151
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Gough G, Szapacs M, Shah T, Clements P, Struble C, Wilson R. Ocular tissue distribution and pharmacokinetic study of a small 13kDa domain antibody after intravitreal, subconjuctival and eye drop administration in rabbits. Exp Eye Res 2018; 167:14-7. [PMID: 29074387 DOI: 10.1016/j.exer.2017.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 09/15/2017] [Accepted: 10/20/2017] [Indexed: 11/22/2022]
Abstract
Domain antibodies (dAb's) comprise the smallest functional unit of human IgG and can be targeted to a range of different soluble cytokine and receptor targets in the eye. In particular their small size may offer advantage for ocular tissue penetration and distribution. To investigate this we used a 13kDa tool molecule to undertake a preliminary short term ocular tissue distribution and pharmacokinetic study in the rabbit eye. The dAb was administered by the intravitreal or subconjunctival route or, as topical eye drops for up to five days and dAb concentrations measured in vitreous, aqueous, conjunctiva, choroid-RPE, retina, iris, sclera, and ciliary body. The observed elimination half-live of the dAb (~3 days) in vitreous showed a similar elimination rate to that of a much larger (∼50kDa) Fab fragment whilst the half-life following subconjunctival administration was ∼24 h and, after eye drop dosing the dAb was detectable in aqueous and conjunctiva. These preliminary data show that the intravitreal half-life of dAb's are similar to much larger antibody fragments, offering the potential to deliver significantly more drug to target on a molar basis with a single intravitreal injection potentially enabling dosing frequencies of once a month or less. Subconjunctival injection may provide short duration therapeutic levels of dAb to the anterior and posterior chamber whilst topical eye drop delivery of dAbs may be useful in front-of-eye disease. These data indicate that small domain antibodies may have utility in ophthalmology. Further studies are warranted.
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152
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Baker N, Amini R, Situ-LaCasse EH, Acuña J, Nuño T, Stolz U, Adhikari S. Can emergency physicians accurately distinguish retinal detachment from posterior vitreous detachment with point-of-care ocular ultrasound? Am J Emerg Med 2018; 36:774-6. [PMID: 29042095 DOI: 10.1016/j.ajem.2017.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 11/22/2022] Open
Abstract
STUDY OBJECTIVE There is significant overlap between the symptoms of patients presenting with retinal detachment (RD) and posterior vitreous detachment (PVD). Urgency to obtain consultation and treatment are dependent on the ability to accurately distinguish these two conditions. The objective of this study was to determine the ability of emergency physicians to differentiate RDs from PVDs using point-of-care (POC) ocular ultrasound. METHODS Single blinded cross-sectional study at an academic medical center. Emergency physicians with varying ultrasound experience completed a brief tutorial on the sonographic findings of RD and PVD. Thirty POC ocular ultrasound clips obtained from ED patients with ocular symptoms were presented to emergency physicians. The sonographic findings in these clips were in agreement with the final diagnosis made by consultant ophthalmologists. There were 14 ultrasound videos showing PVD, 13 videos showing RD, and 3 normal ocular ultrasound videos. The subjects independently reviewed POC ocular ultrasound video clips and submitted their final interpretations. RESULTS A total of 390 ocular video clips were reviewed by 13 emergency physicians. Overall, physicians were able to accurately diagnose the presence of a RD 74.6% (95%CI, 69.8-79.4) of the time, PVD 85.7% (95%CI, 77.6-93.8) of the time, and normal ultrasounds 94.9% (95%CI 87.3-100.0) of the time. There was no statistically significant relationship between correct diagnoses for ocular abnormalities or normal ultrasound images and number of previous ocular ultrasounds performed by emergency physicians. CONCLUSION Emergency physicians were modestly accurate in distinguishing RD from PVD on POC ultrasound.
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153
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Shu DY, Lovicu FJ. Myofibroblast transdifferentiation: The dark force in ocular wound healing and fibrosis. Prog Retin Eye Res 2017; 60:44-65. [PMID: 28807717 PMCID: PMC5600870 DOI: 10.1016/j.preteyeres.2017.08.001] [Citation(s) in RCA: 225] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 08/08/2017] [Accepted: 08/09/2017] [Indexed: 02/06/2023]
Abstract
Wound healing is one of the most complex biological processes to occur in life. Repair of tissue following injury involves dynamic interactions between multiple cell types, growth factors, inflammatory mediators and components of the extracellular matrix (ECM). Aberrant and uncontrolled wound healing leads to a non-functional mass of fibrotic tissue. In the eye, fibrotic disease disrupts the normally transparent ocular tissues resulting in irreversible loss of vision. A common feature in fibrotic eye disease is the transdifferentiation of cells into myofibroblasts that can occur through a process known as epithelial-mesenchymal transition (EMT). Myofibroblasts rapidly produce excessive amounts of ECM and exert tractional forces across the ECM, resulting in the distortion of tissue architecture. Transforming growth factor-beta (TGFβ) plays a major role in myofibroblast transdifferentiation and has been implicated in numerous fibrotic eye diseases including corneal opacification, pterygium, anterior subcapsular cataract, posterior capsular opacification, proliferative vitreoretinopathy, fibrovascular membrane formation associated with proliferative diabetic retinopathy, submacular fibrosis, glaucoma and orbital fibrosis. This review serves to introduce the pathological functions of the myofibroblast in fibrotic eye disease. We also highlight recent developments in elucidating the multiple signaling pathways involved in fibrogenesis that may be exploited in the development of novel anti-fibrotic therapies to reduce ocular morbidity due to scarring.
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Affiliation(s)
- Daisy Y Shu
- Discipline of Anatomy and Histology, Bosch Institute, University of Sydney, NSW, Australia; Save Sight Institute, University of Sydney, NSW, Australia
| | - Frank J Lovicu
- Discipline of Anatomy and Histology, Bosch Institute, University of Sydney, NSW, Australia; Save Sight Institute, University of Sydney, NSW, Australia.
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154
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Erkan Turan K, Taylan Şekeroğlu H, Koç İ, Vural E, Karakaya J, Şener EC, Sanaç AŞ. Ocular Causes of Abnormal Head Position: Strabismus Clinic Data. Turk J Ophthalmol 2017; 47:211-215. [PMID: 28845325 PMCID: PMC5563549 DOI: 10.4274/tjo.42068] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 03/06/2017] [Indexed: 12/01/2022] Open
Abstract
Objectives: To determine the most common ocular causes and types of abnormal head position (AHP) and describe their clinical features. Materials and Methods: Patients with AHP who had been followed in the strabismus unit were retrospectively reviewed. Demographic features and orthoptic characteristics were recorded. Results: A total of 163 patients including 61 women (37.4%) and 102 men (62.6%), with a mean age of 19.9±18.3 were recruited. The most common causes of AHP were determined as fourth cranial nerve palsy (33.7%), Duane retraction syndrome (21.5%), sixth cranial nerve palsy (11%), nystagmus blockage syndrome (9.8%) and Brown syndrome (6.7%). Other less frequent causes were A-V pattern strabismus, comitant strabismus, thyroid orbitopathy and third cranial nerve palsy. The most common types of AHP were head tilt (45.4%) and face turn (36.8%). Out of 142 patients whose visual acuity could be evaluated, 28.2% had amblyopia. The frequency of amblyopia varied depending on the diagnosis (p<0.001), while there was no relation between amblyopia and different types of AHP (p=0.497). Stereopsis and fusion could be tested in 128 patients and 43.8% of them had stereopsis and fusion. The presence of stereopsis and fusion was found to be related with the diagnosis (p=0.001), whereas it was not related with the types of AHP (p=0.580). The presence of amblyopia was not significantly associated with fusion (p=1.000) or stereopsis (p=0.602). Conclusion: There are many ocular pathologies that cause AHP. Patients with similar diagnoses may have different types of AHP. Patients may have amblyopia and impaired binocularity despite AHP. Therefore, all patients with AHP should be examined in detail and these points should be considered in the treatment plan.
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Affiliation(s)
- Kadriye Erkan Turan
- Hacettepe University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | | | - İrem Koç
- Ortaköy State Hospital, Ophthalmology Clinic, Aksaray, Turkey
| | - Esra Vural
- Mardin State Hospital, Ophthalmology Clinic, Mardin, Turkey
| | - Jale Karakaya
- Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
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155
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Zoberi JE, Garcia-Ramirez J, Hedrick S, Rodriguez V, Bertelsman CG, Mackey S, Hu Y, Gach HM, Rao PK, Grigsby PW. MRI-based treatment planning and dose delivery verification for intra ocular melanoma brachytherapy. Brachytherapy 2017; 17:31-39. [PMID: 28818442 DOI: 10.1016/j.brachy.2017.07.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/30/2017] [Accepted: 07/14/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE Episcleral plaque brachytherapy (EPB) planning is conventionally based on approximations of the implant geometry with no volumetric imaging following plaque implantation. We have developed an MRI-based technique for EPB treatment planning and dose delivery verification based on the actual patient-specific geometry. METHODS AND MATERIALS MR images of 6 patients, prescribed 85 Gy over 96 hours from Collaborative Ocular Melanoma Study-based EPB, were acquired before and after implantation. Preimplant and postimplant scans were used to generate "preplans" and "postplans", respectively. In the preplans, a digital plaque model was positioned relative to the tumor, sclera, and nerve. In the postplans, the same plaque model was positioned based on the imaged plaque. Plaque position, point doses, percentage of tumor volume receiving 85 Gy (V100), and dose to 100% of tumor volume (Dmin) were compared between preplans and postplans. All isodose plans were computed using TG-43 formalism with no heterogeneity corrections. RESULTS Shifts and tilts of the plaque ranged from 1.4 to 8.6 mm and 1.0 to 3.8 mm, respectively. V100 was ≥97% for 4 patients. Dmin for preplans and postplans ranged from 83 to 118 Gy and 45 to 110 Gy, respectively. Point doses for tumor apex and base were all found to decrease from the preimplant to the postimplant plan, with mean differences of 16.7 ± 8.6% and 30.5 ± 11.3%, respectively. CONCLUSIONS By implementing MRI for EPB, we eliminate reliance on approximations of the eye and tumor shape and the assumption of idealized plaque placement. With MRI, one can perform preimplant as well as postimplant imaging, facilitating EPB treatment planning based on the actual patient-specific geometry and dose-delivery verification based on the imaged plaque position.
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Affiliation(s)
| | - Jose Garcia-Ramirez
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO
| | | | - Vivian Rodriguez
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO
| | - Carol G Bertelsman
- Department of Radiation Oncology, Barnes Jewish Hospital, Saint Louis, MO
| | - Stacie Mackey
- Department of Radiation Oncology, Barnes Jewish Hospital, Saint Louis, MO
| | - Yanle Hu
- Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ
| | - H Michael Gach
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO; Department of Radiology, Washington University School of Medicine, Saint Louis, MO
| | - P Kumar Rao
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Saint Louis, MO
| | - Perry W Grigsby
- Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO
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156
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Abstract
Sebaceous carcinoma (SC) is a neoplasm derived from the adnexal epithelium of the sebaceous glands, and most studies on this neoplasm have been conducted in Caucasians. We retrospectively reviewed the records of 29 patients with SC (16 extraocular and 13 ocular lesions) who were diagnosed from 2001 to 2014 to analyze the clinical and histopathological features of SC in the Korean population. Sixteen of the patients were women and 13 were men. There was an equal sex distribution for extraocular lesions, and a female predilection (M:F = 1:1.6) for ocular lesions. The mean ages at presentation of extraocular and ocular lesions were 69.19 ± 37.19 (range, 32-87) and 67.46 ± 24.46 (range, 43-85) years, respectively. Most lesions occurred in the eyelid (13/29, 44.83%), and most extraocular lesions occurred in the head and neck area (13/16, 81.25%). There was no recurrence or death during the follow-up period. Most lesions were poorly differentiated (extraocular, 43.75%; ocular, 38.46%), had a lobular infiltrative growth pattern (extraocular, 68.75%; ocular, 76.92%), and were basaloid (extraocular, 56.25%; ocular, 61.54%). Only 5 cases (2 extraocular and 3 ocular lesions) showed pagetoid spread. Extraocular lesions were marginally more common than the ocular form. There were higher incidences in elderly patients, who also had the highest incidence of eyelid lesions. The proportion of cells with sebaceous differentiation and prominent growth patterns were variable. Our results show that SC may not be very aggressive in Koreans.
