Axial length and pharmacologic pupillary dilation in highly myopic patients.

PURPOSE: To determine how high myopia impacts pharmacological pupillary dilation, and to evaluate the relationship between the extent of pharmacologic pupillary dilation and axial length. METHODS: Patients were grouped into high myopes, defined as one or both eyes having a refractive error greater than - 6 diopters, and controls (between - 2 and + 2 diopters). Dilation was achieved with 1 drop each of tropicamide 1% and phenylephrine 2.5%. Pupil size was measured at full and dim light prior to dilation, then 15 and 30 min after dilation. Biometry was measured for each patient. Statistical analyses were performed using the Mann-Whitney-Wilcoxon tests, two-sample Welch's t-tests, and linear mixed effect models and generalized estimating equations models accounting for inter-eye correlation. RESULTS: Forty patients (20 high myopes and 20 controls, 80 eyes total) participated in the study. High myopes had larger pupils at baseline and achieved significantly greater pupillary size (7.08 mm, 95% CI: 6.97 to 7.19 mm) than controls (6.23 mm, 95% CI: 5.94 to 6.52 mm) after 30 min of dilation (P < .0005). Fully dilated pupil size at 30 min was significantly correlated with both refractive error (r = - 0.57, P < .0005) and axial length (r = 0.47, P < .0005). Generalized estimating equations and linear mixed effect models identified other predictive variables of pupil size after dilation including age and white-to-white diameter. CONCLUSIONS: Highly myopic patients dilate to a larger pupillary size compared to other patients. Predicting dilation based on extent of myopia could facilitate intraocular surgery planning and reduce clinic wait times for myopic patients.

Prevalence of peripheral retinal findings in retinal patients using ultra-widefield pseudocolor fundus imaging.

Ultra-widefield retinal imaging is increasingly used in ophthalmology and optometry practices to image patients identifying peripheral abnormalities. However, the clinical relevance of these peripheral retinal abnormalities is unclear. This cross-sectional study aims to firstly validate a new grading system, secondly, assess the prevalence of peripheral retinal abnormalities in retinal patients, and finally understand how peripheral findings may associate with retinal disease. Ultra-widefield pseudocolor fundus images were taken from the eyes of clinic patients. Demographic data and clinical diagnosis for each patient was noted. The grading system was validated using masked retinal specialists. Logistic regression identified associations between retinal disease and peripheral retinal findings. Using the grading system, inter-observer agreement was 76.1% with Cohen's Kappa coefficient 0.542 (p < 0.0001) and the test-retest agreement was 95.1% with Kappa 0.677(p < 0.0001). 971 images were included, with 625 eyes (64.4%) having peripheral abnormalities. Peripheral drusen was the most common abnormality (n = 221, 22.76%) and correlated with age-related macular degeneration (p < 0.001). Novel correlations were also identified between diabetic retinopathy and retinal pigmentation as well as pigmentary degeneration. This study provides a validated system for identifying peripheral abnormalities and adds to literature highlighting peripheral retinal associations with retinal disease which would benefit from further study.

MICROPERIMETRY IN FOVEAL-SPARING ATROPHIC LATE-ONSET RETINAL DEGENERATION.

PURPOSE: To understand the baseline and longitudinal microperimetry characteristics in foveal-sparing atrophic late-onset retinal degeneration. METHOD: Prospective, cross-sectional, longitudinal study in which patients from the retina clinics of two academic teaching hospitals were included. Mesopic microperimetry was performed using a Nidek MP-1 micro-perimeter. Mean total, foveal, inner ring, and outer ring sensitivities were analyzed. RESULTS: A total of 20 eyes from 10 patients had baseline data. The subset of 10 eyes from five patients had follow-up data. The mean baseline macular sensitivity was 10.02 dB (± 5.26) with findings showing symmetry between both eyes. In the follow-up cohort, there was a significant loss of outer ring (0.83 dB per year; P = 0.0001), inner ring (0.67 dB per year; P = 0.034), and foveal sensitivity (0.92 dB loss per year; P = 0.015), whereas the mean sensitivity decreased significantly (0.66 dB per year; P = 0.0008) at 4-year follow-up. The drop in mean sensitivity was associated with significant increases in the number of deep scotoma points (6.20, P = 0.037) and a decrease in the number of normal points (-6.30, P = 0.022). CONCLUSION: Microperimetry is a useful tool for macular function follow-up to measure disease progression in late-onset retinal degeneration.

Potent cytotoxic activity of Saururus cernuus extract on human colon and breast carcinoma cultures under normoxic conditions.

BACKGROUND: Saururus cernuus (Sc) is a small plant, used for the treatment of various human inflammations. The present study aimed at investigating the cytotoxic potential of the methanolic extract of this plant against brine shrimp larvae and human carcinoma cells at normoxic conditions. MATERIALS AND METHODS: The in vivo lethality test was evaluated at various doses against brine shrimp larvae at different time periods. Similarly, the extract was tested for 48 h at various concentrations against human CL-18 and MDA-MB-231 carcinoma cell lines and the toxicity was evaluated using the dye binding crystal-violet assay method. RESULTS: In the shrimp assay, the extract was very active, with ED50 values ranging from 1.83 +/- 0.2 to 2.79 +/- 0.2 microg/ml at various incubation periods. The extract was also very potent in human CL-18 and MDA-MB-231 cultures with LD50 values of 1.9 +/- 0.17 and 0.26 +/- 0.03 microg/ml, respectively. CONCLUSION: The results of this study indicate that Sc extract contains very stable, potent anticancer compounds, which gain access into the cells quickly and kill carcinoma cells and shrimp larvae at normoxic conditions.

Licamichauxiioic-A and -B acids--two ent-kaurene diterpenoids from Licania michauxii.

Bioassay-guided fractionation allowed the isolation of two new cytotoxic ent-kaurene diterpenoids, licamichauxiioic-A and -B acids (1 and 2) from the root extract of Licania michauxii Prance (Chrysobalanaceae). They were characterized as ent-15-oxo-9(11),16-kauradien-19-oic acid (1) and ent-15-oxo-13(14),16-kauradien-19-oic acid (2) by various spectroscopic methods, in particular, 1D and 2D NMR spectra, and chemical evidence.