Development and Clinical Evaluation of Clotrimazole–β-Cyclodextrin Eyedrops for the Treatment of Fungal Keratitis

Nanoemulsions are considered as the most promising solution to improve the delivery of ophthalmic drugs. The design of ophthalmic nanoemulsions requires an extensive understanding of pharmaceutical as well as technological aspects related to the selection of excipients and formulation processes. This Review aims at providing the readers with a comprehensive summary of possible compositions of nanoemulsions, methods for their formulation (both laboratory and industrial), and differences between technological approaches, along with an extensive outline of the research methods enabling the confirmation of in vitro properties, pharmaceutical performance, and biological activity of the obtained product. The composition of the formulation has a major influence on the properties of the final product obtained with low-energy emulsification methods. Increasing interest in high-energy emulsification methods is a consequence of their scalability important from the industrial perspective. Considering the high-energy emulsification methods, both the composition and conditions of the process (e.g., device power level, pressure, temperature, homogenization time, or number of cycles) are important for the properties and stability of nanoemulsions. It is advisible to determine the effect of each parameter on the quality of the product to establish the optimal process parameters’ range which, in turn, results in a more reproducible and efficient production.

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“…If no microbial growth is observed in the samples, the tested product is considered to meet the sterility requirements. 16 , 104 …”

Section: Ocular Nanoemulsions Research Methodsmentioning

confidence: 99%

“…the samples should be incubated for 14 days at 30–35 °C in thioglycolate medium and at 20–25 °C in the casein and soybean hydrolyzate medium. If no microbial growth is observed in the samples, the tested product is considered to meet the sterility requirements. , …”

Section: Ocular Nanoemulsions Research Methodsmentioning

confidence: 99%

Ophthalmic Nanoemulsions: From Composition to Technological Processes and Quality Control

et al. 2021

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“…Hydroxypropyl b CD, a cyclodextrin used as a carrier for ketoconazole, led to a 20-fold increase in drug bioavailability compared to suspensions. [ 128 129 ]…”

Section: Antimicrobialsmentioning

confidence: 99%

Update on diagnosis and management of refractory corneal infections

Agarwal

Khan

Vanathi

et al. 2022

Indian Journal of Ophthalmology

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Infectious keratitis is a medical emergency resulting in significant visual morbidity. Indiscriminate use of antimicrobials leading to the emergence of resistant or refractory microorganisms has further worsened the prognosis. Coexisting ocular surface diseases, delay in diagnosis due to inadequate microbiological sample, a slow-growing/virulent organism, or systemic immunosuppressive state all contribute to the refractory response of the ulcer. With improved understanding of these varied ocular and systemic factors contributing to the refractory nature of the microbes, role of biofilm formation and recent research on improving the bioavailability of drugs along with the development of alternative therapies have helped provide the required multidimensional approach to effectively diagnose and manage cases of refractory corneal ulcers and prevent corneal perforations or further dissemination of disease. In this review, we explore the current literature and future directions of the diagnosis and treatment of refractory keratitis.

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Fungal Keratitis: Update for 2014

Stone

Tan

2014

Curr Ophthalmol Rep

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Fungal keratitis is a challenging problem worldwide, and many obstacles remain to the effective prevention, diagnosis, and therapy of this vision-threatening condition. Recent research has highlighted progress in each of these facets of the clinical approach to keratomycosis. Increased awareness of contact lens-associated fungal keratitis has prompted regulators to pay greater attention to testing of contact lens solutions under realworld conditions. Related research has also delved into the mechanisms of fungal biofilm formation and related therapeutic targets. Advances in polymerase chain reaction methodologies promise to increase the rapidity and accuracy of diagnosis, thereby decreasing the delay in instituting appropriate therapy. Antifungal pharmacologic agents remain the first line of therapy, with the newer azole antifungal voriconazole being utilized in innovative ways, such as via intrastromal injection. Large prospective studies such as the Mycotic Ulcer Treatment Trial have helped delineate optimal treatment algorithms, and variations in surgical techniques and postoperative regimens continue to be refined. Natamycin may still be more effective than other recently utilized antifungals for the treatment of Fusarium infections, but treatment failure is still a concern. Post-keratoplasty immunosuppression may benefit from the use of topical calcineurin inhibitors such as cyclosporine and tacrolimus, given their intrinsic antifungal properties. It can be argued that the prevention, diagnosis, and treatment of fungal keratitis lag behind the state of the art for bacterial keratitis, but dramatic improvements are undoubtedly on the horizon.

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Development and Clinical Evaluation of Clotrimazole–β-Cyclodextrin Eyedrops for the Treatment of Fungal Keratitis

Cited by 12 publications

References 20 publications

Ophthalmic Nanoemulsions: From Composition to Technological Processes and Quality Control

Ophthalmic Nanoemulsions: From Composition to Technological Processes and Quality Control

Update on diagnosis and management of refractory corneal infections

Fungal Keratitis: Update for 2014

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