Floralozone Ameliorated Atherosclerosis in Experimental Atherosclerotic Rats Involved with Sphingosine 1-Phosphate 1 Enhancement.

Atherosclerosis (AS) is a chronical pathological process of the arterial narrows due to the AS plaque formation. The aim of this study was to explore the therapeutic effect and the underlying mechanism of Floralozone on experimental atherosclerotic model rats. Experimental atherosclerotic model rats were induced by the right carotid artery balloon injury and intraperitoneal injection of vitamin D3 in rats after 4 weeks high-fat diet. The results exhibited that Floralozone could ameliorate vascular injury and vasorelaxation of descending aortas and increase the superoxide dismutase activity and the expression of sphingosine 1-phosphate (S1P) 1 and reduce the intercellular cell adhesion molecule-1, vascular cell adhesion molecule-1, interleukin (IL)-1, IL-6 level, and the malondialdehyde activity in experimental atherosclerotic rats. However, Fingolimod, an S1P1 inhibitor, could reverse these Floralozone effects in experimental atherosclerotic rats. Our results indicated that Floralozone could inhibit the atherosclerotic plaque formation and improves arterial stenosis and reduces endothelial dysfunction in experimental atherosclerotic rats, which might be involved with S1P1 enhancement.

Three episodes of non-arteritic posterior ischemic optic neuropathy in the same patient treated with intravenous prostaglandin E1.

Non-arteritic posterior ischemic optic neuropathy (NA-PION) is a disorder involving reduced blood flow to the retrobulbar portion of the optic nerve. This disorder usually develops acutely, and research has suggested that high-dose steroid therapy soon after the onset of visual loss can result in significant visual improvement. This treatment, however, is not universally successful. The addition of a potent vasodilator could help to restore ocular blood flow. This case report describes the use of prostaglandin E1 (PGE1), a powerful vasodilator of the microcirculation, to treat three separate episodes of NA-PION over five years in the same patient. A 68-year-old white male was first seen in June 2009 with NA-PION in the left eye, and the condition was treated with steroids and PGE1. The patient had a subsequent episode in July 2010 that was treated with steroids and PGE1 and another in May 2014 that was treated with PGE1 alone. Visual acuity improved from 4/10 to 11/10 in 2009, from 4/10 to 11/10 in 2010, and from 5/10 to 10/10 in 2014. No complications due to the use of PGE1 were noted. PGE1 should be considered as a treatment for NA-PION to immediately restore blood flow and potentially improve vision.

Central retinal arterial occlusion (CRAO) after phacoemulsification-a rare complication.

BACKGROUND: While peribulbar anesthesia is generally safe, a remote risk of retinal vascular accident exists and its routine use should be done with caution. OBJECTIVE: To report a case of central retinal artery occlusion (CRAO) that occurred within 24 hours of routine uneventful phacoemulsification cataract surgery using peribulbar anesthesia. We share our experience of a 45-year old man who underwent uneventful clear corneal temporal incision phacoemulsification cataract surgery using peribulbar lignocain injection with adrenaline. CASE: A Patient who underwent routine phacoemulsification surgery of left eye for posterior sub-capsular cataract under peribulbar anesthesia developed central retinal artery occlusion in the immediate post-operative period. The surgery was uneventful. CONCLUSION: Central retinal artery occlusion is a rare but dreadful complication seen after uneventful phacoemulsification and the cause is mainly due to anesthesia related.

Does phacoemulsification under topical anesthesia affect retrobulbar blood flow?

PURPOSE: To investigate with color Doppler imaging the effects of phacoemulsification surgery under topical anesthesia on retrobulbar vessels hemodynamics. METHODS: In this prospective study, color Doppler imaging was used to measure the maximum (Vmax) and minimum flow velocity (Vmin) of the central retinal vein, and the Vmax and Vmin, pulsatility index and resistance index of the central retinal artery, nasal, and temporal posterior ciliary arteries, and ophthalmic artery blood flow before and 1 day after phacoemulsification surgery under topical anesthesia. RESULTS: After phacoemulsification surgery under topical anesthesia, Vmin of the central retinal artery increased (p ≤ 0.05), whereas the other variables showed no significant change. CONCLUSIONS: Phacoemulsification surgery under topical anesthesia has a minor effect on retrobulbar blood flow. Therefore topical anesthesia should be suitable for patients with ocular perfusion disorders (eg, glaucoma).

MicroRNA-132-mediated loss of p120RasGAP activates the endothelium to facilitate pathological angiogenesis.

