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Biomedical subjects

I P Pollack

Publications and source records attributed to I P Pollack.

At least 55 records · Page 3Linked to original sources
PubMed1980

Blood dyscrasias in patients using methazolamide (neptazane) for glaucoma.

Carbonic anhydrase inhibitors used in the treatment of glaucoma are rarely associated with blood dyscrasias. Several case reports of aplastic anemia with use of acetazolamide, and two cases with use of methazolamide, have appeared in the literature. This report documents two cases of aplastic anemia, at least one of which was almost certainly induced by the use of methazolamide, one case of agranulocytosis, and two cases of neutropenia related to the use of methazolamide. In each case several weeks to months elapsed between initiation of therapy and onset of reaction. This suggests that changes in patients' general medical condition should be continually monitored when using these drugs.

Adolescent↗
PubMed1980

Use of argon laser energy to produce iridotomies.

Laser iridotomy with the c-w argon laser and the pulsed argon laser has been performed in some 300 eyes, 215 of which are included in the present investigation. Using techniques described in this study, a laser iridotomy was made successfully in 95% of cases. However, in a series of 77 consecutively treated eyes that were followed at regular intervals for up to four years, 34% required retreatment. In no case did an iridotomy close if it remained patent for 6 weeks. The optimum results were obtained using a contact lens and a 50-mu or 100-mu laser spot with energy levels of 0.5 to 2.0 w for 0.2 sec. Larger spots and higher powers, even when combined with shorter pulses, were either less effective or produced superficial corneal burns. The ease with which an iridotomy could be made was partly dependent on iris color and thickness, corneal tolerance and deturgescence. However, success will, in large measure, depend on the technician's proficiency and experience. A test of patency was the visibility of lens capsule through the iridotomy. Even so, a mistaken estimation of patency could result if there were posterior synechiae around the margin of the iridotomy or if one failed to recognize the presence of a barely-visible fibrous membrane bridging the hole. Complications that occurred with laser iridotomy included corneal epithelial and endothelial burns, lens opacity behind the iris defect, and retinal burn. The lens opacity was found to be caused by localized fragmentation of lens fibers and atrophy of the lens epithelium. Iris angiography performed 6 to 36 months after laser iridotomy in human eyes failed to reveal any disturbance in vascular permeability and the blood-aqueous barrier. Laser iridotomy was considered the procedure of choice in monocular patients and for treating the fellow eye in persons who suffered a complicated peripheral iridectomy by surgery in one eye. The laser played an important role, not only in treatment, but also in diagnosis of chronic angle-closure and combined-mechanism glaucoma.

Animals↗
PubMed1979

Aplastic anemia and agranulocytosis in patients using methazolamide for glaucoma.

Carbonic anhydrase inhibitors used in the treatment of glaucoma, seizure disorders, and hypertension are rarely associated with blood dyscrasias. Several case reports of aplastic anemia with use of acetazolamide, and two cases with use of methazolamide, have appeared in the literature. This article describes two cases of aplastic anemia, at least one of which was almost certainly induced by the use of methazolamide, and one case of agranulocytosis related to the use of methazolamide.

Aged↗
PubMed1979

An analysis of visual acuity, visual fields, and disk cupping in childhood glaucoma.

We analyzed the long-term functional results in 102 eyes of 59 patients with childhood glaucoma with specific reference to the pattern of optic nerve damage. Optic disk photography and quantitative perimetry were used to judge the degree of damage that had been sustained. There was a predilection for initial visual field damage in the arcuate area, followed by further arcuate and nasal field loss, similar to the pattern of visual field loss seen in adult glaucoma. In children, as in adults, neural tissue appeared to be lost preferentially at the vertical disk poles. The selective pattern of glaucomatous optic nerve damage seemed not to depend upon the age of the optic nerve structures. In contrast to adult eyes, the scleral canal in children apparently enlarges with high IOP. Thus, disk cup size increase in children could occur from neural tissue loss, from scleral canal enlargement, or from a combination of the two processes.

Adolescent↗
PubMed1978

Timolol. A new drug for management of chronic simple glaucoma.

Timolol maleate, a potent beta-adrenergic antagonist, reduces intraocular pressure in rabbits. With topical application in one eye, a significant reduction in pressure is seen in the contralateral, untreated eye also. When used in conjunction with timolol, other adrenergic amines, such as norepinephrine and epinephrine, produce an additional hypotensive response. On the other hand, pretreatment with timolol does inhibit the ocular hypotensive response to topically applied albuterol. No further reduction in pressure is seen after application of this beta-adrenergic agonist to eyes pretreated with timolol. In a double-blind study with patients who had previously been receiving various medications for control of elevated intraocular pressures, timolol was as effective as pilocarpine in reducing intraocular tension. Many common complaints associated with pilocarpine therapy, including miosis, ocular irritation, and blurred vision, were not encountered with timolol therapy.

