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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Pharmacol. Mar 9, 2016; 5(1): 1-14
Published online Mar 9, 2016. doi: 10.5497/wjp.v5.i1.1
Novel strategies for the treatment of diabetic macular edema
Hoang M Trinh, Mary Joseph, Kishore Cholkar, Dhananjay Pal, Ashim K Mitra
Hoang M Trinh, Mary Joseph, Kishore Cholkar, Dhananjay Pal, Ashim K Mitra, Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, United States
Kishore Cholkar, RiconPharma LLC, Denville, NJ 07834, United States
Author contributions: All the authors contributed to this work; Trinh HM and Joseph M contributed equally to this paper.
Conflict-of-interest statement: The authors are supported by NIH grants R01EY09171-16- and R01EY010659-14. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ashim K Mitra, PhD, Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO 64108, United States. mitraa@umkc.edu
Telephone: +1-816-2351615 Fax: +1-816-2355779
Received: September 25, 2015
Peer-review started: October 6, 2015
First decision: December 4, 2015
Revised: December 19, 2015
Accepted: January 5, 2016
Article in press: January 7, 2016
Published online: March 9, 2016
Abstract

Macular edema such as diabetic macular edema (DME) and diabetic retinopathy are devastating back-of-the-eye retinal diseases leading to loss of vision. This area is receiving considerable medical attention. Posterior ocular diseases are challenging to treat due to complex ocular physiology and barrier properties. Major ocular barriers are static (corneal epithelium, corneal stroma, and blood-aqueous barrier) and dynamic barriers (blood-retinal barrier, conjunctival blood flow, lymph flow, and tear drainage). Moreover, metabolic barriers impede posterior ocular drug delivery and treatment. To overcome such barriers and treat back-of-the-eye diseases, several strategies have been recently developed which include vitreal drainage, laser photocoagulation and treatment with biologics and/or small molecule drugs. In this article, we have provided an overview of several emerging novel strategies including nanotechnology based drug delivery approach for posterior ocular drug delivery and treatment with an emphasis on DME.

Keywords: Diabetic macular edema, Photocoagulation, Retinopathy, Biologics, Vitrectomy, Corticosteroids, Nanoformulations, Laser

Core tip: Macular edema such as diabetic macular edema (DME) and diabetic retinopathy are devastating back-of-the-eye retinal diseases leading to loss of vision. The standard treatments of DME include laser photocoagulation, vitrectomy, intravitreal injections of anti-vascular endothelial growth factor biologics and steroids. In this article we have provided an overview of several emerging novel strategies including nanotechnology based drug delivery approacher for posterior ocular drug delivery and treatment with emphasis on DME.