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PubMed1985

Posterior vitreous detachment. A combined clinical and physiochemical study.

Sixty-one postmortem eyes were examined with clinical methods (slit lamp) and later sectioned for measurement of the liquid and gel vitreous. The amount of liquid vitreous was found to be progressively greater with increasing posterior vitreous detachment (PVD), and it was concluded that slit-lamp examination is a reliable method of evaluating the rheological state of the vitreous in the living eye. The total content of sodium hyaluronate (NaHA) in the vitreous was measured. Eyes proven to have no PVD had a higher concentration of NaHA than eyes with total PVD. Also, females had a lower concentration than males. There was no significant difference in NaHA concentration between the gel and liquid vitreous. The role played by different structural elements for the stability of the vitreous gel is discussed.

Aged↗
PubMed1989

Characterized and predictable rabbit uveitis model for antiinflammatory drug screening.

A model has been developed for the screening of antiinflammatory ophthalmic drugs in rabbits. This simple and rapid method is reproducible and uses fewer animals than do some other methods. Rabbits are sensitized to bovine serum proteins, then challenged intravitreally to induce a uveitis. The basis of the inflammatory response is shown to be due primarily to an immunologic mechanism. At 24 hr postchallenge, animals are sorted into treatment groups of approximately equal "titer" as defined by the slit lamp examination iris score which measures the magnitude of the immunologic response. Topical ocular treatment (control or drug) is then initiated and continued for a total of four days. Iris inflammation is evaluated by daily slit lamp exams. Results indicate that this model has statistically narrower frequency distribution of iris ratings than another published method, and is faster than other equally accurate and precise methods that depend upon blood antibody titer to sort animals.

Administration, Topical↗
PubMed2003

Ocular surface changes and tear film alterations associated with sun gazing during a solar eclipse.

PURPOSE: A solar eclipse occurred in central Europe on August 11th, 1999. Following the eclipse, patients with ocular symptoms were investigated. Gazing at the sun without protection is liable to damage the retina. Our attention was focused on changes of the ocular surface and the tear film. METHODS: Forty-three patients were investigated within one week after the solar eclipse as baseline. 33 of them were followed up one year later. Visual acuity and the central visual-field were measured, and the ocular surface and the fundus were examined using a slit lamp. The quality of the lacrimal tear film was examined using Schirmer's test for the aqueous layer, break-up time for the mucous layer and interference observation for the lipid layer, measured by a slit lamp and a tearoscope. RESULTS: At the baseline 19 patients had non-specific visual problems. Pathological alterations of the tear film were seen in all three tear-film layers: Schirmer's test was pathological in 87%, break-up time decreased in 85%, the interference pattern of the lipid layer changed in 67% and there were changes in 87% using the tearoscope. One year later the non specific visual disorders had disappeared. Schirmer's test did not reveal much change from the baseline: 51% pathological, 24% remained pathological in break-up-time and the lipid layer was normalized except in 9%. Using the tearoscope, lipids were better than grade 3 in all patients. CONCLUSION: After gazing at a solar eclipse the ocular surface and tear film changed. While the aqueous layer remained pathological in many patients, the lipid layer and the mucous layer recovered spontaneously.

Adult↗
PubMed1975

Optic disk topography and visual field defects in patients with increased intraocular pressure.

One hundred one eyes of 54 ocular hypertensive patients were studied to determine the value of optic disk evaluation in predicting the presence or absence and the location and type of visual field defects by means of binocular slit-lamp examination and projected 35-mm monocular color slides. We suspected visual field loss erroneously in only one patient, and failed to detect ten (16%) of 61 eyes with field defects. An examiner experienced in slit-lamp evaluation of the optic disk can accurately predict the presence, absence, and location of field defects in most cases by stereoscopic evaluation of disk topography.

Adult↗
PubMed1998

Corneal thickness in Fuchs' dystrophy with and without epithelial oedema.

