Visual acuity in contact lens wearers.

PURPOSE: The difference between high- and low-contrast visual acuity provides a sensitive indicator of vision loss in ocular disease; however, the effect of refractive error correction on this difference is still debated. METHODS: High- and low-contrast visual acuity was measured in 116 rigid gas permeable contact lens wearers, 51 spectacle wearers, and 50 soft contact lens wearers with habitual and best correction. Twenty-nine of the soft contact lens wearers reported that they wore disposable contact lenses (discarded on a monthly or more frequent basis), whereas the other 21 soft contact lens wearers wore traditional soft contact lenses. RESULTS: Rigid gas permeable contact lens wearers had statistically worse high-contrast habitual visual acuity than spectacle wearers (Tukey-Kramer, p = 0.0075). Traditional soft contact lens wearers had significantly worse low-contrast visual acuity compared with all other groups (Tukey-Kramer, p < 0.02 for each comparison). Traditional soft contact lens wearers had a significantly larger difference between high- and low-contrast visual acuity with best correction compared with rigid gas permeable wearers (Tukey-Kramer, p = 0.0099). CONCLUSIONS: Rigid gas permeable contact lens wearers had statistically worse habitual high-contrast visual acuity compared with spectacle wearers, but no difference was present under best-corrected conditions. We hypothesize that rigid gas permeable contact lens wearers were not wearing their optimal correction habitually. Traditional soft contact lens wearers had significantly worse low-contrast visual acuity. They also had a larger difference between their best-corrected high- and low-contrast visual acuity scores compared with rigid gas permeable contact lens wearers.

Vision-specific quality of life and modes of refractive error correction.

PURPOSE: Many studies currently use surveys to assess patients' reports of vision-specific quality of life to determine the impact of the disease or the most appropriate mode of treatment. One such instrument, the National Eye Institute Visual Function Questionnaire (NEI-VFQ), was developed to assess vision-related quality of life with respect to emotional well-being and social function as well as difficulty with tasks and symptoms. We administered the NEI-VFQ to 218 subjects free of eye disease to see if the survey was sensitive enough to detect differences in three modes of refractive error correction: spectacles, soft contact lenses, and rigid contact lenses. METHODS: Surveys were administered to 117 rigid contact lens wearers, 51 spectacle wearers, and 50 soft contact lens wearers. Kruskal-Wallis one-way analysis of variance was conducted to determine significant differences in each of the subscales. RESULTS: The Peripheral Vision subscale score (mean +/- SD) was 92.6 +/- 15.2 for the spectacle wearers, 100.0 +/- 0.0 for the soft contact lens wearers, and 98.3 +/- 7.1 for the rigid gas-permeable contact lens wearers; the spectacle wearers' Peripheral Vision score was significantly lower than the other two groups (Wilcoxon rank sum, p < 0.003 for both). The spectacle wearers (96.6 +/- 9.2) also had a significantly lower Dependency subscale score than the rigid contact lens group (99.7 +/- 1.5) (Wilcoxon rank sum, p = 0.001). There were no significant differences between the three groups detected in the mean of any of the other subscale scores. At least 50% of the subjects reported the maximum score for 6 of the 11 subscales. Given our sample size, we have 100% power to detect a difference of 10 points with a SD of 10 at the alpha = 0.05 level. CONCLUSION: The NEI-VFQ is not appropriate for detecting significant differences in vision-related quality of life among spectacle, soft contact lens, and rigid gas-permeable contact lens wearers, primarily due to maximum ratings by many of the subjects.

Human norepinephrine transporter kinetics using rotating disk electrode voltammetry.

Rotating disk electrode (RDE) voltammetry is applied to the measurement of the transport of the catecholamine neurotransmitters norepinephrine (4-(2-amino-1-hydroxyethyl)-1,2-benzenediol, NE) and dopamine (3,4-dihydroxyphenethylamine, DA) in suspensions of LLC-NET cells, a line of porcine kidney cells expressing the human norepinephrine transporter (hNET). Initial rate of transport was assessed by following the initial decrease in neurotransmitter after its addition to the cell suspension, as measured by the decrease in oxidation current at +0.45 V vs Ag/AgCl. The initial rate of norepinephrine uptake was saturable, with Vmax and KM of 197 +/- 17 amol min-1 cell-1 and 1.64 +/- 0.46 microM, respectively. The RDE method also allows observation of outward transport (efflux) of the DA or NE previously taken up by the cells. Outward transport was induced by the addition of either d-amphetamine (d-AMPH) or p-tyramine (4-hydroxyphenethylamine, p-TYR), which are also substrates for the NE transporter. The technique was also used to monitor accelerated NE uptake by cells preloaded with p-TYR, a phenomenon distinguishing carriers from channels. Together, these findings document the utility of RDE for the nonisotopic measurement of neurotransmitter influx and efflux from transfected mammalian cells.

Effects of naltrexone pellet implantation on morphine tolerance and physical dependence in the rat.

1. The effect of naltrexone pellets containing either 10 or 30 mg of naltrexone base on the development of tolerance and physical dependence on morphine was assessed in male Sprague-Dawley rats. Tolerance-dependence on morphine was induced by s.c. implantation of six morphine pellets, each containing 75 mg morphine base for 7 days. 2. Naltrexone pellet implantation blocked the development of tolerance to the analgesic and hyperthermic effects of morphine. Similarly, naltrexone pellet implantation reversed morphine withdrawal-induced body weight loss. The effect of pellets containing 10 and 30 mg naltrexone did not differ. 3. The effect of naltrexone (10 mg) pellet implantation on various signs of naltrexone-precipitated withdrawal such as body weight loss, hypothermia and increases in urinary and fecal output was investigated. Naltrexone pellet implantation did not alter the naltrexone-precipitated withdrawal-induced body weight loss. Concurrent naltrexone pellet implantation blocked the naltrexone-precipitated withdrawal-induced hypothermia, increased fecal and urinary output in morphine-dependent rats. 4. These results indicate that a single pellet of 10 mg of naltrexone can effectively block morphine tolerance and physical dependence in the rat. Such a procedure may be useful in studying biochemical, endocrinological and immunological mechanisms involved in opioid addiction processes.

Effect of uridine 5'-diphosphate on cryogenic brain edema in rabbits.

This study was undertaken to examine the effect of uridine 5'-diphosphate, administered intravenously or intraperitoneally, on cold injury-induced brain edema in rabbits. Bolus injection or continuous intravenous infusion of uridine 5'-diphosphate 26 hours after a lesion was established had adverse effects, such as increased intracranial pressure and lowered systolic arterial blood pressure and cerebral perfusion pressure for approximately 10-29 minutes, but these parameters did not change appreciably from 29 minutes to 3 hours after administration. Intraperitoneally administered uridine 5'-diphosphate did not affect these parameters appreciably during 3 hours. Thus, the intravenous administration of uridine 5'-diphosphate is harmful under neurosurgical conditions. In contrast, 10 mg/kg/day i.p. uridine 5'-diphosphate pretreatment and posttreatment, beginning 24 hours before and continuing until 24 hours after the insult, significantly reduced neurologic abnormalities, Evans blue extravasation, water content in the injured gray matter, and intracranial pressure without affecting water content in the white matter. Intravenous dexamethasone pretreatment and posttreatment in this setting significantly reduced only neurologic abnormalities. However, there were no significant differences between intraperitoneal uridine 5'-diphosphate and intravenous dexamethasone effects on cold-injured brain.