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Sample records for bromfenac ophthalmic solution

  1. The ocular distribution of 14C-labeled bromfenac ophthalmic solution 0.07% in a rabbit model

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    Baklayan GA

    2014-09-01

    Full Text Available George A Baklayan, Mauricio Muñoz Bausch + Lomb, Irvine, CA, USA Purpose: To evaluate the ocular distribution of an advanced formulation of bromfenac ophthalmic solution. Two studies were conducted in rabbits: 1 a 12-hour parallel-group study comparing the ocular distribution of 14C-bromfenac ophthalmic solution 0.07%, pH 7.8 with that of 14C-bromfenac ophthalmic solution 0.09%, pH 8.3, and 2 a 24-hour study evaluating the ocular distribution of 14C-bromfenac ophthalmic solution 0.07%, pH 7.8.Methods: In the 12-hour study, rabbits were randomized to receive 50 µL of 14C-bromfenac 0.07%, pH 7.8 or 50 µL 14C-bromfenac 0.09%, pH 8.3 in one eye, whereas, in the 24-hour, study both eyes received 50 µL of 14C-bromfenac 0.07%, pH 7.8. Ocular tissues were collected at 1, 2, 4, 8, 12 (both studies and 24 hours (second study only following drug instillation, and tissue radioactivity was determined using liquid scintillation chromatography. Results: Measureable levels of bromfenac were observed in all ocular tissues, with the exception of vitreous humor, regardless of formulation. In the 12-hour study, high concentrations of 14C-bromfenac were found in the sclera, followed by the iris/ciliary body, aqueous humor, choroid, retina, and lens. There was no significant difference between the bromfenac 0.07%, pH 7.8 and bromfenac 0.09%, pH 8.3 formulations in any 14C-bromfenac tissue levels at any time point, with the exception of in sclera at 2 hours post-instillation (0.451 µg eq/g versus 0.302 µg eq/g, respectively, P<0.001. There was also no significant difference in the total amount of 14C-bromfenac in the tissues evaluated following instillation of the two formulations. In the 24-hour study evaluating bromfenac 0.07%, pH 7.8 only, high concentrations of 14C-bromfenac were found 1 hour post-instillation in the cornea (2.402 µg eq/g and conjunctiva (1.049 µg eq/g, two tissues not evaluated in the 12-hour study. The rank order of 14C-bromfenac

  2. Bromfenac ophthalmic solution for the treatment of postoperative ocular pain and inflammation: safety, efficacy, and patient adherence

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    Rajpal RK

    2014-06-01

    Full Text Available Rajesh K Rajpal, Bryan Ross, Sachin D Rajpal, Khoa HoangSee Clearly Vision Group, McLean, VA, USAAbstract: Ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs are commonly used by clinicians to manage ocular inflammation and pain following cataract surgery. Over the past decade, the US Food and Drug Administration has approved multiple topical NSAIDs for these purposes, including several reformulated products. One of these medications, bromfenac ophthalmic solution, has a long and extensive history, with proven efficacy and safety in patients following cataract surgery. The evolution of bromfenac ophthalmic solution over the years has involved either lowering the concentration of the active ingredient or extending the dosing interval to improve patient adherence/compliance. This review will focus on the history and progression of bromfenac ophthalmic solution and report the available patient preference and adherence data regarding this ocular NSAID throughout its evolution.Keywords: cataract surgery, nonsteroidal anti-inflammatory drugs, COX inhibitors

  3. Evaluation of analgesic efficacy of bromfenac sodium ophthalmic solution 0.09% versus ketorolac tromethamine ophthalmic solution 0.5% following LASEK or Epi-LASIK

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    Wang XJ

    2011-10-01

    Full Text Available Xiao Jing Wang, Sze H Wong, Roshan Givergis, Emil W Chynn Park Avenue LASEK, New York, NY, USA Background: To evaluate the analgesic efficacy of bromfenac sodium ophthalmic solution 0.09% compared with ketorolac tromethamine ophthalmic solution 0.5% in laser epithelial keratomileusis (LASEK or epithelial keratomileusis (epi-LASEK, sometimes referred to as epi-LASIK. Methods: Eighty eyes (from 40 patients, 18 men and 22 women undergoing bilateral simultaneous LASEK or epi-LASEK were randomized to receive ketorolac in one eye and bromfenac in the other. Mean age was 33.13 ± 9.34 years. One drop of bromfenac or ketorolac was instilled in each eye 15 minutes and one minute prior to surgery, and two and four hours following surgery. Patients were instructed to instill the medications on-label each day through postoperative day 4. The subjects completed pain and visual blurriness assessments from day of surgery to postoperative day 4. Uncorrected visual acuity was tested on postoperative days 1 and 6. Results: For each of the five days, pain scores for bromfenac-treated eyes were significantly less than that for ketorolac-treated eyes (P < 0.01. Of the 40 patients, 32 (80% said bromfenac provided better postoperative analgesia than ketorolac. There was no statistically significant difference in visual blurriness scores between the two groups (P > 0.1. Uncorrected visual acuity did not vary significantly between the treatment groups (P > 0.1. No serious adverse events were noted. Conclusion: Bromfenac is subjectively superior to ketorolac in reducing postoperative pain following LASEK or epi-LASEK. The subjects tolerated the drugs well with no serious adverse outcomes and no difference in uncorrected visual acuity. Keywords: LASEK, epi-LASEK, epi-LASIK, ketorolac, bromfenac, postoperative pain, nonsteroidal anti-inflammatory drugs

  4. Bromfenac ophthalmic solution 0.09 %: human aqueous humor concentration detected by high-performance liquid chromatography.

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    Macrì, Angelo; Vagge, Aldo; Salis, Annalisa; Fucile, Carmen; Marini, Valeria; Martelli, Antonietta; Giuffrida, Sebastiano; Iester, Michele; Damonte, Gianluca; Mattioli, Francesca

    2017-04-01

    The purpose of this study was to evaluate the aqueous humor concentrations of bromfenac ophthalmic solution 0.09 % in patients undergoing phacoemulsification. Patients requiring cataract extraction received one drop (50 µL) of bromfenac 0.09 % solution in the eye to be operated, before bedtime the day before surgery or the morning of the surgery. The last administration was recorded. At the time of paracentesis, an aqueous humor sample was collected with a 30-gauge needle attached to a TB syringe and was later analyzed by high-performance liquid chromatography for drug concentration. 188 treated volunteers and 48 control, untreated, subjects were included in the study. The mean aqueous concentration of bromfenac in the treated group was 37.60 ± 68.86 and 0 nM (nmol/L) in the control group (p humor up to about 12 h after instillation.

  5. The efficacy of bromfenac ophthalmic solution 0.07% dosed once daily in achieving zero-to-trace anterior chamber cell severity following cataract surgery

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    Silverstein SM

    2014-05-01

    Full Text Available Steven M Silverstein,1 Mitchell A Jackson,2 Damien F Goldberg,3 Mauricio Muñoz4On behalf of the Bromfenac Ophthalmic Solution 0.07% Once Daily Study Group1Silverstein Eye Centers, Kansas City, MO, USA; 2Jacksoneye, Inc., Lake Villa, IL, USA; 3Wolstan & Goldberg Eye Associates, Torrance, CA, USA; 4Bausch + Lomb, Irvine, CA, USAPurpose: To evaluate the efficacy of bromfenac ophthalmic solution 0.07% dosed once daily in achieving zero-to-trace (0–5 cells anterior chamber cells, following cataract surgery with posterior chamber intraocular lens implantation.Methods: The study designed employed two Phase III, double-masked, placebo-controlled, multicenter clinical trials of 440 subjects, randomized to either bromfenac ophthalmic solution 0.07% (n=222 or placebo (n=218. Subjects self-dosed once daily, beginning 1 day before undergoing cataract surgery with intraocular lens implantation (day −1 and again on the day of surgery (day 0 and for 14 days postoperatively. Follow-up was on days 1, 3, 8, and 15. The outcome measures included the percentage of subjects with zero-to-trace anterior chamber cells at each visit, as determined by the percentage of subjects with ≤5 anterior chamber cells, overall anterior chamber cell grades, and summed ocular inflammation score (SOIS (combined anterior chamber cell and flare scores.Results: The proportion of subjects with zero-to-trace anterior chamber cells was significantly higher in the bromfenac 0.07% group compared with the placebo group as early as day 3 (P=0.0007, continued at day 8 (P<0.0001, and through day 15 (P<0.0001. At day 15, 80.2% of subjects in the bromfenac 0.07% group achieved zero-to-trace anterior chamber cells compared with 47.2% of subjects who did so in the placebo group. The overall anterior chamber cell scores were significantly lower in the bromfenac 0.07% group compared with the placebo group at days 3, 8, and 15 (P<0.0001 at each visit. The SOIS were also significantly lower in the

  6. Clinical observation on 1g/L bromfenac sodium hydrate ophthalmic solution associated with glucocorticoid in high myopia after LASEK

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    Qing-He Li

    2017-06-01

    Full Text Available AIM:To observe the efficacy and safety of 1g/L bromfenac sodium hydrate ophthalmic solution in the partial substitution of glucocorticoid after laser subepithelial keratomileusis(LASEK. METHODS: Totally 104 cases(208 eyeswere received LASEK, which were selected and divided into study group and control group. The study group were adopted 1g/L bromfenac sodium hydrate ophthalmic solution combined with tobramycin dexamethasone eye drops and fluorometholone eye drops, the control group were adopted tobramycin dexamethasone eye drops and fluorometholone eye drops. The changes of visual acuity and intraocular pressure of two groups were recorded before and after surgery, and the score of painness and the occurrence of haze were observed after surgery. RESULTS: At postoperative 1, 2, 3d, respectively, the pain score of the study group were 1.70±0.35, 1.25±0.34, 0.82±0.32, the pain score of the control group were 2.30±0.43, 1.68±0.44, 1.12±0.33, the differences were significant(PP>0.05, and the differences were not significant(P>0.05. At preoperative and postoperative 1, 2wk, 1 and 3mo of surgery, respectively, the intraocular pressure of study group were 17.33±1.58, 7.54±1.28, 7.23±1.58, 7.26±1.47, and 7.30±1.36 mmHg; the intraocular pressure of control group were 17.53±1.43,7.57±1.32,7.73±1.55,7.80±1.38,7.86±1.43 mmHg,the differences were not significant between before and at 2wk after surgery(P>0.05, the differences were significant between the two groups at 2wk, 1mo and 3mo(PP>0.05. CONCLUSION: It is safe and effective that 1g/L bromfenac sodium hydrate ophthalmic solution in the partial substitution of glucocorticoid after laser subepithelial keratomileusis. The patient has a lower intraocular pressure, has similar therapeutic effect as glucocorticoid in vision and antiinflammatory.

  7. Aqueous prostaglandin E(2) of cataract patients at trough ketorolac and bromfenac levels after 2 days dosing.

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    Bucci, Frank A; Waterbury, L David

    2009-06-01

    Ketorolac 0.4% administered four times daily (q.i.d.) has long been used safely and effectively for the alleviation of ocular inflamation and pain and the prevention of intraoperative miosis in patients undergoing cataract surgery. Bromfenac ophthalmic solution 0.09% was recently developed as an ocular anti-inflammatory drug with a twice-daily (b.i.d.) dosing regimen. This study was designed to evaluate if b.i.d. dosing with bromfenac 0.09%, in comparison with q.i.d. dosing with ketorolac 0.4%, provides adequate trough nonsteroidal anti-inflammatory drug levels that were effective enough to reduce aqueous prostaglandin (PG) E(2) levels of patients after cataract surgery toward the end of its dosing cycle. In this single-center, investigator-masked trial, patients undergoing cataract surgery were randomized to receive either ketorolac 0.4% q.i.d. or bromfenac 0.09% b.i.d. for 2 days preoperatively. Aqueous humor was collected at the start of surgery 6 hours after the last dose of ketorolac 0.4% and 12 hours after the last dose of bromfenac 0.09%. Aqueous PGE(2) levels and drug concentrations were evaluated by a competitive enzyme immunoassay and reverse-phase HPLC-mass spectroscopy, respectively. A total of 61 patients received ketorolac 0.4% (n=30) or bromfenac 0.09% (n=31). The mean (+/-SD) aqueous PGE(2) level was 285.6+/-141.9 pg/mL in patients treated with ketorolac 0.4% and 386.2+/-131.0 pg/mL in patients treated with bromfenac 0.09% (P=0.006). The mean (+/-SD) aqueous concentrations of ketorolac and bromfenac were 83.6+/-73.8 ng/mL and 9.2+/-6.6 ng/mL, respectively (P<0.001). Ketorolac 0.4% maintained significantly higher aqueous concentrations and lowered aqueous PGE(2) levels significantly more than bromfenac 0.09% at trough levels. Ketorolac 0.4% administered q.i.d. may provide a more sustained control of intraocular inflammation and pain than bromfenac 0.09% administered b.i.d.

  8. Topical 0.1% Bromfenac Sodium for Intraoperative Miosis Prevention and Prostaglandin E2 Inhibition in Femtosecond Laser-Assisted Cataract Surgery.

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    Chen, Hui; Lin, Haotian; Chen, Wan; Zhang, Bo; Xiang, Wu; Li, Jing; Chen, Weirong

    2017-04-01

    The purpose of this study was to evaluate the effect of topical 0.1% bromfenac sodium, a nonsteroidal anti-inflammatory drug (NSAID), on intraoperative pupil dilation maintenance and prostaglandin E2 (PGE2) inhibition during femtosecond laser-assisted cataract surgery. Sixty patients (30 each in study and control groups) were included in this study. The patients received 0.1% bromfenac ophthalmic solution or control placebo twice a day for 3 days before surgery. Pupil size was measured at the initiation of femtosecond laser pretreatment and phacoemulsification. Aqueous humor was collected at the beginning of routine cataract surgery. PGE2 levels were measured with an enzyme-linked immunoassay. Laser flare photometry was measured preoperatively and at 1 day postoperatively. Compared with untreated patients, the change in pupil size and postoperative day 1 aqueous flare were significantly reduced throughout the operation in the patients treated with 0.1% bromfenac (P miosis, and reducing PGE2 levels.

  9. 21 CFR 524.1982 - Proparacaine hydrochloride ophthalmic solution.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Proparacaine hydrochloride ophthalmic solution... ANIMAL DRUGS § 524.1982 Proparacaine hydrochloride ophthalmic solution. (a) Specifications. The drug is an aqueous solution containing 0.5 percent proparacaine hydrochloride, 2.45 percent glycerin as a...

  10. 21 CFR 524.1200b - Kanamycin ophthalmic aqueous solution.

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    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Kanamycin ophthalmic aqueous solution. 524.1200b... § 524.1200b Kanamycin ophthalmic aqueous solution. (a) Specifications. The drug, which is in an aqueous solution including suitable and harmless preservatives and buffer substances, contains 10 milligrams of...

  11. 21 CFR 524.1044a - Gentamicin ophthalmic solution.

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    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Gentamicin ophthalmic solution. 524.1044a Section... § 524.1044a Gentamicin ophthalmic solution. (a) Specifications. Each milliliter of sterile aqueous solution contains gentamicin sulfate equivalent to 3 milligrams of gentamicin. (b) Sponsor. See No. 000061...

  12. 21 CFR 524.390b - Chloramphenicol ophthalmic solution.

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    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Chloramphenicol ophthalmic solution. 524.390b Section 524.390b Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 524.390b Chloramphenicol ophthalmic solution. (a) Specifications. Each milliliter contains 5...

  13. Lifitegrast Ophthalmic Solution 5%: A Review in Dry Eye Disease.

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    Keating, Gillian M

    2017-02-01

    Lifitegrast is a novel small molecule integrin antagonist that blocks the binding of intercellular adhesion molecule 1 (ICAM-1) to lymphocyte function-associated antigen 1 (LFA-1). Lifitegrast ophthalmic solution 5% (Xiidra™) was recently approved in the USA for the treatment of dry eye disease. The efficacy of lifitegrast ophthalmic solution 5% was compared with vehicle in a 12-week phase 2 study and three 12-week phase 3 studies (OPUS-1, OPUS-2 and OPUS-3) in patients with dry eye disease. Taken as a whole, results of these trials support the treatment effect of lifitegrast ophthalmic solution 5% in improving a symptom of dry eye disease (i.e. the change from baseline to day 84 in the eye dryness visual analogue scale score) and a sign of dry eye disease (i.e. the change from baseline to day 84 in the inferior corneal fluorescein staining score). Lifitegrast ophthalmic solution 5% was generally well tolerated. In conclusion, lifitegrast ophthalmic solution 5% provides a new option for the treatment of dry eye disease.

  14. Ophthalmic regional blocks: management, challenges, and solutions

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    Palte HD

    2015-08-01

    Full Text Available Howard D Palte Department of Anesthesiology, Perioperative Medicine and Pain Management, Miller School of Medicine, University of Miami, Miami, FL, USA Abstract: In the past decade ophthalmic anesthesia has witnessed a major transformation. The sun has set on the landscape of ophthalmic procedures performed under general anesthesia at in-hospital settings. In its place a new dawn has ushered in the panorama of eye surgeries conducted under regional and topical anesthesia at specialty eye care centers. The impact of the burgeoning geriatric population is that an increasing number of elderly patients will present for eye surgery. In order to accommodate increased patient volumes and simultaneously satisfy administrative initiatives directed at economic frugality, administrators will seek assistance from anesthesia providers in adopting measures that enhance operating room efficiency. The performance of eye blocks in a holding suite meets many of these objectives. Unfortunately, most practicing anesthesiologists resist performing ophthalmic regional blocks because they lack formal training. In future, anesthesiologists will need to block eyes and manage common medical conditions because economic pressures will eliminate routine preoperative testing. This review addresses a variety of topical issues in ophthalmic anesthesia with special emphasis on cannula and needle-based blocks and the new-generation antithrombotic agents. In a constantly evolving arena, the sub-Tenon’s block has gained popularity while the deep angulated intraconal (retrobulbar block has been largely superseded by the shallower extraconal (peribulbar approach. Improvements in surgical technique have also impacted anesthetic practice. For example, phacoemulsification techniques facilitate the conduct of cataract surgery under topical anesthesia, and suture-free vitrectomy ports may cause venous air embolism during air/fluid exchange. Hyaluronidase is a useful adjuvant because it

  15. Effects of viscoelastic ophthalmic solutions on cell cultures

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    Madhavan Hajib

    1998-01-01

    Full Text Available The development of mild but significant inflammation probably attributable to viscoelastic ophthalmic solutions in cataract surgery was recently brought to the notice of the authors, and hence a study of the effects of these solutions available in India, on cell cultures was undertaken. We studied the effects of 6 viscoelastic ophthalmic solutions (2 sodium hyaluronate designated as A and B, and 4 hydroxypropylmethylcellulose designated as C, D, E and F on HeLa, Vero and BHK-21 cell lines in tissue culture microtitre plates using undiluted, 1:10 and 1:100 dilutions of the solutions, and in cover slip cultures using undiluted solutions. Phase contrast microscopic examination of the solutions was also done to determine the presence of floating particles. The products D and F produced cytotoxic changes in HeLa cell line and these products also showed the presence of floating particles under phase contrast microscopy. Other products did not have any adverse effects on the cell lines nor did they show floating particles. The viscoelastic ophthalmic pharmaceutical products designated D and F have cytotoxic effects on HeLa cell line which appears to be a useful cell line for testing these products for their toxicity. The presence of particulate materials in products D and F indicates that the methods used for purification of the solution are not effective.

  16. Comparison of bromfenac 0.09% QD to nepafenac 0.1% TID after cataract surgery: pilot evaluation of visual acuity, macular volume, and retinal thickness at a single site

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    Cable M

    2012-07-01

    Full Text Available Melissa CableDiscover Vision Centers, Independence, MO, USAPurpose: The purpose of this study was to investigate the clinical outcomes of bromfenac ophthalmic solution 0.09% once daily (QD and nepafenac 0.1% ophthalmic suspension three times daily following cataract extraction with posterior chamber intraocular lens implantation, specifically looking at any differences in Early Treatment Diabetic Retinopathy Study visual acuities, macular volume, and/or retinal thickness changes.Methods: Subjects were randomly assigned to receive either bromfenac (n = 10 QD or nepafenac (n = 10 three times daily. Dosing began 3 days before cataract surgery, continuing to day 21 postsurgery. In addition to the investigated nonsteroidal antiinflammatory drug regimen, all subjects received antiinfective intraoperative and postoperative standard of care. Subjects were followed at 1 day and 1, 3, and 6 weeks postoperatively. Study visit assessments included best-corrected visual acuity, biomicroscopy, summed ocular inflammation score (anterior chamber cells and flare grading, intraocular pressure measurement, adverse event recording, and concomitant medication review. Optical coherence tomography was performed at 1, 3, and 6 weeks.Results: Both treatment groups had similar baseline measurements. Outcomes for mean letters read (P = 0.318, mean change in macular volume (P = 0.665, and retinal thickness (P = 0.552 were not statistically different between the groups from baseline through week six, although independently only the bromfenac group demonstrated a statistically significant improvement in letters gained from baseline to week six (P = 0.040. In the same time period, mean macular volume and retinal thickening worsened in the nepafenac group, demonstrating a statistically significant increase (P = 0.006 at week six for macular volume when compared to baseline. One subject in the nepafenac group experienced recurrent inflammation at week six, was unmasked, and

  17. Comparison of bromfenac 0.09% QD to nepafenac 0.1% TID after cataract surgery: pilot evaluation of visual acuity, macular volume, and retinal thickness at a single site.

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    Cable, Melissa

    2012-01-01

    The purpose of this study was to investigate the clinical outcomes of bromfenac ophthalmic solution 0.09% once daily (QD) and nepafenac 0.1% ophthalmic suspension three times daily following cataract extraction with posterior chamber intraocular lens implantation, specifically looking at any differences in Early Treatment Diabetic Retinopathy Study visual acuities, macular volume, and/or retinal thickness changes. Subjects were randomly assigned to receive either bromfenac (n = 10) QD or nepafenac (n = 10) three times daily. Dosing began 3 days before cataract surgery, continuing to day 21 postsurgery. In addition to the investigated nonsteroidal antiinflammatory drug regimen, all subjects received antiinfective intraoperative and postoperative standard of care. Subjects were followed at 1 day and 1, 3, and 6 weeks postoperatively. Study visit assessments included best-corrected visual acuity, biomicroscopy, summed ocular inflammation score (anterior chamber cells and flare grading), intraocular pressure measurement, adverse event recording, and concomitant medication review. Optical coherence tomography was performed at 1, 3, and 6 weeks. Both treatment groups had similar baseline measurements. Outcomes for mean letters read (P = 0.318), mean change in macular volume (P = 0.665), and retinal thickness (P = 0.552) were not statistically different between the groups from baseline through week six, although independently only the bromfenac group demonstrated a statistically significant improvement in letters gained from baseline to week six (P = 0.040). In the same time period, mean macular volume and retinal thickening worsened in the nepafenac group, demonstrating a statistically significant increase (P = 0.006) at week six for macular volume when compared to baseline. One subject in the nepafenac group experienced recurrent inflammation at week six, was unmasked, and then rescued with bromfenac 0.09% QD and difluprednate 0.05% QD. Both bromfenac and nepafenac

  18. 76 FR 28045 - Determination That XIBROM (Bromfenac Ophthalmic Solution) 0.09% Was Not Withdrawn From Sale for...

    Science.gov (United States)

    2011-05-13

    ... products under an ANDA procedure. ANDA applicants must, with certain exceptions, show that the drug for... as the ``listed drug,'' which is a version of the drug that was previously approved. ANDA applicants... drug application (NDA). The only clinical data required in an ANDA are data to show that the drug that...

  19. Update on twice-daily bromfenac sodium sesquihydrate to treat postoperative ocular inflammation following cataract extraction

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    Carreño E

    2012-04-01

    Full Text Available Ester Carreño1, Alejandro Portero2, David J Galarreta1,3, José M Herreras1,31Ocular Immunology Unit-IOBA (Instituto Universitario de Oftalmobiología, University of Valladolid, Campus Miguel Delibes, Valladolid, Spain; 2Ocular Immunology Unit, Hospital La Zarzuela, Madrid, Spain; 3Ocular Immunology Unit, Hospital Clínico Universitario de Valladolid, Valladolid, SpainAbstract: Ophthalmic bromfenac sodium sesquihydrate is a topically applied selective cyclooxygenase (COX-2 inhibitor. It is similar to amfenac, except for a bromine atom at the C4 of the benzoyl ring position, which markedly affects its in vitro and in vivo potency, extends the duration of anti-inflammatory activity, and enhances its inhibitory effect on COX-2 absorption across the cornea and penetration into ocular tissues. The United States Food and Drug Administration approved bromfenac in 2005 for the treatment of postoperative inflammation and the reduction of ocular pain in patients who have undergone cataract surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs, and among them bromfenac, could be even more effective than steroids at reestablishing the blood–aqueous barrier, as revealed by flare on slit-lamp examination and as quantitatively measured using ocular fluorophotometry. Similar to other NSAIDs, it has a role in inhibiting intraoperative miosis during cataract surgery. However, bromfenac also seems to be useful in other situations, such as refractive surgery, allergic conjunctivitis (not useful in dry eye, choroidal neovascularization, and even ocular oncology. No reports of systemic toxicity have been published and bromfenac has good topical tolerance with a low incidence of adverse effects.Keywords: bromfenac, ophthalmic nonsteroidal anti-inflammatory drugs, inflammation, cataract surgery

  20. Preparation of tacrolimus ophthalmic solution using cyclodextrins

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    Farzaneh Hajiahmadi

    2017-05-01

    Full Text Available Background and Aim: Application of topical tacrolimus in Vernal Keratoconjunctivitis is considered as an alternative to steroids. Due to the low aqueous solubility of  the drug, preparing a solution of the drug has got particular importance. In the present study, tacrolimus eye drop was prepared using cyclodextrin  ,as a drug solubility enhancer. Materials and Methods: To improve the aqueous solubility of tacrolimus, 5 types of cyclodextrins called α, γ, hydroxypropyl (HP-β, HP-γ, and sulfobutyl ether (SBE-β-cyclodextrin (CD, were used. After phase solubility studies, the most appropriate cyclodextrin was selected to prepare tacrolimus eye drop. For eye drop preparation, phosphate buffer (pH=7.4, hydroxypropyl methylcellulose (HPMC and polyvinyl alcohol (PVA polymers (viscosity increasing agent, methyl paraben and benzalkonium chloride (preservative agent were used together with cyclodextrin-tacrolimus complex. Results: α, HP-β ,and γ-CD had the most effect on aqueous solubility,respectively. These 3 types of CDs,  respectively increased the intrinsic solubility of tacrolimus174, 160, and 102 times. Taking this into account, α and HP-β-CD were chosen to prepare a soluble form of tacrolimus. In the eye drop formulation containing CD-tacrolimus complex, methyl paraben and HPMC, remarkably reduced the drug solubility while there was not a critical change in the solubility of tacrolimus in the case of CD-tacrolimus complex, buffer, HPMC or PVA and benzalkonium chloride. Conclusion: It is possible to prepare tacrolimus eye drop (0.05% using cyclodextrins.

  1. Stability studies on aqueous and oily ophthalmic solutions of diclofenac.

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    Ahuja, Munish; Dhake, Avinash Shridhar; Sharma, Surendra Kumar; Majumdar, Dipak Kanti

    2009-04-01

    Various aqueous and oily diclofenac ophthalmic formulations were subjected to accelerated and long term stability studies. Degradation of diclofenac was found to follow first-order kinetics. Among the aqueous formulations containing preservative, formulation with PMA, PMN, SA, MP/PP and SMS showed diclofenac content above 90% after 6 months of accelerated and 12 months of room temperature storage. Diclofenac 0.1%, w/v aqueous formulation (pH 7.4), with 5-10% overages, containing SMS, MP/PP or PMN look promising taking both stability and corneal permeability in view. However, for use in cataract surgery formulation without preservative appears ideal. Oily ophthalmic formulations except those in olive and mustard oil, had more than 90% drug content after 6 months of accelerated and 12 months of room temperature storage. Diclofenac (0.2%, w/v) ophthalmic solution in sesame oil with 3% overage and containing benzyl alcohol (0.5%, v/v) as preservative, appears ideal, taking both stability and corneal permeability in view.

  2. Carbopol/pluronic phase change solutions for ophthalmic drug delivery.

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    Lin, H R; Sung, K C

    2000-12-03

    The major purpose of this study is to develop and characterize a series of carbopol- and pluronic-based solutions as the in situ gelling vehicles for ophthalmic drug delivery. The rheological properties, in vitro release as well as in vivo pharmacological response of various polymer solutions, including carbopol, pluronic and carbopol/pluronic solution, were evaluated. It was found that the optimum concentration of carbopol solution for the in situ gel forming delivery systems was 0.3% (w/w), and that for pluronic solution was 14% (w/w). The mixture of 0.3% carbopol and 14% pluronic solutions showed a significant enhancement in gel strength in the physiological condition; this gel mixture was also found to be free flowing at pH 4.0 and 25 degrees C. The rheological behaviors of carbopol/pluronic solution were not affected by the incorporation of pilocarpine hydrochloride. Both the in vitro release and in vivo pharmacological studies indicated that the carbopol/pluronic solution had the better ability to retain drug than the carbopol or pluronic solutions alone. The results demonstrated that the carbopol/pluronic mixture can be used as an in situ gelling vehicle to enhance the ocular bioavailability.

  3. 21 CFR 524.1484e - Neomycin sulfate and polymyxin B sulfate ophthalmic solution.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Neomycin sulfate and polymyxin B sulfate ophthalmic solution. 524.1484e Section 524.1484e Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... DOSAGE FORM NEW ANIMAL DRUGS § 524.1484e Neomycin sulfate and polymyxin B sulfate ophthalmic solution. (a...

  4. Rate of bacterial eradication by ophthalmic solutions of fourth-generation fluoroquinolones.

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    Callegan, Michelle C; Novosad, Billy D; Ramadan, Raniyah T; Wiskur, Brandt; Moyer, Andrea L

    2009-04-01

    Antibacterial activity of ophthalmic fourth-generation fluoroquinolones has traditionally been evaluated by comparing only their active ingredients, gatifloxacin and moxifloxacin. However, ophthalmic formulations of fourth-generation fluoroquinolones differ in terms of the inclusion of preservatives. While gatifloxacin ophthalmic solution 0.3% (Zymar; Allergan, Inc., Irvine, CA, USA) contains 0.005% benzalkonium chloride (BAK), moxifloxacin ophthalmic solution 0.5% (Vigamox; Alcon Laboratories, Inc., Fort Worth, TX, USA) is preservative-free. Recent studies have demonstrated that the presence of BAK dramatically affects the antibacterial activity of the ophthalmic formulation of gatifloxacin. This study was designed to compare the kill rates of ophthalmic solutions of fourth-generation fluoroquinolones against isolates of common ocular bacterial pathogens. Approximately 5.6 log(10) colony-forming units (CFU)/mL of Haemophilus influenzae (n=1), Streptococcus pneumoniae (n=1), Staphylococcus aureus (n=2), methicillin-resistant Staphylococcus aureus (MRSA) (n=4), methicillinresistant Staphylococcus epidermidis (MRSE) (n=4), and fluoroquinolone-resistant S. epidermidis (n=1) were incubated with ophthalmic solutions of either gatifloxacin or moxifloxacin. Viable bacteria were quantified at specific time points up to 60 minutes. Gatifloxacin 0.3% completely eradicated H. influenzae and Strep. pneumoniae in 5 minutes, one of two S. aureus isolates in 15 minutes, and the other S. aureus isolate in 60 minutes. Gatifloxacin 0.3% completely killed all MRSA, MRSE, and fluoroquinolone-resistant S. epidermidis isolates in 15 minutes. Moxifloxacin 0.5% completely eradicated Strep. pneumoniae and one of four MRSA isolates in 60 minutes. All other isolates incubated with moxifloxacin 0.5% retained viable bacteria ranging from 1.8 to 4.4 log(10) CFU/mL. The ophthalmic solution of gatifloxacin 0.3% eradicated bacteria that frequently cause postoperative ocular infections

  5. Severe Corneal Disorders Developed After Brimonidine Tartrate Ophthalmic Solution Use.

    Science.gov (United States)

    Maruyama, Yuko; Ikeda, Yoko; Yokoi, Norihiko; Mori, Kazuhiko; Kato, Hiroaki; Ueno, Morio; Kinoshita, Shigeru; Sotozono, Chie

    2017-12-01

    The primary side effects associated with 0.1% brimonidine tartrate (BT) ophthalmic solution with sodium chlorite are allergic conjunctivitis, blepharitis, and conjunctival hyperemia. However, cornea-related side effects are rare. In this study, we report 2 similar cases in which corneal neovascularization, corneal infiltration, and corneal opacity developed after BT eye-drop use. Retrospective report of 2 cases of corneal infiltration after BT eye-drop use. Case 1 involved a 78-year-old woman with follicular conjunctivitis, corneal neovascularization, and infiltration in her left eye after unilateral instillation of BT eye drops in that eye. Case 2 involved a 75-year-old woman with bilateral corneal neovascularization and infiltration after instillation of BT eye drops. In both cases, the corneal complications were deemed to be side effects of BT, so those eye drops were replaced with 0.1% fluorometholone eye drops. After replacement, blepharitis and corneal neovascularization successfully resolved; however, a layer of opacity remained across the transparent layer of the cornea in both cases. We encountered 2 cases of corneal and conjunctival complications that developed as side effects after BT eye-drop use, thus indicating that strict attention should be paid to the possibility of side effects after initiation of antiglaucoma eye-drop use.

  6. Effect of textured eye drop bottles on the photostability of pranoprofen 0.1% ophthalmic solution.

    Science.gov (United States)

    Iwatsuka, Kinya; Inada, Katsuhiro; Ueoka, Hiroki; Otsuka, Tadashi; Maeda, Masaki; Yamaguchi, Masazumi; Yasueda, Shin-ichi

    2015-01-01

    Ophthalmic solutions are usually filled in a plastic bottle due to its durability and disposability. In Japan, photostability is one of the concerns for the quality control because an eye drop bottle must be a transparent container. The present work studied the effect of textured eye drop bottles on its light blocking to improve the photostability of ophthalmic solutions. We investigated the photostability of Pranoprofen ophthalmic solution filled in a variety of textured eye drop bottles. Pranoprofen content was analyzed by high-performance liquid chromatography and surface structure of textured eye drop bottles was evaluated by transmittance, calculated average roughness (Ra) and haze intensity. We observed that eye drop bottle which had greater than Ra value of 1.0 µm and haze intensity 62% clearly showed photostability improvement. This report is the first one which shows that photostability of ophthalmic solution is improved by using textured eye drop bottle. Moreover, this approach is a simple and effective method to improve the photostability. This method is available for not only various ophthalmic applications but also other liquid pharmaceuticals or food products.

  7. Influence of container structures and content solutions on dispensing time of ophthalmic solutions

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    Keiji Yoshikawa

    2010-05-01

    Full Text Available Keiji Yoshikawa1, Hiroshi Yamada21Yoshikawa Eye Clinic, Tokyo, Japan; 2Santen Pharmaceutical Co., Ltd., Osaka, JapanPurpose: To investigate the influence of container structures and content solutions on the time of dispensing from eye dropper bottles.Methods: Eye dropper bottle models, solution models (filtrate water/surfactant solution and a dispensing time measuring apparatus were prepared to measure the dispensing time.Results: With filtrate water and pressure thrust load of 0.3 MPa, the dispensing time significantly increased from 1.1 ± 0.5 seconds to 4.6 ± 1.1 seconds depending on the decrease of inner aperture diameters from 0.4 mm to 0.2 mm (P < 0.0001. When using the bottle models with inner aperture diameters of 0.4 mm or larger, the dispensing time became constant. The dispensing time using surfactant solution showed the same tendency as above. When pressure thrust load was large (0.07 MPa, the solution flew out continuously with inner aperture diameters of 0.4 mm or larger and the dispensing time could not be measured. The inner aperture diameter most strongly explained the variation of the dispensing time in both the content solutions in the multiple linear regression analysis (filtrate water: 46%, R2 = 0.462, surfactant solution: 56%, R2 = 0.563.Conclusions: Among content solutions and container structures, the dispensing time was mostly influenced by the diameter of the inner aperture of bottles.Keywords: dispensing time, model eye dropper bottle, model ophthalmic solution, nozzle internal space volume, nozzle inner aperture diameter

  8. Diquafosol Ophthalmic Solution Increases Pre- and Postlens Tear Film During Contact Lens Wear in Rabbit Eyes.

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    Nagahara, Yukiko; Koh, Shizuka; Oshita, Yoshihiro; Nagano, Takashi; Mano, Hidetoshi; Nishida, Kohji; Watanabe, Hitoshi

    2017-11-01

    To investigate the behavior of prelens tear film (PLTF) and postlens tear film (PoLTF) after the instillation of diquafosol using an experimental rabbit model of eyes with contact lens. Cross-sectional, anterior segment optical coherence tomographic images of the inferior midperipheral cornea were obtained at baseline and at 5, 15, 30, 60, 90, and 120 min after the instillation of 3% diquafosol ophthalmic solution in 10 Japanese white rabbits wearing contact lenses. From the obtained images, the areas of the PLTF and PoLTF were calculated. Both artificial tear solution and 0.1% sodium hyaluronate ophthalmic solution were used for comparison. Significant fluid accumulation in both the PLTF and PoLTF was observed after diquafosol instillation, whereas no fluid accumulation was visible after the instillation of artificial tear or sodium hyaluronate. The increase in PLTF area after diquafosol instillation was significantly higher (P<0.01) at 15 and 30 min than that after the instillation of artificial tear or sodium hyaluronate. The increase in PoLTF area up to 60 min after the instillation of diquafosol was significantly higher (P<0.01) than that after the instillation of either of the other two drugs. Instillation of 3% diquafosol ophthalmic solution increases PLTF and PoLTF in rabbit eyes with contact lenses. Diquafosol has potential as a treatment option for contact lens-related dry eye.

  9. Clinical utility of 3% diquafosol ophthalmic solution in the treatment of dry eyes

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    Koh S

    2015-05-01

    Full Text Available Shizuka Koh Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan Abstract: Diquafosol is a drug used for dry eye treatment with a novel mechanism of action. It stimulates the secretion of tear fluid and mucin on the ocular surface, thus enabling us to selectively treat the tear film layer, playing an important role in the establishment of the concept of “Tear Film Oriented Therapy (TFOT”, an effective therapeutic approach to dry eye in Japan. The 3% diquafosol ophthalmic solution has been widely used for the treatment of dry eye in clinical practice, and it is currently available in Japan and South Korea. This review provides an overview of the clinical utility of 3% diquafosol ophthalmic solution, focusing on the results of clinical studies on various types of dry eye, including aqueous-deficient dry eye, short tear film breakup time-type dry eye, and post dry eye after laser in situ keratomileusis. It also introduces the additive effect of diquafosol on sodium hyaluronate monotherapy for dry eye, and the effect of 3% diquafosol ophthalmic solution for dry eye-related conditions. Additionally, it summarizes the ocular effects of diquafosol in healthy human eyes. Lastly, the importance of improving tear film stability in dry eye treatment, as well as general advances in dry eye treatments, are described. Keywords: diquafosol, dry eye, mucin secretion, fluid secretion, ocular surface, vision

  10. Sedative and physiological effects of brimonidine tartrate ophthalmic solution in healthy cats.

    Science.gov (United States)

    Ogata, Niwako; Kanda, Teppei; Kawahata, Mizuki; Ichikawa, Takayasu; Matsumoto, Yuki; Morimitsu, Waka; Nishino, Yukiko; Itoi, Takamasa; Furumoto, Kayo

    2017-09-01

    To determine the effects of brimonidine tartrate ophthalmic solution on sedation, heart rate (HR), respiratory frequency (fR), rectal temperature (RT) and noninvasive mean arterial pressure (MAP) in healthy cats. Randomized, blinded crossover study, with 1 week washout between treatments. Six healthy purpose-bred cats. Brimonidine tartrate ophthalmic solution 0.1% (one or two drops; 58.6 ± 3.3 μg per drop) or a control solution (artificial tear solution) was administered to six healthy cats. Behavioural observations and measurements of HR, fR, RT and MAP were recorded before and at 30, 60, 90, 120, 180, 240, 300 and 360 minutes after topical administration. Behavioural scores were analysed using Friedman's test for repeated measures to evaluate the time effect in each treatment and treatment effect at each time point. Physiological variables (HR, fR, RT and MAP) were analysed using two-way analysis of variance for repeated measures to evaluate the time and treatment effects. The level of significance was set at p brimonidine resulted in sedation in the cats and decreased HR and MAP. Significant sedative effects occurred between 30 and 120 minutes and for physiological responses up to 360 minutes. The most frequent adverse reaction was vomiting, occurring within 40 minutes in all six cats administered two drops and five of the six cats administered one drop of brimonidine. The results demonstrated that ocular administration of brimonidine 0.1% ophthalmic solution induced sedation in cats and some cardiovascular effects usually associated with α2-adrenoceptor agonists. Further studies should be performed to determine clinical applications for this agent in cats. Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

  11. Corneal sensitivity after topical bromfenac sodium eye-drop instillation

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    Yanai K

    2013-04-01

    Full Text Available Kaori Yanai,1 Jane Huang,1 Kazuaki Kadonosono,2 Eiichi Uchio1 1Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan; 2Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan Purpose: To evaluate the safety of bromfenac sodium eye drops from the standpoint of corneal sensitivity and tear secretion in healthy controls following instillation for 1 month. Methods: A prospective single-blind parallel clinical study was conducted in 20 eyes of ten healthy volunteers with no history of ocular or systemic allergic disease, dry eye, contact lens wear, or ocular surgery. Participants were instructed to instill either bromfenac sodium or artificial tears in each eye twice daily for 28 days. Corneal sensitivity tested using a Cochet–Bonnet esthesiometer was evaluated before and immediately after instillation at 7, 14, and 28 days after the initiation of treatment. Tear secretion was also evaluated by Schirmer's eye test before and at 28 days. Results: No significant difference in mean corneal sensitivity and tear-secretion rate was observed between the bromfenac and artificial-tear treatment groups at any time. Conclusion: These results indicate that bromfenac sodium eye drops are safe with respect to corneal sensitivity and tear secretion in subjects with a normal ocular surface condition. Further evaluation is still necessary to determine whether bromfenac is safe in pathological conditions, such as inflammatory disorders and postsurgical cases. Keywords: bromfenac sodium, cornea, sensitivity, tear, nonsteroidal anti-inflammatory drug

  12. Effect of brimonidine tartrate 0.10% ophthalmic solution on pupil diameter.

    Science.gov (United States)

    Shemesh, Gabi; Moisseiev, Elad; Lazar, Moshe; Kesler, Anat

    2011-03-01

    To evaluate the effect of brimonidine tartrate 0.10% ophthalmic solution on pupil diameter under light and dark luminance conditions. Ophthalmology Department, Tel Aviv Medical Center, Tel Aviv, Israel. Case series. The pupil diameter was measured with a Colvard pupillometer in eyes of healthy volunteers under light (5.0 candelas [cd]/m(2)) and dark (0.0 cd/m(2)) luminance conditions before brimonidine 0.10% instillation and after 30 minutes, 3 hours, and 6 hours. The mean age of the 26 volunteers (52 eyes) was 34.73 years (range 19 to 60 years). Under light conditions, the mean pupil diameter was 4.98 mm ± 0.83 (SD) before instillation of brimonidine 0.10% and 4.64 ± 0.82 mm after instillation. The difference was not statistically significant, with 13.4% of eyes having a clinically significant reduction (>1.0 mm) in pupil diameter after 6 hours. Under dark conditions, the mean pupil diameter was 6.76 ± 1.08 mm before instillation of brimonidine 0.10% and 5.30 ± 0.85 mm after instillation; the difference was statistically significant (PBrimonidine 0.10% ophthalmic solution had an antimydriatic effect under dark luminance conditions and had a negligible effect on pupil diameter under light luminance conditions. The effect was similar to that reported in studies using higher concentrations of brimonidine. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Effect of brimonidine tartrate 0.2% ophthalmic solution on pupil size.

    Science.gov (United States)

    Kesler, Anat; Shemesh, Gabi; Rothkoff, Levi; Lazar, Moshe

    2004-08-01

    To evaluate the effect of brimonidine tartrate 0.2% ophthalmic solution on pupil size under scotopic and photopic luminance conditions in persons considering laser refractive surgery. Ophthalmic Health Center, Tel Aviv, Israel. The pupil size was measured in 36 eyes of 36 participants under scotopic and photopic conditions using the Colvard pupillometer (Oasis Medical) before and after brimonidine tartrate drops were administered. The pupil size was subsequently measured after 30 minutes and 4 and 6 hours. No difference was found in pupil size before brimonidine tartrate instillation in eyes with light or dark irides. Before instillation, the mean photopic pupil size was 4.81 mm +/- 0.54 (SD) (range 4.0 to 6.0 mm). At 30 minutes, all pupils became miotic, with a mean size of 3.77 +/- 0.51 mm (range 3.0 to 5.0 mm) (Pbrimonidine tartrate administration, the mean scotopic pupil size was 6.22 +/- 0.73 mm (range 5.0 to 8.0 mm). There was significant miosis to 4.57 +/- 0.84 mm (range 3.0 to 6.5 mm) (Pbrimonidine tartrate was stronger in eyes with light irides. Brimonidine tartrate caused significant miosis, especially under scotopic conditions, most likely from its alpha-2 adrenergic effect. Under photopic luminance conditions, the miotic effect was pronounced.

  14. Sustainability of Intraocular Pressure Reduction of Travoprost Ophthalmic Solution in Subjects with Normal Tension Glaucoma.

    Science.gov (United States)

    Naito, Tomoko; Okuma, Shinichi; Nagayama, Mikio; Mizoue, Shiro; Ozaki, Mineo; Namiguchi, Koji; Miyamoto, Kazuhisa; Tanito, Masaki; Yoshikawa, Keiji

    2016-03-01

    We examined the sustainability of the intraocular pressure (IOP)-lowering efficacy of travoprost (0.004%) ophthalmic solution in subjects with normal tension glaucoma (NTG). Travoprost ophthalmic solution was given once daily at 9 PM to subjects with newly diagnosed NTG or with NTG who had not received any ocular hypotensives within the previous 30 days. IOP was measured at three time points (9 AM, 1 PM, and 5 PM) at baseline and week 12 visits, and at one time point (9 AM) at week 4 and week 8 visits. Conjunctival hyperemia, superficial punctate keratopathy, and other adverse events were evaluated during the observation period. Thirty subjects (12 males and 18 females; mean age 65.6 years) from 32 subjects enrolled were included in the efficacy analysis. The mean IOPs (±standard deviation) of 16.6 ± 1.4, 15.7 ± 1.8, and 15.7 ± 2.2 mmHg at 9 AM, 1 PM, and 5 PM, respectively, at baseline reduced significantly to the mean IOPs of 13.0 ± 1.8, 12.7 ± 1.8, and 12.8 ± 1.6 mmHg, respectively, at week 12 (P < 0.0001 for every time point). Together with the mean IOPs of 13.4 ± 1.9 mmHg at week 4 and 13.2 ± 1.9 mmHg at week 8, the pooled IOP during the observation period for up to 12 weeks showed a statistically and clinically significant reduction of IOP at 9 AM. (3.4 mmHg or 20.3% reduction from baseline, P < 0.0001). There were no adverse events leading to treatment discontinuation. This multi-center collaborative study suggests that IOP-lowering efficacy of travoprost ophthalmic solution persists during the day at the clinically relevant level in subjects with NTG. Alcon Japan Ltd. University Hospital Medical Information Network, UMIN ID: 000011621.

  15. Comparative effiacy of marine Streptomyces formulation versus ciproflxacin ophthalmic solution for treating Staphylococcus aureus-induced conjunctivitis in animal model

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    Femina Wahaab

    2016-03-01

    Full Text Available Objective: To report the efficacy of marine actinomycetes in controlling Staphylococcus aureus (S. aureus-induced conjunctivitis in experimental rabbit. Methods: The ethyl acetate extracts of the best isolates of actinomycetes from the soil samples of Rameswaram coastal regions, Tamil Nadu, India, were concentrated and re-constituted in buffer and used as actinomycetes ophthalmic suspension in this study. The anti-inflammatory efficacy of actinomycetes ophthalmic suspension was analysed in controlling S. aureusinduced conjunctivitis in rabbit in comparison with that of ciprofloxacin. Results: Among the four best isolates, the RAM25C4 isolate had the highest antimicrobial activity in the secondary screening. Shelf life studies indicated that the activity can be retained for 75 days when it was stored at 8 °C and the optimum temperature for storage was between –20°C and 30°C. The animal model studies indicated that there was a profound anti-conjunctivitis effect. The actinomycetes ophthalmic suspension had better activity than ciprofloxacin ophthalmic solution. Conclusions: This is the first time to report that Streptomyces bacillaris strain RAM25C4 has antimicrobial effect in controlling ophthalmic pathogen S. aureus under in vitro condition and the in vivo anti-inflammatory activity in controlling S. aureus-induced conjunctivitis.

  16. Safety of Lifitegrast Ophthalmic Solution 5.0% in Patients With Dry Eye Disease: A 1-Year, Multicenter, Randomized, Placebo-Controlled Study

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    Donnenfeld, Eric D.; Karpecki, Paul M.; Majmudar, Parag A.; Nichols, Kelly K.; Raychaudhuri, Aparna; Roy, Monica; Semba, Charles P.

    2016-01-01

    Purpose: To evaluate the 1-year safety of lifitegrast ophthalmic solution 5.0% in patients with dry eye disease compared with placebo. Methods: SONATA (Safety Of a 5.0% coNcentrATion of lifitegrAst ophthalmic solution) was a multicenter, randomized, prospective, double-masked, placebo-controlled phase 3 study (NCT01636206). Adults (?18 years) with dry eye disease (Schirmer test score ?1 and ?10 mm; corneal staining score ?2.0) were randomized 2:1 to lifitegrast ophthalmic solution 5.0% or pla...

  17. The Effects of Netarsudil Ophthalmic Solution on Aqueous Humor Dynamics in a Randomized Study in Humans.

    Science.gov (United States)

    Kazemi, Arash; McLaren, Jay W; Kopczynski, Casey C; Heah, Theresa G; Novack, Gary D; Sit, Arthur J

    2018-02-22

    Netarsudil, an inhibitor of Rho kinase and a norepinephrine transporter, has been shown to lower elevated intraocular pressure (IOP) in controlled studies of patients with open-angle glaucoma and ocular hypertension, and in healthy volunteers. The mechanism of this ocular hypotensive effect in humans is unknown. The objective of this study was to evaluate the effect of netarsudil 0.02% on aqueous humor dynamics (AHD) parameters. In this double-masked, vehicle-controlled, paired-eye comparison study, 11 healthy volunteers received topical netarsudil ophthalmic solution 0.02% or its vehicle once daily for 7 days (morning dosing). The primary endpoints were the change in AHD parameters, compared between active and vehicle-treated eyes. In netarsudil-treated eyes, diurnal outflow facility increased from 0.27 ± 0.10 μL/min/mmHg to 0.33 ± 0.11 μL/min/mmHg (+22%; P = 0.02) after 7 days of treatment. In placebo-treated eyes, diurnal outflow facility did not significantly change (P = 0.94). The difference between netarsudil and placebo eyes in diurnal change of outflow facility was 0.08 μL/min/mmHg (P < 0.001). Diurnal episcleral venous pressure (EVP) in netarsudil-treated eyes decreased from 7.9 ± 1.2 mmHg to 7.2 ± 1.8 (-10%; P = 0.01). Diurnal EVP was not significantly different between netarsudil- and placebo-treated eyes. There was a trend toward decreasing aqueous humor flow rate (-15%; P = 0.08). No treatment changes were seen in uveoscleral outflow rate. Once-daily dosing of netarsudil ophthalmic solution 0.02% lowered IOP through increasing trabecular outflow facility and reducing EVP. This suggests a combination of mechanisms that affect both the proximal and distal outflow pathways.

  18. Influence of container structures and content solutions on dispensing time of ophthalmic solutions.

    Science.gov (United States)

    Yoshikawa, Keiji; Yamada, Hiroshi

    2010-05-25

    To investigate the influence of container structures and content solutions on the time of dispensing from eye dropper bottles. Eye dropper bottle models, solution models (filtrate water/surfactant solution) and a dispensing time measuring apparatus were prepared to measure the dispensing time. With filtrate water and pressure thrust load of 0.3 MPa, the dispensing time significantly increased from 1.1 +/- 0.5 seconds to 4.6 +/- 1.1 seconds depending on the decrease of inner aperture diameters from 0.4 mm to 0.2 mm (P bottle models with inner aperture diameters of 0.4 mm or larger, the dispensing time became constant. The dispensing time using surfactant solution showed the same tendency as above. When pressure thrust load was large (0.07 MPa), the solution flew out continuously with inner aperture diameters of 0.4 mm or larger and the dispensing time could not be measured. The inner aperture diameter most strongly explained the variation of the dispensing time in both the content solutions in the multiple linear regression analysis (filtrate water: 46%, R(2) = 0.462, surfactant solution: 56%, R(2) = 0.563). Among content solutions and container structures, the dispensing time was mostly influenced by the diameter of the inner aperture of bottles.

  19. Comparison of Drug Concentrations in Human Aqueous Humor after the Administration of 0.3% Gatifloxacin Ophthalmic Gel, 0.3% Gatifloxacin and 0.5% Levofloxacin Ophthalmic Solutions.

    Science.gov (United States)

    Ding, Wenting; Ni, Weiling; Chen, Huilian; Yuan, Jingqun; Huang, Xiaodan; Zhang, Zheng; Wang, Yao; Yu, Yibo; Yao, Ke

    2015-01-01

    To investigate the penetration of 0.3% gatifloxacin ophthalmic gel, 0.3% gatifloxacin ophthalmic solution and 0.5% levofloxacin ophthalmic solution into aqueous humor after topical application. Age-related cataract patients (150 eyes in 150 cases) receiving phacoemulsification were randomly divided into three groups: a 0.3% gatifloxacin gel group (n=50), a 0.3% gatifloxacin solution group (n=50), and a 0.5% levofloxacin solution group (n=50). Each group was administered one drop of gel or solution every 15 minutes for four doses. Aqueous samples were collected at different time points after the last drop. High pressure liquid chromatography (HPLC) was applied to determine the concentrations. The one-way ANOVA analysis was performed. Our data indicated that the concentration of the gatifloxacin gel group was higher than that of the gatifloxacin solution group at all time points (P levofloxacin solution group at 120.0 min and 180.0 min (Plevofloxacin solutions reached their peak values at 60.0 min. 0.3% gatifloxacin ophthalmic gel application produced highest aqueous humor drug concentration, maintained the longest time, had the best penetration and bioavailability.

  20. Gatifloxacin Ophthalmic Solution for Treatment of Bacterial Conjunctivitis: Safety, Efficacy and Patient Perspective

    Directory of Open Access Journals (Sweden)

    Clyde Schultz

    2012-01-01

    Full Text Available Gatifloxacin is a fourth generation fluroquinolone antibiotic that has been prescribed for systemic use. However, the drug which was developed by Kyorin (Japan was linked to toxic reactions and death and was banned in the United States and Canada for use as an oral dosage form. It continues to be used as a topical application for ophthalmic conditions as the systemic toxicity seen when taking the drug orally has not been observed with ophthalmic use. The available data indicate that ocular use of gatifloxacin is safe, and effective against a broad spectrum of bacteria, including intracellular bacteria and anaerobes.

  1. A randomised, double-masked comparison study of diquafosol versus sodium hyaluronate ophthalmic solutions in dry eye patients

    Science.gov (United States)

    Takamura, Etsuko; Tsubota, Kazuo; Watanabe, Hitoshi; Ohashi, Yuichi

    2012-01-01

    Aims To compare the efficacy and safety of 3% diquafosol ophthalmic solution with those of 0.1% sodium hyaluronate ophthalmic solution in dry eye patients, using mean changes in fluorescein and rose bengal staining scores as endpoints. Trial design and methods In this multicenter, randomised, double-masked, parallel study of 286 dry eye patients with fluorescein and rose bengal staining scores of ≥3 were randomised to the treatment groups in a 1 : 1 ratio. Efficacy and safety were evaluated after drop-wise instillation of the study drug, six times daily for 4 weeks. Results After 4 weeks, the intergroup difference in the mean change from baseline in fluorescein staining score was −0.03; this verified the non-inferiority of diquafosol. The mean change from baseline in rose bengal staining score was significantly lower in the diquafosol group (p=0.010), thus verifying its superiority. The incidence of adverse events was 26.4% and 18.9% in the diquafosol and sodium hyaluronate groups, respectively, with no significant difference. Conclusions Diquafosol (3%) and sodium hyaluronate (0.1%) exhibit similar efficacy in improving fluorescein staining scores of dry eye patients, whereas, diquafosol exhibits superior efficacy in improving rose bengal staining scores. Diquafosol has high clinical efficacy and is well tolerated with a good safety profile. PMID:22914501

  2. Ocular comfort assessment of lifitegrast ophthalmic solution 5.0% in OPUS-3, a Phase III randomized controlled trial.

    Science.gov (United States)

    Nichols, Kelly K; Holland, Edward; Toyos, Melissa M; Peace, James H; Majmudar, Parag; Raychaudhuri, Aparna; Hamdani, Mohamed; Roy, Monica; Shojaei, Amir

    2018-01-01

    To evaluate ocular comfort of lifitegrast ophthalmic solution 5.0% among patients with dry eye disease (DED) in the OPUS-3 trial. OPUS-3 was a multicenter, randomized, double-masked, placebo-controlled study. Adults with DED and recent artificial tear use were randomized 1:1 (lifitegrast:placebo) to ophthalmic drops twice daily for 84 days. On days 0 (baseline), 14, 42, and 84, drop comfort score (scale, 0-10; 0 = very comfortable, 10 = very uncomfortable) was measured at 0, 1, 2, and 3 minutes postinstillation. If the score was >3 at 3 minutes, assessment was repeated at 5, 10, and 15 minutes until score ≤3. Ocular treatment-emergent adverse events (TEAEs) were assessed. Overall, 711 participants were randomized (n=357 received lifitegrast; n=354 received placebo). Drop comfort scores for lifitegrast-treated participants improved within 3 minutes of instillation (mean scores on day 84 for both study and fellow eyes: instillation: lifitegrast, 3.4, placebo, 1.0; 3 minutes: lifitegrast, 1.5, placebo, 0.7). The majority (64%-66%) of participants had scores 3 at 3 minutes, the mean score in the lifitegrast group was similar to or better than that in the placebo group at 5, 10, or 15 minutes postinstillation. Lifitegrast appeared to be well tolerated, with ocular TEAEs rarely leading to discontinuation. In OPUS-3, lifitegrast appeared to be well tolerated and drop comfort scores approached placebo levels by 3 minutes postinstillation.

  3. Evaluating the efficacy of epinastine ophthalmic solution using a conjunctivitis allergen challenge model in patients with birch pollen allergic conjunctivitis.

    Science.gov (United States)

    Tagawa, Yoshiaki; Namba, Kenichi; Nakazono, Yumi; Iwata, Daiju; Ishida, Susumu

    2017-04-01

    The efficacy of epinastine 0.05% ophthalmic solution for pollen allergic conjunctivitis has already been shown in a conjunctival allergen challenge (CAC) test using cedar pollen as a challenge. The present study investigated the efficacy of this solution against birch pollen conjunctivitis in a CAC test. Ten adult subjects (eight males and two females) with asymptomatic birch pollen conjunctivitis were enrolled in this study. The average age of the subjects was 41.1 years. This study was conducted during a period without birch pollen dispersion. In each subject, the epinastine 0.05% ophthalmic solution was instilled in one eye, and an artificial tear fluid was instilled in the fellow eye in a double-blind manner. Five minutes or 4 h after the drug instillation, both eyes were challenged with an optimal concentration of birch pollen, and ocular itching and conjunctival hyperemia were then graded. Tears were collected before the drug instillation and 20 min after the pollen challenge, and the histamine level was measured. The ocular itching scores and palpebral conjunctival hyperemia scores of the epinastine-treated eyes were significantly lower than those of the contralateral control eyes when the eyes were pretreated with the drug 4 h before the CAC. There was a significant correlation between the tear histamine level and mean ocular itching score of three time points (3, 5 and 10 min) following the CAC in the control eyes but not the epinastine-treated eyes. Epinastine is effective in suppressing ocular itching and conjunctival hyperemia in birch pollen conjunctivitis. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  4. Optimising concentrations of antimicrobial agents in pharmaceutical preparations: Case of an oral solution of glycerol and an ophthalmic solution containing cysteamine.

    Science.gov (United States)

    Chan Hew Wai, A; Becasse, P; Tworski, S; Pradeau, D; Planas, V

    2014-11-01

    In the context of current distrust of antimicrobial preservatives, the quantities of these substances in two pharmaceutical formulas were studied: an ophthalmic solution of cysteamine preserved benzalkonium chloride at 1mg/5mL and Glycerotone(®) preserved with sorbic acid at 0.1g/100g. The purpose of this work was to verify that a reduction of the quantities of preservative continues to fulfil the requirements for antimicrobial preservation. The Test of efficacy of antimicrobial preservation, section 5.1.3 of the 8th edition of the European Pharmacopoeia, was carried out on each formulation prepared with decreasing quantities of preservative. The results show that formulations whose preservative concentration was reduced by a factor of four remained compliant with standards. It is to be noted that in formulas without preservative, fungal growth was observed in both the solution of Glycerotone(®) and the ophthalmic solution containing cysteamine. Although there is no question that an antimicrobial preservative is necessary, the quantity of preservative can be reduced without deteriorating the quality of the pharmaceutical product but the minimal effective concentration remains to be determined. The formulations of many pharmaceutical products should therefore be examined in order to limit the quantities of preservative while continuing to guarantee patient's safety. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Ocular comfort assessment of lifitegrast ophthalmic solution 5.0% in OPUS-3, a Phase III randomized controlled trial

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    Nichols KK

    2018-01-01

    Full Text Available Kelly K Nichols,1 Edward Holland,2 Melissa M Toyos,3 James H Peace,4 Parag Majmudar,5 Aparna Raychaudhuri,6 Mohamed Hamdani,6 Monica Roy,6 Amir Shojaei6 1School of Optometry, University of Alabama at Birmingham, Birmingham, AL, 2Cincinnati Eye Institute, Edgewood, KY, 3Toyos Clinic, Nashville, TN, 4United Medical Research Institute, Inglewood, CA, 5Chicago Cornea Consultants, Ltd., Hoffman Estates, IL, 6Shire, Lexington, MA, USA Purpose: To evaluate ocular comfort of lifitegrast ophthalmic solution 5.0% among patients with dry eye disease (DED in the OPUS-3 trial. Methods: OPUS-3 was a multicenter, randomized, double-masked, placebo-controlled study. Adults with DED and recent artificial tear use were randomized 1:1 (lifitegrast:placebo to ophthalmic drops twice daily for 84 days. On days 0 (baseline, 14, 42, and 84, drop comfort score (scale, 0–10; 0 = very comfortable, 10 = very uncomfortable was measured at 0, 1, 2, and 3 minutes postinstillation. If the score was >3 at 3 minutes, assessment was repeated at 5, 10, and 15 minutes until score ≤3. Ocular treatment-emergent adverse events (TEAEs were assessed. Results: Overall, 711 participants were randomized (n=357 received lifitegrast; n=354 received placebo. Drop comfort scores for lifitegrast-treated participants improved within 3 minutes of instillation (mean scores on day 84 for both study and fellow eyes: instillation: lifitegrast, 3.4, placebo, 1.0; 3 minutes: lifitegrast, 1.5, placebo, 0.7. The majority (64%–66% of participants had scores <3 within 3 minutes postinstillation on days 14, 42, and 84. In participants with scores >3 at 3 minutes, the mean score in the lifitegrast group was similar to or better than that in the placebo group at 5, 10, or 15 minutes postinstillation. Lifitegrast appeared to be well tolerated, with ocular TEAEs rarely leading to discontinuation. Conclusion: In OPUS-3, lifitegrast appeared to be well tolerated and drop comfort scores approached placebo

  6. Vitreous and aqueous concentrations of brimonidine following topical application of brimonidine tartrate 0.1% ophthalmic solution in humans.

    Science.gov (United States)

    Takamura, Yoshihiro; Tomomatsu, Takeshi; Matsumura, Takehiro; Takihara, Yuji; Kozai, Seiko; Arimura, Shogo; Yokota, Satoshi; Inatani, Masaru

    2015-06-01

    To determine the vitreous and aqueous concentrations of brimonidine after topical application of the ophthalmic solution 0.1%. The prospective observational case series included patients with an idiopathic epiretinal membrane or macular hole who were scheduled for a pars plana vitrectomy. Brimonidine tartrate ophthalmic solution 0.1% was topically administered twice daily for 1 week preoperatively. Vitreous and aqueous humor was collected before vitrectomy, and then, the brimonidine concentration was measured with liquid chromatography tandem spectrometry (LC/MS/MS). Twenty-four patients (19 phakic eyes and 5 pseudophakic eyes) were enrolled. The mean concentrations in the aqueous humor and vitreous were 336.0 ± 276.2 and 4.8 ± 3.2 nM, respectively. A significant relationship was observed between the vitreous and aqueous samples (P = 0.034, R(2) = 0.22). Nineteen (79%) of the 24 eyes showed more than 2 nM of brimonidine tartrate concentration in the vitreous. In the phakic eyes, the mean concentration of brimonidine in the vitreous was 4.9 ± 3.3 nM, while the mean concentration in the pseudophakic eyes was 4.1 ± 2.4 nM, demonstrating no significant difference between pseudophakic and phakic eyes (P = 0.59). After 1 week of dosing, in most of the patients who topically received brimonidine tartrate 0.1%, the concentration in the vitreous of the molecule was above 2 nM, which is known to activate neuroprotective α-2 receptors in animal retina. The drug penetration into the vitreous seems to be independent of lens status.

  7. Lifitegrast ophthalmic solution 5.0% for treatment of dry eye disease: results of the OPUS-1 phase 3 study.

    Science.gov (United States)

    Sheppard, John D; Torkildsen, Gail L; Lonsdale, John D; D'Ambrosio, Francis A; McLaurin, Eugene B; Eiferman, Richard A; Kennedy, Kathryn S; Semba, Charles P

    2014-02-01

    To assess the efficacy and safety of lifitegrast ophthalmic solution 5.0% compared with placebo in subjects with dry eye disease. Prospective, randomized, double-masked, placebo-controlled, parallel arm, multicenter clinical trial. A total of 588 adult subjects with dry eye disease. Eligible subjects were randomized 1:1 to receive topically administered lifitegrast (5.0%) or placebo (vehicle) twice daily for 84 days after a 14-day open-label placebo run-in period. After enrollment (day 0), subjects were evaluated at days 14, 42, and 84. Key objective (fluorescein and lissamine staining scores [Ora scales]) and subjective (Ocular Surface Disease Index [OSDI], 7-item visual analog scale, and ocular discomfort score [Ora scale]) measures were assessed at all visits. The primary objective efficacy measure (sign) was mean change from baseline inferior corneal staining score (ICSS) at day 84. The co-primary subjective efficacy measure (symptom) was the mean change from baseline in the visual-related function subscale score of the Ocular Surface Disease Index (VR-OSDI). Supportive measures included corneal fluorescein scores (superior, central, total region) and conjunctival lissamine scores (nasal, temporal, total region) and symptom scores at day 84. The study met the primary objective efficacy ICSS end point in demonstrating superiority of lifitegrast compared with placebo (P = 0.0007). Lifitegrast significantly reduced corneal fluorescein staining (superior, P = 0.0392; total cornea, P = 0.0148) and conjunctival lissamine staining (nasal, P = 0.0039; total conjunctiva, P = 0.0086) at day 84 versus placebo. Significant (P lifitegrast dose at day 0. Lifitegrast ophthalmic solution 5.0% significantly reduced corneal fluorescein and conjunctival lissamine staining and improved symptoms of ocular discomfort and eye dryness compared with placebo when administered twice daily over 84 days. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All

  8. Immediate Effects of 3% Diquafosol and 0.1% Hyaluronic Acid Ophthalmic Solution on Tear Break-Up Time in Normal Human Eyes.

    Science.gov (United States)

    Nam, Ki Tae; Ahn, So Min; Eom, Youngsub; Kim, Hyo Myung; Song, Jong Suk

    2015-12-01

    The purpose of this study was to evaluate the immediate effect of 3% diquafosol ophthalmic solution on tear break-up time (TBUT) in normal human eyes, and to compare it with that of saline and 0.1% hyaluronate ophthalmic solution. Cross sectional comparative study in the first study, 10 healthy volunteers underwent topical application of 2 different ophthalmic solutions in each eye. Saline was randomly applied to one eye and 3% diquafosol ophthalmic solution was added to the fellow eye. TBUT was measured and video recorded before application and at 5, 10, 15, and 20 min after. The TBUT in each eye was compared at each time point with regard to the 2 different ophthalmic solutions. In the second study, another 10 healthy volunteers were included. The same methods were used to compare the immediate effects of 0.1% hyaluronate and 3% diquafosol ophthalmic solution application on TBUT. In the first study, topical instillation of saline did not increase TBUT. However, 3% diquafosol significantly increased TBUT for up to 15 min after application. At every time point, the TBUT increased more significantly from baseline in the diquafosol group than it did in the saline group. In the second study, 0.1% hyaluronate increased TBUT for up to 5 min after application, while 3% diquafosol increased TBUT for up to 15 min. Although the TBUT changes after 5 min were not significantly different between the 2 groups, the TBUT changes at 10, 15, and 20 min were significantly greater in the 3% diquafosol group than they were in the 0.1% hyaluronic acid group (+1.58 ± 0.82 vs. +0.53 ± 1.36 at 10 min, +0.67 ± 0.91 vs. -0.04 ± 1.29 at 15 min, and -0.06 ± 0.96 vs. -0.59 ± 0.90, diquafosol group vs. hyaluronic acid group). One drop of 3% diquafosol increased TBUT for up to 15 min after application. The immediate effect of 3% diquafosol on TBUT was greater than that of saline and even that of 1% hyaluronate ophthalmic solution.

  9. Ophthalmic emergencies.

    Science.gov (United States)

    Mandell, Deborah C; Holt, Elaine

    2005-03-01

    Ophthalmic emergencies are common presenting complaints in an emergency room. Most ophthalmic emergencies can be treated and stabilized until an ophthalmologist can be consulted. Most ocular emergencies involve loss of vision, compromised globe integrity, or severe ocular pain. Delay in treating true emergencies may result ina blind eye or loss of an eye. This article discusses the clinical signs,diagnosis, and treatment as well as the prognosis of some of the more common ophthalmic emergencies.

  10. Evaluation of Efficacy and Safety of Brimonidine Tartrate Ophthalmic Solution, 0.025% for Treatment of Ocular Redness.

    Science.gov (United States)

    Torkildsen, Gail L; Sanfilippo, Christine M; DeCory, Heleen H; Gomes, Paul J

    2018-01-01

    Purpose/Aims: This study assessed the efficacy and safety of brimonidine tartrate ophthalmic solution, 0.025% for treating ocular redness in adult subjects. This was a single-center, double-masked, randomized, vehicle-controlled, parallel-group study in subjects ≥40 years, with ocular redness. Subjects were randomized 2:1 to brimonidine or vehicle, instilled QID for four weeks. Subjects completed four visits, the last occurring one week after treatment discontinuation. The investigator assessed ocular redness on a scale of 0-4 pre-instillation and 5-240 minutes post-instillation on Day 0, pre-instillation and 5 minutes post-instillation on Days 14 and 28, and on Day35; subjects assessed redness in diaries throughout the 28-day treatment period and following treatment discontinuation. Safety assessments included adverse events (AEs), rebound redness on treatment discontinuation, comprehensive ophthalmic exams, and vital signs. Drop comfort was assessed upon instillation, and 30 seconds and 1 minute post-instillation at Day 0. Fifty-seven subjects (brimonidine, n = 38; vehicle, n = 19) were randomized. Investigator-assessed ocular redness was significantly reduced with brimonidine across the entire post-instillation time period (overall treatment difference: -1.37; P brimonidine (P ≤ 0.0005). No tachyphylaxis was evident. There were few ocular AEs, all mild to moderate in severity, and no redness rebound was observed upon brimonidine discontinuation. There were no effects on any safety measures, and both brimonidine and its vehicle were reported to be very comfortable. Brimonidine 0.025% appeared safe, well tolerated, and reduced ocular redness for at least 4 hours. No tachyphylaxis or rebound redness upon treatment discontinuation was observed.

  11. [Effects levocabastine ophthalmic solution (H1 receptor antagonist) on symptoms of vernal conjunctivitis. A prospective, randomized double-blind study].

    Science.gov (United States)

    Graue, E

    1994-01-01

    A double blind, prospective and randomized study was carried out in forty patients with clinical diagnosis of vernal conjunctivitis and eosinophilia in conjunctival scrapings. They were divided in two randomized groups of 20 patients each. One of the groups received levocabastine ophthalmic solution and the other saline solution drops. The mean age of the study group was 9.1 years old with a vernal conjunctivitis history of 44 months. The control group mean age was 10.1 years old and a history of vernal conjunctivitis of 48 months prior the enter of the study. One group received levocabastine 0.5 mgrs/ml while the other balanced saline solution, one drop every 12 hours per seven days. The patients evaluated their symptoms through a visual analogic scale (every day). Data collected was analyzed, for the first, third and seventh day, through U-Mann Whitney statistical analysis. Epiphora and photophobia showed a significant improvement. Itching, edema and foreign body sensation showed improvement in the levocabastine group but without statistical significance. Hyperthermia remained the same in both groups studied.

