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1.
Eur Arch Otorhinolaryngol ; 278(9): 3541-3550, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33721067

ABSTRACT

PURPOSE: To propose a new objective, video recording method for the classification of unilateral peripheral facial palsy (UPFP) that relies on mathematical algorithms allowing the software to recognize numerical points on the two sides of the face surface that would be indicative of facial nerve impairment without positioning of markers on the face. METHODS: Patients with UPFP of different House-Brackmann (HB) degrees ranging from II to V were evaluated after video recording during two selected facial movements (forehead frowning and smiling) using a software trained to recognize the face points as numbers. Numerical parameters in millimeters were obtained as indicative values of the shifting of the face points, of the shift differences of the two face sides and the shifting ratio between the healthy (denominator) and the affected side (numerator), i.e., the asymmetry index for the two movements. RESULTS: For each HB grade, specific asymmetry index ranges were identified with a positive correlation for shift differences and negative correlation for asymmetry indexes. CONCLUSIONS: The use of the present objective system enabled the identification of numerical ranges of asymmetry between the healthy and the affected side that were consistent with the outcome from the subjective methods currently in use.


Subject(s)
Bell Palsy , Facial Paralysis , Face , Facial Nerve , Facial Paralysis/diagnosis , Humans , Video Recording
2.
Ophthalmologica ; 229(4): 219-26, 2013.
Article in English | MEDLINE | ID: mdl-23615390

ABSTRACT

PURPOSE: To assess the effect of citicoline on visual field rates of progression in patients with progressing glaucoma. PATIENTS AND METHODS: Forty-one patients with a diagnosis of progressing glaucoma received citicoline in oral solution for 2 years. Included were patients with a disease progression of at least -1 dB/year (at MD, mean deviation) for at least 3 years before entering the study despite controlled intraocular pressure (IOP). Patients were followed with 4 visual field examinations per year for 2 years. RESULTS: At baseline, the mean rate of progression was -1.1 (±0.7) dB/year despite the fact that the IOP had been below 18 mm Hg for at least 3 years. At study inclusion, the mean IOP was 15.5 (±2.6) mm Hg and the mean MD was -9.2 (±6.7) dB in the worst eye. Starting from the first cycle of treatment with citicoline, the mean rate of progression significantly changed to -0.15 (±0.3) dB/year at the end of the study (p = 0.01). CONCLUSIONS: This study seems to indicate that supplementation with citicoline might significantly slow down glaucomatous rates of progression.


Subject(s)
Cytidine Diphosphate Choline/administration & dosage , Glaucoma, Open-Angle/drug therapy , Intraocular Pressure/physiology , Visual Fields , Administration, Oral , Aged , Disease Progression , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Glaucoma, Open-Angle/physiopathology , Humans , Intraocular Pressure/drug effects , Male , Nootropic Agents/administration & dosage , Prospective Studies , Treatment Outcome
3.
Eye (Lond) ; 26(11): 1424-30, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22975658

ABSTRACT

PURPOSE: To evaluate whether a difference in central corneal thickness (CCT) between the paired eyes could be associated to worse glaucoma in the thinner cornea eye. METHODS: From 16 different glaucoma centres, at least 50 glaucomatous patients were saved on the Italian Glaucoma Register. Eight hundred and sixteen glaucomatous patients were found in the register. CCT, ophthalmoscopic cup/disc ratio, mean deviation (MD), pattern SD (PSD), and intraocular pressure (IOP). The difference (Δ) between the paired eyes was calculated for all the considered parameters and two subgroups were created on the basis of ΔCCT. Because the difference between the two eyes could be positive or negative, the absolute value of Δ was considered for all the measurements. Three different ΔCCT cutoffs were selected: 10, 15, and 20 µm. Student's t-test was used to compare the subgroups. RESULTS: When the entire group was divided in two subgroups using 20 µm as ΔCCT cutoff, no significant difference was found for ΔIOP (-0.38 ± 2.53 (mean ± SD) mm Hg and -0.07 ± 2.35 mm Hg, respectively) between the two subgroups. Significant (P<0.001) difference was found for ΔMD (6.58 ± 7.30 and 3.14 ± 4.22 dB, respectively), ΔPSD (3.92 ± 4.01 and 2.16 ± 2.57, respectively), and ΔC/D (0.11 ± 0.14 and 0.08 ± 0.11, respectively) between the two subgroups. No significant correlation was found between ΔCCT and the other parameters. CONCLUSION: The ΔCCT between the two eyes could be associated to a worse glaucoma in the thinner cornea eye.


