 400 µm in length were coated with bevacizumab. A silk suture was placed in the cornea approximately 1 mm from the limbus to induce corneal neovascularization in the eyes of New Zealand white rabbits that were divided into different groups: untreated, microneedle delivery, topical eye drop, and subconjunctival injection of bevacizumab. All drug treatments were initiated 4 days after suture placement and area of neovascularization was measured daily by digital photography for 18 days. RESULTS: Eyes treated once with 4.4 µg bevacizumab using microneedles reduced neovascularization compared with untreated eyes by 44% (day 18). Eyes treated once with 2500 µg bevacizumab using subconjunctival injection gave similar results to microneedle-treated eyes. Eyes treated once with 4.4 µg subconjunctival bevacizumab showed no significant effect compared with untreated eyes. Eyes treated with 52,500 µg bevacizumab by eye drops three times per day for 14 days reduced the neovascularization area compared with untreated eyes by 6% (day 18), which was significantly less effective than the single microneedle treatment. Visual exam and histological analysis showed no observable effect of microneedle treatment on corneal transparency or microanatomical structure. CONCLUSIONS: This study shows that microneedles can target drug delivery to corneal stroma in a minimally invasive way and demonstrates effective suppression of corneal neovascularization after suture-induced injury using a much lower dose compared with conventional methods.


Asunto(s)
Anticuerpos Monoclonales Humanizados/administración & dosificación , Neovascularización de la Córnea/tratamiento farmacológico , Agujas , Inhibidores de la Angiogénesis/administración & dosificación , Animales , Bevacizumab , Neovascularización de la Córnea/patología , Sustancia Propia , Modelos Animales de Enfermedad , Femenino , Inyecciones/instrumentación , Masculino , Miniaturización , Fotograbar , Conejos , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores
6.
Invest Ophthalmol Vis Sci ; 55(11): 7387-97, 2014 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-25212782

RESUMEN

PURPOSE: In this work, we tested the hypothesis that highly targeted delivery of antiglaucoma drugs to the supraciliary space by using a hollow microneedle allows dramatic dose sparing of the drug compared to topical eye drops. The supraciliary space is the most anterior portion of the suprachoroidal space, located below the sclera and above the choroid and ciliary body. METHODS: A single, hollow 33-gauge microneedle, 700 to 800 µm in length, was inserted into the sclera and used to infuse antiglaucoma drugs into the supraciliary space of New Zealand white rabbits (N = 3-6 per group). Sulprostone, a prostaglandin analog, and brimonidine, an α2-adrenergic agonist, were delivered via supraciliary and topical administration at various doses. The drugs were delivered unilaterally, and intraocular pressure (IOP) of both eyes was measured by rebound tonometry for 9 hours after injection to assess the pharmacodynamic responses. To assess safety of the supraciliary injection, IOP change immediately after intravitreal and supraciliary injection were compared. RESULTS: Supraciliary delivery of both sulprostone and brimonidine reduced IOP by as much as 3 mm Hg bilaterally in a dose-related response; comparison with topical administration at the conventional human dose showed approximately 100-fold dose sparing by supraciliary injection for both drugs. A safety study showed that the kinetics of IOP elevation immediately after supraciliary and intravitreal injection of placebo formulations were similar. CONCLUSIONS: This study introduced the use of targeted drug delivery to the supraciliary space by using a microneedle and demonstrated dramatic dose sparing of antiglaucoma therapeutic agents compared to topical eye drops. Targeted delivery in this way can increase safety by reducing side effects and could allow a single injection to contain enough drug for long-term sustained delivery.


