The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial

Bali, Ernesto; Feron, Eric J.; Peperkamp, E.; Veckeneer, Marc; Mulder, Paul; Meurs, Jan C. van

doi:10.1007/s00417-010-1319-8

Cited by 35 publications

(37 citation statements)

References 33 publications

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“…The periocular drug delivery system can release dexamethasone sodium phosphate in a time-dependent manner in vitro in the 2 mg/ml and 5 mg/ml groups in vitro. In this study, we set the subconjunctival injection of DEXP as control group for subconjunctival injection is the easiest and most popular method among periocular injection routes applied by the ophthalmologists (Bali et al, 2010;Dieleman et al, 2011;Manandhar, 2011). However, in this study, DEXP can just persist in the eye for no longer than three days after subconjunctival injection, as no DEXP was detected in the eye three days after subconjunctival injection.…”

Section: Discussionmentioning

confidence: 95%

A study of the dexamethasone sodium phosphate release properties from a periocular capsular drug delivery system

et al. 2014

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The aim of this study was to investigate whether a periocular capsular drug delivery system (DDS) can release dexamethasone sodium phosphate (DEXP) in vitro and in vivo to the posterior segment of rabbit's eye. In vitro, the periocular capsular DDS containing 2 mg/ml or 5 mg/ml DEXP was immersed in modified Franz diffusion cell. Four-hundred microliters of liquid was aspirated at 0.5, 1, 2, 4, 8, 24 and 48 h for determination. In vivo, the DEXP-filled periocular capsular DDS was implanted into the sub-Tenon's sac of the New Zealand rabbit. DEXP concentration at the serum aqueous humor, cornea, iris, lens, ciliary body, vitreous, retina, choroids and sclera was quantified at 1, 3, 7, 14, 28 and 56 d after implantation. The DEXP concentration was determined by ultra-performance liquid chromatography-tandem mass spectrometry. In vitro, the periocular capsular DDS released the DEXP in time-dependent manner from 1/2 to 48 h. In vivo, the concentrations of the DEXP at the retina, choroids, ciliary body and iris were 123.11 (91.23, 732.61) ng/g, 362.46 ± 330.46 ng/g, 71.64 (71.35, 180.21) ng/g and 192.50 ± 42.66 ng/g, respectively, at 56 d after implantation. Minimal DEXP was found in the aqueous, serum and vitreous. Our results demonstrated that DEXP could be sustained released from the periocular capsular DDS, which indicated that the periocular capsular DDS might be a potential candidate of transscleral drug delivery for the management of posterior segment diseases.

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Section: Discussionmentioning

confidence: 95%

A study of the dexamethasone sodium phosphate release properties from a periocular capsular drug delivery system

et al. 2014

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“…PVR rates of 4 % in the steroid group and 11 % in the control group in this study are apparently too small for reliable statistical evidence. Subconjunctival injection of dexamethasone immediately before retinal detachment surgery was claimed to reduce the leakage of the blood-retinal barrier and was discussed as a potential means of reducing the incidence of PVR in a study of Bali et al [13]. Laser flare photometry of the anterior segment was used in this study.…”

Section: Discussionmentioning

confidence: 98%

“…Local injections of triamcinolone acetonide and systemic administration of steroids against PVR reactions have been tested experimentally and in humans [9][10][11][12][13]. The combination of systemic methylprednisolone, sodium diclofenac and colchicine reduced significantly the rate of PVR-induced retinal detachment in rabbits [14].…”

Section: Introductionmentioning

confidence: 98%

Systemic corticosteroids reduce the risk of cellophane membranes after retinal detachment surgery: a prospective randomized placebo-controlled double-blind clinical trial

