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Biomedical subjects

F T Fraunfelder

Publications and source records attributed to F T Fraunfelder.

At least 19 recordsLinked to original sources
PubMed2005

Liquid nitrogen cryotherapy of a conjunctival vascular tumor.

PURPOSE: To report the successful use of liquid nitrogen cryotherapy in treating a conjunctival vascular tumor. METHODS: A Brymil unit with a "D" tip was used to apply a liquid nitrogen spray for cryotherapy, using a previously described double freeze-thaw technique. RESULTS: One year after treatment, the suspected hemangioma was markedly decreased in size and redness. CONCLUSION: Liquid nitrogen cryotherapy should be considered as an alternative to more frequently used methods of treatment of conjunctival vascular tumors.

Conjunctival Neoplasms↗
PubMed2004

Topiramate-associated acute, bilateral, secondary angle-closure glaucoma.

PURPOSE: To evaluate spontaneous reports of ocular side effects associated with topiramate use. DESIGN: Retrospective case series. METHODS: One hundred fifteen case reports, primarily of a specific ocular syndrome (acute secondary angle-closure glaucoma), were collected from spontaneous reporting systems: the Drug Safety section of Ortho-McNeil Pharmaceuticals, Inc. (Raritan, NJ), the Food and Drug Administration (Rockville, MD), the World Health Organization (Uppsala, Sweden), the National Registry of Drug-Induced Side Effects (Casey Eye Institute, Oregon Health & Science University, Portland, Oregon), and the world literature. MAIN OUTCOME MEASURES: The data were evaluated using the World Health Organization Causality Assessment Guide to the certainty of a suspected adverse drug reaction. RESULTS: Eighty-six cases of acute-onset glaucoma (83 bilateral and 3 unilateral), 17 cases of acute bilateral myopia (up to 8.75 diopters), 9 cases of suprachoroidal effusions, 3 cases of periorbital edema, and 4 cases of scleritis were reported. In those cases for which management was reported, 38% had laser or surgical peripheral iridectomy (21 cases). CONCLUSIONS: In the "certain" category of the World Health Organization classification system, the following are caused by topiramate therapy: abnormal vision, acute secondary angle-closure glaucoma, acute myopia, and suprachoroidal effusions. All findings are reversible if recognized early and if the drug is discontinued. The first presenting symptom of acute secondary angle-closure glaucoma in many patients was blurring of vision. Peripheral iridectomy is ineffective for this type of angle-closure glaucoma.

Acute Disease↗
PubMed2004

Adverse ocular drug reactions recently identified by the National Registry of Drug-Induced Ocular Side Effects.

PURPOSE: To report recent ocular adverse drug reactions identified by the National Registry of Drug-Induced Ocular Side Effects. METHODS: Case reports from the National Registry and the World Health Organization were collected and adverse drug reactions categorized as follows: certain, probable/likely, possible, unlikely, and conditional/unclassifiable. RESULTS: Bisphosphonates are associated with ocular inflammation, including the first reports of drug-related scleritis. Topiramate is shown to cause angle-closure glaucoma. Cetirizine can cause an oculogyric crisis, and there is strong evidence retinoids cause intracranial hypertension. CONCLUSION: Recent reports to the National Registry have led to identification of new ocular adverse drug reactions.

Adolescent↗
PubMed2001

Ocular side effects possibly associated with isotretinoin usage.

PURPOSE: To evaluate reported ocular side effects associated with isotretinoin usage. METHODS: One thousand seven hundred forty-one case reports received from spontaneous reporting systems, data from the Drug Safety Section of Roche Pharmaceuticals, and the world's literature were evaluated using the World Health Organization Causality Assessment Guide of Suspected Adverse Reactions. RESULTS: Thirty-eight different signs or symptoms of ocular abnormalities associated with isotretinoin usage have been classified as "certain," "probable/likely," "possible," "unlikely," or "conditional/unclassifiable." CONCLUSION: Adverse ocular side effects secondary to isotretinoin that are "certain" include abnormal meibomian gland secretion, blepharoconjunctivitis, corneal opacities, decreased dark adaptation, decreased tolerance to contact lens, decreased vision, increased tear osmolarity, keratitis, meibomian gland atrophy, myopia, ocular discomfort, ocular sicca, photophobia, and teratogenic ocular abnormalities. Those that are "probable/likely" are decreased color vision (reversible) and permanent loss of dark adaptation. Those that have a "possible" association include permanent keratoconjunctivitis sicca. Suggested guidelines for ocular examination for patients on isotretinoin are given.

