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PubMed1994

Galactose-induced cataract formation in guinea pigs: morphologic changes and accumulation of galactitol.

PURPOSE: To develop and characterize a new model of galactose-induced cataract formation in young, 3- to 4-week-old Hartley guinea pigs. METHODS: Experimental animals were fed 50% galactose in powdered guinea pig chow containing 0.5 g ascorbate/kg diet. Control animals were fed normal powdered guinea pig chow (0.5 g ascorbate/kg diet). Lenses from all animals were subjected to photo-slit-lamp examination, light microscopic analysis, and high-pressure liquid chromatography (HPLC) analysis of polyol content. RESULTS: Photo-slit-lamp examination indicated initial opacities in equatorial subcapsular region between 3 and 5 days in all galactose-fed animals (20/20); opacities progressed toward the anterior pole when diet was extended to 14 days. Histologic analysis of the equatorial changes confirmed progressive cataract formation consisting of small intra-fibrillar vacuoles in the pre-equatorial region (3 days), an increased number of enlarged and coalesced vacuoles (6 days), and progressive tissue swellings with cellular disruption and signs of epithelial multilayering (14 days). The anterior epithelium showed increased cell height and swelling after 3 days of the galactose diet. HPLC analysis of lens tissue indicated progressive accumulation of galactitol, 18 mM after 3 days, which plateaued to about 30 mM between 6 and 14 days. The level of myo-inositol dropped from a control value of 2.8 +/- 0.7 mM to 1.5 +/- 0.7 mM after 3 days, and was nearly undetectable after 14 days of the galactose diet. CONCLUSIONS: The current study suggests that the guinea pig model may serve as a valuable new tool to study sugar-induced cataract formation and to characterize the early morphologic and biochemical events in cataractogenesis.

Animals↗
PubMed1999

Comparative antiviral efficacies of cidofovir, trifluridine, and acyclovir in the HSV-1 rabbit keratitis model.

PURPOSE: To determine the relative antiviral inhibitory activity of topical 1% and 0.5% cidofovir, topical trifluridine (Viroptic; Burroughs-Wellcome, Research Triangle Park, NC), and topical acyclovir (Zovirax; The Wellcome Foundation, London, UK) during a 7-day period for the treatment of herpes simplex virus type 1 (HSV-1) keratitis and HSV-1 replication in the New Zealand rabbit ocular model. METHODS: In a series of four experiments using a two-eye design, a total of 80 New Zealand rabbits were inoculated in both eyes with HSV-1 McKrae after epithelial scarification. Forty-eight hours after inoculation, the rabbits were randomly assigned to a treatment group. Five treatment groups (16 rabbits/group) were evaluated: I, 1% cidofovir, twice daily for 7 days; II, 0.5% cidofovir, twice daily for 7 days; III, 3% acyclovir ointment, five times daily for 7 days; IV, 1% trifluridine, nine times daily for 3 days, then 4 times daily for 4 days; and V, control vehicle twice daily for 7 days. HSV-1 dendritic keratitis was graded in a masked fashion by slit-lamp examination on days 2, 3, 5, 7, 9, 11, and 14. Ocular viral cultures were obtained after slit-lamp examination on days 1, 3, 5, 7, 9, 11, and 14. RESULTS: Compared with the control group, all four treatment groups demonstrated significantly lower viral titers, fewer HSV-1-positive eyes/total during the treatment period, lower keratitis scores, fewer eyes with keratitis/total, and a shorter time to resolution of keratitis. Within the treatment groups, the 1% and 0.5% cidofovir treatments were significantly more effective than acyclovir and trifluridine as measured by the previous viral and keratitis parameters. CONCLUSIONS: Topical 1% and 0.5% cidofovir both appeared to be significantly more efficacious than topical trifluridine and acyclovir, during a 7-day course, in the treatment of experimental HSV-1 ocular disease in the New Zealand rabbit keratitis model.

Acyclovir↗
PubMed1991

Phenylketonuria does not cause cataracts.

In a study of 46 adults aged 28-71 years with untreated phenylketonuria (PKU) there were 3 (6.5%) with cataracts. This incidence was similar to that in the Australian population and in a control series of intellectually disabled adults. Only two of the PKU patients with cataracts could be examined by slit-lamp biomicroscopy and in both the findings suggested that the prolonged use of phenothiazines may have played a role. Slit-lamp examination of a further ten untreated PKU patients and 13 PKU adults who had been treated in childhood revealed only small lens opacities (in 40%) of a type found in 72.7% of a control group. The study provides no support for claims that PKU can cause cataracts.

