RESUMO
PURPOSE: To delineate morphometric and quantitative features of the capillary image derived from high-resolution fundus fluorescein angiography (FFA) and consequently determine the diagnostic value of FFA for studying the retinal capillary circulation. METHODS: Retinal capillary images obtained from healthy young subjects using high-resolution FFA were compared with confocal scanning laser microscopic capillary images derived from the retinas of age-matched human donors. Confocal microscopic images were acquired from retinal flatmount tissue after central retinal artery cannulation, perfusion fixation, and antibody labeling. Capillary images from equivalent retinal regions were morphologically and quantitatively analyzed in both groups. RESULTS: Ten human subjects (mean age, 27.4 years) were used for FFA studies, and five cadaveric eyes (mean donor age, 26.5 years) were used for histologic studies. In histologic specimens the density of the superficial capillary network was significantly greater than that of the deep capillary network. Despite use of a healthy young population, only 30% of high-resolution FFA studies provided clear capillary images. The configuration of the capillary network in FFA images was comparable to the superficial capillary network in confocal microscope images; however, the density of the capillary network in FFA images was consistently lower than that of histologic images. CONCLUSIONS: FFA provides incomplete morphologic information about the superficial capillary network and even less information about the deep capillary network. Caution should, therefore, be exercised when using FFA data to extrapolate information about microvascular histopathologic processes. The usefulness of newer technology for studying retinal capillary detail should be investigated.
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Angiofluoresceinografia , Vasos Retinianos/anatomia & histologia , Adulto , Capilares/anatomia & histologia , Feminino , Humanos , Masculino , Microscopia Confocal , Reprodutibilidade dos Testes , Adulto JovemRESUMO
Corneal neovascularization can be a difficult problem to treat. The authors describe a patient with lipid keratopathy secondary to corneal neovascularization treated with photodynamic therapy. Six months following treatment the neovascularization has not returned and the lipid keratopathy has not increased in size. No significant side effects from the treatment occurred. Photodynamic therapy with Verteporfin was a useful treatment modality in this case of corneal neovascularization with associated lipid keratopathy.
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Ophthalmic imaging has changed dramatically since the 1960s with increasingly complex technologies now available. Arguably, the greatest changes have been the development of the digital camera and the speed, processing power and storage of electronic data. Already, ophthalmic practices in many major institutions overseas have paperless medium storage and electronically generated reporting from all equipment that use a computer interface. It is hard to remember the widespread use of photographic film with its attendant costs, or even to remember the days before optical coherence tomography (OCT). These latest technical improvements in ophthalmic imaging are now standard in large Australian institutions and becoming more widespread in smaller private practices. The technicians that operate and maintain this ever-increasing plethora of gadgetry have seen their work practices change from the darkroom to the complexities of data-based imaging and storage. It is a fitting time to examine the contemporary state of ophthalmic imaging and what lies on the horizon as we move towards 2020.
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Diagnóstico por Imagem/tendências , Olho/patologia , Olho/fisiopatologia , Corantes , Diagnóstico por Computador , Diagnóstico por Imagem/instrumentação , Angiofluoresceinografia , Fundo de Olho , Humanos , Imageamento Tridimensional , Verde de Indocianina , Microscopia Confocal , Oftalmoscopia , Fotografação/instrumentação , Fotografação/métodos , Retina/patologia , Tomografia de Coerência Óptica , Interface Usuário-ComputadorRESUMO
The synthesis of a novel gut selective MTP inhibitor, 5-[(4'-trifluoromethyl-biphenyl-2-carbonyl)-amino]-1H-indole-2-carboxylic acid benzylmethyl carbamoylamide (dirlotapide), and its in vitro and in vivo profile are described. Dirlotapide (3) demonstrated excellent potency against MTP enzyme in HepG2 cells and canine hepatocytes. This novel MTP inhibitor also showed excellent efficacy when tested in a canine food intake model.
