Towards an Optimized Use of Ocular Corticosteroids: EURETINA Award Lecture 2017.
Details
Serval ID
serval:BIB_7417E7E54A8C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Towards an Optimized Use of Ocular Corticosteroids: EURETINA Award Lecture 2017.
Journal
Ophthalmologica
ISSN
1423-0267 (Electronic)
ISSN-L
0030-3755
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
240
Number
2
Pages
111-119
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Since their discovery, glucocorticoids (GCs) have been extensively used for the treatment of ocular diseases because of their anti-inflammatory, anti-edematous and angiostatic properties. Various GCs have been synthetized to optimize their beneficial anti-inflammatory effects and reduce their effects on sodium retention, identified as a mineralocorticoid effect, leading to a potency and specificity grading of the different GCs. However, the side effects, specificity and potency of GCs are highly tissue specific. Because the eye is a confined organ, local GC administration can reduce the systemic undesirable and severe side effects but does not protect from potential local toxicity and side effects, which are dose-dependent, influenced by the disease stage and by genetic and epigenetic susceptibility. GCs can potentially induce retinal cell death through non-classical pathways such as paraptosis and non-caspase-dependent apoptosis that could be undetectable when using classical toxicology tests. To reduce the risks of toxicity, therapeutic lower doses of GCs are desirable and can be achieved using optimized methods of administration such as transscleral iontophoresis or polymeric implants. In the retina, glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) expression is regulated by disease conditions such as ocular inflammation. Activation of the MR pathway by its specific ligand, aldosterone, or by illicit GC occupation can cause retinal edema, subretinal fluid accumulation, and choroidal vasodilation and leakage, suggesting that central serous chorioretinopathy could benefit from MR antagonist. A better understanding of the MR/GR balance in the ocular tissue and the differential effects of their activation in the different ocular cells is still required to envisage an optimized use of GCs for the treatment of different ocular disease conditions.
Keywords
Central serous chorioretinopathy, Corticoids, Drug delivery, Eye, Glucocorticoids, Mineralocorticoid receptors, Retina
Pubmed
Web of science
Open Access
Yes
Create date
17/08/2018 18:18
Last modification date
20/08/2019 15:31