AIMS: To investigate the efficacy and safety of intravitreal Dexamethasone implant (DEX-I) therapy in the treatment of diabetic macular edema (DME) refractory to intravitreal bevacizumab (IVB). MATERIAL AND METHODS: This retrospective and cross-sectional study included 37 eyes of 37 patients who received 3 loading doses of IVB injections for DME with no response and underwent DEX-I implant. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurements and central foveal thickness (CFT) measured by spectral domain optical coherence tomography (SD-OCT) were recorded and compared before DEX-I, at the first week, first, second, third and sixth months. Duration of DME, glycated hemoglobin (HbA1c) levels, DME types and lens status (phakic, pseudophakic) were also recorded. RESULTS: The mean age of the patients was 61.14 ±8.69 years (59.5% male, 40.5% female). 35.1% of the patients had cystoid macular edema, 64.9% had diffuse macular edema and 73 % were phakic and 27% were pseudophakic. BCVA, CFT and IOP values before DEX-I injection were 0.78 ±0.16 LogMAR, 493.73 ±107.6 µm and 13.05 ±2.59 mmHg, respectively. At 6 months after DEX-I, BCVA, CFT and IOP values were 0.64 ±0.11 LogMAR, 397.35 ±59.72 µm and 16.3 ±2.51 mmHg, respectively. In all follow-ups, there was a significant improvement in BCVA, a significant decrease in CFT and a significant increase in IOP compared to pre-injection. Ocular hypertension was observed in 0.8 % of patients and progression of cataract progression in 1% of patients after treatment. CONCLUSION: DEX-I therapy is an effective and safe treatment option for DME refractory to IVB treatment.

• Klíčová slova
• Dexamethasone implant, bevacizumab, cataract, diabetic macular edema, intraocular pressure,
• MeSH
• dexamethason * aplikace a dávkování   škodlivé účinky   MeSH
• diabetická retinopatie * farmakoterapie   komplikace   MeSH
• glukokortikoidy * aplikace a dávkování   MeSH
• implantované léky MeSH
• injekce intravitreální MeSH
• lidé středního věku MeSH
• lidé MeSH
• makulární edém * farmakoterapie   etiologie   MeSH
• optická koherentní tomografie MeSH
• průřezové studie MeSH
• retrospektivní studie MeSH
• senioři MeSH
• zraková ostrost MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• dexamethason * MeSH
• glukokortikoidy * MeSH
• implantované léky MeSH

Spinal cord injury (SCI) results in paralysis, driven partly by widespread glutamate-induced secondary excitotoxic neuronal cell death in and around the injury site. While there is no curative treatment, the standard of care often requires interventive decompression surgery and repair of the damaged dura mater close to the injury locus using dural substitutes. Such intervention provides an opportunity for early and local delivery of therapeutics directly to the injured cord via a drug-loaded synthetic dural substitute for localized pharmacological therapy. Riluzole, a glutamate-release inhibitor, has shown neuroprotective potential in patients with traumatic SCI, and therefore, this study aimed to develop an electrospun riluzole-loaded synthetic dural substitute patch suitable for the treatment of glutamate-induced injury in neurons. A glutamate-induced excitotoxicity was optimized in SH-SY5Y cells by exploring the effect of glutamate concentration and exposure duration. The most effective timing for administering riluzole was found to be at the onset of glutamate release as this helped to limit extended periods of glutamate-induced excitotoxic cell death. Riluzole-loaded patches were prepared by using blend electrospinning. Physicochemical characterization of the patches showed the successful encapsulation of riluzole within polycaprolactone fibers. A drug release study showed an initial burst release of riluzole within the first 24 h, followed by a sustained release of the drug over 52 days to up to approximately 400 μg released for the highest loading of riluzole within fiber patches. Finally, riluzole eluted from electrospun fibers remained pharmacologically active and was capable of counteracting glutamate-induced excitotoxicity in SH-SY5Y cells, suggesting the clinical potential of riluzole-loaded dural substitutes in counteracting the effects of secondary injury in the injured spinal cord.

