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At least 73 records · Page 4Linked to original sources

Dipivefrin and epinephrine treatment of elevated intraocular pressure: a comparative study.

Every 12 hours 0.1% dipivefrin was administered to one eye and 2% epinephrine hydrochloride was administered to the fellow eye of 42 patients with primary open-angle glaucoma or ocular hypertension in a randomized, double-masked study lasting three months. Dipivefrin produced similar percent reductions in intraocular pressure (18.6%) to epinephrine (21.0%), as well as similar increases in outflow facility and pupil diameter. A significantly lower incidence of burning and stinging after drug instillation was noted with dipivefrin therapy. This study supported the contention that dipivefrin is an effective and safe alternative to epinephrine therapy for the reduction of elevated intraocular pressure.

Adult↗

A double-blind short-term trial of guanethidine 3% and adrenaline 0.5% combined in one eye drop.

A double-blind short-term trial was done to test the effect of guanethidine 3% - adrenaline 0.5% (G-A) in a combined eye drop in 18 patients with open-angle glaucoma and one patient with narrow-angle glaucoma. In 9 of the 19 patients we expected an IOP lowering agent. There was one false-negative result. The mean fall in IOP due to G-A was 10.1 mm Hg (range 3 to 23) and 8.7 mm Hg (range-1 to 26) 6 and 8 h after application respectively. There was no effect on IOP in the 9 eyes that received the placebo.

Clinical Trials as Topic↗

The response of ophthalmic arterial pressure to topically applied clonidine.

The effect of topically applied clonidine on aphthalmic arterial pressure was tested in three groups of open-angle glaucoma patients. In this test, 0.125% clonidine eye drops did not cause a statistically significant change in ophthalmic arterial pressure, but 0.25% and 0.5% clonidine caused a statistically significant, dose-dependent decrease in the diastolic and the systolic arterial pressure in the orbit. The clinical relevance of the results is discussed.

Blood Pressure↗

[The effect of timolol and parasympathicomimetica in the treatment of the elevated intraocular pressure (author's transl)].

45 patients with ocular hypertension or open-angle glaucoma were tested to see if, and to what extent timolol and three other different parasympathicomimetics (pilocarpine 2%, carbachol 1.5%, aceclydine 2%) produced an supplementary reduction of the intraocular pressure. An equally marked, additional drop in eye pressure was achieved when patients who had been given timolol over an extended period of time, were additionally treated with one dose of pilocarpine 2% or carbachol 1.5%. Aceclydine 2% produced no statistically significant additional effect. Patients who had only been treated with pilocarpine 2% over an extended period of time and then were given one dose of timolol 0.25% produced a drop in eye presure more than double that of those patients who had been primarily treated with timolol and then received pilocarpine or carbachol. These results will be discussed on the basis of the mode of action of the applied medications.

Carbachol↗

Thymoxamine and intraocular pressure.

Topical treatment with 1% thymoxamine produces in rabbit and human eyes a small but real miotic and tension-lowering effect. The latter is more evident using two different models of experimental ocular hypertension in rabbits. In human open-angle glaucoma eyes, tonographic measurements indicate that the outflow facility is left unchanged by the drug.

Animals↗

The Framingham Eye Study. II. Association of ophthalmic pathology with single variables previously measured in the Framingham Heart Study.

Using the age-sex-specific data collected in the Framingham Heart Study 1948--1964 together with ophthalmic diagnoses made in the Framingham Eye Study in 1973--1975, the following variables were found to be associated with senile cataract: education, casual blood sugar, systemic blood pressure, height, vital capacity, serum phospholipid and hand strength; with senile macular degeneration: systemic blood pressure, height, vital capacity, left ventricular hypertrophy, hand strength and history of lung infection; with diabetic retinopathy: casual blood sugar, urine sugar and other specific elements of diabetes; with ocular hypertension: systemic blood pressure, height, casual blood sugar and pulse rate. No variables were identified as associated with open-angle glaucoma. The paper stresses the need for corroboration of these findings, which may be a mix of real and chance associations, and the need for additional analyses before any of these associations are considered evidence of factors related to risk of ophthalmic disease.

Aged↗

Allergic contact dermatits and conjunctivitis from epinephrine.

