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Biomedical subjects

M G Lynch

Publications and source records attributed to M G Lynch.

29 records · Page 2Linked to original sources
PubMed1987

The afferent pupillary defect in asymmetric glaucoma.

The OCTOPUS 2000 perimeter and a central 30 degrees program were used to study consecutively 27 patients with glaucoma who had either a relative afferent pupillary defect (APD) or asymmetric optic nerve cupping without an APD. The mean difference in visual field sensitivity between fellow eyes was 48.2% (range, 13% to 93%) for the APD group and 5.5% (range, 0% to 9.0%) for the non-APD group. The mean difference in cup-disc ratio was 0.43 (range, 0.2 to 0.6) for the APD group and 0.24 (range, 0.2 to 0.3) for the non-APD group. The APD depth was quantitated with neutral density filters and correlated with visual field asymmetry but not with cup-disc ratio asymmetry. There was no overlap between the APD and non-APD groups in the amount of visual field asymmetry: Every patient with a sensitivity difference of 13% or greater had an APD. The presence of an APD indicates that a threshold of asymmetric optic nerve damage has been exceeded. With automated perimetry, this threshold can be quantitated and may improve the assessment of patients with glaucoma.

Afferent Pathways↗
PubMed1987

Improving the therapeutic index of topical phenylephrine by reducing drop volume.

This study examined the effect of reducing eyedrop volume on the efficacy and systemic absorption of a given quantity of phenylephrine hydrochloride. Aqueous phenylephrine hydrochloride (2.5%) given in the commercially available drop volume of 32 microliters was compared with 10% aqueous phenylephrine given in an 8-microliters volume. Both preparations contained the same total amount of phenylephrine per drop. Ten subjects had both eyes dilated with each of the phenylephrine solutions according to a randomized, double-crossover sequence. The mean final pupillary diameter was nearly 1.0 mm larger for the 8-microliters drop (P = 0.0033). Nine of ten subjects achieved a larger pupillary diameter with the 8-microliters drop. Systemic absorption, as measured by plasma phenylephrine level, was similar for the two drop volumes. Thus, the 8-microliters drop achieved a significantly larger pupillary dilation without an increase in systemic absorption. Phenylephrine may have the most favorable risk-benefit ratio when administered as a high concentration in a small volume.

Administration, Topical↗
PubMed1987

Expression of HLA class I and II antigens on cells of the human trabecular meshwork.

Human corneoscleral tissue containing trabecular meshwork and cultured human trabecular cells were examined for HLA-ABC (class I) and HLA-DR (class II) antigens of the major histocompatibility complex using an indirect immunofluorescence assay. Class I antigens were detected in the trabecular meshwork on frozen sections and on cultured trabecular cells. Class II antigens were constitutively expressed on some, but not all, cells within the trabecular meshwork. Many more cells could be induced to express class II antigens by pre-incubation in human gamma interferon. Cultured trabecular cells did not express class II antigens constitutively, but expression could be induced by gamma interferon. This study suggests that, in addition to Langerhans' cells at the limbus, other cell types within the anterior segment express major histocompatibility complex-encoded class II antigens either constitutively or inducibly. These cells may be important for the initiation and regulation of ocular immunity.

Adult↗
PubMed1987

Beta-adrenergic receptors in human trabecular meshwork. Identification and autoradiographic localization.

Beta-adrenergic receptors were identified in slide-mounted sections of human trabecular meshwork by in-vitro labeling, light microscopic autoradiography. Autoradiograms were generated after incubation of slide-mounted tissue sections with 125I-cyanopindolol, a selective high-affinity probe for beta-adrenergic receptors. Experiments in which an excess of either unlabeled Practolol (beta 1 selective ligand) or Zinterol (beta 2 selective ligand) were included suggested that most of the receptors were of the beta 2 subtype. Data from displacement studies using increasing concentrations of the highly specific beta 1- and beta 2-adrenergic receptor antagonists, ICI-89,406 and ICI-118,551, respectively, confirmed the predominance of the beta 2-adrenergic receptors. Similar results obtained with cultured trabecular endothelial cells suggest that the beta-adrenergic receptors may be associated with the endothelial cells of the trabecular meshwork in vivo. These results provide anatomic evidence for the hypothesis that beta-adrenergic agents improve outflow by direct action on the trabecular meshwork and provide a rationale for the development of more selective beta 2-adrenergic agents to increase outflow facility.

Autoradiography↗
PubMed1986

Surgical vitrectomy for pseudophakic malignant glaucoma.

Four eyes that had undergone cataract extraction with intraocular lens implantation developed malignant glaucoma. Three eyes had posterior chamber lenses and one eye had an anterior chamber lens. Medical therapy was unsuccessful in each case. One eye was treated with Nd-YAG laser disruption of the anterior hyaloid face, but this did not reverse the glaucoma. In all four eyes pars plana vitrectomy reversed the glaucoma process. In the eyes with posterior chamber lenses, the vitrectomy included excision of a localized area of lens capsule and zonules. A pathway for the anterior flow of aqueous was created without dislocating the intraocular lens.

Aged↗
PubMed1986

Neodymium-YAG vitreous surgery for phakic and pseudophakic malignant glaucoma.

Ciliary block (malignant glaucoma) developed in a phakic eye and a pseudophakic eye with a posterior chamber intraocular lens and an intact posterior capsule. In both cases, neodymium-YAG laser treatment (2 to 3 mJ) to the anterior vitreous relieved the blockage, and the anterior chamber returned to normal depth. When technically possible, the neodymium-YAG laser may be used to treat phakic and pseudophakic malignant glaucoma before resorting to surgical vitrectomy.

Adult↗
PubMed1986

The effect of neodymium: YAG laser capsulotomy on aqueous humor dynamics in the monkey eye.

The creation of a posterior capsulotomy utilizing a neodymium:YAG (Nd:YAG) laser is often followed by an increase in the intraocular pressure (IOP). In order to study the cause of this pressure rise, six eyes of three cynomolgus monkeys underwent extracapsular cataract extraction followed 2 to 3 months later by Nd:YAG laser capsulotomy. Eyes were evaluated clinically and examined histopathologically at 1 hour, 3 hours, 1 day, 3 days, 1 week, and 1 month after laser treatment. Although IOP did not increase after laser capsulotomy, outflow facility was decreased 80% from baseline levels at 3 hours, at 3 hours, 1 day, and 3 days. After laser treatment, the anterior chamber and meshwork contained fibrin, lens material, inflammatory cells, pigmented macrophages, erythrocytes, and free pigment. Most of these elements had cleared the meshwork by 1 month.

Animals↗
PubMed1986

The effect of argon laser trabeculoplasty on the rate of filtering surgery.

We examined the impact of argon laser trabeculoplasty (ALT) on the overall rate of filtering surgery on a resident service. From 1981 through 1984, 121 eyes underwent ALT for treatment of uncontrolled primary open-angle glaucoma despite maximum tolerated medical therapy. Mean intraocular pressure decreased from 27 +/- 4 mmHg to 20 +/- 5 mmHg (median follow-up, 9 months). From 1978 through 1981, the mean annual rate of filtering surgery was 16. Only one filtering procedure was performed in 1982, the first full year of ALT use. However, 15 filtering procedures were performed in 1983 and 18 were performed in 1984. Despite a large number of apparently effective ALT treatments and despite an overall reduction in outpatient visits of 20%, the rate of filtering surgery has returned to the pre-ALT level. This suggests that ALT may be effective in delaying the need for surgery, but in many cases it probably does not prevent surgery.

Argon↗