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Affiliation(s)
- Su Kyung Park
- Department of Dermatology, Chonbuk National University Hospital, Jeonju, Korea
| | - Jin Park
- Department of Dermatology, Chonbuk National University Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Han Uk Kim
- Department of Dermatology, Chonbuk National University Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Seok Kweon Yun
- Department of Dermatology, Chonbuk National University Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
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157
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Ramos Suárez A, Ayet Roger I, Serra Castanera A. Neonatal glaucoma associated with juvenile xanthogranuloma: Case report. Arch Soc Esp Oftalmol 2017; 92:394-397. [PMID: 28522113 DOI: 10.1016/j.oftal.2017.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 02/20/2017] [Accepted: 02/20/2017] [Indexed: 06/07/2023]
Abstract
CASE REPORT The case concerns a 22 day-old male child with juvenile xanthogranuloma (JXG), which manifested as a unilateral glaucoma and with fibrinous haemorrhagic exudate in the anterior chamber affecting the angle of the right eye. Despite a high level of suspicion, the definitive diagnosis was not possible until the infant reached the age of 10 months, after the appearance of the skin lesions typical of this condition and histopathological study of them. CONCLUSION JXG is a rare disease, characterised by yellowish skin lesions on the trunk, neck, or head. Up to 10% of cases will have ocular involvement, which is the most common extracutaneous manifestation of the disease.
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Affiliation(s)
- A Ramos Suárez
- Servicio de Oftalmología, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España; Departamento de Oftalmología, Hospital Costa del Sol, Marbella, Málaga, España.
| | - I Ayet Roger
- Servicio de Oftalmología, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - A Serra Castanera
- Servicio de Oftalmología, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
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158
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Zhu K, Li J, Huang X, Xu W, Liu W, Chen J, Chen P, Feng H. Thymectomy is a beneficial therapy for patients with non-thymomatous ocular myasthenia gravis: a systematic review and meta-analysis. Neurol Sci 2017; 38:1753-60. [PMID: 28707128 DOI: 10.1007/s10072-017-3058-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 07/01/2017] [Indexed: 01/26/2023]
Abstract
Ocular myasthenia gravis, an autoimmune disease, is characterized by extraocular muscle weakness. Myasthenia gravis is closely associated with the functional status of the thymus gland. The efficacy of thymectomy for non-thymomatous ocular myasthenia gravis remains controversial. Here, we present the first systematic review and meta-analysis of studies assessing the outcome of thymectomy in patients with non-thymomatous ocular myasthenia gravis and found that the pooled rate of complete stable remission was 0.5074 with considerable heterogeneity. Furthermore, subgroup analysis showed that the efficacy of thymectomy differed according to geographical location. Furthermore, thymectomy outcomes are better in children than they are in adults. Thymectomy clearly represents an effective treatment for patients with non-thymomatous ocular myasthenia gravis. However, more multicenter, randomized, controlled clinical trials are now required to confirm these conclusions.
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159
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Everaert A, Wouters Y, Melsbach E, Zakaria N, Ludwig A, Kiekens F, Weyenberg W. Optimisation of HPMC ophthalmic inserts with sustained release properties as a carrier for thermolabile therapeutics. Int J Pharm 2017. [PMID: 28624658 DOI: 10.1016/j.ijpharm.2017.06.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A methodology was developed and optimised for the preparation of a new drug delivery system (DDS) with sustained release properties to allow ocular protein delivery and to limit destructive production steps during manufacturing. Elevated temperatures, shear forces and an oxidative environment should be avoided in order to prevent denaturation or oxidation of proteins. An aqueous HPMC solution was prepared using heat and casted into small semi-rod-shaped PVC blisters. The polymer solution was allowed to cool down and was partially dehydrated at room temperature. A drug solution containing glycerol, drug and water was subsequently added to rehydrate the partially dehydrated polymer matrix at a temperature of 2°C. Several parameters of the production process were varied to determine their influence on the release kinetics from HPMC inserts from three different molecules of different molecular weight. This production method was further optimised in order to shorten the rehydration time from weeks to days, while eliminating heat and shear forces on the selected drug molecules sodium fluorescein, lysozyme and albumin. Slow release kinetics were achieved for sodium fluorescein and lysozyme as model drug molecules. The higher molecular weight of albumin prevented a good penetration into the insert during the rehydration process resulting in predominantly burst release. The biocompatibility of a viscous HPMC solution was evaluated on SV40-human corneal epithelial cells with PrestoBlue® and no cytotoxic effects were observed.
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Affiliation(s)
- Arnout Everaert
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences, University of Antwerp, Wilrijk, Belgium
| | - Yannick Wouters
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences, University of Antwerp, Wilrijk, Belgium
| | - Eline Melsbach
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Nadia Zakaria
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Annick Ludwig
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences, University of Antwerp, Wilrijk, Belgium
| | - Filip Kiekens
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences, University of Antwerp, Wilrijk, Belgium.
| | - Wim Weyenberg
- Laboratory of Pharmaceutical Technology and Biopharmacy, Department of Pharmaceutical Sciences, University of Antwerp, Wilrijk, Belgium
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160
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Hariharan P, Nabili M, Guan A, Zderic V, Myers M. Model for Porosity Changes Occurring during Ultrasound-Enhanced Transcorneal Drug Delivery. Ultrasound Med Biol 2017; 43:1223-1236. [PMID: 28335999 PMCID: PMC5768443 DOI: 10.1016/j.ultrasmedbio.2017.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 01/09/2017] [Accepted: 01/22/2017] [Indexed: 06/06/2023]
Abstract
Ultrasound-enhanced drug delivery through the cornea has considerable therapeutic potential. However, our understanding of how ultrasound enhances drug transport is poor, as is our ability to predict the increased level of transport for given ultrasound parameters. Described here is a computational model for quantifying changes in corneal porosity during ultrasound exposure. The model is calibrated through experiments involving sodium fluorescein transport through rabbit cornea. Validation was performed using nylon filters, for which the properties are known. It was found that exposure to 800-kHz ultrasound at an intensity 2 W/cm2 for 5 min increased the porosity of the epithelium by a factor of 5. The model can be useful for determining the extent to which ultrasound enhances the amount of drug transported through biological barriers, and the time at which a therapeutic dose is achieved at a given location, for different drugs and exposure strategies.
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Affiliation(s)
- Prasanna Hariharan
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Marjan Nabili
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Allan Guan
- Department of Biomedical Engineering, The George Washington University, Washington, DC, USA
| | - Vesna Zderic
- Department of Biomedical Engineering, The George Washington University, Washington, DC, USA
| | - Matthew Myers
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland, USA.
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161
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Abstract
Background Clinical predictors for myasthenia gravis relapse and ocular myasthenia gravis secondary generalization during the first two years after disease onset remain incompletely identified. This study attempts to investigate the clinical predictors for the prognosis of Myasthenia Gravis. Methods Eighty three patients with myasthenia gravis were concluded in this study. Baseline characteristics were analyzed as predictors. Results Relapse of myasthenia gravis developed in 26 patients (34%). Generalization developed in 34 ocular myasthenia gravis patients (85%). Other autoimmune diseases were observed more commonly in relapsed myasthenia gravis (P = 0.012). Second generalization group contained more late onset patients (P = 0.021). Ocular myasthenia gravis patients with thymus hyperplasia progressed more rapidly than those with other thymus pathology (P = 0.027). Single onset symptom of ocular myasthenia gravis such as ptosis or diplopia predicted early progression than concurrence of ptosis and diplopia (P = 0.027). Treatment effect including glucocorticoid, pyridostigmine, thymectomy, IVIG, immunosuppressive drugs did not show significant difference between the relapsed and non-relapsed groups. The treatment outcome also showed no difference between the single OMG and second generalized groups. Conclusions Occurrence of associated autoimmune disease can serve as a potential predictor for myasthenia gravis relapse. Either ptosis or diplopia, as well as thymic hyperplasia can predict generalization in the first six months.
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Affiliation(s)
- Lili Wang
- Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China.
| | - Yun Zhang
- Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Maolin He
- Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
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162
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Alami-Milani M, Zakeri-Milani P, Valizadeh H, Salehi R, Salatin S, Naderinia A, Jelvehgari M. Novel Pentablock Copolymers as Thermosensitive Self-Assembling Micelles for Ocular Drug Delivery. Adv Pharm Bull 2017; 7:11-20. [PMID: 28507933 PMCID: PMC5426723 DOI: 10.15171/apb.2017.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 01/18/2017] [Accepted: 01/25/2017] [Indexed: 01/24/2023] Open
Abstract
Many studies have focused on how drugs are formulated in the sol state at room temperature leading to the formation of in situ gel at eye temperature to provide a controlled drug release. Stimuli-responsive block copolymer hydrogels possess several advantages including uncomplicated drug formulation and ease of application, no organic solvent, protective environment for drugs, site-specificity, prolonged and localized drug delivery, lower systemic toxicity, and capability to deliver both hydrophobic and hydrophilic drugs. Self-assembling block copolymers (such as diblock, triblock, and pentablock copolymers) with large solubility variation between hydrophilic and hydrophobic segments are capable of making temperature-dependent micellar assembles, and with further increase in the temperature, of jellifying due to micellar aggregation. In general, molecular weight, hydrophobicity, and block arrangement have a significant effect on polymer crystallinity, micelle size, and in vitro drug release profile. The limitations of creature triblock copolymers as initial burst release can be largely avoided using micelles made of pentablock copolymers. Moreover, formulations based on pentablock copolymers can sustain drug release for a longer time. The present study aims to provide a concise overview of the initial and recent progresses in the design of hydrogel-based ocular drug delivery systems.
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Affiliation(s)
- Mitra Alami-Milani
- Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran
| | - Parvin Zakeri-Milani
- Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.,Drug Applied Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Valizadeh
- Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.,Drug Applied Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roya Salehi
- Research Center for Pharmaceutical Nanotechnology, Tabriz University of Medical Science, Tabriz, Iran
| | - Sara Salatin
- Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.,Research Center for Pharmaceutical Nanotechnology, Tabriz University of Medical Science, Tabriz, Iran
| | - Ali Naderinia
- Department of Mechanical Engineering, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Mitra Jelvehgari
- Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.,Drug Applied Research Center and Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
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163
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García-Millán E, Quintáns-Carballo M, Otero-Espinar FJ. Improved release of triamcinolone acetonide from medicated soft contact lenses loaded with drug nanosuspensions. Int J Pharm 2017; 525:226-236. [PMID: 28412447 DOI: 10.1016/j.ijpharm.2017.03.082] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/27/2017] [Accepted: 03/29/2017] [Indexed: 12/01/2022]
Abstract
Drug nanosuspensions (NSs) show a significant potential to improve loading and release properties of the poorly water soluble drug triamcinolone acetonide (TA) from poly(hydroxyethyl methacrylate) (pHEMA) soft contact lenses. In this work, TA NSs were developed by a controlled precipitation method using a fractional factorial Plackett-Burmann design. Poloxamer 407 (PL) and polyvinyl alcohol (PVA) as stabilizing agents were selected. NSs were characterized in terms of their drug content, particle size and morphology. Results indicate that all studied factors, except homogenization speed and sonication, have significant influence on the drug incorporation yield into NSs. Drug nanoparticles showed an interesting size that may be suitable for their incorporation into topical ocular drug delivery systems, as hydrogels. pHEMA hydrogels and daily-wear Hilafilcon B commercial contact lenses (SCLs) were employed to study TA loading capacity and drug release properties using NSs as loading system. Hydrogels have been synthesised by copolymerization of 2-hydroxyethyl methacrylate (HEMA) with methacrylic acid (MA) in accordance with a previous work (García-Millán et al., 2015). Both synthesised hydrogels and SCLs were characterized in terms of their mechanical and physical properties and TA loading and release properties. Selected TA NS was further characterized by studying its physical-chemical stability during the loading process. Results show that the use of TA NSs as loading medium significantly increases drug loading capacity and release of soft contact lenses in comparison with drug saturated solution. Synthesised pHEMA hydrogels and SCLs lenses have good properties as ophthalmic drug delivery systems, but SCLs load higher quantities of drug and release TA in shorter time periods than synthesised pHEMA hydrogel.