Subject(s)
Cornea/pathology , Glaucoma/diagnosis , Optic Disk/pathology , Optic Nerve Diseases/diagnosis , Vision Disorders/diagnosis , Aged , Corneal Pachymetry , Cross-Sectional Studies , Gonioscopy , Humans , Intraocular Pressure/physiology , Middle Aged , Registries , Retrospective Studies , Severity of Illness Index , Visual Acuity/physiology , Visual Field Tests , Visual Fields
4.
Br J Ophthalmol ; 95(9): 1276-83, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21131377

ABSTRACT

AIM: To examine the level of agreement among nine clinicians in assessing progressive deterioration in visual field (VF) overview using three different methods of analysis. METHODS: Each visual field was assessed by Humphrey Field Analyzer (HFA), program 24-2 SITA Standard. Nine expert clinicians assessed the progression status of each series by using HFA 'overview printouts' (HFA OP), the Guided Progression Analysis (GPA) and the Guided Progression Analysis (GPA2). VF series were presented in random order, but each patient's VF remained in chronological order within a given field series. Each clinician adopted his personal methods based on his knowledge to evaluate VF progression. The level of agreement between the clinicians was evaluated by using weighted κ statistics. RESULTS: A total of 303 tests, comprising 38 visual field series of 7.9 ± 3.4 tests (mean ± SD), were assessed by the nine glaucoma specialists. When the intra-observer agreement was evaluated between HFA OP and GPA, the mean κ statistic was 0.58 ± 0.13, between HFA OP and GPA2, κ was 0.55 ± 0.06 and between GPA and GPA2 it was 0.56 ± 0.17. When the inter-observer agreement was analysed κ statistic was 0.65 for HFA OP, 0.54 for GPA and 0.70 for GPA2. CONCLUSIONS: Using any procedure for evaluating the progression of a series of VF, agreement between expert clinicians is moderate. Clinicians had higher agreement when GPA2 was used, followed by HFA OP and GPA printouts, but these differences were not significant.


Subject(s)
Glaucoma, Open-Angle/physiopathology , Visual Field Tests/methods , Visual Fields/physiology , Aged , Disease Progression , Follow-Up Studies , Glaucoma, Open-Angle/diagnosis , Humans , Male , Prognosis , ROC Curve , Retrospective Studies , Time Factors
5.
Inorg Chem ; 49(11): 5216-22, 2010 Jun 07.
Article in English | MEDLINE | ID: mdl-20426405

ABSTRACT

Since the discovery of a formal quintuple bond in Ar'CrCrAr' (CrCr = 1.835 A) by Power and co-workers in 2005, many efforts have been dedicated to isolating dichromium species featuring quintuple-bond character. In the present study we investigate the electronic configuration of several, recently synthesized dichromium species with ligands using nitrogen to coordinate the metal centers. The bimetallic bond distances of Power's compound and Cr(2)-diazadiene (1) (CrCr = 1.803 A) are compared to those found for Cr(2)(mu-eta(2)-ArNC(R)NAr)(2) (2) (CrCr = 1.746 A; R = H, Ar = 2,6-Et(2)C(6)H(3)), Cr(2)(mu-eta(2)-Ar(Xyl)NC(H)NAr(Xyl))(3) (3) (CrCr = 1.740(reduced)/1.817(neutral) A; Ar(Xyl)= 2,6-C(6)H(3)-(CH(3))(2)), Cr(2)(mu-eta(2)-TippPyNMes)(2) (4) (CrCr = 1.749 A; TippPyNMes = 6-(2,4,6-triisopropylphenyl)pyridin-2-yl (2,4,6-trimethylphenyl)amide), and Cr(2)(mu-eta(2)-DippNC(NMe(2))N-Dipp)(2) (5) (CrCr = 1.729 A, Dipp = 2,6-i-Pr(2)C(6)H(3)). We show that the correlation between the CrCr bond length and the effective bond order (EBO) is strongly affected by the nature of the ligand, as well as by the steric hindrance due to the ligand structure (e.g., the nature of the coordinating nitrogen). A linear correlation between the EBO and CrCr bond distance is established within the same group of ligands. As a result, the CrCr species based on the amidinate, aminopyridinate, and guanidinate ligands have bond patterns similar to the Ar'CrCrAr' compound. Unlike these latter species, the dichromium diazadiene complex is characterized by a different bonding pattern involving Cr-Npi interactions, resulting in a lower bond order associated with the short metal-metal bond distance. In this case the short CrCr distance is most probably the result of the constraints imposed by the diazadiene ligand, implying a Cr(2)N(4) core with a closer CrCr interaction.