• Klíčová slova
• SH-SY5Y, electrospinning, glutamate-induced excitotoxicity, riluzole, spinal cord injury,
• MeSH
• implantované léky MeSH
• kyselina glutamová metabolismus   MeSH
• lidé MeSH
• nádorové buněčné linie MeSH
• neurony účinky léků   MeSH
• neuroprotektivní látky * aplikace a dávkování   chemie   farmakologie   MeSH
• polyestery chemie   MeSH
• poranění míchy * farmakoterapie   MeSH
• riluzol * aplikace a dávkování   chemie   farmakologie   MeSH
• uvolňování léčiv MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• implantované léky MeSH
• kyselina glutamová MeSH
• neuroprotektivní látky * MeSH
• polyestery MeSH
• riluzol * MeSH

A 70-year-old woman was examined with a 10-day history of photopsia and floaters in her left eye. Her best-corrected visual acuity was 20/25 in both eyes, with a normal intraocular pressure and some nuclear sclerosis. Spectral-domain optical coherence tomography revealed a separated posterior vitreous, with a rolled internal limiting membrane flap and inner retinal dimples in the left eye. Optical coherence tomography angiography demonstrated reduced vessel density in both the superficial and deep capillary plexuses of the left fundus. Sixteen months earlier, she had received a single intravitreal Dexamethasone implant injection, due to inferotemporal branch retinal vein occlusion-related macular edema. A diagnosis of internal limiting membrane tear following an uneventful posterior vitreous detachment was reached and no treatment was recommended.

• Klíčová slova
• Dexamethasone implant, inner retinal dimples, internal limiting membrane tear, intravitreal injection, macular edema, optical coherence tomography, posterior vitreous detachment, retinal vein occlusion,
• MeSH
• dexamethason * aplikace a dávkování   MeSH
• glukokortikoidy * aplikace a dávkování   MeSH
• implantované léky MeSH
• injekce intravitreální MeSH
• lidé MeSH
• makulární edém * farmakoterapie   komplikace   etiologie   MeSH
• okluze retinální žíly * komplikace   farmakoterapie   MeSH
• optická koherentní tomografie MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• dexamethason * MeSH
• glukokortikoidy * MeSH
• implantované léky MeSH

OBJECTIVE: The aim of this study was to evaluate the outcomes of Ozurdex® (DEX) implant in patients with diabetic macular edema (DME) in real-world clinical practice, and to determine the correlation between known OCT biomarkers and the effect of treatment. MATERIAL AND METHODS: This retrospective study included 42 eyes of 33 patients (16 women, 17 men) treated with DEX at the Department of Ophthalmology, Faculty of Medicine and Dentistry of Palacký University and University Hospital Olomouc for DME indication between 2020 and 2023. Follow-up examinations were conducted at 1, 3, and 6 months after the first DEX application. The main assessed parameters were: best-corrected visual acuity (BCVA), intraocular pressure (IOP), central retinal thickness (CRT), OCT biomarkers. The results were subsequently statistically evaluated. RESULTS: At the first follow-up after DEX application, there was an average decrease in CRT of 186 ±146µm and a gain of 3 ±7 letters. Positive morphological and functional responses were observed in 39 eyes (92.9%) and 23 eyes (54.8%) respectively. The disorganization of retinal inner layers (DRIL) biomarker was initially present in 41 eyes (97.6%), with reduction or disappearance observed in 13 eyes (31%) post-application. Eyes with ellipsoid zone disruption (EZ disruption) had an average initial BCVA of 49.6 letters, compared to 57.8 letters in the group without this biomarker. The mean gain in BCVA was +8.7 letters in treatment-naive eyes and +2.1 letters in previously treated eyes. Chronic DME was less frequent in treatment-naive (n = 1, 14.3%) compared to previously treated eyes (n = 28, 84.8%). All these results were statistically significant (p < 0.05). An increase in IOP post-DEX application occurred in 9 patients (21.4%). CONCLUSION: Our results confirm DEX as a safe and effective treatment option for DME. Treatment-naive patients achieved better functional outcomes. We confirmed ellipsoid zone disruption (EZ disruption) as a negative biomarker. Additionally, we demonstrated the capacity of DEX to reduce disorganization of the retinal inner layers (DRIL).