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Affiliation(s)
- Eva García-Millán
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, Campus Vida s/n, 15782, Santiago de Compostela, Spain
| | - Mónica Quintáns-Carballo
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, Campus Vida s/n, 15782, Santiago de Compostela, Spain
| | - Francisco Javier Otero-Espinar
- Departamento de Farmacología, Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Santiago de Compostela, Campus Vida s/n, 15782, Santiago de Compostela, Spain; Instituto de Farmacia Industrial, Facultad de Farmacia, Universidad de Santiago de Compostela, Campus Vida s/n, 15782, Santiago de Compostela, Spain.
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164
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Al-Amry M, Al-Ghadeer H. Paintball related ocular injuries: First case report in Saudi patients. Saudi J Ophthalmol 2017; 31:55-7. [PMID: 28337066 DOI: 10.1016/j.sjopt.2017.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/16/2017] [Accepted: 01/23/2017] [Indexed: 11/22/2022] Open
Abstract
Paintball is a popular recreational sport. This case series describes three Saudi patients exposed to paintball ocular injuries with sever ocular trauma. Two patients developed hyphema and traumatic cataract and one patient had vitreous hemorrhage, choroidal detachment, commotio retinae and retinal tear. All patients require surgical intervention. Final best corrected visual acuity was 20/200, 20/30 and 20/50 respectively. Paintball related ocular injuries can result in severe visual loss and in most of the time requires surgical intervention. Most injuries occur in under-supervised settings and are easily preventable. Our main aim was to increase awareness among local ophthalmologists and eye professionals about this new game. Improved safety measures and appropriate public education could prevent such serious ocular injuries.
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165
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Abstract
Immune mediated inflammatory anterior segment diseases are variable and their management requires intense immunosuppression. Treatment with topical steroids is associated with serious ocular side effects. In order to overcome the potentially blinding complications of topical steroids, immunomodulatory drugs are being used more frequently. Tacrolimus is a calcineurin inhibitor that induces suppression of T lymphocytes activity and reduction of ocular inflammation. Tacrolimus was recently investigated for application in various anterior segment inflammatory disorders. In this review, we will discuss the therapeutic application of topical tacrolimus as a steroid-sparing agent in treating T cell mediated anterior segment inflammation.
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Affiliation(s)
- Samir S Shoughy
- The Eye Center and the Eye Foundation for Research in Ophthalmology, PO Box 55307, Riyadh, 11534 Saudi Arabia
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166
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El Mograbi A, Soudry E. Ocular cranial nerve palsies secondary to sphenoid sinusitis. World J Otorhinolaryngol Head Neck Surg 2017; 3:49-53. [PMID: 29204579 DOI: 10.1016/j.wjorl.2017.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 01/28/2017] [Accepted: 02/06/2017] [Indexed: 11/21/2022] Open
Abstract
Objective The clinical presentation of sphenoid sinusitis can be highly variable. Rarely, sphenoid sinusitis may present with cranial nerve complications due to the proximity of these structures to the sphenoid sinus. Method A case series from Rabin Medical Center and all cases of cranial nerves palsies secondary to sphenoid sinusitis that have been reported in the literature were reviewed. Results Seventeen patients were identified. The abducent nerve was the most common cranial nerve affected (76%), followed by the oculomotor nerve (18%). One patient had combined oculomotor, trochlear and abducent palsies. The most common pathology was isolated purulent sphenoid sinusitis in 64% followed by allergic fungal sinusitis (AFS) in 18%, and fungal infection in 18%. 94% had an acute presentation. The majority (85%) received a combined intravenous antibiotics and surgical treatment. The remainder received conservative treatment alone. Complete recovery of cranial nerve palsy was noted in 82% during follow up. Conclusion Sphenoid sinusitis presenting as diplopia and headaches is rare. A neoplastic process must be ruled out and early surgical intervention with intravenous antimicrobial therapy carry an excellent outcome with complete resolution of symptoms.
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167
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Eriksen AZ, Brewer J, Andresen TL, Urquhart AJ. The diffusion dynamics of PEGylated liposomes in the intact vitreous of the ex vivo porcine eye: A fluorescence correlation spectroscopy and biodistribution study. Int J Pharm 2017; 522:90-97. [PMID: 28267579 DOI: 10.1016/j.ijpharm.2017.03.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/25/2017] [Accepted: 03/01/2017] [Indexed: 01/22/2023]
Abstract
The diffusion dynamics of nanocarriers in the vitreous and the influence of nanocarrier physicochemical properties on these dynamics is an important aspect of the efficacy of intravitreal administered nanomedicines for the treatment of posterior segment eye diseases. Here we use fluorescence correlation spectroscopy (FCS) to determine liposome diffusion coefficients in the intact vitreous (DVit) of ex vivo porcine eyes using a modified Miyake-Apple technique to minimize the disruption of the vitreous fine structure. We chose to investigate whether the zeta potential of polyethylene glycol functionalized (i.e. PEGylated) liposomes altered liposome in situ diffusion dynamics in the vitreous. Non-PEGylated cationic nanocarriers have previously shown little to no diffusion in the vitreous, whilst neutral and anionic have shown diffusion. The liposomes investigated had diameters below 150nm and zeta potentials ranging from -20 to +12mV. We observed that PEGylated cationic liposomes had significantly lower DVit values (1.14μm2s-1) than PEGylated neutral and anionic liposomes (2.78 and 2.87μm2s-1). However, PEGylated cationic liposomes had a similar biodistribution profile across the vitreous to the other systems. These results show that PEGylated cationic liposomes with limited cationic charge can diffuse across the vitreous and indicate that the vitreous as a barrier to nanocarriers (Ø<500nm) is more complicated than simply an electrostatic barrier as previously suggested.
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Affiliation(s)
- Anne Z Eriksen
- Department for Micro- and Nanotechnology, Technical University of Denmark, Building 345C, 2800 Kgs. Lyngby, Denmark
| | - Jonathan Brewer
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Thomas L Andresen
- Department for Micro- and Nanotechnology, Technical University of Denmark, Building 345C, 2800 Kgs. Lyngby, Denmark
| | - Andrew J Urquhart
- Department for Micro- and Nanotechnology, Technical University of Denmark, Building 345C, 2800 Kgs. Lyngby, Denmark.
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168
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Zhang ML, Suarez MJ, Bosley TM, Rodriguez FJ. Clinicopathological features of peripheral nerve sheath tumors involving the eye and ocular adnexa. Hum Pathol 2017; 63:70-78. [PMID: 28235631 DOI: 10.1016/j.humpath.2017.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/16/2017] [Accepted: 02/09/2017] [Indexed: 12/28/2022]
Abstract
Peripheral nerve sheath tumors (PNSTs) are known to occur in the orbit and comprise 4% of all orbital tumors, but have not been well studied in contemporary literature. Ninety specimens involving the eye and ocular adnexa (1979-2015) from 67 patients were studied. The mean age was 32.5years. Locations included orbit (58.9%), eyelid (60.0%), and other ocular adnexa. Most specimens were neurofibromas (70.0%), followed by schwannomas (11.1%), neuromas (11.1%), granular cell tumors (n=4), nerve sheath myxomas (n=2), and malignant PNST (n=1). Fifty-six (88.9%) neurofibroma cases were neurofibromatosis 1 associated. Among neurofibromas, 31.7% were localized, 38.1% were plexiform, 25.4% were diffuse, and 4.8% were diffuse and plexiform. These tumors involved skin (31.7%), soft tissue (11.1%), skeletal muscle (22.2%), peripheral nerve (63.0%), lacrimal gland (20.6%), and choroid (n=1). Other histologic findings included pseudo-Meissner corpuscles (27%), Schwann cell nodules (4.8%), prominent myxoid component (7.9%), melanin-like pigment (3.2%), and inflammation (14.3%). Available immunostains included S100 (+ in 15/15 cases), EMA (+ in 2/4 cases), CD34 (+ in 4/4 cases), and Ki-67 (<1% in 4/4 cases). Among 10 schwannomas, 8 were conventional and 2 were plexiform. Observed features included capsule (n=5), hyalinized vessels (n=5), Verocay bodies (n=7), and Antoni B pattern (n=5). Immunostaining included S100+ in 4 of 4 cases, and collagen IV+ and Ki-67 <1% in 3 of 3 cases. Neurofibromas are the most common PNST involving the eye and ocular adnexa, and the majority are associated with neurofibromatosis 1. Plexiform and diffuse patterns and the presence of pseudo-Meissner corpuscles are relatively frequent in this area.
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Affiliation(s)
- Mingjuan L Zhang
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231; Department of Pathology, Massachusetts General Hospital, Boston, MA 02114
| | - Maria J Suarez
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Thomas M Bosley
- The Knights Templar Eye Foundation Professor of Ophthalmology, The Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21231
| | - Fausto J Rodriguez
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21231.
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169
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Bajaj DK, Srivastava A, Kushwaha RAS, Joshi A, Pandey MK, Mishra P, Asnani M. Two cases of eyelid tuberculosis - An uncommon presentation of ocular tuberculosis. Indian J Tuberc 2017; 64:47-49. [PMID: 28166917 DOI: 10.1016/j.ijtb.2016.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 06/24/2016] [Indexed: 11/27/2022]
Abstract
Mycobacterium tuberculosis apart from being the causative agent of pulmonary tuberculosis is also notorious to cause tuberculosis at various sites in the human body and ocular tuberculosis is one of the extra pulmonary manifestations of this organism. The most common presentation of ocular tuberculosis is anterior uveitis or choroiditis caused by hematogenous infection or hypersensitivity after another organ infection. Eyelid involvement by tuberculosis is most of the times secondary to orbital involvement and often seen in the form of drainage sinus. Isolated eyelid tuberculosis is however uncommon. Here we report two such cases of eyelid tuberculosis in different age groups; first case in a young female and second case of an old aged female with different presentation. Fortunately both of them responded well to the antitubercular treatment.
