Glaucoma is extensively treated with topical eye drops containing drugs. However, the retention time of the loaded drugs and the in vivo bioavailability of the drugs are highly influenced before reaching the targeted area sufficiently, due to physiological and anatomical barriers of the eye, such as rapid nasolacrimal drainage. Poor intraocular penetration and frequent administration may also cause ocular cytotoxicity. A novel approach to overcome these drawbacks is the use of injectable hydrogels administered intravitreously for sustained drug delivery to the target site. These injectable hydrogels are used as nanocarriers to intimately interact with specific diseased ocular tissues to increase the therapeutic efficacy and drug bioavailability of the anti-glaucomic drugs. The human eye is very delicate, and is sensitive to contact with any foreign body material. However, natural biopolymers are non-reactive, biocompatible, biodegradable, and lack immunogenic and inflammatory responses to the host whenever they are incorporated in drug delivery systems. These favorable biomaterial properties have made them widely applicable in biomedical applications, with minimal adversity. This review highlights the importance of using natural biopolymer-based intravitreal hydrogel drug delivery systems for glaucoma treatment over conventional methods.

This study examines the hemocompatibility of gellan-gum-based hybrid hydrogels, with varying gellan-gum concentrations and constant sodium alginate and silk fibroin concentrations, respectively, in accordance with ISO 10993-4 standards. While previous studies have focused on cytocompatibility, the hemocompatibility of these hydrogels remains underexplored. Hydrogels were formulated with 0.3%, 0.5%, 0.75%, and 1% gellan gum combined with 3% silk fibroin and 4.2% sodium alginate separately, using physical and ionic cross-linking. Swelling behavior was analyzed in phosphate (pH 7.4) and acetic (pH 1.2) buffers and surface morphology was examined by scanning electron microscopy (SEM). Hemocompatibility tests included complete blood count (CBC), coagulation assays, hemolysis index, erythrocyte morphology, and platelet adhesion analysis. Results showed that gellan gum–sodium alginate hydrogels exhibited faster swelling than gellan gum–silk fibroin formulations. SEM indicated smoother surfaces with sodium alginate, while silk fibroin increased roughness, further amplified by higher gellan-gum concentrations. Hemocompatibility assays confirmed normal profiles in formulations with 0.3%, 0.5%, and 0.75% gellan gum, while 1% gellan gum caused significant hemolytic and thrombogenic activity. These findings highlight the excellent hemocompatibility of gellan-gum-based hydrogels, especially the sodium alginate variants, supporting their potential in bioengineering, tissue engineering, and blood-contacting biomedical applications.

Age-related macular degeneration (AMD) is a progressive ocular disease marked by the deterioration of retinal photoreceptor cells, leading to central vision decline, predominantly affecting the elderly population worldwide. Current treatment modalities, such as anti-VEGF agents, laser therapy, and photodynamic therapy, aim to manage the condition, with emerging strategies like stem cell replacement therapy showing promise. However, challenges like immune rejection and cell survival hinder the efficacy of stem cell interventions. Regenerative medicine faces obstacles in maximizing stem cell potential due to limitations in mimicking the dynamic cues of the extracellular matrix (ECM) crucial for guiding stem cell behaviour. Innovative biomaterials like gellan gum hydrogels offer tailored microenvironments conducive to enhancing stem cell culture efficacy and tissue regeneration. Gellan gum-based hydrogels, renowned for biocompatibility and customizable mechanical properties, provide crucial support for cell viability, differentiation, and controlled release of therapeutic factors, making them an ideal platform for culturing human embryonic stem cells (hESCs). These hydrogels mimic native tissue mechanics, promoting optimal hESC differentiation while minimizing immune responses and facilitating localized delivery. This review explores the potential of Gellan Gum-Based Hydrogels in regenerative AMD therapy, emphasizing their role in enhancing hESC regeneration and addressing current status, treatment limitations, and future directions.

The rapid expansion of telemedicine, driven by the COVID-19 pandemic, has highlighted persistent inequities in access, particularly among underserved populations. This chapter explores the digital health divide and how artificial intelligence (AI)-driven telemedicine, combined with policy reforms, can help bridge these gaps. The telemedicine equity framework (TEF) is introduced as a practical tool for policymakers, researchers, and healthcare system designers to assess and address digital health disparities. The TEF focuses on four core areas: technology readiness, infrastructure access, policy environment, and community capacity. It aims to provide a comprehensive approach to ensuring equitable access to telemedicine services. The chapter examines key barriers, including broadband gaps, digital literacy, and healthcare workforce shortages, and the ethical considerations surrounding AI applications in telemedicine. It highlights case studies such as AI-powered maternal health triage in rural Africa and mHealth solutions for tuberculosis adherence in India, which demonstrate the potential of digital health to reach underserved populations. Additionally, the chapter explores the role of blockchain in enabling secure, decentralized health records and discusses the policy challenges that arise from cross-jurisdictional telemedicine, such as licensing restrictions and data sovereignty. Policy recommendations emphasize aligning regulation with equity goals, supporting digital literacy initiatives, and fostering community engagement in digital health solutions. Through global case studies, the chapter illustrates the importance of inclusivity in designing and implementing telemedicine systems, ultimately contributing to universal health coverage and sustainable digital health futures.

Stem cell-based therapies for various ocular conditions are increasingly gaining traction in ophthalmic treatments, with hydrogel-based polymers playing a pivotal role. Current stem cell delivery methods face challenges such as limited cell retention, immunological rejection, and uneven dispersion. Hence, there is a critical demand for innovative delivery systems to enhance the viability, localization, and integration of transplanted stem cells while minimizing adverse effects. Central to this advancement is the meticulous selection of appropriate materials. Among the promising options, gellan gum, a versatile polysaccharide, is emerging as a potential carrier for differentiated progenitor cells in regenerative medicine, particularly in ophthalmology. This study explores the utilization of gellan gum hydrogels as carriers, focusing on their biocompatibility, customizable gelation properties, and ability to encapsulate, transplant, and biofunctionalize cells. Through a review of literature, the impact of gellan gum hydrogels on cell viability parameters is investigated, revealing their potential for promoting tissue regeneration and functional recovery in ocular diseases. Furthermore, this study compares gellan gum systems utilizing natural and synthetic polymers, discerning differences in efficacy, biocompatibility, and suitability for diverse applications in regenerative ophthalmology. This review highlights the promising role of gellan gum in ophthalmic therapies, providing valuable insights into future directions and hurdles in this evolving field.