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Biomedical subjects

P Demailly

Publications and source records attributed to P Demailly.

At least 19 recordsLinked to original sources
PubMed2001

Ocular hypotensive efficacy and safety of once daily carteolol alginate.

BACKGROUND/AIM: Carteolol is a beta adrenoceptor antagonist used topically to reduce intraocular pressure, typically twice daily. In an effort to provide a once daily dosing regimen, carteolol was formulated with 1% alginic acid. The objective of this study was to evaluate the efficacy and safety of carteolol alginate solution in comparison with standard carteolol solution. METHODS: This was a double masked, parallel group, multicentre study. Patients with ocular hypertension or open angle glaucoma (n=235) were randomly assigned to receive either carteolol alginate once daily [corrected] or standard carteolol solution, twice daily. The masking was maintained through the use of a vehicle in the evening for the alginate group. Patients were evaluated at baseline, 15, 60, and 120 days. RESULTS: At 0900 (presumed trough) on day 60, mean reductions in intraocular pressure (IOP) from baseline were 6.09 (SD 2.97) and 6.09 (3.18) mm Hg for the standard carteolol and alginate, respectively. At 1100 (presumed peak), mean reductions were 6.51 (2.53) and 6.47 (2.76) mm Hg, respectively. Results were similar at other times (day 15 and day 120). The most common side effect was transient stinging on instillation of drops, which did not differ significantly between groups. There were no differences of note in other ocular or systemic signs or symptoms. CONCLUSION: The new alginate formulation of carteolol 2% given once daily was as effective as standard carteolol 2% given twice daily with no meaningful differences regarding safety.

Adolescent↗
PubMed2000

[Bioavailability of antiglaucoma drugs].

The biodisponibility of antiglaucoma drugs, generally delivered in an aqueous eye-drop solution depends on their capacity to cross the cornea. The structure of the cornea forms a barrier to strongly lipophilic substances and the continuous renewal of the lacrimal film creates a major obstacle, preventing active substances from penetrating the eye. Active substances must thus be delivered in highly concentrated solutions. The systemic bioavailability of antiglaucoma drugs taken orally, for example beta-blockers, is well known, their behavior after eye-drop administration remains poorly elucidated and highly dependent on individual susceptibility. We reviewed the literature on pilocarpine, beta-blockers, adrenergic drugs (dipivalyl-epinephrine, apraclonidine, brimonidine), carbon anhydrase inhibitors (acetazolamide, dorzolamide).

Biological Availability↗
PubMed1998

[Rapid Tendency Oriented Perimeter (TOP) with the Octopus visual field analyzer].

PURPOSE: To study the capabilities of a new perimetric strategy with the Octopus visual field analyzer: the Tendency Oriented Perimetry. METHODS: Tendency oriented perimetry (TOP) attempts to assess the visual field by using answers to questions to establish thresholds in the neighboring area. We evaluated 79 visual fields with the Octopus strategy using the program 32 and the TOP strategy split into the following groups: normal visual field or glaucoma suspects (52), moderately advanced glaucoma (16), advanced glaucoma (11). The following parameters were analyzed for the two strategies studied: examination time, MS (means sensitivity), MD (mean defect), LV (Loss Variance), short term fluctuation (RF) and the number of points with a deficit with different p values: p < 0.5; p < 1; p < 2; p < 5. RESULTS: TOP perimetry showed a significant reduction of exploration time: 11.87 minutes with the Octopus 32 vs 2.49 minutes with the TOP strategy (p < 0.001). There is no significant modification for the other parameters (MD, MS, RF) except for the LV (Loss Variance) for the global analysis and for each separate group. CONCLUSION: The TOP strategy reduces examination time significantly but seems to be less accurate especially for the calculation of the depth of each scotoma in comparison with the standard Octopus 32 perimetry.

Adult↗
PubMed1996

[Non-penetrating deep sclerectomy combined with a collagen implant in primary open-angle glaucoma. Medium-term retrospective results].

