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1.
Rom J Ophthalmol ; 63(3): 249-256, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687627

RESUMO

Introduction. The topical medications containing benzalkonium chloride (BAK) as preservative is known to induce corneal toxicity and ocular surface disease (OSD) in glaucoma patients. Newer preservatives like SofZia or polyquaternium-1 (Polyquad) have been developed to replace BAK in many medications. The present study aimed at comparing the OSD in glaucoma patients receiving BAK preserved travoprost versus travoprost with polyquad as preservative and controls not receiving any medications. Methods. This prospective, controlled, observational study was conducted on patients of primary open angle glaucoma (POAG) on medications for more than 6 months. The first group comprised of 40 patients receiving BAK preserved travoprost, the second group included 40 patients receiving polyquad preserved travoprost and 30 of control group not receiving any medical treatment. Ocular Surface Disease Index (OSDI) scores using Ocular Surface Disease Index (OSDI) Questionnaire were assessed and compared in all subjects. Results. The mean OSDI score was 29.09 ± 13.45 in BAK group, 12.4 ± 5.085 in polyquad group and 10.93 ± 7.36 in controls. The mean difference in OSDI scores between BAK and polyquad group 16.63 (p < 0.05) and between the BAK and control group was 18.96 (p < 0.05). The mean difference in OSDI scores between the polyquad and control group was 1.53 (p > 0.05). The mean IOP in the BAK group was 19.2 ± 3.5 and in polyquad group was 20.1 ± 4.2. The IOP measured at 12 months of treatment was 13.2 ± 2.1 in BAK group and 12.8 ± 3.3 in polyquad group. The IOP measured at baseline and 12 months showed statistically significant difference in both the groups (p

Assuntos
Compostos de Benzalcônio/farmacologia , Túnica Conjuntiva/patologia , Córnea/patologia , Glaucoma de Ângulo Aberto/tratamento farmacológico , Glaucoma/tratamento farmacológico , Polímeros/farmacologia , Travoprost/administração & dosagem , Administração Tópica , Anti-Hipertensivos/administração & dosagem , Túnica Conjuntiva/efeitos dos fármacos , Córnea/efeitos dos fármacos , Seguimentos , Glaucoma/diagnóstico , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Pressão Intraocular/efeitos dos fármacos , Pressão Intraocular/fisiologia , Conservantes Farmacêuticos/farmacologia , Estudos Prospectivos
2.
Vestn Oftalmol ; 135(5. Vyp. 2): 177-183, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31691657

RESUMO

PURPOSE: To study the effect of ranibizumab and aflibercept on the thickness of retinal nerve fiber layer (RNFL) in patients with neovascular age-related macular degeneration (nAMD) and primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 62 patients (62 eyes) with nAMD and comorbid POAG. Patients were divided into two groups depending on the anti-VEGF treatment. The first group included 42 patients (42 eyes) who received injections of ranibizumab. The second group consisted of 20 patients (20 eyes) who received aflibercept. All patients received three injections of ranibizumab or aflibercept with one-month intervals. In addition to standard ophthalmic examination, patients underwent optical coherence tomography of the macular area and peripapillary RNFL. RESULTS: After anti-VEGF treatment, patients of both groups exhibited improvements expressed in reduced macular edema, increased visual acuity and absence of intraocular pressure (IOP) changes, as well as no statistically significant changes in the width and depth of excavation. There was a statistically significant decrease of peripapillary RNFL thickness in the temporal quadrant after treatment. CONCLUSION: The decrease of peripapillary RNFL thickness in the temporal quadrant occurs due to resorption of macular edema. In the absence of statistically significant changes in IOP, width and depth of excavation, intravitreal injections of ranibizumab and aflibercept can be considered safe treatment options for patients with concomitant nAMD and POAG.


