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PubMed1986

Autonomic mechanisms for morphine and amphetamine mydriasis in the rat.

Morphine sulfate and amphetamine sulfate dilate the pupil of the conscious, unrestrained rat. To examine the mechanisms underlying amphetamine and morphine mydriasis, the pupil diameter of freely moving rats was measured from photographs taken before and after these drugs were administered s.c., i.c.v. or by instillation into the eye. Some rats received monoamine antagonists, sympathetic denervation, or adrenalectomy before drug administration. The results indicate that both amphetamine and morphine mydriasis are primarily due to centrally mediated inhibition of parasympathetic outflow, although for both drugs there may be a sympathetic component. Pharmacological evidence indicates that the mydriatic effect of a low dose of amphetamine is mediated by actions on both alpha-1 and alpha-2 adrenergic receptors, whereas only alpha-2 adrenergic receptors are involved in morphine mydriasis.

Adrenalectomy↗
PubMed1977

[Secondary glaucoma and uveitis: hypertensive uveitis (author's transl)].

The secondary rise of i.o. pressure in uveitis may lead to a true secondary glaucoma or to hypertensive uveitis. The etiology of the endogenous inflammation does not seem to play a role. Pathogenetically the occlusion of the pupil with the formation of iris bombé and the obliteration of the chamber angle by exudate are important factors, while the hypersecretion of aqueous humor plays a minor role. Medical treatment consists in mydriatics and steroids. Surgical treatment depends on the pathogenetic mechanism and consists either in sector iridectomy or a filtering procedure.

Behcet Syndrome↗
PubMed1988

New quantitative method to determine protein concentration and cell number in aqueous in vivo.

We have developed a new quantitative method to determine protein concentration and number of cells in the aqueous in vivo. The principal instruments in the system were a He-Ne laser and a detection system for measuring scattered light intensity. The power of the He-Ne laser was 25 microW and the focused beam diameter was 20 microns. The laser beam was operated by an optical scanner. The sampling window, 0.3 X 0.5 mm, was fixed in the center of the laser path. For the protein concentration measurement, the laser beam was scanned for a length of 0.6 mm vertically, covering the sampling window. To minimize signal contamination by background laser scattering, scattered light intensity produced by aqueous protein (Sp) was calculated as follows. Sp = Si - (S'o + S''o)/2, where Si indicates scattered light intensity when the beam passed in the sampling window and S'o and S''o indicate scattered light intensity when the beam passed above and below the sampling window. For the cell counts, the laser beam (0.25 X 0.6 mm) was scanned over the sampling window and the detected peaks were counted. Each measurement mode took 0.5 seconds. The operation of the instrument and data analysis were performed by a personal computer. In in vitro measurements with human plasma solution in diluting factors ranging from 1/50 to 1/10(4), and bovine serum albumin solution in concentrations ranging from 1 g/100 ml to 1 mg/100 ml, significant linear correlations between the values for concentration and photon counts (/msec) were obtained in each solution (r, ranging from 0.987 to 0.998, P = 0.000). In in vitro experiments with latex particles with diameters of 2.02 or 2.95 microns, significant correlations between the number of detected peaks and latex particles were also obtained. However, as the number of latex particles decreased, the variation in the number of detected peaks was large. In 31 normal young adults, with an average age of 23 years, the average photon count was 4.1 +/- 1.0, which corresponded to 27 mg/100 ml according to the in vitro bovine albumin solution measurement, and there was no definite relation in photon counts between eyes with and without mydriatics. Twenty patients with incipient or immature cataract, whose ages averager 70 years, showed significantly higher average photon counts, 6.2 +/-2.5, than the above young adults.We concluded that this new method of determining protein concentration and cell number in the aqueous enabled us to make a noninvasive and quantitative evaluation of the inflammation in the anterior segment of the eye.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1988

Comparison of 0.5% cyclopentolate plus 0.5% tropicamide and 1% cyclopentolate alone for mydriasis of dark irides.

We studied the mydriatic and cycloplegic effect of a single dose of a combination of 0.5% cyclopentolate hydrochloride and 0.5% tropicamide in 20 healthy subjects with dark brown irides. The mean change in dilatation with the combination drop was 3.5 mm, compared with 0.6 mm with 1% cyclopentolate alone (p less than 0.001). In 92% of 26 eyes studied the difference in refraction between the combination drop and 1% atropine was +1.00 dioptre or less. The combination drop safely provided satisfactory mydriasis and cycloplegia in 20 minutes, allowing for rapid and accurate examination of these patients.

Atropine↗
PubMed1987

Screening for diabetic retinopathy--comparison of a nurse and a doctor with retinal photography.