Asunto(s)
Antihipertensivos/administración & dosificación , Glaucoma/tratamiento farmacológico , Presión Intraocular/efectos de los fármacos , Presión Intraocular/genética , Agujas , Animales , Antihipertensivos/farmacocinética , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Femenino , Glaucoma/metabolismo , Glaucoma/fisiopatología , Inyecciones Intravítreas , Masculino , Miniaturización , Conejos
8.
J Cataract Refract Surg ; 40(3): 460-8, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24581775

RESUMEN

PURPOSE: To compare the sealability and geometry of full-thickness clear corneal incisions (CCIs) created manually or with an ultrashort-pulse laser. SETTING: Lensar, Inc., Orlando, Florida, USA. DESIGN: Experimental study. METHODS: Ex vivo human donor globes were randomly assigned to groups for the manual or laser-generated full-thickness CCIs. Standard 3-plane manual or laser incisions were made in 22 globes. Incision geometry was measured using an optical coherence tomographer. Sealability was assessed by inflating globes to physiologic intraocular pressure (IOP) and pressing a mechanical plunger into the globe to deform the globe and increase IOP until leakage was detected using the Seidel test. The test of sealability at lowered IOP was performed similarly; the anterior chamber was monitored for signs of ingress of a povidone-iodine 10% solution placed externally. RESULTS: The mean IOP elevation at which leakage occurred was higher for the laser than for manually generated full-thickness CCIs, indicating that the mean sealability was better for the laser. However, t tests showed that there was no statistically significant difference in the mean IOP elevation at which full-thickness incision leakage occurred between manual and laser full-thickness CCIs. Thus, the sealability of the manual and laser full-thickness CCIs were equivalent for the incision geometry tested. The laser full-thickness CCIs were statistically closer to target geometry and showed less variability than the manual full-thickness CCIs. CONCLUSIONS: The sealability of laser and manual full-thickness CCIs were statistically equivalent. The laser full-thickness CCIs were more consistent in geometry and closer to the target incision geometry.


Asunto(s)
Córnea/cirugía , Terapia por Láser/métodos , Procedimientos Quirúrgicos Oftalmológicos/métodos , Dehiscencia de la Herida Operatoria/diagnóstico , Cicatrización de Heridas/fisiología , Anciano , Córnea/patología , Fluoresceína/metabolismo , Humanos , Presión Intraocular , Persona de Mediana Edad , Povidona Yodada/metabolismo , Dehiscencia de la Herida Operatoria/metabolismo , Donantes de Tejidos , Tomografía de Coherencia Óptica
9.
Adv Healthc Mater ; 3(8): 1272-82, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24652782

RESUMEN

This study tests the hypothesis that high-density particle-stabilized emulsion droplets (PEDs) can be designed to use gravity to target specific locations in the eye via suprachoroidal space injection. PEDs contain a core of high-density perfluorodecalin measuring ≤35 µm in diameter surrounded and stabilized by fluorescein-tagged, polystyrene nanoparticles that simulate polymeric drug carriers. A hollow microneedle infuses PEDs into the suprachoroidal space of rabbit eyes in vivo, which are later dissected and imaged to quantify distribution of fluorescent nanoparticles within the suprachoroidal space. With cornea oriented upward, such that gravity should move PEDs toward the back of the eye, up to 50% of nanoparticles are in the most posterior quadrant near the macula immediately after injection and 5 d later. With cornea oriented downward, to promote PED movement toward the front of the eye, approximately 60% of injected nanoparticles are targeted to the most anterior quadrant of the posterior segment near ciliary body. Injection of approximately neutral-density particles of the same size shows approximately equal distribution throughout the posterior segment. This study demonstrates for the first time that high-density PEDs can be used to deliver nanoparticles to specific locations in the back of the eye, including targeted delivery to the macula.


Asunto(s)
Coroides/metabolismo , Emulsiones/química , Nanopartículas/química , Animales , Portadores de Fármacos/química , Fluoresceína/química , Fluorocarburos/química , Gravitación , Nanopartículas/metabolismo , Tamaño de la Partícula , Poliestirenos/química , Conejos
10.
J Cataract Refract Surg ; 40(3): 469-76, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24485862