6.
Eur J Ophthalmol ; 19(1): 66-71, 2009.
Article in English | MEDLINE | ID: mdl-19123151

ABSTRACT

PURPOSE: To compare the efficacy and tolerability of a once-daily evening dose of bimatoprost/timolol fixed combination (BTFC) with that of a once-daily evening dose of latanoprost/timolol fixed combination (LTFC) in patients not controlled with prostaglandins analogues monotherapy. METHODS: A total of 82 patients on prostaglandin analogues monotherapy were enrolled in this prospective, multicenter, investigator masked, clinical study and were randomized to either BTFC (n=47) or LTFC (n=35) topical therapy once at night for 12 weeks. The primary endpoint of the study was to compare the mean daily intraocular pressure (IOP) reduction from baseline between the two treatment arms. Secondary endpoints included the mean daily IOP at 1 and 3 months compared to baseline and the percentage of patients showing a mean IOP reduction from baseline greater than or equal to 15% or 20%. RESULTS: Mean IOP at baseline was 22.7+/-2.0 and 22.1+/-2.6 mmHg in the BTFC and LTFC groups, respectively (p=0.23). Both treatments were effective in reducing the IOP from baseline. The mean IOP reduction was significantly greater in the BTFC group than in the LTFC group (-21.4% vs -13.7%, p<0.001). A higher percentage of patients in the BTFC group showed a mean IOP reduction from baseline >or=15% (72.3% vs 40.0%) and >or=20% (61.7% vs 17.1%) compared to patients in the LTFC group. CONCLUSIONS: Both BTFC and LTFC were more effective versus the monotherapy with prostaglandin analogues. BTFC demonstrated higher performance than LTFC in terms of relative IOP reduction.


Subject(s)
Amides/therapeutic use , Antihypertensive Agents/therapeutic use , Cloprostenol/analogs & derivatives , Glaucoma, Open-Angle/drug therapy , Intraocular Pressure/drug effects , Prostaglandins F, Synthetic/therapeutic use , Timolol/therapeutic use , Aged , Amides/adverse effects , Antihypertensive Agents/adverse effects , Bimatoprost , Cloprostenol/adverse effects , Cloprostenol/therapeutic use , Double-Blind Method , Drug Combinations , Female , Follow-Up Studies , Humans , Latanoprost , Male , Middle Aged , Prospective Studies , Prostaglandins F, Synthetic/adverse effects , Timolol/adverse effects , Tonometry, Ocular , Treatment Outcome
7.
Br J Ophthalmol ; 92(12): 1656-60, 2008 Dec.
Article in English | MEDLINE | ID: mdl-18829632

ABSTRACT

AIM: The aim of the study was to investigate the role of Humphrey Matrix threshold testing in the detection of early functional retinal impairment in subjects with type 1 diabetes mellitus (DM1) without any signs of retinal vasculopathy, and to investigate the relationship between both functional and structural retinal parameters and metabolic control. METHODS: Thirty eyes of 30 subjects with DM1, with no sign of retinal vasculopathy, and 30 eyes of 30 age- and sex-matched healthy subjects were enrolled in this cross-sectional clinical study. Functional testing included Humphrey Matrix perimetry and white-on-white Humphrey visual field perimetry (HFA), while retinal nerve fibre layer (RNFL) thickness was measured by scanning laser polarimetry with variable corneal birefringence compensator (GDx VCC). RESULTS: Matrix mean deviation (MD) was found to be significantly reduced in subjects with DM1 compared with controls (-1.10 (SD 2.98; 95% CI -2.21 to 0.01) vs 1.37 (SD 2.11; 95% CI 0.58 to 2.16), p = 0.0005). HFA MD and pattern standard deviation (PSD) were significantly worse in subjects with DM1 compared with controls (p = 0.010 and p = 0.013 respectively). Among structural parameters, average peripapillary RNFL thickness was reduced in DM1 subjects (p = 0.006). Matrix MD and HFA MD and PSD, and average peripapillary and superior RNFL, were significantly reduced in subjects with DM1 with HbA(1c) > or = 7% compared with controls. CONCLUSIONS: Functional and structural retinal testing by Humphrey Matrix and GDx VCC could be useful for the identification of early retinal impairment in people with DM1 with no sign of retinal vasculopathy.


