SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A study of 30 subjects (10 normal and 20 having glaucoma) was done to find out the scleral rigidity in glaucoma cases as compared to normal. The effect of miotics, timolol (0.25%) and pilocarpine (2%) eye drops on the scleral rigidity in cases of glaucoma was observed.
A long (4-14 years, the mean period 7.8 +/- 1.5) follow-up of 52 patients with primary open-angle glaucoma, regularly administered clofelin instillations (over the entire follow-up) has demonstrated a manifest hypotensive and a good functional result of such therapy. Despite reduction of systemic arterial pressure induced by clofelin instillations, rheo-ophthalmography has shown enhanced blood stream in ocular vessels. 52 percent of patients were administered no miotics but only clofelin (16 patients, 28 eyes) or clofelin+timolol (11 patients, 17 eyes).
The authors previously reported light reflex abnormalities and adrenergic supersensitivity to topical epinephrine (DPE; dipivalyl epinephrine) of the pupils in patients with ocular hypertension (OH) and those with primary open angle glaucoma (POAG). In this investigation, we attempted to reconfirm pupillary light reflex abnormalities we reported previously, and to investigate the relationship between the normotensive effect of 0.1% DPE and the pupillary light reflex abnormalities in OHs and POAGs. A total of 11 OHs and 11 POAGs under good oculotensive control with neither mydriatics nor miotics were examined. They were measured by an open-loop photically stimulated infrared videopupilogram, and were neurologically diagnosed by comparing the simulated patterns of the light reflex made by topical autonomic agents. When we considered the progress of the stage of POAG, both OHs and POAGs showed satisfactory reproducibility of pupillary light reflex abnormalities. Other cases in which light reflexes altered, showed worsening of the visual field deficit, which was prominent when OHs developed into POAG. OHs with significant reduction of intraocular pressure (IOP) after topical administration of 0.1% DPE showed various kinds of abnormal pupillary light reflexes. On the contrary, cases with little reduction of IOP after 0.1% DPE instillation showed normal pupillary light reflexes in OHs and afferent pupillary defect on POAGs.
After the presentation of a newborn with congenital glaucoma, four additional members in two generations of a family were found to be affected with megalocornea. The absence of the disorder in the parents of three affected siblings can be explained by autosomal recessive inheritance, autosomal dominant inheritance or germ-line mosaicism. Each affected member showed iris stroma hypoplasia, miotic pupils and defects of the iris pigment epithelium. Less frequently encountered features included increased axial length, high myopia and congenital cataract. Most of the abnormalities can be accounted for by a disturbance in the growth and development of neural crest cells of the anterior chamber angle.
Effects of topical administration of a single dose of timolol maleate, a nonselective beta-adrenergic blocking agent, on intraocular pressure (IOP) and pupil diameter were evaluated in the normotensive eyes of 10 clinically normal cats over 12 hours. Mean (+/- SEM) normal IOP was 17.1 (+/- 1.1) mm of Hg and diurnal fluctuation was observed, with the highest IOP seen in the evening. Mean (+/- SEM) normal pupil diameter was 10.1 (+/- 0.5) mm. Topical treatment with 0.5% timolol resulted in reduction of IOP in treated and nontreated eyes. This effect was time-dependent and was first observed at 6 hours after treatment. Mean reduction of IOP was 22.3% in the treated eye and 16.3% in the nontreated eye. The treated eye had reduced pupil diameter at 30 minutes after treatment, and miosis persisted throughout the 12 hours of the study. Mean reduction of pupil diameter was 38.7%. A contralateral effect on pupil diameter was not seen in the nontreated eye. Topical administration of timolol maleate results in a reduction of IOP in treated and contralateral eyes, which supports the use of timolol for treatment of glaucoma in cats. In addition, the treated eye becomes miotic. This effect may indicate beta-adrenergic inhibition or alpha-adrenergic activation of the iris sphincter muscle. beta-Adrenergic blockade would then result in miosis.
Cataract surgery has evolved dramatically over the last 20 years largely because of developments in intraocular drugs and solutions, as well as intraocular mechanical devices used for removing cataracts. These include viscoelastic materials, intraocular miotics, intraocular irrigating solutions, and intraoperative mydriatics. It also involves attention to subtle details which may cause idiopathic postoperative corneal edema such as the avoidance of using surfactant cleaners or soaps on instruments that are used in the eye. The following discussion briefly outlines some of the intraocular drug issues of which cataract surgeons need to be aware.
