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Biomedical subjects

A Mermoud

Publications and source records attributed to A Mermoud.

98 records · Page 6Linked to original sources
PubMed1990

Double-blind study in the treatment of normal tension glaucoma with naftidrofuryl.

Naftidrofuryl is an antiserotonin S2-specific agent, with the three following effects: (1) peripheral vasodilatation, (2) antiaggregation and (3) increase in cellular metabolic. These effects could be interesting in the management of the optic nerve ischemia of glaucomatous patients and especially of those with normal tension glaucoma. The administration of 2 x 200 mg/day of naftidrofuryl during 6 weeks to 12 patients with normal tension glaucoma has shown an improvement of the visual acuity and the visual field compared with a 6-week period of placebo administration, with a double-blind study method. It suggested that naftidrofuryl might be administered as a useful complement to conventional hypotensive therapy, since it acts positively on the glaucomatous optic nerve damage.

Adult↗
PubMedDate not supplied

Deep sclerectomy: results with and without collagen implant.

PURPOSE: To study the need, the safety and the success rate of collagen implant in eyes that underwent deep sclerectomy, a new non penetrating filtration procedure, we compared the results of deep sclerectomy with (DSCI) and without (DS) collagen implant. METHODS: Of 168 patients (168 eyes) with various types of medically uncontrolled open angle glaucoma, 86 (86 eyes) underwent DSCI, and 82 (82 eyes) underwent DS. Visual acuity, slit lamp examination, intraocular pressure (IOP) measurements were performed before surgery and prospectively at days 1 and 7 and months, 1, 2, 3, 6, 9, 12, 15, 18, and 24 after surgery. Deep sclerectomy was performed according to Kozlov's original technique. The collagen implant drainage device was radially secured in the center of the deep sclerectomy dissection. RESULTS: The mean follow-up period was 9.7 +/- 6.5 months for DSCI, and 9.0 +/- 4.8 months for DS. The mean preoperative IOP was 26.9 +/- 8.8 mmHg for DSCI and 25.8 +/- 8.5 mmHg for DS. The mean postoperative IOP and visual acuity were similar between the two groups. Complete and qualified success rates were better when the collagen implant was used (Log-Rank test: p = 0.0002 and 0.033 for complete and qualified success respectively). The need for postoperative glaucoma medications was significantly lower when the collagen implant was used (0.2 +/- 0.5 versus 0.5 +/- 0.7 medication per patient in the DSCI and DS respectively, Student's t test: p = 0.0038). There was significantly less bleb fibrosis when the collagen implant was used (2% and 11% in DSCI and DS respectively, p = 0.029). CONCLUSION: The collagen implant device is safe, increases the success rate of deep sclerectomy, and lowers the need for postoperative glaucoma medications.

Aged↗
PubMedDate not supplied

Glaucoma associated with uveitis.

Raised intraocular pressure is a common and frequently serious complication of anterior uveitis. The milieu of inflammatory cells, the mediators they release, and the corticosteroid therapy used to treat the uveitis can participate in the pathogenesis of uveitic glaucoma. These factors alter the normal anatomic structure of the anterior chamber and angle, influencing aqueous production and outflow. These changes act to disrupt the homeostatic mechanisms of intraocular pressure control. Structural changes in the angle can be acute, such as in secondary angle closure with pupillary block glaucoma, or chronic, such as combined steroid-induced and secondary open angle glaucoma. Management of uveitic glaucoma may be difficult because of the numerous mechanisms involved in its pathogenesis. Diagnostic and therapeutic decisions are guided by careful delineation of the pathophysiology of each individual case. The goal of treatment is to minimize permanent structural alteration of aqueous outflow and to prevent damage to the optic nerve head. This article reviews the pathogenesis of uveitic glaucoma, with specific attention to etiology. Medical and surgical therapies are also discussed, with emphasis on the more recent developments in each category.

Glaucoma↗
PubMedDate not supplied

Aqueous dynamics in experimental ab externo trabeculectomy.

PURPOSE: This study assessed the decrease in intraocular pressure (IOP), the residual outflow resistance of the trabeculum and the filtration site by histology in enucleated pig and human eyes after ab externo trabeculectomy. METHOD: Measurement of the resistance to aqueous outflow was performed using the constant pressure method before and after ab externo trabeculectomy. RESULTS: The outflow facility was 0.31 +/- 0.13 microl/min/mm Hg in pig eyes and 0.24 +/- 0.08 microl/min/mm Hg in human eyes before surgery, and 79.0 +/- 47. 6 microl/min/mm Hg in pig eyes and 6.33 +/- 6.67 microl/min/mm Hg in human eyes after ab externo trabeculectomy. On histological examinations the aqueous outflow pathway was seen to be at the level of the residual trabecular meshwork. CONCLUSION: This study showed that ab externo trabeculectomy significantly lowers IOP and improves outflow facility in enucleated pig and human eyes.