Adult↗
PubMed1977

Intraocular pressure control with twice-daily pilocarpine in two vehicle solutions.

In a double-blind study no significant difference was found in intraocular pressure control, mean pressure or comparative binocular intraocular pressure difference between pilocarpine in Adsorbobase compared to pilocarpine in 0.5% hydroxypropl-methylcellulose solution. Intraocular pressure control was achieved on fewer than 60% of visits using pilocarpine twice daily in either of the 2 vehicles. While pilocarpine retained some residual hypotensive effect 12 hours after application, twice-daily dosage with the solutions tested gave inadequate control for clinical usefulness.

Adult↗
PubMed1976

The Ocusert pilocarpine system: advantages and disadvantages.

Thirty-four patients with glaucoma were treated with the Ocusert pilocarpine system, a unique method of providing round-the-clock delivery of pilocarpine in the eye for seven-day periods. Advantages of the device include therapeutic effectiveness and continuous release rate, less effect on accommodation, less miosis, convenience for the patient, and reliability in patients who must rely on others for treatment (eg, children and the elderly). Some disadvantages encountered were need for instruction and encouragement of patients; retention difficulties, with some patients unaware when the device was lost; occasional side effects of a cutting sensation (as when the Ocusert sometimes doubles over), movement in the eye, and transient blurring of vision and miosis; and high cost. Overall, when compared to pilocarpine eyedrops, the Ocusert pilocarpine system presents many definite advantages and is a highly desirable method of therapy in selected cases of glaucoma.

Drug Evaluation↗
PubMed1976

Argon laser iridotomy: an experimental and clinical study.

Iridotomies were made in rabbit and human eyes using a continuous wave argon laser. Several of these have been studied histologically to determine the short- and long-term effects on the iris, cornea, lens and retina. Thirty-three eyes of patients with angle-closure glaucoma were treated by argon laser iridotomy and followed for periods of up to twelve months. In two eyes, planned cataract surgery was performed shortly after the laser iridotomy and histologic specimens of the iris were examined. From the experimental and clinical studies, an evaluation was made of the complications and clinical usefulness of the continuous wave argon laser as a means to produce iridotomies for the treatment of angle-closure glaucoma. Further long-term controlled studies are recommended to document the role of laser iridotomy.

Animals↗
PubMed1975

Norepinephrine in treatment of ocular hypertension and glaucoma.

Norepinephrine (4%) as free base produced a significant fall in intraocular pressure and resistance to outflow. This effect was sustained for up to 20 weeks. No significant difference could be shown between the effect of 2%, 3%, and 4% norepinephrine on the aquious humor dynamics. The effect on pressure and facility was shown in eyes with ocular hypertension and with glaucoma. An additive effect was observed after use of norepinephrine with pilocarpine in the treatment of glaucoma. Crossover studies between epinephrine borate 1% and norepinephrine borate 4% revealed no significant difference. Like epinephrine, norepinephrine produces a conjunctival hyperemia in many patients. However, there is an absence of tachycardia after use of norepinephrine, and one person in this study showed an allergic reaction to epinephrine that cleared promptly and completely when norepinephrine was substituted.

Aged↗
PubMed1975

Pilocarpine ocuserts. Long-term clinical trials and selected pharmacodynamics.

For up to one year, 22 patients with occular hypertension or glaucoma wore a seven-day sustained release device (Ocusert) containing pilocarpine with acceptable retention and no important side-effects. Comparison of prestudy medical regimens using eye drops with those defined as minimum controlling concentrations indicated a high rate of over-medication. The hypotensive effect of two Ocusert strengths was compared to four pilocarpine drop concentrations. Concurrent administration of epinephrine drops did not interfere with Ocusert action and had the anticipated additive effect. Further study indicated the need for continuous wearing and delimited the effective duration of action for single Ocuserts to seven days.

Aged↗
PubMed1975

Glaucoma in episcleritis.

Two patients had episcleritis and a secondary open angle glaucoma. Anterior uveitis was absent in three of the four eyes. The low facility of outflow suggests that increased episcleral venous pressure was not the mechanism of the glaucoma. The response of the intraocular pressure and, in one case, the outflow facility to steroid therapy suggests that inflammation of angle structures was the pathogenesis of the raised intraocular pressure.

Arthritis, Rheumatoid↗