Imaging guided neovascular age-related macular degeneration treatment using soluble silicon nanoneedles

Choroidal neovascularization (CNV) is a leading cause of vision impairment in wet macular degeneration. Current treatments like intravitreal anti-vascular endothelial growth factor (VEGF) therapy with drugs such as bevacizumab (BEV) require frequent administration and carry risks like endophthalmitis. This study explores a novel approach using ultrsmall biodegradable silicon nanoneedles (SiNNs) integrated into a tear-soluble contact lens for treating CNV. SiNNs encapsulated with BEV (BEV@SiNNs) were developed for sustained drug delivery. In a rabbit CNV model (n = 7), CNV was induced by subretinal injection of Matrigel and VEGF. A subconjunctival contact lens with SiNNs was placed on the posterior sclera 3 days post-CNV induction. The treatment's efficacy was monitored using color fundus photography, photoacoustic microscopy, OCT, and fluorescein angiography (FA) before treatment and at specified intervals up to 12 months. SiNNs demonstrate potential as an effective platform for long-term, sustained treatment of CNV in this rabbit model, highlighting their suitability for extended drug delivery applications.