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Affiliation(s)
- D K Bajaj
- Assistant Professor, Department of Respiratory Medicine, King George's Medical University, Lucknow, UP, India.
| | - A Srivastava
- Assistant Professor, Department of Respiratory Medicine, King George's Medical University, Lucknow, UP, India
| | - R A S Kushwaha
- Professor, Department of Respiratory Medicine, King George's Medical University, Lucknow, UP, India
| | - A Joshi
- Senior Resident, Department of Respiratory Medicine, King George's Medical University, Lucknow, UP, India
| | - M K Pandey
- Junior Resident, Department of Respiratory Medicine, King George's Medical University, Lucknow, UP, India
| | - P Mishra
- Junior Resident, Department of Pathology, B.R.D. Medical College, Gorakhpur, UP, India
| | - M Asnani
- Assistant Professor, Department of Obstetrics & Gynaecology, King George's Medical University, Lucknow, UP, India
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170
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Hasanreisoglu M, Gulpinar Ikiz GD, Kucuk H, Varan O, Ozdek S. Acute lupus choroidopathy: multimodal imaging and differential diagnosis from central serous chorioretinopathy. Int Ophthalmol 2017; 38:369-374. [PMID: 28050729 DOI: 10.1007/s10792-016-0433-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 12/27/2016] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Systemic lupus erythematosus (SLE) is a thoroughly examined multi-organ disease whose common ocular complications are also well documented. However, SLE choroidopathy, being a rare ocular complication, is needed to be better understood, in order to make the differential diagnosis from clinical conditions such as central serous chorioretinopathy and provide adequate prompt treatment. OBJECTIVE To provide a clear understanding for the clinical course of SLE choroidopathy by the help of enhanced depth imaging optical coherence tomography, fluorescein angiography, and indocyanine angiography. DESIGN The study is designed as a case presentation, consisting of the physical examination results and the data gathered by the relevant screening methods for each visit, applied by the same ophthalmologists and technicians. SETTING The visits were organized as same day examinations as needed, in a university hospital which works as a referral center.
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Affiliation(s)
- Murat Hasanreisoglu
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey.
| | | | - Hamit Kucuk
- Department of Rheumatology, School of Medicine, Gazi University, Ankara, Turkey
| | - Ozkan Varan
- Department of Rheumatology, School of Medicine, Gazi University, Ankara, Turkey
| | - Sengul Ozdek
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
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171
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Young S, Murphy R, Iyer S. A rare case of a direct ocular contact burn to the right eye. Ann R Coll Surg Engl 2017; 99:e31-e33. [PMID: 27659381 PMCID: PMC5392806 DOI: 10.1308/rcsann.2016.0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 11/22/2022] Open
Abstract
Ocular thermal burns represent an oculoplastic emergency, with the potential for blindness owing to limbal ischaemia. We present a rare case of a 66-year-old man who sustained a direct thermal contact burn to the right eye.
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Affiliation(s)
- S Young
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust , Preston , UK
| | - R Murphy
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust , Preston , UK
| | - S Iyer
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust , Preston , UK
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172
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Abstract
Every year in the United States, 1.6 to 3.8 million concussions occur secondary to injuries sustained during sports and recreational activities. Major advances have been made in terms of identifying specific clinical profiles following concussion. Nevertheless, there are continued misunderstandings regarding this injury and variable clinical management strategies being employed that may result in protracted recovery periods for youth athletes. Therefore, it is essential that individualized treatment plans target the particular clinical profile(s) present following concussion. Further progress related to management of this injury depends on medical professionals working as part of multidisciplinary teams to provide appropriate education, accurate information, and treatments based on the identified clinical profiles. It is also important for medical professionals of all disciplines to stay vigilant toward future research and practice guidelines given the evolving nature of this injury.
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173
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Belser JA, Sun X, Creager HM, Johnson A, Ridenour C, Chen LM, Tumpey TM, Maines TR. Role of H7 hemagglutinin in murine infectivity of influenza viruses following ocular inoculation. Virology 2016; 502:13-19. [PMID: 27960109 DOI: 10.1016/j.virol.2016.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 12/01/2016] [Accepted: 12/06/2016] [Indexed: 11/28/2022]
Abstract
H7 subtype influenza viruses have demonstrated an ocular tropism in humans, causing conjunctivitis and not respiratory symptoms in many infected individuals. However, the molecular determinants which confer ocular tropism are still poorly understood. Here, we used a murine model of ocular inoculation to demonstrate that H7 influenza viruses are more likely to cause infection following ocular exposure than are non-H7 subtype viruses. We included investigation regarding the potential role of several properties of influenza viruses with murine infectivity following ocular inoculation, including virus lineage, pathogenicity, and HA cleavage site composition. Furthermore, we examined the potential contribution of internal proteins to murine ocular infectivity. These studies establish a link between H7 subtype viruses and the risk of heightened infectivity in a mammalian species following ocular exposure, and support the development of non-traditional inoculation methods and models to best understand the human risk posed by influenza viruses of all subtypes.
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Affiliation(s)
- Jessica A Belser
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States.
| | - Xiangjie Sun
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Hannah M Creager
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States; Emory University, Atlanta, GA, 30333, United States
| | - Adam Johnson
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Callie Ridenour
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Li-Mei Chen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Terrence M Tumpey
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Taronna R Maines
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
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174
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Abstract
Prostate carcinoma, when metastatic, typically involves bone and produces both osteoblastic and osteolytic changes. A 73-year-old man was admitted to our department because of unilateral progressive proptosis and visual blurriness for 3 months. The patient had a history of prostate adenocarcinoma diagnosis 5 years ago. We report a case of orbital involvement presented that intraorbital mass (including periocular structures), temporal bone and temporal muscle from prostate cancer. The mass was removed with total excision. Despite the frequency of bone metastasis in prostatic carcinoma, triple orbital metastases are extremely rare. The best of our knowledge, prostate adenocarcinoma and its triple (temporal bone, temporal muscle and intraorbital mass) orbital metastases have not been published previously. Metastatic orbital tumor secondary to prostate cancer should be considered in patients who have varying degrees of eye symptoms.
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Affiliation(s)
- Kagan Tun
- Neurosurgery Department, Acibadem Eskisehir Hospital, Acibadem University, Istanbul, Turkey.
| | - Turgay Bulut
- Neurosurgery Department, Kayseri Education and Research Hospital, Kayseri, Turkey
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175
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Türkcü FM, Şahin A, Yüksel H, Çınar Y, Cingü K, Altındağ S, Deveci Ö, Özkurt Z, Çaça İ. Activation of toxoplasma retinochoroiditis during pregnancy and evaluation of ocular findings in newborns. Int Ophthalmol 2017; 37:559-63. [PMID: 27480335 DOI: 10.1007/s10792-016-0311-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/28/2016] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to evaluate patients with activation of toxoplasma retinochoroiditis during pregnancy and ocular findings in newborns. A total of 17 pregnant patients who were clinically and serologically diagnosed with ocular toxoplasmosis were retrospectively reviewed. After birth, ocular findings for all infants were recorded. The mean age of the patients was 29.08 ± 5.71 years. In all cases, activation was present in only one eye. In 13 cases, anterior uveitis was associated with posterior uveitis. Visual acuity in all cases prior to treatment was 0.3 ± 0.21 and increased to 0.55 ± 0.29 after treatment. The mean gestational age of the patients was 19.76 ± 8.71 weeks at the time of hospital admission. No case of toxoplasmic ocular involvement was identified in the infants on postnatal examination. In the case of toxoplasma retinochoroiditis during pregnancy, appropriate treatment and follow-up is very important to protect the newborns and to prevent impaired vision in mothers.
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176
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Johnson JE, Deufel CL, Furutani KM. Investigating the dosimetric impact of seed location uncertainties in Collaborative Ocular Melanoma Study-based eye plaques. Brachytherapy 2016; 15:661-8. [PMID: 27475484 DOI: 10.1016/j.brachy.2016.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 06/01/2016] [Accepted: 06/05/2016] [Indexed: 02/08/2023]
Abstract
PURPOSE To quantify the dosimetric effects of random and systematic seed position uncertainties in Collaborative Ocular Melanoma Study-based eye plaques. METHODS AND MATERIALS An eye plaque dose calculation routine was created using Task Group 43 formalism. A variety of clinical configurations were simulated, including two seed models: (125)I and (103)Pd, three eye plaque sizes, and eight plaque/eye orientations. Dose was calculated at four ocular anatomic sites and three central axis plaque depths. Random seed positional uncertainty was modeled by adding Gaussian random displacements, in one of three seed-motion degrees of freedom, to each seed's nominal coordinate. Distributions of dosimetric outcomes were obtained and fitted after 10(6) randomizations. Similar analysis was performed for deterministic, systematic shifts of the plaque along the eye surface and radially from the globe center. RESULTS Random seed placement uncertainties of 0.2-mm root mean square (RMS) (amplitude) produce dose changes that are typically <4% for each degree of freedom (95% confidence interval). Systematic seed placement uncertainties are generally greater than random uncertainty 95% confidence intervals (factor of 0.72-2.15), with the relative magnitudes depending on plaque size and location of interest. Eye plaque dosimetry is most sensitive to seed movement toward the center of the eye. Dosimetric uncertainty also increases with increasing dose gradients, which are typically greatest near the inner sclera, with smaller plaques, and with lower energy radionuclides (e.g., (103)Pd). CONCLUSIONS Dosimetric uncertainties due to the random seed positional displacements anticipated in the clinic are expected to be <4% for each degree of freedom in most circumstances.
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177
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Romero GB, Keck CM, Müller RH, Bou-Chacra NA. Development of cationic nanocrystals for ocular delivery. Eur J Pharm Biopharm 2016; 107:215-22. [PMID: 27388629 DOI: 10.1016/j.ejpb.2016.07.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 05/18/2016] [Accepted: 07/03/2016] [Indexed: 01/05/2023]
Abstract
A cationic nanocrystal formulation containing dexamethasone acetate nanocrystals (0.05%) and polymyxin B (0.10%) for ophthalmic application was produced using a self-developed small scale method for wet bead milling. The formulation developed offers the advantage of increased saturation solubility of the drug (due to the nano-size of the crystals) and increased residence time in the eye (due to small size and increased mucoadhesion by the cationic charge) resulting ultimately in potential increased bioavailability. Characterization of the nanosuspensions by photon correlation spectroscopy (PCS) and transmission electron microscopy showed that the production method was successful in achieving dexamethasone crystals in the range of about 200-250nm. The physical stabilization of the nanocrystals and generation of the positive charge were realized by using cetylpyridinium chloride (CPC) and benzalkonium chloride (BAC) at the concentration of 0.01%. In contrast to other cationic excipients, they are regulatorily accepted due to their use as preservatives. The drug polymyxin B also contributed to the positive charge. Positive zeta potentials in the range +20 to +30mV were achieved. Isotonicity was adjusted using NaCl and non-ionic excipients (glycerol, sorbitol, dextrose). Physical and chemical stabilities were monitored for a period of 6months at room temperature, 5°C and 40°C. Particle size of the bulk population assessed by PCS remained practically unchanged over 6months of storage for the various formulations without isotonicity agents, and for the CPC-containing formulations with non-ionic isotonicity excipients. The chemical content also proved stable after 6months for all 3 temperatures evaluated. In vitro investigation of mucoadhesion was tested using mucin solutions at different concentrations, and the generated negative zeta potential was used as a measure of the interaction. The zeta potential reversed to about -15mV, indicating distinct interaction. The results show the potential of increased mucoadhesion of such cationic nanocrystals compared to standard eye drop formulations. The positively charged nanocrystal formulation also showed no in vitro cytotoxicity as assessed on fibroblast cell culture. In summary, 3 formulation candidates were identified being a promising alternative for ocular delivery with increased performance compared to what is presently available.
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178
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Calles JA, López-García A, Vallés EM, Palma SD, Diebold Y. Preliminary characterization of dexamethasone-loaded cross-linked hyaluronic acid films for topical ocular therapy. Int J Pharm 2016; 509:237-243. [PMID: 27242313 DOI: 10.1016/j.ijpharm.2016.05.054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 05/23/2016] [Accepted: 05/26/2016] [Indexed: 01/25/2023]
Abstract
The aim of this work was to design and characterize cross-linked hyaluronic acid (HA)-itaconic acid (IT) films loaded with dexamethasone sodium phosphate salt (DEX) for topical therapy of inflammatory ocular surface diseases. Films were chemically cross-linked with polyethylene glycol diglycidyl ether (PEGDE), then physical and mechanical characterization by stress-strain, X-ray diffraction, X-ray fluorescence spectrometry and swelling assays was conducted. A sequential in vitro therapeutic efficacy model was designed to assess changes in interleukin (IL)-6 production in an inflamed human corneal epithelial (HCE) cell line after film exposure. Changes in cell proliferation after film exposure were assessed using the alamarBlue(®) proliferation assay. Experimental findings showed desirable mechanical properties and in vitro efficacy to reduce cell inflammation. A moderately decreased proliferation rate was induced in HCE cells by DEX-loaded films, compared to commercial DEX eye drops. These results suggest that DEX and HA have opposite effects. The sequential in vitro therapeutic efficacy model arises as an efficient tool to study drug release from delivery systems by indirect measurement of a biological response.