Adult↗
PubMed1999

Population-based assessment of the outcome of cataract surgery in an urban population in southern India.

PURPOSE: To assess the outcome of cataract surgery in an urban population in southern India. METHODS: As part of a population-based cross-sectional epidemiologic study, the Andhra Pradesh Eye Disease Study, 2,522 people of all ages, including 1,399 individuals 30 years of age or older, from 24 clusters representative of the population of Hyderabad in southern India underwent a detailed interview and ocular evaluation including logarithm of minimal angle of resolution (logMAR) visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, dilation, cataract grading, aphakia/pseudophakia status, and stereoscopic fundus evaluation. Automated threshold visual fields and slit-lamp and fundus photography were performed when indicated by standardized criteria. Very poor outcome in an eye that had undergone cataract surgery was defined as presenting distance visual acuity worse than 20/200, and poor outcome was defined as visual acuity worse than 20/60 to 20/200. RESULTS: In subjects 50 years of age or older, after adjustment for age and sex distribution, the rate of having had cataract surgery in one or both eyes was 14.6% (95% confidence interval [CI], 11.4% to 17.8%). Of 131 eyes (91 subjects) that had undergone cataract surgery, 28 (21.4%; 95% CI, 14.4% to 28.4%) had very poor outcome and another 40 (30.5%; 95% CI, 22.6% to 38.4%) had poor outcome. The very poor outcome in 20 (71.4%) of 28 eyes and poor outcome in 23 (57.5%) of 40 eyes could be attributed to surgery-related causes or inadequate refractive correction. With multivariate analysis, very poor outcome as a result of surgery-related causes or inadequate refractive correction was more likely to be associated with intracapsular cataract extraction than with extracapsular cataract extraction (odds ratio, 9.34; 95% CI, 2.49 to 35.06) in subjects belonging to the lowest socioeconomic status (odds ratio, 4.92; 95% CI, 1.16 to 20.93) and with date of surgery 3 or fewer years before the survey than with more than 3 years (odds ratio, 4.52; 95% CI, 1.33 to 15.39). Also, very poor or poor outcome as a result of surgery-related causes or inadequate refractive correction was associated with women (odds ratio, 2.55; 95% CI, 1.06 to 6.16). CONCLUSIONS: The very high rate of very poor and poor visual outcome, predominantly as a result of surgery-related causes and inadequate refractive correction, in this urban population of India suggests that more attention is needed to improve the visual outcome of cataract surgery. In order to deal with cataract-related visual impairment in India, as much emphasis on surgical quality, refractive correction, and follow-up care is necessary as on the number of surgeries.

Adult↗
PubMed1987

The objective assessment of cataract.

The objective assessment of cataract is central to any epidemiological or therapeutic study of cataract. The objective methods consist of: 1: A resolution target projection ophthalmoscope (Acuity scope) for the estimation of potential visual acuity. 2: The Oxford Clinical Cataract Classification and Grading System, which records and quantifies the features of the lens that are visible at the slit-lamp microscope. This system is essential since photographic methods cannot define the morphology of cataract. 3: Two photographic methods; slit-lamp photography and retro-illumination photography are needed to give a comprehensive statement about the amount of cataract. The negatives are measured by computerised image analysis systems.

Cataract↗
PubMed1982

Ocular phototoxicity and psoralen plus ultraviolet radiation (320-400 nm) therapy: an experimental and clinical evaluation.

The increase in fluorescent chromophores within the human ocular lens is age related, leading to an increasingly yellow core (nucleus) that presumably results from UV radiation exposure. In approximately 10% of our population this process progresses more rapidly, resulting in the formation of the brown (nuclear) cataract. Some lenticular discoloration may be beneficial, since it enables the mature lens to filter UV and short-wavelength visible radiation, thus protecting the retina from potential photodamage. Aphakic primate retinas can be irreversibly damaged by exposure to approximately 5 mW.cm-2 long-wavelength UV (greater than 325 nm) radiation. Photosensitized damage to the lens and retina with psoralen plus UV radiation (320-400 nm) (PUVA) has been demonstrated in experimental animals, and cataracts have recently been reported in patients given PUVA therapy. A new method to screen patients for lens damage is by enhanced fluorescence measurements. This method, UV slit-lamp densitography, permits detection of lenticular photodamage at a molecular level, years before visible opacities become manifest by conventional slit-lamp examination. This procedure has also demonstrated a significantly lower level of lens fluorescence (hence decreased filtering capacity) in patients with retinal degenerative diseases, suggesting UV photodamage as a factor in the progression and perhaps pathogenesis of these conditions.

