Effects of tetramethylpyrazine on prostaglandin E(2)- and prostaglandin E(2) receptor agonist-induced disruption of blood-aqueous barrier in pigmented rabbits - Kitagawa, K; Hayasaka, S; Nagaki, Y; Watanabe, K (Jpn J Ophthalmol, 2001)
PURPOSE: To evaluate the effect of tetramethylpyrazine on the elevation of aqueous flare and intraocular pressure (IOP) induced by prostaglandin (PG) E(2) and PGE(2) receptor (EP) agonists. METHODS: PGE(2) or EP agonists (11-deoxy PGE(1), EP(2) agonist; 17-phenyl trinor PGE(2), EP(1) and EP(3) agonist; or sulprostone, EP(1) and EP(3) agonist), 25 microg/mL, were transcorneally administered to pigmented rabbits. Animals were pretreated with tetramethylpyrazine intravenously (10 or 30 mg/kg) or topically (0.1% solution). Aqueous flare was measured using a laser flare-cell meter, and the intensity was expressed as the area under the curve (AUC). Intraocular pressure was measured using a noncontact tonometer. RESULTS: After administration of PGE(2), aqueous flare and IOP increased and then gradually decreased. The AUC of eyes pretreated with tetramethylpyrazine, 10 or 30 mg/kg, intravenously, or topical 0.1% solution, was significantly smaller than that of the controls. The mean Delta IOP of eyes pretreated with tetramethylpyrazine, 30 mg/kg intravenously, was significantly lower than that of the controls. After administration of 11-deoxy PGE(1), aqueous flare increased and then gradually decreased. 17-phenyl trinor PGE(2) and sulprostone did not disrupt the blood-aqueous barrier. The AUC of eyes pretreated with tetramethylpyrazine, 10 or 30 mg/kg, intravenously, before 11-deoxy PGE(1) application was significantly smaller than that of the controls. CONCLUSION: The results indicated that tetramethylpyrazine inhibited PGE(2)- or 11-deoxy PGE(1)-induced elevation of aqueous flare and IOP.

Incidence of ocular side effects of topical beta blockers in the Netherlands - van Beek, L M; de Keizer, R J; Polak, B C; Elzenaar, P R; van Haeringen, N J; Kijlstra, A (Br J Ophthalmol, 2000)
BACKGROUND: Several ocular side effects including uveitis, have been reported following topical beta blocker treatment for glaucoma and ocular hypertension. The incidence of these side effects was investigated in the Netherlands. METHODS: A prospective observational design was used whereby monthly questionnaires were sent to all practising ophthalmologists in the Netherlands during 3 consecutive months. Questionnaires were returned at the end of each month. Any patient whose topical beta blocker therapy was altered because of an ocular reaction was noted on this questionnaire. Ophthalmologists who did not return their questionnaires were interviewed by telephone at the end of the study period. The number of patients using topical beta blockers was derived from drug sales figures. RESULTS: 70% (328/467) of the ophthalmologists in the Netherlands participated in the study. During the 3 month study period 34 cases were reported: 15 patients had periorbital dermatitis, in eight patients eyelids and conjunctiva were affected, in seven patients the conjunctiva was affected, and four patients had punctate keratitis. The calculated incidence of ocular side effects during topical beta blocker therapy was 1.51 cases/1000 patient years. CONCLUSION: Topical beta blocker therapy is associated with few clinically important ocular side effects. No cases of uveitis were reported.

Uveitis related to juvenile idiopathic arthritis: familial cases and possible genetic implication in the pathogenesis - Julián, Karina; Terrada, Céline; Quartier, Pierre; Lehoang, Phuc; Bodaghi, Bahram (Ocul Immunol Inflamm, 2010)
PURPOSE: To describe four cases of familial Juvenile Idiopathic Arthritis (JIA) associated uveitis. DESIGN: Retrospective observational case series. METHODS: Clinical data from patients who present familial JIA-associated uveitis are described and possible genetic influence in disease etiology is reviewed. RESULTS: Two sisters, 6- and 7-year-old, developed bilateral anterior uveitis related to oligoarticular JIA. Arthritis in both began by the age of 18 months; uveitis developed simultaneously in one of them and less than one year after arthritis in the other one. Both received topical and systemic treatment to control the ocular disease. Glaucoma occurred in both cases and bilateral cataract in one case. In the other family, a 2-year-old girl developed unilateral uveitis in the context of oligoarticular JIA which was diagnosed by 1-year-old. The disease became soon bilateral and she received topical and systemic immunosuppressive treatment. Her mother suffered from bilateral anterior uveitis associated to oligoarticular inflammatory disease during her infancy, later diagnosed as JIA-associated uveitis. CONCLUSIONS: Familial cases of JIA uveitis, although not very common, support the possible role of genetic influence in the pathogenesis of the disease, with horizontal and vertical inheritance being possible. The evolution of ocular disease is similar to the non-familial cases, except for an earlier age of onset.

Suppressive effects of astaxanthin against rat endotoxin-induced uveitis by inhibiting the NF-kappaB signaling pathway - Suzuki, Yukari; Ohgami, Kazuhiro; Shiratori, Kenji; Jin, Xue-Hai; Ilieva, Iliyana; Koyama, Yoshikazu; Yazawa, Kazunaga; Yoshida, Kazuhiko; Kase, Satoru; Ohno, Shigeaki (Exp Eye Res, 2005)
We investigated the effects of astaxanthin (AST), a carotenoid, on endotoxin-induced uveitis (EIU), and over the course of the disease measured the expression of inflammatory cytokines and chemokines in the presence or absence of AST. EIU was induced in male Lewis rats by footpad injection of lipopolysaccharide (LPS). The animals were randomly divided to 12 groups with eight animals in each. Immediately after the inoculation, AST (1, 10, or 100 mg kg(-1)) was injected intravenously. Aqueous humour was collected at 6, 12 and 24 hr after LPS inoculation and the number of infiltrating cells in the anterior chamber was counted. In addition, we assayed the concentration of protein, nitric oxide (NO), tumour necrosis factor-alpha (TNF-alpha) and prostaglandin E2 (PGE2). Immunohistochemical staining with a monoclonal antibody against activated NF-kappaB was performed in order to evaluate the effects of AST on NF-kappaB activation. Rats injected with AST showed a significant decrease in the number of infiltrating cells in the anterior chamber and additionally there was a significantly lower concentration of protein, NO, TNF-alpha and PGE2 in the aqueous humour. Moreover, even early stages of EIU were suppressed by injection of AST. The number of activated NF-kappaB-positive cells was lower in iris-ciliary bodies treated with 10 or 100 mg kg(-1) AST at 3 hr after LPS injection. These results suggest that AST reduces ocular inflammation in eyes with EIU by downregulating proinflammatory factors and by inhibiting the NF-kappaB-dependent signaling pathway.

Intraocular pressure elevation following triamcinolone acetonide administration as related to administration routes - Hirano, Yoshio; Ito, Takeshi; Nozaki, Miho; Yasukawa, Tsutomu; Sakurai, Eiji; Yoshida, Munenori; Ogura, Yuichiro (Jpn J Ophthalmol, 2009)
PURPOSE: To evaluate the incidence and risk factors of intraocular pressure (IOP) elevation following triamcinolone acetonide (TA) administration. METHODS: In this retrospective observational case series, patients (224 eyes of 202 patients) with diffuse diabetic macular edema (66 eyes), branch retinal vein occlusion (39 eyes), central retinal vein occlusion (25 eyes), exudative age-related macular degeneration (49 eyes), myopic choroidal neovascularization (10 eyes), uveitis (30 eyes), or other conditions (5 eyes) were administered an intravitreal or posterior sub-Tenon capsule injection, or both, of TA. Sub-Tenon capsule injection was performed on 106 eyes (STTA group). Intravitreal injection was performed on 118 eyes (IVTA group), of which 85 eyes underwent simultaneous intravitreal and sub-Tenon capsule injections. Mean follow-up after TA administration was 15.9 +/- 10.4 (range, 3-39) months. The sub-Tenon capsule injection and intravitreal injection of TA were compared with respect to the frequency of IOP elevation and the time between TA administration and the initial IOP elevation, and the possible risk factors responsible for IOP elevation were identified. RESULTS: There was no significant difference in frequency of IOP > 21 mmHg between the STTA group and the IVTA group (P = 0.0588). There was, however, a significant difference in the frequency of IOP > 30 mmHg between the two groups (P = 0.0004). In the IVTA group, more patients needed antiglaucoma medication than in the STTA group (P = 0.0052). The incidence rate of IOP elevation within 1 week after TA administration in the IVTA group was significantly higher than in the STTA group (P = 0.0154). Risk factors for IOP elevation included higher baseline IOP (P < 0.0001), younger patients (P = 0.0095), and simultaneous administration of sub-Tenon capsule and intravitreal injections (P = 0.0228). CONCLUSIONS: Careful follow-up of IOP is required after TA injections.

Bilateral granulomatous uveitis in an elderly female - Kattige, Jyoti; Konana, Vinaya Kumar; Babu, Kalpana (Indian J Ophthalmol, 2019)

[Posner-Schlossman syndrome] - Köhler, U (Ophthalmologica, 1992)
The clinical features of Posner-Schlossman syndrome and the various differential diagnoses are described in a 20-year-old patient. Additional to Posner-Schlossman syndrome this patient showed signs of Axenfeld's anomaly. He also presented symptoms of a status-dysrhaphicus-like state after atrial septal defect and the ability to overstrain the distal finger joints. Posner-Schlossman syndrome, heterochromic cyclitis, anterior-chamber cleavage syndrome and ICE syndrome (iridocorneal-endothelial syndrome: Chandler's, Cogan-Reese syndrome and progressive essential iris atrophy) often produce similar effects at the Descemet membrane, the anterior chamber angle and the iris. Because of the same mesodermal origin of these tissues we suggest that all the diseases mentioned above are merely different clinical expressions of one main disease.

[Brimonidine and acute anterior granulomatous uveitis: A case report and literature review] - Comet, A; Donnadieu, B; Courjaret, J-C; Gascon, P; Denis, D; Matonti, F (J Fr Ophtalmol, 2017)

Granulomatous uveitis and metipranolol - O'Connor, G R (Br J Ophthalmol, 1993)

Transscleral diode laser cyclophotocoagulation for the treatment of refractory glaucoma secondary to inflammatory eye diseases - Schlote, T; Derse, M; Zierhut, M (Br J Ophthalmol, 2000)
BACKGROUND: Inflammatory glaucoma is still a diagnostic and therapeutic dilemma and surgical intervention is always associated with a high risk of failure or reactivation of the inflammatory disease. In this study we prospectively examined the value of transscleral diode laser cyclophotocoagulation (TDLC) for the treatment of refractory inflammatory glaucoma. METHODS: 22 eyes of 20 consecutive patients with inflammatory, medically uncontrollable, glaucoma secondary to chronic uveitis/trabeculitis (n = 18), chemical injury (n = 2), episcleritis (n = 1), and necrotising scleritis with inflammation (n = 1) were treated by TDLC. Nine eyes (41%) had had previous failed glaucoma surgery (trabeculectomy, cyclocryocoagulation) and 15 eyes (68.2%) had had previous anterior segment surgery. All patients were followed for 1 year after the initial treatment. RESULTS: Within 12 months of the first treatment the intraocular pressure was controlled in 77.3% of all eyes (72.2% of those with uveitic glaucoma). No serious side effects such as activation of the inflammatory process, phthisis bulbi or persistent hypotonia were observed, except one patient with a temporary fibrin reaction. More than one treatment was necessary in 63.6% of the patients. The use of systemic carbonic anhydrase inhibitors was reduced from 68.2% before treatment to 27.3% after 1 year. CONCLUSION: TDLC seems to be a safe and effective procedure for the treatment of inflammatory glaucoma and may become an alternative to trabeculectomy with antimetabolites in uveitic glaucoma. TDLC may become the surgical procedure of choice in treating secondary glaucoma caused by chemical injury and also in scleritis associated glaucoma, using reduced parameters for application.

[Cataract surgery and prostaglandin analogs? Yes, but under certain conditions] - Cochereau, I (J Fr Ophtalmol, 2004)
Use of a prostaglandin analog in cataract surgery can cause cystoid macular edema in the pseudophakic patient, but this is a rare complication that resolves when treatment is stopped. However, in the surgical context, this type of eye drop should not be prescribed as first-line treatment and in any case it should be associated with nonsteroidal anti-inflammatory agents.

The long-term hypotensive effect of timolol maleate compared with the effect of pilocarpine in simple and capsular glaucoma - Airaksinen, P J (Acta Ophthalmol (Copenh), 1979)
The long-term intraocular pressure (IOP) lowering effect of a beta-adrenergic blocking agent, timolol maleate, in topical administration was compared with the effect of pilocarpine on simple and capsular glaucoma by means of diurnal pressure curves during a six-month follow-up. In simple glaucoma timolol was more effective than pilocarpine in lowering IOP. In the follow-up a significant but not marked increase of the IOP was observed. In capsular glaucoma timolol was not effective enough, but when it was co-administered with miotics the IOP lowering effect was better than with either substance alone. Timolol induced no accomodative myopia, miosis, reduction of tear flow or other side effects. It increased the outflow facility in simple glaucoma but not in capsular glaucoma. During the trial, the anterior chamber depth increased while the corneal thickness remained unchanged. Four out of the six eyes included in a previous report of secondary glaucoma due to chronic uveitis are still, after one year of therapy, controlled with timolol.

Metipranolol-associated granulomatous anterior uveitis - Akingbehin, T; Villada, J R (Br J Ophthalmol, 1991)
This paper presents for the first time documented evidence, clinical details, and photographic illustrations of metipranolol-associated granulomatous anterior uveitis in 26 eyes of 15 patients being treated for glaucoma. There were 56 episodes of granulomatous anterior uveitis, all associated with large (mutton-fat) keratic precipitates, flare, cells, and 'white eyes' (except in seven episodes). In 30 (53.6%) of these episodes there was loss of control of intraocular pressure. Metipranolol 0.6% was implicated in 54 of the 56 episodes and metipranolol 0.3% in the remaining two. Fifty-one other cases of metipranolol-associated granulomatous anterior uveitis have so far been reported from other parts of the country to the Committee on Safety of Medicines. As a result multidose metipranolol in 0.1%, 0.3%, and 0.6% strengths has been withdrawn from clinical use in the United Kingdom. The pathogenesis of this adverse drug reaction is uncertain.

Molecular mechanisms of topical anti-inflammatory effects of lipoxin A(4) in endotoxin-induced uveitis - Medeiros, Rodrigo; Rodrigues, Gustavo Büchele; Figueiredo, Cláudia Pinto; Rodrigues, Eduardo Büchele; Grumman, Astor, Jr; Menezes-de-Lima, Octavio, Jr; Passos, Giselle Fazzioni; Calixto, João Batista (Mol Pharmacol, 2008)
Lipoxin A(4) (LXA(4)) is a lipid mediator that plays an important role in inflammation resolution. We assessed the anti-inflammatory effect of LXA(4) on endotoxin-induced uveitis (EIU) in rats. The inflammatory cell number and levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), prostaglandin E(2) (PGE(2)), and protein, as well as expression of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF), in the anterior chamber of the eye were determined 24 h after lipopolysaccharide (LPS; 200 mug/paw) intradermal injection. The immunohistochemical reactivities of nuclear factor-kappaB (NF-kappaB) and c-Jun were also examined. Topical LXA(4) (1-10 ng/eye) pretreatment decreased the number of inflammatory cells and the protein leakage into the aqueous humor (AqH). In addition, topical LXA(4) (10 ng/eye) inhibited the LPS-induced production of IL-1beta, TNF-alpha, and PGE(2), and expression of COX-2 and VEGF. A decreased activation of NF-kappaB and c-Jun was also found in LXA(4)-treated eyes. It is very interesting that an anti-inflammatory effect was achieved even when LXA(4) (10 ng/eye) was applied topically after LPS challenge, as indicated by the reduction in the cellular and protein extravasations into the AqH. Moreover, topical treatment of corticosteroid prednisolone (200 mug/eye) beginning before or after LPS injection reduced all of the molecular and biochemical alterations promoted on EIU rats in an efficacy similar to that of LXA(4). Together, the present results provide clear evidence that pharmacological activation of LXA(4) signaling pathway potently reduces the EIU in rats. Therefore, LXA(4) stable analogs could represent promising agents for the management of ocular inflammatory diseases.

15-Deoxy-12,14-prostaglandin J2 inhibits interferon gamma induced MHC class II but not class I expression on ARPE cells through a PPAR gamma independent mechanism - Willermain, François; Dulku, Simon; Gonzalez, Nathalie Suarez; Blero, Daniel; Driessens, Gregory; De Graef, Chantal; Caspers, Laure; Bruyns, Catherine (Prostaglandins Other Lipid Mediat, 2006)
Retinal pigment epithelial (RPE) cells constitute the external part of the blood-retinal-barrier and play a pivotal role in the regulation of retinal immunity. In the present work, we investigated the effects of 15-deoxy-12,14-prostaglandin J2 (15 PGJ2), an endogenous ligand of PPARgamma, on the IFNgamma-induced expression of MHC class II on RPE cells. Indeed, pathological expression of MHC class II molecules at the surface of RPE cells is a common feature of many blinding conditions. We demonstrated that 15 PGJ2 inhibited the IFNgamma-mediated induction of MHC class II on RPE cells without affecting the level of MHC class I and CD54 expression. The other PPARgamma agonist rosiglitazone or troglitazone had no similar effects. Moreover, the inhibitory effect of 15 PGJ2 was not abrogated by co-incubation with PPARgamma antagonists and did not involve the modulation of STAT-1, AKT or ERK1/2 phosphorylation, nor CIITA, IRF1 or IRF2 transcription. In conclusion, 15 PGJ2 inhibits strongly and specifically the IFNgamma-induced MHC class II expression on RPE cells by a PPARgamma independent mechanism. Given the differential role of MHC classes I and II in the development of autoimmune uveitis and the potential toxicity of 15 PGJ2, our data's suggest that the development of novel small molecules targeting similar PPARgamma independent pathways would be useful for the future management of uveitis.

The importance of cellular changes in the conjunctiva of patients with uveitic glaucoma undergoing trabeculectomy - Broadway, D C; Bates, A K; Lightman, S L; Grierson, I; Hitchings, R A (Eye (Lond), 1993)
The results of trabeculectomy in patients with glaucoma secondary to uveitis are poor, but the exact cause of this remains unknown. Therefore, a study was undertaken to determine differences between conjunctiva from patients with glaucoma secondary to uveitis and that from patients with primary open angle glaucoma. Conjunctival biopsies from three patient groups were quantitatively analysed by light microscopy. Group A consisted of 10 patients with glaucoma secondary to uveitis who, prior to surgery, had been treated with topical steroids and topical beta-blocker drugs. Control groups (groups B and C) each consisted of 10 patients with primary open angle glaucoma for whom primary trabeculectomy (group B) or trabeculectomy following failure of topical beta-blockers alone (group C) was planned. Treatment with topical beta-blocker drugs was found to redistribute mast cells within the conjunctiva but to have no significant effect on cell numbers. In comparison with either control group, uveitic conjunctiva was found to contain significantly more fibroblasts, lymphocytes and macrophages. It is possible that these differences are responsible for an enhanced risk of excessive external bleb fibrosis, failure of filtration surgery and poor results with adjunctive 5-fluorouracil.

Comparison of Efficacy and Safety of Loteprednol Etabonate 0.5% and Topical Dexamethasone 1% in Post-Vitrectomy Inflammation - Bilgin, Ahmet Burak; Dogan, Mehmet Erkan; Ayaz, Yusuf; Apaydin, Kadri Cemil (Ocul Immunol Inflamm, 2017)
PURPOSE: To compare the efficacy and safety of postoperative topical loteprednol etabonate (LE) 0.5% with dexamethasone (DEX) 0.1% for the treatment of inflammation following pars plana vitrectomy (PPV). METHODS: A total of 150 eyes of 150 patients who underwent transconjunctival PPV for various diagnoses were included in this prospective, randomized study. The patients were assigned into two groups as Group LE (n = 75) and Group DEX (n = 75). Intraocular inflammation, intraocular pressure (IOP), and the intensity of postoperative pain were compared between the groups. RESULTS: The mean IOP was higher in the patients treated with DEX (p > 0.05). The need for anti-glaucoma medications was significantly lower in Group LE (5.3%) than in Group DEX (17.3%) (p = 0.020). Tyndall scores were less in Group DEX at postoperative Days 1 (p = 0.01) and 3 (p = 0.017). On Day 1, it was more likely for patients to have mild or moderate pain in Group LE (p < 0.001). On Day 3, the number of the patients with no pain was higher in Group DEX (p = 0.005). CONCLUSIONS: Although DEX is more effective in the early postoperative days, LE appears to be as effective in controlling inflammatory response following PPV in the long-term. Topical LE is associated with less increase in the IOP and a lower need for anti-glaucoma medications.
Keywords: Dexamethasone; inflammation; pars plana vitrectomy; loteprednol etabonat

Vogt-Koyanagi-Harada disease presenting as acute angle closure glaucoma at onset - Yang, Peizeng; Liu, Xiaoli; Zhou, Hongyan; Guo, Wenjuan; Zhou, Chunjiang; Kijlstra, Aize (Clin Exp Ophthalmol, 2011)
BACKGROUND: To investigate the clinical features of Vogt-Koyanagi-Harada (VKH) disease presenting as acute angle closure glaucoma at onset. DESIGN: Retrospective non-comparative case series. PARTICIPANTS: Four hundred and eighty-six VKH patients seen from February 2001 to March 2010. METHODS: The history and clinical findings of all patients were reviewed. Auxiliary examinations, including ultrasound biomicroscopy, fundus fluorescein angiography and optical coherence tomography, were performed in certain cases. Corticosteroids with or without cyclosporine A were used to treat these patients. MAIN OUTCOME MEASURE: Patients' demographics, clinical presentation and auxiliary examination findings. RESULTS: Eight out of 486 VKH patients were misdiagnosed as acute angle closure glaucoma. The mean age of these eight patients was 55.6 years. Six patients were female. The mean intraocular pressure (IOP) at disease onset was 32.9 mmHg. All of these patients had a shallow anterior chamber and a narrow or closed angle at their first visit. The complaints of these patients were mostly headache and sudden decreased vision in both eyes. Alterations shown on ultrasound biomicroscopy included detachment of the ciliary body and peripheral choroid. The increased IOP did not respond to anti-glaucoma therapy, but resolved following treatment with corticosteroids. The eye of one patient was enucleated after failed trabeculectomies prior to referral to our uveitis centre. CONCLUSION: VKH disease presenting with a bilateral increased IOP mostly occurs in older women. The strikingly decreased visual acuity associated with mild to moderate increased IOP is a clue to the diagnosis. The increased IOP responded well to corticosteroids but not to anti-glaucoma treatment.