  12. 76 FR 81806 - Ophthalmic and Topical Dosage Form New Animal Drugs; Ivermectin Topical Solution

    Science.gov (United States)

    2011-12-29

    ... Animal Drugs; Ivermectin Topical Solution AGENCY: Food and Drug Administration, HHS. ACTION: Final rule... parasites when cattle are treated with a topical solution of ivermectin. DATES: This rule is effective... topical solution used on cattle to control infestations of certain species of external and internal...

  13. 75 FR 26647 - Ophthalmic and Topical Dosage Form New Animal Drugs; Ivermectin Topical Solution

    Science.gov (United States)

    2010-05-12

    ...; Ivermectin Topical Solution AGENCY: Food and Drug Administration, HHS. ACTION: Final rule, technical... parasites when cattle are treated with a topical solution of ivermectin. DATES: This rule is effective May..., filed a supplement to ANADA 200-340 for PRIVERMECTIN (ivermectin), a topical solution used on cattle to...

  14. Bimatoprost ophthalmic solution 0.03% lowered intraocular pressure of normal-tension glaucoma with minimal adverse events.

    Science.gov (United States)

    Tsumura, Toyoaki; Yoshikawa, Keiji; Suzumura, Hirotaka; Kimura, Tairo; Sasaki, Satoshi; Kimura, Itaru; Takeda, Ryuji

    2012-01-01

    The aim of this study was to evaluate the efficacy and safety of bimatoprost ophthalmic solution 0.03% (bimatoprost) in Japanese normal-tension glaucoma (NTG) patients with an intraocular pressure (IOP) of 18 mmHg or less. Bimatoprost was instilled into the unilateral conjunctival sac of Japanese NTG patients with a baseline IOP of 18 mmHg or less. The time courses of IOP, conjunctival hyperemia, superficial punctate keratitis, and adverse events were examined at 2, 4, 8, and 12 weeks post bimatoprost instillation. Thirty-two of the 38 enrolled NTG patients (mean age, 64.1 ± 12.6 years; 19 males and 19 females) completed the study, with six patients unable to complete the study (two patients discontinued because of side effects and four patients withdrew). The levels of IOP in the treated eyes were significantly reduced (P superficial punctate keratitis scores were noted between the baseline and each point examined. Eyelash disorder, eyelid pigmentation, and deepening of the upper eyelid sulcus were observed in 28, six, and three eyes, respectively. Bimatoprost effectively lowered the IOP. It was well tolerated in Japanese NTG patients, with few patients having to discontinue because of adverse events.

  15. Patient satisfaction with fixed-combination bimatoprost/timolol ophthalmic solution: a survey study in patients with glaucoma in China

    Directory of Open Access Journals (Sweden)

    Sun XH

    2017-04-01

    Full Text Available Xinghuai Sun,1,2 Mingkai Lin,3 Xuanchu Duan,4 Chun Zhang,5 Jian Ming6 1Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, 2Key Laboratory of Myopia, Ministry of Health (Fudan University, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University, Shanghai, 3Zhongshan Ophthalmic Center, Guangzhou, 4The Second Xiangya Hospital of Central South University, Changsha, 5Peking University Third Hospital, Beijing, 6Allergan plc, Shanghai, People’s Republic of China Background: Poor adherence to treatment is a problem in glaucoma, and patient dissatisfaction with topical glaucoma medication is a barrier to adherence. The objective of this study was to evaluate glaucoma patients’ satisfaction with fixed-combination bimatoprost/timolol ophthalmic solution (BTFC. Methods: This observational, multicenter study was conducted in China in adults with glaucoma treated with BTFC for 1–3 months. Five hundred patients answered a questionnaire concerning their demographic characteristics, history of glaucoma and topical glaucoma treatment, and use of BTFC. The primary endpoint was patient satisfaction with BTFC assessed on a 10-point scale (1= very dissatisfied, 10= very satisfied.Results: Patients received BTFC alone (65% or with other treatments (35%, most commonly a carbonic anhydrase inhibitor. Most patients (87% used BTFC as a replacement for other medication, usually a β-blocker or prostaglandin analog; 13% received BTFC as add-on treatment. Key reasons for initiating BTFC therapy were poor efficacy of previous treatment (72% of patients and side effects of previous treatment (32% of patients. Most patients agreed or very much agreed that BTFC provided better control of intraocular pressure (85% of patients, had a simpler administration (87% of patients, and was associated with better tolerance and comfort (82% of patients compared with their previous treatment. Mean satisfaction scores were

  16. Lifitegrast Ophthalmic

    Science.gov (United States)

    Ophthalmic lifitegrast is used to treat the signs and symptoms of dry eye disease. Lifitegrast is in a class of medications called lymphocyte function-associated antigen-1 (LFA-1) antagonist. Lifitegrast works by reducing the swelling in the eye ...

  17. Cyclopentolate Ophthalmic

    Science.gov (United States)

    Cyclopentolate ophthalmic is used to cause mydriasis (pupil dilation) and cycloplegia (paralysis of the ciliary muscle of ... You should bring this list with you each time you visit a doctor or if you are ...

  18. Ocular pharmacokinetics comparison between 0.2% olopatadine and 0.77% olopatadine hydrochloride ophthalmic solutions administered to male New Zealand white rabbits.

    Science.gov (United States)

    Iyer, Ganesh R; Cason, Marita M; Womble, Scott W; Li, Guangming; Chastain, James E

    2015-05-01

    The primary objective of this study was to compare uptake and distribution of the commercially available formulation of 0.2% olopatadine and the newly developed 0.77% olopatadine hydrochloride ophthalmic solution formulation with improved solubility following a single (30 μL), bilateral topical ocular dose in male New Zealand white rabbits. Each animal received a single 30-μL topical ocular dose (0.2% olopatadine or 0.77% olopatadine hydrochloride ophthalmic solution) to the right (OD) eye followed by the left (OS) eye for a total dose of 60 μL. Olopatadine concentrations were measured in ocular tissues (cornea, bulbar, conjunctiva, choroid, iris-ciliary body, whole lens, retina), aqueous humor, and plasma at prespecified time points over 24 h using a qualified liquid chromatography coupled with mass spectrometry (LC-MS/MS) analytical method. Olopatadine was absorbed into the eye and reached maximal levels (Cmax) within 30 min (0.5 h) to 2 h (Tmax) in ocular tissues and plasma for both treatment groups, except for the lens in which the Tmax was 4 h in the 0.2% olopatadine group and 8 h in the 0.77% olopatadine hydrochloride group, respectively. Tissues associated with the site of dosing, that is, the conjunctiva and cornea, had the highest concentrations of olopatadine in both the 0.2% olopatadine (609 and 720 ng/g) and 0.77% olopatadine hydrochloride (3,000 and 2,230 ng/g) dose groups. The greatest differences between 0.2% olopatadine and 0.77% olopatadine hydrochloride were associated with the overall duration and level of ocular exposures. The newly developed 0.77% olopatadine hydrochloride ophthalmic solution formulation resulted in a higher and more prolonged olopatadine concentration in the target tissue, that is, conjunctiva compared to the commercial formulation of 0.2% olopatadine ophthalmic solution.

  19. Safety of Lifitegrast Ophthalmic Solution 5.0% in Patients With Dry Eye Disease: A 1-Year, Multicenter, Randomized, Placebo-Controlled Study.

    Science.gov (United States)

    Donnenfeld, Eric D; Karpecki, Paul M; Majmudar, Parag A; Nichols, Kelly K; Raychaudhuri, Aparna; Roy, Monica; Semba, Charles P

    2016-06-01

    To evaluate the 1-year safety of lifitegrast ophthalmic solution 5.0% in patients with dry eye disease compared with placebo. SONATA (Safety Of a 5.0% coNcentrATion of lifitegrAst ophthalmic solution) was a multicenter, randomized, prospective, double-masked, placebo-controlled phase 3 study (NCT01636206). Adults (≥18 years) with dry eye disease (Schirmer test score ≥1 and ≤10 mm; corneal staining score ≥2.0) were randomized 2:1 to lifitegrast ophthalmic solution 5.0% or placebo twice daily for 360 days. The primary objective was percentage and severity of treatment-emergent adverse events (TEAEs). Secondary objectives were ocular safety measures: corneal fluorescein staining, drop comfort, best-corrected visual acuity, slit-lamp biomicroscopy, and intraocular pressure over 7 visits. Exploratory objectives included concentration of lifitegrast in plasma. The safety population comprised 331 participants (220 lifitegrast; 111 placebo). There were no serious ocular TEAEs. Overall, 53.6% of participants receiving lifitegrast experienced ≥1 ocular TEAE versus 34.2% in the placebo group; most TEAEs were mild to moderate in severity. Rates of discontinuation because of TEAEs were 12.3% (lifitegrast) versus 9.0% (placebo). The most common (>5%) TEAEs occurring in either treatment group were instillation site irritation (burning), instillation site reaction, visual acuity reduced, dry eye, and dysgeusia (change in taste). Ocular safety parameters for lifitegrast were similar to placebo. The mean plasma lifitegrast concentration at 360 days (n = 43) was below the limit of detection. There was no indication of systemic toxicity or localized infectious complications secondary to chronic immunosuppression. Lifitegrast ophthalmic solution 5.0% seemed safe and well tolerated in this study, with no unexpected adverse events.

  20. Efficacy of ophthalmic solutions to detach adhering Pseudomonas aeruginosa from contact lenses

    NARCIS (Netherlands)

    Landa, AS; van der Mei, HC; van Rij, G; Busscher, HJ

    Purpose. To compare the efficacies of two all-in-one contact lens (CL) cleaning solutions and a detergent mixture on the detachment of a pathogenic bacterium adhering to two types of contact lenses in the absence and presence of a tear film. Methods. Bacterial-detachment studies were carried out in

  1. Aqueous Humor Penetration and Biological Activity of Moxifloxacin 0.5% Ophthalmic Solution Alone or with Dexamethasone 0.1.

    Science.gov (United States)

    Gomes, Rachel L R; Viana, Rodrigo Galvão; Melo, Luiz Alberto S; Cruz, Alessandro Carvalho; Suenaga, Eunice Mayumi; Kenyon, Kenneth R; Campos, Mauro

    2017-03-01

    To compare aqueous humor concentrations of topically applied moxifloxacin 0.5% ophthalmic solution alone or in combination with dexamethasone 0.1% and to correlate these concentrations with the minimum inhibitory concentrations (MICs) for common endophthalmitis-causing organisms. Sixty-eight patients undergoing routine phacoemulsification with intraocular lens implantation received either moxifloxacin 0.5% alone or moxifloxacin 0.5% combined with dexamethasone. For both groups, 1 drop of the test solution was instilled 4 times daily 1 day preoperatively and 1 drop 1 h preoperatively. An aqueous humor sample obtained immediately before paracentesis was submitted to high-performance liquid chromatography-tandem mass spectrometry to determine the moxifloxacin concentration. The mean concentrations of moxifloxacin were 986.6 ng/mL in the moxifloxacin with dexamethasone group and 741.3 ng/mL in the moxifloxacin group (P = 0.13). Moxifloxacin concentrations of all samples exceeded the MICs for Staphylococcus epidermidis, S. aureus, and Streptococcus pneumoniae. All samples in the moxifloxacin with dexamethasone group and 94% in the moxifloxacin group achieved the MIC for Enterococcus species. For quinolone-resistant S. aureus, the MIC was achieved in 29% in the moxifloxacin with dexamethasone group and 9% in the moxifloxacin group (P = 0.06). Aqueous humor moxifloxacin concentrations were higher when topically administrated in combination with dexamethasone compared to the moxifloxacin alone. However, this difference was not statistically significant. Nevertheless, the MICs of the most common pathogens associated with endophthalmitis were exceeded in both study groups.

  2. Epinastine 0.05% ophthalmic solution in contact lens-wearing subjects with a history of allergic conjunctivitis.

    Science.gov (United States)

    Nichols, Kelly K; Morris, Scot; Gaddie, Ian B; Evans, David

    2009-01-01

    To assess the comfort and efficacy of epinastine 0.05% ophthalmic solution in contact lens wearers with a history of allergic conjunctivitis and contact lens intolerance during allergy season. One hundred forty-six subjects were enrolled in a multicenter, open-label study. Enrolled subjects instilled rewetting drops twice a day for a one-week run-in period, then were randomized to epinastine 0.05% twice a day plus rewetting drops as required (n = 75) or rewetting drops alone as required (minimum use twice a day) (n = 71). Subjects recorded the length of time that contact lens wear was comfortable, the total time of wear, ocular itch, overall comfort, and use of rewetting drops during the run-in period, at baseline, and on days 2 to 7 of the treatment period. Subjects averaged 34 years of age; 79% were female. No significant differences were shown at baseline between subjects treated with epinastine 0.05% twice a day plus rewetting drops and control subjects treated with rewetting drops alone. Averaged over the treatment period, epinastine provided significant increases in comfortable wearing time (1.33 +/- 2.89 vs. 0.43 +/- 2.28 hr, P=0.012) and total wearing time (0.35 +/- 1.87 vs. -0.32 +/- 1.81 hr, P=0.008) compared with controls. Epinastine users reported less frequent additional rewetting drop use on average by 0.56 uses per day, which was significantly different than controls (reduction of 0.06 uses per day; P=0.012). Epinastine provided significantly greater improvements from baseline in ocular itch and overall eye comfort compared with rewetting drops alone (Pcontact lens wearers.

  3. Incidence of deepening of upper eyelid sulcus after topical use of tafluprost ophthalmic solution in Japanese patients

    Directory of Open Access Journals (Sweden)

    Maruyama K

    2013-07-01

    Full Text Available Katsuhiko Maruyama,1 Asako Tsuchisaka,1 Jumpei Sakamoto,1 Shiroaki Shirato,2 Hiroshi Goto11Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan; 2Yotsuya Shirato Eye Clinic, Tokyo, JapanPurpose: To investigate the incidence of deepening of upper eyelid sulcus (DUES with topical use of tafluprost in Japanese glaucoma patients.Methods: This study was a prospective, open-label, non-controlled case series conducted at a single center. Thirty-six primary open-angle glaucoma Japanese patients who had no history of surgery were enrolled. The patients were prescribed 0.0015% topical tafluprost once daily to one eye that had the more severe visual field disorder, and observed during outpatient visits before and at 30, 60, and 90 days after starting treatment. At every visit, three examiners judged the presence of DUES unanimously by facial photographs including eyebrows and lower eyelids. The primary outcome variable was the incidence of DUES at the end of day 90 in the study as assessed by observer-masked facial photography. The patients were also asked if they noticed any subjective symptom of DUES. Gender, refraction, and intraocular pressure were evaluated as potential risk factors.Results: Thirty-two patients completed this clinical trial. DUES were identified objectively in 19% (6/32 of the patients after 90 days of treatment. The incidence was not related to gender, refraction, baseline or post-treatment intraocular pressure, or intraocular pressure reduction. Finally, 17% (1/6 of patients with objectively diagnosed DUES noticed the presence of DUES by themselves. No patient dropped out of the study because of DUES.Conclusion: Similar to other prostaglandin analogs, topical use of tafluprost ophthalmic solution is associated with DUES as a local adverse reaction.Keywords: prostaglandins, tafluprost, eyelid, deepening, side effect

  4. Degree of corneal anaesthesia after topical application of 0.4% oxybuprocaine hydrochloride and 0.5% proparacaine hydrochloride ophthalmic solution in clinically normal cattle.

    Science.gov (United States)

    Little, W B; Jean, G St; Sithole, F; Little, E; Jean, K Yvorchuk-St

    2016-06-01

    The use of corneal anaesthesia is necessary for a range of clinical purposes. Therefore, we assessed and compared the efficacy of corneal anaesthesia after application of 0.4% oxybuprocaine hydrochloride and 0.5% proparacaine hydrochloride ophthalmic solution in clinically normal cattle. The 24 clinically normal cows were allocated into two groups. Cows in group 1 (n = 12) received 0.2 mL of 0.4% oxybuprocaine hydrochloride with fluorescein ophthalmic solution in one eye and 0.2 mL of sterile saline (0.9% NaCl) with fluorescein in the contralateral eye (control). Group 2 (n = 12) received 0.2 mL of 0.4% oxybuprocaine hydrochloride with fluorescein ophthalmic solution in one eye and 0.2 mL of 0.5% proparacaine hydrochloride with fluorescein in the contralateral eye (control). In each group, corneal touch threshold was determined by Cochet-Bonnet aesthesiometer for both eyes immediately prior to topical administration of solutions, at 1 min and 5 min after administration of topical solutions and every 5 min thereafter for a total of 75 min. Significant corneal anaesthesia was noted immediately following topical application of both oxybuprocaine and proparacaine as compared with controls, with maximal corneal anaesthesia noted 1 min after administration. Both oxybuprocaine and proparacaine produced significant corneal anaesthesia for the duration of the 75-min study. Neither oxybuprocaine hydrochloride nor proparacaine hydrochloride treatment resulted in visible adverse effects. There are limited data available demonstrating the efficacy and duration of corneal anaesthetic agents in cattle. Both oxybuprocaine hydrochloride and proparacaine hydrochloride should be considered practical options for providing corneal anaesthesia in cattle in a clinical setting. © 2016 Australian Veterinary Association.

  5. Ophthalmic Lenses

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    Bhootra, Ajay Kumar

    2009-01-01

    This book is uniquely meant for the ophthalmologists, optometrists and opticians to help the world see better by excellent vision through the services of technicians and clinical principle based ophthalmology so that the management of ocular problems can be done for a better vision . Informs that a wide range of material and design of ophthalmic lenses with innovative developments is available. This book presents comprehensively rich information about the ophthalmic lenses and their dispensing tips . It will be highly useful mainly for the students of optometry and opticians, ophthalmologists,

  6. Comparative efficacy of macrolides containing marine actinomycetes formulation versus ciprofloxacin ophthalmic solution in controlling Pseudomonas aeruginosa induced conjunctivitis on rabbit model

    Directory of Open Access Journals (Sweden)

    Femina Wahaab

    2015-06-01

    Full Text Available The main objective of this study was to evaluate the antimicrobial activity and anti-inflammatory activity of marine actinomycetes extract against ocular pathogen Pseudomonas aeruginosa. Actinomycetes isolated from Rameswaram coastal region, Tamilnadu, India were initially screened by primary screening and secondary screening against ocular pathogen P. aeruginosa. Followed by anti-conjunctivitis efficacy of actinomycetes ethyl acetate extract formulation versus ciprofloxacin ophthalmic solution was evaluated using rabbit as animal model. The bioactive compounds present in the best actinomycetes extract was identified by HPTLC and GC–MS analysis. Finally the screened best actinomycetes was identified by 16S rRNA sequencing method. In primary screening 28 actinomycetes that inhibited the growth of P. aeruginosa were taken for secondary screening. In secondary screening RAM24C2 extract had maximum activity against P. aeruginosa. In vivo study of conjunctivitis developed rabbits treated with RAM24C2 extract formulation showed the best clinical cure than ciprofloxacin ophthalmic solution. The RAM24C2 extract was chromatographically characterized and found to contain macrolides. In addition, the effective major pivotal molecule in the extract was detected as 1, 2 benzene dicarboxylic acid and Bis (2-ethylhexyl phthalate by GC–MS analysis. The RAM24C2 strain was identified as Streptomyces sp. MAD01 and the sequence was submitted in NCBI with accession number JX050218. From our study it is found that the ethyl acetate extract obtained from marine actinomycetes is effective against ocular pathogen P. aeruginosa. Compared to ciprofloxacin ophthalmic solution our RAM24C2 extract formulation hastens the cure of conjunctivitis developed rabbits and need less dosage frequency.

  7. Bimatoprost ophthalmic solution 0.03% lowered intraocular pressure of normal-tension glaucoma with minimal adverse events

    Directory of Open Access Journals (Sweden)

    Tsumura T

    2012-09-01

    Full Text Available Toyoaki Tsumura,1 Keiji Yoshikawa,2 Hirotaka Suzumura,3 Tairo Kimura,4 Satoshi Sasaki,5 Itaru Kimura,6 Ryuji Takeda71Department of Ophthalmology, Fussa Hospital, Fussa, Tokyo, Japan; 2Yoshikawa Eye Clinic, Machida, Tokyo, Japan; 3Department of Ophthalmology, Nakano General Hospital, Nakano, Tokyo, Japan; 4Ueno Eye Clinic, Ueno, Tokyo, Japan; 5Sasaki Eye Clinic, Ueno, Tokyo, Japan; 6Department of Ophthalmology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan; 7Department of Biological Chemistry, Faculty of Agriculture, Kinki University, Nara, Nara, JapanPurpose: The aim of this study was to evaluate the efficacy and safety of bimatoprost ophthalmic solution 0.03% (bimatoprost in Japanese normal-tension glaucoma (NTG patients with an intraocular pressure (IOP of 18 mmHg or less.Methods: Bimatoprost was instilled into the unilateral conjunctival sac of Japanese NTG patients with a baseline IOP of 18 mmHg or less. The time courses of IOP, conjunctival hyperemia, superficial punctate keratitis, and adverse events were examined at 2, 4, 8, and 12 weeks post bimatoprost instillation.Results: Thirty-two of the 38 enrolled NTG patients (mean age, 64.1 ± 12.6 years; 19 males and 19 females completed the study, with six patients unable to complete the study (two patients discontinued because of side effects and four patients withdrew. The levels of IOP in the treated eyes were significantly reduced (P < 0.0001 from the baseline IOP levels. No significant change in IOP was observed in the fellow eyes. There were significant increases in conjunctival hyperemia. No significant superficial punctate keratitis scores were noted between the baseline and each point examined. Eyelash disorder, eyelid pigmentation, and deepening of the upper eyelid sulcus were observed in 28, six, and three eyes, respectively.Conclusion: Bimatoprost effectively lowered the IOP. It was well tolerated in Japanese NTG patients, with few patients having to discontinue

  8. Ocular pharmacokinetics and tolerability of bimatoprost ophthalmic solutions administered once or twice daily in rabbits, and clinical dosing implications

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    Shen J

    2017-09-01

    Full Text Available Jie Shen,1 Margot L Goodkin,2 Warren Tong,2 Mayssa Attar3 1Clinical Pharmacology, 2Clinical Development, 3Clinical Pharmacology, Metabolism and Immunology, Allergan plc, Irvine, CA, USA Purpose: Fixed-combination medications can benefit patients requiring multiple agents to lower their intraocular pressure (IOP, but combining agents with complementary mechanisms of action is challenging if their dosing frequency differs. This study compares in vivo pharmacokinetic and ocular tolerability of bimatoprost 0.01% ophthalmic solutions dosed once or twice daily. Reports of twice-daily dosing in glaucoma patients are also reviewed.Methods: New Zealand White rabbits were administered bimatoprost 0.01% monotherapy or fixed-combination bimatoprost 0.01%/brimonidine 0.1%, once or twice daily in both eyes for 4 days. Ocular tissues were harvested and analyzed by liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters calculated included maximum observed concentration, time to maximum concentration, and area under the concentration-time curve.Results: Due to extensive metabolism, bimatoprost concentration was below the quantitation limit by 1 hour post-dose in all samples. Bimatoprost acid exposure, however, could be measured up to 6–8 hours post-dose and was similar in the aqueous humor and iris-ciliary body (pharmacological site of action of animals treated once or twice daily with either bimatoprost 0.01% or fixed-combination bimatoprost 0.01%/brimonidine 0.1%. Increasing dosage frequency in rabbits did not raise the incidence of drug-related conjunctival hyperemia (most common adverse event associated with bimatoprost use in humans, suggesting comparable ocular tolerability of the once- and twice-daily regimens for each formulation.Conclusion: Bimatoprost 0.01% administered once or twice daily as monotherapy and in fixed-combination with brimonidine 0.1% in rabbits show similar pharmacokinetic profiles of bimatoprost acid

  9. Bromfenac (Broksinak — a new word in the nonsteroidal antiinflamatory drug (literature review

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    E. A. Spiridonov

    2015-01-01

    Full Text Available Eye inflammation can be caused by different factors — allergies, infection, trauma (including surgery. It can have severe complications, last even after elimination the reason and cause the visual impairment as an outcome. Two main classes of anti-inflammatory agents (corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs are used for the prevention and relief of the inflammatory process. Along with the fact that corticosteroids are the «gold standard» treatment of inflammation in ophthalmology, they have a number of serious side effects such as increasing of intraocular pressure and the risk of developing glaucoma, cataracts, activation of bacterial, viral infection and herpes. The positive effects of NSAIDs in comparison with corticosteroids are stable intraocular pressure (IOP, analgesic effect and reduce the risk of secondary infection. The three classes of NSADs are currently used in ophthalmology. They are phenylacetic acid (diclofenac and bromfenac nepafenak, indole acetic acid (indomethacin and geteroariluksunoy acid (ketorolac. The last synthesized NSAIDs for ophthalmology are amfenac and bromfenac. Bromfenac is effective for the relief of the inflammatory symptoms of and fully complies with the requirements for the ideal anti-inflammatory drugs such as good a penetration ability, creating a sufficient concentration inside the eye, the activity of cyclooxygenase, inhibiting the progress of macular edema, a good analgesic effect, minimal toxicity, comfort of use patients. Bromfenac is the only nonsteroidal antiinflammatory drugs, which is applied once a day and has a pronounced anti-inflammatory action.

  10. Ocular comfort assessment of lifitegrast ophthalmic solution 5.0% in OPUS-3, a Phase III randomized controlled trial

    OpenAIRE

    Nichols,Kelly K; Holland,Edward; Toyos,Melissa M; Peace,James H; Majmudar,Parag; Raychaudhuri,Aparna; Hamdani,Mohamed; Roy,Monica; Shojaei,Amir

    2018-01-01

    Kelly K Nichols,1 Edward Holland,2 Melissa M Toyos,3 James H Peace,4 Parag Majmudar,5 Aparna Raychaudhuri,6 Mohamed Hamdani,6 Monica Roy,6 Amir Shojaei6 1School of Optometry, University of Alabama at Birmingham, Birmingham, AL, 2Cincinnati Eye Institute, Edgewood, KY, 3Toyos Clinic, Nashville, TN, 4United Medical Research Institute, Inglewood, CA, 5Chicago Cornea Consultants, Ltd., Hoffman Estates, IL, 6Shire, Lexington, MA, USA Purpose: To evaluate ocular comfort of lifitegrast ophthalmic ...

  11. Lifitegrast ophthalmic solution in the treatment of signs and symptoms of dry eye disease: design, development, and place in therapy

    OpenAIRE

    Godin, Morgan R; Gupta, Preeya K

    2017-01-01

    Morgan R Godin, Preeya K Gupta Department of Ophthalmology, Division of Cornea and Refractive Surgery, Duke University Eye Center, Durham, NC, USA Abstract: A new topical ophthalmic medication, lifitegrast 5%, was recently approved by the US Food and Drug Administration for use in dry eye patients. Lifitegrast is an integrin antagonist that decreases inflammation on the ocular surface, thereby improving dry eye disease (DED). Through a series of prospective, multicenter, randomized, masked,...

  12. Comparison of effect of nepafenac and diclofenac ophthalmic solutions on cornea, tear film, and ocular surface after cataract surgery: the results of a randomized trial

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    Kawahara A

    2016-03-01

    Full Text Available Atsushi Kawahara,1–3 Tsugiaki Utsunomiya,4 Yuji Kato,2 Yoshinori Takayanagi3 1Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, Hokkaido, Japan; 2Sapporo Kato Eye Clinic, Sapporo, Hokkaido, Japan; 3Takayanagi Clinic, Kushiro, Hokkaido, Japan; 4Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan Background: The aim of this study was to compare the effects of nepafenac ophthalmic suspension 0.1% (Nevanac and diclofenac sodium ophthalmic solution 0.1% (Diclod on the cornea, tear film, and ocular surface after cataract surgery. Methods: A total of 60 eyes (60 patients were selected for this study, with no ocular diseases other than cataract (scheduled for cataract surgery by one surgeon. Patients were randomly enrolled to receive nepafenac or diclofenac in the perioperative period, and cataract surgery was performed using torsional microcoaxial phacoemulsification and aspiration with intraocular lens implantation via a transconjunctival single-plane sclerocorneal incision at the 12 o’clock position. We compared intra- and intergroup differences preoperatively and postoperatively in conjunctival and corneal fluorescein staining scores, tear film breakup times, Schirmer’s tests, the Dry Eye Related Quality of Life Scores, and tear meniscus areas using anterior segment optical coherence tomography. Results: The diclofenac group had significantly higher conjunctival and corneal fluorescein staining scores at 4 weeks postoperatively compared with the nepafenac group (P<0.001. Within the diclofenac group, significantly higher conjunctival and corneal fluorescein staining scores were noted at 4 weeks postoperatively than those seen preoperatively (P<0.001 and at 1 week postoperatively (P<0.001. No statistically significant differences were found in any other items. Conclusions: Nepafenac ophthalmic suspension 0.1% is considered safe for the corneal epithelium after cataract surgery. Keywords

  13. Lifitegrast ophthalmic solution in the treatment of signs and symptoms of dry eye disease: design, development, and place in therapy.

    Science.gov (United States)

    Godin, Morgan R; Gupta, Preeya K

    2017-01-01

    A new topical ophthalmic medication, lifitegrast 5%, was recently approved by the US Food and Drug Administration for use in dry eye patients. Lifitegrast is an integrin antagonist that decreases inflammation on the ocular surface, thereby improving dry eye disease (DED). Through a series of prospective, multicenter, randomized, masked, placebo-controlled studies in >2,000 patients total, lifitegrast was shown to be effective for improvement in both the signs and symptoms of DED. A subsequent study focused on the safety profile of lifitegrast and demonstrated that the majority of adverse events were mild and resolved over time. Lifitegrast is now available for use in clinical practice.

  14. Comparison of the clinical efficacy and tolerability of olopatadine hydrochloride 0.1% ophthalmic solution and loteprednol etabonate 0.2% ophthalmic suspension in the conjunctival allergen challenge model.

    Science.gov (United States)

    Berdy, Gregg J; Stoppel, Juan O; Epstein, Arthur B

    2002-06-01

    Olopatadine hydrochloride 0.1% ophthalmic solution and loteprednol etabonate 0.2% ophthalmic suspension are topical antiallergic agents indicated for treatment of the signs and symptoms of allergic conjunctivitis and seasonal allergic conjunctivitis (SAC), respectively. The purpose of this study was to compare the efficacy and tolerability of olopatadine, loteprednol, and placebo in inhibiting the early-phase allergic reaction (within 30 minutes) after conjunctival allergen challenge (CAC). This was a single-center, randomized, double-masked, parallel-controlled CAC study. It consisted of 3 visits, with CAC performed at visit 1, confirmation and randomization at visit 2, and evaluation of the treatments at visit 3. Subjects with a history of allergic conjunctivitis were randomized to receive olopatadine, loteprednol, or placebo in a 2:2:1 ratio. Because loteprednol requires a loading period to achieve maximum efficacy, subjects assigned to this treatment received loteprednol QID bilaterally for a 14-day period; the olopatadine and placebo groups received placebo QID bilaterally during this period. At the evaluation visit, subjects received 1 drop of the assigned treatment in each eye. Fifteen minutes later, they were challenged with allergen. Subjects evaluated itching at 3, 5, and 10 minutes after challenge using a standardized 5-point scale; the investigator evaluated redness at 10, 15, and 20 minutes after challenge. Intraocular pressure (IOP) was measured at baseline and after the 14-day loading period. Nonparametric analyses were performed on the change from visit 2 to visit 3 in mean itching and redness scores for each time point, and on the change in mean IOP from visit 1 to visit 3. Fifty subjects (86% white; 42% male, 58% female; age range, 21-71 years) were enrolled and completed the study (20 olopatadine, 20 loteprednol, 10 placebo). The allergens to which subjects reacted were ragweed pollen (40%), cat hair or dander (30%), grass pollen (24%), and tree

  15. Ultraviolet A: Visible spectral absorbance of the human cornea after transepithelial soaking with dextran-enriched and dextran-free riboflavin 0.1% ophthalmic solutions.

    Science.gov (United States)

    Lombardo, Marco; Micali, Norberto; Villari, Valentina; Serrao, Sebastiano; Pucci, Giuseppe; Barberi, Riccardo; Lombardo, Giuseppe

    2015-10-01

    To evaluate the stromal concentration of 2 commercially available transepithelial riboflavin 0.1% solutions in human donor corneas with the use of spectrophotometry. University of Calabria, Rende, Italy. Experimental study. The absorbance spectra of 12 corneal tissues were measured in the 330 to 700 nm wavelength range using a purpose-designed spectrophotometry setup before and after transepithelial corneal soaking with a 15% dextran-enriched riboflavin 0.1% solution (n = 6) or a hypotonic dextran-free riboflavin 0.1% solution (n = 6). Both ophthalmic solutions contained ethylenediaminetetraacetic acid and trometamol as enhancers. In addition, 4 deepithelialized corneal tissues underwent stromal soaking with a 20% dextran-enriched riboflavin 0.1% solution and were used as controls. All the riboflavin solutions were applied topically for 30 minutes. The stromal concentration of riboflavin was quantified by analysis of absorbance spectra of the cornea collected before and after application of each solution. The mean stromal riboflavin concentration was 0.012% ± 0.003% (SD), 0.0005% ± 0.0003% (P < .001), and 0.004% ± 0.001% (P < .01) in tissues soaked with 20% dextran-enriched, 15% dextran-enriched, and hypotonic dextran-free solutions, respectively. The difference of stromal riboflavin concentration between the 2 transepithelial solutions was statistically significant (P < .01). Dextran-enriched solutions required complete corneal deepithelialization to permit effective stromal soaking with riboflavin. Nevertheless, riboflavin in hypotonic dextran-free solution with enhancers permeates across stroma through an intact epithelium. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  16. Lifitegrast ophthalmic solution in the treatment of signs and symptoms of dry eye disease: design, development, and place in therapy

    Directory of Open Access Journals (Sweden)

    Godin MR

    2017-05-01

    Full Text Available Morgan R Godin, Preeya K Gupta Department of Ophthalmology, Division of Cornea and Refractive Surgery, Duke University Eye Center, Durham, NC, USA Abstract: A new topical ophthalmic medication, lifitegrast 5%, was recently approved by the US Food and Drug Administration for use in dry eye patients. Lifitegrast is an integrin antagonist that decreases inflammation on the ocular surface, thereby improving dry eye disease (DED. Through a series of prospective, multicenter, randomized, masked, placebo-controlled studies in >2,000 patients total, lifitegrast was shown to be effective for improvement in both the signs and symptoms of DED. A subsequent study focused on the safety profile of lifitegrast and demonstrated that the majority of adverse events were mild and resolved over time. Lifitegrast is now available for use in clinical practice. Keywords: OPUS-1, OPUS-2, OPUS-3, SONATA, LFA-1, ICAM-1, OSDI, ocular surface

  17. Evaluation of alcaftadine 0.25% ophthalmic solution in acute allergic conjunctivitis at 15 minutes and 16 hours after instillation versus placebo and olopatadine 0.1%

    Directory of Open Access Journals (Sweden)

    Jack V Greiner

    2011-01-01

    Full Text Available Jack V Greiner1,2, Kimberly Edwards-Swanson3, Avner Ingerman41Schepens Eye Research Institute, Boston, MA; 2Department of Ophthalmology, Harvard Medical School, Boston, MA; 3Johnson & Johnson Consumer and Personal Products Worldwide, Skillman, NJ; 4Ora Inc, Andover, MA, USAPurpose: To evaluate the effectiveness of alcaftadine 0.05%, 0.1%, and 0.25% ophthalmic solutions in treating the signs and symptoms of allergic conjunctivitis when compared with olopatadine hydrochloride 0.1% and placebo using the conjunctival allergen challenge (CAC model.Methods: One hundred and seventy subjects were randomized and 164 subjects completed all visits. CAC was performed to determine and confirm subjects’ eligibility at visits 1 and 2, respectively. The CAC was repeated at visit 3 (day 0 ± 3, 16 hours after study medication instillation, and at visit 4 (day 14 ± 3, 15 minutes after instillation. Ocular itching and conjunctival redness were evaluated after an allergen challenge, along with several secondary endpoints.Results: Alcaftadine 0.25% and olopatadine 0.1% treatments exhibited significantly lower mean scores compared with placebo for ocular itching and conjunctival redness at visits 3 and 4. Most adverse events were self-limiting and mild in severity. No serious treatment-related adverse events occurred.Conclusion: Treatment with alcaftadine 0.25% ophthalmic solution resulted in mean differences of >1 unit (ocular itching and approximately >1 unit (conjunctival redness, which was significant (P < 0.001 compared with placebo treatment. All doses of alcaftadine were safe and well tolerated in the population studied.Keywords: alcaftadine, allergic conjunctivitis, conjunctival allergen challenge

  18. Comparative pharmacokinetics and bioavailability of brimonidine following ocular and dermal administration of brimonidine tartrate ophthalmic solution and gel in patients with moderate-to-severe facial erythema associated with rosacea.

    Science.gov (United States)

    Benkali, K; Leoni, M; Rony, F; Bouer, R; Fernando, A; Graeber, M; Wagner, N

    2014-07-01

    Persistent facial erythema is the most common primary pathological feature of rosacea, the only treatment for which is brimonidine tartrate (BT) gel. To assess the relative bioavailability of topical BT gel in comparison with the ophthalmic BT solution. A pharmacokinetic study was conducted to compare intraindividual systemic exposures after dermal application of BT gel (0·07%, 0·18% and 0·5%) under maximal use conditions in patients with moderate-to-severe facial erythema associated with rosacea, and administration of BT ophthalmic solution 0·2%. Patients who received BT ophthalmic solution 0·2% three times a day for 1 day had a mean Cmax of 54 ± 28 pg mL(-1) and a mean 0-24-h area under the curve (AUC0-24 h ) of 568 ± 277 pg h mL(-1) . Topical application of BT gel for 29 days resulted in quantifiable systemic exposure in 22%, 48%, 71% and 79% of patients who received BT gel 0·07% twice daily, 0·18% once daily, 0·18% twice daily and 0·5% once daily, respectively. The mean Cmax values for the BT gels ranged between 13 and 25 pg mL(-1) , and mean AUC0-24 h values ranged between 42 and 290 pg h mL(-1) . Systemic exposure increased with applied dose, with no drug accumulation for the duration of treatment. The systemic exposure observed with the highest dose of BT gel (0·5% once daily) was significantly lower than the systemic levels observed for the ophthalmic solution. 0·2% apply for all the concentrations. The systemic safety profile of BT gel may be considered better than that of the ophthalmic solution. © 2014 British Association of Dermatologists.

  19. Tear volume estimation using a modified Schirmer test: a randomized, multicenter, double-blind trial comparing 3% diquafosol ophthalmic solution and artificial tears in dry eye patients

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    Miyake H

    2016-05-01

    Full Text Available Hideki Miyake,1 Yuri Kawano,2 Hiroshi Tanaka,2 Akihiro Iwata,3 Takahiro Imanaka,1 Masatsugu Nakamura1 1Ophthalmic Disease Area Strategy Department, 2Clinical Operations Department, 3Data Science Department, R&D Division, Santen Pharmaceutical Co., Ltd. Osaka, Japan Purpose: We aimed to evaluate the feasibility of using a modified Schirmer test to determine the increase in tear volume after administration of 3% diquafosol ophthalmic solution (diquafosol 3% in dry eye patients. Patients and methods: A randomized, multicenter, prospective, double-blind clinical study recruited 50 qualified subjects. They received diquafosol 3% in one eye and artificial tears in the other eye. The study protocol comprised a screening and treatment procedure completed within 1 day. The Schirmer test was performed on closed eyes three times a day. The primary efficacy end points were the second Schirmer test scores 10 minutes after the single dose. Secondary end points were the third Schirmer test scores 3 hours and 40 minutes after the single dose and the symptom scores prior to the second and third Schirmer tests. Results: According to the Schirmer test, 10 minutes after administration, diquafosol 3% significantly increased tear volume compared to artificial tears. Diquafosol 3% and artificial tears both showed significant improvements in the symptom scores compared to baseline. However, there was no significant difference in the symptoms score between diquafosol 3% and artificial tears. Conclusion: The modified Schirmer test can detect a minute change in tear volume in dry eye patients. These findings will be useful in the diagnosis of dry eye, assessment of treatment benefits in daily clinical practice, and the development of possible tear-secreting compounds for dry eye. Keywords: P2Y2, efficacy, Diquas®

  20. Efficacy and safety profile of ketorolac 0.5% ophthalmic solution in the prevention of surgically induced miosis during cataract surgery.

    Science.gov (United States)

    Stewart, R; Grosserode, R; Cheetham, J K; Rosenthal, A

    1999-04-01

    This multicenter, double-masked, randomized, parallel study compared the efficacy and safety profile of ketorolac tromethamine 0.5% ophthalmic solution with that of its vehicle in the maintenance of pupillary mydriasis during cataract surgery. A total of 176 adult patients scheduled to undergo unilateral extracapsular cataract extraction and posterior-chamber intraocular lens implantation received either ketorolac tromethamine 0.5% (n = 89) or vehicle (n = 87), starting 2 hours before surgery. One drop of study medication was instilled every 30 minutes for a total of 4 drops. No epinephrine was used in the intraoperative irrigating solution. Pupil diameter was measured with a caliper at 3 time points during surgery. To ensure participant safety, biomicroscopy, ophthalmoscopy, intraocular pressure, adverse events, and preoperative and postoperative visual acuity and refractive error were also monitored. The mean change in horizontal and vertical pupil diameter from the time of the first incision to after cortical irrigation and aspiration was significantly less with active ketorolac than with vehicle (P miosis during cataract surgery.

  1. A comparative study of validated spectrophotometric and TLC- spectrodensitometric methods for the determination of sodium cromoglicate and fluorometholone in ophthalmic solution

    Science.gov (United States)

    Saleh, Sarah S.; Lotfy, Hayam M.; Hassan, Nagiba Y.; Elgizawy, Samia M.

    2013-01-01

    The determination of sodium cromoglicate (SCG) and fluorometholone (FLU) in ophthalmic solution was developed by simple, sensitive and precise methods. Three spectrophotometric methods were applied: absorptivity factor (a-Factor method), absorption factor (AFM) and mean centering of ratio spectra (MCR). The linearity ranges of SCG were found to be (2.5–35 μg/mL) for (a-Factor method) and (MCR); while for (AFM), it was found to be (7.5–50 μg/mL). The linearity ranges of FLU were found to be (4–16 μg/mL) for (a-Factor method) and (AFM); while for (MCR), it was found to be (2–16 μg/mL). The mean percentage recoveries/RSD for SCG were found to be 100.31/0.90, 100.23/0.57 and 100.43/1.21; while for FLU, they were found to be 100.11/0.56, 99.97/0.35 and 99.94/0.88 using (a-Factor method), (AFM) and (MCR), respectively. A TLC-spectrodensitometric method was developed by separation of SCG and FLU on silica gel 60 F254 using chloroform:methanol:toluene:triethylamine in the ratio of (5:2:4:1 v/v/v/v) as developing system, followed by spectrodensitometric measurement of the bands at 241 nm. The linearity ranges and the mean percentage recoveries/RSD were found to be (0.4–4.4 μg/band), 100.24/1.44 and (0.2–1.6 μg/band), 99.95/1.50 for SCG and FLU, respectively. A comparative study was conducted between the proposed methods to discuss the advantage of each method. The suggested methods were validated in compliance with the ICH guidelines and were successfully applied for the determination of SCG and FLU in their laboratory prepared mixtures and commercial ophthalmic solution in the presence of benzalkonium chloride as a preservative. These methods could be an alternative to different HPLC techniques in quality control laboratories lacking the required facilities for those expensive techniques. PMID:24227962

  2. [Antimicrobial Effects of Iodine-Polyvinyl Alcohol Ophthalmic and Eye Washing Solution (PA * IODO) with Special Reference to its Temperature, Concentration and Time and its Preservation Stability].

    Science.gov (United States)

    Hatano, Hiroshi; Sakamoto, Masako; Hayashi, Kazuo; Kamiya, Seigo

    2015-08-01

    Temperature, concentration and time are the three factors that affect the inactivation capacity of iodine antiseptics. We investigated the effect of these factors on the microbe inactivation of Iodine-Polyvinyl Alcohol ophthalmic and eye washing solution (PA * IODO), and also investigated the preservation conditions on stability of the inactivation activity of the PA * IODO. Test microbes were mixed with PA * IODO, varying the three factors. The live microbes were counted after each reaction. The effects of plugging and preservation temperature were investigated to determine the preserving stability. The inactivation capacity of PA * IODO tended to decrease in almost all microbes tested at 4 degrees C. Twenty times or less diluted PA * IODO killed almost all microbes completely. The time effect was more marked in viruses. Plugging and low-temperature made iodine concentration in diluted PA * IODO remain relatively high. The concentration of PA * IODO affected the inactivation ability more than the temperature and time, although all the three factors correlated positively to the inactivation. For preservation the diluted PA * IODO needed plugging and low temperature.

  3. Validated spectrofluorimetric and spectrophotometric methods for the determination of brimonidine tartrate in ophthalmic solutions via derivatization with NBD-Cl. Application to stability study.

    Science.gov (United States)

    Ibrahim, F; El-Enany, N; El-Shaheny, R N; Mikhail, I E

    2015-05-01

    Two simple, selective and accurate methods were developed and validated for the determination of brimonidine tartrate (BT) in pure state and pharmaceutical formulations. Both methods are based on the coupling of the drug with 4-chloro-7-nitro-2,1,3-benzoxadiazole in borate buffer (pH 8.5) at 70 °C and measurement of the reaction product spectrophotometrically at 407 nm (method I) or spectrofluorimetrically at 528 nm upon excitation at 460 nm (method II). The calibration graphs were rectilinear over the concentration ranges of 1.0-16.0 and 0.1-4.0 µg/mL with lower detection limits of 0.21 and 0.03, and lower quantification limits of 0.65 and 0.09 µg/mL for methods I and II, respectively. Both methods were successfully applied to the analysis of commercial ophthalmic solution with mean recovery of 99.50 ± 1.00 and 100.13 ± 0.71%, respectively. Statistical analysis of the results obtained by the proposed methods revealed good agreement with those obtained using a comparison method. The proposed spectrofluorimetric method was extended to a stability study of BT under different ICH-outlined conditions such as alkaline, acidic, oxidative and photolytic degradation. Furthermore, the kinetics of oxidative degradation of the drug was investigated and the apparent first-order reaction rate constants, half-life times and Arrhenius equation were estimated. The proposed methods are practical and valuable for routine applications in quality control laboratories for the analysis of BT. Copyright © 2014 John Wiley & Sons, Ltd.

  4. In vivo comparative study of ocular vasodilation, a relative indicator of hyperemia, in guinea pigs following treatment with bimatoprost ophthalmic solutions 0.01% and 0.03%

    Directory of Open Access Journals (Sweden)

    Abayomi B Ogundele

    2010-06-01

    Full Text Available Abayomi B Ogundele, David Earnest, Marsha A McLaughlinAlcon Research, Limited, Fort Worth, TX, USAObjective: The objective of this in vivo study was to compare the incidence of vasodilation in guinea pigs following topical administration of bimatoprost ophthalmic solutions 0.01% and 0.03%.Methods: The study comprised 20 guinea pigs assigned to 2 treatment groups (10 per treatment group to receive either bimatoprost 0.01% or bimatoprost 0.03%. Animals were hand-held under 2.75 × magnification to score ocular vasodilation (a measure of hyperemia, using a scoring system developed at Alcon Research, Ltd. Following baseline ocular scoring, each animal received a 30 μL dose to the left eye of either bimatoprost 0.01% (3 μg or bimatoprost 0.03% (9 μg. Vasodilation was again scored at 1, 2, 3, 4, 5 and 6 hours after dosing. Incidence of vasodilation was calculated as the percent of total eyes in each 2-hour time interval with scores ≥2.Results: The incidence of vasodilation was higher in the bimatoprost 0.01% treatment group (range, 45.0% to 60.0% than the bimatoprost 0.03% treatment group (range, 30.0% to 52.2% at all post-dosing time points.Conclusion: The 2 bimatoprost formulations elicited ocular vasodilation of long duration (>6 hours in the guinea pig model, with the bimatoprost 0.01% treatment group showing a higher incidence of ocular vasodilation than the bimatoprost 0.03% treatment group. Further clinical studies would be needed to determine whether the higher incidence of vasodilation may also be attributed to the increased BAK concentration in the bimatoprost 0.01% formulation.Keywords: bitamoprost, ocular vasodilation, hyperemia

  5. Ocular pharmacokinetics of bimatoprost formulated in DuraSite compared to bimatoprost 0.03% ophthalmic solution in pigmented rabbit eyes

    Directory of Open Access Journals (Sweden)

    Shafiee A

    2013-07-01

    Full Text Available Afshin Shafiee,1 Lyle M Bowman,2 Eddie Hou,2 Kamran Hosseini1,3 1Preclinical, 2Development, 3Clinical, InSite Vision, Alameda, CA, USA Purpose: To compare the aqueous humor (AH and iris-ciliary body (ICB concentration of bimatoprost in rabbit eyes treated with ISV-215 (0.03% bimatoprost formulated in DuraSite with the marketed product bimatoprost 0.03% ophthalmic solution. Methods: The left eye of rabbits received a single topical instillation of either ISV-215 (n = 32 eyes or bimatoprost 0.03% (n = 32 eyes. At predetermined time points, levels of bimatoprost and bimatoprost acid in the AH and the ICB were quantified by HPLC-MS/MS. Results: Both bimatoprost and bimatoprost acid were detected in the AH and the ICB within 15 minutes of dosing. Bimatoprost acid concentrations in both compartments were markedly higher than bimatoprost. There was a statistically significant (P < 0.01 increase in the concentration of the prodrug in the AH and its acid form in the ICB in animals treated with ISV-215 compared to bimatoprost 0.03%. In the ISV-215-treated rabbit eyes, the highest concentrations of bimatoprost and bimatoprost acid were in the ICB and AH, respectively, while in the bimatoprost 0.03%-treated eyes, no differences in the drug content of the selected ocular tissues were observed. Conclusions: Bimatoprost 0.03% formulated in DuraSite has superior ocular distribution and area under the curve compared to bimatoprost 0.03% in rabbit eyes. This improvement in the pharmacokinetic parameters of ISV-215 may provide us with a better platform to optimize a bimatoprost formulation that offers the same degree of efficacy in lowering intraocular pressure and improved therapeutic index in glaucomatous patients by lessening the ocular side effects associated with long-term use of topical prostaglandin F2α analogs. Keywords: drug delivery, intraocular pressure, glaucoma, aqueous humor, prostaglandin (PGF2α analogs

  6. Long-term safety evaluation of bimatoprost ophthalmic solution 0.03%: a pooled analysis of six double-masked, randomized, active-controlled clinical trials

    Directory of Open Access Journals (Sweden)

    Wirta D

    2011-06-01

    Full Text Available David Wirta1, Amanda M VanDenburgh2, Emily Weng3, Scott M Whitcup4, Sef Kurstjens5, Frederick C Beddingfield III4,61Private Practice, Newport Beach, CA, USA; 2Clinical Development, 3Biostatistics, 4Research and Development, 5Global Drug Development, Allergan, Inc, Irvine, CA, USA; 6Department of Medicine, Division of Dermatology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USABackground: Bimatoprost ophthalmic solution 0.03% was approved in the US for reducing intraoccular pressure (IOP based on two double-masked, active-controlled clinical trials. Four additional long-term studies (≥ 12months were conducted; however, the aggregate safety profile of the six studies has not been reported.Methods: Adverse events (AEs were pooled from six double-masked, active-controlled, long-term clinical trials in which subjects received bimatoprost 0.03% once daily (QD or twice daily (BID as an eyedrop. AE terms were converted to MedDRA (V.11.0 Preferred Terms and analyzed.Results: In total, 1409 patients received more than one dose of bimatoprost 0.03% QD or BID. Most AEs were mild in severity and reported by 86.7% (QD and 94.8% (BID of subjects (≤ 12 months of treatment. AEs reported through month 12 (aggregate incidence of ≥ 5% were conjunctival hyperemia, increased eyelash growth, eye pruritus, periocular skin hyperpigmentation, eye irritation, dry eye, and hypertrichosis. AE onset was generally reported within four months of treatment. The cumulative incidence of common AEs in the QD treatment group at 24–48 months was similar to that measured at 12 months of treatment.Conclusion: Bimatoprost 0.03% has a favorable safety and tolerability profile as characterized by six long-term studies. Common AEs were due to the known pharmacological activity of bimatoprost and reversible with treatment cessation.Keywords: intraocular pressure, eyelids, pharmacology, clinical trial, medical treatment

  7. Lifitegrast Ophthalmic Solution 5.0% versus Placebo for Treatment of Dry Eye Disease: Results of the Randomized Phase III OPUS-2 Study.

    Science.gov (United States)

    Tauber, Joseph; Karpecki, Paul; Latkany, Robert; Luchs, Jodi; Martel, Joseph; Sall, Kenneth; Raychaudhuri, Aparna; Smith, Valerie; Semba, Charles P

    2015-12-01

    Lifitegrast is an integrin antagonist that decreases T-cell-mediated inflammation associated with dry eye disease (DED). We report the results of OPUS-2, a phase III study evaluating the efficacy and safety of lifitegrast compared with placebo for the treatment of DED. A 12-week, multicenter, randomized, prospective, double-masked, placebo-controlled clinical trial. Adults aged ≥18 years with use of artificial tears within 30 days, inferior corneal staining score ≥0.5 (0-4 scale), Schirmer tear test (without anesthesia) ≥1 and ≤10 mm, and eye dryness score ≥40 (0-100 visual analogue scale [VAS]). Subjects were randomized 1:1 after 14-day placebo run-in to lifitegrast ophthalmic solution 5.0% or placebo twice daily for 84 days. Co-primary efficacy end points were change, from baseline to day 84, in eye dryness score (VAS, both eyes) and inferior corneal fluorescein staining score in the designated study eye. Secondary end points were change, from baseline to day 84, in ocular discomfort score (0-4 scale) in study eye, eye discomfort score (VAS), total corneal staining score in the study eye, and nasal conjunctival lissamine green staining score (0-4 scale) in the study eye. Treatment-emergent adverse events (TEAEs) were recorded. A total of 718 subjects were randomized: placebo, n = 360; lifitegrast, n = 358 (intent-to-treat population). Lifitegrast-treated subjects experienced greater improvement in eye dryness than placebo-treated subjects (treatment effect, 12.61; 95% confidence interval [CI], 8.51-16.70; P lifitegrast-treated subjects: ocular discomfort (nominal P = 0.0005) and eye discomfort (nominal, P lifitegrast-treated subjects (33.7%) than placebo-treated subjects (16.4%) experienced ocular TEAEs; no ocular TEAEs were serious. Lifitegrast met the co-primary symptom end point (eye dryness) but not the co-primary sign end point (inferior corneal staining). Secondary end point findings were consistent with this pattern. Most ocular TEAEs were mild

  8. Updates in ophthalmic pathology.

    Science.gov (United States)

    Mendoza, Pia R; Grossniklaus, Hans E

    2017-05-01

    Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.

  9. Updates in ophthalmic pathology

    Directory of Open Access Journals (Sweden)

    Pia R Mendoza

    2017-01-01

    Full Text Available Ophthalmic pathology has a long history and rich heritage in the field of ophthalmology. This review article highlights updates in ophthalmic pathology that have developed significantly through the years because of the efforts of committed individuals and the confluence of technology such as molecular biology and digital pathology. This is an exciting period in the history of ocular pathology, with cutting-edge techniques paving the way for new developments in diagnostics, therapeutics, and research. Collaborations between ocular oncologists and pathologists allow for improved and comprehensive patient care. Ophthalmic pathology continues to be a relevant specialty that is important in the understanding and clinical management of ocular disease, education of eye care providers, and overall advancement of the field.

  10. Safety and efficacy of MIM D3 ophthalmic solutions in a randomized placebo controlled Phase 2 clinical trial in patients with dry eye

    Directory of Open Access Journals (Sweden)

    Meerovitch K

    2013-06-01

    Full Text Available Karen Meerovitch,1 Gail Torkildsen,2 John Lonsdale,3 Heidi Goldfarb,4 Teresa Lama,1 Garth Cumberlidge,1 George W Ousler III5 1Mimetogen Pharmaceuticals Inc, Montreal, QC, Canada; 2Andover Eye Associates, Andover, MA, USA; 3Central Maine Eye Care, Lewiston, ME, USA; 4SDC, Tempe, AZ, USA; 5Ora Inc, Andover, MA, USA Purpose: To evaluate the safety and efficacy of ophthalmic MIM-D3, a tyrosine kinase TrkA receptor agonist, in patients with dry eye. Design: A prospective, two-center, randomized, double-masked, placebo-controlled Phase 2 study. Methods: A total of 150 dry eye patients were randomized 1:1:1 to study medication (1% MIM-D3, 5% MIM-D3, or placebo and dosed twice daily (BID for 28 days. Key eligibility criteria included exacerbation in corneal staining and ocular discomfort in the Controlled Adverse Environment (CAESM on two visits, separated by 1 week of BID dosing with artificial tears. Safety and efficacy were evaluated at baseline, throughout treatment, and for 2 weeks post-treatment. The pre-specified primary outcome measures were fluorescein corneal staining post-CAE at day 28 and diary worst symptom scores over 28 days. Secondary outcomes included the pre-, post-, and the change from pre- to post-CAE fluorescein and lissamine green staining in both corneal and conjunctival regions, as well as individual diary symptoms. Results: The prespecified primary endpoints were not met. Compared with placebo, fluorescein corneal staining at day 28 was significantly improved (P < 0.05 in the 1% MIM-D3 group for the assessment of change from pre-CAE to post-CAE. In addition, following CAE exposure, patients in the 1% MIM-D3 group showed significant improvements versus placebo (P < 0.05 in inferior fluorescein and lissamine green staining after 14 and 28 days. Compared with placebo, patients in the 5% MIM-D3 group reported significantly lower daily diary scores for ocular dryness (P < 0.05. In a subgroup defined by higher symptom scores during

  11. Assessment of the tolerability profile of an ophthalmic solution of 5% glycyrrhizin and copolymer PEG/PPG on healthy volunteers and evaluation of its efficacy in the treatment of moderate to severe blepharitis

    Directory of Open Access Journals (Sweden)

    Mencucci R

    2013-07-01

    Full Text Available Rita Mencucci, Eleonora Favuzza, Ugo MenchiniDepartment of Surgery and Translational Medicine – Eye Clinic, University of Florence, Florence, ItalyPurpose: To evaluate the tolerability on healthy volunteers and the efficacy on subjects affected by chronic moderate/severe blepharitis of a 5% glycyrrhizin and copolymer poly(ethylene glycol/poly(propylene glycol(PEG/PPG ophthalmic solution.Methods: The study was a randomized, controlled, open label, intra-patient monocentric study. It consisted of two different phases, the assessment of tolerability phase on 20 healthy volunteers, and the evaluation of the efficacy on 21 subjects affected by chronic moderate/severe blepharitis; the treatment period was 2 weeks, followed by 1-week of follow-up. In the efficacy phase, in both eyes, eyelid hygiene was also performed. At day 0, 3, 7, 14, and 21 a complete ophthalmological examination was performed. In the tolerability phase, signs of clinical toxicity were recorded and subject-reported symptoms were collected using a questionnaire. In the efficacy phase, global signs and symptoms of blepharitis scores were collected using standardized photographic scales and questionnaire. The statistical analysis was performed using the Wilcoxon signed-rank test. Results: No ocular signs of drug toxicity were reported. During the treatment period for tolerability phase, there were statistically significant higher scores of tearing and ocular discomfort in the tolerability study group versus the tolerability control group. In the efficacy phase, differences between global scores of the two groups were statistically significant at day 0 (score of the efficacy study group was higher than the efficacy control group; P = 0.005 and at day 21 (score of the efficacy study group was lower than the efficacy control group (P ≤ 0.001.The difference of global scores at day 3, 7, 14, and 21 versus day 0 was statistically significant in both groups. No serious adverse events

  12. Rosacea - the ophthalmic perspective.

    Science.gov (United States)

    Awais, Muhammad; Anwar, Muhammad Irfan; Iftikhar, Raheel; Iqbal, Zohaib; Shehzad, Nazia; Akbar, Bushra

    2015-01-01

    Rosacea is a chronic cutaneous inflammatory disorder with variable presentations. Although primarily considered a skin disease, rosacea may involve the eyes in a significant number of patients leading to ocular complications. It has been recognized that many patients of ocular rosacea in dermatological outpatient department (OPD) go unnoticed as the physicians don't ask about eye symptoms. Same holds true in ophthalmic OPD's where the doctors usually don't consider this diagnosis. The diagnosis of ocular rosacea primarily relies on observation of ophthalmic clinical features but it can be easily missed if accompanying cutaneous features are subtle or inconsistent. The subject diagnosis if not diagnosed and treated promptly, may cause varying degrees of ocular morbidity and may impair vision secondary to corneal involvement. To review published literature and provide an overview on different pathophysiologic mechanisms of ocular rosacea and clinical features required for its diagnosis. As well as to highlight various treatment modalities available for ocular rosacea. In our study Medline and Google Scholar were the key search engines to find literature using keywords like epidemiology, pathogenesis, clinical features, management and complications of ocular rosacea.

  13. Efficacy of olopatadine HCI 0.1%, ketotifen fumarate 0.025%, epinastine HCI 0.05%, emedastine 0.05% and fluorometholone acetate 0.1% ophthalmic solutions for seasonal allergic conjunctivitis: a placebo-controlled environmental trial.

    Science.gov (United States)

    Borazan, Mehmet; Karalezli, Aylin; Akova, Yonca Aydin; Akman, Ahmet; Kiyici, Halil; Erbek, Selim S

    2009-08-01

    We aimed to compare the clinical efficacy and ocular surface variables of olopatadine, ketotifen fumarate, epinastine, emedastine and fluorometholone acetate ophthalmic solutions in preventing the signs and symptoms of seasonal allergic conjunctivitis (SAC). This was a prospective, randomized, double-blinded and placebo-controlled study. A total of 100 patients with SAC were randomly assigned to one of five groups, in which they were administered olopatadine, ketotifen fumarate, epinastine, emedastine or fluorometholone acetate, instilled twice daily for 2 weeks. One eye of each patient was treated with the study drug and the other was treated with a placebo. Signs and symptoms of allergic conjunctivitis (itching, redness, tearing, chemosis and eyelid swelling) were scored on a 4-point scale. Each symptom was assessed at baseline and then again after 1 and 2 weeks of treatment. Ocular surface variables were assessed by conjunctival impression cytology. At weeks 1 and 2, all antiallergic agents were significantly more effective than placebo in alleviating itching, redness, tearing, chemosis and eyelid swelling. Fluorometholone acetate was significantly less effective than the other agents in reducing itching and redness at all control visits. Ocular surface findings by impression cytology improved significantly after all treatments compared with placebo. In patients with SAC, olopatadine, ketotifen, epinastine and emedastine are more efficacious than fluorometholone acetate in preventing itching and redness. All the antiallergic agents gave similar results in terms of reducing tearing, chemosis and eyelid swelling. Our data showed that impression cytology parameters improved after treatment with antiallergic agents in patients with SAC.

  14. The Effects of Two Non-Steroidal Anti-Inflammatory Drugs, Bromfenac 0.1% and Ketorolac 0.45%, on Cataract Surgery.

    Science.gov (United States)

    Jung, Ji Won; Chung, Byung Hoon; Kim, Eung Kweon; Seo, Kyoung Yul; Kim, Tae-im

    2015-11-01

    To compare the additive effects of two types of non-steroidal anti-inflammatory drugs (NSAIDs), bromfenac 0.1% or ketorolac 0.45%, relative to topical steroid alone in cataract surgery. A total 91 subjects scheduled to undergo cataract operation were randomized into three groups: Group 1, pre/postoperative bromfenac 0.1%; Group 2, pre/postoperative preservative-free ketorolac 0.45%; and Group 3, postoperative steroid only, as a control. Outcome measures included intraoperative change in pupil size, postoperative anterior chamber inflammation control, change in macular thickness and volume, and ocular surface status after operation. Both NSAID groups had smaller intraoperative pupil diameter changes compared to the control group (pmiosis, postoperative inflammation, and macular changes more effectively than postoperative steroid alone.

  15. Effects of an opioid (oxycodone/paracetamol) and an NSAID (bromfenac) on driving ability, memory functioning, psychomotor performance, pupil size, and mood.

    Science.gov (United States)

    Verster, Joris C; Veldhuijzen, Dieuwke S; Volkerts, Edmund R

    2006-06-01

    It has been suggested that driving a car is relatively safe when the driver is treated with nonsteroid anti-inflammatory drugs than when he or she is treated with opioid analgesics. However, the evidence for this statement is scarce. The objective of this study was to determine the effects of a nonsteroid anti-inflammatory drug (bromfenac 25 mg and 50 mg) and an opioid (oxycodone/paracetamol 5/325 mg and 10/650 mg), and placebo on driving ability, memory functioning, psychomotor performance, pupil size, and mood. Out of 30 healthy volunteers, 18 completed this randomized, double-blind, placebo-controlled crossover study, before the study had to be stopped due to bromfenac being pulled out from the market. One hour after administration of the drugs, the participants performed a standardized driving test during normal traffic. Thereafter, driving quality, mental effort and mental activation during driving were assessed. A laboratory test battery was performed 2.5 hours after administration of the drug. Visual analog scales assessing mood and pupil measurements were performed on several occasions during each test day. Both analgesics did not significantly affect performance in any test. However, volunteers reported that significantly more effort was needed to perform the driving test when treated with oxycodone/paracetamol, and that they experienced increased sedation and reduced alertness. Also, the pupil size was significantly decreased. In contrast, subjective assessments after both doses of bromfenac matched that of placebo. No significant impairment in behavior was found in the volunteers for both bromfenac and oxycodone/paracetamol. The lack of impairment from oxycodone/paracetamol may have been related to the participants reporting increased effort during driving while under the influence of this drug.

  16. 21 CFR 886.4390 - Ophthalmic laser.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic laser. 886.4390 Section 886.4390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4390 Ophthalmic laser. (a) Identification. An ophthalmic...

  17. 21 CFR 886.4790 - Ophthalmic sponge.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic sponge. 886.4790 Section 886.4790 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4790 Ophthalmic sponge. (a) Identification. An ophthalmic sponge is a device that is an absorbant...

  18. Ophthalmic manifestations of leukemia.

    Science.gov (United States)

    Talcott, Katherine E; Garg, Ravin J; Garg, Sunir J

    2016-11-01

    This article aims to describe the ocular manifestations of leukemia, resulting both from direct infiltration of neoplastic cells and from the more common secondary effects of leukemia and its treatment. The prevalence of these findings is also discussed, along with their clinical significance, association with hematologic markers and the ophthalmologist's role caring for these patients. Recent studies have included a large case series examining the prevalence of ocular manifestations in newly diagnosed leukemic patients as well as case reports of ocular manifestations of leukemia. Patients with leukemia often have ocular manifestations. These occur either from direct infiltration of neoplastic cells or from indirect or secondary causes, including hematologic abnormalities, central nervous system involvement, opportunistic infections, or from treatment. Although nearly all ocular structures can be affected, leukemic retinopathy is often the most clinically apparent manifestation. Awareness of the ophthalmic manifestations of leukemia is important as they may precede systemic diagnosis or may be a sign of leukemia recurrence.

  19. OPHTHALMIC MANIFESTATIONS OF LEUKEMIA

    Directory of Open Access Journals (Sweden)

    E. E. Grishina

    2016-01-01

    Full Text Available Ophthalmic manifestations of leukemia are variable and are predominantly represented by leukemic infiltration of the eye and hemodynamic abnormalities in the retinal vasculature. Leukemic infiltration of the retina should be differentiated from an inflammatory process, such as retinitis, chorioretinitis of viral or fungal origin that are not uncommon in patients with hematological malignancies. Retinal involvement is mainly seen in adult patients with acute myeloid leukemia and is less common in patients with acute lymphoblastic leukemia. Retinopathy is more frequent during relapses of the underlying disease. Also, retinopathy can be the first sign of the disease. Leukemia should be included into the list for differential diagnosis with disorders that can be associated with optical nerve edema and retinal hemorrhages. Fundus abnormalities correlate with peripheral blood parameters. Retinopathy and leukemic optic neuropathy are predictors of unfavorable prognosis. Early diagnostics and timely and adequate treatment may fully eliminate ocular symptoms and improve quality of life in patients with hemoblastoses.

  20. Efficacy of 0.18% hypotonic sodium hyaluronate ophthalmic solution in the treatment of signs and symptoms of dry eye disease.

    Science.gov (United States)

    Baeyens, V; Bron, A; Baudouin, C

    2012-06-01

    To compare the safety and efficacy of hypotonic 0.18% sodium hyaluronate solution (0.18% SH) versus saline and versus 0.3% carbomer for the treatment of signs and symptoms of moderate dry eye syndrome. A total of 304 patients were randomized (1:1:1) in this parallel-group, multi-center, phase III trial. They were instructed to instill one drop of the allocated product in each eye two to four times per day over 84 days. The primary efficacy criterion was the change from baseline at Day 28 in symptom frequency score. The superiority of 0.18% SH (Vismed(®)) over saline and its non-inferiority versus carbomer were statistically tested. At Day 28, there was a statistically significant superiority of 0.18% SH over saline in change from baseline for subjective symptom frequency score (P=0.0376, primary endpoint) and objective fluorescein staining score (P=0.0074, secondary endpoint). 0.18% SH had an excellent safety profile over 84 days. A strong trend was observed in favour of 0.18% SH to cause less blurred vision than carbomer throughout the trial (P=0.0798 at Day 28). 0.18% SH caused a statistically significant improvement in both a subjective endpoint (symptom frequency score) and an objective endpoint (fluorescein staining score). 0.18% SH was well tolerated and resulted in low incidence of adverse events. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  1. Ophthalmic and neuro-ophthalmic manifestations of sarcoidosis.

    Science.gov (United States)

    Kefella, Haben; Luther, Daniel; Hainline, Clotilde

    2017-11-01

    Sarcoidosis is a multisystemic inflammatory disease that commonly affects the eye and less often the neuro-ophthalmic pathways. The manifestations can be quite variable but can have characteristic signs and clinical features. This review provides a comprehensive overview of the various ocular and neuro-ophthalmic manifestations of sarcoidosis, emerging diagnostic measures and approach to treatment. Particular focus is given to recent advances in diagnostic approach and available treatment options. Laboratory investigations, chest and nuclear medicine imaging remain important techniques for helping to diagnose sarcoidosis. Recent evidence suggests a role for aqueous humor analysis in the diagnosis of ocular sarcoidosis. Characteristic neuroimaging may help differentiate neurosarcoidosis from other causes. The role of blind conjunctival biopsy for suspected neurosarcoidosis is discussed. The emerging role and use of biologics is delineated for the treatment of both ocular and neuro-ophthalmic sarcoidosis. Sarcoidosis can affect any part of the visual system: the most common ocular manifestation is uveitis and the most common neuro-ophthalmic manifestation is optic neuropathy. Although diagnosis remains challenging, recent advancements in diagnosis are promising. Emerging biologics with particular efficacy for ocular and neuro-ophthalmic disease provide expanding treatment options for sight-threatening disease.

  2. Ophthalmic nursing delegation to China.

    Science.gov (United States)

    Neault, Gloria A

    2003-01-01

    On September 18, 2001, ASORN sent an ophthalmic nursing delegation to the People's Republic of China. Planning for the trip occurred during a tumultuous year. However, our warm reception in China made us feel safe, cared for, and overwhelmed by the generosity of a people we had just come to know. This article describes the process of preparing for this experience of a lifetime, what we learned from the ophthalmic nurses and doctors we met, and what we learned about ourselves along the way.

  3. Patient adherence and persistence with topical ocular hypotensive therapy in real-world practice: a comparison of bimatoprost 0.01% and travoprost Z 0.004% ophthalmic solutions

    Directory of Open Access Journals (Sweden)

    Campbell JH

    2014-05-01

    Full Text Available Joanna H Campbell,1 Gail F Schwartz,2 Britni LaBounty,3 Jonathan W Kowalski,1 Vaishali D Patel1 1Allergan, Inc., Irvine, CA, USA; 2Greater Baltimore Medical Center and Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; 3Principled Strategies, Inc., Encinitas, CA, USA Background: Effective control of intraocular pressure is predicated upon patient compliance with pharmacotherapy. We compared patient adherence and persistence with two new ocular hypotensive formulations, using real-world utilization data. Methods: This observational cohort study employed pharmacy claims data from the Source® Lx (Wolters Kluwer Pharma Solutions database. Patients with an initial (index prescription for topical bimatoprost 0.01% or travoprost Z (April to June 2011 and no claim for ophthalmic prostaglandin or prostamide analogs within the previous 18 months were identified. Treatment adherence was expressed as proportion of days covered with study medication during the first 365 days after the index prescription. Treatment persistence with study medication was assessed over the first 12 months using Kaplan–Meier survival analyses, allowing a maximum 30-day gap for prescription refill. Treatment status was determined monthly over this period. Results: A total of 12,985 patients were assessed for treatment adherence, and 10,470 for treatment persistence. Adherence was better with bimatoprost 0.01% than with travoprost Z (mean proportion of days covered 0.540 versus [vs] 0.486, P<0.001, and more patients showed high adherence (proportion of days covered >0.80 with bimatoprost 0.01% than travoprost Z (29.1% vs 22.3%, P<0.001. Continuous 12-month persistence was higher with bimatoprost 0.01% than with travoprost Z (29.5% vs 24.2%, P<0.001. At month 12, more patients were on treatment with bimatoprost 0.01% than travoprost Z (48.8% vs 45.7%, P<0.01. Similar findings were demonstrated in cohorts of ocular hypotensive treatment-naïve patients, branded

  4. Prospective Observational Post-marketing Study of Tafluprost 0.0015%/Timolol 0.5% Combination Ophthalmic Solution for Glaucoma and Ocular Hypertension: Short-Term Efficacy and Safety.