• Klíčová slova
• OCT biomarkers, Ozurdex, dexamethasone, diabetic macular edema,
• MeSH
• dexamethason * aplikace a dávkování   MeSH
• diabetická retinopatie * farmakoterapie   MeSH
• glukokortikoidy aplikace a dávkování   MeSH
• implantované léky * MeSH
• injekce intravitreální * MeSH
• lidé středního věku MeSH
• lidé MeSH
• makulární edém * farmakoterapie   MeSH
• optická koherentní tomografie MeSH
• retrospektivní studie MeSH
• senioři MeSH
• zraková ostrost MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• dexamethason * MeSH
• glukokortikoidy MeSH
• implantované léky * MeSH

INTRODUCTION: Ozurdex® (Allergan Pharmaceuticals, Castlebar Road, Westport, Ireland) is an intravitreal implant containing 0.7 mg of dexamethasone. It is indicated in adult patients for the treatment of diabetic macular edema, cystoid macular edema due to central retinal vein occlusion, and in patients with non-infectious uveitis. Common complications after Ozurdex® administration include an increase in intraocular pressure, cataract progression or conjunctival suffusion. Acute retinal necrosis after Ozurdex® administration is a very rare and serious complication. According to our current research, this is the fourth published case. Extreme caution must be exercised when treating immunosuppressed patients with Ozurdex®. CASE REPORT: This is case report about an immunosuppressed 68-year-old patient with diabetic macular edema, who developed acute retinal necrosis 74 days after Ozurdex® implantation. He suffers from chronic myeloid leukemia and takes the cytostatic imatinib 400 mg once per day. Urgent pars plana vitrectomy (PPV) with silicone oil instillation was performed and antiherpetic drugs were initiated intravenously. Serological examination confirmed an active infection of cytomegalovirus etiology (CMV). CONCLUSION: Acute retinal necrosis is a rare necrotizing retinitis. Corticosteroids administered intravitreally reduce the local immune response, which may cause a primary infection or reactivation of a latent viral infection.

• Klíčová slova
• acute retinal necrosis, chronic myeloid leukemia, dexamethasone, diabetic macular edema, diabetic retinopathy, hematopoietic stem cell transplantation, imatinib, imunosupression,
• MeSH
• akutní retinální nekróza * chemicky indukované   komplikace   diagnóza   MeSH
• dexamethason škodlivé účinky   MeSH
• diabetická retinopatie * komplikace   MeSH
• dospělí MeSH
• implantované léky škodlivé účinky   MeSH
• injekce intravitreální MeSH
• lidé MeSH
• makulární edém * diagnóza   farmakoterapie   etiologie   MeSH
• senioři MeSH
• zraková ostrost MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• dexamethason MeSH
• implantované léky MeSH

Due to the additional particle coalescence in the coating, changes in the dissolution profile occur over time in the formulations coated by aqueous ethylcellulose latex. Dry thermal treatment (DT) of the coating can be used as a prevention of this process. Alternatively, it is advisable to take advantage of the synergistic effect of high humidity during wet treatment (WT), which substantially accelerates the film formation. This can be a problem for time-controlled systems, which are based on the coating rupture due to the penetration of water into the core causing the increase in the system volume. This process can begin already during the WT, which may affect the coating adversely. The submitted work was focused on the stability testing of two pellet core compositions: pellets containing swelling superdisintegrant sodium carboxymethyl starch (CMS) and pellets containing osmotically active polyethylene glycol (PEG). Another objective was to identify the treatment/storage condition effects on the pellet dissolution profiles. These pellets are intended to prevent hypoglycemia for patients with diabetes mellitus and therefore, besides the excipients, pellet cores contain 75% or 80% of glucose. The pellet coating is formed by ethylcellulose-based latex, which provides the required lag time (120-360 min). The sample stability was evaluated depending on the pellet core composition (PEG, CMS) for two types of final pellet coating treatment (DT or WT). Scanning electron microscopy and Raman microspectroscopy revealed the penetration of glucose and polyethylene glycol from the core to the PEG pellet surface after WT. For the CMS sample, significant pellet swelling after WT (under the conditions of elevated humidity) was statistically confirmed by the means of stereomicroscopic data evaluation. Therefore, the acceleration of dissolution rate during the stress tests is caused by the soluble substance penetration through the coating in the case of PEG pellets or by dosage form volume increase in the case of CMS pellets. The observed mechanisms can be generally anticipated during the stability testing of the ethylcellulose coated dosage forms. The aforementioned processes do not occur after DT and the pellets are stable in the environment without increased humidity.

