... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Kanamycin ophthalmic aqueous solution. 524.1200b Section 524.1200b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 524.1200b Kanamycin ophthalmic aqueous solution. (a) Specifications. The drug, which is in an...
Full Text Available Howard D Palte Department of Anesthesiology, Perioperative Medicine and Pain Management, Miller School of Medicine, University of Miami, Miami, FL, USA Abstract: In the past decade ophthalmic anesthesia has witnessed a major transformation. The sun has set on the landscape of ophthalmic procedures performed under general anesthesia at in-hospital settings. In its place a new dawn has ushered in the panorama of eye surgeries conducted under regional and topical anesthesia at specialty eye care centers. The impact of the burgeoning geriatric population is that an increasing number of elderly patients will present for eye surgery. In order to accommodate increased patient volumes and simultaneously satisfy administrative initiatives directed at economic frugality, administrators will seek assistance from anesthesia providers in adopting measures that enhance operating room efficiency. The performance of eye blocks in a holding suite meets many of these objectives. Unfortunately, most practicing anesthesiologists resist performing ophthalmic regional blocks because they lack formal training. In future, anesthesiologists will need to block eyes and manage common medical conditions because economic pressures will eliminate routine preoperative testing. This review addresses a variety of topical issues in ophthalmic anesthesia with special emphasis on cannula and needle-based blocks and the new-generation antithrombotic agents. In a constantly evolving arena, the sub-Tenon’s block has gained popularity while the deep angulated intraconal (retrobulbar block has been largely superseded by the shallower extraconal (peribulbar approach. Improvements in surgical technique have also impacted anesthetic practice. For example, phacoemulsification techniques facilitate the conduct of cataract surgery under topical anesthesia, and suture-free vitrectomy ports may cause venous air embolism during air/fluid exchange. Hyaluronidase is a useful adjuvant because it
Hérida Regina Nunes SALGADO; Ana Flavia Ferreira RONCARI
The validation of a simple, sensitive and specific agar diffusion bioassay, applying cylinder-plate method, for the determination of the antibiotic azithromycin in ophthalmic solutions is described. Using a strain of Bacillus subtilis ATCC 9372 as the test organism, azithromycin at concentrations ranging from 50.0 to 200.0 μg·mL -1 could be measured in 1.666 7 mg·mL -1 ophthalmic solutions. A prospective validation of the method showed that the method was linear (r=0.999 9) and precise (RSD=0.70) and accurate (it measured the added quantities). The results obtained by bioassay method could be statistically calculated by linear parallel model and by means of regression analysis and verified using analysis of variance (ANOVA). We conclude that the microbiological assay is satisfactory for quantification of azithromycin in ophthalmic solutions.
... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Proparacaine hydrochloride ophthalmic solution. 524.1982 Section 524.1982 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... longterm toxicity of proparacaine is unknown. Prolonged use may possibly delay wound healing. (d...
Full Text Available The development of mild but significant inflammation probably attributable to viscoelastic ophthalmic solutions in cataract surgery was recently brought to the notice of the authors, and hence a study of the effects of these solutions available in India, on cell cultures was undertaken. We studied the effects of 6 viscoelastic ophthalmic solutions (2 sodium hyaluronate designated as A and B, and 4 hydroxypropylmethylcellulose designated as C, D, E and F on HeLa, Vero and BHK-21 cell lines in tissue culture microtitre plates using undiluted, 1:10 and 1:100 dilutions of the solutions, and in cover slip cultures using undiluted solutions. Phase contrast microscopic examination of the solutions was also done to determine the presence of floating particles. The products D and F produced cytotoxic changes in HeLa cell line and these products also showed the presence of floating particles under phase contrast microscopy. Other products did not have any adverse effects on the cell lines nor did they show floating particles. The viscoelastic ophthalmic pharmaceutical products designated D and F have cytotoxic effects on HeLa cell line which appears to be a useful cell line for testing these products for their toxicity. The presence of particulate materials in products D and F indicates that the methods used for purification of the solution are not effective.
McLellan, Christine; Ngo, Van; Pasedis, Sophia; Dohlman, Claes H
Some patients with a keratoprosthesis (artificial cornea) are required to use prophylactic vancomycin ophthalmic solution daily for life to prevent infection, a regimen which has proven to be highly successful. The objective of this study was to determine whether such vancomycin solutions would remain stable at room temperature for an extended period of time, beyond that suggested by available published stability data and used in current practice. By relaxing the storage requirement and extending the expiration date of this solution, it was hoped that patient adherence and satisfaction would increase. The studied vancomycin ophthalmic solutions were compounded at the Massachusetts Eye and Ear Infirmary, Department of Pharmacy Services, Boston, Massachusetts, and were sent to an outside laboratory for high-performance liquid chromatography potency testing at predefined time points. Vancomycin 14-mg/mL ophthalmic solution compounded with 0.005% benzalkonium retains potency for at least 60 days at room temperature and 6 months frozen. Extending the beyond-use dating of vancomycin may lead to improved patient adherence by lowering costs and increasing convenience of storage and shipment of the medication.
... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Neomycin sulfate and polymyxin B sulfate ophthalmic solution. 524.1484e Section 524.1484e Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... DOSAGE FORM NEW ANIMAL DRUGS § 524.1484e Neomycin sulfate and polymyxin B sulfate ophthalmic solution....
... HUMAN SERVICES Food and Drug Administration Determination That TRAVATAN (Travoprost Ophthalmic Solution... refer to a listed drug. TRAVATAN (travoprost ophthalmic solution), 0.004%, is the subject of NDA 21-257... hypertension. TRAVATAN (travoprost ophthalmic solution), 0.004%, is currently listed in the ``Discontinued...
Ciprofloxacin ophthalmic solution is used to treat bacterial infections of the eye including conjunctivitis (pinkeye; infection of ... in the clear front part of the eye). Ciprofloxacin ophthalmic ointment is used to treat conjunctivitis. Ciprofloxacin ...
... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS...) Limitations. Therapy for cats should not exceed 7 days. As with other antibiotics, prolonged use may result in... animals. The length of time that residues persist in milk or tissues has not been determined. Federal...
... HUMAN SERVICES Food and Drug Administration Determination That XIBROM (Bromfenac Ophthalmic Solution) 0... refer to a listed drug. XIBROM (bromfenac ophthalmic solution) 0.09% is the subject of NDA 021664 held... solution) 0.09% in the ``Discontinued Drug Product List'' section of the Orange Book. The...
... HUMAN SERVICES Food and Drug Administration Determination That REV-EYES (Dapiprazole Hydrochloride... determined that REV-EYES (dapiprazole hydrochloride ophthalmic solution), 0.5%, was not withdrawn from sale... refer to a listed drug. REV-EYES (dapiprazole hydrochloride ophthalmic solution), 0.5%, is the...
... HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 Ophthalmic and Topical Dosage Form New Animal Drugs; Ivermectin Topical Solution AGENCY: Food and Drug Administration, HHS. ACTION: Final rule, technical amendment. SUMMARY: The Food and Drug Administration (FDA) is amending the animal drug...
... HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 Ophthalmic and Topical Dosage Form New Animal Drugs; Ivermectin Topical Solution AGENCY: Food and Drug Administration, HHS. ACTION: Final rule. SUMMARY: The Food and Drug Administration (FDA) is amending the animal drug regulations to...
... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Flumethasone, neomycin sulfate, and polymyxin B sulfate ophthalmic solutions. 524.960 Section 524.960 Food and Drugs FOOD AND DRUG ADMINISTRATION... fundamental healing mechanism. Adrenocorticoid compounds have been reported to cause an increase in...
Full Text Available Keiji Yoshikawa1, Hiroshi Yamada21Yoshikawa Eye Clinic, Tokyo, Japan; 2Santen Pharmaceutical Co., Ltd., Osaka, JapanPurpose: To investigate the influence of container structures and content solutions on the time of dispensing from eye dropper bottles.Methods: Eye dropper bottle models, solution models (filtrate water/surfactant solution and a dispensing time measuring apparatus were prepared to measure the dispensing time.Results: With filtrate water and pressure thrust load of 0.3 MPa, the dispensing time significantly increased from 1.1 ± 0.5 seconds to 4.6 ± 1.1 seconds depending on the decrease of inner aperture diameters from 0.4 mm to 0.2 mm (P < 0.0001. When using the bottle models with inner aperture diameters of 0.4 mm or larger, the dispensing time became constant. The dispensing time using surfactant solution showed the same tendency as above. When pressure thrust load was large (0.07 MPa, the solution flew out continuously with inner aperture diameters of 0.4 mm or larger and the dispensing time could not be measured. The inner aperture diameter most strongly explained the variation of the dispensing time in both the content solutions in the multiple linear regression analysis (filtrate water: 46%, R2 = 0.462, surfactant solution: 56%, R2 = 0.563.Conclusions: Among content solutions and container structures, the dispensing time was mostly influenced by the diameter of the inner aperture of bottles.Keywords: dispensing time, model eye dropper bottle, model ophthalmic solution, nozzle internal space volume, nozzle inner aperture diameter
Vergilis-Kalner, Irene J
In December 2008, bimatoprost ophthalmic solution 0.03% was approved in the United States for the treatment of hypotrichosis of the eyelashes. Since then, there have been several reports in the literature on the off-label use of bimatoprost ophthalmic solution 0.03% for the treatment of thinning in other hair bearing areas, such as in the eyebrows and in the scalp. Herein, a prospective pilot study is presented in which bimatoprost ophthalmic solution 0.03% is evaluated for helping to re-grow hair in the eyebrow region of ten female patients.
Full Text Available Shizuka Koh Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan Abstract: Diquafosol is a drug used for dry eye treatment with a novel mechanism of action. It stimulates the secretion of tear fluid and mucin on the ocular surface, thus enabling us to selectively treat the tear film layer, playing an important role in the establishment of the concept of “Tear Film Oriented Therapy (TFOT”, an effective therapeutic approach to dry eye in Japan. The 3% diquafosol ophthalmic solution has been widely used for the treatment of dry eye in clinical practice, and it is currently available in Japan and South Korea. This review provides an overview of the clinical utility of 3% diquafosol ophthalmic solution, focusing on the results of clinical studies on various types of dry eye, including aqueous-deficient dry eye, short tear film breakup time-type dry eye, and post dry eye after laser in situ keratomileusis. It also introduces the additive effect of diquafosol on sodium hyaluronate monotherapy for dry eye, and the effect of 3% diquafosol ophthalmic solution for dry eye-related conditions. Additionally, it summarizes the ocular effects of diquafosol in healthy human eyes. Lastly, the importance of improving tear film stability in dry eye treatment, as well as general advances in dry eye treatments, are described. Keywords: diquafosol, dry eye, mucin secretion, fluid secretion, ocular surface, vision
Ogata, Niwako; Kanda, Teppei; Kawahata, Mizuki; Ichikawa, Takayasu; Matsumoto, Yuki; Morimitsu, Waka; Nishino, Yukiko; Itoi, Takamasa; Furumoto, Kayo
To determine the effects of brimonidine tartrate ophthalmic solution on sedation, heart rate (HR), respiratory frequency (fR), rectal temperature (RT) and noninvasive mean arterial pressure (MAP) in healthy cats. Randomized, blinded crossover study, with 1 week washout between treatments. Six healthy purpose-bred cats. Brimonidine tartrate ophthalmic solution 0.1% (one or two drops; 58.6 ± 3.3 μg per drop) or a control solution (artificial tear solution) was administered to six healthy cats. Behavioural observations and measurements of HR, fR, RT and MAP were recorded before and at 30, 60, 90, 120, 180, 240, 300 and 360 minutes after topical administration. Behavioural scores were analysed using Friedman's test for repeated measures to evaluate the time effect in each treatment and treatment effect at each time point. Physiological variables (HR, fR, RT and MAP) were analysed using two-way analysis of variance for repeated measures to evaluate the time and treatment effects. The level of significance was set at p < 0.05. Dose-dependent behavioural and physiological responses were noted. A dose of two drops of brimonidine resulted in sedation in the cats and decreased HR and MAP. Significant sedative effects occurred between 30 and 120 minutes and for physiological responses up to 360 minutes. The most frequent adverse reaction was vomiting, occurring within 40 minutes in all six cats administered two drops and five of the six cats administered one drop of brimonidine. The results demonstrated that ocular administration of brimonidine 0.1% ophthalmic solution induced sedation in cats and some cardiovascular effects usually associated with α2-adrenoceptor agonists. Further studies should be performed to determine clinical applications for this agent in cats. Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
Khoh-Reiter, Su; Jessen, Bart A
Background Benzalkonium chloride (BAC) is a common preservative used in ophthalmic solutions. The aim of this study was to compare the cytotoxic effects of BAC-containing ophthalmic solutions with a BAC-free ophthalmic solution using an organotypic 3-dimensional (3-D) corneal epithelial model and to determine the effects of latanoprost ophthalmic solution and its BAC-containing vehicle on corneal thickness in a monkey model. Methods The cytotoxicity of commercially available BAC-containing ophthalmic formulations of latanoprost (0.02% BAC) and olopatadine (0.01% BAC) was compared to that of BAC-free travoprost and saline in a corneal organotypic 3-D model using incubation times of 10 and 25 minutes. To compare the extent of differentiation of 3-D corneal cultures to monolayer transformed human corneal epithelial (HCE-T) cell cultures, expression levels (mRNA and protein) of the corneal markers epidermal growth factor receptor, transglutaminase 1 and involucrin were quantified. Finally, latanoprost ophthalmic solution or its vehicle was administered at suprapharmacologic doses (two 30 μL drops twice daily in 1 eye for 1 year) in monkey eyes, and corneal pachymetry was performed at baseline and at weeks 4, 13, 26 and 52. Results In the 3-D corneal epithelial culture assays, there were no significant differences in cytotoxicity between the BAC-containing latanoprost and olopatadine ophthalmic solutions and BAC-free travoprost ophthalmic solution at either the 10- or 25-minute time points. The 3-D cultures expressed higher levels of corneal epithelial markers than the HCE-T monolayers, indicating a greater degree of differentiation. There were no significant differences between the corneal thickness of monkey eyes treated with latanoprost ophthalmic solution or its vehicle (both containing 0.02% BAC) and untreated eyes. Conclusion The lack of cytotoxicity demonstrated in 3-D corneal cultures and in monkey studies suggests that the levels of BAC contained in ophthalmic
Jessen Bart A
Full Text Available Abstract Background Benzalkonium chloride (BAC is a common preservative used in ophthalmic solutions. The aim of this study was to compare the cytotoxic effects of BAC-containing ophthalmic solutions with a BAC-free ophthalmic solution using an organotypic 3-dimensional (3-D corneal epithelial model and to determine the effects of latanoprost ophthalmic solution and its BAC-containing vehicle on corneal thickness in a monkey model. Methods The cytotoxicity of commercially available BAC-containing ophthalmic formulations of latanoprost (0.02% BAC and olopatadine (0.01% BAC was compared to that of BAC-free travoprost and saline in a corneal organotypic 3-D model using incubation times of 10 and 25 minutes. To compare the extent of differentiation of 3-D corneal cultures to monolayer transformed human corneal epithelial (HCE-T cell cultures, expression levels (mRNA and protein of the corneal markers epidermal growth factor receptor, transglutaminase 1 and involucrin were quantified. Finally, latanoprost ophthalmic solution or its vehicle was administered at suprapharmacologic doses (two 30 μL drops twice daily in 1 eye for 1 year in monkey eyes, and corneal pachymetry was performed at baseline and at weeks 4, 13, 26 and 52. Results In the 3-D corneal epithelial culture assays, there were no significant differences in cytotoxicity between the BAC-containing latanoprost and olopatadine ophthalmic solutions and BAC-free travoprost ophthalmic solution at either the 10- or 25-minute time points. The 3-D cultures expressed higher levels of corneal epithelial markers than the HCE-T monolayers, indicating a greater degree of differentiation. There were no significant differences between the corneal thickness of monkey eyes treated with latanoprost ophthalmic solution or its vehicle (both containing 0.02% BAC and untreated eyes. Conclusion The lack of cytotoxicity demonstrated in 3-D corneal cultures and in monkey studies suggests that the levels of BAC
Le, Qi-hua; Cheng, Neng-neng; Wu, Wei; Chu, Ren-yuan
Nonselective muscarinic receptor antagonist, atropine, was believed to inhibit myopic progression. The purpose of this study was to determine the efficacy, through topical administration, of the M1-selective muscarinic antagonist pirenzepine in preventing experimentally induced form-deprivation myopia in guinea pigs. Fifty-three guinea pigs, which underwent monocular deprivation with their eyelids sutured, were divided into 6 groups. Three groups were treated with 1%, 2% or 4% pirenzepine ophthalmic solutions; the fourth group with atropine; the fifth with saline and the last group left untreated. Ocular refraction, in vivo biometric measurements and wet eye weight were collected before and after the experiment. All the eyes were finally enucleated for histopathological examination to evaluate the possible toxic effects on ocular structures. Animals untreated or treated with saline produced (-2.31+/-1.47) D and (-2.25+/-0.88) D of axial myopia respectively. Those treated with 1% pirenzepine ophthalmic solution produced relative myopia of (-1.63+/-0.48) D, and those under the treatment of 2% and 4% pirenzepine ophthalmic solution only developed a relative myopia of (-0.89+/-0.42) D and (-0.70+/-0.41) D (F=9.56, Ppirenzepine treated animals was caused by significantly less vitreous chamber elongation and axial elongation of the deprived eyes [2% group: (0.009+/-0.052) mm, 4% group: (0.006+/-0.078) mm] when compared with untreated, saline treated or 1% pirenzepine treated guinea pigs (0.057+/-0.056) mm, (0.064+/-0.053) mm and (0.033+/-0.035) mm, respectively]. Histological examinations revealed no obviously toxic effects on the eyes treated with pirenzepine. Topical administration of the M1-selective muscarinic antagonist, pirenzepine, can prevent induced form-deprivation myopia in guinea pigs by inhibiting axial elongation without obvious damage to ocular tissues.
LE Qi-hua; CHENG Neng-neng; WU Wei; CHU Ren-yuan
Background Nonselective muscarinic receptor antagonist, atropine, was believed to inhibit myopic progression. The purpose of this study was to determine the efficacy, through topical administration, of the M1-selective muscarinic antagonist pirenzepine in preventing experimentally induced form-deprivation myopia in guinea pigs.Methods Fifty-three guinea pigs, which underwent monocular deprivation with their eyelids sutured, were divided into 6 groups. Three groups were treated with 1%, 2% or 4% pirenzepine ophthalmic solutions; the fourth group with atropine; the fifth with saline and the last group left untreated. Ocular refraction, in vivo biometric measurements and wet eye weight were collected before and after the experiment. All the eyes were finally enucleated for histopathological examination to evaluate the possible toxic effects on ocular structures.Results Animals untreated or treated with saline produced (-2.31±1.47) D and (-2.25±0.88) D of axial myopia respectively. Those treated with 1% pirenzepine ophthalmic solution produced relative myopia of (-1.63±0.48) D, and those under the treatment of 2% and 4% pirenzepine ophthalmic solution only developed a relative myopia of (-0.89±0.42) D and (-0.70±0.41) D (F=9.56, P<0.05). The significant reduction in myopia in 2% and 4% pirenzepine treated animals was caused by significantly less vitreous chamber elongation and axial elongation of the deprived eyes [2% group: (0.009±0.052) mm, 4% group: (0.006±0.078) mm] when compared with untreated, saline treated or 1% pirenzepine treated guinea pigs [(0.057±0.056) mm, (0.064±0.053) mm and (0.033±0.035) mm, respectively]. Histological examinations revealed no obviously toxic effects on the eyes treated with pirenzepine.Conclusion Topical administration of the M1-selective muscarinic antagonist, pirenzepine, can prevent induced form-deprivation myopia in guinea pigs by inhibiting axial elongation without obvious damage to ocular tissues.
Full Text Available Objective: To report the efficacy of marine actinomycetes in controlling Staphylococcus aureus (S. aureus-induced conjunctivitis in experimental rabbit. Methods: The ethyl acetate extracts of the best isolates of actinomycetes from the soil samples of Rameswaram coastal regions, Tamil Nadu, India, were concentrated and re-constituted in buffer and used as actinomycetes ophthalmic suspension in this study. The anti-inflammatory efficacy of actinomycetes ophthalmic suspension was analysed in controlling S. aureusinduced conjunctivitis in rabbit in comparison with that of ciprofloxacin. Results: Among the four best isolates, the RAM25C4 isolate had the highest antimicrobial activity in the secondary screening. Shelf life studies indicated that the activity can be retained for 75 days when it was stored at 8 °C and the optimum temperature for storage was between –20°C and 30°C. The animal model studies indicated that there was a profound anti-conjunctivitis effect. The actinomycetes ophthalmic suspension had better activity than ciprofloxacin ophthalmic solution. Conclusions: This is the first time to report that Streptomyces bacillaris strain RAM25C4 has antimicrobial effect in controlling ophthalmic pathogen S. aureus under in vitro condition and the in vivo anti-inflammatory activity in controlling S. aureus-induced conjunctivitis.
Full Text Available PURPOSE: To assess the efficacy of topical 1.5% azithromycin in the treatment of moderate to severe chronic blepharitis and to compare the efficacy of two different treatment modalities. METHODS: A randomized clinical trial included 67 patients with chronic anterior and/or posterior blepharitis, followed-up for 3 months. Signs and symptoms were graded according to severity. Patients were randomized into two groups: 33 patients in group I and 34 patients in group II. Group I patients were treated with topical 1.5% azithromycin twice a day for three days, and Group II patients were treated with topical 1.5% azithromycin twice a day for three days then at bedtime for the rest of the month. All patients were instructed to apply warm compresses and an eye-friendly soap twice daily. RESULTS: Patients in both groups tolerated the treatment with minimal irritation. A significant improvement in signs and symptoms was noted at the one week follow-up visit. Group II showed a more pronounced and longer-lasting improvement that persisted after three months of follow-up. CONCLUSION: Topical 1.5% azithromycin ophthalmic solution is an effective treatment option for chronic blepharitis. In moderate to severe blepharitis, a one month treatment is safe and shows better improvement than the three-day protocol with no significant relapse until three months of follow-up.
Full Text Available Yukiko Nagahara,1 Shizuka Koh,1 Kohji Nishida,1 Hitoshi Watanabe1,2 1Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, 2Kansai Rosai Hospital, Amagasaki, Hyogo, Japan Purpose: This study aimed to evaluate the increase in tear meniscus height (TMH induced by 3% diquafosol ophthalmic solution in eyes with contact lens (CL.Methods: Ten healthy subjects wearing high-water-content CLs received topical instillation of two ophthalmic solutions – 3% diquafosol ophthalmic solution in one eye and artificial tears in the other eye. Lower TMH was measured at 5 minutes, 10 minutes, 15 minutes, 30 minutes, and 60 minutes after instillation by anterior segment optical coherence tomography.Results: TMH increased significantly (P<0.001 at 5 minutes and 15 minutes after instillation of saline compared with the baseline values. After instillation of 3% diquafosol ophthalmic solution, TMH significantly increased (P<0.05 at 5 minutes, 15 minutes, 30 minutes, and 60 minutes compared with the baseline values. Increases in TMH after diquafosol instillation were significantly greater (P<0.05 at 15 minutes, 30 minutes, and 60 minutes than increases in TMH after saline instillation.Conclusion: Topical instillation of 3% diquafosol ophthalmic solution increases TMH for up to 60 minutes in eyes with high-water-content CLs. Keywords: diquafosol ophthalmic solution, tear meniscus height, dry eye, contact lenses, tear film
Osman; Sevki; Arslan; Ceyhun; Arici; Mustafa; Unal; Erdogan; Cicik; Mehmet; Serhat; Mangan; Eray; Atalay
AIM:To determine the safety of prophylactic intracameral moxifloxacin after cataract surgery in patients with penetrating keratoplasty(PKP).METHODS:In this retrospective study of consecutive patients who had phacoemulsification cataract surgery after PKP, were treated with intracameral moxifloxacin0.5% ophthalmic solution(0.5 mg/0.1 mL). The main outcome measures were anterior chamber reaction, best corrected visual acuity(BCVA), corneal endothelial cell count(ECC), and central corneal thickness(CCT).RESULTS:Fifty-five patients were recruited(26 males,29 females). The mean age was 54.36±4.97y(range 45-64y).All eyes had improved postoperative BCVA. The mean BCVA was 0.25 preoperatively and 0.57 postoperatively,which was statistically significant(P <0.001). One eye had 3+, 7 eyes had 2+, 12 eyes had 1+ and 8 eyes had trace amount of aqueous cells on the first day after surgery. All eyes had no anterior chamber cells at subsequent follow up examinations. Effective phacoemulsification time was 4.33 ±1.01 s. The mean ECC was 2340.20 cells/mm2 preoperatively and 1948.75 cells/mm21 mo postoperatively(P <0.001). The increase of21.09 μm in postoperative pachymetry 1mo after surgery was statistically significant(P <0.001).CONCLUSION:Nountowardeffectswereobservedafter intracameral injection of moxifloxacin(0.5 mg/0.1 mL) in terms of anterior chamber reaction, CCT, ECC, and visual rehabilitation at the conclusion of cataract surgery in patients with PKP.
Hayashi, Yusuke; Toshida, Hiroshi; Matsuzaki, Yusuke; Matsui, Asaki; Ohta, Toshihiko
Rebamipide ophthalmic suspension was developed for the treatment of dry eyes and for other corneal diseases, promoting the secretion of both mucin in tear fluid and membrane-associated mucin, increasing the number of goblet cells, and restoring the barrier function of the corneal epithelium. We report a case of a persistent corneal epithelial defect in a patient with diabetes treated with topical application of rebamipide ophthalmic suspension. A 73-year-old woman had a history of type 2 diabetes for 35 years and nonproliferative diabetic retinopathy for 23 years. She presented to our department with discharge and ophthalmalgia in the left eye. A corneal ulcer was detected, and culture of corneal scrapings was performed, with Staphylococcus aureus and Streptococcus canis being isolated. The infection was treated with levofloxacin eye drops and ofloxacin ophthalmic ointment based on the sensitivity profile of the isolate. However, a corneal epithelial defect persisted for approximately 2 months despite continuing treatment with 0.1% hyaluronic acid ophthalmic suspension and 0.3% ofloxacin eye ointment. Her hemoglobin A1c was 7.3%. The persistent corneal epithelial defect showed improvement at 2 weeks after treatment with rebamipide unit dose 2% ophthalmic suspension, and it did not recur even when vitrectomy was subsequently performed for vitreous hemorrhage due to progression of diabetic retinopathy. This is the first report about efficacy of rebamipide unit dose 2% ophthalmic suspension for presenting persistent corneal epithelial defect in a patient with diabetes. In the present case, the suggested mechanisms are the following: improving the corneal barrier function, stabilization of mucin on the keratoconjunctival epithelium, and improving the wettability and stability of the tear film, which resulted in the promotion of healing of the corneal epithelial defect in a short time period.
Full Text Available Yusuke Hayashi, Hiroshi Toshida, Yusuke Matsuzaki, Asaki Matsui, Toshihiko Ohta Department of Ophthalmology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan Objective: Rebamipide ophthalmic suspension was developed for the treatment of dry eyes and for other corneal diseases, promoting the secretion of both mucin in tear fluid and membrane-associated mucin, increasing the number of goblet cells, and restoring the barrier function of the corneal epithelium. We report a case of a persistent corneal epithelial defect in a patient with diabetes treated with topical application of rebamipide ophthalmic suspension. Case presentation: A 73-year-old woman had a history of type 2 diabetes for 35 years and nonproliferative diabetic retinopathy for 23 years. She presented to our department with discharge and ophthalmalgia in the left eye. A corneal ulcer was detected, and culture of corneal scrapings was performed, with Staphylococcus aureus and Streptococcus canis being isolated. The infection was treated with levofloxacin eye drops and ofloxacin ophthalmic ointment based on the sensitivity profile of the isolate. However, a corneal epithelial defect persisted for approximately 2 months despite continuing treatment with 0.1% hyaluronic acid ophthalmic suspension and 0.3% ofloxacin eye ointment. Her hemoglobin A1c was 7.3%. The persistent corneal epithelial defect showed improvement at 2 weeks after treatment with rebamipide unit dose 2% ophthalmic suspension, and it did not recur even when vitrectomy was subsequently performed for vitreous hemorrhage due to progression of diabetic retinopathy. Conclusion: This is the first report about efficacy of rebamipide unit dose 2% ophthalmic suspension for presenting persistent corneal epithelial defect in a patient with diabetes. In the present case, the suggested mechanisms are the following: improving the corneal barrier function, stabilization of mucin on the keratoconjunctival epithelium, and
Full Text Available Gatifloxacin is a fourth generation fluroquinolone antibiotic that has been prescribed for systemic use. However, the drug which was developed by Kyorin (Japan was linked to toxic reactions and death and was banned in the United States and Canada for use as an oral dosage form. It continues to be used as a topical application for ophthalmic conditions as the systemic toxicity seen when taking the drug orally has not been observed with ophthalmic use. The available data indicate that ocular use of gatifloxacin is safe, and effective against a broad spectrum of bacteria, including intracellular bacteria and anaerobes.
Full Text Available George A Baklayan, Mauricio Muñoz Bausch + Lomb, Irvine, CA, USA Purpose: To evaluate the ocular distribution of an advanced formulation of bromfenac ophthalmic solution. Two studies were conducted in rabbits: 1 a 12-hour parallel-group study comparing the ocular distribution of 14C-bromfenac ophthalmic solution 0.07%, pH 7.8 with that of 14C-bromfenac ophthalmic solution 0.09%, pH 8.3, and 2 a 24-hour study evaluating the ocular distribution of 14C-bromfenac ophthalmic solution 0.07%, pH 7.8.Methods: In the 12-hour study, rabbits were randomized to receive 50 µL of 14C-bromfenac 0.07%, pH 7.8 or 50 µL 14C-bromfenac 0.09%, pH 8.3 in one eye, whereas, in the 24-hour, study both eyes received 50 µL of 14C-bromfenac 0.07%, pH 7.8. Ocular tissues were collected at 1, 2, 4, 8, 12 (both studies and 24 hours (second study only following drug instillation, and tissue radioactivity was determined using liquid scintillation chromatography. Results: Measureable levels of bromfenac were observed in all ocular tissues, with the exception of vitreous humor, regardless of formulation. In the 12-hour study, high concentrations of 14C-bromfenac were found in the sclera, followed by the iris/ciliary body, aqueous humor, choroid, retina, and lens. There was no significant difference between the bromfenac 0.07%, pH 7.8 and bromfenac 0.09%, pH 8.3 formulations in any 14C-bromfenac tissue levels at any time point, with the exception of in sclera at 2 hours post-instillation (0.451 µg eq/g versus 0.302 µg eq/g, respectively, P<0.001. There was also no significant difference in the total amount of 14C-bromfenac in the tissues evaluated following instillation of the two formulations. In the 24-hour study evaluating bromfenac 0.07%, pH 7.8 only, high concentrations of 14C-bromfenac were found 1 hour post-instillation in the cornea (2.402 µg eq/g and conjunctiva (1.049 µg eq/g, two tissues not evaluated in the 12-hour study. The rank order of 14C
Barnebey, Howard S; Orengo-Nania, Silvia; Flowers, Brian E; Samples, John; Mallick, Sushanta; Landry, Theresa A; Bergamini, Michael V W
To compare the safety and intraocular pressure (IOP)-lowering efficacy of travoprost 0.004%/timolol 0.5% fixed combination ophthalmic solution (Trav/Tim) to its components travoprost 0.004% ophthalmic solution, TRAVATAN, (Trav) and timolol 0.5% ophthalmic solution (Tim) in patients with open-angle glaucoma or ocular hypertension. Randomized multicenter, double-masked, active-controlled, parallel group study. Two hundred sixty-three patients with open-angle glaucoma or ocular hypertension were randomized to receive Trav/Tim once daily AM (and vehicle PM), Trav once daily PM (and vehicle AM), or Tim twice daily (AM and PM). Efficacy and safety were compared across treatment groups over 3 months. Trav/Tim produced a mean IOP decrease from baseline of 1.9 mm Hg to 3.3 mm Hg more than Tim, with a significant decrease in mean IOP at each of the nine study visits (P Trav/Tim decreased mean IOP by 0.9 mm Hg to 2.4 mm Hg more than Trav, with a significant decrease in mean IOP at seven of the nine study visits (P Trav/Tim was comparable to Trav or Tim alone. Over the 3 months of treatment, Trav/Tim produced clinically relevant IOP reductions in patients with open-angle glaucoma or ocular hypertension that were greater than those produced by either Trav or Tim alone. The clinical results that Trav/Tim was safe and well tolerated with an incidence of adverse events was comparable to the results of Trav or Tim alone. Trav/Tim provides both more effective IOP reduction than its components and the benefits of once-daily dosing.
Full Text Available Tejaswini Walimbe,1 Vidya Chelerkar,2 Purvi Bhagat,3 Abhijeet Joshi,4 Atul Raut4 1Walimbe Eye Clinic, 2PBMA’s H.V. Desai Eye Hospital, Pune, 3Glaucoma Clinic, M and J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, 4Clinical Research Department, Sun Pharma Advanced Research Company Ltd., Mumbai, India Introduction: Benzalkonium chloride (BAK, included as a preservative in many topical treatments for glaucoma, induces significant toxicity and alters tear breakup time (TBUT. BAK-containing latanoprost, an ester prodrug of prostaglandin F2a, can cause ocular adverse events (AEs associated with BAK. The purpose of this study was to evaluate the efficacy and safety of BAK-free latanoprost. Patients and methods: A prospective, open-label, single-arm, multicenter, 8-week study in patients with primary open-angle glaucoma or ocular hypertension taking BAK-containing latanoprost for ≥12 months was performed. Patients were switched to BAK-free latanoprost ophthalmic solution 0.005% administered once daily, and eyes were assessed after 28 and 56 days. Primary efficacy and safety variables were TBUT and treatment-emergent AEs, respectively. Results: At day 56, 40 eyes were evaluable. Mean TBUT increased significantly from baseline (3.67±1.60 seconds to 5.03±2.64 and 6.06±3.39 seconds after 28 and 56 days of treatment with BAK-free latanoprost (P<0.0001. Ocular Surface Disease Index© (OSDI© score also decreased significantly to 12.06±13.40 and 7.06±10.75 at 28 and 56 days, respectively, versus baseline (18.09±18.61, P<0.0001. In addition, inferior corneal staining score decreased significantly to 0.53 from baseline (0.85, P=0.0033. A reduction in conjunctival hyperemia and intraocular pressure was observed at both time points. No treatment-related serious AEs were evident and 12 (26.08% treatment-emergent AEs occurred in seven patients, with eye pain and irritation being the most frequent. No clinically significant changes
Macrì, Angelo; Vagge, Aldo; Salis, Annalisa; Fucile, Carmen; Marini, Valeria; Martelli, Antonietta; Giuffrida, Sebastiano; Iester, Michele; Damonte, Gianluca; Mattioli, Francesca
The purpose of this study was to evaluate the aqueous humor concentrations of bromfenac ophthalmic solution 0.09 % in patients undergoing phacoemulsification. Patients requiring cataract extraction received one drop (50 µL) of bromfenac 0.09 % solution in the eye to be operated, before bedtime the day before surgery or the morning of the surgery. The last administration was recorded. At the time of paracentesis, an aqueous humor sample was collected with a 30-gauge needle attached to a TB syringe and was later analyzed by high-performance liquid chromatography for drug concentration. 188 treated volunteers and 48 control, untreated, subjects were included in the study. The mean aqueous concentration of bromfenac in the treated group was 37.60 ± 68.86 and 0 nM (nmol/L) in the control group (p humor up to about 12 h after instillation.
Bimatoprost 0.03%/timolol 0.5% preservative-free ophthalmic solution versus bimatoprost 0.03%/timolol 0.5% ophthalmic solution (Ganfort) for glaucoma or ocular hypertension: a 12-week randomised controlled trial.
Goldberg, Ivan; Gil Pina, Rafael; Lanzagorta-Aresti, Aitor; Schiffman, Rhett M; Liu, Charlie; Bejanian, Marina
To compare the efficacy and safety of single-dose bimatoprost 0.03%/timolol 0.5% preservative-free (PF) ophthalmic solution with bimatoprost 0.03%/timolol 0.5% ophthalmic solution in patients with open-angle glaucoma or ocular hypertension. In this multicentre, randomised, parallel-group study, patients were randomised to bimatoprost/timolol PF or bimatoprost/timolol once daily in the morning for 12 weeks. Primary efficacy endpoints, reflecting differing regional regulatory requirements, included change from baseline in worse eye intraocular pressure (IOP) in the per-protocol population at week 12, and the average eye IOP at weeks 2, 6 and 12 in the intent-to-treat population. 561 patients were randomised (278 to bimatoprost/timolol PF; 283 to bimatoprost/timolol); 96.3% completed the study. Both treatment groups showed statistically and clinically significant mean decreases from baseline in worse eye IOP and in average eye IOP at all follow-up time points (p<0.001). Bimatoprost/timolol PF met all pre-established criteria for non-inferiority and equivalence to bimatoprost/timolol. Ocular adverse events were similar between treatment groups, with conjunctival hyperaemia being the most frequent. Most were mild or moderate in severity. Bimatoprost/timolol PF demonstrated non-inferiority and equivalence in IOP lowering compared with bimatoprost/timolol, with no significant differences in safety and tolerability. NCT01177098. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Altay, Yesim; Demirok, Gulizar; Balta, Ozgur; Bolu, Hulya
The online-ahead-of-print published article, "Azithromycin 1.5% Ophthalmic Solution for Blepharitis Treatment: Comparison of 14- Versus 30-Day Treatment," by Altay Yesim, Demirok Gulizar, Balta Ozgur, and Bolu Hulya (DOI: 10.1089/jop.2015.0099) is being officially retracted from Journal of Ocular Pharmacology and Therapeutics (JOPT) due to post-publication authorship disputes and the discovery of simultaneous submission to both JOPT and the International Journal of Ophthalmology, which is a violation of the proper protocols of peer review. Journal of Ocular Pharmacology and Therapeutics and its editorial leadership are committed to maintaining the highest levels of scientific reporting and publishing, and therefore officially retracts the article based on the infringements listed herein.
Femina Wahaab; Kalidass Subramaniam; Morris Jawahar
Objective:To report the efficacy of marine actinomycetes in controllingStaphylococcus aureus (S. aureus)-induced conjunctivitis in experimental rabbit. Methods: The ethyl acetate extracts of the best isolates of actinomycetes from the soil samples of Rameswaram coastal regions, Tamil Nadu, India, were concentrated and re-constituted in buffer and used as actinomycetes ophthalmic suspension in this study. The anti-inflammatory efficacy of actinomycetes ophthalmic suspension was analysed in controllingS. aureus-induced conjunctivitis in rabbit in comparison with that of ciprofloxacin. Results:Among the four best isolates, theRAM25C4isolate had the highest antimicrobial activity in the secondary screening. Shelf life studies indicated that the activity can be retained for 75 days when it was stored at 8°C and the optimum temperature for storage was between –20°°C and 30°°C. The animal model studies indicated that there was a profound anti-conjunctivitis effect. The actinomycetes ophthalmic suspension had better activity than ciprofloxacin ophthalmic solution. Conclusions:This is the first time to report thatStreptomyces bacillaris strainRAM25C4 has antimicrobial effect in controlling ophthalmic pathogenS. aureus underin vitro condition and thein vivo anti-inflammatory activity in controllingS. aureus-induced conjunctivitis.
Patricia B Williams
Full Text Available Patricia B Williams1,2, Elizabeth Crandall2, John D Sheppard1,21Thomas R Lee Center for Ocular Pharmacology, 2Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, A, USAAbstract: Over 50% of patients who seek treatment for allergies present with ocular symptoms. Our current ability to control ocular allergic symptoms is greater than ever before. Newer dual-acting topical eyedrops attack multiple facets of the allergic cascade. Azelastine has antihistaminic effects providing immediate relief, mast cell stabilization providing early-phase intervention, and inhibition of expression and activation of anti-inflammatory mediators which characterize the late phase of the immune reaction. The ophthalmic eyedrop formulation is approved for treatment of allergic conjunctivitis in adults and children aged over 3 years. In clinical trials comparing azelastine with other dual-acting eyedrops, such as levocabastine and olopatadine, azelastine was reported to be slightly less efficacious and to sting briefly upon administration. Even so, many patients experienced the full benefit of symptom relief, and preferred azelastine. As a broad-spectrum drug, azelastine offers many desirable properties for management of ocular allergies. Because it can often produce maximal effect with just twice-daily dosing, azelastine is a particularly good choice for the allergic population in whom minimizing exposure to topical products and preservatives is a key concern.Keywords: allergic conjunctivitis, dual acting anti-inflammatory, H1 receptor antagonism, mast cell stabilization, inflammatory mediator inhibition
A double blind, prospective and randomized study was carried out in forty patients with clinical diagnosis of vernal conjunctivitis and eosinophilia in conjunctival scrapings. They were divided in two randomized groups of 20 patients each. One of the groups received levocabastine ophthalmic solution and the other saline solution drops. The mean age of the study group was 9.1 years old with a vernal conjunctivitis history of 44 months. The control group mean age was 10.1 years old and a history of vernal conjunctivitis of 48 months prior the enter of the study. One group received levocabastine 0.5 mgrs/ml while the other balanced saline solution, one drop every 12 hours per seven days. The patients evaluated their symptoms through a visual analogic scale (every day). Data collected was analyzed, for the first, third and seventh day, through U-Mann Whitney statistical analysis. Epiphora and photophobia showed a significant improvement. Itching, edema and foreign body sensation showed improvement in the levocabastine group but without statistical significance. Hyperthermia remained the same in both groups studied.
Bimatoprost ophthalmic is used to treat glaucoma (a condition in which increased pressure in the eye can ... condition which causes increased pressure in the eye). Bimatoprost is in a class of medications called prostaglandin ...
Sheppard, John D; Torkildsen, Gail L; Lonsdale, John D; D'Ambrosio, Francis A; McLaurin, Eugene B; Eiferman, Richard A; Kennedy, Kathryn S; Semba, Charles P
To assess the efficacy and safety of lifitegrast ophthalmic solution 5.0% compared with placebo in subjects with dry eye disease. Prospective, randomized, double-masked, placebo-controlled, parallel arm, multicenter clinical trial. A total of 588 adult subjects with dry eye disease. Eligible subjects were randomized 1:1 to receive topically administered lifitegrast (5.0%) or placebo (vehicle) twice daily for 84 days after a 14-day open-label placebo run-in period. After enrollment (day 0), subjects were evaluated at days 14, 42, and 84. Key objective (fluorescein and lissamine staining scores [Ora scales]) and subjective (Ocular Surface Disease Index [OSDI], 7-item visual analog scale, and ocular discomfort score [Ora scale]) measures were assessed at all visits. The primary objective efficacy measure (sign) was mean change from baseline inferior corneal staining score (ICSS) at day 84. The co-primary subjective efficacy measure (symptom) was the mean change from baseline in the visual-related function subscale score of the Ocular Surface Disease Index (VR-OSDI). Supportive measures included corneal fluorescein scores (superior, central, total region) and conjunctival lissamine scores (nasal, temporal, total region) and symptom scores at day 84. The study met the primary objective efficacy ICSS end point in demonstrating superiority of lifitegrast compared with placebo (P = 0.0007). Lifitegrast significantly reduced corneal fluorescein staining (superior, P = 0.0392; total cornea, P = 0.0148) and conjunctival lissamine staining (nasal, P = 0.0039; total conjunctiva, P = 0.0086) at day 84 versus placebo. Significant (P measure (P = 0.7894). However, significant improvements were observed at day 84 in ocular discomfort (P = 0.0273) and eye dryness (P = 0.0291), the most common and severe symptoms reported at baseline in both groups. There were no unanticipated or serious ocular adverse events (AEs). The most frequent reported ocular AEs were transient intermittent
Bhopate, Dhanaji P; Mahajan, Prasad G; Garadkar, Kalyanrao M; Kolekar, Govind B; Patil, Shivajirao R
Based on the known complexation ability between polyvinyl pyrrolidone (PVP) and fluorescein sodium (FL Na(+)), fluorescent PVP capped anthracene nanoparticles (PVP-ANPs) were prepared using a reprecipitation method for detection of fluorescein in aqueous solution using the fluorescence resonance energy transfer (FRET) approach. A dynamic light scattering histogram of PVP-ANPs showed narrower particle size distribution and the average particle size was 15 nm. The aggregation-induced enhanced emission (AIEE) of PVP-ANPs was red shifted from its monomer by 1087.22 cm(-1). The maximum emission was seen to occur at 420 nm. The presence of FL Na(+) in the vicinity of PVP-ANPs quenched the fluorescence of PVP-ANPs because of its adsorption on the surface of PVP-ANPs in aqueous suspension. The FL Na(+) and PVP-ANPs were brought close enough, typically to 7.89 nm, which was less than the distance of 10 nm that is required between the energy donor-acceptor molecule for efficient FRET. The quenching results fit into the Stern-Volmer relationship even at temperatures greater than ambient temperatures. The thermodynamic parameters determined from FRET results helped to propose binding mechanisms involving hydrophobic and electrostatic molecular interaction. The fluorescence quenching results were used further to develop an analytical method for estimation of fluorescein sodium from ophthalmic samples available commercially in the market.
Landa, AS; van der Mei, HC; van Rij, G; Busscher, HJ
Purpose. To compare the efficacies of two all-in-one contact lens (CL) cleaning solutions and a detergent mixture on the detachment of a pathogenic bacterium adhering to two types of contact lenses in the absence and presence of a tear film. Methods. Bacterial-detachment studies were carried out in
Bhootra, Ajay Kumar
This book is uniquely meant for the ophthalmologists, optometrists and opticians to help the world see better by excellent vision through the services of technicians and clinical principle based ophthalmology so that the management of ocular problems can be done for a better vision . Informs that a wide range of material and design of ophthalmic lenses with innovative developments is available. This book presents comprehensively rich information about the ophthalmic lenses and their dispensing tips . It will be highly useful mainly for the students of optometry and opticians, ophthalmologists,
Full Text Available Marco Lombardo,1,2 Marianna Rosati,1 Marco Pileri,3 Domenico Schiano-Lomoriello,1 Sebastiano Serrao11Fondazione G.B. Bietti IRCCS, 2Vision Engineering Italy Srl, 3Azienda Ospedaliera San Giovanni-Addolorata, Rome, ItalyBackground: The purpose of this study was to evaluate the effect of daily administration of mannitol-enriched sodium hyaluronate ophthalmic solution on the corneal optical properties of subjects wearing low Dk hydrogel (etafilcon A contact lenses (CLs.Methods: Forty-five subjects wearing etafilcon A CLs daily for more than 6 months were recruited into this pilot study. Fifteen of the subjects administered a 10% mannitol-enriched 0.05% sodium hyaluronate solution (study group once daily and 30 subjects did not administer any ophthalmic solution (control group. The subjects were examined at baseline and one month after recruitment. Changes in central corneal thickness (CCT and corneal light backscatter were evaluated by Scheimpflug imaging (Pentacam HR. Changes in corneal total high-order aberration, corneal spherical aberration, coma, and trefoil were evaluated using the OPD scan II.Results: At one month, corneal light backscatter decreased significantly in the study group (≤18.30 arbitrary units; P<0.05 and this was highly correlated with a decrease in CCT (R=0.81; P=0.04. The decrease in corneal total high-order aberration, spherical aberration, and coma was significantly higher in the study group than in the control group (P<0.05. No changes in corneal light backscatter or CCT were found in the control group during follow-up.Conclusion: Once-daily administration of a mannitol-enriched lubricant ophthalmic solution was effective for improving the corneal optical quality and reducing corneal swelling in subjects wearing low Dk hydrogel (etafilcon A CLs during one month follow-up.Keywords: corneal optical quality, corneal high-order aberrations, Scheimpflug imaging, corneal backscattering, contact lens, hypertonic lubricant
Full Text Available The main objective of this study was to evaluate the antimicrobial activity and anti-inflammatory activity of marine actinomycetes extract against ocular pathogen Pseudomonas aeruginosa. Actinomycetes isolated from Rameswaram coastal region, Tamilnadu, India were initially screened by primary screening and secondary screening against ocular pathogen P. aeruginosa. Followed by anti-conjunctivitis efficacy of actinomycetes ethyl acetate extract formulation versus ciprofloxacin ophthalmic solution was evaluated using rabbit as animal model. The bioactive compounds present in the best actinomycetes extract was identified by HPTLC and GC–MS analysis. Finally the screened best actinomycetes was identified by 16S rRNA sequencing method. In primary screening 28 actinomycetes that inhibited the growth of P. aeruginosa were taken for secondary screening. In secondary screening RAM24C2 extract had maximum activity against P. aeruginosa. In vivo study of conjunctivitis developed rabbits treated with RAM24C2 extract formulation showed the best clinical cure than ciprofloxacin ophthalmic solution. The RAM24C2 extract was chromatographically characterized and found to contain macrolides. In addition, the effective major pivotal molecule in the extract was detected as 1, 2 benzene dicarboxylic acid and Bis (2-ethylhexyl phthalate by GC–MS analysis. The RAM24C2 strain was identified as Streptomyces sp. MAD01 and the sequence was submitted in NCBI with accession number JX050218. From our study it is found that the ethyl acetate extract obtained from marine actinomycetes is effective against ocular pathogen P. aeruginosa. Compared to ciprofloxacin ophthalmic solution our RAM24C2 extract formulation hastens the cure of conjunctivitis developed rabbits and need less dosage frequency.
Ohguchi, Takeshi; Kojima, Takashi; Ibrahim, Osama M; Nagata, Taeko; Shimizu, Takahiko; Shirasawa, Takuji; Kawakita, Tetsuya; Satake, Yoshiyuki; Tsubota, Kazuo; Shimazaki, Jun; Ishida, Susumu
To investigate the efficacy of 2% rebamipide ophthalmic solution on the tear functions and ocular surface status of the superoxide dismutase-1(Sod1(-/-)) mice. Two percent Rebamipide ophthalmic solution was applied to 40-week-old male Sod1(-/-) and wild-type (WT) mice four times a day for 2 weeks. We examined the cytokine concentrations in the tear fluid (by CytoBead assay), tear film break-up time, amount of tear production, and expressions of mucins 1, 4, and 5AC, by RT-PCR. We also performed vital staining of the ocular surface, PAS staining for muc5AC, and immunohistochemical stainings for 4-hydroxy-2-nonenal (4-HNE), 8-hydroxy-2'-deoxyguanosine (8-OHdG), in the conjunctiva to compare the results before and after rebamipide instillations. The tear functions and ocular surface epithelial damage scores were significantly worse in the Sod1(-/-) than in the WT mice. Application of 2% rebamipide for 2 weeks significantly improved the tear film break-up time, the amount of tear production, and the corneal epithelial damage scores, which also significantly increased the conjunctival goblet cell density and muc5 mRNA expression, in the Sod1(-/-) mice. The mean IL-6, IL-17, TNF-α, and IFN-γ levels in the tear fluid were reduced significantly along with a significant decrease in the density of cells positive for 4-HNE and 8-OHdG in the conjunctiva. Two percent Rebamipide ophthalmic solution significantly improved the tear stability and corneal epithelial damage, and enhanced the expression of muc5 mRNA on the ocular surface. We also observed anti-inflammatory effects in the tear film together with antioxidative effects in the conjunctiva, suggesting the efficacy of rebamipide in age-related dry eye disease attributable to SOD1 knockout.
Objective:To determine the antimicrobial effectiveness of benzalkonium chlorideand explore the appropriate dosage of it in Bimatoprost Ophthalmic Solution.Methods:According to the guidance for antibacterial effectiveness test stated in appendix of Chinese Pharmacopoeia (the 2nd volume of 2010 edition), investigated the antimicrobial effect of samples with different dosage of benzalkonium chloride in the prescription and selected the appropriate dosage of antibacterial agent added.Results:The antimicrobial effects to all 5 challenge standard bacterial strains met the requirements of Chinese Pharmacopoeia when the concentration of benzalkonium chloride in Bimatoprost Ophthalmic Solutions reached 0.006%.Conclusion:Recommended concentration of benzalkonium chloride in Bimatoprost Ophthalmic Solution is 0.006%.%目的：测定贝美前列素滴眼液中苯扎氯铵的抑菌效力，探索贝美前列素滴眼液中苯扎氯铵的合理添加剂量。方法：参照《中国药典》2010年版二部附录抑菌剂效力检查法指导原则的方法，对不同配比浓度苯扎氯铵的抑菌效果进行考察，筛选出适宜的抑菌剂加入量。结果：贝美前列素滴眼液中苯扎氯铵的处方量为0.006％时，对5种挑战微生物的抑菌效力均符合药典规定。结论：贝美前列素滴眼液中苯扎氯铵的处方量建议为0.006％。
Henderson, Bonnie A; Gayton, Johnny L; Chandler, Simon P; Gow, James A; Klier, Sharon M; McNamara, Timothy R
To evaluate the efficacy and ocular safety of bromfenac ophthalmic solution (bromfenac) 0.09% dosed once daily for the treatment of ocular inflammation and pain after cataract surgery with posterior chamber intraocular lens implantation. Randomized, double-masked, vehicle-controlled or active-controlled, multicenter, clinical trials. A total of 872 subjects (872 study eyes: bromfenac in 584, placebo in 288). Four randomized, double-masked, vehicle or active-controlled, clinical trials were conducted at 134 ophthalmology clinics in the United States. Subjects aged ≥ 18 years were randomized to receive either bromfenac 0.09% or placebo dosed once daily beginning 1 day before cataract surgery (day -1), continuing on the day of surgery (day 0), and continuing for an additional postoperative 14 days. Subjects were evaluated for efficacy and safety on days 1, 3, 8, 15, and 22. The primary efficacy end point was cleared ocular inflammation, measured by the summed ocular inflammation score (SOIS; anterior chamber cells and flare) by day 15. The secondary efficacy end point was the number of subjects who were pain-free at day 1. The data from the 4 trials were pooled for analyses. The SOIS and ocular pain. The proportion of subjects who had cleared ocular inflammation by day 15 was significantly higher in the bromfenac 0.09% group than in the placebo group (P < 0.0001). The mean SOIS in the bromfenac 0.09% group was significantly lower than in the placebo group at days 3, 8, 15, and 22 (P < 0.0001). The proportion of subjects who were pain-free at days 1, 3, 8, and 15 was significantly higher in the bromfenac 0.09% group than in the placebo group (P < 0.0001). The incidence of adverse events reported in the bromfenac 0.09% group was significantly lower than in the placebo group (P < 0.0001). On day 15, 84.0% of the bromfenac subjects had ≥ 1-line improvement in visual acuity compared with 66.1% of placebo subjects (P < 0.0001). Bromfenac 0.09% dosed once daily was
Full Text Available Toyoaki Tsumura,1 Keiji Yoshikawa,2 Hirotaka Suzumura,3 Tairo Kimura,4 Satoshi Sasaki,5 Itaru Kimura,6 Ryuji Takeda71Department of Ophthalmology, Fussa Hospital, Fussa, Tokyo, Japan; 2Yoshikawa Eye Clinic, Machida, Tokyo, Japan; 3Department of Ophthalmology, Nakano General Hospital, Nakano, Tokyo, Japan; 4Ueno Eye Clinic, Ueno, Tokyo, Japan; 5Sasaki Eye Clinic, Ueno, Tokyo, Japan; 6Department of Ophthalmology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan; 7Department of Biological Chemistry, Faculty of Agriculture, Kinki University, Nara, Nara, JapanPurpose: The aim of this study was to evaluate the efficacy and safety of bimatoprost ophthalmic solution 0.03% (bimatoprost in Japanese normal-tension glaucoma (NTG patients with an intraocular pressure (IOP of 18 mmHg or less.Methods: Bimatoprost was instilled into the unilateral conjunctival sac of Japanese NTG patients with a baseline IOP of 18 mmHg or less. The time courses of IOP, conjunctival hyperemia, superficial punctate keratitis, and adverse events were examined at 2, 4, 8, and 12 weeks post bimatoprost instillation.Results: Thirty-two of the 38 enrolled NTG patients (mean age, 64.1 ± 12.6 years; 19 males and 19 females completed the study, with six patients unable to complete the study (two patients discontinued because of side effects and four patients withdrew. The levels of IOP in the treated eyes were significantly reduced (P < 0.0001 from the baseline IOP levels. No significant change in IOP was observed in the fellow eyes. There were significant increases in conjunctival hyperemia. No significant superficial punctate keratitis scores were noted between the baseline and each point examined. Eyelash disorder, eyelid pigmentation, and deepening of the upper eyelid sulcus were observed in 28, six, and three eyes, respectively.Conclusion: Bimatoprost effectively lowered the IOP. It was well tolerated in Japanese NTG patients, with few patients having to discontinue
Ayaki, Masahiko; Iwasawa, Atsuo; Soda, Mitsutaka; Yaguchi, Shigeo; Koide, Ryohei
Purpose: Epithelial disorders after eye surgery can result in visual deterioration and patient discomfort. Such disorders may be caused by drug toxicity. In the present study, we evaluated the toxicity of ophthalmic solutions, with or without benzalkonium chloride (BAK) as the preservative, used for postoperative care. Methods: A range of commercially available antibiotic and anti-inflammatory ophthalmic solutions used postoperatively (ie, levofloxacin, moxifloxacin, gatifloxacin, norfloxacin, tosufloxacin, dibekacin, cefmenoxime, diclofenac, bromfenac, pranoprofen, betamethasone, and fluoromethorone) were assessed in three corneal cell lines and one conjunctival cell line. All antibiotic solutions were BAK free. Cell viability was determined with the 3-(4,5-dimethyl-2 thiazoyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay after cells had been exposed to the drugs for 48 h. The effects of preservatives on cell viability were also determined. Toxicity was compared using the cell viability score (CVS). Results: Based on results of the MTT assay and CVS, the order of cell viability after exposure to the antibiotic solutions was cefmenoxime ≥ tosufloxicin ≥ dibekacin ≥ levofloxacin ≥ norfloxacin = gatifloxacin = moxifloxacin. For the anti-inflammatory solutions, the order of cell viability was betamethasone ≥ betamethasone + fradiomycin > preservative-free diclofenac ≥ preservative-free bromfenac >> 0.02% fluoromethorone ≥ 0.1% fluoromethorone = diclofenac + preservative = bromfenac + preservative = pranoprofen. The anti-inflammatory drugs were more toxic than the antibiotics. The toxicity of antibiotic drugs against ocular surface cells was dependent on the pharmaceutical components of the solution, whereas that of the anti-inflammatory drugs was dependent on both the pharmaceutical components and the preservatives. Conclusion: Postoperative drug-induced epitheliopathy may be caused primarily by anti-inflammatory drugs. CVS is useful in comparing the
Utine, Canan Asli
Azithromycin is an azalide that acts by binding to the 50S ribosomal subunit of susceptible microorganisms and interfering with microbial protein synthesis. Azithromycin is also noted by anti-inflammatory and immunomodulatory activity. AzaSite(®) (Inspire Pharmaceuticals, Inc, Durham, NC) is azithromycin ophthalmic solution, 1% formulated in polycarbophil (the aqueous mucoadhesive polymer contained in DuraSite(®)) that delivers high and prolonged azithromycin concentrations in a variety of ocular tissues, including the conjunctiva, cornea and particularly the eyelid. AzaSite was approved by the Food and Drug Administration (FDA) in the US in 2007, for the treatment of bacterial conjunctivitis caused by susceptible isolates. This article aims to evaluate the peer-reviewed published scientific literature and to define well-established uses of AzaSite eye drops in the field of ocular infections.
Utine, Canan Asli
Azithromycin is an azalide that acts by binding to the 50S ribosomal subunit of susceptible microorganisms and interfering with microbial protein synthesis. Azithromycin is also noted by anti-inflammatory and immunomodulatory activity. AzaSite® (Inspire Pharmaceuticals, Inc, Durham, NC) is azithromycin ophthalmic solution, 1% formulated in polycarbophil (the aqueous mucoadhesive polymer contained in DuraSite®) that delivers high and prolonged azithromycin concentrations in a variety of ocular tissues, including the conjunctiva, cornea and particularly the eyelid. AzaSite was approved by the Food and Drug Administration (FDA) in the US in 2007, for the treatment of bacterial conjunctivitis caused by susceptible isolates. This article aims to evaluate the peer-reviewed published scientific literature and to define well-established uses of AzaSite eye drops in the field of ocular infections. PMID:21750614
Jack V Greiner
Full Text Available Jack V Greiner1,2, Kimberly Edwards-Swanson3, Avner Ingerman41Schepens Eye Research Institute, Boston, MA; 2Department of Ophthalmology, Harvard Medical School, Boston, MA; 3Johnson & Johnson Consumer and Personal Products Worldwide, Skillman, NJ; 4Ora Inc, Andover, MA, USAPurpose: To evaluate the effectiveness of alcaftadine 0.05%, 0.1%, and 0.25% ophthalmic solutions in treating the signs and symptoms of allergic conjunctivitis when compared with olopatadine hydrochloride 0.1% and placebo using the conjunctival allergen challenge (CAC model.Methods: One hundred and seventy subjects were randomized and 164 subjects completed all visits. CAC was performed to determine and confirm subjects’ eligibility at visits 1 and 2, respectively. The CAC was repeated at visit 3 (day 0 ± 3, 16 hours after study medication instillation, and at visit 4 (day 14 ± 3, 15 minutes after instillation. Ocular itching and conjunctival redness were evaluated after an allergen challenge, along with several secondary endpoints.Results: Alcaftadine 0.25% and olopatadine 0.1% treatments exhibited significantly lower mean scores compared with placebo for ocular itching and conjunctival redness at visits 3 and 4. Most adverse events were self-limiting and mild in severity. No serious treatment-related adverse events occurred.Conclusion: Treatment with alcaftadine 0.25% ophthalmic solution resulted in mean differences of >1 unit (ocular itching and approximately >1 unit (conjunctival redness, which was significant (P < 0.001 compared with placebo treatment. All doses of alcaftadine were safe and well tolerated in the population studied.Keywords: alcaftadine, allergic conjunctivitis, conjunctival allergen challenge
Full Text Available Masahiko Ayaki1, Atsuo Iwasawa2, Mitsutaka Soda3, Shigeo Yaguchi3, Ryohei Koide41Department of Ophthalmology, Saitama National Hospital, Saitama, Japan; 2Department of Clinical Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan; 3Department of Ophthalmology, Showa University Fujigaoka Rehabilitation Hospital, Yokohama, Japan; 4Department of Ophthalmology, Showa University School of Medicine, Tokyo, JapanPurpose: Epithelial disorders after eye surgery can result in visual deterioration and patient discomfort. Such disorders may be caused by drug toxicity. In the present study, we evaluated the toxicity of ophthalmic solutions, with or without benzalkonium chloride (BAK as the preservative, used for postoperative care.Methods: A range of commercially available antibiotic and anti-inflammatory ophthalmic solutions used postoperatively (ie, levofloxacin, moxifloxacin, gatifloxacin, norfloxacin, tosufloxacin, dibekacin, cefmenoxime, diclofenac, bromfenac, pranoprofen, betamethasone, and fluoromethorone were assessed in three corneal cell lines and one conjunctival cell line. All antibiotic solutions were BAK free. Cell viability was determined with the 3-(4,5-dimethyl-2 thiazoyl-2,5-diphenyl-2H-tetrazolium bromide (MTT assay after cells had been exposed to the drugs for 48 h. The effects of preservatives on cell viability were also determined. Toxicity was compared using the cell viability score (CVS.Results: Based on results of the MTT assay and CVS, the order of cell viability after exposure to the antibiotic solutions was cefmenoxime ≥ tosufloxicin ≥ dibekacin ≥ levofloxacin ≥ norfloxacin = gatifloxacin = moxifloxacin. For the anti-inflammatory solutions, the order of cell viability was betamethasone ≥ betamethasone + fradiomycin > preservative-free diclofenac ≥ preservative-free bromfenac >> 0.02% fluoromethorone ≥ 0.1% fluoromethorone = diclofenac + preservative = bromfenac + preservative = pranoprofen. The anti
Saleh, Sarah S; Lotfy, Hayam M; Hassan, Nagiba Y; Elgizawy, Samia M
The determination of sodium cromoglicate (SCG) and fluorometholone (FLU) in ophthalmic solution was developed by simple, sensitive and precise methods. Three spectrophotometric methods were applied: absorptivity factor (a-Factor method), absorption factor (AFM) and mean centering of ratio spectra (MCR). The linearity ranges of SCG were found to be (2.5-35 μg/mL) for (a-Factor method) and (MCR); while for (AFM), it was found to be (7.5-50 μg/mL). The linearity ranges of FLU were found to be (4-16 μg/mL) for (a-Factor method) and (AFM); while for (MCR), it was found to be (2-16 μg/mL). The mean percentage recoveries/RSD for SCG were found to be 100.31/0.90, 100.23/0.57 and 100.43/1.21; while for FLU, they were found to be 100.11/0.56, 99.97/0.35 and 99.94/0.88 using (a-Factor method), (AFM) and (MCR), respectively. A TLC-spectrodensitometric method was developed by separation of SCG and FLU on silica gel 60 F254 using chloroform:methanol:toluene:triethylamine in the ratio of (5:2:4:1 v/v/v/v) as developing system, followed by spectrodensitometric measurement of the bands at 241 nm. The linearity ranges and the mean percentage recoveries/RSD were found to be (0.4-4.4 μg/band), 100.24/1.44 and (0.2-1.6 μg/band), 99.95/1.50 for SCG and FLU, respectively. A comparative study was conducted between the proposed methods to discuss the advantage of each method. The suggested methods were validated in compliance with the ICH guidelines and were successfully applied for the determination of SCG and FLU in their laboratory prepared mixtures and commercial ophthalmic solution in the presence of benzalkonium chloride as a preservative. These methods could be an alternative to different HPLC techniques in quality control laboratories lacking the required facilities for those expensive techniques.
