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At least 577 records · Page 32Linked to original sources

PubMed1990

Endocapsular closed chamber technique for disc lens implantation.

A simple endocapsular technique for implantation of an 8 mm disc lens is described. Its main features are a scleral three-plane incision, a vertical-stab capsulotomy, cortical hydrodissection, a closed chamber technique during placement of the intraocular lens in the capsular bag, implantation under air and fluid, wherever feasible, and optional anterior capsulectomy with a 27-gauge needle bent at the tip. This technique requires no complicated equipment and allows atraumatic implantation of the disc lens with maximum control of anterior chamber depth.

Humans↗

PubMed1985

Two similar but atypical strains of coryneform group A-4 isolated from patients with endophthalmitis.

Corynebacterium species and other coryneform organisms isolated from clinical specimens are frequently considered contaminants. We isolated two strains of a gram-positive organism from the vitreous fluid of two patients with endophthalmitis who had previously received intraocular lens transplants. The biochemical characteristics and gas chromatographic patterns of both isolates were similar to those of coryneform group A-4 strains. Major differences included esculin hydrolysis, nitrate reduction, growth pigment, and lactic acid production. These two strains along with a limited number of strains collected at the Special Bacterial Pathogens Laboratory (Division of Bacterial Diseases, Centers for Disease Control, Atlanta, Ga.) may represent a subgroup of coryneform group A-4. Results of in vitro susceptibility testing performed with antimicrobial agents commonly used to treat patients with bacterial endophthalmitis underscore the importance of determining MBCs for slow-growing organisms. This report cautions microbiologists not to discard organisms frequently considered contaminants when isolated from body fluids that are normally sterile and from patients receiving local steroids.

Actinomycetales↗

PubMed2004

Trace elements iron, copper and zinc in vitreous of patients with various vitreoretinal diseases.

PURPOSE: To measure the concentrations of iron, copper and zinc in human vitreous and to interpret their levels with various vitreoretinal diseases like proliferative diabetic retinopathy, retinal detachment, intraocular foreign body, Eales' disease and macular hole. METHODS: Undiluted vitreous fluid collected during pars plana vitrectomy was used to measure trace elements using an atomic absorption spectrophotometer. RESULTS: The level of vitreous iron increased threefold in Eales' disease (1.85 +/- 0.36 pg/ml), 2.5-fold in proliferative diabetic retinopathy (1.534 +/- 0.17 pg/ml) and 2.3-fold in eyes with intraocular foreign body (1.341 +/- 0.25 pg/ml) when compared with macular hole (0.588 +/- 0.16 pg/ml). This was statistically significant (P < 0.05). Zinc was found to be low in Eales' disease (0.57 +/- 0.22 pg/ ml) when compared with other groups, though the difference was not statistically significant. CONCLUSION: The increased level of iron with decreased zinc content in Eales' disease confirms the earlier reported oxidative stress mechanism for the disease. In proliferative diabetic retinopathy and intraocular foreign body the level of iron increases. This is undesirable as iron can augment glycoxidation, which can lead to increased susceptibility to oxidative damage, in turn causing vitreous liquefaction, posterior vitreous detachment and ultimately retinal detachment and vision loss.

Adolescent↗

PubMed2003

An unusual case of uveitis-glaucoma-hyphema syndrome.

PURPOSE: To report a case of uveitis-glaucoma-hyphema (UGH) syndrome in which anterior chamber paracentesis led to the diagnosis of sickle cell trait. DESIGN: Observational case report. METHODS: A 43-year-old Cuban pseudophakic male was seen multiple times over a 3-year period complaining of floaters and blurry vision in his left eye. He was noted to have an inferotemporally displaced posterior chamber intraocular lens and recurrent microhyphemas with elevated intraocular pressure (IOP) readings between 29 and 46 mm Hg with each episode. He was diagnosed with UGH syndrome. Posterior chamber intraocular lens explantation and anterior chamber washout was performed. The aqueous fluid was submitted for cytopathologic examination. RESULTS: Postoperatively, the patient's symptoms resolved and he had no further hemorrhages or elevated IOP readings. Cytopathology of the aspirate revealed sickled red blood cells. CONCLUSIONS: Microscopic examination of aqueous fluid can be a valuable tool in diagnosing ophthalmic manifestations of systemic disease.