PURPOSE: To investigate whether the occurrence of epithelial oedema in Fuchs' endothelial dystrophy is associated with a particular corneal thickness or the extent of central corneal guttae. METHODS: Sixty-seven patients, aged 52-90 years, presenting in our clinic with Fuchs' dystrophy were divided on the basis of the presence or absence of epithelial oedema as determined by slit lamp examination. After exclusion of extreme cases, the 56 cases without oedema were compared with the 10 cases with oedema with respect to corneal thickness, measured by ultrasound pachymetry and corneal guttae diameter, obtained from the slit lamp examination. RESULTS: Mean corneal thickness was significantly higher (p = 0.002) in the oedematous group (mean = 0.682 mm) than in the group without epithelial oedema (mean = 0.624 mm). A corneal thickness greater than 0.650 mm was associated with a greater than 85% probability of oedema occurrence. Corneal guttae diameter did not differ significantly (p = 0.941) between the two groups and was not significantly correlated with corneal thickness (p = 0.269). CONCLUSION: There is a demonstrable association between epithelial oedema and the measured thickness of the cornea.

Aged↗
PubMedDate not supplied

A simple accurate method of cataract classification. Cataract-I.

A simple and accurate system of cataract classification using slit lamp and direct ophthalmoscope is reported. Lens opacities are classified into cortical (anterior and posterior), nuclear and posterior sub-capsular and each sub-type of opacity is graded, extent and density wise, using both slit lamp and direct ophthalmoscope. A circle representing enface view of opacity divided into 100 equal parts is used in calculating the area of each opacity. This classification takes into account both the area and depth of opacity in arriving at the total extent of sub-type of each opacity. For density determination, we do not recommend the use of a resolution target projection ophthalmoscope. Intra-observer and inter-observer variability studies using this classification system indicated that the classification system is fairly reliable.

Cataract↗
PubMed1990

A comparison of en face and tangential wide-area excimer surface ablation in the rabbit.

We used an argon fluoride excimer laser (193 nm) to perform anterior corneal surface ablation in New Zealand white rabbits (25 eyes) using both en face and tangential methods. We followed up the animals for 90 days using slit-lamp photography and pachymetry at predetermined intervals. We also examined selected tissues with scanning electron microscopy and transmission electron microscopy. Immediate and subsequent examinations revealed significant differences in clarity between the two groups. When viewed through slit-lamp microscopy, the rabbits undergoing the en face method exhibited hazy corneas and irregular surfaces, whereas the corneas that underwent tangential keratectomy demonstrated less haze and fewer surface irregularities. Through histologic study and electron microscopy, we corroborated this finding. At 30 days, there was a statistically significant difference in clarity between en face--treated corneas and those treated tangentially.

Animals↗
PubMed1995

A comparison of topical diclofenac with prednisolone for postcataract inflammation.

OBJECTIVE: To compare diclofenac sodium with prednisolone acetate for the control of postoperative inflammation after cataract surgery. DESIGN: Fifty-two patients undergoing phacoemulsification with posterior chamber intraocular lens implantation were randomly assigned to receive either 0.1% diclofenac eye drops or 1% prednisolone eye drops as their postoperative anti-inflammatory medication. The patients were examined 1 day (baseline), 1 week, and 1 month after surgery. Postoperative inflammation was evaluated subjectively by slit-lamp assessment of cell and flare and objectively by measurement of cell and flare with a laser cell and flare meter. RESULTS: At each visit, there was no statistically significant difference in postoperative inflammation either by slit-lamp assessment or with the laser cell and flare meter for the two treatment groups. CONCLUSION: In the dosage used, diclofenac was as effective an anti-inflammatory agent for uncomplicated post-cataract inflammation as prednisolone.

Administration, Topical↗
PubMed1997

Should we patch corneal erosions?