赵霞; 李博; 徐光富; 步芬; 王岁楼
Objective: To establish a gas chromatography method for the determination of pyridine in cetylpyridinium chloride ophthalmic solution. Methods: The separation was performed on a capillary column which was a copolymer of 5% diphenyl-95% diphenyl siloxane as stationary phase.Column temperature was 35℃for 5 minutes.Then it increased to 115℃in rate of 8℃per minute.Carrier gas was nitrogen. Injector and detector were set at 120℃and 260℃respectively. Results:Pyridine and contamination could be completely separated with the established method. It was a linear correlation between the peak area and the concentration in concentration range of 0.492~9.84μg/ml.The recovery was 99.8%(n=9).RSD is 4.9%(n=6). Conclusion: The established method was accurate, simple and is suitable for determination of pyridine in cetylpyridinium chloride ophthalmic solution.%目的：建立西吡氯铵滴眼液中吡啶的气相色谱测定法。方法：用5%二苯基-95%二甲基硅氧烷共聚物为固定相的毛细管柱（30m×0.54mm×5.0μm），柱温在35℃维持5分钟，然后以每分钟8℃的升温速率升至115℃，以氮气为载气，气化室和检测器温度分别为120℃和260℃。结果：吡啶与杂质峰之间的分离良好。在0.492~9.84μg/ml的范围内吡啶的峰面积和浓度线性相关，回收率99.8%（n=9），RSD为4.9%（n=6）。结论：该分析方法准确可靠，简便易行，可用于西吡氯铵滴眼液中吡啶的测定。
Full Text Available Yasushi Inoue, Shintarou Ochi Inoue Eye Clinic, Tamano, Okayama, Japan Purpose: To evaluate the effects of diquafosol sodium ophthalmic solution 3% (DQS and artificial tears (AT on higher-order aberrations (HOAs in patients with dry eye after cataract surgery. Design: This was a post hoc analysis of a previously conducted randomized clinical study. Methods: Fifty-nine eyes from 42 patients (17 males and 25 females, aged 72.6±8.0 years with verified or suspected dry eye at 4 weeks after cataract surgery were evaluated. The dry eye patients were randomly assigned to receive DQS or AT for 4 weeks. Tear breakup time (BUT, corneal and conjunctival fluorescein staining scores, and HOAs were analyzed before and after instillation. HOAs were measured consecutively for 10 seconds with a wavefront analyzer. Average HOAs, HOA fluctuations (fluctuation index [FI] and changes in HOAs (stability index [SI] were compared within and between the two groups. Results: After 4 weeks of instillation, BUT significantly increased (P=0.001 compared with preinstillation values in the DQS group, but not in the AT group. This increase in BUT in the DQS group was significantly greater than in the AT group (P=0.014. Corneal and conjunctival fluorescein staining scores after instillation significantly improved compared with preinstillation values in the DQS group (P=0.018. In HOAs, the cornea aberration changed from an upward curve (a sawtooth pattern to an almost constant value (a stable pattern in the DQS group, but not in the AT group. In FI and SI, there were no significant changes in either group; however, FI and SI were significantly lower in the DQS group than in the AT group (both, P=0.004. Conclusion: The dry eye patients after cataract surgery had a visual dysfunction in HOAs. DQS is effective to treat dry eye disease after cataract surgery with improvement of visual function. Keywords: cataract surgery, dry eye, tear film breakup time, higher-order aberrations
Full Text Available Canan Asli UtineYeditepe University, Department of Ophthalmology, Istanbul, Turkey and Ocular Surface Disease and Dry Eye Clinic, Cornea and External Disease Service, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Azithromycin is an azalide that acts by binding to the 50S ribosomal subunit of susceptible microorganisms and interfering with microbial protein synthesis. Azithromycin is also noted by anti-inflammatory and immunomodulatory activity. AzaSite® (Inspire Pharmaceuticals, Inc, Durham, NC is azithromycin ophthalmic solution, 1% formulated in polycarbophil (the aqueous mucoadhesive polymer contained in DuraSite® that delivers high and prolonged azithromycin concentrations in a variety of ocular tissues, including the conjunctiva, cornea and particularly the eyelid. AzaSite was approved by the Food and Drug Administration (FDA in the US in 2007, for the treatment of bacterial conjunctivitis caused by susceptible isolates. This article aims to evaluate the peer-reviewed published scientific literature and to define well-established uses of AzaSite eye drops in the field of ocular infections.Keywords: azithromycin, AzaSite, DuraSite
Full Text Available Abstract Background Although in vitro and in vivo laboratory studies have suggested that benzalkonium chloride (BAK in topical ophthalmic solutions may be detrimental to corneal epithelial cells, multiple short- and long-term clinical studies have provided evidence supporting the safety of BAK. Despite the conflicting evidence, BAK is the most commonly used preservative in ophthalmic products largely due to its proven antimicrobial efficacy. This study was designed to characterize the antimicrobial performance of two commonly used topical ocular hypotensive agents that employ different preservative systems: latanoprost 0.005% with 0.02% BAK and travoprost 0.004% with sofZia, a proprietary ionic buffer system. Methods Each product was tested for antimicrobial effectiveness by European Pharmacopoeia A (EP-A standards, the most stringent standards of the three major compendia, which specify two early sampling time points (6 and 24 hours not required by the United States Pharmacopeia or Japanese Pharmacopoeia. Aliquots were inoculated with between 105 and 106 colony-forming units of the test organisms: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Candida albicans and Aspergillus brasiliensis. Sampling and enumeration were conducted at protocol-defined time points through 28 days. Results BAK-containing latanoprost met EP-A criteria by immediately reducing all bacterial challenge organisms to the test sensitivity and fungal challenges within the first six hours while the preservative activity of travoprost with sofZia did not. Complete bacterial reduction by travoprost with sofZia was not shown until seven days into the test, and fungal reduction never exceeded the requisite 2 logs during the 28-day test. Travoprost with sofZia also did not meet EP-B criteria due to its limited effectiveness against Staphylococcus aureus. Both products satisfied United States and Japanese pharmacopoeial criteria. Conclusions Latanoprost with 0
Background Although in vitro and in vivo laboratory studies have suggested that benzalkonium chloride (BAK) in topical ophthalmic solutions may be detrimental to corneal epithelial cells, multiple short- and long-term clinical studies have provided evidence supporting the safety of BAK. Despite the conflicting evidence, BAK is the most commonly used preservative in ophthalmic products largely due to its proven antimicrobial efficacy. This study was designed to characterize the antimicrobial performance of two commonly used topical ocular hypotensive agents that employ different preservative systems: latanoprost 0.005% with 0.02% BAK and travoprost 0.004% with sofZia, a proprietary ionic buffer system. Methods Each product was tested for antimicrobial effectiveness by European Pharmacopoeia A (EP-A) standards, the most stringent standards of the three major compendia, which specify two early sampling time points (6 and 24 hours) not required by the United States Pharmacopeia or Japanese Pharmacopoeia. Aliquots were inoculated with between 105 and 106 colony-forming units of the test organisms: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Candida albicans and Aspergillus brasiliensis. Sampling and enumeration were conducted at protocol-defined time points through 28 days. Results BAK-containing latanoprost met EP-A criteria by immediately reducing all bacterial challenge organisms to the test sensitivity and fungal challenges within the first six hours while the preservative activity of travoprost with sofZia did not. Complete bacterial reduction by travoprost with sofZia was not shown until seven days into the test, and fungal reduction never exceeded the requisite 2 logs during the 28-day test. Travoprost with sofZia also did not meet EP-B criteria due to its limited effectiveness against Staphylococcus aureus. Both products satisfied United States and Japanese pharmacopoeial criteria. Conclusions Latanoprost with 0.02% BAK exhibited more
Full Text Available David Wirta1, Amanda M VanDenburgh2, Emily Weng3, Scott M Whitcup4, Sef Kurstjens5, Frederick C Beddingfield III4,61Private Practice, Newport Beach, CA, USA; 2Clinical Development, 3Biostatistics, 4Research and Development, 5Global Drug Development, Allergan, Inc, Irvine, CA, USA; 6Department of Medicine, Division of Dermatology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USABackground: Bimatoprost ophthalmic solution 0.03% was approved in the US for reducing intraoccular pressure (IOP based on two double-masked, active-controlled clinical trials. Four additional long-term studies (≥ 12months were conducted; however, the aggregate safety profile of the six studies has not been reported.Methods: Adverse events (AEs were pooled from six double-masked, active-controlled, long-term clinical trials in which subjects received bimatoprost 0.03% once daily (QD or twice daily (BID as an eyedrop. AE terms were converted to MedDRA (V.11.0 Preferred Terms and analyzed.Results: In total, 1409 patients received more than one dose of bimatoprost 0.03% QD or BID. Most AEs were mild in severity and reported by 86.7% (QD and 94.8% (BID of subjects (≤ 12 months of treatment. AEs reported through month 12 (aggregate incidence of ≥ 5% were conjunctival hyperemia, increased eyelash growth, eye pruritus, periocular skin hyperpigmentation, eye irritation, dry eye, and hypertrichosis. AE onset was generally reported within four months of treatment. The cumulative incidence of common AEs in the QD treatment group at 24–48 months was similar to that measured at 12 months of treatment.Conclusion: Bimatoprost 0.03% has a favorable safety and tolerability profile as characterized by six long-term studies. Common AEs were due to the known pharmacological activity of bimatoprost and reversible with treatment cessation.Keywords: intraocular pressure, eyelids, pharmacology, clinical trial, medical treatment
Abayomi B Ogundele
Full Text Available Abayomi B Ogundele, David Earnest, Marsha A McLaughlinAlcon Research, Limited, Fort Worth, TX, USAObjective: The objective of this in vivo study was to compare the incidence of vasodilation in guinea pigs following topical administration of bimatoprost ophthalmic solutions 0.01% and 0.03%.Methods: The study comprised 20 guinea pigs assigned to 2 treatment groups (10 per treatment group to receive either bimatoprost 0.01% or bimatoprost 0.03%. Animals were hand-held under 2.75 × magnification to score ocular vasodilation (a measure of hyperemia, using a scoring system developed at Alcon Research, Ltd. Following baseline ocular scoring, each animal received a 30 μL dose to the left eye of either bimatoprost 0.01% (3 μg or bimatoprost 0.03% (9 μg. Vasodilation was again scored at 1, 2, 3, 4, 5 and 6 hours after dosing. Incidence of vasodilation was calculated as the percent of total eyes in each 2-hour time interval with scores ≥2.Results: The incidence of vasodilation was higher in the bimatoprost 0.01% treatment group (range, 45.0% to 60.0% than the bimatoprost 0.03% treatment group (range, 30.0% to 52.2% at all post-dosing time points.Conclusion: The 2 bimatoprost formulations elicited ocular vasodilation of long duration (>6 hours in the guinea pig model, with the bimatoprost 0.01% treatment group showing a higher incidence of ocular vasodilation than the bimatoprost 0.03% treatment group. Further clinical studies would be needed to determine whether the higher incidence of vasodilation may also be attributed to the increased BAK concentration in the bimatoprost 0.01% formulation.Keywords: bitamoprost, ocular vasodilation, hyperemia
Inoue, Yasushi; Ochi, Shintarou
Purpose To evaluate the effects of diquafosol sodium ophthalmic solution 3% (DQS) and artificial tears (AT) on higher-order aberrations (HOAs) in patients with dry eye after cataract surgery. Design This was a post hoc analysis of a previously conducted randomized clinical study. Methods Fifty-nine eyes from 42 patients (17 males and 25 females, aged 72.6±8.0 years) with verified or suspected dry eye at 4 weeks after cataract surgery were evaluated. The dry eye patients were randomly assigned to receive DQS or AT for 4 weeks. Tear breakup time (BUT), corneal and conjunctival fluorescein staining scores, and HOAs were analyzed before and after instillation. HOAs were measured consecutively for 10 seconds with a wavefront analyzer. Average HOAs, HOA fluctuations (fluctuation index [FI]) and changes in HOAs (stability index [SI]) were compared within and between the two groups. Results After 4 weeks of instillation, BUT significantly increased (P=0.001) compared with preinstillation values in the DQS group, but not in the AT group. This increase in BUT in the DQS group was significantly greater than in the AT group (P=0.014). Corneal and conjunctival fluorescein staining scores after instillation significantly improved compared with preinstillation values in the DQS group (P=0.018). In HOAs, the cornea aberration changed from an upward curve (a sawtooth pattern) to an almost constant value (a stable pattern) in the DQS group, but not in the AT group. In FI and SI, there were no significant changes in either group; however, FI and SI were significantly lower in the DQS group than in the AT group (both, P=0.004). Conclusion The dry eye patients after cataract surgery had a visual dysfunction in HOAs. DQS is effective to treat dry eye disease after cataract surgery with improvement of visual function. PMID:28096651
Full Text Available Afshin Shafiee,1 Lyle M Bowman,2 Eddie Hou,2 Kamran Hosseini1,3 1Preclinical, 2Development, 3Clinical, InSite Vision, Alameda, CA, USA Purpose: To compare the aqueous humor (AH and iris-ciliary body (ICB concentration of bimatoprost in rabbit eyes treated with ISV-215 (0.03% bimatoprost formulated in DuraSite with the marketed product bimatoprost 0.03% ophthalmic solution. Methods: The left eye of rabbits received a single topical instillation of either ISV-215 (n = 32 eyes or bimatoprost 0.03% (n = 32 eyes. At predetermined time points, levels of bimatoprost and bimatoprost acid in the AH and the ICB were quantified by HPLC-MS/MS. Results: Both bimatoprost and bimatoprost acid were detected in the AH and the ICB within 15 minutes of dosing. Bimatoprost acid concentrations in both compartments were markedly higher than bimatoprost. There was a statistically significant (P < 0.01 increase in the concentration of the prodrug in the AH and its acid form in the ICB in animals treated with ISV-215 compared to bimatoprost 0.03%. In the ISV-215-treated rabbit eyes, the highest concentrations of bimatoprost and bimatoprost acid were in the ICB and AH, respectively, while in the bimatoprost 0.03%-treated eyes, no differences in the drug content of the selected ocular tissues were observed. Conclusions: Bimatoprost 0.03% formulated in DuraSite has superior ocular distribution and area under the curve compared to bimatoprost 0.03% in rabbit eyes. This improvement in the pharmacokinetic parameters of ISV-215 may provide us with a better platform to optimize a bimatoprost formulation that offers the same degree of efficacy in lowering intraocular pressure and improved therapeutic index in glaucomatous patients by lessening the ocular side effects associated with long-term use of topical prostaglandin F2α analogs. Keywords: drug delivery, intraocular pressure, glaucoma, aqueous humor, prostaglandin (PGF2α analogs
Mendoza, Pia R; Grossniklaus, Hans E
Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.
Full Text Available Robert P Baughman1, Kenneth L Weiss2, Karl C Golnik31Department of Medicine, 2Department of Radiology, 3Department of Ophthalmology, University of Cincinnati Medical Center, Cincinnati, Ohio, USAAbstract: Neuro-ophthalmic disease occurs in about a third of patients with neurosarcoidosis. Optic nerve involvement is the most common manifestation, but other cranial nerves and the optic chiasm can be involved. However, there are several other common diseases that cause optic neuropathy, including multiple sclerosis. The diagnosis of sarcoidosis can often be made based on the multi-organ nature of the disease and ancillary testing. Most patients with neuro-ophthalmic sarcoidosis require systemic therapy. While corticosteroids are usually the first step in therapy, cytotoxic agents such as methotrexate and azathioprine have been useful as steroid-sparing agents for chronic disease. The monoclonal antibodies directed against tumor necrosis factor have been reported as effective in refractory cases of neuro-ophthalmic disease.Keywords: sarcoidosis, methotrexate, infliximab, multiple sclerosis, optic neuritis, prednisone
Kendall, Cynthia J; Prager, Thomas C; Cheng, Han; Gombos, Dan; Tang, Rosa A; Schiffman, Jade S
Ophthalmic ultrasound is an invaluable tool that provides quick and noninvasive evaluation of the eye and the orbit. It not only allows the clinicians to view structures that may not be visible with routine ophthalmic equipment or neuroimaging techniques but also provides unique diagnostic information in various ophthalmic conditions. In this article, the basic principles of ophthalmic ultrasound and examination techniques are discussed. Its clinical application is illustrated through a variety of ocular pathologic abnormalities (eg, narrow angles, ciliary body tumor, detached retina, choroidal melanoma, and papilledema).
Full Text Available Karen Meerovitch,1 Gail Torkildsen,2 John Lonsdale,3 Heidi Goldfarb,4 Teresa Lama,1 Garth Cumberlidge,1 George W Ousler III5 1Mimetogen Pharmaceuticals Inc, Montreal, QC, Canada; 2Andover Eye Associates, Andover, MA, USA; 3Central Maine Eye Care, Lewiston, ME, USA; 4SDC, Tempe, AZ, USA; 5Ora Inc, Andover, MA, USA Purpose: To evaluate the safety and efficacy of ophthalmic MIM-D3, a tyrosine kinase TrkA receptor agonist, in patients with dry eye. Design: A prospective, two-center, randomized, double-masked, placebo-controlled Phase 2 study. Methods: A total of 150 dry eye patients were randomized 1:1:1 to study medication (1% MIM-D3, 5% MIM-D3, or placebo and dosed twice daily (BID for 28 days. Key eligibility criteria included exacerbation in corneal staining and ocular discomfort in the Controlled Adverse Environment (CAESM on two visits, separated by 1 week of BID dosing with artificial tears. Safety and efficacy were evaluated at baseline, throughout treatment, and for 2 weeks post-treatment. The pre-specified primary outcome measures were fluorescein corneal staining post-CAE at day 28 and diary worst symptom scores over 28 days. Secondary outcomes included the pre-, post-, and the change from pre- to post-CAE fluorescein and lissamine green staining in both corneal and conjunctival regions, as well as individual diary symptoms. Results: The prespecified primary endpoints were not met. Compared with placebo, fluorescein corneal staining at day 28 was significantly improved (P < 0.05 in the 1% MIM-D3 group for the assessment of change from pre-CAE to post-CAE. In addition, following CAE exposure, patients in the 1% MIM-D3 group showed significant improvements versus placebo (P < 0.05 in inferior fluorescein and lissamine green staining after 14 and 28 days. Compared with placebo, patients in the 5% MIM-D3 group reported significantly lower daily diary scores for ocular dryness (P < 0.05. In a subgroup defined by higher symptom scores during
Capino, Amanda C; Dannaway, Douglas C; Miller, Jamie L
Carbonic anhydrase inhibitors are a common cause of normal anion gap metabolic acidosis; however, development is less commonly associated with ophthalmic administration of these agents. We report a case of a premature neonate who was being treated at our institution with betaxolol, dorzolamide, and latanoprost ophthalmic products for suspected bilateral congenital glaucoma. In addition, the patient was also receiving caffeine, ursodiol, and acidified liquid human milk fortifier. The patient developed a normal anion gap metabolic acidosis, and both dorzolamide ophthalmic solution and the acidified human milk fortifier were considered potential causes. Upon discontinuation of the dorzolamide ophthalmic solution and the switching of liquid human milk fortifiers, the normal anion gap metabolic acidosis gradually resolved. As a result of the pH and acidity, the acidified liquid human milk fortifier is thought to be associated with an anion gap acidosis; therefore, dorzolamide is suspected to be the primary cause of a normal gap acidosis. This case demonstrates that systemic effects can occur with ophthalmic administration of dorzolamide in a premature neonate. Ophthalmic agents should not be overlooked as a potential cause of systemic toxicity.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic laser. 886.4390 Section 886.4390 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4390 Ophthalmic laser. (a) Identification. An ophthalmic laser is an AC-powered device intended to coagulate or cut tissue of the eye, orbit, or surrounding...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic sponge. 886.4790 Section 886.4790 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4790 Ophthalmic sponge. (a) Identification. An ophthalmic sponge is a device that is an absorbant sponge, pad, or spear made of folded gauze,...
Assessment of the tolerability profile of an ophthalmic solution of 5% glycyrrhizin and copolymer PEG/PPG on healthy volunteers and evaluation of its efficacy in the treatment of moderate to severe blepharitis
Full Text Available Rita Mencucci, Eleonora Favuzza, Ugo MenchiniDepartment of Surgery and Translational Medicine – Eye Clinic, University of Florence, Florence, ItalyPurpose: To evaluate the tolerability on healthy volunteers and the efficacy on subjects affected by chronic moderate/severe blepharitis of a 5% glycyrrhizin and copolymer poly(ethylene glycol/poly(propylene glycol(PEG/PPG ophthalmic solution.Methods: The study was a randomized, controlled, open label, intra-patient monocentric study. It consisted of two different phases, the assessment of tolerability phase on 20 healthy volunteers, and the evaluation of the efficacy on 21 subjects affected by chronic moderate/severe blepharitis; the treatment period was 2 weeks, followed by 1-week of follow-up. In the efficacy phase, in both eyes, eyelid hygiene was also performed. At day 0, 3, 7, 14, and 21 a complete ophthalmological examination was performed. In the tolerability phase, signs of clinical toxicity were recorded and subject-reported symptoms were collected using a questionnaire. In the efficacy phase, global signs and symptoms of blepharitis scores were collected using standardized photographic scales and questionnaire. The statistical analysis was performed using the Wilcoxon signed-rank test. Results: No ocular signs of drug toxicity were reported. During the treatment period for tolerability phase, there were statistically significant higher scores of tearing and ocular discomfort in the tolerability study group versus the tolerability control group. In the efficacy phase, differences between global scores of the two groups were statistically significant at day 0 (score of the efficacy study group was higher than the efficacy control group; P = 0.005 and at day 21 (score of the efficacy study group was lower than the efficacy control group (P ≤ 0.001.The difference of global scores at day 3, 7, 14, and 21 versus day 0 was statistically significant in both groups. No serious adverse events
E. E. Grishina
Full Text Available Ophthalmic manifestations of leukemia are variable and are predominantly represented by leukemic infiltration of the eye and hemodynamic abnormalities in the retinal vasculature. Leukemic infiltration of the retina should be differentiated from an inflammatory process, such as retinitis, chorioretinitis of viral or fungal origin that are not uncommon in patients with hematological malignancies. Retinal involvement is mainly seen in adult patients with acute myeloid leukemia and is less common in patients with acute lymphoblastic leukemia. Retinopathy is more frequent during relapses of the underlying disease. Also, retinopathy can be the first sign of the disease. Leukemia should be included into the list for differential diagnosis with disorders that can be associated with optical nerve edema and retinal hemorrhages. Fundus abnormalities correlate with peripheral blood parameters. Retinopathy and leukemic optic neuropathy are predictors of unfavorable prognosis. Early diagnostics and timely and adequate treatment may fully eliminate ocular symptoms and improve quality of life in patients with hemoblastoses.
... and trimethoprim ophthalmic combination is used to treat bacterial infections of the eye including conjunctivitis (pinkeye; infection ... follow these steps: Wash your hands thoroughly with soap and water. While tilting your head back, pull ...
Campbell, Joanna H; Schwartz, Gail F; LaBounty, Britni; Kowalski, Jonathan W; Patel, Vaishali D
Background Effective control of intraocular pressure is predicated upon patient compliance with pharmacotherapy. We compared patient adherence and persistence with two new ocular hypotensive formulations, using real-world utilization data. Methods This observational cohort study employed pharmacy claims data from the Source® Lx (Wolters Kluwer Pharma Solutions) database. Patients with an initial (index) prescription for topical bimatoprost 0.01% or travoprost Z (April to June 2011) and no claim for ophthalmic prostaglandin or prostamide analogs within the previous 18 months were identified. Treatment adherence was expressed as proportion of days covered with study medication during the first 365 days after the index prescription. Treatment persistence with study medication was assessed over the first 12 months using Kaplan–Meier survival analyses, allowing a maximum 30-day gap for prescription refill. Treatment status was determined monthly over this period. Results A total of 12,985 patients were assessed for treatment adherence, and 10,470 for treatment persistence. Adherence was better with bimatoprost 0.01% than with travoprost Z (mean proportion of days covered 0.540 versus [vs] 0.486, P0.80) with bimatoprost 0.01% than travoprost Z (29.1% vs 22.3%, P<0.001). Continuous 12-month persistence was higher with bimatoprost 0.01% than with travoprost Z (29.5% vs 24.2%, P<0.001). At month 12, more patients were on treatment with bimatoprost 0.01% than travoprost Z (48.8% vs 45.7%, P<0.01). Similar findings were demonstrated in cohorts of ocular hypotensive treatment-naïve patients, branded latanoprost switchers, and older patients (age ≥65 years), and after inclusion of patient characteristics as covariates. Conclusion For patients with glaucoma or ocular hypertension, bimatoprost 0.01% offers compliance advantages over travoprost Z. PMID:24868144
Sharon J. Krinsky-McHale
Full Text Available A myriad of ophthalmic disorders is associated with the phenotype of Down syndrome including strabismus, cataracts, and refractive errors potentially resulting in significant visual impairment. Ophthalmic sequelae have been extensively studied in children and adolescents with Down syndrome but less often in older adults. In-depth review of medical records of older adults with Down syndrome indicated that ophthalmic disorders were common. Cataracts were the most frequent ophthalmic disorder reported, followed by refractive errors, strabismus, and presbyopia. Severity of intellectual disability was unrelated to the presence of ophthalmic disorders. Also, ophthalmic disorders were associated with lower vision-dependent functional and cognitive abilities, although not to the extent that was expected. The high prevalence of ophthalmic disorders highlights the need for periodic evaluations and individualized treatment plans for adults with Down syndrome, in general, but especially when concerns are identified.
Full Text Available Joanna H Campbell,1 Gail F Schwartz,2 Britni LaBounty,3 Jonathan W Kowalski,1 Vaishali D Patel1 1Allergan, Inc., Irvine, CA, USA; 2Greater Baltimore Medical Center and Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; 3Principled Strategies, Inc., Encinitas, CA, USA Background: Effective control of intraocular pressure is predicated upon patient compliance with pharmacotherapy. We compared patient adherence and persistence with two new ocular hypotensive formulations, using real-world utilization data. Methods: This observational cohort study employed pharmacy claims data from the Source® Lx (Wolters Kluwer Pharma Solutions database. Patients with an initial (index prescription for topical bimatoprost 0.01% or travoprost Z (April to June 2011 and no claim for ophthalmic prostaglandin or prostamide analogs within the previous 18 months were identified. Treatment adherence was expressed as proportion of days covered with study medication during the first 365 days after the index prescription. Treatment persistence with study medication was assessed over the first 12 months using Kaplan–Meier survival analyses, allowing a maximum 30-day gap for prescription refill. Treatment status was determined monthly over this period. Results: A total of 12,985 patients were assessed for treatment adherence, and 10,470 for treatment persistence. Adherence was better with bimatoprost 0.01% than with travoprost Z (mean proportion of days covered 0.540 versus [vs] 0.486, P<0.001, and more patients showed high adherence (proportion of days covered >0.80 with bimatoprost 0.01% than travoprost Z (29.1% vs 22.3%, P<0.001. Continuous 12-month persistence was higher with bimatoprost 0.01% than with travoprost Z (29.5% vs 24.2%, P<0.001. At month 12, more patients were on treatment with bimatoprost 0.01% than travoprost Z (48.8% vs 45.7%, P<0.01. Similar findings were demonstrated in cohorts of ocular hypotensive treatment-naïve patients, branded
李战梅; 黄海; 周李
Objective:To compare the effect of tropicamide and atropine ophthalmic solution in mydriatic refractometry for children.Methods:Totally 260 cases (520 eyes) of ametropia children from 4 to 14 years without other eye disease were received optometry after using the tropicamide eye drops and 1%atropine sulfate,The results of optometry were compared by paired T-test.Results:There existed statistically significant difference between the hyperopia and myopia in 4 to 7 years old group,hyperopia in 8 to 11 years old group.But there were no significant difference between the myopia in 8 to 11 years old group,myopia and hyperopia in 12 to 14 years old group.Conclusion:Aged 8 years and older children with myopia and hyperopia in aged 12 years and above children could receive optometry after using the tropicamide eye drops.% 目的：对比托吡卡胺与阿托品眼液对儿童散瞳验光的效果。方法：用托吡卡胺眼液和1%硫酸阿托品眼膏先后分别对4~14岁260例(520只眼)，无其它眼疾，眼位正常的屈光不正儿童散瞳后进行电脑验光，采用自身配对t检验对两种药物验光结果进行比较。结果：4~7岁组远视、近视和8~11岁组远视两种药物散瞳验光所得结果差异有统计学意义(P0.05)。结论：托吡卡胺散瞳验光方法适用于眼位正常的8岁及以上近视儿童和12岁及以上远视儿童。
Takagi, Yasutaka; Osaki, Hirotaka; Yamashita, Tomohiro; Kai, Yasuhiko
The intraocular pressure (IOP)-lowering effect and safety of tafluprost 0.0015%/timolol maleate 0.5% combination ophthalmic solution (Taf-TFC) were investigated in a real-world clinical setting. A prospective up to 2-year (more than 1 year) observational study has been initiated to collect data on the IOP, conjunctival hyperemia score, corneal staining score, and adverse events suffered by patients with glaucoma or ocular hypertension treated at 3 months, and up to 2 years (more than 1 year) after initiating treatment with Taf-TFC. The 3-month findings are reported here. Among 439 patients enrolled at 100 institutions in Japan, most had normal tension glaucoma (45.3%) or primary open angle glaucoma (36.0%). Adverse drug reaction (ADR) occurred in 5.01%. The important ADRs were conjunctival hyperemia (five patients), blepharitis (four patients), and punctate keratitis (two patients). Serious adverse reactions occurred in two patients (three events). In 410 patients with data both before and after treatment, baseline mean IOP was 17.5 ± 5.0 mmHg, and it was significantly decreased after 1, 2, and 3 months (all P < 0.05, paired-t test). IOP was significantly reduced in patients switched to Taf-TFC from either prostaglandin or β-blocker monotherapy. IOP also decreased significantly in patients switched from a prostaglandin/timolol fixed combination, but not in patients switched from concomitant use of a prostaglandin analog and a β-blocker. The use of Taf-TFC did not worsen the adherence in most patients. Taf-TFC significantly reduced the IOP in patients with glaucoma or ocular hypertension treated in daily clinical practice with controllable or recoverable ADRs in short period. Taf-TFC was effective regardless of treatment patterns, and particularly, Taf-TFC significantly reduced IOP in cases in which requiring the second line therapy as insufficient of monotherapy. Santen Pharmaceutical Co., Ltd., Osaka, Japan.
Lu, Louise J; Liu, Ji
The human ocular surface, consisting of the cornea and conjunctiva, is colonized by an expansive, diverse microbial community. Molecular-based methods, such as 16S rRNA sequencing, has allowed for more comprehensive and precise identification of the species composition of the ocular surface microbiota compared to traditional culture-based methods. Evidence suggests that the normal microbiota plays a protective immunological role in preventing the proliferation of pathogenic species and thus, alterations in the homeostatic microbiome may be linked to ophthalmic pathologies. Further investigation of the ocular surface microbiome, as well as the microbiome of other areas of the body such as the oral mucosa and gut, and their role in the pathophysiology of diseases is a significant, emerging field of research, and may someday enable the development of novel probiotic approaches for the treatment and prevention of ophthalmic diseases.
Singh, Arun D.; Biscotti, Charles V.
A majority of intraocular tumors can be diagnosed based on clinical examination and ocular imaging studies, which obviate the need for diagnostic ophthalmic fine needle aspiration biopsy (FNAB). Overall, diagnostic accuracy of ophthalmic FNAB is high but limited cellularity can compromise the diagnostic potential of ophthalmic aspirate samples. The role of ophthalmic FNAB is limited in retinal tumors. Orbital FNAB should be considered in the evaluation of lacrimal gland tumors, orbital metastasis, and lymphoproliferative lesions. Negative cytologic diagnosis of malignancy should not be considered unequivocal proof that an intraocular malignancy does not exist. With improved understanding of genetic prognostic factors of uveal melanoma, ophthalmic FNAB is gaining popularity for prognostic purposes in combination with eye conserving treatment of the primary tumor. In special clinical indications, ancillary studies such as immunohistochemistry and FISH can be performed on ophthalmic FNAB samples. Assistance of an experienced cytopathologist cannot be overemphasized. PMID:23960981
Sjö, Lene Dissing
With a lifetime risk of 1% and 700 new cases per year, Non-Hodgkin lymphoma (NHL) is the seventh most frequent type of cancer in Denmark. The incidence of NHL has increased considerably in Western countries over the last decades; consequently, NHL is an increasing clinical problem. Ophthalmic lymphoma, (lymphoma localized in the ocular region, i.e. eyelid, conjunctiva, lacrimal sac, lacrimal gland, orbit, or intraocularly) is relatively uncommon, accounting for 5%-10% of all extranodal lymphomas. It is, however, the most common orbital malignancy. The purpose of this thesis was to review specimens from all Danish patients with a diagnosis of ophthalmic lymphoma during the period 1980-2005, in order to determine the distribution of lymphoma subtypes, and the incidence- and time trends in incidence for ophthalmic lymphoma. Furthermore, an extended analysis of the most frequent subtype, extranodal marginal zone lymphoma (MALT lymphoma), was done to analyse clinical factors and cytogenetic changes with influence on prognosis. A total of 228 Danish patients with a biopsy-reviewed verified diagnosis of ocular adnexal-, orbital-, or intraocular lymphoma were identified. We found that more than 50% of orbital- and ocular adnexal lymphomas were of the MALT lymphoma subtype, whereas diffuse large B-cell lymphoma (DLBCL) predominated intraocularly (Sjo et al. 2008a). Furthermore, lymphoma arising in the lacrimal sac was surprisingly predominantly DLBCL (Sjo et al. 2006). Incidence rates were highly dependent on patient age. There was an increase in incidence rates for the whole population from 1980 to 2005, corresponding to an annual average increase of 3.4% (Sjo et al. 2008a). MALT lymphoma arising in the ocular region was found in 116 patients (Sjo et al. 2008b). One third of patients had a relapse or progression of disease after initial therapy and relapses were frequently found at extra-ocular sites. Overall survival, however, was not significantly poorer for patients
Budai-Szű Cs, Mária; Horvát, Gabriella; Gyarmati, Benjámin; Szilágyi, Barnabás Áron; Szilágyi, András; Csihi, Tímea; Berkó, Szilvia; Szabó-Révész, Piroska; Mori, Michela; Sandri, Giuseppina; Bonferoni, Maria Cristina; Caramella, Carla; Csányi, Erzsébet
Ocular drug delivery formulations must meet anatomical, biopharmaceutical, patient-driven and regulatory requirements. Mucoadhesive polymers can serve as a better alternative to currently available ophthalmic formulations by providing improved bioavailability. If all requirements are addressed, a polymeric formulation resembling the tear film of the eye might be the best solution. The optimum formulation must not have high osmotic activity, should provide appropriate surface tension, pH and refractive index, must be non-toxic and should be transparent and mucoadhesive. We would like to highlight the importance of in vitro polymer testing from a pharmaceutical aspect. We, therefore, carried out physical-chemical investigations to verify the suitability of certain systems for ophthalmic formulations. In this work, in situ gelling, mucoadhesive thiolated poly(aspartic acid)s were tested from ophthalmic formulation aspects. The results of preformulation measurements indicate that these polymers can be used as potential carriers in ophthalmic drug delivery.
Saati, Saloomeh; Lo, Ronalee; Li, Po-Ying; Meng, Ellis; Varma, Rohit; Humayun, Mark S
To evaluate the feasibility of developing a novel mini drug pump for ophthalmic use. Using principles of microelectromechanical systems engineering, a mini drug pump was fabricated. The pumping mechanism is based on electrolysis and the pump includes a drug refill port as well as a check valve to control drug delivery. Drug pumps were tested first on the bench-top and then after implantation in rabbits. For the latter, we implanted 4 elliptical (9.9 x 7.7 x 1.8 mm) non-electrically active pumps into 4 rabbits. The procedure is similar to implantation of a glaucoma aqueous drainage device. To determine the ability to refill and also the patency of the cannula, at intervals of 4-6 weeks after implantation, we accessed the drug reservoir with a transconjunctival needle and delivered approximately as low as 1 microL of trypan blue solution (0.06%) into the anterior chamber. Animals were followed by slit lamp examination, photography, and fluorescein angiography. Bench-top testing showed 2.0 microL/min delivery when using 0.4 mW of power for electrolysis. One-way valves showed reliable opening pressures of 470 mmHg. All implanted devices refilled at 4-6 weeks intervals for 4-6 months. No infection was seen. No devices extruded. No filtering bleb formed over the implant. A prototype ocular mini drug pump was built, implanted, and refilled. Such a platform needs more testing to determine the long term biocompatibility of an electrically-controlled implanted pump. Testing with various pharmacological agents is needed to determine its ultimate potential for ophthalmic use.
Russian ophthalmic nurses and physicians are using alternative methods of treatment to supplement traditional eye care. As acupuncture and iridology become more popular in the United States, ophthalmic nurses need to be more knowledgeable about these treatments and the implications for patients.
Rathore K. S.
Full Text Available Promising management of eye ailments take off effective concentration of drug at the eye for sufficient period of time. Dosage forms are administered directly to eye for localized ophthalmic therapy. Most of the treatments call for the topical administration of ophthalmic active drugs to the tissues around the ocular cavity. Conventional ophthalmic drug delivery systems including eye drops, ophthalmic ointments, are no longer sufficient to encounter eye diseases. This article reviews the constraints with conventional ocular therapy and explores various novel approaches like in-situ gel, ocular films or ocuserts, nanosuspension, collagen shields, latex systems, nanoparticles, liposomes, niosomes, iontophorosis, eye implants, etc to improve the ophthalmic bioavailability of drugs to the anterior chamber of the eye.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual ophthalmic surgical instrument. 886.4350... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4350 Manual ophthalmic surgical instrument. (a) Identification. A manual ophthalmic surgical instrument is a nonpowered, handheld...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic bar reader. 886.5800 Section 886.5800...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5800 Ophthalmic bar reader. (a) Identification. An ophthalmic bar reader is a device that consists of a magnifying lens intended for use by a...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic prism reader. 886.5810 Section 886.5810...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5810 Ophthalmic prism reader. (a) Identification. An ophthalmic prism reader is a device intended for use by a patient who is in a supine position...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic electrolysis unit. 886.4250 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4250 Ophthalmic electrolysis unit. (a) Identification. An ophthalmic electrolysis unit is an AC-powered or battery-powered device intended to...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic instrument stand. 886.1860 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1860 Ophthalmic instrument stand. (a) Identification. An ophthalmic instrument stand is an AC-powered or nonpowered device intended to store...
Clark, Antony; Ng, Jonathon Q; Morlet, Nigel; Semmens, James B
Large population-based health administrative databases, clinical registries, and data linkage systems are a rapidly expanding resource for health research. Ophthalmic research has benefited from the use of these databases in expanding the breadth of knowledge in areas such as disease surveillance, disease etiology, health services utilization, and health outcomes. Furthermore, the quantity of data available for research has increased exponentially in recent times, particularly as e-health initiatives come online in health systems across the globe. We review some big data concepts, the databases and data linkage systems used in eye research-including their advantages and limitations, the types of studies previously undertaken, and the future direction for big data in eye research.
PROMOTING ACCESS TO AFRICAN RESEARCH ... Background: Ophthalmic surgical procedures are performed under anaesthesia to enhance ... Local anaesthesia was the more commonly (92.1%) employed while general anaesthesia was ...
Full Text Available Collodion baby is a rare, genetic heterogeneous skin disorder. It refers to a clinicentity used for newborns who are encased by a translucent, tight and parchment paper like skin sheets so called collodion membrane, on the entire body surface. 1 Collodion baby is a phenotype which broadly describes the above condition which includes a number of phenotypes. The two most common phenotypes are lamellar ichthyosis and non-bullous congenital erythroderma which account for 75% of cases and others like Sjögren-Larsson syndrome, Netherton syndrome, Gaucher disease etc account for 15% of the cases. 2 Lamellar ichthyosis which is more common, is an autosomal recessive condition caused by mutations in the transglutaminase-1 gene, defect on chromosome 14q11.Lid ectropion and ocular complications like exposure keratitis are seen commonly in colloidon babies. 3 15 day old male baby, first issue of a second degree consanguineously married couple, born at a gestation age of 36 weeks (normal vaginal delivery was referred to ophthalmic institute for management of ectropion. Child was diagnosed to have lamellar ichthyosis at the paediatric referral institute. At birth baby weighed 2500 grams, length 48 cm, head circumference of 34 cm.
Full Text Available Patients with carotid atherosclerosis can present with ophthalmic symptoms. These symptoms and signs can be due to retinal emboli, hypoperfusion of the retina and choroid, opening up of collateral channels, or chronic hypoperfusion of the globe (ocular ischemic syndrome. These pathological mechanisms can produce many interesting signs and a careful history can bring out important past symptoms pointing toward the carotid as the source of the patient′s presenting symptom. Such patients are at high risk for an ischemic stroke, especially in the subsequent few days following their first acute symptom. It is important for clinicians to be familiar with these ophthalmic symptoms and signs caused by carotid atherosclerosis for making an early diagnosis and to take appropriate measures to prevent a stroke. This review elaborates the clinical features, importance, and implications of various ophthalmic symptoms and signs resulting from atherosclerotic carotid artery disease.
Hu, Xiaohong; Tan, Huaping; Chen, Pin; Wang, Xin; Pang, Juan
Hydrogel contact lens is an attractive drug carrier for the delivery of ophthalmic drugs. But limited drug loading capacity and burst release restricted its application in this field. Polymer micelle laden hydrogel contact lenses were designed for ophthalmic drug delivery in the work. β-CD/PAA/PEG ternary system was chosen to form polymer micelle. The micelle size could be adjusted by β-CD content and PAA/PEG concentration. The zeta potential of micelle was irrelevant to β-CD content, but influenced by PAA/PEG concentration. The absorbed drug concentration in micelle solution depended on both β-CD content and PAA/PEG concentration. Polymer micelle laden hydrogels were obtained by radical polymerization in situ. The transparency of polymer micelle laden hydrogel declined with PAA/PEG concentration increasing. The equilibrium water content and water loss showed that polymer micelle laden hydrogel with higher PAA/PEG concentration was in a higher swollen state. The dynamic viscoelastic properties howed that all polymer micelle laden hydrogels had some characteristics of crosslinked elastomers. The surface structure of freeze dried composite hydrogels was different from freeze dried pure hydrogel. The drug loading and releasing behaviors were detected to evaluate the drug loading and releasing capacity of hydrogels using orfloxacin and puerarin as model drugs. The results indicated the polymer micelle in hydrogel could hold or help to hold some ophthalmic drugs, and slow down orfloxacin release speed or keep puerarin stably stay for a time in hydrogels. In the end, it was found that the transparency of composite hydrogel became better after the hydrogel had been immersed in PBS for several weeks.
Frohman, Larry P
Because of the rarity of neuro-ophthalmic sarcoidosis, there are no therapeutic guidelines based on evidence-based medicine for this disorder. Review of literature combined with personal experience. Corticosteroids are the preferred initial therapy for neuro-ophthalmic sarcoidosis. If patients cannot tolerate the requisite dose of corticosteroid needed to control their disease, or if corticosteroids fail to adequately control the disease process, the choices of a second agent are based on the consideration of rapidity of clinical response and the safety profile. Although methotrexate and mycophenolate mofetil are the medications that are often selected after corticosteroid failure, more rapidly acting agents that have been used are infliximab and intravenous cyclophosphamide.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic conformer. 886.3130 Section 886.3130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... adhesions during the healing process following surgery. ] (b) Classification. Class II (special controls...
Paramore, J.E.; King, V.M. (Ferris State Univ., Big Rapids, MI (USA))
A review of seasonal affective disorder (SAD) is presented with a discussion of its standard treatment of phototherapy. A number of ophthalmic implications related to SAD are proposed. These implications relate to both the condition and the phototherapy used in its treatment, especially the use of full spectrum light which contains ultraviolet and near ultraviolet radiation. 12 references.
Full Text Available AIM: To analyze, summarize and describe ophthalmic imaging features of posterior scleritis. METHODS: Clinical data of 16 patients(21 eyeswith posterior scleritis diagnosed in our hospital from October 2008 to June 2013 were retrospectively analyzed. The results of type-B ultrasonic, fundus chromophotograph, fundus fluorescein angiography, CT were recorded for comprehensive evaluation and analysis of ophthalmic imaging features of posterior scleritis. RESULTS: All patients underwent type-B ultrasonic examination and manifested as diffuse and nodular types. The diffuse type showed diffusely thickened sclera and a dark hypoechoic area that connected with the optic nerve to form a typical “T”-shaped sign. The nodular type showed scleral echogenic nodules and relatively regular internal structure. FFA showed that relatively weak mottled fluorescences were visible in the arterial early phase and strong multiple needle-like fluorescences were visible in the arteriovenous phase, which were then progressively larger and fused; fluorescein was leaked to the subretinal tissue in the late phase; varying degrees of strong fluorescences with less clear or unclear boundaries were visible in the optic disk. CT results showed thickened eyeball wall. CONCLUSION: Posterior scleritis is common in young female patients, whose ophthalmic imaging features are varied and more specific in type-B ultrasonic. Selection of rational ophthalmic imaging examination method, combined with clinical manifestations, can accurately diagnose posterior scleritis and avoid the incidence of missed and delayed diagnosis.
Flynn, T H
Dural arteriovenous malformations in the anterior cranial fossa are rare and are especially prone to haemorrhage. These lesions are usually treated by surgical excision. We report the embolization of an anterior cranial fossa DAVM using an endovascular approach via the ophthalmic artery.
Saettone, M F; Monti, D; Torracca, M T; Chetoni, P
A series of polyanionic natural or semi-synthetic polymers (polygalacturonic acid, hyaluronic acid, carboxymethylamylose, carboxymethylchitin, chondroitin sulfate, heparan sulfate and mesoglycan) were evaluated as potential mucoadhesive carriers for ophthalmic drugs. Solutions containing cyclopentolate (CY) or pilocarpine (PI) as salts (or polyanionic complexes) with the acidic polymers, all showing a low viscosity, were tested for miotic (resp. mydriatic) activity in albino rabbits. In the case of some polymeric complexes, small but significant increases of the areas under the activity vs. time curves (AUC) over reference cyclopentolate hydrochloride (CYHC1) or pilocarpine nitrate (PINO3) vehicles, and significant AUC decreases after removal of precorneal mucin by treatment with N-acetylcysteine were observed. A correlation was found between these data, considered indicative of the occurrence of a mucoadhesive interaction "in vivo", and "in vitro" viscometric data expressing the polymers-mucin force of interaction. The advantages and limitations of the mucoadhesive non-viscous approach in the formulation of ophthalmic vehicles are presented and discussed.
Full Text Available The province of Rudsar is located in the Caspian littoral zone of Iran. In 1970 an ophthalmic health survey was carried out in 25 units, which were selected by random sampling in these areas. A total of 2,165 persons were examined and the results of this evaluation have been prepared in 6 parts, consisting of ophthalmic conditions and health customs, infectious eye diseases, visual status and diseases, blindness and its causes, eye complications of malnutrition, and other eye disease. The prevalence of trachoma is 24% and of conjunctivitis 11.2%, but infectious eye diseases are mild in these areas and their complications are very rare, and trachoma is deviated mainly to inclusion conjunctivitis. Visual defect are important problem in the Rudsar area; 17.8% of the persons examined of 10 years of age and over, had visual defects. The most important causes of visual defects are refraction abnormalities, especially myopic astigmatism and contact. Visual defects are more prevalent in females than in males. Of the total number of persons examined, 2.63% had infectious eye diseases, 2.77% had blindness in at least one eye and 56.7% of the blindness was caused by cataracts. The eye complications of avitaminosis A and ariboflavinosis were observed, especially in rural areas. The establishment of an ophthalmic clinic, the use of a mobile dispensary unit for diagnosis, procedures for introducing patients to the ophthalmic clinic, and special procedures for the health of school children would be beneficial and are recommended for the control of ophthalmic disease. It is also necessary to have a special survey on toxoplasmosis, an investigation for clarification of the causes of differences in visual defects in males and females, and a survey on the causes of blepharitis.
Yuan, Jia-Ying; Zhang, Jian-Hua; Tang, Chong; Zhu, Hong; Xie, Hua; Gao, Shuan-Jie
To analyze the application of microbubble contrast technology in the treatment of ophthalmic diseases, mainly analyzing its advantages and existing problems. A total of 30 representative literatures about the application of ultrasound contrast agent in gene targeted therapy at home and abroad were collected, and focusing on sorting out the literature reporting the treatment of ophthalmic diseases with microbubble contrast technology in recent years, then recalling its advantages and problems, finally making reasonable assessment on existing problems and proposing possible solutions to the problems. DUE TO ITS UNIQUE SAFETY AND EFFICACY, THE TREATMENT OF OPHTHALMIC DISEASES WITH MICROBUBBLE CONTRAST TECHNOLOGY HAS INCREASINGLY DRAWN THE ATTENTION OF CLINICIANS, BUT TWO RELEVANT ISSUES SHOULD BE CONSIDERED: first, the nature of contrast agent and the choice of corresponding ultrasound parameters; second, relative incidence of tissue bleeding, intravascular hemolysis, moderate or severe allergy as well as other side effects. Microbubble may become the carrier of targeted therapy, and as a kind of new non-invasive delivery system, the ultrasound contrast agent has broad application prospects, but its application in ophthalmic research is still in its initial stage and the safety of contrast-enhanced ultrasound still needs further study.
Criado, Susana; García, Norman A
The kinetics and mechanistic aspects of the riboflavin-photosensitised oxidation of the topically administrable ophthalmic drugs Timolol (Tim) and Pindolol (Pin) were investigated in water-MeOH (9:1, v/v) solution employing light of wavelength > 400 nm. riboflavin, belonging to the vitamin B(2) complex, is a known human endogenous photosensitiser. The irradiation of riboflavin in the presence of ophthalmic drugs triggers a complex picture of competitive reactions which produces the photodegradation of both the drugs and the pigment itself. The mechanism was elucidated employing stationary photolysis, polarographic detection of dissolved oxygen, stationary and time-resolved fluorescence spectroscopy, and laser flash photolysis. Ophthalmic drugs quench riboflavin-excited singlet and triplet states. From the quenching of excited triplet riboflavin, the semireduced form of the pigment is generated, through an electron transfer process from the drug, with the subsequent production of superoxide anion radical (O(2)(*-)) by reaction with dissolved molecular oxygen. Through the interaction of dissolved oxygen with excited triplet riboflavin, the species singlet oxygen (O(2)((1)Delta(g))) is also generated to a lesser extent. Both O(2)(*-) and O(2)((1)Delta(g)) induce photodegradation of ophthalmic drugs, Tim being approximately 3-fold more easily photooxidisable than Pin, as estimated by oxygen consumption experiments.
There are considerable variations in the anatomy of the human ophthalmic artery (OphA), such as anomalous origins of the OphA and anastomoses between the OphA and the adjacent arteries. These anatomical variations seem to attribute to complex embryology of the OphA. In human embryos and fetuses, primitive dorsal and ventral ophthalmic arteries (PDOphA and PVOphA) form the ocular branches, and the supraorbital division of the stapedial artery forms the orbital branches of the OphA, and then numerous anastomoses between the internal carotid artery (ICA) and the external carotid artery (ECA) systems emerge in connection with the OphA. These developmental processes can produce anatomical variations of the OphA, and we should notice these variations for neurosurgical and neurointerventional procedures. PMID:27298261
Hsu, Chi-Hsin; Lin, I-Chan; Shen, Yun-Dun; Hsu, Wen-Ming
We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery.
Full Text Available Botulinum toxin chemodenervation has evolved greatly over the past 30 years since its introduction in the 1970s for the management of strabismus. Among ophthalmic plastic surgeons, botulinum toxins are often used as the first line treatment for facial dystonias. These toxins are also efficacious for the temporary management of various other conditions including keratopathies (through so called chemo-tarsorraphy, upper eyelid retraction, orbicularis overaction-induced lower eyelid entropion, gustatory epiphora, Frey′s syndrome, and dynamic facial rhytids such as lateral canthal wrinkles (crow′s feet, glabellar creases and horizontal forehead lines. This article describes the pharmacology, reconstitution techniques and common current applications of botulinum toxins in ophthalmic plastic surgery.
WEI Rui-li; MA Xiao-ye; CAI Ji-ping; ZHU Huang
Objective:To assess MRI in the evaluation of enlarged superior ophthalmic vein (SOV). Methods: MRI manifestations and etiology of forty-six patients with enlarged SOV were analyzed. Results: SOV enlargement was noted to occur in carotid-cavernous fistula, ophthalmic Graves'disease, Tolosa-Hunt syndrome, inflammation at the apex of the orbit, orbital pseudotumor and thrombosis of cavernous sinus. The dilated vein appeared as signal void tubular shadows on both T1 and T2 weighted images. The diameter of the enlarged vein was 3.5-6.0 mm. Extraocular muscle enlargement, orbital pathologies, enlarged carotid cavernous sinus etc were also revealed by MRI. Conclusion: The dilated SOV may be well demonstrated by MRI. The etiological diagnosis of enlarged SOV can be made in combination with the associated findings.
Full Text Available No drug is absolutely safe. Pharmacovigilance is the science related to detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problems. The ocular medications and devices can cause localized and systemic adverse effects. Not all adverse effects are known when a drug or device is launched in market because of limitations of clinical trials. Many adverse effects are recognized due to the spontaneous reporting of the vigilant doctors who observe and report such events encountered in their practice. Despite a large ophthalmic patient population base, India does not have robust adverse drug reaction (ADR database because of lack of reporting culture. Government of India recently launched the Pharmacovigilance Programme of India (PvPI to monitor ADRs and create awareness among the healthcare professionals about the importance of ADRs. Suspecting and reporting a possible drug reaction is very important in developing a safe and rational ophthalmic practice.
Full Text Available Frozen section diagnosis is extensively used in various branches of pathology, but its application in ophthalmic pathology was recognised only in the 1970s. We studied 10 sections of ocular and adenexal lesions by frozen section diagnosis, which included orbital lesions (4 cases, lid lesions (3 cases, and intraocular tissue (1 case. The time taken for processing ranged between 10 to 15 minutes. Diagnoses based on frozen section evaluation included lymphoma, mesenchymal chondrosarcoma, solar keratosis, compound naevus, silicone oil globules in cataractous lens, neurofibromatosis, pseudotumour, retinoblastoma, and chronic blepharitis. Although further histopathologic examination correlated well with the frozen section (100% observations, the diagnosis was deferred in the case of naevus and reactive lymphoid hyperplasia. Our study shows that frozen section diagnosis in ophthalmic surgery is quite reliable and is particularly useful in ocular adenexal lesions
Østergaard, Jens; Prause, Jan U; Heegaard, Steffen
Purpose: This study aimed to make a nationwide clinicopathological study of oncocytic lesions in the ophthalmic region and to characterize their cytokeratin (CK) expression. Methods: All histologically diagnosed oncocytic lesions in the ophthalmic region registered in Denmark over a 25-year period...... were collected and re-evaluated using a monoclonal antimitochondrial antibody (MU213-UC). Clinical data were registered. Immunohistochemical characterization was performed with a panel of anti-CK antibodies. Results: A total of 34 oncocytic lesions were identified and reviewed. The incidence...... that required surgical intervention in the Danish population could be approximated to 0.3 lesions per million capita per year. Patient ages ranged from 45 years to 89 years, with a peak incidence in the eighth decade. Female patients were twice as common as male. Lesions were typically described as red...
Liu, Z; Chen, Y; Lin, Z; Shi, X
Eye is a vital sense organ and reflects the physical and mental wellbeing of a person. Detailed examination of the eye is an essential part in the clinical evaluation of patients with any systemic disorder. The interaction between ophthalmologists and endocrinologists is often limited to Graves' ophthalmopathy and diabetic retinopathy. However, there are many ophthalmic manifestations, which are characteristically seen in endocrine disorders. In this review, we shall discuss the ocular manifestations of the endocrine syndromes excluding the Graves' ophthalmopathy and diabetic retinopathy. We performed a PubMed search of articles published in English showing the ophthalmic features in the endocrine disorders. Relevant cited articles were also retrieved. Most of the publications included in the review were case reports and review articles. Many endocrine disorders have characteristic manifestations pertaining to the various structures of the eye. The involvement is seen from the external structures of the eye to the inner most layers of the retina. Many ocular-endocrine syndromes also exist with characteristic clues to the clinical diagnosis. The endocrinologists need to be aware of these ocular signs that help in the early diagnosis of the underlying disorder. A syndromic approach is essential in the diagnosis of endocrinopathy in patients presenting with ophthalmic features.
Atezhev, V. V.; Barchunov, B. V.; Vartapetov, S. K.; Zav'yalov, A. S.; Lapshin, K. E.; Movshev, V. G.; Shcherbakov, I. A.
Excimer and femtosecond lasers are widely used in ophthalmology to correct refraction. Laser systems for vision correction are based on versatile technical solutions and include multiple hard- and software components. Laser characteristics, properties of laser beam delivery system, algorithms for cornea treatment, and methods of pre-surgical diagnostics determine the surgical outcome. Here we describe the scientific and technological basis for laser systems for refractive surgery developed at the Physics Instrumentation Center (PIC) at the Prokhorov General Physics Institute (GPI), Russian Academy of Sciences.
O'Brien, Terrence P
Acute bacterial conjunctivitis, the most common cause of conjunctivitis, is responsible for approximately 1% of all primary-care consultations. Of the topical ophthalmic antibiotics used to treat acute bacterial conjunctivitis, fluoroquinolones are especially useful because they possess a broad antibacterial spectrum, are bactericidal in action, are generally well tolerated, and have been less prone to development of bacterial resistance. Besifloxacin, the latest advanced fluoroquinolone approved for treating bacterial conjunctivitis, is the first fluoroquinolone developed specifically for topical ophthalmic use. It has a C-8 chlorine substituent and is known as a chloro-fluoroquinolone. Besifloxacin possesses relatively balanced dual-targeting activity against bacterial topoisomerase IV and DNA gyrase (topoisomerse II), two essential enzymes involved in bacterial DNA replication, leading to increased potency and decreased likelihood of bacterial resistance developing to besifloxacin. Microbiological data suggest a relatively high potency and rapid bactericidal activity for besifloxacin against common ocular pathogens, including bacteria resistant to other fluoroquinolones, especially resistant staphylococcal species. Randomized, double-masked, controlled clinical studies demonstrated the clinical efficacy of besifloxacin ophthalmic suspension 0.6% administered three-times daily for 5 days to be superior to the vehicle alone and similar to moxifloxacin ophthalmic solution 0.5% for bacterial conjunctivitis. In addition, besifloxacin ophthalmic suspension 0.6% administered two-times daily for 3 days was clinically more effective than the vehicle alone for bacterial conjunctivitis. Besifloxacin has also been shown in preclinical animal studies to be potentially effective for the "off-label" treatment of infections following ocular surgery, prophylaxis of endophthalmitis, and the treatment of bacterial keratitis. Taken together, clinical and preclinical animal studies
Marks, Randall; Mathine, David L; Peyman, Gholam; Schwiegerling, Jim; Peyghambarian, Nasser
We report on two fluidic lenses that have been developed for ophthalmic applications. The lenses use a circular aperture to demonstrate optical powers between -20 and +20 D and a rectangular aperture to demonstrate astigmatism with values ranging from 0 to 8 D. Measurements of image quality were made with the fluidic lens using a model eye. Both lenses were variable and controllable by adjusting the fluid volume of the lens. To the best of our knowledge this is the first demonstration of a continuously variable lens for control of astigmatism.
Keeney, A H; Duerson, H L
We performed low velocity drop-ball tests using 5/8-, 7/8-, and 1-inch diameter steel balls on ophthalmic crown glass lenses chemically tempered by the ion exchange process. Four representative dioptric strengths (+ 2.50 spherical, - 2.50 spherical, -2.50 cylindrical, and plano) were studied with the isolated lenses mounted, convex side up, on the American National Standards Institute Z80 test block. New ion exchange lenses exhibited a 100 to 350% greater capacity for attenuation of energy from low velocity, large size missiles than matched lenses of similar strength prepared by the conventional heat-treating and air-quenching process.
... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Neomycin sulfate ophthalmic ointment. 524.1484a... § 524.1484a Neomycin sulfate ophthalmic ointment. (a) Specifications. Each gram of the ointment contains 5 milligrams of neomycin sulfate equivalent in activity to 3.5 milligrams of neomycin base....
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Dermatologic and Ophthalmic Drugs Advisory Committee... Dermatologic and Ophthalmic Drugs Advisory Committee scheduled for June 28, 2010, is cancelled. This meeting...
... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Cyclosporine ophthalmic ointment. 524.575 Section... § 524.575 Cyclosporine ophthalmic ointment. (a) Specifications. Each gram of ointment contains 2 milligrams of cyclosporine. (b) Sponsor. See No. 000061 in § 510.600(c) of this chapter. (c) Conditions of...
Biswas, Jyotirmay; Badrinath, Vasanthi; Badrinath, Sengamedu S
Purpose: To investigate and describe the ophthalmic contribution of Raja Serfoji II (1798-1832). Materials and Method: A team of 2 ophthalmologists, director of laboratory services, one archeologist and a photographer visited Sarasvathi Mahal Library, March 2004. Photographs of ophthalmic records were taken and analysed. An interview of the present prince, S Babaji Rajah Bhonsle was taken. Ophthalmologic case sheets of 44 patients, 18 pictures were found. Results: Forty-four patient's ophthalmic records were found. Six records were written in Modi script, 38 were written in English and 18 drawings were found. Conclusion: In Thanjavur, King Serfoji II carried out methodical ophthalmic practices between 1798 and 1832. Both European and Indian medicines were used. Cataract Surgery was performed. Detailed ophthalmic records were maintained. The only evidence of Serfoji's amazing contribution to medicine lies in 50 charts and manuscripts. PMID:22824599
Full Text Available Purpose: To investigate and describe the ophthalmic contribution of Raja Serfoji II (1798-1832. Materials and Method: A team of 2 ophthalmologists, director of laboratory services, one archeologist and a photographer visited Sarasvathi Mahal Library, March 2004. Photographs of ophthalmic records were taken and analysed. An interview of the present prince, S Babaji Rajah Bhonsle was taken. Ophthalmologic case sheets of 44 patients, 18 pictures were found. Results: Forty-four patient′s ophthalmic records were found. Six records were written in Modi script, 38 were written in English and 18 drawings were found. Conclusion: In Thanjavur, King Serfoji II carried out methodical ophthalmic practices between 1798 and 1832. Both European and Indian medicines were used. Cataract Surgery was performed. Detailed ophthalmic records were maintained. The only evidence of Serfoji′s amazing contribution to medicine lies in 50 charts and manuscripts.
Biswas, Jyotirmay; Badrinath, Vasanthi; Badrinath, Sengamedu S
To investigate and describe the ophthalmic contribution of Raja Serfoji II (1798-1832). A team of 2 ophthalmologists, director of laboratory services, one archeologist and a photographer visited Sarasvathi Mahal Library, March 2004. Photographs of ophthalmic records were taken and analysed. An interview of the present prince, S Babaji Rajah Bhonsle was taken. Ophthalmologic case sheets of 44 patients, 18 pictures were found. Forty-four patient's ophthalmic records were found. Six records were written in Modi script, 38 were written in English and 18 drawings were found. In Thanjavur, King Serfoji II carried out methodical ophthalmic practices between 1798 and 1832. Both European and Indian medicines were used. Cataract Surgery was performed. Detailed ophthalmic records were maintained. The only evidence of Serfoji's amazing contribution to medicine lies in 50 charts and manuscripts.