The prolonged in vitro release of pilocarpine (1) from preparations containing polyacrylic acids were represented consecutively . A preparation of polyacrylic acid-F (PAS-F; an acrylic-methacrylic acid copolymer) does not irritate the eyes. According to miotic activity tests in rabbits, the activity is prolonged by PAS-F as well as Carbopol 940 preparations. Differences between the compared preparations are not obtained. In human studies, the 1 action is prolonged and the intensity is increased by PAS-F and Carbopol containing preparations compared with aqueous 1 solution (relative bioavailability about 200%; the duration of the intraocular pressure is 4.5 times in the therapeutical relevant level). A polymeric salt of 1 and PAS-F was particular suitable in this study.
The paper reports on the main pathogenic types of anatomical blocking of the aqueous humor circulation in malignant glaucoma: pupillary, secondary iridolenticular, ciliovitreolenticular, iridociliovitreous blocks and in suprachoroidal effusion. The paper also presents some of the entities correlated with malignant glaucoma: glaucoma with blocked angle following the administration of miotics, traumatisms, the operations of scleral obstruction for retina detachment, panretinal photocoagulation and thrombosis of the retina central vein.
In patients with primary open angle glaucoma (POAG), the evaluation of neurological status is clinically important. A detailed analysis of the pupillary dynamics under the control of the autonomic nervous system was performed in patients with POAG. Pupil size and pupillary light reflex were measured by an infrared videopupillogram in 13 patients with POAG (from 25 to 67 years old) with good oculotensive controls without applications mydriatics nor miotics revealed. Pupillary light reflexes were analyzed by comparing the simulated patterns obtained after the studies with topical autonomic agents. Effects of topical adrenergics (dipivalyl epinephrine: DPE 0.025%) on the pupil were also investigated. Three types of autonomic abnormalities (cholinergic, adrenergic and physiological mydriatic reflex patterns) of the light reflex were detected in 11 eyes of 6 patients, and a normal pattern was found in only 2 eyes of one patient. Afferent pupillary defect (APD) pattern was detected in 13 eyes. Although APD was generally described as a reduced visual input, the degree of APD was not related to the stage of the visual field defect in POAG.
In a limited group of open angle glaucoma patients treated twice daily with timoptol 0.5% and having by this treatment a mean intra-ocular pressure of 21-22 mmHg, the association of timoptol 0.5% with pilocarpine 2% respectively, lowered the intra-ocular pressure to an average of 17.8 mmHg and 16.6 mmHg after one and three weeks of continuous treatment. For this study, the patients have been divided into 3 groups: A group treated with timoptol 0.5% alone throughout the 49 days of the study. A group treated with timoptol 0.5%-pilocarpine 2% (timpilo 2) from day 21 to day 49. A final group treated with timoptol 0.5% until day 21 and then with timoptol 0.5%-pilocarpine 4% (timpilo 4) through out day 49. These patients stopped the treatment before the end of the study. Intra-ocular pressures were measured on days 0, 21 and 49. We found a higher drop of pressure (-4.8 mmHg) in the timpilo 2 group than in the timoptol 0.5% group (-1 mmHg) before instillation as well as 2 hours afterwards (-5.25 mmHg and -2 mmHg respectively). The secondary local effects were due to miotics agents. The secondary systemic effects were those inherent to beta-blockers. These results are comparable with a multicentric study of 220 patients, therefore statistically significant.
A nonpigmented iris stromal cyst was observed in the right eye of a 6-week-old girl. There was no past history of trauma or use of topical miotics, and the remainder of the ocular examination was normal. The pathophysiology and management of this rare developmental anomaly are controversial.
The paper deals with the question about surgical treatment of patients with glaucoma associated with cataract. A new technique of one-stage extracapsular cataract extraction with sinusotrabeculotomy is proposed. Its main point is a change in the sequence of stages: stage I--opening of anterior lens capsule, stage II--antiglaucomatous operation, stage III--extraction of lenticular nucleus and masses through a corneal incision. The operation was made in 30 patients (31 ages). The follow-up period was 2 years. Normalization of intraocular pressure was achieved in all patients, in one eye--miotics had to be used. All patients showed a rise of visual functions: in 21 of 31 eyes vision rose to 0.3 and higher. In one patient vision fell after a year because of progression of the glaucomatous process in the presence of normal intraocular pressure. One-stage extracapsular cataract extraction with sinusotrabeculotomy can be made at any stage of glaucoma. By the authors' data, contraindications can be a rise of intraocular pressure above 40.0 mm Hg as well as the presence of a single eye and severe course of hypertonic disease.
The study of pupil response to stimuli applied at the corneal level is particularly interesting for the study of integrative sensory-vegetative functions in both physiological and clinical research. In the present study we tried to evaluate and describe pupil response to quantified corneal stimuli in 7 healthy subjects by means of a binocular TV pupillometric device. The pupil response to corneal stimuli was bilateral, direct and consensual. It was characterized by a biphasic progression with an initial response in mydriasis and a later miotic component which was smaller, slower and of longer duration. A direct correlation was observed between the intensity of the stimulus applied and the extent of the mydriasis and between the intensity of the stimulus at the corneal level and the length of the mydriatic response.
