Search Results - "International Ophthalmology"

1573-2630

ibopamine ; dopamine analogue ; glaucoma ; provocative test ; IOP

Springer Online Journal Archives 1860-2000

Medicine

Abstract Purpose: Ibopamine is used when performing provocative tests, thanks to its pharmacological property of increasing ocular pressure in eyes with outflow system impairment. This study summarizes the latest results that we have achieved with reference to its clinical-diagnostic use. Methods: 175 (250 eyes) POAG patients, 101 (190 eyes) glaucoma suspects with mild ocular hypertension, 39 (64 eyes) NTG patients and 163 (326 eyes) healthy volunteers underwent an ibopamine provocative test. Among the POAG and the glaucoma suspects, 49 (92 eyes) and 20 (38 eyes) patients were selected who, starting from the performing of ibopamine test, had at least one year of perimetric follow-up. These patients have been assessed for the perimetric defect progression in relation to the (negative or positive) response to ibopamine. Results: the ibopamine test was positive for 92% of the glaucomatous patients, 61% of the glaucoma suspects, 52% of the NTG patients and 0% of the healthy volunteers. It was observed that 28% of the ibopamine-positive glaucoma suspects showed a perimetric deterioration during an average 2.5-year follow-up. No perimetric deterioration was found on ibopamine-negative glaucoma suspects (Fisher's exact test: p = 0.038). Among glaucomatous patients, 46% of the test-positive individuals showed a progressive trend of the perimetric defect, as against about 8% of glaucomatous test-negative patients (Fisher's exact test: p = 0.003). Conclusions: We believe that the ibopamine provocative test can be usefully applied especially to epidemiological screening studies to identify patients who might develop ocular hypertension or glaucoma and in the follow-up of glaucoma suspects, to identify individuals who have a greater risk of developing perimetric defects.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

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1573-2630

trachoma ; ophthalmia ; granular ophthalmia

Springer Online Journal Archives 1860-2000

Medicine

Abstract History of ‘ophthalmia’ is as old as history itself; no race or community is immune to it. There were times when blinding trachoma took a form of disastrous epidemics. The historical and recent literature are reviewed in this paper.

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1573-2630

chlamydia ; chlamydia psittaci ; chlamydia trachomatis

Springer Online Journal Archives 1860-2000

Medicine

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1573-2630

epidemiology ; microbiology ; trachoma

Springer Online Journal Archives 1860-2000

Medicine

Abstract Detailed longitudinal studies of the microbiology of endemic trachoma in field situations have provided useful information concerning the epidemiology of this blinding disease. This knowledge should be of particular value for the further development of diagnostic techniques, and for the design of future trachoma control programs.

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1573-2630

drug therapy ; health education ; intervention ; trachoma

Springer Online Journal Archives 1860-2000

Medicine

Abstract Trachoma continues to be a leading cause of blindness largely confined to developing countries. Trachoma control programs have primarily been oriented to drug therapy, an approach which may be successful if it is community-based. However, the costs to ensure long-term success are substantial. Community-based health education approaches to reduce risk factors currently provide the most promising approach for long-term trachoma control.

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1573-2630

conjunctival cicatrization ; eye dryness ; tear function ; Trachoma ; WHO numerical scoring

Springer Online Journal Archives 1860-2000

Medicine

Abstract In 102 patients equally divided into three groups with mild, moderate, and severe cicatricial trachoma, corresponding to the WHO numerical scoring of 1962, the tear function parameters (tear fluid lysozyme and lactoferrin concentrations), the rose bengal score, the Schirmer test, and the break-up time were studied. All parameters showed a statistically significant difference in tear function among the three groups. There was no statistically significant difference in measurements of tear function in subdivisions of the three groups.

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1573-2630

Lid-splitting ; trachoma ; trichiasis ; upper eyelid entropion

Springer Online Journal Archives 1860-2000

Medicine

Abstract Lid splitting procedures have been described a long time ago. Despite repeated descriptions by various authors, the method is not widely known. We use a bare-tarsus technique, omitting any grafting. In addition, we found radial incisions at the nasal and temporal edges of the anterior lamella advantageous, as the often superimposed blepharospasm is abolished by the weakening of the tarsal part of the orbicularis muscle. Also, there is then less tendency for the recessed anterior lamella to creep back down to the lid margin.