Full Text Available Background: Academic medicine is in a state of dramatic transformation. For this reason strategic thinking is the most essential part of educational planning. The main purpose of the present study was developing the strategic educational planning of Ophthalmology in Iran from 2007 to 2010Methods: A qualitative investigation using focus group discussion has been implemented successfully for developing educational planning. Six to twelve representatives of key stakeholders in the ophthalmic education of Iran participated to this study.Results: Strengths, weaknesses, opportunities and threats of ophthalmology education in Iran were analyzed. Strategic goals in education, research, and health service providing domains were being developed. Educational goals were defined as training of human resources in accordance with the community needs at the level of general practitioner, specialist, and fellowships in ophthalmology. Research goals of the program were defined as scientific inter-departmental and international communications, in order to promote the level of education, research, and treatment in the country. Also, in the field of health services according to the community needs, providing services by the means of advanced and cost effective methods were defined as strategic objectives.Conclusion: Based on this strategic plan in the last three years ophthalmic education in Iran shall be many changes in educational, research and health care provision for social accountability.
Entezari, A; Javadi, MA; Einollahi, B
Background: Academic medicine is in a state of dramatic transformation. For this reason strategic thinking is the most essential part of educational planning. The main purpose of the present study was developing the strategic educational planning of Ophthalmology in Iran from 2007 to 2010 Methods: A qualitative investigation using focus group discussion has been implemented successfully for developing educational planning. Six to twelve representatives of key stakeholders in the ophthalmic education of Iran participated to this study. Results: Strengths, weaknesses, opportunities and threats of ophthalmology education in Iran were analyzed. Strategic goals in education, research, and health service providing domains were being developed. Educational goals were defined as training of human resources in accordance with the community needs at the level of general practitioner, specialist, and fellowships in ophthalmology. Research goals of the program were defined as scientific inter-departmental and international communications, in order to promote the level of education, research, and treatment in the country. Also, in the field of health services according to the community needs, providing services by the means of advanced and cost effective methods were defined as strategic objectives. Conclusion: Based on this strategic plan in the last three years ophthalmic education in Iran shall be many changes in educational, research and health care provision for social accountability. PMID:23113125
Creavin, Alexandra L; Brown, Ray D
A comprehensive review of the available literature was performed to determine the common ophthalmic disorders in children aged 0 to 16 years with Down syndrome. The UK National Library for Health interface was used to search seven electronic databases, including MEDLINE and EMBASE. Terms related to Down syndrome, ophthalmology, and pediatrics were combined in the search strategy, which yielded 230 articles. Application of exclusion criteria left 23 articles to include in the review. Literature synthesis demonstrated that children with Down syndrome are at risk for several ocular disorders. Refractive error was a common finding, particularly hyperopia. Strabismus was also reported regularly, particularly esodeviation. Other frequent findings included poor visual acuity, nystagmus, and blepharitis, whereas cataract and glaucoma were less common but had potentially serious implications for future vision. Only one study compared routine pediatric examination to that of a pediatric ophthalmologist. The findings of this review confirm the need for an ophthalmic screening program for children with Down syndrome. Additional work should investigate how such a program could be best implemented and ascertain how to involve different professionals in such a service.
Reuk, S E; Terekhina, N A
to compare tear, saliva, and plasma levels of acute phase proteins (APPs) of inflammation in patients with herpes keratitis and to use the RESULTS in treatment evaluation. APPs were measured in tears, oral fluid, and blood plasma from 22 adults and 34 children with ophthalmic herpes as well as 68 healthy controls using immunoturbidimetric and spectrophotometric methods of detection. High levels of C-reactive protein and orosomucoid, low levels of ceruloplasmin, α1-antitrypsin, and transferrin in tears from patients with herpes keratitis as well as abnormal tear, saliva, and plasma APPs levels at discharge are poor prognostic signs. They all indicate that corneal inflammation is still intense and that the treatment should not be ceased yet. Severity of APPs concentration changes in tear from patients with herpes keratitis correlates with the depth of corneal lesions, recurrence rate, and disease dynamics. Quantitative determination of acute phase proteins in tear and oral fluid is an early and sensitive inflammation test and may be also used for non-invasive monitoring and antiviral treatment evaluation. Oral fluid allows to extend the capabilities of non-invasive diagnostics of ophthalmic herpes.
Razhev, A. M.; Chernykh, V. V.; Bagayev, S. N.; Churkin, D. S.; Kargapol’tsev, E. S.; Iskakov, I. A.; Ermakova, O. V.
The paper provides an overview of the results of multiyear joint researches of team of collaborators of Institute of Laser Physics SB RAS together with NF IRTC “Eye Microsurgery” for the period from 1988 to the present, in which were first proposed and experimentally realized laser medical technologies for correction of refractive errors of known today as LASIK, the treatment of ophthalmic herpes and open-angle glaucoma. It is proposed to carry out operations for the correction of refractive errors the use of UV excimer KrCl laser with a wavelength of 222 nm. The same laser emission is the most suitable for the treatment of ophthalmic herpes, because it has a high clinical effect, combined with many years of absence of recrudescence. A minimally invasive technique of glaucoma operations using excimer XeCl laser (λ=308 nm) is developed. Its wavelength allows perform all stages of glaucoma operations, while the laser head itself has high stability and lifetime, will significantly reduce operating costs, compared with other types of lasers.
Huang, Weiwei; Zhang, Nan; Hua, Haiying; Liu, Tuanbing; Tang, Yafang; Fu, Lingling; Yang, Yanan; Ma, Xiujie; Zhao, Yongxing
Conventional ophthalmic formulations often eliminate rapidly after administration and cannot provide and maintain an adequate concentration of the drug in the precorneal area. To solve those problems, a thermosensitive in situ gelling and mucoadhesive ophthalmic drug delivery system was prepared and evaluated, the system was composed of poloxamer analogs and polycarbophil (PCP) and betaxolol hydrochloride (BH) was selected as model drug. The concentrations of poloxamer 407 (P407) (22% (w/v)) and poloxamer 188 (P188) (3.5% (w/v)) were identified through central composite design-response surface methodology (CCD-RSM). The BH in situ hydrogel (BH-HG) was liquid solution at low temperature and turned to semisolid at eye temperature. BH-HG showed good stability and biocompatibility, which fulfilled the requirements of ocular application. In vitro studies indicated that addition of PCP enhanced the viscosity of BH-HG and the release results of BH from BH-HG demonstrated a sustained release behavior of BH because of the gel dissolution. In vivo pharmacokinetics and pharmacodynamics studies indicated that the BH-HG formulation resulted in an improved bioavailability and a significantly lower intraocular pressure (IOP). The results suggested BH-HG could be potentially used as an in situ gelling system for ophthalmic delivery to enhance the bioavailability and efficacy.
Makwana, S B; Patel, V A; Parmar, S J
In situ gels are systems which are applied as solutions or suspensions and are capable of undergoing rapid sol-to-gel transformation triggered by external stimulus such as temperature, pH etc. on instillation. The aim of the present study was to formulate and evaluate pH responsive in-situ gel for ophthalmic delivery. Ciprofloxacin hydrochloride is popularly used as a broad spectrum antibiotic in the treatment of corneal ulcers of ocular infections. However, rapid dilution on instillation, wash out, poor retention of drug concentration delimit the therapeutic benefits of the drug when used in form of conventional eye drops. Sodium alginate, an ophthalmic gel forming mucoadhesive polymer was chosen as polymer which undergoes instantaneous gel formation due to formation of calcium alginate by virtue of its interaction with divalent cation (Ca(+2)) present in lachrymal fluid. Hydroxy Propyl Methyl Cellulose (HPMC K4M and E5 0LV) was further incorporated as a viscosity enhancer in order to achieve the desired consistency so as to facilitate sustained drug release. The developed formulations were evaluated for clarity, pH measurement, gelling capacity, drug content, rheological study, and in vitro drug release. Thus, in situ gel based systems containing gums can be a valuable approach for ophthalmic drug delivery when compared to conventional systems.
Pimenta, Andreia F R; Serro, Ana Paula; Paradiso, Patrizia; Saramago, Benilde; Colaço, Rogério
The study of ocular drug delivery systems has been one of the most covered topics in drug delivery research. One potential drug carrier solution is the use of materials that are already commercially available in ophthalmic lenses for the correction of refractive errors. In this study, we present a diffusion-based mathematical model in which the parameters can be adjusted based on experimental results obtained under controlled conditions. The model allows for the design of multi-layered therapeutic ophthalmic lenses for controlled drug delivery. We show that the proper combination of materials with adequate drug diffusion coefficients, thicknesses and interfacial transport characteristics allows for the control of the delivery of drugs from multi-layered ophthalmic lenses, such that drug bursts can be minimized, and the release time can be maximized. As far as we know, this combination of a mathematical modelling approach with experimental validation of non-constant activity source lamellar structures, made of layers of different materials, accounting for the interface resistance to the drug diffusion, is a novel approach to the design of drug loaded multi-layered contact lenses.
Kácerik, M; Alexík, M; Lipková, B
Thrombosis of upper ophthalmic vein is both rare and serious pathologic event. Authors present a case of isolated unilateral upper ophthalmic vein thrombosis in 76-year-old woman, who despite treatment ended with amaurosis and secondary neovascular glaucoma. In differential diagnosis authors focused on searching for inflammatory process of orbit with adjacent structures as well as local and general causes leading to venous thrombosis. None of these were proven; it was a rare case of a patient with isolated upper ophthalmic vein thrombosis.
Davis, J K
Improvements in polycarbonate material, production techniques, and scratch-resistant coatings, combined with a process-oriented design, have resulted in a precision lens series. Surface quality is comparable to that of untreated glass ophthalmic lenses. The repeatability of the process results in closely controlled axial power and off-axis performance. For most lens prescriptions, the ANSI Z80.1 optical-center specifications for prescription accuracy are maintained through a total field of view of 40 deg for an 8-mm range of center-of-rotation distances. Off-axis astigmatism is controlled for near-point seeing. The lenses are both lighter and thinner than those of crown glass. A scratch-resistant coating reduces the reflections normally associated with high-index (1.586) materials. Impact resistance exceeds that required by ANSI Z80.7 and is many times that required by ANSI Z80.1.
Wilson, Graham A
Today, no other classic novelist has the popularity or power of Jane Austen, and in 2013 the world will celebrate 200 years of her comic masterpiece Pride and Prejudice. Her millions of fans have an abiding fascination with all aspects of her life, including her health and the cause of her death. This historical ophthalmic study of Jane Austen, based on very incomplete medical bibliographic data, finds that she had a mild ocular surface disorder from age 23. This disorder did not significantly impact on her visual performance for writing. There are many references to eyes in her novels, but Jane's eyes and those of her characters cannot contribute further to the debate around the cause of her death at age 41.
Rottenkolber, Matthias; Podbielska, Halina
Topographic analysis of the ophthalmic surfaces is an important task. Especially recently, when a laser assisted refractive surgery becomes more and more popular in a daily clinical praxis. Ophthalmologists need to know exact corneal parameters as a basis for proper operational approach, as well as for monitoring of the post-operative process. The fitting of the contact lenses can be more accurate when topography of both, cornea and contacts, can be precisely measured. We develop new coherent methods for measuring of the topography of curved optical surfaces. One of the proposed techniques is based on interferometry with a special distance measurement unit and spatial phase shifting interferogram evaluation. The other one uses deflectometry with spatial carrier frequency. The sensitivity of this method is adjustable and thus it closes the gap between the white light and interferometric measuring methods. The techniques proposed here can be suitable for measurement of the contact lenses or corneal surface.
Harada, Kuniaki; Hashimoto, Masato; Bandoh, Michio; Odawara, Yoshihiro; Kamagata, Masaki; Shirase, Ryuji [Sapporo Medical Univ. (Japan). Hospital
The purpose of this study was to analyze the hemodynamics of ophthalmic artery flow using phase contrast MR angiography (PC-MRA). A total of 14 eyes from 10 normal volunteers and a patient with normal tension glaucoma (NTG) were analyzed. The optimal conditions were time repetition (TR)/echo time (TE)/flip angle (FA)/nex=40 ms/minimum/90 deg/2, field of view (FOV)=6 cm, matrix size=256 x 256. The resistive index (RI) and pulsatillity index (PI) values were significantly raised in the patient with NTG when compared to the control group. We therefore believe that PC-MRA may be a useful clinical tool for the assessment of the mechanism of NTG. (author)
Raising awareness about glaucoma among the general public, ophthalmic patients and health professionals would ... media to be the main source of information about glaucoma. ..... This can be seen in relation to that of rural Indian study in ...
3 HIV positive cases were detected out of 41 ophthalmic .... southern African countries, the national adult HIV prevalence rate has risen ... Africa with a population of 140 million people. ... Corneal transplantation is a possible route of viral.
Sandfeld, L.N.; Jensen, H.; Skov, L.
PURPOSE: To identify diagnoses that increase the risk of ophthalmic disorders in developmentally delayed children. METHODS: A cross-sectional study of 1126 Danish children with developmental delay (IQ Udgivelsesdato: 2008/12......PURPOSE: To identify diagnoses that increase the risk of ophthalmic disorders in developmentally delayed children. METHODS: A cross-sectional study of 1126 Danish children with developmental delay (IQ Udgivelsesdato: 2008/12...
Introduction. Ophthalmic timolol, a topical nonselective beta-blocker, has the potential to be absorbed systemically which may cause adverse cardiovascular effects. This study was conducted to determine whether initiation of ophthalmic timolol was associated with an increased risk of hospitalisation for bradycardia. Materials and Methods. A self-controlled case-series study was undertaken in patients who were hospitalised for bradycardia and were exposed to timolol. Person-time after timolol ...
Full Text Available Masamichi Fukuda, Shinsuke Shibata, Naoko Shibata, Kenta Hagihara, Hiromoto Yaguchi, Hiromi Osada, Nobuo Takahashi, Eri Kubo, Hiroshi SasakiDepartment of Ophthalmology, Kanazawa Medical University, Uchinada, JapanPurpose: To investigate the safety of five types of antiglaucoma prostaglandin analog ophthalmic formulations, and to clarify their differences in accordance with contained additives (preservatives and surface-active agents.Methods: The following five types of ophthalmic solutions and three types of additives were investigated: latanoprost (Xalatan®; latanoprost, tafluprost (Tapros®; tafluprost, bimatoprost (Lumigan®; bimatoprost, travoprost (Travatan®; travoprost, travoprost (Travatan Z®; travoprost-Z, benzalkonium chloride (BAK, polyoxyethylene hardening castor oil 40 (HCO-40, and polysorbate 80 (P-80. These experimental solutions were exposed to the cultured cells of a rabbit-derived corneal cell line for a certain time, and the exposure time causing 50% cell damage (CD50, indicated by the ratio of viable cells to total cells was calculated (in vitro. In addition, corneal resistance (CR was measured and CR ratio (post-treatment CR/pretreatment CR × 100 was calculated (in vivo.Results: CD50 of each ophthalmic solution was the longest with tafluprost, followed by travoprost-Z, bimatoprost, travoprost, and latanoprost. CD50 of 0.005%, 0.01%, and 0.02% BAK was 14.5 minutes, 8.1 minutes, and 4.0 minutes, respectively. The number of viable cells decreased to 60%, 8 minutes after exposure with HCO-40, and 30 minutes after being exposed to P-80. The CR ratio was 81.0% with travoprost and 82.0% with latanoprost, indicating a significant posttreatment reduction of CR (P < 0.05. The CR ratio did not decrease after treatment with tafluprost, travoprost-Z, or bimatoprost. The CR ratio of 0.005%, 0.01%, and 0.02% BAK was 105.0%, 90.5%, and 68.7%, respectively, and that of HCO-40 and P-80 was 108.7% and 114.2%, respectively.Conclusion: BAK
Full Text Available BACKGROUND: Emerging evidence suggests that angiogenic and pro-inflammatory cytokine leptin might be implicated in ocular neovascularization. However, the potential of inhibiting leptin function in ophthalmic cells has never been explored. Here we assessed mitogenic, angiogenic, and signaling leptin activities in retinal and corneal endothelial cells and examined the capability of a specific leptin receptor (ObR antagonist, Allo-aca, to inhibit these functions. METHODS AND RESULTS: The experiments were carried out in monkey retinal (RF/6A and bovine corneal (BCE endothelial cells. Leptin at 50-250 ng/mL stimulated the growth of both cell lines in a dose-dependent manner. The maximal mitogenic response (35±7 and 27±3% in RF6A and BCE cells, respectively was noted at 24 h of 250 ng/mL leptin treatments. Leptin-dependent proliferation was reduced to base levels with 10 and 100 nM Allo-aca in BCE and RF6A cells, respectively. In both cell lines, leptin promoted angiogenic responses, with the maximal increase in tube formation (163±10 and 133±8% in RF6A and BCE cultures, respectively observed under a 250 ng/mL leptin treatment for 3 h. Furthermore, in both cell lines 250 ng/mL leptin modulated the activity or expression of several signaling molecules involved in proliferation, inflammatory activity and angiogenesis, such as STAT3, Akt, and ERK1/2, COX2, and NFκB. In both cell lines, leptin-induced angiogenic and signaling responses were significantly inhibited with 100 nM Allo-aca. We also found that leptin increased its own mRNA and protein expression in both cell lines, and this autocrine effect was abolished by 100-250 nM Allo-aca. CONCLUSIONS: Our data provide new insights into the role of leptin in ocular endothelial cells and represent the first original report on targeting ObR in ophthalmic cell models.
Full Text Available Zora T Marlowe, Stephen R DavioPharmaceutical Product Development, Global Pharmaceutical Research and Development, Bausch and Lomb, Inc, Rochester, NY, USAIntroduction: Loteprednol etabonate (LE ophthalmic gel 0.5% (Lotemax® is a new polycarbophil-based, nonsettling topical ophthalmic formulation. The formulation is a semisolid gel at rest and a shear thinning fluid when expressed through a dropper tip. The present study was undertaken to determine how the nonsettling character of LE ophthalmic gel affects dose uniformity. Prednisolone acetate ophthalmic suspension 1% (Pred Forte® and a generic prednisolone acetate suspension 1% were used as comparators.Methods: Drug concentrations of LE ophthalmic gel, Pred Forte, and a generic prednisolone acetate suspension were determined following simulated dosing – consisting of 2 drops, expressed four times daily for 2 weeks, with bottles that were shaken or not shaken immediately prior to expressing the drops. Drug concentrations were determined using a reverse-phase high-performance liquid chromatography (HPLC method and reported as a percentage of the declared (labeled concentration. Comparative kinetics of drug particle sedimentation were also determined for each formulation, using dispersion analysis under gravity.Results: Mean drug concentrations in drops of all three formulations were within a few percentage points of the declared concentration when the bottles were shaken for 5 seconds prior to dispensing. Only LE ophthalmic gel showed consistent and on-target concentrations when the bottles were unshaken prior to dispensing, with a mean (standard deviation [SD] percent declared concentration of 102% (1.92% over the 2-week dosing regimen. Drug concentrations for the branded and generic prednisolone acetate suspensions following expression from unshaken bottles were highly variable (overall relative SDs of 16.8% and 20.3%, respectively, with mean concentrations for both falling significantly
Omolase C O
Full Text Available Aim: This study aimed at determining the prevalence and pattern of ophthalmic disorders among students of School for the Deaf, Akure, Ondo State, Nigeria.Methodology: This is a cross sectional descriptive study was conducted in October, 2011 as part of activities marking the Annual Physicians’ week of Nigerian Medical Association (NMA,Ondo State. Ethical clearance was obtained from the Ethical Review Committee of Federal Medical Centre, Owo prior to commencement of this study. The permission of the School Authority was also obtained before the commencement of this study. The respondents were selected by simple random sampling technique. All enrolled participants were interviewed with the aid of the study instrument (questionnaire by the authors and interpreters (school teachers.Results: The respondents comprised of 91(56.9% Males and 69 Females (43.1%. Nearly all the respondents;158(98.8% were deaf and dumb. Most respondents; 116(72.5% had ocular examination in the past. Few respondents; 118(73.75% had ophthalmic disorder. The commonest ophthalmic disorder was refractive error which was found in 16 respondents (38.1%. Myopia was diagnosed in 9 respondents.CONCLUSION: Most of the respondents were deaf and dumb. Few respondents had ophthalmic disorder. The commonest ophthalmic disorder was refractive error. Myopia was the most predominant refractive error. There is need for periodic ocular screening and treatment atthe School for the Deaf.
Conclusions: The indicator system for evaluating the quality of ophthalmic nursing has favorable reliability and validity, which means that it is a suitable clinical tool for assessing the quality of ophthalmic nursing.
Sun, Xiaoyi; Cai, Zhengyuan; Yu, Lingyan; Lv, Yuanyuan
Voriconazole (VRC) incorporated in composited polyvinyl alcohol (PVA)/hydroxypropyl-β-cyclodextrin (HPβCD) blended nanofibers were produced via electrospinning for efficient ophthalmic delivery. The VRC loading capacity increased with increasing HPβCD content. The optimal solution for electrospinning consisted of 8% (w/v) PVA, 4% (w/v) HPβCD and 0.5% (w/v) VRC. The nanofibers exhibited bead-free average fiber diameters of 307±31 nm and VRC was released in vitro in a sustained manner. The VRC nanofibers were characterized by infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). The proton nuclear magnetic resonance (1H-NMR) was used to analyze the molar ratio of HPβCD/VRC in the nanofibers. Compared with a VRC solution, the nanofibers significantly prolonged the half life, and increased the bioavailability of VRC in rabbit tears. No obvious signs of irritation were observed after application in the conjunctival sac. VRC nanofibers are promising for ophthalmic drug delivery and further pharmacodynamics studies are needed. PMID:27974859
Full Text Available The present study aimed to prepare a chemically and physically stable formulation of doxycycline (Doxy in an in situ thermally sensitive hydrogel for ophthalmic delivery. An inclusion complex of Doxy and hydroxypropyl-β-cyclodextrin (HP-β-CD was first developed to increase the stability of Doxy in aqueous solution. The physical characteristics (phase solubility profiles, thermal analysis, X-ray powder diffractograms and infrared spectra of the Doxy-HP-β-CD inclusion complex indicated the formation of a stable 1:1 complex. Poloxamers P407 (16–22% and P188 (0–5% were mixed to obtain a hydrogel with an appropriate gelation temperature for opthalmic use. Formulation of the inclusion complex in the poloxamer hydrogel exhibited a suitable gelation temperature (33.3 °C after dilution with simulated tear fluid (Gel:STF=40:7, v/v. The release of Doxy from the poloxamer hydrogel followed a zero order equation suggesting it occurs through corrosion of the poloxamer hydrogel. Stability studies demonstrated that the inclusion of Doxy by HP-β-CD markedly improved its stability in aqueous solution both at 8 and 40 °C. This formulation of a doxycycline-HP-β-CD inclusion complex in an in situ thermally sensitive poloxamer hydrogel represents a potentially effective ophthalmic Doxy delivery system.
Marlowe, Zora T; Davio, Stephen R
Introduction Loteprednol etabonate (LE) ophthalmic gel 0.5% (Lotemax®) is a new polycarbophil-based, nonsettling topical ophthalmic formulation. The formulation is a semisolid gel at rest and a shear thinning fluid when expressed through a dropper tip. The present study was undertaken to determine how the nonsettling character of LE ophthalmic gel affects dose uniformity. Prednisolone acetate ophthalmic suspension 1% (Pred Forte®) and a generic prednisolone acetate suspension 1% were used as comparators. Methods Drug concentrations of LE ophthalmic gel, Pred Forte, and a generic prednisolone acetate suspension were determined following simulated dosing – consisting of 2 drops, expressed four times daily for 2 weeks, with bottles that were shaken or not shaken immediately prior to expressing the drops. Drug concentrations were determined using a reverse-phase high-performance liquid chromatography (HPLC) method and reported as a percentage of the declared (labeled) concentration. Comparative kinetics of drug particle sedimentation were also determined for each formulation, using dispersion analysis under gravity. Results Mean drug concentrations in drops of all three formulations were within a few percentage points of the declared concentration when the bottles were shaken for 5 seconds prior to dispensing. Only LE ophthalmic gel showed consistent and on-target concentrations when the bottles were unshaken prior to dispensing, with a mean (standard deviation [SD]) percent declared concentration of 102% (1.92%) over the 2-week dosing regimen. Drug concentrations for the branded and generic prednisolone acetate suspensions following expression from unshaken bottles were highly variable (overall relative SDs of 16.8% and 20.3%, respectively), with mean concentrations for both falling significantly below the declared concentration for drops expressed at the beginning of the 2-week dosing regimen and significantly above the declared concentration for drops expressed
Maria de Hoyos Guajardo, Ph.D. Candidate, M.Sc., B.Eng.
Full Text Available The theory that is presented below aims to conceptualise how a group of undergraduate students tackle non-routine mathematical problems during a problem-solving course. The aim of the course is to allow students to experience mathematics as a creative process and to reflect on their own experience. During the course, students are required to produce a written ‘rubric’ of their work, i.e., to document their thoughts as they occur as well as their emotionsduring the process. These ‘rubrics’ were used as the main source of data.Students’ problem-solving processes can be explained as a three-stage process that has been called ‘solutioning’. This process is presented in the six sections below. The first three refer to a common area of concern that can be called‘generating knowledge’. In this way, generating knowledge also includes issues related to ‘key ideas’ and ‘gaining understanding’. The third and the fourth sections refer to ‘generating’ and ‘validating a solution’, respectively. Finally, once solutions are generated and validated, students usually try to improve them further before presenting them as final results. Thus, the last section deals with‘improving a solution’. Although not all students go through all of the stages, it may be said that ‘solutioning’ considers students’ main concerns as they tackle non-routine mathematical problems.
Sjö, Lene D; Ralfkiær, Elisabeth Methner; Prause, Jan U;
PURPOSE: To evaluate patient characteristics and incidence of ophthalmic lymphoma in Denmark during the period 1980 to 2005. METHODS: All patients in Denmark with a diagnosis of ophthalmic lymphoma during the period 1980 to 2005 were retrieved from three different population-based registries......: In the Danish population ophthalmic lymphoma consists primarily of orbital MALT lymphoma. Although it is a rare disease in mostly elderly patients, the incidence of ophthalmic lymphoma is increasing at a rapid pace....
Grey, Katherine R; Warshaw, Erin M
Allergic contact dermatitis is an important cause of periorbital dermatitis. Topical ophthalmic agents are relevant sensitizers. Contact dermatitis to ophthalmic medications can be challenging to diagnose and manage given the numerous possible offending agents, including both active and inactive ingredients. Furthermore, a substantial body of literature reports false-negative patch test results to ophthalmic agents. Subsequently, numerous alternative testing methods have been described. This review outlines the periorbital manifestations, causative agents, and alternative testing methods of allergic contact dermatitis to ophthalmic medications.
Fink, Wolfgang; Tarbell, Mark A.; Garcia, Kevin
Smart Ophthalmics© extends ophthalmic healthcare to people who operate/live in austere environments (e.g., military, third world, natural disaster), or are geographically dispersed (e.g., rural populations), where time, cost, and the possibility of travel/transportation make access to even adequate medical care difficult, if at all possible. Operators attach optical devices that act as ophthalmic examination extensions to smartphones and run custom apps to perform examinations of specific areas of the eye. The smartphone apps submit over wireless networks the collected examination data to a smart remote expert system, which provides in-depth medical analyses that are sent back in near real-time to the operators for subsequent triage.
Full Text Available Agmatine, an endogenous polyamine and putative neuromodulator, is known to have neuroprotective effects on various neurons in the central nervous system. We determined whether or not topically administered agmatine could reduce ischemic retinal injury. Transient ocular ischemia was achieved by intraluminal occlusion of the middle cerebral artery of ddY mice (30-35 g for 2 h, which is known to also induce occlusion of the ophthalmic artery. In the agmatine group (N = 6, a 1.0 mM agmatine-containing ophthalmic solution was administered four times daily for 2 weeks before occlusion. In the control group (N = 6, a 0.1% hyaluronic acid ophthalmic solution was instilled at the same times. At 22 h after reperfusion, the eyeballs were enucleated and the retinal sections were stained by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL. Transient ocular ischemia induced apoptosis of retinal cells in the entire retinal layer, and topically administered agmatine can significantly reduce this ischemic retinal injury. The proportion of apoptotic cells was definitely decreased (P < 0.001; Kruskal-Wallis test. Overall, we determined that topical agmatine application effectively decreases retinal damage in an in vivo ocular ischemic injury model. This implies that agmatine is a good candidate as a direct neuroprotective agent for eyes with ocular ischemic diseases.
Full Text Available Objectives: To investigate the frequency and distribution of ophthalmic articles with Turkish origin on Pubmed search engine and to compare these data with those of the world’s leading countries in that field. Materials and Methods: Using the words “ophthalmology” and “Turkey”, an online retrospective search was conducted on Pubmed for the period from 1990 to 2013. Additionally, same search was performed for each ophthalmic journal indexed in Science Citation Index Expanded (SCI-E (n=56 and not indexed in SCI-E (n=8, separately. The articles were divided into two groups (research articles and the other articles as case reports, letters, correspondence, editorials and reviews. Results: A total of 5044 articles in the area of ophthalmology were from Turkey in that period. The United States of America, Japan, and Germany had the maximum number of published articles (25%, 6.8%, and 4.9% of all, respectively. There were 3334 articles on ophthalmic journals. 2822 articles were published in SCI-E journals and of those, 2321 were research articles and 501 were other types of articles. Three SCI-E indexed ophthalmic journals which mostly published Turkish articles are the European Journal of Ophthalmology, Journal of Cataract and Refractive Surgery, and the Ophthalmologica (361, 183, and 152, respectively. Conclusion: In this period, the rate of the published ophthalmic articles originated from Turkey was 1.5%. We observed that the number of Turkish ophthalmic articles has been increasing gradually. (Turk J Ophthalmol 2014; 44: 465-70
... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Prednisolone-neomycin sulfate ophthalmic ointment... ANIMAL DRUGS § 524.1880 Prednisolone-neomycin sulfate ophthalmic ointment. (a) Specifications. Prednisolone-neomycin sulfate ophthalmic ointment contains 2 milligrams prednisolone and 5 milligrams...
... HUMAN SERVICES Food and Drug Administration Dermatologic and Ophthalmic Drugs Advisory Committee... Administration (FDA) is announcing an amendment to the notice of the meeting of the Dermatologic and Ophthalmic... that a meeting of the Dermatologic and Ophthalmic Drugs Advisory Committee would be held on February 27...
Yepez, Juan B; Murati, Felipe A; Pettito, Michele; Peñaranda, Carlos F; de Yepez, Jazmin; Maestre, Gladys; Arevalo, J Fernando
The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed. To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela. This prospective case series included 43 patients from 2 ophthalmic centers in Colombia and Venezuela who underwent evaluation from October 1, 2015, through June 30, 2016, and were clinically diagnosed with congenital Zika syndrome. Twenty patients were Hispanic; 13, African; 8, white; and 2, Native American. Ophthalmic and systemic evaluations and serologic testing were performed on all infants. Patients underwent external ocular examination and dilated ophthalmoscopy. Serologic testing ruled out toxoplasmosis, rubella, cytomegalovirus, syphilis, and human immunodeficiency virus. Ophthalmic manifestations of congenital Zika syndrome. Of the 43 patients included in this series (28 female and 15 male), the mean (SD) age at examination was 2.1 (1.5) months. The mothers of all the children had no ophthalmic findings and did not report ocular symptoms during pregnancy. All patients had bilateral ophthalmic manifestations. Optic nerve findings included hypoplasia with the double-ring sign, pallor, and increased cup-disc ratio in 5 patients (11.6%). Macular abnormalities included mild to severe pigment mottling in 27 patients (63%) and lacunar maculopathy in 3 (6.9%). Chorioretinal scarring was present in 3 patients (7%). Eleven patients (26%) had a combination of lesions in the posterior pole. Five patients (12%) were
Bayuse, T.; Law, J.; Alexander, D.; Moynihan, S.; LeBlanc, C.; Langford, K.; Magalhaes, L.
On orbit, ophthalmic anesthetics are used for tonometry and off-nominal corneal examinations. Proparacaine has been flown traditionally. However, the manufacturers recently changed its storage requirements from room temperature storage to refrigerated storage to preserve stability and prolong the shelf-life. Since refrigeration on orbit is not readily available and there were stability concerns about flying proparacaine unrefrigerated, tetracaine was selected as an alternative ophthalmic anesthetic in 2013. We will discuss the challenges encountered flying and using these anesthetics on the International Space Station.
... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS... conjunctivitis, attempts should be made to determine through susceptibility testing, which antibiotics will be... animals producing meat, eggs, or milk. The length of time that residues persist in milk or tissues has...
Dehdashti, A.R.; Tribolet, N. de [Department of Neurosurgery, HUG, Geneva (Switzerland); Safran, A.B. [Department of Ophthalmology, HUG, Geneva (Switzerland); Martin, J.B.; Ruefenacht, D.A. [Division of Neuroradiology, HUG, Geneva (Switzerland)
We present a rare case of intraorbital ophthalmic artery aneurysm found incidentally, together with a ruptured aneurysm of the tip of the basilar artery. The intraorbital aneurysm was asymptomatic, and no treatment was offered. Angiographic control was recommended to detect any progression. Treatment may be indicated for documented enlargement or significant mass effect of the aneurysm. (orig.)
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic tantalum clip. 886.3100 Section 886.3100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... or temporarily to bring together the edges of a wound to aid healing or prevent bleeding from small...
Roque, S.S.L.T.; Bicho, S.A.A. [IBILI-Biomedical Institute for Research on Light and Image, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas 3000-354 Coimbra (Portugal); Morgado, A.M.L.S. [IBILI-Biomedical Institute for Research on Light and Image, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas 3000-354 Coimbra (Portugal); Department of Physics, Faculty of Science and Technology, University of Coimbra, Rua Larga da Universidade, 3004-516 Coimbra (Portugal)
We present an analysis of the exposure to laser radiation resulting from the use of scanning laser ophthalmoscopes in ophthalmic imaging of the ocular fundus. Exposures limits are determined, based on the IEC/EN 60825-1 standard. These limits are applied on the safety analysis of a commercial scanning laser ophthalmoscope. (author)
Rojo, P.; Royo, S.; Ramírez, J.; Madariaga, I.
A method for general implementation in any software platform of the generalized Coddington equations is presented, developed, and validated within a Matlab environment. The ophthalmic lens design strategy is presented thoroughly, and the basic concepts of generalized ray tracing are introduced. The methodology for ray tracing is shown to include two inter-related processes. Firstly, finite ray tracing is used to provide the main direction of propagation of the considered ray at the incidence point of interest. Afterwards, generalized ray tracing provides the principal curvatures of the local wavefront at that point, and its orientation after being refracted by the lens. The curvature values of the local wavefront are interpreted as the sagital and tangential powers of the lens at the point of interest. The proposed approach is validated using a double-check of the calculated lens performance in the spherical lens case: while finite ray tracing is validated using a commercial ray tracing software, generalized ray tracing is validated using a software application for ophthalmic lens design based on the classical version of Coddington equations. Equations of the complete tracing process are developed in detail for the case of generic astigmatic ophthalmic lenses as an example. Three-dimensional representation of the sagital and tangential powers of the ophthalmic lens at all directions of gaze then becomes possible, and results are presented for lenses with different geometries.
D. N. Cherkasova
Full Text Available Subject of research. Algorithm for calculation of contact ophthalmic lenses for dual application has been suggested based on unified approach for their calculation. The algorithm has been tested on the composition of Goldmann ophthalmic lenses and Panfundoscope lens optical systems. Method. The condition of mutual unambiguous orientation of patient’s eye and instruments is performed at the initial calculation step by face mounting and movement of coordinate table with optical head. Then such type of patient's eye optical system model is selected that the lens would be combined with the front surface of eye cornea optical system. Pupil of patient eye is under anesthesia. At the final calculation step we determine the functions of optical lens image quality and their values based on medical and technical requirements for the components of the complex system. Main results. The algorithm for ophthalmic lenses calculation has been suggested and its correctness has been proved practically on the example of two basic models in the group of such type lenses being applied in practice as a part of complex system with ophthalmic laser coagulators. Optical calculation of Goldmann ophthalmic contact lenses and Panfundoscope is presented. The method of neutralization is optimal for Goldmann lenses. The first component in Panfundoscope operates the position of object planes whereas the second component operates the position of complex system with ophthalmocoagulator's pupils. Computer modeling of complex system "Computer model of eye-ophthalmic lens" in ZEMAX confirmed the correctness of calculation algorithm in which the criteria of diffraction image quality has been used. Application possibility of simplified computer eye model called "Reduced eye" by Verbitskiy has been demonstrated. Practical relevance. The general scientific approach to the problem of synthesis, calculation and research of complex system with contact ophthalmic lenses for diagnostics
Lip, G Y H; Durrani, O M; Roldan, V; Lip, P L; Marin, F; Reuser, T Q
Increasing number of patients presenting for ophthalmic surgery are using oral anti-coagulant and anti-platelet therapy. The current practice of discontinuing these drugs preoperatively because of a presumed increased risk of bleeding may not be evidence-based and could pose a significant risk to the patient's health. To provide an evidence-based review on the peri-operative management of ophthalmic patients who are taking anti-thrombotic therapy. In addition, we briefly discuss the underlying conditions that necessitate the use of these drugs as well as management of the operative field in anti-coagulated patients. A semi-systematic review of literature was performed. The databases searched included MEDLINE, EMBASE, database of abstracts of reviews of effects (DARE), Cochrane controlled trial register and Cochrane systematic reviews. In addition, the bibliographies of the included papers were also scanned for evidence. The published data suggests that aspirin did not appear to increase the risk of serious postoperative bleeding in any type of ophthalmic surgery. Topical, sub-tenon, peri-bulbar and retrobulbar anaesthesia appear to be safe in patients on anti-thrombotic (warfarin and aspirin) therapy. Warfarin does not increase the risk of significant bleeding in most types of ophthalmic surgery when the INR was within the therapeutic range. Current evidence supports the continued use of aspirin and with some exceptions, warfarin in the peri-operative period. The risk of thrombosis-related complications on disruption of anticoagulation may be higher than the risk of significant bleeding by continuing its use for most types of ophthalmic surgery.
Turnbull, Andrew M J; Emsley, Elizabeth S
Video documenting is increasingly used in ophthalmic training and research, with many ophthalmologists routinely recording their surgical cases. Although this modality represents an excellent means of improving technique and advancing knowledge, there are major ethical and legal considerations with its use. Informed consent to record is required in most situations. Patients should be advised of any risk of identification and the purpose of the recording. Systems should be in place to deal with issues such as data storage, withdrawal of consent, and patients requesting copies of their recording. Privacy and security of neither patients nor health care professionals should be compromised. Ownership and distribution of video recordings, the potential for their use in medical litigation, the ethics and legality of editing and the impact on surgeon performance are other factors to consider. Although video recording of ophthalmic surgery is useful and technically simple to accomplish, patient safety and welfare must always remain paramount. Copyright © 2014 Elsevier Inc. All rights reserved.
Kupferman, A; Berrospi, A R; Leibowitz, H M
Hourly topical administration of 0.1% fluorometholone acetate ophthalmic suspension produced, on the average, a 47% reduction in the polymorphonuclear leukocytes invading the cornea during an experimentally induced inflammatory keratitis. This is a significantly greater anti-inflammatory effect than we have previously reported for the alcohol derivative of fluorometholone and is not significantly different from the therapeutic effect of 1.0% prednisolone acetate ophthalmic suspension, the most effective corneal anti-inflammatory agent that we have studied to date. Fluorometholone acetate (0.1%) formulated as a high-viscosity carbomer gel and applied at three-hour intervals reduced invading leukocytes in the cornea an average of 48%, an effect not significantly different from hourly administration of the suspension.
Sosnowska, Magdalena; Zajkowska, Agata; Garkowski, Adam; Czupryna, Piotr; Pancewicz, Sławomir; Zajkowska, Joanna
Herpes zoster ophthalmicus occurs when the latent varicella zoster virus (VZV) reactivates in the trigeminal ganglion and ophthalmic branch of the trigeminal nerve. In the elderly, there is a sharp increase in the tendency of secondary skin bacterial infections occurrence due to the deterioration of capabilities of self-care and changed sanitation. We present a case of patient who developed phlegmon of the orbit, which resulted with complete unilateral blindness. Varicella zoster virus infection in the elderly may have a severe course due to the progressive weakening of the immune system related to the age. Moreover, skin lesions around the eye socket require special care in prevention of bacterial superinfections due to the extremely high risk of life-threatening complications or disability. Neuralgia resistant to pharmacological treatment present in the course of ophthalmic zoster and difficulty in caring about skin lesions predispose to the occurrence of complications. PMID:26759550
Kashiwabuchi, Fabiana; Parikh, Kunal S.; Omiadze, Revaz; Zhang, Shuming; Luo, Lixia; Patel, Himatkumar V.; Xu, Qingguo; Ensign, Laura M.; Mao, Hai-Quan; Hanes, Justin; McDonnell, Peter J.
Purpose To develop and evaluate an antibiotic-eluting suture for ophthalmic surgery. Methods Wet electrospinning was used to manufacture sutures composed of poly(L-lactide), polyethylene glycol (PEG), and levofloxacin. Size, morphology, and mechanical strength were evaluated via scanning electron microscopy and tensile strength, respectively. In vitro drug release was quantified using high performance liquid chromatography. In vitro suture activity against Staphylococcus epidermidis was investigated through bacterial inhibition studies. Biocompatibility was determined via histological analysis of tissue sections surrounding sutures implanted into Sprague-Dawley rat corneas. Results Sutures manufactured via wet electrospinning were 45.1 ± 7.7 μm in diameter and 0.099 ± 0.007 newtons (N) in breaking strength. The antibiotic release profile demonstrated a burst followed by sustained release for greater than 60 days. Increasing PEG in the polymer formulation, from 1% to 4% by weight, improved drug release without negatively affecting tensile strength. Sutures maintained a bacterial zone of inhibition for at least 1 week in vitro and elicited an in vivo tissue reaction comparable to a nylon suture. Conclusions There is a need for local, postoperative delivery of antibiotics following ophthalmic procedures. Wet electrospinning provides a suitable platform for the development of sutures that meet size requirements for ophthalmic surgery and are capable of sustained drug release; however, tensile strength must be improved prior to clinical use. Translational Relevance No antibiotic-eluting suture exists for ophthalmic surgery. A biocompatible, high strength suture capable of sustained antibiotic release could prevent ocular infection and preclude compliance issues with topical eye drops. PMID:28083445
Shohei Eda; Tomoko Terai; Yuko Nishikawa; Masahiro Tonari; Teruyo Kida; Hidehiro Oku; Jun Sugasawa; Shuichi Shimakawa; Masashi Hasegawa; Tohru Ogihara; Tsunehiko Ikeda
Purpose: We performed ophthalmic examinations, including optical coherence tomography (OCT), on a case diagnosed with hydranencephaly. Case Report: This case involved a female infant born at the gestational age of 35 weeks and 4 days, with the birth weight of 2,152 g, who was one of monochorionic diamniotic twins, and the identical twin died in utero at the gestational age of 24 weeks. After that, examination by fetal echo indicated that she had microcephaly and ventriculomegaly. Postnatal ma...
Fischer, David Joel
Unifocal ophthalmic lenses are conventionally designed using homogeneous glass or plastic materials and aspheric surfaces. The desired power and aberration correction are provided by selection of surface shape and refractive index. This thesis studies the design of ophthalmic lenses utilizing gradient-index (GRIN) materials for both the optical power and aberration control. This is done using geometrical optical theory and ray-tracing simulations. Progressive addition lenses (PALS) are vision correction lenses with a continuous change in power used to treat presbyopia. The power variation is typically located in the lower half of the lens. Progressive addition lenses are currently made with aspheric surfaces to achieve the focal power transition and aberration control. These surfaces have at most, mirror symmetry about the vertical axis. The possible design of progressive addition lenses with GRIN materials has not been well studied. This thesis studies PALS and identifies how gradient-index materials can be used to provide both the power progression and aberration control. The optical theory for rotationally symmetric and asymmetric power additions is given. Analytical and numerical methods for calculating the index profile are used, and the results examined using ray-tracing simulations. The theory developed for ophthalmic lenses is applied to the design of GRIN axicon. This is the first GRIN axicon manufactured, and is fabricated using ion-exchanged GRIN glass. Experimental measurements of its performance are compared and found to match theoretical predictions. This demonstrates the generality of the theory developed: it may be applied to non-visual applications, and even to non-imaging applications. Realistic implementation of GRIN technology to ophthalmic application requires the fabrication of large scale refractive index gradients in polymer material systems. The methyl-methacrylate/styrene copolymer system is studied to develop an empirical model of its
Nanda, Tavish; Kovach, Jaclyn L
To report spectral domain optical coherence tomography and fundus autofluorescence documentation of late stage macular findings associated with Sjogren-Larsson Syndrome in three adult siblings. Three adult siblings with Sjogren-Larsson Syndrome underwent ophthalmic examination and imaging. Crystalline maculopathy and subretinal deposits, presumably lipofuscin accumulation, with macular atrophy were present in varying degrees in all three adult siblings. In adults with Sjogren-Larsson Syndrome, crystalline retinopathy can progress to macular atrophy and the appearance of lipofuscin accumulation.
Rojo Badenas, Pilar; Royo Royo, Santiago; RAMÍREZ,JORGE; Madariaga, Inés
A method for general implementation in any software platform of the generalized Coddington equations is presented, developed, and validated within a Matlab environment. The ophthalmic lens design strategy is presented thoroughly, and the basic concepts of generalized ray tracing are introduced. The methodology for ray tracing is shown to include two inter-related processes. Firstly, finite ray tracing is used to provide the main direction of propagation of the considered ray at the incidence ...
To assess the current status of international ophthalmic publications. A collection of 55,591 original articles were found by an on-line National Library of Medicine database Medline search for 32 international ophthalmic journals during a 15-year period from 1988 to 2002 (internet access, November 11-13, 2003). The contributions to international ophthalmic publications were by 49.5% from North America, 31.3% from Western Europe, 15.1% from Asia and Oceania, 2.2% from Middle East, 0.85% from Central and South America, 0.53% from Eastern Europe, and 0.47% from Africa. Countries of Asia and Oceania showed an increasing trend in contributions while North America had a decreasing productivity in a relative sense. The top 10 productive countries were USA, United Kingdom, Japan, Germany, Canada, Australia, Italy, Netherlands, Sweden, and France. Among the Asian countries India ranked 13th, China 18th, and Korea 21st. When related to population, small countries such as Israel, France, Finland, Sweden, and Denmark were more productive. When related to economic productivity as defined by GDP, Israel, the United Kingdom, Australia, Finland, and Sweden were among the most productive countries, whereas rich countries such as Japan and Germany had a lower number of publications relative to their GDP. As regards clinical research in terms of randomized controlled trials, The USA was by far the most productive. The number of authors per article has shown an increasing trend worldwide, so that Japan and France had a significantly larger proportion of multiauthored articles. There is an increasing trend in the productivity of international ophthalmic publications from non-English-speaking countries including Japan, China, and Korea.
Full Text Available Introduction: School children constitute about one fourth of population of India. Early detection and treatment of various eye diseases helps in avoiding many complications. The magnitude of blindness is 3-4 times greater in developing countries. Very few studies have been conducted in Uttarakhand revealing the ophthalmic morbidity in school children or general population. Hilly areas especially the remote ones face various problems like, poor transportation facilities, distant health facilities, use of traditional methods for treatment, faith healing, customs and belief system, lack of information. Moreover water supply, poor personal hygiene and other factors also add up to these problems. Aim: To study the ophthalmic morbidities in school children in 3 schools of Thatyur block. Methodology: It was a cross sectional study. Result: A total of 705 students were enrolled. Permission from school authorities was seeked before the start of study. Schools were visited twice in a week current and preliminary information was taken from the students & teacher regarding education, occupation, income etc. General examination and ophthalmic examination was done with day & torch light along with refraction, with the help of standard Snellen’s chart. Each eye was examined separately. A vision of 6/6 was considered as normal. Near vision was tested with new vision Snellen’s chart at 12-14 inches away from eye.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Contact lens solutions; sterility. 800.10 Section...) MEDICAL DEVICES GENERAL Requirements for Specific Medical Devices § 800.10 Contact lens solutions... ophthalmic use, including contact lens solutions, should be sterile. It is further evident that...
Hutchens, Thomas C.; Darafsheh, Arash; Fardad, Amir; Antoszyk, Andrew N.; Ying, Howard S.; Astratov, Vasily N.; Fried, Nathaniel M.
Ophthalmic surgery may benefit from use of more precise fiber delivery systems during laser surgery. Some current ophthalmic surgical techniques rely on tedious mechanical dissection of tissue layers. In this study, chains of sapphire microspheres integrated into a hollow waveguide distal tip are used for erbium:YAG laser ablation studies in contact mode with ophthalmic tissues, ex vivo. The laser’s short optical penetration depth combined with the small spot diameters achieved with this fibe...
Güler, Nihal Fatma; Ubeyli, Elif Derya
In this study, ophthalmic artery Doppler signals were recorded from 115 subjects, 52 of whom had ophthalmic artery stenosis while the rest were healthy controls. Results were classified using a wavelet-based neural network. The wavelet-based neural network model, employing the multilayer perceptron, was used for analysis of ophthalmic artery Doppler signals. A multilayer perceptron neural network (MLPNN) trained with the Levenberg-Marquardt algorithm was used to detect stenosis in ophthalmic arteries. In order to determine the MLPNN inputs, spectral analysis of ophthalmic artery Doppler signals was performed using wavelet transform. The MLPNN was trained, cross validated, and tested with training, cross validation, and testing sets, respectively. All data sets were obtained from ophthalmic arteries of healthy subjects and subjects suffering from ophthalmic artery stenosis. The correct classification rate was 97.22% for healthy subjects, and 96.77% for subjects having ophthalmic artery stenosis. The classification results showed that the MLPNN trained with the Levenberg-Marquardt algorithm was effective to detect ophthalmic artery stenosis.
Michael A Page
Full Text Available Michael A Page, Frederick W FraunfelderDepartment of Ophthalmology (Casey Eye Institute, Oregon Health and Science University, Portland, OR, USAPurpose: To review the current literature on safety, efficacy, and measures of surgeon and patient satisfaction with lidocaine hydrochloride gel as a tool for ocular anesthesia.Methods: Pubmed search using keywords “lidocaine gel,” “ophthalmic,” and “surgery” and compiling cross-references. Twenty-six total references were reviewed, including 15 prospective randomized controlled trials (RCTs, total N = 933, average N = 62, 6 nonrandomized prospective studies (total N = 234, average N = 39, 2 animal studies, 1 microbiologic study, and 2 letters to the editor.Results: The RCTs and nonrandomized prospective studies evaluated a number of measures including timing of onset of anesthesia, duration of anesthesia, intraoperative and postoperative pain, need for additional anesthetic applications, intracameral lidocaine levels, and adverse effects. Control groups received topical drops, subconjunctival anesthetic, retrobulbar anesthetic, or sham gel. Lidocaine gel was shown to be at least as effective for pain control as alternative therapies in all studies, with longer duration of action than topical drops. Patient and surgeon satisfaction were high, and adverse effects were rare and comparable to those for anesthetic drop formulations. Surgical settings included cataract, pterygium, trabeculectomy, strabismus, intravitreal injection, vitrectomy, and penetrating keratoplasty.Conclusions: Lidocaine gel is a safe, effective, and potentially underutilized tool for ophthalmic surgery.Keywords: lidocaine, gel, topical, ophthalmic, ocular, anesthetic
Bartlett, Jimmy D; Niemann, Katherine; Houde, Barbara; Allred, Troy; Edmondson, Marcia J; Crockett, R S
The objective of this study was to determine the safety and tolerability of pirenzepine ophthalmic gel (PIR) and the magnitude of mydriatic and accommodative effects in myopic children. This was a placebo-controlled, parallel double-masked study of unequal (4:1) randomization. Children were randomized to receive 0.5% PIR, b.i.d., or vehicle (placebo) for one week, then titrated to 1% PIR for one week, then 2% PIR for two weeks, and then for an additional 11 months. Enrolled were 26 normal healthy children, 9-12 years old, with myopia (-0.75 to -3 D) and minimal astigmatism (pirenzepine in a larger patient population.
Golnik, Karl; Mayorga, Eduardo; Spivey, Bruce; Ritch, Robert; Gauthier, Tina-Marie
The International Council of Ophthalmology (ICO) is a global organization with a regional focus. Working in partnership with supranational and ICO member societies, the ICO is building a "World Alliance for Sight" to improve access to the highest-quality eye care worldwide. Designed to preserve and restore vision on an international scale, the ICO initiative, "Refocusing Ophthalmic Education," enhances ophthalmic education of residents, subspecialists, medical students, and allied eye care personnel by redefining the most effective ways to teach and in creating beneficial educational opportunities. The "Teaching the Teachers" program helps ophthalmic educators incorporate more effective methods of training and continuing professional development to meet societal needs, achieved in part through regional courses for residency program directors; symposia, and keynote talks presented by ICO's World Ophthalmology Educational Colloquium, Conferences for Ophthalmic Educators, and ophthalmic surgical competency rubrics. Recognizing that standardized curricula are essential for consistent ophthalmic education, the ICO has developed a curricular framework whereby goals, expectations, knowledge base, competencies, and technical training are delineated. The ICO is defining worldwide models of team training and compiling best practice, which will include training-program accreditation to ensure improvement in the education of ophthalmologists. International Council of Ophthalmology Web-based teaching courses, a Webinar Network, and a technology blog further support information and communication technologies for teaching and learning. At the ICO's Center for Ophthalmic Educators (educators.icoph.org), trainers will find valuable teaching resources in multiple languages as well as ways to share ideas and collaborate with peers and other ophthalmic educators.
... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Prednisolone sodium phosphate-neomycin sulfate... DOSAGE FORM NEW ANIMAL DRUGS § 524.1883 Prednisolone sodium phosphate-neomycin sulfate ophthalmic ointment. (a) Specifications. Prednisolone sodium phosphate-neomycin sulfate ophthalmic ointment...
... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Neomycin sulfate ophthalmic and topical dosage forms. 524.1484 Section 524.1484 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... NEW ANIMAL DRUGS § 524.1484 Neomycin sulfate ophthalmic and topical dosage forms....
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic contact lens radius measuring device... lens radius measuring device. (a) Identification. An ophthalmic contact lens radius measuring device is an AC-powered device that is a microscope and dial gauge intended to measure the radius of a...
... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Dermatologic and Ophthalmic Drugs Advisory Committee; Notice... be open to the public. Name of Committee: Dermatologic and Ophthalmic Drugs Advisory Committee...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Dermatologic and Ophthalmic Drugs Advisory Committee; Notice... be open to the public. Name of Committee: Dermatologic and Ophthalmic Drugs Advisory Committee...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Dermatologic and Ophthalmic Drugs Advisory Committee; Notice... be open to the public. Name of Committee: Dermatologic and Ophthalmic Drugs Advisory Committee...
Cohen, José E; Moscovici, Samuel; Halpert, Michael; Itshayek, Eyal
The poor natural history of central retinal artery occlusion (CRAO) is usually not modified with conventional, conservative management techniques. Guidelines for selective intraarterial ophthalmic thrombolysis are still lacking. While many centers continue to perform this procedure with promising results, others are reluctant due to conflicting findings in recent studies. We present our experience in a 36-year-old male with CRAO. Based on the patient's clinical presentation, we planned to perform selective intraarterial ophthalmic thrombolysis via the ophthalmic artery. When angiography demonstrated that the retina was not supplied by the ophthalmic artery, but by a meningo-ophthalmic artery branching from the internal maxillary artery, we instead administered thrombolytic agents via the meningo-ophthalmic artery. The patient's vision recovered completely, with visual acuity and visual field examination at 30 day follow up comparable to his pre-treatment status. This case emphasizes the need for external carotid artery examination in cases of nonvisualization of the ophthalmic artery. In addition, it illustrates the successful use of the meningo-ophthalmic artery to perform selective intraarterial thrombolysis for CRAO. Copyright © 2011 Elsevier Ltd. All rights reserved.
Kang, Min-Hee; Chae, Min-Joo; Yoon, Jang-Won; Lee, So-Young; Yoo, Jong-Hyun; Park, Hee-Myung
Resistance to fluoroquinolones and methicillin was determined for 49 ophthalmic isolates of Staphylococcus pseudintermedius from dogs with and without ophthalmic disease. Resistance was observed for ciprofloxacin (40.8%), ofloxacin (38.8%), enrofloxacin (38.8%), levofloxacin (34.7%), and moxifloxacin (4.1%). Eighteen isolates, 16 of which were resistant to oxacillin, were mecA-positive. Nine of the 16 oxacillin-resistant mecA-positive S. pseudintermedius isolates were resistant to more than one fluoroquinolone and 2 isolates were resistant to 5 fluoroquinolones. The frequency of mecA gene occurrence and fluoroquinolone resistance was twice as high among S. pseudintermedius isolates derived from dogs with ophthalmic disease compared with isolates for dogs without ophthalmic disease. The high prevalence of methicillin and fluoroquinolone resistance in S. pseudintermedius from dogs with ophthalmic disease is a concern. PMID:24982521
M. I. Razumovsky
Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.
Full Text Available Research question: 1. Whether paramedical ophthalmic assistants can be trained to examine vertical cup disc ratio? 2. Can the PMO As detect abnormal cup disc ratio after training? Objectives: 1. T o train ophthalmic assistants in cup disc ratio examination 2. To evaluate skills of trained ophthalmic assistants in cup disc ratio examination Study design: Cross sectional Setting: OPD of Ophthalmology department, Pt. B.D. Sharma PGIMS, Rohtak Participants: Five paramedical ophthalmic assistants, one ophthalmologist and 322 patients above 40 years of age. Statistical analysis: Sensitivity, specificity, Kappa values. Results: Data analysis of 322 cases was found by PMO As and ophthalmologist revealed sensitivity between 50-65% and specificity between 84.5-92.62%. A good agreement was found among all the examiners on computation of Kappa Values. It was concluded that ophthalmic assistants can examine vertical cup disc ratio after five days training.
M. I. Razumovsky
Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.
Kang, Min-Hee; Chae, Min-Joo; Yoon, Jang-Won; Lee, So-Young; Yoo, Jong-Hyun; Park, Hee-Myung
Resistance to fluoroquinolones and methicillin was determined for 49 ophthalmic isolates of Staphylococcus pseudintermedius from dogs with and without ophthalmic disease. Resistance was observed for ciprofloxacin (40.8%), ofloxacin (38.8%), enrofloxacin (38.8%), levofloxacin (34.7%), and moxifloxacin (4.1%). Eighteen isolates, 16 of which were resistant to oxacillin, were mecA-positive. Nine of the 16 oxacillin-resistant mecA-positive S. pseudintermedius isolates were resistant to more than one fluoroquinolone and 2 isolates were resistant to 5 fluoroquinolones. The frequency of mecA gene occurrence and fluoroquinolone resistance was twice as high among S. pseudintermedius isolates derived from dogs with ophthalmic disease compared with isolates for dogs without ophthalmic disease. The high prevalence of methicillin and fluoroquinolone resistance in S. pseudintermedius from dogs with ophthalmic disease is a concern.
Lara-Smalling, Agueda; Cakiner-Egilmez, Tulay; Miller, Dawn; Redshirt, Ella; Williams, Dale
Currently, ophthalmic surgical cases are not included in the Veterans Administration Surgical Quality Improvement Project data collection. Furthermore, there is no comprehensive protocol in the health system for prospectively measuring outcomes for eye surgery in terms of safety and quality. There are 400,000 operative cases in the system per year. Of those, 48,000 (12%) are ophthalmic surgical cases, with 85% (41,000) of those being cataract cases. The Ophthalmic Surgical Outcome Database Pilot Project was developed to incorporate ophthalmology into VASQIP, thus evaluating risk factors and improving cataract surgical outcomes. Nurse reviewers facilitate the monitoring and measuring of these outcomes. Since its inception in 1778, the Veterans Administration (VA) Health System has provided comprehensive healthcare to millions of deserving veterans throughout the U.S. and its territories. Historically, the quality of healthcare provided by the VA has been the main focus of discussion because it did not meet a standard of care comparable to that of the private sector. Information regarding quality of healthcare services and outcomes data had been unavailable until 1986, when Congress mandated the VA to compare its surgical outcomes to those of the private sector (PL-99-166). 1 Risk adjustment of VA surgical outcomes began in 1987 with the Continuous Improvement in Cardiac Surgery Program (CICSP) in which cardiac surgical outcomes were reported and evaluated. 2 Between 1991 and 1993, the National VA Surgical Risk Study (NVASRS) initiated a validated risk-adjustment model for predicting surgical outcomes and comparative assessment of the quality of surgical care in 44 VA medical centers. 3 The success of NVASRS encouraged the VA to establish an ongoing program for monitoring and improving the quality of surgical care, thus developing the National Surgical Quality Improvement Program (NSQIP) in 1994. 4 According to a prospective study conducted between 1991-1997 in 123
Nicole L. Pratt
Full Text Available Introduction. Ophthalmic timolol, a topical nonselective beta-blocker, has the potential to be absorbed systemically which may cause adverse cardiovascular effects. This study was conducted to determine whether initiation of ophthalmic timolol was associated with an increased risk of hospitalisation for bradycardia. Materials and Methods. A self-controlled case-series study was undertaken in patients who were hospitalised for bradycardia and were exposed to timolol. Person-time after timolol initiation was partitioned into risk periods: 1–30 days, 31–180 days, and >180 days. A 30-day risk period prior to initiating timolol was also included. All remaining time was considered unexposed. Results. There were 6,373 patients with at least one hospitalisation for bradycardia during the study period; 267 were exposed to timolol. Risk of bradycardia was significantly increased in the 31–180 days after timolol initiation (incidence rate ratio (IRR = 1.93; 95% confidence interval (CI 1.00–1.87. No increased risk was observed in the first 30 days or beyond 180 days of continuous exposure (IRR = 1.40; 95% CI 0.87–2.26 and IRR = 1.21; 95% CI 0.64–2.31, resp.. Conclusion. Bradycardia is a potential adverse event following timolol initiation. Practitioners should consider patient history before choosing a glaucoma regime and closely monitor patients after treatment initiation with topical nonselective beta-blocker eye drops.
Ollerton, J E; Hodgetts, T J
This paper analyses all ophthalmic attendances to a deployed emergency department (ED) in Iraq to identify patterns of injury to optimise patient care, plan equipment tables for future operations and emphasise need for prevention of ocular morbidity. The Academic Department of Military Emergency Medicine at the Royal Centre for Defence Medicine in Birmingham maintains an electronic database with derails on all attendances to the emergency departments deployed on Operations. This Operational Emergency Department Attendance Register (OpEDAR) was searched for all patients with medical classification of Ophthalmology over a 52 month period between 1 March 2003 and 30 June 2007. During this period 30,195 patients were seen in the ED on Operation Telic and are available for analysis. Patients with ophthalmic complaints account for 5.3% of all presentations to the ED and rank as the 7th most common reason for attendance. This paper identifies patterns of injury to enable future planning of equipment tables and identifies the need for prevention of injury wherever possible. Implications on days lost from full active duty for the injured can be extrapolated. More data needs to be collated on the use of eye protection and the relevance of contact lenses in deployed personnel with eye injuries.
S. A. Kochergin
Full Text Available Aim. To study the effects of Cationorm for the prevention of ophthalmic complications in intensive care unit (ICU patients and to compare the efficacy of ocular surface lubricants used in ICU. Patients and methods. 50 ICU patients (100 eyes with bilateral lagophthalmos (2 mm or more were enrolled in the study. Study group and control group each included 25 patients (50 eyes who were on deep sedation and ventilator. Before and after the treatment, general examination, biomicroscopy, tonometry, ophthalmoscopy, Schirmer’s test and Norn’s test (with fluorescein were performed. Results. Cationorm significantly improves tear film stability without any corneal epithelial defects (100 % of patients. In 7 controls (14 eyes, 28 %, initial signs of corneal xerosis and exposure keratitis were revealed. Conclusions. ICU patients are at high risk of complications due to hypodynamia and reduced innervation of the eye and its appendages. Bilateral lagophthalmos develops in 16.67 % of ICU patients who are on deep sedation and ventilator (up to 3 days. In the abscence of preventive therapy, lagophthalmos results in complications, i.e., keratitis and, occasionally, corneal ulceration and perforation. ICU patients require ophthalmological examination and tear substitutes. Regular instillations of Cationorm minimize ophthalmic complications due to intensive therapy. Cationorm restores tear firm architectonics and may be considered as a first-line choice for such disorders.
Current estimates of the percentage of anti-reflection coated lenses verses uncoated in the market today range from 3% in the United States (US.), to 60% in Europe, to 80% in Japan. Currently upwards of 80% of all prescription eyewear lenses dispensed are resin. Glass lenses lose market share yearly, as scratch resistant coatings on resin lenses are improved. Photochromic resin materials are also improving and will shortly equal the performance of glass photockromics. Until recently, the performance characteristics of ophthalmic lenses were divided into two schools. In Europe, the emphasis was on keeping the reflections to an absolute minimum, while in the Asian market the emphasis was on producing a lens, which had exceptional scratch resistance. A typical European lens may average .4% reflection across the visible spectrum (400 to 700 urn.), while the Asian lenses averaged in the 1.5% range. The growth ofAR coating in the U.S. 80 million pair a year total ophthalmic market has been lagging foreign markets for several reasons.