Assuntos
Glaucoma , Degeneração Macular , Ranibizumab/uso terapêutico , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Proteínas Recombinantes de Fusão/uso terapêutico , Inibidores da Angiogênese , Seguimentos , Glaucoma/tratamento farmacológico , Humanos , Injeções Intravítreas , Fibras Nervosas , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento
5.
Expert Opin Ther Pat ; 29(10): 781-792, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31596641

RESUMO

Introduction: Glaucoma affects more than 70 million people worldwide. One of the major therapeutic options for its management is based on the inhibition of the metalloenzyme carbonic anhydrases (CAs, EC 4.2.1.1). CA inhibitors (CAIs) diminish ocular hypertension in glaucomatous patients by reducing the rate of bicarbonate formation and thus, the secretion of the aqueous humor. Areas covered: This review is intended to cover the major contributions in terms of patent literature reports for the treatment of ophthalmic diseases by means of CAIs in a time frame spanning from 2013 to date. Expert opinion: The patent literature is dominated by innovative pharmaceutical formulations including a CAI alone or in combination with other therapeutic agents. Very few novelties within drug discovery are currently present and they mainly account for new CAI moieties and classical CAIs merged into scaffolds bearing additional chemical functionalities beneficial for the pharmacological treatment of the disease. It is reasonable to expect that in the near future the so-called 'old drugs' will achieve pharmacological performances in the management of ocular hypertension beyond any expectations and thus open a new era of drug repurposing merely based on material science advancements.


Assuntos
Inibidores da Anidrase Carbônica/administração & dosagem , Glaucoma/tratamento farmacológico , Hipertensão Ocular/tratamento farmacológico , Animais , Inibidores da Anidrase Carbônica/farmacologia , Anidrases Carbônicas/efeitos dos fármacos , Anidrases Carbônicas/metabolismo , Desenho de Drogas , Reposicionamento de Medicamentos , Glaucoma/enzimologia , Humanos , Hipertensão Ocular/enzimologia , Patentes como Assunto
6.
Middle East Afr J Ophthalmol ; 26(3): 181-183, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31619910

RESUMO

An implantable collamer lens® (ICL) V4c model (STAAR Surgical, Monrovia, CA, USA) was placed in the eye of a 31-year-old male patient with high myopia followed by the development of malignant glaucoma. After failing medical treatment for 5 days, a noncomplicated pars plana vitrectomy and anterior hyaloidectomy succeeded in breaking the aqueous misdirection. Sixteen months later, intraoperative miotics were purposefully withheld from the ICL surgery in the fellow eye and malignant glaucoma did not develop. Even though the patient's visual acuity postoperatively was 20/20, OU, a single small atrophic iris patch in the affected eye resulted in slightly more halos and glare in mesopic conditions as compared to the fellow eye. Earlier surgical intervention may have prevented iris ischemia and iridocorneal touch with its subsequent iris atrophy and resulted in an even more favorable visual outcome. Withholding intraoperative miotics during ICL surgery appeared to be beneficial in this case.


Assuntos
Glaucoma/etiologia , Implante de Lente Intraocular/efeitos adversos , Mióticos/administração & dosagem , Lentes Intraoculares Fácicas , Adulto , Glaucoma/tratamento farmacológico , Humanos , Pressão Intraocular/fisiologia , Masculino , Miopia Degenerativa/cirurgia , Pupila/efeitos dos fármacos , Acuidade Visual/fisiologia , Vitrectomia
7.
Expert Opin Ther Pat ; 29(10): 817-827, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31573364

RESUMO

Introduction: Glaucoma is a group of progressive optic neuropathies in which elevated intraocular pressure (IOP) as a consequence of an increased aqueous humor (AH) outflow resistance, is the main and only clinically modifiable risk factor for its development and progression. Relaxing Trabecular meshwork (TM) tissue, Rho-Kinase (ROCK) inhibitors directly decrease resistance in the conventional AH outflow, thus resulting in a significant IOP-lowering effect. Areas covered: The progress made in the field of ROCK inhibitors for glaucoma treatment will be discussed, referring to the recent patent literature published mainly in the last 3 years. Development and last studies conducted on the recently approved ripasudil and netarsudil will be described, along with newly reported combinations with other antiglaucoma agents. New molecular entities as ROCK inhibitors will be reported as well as new biological approaches to affect the Rho/ROCK pathway. Expert opinion: With three drugs currently available on the market belonging to this class, ROCK inhibitors have been definitely validated as therapeutic agents for glaucoma treatment. The literature of the last 3 years confirmed the success of the soft-drug and bis-functional approaches in the design of ROCK inhibitors. However, few completely new molecular scaffolds have been reported.