Adult↗

PubMed1992

Biological modifications of the vitreous in intraocular parasitosis: preliminary study.

In intraocular parasitosis the immunologic reactions in the vitrectomy-fluids depend on the parasitic agent: there is a lymphocytical reaction without any IgE production in toxoplasmic chorioretinitis, whereas there is a strong hypersensitivity reaction with a local IgE production as well as the presence of eosinophils and an antigenic stimulation in fluids with toxocara parasitosis. The electrophoretic patterns are quite similar in both cases.

Adolescent↗

PubMed2004

Use of rotational sutures for limited retinal translocation: a new technique for superior limited macular translocation.

PURPOSE: To report a modified surgical technique for retinal translocation in eyes with subfoveal choroidal neovascularization. DESIGN: Experimental animal study. METHODS: Nine pigmented rabbits were used consecutively to apply this technique. Placement of inferotemporal scleral imbrication sutures was followed by vitrectomy with posterior hyaloid separation. Balanced saline solution (BSS) was injected subretinally with a 30G needle or with a 39G hydrodissection cannula and viscous fluid injector to detach one retinal quadrant. Under low intraocular pressure, the imbrication sutures were tied, the sclerotomy sites were closed, and intravitreal air tamponade was injected. Rotation sutures were passed and the eye globe was rotated approximately 90 degrees counterclockwise. The rotation sutures were removed after 24 hours. Retinal photographs were taken and fundus examination was performed on postoperative days 1, 2 and 7. The animals were sacrificed after 7 to 10 days for postmortem macroscopic examination. RESULTS: The entire procedure was performed in nine eyes of nine rabbits. In eight eyes, translocation could be seen on the first postoperative day after removal of the rotation sutures. The average amount of translocation was 667 microm (range: 500-800 microm) in a nasal to inferonasal direction. Vitreous hemorrhage occurred at the end of surgery in one eye due to hypotony. Iatrogenic small retinal breaks occurred in 2 eyes but did not prevent completion of the procedure. There was only a temporary hyperemia of the eyelids and conjunctiva. CONCLUSION: Limited retinal translocation using rotational sutures provided a predictable amount of translocation in the planned direction. This technique is expected to be useful for superior macular translocation in humans.

Animals↗

PubMed1998

Bilateral secondary angle-closure glaucoma as a complication of anticoagulation in a nanophthalmic patient.

PURPOSE: To describe bilateral hemorrhage of the posterior segment and secondary angle-closure glaucoma as sequelae of anticoagulation therapy in a nanophthalmic patient. METHODS: An 80-year-old man who was nanophthalmic and was undergoing anticoagulation therapy presented with declining visual acuity in left eye. Six months later, he experienced declining visual acuity in his right eye. RESULTS: In the LE and six months later in the RE, ocular examination disclosed angle-closure glaucoma and a hemorrhagic retinal detachment. Peripheral iridoplasty successfully treated the initial attack. The subretinal hemorrhage was successfully drained by pars plana vitrectomy, retinotomy, and air-fluid exchange in the left eye. Anatomic success and intraocular pressure control were obtained, but visual recovery was limited. CONCLUSION: Intraocular hemorrhage and angle-closure glaucoma are potential complications of anticoagulation therapy in a patient with nanophthalmos.

Aged↗

PubMed2006

Corticosteroid-induced glaucoma: a review of the literature.

The intraocular pressure rise that can complicate the use of topical or systemic corticosteroid has been recognised for 50 years. More recently, following isolation of the myocilin gene (previously known as the trabecular meshwork inducible glucocorticoid response or TIGR gene), there has been renewed interest in this steroid-responsive phenomenon. Furthermore, the currently fashionable use of injectable intraocular steroids in the management of clinically significant subretinal fluid and macular oedema has resulted in an increased incidence. Animal studies, cell biology, molecular biology, and an improved knowledge of genetics have provided a better understanding of the mechanisms behind the response. The purpose of this review is to describe the risk factors for developing corticosteroid-induced glaucoma, to discuss the underlying mechanisms and genetics of the condition and to present management options.

