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Biomedical subjects

H J Garzozi

Publications and source records attributed to H J Garzozi.

At least 19 recordsLinked to original sources

Blood flow per unit retinal nerve fibre tissue volume is lower in the human inferior retina.

AIM: To determine if perfusion per unit tissue volume of retinal nerve fibre layer and optic nerve head in the inferior sector is lower than in the superior sector. METHODS: Heidelberg retinal tomogram (HRT) for topographic measurement of optic nerve head and retinal nerve fibre layer and Heidelberg retinal flowmeter (HRF) for retinal blood flow were performed on 19 normal healthy subjects. Measurements from the superior and inferior sectors were compared. The perfusion/nerve fibre ratio (PNR); the blood flow per unit retinal nerve fibre tissue volume, was calculated in each sector with a formula; HRF flow measurements divided by HRT measurements. RESULTS: Retinal nerve fibre layer thickness in the inferior retina was significantly higher than in the superior retina (p<0.05). There were, however, no differences in retinal blood flow between the superior and inferior retinal sectors. The PNR in the inferior sector were significantly lower than in the superior sector (p=0.047 for HRF mean flow/rim volume and p = 0.0282 for HRF 75th percentile flow/rim volume). CONCLUSIONS: The inferior sector of retinal nerve fibre layer and optic nerve head may have lower blood flow per unit nerve tissue volume compared to the superior sector. This result suggests that the inferior sector is more vulnerable to elevated intraocular pressure (IOP) and ischaemic insults in glaucomatous optic neuropathy.

Adult↗

The effects of dorzolamide on choroidal and retinal perfusion in non-exudative age related macular degeneration.

AIM: To comprehensively evaluate the effects of dorzolamide on the choroidal and retinal circulation in patients with age related macular degeneration (AMD). METHODS: In this randomised, double masked, parallel study, 36 non-exudative AMD patients were randomised in a 2 to 1 fashion to placebo versus topical dorzolamide and underwent assessment of their choroidal and retinal circulation. Scanning laser ophthalmoscope indocyanine green angiograms (ICGA) were analysed by a new area dilution analysis technique. Four areas in the perifoveal region and two areas in the temporal peripapillary region were evaluated by plotting intensity of fluorescence of each area over time. The means of the choroidal filling times and the heterogeneity of the filling times were assessed. Scanning laser ophthalmoscope fluorescein angiography (FA) was evaluated for retinal arteriovenous passage (AVP) times by plotting intensity of fluorescence of retinal vessels over time. Assessment was performed at baseline and at 4 months. RESULTS: Compared to placebo, AMD patients treated with dorzolamide showed a significantly increased rapidity of choroidal filling in the superior and inferior peripapillary regions (p=0.007, p=0.02, respectively). No significant difference in choroidal filling times was found in any of the perifoveal areas (p=0.9). Also, on FA assessment, treatment with dorzolamide showed no statistical differences in AVP times (p=0.19). CONCLUSIONS: Dorzolamide may increase peripapillary choroidal perfusion in non-exudative AMD patients. Further studies are merited.

Aged↗

Vitrectomy to remove a posteriorly dislocated endocapsular tension ring.

We treated a patient who had a posteriorly dislocated endocapsular ring associated with decreased vision and intravitreal cortical remnants. The ring was removed by uneventful pars plana vitrectomy. By the last examination, best corrected visual acuity had improved to 6/12 and intraocular pressure had stabilized to within normal limits. A posteriorly dislocated endocapsular ring is a rare complication of cataract surgery. Its removal by pars plana vitrectomy under direct observation is effective and safe.

Aged↗

Simultaneous management of blood flow and IOP in glaucoma.

Factors other than intraocular pressure (IOP) elevation must be involved in initiation and progression of glaucoma. An additional element in disease causation may be ischemia in the retina and optic nerve head. Ischemic damage to neurons in the CNS is similar mechanistically and histopathologically to changes seen in glaucoma. Further, glaucoma patients with normal IOP show clear evidence for cerebral and ocular ischemia. Aging and atherosclerosis reduce the ability of the eye to autoregulate blood flow when ocular perfusion pressure changes: the dependence of blood flow on perfusion pressure links ischemia to IOP. Consequently, neuroprotective treatments for glaucoma should be designed to both reduce IOP and improve ocular nutrient delivery.

Aging↗

Intraocular pressure and photorefractive keratectomy: a comparison of three different tonometers.