RESUMEN

PURPOSE: To compare the extent of corneal endothelial cell loss resulting from creating full-thickness clear corneal incisions manually using a diamond blade with that resulting from use of an ultrashort-pulse laser. SETTING: Lensar, Inc., Orlando, Florida, USA. DESIGN: Experimental study. METHODS: Ex vivo porcine globes were randomly assigned to groups for manual or laser-generated full-thickness CCIs. Standard 3-plane manual or laser incisions were made in freshly excised porcine globes. Two laser incision geometries were tested: with the exit incision perpendicular or 45 degrees to the posterior corneal surface. Corneas excised from the globe were measured immediately and after storage for 48 hours in Dulbecco modified Eagle media. Cell loss was assessed by measuring the area of damaged endothelial cells with a fluorescent microscope after cornea staining with a 3-component fluorescent live cell-dead cell assay. The percentage cell loss was expressed as the damaged area divided by the total area of a typical human corneal endothelium. RESULTS: Endothelial cell losses caused by manual and laser full-thickness CCIs were in the range of 0.8% to 1.4%. Although the mean endothelial cell loss percentages were lower for laser than for manual full-thickness CCIs, the measurements showed no statistically significant differences in the endothelial cell loss percentage between manual full-thickness CCIs and laser full-thickness CCIs with a perpendicular exit incision or 45-degree exit incision geometry. CONCLUSION: Ultrashort-pulse laser-generated full-thickness CCIs resulted in the statistically equivalent levels of corneal endothelial cell loss as full-thickness CCIs created by standard manual methods.


Asunto(s)
Córnea/cirugía , Pérdida de Celulas Endoteliales de la Córnea/etiología , Terapia por Láser/efectos adversos , Procedimientos Quirúrgicos Oftalmológicos/efectos adversos , Animales , Supervivencia Celular , Córnea/patología , Pérdida de Celulas Endoteliales de la Córnea/diagnóstico , Endotelio Corneal/patología , Terapia por Láser/métodos , Microscopía Fluorescente , Procedimientos Quirúrgicos Oftalmológicos/métodos , Porcinos , Tomografía de Coherencia Óptica
11.
Invest Ophthalmol Vis Sci ; 54(14): ORSF23-7, 2013 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-24335063

RESUMEN

PURPOSE: We described anatomic age-related changes in the human eye to determine potential areas of investigation that may lead to identifying eyes at risk for age-related disease. METHODS: A descriptive review of anatomic changes in the eye related to aging was performed in the context of current areas of investigation. The review was performed specifically for differing anatomic ocular structures, including cornea, trabecular meshwork, lens, uveal tract, Bruch's membrane, retina, RPE, vitreous, sclera, and optic nerve. RESULTS: Age-related changes occur in all ocular tissues. The cornea flattens and there is an attrition of endothelial cells. The shape of the trabecular meshwork changes and there is a loss of trabecular endothelium. The lens grows and becomes cataractous. The ciliary body becomes collagenized, there are choroidal vascular changes, and Bruch's membrane thickens. Retinal vessels become hyalinized and there is a loss of rods before cones in the macula. RPE morphometric changes occur with aging. The vitreous becomes liquefied and there is a loss of vitreous compartmentalization. The sclera becomes rigid and may become calcified. The optic nerve exhibits structural changes with age. CONCLUSIONS: There are numerous anatomic age-related changes in the human eye. Current areas of investigation related to these changes include adaptive optics scanning laser ophthalmoscopy imaging of the RPE mosaic in the context of aging, and drug delivery devices that overcome age-related alterations to retinal and macular perfusion.


Asunto(s)
Envejecimiento , Oftalmopatías/diagnóstico , Ojo/patología , Humanos
12.
Mol Vis ; 19: 1198-210, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23734089