Age Factors↗

PubMed1995

Effect of inflammation on intraocular penetration of intravenous ofloxacin in albino rabbits.

The effect of inflammation on the intraocular penetration of ofloxacin was studied in 20 albino rabbits (New Zealand White). Inflammation was induced in the left eye by inoculation of a suspension of 10(9) CFU of heat-killed Staphyloccus epidermidis per 0.1 ml of saline solution (0.9%) in the midvitreous cavity. The other eye was kept as a control. Twenty-four hours following inoculation, ofloxacin was administered in the marginal ear vein at a dose of 15 mg/kg over 20 min with an infusion pump. Animals were sacrificed at different times up to 24 h following drug administration. Ofloxacin levels were determined in aqueous humor, vitreous humor, and serum by a bioassay. Inflammation was scored on the basis of perilimbal and corneal reactions and vitreoretinal statuses. Inflammation had a relevant effect on intraocular penetration of ofloxacin, with levels in the ocular fluids of the inflamed eye markedly exceeding the ones of the control eye. In the uninflamed eye, the levels were rapidly decaying below assay sensitivity and were no longer detectable at approximately 5 h following drug administration while they were still detectable in both ocular fluids of the inflamed eye at 24 h. Ofloxacin levels in the ocular fluids of the inflamed eye were superior to the MIC for several of the bacteria which commonly cause endophthalmitis, including Staphylococcus epidermidis, Staphylococcus aureus, most members of the family Enterobacteriaceae, Haemophilus influenzae, and strains of Pseudomonas aeruginosa.

Animals↗

PubMed1989

[The role of lysosomal enzymes in the pathogenesis of ciliochoroidal detachment].

The paper discusses the role of lysosomal enzymes, in particular beta-galactosidase, as a starting mechanism in the development of ciliochoroidal detachment. The activity of beta-galactosidase was determined in the suprachoroidal fluid, the aqueous humor, in the blood serum before intraocular operation and in posterior sclerotomy. Ciliochoroidal detachment is shown to be accompanied by accumulation of beta-galactosidase in the suprachoroidal space, not correlating with the enzyme content in the blood serum. This allows to speak about a possible participation of this enzyme in the formation of ciliochoroidal detachment.

Cataract↗

PubMed1989

Human centrifuge non-invasive measurements of arterial pressure at eye level during Gz acceleration.

An apparatus for successful repetitive, indirect photokymographic recordings of systolic blood pressure (Ps) on a human centrifuge during World War II is described. Proportionately to 1 Gz hydrostatic heart-to-head Ps differences, eye level Ps decreased approximately 30 mm Hg per delta G, during 15 s Gz exposures of three relaxed volunteers, a finding confirmed subsequently by continuous intra-arterial pressures in 18 subjects. At 2 G.s-1 onset rates, maximal decreases occurred within 7 s after 1.5 Gz followed by compensatory recoveries while acceleration was maintained. Contours of simultaneously recorded decreases in ear opacity (blood content) were closely similar. Anti-G suit protection against subjective visual symptoms was similar to objective decreases in ear blood content but significantly less than against decreases in Ps at eye level. This may be due to relatively higher intraocular pressures secondary to increased intra-abdominal, cerebrospinal fluid and venous pressure produced by inflation, particularly of the abdominal bladder of the suit.

Acceleration↗

PubMed1996

Diagnostic assays in cytomegalovirus retinitis: detection of herpesvirus by simultaneous application of the polymerase chain reaction and local antibody analysis on ocular fluid.