Aging↗
PubMed2005

Detecting cataract causing visual impairment using a nonmydriatic fundus camera.

PURPOSE: To assess the validity of a digital nonmydriatic fundus camera in detecting cataract as a cause of visual impairment. DESIGN: Diagnostic test comparison. METHODS: Photos of the anterior segment of 72 eyes were taken with a nonmydriatic fundus camera and assessed for cataract by two graders. Dilated biomicroscopy examination of the anterior segment of the same 72 eyes was then performed and cataract graded using the Wilmer scale. RESULTS: Grader 1 and 2 reported 90% and 94% sensitivity and 82% and 77% specificity, respectively, when the digital photos were compared with slit-lamp biomicroscopy in determining visually significant cataract. In addition, both graders showed similar substantial agreement between the digital photos and slit-lamp biomicroscopy when assessed for cataract (unweighted kappa 0.87 and 0.92, respectively, for graders 1 and 2). CONCLUSION: The nonmydriatic fundus camera may be an alternative method for screening for visually significant cataract in the community.

Cataract↗
PubMed1997

Excimer laser photorefractive keratectomy with different ablation zones.

In this study we would like to introduce the excimer laser, and to demonstrate our results and complications by using different ablation zones during photorefractive keratectomy (PRK) in the correction of myopia and astigmatismus. In 1996 we performed photorefractive keratectomy on 100 myopic eyes of 52 patients (28 females, 24 males). Mean age was 26.21 years (ranged from 19 to 54 years). The preoperative refraction ranged from -1.0 D to -18.0 Diopters. The diameter of the ablation zones were between 5 and 6.5 mm. We evaluated the results and the complications of the surgeries of 100 eyes which were performed with Schwind keratom F excimer laser. After 2 days, 1 week, 1 month, 3 months, and 6 months postoperatively we tested the best uncorrected and corrected visual acuities, and performed intraocular pressure measurement, slit lamp examination as well as corneal topography. The postoperative refractions were between +/- 0.5 to +/- 1.0 Diopters. After six months postoperatively the slit lamp examination showed that 80% of the patients had no corneal haze while 20% had stage I (Hanna) corneal haze. The smaller the diameter of the ablation zone was, the more pronounced the corneal haze and the night-glare were. The photorefractive excimer laser keratectomy is judged to be a safe method, although it might have some side-effects. The different ablation zones of this treatment means an important modification, that not only allows the method to meet the individual requirements, but reduces the chance of the complications as well. Based on the authors' experiences PRK for moderate myopia with large diameter ablation zones appears more predictable than than with smaller ablation zone diameters.

Adult↗
PubMed2000

Evaluation of the PuriLens contact lens care system: an automatic care system incorporating UV disinfection and hydrodynamic shear cleaning.

PURPOSE: This study evaluates lens care using the PuriLens System, an advanced way to clean and disinfect soft hydrophilic lenses using subsonic agitation and UV radiation, respectively. METHODS: A two-period crossover lens cleaning and safety investigation was conducted using 80 patients. Disinfecting efficacy was tested in accordance with standard FDA protocols. Lens compatibility was studied with Group I and Group IV lenses during the equivalent of a 6-month care regimen by measuring: lens power, base curve, wet diameter, refractive index, clarity, and tint. Safety was evaluated through slit-lamp findings, wearing time, comfort, and visual acuity. RESULTS: The mean wearing time of patients in the study was 13.79 hours. No slit lamp findings greater than grade 2 were noted. Visual acuity was 20/25 or better in 92.5% of examinations. None of the patients lost more than two lines of acuity. Lens surface evaluation showed no deposits (grade 0) to very slight deposits (grade 1) in 94.4% of examinations. Lenses cleaned with the PuriLens System were cleaner by a statistically significant margin (P=0.02) compared to lenses digitally cleaned with a leading multi-purpose solution (ReNu, Bausch & Lomb). Overall, neither the Group I nor Group IV lenses were affected after 180 cleaning cycles. CONCLUSIONS: The PuriLens System provides automatic lens care compliance, superior antimicrobial efficacy, and eliminates the need for daily digital cleaning.

Adolescent↗
PubMed1999

An intelligent, interactive platform for ophthalmic teaching, telemedicine, and telecollaboration: design considerations and prototype construction.

