Post-Surgical Scleritis Associated With the Ganciclovir Implant

Srivastava, Sunil K.; Taylor, Perdita; Wood, Lauren V.; Lee, Susan S.; Robinson, Michael R.

doi:10.3928/1542-8877-20040501-16

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…Irreversible visual loss can be caused by disruption of optic nerves in the retina resulting from retinal disorders such as retinal detachment, retinal vessel occlusion, and macular degeneration. [1] – [3] Due to the complex ocular structure, especially the blood retinal barrier (BRB), the subretinal space has become a target of interest for retinal treatment and thus has been used as an insertion site for drugs or stem cells in many medical procedures including transscleral injection, [4] – [5] subretinal implant, [6] – [7] and subretinal injection with vitrectomy. [8] – [9] All of these procedures require surgical intervention that can cause damage to the ocular tissue, and thus direct injection with a hypodermic needle having a small outer diameter is preferred over trans-scleral or subretinal injections.…”

Section: Introductionmentioning

confidence: 99%

An Arched Micro-Injector (ARCMI) for Innocuous Subretinal Injection

You

Lee

et al. 2014

PLoS ONE

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Several critical ocular diseases that can lead to blindness are due to retinal disorders. Subretinal drug delivery has been developed recently for the treatment of retinal disorders such as hemorrhage because of the specific ocular structure, namely, the blood retinal barrier (BRB). In the present study, we developed an Arched Micro-injector (ARCMI) for subretinal drug delivery with minimal retinal tissue damage. ARCMIs were fabricated using three major techniques: reverse drawing lithography, controlled air flow, and electroplating. In order to achieve minimal retinal tissue damage, ARCMIs were fabricated with specific features such as a 0.15 mm−1 curvature, 45° tip bevel, 5 mm length, inner diameter of 40 µm, and an outer diameter of 100 µm. These specific features were optimized via in-vitro experiments in artificial ocular hemispherical structures and subretinal injection of indocyanine green in porcine eye ex-vivo. We confirmed that the ARCMI was capable of delivering ocular drugs by subretinal injection without unusual subretinal tissue damage, including hemorrhage.

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Section: Introductionmentioning

confidence: 99%

An Arched Micro-Injector (ARCMI) for Innocuous Subretinal Injection

You

Lee

et al. 2014

PLoS ONE

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“…Although drug delivery device implantation into the vitreous showed effective delivery of drug to the retina, these treatments may cause severe side effects, such as infection, vitreous hemorrhage, or retinal detachment [12]–[14]. Drug delivery using viral vectors has been attempted for treatment of devastating retinal diseases [15]; however, this method may induce immune cell or humoral responses [16], [17].…”

Section: Introductionmentioning

confidence: 99%

Transscleral Sustained Vasohibin-1 Delivery by a Novel Device Suppressed Experimentally-Induced Choroidal Neovascularization

et al. 2013

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We established a sustained vasohibin-1 (a 42-kDa protein), delivery device by a novel method using photopolymerization of a mixture of polyethylene glycol dimethacrylate, triethylene glycol dimethacrylate, and collagen microparticles. We evaluated its effects in a model of rat laser-induced choroidal neovascularization (CNV) using a transscleral approach. We used variable concentrations of vasohibin-1 in the devices, and used an enzyme-linked immunosorbent assay and Western blotting to measure the released vasohibin-1 (0.31 nM/day when using the 10 μM vasohibin-1 delivery device [10VDD]). The released vasohibin-1 showed suppression activity comparable to native effects when evaluated using endothelial tube formation. We also used pelletized vasohibin-1 and fluorescein isothiocyanate-labeled 40 kDa dextran as controls. Strong fluorescein staining was observed on the sclera when the device was used for drug delivery, whereas pellet use produced strong staining in the conjunctiva and surrounding tissue, but not on the sclera. Vasohibin-1 was found in the sclera, choroid, retinal pigment epithelium (RPE), and neural retina after device implantation. Stronger immunoreactivity at the RPE and ganglion cell layers was observed than in other retinal regions. Significantly lower fluorescein angiography (FA) scores and smaller CNV areas in the flat mounts of RPE-choroid-sclera were observed for the 10VDD, VDD (1 μM vasohibin-1 delivery device), and vasohibin-1 intravitreal direct injection (0.24 μM) groups when compared to the pellet, non-vasohibin-1 delivery device, and intravitreal vehicle injection groups. Choroidal neovascularization can be treated with transscleral sustained protein delivery using our novel device. We offer a safer sustained protein release for treatment of retinal disease using the transscleral approach.

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“…[789101112] To test the survival, safety and functionality of the injected cells, it is imperative to perform sub-retinal injections in a rodent model and acquire technical expertise. The techniques of subretinal injection of cells are multiple and vary from trans-scleral injections,[1314] subretinal implants[1516] and subretinal injection following vitrectomy. [1718] Attempting subretinal implants or a vitrectomy can be a very challenging situation and often leads to complications.…”

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confidence: 99%

Learning curve of a trained vitreo-retinal surgeon in sub-retinal injections in a rat model: Implications for future clinical trials

Dave

Susaimanickam

Mir

et al. 2019

Indian J Ophthalmol

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Purpose: The sub-retinal injections are not very commonly performed procedures in vitreoretina, but form a crucial step in any cell replacement therapy for retinal diseases. The purpose of this study is to describe the learning curve of a trained vitreo-retinal surgeon in sub-retinal injections in a rat model and its implications in future clinical trials. Methods: This is an in-vivo retrospective animal study using Wistar rats. All ARVO guidelines regarding animal handling were followed. After anesthetization, aspectic preparation and dilating the pupils with 1% tropicamide eye drops, subretinal injection of 10 μl saline was done via a limbal entry. Data recorded included time taken for the procedure, success of injection, associated complications, post-operative infections and complications. The rats were followed up for 1 month post procedure. A trend analysis was done for the above factors to look for improvement in ease of procedure, reduction in procedure time and reduction in complications for the clinician using a novel objective scale. Results: About 20 eyes were studied. Mean weight of the rats was 188 ± 12.82 gram. Mean time taken for the procedure was 14.1 ± 5.07 minutes. There was a significant inverse co-relation between the serial number of the eye and time taken for the procedure (r = −0.89, P < 0.0001). Comparative complications noted between the first ten and the last ten eyes were: conjunctival tear 30% versus 10% ( P = 0.27), lens touch 50% versus 10% ( P = 0.05), subretinal hemorrhage 40% versus 0% ( P = 0.13), vitreous loss 30% versus 0% ( P = 0.06). The successful subretinal injection without intraocular complications was achieved in 40% versus 90% ( P = 0.02). There was a significant co-relation between the serial number of the eye and ease of the procedure (r = 0.87, P < 0.0001). Post operatively none of the eyes had any infection. Six eyes (12%) developed cataract and 3 eyes (6%) had non-resolving retinal detachment at the last examination visit. Conclusion: Subretinal injections in rats have a definite learning curve even for a trained vitreoretinal surgeon. This should be accounted for and resources allocated accordingly to achieve good technical comfort and negate confounding by the surgeon factor in the results of future clinical trials

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Post-Surgical Scleritis Associated With the Ganciclovir Implant

Cited by 7 publications

References 5 publications

An Arched Micro-Injector (ARCMI) for Innocuous Subretinal Injection

An Arched Micro-Injector (ARCMI) for Innocuous Subretinal Injection

Transscleral Sustained Vasohibin-1 Delivery by a Novel Device Suppressed Experimentally-Induced Choroidal Neovascularization

Learning curve of a trained vitreo-retinal surgeon in sub-retinal injections in a rat model: Implications for future clinical trials

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