Full Text Available Methylmalonicaciduia(MMAaccompanied with homocystinuria is a rare autosomal-recessive with congenital metabolic disorder of Vitamin B12. There are three subtypes, cblC, cblD, cblF, in which cblC is the most common one. The diagnostic tests are tandem mass spectrometry and gas chromatography-mass spectrometry. Tests for activity of enzyme in fibroblasts from skin, complementary assay and genetic analysis can be used to make the subtype clear. Early-onset patients, defined by onset of symptoms before the age of 1 year, may have severe ocular involvement, including visual loss, nystagmus, strabismus, retinopathy, maculopathy, optic atrophy, abnormal electroretinography. Late-onset patients, defined by onset of symptoms after the age of 4 year, rarely have ocular manifestations. The pathogenesis of the ophthalmic symptoms may be related to the high level of homocystine, oxidative stress and the abnormal development of nervous systems. The treatment for MMA accompanied with homocystinuria is mostly symptomatic based. Ophthalmic treatment is limited. Early supplement of methionine,GSH or other antioxidants may be helpful for retinopathy. There is no standard ophthalmological examination for those patients in China. It is critical to set up inter-departmental cooperation and early stage examination for the treatments and outcomes of the patients.
Full Text Available Daoud Al-Badriyeh, Chin Fen Neoh, Kay Stewart, David CM KongCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Victoria, AustraliaAbstract: Fungal keratitis is one of the major causes of ophthalmic mycosis and is difficult to treat. The range of common antifungal agents available for fungal keratitis remains inadequate and is generally associated with poor clinical outcomes. Voriconazole is a new generation triazole antifungal agent. Only marketed in systemic formulation and, with broad-spectrum activity and high intraocular penetration, voriconazole has demonstrated effectiveness against fungal keratitis. Systemic voriconazole, however, is not without side effects and is costly. Voriconazole eye drops have been prepared extemporaneously and used for the treatment of ophthalmic fungal keratitis. The current article sought to review the literature for evidence related to the effectiveness and safety of topical voriconazole and its corneal penetration into the aqueous humor of the eye. The voriconazole eye drops used are typically of 1% concentration, well tolerated by the eye, and are stable. Despite existing evidence to suggest that the eye drops are effective in the treatment of fungal keratitis, more studies are needed, especially in relation to using the eye drops as first-line and stand-alone treatment, preparation of higher concentrations, and optimal dosing frequency.Keywords: voriconazole, fungal keratitis, eye drops, corneal penetration
Full Text Available Aim: To investigate the misuse of ‘over the counter’ ophthalmic medications in our city. Method: Responses of a structured questionnaire covering various aspects of over the counter drug use was obtained from pharmacy workers in and around our city. Results: Eighty nine pharmacy workers took part in this cross–sectional study. An average number of seven patients per day with ophthalmic complaints were seen by the pharmacy workers. Dispensing over the counter was practiced by 89.9% of the pharmacists. The most common complaint of the patients visiting the pharmacy, was redness and itching (86.5%. Antibiotics (96.6% were the most common eye drops dispensed over the counter, followed by steroids (55.1%, decongestants (54.1%, antibiotic-steroid combination eye drops (29.2% and lubricants (16.8%. Awareness regarding complications of steroid use was seen in 40.6% of pharmacists. 6.7% pharmacists had seen patients with complications following use of over the counter medications. In our study, majority of the eye drops dispensed were prescription drugs. Conclusion: Availability of prescription eye drops over the counter is an immense public threat. Educating the pharmacist and the population can decrease ocular morbidity. Research into methods to effectively deal with over-the-counter drug misuse is required and law can be enforced based on the findings.
Asgharzadeh Shishavan, Amir; Nordin, Leland; Tjossem, Paul; Abramoff, Michael D.; Toor, Fatima
In this work we present the design of a novel ophthalmic prismatic contact lens to correct for strabismus. Strabismus, colloquially called "crossed-eyes" or "wall eyes," is a condition in which the eyes are not properly aligned with each other. To our knowledge there are no contact lenses that allow for strabismus correction. To address this, we have designed a poly methyl methacrylate (PMMA) based prismatic correction contact lens. Therefore, we modeled a Fresnel lens with the appropriate optical properties and a human eye in COMSOL Multiphysics Ray Optics module. Our first design was created by mapping Fresnel lenses onto the curved surface of the eye, the focus of light on retina was suboptimal. Next we determined two more potential solutions and improved the light focus on the retina but there were still some issues. A small fraction of light ( 5%) diverged and could not be focused. Due to dispersive characteristic of PMMA, chromatic aberration was present. We will use our ray optics solution and convert into a metasurface nanophotonic lens that has the identical behavior and mitigates the issues related with prismatic lens.
Full Text Available Ophthalmic drug delivery is one of the most interesting and challenging endeavor facing the pharmaceutical scientist. The conventional ocular drug delivery systems like solutions, suspensions, and ointments show drawbacks such as increased precorneal elimination, high variability in efficiency, and blurred vision respectively so there was a need for developing advanced drug delivery system. In situ forming polymeric formulations were developed to overcome the conventional drug therapy drawbacks these systems are in solution form before administering in the body, but once administered these systems undergo gelation. The formation of gels depends on factors like change in a specific physico-chemical parameter (pH, temperature, ion-sensitive by which the drug gets released in a sustained and controlled manner. These systems were evaluated for drug content, clarity, pH, gelling capacity, viscosity, in vitro drug release studies, texture analysis, sterility testing , isotonicity evaluation, accelerated studies and irritancy test. FT-IR spectroscopy was used to know drug and polymer incompatibilities.
Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)
Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)
Full Text Available Neuromyelitis optica spectrum disorders (NMOSDs include classic neuromyelitis optica (NMO, opticospinal multiple sclerosis (OSMS, limited form of NMO and isolated optic neuritis or myelitis accompanied by either systemic autoimmune diseases or typical MRI findings of NMO. The common neuro-ophthalmic features of NMOSDs include simultaneous or consecutive bilateral optic neuritis, more commonly seen optic disk edema and surrounding exudate, poor visual recovery, steroid responsiveness and dependency. Combined with serum aquaporin 4 (AQP4 antibody and brain MRI examination, these clinical features can be helpful to the early differential diagnosis between NMOSDs and MS. Some types of eye movement abnormalities have been reported in patients with NMOSDs, but further investigation needs to be done before the specificity of these features are confirmed. doi: 10.3969/j.issn.1672-6731.2014.10.003
I describe a technique for implantation of a 1-piece acrylic foldable intraocular lens (IOL) using an irrigation cannula of the phaco machine without using an ophthalmic viscosurgical device (OVD). The irrigating cannula introduced through a side port provides excellent stability and positioning to the eye; if required, the cannula tip is used to guide the leading haptic of the IOL into the capsular bag. The fluid coming from the side port via a bimanual irrigation cannula maintains adequate formation of the capsular bag and anterior chamber while the foldable IOL is inserted. The hydroimplantation technique has the advantage of increased efficiency, reduced surgical time and cost, no need for OVD removal from behind the IOL or for additional instrumentation, no OVD-induced intraocular pressure elevation postoperatively, and no risk of early capsular bag distension syndrome. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Blanchard, Donald L
Emily Dickinson is one of America's premier poets of the 19th century. Henry Willard Williams, MD, was one of the very first physicians to limit his practice to ophthalmology and was the established leader in his field in Boston, Massachusetts. They met during the time of the Civil War, when Emily consulted him about her ophthalmic disorder. No records of the diagnosis survive. Photophobia, aching eyes, and a restriction in her ability to work up close were her main symptoms. Iritis, exotropia, or psychiatric problems are the most frequent diagnoses offered to explain her difficulties. Rather than attempt a definitive conclusion, this article will offer an additional possibility that Dr Williams likely considered (ie, hysterical hyperaesthesia of the retina). This was a common diagnosis at that time, although it has currently faded from use.
Noval, S; Cabrejas, L; Jarrín, E; Ruiz-Guerrero, M; Ciancas, E
Turkana is the largest district in Kenya, situated in the Northwest of the country. It features a semi-nomadic population of 850,000. Around 60% of population lives below the poverty threshold. The ratio of doctors is 1:75,000 inhabitants. Five ophthalmologists took part in the last deployment in November. Local staff had previously selected the patients from the rural areas, as well as in Lodwar, the capital of the district. Of the 371 patients who attended the clinic, 128 required surgery. To describe the pediatric population attended to in the last «Turkana Eye Project» Camp. Description of the ophthalmic pathologies of the children seen in the clinic in this surgical camp, and the diagnostic and therapeutic options according to the limitations of the environment. Of the 371 patients, 54 were younger than 15 years old (14.5%). Four children had surgery (3.25% of the 128 patients). In 2 more cases surgery was the indicated but not performed. Therefore, of the total of 54 cases, 6 could be considered as surgical (11.1%), and 17 suffered ophthalmic problems other than refraction defects, or mild ocular surface pathologies: traumatic cataracts, neuropathies, impetigo, exophthalmos, retinal dystrophies, dermoid cysts, or nyctalopia. The etiology was traumatic in four of the 17 children (23.5%). Surgical camps are increasing in the developing countries. They are usually focused on particular pathologies, such as cataracts or trachoma. Our case series shows the importance of pediatric teams and the need to be prepared to face complex pediatric pathologies. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.
Full Text Available Purpose: We performed ophthalmic examinations, including optical coherence tomography (OCT, on a case diagnosed with hydranencephaly. Case Report: This case involved a female infant born at the gestational age of 35 weeks and 4 days, with the birth weight of 2,152 g, who was one of monochorionic diamniotic twins, and the identical twin died in utero at the gestational age of 24 weeks. After that, examination by fetal echo indicated that she had microcephaly and ventriculomegaly. Postnatal magnetic resonance imaging (MRI of her head indicated microcephaly and significant enlargement of the lateral ventricle on both sides, with no obvious signs of elevated intracranial pressure. The brain parenchyma of both sides of the frontal lobe, parietal lobe, and occipital lobe had marked thinning, yet that of the temporal lobe, basal ganglia, thalamus, brain stem, and cerebellum had been maintained. Moreover, no obvious hematoma or neoplastic lesions were observed. Ophthalmic examinations indicated that both of her eyes had slight light reflex, attributed to optic nerve atrophy. Examination by use of a hand-held OCT system indicated a layered structure of the retina and thinning of the ganglion cell layer. Flicker electroretinogram (ERG examination by use of a hand-held ERG system indicated an almost normal wave. However, no clear visual reaction was observed when she was 10 months old. Conclusion: Our findings in this case of hydranencephaly revealed that even though the outer layer functions of the patient’s retina were maintained, extensive damage to her cerebral cortex resulted in poor visual function.
Ayaz, Tunahan; Akansel, Gur. E-mail: email@example.com; Hayirlioglu, Alper; Arslan, Arzu; Suer, Necdet; Kuru, Ihsan
Objective: To evaluate the hemodynamic changes in mild-moderate preeclampsia using ophthalmic artery Doppler ultrasonography technique. Methods: Ophthalmic artery pulsatility and resistivity indices were calculated in 30 mild-moderate preeclamptic women and 30 normotensive gravid women of matched gestational age. Student's t-test was performed to test the significance of difference. Results: Both indices of peripheral resistance were found to be significantly lower in the ophthalmic arteries of mild-moderately preeclamptic women than those measured in normotensive gravid women at similar stage of pregnancy. In a small number patients whose disease progressed to severe preeclampsia, both indices increased. Conclusion: In patients with mild-moderate preeclampsia, ophthalmic artery color Doppler ultrasonography detects hemodynamic changes that are not present in normotensive gravid women. Reversal of Doppler patterns in a small number of patients with progressive disease supports the hypotheses suggesting the presence of early vasodilation and late vasospasm in the etiology of preeclampsia.
Choi, Stephanie H; Lionberger, Robert A
For ophthalmic drug products, the determination of bioequivalence can be challenging, as drug concentrations at the site of action cannot always be measured. The FDA has recommended a variety of studies that can be used to demonstrate bioequivalence for different ophthalmic drug products. Product-specific bioequivalence recommendations for 28 ophthalmic products have been posted on FDA's website as of May 2016, outlining the specific tests which should be performed to demonstrate bioequivalence. The type of study that can be used to demonstrate bioequivalence depends on the drug product's active pharmaceutical ingredient(s), dosage form, indication, site of action, mechanism of action, and scientific understanding of drug release/drug availability and drug product characteristics. This article outlines the FDA's current guidance on studies to demonstrate bioequivalence through clinical endpoint studies, pharmacokinetic studies, and in vitro studies for generic ophthalmic drug products.
Folberg, R; Dickinson, L K; Christiansen, R A; Huntley, J S; Lind, D G
The authors designed and implemented a complete curriculum in ophthalmic pathology using IBM- and Macintosh-based interactive videodisc (IVD) technology. They also redesigned a portion of this curriculum for a new television-based platform, compact disc-interactive (CD-I). The following issues were addressed: curriculum design, instructional design, the assembly of illustrations and the ownership of such materials, the generation of computer-based medical art and animation, and programming. The issue of academic credit for faculty participating in this effort also was considered. The computer-based IVD program provides the following features: (1) rapid access to thousands of high-quality illustrations with the option of superimposing graphic labels and text directly over pictures; (2) the ability to view enlargements of photographs; (3) an online glossary to view definition of terms coupled with high-quality photographs; and (4) a dynamic introduction to pathophysiology using interactive animation sequences. The authors were able to incorporate the same interactive features into the CD-I version. High-quality medical illustrations can be used effectively on the CD-I platform. Computer-based multimedia workstations are relatively expensive for personal use but may be useful if the equipment can be shared in a learning center or library. Compared with interactive computer-based solutions, consumer-oriented television-based technology such as CD-I is a relatively inexpensive vehicle for providing continuing medical education programs intended for use in the individual practitioner's office or home.
Krzystkowa, K M; Hydzikowa, M; Szpytma, R
A double blind study with Solcoseryl compounds in ophthalmic gel and with 2.4% cystein in ophthalmic gel was performed in the period 1985-1988; it was used in 18 cases: with chronic recurrent keratitis (11 patients) and sicca keratitis (7 patients). Observed was the influence of these compounds on the epithelialization of the cornea, on the improvement of corneal transparency, the diminutation of the troubles connected with dessication of the eye in sicca keratitis. In spite of the small number of cases the observations were interesting. In patients with a chronic recurrent keratitis the influence of both compounds showed to be beneficial for the condition of the cornea. In patients with keratitis sicca one could observe a better tolerance of the Solcoseryl ophthalmic gel which could be applied for a longer period in comparison with cystein in gel.
Lee, Andrew G; Golnik, Karl C; Tso, Mark O M; Spivey, Bruce; Miller, Kathleen; Gauthier, Tina-Marie
To describe the emerging strategic global perspective of the International Council of Ophthalmology (ICO) efforts in ophthalmic education. A global perspective describing how the development of sophisticated educational tools in tandem with information technology can revolutionize ophthalmic education worldwide. Review of ICO educational tools, resources, and programs that are available to ophthalmic educators across the globe. With the explosive growth of the Internet, the ability to access medical information in the most isolated of locations is now possible. Through specific ICO initiatives, including the ICO curricula, the "Teaching the Teachers" program, and the launching of the new ICO Center for Ophthalmic Educators, the ICO is providing ophthalmic educators across the globe with access to standardized but customizable educational programs and tools to better train ophthalmologists and allied eye care professionals throughout the world. Access to educational tools and strengthening of global learning will help providers meet the goals of VISION 2020 and beyond in eliminating avoidable blindness. It is the intent of the ICO that its programs for ophthalmic educators, including conferences, courses, curricula, and online resources, result in better-trained ophthalmologists and eye care professionals worldwide. Copyright © 2012 Elsevier Inc. All rights reserved.
Huang, Yi; Tao, Qi; Hou, Dongzhi; Hu, Sheng; Tian, Shuangyan; Chen, Yanzhong; Gui, Ruyi; Yang, Lingling; Wang, Yao
As a novel ion-exchange carrier with high surface area and excellent exchangeability, montmorillonite (Mt) was intercalated with betaxolol hydrochloride (BH) to form a nanocomposite and then encapsulated by liposomes (Mt-BH-LPs) for an ophthalmic drug-delivery system. The Mt-BH and Mt-BH-LPs were prepared by an acidification process and ethanol injection combined with ammonium sulfate gradient methods. The successful formation of Mt-BH and Mt-BH-LPs was verified by thermogravimetric analysis, X-ray diffraction, Fourier-transform infrared spectra, and transmission electron microscopy. Mt-BH-LPs possessed the favorable physical characteristics of encapsulation efficiency, drug loading, mean particle size, and ζ-potential. In vitro release studies indicated Mt-BH-LPs effectively maintained a relatively sustained slow release. Immortalized human corneal epithelial cell cytotoxicity, in vivo rabbit eye-irritation tests, and chorioallantoic membrane–trypan blue staining all revealed that Mt-BH-LPs had no obvious irritation on ocular tissues. A new in vitro tear-turnover model, including inserts containing human corneal epithelial cells, was designed to evaluate the precorneal retention time of Mt-BH-LPs. The results showed that Mt-BH-LPs maintained a certain BH concentration in tear fluid for a longer period than the BH solution. In vivo precorneal retention studies also indicated Mt-BH-LPs prolonged drug retention on the ocular surface more than the BH solution. Furthermore, pharmacodynamic studies showed that Mt-BH-LPs had a prolonged effect on decreasing intraocular optical pressure in rabbits. Our results demonstrated that Mt-BH-LPs have potential as an ophthalmic delivery system. PMID:28280338
Hwang, Juyoung; Jo, Kyung-Il; Yeon, Je Young; Hong, Seung-Chyul
We present two patients with a dural arteriovenous fistula (dAVF) of the ophthalmic sheath who developed progressive exophthalmos, conjunctival chemosis, and visual loss. These symptoms mimic those of cavernous sinus dAVFs. Dural AVFs of the ophthalmic sheath are extremely rare and their clinical management is controversial. We successfully treated these two patients by transvenous coil embolization. Transvenous embolization appears to be a safe and effective method to treat dAVFs of the ophthalmic sheath.
Matsuda, Takakuni; Hiraoka, Shogo; Urashima, Hiroki; Ogura, Ako; Ishida, Tatsuhiro
A 2% commercially available, milky-white, rebamipide micro-particle suspension is used to treat dry eyes, and it causes short-term blurring of the patient's vision. In the current study, to improve the transparency of a rebamipide suspension, we attempted to obtain a clear rebamipide suspension by transforming the rebamipide particles to an ultrafine state. In the initial few efforts, various rebamipide suspensions were prepared using a neutralizing crystallization method with additives, but the suspensions retained their opaque quality. However, as a consequence of several critical improvements in the neutralizing crystallization methods such as selection of additives for crystallization, process parameters during crystallization, the dispersion method, and dialysis, we obtained an ultrafine rebamipide suspension (2%) that was highly transparent (transmittance at 640 nm: 59%). The particle size and transparency demonstrated the fewest level of changes at 25°C after 3 years, compared to initial levels. During that period, no obvious particle sedimentation was observed. The administration of this ultrafine rebamipide suspension (2%) increased the conjunctival mucin, which was comparable to the commercially available micro-particle suspension (2%). The corneal and conjunctival concentration of rebamipide following ocular administration of the ultrafine suspension was slightly higher than that of the micro-particle suspension. The ultrafine rebamipide suspension (eye-drop formulation) with a highly transparent ophthalmic clearness should improve a patient's QOL by preventing even a shortened period of blurred vision.
Gibson, Charles Robert; Mader, Thomas H.
Background: Although physiologic and pathologic changes associated with microgravity exposure have been studied extensively, the effect of this environment on the eye is largely unknown. Over the last several years, NASA s Space Medicine Division has documented astronauts presenting with varying degrees of disc edema, globe flattening, choroidal folds, cotton wool spots, and hyperopic shifts after long-duration space flight. Methods: Before and after long-duration space flight, six astronauts underwent complete eye examinations to include cycloplegic and/or manifest refraction and fundus photography. Five of these astronauts had Optical Coherence Tomography (OCT) and Magnetic Resonance Imaging (MRI) performed following their missions. Results: Following exposure to space flight of approximately 6-months duration, six astronauts had neuro-ophthalmic findings. These consisted of disc edema in four astronauts, globe flattening in four astronauts, choroidal folds in four astronauts, cotton wool spots in three astronauts, nerve fiber layer thickening by OCT in five astronauts, and decreased near vision in five astronauts. Four of the astronauts with near vision complaints had a hyperopic shift equal to or greater than + 0.50D between pre- and post-mission spherical equivalent refraction in one or both eyes (range +0.50D to +1.50D). These same four had globe flattening by MRI. Conclusions: The findings we describe may have resulted from a rise in intracranial pressure caused by microgravity fluid shifts, and could represent parts of a spectrum of ocular and cerebral responses to extended microgravity.
Stuerwald, S.; Schmitt, R.
In production of ophthalmic freeform optics like progressive eyeglasses, the specimens are tested according to a standardized method which is based on the measurement of the vertex power on usually less than 10 points. For a better quality management and thus to ensure more reliable and valid tests, a more comprehensive measurement approach is required. For Shack Hartmann Sensors (SHS) the dynamic range is defined by the number of micro-lenses and the resolution of the imaging sensor. Here, we present an approach for measuring wavefronts with increased dynamic range and lateral resolution by the use of a scanning procedure. Therefore, the proposed innovative setup is based on galvo mirrors that are capable of measuring the vertex power with a lateral resolution below one millimeter since this is sufficient for a functional test of progressive eyeglasses. Expressed in a more abstract way, the concept is based on a selection and thereby encoding of single sub-apertures of the wave front under test. This allows measuring the wave fronts slope consecutively in a scanning procedure. The use of high precision galvo systems allows a lateral resolution below one millimeter as well as a significant fast scanning ability. The measurement concept and performance of this method will be demonstrated for different spherical and freeformed specimens like progressive eye glasses. Furthermore, approaches for calibration of the measurement system will be characterized and the optical design of the detector will be discussed.
Sophie Joanna Coutts
Full Text Available OBJECTIVE: This is a cross sectional ophthalmic clinic-based study to estimate the prevalence and severity of pterygium in a selected population in the Amazon Basin, Brazil. METHODS: The study included 225 subjects above 20 years age from three different places of residence of Manaus city (group 1, n=89, river based communities (group 2, n= 116 and indigenous rainforest inhabitants (group 3, n=20. Pterygia was graded 1-4 by torch examination and gender, age and occupation determined. RESULTS: were assessed to have pterygia (grades 2-4 117 people; 52% against 108 control subjects with bilateral disease in 43% of subjects. Prevalence of grades 2-4 increased from 36% in group 1 to 62.5 % in group 2 and 75% in group 3. Of these subjects the percentage with outdoor professions increased across the groups from 31.2% to 67.1 % and 70% respectively. Also subjects of group 2 who worked largely outdoors, showed increasing pterygia severity, from grades 2 at 57% (p=0.0002, grade 3 at 93.3% (p,0.0001 to grade 4 at 100% (p=0.0004 CONCLUSION: Amazonian communities have a high prevalence of pterygia, which correlates to greater outdoor occupation and sun exposure. This study agrees with previous worldwide reports and it is the first study to compare the prevalence of pterygium in rural and urban living in Amazonian in Brazil. This study highlights the public health significance and gross need for intervention studies.
Daniela B. Almeida-Freitas
Full Text Available Purpose: To evaluate the ophthalmic artery hemodynamics in patients with chronic heart failure. Methods: Doppler parameters of ophthalmic artery of 18 patients with chronic heart failure in different stages of the disease were compared with 21 healthy volunteers (control group. These parameters were also correlated with echocardiographic assessments and clinical cardiologic status. Results: Mean diastolic velocity was 5.14 ± 2.4 cm/s in the chronic heart failure group and 7.44 ± 3.5 cm/s in the control group (p=0.007. Mean resistance index of the ophthalmic artery was 0.76 ± 0.08 in the chronic heart failure group and 0.70 ± 0.08 in the control group (p=0.04. Mean systolic velocity of the ophthalmic artery was 22.03 ± 7.7 cm/s in the chronic heart failure group and 25.32 ± 9.2 cm/s in the control group (p=0.24. There was a negative correlation between the resistance index of the ophthalmic artery and systemic blood pressure of patients with chronic heart failure (r= -0.47, p=0.007. Diastolic velocity of the ophthalmic artery correlated positively with systemic blood pressure (r=0.44, p=0.02. Conclusion: Lower diastolic velocity and higher resistance index were observed in the ophthalmic artery of chronic heart failure patients when compared to the control group, which probably reflects the presence of orbital vasoconstriction in response to low cardiac output. Therefore, the influence of these findings on the structure and function of the optic nerve head deserves investigation.
Chennell, P; Delaborde, L; Wasiak, M; Jouannet, M; Feschet-Chassot, E; Chiambaretta, F; Sautou, V
Cyclosporine A eye drops are used at concentrations ranging from 0.5 to 20mg/mL to treat a variety of ophthalmic diseases. Cyclosporine A formulations at high concentrations are difficult to manufacture because of cyclosporine's lipophilicity, and generally require an oil based vector. In this study, we investigated the physicochemical and microbiological stability of two high concentrations (10mg/mL and 20mg/mL) of an ophthalmic cyclosporine A micellar solution in a low density polyethylene multidose eyedropper, at two conservation conditions (5°C and 25°C), before and with simulated use. Analyses used were the following: visual inspection, cyclosporine quantification by a stability-indicating liquid chromatography method, osmolality and pH measurements and turbidity. A complementary analysis by dynamic light scattering was implemented to evaluate potential particle formation or micelle size change. In the in-use study, cyclosporine quantification was also performed on the drops emitted from the multidose eyedroppers. Our results show that the cyclosporine micellar formulation retains good physicochemical and microbiological stability, as all parameters stayed within acceptable range limits, however a higher variability in cyclosporine concentrations was observed for 20mg/mL units stored at 25°C. The in-use study showed that cyclosporine concentrations in the emitted drops were also within acceptable range limits. The micellar formulation presented in this study can therefore be stored at 5°C or at ≤25°C for up to 6months. Copyright © 2017 Elsevier B.V. All rights reserved.
Kinney, Matthew E; Ericsson, Aaron C; Franklin, Craig L; Whiting, Rebecca E H; Pearce, Jacqueline W
The aim of this study was to establish normal ophthalmic parameters for select diagnostic tests in American white pelicans (Pelecanuserythrorhynchos). Twenty-one zoo-housed American white pelicans were manually restrained for noninvasive ocular diagnostic testing and complete ophthalmic examination. Tear production quantification using the phenol red thread test (PRTT), fluorescein staining, and intraocular pressure (IOP) evaluation were performed. In addition, conjunctival aerobic bacterial culture and culture-independent 16S rRNA amplicon sequencing were performed on select eyes. Normal variations and ocular abnormalities detected during complete ophthalmic examination were documented and photographed. Direct pupillary light reflex, menace response, and palpebral reflex were present in all birds. The value (mean ± SD) for PRRT and IOP was 14.9 ± 7.84 mm/15 sec and 9.0 ± 1.41 mm Hg oculus uterque, respectively. Conjunctival culture in nine birds revealed no growth for six birds and Staphylococcus aureus growth in three birds. A high relative abundance of Mycoplasma sp. was detected in all samples based on 16S rRNA sequencing. The normal pelican eye was found to have relative conjunctival hyperemia, absent filoplumes, iris color ranging from light blue to brown, and a subcircular vertically elongated pupil. Ophthalmic abnormalities were noted in 10 of 21 birds. Common findings included corneal fibrosis, cataracts, and asteroid hyalosis. The most common ophthalmic abnormality in this species was cataracts.
Mimura, Masashi; Ueki, Mari; Oku, Hidehiro; Sato, Bunpei; Ikeda, Tsunehiko
To evaluate the effect of the postoperative administration of rebamipide ophthalmic suspension on the success rate of lacrimal stent intubation (LSI) for the treatment of primary acquired nasolacrimal duct obstruction (PANDO). This comparative interventional cohort study investigated 110 consecutive patients with PANDO who were treated with LSI and followed up for 12 months postoperatively at one institution. LSI was performed by one surgeon, and all patients received identical postoperative care. Among the total 110 patients, 71 underwent LSI with postoperative administration of rebamipide ophthalmic suspension, and 39 underwent LSI without administration of the suspension. Data related to patient age, gender, laterality, and postoperative administration of rebamipide ophthalmic suspension were collected and used as independent variables, and logistic regression analyses were performed to compare the anatomical success rate at 12 months postoperatively between patients with and without postoperative administration of the suspension. The anatomical success rate of LSI in patients with and without postoperative administration of rebamipide ophthalmic suspension was 90.1 and 69.2 %, respectively. A comparison of these success rates showed statistical significance, in that the rate of treatment success was higher in PANDO patients who underwent LSI with postoperative administration of the suspension [odds ratio (OR), 3.37; P rebamipide ophthalmic suspension increases the rate of anatomical success in patients who undergo LSI for the treatment of PANDO.
Shek, Karen Mei-Yan; Chau, Janita Pak-Chun
Many of the ophthalmic surgical instruments are extremely fine and sharp. Due to the dim light environment required for ophthalmic surgical procedures, the passing of sharp instruments among surgeons and scrub nurses also poses a risk for glove perforations. A case-control study was performed to determine the number and site of perforations in the surgical gloves used by a group of scrub nurses during ophthalmic surgery. All six nurses working in an eye and refractive surgery centre in Hong Kong participated in the study. A total of 100 (50 pairs) used surgical gloves were collected following 50 ophthalmic surgeries. Fifty pairs of new surgical gloves were also collected. Every collected surgical glove underwent the water leak test. The surgical procedure perforation rate was 8%, and none of the perforations were detected by the scrub nurses. No perforations were found in any unused gloves. The findings indicate that glove perforations for scrub nurses during ophthalmic surgery do occur and mostly go unnoticed. Future studies should continue to explore factors contributing to surgical glove perforation.
Rivera, Rodrigo; Choi, In Sup; Sordo, Juan Gabriel; Giacaman, Pablo; Badilla, Lautaro; Bravo, Eduardo; Echeverria, Daniel
The formation of the ophthalmic artery (OA) is a complex process with two different proposed embryological steps for its development. Several anatomical variants have been described. We present a very unusual origin of the ophthalmic artery from the basilar trunk, in a 45-year-old male with a history of pontine hemorrhagic stroke. MRI and CTA showed evidence of previous hemorrhage in the pons and several intracranial arterial dysplastic dilatations. DSA confirmed several fusiform dilatations of the basilar trunk. In the left ICA, no ophthalmic artery was seen arising from the carotid siphon. The left ophthalmic artery arises from the basilar trunk and runs lateral to the cavernous sinus through the middle cranial fossa, entering the left orbit at the superior orbital fissure. The patient was treated conservatively. Two main theories for this anomaly are known, one from Lasjaunias and the other from Paget. To our knowledge, this basilar origin of the OA has only been described three times in the literature. For its origin, we propose a partial persistence of the trigeminal artery together with a dominance of the dorsal ophthalmic artery.
Shah, Kajal; Naidoo, Kovin; Chagunda, Margarida; Loughman, James
Ophthalmic technicians (OT) work at health facilities in Mozambique and are trained to provide primary and secondary eye care services including basic refraction. This study was designed to assess OT competence and confidence in refraction, and investigate whether an upskilling programme is effective in developing their competence and confidence at refraction. Thirty-one trainee OTs and 16 qualified OTs were recruited to the study. A background questionnaire was administered to determine the demographic profile of the OTs. A confidence levels questionnaire explored their self-reported skills. Clinical competencies were assessed in relation to knowledge (theory exam) and clinical skills (patient exams). 11 OTs were upskilled and the clinical evaluations carried out post training. Initial evaluations demonstrated that confidence and competence levels varied depending on the OTs training (location and duration), and their location of work (clinical load, availability of equipment and other eye care personnel). The qualified OTs were more competent than trainee OTs in most of the evaluations. Post upskilling results demonstrated significant positive impact on confidence and competence levels. These evaluations identified factors affecting the refraction competencies of the OTs and demonstrated that upskilling is effective in improving confidence and competence levels for refraction. They demonstrate the need for a refraction competency framework. The overarching aim of this research was to inform the development of a nationwide programme of OT mentoring, upskilling and leading to the establishment of clinical competency standards for the new OT curricula, relevant to the professional demands. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.
Auffarth, Gerd U; Holzer, Mike P; Vissesook, Nithi; Apple, David J; Völcker, Hans E
To analyze removal techniques for Healon5 (sodium hyaluronate 2.3%). Center for Research on Ocular Therapeutics and Biodevices, Charleston, South Carolina, USA, and Department of Ophthalmology, Ruprecht-Karls-University, Heidelberg, Germany. In a standardized laboratory setup, the Miyake-Apple posterior view video technique in human autopsy eyes was used to evaluate removal of an ophthalmic viscosurgical device (OVD) from capsular bags implanted with poly(methyl methacrylate), silicone, and acrylic intraocular lenses (IOLs). Healon5 was stained with fluorescein for better visualization. Open-sky preparation and an Alcon Legacy Series 20000 phaco machine with a flow rate of 25 mL/minute and a vacuum setting of +500 mm Hg (maximum irrigation/aspiration [I/A]) were used. With Technique 1, the I/A tip was placed on the center of the IOL and maximum aspiration was applied. With Technique 2 (modified rock 'n roll technique), the I/A tip was moved in quick circular movements on top of the IOL to break the OVD chains and facilitate aspiration. With Technique 1, the mean removal time was 59.0 seconds +/- 23.1 (SD) and with Technique 2, 23.6 +/- 10.3 seconds (P =.004). The removal time of Healon5 correlated with the IOL material. With Technique 2, removal was fastest with silicone IOLs (13.5 +/- 2.1 seconds) followed by PMMA IOLs (17.5 +/- 2.1 seconds). With acrylic IOLs, remnants of the OVD trapped behind the IOL optic resulted in a longer removal time of 34.1 +/- 1.2 seconds. Healon5 was completely removed from the capsular bag with the modified rock 'n roll technique. With acrylic IOLs, remnants can be trapped behind the optic and may be overlooked with an unstained OVD. Aspiration behind the optic is recommended with this IOL type.
Zhang, Haohao; Chen, Meiwan; He, Zixin; Wang, Zhouhua; Zhang, Meimei; He, Zhouyang; Wan, Qian; Liang, Dan; Repka, Michael A; Wu, Chuanbin
The aim of the present study was to prepare a stable complex of doxycycline (Doxy) and hydroxypropyl-β-cyclodextrin (HPβCD) for ophthalmic delivery and investigate the inclusion mechanism and the inclusion effects on the stability of Doxy. The Doxy/HPβCD complex was prepared by solution stirring and then characterized by scanning electron microscopy and ultraviolet spectroscopy. Based on results of nuclear magnetic resonance, molecular model of Doxy/HPβCD complex was established using computational simulation of PM3 method implemented in Gaussian 03. Stabilities of Doxy/HPβCD complex in both aqueous solution and solid state at 25°C were evaluated by HPLC. Finally, in vitro antibacterial activity of the Doxy/HPβCD complex was evaluated by disk diffusion test. It was found that the stabilities of Doxy/HPβCD complex in both aqueous solution and solid state were improved obviously as compared with Doxy alone. This stability enhancement is consistent with the inclusion mechanism between HPβCD and Doxy, which showed that the unstable site of Doxy molecule at 6-CH3 was protected in the hydrophobic cavity of HPβCD, additionally, the chelation of Mg2+ provided a synergetic protection of the other unstable site of Doxy at 4-N(CH3)2. The antibacterial activity results indicated that Doxy/HPβCD complex might have potential for clinical applications.
Stewart, William C; Nelson, Lindsay A; Kruft, Bonnie; Stewart, Jeanette A
To identify current challenges facing ophthalmic pharmaceutical start-ups in developing new products. Surveys were distributed to the chief executive officer (CEO) or president of ophthalmic start-ups. The survey attracted 24 responses from 78 surveys distributed (31%). The CEOs stated that a lack of financial capital (n = 18, 75%), FDA regulations (n = 6, 25%), and failure to meet clinical endpoints (n = 6, 25%) were their greatest development hurdles. Risk aversion to medicines in early development (n = 18, 75%), mergers and acquisitions reducing corporate choice for licensing agreements (n = 7, 29%), the emergence of large pharmaceutical-based venture capital funding groups (n = 12, 50%), and the failure of many large pharmaceutical companies to develop their own medicines (n = 10, 42%) were noted as recent prominent trends affecting fundraising. The study suggests that development funding, regulatory burden, and meeting clinical endpoints are the greatest development challenges faced by ophthalmic start-up CEOs. © 2017 S. Karger AG, Basel.
Kojima, Fumiko; Nakagami, Yoshiko; Takemori, Koichi; Iwatani, Yoshinori; Fujimoto, Shuji
Nontypeable (NT) Streptococcus pneumoniae strains isolated from eyes were examined for both penicillin susceptibility by E-test and penicillin-binding protein (PBP) gene alterations using PCR. Of the 25 ophthalmic isolates, 15 proved to be sensitive (PSSP, MIC penicillin (PISP, MIC = 0.1-1 microg/ml). No penicillin-resistant S. pneumoniae (PRSP, MIC > or = 2 microg/ml) were found. PBP gene (pbp1a and pbp2b) alteration PCR indicated that 12 (80.0%) of the 15 ophthalmic PSSPs had unaltered pbp genes and that 3 (20.0%) had alterations in either pbp1a or pbp2b, whereas 8 (80.0%) of the 10 PISPs had unaltered pbp genes and 2 (20.0%) had alterations in both pbp1a and pbp2b. These data suggest that penicillin resistance is spread among NT pneumococci typically associated with ophthalmic infections.
Sears, William R; Francis, Ian C
In this retrospective cohort study, we examined the safety, efficacy, and benefits of utilizing the readily available ophthalmic phacoemulsification instrument for the surgery of seven intramedullary spinal cord tumors. Historically, the conventional neurosurgical ultrasonic aspirator was an adaptation of the original Cavitron Phaco-Emulsifier aspirator used in cataract surgery. The ophthalmic instrument has a 1.0-mm internal diameter operating tip. This is much smaller and provides improved visualization and surgical control when compared with the conventional neurosurgical instrument, which has a tip diameter of 3-4 mm. A satisfactory surgical and clinical outcome was achieved in all seven patients with safe and substantial subtotal excision of their tumors. We found the ophthalmic instrument provided excellent visualization and precision in operating on cases of intramedullary spinal cord tumor.
Michels, Kevin S; Ng, John D; Falardeau, Julie; Roberts, Warren G; Petersen, Bryan; Nesbit, Gary M; Barnwell, Stanley L
A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling.
Koekoek, Clarence G. J.; Meiners, Linda C.; Pott, Jan Willem R.
The aim of the study is to report the frequency of missed diagnoses on magnetic resonance and computerised tomographic imaging in neuro-ophthalmic patients who were referred to an academic ophthalmology department, with apparent normal imaging. The authors included all neuro-ophthalmic patients, ref
Koekoek, Clarence G. J.; Meiners, Linda C.; Pott, Jan Willem R.
The aim of the study is to report the frequency of missed diagnoses on magnetic resonance and computerised tomographic imaging in neuro-ophthalmic patients who were referred to an academic ophthalmology department, with apparent normal imaging. The authors included all neuro-ophthalmic patients,
Full Text Available Andrea Russo, Ivano Riva, Teodoro Pizzolante, Federico Noto, Luciano QuarantaCattedra di Malattie dell’Apparato Visivo, Università degli studi di Brescia, USVD “Centro per lo studio del Glaucoma” Spedali Civili di BresciaAbstract: Latanoprost is a prostaglandin F2-alpha isopropyl ester prodrug which is rapidly hydrolyzed by esterases in the cornea to the biologically active latanoprost acid. When latanoprost is topically administered into the eye, the cornea seems to act like as a slow-release depot to the anterior segment. One hour after administration maximum concentration is found in the iris, followed by the anterior chamber and the ciliary body. Despite extensive research, controversy remains about the real mechanism of action of this drug. Immunohistochemical data have shown that the intraocular pressure (IOP reduction with topical prostaglandin F2-alpha is associated with a reduction of collagens within the uveoscleral outflow pathway. Evidence from several experimental and clinical studies suggests that latanoprost is a valuable addition first-line treatment alternatives for glaucoma, ocular hypertension and even angle-closure glaucoma. Strong points are its efficacy, which is demonstrated to be higher than that of brimonidine, dorzolamide and timolol with fewer systemic adverse effects; a convenient administration schedule; and the IOP-controlling pattern, which is relatively flat compared with timolol and dorzolamide, and enables better control in glaucoma progression, since large fluctuations may be associated with the risk of developing glaucoma in untreated ocular hypertensive subjects.Keywords: latanoprost, intraocular pressure, glaucoma, ocular hypertension
Matsuo, Toshihiko; Gochi, Akira; Hirakawa, Tsuyoshi; Ito, Tadashi; Kohno, Yoshihisa
General electronic medical records systems remain insufficient for ophthalmology outpatient clinics from the viewpoint of dealing with many ophthalmic examinations and images in a large number of patients. Filing systems for documents and images by Yahgee Document View (Yahgee, Inc.) were introduced on the platform of general electronic medical records system (Fujitsu, Inc.). Outpatients flow management system and electronic medical records system for ophthalmology were constructed. All images from ophthalmic appliances were transported to Yahgee Image by the MaxFile gateway system (P4 Medic, Inc.). The flow of outpatients going through examinations such as visual acuity testing were monitored by the list "Ophthalmology Outpatients List" by Yahgee Workflow in addition to the list "Patients Reception List" by Fujitsu. Patients' identification number was scanned with bar code readers attached to ophthalmic appliances. Dual monitors were placed in doctors' rooms to show Fujitsu Medical Records on the left-hand monitor and ophthalmic charts of Yahgee Document on the right-hand monitor. The data of manually-inputted visual acuity, automatically-exported autorefractometry and non-contact tonometry on a new template, MaxFile ED, were again automatically transported to designated boxes on ophthalmic charts of Yahgee Document. Images such as fundus photographs, fluorescein angiograms, optical coherence tomographic and ultrasound scans were viewed by Yahgee Image, and were copy-and-pasted to assigned boxes on the ophthalmic charts. Ordering such as appointments, drug prescription, fees and diagnoses input, central laboratory tests, surgical theater and ward room reservations were placed by functions of the Fujitsu electronic medical records system. The combination of the Fujitsu electronic medical records and Yahgee Document View systems enabled the University Hospital to examine the same number of outpatients as prior to the implementation of the computerized filing system.
Full Text Available Purpose: Cyclosporine (CsA is currently widely used as a primary immunosuppressive agent in ocular disease, particularly in severe uveitis. Posterior reversible encephalopathy syndrome (PRES is a significant complication of CsA therapy. However, there are no reports of the occurrence of PRES in response to the treatment of uveitis in the ophthalmological area. Case Presentation: We report a case with CsA-associated PRES. A 70-year-old woman with sympathetic ophthalmitis was treated with 50 mg/day of CsA for 1 week. However, the trough level in her blood was too low; thus, we increased the dose to 100 mg/day of CsA with prednisolone. She had headaches, hypertension (systolic blood pressure 180-200 mm Hg, loss of consciousness for several hours, and reduced limb movement, and her MRI showed a high signal intensity in both posterior lobes, consistent with PRES. Examination of the cerebrospinal fluid indicated that it was within normal limits. Her CsA trough level in the blood was within normal ranges on the day of the attack. Her symptoms gradually improved over the next several days; however, she presented with cortical blindness, which lasted for several weeks. Finally, she returned to her baseline values from before the attack. Her MRI findings showed that PRES had essentially disappeared. Conclusion: PRES is not directly associated with the dosage of CsA administered; however, in general, it is well known that PRES can affect strongly immunosuppressed cases undergoing organ and bone marrow transplantation. Nevertheless, our CsA dose was only 100 mg (1.8 mg/kg. In this study, we report on the occurrence of PRES after the administration of CsA to treat sympathetic ophthalmia. To our knowledge, PRES can also occur after the administration of a small dose of CsA; thus, ophthalmologists using CsA should carefully observe the systemic conditions of CsA-treated patients.
Full Text Available Takuya Shiba, Hiroshi TsuneokaDepartment of Ophthalmology, Jikei University School of Medicine, Tokyo, JapanPurpose: To examine the influence of the configuration of prefilled syringes on the usability of ophthalmic viscosurgical devices (OVDs.Setting: Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan.Design: Experimental study.Methods: The maximum force needed to extrude the whole OVD (extrusion force was compared among viscous cohesive OVDs (OPEGAN Hi® 0.85 mL and Healon® 0.85 mL and very low viscosity dispersive OVDs (OPEGAN® 0.6 mL and OPEGAN® 1.1 mL. Additionally, to exclude the influence of any differences between syringes of viscous cohesive OVDs on the extrusion force, empty syringes of the same configuration were refilled with the same products. In addition, the syringe inner surface and that of the piston attached to the tip of the plunger were measured.Results: The extrusion force of Healon 0.85 mL (3.28±0.19 kgf was significantly (P<0.01 higher than that of OPEGAN Hi 0.85 mL (2.54±0.23 kgf. The inner syringe chamber for Healon 0.85 mL was vial shaped and had a built-in needle in the Luer tip, which was clearly different from OPEGAN Hi 0.85 mL. There were no significant differences in the extrusion force between refilled syringes. The extrusion force of OPEGAN 1.1 mL (3.44±0.12 kgf was significantly (P<0.01 higher than that of OPEGAN 0.6 mL (1.63±0.06 kgf. The syringe of OPEGAN 1.1 mL was obviously bigger than that of OPEGAN 0.6 mL.Conclusion: It was confirmed that the configuration of the syringes is another determinant of the extrusion force and a factor related to the difference in usability among products that meet the same cohesive class.Keywords: configuration, syringe, extrusion force, viscous cohesive OVDs, low viscosity dispersive OVDs
Malacara, Z; Malacara, D
In this paper the exact shape of the solutions to the equations for lenses free of oblique astigmatism, as well as those free from curvature of field or peripheral focus error, are presented. These solutions, as expected, resemble the Tscherning ellipses, but strongly deformed.
Wang, Liming; Zhang, Kai; Liu, Xiyang; Long, Erping; Jiang, Jiewei; An, Yingying; Zhang, Jia; Liu, Zhenzhen; Lin, Zhuoling; Li, Xiaoyan; Chen, Jingjing; Cao, Qianzhong; Li, Jing; Wu, Xiaohang; Wang, Dongni; Li, Wangting; Lin, Haotian
There are many image classification methods, but it remains unclear which methods are most helpful for analyzing and intelligently identifying ophthalmic images. We select representative slit-lamp images which show the complexity of ocular images as research material to compare image classification algorithms for diagnosing ophthalmic diseases. To facilitate this study, some feature extraction algorithms and classifiers are combined to automatic diagnose pediatric cataract with same dataset and then their performance are compared using multiple criteria. This comparative study reveals the general characteristics of the existing methods for automatic identification of ophthalmic images and provides new insights into the strengths and shortcomings of these methods. The relevant methods (local binary pattern +SVMs, wavelet transformation +SVMs) which achieve an average accuracy of 87% and can be adopted in specific situations to aid doctors in preliminarily disease screening. Furthermore, some methods requiring fewer computational resources and less time could be applied in remote places or mobile devices to assist individuals in understanding the condition of their body. In addition, it would be helpful to accelerate the development of innovative approaches and to apply these methods to assist doctors in diagnosing ophthalmic disease.
Uccello-Barretta, Gloria; Nazzi, Samuele; Balzano, Federica; Sansò, Marco
Mucoadhesive properties of tamarind seed polysaccharide (TSP) and larch arabinogalactan (AG), which are developed for ophthalmic applications, were investigated by NMR spectroscopy. Polysaccharide to mucin affinities were compared by using ketotifen fumarate as low molecular weight interaction probe. Proton selective relaxation rate measurements revealed enhanced affinity of TSP to mucin with respect to AG.
... HUMAN SERVICES Food and Drug Administration 21 CFR Part 886 Medical Devices; Ophthalmic Devices; Classification of the Eyelid Weight AGENCY: Food and Drug Administration, HHS. ACTION: Proposed rule. SUMMARY: The Food and Drug Administration (FDA) is proposing to classify the eyelid weight into class...
Abbey, Ashkan M.; Gregori, Ninel Z.; Surapaneni, Krishna; Miller, Darlene
Purpose While manufacturers recommend cleaning ophthalmic lenses with detergent and water and then a specific disinfectant, disinfectants are rarely used in ophthalmic practices. The aim of this pilot study was to evaluate the efficacy of detergent and water versus bleach, a recommended disinfectant, to eliminate common ocular bacteria and viruses from ophthalmic lenses. Methods Three bacterial strains (Staphylococcus epidermidis, Corynebacterium straitum, and methicillin-resistant Staphylococcus aureus (MRSA) and two viral strains (adenovirus and herpes simplex virus (HSV) type-1) were individually inoculated to 20 gonioscopy and laser lenses. Lenses were washed with detergent and water and then disinfected with 10% bleach. All lenses were cultured after inoculation, after detergent and water, and after the bleach. Bacterial cultures in thioglycollate broth were observed for 3 weeks and viral cultures for 2 weeks. The presence of viruses was also detected by multiplex polymerase chain reaction (PCR). Results All 20 lenses inoculated with Staphylococcus epidermidis, Corynebacterium straitum, adenovirus, and HSV-1 showed growth after inoculation, but no growth after detergent/water and after the bleach. All lenses showed positive HSV and adenovirus PCR after inoculation and negative PCR after detergent/water and after bleach. All MRSA contaminated lenses showed growth after inoculation and no growth after detergent and water. However, one lens showed positive growth after bleach. Conclusions Cleaning with detergent and water appeared to effectively eliminate bacteria and viruses from the surface of contaminated ophthalmic lenses. Further studies are warranted to design practical disinfection protocols that minimize lens damage. PMID:24747806
Hutchens, Thomas C.; Darafsheh, Arash; Fardad, Amir; Antoszyk, Andrew N.; Ying, Howard S.; Astratov, Vasily N.; Fried, Nathaniel M.
Ophthalmic surgery may benefit from use of more precise fiber delivery systems during laser surgery. Some current ophthalmic surgical techniques rely on tedious mechanical dissection of tissue layers. In this study, chains of sapphire microspheres integrated into a hollow waveguide distal tip are used for erbium:YAG laser ablation studies in contact mode with ophthalmic tissues, ex vivo. The laser's short optical penetration depth combined with the small spot diameters achieved with this fiber probe may provide more precise tissue removal. One-, three-, and five-microsphere chain structures were characterized, resulting in FWHM diameters of 67, 32, and 30 μm in air, respectively, with beam profiles comparable to simulations. Single Er:YAG pulses of 0.1 mJ and 75-μs duration produced ablation craters with average diameters of 44, 30, and 17 μm and depths of 26, 10, and 8 μm, for one-, three-, and five-sphere structures, respectively. Microsphere chains produced spatial filtering of the multimode Er:YAG laser beam and fiber, providing spot diameters not otherwise available with conventional fiber systems. Because of the extremely shallow treatment depth, compact focused beam, and contact mode operation, this probe may have potential for use in dissecting epiretinal membranes and other ophthalmic tissues without damaging adjacent retinal tissue.
Hutchens, Thomas C; Darafsheh, Arash; Fardad, Amir; Antoszyk, Andrew N; Ying, Howard S; Astratov, Vasily N; Fried, Nathaniel M
Ophthalmic surgery may benefit from use of more precise fiber delivery systems during laser surgery. Some current ophthalmic surgical techniques rely on tedious mechanical dissection of tissue layers. In this study, chains of sapphire microspheres integrated into a hollow waveguide distal tip are used for erbium:YAG laser ablation studies in contact mode with ophthalmic tissues, ex vivo. The laser's short optical penetration depth combined with the small spot diameters achieved with this fiber probe may provide more precise tissue removal. One-, three-, and five-microsphere chain structures were characterized, resulting in FWHM diameters of 67, 32, and 30 μm in air, respectively, with beam profiles comparable to simulations. Single Er:YAG pulses of 0.1 mJ and 75-μs duration produced ablation craters with average diameters of 44, 30, and 17 μm and depths of 26, 10, and 8 μm, for one-, three-, and five-sphere structures, respectively. Microsphere chains produced spatial filtering of the multimode Er:YAG laser beam and fiber, providing spot diameters not otherwise available with conventional fiber systems. Because of the extremely shallow treatment depth, compact focused beam, and contact mode operation, this probe may have potential for use in dissecting epiretinal membranes and other ophthalmic tissues without damaging adjacent retinal tissue.
Guillaumie, Fanny; Furrer, Pascal; Felt-Baeyens, Olivia
This work presents a comparative study of various hyaluronic acids (HA) produced by fermentation of either Bacillus subtilis or Streptococcus towards the selection of an optimal molecular weight (MW) HA for the preparation of topical ophthalmic formulations. The influence of HA MW on water bindin...
Gause, Samuel; Hsu, Kuan-Hui; Shafor, Chancellor; Dixon, Phillip; Powell, Kristin Conrad; Chauhan, Anuj
Ophthalmic drug for the anterior chamber diseases are delivered into tears by either eye drops or by extended release devices placed in the eyes. The instilled drug exits the eye through various routes including tear drainage into the nose through the canaliculi and transport across various ocular membranes. Understanding the mechanisms relevant to each route can be useful in predicting the dependency of ocular bioavailability on various formulation parameters, such as drug concentration, salinity, viscosity, etc. Mathematical modeling has been developed for each of the routes and validated by comparison with experiments. The individual models can be combined into a system model to predict the fraction of the instilled drug that reaches the target. This review summarizes the individual models for the transport of drugs across the cornea and conjunctiva and the canaliculi tear drainage. It also summarizes the combined tear dynamics model that can predict the ocular bioavailability of drugs instilled as eye drops. The predictions from the individual models and the combined model are in good agreement with experimental data. Both experiments and models predict that the corneal bioavailability for drugs delivered through eye drops is less than 5% due to the small area of the cornea in comparison to the conjunctiva, and the rapid clearance of the instilled solution by tear drainage. A contact lens is a natural choice for delivering drugs to the cornea due to the placement of the contact in the immediate vicinity of the cornea. The drug released by the contact towards the cornea surface is trapped in the post lens tear film for extended duration of at least 30min allowing transport of a large portion into the cornea. The model predictions backed by in vivo animal and clinical data show that the bioavailability increases to about 50% with contact lenses. This realization has encouraged considerable research towards delivering ocular drugs by contact lenses. Commercial
Zhang, Haohao; Chen, Meiwan; He, Zixin; Wang, Zhouhua; Zhang, Meimei; He, Zhouyang; Wan, Qian; Liang, Dan; Repka, Michael A; Wu, Chuanbin
The aim of the present study was to prepare a stable complex of doxycycline (Doxy) and hydroxypropyl-β-cyclodextrin (HPβCD) for ophthalmic delivery and investigate the inclusion mechanism and the inclusion effects on the stability of Doxy...
Dutot, Mélody; Vincent, Jacques; Martin-Brisac, Nicolas; Fabre, Isabelle; Grasmick, Christine; Rat, Patrice
Contact lens care solutions are known to have toxic effects on the ocular surface. The ISO 10993-5 standard describes test methods to assess the cytotoxicity of medical devices, but it needs some improvements to discriminate contact lens care multipurpose solutions. First we evaluated the biological hazards associated with the use of ophthalmic solutions, running a collaborative study with the French medical agency to propose adapted tools to study contact lens care solutions' ocular cytotoxicity (human cell line, short incubation times, and no dilution of solutions to test). Then we took into account the potential risk of these ophthalmic solutions adsorbed on contact lenses and released on the ocular surface, highlighting the addition of a rinse step with unpreserved marine solution in the contact lens cleaning procedure to avoid side effects of contact lens care solutions.
Dornbos, David; Pillai, Promod; Sauvageau, Eric
Small ruptured aneurysms present a unique problem to endovascular therapy. We report a case in which a patient presented with subarachnoid hemorrhage and a very small ruptured ophthalmic artery aneurysm, for which endovascular therapy was preferred secondary to severe cardiac comorbidities. Due to the aneurysm size, a small 1.5 mm coil was needed, but presented a significant risk of migration. Conventional stent assisted coiling was considered suboptimal as the small coil could have easily migrated through the strut. We present a novel technique of flow diverter assisted coil embolization in which a coil was placed within the aneurysm and a pipeline embolization device was then partially deployed, jailing the microcatheter and coil mass. Once in place, the coil was detached, securing the aneurysm, and preventing coil migration. Through the use of a flow diverter, some degree of aneurysm protection would still be expected in the event of coil migration toward the ophthalmic artery origin.
Full Text Available A 47-year-old man presented at the Ophthalmology Department of Saku City Asama General Hospital complaining of hyperemia and pain after industrial sodium hydroxide (approx. 40% concentration had entered his left eye. With an epithelial defect of the bulbar and palpebral conjunctiva, ischemia of the inferior third of the limbal conjunctiva, a total corneal epithelial defect and mild corneal stromal opacity, the damage was determined as Roper-Hall grade III. 2% rebamipide ophthalmic suspension, which is used for dry eye disease, was administered 4 times a day followed by conventional treatment for serious alkali injury. The corneal epithelial defect was resolved, and there were no side effects. The effectiveness of 2% rebamipide ophthalmic suspension in both the repair and improvement of the damage in the conjunctival and corneal epithelia, and its anti-inflammatory effect suggest that it may be an effective treatment not only for dry eye disease but also for alkali ocular damage.
Dewan, Mitali; Bhowmick, Biplab; Sarkar, Gunjan; Rana, Dipak; Bain, Mrinal Kanti; Bhowmik, Manas; Chattopadhyay, Dipankar
The effect of weight average molecular weight (Mw) of methyl cellulose (MC) on the gelation behavior of Poloxamer 407 (PM) and in vitro release of Ketorolac Tromethamine (KT) from different ophthalmic formulations based on PM is examined. A drop of gelation temperature of PM is observed using MC of various M(w) by test tube tilting method, UV-vis spectroscopy, viscometry and rheometry. It is also observed that the viscosity and gel strength of all the formulations are increased with the increase in Mw of MC. PM with highest Mw of MC provides best drug release property among all the formulations. It is evident from this investigation that there is a distinct effect of M(w) of MC on the gelation behavior of PM as well as on the drug release profile of KT from PM-MC based ophthalmic formulations.
Paes, Maria Marta B M; Diniz, Angélica L D
Our aim was to investigate the hemodynamic profile of the ophthalmic artery in preeclamptic women, pregnant smokers and pregnant controls with no known diseases. A prospective cross-sectional study using the performed ophthalmic artery Doppler ultrasonography in 20 mild preeclamptic women and 20 severe preeclamptic women, 37 pregnant smokers and 51 controls. Data evaluated by using Doppler ultrasonography were as follows: resistance index, pulsatility index, peak systolic velocity, end diastolic velocity, second peak systolic velocity and peak ratio. The Doppler results, gestational age, patient age and systolic and diastolic pressure of groups were subjected to analysis of variance (p pregnant smokers showed vasospasm (0.84 ± 0.04, 2.27 ± 0.43, 4.78 ± 1.28, respectively) indicating divergent vascular pattern between these two groups (p changes in pregnant smokers might reduce the number of sudden and catastrophic events in preeclampsia.
Kaulich, Theodor W; Zurheide, Jens; Haug, Thomas; Budach, Wilfried; Nüsslin, Fridtjof; Bamberg, Michael
In radiotherapy of intraocular tumors, e. g., in the case of malign choroid melanomas, episcleral brachytherapy with (106)Ru ophthalmic plaques has proven to be successful. In a study, the authors reported on the discovery of the following shortcomings in industrial quality assurance, which are relevant to therapy, during the course of an internal clinical acceptance test of (106)Ru ophthalmic plaques, manufactured by the company Bebig from Berlin, Germany. This consisted of inconsistent dose rate specifications in the manufacturer's certificate, covering a range of 111% and with the risk of leakage of the plaques. Bebig was called upon to adapt state-of-the-art production methods with regard to (106)Ru ophthalmic plaques. In the meantime, Bebig has modernized production of (106)Ru ophthalmic plaques and adopted all the quality assurance procedures proposed by the authors. Moreover, the requested traceability of the calibration of activity and dose rate of the (106)Ru ophthalmic plaques to standards of the federal authorities in charge of measurement procedures has been implemented. In the year 2002, Bebig updated, among other things, the ASMW (GDR) calibration of the dose rate of the (106)Ru ophthalmic plaques from the years 1987-1989 by a calibration of the NIST (USA). The current NIST calibration, together with the new equipment for the measurement of the depth dose curves, led to the consequence that the new NIST 2001 dose rate values show, in the mean, a deviation of 0.75 times (plaque type CCC) up to 2.06 times (plaque types CCX, CCY, and CCZ) compared to the dose rate values that had been indicated so far in Bebig's certificate, based on the ASMW 1987 calibration. For the 95% confidence interval, Bebig estimated the measurement uncertainty to be +/- 25%. If one takes into consideration the minimal and maximal values in such 95% confidence intervals, it follows that the new NIST 2001 dose rate values deviate between 0.56 times (plaque type CCC) and 2.58 times
Min Ji Kang; Hye Bin Yim; Hyung Bin Hwang
We report two cases of myotonic dystrophy in one family; both diagnosed from genetic analysis following ophthalmic indications, but before the manifestation of systemic symptoms. A 39-year-old female visited our clinic for routine examination. Mild ptosis, sluggish pupillary response, and bilateral snowflake cataracts were found. Fundus examination revealed an increased cup-to-disc ratio (CDR) in both eyes and a defect in the retinal nerve fiber layer in the right eye. Intraocular pressure wa...
Karlica, Dobrila; Skelin, Siniša; Culic, Vida; Galetović, Davor; Znaor, Ljubo; Karlica, Hana; Pavelić, Jasminka
Our aim was to present the ophthalmic anomalies in patients with Down syndrome in Split-Dalmatia County born from 1992 until 2009 year. It was a cross-sectional study. 153 children with Down syndrome aged 0–18 years from the Split-Dalmatia County were examined. One hundred twelve participants were borne in Split,13 in Vrgorac,16 in Makarska, 12 in Sinj. All enrolled children underwent a complete ophthalmological examination (anterior segment, ocular motility, refractive status, fu...
Mali, Mahesh N.; Ashok A. Hajare
Rapid precorneal elimination of drug is a major limitation of conventional ophthalmic formulations. An ion activated in situ gel forming systems of an antibacterial agent moxifloxacin hydrochloride for instillation as drops into eye undergoing a sol to gel transition in the cul-de-sac was formulated. Sodium alginate was used as the gelling agent in combination with hydroxypropylmethyl cellulose. Formulations were evaluated for gelling capacity, pH, in vitro release, rheological study, Draize ...
Costa, Márcia C N; Barden, Amanda T; Andrade, Juliana M M; Oppe, Tércio P; Schapoval, Elfrides E S
Besifloxacin (BSF) is a synthetic chiral fluoroquinolone developed for the topical treatment of ophthalmic infections. The present study reports the development and validation of a microbiological assay, applying the cylinder-plate method, for determination of BSF in ophthalmic suspension. To assess this methodology, the development and validation of the method was performed for the quantification of BSF by high performance liquid chromatography (HPLC). The HPLC method showed specificity, linearity in the range of 20-80 µg mL(-1) (r=0.9998), precision, accuracy and robustness. The microbiological method is based on the inhibitory effect of BSF upon the strain of Staphylococcus epidermidis ATCC 12228 used as a test microorganism. The bioassay validation method yielded excellent results and included linearity, precision, accuracy, robustness and selectivity. The assay results were treated statistically by analysis of variance (ANOVA) and were found to be linear (r=0.9974) in the range of 0.5-2.0 µg mL(-1), precise (inter-assay: RSD=0.84), accurate (101.4%), specific and robust. The bioassay and the previously validated high performance liquid chromatographic (HPLC) method were compared using Student's t test, which indicated that there was no statistically significant difference between these two methods. These results confirm that the proposed microbiological method can be used as routine analysis for the quantitative determination of BSF in an ophthalmic suspension. A preliminary stability study during the HPLC validation was performed and demonstrated that BSF is unstable under UV conditions. The photodegradation kinetics of BSF in water showed a first-order reaction for the drug product (ophthalmic suspension) and a second-order reaction for the reference standard (RS) under UVA light. UVA degraded samples of BSF were also studied in order to determine the preliminary in vitro cytotoxicity against mononuclear cells. The results indicated that BSF does not alter
Full Text Available Complex cavernous sinus fistulae (CCF are still a technical challenge to neurovascular team. The most commonly performed treatment consists in endovascular embolization of the lesion through an arterial or venous approach. Not always these conventional routes are feasible, requiring alternative routes. We report a case of a 44-year-old woman with a complex indirect (Barrow D carotid cavernous sinus fistula treated by two interventional sessions that imposing a retrograde direct transvenous approach via the superior ophthalmic vein.