The development of technologies permitting processing, compression, and transmission of digital images and image sequences enables powerful methodologies for local and remote medical teleconsultation. We are developing a slit-lamp-based ophthalmic augmented reality (image overlay) environment incorporating features to permit real-time, interactive teaching, telemedicine, and telecollaboration. A binocular slit-lamp biomicroscope interfaced to a CCD camera, framegrabber board, and PC permits acquisition and rendering of anterior segment and retinal images. Computer-vision algorithms facilitate robust tracking, registration, and near-video-rate image overlay of previously stored retinal photographic and angiographic images onto the real-time fundus image. Our algorithms facilitate shared control of pointing, drawing, and measuring functions registered with the retinal image video stream and direct audio communication between an examiner (student, generalist) and remote observer (instructor, specialist). Bandwidth and video compression considerations limit the frame rate and latency for video stream transmission. Excellent and acceptable performance are demonstrated in model eyes over a local area network and through a modem connection, respectively. These studies represent the first investigations towards the design and implementation of an intelligent platform for ophthalmic telemedicine and telecollaboration.

Algorithms↗
PubMed1986

In vivo observations of cataract development in Emory mouse.

In order to establish staging of cataract development in Emory mice, in vivo observation of crystallaine leses of 366 eyes in 183 Emory mice were performed with the slit-lamp microscope from the time of opening of the lid fissure to the age of 12 months. The findings were documented by conventional slit-lamp photography and a Scheimpflug camera and were analyzed by the same methods used for human eyes. The cataract development was divided into four stages. Initital opacification in the central part of the anterior superficial cortex appeared until the 2nd month of age (stage I). In stage II, opacification progressed into the deep cortex which was seen by the 6th month at the latest. In the 7th or 8th month, opalescent opacity spread around the nucleus (stage III). Stage IV was total opacification, appearing between the 10th and 12th month.

Animals↗
PubMed1999

Foveal retinoschisis and retinal detachment in severely myopic eyes with posterior staphyloma.

PURPOSE: To evaluate the tomographic features of the retina in patients with severe myopia and posterior staphyloma. METHODS: In a prospective study of 32 eyes of 19 consecutive patients with severe myopia and posterior staphyloma, we performed complete ophthalmic examinations and studied cross-sectional images of the macula with optical coherence tomography. Patients' age ranged from 41 to 83 years (average, 62.7 years). Best-corrected visual acuity ranged from 20/500 to 20/40 (average, 20/120). The study included 26 phakic and six pseudophakic eyes. The refractive errors of 26 phakic eyes ranged from -8 to -31 diopters (average, -16.7 diopters). Although refractive errors were within -8 diopters in six pseudophakic eyes, the eyes had apparent posterior staphyloma. The axial lengths measured by A-mode ultrasonography ranged from 25.7 to 32.7 mm (average, 29.2 mm). Slit-lamp examination with contact lens showed that none of the eyes had a macular hole. RESULTS: In nine eyes with shallow retinal elevation on slit-lamp examination, optical coherence tomography disclosed a foveal retinal detachment with retinoschisis in eight eyes and a foveal retinal detachment in one eye. Two of the remaining 23 eyes had retinoschisis. CONCLUSIONS: Foveal retinal detachment and retinoschisis are common features in severely myopic eyes with posterior staphyloma. Retinal detachment may precede the formation of a macular hole in severely myopic eyes.

Adult↗
PubMed1998

Comparison of Fucithalmic viscous eye drops and Chloramphenicol eye ointment as a single treatment in corneal abrasion.

PURPOSE: To compare the healing of the cornea and the incidence of infection after traumatic corneal epithelial defect after single treatment with double bandage combined with either Fucithalmic single unit dose eye drops or chloramphenicol eye ointment. METHODS: This is a single-centre, randomised, single-blind, parallel-group study of 144 patients with accidental corneal abrasion or corpus alieni cornea who were referred to the Eye Department at Gentofte Hospital. The injured eye was examined with a photo slit-lamp before and 24 hours after treatment. The size of the abrasion was recorded and calculated on a PCX computerized video system and by slit-lamp photography. RESULTS & CONCLUSION: The Fucithalmic and chloramphenicol ointment treated groups showed no significant difference in corneal healing, local side effects, or signs of local infection.

Adult↗
PubMed1987

Recurrent herpes simplex virus type 1 corneal epithelial lesions after radial keratotomy in the rabbit.

The effects of radial keratotomy (RK) on herpes simplex virus type 1 ocular shedding and recurrent corneal epithelial lesions were assessed for 14 days after RK in rabbits latently infected with strain McKrae. Ten latently infected rabbits had RK performed on the right eye. The left eye was used as the control. Viral shedding was monitored by ocular tear-film swabs. The recurrent lesions were monitored by slit-lamp examination. In the RK-treated eyes, 15 (11%) of 140 swabs were positive, compared with six (4%) of 140 swabs in control eyes. Slit-lamp examination disclosed recurrent lesions on 18 (33%) of 55 days on which it was performed in the RK group vs three (5%) of 55 days for the control group. The results suggest that patients who have a history of ocular herpes simplex virus type 1 disease are at risk for recurrences after RK.

