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At least 811 records · Page 45Linked to original sources
PubMed1990

Cytotoxicity studies in ophthalmology.

Ocular tissues and cells are more and more in direct contact not only with drugs but also with biomaterials, such as contact lenses, intraocular implants, corneal shields, and the cell reactivity study is an indispensable step before any clinical and human utilization. The cell toxicity may be direct, by cell membrane damaging, metabolic disturbance, or indirect by mitosis or cell differentiation blocking. In order to evaluate the unwanted effects, cell cultures are performed according to the drug or to the biomaterial to be tested: conjunctival and corneal epithelial cells, lens epithelium, ciliary processes epithelium... In this report, the cytotoxicity of three substances were evaluated on corneal cultured cells: Benzalkonium chloride (BAK), an ophthalmic preservative; Novesine (Oxybuprocaine + BAK), local anaesthetic; Neosynephrine (Phenylephrine chlorydrate), a commonly used mydriatic in ocular surgery. Results of cell counting (cell viability) are given according to curves and histograms (percentage of dead cells depending on time and doses). These data are discussed according to the different mechanisms of action of the three drugs BAK and Oxybuprocaine were found to exert a more direct cell toxicity whereas phenylephrine chloride acted indirectly by causing the sloughing of the cell monolayer.

Anesthetics, Local↗
PubMedDate not supplied

The trigeminal pupillary reflex as a model of vegetative-nociceptive interaction: physiological and clinical aspects.

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.

Adult↗
PubMed1990

[An epidemiological survey of primary angle-closure glaucoma (PACG) in Tibet].

The authors compared the results of a prevalence study of primary angle-closure glaucoma (PACG) in Duilong-Deqing county, suburb of Lhasa, Tibet in 1987, with those of a similar study in Shunyi county, suburb of Beijing in 1985. The prevalences of PACG in subjects over 20 years and over 40 years of age were 0.08% and 0.15% respectively in Tibet, significantly lower than the corresponding figures of 0.62% and 1.17% in Shunyi (P less than 0.001). The incidence of shallow anterior chamber in Tibet was much less than that in Beijing, in consistency with the low prevalence of PACG in Tibet. It was interesting to note that no acute attacks of PACG occurred after mydriasis with neosynephrine among Tibetians, while in Beijing, 6 cases of PACG occurred during mydriatic examination in subjects over 50 years of age.

Adult↗
PubMed1990

Reduced mydriasis from repeated doses of tropicamide and cyclopentolate.

Pupils are often dilated for examination the day before surgery and again on the day of surgery. The following experiment was performed to determine the effect of serial doses of two commonly used mydriatic agents: on two consecutive days the pupil of one of the eyes of 28 subjects was dilated with tropicamide 1%, and the pupil of one of the eyes of 30 subjects was dilated with cyclopentolate hydrochloride 1%. The other eyes in both groups were dilated only on the second day, and thus served as controls. Pupil sizes were measured from photographs before and after dilation. The pupils of the eyes treated twice with either drug did not dilate as well after the second dose as those of the control eyes (P less than .005 for tropicamide, P less than .001 for cyclopentolate). The pupils of the eyes twice-treated with tropicamide were an average of 0.15 mm smaller than the control pupils; those twice-treated with cyclopentolate were 0.36 mm smaller. For subjects treated with cyclopentolate, this decreased mydriasis was related to age (P less than .05) and to eye color (P less than .025): the younger and blue-eyed subjects dilated less on the second day than the older and brown-eyed subjects. If full mydriasis is required at surgery, pupils should probably not be dilated with either tropicamide or cyclopentolate the day before surgery.

Adult↗
PubMed1989

Acanthamoeba keratitis: report of three cases.

