Influence of a new slow-release GnRH analogue implant on reproduction in the Budgerigar (Melopsittacus undulatus, Shaw 1805).

The neuroendocrine conditioning of reproduction in birds could perform a very important role in captive breeding, especially in endangered species. Whereas in domestic and wild mammals pharmacological reproductive conditioning is well developed, in birds an effective method is not available. The aim of this study was to test the influence of a new slow-release GnRH analogue (buserelin acetate) implant on the reproductive activity of the Budgerigar (Melopsittacus undulatus), used as model species for captive-bred endangered birds. The effects were assessed by looking at reproductive parameters (egg-laying rate, egg fertility rate) and measuring excreted sex steroid metabolite concentrations in male and female birds. Modification of reproductive parameters and steroid metabolites excretion patterns were observed among birds administered with a GnRH analogue implant and maintained under artificial photoperiod (group I; 16L:8D). Implanted birds showed higher rates of egg-laying, potentially a higher proportion of fertile eggs and higher excreted steroid metabolite concentrations than birds maintained under natural photoperiod (group II; 10L:14D) and birds maintained under artificial photoperiod (group III; 16L:8D). Thus, it is concluded that the new slow-release GnRH analogue implant may represent an innovative and practicable treatment to rapidly induce reproductive activity in the Budgerigar, and that excreted sex hormone metabolites detection permits to monitor male and female gonadal activity.

The annular tinted contact lens syndrome: corneal topographic analysis of ring-shaped irregular astigmatism caused by annular tinted contact lenses.

PURPOSE: Irregular corneal astigmatism has been reported in association with annular tinted hydrogel contact lenses. We report the abnormal videokeratographic findings of five patients wearing annular tinted contact lenses, who presented with bilateral blurred vision and revealed a loss of best corrected visual acuity. METHODS/RESULTS: The corneal topographic analysis revealed a previously unreported distinct ring-shaped pattern of irregular astigmatism. The topographic circular band of irregular astigmatism was further characterized by concentric areas of relative steepening, flattening, and steepening with a diameter of approximately 4 mm. This pattern suggests that forces acting at the junctional zone between the tinted area and the clear pupillary area are inducing structural abnormalities of the corneal surface. At the time of presentation, the mean surface regularity index (SRI) was 2.06 (range: 0.61-5.88). The topography and best-corrected visual acuity returned to normal within days of discontinuing annular tinted lens use, and the mean SRI decreased to 0.44 (range: 0.21-1.16). Digital imaging of lenses obtained from our patients and of identical control lenses was performed. A masked analysis suggested that the study lenses contain greater amounts of pigment compared to the control lenses. CONCLUSIONS: We present ten characteristic signs and symptoms of this condition, which we have named "the annular tinted contact lens syndrome." Corneal topographic analysis is a powerful tool for detecting specific reversible irregularities of the corneal surface associated with the use of annular tinted contact lenses.

Clinical and overnight corneal swell comparison of the 1-Day Acuvue lens versus the Medalist, Surevue, Biomedics, and Acuvue lenses.

PURPOSE: We characterized the clinical performance of the 1-Day Acuvue contact lens by direct comparison with four frequently prescribed daily wear lenses. METHODS: Forty-eight patients participated in four prospective, randomized masked clinical trials using the 1-Day Acuvue in one eye and the Medalist, Surevue, Acuvue (regular), and Biomedics 55 lenses in the other eye. Each trial lasted 2 weeks. Thirteen symptom variables and overall lens preference were evaluated using a patient preference questionnaire and a symptom-ranking questionnaire. Overnight corneal swell studies were also performed. RESULTS: In the non-allergic (58.4%) subgroup, the overall lens preference variable revealed a significant preference for the Medalist (P = .004), Surevue (P < .001), and Biomedics 55 (P < .001) lenses. In contrast, in the allergic (41.6%) subgroup, the overall lens preferences for the Medalist, Surevue, and Biomedics 55 lenses were completely absent. Multivariate regression analysis in the non-allergic subgroup revealed that lens comfort (.58, P < .001), lens handling upon insertion (.41, P < .001), and quality of vision (.35, P < .001) were significant variables contributing to patient responses regarding overall lens preference. However, in the allergic subgroup, only the lens comfort (.92, P < .001) variable is significant and appears to dominate the decision making. The overnight corneal swell evaluation revealed no significant differences between the 1-Day Acuvue and the Medalist lens. Patients wearing regular Acuvue had significantly less corneal swelling upon awakening (P = .005) and at 60 minutes after awakening (P = .003). CONCLUSIONS: The Medalist, Surevue, and Biomedics 55 lenses outperformed the 1-Day Acuvue lens in the non-allergic subgroup. In the allergic subgroup, there was no statistically significant difference between the 1-Day Acuvue lens and all other lenses tested.