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Affiliation(s)
- J A Calles
- Institute of Applied Ophthalmo-Biology (IOBA), University of Valladolid, 47011 Valladolid, Spain; PLAPIQUI, CONICET, National University at Bahía Blanca (UNS), 8000 Bahía Blanca, Argentina; Department of Biology, Biochemistry and Pharmacy, UNS, 8000 Bahía Blanca, Argentina
| | - A López-García
- Institute of Applied Ophthalmo-Biology (IOBA), University of Valladolid, 47011 Valladolid, Spain; Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain
| | - E M Vallés
- PLAPIQUI, CONICET, National University at Bahía Blanca (UNS), 8000 Bahía Blanca, Argentina
| | - S D Palma
- UNITEFA, CONICET, National University of Córdoba, X5000HUA Córdoba, Argentina
| | - Y Diebold
- Institute of Applied Ophthalmo-Biology (IOBA), University of Valladolid, 47011 Valladolid, Spain; Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain.
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179
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Renna A, Vejarano LF, De la Cruz E, Alió JL. Pharmacological Treatment of Presbyopia by Novel Bin ocularly Instilled Eye Drops: A Pilot Study. Ophthalmol Ther 2016; 5:63-73. [PMID: 27168149 PMCID: PMC4909677 DOI: 10.1007/s40123-016-0050-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Indexed: 10/25/2022] Open
Abstract
PURPOSE The feasibility, in terms of safety and potential efficacy, of a new drug combination for binocular use as a noninvasive pharmacological solution for treating presbyopia was examined. METHODS Fourteen emmetropic presbyopic subjects (28 eyes) were given one drop of the preparation under study in each eye. For each patient, the uncorrected distance visual acuity, uncorrected near visual acuity, near and far refraction, best corrected visual acuity, best corrected far-near visual acuity, photopic and scotopic pupil size, Schirmer's test, endothelial cell count, intraocular pressure, keratometry, pachymetry, and anterior chamber depth were all performed or assessed prior to the administration of the eye drops and then 0.5, 1, 2, 3, 4, and 5 h, 1 week, and 1 month post-administration prospectively in each eye and binocularly. RESULTS The results showed that near uncorrected visual acuity improved by about 2-3 lines from baseline in each eye and binocularly. There was no degradation in uncorrected far vision in each eye and binocularly in any patient. Refractive measurements performed in this study showed there was a maximum myopic shift of just 0.5 D that progressively reduced and disappeared at 4 h. CONCLUSION The new topical drug treatment analyzed herein significantly improved near vision without affecting far vision. This binocular pharmacologic treatment of presbyopia has the potential to ameliorate the reading vision of presbyopes and possesses the advantages of a nonmonovision therapy. A randomized, controlled, double-masked clinical trial with a twice-a-day treatment schedule is ongoing at our institution. FUNDING This study was supported in part by the Spanish Ministry of Health, Instituto Carlos III, Red Temática de Investigación Oftalmológica (OFTALRED), and Fundación Oftalmológica Vejarano (Popayán, Colombia).
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Affiliation(s)
- Antonio Renna
- Vissum Alicante, Calle Cabañal, 1, Edificio Vissum, 03016, Alicante, Spain.,Department of Medical and Biological Sciences-Ophthalmology, University of Udine, Udine, Italy
| | - L Felipe Vejarano
- Fundación Oftalmológica Vejarano, Popayan, Colombia.,Universidad del Cauca, Popayan, Colombia
| | - Ernesto De la Cruz
- Department of Physical Activity and Sport, University of Murcia, Murcia, Spain
| | - Jorge L Alió
- Vissum Alicante, Calle Cabañal, 1, Edificio Vissum, 03016, Alicante, Spain. .,Ophthalmology, Universidad Miguel Hernandez, Alicante, Spain.
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180
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Soltani S, Zakeri-Milani P, Barzegar-Jalali M, Jelvehgari M. Design of eudragit RL nanoparticles by nanoemulsion method as carriers for ophthalmic drug delivery of ketotifen fumarate. Iran J Basic Med Sci 2016; 19:550-60. [PMID: 27403262 PMCID: PMC4923476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Ketotifen fumarate (KF) is a selective and noncompetitive histamine antagonist (H1-receptor) that is used topically in the treatment of allergic conditions of rhinitis and conjunctivitis. The aim of this study was to formulate and improve an ophthalmic delivery system of KF. Ocular nanoparticles were prepared with the objective of reducing the frequency of administration and obtaining controlled release to improve the anti-inflammatory drug delivery. MATERIALS AND METHODS In the present study, ocular KF loaded Eudragit RL 100 nanoparticles were prepared using O/W solvent diffusion method. The nanoparticles were evaluated for particle size, entrapment efficiency, surface morphology, X-ray diffraction (XRD), Fourier transform spectroscopy (FTIR), and differential scanning calorimetry (DSC). In vitro release and permeation studies were also carried out on nanoparticles. RESULTS An average size range of 182 to 314.30 nm in diameter was obtained and encapsulation efficiency up to 95.0% was observed for all the formulations. Drug release for all formulations after 24 hr was between 65.51% and 88.82% indicating effective controlled release property of KF. The mechanism of drug release for best formulation was found to be fickian diffusion mechanism. KF nanoparticles containing high polymer concentration (1:15) presented a faster drug release and a higher drug penetration; on the contrary, nanoparticles containing low polymer concentration (1:7.5) were able to give a more sustained release of the drug and thus a slower KF permeation through the cornea. CONCLUSION The study revealed that KF NPs were capable of releasing the drug for a prolonged period of time and increasing the ocular bioavailability.
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Affiliation(s)
- Saieede Soltani
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Zakeri-Milani
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Barzegar-Jalali
- Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mitra Jelvehgari
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding author: Mitra Jelvehgari. Department of Pharmaceutics, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran. Tel: +98-41-3339-2585; ; ;
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181
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Malik AH, Shah AA, Ahmad I, Shah BA. Ocular Injuries in Patients of Zygomatico-Complex (ZMC) Fractures. J Maxillofac Oral Surg 2017; 16:243-7. [PMID: 28439168 DOI: 10.1007/s12663-016-0907-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 04/05/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Mid face injuries commonly destroy the integrity of the orbital skeleton, and are frequently complicated by injury to the eye, ranging between 2.7 and 90.6 % as reported in literature. The eye injuries range from simple subconjunctival haemorrhage to globe rupture. The paper aims to study the types of ocular injuries in patients with ZMC fractures. PATIENTS AND METHODS A study of 67 patients, who had sustained facial trauma sufficient to lead to a facial bone fracture, was undertaken in the department of Oral and Maxillofacial Surgery, Govt Dental College, Srinagar from 2008 to 2014 and the patients received a comprehensive examination by an ophthalmologist within 1 week of injury. All the patients sustaining confirmed ZMC fracture were examined by an ophthalmologist for any associated ocular injury. A thorough ophthalmologic examination included assessment of visual acuity, pupillary reactivity, anterior and posterior segment examination and extraocular motility. The variables reviewed included patient's gender, mechanism of injury, visual acuity, pupillary reactivity, extra ocular motility, presence or absence of diplopia, ocular and orbital findings, and intraorbital hypoesthesia. RESULTS The most common etiology of trauma was RTA (64.1 %), followed by falls (14.9 %) in our study. In our study 83.5 % of the patients were males. Minor ocular injuries such as subconjunctival haemorrhage and corneal injury accounted for most of the cases. Subconjunctival haemorrhage was the most common injury, present in 86.5 % of the cases. Hyphema was present 13.4 %, vitreous haemorrhage 2.98 %, retinal haemorrhage 1.49 %, corneal abrasion 4.47 %, mydriasis 1.49 %, choroidal rupture 5.97 %, retinal detachment 2.98 %, decreased visual activity 13.4 %, retinal tear and angle recession was present 7.46 % times. CONCLUSION ZMC fractures are associated with higher incidence of ocular injuries. The incidence of traumatic optic neuropathy and other ocular injuries warrants a prompt ophthalmologic examination of all patients with ZMC fractures as quickly as possible to prevent morbidity.
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Abstract
This article reviews a variety of congenital and developmental disorders of the pediatric orbit with particular emphasis on ocular lesions, followed by a description of developmental and neoplastic orbital and ocular masses. The relationship of these diseases to various syndromes and/or known genetic mutations is also highlighted.
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Affiliation(s)
- Behroze A Vachha
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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183
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Sevillano C, Parafita-Fernández A, Rodriguez-Lopez V, Sampil M, Moraña N, Viso E, Cores FJ. A curious fact: Photic sneeze reflex. Autosomical dominant compelling helio-ophthalmic outburst syndrome. ACTA ACUST UNITED AC 2016; 91:305-9. [PMID: 26896062 DOI: 10.1016/j.oftal.2016.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To assess ocular involvement in the pathophysiology of autosomal dominant compelling helio-ophthalmic outburst syndrome (ACHOOs). METHODS An interview was conducted with a Caucasian family that showed clinical features of ACHOOs. Twelve of them had photic reflex and were recruited. A complete eye evaluation was made. RESULTS A dominant autosomal inheritance with mild penetrance was demonstrated, with 67% of the studied subjects showing some degree of prominent corneal nerves. No other eye changes were found. CONCLUSIONS Prominent corneal nerves may be associated with ACHOOs. The other eye structures studied do not seem to play a role in ACHOOs. Further studies are needed to understand the physiology of the ACHOOs.
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Affiliation(s)
- C Sevillano
- Servicio de Oftalmología, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - A Parafita-Fernández
- Servicio de Oftalmología, Complejo Hospitalario de Pontevedra, Pontevedra, Spain.
| | - V Rodriguez-Lopez
- Medicina Familiar y Comunitaria, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - M Sampil
- Servicio de Oftalmología, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - N Moraña
- Servicio de Oftalmología, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - E Viso
- Servicio de Oftalmología, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - F J Cores
- Servicio de Oftalmología, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
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Carbone C, Manno D, Serra A, Musumeci T, Pepe V, Tisserand C, Puglisi G. Innovative hybrid vs polymeric nanocapsules: The influence of the cationic lipid coating on the "4S". Colloids Surf B Biointerfaces 2016; 141:450-457. [PMID: 26895507 DOI: 10.1016/j.colsurfb.2016.02.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 10/22/2022]
Abstract
Polymeric and hybrid aqueous-core nanocapsules were prepared using a low energy organic-solvent free procedure as innovative nanodevices for the ophthalmic delivery of melatonin. In order to evaluate how different cationic lipids could affect the main properties of the nanodevices, we focused our attention on mean particles size, surface charge, shape and stability (the "4S"). The results of our study confirmed the hypothesis that the coating material differently affects the overall nanoparticles properties, above all in terms of morphology: in particular, the cationic lipid dimethyldioctadecylammonium bromide allows the formation of very stable well-defined nanocapsules with non-spherical shape with sustained and prolonged drug release, thus representing a great advantage in ophthalmic application.