During the last year we diagnosed three patients to have Acanthamoeba keratitis. In one patient, who wore soft contact lenses, keratitis had developed after swimming in a contaminated heated swimming pool. Neither a history of trauma was present in two other patients nor did they wear contact lenses. Diagnosis of Acanthamoeba was established by Calcofluor White (cellufluor) staining of the scraped corneal material. Patients were treated with Flagyl (metronidazole) 0.5% eyedrops, Brolene (propamidine isethionate) 0.1% eyedrops, Neomycin eyedrops, topical corticosteroids (including sustain-release corticosteroid subconjunctival injections) and mydriatics. Keratitis in one patient healed within one month with full visual recovery, whereas the disease nearly ameliorated in the second patient. Corneal inflammation subsided markedly in the third patient with medical therapy, but a keratoplasty had to be performed because of a central opaque and ectatic cornea. This patient had already developed severe keratitis with necrosis of the cornea at the time of diagnosis.

Acanthamoeba Keratitis↗
PubMedDate not supplied

[Mucosynechial conjunctivitis and bilateral corneal ulcers in Lyell's syndrome].

The patient, aged 44, presented fever and chills with altered general condition and received an analgesic-antipyretic treatment with salicylic acid and pyrazolon derivatives. A bullous eruption that followed was labelled incipient Lyell syndrome. Both cornea presented ulcers with a tendency to perforation and mucosynechial conjunctivitis. Pathogenic Staphylococcus albus was isolated from the conjunctival secretion. The ocular phenomena improved under mydriatic treatment and trophic medication. Lyell's syndrome is the result of a severe medicamentous toxemia. Stress is laid on the role of Staphylococcus aureus, phage type 71, in the process of epidermal necrosis with detachment of the epithelium and ulceration of the mucosa.

Adult↗
PubMed1989

[The effect of vasoactive intestinal polypeptide (VIP) on ocular inflammation in rabbit ocular tissue].

Intravitreous injection of vasoactive intestinal polypeptide (VIP) induced ocular inflammation in albino rabbits. Protein amounts and cell numbers in aqueous humor were measured. The effect of VIP on the release of cyclic AMP (cAMP) and prostaglandin E2 (PGE2) from the isolated albino rabbit irides was investigated. Mydriatic response was obtained by intravitreous injection of 0.5 microgram or less VIP. 5 microgram or more of VIP induced miosis and breakdown of the blood aqueous barrier. Intravitreous injection of VIP induced on increase of cAMP in the aqueous humor dose-dependently and a slight increase of PGE2. VIP induced a dose-dependent increase of cAMP release and slightly inhibit PGE2 release from isolated irides. In this study, a large quantity of VIP was injected intravitreously induced breakdown of the blood aqueous barrier. The effect of VIP on isolated irides was to activate the release of cAMP and to inhibit that of PGE2.

Animals↗
PubMed1989

[Autonomic dysfunctions in acute intermittent porphyria].

A young woman with acute intermittent porphyria is described. She was admitted in a prolonged attack and had developed a flaccid quadriplegia. During the course she showed various manifestations of the autonomic nervous system, including pupils, gastrointestinal tract, cardiovascular system and others. On admission her pupils were equally mydriatic, and reacted to light sluggishly. Dilation of the pupils was seen when cocaine was instilled, but not when adrenalin. It was suggested that the parasympathetic control of pupils was disturbed. She complained repeatedly abdominal pain, nausea, vomiting, and constipation. However, diarrhea was rarely found. Radiological examinations revealed that her bowel movements were markedly impaired. Sinus tachycardia and elevation of blood pressure were frequently observed with attacks, and they correlated with the clinical course. With tachycardia the coefficient variance of R-R interval was markedly decreased, and large dose of atropine failed to accelerate the heart rate. These indicate that the vagal function was markedly impaired with attacks. The effects of isoproterenol and of propranolol on the heart rate were normal. Phenylephrine and phentolamine changed the blood pressure normally. From these it was concluded that the sympathetic nervous function was not so impaired at the time examined. However, with the elevation of blood pressure plasma and urinary noradrenaline were markedly increased. Other autonomic and related manifestations observed during the course included disorders of sweating, loss of sphincter control, fever of unknown cause and amenorrhea.

Acute Disease↗
PubMed1989

[Progressive hemifacial atrophy with sympathetic nerve dysfunction of central origin].