    Science.gov (United States)

    Takagi, Yasutaka; Osaki, Hirotaka; Yamashita, Tomohiro; Kai, Yasuhiko

    2016-12-01

    The intraocular pressure (IOP)-lowering effect and safety of tafluprost 0.0015%/timolol maleate 0.5% combination ophthalmic solution (Taf-TFC) were investigated in a real-world clinical setting. A prospective up to 2-year (more than 1 year) observational study has been initiated to collect data on the IOP, conjunctival hyperemia score, corneal staining score, and adverse events suffered by patients with glaucoma or ocular hypertension treated at 3 months, and up to 2 years (more than 1 year) after initiating treatment with Taf-TFC. The 3-month findings are reported here. Among 439 patients enrolled at 100 institutions in Japan, most had normal tension glaucoma (45.3%) or primary open angle glaucoma (36.0%). Adverse drug reaction (ADR) occurred in 5.01%. The important ADRs were conjunctival hyperemia (five patients), blepharitis (four patients), and punctate keratitis (two patients). Serious adverse reactions occurred in two patients (three events). In 410 patients with data both before and after treatment, baseline mean IOP was 17.5 ± 5.0 mmHg, and it was significantly decreased after 1, 2, and 3 months (all P < 0.05, paired-t test). IOP was significantly reduced in patients switched to Taf-TFC from either prostaglandin or β-blocker monotherapy. IOP also decreased significantly in patients switched from a prostaglandin/timolol fixed combination, but not in patients switched from concomitant use of a prostaglandin analog and a β-blocker. The use of Taf-TFC did not worsen the adherence in most patients. Taf-TFC significantly reduced the IOP in patients with glaucoma or ocular hypertension treated in daily clinical practice with controllable or recoverable ADRs in short period. Taf-TFC was effective regardless of treatment patterns, and particularly, Taf-TFC significantly reduced IOP in cases in which requiring the second line therapy as insufficient of monotherapy. Santen Pharmaceutical Co., Ltd., Osaka, Japan.

  5. ANAESTHESIA FOR OPHTHALMIC SURGICAL PROCEDURES

    African Journals Online (AJOL)

    East African Medical Journal Vol. 91 No. 3 March 2014. ANAESTHESIA FOR OPHTHALMIC SURGICAL PROCEDURES. O. H. Onakpoya, MBBS, FWACS, FMCOphth, Ophthalmology Unit, Department of Surgery, College of Health Sciences,. Obafemi Awolowo University, F. D. Asudo, FDBSBCH (Dip Anaesth), FWACS, ...

  6. Ophthalmic Disorders in Adults with Down Syndrome

    Directory of Open Access Journals (Sweden)

    Sharon J. Krinsky-McHale

    2012-01-01

    Full Text Available A myriad of ophthalmic disorders is associated with the phenotype of Down syndrome including strabismus, cataracts, and refractive errors potentially resulting in significant visual impairment. Ophthalmic sequelae have been extensively studied in children and adolescents with Down syndrome but less often in older adults. In-depth review of medical records of older adults with Down syndrome indicated that ophthalmic disorders were common. Cataracts were the most frequent ophthalmic disorder reported, followed by refractive errors, strabismus, and presbyopia. Severity of intellectual disability was unrelated to the presence of ophthalmic disorders. Also, ophthalmic disorders were associated with lower vision-dependent functional and cognitive abilities, although not to the extent that was expected. The high prevalence of ophthalmic disorders highlights the need for periodic evaluations and individualized treatment plans for adults with Down syndrome, in general, but especially when concerns are identified.

  7. Human Microbiota and Ophthalmic Disease.

    Science.gov (United States)

    Lu, Louise J; Liu, Ji

    2016-09-01

    The human ocular surface, consisting of the cornea and conjunctiva, is colonized by an expansive, diverse microbial community. Molecular-based methods, such as 16S rRNA sequencing, has allowed for more comprehensive and precise identification of the species composition of the ocular surface microbiota compared to traditional culture-based methods. Evidence suggests that the normal microbiota plays a protective immunological role in preventing the proliferation of pathogenic species and thus, alterations in the homeostatic microbiome may be linked to ophthalmic pathologies. Further investigation of the ocular surface microbiome, as well as the microbiome of other areas of the body such as the oral mucosa and gut, and their role in the pathophysiology of diseases is a significant, emerging field of research, and may someday enable the development of novel probiotic approaches for the treatment and prevention of ophthalmic diseases.

  8. Localized defects in ophthalmic lenses.

    Science.gov (United States)

    Stroud, J S

    1989-03-01

    Ophthalmic lenses made from glass, hard resin, and polycarbonate are inspected with a shadowgraph to determine the nature, frequency, and severity of localized defects, including power aberrations. The most common localized defects are scratches and pits left by incomplete polishing and localized power aberrations caused by variations in the thickness of scratch-resistant coatings. Localized defects are more likely in polycarbonate lenses than in glass or hard resin lenses. The compliance of lenses with standards that limit localized defects is discussed.

  9. Ophthalmic injuries from a TASER.

    Science.gov (United States)

    Han, Jay S; Chopra, Anil; Carr, David

    2009-01-01

    The TASER (TASER International) is an energy-conducting weapon, that is becoming more frequently used by law enforcement officials to subdue combative individuals. Though generally regarded as a safe alternative, the use of such weapons has been reported to cause serious injuries. We describe a case in which ocular injuries were sustained by impalement with a TASER dart. Emergency physicians should be aware of the potential for serious ophthalmic injuries from TASERs and how such injuries should be managed.

  10. Appearance concerns in ophthalmic patients

    Science.gov (United States)

    James, H; Jenkinson, E; Harrad, R; Ezra, D G; Newman, S

    2011-01-01

    Aims This study aimed to determine the psychosocial and appearance-related concerns of a sample of ophthalmic patients by measuring a range of psychological, social, and demographic factors. Methods Standardized psychological measures including anxiety, depression, appearance-related distress, self-discrepancy, appearance salience and valence were administered to 98 participants attending ophthalmic outpatient clinics in either London, Bristol, Sheffield or Bradford. Differences between groups were explored using t-tests and ANOVA, relationships between all variables were investigated using Pearson's correlation coefficient. Results Although mean scores for psychological adjustment were within the normal range, some participants were experiencing considerable levels of generalized anxiety. Being older, male, and married or living with a partner was related to significantly better adjustment. Better adjustment was also related to a less visible area of concern, greater disguisability of the affected area, a more positive evaluation of their own appearance, less engagement in comparing themselves with others, greater feelings of being accepted by others, appearance being less important to their self-concept, and a smaller discrepancy between the persons ideal and actual appearance. Conclusions A majority of ophthalmic patients adjust positively to the demands placed on them. By identifying the variables that are associated with successful adaptation, the specific psychological interventions and appropriate systems of support can be put in place to help those who are adversely affected. PMID:21597486

  11. determinants of general anaesthesia for ophthalmic surgery

    African Journals Online (AJOL)

    DR. CHARLES IMARENGIAYE

    1999-08-01

    Objectives: To study the pattern of anaesthesia for ophthalmic procedures in order to improve the scheduling of cases in the ophthalmic operating room. Methods: The surgical register of the operating room from. August 01, 1999 to July 31, 2004 was examined, to document the types of procedure, timing of surgery (elective ...

  12. Osteopathic Manipulative Treatment to Manage Ophthalmic Conditions.

    Science.gov (United States)

    Sherman, Tatyana; Qureshi, Yasmin; Bach, Austin

    2017-09-01

    Although there is little evidence-based literature regarding osteopathic manipulative treatment for ophthalmic conditions, the general principles and techniques of osteopathic manipulative medicine can be used to manage various ophthalmic pathologic conditions. Additional research to support these treatment options and evaluate the role of OMT as a potential conservative treatment option used by ophthalmologists is needed.

  13. Ophthalmic applications of femtosecond lasers

    Science.gov (United States)

    Kurtz, Ron M.; Spooner, Greg J. R.; Sletten, Karin R.; Yen, Kimberly G.; Sayegh, Samir I.; Loesel, Frieder H.; Horvath, Christopher; Liu, HsiaoHua; Elner, Victor; Cabrera, Delia; Muenier, Marie-Helene; Sacks, Zachary S.; Juhasz, Tibor; Miller, Doug L.; Williams, A. R.

    1999-06-01

    We investigated three potential femtosecond laser ophthalmic procedures: intrastromal refractive surgery, transcleral photodisruptive glaucoma surgery and photodisruptive ultrasonic lens surgery. A highly reliable, all-solid-state system was used to investigate tissue effects and demonstrate clinical practicality. Compared with longer duration pulses, femtosecond laser-tissue interactions are characterized by smaller and more deterministic photodisruptive energy thresholds, smaller shock wave and cavitation bubble sizes. Scanning a 5 (mu) spot below the target tissue surface produced contiguous tissue effects. Various scanning patterns were used to evaluate the efficacy, safety, and stability of three intrastromal refractive procedures in animal eyes: corneal flap cutting, keratomileusis, and intrastromal vision correction (IVC). Superior dissection and surface quality results were obtained for the lamellar procedures. IVC in rabbits revealed consistent, stable pachymetric changes, without significant inflammation or corneal transparency degradation. Transcleral photodisruption was evaluated as a noninvasive method for creating partial thickness scleral channels to reduce elevated intraocular pressure associated with glaucoma. Photodisruption at the internal scleral surface was demonstrated by focusing through tissue in vitro without collateral damage. Femtosecond photodisruptions nucleated ultrasonically driven cavitation to demonstrate non-invasive destruction of in vitro lens tissue. We conclude that femtosecond lasers may enable practical novel ophthalmic procedures, offering advantages over current techniques.

  14. 21 CFR 886.3100 - Ophthalmic tantalum clip.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic tantalum clip. 886.3100 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3100 Ophthalmic tantalum clip. (a) Identification. An ophthalmic tantalum clip is a malleable metallic device intended to be implanted permanently...

  15. 21 CFR 886.1670 - Ophthalmic isotope uptake probe.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic isotope uptake probe. 886.1670 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1670 Ophthalmic isotope uptake probe. (a) Identification. An ophthalmic isotope uptake probe is an AC-powered device intended to measure...

  16. 21 CFR 886.1405 - Ophthalmic trial lens set.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic trial lens set. 886.1405 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1405 Ophthalmic trial lens set. (a) Identification. An ophthalmic trial lens set is a device that is a set of lenses of various dioptric powers...

  17. 21 CFR 886.1410 - Ophthalmic trial lens clip.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic trial lens clip. 886.1410 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1410 Ophthalmic trial lens clip. (a) Identification. An ophthalmic trial lens clip is a device intended to hold prisms, spheres, cylinders, or...

  18. 21 CFR 886.4250 - Ophthalmic electrolysis unit.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic electrolysis unit. 886.4250 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4250 Ophthalmic electrolysis unit. (a) Identification. An ophthalmic electrolysis unit is an AC-powered or battery-powered device intended to destroy...

  19. 21 CFR 886.4770 - Ophthalmic operating spectacles (loupes).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic operating spectacles (loupes). 886.4770... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4770 Ophthalmic operating spectacles (loupes). (a) Identification. Ophthalmic operating spectacles (loupes) are devices that consist of convex...

  20. 21 CFR 886.1665 - Ophthalmic rotary prism.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic rotary prism. 886.1665 Section 886.1665...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1665 Ophthalmic rotary prism. (a) Identification. An ophthalmic rotary prism is a device with various prismatic powers intended to be handheld and...

  1. Ophthalmic Drug Delivery Systems for Antibiotherapy—A Review

    Directory of Open Access Journals (Sweden)

    Marion Dubald

    2018-01-01

    Full Text Available The last fifty years, ophthalmic drug delivery research has made much progress, challenging scientists about the advantages and limitations of this drug delivery approach. Topical eye drops are the most commonly used formulation in ocular drug delivery. Despite the good tolerance for patients, this topical administration is only focus on the anterior ocular diseases and had a high precorneal loss of drugs due to the tears production and ocular barriers. Antibiotics are popularly used in solution or in ointment for the ophthalmic route. However, their local bioavailability needs to be improved in order to decrease the frequency of administrations and the side effects and to increase their therapeutic efficiency. For this purpose, sustained release forms for ophthalmic delivery of antibiotics were developed. This review briefly describes the ocular administration with the ocular barriers and the currently topical forms. It focuses on experimental results to bypass the limitations of ocular antibiotic delivery with new ocular technology as colloidal and in situ gelling systems or with the improvement of existing forms as implants and contact lenses. Nanotechnology is presently a promising drug delivery way to provide protection of antibiotics and improve pathway through ocular barriers and deliver drugs to specific target sites.

  2. Big data and ophthalmic research.

    Science.gov (United States)

    Clark, Antony; Ng, Jonathon Q; Morlet, Nigel; Semmens, James B

    2016-01-01

    Large population-based health administrative databases, clinical registries, and data linkage systems are a rapidly expanding resource for health research. Ophthalmic research has benefited from the use of these databases in expanding the breadth of knowledge in areas such as disease surveillance, disease etiology, health services utilization, and health outcomes. Furthermore, the quantity of data available for research has increased exponentially in recent times, particularly as e-health initiatives come online in health systems across the globe. We review some big data concepts, the databases and data linkage systems used in eye research-including their advantages and limitations, the types of studies previously undertaken, and the future direction for big data in eye research. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Paradigm Shifts in Ophthalmic Diagnostics.

    Science.gov (United States)

    Sebag, J; Sadun, Alfredo A; Pierce, Eric A

    2016-08-01

    Future advances in ophthalmology will see a paradigm shift in diagnostics from a focus on dysfunction and disease to better measures of psychophysical function and health. Practical methods to define genotypes will be increasingly important and non-invasive nanotechnologies are needed to detect molecular changes that predate histopathology. This is not a review nor meant to be comprehensive. Specific topics have been selected to illustrate the principles of important paradigm shifts that will influence the future of ophthalmic diagnostics. It is our impression that future evaluation of vision will go beyond visual acuity to assess ocular health in terms of psychophysical function. The definition of disease will incorporate genotype into what has historically been a phenotype-centric discipline. Non-invasive nanotechnologies will enable a paradigm shift from disease detection on a cellular level to a sub-cellular molecular level. Vision can be evaluated beyond visual acuity by measuring contrast sensitivity, color vision, and macular function, as these provide better insights into the impact of aging and disease. Distortions can be quantified and the psychophysical basis of vision can be better evaluated than in the past by designing tests that assess particular macular cell function(s). Advances in our understanding of the genetic basis of eye diseases will enable better characterization of ocular health and disease. Non-invasive nanotechnologies can assess molecular changes in the lens, vitreous, and macula that predate visible pathology. Oxygen metabolism and circulatory physiology are measurable indices of ocular health that can detect variations of physiology and early disease. This overview of paradigm shifts in ophthalmology suggests that the future will see significant improvements in ophthalmic diagnostics. The selected topics illustrate the principles of these paradigm shifts and should serve as a guide to further research and development. Indeed

  4. Ophthalmic complications associated with orthognathic surgery.

    Science.gov (United States)

    Lanigan, D T; Romanchuk, K; Olson, C K

    1993-05-01

    Ophthalmic complications are rare following maxillary osteotomies. Potential complications include a decrease in visual acuity, extraocular muscle dysfunction, neuroparalytic keratitis, and nasolacrimal problems involving both an increase or a decrease in tearing. Ophthalmic injuries appear to be primarily mediated through indirect injuries to neurovascular structures occurring from traction, compression, or contrecoup injuries from forces transmitted during the pterygomaxillary dysjunction using an osteotome or from fractures extending to the base of the skull or orbit associated with the pterygomaxillary dysjunction or the maxillary downfracture. A review of the literature of previous ophthalmic complications as well as eight new cases are reported. The possible etiologic basis for these injuries is discussed in detail as well as treatment possibilities when appropriate.

  5. Ophthalmic masquerades of the atherosclerotic carotids

    Directory of Open Access Journals (Sweden)

    Anupriya Arthur

    2014-01-01

    Full Text Available Patients with carotid atherosclerosis can present with ophthalmic symptoms. These symptoms and signs can be due to retinal emboli, hypoperfusion of the retina and choroid, opening up of collateral channels, or chronic hypoperfusion of the globe (ocular ischemic syndrome. These pathological mechanisms can produce many interesting signs and a careful history can bring out important past symptoms pointing toward the carotid as the source of the patient′s presenting symptom. Such patients are at high risk for an ischemic stroke, especially in the subsequent few days following their first acute symptom. It is important for clinicians to be familiar with these ophthalmic symptoms and signs caused by carotid atherosclerosis for making an early diagnosis and to take appropriate measures to prevent a stroke. This review elaborates the clinical features, importance, and implications of various ophthalmic symptoms and signs resulting from atherosclerotic carotid artery disease.

  6. Treatment of neuro-ophthalmic sarcoidosis.

    Science.gov (United States)

    Frohman, Larry P

    2015-03-01

    Because of the rarity of neuro-ophthalmic sarcoidosis, there are no therapeutic guidelines based on evidence-based medicine for this disorder. Review of literature combined with personal experience. Corticosteroids are the preferred initial therapy for neuro-ophthalmic sarcoidosis. If patients cannot tolerate the requisite dose of corticosteroid needed to control their disease, or if corticosteroids fail to adequately control the disease process, the choices of a second agent are based on the consideration of rapidity of clinical response and the safety profile. Although methotrexate and mycophenolate mofetil are the medications that are often selected after corticosteroid failure, more rapidly acting agents that have been used are infliximab and intravenous cyclophosphamide.

  7. Dural AVM supplied by the ophthalmic artery.

    LENUS (Irish Health Repository)

    Flynn, T H

    2012-02-03

    Dural arteriovenous malformations in the anterior cranial fossa are rare and are especially prone to haemorrhage. These lesions are usually treated by surgical excision. We report the embolization of an anterior cranial fossa DAVM using an endovascular approach via the ophthalmic artery.

  8. Classical Etymologies of Select Gynaecological and Ophthalmic ...

    African Journals Online (AJOL)

    This paper attempts to identify, through the philological and semantic methods, the Classical stories and linguistic history that surround the etymology of some selected modern gynaecological and ophthalmic terms. It argues that many of these medical terms have interesting beginnings and do not just exist in isolation.

  9. Ophthalmic implications of seasonal affective disorder

    Energy Technology Data Exchange (ETDEWEB)

    Paramore, J.E.; King, V.M. (Ferris State Univ., Big Rapids, MI (USA))

    1989-07-01

    A review of seasonal affective disorder (SAD) is presented with a discussion of its standard treatment of phototherapy. A number of ophthalmic implications related to SAD are proposed. These implications relate to both the condition and the phototherapy used in its treatment, especially the use of full spectrum light which contains ultraviolet and near ultraviolet radiation. 12 references.

  10. determinants of general anaesthesia for ophthalmic surgery

    African Journals Online (AJOL)

    DR. CHARLES IMARENGIAYE

    trabeculectomy and evisceration were the leading indications. General anaesthesia was the more commonly employed anaesthetic technique in younger patients and for emergency ophthalmic procedures. The general anaesthesia was administered by the registrar and senior registrar grades of anaesthetists. Conclusion: ...

  11. Ophthalmic considerations in patients with Pfeiffer syndrome

    Directory of Open Access Journals (Sweden)

    Jeremy D. Clark

    2016-07-01

    Conclusions and importance: It is important for ophthalmologists to be aware of the ophthalmic complications associated with patients with craniosynostosis syndromes. Our case identifies the importance of close communication between ophthalmology and plastic reconstructive surgery to help formulate the most successful plan in treating corneal decompensation and proptosis in Pfeiffer Syndrome patients.

  12. Readability assessment of online ophthalmic patient information.

    Science.gov (United States)

    Edmunds, Matthew R; Barry, Robert J; Denniston, Alastair K

    2013-12-01

    Patients increasingly use the Internet to access information related to their disease, but poor health literacy is known to impact negatively on medical outcomes. Multiple agencies have recommended that patient-oriented literature be written at a fourth- to sixth-grade (9-12 years of age) reading level to assist understanding. The readability of online patient-oriented materials related to ophthalmic diagnoses is not yet known. To assess the readability of online literature specifically for a range of ophthalmic conditions. Body text of the top 10 patient-oriented websites for 16 different ophthalmic diagnoses, covering the full range of ophthalmic subspecialties, was analyzed for readability, source (United Kingdom vs non-United Kingdom, not for profit vs commercial), and appropriateness for sight-impaired readers. Four validated readability formulas were used: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index (GFOG). Data were compared with the Mann-Whitney test (for 2 groups) and Kruskal-Wallis test (for more than 2 groups) and correlation was assessed by the Spearman r. None of the 160 webpages had readability scores within published guidelines, with 83% assessed as being of "difficult" readability. Not-for-profit webpages were of significantly greater length than commercial webpages (P = .02) and UK-based webpages had slightly superior readability scores compared with those of non-UK webpages (P = .004 to P visually impaired readers. To our knowledge, this is the first study to assess readability of patient-focused webpages specifically for a range of ophthalmic diagnoses. In keeping with previous studies in other medical conditions, we determined that readability scores were inferior to those recommended, irrespective of the measure used. Although readability is only one aspect of how well a patient-oriented webpage may be comprehended, we recommend the use of readability scoring

  13. Preparation and Characterization of Ophthalmic Lens Materials Containing Titanium Silicon Oxide and Silver Nanoparticles.

    Science.gov (United States)

    No, Jung-Won; Kim, Dong-Hyun; Lee, Min-Jae; Kim, Duck-Hyun; Kim, Tae-Hun; Sung, A-Young

    2015-10-01

    Hydrogel ophthalmic lenses containing fluorine-substituted aniline group, titanium silicon oxide nartoparticles, and silver nanoparticles were copolymerized, and the physical and optical properties of the hydrogel lenses were measured. To produce the hydrophilic ophthalmic lenses, the additives were added to the mixture containing HEMA, NVP, MA, EGDMA, and AIBN. The cast mold method was used for the manufacture of the hydrogel ophthalmic lenses, and the produced lenses were completely soaked in a 0.9% NaCl normal saline solution for 24 hours for hydration. The physical properties of the produced macromolecule showed that the water content was 32.5-37.6%, the refractive index was 1.450-1.464, the UV-B transmittance was 0.5-35.2%, and the contact angle was between 56 and 69°. Also, the addition of aniline, titanium silicon oxide, and silver nanoparticles allowed the ophthalmic lenses to block UV. These results show that the produced macromolecule can be used as hydrophilic lenses for ophthalmologic purposes that can block UV.

  14. Pulmonary safety of ophthalmic beta-blockers

    DEFF Research Database (Denmark)

    Kristensen, Mathias L.; Simonsen, Jan Henrik; Torp-Pedersen, Christian

    2018-01-01

    PURPOSE: Ophthalmic beta-blockers, used in the treatment of increased intraocular pressure, are known to cause pulmonary adverse effects. Few, if any, studies have quantified the extent of the problem in a real-life population. In this nationwide study, we assess the pulmonary safety of patients...... initiating treatment with ophthalmic beta-blockers. METHODS: Using the Danish Nationwide Registries from 1995 to 2012, we identified all individuals aged 20-90 years who initiated monotherapy with an intraocular pressure-lowering drug, with or without concomitant obstructive pulmonary disease. Risks of (i...... concomitant obstructive pulmonary disease (n = 86 568) were as follows: 1.47 for beta-blockers (95% confidence interval (CI): 1.35-1.61; p

  15. Ophthalmic photography using a digital camera.

    Directory of Open Access Journals (Sweden)

    Fogla Rajesh

    2003-01-01

    Full Text Available Purpose: To report the application of a digital camera for ophthalmic photography in routine clinical use. Methods: A digital camera (Nikon Coolpix 995 was used both for external macrophotography of the eye and ocular adnexa, and slitlamp photography of the anterior segment of the eye. Results: We were able to take external macrophotographs under high magnification of the eye and ocular adnexa. Slitlamp photography could be performed under diffuse, slit beam, and retroillumination. The structures of the angle, the optic disc and surrounding retina could be photographed using appropriate lenses. The attachment to the operating microscope allowed intra-operative photography. It could also be attached to the laboratory microscope to capture images of various histopathology and microbiology slides. Conclusions: A digital camera is a versatile instrument for ophthalmic photography. It is easy to use in routine clinical practice and provides good quality photographs.

  16. Frozen section diagnosis in ophthalmic pathology

    Directory of Open Access Journals (Sweden)

    Biswas Jyotirmay

    1993-01-01

    Full Text Available Frozen section diagnosis is extensively used in various branches of pathology, but its application in ophthalmic pathology was recognised only in the 1970s. We studied 10 sections of ocular and adenexal lesions by frozen section diagnosis, which included orbital lesions (4 cases, lid lesions (3 cases, and intraocular tissue (1 case. The time taken for processing ranged between 10 to 15 minutes. Diagnoses based on frozen section evaluation included lymphoma, mesenchymal chondrosarcoma, solar keratosis, compound naevus, silicone oil globules in cataractous lens, neurofibromatosis, pseudotumour, retinoblastoma, and chronic blepharitis. Although further histopathologic examination correlated well with the frozen section (100% observations, the diagnosis was deferred in the case of naevus and reactive lymphoid hyperplasia. Our study shows that frozen section diagnosis in ophthalmic surgery is quite reliable and is particularly useful in ocular adenexal lesions

  17. [Immunohistochemistry in ophthalmic pathology: applications and limitations].

    Science.gov (United States)

    Pluot, M; Cahn, V; Ducasse, A

    2006-10-01

    We evaluate the applications of immunohistochemistry (IHC) in ophthalmic cytology and pathology. The principles of the techniques used in IHC are described. Recent improvements are highlighted, such as the polymeric labeling two-step method, tyramine signal amplification, rabbit monoclonal antibodies, and labeled nanocrystals. The results of the immunohistochemical methods are collected in bacterial and viral diseases and in tumors of the eye and its adnexa, the pathology of which varies greatly. The results in lymphomas, melanomas, and palpebral tumors were more details for practical reasons. There are widespread applications of IHC in ophthalmic pathology, extending from viral ocular and general diseases to the diagnosis of tumors. In some conditions, this technique needs to be associated with molecular biology investigations. Automation helps establish standard protocols, but IHC is a multistep diagnostic method requiring proper selection, fixation, processing, and staining procedures. From a general standpoint, good communication between pathologists and ophthalmologists is the best guarantee of satisfying results.

  18. Are we pharmacovigilant enough in ophthalmic practice?

    Directory of Open Access Journals (Sweden)

    Ashok Dubey

    2013-01-01

    Full Text Available No drug is absolutely safe. Pharmacovigilance is the science related to detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problems. The ocular medications and devices can cause localized and systemic adverse effects. Not all adverse effects are known when a drug or device is launched in market because of limitations of clinical trials. Many adverse effects are recognized due to the spontaneous reporting of the vigilant doctors who observe and report such events encountered in their practice. Despite a large ophthalmic patient population base, India does not have robust adverse drug reaction (ADR database because of lack of reporting culture. Government of India recently launched the Pharmacovigilance Programme of India (PvPI to monitor ADRs and create awareness among the healthcare professionals about the importance of ADRs. Suspecting and reporting a possible drug reaction is very important in developing a safe and rational ophthalmic practice.

  19. Renal medullary carcinoma with an ophthalmic metastasis

    Directory of Open Access Journals (Sweden)

    Christine Ibilibor

    2017-01-01

    Full Text Available Renal medullary carcinoma (RMC is a rare, aggressive primary renal malignancy that classically occurs in adolescent males with sickle cell trait and universally presents with metastatic disease at presentation. We report a case of medullary carcinoma in a young man with likely ophthalmic metastasis. We also review relevant literature available to date. The patient is a 20-year-old African-American male with a past medical history significant to for sickle cell trait who presented to the University Medical Center with cough and the right eye pain for 1 month as well as painless gross hematuria for 1 week. A chest and abdominal computed tomography showed a 7 cm hypodense right renal mass with bilateral hilar adenopathy, and multiple bilateral pulmonary nodules. A renal biopsy was performed and showed RMC. Ophthalmic exam revealed the right retinal hemorrhage concerning for a metastatic lesion. Palliative chemotherapy was offered to the patient, however, he and his family chose to enroll in hospice care considering his poor prognosis. He subsequently passed away 33 days after presentation. To our knowledge, there is only one other case of ophthalmic metastasis in a patient with metastatic RMC. Thus, we present this case to contribute to current literature regarding orbital metastasis in this largely fatal disease.

  20. 75 FR 54492 - Ophthalmic and Topical Dosage Form New Animal Drugs; Gentamicin and Betamethasone Ophthalmic...

    Science.gov (United States)

    2010-09-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 Ophthalmic and Topical Dosage Form New... AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS 0 1. The authority citation for 21 CFR part 524 continues to...

  1. Mydriatics release from solid and semi-solid ophthalmic formulations using different in vitro methods.

    Science.gov (United States)

    Pescina, Silvia; Macaluso, Claudio; Gioia, Gloria Antonia; Padula, Cristina; Santi, Patrizia; Nicoli, Sara

    2017-09-01

    The aim of the present paper was the development of semi-solid (hydrogels) and solid (film) ophthalmic formulations for the controlled release of two mydriatics: phenylephrine and tropicamide. The formulations - based on polyvinylalcohol and hyaluronic acid - were characterized, and release studies were performed with three different in vitro set-ups, i.e. Franz-type diffusion cell, vial method and inclined plane; for comparison, a solution and a commercial insert, both clinically used to induce mydriasis, were evaluated. Both gels and film allowed for a controlled release of drugs, appearing a useful alternative for mydriatics administration. However, the release kinetic was significantly influenced by the method used, highlighting the need for optimization and standardization of in vitro models for the evaluation of drug release from ophthalmic dosage forms.

  2. 21 CFR 886.1415 - Ophthalmic trial lens frame.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1415 Ophthalmic trial lens frame. (a) Identification. An opthalmic trial lens frame is a mechanical device intended to hold trial lenses for vision testing. (b) Classification. Class I (general controls). The device is exempt from the premarket...

  3. HIV Seroprevalence in Patients Undergoing Ophthalmic Surgery in ...

    African Journals Online (AJOL)

    Aim: The aim of this study was to determine the number of HIV positive cases undergoing ophthalmic surgery at two centres in Nigeria and to assess if routine testing is clinically or economically effective. Methods: All patients listed for ophthalmic surgery in two eye units in southern Nigeria during a six-month period in 2005,

  4. Sildenafil dilates ophthalmic artery in type 2 diabetic patients

    Directory of Open Access Journals (Sweden)

    Akeel AMH Zwain

    2013-08-01

    Full Text Available Background: Conflicting reports exist on the effect of sildenafil on ophthalmic artery blood flow; many visual disturbances due to vascular insult were reported with the use of sildenafil in diabetic patients like nonarteritic ischemic optic neuropathy. Objectives: The present work aimed to investigate whether sildenafil modulates ophthalmic artery vasoreactivity in patients with type 2 diabetes mellitus. Literature reports on this aspect are lacking. Methods: A total of 35 male subjects were enrolled in this study, 18 with type 2 diabetes mellitus matched with 17 normal individuals. Ophthalmic artery was insonated through a transorbital window using colored Doppler equipment with transcranial Doppler facility. Ophthalmic artery reactivity was assessed using breath holding/hyperventilation test, before and after giving 50 mg oral sildenafil. Results: It was found that in both normal subjects and diabetic patients, sildenafil increased baseline control of mean flow velocity of ophthalmic artery significantly (p 0.05 after sildenafil, in normal and diabetic groups. There was a significant increase of resistive index of ophthalmic artery flow in diabetic patients compared with that of normal subject (p < 0.05. Sildenafil decreased resistive index of ophthalmic artery flow significantly only in diabetic patients (p < 0.05. Conclusion: Sildenafil increased MFVopa, but had no significant effect on vasoreactivity of ophthalmic artery; sildenafil decreased resistive index only in type 2 diabetic patients.

  5. Ocular Hazards in Ophthalmic Dispensing Industry in South East ...

    African Journals Online (AJOL)

    The prevalence of ocular hazards in ophthalmic dispensing industry in south east Nigeria was carried out using 70 subjects drawn from different towns in the region. Tables were used to analyze the data obtained from his study. Results showed that ocular hazards are involved in ophthalmic dispensing depending on the ...

  6. Ex vivo corneal epithelial wound healing following exposure to ophthalmic nonsteroidal anti-inflammatory drugs

    Directory of Open Access Journals (Sweden)

    Keping Xu

    2011-02-01

    Full Text Available Keping Xu1, Mark McDermott1, Linda Villanueva2, Rhett M Schiffman2, David A Hollander21The Kresge Eye Institute, Department of Ophthalmology, Wayne State University School of Medicine, Detroit, MI, USA; 2Allergan, Inc., Irvine, CA, USAPurpose: Ketorolac 0.45% is a new formulation of topical ketorolac in which preservative (benzalkonium chloride, BAK was removed and carboxymethylcellulose (CMC was added to improve tolerability and reduce dosing frequency. This study compared the effects of ketorolac 0.45% on corneal wound healing to prior ketorolac formulations (0.4% and 0.5%, bromfenac 0.09%, and nepafenac 0.1%.Methods: Two parallel-group comparisons were performed in series. A 5-mm central epithelial wound was made in fresh porcine corneas. After 24 hours in minimum essential medium (MEM, corneas were incubated for 10 minutes with study drugs, Triton X-100 1% (positive control, or MEM (negative control, followed by 24 hours in MEM. The remaining wound area was stained, photographed, and quantified (pixels. Study 1 compared ketorolac 0.45% to ketorolac 0.4% and ketorolac 0.5%. Study 2 compared ketorolac 0.45% to bromfenac 0.09% and nepafenac 0.1%.Results: The mean (±SD original wound area was 200,506 ± 4,363 pixels, which was reduced to 59,509 ± 4850 at 48 hours after exposure to Triton X-100 1%. In study 1, the mean remaining wound areas at 48 hours in pixels were 2969 ± 1633 with MEM, 586 ± 299 with ketorolac 0.45% (significantly reduced, P < 0.05 vs all other treatments, 10,228 ± 7541 with ketorolac 0.4%, and 50,674 ± 33,409 with ketorolac 0.5% (significantly enlarged, P < 0.05 vs MEM. In study 2, the mean remaining wound areas at 48 hours were 565 ± 1263 with MEM, 322 ± 229 with ketorolac 0.45% (significantly reduced, P < 0.01 vs bromfenac 0.09% and nepafenac 0.1%, 29,093 ± 14,295 with bromfenac 0.09% (significantly enlarged, P < 0.01 vs MEM and 47,322 ± 13,736 with nepafenac 0.1% (significantly enlarged, P < 0.01 vs MEM and vs

  7. SOLUTIONING

    Directory of Open Access Journals (Sweden)

    Maria de Hoyos Guajardo, Ph.D. Candidate, M.Sc., B.Eng.

    2004-11-01

    Full Text Available The theory that is presented below aims to conceptualise how a group of undergraduate students tackle non-routine mathematical problems during a problem-solving course. The aim of the course is to allow students to experience mathematics as a creative process and to reflect on their own experience. During the course, students are required to produce a written ‘rubric’ of their work, i.e., to document their thoughts as they occur as well as their emotionsduring the process. These ‘rubrics’ were used as the main source of data.Students’ problem-solving processes can be explained as a three-stage process that has been called ‘solutioning’. This process is presented in the six sections below. The first three refer to a common area of concern that can be called‘generating knowledge’. In this way, generating knowledge also includes issues related to ‘key ideas’ and ‘gaining understanding’. The third and the fourth sections refer to ‘generating’ and ‘validating a solution’, respectively. Finally, once solutions are generated and validated, students usually try to improve them further before presenting them as final results. Thus, the last section deals with‘improving a solution’. Although not all students go through all of the stages, it may be said that ‘solutioning’ considers students’ main concerns as they tackle non-routine mathematical problems.

  8. Diffusion-Based Design of Multi-Layered Ophthalmic Lenses for Controlled Drug Release.

    Science.gov (United States)

    Pimenta, Andreia F R; Serro, Ana Paula; Paradiso, Patrizia; Saramago, Benilde; Colaço, Rogério

    2016-01-01

    The study of ocular drug delivery systems has been one of the most covered topics in drug delivery research. One potential drug carrier solution is the use of materials that are already commercially available in ophthalmic lenses for the correction of refractive errors. In this study, we present a diffusion-based mathematical model in which the parameters can be adjusted based on experimental results obtained under controlled conditions. The model allows for the design of multi-layered therapeutic ophthalmic lenses for controlled drug delivery. We show that the proper combination of materials with adequate drug diffusion coefficients, thicknesses and interfacial transport characteristics allows for the control of the delivery of drugs from multi-layered ophthalmic lenses, such that drug bursts can be minimized, and the release time can be maximized. As far as we know, this combination of a mathematical modelling approach with experimental validation of non-constant activity source lamellar structures, made of layers of different materials, accounting for the interface resistance to the drug diffusion, is a novel approach to the design of drug loaded multi-layered contact lenses.

  9. Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients

    Directory of Open Access Journals (Sweden)

    Nielsen SA

    2013-01-01

    Full Text Available Steven A Nielsen,1 Marguerite B McDonald,2 Parag A Majmudar31Nielsen Eye Center, Quincy, MA, USA; 2Ophthalmic Consultants of Long Island, Lynbrook, NY, USA; 3Chicago Cornea Consultants Hoffman Estates, IL, USABackground: To evaluate the safety of besifloxacin ophthalmic suspension 0.6% when used in laser-assisted in situ keratomileusis (LASIK prophylactic antibiotic regimens.Methods: Retrospective surveillance of LASIK surgery cases where besifloxacin ophthalmic suspension 0.6% or moxifloxacin ophthalmic solution 0.5% were prescribed as prophylactic medications. Surgeons from nine US surgical centers provided retrospective case information on surgical outcomes from consecutive cases and reported any adverse events related to the antibacterial used. The primary endpoint was the incidence of adverse drug reactions.Results: A total of 801 case reports (801 eyes; 534 besifloxacin, 267 moxifloxacin were obtained. The mean (standard deviation [SD] age at time of surgery was 36.1 (10.6 years. The mean (SD duration of antibiotic treatment was 8.6 (2.2 days in the besifloxacin group and 8.0 (2.3 in the moxifloxacin group; daily dosing frequency was higher in the moxifloxacin group preoperatively, on the day of surgery, and postoperatively. There were no reports of adverse drug reactions for the 801 eyes in this surveillance. There were no differences between the besifloxacin and moxifloxacin treatment groups in rates of unexpected corneal findings (2.1% vs 1.5%, P = 0.949. The distribution of final visual acuity for the besifloxacin and moxifloxacin groups were similar (P = 0.793. Most cases had a final visual acuity of 20/20 or better.Conclusion: In this retrospective surveillance study, the prophylactic use of besifloxacin ophthalmic suspension 0.6% and moxifloxacin ophthalmic solution 0.5% in patients undergoing LASIK surgery was not associated with any adverse drug reactions.Keywords: Besivance, refractive surgery, adverse drug reactions LASIK

  10. Oncocytic lesions of the ophthalmic region

    DEFF Research Database (Denmark)

    Østergaard, Jens; Prause, Jan U; Heegaard, Steffen

    2011-01-01

    were collected and re-evaluated using a monoclonal antimitochondrial antibody (MU213-UC). Clinical data were registered. Immunohistochemical characterization was performed with a panel of anti-CK antibodies. Results: A total of 34 oncocytic lesions were identified and reviewed. The incidence......–brown, cystic and slow-growing. The antimitochondrial antibody MU213-UC produced a distinct and intense immunostaining of all oncocytic lesions and was found to be useful in substantiating oncocytic differentiation. Twenty-six of the lesions originated in the caruncle, three in the conjunctiva, two...... expression. Basal-type oncocytic cells reacted with antibodies against CK 5/6, CK 7, CK 8, CK 13, CK 14, CK 17, CK 18 and CK 19, and suprabasal cells with CK 4, CK 7, CK 8, CK 18 and CK 19. Antibodies against CK 1+10 and CK 20 showed no reaction. Conclusions: Oncocytic lesions of the ophthalmic region most...

  11. A polycarbonate ophthalmic-prescription lens series.

    Science.gov (United States)

    Davis, J K

    1978-08-01

    Improvements in polycarbonate material, production techniques, and scratch-resistant coatings, combined with a process-oriented design, have resulted in a precision lens series. Surface quality is comparable to that of untreated glass ophthalmic lenses. The repeatability of the process results in closely controlled axial power and off-axis performance. For most lens prescriptions, the ANSI Z80.1 optical-center specifications for prescription accuracy are maintained through a total field of view of 40 deg for an 8-mm range of center-of-rotation distances. Off-axis astigmatism is controlled for near-point seeing. The lenses are both lighter and thinner than those of crown glass. A scratch-resistant coating reduces the reflections normally associated with high-index (1.586) materials. Impact resistance exceeds that required by ANSI Z80.7 and is many times that required by ANSI Z80.1.

  12. An historical ophthalmic study of Jane Austen.

    Science.gov (United States)

    Wilson, Graham A

    2012-11-01

    Today, no other classic novelist has the popularity or power of Jane Austen, and in 2013 the world will celebrate 200 years of her comic masterpiece Pride and Prejudice. Her millions of fans have an abiding fascination with all aspects of her life, including her health and the cause of her death. This historical ophthalmic study of Jane Austen, based on very incomplete medical bibliographic data, finds that she had a mild ocular surface disorder from age 23. This disorder did not significantly impact on her visual performance for writing. There are many references to eyes in her novels, but Jane's eyes and those of her characters cannot contribute further to the debate around the cause of her death at age 41.

  13. Flow analysis of the ophthalmic artery

    Energy Technology Data Exchange (ETDEWEB)

    Harada, Kuniaki; Hashimoto, Masato; Bandoh, Michio; Odawara, Yoshihiro; Kamagata, Masaki; Shirase, Ryuji [Sapporo Medical Univ. (Japan). Hospital

    2003-02-01

    The purpose of this study was to analyze the hemodynamics of ophthalmic artery flow using phase contrast MR angiography (PC-MRA). A total of 14 eyes from 10 normal volunteers and a patient with normal tension glaucoma (NTG) were analyzed. The optimal conditions were time repetition (TR)/echo time (TE)/flip angle (FA)/nex=40 ms/minimum/90 deg/2, field of view (FOV)=6 cm, matrix size=256 x 256. The resistive index (RI) and pulsatillity index (PI) values were significantly raised in the patient with NTG when compared to the control group. We therefore believe that PC-MRA may be a useful clinical tool for the assessment of the mechanism of NTG. (author)

  14. Delayed visual maturation: ophthalmic and neurodevelopmental aspects.

    Science.gov (United States)

    Tresidder, J; Fielder, A R; Nicholson, J

    1990-10-01

    Delayed visual maturation (DVM) can present as an isolated anomaly (type 1A), but can be compounded by perinatal problems (type 1B), severe neurodevelopmental delay (type 2), or ocular anomalies/nystagmus (type 3), in which group the common feature appears to be nystagmus. The neurodevelopmental and ophthalmic aspects of 26 infants with DVM were studied. Onset of visual improvement, rate of acquisition of normal vision and eventual outcome were studied quantitatively, using an adaptation of the acuity card procedure. Neurodevelopmental assessment was performed after visual improvement. The results support the long-held clinical impression that if blindness is the presenting feature, neurodevelopmental outlook is excellent. DVM could represent a defect in the extrageniculostriate visual system, and the onset of vision in all types--and the development of nystagmus in type 3--could herald the emergence of geniculostriate function.

  15. Ophthalmic manifestations in recently diagnosed childhood leukemia.

    Science.gov (United States)

    Bitirgen, Gulfidan; Belviranli, Selman; Caliskan, Umran; Tokgoz, Huseyin; Ozkagnici, Ahmet; Zengin, Nazmi

    2016-01-01

    To determine the prevalence and the pattern of ocular involvement in children with leukemia at the time of diagnosis. The data of patients with leukemia who underwent complete ophthalmic examination at the time of diagnosis between January 2005 and December 2014 were retrospectively reviewed. Demographic data, type of leukemia, ocular findings, blood parameters, and duration of follow-up were analyzed. A total of 185 patients (111 male and 74 female) were included in the study, with a median age of 6.0 years (range 0.5-18.0 years) and a median follow-up time of 36.0 months (range 0.5-108.0 months). Ocular signs were present in 24.3% of the patients at the time of diagnosis and 37.8% of them were symptomatic. The prevalence of ocular involvement was 20.4% in patients with acute lymphocytic leukemia (ALL) and 36.4% in patients with acute myelocytic leukemia (AML) (p = 0.051). Fatality rate was significantly higher in subjects with AML compared with ALL (p = 0.019), but was not significantly different between patients with and without ocular involvement (p = 0.166). There were no significant differences in hemoglobin levels, white blood cell counts, or platelet counts between patients with ALL and AML. Platelet counts were significantly lower in patients with ocular signs compared with subjects without ocular involvement (p = 0.012), while hemoglobin levels and white blood cell counts did not differ significantly. Various ocular signs may be present at the time of diagnosis in childhood leukemia, even in patients without any symptoms. Routine ophthalmic examination should be performed in recently diagnosed children with leukemia.

  16. Ophthalmic complications of endoscopic sinus surgery

    Directory of Open Access Journals (Sweden)

    Malgorzata Seredyka-Burduk

    Full Text Available Abstract Introduction: The proximity of the paranasal sinuses to the orbit and its contents allows the occurence of injuries in both primary or revision surgery. The majority of orbital complications are minor. The major complications are seen in 0.01-2.25% and some of them can be serious, leading to permanent dysfunction. Objective: The aim of this study was to determine the risk and type of ophthalmic complications among patients operated due to a chronic rhinosinusitis. Methods: This is a retrospective study of 1658 patients who underwent endoscopic sinus surgery for chronic rhinosinusitis with or without polyps or mucocele. Surgeries were performed under general anesthesia in all cases and consisted of polyps' removal, followed by middle metal antrostomy, partial or complete ethmoidectomy, frontal recess surgery and sphenoid surgery if necessary. The ophthalmic complications were classified according to type, frequency and clinical findings. Results: In our material 32.68% of the patients required revision surgery and only 10.1% had been previously operated in our Department. Overall complications occurred in 11 patients (0.66%. Minor complications were observed in 5 patients (0.3% with the most frequent being periorbital ecchymosis with or without emphysema. Major complications were observed in one patient (0.06% and were related to a lacrimal duct injury. Severe complications occurred in 5 cases (0.3%, with 2 cases and referred to a retroorbital hematoma, optic nerve injury (2 cases and one case of extraocular muscle injury. Conclusions: Orbital complications of endoscopic nasal surgery are rare. The incidence of serious complications, causing permanent disabilities is less than 0.3%. The most important parameters responsible for complications are extension of the disease, previous endoscopic surgery and coexisting anticoagulant treatment.

  17. Ophthalmic injuries in orbito-zygomatic fractures.

    Science.gov (United States)

    Riaz, Nabeela; Chatha, Asad Aizaz; Warraich, Riaz Ahmad; Hanif, Saba; Chinar, Kashif Ali; Khan, Shammas Raza

    2014-09-01

    To assess the frequency and severity of ophthalmic injuries in patients with orbito-zygomatic fractures. A case series. Oral and Maxillofacial Department, KEMU/Mayo Hospital Lahore, from January 2009 to December 2011. Patients with orbito-zygomatic fractures were divided into three groups. Group-1 patients had fracture of floor/medial wall of the orbit (orbital-blow out fracture). Group-2 had comminuted orbito-zygomatic fractures. Group-3 had simple zygomatic bone fractures. Frequency and types of ocular injuries were determined on each group. There were 296 (260 male, 36 female) patients with mean age of 31.7 years. Group-1 (n = 20) had 28 ocular findings in 12 (60%) patients including diplopia (n = 10, 36%), enophthalmos (n = 6, 14%), and hyphema, vitreous hemorrhage, retinal hemorrhage, choroidal rupture, traumatic mydriasis, and commotio retinae in 2 cases, 7% each. In Group-2 (n = 106), 44 ocular findings were identified in 30 (28%) patients including diplopia (n = 10, 23%), enophthalmos (n = 4, 9%), commotio retinae (n = 10, 23%), reduced visual acuity (n = 6, 14%), retinal hemorrhage (n = 4, 9%) and corneal laceration, corneal abrasion, retinal detachment, traumatic mydriasis, and canthal laceration in 2 cases, 4.5%. In Group-3 (n = 170), 22 ocular findings were seen in 16 (9%) patients included diplopia (n = 10, 45%), enophthalmos (n = 4, 18%), and retinal tear, hyphema, angle recession, and traumatic mydriasis in 2 cases, (9%) each. Ophthalmic injuries are a common complication of orbitozygomatic fractures occurring in about 20% of patients in this study, most frequent in the orbital blow fractures subgroup. Ophthalmology consultation is recommended for patients presenting with midface fractures.

  18. Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients.

    Science.gov (United States)

    Nielsen, Steven A; McDonald, Marguerite B; Majmudar, Parag A

    2013-01-01

    To evaluate the safety of besifloxacin ophthalmic suspension 0.6% when used in laser-assisted in situ keratomileusis (LASIK) prophylactic antibiotic regimens. Retrospective surveillance of LASIK surgery cases where besifloxacin ophthalmic suspension 0.6% or moxifloxacin ophthalmic solution 0.5% were prescribed as prophylactic medications. Surgeons from nine US surgical centers provided retrospective case information on surgical outcomes from consecutive cases and reported any adverse events related to the antibacterial used. The primary endpoint was the incidence of adverse drug reactions. A total of 801 case reports (801 eyes; 534 besifloxacin, 267 moxifloxacin) were obtained. The mean (standard deviation [SD]) age at time of surgery was 36.1 (10.6) years. The mean (SD) duration of antibiotic treatment was 8.6 (2.2) days in the besifloxacin group and 8.0 (2.3) in the moxifloxacin group; daily dosing frequency was higher in the moxifloxacin group preoperatively, on the day of surgery, and postoperatively. There were no reports of adverse drug reactions for the 801 eyes in this surveillance. There were no differences between the besifloxacin and moxifloxacin treatment groups in rates of unexpected corneal findings (2.1% vs 1.5%, P = 0.949). The distribution of final visual acuity for the besifloxacin and moxifloxacin groups were similar (P = 0.793). Most cases had a final visual acuity of 20/20 or better. In this retrospective surveillance study, the prophylactic use of besifloxacin ophthalmic suspension 0.6% and moxifloxacin ophthalmic solution 0.5% in patients undergoing LASIK surgery was not associated with any adverse drug reactions.

  19. Selected diagnostic ophthalmic tests in the red kangaroo (Macropus rufus).

    Science.gov (United States)

    Takle, Ginger L; Suedmeyer, W Kirk; Hunkeler, Amy

    2010-06-01

    The following tests were performed on a total of 20 eyes: Schirmer tear test, intraocular pressure (IOP), assessment of conjunctival flora, and pupillary diameter with application of topical tropicamide in 10 healthy captive red kangaroos (Macropus rufus) under manual restraint. The mean Schirmer tear test value was 22.6 +/- 6.07 mm/min. The mean intraocular pressure was 17.45 +/- 7.23 mm Hg. Values did not differ between eyes or gender for either test, but significant differences were identified for IOP values according to age. The most common bacteria isolated from the conjunctival fornix were Staphylococcus epidermidis (54.5%) and Corynebacterium sp. (18.2%). The mean onset of mydriasis after instillation of 1% tropicamide ophthalmic solution was 16.7 +/- 3.34 min and the mean duration of effect was 17.6 +/- 8.26 hr. The data obtained in this investigation will aid veterinary ophthalmologists and zoo veterinarians to diagnose ocular diseases in the red kangaroo accurately.

  20. Risk factors of ophthalmic disorders in children with developmental delay

    DEFF Research Database (Denmark)

    Sandfeld, L.N.; Jensen, H.; Skov, L.

    2008-01-01

    PURPOSE: To identify diagnoses that increase the risk of ophthalmic disorders in developmentally delayed children. METHODS: A cross-sectional study of 1126 Danish children with developmental delay (IQ Udgivelsesdato: 2008/12......PURPOSE: To identify diagnoses that increase the risk of ophthalmic disorders in developmentally delayed children. METHODS: A cross-sectional study of 1126 Danish children with developmental delay (IQ Udgivelsesdato: 2008/12...

  1. Patient education preferences in ophthalmic care

    Directory of Open Access Journals (Sweden)

    Rosdahl JA

    2014-04-01

    Full Text Available Jullia A Rosdahl, Lakshmi Swamy, Sandra Stinnett, Kelly W MuirDepartment of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USABackground: The learning preferences of ophthalmology patients were examined.Methods: Results from a voluntary survey of ophthalmology patients were analyzed for education preferences and for correlation with race, age, and ophthalmic topic.Results: To learn about eye disease, patients preferred one-on-one sessions with providers as well as printed materials and websites recommended by providers. Patients currently learning from the provider were older (average age 59 years, and patients learning from the Internet (average age 49 years and family and friends (average age 51 years were younger. Patients interested in cataracts, glaucoma, macular degeneration, and dry eye were older; patients interested in double vision and glasses were younger. There were racial differences regarding topic preferences, with Black patients most interested in glaucoma (46%, diabetic retinopathy (31%, and cataracts (28% and White patients most interested in cataracts (22%, glaucoma (22%, and macular degeneration (19%.Conclusion: Most ophthalmology patients preferred personalized education: one-on-one with their provider or a health educator and materials (printed and electronic recommended by their provider. Age-related topics were more popular with older patients, and diseases with racial risk factors were more popular with high risk racial groups.Keywords: patient education, eye disease, cataracts, macular degeneration, glaucoma, diabetic retinopathy

  2. Cervical occupational hazards in ophthalmic plastic surgery.

    Science.gov (United States)

    Sivak-Callcott, Jennifer A; Mancinelli, Corrie A; Nimbarte, Ashish D

    2015-07-01

    To increase awareness of cervical musculoskeletal disorders (cMSD) in ophthalmic plastic surgeons (OPS) and review strategies for management and prevention. There are objective data that show OPS spend the majority of their time operating in awkward, prolonged, static, asymmetric postures. These postures increase cervical load and cMSD. Loupes and headlamps further increase this cervical loading by 40%. Risk for cMSD is not limited to the operating room. Muscular demands in the anterior deltoid and cervical trapezius are increased in slit lamp biomicroscopy and indirect ophthalmoscopy. Furthermore, the majority of the office visit is spent keyboarding into the electronic medical record which is associated with cMSD. Habitual postural faults result from these cumulative exposures. These must be addressed to prevent further insult and debilitating injury. Successful management requires education in neutral posture, therapeutic exercise, environmental adjustments in the workplace and home, and supported neutral sleep posture. The risks of cMSD in OPS are well established, and nearly 10% of cervical injury will end a career. Neck pain must not be ignored, and experienced professional help is critical. A long-term approach that incorporates exercise, manual therapy, and education is essential for management and prevention.

  3. New eye phantom for ophthalmic surgery

    Science.gov (United States)

    Fogli, Gessica; Orsi, Gianni; De Maria, Carmelo; Montemurro, Francesca; Palla, Michele; Rizzo, Stanislao; Vozzi, Giovanni

    2014-06-01

    In this work, we designed and realized a new phantom able to mimic the principal mechanical, rheological, and physical cues of the human eye and that can be used as a common benchmark to validate new surgical procedures, innovative vitrectomes, and as a training system for surgeons. This phantom, in particular its synthetic humor vitreous, had the aim of reproducing diffusion properties of the natural eye and can be used as a system to evaluate the pharmacokinetics of drugs and optimization of their dose, limiting animal experiments. The eye phantom was built layer-by-layer starting from the sclera up to the retina, using low cost and easy to process polymers. The validation of the phantom was carried out by mechanical characterization of each layer, by diffusion test with commercial drugs into a purposely developed apparatus, and finally by a team of ophthalmic surgeons. Experiments demonstrated that polycaprolactone, polydimethylsiloxane, and gelatin, properly prepared, are the best materials to mimic the mechanical properties of sclera, choroid, and retina, respectively. A polyvinyl alcohol-gelatin polymeric system is the best for mimicking the viscosity of the human humor vitreous, even if the bevacizumab half-life is lower than in the human eye.

  4. Dose uniformity of loteprednol etabonate ophthalmic gel (0.5%) compared with branded and generic prednisolone acetate ophthalmic suspension (1%)

    Science.gov (United States)

    Marlowe, Zora T; Davio, Stephen R

    2014-01-01

    Introduction Loteprednol etabonate (LE) ophthalmic gel 0.5% (Lotemax®) is a new polycarbophil-based, nonsettling topical ophthalmic formulation. The formulation is a semisolid gel at rest and a shear thinning fluid when expressed through a dropper tip. The present study was undertaken to determine how the nonsettling character of LE ophthalmic gel affects dose uniformity. Prednisolone acetate ophthalmic suspension 1% (Pred Forte®) and a generic prednisolone acetate suspension 1% were used as comparators. Methods Drug concentrations of LE ophthalmic gel, Pred Forte, and a generic prednisolone acetate suspension were determined following simulated dosing – consisting of 2 drops, expressed four times daily for 2 weeks, with bottles that were shaken or not shaken immediately prior to expressing the drops. Drug concentrations were determined using a reverse-phase high-performance liquid chromatography (HPLC) method and reported as a percentage of the declared (labeled) concentration. Comparative kinetics of drug particle sedimentation were also determined for each formulation, using dispersion analysis under gravity. Results Mean drug concentrations in drops of all three formulations were within a few percentage points of the declared concentration when the bottles were shaken for 5 seconds prior to dispensing. Only LE ophthalmic gel showed consistent and on-target concentrations when the bottles were unshaken prior to dispensing, with a mean (standard deviation [SD]) percent declared concentration of 102% (1.92%) over the 2-week dosing regimen. Drug concentrations for the branded and generic prednisolone acetate suspensions following expression from unshaken bottles were highly variable (overall relative SDs of 16.8% and 20.3%, respectively), with mean concentrations for both falling significantly below the declared concentration for drops expressed at the beginning of the 2-week dosing regimen and significantly above the declared concentration for drops expressed

  5. Smart ophthalmics: the future in tele-ophthalmology has arrived

    Science.gov (United States)

    Fink, Wolfgang; Tarbell, Mark A.; Garcia, Kevin

    2016-05-01

    Smart Ophthalmics© extends ophthalmic healthcare to people who operate/live in austere environments (e.g., military, third world, natural disaster), or are geographically dispersed (e.g., rural populations), where time, cost, and the possibility of travel/transportation make access to even adequate medical care difficult, if at all possible. Operators attach optical devices that act as ophthalmic examination extensions to smartphones and run custom apps to perform examinations of specific areas of the eye. The smartphone apps submit over wireless networks the collected examination data to a smart remote expert system, which provides in-depth medical analyses that are sent back in near real-time to the operators for subsequent triage.

  6. Allergic Contact Dermatitis to Ophthalmic Medications: Relevant Allergens and Alternative Testing Methods.

    Science.gov (United States)

    Grey, Katherine R; Warshaw, Erin M

    Allergic contact dermatitis is an important cause of periorbital dermatitis. Topical ophthalmic agents are relevant sensitizers. Contact dermatitis to ophthalmic medications can be challenging to diagnose and manage given the numerous possible offending agents, including both active and inactive ingredients. Furthermore, a substantial body of literature reports false-negative patch test results to ophthalmic agents. Subsequently, numerous alternative testing methods have been described. This review outlines the periorbital manifestations, causative agents, and alternative testing methods of allergic contact dermatitis to ophthalmic medications.

  7. Novel NSAIDs ophthalmic formulation: flurbiprofen axetil emulsion with low irritancy and improved anti-inflammation effect.

    Science.gov (United States)

    Shen, Jinqiu; Gan, Li; Zhu, Chunliu; Zhang, Xinxin; Dong, Yang; Jiang, Min; Zhu, Jiabi; Gan, Yong

    2011-06-30

    The aim of this study was to design and formulate a novel low-irritant NSAIDs ophthalmic emulsion of flurbiprofen axetil (FBA), the prodrug of flurbiprofen (FB). FBA ophthalmic emulsion (FBA-EM) was prepared by high-pressure homogenization with caster oil as oil phase and tween 80 as emulsifying agent. Results from the stability evaluation suggested the protect effect of oil droplets on the stability of FBA. Compared with FBA-oil solution, the AUC(0→10h) of FB in aqueous humor administered in FBA-EMs exhibited 6.7-fold (F2), 4.5-fold (F3) and 4.6-fold (F4) increase. With the increment of oil content, the MRT also prolonged, which of FBA-EM F2-F4 were 5.14 ± 2.23, 5.73 ± 3.35 and 8.71 ± 0.94 h, respectively. No significant difference was found between the ocular bioavailability of FBA-EM F2 and 0.03% FB-Na eye drops. Ocular irritation evaluation revealed that FBA-EM F2 had better ocular biocompatibility than 0.03% FB-Na eye drops, even though the FBA concentration was up to 0.1%. Intraocular anti-inflammation effect evaluation showed that FBA-EM F2 had a quite good anti-inflammation effect. In conclusion, FBA-EM F2 with elevated FBA concentration to be 0.1% might represent a promising NSAIDs ophthalmic emulsion with low irritancy and improved anti-inflammation effect. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. In-use study of potential bacterial contamination of ophthalmic moxifloxacin.

    Science.gov (United States)

    Mason, Ben L; Alfonso, Eduardo C; Miller, Darlene

    2005-09-01

    To determine the contamination rate of topical moxifloxacin 0.5% (Vigamox) after clinical use for preoperative and postoperative prophylaxis for cataract surgery. Bascom Palmer Eye Institute, Miami, Florida, USA. A total of 61 bottles of moxifloxacin were collected in a 2-month time period after use preoperatively by patients (n = 21, mean 2.2 days), postoperatively by patients (n = 16, mean 7.2 days), or by nurses in the operating room (n = 24). For each bottle, cultures of the cap, tip, external thread, and solution were inoculated onto chocolate agar plates and incubated at 35 degrees for 7 days. A total of 13 bottles of benzalkonium chloride (BAC)-preserved gatifloxacin ophthalmic solution (Zymar) were also cultured in a similar manner for comparison. No organisms were found by cultures of the cap, tip, or solution from any bottle in the study. One colony of coagulase-negative Staphylococcus was recovered from the thread of 1 Vigamox bottle. This bottle had negative cultures from its cap, tip, and solution. The only contaminant found in this study was cultured from the bottle thread. This is a location with a high rate of skin contact and minimal solution contact. The remaining cultures from this bottle were negative, showing the solution's ability to self-preserve. These data demonstrate that BAC-free Vigamox can be treated no differently than BAC-preserved solutions by patients and medical staff, without concern for solution contamination.

  9. Challenges Encountered Using Ophthalmic Anesthetics in Space Medicine

    Science.gov (United States)

    Bayuse, T.; Law, J.; Alexander, D.; Moynihan, S.; LeBlanc, C.; Langford, K.; Magalhaes, L.

    2015-01-01

    On orbit, ophthalmic anesthetics are used for tonometry and off-nominal corneal examinations. Proparacaine has been flown traditionally. However, the manufacturers recently changed its storage requirements from room temperature storage to refrigerated storage to preserve stability and prolong the shelf-life. Since refrigeration on orbit is not readily available and there were stability concerns about flying proparacaine unrefrigerated, tetracaine was selected as an alternative ophthalmic anesthetic in 2013. We will discuss the challenges encountered flying and using these anesthetics on the International Space Station.

  10. Ophthalmic Manifestations of Congenital Zika Syndrome in Colombia and Venezuela.

    Science.gov (United States)

    Yepez, Juan B; Murati, Felipe A; Pettito, Michele; Peñaranda, Carlos F; de Yepez, Jazmin; Maestre, Gladys; Arevalo, J Fernando

    2017-05-01

    The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed. To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela. This prospective case series included 43 patients from 2 ophthalmic centers in Colombia and Venezuela who underwent evaluation from October 1, 2015, through June 30, 2016, and were clinically diagnosed with congenital Zika syndrome. Twenty patients were Hispanic; 13, African; 8, white; and 2, Native American. Ophthalmic and systemic evaluations and serologic testing were performed on all infants. Patients underwent external ocular examination and dilated ophthalmoscopy. Serologic testing ruled out toxoplasmosis, rubella, cytomegalovirus, syphilis, and human immunodeficiency virus. Ophthalmic manifestations of congenital Zika syndrome. Of the 43 patients included in this series (28 female and 15 male), the mean (SD) age at examination was 2.1 (1.5) months. The mothers of all the children had no ophthalmic findings and did not report ocular symptoms during pregnancy. All patients had bilateral ophthalmic manifestations. Optic nerve findings included hypoplasia with the double-ring sign, pallor, and increased cup-disc ratio in 5 patients (11.6%). Macular abnormalities included mild to severe pigment mottling in 27 patients (63%) and lacunar maculopathy in 3 (6.9%). Chorioretinal scarring was present in 3 patients (7%). Eleven patients (26%) had a combination of lesions in the posterior pole. Five patients (12%) were

  11. 21 CFR 524.1484 - Neomycin sulfate ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.1484 Neomycin sulfate ophthalmic and topical dosage forms. ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Neomycin sulfate ophthalmic and topical dosage...

  12. 21 CFR 524.1580 - Nitrofurazone ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Nitrofurazone ophthalmic and topical dosage forms... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.1580 Nitrofurazone ophthalmic and topical dosage forms. ...

  13. 21 CFR 524.1600 - Nystatin ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Nystatin ophthalmic and topical dosage forms. 524... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.1600 Nystatin ophthalmic and topical dosage forms. ...

  14. 21 CFR 524.1200 - Kanamycin ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Kanamycin ophthalmic and topical dosage forms. 524... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.1200 Kanamycin ophthalmic and topical dosage forms. ...

  15. 21 CFR 524.660 - Dimethyl sulfoxide ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.660 Dimethyl sulfoxide ophthalmic and topical dosage forms. ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Dimethyl sulfoxide ophthalmic and topical dosage...

  16. 21 CFR 524.1881 - Prednisolone acetate ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.1881 Prednisolone acetate ophthalmic and topical dosage forms. ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Prednisolone acetate ophthalmic and topical dosage...

  17. 21 CFR 524.1044 - Gentamicin sulfate ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.1044 Gentamicin sulfate ophthalmic and topical dosage forms. ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Gentamicin sulfate ophthalmic and topical dosage...

  18. 21 CFR 524.390 - Chloramphenicol ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.390 Chloramphenicol ophthalmic and topical dosage forms. ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Chloramphenicol ophthalmic and topical dosage...

  19. Audit of Referrals to an Ophthalmic Outpatient Clinic of a Tertiary

    African Journals Online (AJOL)

    DR. BONIFACE EZE

    Objectives: To determine the referral pattern and assess the quality and accuracy of referral letters to the ophthalmic outpatient clinic of University of Nigeria Teaching. Hospital, Enugu. Methods: This study is a prospective cross-sectional survey of all new ophthalmic referrals to the ophthalmic outpatient clinic at University of ...

  20. Audit of Referrals to an Ophthalmic Outpatient Clinic of a Tertiary ...

    African Journals Online (AJOL)

    Objectives: To determine the referral pattern and assess the quality and accuracy of referral letters to the ophthalmic outpatient clinic of University of Nigeria Teaching Hospital, Enugu. Methods: This study is a prospective cross-sectional survey of all new ophthalmic referrals to the ophthalmic outpatient clinic at University of ...

  1. Thermoresponsive ophthalmic poloxamer/tween/carbopol in situ gels of a poorly water-soluble drug fluconazole: preparation and in vitro-in vivo evaluation.

    Science.gov (United States)

    Lihong, Wang; Xin, Che; Yongxue, Guo; Yiying, Bian; Gang, Cheng

    2014-10-01

    The purpose of the present study was to optimize the formulations of the thermoresponsive ophthalmic in situ gels of a poorly water-soluble drug fluconazole (FLU) and evaluate the in vitro and in vivo properties of the formulations. The thermoresponsive ophthalmic FLU in situ gels were prepared by mixing FLU, Poloxamer407, Tween80, benzalkonium chloride and carbopol934 in borate buffer solution. The in vivo eye irritation tests and ophthalmic absorption were carried out in rabbits. The formulation compositions influenced the physicochemical properties of FLU in situ gels. The amount of poloxamer407 in the formulation was the main factor that affected the sol-gel transition temperature of the products. Tween80 not only improved the solubility of the FLU but also affected the products' sol-gel transition temperature. In this study, sol-gel transition temperature was not affected by carbopol934. However, carbopol934 affected pH value, transparency and gelling capacity of the products. The product of the optimized formulation was a pseudoplastic fluid and its sol-gel transition temperature was 30.6 ± 1.2 °C. The autoclaving test showed that the sol-gel transition temperature, the flow ability and the flow behavior of the test samples did not change obviously after autoclaving sterilization at 121 °C and 15 psi for 20 min, thus the autoclaving was an acceptable sterilization method for this preparation. The thermoresponsive ophthalmic FLU in situ gels' in vivo ophthalmic absorption was superior to the conventional FLU eye drop. In conclusion, the thermoresponsive ophthalmic FLU in situ gel is a better alternative than the FLU eye drop.

  2. Iatrogenic Cushing's Syndrome Due to Intranasal Usage of Ophthalmic Dexamethasone: A Case Report.

    Science.gov (United States)

    Orton, Sarah; Censani, Marisa

    2016-05-01

    Iatrogenic Cushing's syndrome (ICS) is caused by exogenous corticosteroid administration with suppression of the hypothalamic-pituitary-adrenal axis. It has been commonly described with oral and topical steroid use, but scarce reports have documented intranasal steroid usage as the etiology in infancy. In this article, we describe a case of a 4-month-old infant who developed ICS after 6 weeks of intranasal dexamethasone ophthalmic solution administration for nasal obstruction. To our knowledge, this is the youngest patient reported with ICS due to intranasal use of a prescribed dose of an ophthalmic steroid. His hypothalamic-pituitary-adrenal axis recovered fully 4.5 months after steroid discontinuation. Because of the small body surface area and supine position during administration, infants are particularly susceptible to ICS. Given that intranasal steroids are commonly prescribed to infants and children for a variety of diagnoses, this case highlights the risks inherent in the use of intranasal steroid drops, particularly in young infants, for both adrenal suppression and linear growth deceleration, even with short-term use. Close monitoring of these patients' height and weight should occur while on steroid treatment, with every effort made to decrease or discontinue steroid use when possible. Copyright © 2016 by the American Academy of Pediatrics.

  3. Carboplatin +/− Topotecan Ophthalmic Artery Chemosurgery for Intraocular Retinoblastoma

    Science.gov (United States)

    Francis, Jasmine H.; Gobin, Y. Pierre; Dunkel, Ira J.; Marr, Brian P.; Brodie, Scott E.; Jonna, Gowtham; Abramson, David H.

    2013-01-01

    Purpose Carboplatin administered systemically or periocularly can result in dramatic and prompt regression of retinoblastoma. However, both routes are rarely curative alone and have undesirable side effects. We aimed to assess the efficacy and toxicity of carboplatin +/− topotecan delivered by ophthalmic artery chemosurgery whereby chemotherapy is infused into the eye via the ophthalmic artery. Methods This retrospective, IRB-approved study investigated retinoblastoma patients whom received carboplatin +/− topotecan ophthalmic artery chemosurgery. Patient survival, ocular survival, hematologic toxicity, ocular toxicity, second cancer development and electroretinogram response were all evaluated. Results 57 carboplatin +/− topotecan infusions (of 111 total) were performed in 31 eyes of 24 patients. The remaining infusions were melphalan-containing. All patients were alive and no patient developed a second malignancy at a median follow up of 25 months. The Kaplan-Meier estimate of ocular survival at two years was 89.9% (95% confidence interval [CI], 82.1–97.9%) for all eyes. Grade 3 or 4 neutropenia developed in two patients and one patient developed metastatic disease. By univariate analysis, neither increasing maximum carboplatin/topotecan dose nor cumulative carboplatin/topotecan dose was associated with statistically significant reduction in the electroretinogram responses. Conclusion Carboplatin +/− topotecan infusions are effective for ophthalmic artery chemosurgery in retinoblastoma: they demonstrate low hematologic and ocular toxicity and no statistically significant influence on electroretinogram responses, and used in conjunction with melphalan-containing OAC, demonstrate excellent patient survival and satisfactory ocular survival. PMID:23991112

  4. HIV seroprevalence in patients undergoing Ophthalmic surgery in ...

    African Journals Online (AJOL)

    THAMPY

    against puncture injuries in general surgery, is of uncertain value in most ophthalmic procedures. It might be sensible to take this precaution when performing procedures which involve more exposure to blood, cutting (e.g., exenteration) or drilling bony fragments (e.g., dacryocystorhinostomy).7. Corneal transplantation is a ...

  5. Ethical Dilemmas in Contemporary Ophthalmic Practice in Nigeria

    African Journals Online (AJOL)

    Ethical Dilemmas in Contemporary Ophthalmic. Practice in Nigeria. Emmanuel Olu Megbelayin. Department of Ophthalmology, University of Uyo Teaching Hospital, Uyo, Akwa‑Ibom State, Nigeria. ABSTRACT. Background: Ethics, as a branch of both philosophy and theology, is a systematic study of what is right and wrong ...

