Administration Of Drops Research Articles

Comprehensive Pharmacokinetic Evaluation of High Melanin Binder Levofloxacin in Rabbits Shows Potential of Topical Eye Drops for Posterior Segment Treatment.

The purpose of this work was to understand the impact of melanin binding on ocular pharmacokinetics after administration of a high-binder model drug via different administration routes. We applied levofloxacin to pigmented and albino rabbits as eye drops (single and multiple), as well as by intravitreal and intravenous injections. Ocular tissues and plasma were analyzed for levofloxacin concentrations with liquid chromatography-mass spectrometry (LC-MS/MS), and pharmacokinetic parameters were calculated. The data show enrichment of levofloxacin and weeks-long retention in pigmented tissues. Upon intravitreal injection, the area under the curve (AUC) values in pigmented tissues were about 9 to 15 times higher than the respective values in the albino rabbits, but this difference expanded to 255- to 951-fold following topical eye drop administration. Multiple dosing of eye drops led to substantial accumulation of levofloxacin in the pigmented tissues: AUC values were 3 to 12 times higher than after intravitreal injection. The AUCs were much lower after single topical or intravenous drug administrations. High drug levels (0.1-35 µM) were always observed in the neural retinas of pigmented eyes; the highest exposure was seen after intravitreal administration followed by multiple doses of topical drops. Single topical instillation and intravenous injections to the albino rabbits resulted in vitreal bioavailability values of 0.009% and 0.003%, respectively. Melanin binding can be used to achieve targeted drug delivery and extended retention in pigmented ocular tissues. The results from topical multiple dosing experiments suggest that eye drop treatment may yield drug exposures and responses comparable to intravitreal delivery, even in the retinal pigment epithelium and choroid.

Sublingual administration of atropine eye drops for treating sialorrhea after stroke: A randomized controlled trial

BackgroundSialorrhea is a common concern in patients with swallowing disorders after stroke. Atropine sulfate blocks the muscarinic receptors in the salivary glands and leads to reduced saliva production. ObjectiveThe present study aimed to assess the safety, efficacy, and tolerability of sublingual administration of atropine eye drops for treating sialorrhea after stroke. DesignThis was a prospective cohort study. SettingThis study was conducted at Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei Province, China. PopulationStroke patients with sialorrhea were analyzed. MethodsOne hundred stroke patients with sialorrhea were randomly assigned to the control group and the test group (n = 50 per group). The control group received routine swallowing rehabilitation training and neuromuscular electrical stimulation. The test group received therapy with 1% atropine eye drops, wherein one drop was administered sublingually 3 times per day. The Sialorrhea Scoring Scale and the incidence of adverse events were used to compare the severity of sialorrhea in the two groups. ResultsThe mean (standard deviation) sialorrhea score improved from 5.12 for the control group with routine rehabilitation training to 3.94 for the test group with atropine eye drop administration (P < 0.01). No significant differences in the incidence of adverse events were observed between the two groups. ConclusionsThe sublingual administration of 1% atropine eye drops three times per day can reduce the degree of sialorrhea to an extent more than that achieved with routine rehabilitation training; thus, this approach is effective, safe, and minimally invasive for treating sialorrhea after stroke.

Enhancement of therapeutic efficacy of Brinzolamide for Glaucoma by nanocrystallization and tyloxapol addition