The efficacy of diabetic retinal screening by a nurse trained in ophthalmoscopy and of a diabetologist was assessed by comparison with fundal photography. The study was performed in 282 subjects, 59 with known diabetes and 223 participating in a screening survey, of whom 13 had diabetes and 43 impaired glucose tolerance. The prevalence of retinopathy in the diabetic subjects was 36.8% and serious retinopathy 9.5% while in the screened subjects it was 3.5% and 0.9% respectively. The characteristics of nurse examination as a test to detect retinopathy was: sensitivity 50.0% +/- CL16.8%, specificity 99.2% +/- CL0.9%, which compared with 51.3% +/- CL15.7% and 98.7% +/- CL1.2% for the doctor. The nurse failed to detect serious retinopathy as accurately as the doctor, although new vessels were missed in 5 of 6 cases by the doctor. Screening for retinopathy requires either ophthalmoscopy by an observer trained to a higher level than is common in doctors, or non-mydriatic retinal photography.

Adult↗
PubMed1986

Uveitis associated with Ehrlichia platys infection in a dog.

Bilateral anterior uveitis, nonregenerative anemia, and thrombocytopenia were found in a 9-month-old Chow Chow infected with Ehrlichia platys. Diagnosis was based on the finding of basophilic inclusions in platelets and an E platys antibody titer. The dog was treated orally with tetracycline, topically with antibiotic/corticosteroid, and topically with a mydriatic.

Animals↗
PubMed1987

Effect of topical phenylephrine on the equine pupil.

The mydriatic effect of 10% phenylephrine was evaluated in 9 horses. Base-line pupillary size in mesopic conditions and during light stimulation was ascertained before application of pharmacologic agents. In study 1, 10% phenylephrine was applied to each eye (n = 5 horses). After 15 minutes, the pupillary size was determined in both lighting conditions. Phenylephrine was again applied to each eye, and after an additional 15 minutes, the pupillary size was determined. In study 2, 1% tropicamide was applied to each eye (n = 4 horses), and after 30 minutes, the pupillary size was determined in both lighting conditions. Tropicamide and phenylephrine were applied to each eye immediately after determination of pupillary size, and after an additional 30 minutes, the pupillary size was determined. There was no significant change (P greater than 0.9) in pupillary size when phenylephrine was used alone or when phenylephrine was used in an eye that had been dilated with tropicamide.

Animals↗
PubMedDate not supplied

Clinical manifestations of iridocyclitis in leprosy.

Iridocyclitis--an inflammation of the iris and ciliary body occurs in lepromatous spectrum of leprosy of long duration. It is usually bilateral, has a very chronic course with acute exacerbations which are suppressed with the help of corticosteroids and other antiinflammatory drugs--Mydriatic to keep the Pupil dilated and also an antibiotic to take care of secondary infection which may be present. It is a major cause of blindness, due to its secondary damaging effects on the various ocular tissues. Medical and Paramedical Workers attending these patients must be made aware of the chronicity of the iridocyclitis so that regular referrals for examination of the eyes including slit lamp examination could be done and the activity of the disease and its complications detected early and treated. This chronic variety of iridocyclitis often gets less medical attention because of its insidious onset and minimal clinical signs in early stages, except by slit lamp examination. 57 patients suffering from iridocyclitis attending the ophthalmic department of S.L.R. & T.C. Karigiri were followed up carefully over a period of 2 1/2 years to study the clinical manifestations of iridocyclitis, it's complications and management.

Adult↗
PubMedDate not supplied

Pupillary stretching. A new procedure in vitreous surgery.

During vitreoretinal procedure, 26 aphakic eyes with proliferative vitreoretinopathy and diabetic traction retinal detachment were treated with a new technique for surgical dilatation of a miotic immobile pupil. Four iris loop sutures were laid in such a way that stretching of the pupil in the main directions of the four quadrants was made possible, thus forming a large, square pupil. No functional iris lesion was caused in nine eyes that developed miosis only during surgery. The other 15 eyes already had a miotic and rigid pupil preoperatively. In all but one of these cases, the stretching caused multiple small sphincter tears. The pupils remained partially dilated, but showed a reaction to miotics and mydriatics.

Adult↗
PubMed1985

[A case of septic aneurysm complicated with simultaneous subdural and intracerebral hematoma].