PURPOSE: To evaluate the intraocular pressure (IOP) with three different instruments, Goldmann applanation tonometer (GAT), noncontact tonometer, and Tono-Pen after photorefractive keratectomy (PRK) for myopia. METHODS: A prospective case series study to evaluate preoperative and postoperative IOP measurements of 149 eyes at 12 months. We performed GAT, noncontact tonometry, Tono-Pen central, and Tono-Pen temporal periphery measurements. We also performed measurements of the central corneal thickness (CCT) by ultrasonic pachymetry and keratometry. Pre-operative IOP reading served as control for all studies. RESULTS: After PRK, IOP reading was significantly reduced in the treated eyes when compared with the control measurements (11.87+/-1.73 vs. 13.37+/-1.52 mm Hg, p<0.0001 with GAT; 12.07+/-1.6 vs. 13.51+/-1.59 mm Hg, p<0.0001 with noncontact tonometer; 12.18+/-1.6 vs. 13.48+/-1.55 mm Hg, p<0.0001 with Tono-Pen central; 13.48+/-1.65 vs. 13.71+/-1.56 Hg, p<0.0104 with Tono-Pen temporal periphery). There was also a significant correlation between IOP reading changes measured by GAT, noncontact tonometer, Tono-Pen central, and change of CCT and between reduction of IOP reading and keratometry (r2>0.39, p<0.0001 for each). The correlation between IOP reading change by Tono-Pen temporal periphery and CCT was also significant but r2 value was only 0.034. Tono-Pen temporal periphery postoperative IOP measurements had the best correlation with preoperative GAT IOP (r2 = 0.57, p<0.0001). CONCLUSIONS: PRK reduced IOP reading as measured by GAT, noncontact tonometer, and Tono-Pen central; less so when measured by Tono-Pen temporal periphery. Early detection of glaucoma and IOP follow-up in glaucoma patients may be done best by peripheral Tono-Pen measurements over the nonablated cornea.

Adult↗

Ocular blood flow measurements and their importance in glaucoma and age-related macular degeneration.

This survey of methods for assessing ocular hemodynamics in glaucoma and age-related macular degeneration is not complete, but it does cover those likely to be encountered in the literature. A fundamental problem in getting to grips with the ocular blood flow literature is the difficulty in comparing the results of similar studies employing different assessment techniques. As evident from the discussion above, each technique evaluates a portion of the ocular circulation in a distinct way. Some of the methods overlap with regard to the tissues that can be used for examination, while others are directed at entirely different parts of the ocular vasculature. Despite these difficulties, hemodynamic studies of glaucoma and AMD are likely to grow in importance. On the basis of accumulating epidemiological and clinical evidence, it is becoming apparent that intraocular pressure is not the sole etiological factor in glaucoma, and retinal pigment epithelium senescence is not the sole etiological factor in AMD. Circumstantial evidence of vascular involvement in glaucoma and AMD has now been bolstered by experimental evidence. If the current pace of refinement of newly established technologies for evaluating ocular blood flow is maintained, they will soon be ready for deployment in the clinic. The only problem is the availability of expensive instruments and trained personnel. The ultimate beneficiaries of work in this area will not be researchers, but patients.

Angiography↗

A gene causing autosomal recessive cataract maps to the short arm of chromosome 3.

BACKGROUND: Fourteen loci have been associated with autosomal dominant cataract, but only one with the recessive form of the disease. OBJECTIVES: To find the chromosomal location of a gene causing autosomal recessive cataract in three inbred Arab families. METHODS: A single nucleotide polymorphism-based genome-wide search, with the Effvmetrix GeneChip HuSNP genotyping array, was performed on a pooled DNA sample from six affected family members in a search for regions showing homozygosity. Using conventional microsatellite markers, regions of homozygosity were further analyzed in all the families. RESULTS: A region on chromosome 3p spanning 43 megabases showed homozygosity with 13 consecutive SNPs. Three microsatellite markers from this region yielded lod scores > 3.00. A maximal two-point lod of 4.83 was obtained with the marker D3S1298 at theta = 0.004. Haplotype analysis placed the disease gene in a 20 Mb interval between D3S1768 and D3S2409. CONCLUSIONS: A gene causing autosomal recessive cataract maps to the short arm of chromosome 3.

Arabs↗

[Familial parinaud oculo-glandular syndrome in cat-scratch disease].

Cat-scratch disease is manifested by subacute, regional lymphadenitis and occurs mainly in children. The causative agent is a pleomorphic, gram-negative bacillus, Bartonella henselae carried by asymptomatic cats. Parinaud oculoglandular syndrome is the most common ocular manifestation of this disease. It is characterized by unilateral conjunctivitis with polypoid granuloma, usually of the palpebral conjunctiva, and preauricular lymphadenopathy. The diagnosis is supported by a history of exposure to cats and is confirmed by positive serologic tests or positive PCR assay. The occurrence of more than 1 case of Parinaud syndrome in a family is rare. We describe 2 sisters with Parinaud oculoglandular syndrome, proven by serologic tests. They reported that they used to cuddle with their cats, among them a kitten. Because of the refractory conjunctivitis and signs of imminent periorbital cellulitis, they were treated with oral tetracycline with apparently good responses. We recommend asking about contacts with cats in any atypical conjunctivitis accompanied by regional lymphadenopathy, especially in young patients. Systemic antibiotics should be given when there is any suspicion of significant ocular involvement, if the patient is immunosuppressed, or if there are systemic manifestations of cat-scratch disease.