Subject(s)
Diabetes Mellitus, Type 1/complications , Diabetic Retinopathy/diagnosis , Visual Field Tests/methods , Adult , Cross-Sectional Studies , Diagnostic Techniques, Ophthalmological/instrumentation , Early Diagnosis , Female , Humans , Intraocular Pressure , Male , Severity of Illness Index
8.
Eur J Ophthalmol ; 17(3): 341-9, 2007.
Article in English | MEDLINE | ID: mdl-17534814

ABSTRACT

PURPOSE: To compare the prevalence of side effects between eyedrops with or without preservatives, in terms of subjective symptoms and objective signs in patients with open-angle glaucoma. METHODS: In a multicenter cross-sectional epidemiologic survey in four European countries, ophthalmologists in private practice enrolled 9658 nonconsecutive patients using preservative (P) or preservative-free (PF) beta-blocking eyedrops between June 1997 and December 2003. Subjective symptoms, conjunctival and palpebral signs, and superficial punctate keratitis were explored before and after a change in therapy. For statistical analysis, a Chi-square test was used to calculate the differences in the prevalence of symptoms and signs with or without preservatives. RESULTS: A total of 74% of the patients used P, 12% PF, 10% a P-PF combination, and in 4% the type of medication was unknown. Each recorded symptom and all the palpebral, conjunctival, and corneal signs were significantly more frequent (p<0.0001) in the P-group than in the PF-group, such as pain or discomfort during instillation (48 vs 19%), foreign body sensation (42 vs 15%), stinging or burning (48 vs 20%), and dry eye sensation (35 vs 16%). A total of 68% of the patients had a sec-ond visit performed, of whom 63% (6083) had been evaluated on treatment difference. A significant decrease (p<0.0001) of all ocular symptoms and signs was observed in patients in whom the preserved eyedrops were diminished in number or altered into preservative free drops. CONCLUSIONS: Compared to preserved eyedrops, preservative free eyedrops are significantly less associated with ocular symptoms and signs of irritation.


Subject(s)
Adrenergic beta-Antagonists/adverse effects , Conjunctival Diseases/chemically induced , Eyelid Diseases/chemically induced , Glaucoma/drug therapy , Keratitis/chemically induced , Preservatives, Pharmaceutical/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Antihypertensive Agents/adverse effects , Child , Cross-Sectional Studies , Female , Humans , Incidence , Male , Middle Aged , Ophthalmic Solutions/adverse effects
9.
Br J Ophthalmol ; 89(6): 689-93, 2005 Jun.
Article in English | MEDLINE | ID: mdl-15923503

ABSTRACT

AIM: To evaluate changes in corneal polarisation properties and their influence on peripapillary retinal nerve fibre layer (RNFL) thickness measurements after laser assisted in situ keratomileusis (LASIK) by means of scanning laser polarimetry (SLP) with variable corneal polarisation compensator (VCC) in normal white subjects. METHODS: SLP was performed by means of GDx VCC on 32 eyes of 32 normal subjects who underwent LASIK for ametropia correction. Corneal polarisation axis and magnitude and RNFL thickness were measured before and 8 days after LASIK. RNFL thickness data and corneal polarimetric data of one randomly selected eye per subject were analysed by the Wilcoxon signed ranks test. Correlations between corneal ablation depth, corneal polarimetric changes, and RNFL thickness changes were investigated using Spearman's rho test. RESULTS: The corneal polarisation axis significantly shifted from 15.1 degrees (17.0 degrees ) to 6.9 degrees (12.9 degrees ) (p = 0.00006) after LASIK and this change showed a strong correlation with corneal ablation depth (rho = -0.7, p = 0.00002). Among GDx parameters, TSNIT, SUP, and SD showed significant changes after LASIK and for SUP and SD these changes were well correlated with the shift in corneal polarisation axis (rho = 0.54, p = 0.03 and rho = 0.45, p = 0.01, respectively). SUP and SD changes were neutralised after compensating for corneal polarimetric changes but not TSNIT changes. NFI, a discriminating parameter, was found to be affected after LASIK only after compensating for corneal polarimetric changes. CONCLUSIONS: LASIK induces a shift in corneal polarisation axis which is responsible for inaccuracies in RNFL thickness measurements. A customised compensation for corneal polarimetric changes after LASIK allows normalisation of some of the thickness parameters except for TSNIT and NFI.