12(R)-hydroxyeicosatetraenoic acid (12(R)HETE) is an endogenous corneal epithelial arachidonic acid metabolite formed by the cytochrome P450 system and a potent inhibitor of Na(+)-K(+)-ATPase activity. We studied the effect of topically applied 12(R)HETE, either derived endogenously from corneal epithelium or synthetically prepared, on the IOP of the rabbit eye and compared it to its stereoisomer 12(S)HETE. Topical application of 1 microgram of biologically derived 12(R)HETE to both eyes of rabbits resulted in a marked reduction in IOP: a reduction of 4-7 mmHg occurred within 30-120 min. The IOP reduction effect of a single application of 12(R)HETE was long-lasting (9 days), whereas no effect on IOP was found for the vehicle control. Using synthetic compound, we demonstrated that the effect of 12(R)HETE on IOP is dose-dependent. Single topical application of 1, 10, and 50 micrograms of 12(R)HETE caused a reduction in IOP of 4, 6, and 12 mmHg, respectively. The stereoisomer, 12(S)HETE, did not have any effect on IOP at doses up to 5 micrograms. The IOP reduction effect of 12(R)HETE was not associated with hyperemia, appearance of flare, miotic response, or increased protein concentration of the aqueous humor. This study was the first to demonstrate that an endogenous inhibitor of Na(+)-K(+)-ATPase generated by the corneal epithelium potently and specifically lowers IOP in rabbits. Further studies are needed to elucidate the mechanism by which 12(R)HETE lowers IOP.
The laser scanning ophthalmoscope offers tissue examination and support of papillometrical evaluations as a result of different forms of illumination. Confocal, mixed, and Tyndall light are used in the differential diagnosis and identification of the scleral rim. With highpower mixed light under miotic conditions, imaging of the excavation is possible.
Thirty patients (60 eyes) with bilateral open angle glaucoma in whom normalization of the IOP could not be obtained by a conservatory treatment with miotics are presented. In the period of 3 months they were given twice daily a 0.5% solution of Vistagan-Liquifilm, a compound blocking as well the beta 1 as the beta 2 receptors. After 2 weeks 76.7 p.c. of the treated eyes showed a normalization of the intraocular pressure and 23.3 p.c. an improvement. After 3 months the IOP was normalized in 73.3 p.c.; an improvement showed 26.7 p.c. of the eyes. The compound was well tolerated and did not cause any complications from the side of the respiratory or circulatory system.
If a pupil becomes irreversibly miotic during cataract surgery it is helpful to perform an iridotomy to facilitate lens expression. Reconstructing the pupil with one or two iris sutures is advisable in order to prevent coloboma-related problems. We describe a method of iridoplasty that involves using a vanadium steel suture attached to a long, straight needle. This technique can be used in an eye with surgically low pressure as well as in an eye with elevated vitreous pressure.
The immediate response of the rabbit eye to noxious stimulation is mediated neurogenically through antidromic sensory activation and subsequent action of neuropeptides, CGRP, and substance P or a related tachykinin. The rise in ocular tension and breakdown in the BAB in response to injury are initiated by dilation and increased permeability of the ciliary vessels, which bring about disruptive alterations in the squamous epithelium covering the anterior part of the iridial processes and ciliary ridge. PGs formed during the response to certain types of irritation can enhance the ocular changes to trauma by facilitating the neurogenic pathway. In the rabbit eye substance P acts as a strong miotic in response to injury but has no effect on the IOP rise or disruption of the BAB. Conversely, CGRP is a potent vasodilator that displays no spasmogenic action. Species differences in the ocular response to injury have been observed, with lower mammals such as rabbit and rat generally being more responsive than higher mammals. For the most part, these differences are related to the organization of the iris-ciliary complex and to the sensitivity of the effector elements to the neuromediators. Reciprocal modulation exists between the autonomic and sensory nervous elements and the tissue they innervate, so that altered sensitivity of the effector cells develops in selectively denervated eyes. Chronic sympathetic denervation causes hypersensitivity of the eye to irritation. This increase is owing largely to hypertrophied sensory elements with increased sensory neuropeptide levels and consequently augmented sensory activity. Conversely, chronic sensory denervation is accompanied by an increase in catecholamine-forming enzymes and in the neuropeptide NPY. Future research will no doubt reveal neuromodulation of homeostatic, inflammatory, and vegetative processes and the ability of ocular tissues to recover from wounding. Both the discovery of biogenic neuropeptides in peripheral nervous elements of the eye alongside the classical transmitters and the elucidation of their profound effects on the eye afford scope for the development of potential new therapeutic agents.