Although it is well established that tumors initiate an angiogenic switch, the molecular basis of this process remains incompletely understood. Here we show that the miRNA miR-132 acts as an angiogenic switch by targeting p120RasGAP in the endothelium and thereby inducing neovascularization. We identified miR-132 as a highly upregulated miRNA in a human embryonic stem cell model of vasculogenesis and found that miR-132 was highly expressed in the endothelium of human tumors and hemangiomas but was undetectable in normal endothelium. Ectopic expression of miR-132 in endothelial cells in vitro increased their proliferation and tube-forming capacity, whereas intraocular injection of an antagomir targeting miR-132, anti-miR-132, reduced postnatal retinal vascular development in mice. Among the top-ranking predicted targets of miR-132 was p120RasGAP, which we found to be expressed in normal but not tumor endothelium. Endothelial expression of miR-132 suppressed p120RasGAP expression and increased Ras activity, whereas a miRNA-resistant version of p120RasGAP reversed the vascular response induced by miR-132. Notably, administration of anti-miR-132 inhibited angiogenesis in wild-type mice but not in mice with an inducible deletion of Rasa1 (encoding p120RasGAP). Finally, vessel-targeted nanoparticle delivery of anti-miR-132 restored p120RasGAP expression in the tumor endothelium, suppressed angiogenesis and decreased tumor burden in an orthotopic xenograft mouse model of human breast carcinoma. We conclude that miR-132 acts as an angiogenic switch by suppressing endothelial p120RasGAP expression, leading to Ras activation and the induction of neovascularization, whereas the application of anti-miR-132 inhibits neovascularization by maintaining vessels in the resting state.

Central retinal artery occlusion after peribulbar anesthesia: report of 3 cases.

We report 3 cases of central retinal artery occlusion following peribulbar anesthesia. Those patients were scheduled for retinal detachment repair, removal of a pterygium, and cataract surgery, respectively. In patient 1, a peribulbar anesthesia was performed with 17 ml of ropivacaine and a compression with a Honan's balloon was maintained at 30 mmHg for 30 min to reduce intra ocular pressure and facilitate intra ocular surgery. In the second patient, 13 ml of ropivacaine was administered without compression of the ocular globe. Patient 3 received 14 ml of mepivacaine and compression was maintained at 30 mmHg for 10 min. In these 3 cases, the surgeon noticed a whitening of the retina during the postoperative period, corresponding with a typical occlusion of the central artery of the retina. Several mechanisms may be cited in an attempt to explain this retinal ischemia: the high volume injected, the speed of injection, a compression of the ocular globe at high pressures for a prolonged period of time, and/or an intrinsic vasoconstricting effect of local anesthetic agents.

Effects of hachimi-jio-gan (ba-wei-di-huang-wan) on blood flow in the human central retinal artery.

Hachimi-jio-gan (HJG), a Chinese herbal formula, and a placebo were given to 12 healthy adults, and the changes in blood flow in the central retinal artery were observed with the latest ultrasonic diagnosis device before and after administration. After administration of HJG, the systolic flow velocity, diastolic flow velocity and mean flow velocity in the central retinal artery showed significant increases. No change was observed in vascular resistance. The subjects deemed suitable for use of HJG showed remarkable increases in blood flow. No changes in blood flow velocities and vascular resistance were observed after administration of the placebo. HJG is frequently used in the aged, often with eye diseases such as cataract. It has been reported that a decrease of blood flow in the central retinal artery becomes more marked in proportion to the progress of various eye diseases. As increases in blood flow were obvious in the cases that were treated with HJG, it is suggested that increases in blood flow in the central retinal artery due to HJG give direct evidence supporting the positive effects of HJG on eye diseases.

Quinine ocular toxicity: treatment of blindness using therapy for vasospasm.

A case of ocular toxicity with vasospasm secondary to quinine poisoning is described. Therapy for vasospasm using nimodipine, hypertension, haemodilution and hypervolaemia was instituted with subsequent resolution of symptoms.

Estudo da circulaçäo retrobulbar e do campo visual após dose única oral de citrato de sildenafil (Viagra) / Study of retrobulbar circulation and visual field after oral single dose of sildenafil citrate (Viagra)