Anterior uveitis associated with latanoprost - Fechtner, R D; Khouri, A S; Zimmerman, T J; Bullock, J; Feldman, R; Kulkarni, P; Michael, A J; Realini, T; Warwar, R (Am J Ophthalmol, 1998)
PURPOSE: To report the association of anterior uveitis with the use of latanoprost. METHODS: We studied four patients with complicated open-angle glaucoma who had anterior uveitis associated with the use of latanoprost. The uveitis was unilateral and occurred only in the eye receiving latanoprost in three patients. In one patient, latanoprost was used in both eyes, and the uveitis was bilateral. Four of five eyes had a history of prior inflammation and/or prior incisional surgery. All patients were rechallenged with the drug. RESULTS: The uveitis improved after cessation of latanoprost with or without topical corticosteroids. It recurred after rechallenging with latanoprost in all eyes. CONCLUSION: There is a possible association between latanoprost and anterior uveitis. Topical prostaglandin analogs may be relatively contraindicated in patients with a history of uveitis or prior ocular surgery. This association may also be possible in eyes that have not had previous uveitis or incisional surgery.

Medical treatment of macular edema in patients with uveitis - Rojas, B; Zafirakis, P; Christen, W; Markomichelakis, N N; Foster, C S (Doc Ophthalmol, 1999)
PURPOSE: To determine the efficacy of medical treatment of cystoid macular edema (CME) in patients with uveitis. METHODS: Retrospective study of 40 patients (57 eyes) with uveitis and CME. Inclusion criteria were presence of CME with minimal and no macular pathology, or vascular disease which could account for CME. Patients who had undergone intraocular surgery or had visual acuity (VA) of > or = 20/40 were excluded. The diagnosis of CME was based on clinical and/or angiographic findings. Three treatment groups were defined: (1) transseptal injection of steroids (n=13 eyes); (2) systemic non steroidal anti-inflammatory drugs (NSAIDs) (n=11 eyes); both 1 and 2 (n=33 eyes). RESULTS: Overall, 79% of eyes improved 3 or more lines of Snellen VA after treatment: 51% improved 4 or more lines. The average number of lines improved was 3.8 for eyes treated with transseptal injections of steroids, 2.9 for eyes treated with NSAIDs, and 4 for eyes treated with both. For all 3 treatment groups between 60-70% of eyes improving 2 or more lines reached best VA only after a minimum of 6 months of follow up. CONCLUSIONS: CME, a vision threatening complication of uveitis, respond fairly well to medical treatment; however, the best VA is achieved after several months. The improvement in VA did not differ markedly among the three treatment groups.

Uveitis associated with topical beta-blockers - Beck, R W; Moke, P; Blair, R C; Nissenbaum, R (Arch Ophthalmol, 1996)
OBJECTIVE: To assess the incidence of uveitis associated with topical beta-blockers. DESIGN: Retrospective cohort study. SETTING: A computerized database of a health maintenance organization was used to identify patients who were prescribed metipranolol or other beta-blockers. PATIENTS: Two groups: 1928 patients using 0.3% metipranolol and 3903 patients using other beta-blockers. MAIN OUTCOME MEASURE: Cases of uveitis were identified by noting a prescription of a topical corticosteroid and then conducting a chart review. RESULTS: No cases of uveitis were identified among the 5831 patients. The upper limits of the 95% confidence intervals for the incidence of uveitis in cohorts of this size are 1.87 cases per 1000 person-years of exposure for metipranolol and 1.38 for other beta-blockers. CONCLUSION: Drug-induced uveitis from metipranolol or other beta-blocker administration is a rare event, even if a causal relationship exists.

Pars-plana vitrectomy in cystoid macular edema associated with intermediate uveitis - Wiechens, B; Nölle, B; Reichelt, J A (Graefes Arch Clin Exp Ophthalmol, 2001)
BACKGROUND: Cystoid macular edema (CME) is a common complication in the course of intermediate uveitis. In spite of systemic therapy with steroids or carbonic anhydrase inhibitors, persistence of CME is observed. Pars plana vitrectomy (PPV) is known to influence the course of intermediate uveitis positively. The present study was performed to investigate the role of PPV in the therapy of CME in intermediate uveitis. MATERIALS AND METHODS: Forty-two eyes of 32 patients were re-examined after PPV for CME. In all eyes fluorescein angiography was performed. Average age at the time of surgery was 31.9 years (range 6-64 years). All patients had received systemic corticosteroid and/or immunosuppressive treatment during the course of their disease. In some patients systemic therapy with carbonic anhydrase inhibitors was performed. The mean duration of postoperative follow-up was 20.2 months (range 6-102 months). RESULTS: Preoperative visual acuity (VA) in all eyes was between 1/10 and 0.5. Total regression of CME after surgery was observed in 18 of 42 eyes (42.8%), partial improvement in 7 eyes (16.7%). In 13 of 42 eyes (30.9%) the CME remained unchanged. Twenty-one of 42 eyes (50.0%) experienced a postoperative improvement of VA of 2 lines or more. In 18 of 42 eyes (42.8%) there was no change; in 3 eyes (7.2%) VA was less. In the long-term follow-up the corresponding results were slightly worse (17/17/8 eyes) due to secondary complications. In the majority of patients systemic medical therapy could be reduced or discontinued. CONCLUSION: Pars-plana vitrectomy led to regression of CME in 59% of cases and to subsequent improvement of VA in 50% of eyes with intermediate uveitis. PPV should be considered soon after medical therapy has been shown to be ineffective.

Brimonidine-induced anterior uveitis and conjunctivitis: clinical and histologic features - Nguyen, Ethan V; Azar, Domit; Papalkar, Daya; McCluskey, Peter (J Glaucoma, 2008)
Brimonidine tartarate is a selective alpha2-adrenergic receptor agonist that is indicated for use in the treatment of glaucoma and ocular hypertension. Since its introduction in 1997 there have been a small number of case reports concerning granulomatous anterior uveitis as a late adverse reaction to long-term brimonidine therapy. We report a case of bilateral anterior uveitis and granulomatous papillary conjunctivitis in a 78-year-old gentleman after 2 years of brimonidine therapy. Cessation of brimonidine lead to rapid termination of uveitis. The histologic features of the conjunctiva are described. This has not been previously reported.

Effects of topical administration of 0.005% latanoprost solution on eyes of clinically normal horses - Willis, A M; Diehl, K A; Hoshaw-Woodard, S; Kobayashi, I; Vitucci, M P; Schmall, L M (Am J Vet Res, 2001)
OBJECTIVE: To determine the effect of 0.005% latanoprost solution on intraocular pressure (IOP) of eyes of clinically normal horses and establish the frequency of adverse effects of drug administration. ANIMALS: 20 adult clinically normal horses. PROCEDURE: IOP was recorded (7, 9, and 11 AM; 3, 5, and 7 PM) on days 1 and 2 (baseline), days 3 to 7 (treatment), and days 8 to 9 (follow-up). Latanoprost was administered to 1 randomly assigned eye of each horse every 24 hours during the treatment period, following the 7 AM IOP recording. Pupil size and the presence or absence of conjunctival hyperemia, epiphora, blepharospasm, blepharedema, and aqueous flare were recorded prior to IOP measurement. RESULTS: IOP was reduced from baseline by a mean value of 1.03 mm Hg (5%) in males and 3.01 mm Hg (17%) in females during the treatment period. Miosis developed in all treated eyes and was moderate to marked in 77% of horses, with the peak effect observed 4 to 8 hours after drug administration. Conjunctival hyperemia, epiphora, blepharospasm, and blepharedema were present in 100, 57, 42, and 12% of treated eyes, respectively, 2 to 24 hours following drug administration. Aqueous flare was not observed at any time point. CONCLUSIONS AND CLINICAL RELEVANCE: Although IOP was reduced with every 24-hour dosing of latanoprost, the frequency of prostaglandin-induced adverse events was high. Because recurrent uveitis appears to be a risk factor for glaucoma in horses, topical administration of latanoprost may potentiate prostaglandin-mediated inflammatory disease in affected horses.

Effects of oral administration of Gardeniae fructus extract and intravenous injection of crocetin on lipopolysaccharide- and prostaglandin E2-induced elevation of aqueous flare in pigmented rabbits - Nagaki, Yasunori; Hayasaka, Seiji; Abe, Tomohiro; Zhang, Xue-Yun; Hayasaka, Yoriko; Terasawa, Katsutoshi (Am J Chin Med, 2003)
The purpose of this study was to evaluate the effects of extracts of Coptidis rhizoma, Phellodendri cortex and Gardeniae fructus, which are medicinal herbs in Orengedoku-to (Huanglin-Jie-Du-Tang in Chinese), and crocetin (a major component of Gardeniae fructus) on experimental elevation of aqueous flare in pigmented rabbits. To produce aqueous flare elevation, 0.5 microg/kg lipopolysaccharide (LPS) was injected into the ear vein, or prostaglandin E2 (PGE2) 25 microg/ml, was applied to the cornea by means of a glass cylinder. Animals were pretreated by oral administration of 150 g/day of food containing 0.15% (w/w) extract powder of Coptidis rhizoma, 0.10% (w/w) extract powder of Phellodendri cortex or 0.15% (w/w) extract powder of Gardeniae fructus for 4 days, or by intravenous injection of crocetin, 0.3, 3, 30 or 300 microg/kg, 30 minutes before aqueous flare elevation. Aqueous flare was measured with a laser flare-cell meter. Aqueous flare intensity was expressed as the area under the curve (AUC) in arbitrary units. The AUC of LPS- and PGE2-induced aqueous flare elevation was 4685 and 1386 arbitrary units, respectively. Pretreatment by oral administration of 0.15% (w/w) extract of Coptidis rhizoma or 0.10% (w/w) extract of Phellodendri cortex did not inhibit LPS-induced aqueous flare elevation. Pretreatment by oral administration of 0.15% extract of Gardeniae fructus suppressed LPS-induced aqueous flare elevation (AUC: 1411 arbitrary units). Pretreatment by intravenous injection of 3, 30 or 300 microg/kg of crocetin-inhibited LPS-induced aqueous flare elevation in a dose-dependent manner. Pretreatment with 3 or 30 microg/kg of crocetin did not inhibit PGE2-induced aqueous flare elevation, but 300 microg/kg of crocetin inhibited PGE2-induced aqueous flare elevation (AUC: 918 arbitrary units).

Trabeculectomy with mitomycin C in secondary glaucoma associated with Behçet disease - Elgin, Ufuk; Berker, Nilufer; Batman, Aygen; Soykan, Emel (J Glaucoma, 2007)
PURPOSE: To determine the outcome of initial trabeculectomy with mitomycin C (MMC) in the management of secondary glaucoma associated with Behçet disease (BD) in a 1-year follow-up period. METHODS: Twenty-three eyes of 13 cases with secondary glaucoma associated with BD, were evaluated prospectively. They underwent primary trabeculectomy with MMC. The operative success was defined as an intraocular pressure (IOP) < or =20 mm Hg (+/- medical therapy) in the absence of phthisis and without the necessity of further surgery for glaucoma and success rates at the postoperative first day, first month, sixth month, and first year were determined. RESULTS: Success was achieved in all of the eyes (100%) at the postoperative first day and month, in 21 eyes (91.3%) at the postoperative sixth month and in 19 eyes (82.6%) at the postoperative first year. The mean preoperative IOP was 30.9+/-5.3 mm Hg under the mean 3.3+/-0.7 antiglaucoma medications but it reduced to 16.8+/-3.1 mm Hg under the mean 1.7+/-0.8 medications at the postoperative sixth month and 18.5+/-3.2 mm Hg under the mean 2.6+/-1.1 medications at the postoperative first year. CONCLUSIONS: Trabeculectomy with MMC provides reduction of IOP and the number of antiglaucoma medications in cases with secondary glaucoma associated with BD in a 1-year follow-up period.

[Differential treatment of postoperative and uveitis-induced inflammatory cystoid macular edema] - Guex-Crosier, Y; Othenin-Girard, P; Herbort, C P (Klin Monbl Augenheilkd, 1992)
Twenty-five eyes (23 patients) with inflammatory cystoid macular edema (CME) (11 after cataract surgery and 14 eyes (12 patients) with uveitis) were followed in a prospective open study. The aim was to determine the efficiency of a combined treatment of Diamox (acetazolamide), Voltaren Ophtha (diclofenac, a NSAID) and Ultracortenol (prednisolone acetate) and in the case of treatment failure, the usefulness of posterior subtenon's injections of corticosteroids (Kenacort 40 mg (triamcinolone)). Seven eyes (all pseudophakic CMEs) responded successfully to the initial therapy. Their mean visual acuity improved from 0.31 +/- 0.13 to 0.93 +/- 0.08 after 18 +/- 5 days (p less than or equal to 0.001). Of the sixteen of 18 evaluable eyes that were additionally treated with a mean of 3.28 +/- 1.07 three-weekly posterior subtenon's injections, 15 eyes including all uveitis CME responded to treatment. Their mean visual acuity improved from 0.49 +/- 0.20 to 0.96 +/- 0.31 (p less than or equal to 0.001). Two patients were excluded; in 22/23 eyes the sequential treatment was successful with an overall success rate of 95% of cases (improvement of five lines on the Snellen chart or final visual acuity of 0.8 or better). Initial angiographic cystoid macular edema was comparable and significantly improved after therapy in the two treatment groups. No mean intraocular pressure rise was noted after steroid injections. Measurement of anterior chamber inflammation with the laser flare-cell meter (Kowa FC-1000) showed elevated flare in all cases which significantly decreased in both treatment groups and represented a good follow-up parameter for the effect of antiinflammatory treatment and restoration of blood-ocular barrier.(ABSTRACT TRUNCATED AT 250 WORDS)

Non-necrotizing herpetic vasculitis - Wickremasinghe, Sanjeewa S; Stawell, Richard; Lim, Lyndell; Pakrou, Nima; Zamir, Ehud (Ophthalmology, 2009)

Evaluation of the effect of acetazolamide on cystoid macular oedema in patients with Behcet's disease - Lashay, A R; Rahimi, A; Chams, H; Davatchi, F; Shahram, F; Hatmi, Z N; Khalkhali, H; Beigi, B (Eye (Lond), 2003)
AIM: To study the effect of acetazolamide on cystoid macular oedema (CMO) in patients with Behcet's disease. PATIENTS AND METHODS: A total of 67 eyes of 35 Behcet's patients with chronic, but well-controlled uveitis, and CMO were randomised into a double-masked, crossover trial comparing the effect of acetazolamide vs placebo. The patients received an initial 4-week course of either 250 mg acetazolamide twice daily (b.i.d.) or placebo, followed by a 4-week washout period. They then received a 4-week course of the reverse study medication. An improvement in visual acuity and fundus fluorescein angiographic findings was assessed. RESULTS: In total, 29 patients (55 eyes) completed the trial and were available for analysis. Of the 29, 16 men and 13 were women. The age range was 13-50 years (mean 33.6 years). Patients on acetazolamide showed a slightly better improvement of angiographic signs (at least by one grade improvement) over that of placebo (12 vs five eyes). They also had less deterioration of angiographic signs over that of placebo (three vs seven eyes). However, these findings were not statistically significant (P=0.99). Acetazolamide had no statistically significant effect (P=0.53) on the improvement of visual acuity of patients over that of placebo (13 vs eight eyes), nor on the deterioration of visual acuity (three vs 11 eyes). CONCLUSION: Despite seemingly favourable results, the 4-week course of acetazolamide (250 mg b.i.d.) has no statistically significant effect on the improvement of the visual acuity and the fluorescein angiographic findings in Behcet's patients with CMO.

Ocular complications of latanoprost in uveitic glaucoma: three case reports - Saccà, S; Pascotto, A; Siniscalchi, C; Rolando, M (J Ocul Pharmacol Ther, 2001)
The purpose of this study was to report paradoxical reaction on the intraocular pressure after treatment with latanoprost in 3 cases of uveitic glaucoma. Serial clinical examinations of intraocular pressure by means of daily tonometric curves were performed in three patients with uveitic glaucoma before and after the beginning of latanoprost therapy. All measurements were performed by two doctors, but every patient's IOP was always measured by the same doctor. Adverse reactions, such as increased intraocular pressure and recurrence of inflammation, were noted to occur 7 to 16 days after rechallenging with topical latanoprost therapy for glaucoma in patients with history of uveitic glaucoma. The conclusion indicates that clinicians should be alerted to these possible complications of topical latanoprost therapy in uveitic glaucoma.

Comparison of the effects of IV administration of meloxicam, carprofen, and flunixin meglumine on prostaglandin E(2) concentration in aqueous humor of dogs with aqueocentesis-induced anterior uveitis - Gilmour, Margi A; Payton, Mark E (Am J Vet Res, 2012)
OBJECTIVE: To compare the effects of meloxicam, carprofen, and flunixin meglumine administered IV on the concentration of prostaglandin E(2) (PGE(2)) in the aqueous humor of dogs with aqueocentesis-induced anterior uveitis. ANIMALS: 15 adult dogs with ophthalmically normal eyes. PROCEDURES: Each dog was assigned to 1 of 4 treatment groups. Treatment groups were saline (0.9% NaCl) solution (1 mL, IV), meloxicam (0.2 mg/kg, IV), carprofen (4.4 mg/kg, IV), and flunixin meglumine (0.5 mg/kg, IV). Each dog was anesthetized, treatment was administered, and aqueocentesis was performed on each eye at 30 and 60 minutes after treatment. Aqueous humor samples were frozen at -80°C until assayed for PGE(2) concentration with an enzyme immunoassay kit. RESULTS: For all 4 treatment groups, PGE(2) concentration was significantly higher in samples obtained 60 minutes after treatment, compared with that in samples obtained 30 minutes after treatment, which indicated aqueocentesis-induced PGE(2) synthesis. For aqueous humor samples obtained 60 minutes after treatment, PGE(2) concentration did not differ significantly among groups treated with saline solution, meloxicam, and carprofen; however, the PGE(2) concentration for the group treated with flunixin meglumine was significantly lower than that for each of the other 3 treatment groups. CONCLUSIONS AND CLINICAL RELEVANCE: Flunixin meglumine was more effective than meloxicam or carprofen for minimizing the PGE(2) concentration in the aqueous humor of dogs with experimentally induced uveitis. Flunixin meglumine may be an appropriate pre-medication for use prior to intraocular surgery in dogs.

Granulomatous uveitis and choroidal detachment in a patient after topical treatment with Bimatoprost: A case report - Massimo, Lorusso; Micelli Ferrari, Luisa; Nikolopoulou Gisotti, Eleni; Zito, Roberta; MicelliFerrari, Tommaso; Anna, Ferretta; Bordinone, Marco Antonio (Eur J Ophthalmol, 2021)
BACKGROUND: Bimatoprost 0.03% is an intraocular pressure (IOP) lowering prostaglandin analog with different adverse side effects such as potential ocular inflammatory effect and ocular hyperemia. CASE PRESENTATION: We report a case of 80-year-old woman diagnosed with bilateral glaucomatous uveitis, and choroidal detachment in the left eye after topical bimatoprost administration. During the patient's hospitalization, Bimatoprost treatment was discontinued and local steroid therapy was administrated. After 1 week we reported a marked improvement of visual acuity, IOP measurement was 12 mmHg in both eyes. Anterior segment examination showed complete resolution of conjunctival and pericheratic hyperemia with significant reduction of endothelial precipitates in both eyes. CONCLUSIONS: In our case, the anterior granulomatous uveitis occurred in both pseudophakic eyes and the choroidal detachment (CD) in the eye that previously had trabeculectomy. Probably the scar tissue of the trabeculectomy allowed a better penetration of the Bimatoprost or a greater sensitivity due to an altered trabecular tissue. This work confirms that the onset physiopathology mechanism of granulomatous uveitis and CD following instillation of Bimatoprost remains uncertain.
Keywords: glaucoma; Bimatoprost; granulomatous uveitis; prostaglandin; trabecular outflow; uveoscleral outflow

Passive and oxymetazoline-enhanced delivery with a lens device: pharmacokinetics and efficacy studies with rabbits - Miller, David J; Li, S Kevin; Tuitupou, Anthony L; Kochambilli, Rajan P; Papangkorn, Kongnara; Mix, Donald C, Jr; Higuchi, William I; Higuchi, John W (J Ocul Pharmacol Ther, 2008)
PURPOSE: The aims of this study were to assess the trans-scleral delivery of dexamethasone phosphate (DexP) with a prototype lens device and a formulation comprising a vasoconstrictor and to determine the efficacy of this delivery system in treating experimentally induced uveitis in a rabbit model. METHODS: Passive trans-scleral delivery was performed on New Zealand white rabbits in vivo, using the lens device and a formulation of 0.034 M oxymetazoline (OMZ, the vasoconstrictor) and 0.5 M of dexamethasone sodium phosphate (DexNaP). Trans-scleral delivery of DexP without OMZ was the control. The amounts of DexP delivered into the eye and its distributions in the eye were determined by dissection of the eye and high-performance liquid chromatography assay in the pharmacokinetics study. The efficacy of the DexP delivery system in treating lipopolysaccharide-induced uveitis was also evaluated in the rabbit model in vivo. The effect of OMZ upon DexP delivery and its treatment efficacy was studied by comparing the DexP results with and without OMZ. RESULTS: In the pharmacokinetics study, the amounts of DexP delivered into the eye using the lens system with OMZ were significantly higher than those without OMZ. The results in the efficacy study showed a better treatment outcome with OMZ to relieve the symptoms of endotoxin-induced uveitis in rabbits. CONCLUSIONS: The potential of vasoconstrictors to enhance eye disease treatments in passive trans-scleral drug delivery was demonstrated. The higher DexP level in the eye and the improvement of the outcome in the efficacy study in the presence of the vasoconstrictor are consistent with the hypothesis that the vasoconstrictor enhances drug delivery by decreasing clearance.