Assuntos
Glaucoma/tratamento farmacológico , Inibidores de Proteínas Quinases/farmacologia , Quinases Associadas a rho/antagonistas & inibidores , Animais , Progressão da Doença , Desenvolvimento de Medicamentos , Glaucoma/enzimologia , Humanos , Pressão Intraocular/efeitos dos fármacos , Patentes como Assunto , Inibidores de Proteínas Quinases/administração & dosagem , Quinases Associadas a rho/metabolismo
9.
Expert Opin Ther Pat ; 29(10): 805-815, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31486689

RESUMO

Introduction: Glaucoma is a neurodegenerative disease of the eye characterized by selective retinal ganglion cell loss that provokes progressive defects in the visual field. Elevated intraocular pressure (IOP) is an important contributor for the progression of glaucoma. The current therapeutic arsenal for reducing IOP includes prostaglandin analogs, ß-blockers, carbonic anhydrase inhibitors, α-adrenergic agonist, miotics, rho-kinase inhibitors and combinations thereof, generally administered as eye drops. Areas covered: This manuscript reviews the state of art on adrenergic modulators for treating glaucoma. Both monotherapy and fixed-drugs combinations including α2-adrenergic agonists and ß-blockers are discussed as well as drug delivery systems where these classes of drugs are used. The review then covers the patent literature involving adrenoceptors modulators over the period 2013-2019. Expert opinion: While the scientific community is moving forward novel targets and related modulators for treating glaucoma and ocular hypertension, adrenergic modulators held a prominent position in the therapy of glaucoma and related disorders. Indeed, though not embodying anymore the first-choice monotherapy, they are widely marketed worldwide ordinarily in combination with other drugs, are subjects of many studies for identifying new drug compositions and have been assessed as active ingredients in several innovative ocular drug delivery systems.


Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/administração & dosagem , Antagonistas Adrenérgicos beta/administração & dosagem , Glaucoma/tratamento farmacológico , Antagonistas Adrenérgicos beta/farmacologia , Animais , Combinação de Medicamentos , Sistemas de Liberação de Medicamentos , Desenho de Drogas , Glaucoma/fisiopatologia , Humanos , Pressão Intraocular/efeitos dos fármacos , Hipertensão Ocular/tratamento farmacológico , Patentes como Assunto
11.
Expert Opin Ther Pat ; 29(10): 769-780, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31385719

RESUMO

Introduction: Glaucoma is one of the main leading causes of irreversible blindness in the world. The treatment of this disease relies on the use of drugs able to reduce/control the intraocular pressure (IOP), one of the main risk factors for glaucoma. Current therapies are based on the use of compounds belonging to well-established categories (prostaglandin analogs, ß-adrenergic blockers, α-adrenergic agonists, carbonic anhydrase inhibitors, Rho kinase inhibitors, and cholinergic agonists). However, even if they are effective in reducing IOP, important side effects impair patient compliance, accounting for the necessity of novel therapy approaches. Therefore, new targets are emerging as alternative and more complete routes to fight glaucoma disease. Areas covered: This review provides a comprehensive update on the development state of innovative strategies against glaucoma describing results, administration routes, pharmaceutical compositions, structures, and SARs as well as the related shortcomings within the 2013-2019 range. Expert opinion: New innovative pharmacological targets have been explored in the last six years, allowing a broader therapeutic arsenal against glaucoma and IOP-related pathologies. The endocannabinoid system and FAAH inhibitors were the most investigated from a medicinal chemistry point of view.


Assuntos
Desenvolvimento de Medicamentos , Glaucoma/tratamento farmacológico , Pressão Intraocular/efeitos dos fármacos , Animais , Glaucoma/fisiopatologia , Humanos , Adesão à Medicação , Patentes como Assunto , Fatores de Risco , Relação Estrutura-Atividade
12.
J Manag Care Spec Pharm ; 25(9): 1001-1010, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31456491

