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Latanoprost and brimonidine: Therapeutic and physiologic assessment before and after oral nonsteroidal anti-inflammatory therapy

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2002年第1期133卷 11-18页

作者： Sponsel, WE Paris, G Trigo, Y Pena, M Weber, A Sanford, K McKinnon, S Univ Texas Hlth Sci Ctr S Texas Ocular Imaging Ctr Dept Ophthalmol San Antonio TX 78229 USA

PURPOSE: To assess, before and during oral nonsteroidal anti,inflammatory drug coadministration, latanoprost's and brimonidine's hypotensive action in eyes at risk of glaucomatous progression, assessing the effect of each drug on ocular perfusion and visual function. METHODS: Twenty consenting adults with open-angle glaucoma or ocular hypertension underwent a double. masked, bilateral, randomized prospective study. Treatment started with either latanoprost 0.005% in the morning and placebo in the evening, or brimonidine 0.2% twice daily in one eye;after 1 week starting the other in the fellow eye. After another week, oral indomethacin 25 mg four times a day, commenced for 2 more weeks. Intraocular pressure, ocular circulation, and visual function were monitored pretreatment, after unilateral monotherapy (day 7), bilateral ocular therapy (day 14), and coadministered oral indomethacin (day 28). Intrasubject differences (interocular and intraocular rel, ative to baseline) were determined by two,tailed paired t test. RESULTS: A loss of the significance of intraocular pressure reduction with brimonidine was noted after oral indomethacin coadministration (- 14%;P =.004 for brimonidine alone versus -11%;P =.3 with indomethacin). Significant intraocular pressure reduction with latanoprost persisted despite indomethacin (-25%;P <.0001 for latanoprost alone versus -30%;P <.0001 with indomethacin). Pulsatile ocular blood flow increased 40% with latanoprost but was unchanged with brimonidine (interdrug difference, P =.004). Midperipheral retinal microcirculation increased 23% (P =.03) with latanoprost. Humphrey perimetry and contrast sensitivity remained consistently at or above baseline with both latanoprost and brimonidine. Indomethacin had no significant effect on ocular perfusion or visual function measures. CONCLUSIONS: Circulatory and hydrodynamic find, ings differed substantially for the two drugs. The loss of significance of intraocular pressure reduction with brimonidi

关键词：喹恶啉类/投药和剂量喹恶啉类/治疗应用视网膜血管/药物作用视野/药物作用

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Photodynamic therapy of a subretinal neovascular membrane in type 2A idiopathic juxtafoveolar retinal telangiectasis

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2002年第1期133卷 149-151页

作者： Potter, MJ Szabo, SM Chan, EY Morris, AHC Univ British Columbia Dept Ophthalmol Vancouver BC V5Z 3N9 Canada

PURPOSE: To report the outcome of a patient with a subretinal neovascular membrane secondary to idiopathic juxtafoveolar retinal telangiectasis treated with photodynamic female therapy. METHODS: Interventional case report. A 43 year old female with type 2A idiopathic juxtafoveolar retinal telangiectasis presented with a 2-week history of decreased vision and a subretinal neovascular membrane in the left eye. RESULTS: Visual improvement from 20/70-2 to 20/50-2 in the left eye was observed after two photodynamic therapy treatments of a juxtafoveal subretinal neovascular membrane with verteporfin, and was maintained through 7 months of follow,up. Fluorescein angiography showed no leakage specific to the subretinal neovascular membrane, but leakage from the juxtafoveal telangiectasis continued. CONCLUSION: A substantial improvement was seen in this patient after treatment of the juxtafoveal subretinal neovascular membrane by photodynamic therapy. Given the poor prognosis of these lesions, photodynamic therapy may therefore be a useful treatment for patients with subretinal neovascular membranes associated with idiopathic juxtafoveolar retinal telangiectasis. (Am J Ophthalmol 2002;133:149-151. (C) 2002 by Elsevier Science Inc. All rights reserved).

关键词：荧光素血管造影术眼底光化学疗法光敏感药/治疗应用卟啉类/治疗应用视网膜疾病/并发症视网膜疾病/诊断视网膜疾病/药物疗法视网膜新生血管化/诊断视网膜新生血管化/药物疗法视网膜新生血管化/病因学视网膜血管/药物作用视网膜血管/病理学毛细血管扩张/并发症毛细血管扩张/诊断毛细血管扩张/药物疗法治疗结果视敏度成年人女(雌)性人类

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Decreased macular leukocyte velocity in human immunodeficiency virus-infected individuals

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2001年第5期132卷 711-719页

作者： Lim, MC Cumberland, WG Minassian, SL Ransome, SS Cornish, MJ Terry, BG Holland, GN Univ Calif Los Angeles Sch Med Jules Stein Eye InstOcular Inflammatory Dis Ctr So Calif HIV Eye Consortium Los Angeles CA 90095 USA Univ Calif Los Angeles Sch Med Dept Ophthalmol Los Angeles CA 90095 USA Univ Calif Los Angeles Sch Publ Hlth UCLA AIDS Inst Los Angeles CA 90024 USA Univ Calif Los Angeles Sch Publ Hlth Dept Biostat Los Angeles CA 90024 USA Community Eye Med Pasadena CA USA