Effect of topical ophthalmic latanoprost 0.005% solution alone and in combination with diclofenac 0.1% solution in healthy horses: a pilot study - Tofflemire, Kyle; Whitley, Elizabeth M; Allbaugh, Rachel; Ben-Shlomo, Gil; Griggs, Angela; Strong, Travis; Whitley, R David (Vet Ophthalmol, 2016)
OBJECTIVE: To evaluate the effect of topical ophthalmic 0.005% latanoprost alone and in combination with 0.1% diclofenac on healthy horses. ANIMALS STUDIED: Twelve healthy adult horses. PROCEDURES: A randomized, masked crossover design was used with horses divided into three groups for once daily treatment in one randomly selected eye. For arm 1 of the study, Group D (n = 3) received 0.1% diclofenac, Group L (n = 3) received 0.005% latanoprost, and Group DL (n = 6) received 0.005% latanoprost and 0.2 ml of 0.1% diclofenac. For arm 2 of the study, horses from Group D and L were placed into Group DL and horses from Group DL were placed into either Group D or L. Evaluations of intraocular pressure (IOP), vertical pupil diameter, aqueous flare, conjunctival hyperemia, epiphora, blepharospasm, and blepharoedema were performed 4 times daily on days 1 and 2 (baseline), days 3 to 7 (arm 1 treatment), days 8 to 11 (washout), days 12 to 16 (arm 2 treatment), and days 17 and 18 (return to baseline). RESULTS: During the treatment period, significant reduction in IOP and vertical pupil diameter occurred in treated eyes of Groups L and DL, but not Group D. These variables did not differ significantly between Groups L and DL. Blepharospasm, blepharoedema, epiphora, and conjunctival hyperemia scores were significantly higher in Group L than in Groups D and DL. CONCLUSIONS: Latanoprost reduced IOP in healthy horses and signs of drug-induced discomfort were mitigated by concurrent use of diclofenac.
Keywords: uveitis; glaucoma; intraocular pressure; prostaglandin; miosis; NSAID

Effect of catecholamine on central serous chorioretinopathy - Sun, Jinghua; Tan, Junfeng; Wang, Zhitao; Yang, Hong; Zhu, Xuefei; Li, Lingli (J Huazhong Univ Sci Technolog Med Sci, 2003)
The role of catecholamine (CA) in the pathogenesis and development of macular edema of central serous chorioretinopathy (CSC) was studied, and its relations with visual acuity were investigated. Plasma concentrations of epinephrine (E) and norepinephrine (NE) were determined in 30 consecutive eyes with CSC. Central macular thickness analysis was done by RTA and all the data were compared with normal eyes and analyzed with SAS software package. Plasma concentrations of E and NE were increased to (569 +/- 123) ng/L and (721 +/- 104) ng/L respectively in active CSC patients, significantly higher than those in normal subjects (P < 0.01), and decreased to normal in convalescent stage. RTA analysis revealed that the retinal thickness of CSC patients was increased at active and recovery stage as compared with normal subjects; and the plasma concentration of E was significantly correlated with central macular thickness (t = 2.173, P < 0.05). Also, central macular thickness measured by RTA was significantly correlated with the visual acuity (r = -0.8046, P < 0.001) in CSC eyes. RTA analysis might be useful to quantitatively detect and evaluate prognosis in CSC patients. The plasma concentration of E, which was highly correlated with macular edema, might play an important role in the early damage and the pathogenesis of CSC.

Uveodermatologic syndrome in a rat terrier - Blackwood, Sarah E; Barrie, Kathleen P; Plummer, Caryn E; Taylor, David; Nunnery, Catherine M; Seltzer, Judith D; Ben-Shlomo, Gil; Brooks, Dennis E (J Am Anim Hosp Assoc, 2011)
A 4 yr old intact male rat terrier presented with severe bilateral nonresponsive panuveitis. Bilateral uveitis, blepharospasm, conjunctival hyperemia, diffuse corneal edema, peripheral bullous retinal detachment, and secondary ocular hypertension were noted. Ocular lesions progressed despite aggressive medical treatment and were followed by cutaneous depigmentation and crusting along the nasal planum. Intensive oral and topical anti-inflammatory and topical antiglaucoma medications were administered, but the ocular disease progressed. A bilateral enucleation was performed. Uveodermatologic syndrome was diagnosed from histopathologic examination of a skin biopsy as well as histopathology of both globes after bilateral enucleation. To maintain control of the dermatologic lesions, oral azathioprine was initiated, but it was not well tolerated by this patient. Immunosuppressive doses of oral cyclosporine and anti-inflammatory doses of oral prednisone were used to control the depigmentation and crusting skin lesions.

Transforming growth factor-beta 2 levels in aqueous humor of glaucomatous eyes - Inatani, M; Tanihara, H; Katsuta, H; Honjo, M; Kido, N; Honda, Y (Graefes Arch Clin Exp Ophthalmol, 2001)
PURPOSE: To determine whether clinical characteristics are correlated with increased levels of transforming growth factor-beta 2 (TGF-beta 2) in aqueous humor in glaucomatous eyes. METHODS: Aqueous humor samples were collected from 91 glaucomatous eyes. Included were samples from primary open-angle glaucoma (POAG) in 40 eyes, (pseudo)exfoliation syndrome (EXS) in 18 eyes, primary angle-closure glaucoma (PACG) in 26 eyes and uveitis-related secondary glaucoma (SG) in 7 eyes. TGF-beta 2 in aqueous humor was assessed with a specific-capture ELISA. RESULTS: The mean concentration (+/- standard error) of mature (biologically active) TGF-beta 2 in the aqueous humor of eyes with POAG was 293.6 +/- 33.6 pg/ml, significantly higher than that in eyes with PACG, EXS and SG: 147.5 +/- 28.1, 135.8 +/- 30.2 and 41.0 +/- 10.7 pg/ml, respectively (P = 0.0006, P = 0.0010 and P = 0.0003; analysis of variance). The mean concentration (+/- standard error) of total TGF-beta 2 in the aqueous humor of eyes with POAG was 1647.6 +/- 124.5 pg/ml, not significantly different from that in eyes with PACG, EXS and SG: 1482.9 +/- 148.2, 1442.7 +/- 187.8 and 1929.0 +/- 367.6 pg/ml, respectively. A multivariate analysis using logistic regression showed significant correlations between mature TGF-beta 2 concentration and history of cataract surgery (P = 0.0225) and the use of carbonic anhydrase inhibitors (P = 0.0143). CONCLUSIONS: Our results indicate that increased levels of TGF-beta 2 may play an important role in the pathogenesis of POAG.

Treatment of chronic macular edema with acetazolamide - Cox, S N; Hay, E; Bird, A C (Arch Ophthalmol, 1988)
In a prospective study, 41 patients with documented chronic macular edema of various causes were entered into a therapeutic trial of acetazolamide sodium, a carbonic anhydrase inhibitor. Each patient received a five-cycle cross-over regimen of treatment/no treatment with a further two cycles of cross-over with another diuretic, cyclopenthiazide, which does not inhibit carbonic anhydrase. At each cross-over patients were examined for evidence of macular edema. Sixteen of 41 patients showed a reproducible response to acetazolamide with partial or complete resolution of edema and improvement of visual acuity. The therapeutic effect occurred in more than half of the patients with inherited outer retinal disease or uveitis, but in none with primary retinal vascular disorders. There was no correlation between the response to treatment and the extent or duration of the edema. No influence of cyclopenthiazide on macular edema was detected.

Effects of latanoprost on blood-retinal barrier permeability in rabbits - Kitaya, Norihiko; Mori, Fumihiko; Hikichi, Taiichi; Takahashi, Junichi; Yoshida, Akitoshi (Ophthalmic Res, 2003)
PURPOSE: To investigate the effect of latanoprost (LP) on the inward and outward permeability (Pin and Pout) of the blood-retinal barrier (BRB). METHODS: Four New Zealand white rabbits received topical LP (0.005%) once daily for 3 weeks in one eye and phosphate-buffered saline (PBS) in the fellow eye (topical group). Five New Zealand white rabbits were injected intravitreously with LP (0.1 ml, 0.005%) in one eye and PBS (0.1 ml) in the fellow eye (injection group). In the injection group, vitreous fluorophotometry (VFP) to estimate the Pin and differential vitreous fluorophotometry (DVF) to estimate the Pout were performed 60 min after LP was injected. After the baseline measurements, VFP and DVF were performed 60 and 180 min after intravenous injection of sodium fluorescein, respectively. Fluorescein (F) and fluorescein monoglucuronide (FG) concentrations were obtained by DVF, and the F/FG ratio was calculated as an index of the Pout. RESULTS: In the topical group, there were no significant differences in the Pin or F/FG ratio between the LP- and the PBS-treated eyes. In the injection group, the Pin in the LP-treated eyes was significantly higher than in PBS-treated eyes (p < 0.05). There was no significant difference in the F/FG ratio between the two groups. CONCLUSION: Although we cannot exclude the effect of differences in species, the physiologic effect of LP, which increased the Pin, was seen in experimental studies. Because antiglaucoma drugs are generally used over an extended period, further clinical studies of the effect of LP on the BRB should be performed in patients who have BRB breakdown, such as in uveitis, and in patients who are pseudophakic and aphakic.

Transitory outward pupillary curling in a case of HSV associated acute anterior uveitis: a hitherto unreported sign - Karkhur, Samendra; Soni, Deepak; Sharma, Bhavana (BMJ Case Rep, 2020)
We report a case of herpes simplex virus (HSV) associated acute anterior uveitis in otherwise healthy 38-year-old man with an unusual finding of outward pupillary margin curling. At presentation visual acuity was 20/60 in right eye (OD) and 20/20 in left eye (OS). Intraocular pressure was 44 and 18 mm Hg in OD and OS respectively. OD revealed diffuse conjunctival congestion, stromal oedema, pigmented keratic precipitates, cells grade 3+ and flare 2+ on slit-lamp examination and diminished corneal sensations. OS was unremarkable. There was a history of three similar episodes in last 1 year. Aetiology of this recurrent acute anterior uveitis was confirmed to be HSV via DNA-PCR assay of aqueous fluid. This hitherto unreported sign associated with viral hypertensive uveitis was transitory in nature and reversible with control of anterior chamber inflammation, without leaving any permanent damage. Topical steroids and antiglaucoma were stopped, while antiviral therapy was continued for 3 months.
Keywords: glaucoma; anterior chamber; iris; pupil

Brimonidine-timolol fixed combination induced granulomatous inflammation of the eye - Carrasco, María Alejandra; Schlaen, Bernardo Ariel; Zárate, Jorge Oscar (Int Ophthalmol, 2012)
We report on two cases of granulomatous conjunctivitis and uveitis related with the use of a brimonidine-timolol fixed combination. Case report and a review of medical literature. A 64-year-old man was diagnosed with marked granulomatous uveitis and a 57-year-old woman was diagnosed with granulomatous conjunctivitis. Both patients were using a topical fixed combination of brimonidine 0.2 %-timolol 0.5 % for open angle glaucoma. Bilateral granulomatous uveitis and conjunctivitis were diagnosed after 16 months of treatment with a fixed combination of brimonidine-timolol in both cases. Granulomatous inflammation resolved with the cessation of antiglaucomatous drugs and topical corticosteroid treatment. When the inflammation had resolved completely, both patients were rechallenged with topical brimonidine in one eye only to determine causality. Conjunctival hyperemia is a common side effect of glaucoma medications and is sometimes overlooked. Hyperemia may be associated with other signs such as iritis and keratic precipitates or conjunctival inflammation. In such cases, granulomatous inflammation may be considered in the differential diagnosis. The fixed-combination of brimonidine-timolol may cause this clinical picture.

The effect of phenylephrine on pain and flare intensity in eyes with uveitis - Zaczek, A; Zetterström, C (Acta Ophthalmol Scand, 2000)
PURPOSE: To investigate the influence of protein concentration in the anterior chamber, measured by laser flare meter, on pain sensation after phenylephrine instillation in patients with iridocyclitis. METHODS: Twenty-five consecutive patients with iridocyclitis were included. Patients with cataract, exfoliation syndrome, diabetes mellitus, glaucoma or any other previous ocular diseases or ocular surgery were excluded. Patients were divided into two groups: Group 1--without fibrinoid reaction (FR) in the anterior chamber (18 patients), and Group 2--with FR (7 patients). Protein concentration in the anterior chamber was measured with laser flare meter (FC 500, Kowa Co., Japan). Pupil size was measured by Alcon Tilo Scale, and pain sensation was estimated by Visual Analogue Scale (VAS, Kabi Pharmacia). All measurements were done before and 1 hour after topical instillation of 10% phenylephrine hydrochloride into the subconjunctival sac of the inflamed eyes. RESULTS: Eyes with iridocyclitis and fibrinoid reaction (FR) have a higher flare intensity compared to those without FR (p<0.05). Pupil size was significantly increased after phenylephrine instillation in both study groups (Wilcoxon test, p<0.05). The VAS pain and flare intensity were significantly decreased in group without FR after phenylephrine instillation (Group 1) compared to values before treatment (Wilcoxon test, p<0.05). In eyes with FR (Group 2), no significant influence of phenylephrine instillation was found on VAS pain and flare intensity. CONCLUSIONS: After phenylephrine instillation, flare intensity and pain were significantly decreased only in eyes with iridocyclitis and without FR. The decreasing level of flare intensity, and paralysis of the pupil after phenylephrine instillation seem to alleviate pain in those eyes.

[Anterior uveitis and topical brimonidine: a case report] - Velasque, L; Ducousso, F; Pernod, L; Vignal, R; Deral, V (J Fr Ophtalmol, 2004)
We report the case of a 66-year-old patient treated for 13 months with brimonidine, who presented granulomatous anterior uveitis associated with an increase in intraocular pressure, allergic conjunctivitis and blepharitis in both eyes. No ocular or general cause for uveitis was found. The uveitis responded rapidly to cessation of brimonidine. This report illustrates that anterior uveitis can occur when brimonidine is used after approximately 1 year of treatment. Physicians must be informed of this side effect even though it is rare, with only four similar cases having been described in the literature.

Preventive effects of tyrosol, a natural phenolic compound, on anterior uveitis induced by anterior chamber paracentesis in healthy beagle dogs - Sato, Kazuaki; Kanai, Kazutaka; Ozaki, Maiko; Kagawa, Takaaki; Kita, Mizuki; Yamashita, Yohei; Nagai, Noriaki; Tajima, Kazuki (J Vet Med Sci, 2019)
We investigated the effects of tyrosol (Tyr) on anterior chamber paracentesis (ACP)-induced anterior uveitis in beagle dogs, as determined by protein and prostaglandin E2 (PGE2) concentrations in the aqueous humor (AH). Tyr at a dose of 100 or 200 mg/kg or 2.2 mg/kg of carprofen as a positive control was administered orally twice daily from 2.5 days before paracentesis. The initial ACP was performed in one eye of individual dogs and 0.5 ml AH was aspirated. The secondary AH was collected 60 min later. Pretreatment with 200 mg/kg of Tyr and carprofen significantly decreased aqueous protein and PGE2 concentrations compared to the control group. Overall, these findings suggested that Tyr was useful for the management of canine anterior uveitis.
Keywords: anterior uveitis; anterior chamber paracentesis; blood–aqueous barrier; dog; tyrosol

Intraocular pressure elevation after intravitreal triamcinolone acetonide injection - Jonas, Jost B; Degenring, Robert F; Kreissig, Ingrid; Akkoyun, Imren; Kamppeter, Bernd A (Ophthalmology, 2005)
PURPOSE: To report on intraocular pressure (IOP) after intravitreal injections of triamcinolone acetonide. DESIGN: Meta-analysis of previously reported data and case series studies. PARTICIPANTS: The study included 272 patients (305 eyes) receiving an intravitreal injection of approximately 20 mg triamcinolone acetonide as treatment for diffuse diabetic macular edema (n = 84 patients), exudative age-related macular degeneration (n = 181 patients), retinal vein occlusions (n = 20 patients), uveitis (n = 9), pseudophakic cystoid macular edema (n = 6), and other reasons (n = 5). Mean follow-up was 10.4+/-6.7 months (median, 7.9 months; range, 3.0-35.7 months). INTERVENTION: Intravitreal injection of approximately 20 mg triamcinolone acetonide. MAIN OUTCOME MEASURE: Intraocular pressure. RESULTS: Intraocular pressure readings higher than 21 mmHg, 30 mmHg, 35 mmHg, and 40 mmHg, respectively, were measured in 112 (41.2%) patients, 31 (11.4%) patients, 15 (5.5%) patients, and 5 (1.8%) patients, respectively. Triamcinolone-induced IOP elevation was treated by antiglaucoma medication in all but 3 (1.0%) eyes, for which filtering surgery was performed. Mean IOP started to rise 1 week after injection and returned to baseline values approximately 8 to 9 months after injection. Younger age (P = 0.029) was significantly associated with triamcinolone-induced ocular hypertension. Triamcinolone responders and triamcinolone nonresponders did not vary significantly in gender (P = 0.42), refractive error (P = 0.86), diabetes mellitus status (P = 0.74), and reason for treatment. CONCLUSIONS: These findings may be useful for comparing risks and benefits of intravitreal triamcinolone acetonide therapy.

[Pharmacological pseudo-Fuchs] - Sevillano Torrado, C; Lugo Adán, E; Viso Outeiriño, E (Arch Soc Esp Oftalmol, 2012)
CASE REPORT: A case of unilateral iridis hyperpigmentation and uveitis due to travoprost is presented. DISCUSSION: Anterior uveitis is a rare side-effect of travoprost. In this case, heterochromic iris was also presented, which led us to the wrong diagnosis of a Fuchs heterochromic iridocyclitis. The differencial diagnosis along with the associated literature is discussed.

Pustular psoriasis precipitated by acetazolamide - Kuroda, K; Kojima, T; Tanabe, E; Fujita, M; Shinkai, H (J Dermatol, 1995)
We report a case of pustular psoriasis precipitated by acetazolamide, a carbonic anhydrase inhibitor. A 28-year-old man suffering from 20 years-standing generalized pustular psoriasis developed psoriatic arthritis and glaucoma and experienced a precipitation of pustular lesions and widespread erythema after initiation of oral acetazolamide for glaucoma. The cutaneous lesions and systemic symptoms improved after restriction of acetazolamide and administration of oral etretinate. Readministration of acetazolamide confirmed that generalized pustules arose within 24 hours.

[Iritis : What has glaucoma to do with it?] - Hopf, S; Prokosch, V; Bornscheuer, C; Pfeiffer, N (Ophthalmologe, 2017)

Cystoid macular edema associated with latanoprost therapy in a case series of patients with glaucoma and ocular hypertension - Moroi, S E; Gottfredsdottir, M S; Schteingart, M T; Elner, S G; Lee, C M; Schertzer, R M; Abrams, G W; Johnson, M W (Ophthalmology, 1999)
OBJECTIVE: To identify coexisting ocular diagnoses in a case series of eyes that developed cystoid macular edema (CME) associated with latanoprost therapy. DESIGN: Retrospective observational case series. PARTICIPANTS: Seven eyes of seven patients who developed CME possibly associated with latanoprost treatment were studied. INTERVENTION: When these patients, all of whom were treated with latanoprost in addition to other glaucoma medications, described blurred vision or eye irritation, ocular examination revealed CME, which was confirmed by fluorescein angiography. Latanoprost was discontinued, and in three cases topical corticosteroids and nonsteroidal anti-inflammatory agents were used to treat the CME. MAIN OUTCOME MEASURES: Visual acuity and intraocular pressure were determined before latanoprost use began, during therapy, and after latanoprost use ceased. In these cases, resolution of CME was documented clinically after discontinuing latanoprost. RESULTS: Clinically significant CME developed after 1 to 11 months of latanoprost treatment, with an average decrease of 3 lines in Snellen visual acuity. Intraocular pressure decreased an average of 27.9% during treatment. Cystoid macular edema was confirmed in all cases by fluorescein angiography. In these seven patients, the following coexisting ocular conditions may have placed these eyes at risk for prostaglandin-mediated blood-retinal barrier vascular insufficiency: history of dipivefrin-associated CME, epiretinal membrane, complicated cataract surgery, history of macular edema associated with branch retinal vein occlusion, history of anterior uveitis, and diabetes mellitus. In all cases, the macular edema resolved following discontinuation of latanoprost, in some instances with concomitant use of steroidal and nonsteroidal anti-inflammatory agents. CONCLUSIONS: In this case series of pseudophakic, aphakic, or phakic eyes, the temporal relationships between the use of latanoprost and developing CME, and the resolution of CME following cessation of the drug, suggest an association between latanoprost and CME. In all cases, coexisting ocular conditions associated with an altered blood-retinal barrier were present.

Vogt-Koyanagi-Harada syndrome in a 6-year-old Hispanic boy - Hernandez, Claudia; LePoole, Caroline; Tessler, Howard H (Pediatr Dermatol, 2011)
A 6-year-old Hispanic boy presented to the ophthalmology department with complaints of pain, photophobia, and blurry vision of both eyes. He was found to have bilateral granulomatous panuveitis, cataracts, and high intraocular pressures. He later developed multiple asymptomatic, ovoid, hypopigmented patches over the mid-lumbosacral back. Biopsy of lesional skin was significant for low melanocyte counts and a mild lymphocytic infiltrate. The patient was diagnosed with Vogt-Koyanagi-Harada syndrome (VKH). This article reviews the literature regarding the cutaneous presentation of VKH.

Hypertensive acute granulomatous anterior uveitis as a side effect of topical brimonidine - Clemente-Tomás, R; Arciniegas-Perasso, C A; Hervás-Hernandis, J M; García-Ibor, F; Ruiz-Del Río, N; Duch-Samper, A M (Arch Soc Esp Oftalmol (Engl Ed), 2018)
CLINICAL CASE: The case concerns an 81-year-old woman on treatment with a topical fixed combination of timolol and brimonidine who was diagnosed in the Emergency Department with acute anterior granulomatous hypertensive uveitis. The patient responded favourably to the withdrawal of the eye drops without showing any subsequent relapse. DISCUSSION: Uveitis due to brimonidine is a rare adverse effect, but it must be known. Once the diagnosis is suspected, the effective treatment is the withdrawal of brimonidine, with or without the addition of topical corticosteroids to control inflammation depending on the severity of the condition. It is a process with an excellent prognosis.
Keywords: Brimonidine; Anterior granulomatous uveítis; Brimonidina; Brimonidine induced uveitis; Mutton-fat keratic precipitates; Precipitados retroqueráticos en grasa de carnero; Uveítis anterior granulomatosa; Uveítis inducida por brimonidina

Posner-Schlossman syndrome: a case report - Harrington, J R (J Am Optom Assoc, 1999)
BACKGROUND: Glaucomatocyclitic Crisis (AKA Posner-Schlossman syndrome) is a syndrome that affects patients between the ages of 20 and 50 years. It is characterized by a mild recurrent anterior uveitis associated with an out-of-proportion intraocular pressure spike in the same eye. The cause is unclear, but many theories exist. Some researchers have tried to connect it with primary open-angle glaucoma. CASE REPORT: A review of the record of a 41-year-old Hispanic woman with Posner-Schlossman syndrome is discussed. She sought treatment on multiple occasions with symptoms of mild pain, photophobia, and a blurry left eye. Examination revealed mild anterior chamber reaction and an intraocular pressure (IOP) spike in the same eye. She was treated with topical anti-inflammatory and pressure-lowering agents. Each individual flare-up was treated successfully, but the patient began to show equivocal signs of primary open-angle glaucoma (PDAG). She is currently treated prophylactically for POAG with a beta-blocker. No etiologic factor was identified in this patient. The differential diagnosis is straight-forward and the treatment is general uveitic therapy--minus cycloplegics--combined with an IOP-lowering drop. CONCLUSION: This is an interesting and relatively rare uveitic condition. The list of differential diagnoses is long, as is the theorized etiologies; however, clinically the condition is relatively quickly identifiable by the presence (and absence) of signs and symptoms.

