Abstract

Glaucoma is considered to be one of the biggest health problems in the world. It is the main cause of preventable blindness due to its asymptomatic nature in the early stages on the one hand and patients’ non-adherence on the other. There are several approaches in glaucoma treatment, whereby this has to be individually designed for each patient. The first-line treatment is medication therapy. However, taking into account numerous disadvantages of conventional ophthalmic dosage forms, intensive work has been carried out on the development of novel drug delivery systems for glaucoma. This review aims to provide an overview of formulation solutions and strategies in the development of in situ gel systems, nanosystems, ocular inserts, contact lenses, collagen corneal shields, ocular implants, microneedles, and iontophoretic devices. The results of studies confirming the effectiveness of the aforementioned drug delivery systems were also briefly presented.

Highlights

  • The lack of neurotrophic factors in the optic nerve contributes to the occurrence and progression of glaucomatous optic neuropathy (GON) which is caused by high intraocular pressure (IOP)

  • Researchers and scientists face numerous obstacles to developing improved novel drug delivery systems and solutions that sometimes look like an art

  • The most intensive research on in situ gel systems (IGS) has been carried out as it is a non-invasive type of treatment, and its form of eye drops is not unknown to the patient

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Summary

Introduction

Glaucoma is a chronic disease that affected approximately 60.5 million people worldwide in 2010 [1]. Glaucoma is the second most common eye disease after cataracts [4] It is known as the “silent thief of vision” because its symptoms are usually only felt in the late stages of the disease when the visual field and vision are seriously impaired [5]. Glaucomatous havoc affects the retinal ganglion cell stroma, photoreceptors, the lateral geniculate body, and the visual cortex, the main reason for vision loss is the impairment of retinal ganglion cell axons within the lamina cribrosa of the optic nerve head [11]. Pharmaceutics 2021, 13, 28 the therapy aims to decrease IOP to an individual target level at which further progression of glaucomatous optic nerve damage is unlikely. The more the optic nerve is damaged, and more risk factors are present, the lower the target IOP level is. The choice of therapy depends on cost, side effects, and dosing frequency, generally, PAs are the first-line medical treatment [3]

Wound Modulating Agents
Novel Drug Delivery Systems
In Situ Gel Systems
Nanosystems
Nanoparticles
Nanoemulsions
Nanosuspensions
Liposomes
Niosomes
Dendrimers
Cyclodextrin Complexes
Nanocrystals
Nanodiamonds
Ocular Inserts
Topical Ophthalmic Drug Delivery Device
Topical Ocular Ring
Punctal Plugs
Contact Lenses
Collagen Corneal Shields
Ocular Implants
Microneedles
Ocular Iontophoresis
Gene Therapy
Neuroprotection
Glutamate Antagonists
Neurotrophic Factors
Antioxidants
Calcium Channel Blockers
Findings
Conclusions
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