Suprachoroidal Drug Delivery – A New Approach for the Treatment of Severe Macular Diseases

In this article, we review recent research in suprachoroidal drug administration for the treatment of advanced, refractory, retinal disease. A microcatheter (iTRACKTM 400) has been used to access and deliver drugs to the suprachoroidal space. This technology has been investigated in several animal models as well as in patients with advanced disease stages and/or who are unresponsive to conventional treatments. In groups with either age-related macular degeneration (AMD) and/or macular oedema resulting from other diseases, significant effects were achieved by using this technology to apply steroids and/or anti-vascular endothelial growth factor (VEGF) drugs, with no surgical or postoperative complications observed. Suprachoroidal drug administration directly adjacent to the choroid in the submacular region might therefore be a potential treatment for many retinal diseases. Human pilot studies in patients with advanced, refractory retinal disease that is unresponsive to conventional treatments showed some increase in residual vision and significant reduction of macular oedema, with few complications. Prospective trials are necessary to confirm the pilot results obtained by different research groups.