A case of septic aneurysms complicated with simultaneous subdural and intracerebral hematoma is presented. A 13-year-old girl had been operated on for endocardial cushion defect when she was 5 years old, and residual mitral regurgitation was followed up. She suddenly complained of headache, vomited and lost consciousness. She was brought to the Tokyo Women's Medical College Hospital by an ambulance. On arrival, she was semicomatose. Her left pupil was mydriatic and did not react to light. Right hemiparesis was noted. Systolic murmur was audible in the apical region of the heart. Laboratory data showed a mild anemia and a white cell count of 23,000. CT scan showed a subdural hematoma in the left frontotemporoparietal region and a small subcortical hematoma in the left occipital lobe. An emergency operation was carried out for the subdural hematoma. When the dura was opened, about 10 ml bloody CSF flowed out. A hematoma weighing about 50 g was removed. A bleeding point or an aneurysm could not be discovered on the dura, arachnoid membrane or surface of the brain at the operation. On the 15th day after the operation, when the fever was decreased, cerebral angiography was done. The left vertebral angiogram showed an aneurysm on a peripheral branch of the calcarine artery, which was considered the origin of the subcortical hematoma in the left occipital lobe. The left carotid angiogram showed no aneurysm. On the seventh day after that study, the aneurysm did not appear by left vertebral angiography. She was discharged with no neurological deficit. One month later, she was admitted again with a high fever.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Cardiac dysrhythmias associated with ophthalmic atropine.

Atropine sulfate, a mydriatic and cycloplegic agent, is frequently used in patients undergoing glaucoma surgery. Trabeculectomy with peripheral iridectomy is the most common glaucoma surgery performed to decrease intraocular pressure and preserve vision. Systemic absorption of ophthalmic atropine does occur and may result in toxic and adverse side effects. Cardiac dysrhythmias are one of the major adverse reactions. This case study reviews three patients who had a trabeculectomy for glaucoma and received ophthalmic atropine. One patient received both systemic and ocular atropine. Two patients developed atrial fibrillation and one a supraventricular tachycardia. Two patients required admission to a cardiac intensive care unit for management of the dysrhythmia and a third reverted to normal sinus rhythm spontaneously. The cardiac effects of ophthalmic atropine should be considered in the preoperative and postoperative assessment of patients with dysrhythmias.

Absorption↗
PubMed1986

[The problem of the impairment of the action of parasympatholytic substances. Ophthalmologic criteria and methods].

UNLABELLED: The parasympatholytic effects on the eye were investigated in 12 healthy volunteers. In a randomized cross-over double-blind trial 20 or 40 mg N-butylscopolaminium bromide (Buscopan) or placebo was given by i.v. injection. Pupillary light reaction, range of accommodation, visual acuity, and nyctometer values were measured up to 45 min after injection. RESULTS: 1. The mydriatic effect of both dosages of the drug is moderate. Pupil diameters at the end of the light reaction are only slightly greater under the influence of the drug than in control experiments. The dynamics of the reaction remains unaltered. 2. The range of accommodation diminishes in a dose-dependent manner. 9-15 min after the injection the inhibition is maximum. 45 min after injection, even of the 40 mg dosage, only a small effect remains. 3. Visual acuity and nyctometer values are not affected by N-butylscopolaminium bromide. The findings were discussed with respect to the ability to meet the requirements of road traffic.

Adult↗
PubMed1985

Posterior synechiae in extracapsular cataract extraction with posterior-chamber intraocular lenses.

Posterior synechiae formation was studied in 294 consecutive cases of extracapsular cataract extraction with posterior-chamber intraocular lens implantation. The synechiae are mainly a cosmetic blemish and may hinder future pupillary dilation. Formation can be reduced by elimination of the iridectomy, elimination of routine mydriatic drops, and minimization of iris trauma at the time of surgery.

Cataract Extraction↗
PubMed1978

[Clinical aspects and therapy of the posner-schlossmann-syndrom (author's transl)].

UNLABELLED: Difficulties in the early diagnosis of the Posner-Schlossmann syndrome can be avoided by looking for the following typical clinical signs: Very fine, unpigmented precipitates, which are often only signly present, and which are scattered over the entire cornea: bright white in incident light, translucent in reflected light, and in transmitted light dark in spots. Posterior synechiae are not present. Obvious differences in color or heterochromia are present in only 30-40% of the cases. In the remaining cases, there ist only a slight color difference or unilateral, diffusely trophic hypochromia of the iris, often only after several attacks. The chamber angle is and remains open during the attacks. There are similarities between glaucomatocyclitic crisis and heterochromic cyclitis: Unilaterality, the same specific precipitates, no synechiae, and practically the same percentage of color differences of the iris. Hypochromic dystrophy of the iris dependent on the magnitude and duration of the cyclitic process. In both cases, there is the same rate of physical changes, pointing to a congenital damage of the sympathetic nervous system (status dysraphicus Passow). Hence, the Posner-Schlossmann syndrome can be regarded as a special case of heterochromic cyclitis. THERAPY: Neither miotics nor mydriatics, nor operation during the crisis. Acetazolamide (Diamox) combined with local cortisone will stop the crisis.

