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This review seeks to offer a synopsis of the research advancements concerning GCS in BU treatment over the past decade. 611, Almeida, Nanoparticles in ocular drug delivery systems for topical administration: promises and challenges, Curr Pharm Des, 21, . 2554, Linetsky, UVA light-excited kynurenines oxidize ascorbate and modify lens proteins through the formation of advanced glycation end products: implications for human lens aging and cataract formation, J Biol Chem, 289, . utilized intravitreal fluocinolone acetonide implant therapy on seven patients (eight eyes) with refractory Behet's uveitis (BU), with an average age of 35.3years and a mean follow-up of 47.8months. The site is secure. N-acetylcysteine amide and N-acetylcarnosine are two compounds that have increased bioavailability over their precursors, alleviating the challenges that have come with topical administration. 593, Goodman, Complications of cataract extraction with intraocular lens implantation, Ophthalmic Surg, 20, . PDF Advances in pharmacotherapy of cataracts - Semantic Scholar In 2013, Lightman et al. Medical treatment of cataract - PubMed Indian J Ophthalmol 2009;57:175-83. Further research is warranted to elucidate the ideal combination therapy for BU patients, aiming to attain long-term remission of uveitis and improve visual outcomes. Multiple studies have substantiated that high-dose methylprednisolone intravenous pulse therapy can expeditiously control inflammatory reactions in severe BU patients and ameliorate vision [52,53,54]. sharing sensitive information, make sure youre on a federal Topical drug delivery is the most popular noninvasive method for the treatment of ocular diseases , though it must be able to reach the treatment area, provide adequate doses of drug ingredients, and maintain them in the eye continuously. https://doi.org/10.1097/00002281-200207000-00001, Leder HA, Jabs DA, Galor A, Dunn JP, Thorne JE (2011) Periocular triamcinolone acetonide injections for cystoid macular edema complicating noninfectious uveitis. Our advertisers are important supporters of this site, and content cannot be accessed if ad-blocking software is activated. They also provide much higher drug bioavailability compared to eye drops. Some anti-cataract drugs, such as carnosine, have now reached clinical trials and showed encouraging results that warrant further investigation. In March 2020, the FDA approved the use of the first intracameral bimatoprost implant (Durysta, Allergan). Global prevalence and economic and humanistic burden of astigmatism in cataract patients: a systematic literature review. The authors report grants from National Natural Science Foundation of China, grants from Zhejiang Province Key Research and Development Program, during the conduct of the study. Google Scholar, Alpsoy E (2012) New evidence-based treatment approach in Behcets disease. Age-related cataract and drug therapy: opportunities and challenges for 2 Overview of nano-drug delivery systems for cancer therapy. PubMed Central Disclaimer. Journal of Biomaterials and Nanobiotechnology > Vol.2 No.5, December 2011. Ocul Immunol Inflamm 23:437443, Fabiani C, Emmi G, Lopalco G, Vannozzi L, Bacherini D, Guerriero S, Franceschini R, Frediani B, Iannone F, Marco Tosi G et al (2017) Intravitreal Dexamethasone Implant as an Adjunct Weapon for Severe and Refractory Uveitis in Behcets Disease. Targeting caveolae to pump bispecific antibody to TGF- into diseased lungs enables ultra-low dose therapeutic efficacy. Following the procedure, the visual acuity of six eyes (75%) improved by three lines or more, five patients discontinued all systemic medications, and six eyes (75%) experienced a postoperative intraocular pressure peak above 30mmHg, with five patients requiring glaucoma shunt surgery for intraocular pressure management. The https:// ensures that you are connecting to the Generally, GCS can attain favorable therapeutic outcomes through oral administration and intravenous drip, rendering intravenous administration largely superfluous, particularly to circumvent high-dose steroid pulse therapy utilization. 358, Bloemendal, Ageing and vision: structure, stability and function of lens crystallins, Prog Biophys Mol Biol, 86, . Emerging potential of stimulus-responsive nanosized anticancer drug delivery systems for systemic applications. 25-diol; 979, Babizhayev, N-Acetylcarnosine sustained drug delivery eye drops to control the signs of ageless vision: glare sensitivity, cataract amelioration and quality of vision currently available treatment for the challenging 50,000-patient population, Clin Interv Aging, 4, . Drug delivery. 5. You may be trying to access this site from a secured browser on the server. 132, Hong, Intraoperative management of posterior capsular rupture, Curr Opin Ophthalmol, 26, . 