Adolescent↗
PubMed2000

Monitoring patients taking oral carbonic anhydrase inhibitors.

Although no prospective studies have been done and no recommendations can be reasonably evidenced based, we believe that our "alternative views" are reason-able, taking into account the serious nature of aplastic anemia and its more favorable prognosis when this disorder is treated early. Because aplastic anemia represents only about one half of possible CAl blood dyscrasias, early recognition of non-aplastic anemia dyscrasias alone Justifies hematologic screening.

Administration, Oral↗
PubMed1999

Irreversible corneal decompensation in patients treated with topical dorzolamide.

PURPOSE: To describe irreversible corneal decompensation after topical dorzolamide hydrochloride (Trusopt; Merck and Co, Inc, West Point, Pennsylvania) therapy in nine patients who had histories consistent with corneal endothelial compromise. METHOD: Multicenter review of patients' charts. RESULTS: Nine eyes of nine patients developed overt corneal decompensation after starting topical dorzolamide, a condition that did not resolve with drug cessation. This occurred after 3 to 20 weeks (mean, 7.8) of therapy. All nine patients had undergone intraocular surgery. Eight patients had undergone cataract surgery; three were aphakic and three had posterior chamber intraocular lenses. Two patients had anterior chamber intraocular lenses and also had undergone trabeculectomies. Four patients had undergone penetrating keratoplasties, each case complicated by episodes of corneal allograft rejection that were successfully treated. Two patients had asymptomatic Fuchs endothelial dystrophy. Seven patients have since undergone successful penetrating keratoplasties. CONCLUSION: The reports suggest that dorzolamide can cause irreversible corneal edema in a subset of glaucoma patients with endothelial compromise. The findings suggest a rationale for research into the long-term effects of dorzolamide on the corneal endothelium.

Administration, Topical↗
PubMed1999

Features of amiodarone-induced optic neuropathy.

PURPOSE: To report clinical features of amiodarone-induced optic neuropathy and outline the differentiation of amiodarone optic neuropathy from nonarteritic anterior ischemic optic neuropathy. METHOD: We reviewed data from 73 patients reported to have developed an optic neuropathy while taking amiodarone. RESULTS: Amiodarone optic neuropathy is characterized by an insidious onset, slow progression, bilateral visual loss, and protracted disk swelling that tends to stabilize within several months of discontinuing the medication. Nonarteritic ischemic optic neuropathy is characterized by acute, unilateral visual loss that is usually complete at onset, with resolution of disk edema over several weeks. CONCLUSION: Unique clinical features of amiodarone-induced optic neuropathy may help clinicians diagnose and distinguish between amiodarone-induced optic neuropathy and nonarteritic anterior ischemic optic neuropathy.

Amiodarone↗
PubMed1999

Managed care and physician disability.

The number of disability claims by physicians has skyrocketed during the last decade. One of the primary reasons for this escalation is decreased job satisfaction brought about by managed care. Certain physician groups are more vulnerable to the stress of advanced managed care: solo practitioners, specialists and subspecialists, certain generalists, doctors with independent personalities, middle-aged or near-retirement physicians, impaired physicians, and those whose practices are almost solely contract driven. Based on analysis of physician disability claims, certain protective measures are recommended to relieve stress and promote survival in today's health care market.

Community Networks↗
PubMed1999

Ocular safety of Viagra, (sildenafil citrate).