McKenzie, Barbara; Kay, Graeme; Matthews, Kerr H; Knott, Rachel M; Cairns, Donald
A modified hen's egg chorioallantoic membrane (HET-CAM) test has been developed, combining ImageJ analysis with Adobe(®) Photoshop(®). The irritation potential of an ophthalmic medicine can be quantified using this method, by monitoring damage to blood vessels. The evaluation of cysteamine containing hyaluronate gel is reported. The results demonstrated that the novel gel formulation is non-irritant to the ocular tissues, in line with saline solution (negative control). In conclusion, the modification of the established HET-CAM test can quantify the damage to minute blood vessels. These results offer the possibility to formulate cysteamine in an ocular applicable gel formulation.
Kang, Min-Hee; Chae, Min-Joo; Yoon, Jang-Won; Kim, Seung-Gon; Lee, So-Young; Yoo, Jong-Hyun; Park, Hee-Myung
The prevalence, virulence potential, and antibiotic resistance of ophthalmic Staphylococcus pseudintermedius (SP) isolated from dogs were examined. Sixty-seven Staphylococcus species were isolated from ophthalmic samples and surveyed for species-specific sequences in the Staphylococcus intermedius group (SIG) nuclease gene (SInuc), exfoliative toxin gene for SIG (siet), and antibiotic resistance genes (blaZ and mecA). PCR-restriction fragment length polymorphism analysis of the pta gene was also performed. Fifty isolates were identified as SIG strains, all of which were found to be SP. The blaZ gene was detected in 42 of the 50 SP strains and mecA gene was observed in 18 of the 50 SP strains. The 50 SP strains were most susceptible to amoxicillin/clavulanic acid (94%) and chlorampenicol (70%), and highly resistant to tetracycline (94%) and penicillin (92%). It was also found that 16 (88.9%) mecA-positive SP strains were resistant to oxacillin, tetracycline and penicillin. All mecA-positive SP were resistant to more than four of the eight tested antibiotics and therefore considered SP with multi-drug resistance (MDR). Our results indicate a high prevalence of antibiotic resistance genes in ophthalmic SP along with a close relationship between MDR SP strains and the mecA gene. Based on our findings, judicious administration of antibiotics to companion dogs is necessary.
Manicam, Caroline; Staubitz, Julia; Brochhausen, Christoph; Grus, Franz H; Pfeiffer, Norbert; Gericke, Adrian
Cholinergic regulation of arterial luminal diameter involves intricate network of intercellular communication between the endothelial and smooth muscle cells that is highly dependent on the molecular mediators released by the endothelium. Albeit the well-recognized contribution of nitric oxide (NO) towards vasodilation, the identity of compensatory mechanisms that maintain vasomotor tone when NO synthesis is deranged remain largely unknown in the ophthalmic artery. This is the first study to identify the vasodilatory signalling mechanisms of the ophthalmic artery employing wild type mice. Acetylcholine (ACh)-induced vasodilation was only partially attenuated when NO synthesis was inhibited. Intriguingly, the combined blocking of cytochrome P450 oxygenase (CYP450) and lipoxygenase (LOX), as well as CYP450 and gap junctions, abolished vasodilation; demonstrating that the key compensatory mechanisms comprise arachidonic acid metabolites which, work in concert with gap junctions for downstream signal transmission. Furthermore, the voltage-gated potassium ion channel, Kv1.6, was functionally relevant in mediating vasodilation. Its localization was found exclusively in the smooth muscle. In conclusion, ACh-induced vasodilation of mouse ophthalmic artery is mediated in part by NO and predominantly via arachidonic acid metabolites, with active involvement of gap junctions. Particularly, the Kv1.6 channel represents an attractive therapeutic target in ophthalmopathologies when NO synthesis is compromised.
Full Text Available Needle segmentation is a fundamental step for needle reconstruction and image-guided surgery. Although there has been success stories in needle segmentation for non-microsurgeries, the methods cannot be directly extended to ophthalmic surgery due to the challenges bounded to required spatial resolution. As the ophthalmic surgery is performed by finer and smaller surgical instruments in micro-structural anatomies, specifically in retinal domains, difficulties are raised for delicate operation and sensitive perception. To address these challenges, in this paper we investigate needle segmentation in ophthalmic operation on 60 Optical Coherence Tomography (OCT cubes captured during needle injection surgeries on ex-vivo pig eyes. Furthermore, we developed two different approaches, a conventional method based on morphological features (MF and a specifically designed full convolution neural networks (FCN method, moreover, we evaluate them on the benchmark for needle segmentation in the volumetric OCT images. The experimental results show that FCN method has a better segmentation performance based on four evaluation metrics while MF method has a short inference time, which provides valuable reference for future works.
Camara, Jorge G; Ruszkowski, Joseph M; Worak, Sandra R
Music and surgery. To determine the effect of live classical piano music on vital signs of patients undergoing ophthalmic surgery. Retrospective case series. 203 patients who underwent various ophthalmologic procedures in a period during which a piano was present in the operating room of St. Francis Medical Center. [Note: St. Francis Medical Center has recently been renamed Hawaii Medical Center East.] Demographic data, surgical procedures, and the vital signs of 203 patients who underwent ophthalmic procedures were obtained from patient records. Blood pressure, heart rate, and respiratory rate measured in the preoperative holding area were compared with the same parameters taken in the operating room, with and without exposure to live piano music. A paired t-test was used for statistical analysis. Mean arterial pressure, heart rate, and respiratory rate. 115 patients who were exposed to live piano music showed a statistically significant decrease in mean arterial blood pressure, heart rate, and respiratory rate in the operating room compared with their vital signs measured in the preoperative holding area (P piano music showed a statistically significant increase in mean arterial blood pressure (P piano music lowered the blood pressure, heart rate, and respiratory rate in patients undergoing ophthalmic surgery.
Ueda, Kaori; Matsumiya, Wataru; Otsuka, Keiko; Maeda, Yoshifumi; Nagai, Takayuki; Nakamura, Makoto
Rebamipide with mucin secretagogue activity was recently approved for the treatment of dry eye. The efficacy and safety in the treatment of rebamipide were shown in two pivotal clinical trials. It was the aim of this study to evaluate the effect of 2% rebamipide ophthalmic suspension in patients with dry eye and analyze relevant factors for favorable effects of rebamipide in clinical practice. This was a retrospective cohort study of 48 eyes from 24 patients with dry eye treated with 2% rebamipide ophthalmic suspension. Dry eye-related symptom score, tear film break-up time (TBUT), fluorescein ocular surface staining score (FOS) and the Schirmer test were used to collect the data from patients at baseline, and at 2, 4, 8, and 12 week visits. To determine the relevant factors, multiple regression analyses were then performed. Mean dry eye-related symptom score showed a significant improvement from the baseline (14.5 points) at 2, 4, 8 and 12 weeks (9.80, 7.04, 7.04 and 7.83 points, corrected P value rebamipide ophthalmic suspension was an effective therapy for dry eye patients. Moreover the fluorescein conjunctiva staining score and dry eye-related symptom score might be good relevant factors for favorable effects of rebamipide.
Igarashi, Akihito; Kamiya, Kazutaka; Kobashi, Hidenaga; Shimizu, Kimiya
To assess the changes in intraocular scattering before and after instillation of rebamipide ophthalmic suspension in patients with dry eye after corneal refractive surgery. This study enrolled 60 eyes of 30 dry eye patients undergoing corneal refractive surgery. Patients were randomly assigned to start topical administration of rebamipide ophthalmic suspension (rebamipide group) or artificial tears (control group) 4 times daily for 4 weeks. Tear secretion, tear break-up time (TBUT), and the fluorescein score were measured before and after treatment. Intraocular light scattering was also measured as the objective scattering index (OSI) at 0.5-second intervals over 10 seconds. In the rebamipide group, the Schirmer I test, TBUT, and fluorescein score improved significantly, from 11.4 ± 9.0 mm, 2.2 ± 0.7 seconds, and 4.3 ± 1.3 to 14.9 ± 7.4 mm, 4.5 ± 1.7 seconds, and 1.9 ± 1.0, respectively (P = 0.006, P Rebamipide ophthalmic suspension was effective for improving both ocular surface parameters and optical quality in patients with dry eye undergoing corneal refractive surgery, suggesting that it may hold promise for the treatment of such patients.
Hutchens, Thomas C.; Darafsheh, Arash; Fardad, Amir; Antoszyk, Andrew N.; Ying, Howard S.; Astratov, Vasily N.; Fried, Nathaniel M.
Ophthalmic surgery may benefit from the use of more precise fiber delivery systems for laser surgery. In this study, chains of sapphire microspheres integrated into the distal tip of a hollow waveguide are used for preliminary mid-infrared, Erbium:YAG laser ablation studies in contact mode with ophthalmic tissues, ex vivo. The combination of the Er:YAG laser's short optical penetration depth and small spot diameters achieved with this novel fiber probe may provide more precise tissue removal. One, three, and five microsphere chain structures were assembled and compared, resulting in spot diameters of 67, 32, and 30 μm, respectively. Single laser pulses of 0.1 mJ energy and 75 μs duration produced craters with average widths of 44, 30, and 17 μm and depths of 26, 10, and 8 μm, for one, three, and five sphere structures, respectively. Chains of microspheres produced spatial filtering of the multimode Er:YAG laser beam and fiber, thus providing spot diameters not otherwise available for precise tissue ablation using conventional fiber delivery systems. With further probe development, this novel approach to mid-IR laser ablation may provide an alternative to mechanical tools for ultra-precise surgical dissection and removal of ophthalmic tissues.
Leffler, Christopher T; Schwartz, Stephen G; Davenport, Byrd; Randolph, Jessica; Busscher, Joshua; Hadi, Tamer
Three English ophthalmic texts of the 1580s were frequently republished: 1) Walter Bailey's A Briefe Treatise Touching the Preseruation of the Eie Sight, 2) The Method of Phisicke, an adaptation of the medieval treatise of Benevenutus Grassus, and 3) A Worthy Treatise of the Eyes, a translation of Jacques Guillemeau's treatise. Their history is intertwined through composite publications, some of which lacked clear attribution. At least 21 editions incorporated these texts. Although not previously realized, major elements of all 3 works are found in Two Treatises Concerning the Preseruation of Eie-sight, first published in 1616. To preserve eyesight, Bailey recommended eyebright (Euphrasia officinalis), fennel (Fæniculum vulgare), and a moderate lifestyle incorporating wine. In the works of Grassus and Guillemeau, cataracts were believed to lie anterior to the 'crystalline humor,' and were treated by the 'art of the needle,' or couching. Links are found between Grassus, Guillemeau, and eighteenth century glaucoma concepts. Although one of his students has traditionally received credit, it was English oculist John Thomas Woolhouse who first combined the early concepts and used the term glaucoma to describe the palpably hard eye in the early eighteenth century. The three primary ophthalmic texts of 1580s England influenced ophthalmic thought for over a century.
Xu, Xiaoming; Al-Ghabeish, Manar; Rahman, Ziyaur; Krishnaiah, Yellela S R; Yerlikaya, Firat; Yang, Yang; Manda, Prashanth; Hunt, Robert L; Khan, Mansoor A
Owing to its unique anatomical and physiological functions, ocular surface presents special challenges for both design and performance evaluation of the ophthalmic ointment drug products formulated with a variety of bases. The current investigation was carried out to understand and identify the appropriate in vitro methods suitable for quality and performance evaluation of ophthalmic ointment, and to study the effect of formulation and process variables on its critical quality attributes (CQA). The evaluated critical formulation variables include API initial size, drug percentage, and mineral oil percentage while the critical process parameters include mixing rate, temperature, time and cooling rate. The investigated quality and performance attributes include drug assay, content uniformity, API particle size in ointment, rheological characteristics, in vitro drug release and in vitro transcorneal drug permeation. Using design of experiments (DoE) as well as a novel principle component analysis approach, five of the quality and performance attributes (API particle size, storage modulus of ointment, high shear viscosity of ointment, in vitro drug release constant and in vitro transcorneal drug permeation rate constant) were found to be highly influenced by the formulation, in particular the strength of API, and to a lesser degree by processing variables. Correlating the ocular physiology with the physicochemical characteristics of acyclovir ophthalmic ointment suggested that in vitro quality metrics could be a valuable predictor of its in vivo performance. Published by Elsevier B.V.
Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Lieske, P Alexander
Although the patient value gain (improvement in quality-of-life and/or length-of-life) has been highlighted in Value-based Medicine cost-utility analyses, the financial value gain associated with healthcare interventions has received less emphasis. It is important for professional healthcare providers to realize their interventions often confer a large financial return-on-investment (ROI) to society. The societal costs associated with vitreoretinal and other ophthalmic interventions include: direct ophthalmic medical costs expended (hospital, physician, drug, diagnostic testing and so forth), direct medical costs saved (decreased costs for depression, injury, skilled nursing facility, nursing home and others), direct nonmedical costs saved (decreased costs for caregivers, transportation, residence costs, moving costs, and others), and indirect medical costs saved (improving employment incidence and wages). The financial ROI for direct ophthalmic medical costs expended for ranibizumab therapy for neovascular age-related macular degeneration is 450%, whereas that for cataract surgery is 4500% and for medical open-angle glaucoma therapy is 4000%. Many costs gained add to the Gross Domestic Product and increase the wealth of the nation. Many vitreoretinal and other ophthalmologic interventions confer considerable patient value, but also result in a large financial ROI to society. This financial ROI increases the wealth of the nation.
Full Text Available Richard Busayo Olatunji,1 Ademola Joseph Adekanmi,1 Millicent Olubunmi Obajimi,1 Olumuyiwa Adebola Roberts,2 Temitope Olumuyiwa Ojo3 1Department of Radiology, 2Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, 3Department of Community Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria Background: Pre-eclampsia (PE poses a serious challenge to maternal and fetal health in Africa. It is associated with hemodynamic changes that may affect the internal carotid/ophthalmic artery circulation with consequent neuro-ophthalmic manifestations. Ophthalmic artery Doppler (OAD ultrasound is an important tool that can be used to detect hemodynamic changes in PE and monitor its severity. In this study, we evaluated hemodynamic changes on OAD ultrasound in the ophthalmic arteries of pre-eclamptic women and compared these with values in healthy pregnant women. Methods: OAD parameters, such as, peak systolic velocity, peak diastolic velocity, end diastolic velocity, pulsatility index, and peak ratio, were measured on transorbital triplex ultrasound scan with a 7–10 MHz multifrequency linear transducer in 42 consenting pre-eclamptic patients and 41 pregnant controls matched for maternal age, gestational age, and parity at the Department of Radiology, University College Hospital, Ibadan. Univariate, bivariate, and receiver operating characteristic curve data analyses were performed. P<0.05 was considered to be statistically significant. Results: Mean resistivity index, pulsatility index, and peak systolic velocity were significantly lower in pre-eclamptic patients than in the controls. Mean peak diastolic velocity, end diastolic velocity, and peak ratio were significantly higher in the pre-eclamptic group. The receiver operating characteristic curve showed that the resistivity index (sensitivity 75%, specificity 77.8% could distinguish mild from severe PE while the peak ratio
Full Text Available Chloramphenicol eye drops are commonly prescribed in concentrations of 0.5-1% in the treatment of infectious conjunctivitis. In terms of ophthalmic solution preparation, the major disadvantage of chloramphenicol consists in its low solubility in water. The solubility is increased by substances that form chloramphenicol-complexes, for example: boric acid/borax or cyclodextrins. Objective: Experimental studies aimed to evaluate the potential advantages of enhancing the solubility and stability of chloramphenicol (API by molecular encapsulation in b-cyclodextrin (CD, in formulation of ophthalmic solutions buffered with boric acid/borax system. Methods and Results: We prepared four APIb- CD complexes, using two methods (kneading and co-precipitation and two molar ratio of API/b-cyclodextrin (1:1 and 1:2. The formation of complexes was proved by differential scanning calorimetry (DSC and the in vitro dissolution tests. Using these compounds, we prepared eight ophthalmic solutions, formulated in two variants of chloramphenicol concentrations (0.4% and 0.5%. Each solution was analyzed, by the official methods, at preparation and periodically during three months of storing in different temperature conditions (4°C, 20°C and 30°C. Conclusions: Inclusion of chloramphenicol in b-cyclodextrin only partially solves the difficulties due to the low solubility of chloramphenicol. The protection of chloramphenicol molecules is not completely ensured when the ophthalmic solutions are buffered with the boric acid/borax system.
Tataru, G; Popa, M; Costin, D; Desbrieres, J
Sodium salt of carboxymethylcellulose/poly(vinyl alcohol) particles suitable for application in ocular drug administration were prepared by crosslinking with epichlorohydrin in an alkaline medium, in reverse emulsion. The influence of parameters related with the particles elaboration process (ratio between polymer mixture and crosslinking agent, concentration of polymer solution, duration of crosslinking reaction, stirring intensity, etc.) based on their composition, size, and swelling ability was studied. Obtained microparticles fulfill the requirements for biomaterials-they are formed from biocompatible polymers; the acute toxicity value (LD(50)) is high enough to consider these materials as weakly toxic (hence able to introduce within the organism); they are able to include and release drugs in a controlled way. The in vivo adrenalin ocular delivery from the microparticles was tested on voluntary human patient. The particles showed good adhesion properties without irritation to the patient and proved the capability to treat the ocular congestion. Copyright © 2012 Wiley Periodicals, Inc.
Ahuja, Munish; Dhake, Avinash S; Sharma, Surendera K; Majumdar, Dipak K
In this study, diclofenac-loaded Eudragit S100-based nanosuspension was prepared by nanoprecipitation method and characterised for particle size, morphology, in vitro release, and for its in vivo ocular anti-inflammatory activity. The diclofenac-loaded Eudragit S100 nanosuspension was found to have a particle size of 172 nm, polydispersibility index of 0.14 and zeta potential of -23.7 +/- 6.07 mV, indicating that the nanosuspension is fairly stable. The nanosuspended particles were found to be spherical in shape. The nanosuspension was found to provide a sustained in vitro release, following the Higuchi square-root release kinetics. The results indicated that the nanosuspension released the drug by combination of dissolution and diffusion. The in vivo evaluation of nanosuspension in PGE(2)-induced ocular inflammation in rabbit model revealed a significantly (p < 0.05) higher inhibition of PGE(2)-induced polymorphonuclear leukocytes migration and lid-closure scores as compared with the aqueous solution of diclofenac.
Sheil, Conor; Goncharov, Alexander V.
A physical model eye was constructed to test the quality of ophthalmic instruments. The accuracy and precision of two commercially available instruments were analysed. For these instruments, a particular model eye was obtained which mimicked the physical properties that would be usually measured e.g. corneal topography or optical path within the human eye. The model eye was designed using relatively simple optical components (e.g. plano-convex lenses) separated by appropriate intraocular distances taken from the literature. The dimensions of the model eye were known a priori: The lenses used in the construction of the model eye were characterised ac cording to values given in the manufacturers' data sheets and also through measurement using an interferometer. The distances between the lens surfaces were calculated using the interferometric data with reverse ray-tracing. Optical paths were calculated as the product of refractive index and axial distance. The errors inherent in mea suring these ocular parameters by different ophthalmic instruments can be considered as producing an erroneous value for the overall refractive power of the eye. The latter is a useful metric for comparing various ophthalmic devices where the direct comparison of quality is not possible or is not practical. For example, a 1% error in anterior corneal radius of curvature will have a more detrimental effect than the same error in posterior corneal radius, due to the relative differences in refractive indices at those surface boundaries. To quantify the error in ocular refractive power, a generic eye model was created in ZEMAX optical design software. The parametric errors were then used to compute the overall error in predicting ocular refractive power, thus highlighting the relative importance of individual errors. This work will help in future determination of acceptable levels of metrological errors in ocular instrumentation.
Kapoor, Yash; Thomas, Justin C; Tan, Grace; John, Vijay T; Chauhan, Anuj
Eye drops are inefficient means of delivering ophthalmic drugs because of limited bioavailability and these can cause significant side effects due to systemic uptake of the drug. The bioavailability for ophthalmic drugs can be increased significantly by using contact lenses. This study focuses on the development of surfactant-laden poly-hydroxy ethyl methacrylate (p-HEMA) contact lenses that can release Cyclosporine A (CyA) at a controlled rate for extended periods of time. We focus on various Brij surfactants to investigate the effects of chain length and the presence of an unsaturated group on the drug release dynamics and partitioning inside the surfactant domains inside the gel. The gels were imaged by cryogenic scanning electron microscopy (cryo-SEM) to obtain direct evidence of the presence of surfactant aggregates in the gel, and to investigate the detailed microstructure for different surfactants. The images show a distribution of nano pores inside the surfactant-laden hydrogels which we speculate are regions of surfactant aggregates, possibly vesicles that have a high affinity for the hydrophobic drug molecule. The gels are further characterized by studying their mechanical and physical properties such as transparency, surface contact angle and equilibrium water content to determine their suitability as extended wear contact lenses. Results show that Brij surfactant-laden p-HEMA gels provide extended release of CyA, and possess suitable mechanical and optical properties for contact lens applications. The gels are not as effective for extended release of two other hydrophobic ophthalmic drugs, dexamethasone (DMS) and dexamethasone 21 acetate (DMSA) because of insufficient partitioning inside the surfactant aggregates.
Jenke, Dennis; Egert, Thomas; Hendricker, Alan; Castner, James; Feinberg, Thomas; Houston, Christopher; Hunt, Desmond; Lynch, Michael; Nicholas, Kumudini; Norwood, Daniel L; Paskiet, Diane; Ruberto, Michael; Smith, Edward J; Holcomb, Frank
A simulating leaching (migration) study was performed on a model container-closure system relevant to parenteral and ophthalmic drug products (PODP). This container-closure system consisted of a linear-low density polyethylene bottle (primary container), a polypropylene cap and an elastomeric cap liner (closure), an adhesive label (labeling) and a foil overpouch (secondary container). The bottles were filled with simulating solvents (aqueous salt/acid mixture at pH 2.5, aqueous buffer at pH 9.5, and 1/1(v/v) IPA/water), a label was affixed to the filled and capped bottles, the filled bottles were placed into the foil overpouch and the filled and pouched units were stored either upright or inverted for up to 6 months at 40°C. After storage, the leaching solutions were tested for leached substances using multiple complementary analytical techniques to address volatile, semi-volatile, and non-volatile organic and inorganic extractables as potential leachables. The leaching data generated supported several conclusions, including that (a) the extractables (leachables) profile revealed by a simulating leaching study can qualitatively be correlated with compositional information for materials of construction, (b) the chemical nature of both the extracting medium and the individual extractables (leachables) can markedly affect the resulting profile and (c) while direct contact between a drug product and a system's material of construction may exacerbate the leaching of substances from that material by the drug product, direct contact is not a prerequisite for migration and leaching to occur.
Richer, S P; Little, A C; Adams, A J
The majority of ophthalmic filters, whether they be in the form of spectacles or contact lenses, are absorbance type filters. Although color vision researchers routinely provide spectrophotometric transmission profiles of filters, filter thickness is rarely specified. In this paper, colorimetric tools and volume color theory are used to show that the color of a filter as well as its physical properties are altered dramatically by changes in thickness. The effect of changes in X-Chrom filter thickness on predicted monocular dichromatic luminance and chromaticity discrimination is presented.
Sílvia Regina Ferreira Gonçalves Pereira
Full Text Available Two different procedures for inoculation of HSV on corneas of BALB/c mice were evaluated. The first was by the use of HSV suspensions directly on the corneas and the other was after corneal scarification. Animals by this later method presented greater morbidity and mortality than those of first group, suggesting that inoculation of HSV without scarification of the cornea should be the method of choice for the study of HSV ophthalmic infection. This model showed also be an efficient experimental system to testing antiviral drugs.
Demirtas, Nihat; Kazancioglu, Hakki Oguz; Ezirganli, Seref
Ectopic teeth erupt into regions other than the natural position or should be impacted in unusual location. Etiology of these teeth includes trauma, infection, and developmental diseases; however, in many cases, it is idiopathic. In addition, dentigerous cysts that are related with ectopic teeth may also affect adjacent anatomic regions. The occurrence of ophthalmic complications related with ectopic teeth is a rare situation. In this article, we aimed to present a patient who had a blurred vision thought that resulted from the dentigerous cyst associated with the ectopic third molar in the maxillary sinus roof.
This paper provides an empirical test of the theory of strategic regulatory entry deterrence--the theory that subgroups of firms within an industry will use the regulatory process to increase rivals' costs and thereby deter rivals' entry. The results suggest that the commercial practice restrictions present in the ophthalmic industry deterred chain optical firms' entry into the market. This result in combination with earlier findings that the restrictions increase optometrists' prices suggests that cost-raising strategies can be used to disadvantage rivals or drive them out of the market without the need to lower price.
Sílvia Regina Ferreira Gonçalves Pereira
Full Text Available Two different procedures for inoculation of HSV on corneas of BALB/c mice were evaluated. The first was by the use of HSV suspensions directly on the corneas and the other was after corneal scarification. Animals by this later method presented greater morbidity and mortality than those of first group, suggesting that inoculation of HSV without scarification of the cornea should be the method of choice for the study of HSV ophthalmic infection. This model showed also be an efficient experimental system to testing antiviral drugs.
De Morais Mendonca Teles, Antonio; Gonçalves, Cristiane
Well, we propose a series of long-period medical simulations in scientific bases at the Arctic, at Antarctica and aboard the International Space Station (ISS), involving natural ophthalmic diseases such as radiation, solar and trauma retinopathy, keratoconus, cataract, glaucoma, etc., and ophthalmic alterations by accidental injuries. These natural diseases, without a previous diagnosis, specially those specific retinopathy, appear after 1 month to 1.5 year, in average. Such studies will be valuable for the human deep-space exploration because during long-duration spaceflight, such as staying at the ISS, a Moon base and a manned trip to planet Mars, requires several months within such environments, and during such periods ophthalmic diseases and accidents might eventually occur, which could seriously affect the 'round-the-clock' work schedule of the astronauts and the long-duration spaceflight manned program.
Liu, Rui; Wang, Shuangshuang; Fang, Shiming; Wang, Jialu; Chen, Jingjing; Huang, Xingguo; He, Xin; Liu, Changxiao
The purpose of this study was to develop novel liquid crystalline nanoparticles (LCNPs) that display improved pre-ocular residence time and ocular bioavailability and that can be used as an ophthalmic delivery system for tetrandrine (TET). The delivery system consisted of three primary components, including glyceryl monoolein, poloxamer 407, and water, and two secondary components, including Gelucire 44/14 and amphipathic octadecyl-quaternized carboxymethyl chitosan. The amount of TET, the amount of glyceryl monoolein, and the ratio of poloxamer 407 to glyceryl monoolein were selected as the factors that were used to optimize the dependent variables, which included encapsulation efficiency and drug loading. A three-factor, five-level central composite design was constructed to optimize the formulation. TET-loaded LCNPs (TET-LCNPs) were characterized to determine their particle size, zeta potential, entrapment efficiency, drug loading capacity, particle morphology, inner crystalline structure, and in vitro drug release profile. Corneal permeation in excised rabbit corneas was evaluated. Pre-ocular retention was determined using a noninvasive fluorescence imaging system. Finally, pharmacokinetic study in the aqueous humor was performed by microdialysis technique. The optimal formulation had a mean particle size of 170.0 ± 13.34 nm, a homogeneous distribution with polydispersity index of 0.166 ± 0.02, a positive surface charge with a zeta potential of 29.3 ± 1.25 mV, a high entrapment efficiency of 95.46 ± 4.13 %, and a drug loading rate of 1.63 ± 0.07 %. Transmission electron microscopy showed spherical particles that had smooth surfaces. Small-angle X-ray scattering profiles revealed an inverted hexagonal phase. The in vitro release assays showed a sustained drug release profile. A corneal permeation study showed that the apparent permeability coefficient of the optimal formulation was 2.03-fold higher than that of the TET solution. Pre-ocular retention
Benndorf, G. [Neuroangiography, Department of Radiology, Charite, Humboldt University Berlin (Germany); Bender, A. [Neuroradiology, Department of Radiology, Charite, Humboldt University Berlin (Germany); Campi, A. [Dept. of Neuroradiology, Hospital San Raffaele, Milan (Italy); Menneking, H. [Dept. of Maxillofacial Surgery, Charite, Humboldt University Berlin (Germany); Lanksch, W.R. [Department of Neurosurgery, Charite, Humboldt University Berlin, Augustenburger Platz 1, 13 353 Berlin (Germany)
In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula. (orig.)
Selcuk, Hakan, E-mail: firstname.lastname@example.org; Soylu, Nur; Albayram, Sait; Selcuk, Dogan; Ozer, Harun; Kocer, Naci; Islak, Civan [Cerrahpasa Medical School, Istanbul University, Department of Radiology, Division of Neuroradiology (Turkey)
We present the case of a 60-year-old man with persistent epistaxis for 20 days that had started 2 weeks after removal of a nasogastric tube placed for an abdominal operation. There was no pathologic finding at selective facial and internal maxillary artery injections. An injury to the ethmoidal branches of the ophthalmic arteries or other arterial origins of bleeding was suspected. The internal carotid artery angiography revealed a pseudoaneurysm of an anterior ethmoidal branch of the left ophthalmic artery. The pseudoaneurysm was occluded with NBCA-histoacryl (25%) injection.
Angelocci, Lucas V.; Fonseca, Gabriel P.; Yoriyaz, Helio, E-mail: email@example.com [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)
Eye tumors can be treated with brachytherapy using Co-60 plaques, I-125 seeds, among others materials. The human eye has regions particularly vulnerable to ionizing radiation (e.g. crystalline) and dosimetry for this region must be taken carefully. A mathematical model was proposed in the past  for the eye anatomy to be used in Monte Carlo simulations to account for dose distribution in ophthalmic brachytherapy. The model includes the description for internal structures of the eye that were not treated in previous works. The aim of this present work was to develop a new eye model based on the Mesh geometries of the MCNP6 code. The methodology utilized the ABAQUS/CAE (Simulia 3DS) software to build the Mesh geometry. For this work, an ophthalmic applicator containing up to 24 model Amersham 6711 I-125 seeds (Oncoseed) was used, positioned in contact with a generic tumor defined analytically inside the eye. The absorbed dose in eye structures like cornea, sclera, choroid, retina, vitreous body, lens, optical nerve and optical nerve wall were calculated using both models: analytical and MESH. (author)
Rahman, Ziyaur; Xu, Xiaoming; Katragadda, Usha; Krishnaiah, Yellela S R; Yu, Lawrence; Khan, Mansoor A
Restasis is an ophthalmic cyclosporine emulsion used for the treatment of dry eye syndrome. There are no generic products for this product, probably because of the limitations on establishing in vivo bioequivalence methods and lack of alternative in vitro bioequivalence testing methods. The present investigation was carried out to understand and identify the appropriate in vitro methods that can discriminate the effect of formulation and process variables on critical quality attributes (CQA) of cyclosporine microemulsion formulations having the same qualitative (Q1) and quantitative (Q2) composition as that of Restasis. Quality by design (QbD) approach was used to understand the effect of formulation and process variables on critical quality attributes (CQA) of cyclosporine microemulsion. The formulation variables chosen were mixing order method, phase volume ratio, and pH adjustment method, while the process variables were temperature of primary and raw emulsion formation, microfluidizer pressure, and number of pressure cycles. The responses selected were particle size, turbidity, zeta potential, viscosity, osmolality, surface tension, contact angle, pH, and drug diffusion. The selected independent variables showed statistically significant (p quality control or sameness of cyclosporine ophthalmic products.
M. Jothi, S.L. Harikumar* and Geeta Aggarwal
Full Text Available Topical administration of a drug in the conjunctival cul-de-sac is the treatment of choice for diseases of the anterior segment of eye. Development of ophthalmic drug delivery systems has always been challenging because of the drawbacks with this route, like non-productive absorption, drainage, induced lacrimation, tear turn over, impermeability of drugs to cornea. New approaches have been investigated for delivery of drugs to the eye by means of polymeric delivery of ophthalmic drugs to the pre-and intra ocular tissues, have been attempted to increase the bioavailability and the duration of therapeutic action of ocular drug. Certain new approaches to increase the ocular bioavailability, duration of the drug action and to reduce the undesirable side effects are by using drug carriers that regulate pre-corneal drug loss and improve the corneal contact time. Many of these systems prolong ocular bioavailability but do not control drug penetration through the cornea. Consequently, the drug concentration at the site of action might remain inadequate. Therefore, it is necessary to develop safer, efficacious and more acceptable ocular therapeutic system. The ocular bioavailability of the drugs can be improved by prolonging their residence time in the cul-de-sac and by increasing their corneal permeability. There are various new dosage forms like in-situ gel, collagen shield, etc.
Schaefer, Jamie Lea; Aubert Bonn, Noemie; Craenen, Geert
The importance of transparency with financial ties in biomedical research is widely recognized, and most peer-reviewed journals require declarations of Conflicts of Interest (COI). Nonetheless, variability in the consistency of declarations of COI has been sparsely assessed. To assess consistency and rates of COI declarations in the ophthalmic literature and the effectiveness of journal COI policies. We analyzed consistency and completeness of declaration of COI in the ophthalmic literature and compared the levels of completeness to specific journal requirements. Six-hundred forty-two peer reviewed articles satisfied the inclusion criteria. In 64%, COIs were unreported, in 25% declaration of COI was incomplete, and 11% of the articles reviewed had complete declaration of COI. Of the 33 journals in which the most frequently published authors' articles appeared, 10 required the authors to complete the International Committee of Medical Journal Editors (ICMJE) form or an equivalent form, but this did not affect the rates of COI declaration. In a random sampling of the most frequently published authors in the field of ophthalmology, declaration of COI was low and highly inconsistent. Requiring a standardized COI form has no significant effect on the rate of accurate COI reporting. Our findings lend support to the growing body of literature that shows that journals and editors may need to take a more active role in ensuring accurate and consistent COI reporting.
Choy, Young Bin; Prausnitz, Mark R
The Rule of Five predicts suitability of drug candidates, but was developed primarily using orally administered drugs. Here, we test whether the Rule of Five predicts drugs for delivery via non-oral routes, specifically ophthalmic, inhalation and transdermal. We assessed 111 drugs approved by FDA for those routes of administration and found that >98% of current non-oral drugs have physicochemical properties within the limits of the Rule of Five. However, given the inherent bias in the dataset, this analysis was not able to assess whether drugs with properties outside those limits are poor candidates. Indeed, further analysis indicates that drugs well outside the Rule of Five limits, including hydrophilic macromolecules, can be delivered by inhalation. In contrast, drugs currently administered across skin fall within more stringent limits than predicted by the Rule of Five, but new transdermal delivery technologies may make these constraints obsolete by dramatically increasing skin permeability. The Rule of Five does appear to apply well to ophthalmic delivery. We conclude that although current non-oral drugs mostly have physicochemical properties within the Rule of Five thresholds, the Rule of Five should not be used to predict non-oral drug candidates, especially for inhalation and transdermal routes.
Amália Turner Giannico
Full Text Available ABSTRACT Purpose: The aim of this study was to investigate the effects of prostaglandin analogs on blood flow in the ophthalmic artery of clinically healthy rabbits. Methods: Fifty-five clinically healthy New Zealand white rabbits were divided into six groups, and the left eyes were treated for four weeks with the preservative benzalkonium chloride (BAK only or a topical formulation of different prostaglandin analogs (bimatoprost BAK, tafluprost BAK-free, travoprost BAK, travoprost POLYQUAD, and latanoprost BAK. Color Doppler imaging was performed before and after the treatments. The mean values of the peak systolic velocity (PSV and end diastolic velocity and the resistive index (RI were calculated. Statistical analysis was performed to compare the differences pre- and post-treatment for each drug and post-treatment among the drugs. Results: The prostaglandin analogs did not affect PSV. Bimatoprost BAK, travoprost POLYQUAD, and latanoprost BAK did not change RI. Tafluprost BAK-free and travoprost BAK therapy resulted in similar reductions in RI. No significant differences pre- and post-treatment were found when BAK was administered alone. Conclusion: The prostaglandin analogs tafluprost BAK-free and travoprost BAK improved blood flow in the ophthalmic artery in healthy New Zealand white rabbits, which suggests that these drugs enhance the prevention of the progression the progression of glaucoma.
Shen, Yan; Xu, Sheng-jie; Wang, Shi-chun; Tu, Jia-sheng
A high-performance liquid chromatography (HPLC) system was used in the reversed phase mode for the determination of benzalkonium chloride (BKC) in azithromycin viscous ophthalmic drops. A Venusil-XBP(L)-C18 (150 mm×4.6 mm, 5 μm) column was used at 50 °C. The mobile phase consisted of a mixture of methanol-potassium phosphate (16:5, v/v). Two sample preparation methods were compared. The results suggested that, compared with an extraction procedure, a deproteinization procedure was much quicker and more convenient. Using the deproteinization procedure for sample preparation, calibration curves were linear in the range 5.0~50 μg/ml. The within-day and inter-day coefficients of variation were less than 10%. The average recoveries were determined as 96.70%, 98.52%, and 97.96% at concentrations of 10.0, 30.0, and 50.0 μg/ml, respectively. Variability in precision did not exceed 5%. In conclusion, this HPLC method using a simple sample treatment procedure appears suitable for monitoring BKC content in azithromycin viscous ophthalmic drops. PMID:19946951
Min Ji Kang
Full Text Available We report two cases of myotonic dystrophy in one family; both diagnosed from genetic analysis following ophthalmic indications, but before the manifestation of systemic symptoms. A 39-year-old female visited our clinic for routine examination. Mild ptosis, sluggish pupillary response, and bilateral snowflake cataracts were found. Fundus examination revealed an increased cup-to-disc ratio (CDR in both eyes and a defect in the retinal nerve fiber layer in the right eye. Intraocular pressure was low, but within the normal range in both eyes. Because cataracts are characteristic of myotonic dystrophy, we suggested that her 14-year-old daughter, who did not have any systemic complaints, undergo ophthalmic examination. She also had mild ptosis and snowflake cataracts. Both patients underwent genetic evaluation and were diagnosed with myotonic dystrophy caused by unstable expansion of cytosine-thymine-guanine trinucleotide repeats in the dystrophia myotonica-protein kinase gene. Ophthalmologists can diagnose myotonic dystrophy based on clinical and genetic findings, before the manifestation of systemic abnormalities.
Sato, Taku; Sasaki, Tatsuya; Sakuma, Jun; Suzuki, Kyouichi; Matsumoto, Masato; Sato, Masanori; Itakura, Takeshi; Kodama, Namio
A rare case of ruptured carotid-ophthalmic aneurysm splitting the optic nerve was reported. A 52-year-old man presented with a sudden severe headache and bilateral visual deterioration. His right visual acuity was hand motion and the left was 2.0. His left visual field revealed a partial defect of the temporal visual field. Three-dimensional CT angiography revealed an ophthalmic aneurysm of 9 mm projecting superior-medially, The operation was performed to preserve the visual function as much as possible. The C2 portion aneurysm splitting the right optic nerve was visible. Before aneurysm clipping, the right anterior clinoid process and optic canal were drilled out to reduce the tension of the optic nerve. Intraoperative monitoring of visual evoked potential (VEP) under propofol anesthesia was performed to prevent further visual disturbance. Electroretinogram (ERG) was introduced to ascertain the arrival of the light stimulus at the retina even when the VEP could not be recorded. The right ERG was recorded, but the right VEP was flat. Both ERG and VEP were reproducible on the left side. Six months after the operation, the right visual acuity had improved to 0.08 and the visual field revealed nasal hemianopsia. The left visual acuity was unchanged while the visual field had improved to upper temporal quadrant hemianopsia. Various attempts to preserve the visual function were discussed.
Montiani-Ferreira, Fabiano; Shaw, Gillian; Mattos, Bianca Chaim; Russ, Heloisa Helena Abil; Vilani, Ricardo G D'O C
To perform selected ophthalmic diagnostic tests in healthy capuchin monkeys (Cebus apella) with the aim of establishing normal physiological reference values for this species. A total of 15 healthy, capuchin monkeys were used to test most of the parameters in this investigation. Five of the 15 monkeys were used for the evaluation of normal conjunctival flora. Ages varied from 6 to 20 years of age. Selected diagnostic ocular tests were performed including Schirmer tear test (STT), tonometry using an applanation tonometer (Tonopen), central corneal thickness (CCT) using an ultrasonic pachymeter (Sonomed, Micropach), Model 200P+) and culture of the normal conjunctival bacterial flora. Results for selected ocular diagnostic tests investigated here for the capuchin monkey eye were as follows: IOP: 18.4 +/- 3.8 mmHg; STT: 14.9 +/- 5.1 mm/min; CCT: 0.46 +/- 0.03 mm. No statistically significant differences between ages or genders were found for any of the results. Streptococcus sp. and Corynebacterium sp. were isolated from healthy conjunctival and eyelid margins, suggesting they are normal constituents of the conjunctival flora of the capuchin monkey. The data obtained in this investigation will help veterinary ophthalmologists and laboratory animal medicine specialists to more accurately diagnose ocular diseases in the capuchin monkey. These ophthalmic reference values will be particularly useful to diagnose discrete or unusual pathological changes of the capuchin monkey eye.
刘志东; 李佳玮; 刘睿; 张欣华; 赵诤
BACKGROUND: Ribavirin is easily diluted by lacrimal fluid and has low bioavailability. In situ ophthalmic gel changes from liquid drug to gel phase upon exposure to physiological conditions, resulting in an increase in the precorneal residence time of drugs. OBJECTIVE: To prepare ribavirin in situ ophthalmic gel and valuate its theological feature. DESIGN, TIME AND SETTING: In vitro controlled observation, performed at the Engineering Research Center of Modem Chinese Medicine Discovery and Preparation Technique, Ministry of Education, Tianjin University of Traditional Chinese Medicine between September and October 2006. MATERIALS: Sodium alginate, Carbopol, and ribavirin. METHODS: Sodium alginate (1% and 2%) and Carbopol (0.3%, 0.6%, and 2%) were combined at different proportions to prepare in sire ophthalmic gel, then in which ribavirin was added. MAIN OUTCOME MEASURES: Viscosity determinations of prepared different concentrations of formulations were determined using a cone and plate viscometer. RESULTS: Ribavirin in situ ophthalmic gel prepared with 1% sodium alginate and 0.6% Carbopol had the largest viscosity. The viscosity change was not influenced by the addition of ribavirin. The in situ ophthalmic gel prepared with sodium alginate and Carbopol changed to the gel phase upon exposure to lacrimal fluid. CONCLUSION: 1% sodium alginate and 0.6% Carbopol produced the best rheological feature and could prolonge the precorneal residence time of drug than that of conventional ophthalmic solution.%背景:利巴韦林易被泪液稀释,生物利用度低.在体凝胶剂可使药物在生理条件下由溶液向凝胶转化,延长药物在角膜前的滞留时间.目的:制备利巴韦林眼用在体凝胶剂,并评价其流变学性质.设计、时间及地点:体外对比观察实验,于2006-09/10在天津中医药大学现代中药发现与制剂技术教育部工程研究中心完成.材料:海藻酸钠、卡波姆、利巴韦林.方法:质量分数分别为0
Fledelius, Hans C.; Sandfeld, Lisbeth; Rasmussen, Åse Krogh
PURPOSE: Enzyme replacement therapy (ERT) was offered from year 2001 to patients with Fabry disease. The ophthalmic experience was analysed, as part of a general 10-year status. METHODS: A retrospective observational series comprising 39 patients (25 females, 14 males) closely followed by the end...
Full Text Available Purpose. The aim of this study was to investigate the effect of tea polyphenols (TP ophthalmic gel on lens epithelial cells (LECs in rabbits with silicone oil tamponade after vitrectomy. Methods. In this study, unilateral vitrectomy with silicone oil tamponade was performed using 2-month-old New Zealand white rabbits (n = 72; meanwhile, age-matched nonoperated rabbits (n = 18 were used as controls. The TP ophthalmic gel was administered topically in the surgical eyes till they were sacrificed. On days 45 and 90 after operation, the levels of reactive oxygen species (ROS, mitochondrial membrane potential (ΔΨm, and apoptosis of LECs were analyzed, respectively. Meanwhile, caspase-3 mRNA and protein levels were also determined. Results. The results indicate that the levels of ROS and apoptosis were elevated for LECs in rabbits after operation, whereas ΔΨm was decreased. Caspase-3 was apparently increased at both mRNA and protein levels. Treatment of TP ophthalmic gel could reduce the generation of ROS, maintain ΔΨm, inhibit the overexpression of caspase-3, and thus decrease the apoptosis of LECs of rabbits after operation. Conclusions. TP ophthalmic gel can efficiently inhibit caspase-3 overexpression, reduce the apoptosis of LECs, and prevent LECs from damage. Our result provides a new approach to prevent the development of complicated cataract after vitrectomy.
Full Text Available When internal carotid artery stenosis is accompanied by ocular ischemic syndrome, intervention is recommended to prevent irreversible visual loss. In this study, we used laser speckle flowgraphy to measure the ocular microcirculation in the optic nerve head before and after carotid artery stenting (CAS of 40 advanced internal carotid stenosis lesions from 37 patients. The aim was to investigate the relationship between ocular microcirculation and the direction of ophthalmic artery blood flow obtained by angiography. We found that there was a significant increase in blood flow after CAS (P=0.003. Peak systolic velocity as an indicator of the rate of stenosis was also significantly higher in the group with retrograde/undetected flow of the ophthalmic artery than in the group with antegrade flow (P=0.002. In all cases where retrograde flow of the ophthalmic artery was observed before stenting, the flow changed to antegrade after stenting. Through the use of laser speckle flowgraphy, this study found that CAS can improve ocular microcirculation. Furthermore, while patients displaying retrograde flow of the ophthalmic artery before stenting have a poor prognosis, CAS corrected the flow to antegrade, suggesting that visual loss can be prevented by improving the ocular microcirculation.
Hommer, A.; Thygesen, J.; Ferreras, A.;
PURPOSE: Efficacy, safety, and cost implications are important considerations when choosing an ophthalmic treatment. Fixed-combination glaucoma medications containing brimonidine 0.2% and timolol 0.5%, or dorzolamide 2% and timolol 0.5%, were compared with brimonidine 0.2% and dorzolamide 2...
Knudsen, Lars Loumann; Lervang, Hans-Henrik; Lundbye-Christensen, Søren
Background: The influence of non-ophthalmic parameters on the prevalence of clinically significant macular oedema has not been unambiguously established. The present study was initiated with the aim of clarification. Methods: This cross-sectional study comprised 656 type 1 and 328 type 2 diabetic...
... not wear contact lenses if your eyes are red or irritated, and you should not use epinastine eye drops to treat irritation that you think may be caused by contact lenses. You should also not instill epinastine eye drops while you are wearing contact lenses. Remove your contact lenses before you ...
Apr 24, 2008 ... Evaluation of Competence of Medical Students in Performing ... satisfactory and may have reflected self-reported challenges faced in CDR estimation by the ... Examination-Success ... in update courses, If the courses improved understanding, If part 1 ... and14 (27.45%) were fellows of West African College.
... discolored eye drops (yellowish brown to deep reddish brown).Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose ...
... and swelling of eye caused by chemicals, heat, radiation, infection, allergy, or foreign bodies in the eye. ... open them easily. To protect young children from poisoning, always lock safety caps and immediately place the ...
... swelling of eye inflammation caused by chemicals, heat, radiation, infection, allergy, or foreign bodies in the eye. ... open them easily. To protect young children from poisoning, always lock safety caps and immediately place the ...
... eye examinations to dilate (open) the pupil, the black part of the eye through which you see. ... hands thoroughly with soap and water. Use a mirror or have someone else apply the ointment. Avoid ...
... Metipranolol is in a class of medications called beta-blockers. It works by decreasing the pressure in the ... and pharmacist if you are allergic to metipranolol, beta blockers, or any other medications.tell your doctor and ...
... Timolol is in a class of medications called beta-blockers. It works by decreasing the pressure in the ... and pharmacist if you are allergic to timolol, beta blockers, or any other drugs.tell your doctor and ...
... Levobunolol is in a class of medications called beta blockers. It works by decreasing the pressure in the ... pharmacist if you are allergic to levobunolol, other beta blockers, sulfites, or any other drugs.tell your doctor ...
... hands thoroughly with soap and water. Use a mirror or have someone else apply the gel. Remove ... not go away: blurred or dim vision stinging, burning, or discomfort in the eye itching or redness ...
... hands thoroughly with soap and water. Use a mirror or have someone else apply the ointment. Avoid ... not go away: eye tearing itching, stinging, or burning of the eye swelling of the eye temporary ...
... hands thoroughly with soap and water. Use a mirror or have someone else apply the ointment. Avoid ... or do not go away: itching, stinging, or burning of the eye Bacitracin eye ointment may cause ...
... hands thoroughly with soap and water. Use a mirror or have someone else apply the ointment. Avoid ... do not go away: redness, itching, stinging, or burning of the eye Erythromycin eye ointment may cause ...
Full Text Available Eye health workers carry out many basic routine procedures. Sometimes bad practice develops and this, in turn, may lead to new members of staff learning unsafe methods. Community Eye Health Journal plans to run a series on practical procedures, when applicable, relating to the theme.
... color, or number of your eyelashes, or fine hair on your eyelids. The eyelash changes and any ... to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in ...
... color, or number of your eyelashes, or fine hair on your eyelids. The eyelash changes and any ... to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in ...
... go away: eye irritation eye tearing headache dizziness insomnia Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: difficulty breathing change in ...
... irritation and redness caused by colds, pollen, and swimming. ... must be kept clean. While tilting your head back, pull down the lower lid of your eye ... of your medication is through a medicine take-back program. Talk to your pharmacist or contact your ...
Full Text Available Jie Lou,1 Wenjing Hu,2 Rui Tian,3 Hua Zhang,1 Yuntao Jia,4 Jingqing Zhang,1 Liangke Zhang11Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing, People’s Republic of China; 2Chongqing Xijiao Hospital, Chongqing, People’s Republic of China; 3The Experimental Teaching Centre, Chongqing Medical University, Chongqing, People’s Republic of China; 4Department of Pharmacy, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaAbstract: This study aimed to optimize and evaluate a thermoresponsive ophthalmic in situ gel containing curcumin-loaded albumin nanoparticles (Cur-BSA-NPs-Gel. Albumin nanoparticles were prepared via a desolvation method, and the gels were prepared via a cold method. The central composite design and response surface method was used to evaluate the effects of varying Pluronic® F127 and Pluronic® F68 concentrations on the sol–gel transition temperature, which is an indicator of optimum formulations. The optimized formulation was a free-flowing liquid below 30.9°C that transformed into a semi-solid gel above 34.2°C after dilution with simulated tear fluid. Results of the in vitro release and erosion behavior study indicated that Cur-BSA-NPs-Gel achieved superior sustained-release effects and that incorporation of albumin nanoparticles exerted minimal effects on the gel structure. In addition, in vivo ophthalmic experiments employing Cur-BSA-NPs-Gel were subsequently performed in rabbits. In vivo eye irritation results showed that Cur-BSA-NPs-Gel might be considered safe for ophthalmic drug delivery. The in vivo study also revealed that the formulation could significantly increase curcumin bioavailability in the aqueous humor. In conclusion, the optimized in situ gel formulation developed in this work has significant potential for ocular application.Keywords: diabetic retinopathy, sustained release
Huang, Wenbin; Wang, Wei; Zhan, Jiao; Zhou, Minwen; Chen, Shida; Zhang, Xiulan
Eye diseases with increasing mortality are common health problems that affect people of all ages and demographic backgrounds. In this study, we study the publication characteristics in international ophthalmic journals of the US, the UK, Germany, Australia, Japan, and China. Articles published in 53 ophthalmic journals from 2000 to 2011 were retrieved from the PubMed database. We recorded the number of articles published each year, analyzed the publication type, and evaluated the accumulated and average impact factors (IFs), and the distribution of articles in ophthalmic journals in relation to IFs. The characteristics of publication outputs from China and other top-ranking countries were compared. The total number of articles increased significantly during the past 12 years, with an increase of 51.0%. The growth in the annual number of articles from the US, the UK, Australia, and China showed a significantly positive trend. Publications from the US exceeded those from any other country and had the highest IFs, largest number of total citations of articles, and the most articles published in leading ophthalmic journals. During the past 12 years, China contributed 3.5% of the total publications, and the number of Chinese articles showed a more than 6-fold increase (from 99 to 605, R2 =0.947, P<0.001). The numbers of IFs and citations of articles originating in China were mostly lower than for other top-ranking counties. Research on ophthalmic journals has maintained an upward growing trend from 2000 to 2011. Chinese ophthalmology research has developed rapidly, but the gap still exists between China and other top-ranking countries for the advanced level of research.
Ladner, Travis R; Davis, Brandon J; He, Lucy; Mawn, Louise A; Mocco, J
Aseptic cavernous sinus thrombosis (CST) is rare and may clinically masquerade as a carotid cavernous fistula. Conventional management includes oral anticoagulation, but cases of ocular hypertension affecting vision may require more aggressive intervention. We report a case of a woman with spontaneous bilaterally occluded cavernous sinuses with elevated intraocular pressure (IOP), which resolved immediately following unilateral superior ophthalmic vein (SOV) sacrifice. She was subsequently placed on oral anticoagulants. By 4 months postoperatively her IOP was normalized and her vision had improved. Repeat angiography demonstrated stable venous filling, with some mild improvement of flow through the cavernous sinus. Coil-mediated sacrifice of the SOV might be an effective means to relieve ocular hypertension and preserve vision in the setting of aseptic CST.
Zhu, Dexi; Shen, Meixiao; Jiang, Hong; Li, Ming; Wang, Michael R.; Wang, Yuhong; Ge, Lili; Qu, Jia; Wang, Jianhua
Spectral domain optical coherence tomography (SD-OCT) with ultrahigh resolution can be used to measure precise structures in the context of ophthalmic imaging. We designed an ultrahigh resolution SD-OCT system based on broadband superluminescent diode (SLD) as the light source. An axial resolution of 2.2 μm in tissue, a scan depth of 1.48 mm, and a high sensitivity of 93 dB were achieved by the spectrometer designed. The ultrahigh-resolution SD-OCT system was employed to image the human cornea and retina with a cross-section image of 2048 × 2048 pixels. Our research demonstrated that ultrahigh -resolution SD-OCT can be achieved using broadband SLD in a simple way. PMID:22191923
Zhu, Dexi; Shen, Meixiao; Jiang, Hong; Li, Ming; Wang, Michael R; Wang, Yuhong; Ge, Lili; Qu, Jia; Wang, Jianhua
Spectral domain optical coherence tomography (SD-OCT) with ultrahigh resolution can be used to measure precise structures in the context of ophthalmic imaging. We designed an ultrahigh resolution SD-OCT system based on broadband superluminescent diode (SLD) as the light source. An axial resolution of 2.2 μm in tissue, a scan depth of 1.48 mm, and a high sensitivity of 93 dB were achieved by the spectrometer designed. The ultrahigh-resolution SD-OCT system was employed to image the human cornea and retina with a cross-section image of 2048 × 2048 pixels. Our research demonstrated that ultrahigh -resolution SD-OCT can be achieved using broadband SLD in a simple way.
Chiu, Stephanie J; Toth, Cynthia A; Bowes Rickman, Catherine; Izatt, Joseph A; Farsiu, Sina
This paper presents a generalized framework for segmenting closed-contour anatomical and pathological features using graph theory and dynamic programming (GTDP). More specifically, the GTDP method previously developed for quantifying retinal and corneal layer thicknesses is extended to segment objects such as cells and cysts. The presented technique relies on a transform that maps closed-contour features in the Cartesian domain into lines in the quasi-polar domain. The features of interest are then segmented as layers via GTDP. Application of this method to segment closed-contour features in several ophthalmic image types is shown. Quantitative validation experiments for retinal pigmented epithelium cell segmentation in confocal fluorescence microscopy images attests to the accuracy of the presented technique.
Paes, Maria Marta Bini Martins; Diniz, Angélica Lemos Debs; Jorge, Ana Paula Lino
To compare the ophthalmic artery (OA) perfusion of pregnant smokers and nonsmokers by Doppler indexes. Correlate these with the interval of last cigarette, cigarettes per day, years smoking and carbon monoxide expired (COex). Transversal study involving 70 pregnant smokers divided into 33 pregnant who smoked until 2 h: A group (AG) and B group (BG): 37, who smoked between 2 and 24 h before test. Control group (CG) was composed of 51 pregnant nonsmokers. Doppler indexes were assessed: PSV (Peak Systolic Velocity), EDV (End Diastolic Velocity), PI (Pulsatility Index), RI (Resistance Index) and PR (Peak Ratio). Groups were compared using ANOVA, Kruskal-Wallis test, Student's t test, Mann-Whitney and Pearson's correlation coefficient, whereas p pregnant smokers shows a biphasic pattern of perfusion correlated with the time of consumption of the last cigarette. There are signs of vasoconstriction and hypoperfusion to tobacco exposure between 2 and 24 and hyperperfusion in A Group compared to B Group.
Fiorello, Christine V; Freeman, Kate; Elias, Becky A; Whitmer, Emily; Ziccardi, Michael H
The safety of chemical dispersants used during oil spill responses is largely unknown in birds. We captured common murres in Monterey Bay, CA and exposed them to Corexit EC9500a, crude oil, or a combination in artificial seawater. We performed ophthalmic examinations and measured intraocular pressures and tear production before and after exposure. Loglinear analysis found that exposure to oil or dispersant was related to the development of conjunctivitis and corneal ulcers. Odds ratios for birds exposed to oil or dispersant were positive and significant for the development of conjunctivitis, while odds ratios for the development of corneal ulcers were positive and significant only for birds exposed to a high concentration of oil. Ocular exposure to dispersants and petroleum in seabirds may cause conjunctivitis and may play a role in the development of corneal ulcers. These results have implications for policymakers who develop protocols for the use of dispersants during marine oil spills. Copyright © 2016 Elsevier Ltd. All rights reserved.
Solomon, Paige; Nelson, Jenny
In this study, we investigated the elemental impurities present in the plastic material of ophthalmic eye drop bottles using inductively coupled plasma-mass spectrometry (ICP-MS). Metallic contaminations, especially localized within the small cavity of the eye, can significantly perturb the ocular metallome. The concern is two-fold: first certain elements, for example heavy metals, can be toxic to humans at even trace levels, and second, these contaminations can have adverse reactions with other medicines or enzymatic processes in the eye. The implication of redox-active metals in cataract formation is one such biological consequence. The analysis demonstrated the effect of aggressive storage and transportation conditions on elemental extractable and leachable contamination, and posits that release of these elemental impurities can disrupt metallome equilibrium in the ocular compartment, leading to toxicity and disease.
Derang, J; Ying, H; Long, Y; Reifa, S; Qiming, W; Yimu, F; Guoxiang, S; Shimin, C; Lihua, X; Shi, W; Zunhua, C
Carotid-cavernous sinus fistula is an old difficulty in neurosurgery. At present, the main way to deal with it is by embolizing the fistula via an arterial route. But if the fistula is small or supplied by several branches, it is difficult to embolize via an arterial approach. In this report, 21 patients with carotid-cavernous sinus fistulae were successfully cured by embolizing the fistula via the SOV approach. All patients were cured, and there were no serious postoperative complications. Follow-up has been carried out in 19 cases for 8 months to more than 4 years; no recurrence manifested. For carotid-cavernous sinus fistulae that cannot be embolized arterially, the superior ophthalmic vein route is an easy, safe, effective and promising approach.
Full Text Available Background: Wearing spectacles is the most common approach in correcting the refractive errors worldwide. Due to harmful effects of overexposure to solar ultraviolet radiations, the usage of multi-layer coatings in ophthalmic lenses has recently been increased. These lenses can reduce the reflections and hence increase the transmission of visible light; they can also decrease the transmission of ultraviolet rays. This study aims to compare the transmission of ultraviolet (A and B and visible rays through coated and uncoated prescriptive ophthalmic plastic lenses.Materials and Methods: In this study, 39 minus non-photochromic multi-coated white plastic single-vision lenses; 9 similar lenses but without any coatings were assessed by spectral transmittancemeter for evaluation of the transmission of visible and ultraviolet rays.Results: The transmission of visible light was 97.9%±1.07% for coated lenses and 93.5%±0.54% for lenses without coating. Ultraviolet-A transmission was 12.15%±8.02% for coated lenses compared to 66.27%±23.92% in lenses without coating. The transmission of ultraviolet-B rays was 1.21%±0.4% and 23.0%±15.97% for lenses with and without coatings, respectively.Conclusion: The transmission of visible light was significantly higher in multi-coated lenses compared to uncoated samples; whereas the transmissions of ultraviolet rays in multi-coated lenses were significantly lower than uncoated ones. Therefore, it is recommended that, except for particular cases, prescribed lenses be equipped with this multi-layer coating.
Full Text Available Masahiro Fujimoto,1 Ken Ogino,1 Chika Miyazaki,1,2 Miou Hirose,1,3 Hiroko Matsuyama,1,4 Takeshi Moritera,1,5 Nagahisa Yoshimura1 1Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; 2Department of Ophthalmology, Hyogo Prefectural Tsukaguchi Hospital, Hyogo, Japan; 3Department of Ophthalmology, Hyogo Prefectural Amagasaki Hospital, Hyogo, Japan; 4Department of Ophthalmology, National Hospital Organization Himeji Medical Center, Hyogo, Japan; 5Moritera Eye Clinic, Shiga, Japan Purpose: To evaluate the surgical outcome of dacryocystorhinostomy (DCR by measuring the tear meniscus, using optical coherence tomography and rebamipide ophthalmic suspension. Methods: Patients with nasolacrimal obstruction and chronic dacryocystitis who were scheduled for an endonasal DCR underwent tear meniscus examinations before and 2 months after surgery. Vertical scans of the inferior menisci were performed before and at 1, 3, 5, 7, and 10 minutes after the instillation of rebamipide ophthalmic suspension. The tear menisci areas were measured with imaging software. Ten young adults without epiphora formed the control group.Results: Anatomical success was achieved on 22 sides of 21 patients. The patients’ postoperative tear menisci were significantly smaller than the preoperative menisci at all points during the test, and the response to volume loading in the postoperative patients was corrected to nearly that of the young, healthy adults. Nevertheless, the postoperative meniscus area tended to be larger than that of the young adults at all points.Conclusion: The reduced tear meniscus area after DCR reflected the success of the surgical procedure. However, incomplete recovery of the meniscus after the test might suggest a residual disorder of the lacrimal drainage system after DCR. Keywords: dacryocystorhinostomy, tear meniscus, rebamipide, optical coherence tomography
Baulig, Werner; Weber, Monica; Beck-Schimmer, Beatrice; Theusinger, Oliver M; Biro, Peter
To assess the impact of short time hypnosis for retro-bulbar anesthesia on ventilation in patients undergoing ophthalmic surgery of the anterior eye chamber. In all patients, a combined continuous transcutaneous carbon dioxide tension (PtcCO2) and partial oxygen saturation (SpO2) measurement was applied in addition to routine monitoring. To enable unconscious application of retro-bulbar anesthesia, intravenous thiopental was given in one to multiple bolus doses. Transient breathing support included chin lift, Esmarch maneuver and manual hand-bag ventilation via face mask. Main endpoints were apnea time, recovery time according to the Richmond Agitation Sedation Scale, as well as SpO2 and PtcCO2 readings at predefined time points. Fifty-two patients with a mean age of 68 ± 13 years were included. Average thiopental dose was 2.7 ± 0.6 mg/kg. In seven (13.5%) patients repeated doses of thiopental were necessary to a total of 3.3 ± 1.1 mg/kg. Except one patient, no severe, significant or clinical relevant hypercapnia or desaturation periods were observed, and the occurring elevation of PtcCO2 values did not correlate with the application of repeated doses of thiopental or the need for the Esmarch maneuver. Higher PtcCO2 values were associated with the presence of hypertension and smoking. Apnea (p < 0.001) and recovery (p = 0.003) time were significantly prolonged in the patients needing the Esmarch maneuver. Short term anesthesia with thiopental in ophthalmic surgery is associated with a mild but not clinically relevant hypercapnia.
