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At least 379 records · Page 21Linked to original sources
PubMed1986

Combined intracapsular cataract extraction and trabeculectomy with Severin five-loop posterior chamber intraocular lens.

The efficacy and safety of a combined operation for cataract and glaucoma is established. This procedure of combined cataract extraction and trabeculectomy is taken one step further by the simultaneous insertion of the Severin intraocular posterior chamber lens implant. The results of treating 24 eyes in terms of control of glaucoma are discussed. Postoperative miotics may be required to improve stability of the implant, especially after delivery of the lens through a pupil rendered tight by long term preoperative miotic administration.

Aged↗
PubMed1998

Pharmacological evaluation of a new timolol/pilocarpine formulation.

A new formulation (HYA) based on timolol hyaluronate and pilocarpine hyaluronate salts has been shown to improve the bioavailability of the drugs and to extend the duration of their action. Extent of the intraocular pressure lowering effect, duration of action and aqueous bioavailability of timolol and pilocarpine of HYA were compared with a commercial preparation. Ocular hypertension in the rabbit was induced by alpha-chymotrypsin or by water loading. The hypotensive effect of HYA treatment was significantly greater and longer than that observed in rabbit eyes treated with the commercial preparation both in the normotensive and in the hypertensive animals. Furthermore, we evaluated the miotic response; due to pilocarpine, normotensive rabbits showed a greater miotic response and an extended duration when the eyes were treated with HYA. The new formulation increased the aqueous availability of timolol and pilocarpine compared to the commercial preparation as determined by HPLC. The pharmacodynamic and pharmacokinetic profiles of HYA indicate an increase in efficacy and duration of action along with an increase in bioavailability of timolol and pilocarpine in comparison with the commercial preparation.

Adrenergic beta-Antagonists↗
PubMed2000

Effects of pentagastrin and the cold pressor test on the acoustic startle response and pupillary function in man.

Pentagastrin, a cholecystokinin2 (CCK2) receptor agonist, evokes autonomic and subjective features of anxiety in healthy volunteers. The present experiments examined the effects of pentagastrin on two responses with known sensitivity to another anxiogenic procedure (threat of electric shock): the acoustic startle response and the pupillary light reflex. The effects of pentagastrin were compared with those of the cold pressor test, a procedure known to elicit sympathetic activation. Twelve healthy males (18-35 years) participated in two experiments each consisting of two sessions in which they received (1) pentagastrin (0.3 microg/kg, i.v.) and a control infusion (saline), and (2) cold pressor test (90 s hand immersion at 4 degrees C) and a control immersion (37 degrees C), using a balanced single-blind protocol. Electromyographic responses of the orbicularis oculi to 40 ms, 1 kHz, 115 dB tones ('startle responses') [Experiment 1], and miotic responses to 200 ms, 0.43 mW/cm2 light pulses [Experiment 2] were recorded before, during and after the infusions and hand immersions. Heart rate, blood pressure and subjective feelings were also recorded. The amplitude of the startle response was not significantly affected by pentagastrin, but was reduced during the cold pressor test. Resting pupil diameter increased during both pentagastrin infusion and the cold pressor test, but neither procedure altered the amplitude of the light reflex. Tachycardia, increased blood pressure and subjective anxiety were induced by both pentagastrin and the cold pressor test. The cardiovascular and mydriatic effects of pentagastrin and the cold pressor test are consistent with the known ability of these treatments to induce sympathetic activation. The anxiety induced by these treatments, unlike anxiety induced by threat of electric shock, was not accompanied by potentiation of the startle response or reduction of the miotic response. The results indicate that different anxiogenic procedures do not have equivalent effects on these reflexes.

Adolescent↗
PubMed1999

The effects of the novel anxiolytic drug lesopitron, a full and selective 5-HT1A receptor agonist, on pupil diameter and oral temperature in man: comparison with buspirone.