  6. Glaucoma awareness among ophthalmic patients at Menelik II ...

    African Journals Online (AJOL)

    Background: Glaucoma is one of the main causes of blindness worldwide that has been considered as a major public health issue. Raising awareness about glaucoma among the general public, ophthalmic patients and health professionals would be key instrument for early case identification and prevention of blindness.

  7. How relevant is current Nigerian postgraduate ophthalmic training to ...

    African Journals Online (AJOL)

    Objectives • To determine the pattern of referrals to an ophthalmic department • To determine the scope of other sub-specialty knowledge required of the practicing ophthalmologist • To determine the impact of referral pattern on the needed practice skills in ophthalmology. Method: A study of one hundred consecutive ...

  8. Ethical Dilemmas in Contemporary Ophthalmic Practice in Nigeria ...

    African Journals Online (AJOL)

    Aim: The aim was to discuss common plausible clinical scenarios that pose ethical questions in typical ophthalmic set‑ups in Nigeria and suggest modalities of resolving them. Methods: Involved extensive literature search on ethics and medical jurisprudence. Result: There is hardly an area in medicine that does not have ...

  9. Ophthalmic Skills Assessment of Primary Health Care Workers at ...

    African Journals Online (AJOL)

    Primary eye care is at the frontline in the elimina on of the avoidable causes of blindness. Proficiency in the basic ophthalmic skills is a cri cal factor in the effec ve delivery of eye care services at the primary level of care. The aim of the study was to assess the ability of the primary health care workers to provide basic.

  10. Glaucoma awareness among ophthalmic patients at Menelik II ...

    African Journals Online (AJOL)

    admin

    Glaucoma awareness among ophthalmic patients at Menelik. II Hospital, Addis Ababa, Ethiopia. Hiwot Degineh1, Abeba T. Giorgis1. Abstract. Background: Glaucoma is one of the main causes of blindness worldwide that has been considered as a major public health issue. Raising awareness about glaucoma among the ...

  11. Fundamentals of ophthalmic diagnostical methods based on laser light scattering

    Science.gov (United States)

    Tuchin, Valery V.; Maksimova, Irina L.; Kochubey, Vyacheslav I.; Semyonova, Tatjana N.; Tatarintsev, Sergey N.; Babkova, N. L.

    1995-05-01

    The basic principles of light scattering methods which should be very useful for ophthalmic disease diagnostics and monitoring are discussed. As an example a human eye lens tissue was considered. Angular-dependent scattering spectra and scattering matrix elements M12, M33, M34 and M44 are suggested as informative parameters for eye lens aging and cataract monitoring.

  12. 21 CFR 524.390a - Chloramphenicol ophthalmic ointment.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Chloramphenicol ophthalmic ointment. 524.390a Section 524.390a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... bacterial conjunctivitis caused by pathogens susceptible to chloramphenicol. (3) Limitations. Continue...

  13. Common causes of red eye presenting at an ophthalmic clinic ...

    African Journals Online (AJOL)

    Background: Redness of the eye is a common ophthalmic symptom. The problem causing redness could arise from within or outside the globe. These range from cases of simple inflammation following itching and minor trauma for example, to severe cases like orbital cellulitis and tumours. Patients may not even be aware of ...

  14. Pattern of paediatric ophthalmic admissions into the Ogun State ...

    African Journals Online (AJOL)

    The possibility of rubella aetiology of the cataract could not be ruled out in these patients. There is a need for sustained commitment to immunization. The availability of ophthalmic microsurgical instruments will improve the surgical care of patients with a view to better visual outcome. Nigerian Journal of Paediatrics 2002; ...

  15. 21 CFR 200.50 - Ophthalmic preparations and dispensers.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Ophthalmic preparations and dispensers. 200.50... preparations and dispensers. (a)(1) Informed medical opinion is in agreement that all preparations offered or... of injury resulting from contamination during use. (c) Eye cups, eye droppers, and other dispensers...

  16. Ophthalmic surgical procedures in children at the University of Benin ...

    African Journals Online (AJOL)

    A retrospective study of paediatric eye surgeries at the University of Benin Teaching Hospital was carried out to determine the frequency and pattern of eye surgeries in children in order to provide a database for such operations. During the study period, January 1996 to December 2000, a total of 757 ophthalmic surgeries ...

  17. Anaesthesia for Ophthalmic Procedures in a Teaching Hospital ...

    African Journals Online (AJOL)

    . Results: A total of 970 patients (506 males, 464 females) had ophthalmic surgery in the five-year period under review. General anaesthesia was employed for 119 (12.3%) patients and regional anaesthesia for 851 (87.7%). 400 patients had ...

  18. Location of the internal carotid artery and ophthalmic artery ...

    African Journals Online (AJOL)

    Yasin Hamarat

    2017-10-06

    Oct 6, 2017 ... There are some published results of OA anatomical studies [18,20-22]. .... right eye) and the depth of intracranial segment of ophthal- mic artery ... internal carotid artery and segments of ophthalmic artery in high tension glaucoma patients. No. of glaucoma patients. Eye. ICA edge, mm. IOA, mm. EOA, mm.

  19. Pediatric ophthalmic indications for examination under anesthesia in ...

    African Journals Online (AJOL)

    Objective: To determine the ophthalmic indications and challenges for pediatric ocular examination under anesthesia (EUA). Methods: The surgical register and patients' records of children who underwent EUA between 1990 and 2007 were examined to document patients' bio data, diagnoses and details of procedures and ...

  20. Anaesthesia for Ophthalmic Procedures in a Teaching Hospital ...

    African Journals Online (AJOL)

    Cataract extraction, repair of corneal/scleral/conjunctival/lid lacerations, excision biopsy, trabeculectomy and evisceration were the leading indications. General anaesthesia was the more commonly employed anaesthetic technique in younger patients and for emergency ophthalmic procedures. The general anaesthesia ...

  1. ocular aids: experience at the guinness ophthalmic unit, kaduna ...

    African Journals Online (AJOL)

    .

    Herpes Zoster Ophthalmicus (HZO), was the commonest form of presentation in 87 (69.6%) patients, followed by ocular tumours in 17 ... without ophthalmic treatment after a diagnosis of HIV infection had been made. About twelve ... acyclovir, in oral and ointment forms, oral non- steroidal anti-inflammatory drugs, topical ...

  2. Carboplatin +/- topotecan ophthalmic artery chemosurgery for intraocular retinoblastoma.

    Directory of Open Access Journals (Sweden)

    Jasmine H Francis

    Full Text Available PURPOSE: Carboplatin administered systemically or periocularly can result in dramatic and prompt regression of retinoblastoma. However, both routes are rarely curative alone and have undesirable side effects. We aimed to assess the efficacy and toxicity of carboplatin +/- topotecan delivered by ophthalmic artery chemosurgery whereby chemotherapy is infused into the eye via the ophthalmic artery. METHODS: This retrospective, IRB-approved study investigated retinoblastoma patients whom received carboplatin +/- topotecan ophthalmic artery chemosurgery. Patient survival, ocular survival, hematologic toxicity, ocular toxicity, second cancer development and electroretinogram response were all evaluated. RESULTS: 57 carboplatin +/- topotecan infusions (of 111 total were performed in 31 eyes of 24 patients. The remaining infusions were melphalan-containing. All patients were alive and no patient developed a second malignancy at a median follow up of 25 months. The Kaplan-Meier estimate of ocular survival at two years was 89.9% (95% confidence interval [CI], 82.1-97.9% for all eyes. Grade 3 or 4 neutropenia developed in two patients and one patient developed metastatic disease. By univariate analysis, neither increasing maximum carboplatin/topotecan dose nor cumulative carboplatin/topotecan dose was associated with statistically significant reduction in the electroretinogram responses. CONCLUSION: Carboplatin +/- topotecan infusions are effective for ophthalmic artery chemosurgery in retinoblastoma: they demonstrate low hematologic and ocular toxicity and no statistically significant influence on electroretinogram responses, and used in conjunction with melphalan-containing OAC, demonstrate excellent patient survival and satisfactory ocular survival.

  3. Development of a poloxamer analogs/carbopol-based in situ gelling and mucoadhesive ophthalmic delivery system for puerarin.

    Science.gov (United States)

    Qi, Hongyi; Chen, Wenwen; Huang, Chunyan; Li, Li; Chen, Chuming; Li, Wenmin; Wu, Chunjie

    2007-06-07

    Conventional ophthalmic solutions often eliminate rapidly after administration and cannot provide and maintain an adequate concentration of the drug in the precorneal area. To solve these problems, we developed a thermosensitive in situ gelling and mucoadhesive ophthalmic drug delivery system containing puerarin based on poloxamer analogs (21% (w/v) poloxamer 407/5% (w/v) poloxamer 188) and carbopol (0.1% (w/v) or 0.2% (w/v) carbopol 1342P NF). The combined solutions would convert to firm gels under physiological condition and attach to the ocular mucosal surface for a relative long time. The incorporation of carbopol 1342P NF not only did not affect the pseudoplastic behavior with hysteresis of the poloxamer analogs solution and led to a higher shear stress at each shear rate, but also enhanced the mucoadhesive force significantly. In vitro release studies demonstrated diffusion-controlled release of puerarin from the combined solutions over a period of 8h. In vivo evaluation (the elimination of puerarin in tear and intraocular pressure-lowering effect) indicated the combined solutions had better ability to retain drug than poloxamer analogs or carbopol alone. It appears that ocular bioavailability can be increased more readily by using the in situ gelling and mucoadhesive vehicle.

  4. Poly(amidoamine) dendrimers as ophthalmic vehicles for ocular delivery of pilocarpine nitrate and tropicamide.

    Science.gov (United States)

    Vandamme, Th F; Brobeck, L

    2005-01-20

    The purpose of this study was to determine the influence of a controlled incremental increase in size, molecular weight and number of amine, carboxylate and hydroxyl surface groups in several series of poly(amidoamine) (PAMAM) dendrimers for controlled ocular drug delivery. The duration of residence time was evaluated after solubilization of several series of PAMAM dendrimers (generations 1.5 and 2-3.5 and 4) in buffered phosphate solutions containing 2 per thousand (w/v) of fluorescein. The New Zealand albino rabbit was used as an in vivo model for qualitative and quantitative assessment of ocular tolerance and retention time after a single application of 25 microl of dendrimer solution to the eye. The same model was also used to determine the prolonged miotic or mydriatic activities of dendrimer solutions, some containing pilocarpine nitrate and some tropicamide, respectively. Residence time was longer for the solutions containing dendrimers with carboxylic and hydroxyl surface groups. No prolongation of remanence time was observed when dendrimer concentration (0.25-2%) increased. The remanence time of PAMAM dendrimer solutions on the cornea showed size and molecular weight dependency. This study allowed novel macromolecular carriers to be designed with prolonged drug residence time for the ophthalmic route.

  5. Ophthalmic examination in early diagnosis of Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Xin Li

    2018-02-01

    Full Text Available Alzheimer's disease is a progressive neurodegenerative disorder causing irreversible deterioration in memory and loss of self-care ability, which is seriously affecting the quality of life. There is no cure for Alzheimer's disease. Medication only can control the progression of the disease. Early diagnosis and control of disease progress is of great significance in improving the quality of life of the patients and reducing the burden of family and society. Ophthalmic examination is seen as a window which can “see” brain directly, and some changes in the eye can reflect the changes of the brain most directly. This paper reviews the ophthalmic examination of Alzheimer's disease, including optical coherence tomography(OCT, visual field, contrast sensitivity and eye movements, et al. We hope to provide a new idea for the early diagnosis of Alzheimer's disease.

  6. Video recording of ophthalmic surgery--ethical and legal considerations.

    Science.gov (United States)

    Turnbull, Andrew M J; Emsley, Elizabeth S

    2014-01-01

    Video documenting is increasingly used in ophthalmic training and research, with many ophthalmologists routinely recording their surgical cases. Although this modality represents an excellent means of improving technique and advancing knowledge, there are major ethical and legal considerations with its use. Informed consent to record is required in most situations. Patients should be advised of any risk of identification and the purpose of the recording. Systems should be in place to deal with issues such as data storage, withdrawal of consent, and patients requesting copies of their recording. Privacy and security of neither patients nor health care professionals should be compromised. Ownership and distribution of video recordings, the potential for their use in medical litigation, the ethics and legality of editing and the impact on surgeon performance are other factors to consider. Although video recording of ophthalmic surgery is useful and technically simple to accomplish, patient safety and welfare must always remain paramount. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Three cases with unusual ophthalmic phenotypes of congenital aniridia.

    Science.gov (United States)

    Lee, Na Young; Lee, Yong Eun; Mok, Jeewon; Kim, Myungshin; Park, Shin Hae

    2013-08-01

    To report 3 cases with unusual ophthalmic phenotypes of congenital aniridia. Interventional case series. A 10-day-old infant with cloudy and large cornea in both eyes, 1 month-old male with bilateral corneal opacity, and 27-year-old male with low vision. Complete ophthalmic examination and genetic evaluation. Case 1 was a neonate with concurrent presentation of congenital aniridia and glaucoma. Case 2 was diagnosed as congenital aniridia combined with Peters anomaly in both eyes. Case 3 had 2 unusual features of aniridia, which were asymmetric iris involvement and absence of limbal deficiency. It is important to perform thorough ophthalmologic evaluations in patients with congenital aniridia because of the possibilities of coexistence of other ocular abnormalities. Copyright © 2013. Published by Elsevier Inc.

  8. One-Year Progress in Ophthalmic Education: Annual Review.

    Science.gov (United States)

    Mayorga, Eduardo; Golnik, Karl; Palis, Gabriela

    2015-01-01

    The aim of this study was to update the practicing ophthalmologist on the English language literature about medical education from the prior year. A search of English language literature was performed on PubMed from January 1, 2014, to December 31, 2014. Because the search using the main topic of the review "medical education" came up with 7394 citations, authors finally decided to narrow the search to 3 topics of their interest:1. Current state of competency-based education and teaching methods of competencies. This section included ophthalmic/ophthalmology education, core competencies, competency-based education, teaching strategies, tools and methods in medical education.2. E-learning. This section included e-learning, online learning, online teaching, Web-based teaching, Web-based learning, and flipped classroom.3. This section included assessment of medical students, residents, fellows, faculty, attending physicians, and medical teachers, assessment of medical student ophthalmology programs, ophthalmology residency programs, residency programs, and fellowship programs. The authors reviewed and summarized articles published in 2014 examining or describing the 3 main areas of the review described previously. This review updates the comprehensive ophthalmologist on advances in ophthalmic medical education. Ophthalmic educators could apply the ideas presented in this review according to their possibilities in their own settings and programs.

  9. Description of Ophthalmic Pharmaceutical and Device Start-Up Companies.

    Science.gov (United States)

    Sharpe, R Allan; Austin, Jennifer P; Kruft, Bonnie; Nelson, Lindsay A; Stewart, Jeanette A; Stewart, William C

    2015-01-01

    To describe the number, type and location of ophthalmic companies and their associated product areas and indications. A retrospective, non-patient-based, observational review of ophthalmic pharmaceutical and device companies with a new product in development. Data was compiled by Internet searches. We identified 190 companies currently developing ophthalmic products: 134 (71%) were privately held and 56 (29%) publicly held, while 136 (72%) were in the United States and 53 (28%) were outside the United States. There were 436 total products of which 338 (78%) were pharmaceuticals and 98 (22%) devices. With pharmaceuticals we identified 46 separate indications with age-related macular degeneration (n = 75), glaucoma (n = 52) and dry eye (n = 46) as most common; anti-vascular endothelial growth factor, hormone therapy and anti-inflammatory products were also common classes. With devices there were 30 indications with glaucoma (n = 26), age-related macular degeneration (n = 19) and dry eye (n = 6) as most common; drug delivery, ocular implants and prostheses were less common classes. Ophthalmology as a specialty is benefited by a wide effort in new medicine and device development. However, a concentration of effort into relatively few indications suggests a potential lack of market analysis and possible difficulty for many companies in commercializing their product. © 2015 S. Karger AG, Basel.

  10. Ophthalmic Morbidity in School Children in Hilly Areas of Uttarakhand

    Directory of Open Access Journals (Sweden)

    Surekha Kishore

    2014-03-01

    Full Text Available Introduction: School children constitute about one fourth of population of India. Early detection and treatment of various eye diseases helps in avoiding many complications. The magnitude of blindness is 3-4 times greater in developing countries. Very few studies have been conducted in Uttarakhand revealing the ophthalmic morbidity in school children or general population. Hilly areas especially the remote ones face various problems like, poor transportation facilities, distant health facilities, use of traditional methods for treatment, faith healing, customs and belief system, lack of information.  Moreover   water supply, poor personal hygiene and other factors also add up to these problems. Aim: To study the ophthalmic morbidities in school children in 3 schools of Thatyur block. Methodology: It was a cross sectional study. Result: A total of 705 students were enrolled. Permission from school authorities was seeked before the start of study. Schools were visited twice in a week current and preliminary information was taken from the students & teacher regarding education, occupation, income etc. General examination and ophthalmic examination was done with day & torch light along with refraction, with the help of standard Snellen’s chart. Each eye was examined separately. A vision of 6/6 was considered as normal. Near vision was tested with new vision Snellen’s chart at 12-14 inches away from eye.

  11. Physicochemical attributes and dissolution testing of ophthalmic ointments.

    Science.gov (United States)

    Bao, Quanying; Jog, Rajan; Shen, Jie; Newman, Bryan; Wang, Yan; Choi, Stephanie; Burgess, Diane J

    2017-05-15

    The investigation of semisolid ophthalmic ointments is challenging due to their complex physicochemical properties and the unique anatomy of the human eye. Using Lotemax® as a model ophthalmic ointment, three different manufacturing processes and two excipient sources (Fisher® (OWP) and Fougera® (NWP)) were used to prepare loteprednol etabonate ointments that were qualitatively and quantitatively the same across the manufactured formulations. Physicochemical properties including drug content and uniformity, particle size and distribution, as well as rheological parameters (onset point, crossover modulus, storage modulus and Power law consistency index) were investigated. In addition, USP apparatus 2 with enhancer cells was utilized to study the in vitro drug release characteristics of the ophthalmic ointments. Both manufacturing processes and excipient sources had a significant influence on the physicochemical attributes and the in vitro drug release profiles of the prepared ointments. Ointments prepared via the hot melt processes exhibited higher rheological parameters and lower drug release rates compared to ointments prepared without hot melting. Ointments prepared with OWP demonstrated higher rheological parameters and lower in vitro drug release rates compared to ointments prepared with NWP. A strong correlation between the rheological parameters and in vitro drug release rate was shown using logarithmic linear regression. This correlation may be useful in predicting in vitro drug release from measured physicochemical properties, and identifying the critical quality attributes during the development of ointment formulations. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Ophthalmic vehicles containing polymer-solubilized tropicamide: "in vitro/in vivo" evaluation.

    Science.gov (United States)

    Carmignani, C; Rossi, S; Saettone, M F; Burgalassi, S

    2002-01-01

    Commercial 1.0% aqueous tropicamide (TR) eyedrops are buffered to pH 4.4-5.0 to produce sufficiently stable solutions of the weakly basic, poorly soluble drug. These acidic solutions, however, are irritants and may induce copious lachrimation, thus reducing the drug bioavailability. The aim of the present study was to evaluate some solubilizing agents for the preparation of 1.0% TR ophthalmic solutions adjusted at physiologically compatible pH, potentially showing increased eye tolerance, activity, and stability when compared with standard commercial eyedrops. The tested solubilizers were two non-ionic surfactants-Tyloxapol (TY) and Cremophor EL (CR) and one polymer, Pluronic P85 (PL). Four stable 1% TR formulations, containing 3% TY, 7.5% CR, 15% PL, or 5% CR + 10% PL were submitted to mydriatic activity tests in rabbits. They improved to a small but statistically significant extent the AUC for mydriatic effect of TR in the test animals when compared with commercial 1.0% TR eyedrops.

  13. Validation of a stability-indicating spectrometric method for the determination of sulfacetamide sodium in pure form and ophthalmic preparations

    Directory of Open Access Journals (Sweden)

    Sofia Ahmed

    2017-01-01

    Full Text Available Introduction: Sulfacetamide sodium is a widely used sulfonamide for ophthalmic infections. Objective: A number of analytical methods have been reported for the analysis of sulfacetamide but they lack the ability to determine both the active drug and its major degradation product, sulfanilamide, simultaneously in a sample. Materials and Methods: In the present study a simple, rapid and economical stability-indicating UV spectrometric method has been validated for the simultaneous assay of sulfacetamide sodium and sulfanilamide in pure form and in ophthalmic preparations. Results: The method has been found to be accurate (recovery 100.03 ±0.589% and precise (RSD 0.587% with detectable and quantifiable limits of 1.67×10–6 M (0.04 mg% and 5.07×10–6 M (0.13 mg%, respectively for the assay of pure sulfacetamide sodium. The method is also found to be accurate and precise to small changes in wavelength, pH and buffer concentration as well as to forced degradation. The study further includes the validation of the method for the assay of pure sulfanilamide in solution, which has been found to be accurate, precise and robust. Conclusion: The results indicate that the proposed two-component spectrometric method is stability-indicating and can be used for the simultaneous assay of both sulfacetamide sodium and sulfanilamide in synthetic mixtures and degraded solutions.

  14. Extensive Allergic Fungal Rhinosinusitis: Ophthalmic and Skull Base Complications.

    Science.gov (United States)

    Vashishth, Ashish

    2015-09-01

    To review the clinical features, ophthalmic and skull base complications, radiologic correlates, surgical methods and outcomes in cases of extensive allergic fungal rhinosinusitis (AFRS). The retrospective review was carried out at a tertiary referral center and included 11 patients with extensive AFRS. Inclusion criteria were confirmed cases of AFRS with intracranial extension, gross erosion of the skull base or medial orbital wall and/or ophthalmic complications of AFRS, including visual loss. Acute bacterial or invasive fungal sinusitis and other non-AFRS sinus pathologies with orbital or skull base complications were excluded from the study. The mean age of patients was 22.7 years. Proptosis was the most common presenting feature followed by diplopia and visual loss. Four patients exhibited unilateral visual loss with one case of sudden acute onset. Intracranial extradural spread to the middle cranial fossa was observed in two cases with cavernous sinus involvement, destruction of the entire cranial base and extension to the petrous temporal bone. Ten patients exhibited co-existing orbital and skull base erosion whereas gross erosion of the lamina papyracea alone was seen in one patient. All patients underwent endoscopic sinus surgery with complete disease clearance. The minimum and maximum follow-up periods were 1 and 3 years, respectively with one documented recurrence 18 months after surgery. Visual recovery was complete after sudden vision loss whereas it was only partial or absent in patients with prolonged vision loss. Cases of extensive AFRS with ophthalmic and skull base complications pose diagnostic and therapeutic challenges and merit early intervention with long-term follow-up.

  15. Simultaneous Bilateral Ophthalmic Artery Chemosurgery for Bilateral Retinoblastoma (Tandem Therapy.

    Directory of Open Access Journals (Sweden)

    David H Abramson

    Full Text Available Report on the 7-year experience with bilateral ophthalmic artery chemosurgery (OAC-Tandem therapy for bilateral retinoblastoma.Retrospective, single institution study.120 eyes of 60 children with bilateral retinoblastoma treated since March 2008.Retrospective review of all children treated at Memorial Sloan Kettering with bilateral ophthalmic artery chemosurgery (Melphalan, Carboplatin, Topotecan, Methotrexate delivered in the same initial session to both naïve and previously treated eyes.Ocular survival, metastatic disease, patient survival from metastases, second cancers, systemic adverse effects, need for transfusion of blood products, electroretinogram before and after treatment.116 eyes were salvaged (4 eyes were enucleated: 3 because of progressive disease, 1 family choice. Kaplan Meier ocular survival was 99.2% at one year, 96.9% at 2 and 3 years and 94.9% for years 4 through 7. There were no cases of metastatic disease or metastatic deaths with a mean follow-up of 3.01 years. Two children developed second cancers (both pineoblastoma and one of them died. Transfusion of blood products was required in 3 cases (4 transfusions, 1.9%. Two children developed fever/neutropenia requiring hospitalization (0.95%. ERGs were improved in 21.6% and unchanged after treatment in 52.5% of cases (increase or decrease of less than 25μV.Bilateral ophthalmic artery chemosurgery is a safe and effective technique for managing bilateral retinoblastoma-even when eyes are advanced bilaterally, and if both eyes have progressed after systemic chemotherapy. Ocular survival was excellent (94.9% at 8 years, there were no cases of of metastatic disease and no deaths from metastatic disease, but children remain at risk for second cancers. In 21.6% of cases ERG function improved. Despite using chemotherapy in both eyes in the same session, systemic toxicity was low.

  16. [Delayed diagnosis of ophthalmic artery obstruction due to atrial myxoma].

    Science.gov (United States)

    Sabater, N; Alforja, S; Rey, A; Giralt, J

    2013-08-01

    A 56 year old woman with atrial myxoma presented with a visual acuity of no light perception after acute ophthalmic artery obstruction (OAO) associated with stroke. She developed late retinal pigmentary changes due choroidal infarction, typical of the OAO. Simultaneous obstruction of the retinal and choroidal circulation was observed in the OAO. Atrial myxoma should be suspected in patients who suffer from OAO associated with stroke. Systemic studies should be performed to find the origin of OAO. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  17. Interferometric measurement of actual oblique astigmatism of ophthalmic lenses

    Science.gov (United States)

    Wihardjo, Erning

    1995-03-01

    A technique for measuring oblique astigmatism error of ophthalmic lenses is described. The technique is based on a Mach-Zehnder interferometer, which allows us to simulate the actual conditions of the eye. The effects of the lens power, the pupilary aperture size and the viewing distance in calculating a projected pupil zone on the lens are discussed. The projected pupil size on the lens affects the measurement result of the oblique astigmatism error. Conversion of the interferogram to astigmatism error in diopters is given.

  18. [Terson syndrome associated with a carotid-ophthalmic giant aneurysm].

    Science.gov (United States)

    Peris Martínez, C; Aviñó Martínez, J A; España Grégori, E; Risueño Reguillo, P; Díaz-Llopis, M; Menezo, J L; Vázquez-Añón, V

    2002-01-01

    PURPOSE/MATERIAL AND METHOD: A case of a 42 year-old woman presenting headache, vomiting and loss of consciousness of sudden onset. Upon testing right eye presented amaurosis while left eye showed a visual acuity of 20/50. Brain angiography showed a right sided giant carotid aneurysm at the ophthalmic artery area. Globe fundus in left eye showed vitreal and intra-retinal hemorrhage appearing in retinal posterior pole and periphery of the retina. Subarachnoidal hemorrhage accompanied by intra-vitreal bleeding is known as Terson's Syndrome. Peculiarities of this clinical case are discussed in this paper.

  19. Ophthalmic findings in Setleis syndrome: two new cases in a mother and son.

    Science.gov (United States)

    Kent, Jerrod S; Romanchuk, Kenneth G; Lemire, Edmond G

    2007-06-01

    Setleis syndrome is a rare ectodermal dysplasia with characteristic ophthalmic findings. We describe the first 2 reported cases in Canadian individuals of Aboriginal descent. Although most ophthalmic findings are benign, it is important to recognize the clinical significance for management and genetic counselling. We postulate an autosomal dominant inheritance in our cases.

  20. 21 CFR 524.1662 - Oxytetracycline hydrochloride ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Oxytetracycline hydrochloride ophthalmic and topical dosage forms. 524.1662 Section 524.1662 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... DOSAGE FORM NEW ANIMAL DRUGS § 524.1662 Oxytetracycline hydrochloride ophthalmic and topical dosage forms. ...

  1. 21 CFR 524.981 - Fluocinolone acetonide ophthalmic and topical dosage forms.

    Science.gov (United States)

    2010-04-01

    ... dosage forms. 524.981 Section 524.981 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.981 Fluocinolone acetonide ophthalmic and topical dosage forms. ...

  2. 75 FR 16346 - Ophthalmic and Topical Dosage Form New Animal Drugs; Orbifloxacin, Mometasone Furoate Monohydrate...

    Science.gov (United States)

    2010-04-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 Ophthalmic and Topical Dosage Form New... Veterinary Medicine, 21 CFR part 524 is amended as follows: PART 524--OPHTHALMIC AND TOPICAL DOSAGE FORM NEW...

  3. 75 FR 4692 - Ophthalmic and Topical Dosage Form New Animal Drugs; Miconazole, Polymixin B, and Prednisolone...

    Science.gov (United States)

    2010-01-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 Ophthalmic and Topical Dosage Form New... Veterinary Medicine, 21 CFR part 524 is amended as follows: PART 524--OPHTHALMIC AND TOPICAL DOSAGE FORM NEW...

  4. 77 FR 3598 - Ophthalmic and Topical Dosage Form New Animal Drugs; Gentamicin and Betamethasone Spray

    Science.gov (United States)

    2012-01-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 Ophthalmic and Topical Dosage Form New...--OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS 0 1. The authority citation for 21 CFR part 524 continues...

  5. 76 FR 72619 - Ophthalmic and Topical Dosage Form New Animal Drugs; Eprinomectin

    Science.gov (United States)

    2011-11-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 Ophthalmic and Topical Dosage Form New...--OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS 0 1. The authority citation for 21 CFR part 524 continues...

  6. Neuro-ophthalmic and clinical characteristics of brain tumours in a ...

    African Journals Online (AJOL)

    Background: Anecdotally, increasing number of patients are seen at Korle Bu Teaching Hospital (KBTH) with brain tumour. Neuro-ophthalmic symptoms and signs may help in timely diagnosis and intervention. Objective: To evaluate the neuro-ophthalmic and clinical characteristics of brain tumour in patients presenting at a ...

  7. Pattern of Ophthalmic Consult from the Ear, Nose and Throat Ward ...

    African Journals Online (AJOL)

    Objective: To study the pattern and indications for ophthalmic referral of patients with otorhinolaryngology problems. Method: A retrospective study of patients who were admitted into the Ear, Nose and Throat (ENT) ward of the University College Hospital, Ibadan and had ophthalmic referral between. July 2000 and June ...

  8. Pattern of Ophthalmic Consult from the Ear, Nose and Throat Ward ...

    African Journals Online (AJOL)

    Objective: To study the pattern and indications for ophthalmic referral of patients with otorhinolaryngology problems. Method: A retrospective study of patients who were admitted into the Ear, Nose and Throat (ENT) ward of the University. College Hospital, Ibadan and had ophthalmic referral between. July 2000 and June ...

  9. 21 CFR 524.390d - Chloramphenicol-prednisolone ophthalmic ointment.

    Science.gov (United States)

    2010-04-01

    ... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.390d Chloramphenicol-prednisolone ophthalmic ointment. (a) Specifications. Each gram... should not be used until the infection is under control and corneal regeneration is well underway...

  10. 21 CFR 524.1883 - Prednisolone sodium phosphate-neomycin sulfate ophthalmic ointment.

    Science.gov (United States)

    2010-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.1883 Prednisolone sodium phosphate-neomycin sulfate ophthalmic... ulcers. They should not be used until the infection is under control and corneal regeneration is well...

  11. 21 CFR 524.1880 - Prednisolone-neomycin sulfate ophthalmic ointment.

    Science.gov (United States)

    2010-04-01

    ... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS § 524.1880 Prednisolone-neomycin sulfate ophthalmic ointment. (a) Specifications... control and corneal regeneration is well underway. For use only by or on the order of a licensed...

  12. 10 CFR 35.2433 - Records of decay of strontium-90 sources for ophthalmic treatments.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Records of decay of strontium-90 sources for ophthalmic... Records § 35.2433 Records of decay of strontium-90 sources for ophthalmic treatments. (a) A licensee shall maintain a record of the activity of a strontium-90 source required by § 35.433 for the life of the source...

  13. 10 CFR 35.433 - Decay of strontium-90 sources for ophthalmic treatments.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Decay of strontium-90 sources for ophthalmic treatments... Brachytherapy § 35.433 Decay of strontium-90 sources for ophthalmic treatments. (a) Only an authorized medical physicist shall calculate the activity of each strontium-90 source that is used to determine the treatment...

  14. A Study To Evaluate Skills Of Ophthalmic Assistants For Assessment Of Cup Disc Ratio

    Directory of Open Access Journals (Sweden)

    Malik J.S

    1999-01-01

    Full Text Available Research question: 1. Whether paramedical ophthalmic assistants can be trained to examine vertical cup disc ratio? 2. Can the PMO As detect abnormal cup disc ratio after training? Objectives: 1. T o train ophthalmic assistants in cup disc ratio examination 2. To evaluate skills of trained ophthalmic assistants in cup disc ratio examination Study design: Cross sectional Setting: OPD of Ophthalmology department, Pt. B.D. Sharma PGIMS, Rohtak Participants: Five paramedical ophthalmic assistants, one ophthalmologist and 322 patients above 40 years of age. Statistical analysis: Sensitivity, specificity, Kappa values. Results: Data analysis of 322 cases was found by PMO As and ophthalmologist revealed sensitivity between 50-65% and specificity between 84.5-92.62%. A good agreement was found among all the examiners on computation of Kappa Values. It was concluded that ophthalmic assistants can examine vertical cup disc ratio after five days training.

  15. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    Directory of Open Access Journals (Sweden)

    M. I. Razumovsky

    2014-07-01

    Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.

  16. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    Directory of Open Access Journals (Sweden)

    M. I. Razumovsky

    2014-01-01

    Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.

  17. Efficacy of Ophthalmic Viscosurgical Devices in Preventing Temperature Rise at the Corneal Endothelium during Phacoemulsification.

    Science.gov (United States)

    Suzuki, Hisaharu; Igarashi, Tsutomu; Shiwa, Toshihiko; Takahashi, Hiroshi

    2016-12-01

    To investigate temperature alterations in the aqueous humor and the corneal endothelium during phacoemulsification, and to evaluate the effect of ophthalmic viscosurgical devices in preventing a temperature rise at the corneal endothelium during phacoemulsification. Temperatures of the aqueous humor and corneal endothelium were measured using two temperature probes set in the anterior chamber during ultrasound oscillation in porcine eyes, with or without ophthalmic viscosurgical devices. Without an ophthalmic viscosurgical device, temperatures in both the aqueous humor and the corneal endothelium rapidly rose during the ultrasound oscillation, while with an ophthalmic viscosurgical device, the temperature elevation of the corneal endothelium site was suppressed compared with the aqueous humor. Surgeons need to be especially aware of ophthalmic viscosurgical device retention during phacoemulsification, because it can protect the corneal endothelium from heat generated during this procedure.

  18. Development of the Veterans Healthcare Administration (VHA) Ophthalmic Surgical Outcome Database (OSOD) project and the role of ophthalmic nurse reviewers.

    Science.gov (United States)

    Lara-Smalling, Agueda; Cakiner-Egilmez, Tulay; Miller, Dawn; Redshirt, Ella; Williams, Dale

    2011-01-01

    Currently, ophthalmic surgical cases are not included in the Veterans Administration Surgical Quality Improvement Project data collection. Furthermore, there is no comprehensive protocol in the health system for prospectively measuring outcomes for eye surgery in terms of safety and quality. There are 400,000 operative cases in the system per year. Of those, 48,000 (12%) are ophthalmic surgical cases, with 85% (41,000) of those being cataract cases. The Ophthalmic Surgical Outcome Database Pilot Project was developed to incorporate ophthalmology into VASQIP, thus evaluating risk factors and improving cataract surgical outcomes. Nurse reviewers facilitate the monitoring and measuring of these outcomes. Since its inception in 1778, the Veterans Administration (VA) Health System has provided comprehensive healthcare to millions of deserving veterans throughout the U.S. and its territories. Historically, the quality of healthcare provided by the VA has been the main focus of discussion because it did not meet a standard of care comparable to that of the private sector. Information regarding quality of healthcare services and outcomes data had been unavailable until 1986, when Congress mandated the VA to compare its surgical outcomes to those of the private sector (PL-99-166). 1 Risk adjustment of VA surgical outcomes began in 1987 with the Continuous Improvement in Cardiac Surgery Program (CICSP) in which cardiac surgical outcomes were reported and evaluated. 2 Between 1991 and 1993, the National VA Surgical Risk Study (NVASRS) initiated a validated risk-adjustment model for predicting surgical outcomes and comparative assessment of the quality of surgical care in 44 VA medical centers. 3 The success of NVASRS encouraged the VA to establish an ongoing program for monitoring and improving the quality of surgical care, thus developing the National Surgical Quality Improvement Program (NSQIP) in 1994. 4 According to a prospective study conducted between 1991-1997 in 123

  19. Clinical utility of voriconazole eye drops in ophthalmic fungal keratitis

    Science.gov (United States)

    Al-Badriyeh, Daoud; Neoh, Chin Fen; Stewart, Kay; Kong, David CM

    2010-01-01

    Fungal keratitis is one of the major causes of ophthalmic mycosis and is difficult to treat. The range of common antifungal agents available for fungal keratitis remains inadequate and is generally associated with poor clinical outcomes. Voriconazole is a new generation triazole antifungal agent. Only marketed in systemic formulation and, with broad-spectrum activity and high intraocular penetration, voriconazole has demonstrated effectiveness against fungal keratitis. Systemic voriconazole, however, is not without side effects and is costly. Voriconazole eye drops have been prepared extemporaneously and used for the treatment of ophthalmic fungal keratitis. The current article sought to review the literature for evidence related to the effectiveness and safety of topical voriconazole and its corneal penetration into the aqueous humor of the eye. The voriconazole eye drops used are typically of 1% concentration, well tolerated by the eye, and are stable. Despite existing evidence to suggest that the eye drops are effective in the treatment of fungal keratitis, more studies are needed, especially in relation to using the eye drops as first-line and stand-alone treatment, preparation of higher concentrations, and optimal dosing frequency. PMID:20463910

  20. Association between Ophthalmic Timolol and Hospitalisation for Bradycardia

    Directory of Open Access Journals (Sweden)

    Nicole L. Pratt

    2015-01-01

    Full Text Available Introduction. Ophthalmic timolol, a topical nonselective beta-blocker, has the potential to be absorbed systemically which may cause adverse cardiovascular effects. This study was conducted to determine whether initiation of ophthalmic timolol was associated with an increased risk of hospitalisation for bradycardia. Materials and Methods. A self-controlled case-series study was undertaken in patients who were hospitalised for bradycardia and were exposed to timolol. Person-time after timolol initiation was partitioned into risk periods: 1–30 days, 31–180 days, and >180 days. A 30-day risk period prior to initiating timolol was also included. All remaining time was considered unexposed. Results. There were 6,373 patients with at least one hospitalisation for bradycardia during the study period; 267 were exposed to timolol. Risk of bradycardia was significantly increased in the 31–180 days after timolol initiation (incidence rate ratio (IRR = 1.93; 95% confidence interval (CI 1.00–1.87. No increased risk was observed in the first 30 days or beyond 180 days of continuous exposure (IRR = 1.40; 95% CI 0.87–2.26 and IRR = 1.21; 95% CI 0.64–2.31, resp.. Conclusion. Bradycardia is a potential adverse event following timolol initiation. Practitioners should consider patient history before choosing a glaucoma regime and closely monitor patients after treatment initiation with topical nonselective beta-blocker eye drops.

  1. Intra-operative decision making by ophthalmic surgeons.

    Science.gov (United States)

    Pauley, Keryn; Flin, Rhona; Azuara-Blanco, Augusto

    2013-10-01

    Research on surgical decision making and risk management usually focuses on peri-operative care, despite the magnitude and frequency of intra-operative risks. The aim of this study was to examine ophthalmic surgeons' intra-operative decisions and risk management strategies in order to explore differences in cognitive processes. Critical decision method interviews were conducted with 12 consultant ophthalmologists who recalled cases and selected important decisions during the operations. These decisions were then discussed in detail in relation to decision making style and risk management. Transcripts were coded according to decision making strategy (analytical, recognition primed decision, creative and rule-based) and risk management (threats, risk assessment and risk tolerance). The key decision in each case was made using either a rapid, intuitive mode of thinking (n=6, 50%) or a more deliberate comparison of alternative courses of action (n=6, 50%). Rule-based or creative decision making was not used. Risk management involved the perception of threats and assessment of threat impact but was also influenced by personal risk tolerance. Risk tolerance seemed to play a major role during situations requiring a stopping rule. Risk management did not appear to be influenced by time pressure. Surgeons described making key intra-operative decisions using either an intuitive or an analytical mode of thinking. Ophthalmic surgeons' risk assessment, risk tolerance and decision strategies appear to be influenced by personality.

  2. Microgravity-Induced Fluid Shift and Ophthalmic Changes

    Directory of Open Access Journals (Sweden)

    Emily S. Nelson

    2014-11-01

    Full Text Available Although changes to visual acuity in spaceflight have been observed in some astronauts since the early days of the space program, the impact to the crew was considered minor. Since that time, missions to the International Space Station have extended the typical duration of time spent in microgravity from a few days or weeks to many months. This has been accompanied by the emergence of a variety of ophthalmic pathologies in a significant proportion of long-duration crewmembers, including globe flattening, choroidal folding, optic disc edema, and optic nerve kinking, among others. The clinical findings of affected astronauts are reminiscent of terrestrial pathologies such as idiopathic intracranial hypertension that are characterized by high intracranial pressure. As a result, NASA has placed an emphasis on determining the relevant factors and their interactions that are responsible for detrimental ophthalmic response to space. This article will describe the Visual Impairment and Intracranial Pressure syndrome, link it to key factors in physiological adaptation to the microgravity environment, particularly a cephalad shifting of bodily fluids, and discuss the implications for ocular biomechanics and physiological function in long-duration spaceflight.

  3. Over the counter ophthalmic drug misuse, are we aware?

    Directory of Open Access Journals (Sweden)

    Rajani Kadri

    2010-07-01

    Full Text Available Aim: To investigate the misuse of ‘over the counter’ ophthalmic medications in our city. Method: Responses of a structured questionnaire covering various aspects of over the counter drug use was obtained from pharmacy workers in and around our city. Results: Eighty nine pharmacy workers took part in this cross–sectional study. An average number of seven patients per day with ophthalmic complaints were seen by the pharmacy workers. Dispensing over the counter was practiced by 89.9% of the pharmacists. The most common complaint of the patients visiting the pharmacy, was redness and itching (86.5%. Antibiotics (96.6% were the most common eye drops dispensed over the counter, followed by steroids (55.1%, decongestants (54.1%, antibiotic-steroid combination eye drops (29.2% and lubricants (16.8%. Awareness regarding complications of steroid use was seen in 40.6% of pharmacists. 6.7% pharmacists had seen patients with complications following use of over the counter medications. In our study, majority of the eye drops dispensed were prescription drugs. Conclusion: Availability of prescription eye drops over the counter is an immense public threat. Educating the pharmacist and the population can decrease ocular morbidity. Research into methods to effectively deal with over-the-counter drug misuse is required and law can be enforced based on the findings.

  4. Ophthalmic manifestations of methylmalonic aciduria accompanied with homocystinuria

    Directory of Open Access Journals (Sweden)

    Qiu-Jing Huang

    2015-12-01

    Full Text Available Methylmalonicaciduia(MMAaccompanied with homocystinuria is a rare autosomal-recessive with congenital metabolic disorder of Vitamin B12. There are three subtypes, cblC, cblD, cblF, in which cblC is the most common one. The diagnostic tests are tandem mass spectrometry and gas chromatography-mass spectrometry. Tests for activity of enzyme in fibroblasts from skin, complementary assay and genetic analysis can be used to make the subtype clear. Early-onset patients, defined by onset of symptoms before the age of 1 year, may have severe ocular involvement, including visual loss, nystagmus, strabismus, retinopathy, maculopathy, optic atrophy, abnormal electroretinography. Late-onset patients, defined by onset of symptoms after the age of 4 year, rarely have ocular manifestations. The pathogenesis of the ophthalmic symptoms may be related to the high level of homocystine, oxidative stress and the abnormal development of nervous systems. The treatment for MMA accompanied with homocystinuria is mostly symptomatic based. Ophthalmic treatment is limited. Early supplement of methionine,GSH or other antioxidants may be helpful for retinopathy. There is no standard ophthalmological examination for those patients in China. It is critical to set up inter-departmental cooperation and early stage examination for the treatments and outcomes of the patients.

  5. Antireflection coating standards of ophthalmic resin lens materials

    Science.gov (United States)

    Porden, Mark

    1991-12-01

    Current estimates of the percentage of anti-reflection coated lenses verses uncoated in the market today range from 3% in the United States (US.), to 60% in Europe, to 80% in Japan. Currently upwards of 80% of all prescription eyewear lenses dispensed are resin. Glass lenses lose market share yearly, as scratch resistant coatings on resin lenses are improved. Photochromic resin materials are also improving and will shortly equal the performance of glass photockromics. Until recently, the performance characteristics of ophthalmic lenses were divided into two schools. In Europe, the emphasis was on keeping the reflections to an absolute minimum, while in the Asian market the emphasis was on producing a lens, which had exceptional scratch resistance. A typical European lens may average .4% reflection across the visible spectrum (400 to 700 urn.), while the Asian lenses averaged in the 1.5% range. The growth ofAR coating in the U.S. 80 million pair a year total ophthalmic market has been lagging foreign markets for several reasons.

  6. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)

    2012-08-15

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  7. Evolution of Concepts and Technologies in Ophthalmic Laser Therapy.

    Science.gov (United States)

    Palanker, Daniel

    2016-10-14

    Ophthalmology was the first medical specialty to adopt lasers right after their invention more than 50 years ago, and they gradually revolutionized ocular imaging, diagnostics, therapy, and surgery. Challenging precision, safety, and selectivity requirements for ocular therapeutic and surgical procedures keep advancing the laser technologies, which in turn continue enabling novel applications for the preservation and restoration of sight. Modern lasers can provide single-cell-layer selectivity in therapy, submicrometer precision in three-dimensional image-guided surgery, and nondamaging retinal therapy under optoacoustic temperature control. This article reviews the evolution of laser technologies; progress in understanding of the laser-tissue interactions; and concepts, misconceptions, and accidental discoveries that led to modern therapeutic and surgical applications of lasers in ophthalmology. It begins with a brief historical overview, followed by a description of the laser-tissue interactions and corresponding ophthalmic applications.

  8. Training Principles for Ophthalmic Care in Developing Countries

    Directory of Open Access Journals (Sweden)

    T Otis Paul

    2003-01-01

    Full Text Available Over the past few decades the authors have visited a number of developing countries in Africa, Asia and the Americas, provid- ing both general ophthalmology care and specialised consultation, teaching and service. The programmes initially were largely oriented towards cataract surgery and glaucoma care in more rural areas, then towards teaching in the field of paediatric ophthalmology and strabismus in large city hospitals. There seems to be a never-ending amount of service needed in these countries, although, over time, the ability of colleagues to provide service to their own people has increased. However, as the cataract backlog is reduced, there develops an interest in learning specialised ophthalmic concepts and surgery techniques.

  9. Neuro-ophthalmic manifestation of neuromyelitis optica spectrum disorders

    Directory of Open Access Journals (Sweden)

    Xiao-jun ZHANG

    2014-10-01

    Full Text Available Neuromyelitis optica spectrum disorders (NMOSDs include classic neuromyelitis optica (NMO, opticospinal multiple sclerosis (OSMS, limited form of NMO and isolated optic neuritis or myelitis accompanied by either systemic autoimmune diseases or typical MRI findings of NMO. The common neuro-ophthalmic features of NMOSDs include simultaneous or consecutive bilateral optic neuritis, more commonly seen optic disk edema and surrounding exudate, poor visual recovery, steroid responsiveness and dependency. Combined with serum aquaporin 4 (AQP4 antibody and brain MRI examination, these clinical features can be helpful to the early differential diagnosis between NMOSDs and MS. Some types of eye movement abnormalities have been reported in patients with NMOSDs, but further investigation needs to be done before the specificity of these features are confirmed. doi: 10.3969/j.issn.1672-6731.2014.10.003

  10. Effects of coatings on the fracture resistance of ophthalmic lenses.

    Science.gov (United States)

    Corzine, J C; Greer, R B; Bruess, R D; Lee, G K; Scaief, A L

    1996-01-01

    Scratch-resistant (SR) and anti-reflective (AR) coatings are commonly applied to plastic ophthalmic lenses. Fracture resistance is greatly affected by surface characteristics, and coatings may have a weakening effect. Static load testing is an efficient, quantifiable alternative to the drop ball test and has been suggested as useful for comparing lenses of a given material. An Instron static load tester was used to test the fracture resistance of 140 CR-39 lenses divided into 4 groups: uncoated, prepared for AR coating but not actually coated, AR coated, and factory SR coated. Compared to the control uncoated group, AR coating reduced the required fracture energy by 63% and SR coating by 57%. Preparation for AR coating had no significant effect. These results are at least qualitatively consistent with drop ball testing and have significant implications as new plastic materials are developed, made thinner, and variously coated.

  11. Therapeutic management of trypanosomosis with ophthalmic involvement in a dog.

    Science.gov (United States)

    Behera, S K; Sarma, K; Behera, Parthasarathi; Ayub Ali, M

    2017-12-01

    The present report communicates a case of canine trypanosomosis with ophthalmic involvement, its diagnosis, hemato-biochemistry and therapeutic management in a 2 year old dog. The dog had history of bilateral corneal opacity and impaired vision since last 4 weeks. On the basis of history and clinical signs, a presumptive diagnosis of canine trypanosomosis was made followed by confirmation with Giemsa stained buffy coat smear examination. Therapeutic regimen was comprised of Diminazine aceturate @ 3.5 mg/kg deep IM for two occasions 24 h apart along with parenteral fluids, hematinics, NSAID and multivitamins which yielded favourable response by third day post-therapy. Haemato-biochemical parameters took nearly 14 days of time to return to near normal levels. Improvement with respect to corneal opacity took 6 weeks of time and the animal was followed up to 3 months without any recurrence.

  12. Ophthalmic profile and systemic features of pediatric facial nerve palsy.

    Science.gov (United States)

    Patil-Chhablani, Preeti; Murthy, Sowmya; Swaminathan, Meenakshi

    2015-12-01

    Facial nerve palsy (FNP) occurs less frequently in children as compared to adults but most cases are secondary to an identifiable cause. These children may have a variety of ocular and systemic features associated with the palsy and need detailed ophthalmic and systemic evaluation. This was a retrospective chart review of all the cases of FNP below the age of 16 years, presenting to a tertiary ophthalmic hospital over the period of 9 years, from January 2000 to December 2008. A total of 22 patients were included in the study. The average age at presentation was 6.08 years (range, 4 months to 16 years). Only one patient (4.54%) had bilateral FNP and 21 cases (95.45%) had unilateral FNP. Seventeen patients (77.27%) had congenital palsy and of these, five patients had a syndromic association, three had birth trauma and nine patients had idiopathic palsy. Five patients (22.72%) had an acquired palsy, of these, two had a traumatic cause and one patient each had neoplastic origin of the palsy, iatrogenic palsy after surgery for hemangioma and idiopathic palsy. Three patients had ipsilateral sixth nerve palsy, two children were diagnosed to have Moebius syndrome, one child had an ipsilateral Duane's syndrome with ipsilateral hearing loss. Corneal involvement was seen in eight patients (36.36%). Amblyopia was seen in ten patients (45.45%). Neuroimaging studies showed evidence of trauma, posterior fossa cysts, pontine gliosis and neoplasms such as a chloroma. Systemic associations included hemifacial macrosomia, oculovertebral malformations, Dandy Walker syndrome, Moebius syndrome and cerebral palsy FNP in children can have a number of underlying causes, some of which may be life threatening. It can also result in serious ocular complications including corneal perforation and severe amblyopia. These children require a multifaceted approach to their care.

  13. Common causes of red eye presenting at an ophthalmic clinic.

    Science.gov (United States)

    Ubah, J N; Adeoti, C O; Isawumi, M A

    2006-01-01

    Redness of the eye is a common ophthalmic symptom. The problem causing redness could arise from within or outside the globe. These range from cases of simple inflammation following itching and minor trauma for example, to severe cases like orbital cellulitis and tumours. Patients may not even be aware of the redness. The aim of this study is to highlight the common causes of red eye as seen in an outpatient department in an ophthalmic set up. This should be of immense help to the general medical practitioners to whom the patients often first present. All patients presenting for the first time to Ladoke Akintola University of Technology Teaching Hospital over a four month period were screened. 117 had red eyes and were recruited. 125 eyes were found to be red. The characteristics of the redness were then studied to determine the cause. There was a male preponderance, M : F of 2:1. Persons 45 years and below, were most commonly involved 88 (66.67%). The most frequent cause of red eye was trauma, in 48 (41.03%) patients, followed by allergic conjunctivitis in 29 (24.77%). The main causes of redness differed in different age groups and occupation. There was no case of angle closure glaucoma seen as a cause of redness. There are diverse causes of redness of the eye. Persons who are not eye specialists to whom patients with red eyes present first should be conversant with the causes, to know what action to take, especially when to refer to the eye specialist.

  14. Microbiological evaluation of various parameters in ophthalmic operating rooms. The need to establish guidelines.

    Directory of Open Access Journals (Sweden)

    Kelkar Uday

    2003-01-01

    Full Text Available Purpose: Postoperative infections can be caused by a contaminated environment, unsterile equipment, contaminated surfaces, and infected personnel as well as contaminated disinfectants. In order to establish guidelines for microbiological monitoring, a detailed microbiological surveillance was carried out in an ophthalmic hospital. Method: Over a period of 21 months, we assessed environmental Bacteria Carrying Particle (BCP load and surface samples weekly (n=276; the autoclaving system once a month and repeated whenever the process failed (n= 24; the air conditioning filters for fungal growth once in four months (n = 15, and the disinfectant solution for contamination once in two months (n = 10. Additionally, the personnel involved directly in surgery were screened for potential pathogens such as Staphylococcus aureus and β haemolytic streptococci. Result: On 14 (5.07% occasions the environment in the operating rooms had a significant risk of airborne infections. Sterilisation of instruments in the autoclaves was unsatisfactory on 4 (16.66 % occasions. Samples from the filters of the air-conditioning units yielded potentially pathogenic fungi on 3 (20% occasions. Personnel sampling revealed that 5 (8.77% individuals harboured β haemolytic Streptococci in the throat and 4 (7.01 % harboured S. aureus in the nasal cavity. The samples of disinfectant in use were not contaminated. Conclusion: There is a need to standardise microbiological evaluation protocols for operating rooms.

  15. Preparation and evaluation of a Carbopol/HPMC-based in situ gelling ophthalmic system for puerarin.

    Science.gov (United States)

    Wu, Chunjie; Qi, Hongyi; Chen, Wenwen; Huang, Chunyan; Su, Cheng; Li, Wenmin; Hou, Shixiang

    2007-01-01

    The purpose of this study was to develop a pH-triggered in situ gelling vehicle for ophthalmic delivery of puerarin. The effect of hydroxypropyl-beta-cyclodextrin (HP-beta-CD) on the aqueous solubility and in vitro corneal permeation of puerarin was also investigated. The puerarin solubility increased linearly and proportionally to the HP-beta-CD concentrations and 5% (w/v) HP-beta-CD enhanced its ocular permeability significantly. Carbopol 980NF was used as the gelling agent in combination with HPMC (Methocel E4M) which acted as a viscosity-enhancing agent. The optimum concentrations of Carbopol 980NF and HPMC E4M for the in situ gel-forming delivery systems were 0.1% (w/v) and 0.4% (w/v), respectively. When these two vehicles were combined, an in situ gel that had the appropriate gel strength and gelling capacity under physiological condition could be obtained. This combined solution could flow freely under non- physiological condition and showed the character of pseudoplastic fluid under both conditions. Both in vitro release studies and in vivo pharmacokinetics studies indicated that the combined polymer systems performed better in retaining puerarin than puerarin eye drops did. These results demonstrate that the Carbopol 980NF/HPMC E4M can be a viable alternative to conventional puerarin eye drops to enhance ocular bioavailability and patient compliance.

  16. 75 FR 35495 - Ophthalmic Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-06-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Ophthalmic Devices Panel of the Medical Devices Advisory... should have normal gonioscopic anatomy and a visually significant cataract eligible for...

  17. Virulence Attributes and Antifungal Susceptibility Profile of Opportunistic Fungi Isolated from Ophthalmic Infections

    NARCIS (Netherlands)

    Sav, H.; Ozdemir, H.G.; Altinbas, R.; Kiraz, N.; Ilkit, M.; Seyedmousavi, S.

    2016-01-01

    Investigations of both virulence factors and antifungal susceptibility profiles are crucial for understanding the pathogenesis and prognosis of ophthalmic mycoses. In this study, we investigated the in vitro antifungal susceptibility of amphotericin B (AMB), voriconazole (VRC), and natamycin (NAT)

  18. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    National Research Council Canada - National Science Library

    M. I. Razumovsky; O. E. Kolyuka; A. M. Razumovskaya

    2014-01-01

    ... (accommodation measurement, professional testing using automated system «Proftest-1») were performed. Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired...

  19. Ophthalmic artery color Doppler ultrasonography in mild-to-moderate preeclampsia

    Energy Technology Data Exchange (ETDEWEB)

    Ayaz, Tunahan; Akansel, Gur. E-mail: gakansel@superonline.com; Hayirlioglu, Alper; Arslan, Arzu; Suer, Necdet; Kuru, Ihsan

    2003-06-01

    Objective: To evaluate the hemodynamic changes in mild-moderate preeclampsia using ophthalmic artery Doppler ultrasonography technique. Methods: Ophthalmic artery pulsatility and resistivity indices were calculated in 30 mild-moderate preeclamptic women and 30 normotensive gravid women of matched gestational age. Student's t-test was performed to test the significance of difference. Results: Both indices of peripheral resistance were found to be significantly lower in the ophthalmic arteries of mild-moderately preeclamptic women than those measured in normotensive gravid women at similar stage of pregnancy. In a small number patients whose disease progressed to severe preeclampsia, both indices increased. Conclusion: In patients with mild-moderate preeclampsia, ophthalmic artery color Doppler ultrasonography detects hemodynamic changes that are not present in normotensive gravid women. Reversal of Doppler patterns in a small number of patients with progressive disease supports the hypotheses suggesting the presence of early vasodilation and late vasospasm in the etiology of preeclampsia.

  20. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    OpenAIRE

    M. I. Razumovsky; O. E. Kolyuka; A. M. Razumovskaya

    2014-01-01

    Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy) as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency) and ophthalmic ergonomics tests (accommodation measurement, professional testing u...

  1. Acute cytotoxic effects of marketed ophthalmic formulations on human corneal epithelial cells.

    Science.gov (United States)

    Hakkarainen, Jenni J; Reinisalo, Mika; Ragauskas, Symantas; Seppänen, Aila; Kaja, Simon; Kalesnykas, Giedrius

    2016-09-10

    The purpose of the study was to devise a fast, reliable and sensitive cell viability assay for assessment of acute cytotoxicity on human corneal epithelial cells by using a clinically relevant exposure time. Acute cytotoxic effects of the pharmaceutical excipients benzalkonium chloride (BAC), macrogolglycerol hydroxystearate (MGHS40), polysorbate 80 (PS80) and marketed ophthalmic formulations (Lumigan(®), Monoprost(®), Taflotan(®), Travatan(®), Xalatan(®)) containing these excipients were tested. Human corneal epithelial cell (HCE-T) viability was assessed by measuring the reduction of resazurin to highly fluorescent resorufin. Expression of the tight junction proteins in HCE-T cells were characterized by immunofluorescence staining. Presence of tight junction proteins in HCE-T cells was demonstrated. BAC preserved ophthalmic formulations showed concentration-dependent and time-dependent cytotoxicity to human corneal epithelium. In contrast, no acute cytotoxicity of non-ionic stabilizing/solubilizing excipients (MGSH40 and PS80) or ophthalmic formulation containing these excipients was observed. Marketed ophthalmic formulations used for glaucoma medication show differential toxicity on human corneal epithelial cells. The present study revealed that BAC-preserved ophthalmic formulations were able to induce acute cytotoxic effects even during a clinically relevant exposure time, which was not observed with MGSH40 and PS80 excipients or ophthalmic formulations containing these excipients. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Gestational diabetes mellitus is a significant risk factor for long-term ophthalmic morbidity.

    Science.gov (United States)

    Beharier, Ofer; Sergienko, Ruslan; Kessous, Roy; Szaingurten-Solodkin, Irit; Walfisch, Asnat; Shusterman, Eden; Tsumi, Erez; Sheiner, Eyal

    2017-06-01

    To investigate whether patients with a history of gestational diabetes mellitus (GDM) have an increased risk for long-term ophthalmic morbidity. Design a population-based study compared the incidence of long-term maternal ophthalmic morbidity in a cohort of women with and without a history of GDM. Setting Soroka University Medical Center. All singleton pregnancies of women who delivered between 1988 and 2013. Main outcome measure(s) Diagnosis of ophthalmic morbidity. Analyses A Kaplan-Meier survival curve was used to estimate cumulative incidence of ophthalmic morbidity. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for ophthalmic morbidity. During the study period, 104,751 deliveries met the inclusion criteria; 9.4% (n = 9888) of which occurred in patients with a diagnosis of GDM during at least one of their pregnancies. Patients with GDM had a significantly higher incidence of ophthalmic morbidity such as glaucoma, diabetic retinopathy, and retinal detachment compared with controls (0.1 vs. 0.02%, p morbidity (p morbidity (adjusted HR 2.0; 95% CI 1.5-2.8; p morbidity.

  3. A novel ion-exchange carrier based upon liposome-encapsulated montmorillonite for ophthalmic delivery of betaxolol hydrochloride.

    Science.gov (United States)

    Huang, Yi; Tao, Qi; Hou, Dongzhi; Hu, Sheng; Tian, Shuangyan; Chen, Yanzhong; Gui, Ruyi; Yang, Lingling; Wang, Yao

    2017-01-01

    As a novel ion-exchange carrier with high surface area and excellent exchangeability, montmorillonite (Mt) was intercalated with betaxolol hydrochloride (BH) to form a nanocomposite and then encapsulated by liposomes (Mt-BH-LPs) for an ophthalmic drug-delivery system. The Mt-BH and Mt-BH-LPs were prepared by an acidification process and ethanol injection combined with ammonium sulfate gradient methods. The successful formation of Mt-BH and Mt-BH-LPs was verified by thermogravimetric analysis, X-ray diffraction, Fourier-transform infrared spectra, and transmission electron microscopy. Mt-BH-LPs possessed the favorable physical characteristics of encapsulation efficiency, drug loading, mean particle size, and ζ-potential. In vitro release studies indicated Mt-BH-LPs effectively maintained a relatively sustained slow release. Immortalized human corneal epithelial cell cytotoxicity, in vivo rabbit eye-irritation tests, and chorioallantoic membrane-trypan blue staining all revealed that Mt-BH-LPs had no obvious irritation on ocular tissues. A new in vitro tear-turnover model, including inserts containing human corneal epithelial cells, was designed to evaluate the precorneal retention time of Mt-BH-LPs. The results showed that Mt-BH-LPs maintained a certain BH concentration in tear fluid for a longer period than the BH solution. In vivo precorneal retention studies also indicated Mt-BH-LPs prolonged drug retention on the ocular surface more than the BH solution. Furthermore, pharmacodynamic studies showed that Mt-BH-LPs had a prolonged effect on decreasing intraocular optical pressure in rabbits. Our results demonstrated that Mt-BH-LPs have potential as an ophthalmic delivery system.

  4. Effect of Ultraviolet Exposure on Impact Resistance of Ophthalmic Lenses.

    Science.gov (United States)

    Chou, B Ralph; Dain, Stephen J; Cheng, Brian B

    2015-12-01

    To investigate the effect of ultraviolet radiation (UVR) on the impact resistance of organic ophthalmic lens materials. Plano power CR39, Phoenix, Trilogy, and polycarbonate lenses with various scratch-resistant (SR) and/or antireflection (AR) coatings were obtained in batches of 40 units. All lenses had a nominal thickness of 2 mm. Half of each batch was conditioned following the European Standard EN 168 protocol for the test of resistance to UVR (exposed group). The remaining lenses comprised an unexposed group for that combination of lens substrate and coating treatment. Each group was subjected to ballistic impact with 6-mm steel balls following the ZEST protocol to determine its mean breakage velocity. The difference in mean breakage velocity between exposed and unexposed groups of each combination of lens substrate and coating was assessed for statistical significance. Exposed uncoated CR39 showed a reduction in fracture velocity of 10.3 m/s whereas CR39 with ultra hard coat had a reduction of 3.5 m/s and CR39 with AR and SR coating had a reduction of 4.1 m/s. Scratch-resistant coated Phoenix had a reduction of 4.8 m/s whereas AR-coated Phoenix had a reduction of 3.7 m/s. The corresponding reductions for Trilogy were 3.9 and 17.8 m/s. All differences were significant at the p level of less than 0.05. Although we were unable to break unexposed SR-coated polycarbonate lenses with our test apparatus, exposed SR-coated polycarbonate had a mean breakage velocity of 142 m/s. Our data suggest that extended UVR exposure causes a significant reduction in the impact resistance of the ophthalmic lens substrates commonly used for occupational eye protectors. Protective lenses that have been exposed to high levels of UVR for extended periods should be replaced regularly to maintain optimal impact protection, even if they do not show visible damage owing to wear and tear.

  5. [Ophthalmic disorders as a manifestation of Parkinson's disease].

    Science.gov (United States)

    Chesnokova, N B; Pavlenko, T A; Ugrumov, M V

    Parkinson's disease is a severe neurodegenerative disease accompanied with the degeneration of dopaminergic neurons in the central and peripheral nervous system. The diagnosis of Parkinson's disease can still be made only on the stage of irreversible and nearly total degeneration of the nigrostriatum dopaminergic system and exhaustion of brain compensatory mechanisms that explains the low efficacy of therapy. Ophthalmic pathology is one of the nonmotor symptoms of Parkinson's disease. This can be explained firstly by the fact that eye is a 'peripheral part of brain' and secondly by the involvement of dopaminergic neurons (dopamine-producing cells) that are subject to the selective degeneration during Parkinson's disease in the regulation of visual function in the eye and brain. Dopaminergic neurons and dopamine receptors are present in all structures of the eye. Parkinson's disease cause abnormalities not only in the retina but in the whole optic tract and can be considered as peripheral manifestations of the disease that precede the well-known motor dysfunctions. This review describes ophthalmological symptoms of Parkinson's disease, possible pathophysiological mechanisms of their development, optical disorders in experimental models of Parkinson's disease and also the perspectives of experimental and clinical studies of visual disorders for the development of preclinical diagnosis of Parkinson's disease.

  6. Cysteamine ophthalmic hydrogel for the treatment of ocular cystinosis

    Directory of Open Access Journals (Sweden)

    Anxo Fernández-Ferreiro

    2017-11-01

    Full Text Available Ocular cystinosis is a rare disease characterised by the deposit of cystine crystals on the corneal surface, which hinder patients’ eyesight. Oral cysteamine is given as cysteamine; however, it does not reach the cornea due to the lack of corneal vascularization making necessary its administration by the topical ocular route. The aim of the present study is to determine the stability of an ophthalmic hydrogel of cysteamine, which can be potentially prepared at hospital pharmacy departments, under different preservation conditions during a follow-up of 30 days. Different physical and chemical parameters were evaluated: osmolality, pH and cysteamine concentration, which has been measured by a method of ultra performance liquid chromatography-tandem mass spectrometer (UPLC-MS/MS. Descriptive assays were also performed, such as transparency measurement and microbiological assays in order to verify its sterility. The obtained results allow us to conclude that the cysteamine hydrogel is stable during 30 days, being recommendable its preservation in refrigerated conditions.

  7. Optimization of sup 125 I ophthalmic plaque brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Astrahan, M.A.; Luxton, G.; Jozsef, G.; Liggett, P.E.; Petrovich, Z. (Univ. of Southern California School of Medicine, Los Angeles (USA))

    1990-11-01

    Episcleral plaques containing {sup 125}I sources are often used in the treatment of ocular melanoma. Within four years post-treatment, however, the majority of patients experience some visual loss due to radiation retinopathy. The high incidence of late complications suggests that careful treatment optimization may lead to improved outcome. The goal of optimization would be to reduce the magnitude of vision-limiting complications without compromising tumor control. We have developed a three-dimensional computer model for ophthalmic plaque therapy which permits us to explore the potential of various optimization strategies. One simple strategy which shows promise is to maximize the ratio of dose to the tumor apex (T) compared to dose to the macula (M). By modifying the parameters of source location, activity distribution, source orientation, and shielding we find that the calculated T:M ratio can be varied by a factor of 2 for a common plaque design and posterior tumor location. Margins and dose to the tumor volume remain essentially unchanged.

  8. Space Flight-Induced Intracranial Hypertension: An Ophthalmic Review

    Science.gov (United States)

    Gibson, Charles Robert; Mader, Thomas H.

    2010-01-01

    Background: Although physiologic and pathologic changes associated with microgravity exposure have been studied extensively, the effect of this environment on the eye is largely unknown. Over the last several years, NASA s Space Medicine Division has documented astronauts presenting with varying degrees of disc edema, globe flattening, choroidal folds, cotton wool spots, and hyperopic shifts after long-duration space flight. Methods: Before and after long-duration space flight, six astronauts underwent complete eye examinations to include cycloplegic and/or manifest refraction and fundus photography. Five of these astronauts had Optical Coherence Tomography (OCT) and Magnetic Resonance Imaging (MRI) performed following their missions. Results: Following exposure to space flight of approximately 6-months duration, six astronauts had neuro-ophthalmic findings. These consisted of disc edema in four astronauts, globe flattening in four astronauts, choroidal folds in four astronauts, cotton wool spots in three astronauts, nerve fiber layer thickening by OCT in five astronauts, and decreased near vision in five astronauts. Four of the astronauts with near vision complaints had a hyperopic shift equal to or greater than + 0.50D between pre- and post-mission spherical equivalent refraction in one or both eyes (range +0.50D to +1.50D). These same four had globe flattening by MRI. Conclusions: The findings we describe may have resulted from a rise in intracranial pressure caused by microgravity fluid shifts, and could represent parts of a spectrum of ocular and cerebral responses to extended microgravity.

  9. Non-specificity of the superior ophthalmic vein on CT

    Energy Technology Data Exchange (ETDEWEB)

    Yamasaki, Masahiro; Matsumoto, Sadayuki; Itoh, Hidefumi; Yamamoto, Tooru; Kusaka, Hirofumi; Maya, Kiyomi; Imai, Terukuni (Kitano Hospital, Osaka (Japan))

    1989-02-01

    An enlarged superior ophthalmic vein (SOV) on computed tomography has been considered by several authors to be a pathognomonic sign of a carotid cavernous sinus fistula (CCF). However, according to some other investigators, SOV has been observed in various orbital and cavernous sinus diseases, and even in normal persons. We reviewed the ordinal axial head and orbital CT results (third generation) of 1293 patients with miscellaneous neurologic diseases in an attempt to ascertain the diagnostic significance of SOV. SOV was observed in 88 patients, unilaterally in 29 and bilaterally in 59. SOV was detected in 65 patients by means of 5-mm-thick slice scanning and in 23, by 10-mm. SOV was observed in 76 cases on plain CT and in 12 on enhanced. The maximal diameter of SOV was 3.3 mm of more in all patients except one with orbital or cavernous sinus desease (a skullbase tumor extending into the cavernous sinus, a case of orbital cellulitis, and a case with CCF) in the present study. On the other hand, the maximal diameter of SOV with diseases other than orbital of cavernous sinus pathology was less than 3.0 mm. In conclusion, a SOV is not pathognomonic on CCF and is observed under various conditions. However, when the diameter of the SOV is 3.3 mm or more one should consider the possibility of orbital or cavernous sinue disease. (author).

  10. Ophthalmic manifestations of atypical IgD multiple myeloma

    Science.gov (United States)

    Edmunds, Matthew R; Cikatricis, Peter; Mukherji, Subhanjan; Bowyer, Jeremy D

    2012-01-01

    A previously healthy 32-year-old Caucasian female presented with sudden-onset horizontal diplopia following a paroxysm of coughing. She had recently sustained a pubic ramus fracture during an innocuous fall and had also noted a firm lump developing at the right side of her forehead. On examination, she had a right fronto-temporal mass. Visual acuities were 6/6 bilaterally. There was reduced abduction of the right eye, bilateral white, granular corneal opacities and evidence of bilateral optic disc swelling. Haematological investigations revealed normocytic anaemia, hypercalcaemia and raised erythrocyte sedimentation rate (ESR). CT showed lytic foci throughout the skull, ribs, scapulae, spine, pelvis and upper femora. Serum protein electrophoresis revealed immunoglobulin D (IgD)-kappa paraproteinaemia; urine electrophoresis showed free light chain kappa and bone marrow biopsy demonstrated 87% plasma cells. A diagnosis of IgD multiple myeloma was made, with subsequent chemotherapeutic treatment and eventual autologous stem cell transplant resulting in resolution of neuro-ophthalmic manifestations and prolonged disease remission. PMID:22814986

  11. Preoperative Hand Decontamination in Ophthalmic Surgery: A Comparison of the Removal of Bacteria from Surgeons' Hands by Routine Antimicrobial Scrub versus an Alcoholic Hand Rub.