OBJECTIVE: To study the effect of patching on the speed of reepithelialization, slit-lamp signs of epithelial wound healing, and patient discomfort following a corneal abrasion. METHODS: Forty-eight eyes of 46 patients with corneal erosion sparing Bowman membrane were randomized into 2 groups: with or without patching. Slit-lamp examination and photographs of the fluorescein-stained cornea were performed on a daily basis until reepithelialization was complete. Photographs were analyzed using computer-assisted planimetry. RESULTS: No statistically significant difference was found between patched (n = 25) and nonpatched (n = 22) eyes for the mean size of the initial erosion (patched eyes, 23.7 mm2; nonpatched eyes, 18.9 mm2; P = .42), linear speed of reepithelialization (reduction over time of the radius of the largest circle included in the erosion: patched eyes, 0.0375 mm/h; nonpatched eyes, 0.0353 mm/h; P = .78), and surface speed of reepithelialization (reduction over time of the erosion area: patched eyes, 0.6510 mm2/h; nonpatched eyes, 0.5657 mm2/h; P = .60). The power to detect a 12-hour delay of epithelial closure was 95%. There were no significant differences between the 2 groups for pain, analgesia, insomnia, aspect of the epithelial border, intensity and duration of stromal edema, Descemet folds, anterior uveitis, and filaments. CONCLUSIONS: Patching a corneal erosion does not significantly accelerate reepithelialization and does not alter the epithelial wound healing pattern. It does not reduce the incidence and severity of inflammation nor relieve pain when compared with treatment without patching.

Adult↗
PubMed1983

Stromal damage in rabbit corneas exposed to CO2 laser radiation.

Threshold damage to the cornea from CO2 lasers is confined to the epithelium. Exposures well above the threshold for epithelial damage produce bowl-shaped stromal wounds. Light and electron microscopy and slit-lamp photographs all show a sharp demarcation between the damaged and undamaged regions 48 hr after exposure. The micrographs also show that the damaged region is accellular. Calculations of the expected temperature increases combined with analyses of slit lamp photographs show that the wound boundary corresponds to a surface of equal peak temperature increase. Comparisons with epithelial and endothelial damage conditions suggest that stromal, endothelial and epithelial cells have essentially the same thermal damage mechanism.

Animals↗
PubMed2005

Comparison of efficacy of oral valacyclovir and topical acyclovir in the treatment of herpes simplex keratitis: a randomized clinical trial.

Thirty eyes of 28 patients with herpetic disease were included in the study. Group 1 patients (15 eyes of 15 subjects) received topical acyclovir (ACV) ointment. Oral valacyclovir (VACV) was prescribed to group 2 (15 eyes of 13 patients). The anterior segment of each eye was carefully examined by slit lamp and scored. Each patient was also instructed to grade his/her subjective symptoms. The corneal lesion healed significantly faster in the group 2 eyes compared to the group 1 eyes. Photophobia score on day 3 and slit-lamp score on day 10 were at significantly lower levels in group 2 compared to group 1. In herpetic keratitis, oral VACV can be a good alternative to ACV ointment therapy.

Acyclovir↗
PubMed2004

[Observation of early closure of idiopathic macular hole after vitrectomy surgery with internal limiting membrane peeling].

PURPOSE: To observe the early closure of idiopathic macular hole after vitrectomy surgery with internal limiting membrane (ILM) peeling. METHODS: Retrospectively, 25 eyes of idiopathic macular hole in 25 patients were performed vitrectomy surgery with ILM peeling from January of 2001 to October of 2003. All patients maintained the prone position at least 2 weeks after surgery. Slit-lamp examination and optical coherence topography (OCT) were performed to observe the closure of macular hole during 1 month post-operatively. RESULTS: All but 2 eyes of the ILM around the macular hole were peeled successfully. Slit lamp examination showed the configurations of macular hole disappeared in 23 eyes in 24-48 hours post-operatively and OCT confirmed the macular holes were closed in these eyes during 1 month after surgery. The anatomical closure rate was 92%. The repaired macular holes were classified by the OCT images as being of "simple closure" or "bridge shape". CONCLUSIONS: The majority of the idiopathic macular holes were closed in the early stage after surgery. It suggests that there are no or very little tissue loss in the process of idiopathic macular hole, after dismissing the mechanic traction caused by vitreous especially ILM, the hole could be closed.

Adult↗
PubMed1980

[Results of long-term treatment of glaucoma with timolol ophthalmic solution (author's transl)].

