Cannulation of the uprachoroidal pace: A Novel Drug Delivery Methodology to the Poterior egment Original Reearch Article

Purpoe To decribe, tet, and evaluate the pharmacokinetic of a novel poterior drug delivery ytem (PD) by mean of microcannulation of the uprachoroidal pace in both the primate and pig animal model. Deign Animal tudy. Method A rheu macaque (Macaca mulatta) (n = 1) and pig model (n = 93) were ued to evaluate the PD, a microcannula that combine a drug delivery channel with a fiber-optic illumination and optimal tranition propertie. The urgical technique, afety profile, hitopathology, retinal and choroidal blood flow, injection of tracer dye, and triamcinolone pharmacokinetic were tudied. Pre- and poturgical high-peed video confocal canning laer ophthalmocopy (cLO) that ued fluorecein and indocyanine green (ICG) imaging and wide-field fundu imaging tudie were performed. Globe were enucleated for either hitopathology or pharmacokinetic. Reult Cannulation wa performed in 93 of 94 animal. Complication included: endophthalmiti (1/94), choroidal tear (1/94), choroidal blood flow irregularitie (4/94), potoperative inflammation (6/94), cleral ectaia (4/94), wound abce (1/94), and other. Hitopathology demontrated normal anatomy in uncomplicated cae. Triamcinolone remain in the local ocular tiue for at leat 120 day, and meaurable at very low level in the ytemic circulation. Concluion Acceing the uprachoroidal pace by the microcannulation ytem can be performed in a afe and reproducible manner by uing careful urgical technique. Forceful PD tip impact into connective tiue in the macular and optic nerve region hould be avoided. Triamcinolone pharmacokinetic are unique and ugget long-term local tiue level with low ytemic level. PD acce to the uprachoroidal pace repreent a novel drug delivery method, applicable to a wide variety of pharmacotherapie to the macula, optic nerve, and poterior pole.