• Klíčová slova
• Coated pellets, Coating penetration, Pellet volume increase, Stability, Wet treatment,
• MeSH
• celulosa analogy a deriváty   chemie   MeSH
• farmaceutická chemie MeSH
• glukosa chemie   farmakologie   MeSH
• hypoglykemie prevence a kontrola   MeSH
• implantované léky chemie   MeSH
• léky s prodlouženým účinkem MeSH
• polyethylenglykoly chemie   MeSH
• pomocné látky chemie   MeSH
• povrchové vlastnosti MeSH
• příprava léků metody   MeSH
• rozpustnost MeSH
• škrob analogy a deriváty   chemie   MeSH
• stabilita léku MeSH
• uvolňování léčiv MeSH
• velikost částic MeSH
• vysoká teplota MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• carboxymethyl starch MeSH Prohlížeč
• celulosa MeSH
• ethyl cellulose MeSH Prohlížeč
• glukosa MeSH
• implantované léky MeSH
• léky s prodlouženým účinkem MeSH
• polyethylenglykoly MeSH
• pomocné látky MeSH
• škrob MeSH

The purpose of the present work was to evaluate in vivo different antimicrobial therapies to eradicate osteomyelitis created in the femoral head of New Zealand rabbits. Five phosphate-based cements were evaluated: calcium phosphate cements (CPC) and calcium phosphate foams (CPF), both in their pristine form and loaded with doxycycline hyclate, and an intrinsic antimicrobial magnesium phosphate cement (MPC; not loaded with an antibiotic). The cements were implanted in a bone previously infected with Staphylococcus aureus to discern the effects of the type of antibiotic administration (systemic vs. local), porosity (microporosity, i.e. <5 μm vs. macroporosity, i.e. >5 μm) and type of antimicrobial mechanism (release of antibiotic vs. intrinsic antimicrobial activity) on the improvement of the health state of the infected animals. A new method was developed, with a more comprehensive composite score that integrates 5 parameters of bone infection, 4 parameters of bone structural integrity and 4 parameters of bone regeneration. This method was used to evaluate the health state of the infected animals, both before and after osteomyelitis treatment. The results showed that the composite score allows to discern statistically significant differences between treatments that individual evaluations were not able to identify. Despite none of the therapies completely eradicated the infection, it was observed that macroporous materials (CPF and CPFd, the latter loaded with doxycycline hyclate) and intrinsic antimicrobial MPC allowed a better containment of the osteomyelitis. This study provides novel insights to understand the effect of different antimicrobial therapies in vivo, and a promising comprehensive methodology to evaluate the health state of the animals was developed. We expect that the implementation of such methodology could improve the criteria to select a proper antimicrobial therapy.

• Klíčová slova
• Calcium phosphate cements, Calcium phosphate foams, Drug delivery, In vivo, Magnesium phosphate cements, Osteomyelitis,
• MeSH
• antibakteriální látky aplikace a dávkování   farmakokinetika   farmakologie   MeSH
• doxycyklin aplikace a dávkování   farmakologie   MeSH
• femur diagnostické zobrazování   patologie   MeSH
• fosforečnany vápenaté chemie   MeSH
• implantované léky chemie   farmakologie   MeSH
• infekční nemoci kostí farmakoterapie   terapie   MeSH
• kostní cementy chemie   farmakologie   MeSH
• králíci MeSH
• lékové transportní systémy metody   MeSH
• osteomyelitida farmakoterapie   terapie   MeSH
• poréznost MeSH
• regenerace kostí účinky léků   MeSH
• stafylokokové infekce farmakoterapie   terapie   MeSH
• uvolňování léčiv MeSH
• viskoelastické látky chemie   MeSH
• výsledek terapie MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antibakteriální látky MeSH
• calcium phosphate MeSH Prohlížeč
• doxycyklin MeSH
• fosforečnany vápenaté MeSH
• implantované léky MeSH
• kostní cementy MeSH
• viskoelastické látky MeSH