RESUMO

BACKGROUND: Prostaglandin analogs (PGAs) are considered an initial therapy to manage increased intraocular pressure (IOP) for patients with glaucoma. When the initial PGA treatment fails to lower IOP adequately, the patient may add or change medications or have surgery/laser treatment. OBJECTIVE: To compare medication adherence, duration of therapy, and treatment patterns among 3 PGAs-latanoprost, travoprost, and bimatoprost-as initial therapies for patients with glaucoma or ocular hypertension. METHODS: This was a retrospective cohort study using administrative claims data. The cohort consisted of patients newly diagnosed with glaucoma or ocular hypertension with at least 1 prescription claim for latanoprost, travoprost, or bimatoprost and enrolled in a Medicare Advantage plan between 2007 and 2012. The 24-month medication possession ratio (MPR) was used to measure medication adherence. Discontinuation of first-line PGA therapy was defined as nonpersistence (90-day gap allowance) of the index PGA or a change in therapy during the 24-month follow-up period. Types of second-line therapy (i.e., switch, addition, and surgery) were identified. The 1:1:1 propensity score matching was used. RESULTS: Patients who met the inclusion criteria were propensity score matched, resulting in 1,296 patients per PGA group. Latanoprost users showed higher adherence (50.1%) than travoprost (48.8%) and bimatoprost (43.0%) users. The latanoprost and travoprost groups had significantly higher MPRs than bimatoprost (P < 0.0001). The latanoprost group showed significantly longer duration of first-line therapy (372 days) than the bimatoprost group (343 days; P = 0.003) but not the travoprost group (361 days). After controlling for demographic and clinical characteristics, a Cox proportional hazards model showed that the travoprost and bimatoprost groups had a higher risk of discontinuation of first-line therapy than the latanoprost group (P < 0.0001). The percentage of patients continuing on the index PGA without treatment pattern change (i.e., switches, additions, and surgery) was higher for latanoprost users (52.9%) compared with travoprost (39.0%) or bimatoprost users (42.1%; P < 0.001). CONCLUSIONS: Patients who used latanoprost as their initial therapy were more likely to adhere and persist to the index PGA compared with bimatoprost users. The latanoprost group demonstrated a lower risk of discontinuing first-line therapy than the travoprost and bimatoprost groups. The results may assist ophthalmologists in determining the optimal management of this patient population with respect to treatment patterns. DISCLOSURES: No outside funding supported this study. All authors except Heo and Nair are employed by The University of Texas at Austin College of Pharmacy. Heo was with the Health Outcomes Division, The University of Texas at Austin College of Pharmacy during a portion of this study and is employed by Genesis Research. Nair is employed by Humana. The authors have no financial relationships relevant to this article to disclose. This study was presented as a poster at the 2016 International Society for Pharmacoeconomics and Outcomes Research Annual Meeting, May 2016, Washington, DC.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma/tratamento farmacológico , Hipertensão Ocular/tratamento farmacológico , Prostaglandinas Sintéticas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pressão Intraocular/efeitos dos fármacos , Masculino , Medicare , Adesão à Medicação , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos
13.
Expert Opin Ther Pat ; 29(10): 753-759, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31438732

RESUMO

Introduction: Glaucoma refers to a heterogeneous group of optic neuropathies characterized by an enhanced intraocular pressure (IOP). To date, there are six available different drug classes for the treatment of glaucoma and ocular hypertension: ß-adrenergic antagonists, prostaglandins, carbonic anhydrase inhibitors, α2-selective adrenergic, muscarinic agonists and rho kinase inhibitors, which act by reducing the production or increasing the drainage of aqueous humor. Areas covered: This manuscript reviews patent US2018244666A1, that describes the synthesis of novel potential rho kinase and monoamine transporters inhibitors with a benzamide or isoquinoline amide scaffolds, and patent US2018256595A1 that investigates the long-term treatment of glaucoma or ocular hypertension with ripasudil, a rho kinase inhibitor. Expert opinion: A variety of netarsudil congeners were synthesized as rho kinases inhibitors in patent US2018244666A1. Results of patent US2018256595A1 showed that ripasudil is among the best candidates for glaucoma long-term treatment, as IOP continuously dropped over the course of the treatment.


Assuntos
Glaucoma/tratamento farmacológico , Hipertensão Ocular/tratamento farmacológico , Quinases Associadas a rho/antagonistas & inibidores , Benzoatos/administração & dosagem , Benzoatos/farmacologia , Glaucoma/patologia , Humanos , Pressão Intraocular/efeitos dos fármacos , Isoquinolinas/administração & dosagem , Isoquinolinas/farmacologia , Hipertensão Ocular/patologia , Patentes como Assunto , Inibidores de Proteínas Quinases/administração & dosagem , Inibidores de Proteínas Quinases/farmacologia , Sulfonamidas/administração & dosagem , Sulfonamidas/farmacologia , beta-Alanina/administração & dosagem , beta-Alanina/análogos & derivados , beta-Alanina/farmacologia , Quinases Associadas a rho/metabolismo
14.
Int J Mol Sci ; 20(17)2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31443568