RESUMEN

PURPOSE: First, to determine the influence of drug lipophilicity (using eight beta-blockers) and molecular weight (using 4 kDa and 40 kDa fluoroscein isothiocyanate [FITC]-dextrans) on suprachoroidal delivery to the posterior segment of the eye by using a rabbit ex vivo eye model. Second, to determine whether drug distribution differs between the dosed and undosed side of the eye following suprachoroidal delivery. Third, to compare the suprachoroidal delivery of sodium fluorescein (NaF) with the intracameral and intravitreal routes by using noninvasive fluorophotometry. METHODS: Using a small hypodermic 26G needle (3/8") with a short bevel (250 µm), location of the suprachoroidal injection in an ex vivo New Zealand white rabbit eye model was confirmed with India ink. Ocular tissue distribution of NaF (25 µl of 1.5 µg/ml) at 37 °C was monitored noninvasively using the Fluorotron Master(TM) at 0, 1, and 3 h following suprachoroidal, intravitreal, or intracameral injections in ex vivo rabbit eyes. For assessing the influence of lipophilicity and molecular size, 25 µl of a mixture of eight beta-blockers (250 µg/ml each) or FITC-dextran (4 kDa and 40 kDa, 30 mg/ml) was injected into the suprachoroidal space of excised rabbit eyes and incubated at 37 °C. Eyes were incubated for 1 and 3 h, and frozen at the end of incubation. Ocular tissues were isolated in frozen condition. Beta-blocker and FITC-dextran levels in excised ocular tissue were measured by liquid chromatography-tandem mass spectrometry and spectrofluorometry, respectively. RESULTS: Histological sections of India ink-injected albino rabbit eye showed the localization of dye as a black line in the suprachoroidal space. Suprachoroidal injection of NaF showed signal localization to the choroid and retina at 1 and 3 h post injection when compared with intravitreal and intracameral injections. Drug delivery to the vitreous after suprachoroidal injection decreased with an increase in solute lipophilicity and molecular weight. With an increase in drug lipophilicity, drug levels in the choroid-retinal pigment epithelium (RPE) and retina generally increased with some exceptions. Beta-blockers and FITC-dextrans were localized more to the dosed side when compared to the opposite side of the sclera, choroid-RPE, retina, and vitreous. These differences were greater for FITC-dextrans as compared to the beta-blockers. CONCLUSIONS: The suprachoroidal route of injection allows localized delivery to the choroid-RPE and retina for small as well as large molecules. Suprachoroidal drug delivery to the vitreous declines with an increase in drug lipophilicity and molecular weight. Drug delivery differs between the dosed and opposite sides following suprachoroidal injection, at least up to 3 h.


Asunto(s)
Antagonistas Adrenérgicos beta/administración & dosificación , Antagonistas Adrenérgicos beta/farmacología , Coroides/efectos de los fármacos , Sistemas de Liberación de Medicamentos , Animales , Carbono/farmacología , Dextranos/farmacocinética , Vías de Administración de Medicamentos , Fluoresceína/metabolismo , Fluoresceína-5-Isotiocianato/análogos & derivados , Fluoresceína-5-Isotiocianato/farmacocinética , Fluorofotometría , Técnicas In Vitro , Inyecciones Intravítreas , Modelos Animales , Conejos , Retina/efectos de los fármacos , Distribución Tisular/efectos de los fármacos
14.
Invest Ophthalmol Vis Sci ; 53(8): 4433-41, 2012 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-22669719

RESUMEN

PURPOSE: This study seeks to determine the intraocular pharmacokinetics of molecules and particles injected into the suprachoroidal space of the rabbit eye in vivo using a hollow microneedle. METHODS: Suprachoroidal injections of fluorescein and fluorescently tagged dextrans (40 and 250 kDa), bevacizumab, and polymeric particles (20 nm to 10 µm in diameter) were performed using microneedles in New Zealand white rabbits. The fluorescence intensity within the eye was monitored in each animal using an ocular fluorophotometer to determine the distribution of the injected material in the eye over time as compared with intravitreal injection of fluorescein. Fundus photography and histology were performed as well. RESULTS: Molecules and particles injected near the limbus using a microneedle flowed circumferentially around the eye within the suprachoroidal space. By targeting the suprachoroidal space, the concentration of injected materials was at least 10-fold higher in the back of the eye tissues than in anterior tissues. In contrast, intravitreal injection of fluorescein targeted the vitreous humor with no significant selectivity for posterior versus anterior segment tissues. Half-lives in the suprachoroidal space for molecules of molecular weight from 0.3 to 250 kDa ranged from 1.2 to 7.9 hours. In contrast, particles ranging in size from 20 nm to 10 µm remained primarily in the suprachoroidal space and choroid for a period of months and did not clear the eye. No adverse effects of injection into the suprachoroidal space were observed. CONCLUSION: Injection into the suprachoroidal space using a microneedle offers a simple and minimally invasive way to target the delivery of drugs to the choroid and retina.


