Thermal Effects on Fluid Mixing in the Eye

Ann Biomed Eng. 2021 Jan;49(1):251-261. doi: 10.1007/s10439-020-02534-9. Epub 2020 May 26.

Abstract

Age-related macular degeneration (AMD) is the leading cause of central vision loss in the developed world. Wet AMD can be managed through serial intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents. However, sometimes the treatment is ineffective. Given that the half-life of the drug is limited, inefficient mixing of the injected drug in the vitreous chamber of the eye may contribute to the ineffectiveness. Here, we introduce thermal heating as a means of enhancing the mixing-process in the vitreous chamber and investigate parameters that potentially influence its effectiveness. Our in vitro studies reveal the importance of the heating location on the eye. A significant increase in the mixing and delivery of drugs to the targeted area (the macula) could be achieved by placing heating pads to induce a current, against gravity, in the vitreous. The presented results can potentially help in the development of a better strategy for intravitreal injection, subsequently improving the quality of patient care.

Keywords: Age-related macular degeneration (AMD); Drug delivery; Flow in the human eye; Intravitreal injections; Particle imaging velocimetry (PIV); Thermally-induced convection; Vitreous.

MeSH terms

  • Drug Delivery Systems*
  • Fluorescein / administration & dosage
  • Glycerol / administration & dosage
  • Hot Temperature*
  • Humans
  • Intravitreal Injections
  • Macula Lutea / metabolism
  • Models, Biological*
  • Vitreous Body*
  • Water / administration & dosage
  • Wet Macular Degeneration / drug therapy

Substances

  • Water
  • Glycerol
  • Fluorescein