Comprehensive insights into the role of nanocarriers in advancing azole-based ocular therapeutics

Ocular fungal infections pose particularly significant pharmacotherapeutic complications due to the intricate anatomical and physiological features of the eye, which interfere with the efficient delivery of therapeutic agents to targeted ocular areas. Azole derivatives, including imidazoles and triazoles, have been established as a fundamental component in managing these infections due to their broad antifungal spectrum against various causative pathogenic fungal species, such as Candida, Aspergillus, and Fusarium. In contrast, the inefficient physicochemical characteristics, non-selectivity resulting in toxicity, and development of resistance in azole antifungal compounds restrict their effectiveness. This has encouraged research on developing new azole derivatives to overcome these limitations and improve antifungal effectiveness. Focusing on addressing the complex restrictions imposed by ocular barriers and the limitations associated with azole compounds, researchers have been actively developing innovative strategies for ocular drug delivery. These advancements include nanoformulations such as nanoparticles, liposomes, niosomes, nanomicelles, microemulsions, nanoemulsions, nanofibers, and cubosomes, as well as ocular drug delivery devices, including drug-eluting contact lenses, microneedles, and ocular inserts. The article highlights the development of new azole antifungal compounds, along with innovative formulation approaches currently being explored to overcome these barriers, with a particular emphasis on nanoformulations, aiming to improve the management of ocular fungal infections.