PURPOSE: To evaluate the middle term tonometric results of a new filtering procedure, the non penetrating deep sclerectomy with collagen device, in primary open-angle glaucoma. This technique aims to eliminate or minimize the complications of classical trabeculectomy. MATERIAL AND METHOD: This procedure has been developed by Koslov et al. Under a limbal-base conjunctival flap and a superficial scleral flap, the ablation of a deep scleral flap takes away the external wall of Schlemm's canal, leaving only the Descemet membrane. A visible filtration across the opened Schlemm's canal and Descemet membrane is obtained. To improve the aqueous filtration, a cylindric collagen device, made from biocompatible porcine scleral tissue, known for its high water content, is fixed in the deep scleral bed with a 10/0 nylon suture. This device provides a support for the elimination route of aqueous humor and acts like a sponge, carrying the liquid by capillary action. It is sterilized by irradiation. Full guarantee against viral contamination is provided. This procedure ends in one suture (40/0 nylon) of superficial scleral flap and conjunctival closing suture. We conducted a retrospective study. Our material included 159 patients (92 males, 65 females), 2/9 eyes. The mean age was 65 years (11-91). The mean follow-up : 8 months (3-20). The types of glaucoma were: POAG: 183 eyes; juvenile POAG: 18 eyes: pigmentary glaucoma: 11 eyes; capsular glaucoma: 7 eyes, 58 eyes (40 patients) presented one or several risk factors of failure for filtering surgery. RESULTS: The mean pre-operative IOP was 24 mmHg +/- 6.60; 15.7 +/- 5.30 at the end of the follow-up (delta average IOP: 9.1 +/- 7.1). The probability success rate (IOP < or = 20 mmHg), according to the Kaplan-Meier Method, was 89% at six months, 75.6% at 16 months. With monotherapy with beta blockers, 79% at 16 months. It was better in the without risk factors group. The mean change in visual acuity was inferior to 0.1 at the end of the follow-up. Except several hyphemas, no complications of the trabeculectomy were observed. The reelevation of IOP was due to an internal obstruction (goniosynechiae or bad filtration), it was treated with Nd-Yag laser with a 2/3 of success rate. External obstruction was treated by 5FU injections into the bleb. CONCLUSION: Non penetrating deep sclerectomy with collagen device can be an excellent alternative to trabeculectomy in open and wide angles. It does not modify visual actuity. It carries less complications than trabeculectomy and the use of antimitotic agents is safer.

Adolescent↗
PubMed1993

Comparison of apraclonidine and timolol in chronic open-angle glaucoma. A three-month study.

PURPOSE: To compare the safety and efficacy of apraclonidine ophthalmic solution 0.25% and 0.5% (both given 3 times daily) to timolol maleate (0.5%) given twice daily, in primary open-angle glaucoma or ocular hypertension. METHODS: This study was a 90-day prospective, multicenter, double-masked, randomized, parallel group trial. Intraocular pressure (IOP) measurements were made between 8:00 and 10:00 AM before the morning dose (i.e., up to 12 hours after the evening dose of glaucoma medication) and at 4:00 PM (i.e., 8 hours after the morning dose of glaucoma medication). Patients with off-therapy IOP of greater than 22 mmHg and less than 35 mmHg were entered into the study and were assessed 14, 30, and 90 days after treatment. RESULTS: Sixty-nine patients were enrolled; there were no significant demographic differences among the three study groups. All three treatments significantly reduced IOP over 90 days (P < 0.011). For apraclonidine 0.5%, IOP reductions from 25.8 +/- 3.2 mmHg (pretreatment) to 20.4 +/- 4.00 mmHg (day 90) were observed; for apraclonidine 0.25%, from 25.7 +/- 3.05 mmHg (pretreatment) to 22.1 +/- 4.24 mmHg (day 90); and for timolol 0.5% from 26.1 +/- 3.79 mmHg to 21.1 +/- 5.91 mmHg (day 90). The 90-day period of therapy was completed by 12 patients treated with apraclonidine 0.5%, 21 patients treated with apraclonidine 0.25%, and 23 patients treated with timolol 0.5%. There were no serious adverse events. Fourteen of 22 patients (0.5% apraclonidine) and 21 of 23 patients (0.25% apraclonidine) tolerated the drug well; ocular allergy developed in the remaining patients treated with apraclonidine, which resolved upon discontinuation. CONCLUSIONS: Apraclonidine effectively lowers IOP associated with open-angle glaucoma or ocular hypertension; these pilot results will need to be confirmed by a larger pivotal study. Long-term therapy for some patients may be inhibited by ocular allergy for which there was a higher incidence to the 0.5% apraclonidine solution than to the 0.25% solution in this study. Apraclonidine may be of value as an additional therapy for open-angle glaucoma in selected patients.

Adult↗
PubMed1993

[Clinical evaluation of betaxolol in ophthalmic suspension with or without preservative agent in patients with glaucoma or ocular hypertension].

A prospective, randomized, cross-over, double-blind trial was designed to compare the safety and intraocular pressure (IOP) lowering effect of betaxolol 0.25% ophthalmic suspension with and without preservative (benzalkonium chloride). Twenty-seven patients with primary open angle glaucoma or with ocular hypertension were assigned randomly to receive either the preserved or the unpreserved unit dose betaxolol suspension first, followed by the second medication after a 7-10 day washout period. Both test medications significantly reduced IOP from baseline (p < 0.01) twelve hours after dosing at each observation times. IOP was reduced from a mean of 26.1 mmHg at baseline to 21.6 mmHg (preserved formulation) and from a mean of 25.7 mmHg at baseline to 22.3 mmHg (unpreserved formulation) on day 7. There were no significant differences between treatments, nor was there any evidence of any order effect. Adverse events possibly associated with study drugs included transient headache following instillation in one patient on both preserved and unpreserved formulations. It is concluded from this study that inclusion of a preservative in the betaxolol suspension formulation has no effect on the IOP control afforded by betaxolol, and that both preserved and unpreserved suspensions were safe for use in treatment of glaucoma and ocular hypertension.