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Affiliation(s)
- C Carbone
- Laboratory of Drug Delivery Technology, Department of Drug Sciences, University of Catania, V.le A. Doria 6, 95125 Catania, Italy; NANO-i-Research Centre On Ocular Nanotechnology-University of Catania, Catania, Italy.
| | - D Manno
- Physics Applied to Material Science Laboratory, Department of Environmental and Biological Sciences and Technologies, University of Salento, via Provinciale Lecce-Monteroni, Lecce, Italy
| | - A Serra
- Physics Applied to Material Science Laboratory, Department of Environmental and Biological Sciences and Technologies, University of Salento, via Provinciale Lecce-Monteroni, Lecce, Italy
| | - T Musumeci
- Laboratory of Drug Delivery Technology, Department of Drug Sciences, University of Catania, V.le A. Doria 6, 95125 Catania, Italy; NANO-i-Research Centre On Ocular Nanotechnology-University of Catania, Catania, Italy
| | - V Pepe
- Laboratory of Drug Delivery Technology, Department of Drug Sciences, University of Catania, V.le A. Doria 6, 95125 Catania, Italy; NANO-i-Research Centre On Ocular Nanotechnology-University of Catania, Catania, Italy
| | - C Tisserand
- Formulaction SA 10, Impasse Borde Basse, 31240 L'Union, France
| | - G Puglisi
- Laboratory of Drug Delivery Technology, Department of Drug Sciences, University of Catania, V.le A. Doria 6, 95125 Catania, Italy; NANO-i-Research Centre On Ocular Nanotechnology-University of Catania, Catania, Italy
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Haring RS, Canner JK, Haider AH, Schneider EB. Ocular injury in the United States: Emergency department visits from 2006-2011. Injury 2016; 47:104-8. [PMID: 26275512 DOI: 10.1016/j.injury.2015.07.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 07/08/2015] [Accepted: 07/11/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Ocular complaints represent a sizeable burden to emergency departments, accounting for an estimated 2.4 million ED visits annually. We sought to characterise visits associated with ocular injury and examine factors contributing to inpatient admission. METHODS We searched the Nationwide Emergency Department Sample between 2006 and 2011 and identified cases in which patients presented with a primary or secondary diagnosis of ocular trauma. We described these cases according to age, sex, external mechanism of injury, payer status, and identified relationships between these variables. Logistic regression models were employed to identify crude and adjusted relative odds of admission to inpatient status based on patient demographics, mechanism of injury, payer status, and the existence of multiple injuries. RESULTS Between 2006 and 2011, a total of 5541,434 visits were made to EDs in the United States with a primary or other diagnosis of ocular trauma; ocular trauma was the primary diagnosis in 77.9% of these cases. Overall, mean age at presentation was 33.8 years and the majority of patients were male (64.8%). Male sex, older age, being struck by or against an object, the existence of multiple injuries, and Medicaid as a primary payer were all associated with significantly higher odds of hospital admission. DISCUSSION The distribution of primary external mechanism of injury suggested that individuals are at higher risks for different injury types at each successive stage of life. Age and injury mechanism were correlated with odds of admission to inpatient status, with the highest odds among older adults who had been injured by being struck by or against an object. CONCLUSIONS Ocular injury plays a substantial role in the ED. Further work is necessary to determine whether developing and implementing age- and sex-appropriate prevention strategies could reduce the incidence of ocular injury and reduce morbidity related to these types of injuries.
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Affiliation(s)
- R Sterling Haring
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Joseph K Canner
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Adil H Haider
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Eric B Schneider
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
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186
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Foldvari M, Chen DW, Nafissi N, Calderon D, Narsineni L, Rafiee A. Non-viral gene therapy: Gains and challenges of non-invasive administration methods. J Control Release 2015; 240:165-190. [PMID: 26686079 DOI: 10.1016/j.jconrel.2015.12.012] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/26/2015] [Accepted: 12/09/2015] [Indexed: 12/20/2022]
Abstract
Gene therapy is becoming an influential part of the rapidly increasing armamentarium of biopharmaceuticals for improving health and combating diseases. Currently, three gene therapy treatments are approved by regulatory agencies. While these treatments utilize viral vectors, non-viral alternative technologies are also being developed to improve the safety profile and manufacturability of gene carrier formulations. We present an overview of gene-based therapies focusing on non-viral gene delivery systems and the genetic therapeutic tools that will further revolutionize medical treatment with primary focus on the range and development of non-invasive delivery systems for dermal, transdermal, ocular and pulmonary administrations and perspectives on other administration methods such as intranasal, oral, buccal, vaginal, rectal and otic delivery.
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Affiliation(s)
- Marianna Foldvari
- School of Pharmacy, Waterloo Institute of Nanotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Center for Bioengineering and Biotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada.
| | - Ding Wen Chen
- School of Pharmacy, Waterloo Institute of Nanotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Center for Bioengineering and Biotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Nafiseh Nafissi
- School of Pharmacy, Waterloo Institute of Nanotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Center for Bioengineering and Biotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Daniella Calderon
- School of Pharmacy, Waterloo Institute of Nanotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Center for Bioengineering and Biotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Lokesh Narsineni
- School of Pharmacy, Waterloo Institute of Nanotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Center for Bioengineering and Biotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Amirreza Rafiee
- School of Pharmacy, Waterloo Institute of Nanotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Center for Bioengineering and Biotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
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Dalvin LA, Smith WM. Orbital and external ocular manifestations of Mycobacterium tuberculosis: A review of the literature. J Clin Tuberc Other Mycobact Dis 2015; 4:50-57. [PMID: 31723688 PMCID: PMC6850259 DOI: 10.1016/j.jctube.2015.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/07/2015] [Accepted: 11/16/2015] [Indexed: 11/24/2022] Open
Abstract
Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis that most commonly affects the lungs. However, extrapulmonary manifestations of TB can affect the eye and surrounding orbital tissues. TB can affect nearly any tissue in the eye, and a high index of suspicion is required for accurate diagnosis. Systemic anti-tuberculosis treatment is required in cases of ocular TB, and steroids are sometimes necessary to prevent tissue damage secondary to inflammation. Delays in diagnosis are common and can result in morbidities such as loss of an affected eye. It is important for ophthalmologists and infectious disease specialists to work together to accurately diagnose and treat ocular TB in order to prevent vision loss. This article reports the various known presentations of orbital and external ocular TB and reviews important elements of diagnosis and treatment.
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Affiliation(s)
- Lauren A Dalvin
- Department of Ophthalmology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Wendy M Smith
- Department of Ophthalmology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
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Sevillano C, Moraña MN, Estévez S. Visual involvement in foreign-body intestinal perforations. ACTA ACUST UNITED AC 2015; 91:20-2. [PMID: 26560165 DOI: 10.1016/j.oftal.2015.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 09/15/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Intestinal perforation due to ingestion of a foreign body accounts for 21% of the total in our hospital. METHODS All cases of intestinal perforation due to foreign body ingestion occurring since 1990 were collected (29 cases), and the visual characteristics of these patients were analysed. RESULTS AND DISCUSSION The mean age was 74.2 years (all of them presbyopic) with the majority being female (1.9:1). The most frequently ingested foreign body was fish bone (55%). The corrected near visual acuity obtained a mean value of 0.73, while the real visual accuity (only one of them wore glasses to eat) was 0.145. Four patients (20%) had only one eye, and the TNO test was positive in only 12 (60%). At least 13 (65%) had some degree of cataract. CONCLUSIONS Improving near visual acuity with either early cataract surgery and/or multifocal intraocular lenses may decrease the number of gastrointestinal perforations.
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Affiliation(s)
- C Sevillano
- Servicio de Oftalmología, Complexo Hospitalario de Pontevedra, Pontevedra, España.
| | - M N Moraña
- Servicio de Cirugía General y Digestiva, Complexo Hospitalario de Pontevedra, Pontevedra, España
| | - S Estévez
- Servicio de Cirugía General y Digestiva, Complexo Hospitalario de Pontevedra, Pontevedra, España
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Ehsan S, Amirzargar A, Yekaninejad MS, Mahmoudi M, Mehravar S, Moradi B, Nafissi S. Association of HLA class II (DRB1, DQA1, DQB1) alleles and haplotypes with myasthenia gravis and its subgroups in the Iranian population. J Neurol Sci 2015; 359:335-42. [PMID: 26671138 DOI: 10.1016/j.jns.2015.11.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 11/01/2015] [Accepted: 11/11/2015] [Indexed: 11/20/2022]
Abstract
Heterogenic pattern of HLA associations with myasthenia gravis (MG) among different ethnicities and also among different MG subgroups has been the subject of debate in large series of many studies. One hundred and sixty Iranian MG patients were investigated for HLA class II (DRB1, DQA1, DQB1) associations compared to two hundred healthy controls from the same ethnic population. DRB1*11 DQA1*0501 DQB1*0301 haplotype was found to be protective for total (ocular plus generalized) MG (Pc=0.005, OR=0.49) and generalized MG (Pc=0.008, OR=0.49). DRB1*04 DQA1*0301 DQB1*0302 haplotype (Pc=0.03, OR=2.25) was predisposing for anti-acetylcholine receptor (AChR) antibody-positive MG, while DRB1*16 DQA1*0102 DQB1*05 (Pc=0.013, OR=4.28) was predisposing for anti-muscle specific tyrosine kinase (MuSK) antibody-positive MG. There was also a trend of positive association for DRB1*14 DQA1*0104 DQB1*05 haplotype with MuSK-positive MG (Pc=0.054, OR=3.97). Among other MG subgroups and with less significance, DRB1*0101 DQA1*0101 DQB1*05 haplotype (P=0.016, OR=3.68) had positive association with pure ocular MG, and DRB1*03 DQA1*0501 DQB1*0201 haplotype (P=0.024) had negative association with thymomatous MG. This study highlights the importance of appropriate MG subgrouping according to clinical and paraclinical characteristics in HLA studies among MG patients.
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190
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Chastain JE, Sanders ME, Curtis MA, Chemuturi NV, Gadd ME, Kapin MA, Markwardt KL, Dahlin DC. Distribution of topical ocular nepafenac and its active metabolite amfenac to the posterior segment of the eye. Exp Eye Res 2015; 145:58-67. [PMID: 26474497 DOI: 10.1016/j.exer.2015.10.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/29/2015] [Accepted: 10/06/2015] [Indexed: 10/22/2022]
Abstract
Nepafenac ophthalmic suspensions, 0.1% (NEVANAC(®)) and 0.3% (ILEVRO™), are topical nonsteroidal anti-inflammatory drug (NSAID) products approved in the United States, Europe and various other countries to treat pain and inflammation associated with cataract surgery. NEVANAC is also approved in Europe for the reduction in the risk of postoperative macular edema (ME) associated with cataract surgery in diabetic patients. The efficacy against ME suggests that topical administration leads to distribution of nepafenac or its active metabolite amfenac to the posterior segment of the eye. This article evaluates the ocular distribution of nepafenac and amfenac and the extent of local delivery to the posterior segment of the eye, following topical ocular instillation in animal models. Nepafenac ophthalmic suspension was instilled unilaterally in New Zealand White rabbits as either a single dose (0.1%; one drop) or as multiple doses (0.3%, one drop, once-daily for 4 days, or 0.1% one drop, three-times daily for 3 days and one morning dose on day 4). Nepafenac (0.3%) was also instilled unilaterally in cynomolgus monkeys as multiple doses (one drop, three-times daily for 7 days). Nepafenac and amfenac concentrations in harvested ocular tissues were measured using high-performance liquid chromatography/mass spectrometry. Locally-distributed compound concentrations were determined as the difference in levels between dosed and undosed eyes. In single-dosed rabbit eyes, peak concentrations of locally-distributed nepafenac and amfenac showed a trend of sclera > choroid > retina. Nepafenac peak levels in sub-samples posterior to the eye equator and inclusive of the posterior pole (E-PP) were 55.1, 4.03 and 2.72 nM, respectively, at 0.25 or 0.50 h, with corresponding amfenac peak levels of 41.9, 3.10 and 0.705 nM at 1 or 4 h. By comparison, peak levels in sclera, choroid and retina sub-samples in a band between the ora serrata and the equator (OS-E) were 13- to 40-fold (nepafenac) or 11- to 23-fold (amfenac) higher, indicating an anterior-to-posterior directional concentration gradient. In multiple-dosed rabbit eyes, with 0.3% nepafenac instilled once-daily or 0.1% nepafenac instilled three-times daily, cumulative 24-h locally-distributed levels of nepafenac in E-PP retina were similar between these groups, whereas exposure to amfenac once-daily dosing nepafenac 0.3% was 51% of that achieved with three-times daily dosing of 0.1%. In single-dosed monkey eyes, concentration gradients showed similar directionality as observed in rabbit eyes. Peak concentrations of locally-distributed nepafenac were 1580, 386, 292 and 13.8 nM in E-PP sclera, choroid and retina, vitreous humor, respectively, at 1 or 2 h after drug instillation. Corresponding amfenac concentrations were 21.3, 11.8, 2.58 and 2.82 nM, observed 1 or 2 h post-instillation. The data indicate that topically administered nepafenac and its metabolite amfenac reach pharmacologically relevant concentrations in the posterior eye segment (choroid and retina) via local distribution, following an anterior-to-posterior concentration gradient. The proposed pathway involves a choroidal/suprachoroidal or periocular route, along with an inward movement of drug through the sclera, choroid and retina, with negligible vitreal compartment involvement. Sustained high nepafenac concentrations in posterior segment tissues may be a reservoir for hydrolysis to amfenac.
