ABSTRACT

Introduction: Diabetes is a pandemic disease that causes relevant ocular pathologies. Diabetic retinopathy, macular edema, cataracts, glaucoma, or keratopathy strongly impact the quality of life of the patients. In addition to glycemic control, intense research is devoted to finding more efficient ocular drugs and improved delivery systems that can overcome eye barriers. Areas covered: The aim of this review is to revisit first the role of diabetes in the development of chronic eye diseases. Then, commercially available drugs and new candidates in clinical trials are tackled together with the pros and cons of their administration routes. Subsequent sections deal with self-assembled drug carriers suitable for eye instillation combining patient-friendly administration with high ocular bioavailability. Performance of topically administered polymeric micelles, liposomes, and niosomes for the management of diabetic eye diseases is analyzed in the light of ex vivo and in vivo results and outcomes of clinical trials. Expert opinion: Self-assembled carriers are being shown useful for efficient delivery of not only a variety of small drugs but also macromolecules (e.g. antibodies) and genes. Successful design of drug carriers may offer alternatives to intraocular injections and improve the treatment of both anterior and posterior segments diabetic eye diseases.

摘要

简介: 糖尿病是一种引起相关眼部病变的大流行性疾病。糖尿病视网膜病变、黄斑水肿、白内障、青光眼或角膜病变严重影响患者的生活质量。除了血糖控制之外，大量研究还致力于寻找更有效的眼部药物和可以克服眼部障碍的改进输送系统。覆盖区域：这篇综述的目的是首先重新审视糖尿病在慢性眼病发展中的作用。然后，商业上可用的药物和临床试验中的新候选药物与其给药途径的利弊一起被处理。随后的部分涉及适合眼部滴注的自组装药物载体，结合患者友好给药和高眼部生物利用度。根据体外和体内结果以及临床试验结果，分析了局部给药的聚合物胶束、脂质体和 niosomes 用于治疗糖尿病眼病的性能。专家意见：自组装载体被证明不仅可用于有效递送各种小药物，还可用于有效递送大分子（例如抗体）和基因。药物载体的成功设计可以提供眼内注射的替代方案，并改善前段和后段糖尿病眼病的治疗。