We investigated the effects of two 5-HT1A receptor agonists, buspirone and lesopitron, upon pupil size in human volunteers at an ambient luminance level of 32 Cd m(-2) and in darkness. Pupil diameter was monitored with a binocular infrared television pupillometer, before and after the administration of treatments for 4 h at 20-min intervals. Two experiments were conducted. In Experiment 1, 14 healthy male volunteers participated in seven weekly sessions, each associated with the ingestion of one capsule (buspirone 5, 10 and 20 mg, lesopitron 10, 20 and 40 mg and placebo), according to a double-blind balanced, cross-over design. Both buspirone and lesopitron tended to decrease pupil diameter. In darkness, only the highest dose of buspirone (20 mg) caused a miosis that was statistically significant. However, at the luminance level of 32 Cd m(-2) buspirone 10 and 20 mg evoked statistically significant miotic effects, as did the highest dose of lesopitron (40 mg). The miotic effect was significantly greater at 32 Cd m(-2) than in darkness after each dose of buspirone and the highest dose (40 mg) of lesopitron. In Experiment 2, pupil diameter and oral temperature were monitored with an electronic thermometer at 40-min intervals. Twenty healthy male volunteers participated in two weekly sessions, each associated with the sublingual application of 100 microl hydroalcoholic solution (lesopitron 20 mg, placebo), according to a double-blind balanced cross-over design. Lesopitron caused a significant miosis both in darkness and at the luminance level of 32 Cd m(-2); the miosis was greater at 32 Cd m(-2) than in darkness. Lesopitron tended to decrease oral temperature; this effect however, was not statistically significant. The greater effectiveness on the pupil of lesopitron administered sublingually in a solution indicates the importance of first-pass metabolism in reducing the effectiveness of the drug when administered by the mouth. The miosis observed in both experiments may be due to either a sympatholytic or a parasympathomimetic effect of the drugs, or both. The light-dependence of the miosis indicates that the 5-HT1A receptor agonists can modulate the light reflex, possibly via the noradrenergic control of central cholinergic neurones in the Edinger-Westphal nucleus.

Adult↗
PubMed1989

Sodium hyaluronate as an ophthalmic vehicle: some factors governing its effect on the ocular absorption of pilocarpine.

Sodium hyaluronate, as an additive to aqueous ophthalmic formulations, has been claimed to increase the ocular contact time and, thereby, the drug bioavailability. In the present study, the effect of sodium hyaluronate on corneal residence time and drug absorption in rabbits was investigated. Addition of sodium hyaluronate (0.125%) to a 3H-pilocarpine HCl solution resulted in increased retention of radioactivity in tear fluid and a 2-fold increase in drug concentration in the cornea and aqueous humor. Further, the effects of concentration and molecular weight of sodium hyaluronate on the miosis induced by pilocarpine in rabbits were studied. A significant increase of miotic response was seen at concentrations just less than 0.1% sodium hyaluronate. Pilocarpine solutions prepared from high mol.wt. sodium hyaluronate exhibited a greater miotic response than those prepared from lower mol.wt. samples. This might indicate that other physicochemical properties of sodium hyaluronate influence drug bioavailability.

Administration, Topical↗
PubMed1994

The effect of a modified beta-cyclodextrin, SBE4-beta-CD, on the aqueous stability and ocular absorption of pilocarpine.

In the present study, the effects of a novel, modified beta-cyclodextrin derivative (SBE4-beta-CD; a variably substituted sulfobutyl ether of beta-cyclodextrin with an average degree of substitution of four) on the aqueous stability of pilocarpine and on its ocular absorption in albino rabbits were studied. For stability reasons, commercial pilocarpine eyedrops are formulated at pH 4-5, a pH range where pilocarpine (pKa approximately 7) is almost completely ionized. As shown in the present and past studies, increasing the pH of the pilocarpine solution from 4.5 to 7.0 increases the ocular absorption of pilocarpine. SBE4-beta-CD increased the aqueous stability of pilocarpine (0.36 mM) at pH 7.0 (4 degrees C, projected values from Arrhenius data at 25 degrees C, 37 degrees C and 50 degrees C); in the absence of SBE4-beta CD, t90% was 236 days. In the presence of 1 mM and 25 mM of SBE4-beta-CD, t90% was 382 days and 2054 days, respectively suggesting that indeed, pilocarpine does interact with SBE4-beta-CD. SBE4-beta-CD did not damage the corneal epithelium in vitro and was well-tolerated by the rabbit eye in vivo. Coadministered SBE4-beta-CD did not significantly affect the miotic response of pilocarpine solutions at pH values of 4.5 or 7.0 when the molar ratio of SBE4-beta-CD to pilocarpine was between 0.2:1-7:1. The effect of the coadministered SBE4-beta-CD on the miotic response of pilocarpine solutions was also compared to that of 2-hydroxypropyl-beta-cyclodextrin (HP-beta-CD) which has recently been suggested to increase ocular bioavailability of pilocarpine in rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)

2-Hydroxypropyl-beta-cyclodextrin↗
PubMed1999

Latrunculin-A causes mydriasis and cycloplegia in the cynomolgus monkey.