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Carbamatos/síntese química , Ácidos Carboxílicos/química , Ácidos Carboxílicos/síntese química , Proteínas de Transporte/antagonistas & inibidores , Química Farmacêutica/métodos , Indóis/síntese química , Obesidade/tratamento farmacológico , Animais , Carbamatos/química , Carbamatos/farmacologia , Ácidos Carboxílicos/farmacologia , Cães , Desenho de Fármacos , Avaliação Pré-Clínica de Medicamentos , Humanos , Concentração de Íons de Hidrogênio , Técnicas In Vitro , Indóis/química , Indóis/farmacologia , Concentração Inibidora 50 , Modelos Químicos , Conformação Molecular , RatosRESUMO
BACKGROUND: Retinal vein pulsation is often absent in glaucoma, but can be induced by applying a graded ophthalmodynamometric force (ODF) to the eye, which is elevated in glaucoma. AIM: To assess whether ODF has a predictive value in determining glaucoma progression. METHODS: 75 patients with glaucoma and suspected glaucoma were examined prospectively in 1996, and then re-examined at a mean of 82 months later. All subjects had intraocular pressure, visual fields, stereo optic disc photography and ODF measured on their initial visit. When venous pulsation was spontaneous, the ODF was said to be 0 g. At re-examination, central corneal thickness and blood pressure were also measured. Initial and subsequent optic disc photographs were compared and graded into those that had increased excavation and those that had remained stable. The relationship between increased excavation (recorded as a binary response) and the measured variables was modelled using a multiple mixed effects logistic regression. RESULTS: ODF at the initial visit was strongly predictive of increased excavation (p = 0.004, odds ratio 1.16/g, range 0-60 g), with greater predictive value in women than in men (p = 0.004). Visual field mean deviation was predictive of increased excavation (p = 0.044), as was optic nerve haemorrhage in association with older age (p = 0.038). Central corneal thickness was not significantly predictive of increased excavation (p = 0.074) after having adjusted for other variables. CONCLUSION: ODF measurement seems to be strongly predictive of the patient's risk for increased optic disc excavation. This suggests that ODF measurement may have predictive value in assessing the likelihood of glaucoma progression.
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Glaucoma/diagnóstico , Disco Óptico/fisiopatologia , Veia Retiniana/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Métodos Epidemiológicos , Feminino , Glaucoma/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmodinamometria , Fluxo Pulsátil , Resistência Vascular , Campos VisuaisRESUMO
Western Australia has a large landmass and low population density. Dating back to the 1970s and even today, specialist medical services are often lacking or non-existent outside of Perth, the capital city. Diabetes has always been a major health problem, particularly in the Australian Aboriginal community. In conjunction with the Lions Save Sight Foundation and Diabetes Foundation of Western Australia a diabetic screening programme was initiated in 1978 for rural and remote diabetics. The programme aimed to screen for diabetic retinopathy, educate diabetics, medical and paramedical personnel and to arrange treatment for sight threatening eye disease. Eye screening continues to date although the role of the Lions Eye Institute has changed from programme initiator to reading centre and teaching unit, and continues to evolve with changing technologies.
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Diabetes Mellitus/diagnóstico , Programas de Rastreamento/métodos , Ilustração Médica , Havaiano Nativo ou Outro Ilhéu do Pacífico , Humanos , Fotografação , Telemedicina/métodos , Austrália OcidentalRESUMO
We have successfully identified a number of novel MTP inhibitors with single digit nanomolar potency. Analogues 10aq and 10dq demonstrated in vivo efficacy in a murine gut retention assay.
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Fármacos Antiobesidade/síntese química , Fármacos Antiobesidade/farmacologia , Proteínas de Transporte/antagonistas & inibidores , Administração Oral , Animais , Fármacos Antiobesidade/administração & dosagem , Fármacos Antiobesidade/química , Proteínas de Transporte/metabolismo , Camundongos , Estrutura Molecular , Relação Estrutura-AtividadeRESUMO
We report a case of a displaced laser in situ keratomileusis flap. The flap displacement was enhanced by using cross-polarized filters.