A 37-year-old unmarried man was admitted because of gait disturbance and right hemifacial atrophy. Family history was unremarkable. He had an unconscious attack at age 13 and had writer's cramp since age 15. He was thin and lipodystrophic. In reviewing his portraits, hemifacial atrophy was considered to develop in his early teens and to be progressive since then. Pigmented gum, high arched palate, mild mental retardation, pseudo-Argyll Robertson's pupil, sexual impotence, amyotrophy of the left thigh and the right calf, and a limp due to bony abnormalities was detected. Serological tests for syphilis were negative. Bone X-rays disclosed coxa-deformance. Cerebrospinal fluid. EMG, EEG, muscle biopsy and brain CT were normal. Hearing was decreased to 20-35 dB bilaterally. Plasma norepinephrine levels were 450 pg/ml in the supine position and 539 pg/ml in standing. Plasma renin activity was 5.1-5.4 ng/ml/hr. Microneurography revealed highly accentuated muscle and skin sympathetic nerve activities. Hypothermia on the feet, reduced CVR-R and decreased mydriatic response to 5% cocaine instillation were present. Intravenous infusion of norepinephrine and intradermal injection of either acetylcholine or histamine revealed normal results. In the case, sympathicotonia due to dysfunction in the central nervous system is considered to be related to the pathogenesis of hemifacial atrophy.

Adult↗
PubMed1977

The ocular manifestations of juvenile rheumatoid arthritis.

We followed 210 cases of JRA closely for 14 years. Thirty-six patients (17.2%) developed iridocyclitis; it most frequently occurred in young females (0-4 years) with monarticular or pauciarticular form of the disease. In 30% of the patients iridocyclitis was first detected after 16 years of age. Forty-two percent had active iridocyclitis on entry. By combining quantitative antinuclear antibody titers with age, sex, and time on onset of arthritis, it has been possible to define the risk of developing iridocyclitis in individual patients. Our approach was effective in detecting iridocyclitis in new cases and exacerbations of the disease in established cases. Forty-four percent of patients with iridocyclitis had one or more identifiable early signs or symptoms. Iridocyclitis in 36% of patients did not respond to more than 6 months of intensive topical treatment with corticosteroids and mydriatics. Despite this statistic, patients had a better outcome than those experiencing the 50% incidence of blinding complications cited in earlier studies. Cataract and band keratopathy occurred in only 19% and 11% of our group, respectively. Only one case of chorioretinopathy was found in 173 patients who had received antimalarials; a significant number of posterior subcapsular cataracts were found in 75 patients who had received systemic corticosteroids. Keratoconjunctivitis sicca developed in 3 patients with iridocyclitis. Surgical treatment of cataracts, band keratopathy, and glaucoma achieved uniformly discouraging results.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Hereditary paracentric inversion of chromosome 3].

A complete uveal dysgenesis with absence of the anterior chamber and fixed mydriatic pupil was observed in the left eye of a boy. His younger sister and his father, and also the right eye of the patient showed similar but more discrete anterior uveal alterations. All three persons present some facial peculiarities. They are also heterozygous for a paracentric inversion of the short arm of chromosome 3. Four other cases with this chromosomal aberration were found in the literature, none with eye anomalies.

Chromosome Aberrations↗
PubMed1989

Transdermal delivery of drugs by iontophoresis: a review.

The advantages and limitations, theory, and factors in the use of electric current to deliver drugs across the skin are discussed. Application of the technique in the delivery of local anaesthetics, antibiotics/antibacterials, mydriatics, vinca alkaloids, non-electrolytes, biogenic amines, peptides, and other agents is reviewed. It is concluded that the method alone, or in combination with phonophoresis (delivery via ultrasonic perturbation), offers considerable scope in the transdermal delivery of drugs.

Administration, Cutaneous↗
PubMed1989

Pupil responsiveness in diabetes mellitus.

The authors compared pupil responsiveness to light, convergence, and the effects of topical cocaine 4%, epinephrine 1%, phenylephrine 1%, homatropine 10%, and pilocarpine 1% in a group of 62 diabetics with a sex- and age-matched group of normal subjects. The duration of disease, metabolic control, and type of diabetes mellitus, the presence and severity of diabetic retinopathy, and evidence of systemic vegetative neuropathy were considered. It was found that sympathetic denervation was related significantly to the duration of disease and to the development of systemic autonomic neuropathy. There were also signs of iris myopathy in the pupil alterations of long-standing diabetics, explaining the poor pupil responsiveness to mydriatics occasionally found in these patients. Pupillary autonomic diabetic neuropathy should be considered an early and major sign of the development of systemic vegetative diabetic disease.