Animals↗
PubMedDate not supplied

Multicenter evaluation of tendency-oriented perimetry (TOP) using the G1 grid.

PURPOSE: The G1-TOP program is a short automated perimetric strategy which sub-divides the G1 grid of 59 points into four sub-grids. Each point is tested only once, but each patient's response is used to modify that particular point and the surrounding ones from the remaining sub-grids. This study compared the results of the G1-TOP program with the Standard Bracketing strategy. METHODS: Eleven participating institutions provided data from 213 patients (406 eyes). The main group consisted of 284 glaucomas and 55 glaucoma suspects. Other groups included 31 eyes with neurological disorders, 20 with chorioretinal lesions and 16 normal eyes. Mean age was 62.7 +/- 15.4 (range 14-88) years. All subjects had previous perimetric experience and visual acuity better than 0.5. Examination included G1-Standard Bracketing and G1-TOP testing, in interchangeable order, with the Octopus 1-2-3 perimeter. RESULTS: The correlation coefficient for mean defect (MD) was 0.95. Standard error (YX) for MD, square root of loss variance (LV) and individual thresholds were 1.86 dB, 1.29 dB, and 4.72 dB, respectively. Mean sensitivity values were similar (difference 0.04 +/- 1.87 dB) (p>0.05). Mean duration for G1-TOP was 2.19 +/- 0.26 min, while G1-Standard Bracketing took 11.51 +/- 1.52 min (ratio 1/5.1, or a net reduction of 80.4%). The sensitivity of G1-TOP versus G1-Standard Bracketing was: glaucoma 77.1/78.5, glaucoma suspects 38.2/47.3, neurological disorders 87.1/87.1 and chorioretinal lesions 80.0/85.0. CONCLUSIONS: The G1-TOP program gave very similar results to G1-Standard Bracketing in only 20% of the time required by the standard strategy.

Adolescent↗
PubMedDate not supplied

Retinal nerve fiber layer measured by Heidelberg retina tomograph and nerve fiber analyzer.

PURPOSE: To compare retinal nerve fiber layer (RNFL) thickness measured by Heidelberg retina tomograph (HRT) and nerve fiber analyzer (GDx). METHODS: Twenty eyes of 20 consecutive healthy subjects were recruited for this study. Each subject had a normal visual field and a normal optic nerve head, which was assessed by slit-lamp biomicroscopy using a 90 degrees lens. Using the HRT and GDx, RNFL measurement was calculated as for software vs 2.01 and vs 1.0.14, respectively. Retinal nerve fiber layer thickness was evaluated for the entire annulus surface every 5 degrees degrees. RNFL was assessed by HRT and GDx. HRT RNFL measurement was calculated at 0 microm from the edge, while GDx RNFL measurement at 1.75 disc diameter as for software. The difference between the highest points and the deepest points was calculated and compared. Furthermore, because of the possibility of different scales in the two systems, the following ratio was calculated: superior/inferior, superior/temporal, superior/nasal, inferior/temporal, and inferior/nasal. RESULTS: When the entire RNFL thickness was considered, a significant (p<0.001) difference was found between the HRT and GDx measurements. A difference of 200 microm was found between the highest and the deepest HRT points while a difference of 40 microm was found between the highest and the deepest GDx points. CONCLUSIONS: HRT and GDx RNFL measurements were statistically different in each sector. However, ratio parameters showed no difference between the obtained values except for superior/temporal ratio and inferior/temporal ratio.

Aged↗
PubMedDate not supplied

Trabeculectomy with mitomycin C in glaucoma associated with uveitis.

Twenty-four trabeculectomies performed in 24 patients for control of uveitic glaucoma were retrospectively evaluated to analyze the effect of intraoperative application of mitomycin C (MMC) on the short-term outcome of trabeculectomy for glaucoma associated with uveitis. Success rates, postoperative levels of intraocular pressure (IOP), and complications were studied. After a mean follow up of 9.87 months (range, 3 to 27 months), 18 eyes (75%) achieved an IOP of 21 mm Hg or less without antiglaucoma medications. The same IOP level with one antiglaucoma medication was achieved in four eyes (16.6%). Statistical analysis demonstrated a significant reduction in IOP postoperatively during the period studied (P = .0001). Complications observed included exacerbation of the uveitis (12.5%), choroidal detachment (12.5%), hypotony (8.3%), postoperative shallow anterior chamber (4.2%), wound leak (4.2%), hyphema (4.2%), and macular edema (4.2%). The results of this retrospective and uncontrolled study suggest that intraoperative application of MMC may be a good option for enhancement of short-term trabeculectomy success rates in cases of uveitic glaucoma.

Adolescent↗