    Science.gov (United States)

    Forer, Yaara; Block, Colin; Frenkel, Shahar

    2017-09-01

    The goal of this experiment was to evaluate and compare the antimicrobial efficacy of routine preoperative hand washing using commercial medicated sponge brushes versus an alcoholic hand rub, by comparing bacterial growth on ophthalmic surgeons' hands after application of each of these methods. Twenty ophthalmic surgeons were recruited at the Hadassah-Hebrew University Medical Center in Jerusalem, Israel. Samples were collected twice from the hands of each surgeon after hand decontamination using two different protocols during routine surgical practice. The routine preparation consisted of a 3-minute surgical scrub using commercial brush-sponges incorporating either 4% chlorhexidine gluconate (CHG) or 1% povidone-iodine (PVP-I) formulations with detergent, followed by drying the hands with a sterile towel, while the 70% ethanol solution was applied for 60-seconds and allowed to air dry. Half of the group was randomly assigned to provide samples first after the routine method and the alcoholic solution a week later, and the other half of the group was sampled in the reverse order. Viable counts of bacteria were evaluated using a modified glove juice method. Bacterial colonies were enumerated after incubation for 24 hours and expressed as colony forming units (CFU)/mL for each pair of hands. Geometric mean counts were 1310 and 39 CFU/mL, in the routine and alcohol rub groups, respectively, representing a mean log10 reduction in 1.53. The difference between the paired bacterial counts for the routine versus the alcohol rub was statistically significant (p rub protocol is more effective in reducing bacterial counts on hands than routine surgical hand preparation with PVP-I and CHG in a population of practicing ophthalmic surgeons in the operative clinical setting. Thus, it provides a safe alternative as a preoperative hand disinfection method.

  12. Color Doppler imaging of the ophthalmic artery in patients with chronic heart failure.

    Science.gov (United States)

    Almeida-Freitas, Daniela B; Meira-Freitas, Daniel; Melo Jr, Luiz Alberto Soares de; Paranhos Jr, Augusto; Iared, Wagner; Ajzen, Sergio

    2011-01-01

    To evaluate the ophthalmic artery hemodynamics in patients with chronic heart failure. Doppler parameters of ophthalmic artery of 18 patients with chronic heart failure in different stages of the disease were compared with 21 healthy volunteers (control group). These parameters were also correlated with echocardiographic assessments and clinical cardiologic status. Mean diastolic velocity was 5.14 ± 2.4 cm/s in the chronic heart failure group and 7.44 ± 3.5 cm/s in the control group (p=0.007). Mean resistance index of the ophthalmic artery was 0.76 ± 0.08 in the chronic heart failure group and 0.70 ± 0.08 in the control group (p=0.04). Mean systolic velocity of the ophthalmic artery was 22.03 ± 7.7 cm/s in the chronic heart failure group and 25.32 ± 9.2 cm/s in the control group (p=0.24). There was a negative correlation between the resistance index of the ophthalmic artery and systemic blood pressure of patients with chronic heart failure (r= -0.47, p=0.007). Diastolic velocity of the ophthalmic artery correlated positively with systemic blood pressure (r=0.44, p=0.02). Lower diastolic velocity and higher resistance index were observed in the ophthalmic artery of chronic heart failure patients when compared to the control group, which probably reflects the presence of orbital vasoconstriction in response to low cardiac output. Therefore, the influence of these findings on the structure and function of the optic nerve head deserves investigation.

  13. Color Doppler imaging of the ophthalmic artery in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Daniela B. Almeida-Freitas

    2011-10-01

    Full Text Available Purpose: To evaluate the ophthalmic artery hemodynamics in patients with chronic heart failure. Methods: Doppler parameters of ophthalmic artery of 18 patients with chronic heart failure in different stages of the disease were compared with 21 healthy volunteers (control group. These parameters were also correlated with echocardiographic assessments and clinical cardiologic status. Results: Mean diastolic velocity was 5.14 ± 2.4 cm/s in the chronic heart failure group and 7.44 ± 3.5 cm/s in the control group (p=0.007. Mean resistance index of the ophthalmic artery was 0.76 ± 0.08 in the chronic heart failure group and 0.70 ± 0.08 in the control group (p=0.04. Mean systolic velocity of the ophthalmic artery was 22.03 ± 7.7 cm/s in the chronic heart failure group and 25.32 ± 9.2 cm/s in the control group (p=0.24. There was a negative correlation between the resistance index of the ophthalmic artery and systemic blood pressure of patients with chronic heart failure (r= -0.47, p=0.007. Diastolic velocity of the ophthalmic artery correlated positively with systemic blood pressure (r=0.44, p=0.02. Conclusion: Lower diastolic velocity and higher resistance index were observed in the ophthalmic artery of chronic heart failure patients when compared to the control group, which probably reflects the presence of orbital vasoconstriction in response to low cardiac output. Therefore, the influence of these findings on the structure and function of the optic nerve head deserves investigation.

  14. Latanoprost ophthalmic solution in the treatment of open angle glaucoma or raised intraocular pressure: a review

    Directory of Open Access Journals (Sweden)

    Andrea Russo

    2009-01-01

    Full Text Available Andrea Russo, Ivano Riva, Teodoro Pizzolante, Federico Noto, Luciano QuarantaCattedra di Malattie dell’Apparato Visivo, Università degli studi di Brescia, USVD “Centro per lo studio del Glaucoma” Spedali Civili di BresciaAbstract: Latanoprost is a prostaglandin F2-alpha isopropyl ester prodrug which is rapidly hydrolyzed by esterases in the cornea to the biologically active latanoprost acid. When latanoprost is topically administered into the eye, the cornea seems to act like as a slow-release depot to the anterior segment. One hour after administration maximum concentration is found in the iris, followed by the anterior chamber and the ciliary body. Despite extensive research, controversy remains about the real mechanism of action of this drug. Immunohistochemical data have shown that the intraocular pressure (IOP reduction with topical prostaglandin F2-alpha is associated with a reduction of collagens within the uveoscleral outflow pathway. Evidence from several experimental and clinical studies suggests that latanoprost is a valuable addition first-line treatment alternatives for glaucoma, ocular hypertension and even angle-closure glaucoma. Strong points are its efficacy, which is demonstrated to be higher than that of brimonidine, dorzolamide and timolol with fewer systemic adverse effects; a convenient administration schedule; and the IOP-controlling pattern, which is relatively flat compared with timolol and dorzolamide, and enables better control in glaucoma progression, since large fluctuations may be associated with the risk of developing glaucoma in untreated ocular hypertensive subjects.Keywords: latanoprost, intraocular pressure, glaucoma, ocular hypertension

  15. The impact of topical mydriatic ophthalmic solutions on retinal vascular reactivity and blood flow.

    Science.gov (United States)

    Tsui, Edmund; Sehi, Mitra; Cheng, Richard W F; Wan, Jennifer; Wong, Tien; Dorner, Stephanie; Fisher, Joseph A; Hudson, Christopher

    2013-07-01

    The impact of mydriatic agents on the standardized provocation of retinal vascular reactivity has not been systematically investigated. Our aim was to investigate the effect of commonly used mydriatic agents on the provoked vascular response of retinal arterioles. One eye was randomly selected for mydriasis from 10 healthy volunteers (age 23.3 ± 4.9 years). A single drop of: 1% tropicamide (T), or a combination of 0.8% tropicamide and 5% phenylephrine (TP), or 1% cyclopentolate (C) were instilled into the volunteers lower fornix at each of three visits. Volunteers underwent a standardized isocapnic hyperoxic provocation. Four retinal hemodynamic measurements were acquired with the Canon Laser Blood Flowmeter at equivalent positions on the superior temporal arteriole (STA) and inferior temporal arteriole (ITA) at baseline, during provocation and after recovery. Statistical analysis was performed using linear mixed-effect models. Pre- and post-dilation measurements indicated that pupil diameter increased with use of T, TP, C (all 0.05). In response to a standardized isocapnic hyperoxic challenge, blood vessel diameter, blood velocity and flow decreased in both the STA and ITA relative to baseline. Comparison between the change elicited by isocapnic hyperoxic gas stimuli with respect to blood vessel diameter, blood velocity, blood flow, were equivalent for each mydriatic agent in the STA (p = 0.66, p = 0.99, p = 0.99, respectively) and the ITA (p = 0.85, p = 0.80, p = 0.66, respectively). Furthermore, comparison between the change in the STA and ITA with respect to the above parameters showed equivalent responses in both vessels for each mydriatic agent: T (p = 0.92, p = 0.99, p = 0.35; respectively), TP (p = 0.89, p = 0.96, p = 0.62; respectively), and C (p = 0.87, p = 0.35, p = 0.56; respectively). The provoked retinal vascular reactivity response to standardized isocapnic hyperoxia was equivalent irrespective of the agent used to achieve mydriasis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. 21 CFR 524.960 - Flumethasone, neomycin sulfate, and polymyxin B sulfate ophthalmic solutions.

    Science.gov (United States)

    2010-04-01

    .... Dogs: 1 to 2 drops per eye, every 6 hours. (ii) Preparation without hydroxyproply methylcellulose. Dogs... contraindicated in infectious tuberculous lesions of the eye, early acute stages of viral diseases of the cornea...

  17. The physical properties of generic latanoprost ophthalmic solutions are not identical

    DEFF Research Database (Denmark)

    Kolko, Miriam; Koch Jensen, Peter

    2017-01-01

    and the number of drops in the bottles varied significantly between the generic drugs. The control value of pH in the brand version (Xalatan® ) was markedly lower compared to the generic latanoprost products. Titration of Xalatan® to neutrality required substantially more NaOH compared to the generic latanoprost...

  18. Ganciclovir ophthalmic gel 0.15%: in acute herpetic keratitis (dendritic ulcers).

    Science.gov (United States)

    Croxtall, Jamie D

    2011-03-26

    Dendritic epithelial keratitis is most commonly caused by infections of herpes simplex virus (HSV) type 1 (HSV-1), and less frequently by HSV type 2 (HSV-2). Ganciclovir, a guanosine nucleoside analogue, is a well established broad-spectrum antiviral agent that inhibits replication of viral DNA and is active against both HSV-1 and -2 and several other viruses. Ganciclovir ophthalmic gel 0.15% is a five-times-daily topical preparation that is indicated for the treatment of acute herpetic keratitis (dendritic ulcers). A randomized, open-label, phase III trial in immunocompetent patients with acute herpetic keratitis showed that ganciclovir ophthalmic gel 0.15% applied five times daily provided effective clinical resolution of dendritic ulcers following 7 days of treatment (primary endpoint). Moreover, a retrospective analysis of noninferiority showed that ganciclovir ophthalmic gel 0.15% was no less effective than aciclovir (acyclovir) ointment 3%. A pooled analysis of three randomized, single-masked, phase II multinational trials also showed high rates of dendritic ulcer healing at day 7 for eyes treated with ganciclovir ophthalmic gel 0.15% and aciclovir ointment 3%. Furthermore, in the individual phase II trials, most patients showed evidence of healed dendritic and geographic ulcers at day 14 in either treatment arm. Median healing times with either treatment ranged from 6 to 10 days. Ganciclovir ophthalmic gel 0.15% was generally well tolerated and was associated with a significantly lower incidence of visual disturbances than aciclovir ointment 3% in the phase III trial.

  19. Parenteral ophthalmic tropicamide or cyclopentolate protects rats from lethal organophosphate poisoning.

    Science.gov (United States)

    Bryant, Sean M; Rhee, James W; Thompson, Trevonne M; Lu, Jenny J; Aks, Steven E

    2009-01-01

    We determine the efficacy of parenteral ophthalmic antimuscarinic agents (tropicamide ophthalmic 1% and cyclopentolate hydrochloride ophthalmic 1%) on survivability in a rat model of acute, lethal organophosphate pesticide (OP) poisoning. After obtaining an appropriate dose-response for study comparison, rodents were randomized to receive 1 of 4 intraperitoneal antidotes; (1) 0.3 mL normal saline, (2) atropine 10 mg/kg, (3) ophthalmic tropicamide 20 mg/kg, or (4) ophthalmic cyclopentolate 20 mg/kg. Five minutes after pretreatment, 15 mg/kg of dichlorvos was administered subcutaneously. Mortality rates and time to death were compared using Fisher exact test and the Kaplan-Meier method with log-rank test, respectively. If alive at 120 minutes, survival was assumed and the study was terminated. Survival in rats pretreated with atropine (10 mg/kg) was 90%. Survival in rats pretreated with tropicamide (20 mg/kg) and cyclopentolate (20 mg/kg) were 90% [P tropicamide or cyclopentolate) was equivalent to standard atropine in preventing lethality in this rat model of acute, lethal OP poisoning.

  20. A STUDY ON OPHTHALMIC MANIFESTATIONS IN PITUITARY GLAND TUMOURS

    Directory of Open Access Journals (Sweden)

    Chitra Munusamy Rajendran

    2017-09-01

    Full Text Available BACKGROUND Pituitary adenoma is a benign tumour that originates from the adenohypophyseal cells of the anterior lobe of pituitary gland. It accounts for 12% to 15% of all intracranial tumours. A spectrum of ocular manifestations are seen with these tumours ranging from the absence of any visual symptoms to severe visual field defects and loss of vision. The aim of the study is to study the various ocular features and its effect on vision, visual fields and ocular motility in cases of pituitary adenoma diagnosed on CT or MRI. MATERIALS AND METHODS This is a prospective study for a period of 1 year and 8 months conducted in Regional Institute of Ophthalmology, Madras Medical College. 25 patients aged between 25 to 65 years diagnosed as pituitary adenomas on radiological imaging who presented to squint clinic were evaluated after detailed history with visual acuity, pupillary reaction, colour vision, extraocular movements, slit lamp and fundus examination. Visual field examination was done with Octopus field analyser. RESULTS In our study, 25 patients of pituitary adenoma diagnosed on radio imaging were enrolled and evaluated. Most patients were above 50 years, 15 patients of the 25 were above 50 yrs. (60%. Females were predominantly affected (76%. Visual acquity of the patient was between 6/12-6/6 (62% on presentation. Headache was the commonest mode of presentation (80%. 76% showed field defects of which bitemporal hemianopia was the commonest in 52.9%. Pituitary macroadenoma 96% was the commonest type. Optic atrophy was seen only in 4 cases. Others had normal fundus. CONCLUSION Neuro-ophthalmic evaluation plays a major role not only in early detection, planning of treatment and further follow up, but also prevents visual loss if intervened early.

  1. Dosimetric Benefit of a New Ophthalmic Radiation Plaque

    Energy Technology Data Exchange (ETDEWEB)

    Marwaha, Gaurav, E-mail: marwahg2@ccf.org [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Cleveland Clinic Foundation, Cleveland, Ohio (United States); Wilkinson, Allan [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Cleveland Clinic Foundation, Cleveland, Ohio (United States); Bena, James [Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Cleveland Clinic Foundation, Cleveland, Ohio (United States); Macklis, Roger [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Cleveland Clinic Foundation, Cleveland, Ohio (United States); Singh, Arun D. [Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio (United States); Cleveland Clinic Foundation, Cleveland, Ohio (United States)

    2012-12-01

    Purpose: To determine whether the computed dosimetry of a new ophthalmic plaque, EP917, when compared with the standard Collaborative Ocular Melanoma Study (COMS) plaques, could reduce radiation exposure to vision critical structures of the eye. Methods and Materials: One hundred consecutive patients with uveal melanoma treated with COMS radiation plaques between 2007 and 2010 were included in this study. These treatment plans were generated with the use of Bebig Plaque Simulator treatment-planning software, both for COMS plaques and for EP917 plaques using I-125. Dose distributions were calculated for a prescription of 85 Gy to the tumor apex. Doses to the optic disc, opposite retina, lens, and macula were obtained, and differences between the 2 groups were analyzed by standard parametric methods. Results: When compared with the COMS plaques, the EP917 plaques used fewer radiation seeds by an average difference of 1.94 (P<.001; 95% confidence interval [CI], -2.8 to -1.06) and required less total strength of radiation sources by an average of 17.74 U (air kerma units) (P<.001; 95% CI, -20.16 to -15.32). The total radiation doses delivered to the optic disc, opposite retina, and macula were significantly less by 4.57 Gy, 0.50 Gy, and 11.18 Gy, respectively, with the EP917 plaques vs the COMS plaques. Conclusion: EP917 plaques deliver less overall radiation exposure to critical vision structures than COMS treatment plaques while still delivering the same total therapeutic dose to the tumor.

  2. Ophthalmic nepafenac use in the Netherlands and Denmark.

    Science.gov (United States)

    Margulis, Andrea V; Houben, Eline; Hallas, Jesper; Overbeek, Jetty A; Pottegård, Anton; Torp-Pedersen, Tobias; Perez-Gutthann, Susana; Arana, Alejandro

    2017-08-01

    To describe nepafenac use in the Netherlands and Denmark with reference to its approved indications. For context, we also describe the use of ketorolac and diclofenac. We identified users in the PHARMO Database Network (the Netherlands, 2008-2013) and the Danish national health registers (Denmark, 1994-2014). We described prevalence of cataract surgery and duration of use in patients with cataract surgery with and without diabetes. In the Netherlands, 9530 nepafenac users (mean age, 71 years; 60% women) contributed 12 691 therapy episodes, of which 21% had a recently recorded cataract surgery. Of 2266 episodes in adult non-diabetic patients with cataract surgery, 60% had one bottle dispensed (treatment duration ≤21 days). Of 441 episodes in adult diabetic patients with cataract surgery, 90% had up to two bottles dispensed (≤60 days). Denmark had 60 403 nepafenac users (mean age, 72 years; 58% women) and 73 648 episodes (41% had recorded cataract surgery). Of 26 649 nepafenac episodes in adult non-diabetic patients with cataract surgery, 92% had one bottle dispensed. Of 3801 episodes in adult diabetic patients with cataract surgery, 99.8% had up to two bottles dispensed. Use patterns of nepafenac, ketorolac and diclofenac were roughly similar in the Netherlands, but not in Denmark. Less than half of therapy episodes were related to cataract surgery; around 90% of episodes with surgery were within the approved duration. Underrecording of ophthalmic conditions and procedures was a challenge in this study. © 2017 The Authors Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

  3. Evaluations of refraction competencies of ophthalmic technicians in Mozambique.

    Science.gov (United States)

    Shah, Kajal; Naidoo, Kovin; Chagunda, Margarida; Loughman, James

    2016-01-01

    Ophthalmic technicians (OT) work at health facilities in Mozambique and are trained to provide primary and secondary eye care services including basic refraction. This study was designed to assess OT competence and confidence in refraction, and investigate whether an upskilling programme is effective in developing their competence and confidence at refraction. Thirty-one trainee OTs and 16 qualified OTs were recruited to the study. A background questionnaire was administered to determine the demographic profile of the OTs. A confidence levels questionnaire explored their self-reported skills. Clinical competencies were assessed in relation to knowledge (theory exam) and clinical skills (patient exams). 11 OTs were upskilled and the clinical evaluations carried out post training. Initial evaluations demonstrated that confidence and competence levels varied depending on the OTs training (location and duration), and their location of work (clinical load, availability of equipment and other eye care personnel). The qualified OTs were more competent than trainee OTs in most of the evaluations. Post upskilling results demonstrated significant positive impact on confidence and competence levels. These evaluations identified factors affecting the refraction competencies of the OTs and demonstrated that upskilling is effective in improving confidence and competence levels for refraction. They demonstrate the need for a refraction competency framework. The overarching aim of this research was to inform the development of a nationwide programme of OT mentoring, upskilling and leading to the establishment of clinical competency standards for the new OT curricula, relevant to the professional demands. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  4. Formulation and evaluation of new long acting metoprolol tartrate ophthalmic gels

    Science.gov (United States)

    Abou el Ela, Amal El Sayeh F.; Khatib, Mona Mohamed El

    2014-01-01

    The rationale of the present work is to formulate and evaluate metoprolol tartrate (MT), which is a beta-1 selective adrenergic blocking agent in a new ocular gel delivery system; this is our way and method to increase its contact to the cornea, giving a longer time of drug contact to the eye and slow possible release from the preparation. Metoprolol tartrate is chosen as a candidate for gel formulation because although it has been available for a few years as ophthalmic solutions, it has not been marketed as an ocular gel yet. Two polymers; Carbopol 934 and Pluronic F127 (PF127) were used in two different concentrations in this study. Metoprolol tartrate was used in two concentrations, 0.5% and 1% (w/w). All formulations were exposed to visual examinations, pH measurement, in vitro release, rheological study and differential scanning calorimetry (DSC). Results showed that all formulations were clear, showed pH within the acceptable range suitable to be administered in the eye, and exhibited pseudoplastic flow behavior. DSC results concluded that, MT was compatible with different polymers used. In vitro release results showed that the release rate of metoprolol tartrate from gel preparations decreased as an inverse function of polymer concentration, and the release rate of the drug increased as the initial concentration increased. Intra-ocular pressure (IOP) measurements of rabbit’s eye treated with 1% (w/w) metoprolol tartrate in gel formulations with different concentrations of the polymer were determined. Carbopol 934 gel formulations showed that this polymer extended the duration of pressure reducing effect of MT to more than 5hr when compared with Pluronic F127 gel formulations. The area above the curve (AAC), maximum response, time of maximum response (tmax), and the duration of the drug action were also calculated. PMID:25561869

  5. Effect of ophthalmic viscosurgical devices on lens epithelial cells: a morphological study.

    Science.gov (United States)

    Budo, Camille; Goffinet, G; Bellotto, Dennis; Petroll, W Matthew

    2003-12-01

    To investigate the morphological effects of Viscoat (sodium hyaluronate 3.0%-chondroitin sulfate 4.0%) on lens epithelial cells (LECs). Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, USA, and the Laboratory of Ultrastructural Morphology, Zoological Institute, University of Liège, Liège, Belgium. Human LECs collected via capsulorhexis were examined by light microscopy (LM) and transmission electron microscopy (TEM). Lens epithelial cells from rabbit capsulorhexis samples were studied by LM and TEM following exposure to Provisc (sodium hyaluronate 1.0%) or Viscoat ophthalmic viscoelastic device (OVD). Since Viscoat is hypertonic (340 mOsm), hypertonic, isotonic, and hypotonic solutions were compared to investigate a possible mechanism for the observed effects. The effects of Provisc and Viscoat on rabbit LECs in the intact lens were also compared. Human LECs gathered via capsulorhexis following exposure to Viscoat were generally thinner than control samples and often had condensed nuclei and increased intracellular vacuolization. Rabbit capsular tissue exposed in situ to Viscoat demonstrated changes similar to those seen in humans. Cells exposed to Provisc were similar to cells in untreated controls in humans and rabbits. Corneal endothelial cells exposed to either agent were unaffected. Experiments with hypertonic and hypotonic buffers induced some of the changes noted with Viscoat, but the effects were less severe. Lens epithelial cells in intact rabbit lenses exposed to Viscoat appeared similar to LECs in the control samples. Light microscopy and TEM of human lens capsule tissue suggest that Viscoat induces significant morphological changes in LECs during cataract surgery. The changes may underlie the improved visualization of these cells that has been reported during cataract surgery. Corneal endothelial cells were unaffected by exposure to Viscoat. Studies in a rabbit model suggest that the hyperosmolarity of

  6. Reduction in drop size of ophthalmic topical drop preparations and the impact of treatment

    Directory of Open Access Journals (Sweden)

    Shiva Kumar

    2011-01-01

    Full Text Available In this work we devised a method to create smaller eye drops of the glaucoma medication timolol maleate by altering the dropper tip design and changing the physical properties of the formulation. Most ocular diseases are treated with topical application of eye drops. After instillation of an eye drop, typically, less than 5% of the applied drug penetrates the cornea and reaches the intraocular tissues; the major fraction of the instilled drug is absorbed and enters the systemic circulation. Ophthalmic solutions are available in multidose or single-dose glass/plastic dropper bottles that deliver drops with a volume that ranges from 25 μL to 70 μL (average 40 μL. Because of the low capacity of the precorneal area, the optimal drop volume is about 20 μL; with larger volumes there is the risk of adverse systemic effects due to absorption of the drug via the nasal mucosa. Thus, both from the biopharmaceutical and economic point of view, drops of only 5-15 mL volume should be instilled into the eye. In this present work we devised a method to reduce the size of the drop by inserting a glass capillary tube into the dropper tip and by changing the physical properties of the formulation (by altering the concentration of Tween 80™, i.e., 0.05% and 0.1% of Tween 80™. We measured the drop sizes of the different timolol eye drop formulations available in the market and estimated the yearly cost of the medications. Our timolol maleate formulation with 0.1% concentration of Tween 80™ delivered through the dropper tip with the inserted glass capillary was shown to be better than the other formulations available in the market in terms of ability to deliver smaller drops, meaning that each bottle would last longer and that the yearly cost of treatment would be lower.

  7. NMR analysis of ion pair formation between timolol and sorbic acid in ophthalmic preparations.

    Science.gov (United States)

    Higashiyama, Masayo; Inada, Katsuhiro; Ohtori, Akira; Kakehi, Kazuaki

    2007-03-12

    Ion pair formation between timolol and sorbic acid was investigated using NMR spectroscopy in order to clarify their interactions within ophthalmic preparation. (13)C and (1)H NMR spectra of timolol, sorbic acid, and a mixture of the two were obtained, and the signal changes induced by pairing were observed. The carbon signals of the butylaminopropanol moiety of timolol were markedly shifted in the mixture, as were the carboxyl and conjugated carbons assigned to sorbic acid. The localizations of the changes in each molecule revealed the binding sites. The profiles of butylaminopropanol carbon chemical shifts plotted against a molar ratio of sorbate were synchronized, which suggested a single type of interaction with sorbic acid. The Job plot showed a typical pattern with a single-maximum at a mole function of 0.5, indicating the presence of a 1:1 complex of timolol and sorbic acid. The stability constants (K) of the timolol-sorbate and timolol-maleate pairs were 1.9x10(1) and 2.2x10(2)M(-1), respectively. The higher K value of the timolol-maleate interaction suggested that it was dominant to the timolol-sorbate interaction when maleate and sorbate coexisted within a timolol solution. Here, we demonstrated evidence of an interaction between timolol and sorbic acid using simple NMR measurements, which suggested the existence of ion pair formation derived from charge neutralization. Our analysis using NMR spectroscopy should advance the understanding and optimization of formulations that are based on ion pair.

  8. Application of operational simulation training system in the training of ophthalmic students

    Directory of Open Access Journals (Sweden)

    Wei Sun

    2014-09-01

    Full Text Available AIM: To assess the impact of the operational simulation training system on the cultivation of ophthalmic students. METHODS: Four hundred and eighty ophthalmic students in China Medical University from 2009 to 2011 were chosen as objects and divided into two groups at random. The students in the experimental group used operation simulation training system combined with traditional teaching methods, while the students in the control group only used traditional teaching methods. We examined the operation skills and the confidence of all the students half a year later. RESULTS: The improvement of the operation skills during the suture technique examination, and the confidence for operation technology were significantly different in two groups. The basic skills of the students in the examination groups improved apparently during the operational simulation training and they were full of confidence to their operational technique. CONCLUSION: The operational simulation training is useful for promoting the clinical ability for ophthalmic students and should be widely popularized.

  9. Increasing incidence of ophthalmic lymphoma in Denmark from 1980 to 2005

    DEFF Research Database (Denmark)

    Sjö, Lene D; Ralfkiær, Elisabeth Methner; Prause, Jan U

    2008-01-01

    PURPOSE: To evaluate patient characteristics and incidence of ophthalmic lymphoma in Denmark during the period 1980 to 2005. METHODS: All patients in Denmark with a diagnosis of ophthalmic lymphoma during the period 1980 to 2005 were retrieved from three different population-based registries....... Specimens from all patients were collected and reclassified according to the World Health Organization (WHO) classification system. Incidence rates were calculated by using Poisson regression models. RESULTS: A total of 228 patients with a histologically verified diagnosis of ophthalmic lymphoma were...... frequently in males than in females. Incidence rates were highly dependent on the patient's age. For all ages, a statistically significant annual average increase of 3.4% during the 26-year period was found. This increase was primarily due to a rise in the incidence of MALT lymphoma. CONCLUSIONS...

  10. Real-time and static in vivo ophthalmic imaging by spectral optical coherence tomography

    Science.gov (United States)

    Wojtkowski, Maciej; Bajraszewski, Tomasz; Targowski, Piotr; Kowalczyk, Andrzej

    2004-07-01

    Fast Spectral Optical Coherence Tomography (SOCT) technique is used to perform cross sectional and three-dimensional ophthalmic images. Static, real-time and 3-D in vivo images of the human cornea, lens, iris, corneo-scleral junction, retinal layers, optic disc and macula lutea are presented. The ophthalmic application of SOCT is promising because this technique ensures fast acquisition with relatively low optical power of incident light. All demonstrated images are obtained with the aid of SOCT instrument, which was constructed in the optical laboratory of medical physics group at Nicolaus Copernicus University (Torun, Poland). What is to our knowledge there are the first good quality (>90dB sensitivity) ophthalmic OCT images obtained by technique, which is different than time domain OCT.

  11. Ophthalmic Start-Up Chief Executive Officers' Perceptions of Development Hurdles.

    Science.gov (United States)

    Stewart, William C; Nelson, Lindsay A; Kruft, Bonnie; Stewart, Jeanette A

    2017-08-26

    To identify current challenges facing ophthalmic pharmaceutical start-ups in developing new products. Surveys were distributed to the chief executive officer (CEO) or president of ophthalmic start-ups. The survey attracted 24 responses from 78 surveys distributed (31%). The CEOs stated that a lack of financial capital (n = 18, 75%), FDA regulations (n = 6, 25%), and failure to meet clinical endpoints (n = 6, 25%) were their greatest development hurdles. Risk aversion to medicines in early development (n = 18, 75%), mergers and acquisitions reducing corporate choice for licensing agreements (n = 7, 29%), the emergence of large pharmaceutical-based venture capital funding groups (n = 12, 50%), and the failure of many large pharmaceutical companies to develop their own medicines (n = 10, 42%) were noted as recent prominent trends affecting fundraising. The study suggests that development funding, regulatory burden, and meeting clinical endpoints are the greatest development challenges faced by ophthalmic start-up CEOs. © 2017 S. Karger AG, Basel.

  12. Re-evaluation of Magnetic Resonance and Computerised Tomographic Imaging in Neuro-Ophthalmic Patients in an Academic Centre

    NARCIS (Netherlands)

    Koekoek, Clarence G. J.; Meiners, Linda C.; Pott, Jan Willem R.

    The aim of the study is to report the frequency of missed diagnoses on magnetic resonance and computerised tomographic imaging in neuro-ophthalmic patients who were referred to an academic ophthalmology department, with apparent normal imaging. The authors included all neuro-ophthalmic patients,

  13. Ophthalmic manifestation of aids in Armed Forces General Teaching Hospital, Addis Ababa.

    Science.gov (United States)

    T/Giorgis, Abeba; Melka, Fikru; G/Mariam, Agazi

    2007-10-01

    The eye is one of the commonly affected organs by HIV/AIDS. However, data on HIV/AIDS related ophthalmic lesion is scarce in Ethiopia and in other sub-Saharan Africa countries, where two-third of the world-infected people are living. To determine the proportion, describe the pattern, and assess the visual impairment of AIDS related ophthalmic lesions in comparison to CD+ T-lymphocyte count. This is a cross-sectional descriptive study conducted on AIDS patients. Consecutive patients whose CD4+ T-lymphocyte count was 200 cell/microl and below, diagnosed to have AIDS and not started on Antiretroviral therapy (ART) were evaluated for ophthalmic lesions over a period of one year. A total of 186 (26 females and 160 males) with mean age 34.3 +/- 7.6 years were examined CD4+ T-lymphocyte was ranging from 1 to 200 cell/microl. Sixty-one (32.8%) patients were found to have HIV/AIDS related ophthalmic lesions. Four of them had more than one lesion. Among the lesions, microvasculopathy (64% of them having CD4 less than 50) was by far the commonest accounting for 25/65 (38.1%), followed by Molluscum contageosum of the eyelids 10/65 (15%). Herpes Zoster Opthalmicus (HZO), uveitis, CMV retinitis were next common 4/65 (6.2% each). Eleven unilaterally and two bilaterally were blind. The leading cause of blindness was cytomegalovirus retinitis followed by HZO, uveitis and presumed toxoplasmisis chorioretinitis. The likelihood of having HIV/AIDS related lesion was higher among cases with CD4+ T-lymphocyte count of 50 and below (Adjusted OR = 12.25; 95% CI; 1.09, 4.63). The presence of visual threatening ophthalmic lesions in highly immunocompromised AIDS patient shows the importance of early detection and treatment. ART could have impact on the pattern of the ophthalmic lesions, hence further study is recommended.

  14. Dosimetry of a New P-32 Ophthalmic Applicator

    Science.gov (United States)

    Choi, Chang Heon; Han, Hyon Soo; Son, Kwang-Jae; Park, Ul Jae; Ye, Sung-Joon

    2010-11-01

    Purpose: A 90Sr/Y applicator has been used as a β-source for postoperative irradiation after pterygium excision. As an alternative to 90Sr/Y irradiation, we proposed treatments with 32P. This study aims to provide the dosimetry for this new applicator. Method and Materials: A 32P ophthalmic applicator, of which the design and materials were optimally designed by Monte Carlo simulations, was fabricated by the Korea Atomic Energy Research Institute. The absorbed dose at the front surface of the cylindrical 32P applicator was measured by using an extrapolation ionization chamber. Radiochromic film (RCF) was used to measure depth dose distributions and dose profiles at various depths. A micro-MOSFET detector was used for depth dose measurements. Results: The absorbed dose rates to the reference point (i.e., at the centre on the front surface of 32P applicator) were 0.238 ± 0.012 cGy/s for an extrapolation ionization chamber, 0.280 ± 0.001 cGy/s for RCF, and 0.257 ± 0.020 cGy/s for MOSFET. The axial depth dose rate was reduced into approximately 1/10 as 32P betas penetrate every 2 mm depth. Measured data in depths of 1 mm to 3.5 mm agreed with Monte Carlo data. Due to non-uniform absorption of 32P into an absorbent disk, the dose at the centre of trans-axial plane was 2%-4% less than the peak dose around the periphery. We confirmed no leakage of 32P activities and negligible exposure rate around the hand grip of the applicator. Conclusions: The 32P applicator can deliver uniform therapeutic doses to the surface of the conjunctiva, while sparing the lens better than 90Sr/Y applicators. The doses at any points from the 32P applicator can be calculated by using these measured data sets. The safety of 32P applicator was confirmed. However, prior to the clinical application of every new applicator, safety, dose uniformity, and absorbed dose rate at the reference point should be carefully evaluated by the method developed in this study.

  15. Dosimetry of a New P-32 Ophthalmic Applicator

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Chang Heon; Ye, Sung-Joon [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul Korea 110-744 (Korea, Republic of); Han, Hyon Soo; Son, Kwang-Jae; Park, Ul Jae, E-mail: sye@snu.ac.k [Hanaro Applications Research, Korea Atomic Energy Research Institute, Daejeon Korea 305-353 (Korea, Republic of)

    2010-11-01

    Purpose: A {sup 90}Sr/Y applicator has been used as a {beta}-source for postoperative irradiation after pterygium excision. As an alternative to {sup 90}Sr/Y irradiation, we proposed treatments with {sup 32}P. This study aims to provide the dosimetry for this new applicator. Method and Materials: A {sup 32}P ophthalmic applicator, of which the design and materials were optimally designed by Monte Carlo simulations, was fabricated by the Korea Atomic Energy Research Institute. The absorbed dose at the front surface of the cylindrical {sup 32}P applicator was measured by using an extrapolation ionization chamber. Radiochromic film (RCF) was used to measure depth dose distributions and dose profiles at various depths. A micro-MOSFET detector was used for depth dose measurements. Results: The absorbed dose rates to the reference point (i.e., at the centre on the front surface of {sup 32}P applicator) were 0.238 {+-} 0.012 cGy/s for an extrapolation ionization chamber, 0.280 {+-} 0.001 cGy/s for RCF, and 0.257 {+-} 0.020 cGy/s for MOSFET. The axial depth dose rate was reduced into approximately 1/10 as {sup 32}P betas penetrate every 2 mm depth. Measured data in depths of 1 mm to 3.5 mm agreed with Monte Carlo data. Due to non-uniform absorption of {sup 32}P into an absorbent disk, the dose at the centre of trans-axial plane was 2%-4% less than the peak dose around the periphery. We confirmed no leakage of {sup 32}P activities and negligible exposure rate around the hand grip of the applicator. Conclusions: The {sup 32}P applicator can deliver uniform therapeutic doses to the surface of the conjunctiva, while sparing the lens better than {sup 90}Sr/Y applicators. The doses at any points from the {sup 32}P applicator can be calculated by using these measured data sets. The safety of {sup 32}P applicator was confirmed. However, prior to the clinical application of every new applicator, safety, dose uniformity, and absorbed dose rate at the reference point should be

  16. Use of statistical analyses in the ophthalmic literature.

    Science.gov (United States)

    Lisboa, Renato; Meira-Freitas, Daniel; Tatham, Andrew J; Marvasti, Amir H; Sharpsten, Lucie; Medeiros, Felipe A

    2014-07-01

    To identify the most commonly used statistical analyses in the ophthalmic literature and to determine the likely gain in comprehension of the literature that readers could expect if they were to add knowledge of more advanced techniques sequentially to their statistical repertoire. Cross-sectional study. All articles published from January 2012 through December 2012 in Ophthalmology, the American Journal of Ophthalmology, and Archives of Ophthalmology were reviewed. A total of 780 peer-reviewed articles were included. Two reviewers examined each article and assigned categories to each one depending on the type of statistical analyses used. Discrepancies between reviewers were resolved by consensus. Total number and percentage of articles containing each category of statistical analysis were obtained. Additionally, we estimated the accumulated number and percentage of articles that a reader would be expected to be able to interpret depending on their statistical repertoire. Readers with little or no statistical knowledge would be expected to be able to interpret the statistical methods presented in only 20.8% of articles. To understand more than half (51.4%) of the articles published, readers would be expected to be familiar with at least 15 different statistical methods. Knowledge of 21 categories of statistical methods was necessary to comprehend 70.9% of articles, whereas knowledge of more than 29 categories was necessary to comprehend more than 90% of articles. Articles related to retina and glaucoma subspecialties showed a tendency for using more complex analysis when compared with articles from the cornea subspecialty. Readers of clinical journals in ophthalmology need to have substantial knowledge of statistical methodology to understand the results of studies published in the literature. The frequency of the use of complex statistical analyses also indicates that those involved in the editorial peer-review process must have sound statistical knowledge to

  17. Audit of Referrals to an Ophthalmic Outpatient Clinic of a Tertiary ...

    African Journals Online (AJOL)

    provided information on demography, referral source, referral diagnosis, definitive diagnosis and quality of referral letter. The number of ophthalmic outpatient consultations during the study period was obtained from clinic records. Data were analysed with the Statistical Package for Social Sciences to generate frequency ...

  18. Hemodynamic features and recurrence risk analysis of subtotally embolized ophthalmic aneurysms

    Directory of Open Access Journals (Sweden)

    Chuan-hui LI

    2011-12-01

    Full Text Available Objective The present study investigates the hemodynamic features in the residual necks of subtotally embolized ophthalmic aneurysms and their influence on the recurrence after operation.Methods Four ophthalmic aneurysm cases from January 2007 to July 2008 were studied.The aneurysms of the patients had residual necks after being embolized.Three-dimensional cerebral angiography images were taken before and after embolization,and the aneurysm modes were determined based on these images.The hemodynamic features in the residual neck before and after operation and during recurrence were analyzed by using a hydrodynamic software program and the finite-element method.Results The hemodynamic analysis shows that the residual neck had high shear stress and blood flow velocity regions after embolization in all four cases.Out of the four patients,three experienced recurrence,where blood flowed into the tumor cavity coinciding with the high shear stress regions.Conclusions High shear stress and blood flow velocity in the residual neck of embolized ophthalmic aneurysms manifested in the location of recurrence.Thus,hemodynamic factors may have an important role in the recurrence of ophthalmic aneurysms after embolization.

  19. 21 CFR 349.55 - Labeling of ophthalmic astringent drug products.

    Science.gov (United States)

    2010-04-01

    .... 349.55 Section 349.55 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE OPHTHALMIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Labeling... vision, continued redness or irritation of the eye, or if the condition worsens or persists for more than...

  20. 21 CFR 349.60 - Labeling of ophthalmic demulcent drug products.

    Science.gov (United States)

    2010-04-01

    .... 349.60 Section 349.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE OPHTHALMIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Labeling....12: (1) “If you experience eye pain, changes in vision, continued redness or irritation of the eye...

  1. 21 CFR 349.65 - Labeling of ophthalmic emollient drug products.

    Science.gov (United States)

    2010-04-01

    .... 349.65 Section 349.65 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE OPHTHALMIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Labeling... identified in § 349.14: “If you experience eye pain, changes in vision, continued redness or irritation of...

  2. 21 CFR 349.75 - Labeling of ophthalmic vasoconstrictor drug products.

    Science.gov (United States)

    2010-04-01

    ... products. 349.75 Section 349.75 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE OPHTHALMIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Labeling....18: (1) “If you experience eye pain, changes in vision, continued redness or irritation of the eye...

  3. 21 CFR 349.70 - Labeling of ophthalmic hypertonicity drug products.

    Science.gov (United States)

    2010-04-01

    .... 349.70 Section 349.70 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE OPHTHALMIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Labeling... supervision of a doctor. If you experience eye pain, changes in vision, continued redness or irritation of the...

  4. 76 FR 78150 - Ophthalmic and Topical Dosage Form New Animal Drugs; Hydrocortisone Aceponate, Miconazole Nitrate...

    Science.gov (United States)

    2011-12-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 524 Ophthalmic and Topical Dosage Form New... AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS 0 1. The authority citation for 21 CFR part 524 continues to...

  5. Chlamydial IgG and IgM assessment in patients with non infectious ophthalmic diseases

    Directory of Open Access Journals (Sweden)

    Asadi Amoli F

    2008-11-01

    Full Text Available "nBackground: Chlamydia Trachomatis is the most common cause of trachoma and subsequently give rise to neonatal chlamydial conjunctivitis (NCC, adult ophthalmic inclusion infection, sexually transmitted diseases (STD and pneumonia. The goal of this study was to access the incidence of chlamydia trachomatis in the normal (ophthalmic infection free population. "nMethods: In a cross sectional study 250 patients referring to Farabi Eye university Hospital Tehran, Iran for non infectious ophthalmic disease in different age categories were selected and accessed for chlamydial IgM and IgG by ELISA method. "nResults: 250 patients (50% men and 50% women with the mean age of 40 (ranging from one to 83 years old were tested. IgG was detected in 11 (five females and six males patients (4.4% All of them had more than 31 years old. IgM was detected in 18 (13 females and 5 males patients (7.2%. No test revealed simultaneous high IgG and IgM titre in the same patient. "nConclusions: There was a low grade of chlamydial infection in our study population. So it is recommended to use serological methods for screening of ophthalmic infections in centers where no other test methods are available and in case of positive results confirmatory antigen tests to be used.

  6. The international forum of ophthalmic simulation: developing a virtual reality training curriculum for ophthalmology.

    Science.gov (United States)

    Saleh, George M; Lamparter, Julia; Sullivan, Paul M; O'Sullivan, Fiona; Hussain, Badrul; Athanasiadis, Ioannis; Litwin, Andre S; Gillan, Stewart N

    2013-06-01

    To investigate the effect of a structured, supervised, cataract simulation programme on ophthalmic surgeons in their first year of training, and to evaluate the level of skill transfer. Trainees with minimal intraocular and simulator experience in their first year of ophthalmology undertook a structured, sequential, customised, virtual reality (VR) cataract training programme developed through the International Forum of Ophthalmic Simulation. A set of one-handed, bimanual, static and dynamic tasks were evaluated before and after the course and scores obtained. Statistical significance was evaluated with the Wilcoxon sign-rank test. The median precourse score of 101.50/400 (IQR 58.75-145.75) was significantly improved after completing the training programme ((postcourse score: 302/400, range: 266.25-343), p<0.001). While improvement was evident and found to be statistically significant in all parameters, greatest improvements were found for capsulorhexis and antitremor training ((Capsulorhexis: precourse score=0/100, range 0-4.5; postcourse score=81/100, range 13-87.75; p=0.002), (antitremor training: precourse score=0/100, range 0-0; postcourse score=80/100, range 60.25-91.50; p=0.001)). Structured and supervised VR training can offer a significant level of skills transfer to novice ophthalmic surgeons. VR training at the earliest stage of ophthalmic surgical training may, therefore, be of benefit.

  7. Acute Herpetic Keratitis: What is the Role for Ganciclovir Ophthalmic Gel?

    Directory of Open Access Journals (Sweden)

    Afsun Sahin

    2012-01-01

    Full Text Available Herpes simplex keratitis (HSK is a major cause of corneal blindness in the world. Following the primary infection, the virus enters into a latent phase. Recurrent infectious or immune keratitis cause structural damage to the cornea, scarring, and may lead to blindness. Several commercially available topical and oral antiviral drugs for HSK are currently available. However, toxicity and low patient compliance hamper their use in HSK. Further, oral antiviral drugs alone are not always effective in HSK. Thus, there had been a need for safe and effective topical antiviral agents against HSK. Systemic ganciclovir has been in use for the treatment of cytomegalovirus infections. Recently, topical ganciclovir has become available for use in patients with HSK. Ganciclovir 0.15% ophthalmic gel has been shown to be both safe and effective against viruses of the herpes family. Topical ganciclovir ophthalmic gel is well tolerated and does not cause significant toxic effects on the ocular surface. Several multicenter studies have revealed the potential role of ganciclovir ophthalmic gel in the treatment and prophylaxis of epithelial HSK. In this paper, we have reviewed the pharmacology, efficacy, side effects, and the role of ganciclovir ophthalmic gel 0.15% in the treatment of acute herpetic keratitis.

  8. 10 CFR 35.491 - Training for ophthalmic use of strontium-90.

    Science.gov (United States)

    2010-01-01

    ... of classroom and laboratory training applicable to the medical use of strontium-90 for ophthalmic... Section 35.491 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Manual Brachytherapy...; (iii) Mathematics pertaining to the use and measurement of radioactivity; and (iv) Radiation biology...

  9. Deep lateral wall orbital decompression following strabismus surgery in patients with Type II ophthalmic Graves' disease.

    Science.gov (United States)

    Ellis, Michael P; Broxterman, Emily C; Hromas, Alan R; Whittaker, Thomas J; Sokol, Jason A

    2018-01-10

    Surgical management of ophthalmic Graves' disease traditionally involves, in order, orbital decompression, followed by strabismus surgery and eyelid surgery. Nunery et al. previously described two distinct sub-types of patients with ophthalmic Graves' disease; Type I patients exhibit no restrictive myopathy (no diplopia) as opposed to Type II patients who do exhibit restrictive myopathy (diplopia) and are far more likely to develop new-onset worsening diplopia following medial wall and floor decompression. Strabismus surgery involving extra-ocular muscle recession has, in turn, been shown to potentially worsen proptosis. Our experience with Type II patients who have already undergone medial wall and floor decompression and strabismus surgery found, when additional decompression is necessary, deep lateral wall decompression (DLWD) appears to have a low rate of post-operative primary-gaze diplopia. A case series of four Type II ophthalmic Graves' disease patients, all of whom had already undergone decompression and strabismus surgery, and went on to develop worsening proptosis or optic nerve compression necessitating further decompression thereafter. In all cases, patients were treated with DLWD. Institutional Review Board approval was granted by the University of Kansas. None of the four patients treated with this approach developed recurrent primary-gaze diplopia or required strabismus surgery following DLWD. While we still prefer to perform medial wall and floor decompression as the initial treatment for ophthalmic Graves' disease, for proptosis following consecutive strabismus surgery, DLWD appears to be effective with a low rate of recurrent primary-gaze diplopia.

  10. Spectral domain optical coherence tomography - Ultra-high speed, ultra-high resolution ophthalmic imaging

    NARCIS (Netherlands)

    Chen, T.; Cense, B.; Pierce, M. C.; Nassif, N. A.; Park, B. H.; Yun, S. H.; White, B.; Bouma, B. E.; Tearney, G. J.; de Boer, J.F.

    2005-01-01

    Objective: To introduce a new ophthalmic optical coherence tomography technology that allows unprecedented simultaneous ultra-high speed and ultra-high resolution. Methods: Using a superluminescent diode source, a clinically viable ultra-high speed, ultra-high resolution spectral domain optical

  11. 76 FR 51876 - Medical Devices; Ophthalmic Devices; Classification of the Eyelid Thermal Pulsation System

    Science.gov (United States)

    2011-08-19

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Part 886 Medical Devices; Ophthalmic Devices... Sterility and Shelf Life Testing. Adverse tissue reaction Biocompatibility. Electrical shock Electrical...; (3) Performance data should demonstrate the sterility of patient-contacting components and the shelf...

  12. OPHTHALMIC MANIFESTATIONS OF TAKAYASU ARTERITIS IN SOUTH INDIAN POPULATION

    Directory of Open Access Journals (Sweden)

    Nandhini Arumugam

    2017-06-01

    and the mean duration of the disease after which the patient developed eye or eye related symptomatology was 2 years. The commonest ocular manifestation was type 3 Takayasu retinopathy. Other posterior segment manifestations included, Type 1 and Type 3 Takayasu retinopathy, ocular ischaemic syndrome, retinal vasculitis and Anterior ischaemic optic neuropathy. The commonest anterior segment manifestation was posterior sub capsular cataract which was found in 33.3% of the patients. Fundus Fluorescein angiography was performed in 34 patients. CONCLUSION This study is to highlight the fact that Takayasu arteritis can present with multitudinous ocular manifestations which can be hypertensive or hypoperfusive and can lead to significant ocular morbidity if not for timely intervention. This study is to strongly emphasise routine and regular ophthalmic screening in patients with Takayasu arteritis at the time of diagnosis and also at adequate intervals to diagnose significant treatment related complications like steroid induced cataract at an early stage.

  13. Ultraviolet light absorption of an ophthalmic formulation with Aloe extracts.

    Science.gov (United States)

    Ji, Yimei; Jia, Jicheng

    2009-09-01

    Aloin and polysaccharide present in extracts of Aloe arborescens Miller were formulated into a binary solution to protect eyes from bacterial infection and ultraviolet radiation (UVR). The UVR absorption spectrum was recorded from 190 to 440 nm using a UV spectrometer. The physical properties of the product were examined in terms of its appearance, odor, pH, viscosity, density, refractive index, and stability. The binary solution exhibited three absorption peaks in the UVA, B and C regions, respectively. Such UV absorption capability was attributed to the phenolic chromophores pertaining to aloin. The present study suggested that the formulated binary solution has potential application as an UV absorption agent with built-in antimicrobial activity.

  14. Effect of ophthalmic administration of S-596 (Arotinolol) on intraocular pressure and haemodynamics in health volunteers: comparison with timolol.

    Science.gov (United States)

    Nakashima, M; Uematsu, T; Takiguchi, Y; Hashimoto, H; Watanabe, I; Morioka, S; Hibino, T

    1985-01-01

    The effects on intraocular pressure (IOP) and haemodynamics of two beta-blockers, arotinolol and timolol, administered topically to the eye, were studied in 6 healthy volunteers in a cross-over trial. 0.5% timolol or 0.5% arotinolol ophthalmic solutions drop was instilled in both eyes of the volunteers at an interval of 48 hours. Timolol lowered IOP by about 31.9% 1 hour after administration and the effect continued until 3 h, whilst arotinolol lowered it significantly 2 h after instillation and the same maximum effect as that of timolol was obtained after 3 h. Arotinolol was detected in blood in all subject and timolol in blood in one subject, although it was found in all subjects in urine. Both drugs lowered heart rate at rest and attenuated the increase in the double product (products of blood pressure and heart rate) at exercise. The effect of timolol on the double products was larger. Thus, arotinolol and timolol decreased IOP to similar extent, although the maximal effect of arotinolol was delayed. Arotinolol as well as timolol affected haemodynamics through absorption into circulation, but the former had less effect on haemodynamics during exercise.

  15. Limitations when use chloramphenicol-bcyclodextrins complexes in ophtalmic solutions buffered with boric acid/borax system

    Directory of Open Access Journals (Sweden)

    Todoran Nicoleta

    2014-12-01

    Full Text Available Chloramphenicol eye drops are commonly prescribed in concentrations of 0.5-1% in the treatment of infectious conjunctivitis. In terms of ophthalmic solution preparation, the major disadvantage of chloramphenicol consists in its low solubility in water. The solubility is increased by substances that form chloramphenicol-complexes, for example: boric acid/borax or cyclodextrins. Objective: Experimental studies aimed to evaluate the potential advantages of enhancing the solubility and stability of chloramphenicol (API by molecular encapsulation in b-cyclodextrin (CD, in formulation of ophthalmic solutions buffered with boric acid/borax system. Methods and Results: We prepared four APIb- CD complexes, using two methods (kneading and co-precipitation and two molar ratio of API/b-cyclodextrin (1:1 and 1:2. The formation of complexes was proved by differential scanning calorimetry (DSC and the in vitro dissolution tests. Using these compounds, we prepared eight ophthalmic solutions, formulated in two variants of chloramphenicol concentrations (0.4% and 0.5%. Each solution was analyzed, by the official methods, at preparation and periodically during three months of storing in different temperature conditions (4°C, 20°C and 30°C. Conclusions: Inclusion of chloramphenicol in b-cyclodextrin only partially solves the difficulties due to the low solubility of chloramphenicol. The protection of chloramphenicol molecules is not completely ensured when the ophthalmic solutions are buffered with the boric acid/borax system.

  16. The superior ophthalmic vein approach for the treatment of carotid-cavernous fistulas: our first experience

    Directory of Open Access Journals (Sweden)

    Chiriac A.

    2016-06-01

    Full Text Available Complex cavernous sinus fistulae (CCF are still a technical challenge to neurovascular team. The most commonly performed treatment consists in endovascular embolization of the lesion through an arterial or venous approach. Not always these conventional routes are feasible, requiring alternative routes. We report a case of a 44-year-old woman with a complex indirect (Barrow D carotid cavernous sinus fistula treated by two interventional sessions that imposing a retrograde direct transvenous approach via the superior ophthalmic vein.

  17. Comparison of sedation by intranasal dexmedetomidine and oral chloral hydrate for pediatric ophthalmic examination.

    Science.gov (United States)

    Cao, Qianzhong; Lin, Yiquan; Xie, Zhubin; Shen, Weihua; Chen, Ying; Gan, Xiaoliang; Liu, Yizhi

    2017-06-01

    Pediatric ophthalmic examinations can be conducted under sedation either by chloral hydrate or by dexmedetomidine. The objective was to compare the success rates and quality of ophthalmic examination of children sedated by intranasal dexmedetomidine vs oral chloral hydrate. One hundred and forty-one children aged from 3 to 36 months (5-15 kg) scheduled to ophthalmic examinations were randomly sedated by either intranasal dexmedetomidine (2 μg·kg-1 , n = 71) or oral chloral hydrate (80 mg·kg-1 , n = 70). The primary endpoint was successful sedation to complete the examinations including slit-lamp photography, tonometry, anterior segment analysis, and refractive error inspection. The secondary endpoints included quality of eye position, intraocular pressure, onset time, duration of examination, recovery time, discharge time, any side effects during examination, and within 48 h after discharge. Sixty-one children were sedated by dexmedetomidine with a success rate of 85.9%, which is significantly higher than that by chloral hydrate (64.3%) [OR 3.39, 95% CI: 1.48-7.76, P = 0.003]. Furthermore, children in the dexmedetomidine group displayed better eye position in anterior segment analysis than in chloral hydrate group median difference. All children displayed stable hemodynamics and none suffered hypoxemia in both groups. Oral chloral hydrate induced higher percentages of vomiting and altered bowel habit after discharge than dexmedetomidine. Intranasal dexmedetomidine provides more successful sedation and better quality of ophthalmic examinations than oral chloral hydrate for small children. © 2017 John Wiley & Sons Ltd.

  18. Efficacy of detergent and water versus bleach for disinfection of direct contact ophthalmic lenses.

    Science.gov (United States)

    Abbey, Ashkan M; Gregori, Ninel Z; Surapaneni, Krishna; Miller, Darlene

    2014-06-01

    Although manufacturers recommend cleaning ophthalmic lenses with detergent and water and then with a specific disinfectant, disinfectants are rarely used in ophthalmic practices. The aim of this pilot study was to evaluate the efficacy of detergent and water versus that of bleach, a recommended disinfectant, to eliminate common ocular bacteria and viruses from ophthalmic lenses. Three bacterial strains (Staphylococcus epidermidis, Corynebacterium straitum, and methicillin-resistant Staphylococcus aureus and 2 viral strains (adenovirus and herpes simplex virus [HSV] type-1) were individually inoculated onto 20 gonioscopy and laser lenses. The lenses were washed with detergent and water and then disinfected with 10% bleach. All the lenses were cultured after inoculation, after washing with detergent and water, and after disinfecting with the bleach. Bacterial cultures in thioglycollate broth were observed for 3 weeks, and viral cultures were observed for 2 weeks. The presence of viruses was also detected by multiplex polymerase chain reaction (PCR). All 20 lenses inoculated with S. epidermidis, C. straitum, adenovirus, and HSV-1 showed growth after inoculation but no growth after washing with detergent/water and after disinfecting with the bleach. All lenses showed positive HSV and adenovirus PCR results after inoculation and negative PCR results after washing with detergent/water and after disinfecting with bleach. All methicillin-resistant S. aureus-contaminated lenses showed growth after inoculation and no growth after washing with detergent and water. However, 1 lens showed positive growth after disinfecting with bleach. Cleaning with detergent and water seemed to effectively eliminate bacteria and viruses from the surface of contaminated ophthalmic lenses. Further studies are warranted to design practical disinfection protocols that minimize lens damage.

  19. Diode-light transillumination for ophthalmic plaque localization around juxtapapillary choroidal melanomas.

    Science.gov (United States)

    Finger, P T; Iezzi, R; Esteveo, M L; Szechter, A; Rosen, R B; Berson, A

    1999-07-01

    An evaluation of plaque-mounted diode-light transillumination (DLT) for localization of episcleral plaques beneath juxtapapillary tumors. Two patients scheduled for radiotherapy for juxtapapillary melanomas were offered DLT as an additional method of ophthalmic plaque localization. Plaques were constructed by affixing 4 non-heat producing, light-emitting diodes with their apertures flush with the episcleral outer surface of the plaque's rim. Bio-implantable epoxy was used to encapsulate the electronic components. Then the plaques were loaded with 103Pd seeds. After the eye-plaques were sewn to the episclera covering the base of the intraocular tumors; the diode-lights were illuminated, viewed and recorded. Photodocumentation of the relative position of the 4 lights around tumor's base was obtained in both cases. Digital images of plaque-mounted diode retro-transillumination were obtained. No evidence of diode-light toxicity was noted. Both tumors were found to be covered by the ophthalmic plaques. Juxtapapillary tumors are often difficult or impossible to visualize with standard transillumination techniques and have been associated with poor local control rates. We have developed plaque-mounted DLT in an effort to improve ophthalmic plaque localization. Retrobulbar transillumination was viewed by indirect ophthalmoscopy and recorded with video-imaging. This technique provides unique photographic documentation of episcleral plaque localization beneath juxtapapillary tumors.

  20. Surface tension examination of various liquid oral, nasal, and ophthalmic dosage forms.

    Science.gov (United States)

    Han, Kimberly; Woghiren, Osakpolor E; Priefer, Ronny

    2016-01-01

    Surface tension at the surface-to-air interface is a physico-chemical property of liquid pharmaceutical formulations that are often overlooked. To determine if a trend between surface tension and route of administration exists, a suite of oral, nasal, and ophthalmic drug formulations were analyzed. The surface tension at the surface-to-air interface of the oral formulations studied were in or above the range of the surface tension of gastric, duodenum, and jejunum fluids. The range of surface tensions for oral formulations were 36.6-64.7 dynes/cm. Nasal formulations had surface tensions below that of the normal mucosal lining fluid with a range of 30.3-44.9 dynes/cm. Ophthalmic OTC formulations had the largest range of surface tensions at the surface-to-air interface of 34.3-70.9 dynes/cm; however, all formulations indicated for treatment of dry eye had surface tensions higher than that of normal tears, while those for treatment of red eye had surface tensions below. Therefore, surface tension at the surface-to-air interface of liquid formulations is dependent on the route of administration, environment at site of introduction, and for ophthalmics, what the formulation is indicated for.

  1. Review of hydroxypropyl cellulose ophthalmic inserts for treatment of dry eye

    Directory of Open Access Journals (Sweden)

    Nguyen T

    2011-05-01

    Full Text Available Theresa Nguyen, Robert LatkanyDry Center, Physician Eyecare of New York, New York, NY, USAAbstract: Dry eye syndrome is a prevalent disease that affects visual acuity, activities of daily living, and quality of life. A number of contributory factors affect the severity of dry eye syndrome, including autoimmune disease, environmental surroundings, contact lens use, hormonal changes, anatomical features, chronic inflammation, infections, and iatrogenic factors, such as medications or surgery. Symptoms may include intermittent or constant blurry vision, discomfort, burning, foreign body sensation, hyperemia, dryness, and photophobia. The severity of dry eye syndrome can range from very mild disease to extremely severe cases with vision-threatening consequences. A variety of dry eye treatment modalities exist to address the different causes, symptoms, and consequences of ocular surface disease, including artificial tears, lubricating gels, ophthalmic inserts, anti-inflammatory drops, and surgical procedures. In this paper, an assortment of literature pertaining to the treatment of dry eye syndrome, in particular hydroxypropyl cellulose ophthalmic inserts, is reviewed. These inserts can be used effectively as monotherapy, or in conjunction with other therapies, and should be considered in the treatment of dry eye syndrome.Keywords: hydroxypropyl cellulose ophthalmic inserts, dry eye, punctal occlusion, ocular surface disease

  2. Ophthalmic immunoglobulin G4-related disease IgG4-RD Current concepts.

    Science.gov (United States)

    Mulay, Kaustubh; Wick, Mark R

    2016-05-01

    IgG4-related disease (IgG4-RD) is a distinct entity that frequently occurs in an ophthalmic location. As such, IgG4-RD is not limited to the orbit but may also involve other anatomical structures in and around the eye. Hence, the term 'ophthalmic IgG4-RD' is preferred over 'orbital IgG4-RD.' A high level of suspicion for the diagnosis can be derived from careful clinicoradiologic examination; the use of immunohistochemical staining for IgG4 in the context of characteristic histopathologic features is needed to reach a correct diagnosis. Recently described diagnostic criteria for ophthalmic IgG4-RD address subtle, yet significant, differences from IgG4-RD as seen in other systemic sites. Serum IgG4 titers are neither sensitive nor specific for the diagnosis of IgG4-RD and should not relied upon solely. Although most cases respond well to therapy with glucocorticoids, refractoriness to treatment and relapses are common. They necessitate the use of additional immunotherapy in such patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Needle Segmentation in Volumetric Optical Coherence Tomography Images for Ophthalmic Microsurgery

    Directory of Open Access Journals (Sweden)

    Mingchuan Zhou

    2017-07-01

    Full Text Available Needle segmentation is a fundamental step for needle reconstruction and image-guided surgery. Although there has been success stories in needle segmentation for non-microsurgeries, the methods cannot be directly extended to ophthalmic surgery due to the challenges bounded to required spatial resolution. As the ophthalmic surgery is performed by finer and smaller surgical instruments in micro-structural anatomies, specifically in retinal domains, difficulties are raised for delicate operation and sensitive perception. To address these challenges, in this paper we investigate needle segmentation in ophthalmic operation on 60 Optical Coherence Tomography (OCT cubes captured during needle injection surgeries on ex-vivo pig eyes. Furthermore, we developed two different approaches, a conventional method based on morphological features (MF and a specifically designed full convolution neural networks (FCN method, moreover, we evaluate them on the benchmark for needle segmentation in the volumetric OCT images. The experimental results show that FCN method has a better segmentation performance based on four evaluation metrics while MF method has a short inference time, which provides valuable reference for future works.

  4. Wideband Electrically-Pumped 1050 nm MEMS-Tunable VCSEL for Ophthalmic Imaging.

    Science.gov (United States)

    John, Demis D; Burgner, Christopher B; Potsaid, Benjamin; Robertson, Martin E; Lee, Byung Kun; Choi, Woo Jhon; Cable, Alex E; Fujimoto, James G; Jayaraman, Vijaysekhar

    2015-08-15

    In this paper, we present a 1050 nm electrically-pumped micro-electro-mechanically-tunable vertical-cavity-surface-emitting-laser (MEMS-VCSEL) with a record dynamic tuning bandwidth of 63.8 nm, suitable for swept source optical coherence tomography (SS-OCT) imaging. These devices provide reduced cost & complexity relative to previously demonstrated optically pumped devices by obviating the need for a pump laser and associated hardware. We demonstrate ophthalmic SS-OCT imaging with the electrically-pumped MEMS-VCSEL at a 400 kHz axial scan rate for wide field imaging of the in vivo human retina over a 12 mm × 12 mm field and for OCT angiography of the macula over 6 mm × 6 mm & 3 mm × 3 mm fields to show retinal vasculature and capillary structure near the fovea. These results demonstrate the feasibility of electrically pumped MEMS-VCSELs in ophthalmic instrumentation, the largest clinical application of OCT. In addition, we estimate that the 3 dB coherence length in air is 225 meters ± 51 meters, far greater than required for ophthalmic SS-OCT and suggestive of other distance ranging applications.

  5. Financial return-on-investment of ophthalmic interventions: a new paradigm.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Lieske, P Alexander

    2014-05-01

    Although the patient value gain (improvement in quality-of-life and/or length-of-life) has been highlighted in Value-based Medicine cost-utility analyses, the financial value gain associated with healthcare interventions has received less emphasis. It is important for professional healthcare providers to realize their interventions often confer a large financial return-on-investment (ROI) to society. The societal costs associated with vitreoretinal and other ophthalmic interventions include: direct ophthalmic medical costs expended (hospital, physician, drug, diagnostic testing and so forth), direct medical costs saved (decreased costs for depression, injury, skilled nursing facility, nursing home and others), direct nonmedical costs saved (decreased costs for caregivers, transportation, residence costs, moving costs, and others), and indirect medical costs saved (improving employment incidence and wages). The financial ROI for direct ophthalmic medical costs expended for ranibizumab therapy for neovascular age-related macular degeneration is 450%, whereas that for cataract surgery is 4500% and for medical open-angle glaucoma therapy is 4000%. Many costs gained add to the Gross Domestic Product and increase the wealth of the nation. Many vitreoretinal and other ophthalmologic interventions confer considerable patient value, but also result in a large financial ROI to society. This financial ROI increases the wealth of the nation.

  6. Ophthalmic artery chemosurgery for less advanced intraocular retinoblastoma: five year review.

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    David H Abramson

    Full Text Available BACKGROUND: Ophthalmic artery chemosurgery (OAC for retinoblastoma was introduced by us 5 years ago for advanced intraocular retinoblastoma. Because the success was higher than with existing alternatives and systemic side effects limited we have now treated less advanced intraocular retinoblastoma (Reese-Ellsworth (RE I-III and International Classification Retinoblastoma (ICRB B and C. METHODOLOGY/PRINCIPAL FINDINGS: Retrospective review of 5 year experience in eyes with Reese Ellsworth (Table 1 I (7 eyes, II (6 eyes or III (6 eyes and/or International Classification (Table 2 B (19 eyes and C (11 eyes treated with OAC (melphalan with or without topotecan introduced directly into the ophthalmic artery. Patient survival was 100%. Ocular event-free survival was 100% for Reese-Ellsworth Groups I, II and III (and 96% for ICRB B and C at a median of 16 months follow-up. One ICRB Group C (Reese-Ellsworth Vb eye could not be treated on the second attempt for technical reasons and was therefore enucleated. No patient required a port and only one patient required transfusion of blood products. The electroretinogram (ERG was unchanged or improved in 14/19 eyes. CONCLUSIONS/SIGNIFICANCE: Ophthalmic artery chemosurgery for retinoblastoma that was Reese-Ellsworth I, II and III (or International Classification B or C was associated with high success (100% of treatable eyes were retained and limited toxicity with results that equal or exceed conventional therapy with less toxicity.

  7. Maternal ophthalmic artery Doppler velocimetry in pre-eclampsia in Southwestern Nigeria

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    Olatunji RB

    2015-07-01

    Full Text Available Richard Busayo Olatunji,1 Ademola Joseph Adekanmi,1 Millicent Olubunmi Obajimi,1 Olumuyiwa Adebola Roberts,2 Temitope Olumuyiwa Ojo3 1Department of Radiology, 2Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, 3Department of Community Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria Background: Pre-eclampsia (PE poses a serious challenge to maternal and fetal health in Africa. It is associated with hemodynamic changes that may affect the internal carotid/ophthalmic artery circulation with consequent neuro-ophthalmic manifestations. Ophthalmic artery Doppler (OAD ultrasound is an important tool that can be used to detect hemodynamic changes in PE and monitor its severity. In this study, we evaluated hemodynamic changes on OAD ultrasound in the ophthalmic arteries of pre-eclamptic women and compared these with values in healthy pregnant women. Methods: OAD parameters, such as, peak systolic velocity, peak diastolic velocity, end diastolic velocity, pulsatility index, and peak ratio, were measured on transorbital triplex ultrasound scan with a 7–10 MHz multifrequency linear transducer in 42 consenting pre-eclamptic patients and 41 pregnant controls matched for maternal age, gestational age, and parity at the Department of Radiology, University College Hospital, Ibadan. Univariate, bivariate, and receiver operating characteristic curve data analyses were performed. P<0.05 was considered to be statistically significant. Results: Mean resistivity index, pulsatility index, and peak systolic velocity were significantly lower in pre-eclamptic patients than in the controls. Mean peak diastolic velocity, end diastolic velocity, and peak ratio were significantly higher in the pre-eclamptic group. The receiver operating characteristic curve showed that the resistivity index (sensitivity 75%, specificity 77.8% could distinguish mild from severe PE while the peak ratio

  8. Dose uniformity of topical corticosteroid preparations: difluprednate ophthalmic emulsion 0.05% versus branded and generic prednisolone acetate ophthalmic suspension 1%

    Science.gov (United States)

    Stringer, William; Bryant, Roy

    2010-01-01

    Purpose To compare the dose uniformity of difluprednate ophthalmic emulsion 0.05% (Durezol®) with both branded and generic prednisolone acetate ophthalmic suspension 1% under different simulated patient usage conditions. Methods Drug concentrations of difluprednate emulsion, branded prednisolone acetate suspension (Pred Forte®) and generic prednisolone acetate suspension following three storage conditions (upright, then shaken; upright, not shaken; inverted, not shaken) were analyzed by high performance liquid chromatography assay and results were reported as percent of declared concentration. Two drops were dispensed every four hours four times daily. Results Regardless of bottle orientation and shaking, all difluprednate emulsion concentrations at each time point analyzed were within 15% of declared concentration. Both branded and generic prednisolone acetate suspension concentrations varied substantially throughout the study. For the bottle stored upright and not shaken, 46% of the branded concentrations were not within 15% of declared concentration; for the bottle stored upright and shaken prior to use, 60% failed to meet this criterion. None of the branded concentrations from the inverted and not shaken bottle was within 15% of declared concentration. Generic prednisolone concentrations demonstrated the poorest dose uniformity, with 96% of the concentrations from the inverted and not shaken bottle not within 15% of declared concentration; 94% of the concentrations from the upright and shaken bottle and 87% from the upright and not shaken bottle similarly failed to meet this criterion. Conclusions Dose uniformity of Durezol emulsion was predictable in all simulated patient usage conditions, whereas the drop concentrations of Pred Forte and generic prednisolone acetate suspensions were highly variable throughout the study. Drop concentrations are more predictable with Durezol emulsion than with either prednisolone acetate suspension. PMID:20957058

  9. Dose uniformity of topical corticosteroid preparations: difluprednate ophthalmic emulsion 0.05% versus branded and generic prednisolone acetate ophthalmic suspension 1%

    Directory of Open Access Journals (Sweden)

    William Stringer

    2010-09-01

    Full Text Available William Stringer1, Roy Bryant21Module 3 Pharma Services, St. Petersburg, Florida; 2Encompass Pharmaceutical Services, Norcross, Georgia, USAPurpose: To compare the dose uniformity of difluprednate ophthalmic emulsion 0.05% (Durezol® with both branded and generic prednisolone acetate ophthalmic suspension 1% under different simulated patient usage conditions.Methods: Drug concentrations of difluprednate emulsion, branded prednisolone acetate suspension (Pred Forte® and generic prednisolone acetate suspension following three storage conditions (upright, then shaken; upright, not shaken; inverted, not shaken were analyzed by high performance liquid chromatography assay and results were reported as percent of declared concentration. Two drops were dispensed every four hours four times daily.Results: Regardless of bottle orientation and shaking, all difluprednate emulsion concentrations at each time point analyzed were within 15% of declared concentration. Both branded and generic prednisolone acetate suspension concentrations varied substantially throughout the study. For the bottle stored upright and not shaken, 46% of the branded concentrations were not within 15% of declared concentration; for the bottle stored upright and shaken prior to use, 60% failed to meet this criterion. None of the branded concentrations from the inverted and not shaken bottle was within 15% of declared concentration. Generic prednisolone concentrations demonstrated the poorest dose uniformity, with 96% of the concentrations from the inverted and not shaken bottle not within 15% of declared concentration; 94% of the concentrations from the upright and shaken bottle and 87% from the upright and not shaken bottle similarly failed to meet this criterion.Conclusions: Dose uniformity of Durezol emulsion was predictable in all simulated patient usage conditions, whereas the drop concentrations of Pred Forte and generic prednisolone acetate suspensions were highly variable

  10. Improving sustained drug delivery from ophthalmic lens materials through the control of temperature and time of loading.