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Affiliation(s)
- James E Chastain
- Ocular Pharmacokinetics and Disposition, Alcon Research Ltd., Fort Worth, TX, USA.
| | - Mark E Sanders
- Ocular Pharmacokinetics and Disposition, Alcon Research Ltd., Fort Worth, TX, USA
| | - Michael A Curtis
- Ocular Pharmacokinetics and Disposition, Alcon Research Ltd., Fort Worth, TX, USA
| | - Nagendra V Chemuturi
- Ocular Pharmacokinetics and Disposition, Alcon Research Ltd., Fort Worth, TX, USA
| | - Martha E Gadd
- Novartis Institutes for Biomedical Research, Fort Worth, TX, USA
| | - Michael A Kapin
- Clinical Development, Alcon Research Ltd., Fort Worth, TX, USA
| | - Kerry L Markwardt
- Pharmaceutical Development, Alcon Research, Ltd., Fort Worth, TX, USA
| | - David C Dahlin
- Ocular Pharmacokinetics and Disposition, Alcon Research Ltd., Fort Worth, TX, USA
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191
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Chen JJ, Sartori J, Aakalu VK, Setabutr P. Review of Ocular Manifestations of Nevoid Basal Cell Carcinoma Syndrome: What an Ophthalmologist Needs to Know. Middle East Afr J Ophthalmol 2015; 22:421-7. [PMID: 26692711 PMCID: PMC4660526 DOI: 10.4103/0974-9233.167815] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Nevoid basal cell carcinoma syndrome (NBCCS) is a rare, autosomal dominant disorder characterized by multiple basal cell carcinomas (BCCs), odontogenic keratocysts, palmar and/or plantar pits, and ectopic calcifications of the falx cerebri. Myriad ophthalmologic findings are associated with NBCCS, including periocular BCCs, hypertelorism, strabismus, myelinated nerve fibers, and disorders of the retina and retinal pigment epithelium. We performed a literature search in PubMed for articles on the ophthalmologic manifestations of Gorlin syndrome, published between 1984 and 2014. Of 33 papers, 31 were included. Although Gorlin syndrome is due to mutations in a single gene, it displays variable phenotypic expressivity. Therefore, familiarity with this disorder across clinical specialties is necessary to avoid misdiagnosis. The ophthalmologist should be included in the multidisciplinary team for the management of Gorlin syndrome in order to prevent visual loss and improve the quality of life of these patients.
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Affiliation(s)
- Judy J. Chen
- Department of Ophthalmology and Visual Sciences, Illinois Eye Institute, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Juliana Sartori
- Department of Ophthalmology and Visual Sciences, Illinois Eye Institute, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-UNIFESP, Sao Paulo, Brazil
| | - Vinay K. Aakalu
- Department of Ophthalmology and Visual Sciences, Illinois Eye Institute, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Pete Setabutr
- Department of Ophthalmology and Visual Sciences, Illinois Eye Institute, University of Illinois at Chicago, Chicago, Illinois, USA
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192
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de Sá FA, Taveira SF, Gelfuso GM, Lima EM, Gratieri T. Liposomal voriconazole (VOR) formulation for improved ocular delivery. Colloids Surf B Biointerfaces 2015; 133:331-8. [PMID: 26123854 DOI: 10.1016/j.colsurfb.2015.06.036] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 06/10/2015] [Accepted: 06/16/2015] [Indexed: 11/23/2022]
Abstract
Treating infectious eye diseases topically requires a drug delivery system capable of overcoming the eye's defense mechanisms, which efficiently reduce the drug residence time right after its administration, therefore reducing absorption. In order to try to surpass such administration issues and improve life quality for patients with fungal keratitis, liposomal voriconazol (VOR) formulations were prepared. Formulations were composed of soy phosphatidylcholine (PC) containing or not 1,2-dioleoyl-3-trimethylammonium-propane (DOTAP) and cholesterol. Liposomes were characterized by their drug entrapment efficiency (EE), drug recovery (DR), average diameter (size) and polydispersivity index (PdI). In vitro mucosal interaction and irritancy levels, ex vivo permeation, as well as the short-term stability were also assessed. Liposomal VOR formulation produced with 7.2:40mM VOR:PC showed to be the most promising formulation: mean size of 116.6±5.9nm, narrow PdI (0.17±0.06), negative zeta potential (∼-7mV) and over 80% of EE and yield, remaining stable for at least 30 days in solution and 90 days after lyophilization. This formulation was classified as 'non-irritant' after HET-CAM's test and was able to deliver about 47.85±5.72μg/cm(2) of VOR into porcine cornea after 30min of permeation test. Such drug levels are higher than the minimal inhibitory concentrations (MIC) of several fungi species isolated from clinical cases of corneal keratitis. Overall results suggest VOR can be effectively incorporated in liposomes for potential topical treatment of fungal keratitis.
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193
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Kotwal A, Biswas D, Kakati B, Bahadur H, Gupta N. Non traumatic keratitis due to colletotrichum coccodes: a case report. J Clin Diagn Res 2015; 9:DD01-2. [PMID: 25859457 DOI: 10.7860/jcdr/2015/10843.5529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/31/2014] [Indexed: 11/24/2022]
Abstract
Colletotrichum species, a rare and emerging fungus is a well- known plant pathogen and an uncommon cause of human infection. It has been implicated as the etiological agent of cutaneous phaeohyphomycosis and keratitis, particularly following colonization of traumatized tissues or in immunocompromised patients. However, it has hardly ever been reported in the absence of such predisposing risk factors. Here, we report a case of keratitis with Colletotrichum coccodes occurring in a middle- aged, immunocompetent person without any history of trauma or co-morbidity. The isolate was sensitive to Amphotericin B and Voriconazole, and accordingly the patient was treated successfully with ocular administration of Amphotericin B.
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Affiliation(s)
- Aarti Kotwal
- Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences , Dehradun, Uttarakhand, India
| | - Debasis Biswas
- Additional Professor, Department of Microbiology, AIIMS Bhopal, Saket Nagar, Bhopal, MP, India
| | - Barnali Kakati
- Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences , Dehradun, Uttarakhand, India
| | - Harsh Bahadur
- Professor, Department of Ophthalmology, Himalayan Institute of Medical Sciences , Dehradun, Uttarakhand, India
| | - Neeti Gupta
- Assistant Professor, Department of Ophthalmology, Himalayan Institute of Medical Sciences , Dehradun, Uttarakhand, India
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194
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Romera Romero P, Monés Llivina A, Blazquez Abisu A, Sabala Llopart A. [Optic nerve infarction in Sneddon's syndrome]. Arch Soc Esp Oftalmol 2015; 90:180-184. [PMID: 25529358 DOI: 10.1016/j.oftal.2014.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 03/16/2014] [Accepted: 07/08/2014] [Indexed: 06/04/2023]
Abstract
CLINICAL CASE We report a case of a 26 year old woman with Raynaud's phenomenon and livedo reticularis 2 years onset, who presented with visual field defects accompanied by hypertension, hematuria, and headache. The examination revealed multiple retinal and optic nerve head infarcts in both eyes. DISCUSSION Sneddon's syndrome is a vasculitis that produces livedo reticularis, neurological symptoms, and less frequently myocardial, renal and retinal infarction. After reviewing the literature, this is the first case described of Sneddon's syndrome presenting with optic nerve infarction.
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Affiliation(s)
- P Romera Romero
- Departamento de Oftalmología, sección de neuroftalmología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
| | - A Monés Llivina
- Departamento de Oftalmología, sección de neuroftalmología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - A Blazquez Abisu
- Departamento de Oftalmología, sección de neuroftalmología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - A Sabala Llopart
- Departamento de Oftalmología, sección de neuroftalmología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
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195
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Huu VAN, Luo J, Zhu J, Zhu J, Patel S, Boone A, Mahmoud E, McFearin C, Olejniczak J, de Gracia Lux C, Lux J, Fomina N, Huynh M, Zhang K, Almutairi A. Light-responsive nanoparticle depot to control release of a small molecule angiogenesis inhibitor in the posterior segment of the eye. J Control Release 2015; 200:71-7. [PMID: 25571784 PMCID: PMC4384820 DOI: 10.1016/j.jconrel.2015.01.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/22/2014] [Accepted: 01/02/2015] [Indexed: 11/18/2022]
Abstract
Therapies for macular degeneration and diabetic retinopathy require intravitreal injections every 4-8 weeks. Injections are uncomfortable, time-consuming, and carry risks of infection and retinal damage. However, drug delivery via noninvasive methods to the posterior segment of the eye has been a major challenge due to the eye's unique anatomy and physiology. Here we present a novel nanoparticle depot platform for on-demand drug delivery using a far ultraviolet (UV) light-degradable polymer, which allows noninvasively triggered drug release using brief, low-power light exposure. Nanoparticles stably retain encapsulated molecules in the vitreous, and can release cargo in response to UV exposure up to 30 weeks post-injection. Light-triggered release of nintedanib (BIBF 1120), a small molecule angiogenesis inhibitor, 10 weeks post-injection suppresses choroidal neovascularization (CNV) in rats. Light-sensitive nanoparticles are biocompatible and cause no adverse effects on the eye as assessed by electroretinograms (ERG), corneal and retinal tomography, and histology.
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Affiliation(s)
- Viet Anh Nguyen Huu
- Department of Nanoengineering, University of California, San Diego, United States; Department of Material Sciences and Engineering, University of California, San Diego, United States
| | - Jing Luo
- Shiley Eye Center and Institute for Genomic Medicine, University of California, San Diego, United States
| | - Jie Zhu
- Shiley Eye Center and Institute for Genomic Medicine, University of California, San Diego, United States
| | - Jing Zhu
- Shiley Eye Center and Institute for Genomic Medicine, University of California, San Diego, United States
| | - Sherrina Patel
- Shiley Eye Center and Institute for Genomic Medicine, University of California, San Diego, United States
| | - Alexander Boone
- Department of Bioengineering, University of California, San Diego, United States
| | - Enas Mahmoud
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, United States
| | - Cathryn McFearin
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, United States
| | - Jason Olejniczak
- Department of Chemistry and Biochemistry, University of California, San Diego, United States
| | - Caroline de Gracia Lux
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, United States
| | - Jacques Lux
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, United States
| | - Nadezda Fomina
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, United States
| | - Michelle Huynh
- Department of Chemistry and Biochemistry, University of California, San Diego, United States
| | - Kang Zhang
- Shiley Eye Center and Institute for Genomic Medicine, University of California, San Diego, United States; KACST-UCSD Center of Excellence in Nanomedicine, University of California, San Diego, United States
| | - Adah Almutairi
- Department of Nanoengineering, University of California, San Diego, United States; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, United States; Department of Chemistry and Biochemistry, University of California, San Diego, United States; Department of Material Sciences and Engineering, University of California, San Diego, United States; KACST-UCSD Center of Excellence in Nanomedicine, University of California, San Diego, United States.