AIM: To determine the value of the polymerase chain reaction (PCR) technique and the analysis of intraocularly produced antibodies by calculating a Goldmann-Witmer quotient (GWq) as diagnostic assays in the confirmation of a clinically diagnosed cytomegalovirus (CMV) retinitis in a group of unselected AIDS patients. METHODS: Eleven samples of undiluted ocular fluid, obtained from nine AIDS patients with a clinically diagnosed CMV retinitis were analysed for the presence of genomic DNA from CMV, HSV-1, VZV, and EBV by PCR. Nine of these samples were analysed for the presence of locally produced IgG antibodies against these herpesviruses by calculating a GWq. Ten samples obtained from patients with various entities of clinical non-herpetic uveitis and 17 samples of aqueous humour obtained at cataract surgery were used as controls. RESULTS: In 10 out of 11 samples from AIDS patients (91%) the presence of CMV DNA was demonstrated. In four out of nine (44%) patients this was accompanied by CMV DNA in the blood indicating a CMV viraemia. In one sample, VZV DNA was detected and in another sample both CMV and VZV DNA were detected. No HSV-1 or EBV DNA could be demonstrated in these 11 samples. In contrast, simultaneous analysis of locally produced IgG antibodies against herpesviruses could not confirm the initial diagnosis of CMV retinitis. Ocular fluid samples obtained from 10 control uveitis patients were negative for DNA from CMV, VZV, and EBV by PCR. In one of 10 uveitis control samples HSV-1 DNA was detected; antibody analysis did not confirm this. In the uveitis control group, a significant GWq was calculated in one sample for HSV-1 and in another sample for VZV. The cataract control samples were all herpesvirus DNA negative by PCR. CONCLUSIONS: To establish the diagnosis of CMV retinitis in AIDS patients, ophthalmoscopic examination is a sensitive method. In confirming a diagnosis in indistinctive cases, application of a PCR assay detecting CMV DNA is a more sensitive method than analysis of locally produced antibodies by calculating a GWq. In clinical non-herpetic uveitis, secondary release of HSV-1 and VZV should be considered requiring additional therapeutic anticipation.

AIDS-Related Opportunistic Infections↗

PubMed1996

Comparison of three tonometers for measuring intraocular pressure in rabbits.

PURPOSE: Rabbits are used commonly for the evaluation of drugs and surgery to lower intraocular pressure (IOP). The authors compared the accuracy and variability of three tonometers for measuring IOP in rabbits. METHODS: The anterior chamber of adult rabbits was cannulated with a 25-gauge needle connected to an elevated bottle of balanced salt solution. The bottle was raised and lowered to control IOP. A fluid-filled pressure transducer also was placed in the anterior chamber. Intraocular pressure was decreased in increments of 5 to 10 cm H2O from 50 to 0 mm Hg and was recorded with each of these instruments: the hand-held applanation tonometer, the Tono-pen XL, and the pneumatonometer. RESULTS: The Tono-pen XL and the hand-held applanation tonometer underestimated the IOP, whereas the pneumatonometer slightly overestimated IOP. Under close stopcock conditions, at IOPs between 3 and 30 mm Hg, the Tono-pen XL was as accurate as the pneumatonometer but had a smaller variance; the hand-held applanation tonometer had lower accuracy and higher variability. CONCLUSIONS: The Tono-pen XL is the tonometer of choice for measuring IOP in rabbits within the range of IOP 3 to 30 mm Hg. All tonometers were less accurate when the IOP was elevated markedly.

Animals↗

PubMed1991

Effects of caffeinated coffee on intraocular pressure.

This study examined the effects of caffeinated coffee on the intraocular pressure of nonglaucomatous subjects. Subjects were randomly assigned to receive each of three treatments: caffeinated coffee, hot water, and no fluid. All subjects were given the three treatment conditions over 3 days. The study revealed that intraocular pressure after ingesting caffeinated coffee was significantly higher than after receiving the other two treatment conditions. It was further found that increased intraocular pressure was maintained at significant levels over a 3-hour period. No significant changes were found in the pulse rate, and findings on blood pressure were inconclusive.

Adult↗

PubMedDate not supplied

Pseudomonas aeruginosa endogenous endophthalmitis with choroidal abscess in a patient with cystic fibrosis.

PURPOSE: To describe the clinical presentation, management, and outcome of a case of endogenous intraocular infection due to Pseudomonas aeruginosa in a patient with cystic fibrosis (CF). METHODS: The authors describe a case of an adult patient with CF who developed an intraocular infection by P. aeruginosa. RESULTS: Diagnosis was confirmed by culture of purulent fluid obtained by transcleral incision and drainage. The infection persisted in spite of aggressive surgical intervention including extensive endoresection of the visibly affected retina and choroid and multiple administrations of appropriate intraocular, subconjunctival, and systemic antibiotics. Eventually, the eye became blind and painful and was enucleated. CONCLUSIONS: Endogenous intraocular infection by P. aeruginosa can occur in patients with CF who have not undergone lung transplantation. An infection of this type may be impossible to eradicate by aggressive surgical intervention and appropriate antibiotic therapy.