Full Text Available Mladen Lesin,1,* Mirna Dzaja Lozo,1,* Zeljka Duplancic-Sundov,1 Ivana Dzaja,1 Nikolina Davidovic,2 Adriana Banozic,3 Livia Puljak3 1Department of Ophthalmology, 2Department of Psychiatry, University Hospital Split, 3Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia *These authors contributed equally to this work Background: Risk factors associated with postoperative pain intensity and duration, as well as consumption of analgesics after ophthalmic surgery are poorly understood. Methods: A prospective study was conducted among adults (N=226 who underwent eye surgery at the University Hospital Split, Croatia. A day before the surgery, the patients filled out questionnaires assessing personality, anxiety, pain catastrophizing, sociodemographics were given and details about the procedure, anesthesia, and analgesia for each postoperative day. All scales were previously used for the Croatian population. The intensity of pain was measured using a numerical rating scale from 0 to 10, where 0 was no pain and 10 was the worst imaginable pain. The intensity of pain was measured before the surgery and then 1 hour, 3 hours, 6 hours, and 24 hours after surgery, and then once a day until discharge from the hospital. Univariate and multivariate analyses were performed. Results: A multivariate analysis indicated that independent predictors of average pain intensity after the surgery were: absence of premedication before surgery, surgery in general anesthesia, higher pain intensity before surgery and pain catastrophizing level. Independent predictors of postoperative pain duration were intensity of pain before surgery, type of anesthesia, and self-assessment of health. Independent predictors of pain intensity ≥5 during the first 6 hours after the procedure were the type of procedure, self-assessment of health, premedication, and the level of pain catastrophizing. Conclusion: Awareness about independent predictors associated
Cao, Zhenggang; Ding, Zengqian; Hu, Zhixiong; Wen, Tao; Qiao, Wen; Liu, Wenli
Optical coherence tomography (OCT) has been widely applied in diagnosis of eye diseases during the last 20 years. Differing from traditional two-dimension imaging technologies, OCT could also provide cross-sectional information of target tissues simultaneously and precisely. As well known, axial resolution is one of the most critical parameters impacting the OCT image quality, which determines whether an accurate diagnosis could be obtained. Therefore, it is important to evaluate the axial resolution of an OCT equipment. Phantoms always play an important role in the standardization and validation process. Here, a standard model eye with micro-scale multilayer structure was custom designed and manufactured. Mimicking a real human eye, analyzing the physical characteristic of layer structures of retina and cornea in-depth, appropriate materials were selected by testing the scattering coefficient of PDMS phantoms with difference concentration of TiO2 or BaSO4 particles. An artificial retina and cornea with multilayer-films which have a thickness of 10 to 60 micrometers for each layer were fabricated using spin coating technology. Considering key parameters of the standard model eye need to be traceable as well as accurate, the optical refractive index and layer structure thicknesses of phantoms were verified by utilizing Thickness Monitoring System. Consequently, a standard OCT model eye was obtained after the retinal or corneal phantom was embedded into a water-filled model eye which has been fabricated by 3D printing technology to simulate ocular dispersion and emmetropic refraction. The eye model was manufactured with a transparent resin to simulate realistic ophthalmic testing environment, and most key optical elements including cornea, lens and vitreous body were realized. By investigating with a research and a clinical OCT system respectively, the OCT model eye was demonstrated with similar physical properties as natural eye, and the multilayer film measurement
Gornik, Kara R; Pirie, Christopher G; Marrion, Ruth M; Wocial, Julika N; Innis, Charles J
To determine central corneal thickness (total corneal thickness [TCT], epithelial thickness [ET], and stromal thickness [ST]), anterior chamber depth (ACD), and intraocular pressure (IOP) in Kemp's ridley sea turtles (Lepidochelys kempii). Prospective cross-sectional study. 25 healthy rehabilitated juvenile Kemp's ridley sea turtles. PROCEDURES; Body weight and straight-line standard carapace length (SCL) were recorded. All turtles underwent a complete anterior segment ophthalmic examination. Central TCT, ET, ST, and ACD were determined by use of a spectral-domain optical coherence tomography device. Intraocular pressure was determined with a rebound tonometer; the horse setting was used to measure IOP in all 25 turtles, and the undefined setting was also used to measure IOP in 20 turtles. For each variable, 3 measurements were obtained bilaterally. The mean was calculated for each eye and used for analysis purposes. The mean ± SD body weight and SCL were 3.85 ± 1.05 kg (8.47 ± 2.31 lb) and 29 ± 3 cm, respectively. The mean ± SD TCT, ET, ST, and ACD were 288 ± 23 μm, 100 ± 6 μm, 190 ± 19 μm, and 581 ± 128 μm, respectively. Mean ± SD IOP was 6.5 ± 1.0 mm Hg when measured with the horse setting and 3.8 ± 1.1 mm Hg when measured with the undefined setting. Results provided preliminary reference ranges for objective assessment of ophthalmic variables in healthy juvenile Kemp's ridley sea turtles.
Oriá, Arianne P; Oliveira, Alberto Vinícius D; Pinna, Melissa H; Martins Filho, Emanoel F; Estrela-Lima, Alessandra; Peixoto, Tiago C; Silva, Renata Maria M da; Santana, Fernanda O; Meneses, Íris Daniela S; Requião, Kátia G; Ofri, Ron
The aim of this study was to establish normal ophthalmic parameters for selected diagnostic tests, and to describe the orbital anatomy and adnexal histology of the broad-snouted caiman. A total of 35 Caiman latirostris that were free of obvious ocular diseases were used to measure the parameters in this investigation. Ages ranged from 5 to 15 years. Ophthalmic diagnostic tests were conducted, including evaluation of tear production with Schirmer Tear test-1 (STT1), culture of the conjunctival bacterial flora, applanation tonometry, conjunctival cytology, nictiating membrane incursion frequency test (NMIFT), endodontic absorbent paper point tear test (EAPPTT), palpebral fissure length measurement (PFL) and B-mode ultrasonography. Adnexal histology and skull samples were studied. Mean (±SD) STT1 was 3.4 ± 3.6 mm/min (95% confidence interval of 2.01-4.78 mm/min), intraocular pressure (IOP) was 12.9 ± 6.2 mmHg, NMIFT was 6.0 ± 3.5, EAPPTT was 17.1 ± 2.5 mm/min, PFL was 28.9 ± 3.0 mm, anterior chamber depth was 3.1 ± 0.3 mm, lens axial length was 8.4 ± 0.6 mm, vitreous chamber depth was 7.9 ± 0.7 mm and axial globe length was 19.9 ± 1.3 mm. For all animals evaluated, Bacillus sp., Diphteroids and Staphylococcus sp. were predominant. © 2013 American College of Veterinary Ophthalmologists.
Full Text Available Identification of the origin of the central retinal artery (CRA is imperative in tailoring angiographic studies to resolve a given clinical problem. A case with dual ophthalmic arteries (OAs, characterized by different origins and distinct branching patterns, is documented for training purposes. Pre-clinical diagnosis of a 9-year-old child who presented with a sharp wire in the left-side eyeball was primarily corneal laceration. For imaging, a selected six-vessel angiographic study with the transfemoral approach was performed. Embolization was not required and the wire could be successfully removed. Right-side OA anatomy was normal, while left-side dual OAs with external carotid artery (ECA and internal carotid artery (ICA origins were seen. The case presented with a left-side meningo-ophthalmic artery (M-OA anomaly via the ECA, marked by a middle meningeal artery (MMA (origin: Maxillary artery; course: Through foramen spinosum with normal branches (i.e. anterior and posterior branches, and an OA variant (course: Through superior orbital fissure with a distinct orbital branching pattern. A smaller OA (origin: ICA; course: Through optic foramen with a distinct ocular branching pattern presented with the central retinal artery (CRA. The presence of the dual OAs and the M-OA anomaly can be explained by disturbed evolutionary changes of the primitive OA and stapedial artery during development. The surgical interventionist must be aware of dual OAs and M-OA anomalies with branching pattern variations on retinal supply, because of dangerous extracranial-intracranial anastomotic connections. It is of clinical significance that the origin of the CRA from the ICA or ECA must be determined to avoid complications to the vision.
Full Text Available Background Eye infections can be vision-threatening and must be treated effectively by appropriate and safe use of topical ophthalmic anti-infectives. This review will essentially consider the current and evolving treatment options for the various types of bacterial eye infections. Ocular surface bacterial infections affect subjects of all ages with a high frequency in newborns and children. Methods This article presents a review of the peer-reviewed published scientific literature in order to define the well-established uses of anti-infective eye drops in the field of ocular infections. A comprehensive search of the recent published literature including topical ophthalmic anti-infectives effective in bacterial ocular infections was performed. Clinical studies provide relevant data concerning the characteristics and clinical efficacy of antibacterial eye drops in ocular anterior segment infections or for perioperative prophylaxis. Publications were included to cover the current options of antibacterial eye drops available in Europe. Results Several recent publications identified effective topical ocular antibacterials requiring a reduced dose regimen and a short treatment course. Additional literature reviewed included data on novel perioperative prophylaxis, indications for topical fortified antibiotics and innovative research including the risk of resistance. Conclusions Safe and effective topical antibiotic eye drops for the treatment and prevention of ocular infections must be adapted to the type of bacteria suspected. Usual topical antimicrobials should be replaced by more recent and more effective treatments. The use of highly effective fluoroquinolones should be reserved for the most severe cases to avoid resistance. Short treatment courses, such as azithromycin, can be easily used in children, thereby improving quality of life.
J Charles Henry
Full Text Available J Charles Henry1, James H Peace2, Jeanette A Stewart3,4, William C Stewart3,41Little Rock Eye Clinic, Little Rock, AR, USA; 2Diabetic Eye Medical Clinic, Inglewood, CA, USA; 3PRN Pharmaceutical Research Network, LLC, Dallas,TX, USA; 4Carolina Eye Institute, University of South Carolina, School of Medicine, Columbia, SC, USAPurpose: To evaluate the efficacy, safety and tolerability of changing to travoprost BAK-free from prior prostaglandin therapy in patients with primary open-angle glaucoma or ocular hypertension.Design: Prospective, multi-center, historical control study.Methods: Patients treated with latanoprost or bimatoprost who needed alternative therapy due to tolerability issues were enrolled. Patients were surveyed using the Ocular Surface Disease Index (OSDI to evaluate OSD symptoms prior to changing to travoprost BAK-free dosed once every evening. Patients were re-evaluated 3 months later.Results: In 691 patients, travoprost BAK-free demonstrated improved mean OSDI scores compared to either latanoprost or bimatoprost (p < 0.0001. Patients having any baseline OSD symptoms (n = 235 demonstrated significant improvement after switching to travoprost BAK-free (p < 0.0001. In 70.2% of these patients, symptoms were reduced in severity by at least 1 level. After changing medications to travoprost BAK-free, mean intraocular pressure (IOP was significantly decreased (p < 0.0001. Overall, 72.4% preferred travoprost BAK-free (p < 0.0001, travoprost BAK-free vs prior therapy. Travoprost BAK-free demonstrated less conjunctival hyperemia than either prior therapy (p < 0.0001.Conclusions: Patients previously treated with a BAK-preserved prostaglandin analog who are changed to travoprost BAK-free have clinically and statistically significant improvement in their OSD symptoms, decreased hyperemia, and equal or better IOP control.Keywords: glaucoma, prostaglandin analog, travoprost, latanoprost, bimatoprost, preservative, benzalkonium chloride, ocular surface disease
Full Text Available DeGaulle I Chigbu, Alissa M Coyne Pennsylvania College of Optometry Salus University, Elkins Park, PA, USA Abstract: Allergic disorders of the ocular surface are primarily characterized as IgE- and/or T-lymphocyte-mediated disorders that affect the cornea, conjunctiva, and eyelid. Approximately 40% of individuals in the developed countries have allergic conjunctivitis, and as such, it is the most common form of ocular allergy. Seasonal allergic conjunctivitis is the most prevalent type of allergic conjunctivitis that impacts the quality of life of patients. This article reviews the pharmacology, pharmacodynamics, pharmacokinetics, clinical trials, clinical efficacy, and safety of alcaftadine. Histamine and the pathological mechanism of ocular allergy will be briefly reviewed with the intent of providing a background for the detailed discussion on the clinical utility of alcaftadine in allergic conjunctivitis. The Medline PubMed, Elsevier Science Direct, and Google Scholar databases were used to search for evidence-based literature on histamine and immunopathological mechanism of allergic conjunctivitis, as well as on pharmacology, pharmacodynamics, pharmacokinetics, clinical trials, and clinical efficacy of alcaftadine. The treatment and management goals of allergic conjunctivitis are to prevent or minimize the inflammatory cascade associated with allergic response in the early stages of the pathological mechanism. It is of note that activation of histamine receptors on immune and nonimmune cells are associated with allergen-induced inflammation of the conjunctiva and its associated ocular allergic manifestations, including itching, edema, hyperemia, and tearing. Alcaftadine is an efficacious multiple action antiallergic therapeutic agent with inverse agonist activity on H1, H2, and H4 receptors, as well as anti-inflammatory and mast cell stabilizing effects that could provide therapeutic benefits to patients with allergic conjunctivitis. Keywords: alcaftadine, allergic conjunctivitis, histamine, immunopathological mechanisms, ocular allergies
Full Text Available Tsumura T, Yoshikawa K, Suzumura H, Kimura T, Sasaki S, Kimura I, Takeda R. Clinical Ophthalmology. 2012;6:1547–1552.On page 1549 the significant difference in MD values was stated as:(−5.22 ± 4.07 dB and −2.72 ± 4.06 dB, P = 0.0385It should have been:(−5.47± 4.78 dB and −5.26 ± 5.22 dB, P = 0.6757Figure 2 legend was missing the words:Left axis relates to the bars and right axis relates to the line chart.Read the original article
Chigbu, DeGaulle I; Coyne, Alissa M
Allergic disorders of the ocular surface are primarily characterized as IgE- and/or T-lymphocyte-mediated disorders that affect the cornea, conjunctiva, and eyelid. Approximately 40% of individuals in the developed countries have allergic conjunctivitis, and as such, it is the most common form of ocular allergy. Seasonal allergic conjunctivitis is the most prevalent type of allergic conjunctivitis that impacts the quality of life of patients. This article reviews the pharmacology, pharmacodynamics, pharmacokinetics, clinical trials, clinical efficacy, and safety of alcaftadine. Histamine and the pathological mechanism of ocular allergy will be briefly reviewed with the intent of providing a background for the detailed discussion on the clinical utility of alcaftadine in allergic conjunctivitis. The Medline PubMed, Elsevier Science Direct, and Google Scholar databases were used to search for evidence-based literature on histamine and immunopathological mechanism of allergic conjunctivitis, as well as on pharmacology, pharmacodynamics, pharmacokinetics, clinical trials, and clinical efficacy of alcaftadine. The treatment and management goals of allergic conjunctivitis are to prevent or minimize the inflammatory cascade associated with allergic response in the early stages of the pathological mechanism. It is of note that activation of histamine receptors on immune and nonimmune cells are associated with allergen-induced inflammation of the conjunctiva and its associated ocular allergic manifestations, including itching, edema, hyperemia, and tearing. Alcaftadine is an efficacious multiple action antiallergic therapeutic agent with inverse agonist activity on H1, H2, and H4 receptors, as well as anti-inflammatory and mast cell stabilizing effects that could provide therapeutic benefits to patients with allergic conjunctivitis.
Full Text Available Tsumura T, Yoshikawa K, Suzumura H, Kimura T, Sasaki S, Kimura I, Takeda R. Clinical Opthalmology. 2012;6:1547–1552. On page 1549 the significant difference in MD values was stated as in Table 1: −5.22 ± 4.07 It should have been: −5.47 ± 4.78Read the original article
Koppala, Srinivasarao; Reddy, V Ranga; Anireddy, Jaya Shree
A new rapid stability-indicating reversed-phase UPLC method was developed and validated for the determination of Bromfenac sodium and its impurities in Bromfenac ophthalmic solution. During literature search, only a few publications were found about Bromfenac sodium. There is no official monograph in the pharmacopoeias about Bromfenac sodium. Chromatographic separation has been achieved on a polar-embedded Waters Acquity BEH Shield RP18 (100 mm × 2.1 mm, 1.7 μm) column under gradient elution by using a binary mixture of potassium dihydrogen phosphate (0.01 M, pH 3.3) and acetonitrile (ACN) at a flow rate of 0.5 mL/min. Chromatogram was monitored at 265 nm using a photodiode array detector (PDA). The drug and its related impurities are eluted within 13 min. Resolution of Bromfenac sodium and all eight potential impurities have been achieved greater than 4.0 for all pairs of compounds. To prove the stability-indicating power of the method, the drug was subjected to hydrolytic (acid, alkaline and water), oxidative, photolytic and thermal stress, and the major degradation products were identified based on LC-MS analysis. The developed method was validated as per ICH guidelines with respect to specificity, linearity, limit of detection, limit of quantification, precision, accuracy and robustness.
Liu, Qiaoyan; Li, Yuejie; Xu, Qiujing; Zhao, Jincheng; Wang, Liwei; Gao, Yonghe
This investigation introduces GPU (Graphics Processing Unit)- based CUDA (Compute Unified Device Architecture) technology into signal processing of ophthalmic FD-OCT (Fourier-Domain Optical Coherence Tomography) imaging system, can realize parallel data processing, using CUDA to optimize relevant operations and algorithms, in order to solve the technical bottlenecks that currently affect ophthalmic real-time imaging in OCT system. Laboratory results showed that with GPU as a general parallel computing processor, the speed of imaging data processing using GPU+CPU mode is more than dozens times faster than traditional CPU platform based serial computing and imaging mode when executing the same data processing, which reaches the clinical requirements for two dimensional real-time imaging.
O'Gallagher, M K; Lewis, G; Mercieca, K; Moutray, T
To assess ophthalmic trainees' perspective of the impact of the European Working Time Regulations (EWTR) on their training. All trainees in ophthalmology in the UK were emailed a link to an electronic survey asking about their experiences of the EWTR. 324 trainees (46% of those invited) responded to the survey. 44.4% of trainees reported that their posts were compliant with the EWTR. 40.7% felt that training had been adversely affected. 49.1% thought that ophthalmic trainees should opt out of the EWTR to work more than 48 h per week, with 57 the mean number of hours suggested appropriate. Many ophthalmic trainees in the United Kingdom are working in rotas which are not compliant with the European Working Time Directive. Many trainees feel that implementation of the EWTD has had a negative effect on training and feel it would be acceptable to work a higher number of hours per week. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Muhammad Waseem; M. Amin Ullah Shah; Rizwana Aleem Qureshi; Iqbal Muhammad; Rabia Afza; Saeeda Yousaf
The present paper represents the ethnopharmacological survey of Sudhan Gali, Kashmir, Pakistan. The study revealed that 12 plant species belonging to 11 famihes were used for the treatment of stomach, diabetes and ophthalmic diseases by the local people in Sudhan GaB. Achillea millefolium, Aconitun heterophyllum, Berberis lycium, Polygonum amplexicaule, Mentha longifolia, Paeonia emodi, Plantago lanceolata were locally used for stomach related problemstreatment; Berberis lycium, Skimmia lareola, Solanum dulcamara for diabetes and Geranium wallichianum, Artemisia vulgaris, Solanum dulcamara, and Corydalis crassifolia used for the treatment of ophthalmic diseases. Two species Berberis lycium and Solanum dulcamara have multipurpose value. Former is used to treat stomach as well as diabetes while latter is used to treat not only to diabetes but also ophthalmic diseases. According to IUCN categories, out of these 12 plant species collected and marketed, Polygonum amplexicaule and Paeonia emodi are endangered, Aconitum heterophyllum; Berberis lycium species are vulnerable while Plantago lanceolata and Skimmia lareola species are rare.The availability of these medicinal plants has decreased during the past 20 years and these are facing a drastic biotic pressure due to their extensive usage and non-scientific methods of collection. It is quite evident that these valuable native medicinal plants species are going to decline in number and ultimately will become extinct if no timely proper conservation strategies are adopted.
Al-Ghabeish, Manar; Xu, Xiaoming; Krishnaiah, Yellela S R; Rahman, Ziyaur; Yang, Yang; Khan, Mansoor A
The availability of in vitro performance tests such as in vitro drug release testing (IVRT) and in vitro permeation testing (IVPT) are critical to comprehensively assure consistent delivery of the active component(s) from semisolid ophthalmic drug products. The objective was to study the impact of drug loading and type of ointment base on the in vitro performance (IVRT and IVPT) of ophthalmic ointments using acyclovir as a model drug candidate. The in vitro drug release for the ointments was evaluated using a modified USP apparatus 2 with Enhancer cells. The transcorneal permeation was carried out using rabbit cornea on modified vertical Franz cells. The drug retention in cornea (DRC) was also determined at the end of transcorneal drug permeation study. The in vitro drug release, transcorneal drug permeation as well as DRC exhibited a proportional increase with increasing drug loading in the ointment. On comparing the in vitro drug release profile with transcorneal permeation profile, it appears that drug release from the ointment is controlling acyclovir transport through the cornea. Furthermore, enhanced in vitro transcorneal permeation relative to the in vitro drug release underscores the importance of the interplay between the physiology of the ocular tissue and ointment formulation. The results indicated that IVRT and IVPT could be used to discriminate the impact of changes in drug load and formulation composition of ophthalmic ointments.
Lim, Rongxuan; Sethi, Mieran; Morley, Ana M S
To document the ocular manifestations of xeroderma pigmentosum (XP), presenting via the United Kingdom (UK) XP service, and to analyze the correlations between XP genotype and ophthalmic phenotype. Prospective observational case series. Eighty-nine patients seen by the UK Nationally Commissioned XP Service, from April 2010 to December 2014, with a genetically confirmed diagnosis of XP. Patients underwent a full ophthalmic examination at each visit. Clinical features from both eyes were recorded on a standard proforma. The most recent assessments were analyzed. A 2-tailed Fisher exact test was used to assess for differences in ocular features between patients in XP subgroups with impaired transcription coupled nucleotide excision repair (TC-NER) (category 1: XP-A, B, D, F, and G) and preserved TC-NER (category 2: XP-C, E, and V). Lid and periocular abnormalities, ocular surface pathologies, neuro-ophthalmologic abnormalities, lens and retinal abnormalities, and visual acuity (VA). Ninety-three percent of XP patients in our cohort had ocular involvement, with 65% describing photophobia. The most common abnormalities were in the periocular skin and ocular surface, including interpalpebral conjunctival melanosis (44%) and conjunctival injection (43%). Eleven percent of patients had required treatment for periocular cancers and 2% for ocular surface cancers. The most common neuro-ophthalmologic finding was minimal pupillary reaction to light (25%). Patients in category 2 had significantly more ocular surface abnormalities than patients in category 1, including a greater proportion of conjunctival injection (P = 0.003), conjunctival corkscrew vessels (P surface signs related to XP, before any formal diagnosis of XP was made. A large proportion of XP patients have ocular involvement. Regular examination by an ophthalmologist is essential, especially in screening for eyelid and ocular surface tumors. The ocular phenotype-genotype segregation within XP patients suggests
Lima, Leandro; Montiani-Ferreira, Fabaino; Tramontin, Mariana; Leigue Dos Santos, Lucianne; Machado, Marcello; Ribas Lange, Rogério; Helena Abil Russ, Heloisa
To carry out a descriptive investigation into the most relevant morphological features of the chinchilla eye and bony orbit, as well as to perform selected ophthalmic diagnostic tests with the aim of establishing normal anatomic and physiologic references for this species. A total of 57 healthy, chinchillas were used to test most of the parameters in this investigation. Besides morphologic observations of the globe and adnexa, selected ocular tests and parameters were investigated, including blink frequency, palpebral fissure length (PFL), Schirmer tear test (STT), esthesiometry, intraocular pressure (IOP), central corneal thickness (CCT), B-mode echobiometric measurements of the globe and culture of the normal conjunctival bacterial microbiota. Morphologic observations were made using six formalin-fixed globes and four macerated skulls. Normal parameters found for selected ocular diagnostic tests were: blink frequency: 2.6 ± 0.84 blinks per 10 min; STT: 1.07 ± 0.54 mm; esthesiometry: 1.24 ± 0.46 cm; IOP: 17.71 ± 4.17 mmHg; CCT: 0.34 ± 0.03 mm; PFL: 1.44 ± 0.11 cm; anterior chamber depth: 2.01 ± 0.2 mm; axial lens thickness: 5.49 ± 0.43 mm; vitreous chamber depth (internal): 3.69 ± 0.52 mm; axial globe length: 1.14 ± 0.07 cm. The most frequent bacteria isolated from the conjunctiva were Streptococcus sp. (27.45%), Staphylococcus aureus (23.52%) and coagulase-negative Staphylococcus (19.60%). No statistically significant differences between left or right eyes or genders were found for any of the results. Reference data and morphologic observations obtained in this investigation will help veterinary ophthalmologists to recognize unique morphological features and more accurately diagnose ocular diseases in the chinchilla, an animal already being used as a biological model for ophthalmic studies.
Full Text Available Kazuki Matsuura,1 Yoshitsugu Inoue2 1Nojima Hospital, 2Tottori University, Kurayoshi City, Tottori, Japan Background: The purpose of this study was to assess the risk of intraocular contamination caused by intraocular lens (IOL insertion with injectors by observing the dynamics of an ophthalmic viscosurgical device (OVD. Methods: Each type of injector was equipped with a colored OVD and IOL, and a 2 mm length from the tip of the cartridge was replaced with a colored OVD. The various combinations of IOLs and injectors used were: a three-piece shaped IOL, VA60BBR + TypeE1 (HOYA incision size 2.5 mm; group A, n=5; a single-piece IOL, 251+ iSert micro, preloaded (HOYA, incision size 2.2 mm; group G, n=5; and a single-piece IOL, SN6CWS preloaded (Alcon, incision size 2.7 mm; group C, n=5. Results: In group A, the intraocular OVD instantly flowed backward into the injector, whereas the colored OVD was pushed backward deep inside the cartridge without flowing into the eye. In group B, the backflow of the intraocular OVD into the injector was limited, resulting in the influx of a large amount of the colored OVD into the eye along with the IOL. In group C, as in group A, a large amount of the intraocular OVD flowed backward into the injector. Consequently, a small amount of the colored OVD flowed into the eye. Conclusion: The tip of the injector and OVD could be contaminated because the surgical field cannot be completely sterile, even after preoperative disinfection. Our experiments revealed that OVD backflow into the injector cavity occurs during IOL insertion, and this phenomenon may have minimized intraocular contamination. However, small-diameter cartridges along with plate-type haptics allow insufficient OVD backflow, resulting in intraocular influx of the contaminated OVD. Surgeons have to be notified that intraoperative bacterial contamination can occur even after IOL insertion using injectors. Keywords: intraocular lens insertion
Delcourt, Cécile; Korobelnik, Jean-François; Buitendijk, Gabriëlle H S; Foster, Paul J; Hammond, Christopher J; Piermarocchi, Stefano; Peto, Tunde; Jansonius, Nomdo; Mirshahi, Alireza; Hogg, Ruth E; Bretillon, Lionel; Topouzis, Fotis; Deak, Gabor; Grauslund, Jakob; Broe, Rebecca; Souied, Eric H; Creuzot-Garcher, Catherine; Sahel, José; Daien, Vincent; Lehtimäki, Terho; Hense, Hans-Werner; Prokofyeva, Elena; Oexle, Konrad; Rahi, Jugnoo S; Cumberland, Phillippa M; Schmitz-Valckenberg, Steffen; Fauser, Sascha; Bertelsen, Geir; Hoyng, Carel; Bergen, Arthur; Silva, Rufino; Wolf, Sebastian; Lotery, Andrew; Chakravarthy, Usha; Fletcher, Astrid; Klaver, Caroline C W
The European Eye Epidemiology (E3) consortium is a recently formed consortium of 29 groups from 12 European countries. It already comprises 21 population-based studies and 20 other studies (case-control, cases only, randomized trials), providing ophthalmological data on approximately 170,000 European participants. The aim of the consortium is to promote and sustain collaboration and sharing of data and knowledge in the field of ophthalmic epidemiology in Europe, with particular focus on the harmonization of methods for future research, estimation and projection of frequency and impact of visual outcomes in European populations (including temporal trends and European subregions), identification of risk factors and pathways for eye diseases (lifestyle, vascular and metabolic factors, genetics, epigenetics and biomarkers) and development and validation of prediction models for eye diseases. Coordinating these existing data will allow a detailed study of the risk factors and consequences of eye diseases and visual impairment, including study of international geographical variation which is not possible in individual studies. It is expected that collaborative work on these existing data will provide additional knowledge, despite the fact that the risk factors and the methods for collecting them differ somewhat among the participating studies. Most studies also include biobanks of various biological samples, which will enable identification of biomarkers to detect and predict occurrence and progression of eye diseases. This article outlines the rationale of the consortium, its design and presents a summary of the methodology.
Maritza F. Díaz
Full Text Available Context: Ozonized vegetable oils present germicidal effects which can be used as active principle in different cosmetological compositions. The thematic about of the corporal massage advantage have been very treatment by aesthetics, dermatologic and consumers. OLEOMASAJE formulation content ozonized sunflower oil OLEOZON as active principle active which present moisturizer and conditioner effects. Aims: To determine the possible dermal and ophthalmic irritability effects of the OLEOMASAJE. Methods: The trial was conducted in rabbits and the techniques described in the standardized procedures of the work established by the Center of Biological Research and Evaluations from Pharmacy and Food Institute of Havana University were used according to Norma ISO 10993-10. The ethical principles of the Good Practices of Laboratory were fulfilled to avoid suffering to the animals during the experimentation. Male rabbits with body weight between 2.05 and 2.48 kg were used. In the skin and the ocular structures the effects were observed immediately after of the application at 1, 24, 48 and 72 hours. Draize´s scale was applied to evaluate skin and ocular structures lesions. Results: The OLEOMASAJE formulation does not irritate de skin of the assayed rabbits. However, the ocular structures irritability index was of 4.5 after of first hour to apply of product. These wounds were missing before of 24 hours to apply of product. Conclusions: The OLEOMASAJE formulation obeys the indispensable requirements for the acceptance as cosmetic product and for it is used in corporal massage.
Gramatikov, Boris I; Rangarajan, Shreya; Irsch, Kristina; Guyton, David L
This study relates to eye fixation systems with combined optical and audio systems. Many devices for eye diagnostics and some devices for eye therapeutics require the patient to fixate on a small target for a certain period of time, during which the eyes do not move and data from substructures of one or both eyes are acquired and analyzed. With young pediatric patients, a monotonously blinking target is not sufficient to retain attention steadily. We developed a method for modulating the intensity of a point fixation target using sounds appropriate to the child's age and preference. The method was realized as a subsystem of a Pediatric Vision Screener which employs retinal birefringence scanning for detection of central fixation. Twenty-one children, age 2-18, were studied. Modulation of the fixation target using sounds ensured the eye fixated on the target, and with appropriate choice of sounds, performed significantly better than a monotonously blinking target accompanied by a plain beep. The method was particularly effective with children of ages up to 10, after which its benefit disappeared. Typical applications of target modulation would be as supplemental subsystems in pediatric ophthalmic diagnostic devices, such as scanning laser ophthalmoscopes, optical coherence tomography units, retinal birefringence scanners, fundus cameras, and perimeters. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.
Full Text Available To investigate the temporary tamponade effects of an ophthalmic viscosurgical device (OVD for experimental retinal tears, we performed vitrectomy in four rabbit eyes and created a posterior vitreous detachment and artificial retinal tear to produce retinal detachment. The retina was flattened with liquid perfluorocarbon (PFC, the area peripheral to the tear was photocoagulated, an OVD was applied to the retinal tear surface below the PFC and the PFC was removed by aspiration. In the control group, PFC was removed without application of OVD. At one, three and seven days postoperatively, funduscopy and optical coherence tomography (OCT were performed to examine the sealing process of the retinal tear. In OVD-treated eyes, the OVD remained on the retinal surface, and the retinal tear was patched for ≥ 3 days postoperatively. By seven days postoperatively, the OVD on the retinal surface had disappeared, and the retina was reattached. In control eyes, the edge of the retinal tear was rolled, and retinal detachment persisted. In OVD-treated eyes, the border of the retinal tear was indistinct, and the defect area was significantly decreased. These results show that application of an OVD effectively seals retinal tears and eliminates retinal detachments.
Full Text Available Tomoyuki Kashima,1 Hirotaka Itakura,1,2 Hideo Akiyama,1 Shoji Kishi11Department of Ophthalmology, Gunma University, School of Medicine, Maebashi, Gunma, Japan; 2Department of Ophthalmology, Maebashi Red Cross Hospital, Maebashi, Gunma, JapanAbstract: Rebamipide was initially developed and approved for use in treating gastric ulcers and lesions associated with gastritis. Discovery of its ability to increase gastric mucin led to investigations of its effect on ocular surface mucin and the subsequent development for use in dry eye patients. Investigations have confirmed that rebamipide increases corneal and conjunctival mucin-like substances along with improving corneal and conjunctival injury. Clinically, rebamipide ophthalmic suspensions can effectively treat tear deficiency and mucin-caused corneal epithelial damage, and can restore the microstructure responsible for tear stability. Topical rebamipide has also been shown to be effective in treating other ocular surface disorders such as lagophthalmos, lid wiper epitheliopathy, and persistent corneal erosion. Rebamipide’s ability to modify epithelial cell function, improve tear stability, and suppress inflammation in the absence of any known major side effects suggest that it may be a beneficial first drug of choice for severe dry eye treatment and other ocular surface disorders. This review summarizes the history and development of this innovative dry eye treatment from its initial use as an effective stomach medication to its current use in the treatment of dry eye in Japan.Keywords: quinolinone derivative, tear deficiency, ocular surface disorder, mucin secretion, Mucosta
Guiqin Wang; Qian Shi; Lin Sun; Jing Wang; Lei Li; Tianchang Li; Wei Wang
Purpose:.To perform ophthalmic examinations to evaluate the ocular characteristics of children living in the Tibet plateau and diagnosed with congenital heart disease.Methods:.Children with congenital heart disease underwent a conventional ocular examination including distant acuity test, slit-lamp examination,.fundus examination,.non-contact in-traocular pressure measurement,.measurement of corneal thickness, and fundus photography.Results: Forty-two Tibetan children, aged between 4 and 18 years and diagnosed with congenital heart disease,.were en-rolled in this study..The percentage of low visual acuity was 4.76%, mean intraocular pressure was (13.67±2.15) mmHg, average corneal thickness was (492.55±33.79) μm,.96.43%had an anterior chamber depth of 1 / 2 corneal thickness (CT), and 35.7% had an obvious fundus vascular tortuosity.Conclusion:.This study adds to the understanding of the ocu-lar status of the population living in the Tibet plateau, thereby offering clinical evidence for the prevention and treatment of eye diseases in this area. (Eye Science 2014; 29:134-137)
To determine the intraocular bioavailability of a novel embodiment for vitamin B(12) delivered to the ocular surface by a piezo-electric ultrasonic nebulizer. The semisolid embodiment contained 0.02% (w/w) vitamin B(12) in 1 g of ointment, which was immiscible and insoluble in 5 mL sterilized warm water. To confirm in vitro functionality, nebulized mist particles of the embodiment were collected and analysed for vitamin B(12) content. The in vivo arm of the study was designed as randomization of 23 patients who were scheduled to undergo cataract surgery in hospital. Fourteen patients were treated with nebulized vitamin B(12), five patients had one drop of 0.02% vitamin B(12) instilled in the conjunctival cul de sac, and four control patients had no medication. Twelve hours after the vitamin was delivered, the patients underwent the cataract procedure and a sample of aqueous humour was collected from each. High performance liquid chromatography was used for detection of vitamin B(12) in all samples. The in vitro analysis of mist particles showed increasing concentrations of vitamin B(12). In the patient tests, analysis of the aqueous humour samples showed that none of the controls or those receiving eye drops had detectable vitamin B(12) in the aqueous humour. However, 4 of 14 in the nebulizer group had vitamin B(12) detected in the aqueous humour in the amount of 10(-7) mol. The small-volume nebulizer system might provide another method of ophthalmic drug delivery.
Rowe, T. Scott; Zawadzki, Robert J.
We document our latest work in developing eye models with solid-state retinal tissue phantoms designed for demonstrating, validating and comparing ophthalmic Optical Coherence Tomography (OCT) instruments. Eye models with retina tissue phantoms can serve a variety of purposes, including demonstrating OCT functionality and performance in both the clinic and exhibit hall, validating retina layer thickness measurements from different commercial OCT instruments and as an aide for the R&D engineer and field service technician in the development and repair of instruments, respectively. The ideal eye model for OCT, the optical cross-sectional imaging modality, would have a volumetric morphology and scattering and absorption properties similar to that of normal human retina. These include a multi-layered structure of equivalent thickness to nominal human retina layers, a foveal pit that can be used to orient the image, and a RPE/OS and choroid like layers to demonstrate the depth penetration of the OCT system. A solid state tissue phantom relieves the user of constant cleaning and maintenance associated with the more common water bath model eyes. Novel processes12 have been developed to create retinal layers model that closely mimic the reflectance and scattering coefficients of the real layers of the retina, as imaged by spectral bandwidth of OCT.
Pawar Sagar D
Full Text Available Recently, controlled drug delivery has become the standard in modern Pharmaceutical design and an intensive research have been undertaken in achieving much better drug product effectiveness, reliability and safety. This interest has been sparked by the advantages shown by in situ forming polymeric delivery systems such as ease of administration and reduced frequency of administration, improved patient compliance and comfort. In situ hydrogels are instilled as drops into the eye and undergoes a sol to gel transition in the cul-de-sac, improved ocular bioavailability by increasing the duration of contact with corneal tissue, thereby reducing the frequency of administration. The purpose of the present work was to develop an ophthalmic drug delivery system using the three different gelling agents with different mechanisms for in situ gelation of Gatifloxacin hydrochloride, a fluoroquinolone antibiotic. Polyox – a pH sensitive gelling agent and sodium alginate is an ion sensitive gelling agent and Poloxamer – a temperature sensitive gelling agent were employed for the formation of in situ hydrogel along with HPMC K4M as viscofying agent. The promising formulations were evaluated for pH, drug content, in vitro gelation, in vitro drug release, in vivo drug release, ocular irritation.
Chen, Jian-Xiu; Guo, Zhen; Li, Hai-Yan; Wu, Li; He, Zhong-Gui; Hu, Rong-Feng; Zhang, Ji-Wen
In this paper, chloramphenicol was selected as a model drug to prepare in situ gels. The intrinsic dissolution rate of chloramphenicol from in situ gel was evaluated using the surface dissolution imaging system. The results indicated that intrinsic dissolution rate of chloramphenicol thermosensitive in situ gel decreased significantly when the poloxamer concentration increased. The addition of the thickener reduced the intrinsic dissolution rate of chloramphenicol thermosensitive gel, wherein carbomer had the most impact. Different dilution ratios of simulated tear fluid greatly affected gel temperature, and had little influence on the intrinsic dissolution rate of chloramphenicol from the thermosensitive in situ gel. The pH of simulated tear fluid had little influence on the intrinsic dissolution rate of chloramphenicol thermosensitive in situ gel. For the pH sensitive in situ gel, the dissolution rates of chloramphenicol in weak acidic and neutral simulated tear fluids were slower than that in weak alkaline simulated tear fluid. In conclusion, the intrinsic dissolution of chloramphenicol from in situ gel was dependent on formulation and physiological factors. With advantages of small volume sample required and rapid detection, the UV imaging method can be an efficient tool for the evaluation of drug release characteristics of ophthalmic in situ gel.
Aslan, Lokman; Aslankurt, Murat; Bozkurt, Selim; Aksoy, Adnan; Ozdemir, Murat; Gizir, Harun; Yasar, Ibrahim
The aim of this study is to report ophthalmic findings of acute mercury poisoning in 48 adults referred to emergency department. Full ophthalmologic examination including the best corrected visual acuity, external eye examination, reaction to light, a slit-lamp examination, funduscopy, intraocular pressure measurements, and visual field (VF) and color vision (CV) tests were performed at the presentation and repeated after 6 months. The parametric values of VF test, the mean deviation (MD), and pattern standard deviation (PSD) were recorded in order to compare patients and the 30 healthy controls. The mean parameter of color confusion index in patients was found to be statistically different than controls (p < 0.01). The MD and PSD in patients were different from controls statistically significant (p < 0.01 and p < 0.01, respectively). There was no correlation between the ocular findings and the urine and blood mercury levels. Methyl mercury, held in the school laboratory for experimental purpose, may be a source of poisoning. In this case series, we showed that acute exposure to mercury had hazardous effect on the visual system, especially CV and VF. We propose that emphasizing the public education on the potential hazards of mercury is crucial for preventive community health.
Badawi, Amani E; Moemen, Dalia; El-Tantawy, Nora L
AIM To analyze the epidemiological, clinical and laboratory findings of infectious keratitis. METHODS A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was done at Mansoura Ophthalmic Center, Egypt. Corneal scrapings were performed and processed for direct microscopy and culture in appropriate media using standard laboratory protocols. RESULTS Out of 245 patients enrolled for study, 247 corneal scrapings were obtained. Ocular trauma was the most common predisposing factor (51.4%), followed by diabetes mellitus (15.1%). Cultures were positive in 110 scraping samples (44.5%): 45.5% samples had pure fungal infection, 40% had pure bacterial infections and 10% had mixed fungal and bacterial growths. Acanthamoeba was detected in 5 (4.5%) samples. The most common fungal pathogen was Aspergillus spp. (41%). The most common bacterial isolates were Staphylococcus aureus (38.2%) and Pseudomonas aeruginosa (21.8%). CONCLUSION Incidence of fungal keratitis is high in our region. Therapeutic approach can initially be based on clinical features and sensitivity/resistance patterns. Microbiological research should direct the antimicrobial treatment. Antibiotic resistance to fluoroquinolones and aminoglycosides is an important consideration. PMID:28149778
Labelle, A L; Hamor, R E; Macneill, A L; Lascola, K M; Breaux, C B; Tolar, E L
There is little scientific information available about the ability of ocular disease to cause a systemic inflammatory response. Horses are frequently affected with ocular disease and ensuring their systemic health prior to performing vision saving surgery under anaesthesia is essential for the successful treatment of ophthalmic disease. Ocular disease will cause elevations in the concentration of the acute phase proteins fibrinogen and serum amyloid A in peripheral blood. Whole blood and serum samples were obtained from 38 mature horses with ulcerative keratitis or uveitis and no evidence of systemic disease, 9 mature horses with no evidence of ocular or systemic disease (negative controls) and 10 mature horses with systemic inflammatory disease and no evidence of ocular disease (positive controls). Blood samples were assayed for concentrations of the acute phase proteins fibrinogen and serum amyloid A. Fibrinogen and serum amyloid A were significantly different in the positive control group compared to the negative control, corneal disease and uveitis groups (P<0.126). There was no significant difference between the negative control, corneal disease and uveitis groups (P<0.001). Ulcerative keratitis and anterior uveitis are not associated with elevated concentrations of the acute phase proteins fibrinogen and serum amyloid A in peripheral blood. When the clinician is presented with a patient with ocular disease and elevated plasma fibrinogen or serum amyloid A concentrations, a nonocular inflammatory focus should be suspected. © 2011 EVJ Ltd.
Kashima, Tomoyuki; Itakura, Hirotaka; Akiyama, Hideo; Kishi, Shoji
Rebamipide was initially developed and approved for use in treating gastric ulcers and lesions associated with gastritis. Discovery of its ability to increase gastric mucin led to investigations of its effect on ocular surface mucin and the subsequent development for use in dry eye patients. Investigations have confirmed that rebamipide increases corneal and conjunctival mucin-like substances along with improving corneal and conjunctival injury. Clinically, rebamipide ophthalmic suspensions can effectively treat tear deficiency and mucin-caused corneal epithelial damage, and can restore the microstructure responsible for tear stability. Topical rebamipide has also been shown to be effective in treating other ocular surface disorders such as lagophthalmos, lid wiper epitheliopathy, and persistent corneal erosion. Rebamipide’s ability to modify epithelial cell function, improve tear stability, and suppress inflammation in the absence of any known major side effects suggest that it may be a beneficial first drug of choice for severe dry eye treatment and other ocular surface disorders. This review summarizes the history and development of this innovative dry eye treatment from its initial use as an effective stomach medication to its current use in the treatment of dry eye in Japan. PMID:24940041
Dilbaghi, Neeraj; Kaur, Harmanmeet; Ahuja, Munish; Kumar, Sandeep
The present study was aimed to prepare tamarind seed nanoaggregates and its evaluation for ophthalmic delivery. The preparation of tropicamide-loaded tamarind seed xyloglucan nanoaggregates was optimized using face centred central composite experimental design, employing the concentrations of tamarind seed xyloglucan and Poloxamer-407, as independent variables. The results revealed that concentration of TSX has a significant antagonistic effect on particle size, while poloxamer displayed a significant synergistic effect on encapsulation efficiency. The optimal concentrations of TSX and poloxamer were found to be 0.45% (w/v) and 0.5% (w/v) respectively. The optimized formulation of tropicamide-loaded TSX nanoaggregates showed a significantly higher corneal permeation of tropicamide across the isolated goat cornea compared to commercial conventional aqueous formulation. The results revealed excellent mucoadhesive properties of TSX nanoaggregates. Further, the tropicamide-loaded TSX nanoaggregates formulation showed excellent ocular tolerance and biocompatibility as determined by hen's egg test chorioallantoic membrane and resazurin assay on Vero cell lines.
Romero, Lenny A; Millán, María S; Jaroszewicz, Zbigniew; Kolodziejczyk, Andrzej
The aged human eye is commonly affected by presbyopia, and therefore, it gradually loses its capability to form images of objects placed at different distances. Extended depth of focus (EDOF) imaging elements can overcome this inability, despite the introduction of a certain amount of aberration. This paper evaluates the EDOF imaging performance of the so-called peacock eye phase diffractive element, which focuses an incident plane wave into a segment of the optical axis and explores the element's potential use for ophthalmic presbyopia compensation optics. Two designs of the element are analyzed: the single peacock eye, which produces one focal segment along the axis, and the double peacock eye, which is a spatially multiplexed element that produces two focal segments with partial overlapping along the axis. The performances of the peacock eye elements are compared with those of multifocal lenses through numerical simulations as well as optical experiments in the image space. The results demonstrate that the peacock eye elements form sharper images along the focal segment than the multifocal lenses and, therefore, are more suitable for presbyopia compensation. The extreme points of the depth of field in the object space, which represent the remote and the near object points, have been experimentally obtained for both the single and the double peacock eye optical elements. The double peacock eye element has better imaging quality for relatively short and intermediate distances than the single peacock eye, whereas the latter seems better for far distance vision.
Pérez, Mario A.; Bruce, Beau B.; Newman, Nancy J.; Biousse, Valérie
Background Ocular fundus examination is an important element of the neurological examination. However, direct ophthalmoscopy is difficult to perform without pupillary dilation and requires extensive practice to accurately recognize optic nerve and retinal abnormalities. Recent studies have suggested that digital retinal photography can replace direct ophthalmoscopy in many settings. Review Summary Ocular fundus imaging is routinely used to document and monitor disease progression in ophthalmology. Advances in optical technology have made it easier to obtain high-quality retinal imaging, even without pupillary dilation. Retinal photography has a high sensitivity, specificity, and inter-/intra-examination agreement compared to in-person ophthalmologist examination, suggesting that photographs can be used in lieu of ophthalmoscopy in many clinical situations. Non-mydriatic retinal photography has recently gained relevance as a helpful tool for diagnosing neuro-ophthalmologic disorders in the emergency department. Additionally, several population-based studies have used retinal imaging to relate ophthalmic abnormalities to the risk of hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment. The possibility of telemedical consultation offered by digital retinal photography has already increased access to timely and accurate subspecialty care, particularly for underserved areas. Conclusion Retinal photography (even without pupillary dilation) has become increasingly available to medical fields outside of ophthalmology, allowing for faster and more accurate diagnosis of various ocular, neurologic and systemic disorders. The potential for telemedicine may provide the additional benefits of improving access to appropriate urgent consultation in both clinical and research settings. PMID:23114666
Oriá, Arianne P; Gomes Junior, Deusdete C; Oliveira, Alberto Vinícius D; Curvelo, Victor P; Estrela-Lima, Alessandra; Pinna, Melissa H; Meneses, Íris D S; Filho, Emanoel F M; Ofri, Ron
The purpose of this study was to establish reference values for diagnostic ophthalmic tests in sambar deer (Rusa unicolor) as well as to describe the most relevant features of the bony orbital anatomy and ocular histology. Twenty healthy animals, free living in a forest reserve, that were captured for clinical evaluation as part of a health survey were evaluated. Schirmer tear test-1 (STT1), conjunctival microbiota, intraocular pressure (IOP), conjunctival cytology, anatomy of the bony orbit, and ocular histology were studied. Mean ± SD STT1 and IOP values were 18.8 ± 4.7 mm and 11.4 ± 2.8 mmHg, respectively. IOP was significantly higher in adult (4-8 years) animals (P = 0.04). Bacterial growth was present in 100% of the samples, with a prevalence for Staphylococcus sp. and Bacillus sp. The conjunctival cytology revealed predominance of columnar epithelial cells with mild pigmentation. The sambar deer orbit is completely encompassed by bone. The ocular histology was very similar to most mammalians. The findings in this study will be useful in the diagnosis of ocular diseases in Rusa unicolor. © 2014 American College of Veterinary Ophthalmologists.
Kim, H.-C.; Träger, J.; Zorn, M.; Haberkorn, N.; Hampp, N.
Intraocular lens (IOL) implantation is the standard technique to treat cataract. Despite recent progress in surgical procedures, posterior capsule opacification is one of the sill remaining postoperative complications of cataract surgery. We present a novel strategy to reduce the incidence of posterior capsule opacification. A drug delivery polymer suitable for manufacturing intraocular lenses has been developed which enables repeated drug release in a non-invasive and controlled manner. The therapeutic molecules are attached through a UV light sensitive linkage to the polymer backbone which is mainly responsible for the optical properties of the intraocular lenses. However, UV light can not trigger the release of drug from the polymer due to the high absorption of the cornea. We developed linkers which enable drug release by two-photon absorption induced cleavage of the linker structure. Since the two-photon absorption requires high photon densities, this does not occur in ambient light conditions in daily life, but is easily triggered by focused laser beams from a pulsed laser. In this proof-of-principle study we have employed a cyclobutane type linker and investigated the properties of the therapeutic system with the approved drugs 5-fluorouracil and chlorambucil. The controlled drug delivery was successfully demonstrated in vitro and additional cell tests confirmed that the device itself shows no cytotoxicity until photochemical activation. This presented concept can provide a powerful method in ophthalmic drug delivery.
Onakpoya, Oluwatoyin Helen; Omotoye, Olusola J
To detect the presence of ophthalmic abnormalities and visual impairment in deaf students. A cross-sectional survey of all students in the school for the deaf was conducted following ethical clearance from the Ministry of Health. Age, sex, and previous eye examination was recorded for each student as well as visual acuity, penlight eye examination, intraocular pressure, dilated funduscopy, and refraction (when applicable). Data were analyzed with SPSS version 11 and statistical significance inferred at pvisually impaired, 4 (2.6%) had unilateral visual impairment, and 4 (2.6%) had unilateral blindness. Blindness was caused by Usher syndrome in 1 (50%) and bilateral pigmented macular scar in 1 (50%) patient. Uncorrected refractive errors were the leading cause of unilateral visual impairment (75%), visual impairment (60%), and unilateral blindness (50%). Ocular abnormality was present in 53 (34%) students while uncorrected refractive error (18.6%), retina changes (7%), and allergic conjunctivitis (3.8%) were the leading disorders. Previous eye examination was more common among primary school students (pdevelopment of a deaf child, and conduct an initial and periodic eye examination for every intake.
Francis, Jasmine H., E-mail: firstname.lastname@example.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Barker, Christopher A.; Wolden, Suzanne L.; McCormick, Beryl; Segal, Kira; Cohen, Gil [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Gobin, Y. Pierre; Marr, Brian P. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, New York (United States); Brodie, Scott E. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Mount Sinai School of Medicine, New York, New York (United States); Dunkel, Ira J.; Abramson, David H. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, New York (United States)
Purpose: To evaluate the efficacy and toxicity of brachytherapy after ophthalmic artery chemosurgery (OAC) for retinoblastoma. Methods and Materials: This was a single-arm, retrospective study of 15 eyes in 15 patients treated with OAC followed by brachytherapy at (blinded institution) between May 1, 2006, and December 31, 2012, with a median 19 months' follow-up from plaque insertion. Outcome measurements included patient and ocular survival, visual function, and retinal toxicity measured by electroretinogram (ERG). Results: Brachytherapy was used as adjuvant treatment in 2 eyes and as salvage therapy in 13 eyes of which 12 had localized vitreous seeding. No patients developed metastasis or died of retinoblastoma. The Kaplan-Meier estimate of ocular survival was 79.4% (95% confidence interval 48.7%-92.8%) at 18 months. Three eyes were enucleated, and an additional 6 eyes developed out-of-target volume recurrences, which were controlled with additional treatments. Patients with an ocular complication had a mean interval between last OAC and plaque of 2.5 months (SD 2.3 months), which was statistically less (P=.045) than patients without ocular complication who had a mean interval between last OAC and plaque of 6.5 months (SD 4.4 months). ERG responses from pre- versus postplaque were unchanged or improved in more than half the eyes. Conclusions: Brachytherapy following OAC is effective, even in the presence of vitreous seeding; the majority of eyes maintained stable or improved retinal function following treatment, as assessed by ERG.
Full Text Available A sustain release thermo reversible in situ gel of Moxifloxacin Hydrochloride using mucoadhesive polymer was prepared. Mucoadhesive polymer was used to obtain an ophthalmic delivery system with improved mechanical and mucoadhesive properties that will provide prolong retention time for treatment of ocular diseases. Developed formulations were evaluated for drug-excipient compatibility study, pH, Clarity, Gelation temperature study, Mucoadhesion properties and in-vitro release studies. Drug-excipient compatibility study was performed by FTIR technique.The individual IR spectra of the pure drug and polymers as well as the combination spectra of the drug and polymer were taken, which indicate no interaction between Moxifloxacin and polymers when compared with infrared spectrum of pure drug as all functional group frequencies were present. The values of other parameters obtained were in acceptable range. In vitro release tests revealed that 98% drug was released from the in situ gel containing 0.5% and 1.00% HPMC in 12 hr. provides prolonged release.
Montiani-Ferreira, Fabiano; Mattos, Bianca Chaim; Russ, Heloisa Helena Abil
To perform selected ophthalmic diagnostic tests in healthy ferrets with the aim of establishing normal physiological reference values for this species. A total of 15 healthy, unrelated ferrets were used to test most of the parameters in this investigation. Eight of the 15 ferrets were used for central corneal thickness evaluation. Ages varied from 1.5 to 6 years of age. Selected diagnostic ocular tests were performed including Schirmer tear test, tonometry using an applanation tonometer (Tonopen), central corneal thickness using an ultrasonic pachymeter (Sonomed, Micropach, Model 200P +) and culture of the normal conjunctival bacterial flora. Staphylococcus sp. and Corynebacterium sp. were isolated from healthy conjunctival and eyelid margins, suggesting they are normal constituents of the conjunctival flora of the ferret. Results for selected ocular diagnostic tests investigated here for the ferret eye were as follows: intraocular pressure: 14.50 +/- 3.27 mmHg; Schirmer tear test: 5.31 +/- 1.32 mm/min; central corneal thickness: 0.337 +/- 0.020 mm. No statistically significant differences between ages or genders were found for any of the results. The reference data for the ocular tests obtained in this investigation will help veterinary ophthalmologists to more accurately diagnose ocular diseases in the ferret. Knowledge of these reference values will be particularly useful to diagnose discrete or unusual pathological changes of the ferret eye.
Dubin, Stephen; Ansari, Rafat R.; Tulp, Orien; Steinberg, Sheldon; Koch, Seth; DellaVecchia, Michael A.; Cozmi, Mihaela; Victor, Mary
The absence of verbal feedback, available from most human patients, is a major limitation in veterinary diagnosis in general and in the evaluation of ophthalmic lens opacity in particular. A novel compact dynamic light scattering (DLS) instrument, developed at NASA, offers significant mitigation to this limitation. It not only yields objective repeatable non-invasive estimation of lens opacity but also provides insight into the nature of chemical and physical alternations in the lens and other eye structures. For example, DLS measurements of the cataractous lens may be interpreted in terms of alpha crystalline protein size. In contrast to most conventional methods, the examination results are numerical and readily accommodate statistical analysis. We present results of DLS measurements in laboratory rabbits with naphthalene induced cataracts, rodents with genetically conditioned hypertension and/or diabetes mellitus; as well as applications of the DLS method in clinical veterinary patients. Use of DLS in examination of phacoemulsification fluid, urine and other biological materials, and potential applications in ocular toxically will also be discussed.
Silva, Diana; Pinto, Luís F V; Bozukova, Dimitriya; Santos, Luís F; Serro, Ana Paula; Saramago, Benilde
In this study we investigated the possibility of using layer-by-layer deposition, based in natural polymers (chitosan and alginate), to control the release of different ophthalmic drugs from three types of lens materials: a silicone-based hydrogel recently proposed by our group as drug releasing soft contact lens (SCL) material and two commercially available materials: CI26Y for intraocular lens (IOLs) and Definitive 50 for SCLs. The optimised coating, consisting in one double layer of (alginate - CaCl2)/(chitosan+glyoxal) topped with a final alginate-CaCl2 layer to avoid chitosan degradation by tear fluid proteins, proved to have excellent features to control the release of the anti-inflammatory, diclofenac, while keeping or improving the physical properties of the lenses. The coating leads to a controlled release of diclofenac from SCL and IOL materials for, at least, one week. Due to its high hydrophilicity (water contact angle≈0) and biocompatibility, it should avoid the use of further surface treatments to enhance the useŕs comfort. However, the barrier effect of this coating is specific for diclofenac, giving evidence to the need of optimizing the chemical composition of the layers in view of the desired drug.
Golnik, C; Beaver, Hilary; Gauba, Vinod; Lee, Andrew G; Mayorga, Eduardo; Palis, Gabriela; Saleh, George M
To test the validity and reliability of a new tool for assessing residents' competence in ophthalmic surgery. Changing paradigms of ophthalmic education in the United States have influenced worldwide ophthalmic education and necessitated new methods of assessing resident competence. Accordingly, a new tool for assessing residents' competence in ophthalmic surgery (phacoemulsification) that could be applicable internationally was developed. We hypothesize that this instrument is valid and reliable. A panel of six international content experts adapted a previously published tool for assessing phacoemulsification. The tool (called the International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric, or ICO-OSCAR:phaco) was reviewed by 12 international content experts for their constructive comments, which were incorporated to ensure content validity. Ten expert cataract surgery teachers then graded six recorded phacoemulsification surgeries with the ICO-OSCAR:phaco to investigate inter-rater reliability. The coefficient alpha statistic (a measure of reliability/internal consistency) for the ICO-OSCAR:phaco as a whole was 0.92, and 17 of its 20 dimensions had alpha coefficients greater than 0.70. The ICO-OSCAR:phaco is a valid and reliable assessment tool that could be applied internationally to satisfy the global need of new instruments to comply with emerging trends in ophthalmic education. A toolbox of similar surgical competency assessment tools is being developed.
Golnik, C.; Beaver, Hilary; Gauba, Vinod; Lee, Andrew G.; Mayorga, Eduardo; Palis, Gabriela; Saleh, George M.
Purpose: To test the validity and reliability of a new tool for assessing residents’ competence in ophthalmic surgery. Changing paradigms of ophthalmic education in the United States have influenced worldwide ophthalmic education and necessitated new methods of assessing resident competence. Accordingly, a new tool for assessing residents’ competence in ophthalmic surgery (phacoemulsification) that could be applicable internationally was developed. We hypothesize that this instrument is valid and reliable. Methods: A panel of six international content experts adapted a previously published tool for assessing phacoemulsification. The tool (called the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric, or ICO-OSCAR:phaco) was reviewed by 12 international content experts for their constructive comments, which were incorporated to ensure content validity. Ten expert cataract surgery teachers then graded six recorded phacoemulsification surgeries with the ICO-OSCAR:phaco to investigate inter-rater reliability. Results: The coefficient alpha statistic (a measure of reliability/internal consistency) for the ICO-OSCAR:phaco as a whole was 0.92, and 17 of its 20 dimensions had alpha coefficients greater than 0.70. Conclusions: The ICO-OSCAR:phaco is a valid and reliable assessment tool that could be applied internationally to satisfy the global need of new instruments to comply with emerging trends in ophthalmic education. A toolbox of similar surgical competency assessment tools is being developed. PMID:24072944
Full Text Available Purpose: To determine the publication rates of free papers and posters presented at the All India Ophthalmic Conference (AIOC 2010 in peer-reviewed journals up to December 2015 and compare this with publication rates from AIOC2000 published previously. Methods: A thorough literature search was conducted using PubMed, Google Scholar, and the general Google search engine by two independent investigators. The title of the paper, keywords and author names were used to “match” the AIOC free-paper with the published paper. In addition, the “purpose,” “methods,” and “outcome measures” between the two were studied to determine the “match.” Results: A total of 58 out of 394 free-papers (14.7% from AIOC2010 were published till December 2015 compared to 16.5% from AIOC2000. Out of these, 52 (90% were published in PubMed indexed journals. Maximum publications were seen in pediatric ophthalmology (50% followed by glaucoma (24.4% and cornea (23.8%. Fifteen out of 272 posters (5.5% were published; orbit/oculoplastics had the highest poster publications (13%. Excluding papers in nonindexed journals and those by authors with international affiliations, the publication rate was approximately 12%. Conclusion: The publication rate of free papers from AIOC2010 has marginally reduced compared to AIOC2000. Various causes for this such as lack of adequate training, motivation, and lack of incentives for research in the Indian scenario have been explored, and measures to improve this paradigm have been discussed. It will be prudent to repeat this exercise every decade to compare publication rates between periodic AIOC, stimulate young minds for quality research and educate policy makers toward the need for developing dedicated research departments across the country.
Liang, David; Alvarado, Thomas P; Oral, Deniz; Vargas, Jose M; Denena, Melissa M; McCulley, James P
This study examined the captive western lowland gorilla (Gorilla gorilla gorilla) eye as compared and contrasted with the human eye. Bilateral ophthalmic examinations of western lowland gorillas (n = 5) while under general anesthesia were performed opportunistically, including slit-lamp biomicroscopy, dilated fundus examination, cycloplegic retinoscopy, Schiotz tonometry, corneal diameter and thickness measurements, A-scan and B-scan ultrasonography, keratometry, and cultures of the eyelid margins and bulbar conjunctiva. Mean spherical equivalent refractive error by cycloplegic retinoscopy was +1.20 +/- 0.59 diopters. Mean intraocular pressure by Schiotz tonometry was 12.0 +/- 4.3 mm Hg. Mean optic nerve head cup to disc ratio was 0.42 +/- 0.11. Mean horizontal corneal diameter was 13.4 +/- 0.8 mm, and mean vertical cornea diameter was 12.7 +/- 0.8 mm. Mean central corneal thickness by ultrasound pachymetry was 489 +/- 52 microm. Mean axial length of the eye by A-scan was 22.75 +/- 0.71 mm. Mean lens thickness by A-scan was 4.23 +/- 0.34 mm. Mean anterior chamber depth by A-scan was 4.00 +/- 0.26 mm. Mean keratometry reading was 44.38 +/- 1.64 diopters. Eyelid margin and bulbar conjunctival cultures isolated Candida sp. (n = 5), Staphylococcus aureus (n = 4), Staphylococcus epidermidis (n = 3), Staphylococcus saccharolyticus (n = 3), and Micrococcus sp. (n = 3). This study suggests important similarities between western lowland gorilla and human eyes. These similarities may allow diagnostics, techniques, and equipment for human eye surgery, such as those used for cataract extraction and intraocular lens implantation, to be successfully utilized for gorillas.
Full Text Available Barmak Abdolrahimzadeh,1 Domenica Carmen Piraino,2 Giorgio Albanese,2 Filippo Cruciani,2 Siavash Rahimi3 1Polimed Beltramelli Medical Center, Rome, Italy; 2Section of Ophthalmology, Department of Sense Organs, University of Rome “Sapienza”, Rome, Italy; 3Pathology Centre, Queen Alexandra Hospital, Portsmouth, UK Abstract: Neurofibromatosis (NF is a multisystem disorder and tumor predisposition syndrome caused by genetic mutation on chromosome 17-17q11.2 in NF type 1 (NF1, and on chromosome 22-22q12.2 in NF type 2. The disorder is characterized by considerable heterogeneity of clinical expression. NF1 is the form with the most characteristic ocular manifestations. Lisch nodules of the iris are among the well-known diagnostic criteria for the disease. Glaucoma and associated globe enlargement have been described in a significant proportion of patients with NF1 and orbital–facial involvement. Optic nerve glioma may cause strabismus and proptosis, and palpebral neurofibroma may reach considerable size and occasionally show malignant transformation. Near infrared reflectance has greatly contributed to enhancing our knowledge on choroidal alterations in NF1. Indeed, some authors have proposed to include these among the diagnostic criteria. Optical coherence tomography has given new insight on retinal alterations and is a noninvasive tool in the management of optic nerve gliomas in children. Ocular manifestations in NF type 2 can range from early-onset cataracts in up to 80% of cases to optic nerve hamartomas and combined pigment epithelial and retinal hamartomas. Keywords: neurofibromatosis, ophthalmic, optical coherence tomography, infrared reflectance, choroideal nodules, Lisch nodules
Kobayashi, Sho; Lee, Jaeyong; Takao, Toshifumi; Fujii, Junichi
Glutathione (GSH) plays pivotal roles in antioxidation and detoxification. The transsulfuration pathway, in conjunction with methionine metabolism, produces equimolar amounts of cysteine (Cys) and 2-oxobutyric acid (2OB). The resulting 2OB is then converted into 2-aminobutyric acid (2AB) by a transaminase and is utilized as a substitute for Cys by the GSH-synthesizing machinery to produce ophthalmic acid (OPT). By establishing a method for simultaneously measuring Cys, GSH, and OPT by liquid chromatography-mass spectrometry, we found that fasting causes an elevation in OPT levels in the liver and blood plasma, even though the levels of Cys and GSH are decreased. Autophagy was activated, but the levels of GSH/OPT-synthesizing enzymes remained unchanged. After 6 h of fasting, the mice were given 1% 2AB and/or 5% glucose in the drinking water for an additional 24 h and the above metabolites analyzed. 2AB administration caused an increase in OPT levels, and, when glucose was co-administered with 2AB, the levels of OPT were elevated further but GSH levels were decreased somewhat. These results suggest that, while Cys is utilized for glyconeogenesis under fasting conditions, reaching levels that were insufficient for the synthesis of GSH, 2OB was preferentially converted to 2AB via amino acid catabolism and was utilized as a building block for OPT. Thus the consumption of Cys and the parallel elevation of 2AB under fasting conditions appeared to force γ-glutamylcysteine synthetase to form γ-glutamyl-2AB, despite the fact that the enzyme has a higher Km value for 2AB than Cys. Copyright © 2017 Elsevier Inc. All rights reserved.