    Science.gov (United States)

    Topete, Ana; Oliveira, Andreia S; Fernandes, A; Nunes, T G; Serro, A P; Saramago, B

    2018-02-14

    Although the possibility of using drug-loaded ophthalmic lens to promote sustained drug release has been thoroughly pursued, there are still problems to be solved associated to the different alternatives. In this work, we went back to the traditional method of drug loading by soaking in the drug solution and tried to optimize the release profiles by changing the temperature and the time of loading. Two materials commercially available under the names of CI26Y and Definitive 50 were chosen. CI26Y is used for intraocular lenses (IOLs) and Definitive 50 for soft contact lenses (SCLs). Three drugs were tested: an antibiotic, moxifloxacin, and two anti-inflammatories, diclofenac and ketorolac. Sustained drug release from CI26Y disks for, at least 15 days, was obtained for moxifloxacin and diclofenac increasing the loading temperature up to 60 °C or extending the loading time till two months. The sustained release of ketorolac was limited to about 8 days. In contrast, drug release from Definitive 50 disks could not be improved by changing the loading conditions. An attempt to interpret the impact of the loading conditions on the drug release behavior was done using solid-state NMR and differential scanning calorimetry. These studies suggested the establishment of reversible, endothermic interactions between CI26Y and the drugs, moxifloxacin and diclofenac. The loading temperature had a slight effect on the mechanical and optical properties of drug loaded CI26Y samples, which still kept adequate properties to be used as IOL materials. The in vivo efficacy of CI26Y samples, drug loaded at 60 °C for two weeks, was predicted using a simplified mathematical model to estimate the drug concentration in the aqueous humor. The estimated concentrations were found to comply with the therapeutic needs, at least, for moxifloxacin and diclofenac. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Ophthalmic Artery Doppler Prediction of Preeclampsia: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kalafat, Erkan; Laoreti, Ariana; Khalil, Asma; Da Silva Costa, Fabricio; Thilaganathan, Basky

    2018-01-12

    To determine the accuracy of ophthalmic artery Doppler in pregnancy for the prediction of preeclampsia. MEDLINE (1947-2017), EMBASE (1974-2017), CINAHL (inception-2017) and the Cochrane Library (inception-2017) were searched for relevant citations without language restrictions. Two reviewers independently selected studies that evaluated the accuracy of ophthalmic artery Doppler to predict the development of preeclampsia and performed data extraction to construct 2 × 2 tables. Individual patient data was obtained from the authors where available. A bivariate random-effects model was used for the quantitative synthesis of data. In total, 87 citations matched the search criteria. After exclusions, three studies (n=1119 pregnancies) were included for analysis. All included studies had clear descriptions of the index and reference tests, avoidance of verification bias and adequate follow-up. Individual patient data was obtained for all the included studies. The first diastolic peak velocity of ophthalmic artery Doppler at the cutoff of 23.3cm/s showed modest sensitivity (61.0%, 95% confidence interval: 44.2%-76.1%) and a specificity (73.2%, 95% confidence interval: 66.9%-78.7%) for the prediction of early-onset preeclampsia (area under the curve 0.68, confidence interval: 0.61-0.76). The first diastolic peak velocity had a much lower sensitivity for the prediction of late-onset preeclampsia (39.0%, 95% confidence interval: 20.6%-61.0%) with a similar specificity (73.2, 95% confidence interval: 66.9%-78.7%) and a lower area under the curve (0.58, confidence interval: 0.52-0.65). The pulsatility index of the ophthalmic artery didn't obtain a clinically useful sensitivity and specificity levels at any cutoff for early- or late-onset preeclampsia. A peak ratio above 0.65 showed a similar diagnostic accuracy compared to the first diastolic peak velocity with an area under the curve of 0.67 (95% confidence interval: 0.58-0.77) for early onset disease and 0.57 (95% confidence

  12. CADS grading scale: towards better grading of ophthalmic involvement in facial nerve paralysis.

    Science.gov (United States)

    Malhotra, Raman; Ziahosseini, Kimia; Litwin, Andre; Nduka, Charles; El-Shammah, Nora

    2016-06-01

    Ophthalmologists lack a facial nerve grading instrument (FNGI) that comprehensively encompasses the ophthalmic sequelae of facial nerve paralysis (FNP). Assessment and management of ophthalmic sequelae remains inconsistent, and outcomes of clinical studies are incomparable. We have developed and successfully adopted an FNGI based on four aspects of periorbital involvement: cornea, asymmetry, dynamic function and synkinesis. This CADS classification is specific for periorbital involvement, with objective and subjective parameters, to standardise grading. We present this classification and the results of a validation study in clinical practice. A cross-sectional, validation study. Two clinicians independently assessed and graded each patient on the same day, blinded to each other's grading. Each grader assigned a score to each of four parameters: C (0-3, ±a), A (0-2), D (0-3), S (0-2). Thirty patients (19 females, mean age 60, range 30-84 years) with unilateral facial paralysis were graded. A total of 60 assessments were conducted. CADS scores ranged from C0A0D1S1 to C3aA2D3S0. In the first 30 assessments (of the first 15 patients), the two assessors disagreed over the corneal grading in four patients. The last 30 assessments of 15 patients showed complete agreement in all four parameters of the grading scale. The overall inter-observer agreement was 86.7% for cornea, 93.3% for resting asymmetry, 93.3% for dynamic function and 86.7% for synkinesis. After the first six patients, Cohen's κ reached 1 for all but synkinesis that ranged between 0.9 and 1. We present a validation study of an FNGI specifically designed for ophthalmic involvement of FNP. Objective and subjective parameters helped standardise grading and management planning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Persistent dorsal ophthalmic artery arising from the internal carotid artery: Report of three cases

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    Shin, Jae Hwan; Lee, Ghi Jai; Shim, Jae Chan; Lee, Kyoung Eun; Kim, Ho Kyun; Suh, Jung Ho [Dept. of Radiology, Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    Normally, the ophthalmic artery (OA) arises from the supraclinoid segment of the internal carotid artery (ICA) and enters the orbit via the optic canal. A persistent dorsal OA is a rare variation that originates from the cavernous segment of the ICA and enters the orbit via the superior orbital fissure. To the best of our knowledge, persistent dorsal OA has not been described in the Korean literature. In this paper, we report three cases of persistent dorsal OA with review of the literature on embryogenesis and other origins of the OA.

  14. [Research and realization of signal processing algorithms based on FPGA in digital ophthalmic ultrasonography imaging].

    Science.gov (United States)

    Fang, Simin; Zhou, Sheng; Wang, Xiaochun; Ye, Qingsheng; Tian, Ling; Ji, Jianjun; Wang, Yanqun

    2015-01-01

    To design and improve signal processing algorithms of ophthalmic ultrasonography based on FPGA. Achieved three signal processing modules: full parallel distributed dynamic filter, digital quadrature demodulation, logarithmic compression, using Verilog HDL hardware language in Quartus II. Compared to the original system, the hardware cost is reduced, the whole image shows clearer and more information of the deep eyeball contained in the image, the depth of detection increases from 5 cm to 6 cm. The new algorithms meet the design requirements and achieve the system's optimization that they can effectively improve the image quality of existing equipment.

  15. Herpes simplex virus ophthalmic disease induced using two different methods of mice inoculation

    Directory of Open Access Journals (Sweden)

    Sílvia Regina Ferreira Gonçalves Pereira

    Full Text Available Two different procedures for inoculation of HSV on corneas of BALB/c mice were evaluated. The first was by the use of HSV suspensions directly on the corneas and the other was after corneal scarification. Animals by this later method presented greater morbidity and mortality than those of first group, suggesting that inoculation of HSV without scarification of the cornea should be the method of choice for the study of HSV ophthalmic infection. This model showed also be an efficient experimental system to testing antiviral drugs.

  16. Ganciclovir ophthalmic gel 0.15%: safety and efficacy of a new treatment for herpes simplex keratitis.

    Science.gov (United States)

    Kaufman, Herbert E; Haw, Weldon H

    2012-07-01

    Until the availability of ganciclovir ophthalmic gel in 2009, the only option for treating herpes simplex (HSV) keratitis in the USA has been trifluridine (TFT), a compound with tolerability issues related to its nonselective inhibition of DNA replication in both normal cells and virus-infected cells. Ganciclovir has selective pharmacologic activity on viral thymidine kinase and a lower potential for toxicity to healthy human cells. Our objective was to evaluate safety and efficacy findings reported with the use of ganciclovir ophthalmic gel, both for HSV keratitis and other potential clinical indications. Clinical and preclinical data with ganciclovir were identified through a comprehensive electronic search of PubMed and Medline, using the search terms ganciclovir, ganciclovir 0.15% ophthalmic gel, acyclovir, acyclovir ointment 3%, herpes simplex keratitis, treatment of herpes simplex keratitis, and adenoviral keratoconjunctivitis. The authors were also granted access to previously unpublished ganciclovir surveillance safety data from Bausch & Lomb, Inc. No clinical data comparing ganciclovir ophthalmic gel to 1% trifluorothymidine (TFT) for HSV keratitis could be identified. Four international, randomized, multicenter clinical trials have demonstrated that ganciclovir gel is at least as effective as acyclovir ointment for the treatment of HSV keratitis. Ganciclovir gel was better tolerated, with lower rates of blurred vision, eye irritation, and punctate keratitis. Recent data also indicate it may hold promise as a treatment for adenoviral keratoconjunctivitis. Worldwide safety surveillance data collected over the past 10-15 years in over 30 countries suggests an extremely low rate of spontaneously reported adverse events with ganciclovir ophthalmic gel. Current data suggest that ganciclovir ophthalmic gel has similar efficacy as acyclovir ointment for the treatment of HSV keratitis and is better tolerated. Clinical head-to-head studies comparing ganciclovir and

  17. Treatment of a cavernous sinus dural arteriovenous fistula by deep orbital puncture of the superior ophthalmic vein

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    Benndorf, G. [Neuroangiography, Department of Radiology, Charite, Humboldt University Berlin (Germany); Bender, A. [Neuroradiology, Department of Radiology, Charite, Humboldt University Berlin (Germany); Campi, A. [Dept. of Neuroradiology, Hospital San Raffaele, Milan (Italy); Menneking, H. [Dept. of Maxillofacial Surgery, Charite, Humboldt University Berlin (Germany); Lanksch, W.R. [Department of Neurosurgery, Charite, Humboldt University Berlin, Augustenburger Platz 1, 13 353 Berlin (Germany)

    2001-06-01

    In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula. (orig.)

  18. Cationic lipid emulsions as potential bioadhesive carriers for ophthalmic delivery of palmatine.

    Science.gov (United States)

    Yin, Juntao; Xiang, Cuiyu; Lu, Guangxiu

    2016-12-01

    Palmatine (PM) is a potent anti-infective agent used to treat eye diseases. However, PM is less effective for ocular application due to short residence time within the eyes. This study aimed to develop a cationic lipid emulsions (CLEs) for ophthalmic delivery of PM and evaluate its suitability in infection treatment. PM-loaded CLEs (PM-CLEs) were prepared through emulsifying/high-pressure homogenisation and characterised by particle size, ζ potential and morphology. The resulting PM-CLEs possessed a particle size of 192 nm and ζ potential of 45 mV around. In vitro release illustrated that PM was released less from CLEs. Corneal bioadhesion test showed that PM-CLEs exhibited an enhanced ocular residence time. Improved anti-infective activity was achieved in the model of fungus-induced keratitis. Furthermore, PM-CLEs demonstrated predominant cellular uptake and internalisation in the corneal epithelial cells. These results provide proof of concept that CLEs are promising bioadhesive carriers for ophthalmic delivery of PM.

  19. Use of an ophthalmic formulation of megestrol acetate for the treatment of eosinophilic keratitis in cats.

    Science.gov (United States)

    Stiles, Jean; Coster, Martin

    2016-07-01

    To evaluate a compounded ophthalmic formulation of 0.5% megestrol acetate to treat eosinophilic keratitis in cats. Prospective study. Seventeen client owned cats with eosinophilic keratitis in one or both eyes. Eosinophilic keratitis was confirmed by cytology. At each visit, fluorescein staining and photography were performed. Cats were initially treated q 8-12 h with 0.5% megestrol acetate in an aqueous base. Serum glucose was measured at the first or second reexamination. Fifteen of 17 (88%) cats had a positive response to treatment, with 6 of 17 (35%) having complete resolution at the first reexamination (2-4 weeks). Two of 17 (12%) cats did not respond to treatment. Most cats required a treatment frequency of once daily to once weekly to maintain remission of disease. No ocular irritation or systemic side effects were noted in any cat. The use of an ophthalmic formulation of 0.5% megestrol acetate is a viable option for treating feline eosinophilic keratitis. © 2016 American College of Veterinary Ophthalmologists.

  20. Hospital management and clinical factors associated with ophthalmic involvement in toxic epidermal necrolysis.

    Science.gov (United States)

    Hii, Belinda W; Mahar, Patrick D; Wasiak, Jason; Hall, Anthony J; Paul, Eldho; Marsh, Philip; Buck, Danielle A; Cleland, Heather

    2014-08-01

    Toxic Epidermal Necrolysis (TEN) is characterized by an exfoliative rash resembling widespread burns. It is often considered on the same spectrum of disease as Stevens Johnson Syndrome but is distinguished by epidermal detachment of >30% of total body surface area (TBSA). Ocular involvement of TEN may result in complications requiring intensive topical, systemic or operative treatment. This study aimed to identify the current hospital management of, and factors associated with, ophthalmic involvement in adult TEN patients. All adult TEN patients admitted to the Victorian Adult Burns Service over an 12-year period were included. Retrospective data analyzed included patient demographics, site of TEN involvement, % TBSA, complications, duration of ocular follow up and visual outcomes. TEN patients with and without ocular involvement were compared. Cutaneous involvement of the head and neck was found to be significantly associated with ocular involvement of TEN. Age, TBSA involvement, presence of a prodrome, and presence of comorbidities were not found to be significantly associated with ocular involvement. Management of ophthalmic involvement of TEN varied between patients. Clinicians should have a high index of suspicion for ocular involvement when exfoliation of the head and neck is present and should seek ophthalmological advice early in the course of disease. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  1. Declaring Conflict of Interest - Current State of Affairs in the Ophthalmic Literature.

    Science.gov (United States)

    Schaefer, Jamie Lea; Aubert Bonn, Noemie; Craenen, Geert

    2017-01-01

    The importance of transparency with financial ties in biomedical research is widely recognized, and most peer-reviewed journals require declarations of Conflicts of Interest (COI). Nonetheless, variability in the consistency of declarations of COI has been sparsely assessed. To assess consistency and rates of COI declarations in the ophthalmic literature and the effectiveness of journal COI policies. We analyzed consistency and completeness of declaration of COI in the ophthalmic literature and compared the levels of completeness to specific journal requirements. Six-hundred forty-two peer reviewed articles satisfied the inclusion criteria. In 64%, COIs were unreported, in 25% declaration of COI was incomplete, and 11% of the articles reviewed had complete declaration of COI. Of the 33 journals in which the most frequently published authors' articles appeared, 10 required the authors to complete the International Committee of Medical Journal Editors (ICMJE) form or an equivalent form, but this did not affect the rates of COI declaration. In a random sampling of the most frequently published authors in the field of ophthalmology, declaration of COI was low and highly inconsistent. Requiring a standardized COI form has no significant effect on the rate of accurate COI reporting. Our findings lend support to the growing body of literature that shows that journals and editors may need to take a more active role in ensuring accurate and consistent COI reporting.

  2. Human eye analytical and mesh-geometry models for ophthalmic dosimetry using MCNP6

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    Angelocci, Lucas V.; Fonseca, Gabriel P.; Yoriyaz, Helio, E-mail: hyoriyaz@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    Eye tumors can be treated with brachytherapy using Co-60 plaques, I-125 seeds, among others materials. The human eye has regions particularly vulnerable to ionizing radiation (e.g. crystalline) and dosimetry for this region must be taken carefully. A mathematical model was proposed in the past [1] for the eye anatomy to be used in Monte Carlo simulations to account for dose distribution in ophthalmic brachytherapy. The model includes the description for internal structures of the eye that were not treated in previous works. The aim of this present work was to develop a new eye model based on the Mesh geometries of the MCNP6 code. The methodology utilized the ABAQUS/CAE (Simulia 3DS) software to build the Mesh geometry. For this work, an ophthalmic applicator containing up to 24 model Amersham 6711 I-125 seeds (Oncoseed) was used, positioned in contact with a generic tumor defined analytically inside the eye. The absorbed dose in eye structures like cornea, sclera, choroid, retina, vitreous body, lens, optical nerve and optical nerve wall were calculated using both models: analytical and MESH. (author)

  3. Automated stereo vision instrument tracking for intraoperative OCT guided anterior segment ophthalmic surgical maneuvers.

    Science.gov (United States)

    El-Haddad, Mohamed T; Tao, Yuankai K

    2015-08-01

    Microscope-integrated intraoperative OCT (iOCT) enables imaging of tissue cross-sections concurrent with ophthalmic surgical maneuvers. However, limited acquisition rates and complex three-dimensional visualization methods preclude real-time surgical guidance using iOCT. We present an automated stereo vision surgical instrument tracking system integrated with a prototype iOCT system. We demonstrate, for the first time, automatically tracked video-rate cross-sectional iOCT imaging of instrument-tissue interactions during ophthalmic surgical maneuvers. The iOCT scan-field is automatically centered on the surgical instrument tip, ensuring continuous visualization of instrument positions relative to the underlying tissue over a 2500 mm(2) field with sub-millimeter positional resolution and <1° angular resolution. Automated instrument tracking has the added advantage of providing feedback on surgical dynamics during precision tissue manipulations because it makes it possible to use only two cross-sectional iOCT images, aligned parallel and perpendicular to the surgical instrument, which also reduces both system complexity and data throughput requirements. Our current implementation is suitable for anterior segment surgery. Further system modifications are proposed for applications in posterior segment surgery. Finally, the instrument tracking system described is modular and system agnostic, making it compatible with different commercial and research OCT and surgical microscopy systems and surgical instrumentations. These advances address critical barriers to the development of iOCT-guided surgical maneuvers and may also be translatable to applications in microsurgery outside of ophthalmology.

  4. Superior Ophthalmic Vein Access for Embolization of an Indirect Carotid Cavernous Fistula.

    Science.gov (United States)

    Haider, Ali S; Garg, Prabhat; Leonard, Dean; Osumah, Tijani; Khan, Umair; Vayalumkal, Steven; Lee, Lyndon K; Nguyen, Phu; Gilliland, Grant; Layton, Kennith F

    2017-09-01

    Carotid cavernous fistulae (CCF) are defined as abnormal connections between the carotid circulation and cavernous sinus. CCFs can be categorized as being direct or indirect. Direct CCFs are usually associated with trauma, whereas indirect CCFs are associated with revascularization following cavernous sinus thrombosis. We present a case of a 53-year-old male who presented with tinnitus, proptosis, conjunctivitis, and blurry vision. The patient had a recent endovascular transvenous embolization that was only partially successful, with a residual carotid cavernous fistula draining to the left superior ophthalmic vein and multiple cortical veins. A physical examination of the patient showed elevated intraocular pressures bilaterally. The patient had a high-flow indirect carotid cavernous fistula with bilateral superior ophthalmic vein (SOV) and retrograde cortical vein drainage. The SOV was punctured with a micropuncture needle and was used to successfully gain access to the cavernous sinus. Multiple coils were placed in the posterior aspect of the sinus until there was complete occlusion of venous flow. Coils were packed up to the posterior aspect of the orbit near the junction of the cavernous sinus with the SOV, and the embolization was successful. Indirect CCFs have gradual onset and are usually low-flow. Low-flow CCFs might improve with medical management.Some CCFs may cause ocular manifestations and can be symptomatically managed with prism therapy or ocular patching for diplopia, lubrication for keratopathy, or topical agents for elevated intraocular pressures. However, patients presenting with persistent ocular morbidity may require surgical or endovascular intervention.

  5. Ophthalmic patients' utilization of technology and social media: an assessment to improve quality of care.

    Science.gov (United States)

    Aleo, Chelsea L; Hark, Lisa; Leiby, Benjamin; Dai, Yang; Murchison, Ann P; Martinez, Patricia; Haller, Julia A

    2014-10-01

    E-health tools have the potential to improve the quality of care for ophthalmic patients, many of whom have chronic conditions. However, little research has assessed ophthalmic patients' use or acceptance of technological devices and social media platforms for health-related purposes. The present study evaluated utilization of technological devices and social media platforms by eye clinic patients, as well as their willingness to receive health reminders through these technologies. A 31-item paper questionnaire was administered to eye clinic patients (n=843) at an urban, tertiary-care center. Questions focused on technology ownership, comfort levels, frequency of use, and preferences for receiving health reminders. Demographic data were also recorded. Eye clinic patients most commonly owned cellular phones (90%), landline phones (81%), and computers (80%). Overall, eye clinic patients preferred to receive health reminders through phone calls and e-mail and used these technologies frequently and with a high level of comfort. Less than 3% of patients preferred using social networking to receive health reminders. In addition, age was significantly associated with technology ownership, comfort level, and frequency of use (ptechnologies more frequently and with a higher comfort level (ptechnologies for appointment reminders, general eye and vision health information, asking urgent medical questions, and requesting prescription refills. Future controlled trials could further explore the efficacy of e-health tools for these purposes.

  6. Ophthalmic, clinical and visual electrophysiological findings in children born to mothers prescribed substitute methadone in pregnancy.

    Science.gov (United States)

    Hamilton, R; McGlone, L; MacKinnon, J R; Russell, H C; Bradnam, M S; Mactier, H

    2010-06-01

    There are growing concerns regarding visual outcome of infants exposed to opiates (including substitute methadone) and/or benzodiazepines in utero. We describe the combined ophthalmology and visual electrophysiology findings in 20 infants and children who had been exposed to substitute methadone and other drugs of misuse in utero. This was a descriptive case series of 20 patients, all of whom had been referred to a paediatric visual electrophysiology service because of concerns regarding visual function, and all of whom had been exposed to methadone in utero. All children underwent a full ophthalmic and orthoptic examination as well as visual electrophysiology testing deemed appropriate on an individual basis. A review was undertaken of paediatric case notes and of maternal antenatal urine toxicology. Ophthalmic abnormalities included reduced acuity (95%), nystagmus (70%), delayed visual maturation (50%), strabismus (30%), refractive errors (30%), and cerebral visual impairment (25%). Visual electrophysiology was abnormal in 60%. A quarter of the children had associated neurodevelopmental abnormalities. The majority of children with nystagmus (79%) had been treated for neonatal abstinence syndrome (NAS). Infants born to drug-misusing mothers prescribed methadone in pregnancy are at risk of a range of visual problems, the underlying causes of which are not clear. Those infants with NAS severe enough to receive pharmaceutical treatment may be at particular risk of developing nystagmus. The inclusion of visual electrophysiology in comprehensive visual assessment of children exposed to substance misuse in utero may help clarify the underlying causes by differentiating abnormalities of retinal and cortical origin.

  7. Cytotoxicity and mutagenicity of opthalmic solution preservatives and UVA radiation in L5178Y cells

    Energy Technology Data Exchange (ETDEWEB)

    Withrow, T.J.; Brown, N.T.; Hitchins, V.M.; Strickland, A.G. (Food and Drug Administration, Rockville, MD (USA). Center for Devices and Radiological Health)

    1989-09-01

    Four preservatives used in ophthalmic solutions were tested for toxic and mutagenic potential in mouse lymphoma cells with and without exposure of cells to ultraviolet A (UVA) radiation. The preservatives tested were benzalkonium chloride (BAK), chlorhexidine, thimerosal and ethylenediaminetetraacetic acid (EDTA). Cell survival and mutagenesis were measured using the L5178Y mouse lymphoma (TK{sup +/-}) system. Cells were exposed to varying amounts of preservatives for 1 h at 37{sup 0}C, and aliquots irradiated with UVA radiation (during exposure to preservative). Cells were then assayed for survival, and mutagenesis at the thymidine kinase (TK) locus. In concentrations commonly found in ophthalmic solutions, BAK, chlorhexidine, and thimerosal were toxic to cells, and thimerosal was slightly mutagenic. When cells were exposed to preservative and UVA radiation, chlorhexidine was mutagenic and the mutagenic activity of thimerosal was enhanced. (author).

  8. Erythromycin Ophthalmic

    Science.gov (United States)

    ... prevent bacterial infections of the eye in newborn babies. Erythromycin is in a class of medications called ... This branded product is no longer on the market. Generic alternatives may be available.

  9. Brimonidine Ophthalmic

    Science.gov (United States)

    ... may damage nerves and cause vision loss) and ocular hypertension (pressure in the eyes that is higher ... squeeze your eyelids. Place a finger on the tear duct and apply gentle pressure. Wipe any excess ...

  10. OPHTHALMIC EDUCATION

    African Journals Online (AJOL)

    2008-04-24

    Apr 24, 2008 ... Hammersmith Hospital London has been running magnetic resonance cholangiopancreatography (MRCP) Part 1. Part 2 and Program of All- inclusive Care for the Elder[3] revision courses for doctors and medical students for over 10years and consistently gets excellent feedbacks. They aim to provide ...

  11. Tetrahydrozoline Ophthalmic

    Science.gov (United States)

    ... drops and call your doctor immediately: headache sweating fast or irregular heartbeat nervousness If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting ...

  12. Atropine Ophthalmic

    Science.gov (United States)

    ... following symptoms, call your doctor immediately: fever irritability fast pulse irregular heartbeat mental confusion difficulty urinating If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting ...

  13. Dipivefrin Ophthalmic

    Science.gov (United States)

    ... of the following symptoms, call your doctor immediately: fast or irregular heartbeat chest pain wheezing difficulty breathing If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting ...

  14. Epinastine Ophthalmic

    Science.gov (United States)

    ... they are exposed to certain substances in the air). Epinastine is in a class of medications called ... of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, ...

  15. Bepotastine Ophthalmic

    Science.gov (United States)

    ... they are exposed to certain substances in the air). Bepotastine is in a class of medications called ... of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, ...

  16. Travoprost Ophthalmic

    Science.gov (United States)

    ... immediately wash the exposed area with soap and water.you should know that travoprost eye drops contain benzalkonium chloride, which can be absorbed by soft contact lenses. If you wear contact lenses, remove them before ...

  17. Sulfacetamide Ophthalmic

    Science.gov (United States)

    ... your vision is blurred. Do not drive a car or operate machinery if you are unable to ... to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in ...

  18. Apraclonidine Ophthalmic

    Science.gov (United States)

    ... Apraclonidine is in a class of medications called alpha-2-adrenergic agonists. It lowers the pressure in ... of these symptoms are severe or do not go away: red, swollen, itchy, or teary eyes eye ...

  19. Latanoprost Ophthalmic

    Science.gov (United States)

    ... in patients who already have some brown eye coloring. Latanoprost may also cause your eyelashes to grow ... your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting ...

  20. OPHTHALMIC EDUCATION

    African Journals Online (AJOL)

    2008-04-24

    Apr 24, 2008 ... hoped this will form a template on feature longitudinal studies directed at how much of ... Methods: It was a cross-sectional study of year five medical students. .... statistically significant difference between the ages of male and.

  1. Ophthalmic practice

    Directory of Open Access Journals (Sweden)

    Sue Stevens

    2005-03-01

    Full Text Available Eye health workers carry out many basic routine procedures. Sometimes bad practice develops and this, in turn, may lead to new members of staff learning unsafe methods. Community Eye Health Journal plans to run a series on practical procedures, when applicable, relating to the theme.

  2. Tafluprost Ophthalmic

    Science.gov (United States)

    ... you should know that there may be a difference in color between your eyes after using tafluprost. ... protect young children from poisoning, always lock safety caps and immediately place the medication in a safe ...

  3. Bimatoprost Ophthalmic

    Science.gov (United States)

    ... you should know that there may be a difference between your eyes after taking bimatoprost. Call your ... protect young children from poisoning, always lock safety caps and immediately place the medication in a safe ...

  4. Unoprostone Ophthalmic

    Science.gov (United States)

    ... itching of the eye dry eyes Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately: redness, swelling, discharge, or pain of the eye or eyelid changes in color vision, blurred vision, or other changes in vision Unoprostone ...

  5. 76 FR 71044 - Determination That TRAVATAN (Travoprost Ophthalmic Solution), 0.004%, Was Not Withdrawn From Sale...

    Science.gov (United States)

    2011-11-16

    ... products under an ANDA procedure. ANDA applicants must, with certain exceptions, show that the drug for... as the ``listed drug,'' which is a version of the drug that was previously approved. ANDA applicants... drug application (NDA). The only clinical data required in an ANDA are data to show that the drug that...

  6. Efficacy of brimonidine tartrate 0.2% ophthalmic solution in reducing halos after laser in situ keratomileusis.

    Science.gov (United States)

    Lee, Ji Hoon; You, Yong Sung; Choe, Chul Myong; Lee, Eun Suk

    2008-06-01

    To quantitatively evaluate the effect of brimonidine tartrate 0.2% (Alphagan) on halo and pupil size in patients who had symptomatic night-vision difficulties after laser in situ keratomileusis (LASIK). Nune Eye Hospital, Seoul, Korea. This study comprised 28 eyes of 14 patients with symptomatic night-vision difficulties after LASIK. Pupil diameter was measured with a Colvard pupillometer (Oasis Medical, Inc.). Quantitative analysis of halos was performed by measuring the area using a new computerized method. Pupil size and halo size were evaluated under scotopic and normal room light conditions. Alphagan was administered, and the effect was measured after 30 minutes and 1, 6, 12, and 24 hours. There was a statistically significant correlation between pupil size and halo size (r = 0.527; P<.0001; slope = 691.6 pixel/mm). Pupil size and halo size decreased significantly 30 minutes after Alphagan instillation under both luminance conditions (all P< .0001). Under normal room light, the pupil and halo remained decreased until the last measurement at 24 hours. Under scotopic conditions, the pupil returned to its preinstillation size at 24 hours while the halo remained decreased. The maximum effect on halos was observed after 6 hours, when the mean reduction over preinstillation size was 28.2% and 29.1% under normal room light conditions and scotopic conditions, respectively. Alphagan effectively reduced halo size and pupil size in postoperative LASIK patients with night-vision symptoms.

  7. 78 FR 27971 - Determination That REV-EYES (Dapiprazole Hydrochloride Ophthalmic Solution), 0.5%, Was Not...

    Science.gov (United States)

    2013-05-13

    ... this drug product should be revised to meet current standards, the Agency will advise ANDA applicants... amendments), which authorized the approval of duplicate versions of drug products under an ANDA procedure... include what is now section 505(j)(7) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355(j)(7...

  8. Update and clinical utility of alcaftadine ophthalmic solution 0.25% in the treatment of allergic conjunctivitis

    Directory of Open Access Journals (Sweden)

    Chigbu DI

    2015-07-01

    Full Text Available DeGaulle I Chigbu, Alissa M Coyne Pennsylvania College of Optometry Salus University, Elkins Park, PA, USA Abstract: Allergic disorders of the ocular surface are primarily characterized as IgE- and/or T-lymphocyte-mediated disorders that affect the cornea, conjunctiva, and eyelid. Approximately 40% of individuals in the developed countries have allergic conjunctivitis, and as such, it is the most common form of ocular allergy. Seasonal allergic conjunctivitis is the most prevalent type of allergic conjunctivitis that impacts the quality of life of patients. This article reviews the pharmacology, pharmacodynamics, pharmacokinetics, clinical trials, clinical efficacy, and safety of alcaftadine. Histamine and the pathological mechanism of ocular allergy will be briefly reviewed with the intent of providing a background for the detailed discussion on the clinical utility of alcaftadine in allergic conjunctivitis. The Medline PubMed, Elsevier Science Direct, and Google Scholar databases were used to search for evidence-based literature on histamine and immunopathological mechanism of allergic conjunctivitis, as well as on pharmacology, pharmacodynamics, pharmacokinetics, clinical trials, and clinical efficacy of alcaftadine. The treatment and management goals of allergic conjunctivitis are to prevent or minimize the inflammatory cascade associated with allergic response in the early stages of the pathological mechanism. It is of note that activation of histamine receptors on immune and nonimmune cells are associated with allergen-induced inflammation of the conjunctiva and its associated ocular allergic manifestations, including itching, edema, hyperemia, and tearing. Alcaftadine is an efficacious multiple action antiallergic therapeutic agent with inverse agonist activity on H1, H2, and H4 receptors, as well as anti-inflammatory and mast cell stabilizing effects that could provide therapeutic benefits to patients with allergic conjunctivitis. Keywords: alcaftadine, allergic conjunctivitis, histamine, immunopathological mechanisms, ocular allergies

  9. 21 CFR 510.410 - Corticosteroids for oral, injectable, and ophthalmic use in animals; warnings and labeling...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Corticosteroids for oral, injectable, and... RELATED PRODUCTS NEW ANIMAL DRUGS Requirements for Specific New Animal Drugs § 510.410 Corticosteroids for... ophthalmic use of corticosteroid animal drugs. The use of these drugs administered orally or by injection has...

  10. Relationship between the Direction of Ophthalmic Artery Blood Flow and Ocular Microcirculation before and after Carotid Artery Stenting

    Directory of Open Access Journals (Sweden)

    Masashi Ishii

    2016-01-01

    Full Text Available When internal carotid artery stenosis is accompanied by ocular ischemic syndrome, intervention is recommended to prevent irreversible visual loss. In this study, we used laser speckle flowgraphy to measure the ocular microcirculation in the optic nerve head before and after carotid artery stenting (CAS of 40 advanced internal carotid stenosis lesions from 37 patients. The aim was to investigate the relationship between ocular microcirculation and the direction of ophthalmic artery blood flow obtained by angiography. We found that there was a significant increase in blood flow after CAS (P=0.003. Peak systolic velocity as an indicator of the rate of stenosis was also significantly higher in the group with retrograde/undetected flow of the ophthalmic artery than in the group with antegrade flow (P=0.002. In all cases where retrograde flow of the ophthalmic artery was observed before stenting, the flow changed to antegrade after stenting. Through the use of laser speckle flowgraphy, this study found that CAS can improve ocular microcirculation. Furthermore, while patients displaying retrograde flow of the ophthalmic artery before stenting have a poor prognosis, CAS corrected the flow to antegrade, suggesting that visual loss can be prevented by improving the ocular microcirculation.

  11. Protective Effect of Tea Polyphenol Ophthalmic Gel on Lens Epithelial Cells in Rabbits with Silicone Oil Tamponade after Vitrectomy

    Directory of Open Access Journals (Sweden)

    Xianzhen Ma

    2014-01-01

    Full Text Available Purpose. The aim of this study was to investigate the effect of tea polyphenols (TP ophthalmic gel on lens epithelial cells (LECs in rabbits with silicone oil tamponade after vitrectomy. Methods. In this study, unilateral vitrectomy with silicone oil tamponade was performed using 2-month-old New Zealand white rabbits (n = 72; meanwhile, age-matched nonoperated rabbits (n = 18 were used as controls. The TP ophthalmic gel was administered topically in the surgical eyes till they were sacrificed. On days 45 and 90 after operation, the levels of reactive oxygen species (ROS, mitochondrial membrane potential (ΔΨm, and apoptosis of LECs were analyzed, respectively. Meanwhile, caspase-3 mRNA and protein levels were also determined. Results. The results indicate that the levels of ROS and apoptosis were elevated for LECs in rabbits after operation, whereas ΔΨm was decreased. Caspase-3 was apparently increased at both mRNA and protein levels. Treatment of TP ophthalmic gel could reduce the generation of ROS, maintain ΔΨm, inhibit the overexpression of caspase-3, and thus decrease the apoptosis of LECs of rabbits after operation. Conclusions. TP ophthalmic gel can efficiently inhibit caspase-3 overexpression, reduce the apoptosis of LECs, and prevent LECs from damage. Our result provides a new approach to prevent the development of complicated cataract after vitrectomy.

  12. A European perspective on costs and cost effectiveness of ophthalmic combinations in the treatment of open-angle glaucoma

    DEFF Research Database (Denmark)

    Hommer, A.; Thygesen, J.; Ferreras, A.

    2008-01-01

    PURPOSE: Efficacy, safety, and cost implications are important considerations when choosing an ophthalmic treatment. Fixed-combination glaucoma medications containing brimonidine 0.2% and timolol 0.5%, or dorzolamide 2% and timolol 0.5%, were compared with brimonidine 0.2% and dorzolamide 2...

  13. Vision status, ophthalmic assessment, and quality of life in the very old

    Directory of Open Access Journals (Sweden)

    Marcela Colussi Cypel

    Full Text Available ABSTRACT Purpose: To determine the vision status, ophthalmic findings, and quality of life among the very elderly. Methods: This was a cross-sectional observational study of individuals aged 80 years and above. A comprehensive ophthalmic exam was performed with mea surement of both the presenting (PVA and best-corrected visual acuity. The Quality of Life Short Form-36 (SF-36 and the Visual Function Questionnaire (VFQ-25 were also administered. Results: A total of 150 non-institutionalized participants were assigned to three age groups: 80-89 years (n=70, 90-99 years (n=50, and 100 years and older (n=30. PVA and best-corrected visual acuity were normal (≥20/30 in 20 (13.3% and 37 participants (24.7%, respectively. Regarding PVA, mild visual impairment (<20/30 to ≥20/60 was found in in 53 (35.4%, moderate visual impairment (<20/60 to ≥20/200 in 50 (33.3%, severe visual impairment (<20/200 to ≥20/400 in 8 (5.3%, and blindness (<20/400 in 19 (12.7% participants. Regarding best-corrected visual acuity, mild, moderate, and severe visual impairments were present in 55 (36.7%, 38 (25.3%, and 5 (3.3% participants, respectively, and blindness was present in 15 (10%. The main causes of visual impairment/blindness were cataract (43.8%, refractive errors (21.5%, age-related macular degeneration (17.7%, and myopic degeneration (3.8%. SF-36 scores were worse in those with low visual acuity, while VFQ-25 domain scores were poorer in those with vision impairment/blindness. Conclusion: Vision impairment and blindness was present in three-quarters of this sample, but it was notable that adequate correction with spectacles improved visual acuity. This reinforces the need for regular ophthalmic care in elderly patients to improve their quality of life by optimizing vision.

  14. Ophthalmic Manifestations and Long-Term Visual Outcomes in Patients with Cobalamin C Deficiency

    Science.gov (United States)

    Brooks, Brian P.; Thompson, Amy H.; Sloan, Jennifer; Manoli, Irini; Carrillo-Carrasco, Nuria; Zein, Wadih M.; Venditti, Charles P.

    2015-01-01

    Ocular manifestations of cobalamin C deficiency include a developmental as well as a degenerative phenotype and lack strict correlation to metabolic status, but may be mitigated by prenatal or early treatment. Purpose To explore the ocular manifestations of cobalamin C (cblC) deficiency, an inborn error of intracellular vitamin B12 metabolism caused by mutations in the MMACHC gene. Design Retrospective, observational case series. Participants Twenty-five cblC patients underwent clinical and ophthalmic examination at the National Institutes of Health Clinical Center between August 2004 and September 2012. Patient ages ranged from 2 to 27 years at last ophthalmic visit, and follow-up ranged from 0 to 83 months (median, 36 months; range, 13–83 months) over a total of 69 visits. Methods Best-corrected Snellen visual acuity, slit-lamp biomicroscopy, dilated fundus examination, wide-field photography, fundus autofluorescence imaging, sedated electroretinography, spectral-domain optical coherence tomography, and metabolite assessment. Main Outcome Measures Visual acuity and presence and degree of retinal degeneration and optic nerve pallor. Results Nystagmus (64%), strabismus (52%), macular degeneration (72%), optic nerve pallor (68%), and vascular changes (64%) were present. c.271dupA (p.R91KfsX14) homozygous patients (n = 14) showed early and extensive macular degeneration. Electroretinography showed that scotopic and photopic responses were reduced and delayed, but were preserved remarkably in some patients despite severe degeneration. Optical coherence tomography images through the central macular lesion of a patient with severe retinal degeneration showed extreme thinning, some preservation of retinal lamination, and nearly complete loss of the outer nuclear layer. Despite hyperhomocysteinemia, no patients exhibited lens dislocation. Conclusions This longitudinal study reports ocular outcomes in the largest group of patients with cblC deficiency systematically

  15. Five-year mortality rate in an ophthalmic ward in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Pamidzai Madzima

    2015-03-01

    Full Text Available Objective: To determine the mortality rate in the ophthalmic ward at the Sekuru KaguviHospital Eye Unit (SKHEU, Zimbabwe, from January 2009 to December 2013 and to identify the causes of death.Design: A hospital-based clinical audit.Methods: Data from completed hospital death notification forms and medical records of patients who had died in the ward during the review period were collected that included age, gender, diagnoses, date of admission, date of death and cause of death. The data were analysed using Epi Info7 software.Setting: The audit was conducted at SKHEU, the largest tertiary eye unit in Zimbabwe. It comprises an ophthalmic ward with 30 beds and caters for about 900 patients per year. Patients are admitted via the Out-patients Department where about 30 000 patients are seen yearly. SKHEU is part of the Parirenyatwa Group of Hospitals, which is one of the four major referral hospitals in Zimbabwe.Results: Of the 4722 ophthalmic admissions at SKHEU during the 5-year study period, therewere 15 (0.3% deaths, with a male:female ratio of 3:2 giving a mortality rate of 0.3% and an average of 3 deaths per year. The highest number of deaths was in 2009 when 7 deaths occurred, whilst the lowest number was 1 death in 2010 and 1 in 2013. Of the 15 deaths,4 (26.7% were children < 12 years old and 11 (73.3% were adults; of whom 12 (80% patients had orbital malignancies, 2 (13.3% had orbital cellulitis and 1 (6.7% had ocular trauma. Theorbital malignancies included ocular surface squamous neoplasia (OSSN, retinoblastomaand non-Hodgkins lymphoma (NHL. The most common probable cause of death was OSSN which accounted for 9 (60% of the deaths.Conclusion: The mortality rate at SKHEU was 0.3%, with approximately 3 deaths occurring per year. The most common attributable cause of death was OSSN.

  16. Clinical utility of antimicrobial susceptibility measurement plate covering formulated concentrations of various ophthalmic antimicrobial drugs

    Directory of Open Access Journals (Sweden)

    Tou N

    2016-11-01

    Full Text Available Norihiko Tou,1 Ryohei Nejima,2 Yoshifumi Ikeda,3 Yuichi Hori,4 Kaoru Araki-Sasaki,5 Kazunori Miyata,2 Yoshitsugu Inoue,3 Akihiko Tawara1 1Department of Ophthalmology, University of Occupational and Environmental Health, Fukuoka, 2Miyata Eye Hospital, Miyazaki, 3Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University, Tottori, 4Department of Ophthalmology, Toho University Sakura Medical Center, Chiba, 5Ideta Eye Hospital, Kumamoto, Japan Purpose: The purpose of this study was to evaluate the clinical utility of SG17, an ophthalmic antimicrobial susceptibility measurement plate.Design: This was a multicenter, retrospective, observational study.Patients and methods: Using clinical isolates from patients with ocular infections, drug susceptibility testing using the Clinical Laboratory and Standards Institute standards was routinely conducted at five facilities. The minimum inhibitory concentrations of the isolated strains were determined using SG17 at the Research Foundation for Microbial Diseases of Osaka University. The records of antimicrobial drugs used and the therapeutic course were evaluated for all cases. The susceptibility results from SG17 and routine methods used at each facility were compared.Results: A total of 112 bacterial strains were isolated from 92 patients. Of these cases, keratitis was the most common (52.2%, followed by conjunctivitis (21.7% and others (26.1%. Principal signs and symptoms resolved in all patients, indicating that therapeutic effects had been achieved. With SG17, drug susceptibility was determined in 98.9% of isolates compared with 30.4% of isolates determined using conventional methods. By adapting the Clinical Laboratory and Standards Institute standards to SG17 results, we found that 91.3% of patients were susceptible and 7.6% were resistant. In five patients, drugs with a resistant evaluation were initially administered with no effect, and the patients were then switched to

  17. Rescue Sedation With Intranasal Dexmedetomidine for Pediatric Ophthalmic Examination After Chloral Hydrate Failure: A Randomized, Controlled Trial.

    Science.gov (United States)

    Gan, Xiaoliang; Lin, Haotian; Chen, Jingjing; Lin, Zhuoling; Lin, Yiquan; Chen, Weirong

    2016-06-01

    It is a challenge to rescue ophthalmology examinations performed in children in the sedation room after initial chloral hydrate failure. Intranasal dexmedetomidine can be used in rescue sedation in children undergoing computed tomography. The present study aimed to assess the efficacy and tolerability of intranasal dexmedetomidine use in children undergoing ophthalmic examination after chloral hydrate failure. Sixty uncooperative pediatric patients with cataract (aged 5-36 months; weight, 7-15 kg) presented for follow-up ophthalmic examination. Patients who experienced chloral hydrate failure were randomized to 1 of 2 groups to receive intranasal dexmedetomidine 1 or 2 μg/kg for rescue sedation. Each group contained 30 patients. The primary outcome was the rate of a successful ophthalmic examination. Secondary outcomes included sedation onset time, recovery time, duration of examination, discharge time, and adverse events, including percentage of heart rate reduction, respiratory depression, vomiting, and postsedative agitation. A successful ophthalmic examination was achieved in 93.3% (28/30) of patients in the 2-μg/kg dose group and in 66.7% (20/30) of patients in the 1-μg/kg dose group (P = 0.021). The onset time, recovery time, and discharge time did not significantly differ between the 2 groups. None of the patients required clinical intervention due to heart rate reduction, and none of the patients in either group experienced vomiting, respiratory depression, or agitation after the administration of dexmedetomidine. In children undergoing ophthalmic examination, intranasal dexmedetomidine can be administered in the sedation room for rescue sedation after chloral hydrate failure, with the 2-μg/kg dose being more efficacious than the 1-μg/kg dose, as measured by success rate. ClinicalTrials.gov identifier: NCT02077712. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  18. Scientific publications in ophthalmic journals from China and other top-ranking countries: a 12-year review of the literature.

    Science.gov (United States)

    Huang, Wenbin; Wang, Wei; Zhan, Jiao; Zhou, Minwen; Chen, Shida; Zhang, Xiulan

    2013-06-26

    Eye diseases with increasing mortality are common health problems that affect people of all ages and demographic backgrounds. In this study, we study the publication characteristics in international ophthalmic journals of the US, the UK, Germany, Australia, Japan, and China. Articles published in 53 ophthalmic journals from 2000 to 2011 were retrieved from the PubMed database. We recorded the number of articles published each year, analyzed the publication type, and evaluated the accumulated and average impact factors (IFs), and the distribution of articles in ophthalmic journals in relation to IFs. The characteristics of publication outputs from China and other top-ranking countries were compared. The total number of articles increased significantly during the past 12 years, with an increase of 51.0%. The growth in the annual number of articles from the US, the UK, Australia, and China showed a significantly positive trend. Publications from the US exceeded those from any other country and had the highest IFs, largest number of total citations of articles, and the most articles published in leading ophthalmic journals. During the past 12 years, China contributed 3.5% of the total publications, and the number of Chinese articles showed a more than 6-fold increase (from 99 to 605, R2 =0.947, P<0.001). The numbers of IFs and citations of articles originating in China were mostly lower than for other top-ranking counties. Research on ophthalmic journals has maintained an upward growing trend from 2000 to 2011. Chinese ophthalmology research has developed rapidly, but the gap still exists between China and other top-ranking countries for the advanced level of research.

  19. Ophthalmic applications of confocal microscopy: diagnostics, refractive surgery, and eye banking

    Science.gov (United States)

    Masters, Barry R.

    1990-11-01

    Confocal microscopy of ocular tissue provides two advantages over traditional imaging techniques: increased range and transverse resolution and increased contrast. The semitransparent cornea and ocular lens in the living eye can be optically sectioned and observed by reflected light confocal microscopy. Within the cornea we observed various cell components nerve fibers nerve cell bodies and fibrous networks. The confocal microscopic images from the in-situ ocular lens show the lens capsule the lens epithelium and the individual lens fibrils. All of the reflected light confocal microscopic images have high contrast and high resolution. Some of the applications of confocal imaging in ophthalmology include: diagnostics of the cornea and the ocular lens examination prior to and after refractive surgery examination of intraocular lenses (IOL) and examination of eye bank material. Other ophthalmic uses of confocal imaging include: studies of wound healing therapeutics and the effects of contact lenses on the cornea. The proposed features of a clinical confocal microscope are reviewed. 2.

  20. A comparative study of ibuprofen with paracetamol versus oxyphenbutazone with analgin combination in ophthalmic practice

    Directory of Open Access Journals (Sweden)

    Roy I

    1988-01-01

    Full Text Available A total of 200 patients of either sex with various ophthalmic inflammatory disorders of surgical and non-surgical types were treated with ibuprofen with paracetamol 1 tablet tid. or a combination of oxyphenbutazone and analgin-1 tablet t. i. d. for 7 days/ Patients in the ibuprofen with Paracetamol group recorded a signifi-cantly greater reduction in pain scores; on day 1 and 2 and in swelling scores on day 2, 5 and 7 as compared to patients receiving the combination of ox yphenbutazone and analgin. A significantly lesserr number of patients in the ibuprofen with paraeetamol group required escape analgesics. Seventy six per cent of patients in the Ibuprofen with paracetamol group were judged as showing a Very good - Good, response to treatment as against 55 per cent in the oxvphenbutazone-analgin group. It is concluded that ibuprofen with Paracetamol is superior in efficacy and a safer alternative to a combination of oxyphenbutazone and analgin.

  1. A template for reducing ophthalmology outpatient waiting times: community ophthalmic care.

    Science.gov (United States)

    Goetz, R K; Hughes, F E; Duignan, E S; O'Neill, E C; Connell, P P; Fulcher, T P; Treacy, M P

    2018-02-01

    Through an Irish Health Service Executive (HSE) initiative to tackle excessive hospital outpatient waiting times, 996 patients referred to the Ophthalmology Outpatient Department (OPD) of the Mater Misericordiae University Hospital (MMUH), Eccles Street, Dublin 7, Ireland, were outsourced to a community medical eye clinic (CMEC) for consultation with specialist-registered ophthalmologists. The study aims to determine if patients referred as routine to the OPD department could be managed in a community setting. 996 patients were reviewed in the CMEC, and their data was collected and placed into a spreadsheet for analysis. 61.2% of patients referred to the OPD were fully managed in the community clinic, and 34.9% required ophthalmic surgery in hospital. By facilitating direct listing of some of the surgical patients to the hospital theatre list, 89.8% of the 996 referrals received treatment without needing to attend the hospital outpatients department.

  2. Evaluation of microsurgical tasks with OCT-guided and/or robot-assisted ophthalmic forceps

    Science.gov (United States)

    Yu, Haoran; Shen, Jin-Hui; Shah, Rohan J.; Simaan, Nabil; Joos, Karen M.

    2015-01-01

    Real-time intraocular optical coherence tomography (OCT) visualization of tissues with surgical feedback can enhance retinal surgery. An intraocular 23-gauge B-mode forward-imaging co-planar OCT-forceps, coupling connectors and algorithms were developed to form a unique ophthalmic surgical robotic system. Approach to the surface of a phantom or goat retina by a manual or robotic-controlled forceps, with and without real-time OCT guidance, was performed. Efficiency of lifting phantom membranes was examined. Placing the co-planar OCT imaging probe internal to the surgical tool reduced instrument shadowing and permitted constant tracking. Robotic assistance together with real-time OCT feedback improved depth perception accuracy. The first-generation integrated OCT-forceps was capable of peeling membrane phantoms despite smooth tips. PMID:25780736

  3. [On the importance of multidrug-resistant strains of pathogenic microorganisms in ophthalmic practice].

    Science.gov (United States)

    Galeeva, G Z; Samoylov, A N; Rascheskov, A Yu

    2015-01-01

    This is a review of epidemiological, microbiological and ophthalmological publications on the importance of multidrug-resistant bacterial strains in medical, particularly ophthalmological, care. Current state of pharmaceutical market and wide variety of generics confuses doctor's (including ophthalmologist's) sense of decision-making on the optimum antibiotic for the treatment of purulent inflammation. Indiscriminate use of antibiotics contributes to multiple drug resistance in bacteria. The world returns to the pre-antibiotic era, in which there was no treatment for severe infectious and inflammatory diseases. The most dangerous multiresistant strains known to medical science and their role in etiology of inflammatory eye diseases are listed in the article. Since neonatal conjunctivitis and postoperative endophthalmitis are the most common ocular inflammatory diseases caused by nosocomial multiresistant bacteria, their etiological classification is also described. Emergence of antibiotic resistance to most frequently used ophthalmic agents and prevention strategies are discussed.

  4. A curious fact: Photic sneeze reflex. Autosomical dominant compelling helio-ophthalmic outburst syndrome.

    Science.gov (United States)

    Sevillano, C; Parafita-Fernández, A; Rodriguez-Lopez, V; Sampil, M; Moraña, N; Viso, E; Cores, F J

    2016-07-01

    To assess ocular involvement in the pathophysiology of autosomal dominant compelling helio-ophthalmic outburst syndrome (ACHOOs). An interview was conducted with a Caucasian family that showed clinical features of ACHOOs. Twelve of them had photic reflex and were recruited. A complete eye evaluation was made. A dominant autosomal inheritance with mild penetrance was demonstrated, with 67% of the studied subjects showing some degree of prominent corneal nerves. No other eye changes were found. Prominent corneal nerves may be associated with ACHOOs. The other eye structures studied do not seem to play a role in ACHOOs. Further studies are needed to understand the physiology of the ACHOOs. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Tailored (meth)acrylate shape-memory polymer networks for ophthalmic applications.

    Science.gov (United States)

    Song, Li; Hu, Wang; Wang, Guojie; Niu, Guoguang; Zhang, Hongbin; Cao, Hui; Wang, Kaijie; Yang, Huai; Zhu, Siquan

    2010-10-08

    The unique features of shape-memory polymers enables their use in minimally invasive surgical procedures with a compact starting material switching over to a voluminous structure in vivo. In this work, a series of transparent, thermoset (meth)acrylate shape-memory polymer networks with tailored thermomechanics have been synthesized and evaluated. Fundamental trends were established for the effect of the crosslinker content and crosslinker molecular weight on glass transition temperature, rubbery modulus and shape-recovery behavior, and the results are intended to help with future shape-memory device design. The prepared (meth)acrylate networks with high transparency and favorable biocompatibility are presented as a promising shape-memory ophthalmic biomaterial.

  6. Ophthalmic findings in acute mercury poisoning in adults: A case series study.

    Science.gov (United States)

    Aslan, Lokman; Aslankurt, Murat; Bozkurt, Selim; Aksoy, Adnan; Ozdemir, Murat; Gizir, Harun; Yasar, Ibrahim

    2015-08-01

    The aim of this study is to report ophthalmic findings of acute mercury poisoning in 48 adults referred to emergency department. Full ophthalmologic examination including the best corrected visual acuity, external eye examination, reaction to light, a slit-lamp examination, funduscopy, intraocular pressure measurements, and visual field (VF) and color vision (CV) tests were performed at the presentation and repeated after 6 months. The parametric values of VF test, the mean deviation (MD), and pattern standard deviation (PSD) were recorded in order to compare patients and the 30 healthy controls. The mean parameter of color confusion index in patients was found to be statistically different than controls (p effect on the visual system, especially CV and VF. We propose that emphasizing the public education on the potential hazards of mercury is crucial for preventive community health. © The Author(s) 2013.

  7. A European Perspective on Topical Ophthalmic Antibiotics: Current and Evolving Options

    Directory of Open Access Journals (Sweden)

    D. Bremond-Gignac

    2011-01-01

    Full Text Available Background Eye infections can be vision-threatening and must be treated effectively by appropriate and safe use of topical ophthalmic anti-infectives. This review will essentially consider the current and evolving treatment options for the various types of bacterial eye infections. Ocular surface bacterial infections affect subjects of all ages with a high frequency in newborns and children. Methods This article presents a review of the peer-reviewed published scientific literature in order to define the well-established uses of anti-infective eye drops in the field of ocular infections. A comprehensive search of the recent published literature including topical ophthalmic anti-infectives effective in bacterial ocular infections was performed. Clinical studies provide relevant data concerning the characteristics and clinical efficacy of antibacterial eye drops in ocular anterior segment infections or for perioperative prophylaxis. Publications were included to cover the current options of antibacterial eye drops available in Europe. Results Several recent publications identified effective topical ocular antibacterials requiring a reduced dose regimen and a short treatment course. Additional literature reviewed included data on novel perioperative prophylaxis, indications for topical fortified antibiotics and innovative research including the risk of resistance. Conclusions Safe and effective topical antibiotic eye drops for the treatment and prevention of ocular infections must be adapted to the type of bacteria suspected. Usual topical antimicrobials should be replaced by more recent and more effective treatments. The use of highly effective fluoroquinolones should be reserved for the most severe cases to avoid resistance. Short treatment courses, such as azithromycin, can be easily used in children, thereby improving quality of life.

  8. Imaging of Dual Ophthalmic Arteries: Identification of the Central Retinal Artery

    Directory of Open Access Journals (Sweden)

    Louise Louw

    2014-01-01

    Full Text Available Identification of the origin of the central retinal artery (CRA is imperative in tailoring angiographic studies to resolve a given clinical problem. A case with dual ophthalmic arteries (OAs, characterized by different origins and distinct branching patterns, is documented for training purposes. Pre-clinical diagnosis of a 9-year-old child who presented with a sharp wire in the left-side eyeball was primarily corneal laceration. For imaging, a selected six-vessel angiographic study with the transfemoral approach was performed. Embolization was not required and the wire could be successfully removed. Right-side OA anatomy was normal, while left-side dual OAs with external carotid artery (ECA and internal carotid artery (ICA origins were seen. The case presented with a left-side meningo-ophthalmic artery (M-OA anomaly via the ECA, marked by a middle meningeal artery (MMA (origin: Maxillary artery; course: Through foramen spinosum with normal branches (i.e. anterior and posterior branches, and an OA variant (course: Through superior orbital fissure with a distinct orbital branching pattern. A smaller OA (origin: ICA; course: Through optic foramen with a distinct ocular branching pattern presented with the central retinal artery (CRA. The presence of the dual OAs and the M-OA anomaly can be explained by disturbed evolutionary changes of the primitive OA and stapedial artery during development. The surgical interventionist must be aware of dual OAs and M-OA anomalies with branching pattern variations on retinal supply, because of dangerous extracranial-intracranial anastomotic connections. It is of clinical significance that the origin of the CRA from the ICA or ECA must be determined to avoid complications to the vision.

  9. Short term general anesthesia for retro-bulbar block in ophthalmic surgery generates no significant hypercapnia.

    Science.gov (United States)

    Baulig, Werner; Weber, Monica; Beck-Schimmer, Beatrice; Theusinger, Oliver M; Biro, Peter

    2017-03-11

    To assess the impact of short time hypnosis for retro-bulbar anesthesia on ventilation in patients undergoing ophthalmic surgery of the anterior eye chamber. In all patients, a combined continuous transcutaneous carbon dioxide tension (PtcCO2) and partial oxygen saturation (SpO2) measurement was applied in addition to routine monitoring. To enable unconscious application of retro-bulbar anesthesia, intravenous thiopental was given in one to multiple bolus doses. Transient breathing support included chin lift, Esmarch maneuver and manual hand-bag ventilation via face mask. Main endpoints were apnea time, recovery time according to the Richmond Agitation Sedation Scale, as well as SpO2 and PtcCO2 readings at predefined time points. Fifty-two patients with a mean age of 68 ± 13 years were included. Average thiopental dose was 2.7 ± 0.6 mg/kg. In seven (13.5%) patients repeated doses of thiopental were necessary to a total of 3.3 ± 1.1 mg/kg. Except one patient, no severe, significant or clinical relevant hypercapnia or desaturation periods were observed, and the occurring elevation of PtcCO2 values did not correlate with the application of repeated doses of thiopental or the need for the Esmarch maneuver. Higher PtcCO2 values were associated with the presence of hypertension and smoking. Apnea (p < 0.001) and recovery (p = 0.003) time were significantly prolonged in the patients needing the Esmarch maneuver. Short term anesthesia with thiopental in ophthalmic surgery is associated with a mild but not clinically relevant hypercapnia.

  10. A European Perspective on Topical Ophthalmic Antibiotics: Current and Evolving Options

    Science.gov (United States)

    Bremond-Gignac, D.; Chiambaretta, F.; Milazzo, S.

    2011-01-01

    Background Eye infections can be vision-threatening and must be treated effectively by appropriate and safe use of topical ophthalmic anti-infectives. This review will essentially consider the current and evolving treatment options for the various types of bacterial eye infections. Ocular surface bacterial infections affect subjects of all ages with a high frequency in newborns and children. Methods This article presents a review of the peer-reviewed published scientific literature in order to define the well-established uses of anti-infective eye drops in the field of ocular infections. A comprehensive search of the recent published literature including topical ophthalmic anti-infectives effective in bacterial ocular infections was performed. Clinical studies provide relevant data concerning the characteristics and clinical efficacy of antibacterial eye drops in ocular anterior segment infections or for perioperative prophylaxis. Publications were included to cover the current options of antibacterial eye drops available in Europe. Results Several recent publications identified effective topical ocular antibacterials requiring a reduced dose regimen and a short treatment course. Additional literature reviewed included data on novel perioperative prophylaxis, indications for topical fortified antibiotics and innovative research including the risk of resistance. Conclusions Safe and effective topical antibiotic eye drops for the treatment and prevention of ocular infections must be adapted to the type of bacteria suspected. Usual topical antimicrobials should be replaced by more recent and more effective treatments. The use of highly effective fluoroquinolones should be reserved for the most severe cases to avoid resistance. Short treatment courses, such as azithromycin, can be easily used in children, thereby improving quality of life. PMID:23861622

  11. Comparative evaluation of efficacy and safety of ophthalmic viscosurgical devices in phacoemulsification [ISRCTN34957881

    Directory of Open Access Journals (Sweden)

    Titiyal Jeewan S

    2005-07-01

    Full Text Available Abstract Background Various ophthalmic viscosurgical devices (OVD are used to perform phacoemulsification and other intraocular surgeries. We performed a study to compare the efficacy and safety of three ophthalmic viscosurgical devices that are routinely used in phacoemulsification. Methods Fifty-six patients of immature senile cataract with hard nucleus (grade 3 and 4 who underwent phacoemulsification were included. Depending upon the type of OVD, patients were randomly allocated into three groups; group 1 (n = 19, Viscoat® was used; group 2 (n = 19, Healon GV® was used; group 3 (n = 18, Healon 5® was used. Parameters evaluated were uncorrected and best corrected visual acuity, specular microscopy, intraocular pressure and pachymetry both preoperatively and postoperatively on day 1, 1 week, 1 month and 3 months and development of any complication both intraoperative and postoperative were also noted. Results The mean increase in central corneal thickness was 15.17% (group 1; 17.26% (group 2 and 16.21% (group 3 on first postoperative day and was comparable in the three groups. The density of endothelial cells decreased postoperatively (day 1 by 12.54% (group 1, 13.76% (group 2 and 13.06% (group 3 and was comparable. The mean preoperative intraocular pressure in groups 1, 2 and 3 were 13.3 ± 2.0, 14.0 ± 2.2 and 13.2 ± 3.2 mmHg respectively, which changed to 16.0 ± 4.7, 12.2 ± 4.7 and 12.3 ± 4.8 respectively on first postoperative day and the change in intraocular pressure was significantly higher in group 1 (1 vs 2 & 1 vs 3; p = 0.02; oneway ANOVA. Conclusion Viscoat®, Healon GV® and Healon 5® give comparable results in terms of efficacy and safety in performing phacoemulsification.

  12. Multimodal ophthalmic imaging using spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography

    Science.gov (United States)

    El-Haddad, Mohamed T.; Malone, Joseph D.; Li, Jianwei D.; Bozic, Ivan; Arquitola, Amber M.; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.

    2017-08-01

    Ophthalmic surgery involves manipulation of delicate, layered tissue structures on milli- to micrometer scales. Traditional surgical microscopes provide an inherently two-dimensional view of the surgical field with limited depth perception which precludes accurate depth-resolved visualization of these tissue layers, and limits the development of novel surgical techniques. We demonstrate multimodal swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (SS-SESLO-OCT) to address current limitations of image-guided ophthalmic microsurgery. SS-SESLO-OCT provides inherently co-registered en face and cross-sectional field-of-views (FOVs) at a line rate of 400 kHz and >2 GPix/s throughput. We show in vivo imaging of the anterior segment and retinal fundus of a healthy volunteer, and preliminary results of multi-volumetric mosaicking for ultrawide-field retinal imaging with 90° FOV. Additionally, a scan-head was rapid-prototyped with a modular architecture which enabled integration of SS-SESLO-OCT with traditional surgical microscope and slit-lamp imaging optics. Ex vivo surgical maneuvers were simulated in cadaveric porcine eyes. The system throughput enabled volumetric acquisition at 10 volumes-per-second (vps) and allowed visualization of surgical dynamics in corneal sweeps, compressions, and dissections, and retinal sweeps, compressions, and elevations. SESLO en face images enabled simple real-time co-registration with the surgical microscope FOV, and OCT cross-sections provided depth-resolved visualization of instrument-tissue interactions. Finally, we demonstrate novel augmented-reality integration with the surgical view using segmentation overlays to aid surgical guidance. SS-SESLO-OCT may benefit clinical diagnostics by enabling aiming, registration, and mosaicking; and intraoperative imaging by allowing for real-time surgical feedback, instrument tracking, and overlays of computationally extracted biomarkers of disease.

  13. Ophthalmic diagnostic tests, orbital anatomy, and adnexal histology of the broad-snouted caiman (Caiman latirostris).

    Science.gov (United States)

    Oriá, Arianne P; Oliveira, Alberto Vinícius D; Pinna, Melissa H; Martins Filho, Emanoel F; Estrela-Lima, Alessandra; Peixoto, Tiago C; Silva, Renata Maria M da; Santana, Fernanda O; Meneses, Íris Daniela S; Requião, Kátia G; Ofri, Ron

    2015-01-01

    The aim of this study was to establish normal ophthalmic parameters for selected diagnostic tests, and to describe the orbital anatomy and adnexal histology of the broad-snouted caiman. A total of 35 Caiman latirostris that were free of obvious ocular diseases were used to measure the parameters in this investigation. Ages ranged from 5 to 15 years. Ophthalmic diagnostic tests were conducted, including evaluation of tear production with Schirmer Tear test-1 (STT1), culture of the conjunctival bacterial flora, applanation tonometry, conjunctival cytology, nictiating membrane incursion frequency test (NMIFT), endodontic absorbent paper point tear test (EAPPTT), palpebral fissure length measurement (PFL) and B-mode ultrasonography. Adnexal histology and skull samples were studied. Mean (±SD) STT1 was 3.4 ± 3.6 mm/min (95% confidence interval of 2.01-4.78 mm/min), intraocular pressure (IOP) was 12.9 ± 6.2 mmHg, NMIFT was 6.0 ± 3.5, EAPPTT was 17.1 ± 2.5 mm/min, PFL was 28.9 ± 3.0 mm, anterior chamber depth was 3.1 ± 0.3 mm, lens axial length was 8.4 ± 0.6 mm, vitreous chamber depth was 7.9 ± 0.7 mm and axial globe length was 19.9 ± 1.3 mm. For all animals evaluated, Bacillus sp., Diphteroids and Staphylococcus sp. were predominant. © 2013 American College of Veterinary Ophthalmologists.

  14. Distribution and drug resistance of pathogens isolated from ophthalmic infections in general hospital

    Directory of Open Access Journals (Sweden)

    Xuan Cai

    2017-03-01

    Full Text Available AIM: To summarize the eye infection distribution of pathogens and drug resistance characteristics in our hospital in latest 5a, hoping to provide a theoretical basis for clinical anti-infective therapy and nosocomial infection control. METHODS:In this study, we collected positive strains isolated from the hospitalized patients in Renmin Hospital of Wuhan University from January 2011 to December 2015. Data were analyzed with WHONET 5.6 software. RESULTS: A total of 4 486 cases of ophthalmic inpatients were included in the study, 736 strains of pathogenic microorganisms were isolated, including 510 gram-positive bacteria, 107 gram-negative bacteria and 119 fungi. The most common type of gram positive bacteria as the epidermis staphylococcus(247 strains, followed by coryne bacterium(153 strains. The most common type of gram negative bacteria for pseudomonas aeruginosa(39 strains. The most common type of fungi for sickle bacterium(77 strains, followed by aspergillus strain(31 strains. The staphylococcus was sensitive to rifampicin, trimethoprim, linezolid, vancomycin and teicoplanin. The Streptococcus pneumoniae was sensitive to levofloxacin, linezolid, vancomycin and teicoplanin. The drug sensitive rates of non-fermenters to cefoperazone/sulbactam and colistin, enterobacteriaceae to imipenem, meropenem and levofloxacin were all 100%. The detection rates of methicillin-resistant staphylococci and penicillin-resistant Streptococcus pneumoniae were 37.5% and 40.0%, respectively. CONCLUSION:We should strengthen the monitoring of pathogen resistance, to keep abreast of the epidemic characteristics of ophthalmic infection pathogens and drug resistance trends, which are of great significance for the rational application of antibiotics in clinical anti-infective treatment, reducing the emergence of drug-resistant bacteria and hospital infection control measures.

  15. A standard model eye with micro scale multilayer structure for ophthalmic optical coherence tomography equipment

    Science.gov (United States)

    Cao, Zhenggang; Ding, Zengqian; Hu, Zhixiong; Wen, Tao; Qiao, Wen; Liu, Wenli

    2016-10-01

    Optical coherence tomography (OCT) has been widely applied in diagnosis of eye diseases during the last 20 years. Differing from traditional two-dimension imaging technologies, OCT could also provide cross-sectional information of target tissues simultaneously and precisely. As well known, axial resolution is one of the most critical parameters impacting the OCT image quality, which determines whether an accurate diagnosis could be obtained. Therefore, it is important to evaluate the axial resolution of an OCT equipment. Phantoms always play an important role in the standardization and validation process. Here, a standard model eye with micro-scale multilayer structure was custom designed and manufactured. Mimicking a real human eye, analyzing the physical characteristic of layer structures of retina and cornea in-depth, appropriate materials were selected by testing the scattering coefficient of PDMS phantoms with difference concentration of TiO2 or BaSO4 particles. An artificial retina and cornea with multilayer-films which have a thickness of 10 to 60 micrometers for each layer were fabricated using spin coating technology. Considering key parameters of the standard model eye need to be traceable as well as accurate, the optical refractive index and layer structure thicknesses of phantoms were verified by utilizing Thickness Monitoring System. Consequently, a standard OCT model eye was obtained after the retinal or corneal phantom was embedded into a water-filled model eye which has been fabricated by 3D printing technology to simulate ocular dispersion and emmetropic refraction. The eye model was manufactured with a transparent resin to simulate realistic ophthalmic testing environment, and most key optical elements including cornea, lens and vitreous body were realized. By investigating with a research and a clinical OCT system respectively, the OCT model eye was demonstrated with similar physical properties as natural eye, and the multilayer film measurement

  16. Ocular Pharmacokinetics of a Novel Loteprednol Etabonate 0.4% Ophthalmic Formulation.

    Science.gov (United States)

    Schopf, Lisa; Enlow, Elizabeth; Popov, Alexey; Bourassa, James; Chen, Hongming

    2014-12-01

    Topical ophthalmic formulations of corticosteroids are commonly used to treat a variety of ocular diseases and conditions that have an inflammatory component. The purpose of this study was to evaluate the effect of the mucus-penetrating particle (MPP) technology on the pharmacokinetic profile of loteprednol etabonate in the ocular tissues of rabbits. Forty-eight New Zealand White rabbits were randomly assigned to two groups (n = 3 rabbits or 6 eyes per time point) and treated with either the novel loteprednol etabonate MPP suspension formulation, 0.4% (LE-MPP 0.4%), or the commercial Lotemax(®)-brand loteprednol etabonate ophthalmic suspension, 0.5% (Lotemax 0.5%) (Bausch & Lomb Incorporated, Inc., Rochester, NY, USA). Samples of aqueous humor, various ocular tissues, and plasma were collected from animals over a 12-h period after a single dose of the test articles. Loteprednol etabonate concentrations were assayed using liquid chromatography-tandem mass spectrometry (LC/MS/MS). Loteprednol etabonate was rapidly absorbed into ocular tissues following administration of either formulation. A higher ocular exposure was achieved using LE-MPP 0.4%, with peak concentrations of approximately threefold higher in ocular tissues and the aqueous humor than Lotemax 0.5%. Administration of LE-MPP 0.4% improved loteprednol etabonate pharmacokinetic profile in ocular tissues of rabbits. The results of this study support the premise that the MPP technology can be used to enhance ocular exposure for topically applied therapeutic agents. Further studies to assess the clinical efficacy and safety of the LE-MPP formulation are warranted.

  17. Comparison of ophthalmic sponges and extraction buffers for quantifying cytokine profiles in tears using Luminex technology.