PURPOSE: To determine the effect of latrunculin (LAT)-A, which binds to G-actin and disassembles actin filaments, on the pupil, accommodation, and isolated ciliary muscle (CM) contraction in monkeys. METHODS: Pupil diameter (vernier calipers) and refraction (coincidence refractometry) were measured every 15 minutes from 0.75 to 3.5 hours after topical LAT-A 42 microg (approximately 10 microM in the anterior chamber [AC]). Refraction was measured every 5 minutes from 0.5 to 1.5 hours after intracameral injection of 10 microl of 50 microM LAT-A (approximately 5 microM in AC), with intramuscular infusion of 1.5 mg/kg pilocarpine HCl (PILO) during the first 15 minutes of measurements. Pupil diameter was measured at 1 and 2 hours, and refraction was measured every 5 minutes from 1 to 2 hours, after intravitreal injection of 20 microl of 1.25 mM LAT-A (approximately 10 microM in vitreous), with intramuscular infusion of 1.5 mg/kg PILO during the first 15 minutes of measurements (all after topical 2.5% phenylephrine), and contractile response of isolated CM strips, obtained <1 hour postmortem and mounted in a perfusion apparatus, to 10 microM PILO +/- LAT-A was measured at various concentrations. RESULTS: Topical LAT-A of 42 microg dilated the pupil without affecting refraction. Intracameral LAT-A of 5 microM inhibited miotic and accommodative responses to intramuscular PILO. Intravitreal LAT-A of 10 microM had no effect on accommodative or miotic responses to intramuscular PILO. LAT-A dose-dependently relaxed the PILO-contracted CM by up to 50% at 3 microM in both the longitudinal and circular vectors. CONCLUSIONS: In monkeys, LAT-A causes mydriasis and cycloplegia, perhaps related to its known ability to disrupt the actin microfilament network and consequently to affect cell contractility and adhesion. Effects of LAT-A on the iris and CM may have significant physiological and clinical implications.

Accommodation, Ocular↗
PubMed1975

[Pilocarpine-ocusert-p-40 in the handicapped glaucoma patient (author's transl)].

A group of 15 patients with chronic open angle glaucoma had been selected for this study. All of them were handicapped in the long-term self-medication of their antiglaucomatous eye drops either by visual function loss or by, physical or mental disorders. A preliminary test was made in each patient whether there was an essential difference in the therapeutic effect after self-medication and after optimal local application of the miotics by the doctor. Each of the selected patients had profile tonometry after self-medication, after medication by the observer and after Pilocarpine-Ocusert-P-40. There was evidence that the most pronounced therapeutic effect could be achieved by the correct placement of the antiglaucomatous drug in the individual eye. The results on the ocusert system indicate that pilocarpine ocuserts are advantageous over the incorrect placement of different miotics by the handicapped patient. The results had been statistically evaluated using the t-test. The possibilities of using the ocuserts in the elderly glaucoma patient are discussed.

Adult↗
PubMed1975

Mechanism of morphine-induced miosis in the dog.

It was observed that dogs under 50 percent nitrous oxide and succinylcholine exhibited a moderately large pupil, maintained a good pupillary light reflex and had a relatively high sensitivity to the miotic effects of morphine. A cumulative dose of 1 mg/kg. i.v. of morphine caused marked and sustained miosis in these animals. Morphine, 1 mg, was found to have no pupillary effect by intraocular administration. Optic nerve section and cervical sympathectomy did not interfere with the miotic response in either acute or chronic preparations. Conversely, a cumulative i.v. dose of 30 mg/kg of morphine failed to cause pupillary constriction when oculomotor innervation had been interrupted. In addition, morphine, 0.2 to 0.6 mg/kg i.v., caused marked miosis in dogs whose occipital lobes or cerebral hemispheres had been removed. These findings suggest that morphine acts on a subcortical region causing constriction of the pupil. The possible location was ascertained by unit recording with microelectrodes. It was observed that pupilloconstrictor neurons in the visceral nuclei of the oculomotor nuclear complex responded to morphine, 0.2 mg/kg i.v., by increased frequency of discharge. Other neurons in the pupillary light reflex pathway showed depressed activity. Levallorphan, 0.05 mg/kg i.v., but not phenylephrine (locally applied to the conjunctival sac) antagonized all of the actions of morphine on the pupilloconstrictor neurons. The present findings demonstrate that the miosis induced by morphine is accomplished by an excitatory action of the narcotic on the visceral nuclei of the oculomotor nuclear complex.