Subject(s)
Cornea/physiopathology , Keratomileusis, Laser In Situ , Refractive Surgical Procedures , Retinal Ganglion Cells/pathology , Adult , Birefringence , Female , Humans , Male , Middle Aged , Nerve Fibers/pathology , Postoperative Period , Refraction, Ocular , Refractive Errors/pathology , Refractive Errors/physiopathology
10.
Eur J Ophthalmol ; 14(6): 486-94, 2004.
Article in English | MEDLINE | ID: mdl-15638097

ABSTRACT

PURPOSE: To evaluate the neural conduction along crossed and uncrossed visual pathways in patients with ocular hypertension (OHT). METHODS: Fifteen patients (mean age 59.1+/-6.8 years) with OHT (IOP>22 mmHg, Humphrey 24-2 with mean deviation [MD]>-2 dB) were enrolled. They were compared to 15 age-matched controls. In OHT patients and control subjects, visual evoked potentials (VEPs) were recorded using full-field checkerboard patterns (the check subtended 15' of visual arc; contrast 80%) reversed at 2 Hz. VEP responses were simultaneously recorded in the homolateral visual cortex (HC) and in the contralateral visual cortex (CC), with respect to the stimulated eye. RESULTS: In OHT patients, VEP P100 implicit times observed in HC and CC were both significantly delayed (analysis of variance, p<0.01) when compared to those of controls, and, in particular, longer in CC than in HC. The interhemispheric differences (ID: P100 implicit time in HC - P100 implicit time in CC) were significantly higher in OHT patients than controls (-3.16+/-1.80 msec and 1.16+/-1.04 msec, respectively, p=0.001). In OHT patients we observed an MD hemifield difference (difference between nasal and temporal MD values) higher than in controls (-0.82+/-0.80 dB and 0.04+/-1.03 dB, respectively, p<0.01) and significantly correlated with the ID (r: 0.836, p<0.001). CONCLUSIONS: The observed asymmetry in the bioelectrical cortical responses and in the visual hemifield parameters suggests that crossed visual pathways could be impaired earlier than uncrossed visual pathways in OHT patients.


Subject(s)
Neural Conduction , Ocular Hypertension/physiopathology , Visual Pathways/physiopathology , Aged , Evoked Potentials, Visual , Humans , Intraocular Pressure , Middle Aged , Reaction Time , Visual Field Tests , Visual Fields
14.
Eur J Ophthalmol ; 12(4): 276-80, 2002.
Article in English | MEDLINE | ID: mdl-12219996

ABSTRACT

PURPOSE: To study pulsatile ocular blood flow (POBF) throughout pregnancy. METHODS: We enrolled twenty-seven healthy women in the first trimester of gestation, only ten of which were followed through the second trimester, and fourteen non pregnant healthy women. In each subject we measured POBF with the POBF pneumotonometer (OBF Ltd. UK), IOP, blood pressure (BP) and heart rate (HR). An unpaired Student t-test was used to compare pregnant women with non-pregnant women, and a two-tailed paired Student t-test was used to compare the same women in the first and second trimester of pregnancy. p <0.05 is considered statistically significant. RESULTS: Results are presented as means +/- SD. In the first trimester of pregnancy the age was 32 +/- 6, POBF 1516.4 +/- 382 ml/min, IOP 13 +/- 3 mmHg, BP 92 +/- 6 mmHg, and HR 86 +/- 14 beats/min. In the second trimester POBF was 1629.11 +/- 352.4 ml/min, intraocular pressure (IOP) 12 +/- 3 mmHg, BP 96 +/- 3 mmHg, and HR 93 +/- 10 beats/min. In the control group the age was 27 +/- 9, POBF 972.23 +/- 329.3 ml/min, BP 88 +/- 4.3 mmHg, and HR 80 +/- 14 beats/min. POBF increases during the first trimester (p = 0.00008). In the second trimester POBF was higher compared to the first trimester (p = 0.0008). Non significant differences were observed for the other parameters. CONCLUSIONS: The POBF increases throughout gestation. During pregnancy there is an increase in estrogen which induces endothelial-dependent vasodilatation in several tissues. The estrogen changes may influence POBF.


