脉络膜上腔给药治疗眼后节疾病的研究进展

Recent advances in suprachoroidal drug delivery for the treatment of ocular posterior segment diseases

脉络膜上腔是位于巩膜与脉络膜之间的潜在腔隙,脉络膜上腔给药针对性作用于脉络膜、视网膜色素上皮层及视网膜组织,而眼部其他组织内药物浓度极低,具有较高的生物利用度和安全性。近些年脉络膜上腔给药系统、药代动力学及临床试验方面有较大的进展。临床试验证实脉络膜上腔注射曲安奈德混悬液治疗非感染性葡萄膜炎及糖尿病黄斑水肿有较好疗效。目前曲安奈德混悬液是唯一一种经美国食品药品监督管理局批准经脉络膜上腔给药治疗非感染性葡萄膜炎的药物。目前临床上已开展了多项脉络膜上腔给药治疗眼后节疾病的临床试验,尽管还存在一些风险及不确定性,但相信随着技术的不断发展进步,脉络膜上腔给药在眼后节疾病治疗中将会有更为广阔的应用前景。

The suprachoroidal space is a potential space between the sclera and choroid.Suprachoroidal spacedrug delivery is becoming an applicable method to the ocular posterior segment diseases.Because it targets the choroid,retinal pigment epithelium and retina with high bioavailability and safety,while maintaining low levels elsewhere in the eye.In recent years,new discoveries has been carried out in different areas of interest,such as drug delivery methods,pharmacokinetics and clinical trials.Clinical trials with suprachoroidal space injection of triamcinolone acetonide are executed with promising findings for patients with noninfectious uveitis and diabetic macular edema.Suprachoroidal space triamcinolone acetonide injectable suspension is the first and currently the only agent specifically approved for uveitic macular edema by Food and Drug Administration.Nowadays,many clinical trails with suprachoroidal space drug delivery have been explored,although there are still many risks and uncertainties.With the development of technology in the future,suprachoroidal space drug delivery appears to be a promising treatment modality for ocular posterior segment diseases.