Abscess↗

PubMed1990

Retained intraocular foreign bodies and endophthalmitis.

Retained intraocular foreign bodies (IOFBs) are associated with endophthalmitis in approximately 7 to 13% of cases. The role of prompt surgical removal of the foreign body along with the use of intravitreal antibiotics in reducing this figure is uncertain. Retained IOFBs presenting to The Medical College of Wisconsin between July 1986 and June 1989 were reviewed. A total of 27 cases were evaluated and surgically treated. None of the 27 cases presented with or developed clinical signs of endophthalmitis, yet bacterial cultures of the removed intraocular material were positive in seven cases (foreign body in 5 cases, the aqueous fluid and the vitreous fluid in 1 case each). All eyes presenting within 24 hours of injury underwent immediate surgery (average, 4.5 hours after presentation). Of the seven eyes with positive intraocular cultures, all had pars plana vitrectomy removal of the IOFB and three of these eyes received intravitreal antibiotics at the time of surgery over concern of a high risk of infection. Two of these eyes eventually grew out the Bacillus sp. All eyes received subconjunctival antibiotics and postoperative topical and systemic antibiotics. Even after the positive cultures, no signs of clinical infection developed in any of the eyes. All seven eyes retained excellent visual acuity of 20/70 or better at an average of 10 months' follow-up. Follow-up ranged from 1 to 31 months. Prompt surgical intervention, the use of intravitreal antibiotics in high-risk-type injuries, and the possible use of vitrectomy surgery may reduce the incidence and severity of endophthalmitis.

Adolescent↗

PubMed1999

Capsular bag distension after optic capture of a sulcus-fixated intraocular lens.

Capsular bag distension from occlusion of the circular anterior capsule opening by the intraocular lens (IOL) optic is a rare complication of capsulorhexis. The nature and source of fluid remain unclear. We report a case of capsular bag distension in an eye with an optic-captured, all-poly(methyl methacrylate), sulcus-fixated IOL. The fluid behind the IOL optic was visible on the first postoperative day and resolved spontaneously by the sixth postoperative week. We believe that retained viscoelastic material in the capsular bag was a major contributor to the fluid.

Aged↗

PubMed2006

Elevated orbital pressure: another untoward effect of massive resuscitation after burn injury.

BACKGROUND: Fluid resuscitation remains a fundamental component of early burn care management. However, recent studies suggest that excessive volumes of resuscitation are being administered. Overresuscitation results in negative sequelae including abdominal and extremity compartment syndromes. Elevated intraocular pressure (IOP) has been described as another potentially devastating effect of massive fluid resuscitation in trauma patients. The orbit, similar to the abdomen and extremity, is a compartment, limited to expansion from edema anteriorly by the eyelids and orbital septum, and posteriorly by the bony orbital walls. The purpose of this study was to review the incidence of elevated IOP in a series of patients with major burn injury. METHODS: We retrospectively reviewed the charts of 13 consecutive patients admitted to our burn center with burn sizes >25% total body surface area (TBSA). All patients underwent serial IOP measurements for the first 72 hours following admission. Medical records were reviewed for fluid resuscitation volume, IOP measurements, need for canthotomy, and results of canthotomy procedures. RESULTS: Five of 13 patients had IOP >30 mm Hg and required lateral canthotomy. Canthotomy immediately reduced IOP (p = 0.009). Patients who developed elevated IOP received a significantly larger fluid resuscitation (9.0 cc/kg/%TBSA versus 6.0 cc/kg/%TBSA, p = 0.02). Elevated IOP was significantly associated with delivery of larger fluid resuscitation volume (p = 0.027). CONCLUSIONS: Massive fluid resuscitation following burn injury can result in orbital compartment syndrome requiring lateral canthotomy. Early diagnosis and treatment of orbital compartment syndrome should be incorporated into the management of patients with major burn injury receiving large fluid resuscitation volume.

Adult↗