Clinical performance of the Optima toric contact lens versus the CSI toric contact lens.

PURPOSE: To compare the clinical performance of the Optima soft toric contact lens versus the CSI soft toric contact lens. METHODS: Twenty-one patients (five affected by allergies) were followed at 2-week intervals for 4 months in a prospective, randomized, double-masked study comparing the Optima soft toric contact lens to the CSI soft toric contact lens. RESULTS: The patients preference evaluation revealed a statistically significant preference for the CIS toric lens in 14 of 16 variables including overall lens preference (P = 0.0001). The two remaining variables, lens awareness (P = 0.07) and foreign body sensation (P = 0.06), showed a trend toward a preference for the CSI toric lens. The less sensitive symptom ranking questionnaire revealed a significance for, or a trend toward, a significant difference in three of 10 variables, all in favor of the CSI toric lens. The mean degrees of axis rotation were 3.5* for the CSI lens and 7.6* for the Optima lens (P = 0.0001). Factor analysis identified a clustering of variables around specific ranked factors. Factors related to 1) allergy status (.93); 2) visual function (.87); 3) ocular surface (.82); and 4) refractive characteristics (.71) were most significant in determining the overall clinical performance of these toric lenses. Allergic patients significantly preferred the CSI toric lens for 15 of 16 variables, whereas non-allergic patients preferred the CSI lens for seven of 16 variables. CONCLUSIONS: The patient preference, symptom ranking, and axis rotation analysis of this study revealed a superior performance by the CSI toric contact lens when compared to the Optima toric contact lens. Allergic patients revealed an even stronger and statistically significant preference for the CSI lens when compared to non-allergic patients.

Mottled cyan opacification of the posterior cornea in contact lens wearers.

PURPOSE: We studied patients who had mottled cyan-colored opacities of the cornea to better understand the cause and prognosis of this entity. METHODS: We reviewed examinations of patients who had a mottled cyan opacification of the cornea. Risk factors, including contact lens wear and exposure to heavy metals, were analyzed. Clinical findings, pachymetry specular microscopy, and progression of the abnormality were noted. RESULTS: Six patients who had a mottled cyan opacification at the level of Descemet's membrane were identified. These opacities were located in the peripheral and midperipheral cornea. All patients had bilateral findings, had visual acuities of 20/20 or better, and were asymptomatic. All patients had worn soft contact lenses bilaterally for periods ranging from seven to 14 years. CONCLUSION: All patients had the similar clinical appearance of a mottled cyan opacification at the level of Descemet's membrane in the peripheral cornea. Long-term contact lens wear appears to be associated; however, the exact cause is unclear.

The clinical performance of the Surevue, Focus, and CSI daily wear lenses in allergic and normal contact lens patients.

Sixty-three daily wear contact lens patients (42 non-allergic [66.7%] and 21 allergic [33.3%]) were randomized into three groups (CSI vs. Surevue; Focus vs. CSI; Focus vs. Surevue) and evaluated every two weeks for six months with regard to patient preferences and ranked symptom responses for 14 variables, including overall contact lens preference. Allergic patients (43.9 +/- 94.3 ng/mL) revealed significantly higher (P = .011) tear IgE levels versus non-allergic patients (15.6 +/- 25.8 ng/mL). Non-allergic patients preferred CSI over Surevue for 12 of 14 variables including overall lens preference (P < .001); CSI over Focus for 6 of 14 variables, including overall lens preference (P < .009); and Focus over Surevue for 13 of 14 variables, including overall lens preference (P < .001). In contrast, allergic patients preferred Focus over CSI for 8 of 14 variables; CSI over Surevue for 4 of 14 variables, including overall lens preference (P < .001); Focus over Surevue for 4 of 14 variables, including overall lens preference (P < .001). Surevue and Focus lenses were replaced at 4 and 8 week intervals, respectively. No significant differences in the ranked symptom responses were observed for Surevue at 4 weeks versus 2 weeks, or for Focus at 8 weeks versus 4 weeks. A regression of time versus symptom responses for non-allergic patients wearing the CSI lens revealed decreasing symptoms over time, while the allergic patients showed no significant difference.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of the clinical performance of the Acuvue disposable contact lens and CSI lens in patients with giant papillary conjunctivitis.