[Side-effects and risk profile of latanoprost 0.005% (Xalatan)] - Schlote, T (Ophthalmologe, 2002)
BACKGROUND: Latanoprost, a prostaglandin F(2alpha)-analogue, has been widely in use in clinical practice for a period of over 5 years. The side-effects of latanoprost are analyzed and the clinical relevance is discussed. RESULTS: Hypertrichosis and increased pigmentation of eyelashes will develop in the majority of patients using latanoprost for more than 6 months. Increased pigmentation of the eyelids may also occur. Hyperpigmentation of the iris is seen in 12-18% of caucasians using latanoprost over a period of 1-2 years. Increased iris pigmentation seems more common in asian people and remains unchanged after discontinuation of therapy. Pigmentation of intra- and extraocular structures is caused by increased melanogenesis, not by melanocyte proliferation. Mild conjunctival hyperemia may develop in approximately 30% of patients, but is most often without clinical relevance. Further reported side-effects include anterior uveitis, reactivation of herpes-keratitis/-dermatitis and cystoid macular edema in pseudophakic and aphakic patients. A causal relationship has still not been proven for these side-effects. Systemic side-effects are rare (e.g. headache, facial rash, cardiovascular effects). No experience exists for treatment of glaucoma with latanoprost in childhood. CONCLUSION: Latanoprost represents a highly effective antiglaucomatous drug, rarely associated with vision-threatening complications. The most common complications are hypertrichosis of eyelashes and increased pigmentation of extra- and intraocular structures. A careful lifetime evaluation of these patients is recommended. Systemic side-effects are rare, but may occur.

Lack of feedback inhibition of insulin secretion in denervated human pancreas - Luzi, L; Battezzati, A; Perseghin, G; Bianchi, E; Vergani, S; Secchi, A; La Rocca, E; Staudacher, C; Spotti, D; Ferrari, G (Diabetes, 1992)
In this study, pancreas transplantation is used as a clinical model of pancreas denervation in humans. To assess the role of innervation on the feedback autoinhibition of insulin secretion, we studied four groups of subjects--group 1: 16 patients with combined pancreas and kidney transplantation (plasma glucose = 5.1 mM, HbA1c = 6.4%, creatinine = 86 mM); group 2: 8 patients with chronic uveitis on the same immunosuppressive therapy as transplanted patients (12 mg/day prednisone, 5 mg.kg-1.day-1 CsA); group 3: 4 uremic, nondiabetic patients in chronic hemodialysis; group 4: 7 normal, nondiabetic control subjects. The following means were used to study the groups: 1) a two-step hyperinsulinemic euglycemic clamp (insulin infusion rate = 1 mU and 5 mU.kg-1.min-1); and 2) a 0.3 mU.kg-1.min-1 hypoglycemic clamp (steady-state plasma glucose = 3.1 mM). Basal plasma-free IRI (84 +/- 6, 42 +/- 12, 72 +/- 12, and 30 +/- 6 pM in groups 1, 2, 3, and 4, respectively), basal C-peptide (0.79 +/- 0.05, 0.66 +/- 0.05, 3.04 +/- 0.20, and 0.59 +/- 0.06 nM in groups 1, 2, 3, and 4, respectively), and glucagon (105 +/- 13, 69 +/- 4, 171 +/- 10, and 71 +/- 5 pg/ml in groups 1, 2, 3, and 4, respectively) were increased in groups 1 and 3 with respect to groups 2 and 4 (P < 0.01). During euglycemic hyperinsulinemia, plasma C-peptide decreased by 45, 20, and 44% in groups 2, 3, and 4, respectively, but showed no significant change from the basal in patients with transplanted pancreases.(ABSTRACT TRUNCATED AT 250 WORDS)

Bimatoprost 0.03% gel for cosmetic eyelash growth and enhancement - Woodward, Julie A; Haggerty, Chris J; Stinnett, Sandra S; Williams, Zinaria Y (J Cosmet Dermatol, 2010)
OBJECTIVE: To evaluate a bimatoprost gel for enhancing eyelash growth, adverse effects, and change in intraocular pressure (IOP). METHODS: Prospective, double-masked, randomized controlled study. Fifty-two patients without ocular disease were assigned a control or bimatoprost 0.03% gel to apply to the eyelid margin once a day. RESULTS: The adjusted mean change in eyelash length from baseline to 6 months was 0.77 mm in the bimatoprost group and -0.12 mm in the control group (P = 0.004). Adverse effects were experienced by 2 of 16 patients (12.5%) in the control group and 9 of 36 patients (25%) in the bimatoprost gel group. Mean change in IOP from baseline to 6 months was 0.685 mmHg in the control group and -2.04 mmHg in the bimatoprost group (P = 0.009). CONCLUSIONS: Bimatoprost gel was effective in enhancing eyelash growth. The most common adverse effect for the bimatoprost gel was conjunctival and eyelid hyperemia, while the most severe was recurrent anterior uveitis. Mean IOP was reduced in subjects using the bimatoprost gel.

Comparison of early posttreatment effects of two steroidal anti-inflammatory ophthalmic drugs on the ocular inflammatory response induced by paracentesis in healthy canine eyes - Sato, Kazuaki; Iwasaki, Kiwako; Nagai, Noriaki; Yamashita, Yohei; Chikazawa, Seishiro; Hoshi, Fumio; Kanai, Kazutaka (Vet Ophthalmol, 2019)
OBJECTIVE: We investigated the early posttreatment effects of two steroidal anti-inflammatory ophthalmic drugs on blood-aqueous barrier (BAB) breakdown by paracentesis in dogs. ANIMAL STUDIES: We studied 21 healthy beagles with normal eyes. PROCEDURES: Controlled anterior chamber paracentesis (0.5 mL) was performed in one eye of each dog. Control group dogs (n = 7) received no medication, whereas those in the treatment groups received a topical anti-inflammatory medication (difluprednate [DFBA] ophthalmic emulsion 0.05% [n = 7] or betamethasone [BMZ] sodium phosphate ophthalmic solution 0.1% [n = 7]) at 0, 15, 30, and 45 minutes after initial paracentesis in the paracentesed eyes. Secondary aqueous humor (AH) was collected 60 minutes after initial paracentesis. Protein and prostaglandin E(2) (PGE(2) ) concentrations in AH were determined using the bicinchoninic acid assay and commercially available immunoassay kit, respectively. All mean values in the three groups were compared using analysis of variance followed by Tukey's post hoc test. RESULTS: Aqueous protein and PGE(2) concentrations were markedly increased at 60 minutes following paracentesis. Both concentrations in the secondary AH of the DFBA group were significantly lower than those of the control group; however, treatment with BMZ had no significant effects. CONCLUSIONS: Early postparacentesis treatment with DFBA was more effective than that with BMZ for reducing aqueous protein and PGE(2) contents in dogs with paracentesis-induced BAB breakdown. DFBA may be an appropriate treatment during the early stage of anterior uveitis caused by intraocular surgery in dogs.
Keywords: uveitis; dog; blood-aqueous barrier; corticosteroid; paracentesis; topical administration

Increased intraocular pressure during treatment for chronic uveitis - BenEzra, D; Wysenbeek, Y S; Cohen, E (Graefes Arch Clin Exp Ophthalmol, 1997)
OBJECTIVES: (1) To prospectively evaluate the incidence of increased intraocular pressure (IOP) in patients suffering from chronic uveitis. (2) To identify the main factors responsible for an increase in the IOP among these patients. METHODS: Two hundred and one patients suffering from chronic uveitis were included. Enrolled patients had an initial IOP of 8-18 mmHg. The patients were treated and clinically monitored during a period of 4 years. The IOP was measured at each visit and its changes followed prospectively. All patients were followed up for at least 12 months after enrollment. RESULTS: Twenty-four (12%) of the 201 patients had IOP higher than 24 mmHg at two or more consecutive visits. Of these 24 patients, 19 suffered from bilateral uveitis and 5 had unilateral disease. Four of the 19 patients with bilateral uveitis developed a constant IOP higher than 24 mmHg in both eyes, while in 15 patients an IOP higher than 24 mmHg persisted only in one eye. A close association between the increased IOP and the use of corticosteroids was found in 18 of the 24 cases (75%). This association was ascertained in 16 of these patients by the decrease in IOP levels on discontinuation of the corticosteroid regimen and the renewed increase IOP was due to pupillary block in three cases (12.5%), to iris and angle neovascularization in two (8.3%), and to the inflammatory process per se in one case only (4.2%). CONCLUSIONS: This study demonstrates that a persistent elevation of the IOP in patients suffering from chronic uveitis is, in the majority of cases, associated with the use of corticosteroids.

Long-term effect of acetazolamide treatment of patients with uveitic chronic cystoid macular edema is limited by persisting inflammation - Schilling, Harald; Heiligenhaus, Arnd; Laube, Thomas; Bornfeld, Norbert; Jurklies, Bernhard (Retina, 2005)
PURPOSE: To assess the long-term effect of acetazolamide treatment on patients with cystoid macular edema (CME) in the course of intermediate or posterior chronic uveitis and to define those patients who may particularly benefit from the drug. METHODS: Fifty-two eyes (45 patients) with chronic uveitic CME were treated with acetazolamide at an initial dosage of 500 mg/d. The effect of treatment was assessed by fluorescein angiography, ophthalmoscopy, visual acuity, and Amsler testing. Therapy was withdrawn when CME did not improve at 3 weeks. In cases with CME improvement, the dosage was gradually tapered. RESULTS: The mean follow-up was 3.1 years (minimum, 1.5 years). Two subgroups were identified: group 1, quiescence of uveitis with acetazolamide as the single therapeutic agent (33 eyes); and group 2, chronically active uveitis requiring additional systemic antiinflammatory drugs (19 eyes). In both groups, visual acuity improvement was statistically significant (group 1, P = 0.012; group 2, P = 0.025). In 12 patients with a stable visual acuity gain, the medication dose could be tapered off completely without any recurrent edema shown by fluorescein angiography after a minimum follow-up of 1 year. Sixteen patients required a maintenance dosage, ranging from 125 to 500 mg daily. No major adverse effects of the medication were observed. CONCLUSIONS: During long-term follow-up, low-dose acetazolamide can be a useful therapeutic option for chronic CME in uveitis. The effect was better in patients with quiescence of uveitis than in those with chronically active uveitis. Permanent therapy is not imperative in every case.

[Therapy of cystoid diffuse macular edema after uveitis and cataract surgery with the carbonic anhydrase inhibitor acetazolamide (Diamox)] - Schilling, H; Pauleikhoff, D; Schrenk, M; Wessing, A (Klin Monbl Augenheilkd, 1993)
BACKGROUND: Observations made by Cox, Bird et al. (1988), who first used acetazolamide (Diamox) for treatment of macular edema of various origin in a higher number of patients, let assume a positive effect of this therapy on fluid accumulation specifically inside the inner retinal layers. Based on these studies 15 patients (20 eyes) with cystoid or cystoid-diffuse macular edema were treated with acetazolamide in a pilot-study. MATERIALS AND METHODS: Eleven patients (fifteen eyes) had postuveitic macular edema, four other patients (five eyes) had cystoid edema following cataract surgery. Patients with additional diseases causing macular edema of retinal vascular origin were excluded. The initial dose was 500 mg daily. In one patient responding to therapy the dose was gradually reduced after three weeks down to a minimum of 125 mg every second day. For evaluation of the therapeutical results fluorescein angiography and visual acuity were taken into account. RESULTS: Eleven patients (fourteen out of twenty eyes) showed a distinct therapeutical effect with decrease of macular edema in repeatedly controlled fluorescein angiography. All these patients had a subjective improvement of vision which correlated with an increase of visual acuity in exactly one half of all patients. Therapy was stopped, when the macular edema had still appeared unchanged in angiography after three weeks or when--in spite of fluid reduction in angiography--no improvement of visual acuity could be obtained in the next two months. The maintenance dose showed large individual variation with a minimum of 125 mg every second day and a maximum of 250 mg per day. Attempts to stop therapy resulted in a early reappearance of the edema of original extension with corresponding deterioration of visual acuity and sensitivity of central visual field. In a few patients even the reduction of the dose below the individual maintenance dose could be demonstrated angiographically. All patients were under continuous internal medical control, permanent side-effects of acetazolamide with the doses used in this study were not seen. CONCLUSIONS: The results show that acetazolamide is a basically effective agent against cystoid macular edema and that a therapeutical trial is justified based on the treatment criteria of this study. The factors limiting the therapeutical effect of acetazolamide cannot yet be evaluated on the basis of the small amount of patients in this pilot-study. Considering the patient data a time factor depending on the period between onset of edema-related symptoms and begin of treatment is likely. In the group of unsuccessfully treated cases we had the patients with the longest period of preexisting edema (more than one year) of the study.

The effect on intraocular pressure of latanoprost once or four times daily - Lindén, C; Alm, A (Br J Ophthalmol, 2001)
AIMS: To compare the effect on intraocular pressure (IOP) of latanoprost applied once daily with four times daily and to study if the difference persisted when treatment changed to once daily. METHODS: IOP was followed in 28 healthy volunteers in a double masked randomised 52 day study. Latanoprost 50 microg/ml was administered once daily in one eye and four times daily in the other during 2 weeks. Subsequently both eyes received one daily drop for 2 weeks. After another 3 weeks without treatment, a single drop was instilled in each eye. RESULTS: The IOP reduction on days 2 and 3 was greater in the eyes treated with four daily doses (p<0.01). During the following period there were no statistically significant differences between the eyes. After 3 weeks without treatment the IOP was lower than pretreatment (p<0.001). A single dose of latanoprost on day 50 resulted in a similar decrease in IOP in both eyes. Transient photophobia, mild flare, and/or a few cells occurred in 15 subjects. Two subjects were withdrawn because of photophobia and/or signs of anterior uveitis. CONCLUSION: Latanoprost four times daily caused an IOP reducing effect which was similar to once daily dosing, except for the first 2 days of treatment when it was more effective. Transient photophobia, cells, and flare were common during the four dose regimen, but resolved spontaneously without cessation of treatment.

GLC756 decreases TNF-alpha via an alpha2 and beta2 adrenoceptor related mechanism - Laengle, Ulrich W; Trendelenburg, Anne U; Markstein, Rudolf; Nogues, Vicente; Provencher-Bollinger, Anne; Roman, Danielle (Exp Eye Res, 2006)
GLC756, a polyvalent anti-glaucoma drug showed in an endotoxin-induced-uveitis model (EIU) in rats a significant tumor necrosis factor-alpha (TNF-alpha) decrease in serum, indicating an additional anti-inflammatory potential of this compound. The receptors on which GLC756 binds (D1, D2, D4, alpha-1, alpha-2, 5-HT1A, 5-HT2C, 5-HT1D, 5-HT2 A, beta-1, and beta-2) were suggested to play a role. In order to identify a receptor type mediating the TNF-alpha lowering response, GLC756 was combined with various counteracting compounds (CP). For EIU, 8-week-old Lewis rats were intravenously injected at 160 microg lipopolysaccharide (LPS) from Salmonella typhimurium. Before EIU-induction animals received either one of the CP's or GLC756 alone, or GLC756 in combination with one of the CP's. TNF-alpha was determined in serum 2h post EIU-induction. Treatment with CP's alone indicated that agonistic effects on beta-2 adrenoceptors and antagonistic effects on alpha-2, 5-HT1A and 5-HT1D receptors resulted in statistically significant decreased TNF-alpha levels in comparison to the LPS-control group. In combination with GLC756, the counteracting CP's domitor (alpha-2 adrenoceptor agonist) and ICI 118551 (beta-2 adrenoceptor antagonist) inhibited completely the TNF-alpha decreasing effect of GLC756. Counteracting the 5-HT1A receptor with the 5-HT1A agonist 8-OH-DPAT could not prevent the TNF-alpha decreasing effect of GLC756. In conclusion, the antagonistic effect on alpha-2 adrenoceptors and the agonistic effect on beta-2 adrenoceptors were identified as mechanism for the TNF-alpha decreasing effect of GLC756.

Effects of astaxanthin on lipopolysaccharide-induced inflammation in vitro and in vivo - Ohgami, Kazuhiro; Shiratori, Kenji; Kotake, Satoshi; Nishida, Tomomi; Mizuki, Nobuhisa; Yazawa, Kazunaga; Ohno, Shigeaki (Invest Ophthalmol Vis Sci, 2003)
PURPOSE: Astaxanthin (AST) is a carotenoid that is found in marine animals and vegetables. Several previous studies have demonstrated that AST exhibits a wide variety of biological activities including antioxidant, antitumor, and anti-Helicobacter pylori effects. In this study, attention was focused on the antioxidant effect of AST. The object of the present study was to investigate the efficacy of AST in endotoxin-induced uveitis (EIU) in rats. In addition, the effect of AST on endotoxin-induced nitric oxide (NO), prostaglandin E2 (PGE2), and tumor necrosis factor (TNF)-alpha production in a mouse macrophage cell line (RAW 264.7) was studied in vitro. METHODS: EIU was induced in male Lewis rats by a footpad injection of lipopolysaccharide (LPS). AST or prednisolone was administered intravenously at 30 minutes before, at the same time as, or at 30 minutes after LPS treatment. The number of infiltrating cells and protein concentration in the aqueous humor collected at 24 hours after LPS treatment was determined. RAW 264.7 cells were pretreated with various concentrations of AST for 24 hours and subsequently stimulated with 10 microg/mL of LPS for 24 hours. The levels of PGE2, TNF-alpha, and NO production were determined in vivo and in vitro. RESULTS: AST suppressed the development of EIU in a dose-dependent fashion. The anti-inflammatory effect of 100 mg/kg AST was as strong as that of 10 mg/kg prednisolone. AST also decreased production of NO, activity of inducible nitric oxide synthase (NOS), and production of PGE2 and TNF-alpha in RAW264.7 cells in vitro in a dose-dependent manner. CONCLUSIONS: This study suggests that AST has a dose-dependent ocular anti-inflammatory effect, by the suppression of NO, PGE2, and TNF-alpha production, through directly blocking NOS enzyme activity.

Effects of L-NAME and timolol on aqueous IL-1beta, IL-6, IL-8, TNF-alpha and NO levels after Nd:YAG laser iridotomy in rabbits - Er, H; Doganay, S; Evereklioglu, C; Cekmen, M; Daglioglu, M C; Isci, N (Eur J Ophthalmol, 2002)
PURPOSE: Pro-inflammatory cytokines are produced by tissues and play a vital role in the host inflammatory response and uveitis. Nitric oxide (NO) can be produced in large amounts as a response to experimentally-induced uveitis or cytokines. In this study, we measured the levels of pro-inflammatory cytokines such as interleukin (IL)-1beta, IL-6, IL-8, tumor necrosis factor (TNF)-alpha and free-radical in aqueous humor after Nd:YAG laser iridotomy in rabbits, and investigated whether timolol maleate an anti-glaucoma drug, or a NO synthase inhibitor, NG-nitro-L-arginine methyl esther (L-NAME) had an inhibitory effect on these molecules, since L-NAME is a known anti-inflammatory agent in rabbits. METHODS: Bilateral experimental Nd:YAG laser iridotomy (power 7.5 mJ, mode single burst, aiming beam 4) was performed on 18 rabbits under general plus topical anesthesia. Aqueous humor samples were taken by clear corneal paracentesis preoperatively, and 1 and 24 h postoperatively. Six rabbits (12 eyes) were given bilateral topical timolol maleate 0.5% (Timoptic) drop b.i.d. (group 1), six rabbits (12 eyes) received bilateral 0.1 ml subconjuntival injections of L-NAME (150 mg/kg) (group 2), and six rabbits (12 eyes) were treated with topical balanced salt solution (BSS) b.i.d. (control). RESULTS. Preoperative cytokine and NO levels were comparable in the three groups, with no significant differences. In addition, there was no significant difference in baseline cytokine levels between the right and left eyes. In all groups, pre- and postoperative mean IL-1beta levels were below the detection limit of the assay (<5.0 pg/ml). In the control group, postoperative mean IL-6, IL-8 and NO levels were significantly higher after Nd:YAG laser iridotomy than before (for each, p < 0.01). Timolol and L-NAME both inhibited the rise in IL-8 and TNF-alpha levels. Timolol also inhibited the rise in IL-6 but not NO. L-NAME had an inhibitory effect against NO, but not IL-6. CONCLUSIONS: L-NAME has an inhibitory effect on IL-8, TNF-alpha and NO, but not on IL-6. Timolol had inhibitory effects on IL-6, IL-8 and TNF-alpha, but not on NO. These preliminary experimental results might help in assssing the effect of Nd:YAG laser iridotomy in aqueous humor, and to understand the inhibitory effects of timolol and L-NAME against these molecules.

Recurrent herpes simplex uveitis in humans - O'Connor, G R (Surv Ophthalmol, 1976)
Herpetic uveitis in man is generally, although not always, a complication of chronic stromal disease of the cornea. It is characterized by pain, photophobia, and redness, and may be abrupt in onset, particularly in recurrent cases. It is often accompanied by a severe secondary glaucoma. Various theories of the pathogenesis are discussed. The weight of experimental evidence favors the proliferation of living virus in the uveal tissues as the cause of the inflammation, although the virus has been isolated only rarely from aspirated aqueous humor. Autoimmune factors must be considered. Cyclopegia is the most important element of treatment, most cases being self-limited and non-destructive. Secondary glaucoma sometimes poses a serious problem that must be treated by radical measures. Antiviral medications such as adenine arabinoside may play an important role in the treatment of resistant cases. Corticosteroid therapy is to be avoided, if possible.

Intraoperative mydriasis by intracameral injection of mydriatic eye drops: in vivo efficacy and in vitro safety studies - Mori, Yosai; Miyai, Takashi; Kagaya, Fumie; Nagai, Nobuyuki; Osakabe, Yasuhiro; Miyata, Kazunori; Amano, Shiro (Clin Exp Ophthalmol, 2011)
BACKGROUND: This study investigated the efficacy and safety of intracameral injection of commercially available eye drops containing 0.5% tropicamide and 0.5% phenylephrine hydrochloride (Mydrin-P, Santen Pharmaceutical, Osaka, Japan). DESIGN: In vitro experiment and prospective clinical study at a private hospital. PARTICIPANTS AND SAMPLES: Mydrin-P was applied to confluent cultured human corneal endothelial cells, and the cellular morphology was examined. Clinical study subjects were 65 eyes of 65 patients that underwent phaco-emulsification and aspiration with intraocular lens implantation and received intracameral injection of Mydrin-P for poor mydriasis after preoperative topical instillation of mydriatics (intraocular mydriasis group; with five subgroups based on cause: diabetes, pseudo-exfoliation, post-surgery, uveitis, unknown). Controls, comprising 39 eyes of 39 patients, were not injected with Mydrin-P. METHODS: The ratio of pupillary diameter to corneal diameter was determined before and after injection of Mydrin-P. Corneal endothelial density was measured preoperatively and 3 months and 1 year postoperatively. MAIN OUTCOME MEASURES: Pupillary diameter and corneal endothelial density. RESULTS: Human corneal endothelial cell morphology was unaltered after Mydrin-P injection. The mean ratio of the pupillary diameter to corneal diameter increased in the intraocular mydriasis group (before: 54.2 ± 4.8%, after: 58.4 ± 6.6%; P < 0.001) and in the diabetes and unknown subgroups. The corneal endothelial cell density reduction rate 3 months and 1 year after surgery was not significantly different between the intraocular mydriasis group and controls. CONCLUSION: Intracameral injection of Mydrin-P appears to be effective and safe for dilating the pupil in cases with poor mydriasis after preoperative instillation of mydriatics.