Objetivo: Estudar os efeitos na circulaçäo retrobulbar e no campo visual de uma dose oral única de 100 mg de citrato de sildenafil (Viagra). Métodos: Um estudo duplo-mascarado e controlado por placebo foi realizado em 10 voluntários do sexo masculino, com idade média de 27,7 ñ 5,68 anos. O olho direito de cada voluntário foi submetido aos exames de Doppler colorido de órbita e análise de campo visual por meio de perimetria computadorizada (Humphrey, programa 30-2, estratégia "Full Threshold") em 3 ocasiöes: "baseline",1 hora após placebo e 1 hora após 100 mg de sildenafil via oral. No campo visual, analisaram-se o limiar foveal e o "mean deviation" (MD) nas 3 ocasiöes. No Doppler colorido, medimos a velocidade sistólica máxima (VSM), a velocidade diastólica final (VDF) e o índice de resistência (IR) da artéria central da retina (ACR) e da artéria oftálmica (AO) nas 3 ocasiöes. Resultados: A administraçäo do sildenafil näo alterou significativamente o limiar foveal e o "mean deviation" em relaçäo ao "baseline" e ao placebo. Houve um aumento significativo da velocidade sistólica máxima e velocidade diastólica final na artéria oftálmica após a administraçäo do citrato de sildenafil (p<0,001). Näo houve alteraçäo significativa dos parâmetros hemodinâmicos na artéria central da retina e no índice de resistência da artéria oftálmica. Conclusöes: A administraçäo de 100 mg de citrato de sildenafil promoveu um aumento da velocidade de fluxo sanguíneo na artéria oftálmica de indivíduos normais e näo promoveu alteraçäo significativa no limiar foveal e "mean deviation" da campimetria computadorizada.

[Calcium channel blockers in the treatment of primary open-angle glaucoma]. / Blokatory kal'tsievykh kanalov v lechenii pervichnoi otkrytougol'noi glaukomy.

Study of nifedipine effect on the hemodynamics in the orbital and central retinal arteries showed that nifedipine therapy in a dose of 10 mg 3 times a day for 1 month results in decrease of resistance of the orbital and central retinal arteries in patients with stage I primary open-angle glaucoma. No changes in the visual field, arterial pressure, or hydrodynamics were noted.

A color Doppler analysis of nifedipine-induced posterior ocular blood flow changes in open-angle glaucoma.

PURPOSE: This pilot study used color Doppler imaging to investigate the effects of nifedipine on the posterior ocular blood flow of patients with glaucoma progression at normal intraocular pressures. PATIENTS AND METHODS: Eighteen patients, 11 men and seven women with a median age of 61.7 years, were imaged before and 6 weeks after the initiation of 30 mg of sustained-release nifedipine (Procardia XL; produced by either Pfizer or Pratt) daily. RESULTS: There was no statistically significant change in the blood velocity of the ophthalmic artery, central retinal artery, and main nasal and temporal short posterior ciliary arteries after treatment with nifedipine. CONCLUSION: The routine use of nifedipine in patients with normal tension glaucoma progression is not supported by this study.

[Ocular side effects of added sympathomimetics in local anesthetics]. / Nebenwirkungen am Auge von Sympathomimetikazusätzen in Lokalanästhetika.

In facial dermatosurgery, the addition of sympathomimetics to local anesthetics produces a desirable topical effect as they provide an almost bloodless operation field due to temporary vasoconstriction. In an 87-year-old woman, who had lost her left sight owing to a meningoma, we removed a basal-cell carcinoma from the right side of her nose. The local anesthetic applied contained noradrenaline at a concentration of 1:50,000. After the operation, the patient complained of a headache and a transitory loss of sight. We suppose that noradrenaline reached the arteria centralis retinae via arterial periorbital anastomoses, thus causing a vasoconstriction of this artery. As far as dermatosurgery of the middle and upper face is concerned, patients with severe vision disorders should be considered as a risk group; in local anesthesia of those patients an addition of sympathomimetics should be avoided.

Central retinal artery occlusion without retrobulbar hemorrhage after retrobulbar anesthesia.

Four patients had central retinal artery occlusions after retrobulbar anesthesia with lidocaine HCl was administered before photocoagulation. One of these four had two separate episodes of closure. Only one had permanent visual loss, and none had evidence of retrobulbar hemorrhage. Each patient had a severe hematologic or vascular disorder. We think that direct trauma to the central retinal artery behind the globe, the pharmacologic or compressive effects of the injected solution, or both caused the occlusions in these patients.

Central retinal artery occlusion without retrobulbar hemorrhage after retrobulbar anaesthesia

Four patients had central retinal artery occlusions after retrobulbar anaesthesia with lidocaine HCl was administered before photocoagulation. One of these four had two separate episodes of closure. Only one had permanent visual loss and none had evidence of retrobulbar hemorrhage. Each patient had a severe hematologic or vascular disorder. We think that direct trauma to the central retinal artery behind the globe, the pharmacologic or compressive effects of the injected solution,or both caused the occlusions in these patients. (AU)