Biomedical subjects
T J Zimmerman
Publications and source records attributed to T J Zimmerman.
Timolol plus maximum-tolerated antiglaucoma therapy.
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Timolol maleate: efficacy and safety.
A randomized, double-masked trial of various concentrations of timolol maleate ophthalmic solution (0.1%, 0.25%, 0.5%, and 1.0%) vs placebo demonstrated that all concentrations of timolol effectively lowered intraocular pressure (IOP). A 0.5% solution of timolol was as effective in reducing IOP as the 1.0% concentration. Blood pressure, visual acuity, and pupillary diameter were not altered significantly by any concentration of timolol tested during this study. There was a dose-dependent decrease in resting pulse rate with increasing concentrations of timolol. No objective signs of drug intolerance were found on external ocular examination, nor were any subjective symptoms elicited on questioning the subjects. Timolol applied topically twice daily in concentrations of 0.1% to 0.5% appeared to be an effective and safe ocular hypotensive agent.
Apneic spells associated with timolol therapy in a neonate.
A 2-week-old premature child with congenital glaucoma secondary to anterior cleavage syndrome was treated with timolol maleate and cyclocryotherapy. The patient had apneic spells of up to 30 seconds that stopped soon after timolol maleate therapy was discontinued. No apnea was seen before timolol maleate administration, and no further spells were noted after subsequent cyclocryotherapy without timolol maleate treatment. Possible central nervous system toxicity of timol maleate or its metabolic by-products in neonates with immature blood-brain barriers was noted.
Timolol--further observations.
Data from clinical records of patients using timolol confirm the ocular hypotensive effect of the drug in secondary glaucoma, aphakic glaucoma, ocular hypertension, and when used in combination with various other forms of glaucoma therapy. No serious local or systemic side effects were noted. Although many adrenergic agents ultimately produce tachyphylaxis, this effect is infrequent in timolol therapy.
Nickel deprivation in rats: nickel-iron interactions.
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Size of donor corneal button and outflow facility in aphakic eyes.
Outflow facility was measured in 6 human eye bank eyes following penetrating keratoplasty and cataract extraction. A 7.5 mm corneal button was removed and replaced by an 8 mm button using conventional mid-to-deep stromal sutures. Baseline outflow facility in the phakic eyes (0.28 +/- 0.12 microliter/min/mm Hg, mean +/- SD) was unchanged (0.29 +/- 0.12) following the cataract extraction and penetrating keratoplasty using the larger corneal button.
Intraocular pressure after aphakic penetrating keratoplasty "through-and-through" suturing.
Our clinical study was designed to determine whether "through-and-through" corneal sutures would prevent the postoperative intraocular pressure rise that occurs in 70% of aphakic eyes after uncomplicated penetrating keratoplasty. Twenty-five aphakic patients received the same operative procedure except that the corneal buttons of ten of them were sutured into place with "through-and-through" sutures. The intraocular pressures of patients with the "through-and-through" sutures were significantly lower than those of the other patients during the entire postoperative course.
Effects of timolol and Daranide on elevated intraocular pressure after aphakic keratoplasty.
In a randomized, blind clinical study, we tested the effect of timolol and Daranide against placebo medications among patients who had intraocular pressures greater than 30 mm Hg on the first postoperative day after aphakic keratoplasty. The study failed to show any significant difference in the pressure course. We concluded that because this type of severe secondary glaucoma is extremely difficult to treat, it should be prevented by using a donor cornea larger in size than the recipient bed.
The effect of suture depth on outflow facility in penetrating keratoplasty.
Outflow facility was measured in human eye bank eyes following penetrating keratoplasty (PKP) and cataract extraction. After measuring baseline outflow facility, a PKP and lens extraction was performed with the corneal button replaced by both interrupted "through-and-through" sutures and a conventional mid-to-deep stromal running suture. Outflow facility was unchanged from baseline with both sutures. However, following removal of through-and-through sutures outflow facility decreased 37%. This same suturing procedure was repeated in a second group of phakic eyes in which suture depth did not influence outflow facility.
Intraocular pressure and glaucoma in the Zuni indians.
A glaucoma-screening examination was performed on 119 full-blooded Zuni Indians and 286 control subjects who were aged 40 years or older. The mean intraocular pressure (IOP) of the Zuni Indians was significantly lower than that of the control group, adjusted for age and sex differences, in both diabetic and nondiabetic subjects. The control group demonstrated an increasing IOP with age, while the Zunis did not. The prevalence of ocular hypertension was significantly greater in the control group than in the Zunis. The majority of the Zuni subjects with ocular hypertension had diabetes mellitus. None of the Zuni Indians who were screened had primary open-angle glaucoma and none had a family history of glaucoma.
A fluorophotometric study of the effect of topical timolol on aqueous humor dynamics.
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Intake of nickel and vanadium by humans. A survey of selected diets.
The nickel and vanadium contents of nine institutional diets were determined by atomic absorption spectrometry with background correction. The following values were obtained for nickel: mean concentration, 0.27 +/- 0.02 microgram/g (dry weight); range, 0.19 and 0.41 microgram/g; mean intake, 165 +/- 11 microgram/day or 75 +/- 10 microgram/1000 cal. The respective values for vanadium were: 0.032 +/- 0.004 microgram/g (dry weight); 0.019 to 0.050 microgram/g; 20.4 +/- 2.3 microgram/day or 8.9 +/- 1.0 microgram/1000 cal. Thus, vanadium is present at approximately one order of magnitude less than nickel.
What's new for the medical therapy of glaucoma?
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Glaucoma report. Elevated intraocular pressure after aphakic keratoplasty: iatrogenic disease and prevention.
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On presentation of the Proctor Medal of the Association for Research in Vision and Ophthalmology to Dr. Herbert E. Kaufman.
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Timolol. A beta-adrenergic blocking agent for the treatment of glaucoma.
Timolol maleate, a beta-adrenergic blocking agent, was studied in 30 patients with glaucoma. Significant intraocular pressure lowering was achieved with 0.5% and 1.5% solution of the drug. At seven hours following treatment, the IOP was lowered 50% from the pretreatment pressure with both strengths of timolol. There were no subjective or objective ocular or systemic side effects detected. Visual acuity and pupil response were unchanged from pretreatment levels throughout the study. beta-Adrenergic blocking agents and specifically timolol may be an important breakthrough for the medical management of glaucoma.
Timolol, dose response and duration of action.
Timolol maleate, a beta-adrenergic blocking agent, was used in a study of 20 adult patients with chronic open-angle glaucoma. This single-dose study demonstrated a dose response for this drug using concentrations of 0.1%, 0.25%, 0.5%, and 1.0%. Timolol, 0.5%, appears to give the maximal ocular hypotensive effect; however, each concentration of the drug produced an ocular hypotensive effect for at least 24 hours. No local or systemic side effects were discovered throughout the study. Timolol may be an effective, innocuous, once-a-day, topical agent for the treatment of glaucoma.