BackgroundBrinzolamide (BRI) suspensions are used for the treatment of glaucoma; however, sufficient drug delivery to the target tissue after eye drop administration is hampered by poor solubility. To address this issue, we focused on nanocrystal technology, which is expected to improve the bioavailability of poor-solubility drugs, and investigated the effect of BRI nanocrystal formulations on corneal permeability and intraocular pressure (IOP)-reducing effect.MethodsBRI nanocrystal formulations were prepared by the wet-milling method with beads and additives. The particle size was measured by NANOSIGHT LM10, and the morphology was determined using a scanning probe microscope (SPM-9700) and a scanning electron microscope (SEM). Corneal permeability was evaluated in vitro using a Franz diffusion cell with rat corneas and in vivo using rabbits, and the IOP-reducing effect was investigated using a rabbit hypertensive model.ResultsThe particle size range for prepared BRI nanocrystal formulation was from 50 to 300 nm and the mean particle size was 135 ± 4 nm. The morphology was crystalline, and the nanoparticles were uniformly dispersed. In the corneal permeability study, BRI nanocrystallization exhibited higher corneal permeability than non-milled formulations. This result may be attributed to the increased solubility of BRI by nanocrystallization and the induction of energy-dependent endocytosis by the attachment of BRI nanoparticles to the cell membrane. Furthermore, the addition of tyloxapol to BRI nanocrystal formulation further improved the intraocular penetration of BRI and showed a stronger IOP-reducing effect than the commercial product.ConclusionsThe combination of BRI nanocrystallization and tyloxapol is expected to be highly effective in glaucoma treatment and a useful tool for new ophthalmic drug delivery.

Scanning Electron Microscopy (SEM) Evaluation of the Ultrastructural Effects on Conjunctival Epithelial Cells of a New Multiple-Action Artificial Tear Containing Cross-Linked Hyaluronic Acid, Cationic Liposomes and Trehalose.

The authors performed an ex vivo and in vivo evaluation of the ultrastructural effects on the conjunctival epithelial cells of a new multiple-action tear substitute containing cross-linked hyaluronic acid, lipids and trehalose (Trimix®), using scanning electron microscopy (SEM) with conjunctival impression cytology. The ex vivo study highlights the persistence and distribution of the product at 5 and 60 min on a monolayer of conjunctival epithelial cells and an increase in microvilli density at the 60 min evaluation. In vivo examination was conducted on three subjects with different grades of ocular surface inflammation, treated with one drop of the product twice daily for thirty days. At the baseline (T0) and twelve hours after the last administration of the tear drop (T30), impression cytology of the upper bulbar conjunctiva for SEM evaluation of conjunctival epithelial cells was carried out. Slit lamp examination (SLE), corneal and conjunctival Fluotest, tear film break-up time (TBUT), and ocular surface disease index (OSDI) questionnaires were also performed to correlate the ultrastructural results with the clinical findings. After 30 days of treatment, a significant improvement in all clinical and symptomatic parameters and in the condition of the ocular surface was detected, with microvillar regeneration and strengthening in all the patients, and a complete restoration in 2/3 of them. The persistence and distribution of the product on the epithelial cells was also noted 12 h after the last administration. The results, therefore, suggest a marked epitheliotropic effect along with a high residence time of the tear substitute.

Corneal application of SOCS1/3 peptides for the treatment of eye diseases mediated by inflammation and oxidative stress.

Several blinding diseases affecting the retina and optic nerve are exacerbated by or caused by dysregulated inflammation and oxidative stress. These diseases include uveitis, age related macular degeneration, diabetic retinopathy and glaucoma. Consequently, despite their divergent symptoms, treatments that reduce oxidative stress and suppress inflammation may be therapeutic. The production of inflammatory cytokines and their activities are regulated by a class of proteins termed Suppressors of Cytokine Signaling (SOCS). SOCS1 and SOCS3 are known to dampen signaling via pathways employing Janus kinases and signal transducer and activator of transcription proteins (JAK/STAT), Toll-like Receptors (TLR), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), mitogen activated kinase (MAPK) and NLR family pyrin domain containing 3 (NLRP3). We have developed cell-penetrating peptides from the kinase inhibitory region of the SOCS1 and SOCS3 (denoted as R9-SOCS1-KIR and R9-SOCS3-KIR) and tested them in retinal pigment epithelium (RPE) cells and in macrophage cell lines. SOCS-KIR peptides exhibited anti-inflammatory, anti-oxidant and anti-angiogenic properties. In cell culture, both Th1 and Th17 cells were suppressed together with the inhibition of other inflammatory markers. We also observed a decrease in oxidants and a simultaneous rise in neuroprotective and anti-oxidant effectors. In addition, treatment prevented the loss of gap junction proteins and the ensuing drop in transepithelial electrical resistance in RPE cells. When tested in mouse models by eye drop instillation, they showed protection against autoimmune uveitis, as a prophylactic as well as a therapeutic. Mice with endotoxin-induced uveitis were protected by eye drop administration as well. R9-SOCS3-KIR was particularly effective against the pathways acting through STAT3, e.g. IL-6 and VEGF-A mediated responses that lead to macular degeneration. Eye drop administration of R9-SOCS3-KIR stimulated production of antioxidant effectors and reduced clinical symptoms in mouse model of oxidative stress that replicates the RPE injury occurring in AMD. Because these peptides suppress multiple pathogenic stimuli and because they can be delivered topically to the cornea, they are attractive candidates for therapeutics for uveitis, macular degeneration, diabetic retinopathy and glaucoma.