Adolescent↗

[Color Doppler imaging of central retinal artery in retinopathy of prematurity].

Color Doppler imaging (CDI) is a noninvasive technique, combining 2-dimensional brightness-modulated (B-mode) ultrasound evaluation of eye and orbital structures, with simultaneous color-coded Doppler imaging of orbital blood flow. It has been used to characterize various ophthalmic disorders in adults. Currently there is no data describing orbital blood flow parameters in either normal children or in those with ophthalmic disease, such as the retinopathy of prematurity (ROP). We evaluated blood flow in the central retinal artery of preterm infants undergoing examination for ROP. We also investigated whether useful readings could be obtained on a consistent basis, and the reproducibility of differences in central retinal artery blood flow between subjects with and without ROP (including the influence of "plus" disease). We obtained hemodynamic readings in 43 of 46 eyes of preterm infants. 13 eyes had no signs of ROP; 18 had ROP (at least stage 1) without "plus" disease, and 12 had ROP with "plus" disease. There were no statistically significant differences in systolic blood flow velocity within the 3 groups. However the average velocity was slower in the "plus" disease group, correlating with the clinical finding of dilated and tortuous blood vessels which characterize the posterior retina of ROP eyes with "plus" disease.

Blood Flow Velocity↗

Estrogen-replacement therapy: effects on retrobulbar hemodynamics.

PURPOSE: Estrogen-replacement therapy causes vasodilation and increased blood flow in major peripheral arteries. We examined the role that estrogen may play in enhancing perfusion within the watersheds of several major and minor retrobulbar arteries. METHODS: Postmenopausal women receiving estrogen-replacement therapy (n = 16) were compared with both age-matched women not receiving estrogen (n = 16) and with young women (n = 20). Studies involved color Doppler imaging analysis of flow velocities measured in the ophthalmic, central retinal, and nasal and temporal posterior ciliary arteries. RESULTS: In the ophthalmic artery, young women and postmenopausal women receiving estrogen exhibited reduced resistance indexes as compared with postmenopausal women not receiving estrogen (each P <. 001). In contrast, flow velocities in the central retinal artery were similar among the three groups of women. In the posterior ciliary arteries, a different pattern emerged: young women, as compared with either group of postmenopausal women, showed greater peak systolic and end-diastolic velocities at similar resistance index (each P <.05). CONCLUSIONS: Estrogen-replacement therapy in postmenopausal women apparently helps reduce vascular resistance distal to the ophthalmic artery to levels matching those of young women. However, estrogen replacement has little impact on flow velocities in the posterior ciliary arteries. In those vessels, aging per se may reduce perfusion, potentially contributing to the age-dependent risk of major eye diseases, such as glaucoma and age-related macular degeneration.

Adult↗

Vascular aspects in the pathophysiology of glaucomatous optic neuropathy.

Glaucoma remains a major eye illness with unknown etiology. Although elevated intraocular pressure is clearly a major risk factor, vascular deficits may contribute to initiation and progression of glaucoma. When intraocular pressure is acutely elevated in healthy individuals, the resistance index (derived from the peak systolic and end-diastolic velocities and an indirect index of vascular resistance distal to the site of measurement) in the central retinal and posterior ciliary arteries increases progressively. This result implies that mechanical and vascular factors may be coupled in such a way that perfusion of the retina and optic nerve head may be influenced by changes in the intraocular pressure. Further, at night, when ophthalmic artery flow velocities fall as arterial blood pressure falls in glaucoma patients, the risk of disease progression may be increased. The constancy of these same flow velocities in age-matched healthy individuals points to a possible vascular autoregulatory defect in glaucoma. In addition, in normal-tension glaucoma, vasodilation (CO2 inhalation) normalizes retrobulbar arterial flow velocities, hinting that some vascular deficits in glaucoma may be reversible. Finally, Ca2+ channel blockade improves contrast sensitivity in patients with normal-tension glaucoma, who also show increased retrobulbar vessel flow velocities, a result suggesting that visual function loss may be linked to ocular ischemia. Emerging evidence points to a role of ischemia in the pathogenesis of glaucoma, suggesting that treatments designed to improve ocular blood flow may benefit glaucoma patients.

Animals↗