Subject(s)
Eye/blood supply , Pregnancy/physiology , Pulsatile Flow/physiology , Adolescent , Adult , Blood Flow Velocity , Blood Pressure/physiology , Endothelium, Vascular/physiology , Estrogens/physiology , Female , Heart Rate/physiology , Humans , Intraocular Pressure/physiology , Pregnancy Trimester, First , Pregnancy Trimester, Second , Tonometry, Ocular , Vasodilation/physiology
15.
Ophthalmology ; 108(5): 905-12, 2001 May.
Article in English | MEDLINE | ID: mdl-11320021

ABSTRACT

OBJECTIVE: [corrected] To correlate the nerve fiber layer (NFL) thickness and the visual function evaluated by electrophysiologic retinal and cortical responses assessed in open-angle glaucoma (OAG) eyes. DESIGN: Prospective case-control study. PARTICIPANTS: Thirty glaucoma patients (mean age, 47.1 +/- 7.15 years; refractive error range, +/- 2 spherical equivalent) with a mean deviation of computerized static perimetry (24/2 Humphrey, Dublin, CA) from -5 to -28 dB and intraocular pressure less than 21 mmHg on pharmacologic treatment and 14 age-matched control participants. METHODS: Nerve fiber layer thickness was measured by optical coherence tomography. Retinal and visual pathway function was assessed by simultaneously recording pattern electroretinograms (PERGs) and visual evoked potentials (VEPs) using high-contrast (80%) checkerboard stimuli (the single check edges subtend 15 minutes of the visual arc) reversed at the rate of two reversals per second. Linear regression analyses were adopted to establish the correlation between NFL thickness and PERG and VEP parameters. MAIN OUTCOME MEASURES: Nerve fiber layer thickness measurements in each quadrant (superior, inferior, nasal, and temporal) were taken and then averaged (12 values averaged) and identified as NFL overall, whereas the data obtained in the temporal quadrant only (three values averaged) were identified as NFL temporal. PERG P50 implicit time and P50-N95 amplitude and VEP P100 implicit time and N75-P100 amplitude were also measured. RESULTS: In OAG eyes, we found a significant (P < 0.01) reduction in NFL thickness in both NFL overall and NFL temporal evaluations with respect to the values observed in control eyes. PERG and VEP parameters showed a significant (P < 0.01) delay in implicit time and a reduction in peak-to-peak amplitude. In OAG eyes, the NFL overall and NFL temporal values were significantly correlated (P < 0.01) with the PERG P50 implicit time and P50-95 peak-to-peak amplitude. No correlations (P > 0.01) between NFL values and VEP parameters were found. CONCLUSIONS: There is a correlation between PERG changes and NFL thickness, but there is no correlation between VEP changes and NFL thickness in patients affected by OAG.


Subject(s)
Diagnostic Techniques, Ophthalmological , Glaucoma, Open-Angle/diagnosis , Glaucoma, Open-Angle/physiopathology , Nerve Fibers/pathology , Retina/physiopathology , Visual Pathways/physiopathology , Adult , Electroretinography , Evoked Potentials, Visual , Female , Humans , Interferometry , Intraocular Pressure , Light , Male , Middle Aged , Optic Nerve/pathology , Prospective Studies , Retinal Ganglion Cells/pathology , Tomography/methods
16.
Graefes Arch Clin Exp Ophthalmol ; 238(4): 302-5, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10853928