The effect of ethanol extracts of loulu flower on LPS-induced acute lung injury in mice

Ethnopharmacological relevanceIn Mongolian medicine, Loulu flower (LLF), the dried inflorescence of Rhaponticum uniflorum (L.) DC. from the Compositae family, has been used to clear heat and relieve toxicity for millennia, particularly in the treatment of pneumonia. Aim of this studyTo reveal the effects of LLF on mice with lipopolysaccharide (LPS)-stimulated acute lung injury (ALI) and elucidate the underlying mechanisms. Materials and methodsALI was established in BALB/c mice via nasal drops administration of LPS (5 mg/kg). The mice were then orally administrated with various doses of LLF extracts and the positive drug dexamethasone (DEX, 5 mg/kg), once daily for seven consecutive days. Last day, after being stimulated with LPS for 6h, the mice were closed dislocation of cervical vertebra, the serum, bronchus alveolar lavage fluid (BALF) and lung tissue were put into the EP tube and stored at −80 °C for further analysis. The changes of histopathology were tested by hematoxylin and eosin stain (H&E), the levels of, IL-1β, IL-18, TNF-α and IL-4 in BALF and serum were measured by ELISA. The pathways related to the treatment of ALI were predicted by network pharmacology. The expression levels of TLR4/NF-κB and NLRP3 signaling pathway-associated proteins, COX-2 and ERK were tested by western blotting. The levels of P65 and NLRP3 in lung tissues were determined by immunofluorescence analysis. ResultsLLF total extract and the extract parts could alleviate the inflammatory cell infiltration, thicken the alveolar walls in lung tissues, reduce the levels of IL-18, IL-1β in BALF, the TNF-α in both BALF and serum, meantime enhance the level of IL-4 in BALF and serum in mice with LPS-induced ALI. Our network pharmacology and comprehensive gene ontology analyses revealed the active constituents of LLF and the pathways, including TLR4/NF-κB, NLRP3 and MAPK signaling pathways, which play significant roles in ALI. Furthermore, both the total extract and its extraction portions suppressed the expressions of proteins related with the COX-2, p-ERK and TLR4/NF-κB signaling pathway (TLR4, p-IκB, p-p65), as well as the NLRP3 signaling pathway (NLRP3, cleaved caspase-1, caspase-1, IL-1β). ConclusionLLF could improve the pathological changes and reducing inflammatory reactions in mice induced by LPS. The mechanism may be related to the modulation of the TLR4/NLRP3 signaling pathways.

Real-world evaluation of novel eye drop bottle sensors: Cloud-based AI support for eye drop adherence