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1573-2630

giant tear ; perfluorocarbon liquid ; proliferative vitreoretinopathy ; retinal detachment

Springer Online Journal Archives 1860-2000

Medicine

Abstract Background: To evaluate the effect of perfluoroperhydrophenanthrene on the outcome of traumatic retinal detachment with proliferative vitreoretinopathy, a retrospective study of 111 patients was performed at 35 tertiary care centers, both private practice and institutional. We believed that perfluoroperhydrophenanthrene would assist in manipulating the retina during surgery, removing intraocular foreign bodies, draining suprachoroidal hemorrhage, and reattaching the retina because of the perfluorocarbon's high specific gravity. Methods: Of the 700 patients in the Vitreon study group, 111 with a history of trauma (109 had retinal detachment, 50 had proliferative vitreo-retinopathy) were chosen for this study. Perfluoroperhydrophenanthrene was used intraoperatively to manipulate the retina hydrokinetically, remove intraocular foreign bodies, drain suprachoroidal hemorrhage, and to reattach the retina in the case of giant tears. Results: Logistic multiple regression analysis was used to identify factors as being predictive of poor visual outcome. Factors predictive of poor visual outcome were: type of trauma (p = 0.0065) (ruptured globe); presence of giant retinal tear (p = 0.0253); and low preoperative visual acuity (p = 0.044). At the last follow-up examination, the reattachment rate was 75.6% (i.e., 84 eyes). Of those 84 eyes, 55 (49.5%) had achieved a visual acuity of ≥ 5/200 and 34 (30.6%) had a visual acuity of ≥ 20/200. In cases complicated by proliferative vitreoretinopathy, the final reattachment rate was 66%, with 40% of the eyes studied obtaining a visual acuity of ≥ 5/200. Conclusions: Perfluoroperhydrophenanthrene has been used intraoperatively in the management of traumatic retinal detachments without any apparent ill effects.

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1573-2630

B-lymphocytes ; T-lymphocytes ; conjunctiva ; cytotoxic/suppressor lymphocytes ; helper/inducer ; lymphocytes ; monoclonal antibodies ; Chlamydia trachomatis ; trachoma

Springer Online Journal Archives 1860-2000

Medicine

Abstract Monoclonal antibodies were used to assess the lymphocyte populations in conjunctival biopsy specimens obtained from patients with trachoma (active or inactive) undergoing tarsotomy for the correction of trachoma-induced entropion and in three control patients. Peroxidase-labelled monoclonal antibodies OKT4 (identifies T-helper/inducer lymphocytes), OKT8 (identifies T-suppressor/cytotoxic lymphocytes), OKIal (identifies B-lymphocytes) and antisera specific for IgG, IgA and IgM were used to identify lymphocyte subpopulations and immunoglobulins in the conjunctival biopsy specimens. When grouped by disease activity, conjunctival tissue specimens revealed predominant T-helper/inducer lymphocytes in the substantia propria of patients with active trachoma while inactive trachoma patients had predominant T-suppressor/ cytotoxic lymphocytes in the conjunctival biopsy specimens. B-lymphocytes were seen in moderate numbers in all conjunctival biopsy specimens from patients with active trachoma and all specimens from active cases stained for IgG, IgM, and IgA. Immunoglobulin staining was strongest with IgG and IgM.

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1573-2630

ELISA ; chlamydial antigen ; trachoma

Springer Online Journal Archives 1860-2000

Medicine

Abstract The diagnostic roles of enzyme immunoassay and indirect immunofluorescence tests were studied in 99 patients with various grades of active trachoma and in 72 patients with inactive trachoma. Normal invididuals and patients with non-specific chronic conjunctivitis were used as a control group. Chlamydial antigens were detected in the conjunctival swabs from a large proportion of patients with severe or moderate trachoma. Cases with ‘antigen-negative’ but clinically severe trachoma showed presence of specific IgG in the blood, thus indicating that serological tests may complement the ELISA test for the detection of chlamydia in infected tissues. The nature of cellular reaction in the conjunctiva seems to be related to the severity of trachoma and presence of the infective organism. ‘Antigen-negative’ trachoma thus represents either an error of diagnosis or limited sensitivity of currently available immunologic techniques, or a predominantly hypersensitivity state triggered by transient tissue parasitism. Recombinant DNA technology and chronobiologic study of infiltrating lymphocytes are likely to provide some insight in such cases.

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1573-2630

trachoma ; minocycline ; tetracycline ; Chlamydia trachomatis

Springer Online Journal Archives 1860-2000

Medicine

Abstract Minocycline has a unique solubility in lipids and may reach therapeutic concentrations in tears and saliva. In two consecutive prospective double-masked clinical trials that were carried out in two villages in Saudi Arabia, we assessed the effects of oral minocycline in the treatment of trachoma and compared its effects with those of topical tetracycline ointment in the first study and to tetracycline ointment and placebo in the second study. A total of 178 eyes in 96 patients were included. The age range was 7 to 14 years, with a mean age of 9 years. All patients underwent complete ophthalmologic evaluation. School children were divided into two groups in a double-masked fashion. The first group received either oral minocycline or topical tetracycline 1% ointment and the second group was divided into three subgroups, each receiving one of the following therapeutic modalities: oral minocycline, topical tetracycline ointment, or placebo ointment. All patients were evaluated before initiation of therapy, at three weeks and at 12 months following treatment. Therapy was continued for a period of five weeks. These two double-masked field-based clinical trials have shown both minocycline given orally and tetracycline ointment given topically were effective in decreasing the intensity of inflammation due to trachoma. Oral minocycline was found to be equally effective as topical tetracycline ointment in the treatment of trachoma at three weeks. Minocycline, however, was found to be superior to topical tetracycline when patients were evaluated one year after therapy (p〈0.05). These clinical trials have shown that long acting antibiotic agents such as minocycline is an effective therapeutic modality in the treatment of trachoma. Once a day minocycline administration assures compliance and helps in the eradication of the disease.