Adult↗
PubMed1992

X-PERT NCT advanced logic tonometer valuation.

The air pulsed automatic tonometer X-PERT NCT has been tested in hospitals on glaucomatous patients. This new technique avoids direct contact with the patient's eyes and therefore avoids any risk of contamination. The population studied consisted of 118 eyes of 60 patients whose intraocular pressure (I.O.P.) is measured by applanation with the Goldmann tonometer and then by the air pulsed tonometer. The average I.O.P. obtained by Goldmann tonometer is 17.5 +/- 5 mmHg while by X-PERT tonometer, the average I.O.P. is 17.4 +/- 1.5 mmHg. Statistical analysis of these data showed a very good correlation (r = 0.969) in the two methods of measurement.

Adolescent↗
PubMed1992

Daunorubicin versus 5-fluoro-uracil in surgical treatment of primary open angle glaucoma: a prospective study.

In a prospective randomized study, we compare the results at 20 months of 5 Fluoro-Uracil and Daunorubicin filtering surgery in two groups of 25 patients with primary open-angle glaucoma. For the first group of 14 eyes, 10 injections of 5FU are done and only one subconjunctival preoperative injection of Daunorubicin in the second group of 13 eyes. 5FU group consists of 13 patients: 9 males, 4 females. The mean age is 52.3 +/- 18.4 years. The mean follow-up is 6.9 +/- 7 months. Daunorubicin group consists of 12 patients: 9 males, 3 females. The mean age is 50.2 +/- 21.4 years. The mean follow-up is 7.3 +/- 7 months. By Kaplan-Meier method, the probability success rate is 79 per 100 with 5FU and 68 per 100 with Daunorubicin. After 5FU procedure, the most disturbing complication is related to the decrease in IOP during the first postoperative days: flat anterior chamber (9 eyes) (7 eyes after Daunorubicin), choroïdal detachment (6 eyes) (2 eyes after Daunorubicin), cataract (3 eyes in the two groups). After Daunorubicin, corneal complications are less frequent: corneal ulcer (2 eyes) (3 eyes after 5FU), corneal dystrophy (1 eye in the two groups). Transient chemosis and local palpebral oedema are constant after Daunorubicin. We compared the IOP reduction rate and visual function loss in the two groups.

Aged↗
PubMed1989

[Glaucoma: detection and therapeutic indications].

Glaucoma screening requires a good knowledge of the epidemiology and risk factors of this disease. So, we measure the intraocular pressure, analyse the visual field and examin the optic nerve head by ophtalmoscopy. Other investigations have been described, allowing early treatment. Some medications are active on aqueous humor production, others on outflow but side effects are often observed. Laser therapy is an alternative to surgery.

Glaucoma↗
PubMed1989

[Trabeculectomy and trabeculo-retraction in the treatment of chronic primary open-angle glaucoma. Long-term tonometric results].

The long term tonometric results of laser (Argon Laser Trabeculoplasty) and surgical (Trabeculectomy and combined-surgery) treatment in Primitive Chronic Open Angle Glaucoma are analysed on 184 eyes by a retrospective study. Three groups of patients are compared: group I: 81 trabeculoplasties followed 4 years, group II: 75 trabeculectomies followed 5 years, group III: 28 combined-surgery (intra-capsular cataract extraction without implantation combined with a trabeculectomy) followed 5 years. For the three groups, reduce of IOP is noted after 6 months but seems less important after 30 months. Instantaneous results curves show a success rate of 80 to 100% (of which 10 to 20% with additional medical treatment). But cumulative failures rates are higher: more than 50% at 4 years for group I and group II, and only 29% at 5 years for group III. These results are confirmed by actuarial curves: group I: probability success rate of 65% at 4 years group II: probability success rate of 49% at 5 years group III: probability success rate of 73% at 5 years. The comparison of group I and II by actuarial curves is not statistically significant (Logrank test: chi 2 = 0.05). We had discussed the advantage of a new prospective randomised study.

Actuarial Analysis↗
PubMed1989

[Personalities and chronic glaucoma].

This survey has investigated the occurence of psychopathological affections and their relationship with compliance in open angle glaucomatous patients. Three groups have been considered: 48 severe glaucomas, 37 early glaucomas and 48 control patients, under treatment for other ophthalmological affections. These groups have taken a psychiatric interview, compliance evaluating scale and psychological assessment (inducling: Vocabulaire Binois Pichot, Cattel's 16 Personality Factors and Autoanalyse, Thematic Aperception Test and the Rorschach Test analysed through Exner's Synthetic System). Anxiety personality and disoders are more frequent in the glaucomatous group than the control or early (P = 0.0156). Patients in the early group appeared to be most compliant. Personality structure play a role in the acceptance of the disease and in the degree of cooperation with treatment. Maximal compliance is observed at the beginning of the disease. Personality scales show that glaucomatous patients have difficulties in coping with aggressive pulsions and tend to react to affect loaded situations by a defensive or avoiding attitude.

Adult↗