PurposeTo understand real-world eye drop adherence among glaucoma patients and evaluate the performance of our proposed cloud-based support for eye drop adherence (CASEA). DesignProspective, observational case series. MethodsSetting: The Department of Ophthalmology at Tsukazaki Hospital.Patient or study population: Glaucoma patients treated at the hospital from May 2021 to September 2022, with 61 patients initially enrolled.Intervention or observation procedures: Pharmacists guided eye drop administration before the study. Changes in bottle orientation were detected using an accelerometer attached to the container, and acceleration waveforms and date/time data were recorded. Patients visited the clinic during the 4th and 8th weeks to report their eye drop administration, and the data were uploaded to the cloud.Main outcome measures: Two AI models (B-LSTM) were created to analyze the eye drop bottle movement time-series data for patients treating one or both eyes. The models were evaluated by comparing the true administration status with the AI model judgment. ResultsFour of the 61 study subjects dropped out. The remaining 57 patients achieved recall, precision, and accuracy values of 98.6 %, 98.6 %, and 95.9 %, respectively, for the two-eyes model and 95.8 %, 98.8 %, and 95.6 % for the one-eye model. Three low-accuracy participants (77.1 %, 71.0 %, and 81.0 %) improved to 100 %, 99.1 %, and 100 %, respectively, after undergoing an additional 8-week performance validation using an aid-type container designed to ensure that the bottle was fully inverted during instillation. ConclusionsCASEA precisely monitored daily eye drop adherence and enhanced treatment efficacy by identifying patients with difficulty self-medicating. This system has the potential to improve glaucoma patient outcomes by supporting adherence.

Improving corneal permeability of dexamethasone using penetration enhancing agents: First step towards achieving topical drug delivery to the retina

With an ever-increasing burden of vision loss caused by diseases of the posterior ocular segment, there is an unmet clinical need for non-invasive treatment strategies. Topical drug application using eye drops suffers from low to negligible bioavailability to the posterior segment as a result of static and dynamic defensive ocular barriers to penetration, while invasive delivery systems are expensive to administer and suffer potentially severe complications. As the cornea is the main anatomical barrier to uptake of topically applied drugs from the ocular surface, we present an approach to increase corneal permeability of a corticosteroid, dexamethasone sodium-phosphate (DSP), using a novel penetration enhancing agent (PEA). We synthesised a novel polyacetylene (pAc) polymer and compared its activity to two previously described cell penetrating peptide (CPP) based PEAs, TAT and penetratin, with respect to increasing transcorneal permeability of DSP in a rapid ex-vivo porcine corneal assay over 60 min. The transcorneal apparent permeability coefficients (Papp) for diffusion of pAc, and fluorescein isothiocyanate (FITC) conjugated TAT and penetratin were up to 5 times higher (p < 0.001), when compared to controls. When pAc was used in formulation with DSP, an almost 5-fold significant increase was observed in Papp of DSP across the cornea (p = 0.0130), a significant 6-fold increase with TAT (p = 0.0377), and almost 7-fold mean increase with penetratin (p = 0.9540). Furthermore, we investigated whether the PEAs caused any irreversible damage to the barrier integrity of the corneal epithelium by measuring transepithelial electrical resistance (TEER) and immunostaining of tight junction proteins using zonula occludens-1 (ZO-1) and occludin antibodies. There was no damage or structural toxicity, and the barrier integrity was preserved after PEA application. Finally, an in-vitro cytotoxicity assessment of all PEAs in human retinal pigment epithelium cells (ARPE-19) demonstrated that all PEAs were very well-tolerated, with IC50 values of 64.79 mM for pAc and 1335.45 µM and 87.26 µM for TAT and penetratin, respectively. Our results suggest that this drug delivery technology could potentially be used to achieve a significantly higher intraocular therapeutic bioavailability after topical eye drop administration, than currently afforded.

Efficacy of 3% diquafosol long-acting eye drops in dry eye patients treated for three months.

To investigate changes in the ocular surface and subjective symptoms during a three months administration of 3% diquafosol long-acting (DQL) eye drops. Prospective observational study. DQL eye drops were administered as the sole treatment for all patients, including those in the group where DQL eye drops were newly prescribed (New DQL) and the group who switched from 3% diquafosol (DQS) eye drops (Switched DQL) in this prospective study. Each group underwent assessment of tear meniscus height (TMH), ocular surface disease index (OSDI), fluorescein break-up time (FBUT), fluorescein score, and Schirmer 1 test before DQL administration, at one month, and at three months. Changes in ocular surface scores and subjective symptoms at each time point were analyzed. The study included a total of 63 eyes of 63 patients, with a mean age of 60.3 ±14.6 (SD). Among them, 29 patients (20 women) were in the New DQL group, and 34 patients (24 women) were in the Switched DQL group. Both the New DQL and Switched DQL groups showed significant improvements in TMH, OSDI, FBUT, Fluorescein Score, and Schirmer 1 test after three months of DQL eye drop administration. DQL eye drops have the potential to improve ocular scores and subjective symptoms in patients with DE over a three months period, regardless of whether it is newly initiated or as a switch from DQS eye drops.

