Ophthalmic Drug Delivery

Biswajit Mondal

Introduction
The Pharmacotherapy of eye disease generally requires
high local concentrations of drug at the ocular tissues.
Treatment of ocular surface infections or inflammations
necessitates effective drug delivery to the eyelids,
conjunctiva, or cornea. In contrast treatment of Uveitis,
glaucoma, or retinitis involves therapeutic drug levels at
appropriate target sites deep within the globe. Although
many systems have been developed specifically for drug
delivery to the eye, most of them suffer from lack of
precision, and those associated with intraocular drug
delivery can lead to unacceptable toxicity. Here we will
discuss the most clinically useful drug delivery system
developed for ocular pharmacotherapy, with emphasis on
those used in primary eye care.

Routes of Ophthalmic Drug

Administration

Topical Administration
Periocular Administration
Intracameral Administration
Intravitreal Administration
Photodynamic Therapy

Topical Administration

Solutions & Suspensions

Sprays
Ointments
Lid Scrubs
Gels
Solid Delivery Devices
Continuous Flow Devices

Solid Delivery Devices

Soft Contact Lenses

Collagen Shields
Filter Paper Strips
Cotton Pledgets

Continuous Flow Devices

Conventional Irrigating Systems
Continuous Irrigating Systems

Periocular Administration

Subconjunctival Injection
Anterior Sub-Tenons Injection
Posterior Sub-Tenons Injection
Retrobulber Injection
Peribulbar Injection

Intracameral Administration
&
Intravitreal Administration

Photodynamic Therapy
A form of treatment using an photosensitizing
agent administered intravenously which
concentrates selectively in tumor cells, followed
by exposure of the tumor tissue to a special red
laser light, in order to destroy as much of the
tumor as possible.
A laser-assisted surgical procedure (e.g.,to
correct age-related macular degeneration) during
which a photosensitizer is activated by exposure
to light to produce photochemical effects in the
target area of the eye requiring care.

Cont

Photodynamic therapy has been shown to be effective in

helping to prevent further loss of sight in people who are
afflicted by the classic form of exudative (wet) macular
degeneration. Neil M. Bressler, M.D., associate professor of
ophthalmology at Johns Hopkins, chaired the multicenter
trial, and the chemical Visudyne, used in the therapy, has
been approved for use in the United States (see the related
press release in the MD Support Library), Canada, Europe,
and Japan.
Current laser therapy uses a "hot" laser to coagulate
leaking blood vessels, while destroying surrounding healthy
tissue. Photodynamic therapy does not use heat, so no
damage results, and the procedure can be repeated as
many times as necessary on an out-patient basis.
First, a drug called BPD-MA (also known as both verteporfrin
and Visudyne) is injected into a vein. The drug is then

Cont
Second, a beam of red laser light is aimed into the eye.
This cool beam activates the drug, which produces a
toxic form of oxygen, causing the leaking to stop.
Photodynamic therapy is not a cure, but it is proving to
be an effective and safe treatment for exudative MD.
Based upon the study by QLT PhotoTherapeutics Inc.
(QLT) and CIBA Vision Corporation (the eye care unit of
Novartis AG), patients treated with Visudyne therapy
were more likely to have stable vision (defined as a loss
of less than 3 lines of vision on a standard eye chart) or
improved vision compared to placebo-treated patients.

Thank you