Intravitreal Dexamethasone Implant as a Sustained Release Drug Delivery Device for the Treatment of Ocular Diseases: A Comprehensive Review of the Literature

Drug delivery into the vitreous chamber remains a great challenge in the pharmaceutical industry due to the complex anatomy and physiology of the eye. Intravitreal injection is the mainstream route of drug administration to the posterior segment of the eye. The purpose of this review is to assess the current literature about the widening use of the intravitreal 0.7 mg dexamethasone (Dex) implant, and to provide a comprehensive collection of all the ocular disorders that benefit from Dex administration. Although anti-vascular endothelial growth-factors (VEGFs) have been largely indicated as a first-choice level, the Dex implant represents an important treatment option, especially in selected cases, such as vitrectomized eyes or patients in whom anti-VEGF failed or are contraindicated. In this article, the safety profile as well as the list of the possible complications related to intravitreal Dex injection are also discussed.

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Drug Delivery to the Posterior Segment of the Eye: Biopharmaceutic and Pharmacokinetic Considerations

Pharmaceutics ◽

10.3390/pharmaceutics12030269 ◽

2020 ◽

Vol 12 (3) ◽

pp. 269 ◽

Cited By ~ 11

Author(s):

Rubén Varela-Fernández ◽

Victoria Díaz-Tomé ◽

Andrea Luaces-Rodríguez ◽

Andrea Conde-Penedo ◽

Xurxo García-Otero ◽

...

Keyword(s):

Drug Delivery ◽

Posterior Segment ◽

Anatomy And Physiology ◽

Administration Routes ◽

Age Related ◽

Complex Anatomy ◽

Site Of Action ◽

Intraocular Drug Delivery ◽

Novel Drug ◽

Drug Pharmacokinetics

The treatment of the posterior-segment ocular diseases, such as age-related eye diseases (AMD) or diabetic retinopathy (DR), present a challenge for ophthalmologists due to the complex anatomy and physiology of the eye. This specialized organ is composed of various static and dynamic barriers that restrict drug delivery into the target site of action. Despite numerous efforts, effective intraocular drug delivery remains unresolved and, therefore, it is highly desirable to improve the current treatments of diseases affecting the posterior cavity. This review article gives an overview of pharmacokinetic and biopharmaceutics aspects for the most commonly-used ocular administration routes (intravitreal, topical, systemic, and periocular), including information of the absorption, distribution, and elimination, as well as the benefits and limitations of each one. This article also encompasses different conventional and novel drug delivery systems designed and developed to improve drug pharmacokinetics intended for the posterior ocular segment treatment.

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An Overview of Robotic Capsules for Drug Delivery to the Gastrointestinal Tract

Journal of Clinical Medicine ◽

10.3390/jcm10245791 ◽

2021 ◽

Vol 10 (24) ◽

pp. 5791

Author(s):

Pablo Cortegoso Valdivia ◽

Alexander R. Robertson ◽

Nanne K. H. De Boer ◽

Wojciech Marlicz ◽

Anastasios Koulaouzidis

Keyword(s):

Drug Delivery ◽

Targeted Therapy ◽

Gastrointestinal Tract ◽

Small Bowel ◽

Drug Delivery Systems ◽

Rapid Evolution ◽

Gi Tract ◽

Standard Drug ◽

Anatomy And Physiology ◽

Complex Anatomy

The introduction of capsule endoscopy two decades ago marked the beginning of the “small bowel revolution”. Since then, the rapid evolution of microtechnology has allowed the development of drug delivery systems (DDS) designed to address some of the needs that are not met by standard drug delivery. To overcome the complex anatomy and physiology of the gastrointestinal (GI) tract, several DDS have been developed, including many prototypes being designed, built and eventually produced with ingenious drug-release mechanisms and anchoring systems allowing targeted therapy. This review highlights the currently available systems for drug delivery in the GI tract and discusses the needs, limitations, and future considerations of these technologies.

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Intravitreal Dexamethasone Implant (Ozurdex) Versus Bevacizumab in Patients With Diabetic Macular Edema Undergoing Cataract Surgery

Case Medical Research ◽

10.31525/ct1-nct04067856 ◽

2019 ◽

Author(s):

Keyword(s):

Cataract Surgery ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Dexamethasone Implant ◽

Intravitreal Dexamethasone Implant ◽

Intravitreal Dexamethasone

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Free flap for soft palate reconstruction: long-term functional evaluation of a new technique

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-06897-0 ◽

2021 ◽

Author(s):

A. Colliard ◽

L. Pincet ◽

C. Simon ◽

L. May ◽

K. Lambercy

Keyword(s):

Soft Palate ◽

Free Flap ◽

New Technique ◽

Tumour Resection ◽

Functional Evaluation ◽

Anatomy And Physiology ◽

Complex Anatomy ◽

A New Technique ◽

Anderson Dysphagia Inventory ◽

Nasal Regurgitation

Abstract Purpose The soft palate (SP) has a complex anatomy and physiology. Reconstruction after tumour resection is a challenge, and procedures that only restore bulk don’t give good results. We aim to present a new technique for the in-setting and the functional outcomes. Methods We retrospectively included in a monocentric retrospective cohort study every patient with a first diagnosis of a soft palate squamous cell carcinoma (SPSCC), who underwent a tumoral resection with a free flap reconstruction, from February 2013 to July 2017. For the in-setting, a special care is given for the flap in-setting: we suture the flap more caudally than usual under the tongue base, creating a neo-posterior pilar. The primary outcome was the deglutition function, assessed by the M. D Anderson Dysphagia Inventory (MDADI). We also analyzed the patient’s quality of life with the FOSS score and the occurrence of nasal regurgitation or larynx aspiration. Results We included twenty patients, with a median follow-up of 26.5 months. The median MDADI score was 89, and the mode was 93. A Fisher test shows a significant improvement of MDADI scores for unilateral vs bilateral reconstructions (p = 0.03). The median FOSS score was 2, and the mode was 2. Seven (35%) patients complained of nasal regurgitation, three (15%) reported episodic laryngeal aspiration.

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