A patient with chronic open-angle glaucoma was suspected of having allergic dermatitis and conjunctivitis to epinephrine. He was tested with epinephrine and other active substances, the preservatives and antioxidants usually used in the preparation of eye drops. He was also tested with other possible contactants with which he had had contact. The patient showed positive allergic patch test reactions to the chloride solution of epinephrine. The patient showed an unexpected positive reaction when tested with di-isopropyl fluorophosphate (DFP). The importance of routine patch testing in ophthalmic practice to detect sensitizers in cases of contact allergy is stressed.

Aged↗

Theoretical approach to laser trabeculotomy.

Theoretical aspects of laser characteristics as well as the physics parameters involved in laser trabeculotomy in open-angle glaucoma are put forward. Outflow hydrodynamics and perforation mechanism as well as the required optical matching system are evaluated in detail.

Animals↗

Influence of pH on the efficacy of pilocarpine.

Pilocarpine 4% solutions at pH 4.1 and 5.8 were compared in a double-blind clinical trial on 24 eyes of patients with primary open-angle glaucoma. Each drug was used over a period of 1 week. No significant difference in the lowering of intraocular pressure was found, and the near-neutral solution of pilocarpine was found to be equally stable when compared to the acid solution over a 6-month period.

Clinical Trials as Topic↗

[Investigations on the effect of various doses of acetazolamide (Diamox) on intraocular pressure (author's transl)].

In the scope of a clinical-experimental study on 12 patients with chronic open-angle glaucoma we proved that a reduction in the individual doses of Acetazolamide (Diamox) brought no reduction in the effect on raised intraocular pressure when the frequency of application was the same. Daily doses of 3 X 125 mg were compared with those of 3-250 mg and 2 X 500 mg (Retardform). A additional trial on 6 patients with a daily dose of 3 X 62.5 mg also showed an obvious effect. The possibilities of long term treatment with acetazolamide are discussed.

Acetazolamide↗

The management of special problems associated with Stevens-Johnson syndrome and ocular pemphigoid.

Various surgical treatment methods were outlined that are currently used in treatment of the severe chronic contractual changes seen in Stevens-Johnson syndrome and ocular pemphigoid. All methods described are not 100% successful in view of the chronicity of the disease, but have greatly aided in delaying the destructive course of action because of various degrees of cicatricial entropion formation. The potential association of ocular pemphigoid with Phospholine Iodide medications in the treatment of open-angle glaucoma is under investigation.

Cheek↗

[Clinical studies conducted with a new epinephrine derivative for the treatment of glaucoma (Dipivalyl epinephrine)].

Dipivalyl epinephrine, an epinephrine derivative, has been developed to improve the pharmacokinetic properties of the compound. Our open-label investigation included the administration of dipivalyl epinephrine ophthalmic solution to the eyes of 33 patients with an open-angle glaucoma. Former topical medication of parasympathomimetic agents was continued. The 0.1% dipivalyl epinephrine treatment approximated the results obtained with 1% epinephrine borate or phenylephrine 5% in reducing the intraocular pressure.

Clinical Trials as Topic↗

Demonstration of acid mucopolysaccharides in the trabecular meshwork of the Rhesus monkey.

The ability to demonstrate AMPS in the trabecular region in the normal eye of the Rhesus monkey was shown to be critically dependent upon technical variation. Staining the fixed specimen prior to dehydration and embedding permits the uniform demonstration of AMPS in the trabecular region of the Rhesus monkey and shows it to be hyaluronidase-sensitive. Electron microscopy using the modified technique shows the reaction products to be present within the trabecular band, the intertrabecular spaces, and the canal of Schlemm. More impressive distribution was seen in the basement membrane of trabecular endothelium intimately related to the cell wall and in the ground substance and basement membrane of the endothelium of the inner wall of the canal Schlemm. The technique is also successful in the human eye and suggests a greater abundance of trabecular AMPS in open-angle glaucoma.

Animals↗

The Use of ChatGPT to Assist in Diagnosing Glaucoma Based on Clinical Case Reports.

