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At least 523 records · Page 29Linked to original sources
PubMed1992

Acanthamoeba keratitis.

During the last year we came across three cases of Acanthamoeba keratitis. They were all contact lens wearers. The diagnosis of Acanthamoeba keratitis was established by the history, clinical picture and the culture of corneal and conjunctival swabs. The patients were treated with metronidazole (Flagyl) 0.5% eyedrops, propamidine isethionate (Brolene) 0.1% eyedrops, Neomycin eyedrops, topical corticosteroids, mydriatics and beta-blockers. One tablet or itraconazole (Sporanox) a day was given orally. Infection subsided in two patients. The third patient still suffers from recurrent corneal erosions and shows a pronounced corneal immune reaction.

Acanthamoeba↗
PubMedDate not supplied

Maximal mydriasis evaluation in cataract surgery.

We propose the Maximal Mydriasis Test (MMT) as a simple and safe means to provide the cataract surgeon with objective and dependable pre-operative information on the idiosyncratic mydriatic response of the pupil. The MMT results of a consecutive series of 165 eyes from 100 adults referred for cataract evaluation are presented to illustrate its practical applications and value. The results of the MMT allows the surgeon to anticipate problem eyes pre-operatively so that he can plan his surgical strategy more appropriately and effectively. Conversely, the surgeon can also appropriately and confidently plan surgical procedures where wide pupillary dilation is important. The MMT has also helped improve our cost-effectiveness by cutting down unnecessary delays in the operating room and enabling better utilisation of restricted costly resources.

Aged↗
PubMed1992

Dapiprazole: will it affect the standard of care for pupillary dilation?

One of the most controversial clinical issues in optometry is the use of "routine" pupillary dilation. Many optometrists are still reluctant to employ routine dilation because of concerns regarding patient inconvenience, angle-closure glaucoma, or systemic side effects. Dapiprazole, a new alpha-adrenergic blocking agent, is now available to reverse the effects of tropicamide- or phenylephrine-induced mydriasis. This article discusses the advantages, clinical uses, limitations, and legal aspects of this mydriatic antagonist in optometric practice.

Adrenergic alpha-Antagonists↗
PubMed1976

[Diagnostic and therapeutic use of cyclopentolate cycloplegia].

0,5 p. 100 Cyclopentolate is an important short-acting cycloplegic and mydriatic preparation. It has the same effect on accommodation as the prolonged instillation of Atropine. Nevertheless it must be remembered that it is not a perfect cycloplegic; just as much as with Atropine resistance is frequently found in young children, in subjects with brown irides, in pigmented races, and above all in cases where there is a tonic spasm of accommodation producing functional signs or oculomotor imbalance.

Age Factors↗
PubMed2006

Pharmacological effects of some newly developed soft anticholinergics and a receptor-binding QSAR study.

Receptor-binding studies using cloned human muscarinic receptors (M1-M4 subtypes) were performed on newly synthesized soft anticholinergics (F-828, F-838, SGM, SGE, SA-A) that are isosteric/ isoelectronic analogs of glycopyrrolate. The receptor binding pK(i) values of the new soft drugs were in the 5.5-9.5 range; with the majority being in the 7.0-8.5 range. As previously observed for similar structures, the pK(i) values tended to decrease with increasing molecular size, and with the introduction of three structural indicator variables, a QSAR equation accounting for close to 75% of the variability could be established. Confirming the known stereospecificity of these receptors, pure 2R isomers were found more active than the corresponding isomeric mixtures. In agreement with soft drug design principles, acid metabolites (SA-A) were found considerably less active than their parent esters. The more active, 2R isomer of SA-A showed some muscarinic subtype selectivity (M3/M2), which was not observed for the parent compounds of this zwitterionic metabolite. Guinea pig ileum assay pA2 values have also been determined, and they were found to be in good agreement with the pK(i), values obtained from the binding study (r2 = 0.72). SGM and SGE caused pupil-dilation in rabbit eyes, but their mydriatic effects lasted considerably shorter than that of glycopyrrolate, and they did not induce dilation of the pupil in the contralateral, water-treated eyes, indicating that they are locally active and safe, with a low potential to cause systemic side effects.

Algorithms↗
PubMedDate not supplied

Pharmacological studies on 2- and 4-pyridylethylamides of acetyltropic acid (PAT-2 and PAT-4).

Two new compounds: 2- and 4-pyridylmethylamides of acetyltropic acid (PAT 2 and PAT-4) show spasmolytic effects on isolated guinea pig ileum, have mydriatic actevity in rabbits and block restraint produced ulceration in rats. PAT-4 causes a strong inhibition of the salivary secretion in mice. Both of the test compounds inhibit also the effects of ACh and vagus stimulation on the blood pressure and have local anaesthetic activity. PAT-4 inhibits the aggressive behaviour in mice and rats, prolongs the hexobarbital sleeping time, increases the pain treshold and inhibits the oxotremorine induced tremor in mice. Both PAT-2 and PAT-4 had no effect on the convulsant action of pentetrazole. EEG findings show that central cholinolytic activity is present in both compound tested.