ABSTRACT

PURPOSE: To assess the acute intraocular hypotensive efficacy of brimonidine tartrate 0.2% (a highly selective alpha2-adrenergic agonist) compared with dorzolamide 2% (a topical carbonic anhydrase inhibitor) as adjunct therapy to topical beta-blockers in patients with primary open-angle glaucoma. METHODS: A randomized cross-over masked study was performed. We enrolled one eye of each of 28 patients who were on different beta-blocker therapy. We measured the intraocular pressure (IOP) 2 h after the beta-blocker instillation; we then randomly administered one of the two drugs and we compiled an IOP diurnal curve. One month later we repeated the same procedures with the second drug. Unpaired Mann-Whitney U-test was used to compare decreases in IOP between the two drugs (P<0.05). RESULTS: Both brimonidine 0.2% and dorzolamide 2% have good ocular hypotensive efficacy, significantly lowering IOP when compared to beta-blocker therapy alone, for the whole diurnal curve. Maximum mean percent IOP decrease from baseline was 22.0+/-15.7% (4.0+/-2.9 mmHg) for dorzolamide 2% 6 h after instillation and 35.5+/-16.4% (7.0+/-4.1 mmHg) for brimonidine 0.2% 8 h after administration of the drug. When we compared the two treatments, brimonidine 0.2% showed a higher hypotensive effect than 2% dorzolamide after 4 h (28.4+/-16.8% vs 17.6 +/-9.3%; P=0.04) and 8 h (35.5+/-16.4% vs 21.6 +/-10.8%; P=0.04). CONCLUSION: This study indicates that 0.2% brimonidine acutely associated with beta-blockers is an interesting new combination treatment useful in the management of glaucoma.


Subject(s)
Adrenergic alpha-Agonists/therapeutic use , Adrenergic beta-Antagonists/therapeutic use , Carbonic Anhydrase Inhibitors/therapeutic use , Glaucoma, Open-Angle/drug therapy , Intraocular Pressure/drug effects , Quinoxalines/therapeutic use , Sulfonamides/therapeutic use , Thiophenes/therapeutic use , Adrenergic alpha-Agonists/administration & dosage , Adrenergic beta-Antagonists/administration & dosage , Aged , Aged, 80 and over , Brimonidine Tartrate , Carbonic Anhydrase Inhibitors/administration & dosage , Cross-Over Studies , Double-Blind Method , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Ophthalmic Solutions/administration & dosage , Ophthalmic Solutions/therapeutic use , Quinoxalines/administration & dosage , Sulfonamides/administration & dosage , Thiophenes/administration & dosage , Tonometry, Ocular , Treatment Outcome
17.
Br J Ophthalmol ; 84(7): 786-7, 2000 Jul.
Article in English | MEDLINE | ID: mdl-10873995

ABSTRACT

AIMS: To investigate the relation between pulse amplitude (PA), pulsatile ocular blood flow (POBF), and sex and hormonal status. METHODS: Measurements of POBF and PA were obtained by ocular blood flow tonography in 76 healthy subjects: 32 males and 44 females (age range 17-77 years). Females were divided into two age groups: group 1 (premenopausal) 17-42 years, and group 2 (post-menopausal) 55 years old and over. Two groups of age matched males served as controls. RESULTS: Premenopausal females demonstrated a significantly higher rate of POBF and PA than age matched males and post-menopausal females. CONCLUSION: Sex and hormonal status were shown to influence choroidal circulation.


Subject(s)
Choroid/blood supply , Hormones/physiology , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Postmenopause/physiology , Premenopause/physiology , Pulsatile Flow/physiology , Pulse , Regional Blood Flow/physiology , Sex Factors
19.
Invest Ophthalmol Vis Sci ; 40(11): 2520-7, 1999 Oct.
Article in English | MEDLINE | ID: mdl-10509645