A previous double-blind study carried out for 17 weeks on 50 patients with open-angle glaucoma reported on the results of treatment with Timolol and Pilocarpine eye drops. On completion of a long-term study with Timolol over a two-year period, the remaining findings can now be given. Of the 25 patients treated twice a day with 0.1% to 0.5% Timolol eye drops, intraocular pressure was not adequately controlled in six patients with the use of Timolol alone, and treatment had to be discontinued after three to five weeks. In the remaining 19 patients, intraocular pressure was controlled well over the entire two-year period, but in some cases it was necessary after a while to increase the dosage to a higher concentration. The following checks were carried out regularly in accordance with a fixed schedule: intraocular pressure, tonographic examination, visual acuity, pupil size, visual field, pulse and blood pressure, tear production (Schirmer test), slit-lamp biomicroscopy and fundaloscopy. Evaluation of the results shows that in the long term Timolol reduced intraocular pressure by 31%. There were no changes in visual acuity, visual field, excavation and degeneration of the optic disc, or slit lamp examination findings. During treatment with Timolol the mean pulse rate decreased by 12%, and there was a drop in blood pressure of 3.8% systolic and 2.8% diastolic. Moreover, tear production decreased by 10.2%. During the entire observation period there were no local or systemic side-effects, nor any adverse reaction. The six patients whose intraocular pressure was not reduced satisfactorily by Timolol alone were treated successfully with a combination of Timolol and miotics. A dosage without additional Timolol would not have sufficed for any of the patients.

Clinical Trials as Topic↗
PubMed2005

Effectiveness of topical taurolidine versus ciprofloxacin, ofloxacin, and fortified cefazolin in a rabbit Staphylococcus aureus keratitis model.

PURPOSE: Taurolidine is a broad-spectrum, non antibiotic antimicrobial agent, not previously tested against the common causes of bacterial keratitis. This study, employing an experimental rabbit model of Staphylococcus aureus keratitis, investigated the effectiveness of topical taurolidine in reducing the number of bacteria, and its effectiveness was compared with topical ciprofloxacin, ofloxacin, and 5% cefazolin. METHODS: The right corneas of all rabbits were intrastromally injected with 100 colony-forming units of Staphylococcus aureus ATCC strain 25923. The animals were divided into the following seven groups: Group 1 (6 rabbits) received taurolidine, group 2 (6 rabbits) received ciprofloxacin, group 3 (6 rabbits) received ofloxacin, group 4 (6 rabbits)received cefazolin, group 5 (5 rabbits) received polyvinylpyrrolidone (vehicle),group 6 (4 rabbits) received sterile water, and group 7 (4 rabbits) was left un-treated (control group). The eyes were topically treated every 30 min with the above-mentioned substances from 4 to 9 h postinjection. One hour after the last drop administration (at 10 h postinjection), signs of inflammation were scored in a masked fashion by slit-lamp examination. Then, their corneas were processed. The number of colony-forming units (cfu) per cornea in all eyes was also determined. RESULTS: All antimicrobial (taurolidine, ciprofloxacin, ofloxacin, and cefazolin) treatments significantly reduced cfu numbers and slit-lamp examination scores compared with untreated eyes, eyes that received the vehicle, or eyes with sterile water (all p values <0.05). Regarding cfu numbers, although taurolidine therapy was significantly less effective than ciprofloxacin or ofloxacin,there was no significant difference between taurolidine and cefazolin groups.However, taurolidine had similar clinical examination scores with the other antimicrobials, while it had lower scores than the vehicle, sterile water, or un-treated eyes. CONCLUSIONS: The results obtained in this study suggest that topicaltaurolidine is an effective, novel ocular chemotherapeutic agent for the therapy of rabbit experimental Staphylococcus aureus keratitis. This drug may be a useful and promising ocular antimicrobial.

Administration, Topical↗
PubMedDate not supplied

Radial keratotomy clear zone diameter errors.

PURPOSE: To examine the variability of achieved clear zone diameters following radial keratotomy and to determine if refractive outcomes are correlated to clear zone diameter errors. METHODS: Twenty-six patients with radial keratotomy (51 eyes) were studied retrospectively. The central clear zone diameter for each radial incision meridian was measured using a slit-lamp and a photograph. The achieved clear zone diameters were statistically compared to the intended clear zone sizes and to the refractive outcomes. RESULTS: Twenty-nine of the 51 eyes met various exclusion criteria. Ninety individual slit-lamp clear zone measurements were obtained for the remaining 22 eyes. Sixty-two of 90 (69%) achieved clear zone diameters were more than 0.25 mm different than the intended clear zone size. A maximum difference of +/- 0.80 mm from the intended clear zone marker size was observed. The average clear zone diameter error did not statistically differ between the three refractive outcome groups (undercorrection, emmetropia, and overcorrection). CONCLUSIONS: In selected cases of centripetal radial keratotomy, the achieved clear zone diameter can vary widely from the intended clear zone size despite extensive surgeon experience.