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1573-2630

antibody ; micro-immunofluorescence ; monkey ; trachoma ; vaccine

Springer Online Journal Archives 1860-2000

Medicine

Abstract We evaluated antibody responses to trachoma vaccine in Taiwan monkeys using the micro-immunofluorescence assay. In the experiment with B/TW-5 gradient and genetron vaccines, the level of antibody titers could be correlated with the vaccine dose administered. Immunotype-specific protection from disease or modification of disease severity was associated with higher homologous antibody titer. In the experiment with A/G17, A/SA-6, and C/TW-3 genetron vaccines, an extraordinary high antibody response was demonstrated. Again, the high homologous antibody titers were associated with complete or partial protection from eye disease caused by the eye challenge inoculations. Cross reactions between immunotype A and C in the micro-IF test were also reflected in the vaccine protection observed in this experiment. It is concluded that there is an excellent correlation between the micro-IF antibody responses, the mouse toxicity prevention test, and vaccine prevention of monkey trachoma eye disease. Study of micro-IF antibody responses should be a useful tool for development of effective trachoma vaccine.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

Abstract Various techniques which use monocolonal antibodies to detect Chlamydia trachomatis in clinical specimens are reviewed. An investigation comparing the efficacy of immunofluorescent staining with Giemsa staining in detecting Chlamydia in conjunctival scrapings from cases of active trachoma is presented. Sixty-two eyes of schoolboys with moderate to severe trachoma were studied. Giemsa staining detected chlamydial inclusion bodies in 34 percent of the specimens. Free elementary bodies were detected by fluorescent monoclonal antibody in 21 percent. Eleven percent were positive by both Giemsa and immunofluorescence and 55 percent were positive by either Giemsa and/or immunofluorescence. The addition of fluorescent monoclonal antibody assay to routine Giemsa staining resulted in an increase in the yield of positive specimens by 29 percent.

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

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1573-2630

Springer Online Journal Archives 1860-2000

Medicine

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1573-2630

chlamydia ; acute conjunctivitis ; neonatal conjunctivitis ; direct fluorescent antibody cytology ; diagnosis ; treatment

Springer Online Journal Archives 1860-2000

Medicine

Abstract Chlamydial conjunctivitis will usually go unrecognized and therefore untreated unless it is specifically considered. The possibility of chlamydial infection must be borne in mind in neonatal conjunctivitis, in acute conjunctivitis in sexually active adults, and in chronic follicular conjunctivitis. Chlamydial conjunctivitis is often indistinguishable from other forms of conjunctivitis on clinical grounds, and accurate diagnosis is based on laboratory tests. It seems that direct fluorescent antibody (DFA) cytology offers an attractive alternative to the more complicated and time-consuming tissue culture isolation method. Once diagnosed, chlamydial infection should be treated with the appropriate systemic antibiotics, and proper posttreatment follow-up is necessary to assess the efficacy of treatment.

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1573-2630

cyclosporine ; liposomes ; rabbits ; retina ; vitreous

Springer Online Journal Archives 1860-2000

Medicine

Abstract The retinal toxicity of intraocular liposome-bound cyclosporine was studied in albino rabbits by means of electrophysiology and histopathology. During a followup period of one month, no histopathological or electroretinographic changes were noted using concentrations of 100, 200 and 500 micrograms injected intravitreally.

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1573-2630

aqueous ; cyclosporine ; HPLC ; liposome ; rabbit ; vitreous

Springer Online Journal Archives 1860-2000

Medicine

Abstract The concentration of cyclosporine in the aqueous and vitreous humors of albino rabbits was measured, using HPLC at intervals of 24, 48, 96, and 192 hours after subconjunctival injections of 2.5 mg of free or liposome-bound cyclosporine. The aqueous concentration was reasonably high in both groups until day 4: 1050 nanograms per milliliter in the group receiving free cyclosporine, and 1438 nanograms per milliliter in the group receiving liposome-bound cyclosporine. The vitreous concentration was very low in both groups.

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1573-2630

aqueous ; cyclosporine ; HPLC ; liposome ; rabbit ; vitreous

Springer Online Journal Archives 1860-2000

Medicine

Abstract The concentration of cyclosporine in the vitreous after intravitreal injection of 100 micrograms of either free or liposome-bound cyclosporine was studied in albino rabbits. We found that the half-life of free cyclosporine was about 6 hours and that of liposome-bound cyclosporine was about 3 days. The finding indicates that liposome-bound cyclosporine prolongs the availability of the drug.

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