PURPOSE: To determine whether human immunodeficiency virus (HIV)-infected individuals have decreased macular capillary blood flow in vivo. DESIGN: Case control study. METHODS: Macular leukocyte velocity and perceived leukocyte density were determined in 41 HIV-infected individuals without cytomegalovirus retinitis and 31 HIV-negative control subjects using the blue field simulation technique (BFS-2000, Oculix, Inc., Jenkintown, PA). Velocity and density measurements for HIV,infected individuals were compared to current and lowest previous CD4+ T-lymphocyte counts, HIV RNA blood levels, and blood leukocyte counts. RESULTS: Mean macular leukocyte velocity was lower in HIV-infected individuals than in controls (P = 0.0006). No correlations were identified between velocity measurements and the following factors in HIV-infected individuals: current or lowest previous CD4+ T-lymphocyte count;or HIV RNA blood level. Mean perceived leukocyte density in HIV-infected individuals was lower than in controls (P = 0.003), but was not correlated with blood leukocyte count in HIV-infected individuals. No relationships were identified between macular leukocyte velocity and duration of medication use or duration of elevated CD4+ T-lymphocyte count in patients receiving potent antiretroviral therapy. CONCLUSIONS: Reduced macular leukocyte velocity may have important implications for understanding the retinal microvasculopathy of HIV disease, the pathogenesis of opportunistic retinal infections, and visual dysfunction in HIV-infected individuals who do not have opportunistic retinal infections. We found no evidence that macular leukocyte velocity increased with immune reconstitution. (C) 2001 by Elsevier Science Inc. All rights reserved.

关键词：抗病毒药/治疗应用血流速度 CD4淋巴细胞计数毛细血管病例对照研究眼感染病毒性/药物疗法眼感染病毒性/病理生理学 HIV感染/药物疗法 HIV感染/病理生理学 HIV-1/遗传学白细胞计数白细胞/生理学 RNA 病毒/血液视网膜疾病/药物疗法视网膜疾病/病理生理学视网膜血管/药物作用视网膜血管/病理生理学视觉内视成年人人类

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Frosted branch angiitis in a child with HIV infection

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2001年第3期131卷 394-396页

作者： Fine, HF Smith, JA Murante, BL Nussenblatt, RB Robinson, MR NEI Clin Res Training Program NIH Bethesda MD 20892 USA NEI Immunol Lab NIH Bethesda MD 20892 USA Univ Rochester Strong Mem Hosp Childrens Hosp Strong Dept Pediat Infect Dis Rochester NY 14642 USA NEI Off Clin Director NIH Bethesda MD 20892 USA

PURPOSE: In adults with human immunodeficiency virus (HIV) infection, frosted branch angiitis is commonly associated with cytomegalovirus retinitis and responds to anti-cytomegalovirus therapy. We describe the first pediatric case of HIV-associated frosted branch angiitis. METHODS: Case report. RESULTS: A 7-year-old HIV-infected male with frosted branch angiitis was refractory to induction doses of intravenous ganciclovir and foscarnet over a 2-month period. Although cytomegalovirus antigenemia resolved, the angiitis only improved after subsequent treatment with systemic corticosteroids, CONCLUSION: Frosted branch angiitis in this patient was not attributed to cytomegalovirus. The pathogenesis of HIV-associated frosted branch angiitis may differ between children and adults. (Am J Ophthalmol 2001;131:394-396, (C) 2001 by Elsevier Science Inc. All rights reserved.).

关键词：抗病毒药/治疗应用巨细胞病毒视网膜炎/并发症巨细胞病毒视网膜炎/诊断巨细胞病毒视网膜炎/药物疗法膦甲酸/治疗应用更昔洛韦/治疗应用糖皮质激素类/治疗应用 HIV感染/并发症 HIV感染/诊断 HIV感染/药物疗法视网膜疾病/诊断视网膜疾病/药物疗法视网膜疾病/病因学视网膜血管/药物作用视网膜血管/病理学血管炎/诊断血管炎/药物疗法血管炎/病因学儿童人类男(雄)性

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Bax is increased in the retina of diabetic subjects and is associated with pericyte apoptosis in vivo and in vitro

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AMERICAN JOURNAL OF PATHOLOGY 2000年第3期156卷 1025-1032页

作者： Podestà, F Romeo, G Liu, WH Krajewski, S Reed, JC Gerhardinger, C Lorenzi, M Harvard Univ Sch Med Schepens Eye Res Inst Boston MA 02114 USA Harvard Univ Sch Med Dept Ophthalmol Boston MA 02114 USA Burnham Inst La Jolla CA 92037 USA