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196
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Reimondez-Troitiño S, Csaba N, Alonso MJ, de la Fuente M. Nanotherapies for the treatment of ocular diseases. Eur J Pharm Biopharm 2015; 95:279-93. [PMID: 25725262 DOI: 10.1016/j.ejpb.2015.02.019] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/09/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
Abstract
The topical route is the most frequent and preferred way to deliver drugs to the eye. Unfortunately, the very low ocular drug bioavailability (less than 5%) associated with this modality of administration, makes the efficient treatment of several ocular diseases a significant challenge. In the last decades, it has been shown that specific nanocarriers can interact with the ocular mucosa, thereby increasing the retention time of the associated drug onto the eye, as well as its permeability across the corneal and conjunctival epithelium. In this review, we comparatively analyze the mechanism of action and specific potential of the most studied nano-drug delivery carriers. In addition, we present the success achieved until now using a number of nanotherapies for the treatment of the most prevalent ocular pathologies, such as infections, inflammation, dry eye, glaucoma, and retinopathies.
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Affiliation(s)
- S Reimondez-Troitiño
- Nano-oncologicals Lab, Translational Medical Oncology Group, Health Research Institute of Santiago de Compostela (IDIS), Clinical University Hospital of Santiago de Compostela (CHUS), Santiago de Compostela, Spain; Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), Dept. of Pharmacy and Pharmaceutical Technology, School of Pharmacy, Univ. of Santiago de Compostela, Santiago de Compostela, Spain
| | - N Csaba
- Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), Dept. of Pharmacy and Pharmaceutical Technology, School of Pharmacy, Univ. of Santiago de Compostela, Santiago de Compostela, Spain
| | - M J Alonso
- Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), Dept. of Pharmacy and Pharmaceutical Technology, School of Pharmacy, Univ. of Santiago de Compostela, Santiago de Compostela, Spain
| | - M de la Fuente
- Nano-oncologicals Lab, Translational Medical Oncology Group, Health Research Institute of Santiago de Compostela (IDIS), Clinical University Hospital of Santiago de Compostela (CHUS), Santiago de Compostela, Spain.
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197
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Witting M, Obst K, Friess W, Hedtrich S. Recent advances in topical delivery of proteins and peptides mediated by soft matter nanocarriers. Biotechnol Adv 2015; 33:1355-69. [PMID: 25687276 DOI: 10.1016/j.biotechadv.2015.01.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 01/27/2015] [Accepted: 01/27/2015] [Indexed: 11/19/2022]
Abstract
Proteins and peptides are increasingly important therapeutics for the treatment of severe and complex diseases like cancer or autoimmune diseases due to their high specificity and potency. Their unique structure and labile physicochemical properties, however, require special attention in the production and formulation process as well as during administration. Aside from conventional systemic injections, the topical application of proteins and peptides is an appealing alternative due to its non-invasive nature and thus high acceptance by patients. For this approach, soft matter nanocarriers are interesting delivery systems which offer beneficial properties such as high biocompatibility, easiness of modifications, as well as targeted drug delivery and release. This review aims to highlight and discuss technological developments in the field of soft matter nanocarriers for the delivery of proteins and peptides via the skin, the eye, the nose, and the lung, and to provide insights in advantages, limitations, and practicability of recent advances.
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Affiliation(s)
- Madeleine Witting
- Department of Pharmaceutical Sciences, Ludwig-Maximilians-Universität, Munich, Germany
| | - Katja Obst
- Institute for Pharmaceutical Sciences, Freie Universität Berlin, Germany
| | - Wolfgang Friess
- Department of Pharmaceutical Sciences, Ludwig-Maximilians-Universität, Munich, Germany
| | - Sarah Hedtrich
- Institute for Pharmaceutical Sciences, Freie Universität Berlin, Germany.
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198
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Rossi A, Peix Á, Pavlikovskaya T, Sagach O, Nikolaenko S, Chizh N, Kartashev V, Simón F, Siles-Lucas M. Genetic diversity of Dirofilaria spp. isolated from subcutaneous and ocular lesions of human patients in Ukraine. Acta Trop 2015; 142:1-4. [PMID: 25447827 DOI: 10.1016/j.actatropica.2014.10.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/09/2014] [Accepted: 10/27/2014] [Indexed: 11/15/2022]
Abstract
This short communication describes the phylogenetic analysis of 48 Dirofilaria worms isolated from human patients in Ukraine. 102 cases were both of subcutaneous (47; 46.1%) and ocular (54; 52.9%) locations. Worms from 44 patients (15 subcutaneous and 29 ocular) were subjected to DNA extraction and amplification of a specific fragment of the 12S rRNA subunit, and sequences were used for phylogenetic analysis. Results showed that 13.8% of the ocular cases analyzed at molecular level were caused by Dirofilaria immitis. Very few cases of ocular human dirofilariosis due to D. immitis have been described in the literature to date, majority of them attributed to Dirofilaria repens. Our results show that ocular dirofilariosis cannot be excluded in areas of low endemicity for D. repens were D. immitis is also present.
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Affiliation(s)
- Alice Rossi
- Instituto de Recursos Naturales y Agrobiología de Salamanca, Agencia Estatal Consejo Superior de Investigaciones Científicas, Salamanca, Spain
| | - Álvaro Peix
- Instituto de Recursos Naturales y Agrobiología de Salamanca, Agencia Estatal Consejo Superior de Investigaciones Científicas, Salamanca, Spain
| | - Tamara Pavlikovskaya
- Central Sanitary and Epidemiological Station of the Ukrainian Ministry of Health, Kiev, Ukraine
| | - Olga Sagach
- Central Sanitary and Epidemiological Station of the Ukrainian Ministry of Health, Kiev, Ukraine
| | - Svetlana Nikolaenko
- Central Sanitary and Epidemiological Station of the Ukrainian Ministry of Health, Kiev, Ukraine
| | - Nina Chizh
- Central Sanitary and Epidemiological Station of the Ukrainian Ministry of Health, Kiev, Ukraine
| | - Vladimir Kartashev
- Department of Infectious Diseases, Rostov State Medical University, Rostov-na-Donu, Russia
| | - Fernando Simón
- Laboratory of Parasitology, Faculty of Pharmacy & IBSAL, University of Salamanca, Salamanca, Spain
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca, Agencia Estatal Consejo Superior de Investigaciones Científicas, Salamanca, Spain.
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199
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Seck SM, Agboton G, Gueye NN, Diop J, Seck CM, Lam A. [Epidemiological and clinical characteristics of primary ocular cancers in blacks: our experience with 111 cases]. J Fr Ophtalmol 2015; 38:41-5. [PMID: 25530349 DOI: 10.1016/j.jfo.2014.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 06/23/2014] [Accepted: 06/23/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION In this work, the authors aim to study clinical and epidemiological characteristics of ocular and orbital primary cancers in sub-Saharan African. PATIENTS AND METHODS This is a retrospective study over a period of 21 years, from 1984 to 2004, including all cases of ocular cancer, histologically proven after surgery of the globe or the orbit. For each patient, we studied the following parameters: age, sex, reason(s) for consultation, the affected eye, and histological result of the operative specimen. These data were collected by studying the departmental surgical registry, patient medical records and the tumor registry of the anatomicopathology laboratory of a tertiary care hospital in sub-Saharan Africa. RESULTS We collected data on 111 black patients, among whom 15 cases (13.5%) presented with bilateral involvement, for a total of 126 eyes. The sex ratio was 1.17. Presenting signs showed a predominance of leukocoria (30.2%) followed by proptosis (21.7%) and in third place, protruding conjunctival mass (10.8%). Retinoblastoma was found most frequently, representing 66.6% of the oculo-orbital tumors and 95.45% of the tumors of the globe; followed by epidermoid carcinoma, representing 15.08% of cases. Malignant melanoma was third most common, representing 4.76%, with 83% arising in the anterior uvea and 7% in the choroid. Basal cell carcinoma and rhabdomyosarcoma follow in fourth place. Basal cell carcinoma constituted half (50%) of the eyelid tumors. Rhabdomyosarcoma was the most common orbital tumor in our series (57%). Next were lymphomas with conjunctival localization (2.38%), acute leukemia with orbital localization (1.59%) and rare tumors, palpebral dermatofibrosarcoma (0.79%), an orbital angiosarcoma (0.79%), a glioblastoma of the globe (0.79%) and a malignant solitary fibrous tumor of the orbit (0.79%). CONCLUSION Ocular and orbital primary cancers in blacks remain tumors of the young, equally distributed between the sexes. Retinoblastoma is the most frequent, followed by epidermoid carcinoma. The globe is the preferential localization of these cancers.
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200
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Tsivgoulis G, Dervenoulas G, Kokotis P, Zompola C, Tzartos JS, Tzartos SJ, Voumvourakis KI. Double seronegative myasthenia gravis with low density lipoprotein-4 (LRP4) antibodies presenting with isolated ocular symptoms. J Neurol Sci 2014; 346:328-30. [PMID: 25248951 DOI: 10.1016/j.jns.2014.09.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 09/04/2014] [Accepted: 09/10/2014] [Indexed: 11/17/2022]
Abstract
The detection of low density lipoprotein-4 (LRP4) antibodies in double seronegative (dSN) myasthenia gravis (MG) patients has provided new insights in the diagnosis and treatment of MG. However, there are limited data regarding the clinical presentation and treatment response in dSN MG patients with LRP4-antibodies. We present a case series of three Caucasian dSN MG patients with positive LRP4-antibodies sharing a common ethnic background that presented with isolated ocular symptoms (MGFA I). The demographic and clinical characteristics, the diagnostic work-up as well as the treatment response during a follow-up period of 12-24 months are described in detail. All patients were treated successfully with acetylcholinesterase inhibitors (AcheI) and prednisone with two exhibiting full remission of their symptoms, while the remaining exhibited mild residual diplopia. Notably, we documented no signs of generalized disease progression, while no patient required immunosuppressive treatment. In conclusion, the distinct clinical phenotype of our patients highlights the clinical relevance of screening for LRP4-antibodies in patients presenting with isolated ocular MG independent of age and gender, since it may lead to the timely diagnosis of MG and prompt initiation of effective therapy with ACheI and corticosteroids.
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Affiliation(s)
- Georgios Tsivgoulis
- Second Department of Neurology, University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece; International Clinical Research Center, St. Anne's University Hospital in Brno, Czech Republic.
| | - Georgios Dervenoulas
- Second Department of Neurology, University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece
| | - Panagiotis Kokotis
- Second Department of Neurology, University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece; First Department of Neurology, University of Athens, School of Medicine, "Eginition" University Hospital, Athens, Greece
| | - Christina Zompola
- Second Department of Neurology, University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece
| | | | - Socrates J Tzartos
- Hellenic Pasteur Institute, Athens, Greece; Tzartos NeuroDiagnostics, Athens, Greece
| | - Konstantinos I Voumvourakis
- Second Department of Neurology, University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece
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