Sav, Hafize; Ozdemir, Havva Gül; Altınbas, Rabiye; Kiraz, Nuri; Ilkit, Macit; Seyedmousavi, Seyedmojtaba
Investigations of both virulence factors and antifungal susceptibility profiles are crucial for understanding the pathogenesis and prognosis of ophthalmic mycoses. In this study, we investigated the in vitro antifungal susceptibility of amphotericin B (AMB), voriconazole (VRC), and natamycin (NAT) against a set of 50 fungal isolates obtained from patients with ocular mycoses using the Clinical and Laboratory Standards Institute broth microdilution method. In addition, putative virulence factor, such as secretory phospholipases and proteinases, and biofilm formation activity were analyzed. The geometric means (GMs) of the minimum inhibitory concentrations (MICs) of the antifungals across all isolates were the following (in increasing order): VRC (0.70 μg/mL), AMB (0.81 μg/mL), and NAT (1.05 μg/mL). The highest activity against 14 Aspergillus strains was exhibited by VRC (GM MIC: 0.10 μg/mL), followed by AMB and NAT (GM MICs: 0.21 and 0.27 μg/mL), respectively. However, for 12 Fusarium spp., the GM MIC of VRC (2.66) was higher than those of NAT and AMB (GM MICs 1.3 and 0.8 μg/mL, respectively). Proteinase and phospholipase activity were observed in 30 % and 42 % of the isolates, respectively, whereas only 8 % of the isolates were able to produce biofilms. Phospholipase activity was observed in all Fusarium isolates, but not in any of the Aspergillus isolates. In contrast, biofilm-forming capability was detected in 25 % of the Fusarium isolates, but none of the Aspergillus isolates. The differences in the MICs of AMB, VRC, and NAT, biofilm-forming ability and proteinase and phospholipase activities among the isolates were not significant (p > 0.05). Overall, our study suggests no significant correlation between the antifungal susceptibility profiles and virulence attributes of ocular fungal isolates.
Full Text Available Background: Sympathetic ophthalmitis (SO has been reported following vitrectomy; however, there is a lack of data on the role of antecedent penetrating ocular trauma impacting the disease manifestation in eyes developing SO following vitrectomy. Aim: To report differences in the presentation and outcomes of SO in eyes with or without a history of antecedent penetrating trauma; SO being diagnosed after vitreoretinal (VR surgery. Design: Comparative case series. Methods: Seventeen consecutive patients presenting with SO following VR surgery, diagnosed between 1995 and 2011 were included. Eyes with and without prior penetrating injury were included in Group I (n = 7 and Group II (n = 10, respectively. All Group I patients had received systemic steroids prior to presentation. Demographic and clinical parameters were evaluated. Results: Differences were observed between Group I and Group II mainly with regards to time interval between VR surgery and diagnosis of SO (1.5 months vs. 8 months, P = 0.10, presence of neurosensory detachments (100% vs. 30%, P = 0.01, and the inciting eye vision at presentation (nil light perception in 28.5% vs. 80%, P = 0.049. Other differences observed though not statistically significant were optic disc and retinal vessel involvement (42% vs. 70%, P = 0.28, Dalen-Fuchs nodules (localized vs. diffuse and leaks on fundus fluorescein angiography (pin-head vs. pin-point leak. Conclusion: SO in patients with antecedent penetrating ocular trauma present early with the central serous chorioretinopathy-like picture. Prior use of systemic steroids might have a bearing on the differences in presentation and the visual acuities between the two groups.
Full Text Available Hyaluronic acid (HA is one of the most important ophthalmic biomaterials, while also being used for tissue engineering and drug delivery. Although chemical cross-linking is an effective way to improve the material performance, it may as a consequence be detrimental to the living cells/tissues. Given that the cross-linking efficiency is mediated by the solvent composition during the chemical modification, this study aims to explore the stability and biocompatibility of carbodiimide cross-linked HA in relation to material processing conditions by varying the acetone/water volume ratio (from 70:30 to 95:5 at a constant 1-ethyl-3-(3-dimethyl aminopropyl carbodiimide (EDC concentration of 100 mM. Our results indicated that after the EDC treatment in the presence of an acetone/water mixture (85:15, v/v, the HA hydrogel membranes have the lowest equilibrium water content, the highest stress at break and the greatest resistance to hyaluronidase digestion. Live/Dead assays and pro-inflammatory cytokine expression analyses showed that the cross-linked HA hydrogel membranes, irrespective of the solvent composition, are compatible with human RPE cell lines without causing toxicity and inflammation. However, it should be noted that the test samples prepared by the cross-linking in the presence of acetone/water mixtures containing 70, 75, and 95 vol % of acetone slightly inhibit the metabolic activity of viable ARPE-19 cultures, probably due to the alteration in the ionic interaction between the medium nutrients and polysaccharide biomaterials. In summary, the water content, mechanical strength and RPE cell proliferative capacity strongly depends on the solvent composition for carbodiimide cross-linking of HA materials.
Hutchens, Thomas C; Darafsheh, Arash; Fardad, Amir; Antoszyk, Andrew N; Ying, Howard S; Astratov, Vasily N; Fried, Nathaniel M
Vitreoretinal surgery is performed using mechanical dissection that sometimes results in iatrogenic complications, including vitreous hemorrhage, retinal breaks, incomplete membrane delamination, retinal distortion, microscopic damage, etc. An ultraprecise laser probe would be an ideal tool for cutting away pathologic membranes; however, the depth of surgery should be precisely controlled to protect the sensitive underlying retina. The ultraprecise surgical microprobe formed by chains of dielectric spheres for use with the erbium:YAG laser source (λ=2940 nm), with extremely short optical penetration depth in tissue, was optimized. Numerical modeling demonstrated a potential advantage of five-sphere focusing chains of sapphire spheres with index n=1.71 for ablating the tissue with self-limited depth around 10 to 20 μm. Novel detachable microsphere scalpel tips formed by chains of 300 μm sapphire (or ruby) spheres were tested on ophthalmic tissues, ex vivo. Detachable scalpel tips could allow for reusability of expensive mid-infrared trunk fibers between procedures, and offer more surgical customization by interchanging various scalpel tip configurations. An innovative method for aiming beam integration into the microsphere scalpel to improve the illumination of the surgical site was also shown. Single Er:YAG pulses of 0.2 mJ and 75-μs duration produced ablation craters in cornea epithelium for one, three, and five sphere structures with the latter generating the smallest crater depth (10 μm) with the least amount of thermal damage depth (30 μm). Detachable microsphere laser scalpel tips may allow surgeons better precision and safety compared to mechanical scalpels when operating on delicate or sensitive areas like the retina.
Kliescikova, Jarmila; Kulda, Jaroslav; Nohynkova, Eva
Propylene glycol used as an ophthalmic demulcent in certain contact-lens care systems has been included recently among factors responsible for increasing Acanthamoeba keratitis. In this study, we provide evidence that propylene glycol as well as examined contact-lens solutions containing it induce rapid differentiation of acanthamoebae into pseudocysts. The partial resistance of the pseudocysts and their reversibility to viable trophozoites even after 24-h exposure to the contact-lens solutions indicate a potential risk of infection to contact-lens users.
Somma, André T; Lima, Leandro; Lange, Rogério R; Turner-Giannico, Amália; Montiani-Ferreira, Fabiano
To perform a descriptive investigation of the red-eared slider turtle (Trachemys scripta elegans) eye, performing selected ophthalmic diagnostic tests with the aim of establishing normal reference values for this species. Thirty adult healthy red-eared slider turtles were used to establish normal ophthalmic test values in this investigation. Selected ophthalmic tests included: collection of material for bacterial culture analysis, esthesiometry, intraocular pressure (IOP), A- and B-mode ultrasonic biometry, fundus photography, and central corneal thickness (CCT). Normal parameters found for the ocular diagnostic tests were: esthesiometry: 5.84 ± 0.48 cm; IOP: 5.42 ± 1.70 mmHg; CCT: 154.5 ± 0.14 μm; palpebral fissure length: 9.71 ± 0.55 mm; modified Schirmer tear test: 2.55 ± 3.4 mm; globe axial length: 7.60 ± 0.23 mm; anterior chamber depth: 0.76 ± 0.23 mm; lens axial length: 2.45 ± 0.28 mm; vitreous chamber depth: 4.31 ± 0.42 mm. An avascular retinal pattern with nerve fibers radiating from the small white circular optic disk was observed. None of the animals had a conus papillaris. The most frequent bacteria found were Bacillus spp. (33.33%) followed by Proteus vulgaris (20.69%) and Staphylococcus aureus (18.39%). No significant differences between left and right eyes or genders were found for any of the results. Reference data and morphologic observations obtained in this investigation might help veterinary ophthalmologists to diagnose ocular diseases in the red-eared slider turtle. © 2014 American College of Veterinary Ophthalmologists.
Full Text Available Patients undergoing ophthalmic surgery are usually elderly and, due to systemic disease, may be on long-term therapy, such as antithrombotic agents. Rates of hemorrhagic complications associated with invasive procedures may be increased by the use of anticoagulants and antiplatelet agents.To compare the incidence of hemorrhagic complications in patients undergoing needle-based ophthalmic regional anesthesia between patients on antithrombotic therapy and those not on such therapy.A systematic review was conducted by two independent reviewers based on searches of Cochrane, LILACS, PubMed, Scopus, Web of Science, and the "gray" literature (Google Scholar. The end search date was May 8, 2015, across all databases.Five studies met the eligibility criteria. In three studies, individual risk of bias was low, and in two of them, moderate. In all studies, no differences regarding mild to moderate incidence of hemorrhagic complications were found between patients using antithrombotics (aspirin, clopidogrel, and warfarin and those not using them. Rates of severe hemorrhagic complication were very low (0.04% in both groups, supporting the safety of needle blocks, even in patients using antithrombotics. High heterogeneity across studies prevented meta-analysis. Limitations to these results include low statistical power in three experimental studies and a large 95% confidence interval in the two retrospective cohorts.In this review, none of the selected studies showed significant bleeding related to needle-based ophthalmic regional anesthesia in association with the use of aspirin, clopidogrel, or vitamin K inhibitors. Since the available data is not powerful enough to provide a reliable evaluation of the true effect of antithrombotics in this setting, new studies to address these limitations are necessary.
Blixt, Frank W; Johansson, Sara Ellinor; Johnson, Leif
Cerebral vasculature is often the target of stroke studies. However, the vasculature supplying the eye might also be affected by ischemia. The aim of the present study was to investigate if the transient global cerebral ischemia (GCI) enhances vascular effect of endothelin-1 (ET-1) and 5...... decreased function at 72 hours, but recovered almost completely after 7 days. In conclusion, we propose that the increased contractile response via ET-1 receptors in the ophthalmic artery after 48 hours may elicit negative retinal consequences due to a second ischemic period. This may exacerbate retinal...
Cvetko, E; Bosnjak, R
Bilateral ophthalmic origin of the middle meningeal artery with an unilateral absence of foramen spinosum has not yet been described. We report on a skull with endocranial meningeal grooves indicating bilateral ophthalmic origin of the middle meningeal artery, however, its branches were normal both in their position and distribution. In addition, a rare venous sinus variation was present unilaterally - a sinus of Hyrtl. Imaging identification of the anomalous origin of the middle meningeal artery is important while planning surgical and endovascular interventions in the middle cranial fossa and the orbit.
A class of exact solutions of the Einstein-Maxwell equations is presented which contains infinite sets of gravitoelectric, gravitomagnetic and electromagnetic multipole moments. The multipolar structure of the solutions indicates that they can be used to describe the exterior gravitational field of an arbitrarily rotating mass distribution endowed with an electromagnetic field. The presence of gravitational multipoles completely changes the structure of the spacetime because of the appearance of naked singularities in a confined spatial region. The possibility of covering this region with interior solutions is analyzed in the case of a particular solution with quadrupole moment.
Full Text Available Congenital cataract (CC is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC in Guangzhou, China. Residence, gender, age at surgery, hospitalization time, and the presence of other ocular abnormalities were extracted and statistically analyzed in different subgroups. The search identified 1314 patients diagnosed with CC from a total of 136154 hospitalizations, which accounted for 2.39% of all the cataract in-patients and 1.06% of the total in-patients over the six-year study period. Of the identified CC patients, 9.2% had ≥ 2 hospitalizations due to the necessity of additional surgeries, with a total ratio of boys to girls of 1.75 ∶ 1. Based on a subgroup analysis according to age, patients 2-6 years old constituted the highest proportion (29.22% of all hospitalized CC patients, and those 13-18 years old constituted the lowest proportion (13.47% of the total number. The average age at surgery was 27.62 ± 23.36 months, but CC patients ≤ 6 years old (especially ≤ 6 months old became increasingly prevalent throughout the 6-year study period. A total of 276 cases (20.93% of CC were associated with one or more other ocular abnormalities, the highest incidence rates were observed for exotropia (6.24%, nystagmus (6.16%, and refractive error (3.65%. In conclusion, CC patients accounted for 2.39% of all cataract in-patients in a review of 6 years of hospitalization charts from ZOC. The age at the time of surgery decreased over the 6-year study period, which probably reflects the continuing improvement of public awareness of children's eye care in China.
Lin, Haotian; Yang, Ye; Chen, Jingjing; Zhong, Xiaojian; Liu, Zhaochuan; Lin, Zhuoling; Chen, Wan; Luo, Lixia; Qu, Bo; Zhang, Xinyu; Zheng, Danying; Zhan, Jiao; Wu, Hanfu; Wang, Zhirong; Geng, Yu; Xiang, Wu; Chen, Weirong; Liu, Yizhi
Congenital cataract (CC) is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC) in Guangzhou, China. Residence, gender, age at surgery, hospitalization time, and the presence of other ocular abnormalities were extracted and statistically analyzed in different subgroups. The search identified 1314 patients diagnosed with CC from a total of 136154 hospitalizations, which accounted for 2.39% of all the cataract in-patients and 1.06% of the total in-patients over the six-year study period. Of the identified CC patients, 9.2% had ≥ 2 hospitalizations due to the necessity of additional surgeries, with a total ratio of boys to girls of 1.75 ∶ 1. Based on a subgroup analysis according to age, patients 2-6 years old constituted the highest proportion (29.22%) of all hospitalized CC patients, and those 13-18 years old constituted the lowest proportion (13.47%) of the total number. The average age at surgery was 27.62 ± 23.36 months, but CC patients ≤ 6 years old (especially ≤ 6 months old) became increasingly prevalent throughout the 6-year study period. A total of 276 cases (20.93%) of CC were associated with one or more other ocular abnormalities, the highest incidence rates were observed for exotropia (6.24%), nystagmus (6.16%), and refractive error (3.65%). In conclusion, CC patients accounted for 2.39% of all cataract in-patients in a review of 6 years of hospitalization charts from ZOC. The age at the time of surgery decreased over the 6-year study period, which probably reflects the continuing improvement of public awareness of children's eye care in China.
need for ophthalmic care in children with DS. Routine eye care such as the use of spectacles when necessary is recommended for people with DS at all ages to improve their educational and social needs as well as overall quality of life.Keywords: Down syndrome, refractive errors, strabismus, ocular diseases
Cassie A Ludwig
Full Text Available Aim of Study: To evaluate the ability of ancillary health staff to use a novel smartphone imaging adapter system (EyeGo, now known as Paxos Scope to capture images of sufficient quality to exclude emergent eye findings. Secondary aims were to assess user and patient experiences during image acquisition, interuser reproducibility, and subjective image quality. Materials and Methods: The system captures images using a macro lens and an indirect ophthalmoscopy lens coupled with an iPhone 5S. We conducted a prospective cohort study of 229 consecutive patients presenting to L. V. Prasad Eye Institute, Hyderabad, India. Primary outcome measure was mean photographic quality (FOTO-ED study 1–5 scale, 5 best. 210 patients and eight users completed surveys assessing comfort and ease of use. For 46 patients, two users imaged the same patient's eyes sequentially. For 182 patients, photos taken with the EyeGo system were compared to images taken by existing clinic cameras: a BX 900 slit-lamp with a Canon EOS 40D Digital Camera and an FF 450 plus Fundus Camera with VISUPAC™ Digital Imaging System. Images were graded post hoc by a reviewer blinded to diagnosis. Results: Nine users acquired 719 useable images and 253 videos of 229 patients. Mean image quality was ≥ 4.0/5.0 (able to exclude subtle findings for all users. 8/8 users and 189/210 patients surveyed were comfortable with the EyeGo device on a 5-point Likert scale. For 21 patients imaged with the anterior adapter by two users, a weighted κ of 0.597 (95% confidence interval: 0.389–0.806 indicated moderate reproducibility. High level of agreement between EyeGo and existing clinic cameras (92.6% anterior, 84.4% posterior was found. Conclusion: The novel, ophthalmic imaging system is easily learned by ancillary eye care providers, well tolerated by patients, and captures high-quality images of eye findings.
Full Text Available Alexander Feng, John O’Neill, Mitchell Holt, Catherine Georgiadis, Martha M Wright, Sandra R Montezuma Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA Purpose: The purpose of this study is to evaluate the success and usefulness of patient education in eyedrop self-administration technique via an educational handout and a short instructional video. Patients and methods: We conducted a prospective study that included 34 patients who were self-administering ophthalmic drops. Of the total patients included, 12% had used drops for <12 months, and 88% had used drops for >12 months. Average age of patients in the study was 67 years, with an age range of 19–91 years. Of the total patients included, 82% had glaucoma, 6% had dry eyes, and 12% did not have a specific diagnosis. Subjects were video recorded and assessed by a trained observer on two occasions: at baseline and after they viewed a demonstrational video and handout. A maximum score of 15 points was awarded based on 15 criteria. A written self-assessment was administered at the end of each study. Results: Pre- and post-teaching assessment scores improved significantly with education. Patients initially scored an average 2.53 points compared to a post-education score of 6.15 out of 15 points, demonstrating a 2.43 (P=0.008 factor of improvement. After education, 94% of patients versus 47% pre-teaching (P=0.0001 pulled down their lower eyelids. A total of 91% pre-teaching versus 59% post-teaching (P=0.0042 patients squeezed one drop into the lower fornix, 74% pre-teaching versus 26% post-teaching (P=0.0002 patients released the eyelid and closed the eye for 1 minute, and 56% pre-teaching versus 3% post-teaching (P=0.0001 patients applied nasal digital pressure on each eye. We found no significant difference in score changes between those who previously received education and those who had not (P=0.37. A total of 91% patients responded in a
Usman, Shahnaz; Akram, Muhammad; Aziz, Asif; Ramesh, Venkat; Sarheed, Omar Abdulraheem
The aim of the present study was to develop and validate an analytical method for the estimation of nepafenac as a raw material as well as in dosage form (suspension) by using reverse phase high performance liquid chromatographic (RP-HPLC). The target was to obtain an easy, rapid, reproducible as well as a rugged method. The HPLC system that was used in the proposed study was LC-20AD liquid chromatograph equipped with SPD-20A UV-VIS detector. The separation was performed on C18 column which was attached with loop 20 β l. Elution was done at ambient temperature with a mobile phase consisting of acetonitrile: Water (40: 60v/v) at a flow rate of 1ml/min and at a wavelength of 254 nm. The proposed method was validated as per the ICH guidelines. The retention time for nepafenac was 7.49 minutes (% CV=0.0076). The percentage coefficient variation (CV) of six consecutive peak areas of injections was 0.34% with tailing factor 1.76. The peak area responses were linear within the concentration range of 0.078-20.0 βg/ml (R(2)=0.9993). The sensitivity of the method could be evaluated by limits of detection (LOD) (0.0195 β g/ml) and limits of quantitation (LOQ) (0.039 β g/ml). Nepafenac drug is s in its diluent that could see by intra-day (% CV =0.45-1.96) and inter-day variation (%CV=0.173-1.898%). The accuracy and recovery results of 80%, 100% and 120% were 97.40% to 102.10% with % CV of 0.3201% to 1.3496%. The robustness and ruggedness of the method are significantly broader and is reproducible. It could be used as a more convenient, efficient, easy and time saving method for the analysis of drug in raw material as well as in dosage form (ophthalmic suspension).
Du, Shibin; Ma, Xiaoliang; Li, Xiaoqin; Yuan, Hongjie
Trigeminal neuralgia is an intense neuralgia involving facial areas supplied by trigeminal nerve. The pain is characterized by sudden onset, short persistence, sharp or lancinating. Trigeminal neuralgia commonly affects frontal areas, infraorbital or paranasal areas, mandibular areas and teeth. While Trigeminal neuralgia affecting merely the upper eyelid is rare. Here we report a case of atypical Trigeminal neuralgia confined to the upper eyelid. The patient was pain free during the follow-up period of 6 months after unusual ophthalmic branch radiofrequency thermocoagulation. A 55-year-old female patient was diagnosed as primary trigeminal neuralgia involving the right upper eyelid. As the pain could not be controlled by drug therapy, peripheral nerve branch radiofrequency thermocoagulation was recommended. A combination of infratrochlear, supratrochlear and lacrimal radiofrequency thermocoagulation was implemented in this case. The point where the bridge of the nose abuts the supraorbital ridge and the point slightly above the lateral canthus along outer border of the orbit were selected respectively as the puncture sites. After positive diagnostic test, radiofrequency thermocoagulation of the above-mentioned nerve branches was performed respectively. The patient was pain free immediately after the treatment and during the follow-up period of 6 months. Trigeminal neuralgia is a common severe and chronic facial neuralgia which requires accurate diagnosis and effective therapy. With typical clinical symptoms, normal neurological signs, normal CT and MRI findings, the patient was diagnosed as classic trigeminal neuralgia. As the patient was drug resistant, some invasive treatments were considered. Peripheral branch neurolysis was chosen for its minimal invasiveness, convenience, low risk and not affecting further invasive treatments. According to the anatomic data and the diagnostic test results, infratrochlear, supratrochlear and lacrimal nerve were responsible
Park, Jong Taek; Lim, Hyun Kyo; Jang, Kyu-Yong; Um, Dea Ja
For ophthalmic surgery anesthesia, it is vital that intraocular pressure (IOP) is controlled. Most anesthetic drugs affect IOP dose-dependently, and inhalational anesthetics dose-dependently decrease IOP. In this study, we compared the effects of desflurane and sevoflurane on IOP and hemodynamics in pediatric ophthalmic surgery. Thirty eight pediatric patients from the age of 6 to 15 years, who were scheduled for strabismus surgery and entropion surgery, were randomized to be administered desflurane (group D, n = 19) or sevoflurane (group S, n = 19). IOPs and hemodynamic parameters were measured before induction of anesthesia (B), after induction but immediately before intubation (AI), 1 min after intubation (T1), 3 min after intubation (T3), and 5 min after intubation (T5). The mean arterial pressure (MAP) at T1 and heart rates (HRs) at T1 and T3 were significantly higher in group D than those in group S. There was no significant difference between the groups in IOP, cardiac index (CI) and stroke index (SI). There was a significant difference within the group in IOP, SI, MAP and HR. There was no significant difference within the group in CI. There was no significant difference between the groups in IOP and hemodynamic parameters. The two anesthetic agents maintained IOP and hemodynamic parameters in the normal range during anesthetic induction.
Ambhore, Nitin Prabhakar; Dandagi, Panchaxari Mallapa; Gadad, Anand Panchakshari
Ophthalmic nanosuspensions (ONS) have shown a potential for ophthalmic delivery over the conventional ocular formulations. The objective of the study was to assess the effect of surfactants and polymers on particle size and drug release. Sparfloxacin ONS were prepared by optimizing the concentration of HPMC E5 and water soluble chitosan by using solvent diffusion method followed by probe sonication. The Poloxamer 407 and Kolliphor P188 were used as a surfactant. The produced nanosuspensions were characterized for particle size, shape, zeta potential and drug release. The average particle size of the nanosuspension was 300 to 500 nm. The in vitro drug release study showed that the optimized nanosuspension of water soluble chitosan sustained drug release up to 9 h compared to 6 h for the hydroxypropylmethylcellulose (HPMC) nanosuspension. Further, the sparfloxacin ONS formulation showed excellent ocular tolerance and biocompatibility as determined by hen's egg test chorioallantoic membrane (HET CAM) and resazurin assay on Vero cell lines. Moreover, optimized formulation was found to be stable, isotonic, non-toxic with higher in vitro and in vivo antimicrobial potential.
Başaran, Berrin; Bozkir, Asuman
The prolonged residence of drug formulation in the ocular cavity is important for ocular drug delivery. The purpose of the present study was to develop ophthalmic in situ gelling systems of ciprofloxacin hydrochloride with reduced pre-corneal elimination in order to improve the bioavailability and therapeutic response. Hydroxypropyl-beta-cyclodextrin was used in order to increase the stability of ciprofloxacin hydrochloride. In situ gels were prepared based on the concept of thermosensitive and pH induced in situ gelation. The inclusion complex of ciprofloxacin hydrochloride with hydroxypropyl-beta-cyclodextrin was prepared at a 1:1 molar ratio. The complex formation was thoroughly confirmed using various techniques, including (1)H NMR spectroscopy, FTIR spectrophotometry and differential scanning calorimetry. Both pure ciprofloxacin HCI and the inclusion complex were individually used in the formulations. Formulations were successfully prepared which were liquid at room temperature and exhibited viscosity increase and gelation at ophthalmic temperature. As a result of antimicrobial efficacy and in vitro release experiments, the developed formulations were found therapeutically efficient and provided sustained release of the drug over an 8 h period. These systems can be more advantageous than conventional eye drops.
Misiulis, Edgaras; Džiugys, Algis; Navakas, Robertas; Striūgas, Nerijus
Accurate and clinically safe measurements of intracranial pressure (ICP) are crucial for secondary brain damage prevention. There are two methods of ICP measurement: invasive and noninvasive. Invasive methods are clinically unsafe; therefore, safer noninvasive methods are being developed. One of the noninvasive ICP measurement methods implements the balance principle, which assumes that if the velocity of blood flow in both ophthalmic artery segments - the intracranial (IOA) and extracranial (EOA) - is equal, then the acting ICP on the IOA and the external pressure (Pe) on the EOA are also equal. To investigate the assumption of the balance principle, a generalized computational model incorporating a fluid-structure interaction (FSI) module was created and used to simulate noninvasive ICP measurement by accounting for the time-dependent behavior of the elastic internal carotid (ICA) and ophthalmic (OA) arteries and their interaction with pulsatile blood flow. It was found that the extra balance pressure term, which incorporates the hydrodynamic pressure drop between measurement points, must be added into the balance equation, and the corrections on a difference between the velocity of blood flow in the IOA and EOA must be made, due to a difference in the blood flow rate.
Kawabata, Shuhei; Toyota, Shingo; Kumagai, Tetsuya; Goto, Tetsu; Mori, Kanji; Taki, Takuyu
Background Progressive visual loss after coil embolization of a large internal carotid ophthalmic aneurysm has been widely reported. It is generally accepted that the primary strategy for this complication should be conservative, including steroid therapy; however, it is not well known as to what approach to take when the conservative therapy is not effective. Case Presentation We report a case of a 55-year-old female presenting with progressive visual loss after the coiling of a ruptured large internal carotid ophthalmic aneurysm. As the conservative therapy had not been effective, we performed neck clipping of the aneurysm with optic canal unroofing, anterior clinoidectomy, and partial removal of the embolized coils for the purpose of optic nerve decompression. After the surgery, the visual symptom was improved markedly. Conclusions It is suggested that direct surgery for the purpose of optic nerve decompression may be one of the options when conservative therapy is not effective for progressive visual disturbance after coil embolization. PMID:28229036
Reviewed in this statement are methods of preparing solutions to be used in laboratory experiments to examine technical issues related to the safe disposal of nuclear waste from power generation. Each approach currently used to prepare solutions has advantages and any one approach may be preferred over the others in particular situations, depending upon the goals of the experimental program. These advantages are highlighted herein for three approaches to solution preparation that are currently used most in studies of nuclear waste disposal. Discussion of the disadvantages of each approach is presented to help a user select a preparation method for his particular studies. Also presented in this statement are general observations regarding solution preparation. These observations are used as examples of the types of concerns that need to be addressed regarding solution preparation. As shown by these examples, prior to experimentation or chemical analyses, laboratory techniques based on scientific knowledge of solutions can be applied to solutions, often resulting in great improvement in the usefulness of results.
眼整形眼眶病是一门年轻而发展迅猛的眼科学分支专业,包括眼整形、眼美容和眼眶外科.近年来,眼整形眼眶病领域的新技术和新手术不断涌现,技术创新和学科交叉使其对眼睑和眼眶等疾病的治疗力求达到功能重建及形态修复的完美结合.我国眼整形眼眶病专业起步较晚,但立足于创新性研究,积极开展学科交叉、医工合作和国际学术交流,取得了快速发展.针对目前我国眼整形眼眶外科发展中存在的问题,必须规范专业化人才培养、加强国内外多渠道交流、重视基础与临床转化研究,进一步促进眼整形眼眶病专业的发展.%Ophthalmic plastics and orbital diseases have developed rapidly as a young branch of ophthalmology in recent years. The current situation and development of ophthalmic aesthetics,plastics and orbital surgery are discussed in this paper. The functional reconstruction and appearance rehabilitation are both important to the ophthalmic plastic surgery. Although the ophthalmic plastics and orbital surgery started late in China,it developmented rapidly. The development of this branch is based on innovative research,active interdisciplinary,medical-engineering cooperation and academic exchange. However,there are still some problems about ophthalmic plastics and orbital surgery in China. To promote the development of ophthalmic plastic and orbital surgery,we should regulate the training of ophthalmic plastic surgeons,and pay attention to the clinical translational research.
Paskiet, Diane; Jenke, Dennis; Ball, Douglas; Houston, Christopher; Norwood, Daniel L; Markovic, Ingrid
The Product Quality Research Institute (PQRI) is a non-profit consortium of organizations working together to generate and share timely, relevant, and impactful information that advances drug product quality and development. The collaborative activities of PQRI participants have, in the case of orally inhaled and nasal drug products (OINDPs), resulted in comprehensive and widely-accepted recommendations for leachables assessments to help ensure patient safety with respect to this class of packaged drug products. These recommendations, which include scientifically justified safety thresholds for leachables, represent a significant milestone towards establishing standardized approaches for safety qualification of leachables in OINDP. To build on the success of the OINDP effort, PQRI's Parenteral and Ophthalmic Drug Products (PODP) Leachables and Extractables Working Group was formed to extrapolate the OINDP threshold concepts and best practice recommendations to other dosage forms with high concern for interaction with packaging/delivery systems. This article considers the general aspects of leachables and their safety assessment, introduces the PODP Work Plan and initial study Protocol, discusses the laboratory studies being conducted by the PODP Chemistry Team, outlines the strategy being developed by the PODP Toxicology Team for the safety qualification of PODP leachables, and considers the issues associated with application of the safety thresholds, particularly with respect to large-volume parenterals. Lastly, the unique leachables issues associated with biologics are described. The Product Quality Research Institute (PQRI) is a non-profit consortium involving industry organizations, academia, and regulatory agencies that together provide recommendations in support of regulatory guidance to advance drug product quality. The collaborative activities of the PQRI Orally Inhaled and Nasal Drug Products Leachables and Extractables Working Group resulted in a
We describe the cases of 2 autistic children with ophthalmic and systemic manifestations of vitamin A deficiency due to food faddism. Although vitamin A deficiency is common in the developing world, reports in developed societies are rare. Our patients presented over a 1-year period. The patients were 14 and 13 years old at the time of presentation and were both found to have marked features of vitamin A deficiency related to unusual dietary habits. Anterior segment signs of xerophthalmia were present in both patients. In addition, patient 1 showed evidence of a rod-predominant retinopathy, which resolved with vitamin A supplementation. Due to its rare occurrence, hypovitaminosis A must be highlighted and anticipated in this cohort.
Grzybowski, Andrzej; Wilhelm, Helmut
Although the work for which Emil von Behring (1854-1917) was awarded the first Nobel Prize Winner for Medicine or Physiology in 1901 was on serum therapy, not only was he trained and worked as an ophthalmologist but he also wrote his doctoral dissertation on a practical ophthalmological topic whilst in Berlin under Carl Schweigger (1830-1905). He later worked for 3 years as an assistant and co-worker with the famous Polish ophthalmologist Boleslaw Wicherkiewicz (1847-1915), in Poznan where he described an interesting ophthalmic case in a scientific journal. His life and work in other fields have been well studied, but his interests and relationship to ophthalmology that played an important role in, at least part of, Behring's life have never previously been analysed thoroughly.
N G Nanjundaswamy
Full Text Available Guar gum is derived from the seeds of Cyamopsis tetragonolobus. Guar has certain drawbacks such as uncontrolled rate of hydration, fall in viscosity on storage, susceptibility to microbial degradation, and turbidity in aqueous dispersion. Many of these drawbacks can be overcome by using guar derivatives. Guar derivatives upon contact with water hydrate to form hydrogels for controlled-release mechanism and show stimuli-responsive changes in their structural network, and hence, the drug release. The present investigation aims at screening guar derivative (hydroxyl propyl guar during preformulation stage by spectral (FTIR spectroscopy, thermal (differential scanning calorimetry (DSC, isothermal (HPLC technique, and rheological characterization for the development of stable in situ ophthalmic dosage using linezolid as the model drug.
Full Text Available We describe the cases of 2 autistic children with ophthalmic and systemic manifestations of vitamin A deficiency due to food faddism. Although vitamin A deficiency is common in the developing world, reports in developed societies are rare. Our patients presented over a 1-year period. The patients were 14 and 13 years old at the time of presentation and were both found to have marked features of vitamin A deficiency related to unusual dietary habits. Anterior segment signs of xerophthalmia were present in both patients. In addition, patient 1 showed evidence of a rod-predominant retinopathy, which resolved with vitamin A supplementation. Due to its rare occurrence, hypovitaminosis A must be highlighted and anticipated in this cohort.
Muhammad Asim Rana
Full Text Available Timolol Maleate (also called Timolol is a nonselective beta-adrenergic blocker and a class II antiarrhythmic drug, which is used to treat intraocular hypertension. It has been reported to cause systemic side effects especially in elderly patients with other comorbidities. These side effects are due to systemic absorption of the drug and it is known that Timolol is measurable in the serum following ophthalmic use. Chances of life threatening side effects increase if these are coprescribed with other cardiodepressant drugs like calcium channel or systemic beta blockers. We report a case where an elderly patient was admitted with three side effects of Timolol and his condition required ICU admission with mechanical ventilation and temporary transvenous pacing. The case emphasizes the need of raising awareness among physicians of such medications about the potential side effects and drug interactions. A close liaison among patient’s physicians is suggested.
Christov, Ivan C
In classical continuum physics, a wave is a mechanical disturbance. Whether the disturbance is stationary or traveling and whether it is caused by the motion of atoms and molecules or the vibration of a lattice structure, a wave can be understood as a specific type of solution of an appropriate mathematical equation modeling the underlying physics. Typical models consist of partial differential equations that exhibit certain general properties, e.g., hyperbolicity. This, in turn, leads to the possibility of wave solutions. Various analytical techniques (integral transforms, complex variables, reduction to ordinary differential equations, etc.) are available to find wave solutions of linear partial differential equations. Furthermore, linear hyperbolic equations with higher-order derivatives provide the mathematical underpinning of the phenomenon of dispersion, i.e., the dependence of a wave's phase speed on its wavenumber. For systems of nonlinear first-order hyperbolic equations, there also exists a general ...
Liu, T; Zhang, B; Jin, X; Wang, W; Lee, J; Li, J; Yuan, H; Cheng, X
To describe the characteristic ophthalmic phenotypes of a large Chinese family with familial amyloid polyneuropathy due to a missense mutation in transthyretin (TTR) (c.307 C>G). Twenty-seven individuals (12 affected, 15 unaffected) from a five-generation Chinese family underwent general medical examination and comprehensive ophthalmic examination, including best correct visual acuity, intraocular pressure measurements, Schirmer test, slitlamp examination, fundoscopy, and ocular ultrasonography. Histological examination of vitreous biopsies using Congo red staining and immunohistochemistry was performed. Cardiovascular magnetic resonance (CMR), electrocardiogram, and echocardiogram were used to evaluate cardiac amyloidosis. Electromyography was used to evaluate nerve function. All four exons of TTR were amplified by PCR, sequenced using a Bigdye terminator v3.1 cycle sequencing kit and analyzed on an ABI 3700XL Genetic Analyzer. All 12 affected individuals in the family had ocular manifestations, including severe vitreous opacities, secondary glaucoma, xerophthalmia, dyscoria, and attenuated retinal arteries. Congo red staining demonstrated amyloid deposits in the vitreous, and immunohistochemical staining confirmed the deposition of TTR proteins in the vitreous. Twelve individuals had polyneuropathy, and electromyography detected functional damage in peripheral nerves. One individual was diagnosed with cardiac amyloidosis by CMR. Direct sequencing revealed the heterozygous missense mutation in TTR (c.307 C>G p.Gly83Arg) in all 12 affected individuals. The mutation co-segregated with the disease phenotype and was absent in 100 normal controls. Vitreous opacity is very common in patients with the TTR Gly83Arg mutation; other clinical characteristics associated with the mutation include polyneuropathy and cardiac amyloidosis.
Full Text Available This paper describes the study design, methodology, cohort profile and self-reported diseases in the ophthalmological branch of the Gutenberg Health Study (GHS.The GHS is an ongoing, prospective, interdisciplinary, single-center, population-based cohort study in Germany. The main goals of the ophthalmological section are to assess the prevalence and incidence of ocular diseases and to explore risk factors, genetic determinants and associations with systemic diseases and conditions. The eye examination at baseline included a medical history, self-reported eye diseases, visual acuity, refractive errors, intraocular pressure, visual field, pachymetry, keratometry, fundus photography and tear sampling. The 5-year follow-up visit additionally encompassed optical coherence tomography, anterior segment imaging and optical biometry. The general examination included anthropometry; blood pressure measurement; carotid artery ultrasound; electrocardiogram; echocardiography; spirometry; cognitive tests; questionnaires; assessment of mental conditions; and DNA, RNA, blood and urine sampling.Of 15,010 participants (aged 35-74 years at the time of inclusion, ocular data are available for 14,700 subjects (97.9%. The mean visual acuity (standard deviation, mean spherical equivalent, median decimal visual acuity, and mean intraocular pressure were 0.08 (0.17 logMar, -0.42 (2.43 diopters, 0.9 and 14.24 (2.79 mm Hg, respectively. The frequencies of self-reported strabismus, glaucoma, surgery for retinal detachment and retinal vascular occlusions were 2.7%, 2.3%, 0.2% and 0.4%, respectively.The GHS is the most extensive dataset of ophthalmic diseases and conditions and their risk factors in Germany and one of the largest cohorts worldwide. This dataset will provide new insight in the epidemiology of ophthalmic diseases and related medical specialties.
Full Text Available Bevacizumab is believed to be as effective and safe as ranibizumab for ophthalmic diseases; however, its magnitude of effectiveness and safety profile remain controversial. Thus, a meta-analysis and systematic review appears necessary.PubMed and EMBASE were systematically searched with no restrictions. All relevant citations comparing ranibizumab and bevacizumab were considered for inclusion. Pooled effect estimates were obtained using a fixed- and random-effects meta-analysis.Nine independent randomised-controlled clinical trials (RCTs involving 2,289 participants were identified. Compared with bevacizumab, the overall combined weighted mean difference (WMD of the mean change in visual acuity for ranibizumab was 0.52 letters (95% CI -0.11-1.14. The odds ratios (ORs of gaining ≥15, gaining 5-14, losing 5-14 and losing ≤15 letters were 1.10 (95% CI 0.90-1.33, 0.93 (95% CI 0.77-1.11, 0.89 (95% CI 0.65-1.22 and 0.95 (95% CI 0.73-1.25, respectively. The risk of serious systemic events increased by 17% (95% CI 6%-27%, p = 0.0042 for bevacizumab treatment in comparison with ranibizumab. No statistically significant differences between the two treatments were found for the nonfatal arterial thrombotic events, ocular serious adverse, death from vascular and all causes events.Bevacizumab is not inferior to ranibizumab as a treatment for achieving visual acuity. The use of bevacizumab was associated with an increased risk of developing serious systemic events. Weighing the costs and health outcomes is necessary when selecting between bevacizumab and ranibizumab for ophthalmic diseases. Due to the limitations of the available data, further research is needed.
Efeoglu, Arkin; Møller, Charles; Serie, Michel
This paper outlines an artifact building and evaluation proposal. Design Science Research (DSR) studies usually consider encapsulated artifact that have relationships with other artifacts. The solution prototype as a composed artifact demands for a more comprehensive consideration in its systematic...... environment. The solution prototype that is composed from blending product and service prototype has particular impacts on the dualism of DSR’s “Build” and “Evaluate”. Since the mix between product and service prototyping can be varied, there is a demand for a more agile and iterative framework. Van de Ven...
Geoghegan, Michael W
Podcasting is the art of recording radio show style audio tracks, then distributing them to listeners on the Web via podcasting software such as iPodder. From downloading podcasts to producing a track for fun or profit, ""Podcast Solutions"" covers the entire world of podcasting with insight, humor, and the unmatched wisdom of experience.
Sonneveld, C.; Voogt, W.
The characteristics of the soil solution in the root environment in the greenhouse industry differ much from those for field grown crops. This is caused firstly by the growing conditions in the greenhouse, which strongly differ from those in the field and secondly the function attributed to the soil
Reza A Zoroofi
Full Text Available Medal Electronic (ME Engineering Company provides high quality systems, software and services in medical image management, processing and visualization. We assist health care professionals to improve and extend the efficiency of their practices with cost effective solutions. ME is the developer of several medical software including MEDAL-PACS, 3D-Sonosoft, Analytical-Electrophoresis, CBONE and Rhino-Plus. ME is also the exclusive distributor of PACSPLUS in Iran. PACSPLUS is an international, standard, scalable and enterprise PACS solution. PACSPLUS is of ISO, CE and FDA-510 approvals. It is now operational in more than 1000 clinical environment throughout the globe. We discuss about the key features of PACSPLUS system for dealing with real world challenge in PACS as well as the PACS solu-tions needed to fulfill the demands of the clinicians in Iran. Our experience in developing high-end medical software confirms our capability in providing the PACSPLUS as an ultimate PACS solution in Iran.
Tomashevskiy, L.P.; Boldin, V.M.; Borovikov, P.A.; Fedorova, G.G.; Koshelova, I.F.; Krivoshchekova, N.P.; Prokhorevich, L.D.; Prudnikova, N.N.; Vin, L.R.
This solution is designed to quickly harden in a cool environment. Phenoformaldyhyde tar is used as a hardening agent along with a modified diethyleneglycol in the amounts of (part by weight): phenoformaldyhyde tar and diethyleneglycol=1oo; acidic hardener=8-16; water=2-4.
@@ World Expo's China Pavilion is a large crimson building,but it's green at heart.The pavilion,a magnificent symbol of Chinese culture,is also a "green landmark" on the world stage,thanks to German company Siemens' energy-saving solutions.
杨龙华; 宿洁; 陈涛; 卢京光
Objective To establish an HPLC method for the determination of benzalkonium chloride in Loteprednol and Tobramycin Ophthalmic Suspension. Methods After being filtrated,samples were separated by HPLC on a Waters Spherisorb S5 CN column(250 mm × 4. 6 mm,5 μm). The mobile phase was 0. 1% phosphoric acid water solution- acetonitrile- tetrahydrofuran(52 :39 :15). The detec-tion wavelength was 216 nm. The flowing speed was 1. 5 mL/min. The column temperature was 30 ℃. Results The mass concentration of benzalkonium chloride was in good linear relationship with the peak area in the range of 0. 04-0. 20 g/L ( r=0. 999 9,n=5), and the average recovery rate was 100. 22%,RSD=0. 59%( n=9). Conclusion The method is sensitive,accurate and convenient with good resolution,it can be applied to control the quality of Loteprednol and Tobramycin Ophthalmic Suspension.%目的：建立测定氯替泼诺妥布霉素复方混悬滴眼液中防腐剂苯扎氯铵含量的高效液相色谱（HPLC）法。方法色谱柱为Waters Spherisorb S5 CN柱（250 mm ×4.6 mm，5μm），流动相为0.1%磷酸溶液－乙腈－四氢呋喃（52：39：15），流速为1.5 mL/min，检测波长为216 nm，柱温为30℃。结果苯扎氯铵质量浓度在0.04~0.20 g/L（ r=0.9999，n=5）范围内与峰面积线性关系良好，平均回收率为100.22%，RSD为0.59%( n=9）。结论该方法简便、灵敏，色谱峰分离度良好，结果准确、可靠，可用于氯替泼诺妥布霉素混悬滴眼液的质量控制。
... reflect approval of a supplemental new animal drug application (NADA) filed by Merial Ltd. The supplemental NADA provides for addition of a warning statement against the use of eprinomectin topical solution... supplement to NADA 141-079 for EPRINEX (eprinomectin) Pour-On for Beef and Dairy Cattle, a topical...
王宁; 秦明照; 周丹
Elderly patients presenting for ophthalmic surgery are often having systemic diseases and using multiple drugs, particularly antithrombotic drugs.Different antithrombotic drugs has different perioperative bleeding risks in a variety of ophthalmic surgeries, thus it is necessary to adjust antithrombotic strategies, manage antiplatelet drugs and anticoagulants drugs to balance the risk of bleeding and thrombosis.%眼科手术中的老年患者常合并全身性疾病,需应用多种药物,特别是抗栓药物.不同类型的眼科手术围术期应用抗栓药物的出血风险不同,因此需要调整抗栓策略,对抗血小板药物及抗凝药物进行管理,以平衡术中及术后出血及血栓的风险.
Leino, M; Montan, P; Njå, F
In a multicenter, double-blind, single-dummy, group-comparative study, 169 patients received ophthalmic sodium cromoglycate 2% four times daily, and 170 patients received 4% ophthalmic sodium cromoglycate twice daily, together with placebo eye-drops twice daily, for the treatment of seasonal allergic conjunctivitis (SAC) to birch pollen. The treatment period was 4 weeks during the birch pollen season. Daily pollen counts were used to identify the peak 14-d period. Clinical examinations were made before the start of treatment, after 1 week of treatment, and at the end of the treatment period. Patients kept daily diary record cards of eye symptom severity and concomitant therapy. Symptoms were generally mild and, except for chemosis (week 4) and soreness (weeks 2 and 3), which were less in the 4% group (P sodium cromoglycate eye-drops twice daily is as effective and well tolerated as 2% sodium cromoglycate four times daily in the treatment of birch-pollen conjunctivitis.
Tan, Donald T H; Lam, Dennis S; Chua, Wei Han; Shu-Ping, Dorothy Fan; Crockett, R Stephens
To evaluate the safety and efficacy of the relatively selective M(1)-antagonist, pirenzepine ophthalmic gel (gel), in slowing the progression of myopia in school-aged children. Parallel-group, placebo-controlled, randomized, double-masked study. Three hundred fifty-three healthy children, 6 to 12 years old, with a spherical equivalent (SE) of -0.75 to -4.00 diopters (D) and astigmatism of pirenzepine-treated subjects. Of the 15 serious adverse events reported in 12 subjects (all in the active groups), none was ophthalmic in nature, all subjects recovered, and only 1 (abdominal colic preceded by a flu) was judged possibly related to treatment. Gel (2% twice daily) was effective and relatively safe in slowing the progression of myopia over a 1-year treatment period.
Optometers measure the required correction for an eye so that the eye can focus parallel rays onto the retina when the eye is relaxed. Automatic op...size of the laser, it must know the ab- solute size of the features on the retina. Using an optometer to measure eye correction and laser range...made so that the size of retinal fea- tures can be accurately calculated. Cornsweet and Crane have developed an auto- mated optometer that is accurate
Lina Zhu,1 Junping Ao,2 Peiling Li11Department of Ophthalmology, 2State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of ChinaAbstract: In this study, an ion-activated ketotifen ophthalmic delivery system was developed by using a natural polysaccharide, deacetylase gellan gum. Its rheological characteristics, stability, in vitro gelation, release in vitro, and ...
Kim, Jun Young; Hong, Chang Ki; Suh, Sang Hyun [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Dong Ik [Dept. of of Radiology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)
A 31-year-old man was admitted with exophthalmos. He suffered from progressive exophthalmos, bruit and conjunctival chemosis 7 days after head trauma caused by falling down. Cerebral angiography showed a dural arteriovenous fistula (DAVF) draining into the ophthalmic vein caused by tear in the inferolateral trunk, which is a rare presentation of traumatic DAVF. Selective transvenous coil embolization was performed via the facial vein without neurologic complications.
Naqvi, Jawad; Laitt, Roger; Leatherbarrow, Brian; Herwadkar, Amit
A 72-year-old male presented with progressive right axial proptosis and red eye. Catheter angiography demonstrated an intraorbital arteriovenous fistula (IAVF) distal to the central retinal artery (CRA). Transvenous embolisation following direct surgical exposure of the superior ophthalmic vein (SOV) resulted in rapid resolution of his symptoms and signs. Transvenous embolisation via the SOV is a safe, effective alternative to transarterial embolisation for treating spontaneous IAVF where transarterial embolisation poses a risk of CRA occlusion.
Rani A Sunder
Full Text Available Background: Supraglottic airway devices play an important role in ophthalmic surgery. The flexible laryngeal mask airway (LMA TM is generally the preferred airway device. However, there are no studies comparing it with the Cobra perilaryngeal airway (CobraPLA TM in pediatric ophthalmic procedures. Aims: To analyze the intraoperative device stability and ability to maintain normocarbia of CobraPLA TM and compare it to that with flexible LMA TM . Materials and Methods: Ninety children of American Society for Anesthesiologists physical status 1 and 2, aged 3-15 years scheduled for elective ophthalmic surgeries were randomly assigned to either the CobraPLA TM or the flexible LMA TM group. After placement of each airway device, oropharyngeal leak pressure (OLP was noted. Adequate seal of the devices was confirmed at an inspired pressure of 15 cm H 2 O and pressure-controlled ventilation was initiated. Device displacement was diagnosed if there was a change in capnograph waveform, audible or palpable gas leak, change in expired tidal volume to 6 kPa, or need to increase inspired pressure to >18 cm H 2 O to maintain normocarbia. Results: Demographic data, duration, and type of surgery in both the groups were similar. A higher incidence of intraoperative device displacement was noted with the CobraPLA TM in comparison to flexible LMA TM (P < 0.001. Incidence of displacement was higher in strabismus surgery (7/12. Insertion characteristics and ventilation parameters were comparable. The OLP was significantly higher in CobraPLA TM group (28 ± 6.8 cm H 2 O compared to the flexible LMA TM group (19.9 ± 4.5 cm H 2 O (P < 0.001. Higher surgeon dissatisfaction (65.9% was seen in the CobraPLA TM group. Conclusion: The high incidence of device displacement and surgeon dissatisfaction make CobraPLA TM a less favorable option than flexible LMA TM in ophthalmic surgery.
Zhao, Jun-Hong; Jin, Tian-Bo; Liu, Qing-Bo; Chen, Chao; Hu, Hai-Tao
The purpose of this paper is to describe ophthalmic findings in a family with isolated ectopia lentis (EL) caused by a specific FBN1 mutation. Detailed family histories and clinical data were recorded for six isolated EL patients of 11 family members. The ophthalmological and systematic examinations were performed on patients and unaffected members of the investigated family. The detailed ocular examinations included visual acuity, anterior chamber depth, pupil size, lens location, optometry, central corneal thickness, keratometry, slitlamp examination, fundus examination, axial length, ocular B-ultrasound, gonioscope checking, ultrasound biomicroscopy (UBM) and intraocular pressure (IOP; Goldmann applanation tonometer). Systematic examinations included the measurement of echocardiogram, height, arm span, skull, face, jaw, tooth, breast bone, spinal column, and skin. Genomic DNA was extracted using the phenol-chloroform extraction method for all subjects, and sequencing was carried out on an ABI Prism 3730 Genetic Analyzer. A heterozygous mutation, c.184C>T (p.Arg62Cys) in exon 2 of FBN1 was identified in all affected members but was not found in any unaffected member of the family. Our study presented detailed clinical manifestations, including some novel ophthalmic findings, such as pupillary abnormality, different types of glaucoma, and progressive hyperopia. Ophthalmic findings and the p.Arg62Cys mutation of FBN1 gene were reported in a family with early-onset isolated ectopia lentis.
Marley, Adrian; Stalcup, Apryll M; Connolly, Damian
A new stability indicating reversed phase high performance liquid chromatography (RP-HPLC) method was developed and validated under current International Conference of Harmonisation (ICH) guidance for the determination of prednisolone acetate (PAC) and impurities in an ophthalmic suspension. The developed method is presented as an alternative to a modified version of the current RP-HPLC method described in the USP monograph for the assay of PAC in an ophthalmic suspension. Along with the assay of PAC, the new method is also capable of identifying and quantifying eight selected PAC impurities and degradation products in an ophthalmic suspension. Using an Agilent Poroshell 120 EC-C18 100 mm × 4.6mm (dp: 2.7 μm) column set to 60°C with step gradient elution generated using mobile phase A: acetonitrile/water (10:90) (v/v) and mobile phase B: acetonitrile delivered at 1.2 mL min(-1), all peaks of interest are eluted in 33 min with resolution of 1.5 between the critical pairs. The developed method was validated for PAC and impurities to ICH recommendations for accuracy, linearity, precision (repeatability), limit of detection, limit of quantitation, robustness and specificity.
Full Text Available Settings and Design: This study documents a survey of final-year ophthalmology postgraduates on the subject of their surgical training and their future plans after residency. Purpose: This survey aimed to answer the question, "What is the present status of surgical training in ophthalmic training centers?" by obtaining information from students about (1 various methods used in surgical training (2 numbers and types of surgeries performed by them in the training centers (3 their plans after residency. Materials and Methods: A questionnaire containing 21 questions was distributed to 155 students attending an intensive 4-day teaching program. The questions related to orientation training, wet lab training, facilities for training, free surgical camps and detailed information about numbers and types of surgeries observed and performed. Completed questionnaires were collected, and responses analyzed. Results: One hundred and seven completed responses were analyzed. The majority had not received formal orientation training. More than half had undergone wet lab training. Most residents performed their first ophthalmic surgery during the 1 st year of residency and went to the operation theatre multiple times a week. Most of the students planned to undergo further training after residency. More than half of the students found their surgical training to be fair or satisfactory. Conclusions: The number and frequency of ophthalmic surgeries done by residents appear satisfactory, but further efforts from trainers on enhancing the quality and range of surgical training would benefit students and improve their satisfaction.
Full Text Available Timothy L Comstock,1 Timothy W Morris,2 Lynne S Gearinger,2 Heleen H DeCory11Medical Affairs, 2Department of Microbiology and Sterilization Sciences, Bausch + Lomb, Rochester, NY, USAPurpose: Besifloxacin is a chlorofluoroquinolone approved for use in the treatment of bacterial conjunctivitis. This study assessed the clinical efficacy of besifloxacin ophthalmic suspension 0.6% against conjunctivitis infections caused by potentially consequential pathogens.Design: Post hoc analysis of clinical outcomes for patients with conjunctival infections due to Pseudomonas aeruginosa, Serratia marcescens, Neisseria spp., methicillin-resistant Staphylococcus aureus (MRSA, and methicillin-resistant Staphylococcus epidermidis (MRSE who were treated with besifloxacin in four multicenter, double-masked, randomized clinical trials.Methods: Minimum inhibitory concentrations (MICs of besifloxacin against potentially consequential pathogens were pooled. Clinical outcome data for patients treated with besifloxacin with baseline infections due to these pathogens were pooled and summarized. Bacterial eradication was defined as the absence of ocular bacterial species present at or above threshold at baseline.Results: A total of 1,317 patients had culture-confirmed bacterial conjunctivitis across the four studies, and 151 infections were due to the aforementioned pathogens (P. aeruginosa n=9; S. marcescens n=10; Neisseria spp. n=16; MRSA n=35; MRSE n=81. Among MRSA and MRSE infections, 48.3% demonstrated concurrent ciprofloxacin resistance (ciprofloxacin-resistant [CipR]-MRSA n=24; CipR-MRSE n=32. The MIC90 (MIC for 90% of isolates for besifloxacin was 1 µg/mL for S. marcescens, 0.25 µg/mL for Neisseria spp., 0.06 µg/mL for both ciprofloxacin-sensitive MRSA and ciprofloxacin-sensitive MRSE, and 4 µg/mL for both CipR-MRSA and CipR-MRSE. Against P. aeruginosa, the MIC range was 1–4 µg/mL. Bacterial eradication rates in patients treated with besifloxacin were 100% by
K. P. Mashige
Full Text Available In anendeavour to improve the quality of optometric eye care services in South Africa, the scope of practice was expanded to include the use of ocular diagnostic procedures such as goniosco-py that require the use of ophthalmic drugs. The purpose of this study was to assess the practices of specific diagnostic techniques (contact tonometry, 78 D/90 D lens fundus examination, binocular indirect ophthalmoscopy and gonioscopy requiring the use of ophthalmic drugs among optometrists in KwaZulu-Natal (KZN province. These specific techniques are referred to as diagnostic procedures in this article. A questionnaire containing information on demography and practice of these specific techniques was sent to all 213 KwaZulu-Natal registered optometrists who owned private practices. One hundred and thirty two completed questionnaires were received, a response rate of 62%. One hundred and seventeen (55% of the questionnaires were included in the analysis of which 55% of the respondents were females and 45% were males. Sixty two optometrists (53% were certified in di-agnostic procedures but many procedures were not being practiced. These procedures and the percentage respondents were: Contact tonometry (60%, 78 D/90 D lens fundus examination (60%, binocular indirect ophthalmoscopy (84% and gonioscopy (78%. Also, among these certified respondents (62 optometrists, a significant proportion (60% disagreed when asked if they were confident and proficient in performing the relevant diagnostic procedures. Many, (61% agreed that lack of incentives discouraged them from routinely performing the procedures. More than half (58%, agreed that chair time was an important factor in deciding whether or not to perform these diagnostic procedures. Of the total respondents (117, 86% agreed that they were confident about the accuracy of their referrals and less than half (45% disagreed that diagnostic procedures should be the sole responsibility of ophthalmologists. Less than
K. P. Mashige
Full Text Available In anendeavour to improve the quality of optometric eye care services in South Africa, the scope of practice was expanded to include the use of ocular diagnostic procedures such as gonioscopy that require the use of ophthalmic drugs. The purpose of this study was to assess the practices of specific diagnostic techniques (contact tonometry, 78 D/90 D lens fundus examination, binocular indirect ophthalmoscopy and gonioscopy requiring the use of ophthalmic drugs among optometrists in KwaZulu-Natal (KZN province. These specific techniques are referred to as diagnostic procedures in this article. A questionnaire containing information on demography and practice of these specific techniques was sent to all 213 KwaZulu-Natal registered optometrists who owned private practices. One hundred and thirty two completed questionnaires were received, a response rate of 62%. One hundred and seventeen (55% of the questionnaires were included in the analysis of which 55% of the respondents were females and 45% were males. Sixty two optometrists (53% were certified in di-agnostic procedures but many procedures were not being practiced. These procedures and the percentage respondents were: Contact tonometry (60%, 78 D/90 D lens fundus examination (60%, binocular indirect ophthalmoscopy (84% and gonioscopy (78%. Also, among these certified respondents (62 optometrists, a significant proportion (60% disagreed when asked if they were confident and proficient in performing the relevant diagnostic procedures. Many, (61% agreed that lack of incentives discouraged them from routinely performing the procedures. More than half (58%, agreed that chair time was an important factor in deciding whether or not to perform these diagnostic procedures. Of the total respondents (117, 86% agreed that they were confident about the accuracy of their referrals and less than half (45% disagreed that diagnostic procedures should be the sole responsibility of ophthalmologists. Less than
This work presents a calculational methodology for dose determination in human eye structures, such as: sclera, choroid, retina, lens, vitreous body, optic nerve and disc, and cornea, as well as tumor due to treatment to the eye plaques. A human eye model was constructed taking into consideration its main structural and dimension characteristics. Beyond that a mathematical model for the Co-60 and 1-125 plaques with all geometric details were built employing the MCNP-4C code. This model is able to calculate the axial and radial doses in any point of the eye and for each of its structures. An acrylic eye simulator was also built with the aim to obtain experimental results for the both model validations. This simulator is made of an acrylic sphere split into foils of 1 mm thickness which allow the introduction of a radiographic film to measure the axial and radial doses. The experimental data were used to validate the MCNP-4C results. The data from the mathematical model will serve as the basis to build a data bank for all the eye structures allowing different position and sizes of tumor as well as the replacement of all ophthalmic plaques used in the treatment. This data bank will be the principal part for the construction of a national software for the dose calculation and can be of great help for a reliable treatment system planning in radiotherapy/brachytherapy. (author)
Full Text Available Stem cells hold promise for treating a wide variety of diseases, including degenerative disorders of the eye. The eye is an ideal organ for stem cell therapy because of its relative immunological privilege, surgical accessibility, and its being a self-contained system. The eye also has many potential target diseases amenable to stem cell-based treatment, such as corneal limbal stem cell deficiency, glaucoma, age-related macular degeneration (AMD, and retinitis pigmentosa (RP. Among them, AMD and glaucoma are the two most common diseases, affecting over 200 million people worldwide. Recent results on the clinical trial of retinal pigment epithelial (RPE cells from human embryonic stem cells (hESCs and induced pluripotent stem cells (iPSCs in treating dry AMD and Stargardt’s disease in the US, Japan, England, and China have generated great excitement and hope. This marks the beginning of the ocular stem cell therapy era. The recent Zhongshan Ophthalmic Center Ocular Stem Cell Symposium discussed the potential applications of various stem cell types in stem cell-based therapies, drug discoveries and tissue engineering for treating ocular diseases.
Li, Yanan; Zhang, Yong; Li, Pengmei; Mi, Gujie; Tu, Jiasheng; Sun, Linlin; Webster, Thomas J; Shen, Yan
Myopia is one of the most common ocular disorders for which standard treatments, such as refractive surgery, often involve invasive procedures. Pirenzepine (PRZ), a muscarinic receptor antagonist, has been recognized as a promising candidate for the treatment of myopia, but possesses poor ocular bioavailability. The overall objective of this study was to prepare PRZ-sorbic acid complexes suitable to be encapsulated into micelles with high efficiency for optimal ophthalmic delivery. The results demonstrated that sorbic acid, used as the counter ion, had the most significant effects in increasing the octanol-water distribution coefficient of PRZ as well as improving its corneal permeability in vitro among various counter ions tested. In vivo absorption results showed that a 1.5 times higher bioavailability was achieved by the addition of sorbic acid at a 1:1 ratio. Cytotoxicity studies in vitro and biocompatibility studies in vivo indicated that the micelles did not cause significant toxicities to the eyes. Copyright © 2017 Elsevier Inc. All rights reserved.
Ruhi A. Khan
Full Text Available Objectives: This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital. Methods: This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot™ Vision Screener (Welch Allyn Inc., Skaneateles Falls, New York, USA. Results: A total of 150 nurses participated in the study (response rate: 30.0%. The mean age was 41.2 ± 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 (24.7%, 32 (21.3% and 10 (6.7% nurses, respectively. A total of 58 nurses (38.7% failed the vision screening test. Visual defects were detected for the first time in 13 nurses (8.7%. With regards to regular eye checkups, 77 participants (51.3% reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids (P <0.01 each. Conclusion: A high proportion of participants failed the vision screening tests and only half displayed good ocular healthcare-seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population.