ABSTRACT

PURPOSE: To assess whether a correlation exists between optic nerve fiber layer (NFL) thickness and the retinal or visual pathway function in multiple sclerosis (MS) patients previously affected by optic neuritis. METHODS: Fourteen patients with a diagnosis of definite MS were examined. All had been affected by optic neuritis (MSON) with complete recovery of visual acuity (14 eyes included in study). These were compared with 14 eyes from 14 age-matched control subjects. NFL thickness was measured by optical coherence tomography (OCT). Three different measurements in each quadrant (superior, inferior, nasal, and temporal) were taken and averaged. The data in all quadrants (12 values averaged) were identified as NFL Overall, whereas the data obtained in the temporal quadrant only (3 values averaged) were identified as NFL Temporal. Retinal and visual pathway function was assessed by simultaneously recording pattern electroretinograms (PERGs) and visual evoked potentials (VEPs) using high-contrast (80%) checkerboard stimuli subtending 15 minutes and 60 minutes of the visual arc (min arc) and reversed at the rate of two reversals per second. RESULTS: In MSON eyes there was a significant (P < 0.01) reduction in NFL thickness in both NFL Overall and NFL Temporal evaluations compared with the values observed in control eyes. PERG, (15-min arc checks) and VEP (15-min arc and 60-min arc checks), showed a significant (P < 0.01) delay in latency and reduction in amplitude. NFL Overall and NFL Temporal values were significantly correlated (P < 0.01) to the PERG P50 latency and P50 to N95 amplitude recorded with 15-min arc checks. No correlations (P > 0.01) between NFL values and the other electrophysiological data (PERG recorded with 60-min arc checks and VEP recorded with 15-min arc and 60-min arc checks) were found. CONCLUSIONS: There is a correlation between PERG changes and NFL thickness in MS patients previously affected by optic neuritis, but there is no correlation between VEP changes and NFL thickness.


Subject(s)
Evoked Potentials, Visual , Multiple Sclerosis/physiopathology , Nerve Fibers/pathology , Optic Nerve/pathology , Optic Neuritis/physiopathology , Retina/physiopathology , Visual Pathways/physiopathology , Adult , Electroretinography , Female , Humans , Male , Multiple Sclerosis/complications , Multiple Sclerosis/pathology , Optic Neuritis/complications , Optic Neuritis/pathology , Tomography/methods
20.
Pharmacol Res ; 40(3): 249-55, 1999 Sep.
Article in English | MEDLINE | ID: mdl-10479469

ABSTRACT

PURPOSE: The retinal dysfunction and the delayed visual cortex responses shown by patients affected by glaucoma can be objectively assessed by Pattern Electroretinogram (PERG) and Visual Evoked Potentials (VEP) recordings. The present study aims to evaluate the effects of nicergoline on the retinal function and on the visual cortical responses in glaucoma patients. METHODS: Sixty patients (mean age 44.6+/-3.7) with open angle glaucoma were enrolled. The patients were divided into two groups: NG Group, where 30 patients were treated with nicergoline (Cebran((R)), 2 cps day) for 30 days; and CG Group, where 30 patients were not treated. Simultaneous recordings of PERG and VEP were performed in NG patients at the baseline, at 30 days after treatment with nicergoline (day 30), and at 45 days from the end of the treatment (day 75). PERG and VEP were recorded in CG patients at the baseline and after 30 and 75 days. The visual stimulus for recording PERGs and VEPs was a checkerboard whose elements subtended a visual arc of 60' and 15' with a 70% contrast, and alternated at a frequency of 2 Hz. RESULTS: At the baseline none of the electrophysiological parameters observed in NG Group patients differed (P>0.05) from those of CG Group patients. At days 30 and 75, in CG Group patients the values of the PERG and VEP parameters were unmodified (P>0.05) with respect to the baseline. In NG Group patients, the 30-day treatment period with nicergoline induced a significant (P<0.01) improvement of the PERG and VEP parameters. At day 75 all the electrophysiological parameters of NG Group did not differ significantly (P>0.05) from those at the baseline. CONCLUSION: Treatment with nicergoline induces an improvement of the retinal function and of the visual cortical responses in patients affected by glaucoma. This effect disappears within 45 days after the suspension of the treatment.


Subject(s)
Adrenergic alpha-Antagonists/pharmacology , Glaucoma, Open-Angle/drug therapy , Glaucoma, Open-Angle/physiopathology , Nicergoline/pharmacology , Retina/drug effects , Visual Cortex/drug effects , Adult , Electrophysiology , Electroretinography/drug effects , Evoked Potentials, Visual/drug effects , Female , Humans , Male , Middle Aged , Neural Conduction/drug effects , Retina/physiopathology , Visual Cortex/physiopathology
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