Adult↗
PubMed1981

[Pharmacological study of Mequitazine (LM-209). (V). Pharmacological actions of a main metabolite of LM-209, mequitazine sulfoxide (LM-209 SO) (author's transl)].

The pharmacological action of a main metabolite of Mequitazine (LM-209), Mequitazine sulfoxide (LM-209 SO), was compared with data on LM-209 to investigate whether LM-209 is metabolized in vivo to the active form and if it has pharmacological actions. In the excised ileum of guinea-pigs, the anti-histaminic and anti-cholinergic activities of LM-209 SO were about 1/8 and 1/20, respectively, of LM-209. The protective activity of LM-209 SO on sudden death induced by histamine in mice was about 1/2.5 of LM-209. Acute toxicity of LM-209 SO given orally to mice was 1/3 of LM-209. In the EEG of rabbits, LM-209 SO did not affect the spontaneous pattern or the arousal and recruiting responses. The mydriatic and local anesthetic activities of LM-209 SO were significantly less than those of LM-209. Thus, the pharmacological activities and toxicity of LM-209 SO were significantly less potent than those of LM-209.

Animals↗
PubMed1982

Possible lateralization of the cardiac sympathetic function in cluster headache.

In cluster headache an adrenergic dysfunction of the pupillary sympathetic system can be demonstrated even during pain-free periods by instillation of tyramine in the conjunctival sac. In this study 10 patients with typical cluster headache syndrome exhibited a positive tyramine conjunctival test (minor mydriatic response in the pain side). As the adrenergic dysfunction may also involve the heart, possible neurogenic changes in ventricular repolarization were investigated in a group of patients with cluster headache by means of a hyperventilation test. When compared to controls, an increase of the QTc interval, a faster heart rate and a minor shortening of the QT interval, were observed. In all cases except one the T waves became bifid or inverted, sometimes showing a pseudoischemic aspect. Since the positive response to hyperventilation seems to depend on an asynchronous repolarization which can, in turn, be related to asymmetric sympathetic function, the present results seem to suggest the presence of a possible lateralization of the cardiac sympathetic function, in cluster headache patients.

Adolescent↗
PubMed1983

Juvenile xanthogranuloma.

Three infants with juvenile xanthogranuloma are described. Of the two with ocular involvement, one responded to topical corticosteroid and mydriatic therapy and the other to irradiation. The third had skin lesions alone. In the first case new histologic findings were made: lipid vacuoles were observed, by light and electron microscopy, in smooth muscle cells of erector pili and in Schwann cells of small nerves. These findings, along with the detection of lipid vacuoles in mast cells, support the concept that the condition results from local tissue injury that evokes a histioxanthomatous response. Treatment of juvenile xanthogranuloma should be tailored to the individual case and ranges from no active intervention (when there are skin lesions alone or ocular involvement limited to the eyelid or the epibulbar tissue) to a combination of corticosteroid therapy, irradiation and surgery (when there are iris lesions, which rarely resolve spontaneously and may have serious complications). A trial of topical corticosteroid therapy alone in uncomplicated cases is suggested since it was curative in one of the cases presented here.

Conjunctiva↗
PubMed1982

[Studies on the CNS activity profile of thalidomide analogs (author's transl)].

CNS activity of thalidomide was compared with that of 5 analogs modified in the phthalimide or 2,6-dioxopiperidine moiety. All compounds had a qualitatively comparable profile of CNS-depressant actions. In low dosages spontaneous motor activity was depressed, threshold of barbiturate anaesthesia was lowered, and isolation-induced aggression was inhibited. All compounds suppressed tonic convulsions induced by maximum electroshock. Only at high dosages muscle tone and body temperature were lowered. Protection against nicotine lethality revealed antagonistic activity at central nicotinergic synapses. Corresponding depression of peripheral ganglionic transmission was indicated by mydriatic and antidiarrhoeal activity. While thalidomide, supidimide, EM 8, and EM 255 did not induce anaesthesia up to highest or lethal-toxic doses, EM 136 and EM 12 in accordance with common sedative-hypnotic drugs induced loss of righting reflex at high dosages. EM 136 differs from thalidomide only in that one oxygen group at the piperidine moiety is missing. This finding indicates that a minor structural change shifts CNS depression towards anaesthetic properties. A clearcut relation between structure and teratogenic activity had been established in this group of compounds, whereas CNS-depressant efficacy could not be unequivocally related to particular structural features.

Animals↗