Diabetes of even short duration accelerates the death of capillary cells and neurons in the inner retina by a process consistent with apoptosis. We examined whether the process is accompanied by changes in the expression of endogenous regulators of apoptosis. In postmortem retinas of 18 diabetic donors (age 67 +/- 6 years, diabetes duration 9 +/- 4 years) the levels of pro-apoptotic Bax were slightly, but significantly, increased when compared with levels in 20 age-matched nondiabetic donors (P = 0.04). In both groups, Bax localized to vascular and neural cells of the inner retina. Neither pro-apoptotic Bcl-X-S, nor pro-survival Bcl-X-L appeared affected by diabetes. The levels of these molecules could not be accurately quantitated in lysates of retinal vessels because of variable degrees of glial contamination. However, studies in situ showed in several pericytes, the outer cells of retinal capillaries, intense Bax staining often in conjunction with DNA fragmentation. Bovine retinal pericytes exposed in vitro to high glucose levels for 5 weeks showed elevated levels of Bax (P = 0.03) and increased frequency of annexin V binding, indicative of early apoptosis, Hence, human diabetes selectively alters the expression of Bax in the retina and retinal vascular pericytes at the same time as it causes increased rates of apoptosis. The identical program induced by high glucose in vitro implicates hyperglycemia as a causative factor in vivo, and provides a model for establishing the role of Bax in the accelerated death of retinal cells induced by diabetes.

关键词：膜联蛋白A5/代谢细胞凋亡印迹法蛋白质细胞培养的糖尿病视网膜病变/代谢糖尿病视网膜病变/病理学葡萄糖/药理学免疫组织化学原位缺口末端标记分子序列数据周细胞/药物作用周细胞/代谢周细胞/病理学原癌基因蛋白质类/遗传学原癌基因蛋白质类/代谢原癌基因蛋白质c-bcl-2/遗传学原癌基因蛋白质c-bcl-2/代谢 RNA 信使/代谢视网膜/代谢视网膜/病理学视网膜血管/药物作用视网膜血管/代谢视网膜血管/病理学逆转录聚合酶链反应 bcl-2相关X蛋白质 bcl-X蛋白质老年人女(雌)性人类男(雄)性

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Labial adenocarcinoma after treatment with cyclosporin a in a patient with panuveitis

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第1期130卷 127-128页

作者： Ramchandani, M Brown, AMS Rippin, JW Murray, PI City Hosp NHS Trust Birmingham & Midland Eye Hosp Div Immuni & Infect Acad Unit Ophthalmol Birmingham B18 7QU W Midlands England

PURPOSE: To report a case of labial basal cell adenocarcinoma in a patient with uveitis on treatment with cyclosporin A. METHOD: Case report. A 73-year-old woman with panuveitis and retinal vasculitis presented with a lump on her lip after 52 months of treatment with cyclosporin A. RESULT: Excision biopsy showed a labial adenocarcinoma. CONCLUSION: Malignancy can occur after long-term cyclosporin A treatment for uveitis. (C) 2000 by Elsevier Science Inc. All rights reserved.

关键词：腺癌/化学诱导腺癌/病理学环孢菌素/治疗应用免疫抑制剂/治疗应用唇肿瘤/化学诱导唇肿瘤/病理学全葡萄膜炎/药物疗法泼尼松龙/治疗应用视网膜疾病/药物疗法视网膜血管/药物作用血管炎/药物疗法老年人女(雌)性人类

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Atypical reginal vasculitis associated with ticlopidine hydrochloridine use

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第5期129卷 684-685页

作者： Barak, A Morse, LS Schwab, IR Univ Calif Davis Dept Ophthalmol Sacramento CA 95817 USA

PURPOSE: To describe two cases of retinal vasculitis shortly after the initiation of ticlopidine hydrochloride (Ticlid, Roche, Kingsland St, NJ) therapy. METHODS: Case reports of two patients, The first patient was a 43-year-old white woman complaining of spots, floaters, and flashes of lights in both eyes 3 weeks after the initiation of treatment with ticlopidine hydrochloride. The second patient was a 72-year-old woman complaining of decreased visual acuity in the left eye for 2 weeks ,4 weeks after initiating oral administration of ticlopidine hydrochloride. RESULTS: Both patients had resolution of the vasculitis after the discontinuation of ticlopidine therapy. CONCLUSION: The temporal relation and the resolution of symptoms after discontinuation of ticlopidine hydrochloride:suggest:that the vasculitis was related to the ticlopidine:hydrochloride administration. Knowledge of this potential complication of ticlopidine hydrochloride is important for the early diagnosis of this possible druginduced side effect and the cessation of ticlopidine hydrochloride. (C) 2000 by Elsevier Science Inc. All rights reserved.

关键词：荧光素血管造影术眼底视网膜疾病/化学诱导视网膜疾病/病理生理学视网膜血管/药物作用视网膜血管/病理生理学血管炎/化学诱导血管炎/病理生理学视敏度成年人老年人女(雌)性人类

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