Recurrent Uveal Effusion after Laser Iridotomy.

A 59-year-old woman was seen by an ophthalmologist for blurred vision, ocular pain, headache, and nausea. She was diagnosed with acute primary angle closure (APAC) and successfully treated with medications. Using ultrasound biomicroscopy (UBM), engorged episcleral vein was observed and small uveal effusion was diagnosed after laser peripheral iridotomy (LPI). The uveal effusion disappeared and was again diagnosed by UBM together with anterior segment inflammation with ocular pain. Iritis caused by LPI after APAC might be a cause of uveal effusion in this specific case.

A novel rapid quantitative analysis of drug migration on tablets using laser induced breakdown spectroscopy.

There have been few reports wherein drug migration from the interior to the surface of a tablet has been analyzed quantitatively until now. In this paper, we propose a novel, rapid, quantitative analysis of drug migration in tablets using laser induced breakdown spectroscopy (LIBS). To evaluate drug migration, model tablets containing nicardipine hydrochloride as active pharmaceutical ingredient (API) were prepared by a conventional wet granulation method. Since the color of this API is pale yellow and all excipients are white, we can observe the degree of drug migration by visual inspection in these model tablets. In order to prepare tablets with different degrees of drug migration, the temperature of the drying process after tableting was varied between 50 to 80 °C. Using these manifold tablets, visual inspection, Fourier transform (FT)-IR mapping and LIBS analysis were carried out to evaluate the drug migration in the tablets. While drug migration could be observed using all methods, only LIBS analysis could provide quantitative analysis wherein the average LIBS intensity was correlated with the degree of drug migration obtained from the drying temperature. Moreover, in this work, we compared the sample preparation, data analysis process and measurement time for visual inspection, FT-IR mapping and LIBS analysis. The results of the comparison between these methods demonstrated that LIBS analysis is the simplest and the fastest method for migration monitoring. From the results obtained, we conclude that LIBS analysis is one of most useful process analytical technology (PAT) tools to solve the universal migration problem.

Uveal effusion in primary angle-closure glaucoma.

PURPOSE: To determine the prevalence of uveal effusion in acute and chronic primary angle-closure glaucoma (PACG) or primary angle closure (PAC) and to compare it with the prevalence in eyes with open-angle glaucoma (OAG) or ocular hypertension. DESIGN: Prospective consecutive case series. PARTICIPANTS: Five hundred one eyes of 351 consecutive patients with PAC and 156 eyes of 116 randomly selected primary OAG or ocular hypertension patients. The PAC group included 40 eyes of 35 patients with acute PACG and 30 unaffected fellow eyes, 39 eyes and 35 fellow eyes with a history of acute PACG, and 357 eyes with chronic PAC. METHODS: Ultrasound biomicroscopic examination was performed to diagnose uveal effusion and to measure anterior chamber depth (ACD). MAIN OUTCOME MEASURES: Presence of uveal effusion and ACD. RESULTS: Uveal effusion was demonstrated in 23 eyes (58%) with acute PACG and 7 fellow eys (23%) (chi2 = 8.17, P = 0.0043). Among eyes with chronic PAC, uveal effusion was present in 69 [corrected](14%[corrected]), a higher prevalence than was found in open-angle patients (2 eyes [1.3%]) (chi2 = 19.3, P<0.001). In the chronic PAC group, the ACD of phakic eyes with uveal effusion (1.92+/-0.42 mm) was significantly shallower than that of phakic eyes without effusion (2.06+/-0.32 mm) (P = 0.019). CONCLUSIONS: Uveal effusion diagnosed by ultrasound biomicroscopy is a special feature in PAC, and is prevalent in acute PACG. Uveal effusion in phakic eyes with PAC is associated with shallowing of ACD.

Persistence of retinal indocyanine green dye following vitreous surgery.

BACKGROUND AND OBJECTIVE: To investigate the duration of postoperative persistence of indocyanine green (ICG) dye used during vitreous surgery. PATIENTS AND METHODS: Thirty-three patients (34 eyes) underwent macular surgery with removal of the internal limiting membrane (ILM) or epiretinal membrane using ICG dye to stain the membrane for better visualization. Infrared fundus photographs were taken postoperatively until infrared fluorescence had completely disappeared. The time for residual ICG dye to fade from the retina was studied for eyes with full-thickness macular hole, epiretinal membrane, and macular edema for comparison. served at sites where macular hole was present, sites of normal ILM that had not been removed, and the optic disc. ICG dye faded at an average of 7.3 months for patients with macular hole and 3.4 months for patients with other macular diseases (P< .01). CONCLUSIONS: ICG dye used during macular surgery can persist in the macular region for up to 7 months following surgery, and seems to remain for a longer period of time in cases with macular hole than in cases with other diseases. Caution is required regarding light exposure by postoperative fundus examinations, daylight, and other natural light.

Prevalence of ciliochoroidal effusion after prophylactic laser iridotomy.

PURPOSE: To study the prevalence of ciliochoroidal effusion (CE) after prophylactic laser iridotomy (LI). METHODS: An ultrasound biomicroscope (UBM) examination was performed before, 2, and 24 hours after LI to investigate the changes in supraciliary-choroidal space after LI in circumference of 38 eyes in 23 chronic primary angle-closure patients. Subjects were divided randomly into two groups based on LI settings: 21 eyes by argon laser (Ar-LI group) and argon combined with yttrium-aluminum-garnet (YAG) laser in 17 eyes (Ar-YAG-LI group). Ciliochoroidal effusion was observed predominantly in the inferior sector (12 of 12 eyes, 100%) and rare in nasal part of the eyes (4 of 12 eyes, 33%). Ciliochoroidal effusion appeared more often in the Ar-LI group (10 eyes, 52%) than in the Ar-YAG-LI group (2 eyes, 12%). All CE disappeared 7 days after by UBM observation. CONCLUSIONS: Subclinical CE observed by UBM frequently occurs after LI.

Immunolocalization of heat shock proteins in the retina of normal monkey eyes and monkey eyes with laser-induced glaucoma.

PURPOSE: To examine the expression and localization of heat shock proteins (HSPs) in the retinas of normal and experimentally induced primate glaucoma eyes. These proteins are known to be produced in response to a variety of stresses. METHODS: Experimental glaucoma was induced in the right eyes of three adult monkeys by repeated applications of argon laser to the chamber angle. Immunostaining with a panel of antibodies against HSP 90, 70, 60, 47, and 27 was performed on retinal sections prepared from the normal and glaucomatous monkey eyes. RESULTS: The intensity of immunostaining for HSP 90, 60, and 27 was greatly enhanced in the retinas of glaucomatous eyes. Prominent reactivity was observed in the inner retinal layers, especially in the ganglion cell and nerve fiber layers. The staining intensity for HSP 70 was also moderately increased, while immunoreactivity against HSP 47 remained almost unchanged in glaucomatous retinas. Immunostaining against glial fibrillary acidic protein was increased and the immunolabeling pattern appeared to be identical with that of HSP 90 in glaucoma retinas. CONCLUSIONS: The level of HSP 90, 70, 60, and 27 in primate retinas was increased in experimentally induced ocular hypertension. The differences in expression pattern suggest that each HSP may have its unique role in responding to damage or injury related to intraocular pressure elevation.