Mydriasis in eastern box turtles (Terrapene carolina carolina) following topical administration of proparacaine, 10% phenylephrine, and rocuronium bromide.

To determine the mydriatic effect of topical 10% phenylephrine with 10 mg/mL rocuronium bromide and compare this protocol with and without pretreatment with proparacaine. Ten client-owned pet adult eastern box turtles (Terrapene carolina carolina). All turtles were sedated with 8 mg/kg alfaxalone intramuscularly. One group of four turtles received four 20 μL drops of 10% phenylephrine and four 20 μL drops of rocuronium bromide in the right eye. Another group of four turtles received one standard drop of proparacaine followed by four 20 μL drops of 10% phenylephrine and four 20 μL drops of rocuronium bromide in the right eye. Two control group turtles received four 20 μL drops of saline in the right eye. The left eye was untreated in all turtles. Drops of the same type were separated by 2 min while drops of different types were separated by 5 min. Pupil size was recorded at 0, 15, 30, 60, 90, 120, 180, 240, and 360 min after administration of the final drop. Treatment with 10% phenylephrine and rocuronium bromide resulted in pupil diameter changes from baseline that were statistically significant from zero at 60, 90, and 120 min in the non-proparacaine group and 90 min in the proparacaine group. The time to peak effect was 90 min in the proparacaine group and 75 min in the non-proparacaine group. Saline-treated pupils in the control group decreased in diameter over the study period. Overall, the treated eyes of the proparacaine group and non-proparacaine group were not different from each other, but both dilated more than the control group. Rocuronium bromide and 10% phenylephrine can produce effective and safe mydriasis in eastern box turtles, but there was wide interindividual variation in effectiveness. Proparacaine did not improve the mydriatic effect.

ВЛИЯНИЕ ГИПОТЕНЗИВНЫХ ПРЕПАРАТОВ В ПОСЛЕОПЕРАЦИОННОМ ПЕРИОДЕ У ПАЦИЕНТОВ С ПСЕВДОЭКСФОЛИАТИВНЫМ СИНДРОМОМ НА ФОНЕ ОСЛОЖНЕННОЙ КАТАРАКТЫ

In modern surgery of complicated cataracts, an important factor is the preservation of visual functions with minimal costs. The surgeon’s experience and modern technology, which makes it possible to identify hidden symptoms of certain pathologies at the diagnostic stage, allows for a favorable completion of surgery with minimal intraoperative complications. This article shows the approach and observations of patients at risk of increasing eye pressure in the postoperative period due to the anatomical structures of the eye (in these cases, patients with open-angle glaucoma) to antihypertensive drugs. 131 patients (134 eyes) with various signs of pseudoexfoliation syndrome participated in the observation. Before planned surgery for complicated cataracts, all patients underwent ophthalmological diagnostics, medical history, and laboratory tests according to generally accepted methods. All operations were performed by the same surgeon. Cataract surgery was performed according to the standard technique (Phaco + intraocular lens) through a 2.2 mm incision, two 1.2 mm paracentesis, but for some patients other components of surgical interventions were added. In the observation groups, for better fixation and a lower percentage of complications in long-term follow-up periods, RPR, T-19, Myol were implanted in 27.7%. A large percentage of 34% were implanted with the HO Acrylic IOL model lens, which requires a 2.2 mm corneal incision. In observation groups 2 and 3, 32.5 and 31.8% preferred lenses to the Acrysoft IQ model. And in 32.5% and 13.6%, respectively, the AFY model. The choice of the method of surgical intervention, as well as the model of intraocular lenses, made it possible to predict the long-term postoperative period with less toxicity for the patient’s condition. No intraoperative complications were observed; the administration of antihypertensive drops, both in combination and in monotherapy in the early stages of the postoperative period, allowed maintaining eye pressure within normal limits in all observation groups.

