Clinical Applications of Dexamethasone for Aged Eyes

Abstract

The risk of severe eye problems has been found to increase significantly with age, particularly between the fifth and sixth decades of life. Cataracts, dry eye, neovascular age-related macular degeneration, diabetic retinopathy and retinal vein occlusion (RVO) are very common and very different age-related ocular diseases that reduce the patient's quality of life. The rationale for using corticosteroids to treat anterior and posterior ocular segment diseases is driven by inflammation. Dexamethasone, one of the most powerful corticosteroids available, is widely used for topical or intravitreal administration. Topical dexamethasone has proven efficacy for the management of postoperative inflammation in the anterior segment after cataract surgery and symptom relief in dry-eye disease. A new sustained-release 700 µg dexamethasone intravitreal implant (DEX) was recently approved for the treatment of macular edema following RVO, diabetic macular edema, or non-infectious uveitis, and its use is increasing, especially when other therapeutic agents have failed. The most common side effects are increased intraocular pressure and cataract formation. The potency of DEX, alone or in combination with other agents, makes DEX a promising option for treating several retinal diseases.

Cyclodextrin-containing hydrogels as an intraocular lens for sustained drug release

“…Both cataract surgery (considered a traumatic stimulation) and coexisting ocular diseases (such as uveitis) can promote the migration of inflammatory cells and the release of inflammatory factors, resulting in post-operative inflammation [ 8 ]. Corticosteroids, such as dexamethasone and hydrocortisone, are widely used to prevent inflammation post-cataract surgery [ 9 , 10 ]. Ophthalmic formulations, such as dexamethasone eye drops, are the primary mode of topical administration [ 11 ].…”

Cyclodextrin-Based Nanohydrogels Containing Polyamidoamine Units: A New Dexamethasone Delivery System for Inflammatory Diseases

“…Dexamethasone is widely used for its ocular anti-inflammatory effect [1,28,29,30] but can also treat lymphoid neoplasia [31], and it has been used in solid cancer therapies in combination with antitumor drugs, such as 5-fluorouracil and cisplatin [32]. It exerts its anti-inflammatory and immunosuppressive effects by reducing the expression of cytokines and adhesion molecules, inhibiting leukocyte trafficking and access to inflammation sites and interfering with leukocyte, fibroblast and endothelial cell function.…”

Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy

“… 27 , 28 Importantly, we know from prior studies that prostaglan-dins play an important role in mediating pain, hyperemia, photophobia, lacrimation, and decreased vision from cystoid macular edema, symptoms that are commonly exhibited in post-cataract eyes. 29 , 30 DXM, similar to all corticosteroids, inhibits the production of prostaglandins by blocking the enzymatic activity of phospholipase A 2 -mediated release of arachidonic acid from cell membranes. 31 Experimental studies of inflammation have established that prostaglandin production is significantly higher in inflamed eyes compared to the non-inflamed baseline state.…”