Ophthalmic Corticosteroids: Innovations in Delivery Systems and Future Therapeutic Outlook

The treatment of a variety of ocular disorders affecting the anterior and posterior regions of the eye as well as the ocular surface still relies heavily on corticosteroids. They possess strong anti-inflammatory, anti-edematous, and anti-angiogenic qualities that contribute to their therapeutic effects. Ophthalmic corticosteroids such as loteprednol etabonate, triamcinolone acetonide, fluocinolone acetonide, dexamethasone, prednisolone, and prednisolone acetate are frequently used. The ocular efficacy and potency of these agents vary because of their inherent pharmacological and medicinal properties. Corticosteroid delivery in ophthalmology can be optimized using a range of administration methods and regimens. For conditions that only affect the ocular surface and anterior portion, topical treatment is still the recommended method. Conversely, to better treat posterior segment diseases, periocular, intravitreal, and suprachoroidal injections are used. But there are hazards associated with corticosteroid medication. Notable local side effects linked to topical and systemic corticosteroid use include cataract development and elevated intraocular pressure. Invasive delivery techniques, like intracameral, subconjunctival, and intravitreal injections, can lower the frequency of dose and greatly increase ocular absorption, but they may also raise the risk of problems from steroids. The therapeutic uses of corticosteroids in ophthalmology are critically examined in this review, with particular attention paid to drug delivery principles, delivery routes, new implantable steroid systems, what influences side effects, and developing methods for safer and more efficient ocular corticosteroid therapy.