A mechanical device for precise self-administration of ocular drugs

Individuals with glaucoma are routinely prescribed and required to self-administer eye drop-based medication multiple times a day. Unfortunately, the process of self-administering eye drops requires a level of dexterity, strength, and visual acuity that the elderly population often do not possess, resulting in poor adherence and worsening condition. In this paper, we detail a prototyped eye drop assist device designed to safely and reliably deliver prescription medications. The ergonomic device safely anchors the eye drop bottle tip an optimal distance away from the face, aligns to the pupil, and provides feedback to the user when their head is at an appropriate tilt for a successful eye drop administration. We experimentally verify that the device improves hand steadiness, provides accurate head tilt feedback, precisely positions the bottle tip, and predictably delivers eye drops into the eye according to a parameterized model.

Studies on cationic ocular emulsions containing bipartitioned oil droplets to codeliver cyclosporin A and etodolac.

Background: To prepare ocular emulsions containing bipartitioned oil droplets to entrap cyclosporin A (0.05% w/w) and etodolac (0.2% w/w) by using castor, olive and silicon oils. Methods: The physicochemical characterizations of prepared emulsions were performed. The drug's biodistribution profiles and pharmacokinetic parameters from emulsions were checked using the ultraperformance liquid chromatography-tandemmass spectrometry method in the ocular tissues of the healthy rabbit eye model. Results: The emulsions displayed 365.13±7.21nm size and 26.45±2.09mV zeta potential. The ferrying of two drugs after releasing from emulsions occurred across corneal/conjunctival tissues to enter the vitreous and sclera following a single drop administration into the rabbit's eyes. Conclusion: The dual drug-loaded emulsions weremore likely to produce synergistic anti-inflammatory activity for managing moderate-to-severe dry eye disease.

Ocular Drug Delivery into the Eyes Using Drug-Releasing Soft Contact Lens

The impact of visual impairment, such as blindness, on quality of life is immeasurable. However, effective ocular drug delivery into the eyes has not yet been established, primarily due to the impermeability imposed by the blood–retinal barrier (BRB) based on the tight junctions and efflux transporters at the endothelium or the epithelium in oral or intravenous administration, as well as the dilution with tear fluid and excretion through the nasolacrimal duct in eye drop administration. Furthermore, intravitreous injections induce pain and fear in patients. Unmet medical needs persist in ocular diseases such as age-related macular degeneration and diabetic retinopathy. Therefore, innovative non-invasive administration methods should be developed. Drug-releasing soft contact lenses (DR-SCLs) affixed to the eye’s surface can continuously and locally deliver their loaded drugs to the eyes. The use of DR-SCLs is expected to greatly enhance the bioavailability and patient adherence to the drug regimen. It is known that several solute carrier (SLC) transporters are expressed in various parts of the eyes, including the cornea, the ciliary body, and the bulbar conjunctiva. Carrier-mediated transport through SLC transporters may occur in addition to passive diffusion. Moreover, nanoparticles can be loaded into DR-SCLs, offering various intelligent approaches based on modifications to induce receptor-mediated endocytosis/transcytosis or to control the loaded drug release within this delivery system. In this perspective review, I discuss the implementation and potential of DR-SCL-mediated ocular drug delivery, particularly focusing on low-molecular-weight compounds because of their fine distribution in living body, ease of handling, and ease of manufacturing.

Tear film stability in patients with symptoms of dry eye after instillation of dual polymer hydroxypropyl guar/sodium hyaluronate vs single polymer sodium hyaluronate.