Asunto(s)
Inhibidores de la Angiogénesis/administración & dosificación , Anticuerpos Monoclonales Humanizados/administración & dosificación , Coroides/efectos de los fármacos , Dextranos/administración & dosificación , Sistemas de Liberación de Medicamentos , Fluoresceína/administración & dosificación , Fluoresceínas/administración & dosificación , Segmento Posterior del Ojo/efectos de los fármacos , Inhibidores de la Angiogénesis/farmacocinética , Animales , Anticuerpos Monoclonales Humanizados/farmacocinética , Bevacizumab , Coroides/metabolismo , Dextranos/farmacocinética , Fluoresceína/farmacocinética , Fluoresceínas/farmacocinética , Fluorescencia , Fluorofotometría , Inyecciones Intraoculares , Agujas , Segmento Posterior del Ojo/metabolismo , Conejos
15.
Int J Pharm ; 434(1-2): 140-7, 2012 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-22633904

RESUMEN

PURPOSE: One objective of this study was to determine whether polymeric nanoparticles and/or microparticles sustain transscleral choroidal and retinal delivery of triamcinolone acetonide (TA) for two months in therapeutically effective concentrations after single periocular administration. Another objective of this study was to assess the influence of choroidal neovascularization on transscleral delivery of TA. METHODS: Polymeric nano- and micro-particles of TA were prepared by o/w emulsion-solvent evaporation method using poly-l-lactide (PLA). Particles were characterized for drug loading, size, surface morphology, and the in vitro drug release profile. Choroidal neovascularization (CNV) was induced in brown Norway (BN) rats using a 532 nm diode argon laser and the CNV induction was assessed using fluorescein angiography. In vivo delivery was assessed in control and CNV induced rats at 2 months after periocular injection of TA loaded nano- or micro-particle suspension, or plain TA suspension in PBS (pH 7.4). Ocular tissue levels of TA were estimated using LC-MS/MS following liquid-liquid extraction of drug from tissue samples. Nile red loaded microparticles entrapped in periocular tissue at the end of the study was visualized using scanning electron microscopy and confocal microscopy. Inhibitory effect of TA on VEGF secretion was evaluated in ARPE-19 cells. RESULTS: Triamcinolone acetonide-PLA nano- (551 nm) and micro-particles (2090 nm), with 14.7 and 29.5% drug loading, respectively, sustained in vitro TA release for about 45 and 120 days. After subconjunctival injection, microparticles were able to sustain the delivery in all intraocular tissues for 2 months; whereas no drug levels were detected for TA loaded nanoparticles and plain suspension of TA. Intraocular delivery of TA from microparticles was higher in CNV induced rats when compared to control rats. Significant amount of microparticles remained in periocular tissue at 2 months after injection, and maintained spherical shape. TA decreased VEGF secretion by 50% at 0.07 µM. At the end of the in vivo study, choroid-RPE and retina TA levels in CNV induced rats were 16- and 5-fold higher than the IC(50) for VEGF secretion. CONCLUSIONS: Single periocular injection of polymeric microparticles but not nanoparticles sustained effective levels of TA in choroid-RPE and retina for 2 months, with the TA delivery being greater in CNV induced rats than the control rats.


Asunto(s)
Neovascularización Coroidal/fisiopatología , Sistemas de Liberación de Medicamentos , Poliésteres/química , Triamcinolona Acetonida/administración & dosificación , Administración Oftálmica , Animales , Línea Celular , Preparaciones de Acción Retardada , Portadores de Fármacos/química , Emulsiones , Glucocorticoides/administración & dosificación , Glucocorticoides/farmacocinética , Glucocorticoides/farmacología , Humanos , Concentración 50 Inhibidora , Masculino , Microesferas , Nanopartículas , Tamaño de la Partícula , Ratas , Ratas Endogámicas BN , Epitelio Pigmentado de la Retina/citología , Epitelio Pigmentado de la Retina/efectos de los fármacos , Epitelio Pigmentado de la Retina/metabolismo , Esclerótica/metabolismo , Factores de Tiempo , Distribución Tisular , Triamcinolona Acetonida/farmacocinética , Triamcinolona Acetonida/farmacología , Factor A de Crecimiento Endotelial Vascular/metabolismo
16.
Invest Ophthalmol Vis Sci ; 52(10): 7038-45, 2011 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-21791594