Animals↗
PubMedDate not supplied

[Preservation of tissue culture cells by deep freezing].

The effect of polyethylene oxide, mol. wght 400 and 4000, the rate of freezing in liquid nitrogen, and thawing in a water bath at 37 degrees C on the survival rate, the growth activity, miotic activity and the activity of some oxidation-reduction enzymes of the most important links of the chain of biological oxidation, SDG, NAD-H2, NADP-H2- diaphorases, electrophoretic motility of continuous human and animal tissue culture cells, RH HEp-2, SPEV were studied. The developed regimen of freezing at a rate of 30 degrees per minute retains 95% viable cells. The miotic activity, enzymatic activity and electrophoretic motility of frozen-thawed cells did not differ from those of the controls.

Cell Survival↗
PubMed1992

Overview of the corneal toxicity of surgical solutions and drugs: and clinical concepts in corneal edema.

Surgical solutions and drugs are important in ocular surgery. These include irrigating solutions, viscoelastic substances, mydriatics and miotics, and a growing number of other agents designed to enhance intraocular surgery and its outcome. Potential for damage to the corneal endothelium and other tissues is related to the chemical composition, pH, and osmolality of the irrigating solutions that bathe tissues. Quality balanced salt solutions (BSS) are usually safe for use as an intraocular solution in patients with normal corneal endothelium. If prolonged irrigation times are expected, or the patient already has decompensated endothelium, i.e., primary or secondary endotheliopathy, the use of a "complete" BSS solution is indicated to minimize damage. Intraocular sulfite-containing epinephrine may cause severe corneal edema and should be avoided, or if used, be well diluted. Sulfite-free epinephrine solution is now available and does not cause the endothelial toxicity that one may see with sulfite-containing epinephrine solutions. Current formulations of acetylcholine and carbachol used as miotics in surgery have been evaluated in humans and caution is recommended in using acetylcholine solutions intracamerally in patients with already decompensated endothelium. Chondroitin sulfate, hydroxypropyl methylcellulose, and sodium hyaluronate are non-toxic to animal endothelial cells under conditions analogous to cataract extraction in humans but can be toxic to endothelium if there is continued contact with endothelium for hours. Chondroitin sulfate has been shown to have more of a protective effect in mechanical pseudophakos trauma probably because of its cohesiveness and tendency to coat the endothelium. Viscoelastics cause a significant rise in intraocular pressure of > 30 mm Hg in 3-10% of patients. Very high intraocular pressures are often seen postoperatively after viscoelastic use surgically in patients who preoperatively have a history of ocular hypertension or glaucoma.

Cell Count↗
PubMed1992

Tangent Streak RGP bifocal contact lenses in the treatment of accommodative esotropia with high AC/A ratio.

Patients with the diagnosis of high accommodative convergence/accommodation (AC/A) ratio, accommodative esotropia traditionally have been fit with bifocal spectacles. For cosmetic reasons, however, many patients prefer non-spectacle correction. Orthoptics, miotics, contact lenses, and surgery have been used as alternatives. We describe the treatment of three patients with the Tangent Streak bifocal rigid gas permeable (RGP) contact lens in which functional control of the patient's deviation was attained. Tangent Streak RGP bifocal contact lenses offer an acceptable alternative to bifocal spectacles, surgery, miotics, or orthoptics in the treatment of accommodative esotropia with high AC/A ratio.

Accommodation, Ocular↗
PubMed1989

[Drug therapy of initial open-angle glaucoma].

The paper analyses results of long-term general and local medicamentous treatment of 86 patients with open-angle initial glaucoma. The hypotensive preparations were miotics, sympathomimetics, beta-blockers, carbonic anhydrase inhibitors. Regulation of intraocular pressure by means of miotics was achieved in 30% of cases and by means of sympathomimetics--in 53%. The best hypotensive effect with a long-term regulation of intraocular pressure was achieved by means of beta-blockers. In order to correct vascular disturbances, angioprotectors, cavinton, rheopolyglucin, 2 courses a year were used. A systematic, pathogenetically grounded medicamentous treatment of initial glaucoma allows to achieve stabilization of glaucomatous process in 88% of cases.

Adult↗
PubMed1988

[Fluoroiridographic aspects of iridoschisis].

