Evaluation of a liposomal steroid sustained drug delivery system for the treatment of experimental anterior uveitis

Session Details

Session Title: Ocular Pathology/Education & Training

Session Date/Time: Tuesday 17/09/2019 | 14:00-16:00

Paper Time: 15:06

Venue: Free Paper Forum: Podium 4

First Author: : T.Wong SINGAPORE

Co Author(s): :    C. Wong   B. Czarny   B. Metsalaar   G. Storm                    

Abstract Details

Purpose:

Non-infectious anterior uveitis (AU) is a potentially sight threatening inflammatory condition. The current gold standard for treatment is topical steroids, but low ocular bioavailability and compliance issues with the intensive dosing regimen limit the efficacy of this treatment. Liposomes as a drug delivery system may help to overcome these problems.

Setting:

We studied the efficacy of a PEG-liposomal formulation of liposomal steroids, administered as a single subconjunctival dose, in the treatment of experimental uveitis in rabbit eyes.

Methods:

New Zealand White rabbits were randomized into one of five groups: subconjunctival liposomal prednisolone phosphate, subconjunctival liposomal triamcinolone, subconjunctival free prednisolone phosphate, topical prednisolone acetate 1% and no treatment. Experimental uveitis was induced by intravitreal injection on Day 0 in preimmunized rabbits with Mycobacterium tuberculosis H37Ra antigen. To simulate a recurrence of uveitis, a repeat injection was given on Day 8. Slit-lamp photography of the anterior segment, IOP measured and dilated fundal examination were performed. Severity of uveitis was scored by evaluating anterior chamber cells/flares, vitreous haze, and iris vessels. Eyes were enucleated on D30 for histological analysis.

Results:

Eyes treated with liposomal triamcinolone acetonide (LTA) or liposomal prednisolone phosphate (LPP) had significantly lower mean inflammatory scores than untreated controls after induction of uveitis (LPP vs controls, p = 0.049) and 8 (LPP vs controls, p = 0.007; LTA vs controls, p = 0.019), and lower scores than the topical PredForte1% group (p = 0.03). After antigen rechallenge, the liposomal steroid groups had a greater suppression of inflammation than untreated controls (p = 0.02). There was no significant increase in IOP and no difference in cataract formation between groups. Fewer inflammatory cells were present in LTA and LPP groups.

Conclusions:

A single subconjunctival injection of liposomal steroids induced an effective and sustained anti-inflammatory action compared to topical steroids. Liposomal steroid sustained delivery system had a greater suppression in the inflammatory response compared to topical steroids following an antigen rechallenge which simulated a clinical relapse.

Financial Disclosure:

gains financially from product or procedure presented