RESUMEN

PURPOSE: To evaluate the transscleral delivery of fluoresceinated dextrans (FITC-D) with molecular mass up to 70 kDa to the rabbit posterior segment using sub-Tenon injections. METHODS: Eighteen NZW rabbits received a unilateral 200-µL injection of 2 mg/mL sodium fluorescein (NaF), 25 mg/mL 40-kDa FITC-D, or 25 mg/mL 70-kDa FITC-D, with (n = 9) or without (n = 9) immediate euthanatization. In live animals, fluorescence was measured in the retina/choroid and mid-vitreous by fluorophotometry, immediately after injection and after 4, 24, 48, and 72 hours. Euthanatized animals were examined hourly through 5 or 6 hours. RESULTS: In live animals, the average peak NaF concentration in the retina/choroid was 310.2 ng/mL, measured 3 hours after injection. Average 40- and 70-kDa FITC-D concentrations in the retina/choroid peaked at 5409.6 and 2375.6 ng/mL, respectively, 24 hours after injection. Fluorescence returned to baseline levels 6 hours after NaF injection, and 48 and 72 hours after 40- and 70-kDa FITC-D injections, respectively. Rabbits that received NaF followed by euthanatization exhibited a continuous increase in retina/choroid and mid-vitreous fluorescence, beginning 1 hour after injection, whereas FITC-D-injected eyes did not show elevated retina/choroid or mid-vitreous fluorescence through 6 hours. CONCLUSIONS: FITC-D weighing up to 70-kDa, as well as NaF, reached the posterior retina/choroid after sub-Tenon injections in live rabbits. NaF and 40-kDa FITC-D reached higher peak concentrations and were cleared from the eye more rapidly than was 70-kDa FITC-D. There was minimal penetration of NaF and FITC-D into the mid-vitreous in the in vivo experiments.


Asunto(s)
Coroides/metabolismo , Dextranos/farmacocinética , Fluoresceína-5-Isotiocianato/análogos & derivados , Fluoresceína/farmacocinética , Fluorofotometría , Retina/metabolismo , Esclerótica/metabolismo , Cuerpo Vítreo/metabolismo , Animales , Difusión , Fluoresceína-5-Isotiocianato/farmacocinética , Inyecciones Intraoculares , Conejos , Distribución Tisular
17.
J Cataract Refract Surg ; 37(4): 767-77, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21420604

RESUMEN

UNLABELLED: The endothelium is vital to the health and optical clarity of the human cornea. The safety of procedures to correct refractive errors depends on preservation of an intact corneal endothelium. Disease states and genetic and environmental factors affect the corneal endothelium; an unstable corneal endothelium can impact the success of refractive surgery. Technological advances and recent laboratory findings have improved the ability to assess the endothelium. The status of the corneal endothelium after laser in situ keratomileusis, photorefractive keratectomy, phakic intraocular lenses, and adjuvants to these treatments has been the topic of numerous clinical trials. Safety guidelines for refractive surgery procedures should be followed to minimize deleterious effects on the corneal endothelium. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.


Asunto(s)
Endotelio Corneal/fisiología , Procedimientos Quirúrgicos Refractivos , Animales , Humanos
18.
Invest Ophthalmol Vis Sci ; 52(8): 5387-99, 2011 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-21282583

