Scleral melt following Retisert intravitreal fluocinolone implant

Georgalas, Ilias; Koutsandrea, Chryssanthi; Papaconstantinou, Dimitris; Mpouritis, Dimitrios; Petrou, Petros

doi:10.2147/dddt.s66634

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…In one randomized trial (ClinicalTrials.gov number, NCT00132691), the inflammation of NIU was controlled better with 0.59 mg FA implant than systemic treatment at 24 months [ 81 ]. However, the side effects related to Retisert also include cataracts and glaucoma [ 78 , 79 , 82 ]. Less common side effects are retinal detachment, vitreous hemorrhage, and scleral thinning over the implant [ 83 – 87 ].…”

Section: Pathogenesis and Experimental Models Of Niumentioning

confidence: 99%

Pathogenesis and current therapies for non-infectious uveitis

Tao

Zhu

et al. 2022

Clin Exp Med

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Non-infectious uveitis (NIU) is a disorder with various etiologies and is characterized by eye inflammation, mainly affecting people of working age. An accurate diagnosis of NIU is crucial for appropriate therapy. The aim of therapy is to improve vision, relieve ocular inflammation, prevent relapse, and avoid treatment side effects. At present, corticosteroids are the mainstay of topical or systemic therapy. However, repeated injections are required for the treatment of chronic NIU. Recently, new drug delivery systems that may ensure intraocular delivery of therapeutic drug levels have been highlighted. Furthermore, with the development of immunosuppressants and biologics, specific therapies can be selected based on the needs of each patient. Immunosuppressants used in the treatment of NIU include calcineurin inhibitors and antimetabolites. However, systemic immunosuppressive therapy itself is associated with adverse effects due to the inhibition of immune function. In patients with refractory NIU or those who cannot tolerate corticosteroids and immunosuppressors, biologics have emerged as alternative treatments. Thus, to improve the prognosis of patients with NIU, NIU should be managed with different drugs according to the response to treatment and possible side effects.

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Section: Pathogenesis and Experimental Models Of Niumentioning

confidence: 99%

Pathogenesis and current therapies for non-infectious uveitis

Tao

Zhu

et al. 2022

Clin Exp Med

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“…Additional implants can be inserted extending the duration of treatment available with this sustained release drug delivery implant [ 84 ]. Due to the wound size required for implantation, associated scleral thinning and rare reports of scleral melt, scleral integrity should be monitored, particularly in patients undergoing reimplantation [ 85 , 86 ].…”

Section: Surgical Implantsmentioning

confidence: 99%

A Review of Ocular Drug Delivery Platforms and Drugs for Infectious and Noninfectious Uveitis: The Past, Present, and Future

Conrady

Yeh

2021

Pharmaceutics

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Uveitis refers to a broad group of inflammatory disorders of the eye that often require medical and surgical management to improve or stabilize vision and prevent vision-threatening pathological changes to the eye. Drug delivery to the eye to combat inflammation and subsequent complications from uveitic conditions is complex as there are multiple barriers to absorption limiting availability of the needed drug in the affected tissues. As such, there has been substantial interest in developing new drugs and drug delivery platforms to help reduce intraocular inflammation and its complications. In this review, we discuss the challenges of drug delivery, novel technologies recently approved for uveitis patient care and promising drug delivery platforms for uveitis and sequelae of ocular inflammation.

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“…Although ILUVIEN® has the convenience of a suture-less procedure, there are reports of implant migration into the anterior chamber, blocking the visual axis, and dislodgement into the infusion cannula during vitrectomy (Andreatta et al 2017;El-Ghrably et al 2015;Moisseiev and Morse 2016;Papastavrou et al 2017). Reported Retisert® adverse effects are mostly sclerotomy-related: hypotony, temporary decrease in visual acuity, cataract formation, choroidal detachment, retinal detachment, vitreous hemorrhage, wound dehiscence, implant dislocation, and scleral melt (FDA Reference ID: 2955048) (Almeida et al 2015;Chang et al 2015;Freitas-Neto et al 2015;Petrou et al 2014;Yasin et al 2014). For these reasons, the doctor performs indirect ophthalmoscopy to verify correct placement of the implant, adequate central retinal artery perfusion, and absence of complications (FDA Reference IDs: 2955048; 3635981) (Bausch & Lomb n.d.;Yasin et al 2014).…”

Section: Intraocular Placementmentioning

confidence: 99%

Advanced implantable drug delivery technologies: transforming the clinical landscape of therapeutics for chronic diseases

Pons‐Faudoa

Ballerini

Sakamoto

et al. 2019

Biomed Microdevices

149

105

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Chronic diseases account for the majority of all deaths worldwide, and their prevalence is expected to escalate in the next 10 years. Because chronic disorders require long-term therapy, the healthcare system must address the needs of an increasing number of patients. The use of new drug administration routes, specifically implantable drug delivery devices, has the potential to reduce treatment-monitoring clinical visits and follow-ups with healthcare providers. Also, implantable drug delivery devices can be designed to maintain drug concentrations in the therapeutic window to achieve controlled, continuous release of therapeutics over extended periods, eliminating the risk of patient non-compliance to oral treatment. A higher local drug concentration can be achieved if the device is implanted in the affected tissue, reducing systemic adverse side effects and decreasing the challenges and discomfort of parenteral treatment. Although implantable drug delivery devices have existed for some time, interest in their therapeutic potential is growing, with a global market expected to reach over $12 billion USD by 2018. This review discusses implantable drug delivery technologies in an advanced stage of development or in clinical use and focuses on the state-of-the-art of reservoir-based implants including pumps, electromechanical systems, and polymers, sites of implantation and side effects, and deployment in developing countries.

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Scleral melt following Retisert intravitreal fluocinolone implant

Cited by 4 publications

References 9 publications

Pathogenesis and current therapies for non-infectious uveitis

Pathogenesis and current therapies for non-infectious uveitis

A Review of Ocular Drug Delivery Platforms and Drugs for Infectious and Noninfectious Uveitis: The Past, Present, and Future

Advanced implantable drug delivery technologies: transforming the clinical landscape of therapeutics for chronic diseases

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