Detection of Ocular & Systemic Disease

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1 Disclosures: Lyndon Jones Biosensing & Drug Delivery Lyndon Jones PhD FCOptom FAAO FCAHS Professor & University Research Chair School of Optometry & Vision Science Director, Centre for Ocular Research & Education (CORE), University of Waterloo, Ontario, Canada Over the past three years members of CORE have received research funding and/or honoraria from the following companies: Advanced Vision Research Alcon Allergan Contamac CooperVision Essilor GL Chemtec Inflamax Research Johnson & Johnson Vision Menicon Nature s Way Novartis Ocular Dynamics Oculus Safilens Santen Shire TearLab TearScience 3 Update on Technologies Detection of Ocular & Systemic Disease Revolutionary future uses of contact lenses. Optom Vis Sci April Wearable Sensor Market Market for wearable technology is expected to reach $US Billion by 2020, at annual growth rate of 17.8% smartwatches wristbands Major players Adidas; Apple; Fitbit; Garmin; Google; Nike; Samsung; Sony Smart CL System 1

2 J&J; Samsung; Sony; Medella Health CL Monitoring Devices Glaucoma Sensimed Triggerfish Smart" contact lens with tiny embedded strain gauge to monitor curvature of the eye over a period of 24 hours Looks at relative changes in IOP not absolute values Silicone-based (Dk~350) Thickness ~ 600µm Dk/t ~ 60 hypoxia with overnight wear Single-use only >85 patents since Mansouri et al.: Continuous 24-hour monitoring of intraocular pressure patterns with a contact lens sensor: safety, tolerability, and reproducibility in patients with glaucoma. Arch Ophthalmol 2012; 130;12: Mansouri & Weinreb: Meeting an unmet need in glaucoma: continuous 24-h monitoring of intraocular pressure. Expert Rev Med Devices 2012; 9;3: Tojo et al.: Comparison of fluctuations of intraocular pressure before and after selective laser trabeculoplasty in normal-tension glaucoma patients. J Glaucoma 2014; 23;8: e Tojo et al.: Correlation between short-term and long-term intraocular pressure fluctuation in glaucoma patients. Clin Ophthalmol 2016; Aptel et al.: 24-Hour Intraocular Pressure Rhythm in Patients With Untreated Primary Open Angle Glaucoma and Effects of Selective Laser Trabeculoplasty. J Glaucoma 2017; 26;3: Dunbar et al.: The Sensimed Triggerfish contact lens sensor: efficacy, safety, and patient perspectives. Clin Ophthalmol 2017; Tojo et al.: Comparison of intraocular pressure fluctuations before and after ab interno trabeculectomy in pseudoexfoliation glaucoma patients. Clin Ophthalmol 2017; Verily (Google Life Sciences): July 15 th 2014 Potential CL Biosensor Targets Ocular IOP osmolarity Biomarkers dry eye disease etc Systemic diabetes cancer markers blood pressure neurological disorders heart rate kidney function ovulation Topical Drops Drug Delivery >95% of current market for disease management poor insertion technique in >50% over-spill poor compliance in 50% rapid tear flow drainage drug diluted by blinking Substantial systemic absorption <5% of drug gets to target 15 2

3 What about using CL? Soaked CL should release drugs much slower First suggested in original Wichterle hydrogel patents in 1960 s 1 first published manuscript in % of surveyed clinicians would be interested in using a drug delivering bandage CL 3 Clinical success depends on drug loading drug release affinity between drug and material Number of Peer-Reviewed Articles Plenty of recent interest 207 PubMed search: drug delivery + contact lens = Wichterle & Lim. Cross-linked hydrophilic polymers and articles made therefrom. US patent: ; Morgan. A new drug delivery system for the eye. IMS Ind Med Surg 1971;40: Karlgard et al.: Survey of bandage lens use in North America, October-December Eye Contact Lens 2004; 30;1: Long-Term Therapy Glaucoma Allergy What diseases may be relevant? 19 Management of Severe Abrasions branch Microbial Keratitis paper cut curling iron 3

4 Topical Drugs & CL Materials Why not just use commercial contact lenses? 23 CORE published 30 papers on this topic. Delivery NOT controlled & too rapid Hydrogel Drug Delivering Concepts What slow release technologies have been investigated? Molecular imprinting 25 Hui & Willcox. In Vivo Studies Evaluating the Use of Contact Lenses for Drug Delivery. Optom Vis Sci 2016;93: Drugs Under Investigation Anti-infectives Anti-inflammatories Anti-glaucoma Epidermal growth factor Anti-allergy J&J have already evaluated and reported on 4 trials of a ketotifen-releasing DD lens ( ) antihistamine/mast cell stabilizer Clinically Relevant Amounts of Ciprofloxacin Release up to 14 days Hui A, Sheardown H, Jones L. Acetic and Acrylic Acid Molecular Imprinted Model Silicone Hydrogel Materials for Ciprofloxacin-HCl Delivery. Materials 2012;5:

5 Ciprofoxacin Delivery by phema-plga sandwich PLGA Films for Glaucoma Management Sustained delivery of latanoprost by contact lenses is at least as effective as delivery with daily latanoprost ophthalmic solution Ciolino et al. A drug-eluting contact lens. Invest Ophthalmol Vis Sci. 2009;50: Ciolino et al. Latanoprost-Eluting Contact Lenses in Glaucomatous Monkeys. Ophthalmology 2016;123: Vitamin A Diffusion Barriers THANK YOU 1. Peng et al. Extended delivery of hydrophilic drugs from silicone-hydrogel contact lenses containing vitamin E diffusion barriers. Biomaterials 2010;31: Peng & Chauhan. Extended cyclosporine delivery by silicone-hydrogel contact lenses. J Control Release 2011;154: Peng et al. Transport of topical anesthetics in vitamin E loaded silicone hydrogel contact lenses. Langmuir 2012;28: Peng et al. Drug delivery by contact lens in spontaneously glaucomatous dogs. Curr Eye Res 2012;37: Hsu et al. Dual drug delivery from vitamin E loaded contact lenses for glaucoma therapy. Eur J Pharm Biopharm 2015;94: Hsu et al. Release of betaine and dexpanthenol from vitamin E modified silicone-hydrogel contact lenses. Curr Eye Res 2015;40: Paradiso et al. Controlled Release of Antibiotics From Vitamin E-Loaded Silicone-Hydrogel Contact Lenses. J Pharm Sci 2016;105:

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