Iridoschisis is a rare condition of uncertain etiology characterized by a cleavage of the iris layers. We report four cases studied by fluorescein angiography to display possible occurrence of vascular abnormalities in the pathogenesis of the disease. Case 1: 80 year old woman with bilateral schisis of the peripheral iris, in the inferonasal quadrant in RE and inferotemporal in LE. A shallow anterior chamber was present in OU; IOP was 18 in RE and 15 in LE. No corneal abnormalities were present. Fluoroiridography showed a normal pattern filling of the iris vascularity, that was more visible in the schisis area. Case 2: 66 year old man with diabetes and open-angle glaucoma operated on for trabeculectomy five years previously. The examination showed a normal cornea, a shallow anterior chamber and miotic pupils for pilocarpine therapy. IOP was 12 in OU. The iridoschisis was present in RE in the lower sectors which were totally involved from the outer iris to the inner pupillary margin. Fluoroiridography indicated a normal vessel perfusion without any abnormality in the affected sectors. A slight bilateral pupillary dye leakage without any stromal diffusion was attributable to the patient's age. Case 3: 55 year old woman treated with miotics in RE for a glaucoma diagnosed after head trauma twenty years before, after which the vision in LE was reduced to 2/200 for post-traumatic optic nerve atrophy. No corneal abnormality was present. The anterior chamber was shallow and the ocular tension was 14 in RE and 10 in LE.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1980

[Treatment of glaucoma with beta receptor blockers].

We report the possibility of treatment with beta-adrenergic blocking agents in glaucoma-therapy. In open-angle glaucoma the therapy with beta-adrenergic blocking agents is often the best one. The combination of beta-adrenergic blocking agents with miotics is the therapy of choice in the treatment of closure-angle glaucoma. In special forms of glaucoma it is necessary to decide if the best therapy is the treatment with beta-adrenergaic blocking agents alone or a combined treatment of beta-adrenergic blocking agents with miotics. The beta-adrenergic blocking agent timolol (Chibro-Timoptol) and bupranolol (Ophtorenin) lower in the intraocular pressure to a greater extent than other beta-adrenergic blocking agents. Timolol eye drops and bupranolol eye drops are therefore the best beta-adrenergic blocking agents in therpay of glaucoma.

Adrenergic beta-Antagonists↗
PubMed1978

Unusual course and long-term follow-up in malignant glaucoma.

One man and 2 women, aged 67, 63 and 68 years, observed for 8, 6, and 2 years, developed a classical postoperative malignant glaucoma. After a second operation, the use of atropine drops was continued for 2 years in one case, whereas in the other 2 cases miotics and later acetazolamide (Diamox) were necessary in order to maintain normal intraocular pressure. All 3 patients refused a preventive operation in the fellow eye and the use of miotics proved both necessary and effective in maintaining normal intraocular pressure, normal visual acuity, and normal visual fields.

Acetazolamide↗
PubMed1977

Glaucoma and retinal detachment.

In a survey of 817 patients undergoing primary operations for retinal detachment, glaucoma was present in 9.5%. Ocular hypertension (intraocular pressure [IOP] greater than 21 mm Hg) was present in an additional 6.5%. Primary open-angle glaucoma; the type of glaucoma most frequently encountered, occurred in 4% of the patients. Aphakic eyes and eyes with peripheral anterior synechiae had high prevalences of glaucoma. A high percentage of eyes with posttraumatic angle recessions had either glaucoma or elevated IOPs. Miotics used in the treatment of glaucoma could not be definitely implicated as a cause of retinal detachment. The rate of successful retinal reattachment was the same, whether or not glaucoma was present. However, a good visual result occurred less frequently in patients with glaucoma.

Eye Injuries↗
PubMed1980

Characteristics of infantile esotropia following early bimedial rectus recession.

A homogeneous group of infantile esotropes were studied who underwent surgical alignment before 1 year of age. Three groups emerged: those who remained stable following their initial early alignment, those who were well aligned and remained stable for prolonged periods of time and then decompensated, and those who were unstable throughout the observation period. Preoperatively, no factors were identified that predicted into which group each patient might enter. Other associated factors were identified that affected the strabismic angle and these were overactions of the inferior oblique muscles, dissociative vertical deviation, rotary and other forms of nystagmus, amblyopia, and changing refractive errors. The treatment modalities consisted of miotics, glasses, bifocals, occlusion, and repeated operations. This study underscores the instability of the conditions of patients with infantile esotropia and the need for repeated observations throughout the first decade of life.

Amblyopia↗