Adolescent↗
PubMed1989

[Aqueous flare and cells after mydriasis in normal human eyes].

The influence of mydriasis on aqueous flare intensity and cell number was investigated in normal human eyes. A mixture of 0.5% phenylephrine and 0.5% tropicamide (Mydrin P) was topically instilled in 173 eyes of normal subjects ranging from 20 to 79 years old, and measurements with a laser flare-cell meter were carried out before and 1 hour after the application. For statistical analysis, subjects were divided into groups based on ten-year age intervals ranging from 20-29 years to 70-79 years. Aqueous flare intensity was significantly decreased by mydriasis in all age groups. Prior to drug application, aqueous cells were observed in none of the cases, while after mydriasis, apparent aqueous floaters appeared in 9.2% of the cases, all of whom were over 40 years of age. Appearance of aqueous floaters following mydriasis was not accompanied by an increase in aqueous flare intensity. Time course of changes in aqueous flare intensity after topical instillation of 5% phenylephrine and 0.4% tropicamide were investigated separately. Tropicamide decreased aqueous flare intensity in normal young human subjects, and values at 1 and 1.5 hours post-application differed significantly from those of the contralateral control eyes. The instillation of phenylephrine in normal young subjects resulted in a significant decrease of aqueous flare at 3 hours post-application. Observed decreases in aqueous flare intensity by a commonly used mydriatic agent, a combined solution of phenylephrine and tropicamide, was considered to be the result of the pharmacological effects of tropicamide.

Adult↗
PubMed1986

The pupil cycle time in Horner's syndrome.

Edge-light pupil cycle time has been introduced recently as a simple method for examining parasympathetic pupillary innervation. Since the sympathetic system is not thought to be involved in the light reflex, it was assumed that edge-light pupil cycle time would be unimpaired in lesions of the sympathetic pathways. In 12 patients with unilateral Horner's syndrome of different etiologies, the edge-light pupil cycle time was determined in both eyes. In all cases the edge-light pupil cycle time was significantly prolonged on the abnormal side. Patients with central, preganglionic, or postganglionic lesions showed the differences consistently. These data support the notion that the sympathetic system plays a role in the pupillo-dilating phase of edge-light pupil cycle time, presumably by exerting a tonic mydriatic effect. Since this tonic effect is lost in Horner's syndrome, leading to slowed redilatation, the edge-light pupil cycle time becomes prolonged. Thus, edge-light pupil cycle time may prove to be a valuable diagnostic test for Horner's syndrome.

Aged↗
PubMed1988

Factors affecting the normal perimetric profile derived by automated static threshold LED perimetry. I. Pupil size.

The relationship between pupil size and perimetric sensitivity was investigated in a group of clinically normal emmetropic subjects using the Dicon AP3000 computer-assisted perimeter at bowl luminances of 10 asb and 45 asb. Pupil size was modified with the miotic thymoxamine 0.5% and the mydriatic phenylephrine 10%; saline was used as the control. Perimetric sensitivity increased with an increase in pupil size. The effect was greatest for peripheral locations for both bowl luminances. The fluctuations in perimetric sensitivity increased with peripheral angle and with decrease in pupil size for both bowl luminances.

Adult↗
PubMed1979

Squamous metaplasia or epidermalization of the conjunctiva as an adverse reaction to topical medication.

Prolonged topical medication causes epidermalization of the conjunctiva in some patients. Loss of the normal conjunctival goblet cells, direct toxic effects on the corneal epithelium, and disturbance of lid function may combine to produce corneal changes which may be misinterpreted and treated with further potentially toxic compounds. Examples of conjunctival changes caused by miotic and non-miotic antiglaucoma therapy, mydriatics, preservatives, and antiviral compounds are presented.

Aged↗