Pediatric ocular nanomedicines: Challenges and opportunities

Abstract

The eye is a highly complex, yet readily accessible organ within the human body. As such, the eye is an appealing candidate target for a vast array of drug therapies. Despite advances in ocular drug therapy research, the focus on pediatric ocular drug delivery continues to be highly underrepresented due to the limited number of degenerative ocular diseases with childhood onset. In this review, we explore more deeply the reasons underlying the disparity between ocular therapies available for children and for adults by highlighting diseases that most commonly afflict children (with focus on the anterior eye) and existing prognoses, recent developments in ocular drug delivery systems and nanomedicines for children, and barriers to use for pediatric patients.

Mildly Cross-Linked Dendrimer Hydrogel Prepared via Aza-Michael Addition Reaction for Topical Brimonidine Delivery

“…To date, topical administration is the safest and effective treatment for most ocular diseases because of ease of use and low-cost manufacturing. 3–5 Efforts have been devoted to develop drug delivery systems to extend drug activity, thus reducing dosing frequency and improving patient compliance. 6–8 Topical drug vehicles are expected to be biocompatible, mucoadhesive, and have suitable viscosity.…”

An ion‐paired moxifloxacin nanosuspension eye drop provides improved prevention and treatment of ocular infection

“…Adherence to eye drop regimens is an often cited problem, and eye drops can only be effective when they are used as prescribed 44 . Adherence is particularly a concern for elderly and pediatric patients, where reducing the required number of drops per day could significantly improve quality of life 44,45 . Better adherence in addition to increased and more effective drug concentrations can also circumvent issues with the development of bacterial resistance 46 .…”

“… 44 Adherence is particularly a concern for elderly and pediatric patients, where reducing the required number of drops per day could significantly improve quality of life. 44 , 45 Better adherence in addition to increased and more effective drug concentrations can also circumvent issues with the development of bacterial resistance. 46 In the case of LE‐MPP, the formulation was developed as a 1% suspension and approved in 2018 as the first twice‐daily ocular corticosteroid for post‐surgical inflammation and pain, where other prior products had to be dosed four times per day.…”

DenTimol as A Dendrimeric Timolol Analogue for Glaucoma Therapy: Synthesis and Preliminary Efficacy and Safety Assessment

“…10 Like current antiglaucoma drugs or other small molecule drugs, new drugs may eventually need an enabling delivery system to achieve sustained and effective delivery and improved bioavailability. 11 In our opinion, a compelling proactive approach for antiglaucoma drug development is to build molecules with a known therapeutic effect or established therapeutic potential into a polymeric backbone to form pharmacologically active polymeric drugs. While much advances have been made in the development of polymeric drugs for some diseases, 12–16 it is rarely used in the rational design of antiglaucoma drugs.…”

“…New antiglaucoma drugs are being actively pursued by targeting different therapeutic targets to acquire IOP reduction and neuroprotective benefits, for example, via increasing optic nerve head blood flow or trabecular meshwork outflow . Like current antiglaucoma drugs or other small molecule drugs, new drugs may eventually need an enabling delivery system to achieve sustained and effective delivery and improved bioavailability . In our opinion, a compelling proactive approach for antiglaucoma drug development is to build molecules with a known therapeutic effect or established therapeutic potential into a polymeric backbone to form pharmacologically active polymeric drugs.…”