Cornea↗
PubMed1984

Effect of 8-methoxypsoralen on rat lens cations, membrane potential and protein levels.

Systemic application of 8-methoxypsoralen to rats, followed by u.v.-irradiation, induces a minor change in the lens membrane potential after one week, and by this time marked histological changes have already occurred. Alterations in lens sodium and potassium concentrations followed these early changes and coincided with the appearance of small light-scattering vacuoles when the lenses were examined in vivo with a slit lamp. Dramatic changes in the dry weight, soluble protein and calcium content of the lenses were apparent only after eight weeks from the start of treatment, and these changes coincided with the appearance of very large vacuoles in slit-lamp examinations of the eye.

Animals↗
PubMed2000

Pterygium-induced corneal astigmatism.

BACKGROUND: Previous work has suggested an association between increasing size of pterygium and increasing degrees of induced corneal astigmatism. OBJECTIVES: To assess the quantitative relation between pterygium size and induced corneal astigmatism using a computerized corneal analysis system (TMS II) and slit-lamp beam evaluation of pterygium size, and to conclude whether corneal astigmatism is an early indication for surgical intervention. METHODS: We evaluated 94 eyes of 94 patients with unilateral primary pterygium of different sizes, using TMS II and slit-lamp beam measurements of the size of the pterygium (in millimeters) from the limbus to assess parameters of pterygium size with induced corneal astigmatism. Best corrected visual Snellen acuity was performed. RESULTS: Primary pterygium induced with-the-rule astigmatism. Pterygium extending > 16% of the corneal radius or 1.1 mm or less from the limbus produced increasing degrees of induced astigmatism of more than 1.0 diopter. Significant astigmatism was found in 16.16% of 24 eyes with pterygium of 0.2 up to 1.0 mm in size, in 45.45% of 22 eyes with pterygium of 1.1 up to 3.0 mm in size (P < or = 0.0004), and in 100% of 3 eyes with pterygium of 5.1 up to 6.7 mm in size (P = 0.0005). We found that visual acuity was decreased when topographic astigmatism was increased. CONCLUSIONS: When primary pterygium reaches more than 1.0 mm in size from the limbus it induces with-the-rule significant astigmatism (> or = 1.0 diopter). This significant astigmatism tends to increase with the increasing size of the lesion. Topographic astigmatism tends to be improved by successful removal of the pterygium. These findings suggest that early surgical intervention in the pterygium may be indicated when the lesion is more than 1.0 mm in size from the limbus.

Astigmatism↗
PubMedDate not supplied

Increased tear evaporation in a patient with ectrodactyly-ectodermal dysplasia-clefting syndrome.

PURPOSE: To describe the tear function and ocular surface disorders in a patient with ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome. METHODS: Routine ophthalmic examinations were performed, including slit-lamp biomicroscopy, anterior segment photography including transillumination photos of the lids, Schirmer tests I and II, tear film break-up time (BUT) assessment, corneal fluorescein staining, DR-1 tear film lipid layer interferometry, and tear evaporation rate measurements. RESULTS: Slit-lamp examination revealed conjunctival hyperemia, superficial punctate keratopathy, and corneal leucoma with neovascularization. Although the Schirmer test values were within normal limits, the BUT value was 0 s in both eyes. Transillumination of the lids showed the absence of meibomian glandular structures. DR-1 tear film lipid layer interferometry results were dry eye grade 5 with an irregular tear film, areas of corneal surface exposure, and several dry spots. The tear evaporation rate was elevated and was measured as 6.98 x 10(-7) g/cm2 per second (normal, 4.1 +/- 1.4 x 10(-7) g/cm2 per second). CONCLUSION: The ocular surface disorder and shortened BUT in EEC syndrome were attributed to the absence of meibomian glands, leading to lipid layer deficiency in the tear film with a concomitant increase in tear evaporation.

Adolescent↗