Keratoconjunctivitis sicca with associated secondary uveitis elicited in rats after systemic xylazine/ketamine anesthesia - Kufoy, E A; Pakalnis, V A; Parks, C D; Wells, A; Yang, C H; Fox, A (Exp Eye Res, 1989)
The systemic administration of an anesthetic dosage of a combination of xylazine and ketamine hydrochloride produced an acute exposure keratopathy which progressed into a syndrome resembling keratoconjunctivitis sicca. Within a few minutes corneal changes occurred that were characterized by viscous mucus, loss of corneal luster and dryness. Other acute but transient changes included development of cataracts, mydriasis and proptosis. Progressive changes were observed in the cornea within 4 days which lasted at least 8 weeks in some cases, and included punctate epithelial keratopathy progressing to devitalized or keratinized epithelial plaques. Polymorphonuclear cell infiltration of the corneal stroma associated with plaques occurred. Epithelial denudation and neovascularization of the cornea, dilation and engorgement of iridial blood vessels, as well as flare in the anterior chamber were also seen. The ocular lesions induced by xylazine/ketamine should be considered carefully when designing or interpreting research on the anterior segment. Ketamine hydrochloride with sodium pentobarbital produced excellent anesthesia without any significant ocular side-effects and may be preferred in many instances.

[Treatment of refractory glaucomas by transscleral cyclophotocoagulation using semiconductor diode laser. Analysis of 50 patients followed-up over 19 months] - Hamard, P; Gayraud, J M; Kopel, J; Valtot, F; Quesnot, S; Hamard, H (J Fr Ophtalmol, 1997)
PURPOSE: To evaluate the effects of transscleral cyclophotocoagulation with the diode laser for refractory glaucoma with respect to intra-ocular pressure, reduction of medical therapy and complications. METHODS: The diode laser system (Iris Medical Instrument, Oculight SLX) was used to treat 50 eyes of 47 patients with therapy resistant glaucoma and a poor prognosis with filtering surgery. All eyes had maximal hypotonic therapy and 40 (82%) patients were using carbonic anhydrase inhibitors. Laser energy was delivered to the eye through a quartz glass fiber optic probe [13 to 20 spots over 270 degrees using 3.5 J (1.75 W x 2.0 sec)]. The mean follow-up was 19.4 +/- 9.1 months (from 12 to 29 months). RESULTS: Intra-ocular pressure significantly decreased from mean baseline 32.4 +/- 9.1 mmHg to 19.7 +/- 8.1 mmHg at the end of the follow-up (p < 0.001). An intra-ocular-pressure below 20 mmHg was obtained in 66% of the eyes. In 13 patients the carbonic anhydrase inhibitors were discontinued. Six of the 8 painful eyes had pain relief. Visual acuity decreased in 17 (34%): cataract progression in 5 eyes, uncontrolled intra-ocular-pressure in 4 eyes, glaucoma progression despite controlled intra-ocular-pressure in 3 eyes, corneal dystrophy in 3 eyes. Chronic uveitis occurred in 5 (10%) eyes. No conjonctival, scleral or direct lens damage was detected. CONCLUSION: Contact transscleral cylophotocoagulation with the diode laser system can be successfully used to reduce intra-ocular-pressure in therapy resistant glaucoma. The incidence of complications is low with no loss of vision related to cyclodestruction.

Juvenile idiopathic arthritis-associated uveitis complicated by glaucoma and Brown's syndrome - Tejada, Pilar; Enríquez, Eugenia; Rodríguez del Valle, José María; Barceló, Ana; Gutiérrez, Esperanza; de Inocencio, Jaime (Rheumatology (Oxford), 2012)

Secondary angle closure glaucoma by lupus choroidopathy as an initial presentation of systemic lupus erythematosus: a case report - Han, Young Soo; min Yang, Chan; Lee, Sang-Hoon; Shin, Jae Ho; Moon, Sang Woong; Kang, Ja Heon (BMC Ophthalmol, 2015)
BACKGROUND: We present a rare case of secondary angle closure glaucoma due to systemic lupus erythematosus choroidopathy as initial presentation of systemic lupus erythematosus, accompanied by central nervous system vasculitis and uncontrolled nephropathy. CASE PRESENTATION: A 31-year-old woman presented with decreased visual acuity, nausea, vomiting, fever, and bilateral angioedema-like eyelid swelling. She had persistent dry cough while taking medication for 3 months, and had usual posterior neck pain, which was treated with analgesic medication and Asian medicines. Intraocular pressure was 32 and 34 mmHg in her right and left eyes, respectively. Peripheral anterior chambers were shallow (grade I) using the van Herick method. Gonioscopy revealed 360° closed angle in both eyes. In both eyes, serous retinal detachment was found using optical coherence tomography and B scan ultrasonography, as well as choroidal thickening with effusion. Secondary acute angle closure glaucoma was drug induced, or caused by uveitis of unknown etiology when she was first treated with intraocular pressure-lowering medication. During evaluation of the drug-induced angioedema in the internal medicine department, systemic lupus erythematosus was diagnosed, based on malar rash, photosensitivity, proteinuria, and positive anti-Smith and anti-DNA antibodies, followed by initiation of steroid pulse therapy. Using fluorescein angiography, multifocal subretinal pinpoint foci were detected at the middle phase. We then diagnosed bilateral angle closure glaucoma by choroidal effusions, with lupus choroidopathy. At 2 months after steroid pulse therapy, subretinal fluid was not found, and visual acuity improved to normal. During the subsequent 2 years, lupus choroidopathy was not aggravated but lupus nephritis was not controlled. CONCLUSION: Patients with systemic lupus erythematosus choroidopathy can develop ciliochoroidal effusion, which can lead to acute angle closure glaucoma. Systemic lupus erythematosus choroidopathy is an early sign of severe complications. Angle closure glaucoma by systemic lupus erythematosus choroidopathy can be effectively treated using antiglaucoma drugs and immunosuppressive therapy.

Acute tuberculous panophthalmitis - Arrell, R W (Arch Ophthalmol, 1967)

Betaxolol-associated anterior uveitis - Jain, S (Eye (Lond), 1994)

Anterior uveitis as a side effect of topical brimonidine - Byles, D B; Frith, P; Salmon, J F (Am J Ophthalmol, 2000)
PURPOSE: To report anterior uveitis as a late side-effect of topical brimonidine tartrate 0.2% (Alphagan; Allergan Inc., Irvine, California). METHODS: Four patients aged 79 to 91 (mean, 83) years, who developed acute anterior uveitis while using topical brimonidine for chronic glaucoma, were clinically evaluated for causes of uveitis. When the inflammation had completely cleared, topical brimonidine was recommenced in one eye only to determine causality. RESULTS: All four patients developed acute granulomatous anterior uveitis, which resolved rapidly on stopping brimonidine and receiving treatment with topical corticosteroids. The uveitis occurred 11 to 15 (mean, 13.8) months after commencement of brimonidine 0.2% twice daily. None of the patients had a previous history of uveitis, and no other identifiable cause of uveitis was found. In all patients, on rechallenge with brimonidine instilled twice daily to one eye, uveitis recurred within 3 weeks in that eye only. CONCLUSIONS: These findings suggest that brimonidine can cause anterior uveitis as a late side effect. The inflammation settles rapidly on stopping the medication and on using topical corticosteroids and recurs on rechallenge with brimonidine.

Surgical technique for advanced juvenile glaucoma - Molteno, A C; Ancker, E; Van Biljon, G (Arch Ophthalmol, 1984)
The main causes of drainage operation failure are early hypotonia, blockage of the surgical opening, and excessive bleb scarring. By using draining implants, inserted in two stages, together with the temporary administration of medication to control bleb fibrosis, the surgeon can circumvent these causes of failure and drain the most severe and complex cases of glaucoma with good immediate and long-term results. This surgical technique failed in only four of the 83 eyes with advanced juvenile glaucoma.

[Aqueous humor] - Gamm, E G (Vestn Oftalmol, 1977)

Granulomatous anterior uveitis associated with bimatoprost: a case report - Parentin, Fulvio (Ocul Immunol Inflamm, 2003)
PURPOSE: To describe a previously unreported case of anterior granulomatous uveitis in a patient using bimatoprost. METHODS: A 72-year-old woman with a long-standing history of anisometropic amblyopia and pseudoexfoliative glaucoma in the right eye started therapy with bimatoprost 0.03% once a day in the right eye. She had no previous history of ocular inflammation or ocular surgery. Her medical history was negative for systemic diseases associated with ocular inflammation. RESULTS: After one week, the patient developed severe conjunctival injection, cells and flare, and numerous 'mutton fat' keratic precipitates in the right eye. Examination of the left eye revealed no evidence of inflammation. Bimatoprost was discontinued; no topical steroid therapy was started. Systemic investigations were normal. The inflammation resolved over two weeks, solely with the discontinuation of bimatoprost. CONCLUSIONS: Bimatoprost is a synthetic prostamide, chemically related to prostamide F. Prostamides are naturally occurring substances, biosynthesized from anandamide in a pathway that includes COX2. Even though anandamide has proven suggestive potential pro-inflammatory effects, the mechanism of induction of inflammation by bimatoprost remains uncertain and speculative. In our report, the onset of acute uveitis in a patient using bimatoprost, after a long-term and well-tolerated treatment with a prostaglandin analog, suggests a distinct potential pro-inflammatory action of prostamides. This can indirectly support the concept that the target receptor of bimatoprost is different, and that the mechanism of action of prostamides is pharmacologically unique.

Persistence of counter-regulatory abnormalities in insulin-dependent diabetes mellitus after pancreas transplantation - Battezzati, A; Luzi, L; Perseghin, G; Bianchi, E; Spotti, D; Secchi, A; Vergani, S; Di Carlo, V; Pozza, G (Eur J Clin Invest, 1994)
Conventional insulin therapy does not correct the counter-regulatory abnormalities of insulin-dependent diabetes mellitus. Pancreas transplantation is an alternative therapy that restores the endogenous insulin secretion in diabetes. In this study, the effects of segmental pancreas transplantation on counter-regulation to mild hypoglycaemia were evaluated. Glucose kinetics and the counter-regulatory hormonal responses were assessed in eight insulin-dependent diabetics with end-stage renal failure who had received pancreas and kidney transplantation 1 year previously, seven diabetic uraemic subjects (candidates for combined transplantation), five patients with chronic uveitis on immunosuppressive therapy comparable to pancreas recipients and 10 normal subjects. Insulin (0.3 mU kg-1 min-1) was infused for 2 h to induce mild hypoglycaemia (plasma glucose 3.2-3.5 mmol l-1) and exogenous glucose was infused as required to prevent any glucose decrease below 3.1 mmol l-1. After transplantation, two of eight recipients had hypoglycaemic episodes reported in their medical records. During the study, hepatic glucose production was rapidly suppressed in the controls and in the patients on immunosuppression (-80 +/- 7 and -54 +/- 7%, P < 0.001 vs. basal), and rebounded to the baseline values within 1 h (-3 +/- 1 and -6 +/- 2%, P = NS vs. basal). The transplant recipients had similar suppression in the first hour (-88 +/- 8%, P < 0.001 vs. basal), but the suppression persisted in the second hour (-69 +/- 11%, P < 0.001 vs. basal) indicating a lack of glucose counter-regulatory response.(ABSTRACT TRUNCATED AT 250 WORDS)

A randomized, masked, cross-over trial of acetazolamide for cystoid macular edema in patients with uveitis - Whitcup, S M; Csaky, K G; Podgor, M J; Chew, E Y; Perry, C H; Nussenblatt, R B (Ophthalmology, 1996)
PURPOSE: To study the effect of acetazolamide on cystoid macular edema in patients with uveitis. METHODS: Forty patients with chronic intermediate, posterior, or panuveitis associated cystoid macular edema were randomized into a masked, cross-over trial comparing acetazolamide versus placebo. Patients received an initial 4-week course of either acetazolamide or placebo (course A) followed by a 4-week washout period. They then received a 4-week course of the opposite study medication (course B). Primary endpoints included area of cystoid macular edema measured on late-phase views of fluorescein angiography and visual acuity. RESULTS: Thirty-seven patients completed the trial and were available for analysis; 17 (46%) were randomized to receive acetazolamide and 20 (54%) to receive placebo during course A. Acetazolamide resulted in a 0.5-disc area (25%) decrease in cystoid macular edema over that of placebo (P = 0.01; estimated treatment effect = -0.5 disc areas; 95% confidence interval, -0.9 to -0.1). However, there was no statistically significant effect of acetazolamide on visual acuity (P = 0.61; estimated treatment effect = 0.6 letters; 95% confidence interval, -2 to 3). CONCLUSIONS: A 4-week course of acetazolamide therapy results in a statistically significant but small decrease in cystoid macular edema in patients with chronic uveitis, and does not improve visual acuity. In contrast to previous studies in the literature, acetazolamide may have a more limited clinical benefit in patients with long-standing cystoid macular edema associated with chronic uveitis.

Pathology in practice. Uveodermatologic syndrome - Horikawa, Taemi; Vaughan, Rachel Keller; Sargent, Sandra J; Toops, Elizabeth E; Locke, Erin P (J Am Vet Med Assoc, 2013)

Effect of apraclonidine hydrochloride on the attack of Posner-Schlossman syndrome - Hong, C; Song, K Y (Korean J Ophthalmol, 1993)
The intraocular pressure (IOP) of glaucomatocyclitic crisis with the attack fell 50.3%, from 37.8 +/- 8.2 mmHg to 18.8 +/- 4.8 mmHg, 4 hours after instillation of 1% apraclonidine. Glaucomatocyclitic crisis showed a more significant hypotensive response to 1% apraclonidine than primary open-angle glaucoma (24.8%, from 43. 1 +/- 8.1 mmHg to 32.4 +/- 7.5 mmHg after 4 hours). The intraocular pressure decrease percentage was similar regardless of the initial level of intraocular pressure. Clinically significant changes in mean systolic and diastolic blood pressures, were not observed, however, a mild decrease in the pulse rate was noted. And the local mydriatic effect on the pupillary diameter was significant. Apraclonidine, 1% might be newly indicated to control the IOP rise of glaucomatocyclitic crisis. Further studies on the possible mechanism of the prostaglandin mediated hypotensive effect of 1% apraclonidine are suggested.

The effect of nebivolol on P wave duration and dispersion in patients with Behçet's disease; a prospective single-arm controlled study - Akkaya, Hasan; Karakaş, Mustafa Serkan; Sahin, Omer; Borlu, Murat; Oğuzhan, Abdurrahman (Anadolu Kardiyol Derg, 2013)
OBJECTIVE: Behçet's disease (BD) is a chronic multi-system disease presenting with recurrent oral and genital ulceration, and relapsing uveitis. Left ventricular diastolic dysfunction, ventricular arrhythmia and sudden cardiac death have been documented in BD. P wave dispersion (PD) has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. PD has been reported to be longer in patients with BD. Nebivolol, besides its selective beta1-blocking activity, causes an endothelium dependent vasodilatation through nitric oxide release. In this study, we searched for the effects of nebivolol on P wave duration and dispersion in patients with BD. METHODS: This study was designed as prospective single-arm controlled study. We prospectively studied 35 Behçet's patients who were diagnosed according to the International Study Group criteria. Patients received 5 mg nebivolol per day for 3 months. The patients were evaluated with 12-leads electrocardiography at baseline and after for 3-month therapy. The difference between maximum and minimum P wave durations was defined as PD. The paired samples t test, Wilcoxon test were used for statistical analysis. RESULTS: A significant decrease was observed in PD after therapy period (62.85±21.62 vs. 44.28±18.03 msec, p=0.001). No adverse effects were observed in treatment period. CONCLUSION: BD is associated with prolonged P wave duration and dispersion. We have shown for the first time that nebivolol causes a significant decrease in maximum P wave duration and PD in patients with BD. However, further comprehensive studies are needed to determine the long-term effects of nebivolol.

Bilateral rubeosis iridis and rubeotic glaucoma due to peripheral occlusive vasculitis associated with multiple sclerosis - Turner, S J; Dharmasena, A; Deane, J (Ocul Immunol Inflamm, 2011)
Multiple sclerosis is associated with iridocyclitis, intermediate uveitis, retinal periphlebitis, and optic neuritis. The periphlebitis is known to be rarely sight-threatening as a result of the sequelae of retinal neovascularization. CASE: This is a rare case of bilateral rubeosis iridis and rubeotic glaucoma in the setting of a branch retinal vein occlusion, widespread peripheral periphlebitis, and angiographic peripheral closure associated with "clinically definite" multiple sclerosis. DISCUSSION: The case illustrates the extreme end of the spectrum of peripheral retinal ischemia and neovascularization associated with demyelinating disease, which can present as rubeotic glaucoma. Such patients require a proactive approach to inflammation, neovascularization, and raised intraocular pressure, including systemic immunosuppression, photocoagulation, and augmented trabeculectomy, respectively. As with other causes of peripheral ischemia, a favorable visual outcome can often be achieved using this strategy.

Ocular toxicity by latex of Calotropis procera (Sodom apple) - Basak, Samar K; Bhaumik, Arup; Mohanta, Ayan; Singhal, Prashant (Indian J Ophthalmol, 2009)
We report the spectrum of ocular toxicity following accidental inoculation of latex of Calotropis procera (Sodom apple) in 29 eyes between January 2003 and December 2006. All patients presented with sudden painless dimness of vision with photophobia. Twenty-five (86%) patients had initial visual acuity of less than 20/60. All eyes had conjunctival congestion and mild to severe corneal edema with Descemet's folds. Three (10%) eyes had an epithelial defect, nine (31%) had iridocyclitis, and seven (24%) had associated secondary glaucoma. After treatment with topical corticosteroids, antiglaucoma agents, cycloplegics, hypertonic saline and tears supplements, 27 (93%) eyes recovered completely within 3-14 days. After three months, 17 (74%) out of 23 eyes showed a significant low endothelial cell count compared to the normal fellow eye ( P 0.001). The latex of Calotropis procera causes significant ocular morbidity which may be preventable by simple health education. The long-term effect on corneal endothelium has to be studied further.

[Pseudotumor cerebri secondary to Behçet disease. Report of one case] - Durán, Josefina; Jurado, Marisol; Jacobelli, Sergio; Eymin, Gonzalo; Castiglione, Enzo; Valenzuela, Raúl; Gutiérrez, Miguel A (Rev Med Chil, 2010)
The classical manifestations of Behçet disease are mouth ana genital ulcers, cutaneous lesions ana ocular involvement. The central nervous system is affected in 5 to 59% of the cases, usually in the form of meningoencephalitis or sinus venous thrombosis. We report a 17-year-old femóle presenting with a two weeks history of progressive headache, nausea and blurred vision. An initial magnetic resonance was normal. Fifteen days later she was admitted to the hospital due to progression of visual impairment. She gave a history of oral ulcers and arthralgias. A new magnetic resonance was normal. A lumbar puncture showed a cerebrospinal fluid with a protein concentration of 14 mg/dl, a glucose concentration of 64 mg/dl, 20 fresh red blood cells and a pressure of 26 cm H(2)0. The diagnosis of a pseudotumor cerebri, secondary to Behçet disease was raised and the patient was treated with colchicine and acetazolamide. The evolution was torpid and an anterior uveitis was also found. After discharge, she continued with oral and genital ulcers and was treated with infliximab. Despite treatment, headache persists.

Tonic Pupil in Cytomegalovirus Anterior Uveitis in an Immunocompetent Adult Male - A Case Report - Babu, Kalpana; Parameswarappa, Deepika C; Sudheer, Bhagya (Ocul Immunol Inflamm, 2017)
PURPOSE: To report an interesting case of development of tonic pupil in an immunocompetent male with cytomegalovirus (CMV) anterior uveitis. METHODS: Retrospective case report Results: A 30-year-old Iranian healthy male was diagnosed to have Posner-Schlossman syndrome (OS). Aqueous tap was positive for CMV by multiplex Polymerase chain reaction (PCR). Adequate control of inflammation and Intraocular pressures (IOP) were achieved with topical steroids, ganciclovir gel, and antiglaucoma medications. On a follow-up visit, he complained of recent onset of blurring of vision (OS) despite appropriate refractive correction, quiet anterior chamber, and normal IOP. Pupillary examination showed anisocoria (larger pupil in OS). Pupillary constriction (OS) on instillation of 0.125% pilocarpine drops confirmed the diagnosis of a tonic pupil. CONCLUSION: We describe a unique finding of tonic pupil on a follow-up examination in an immunocompetent adult male with CMV anterior uveitis. A prior association has not been described in literature (Medline Search).
Keywords: anterior uveitis; Posner–Schlossman syndrome; Anisocoria; cytomegalovirus; tonic pupil

One year of intravitreal injections of steroids - Deckers, V; Priem, H; Verbraeken, H (Bull Soc Belge Ophtalmol, 2005)
PURPOSE: Chronic macular oedema sometimes does not respond to classic treatment such as laserphotocoagulation, periocular and systemic steroids or carbonic anhydrase inhibitors. High dose intravitreal injection of steroids can be a valuable alternative in these patients. METHODS: Sixty-four eyes of 51 patients with chronic macular oedema, refractory to conventional treatments, received an intravitreal injection of 4 mg Kenacort (triamcinolone acetonide). At postoperative controls (1 day, 1 month, 3 months, 6 months, 1 year), the visual acuity, intraocular pressure, central retinal thickness on OCT II were analyzed retrospectively. RESULTS: In the diabetic group, but also in cases of chronic uveitis, retinal vein thrombosis, birdshot chorioretinopathy, Irvine Gass syndrome, cellophane maculopathy and age-related macular degeneration with classic subfoveolar neovascular membrane, dramatic decrease of the oedema was observed on funduscopy and OCT. A statistically significant reduction of mean central foveal thickness of 61% at 1 week and 49% at 3 months post-injection was demonstrated on OCT. Considerable gain in visual acuity was noted. The highest benefit in post-operative visual acuity was achieved after 3 months and averaged a gain of +3.55 Snellen lines (n=39). In 17% of eyes a rise in intraocular pressure was noted. Unfortunately we had one case of endophthalmitis in a poorly regulated diabetic woman. Six eyes were retreated because of recurrence of macular oedema. CONCLUSION: Intravitreal injection of steroids can dramatically help in some cases of chronic macular oedema, not reacting to classic treatment. The injection should be performed under sterile conditions since endophthalmitis is a potential risk. The most frequent complication seems to be a rise in intraocular pressure in cortisone responders.

