Barrières hémato-oculaires. Physiologie

Successful management of poisoning with ivermectin (Mectizan) in the Obala health district (Centre Region, Cameroon): a case report

“…Also, the inability of ivermectin to cross the aqueous humoral barrier was previously described, likely due to its high molecular size, as other macrocyclic lactones. The blood-eye barriers thus block the penetration of ivermectin into the ocular globe [ 14 ]. An MRI would have been necessary to better investigate the causes of this visual deficit.…”

Modeling Approach To Characterize Intraocular Doripenem Pharmacokinetics after Intravenous Administration to Rabbits, with Tentative Extrapolation to Humans

“…Furthermore, these experimental data obtained in noninfected rabbits may be extrapolated to patients only if efflux system activity is not affected by infection. However, it is known that during BE, the blood-eye barrier is disrupted, and it could be suggested that the concentrations achieved both in AH and in VF would be higher in such cases (26). Therefore, the same type of study should now be conducted in patients to assess the potential species and/or disease effect on doripenem intraocular pharmacokinetics.…”

“…In addition to their intrinsic antibacterial properties, a major obstacle to predicting the efficacy of antibiotics against BE is their ability to reach the infectious site. Intraocular penetration of drugs after systemic administration is limited by the blood-ocular barriers, one regulating exchanges between blood and aqueous humor (AH) (the blood-aqueous barrier) and the second regulating the exchanges between blood and retina (the blood-retina barrier) (11,12,26). The blood-aqueous barrier is located primarily in the ciliary iris body and has been described as having two morphological components: an epithelial barrier at the level of the nonpigmented ciliary epithelium and an endothelial component at the level of the iris blood vessels (11).…”

“…injections of 0.5 to 1 g are usually administered (21,33), whereas 3 daily injections of 500 mg would be enough with doripenem (18,25), Doripenem is active against a broad range of Gram-positive and Gram-negative bacteria (18), with a spectrum similar to those of meropenem and imipenem. Doripenem has a low molecular weight and a low plasma-protein binding rate and is relatively lipophilic (18,25), which may favor its penetration into the intraocular fluids (11,20,26,31), with a potential interest for the treatment of intraocular infections. The objective of this study was to characterize the pharmacokinetics of doripenem in the aqueous humor (AH) and vitreous fluid (VF) after i.v.…”