Intraocular sustained-release drug delivery in Uveitis
The main goal in the treatment of uveitis is to eliminate intraocular inflammation and thereby relieve discomfort and prevent visually significant complications such as cataract, cystoid macular edema, and hypotony. When anti-inflammatory drugs are given systemically, it is often necessary to give high doses over long time periods to achieve an effective ocular anti-inflammatory effect. Corticosteroids are the mainstay of uveitis therapy, however treatment may not be fully effective, or side effects may be treatment-limiting. It is then often necessary to switch to alternative drugs. These agents can be broadly described as steroid-sparing drugs as they can either reduce the amount of corticosteroids needed in a given patient, or they can replace corticosteroids altogether. Broadly speaking these steroid-sparing medications can be classified as immunosuppressives and immunomodulators. Immunosuppressives include antimetabolites, such as methotrexate, azathioprine and mycophenolate mofetil and alkylating agents, such as cyclophosphamide and chlorambucil. Immunomodulators include calcineurin inhibitors such as cyclosporin A (CsA) and tacrolimus (FK506), and cytokine inhibitors including etanercept and infliximab.