STEROID THERAPY AND SECONDARY GLAUCOMA - Lerman, S (Am J Ophthalmol, 1963)
Keywords: ACETAZOLAMIDE; CATARACT EXTRACTION; GLAUCOMA; INTRAOCULAR PRESSURE; IRIDOCYCLITIS; NEGROES; POSTOPERATIVE COMPLICATIONS; PREDNISONE; TONOMETRY

Effects of topical antiglaucoma eye drops on prostaglandin E(2)-induced aqueous flare elevation in pigmented rabbits - Hayasaka, Yoriko; Hayasaka, Seiji; Zhang, Xue-Yun; Nagaki, Yasunori (Invest Ophthalmol Vis Sci, 2002)
PURPOSE: To evaluate the role of topical instillation of some antiglaucoma agents on experimental elevation of aqueous flare induced by prostaglandin E(2) (PGE(2)) in pigmented rabbits. METHODS: Transcorneal diffusion of PGE(2) (25 microg/mL or 7.09 x 10(-2) mM) with the use of a glass cylinder was achieved to produce aqueous flare elevation in pigmented rabbits. An antiglaucoma agent was topically administered before application of PGE(2). Aqueous flare was measured with a laser flare cell meter. RESULTS: A single instillation of apraclonidine 1.15%, two instillations of epinephrine 1.25%, two instillations of dipivefrin 0.1%, and two instillations and one instillation of dipivefrin 0.04% eye drops inhibited 98%, 96%, 87%, 73%, and 47% of PGE(2)-induced aqueous flare elevation, respectively. Timolol 0.5%, nipradilol 0.25%, dorzolamide 1%, and pilocarpine 2% eye drops had no effects on the increase of PGE(2)-induced flare. CONCLUSIONS: Apraclonidine, epinephrine, and dipivefrin eye drops inhibit PGE(2)-induced elevation of aqueous flare in pigmented rabbits.

Autonomic nervous system involvement in Behçet's disease: a pupillometric study - Bayramlar, H; Hepŝen, I F; Uğuralp, M; Bölük, A; Ozcan, C (J Neuroophthalmol, 1998)
The aim of this study was to elucidate whether autonomic nervous system dysfunction exists in patients with Behçet's disease by pupillometric tests. Thirty-one patients with Behçet's disease with a mean age of 41.3 years (range 21-64) and 41 control subjects with a mean age of 39.5 years (range 18-66) were selected for the study. To test the autonomic nervous system, four pupillometric techniques were used: pupil cycle time (PCT), dark-adapted pupil size (DAPS), 0.05% pilocarpine drop test, and 1% phenylephrine drop test. In all four tests, there were significant differences between the patients and controls. Mean PCTs were 1,156 ms (range 856-1,560 ms) and 919 ms (range 650-1,261 ms) in the patients and controls, respectively (p < 0.0001). The mean DAPS was 0.45 (range 0.31-0.66) in the patients, whereas it was 0.56 (range 0.42-0.67) in controls (p < 0.001). Iris sensitivity to both 0.05% pilocarpine and 1% phenylephrine showed significant differences between patients and controls, respectively (p < 0.05, p < 0.05). Among all four tests, only 0.05% pilocarpine sensitivity was correlated with the duration of Behçet's disease (p < 0.05). The results suggest that the autonomic nervous system innervating the iris is affected in Behçet's disease. This involvement may be due to the vasculitic nature of Behçet's disease.

Effects of inhibitors of arachidonic acid metabolism on endotoxin-induced ocular inflammation - Fleisher, L N (Curr Eye Res, 1988)
Rabbits were treated with the cyclooxygenase inhibitors indomethacin (2.5 and 10 mg/kg; IP) or flunixin meglumine (2.2 and 8.8 mg/kg; IM), or the dual cyclooxygenase/lipoxygenase inhibitor BW755C (10 and 30 mg/kg; IP) (administered 4 times over 25 hours). One hour following drug administration, 10 ng of E. coli endotoxin was injected into the vitreal chamber and the subsequent inflammatory response was measured 24 h later. Indomethacin was the most effective inhibitor of prostaglandin (PG) E2 and PGF 2 alpha accumulation in the aqueous humor and their ex vivo production by the lens. It was the only agent that decreased iridal hyperemia and protein concentration in the aqueous humor. Flunixin decreased PG production, although generally to a lesser degree than indomethacin. BW755C produced modest inhibition of PG production in the aqueous humor, but did not affect PG production by the lens. The high dose of BW755C also reduced 5-hydroxyeicosatetraenoic acid (5-HETE) levels in the aqueous humor, but did not alter production by the lens. The results indicate that despite drastic reductions in PG levels in the aqueous humor and PG production by the lens, only modest decreases in aqueous humor protein concentration and iridal hyperemia were achieved. Furthermore, 5-HETE does not appear to be important in the modulation of these inflammatory signs, although it is possible that larger decreases in its production could result in more dramatic effects.

Retinal and choroidal vascular occlusion after posterior sub-tenon triamcinolone injection - Moshfeghi, Darius M; Lowder, Careen Y; Roth, Daniel B; Kaiser, Peter K (Am J Ophthalmol, 2002)
PURPOSE: To report a case of retinal and choroidal vascular occlusion occurring as a complication after posterior sub-Tenon triamcinolone injection for treatment of uveitic cystoid macular edema. DESIGN: Interventional case report. METHODS: Retrospective study. A 32-year-old woman with uveitis and cystoid macular edema underwent a right posterior sub-Tenon injection of triamcinolone (40 mg/ml, 1 ml total) through a superotemporal approach after topical anesthesia. After the procedure, the patient experienced severe eye pain, orbital ecchymosis, and globe proptosis consistent with retrobulbar hemorrhage. RESULTS: Dilated fundus examination of the right eye (OD) demonstrated multiple intraretinal hemorrhages with particulate white emboli occluding the retinal and choroidal vessels. Visual acuity was no light perception. Ocular massage and hypotensive therapy was initiated for an intraocular pressure of 50 mm Hg. Canthotomy and cantholysis were performed. A total of 39 months post-incident, her visual acuity improved to 20/100. CONCLUSION: Posterior sub-Tenon triamcinolone injection can rarely result in retinal and choroidal occlusion. Immediate intervention may preserve limited visual acuity.

Treatment of traumatic hyphaema - Oksala, A (Br J Ophthalmol, 1967)

Treatment of glaucomatocyclitic crises - Hung, P T; Chang, J M (Am J Ophthalmol, 1974)

Oral glycerol in glaucoma - Consul, B N; Kulshrestha, O P (Am J Ophthalmol, 1965)

THERAPY OF TOXOPLASMOSIS UVEITIS - Ghosh, M; Levy, P M; Leopold, I H (Am J Ophthalmol, 1965)
Keywords: ACETAZOLAMIDE; ASCORBIC ACID, THERAPEUTIC; CHORIORETINITIS; DRUG THERAPY; METHYLPREDNISOLONE; MYDRIATICS; PHENYLEPHRINE; PREDNISOLONE, TOPICAL; PYRIMETHAMINE; SULFAMETHOXYPYRIDAZINE; TOXICOLOGIC REPORT; TOXOPLASMOSIS, OCULAR; UVEITIS

[Diode laser cyclophotocoagulation of secondary glaucoma caused by anterior, necrotizing scleritis] - Schlote, T; Mielke, J; Zierhut, M; Jean, B; Thiel, H J (Klin Monbl Augenheilkd, 1998)
PATIENT: A 60-year-old female patient presented with recurrent anterior, necrotizing scleritis with inflammation and a newly developed secondary glaucoma in the right eye. Anterior uveitis occurred some years before. Severe scleral thinning was circumferentially present and focal scleral ectasia was found. Physical examination revealed no systemic association of scleritis. Immunosuppressive therapy with metotrexate was initiated and control of scleritis achieved. Intraocular pressure elevation persisted and was refractory to glaucoma medication. Diurnal pressure curve showed IOP-values of 40 mm Hg despite the use of systemic carbonic anhydrase inhibitors. Visual acuity was 20/50 in the right and 20/25 in the left eye. METHOD: Diode laser cyclophotocoagulation (Oculight SLx 810 nm, Iris Medical Instruments Inc. California, USA) was performed under general anaesthesia using reduced parameters for application (12 laser spots, 1 second, 1.25 W). No complications occurred during and after laser application. Postoperatively, intraocular pressure was within normal range between 14 and 18 mm Hg. No reactivation of scleritis or uveitis was seen. CONCLUSION: In our experience, diode laser cyclophotocoagulation is effective and safe in treating secondary glaucoma associated with anterior, necrotizing scleritis with inflammation and uveitis using reduced parameters for application.

Bilateral nongranulomatous anterior uveitis associated with bimatoprost - Packer, Mark; Fine, I Howard; Hoffman, Richard S (J Cataract Refract Surg, 2003)
A 72-year-old man with long-standing bilateral glaucoma became refractory to levobunolol ophthalmic solution therapy after many years. Brimonidine was prescribed, but the patient developed a hypersensitivity several months later that was treated with loteprednol ophthalmic suspension. Bimatoprost was initiated 2 weeks later. Within an hour of the first dose of bimatoprost, the patient reported eye pain and photophobia that remained unresolved the following day. Examination revealed acute bilateral nongranulomatous anterior uveitis that was effectively treated with loteprednol. While observations in human and animal models suggest an association between certain prostaglandin-like agents and intraocular inflammation, this report is one of the first to suggest a link between bimatoprost and intraocular inflammatory reaction.

HETEROCHROMIC IRITIS AND SECONDARY NEOVASCULAR GLAUCOMA - Lerman, S; Levy, C (Am J Ophthalmol, 1964)
Keywords: ACETAZOLAMIDE; GLAUCOMA; GONIOSCOPY; IRITIS; STEROIDS; SURGERY, OPERATIVE; SYMPATHOMIMETICS

Subretinal neovascularisation and snow banking in a case of sarcoidosis: case report - Pellegrini, V; Ohno, S; Hirose, S; Matsuda, H; Hiraga, Y (Br J Ophthalmol, 1986)
A 49-year-old Japanese man presented with chronic granulomatous uveitis in his left eye. Later he developed macular subretinal neovascularisation. The chest x-ray showed bilateral hilar lymphadenopathy. Bronchoscopy and gallium-67 scanning were positive, PPD skin test negative, and serum angiotensin converting enzyme (ACE) levels increased. Ophthalmoscopy and fluorescein angiography of the left eye showed perivasculitis, retinochoroidal exudates, snow banking, and vitreous opacity. On these findings, the diagnosis of sarcoidosis was made. Treatment was based on topical corticosteroids, mydriatics, beta blockers, and oral carbonic anhydrase inhibitors. After 15 months the visual acuity decreased in the left eye, and a neovascular membrane was observed in the macula. Fluorescein angiography confirmed subretinal neovascularisation. Almost two years later the patient still has the neovascular membrane in his left eye.

Cystoid macular edema associated with topical latanoprost in glaucomatous eyes with a normally functioning blood-ocular barrier - Furuichi, M; Chiba, T; Abe, K; Kogure, S; Iijima, H; Tsukahara, S; Kashiwagi, K (J Glaucoma, 2001)
PURPOSE: To study prospectively using optical coherence tomography (OCT) whether topical latanoprost induces retinal disorders, such as cystoid macular edema, in patients with glaucoma and a normally functioning blood-ocular barrier. METHODS: Sixty-eight eyes of 38 patients with glaucoma and no history of intraocular surgery, uveitis, or laser trabeculoplasty were studied. Before initiation of latanoprost treatment and after 1, 3, and 6 months of treatment, OCT images were taken, and the following tests were performed: visual acuity examination, fundus ophthalmoscopy, intraocular pressure measurement, and fundus color photography. To evaluate retinal thickness in the fovea accurately. OCT scanning was repeated six times, and the smallest value was used as the retinal thickness in the fovea. RESULTS: Latanoprost ophthalmic solution did not influence retinal thickness in the fovea at any investigated time points compared with the time before instillation, and no changes were observed in visual acuity, ophthalmoscopic findings, and fundus photographs. The intraocular pressure was reduced significantly at all investigated time points compared with the time before instillation. CONCLUSIONS: It is unlikely that topical latanoprost induces retinal disorders, such as cystoid macular edema, in glaucomatous eyes with a normally functioning blood-ocular barrier.

Posner-Schlossman syndrome and nonarteritic anterior ischemic optic neuropathy - Irak, Inci; Katz, Bradley J; Zabriskie, Norm A; Zimmerman, Paul L (J Neuroophthalmol, 2003)
A 41-year-old woman with acute OD pain and decreased visual acuity presented with anterior uveitis, an intraocular pressure of 56 mm Hg, an open angle, ipsilateral nerve fiber bundle visual field defects, and optic nerve edema. With control of intraocular pressure and uveitis, visual acuity improved to 20/25, visual field defects persisted, and optic disc pallor developed. She has remained stable over 23 months of follow-up. This case represents a concurrence of glaucomatocyclitic crisis (Posner-Schlossman syndrome, PSS) and nonarteritic ischemic optic neuropathy (NAION). Although this combination occurs rarely, patients with PSS and other risk factors for NAION, including an optic disc that lacks a physiologic cup, should be protected against NAION by prophylactic treatment with ocular antihypertensive medications.

Emergency eye care - Hale, L M (Am Fam Physician, 1972)

Case of phenylephrine hydrochloride-induced periorbital contact dermatitis with fulminant keratoconjunctivitis causing pseudomembrane formation - Kato, Miyuki; Nitta, Kiriko; Kano, Yoko; Yamada, Masakazu; Ishii, Norito; Hashimoto, Takashi; Ohyama, Manabu (J Dermatol, 2017)

[Current therapeutic possibilities for uveal ocular hypertension] - Belousova, N Iu (Vestn Oftalmol, 2014)
OBJECTIVE: to evaluate the efficacy of combination therapy with three antiglaucoma agents (dorzolamide + brimonidine/timolol) for uveal ocular hypertension. MATERIAL AND METHODS: The study enrolled 20 patients with anterior uveitis complicated by intraocular pressure (IOP) elevation. Besides standard anti-inflammatory agents, the treatment included IOP-lowering instillations, namely dorzolamide 2% 3 times daily and timolol 0.5% 2 times daily. Those patients whose IOP remained uncompensated were then switched to a three-drug regimen: dorzolamide 2% 3 times daily and a fixed combination of brimonidine 0.2%, an aLPHA2-receptor agonist, and timolol 0.5%, a 3-blocker, 2 times daily (Combigan, Allergan). IOP was measured with Maklakov tonometer three times during the day before the treatment and then three times daily while performing the two- or three-drug combination therapy. RESULTS: The mean initial IOP was 34.57 +/- 0.09 mmHg with daily fluctuations of 5.2 +/- 0.08 mmHg. After starting the unfixed combination therapy (dorzolamide + timolol) the mean IOP decreased by 7.86 +/- 0.07 mmHg. Switching to the three-drug therapy (dorzolamide+ brimonidine/timolol) enabled an additional decrease in IOP by 5.43 +/- 0.06 mmHg. Thus, with the new regimen the total decrease in IOP averaged 13.29 +/- 0.09 mmHg with daily fluctuations of 2.5?0.06 mmHg, which ensured that the target IOP was achieved in all patients. All the drugs were well-tolerated. CONCLUSION: Combination therapy with three antiglaucoma agents in the form of two medications--dorzolamide 2% and brimonidine/timolol fixed combination (Combigan)--is shown to be effective in uveal ocular hypertension patients.

Bilateral severe fibrinous anterior uveitis--an unusual complication of pamidronate therapy exacerbated by topical latanoprost - Ramasamy, Balasubramanian; Quah, Sayaun; Sahni, Jayashree N; Palimar, Prasad (J Ocul Pharmacol Ther, 2007)
AIM: The aim of this study was to report a case of severe bilateral fibrinous anterior uveitis following pamidronate therapy in a patient on latanoprost. METHODS: This study is presented as an interventional case report. RESULTS: Clinical examination showed bilateral severe fibrinous uveitis following an intravenous infusion of disodium pamidronate. Ocular signs and symptoms responded to stopping latanoprost and treatment with oral prednisolone (60 mg) and hourly topical prednisolone acetate 1%. The reintroduction of latanoprost resulted in a recurrence, which was stopped with subsequent improvement. CONCLUSIONS: Mild anterior uveitis is an unfamiliar adverse effect of pamidronate therapy. However, severe fibrinous uveitis has not been previously described. This may be due to the compounding effect of latanoprost. This case highlights the importance of history taking and awareness of the otherwise uncommon side effect of this commonly prescribed medication.

Effect of a single drop of latanoprost on intraocular pressure and blood-aqueous barrier permeability in patients with uveitis - Kiuchi, Yoshiaki; Okada, Koji; Ito, Nami; Hayashida, Yasutaka; Fukui, Kanae; Ohnishi, Takako; Ishimoto, Ichiro; Saitoh, Yoshihiro (Kobe J Med Sci, 2002)
The purpose of our study is to evaluate the effect of a single drop of latanoprost on the intraocular pressure and blood-aqueous barrier permeability in 8 patients with uveitis. The degree of inflammation was determined by the intensity of aqueous flare measured with a laser flare cell meter every 2 hours from 11:00 to 17:00 hours for 2 days. Intraocular pressure was measured at 11:00 and 17:00 hours with a Goldmann applanation tonometer on both days. Patients were given one drop of 0.005% latanoprost at 11:00 hours on day 2 and results were compared with day 1 when latanoprost was not administered. There was no significant difference in the intensity of aqueous flare or intraocular pressure between day 1 and day 2. A single drop of latanoprost had little effect on intraocular pressure and aqueous flare intensity in patients with uveitis.

Metipranolol-induced adverse reactions: I. The rechallenge study - Akingbehin, T; Villada, J R; Walley, T (Eye (Lond), 1992)
Previously unreported adverse drug reactions can be difficult to detect and it may be even more difficult to establish a cause and effect relationship, particularly if the adverse reactions mimic naturally occurring disease. In a previous paper we reported 29 patients with granulomatous anterior uveitis, blepharoconjunctivitis, periorbital dermatitis, marginal keratitis and elevation in intraocular pressure (IOP), suspected to be caused by metipranolol (Glauline). With the approval of the District Ethics Committee 7 of those patients were rechallenged with metipranolol 0.3% compared to timolol maleate 0.5% in a double blind trial. The 7 metipranolol treated eyes developed an adverse reaction within 14 days. Metipranolol (Glauline) has been conclusively proven to cause granulomatous anterior uveitis, blepharoconjunctivitis and elevation in IOP, adverse effects never previously reported with any of the ophthalmic topical beta-blockers. The multidose preparations of metipranolol (Glauline) in all three strengths 0.1%, 0.3% and 0.6% and the single dose minim preparation of metipranolol 0.6% have now been withdrawn from clinical use in the United Kingdom.

[The effectiveness of latanoprost for the treatment of pediatric glaucoma] - Urban, Beata; Bakunowicz-Lazarczyk, Alina; Mrugacz, Małgorzata; Oziebło-Kupczyk, Monika (Klin Oczna, 2004)
Latanoprost is a prostaglandin F2alpha analog that reduces intraocular pressure by 20-40% in adults with open-angle glaucoma. The efficacy and safety of this drug in children has not been widely reported. In our study we evaluated the effect of latanoprost in 14 children aged 12-18 years (mean 15 years): 10 patients with glaucoma juvenile (I group); 2 patients with secondary glaucoma because of uveitis recidivans and 2 patients with aniridia and albinismus (II group). In the I group the average IOP decrement was 9 mmHg or 36.5% (range 29-44%). In the II group the average IOP decrement was 6.5 mmHg or 23.5% (range 11-33%). In one child with aniridia after one year of treatment IOL rose again to 26 mmHg and antiglaucomatous surgery was necessary. Ocular side effects in children of latanoprost are mild.

Glaucomatocyclitic crisis in a child - Burnstein, Y; Shelton, K; Higginbotham, E J (Am J Ophthalmol, 1998)
PURPOSE: To report a case of glaucomatocyclitic crisis (Posner-Schlossman syndrome) in a child. METHOD: Case report. A 13-year-old boy presented with decreased vision, photophobia, halos, and pain in the right eye. RESULT: Findings in this child were consistent with a diagnosis of Posner-Schlossman syndrome. CONCLUSION: Glaucomatocyclitic crisis can occur in a child and must be included in the differential diagnosis of uveitis and glaucoma in pediatric patients.

[The Posner-Schlossman syndrome] - Dernouchamps, J P (Bull Soc Belge Ophtalmol, 1989)
The Posner-Schlossman syndrome, also called glaucomato-cyclitic crisis, is an ocular disease characterized by monocular rises in intraocular pressure and cyclitis. The cause of the disease remains unknown. However it could be asked whether this syndrome is not the clinical expression of immunologic reactions of the anaphylactoid type, in connection with a viral infection, in genetically predisposed patients. The treatment of the crisis consists of the administration of inhibitors of carbonic anhydrase as well as local application of betablockers and corticosteroids drops. There is actually no treatment preventing recurrences.

The pupil - Burde, R M (Int Ophthalmol Clin, 1967)

The effects of betamethasone derivatives on endotoxin-induced uveitis in guinea pigs - Tsuji, F; Sawa, K; Ikuse, T; Shirasawa, E (Inflamm Res, 1997)
OBJECTIVE AND DESIGN: We reported previously that the betamethasone derivative betamethasone dipropionate behaves as an anti-glucocorticoid in rat endotoxin-induced uveitis (EIU). In the present study, we produced EIU in guinea pigs and investigated the effects of betamethasone dipropionate on the EIU. MATERIAL: Male Hartley guinea pigs were used. TREATMENT: Glucocorticoids were instilled into the eye. METHOD: To elicit EIU, lipopolysaccharide (LPS) was injected into the anterior chamber of the eye. Cell numbers in the aqueous humor after LPS injection were determined by flow cytometry. Prostaglandin E2 (PGE2) production after LPS injection into the anterior chamber was also examined. RESULTS: Intracameral injection of LPS (1 microgram/eye) induced cell infiltration into the anterior chamber and PGE2 production. Betamethasone dipropionate inhibited cell infiltration and PGE2 production more strongly than betamethasone. These results suggest that betamethasone dipropionate is a potent glucocorticoid in guinea pigs. CONCLUSIONS: Structure-activity relationships of glucocorticoids in the guinea pig EIL model may differ from those in the rat EIU model.