RESUMEN

PURPOSE: To determine the influence of drug lipophilicity, ocular pigmentation, and species differences on transscleral solute transport. METHODS: The transport of eight ß-blockers across excised sclera/sclera-choroid-RPE (SCRPE) of albino rabbit, pigmented rabbit, human, porcine, and bovine eyes was determined over 6 hours. The ex vivo transscleral ß-blocker transport to the vitreous at the end of 6 hours was determined in euthanatized, pigmented Brown Norway rats. The thicknesses of the sclera and SCRPE and the melanin content in choroid-RPE (CRPE) were measured to determine whether species differences in drug transport can be explained on this basis. RESULTS: Solute lipophilicity inversely correlated with the SCRPE cumulative percentage of transport in all species (R(2) ≥ 0.80). The CRPE impeded the SCRPE transport of all ß-blockers (51%-64% resistance in the rabbits; 84%-99.8% in the bovine and porcine eyes) more than the sclera, with the impedance increasing with lipophilicity. SCRPE transport followed the trend albino rabbit > pigmented rabbit > human > porcine > bovine, and a cross-species comparison showed good Spearman's rho correlation (R(2) ≥ 0.85). Bovine (R(2) = 0.84), porcine (R(2) = 0.84), and human (R(2) = 0.71) SCRPE transport was more predictive than that in the rabbit models (R(2) = 0.60-0.61) of transscleral solute transport to the vitreous in rats. The CRPE concentrations were higher in pigmented rabbits than in albino rabbits. The melanin content of the CRPE exhibited the trend albino rabbit ≪ pigmented rabbit < porcine ∼ bovine < rat. Normalization to scleral thickness abolished the species differences in scleral transport. Normalization to SCRPE thickness and melanin content significantly reduced species differences in SCRPE transport. CONCLUSIONS: Owing to the presence of pigment and drug binding, choroid-RPE is the principal barrier to transscleral ß-blocker transport, with the barrier being more significant for lipophilic ß-blockers. Although different in magnitude between species, sclera/SCRPE transport can be correlated between species. Tissue thickness accounts for the species differences in scleral transport. Differences in tissue thickness and melanin content largely account for the species differences in SCRPE transport.


Asunto(s)
Antagonistas Adrenérgicos beta/metabolismo , Coroides/metabolismo , Epitelio Pigmentado de la Retina/metabolismo , Esclerótica/metabolismo , Anciano , Anciano de 80 o más Años , Animales , Transporte Biológico , Bovinos , Cromatografía Líquida de Alta Presión , Humanos , Melaninas/metabolismo , Persona de Mediana Edad , Permeabilidad , Conejos , Ratas , Ratas Endogámicas BN , Especificidad de la Especie , Porcinos , Espectrometría de Masas en Tándem
20.
Invest Ophthalmol Vis Sci ; 52(5): 2627-33, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21245405

RESUMEN

PURPOSE: To test the hypothesis that mucoadhesive microparticles formulated in a rapidly dissolving tablet can achieve sustained drug delivery to the eye. METHODS: Mucoadhesive microparticles, smaller than 5 µm were fabricated with poly(lactic-co-glycolic acid) and poly(ethylene glycol) as a core material and mucoadhesion promoter, respectively, and encapsulated pilocarpine as a model drug. These microparticles were embedded in a poly(vinyl alcohol) matrix to form a dry tablet designed to reduce rapid clearance of the microparticles on initial application to the eye. RESULTS: This in vitro drug release study exhibited that for all formulations, approximately 90% of pilocarpine was released during the first 10 minutes, and the remaining 10% was released slowly for 3 hours. In vivo mucoadhesion test on the rabbit eye indicated that mucoadhesive microparticles adhered significantly better to the preocular surface than other formulations. To assess the pharmacodynamics, the most prolonged pilocarpine-induced pupil constriction was observed in rabbit eyes in vivo using a tablet with mucoadhesive microparticles; it lasted up to 330 minutes. CONCLUSIONS: The authors conclude that mucoadhesive microparticles formulated into a dry dosage form is a promising system for sustained drug delivery to the eye.


Asunto(s)
Portadores de Fármacos , Sistemas de Liberación de Medicamentos/instrumentación , Mióticos/administración & dosificación , Pilocarpina/administración & dosificación , Polietilenglicoles , Poliglactina 910 , Pupila/efectos de los fármacos , Comprimidos , Adhesividad , Animales , Disponibilidad Biológica , Sistemas de Liberación de Medicamentos/métodos , Femenino , Iris/metabolismo , Microesferas , Mióticos/farmacocinética , Pilocarpina/farmacocinética , Conejos
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