Patients tend to evade the occurrence of hypoglycemic episodes by excessive carbohydrate intake. Glucose pellets with delayed release in the time of the maximum effect of insulin can not only prevent hypoglycemia but also eliminate the preventive carbohydrate intake. The pellets can be administered in a mixture with semisolid food. The cores containing glucose in combination with osmotically active agents (croscarmellose sodium, carmellose sodium, polyethylene glycol, or carboxymethyl starch) were prepared by extrusion-spheronization and coated with 15% water ethylcellulose dispersion (Surelease® B NF) in Wurster column (Medipo, Havlíčkův Brod, Czech Republic) into four coating levels (12.5, 25, 35, and 50%). Mean particle size is 0.63-0.73 for cores and 0.82-0.98 for coated pellets. Cores and coated pellets have excellent or good flow properties according to Hausner ratio and Carr index. Aspect ratio ranges from 1.78 to 2.17 for cores and from 1.73 to 2.31 for coated pellets. Dissolution was performed using pH-independent method and method with continual change of pH. The suitable pH-independent release was achieved in the samples containing carboxymethyl starch or polyethylene glycol. Glucose release is enabled by a membrane rupture caused by core swelling. It can be, therefore, assumed that the glucose release profile will not be affected by food or transit time.

• Klíčová slova
• Delayed release, diabetes mellitus, hypoglycemia, pellets,
• MeSH
• celulosa analogy a deriváty   chemie   MeSH
• diabetes mellitus farmakoterapie   MeSH
• dítě MeSH
• farmaceutická chemie metody   MeSH
• glukosa aplikace a dávkování   MeSH
• hypoglykemie farmakoterapie   MeSH
• hypoglykemika aplikace a dávkování   MeSH
• implantované léky aplikace a dávkování   MeSH
• lékové formy MeSH
• lékové transportní systémy metody   MeSH
• léky s prodlouženým účinkem aplikace a dávkování   chemie   MeSH
• lidé MeSH
• polyethylenglykoly chemie   MeSH
• pomocné látky chemie   MeSH
• rozpustnost MeSH
• škrob analogy a deriváty   chemie   MeSH
• velikost částic MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• carboxymethyl starch MeSH Prohlížeč
• celulosa MeSH
• ethyl cellulose MeSH Prohlížeč
• glukosa MeSH
• hypoglykemika MeSH
• implantované léky MeSH
• lékové formy MeSH
• léky s prodlouženým účinkem MeSH
• polyethylenglykoly MeSH
• pomocné látky MeSH
• škrob MeSH

PURPOSE: Intravitreal implantation of dexamethasone implant (Ozurdex®) is being widely used for the treatment of macular edema (ME) after branch or central retinal vein occlusion, diabetic ME, and persistent ME associated with uveitis or Irvine-Gass syndrome. We describe a complication: migration of the dexamethasone implant into the anterior chamber through basal iridectomy (Ando) in a pseudophakic patient with development of corneal edema and secondary high intraocular pressure. METHODS: This is a case report of migration of Ozurdex® through basal iridectomy in a pseudophakic patient with iris claw lens. CONCLUSIONS: Pseudophakic patients, with a history of vitrectomy, even those with a basal iridectomy (Ando), are at high risk for migration of the Ozurdex® into the anterior chamber and development of corneal edema.

• MeSH
• dexamethason aplikace a dávkování   MeSH
• edém rohovky etiologie   MeSH
• fakoemulzifikace MeSH
• glukokortikoidy aplikace a dávkování   MeSH
• implantace nitrooční čočky MeSH
• implantované léky škodlivé účinky   MeSH
• injekce intravitreální MeSH
• iridektomie * MeSH
• lidé MeSH
• makulární edém farmakoterapie   MeSH
• oční hypertenze etiologie   MeSH
• přední komora oční patologie   MeSH
• pseudofakie etiologie   MeSH
• selhání protézy etiologie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• dexamethason MeSH
• glukokortikoidy MeSH
• implantované léky MeSH

Macular edema due to retinal vein occlusion is the second most common cause of vascular vision impairment. The authors refer two case reports that describe different response to treatment with OZURDEX, biodegradable injectable implant slowly releasing 700 µg dexamethasone. Treatment with corticosteroids is effective also in the case of cystic retinal edema, but its effect can be temporary. The most common adverse events are elevation of intraocular pressure and cataract development.

• MeSH
• dexamethason aplikace a dávkování   MeSH
• glukokortikoidy aplikace a dávkování   MeSH
• implantované léky MeSH
• injekce intravitreální MeSH
• lidé středního věku MeSH
• lidé MeSH
• makulární edém farmakoterapie   etiologie   MeSH
• okluze retinální žíly komplikace   MeSH
• vstřebatelné implantáty * MeSH
• zraková ostrost * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• dexamethason MeSH
• glukokortikoidy MeSH
• implantované léky MeSH