Effects of isopropyl unoprostone, latanoprost, and prostaglandin E(2) on acute rise of aqueous flare in pigmented rabbits - Zhang, Xue-Yun; Hayasaka, Seiji; Hayasaka, Yoriko; Yanagisawa, Shuichiro; Nagaki, Yasunori (Ophthalmic Res, 2002)
PURPOSE: To evaluate the effect of isopropyl unoprostone, latanoprost, and prostaglandin E(2) (PGE(2)) on aqueous flare elevation. METHODS: Isopropyl unoprostone (0.12%) or latanoprost (0.005%) was topically instilled. Transcorneal diffusion of PGE(2), 25 microg/ml, using a glass cylinder, was achieved in pigmented rabbits. Aqueous flare was measured with a laser flare cell meter. RESULTS: Topical instillation of isopropyl unoprostone induced aqueous flare elevation in rabbit eyes. Also, topical isopropyl unoprostone additionally induced aqueous flare elevation in eyes with transcorneal diffusion of PGE(2). Latanoprost did not induce flare elevation. CONCLUSION: Isopropyl unoprostone induced aqueous flare elevation in rabbits, and latanoprost did not produce aqueous flare elevation.

Bilateral poliosis and granulomatous anterior uveitis associated with latanoprost use and apparent hypotrichosis on its withdrawal - Waheed, K; Laganowski, H (Eye (Lond), 2001)

[A brief review of recent achievements concerning biochemistry and physiology of prostaglandins in the eye] - Kahán, L I; Dekov, A M; Pálfalvi, M; Imre, G (Orv Hetil, 1999)
Two prostaglandin molecules have important physiological and pathophysiological role in the tissues of the eye. Prostaglandin F2 alpha takes part in mediating intraocular pressure, prostaglandin E2 is the mediator of inflammation. In case of increased intraocular pressure, latanoprost a derivative of prostaglandin F2 alpha can be applied. Numerous data are available on the favourable intraocular pressure lowering effect of latanoprost. It can be applied as a single hypotensive or it can be combined with eye-drops currently used in glaucoma. It exerts its therapeutic effect by increasing uveoscleral outflow. Inflammation in the eye can be diminished by nonsteroidal anti-inflammatory drugs similarly to inflammations in other tissues of the organism. Literature on nonsteroidal anti-inflammatory drugs is enormous. Molecules of different structures inhibit the synthesis of prostaglandins. Primarily they are useful anti-inflammatory agents, reduce intraocular pressure in secundary glaucoma, inhibit intraocular miosis and prevent development of cystoid macula oedema. Nonsteroidal anti-inflammatory drugs do not exert their effects on prostaglandins themselves, but inhibit their synthesis. Hence the use of both, latanoprost and nonsteroidal anti-inflammatory drugs simultaneously, improves safety of therapy in case of patients prone to uveitis.

Dimethylthiourea inhibits the inflammatory response to intravitreally-injected endotoxin - Fleisher, L N; Ferrell, J B; Olson, N C; McGahan, M C (Exp Eye Res, 1989)
Dimethylthiourea, a potent scavenger of toxic oxygen metabolites such as the hydroxyl radical, hypochlorous acid, and hydrogen peroxide, was tested for its ability to inhibit an experimentally induced inflammatory response. Inflammation was induced in one eye of male New Zealand white rabbits by intravitreal injection of 10 ng Escherichia coli endotoxin; the contralateral eye received an equal volume of pyrogen-free saline vehicle. Dimethylthiourea was administered intraperitoneally to these animals at 0, 300, 450 and 600 mg kg-1. At 24 h post-endotoxin injection, all vehicle-injected eyes appeared normal with the exception of a small, but significant increase in aqueous humor protein concentration in the 600 mg kg-1 dimethylthiourea group. In endotoxin-injected eyes, treatment with dimethylthiourea, especially at the highest dose, significantly reduced iridal hyperemia, aqueous humor cell number and protein and prostaglandin-E concentrations, and the ex vivo release of prostaglandin-E from the lens. The ability of dimethylthiourea to significantly inhibit the inflammatory response to intravitreally-injected endotoxin suggests that toxic oxygen metabolites may play an important role in the initiation and/or propagation of this form of acute anterior uveitis. Furthermore, the data are consistent with an important interaction between toxic oxygen and arachidonic acid metabolites.

Recurrent anterior uveitis and glaucoma associated with inadvertent entry of ointment into the anterior chamber after radial keratotomy - Garzozi, H J; Muallem, M S; Harris, A (J Cataract Refract Surg, 1999)
Anterior uveitis and elevated intraocular pressure (IOP) occurred after radial keratotomy that was complicated by microperforation and penetration of antibiotic ophthalmic ointment into the anterior chamber. Anterior uveitis and IOP elevation were observed during the early postoperative follow-up and 41 and 61 months after surgery. All 3 attacks responded well to topical anti-inflammatory and antiglaucoma treatment. The probable causes of the uveitis and glaucoma in this case are discussed.

[Massive metrorrhagia in a patient under warfarin anticoagulation. Rapid reversal with a concentrated prothrombin complex (Prothromplex Immuno TIM 4 600 IU)] - Fuentes Pradera, M A; Suárez Delgado, J M; Yanes Vidal, G; Yerga Pozo, G (Rev Esp Anestesiol Reanim, 2006)

Gentian violet keratoconjunctivitis - Parker, W T; Binder, P S (Am J Ophthalmol, 1979)
A case of bilateral keratoconjunctivitis caused by self-instillation of a 1% aqueous solution of gentian violet was complicated by a secondary uveitis and gram-negative conjunctivitis. The patient was treated with cycloplegics and specific antibiotics and after resolution of the bacterial infection, a mild topical corticosteroid was used. After six months the patient had completely recovered from the keratitis, but bilateral corneal vascularization, had unilateral posterior synechiae, corneal scarring, and cataract formation were present. Cationic dyes such as gentian violet appear to be toxic to the ocular surfaces and tend to produce severe intraocular inflammation.

Clinical application of laser flare-cell meter - Sawa, M (Jpn J Ophthalmol, 1990)
Clinical application of the laser flare-cell meter was described. The instrument was developed for concurrent quantitative determinations of the flare and number of cells in the aqueous humor. Diurnal variations were demonstrated in the aqueous flare, and also an increase in the flare with increasing age. The effects of drugs on aqueous humor dynamics were also studied. Orally administered 500 mg of carbonic anhydrase inhibitor reduced the aqueous humor formation by one-third. Concurrent study with the laser flare-cell meter and slit-lamp microscopy in uveitis cases has revealed that the former instrument is superior to the latter in making a quantitative evaluation of inflammation in the anterior segment of the eye. A follow-up study of postoperative inflammation was performed in patients undergoing extracapsular cataract extraction with posterior chamber intraocular lens implantation. Cases with uneventful postoperative course showed intense flare on the first postoperative day followed by a rapid decrease. Cases with inflammation and fibrin had high aqueous flare which showed an increase even before detection of fibrin in the aqueous by slit-lamp microscopy. Topical 0.5% indomethacin treatment was shown to be effective in suppressing the postoperative increase in aqueous flare but had little effect on cell count. In cases undergoing Argon laser trabeculoplasty, the aqueous flare in the treated eyes was determined to be significantly higher than that in the fellow eyes for four weeks postoperatively (P less than 0.05). The laser flare-cell meter has made it possible to determine the flare and number of cells in the aqueous humor quantitatively. This capability differentiates the instrument from the slit-lamp microscope as well as the instruments previously developed for similar purposes. The laser flare-cell meter is a newly developed useful tool to investigate the pathophysiology of the eye.

Untoward effects associated with practolol administration: oculomucocutaneous syndrome - Wright, P (Br Med J, 1975)
Keratoconjunctivitis sicca, conjunctival scarring, fibrosis, metaplasia, and shrinkage developed in 27 patients as an adverse reaction to practolol. Rashes, nasal and mucosal ulceration, fibrous or plastic peritonitis, pleurisy, cochlear damage, and secretory otitis media also occurred in some cases. Three patients suffered profound visual loss though most retained good vision. Symptoms and signs improved on withdrawal of the drug, but reduction of tear secretion persisted in most patients.

GLAUCOMA AND POSTERIOR SUBCAPSULAR CATARACT FOLLOWING TOPICAL PREDNISOLONE (ULTRACORTENOL) THERAPY - Frandsen, E (Acta Ophthalmol (Copenh), 1964)
Keywords: GLAUCOMA; PREDNISOLONE, TOPICAL; TOXICOLOGIC REPORT; UVEITIS; ADOLESCENCE; ARTHRITIS, RHEUMATOID; CATARACT; KERATOCONJUNCTIVITIS; PREDNISONE TOXICOLOGY

Metipranolol-associated nongranulomatous anterior uveitis - Patel, N P; Patel, K H; Moster, M R; Spaeth, G L (Am J Ophthalmol, 1997)
PURPOSE: To describe the findings in a patient with a nongranulomatous anterior uveitis, presumed to be induced by metipranolol. METHOD: A 69-year-old woman developed bilateral, nongranulomatous, anterior uveitis while undergoing treatment with metipranolol 0.3% for primary open-angle glaucoma. Four months after resolution of the initial episode, the patient was challenged with metipranolol 0.3% in the right eye. RESULT: On reinstituting metipranolol 0.3%, the patient once again developed a unilateral, nongranulomatous, anterior uveitis in the challenged eye. CONCLUSION: Metipranolol 0.3% eyedrops, used to treat primary open-angle glaucoma, appear to cause a nongranulomatous anterior uveitis.

Influence of some factors on the sutures of the lens - Polunin, G S; Fyodorov, S; Ivanov, A A (Lens Eye Toxic Res, 1990)
A clinical study of the lens transparency conditions was made on 118 patients with regard for an applicable treatment, the use of hyperbaric oxygenation and a type of lesion. It showed, that sutures of the lens were wider in patients with uveitis and in diabetic patients as compared with the control-group patients who had no other pathologies. Glaucomatous patients had very narrow sutures. Initial opacifications of the lens were perceived in patients with uveitis and in diabetic patients as stars oriented along sutures beneath the posterior capsule in the area of the nucleus. Following hyperbaric oxygenation and equally the corticosteroid therapy, there was a decrease in the thickness of the sutures, and the degree of transparency of the lenticular nucleus changed as well mainly in the zone bordering on the posterior cortex strata. The study underlines the importance of examination of the condition of the lens sutures in determining the toxic impact produced by different factors on the lens.

Nd:YAG laser iridotomy in the management of secondary glaucoma associated with Behçet's disease - Elgin, U; Berker, N; Batman, A; Soykan, E (Eur J Ophthalmol, 2007)
PURPOSE: To report the outcome of Nd:YAG laser iridotomy in the management of secondary glaucoma associated with Behçet's disease (BD). METHODS: In this prospective study, Nd:YAG laser iridotomy was performed on eyes with secondary angle-closure and pupillary block glaucoma associated with BD. The pretreatment and post-treatment intraocular pressures (IOP) and the number of antiglaucoma medications were compared by Mann-Whitney U test. RESULTS: The study consisted of 16 eyes of 11 patients (2 female, 9 male, mean age 39.2+/-8.9 years). Post-treatment follow-up ranged from 6 to 36 months (mean 13.8+/-8.9). The mean IOP was 21.6+/-2.5 mmHg on 2.5+/-0.6 medications before iridotomy. IOP reduced to 17.7+/-2.5 mmHg on 1+/-0.6 medications at the first month and 17.1+/-3.2 mmHg on 1.7+/-0.9 medications at the sixth month of treatment. The differences between IOP and number of antiglaucoma medications at baseline and at the sixth month of the treatment was statistically significant (p<0.00001). For four eyes trabeculectomy with mitomycin C and for one eye Ahmed valve implantation were performed in the follow-up period. CONCLUSIONS: Nd:YAG laser iridotomy can provide reduction of IOP and the number of antiglaucoma medications in selected cases with secondary glaucoma associated with Behcet's disease.

The role of platelet-activating factor in cell infiltration in endotoxin-induced uveitis in guinea pigs - Tsuji, F; Shirasawa, E (Curr Eye Res, 1998)
PURPOSE: We investigated the role of platelet-activating factor (PAF) in cell infiltration in endotoxin-induced uveitis (EIU) in guinea pigs. METHODS: To elicit EIU, lipopolysaccharide (LPS) was injected into the anterior chamber of the eye. Cell numbers in the aqueous humor after LPS injection were determined by flow cytometry. PAF and prostaglandin E2 (PGE2) production after LPS injection were also examined. RESULTS: Intracameral injection of LPS induced cell infiltration into the anterior chamber, and platelet-activating factor (PAF) was detected in the aqueous humor. In addition, topical apafant (PAF antagonist) partially inhibited cell infiltration. Intracameral injection of PAF scarcely induced cell infiltration but the reaction with EIU was accelerated by intracameral injection of a small amount of PAF. CONCLUSIONS: These results suggest that PAF has weak direct activity on cell infiltration in intraocular inflammation but enhances intraocular inflammation.

Proceedings: Hemp in connection with ophthalmology - Valk, L E (Ophthalmologica, 1973)

Glaucoma in the Hallermann-Streiff syndrome - Hopkins, D J; Horan, E C (Br J Ophthalmol, 1970)

A simple technique to administer mydricaine in needle-phobic patients - Rahman, W; Pavesio, C (Br J Ophthalmol, 2009)

Hypotensive effect of timolol on secondary glaucoma in chronic uveitis - Saari, K M; Airaksinen, P J; Jaanio, E A (Lancet, 1978)

Treatment of uveitic macular edema with acetazolamide - Zierhut, M; Thiel, H J; Schlote, T (Doc Ophthalmol, 1999)

Ocular changes in renal transplant patients - Hovland, K R; Ellis, P P (Am J Ophthalmol, 1967)

Trabeculectomy ab interno (trabectome): yet another possibility in the treatment of uncontrolled glaucomatocyclitic crisis under systemic valganciclovir therapy? - Pahlitzsch, M; Torun, N; Gonnermann, J; Maier, A K B; Pleyer, U; Bertelmann, E; Joussen, A; Klamann, M K J (Eye (Lond), 2015)
PURPOSE: To assess the outcome of trabectome surgery in the treatment of glaucomatocyclitic crisis (Posner-Schlossman syndrome) in patients with uncontrolled intraocular pressure (IOP). PATIENTS/METHODS: Trabectome surgery was performed in seven patients with diagnosed glaucomatocyclitic crisis and uncontrolled IOP where cytomegalovirus DNA was verified by polymerase chain reaction in aqueous humour samples. All patients were treated with oral valganciclovir. After surgery the patients were followed-up for 12 months. RESULTS: Mean IOP before trabectome surgery was 40±10 mm Hg (range 33-58 mm Hg). The mean number of antiglaucoma medication prior to surgery was 3.1±0.4. By the end of the 12 months, IOP in all patients was reduced to normal level (13±1 mm Hg) and their antiglaucoma medication was decreased to 0.8±1.1. No recurring attack of glaucomatocyclitic crisis occurred. DISCUSSION: In addition to oral valganciclovir therapy, trabectome surgery seems to be a reliable and effective tool for the management of glaucomatocyclitic crisis with uncontrolled IOP.

Effect of cooled intraocular irrigating solution on the blood-aqueous barrier after cataract surgery - Findl, O; Amon, M; Kruger, A; Petternel, V; Schauersberger, J (J Cataract Refract Surg, 1999)
PURPOSE: To evaluate the effect of cooled intraocular irrigating solution during phacoemulsification on postoperative blood-aqueous barrier (BAB) disturbance. SETTING: Department of Ophthalmology, University of Vienna, Austria. METHODS: In a prospective, randomized clinical study, 40 eyes with senile cataract had phacoemulsification with irrigating solutions cooled to approximately 10 degrees C (n = 20) or at room temperature (n = 20). Surgical procedure and postoperative therapy were otherwise identical in both groups. Postoperative BAB disturbance was assessed with the laser flare-cell meter on days 1, 3, 7, 14, and 28. RESULTS: Anterior chamber flare was significantly lower in the group with cooled irrigating solution on postoperative day 1. There was no significant between-group difference in flare on any other postoperative day. CONCLUSION: Cooled intraocular irrigating solution reduced immediate postoperative inflammation compared with irrigating solution at room temperature. However, this effect was of short duration.

True exfoliation of the lens capsule following uveitis - Yamamoto, N; Miyagawa, A (Graefes Arch Clin Exp Ophthalmol, 2000)
PURPOSE: To report a rare case of true exfoliation of the lens capsule following panuveitis, with slit-lamp photographs before and following the development of the true exfoliation. METHODS: Case report. Review of the history and clinical features of a 70-year-old woman who developed true exfoliation during the treatment for panuveitis. RESULTS: After 7 months of treatment for bilateral panuveitis with topical steroid and tropicamide, the patient developed a thin, transparent membrane arising on the lens surface in the right eye. A diagnosis of true exfoliation of the lens capsule was made. CONCLUSIONS: True exfoliation of the lens capsule following uveitis may occur due to the weakening of the anterior capsule by metabolic disorder caused by uveitis and precipitated by repeated mydriasis.

Successful treatment for sympathetic storms in a patient with neuro-Behçet's disease - Gono, Takahisa; Murata, Megumi; Kawaguchi, Yasushi; Wakasugi, Daisuke; Soejima, Makoto; Yamanaka, Hisashi; Hara, Masako (Clin Rheumatol, 2008)
Sympathetic storms (SyS) are characterized by hyperactivity of autonomic functions, resulting in episodes of hyperthermia, hypertension, tachycardia, and hyperhidrosis. We show here a patient with neuro-Behçet's disease (NBD) complicated by SyS. Although SyS is well known to occur with brain tumors, trauma, and hydrocephalus, this is the first report to show that SyS is a manifestation of central nervous system involvement in a patient with NBD. High concentrations of norepinephrine (NE) and IL-8 in cerebrospinal fluid reflected the activity of SyS. The patient's symptoms showed almost complete improvement after treatment with corticosteroids and intravenous cyclophosphamide. Also, the concentrations of NE and IL-8 were decreased to normal levels. An awareness of the potential for SyS and adequate immunosuppressant therapy are of importance when dealing with patients with NBD.

[Treatment of central serous choroidopathy with the beta receptor blocker metoprolol (preliminary results)] - Avci, R; Deutman, A F (Klin Monbl Augenheilkd, 1993)
Numerous theories have been proposed to explain the origin of central serous choroidopathy (CSC). However, it has been shown recently that there is a close relationship between CSC and type A-behaviour pattern (TABP) which is characterized by high adrenergic activity in the body. It is interesting to note that one of our patients who had chronic central serous choroidopathy, and metoprolol treatment for hypertension during one year, developed a recurrence of CSC three weeks after cessation of metoprolol treatment. This was one of the reasons to start this treatment modality for CSC. In this study, we present 6 cases of CSC in which the diagnosis was established by ophthalmoscopy and fluorescein angiography. In these patients, we proposed to analyse the relationship between CSC and a high adrenergic activity by the use of a selective beta-blocker (metoprolol; 50 mg tablets, twice daily). In two of the six cases, laser photocoagulation was also performed prior to commencement of the metoprolol treatment. Visual acuity improved in two patients, stayed at 1.0 in three patients and stabilized on the pretreatment level (0.8) in one patient (case-5). However, the symptoms (metamorphopsia and micropsia) and the signs (serous retinal detachment and angiographic hyperfluorescence) decreased or disappeared in all patients after treatment. Also visual complaints in all patients improved subjectively. No recurrences were noted during the metoprolol treatment in any of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical analysis of steroid glaucoma - Kong, L; Zhang, C; Chen, M; Xue, G (Yan Ke Xue Bao, 1995)
PURPOSE: The authors accumulated 15 cases (26 eyes) of steroid glaucoma due to topical administration of dexamethasone or prednisolone. METHODS: From 1970 to 1990, 26 eyes in 15 cases were observed (bilateral 11 cases, unilateral 4 cases) including 12 right eyes and 14 left eyes. 10 cases were male and 5 cases female with age ranging from 14 to 52 years averaging 28 years. 25 eyes had the manifestation of chronic open angle glaucoma in the clinical course, and 1 eye simulated an acute glaucoma attack. RESULTS: All patients had taken antiglaucoma medication before coming to our hospital, but the IOP was over 6.7 kPa in 9 eyes. The C/D ratio was equal to or over 0.6 in 9 cases (16 eyes), and the values were inconsistent between both eyes in 55% of the patients. Treatment for glaucoma was immediate discontinuation of the steroids with antiglaucoma medication if necessary. Three eyes received filtering operations and 2 eyes had the removal of subconjunctival residual steroid. Normal IOP was restored in months up to a year. CONCLUSION: Dexamethasone or prednisolone were the easiest to induce steroid glaucoma when the patients had long-term use of steroid eyedrops.

Toxic Anterior Segment Syndrome: Inadvertent Administration of Intracameral Lidocaine 1% and Phenylephrine 2.5% Preserved With 10% Benzalkonium Chloride During Cataract Surgery - Bielory, Brett P; Shariff, Ayesha; Hussain, Rehan M; Bermudez-Magner, Jose Antonio; Dubovy, Sander R; Donaldson, Kendall E (Cornea, 2017)
PURPOSE: To report 3 patients with corneal decompensation and anterior uveitis within 24 hours of cataract surgery from a single ambulatory surgery center using intracameral lidocaine HCl 1% and phenylephrine 2.5% inadvertently preserved with 10% benzalkonium chloride. METHODS: This case series describes 3 patients who underwent traditional cataract extraction with a significant decrease in visual acuity in the immediate postoperative period resulting in secondary surgical intervention for corneal decompensation in 2 patients. RESULTS: All 3 patients experienced a dramatic decrease in visual acuity on the day of surgery, ranging from 20/400 to light perception. They were treated with topical steroids and sodium chloride, with stabilization of vision at 20/60 in 1 patient. The remaining 2 patients did not recover with medical management. One underwent Descemet stripping automated endothelial keratoplasty with placement of the corneal graft on top of Descemet membrane, which could not be removed secondary to extensive fibrosis. The third patient underwent penetrating keratoplasty secondary to deep corneal scarring. CONCLUSIONS: This is the first case series of toxic anterior segment syndrome occurring secondary to the use of benzalkonium chloride-preserved intracameral lidocaine and phenylephrine. Clinicians should remain alert to this phenomenon, and should refrain from using intracameral preservatives during cataract surgery.

Glaucoma associated with precipitates on the trabecular meshwork - Roth, M; Simmons, R J (Ophthalmology, 1979)
Precipitates on the trabecular meshwork may be the only sign of ocular inflammation. Fourteen patients who had glaucoma associated with precipitates on the trabecular meshwork and minimal or no other signs of ocular inflammation did not respond to usual antiglaucoma therapy. Treatment with topical steroids eliminated the precipitates and lowered the intraocular pressure. Careful gonioscopy is the key to accurate diagnosis.

