Ophthalmology and eye diseases最新文献

Aims: To assess the efficacy of topical dorzolamide for treating cystoid macular edema in patients with retinitis pigmentosa and minimize the secondary effects of maintenance therapy in patients with retinitis pigmentosa (RP) who present with chronic microcystic macular edema.

Methods: To replace acetazolamide systemic treatment, with a topical treatment using 2% dorzolamide in three patients. The methods performed were OCT scan with a Spectralis HRA-OCT, for the measurement of macular thickness and morphology; best corrected visual acuity was assessed using Early Treatment Diabetic Retinopathy Study (ETDRS), was assessed slit-lamp biomicroscopy, ocular tonometry, fundus biomiocrosopy, and color fundus photography. This therapeutic protocol has been applied and described in three patients.

Results: In all three tested patients, following the administration of dorzolamide in eye drop, we observed a remarkable decrease in macular edema, almost comparable to that obtained with acetazolamide per os.

Conclusion: The study confirms the anti-edematogenic effect of topical dorzolamide in RP with recurring macular cysts, as this can have a favorable response with topical dorzolamide. In all the three examined patients, the instillation of topical dorzolamide caused a remarkable reduction in their macular edema, as highlighted on OCT.

Purpose: To determine whether prior instillation of amethocaine would increase the rate and magnitude of tropicamide-induced pupillary dilatation in darkly pigmented irides.

Method: A total of 50 healthy Africans aged 18-40 years, with darkly pigmented irides, received a drop of amethocaine in one eye and a drop of placebo in the contralateral eye, followed by two drops of tropicamide in both eyes. Serial pupil diameters were measured using a monocular infrared video pupillometer. Rate of pupillary dilatation was compared in both eyes. Survival statistics were calculated for the time taken to reach a clinically effective dilatation, clinically effective diameter (CED) of 6.0 mm.

Results: Mean difference in pupil diameters between amethocaine- and placebo-treated eyes was 0.30 ± 0.09 mm (P < 0.002). In all, 62% of amethocaine-treated eyes and only 46% of placebo-treated eyes reached the CED.

Conclusion: We observed a small but statistically significant potentiating effect of a drop of amethocaine on tropicamide-induced dilatation within 20 minutes.

In vitro cytotoxicity of tafluprost, which is the most recently developed anti-glaucoma prostaglandin (PG) analog, in ocular surface cells is addressed in comparison with other PG analogs. Irrespective of cell lines and models, the cytotoxicity of anti-glaucoma PG eyedrops was primarily related to the concentration of benzalkonium chloride (BAK) contained in the eyedrops as a preservative. Accordingly, preservative-free tafluprost was apparently less cytotoxic than BAK-preserved PG analogs. Furthermore, our study for cytotoxicity assays on ocular cells, conducted by comprehensive investigations covering a variety of concentrations and treatment times, which is termed the cell viability score (CVS) system, demonstrated that 0.001% BAK-preserved tafluprost was not cytotoxic, and suggested that tafluprost may even reduce the cytotoxic effect of BAK. It has been reported that adverse reactions associated with tafluprost in healthy human volunteers and patients with glaucoma include conjunctival hyperemia, eyelid pigmentation, eyelash bristles, and deepening of upper eyelid sulcus. Nonetheless, most clinical studies have demonstrated that not only preservative-free tafluprost but also BAK-preserved tafluprost is well tolerated and safe in patients with glaucoma and ocular hypertension.

We conducted a cohort study to evaluate post-cataract surgery endophthalmitis rates in relation to prophylactic intracameral moxifloxacin administration. A total of 2332 patients (2674 eyes) who underwent phacoemulsification by a single surgeon from January 2007 through December 2012 were included in the study. A total of 1056 eyes did not receive intracameral prophylactic moxifloxacin and the antibiotic was injected in 1618 eyes. The incidence of presumed postoperative endophthalmitis in the 2 groups was calculated. The rate of presumed infectious endophthalmitis after cataract surgery between January 2007 and June 2009 (without intracameral moxifloxacin) was 0.094%. The rate in the second period, from July 2009 to December 2012 (with prophylactic intracameral moxifloxacin), was 0%. In our patients, a decline in the incidence of presumed infectious postoperative endophthalmitis appeared to be associated with the application of intracameral moxifloxacin.