Anecdotal reports have suggested that the use of disposable contact lenses is an effective treatment for giant papillary conjunctivitis. In a prospective randomized double-masked study, we compared the clinical performance of the Acuvue (Vistakon, Jacksonville, Florida) disposable contact lens to the traditional daily-wear lens of choice, CSI (Pilkington Barnes Hind, Sunnyvale, California), in 37 patients with previously diagnosed giant papillary conjunctivitis who were examined at one-month intervals for six months. A survey questionnaire for grading symptoms disclosed significant improvement in itching, discharge, and blurred vision in both groups early in the study. Evaluation of patient preference showed that the CSI lens was strongly preferred with regard to lens handling (76% vs 8%). In contrast, the Acuvue lens was strongly preferred with regard to lens comfort (62% vs 11%). For the variable of overall lens preference, there was no significant difference between the two lenses (CSI, 43% and Acuvue, 41%). Multiple regression analysis disclosed that both lens comfort (P < .002) and lens handling (P = .05) contributed significantly to the choices made regarding the dependent variable of overall lens preference. Lens comfort (beta = .71) was observed to be approximately 50% more powerful than lens handling (beta = .48). There was no significant difference in the rate or cost of torn lenses between groups, suggesting that the Acuvue lens can withstand the physical manipulation associated with daily-wear use for up to one month. The results of this study suggest that the use of disposable contact lenses for the treatment of giant papillary conjunctivitis is at least as effective as the traditional daily-wear lens of choice.

Total pupillary capture with a foldable silicone intraocular lens.

We report a case of total pupillary capture on the 1st postoperative day in a patient who had undergone phacoemulsification and placement of a silicone foldable posterior chamber intraocular lens. Anterior displacement of the lens optic resulted in 2.25 diopters of induced myopia. Dilation of the pupil corrected the lens capture and reversed the induced myopia, yielding a refraction of plano. Higher rates of pupillary capture have been associated with sulcus fixation and nonangulated flexible (polypropylene) haptics. Contraction of the capsular bag on the flexible polypropylene haptics of this silicone lens is thought to force the optic anteriorly, increasing the probability of lens capture by the iris.

Branch retinal artery occlusion secondary to percutaneous transluminal coronary angioplasty.

We report on a patient suffering a branch retinal artery occlusion immediately following percutaneous transluminal coronary angioplasty. Balloon angioplasty may produce ocular embolic events consistent with previously reported neurological complaints.

Dietary myo-inositol effect on sugar cataractogenesis.

The lens myo-inositol (MI) content is known to be depleted during initial cataractogenesis in both streptozocin (STZ)-induced diabetic and 50% galactose-maintained rats. The objective of this study is to establish whether dietary MI supplementation protects lens transparency, MI content and individual fiber cell ultrastructure is both model systems of sugar cataract. In the diabetic study, after induction with STZ, rats were immediately placed on normal chow supplemented with 2% MI for 14 weeks while additional age-matched control and diabetic rats remained untreated. Within 14 weeks, untreated diabetic rat lenses were totally opaque with undetectable MI content; MI was undetectable by 1 month. These opaque lenses were devoid of fiber cells and exhibited only acellular, amorphous cortical regions between 0 and 500 microns from the capsule. In contrast, 14-week, MI-treated diabetic rat lenses exhibited only cortical vacuolation indicative of initial cataractogenesis; MI content was 0.41 +/- 0.26 mumol/g wet weight of lens. Scanning electron micrographs indicated a granulated, acellular region subadjacent to the capsule and confirmed the presence of cortical fiber cells, approximately 100 microns from the capsule. In 50% galactose-maintained rats, daily administration of MI for 1 month was unable to prevent total opacification or reverse initial cataractogenesis indicating that in rapidly progressing galactose cataracts, MI was unable to protect lens transparency, MI content and cortical fiber ultrastructure. The combined results suggest that MI may exert a protective effect on the slowly developing diabetic cataract. Of the 2 models, the time course and polyol content in STZ diabetic lenses more closely correlate to the human diabetic lens which has a low activity of aldose reductase; therefore, it is possible that MI may exert a protective effect in human diabetic cataract.

Neurologic complications of herpes zoster.

Encephalitis, contralateral hemiplegia and postherpetic neuralgia are the most serious neurologic sequelae of herpes zoster infections. Encephalitis occurs more frequently in the presence of cutaneous dissemination and cranial nerve lesions. Contralateral hemiplegia following herpes zoster ophthalmicus results from vasculitic and thrombotic lesions. The combination of a tricyclic antidepressant and a phenothiazine is the most effective medical treatment for postherpetic neuralgia.

Herpes zoster ophthalmicus.

The incidence and severity of herpes zoster ophthalmicus have increased because of the growing number of immunocompromised patients. Uveitis and keratitis are the most common inflammatory complications. Corneal exposure from scarring and contraction of the upper lid may require reconstructive plastic surgery. Preliminary studies of oral acyclovir, specifically targeted at preventing ocular complications, are encouraging.