RESUMEN
PURPOSE: We describe a 39-year-old Japanese woman with chronic angle closure glaucoma secondary to spherophakia and frail zonular fibres. The patient was 143 cm in height with short fingers and had no family history of eye problems. High intraocular pressure, total optic disc cupping and severe visual field constriction were found in the right eye. METHODS: The patient was treated successfully with trabeculectomy in the right eye and laser iridotomy in the left eye. CONCLUSION: The clinical findings imply that this was a borderline case of Weil-Marchesani syndrome.
Asunto(s)
Cuerpo Ciliar , Glaucoma de Ángulo Cerrado/etiología , Deformidades Congénitas de la Mano/complicaciones , Enfermedades del Cristalino/complicaciones , Enfermedades de la Úvea/complicaciones , Adulto , Enfermedad Crónica , Femenino , Glaucoma de Ángulo Cerrado/diagnóstico , Glaucoma de Ángulo Cerrado/fisiopatología , Glaucoma de Ángulo Cerrado/cirugía , Gonioscopía , Humanos , Presión Intraocular , Iris/cirugía , Terapia por Láser , Enfermedades del Cristalino/patología , Disco Óptico , Síndrome , Trabeculectomía , Enfermedades de la Úvea/patología , Campos VisualesRESUMEN
BACKGROUND AND OBJECTIVE: To investigate silicone naphthalocyanine (SINc; 0.5 mg/kg) for photodynamic therapy (PDT) of the ciliary body in pigmented rabbits. STUDY DESIGN/MATERIALS AND METHODS: SINc was dissolved in canola oil by heating, emulsified with Tween-80, and given by ear vein. Pharmacokinetics were studied in frozen sections by fluorescence microscopy using a CCD camera-based, low light detection system with digital image processing at 1 hr and 24 hr (12 rabbits, 24 eyes total). A Ti:Sapphire laser delivered light at 770 nm by contact fiberoptic (1,000 microns; 80 mW/cm2;20,40 and 80 J/cm2). Controls (5 rabbits), received laser light at 770 nm without SINc. For comparison, eyes received continuous wave Nd:YAG laser by fiberoptic contact (0.8-1.2 J). RESULTS: Localization studies showed intravascular distribution shifting to a ciliary body distribution at 24 hr. PDT at 1 hr and 24 hr postinjection showed a more selective destruction of the ciliary body at 24 hr. Ciliary processes treated at 24 hr showed infarction and marked edema with sparing of iris. Tissue thermal damage was minimal in PDT controls. Eyes treated with the Nd:YAG laser exhibited full-thickness thermal necrosis of iris, ciliary processes, and a fibrinous iridocyclitis. In contrast, eyes treated by PDT were quiet with thrombosis of superficial blood vessels. CONCLUSION: Tissue photon penetration is good at 770 nm and thermal effects from the exciting laser alone were minimal. The ciliary processes of pigmented rabbits exhibit a selective retention of SINc and on that basis can be selectively destroyed with a minimum on thermal damage to nontarget tissues.
Asunto(s)
Cuerpo Ciliar/efectos de los fármacos , Metaloporfirinas/uso terapéutico , Compuestos de Organosilicio/uso terapéutico , Fotoquimioterapia , Fármacos Fotosensibilizantes/uso terapéutico , Óxido de Aluminio , Silicatos de Aluminio , Animales , Cuerpo Ciliar/irrigación sanguínea , Cuerpo Ciliar/metabolismo , Edema/patología , Tecnología de Fibra Óptica/instrumentación , Procesamiento de Imagen Asistido por Computador , Infarto/patología , Iridociclitis/patología , Iris/patología , Coagulación con Láser/instrumentación , Metaloporfirinas/farmacocinética , Microscopía Fluorescente , Neodimio , Compuestos de Organosilicio/farmacocinética , Fármacos Fotosensibilizantes/farmacocinética , Conejos , Trombosis/patología , Titanio , Enfermedades de la Úvea/patología , ItrioRESUMEN
Two studies were conducted to assess the toxicity of rosaramicin (a macrolide antibiotic) when given intravenously for 30 consecutive days to beagle dogs with and without a tapetum lucidum (a light reflecting structure within the choroid of the eye). In the initial study, groups of three tapetal dogs/sex were given 20, 40, or 80 mg of rosaramicin/kg, twice daily. Ophthalmoscopic examination during Week 4 revealed dose-related, bilateral ocular changes characterized by a brown-tan discoloration and general pallor or loss of reflectivity of the normally blue-purple or yellow-green, highly reflective tapetum lucidum. These findings were restricted to the tapetal fundus; recovery occurred between Weeks 4 and 10 of the postdose period. To further investigate these changes, a second study was conducted in which groups of three tapetal dogs were given rosaramicin or erythromycin lactobionate (comparative macrolide antibiotic) at 80 mg/kg, twice daily. A third group of atapetal dogs was given 80 mg of rosaramicin/kg, twice daily. A similar change was observed in tapetal dogs given 80 mg of rosaramicin/kg, twice daily, in the follow-up study, but not in the other two groups. No other compound-related changes were observed in either study. The ocular changes observed in dogs given rosaramicin were reversible and structure-specific, occurring only in animals possessing a tapetum lucidum.
Asunto(s)
Coroides/efectos de los fármacos , Leucomicinas/toxicidad , Enfermedades de la Úvea/inducido químicamente , Animales , Perros , Evaluación Preclínica de Medicamentos , Femenino , Infusiones Parenterales , Masculino , Oftalmoscopía , Enfermedades de la Úvea/patologíaRESUMEN
Two patients had milder variants of the usual form of gyrate atrophy. Although the appearance of the chorioretinal degeneration was identical, the progression of the clinical signs and symptoms were slower with night blindness, cataracts, and decreased vision occurring at an older age. Additionally, the level of hyperornithinemia, although still increased above normal, was lower than that usually found in such patients (between 448 and 676 microM). Additionally, one of our patients responded to high dosage vitamin B6 with a 27% reduction in plasma ornithine. The difference in the quantitation of the increase in plasma ornithine, the difference in responsiveness to vitamin B6, and the difference in the clinical consequences of this underlying biochemical abnormality, indicated a variant form of gyrate atrophy, suggesting the presence of genetic heterogeneity.