RESUMO

Glaucoma is a neurodegenerative disease characterized by the loss of retinal ganglion cells (RGCs). An increase in the intraocular pressure is the principal risk factor for such loss, but controlling this pressure does not always prevent glaucomatous damage. Activation of immune cells resident in the retina (microglia) may contribute to RGC death. Thus, a substance with anti-inflammatory activity may protect against RGC degeneration. This study investigated the neuroprotective and anti-inflammatory effects of a hydrophilic saffron extract standardized to 3% crocin content in a mouse model of unilateral, laser-induced ocular hypertension (OHT). Treatment with saffron extract decreased microglion numbers and morphological signs of their activation, including soma size and process retraction, both in OHT and in contralateral eyes. Saffron extract treatment also partially reversed OHT-induced down-regulation of P2RY12. In addition, the extract prevented retinal ganglion cell death in OHT eyes. Oral administration of saffron extract was able to decrease the neuroinflammation associated with increased intraocular pressure, preventing retinal ganglion cell death. Our findings indicate that saffron extract may exert a protective effect in glaucomatous pathology.


Assuntos
Anti-Inflamatórios/química , Anti-Inflamatórios/farmacologia , Crocus/química , Fármacos Neuroprotetores/química , Fármacos Neuroprotetores/farmacologia , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Animais , Biomarcadores , Modelos Animais de Doenças , Glaucoma/tratamento farmacológico , Glaucoma/etiologia , Glaucoma/metabolismo , Glaucoma/fisiopatologia , Interações Hidrofóbicas e Hidrofílicas , Pressão Intraocular/efeitos dos fármacos , Camundongos , Microglia/efeitos dos fármacos , Microglia/metabolismo , Retina/efeitos dos fármacos , Retina/metabolismo , Retina/patologia
15.
Expert Opin Ther Pat ; 29(10): 793-803, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31462124

RESUMO

Introduction: Elevated intraocular pressure (IOP) is the most prevalent risk factor for glaucoma. Prostaglandin analogs are a first-line therapy for glaucoma due to their ability to reduce IOP, once-daily dosing, efficacy, and minimal side-effect profile. Many compounds targeting different PG receptors have been developed in the last years, some of them being in clinical use. Latanoprost, Bimatoprost, Travoprost, and Tafluprost are clinically used as antiglaucoma drugs and act as agonists of the PGF2α receptor. The inability to fully understand the mechanism of action of clinically used PGF2α analogs is thus a strong driver for additional research into the mechanism of action of ocular hypotensive drugs belonging to this class of pharmacological agents. Areas covered: This review explores the last 5 years (2013-2018), where many patents describing new compounds acting on different prostaglandin receptors, and mainly targeting EP1-4 and FP receptors, were released. Expert opinion: To date, there has been a growing awareness over recent years of the therapeutic use of novel derivatives as new antiglaucoma pharmaceutical products. Patents involved in discovering new approaches and new molecules for the treatment of glaucoma diseases encouraged the scientific community to increase the variety of drugs available for the treatment of ocular diseases.


Assuntos
Glaucoma/tratamento farmacológico , Prostaglandinas Sintéticas/farmacologia , Receptores de Prostaglandina/agonistas , Animais , Anti-Hipertensivos/farmacologia , Desenvolvimento de Medicamentos , Glaucoma/patologia , Humanos , Pressão Intraocular/efeitos dos fármacos , Patentes como Assunto , Fatores de Risco
16.
Drug Deliv ; 26(1): 812-819, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31389267