Koerner

Koerner-Stiefbold

Garweg

2012

Graefes Arch Clin Exp Ophthalmol

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“…[16][17][18] Dexamethasone has been shown to differentially alter the expression of efflux transporters such as P-gp in the barriers of brain, gut, liver, and lung [19][20][21][22] ; however, it remains unclear whether dexamethasone also has an effect on the functional expression of efflux transporters at the BRB. Because dexamethasone is often a concomitant agent for the treatment of ocular disease secondary to the BRB breakdown, 17,18,23 it is important to determine how dexamethasone affects the functional expression of efflux transporters in RPE cells. Using cultured human RPE cells, we set to investigate the effect of dexamethasone on the expression and functional activity of P-gp in cultured human RPE cells.…”

mentioning

confidence: 99%

Expression and Activity of p-Glycoprotein Elevated by Dexamethasone in Cultured Retinal Pigment Epithelium Involve Glucocorticoid Receptor and Pregnane X Receptor

Zhang

Lü

Sun

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate whether dexamethasone has an effect on functional expression of p-glycoprotein in cultured human RPE and, if so, whether this occurs through interaction with glucocorticoid receptor (GR) and pregnane X receptor (PXR).METHODS. The human RPE D407 was treated with increasing concentrations of dexamethasone and/or RU486 for various time periods up to 24 hours. Treated cells were collected for cell viability, expressions of p-glycoprotein and PXR, and rhodamine 123 accumulation assays. GR expression plasmid and rifampicin were chosen to investigate the relationship of GR/PXR activation and p-glycoprotein expression.RESULTS. Significant increases in p-glycoprotein, as indicated by mRNA and protein levels, as well as by functional activity, were induced within 12 hours of dexamethasone treatment, persisted as long as 24 hours, and were dose-dependent and attenuable with coculture of RU486. In parallel, a dosedependent upregulation of PXR was notable at both mRNA and protein levels by 24 hours of dexamethasone treatment, and was partially reversible with RU486 coculture. Additionally, transfection of GR expression plasmid increased the transitional expressions of PXR and p-glycoprotein in untreated cells, and enhanced PXR transcriptional expression in dexamethasone-treated cells. Further, PXR silencing inhibited the dexamethasone-induced p-glycoprotein alterations; however, rifampicin had no apparent effects on the dexamethasoneinduced p-glycoprotein alterations. CONCLUSIONS.Our results suggest for the first time that expression and activation of p-glycoprotein involve GR and PXR in human RPE. (Invest Ophthalmol Vis Sci. 2012;53:3508-3515) DOI:10.1167/iovs.11-9337 R PE plays an essential role in protecting neural tissues from toxic materials and in maintaining vision and neural function in the retina by forming the outer blood-retinal barrier (BRB). It has been demonstrated that the outer BRB not only regulates the ionic environment of the subretinal space, secretes factors for structural integrity of the retina, phagocytizes shed outer segments of photoreceptors, and participates in the visual cycle, 1 but also limits vitreal penetration of drugs administered by the systemic and transscleral routes. 2-4 Efflux transport systems provide further barriers for the retina, by actively removing cytotoxic drugs and specific xenobiotic compounds from the retina and transferring them back into the systemic circulation.5,6 P-glycoprotein (P-gp), a 170-kDa protein encoded by the multiple drug resistance human MDR1 gene, is a member of the ABC superfamily of energy-dependent transport systems.7 As a well-characterized efflux transporter, P-gp is strongly expressed by retinal vascular endothelial cells 8 and has recently been identified in human RPE. 9 P-gp displays broad specificity, accepting many structurally, functionally, and mechanistically unrelated compounds, 10 and its role in limiting drug penetration across biological barriers is well established. Although efflux pumps such as P-gp are best known ...

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The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial

Cited by 35 publications

References 33 publications

A study of the dexamethasone sodium phosphate release properties from a periocular capsular drug delivery system

A study of the dexamethasone sodium phosphate release properties from a periocular capsular drug delivery system

Systemic corticosteroids reduce the risk of cellophane membranes after retinal detachment surgery: a prospective randomized placebo-controlled double-blind clinical trial

Expression and Activity of p-Glycoprotein Elevated by Dexamethasone in Cultured Retinal Pigment Epithelium Involve Glucocorticoid Receptor and Pregnane X Receptor

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