ABSTRACT
PURPOSE: Ibopamine is a prodrug of N-methyldopamine that has a non-cycloplegic mydriatic action due to its alpha-adrenergic properties and is able to induce, when topically given, a transient increase of intraocular pressure (IOP) in eyes with hydrodynamic disorders. METHODS: This is a randomized, crossover, open-labeled, two- center study. Forty patients (20 open-angle glaucoma patients and 20 healthy subjects) were treated with ibopamine 2% eye drops and phenylephrine 10% eye drops. RESULTS: Ibopamine induced a significant increase in IOP only in glaucomatous eyes (p<0.001) without a significant hypertensive effect in normal eyes. Ibopamine and phenylephrine showed a similar mydriatic activity but ibopamine was able to induce an hypertensive effect only in glaucomatous eyes. CONCLUSIONS: The results confirm the use of ibopamine as provocative test in detection of hydrodynamic disorders.
Subject(s)
Deoxyepinephrine/analogs & derivatives , Deoxyepinephrine/pharmacology , Glaucoma, Open-Angle/complications , Intraocular Pressure/drug effects , Mydriatics/pharmacology , Pupil/drug effects , Administration, Topical , Aged , Antihypertensive Agents/therapeutic use , Cross-Over Studies , Deoxyepinephrine/administration & dosage , Female , Glaucoma, Open-Angle/diagnosis , Glaucoma, Open-Angle/drug therapy , Humans , Male , Middle Aged , Mydriatics/administration & dosage , Ophthalmic Solutions/administration & dosage , Ophthalmic Solutions/pharmacology , Phenylephrine/administration & dosage , Phenylephrine/therapeutic use , Tonometry, OcularABSTRACT
The authors evaluated the effect of the replacement of beta-blockers with brimonidine drops in patients taking beta-blockers only or with dorzolamide, having IOP > 20 mmHg. The study was divided into two sections: one group treated with brimonidine b.i.d. (23 patients) and the other group treated with brimonidine + dorzolamide b.i.d. (17 patients). The effect of the substitution showed after 90 days of treatment with a reduction of 8.59 +/- 1.2 mmHg (P < 0.001) in the first group and 6.1 +/- 1.7 mmHg (P < 0.001) in the second group. Three patients in the first group and four patients in the second group presented minor adverse effects which did not justify discontinuation of treatment. Brimonidine was effective treatment as a substitute for beta-blockers only when associated with dorzolamide.
Subject(s)
Adrenergic alpha-Agonists/therapeutic use , Adrenergic beta-Antagonists/therapeutic use , Glaucoma, Open-Angle/drug therapy , Intraocular Pressure/drug effects , Quinoxalines/therapeutic use , Aged , Aged, 80 and over , Brimonidine Tartrate , Chronic Disease , Female , Humans , Male , Middle Aged , Prospective Studies , Treatment FailureABSTRACT
BACKGROUND: Solitary fibrous tumor (SFT), which usually presents in the pleura and is thought to be mesothelial in nature, has been recently discovered in extrapleural sites, including the orbit. Presently ultrastructural studies show absence of epithelial-mesothelial features, and reactivity of the tumor cells to CD34 antigen on immunohistochemical analysis suggests the mesenchymal origin of such tumors. CASE DESCRIPTION: A 40-year-old woman had a 4-year history of progressive swelling of her right upper lid and a slow-growing palpable mass of the orbit. CT and MR imaging showed a well circumscribed, nonenhanced extraconal mass with mild erosion of the right orbital roof. The tumor was totally excised. Histological examination disclosed a spindle-cell tumor in a dense fibrous tissue. Immunohistochemistry showed positive staining for vimentin and CD34. We review the clinical, diagnostic, and surgical features of 22 orbital SFTs including the present case. CONCLUSIONS: Orbital SFT generally pursues a slow, indolent, and nonaggressive course, reaches a size up to 4.5 cm, and can be cured by a single excision. It must be immunohistochemically differentiated from other spindle-cell tumors of the orbit.
Subject(s)
Neoplasms, Fibrous Tissue/diagnosis , Orbital Neoplasms/diagnosis , Adult , Antigens, CD34/metabolism , Female , Humans , Immunohistochemistry , Neoplasms, Fibrous Tissue/metabolism , Neoplasms, Fibrous Tissue/pathology , Neoplasms, Fibrous Tissue/surgery , Orbital Neoplasms/metabolism , Orbital Neoplasms/pathology , Orbital Neoplasms/surgery , Vimentin/metabolismSubject(s)
Cataract/congenital , Glaucoma/congenital , Adult , Cataract/diagnostic imaging , Ciliary Body/surgery , Follow-Up Studies , Glaucoma/diagnostic imaging , Glaucoma/surgery , Gonioscopy , Humans , Intraocular Pressure , Laser Coagulation , Male , Retinal Detachment/surgery , Scleral Buckling , UltrasonographySubject(s)
Deoxyepinephrine/analogs & derivatives , Deoxyepinephrine/administration & dosage , Mydriatics/administration & dosage , Refraction, Ocular/physiology , Aged , Aged, 80 and over , Female , Humans , Intraocular Pressure/drug effects , Male , Middle Aged , Ophthalmic Solutions , Prospective StudiesABSTRACT
PURPOSE: Up to date the pathogenetic aspects of exfoliation syndrome which are not well agreed upon even though the vascular damage plays a major role. METHODS: In order to evaluate the electrophysiological changes occurring in patients affected by exfoliation syndrome a case-control study with pattern electrofunctional examinations and oscillatory potentials from standard flash-ERG in 80 eyes affected by exfoliation syndrome with or without ocular hypertension was undertaken. RESULTS: Some statistically significant PERG, P-PEV and OP abnormalities were found in eyes affected by exfoliation syndrome with or without ocular hypertension (p < 0.001). There is no statistically significant difference between affected and control eyes in monolateral syndrome (p > 0.05). The electrofunctional examination did not mark any statistically significant difference between eyes with and without ocular hypertension (p > 0.05). CONCLUSION: The results stressed by pattern and oscillatory potentials examinations may support the hypothesis of a primitive change of the optic nerve.
Subject(s)
Exfoliation Syndrome/physiopathology , Adult , Aged , Electroretinography , Evoked Potentials, Visual , Female , Humans , Male , Middle Aged , Ocular Hypertension/physiopathology , Oscillometry , Prospective StudiesABSTRACT
Pattern-reversal electroretinograms (PERG) and visual evoked potentials (P-VEP) were measured for 10 eyes from 10 rigorously selected patients with bilateral advanced primary open angle glaucoma (POAG), before and after surgical trabeculectomy. The aim was to establish whether electrofunctional examinations improved after major IOP reduction. Only one eye at random was operated, and the fellow eye was used as control. The aim of this study, using electrofunctional examinations, was to clarify whether ganglion cell damage was reversible after marked reduction of IOP by surgery. The results indicate that glaucomatous damage seems to be irreversible.