To date, sildenafil citrate (Viagra) gives every evidence of being a safe drug for the eye despite a series of expressed concerns. A review of how its ocular safety profile has been identified offers insights into the strengths and weaknesses of present systems and resources for judging the ocular safety of Viagra or, for that matter, of any new drug. Such insights include: The great value of careful, informed assessment of preclinical information gleaned from laboratory experiments. By and large, such assessments point the way toward appropriate clinical evaluation. For Viagra, early in its development it was noted that besides exerting a major inhibitory effect on the intended target, the vascular-associated enzyme phosphodiesterase 5 (PDE5), the drug also exerts a lesser but definite inhibitory effect on the closely related PDE6, located in the retina. For this reason, preclinical evaluation of the drug included electroretinography plus postmortem histology. In addition, an extended eye examination was incorporated into clinical protocols. The often chaotic but invaluable information stream that becomes available once marketing approval has been gained and large populations begin to use a drug. False alarms, misattribution, and erroneous information are the order of the day. Nevertheless, as information accumulates, patterns of response clarify and the true nature of special susceptibility for subpopulations, if any, becomes apparent. A role for the astute clinician remains: Subtle changes or unusual risks for subpopulations can be missed entirely for long periods of time. A manifest need for improvement in evaluation of postmarketing side-effects. This need has led to the establishment of a new discipline: pharmacoepidemiology. In ophthalmology, the National Registry of Drug Induced Ocular Side-Effects maintains a constant and invaluable surveillance. Examples are supplied to illustrate each of these major points: Our presentation will include data gleaned from clinical trials plus postmarketing information on the incidence, duration, and type of color vision defects observed at different doses of Viagra.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed1997

Minocycline-induced scleral pigmentation.

PURPOSE: Minocycline is a commonly used drug in the management of acne and rosacea. Four individual cases of oral minocycline-induced scleral pigmentation are reported in the dermatologic literature. This is the first report in the ophthalmic literature and will add three new cases of probable minocycline-induced scleral pigmentation. MATERIALS AND METHODS: Data on minocycline from the spontaneous reporting systems of the National Registry of Drug-Induced Ocular Side Effects, Food and Drug Administration, World Health Organization, and Lederle Laboratories were reviewed as to minocycline-related scleral pigmentation. Photographs, published cases, discussions with the examining ophthalmologists, and the personal observation of one patient (case 1) are the basis of the authors' conclusions. RESULTS: Seven cases of probable oral minocycline-induced scleral pigmentation are presented. These changes may or may not be associated with minocycline-induced pigmentary changes in other tissues, such as the skin, teeth, fingernails, bone, thyroid, or mucosa. The characteristic scleral pattern is a blue-gray 3- to 5-mm band starting at the limbus, which usually is enhanced in the palpebral aperture, possible due to the photosensitizing properties of the drug. CONCLUSIONS: Oral minocycline can cause scleral pigmentation. This pigmentation may resolve within years, or it may be permanent.

Adult↗
PubMed1995

Stevens-Johnson syndrome associated with methazolamide treatment reported in two Japanese-American women.

BACKGROUND: Systemic acetazolamide treatment has been reported in association with Stevens-Johnson syndrome (SJS). This is the first report of this syndrome associated with methazolamide treatment. The association is reported in two Japanese-American women. METHOD AND RESULTS: Two patients with SJS, which developed during treatment with methazolamide, are described. Other potential associations are discussed. CONCLUSIONS: Systemically administered carbonic anhydrase inhibitors, including both acetazolamide and methazolamide can be associated with SJS.

Adult↗
PubMed1995

Adverse ocular effects associated with niacin therapy.

In a retrospective survey of patients taking medication for hyperlipidaemia, those taking niacin (nicotinic acid) were more likely (p < 0.05) to report sicca syndromes, blurred vision, eyelid oedema, and macular oedema compared with those who never took niacin. Additionally, 7% of those taking niacin discontinued the drug owing to adverse ocular side effects, while none of the other lipid lowering agents were found to cause these side effects (p = 0.016). Data from spontaneous reporting systems support a possible association of decreased vision, cystoid macular oedema, sicca-like symptoms, discoloration of the eyelids with or without periorbital or eyelid oedema, proptosis, loss of eyebrow or eyelashes, and superficial punctate keratitis with the use of niacin in high doses. Decreased vision may be marked, and if the drug is not discontinued, may progress to cystoid macular oedema. All ocular side effects listed above are reversible if the association with niacin is recognised and the drug is discontinued; both the incidence and severity of the ocular side effects seem to be dose dependent.

Adult↗