    Science.gov (United States)

    Inic-Kanada, Aleksandra; Nussbaumer, Andrea; Montanaro, Jacqueline; Belij, Sandra; Schlacher, Simone; Stein, Elisabeth; Bintner, Nora; Merio, Margarethe; Zlabinger, Gerhard J; Barisani-Asenbauer, Talin

    2012-01-01

    Evaluating cytokine profiles in tears could shed light on the pathogenesis of various ocular surface diseases. When collecting tears with the methods currently available, it is often not possible to avoid the tear reflex, which may give a different cytokine profile compared to basal tears. More importantly, tear collection with glass capillaries, the most widely used method for taking samples and the best method for avoiding tear reflex, is impractical for remote area field studies because it is tedious and time-consuming for health workers, who cannot collect tears from a large number of patients with this method in one day. Furthermore, this method is uncomfortable for anxious patients and children. Thus, tears are frequently collected using ophthalmic sponges. These sponges have the advantage that they are well tolerated by the patient, especially children, and enable standardization of the tear collection volume. The aim of this study was to compare various ophthalmic sponges and extraction buffers to optimize the tear collection method for field studies for subsequent quantification of cytokines in tears using the Luminex technology. Three ophthalmic sponges, Merocel, Pro-ophta, and Weck-Cel, were tested. Sponges were presoaked with 25 cytokines/chemokines of known concentrations and eluted with seven different extraction buffers (EX1-EX7). To assess possible interference in the assay from the sponges, two standard curves were prepared in parallel: 1) cytokines of known concentrations with the extraction buffers and 2) cytokines of known concentrations loaded onto the sponges with the extraction buffers. Subsequently, a clinical assessment of the chosen sponge-buffer combination was performed with tears collected from four healthy subjects using 1) aspiration and 2) sponges. To quantify cytokine/chemokine recovery and the concentration in the tears, a 25-plex Cytokine Panel and the Luminex xMap were used. This platform enables simultaneous measurement of

  18. Design and development of a novel pH triggered nanoemulsified in-situ ophthalmic gel of fluconazole: ex-vivo transcorneal permeation, corneal toxicity and irritation testing.

    Science.gov (United States)

    Pathak, Mukesh K; Chhabra, Gulshan; Pathak, Kamla

    2013-05-01

    The objective of the present research was to develop a novel pH triggered nanoemulsified in-situ gel (NE-ISG) for ophthalmic delivery of fluconazole (FLZ) to enhance the permeation and residence time of the formulation, by overcoming the limitations associated with protective ocular barriers. Pseudoternary phase diagrams were constructed using capmul MCM (oil phase), tween 80 (surfactant) and transcutol P (cosurfactant) to identify the NE region. Nanoemulsions (NE1-NE6) of FLZ were prepared by spontaneous emulsification method and evaluated for various pharmacotechnical characteristics. NE4 was selected as optimized NE and was dispersed in carbopol 934 solution to form nanoemulsified sols (NE-ISG1 to NE-ISG5) that were expected to convert in to in-situ gels at corneal pH (7.4). The optimized NE-ISG was selected on the basis of gelation ability with a residence time up to or more than 6 h. Ex-vivo transcorneal permeation study displayed significantly higher (p toxicity study revealed no visual signs of tissue damage. Hence it can be concluded that NE-ISG5 may offer a more intensive treatment of ocular fungal infections due to higher permeation, prolonged precorneal residence time and sustained drug release along with higher in-vitro efficacy, safety and greater patient compliance.

  19. Viscosity Solution

    OpenAIRE

    Camilli, Fabio; Prados, Emmanuel

    2011-01-01

    International audience; Viscosity solution is a notion of weak solution for a class of partial differential equations of Hamilton-Jacobi type. The range of applications of the notions of viscosity solution and Hamilton-Jacobi equations is enormous, including common class of partial differential equations such as evolutive problems and problems with boundary conditions, equations arising in optimal control theory, differential games, second-order equations arising in stochastic optimal control...

  20. Shortcomings of the industrial quality assurance of {sup 106}Ru ophthalmic plaques; Therapierelevante Schwachstellen bei der industriellen Qualitaetssicherung von {sup 106}Ru-Augenapplikatoren

    Energy Technology Data Exchange (ETDEWEB)

    Kaulich, T.W.; Nuesslin, F. [Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany). Abt. Medizinische Physik; Zurheide, J. [BrainLAB AG, Heimstetten (Germany); Fluehs, D. [Abt. Strahlentherapie, Bereich klinische Strahlenphysik, Universitaetsklinikum Essen (Germany); Haug, T. [Isotopenlabor der Univ. Tuebingen (Germany); Bamberg, M. [Abt. Radioonkologie, Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany)

    2001-11-01

    Background: Beta emitting {sup 106}Ru applicators manufactured by Bebig GmbH (Berlin, Germany) are widely used to treat intraocular tumors. The applicators are fixed to the bulbus and removed after several days. The following therapy relevant defects have been detected by an internal clinical acceptance test: risk of leakage and inconsistent dose-rate specifications by the manufacturer. In the meantime, components of the internal clinical acceptance test have been adopted successfully by the manufacturer of the {sup 106}Ru ophthalmic plaques. Material and Method: {sup 106}Ru ophthalmic plaques were tested with the following internal clinical acceptance tests: visual inspection, surface contamination, leakage, and dose-rate verification. The surface contamination test consists of a wet wipe test at moderate pressure. For the leakage test of the {sup 106}Ru ophthalmic plaques a clinically relevant scenario was developed in which the contact of the applicator with human tissue is simulated. In the course of it the applicator is inserted into Ringer's solution for several days. The certified energy dose-rate statements of the manufacturer are examined with a 1 mm{sup 3} plastic scintillator for consistency. (orig.) [German] Hintergrund: {sup 106}Ru-Augenapplikatoren der Fa. Bebig (Berlin) werden zur strahlentherapeutischen Behandlung von intraokularen Tumoren eingesetzt. Die Applikatoren werden sklerakontaktierend am Bulbus fixiert und nach mehreren Tagen wieder entfernt. Durch eine klinikinterne Eingangspruefung wurden folgende therapierelevante Maengel bei den Augenapplikatoren entdeckt: mangelhafte Dichtheit und inkonsistente Dosisleistungsangaben des Herstellers. Ein Teil dieser klinikinternen Eingangspruefung wurde inzwischen vom Hersteller der {sup 106}Ru-Augenapplikatoren uebernommen und erfolgreich eingesetzt. Material und Methode: Es wurden {sup 106}Ru-Augenapplikatoren durch folgende klinikinterne Eingangspruefungen getestet: optische Inspektion

  1. Ophthalmic examination as a means to diagnose Subacute Sclerosing Panencephalitis: an optical coherence tomography and ultrawide field imaging evaluation.

    Science.gov (United States)

    Tripathy, Koushik; Chawla, Rohan; Mittal, Kanhaiya; Farmania, Rajni; Venkatesh, Pradeep; Gulati, Sheffali

    2017-01-01

    Subacute sclerosing panencephalitis (SSPE) is a potentially fatal complication of measles. The authors report a case of recurrent myoclonic jerks under investigation, whose ophthalmic examination pointed to the diagnosis. A 12-year-old boy with recurrent episodes of myoclonic jerks was found to have optic disc pallor and an irregular macular scar with pigmentation in the left eye. The retinal finding proved to be a strong diagnostic clue for SSPE. There was a history of exanthematous fever in childhood. Antibodies against measles were detected in both the cerebrospinal fluid and serum. Retinitis with intraretinal and subretinal hemorrhage in the right eye was noted 6-weeks after the initial presentation. The authors describe the importance of ophthalmic evaluation in cases of recurrent myoclonic jerks. Optical coherence tomographic features and ultrawide field imaging characteristics of a case of SSPE are described.

  2. Five year follow-up of two sisters with type II sialidosis: systemic and ophthalmic findings including OCT analysis.

    Science.gov (United States)

    Rosenberg, Rémi; Halimi, Emmanuel; Mention-Mulliez, Karine; Cuisset, Jean-Marie; Holder, Muriel; Defoort-Dhellemmes, Sabine

    2013-07-02

    The authors report a 5-year follow-up examination of two sisters diagnosed as having a juvenile form of type II sialidosis. Diagnosis occurred during a routine ophthalmic examination when the girls were 5 and 3 years old after bilateral macular cherry-red spots were revealed. Main clinical findings were hypotonia, hepatosplenomegaly, hearing loss, dysostosis, and respiratory distress. Ophthalmic symptoms were low visual acuity and nystagmus. Spectral-domain optical coherence tomography examination showed increased reflectivity of the retinal ganglion cells. Sialidosis may present as a mild form with slow progression. The cherry-red spots may be the first clue for proper diagnosis of storage disease. Spectral-domain optical coherence tomography examination unveiled the accumulation of sialic acid in the retinal ganglion cells and could potentially be used to monitor the progression of storage diseases. Copyright 2013, SLACK Incorporated.

  3. Clinical analysis of diclofenac sodium eye drops combined with sodium hyaluronate eye drops for dry eye after ophthalmic surgery

    Directory of Open Access Journals (Sweden)

    Li-Ping Liu

    2017-07-01

    Full Text Available AIM: To study and analyze the clinical efficacy of diclofenac sodium eye drops combined with sodium hyaluronate eye drops in treating dry eyes after ophthalmic surgery. METHODS: Totally 94 eyes from 94 patients with dry eyes were slected, and they were randomly divided into orbervation group and control group. Fouty-seven patients in the control group using conventional treatment combined with sodium hyaluronate eye drops. Other 47 patients in orbervation group were treated with diclofenac sodium eye drops on the basis of control group. We compared symptoms, fluorescein station, tear film break time, Schirmer Ⅰ test between the two groups.RESULTS: Compared with before treatment, patients of both groups with sympotom, fluorescein station score, BUT, and Schirmer Ⅰ test were significantly improved(PPPCONCLUSION: Diclofenac sodium eye drops combined with sodium hyaluronate eye drops have significant efficacy in treatment of dry eyes after ophthalmic surgery, which can effectively relieve clinical symptoms, improve BUT and Schirmer Ⅰ test.

  4. A New Anatomic Variation: Coexistence of Both Dandy-Walker Variant and Ophthalmic Artery Originating From Contralateral Internal Carotid Artery.

    Science.gov (United States)

    Ogul, Hayri; Havan, Nuri; Gedikli, Yusuf; Pirimoglu, Berhan; Kantarci, Mecit

    2016-06-01

    The authors report on 1 patient of variant origin of right ophthalmic artery (OA) from ophthalmic segment of the left internal carotid artery. A 41-year-old man was performed magnetic resonance (MR) imaging and MR angiography. Cerebral MR imaging revealed a Dandy-Walker variant. In MR angiography the authors observed this unusual variant of origin of OA and a complete occlusion of right internal carotid artery. To the authors' knowledge, this is the first patient who has coincidence of both Dandy-Walker variant and origin of OA from contralateral internal carotid artery. Careful observation of MR angiography images with maximum intensity projection is very important for detecting rare vascular variations.

  5. Blind endovascular catheterization and direct access of an occluded superior ophthalmic vein for treatment of carotid cavernous fistula

    Science.gov (United States)

    Alaraj, Ali; Kim, Bobby; Oh, Gerald; Aletich, Victor

    2013-01-01

    We describe a case of an elderly patient who presented with right-sided ophthalmoplegia, proptosis, chemosis, and increased intraocular pressure. An angiogram showed feeding vessels from the bilateral internal and external carotid arteries. Our initial attempt to blindly probe the inferior petrosal sinus was unsuccessful. This was followed by a right anterior orbitotomy exposing the superior ophthalmic vein which was directly cannulated with an 18 gauge angiocatheter. However, a proximal third of the superior ophthalmic vein within the orbit which was thrombosed was probed blindly. The thrombosed vein was cannulated with a microcatheter to obtain coil embolization of the carotid cavernous fistula. The implications of the procedure are discussed, given that, to our knowledge, such an endeavor has never been performed. PMID:23761619

  6. Predicting small for gestational age in the first trimester of pregnancy using maternal ophthalmic artery Doppler indices.

    Science.gov (United States)

    Gurgel Alves, Júlio Augusto; Maia e Holanda Moura, Sammya Bezerra; Araujo Júnior, Edward; Tonni, Gabriele; Martins, Wellington P; Da Silva Costa, Fabrício

    2016-01-01

    To assess the capacity of maternal ophthalmic Doppler indices for predicting small for gestational age (SGA) newborns in the first trimester of pregnancy. We performed a prospective observational cohort study involving 499 singleton pregnancies during the first trimester scan (11-14 weeks). The following maternal ophthalmic Doppler indices were assessed: pulsatility index (PI), first diastolic peak velocity (PD1) and peak ratio (PR) = PD1/peak systolic velocity. We considered SGA all newborns with weight below 10th percentile. We used chi-square test (χ(2)) to compare the groups. We used area under receiver operating characteristics (ROC) curves with 95% confidence intervals (CI) and detection rate of 5% of false positive of each maternal ophthalmic Doppler index and the mean uterine artery PI for prediction SGA. 27 (5.4%) patients delivered SGA newborns, 12 (2.4%) patients developed preeclampsia (PE) and delivered SGA newborns, and 460 had uneventful pregnancies (controls). We observed significant difference of PI and PR between SGA (SGA and SGA+PE) and control groups, p = 0.043 and p = 0.014, respectively. To 5% of false positive, the detection rate of SGA (SGA and SGA+PE groups) using PI, PD1 and PR were 14.8, 3.7, 14.8, 16.7, 16.7 and 16.7%, respectively. Mean uterine PI was significantly higher in the SGA+PE group (p = 0.003). The isolated use of maternal ophthalmic Doppler indices or in combination with uterine artery Doppler, in the first trimester of pregnancy, was not efficient to predict SGA newborns.

  7. A pilot study for development of a novel tool for clinical decision making to identify fallers among ophthalmic patients.

    Science.gov (United States)

    Melillo, P; Orrico, A; Attanasio, M; Rossi, S; Pecchia, L; Chirico, F; Testa, F; Simonelli, F

    2015-01-01

    Falls in the elderly is a major problem. Although falls have a multifactorial etiology, a commonly cited cause of falls in older people is poor vision. This study proposes a method to discriminate fallers and non-fallers among ophthalmic patients, based on data-mining algorithms applied to health and socio-demographic information. A group of 150 subjects aged 55 years and older, recruited at the Eye Clinic of the Second University of Naples, underwent a baseline ophthalmic examination and a standardized questionnaire, including lifestyles, general health, social engagement and eyesight problems. A subject who reported at least one fall within one year was considered as faller, otherwise as non-faller. Different tree-based data-mining algorithms (i.e., C4.5, Adaboost and Random Forest) were used to develop automatic classifiers and their performances were evaluated by assessing the receiver-operator characteristics curve estimated with the 10-fold-crossvalidation approach. The best predictive model, based on Random Forest, enabled to identify fallers with a sensitivity and specificity rate of 72.6% and 77.9%, respectively. The most informative variables were: intraocular pressure, best corrected visual acuity and the answers to the total difficulty score of the Activities of Daily Vision Scale (a questionnaire for the measurement of visual disability). The current study confirmed that some ophthalmic features (i.e. cataract surgery, lower intraocular pressure values) could be associated with a lower fall risk among visually impaired subjects. Finally, automatic analysis of a combination of visual function parameters (either self-evaluated either by ophthalmological tests) and other health information, by data-mining algorithms, could be a feasible tool for identifying fallers among ophthalmic patients.

  8. Hydroxypropyl Cellulose Ophthalmic Inserts (Lacrisert) Reduce the Signs and Symptoms of Dry Eye Syndrome and Improve Patient Quality of Life

    Science.gov (United States)

    McDonald, Marguerite; D’Aversa, Gerard; Perry, Henry D.; Wittpenn, John R.; Donnenfeld, Eric D.; Nelinson, Donald S.

    2009-01-01

    Purpose: A multicenter, 2-visit, open-label, 4-week study was conducted to determine the acceptability of hydroxypropyl cellulose ophthalmic inserts in adult patients with a history of dry eye syndrome (DES). Methods: At visit 1, patients (N = 520) were evaluated, screened by slit-lamp biomicroscopy, and completed the Ocular Surface Disease Index (OSDI), a validated measure of quality of life. Patients were trained in the proper placement and use of hydroxypropyl cellulose ophthalmic inserts and were contacted by telephone on day 3 of the study. At week 4, patients were given a clinical evaluation and completed a second questionnaire. Answers determined changes in symptoms and quality of life. Adverse events were monitored throughout the study. Results: Four hundred eighteen patients completed the study and reported significant improvements in discomfort, burning, dryness, grittiness, stinging, and light sensitivity (P = .05) after 4 weeks use of hydroxypropyl cellulose ophthalmic inserts. Significant improvements in clinical signs (keratitis, conjunctival staining, and tear volume) were reported. Contact lens wearers reported significant improvements similar to nonwearers, with a strong trend toward improvement in light sensitivity. Mean OSDI total scores, measuring quality of life, significantly improved by 21.3% (from 41.8 ± 22.38 to 32.9 ± 21.97, P ≤ .0215). The most commonly reported adverse event leading to discontinuation was blurred vision, observed in 8.7% of patients (n = 45). Compliance during the study was good; 41.5% of subjects were fully compliant. Of the 58.5% of subjects who missed doses, the majority (69.4%) missed only one to five. Conclusions: Hydroxypropyl cellulose ophthalmic inserts significantly reduced symptoms and clinical signs of moderate to severe DES. They also significantly improved DES in patients wearing contact lenses. Patients experienced a statistically significant improvement in quality of life, as measured by the OSDI, of

  9. Solution preparation

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, M.G.

    1982-01-01

    Reviewed in this statement are methods of preparing solutions to be used in laboratory experiments to examine technical issues related to the safe disposal of nuclear waste from power generation. Each approach currently used to prepare solutions has advantages and any one approach may be preferred over the others in particular situations, depending upon the goals of the experimental program. These advantages are highlighted herein for three approaches to solution preparation that are currently used most in studies of nuclear waste disposal. Discussion of the disadvantages of each approach is presented to help a user select a preparation method for his particular studies. Also presented in this statement are general observations regarding solution preparation. These observations are used as examples of the types of concerns that need to be addressed regarding solution preparation. As shown by these examples, prior to experimentation or chemical analyses, laboratory techniques based on scientific knowledge of solutions can be applied to solutions, often resulting in great improvement in the usefulness of results.

  10. Ophthalmic manifestations of acute and chronic leukemias presenting to a tertiary care center in India.

    Science.gov (United States)

    Koshy, Jacob; John, M Joseph; Thomas, Satish; Kaur, Gurvinder; Batra, Nitin; Xavier, Wilson J

    2015-08-01

    Screening for ocular manifestations of leukemia, although not a routine practice, is important as they may antedate systemic disease or form an isolated focus of its relapse. This study evaluates the spectrum of ocular manifestations in acute and chronic leukemias presenting to a tertiary care center in India. Subjects of leukemia presenting to a tertiary care center in India. A prospective, cross-sectional study looking at the spectrum of ocular manifestations in all inpatients of acute or chronic leukemia. The collected data were analyzed using the Statistical Package for Social Sciences for Windows software, version 16 (SPSS Inc., Chicago, Illinois, USA). The study subjects (n = 96) comprised 61 males and 35 females whose age ranged from 18 months to 91 years (mean = 39.73, ±22.1). There were 79 adults and 17 children, 53 new and 43 existing patients, 68 acute and 28 chronic, 61 myeloid and 35 lymphoid patients. Ocular lesions were found in 42 patients (43.8%). The ocular manifestations of leukemia were significantly (P = 0.01467) more frequent in acute 35/68 (51.9%) than chronic 7/28 (25%) leukemias. Primary or direct leukemic infiltration was seen in 8 (8.3%) subjects while secondary or indirect involvement due to anemia, thrombocytopenia, hyperviscosity, total body irradiation, and immunosuppression were seen in 42 (43.8%) subjects. Ocular changes were present in 37/79 (46.8%) adults and 5/17 (29.4%) children (P = 0.09460). Twenty-eight males (28/61) 45.9% and 14/35 (40%) females had ocular manifestations (P = 0.2874). The ocular manifestations were significantly (P = 0.01158) more frequent in myeloid leukemias 32/61 (52.9%) than lymphoid leukemias 10/35 (28.6%). Leukemic ophthalmic lesions were found in 42/96 (43.8%) patients. Ocular involvement is more often seen in adults, acute and myeloid leukemias. All the primary leukemic manifestations were seen in males. A periodic ophthalmic examination should be mandatory for all leukemic patients, as ocular

  11. Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the DISCOVER Study RESCAN Results.

    Science.gov (United States)

    Ehlers, Justis P; Goshe, Jeff; Dupps, William J; Kaiser, Peter K; Singh, Rishi P; Gans, Richard; Eisengart, Jonathan; Srivastava, Sunil K

    2015-10-01

    Optical coherence tomography (OCT) has transformed the clinical management of a myriad of ophthalmic conditions. Applying OCT to ophthalmic surgery may have implications for surgical decision making and patient outcomes. To assess the feasibility and effect on surgical decision making of a microscope-integrated intraoperative OCT (iOCT) system. Report highlighting the 1-year results (March 2014-February 2015) of the RESCAN 700 portion of the DISCOVER (Determination of Feasibility of Intraoperative Spectral Domain Microscope Combined/Integrated OCT Visualization During En Face Retinal and Ophthalmic Surgery) study, a single-site, multisurgeon, prospective consecutive case series regarding this investigational device. Participants included patients undergoing ophthalmic surgery. Data on clinical characteristics were collected, and iOCT was performed during surgical milestones, as directed by the operating surgeon. A surgeon questionnaire was issued to each surgeon and was completed after each case to evaluate the role of iOCT during surgery and its particular role in select surgical procedures. Percentage of cases with successful acquisition of iOCT (ie, feasibility). Percentage of cases in which iOCT altered surgical decision making (ie, utility). During year 1 of the DISCOVER study, a total of 227 eyes (91 anterior segment cases and 136 posterior segment cases) underwent imaging with the RESCAN 700 system. Successful imaging (eg, the ability to acquire an OCT image of the tissue of interest) was obtained for 224 of 227 eyes (99% [95% CI, 98%-100%]). During lamellar keratoplasty, the iOCT data provided information that altered the surgeon's decision making in 38% of the cases (eg, complete graft apposition when the surgeon believed there was interface fluid). In membrane peeling procedures, iOCT information was discordant with the surgeon's impression of membrane peel completeness in 19% of cases (eg, lack of residual membrane or presence of occult membrane), thus

  12. Ocular drug metabolism of the bioactivating antioxidant N-acetylcarnosine for vision in ophthalmic prodrug and codrug design and delivery.

    Science.gov (United States)

    Babizhayev, Mark A

    2008-10-01

    The basic idea in this study relates to the interesting research problem to employ with the knowledgeable pharmacy staff N-acetylcarnosine (NAC) in the developed suitable compounded prodrug ophthalmic preparations, which are currently used for the treatment of cataract and have antioxidant effect, in order to provide the molecular support to one of the most popular beliefs of the growing market for the treatment of senile cataract in patients and animals with efficacious NAC drug formulations worldwide patented by the author. This work presents the progress in ocular NAC prodrug and codrug design and delivery in light of revealed ocular metabolic activities. There is a considerable interest in the ophthalmic codrug design including NAC prodrug based on the strategies to improve ophthalmic drug delivery of the active peptide principal L-carnosine through the sustained intraocular metabolic activation of a dipeptide while making it resistant to enzymatic hydrolysis. Novel approaches to ocular NAC drug delivery, developed by Innovative Vision Products, Inc. (IVP), aim at enhancing the drug bioavailability by ensuring a prolonged retention of the medication in the eye, and/or by facilitating transcorneal penetration. IVP team studied the effects of lubricant eye drops designed as 1% NAC prodrug of L-carnosine containing a mucoadhesive cellulose-based and corneal absorption promoters in a drug delivery system. The predicted responses of the corneal and conjunctival penetrations to the synergistic promoters are useful in controlling the extent and pathway of the ocular and systemic absorptions of instilled NAC prodrug in designed ophthalmic formulations thereof. Utility of peptidase enzyme inhibitors in the codrug formulation to modulate the transport and metabolism of NAC prodrug appears to be a promising strategy for enhancing dipeptide drug transport across the cornea. The developed and officially CE mark registered by IVP NAC prodrug and codrug lubricating eye drop

  13. Ophthalmic parameters in adult lowland paca (Cuniculus paca) raised in captivity.

    Science.gov (United States)

    Balthazar da Silveira, Camila P; Lima, Tiago B; Crivelaro, Roberta M; de Lacerda, Luciana C C; Pádua, Ivan R M; Renzo, Roberta; de Barros Sobrinho, Alexandre A F; Oliveira, Fabrício S; Aldrovani, Marcela; Laus, José L

    2018-01-01

    To investigate the ophthalmic parameters of lowland pacas, including the anatomic features, tear production, intraocular pressure, central corneal thickness, and morphology of the corneal endothelium. Thirteen adult, anesthetized Cuniculus paca. Eyes were evaluated using slit-lamp biomicroscopy, the Schirmer tear test I, digital applanation tonometry, binocular indirect ophthalmoscopy, and noncontact specular microscopy. The biomicroscopy findings showed blue/brown pigmented bulbar conjunctivae, well-developed cilia (only in the upper eyelid margin), superior and inferior lacrimal puncta, brown irides, round pupils, and vestiges of the nictitating membrane. The results of the Schirmer tear test I revealed (mean ± SD) a lacrimation rate of 4.10 ± 0.44 mm/min. The intraocular pressure was 6.34 ± 0.43 mmHg. Central corneal thickness measured by specular microscopy was 0.35 ± 0.01 mm. The mean values of density, hexagonality, and the area of the endothelial cells were 2083.15 ± 42.47 cells/mm 2 , 67.07 ± 3.30%, and 486.30 ± 9.56 μm 2 , respectively. The ocular parameters defined in this study may be used for reference in future studies and might also contribute to therapeutic approaches appropriate to this species. © 2017 American College of Veterinary Ophthalmologists.

  14. Increasing efficacy and reducing systemic absorption of brimonidine tartrate ophthalmic gels in rabbits.

    Science.gov (United States)

    Pang, Xiaochen; Li, Jiawei; Pi, Jiaxin; Qi, Dongli; Guo, Pan; Li, Nan; Wu, Yumei; Liu, Zhidong

    2017-05-31

    Systemic absorption of ocularly administered Brimonidine Tartrate has been reported to give rise to several side-effects. Hence, it has become crucial to develop a delivery system that could increase efficacy and reduce systemic absorption. Therefore, the present work aims to develop Brimonidine Tartrate gels with different concentrations (0.05%, 0.1%, and 0.2% w/v, respectively) using Carbopol 974 P and HPMC E4M, and compare the therapeutic efficacy and systemic absorption with that of eye drop (0.2%, w/v) by UPLC-MS/MS. The result of histological analysis did not show any morphological or structural changes after the administration of formulations. In vitro residence time studies demonstrated that the gels exhibited a better precorneal residence time as compared with the eye drop. The gels with lower concentrations of the drug (0.05% and 0.1%, w/v) could significantly decrease intraocular pressure (IOP) in both normal and water-loaded rabbits as compared to the eye drop. Finally, the values of the ratio of AUC(0→∞) in comparison to eye drop showed the gels with lower concentrations of Brimonidine Tartrate could decrease the systemic absorption. From the result, it can be concluded the 0.1% ophthalmic gel has a potential to improve therapeutic efficacy and reduce the potential toxicity caused by systemic absorption.

  15. Evaluation of the ophthalmic and dermal irritability of the OLEOMASAJE formulation

    Directory of Open Access Journals (Sweden)

    Maritza F. Díaz

    2015-08-01

    Full Text Available Context: Ozonized vegetable oils present germicidal effects which can be used as active principle in different cosmetological compositions. The thematic about of the corporal massage advantage have been very treatment by aesthetics, dermatologic and consumers. OLEOMASAJE formulation content ozonized sunflower oil OLEOZON as active principle active which present moisturizer and conditioner effects. Aims: To determine the possible dermal and ophthalmic irritability effects of the OLEOMASAJE. Methods: The trial was conducted in rabbits and the techniques described in the standardized procedures of the work established by the Center of Biological Research and Evaluations from Pharmacy and Food Institute of Havana University were used according to Norma ISO 10993-10. The ethical principles of the Good Practices of Laboratory were fulfilled to avoid suffering to the animals during the experimentation. Male rabbits with body weight between 2.05 and 2.48 kg were used. In the skin and the ocular structures the effects were observed immediately after of the application at 1, 24, 48 and 72 hours. Draize´s scale was applied to evaluate skin and ocular structures lesions. Results: The OLEOMASAJE formulation does not irritate de skin of the assayed rabbits. However, the ocular structures irritability index was of 4.5 after of first hour to apply of product. These wounds were missing before of 24 hours to apply of product. Conclusions: The OLEOMASAJE formulation obeys the indispensable requirements for the acceptance as cosmetic product and for it is used in corporal massage.

  16. Epidemiological, clinical and laboratory findings of infectious keratitis at Mansoura Ophthalmic Center, Egypt

    Science.gov (United States)

    Badawi, Amani E; Moemen, Dalia; El-Tantawy, Nora L

    2017-01-01

    AIM To analyze the epidemiological, clinical and laboratory findings of infectious keratitis. METHODS A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was done at Mansoura Ophthalmic Center, Egypt. Corneal scrapings were performed and processed for direct microscopy and culture in appropriate media using standard laboratory protocols. RESULTS Out of 245 patients enrolled for study, 247 corneal scrapings were obtained. Ocular trauma was the most common predisposing factor (51.4%), followed by diabetes mellitus (15.1%). Cultures were positive in 110 scraping samples (44.5%): 45.5% samples had pure fungal infection, 40% had pure bacterial infections and 10% had mixed fungal and bacterial growths. Acanthamoeba was detected in 5 (4.5%) samples. The most common fungal pathogen was Aspergillus spp. (41%). The most common bacterial isolates were Staphylococcus aureus (38.2%) and Pseudomonas aeruginosa (21.8%). CONCLUSION Incidence of fungal keratitis is high in our region. Therapeutic approach can initially be based on clinical features and sensitivity/resistance patterns. Microbiological research should direct the antimicrobial treatment. Antibiotic resistance to fluoroquinolones and aminoglycosides is an important consideration. PMID:28149778

  17. FGF Signaling Is Essential for Ophthalmic Trigeminal Placode Cell Delamination and Differentiation

    Science.gov (United States)

    Lassiter, Rhonda N.T.; Reynolds, Stephanie B.; Marin, Kristopher D.; Mayo, Tyler F.; Stark, Michael R.

    2010-01-01

    The ophthalmic trigeminal (opV) placode gives rise exclusively to sensory neurons of the peripheral nervous system, providing an advantageous model for understanding neurogenesis. The signaling pathways governing opV placode development have only recently begun to be elucidated. Here, we investigate the fibroblast growth factor receptor-4 (FGFR4), an opV expressed gene, to examine if and how FGF signaling regulates opV placode development. After inhibiting FGFR4, Pax3+ opV placode cells failed to delaminate from the ectoderm and did not contribute to the opV ganglion. Blocking FGF signaling also led to a loss of the early and late neuronal differentiation markers Ngn2, Islet-1, NeuN, and Neurofilament. In addition, without FGF signaling, cells that stalled in the ectoderm lost their opV placode-specific identity by down-regulating Pax3. We conclude that FGF signaling, through FGFR4, is necessary for delamination and differentiation of opV placode cells. PMID:19347953

  18. Rebamipide ophthalmic suspension for the treatment of dry eye syndrome: a critical appraisal

    Directory of Open Access Journals (Sweden)

    Kashima T

    2014-05-01

    Full Text Available Tomoyuki Kashima,1 Hirotaka Itakura,1,2 Hideo Akiyama,1 Shoji Kishi11Department of Ophthalmology, Gunma University, School of Medicine, Maebashi, Gunma, Japan; 2Department of Ophthalmology, Maebashi Red Cross Hospital, Maebashi, Gunma, JapanAbstract: Rebamipide was initially developed and approved for use in treating gastric ulcers and lesions associated with gastritis. Discovery of its ability to increase gastric mucin led to investigations of its effect on ocular surface mucin and the subsequent development for use in dry eye patients. Investigations have confirmed that rebamipide increases corneal and conjunctival mucin-like substances along with improving corneal and conjunctival injury. Clinically, rebamipide ophthalmic suspensions can effectively treat tear deficiency and mucin-caused corneal epithelial damage, and can restore the microstructure responsible for tear stability. Topical rebamipide has also been shown to be effective in treating other ocular surface disorders such as lagophthalmos, lid wiper epitheliopathy, and persistent corneal erosion. Rebamipide’s ability to modify epithelial cell function, improve tear stability, and suppress inflammation in the absence of any known major side effects suggest that it may be a beneficial first drug of choice for severe dry eye treatment and other ocular surface disorders. This review summarizes the history and development of this innovative dry eye treatment from its initial use as an effective stomach medication to its current use in the treatment of dry eye in Japan.Keywords: quinolinone derivative, tear deficiency, ocular surface disorder, mucin secretion, Mucosta

  19. Metastatic deaths in retinoblastoma patients treated with intraarterial chemotherapy (ophthalmic artery chemosurgery) worldwide.

    Science.gov (United States)

    Abramson, David H; Shields, Carol L; Jabbour, Pascal; Teixeira, Luiz Fernando; Fonseca, José Roberto Falco; Marques, Marcio Chaves Pedro; Munier, Francis L; Puccinelli, Francesco; Hadjistilianou, Theodora; Bracco, Sandra; Chantada, Guillermo; Ceciliano, Alejandro; Gobin, Y Pierre

    2017-01-01

    Ophthalmic artery chemosurgery [OAC, intra-arterial chemotherapy (IAC)] was introduced in 2006 as treatment modality for intraocular retinoblastoma. The purpose of this commentary is to retrospectively review the incidence of metastatic deaths in retinoblastoma patients treated with OAC worldwide over a 10 year period. Retrospective data regarding metastatic deaths was collected from six international retinoblastoma centers (New York City USA, Philadelphia USA, Sao Paulo Brazil, Siena Italy, Lausanne Switzerland and Buenos Aires Argentina). All retinoblastoma patients from these centers (naive and recurrent, unilateral and bilateral) treated with OAC/IAC since 2006 have been included in this study. Data regarding number of patients, number of OAC/IAC infusions, number unilateral and bilateral, number treated for naive disease or salvage and number of metastatic deaths have been assessed. Over a 10-year period of time 1139 patients received OAC/IAC for 4396 infusions. At last follow-up there were only three metastatic deaths (all treated in Buenos Aires). The current survey assessed the recorded risk of metastatic deaths in six retinoblastoma centers worldwide in children with retinoblastoma (unilateral or bilateral) treated with OAC/IAC as primary or secondary therapy. Overall, the observed risk for metastatic deaths from retinoblastoma was <1% in OAC/IAC treated children.

  20. Ophthalmic acid is a marker of oxidative stress in plants as in animals.

    Science.gov (United States)

    Servillo, Luigi; Castaldo, Domenico; Giovane, Alfonso; Casale, Rosario; D'Onofrio, Nunzia; Cautela, Domenico; Balestrieri, Maria Luisa

    2018-04-01

    Ophthalmic acid (OPH), γ-glutamyl-L-2-aminobutyryl-glycine, a tripeptide analogue of glutathione (GSH), has recently captured considerable attention as a biomarker of oxidative stress in animals. The OPH and GSH biosynthesis, as well as some biochemical behaviors, are very similar. Here, we sought to investigate the presence of OPH in plants and its possible relationship with GSH, known to possess multiple functions in the plant development, growth and response to environmental changes. HPLC-ESI-MS/MS analysis was used to examine the occurrence of OPH in leaves from various plant species, and flours from several plant seeds. Different types of oxidative stress, i.e., water, dark, paraquat, and cadmium stress, were induced in rye, barley, oat, and winter wheat leaves to evaluate the effects on the levels of OPH and its metabolic precursors. OPH and its dipeptide precursor, γ-glutamyl-2-aminobutyric acid, were found to occur in phylogenetically distant plants. Interestingly, the levels of OPH were tightly associated with the oxidative stress tested. Levels of OPH precursors, γ-glutamyl-2-aminobutyric acid and 2-aminobutyric acid, the latter efficiently formed in plants via biosynthetic pathways absent in the animal kingdom, were also found to increase during oxidative stress. OPH occurs in plants and its levels are tightly associated with oxidative stress. OPH behaves as an oxidative stress marker and its biogenesis might occur through a biochemical pathway common to many living organisms. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Time to declare ophthalmology an independent discipline by initiating Bachelor of Ophthalmic Surgery programme.

    Science.gov (United States)

    Maqsood, Hira; Baig, Kashif

    2015-08-01

    Medical education, associated with lengthy, exhaustive pathways requisite of time, energy and efforts, restrain an individual from pursuing a career in medicine. Most students enrol in medical colleges under the influence of their family members, and only some strive to seek medicine as their own ambition. Medical students confront a number of problems in memorising huge amount of data and the various strategies are integrated in MBBS curriculum from time to time. After MBBS programme, most graduates tend to abandon studies, some migrate abroad, a few continue as general physicians and even fewer strive to get registered for postgraduate specialisation. This results in suboptimal supply of medical workforce. Inconsideration of the current ophthalmologist work ratio and growing demand for eye care services, an initiative is put forward to introduce Bachelors of Ophthalmic Surgery programme similar to Bachelor of Dental Surgery. Such initiative may facilitate effective learning, enable command in a particular area and encourage more individuals to pursue a career in ophthalmology. Using a questionnaire to undergraduate medical students, medical professors and ophthalmologists were surveyed to evaluate the efficacy of the proposed initiative. The results threw a mixed response.

  2. Validation of ultrasound parameters to assess collateral flow via ophthalmic artery in internal carotid artery occlusion.

    Science.gov (United States)

    Tanaka, Tomotaka; Doijiri, Ryosuke; Saito, Kozue; Kajimoto, Katsufumi; Ihara, Masafumi; Yamagami, Hiroshi; Miyashita, Kotaro; Nagatsuka, Kazuyuki

    2014-01-01

    This study aimed to characterize the flow patterns using ultrasound (US) in the external carotid artery (ECA) in patients with total occlusion of internal carotid artery (ICA) and characterize collateral retrograde flow through the ophthalmic artery (OA, secondary collateral, internalization). This study was performed on 45 patients who were retrospectively selected with total occlusion of the ICA, who underwent digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and US (43 men; mean age 68.1 ± 7.9 years). Collateral retrograde flow and collateral flow through the circle of Willis (primary collateral) were determined by DSA and MRA. We compared several US parameters such as ECA peak systolic velocity, mean velocity, end-diastolic (ED) velocity, pulsatility index (PI), and pulsatility transmission index (PTI). PTI was defined as the ratio of ipsilateral ECA PI to the ipsilateral common carotid artery (CCA). In this patient group, 27 patients showed retrograde flow through OA as assessed by DSA. The presence of primary collateral flow was significantly lower in patients with retrograde flow than without (P ECA ED velocity was significantly higher, and PI and PTI were significantly lower with retrograde flow through OA than without (P ECA because a collateral pathway through OA in cases of ICA occlusion had less primary collateral pathways. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Selected ophthalmic diagnostic tests, bony orbit anatomy, and ocular histology in sambar deer (Rusa unicolor).

    Science.gov (United States)

    Oriá, Arianne P; Gomes Junior, Deusdete C; Oliveira, Alberto Vinícius D; Curvelo, Victor P; Estrela-Lima, Alessandra; Pinna, Melissa H; Meneses, Íris D S; Filho, Emanoel F M; Ofri, Ron

    2015-01-01

    The purpose of this study was to establish reference values for diagnostic ophthalmic tests in sambar deer (Rusa unicolor) as well as to describe the most relevant features of the bony orbital anatomy and ocular histology. Twenty healthy animals, free living in a forest reserve, that were captured for clinical evaluation as part of a health survey were evaluated. Schirmer tear test-1 (STT1), conjunctival microbiota, intraocular pressure (IOP), conjunctival cytology, anatomy of the bony orbit, and ocular histology were studied. Mean ± SD STT1 and IOP values were 18.8 ± 4.7 mm and 11.4 ± 2.8 mmHg, respectively. IOP was significantly higher in adult (4-8 years) animals (P = 0.04). Bacterial growth was present in 100% of the samples, with a prevalence for Staphylococcus sp. and Bacillus sp. The conjunctival cytology revealed predominance of columnar epithelial cells with mild pigmentation. The sambar deer orbit is completely encompassed by bone. The ocular histology was very similar to most mammalians. The findings in this study will be useful in the diagnosis of ocular diseases in Rusa unicolor. © 2014 American College of Veterinary Ophthalmologists.

  4. Ophthalmic examination findings in a captive colony of western gray kangaroos (Macropus fuliginosus).

    Science.gov (United States)

    Labelle, Amber L; Low, Martha; Hamor, Ralph E; Breaux, Carrie B; Langan, Jennifer N; Zarfoss, Mitzi K; Zachariah, Trevor T

    2010-09-01

    Complete ophthalmic examination of a mob of western gray kangaroos (Macropus fuliginosus) was performed under chemical restraint. Examination included intraocular pressure (IOP) measurement by rebound and applanation tonometry, fluorescein staining, corneal diameter measurement, slit-lamp biomicroscopy and indirect funduscopy. The corneal diameters had a mean of 19.52 mm, SD 2.16 mm, 95% confidence interval (CI) 18.71-20.32 mm. Ocular abnormalities were noted in 4/8 (50%) of examined kangaroos. Intraocular pressure as estimated by rebound tonometry was 9.00 mm Hg with a 25-75% quartile range of 6.5-10.75 mm Hg and a minimum-maximum range of 5.00-23.00 mm Hg. Intraocular pressure as estimated by applanation tonometry was 11.50 mm Hg with a 25-75% quartile range of 10.00-17.00 mm Hg and a minimum-maximum range of 9.00-20.00 mm Hg. This is the first report of ocular examination findings in a mob of captive western gray kangaroos and provides ranges and values for tonometry and corneal diameter.

  5. Chitosan/alginate based multilayers to control drug release from ophthalmic lens.

    Science.gov (United States)

    Silva, Diana; Pinto, Luís F V; Bozukova, Dimitriya; Santos, Luís F; Serro, Ana Paula; Saramago, Benilde

    2016-11-01

    In this study we investigated the possibility of using layer-by-layer deposition, based in natural polymers (chitosan and alginate), to control the release of different ophthalmic drugs from three types of lens materials: a silicone-based hydrogel recently proposed by our group as drug releasing soft contact lens (SCL) material and two commercially available materials: CI26Y for intraocular lens (IOLs) and Definitive 50 for SCLs. The optimised coating, consisting in one double layer of (alginate - CaCl2)/(chitosan+glyoxal) topped with a final alginate-CaCl2 layer to avoid chitosan degradation by tear fluid proteins, proved to have excellent features to control the release of the anti-inflammatory, diclofenac, while keeping or improving the physical properties of the lenses. The coating leads to a controlled release of diclofenac from SCL and IOL materials for, at least, one week. Due to its high hydrophilicity (water contact angle≈0) and biocompatibility, it should avoid the use of further surface treatments to enhance the useŕs comfort. However, the barrier effect of this coating is specific for diclofenac, giving evidence to the need of optimizing the chemical composition of the layers in view of the desired drug. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Rebamipide ophthalmic suspension for the treatment of dry eye syndrome: a critical appraisal.

    Science.gov (United States)

    Kashima, Tomoyuki; Itakura, Hirotaka; Akiyama, Hideo; Kishi, Shoji

    2014-01-01

    Rebamipide was initially developed and approved for use in treating gastric ulcers and lesions associated with gastritis. Discovery of its ability to increase gastric mucin led to investigations of its effect on ocular surface mucin and the subsequent development for use in dry eye patients. Investigations have confirmed that rebamipide increases corneal and conjunctival mucin-like substances along with improving corneal and conjunctival injury. Clinically, rebamipide ophthalmic suspensions can effectively treat tear deficiency and mucin-caused corneal epithelial damage, and can restore the microstructure responsible for tear stability. Topical rebamipide has also been shown to be effective in treating other ocular surface disorders such as lagophthalmos, lid wiper epitheliopathy, and persistent corneal erosion. Rebamipide's ability to modify epithelial cell function, improve tear stability, and suppress inflammation in the absence of any known major side effects suggest that it may be a beneficial first drug of choice for severe dry eye treatment and other ocular surface disorders. This review summarizes the history and development of this innovative dry eye treatment from its initial use as an effective stomach medication to its current use in the treatment of dry eye in Japan.

  7. Use of an Ophthalmic Viscosurgical Device for Experimental Retinal Detachment in Rabbit Eyes

    Directory of Open Access Journals (Sweden)

    Satoshi Okinami

    2013-01-01

    Full Text Available To investigate the temporary tamponade effects of an ophthalmic viscosurgical device (OVD for experimental retinal tears, we performed vitrectomy in four rabbit eyes and created a posterior vitreous detachment and artificial retinal tear to produce retinal detachment. The retina was flattened with liquid perfluorocarbon (PFC, the area peripheral to the tear was photocoagulated, an OVD was applied to the retinal tear surface below the PFC and the PFC was removed by aspiration. In the control group, PFC was removed without application of OVD. At one, three and seven days postoperatively, funduscopy and optical coherence tomography (OCT were performed to examine the sealing process of the retinal tear. In OVD-treated eyes, the OVD remained on the retinal surface, and the retinal tear was patched for ≥ 3 days postoperatively. By seven days postoperatively, the OVD on the retinal surface had disappeared, and the retina was reattached. In control eyes, the edge of the retinal tear was rolled, and retinal detachment persisted. In OVD-treated eyes, the border of the retinal tear was indistinct, and the defect area was significantly decreased. These results show that application of an OVD effectively seals retinal tears and eliminates retinal detachments.

  8. New method for ophthalmic delivery of azithromycin by poloxamer/carbopol-based in situ gelling system.

    Science.gov (United States)

    Cao, Feng; Zhang, Xiaolin; Ping, Qineng

    2010-01-01

    This study focused on preparation and evaluation of a thermosensitive and mucoadhesive in situ gelling ophthalmic system of azithromycin (ATM). Poloxamer 407 (P407) and poloxamer 188 (P188) were used as gelling agents. Addition of Carbopol 974P (CP 974P) to the gelling systems could increase the solubility of ATM by salt effect and enhance the mucoadhesive property of the systems. Gelation temperature of these systems ranged from 31.21-36.31 degrees C depending on the ratio of P407 and P188. Mucoadhesion force of the system composed of P407/P188/CP 974P (21/5/0.3%, w/v) was 2.3-fold that without carbopol 974P. Viscosity of the formulation was in a suitable range at 25 degrees C and pseudoplastic behavior was observed at 35 degrees C. The formulation exhibited a 24-h sustained release of ATM. In vivo resident experiments showed AUC(0-12) of ATM in rabbit tears increased by 1.78-fold for in situ gel compared with eye drop. At 12 h, tear concentrations exceeded minimum inhibitory concentration (MIC) breakpoint for the most common causative pathogens of bacterial conjunctivitis by 2.8-fold. Results in vitro and in vivo indicated that this droppable gel performed better than ATM eye drop did.

  9. Ophthalmic manifestations of leukemia in a tertiary hospital population of adult nigerian africans.

    Science.gov (United States)

    Eze, Boniface I; Ibegbulam, Godswill O; Ocheni, Sunday

    2010-10-01

    To determine the prevalence and pattern of leukemic ophthalmopathy among adults at the University of Nigeria Teaching Hospital (UNTH), Enugu, south-eastern, Nigeria. This prospective, observational case series surveyed adult leukemia patients presenting at UNTH's departments of Hematology/Immunology and Ophthalmology from July 2003 to August 2008. The demographic profile, clinical data from for each individual in the cohort were statistically collated and analyzed. A P manifestations of leukemia were retinal vascular abnormalities in 50.0% of subjects, conjunctival pallor in 27.8% of subjects, sub-conjunctival hemorrhage in 19.4% of subjects, and retinal hemorrhage in 16.7% of subjects. Ocular co-morbidity was present in 47.2% of subjects. Vision loss occurred in 37.5% of subjects, of which 32.1% was leukemia related, and the remaining due to ocular co-morbidity. Leukemic ophthalmopathy was more prevalent in chronic leukemia (P leukemia (P = 0.0822) or leukemic ophthalmopathy (P = 0.6624). The prevalence of leukemic ophthalmopathy in Enugu is high. It is often associated with significant ocular co-morbidity and vision loss. These have implications for clinicians involved in leukemia management. Early diagnosis and regular ophthalmic examinations are recommended to optimize treatment outcomes.

  10. The use of retinal photography in non-ophthalmic settings and its potential for neurology

    Science.gov (United States)

    Pérez, Mario A.; Bruce, Beau B.; Newman, Nancy J.; Biousse, Valérie

    2012-01-01

    Background Ocular fundus examination is an important element of the neurological examination. However, direct ophthalmoscopy is difficult to perform without pupillary dilation and requires extensive practice to accurately recognize optic nerve and retinal abnormalities. Recent studies have suggested that digital retinal photography can replace direct ophthalmoscopy in many settings. Review Summary Ocular fundus imaging is routinely used to document and monitor disease progression in ophthalmology. Advances in optical technology have made it easier to obtain high-quality retinal imaging, even without pupillary dilation. Retinal photography has a high sensitivity, specificity, and inter-/intra-examination agreement compared to in-person ophthalmologist examination, suggesting that photographs can be used in lieu of ophthalmoscopy in many clinical situations. Non-mydriatic retinal photography has recently gained relevance as a helpful tool for diagnosing neuro-ophthalmologic disorders in the emergency department. Additionally, several population-based studies have used retinal imaging to relate ophthalmic abnormalities to the risk of hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment. The possibility of telemedical consultation offered by digital retinal photography has already increased access to timely and accurate subspecialty care, particularly for underserved areas. Conclusion Retinal photography (even without pupillary dilation) has become increasingly available to medical fields outside of ophthalmology, allowing for faster and more accurate diagnosis of various ocular, neurologic and systemic disorders. The potential for telemedicine may provide the additional benefits of improving access to appropriate urgent consultation in both clinical and research settings. PMID:23114666

  11. Refresher training and continuing education for para-medical ophthalmic assistants

    Directory of Open Access Journals (Sweden)

    Shamanna B

    1999-01-01

    Full Text Available This paper describes a refresher training and continuing education programme in clinical and community ophthalmology for para-medical ophthalmic assistants (PMOAs conducted by the Lions Aravind Institute of Community Ophthalmology. The course participants included 60 PMOAs working either in district hospitals, primary health centres or mobile units from the districts in Maharashtra. Each training programme was spread over 43 hours in 4 days and included lectures, practical demonstrations, and hands-on training in the outpatient, inpatient, and operation theatre of the training institution. Participants were given exposure to outreach activities in an eye camp and a satellite eye centre resembling a district hospital. The PMOAs found the training to be useful and it was seen that areas like patient counselling, instrument and equipment maintenance, and assistance in the operation theatre for newer surgical procedures which were lacking in the basic training were fulfilled in this training programme. Regional Institutes of Ophthalmology, upgraded medical colleges, and other eye-care institutions which have facilities and manpower could organise similar refresher and continuing education programmes for PMOAs so that they could be utilised more efficiently in the blindness-control activities in the country.

  12. Evaluation of the efficacy and safety of the ophthalmic insert Mydriasert in patients undergoing retinal angiography.

    Science.gov (United States)

    Cagini, Carlo; Caricato, Anna; Tosi, Gianluigi; Pascale, Angelo; Cesari, Claudia; Fiore, Tito

    2014-01-01

    To verify the efficacy to obtain mydriasis and cardiovascular safety of Mydriasert (ophthalmic insert containing tropicamide and phenylephrine) in diabetic and nondiabetic patients undergoing retinal angiography by comparing it with usually administered eyedrops (tropicamide 1% and phenylephrine 10%). This was a prospective randomized study. A total of 154 eyes of 77 patients were randomly divided into 2 groups: group 1 consisted of 78 eyes, group 2 consisted of 76 eyes, and the patients were monitored for pupillary dilation, blood pressure, heart rate, and possible adverse effects at 0, 20, 40, 60, and 90 minutes. No severe adverse effects were observed in either group. In the entire sample studied, the mean pupillary diameter was greater in the eyedrops group after 20 and 40 minutes, while mydriasis was similar in the 2 groups after 60 minutes. The diabetic patients treated with Mydriasert had less mydriasis than those treated with eyedrops after 20 and 40 minutes, and diabetic patients showed less mydriasis than the nondiabetic patients after 60 and 90 minutes. There was no significant between-group difference in mean heart rate or systolic and diastolic blood pressure at any of the time points. Mydriasert assures an adequate degree of mydriasis for retinal angiography in both diabetic and nondiabetic patients. There are no differences in efficacy or safety between the insert and the usually administered eyedrops, but the low total drug dose administered with the insert reduces the risk of cardiovascular side effects.

  13. Evaluation of tropicamide-loaded tamarind seed xyloglucan nanoaggregates for ophthalmic delivery.

    Science.gov (United States)

    Dilbaghi, Neeraj; Kaur, Harmanmeet; Ahuja, Munish; Kumar, Sandeep

    2013-04-15

    The present study was aimed to prepare tamarind seed nanoaggregates and its evaluation for ophthalmic delivery. The preparation of tropicamide-loaded tamarind seed xyloglucan nanoaggregates was optimized using face centred central composite experimental design, employing the concentrations of tamarind seed xyloglucan and Poloxamer-407, as independent variables. The results revealed that concentration of TSX has a significant antagonistic effect on particle size, while poloxamer displayed a significant synergistic effect on encapsulation efficiency. The optimal concentrations of TSX and poloxamer were found to be 0.45% (w/v) and 0.5% (w/v) respectively. The optimized formulation of tropicamide-loaded TSX nanoaggregates showed a significantly higher corneal permeation of tropicamide across the isolated goat cornea compared to commercial conventional aqueous formulation. The results revealed excellent mucoadhesive properties of TSX nanoaggregates. Further, the tropicamide-loaded TSX nanoaggregates formulation showed excellent ocular tolerance and biocompatibility as determined by hen's egg test chorioallantoic membrane and resazurin assay on Vero cell lines. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Ganciclovir ophthalmic gel in herpes simplex virus rabbit keratitis: intraocular penetration and efficacy.

    Science.gov (United States)

    Castela, N; Vermerie, N; Chast, F; Sauvageon-Martre, H; Denis, J; Godard, V; Goldschmidt, P; Pouliquen, Y

    1994-01-01

    A chronic administration of three ganciclovir gels (0.2%, 0.05%, 0.0125%) was compared with a placebo gel and a 3% acyclovir ophthalmic ointment in the treatment of HSV-1 rabbit keratitis. All the ganciclovir gels showed a clinical efficacy: a significant reduction of the corneal ulcer area, clouding and vascularization (p efficacy was slower than using acyclovir ointment. No significant difference could be shown between the 0.2% and 0.05% ganciclovir gels or the 0.05% ganciclovir gel and the acyclovir treatment on viral isolation, when it was performed on pooled samples. The distribution of ganciclovir and acyclovir into the rabbit eyes (HPLC methods), were similar but markedly higher in solid tissues than ocular fluids. It might explain the recovery from tissue damages. The mean corneal ganciclovir concentrations were largely higher than ED 50 of ganciclovir for HSV-1. No toxicity was expected, due to very limited systemic availability. This study suggests a comparable activity on HSV-1 superficial keratitis between 0.05%, 0.2% ganciclovir gels and 3% acyclovir ointment. Higher concentration of ganciclovir gels are probably necessary in order to treat the HSV-1 kerato-uveitis.

  15. Salvage/Adjuvant Brachytherapy After Ophthalmic Artery Chemosurgery for Intraocular Retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Francis, Jasmine H., E-mail: francij1@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Barker, Christopher A.; Wolden, Suzanne L.; McCormick, Beryl; Segal, Kira; Cohen, Gil [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Gobin, Y. Pierre; Marr, Brian P. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, New York (United States); Brodie, Scott E. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Mount Sinai School of Medicine, New York, New York (United States); Dunkel, Ira J.; Abramson, David H. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Weill-Cornell Medical College, New York-Presbyterian Hospital, New York, New York (United States)

    2013-11-01

    Purpose: To evaluate the efficacy and toxicity of brachytherapy after ophthalmic artery chemosurgery (OAC) for retinoblastoma. Methods and Materials: This was a single-arm, retrospective study of 15 eyes in 15 patients treated with OAC followed by brachytherapy at (blinded institution) between May 1, 2006, and December 31, 2012, with a median 19 months' follow-up from plaque insertion. Outcome measurements included patient and ocular survival, visual function, and retinal toxicity measured by electroretinogram (ERG). Results: Brachytherapy was used as adjuvant treatment in 2 eyes and as salvage therapy in 13 eyes of which 12 had localized vitreous seeding. No patients developed metastasis or died of retinoblastoma. The Kaplan-Meier estimate of ocular survival was 79.4% (95% confidence interval 48.7%-92.8%) at 18 months. Three eyes were enucleated, and an additional 6 eyes developed out-of-target volume recurrences, which were controlled with additional treatments. Patients with an ocular complication had a mean interval between last OAC and plaque of 2.5 months (SD 2.3 months), which was statistically less (P=.045) than patients without ocular complication who had a mean interval between last OAC and plaque of 6.5 months (SD 4.4 months). ERG responses from pre- versus postplaque were unchanged or improved in more than half the eyes. Conclusions: Brachytherapy following OAC is effective, even in the presence of vitreous seeding; the majority of eyes maintained stable or improved retinal function following treatment, as assessed by ERG.

  16. Wave Solutions

    CERN Document Server

    Christov, Ivan C

    2012-01-01

    In classical continuum physics, a wave is a mechanical disturbance. Whether the disturbance is stationary or traveling and whether it is caused by the motion of atoms and molecules or the vibration of a lattice structure, a wave can be understood as a specific type of solution of an appropriate mathematical equation modeling the underlying physics. Typical models consist of partial differential equations that exhibit certain general properties, e.g., hyperbolicity. This, in turn, leads to the possibility of wave solutions. Various analytical techniques (integral transforms, complex variables, reduction to ordinary differential equations, etc.) are available to find wave solutions of linear partial differential equations. Furthermore, linear hyperbolic equations with higher-order derivatives provide the mathematical underpinning of the phenomenon of dispersion, i.e., the dependence of a wave's phase speed on its wavenumber. For systems of nonlinear first-order hyperbolic equations, there also exists a general ...

  17. Solution Prototype

    DEFF Research Database (Denmark)

    Efeoglu, Arkin; Møller, Charles; Serie, Michel

    2013-01-01

    This paper outlines an artifact building and evaluation proposal. Design Science Research (DSR) studies usually consider encapsulated artifact that have relationships with other artifacts. The solution prototype as a composed artifact demands for a more comprehensive consideration in its systematic...... environment. The solution prototype that is composed from blending product and service prototype has particular impacts on the dualism of DSR’s “Build” and “Evaluate”. Since the mix between product and service prototyping can be varied, there is a demand for a more agile and iterative framework. Van de Ven...

  18. Podcast solutions

    CERN Document Server

    Geoghegan, Michael W

    2005-01-01

    Podcasting is the art of recording radio show style audio tracks, then distributing them to listeners on the Web via podcasting software such as iPodder. From downloading podcasts to producing a track for fun or profit, ""Podcast Solutions"" covers the entire world of podcasting with insight, humor, and the unmatched wisdom of experience.

  19. Development of a New Valid, Reliable, and Internationally Applicable Assessment Tool of Residents’ Competence in Ophthalmic Surgery (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Golnik, C.; Beaver, Hilary; Gauba, Vinod; Lee, Andrew G.; Mayorga, Eduardo; Palis, Gabriela; Saleh, George M.

    2013-01-01

    Purpose: To test the validity and reliability of a new tool for assessing residents’ competence in ophthalmic surgery. Changing paradigms of ophthalmic education in the United States have influenced worldwide ophthalmic education and necessitated new methods of assessing resident competence. Accordingly, a new tool for assessing residents’ competence in ophthalmic surgery (phacoemulsification) that could be applicable internationally was developed. We hypothesize that this instrument is valid and reliable. Methods: A panel of six international content experts adapted a previously published tool for assessing phacoemulsification. The tool (called the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric, or ICO-OSCAR:phaco) was reviewed by 12 international content experts for their constructive comments, which were incorporated to ensure content validity. Ten expert cataract surgery teachers then graded six recorded phacoemulsification surgeries with the ICO-OSCAR:phaco to investigate inter-rater reliability. Results: The coefficient alpha statistic (a measure of reliability/internal consistency) for the ICO-OSCAR:phaco as a whole was 0.92, and 17 of its 20 dimensions had alpha coefficients greater than 0.70. Conclusions: The ICO-OSCAR:phaco is a valid and reliable assessment tool that could be applied internationally to satisfy the global need of new instruments to comply with emerging trends in ophthalmic education. A toolbox of similar surgical competency assessment tools is being developed. PMID:24072944

  20. Development of a new valid, reliable, and internationally applicable assessment tool of residents' competence in ophthalmic surgery (an American Ophthalmological Society thesis).

    Science.gov (United States)

    Golnik, C; Beaver, Hilary; Gauba, Vinod; Lee, Andrew G; Mayorga, Eduardo; Palis, Gabriela; Saleh, George M

    2013-09-01

    To test the validity and reliability of a new tool for assessing residents' competence in ophthalmic surgery. Changing paradigms of ophthalmic education in the United States have influenced worldwide ophthalmic education and necessitated new methods of assessing resident competence. Accordingly, a new tool for assessing residents' competence in ophthalmic surgery (phacoemulsification) that could be applicable internationally was developed. We hypothesize that this instrument is valid and reliable. A panel of six international content experts adapted a previously published tool for assessing phacoemulsification. The tool (called the International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric, or ICO-OSCAR:phaco) was reviewed by 12 international content experts for their constructive comments, which were incorporated to ensure content validity. Ten expert cataract surgery teachers then graded six recorded phacoemulsification surgeries with the ICO-OSCAR:phaco to investigate inter-rater reliability. The coefficient alpha statistic (a measure of reliability/internal consistency) for the ICO-OSCAR:phaco as a whole was 0.92, and 17 of its 20 dimensions had alpha coefficients greater than 0.70. The ICO-OSCAR:phaco is a valid and reliable assessment tool that could be applied internationally to satisfy the global need of new instruments to comply with emerging trends in ophthalmic education. A toolbox of similar surgical competency assessment tools is being developed.

  1. Health claims database study of cyclosporine ophthalmic emulsion treatment patterns in dry eye patients

    Directory of Open Access Journals (Sweden)

    Stonecipher KG

    2013-10-01

    Full Text Available Karl G Stonecipher,1 Jenny Chia,2 Ahunna Onyenwenyi,2 Linda Villanueva,2 David A Hollander2 1TLC Laser Eye Centers, Greensboro, NC, 2Allergan, Inc., Irvine, CA, USA Background: Dry eye is a multifactorial, symptomatic disease associated with ocular surface inflammation and tear film hyperosmolarity. This study was designed to assess patterns of topical cyclosporine ophthalmic emulsion 0.05% (Restasis® use in dry eye patients and determine if there were any differences in use based on whether dry eye is physician-coded as a primary or nonprimary diagnosis. Methods: Records for adult patients with a diagnosis of dry eye at an outpatient visit from January 1, 2008 to December 31, 2009 were selected from Truven Health MarketScan® Research Databases. The primary endpoint was percentage of patients with at least one primary versus no primary dry eye diagnosis who filled a topical cyclosporine prescription. Data analyzed included utilization of topical corticosteroids, oral tetracyclines, and punctal plugs. Results: The analysis included 576,416 patients, accounting for 875,692 dry eye outpatient visits: 74.7% were female, 64.2% were ages 40-69 years, and 84.4% had at least one primary dry eye diagnosis. During 2008–2009, 15.9% of dry eye patients with a primary diagnosis versus 6.5% with no primary diagnosis filled at least one cyclosporine prescription. For patients who filled at least one prescription, the mean months’ supply of cyclosporine filled over 12 months was 4.44. Overall, 33.9% of dry eye patients filled a prescription for topical cyclosporine, topical corticosteroid, or oral tetracycline over 2 years. Conclusion: Patients with a primary dry eye diagnosis were more likely to fill a topical cyclosporine prescription. Although inflammation is key to the pathophysiology of dry eye, most patients seeing a physician for dry eye may not receive anti-inflammatory therapies. Keywords: corticosteroids, cyclosporine, dry eye syndromes

  2. Physical crosslinking modulates sustained drug release from recombinant silk-elastinlike protein polymer for ophthalmic applications.

    Science.gov (United States)

    Teng, Weibing; Cappello, Joseph; Wu, Xiaoyi

    2011-12-10

    We evaluated the drug release capability of optically transparent recombinant silk-elastinlike protein polymer, SELP-47K, films to sustainably deliver the common ocular antibiotic, ciprofloxacin. The ciprofloxacin release kinetics from drug-loaded SELP-47K films treated with ethanol or methanol vapor to induce different densities of physical crosslinking was investigated. Additionally, the drug-loaded protein films were embedded in a protein polymer coating to further prolong the release of the drug. Drug-loaded SELP-47K films released ciprofloxacin for up to 132 h with near first-order release kinetics. Polymer coating of drug-loaded films prolonged drug release for up to 220 h. The antimicrobial activity of ciprofloxacin released from the drug delivery matrices was not impaired by the film casting process or the ethanol or methanol treatments. The mechanism of drug release was elucidated by analyzing the physical properties of the film specimens, including equilibrium swelling, soluble fraction, surface roughness and hydrophobicity. Additionally, the conformation of the SELP-47K and its physical crosslinks in the films was analyzed by FTIR and Raman spectroscopy. A three-parameter physics based model accurately described the release rates observed for the various film and coating treatments and attributed the effects to the degree of physical crosslinking of the films and to an increasing affinity of the drug with the polymer network. Together, these results indicate that optically transparent silk-elastinlike protein films may be attractive material candidates for novel ophthalmic drug delivery devices. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Microsurgical clipping of ophthalmic artery aneurysms: surgical results and visual outcomes with 208 aneurysms.

    Science.gov (United States)

    Kamide, Tomoya; Tabani, Halima; Safaee, Michael M; Burkhardt, Jan-Karl; Lawton, Michael T

    2018-01-26

    OBJECTIVE While most paraclinoid aneurysms can be clipped with excellent results, new postoperative visual deficits are a concern. New technology, including flow diverters, has increased the popularity of endovascular therapy. However, endovascular treatment of paraclinoid aneurysms is not without procedural risks, is associated with higher rates of incomplete aneurysm occlusion and recurrence, and may not address optic nerve compression symptoms that surgical debulking can. The increasing endovascular management of paraclinoid aneurysms should be justified by comparisons to surgical benchmarks. The authors, therefore, undertook this study to define patient, visual, and aneurysm outcomes in the most common type of paraclinoid aneurysm: ophthalmic artery (OphA) aneurysms. METHODS Results from microsurgical clipping of 208 OphA aneurysms in 198 patients were retrospectively reviewed. Patient demographics, aneurysm morphology (size, calcification, etc.), clinical characteristics, and patient outcomes were recorded and analyzed. RESULTS Despite 20% of these aneurysms being large or giant in size, complete aneurysm occlusion was accomplished in 91% of 208 cases, with OphA patency preserved in 99.5%. The aneurysm recurrence rate was 3.1% and the retreatment rate was 0%. Good outcomes (modified Rankin Scale score 0-2) were observed in 96.2% of patients overall and in all 156 patients with unruptured aneurysms. New visual field defects (hemianopsia or quadrantanopsia) were observed in 8 patients (3.8%), decreased visual acuity in 5 (2.4%), and monocular blindness in 9 (4.3%). Vision improved in 9 (52.9%) of the 17 patients with preoperative visual deficits. CONCLUSIONS The most important risk associated with clipping OphA aneurysms is a new visual deficit. Meticulous microsurgical technique is necessary during anterior clinoidectomy, aneurysm dissection, and clip application to optimize visual outcomes, and aggressive medical management postoperatively might potentially

  4. Increased ophthalmic acid production is supported by amino acid catabolism under fasting conditions in mice.

    Science.gov (United States)

    Kobayashi, Sho; Lee, Jaeyong; Takao, Toshifumi; Fujii, Junichi

    2017-09-23

    Glutathione (GSH) plays pivotal roles in antioxidation and detoxification. The transsulfuration pathway, in conjunction with methionine metabolism, produces equimolar amounts of cysteine (Cys) and 2-oxobutyric acid (2OB). The resulting 2OB is then converted into 2-aminobutyric acid (2AB) by a transaminase and is utilized as a substitute for Cys by the GSH-synthesizing machinery to produce ophthalmic acid (OPT). By establishing a method for simultaneously measuring Cys, GSH, and OPT by liquid chromatography-mass spectrometry, we found that fasting causes an elevation in OPT levels in the liver and blood plasma, even though the levels of Cys and GSH are decreased. Autophagy was activated, but the levels of GSH/OPT-synthesizing enzymes remained unchanged. After 6 h of fasting, the mice were given 1% 2AB and/or 5% glucose in the drinking water for an additional 24 h and the above metabolites analyzed. 2AB administration caused an increase in OPT levels, and, when glucose was co-administered with 2AB, the levels of OPT were elevated further but GSH levels were decreased somewhat. These results suggest that, while Cys is utilized for glyconeogenesis under fasting conditions, reaching levels that were insufficient for the synthesis of GSH, 2OB was preferentially converted to 2AB via amino acid catabolism and was utilized as a building block for OPT. Thus the consumption of Cys and the parallel elevation of 2AB under fasting conditions appeared to force γ-glutamylcysteine synthetase to form γ-glutamyl-2AB, despite the fact that the enzyme has a higher Km value for 2AB than Cys. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Quantitative analysis of the text and graphic content in ophthalmic slide presentations.

    Science.gov (United States)

    Ing, Edsel; Celo, Erdit; Ing, Royce; Weisbrod, Lawrence; Ing, Mercedes

    2017-04-01

    To determine the characteristics of ophthalmic digital slide presentations. Retrospective quantitative analysis. Slide presentations from a 2015 Canadian primary eye care conference were analyzed for their duration, character and word count, font size, words per minute (wpm), lines per slide, words per slide, slides per minute (spm), text density product (wpm × spm), proportion of graphic content, and Flesch Reading Ease (FRE) score using Microsoft PowerPoint and Word. The median audience evaluation score for the lectures was used to dichotomize the higher scoring lectures (HSL) from the lower scoring lectures (LSL). A priori we hypothesized that there would be a difference in the wpm, spm, text density product, and FRE score between HSL and LSL. Wilcoxon rank-sum tests with Bonferroni correction were utilized. The 17 lectures had medians of 2.5 spm, 20.3 words per slide, 5.0 lines per slide, 28-point sans serif font, 36% graphic content, and text density product of 136.4 words × slides/minute 2 . Although not statistically significant, the HSL had more wpm, fewer words per slide, more graphics per slide, greater text density, and higher FRE score than LSL. There was a statistically significant difference in the spm of the HSL (3.1 ± 1.0) versus the LSL (2.2 ± 1.0) at p = 0.0124. All presenters showed more than 1 slide per minute. The HSL showed more spm than the LSL. The descriptive statistics from this study may aid in the preparation of slides used for teaching and conferences. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  6. Red eyes and red-flags: improving ophthalmic assessment and referral in primary care.

    Science.gov (United States)

    Kilduff, Caroline; Lois, Charis

    2016-01-01

    Up to five percent of primary care consultations are eye-related, yet 96% of General Practitioners (GPs) do not undergo postgraduate ophthalmology training. Most do not feel assured performing eye assessments. Some red eye conditions can become sight threatening, and often exhibit red-flag features. These features include moderate pain, photophobia, reduced visual acuity (VA), eye-trauma, or unilateral marked redness. The aim of this project was to improve primary care assessment and referral of patients presenting with red-flag features based on the NICE 'Red Eye' Clinical Knowledge Summary recommendations. Data was collected retrospectively from 139 red eye consultations. A practice meeting highlighted poor awareness of red-flag features, low confidence levels in eye assessments, and time-constraints during appointments. Interventions were based on feedback from staff. These included a primary care teaching session on red-flag features, a VA measurement tutorial, and provision of a red eye toolkit, including VA equipment, to each consultation room. At baseline, each patient had on average 0.9 red-flag features assessed. Only 36.0% (9/25) of patients with red-flag features were appropriately referred to same-day ophthalmology services. Following two improvement cycles, a significant improvement was seen in almost every parameter. On average, each patient had 2.7 red-flag features assessed (vs 0.9, peye-trauma or foreign-body (51.8% vs 8.6%, predness was documented in 66.7% (vs 14.4%, p<0.001). Only photophobia remained poorly assessed (18.5% vs 14.4%, p=0.75). Following this, 75.0% (6/8) of patients were appropriately referred. This project reflected the literature regarding low confidence and inexperience amongst GPs when faced with ophthalmic conditions. Improvements in education are required to ensure accurate assessments can be undertaken in a time-constrained environment.

  7. Solvent Composition is Critical for Carbodiimide Cross-Linking of Hyaluronic Acid as an Ophthalmic Biomaterial

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    Jui-Yang Lai

    2012-10-01

    Full Text Available Hyaluronic acid (HA is one of the most important ophthalmic biomaterials, while also being used for tissue engineering and drug delivery. Although chemical cross-linking is an effective way to improve the material performance, it may as a consequence be detrimental to the living cells/tissues. Given that the cross-linking efficiency is mediated by the solvent composition during the chemical modification, this study aims to explore the stability and biocompatibility of carbodiimide cross-linked HA in relation to material processing conditions by varying the acetone/water volume ratio (from 70:30 to 95:5 at a constant 1-ethyl-3-(3-dimethyl aminopropyl carbodiimide (EDC concentration of 100 mM. Our results indicated that after the EDC treatment in the presence of an acetone/water mixture (85:15, v/v, the HA hydrogel membranes have the lowest equilibrium water content, the highest stress at break and the greatest resistance to hyaluronidase digestion. Live/Dead assays and pro-inflammatory cytokine expression analyses showed that the cross-linked HA hydrogel membranes, irrespective of the solvent composition, are compatible with human RPE cell lines without causing toxicity and inflammation. However, it should be noted that the test samples prepared by the cross-linking in the presence of acetone/water mixtures containing 70, 75, and 95 vol % of acetone slightly inhibit the metabolic activity of viable ARPE-19 cultures, probably due to the alteration in the ionic interaction between the medium nutrients and polysaccharide biomaterials. In summary, the water content, mechanical strength and RPE cell proliferative capacity strongly depends on the solvent composition for carbodiimide cross-linking of HA materials.