Acetylcholine↗
PubMed1991

Phenylephrine prodrug. Report of clinical trials.

The authors evaluated the mydriatic effect of phenylephrine oxazolidine prodrug, a lipophilic sympathomimetic that undergoes hydrolysis to phenylephrine as it passes through the cornea and aqueous humor. Double-masked clinical trials were performed randomizing 66 healthy subjects to receive either the silicone vehicle as a placebo, 10% viscous phenylephrine hydrochloride (HCl), or prodrug in 0.25%, 0.50%, or 1.0% concentrations. A mean horizontal pupillary diameter of 8.8 mm was achieved in 30 minutes in those receiving 1% prodrug versus 6.5 mm obtained at 30 minutes with 10% viscous phenylephrine HCl. Statistically, this difference was highly significant at P less than or equal to 0.0001. There were minimal systemic or ocular adverse effects from any preparation.

Administration, Topical↗
PubMed1991

Possible allergic reactions to cyclopentolate hydrochloride: case reports with literature review of uses and adverse reactions.

Cyclopentolate has been widely used as a cycloplegic and mydriatic agent for over 30 years. It has gained widespread use as the cycloplegic drug of first choice for most children over the age of 1 year and allows many optometrists and ophthalmologists to carry out quick, successful cycloplegic refractions with few complications. During this time very few side-effects have been reported with the most commonly used 1% solution. This paper outlines two cases in which a possible allergic-type reaction occurred shortly after the instillation of 1% cyclopentolate hydrochloride in 'Minims' form (Smith and Nephew). This article also reviews the uses and side-effects of cyclopentolate and aims to warn practitioners about the possibility of such reactions, ways of avoiding their occurrence and suitable measures to take should they occur.

Child↗
PubMed1975

Differential effects of inhibitors of monoamine oxidase Types A and B on the adrenergic system of the rabbit iris.

Topical instillation of inhibitors of monoamine oxidase Types A and B into the rabbit eye, followed by the administration of a releaser of monoamines (Ro 4-1284), induces strong and sustained dilation of the iris. The mydriatic pattern differs markedly with A- and B-inhibitors and with the duration of the inhibitor treatment. The Type B inhibitor, deprenyl, prevents the degradation of exogenous 2-phenylethylamine and possibly of the endogenous amine X capable of releasing monoamines from a compartment less accessible to Ro-1284.

5-Methoxytryptamine↗
PubMed1988

Trabeculectomy, ECCE with PC-IOL implant, and vitrectomy after malignant glaucoma.

A patient with narrow-angle glaucoma developed a post peripheral iridectomy malignant glaucoma in both eyes. The intraocular pressure (IOP) in both eyes was controlled with mydriatics, cycloplegics, and Diamox for 2 years. Subsequently the patient developed a dense cataract and uncontrollable IOP in her left eye. An extracapsular cataract extraction, posterior chamber lens implant, and trabeculectomy were combined with an anterior vitrectomy. The IOP in both eyes has been controlled for 3 years postoperatively.

Aged↗
PubMedDate not supplied

[Effect of adamantyl quaternary ammonium derivatives on the autonomic ganglia].

The ganglionic blocking activity of mono- and bis-quaternary ammonium compounds with adamantyl radicals was studied on unanesthetized mice my measuring the pupil diameter with a binocular lens. To measure the mydriatic action of the agents, experiments were performed on anesthetized cats with recording of nictiating membrane contractions under the stimulation of the cervical sympathetic trunk. It was established that the ganglionic blocking activity of mono-quaternary compounds depends on the position of the adamantyl radical in the molecule. The maximal ganglionic blocking activity was formed in ethyl-n-toluenesulphonate of beta-diethylaminoethyl ether of I-adamantyl acetic acid and in N-adamantyl analogue of tetramethylammonium. Introduction of the adamantyl radical into the cation centres of symmetrical polymethylene bis-trimethylammonium compounds (with the length of interinonic chain of 5-10 carbon atoms) leads to the loss of the ganglionic blocking activity.

Adamantane↗
PubMed1986

Pharmacological properties of the novel antimuscarinic agent 4-[2-(1,2-benzisoxazol-3-yl)-2-(hexahydro-1H-azepin-1-yl)a cetoxy]-1-et hyl-1- methylpiperidinium iodide.