407, Brennan, Mechanisms of organelle elimination for lens development and differentiation, Exp Eye Res, 209, . Enzymes can also trigger drug release from the lenses. Advanced drug delivery 2020 and beyond: Perspectives on the future Please try after some time. BU incidence exhibits marked regional variability but affects a considerable proportion of BS patients [2, 17, 18], typified by recurrent episodes and protracted non-healing, culminating in bilateral panuveitis and irreversible visual impairment for the majority of patients [15, 19,20,21]. In this review, we would mainly focus on the advancement of cataract pharmacotherapy based on the targets for anti-cataract drugs. Advances in ophthalmic drug delivery technology for - ResearchGate HHS Vulnerability Disclosure, Help Principles for the delivery, self-bioactivation, molecular targets and interaction with a highly evolved histidyl-hydrazide structure in the treatment and therapeutic management of a group of sight-threatening eye diseases. https://doi.org/10.1016/j.ophtha.2009.11.027, Ahmad ZM, Hughes BA, Abrams GW, Mahmoud TH (2012) Combined posterior chamber intraocular lens, vitrectomy, Retisert, and pars plana tube in noninfectious uveitis. BU pathogenesis remains incompletely elucidated, with the prevailing hypothesis implicating an autoimmune inflammatory response mediated by neutrophils and Th1 cells [22], resulting in non-granulomatous uveitis and retinal vasculitis [5, 23]. the drug-eluting implants have the potential to provide uninterrupted treatment and a reduction in drug dosage (hence a less frequent need for dosing . 4117, Wang, Hyperoxia-induced lens damage in rabbit: protective effects of N-acetylcysteine, Mol Vis, 15, . Glycopolymer and Poly(-amino ester)-Based Amphiphilic Block Copolymer as a Drug Carrier. Advances in drug therapy and delivery for cataract treatment Epub 2020 Mar 30. Advances in Delivery of Chemotherapeutic Agents for Cancer Treatment Clin Rheumatol 35:25012507, Zhang F, Su M, Zhang B, Dong Y, Li P (2015) Clinical features and disease activity index of Behets disease. This review summarizes recent findings in pharmacological treatment and delivery, focusing on drugs that target oxidative stress and the aggregation of crystallins. 10.1097/ICU.0000000000000340 This treatment modality, superior to eye drops and periocular injections, improves posterior segment penetration with smaller doses and minimal systemic adverse reactions. GCS play a crucial role in the management of Behet's Uveitis (BU), offering rapid control of intraocular inflammation and mitigating ocular damage. 31, Dubois, N-acetylcarnosine (NAC) drops for age-related cataract, Cochrane Database Syst Rev, 2, . CD009493, Lian, The quest for homeopathic and nonsurgical cataract treatment, Curr Opin Ophthalmol, 31, . Cataract drug delivery Satellite CME. Smart Resources in Ophthalmology: Applications and Social Networking. 779, Ates, Antioxidant and free radical scavenging properties of N-acetylcysteine amide (NACA) and comparison with N-acetylcysteine (NAC), Free Radic Res, 42, . Their intervention, delivered to a cohort of 15 intractable cases of Behet's uveitis, led to the complete resolution of inflammation and an enhancement in the best-corrected visual acuity [32]. BS typically affects young adults between the ages of 25 and 35 [8], with ocular involvement commonly presenting 24years after disease onset, and is the leading cause of non-infectious uveitis in referral centers in Italy [9] and Turkey [10]. Advances in drug therapy and delivery for cataract treatment lens crystallins, Affiliations: Similar to drug-eluting contact lenses, punctal plugs have been redeveloped for sustained drug release. Unauthorized use of these marks is strictly prohibited. 2: Targeted communication during consultation. doi: 10.1093/pcmedi/pbac021. 2020 May 15;581:119283. doi: 10.1016/j.ijpharm.2020.119283. Ichhpujani P, Kalra G, Singla E, Kumar S. Breaking bad news about glaucoma: a SPIKES strategy primer. [48]. Advances in drug therapy and delivery for cataract treatment. - Europe PMC The https:// ensures that you are connecting to the published a clinical study involving 153 patients with non-infectious uveitis, demonstrating that intravitreal implantation of a 0.7mg dexamethasone sustained-release device significantly enhanced best-corrected visual acuity after eight weeks, with the therapeutic effect persisting for 26weeks [46]. Optimizing glucocorticoid therapy for Behet's uveitis: efficacy, adverse effects, and advances in combination approaches. Combining GCS therapy with immunosuppressive drugs and biological agents can reduce GCS dosage, decrease the recurrence rate, and facilitate long-term remission of uveitis, ultimately improving the overall prognosis for BU patients. https://doi.org/10.1016/j.clim.2011.01.014, Kitaichi N, Miyazaki A, Iwata D, Ohno S, Stanford MR, Chams H (2007) Ocular features of Behets disease: an international collaborative study. Targeting Brain Tumors with Nanomedicines: Overcoming Blood Brain Barrier Challenges. 