RESUMO

The aim of this study is to investigate the effects and toxicities of poly(3-hydroxybutyric acid-co-3-hydroxyvaleric acid) (PHBV)-loading rosiglitazone on preventing scar formation after glaucoma filtration surgery (GFS) in the rabbit model. Rosiglitazone/PHBV drug delivery system was prepared via electrospinning. Release behavior of RSG/PHBV membrane was evaluated by high-performance liquid chromatography. The different concentration membranes were implanted under the conjunctiva of the rabbit's eyes (RSG/PHBV groups). Also, MMC-soaked sponges were placed under the conjunctiva of the eyes (positive group) for 3 min. Intraocular pressures and bleb features were then assessed for 4 weeks postoperative. Bleb sections were stained with HE, Masson's trichrome and α smooth muscle action (αSMA) immunohistochemistry. The protein expression of collagen I, αSMA, and connective tissue growth factor in the bleb area were then quantified. The following results were observed: (1) the concentration of rosiglitazone would not affect the morphology of RSG/PHBV membrane. (2) RSG/PHBV membrane would effective and safety prevent the formation of fibrosis after GFS in the rabbit model. Implantation of RSG/PHBV membrane prevents scar formation after GFS. What's more, it ameliorated toxicity to conjunctiva and cornea compared with the placement of MMC. The RSG/PHBV membrane would be a more effectivity and safer strategy than MMC.


Assuntos
Fibrose/tratamento farmacológico , Glaucoma/tratamento farmacológico , Poliésteres/administração & dosagem , Rosiglitazona/administração & dosagem , Animais , Cicatriz/tratamento farmacológico , Túnica Conjuntiva/efeitos dos fármacos , Córnea/efeitos dos fármacos , Modelos Animais de Doenças , Sistemas de Liberação de Medicamentos/métodos , Cirurgia Filtrante/métodos , Pressão Intraocular/efeitos dos fármacos , Coelhos , Cicatrização/efeitos dos fármacos
17.
Amyloid ; 26(3): 103-111, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31339362

RESUMO

Timely diagnosis of hereditary variant transthyretin (ATTRv) amyloidosis is critical for appropriate treatment and optimal outcomes. Significant differences are seen between patients receiving treatment and those who are not, though disease progression may continue despite treatment in some patients. Healthcare professionals caring for patients with ATTRv amyloidosis therefore need reliable ongoing assessments to understand the continuing course of disease and make appropriate treatment choices on an individual basis. Various signs and symptoms experienced by patients may be evaluated as indicators of disease progression, though there is currently no validated score that can be used for such ongoing assessment. Recognizing this situation, a group of clinicians highly experienced in ATTR amyloidosis developed an approach to understand and define disease progression in diagnosed and treated patients with ATTRv amyloidosis. The suggested approach is based on the recognition of distinct phenotypes which may usefully inform the particular tools, tests and investigations that are most likely to be appropriate for individual patients. It is aimed at implementing appropriate and ongoing assessment of patients being treated for ATTRv amyloidosis, such that the effectiveness of management can be usefully assessed throughout the course of disease and management can be tailored according to the patient's requirements.


Assuntos
Neuropatias Amiloides Familiares/diagnóstico , Cardiomiopatias/diagnóstico , Gerenciamento Clínico , Glaucoma/diagnóstico , Neuropatias Hereditárias Sensoriais e Autônomas/diagnóstico , Adulto , Idade de Início , Idoso , Neuropatias Amiloides Familiares/tratamento farmacológico , Neuropatias Amiloides Familiares/genética , Neuropatias Amiloides Familiares/fisiopatologia , Cardiomiopatias/tratamento farmacológico , Cardiomiopatias/genética , Cardiomiopatias/fisiopatologia , Consenso , Progressão da Doença , Feminino , Glaucoma/tratamento farmacológico , Glaucoma/genética , Glaucoma/fisiopatologia , Testes de Função Cardíaca , Neuropatias Hereditárias Sensoriais e Autônomas/tratamento farmacológico , Neuropatias Hereditárias Sensoriais e Autônomas/genética , Neuropatias Hereditárias Sensoriais e Autônomas/fisiopatologia , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Mutação , Fármacos Neuroprotetores/uso terapêutico , Pré-Albumina/deficiência , Pré-Albumina/genética
18.
Curr Med Chem ; 26(22): 4241-4252, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31345142

RESUMO

Glaucoma is the second leading cause of blindness in the world, affecting more than 60 million people globally. In order to reduce the progression of the disease, both medical and surgical treatments are used. Frequent side effects of both treatments include a range of modifications of the ocular surface grouped as the Ocular Surface Disease (OSD), which include Dry Eye Disease (DED). DED and other OSD negatively impact on the success of anti-glaucoma treatments and reduce the adherence to medical therapies. Tear film osmolarity (TFO) is a relatively novel test which has become a hallmark of DED. The aim of this paper was to review the association between OSD, DED and glaucoma in view of published TFO data, and to discuss future fields of research and treatments on the topic of glaucoma iatrogenic damage.