This study evaluated the tear film stability in patients with symptoms of dry eye after installation of dual polymer hydroxypropyl guar/sodium hyaluronate (DPHG/SH) vs single polymer SH. Patients with recently diagnosed mild to moderate dry eye disease (OSDI score 23-32 points) were included. For each patient, the right eye was randomized to receive DPHG/SH or 0.15% SH. Just after the administration of the drop to the right eye, the fellow eye received the other eye drop. The first non-invasive Keratograph first break-up time (NIKBUT), average NIKBUT and tear meniscus height (TMH) were measured before administration of the eye drops, at 1-min, 15min, 30min, 60min, 90min, and 120min after instillation. A total of 29 patients aged 22.8 ± 2.2years participated in the study (21 women). No differences between the eye receiving DPHG/SH and single polymer SH were observed for the first NIKBUT (p = 0.45) and average NIKBUT (p = 0.24) variables at any time point. Both DPHG/SH and single polymer SH increased the TMH (p of time effect < 0.001), but with no difference between groups (p = 0.95). Both DPHG/SH and single polymer SH solutions provide lubrication of the eye surface, however, with no difference in NIKBUT and TMH evaluations for up to two hours following administration.

Evaluation of the safety and efficacy of the novel Mycoplasma gallisepticum vaccine, Vaxsafe MG304, after spray-vaccination of 1-day-old specific pathogen-free chicks

Mycoplasma gallisepticum causes chronic respiratory disease in poultry. A novel vaccine, Vaxsafe MG304 (the ts-304 strain), has greater protective efficacy in chickens than the Vaxsafe MG (strain ts-11) vaccine when delivered by eye drop at 3 weeks of age. Applying this vaccine in the hatchery to 1-day-old birds, using mass administration methods, would improve animal welfare and reduce labour costs associated with handling individual birds. This study assessed the protection provided by vaccination with Vaxsafe MG304 after administration to 1-day-old chicks. Chicks were administered a single dose of the vaccine to assess the efficacy of either a high dose (107.0 colour changing units, CCU) or a low dose (105.7 CCU) after eye drop or spray (in water or gel) administration against experimental challenge with virulent M. gallisepticum strain Ap3AS at 7 weeks of age. The vaccine was able to colonise the palatine cleft of chicks after vaccination by eye drop (at both doses) or by spray (in water or gel) (at the high dose). The high dose of vaccine, when delivered by eye drop or spray, was shown to be safe and induced a serological response and protective immunity (as measured by tracheal mucosal thickness and air sac lesion scores) against challenge. Vaccination of 1-day-old chicks with Vaxsafe MG304 by eye drop induced protective immunity equivalent to vaccination at 3 weeks of age. Vaxsafe MG304 was also protective when applied by both coarse- and gel spray methods at the higher dose and is therefore a suitable live attenuated vaccine for use in 1-day-old chicks.

Enhancing the Technique of Eye Drop Administration through Evaluation and Education: A Quality Improvement Initiative

Purpose: To evaluate the eye-drop administration technique and see the effect of education in improving the eye drop delivery method. Study Design: Interventional case series. Place and Duration of Study: Central Park Teaching Hospital Lahore from May-2022 to September-2022 Methods: This study includes 341 patients who had been self-administering eye drops as a treatment for glaucomaor any other disorder. The patients were asked to instill the drop by using a 5ml Systane bottle, as they should do at home. Two observers assessed the technique. Patients were educated about the techniques and they were re-assessed in the form of a post-test. They were evaluated by the same observers again. Data was analyzed suing Fisher’s Exact test. Results: A significant improvement was observed in several parameters, including the mean time (in seconds) taken to instill the first drop, the number of drops squeezed, the number of drops reaching the conjunctival sac at the first attempt, hand washing, shaking the bottle before instillation, tilting the head backwards during drop instillation, and the occurrence of drops falling on the cheek (p ≤ 0.05). Conversely, statistically insignificant improvements were noted in parameters such as touching the tip of the dropper and closing the eye for a minute. Conclusion: The findings underscore the importance of enhancing patient education regarding the correct technique for drop instillation.

Eye Drop with Fas-Blocking Peptide Attenuates Age-Related Macular Degeneration.