Animals↗
PubMed2000

Lens thickness and five-year cumulative incidence of cataracts: The Beaver Dam Eye Study.

PURPOSE: To evaluate whether lens thickness is related to incidence of cataracts. METHODS: Lens thickness was measured from slit-lamp photographs of the lens at the time of the prevalence evaluation in the Beaver Dam Eye Study. Incident cataract was determined by grading standard slit-lamp and retroillumination photographs of the lens at the baseline and five-year follow-up examinations. Medical history was obtained and blood pressures, height and weight were measured according to protocol. RESULTS: Lens thickness was positively associated with incident nuclear cataract and inversely associated with incident cortical cataract after accounting for age, sex, diabetes status, hypertension, heavy drinking and cigarette smoking. CONCLUSIONS: Lens thickness is related to incidence of cataracts. Mechanisms to explain these relationships require further laboratory and epidemiologic investigation.

Adult↗
PubMed1994

Estimation of optic disc size using indirect biomicroscopy.

The use of the 90 dioptre fundus lens in conjunction with slit-lamp biomicroscopy as a method of estimating optic size was evaluated in a series of 37 patients. The measurements taken from the Haag-Streit slit-lamp were compared with values obtained planimetrically in order to assess a conversion factor and also the reliability of the method. This technique is a quick and easy method of obtaining an estimate of optic nerve head size in the clinic, but cannot replace more accurate methods of optic disc planimetry.

Humans↗
PubMedDate not supplied

Effect of nitric oxide synthase inhibition in experimental Pseudomonas keratitis in rabbits.

PURPOSE: The aim of this study was to assess the efficacy of the nitric oxide synthase inhibitor L-NG-nitro-arginine-methyleser (L-NAME) in the treatment of experimental Pseudomonas keratitis. METHODS: Twelve young New Zealand white rabbits were given intrastromal injections of Pseudomonas aeruginosa strains. Twenty-four hours later, the rabbits were randomly divided into four groups: group 1 was treated with topical 0.3% ciprofloxacin drops and a single subconjunctival injection of L-NAME (150 mg/kg); group 2 received topical 0.3% ciprofloxacin drops alone; group 3 received a single subconjunctival injection of L-NAME alone; group 4, the control group, was treated with topical balanced salt solution (BSS) drops. One drop of either ciprofloxacin of BSS was applied at each treatment interval. Twenty-six hours after the start of treatment, the eyes were examined by slit lamp to assess inflammation. Aqueous humor specimens were collected from each eye to measure the nitric oxide concentration. Corneas were removed to count bacteria results. RESULTS: Slit lamp examination cell scores were significantly lower for groups 1 and 3 than groups 2 and 4 eyes (p = 0.002 to p = 0.004). No viable bacteria were detected in the corneas of groups 1 and 2. Group 3 corneas had significantly fewer bacteria (6.33 +/- 0.42 x 10(3)) than group 4 (5.94 +/- 0.16 x 10(4)) (p < 0.05). Nitric oxide levels in the aqueous humor were significantly lower for group 1 eyes than for groups 2, 3, or 4 (p = 0.02, p = 0.01, and p = 0.003, respectively). CONCLUSIONS: We conclude that nitric oxide synthase inhibitors may be a useful adjunct but are not a replacement for traditional antibiotic drop therapy.

Animals↗
PubMed1997

Vitreous cells as an indicator of retinal tears in asymptomatic or not recently symptomatic eyes.

PURPOSE: To define the relationship between vitreous cells and retinal tears in eyes without recent flashes or floaters. METHODS: Five hundred eighty-five consecutive patients who complained of light flashes, floaters, or both in one eye had their asymptomatic or not recently symptomatic fellow eye examined prospectively for vitreous cells and retinal tears. RESULTS: Of these fellow eyes with 2+ or more vitreous cells (10 or more cells per 1-mm slit-lamp field), 31.6% (6/19) had one or more tears vs 1.6% (9/566) of those with 1+ or fewer cells (less than nine cells per 1-mm slit-lamp field) (P = .0001). CONCLUSIONS: A substantial number of vitreous cells, even in an eye with no recent symptoms, is correlated with the presence of a retinal tear. Additionally, a retinal tear may exist in an eye with 1+ or fewer cells.

Adolescent↗