Assuntos
Anti-Hipertensivos/farmacologia , Doenças da Córnea/tratamento farmacológico , Glaucoma/tratamento farmacológico , Conservantes Farmacêuticos/farmacologia , Lágrimas/efeitos dos fármacos , Animais , Anti-Hipertensivos/química , Humanos , Concentração Osmolar , Conservantes Farmacêuticos/química , Propriedades de Superfície
19.
Medicine (Baltimore) ; 98(29): e16526, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335731

RESUMO

BACKGROUND: This study will evaluate the efficacy of travoprost for patients with glaucoma systematically. METHODS: A comprehensive literature search will be carried from following literature sources from inception to the present: Cochrane Library, MEDLINE, EMBASE, Web of Science, Google scholar, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. We will only consider randomized controlled trials on assessing the efficacy and safety of travoprost for glaucoma for inclusion. We will use Cochrane risk of bias tool for the methodological quality assessment for each qualified study. If it is possible, we will pool the outcome data, and will perform meta-analysis. RESULTS: This study will systematically evaluate the efficacy and safety of travoprost for glaucoma. Primary outcomes include intraocular pressure (IOP), mean IOP, and mean reduction of IOP. Secondary outcomes consist of diastolic ocular perfusion pressure, central corneal thickness, and quality of life, as measured by 36-Item Short Form Health Survey, and treatment-related adverse events included hyperemia, eye pain, and eye pruritus. CONCLUSION: The findings of the present study will summarize the updated evidence of travoprost for patients with glaucoma.PROSPERO registration number: PROSPERO CRD42019126956.


Assuntos
Anti-Hipertensivos/uso terapêutico , Glaucoma/tratamento farmacológico , Travoprost/uso terapêutico , Anti-Hipertensivos/efeitos adversos , Paquimetria Corneana , Dor Ocular/induzido quimicamente , Glaucoma/fisiopatologia , Humanos , Hiperemia/induzido quimicamente , Pressão Intraocular/efeitos dos fármacos , Prurido/induzido quimicamente , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Travoprost/efeitos adversos
20.
Mater Sci Eng C Mater Biol Appl ; 103: 109730, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31349399

RESUMO

Primary treatment for glaucoma relies on chronic instillation (daily) of intraocular pressure (IOP) lowering eye drops. Present study tends to develop and assess a novel sustained release bimatoprost loaded nanovesicular (BMT-NV) - thermosensitive in-situ gelling implant (BMT-NV-GEL-IM), for subconjunctival delivery. BMT-NVs developed using novel composition and method of preparation, (IPA/700/DEL/2014) and industrially viable methodology were characterized and evaluated comprehensively for ocular suitability. Their incorporation into an in-situ gelling formula was safe (in vitro and in vivo) and stable upon sterilization. Autoclavability was an important consideration, as a preservative-free, single-use BMT-NV-GEL-IM will avoid side- effects associated with repetitive application of drops containing preservatives like benzalkonium chloride (BAK). An extended in vitro release of BMT (80.23%) was observed for 10 days while the IOP lowering effect extended over 2 months with single subconjunctival injection of BMT-NV-GEL-IM in rats. No clinical signs of irritation, inflammation, or infection were observed in any injected eye, throughout the study, as also confirmed by histology. Furthermore, single administration of BMT-NV-GEL as topical drop lowered the IOP over 5 days. Presence of significant diffuse fluorescence in confocal microscopy of internal eye tissues post-in vivo application, as subconjunctival implant, even after 2 month and eye drops upto1 week provide direct evidence of successful sustained delivery. We thus provide an improved modality for antiglaucoma medication in patients who are challenged to adhere to a regimen of daily eye drops.


Assuntos
Bimatoprost , Glaucoma , Nanoestruturas , Animais , Bimatoprost/química , Bimatoprost/farmacocinética , Bimatoprost/farmacologia , Avaliação Pré-Clínica de Medicamentos , Implantes de Medicamento , Glaucoma/tratamento farmacológico , Glaucoma/metabolismo , Glaucoma/patologia , Masculino , Nanoestruturas/química , Nanoestruturas/uso terapêutico , Ratos , Ratos Wistar
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