INTRODUCTION: The purpose of this study was to evaluate the capabilities of large language models such as Chat Generative Pretrained Transformer (ChatGPT) to diagnose glaucoma based on specific clinical case descriptions with comparison to the performance of senior ophthalmology resident trainees. METHODS: We selected 11 cases with primary and secondary glaucoma from a publicly accessible online database of case reports. A total of four cases had primary glaucoma including open-angle, juvenile, normal-tension, and angle-closure glaucoma, while seven cases had secondary glaucoma including pseudo-exfoliation, pigment dispersion glaucoma, glaucomatocyclitic crisis, aphakic, neovascular, aqueous misdirection, and inflammatory glaucoma. We input the text of each case detail into ChatGPT and asked for provisional and differential diagnoses. We then presented the details of 11 cases to three senior ophthalmology residents and recorded their provisional and differential diagnoses. We finally evaluated the responses based on the correct diagnoses and evaluated agreements. RESULTS: The provisional diagnosis based on ChatGPT was correct in eight out of 11 (72.7%) cases and three ophthalmology residents were correct in six (54.5%), eight (72.7%), and eight (72.7%) cases, respectively. The agreement between ChatGPT and the first, second, and third ophthalmology residents were 9, 7, and 7, respectively. CONCLUSIONS: The accuracy of ChatGPT in diagnosing patients with primary and secondary glaucoma, using specific case examples, was similar or better than senior ophthalmology residents. With further development, ChatGPT may have the potential to be used in clinical care settings, such as primary care offices, for triaging and in eye care clinical practices to provide objective and quick diagnoses of patients with glaucoma.

Artificial intelligence (AI)↗

Clinical experiences with the use of an automated perimeter (Octopus) in the diagnosis and management of patients with glaucoma and neurologic diseases.

This is a study of 59 patients, 42 with glaucoma and 17 with neurological disease, to compare the Octopus automated perimeter with the conventional Goldmann and Tubinger perimeters for detection and assessment of visual field defects. We believe the Octopus automated perimeter is an excellent method for screening patients suspected of glaucoma and can be expected to identify over 90% of the patients actually having visual field loss due to glaucoma. In patients with neurological disease, the Goldmann perimeter was superior to either the Octopus or Tubinger perimeters in providing clinically useful information.

Adolescent↗

Investigating the miRNA-mRNA interactome of human trabecular meshwork cells treated with TGF-β1 provides insights into the pathogenesis of pseudoexfoliation glaucoma.

Pseudoexfoliation glaucoma is a severe form of secondary open angle glaucoma and is associated with activation of the TGF-β pathway by TGF-β1. MicroRNAs (miRNAs) are small non-coding RNA species that are involved in regulation of mRNA expression and translation. To investigate what glaucomatous changes occur in the trabecular meshwork and how these changes may be regulated by miRNAs, we performed a bioinformatics analysis resulting in a miRNA-mRNA interactome. Primary human trabecular meshwork cells originating from normal donors were treated with TGF-β1 at 5 ng/mL for 24h; total RNA was extracted followed by RNA-Seq and miRNA-Seq. For both mRNA and miRNA species, differential expression was determined using a bioinformatics pipeline consisting of FastQC, STAR, FeatureCounts, edgeR (for miRNA) and DESeq2 (for mRNA). Putative mRNA-miRNA interactions between differentially expressed mRNA and miRNA species were determined using interaction databases miRWalk, miRTarBase, TarBase and TargetScan. To classify mRNA species by function and pathway, gene enrichment was performed using Enrichr. The resulting miRNA-mRNA interactome consisted of 1202 interactions. Some highly connected microRNAs were hsa-let-7e-5p, hsa-miR-20a-5p, hsa-miR-122-5p, and hsa-miR-29c-3p. Most differentially expressed genes were indicated to be regulated by miRNAs. The sub-interactomes of genes involved in specific pseudoexfoliation glaucoma related enrichment terms such as oxidative stress, unfolded protein response, signal molecules and ECM remodelling were determined. This is the first study to present a genome-wide microRNA-mRNA regulatory network for human trabecular meshwork cells treated with TGF-β1 and may serve to generate unbiased hypotheses about regulatory functions and mRNA targets of miRNAs in pseudoexfoliation glaucoma and may help to develop miRNA-based therapeutics.

Humans↗