  8. A novel smartphone ophthalmic imaging adapter: User feasibility studies in Hyderabad, India.

    Science.gov (United States)

    Ludwig, Cassie A; Murthy, Somasheila I; Pappuru, Rajeev R; Jais, Alexandre; Myung, David J; Chang, Robert T

    2016-03-01

    To evaluate the ability of ancillary health staff to use a novel smartphone imaging adapter system (EyeGo, now known as Paxos Scope) to capture images of sufficient quality to exclude emergent eye findings. Secondary aims were to assess user and patient experiences during image acquisition, interuser reproducibility, and subjective image quality. The system captures images using a macro lens and an indirect ophthalmoscopy lens coupled with an iPhone 5S. We conducted a prospective cohort study of 229 consecutive patients presenting to L. V. Prasad Eye Institute, Hyderabad, India. Primary outcome measure was mean photographic quality (FOTO-ED study 1-5 scale, 5 best). 210 patients and eight users completed surveys assessing comfort and ease of use. For 46 patients, two users imaged the same patient's eyes sequentially. For 182 patients, photos taken with the EyeGo system were compared to images taken by existing clinic cameras: a BX 900 slit-lamp with a Canon EOS 40D Digital Camera and an FF 450 plus Fundus Camera with VISUPAC™ Digital Imaging System. Images were graded post hoc by a reviewer blinded to diagnosis. Nine users acquired 719 useable images and 253 videos of 229 patients. Mean image quality was ≥ 4.0/5.0 (able to exclude subtle findings) for all users. 8/8 users and 189/210 patients surveyed were comfortable with the EyeGo device on a 5-point Likert scale. For 21 patients imaged with the anterior adapter by two users, a weighted κ of 0.597 (95% confidence interval: 0.389-0.806) indicated moderate reproducibility. High level of agreement between EyeGo and existing clinic cameras (92.6% anterior, 84.4% posterior) was found. The novel, ophthalmic imaging system is easily learned by ancillary eye care providers, well tolerated by patients, and captures high-quality images of eye findings.

  9. A novel smartphone ophthalmic imaging adapter: User feasibility studies in Hyderabad, India

    Science.gov (United States)

    Ludwig, Cassie A; Murthy, Somasheila I; Pappuru, Rajeev R; Jais, Alexandre; Myung, David J; Chang, Robert T

    2016-01-01

    Aim of Study: To evaluate the ability of ancillary health staff to use a novel smartphone imaging adapter system (EyeGo, now known as Paxos Scope) to capture images of sufficient quality to exclude emergent eye findings. Secondary aims were to assess user and patient experiences during image acquisition, interuser reproducibility, and subjective image quality. Materials and Methods: The system captures images using a macro lens and an indirect ophthalmoscopy lens coupled with an iPhone 5S. We conducted a prospective cohort study of 229 consecutive patients presenting to L. V. Prasad Eye Institute, Hyderabad, India. Primary outcome measure was mean photographic quality (FOTO-ED study 1–5 scale, 5 best). 210 patients and eight users completed surveys assessing comfort and ease of use. For 46 patients, two users imaged the same patient's eyes sequentially. For 182 patients, photos taken with the EyeGo system were compared to images taken by existing clinic cameras: a BX 900 slit-lamp with a Canon EOS 40D Digital Camera and an FF 450 plus Fundus Camera with VISUPAC™ Digital Imaging System. Images were graded post hoc by a reviewer blinded to diagnosis. Results: Nine users acquired 719 useable images and 253 videos of 229 patients. Mean image quality was ≥ 4.0/5.0 (able to exclude subtle findings) for all users. 8/8 users and 189/210 patients surveyed were comfortable with the EyeGo device on a 5-point Likert scale. For 21 patients imaged with the anterior adapter by two users, a weighted κ of 0.597 (95% confidence interval: 0.389–0.806) indicated moderate reproducibility. High level of agreement between EyeGo and existing clinic cameras (92.6% anterior, 84.4% posterior) was found. Conclusion: The novel, ophthalmic imaging system is easily learned by ancillary eye care providers, well tolerated by patients, and captures high-quality images of eye findings. PMID:27146928

  10. High-level fluoroquinolone resistance in ophthalmic clinical isolates belonging to the species Corynebacterium macginleyi.

    Science.gov (United States)

    Eguchi, Hiroshi; Kuwahara, Tomomi; Miyamoto, Tatsuro; Nakayama-Imaohji, Haruyuki; Ichimura, Minoru; Hayashi, Tetsuya; Shiota, Hiroshi

    2008-02-01

    The clinical importance of nondiphtherial Corynebacterium, a ubiquitous member of the normal human microflora of the skin and mucous membrane, for ocular surface infections has been recognized recently. We performed an antimicrobial susceptibility test with Etest strips for three fluoroquinolones (ciprofloxacin, norfloxacin, and levofloxacin) and a taxonomic analysis on 21 isolates of Corynebacterium from ophthalmic samples. Of these, 16 isolates were identified as C. macginleyi at the species level on the basis of 16S rRNA gene sequence comparisons. The remaining five isolates were determined to be C. mastitidis (four) or C. accolens (one). Eleven of the C. macginleyi isolates showed high levels of resistance to all of the fluoroquinolones tested, and one isolate was resistant to norfloxacin alone. An analysis of the amplified quinolone-resistance-determining regions of the gyrA genes revealed that a single amino acid substitution in position 83 of the gyrA product was sufficient to generate the norfloxacin resistance phenotype, and double mutations leading to amino acid changes in positions 83 and 87 were necessary for high-level resistance against the other fluoroquinolones. We conducted the first example of multilocus sequence typing (MLST) analysis on C. macginleyi. The MLST analysis grouped the majority of C. macginleyi isolates into a single lineage, and another molecular strain typing by random amplified polymorphic DNA fragment patterns supported the finding, indicating that a particular lineage of C. macginleyi is dominant on the human ocular surface. This type of population might be particularly adaptable to the milieu on the human ocular surface.

  11. MICROBIAL CONTAMINATION OF PRESERVED OPHTHALMIC DROPS IN OUTPATIENT DEPARTMENTS: POSSIBILITY OF AN EXTENDED PERIOD OF USE

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    MOHAMMAD REZA FAZELI

    2004-09-01

    Full Text Available Ocular infections may arise from topical ophthalmic medications. A standard imposed by the British Pharmaceutical Codex implies that eye drops should be discarded after 1-day use when these remedies are used in outpatient departments. In this study the bioburden rates arising from 2, 4 and 7 days’ use were evaluated and compared with those of 1 day’s use to determine whether it is possible to extend the period of use of preserved eye drops in outpatient departments. A total of 200 eye drops were taken from outpatient departments of Farabi Eye Hospital after 1, 2, 4 and 7 days’ use and the contamination rates of the residual contents, caps and droppers were determined using conventional techniques. High biobudren rates were obtained in all the samples tested. Although the overall recorded incidences of microbial contamination in the 2 and 4-day drops were not considerably different from those of first day (P>0.01 but those of 7 days’ use were significant (P<0.01. However, when contamination rate of drop contents was taken into account there was a significant difference between 4 and 7 days’ use compared to 1-day drops. Most of the isolated organisms were either of human flora types of Gram-positive bacteria or air-borne fungi. It is concluded that the use of eye drops for outpatient practice may be extended up to 2 days; yet, care should be taken to reduce the overall contamination rates of these preparations for prevention of ocular nosocomial infections.

  12. The eye of the red-eared slider turtle: morphologic observations and reference values for selected ophthalmic diagnostic tests.

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    Somma, André T; Lima, Leandro; Lange, Rogério R; Turner-Giannico, Amália; Montiani-Ferreira, Fabiano

    2015-01-01

    To perform a descriptive investigation of the red-eared slider turtle (Trachemys scripta elegans) eye, performing selected ophthalmic diagnostic tests with the aim of establishing normal reference values for this species. Thirty adult healthy red-eared slider turtles were used to establish normal ophthalmic test values in this investigation. Selected ophthalmic tests included: collection of material for bacterial culture analysis, esthesiometry, intraocular pressure (IOP), A- and B-mode ultrasonic biometry, fundus photography, and central corneal thickness (CCT). Normal parameters found for the ocular diagnostic tests were: esthesiometry: 5.84 ± 0.48 cm; IOP: 5.42 ± 1.70 mmHg; CCT: 154.5 ± 0.14 μm; palpebral fissure length: 9.71 ± 0.55 mm; modified Schirmer tear test: 2.55 ± 3.4 mm; globe axial length: 7.60 ± 0.23 mm; anterior chamber depth: 0.76 ± 0.23 mm; lens axial length: 2.45 ± 0.28 mm; vitreous chamber depth: 4.31 ± 0.42 mm. An avascular retinal pattern with nerve fibers radiating from the small white circular optic disk was observed. None of the animals had a conus papillaris. The most frequent bacteria found were Bacillus spp. (33.33%) followed by Proteus vulgaris (20.69%) and Staphylococcus aureus (18.39%). No significant differences between left and right eyes or genders were found for any of the results. Reference data and morphologic observations obtained in this investigation might help veterinary ophthalmologists to diagnose ocular diseases in the red-eared slider turtle. © 2014 American College of Veterinary Ophthalmologists.

  13. Impact of digital imaging and communications in medicine workflow on the integration of patient demographics and ophthalmic test data.

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    Pandit, Ravi R; Boland, Michael V

    2015-02-01

    To determine the impact of a Digital Imaging and Communications in Medicine (DICOM) workflow on the linkage of demographic information to ophthalmic testing data. Evaluation of technology. Six hundred ninety-nine visual field testing encounters performed by 6 ophthalmic technicians and the transfer error queue of 37 442 ophthalmic test results. At 3 months before and 6 and 18 months after implementation of a DICOM workflow, technicians recorded the work required to enter, confirm, or edit patient demographics in each visual field device. We also determined the proportion of imaging tests sent to an error queue for manual reconciliation because of incorrect demographic information before and 3, 6, and 18 months after the DICOM workflow was established. The proportion of testing encounters for which staff had to enter, edit, or merge patient demographics and the proportion of misfiled images. Staff entered, edited, or merged data for 48% of patients before implementation (n = 237). This decreased to 24% within 6 months and 20% within 18 months of implementing the DICOM archive (n = 230 and n = 232, respectively). Staff could locate a patient in a DICOM work list for 97% of encounters at 3 months and 99% at 18 months. Before implementation, 9.2% of the images required additional intervention to be associated with the correct patient (n = 3581). This decreased by 85% over 6 months to 1.4% (n = 9979; P workflow in an ophthalmology clinic reduced the need to enter or edit patient demographic information into imaging or testing devices by more than 50% and reduced the need to manage misfiled images by 76%. In a clinical environment that demands both efficiency and patient safety, the DICOM workflow is an important update to current practice. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  14. Risk of Hemorrhage during Needle-Based Ophthalmic Regional Anesthesia in Patients Taking Antithrombotics: A Systematic Review.

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    Augusto Takaschima

    Full Text Available Patients undergoing ophthalmic surgery are usually elderly and, due to systemic disease, may be on long-term therapy, such as antithrombotic agents. Rates of hemorrhagic complications associated with invasive procedures may be increased by the use of anticoagulants and antiplatelet agents.To compare the incidence of hemorrhagic complications in patients undergoing needle-based ophthalmic regional anesthesia between patients on antithrombotic therapy and those not on such therapy.A systematic review was conducted by two independent reviewers based on searches of Cochrane, LILACS, PubMed, Scopus, Web of Science, and the "gray" literature (Google Scholar. The end search date was May 8, 2015, across all databases.Five studies met the eligibility criteria. In three studies, individual risk of bias was low, and in two of them, moderate. In all studies, no differences regarding mild to moderate incidence of hemorrhagic complications were found between patients using antithrombotics (aspirin, clopidogrel, and warfarin and those not using them. Rates of severe hemorrhagic complication were very low (0.04% in both groups, supporting the safety of needle blocks, even in patients using antithrombotics. High heterogeneity across studies prevented meta-analysis. Limitations to these results include low statistical power in three experimental studies and a large 95% confidence interval in the two retrospective cohorts.In this review, none of the selected studies showed significant bleeding related to needle-based ophthalmic regional anesthesia in association with the use of aspirin, clopidogrel, or vitamin K inhibitors. Since the available data is not powerful enough to provide a reliable evaluation of the true effect of antithrombotics in this setting, new studies to address these limitations are necessary.

  15. Occurrence of sectoral choroidal occlusive vasculopathy and retinal arteriolar embolization after superselective ophthalmic artery chemotherapy for advanced intraocular retinoblastoma.

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    Munier, Francis L; Beck-Popovic, Maja; Balmer, Aubin; Gaillard, Marie-Claire; Bovey, Etienne; Binaghi, Stefano

    2011-03-01

    Superselective ophthalmic artery chemotherapy (SOAC) has recently been proposed as an alternative to intravenous chemoreduction for advanced intraocular retinoblastoma. Preliminary results appear promising in terms of tumor control and eye conservation, but little is known regarding ocular toxicity and visual prognosis. In this study, we report on the vascular adverse effects observed in our initial cohort of 13 patients. The charts of 13 consecutive patients with retinoblastoma who received a total of 30 injections (up to 3 injections of a single agent per patient at 3-week interval) of melphalan (0.35 mg/kg) in the ophthalmic artery between November 2008 and June 2010 were retrospectively reviewed. RetCam fundus photography and fluorescein angiography were performed at presentation and before each injection. Vision was assessed at the latest visit. Enucleation and external beam radiotherapy could be avoided in all cases but one, with a mean follow-up of 7 months. Sectoral choroidal occlusive vasculopathy leading to chorioretinal atrophy was observed temporally in 2 eyes (15%) 3 weeks to 6 weeks after the beginning of SOAC and retinal arteriolar emboli in 1 eye 2 weeks after injection. There was no stroke or other clinically significant systemic side effects except a perioperative transient spasm of the internal carotid artery in one patient. Vision ranged between 20/1600 and 20/32 depending on the status of the macula. Superselective ophthalmic artery chemotherapy was effective in all patients with no stroke or other systemic vascular complications. Unlike intravenous chemoreduction, SOAC is associated with potentially sight-threatening adverse effects, such as severe chorioretinal atrophy secondary to subacute choroidal occlusive vasculopathy or central retinal artery embolism, not to mention the risk of ophthalmic artery obstruction, which was not observed in this series. Further analysis of the risks and benefits of SOAC will define its role within the

  16. Current Trends in Upper and Lower Eyelid Blepharoplasty Among American Society of Ophthalmic Plastic and Reconstructive Surgery Members.

    Science.gov (United States)

    Kossler, Andrea L; Peng, Grace L; Yoo, Donald B; Azizzadeh, Babak; Massry, Guy G

    To assess current practice patterns for management of upper and lower eyelid blepharoplasty by active American Society of Ophthalmic Plastic and Reconstructive Surgery members. An invitation to participate in a web-based anonymous survey was sent to the active American Society of Ophthalmic Plastic and Reconstructive Surgery membership via email. The survey consists of 34 questions, both multiple choice and free response, regarding upper and lower eyelid blepharoplasty surgery. Practice patterns for both aesthetic and functional blepharoplasty are assessed. Thirty-four percent (161/472) of American Society of Ophthalmic Plastic and Reconstructive Surgery members polled responded to the survey. Members perform an average of 196 upper eyelid, 46 lower eyelid, and 53 four-eyelid blepharoplasty procedures per year, with 70% of cases being functional and 30% purely aesthetic. Most members prefer monitored care (71%) to local (21%) or general (8%) anesthesia. Eighty-nine percent of surgeons use topical antibiotics after surgery, erythromycin being the most common (51%). Fourteen percent of members use postoperative oral antibiotics, with cephalexin (81%) being most common. In upper eyelid blepharoplasty, orbicularis muscle is excised by 86% of respondents. Orbital fat is excised, when deemed appropriate, in 97% of cases, with nasal fat excised most commonly (88%). Less commonly, fat repositioning (36%) and adjunctive fat grafting (33%) are performed. In lower eyelid blepharoplasty, surgeons report using one or more of the following approaches: transconjunctival (96%), transcutaneous (82%), and both transconjunctival and transcutaneous (51%). Common adjunctive procedures include orbital fat excision (99%), fat repositioning (80%), and lateral canthal suspension (96%). Less common adjunctive procedures include laser skin resurfacing (36%) and chemical peels (29%). This report outlines contemporary practice patterns among active American Society of Ophthalmic Plastic and

  17. Congenital cataract: prevalence and surgery age at Zhongshan Ophthalmic Center (ZOC.

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    Haotian Lin

    Full Text Available Congenital cataract (CC is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC in Guangzhou, China. Residence, gender, age at surgery, hospitalization time, and the presence of other ocular abnormalities were extracted and statistically analyzed in different subgroups. The search identified 1314 patients diagnosed with CC from a total of 136154 hospitalizations, which accounted for 2.39% of all the cataract in-patients and 1.06% of the total in-patients over the six-year study period. Of the identified CC patients, 9.2% had ≥ 2 hospitalizations due to the necessity of additional surgeries, with a total ratio of boys to girls of 1.75 ∶ 1. Based on a subgroup analysis according to age, patients 2-6 years old constituted the highest proportion (29.22% of all hospitalized CC patients, and those 13-18 years old constituted the lowest proportion (13.47% of the total number. The average age at surgery was 27.62 ± 23.36 months, but CC patients ≤ 6 years old (especially ≤ 6 months old became increasingly prevalent throughout the 6-year study period. A total of 276 cases (20.93% of CC were associated with one or more other ocular abnormalities, the highest incidence rates were observed for exotropia (6.24%, nystagmus (6.16%, and refractive error (3.65%. In conclusion, CC patients accounted for 2.39% of all cataract in-patients in a review of 6 years of hospitalization charts from ZOC. The age at the time of surgery decreased over the 6-year study period, which probably reflects the continuing improvement of public awareness of children's eye care in China.

  18. Removal times for a dispersive and a cohesive ophthalmic viscosurgical device correlated with intraocular lens material.

    Science.gov (United States)

    Auffarth, Gerd U; Holzer, Mike P; Visessook, Nithi; Apple, David J; Völcker, Hans E

    2004-11-01

    To investigate the removal times of ophthalmic viscosurgical devices (OVDs) with different intraocular lens (IOL) designs and materials. Center for Research on Ocular Therapeutics and Biodevices, Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA, and Heidelberg IOL & Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany. In a standardized laboratory setup, the Miyake-Apple posterior view video technique was used to evaluate OVD removal from capsular bags in human autopsy eyes implanted with poly(methyl methacrylate) (PMMA), silicone, and acrylic IOLs. The cohesive OVD ProVisc (sodium hyaluronate 1.0%) and the dispersive OVD Viscoat (sodium hyaluronate 3.0% and chondroitin sulfate 4.0%) were stained with fluorescein for better visualization. The open-sky preparation and an Alcon Series 20000 Legacy phaco machine with a flow rate of 25 mL/min and a vacuum setting of +500 mm Hg (maximum irrigation/aspiration) were used. The time needed for complete removal of the cohesive and dispersive OVDs with each IOL type was measured and analyzed statistically. The mean removal times for both OVDs were as follows: Alcon MZ60BD PMMA IOL-25.0 seconds +/- 3.7 (SD) (Viscoat), 15.9 +/- 6.9 seconds (ProVisc); Alcon AcrySof MA60BM IOL-35.5 +/- 10.0 seconds (Viscoat), 25.6 +/- 4.7 seconds (ProVisc); Chiron/Bausch & Lomb C1043 silicone IOL-46.5 +/- 10.5 seconds (Viscoat), 17.3 +/- 2.1 seconds (ProVisc); AMO SI-30 silicone IOL-33.5 +/- 3.1 seconds (Viscoat), 15.3 +/- 6.3 seconds (ProVisc); and Pharmacia 912 silicone IOL-18.3 +/- 5.8 seconds (Viscoat), 19.8 +/- 4.3 seconds (ProVisc). Differences in OVD removal times were detected. The removal time for the cohesive OVD correlated with the IOL material. Overall, the time needed for complete removal was significantly longer for the dispersive OVD than for the cohesive OVD.

  19. Development and validation of HPLC analytical method for nepafenac in ophthalmic dosage form (suspension).

    Science.gov (United States)

    Usman, Shahnaz; Akram, Muhammad; Aziz, Asif; Ramesh, Venkat; Sarheed, Omar Abdulraheem

    2014-09-01

    The aim of the present study was to develop and validate an analytical method for the estimation of nepafenac as a raw material as well as in dosage form (suspension) by using reverse phase high performance liquid chromatographic (RP-HPLC). The target was to obtain an easy, rapid, reproducible as well as a rugged method. The HPLC system that was used in the proposed study was LC-20AD liquid chromatograph equipped with SPD-20A UV-VIS detector. The separation was performed on C18 column which was attached with loop 20 β l. Elution was done at ambient temperature with a mobile phase consisting of acetonitrile: Water (40: 60v/v) at a flow rate of 1ml/min and at a wavelength of 254 nm. The proposed method was validated as per the ICH guidelines. The retention time for nepafenac was 7.49 minutes (% CV=0.0076). The percentage coefficient variation (CV) of six consecutive peak areas of injections was 0.34% with tailing factor 1.76. The peak area responses were linear within the concentration range of 0.078-20.0 βg/ml (R(2)=0.9993). The sensitivity of the method could be evaluated by limits of detection (LOD) (0.0195 β g/ml) and limits of quantitation (LOQ) (0.039 β g/ml). Nepafenac drug is s in its diluent that could see by intra-day (% CV =0.45-1.96) and inter-day variation (%CV=0.173-1.898%). The accuracy and recovery results of 80%, 100% and 120% were 97.40% to 102.10% with % CV of 0.3201% to 1.3496%. The robustness and ruggedness of the method are significantly broader and is reproducible. It could be used as a more convenient, efficient, easy and time saving method for the analysis of drug in raw material as well as in dosage form (ophthalmic suspension).

  20. A novel smartphone ophthalmic imaging adapter: User feasibility studies in Hyderabad, India

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    Cassie A Ludwig

    2016-01-01

    Full Text Available Aim of Study: To evaluate the ability of ancillary health staff to use a novel smartphone imaging adapter system (EyeGo, now known as Paxos Scope to capture images of sufficient quality to exclude emergent eye findings. Secondary aims were to assess user and patient experiences during image acquisition, interuser reproducibility, and subjective image quality. Materials and Methods: The system captures images using a macro lens and an indirect ophthalmoscopy lens coupled with an iPhone 5S. We conducted a prospective cohort study of 229 consecutive patients presenting to L. V. Prasad Eye Institute, Hyderabad, India. Primary outcome measure was mean photographic quality (FOTO-ED study 1–5 scale, 5 best. 210 patients and eight users completed surveys assessing comfort and ease of use. For 46 patients, two users imaged the same patient's eyes sequentially. For 182 patients, photos taken with the EyeGo system were compared to images taken by existing clinic cameras: a BX 900 slit-lamp with a Canon EOS 40D Digital Camera and an FF 450 plus Fundus Camera with VISUPAC™ Digital Imaging System. Images were graded post hoc by a reviewer blinded to diagnosis. Results: Nine users acquired 719 useable images and 253 videos of 229 patients. Mean image quality was ≥ 4.0/5.0 (able to exclude subtle findings for all users. 8/8 users and 189/210 patients surveyed were comfortable with the EyeGo device on a 5-point Likert scale. For 21 patients imaged with the anterior adapter by two users, a weighted κ of 0.597 (95% confidence interval: 0.389–0.806 indicated moderate reproducibility. High level of agreement between EyeGo and existing clinic cameras (92.6% anterior, 84.4% posterior was found. Conclusion: The novel, ophthalmic imaging system is easily learned by ancillary eye care providers, well tolerated by patients, and captures high-quality images of eye findings.

  1. Intra-Arterial Chemotherapy (Ophthalmic Artery Chemosurgery for Group D Retinoblastoma.

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    David H Abramson

    Full Text Available To report globe salvage rates, patient survival and adverse events of ophthalmic artery chemosurgery (OAC for International Classification of Retinoblastoma (ICRB group D retinoblastoma (naive and after prior failures.Single institution retrospective review of all Group D eyes treated with OAC from 5/2006-12/2012. Patients were treated according to our previously-published techniques. Primary outcome was globe retention without need for external beam radiotherapy (EBRT. Demographics, prior treatments, OAC agents used, and adverse events were also recorded.112 group D eyes (103 patients that underwent OAC were included (average follow-up was 34 months, range: 2-110 months. 47 eyes were treatment-naïve, 58 eyes received prior treatments elsewhere, and 7 young infants (7 eyes underwent our published "bridge therapy" (single agent intravenous carboplatin until old enough to undergo OAC. Median number of OAC sessions/eye was 3 (range 1-9. 110/112 eyes received intra-arterial melphalan, but only 31 eyes received melphalan alone. 43 eyes received carboplatin, and 78 eyes received topotecan (never as a single agent. 80/112 eyes received >1 drug over their treatment course, and 39 eyes received all three agents. 24 eyes (16 pretreated, 7 treatment-naïve, 1 bridge failed treatment and required enucleation during the study period. Enucleation and EBRT were avoided in 88/112 eyes (78.6%; including 40/47 [85.1%] treatment-naïve eyes, 42/58 [72.4%] previously-treated eyes, and 6/7 eyes [85.7%] among bridge patients. By Kaplan-Meier survival analysis, globe salvage rate was 74% at 110 months among all patients, and 85% at 110 months in the treatment-naïve subgroup. Transient grade 3/4 neutropenia was more common in patients receiving OAC bilaterally. No child died of metastatic disease.OAC is effective for curing group D retinoblastoma, achieving rates of globe salvage many times higher than systemic chemotherapy (10-47%, even in eyes that previously

  2. Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients

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    Nielsen SA

    2013-04-01

    Full Text Available CorrigendumNielsen SA, McDonald MB, Majmudar PA. Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients. Clinical Ophthalmology. 2013;7:149–156. The paper titled "Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients," contains an inaccurate description of the intraoperative use of medications.In the Results section it is reported that 31.8% (170/534 of besifloxacin cases and 97.0% (259/267 of moxifloxacin cases had drops applied directly to the flap interface. We have determined that ambiguity in the design of the electronic case report form resulted in all day-of-surgery drops provided to patients in the LASER suite being reported in the flap interface field. The authors have since clarified with each surgeon who reported intraoperative drug use that the drops were delivered either prior to the flap creation, or following replacement of the flap.The sentence at the top of page 152 stating: "Of note, 31.8% (170/534 of besifloxacin cases and 97.0% (259/267 of moxifloxacin cases had drops applied directly to the flap interface" should say: "Of note, 31.8% (170/534 of besifloxacin cases and 97.0% (259/267 of moxifloxacin cases had intraoperative drops applied."Read the original article

  3. An evidence-based medicine audit of the ophthalmic emergency services unit of King Abdulaziz University Hospital (KAUH).

    Science.gov (United States)

    Alsuhaibani, Adel; AlRajeh, Mohammed; Gikandi, Priscilla; Mousa, Ahmed

    2017-10-10

    To improve the interventions provided for patients presenting with acute ophthalmic conditions to the ophthalmic emergency unit through applying the best available evidences from quality literature for managing such conditions. A retrospective cohort study at a tertiary eye care university hospital in Riyadh, Saudi Arabia, involving a two-phase audit of diagnosis-intervention was conducted. The first phase was done retrospectively for the duration from April 1 to May 30, 2014, after disseminating the results of the first phase to King Abdulaziz University Hospital ophthalmology department staff, and the second phase was done retrospectively for the duration from November 1 to December 30, 2015. The validity of outcomes was assessed through a literature search using Medline and the Cochrane Database of Systematic Reviews. The participants were masked on the study objectives to avoid Hawthorne's phenomenon (prescribing bias). In the first part of the audit, 73.2% out of 355 interventions were found to be evidence based. There was notable improvement of 80.9% in the number of evidence-based interventions in the second part of the audit. This improvement was statistically significant (p = 0.017). Evidence-based medicine audit can be a helpful tool to assess the performance and can lead to quality improve of the provided care by reducing the number of medical errors and refining medical decisions and interventions.

  4. Curative effect of pranoprofen eye drops with tobramycin and dexamethasone ophthalmic suspension for cataract patients after surgery

    Directory of Open Access Journals (Sweden)

    Jiang-Song Feng

    2017-09-01

    Full Text Available AIM: To explore the application effect of pranoprofen combined with tobramycin and dexamethasone ophthalmic suspension in cataract extraction after IOL implantation.METHODS: Retrospective analysis of the clinical data of cataract patients treated from May 2015 to June 2016 in our hospital. According to the treatment methods, patients were divided into tobramycin and dexamethasone ophthalmic suspension with pranoprofen group(combined treatment groupand pranoprofen treatment group. The difference of visual acuity, intraocular pressure, anterior chamber flash change, satisfaction rate and symptom score before and after treatment in two groups were observed. RESULTS: The vision of the two groups before treatment had no difference(P>0.05. At 1wk and 1mo after treatment, the visual acuity of the two groups all improved compared with before treatment, there was no significant difference between the two groups(P>0.05. Before treatment, the anterior chamber flare of the two groups had no difference(P>0.05. At 1wk and 1mo after treatment, the anterior chamber flare of combined treatment group was lower, the difference was statistically different(t=2.435, 1.864; PP>0.05. After treatment, the symptoms and signs of combined treatment group was significantly lower than that of pranoprofen group(t=2.586, 7.820; PCONCLUSION: Pranoprofen and tobradex in the treatment of cataract extraction and intraocular lens implantation has good application effect, can significantly improve the patient's symptoms and signs.

  5. Effect of rebamipide ophthalmic suspension on optical quality in the short break-up time type of dry eye.

    Science.gov (United States)

    Koh, Shizuka; Inoue, Yasushi; Sugmimoto, Toshiki; Maeda, Naoyuki; Nishida, Kohji

    2013-09-01

    To determine the effect of rebamipide ophthalmic suspension on optical quality in patients with dry eye with short break-up time (BUT) of the tear film. Twenty-six eyes of 16 patients with the short BUT type of dry eye were enrolled and treated with 2% rebamipide ophthalmic suspension. At baseline and at 2 and 4 weeks after initiating the treatment, the serial corneal higher-order aberrations (HOAs), BUT, fluorescein staining, and Schirmer test were measured. Patients were asked to complete questionnaires about the changes in dry eye-related ocular symptoms after the treatment. Before the treatment, the pattern of postblink corneal HOAs for 10 seconds showed a sawtooth pattern, with a marked upward curve that increased after blinking. Treatment with rebamipide for 4 weeks significantly (P < 0.05) improved the postblink corneal HOAs and stabilized the pattern of the corneal HOAs. Significant increases in the tear film BUT were seen 2 and 4 weeks after the treatment (P < 0.001 for both comparisons). Rebamipide administered to treat the short BUT type of dry eye significantly improved optical quality because of the improvement in tear stability.

  6. Improved signs, symptoms, and quality of life associated with dry eye syndrome: hydroxypropyl cellulose ophthalmic insert patient registry.

    Science.gov (United States)

    Koffler, Bruce H; McDonald, Marguerite; Nelinson, Donald S

    2010-05-01

    To evaluate the acceptability, ease of use, and efficacy of hydroxypropyl cellulose ophthalmic inserts in reducing signs and symptoms of moderate-to-severe dry eye syndrome (DES), and improving quality of life (QoL) and activities of daily living (ADL). The multicenter, prospective, open-label, 4-week registry comprised 520 patients with bilateral DES and a history of artificial tear use, or a desire to use artificial tears within the previous week. Visit 1 encompassed a clinical evaluation and symptom and QoL questionnaires, including the Ocular Surface Disease Index. Patients were trained to use inserts, which were used once daily, thereafter, as monotherapy or with existing therapy. At visit 2, clinical evaluation and questionnaires evaluated changes in signs, symptoms, ADL, and QoL. Adverse events were monitored throughout the registry. There were 418 (80.4%) completers. Statistically significant improvements in discomfort, burning, dryness, grittiness, stinging, and light sensitivity, as well as clinical signs of keratitis, conjunctival staining, and tear volume were seen (PIndex total scores improved by 21.3% (P<0.05). Blurred vision, affecting 8.7% of patients, was the most commonly reported adverse event leading to discontinuation. Hydroxypropyl cellulose ophthalmic inserts significantly improved signs and symptoms of moderate-to-severe DES, as well as ADL and QoL. Benefits were additive to those seen with patients' existing care.

  7. Doses of radiation in the environment of patients undergoing treatment of ophthalmic brachytherapy; Dosis de radiaciones en el entorno de pacientes sometidos a tratamientos de braquiterapia oftalmica

    Energy Technology Data Exchange (ETDEWEB)

    Terron Leon, J. A.; Moreno Reyes, J. C.; Perales Molina, A.; Miras, H.; Ortiz, M.; Macias, J.

    2013-07-01

    This paper presents results for measures of dose made to different patient undergoing treatment with ophthalmic brachytherapy. The aim of these measures has been, on the one hand, verify assessments relating to radiation protection in the memory of the installation and, on the other hand, experimental measures that can serve to reduce the perception of the radiological risk professionals have. (Author)

  8. Effectiveness and safety of 0.15% ganciclovir in situ ophthalmic gel for herpes simplex keratitis - a multicenter, randomized, investigator-masked, parallel group study in Chinese patients.

    Science.gov (United States)

    Lin, Tong; Gong, Lan; Sun, Xing-Huai; Zhao, Nai-Qing; Chen, Wei; Yuan, Hui-Ping; Shao, Yan; Gao, Ming-Hong; Tang, Hai

    2013-01-01

    Parallel comparison with 0.15% ganciclovir (GCV) ophthalmic gel to evaluate the effectiveness and safety of 0.15% GCV in situ ophthalmic gel for the treatment of herpes simplex keratitis (HSK). This was a multicenter, randomized, investigator-masked, parallel group study. HSK patients were randomly divided into two groups, with the corresponding treatment of 0.15% GCV ophthalmic gel or 0.15% GCV in situ ophthalmic gel. Symptoms and signs were observed before administration, and 3 (±1), 7 (±1), 14 (±2), and 21 (±3) days after the administration. The clinical effective rate was considered as the primary outcome. The safety profile was evaluated by AEs, visual acuity, and ocular tolerance. The clinical effective rate in the per-protocol (PP) dataset for the treatment group and the control group were 95.10% and 93.00%, respectively (P = 0.5282). The noninferiority test showed significant differences (P = 0.000305, P < 0.025), indicating that the tested drug was noninferior to the control. Patients in the PP dataset of both groups experienced decreases in the total scores of clinical indicators. Ocular AEs were few but similar between the two groups. There were no significant differences between patients' visions between the two groups before and after administration in the safety analysis set. In terms of drug tolerance, the rates of patients without transient blurred vision during all the visits in the treatment group were higher than those for the control group (P < 0.05). During the third and fourth visits, the rates of patients with eye itching were 4.08% and 1.22% in the treatment group, and 13.59% and 8.14% in the control group, respectively (P < 0.05). During the second visit, the rates of patients with eye irritation were 14.42% in the treatment group and 25.71% in the control group (P < 0.05). The 0.15% GCV in situ ophthalmic gel was effective and safe for the treatment of HSK, and was not inferior to 0.15% GCV ophthalmic gel. The 0.15% GCV in situ

  9. Alloy solution hardening with solute pairs

    Science.gov (United States)

    Mitchell, John W.

    1976-08-24

    Solution hardened alloys are formed by using at least two solutes which form associated solute pairs in the solvent metal lattice. Copper containing equal atomic percentages of aluminum and palladium is an example.

  10. Rotational stability of a single-piece hydrophobic acrylic intraocular lens during removal of ophthalmic viscosurgical devices.

    Science.gov (United States)

    Hyon, Joon Young; Yeo, Hwan Eok

    2010-02-01

    To compare the effect of cohesive and dispersive ophthalmic viscosurgical device (OVD) on intraoperative rotational stability of the intraocular lens (IOL) with single-piece hydrophobic acrylate platform. Prospective, comparative study. This institutional clinical study included 60 eyes of 60 patients who underwent phacoemulsifcation. The patients were equally divided into cohesive OVD (Healon GV; Abbott Medical Optics, Abbott Park, Illinois, USA) group and dispersive OVD (Viscoat; Alcon Laboratories, Fort Worth, Texas, USA) group. Image analysis from the captured digital image was used to measure intraoperative rotation of single-piece hydrophobic acrylate IOL (SA60AT or SA60NT) during OVD removal. Mean intraoperative rotation was 7.42 degrees +/- 4.16 (standard deviation) in dispersive OVD group and 13.08 degrees +/- 5.25 (standard deviation) in cohesive OVD group (P stability of IOL was greater with Viscoat than with Healon GV. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  11. The north Jutland county diabetic retinopathy study (NCDRS) 2. Non-ophthalmic parameters and clinically significant macular oedema

    DEFF Research Database (Denmark)

    Knudsen, Lars Loumann; Lervang, Hans-Henrik; Lundbye-Christensen, Søren

    2007-01-01

    , and urinary albumin excretion was explored using multiple logistic regression analysis. Findings: We found no significant association between the presence of clinically significant macular oedema and any of the examined parameters in type 1 diabetic subjects. In type 2 diabetic subjects the duration......Background: The influence of non-ophthalmic parameters on the prevalence of clinically significant macular oedema has not been unambiguously established. The present study was initiated with the aim of clarification. Methods: This cross-sectional study comprised 656 type 1 and 328 type 2 diabetic...... subjects undergoing retinopathy screening in the county of North Jutland. The association between the presence of clinically significant macular oedema and blood-pressure, HbA1c, BMI, age, onset of diabetes, duration of diabetes, blood pressure reducing medication, lipid lowering medication, neuropathy...

  12. Little known ophthalmic interests of Emil von Behring, the first Nobel Prize Laureate in Medicine or Physiology.

    Science.gov (United States)

    Grzybowski, Andrzej; Wilhelm, Helmut

    2013-06-01

    Although the work for which Emil von Behring (1854-1917) was awarded the first Nobel Prize Winner for Medicine or Physiology in 1901 was on serum therapy, not only was he trained and worked as an ophthalmologist but he also wrote his doctoral dissertation on a practical ophthalmological topic whilst in Berlin under Carl Schweigger (1830-1905). He later worked for 3 years as an assistant and co-worker with the famous Polish ophthalmologist Boleslaw Wicherkiewicz (1847-1915), in Poznan where he described an interesting ophthalmic case in a scientific journal. His life and work in other fields have been well studied, but his interests and relationship to ophthalmology that played an important role in, at least part of, Behring's life have never previously been analysed thoroughly. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  13. Ophthalmic manifestations of vitamin A and D deficiency in two autistic teenagers: case reports and a review of the literature.

    LENUS (Irish Health Repository)

    Duignan, Emma

    2015-01-01

    We describe the cases of 2 autistic children with ophthalmic and systemic manifestations of vitamin A deficiency due to food faddism. Although vitamin A deficiency is common in the developing world, reports in developed societies are rare. Our patients presented over a 1-year period. The patients were 14 and 13 years old at the time of presentation and were both found to have marked features of vitamin A deficiency related to unusual dietary habits. Anterior segment signs of xerophthalmia were present in both patients. In addition, patient 1 showed evidence of a rod-predominant retinopathy, which resolved with vitamin A supplementation. Due to its rare occurrence, hypovitaminosis A must be highlighted and anticipated in this cohort.

  14. The knowledge and attitude of non-ophthalmic medical doctors towards glaucoma in two tertiary institutions in south eastern Nigeria.

    Science.gov (United States)

    Achigbu, E O; Chuka-Okosa, C M

    2014-06-01

    This study is aimed at determining how much knowledge of glaucoma the non-ophthalmic medical doctors still possess and their personal attitudes toward glaucoma. Self- administered questionnaires were randomly distributed to the non-ophthalmic medical doctors in two specialist hospitals in south eastern Nigeria: The data obtained were the age, sex, professional and number of years of practice of the participants, their knowledge of the symptoms/ aetiology/risk factors, examination/investigation, treatment of glaucoma as well as their personal attitude towards glaucoma. There were two hundred respondents; one hundred and forty two males and fifty eight females (M:F=2.4:1); comprising 82.5% Resident doctors; 51% of whom had been in practice for less than 5 years.All the doctors had heard of glaucoma; approximately seventy two per cent (72.5%) had a good knowledge of glaucoma symptoms and 52.0% of these had been in practice for only 5 years or less. Similarly, of the 83% of the doctors who correctly answered the questions on the aetiology of glaucoma, majority (84.3%) had been in practice for 5 years or less. Only 24.5% and 38.5% respectively of the doctors had a good knowledge of the basic examination and treatment required for the management of glaucoma.There was no statistically significant relationship between most variables tested. Only the relationship between the knowledge of the symptoms of glaucoma and the duration of practice of the doctors was statistically significant (pdoctors have a basic knowledge of glaucoma and how to investigate it but showed a poor knowledge of examination and treatment modalities. They also acknowledged the importance of regular eye checks but only very few had had their eyes examined.

  15. Simultaneous determination of gatifloxacin and prednisolone acetate in ophthalmic formulation using first-order UV derivative spectroscopy

    Directory of Open Access Journals (Sweden)

    Rúbia A. Sversut

    2017-07-01

    Full Text Available A simple method for simultaneous determination of gatifloxacin and prednisolone acetate in ophthalmic formulation was developed and validated using UV spectrophotometry. Gatifloxacin and prednisolone acetate were quantified using the first-order derivative of the UV spectra. The proposed method was validated according to the guidelines of the International Conference on Harmonization and the Association of Official Analytical Chemists International. The measurements were made in acetonitrile/water (70:30 v/v at 348 nm for gatifloxacin and at 263 nm for prednisolone acetate. The calibration curves were linear in the concentration range of 3–21 μg mL−1 for gatifloxacin and 6–42 μg mL−1 for prednisolone acetate with Sandell’s sensitivities of 0.349 μg cm−2 and 0.402 μg cm−2, respectively. The mean recovery and the limit of quantification for gatifloxacin were 99.76 ± 0.41% and 1.11 μg mL−1 and for prednisolone acetate were 99.52 ± 0.87% and 0.55 μg mL−1, respectively. The method was precise, with a relative standard deviation of less than 2.50% for both drugs. For robustness, the factors analyzed did not significantly affect the quantification of gatifloxacin and prednisolone acetate. The results of the validated method did not differ significantly from high-performance liquid chromatography (HPLC, which was previously developed and validated for the same drugs. In this form, the method was suitable for routine analysis of gatifloxacin and prednisolone acetate in their combined dosage form in ophthalmic formulations.

  16. The ophthalmic branch of the Gutenberg Health Study: study design, cohort profile and self-reported diseases.

    Directory of Open Access Journals (Sweden)

    René Höhn

    Full Text Available This paper describes the study design, methodology, cohort profile and self-reported diseases in the ophthalmological branch of the Gutenberg Health Study (GHS.The GHS is an ongoing, prospective, interdisciplinary, single-center, population-based cohort study in Germany. The main goals of the ophthalmological section are to assess the prevalence and incidence of ocular diseases and to explore risk factors, genetic determinants and associations with systemic diseases and conditions. The eye examination at baseline included a medical history, self-reported eye diseases, visual acuity, refractive errors, intraocular pressure, visual field, pachymetry, keratometry, fundus photography and tear sampling. The 5-year follow-up visit additionally encompassed optical coherence tomography, anterior segment imaging and optical biometry. The general examination included anthropometry; blood pressure measurement; carotid artery ultrasound; electrocardiogram; echocardiography; spirometry; cognitive tests; questionnaires; assessment of mental conditions; and DNA, RNA, blood and urine sampling.Of 15,010 participants (aged 35-74 years at the time of inclusion, ocular data are available for 14,700 subjects (97.9%. The mean visual acuity (standard deviation, mean spherical equivalent, median decimal visual acuity, and mean intraocular pressure were 0.08 (0.17 logMar, -0.42 (2.43 diopters, 0.9 and 14.24 (2.79 mm Hg, respectively. The frequencies of self-reported strabismus, glaucoma, surgery for retinal detachment and retinal vascular occlusions were 2.7%, 2.3%, 0.2% and 0.4%, respectively.The GHS is the most extensive dataset of ophthalmic diseases and conditions and their risk factors in Germany and one of the largest cohorts worldwide. This dataset will provide new insight in the epidemiology of ophthalmic diseases and related medical specialties.

  17. Comparative studies of various hyaluronic acids produced by microbial fermentation for potential topical ophthalmic applications

    DEFF Research Database (Denmark)

    Guillaumie, Fanny; Furrer, Pascal; Felt-Baeyens, Olivia

    2010-01-01

    /v) and HA origin did not significantly affect the corneal residence time on rabbit eyes. A 0.3% solution of high MW HA had a prolonged residence time in the precorneal area compared to a medium MW HA at the same concentration. Finally, an in vivo ocular irritation test based on confocal laser scanning...

  18. Multiscale modelling approach combining a kinetic model of glutathione metabolism with PBPK models of paracetamol and the potential glutathione-depletion biomarkers ophthalmic acid and 5-oxoproline in humans and rats

    NARCIS (Netherlands)

    Geenen, S.; Yates, J.W.T.; Kenna, J.G.; Bois, F.Y.; Wilson, I.D.; Westerhoff, H.V.

    2013-01-01

    A key role of the antioxidant glutathione is detoxification of chemically reactive electrophilic drug metabolites within the liver. Therefore glutathione depletion can have severe toxic consequences. Ophthalmic acid and 5-oxoproline are metabolites involved in glutathione metabolism, which can be

  19. Ophthalmic: Laboratorio virtual para el diseño de nuevas lentes oftálmicas

    Directory of Open Access Journals (Sweden)

    Arnau Calatayud

    2013-06-01

    Full Text Available This work presents a new virtual laboratory, OPHTALMIC, developed with MATLAB GUI for using in Optics and Optometry courses as a computer tool for studying the focusing properties of multifocal diffractive both on unconventional structures both periodic and aperiodic. This virtual laboratory enables students to quickly and easily analyze the influence of the different parameters of construction and find the best solution for a user.

  20. Mechanically triggered solute uptake in soft contact lenses.

    Science.gov (United States)

    Tavazzi, Silvia; Ferraro, Lorenzo; Fagnola, Matteo; Cozza, Federica; Farris, Stefano; Bonetti, Simone; Simonutti, Roberto; Borghesi, Alessandro

    2015-06-01

    Molecular arrangement plays a role in the diffusion of water and solutes across soft contact lenses. In particular, the uptake of solutes in hydrated contact lenses can occur as long as free water is available for diffusion. In this work, we investigated the effect of mechanical vibrations of low frequency (200 Hz) on the solute uptake. Hyaluronan, a polysaccharide of ophthalmic use, was taken as example of solute of interest. For a specific water-hydrated hydrogel material, differential scanning calorimetry experiments showed that a large fraction of the hydration water accounted for loosely-bound water, both before and after one week of daily-wear of the lenses. The size (of the order of magnitude of few hundreds of nanometers) of hyaluronan in aqueous solution was found to be less than the size of the pores of the lens observed by scanning electron microscopy. However, solute uptake in already-hydrated lenses was negligible by simple immersion, while a significant increase occurred under mechanical vibrations of 200 Hz, thus providing experimental evidence of mechanically triggered enhanced solute uptake, which is attributed to the release of interfacial loosely-bound water. Also other materials were taken into consideration. However, the effectiveness of mechanical vibrations for hyaluronan uptake is restricted to lenses containing interfacial loosely-bound water. Indeed, loosely-bound water is expected to be bound to the polymer with bonding energies of the order of magnitude of 10-100 J/g, which are compatible with the energy input supplied by the vibrations. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. A traumatic dural arteriovenous fistula between the inferolateral trunk of the internal carotid artery and the ophthalmic vein: A case of transvenous coil embolization via the facial vein

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Young; Hong, Chang Ki; Suh, Sang Hyun [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Dong Ik [Dept. of of Radiology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2017-05-15

    A 31-year-old man was admitted with exophthalmos. He suffered from progressive exophthalmos, bruit and conjunctival chemosis 7 days after head trauma caused by falling down. Cerebral angiography showed a dural arteriovenous fistula (DAVF) draining into the ophthalmic vein caused by tear in the inferolateral trunk, which is a rare presentation of traumatic DAVF. Selective transvenous coil embolization was performed via the facial vein without neurologic complications.

  2. Proceedings of the Symposium of Medical (Ophthalmic) Surveillance of Personnel Potentially Exposed to Laser Radiation Held on 8-9 September 1982.

    Science.gov (United States)

    1982-01-01

    somewhat difficult to maintain that damage to Bruch’s membrane from a laser would predispose the subject to the formation of disciform maculopathy ...because that is the way one treats disciform maculopathy . COL Whitmore: We are referring to reports in the literature of this pathology following laser ...Medical (Ophthalmic) Surveillance of Personnel Potentially Exposed to Laser Radiation, 8-9 September 1982 12 PERSONAL AUTHOR(S) r Pitf Dyrid H_

  3. Comparison of Cobra perilaryngeal airway (CobraPLA TM with flexible laryngeal mask airway in terms of device stability and ventilation characteristics in pediatric ophthalmic surgery

    Directory of Open Access Journals (Sweden)

    Rani A Sunder

    2012-01-01

    Full Text Available Background: Supraglottic airway devices play an important role in ophthalmic surgery. The flexible laryngeal mask airway (LMA TM is generally the preferred airway device. However, there are no studies comparing it with the Cobra perilaryngeal airway (CobraPLA TM in pediatric ophthalmic procedures. Aims: To analyze the intraoperative device stability and ability to maintain normocarbia of CobraPLA TM and compare it to that with flexible LMA TM . Materials and Methods: Ninety children of American Society for Anesthesiologists physical status 1 and 2, aged 3-15 years scheduled for elective ophthalmic surgeries were randomly assigned to either the CobraPLA TM or the flexible LMA TM group. After placement of each airway device, oropharyngeal leak pressure (OLP was noted. Adequate seal of the devices was confirmed at an inspired pressure of 15 cm H 2 O and pressure-controlled ventilation was initiated. Device displacement was diagnosed if there was a change in capnograph waveform, audible or palpable gas leak, change in expired tidal volume to 6 kPa, or need to increase inspired pressure to >18 cm H 2 O to maintain normocarbia. Results: Demographic data, duration, and type of surgery in both the groups were similar. A higher incidence of intraoperative device displacement was noted with the CobraPLA TM in comparison to flexible LMA TM (P < 0.001. Incidence of displacement was higher in strabismus surgery (7/12. Insertion characteristics and ventilation parameters were comparable. The OLP was significantly higher in CobraPLA TM group (28 ± 6.8 cm H 2 O compared to the flexible LMA TM group (19.9 ± 4.5 cm H 2 O (P < 0.001. Higher surgeon dissatisfaction (65.9% was seen in the CobraPLA TM group. Conclusion: The high incidence of device displacement and surgeon dissatisfaction make CobraPLA TM a less favorable option than flexible LMA TM in ophthalmic surgery.

  4. The design of contact lens based ocular drug delivery systems for single-day use: Part (I) Structural factors, surrogate ophthalmic dyes and passive diffusion studies.

    Science.gov (United States)

    Mahomed, Anisa; Tighe, Brian J

    2014-09-01

    The poor retention and efficacy of instilled drops as a means of delivering drugs to the ophthalmic environment is well-recognised. The potential value of contact lenses as a means of ophthalmic drug delivery, and consequent improvement of pre-corneal retention is one obvious route to the development of a more effective ocular delivery system. Furthermore, the increasing availability and clinical use of daily disposable contact lenses provides the platform for the development of viable single-day use drug delivery devices based on existing materials and lenses. In order to provide a basis for the effective design of such devices, a systematic understanding of the factors affecting the interaction of individual drugs with the lens matrix is required. Because a large number of potential structural variables are involved, it is necessary to achieve some rationalisation of the parameters and physicochemical properties (such as molecular weight, charge, partition coefficients) that influence drug interactions. Ophthalmic dyes and structurally related compounds based on the same core structure were used to investigate these various factors and the way in which they can be used in concert to design effective release systems for structurally different drugs. Initial studies of passive diffusional release form a necessary precursor to the investigation of the features of the ocular environment that over-ride this simple behaviour. Commercially available contact lenses of differing structural classifications were used to study factors affecting the uptake of the surrogate actives and their release under 'passive' conditions. The interaction between active and lens material shows considerable and complex structure dependence, which is not simply related to equilibrium water content. The structure of the polymer matrix itself was found to have the dominant controlling influence on active uptake; hydrophobic interaction with the ophthalmic dye playing a major role. © The

  5. A Dual Egalitarian Solution

    NARCIS (Netherlands)

    Klijn, F.; Slikker, M.; Tijs, S.H.

    2000-01-01

    In this note we introduce an egalitarian solution, called the dual egalitarian solution, that is the natural counterpart of the egalitarian solution of Dutta and Ray (1989).We prove, among others, that for a convex game the egalitarian solution coincides with the dual egalitarian solution for its

  6. A pilot study on providing ophthalmic training to medical students while initiating a sustainable eye care effort for the underserved.

    Science.gov (United States)

    Byrd, Julia M; Longmire, Michelle R; Syme, Noah P; Murray-Krezan, Cristina; Rose, Linda

    2014-03-01

    We present a method to reintroduce ophthalmic training into the medical school curriculum. To evaluate knowledge and skills acquired when participating in a service project, the Community Vision Project, and to develop a quantitative method for testing skills with the direct ophthalmoscope in patients. Second-year medical students participated in the study. After 1 month, their knowledge was compared with that of peers and graduates (internal medicine residents). Also at 1 month, their direct ophthalmoscope skills were compared with those of upperclassmen who had completed all core clerkships. One year later, after the participants had completed their core clerkships, long-term ophthalmoscope skills retention was tested, and their performance was compared with that of their classmates. Training occurred in mobile eye clinics. Knowledge and skills assessments were performed in the hospital eye clinic among students and residents at The University of New Mexico School of Medicine. Patients were recruited from the hospital eye clinic. Participants attended a 3-hour training session held by an attending physician in the hospital eye clinic and took part in at least 1 mobile eye clinic. A knowledge assessment quiz was administered to participants (n = 12), their classmates (n = 18), and internal medicine residents (n = 33). Skills assessment with the direct ophthalmoscope was performed at 1 month and at 1 year in 5 participants and 5 nonparticipants. Tonometer skills were assessed by comparing participants' readings with those of an ophthalmologist's obtained in patients at the mobile eye clinics. RESULTS Participants' median knowledge assessment scores were 48% higher than those of their classmates and 37% higher than those of internal medicine residents (P < .001 for both). Short-term (1 month) direct ophthalmoscopy median scores were 60% (quartile 1 to quartile 3 range, 40%-80%) for participants and 40% (quartile 1 to quartile 3 range, 20%-60%) for nonparticipating

  7. Current practices of diagnostic techniques requir- ing the use of ophthalmic drugs among KwaZulu- Natal optometrists*

    Directory of Open Access Journals (Sweden)

    K. P. Mashige

    2009-12-01

    Full Text Available In anendeavour to improve the quality of optometric eye care services in South Africa, the scope of practice was expanded to include the use of ocular diagnostic procedures such as goniosco-py that require the use of ophthalmic drugs. The purpose of this study was to assess the practices of specific diagnostic techniques (contact tonometry, 78 D/90 D lens fundus examination, binocular indirect ophthalmoscopy and gonioscopy requiring the use of ophthalmic drugs among optometrists in KwaZulu-Natal (KZN province. These specific techniques are referred to as diagnostic procedures in this article. A questionnaire containing information on demography and practice of these specific techniques was sent to all 213 KwaZulu-Natal registered optometrists who owned private practices. One hundred and thirty two completed questionnaires were received, a response rate of 62%. One hundred and seventeen (55% of the questionnaires were included in the analysis of which 55% of the respondents were females and 45% were males. Sixty two optometrists (53% were certified in di-agnostic procedures but many procedures were not being practiced. These procedures and the percentage respondents were: Contact tonometry (60%, 78 D/90 D lens fundus examination (60%, binocular indirect ophthalmoscopy (84% and gonioscopy (78%. Also, among these certified respondents (62 optometrists, a significant proportion (60% disagreed when asked if they were confident and proficient in performing the relevant diagnostic procedures. Many, (61% agreed that lack of incentives discouraged them from routinely performing the procedures. More than half (58%, agreed that chair time was an important factor in deciding whether or not to perform these diagnostic procedures. Of the total respondents (117, 86% agreed that they were confident about the accuracy of their referrals and less than half (45% disagreed that diagnostic procedures should be the sole responsibility of ophthalmologists. Less than

  8. Location of the internal carotid artery and ophthalmic artery segments for non-invasive intracranial pressure measurement by multi-depth TCD.

    Science.gov (United States)

    Hamarat, Yasin; Deimantavicius, Mantas; Kalvaitis, Evaldas; Siaudvytyte, Lina; Januleviciene, Ingrida; Zakelis, Rolandas; Bartusis, Laimonas

    2017-12-01

    The aim of the present study was to locate the ophthalmic artery by using the edge of the internal carotid artery (ICA) as the reference depth to perform a reliable non-invasive intracranial pressure measurement via a multi-depth transcranial Doppler device and to then determine the positions and angles of an ultrasonic transducer (UT) on the closed eyelid in the case of located segments. High tension glaucoma (HTG) patients and healthy volunteers (HVs) undergoing non-invasive intracranial pressure measurement were selected for this prospective study. The depth of the edge of the ICA was identified, followed by a selection of the depths of the IOA and EOA segments. The positions and angles of the UT on the closed eyelid were measured. The mean depth of the identified ICA edge for HTG patients was 64.3 mm and was 63.0 mm for HVs (p = 0.21). The mean depth of the selected IOA segment for HTG patients was 59.2 mm and 59.3 mm for HVs (p = 0.91). The mean depth of the selected EOA segment for HTG patients was 48.5 mm and 49.8 mm for HVs (p = 0.14). The difference in the located depths of the segments between groups was not statistically significant. The results showed a significant difference in the measured UT angles in the case of the identified edge of the ICA and selected ophthalmic artery segments (p = 0.0002). We demonstrated that locating the IOA and EOA segments can be achieved using the edge of the ICA as a reference point. OA: ophthalmic artery; IOA: intracranial segments of the ophthalmic artery; EOA: extracranial segments of the ophthalmic artery; ICA: internal carotid artery; UT: ultrasonic transducer; HTG: high tension glaucoma; SD: standard deviation; ICP: intracranial pressure; TCD: transcranial Doppler.

  9. Ocular Stem Cell Research from Basic Science to Clinical Application: A Report from Zhongshan Ophthalmic Center Ocular Stem Cell Symposium

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    Hong Ouyang

    2016-03-01

    Full Text Available Stem cells hold promise for treating a wide variety of diseases, including degenerative disorders of the eye. The eye is an ideal organ for stem cell therapy because of its relative immunological privilege, surgical accessibility, and its being a self-contained system. The eye also has many potential target diseases amenable to stem cell-based treatment, such as corneal limbal stem cell deficiency, glaucoma, age-related macular degeneration (AMD, and retinitis pigmentosa (RP. Among them, AMD and glaucoma are the two most common diseases, affecting over 200 million people worldwide. Recent results on the clinical trial of retinal pigment epithelial (RPE cells from human embryonic stem cells (hESCs and induced pluripotent stem cells (iPSCs in treating dry AMD and Stargardt’s disease in the US, Japan, England, and China have generated great excitement and hope. This marks the beginning of the ocular stem cell therapy era. The recent Zhongshan Ophthalmic Center Ocular Stem Cell Symposium discussed the potential applications of various stem cell types in stem cell-based therapies, drug discoveries and tissue engineering for treating ocular diseases.

  10. Design and construction of ophthalmic simulators for clinical applications; Projeto e confeccao de simuladores oftalmicos para aplicacoes clinicas

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    Sanchez, Andrea

    2006-07-01

    This work presents a calculational methodology for dose determination in human eye structures, such as: sclera, choroid, retina, lens, vitreous body, optic nerve and disc, and cornea, as well as tumor due to treatment to the eye plaques. A human eye model was constructed taking into consideration its main structural and dimension characteristics. Beyond that a mathematical model for the Co-60 and 1-125 plaques with all geometric details were built employing the MCNP-4C code. This model is able to calculate the axial and radial doses in any point of the eye and for each of its structures. An acrylic eye simulator was also built with the aim to obtain experimental results for the both model validations. This simulator is made of an acrylic sphere split into foils of 1 mm thickness which allow the introduction of a radiographic film to measure the axial and radial doses. The experimental data were used to validate the MCNP-4C results. The data from the mathematical model will serve as the basis to build a data bank for all the eye structures allowing different position and sizes of tumor as well as the replacement of all ophthalmic plaques used in the treatment. This data bank will be the principal part for the construction of a national software for the dose calculation and can be of great help for a reliable treatment system planning in radiotherapy/brachytherapy. (author)

  11. Vision Screening of Ophthalmic Nursing Staff in a Tertiary Eye Care Hospital: Outcomes and ocular healthcare-seeking behaviours.

    Science.gov (United States)

    Khan, Ruhi A; Souru, Ches; Vaghese, Sejo; Yasir, Ziaul; Khandekar, Rajiv

    2017-02-01

    This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital. This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot™ Vision Screener (Welch Allyn Inc., Skaneateles Falls, New York, USA). A total of 150 nurses participated in the study (response rate: 30.0%). The mean age was 41.2 ± 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 (24.7%), 32 (21.3%) and 10 (6.7%) nurses, respectively. A total of 58 nurses (38.7%) failed the vision screening test. Visual defects were detected for the first time in 13 nurses (8.7%). With regards to regular eye checkups, 77 participants (51.3%) reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids (P seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population.

  12. Simultaneous multimodal ophthalmic imaging using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography

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    Malone, Joseph D.; El-Haddad, Mohamed T.; Bozic, Ivan; Tye, Logan A.; Majeau, Lucas; Godbout, Nicolas; Rollins, Andrew M.; Boudoux, Caroline; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.

    2016-01-01

    Scanning laser ophthalmoscopy (SLO) benefits diagnostic imaging and therapeutic guidance by allowing for high-speed en face imaging of retinal structures. When combined with optical coherence tomography (OCT), SLO enables real-time aiming and retinal tracking and provides complementary information for post-acquisition volumetric co-registration, bulk motion compensation, and averaging. However, multimodality SLO-OCT systems generally require dedicated light sources, scanners, relay optics, detectors, and additional digitization and synchronization electronics, which increase system complexity. Here, we present a multimodal ophthalmic imaging system using swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (SS-SESLO-OCT) for in vivo human retinal imaging. SESLO reduces the complexity of en face imaging systems by multiplexing spatial positions as a function of wavelength. SESLO image quality benefited from single-mode illumination and multimode collection through a prototype double-clad fiber coupler, which optimized scattered light throughput and reduce speckle contrast while maintaining lateral resolution. Using a shared 1060 nm swept-source, shared scanner and imaging optics, and a shared dual-channel high-speed digitizer, we acquired inherently co-registered en face retinal images and OCT cross-sections simultaneously at 200 frames-per-second. PMID:28101411

  13. Cross-linked chitosan-dextran sulphate vehicle system for controlled release of ciprofloxaxin drug: An ophthalmic application

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    Chetan Chavan

    2017-01-01

    Full Text Available The major challenge associated with conventional eye-drop is the rapid drug loss due to precorneal defence barrier. In this context, controlled-release system of ciprofloxacin-conjugated chitosan (CS-Dextran sulphate (DS nanoparticles (NPs have been synthesized, to increase the bioavailability. The formulated drug delivery vehicle was evaluated for its therapeutic value in the simulated tear fluidat pH 7.4. Ophthalmic microbes were tested with this formulation, to confirm the drug efficacy; which showed conducive therapeutic values of both MIC and MBC. Ocular irritancy test was performed using HET-CAM test, which showed that the CS-DS system did not yield any vascular response, offering it to be a non-irritant to the ocular surface. The release studies showed monotonous controlled-release for duration of 21 h. A fine cross-linking between CS and DS has been demonstrated to form CS-DS NPs and their interaction with drug has been evaluated using conventional characterization tools.

  14. Spectroscopic studies of the silicone oil impact on the ophthalmic hydrogel based materials conducted in time dependent mode.

    Science.gov (United States)

    Chamerski, Kordian; Stopa, Marcin; Jelen, Piotr; Lesniak, Magdalena; Sitarz, Maciej; Filipecki, Jacek

    2017-10-18

    Silicone oil is the one of the artificial materials used in vitreoretinal surgery for retinal detachment treatment. Since the silicone oil is sometimes applied along with intraocular lens (IOL) implantation the direct influence of silicone oil on the artificial implant should be taken into account. Presented study was performed in order to determine the time-dependent impact of silicone oil on hydrogel based ophthalmic materials. Two kinds of IOLs based on hydroxyethyl 2-methacrylate (HEMA) hydrogel material were immersed in silicone oil based on linear poly(dimethylsiloxane) (PDMS). Incubation in oil medium was performed in 37°C for 1, 3 and 6months. After appropriate period of the incubation samples were examined by means of FTIR-ATR method as the technique of surface study as well as Positron Annihilation Lifetime Spectroscopy (PALS) as the method of internal structure investigation. Results obtained during the study revealed that silicone oil is not capable to penetrate the internal structure of investigated materials and its impact has come down to interaction with the samples surfaces only. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Vision Screening of Ophthalmic Nursing Staff in a Tertiary Eye Care Hospital; Outcomes and ocular healthcare-seeking behaviours

    Directory of Open Access Journals (Sweden)

    Ruhi A. Khan

    2017-03-01

    Full Text Available Objectives: This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital. Methods: This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot™ Vision Screener (Welch Allyn Inc., Skaneateles Falls, New York, USA. Results: A total of 150 nurses participated in the study (response rate: 30.0%. The mean age was 41.2 ± 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 (24.7%, 32 (21.3% and 10 (6.7% nurses, respectively. A total of 58 nurses (38.7% failed the vision screening test. Visual defects were detected for the first time in 13 nurses (8.7%. With regards to regular eye checkups, 77 participants (51.3% reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids (P <0.01 each. Conclusion: A high proportion of participants failed the vision screening tests and only half displayed good ocular healthcare-seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population.

  16. The Dynamics of Glutathione Species and Ophthalmate Concentrations in Plasma from the VX2 Rabbit Model of Secondary Liver Tumors

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    R. Abbas

    2011-01-01

    Full Text Available Purpose. Available tumor markers have low sensitivity/specificity for the diagnosis of liver tumors. The present study was designed to evaluate the oxidoreductive status of the liver as surrogates of tumor subsistence and growth. Methods. Glutathione species (GSH:GSSG, ophthalmate (OA concentrations, and their turnover were measured in plasma of rabbits (n=6 in their healthy state and in the state of tumor growth after implantation of the VX2 carcinoma in their liver. Tumors were allowed to grow for a period of 14 days when rabbits were sacrificed. Livers were removed and cysteine concentration was measured in liver tissue. Results. Tumor growth was found in 100% of the rabbits. Concentration and labeling of GSH/GSSG were similar in experimental animals before and after tumor implantation and to sham animals. In contrast, OA concentration increased significantly in experimental animals after tumor implantation when compared to same animals prior to tumor implantation and to sham animals (P<.05. The concentration of cysteine, a precursor of GSH, was found to be significantly lower in the liver tissue adjacent to the tumor (P<.05. Conclusion. Disturbances in the oxidoreductive state of livers appear to be a surrogate of early tumor growth.

  17. Disturbances in the Glutathione/Ophthalmate Redox Buffer System in the Woodchuck Model of Hepatitis Virus-Induced Hepatocellular Carcinoma

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    Rafael Andres Ibarra

    2011-01-01

    Full Text Available Purpose. The incidence of liver tumors is rising in USA. The purpose of this study was to evaluate liver oxido-reductive status in the presence of chronic liver disease and hepatocellular carcinoma (HCC. Methods. Glutathione species and ophthalmate (OA concentrations were measured by LC-MS in processed plasma and red blood cells (RBC from infected Woodchuck with hepatitis virus (WHV. Blood samples were obtained from: (i infected animals with tumors (WHV+/HCC+, (ii infected animals without tumors (WHV+/HCC− and (iii healthy animals (WHC−/HCC−. Results. The concentration of reduced glutathione (GSH and the ratio GSH/GSG were lower in plasma from WHV+/HCC+ animals when compared to WHV+/HCC− and WHV−/HCC− (P<0.01. In contrast, the concentration of oxidized glutathione (GSSG was found to be higher in plasma from WHV+/HCC+ animals when compared to WHV+/HCC− and WHV−/HCC− (P<0.01. The Glutathione species and its ratio from the RBC compartment were similar among all groups. OA concentration in both plasma and RBC was significantly higher from WHV+/HCC+ when compared to WHV+/HCC− and WHV−/HCC− (P<0.01. Conclusions. Disturbances of the glutathione redox buffer system and higher concentrations of OA were found in the WCV+/HCC+ animal model. The role of these compounds as biomarkers of early tumor development in patients with end stage liver disease remains to be determined.

  18. Electroretinogram monitoring of dose-dependent toxicity after ophthalmic artery chemosurgery in retinoblastoma eyes: six year review.

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    Jasmine H Francis

    Full Text Available To report electroretinogram responses of retinoblastoma children under anesthesia before and after treatment with chemotherapeutic drugs (melphalan, topotecan, carboplatin delivery by ophthalmic artery chemosurgery (OAC.A cohort study of 81 patients with retinoblastoma treated with OAC. All patients treated with OAC at our center through May 2012 for whom the requisite ERG data were available are included in the analysis. This study recorded the ERG 30 Hz flicker amplitude response changes from baseline, at 3 and 12 months following OAC treatment completion. Both univariate and multivariate linear regression models were evaluated, with generalized estimating equations to correct for correlations within patients. Independent numerical variables included maximum doses and cumulative doses of melphalan, topotecan and carboplatin.By univariate analysis, both melphalan and topotecan appear to be associated with changes in ERG amplitude at both 3 and 12 months; but for the most part, these changes are minimal and likely clinically insignificant. By multivariate analysis, maximum and cumulative melphalan have a modest, temporary effect on the ERG amplitude change, which is apparent at 3 months but no longer evident at 12 months after completing treatment. By multivariate analysis, topotecan and carboplatin do not appear to adversely effect the change in ERG response.Melphalan has the strongest, and carboplatin the weakest association with reduction in ERG response amplitudes; but for the most part, these changes are minimal and likely clinically insignificant. These conclusions apply only over the dose ranges used here, and should be applied with caution.

  19. Comparison of two hydrogel formulations for drug release in ophthalmic lenses.

    Science.gov (United States)

    Paradiso, P; Galante, R; Santos, L; Alves de Matos, A P; Colaço, R; Serro, A P; Saramago, B

    2014-08-01

    In the present work two types of polymers were investigated as drug releasing contact lens materials: a poly-hydroxyethylmethacrylate (pHEMA) based hydrogel and a silicone hydrogel. The silicone hydrogel resulted from the addition of TRIS, a hydrophobic monomer containing silicon (3-tris(trimethylsilyloxy)silylpropyl 2-methylprop-2-enoate), to pHEMA. Both hydrogels were loaded with an antibiotic (levofloxacin) and an antiseptic (chlorhexidine) by soaking in the drug solutions. The hydrogel properties were determined to be within the range demanded for lens materials. The release profiles of both drugs from the hydrogels were obtained and eventual drug/polymer interactions were assessed with the help of Raman spectra. A mathematical model, developed to mimic the eye conditions, was applied to the experimental results in order to predict the in vivo efficacy of the studied systems. The release profiles were compared with those resulting from the application of commercial eyedrops. The pHEMA based hydrogel demonstrated to be the best material to achieve a controlled release of levofloxacin. In the case of chlorhexidine, the silicone hydrogel seems to lead to better results. In both cases, our results suggest that these materials are adequate for the preparation of daily disposable therapeutic contact lenses. © 2014 Wiley Periodicals, Inc.

  20. Evaluation of the Performance of an Ophthalmic Thermosensitive Hydrogel Containing Combination of Suramin and Bevacizumab.

    Science.gov (United States)

    Quinteros, Daniela Alejandra; Lopez, Emiliano Sebastian; Couto, Juan Lucio Silva; Maletto, Belkys Angelica; Allemandi, Daniel Alberto; Palma, Santiago Daniel; Gallo, Juan Eduardo

    2016-01-01

    Suramab (SUM) is a new pharmaceutical combination made up of suramine (SUR) and bevacizumab (BVM), which showed a high synergistic effect when administered jointly. As the pharmaceutical vehicle, poloxamer aqueous dispersions were used since this system is able to maintain their fluidity at low temperatures (corporal environment (>35ºC). In the present study we aimed at evaluating the effect of Poloxamer to prolong the effect of SUM. These formulations were characterized using rheological, biopharmaceutical (drug release) and morphological (SEM) technique. Corneal NV was induced in Sprague Dawley rats Corneal. At 15 days of follow up animals were sacrificed and perfused with black drawing ink. Digital photographs were taken and the area of neovascularisation (ANV) was calculated using the image programmed. The rheological behavior was influenced by the addition of drugs, resulting in a decrease in the gelation temperature (Tsol/gel). Both drugs were released from poloxamer gels by means of an anomalous mechanism. However, BVM was released faster than SUR, with their combination (SUM) to appearing to reduce delivery, probably due to interactions between the drugs or with the polymeric matrix. The in vivo studies showed that SUM-poloxamer gel was able to increase the corneal antiangiogenic effect compared to the SUM solution and BVM alone at 15 days of follow-up. Furthermore no injurious effects were observed in the histological tissue examination after drug administration. The presence of Poloxamer, known to modulate control release of biological agents, seems to have a favorable effect on SUM subconjunctival administered. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.