Kurata, A.; Suzuki, S.; Iwamoto, K.; Miyazaki, T.; Inukai, M.; Abe, K.; Niki, J.; Yamada, M.; Fujii, K. [Kitasato University School of Medicine, Department of Neurosurgery, Kanagawa (Japan); Kan, S. [Kitasato University School of Medicine, Department of Radiology, Kanagawa (Japan)
The transvenous approach via the superior ophthalmic vein (SOV) is an available approach for carotid cavernous fistula (CCF), especially in the event that there is no other suitable approach route to the fistula. Surgical exposure of the peripheral roots of the SOV is commonly used; however, often, the SOV is often not accessible because of anatomical problems and/or complications. In this paper, we present and discuss our original direct-puncture approach to the extraconal portion of the SOV. An attempt on three patients with traumatic CCF failed with the transarterial approach and the conventional venous approach via the inferior petrosal sinus; therefore, the patients were treated with the direct-puncture approach to the extraconal portion of the SOV using two-dimensional digital subtraction angiography with local anesthesia. All cases that had tortuous and partially stenotic division of the SOV were treated successfully with this approach and without complications. This approach will become an alternate approach, especially when the peripheral roots of the SOV are focally narrowed and tortuous, making it impossible to insert a catheter. (orig.)
Kinoshita, Shigeru; Awamura, Saki; Nakamichi, Norihiro; Suzuki, Hiroyuki; Oshiden, Kazuhide; Yokoi, Norihiko
To investigate the efficacy and safety of 2% rebamipide ophthalmic suspension administered 4 times daily for 52 weeks in patients with dry eye. Multicenter (17 sites), open-label, single-arm study. A total of 154 patients with dry eye were enrolled in this study. After a 2-week screening period, patients received 2% rebamipide, instilled as 1 drop in each eye, 4 times daily for 52 weeks. The signs and symptoms measures were assessed at baseline, at weeks 2 and 4, and at every 4 weeks thereafter. The objective signs were fluorescein corneal staining score, lissamine green conjunctival staining score, and tear film break-up time, while subjective symptoms were dry eye-related ocular symptoms (foreign body sensation, dryness, photophobia, eye pain, and blurred vision). The safety variable was the occurrence of adverse events. For all objective signs and subjective symptoms, the scores significantly improved at week 2 compared with baseline (P rebamipide is effective in improving both the objective signs and subjective symptoms of dry eye patients for at least 52 weeks. In addition, 2% rebamipide treatment was generally well tolerated. Copyright © 2014. Published by Elsevier Inc.
Carrasco-Zevallos, O. M.; Keller, B.; Viehland, C.; Shen, L.; Waterman, G.; Todorich, B.; Shieh, C.; Hahn, P.; Farsiu, S.; Kuo, A. N.; Toth, C. A.; Izatt, J. A.
Minimally-invasive microsurgery has resulted in improved outcomes for patients. However, operating through a microscope limits depth perception and fixes the visual perspective, which result in a steep learning curve to achieve microsurgical proficiency. We introduce a surgical imaging system employing four-dimensional (live volumetric imaging through time) microscope-integrated optical coherence tomography (4D MIOCT) capable of imaging at up to 10 volumes per second to visualize human microsurgery. A custom stereoscopic heads-up display provides real-time interactive volumetric feedback to the surgeon. We report that 4D MIOCT enhanced suturing accuracy and control of instrument positioning in mock surgical trials involving 17 ophthalmic surgeons. Additionally, 4D MIOCT imaging was performed in 48 human eye surgeries and was demonstrated to successfully visualize the pathology of interest in concordance with preoperative diagnosis in 93% of retinal surgeries and the surgical site of interest in 100% of anterior segment surgeries. In vivo 4D MIOCT imaging revealed sub-surface pathologic structures and instrument-induced lesions that were invisible through the operating microscope during standard surgical maneuvers. In select cases, 4D MIOCT guidance was necessary to resolve such lesions and prevent post-operative complications. Our novel surgical visualization platform achieves surgeon-interactive 4D visualization of live surgery which could expand the surgeon’s capabilities.
El-Laithy, Hanan M; Nesseem, Demiana I; El-Adly, Amira A; Shoukry, Meriana
In this study, six in situ gelling formulations based on Gelrite were prepared and evaluated for the retained ophthalmic delivery of Moxifloxacin (Mox). The effectiveness of the best developed formula G5 was compared with photodynamic therapy (PDT), the recent expanding approach for the treatment of ophthalmologic disorders after the assessment of optimum photodynamic inactivation parameters that permit efficient pathogens eradication. It was found that, Staphylococcus aureus (S. aureus) (Gram-positive) was more susceptible to effective lethal photosensitization that reaches 93.5% reduction in viable count than Escherichia coli (E. coli) (Gramnegative) of 76.1% using 3 mg/mL Hematoporphyrin (HP), illuminated by 630 nm Light Emitting Diode (LED) at 9 J/cm(2) and incubated for 15 min. Following topical instillation of G5 to rabbits corneas, higher amount of Mox was retained in the aqueous humor up to 24 h with significant 6-fold increase in the C(max) and AUC((0-∞)) compared to vigamox commercial eye drops. After post corneal infection with S. aureus, both approaches were effectively treating the infection without causing ocular irritation or collateral damage to corneal tissue where G5 showed remarkable improvement after four days compared to seven days of PDT treatment.
Rafael Andres Ibarra
Full Text Available Purpose. The incidence of liver tumors is rising in USA. The purpose of this study was to evaluate liver oxido-reductive status in the presence of chronic liver disease and hepatocellular carcinoma (HCC. Methods. Glutathione species and ophthalmate (OA concentrations were measured by LC-MS in processed plasma and red blood cells (RBC from infected Woodchuck with hepatitis virus (WHV. Blood samples were obtained from: (i infected animals with tumors (WHV+/HCC+, (ii infected animals without tumors (WHV+/HCC− and (iii healthy animals (WHC−/HCC−. Results. The concentration of reduced glutathione (GSH and the ratio GSH/GSG were lower in plasma from WHV+/HCC+ animals when compared to WHV+/HCC− and WHV−/HCC− (P<0.01. In contrast, the concentration of oxidized glutathione (GSSG was found to be higher in plasma from WHV+/HCC+ animals when compared to WHV+/HCC− and WHV−/HCC− (P<0.01. The Glutathione species and its ratio from the RBC compartment were similar among all groups. OA concentration in both plasma and RBC was significantly higher from WHV+/HCC+ when compared to WHV+/HCC− and WHV−/HCC− (P<0.01. Conclusions. Disturbances of the glutathione redox buffer system and higher concentrations of OA were found in the WCV+/HCC+ animal model. The role of these compounds as biomarkers of early tumor development in patients with end stage liver disease remains to be determined.
车宁; 史爱欣; 傅得兴
Canan Asli UtineYeditepe University, Department of Ophthalmology, Istanbul, Turkey and Ocular Surface Disease and Dry Eye Clinic, Cornea and External Disease Service, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Azithromycin is an azalide that acts by binding to the 50S ribosomal subunit of susceptible microorganisms and interfering with microbial protein synthesis. Azithromycin is also noted by anti-inflammatory and immunomodulatory a...
Paradiso, P; Galante, R; Santos, L; Alves de Matos, A P; Colaço, R; Serro, A P; Saramago, B
In the present work two types of polymers were investigated as drug releasing contact lens materials: a poly-hydroxyethylmethacrylate (pHEMA) based hydrogel and a silicone hydrogel. The silicone hydrogel resulted from the addition of TRIS, a hydrophobic monomer containing silicon (3-tris(trimethylsilyloxy)silylpropyl 2-methylprop-2-enoate), to pHEMA. Both hydrogels were loaded with an antibiotic (levofloxacin) and an antiseptic (chlorhexidine) by soaking in the drug solutions. The hydrogel properties were determined to be within the range demanded for lens materials. The release profiles of both drugs from the hydrogels were obtained and eventual drug/polymer interactions were assessed with the help of Raman spectra. A mathematical model, developed to mimic the eye conditions, was applied to the experimental results in order to predict the in vivo efficacy of the studied systems. The release profiles were compared with those resulting from the application of commercial eyedrops. The pHEMA based hydrogel demonstrated to be the best material to achieve a controlled release of levofloxacin. In the case of chlorhexidine, the silicone hydrogel seems to lead to better results. In both cases, our results suggest that these materials are adequate for the preparation of daily disposable therapeutic contact lenses.
Wang, Fengzhen; Chen, Li; Jiang, Sunmin; He, Jun; Zhang, Xiumei; Peng, Jin; Xu, Qunwei; Li, Rui
The purpose of the present study was to optimize methazolamide (MTZ)-loaded solid lipid nanoparticles (SLNs) which were used as topical eye drops by evaluating the relationship between design factors and experimental data. A three factor, three-level Box-Behnken design (BBD) was used for the optimization procedure, choosing the amount of GMS, the amount of phospholipid, the concentration of surfactant as the independent variables. The chosen dependent variables were entrapment efficiency, dosage loading, and particle size. The generated polynomial equations and response surface plots were used to relate the dependent and independent variables. The optimal nanoparticles were formulated with 100 mg GMS, 150 mg phospholipid, and 1% Tween80 and PEG 400 (1:1, w/v). A new formulation was prepared according to these levels. The observed responses were close to the predicted values of the optimized formulation. The particle size was 197.8 ± 4.9 nm. The polydispersity index of particle size was 0.239 ± 0.01 and the zeta potential was 32.7 ± 2.6 mV. The entrapment efficiency and dosage loading were about 68.39% and 2.49%, respectively. Fourier transform infrared spectroscopy (FT-IR) study indicated that the drug was entrapped in nanoparticles. The optimized formulation showed a sustained release followed the Peppas model. MTZ-SLNs showed significant prolonged decreasing intraocular pressure effect comparing with MTZ solution in vivo pharmacodynamics studies. The results of acute eye irritation study indicated that MTZ-SLNs and AZOPT both had no eye irritation. Furthermore, the MTZ-SLNs were suitable to be stored at low temperature (4 °C).
Fernández, Enrique; Drexler, Wolfgang
Optical coherence tomography (OCT) enables visualization of the living human retina with unprecedented high axial resolution. The transverse resolution of existing OCT approaches is relatively modest as compared to other retinal imaging techniques. In this context, the use of adaptive optics (AO) to correct for ocular aberrations in combination with OCT has recently been demonstrated to notably increase the transverse resolution of the retinal OCT tomograms. AO is required when imaging is performed through moderate and large pupil sizes. A fundamental difference of OCT as compared to other imaging techniques is the demand of polychromatic light to accomplish high axial resolution. In ophthalmic OCT applications, the performance is therefore also limited by ocular chromatic aberrations. In the current work, the effects of chromatic and monochromatic ocular aberrations on the quality of retinal OCT tomograms, especially concerning transverse resolution, sensitivity and contrast, are theoretically studied and characterized. The repercussion of the chosen spectral bandwidth and pupil size on the final transverse resolution of OCT tomograms is quantitatively examined. It is found that losses in the intensity of OCT images obtained with monochromatic aberration correction can be up to 80 %, using a pupil size of 8 mm diameter in combination with a spectral bandwidth of 120 nm full width at half maximum for AO ultrahigh resolution OCT. The limits to the performance of AO for correction of monochromatic aberrations in OCT are established. The reduction of the detected signal and the resulting transverse resolution caused by chromatic aberration of the human eye is found to be strongly dependent on the employed bandwidth and pupil size. Comparison of theoretical results with experimental findings obtained in living human eyes is also provided.
Xu, Jianjiang; Liu, Zuguo; Mashaghi, Alireza; Sun, Xinghuai; Lu, Yi; Li, Yimin; Wu, Dan; Yang, Yujing; Wei, Anji; Zhao, Yujin; Lu, Chun; Hong, Jiaxu
In patients with primary canaliculitis, conservative medical therapy is associated with a high recurrence rate. Surgical treatments carry a great resolution rate but sometimes can result in the lacrimal pump dysfunction and canalicular scarring. The aim of this study is to introduce a minimally invasive approach, intracanalicular ophthalmic corticosteroid/antibiotic combination ointment infiltration (IOI, intracanalicular ointment infiltration), and to report our preliminary results for treating primary canaliculitis. In this retrospective, interventional case series, 68 consecutive patients with newly developed primary canaliculitis at a major tertiary eye center between January 2012 and January 2015. Thirty-six patients received conservative medical treatment alone (group 1; 36 eyes). Twenty-two patients and 10 medically uncontrolled patients from group 1 underwent IOI therapy (group 2; 32 eyes). Ten patients and 26 recurrent patients from group 1 and group 2 underwent surgery (group 3; 36 eyes). Patients were followed-up for at least 8 weeks. Clinical characteristics and outcomes were analyzed and compared. In this study, patients' age, sex, onset location, and durations of disease among 3 groups showed no significant difference. The resolution rate in group 2 was 72.7% (16/22) for new patients and 68.8% (22/32) for gross patients, respectively, both of which are higher than that of group 1 (22.2%, 10/36) but lower than that of group 3 (100%, 36/36). Of group 3, 2 patients received 2 surgical interventions and resolved finally. Microbiological workup was available in 51 patients. The most common isolates were staphylococcus species (27.9%) and streptococcus species (20%). Canalicular laceration developed in 1 patient during the IOI procedure and 1 patient undergoing surgery. Only 2 had postoperative lacrimal pump dysfunction and 1 had canalicular scarring in group 3. The IOI may be an effective and minimally invasive technique for treating primary canaliculitis
Full Text Available BACKGROUND Laryngoscopy and tracheal intubation are associated with hypertension, tachycardia, increased circulating catecholamines and increase in intraocular pressure. Aim of this study is to compare the effect of IV Dexmedetomidine and IV Clonidine premedication on the intraocular pressure changes, haemodynamic responses after succinylcholine injection and intubation. METHODS Sixty cases both male and female patients ranging between the age group 18 to 60 years belonging to ASA 1 or ASA 2 grades, undergoing elective non-ophthalmic surgeries under general anaesthesia were studied. All patients were randomized into 3 groups of 20 patients each. Each group consists of 20 patients. Dexmedetomidine Group (Group 1 patients received intravenous Dexmedetomidine 1 micro/kg in 100 mL normal saline, Clonidine Group (Group 2 patients received intravenous Clonidine 1 micro/kg in 100 mL normal saline, Control Group (Group 3 patients received intravenous 100 mL saline infused over 10 minutes. Mean Arterial Pressure (MAP, Heart Rate (HR and IOP were recorded at before premedication 5 min. after premedication, 30 s after succinylcholine, 1 min. after intubation, 5 mins. after intubation. RESULT Fall in Pulse rate, Systolic blood pressure. Diastolic blood pressure, Mean arterial pressure and intraocular pressure were observed following administration of dexmedetomidine and clonidine groups after suxamethonium injection and endotracheal intubation. Pulse rate, blood pressure (Systolic, Diastolic and Mean and IOP differences were statistically significant (p value between 0.000 and 0.5 in dexmedetomidine and clonidine group compared to control groups 1 min. and 5 minutes after intubation, but it was statistically not significant between dexmedetomidine and clonidine group. CONCLUSION Dexmedetomidine (1 micro/kg given 10 minutes before induction is much more effective in controlling both the tachycardia, hypertension and IOP following laryngoscopy and intubation
Oshika, T; Okamoto, F; Kaji, Y; Hiraoka, T; Kiuchi, T; Sato, M; Kawana, K
To assess the retention and removal properties of a new viscous dispersive ophthalmic viscosurgical device (OVD), DisCoVisc, in comparison with those of cohesive (Provisc), dispersive (Viscoat), and viscoadaptive (Healon5) OVDs. In 20 porcine eyes, cataract surgery was simulated using one of the four OVDs which were stained with fluorescein for better visualisation. Three parameters were measured. Firstly, the presence/absence of OVDs in the chamber at the completion of phacoemulsification was recorded. Secondly, the time until the OVDs were completely removed from the anterior chamber using the phaco needle was measured. Thirdly, after intraocular lens (IOL) implantation, the time needed to completely remove the OVDs from the chamber with irrigation/aspiration tip was recorded. At the completion of phacoemulsification, the OVDs retained in 0% (0/5) for Provisc, 80% (4/5) for Healon5, 100% (5/5) for DisCoVisc, and 100% (5/5) for Viscoat. The retention of OVDs during phacoemulsification was greatest with Viscoat followed by, in descending order, DisCoVisc, Healon5, and Provisc. The removal of OVDs after IOL implantation took longest with Viscoat followed by Healon5, DisCoVisc, and Provisc. The viscous dispersive DisCoVisc showed excellent retention during phacoemulsification, while its removal after IOL implantation was very easy. When compared with the viscoadaptive Healon5, DisCoVisc was retained better in the chamber and was easier to remove. These features of DisCoVisc should be highly advantageous when considering covering the entire cataract surgery procedure with a single OVD.
Aslam, Tariq M; Tahir, Humza J; Parry, Neil R A; Murray, Ian J; Kwak, Kun; Heyes, Richard; Salleh, Mahani M; Czanner, Gabriela; Ashworth, Jane
To report on the utility of a computer tablet-based method for automated testing of visual acuity in children based on the principles of game design. We describe the testing procedure and present repeatability as well as agreement of the score with accepted visual acuity measures. Reliability and validity study. Setting: Manchester Royal Eye Hospital Pediatric Ophthalmology Outpatients Department. Total of 112 sequentially recruited patients. For each patient 1 eye was tested with the Mobile Assessment of Vision by intERactIve Computer for Children (MAVERIC-C) system, consisting of a software application running on a computer tablet, housed in a bespoke viewing chamber. The application elicited touch screen responses using a game design to encourage compliance and automatically acquire visual acuity scores of participating patients. Acuity was then assessed by an examiner with a standard chart-based near ETDRS acuity test before the MAVERIC-C assessment was repeated. Reliability of MAVERIC-C near visual acuity score and agreement of MAVERIC-C score with near ETDRS chart for visual acuity. Altogether, 106 children (95%) completed the MAVERIC-C system without assistance. The vision scores demonstrated satisfactory reliability, with test-retest VA scores having a mean difference of 0.001 (SD ±0.136) and limits of agreement of 2 SD (LOA) of ±0.267. Comparison with the near EDTRS chart showed agreement with a mean difference of -0.0879 (±0.106) with LOA of ±0.208. This study demonstrates promising utility for software using a game design to enable automated testing of acuity in children with ophthalmic disease in an objective and accurate manner. Copyright © 2016 Elsevier Inc. All rights reserved.
Bain, Mrinal Kanti; Bhowmick, Biplab; Maity, Dipanwita; Mondal, Dibyendu; Mollick, Md Masud Rahaman; Paul, Bijan Kumar; Bhowmik, Manas; Rana, Dipak; Chattopadhyay, Dipankar
The effect of molecular weight of poly(vinyl alcohol) (PVA) and sodium chloride on the gelation temperature of methylcellulose (MC) was studied with the objective to develop a MC based formulation for sustained delivery of ketorolac tromethamine a model ophthalmic drug. Pure MC showed sol-gel transition at 61.2 °C. In order to reduce the gelation temperature of MC and to increase the drug release time, PVA was used. Different techniques such as test tube tilting method, UV-vis spectroscopy, viscometry and rheometry were used to measure gelation temperature of all the binary combinations of MC and PVA. It was observed that the gelation temperature of MC was reduced with the addition of 4% PVA and also the extent of reduction of the gelation temperature of MC was dependent on the molecular weight of PVA. The strong interactions between MC and PVA molecules were established using Fourier transform infrared spectroscopy. To study the in vitro drug release properties of the MC-PVA binary combinations, 6% sodium chloride was used to reduce the gelation temperature further up to physiological temperature. It was observed that the drug release time increased from 5 to 8h with the increase of molecular weight of PVA from 9×10(3) to 1.3×10(5) and this was due to the higher viscosity, better gel strength and greater interactions between the drug and PVA molecules in case of PVA (1.3×10(5)) compared to PVA (9×10(3)). In order to have an idea about the nature of interactions between the functional moieties of the drug and the polymer unit of PVA, a theoretical study was carried out.
Turalba, Angela; Cakiner-Egilmez, Tulay; Payal, Abhishek R; Gonzalez-Gonzalez, Luis A; Chomsky, Amy S; Vollman, David E; Baze, Elizabeth F; Lawrence, Mary G; Daly, Mary K
To compare clinical outcomes of cataract surgery in eyes with and without pseudoexfoliation (PXF). Retrospective deidentified data analysis. A total of 123 PXF and 4776 non-PXF eyes of patients who underwent cataract surgery. We compared data on visual acuity, Visual Function Questionnaire (VFQ)-based quality of life, and complications in PXF and non-PXF eyes from the Veterans Affairs (VA) Ophthalmic Surgery Outcomes Data Project across 5 VA medical centres. Pupillary expansion devices were used in 31 (25.2%) PXF cases and 398 (8.4%) non-PXF cases (p < 0.0001). Capsular tension rings were used in 6 (4.9%) PXF cases and 55 (1.2%) non-PXF cases (p < 0.004). The following complications occurred more frequently in PXF cases: zonular dehiscence without vitrectomy (4 [3.3%] PXF cases vs 40 [0.8%] non-PXF cases p = 0.02), persistent inflammation (28 [24.1%] vs 668 [14.5%]; p = 0.007), and persistent intraocular pressure elevation (5 [4.3%] vs 68 [1.5%]; p = 0.03). Best corrected visual acuity (BCVA) improved in both groups after 1 month, but 87 (83.7%) PXF cases achieved postoperative BCVA better than or equal to 20/40 compared to 3991 (93.8%) non-PXF cases (p = 0.0003). There was no significant difference in the postoperative composite VFQ scores between PXF (82.1 ± 16.9) and non-PXF cases (84.2 ± 16.8, p = 0.09). Several complications occurred more frequently in the PXF group compared to the non-PXF group, and fewer PXF cases achieved BCVA better than or equal to 20/40. Despite this, both groups experienced similar improvement in vision-related quality of life after cataract surgery. Published by Elsevier Inc.
满玉清; 魏传梅; 刘明华; 左小信; 胡丽敏
Objective To prepare Fluconazole Ophthalmic Gel and establish its quality control standards. Methods the matrix formulation was optimized by orthogonal design;HPLC was used to determine the content of fluconazole,and in-vestigate the stimulating and stability of the preparation. Results The best prescription of Fluconazole Ophthalmic Gel for quality(mass to volume ratio)were:carbomer - 940 0. 3% ,borax 0. 4% and glycerol 2% . The linear range of fluconazole was 1. 0 ~ 8. 0 μg(r = 0. 999 8),and the average recovery was 99. 43%(RSD = 0. 75% );The prescription was stable and nonirritating. Conclusion The prescription of Fluconazole Ophthalmic Gel was reasonable,and the quality was controlla-ble.%目的：制备氟康唑滴眼凝胶并建立质量控制方法。方法采用正交设计对基质处方进行优化；用高效液相色谱法测定氟康唑的含量，并进行制剂刺激性及稳定性考察。结果氟康唑眼凝胶最佳基质处方为（质量体积比）：卡波姆-9400.3%，硼砂0.4%，甘油2%；氟康唑进样量在1.0~8.0μg 的范围内线性关系良好（ r =0.9998），加样回收率为99.43%（RSD =0.75%）；制剂无刺激性，稳定性好。结论氟康唑滴眼凝胶处方合理，质量可控。
Justis P Ehlers
Full Text Available PURPOSE: To demonstrate key integrative advances in microscope-integrated intraoperative optical coherence tomography (iOCT technology that will facilitate adoption and utilization during ophthalmic surgery. METHODS: We developed a second-generation prototype microscope-integrated iOCT system that interfaces directly with a standard ophthalmic surgical microscope. Novel features for improved design and functionality included improved profile and ergonomics, as well as a tunable lens system for optimized image quality and heads-up display (HUD system for surgeon feedback. Novel material testing was performed for potential suitability for OCT-compatible instrumentation based on light scattering and transmission characteristics. Prototype surgical instruments were developed based on material testing and tested using the microscope-integrated iOCT system. Several surgical maneuvers were performed and imaged, and surgical motion visualization was evaluated with a unique scanning and image processing protocol. RESULTS: High-resolution images were successfully obtained with the microscope-integrated iOCT system with HUD feedback. Six semi-transparent materials were characterized to determine their attenuation coefficients and scatter density with an 830 nm OCT light source. Based on these optical properties, polycarbonate was selected as a material substrate for prototype instrument construction. A surgical pick, retinal forceps, and corneal needle were constructed with semi-transparent materials. Excellent visualization of both the underlying tissues and surgical instrument were achieved on OCT cross-section. Using model eyes, various surgical maneuvers were visualized, including membrane peeling, vessel manipulation, cannulation of the subretinal space, subretinal intraocular foreign body removal, and corneal penetration. CONCLUSIONS: Significant iterative improvements in integrative technology related to iOCT and ophthalmic surgery are demonstrated.
James O Rushton
Full Text Available BACKGROUND: To date the influence of herpesviruses on the development of equine ocular diseases has not been clearly determined. OBJECTIVE: The purpose of this study was to illustrate the course of equine ocular findings over a period of 18 months at 6 month intervals, in correlation with the results of herpesvirus detection. METHODS: 266 Lipizzaners in 3 federal states of Austria underwent complete ophthalmologic examination 4 times. Blood samples, nasal- and conjunctival swabs were obtained at the same time and used for the detection of the equid gammaherpesviruses EHV-2 and EHV-5 using consensus herpesvirus PCR and type-specific qPCRs. Ophthalmic findings and results of herpesvirus PCRs were recorded and statistically analysed using one-way ANOVA, and multiple logistic regression analysis to determine the influence of herpesvirus infections and other contributing factors on the presence of ophthalmic findings. RESULTS: In the first, second, third and fourth examination period 266, 261, 249 and 230 horses were included, respectively. Ophthalmic findings consistent with herpesvirus infections included conjunctival- and corneal pathologies. Statistical analysis revealed that the probability of positive herpesvirus PCR results decreased with progressing age; however the presence of corneal findings increased over time. At the time of each examination 45.1%, 41.8%, 43.0%, and 57.0% of horses with conjunctival or corneal findings, respectively, were positive for EHV-2 and/or EHV-5. However, 31.6%, 17.6%, 20.1%, and 13.0% of clinically sound horses were positive for these herpesviruses at each examination period, too. CONCLUSION: Based on the results of our study there is a significant influence of young age on EHV-2 and/or EHV-5 infection. Corneal pathologies increased over time and with progressing age. Whether the identified findings were caused by herpesviruses could not be unequivocally determined.
Full Text Available Introduction We express the detection of the prohibited substance prednisone, prednisolone in player’s urine sample by long and intensive use eye steroid drops. Case Presentation In a rare case in Iranian football, a player’s urine sample had corticosteroids. After all investigations, it was demonstrated that systemic effects can be induced by using long-term of ophthalmic prednisone. Conclusions It seems to be required to investigate the systemic effects on long term and excessive use of topical corticosteroid drops can have on the result of the sample analysis and showing positive results.
温坚; 李芳; 汪德凤; 黄娜; 洪宝贤; 林三清; 夏敬民
Objective To and to establish quality control method of sparfloxacin ophthalmic gel. Methods Carhomer -940 was used as matrix to prepare Sparfloxacin Ophthalmic Gel. The appearance of the gel was observed and the pH value of it was determined by pHS -25C digital acidometer. The content of sparfloxacin in the gel was determined by ultraviolet spectrophotometer at the wavelength of 297 nm. Results Sparfloxacin Ophthalmic Cel was faint yellow colloid and it accorded with relative quality requirement of Chinese Pharmacopoeia( 2005). A linear calibration curve for assay of sparfloxacin was obtained in the range of 2. 04 - 14. 28 μg/mL, r=0. 999 95( n =7 ) and the average recoveries were 99. 48％, RSD =0. 738( n =6 ). Conclusion The quality control method of Sparfloxacin Ophthalmic Gel is feasible, and it is accurate and fast that the content of sparfloxacin in the gel is determined by ultraviolet spectrophotometer.%目的 建立司帕沙星眼用凝胶的质量控制方法.方法 观察以卡波姆-940为基质制备的司帕沙星眼用凝胶的外观性状,用pHS-25C型数字酸度计测定其pH,在297 nm波长处采用紫外分光光度法测定其中主药的含量.结果 所得制剂为淡黄色胶体,凝胶质量符合2010年版中眼用凝胶的质量要求;司帕沙星质量浓度在2.04～14.28μg/mL范围内与吸光度线性关系良好,r=0.999 95(n=7),平均回收率为99.48%,RSD为0.73%(n=6).结论 司帕沙星眼用凝胶的质量控制方法可行,采用紫外分光光度法测定其主药含量准确、快速.
Palte, Howard D; Gayer, Steven; Arrieta, Esdras; Scot Shaw, Eric; Nose, Izuru; Lee, Elizabete; Arheart, Kristopher L; Dubovy, Sander; Birnbach, David J; Parel, Jean-Marie
Since Atkinson's original description of retrobulbar block in 1936, needle-based anesthetic techniques have become integral to ophthalmic anesthesia. These techniques are unfortunately associated with rare, grave complications such as globe perforation. Ultrasound has gained widespread acceptance for peripheral nerve blockade, but its translation to ocular anesthesia has been hampered because sonic energy, in the guise of thermal or biomechanical insult, is potentially injurious to vulnerable eye tissue. The US Food and Drug Administration (FDA) has defined guidelines for safe use of ultrasound for ophthalmic examination, but most ultrasound devices used by anesthesiologists are not FDA-approved for ocular application because they generate excessive energy. Regulating agencies state that ultrasound examinations can be safely undertaken as long as tissue temperatures do not increase >1.5°C above physiological levels. Using a rabbit model, we investigated the thermal and mechanical ocular effects after prolonged ultrasonic exposure to single orbital- and nonorbital-rated devices. In a dual-phase study, aimed at detecting ocular injury, the eyes of 8 rabbits were exposed to continuous 10-minute ultrasound examinations from 2 devices: (1) the Sonosite Micromaxx (nonorbital rated) and (2) the Sonomed VuMax (orbital rated) machines. In phase I, temperatures were continuously monitored via thermocouples implanted within specific eye structures (n = 4). In phase II the eyes were subjected to ultrasonic exposure without surgical intervention (n = 4). All eyes underwent light microscopy examinations, followed at different intervals by histology evaluations conducted by an ophthalmic pathologist. Temperature changes were monitored in the eyes of 4 rabbits. The nonorbital-rated transducer produced increases in ocular tissue temperature that surpassed the safe limit (increases >1.5°C) in the lens of 3 rabbits (at 5.0, 5.5, and 1.5 minutes) and cornea of 2 rabbits (both at 1
Full Text Available Introduction and objective. We wished to establish the prevalence of eye diseases and eye disease risk factors at postmenopausal age and to compare ophthalmic problems in urban and rural areas of Raciborz. Patients and methods. The study was performed in 2010. Out of the whole population of Raciborz, Poland, 10 percent (1750 of women were randomly selected for the reported study. Finally, ocular diseases, ophthalmic agents, health status (physical activity level, body mass index – BMI, reproductive history, the use of psychotropic drugs and hormone replacement therapy – HRT were recorded in 623 women. The women underwent visual acuity test and anterior segment examination, applanation tonometry and indirect ophthalmoscopy. Results. The mean age of the selected patients was 66.01±7.76 years, 275 (44% of them originating from rural and 348 (56% from urban regions. The average woman was obese (BMI=30.54±5.38 kg/m2, with near normal agility and reproductive history of 2.59±1.55 births, 147 (24% subjects remained under regular HRT support. According to the WHO, the visual acuity was classified as normal or near normal in 87.5%, while no blindness was recorded at all. Visual acuity depended, first of all, on lens status and was better among subjects with good agility (R=-0.31, p=0.001. Dry eye prevalence increased significantly over age of 67 years (p=0.000 and HRT seemed to be a dry eye protective factor (p=0.010. Except age, No other risk factors of cataract, other than age, were identified. Normal agility (p=0.003 and HRT (p=0.032 were associated with lower AMD (age-related macular degeneration prevalence rates. The differences between urban and rural participants were presented only in education, reproductive history, hypertension and frequency of ophthalmic examinations. Conclusions. Older adult women living in neighboring urban and rural areas present no differential in ophthalmic health problems.
O. Matthew Oriowo
Full Text Available Purpose: To investigate the relative cytotoxic effects of contact lens multipurpose solutions on cultured crystalline lenses.Methods: A comparison of the fluorescence emission levels of cultured bovine lenses as affected by three hour experimental exposure to three contact lens multipurpose solutions (COMPLETE Moisture Plus, AMO; OPTI-FREE Express, Alcon; and ReNu MultiPlus, Bausch & Lomb was carried out. The pre- and post-exposure fluorescence levels of the lenses were obtained and values were compared to baseline and control measurements.Results: The solutions yielded varying degrees of cytotoxicity, demonstrating significant (p < 0.01 reversible reduction of cellular viability levels of the cultured crystalline lenses as revealed by the degree of fluorescence emissions in the following order (OPTI-FREE Express > ReNu MultiPlus > COMPLETE MoisturePlus multi-purpose solutionsConclusions: The results show that OPTI-FREE Express and ReNu MultiPlus solutions exhibited more cytotoxic effect compared to COMPLETE MoisturePlus solution. The findings support reportsfrom previous clinical and laboratory studies. These results suggest that the in vitro approach herein presented would be a valuable system for relatively inexpensive and repeatable laboratory investigations of the possible ocular surface reactions of ophthal-mic solutions, cosmetics and pharmaceuticals at pre- and during commercial phases.
Hermida-López, Marcelino; Brualla, Lorenzo
To assess the influence of the (106) Rh gamma spectrum on the Monte Carlo simulation of (106) Ru/(106) Rh ophthalmic plaques, which has been neglected without a quantitative estimation in all previous publications. Simulations were run with the penelope 2014 Monte Carlo code for radiation transport. Depth-dose distributions in water were simulated for the plaque models CCA, CCC, CCX and CIA. In addition to the (106) Rh beta spectrum, all gamma components from the (106) Rh gamma spectrum were included in the simulations. Depth-dose curves were compared with those obtained without considering the (106) Rh gamma spectrum. Moreover, half-value (HVL) and tenth-value layers (TVL) were estimated for the (106) Rh gamma spectrum in water, PMMA, stainless steel and lead. Some practical radiation protection applications were discussed. Parallel computing was implemented to reduce computing time. The contribution of the (106) Rh gamma spectrum on the depth-dose curves is negligible at depths of clinical interest. The HVL and TVL of the (106) Rh gamma spectrum were found to be similar to those of (137) Cs. The air-kerma rate at 1 m for a CCA plaque in typical clinical conditions was about 0.4μGym2h-1, resulting in equivalent doses at that point elow 0.05 mSv during a treatment. The air-kerma rate would be underestimated by a factor of 5 if the (106) Rh gamma spectrum were not considered. Also, a freely available software tool was developed to ease parallelization of penelope 2014 simulations that use penmain as steering main program. The influence of the (106) Rh gamma spectrum is not relevant for clinical purposes, thus validating the common assumption from the literature. However, for simulations at large distances from the plaques, such as for radiation shielding assessment and estimation of dose to personnel, the gamma spectrum from (106) Rh must be taken into account to obtain accurate results. © 2017 American Association of Physicists in Medicine.
Mohammad Ghasem Hanafi
Full Text Available Diabetic retinopathy is the most common eye complication in diabetic patients that early detection of this complication is essential. The aim of this study was to evaluate ophthalmic artery index in diabetic retinopathy by Doppler ultrasound. . In this cross-sectional study, 64 patients were studied in 4 groups (healthy, diabetic without retinopathy, background retinopathy and proliferative retinopathy. Resistance index (RI and Pulsatile Index (PI were assessed by color Doppler ultrasound. The obtained data were analyzed by ANOVA and chi-square test and ROC curve. RI in diabetic patients with proliferative retinopathy has the highest mean (0.83 and the lowest mean was observed in healthy subjects (0.54 (P <0.001 as well as in PI, the highest rate was in diabetic patients with proliferative retinopathy (1.41 and the lowest was in healthy subjects (0.92 (P <0.001. The results of our study showed that the sensitivity, specificity, positive and negative predictive values and overall accuracy of RI and PI in diabetic patients with proliferative retinopathy in the best cut-off points (0.645 and 1.0175 respectively were 100%.Ophthalmic artery index RI and PI was significantly increased in patients with diabetic retinopathy and the sensitivity and specificity for detection retinopathy was 100%. Color Doppler ultrasound method is more efficient for screening diabetic patients with retinopathy.
Siatkowski, R Michael; Cotter, Susan A; Crockett, R S; Miller, Joseph M; Novack, Gary D; Zadnik, Karla
To evaluate if the safety and efficacy of the relatively selective M1-antagonist, pirenzepine, in slowing the progression of myopia in children is sustained over a 2-year period. This was a multicenter, parallel-group, placebo-controlled, double-masked, randomized clinical trial. Enrolled were children aged 8 to 12 years, with entry spherical equivalent refractive error of -0.75 to -4.00 D and astigmatism pirenzepine ophthalmic gel or a placebo control (vehicle), twice daily to each eye. The main outcome measure was spherical equivalent refractive error via cycloplegic autorefraction. At study entry, spherical equivalent was -2.10 +/- 0.90 D (mean +/- SD) for the pirenzepine group (n = 117) and -1.93 +/- 0.83 D for the placebo group (n = 57; p = 0.22). At 1 year, there was a mean increase in myopia of 0.26 D in the pirenzepine group versus 0.53 D in the placebo group (p pirenzepine = 53, placebo = 31). At 2 years, the mean increase in myopia was 0.58 D for the pirenzepine group and 0.99 D for the placebo group (p = 0.008). Thirteen (11%) pirenzepine patients dropped out due to adverse effects in the first year, and 1 did so in the second year. Pirenzepine ophthalmic gel 2% was effective compared with placebo in slowing the progression of myopia over a 2-year treatment period and demonstrated a clinically acceptable safety profile.
Soussan, J. Ben; Sadik, J.C.; Savatovsky, J.; Heran, F.; Lecler, A. [Fondation Ophtalmologique Adolphe de Rothschild, Department of Radiology, Paris (France); Deschamps, R. [Fondation Ophtalmologique Adolphe de Rothschild, Department of Neurology, Paris (France); Deschamps, L. [Bichat Hospital, APHP, Department of Pathology, Paris (France); Puttermann, M. [Necker-Enfants Malades Hospital, APHP, Department of Pathology, Paris (France); Zmuda, M.; Galatoire, O. [Fondation Ophtalmologique Adolphe de Rothschild, Department of Orbitopalpebral Surgery, Paris (France); Picard, H. [Fondation Ophtalmologique Adolphe de Rothschild, Clinical Research Unit, Paris (France)
To measure the frequency of infraorbital nerve enlargement (IONE) on magnetic resonance imaging (MRI) in European patients suffering from an IgG4-related ophthalmic disease (IgG4-ROD) as compared to patients suffering from non-IgG4-related ophthalmic disease (non-IgG4-ROD). From January 2006 through April 2015, 132 patients were admitted for non-lymphoma, non-thyroid-related orbital inflammation. Thirty-eight had both pre-therapeutic orbital MRI and histopathological IgG4 immunostaining. Fifteen patients were classified as cases of IgG4-ROD and 23 patients as cases of non-IgG4-ROD. Two readers performed blinded analyses of MRI images. The main criterion was the presence of an IONE, defined as the infraorbital nerve diameter being greater than the optic nerve diameter in the coronal section. IONE was present in 53% (8/15) of IgG4-ROD cases whereas it was never present (0/23) in cases of non-IgG4-ROD (P < 0.0001). IONE was only present in cases where, on MRI, the inflammation of the inferior quadrant was present and in direct contact with the ION canal. In European patients suffering from orbital inflammation, the presence of IONE on an MRI is a specific sign of IgG4-ROD. Recognition of this pattern may facilitate the accurate diagnosis for clinicians and allow for the adequate management and appropriate care of their patients. (orig.)
•There is the strong epidemiologic evidence of gender-specific difference for the incidence of the same ophthalmic disorder recently. Physiologic, behavioral, environmental and hereditary factors may contribute to these differences, but its pathogenesis is still unclear. This paper gives a brief review of research progress on epidemiologic feature and mechanism of the common ophthalmic disorders, including cataract, glaucoma, neuro-ophthalmologic disorders, and hereditary ocular disorders.%近年来，流行病学资料显示人群中同一眼病的发病率存在着显著的性别差异，可能与男女本身的生理结构、行为习惯、环境、遗传等因素有关，但具体机制尚不清楚，仍需进一步研究。本文就白内障、青光眼、神经性眼病、遗传性眼病等眼科常见病的流行病学特征及可能原因的研究进展作一综述。
Full Text Available Lina Zhu,1 Junping Ao,2 Peiling Li11Department of Ophthalmology, 2State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of ChinaAbstract: In this study, an ion-activated ketotifen ophthalmic delivery system was developed by using a natural polysaccharide, deacetylase gellan gum. Its rheological characteristics, stability, in vitro gelation, release in vitro, and pharmacodynamic activity in vivo were investigated. The formulation had an optimum viscosity that will allow easy drop as a liquid, which then underwent a rapid sol–gel transition due to ionic interaction. There were negligible alterations in the initial values of viscosity of the formulations over a storage period of 180 days. The in vitro release profiles indicated that the release of ketotifen from in situ gels exhibited a sustained feature. Scintigraphic studies indicated that deacetylase gellan gum could increase the residence time of the formulation. At the same dose, in situ gels demonstrated a typical sustained and prolonged drug-effects behavior compared with the common drops.Keywords: ophthalmic delivery, deacetylase gellan gum, sol–gel transition, scintigraphic studies, pharmacodynamic
Full Text Available The purpose of this study was to describe the normal ocular anatomy and establish reference values for ophthalmic tests in the Barbary sheep or aoudad (Ammotragus lervia. Aoudad eyes are large and laterally positioned in the head with several specialized anatomic features attributed to evolutionary adaptations for grazing. Normal values for commonly used ophthalmic tests were established, Schirmer tear test (STT - 27.22 ± 3.6 mm/min; Predominant ocular surface bacterial microbiota - Staphylococcus sp.; Corneal esthesiometry- 1.3 ± 0.4 cm; Intraocular pressure by rebound tonometry- 19.47 ± 3.9 mmHg; Corneal thickness- 630.07 ± 20.67 μm, B-mode ultrasonography of the globe- axial eye globe length 29.94 ± 0.96 mm, anterior chamber depth 5.03 ± 0.17 mm, lens thickness 9.4 ± 0.33 mm, vitreous chamber depth 14.1 ± 0.53 mm; Corneal diameter- horizontal corneal diameter 25.05 ± 2.18 mm, vertical corneal diameter 17.95 ± 1.68 mm; Horizontal palpebral fissure length- 34.8 ± 3.12 mm. Knowledge of these normal anatomic variations, biometric findings and normal parameters for ocular diagnostic tests may assist veterinary ophthalmologists in the diagnosis of ocular diseases in this and other similar species.
Fornazari, G A; Montiani-Ferreira, F; Filho, I R de Barros; Somma, A T; Moore, B
The purpose of this study was to describe the normal ocular anatomy and establish reference values for ophthalmic tests in the Barbary sheep or aoudad (Ammotragus lervia). Aoudad eyes are large and laterally positioned in the head with several specialized anatomic features attributed to evolutionary adaptations for grazing. Normal values for commonly used ophthalmic tests were established, Schirmer tear test (STT) - 27.22 ± 3.6 mm/min; Predominant ocular surface bacterial microbiota - Staphylococcus sp.; Corneal esthesiometry- 1.3 ± 0.4 cm; Intraocular pressure by rebound tonometry- 19.47 ± 3.9 mmHg; Corneal thickness- 630.07 ± 20.67 µm, B-mode ultrasonography of the globe-axial eye globe length 29.94 ± 0.96 mm, anterior chamber depth 5.03 ± 0.17 mm, lens thickness 9.4 ± 0.33 mm, vitreous chamber depth 14.1 ± 0.53 mm; Corneal diameter-horizontal corneal diameter 25.05 ± 2.18 mm, vertical corneal diameter 17.95 ± 1.68 mm; Horizontal palpebral fissure length- 34.8 ± 3.12 mm. Knowledge of these normal anatomic variations, biometric findings and normal parameters for ocular diagnostic tests may assist veterinary ophthalmologists in the diagnosis of ocular diseases in this and other similar species.
Staff dose of hospitalization in the treatment of patients in ophthalmic brachytherapy with 125 I; Dosis al personal de hospitalizacion en el tratamiento de pacientes de braquiterapia oftalmica con I-125
Terron Leon, J. A.; Gomez Palacios, M.; Moreno Reyes, J. C.; Perales Molina, A.
The objective of this work, therefore, has been the evaluation of the dose levels which nursing staff can receive in care for ophthalmic brachytherapy patients treated with 125 I from measurements made on the same, evaluating, in an experimental way, job security following the PR rules laid down for these treatments. (Author)
Multiscale modelling approach combining a kinetic model of glutathione metabolism with PBPK models of paracetamol and the potential glutathione-depletion biomarkers ophthalmic acid and 5-oxoproline in humans and rats
Geenen, S.; Yates, J.W.T.; Kenna, J.G.; Bois, F.Y.; Wilson, I.D.; Westerhoff, H.V.
A key role of the antioxidant glutathione is detoxification of chemically reactive electrophilic drug metabolites within the liver. Therefore glutathione depletion can have severe toxic consequences. Ophthalmic acid and 5-oxoproline are metabolites involved in glutathione metabolism, which can be me
The additional yield of a periodic screening programme for open-angle glaucoma : a population-based comparison of incident glaucoma cases detected in regular ophthalmic care with cases detected during screening
Stoutenbeek, R.; de Voogd, S.; Wolfs, R. C. W.; Hofman, A.; de Jong, P. T. V. M.; Jansonius, N. M.
Aim: To study the additional yield of a periodic screening programme for open-angle glaucoma (OAG) by comparing, in a population-based setting, incident OAG (iOAG) cases detected in regular ophthalmic care with those detected during screening. Methods: Participants aged 55 and over from the populati
Delcourt, Cécile; Korobelnik, Jean-François; Buitendijk, Gabriëlle H S
The European Eye Epidemiology (E3) consortium is a recently formed consortium of 29 groups from 12 European countries. It already comprises 21 population-based studies and 20 other studies (case-control, cases only, randomized trials), providing ophthalmological data on approximately 170,000 Euro...
Atlan- tic Treaty Organization (NATO) nations and of other officially rec- ognized foreign military personnel at military installations within the...representatives of religious groups, celebrities, and enter- tainers; representatives of the United Service Organization( USO ), other social agencies, and...from DOD, or from one of the military depart- ments, to visit military commands overseas. b. Dependents of USO oversea area executives, club directors
... will check your vision ( visual acuity ) using a Snellen chart. You will be asked to read random ... as your eyes move down the chart. Some Snellen charts are actually video monitors showing letters or ...
management. .... In a child who has the eyes shut, topical anaesthesia and sedation may help, but a ... Photographs are valuable – current or previous. ey may allow additional information to the examination and can be forwarded for com-.
... is in a class of medications called topical beta blockers. Dorzolamide and timolol lowers pressure in the eye ... Be sure to mention any of the following: beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, ...
Abu-Amero, Khaled K.; Kondkar, Altaf A.; Chalam, Kakarla V.
Resveratrol, a naturally occurring plant polyphenol found in grapes, is the principal biologically active component in red wine. Clinical studies have shown that resveratrol due to its potent anti-oxidant and anti-inflammatory properties are cardio-protective, chemotherapeutic, neuroprotective, and display anti-aging effects. Oxidative stress and inflammation play a critical role in the initiation and progression of age-related ocular diseases (glaucoma, cataract, diabetic retinopathy and macular degeneration) that lead to progressive loss of vision and blindness. In vitro and in vivo (animal model) experimental studies performed so far have provided evidence for the biological effects of resveratrol on numerous pathways including oxidative stress, inflammation, mitochondrial dysfunction, apoptosis, pro-survival or angiogenesis that are implicated in the pathogenesis of these age-related ocular disorders. In this review, we provide a brief overview of current scientific literature on resveratrol, its plausible mechanism(s) of action, its potential use and current limitations as a nutritional therapeutic intervention in the eye and its related disorders. PMID:27058553
Khaled K. Abu-Amero
Full Text Available Resveratrol, a naturally occurring plant polyphenol found in grapes, is the principal biologically active component in red wine. Clinical studies have shown that resveratrol due to its potent anti-oxidant and anti-inflammatory properties are cardio-protective, chemotherapeutic, neuroprotective, and display anti-aging effects. Oxidative stress and inflammation play a critical role in the initiation and progression of age-related ocular diseases (glaucoma, cataract, diabetic retinopathy and macular degeneration that lead to progressive loss of vision and blindness. In vitro and in vivo (animal model experimental studies performed so far have provided evidence for the biological effects of resveratrol on numerous pathways including oxidative stress, inflammation, mitochondrial dysfunction, apoptosis, pro-survival or angiogenesis that are implicated in the pathogenesis of these age-related ocular disorders. In this review, we provide a brief overview of current scientific literature on resveratrol, its plausible mechanism(s of action, its potential use and current limitations as a nutritional therapeutic intervention in the eye and its related disorders.
Full Text Available Abstract Background This study set out to determine the incidence, socio-demographic, and clinical correlates of Traditional Eye Medicine (TEM use in a population of newly presenting ophthalmic outpatients attending a tertiary eye care centre in south-eastern Nigeria. Methods In a comparative cross-sectional survey at the eye clinic of the University of Nigeria Teaching Hospital (UNTH, Enugu, between August 2004 - July 2006, all newly presenting ophthalmic outpatients were recruited. Participants' socio-demographic and clinical data and profile of TEM use were obtained from history and examination of each participant and entered into a pretested questionnaire and proforma. Participants were subsequently categorized into TEM- users and non-users; intra-group analysis yielded proportions, frequencies, and percentages while chi-square test was used for inter-group comparisons at P = 0.01, df = 1. Results Of the 2,542 (males, 48.1%; females, 51.9% participants, 149 (5.9% (males, 45%; females, 55% used TEM for their current eye disease. The TEMs used were chemical substances (57.7%, plant products (37.7%, and animal products (4.7%. They were more often prescribed by non-traditional (66.4% than traditional (36.9% medicine practitioners. TEMs were used on account of vision loss (58.5%, ocular itching (25.4% and eye discharge (3.8%. Reported efficacy from previous users (67.1% and belief in potency (28.2% were the main reasons for using TEM. Civil servants (20.1%, farmers (17.7%, and traders (14.1% were the leading users of TEM. TEM use was significantly associated with younger age (p Conclusion The incidence of TEM use among new ophthalmic outpatients at UNTH is low. The reasons for TEM use are amenable to positive change through enhanced delivery of promotive, preventive, and curative public eye care services. This has implications for eye care planners and implementers. To reverse the trend, we suggest strengthening of eye care programmes, even
池成涛; 艾德梅; 张宝弟
With the development of economy, the improvement of people's living standard, people's health consciousness and rights protection consciousness is also more and more high, and nursing work of cardiovascular surgery has gotten the attention of people. This paper made a simple analysis on how to strengthen humanized management to ophthalmic nursing and its significance.%随着经济的发展,人民生活水平的提高,人们对于健康意识和维权意识也越来越高,心外科的护理工作得到了人们的关注.如何加强对眼科护理进行人性化的管理和对眼科护理人性化管理有什么意义,本文在这里针对这个问题进行简单的分析.
Zhu, Lina; Ao, Junping; Li, Peiling
In this study, an ion-activated ketotifen ophthalmic delivery system was developed by using a natural polysaccharide, deacetylase gellan gum. Its rheological characteristics, stability, in vitro gelation, release in vitro, and pharmacodynamic activity in vivo were investigated. The formulation had an optimum viscosity that will allow easy drop as a liquid, which then underwent a rapid sol-gel transition due to ionic interaction. There were negligible alterations in the initial values of viscosity of the formulations over a storage period of 180 days. The in vitro release profiles indicated that the release of ketotifen from in situ gels exhibited a sustained feature. Scintigraphic studies indicated that deacetylase gellan gum could increase the residence time of the formulation. At the same dose, in situ gels demonstrated a typical sustained and prolonged drug-effects behavior compared with the common drops.
Full Text Available BACKGROUND: Patients undergoing certain ophthalmic operation are more likely to experience serious postoperative pain. This study was carried out to evaluate the effects of pre-emptive vs. preventive analgesia with oral acetaminophen on postoperative pain in painful ophthalmic surgeries. METHODS: In a double blind clinical trial, 60 patients undergoing strabismus, retinal detachment or deep vitrectomy were randomized into three equal groups. The first group (G1 received oral acetaminophen one hour before induction of general anesthesia and placebo postoperatively. The second group received placebo before induction and acetaminophen after the operation (G2. The third group received placebo at both times (G3. Blood pressure, heart rate and occurrence of oculocardiac reflex (OCR were recorded during the operation. Pain score (VAS: visual analog scale, the time of the first analgesic use (in hours, and total analgesic requirement (acetaminophen: mg were determined until 24 hours postoperatively. Data was analyzed using ANOVA, Chi-2 and Kruskal-Wallis tests. RESULTS: The mean pain score was lower in G1 compared with G2 at 2 and 24 hours after the operation (2.1 ± 0.6 vs. 2.7 ± 0.4, P = 0.001 and 1.1 ± 0.3 vs. 1.5 ± 0.5, P = 0, respectively. The pain score at 2, 6 and 24 hours after the operation was greater in G3 compared with G1 (2.8 ± 0.3 vs. 2.1 ± 0.6, P = 0, 2.3 ± 0.7 vs. 1.7 ± 0.5, P = 0 and 1.6 ± 0.4 vs. 1.1 ± 0.3, P = 0.001, respectively. There was no significant difference among the three groups with respect to the intraoperative hemodynamic changes, occurrence of OCR, the
BACKGROUND: Patients undergoing certain ophthalmic operation are more likely to experience serious postoperative pain. This study was carried out to evaluate the effects of pre-emptive vs. preventive analgesia with oral acetaminophen on postoperative pain in painful ophthalmic surgeries.
METHODS: In a double blind clinical trial, 60 patients undergoing strabismus, retinal detachment or deep vitrectomy were randomized into three equal groups. The first group (G1 received oral acetaminophen one hour before induction of general anesthesia and placebo postoperatively. The second group received placebo before induction and acetaminophen after the operation (G2. The third group received placebo at both times (G3. Blood pressure, heart rate and occurrence of oculocardiac reflex (OCR were recorded during the operation. Pain score (VAS: visual analog scale, the time of the first analgesic use (in hours, and total analgesic requirement (acetaminophen: mg were determined until 24 hours postoperatively. Data was analyzed using ANOVA, Chi-2 and Kruskal-Wallis tests.
RESULTS: The mean pain score was lower in G1 compared with G2 at 2 and 24 hours after the operation (2.1 ± 0.6 vs. 2.7 ± 0.4, P = 0.001 and 1.1 ± 0.3 vs. 1.5 ± 0.5, P = 0, respectively. The pain score at 2, 6 and 24 hours after the operation was greater in G3 compared with G1 (2.8 ± 0.3 vs. 2.1 ± 0.6, P = 0, 2.3 ± 0.7 vs. 1.7 ± 0.5, P = 0 and 1.6 ± 0.4 vs. 1.1 ± 0.3, P = 0.001, respectively. There was no significant difference among the three groups with respect to the intraoperative hemodynamic changes, occurrence of OCR, the
Wei Sun; Sui-Fang Chen; Jing Li; Huan-Huan Zhao; Su-Zhen Xie; Xue-Lin Huang; Shu-Ke Luo
Background: To investigate the 1-time success rate of probing alone and nasolacrimal duct probing combined with nasolacrimal injection of levofloxacin ophthalmic gel on congenital nasolacrimal duct obstruction (CNLDO) in young children. Methods: A retrospective case series was performed on 494 cases (647 eyes) of 3–12 month-old children with CNLDO between July 2014 and July 2015. Material obtained from the lacrimal sac was cultured to isolate infectious agents. Susceptibility testing was done. Children from 3–12 months of age who were found to be sensitive to Levofloxacin (n=493 eyes) were separated into two groups: 3–6 months of age (276 eyes) and 7–12 months of age (217 eyes). Each of the groups were then randomized into group A (138 eyes of 3–6 months of age; 102 eyes of 7–12 months of age) and group B (138 eyes of 3–6 months of age; 115 eyes of 7–12 months of age). Children in group A underwent nasolacrimal duct probing alone; those in group B underwent nasolacrimal duct probing plus nasolacrimal duct injection of levofloxacin and the efficacy of probing was evaluated. Results: The average detection rate of pathogenic bacteria in dacryocystitis was 75.1%, andStaphylococcus aureuswas found to be the main pathogenic bacteria (42.59%, 106 cases). Among children from 7–12 months of age, the 1-time success rate of nasolacrimal duct probing alone was 88.24% and the 1-time success rate of probing combined with nasolacrimal duct injection of levolfoxacin ophthalmic gel was 96.52% (statistical signiifcance, P=0.02<0.05). Conclusions: Most pathogenic bacteria (96.81%) were sensitive to levofloxacin. Nasolacrimal duct probing combined with nasolacrimal duct injection of levolfoxacin may improve the success rate of probing in children older than 6 months of age.
Williams, Hayley; Jones, Stephen; Wood, Kelly; Scott, Robert A H; Eddleston, Michael; Thomas, Simon H L; Thompson, John Paul; Vale, J Allister
CONTEXT. Data on the ophthalmic and central nervous system (CNS) adverse effects of liquid detergent capsules (liquid laundry pods) are limited. OBJECTIVE. To ascertain the reported toxicity of liquid detergent capsules, particularly their ophthalmic and CNS adverse effects, in a large case series. METHODS. Between 1 May 2009 and 30 July 2012 the UK National Poisons Information Service collected prospectively 1509 telephone enquiries (involving 1486 exposures) relating to liquid detergent capsules. RESULTS. The majority of patients (95.6%) were children aged less than 5. Exposure to these products occurred mainly as a result of ingestion alone (n = 1215; 81.8%), with eye contact alone (n = 110; 7.4%), and skin contact alone (n = 20; 1.3%) being less common; multiple routes of exposure were involved in 141 (9.5%) cases. Following ocular exposure (n = 212), features suggesting conjunctivitis (n = 145; 68.4%) and corneal ulceration (n = 6; 2.8%) developed. The most common features reported following ingestion alone were nausea and vomiting (n = 721; 59.3%), followed by coughing (n = 53; 4.4%), drowsiness/CNS depression (n = 49; 42 of these were children were aged 2 years or less) and foaming at the mouth (n = 47; 3.9%). A rash occurred in 22 patients where ingestion was considered to be the route of exposure. Twenty patients were exposed via the dermal route alone and developed erythema (n = 9), rash (n = 6) and burn (n = 3). CONCLUSIONS. Ocular exposure to liquid detergent capsules may lead to conjunctivitis and corneal ulceration; detergent ingestion may result in central nervous system (CNS)depression. Greater consumer awareness is required to reduce injury from liquid detergent capsules, particularly that involving the eye.
Full Text Available Low Birth weight infants are at risk of many problems. Therefore their outcome must evaluate in different ages especially in school age. In this study we determined prevalence of ophthalmic, hearing, speaking and school readiness problems in children who were born low birth weight and compared them with normal birth weight children. In a cross-sectional and retrospective study, all Primary School children referred to special educational organization center for screening before entrance to school were elected in Mashhad, Iran. In this study 2400 children enrolled to study and were checked for ophthalmic, hearing, speaking and school readiness problems by valid instrument. Data were analyzed by SPSS 11.5. This study showed that 8.3% of our population had birth weight less than 2500 gram. Visual impairment in LBW (Low Birth Weight and NBW (Normal Birth Weight was 8.29% vs. 5.74% and there was statistically significant difference between them (P=0.015. Hearing problem in LBW and NBW was 2.1% vs. 1.3 and it was not statistically significant. Speaking problem in LBW and NBW was 2.6% vs. 2.2% and it was not statistically significant. School readiness problem in LBW and NBW was 12.4% vs. 5.8% and it was statistically significant (P<0.001. According to the results, neurological problems in our society is more than other society and pay attention to this problem is critical. We believe that in our country, it is necessary to provide a program to routinely evaluate LBW children.
Ahmed, Tarek Abdelnapy; Aljaeid, Bader M
Oral ketoconazole therapy is commonly associated with serious hepatotoxicity. Improving ocular drug delivery could be sufficient to treat eye fungal infections. The purpose of this study was to develop optimized ketoconazole poly(lactide-co-glycolide) nanoparticles (NPs) with subsequent loading into in situ gel (ISG) formulation for ophthalmic drug delivery. Three formulation factors were optimized for their effect on particle size (Y1) and entrapment efficiency (Y2) utilizing central composite experimental design. Interaction among components was studied using differential scanning calorimetry (DSC) and Fourier transform infrared (FTIR) spectroscopy. Ketoconazole crystalline state was studied using X-ray powder diffraction. Six different polymeric ISG formulations were prepared and loaded with either optimized NPs or a pure drug. The prepared ISG formulations were characterized for in vitro gelation, drug release and antifungal activity. The permeation through human epithelial cell line was also investigated. The results revealed that all the studied formulation parameters significantly affected Y1 and Y2 of the developed NPs. DSC and FTIR studies illustrated compatibility among NP components, while there was a change from the crystalline state to the amorphous state of the NPs. The in vitro release from the ISG formulations loaded with drug NPs showed sustained and enhanced drug release compared to pure drug formulations. In addition, ISG loaded with NPs showed enhanced anti-fungal activity compared to pure drug formulations. Alginate–chitosan ISG formulation loaded with optimized ketoconazole NPs illustrated higher drug permeation through epithelial cell lines and is considered as an effective ophthalmic drug delivery in the treatment of fungal eye infections. PMID:28331311
Li, Jianwei D.; Malone, Joseph D.; El-Haddad, Mohamed T.; Arquitola, Amber M.; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.
Surgical interventions for ocular diseases involve manipulations of semi-transparent structures in the eye, but limited visualization of these tissue layers remains a critical barrier to developing novel surgical techniques and improving clinical outcomes. We addressed limitations in image-guided ophthalmic microsurgery by using microscope-integrated multimodal intraoperative swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (iSS-SESLO-OCT). We previously demonstrated in vivo human ophthalmic imaging using SS-SESLO-OCT, which enabled simultaneous acquisition of en face SESLO images with every OCT cross-section. Here, we integrated our new 400 kHz iSS-SESLO-OCT, which used a buffered Axsun 1060 nm swept-source, with a surgical microscope and TrueVision stereoscopic viewing system to provide image-based feedback. In vivo human imaging performance was demonstrated on a healthy volunteer, and simulated surgical maneuvers were performed in ex vivo porcine eyes. Denselysampled static volumes and volumes subsampled at 10 volumes-per-second were used to visualize tissue deformations and surgical dynamics during corneal sweeps, compressions, and dissections, and retinal sweeps, compressions, and elevations. En face SESLO images enabled orientation and co-registration with the widefield surgical microscope view while OCT imaging enabled depth-resolved visualization of surgical instrument positions relative to anatomic structures-of-interest. TrueVision heads-up display allowed for side-by-side viewing of the surgical field with SESLO and OCT previews for real-time feedback, and we demonstrated novel integrated segmentation overlays for augmented-reality surgical guidance. Integration of these complementary imaging modalities may benefit surgical outcomes by enabling real-time intraoperative visualization of surgical plans, instrument positions, tissue deformations, and image-based surrogate biomarkers correlated with completion of
William C. Troy
Full Text Available We investigate solutions of and focus on the regime and . Our advance is to develop a technique to efficiently classify the behavior of solutions on , their maximal positive interval of existence. Our approach is to transform the nonautonomous equation into an autonomous ODE. This reduces the problem to analyzing the phase plane of the autonomous equation. We prove the existence of new families of solutions of the equation and describe their asymptotic behavior. In the subcritical case there is a well-known closed-form singular solution, , such that as and as . Our advance is to prove the existence of a family of solutions of the subcritical case which satisfies for infinitely many values . At the critical value there is a continuum of positive singular solutions, and a continuum of sign changing singular solutions. In the supercritical regime we prove the existence of a family of “super singular” sign changing singular solutions.
This Functional Design Criteria (FDC) addresses remediation of the plutonium-bearing solutions currently in inventory at the Plutonium Finishing Plant (PFP). The recommendation from the Environmental Impact Statement (EIS) is that the solutions be treated thermally and stabilized as a solid for long term storage. For solutions which are not discardable, the baseline plan is to utilize a denitration process to stabilize the solutions prior to packaging for storage.
Moskowitz, G W; Bowman, R L
A mixer made from a bundle of glass tubules can mix two solutions within 30 microseconds, with a total-solution flow rate of 1.33 milliliters per second. One solution passes through the interstices of the bundle; the other moves through the lumens of the tubes.
Li, Xin; Worm, Verner; Peihong, Xie
Organizations face all kinds of paradoxical problems. There exist various solutions to organizational paradoxes. We develop a typology that lists nine possible logical approaches to understanding the relationship between paradoxical opposites, out of which we identify five types of solutions...... to organizational paradox. Four of the five solutions are explicitly associated with four prominent philosophies. We show the relevance of the five solutions to the real world by applying our scheme to understand different solutions to the generic strategy paradox. Finally, we address the question whether...