Age-related macular degeneration (AMD), characterized by macular retinal degeneration, poses a significant health concern due to the lack of effective treatments for prevalent dry AMD. The progression of AMD is closely linked to reactive oxygen species and Fas signaling, emphasizing the need for targeted interventions. In this study, we utilized a NaIO3-induced retinal degeneration mouse model to assess the efficacy of Fas-blocking peptide (FBP). Intravitreal administration of FBP successfully suppressed Fas-mediated inflammation and apoptosis, effectively arresting AMD progression in mice. We developed a 6R-conjugated FBP (6R-FBP) for eye drop administration. 6R-FBP, administered as an eye drop, reached the retinal region, attenuating degeneration by modulating the expression of inflammatory cytokines and blocking Fas-mediated apoptosis in rodent and rabbit NaIO3-induced retinal degeneration models to address practical concerns. Intravitreal FBP and 6R-FBP eye drops effectively reduced retinal degeneration and improved retinal thickness in rodent and rabbit models. This study highlights the therapeutic potential of FBP, particularly 6R-FBP as an eye drop, in inhibiting Fas-mediated cell signaling and protecting against retinal cell death and inflammation in dry AMD. Future investigations should explore the translational prospects of this approach in primates with eye structures comparable to those of humans.

Improving medication adherence in glaucoma patients: a randomized controlled interventional study

Abstract Objectives The main objective of our study was to assess the adherence of Jordanian patients to their glaucoma treatment after a brief educational session. Methods The current study was a randomized controlled interventional study. One hundred and ninety open-angle glaucoma patients were divided into control and intervention groups. After baseline assessment, patients in the intervention group received an educational session about glaucoma, while patients in the control group only received the usual care. Adherence to medication, eye drop administration technique, and knowledge about glaucoma were assessed at baseline and at follow-up. Key findings The mean MGL adherence scale score baseline value was 0.67 and significantly improved to 0.4 at the follow-up (P-value = .039) for patients in the intervention group. Multivariate regression showed that having less than three kids and experiencing glaucoma medication side effects were negatively correlated with adherence to glaucoma eye drops. The mean Eye Drops Administration scale score for patients in the intervention group improved significantly from 6.25 at baseline to 7.7 at the follow-up (P-value &amp;lt; .001). The mean knowledge scale score for the intervention group patients at baseline was 8.8, which significantly increased to 10 at the follow-up (P-value &amp;lt; .001). The knowledge score was found to be significantly higher for younger patients, those who have higher education levels and health care-related education, patients who rely on the ophthalmologist for glaucoma, and patients with a longer duration glaucoma. Conclusions A short educational session improves patients’ adherence, knowledge, and eye drop administration technique in the intervention group significantly. Patients in Jordan have a relatively high adherence to glaucoma medications. Educational sessions should be provided to glaucoma patients to help the patients in managing their condition.

Development of Assistive Devices for Eye Drop Administration in Patients with Cerebral Palsy

Background:Cerebral Palsy is a non-progressive neurological disorder that affects movement, posture, and muscle coordination, caused by damage to the developing brain. It is one of the most common motor disabilities in childhood, with significant implications for an individual's physical and functional abilities. The severe impact on fine motor control in Cerebral Palsy patients is often most evident when performing actions where precision and accuracy are needed such as applying eye drops. This work addresses the design, development, and deployment of assistive devices for fine motor control of objects.&#x0D; Methods:Using 3D modeling and printing, three prototypes were created and assessed for their efficacy in assisting patients with eye drop administration based on the needs and abilities of the individual, considering factors such as ease of use, affordability, and adaptability to different environments. After evaluation, changes were made to each prototype in order to better adapt the design according to the feedback received.&#x0D; Results:Three final products were presented for patient review. Two of these addressed deficiencies of eye drop accuracy and the other fine motor control and bottle manipulation. Patients noted in their final evaluation of the assistive devices improvement in ability to manipulate eye drop bottles as well as better ability to aim the eye dropper for application in comparison to previous methods of application.&#x0D; Conclusion and Impact:By understanding the challenges faced by the individual and evaluating the need for assistive devices, the fine motor challenges associated with eye drop administration due to cerebral palsy were addressed and three valuable products were created that improved patient autonomy and quality of life. Additionally, these devices could be useful for patients with a variety of motor limitations, enabling self-sufficiency while improving ease and accuracy of administration and minimizing waste.