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare pre-operative and post-operative visual acuity (VA) and intraocular pressure (IOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9-75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2-12 months). The mean log-MAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively (P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.

We evaluated the effect of intravitreal bevacizumab (IVB) injection before pars plana vitrectomy (PPV) on intravitreal hemorrhage (VH) during and after vitrectomy for postoperative the first day and the first month in pseudophakic patients with proliferative diabetic retinopathy (PDR). This retrospective study was performed on 44 eyes of 44 patients who underwent vitrectomy for PDR. Patients were divided into PPV (n = 22 eyes) and PPV + IVB (n = 22 eyes) groups. Injection of bevacizumab (1.25 mg/0.05 mL) was performed 3 days before vitrectomy. Outcomes of visual acuity as well as intraoperative and postoperative VH were compared between the two groups. One month after surgery, visual acuity improved in PPV and PPV + IVB groups (P = 0.005, P = 0.006), respectively. There was no difference between the two groups in best corrected visual acuity at baseline and after vitrectomy (P = 0.71). Intraoperative bleeding into the vitreous was recorded in 14 (63.6%) cases in the PPV group and in 7 (31.8%) cases in the PPV + IVB group. The first month, intravitreal hemorrhage was recorded in six patients in the PPV group and in two patients in the PPV + IVB group (P = 0.03). The mean pre-postoperative central macular thickness was similar in both groups. Intravitreal injection of IVB before vitrectomy decreased the rate of VH at the time of surgery and at the first postoperative month in patients with PDR.

Voclosporin is a relatively new calcineurin inhibitor that has been used successfully in humans for the treatment of plaque psoriasis. Available data indicate a good safety profile for this treatment and a significant increase in quality of life for psoriasis patients. More recently, voclosporin has been used to treat ophthalmic conditions such as uveitis. The limited data available indicate at least comparable results relative to current therapy with a better safety profile. Here, we analyze data from human and animal studies and the mode of action of voclosporin. Available safety profile data are also discussed.

While conducting medical aid in Mozambique, a 41 year old African male presented to our eye clinic complaining of visual impairment. The male was found to have Peters' anomaly type 2, a rare congenital ocular malformation leading to sensory amblyopia and glaucoma.

Interleukin-4 (IL-4) and interleukin-10 (IL-10) are key cytokines whose increased production during systemic HIV infection has been associated with decreased cellular immunity during AIDS. We examined whether HIV-induced stimulation of IL-4 or IL-10 production leads to increased susceptibility to AIDS-related human cytomegalovirus retinitis. It was confirmed that there were increased amounts of IL-4 and IL-10 mRNA levels in mice with MAIDS of 10 weeks duration when most susceptible to MCMV retinitis. Surprisingly, however, MCMV-infected eyes of IL-4 -/- and IL-10 -/- mice with MAIDS of 8 weeks duration exhibited retinitis and infectious virus equivalent to that observed in MCMV-infected eyes of wild-type mice with MAIDS. We conclude that neither IL-4 nor IL-10 alone play a role in increased susceptibility to MAIDS-related MCMV retinitis, but may work collectively with other retrovirus-induced immunosuppressive factors to allow for retinal disease.

Introduction: Various aspects of management of traumatic hyphaema are enmeshed in controversy. Surgery is done to prevent complications: optic atrophy and corneal blood staining occurring if a high risk exists of either or both occurring. Circumstances considered high risk do not enjoy universal consensus.

Objectives: To determine what Nigerian ophthalmologists consider absolute indications for surgical intervention by means of anterior chamber paracentesis and hyphaema washout in closed globe traumatic hyphaema, evaluate these absolute indications, and attempt to evolve a guideline for surgical intervention based on areas of consensus and disagreement.

Method: A semi-structured, pre-tested questionnaire with responses analyzed with SPSS 11 software.

Result: Near universal agreement on indication exist on early corneal blood staining and sickle cell haemoglobinopathy. Differing views concern blackball, volume and duration of hyphaema and secondary hypertension-associated hyphaema. However, it appears surgery is embarked on earlier than other practitioners elsewhere may consider necessary.

Conclusion: Risk level for non-surgical management against risk and benefit of surgery should be evaluated for each individual before surgery.