Pharmacological properties of 4-[2-(1, 2-benzisoxazol-3-yl)-2-(hexahydro-1H-azepin-1-yl)acetoxy]-1- ethyl-1- methylpiperidinium iodide (SX-810) were investigated and the following results were obtained. 1. In isolated guinea-pig ileum, SX-810 showed a competitive antagonistic effect against acetylcholine with a pA2 value of 7.93. 2. SX-810 (10-50 mg/kg p.o. or 10-50 micrograms/kg i.v.) inhibited the gastroduodenal contractions induced by bethanechol and carbachol in anaesthetized rats. 3. SX-810 (10-100 mg/kg p.o.) inhibited spontaneous gastric motility in conscious rats and rabbits. 4. SX-810 (10-100 mg/kg p.o.) inhibited gastric secretion in pylorus-ligated rats. 5. SX-810 (20-200 mg/kg p.o. or 1-10 mg/kg s.c.) inhibited the ulceration induced by pylorus ligation or by exposure to restrained and water-immersed stress in rats. 6. When administered orally to rats, SX-810 had no mydriatic effect even at 3000 mg/kg, but subcutaneously administered SX-810 (0.5-10 mg/kg) exhibited such action. 7. When administered orally to rats, SX-810 (100-500 mg/kg) caused no significant inhibition of the salivation induced by pilocarpine, but subcutaneously administered SX-810 (0.5-10 mg/kg) exhibited an inhibition of the salivation. In rabbits, SX-810 (200-500 mg/kg p.o.) also caused no significant inhibition of the salivation except at an extremely high dose of 1000 mg/kg p.o. 8. SX-810 (100-500 mg/kg p.o.) caused no significant effect on urine and electrolyte excretion in rats. These results indicate that oral use of SX-810 exhibits marked spasmolytic and antiulcerative activities without exerting systemic antimuscarinic side effects.

Animals↗
PubMed1985

Manipulation of the iris in extracapsular lens extraction.

Successful extracapsular cataract surgery depends on adequate mydriasis, which will facilitate the anterior capsulotomy and provide a full field of view throughout the operation. The surgeon, especially the neophyte, must recognise which irises may present a difficulty in establishing, maintaining, and reversing mydriasis, with or without the introduction of an intraocular lens. The author describes the preliminary assessment of the iris for disease, previous iris surgery, ease of dilatation, and the place of primary iridectomy. Topical and subconjunctival preoperative mydriatics are assessed, and a practical account of the pharmacological, mechanical, and surgical means of maintaining intra-operative mydriasis is given. The indication for iridectomy in extracapsular lens extraction with or without an intraocular lens is reviewed, and the postoperative manipulation of the iris is described with reference to the problems caused by rebound mydriasis.

Cataract Extraction↗
PubMed1985

Controlled retrobulbar anesthesia for ECCE and IOL implantation.

A method of controlled retrobulbar anesthesia was used in 20 patients undergoing extracapsular cataract extraction with intraocular lens implantation. The method includes: leaving the pupil undilated before anesthesia; applying topical anesthetic to the conjunctiva; injecting about 0.25 ml of anesthesia through the non-sensitive conjunctiva into the muscle cone, then waiting until the pupil becomes dilated before injecting an additional 1.5 ml; injecting 0.25 ml anesthesia under the conjunctiva and into the tendon of the superior rectus muscle; and applying short-acting mydriatics after the injection. This method is almost painless and does not result in increased intraocular pressure after injection. Massage or compression to soften the eye is not required, and there is excellent anesthesia and akinesia.

Adult↗
PubMed1979

Congenital miosis.

The inheritance of congenital miosis in 2 pedigrees is described. The inheritance was autosomal dominant in one and autosomal recessive in the other. The pupils were 0.5-2.5 mm diameter, reacted normally to light and accommodation but dilated poorly with mydriatics. In both pedigrees, the affected members had enlarged corneas. The five members in the autosomal dominant family were myopic and had translucent peripheral irides. Iridodonesis was presented in both members of the autosomal recessive pedigree. The embryology and innervation of the iris muscles together with the ocular abnormalities and syndromes associated with congenital miosis are reviewed.

Adult↗
PubMed1982

[Preliminary study of the topical use of thymoxamine].

In this work the Authors have tried to show the efficacy of TMX, as a miotic drug, and to find out the lowest concentration which can give the best results with the minor complications. Seven patients, in whom TMX was instilled in both eyes at 0.50%, 1%, 2% concentrations, were studied. A mydriatic was instilled before in the right eye, in order to obtain mydriasis whereas the left eye served as control. The 0.5% concentration was as efficacious as 1% and 2% ones, but had less side-effects.

Administration, Topical↗
PubMed1982

Mydriasis induced by tetrahydrocannabinol (THC) in rats.

Male albino rats, injected intravenously or intracerebroventricularly with delta 1-tetrahydrocannabinol (THC), develop mudriasis. The median effective dose of the intravenous administration group was 5 mg/kg THC, whereas that for the intracerebroventricular route was 150 microgram/kg THC. Sympathectomy significantly decreased the THC-induced mydriasis. The mydriatic effect was not influenced by naloxone. We conclude that THC produces mydriasis through a central action, the efferent pathway of which is the sympathetic system.

Animals↗
PubMed1983

[Pupillometry: a non-invasive pharmacokinetic and pharmacodynamic method to study the action of trospium chloride (Spasmo-lyt) on smooth muscle].

The basic principle of pupillometry is to measure the changes of pupillar++ diameter versus time. We used a special device: split lam stand, black and white television camera with monitor fixed to a Polaroid. Trospium chloride is a compound with anticholinergic efficacy. The injection of 0.8 mg of trospium chloride followed by oral administrations of 10, 20, and 40 mg showed increasing effects on the mydriatic reaction. Comparing the area under the curves made it possible to estimate the bioavailability of the compound.

Benzilates↗