615, Mundy, Socioeconomic disparities in cataract prevalence, characteristics, and management, Semin Ophthalmol, 31, . Accessibility In 2019, the POINT trial, a multicenter, randomized clinical study, found that both intravitreal triamcinolone acetonide (ITA) and the intravitreal dexamethasone implant (IDI) offered superior efficacy compared to periocular triamcinolone acetonide (PTA) in treating uveitic macular edema, signified by greater reductions in central subfield thickness and better visual acuity improvements, albeit with a modestly increased risk of intraocular pressure elevation. 3-8(6), DOI: https://doi.org/10.1097/ICU.0000000000000910, Keywords: Common complications include elevated intraocular pressure (steroid-induced glaucoma) and concurrent cataract formation (typically posterior capsule opacity). Drug screening research for cataracts has attracted a lot of attention, and some recent studies have reported several compounds that could prevent and dissolve protein aggregates in the lens, offering a novel anti-cataract drug screening strategy (8,9). PubMed This study does not contain any individual person's data in any form. https://doi.org/10.2147/OPTH.S89341, Atmaca LS, Yalinda FN, zdemir (2007) Intravitreal triamcinolone acetonide in the management of cystoid macular edema in Behets disease. Studies indicate that fluocinolone acetonide implantation effectively reduces uveitis recurrence rates without systemic steroid-related complications, though local complications like elevated intraocular pressure and cataracts may arise. also found IVTA injections effective for treating BU-associated macular edema, but also observed increased intraocular pressure in 6 of 10 eyes (60%) post-IVTA injection, with one eye requiring glaucoma surgery [36]. Drug Delivery Systems Gold Humans Metal Nanoparticles* Nanoparticles* Nanotubes, Carbon* Neoplasms* / drug therapy Platinum / therapeutic use Substances Antineoplastic Agents Drug Carriers Nanotubes, Carbon Platinum Scientists edge closer to treating cataracts without surgery Clin Exp Rheumatol 36:6873, Yalnda FN, zdal PC, zyazgan Y et al (2018) Demographic and clinical characteristics of uveitis in Turkey: the first national registry report. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 1031, Pfaff, Thiol antioxidants protect human lens epithelial (HLE B-3) cells against tert-butyl hydroperoxide-induced oxidative damage and cytotoxicity, Biochem Biophys Rep, 29, . 196, Aitio, N-acetylcysteine passe-partout or much ado about nothing?, Br J Clin Pharmacol, 61, . government site. 1122, Amer, N-acetylcysteine amide (AD4) attenuates oxidative stress in beta-thalassemia blood cells, Biochim Biophys Acta, 1780, . Copyright 2022 Wolters Kluwer Health, Inc. All rights reserved. Makley and Zhao recently identified two kinds of novel pharmacological substances (25-hydroxycholesterol, lanosterol) that can reverse lens opacity by dissolving the aggregation of crystallin proteins, indicating that protein aggregation is not an endpoint and could be reversed with specific small-molecule drugs, significantly boosting the development of the cataract pharmacopeia and being regarded as a new dawn for cataract treatment. Eye Res., 37 (5) (2012), pp. Recent advances in drug delivery systems for targeting brain tumors Springer Singapore; 2018:71-96. One can simplify it as "making drugs work better [ 1 ].". 709, Lim, Age-dependent changes in glutathione metabolism pathways in the lens: new insights into therapeutic strategies to prevent cataract formationa review, Clin Exp Ophthalmol, 48, . Subsequent to the maintenance stage, the dose ought to be incrementally decreased to gradually restore adrenal cortical function. Babizhayev MA, Burke L, Micans P, Richer SP. Advances in ophthalmic drug delivery technology for postoperative management after cataract surgery DOI: Authors: Kangmin Lee Gahye Lee Soomin Lee Choul Yong Park Dongguk University Request. Systemic corticosteroids should be administered once in the morning between 78 am, coinciding with the physiological peak in plasma cortisol concentration, which subsequently declines from morning to midnight and gradually ascends from midnight to the following morning. 4: Measures to ensure compliance . 2020;12:2515841420905740. PubMed Zhonghua Yi Xue Za Zhi 95:25472550, Wu H, Li G, Chen H, Zheng W, Zhang M, Zhao Y (2014) A clinical analysis of ocular involvement in 111 cases of Behcets disease. Advanced drug delivery 2020 and beyond: Perspectives on the future Evaluation of automatic monitoring of instillation adherence using eye dropper bottle sensor and deep learning in patients with glaucoma. Consequently, GCS should be combined with other immunosuppressive drugs or biological agents to minimize GCS dosage and reduce the recurrence rate. This review summarizes recent findings in pharmacological treatment and delivery, focusing on drugs that target oxidative stress and the aggregation of crystallins. Thrimawithana TR, Rupenthal ID, Rsch SS, Lim JC, Morton JD, Bunt CR.