Acetazolamide treatment of CME in patients with uveitis - Rho, D (Ophthalmology, 1996)

Effect of topical betaxolol on the acute rise of aqueous flare induced by highly selective agonists for prostaglandin E2 receptor subtypes in pigmented rabbits - Yanagisawa, Shuichiro; Hayasaka, Seiji; Zhang, Xue-Yun; Hayasaka, Yoriko; Nagaki, Yasunori; Kitagawa, Kiyotaka (Ophthalmic Res, 2002)
PURPOSE: To evaluate the role of topical betaxolol on experimental ocular inflammation in rabbits. METHOD: Transcorneal diffusion of highly selective agonists for prostaglandin E2 receptor subtypes (EP), 25 microg/ml, with the use of a glass cylinder, was performed to produce aqueous flare elevation in pigmented rabbits. Betaxolol was topically administered before EP agonist application. Aqueous flare was measured with a laser flare cell meter. RESULTS: Performing topical instillation of 0.5% betaxolol 4 times inhibited 52 +/- 9% of EP2-agonist (ONO-AE1-259-01)-induced aqueous flare elevation. The inhibition of flare elevation was dependent on the number of betaxolol instillations. Betaxolol did not suppress the elevation induced by an EP4 agonist (ONO-AE1-392). CONCLUSION: Betaxolol inhibited EP2-agonist-induced aqueous flare elevation in pigmented rabbits.

Effects of endothelin receptor antagonists on anterior chamber inflammation induced by intravitreal injection of endothelin-1 - Shoji, N; Oshika, T; Amano, S; Masuda, K (Exp Eye Res, 1999)
To investigate the role of endothelin receptors (ET(A) and ET(B)) in the inflammatory reaction induced by endothelin-1 (ET-1), the time course of changes in aqueous protein concentration (APC) after the intravitreal injection of ET-1 (10(-4), 10(-5) M) was measured using a laser flare-cell meter in pigmented rabbit eyes. The effects of pre-treatment with specific ET(A) receptor antagonist (97-139) (10(-1), 10(-2), 10(-3), 10(-4) M), specific ET(B) receptor antagonist (BQ-788) (1.6 x 10(-3) M), and vehicle solution were assessed. The influence of ET(A)receptor antagonist pre-treatment on aqueous prostaglandin E(2) and leukotriene B(4) concentrations was also evaluated. As a result, pre-treatment with ET(A) receptor antagonist blocked the APC increase induced by 10(-4) M ET-1 in a dose dependent fashion, while BQ-788 did not suppress the inflammatory reaction. The injection of ET-1 increased aqueous prostaglandin E(2) concentration, which was inhibited by pre-treatment with ET(A) receptor antagonist. Aqueous leukotriene B(4) concentration was not affected by ET-1 nor ET(A) receptor antagonist. In conclusion, ET(A) receptor mediates the increases in aqueous protein and prostaglandin E(2) concentration induced by ET-1 injection, and this inflammatory reaction occurs via the cyclooxygenase pathway of arachidonic acid cascade.

Bilateral anterior uveitis associated with travoprost - Suominen, Sakari; Välimäki, Juha (Acta Ophthalmol Scand, 2006)

Benzalkonium chloride induces anterior chamber inflammation in previously untreated patients with ocular hypertension as measured by flare meter: a randomized clinical trial - Stevens, Anna M; Kestelyn, Philippe A; De Bacquer, Dirk; Kestelyn, Philippe G (Acta Ophthalmol, 2012)
PURPOSE: The deleterious effects of benzalkonium chloride (BAK) on the ocular surface are well known. However, few clinical data are available to prove a toxic effect at the level of the anterior chamber. The laser flare meter is a reliable tool to detect low levels of inflammation in the anterior chamber. We wanted to know whether instillation of BAK-preserved timolol in one eye would result in higher laser flare values than the instillation of preservative-free timolol in the fellow eye. METHODS: Randomized prospective, single-masked clinical trial. Twenty-eight untreated patients with ocular hypertension were recruited. After obtaining baseline flare values, we randomly assigned one eye to BAK-preserved timolol and the fellow eye to preservative-free timolol. After 1 month, flare measurements were repeated. RESULTS: There was a significant increase in the flare values in the two treatment regimens, but the increase in the BAK-treated eyes was higher than in the preservative-free treated eyes, and this difference in increase was statistically significant. CONCLUSION: This is the first study to show that short-term BAK administration produces inflammation in the anterior segment of previously untreated patients whose blood-aqueous barrier was not affected by recent intraocular surgery.

Naphazoline, an effective curative in the treatment of irido-cyclitis and glaucoma - Von Nordheim, R W (Ophthalmologica, 1955)
Keywords: GLAUCOMA/therapy; IRIDOCYCLITIS/therapy; SYMPATHOMIMETICS/therapeutic use

Suspected granulomatous anterior uveitis associated with brimonidine tartrate 0.2% and timolol maleate 0.5% ophthalmic solution - Casado, Alfonso; Cabarga, Carmen; de la Fuente, Miguel A; Muñoz-Negrete, Francisco J (Graefes Arch Clin Exp Ophthalmol, 2013)

Bilateral response following unilateral intravitreal bevacizumab injection in a child with uveitic cystoid macular edema - Al-Dhibi, Hassan; Khan, Arif O (J AAPOS, 2009)
Untreated cystoid macular edema (CME) is a major cause for visual loss in intermediate and posterior forms of uveitis. Conventional treatments for inflammatory CME include steroids, nonsteroidal antiinflammatory agents, and carbonic anhydrase inhibitors; however, not all patients respond, even after quieting of the uveitis. Intravitreal injection of bevacizumab, a monoclonal antibody to vascular endothelial growth factor, has recently been suggested as a short-term treatment for inflammatory CME in adults. Because unilaterally injected bevacizumab can reach the contralateral eye via the systemic circulation there may be a contralateral clinical effect; however, the few reports that evaluate this in adults are conflicting. The purpose of this report is to document bilateral reduction of uveitic CME following unilateral intravitreal bevacizumab injection in an 8-year-old girl.

Focal corneal decompensation after filtering surgery with mitomycin C - Mohammadpour, Mehrdad; Jabbarvand, Mahmood; Javadi, Mohammad Ali (Cornea, 2007)
PURPOSE: To report a case with focal corneal decompensation after filtering surgery with inadvertent inadequate irrigation of mitomycin C (MMC). METHODS: Case report and review of literature. RESULTS: A 25-year-old man first referred with the complaint of photophobia. His ocular examinations revealed diffuse keratic precipitates and many iris nodules in both eyes. The primary diagnosis was idiopathic bilateral granulomatous anterior uveitis. The intraocular pressure (IOP) gradually increased in the left eye and was not controlled with a prescription of topical antiglaucoma medications. As the disease progressed, the left eye underwent filtering surgery with MMC 0.02%. The postoperative period was uneventful, and the anterior chamber was deep after surgery. The IOP was controlled without medications; however; the inferior third of the cornea was edematous because of severe endothelial dysfunction. CONCLUSIONS: Inadequate irrigation of MMC during filtering surgery can cause focal corneal decompensation.

Anterior uveitis is associated with travoprost - Kumarasamy, Manjula; Desai, Shrivatsa P (BMJ, 2004)

Iris involvement in leukaemia - Johnston, S S; Ware, C F (Br J Ophthalmol, 1973)

[Double-blind study of the effectiveness of the prostaglandin synthesis inhibitor diclofenac and dexamethasone phosphate in the treatment of iritis after local administration] - Quentin, C D; Behrens-Baumann, W (Fortschr Ophthalmol, 1987)

Re: Outcome of raised intraocular pressure in uveitic eyes with and without a corticosteroid-induced hypertensive response - Nazm, Nazneen; Dubey, Suneeta; Gandhi, Monica; Pegu, Julie (Am J Ophthalmol, 2010)

The diagnosis and management of episcleritis and scleritis - Watson, P G; Lobascher, D (Trans Ophthalmol Soc U K, 1965)

Use of technetium-99m hexamethylpropylene amine oxime SPET for the study of cerebral blood flow reactivity after acetazolamide infusion in patients with Behçet's disease - Pupi, A; Sestini, S; De Cristofaro, M T; Emmi, L; Marchione, T; Salvati, G; Gobbi, F L; Massacesi, L; Meldolesi, U (Eur J Nucl Med, 2000)
The purpose of this study was to characterise the nature of the baseline perfusion defects found in patients with Behçet's disease using hexamethylpropylene amine oxime single-photon emission tomography in conjunction with acetazolamide test (Acz SPET). Eleven patients underwent both baseline and Acz SPET. Regions of interest (ROIs) were drawn on the areas with decreased perfusion (D-ROI) and, in the same section, on areas with normal perfusion (N-ROI). The ROIs were then repositioned on the corresponding section on Acz SPET. The mean ROI counts were then transformed into a perfusion index value (PIV) with reference to the global brain counts. In total we found 24 D-ROIs (17 in the cortical and 7 in subcortical grey matter). The influence of Acz infusion was selectively registered in the D-ROIs, where PIVs changed from 1.23+/-0.17 (baseline SPET) to 1.63+/-0.23 (Acz SPET) (P<0.001). No significant difference was seen in the N-ROIs (1.46+/-0.21 and 1.40+/-0.17, respectively, on baseline SPET and Acz SPET). Our results demonstrate that Acz infusion increases the regional cerebral blood flow within baseline grey matter perfusion defects. This finding suggests that baseline perfusion abnormalities could reflect a disconnection rather than local vasculitic involvement.

[Use of small-dose Cyclosporine HEXAL in the treatment of postoperative inflammation during intraocular surgical reinterventions] - Levanova, O G; Arkhipova, L T (Vestn Oftalmol, 2009)
The effectiveness of small doses of the selective immunosuppressive agent Cyclosporine HEXAL (2-2.5 mg/kg) was studied in 112 patients with early inflammatory reactions developing after various surgical reinterventions (cataract phacoemulsification with intraocular lens implantation after antiglaucoma surgery, repeated antiglaucoma, reconstructive operations, etc.). The drug was given as a short course for 5-10 days. As compared to the conventional treatment with corticosteroids and nonsteroidal anti-inflammatory drugs (NSAID), Cyclosporine HEXAL exerted a rapider therapeutic effect, reducing the duration of exudate resolution and corneal edema and the length of hospital stay and improving functional outcomes. The drug was found to be well tolerated and induced adverse reactions in sporadic cases. Cyclosporine HEXAL may be recommended as the drug of choice in the treatment of the severest postoperative uveitis, particularly if there are contraindications to systemic and long-term use of corticosteroids and NSAID.

Delayed filtering bleb encapsulation - Ophir, A; Ticho, U (Ophthalmic Surg, 1992)
Encapsulated filtering blebs concomitant with increased intraocular pressure (IOP) developed 47 and 6 months, respectively, after surgery in two women, 46 and 60 years old, respectively, who had undergone trabeculectomy operations in one eye. Both blebs were associated with mild anterior uveitis. Following treatment with topical steroids, cyclopentolate, hypotensive medications, and digital massage, the uveitis resolved and the IOP fell. The likely cause of these late-appearing encapsulated blebs was anterior uveitis.

CME and anterior uveitis with latanoprost use - Thorne, J E; Maguire, A M; Lanciano, R (Ophthalmology, 1998)

Progressive herpetic corneal endotheliitis - Robin, J B; Steigner, J B; Kaufman, H E (Am J Ophthalmol, 1985)

[Are metipranolol eyedrops responsible for intraocular side effects?] - Christ, T; Kessler, C (Ophthalmologe, 1992)
Metipranolol is a beta-blocker that has been used in ophthalmology and in systemic therapy for about 10 years. Reports about reversible uveitis under the product Glauline (metipranolol-containing eye drops) in England were the reason for extensive studies with metipranolol-containing eye drops produced with different methods. Analytical studies concerning the influence of irradiation sterilization on the drug containers, studies on the toxicity of the ophthalmic drug on tissue cultures, and prospective and retrospective clinical studies on 2,800 glaucoma patients were performed. Irradiation sterilization leads to the formation of free radicals on the surface of the containers and, depending on the radiation dose, to a decrease in the pH of the drug solution. In prospective studies involving 1,516 glaucoma patients, no intraocular side effects due to metipranolol-containing eye drops were found. In the retrospective examination including 1,306 glaucoma patients, 19 cases of uveitis were found. Thirteen cases of recurring iritis were diagnosed, which had already been observed before the onset of glaucoma therapy. In 2 cases the iritis led to secondary glaucoma and was treated with metipranolol. In 2 cases glaucoma was treated with pilocarpine (and dipivefrin) and metipranolol concomitantly. One case of rubeosis iridis was incorrectly classified as iritis. One case is possibly related to metipranolol despite the assessment to the contrary by the ophthalmologist in question. Following the results of these studies, an accumulation of cases of uveitis caused by metipranolol can be excluded.

Corneal oedema and acute anterior uveitis after two doses of travoprost - Aydin, Sayime; Ozcura, Fatih (Acta Ophthalmol Scand, 2007)

Bilateral spontaneous hyphema with uveitis in a young girl - Shimada, Yoshiaki; Horiguchi, Masayuki; Okubo, Taku (J Pediatr Ophthalmol Strabismus, 2004)
A healthy 5-year-old girl presented with bilateral hyphema as an initial symptom of uveitis. The ocular findings and the patient's age suggested that the uveitis was due to juvenile rheumatic arthritis or chronic iridocyclitis.

Effect of flunixin meglumine on the breakdown of the blood-aqueous barrier following paracentesis in the canine eye - Regnier, A; Whitley, R D; Benard, P; Bonnefoi, M (J Ocul Pharmacol, 1986)
The protein and PGE2 metabolite content of the aqueous humor from untreated and flunixin meglumine pretreated dogs was determined prior to and after anterior chamber paracentesis. In the untreated dogs the concentrations of protein and PGE2 metabolite in aqueous humor were greatly elevated secondary to paracentesis. Intravenously administered flunixin meglumine (1.1 mg/kg or 2.2 mg/kg) significantly reduced these inflammatory parameters, confirming that prostaglandins are involved in the stability of the blood-aqueous barrier by paracentesis in the canine eye. The clinical implication of these results is that intravenous administration of flunixin meglumine before intraocular surgery should be considered as an adjunct therapy to reduce intraoperative and postoperative uveitis.

Infiltration of the iris in chronic lymphatic leukaemia - Martin, B (Br J Ophthalmol, 1968)

Anterior uveitis and concurrent allergic conjunctivitis associated with long-term use of topical 0.2% brimonidine tartrate - Becker, Heidi I; Walton, R Christopher; Diamant, Jonathan I; Zegans, Michael E (Arch Ophthalmol, 2004)

Orthostatic intolerance in Behcet's disease - Tellioglu, T; Robertson, D (Auton Neurosci, 2001)
Neurological manifestations are known to occur in patients with Behcet's Disease (BD) and significantly affect the clinical course of the disease. Nevertheless, the prevalence, pattern and severity of autonomic impairment in such patients have yet to be defined. In this paper, we presented a BD patient with orthostatic tachycardia. Non-invasive standardized autonomic function tests revealed no evidence of autonomic impairment, but profound orthostatic tachycardia accompanied by abnormal catecholamine increase was observed upon standing. The diagnosis of Orthostatic Intolerance (OI) was made and initial symptomatic therapy was started. The contribution of an immunological damage to components of neural pathways in the pathogenesis of the autonomic involvement can be assumed.
Keywords: Non-programmatic

Modified goniotomy for inflammatory glaucoma. Histologic evidence for the mechanism of pressure reduction - Herschler, J; Davis, E B (Arch Ophthalmol, 1980)
A modified goniotomy (trabeculodialysis) was performed on both eyes of a 33-year-old woman who had glaucoma secondary to sarcoid uveitis. One month after trabeculodialysis, a cataract extraction was performed on one eye and a histologic specimen was obtained from the area of the filtration angle that was previously incised. Successful control of intraocular pressure has been maintained in both eyes for 18 months following trabeculodialysis. By light and electron microscopic examination, there was a nonhealed incision between the anterior chamber and Schlemm's canal. Trabeculodialysis, it is concluded, works by providing direct communication between the anterior chamber and Schlemm's canal, and might be effective in all trabecular obstructive glaucoma of short duration before secondary changes occur in the outer drainage channels.

Methazolamide-induced hepatitis and pure RBC aplasia - Krivoy, N; Ben-Arieh, Y; Carter, A; Alroy, G (Arch Intern Med, 1981)

Peripheral iridectomy in angle-closure glaucoma: a common complication - Phillips, C I; Snow, J T (Br J Ophthalmol, 1967)

Chronic open-angle glaucoma secondary to rhegmatogenous retinal detachment - Schwartz, A (Am J Ophthalmol, 1973)

The glucose content of the aqueous humour in man - Pohjola, S (Acta Ophthalmol (Copenh), 1966)

The use of privine as a pressure-reducing medium in iridocyclitis glaucomatosa - Huggert, A (Acta Ophthalmol (Copenh), 1950)
Keywords: IRIDOCYCLITIS; IMIDAZOLES

Estimation of sodium fusidate levels in human serum, aqueous humour, and vitreous body - Williamson, J; Russell, F; Doig, W M; Paterson, R W (Br J Ophthalmol, 1970)

Nonarteritic anterior ischemic optic neuropathy associated with acute glaucoma secondary to Posner-Schlossman syndrome - Kim, Rubin; Van Stavern, Gregory; Juzych, Mark (Arch Ophthalmol, 2003)

Presumed activation of herpetic keratouveitis after Argon laser peripheral iridotomy - Gaynor, B D; Stamper, R L; Cunningham, E T, Jr (Am J Ophthalmol, 2000)
PURPOSE: To describe presumed activation of herpetic keratouveitis after argon laser peripheral iridotomy. METHOD: Case report. RESULTS: A 68-year-old man developed chronic, unilateral, anterior uveitis associated with decreased corneal sensation, focal keratitis, and increased intraocular pressure after argon laser peripheral iridotomy. Treatment with oral acyclovir and discontinuation of topical latanoprost resulted in prompt and continued control of both the intraocular inflammation and pressure. CONCLUSION: Herpetic keratouveitis may occur after argon laser iridotomy, and it should be considered when postoperative inflammation persists despite appropriate use of topical corticosteroids, particularly in patients with a history of herpetic eye disease.

LONG-TERM TREATMENT WITH IDOXURIDINE AND STEROIDS: A COMPLICATION IN HERPETIC KERATITIS - Dohlman, C H; Zucker, B B (Arch Ophthalmol, 1965)
Keywords: ACETAZOLAMIDE; DRUG THERAPY; PREDNISOLONE, TOPICAL; TOXICOLOGIC REPORT; IRITIS; BLINDNESS; DEXAMETHASONE; ERYTHROMYCIN; GERIATRICS; IDOXURIDINE; KERATITIS, DENDRITIC; STAPHYLOCOCCAL INFECTIONS

Ocular inflammatory pseudotumor associated with propranolol therapy - Yeomans, S M; Knox, D L; Green, W R; Murgatroyd, G W (Ophthalmology, 1983)
A 60-year-old man presented with a unilateral mass involving the iris and ciliary body associated with iridocyclitis, which was refractive to both topical and systemic corticosteroid therapy. After a systemic work-up was negative, anterior chamber paracentesis and transcorneal biopsy were performed to rule out malignant melanoma and other tumors. The lesion proved to be an inflammatory lymphoid process, which resolved when systemic propranolol administration was withdrawn. Evidence for the possible role of propranolol in the induction of an intraocular inflammatory pseudotumor is presented.

Brimonidine tartarate 0.2% (Alphagan) associated granulomatous anterior uveitis - Goyal, R; Ram, A R (Eye (Lond), 2000)

GLAUCOMA IRIDECTOMY - Lewis, P M (Eye Ear Nose Throat Mon, 1964)
Keywords: GLAUCOMA; POSTOPERATIVE COMPLICATIONS; MYDRIATICS; IRITIS; SURGERY, OPERATIVE; ANESTHESIA, LOCAL; EPINEPHRINE; IRIS; PREANESTHETIC MEDICATION; PUPIL; TETRACAINE

Acute anterior uveitis and corneal edema associated with travoprost - Faulkner, William J; Burk, Scott E (Arch Ophthalmol, 2003)

Ophthalmic manifestations of immune reconstitution inflammatory syndrome associated with Cryptococcus neoformans - Khurana, Rahul N; Javaheri, Micheal; Rao, Narsing (Ocul Immunol Inflamm, 2008)
PURPOSE: To describe the ophthalmic manifestations of immune reconstitution inflammatory syndrome (IRIS) associated with Cryptococcus neoformans. METHODS: Four HIV-positive patients on highly active anti-retroviral therapy (HAART) presented with marked optic disk swelling. RESULTS: Three months after the episode of IRIS, 2 of the patients maintained 20/20 visual acuity whose elevated intracranial pressure (ICP) was successfully managed, while 2 patients visual acuities were worse than 20/400 whose ICP was persistently elevated. CONCLUSION: Cryptococcus is another opportunistic infectious organism associated with IRIS with ophthalmic manifestations. Ophthalmologists have the opportunity to play a key role in the early diagnosis and management to prevent serious visual loss.

Reduction of macular oedema by acetazolamide in patients with chronic iridocyclitis: a randomised prospective crossover study - Farber, M D; Lam, S; Tessler, H H; Jennings, T J; Cross, A; Rusin, M M (Br J Ophthalmol, 1994)
Thirty patients with cystoid macular oedema secondary to chronic iridocyclitis were enrolled in a two period, prospective, randomised, double masked, crossover study that compared sustained release acetazolamide (500 mg twice a day) with a placebo to measure the effects on the reduction of cystoid macular oedema and improvement of visual acuity. All patients were treated for 1 month with either acetazolamide or placebo, received no treatment for 1 month, and were then treated for 1 month with the other medication. Statistically significant improvement in visual acuity was seen at 14 and 28 days in the treated patients. No improvement was seen when patients received placebo. Improved visual acuity was not associated with race or sex. However, younger patients (under age 55 years) were more likely to benefit from treatment. Results of vitreous fluorophotometry, obtained at baseline and 4 weeks, demonstrated an improvement in posterior vitreous penetration ratios and mid vitreous penetration ratios after treatment with acetazolamide but not with placebo.

[Experimental triethyltin ocular hypertension. Pharmacological and histopathological studies (author's transl)] - Pecori-Giraldi, J; Pellegrino, N; Motolese, E D; Santillo, C; Virno, M (Klin Monbl Augenheilkd, 1977)
The experiments were prompted by the need felt in pharmacology of eyes with hypertension of easy availability, rather long duration and fairly constant levels, to allow observation of the effects of hypotensive agents and to study their mechanism of action. Single doses of 1 mg Triethyltin, a substance producing a hydrodynamic compromission of the brain, were injected into the anterior chamber of rabbit eyes. A rise in ocular tension, beginning within 24 hours and lasting seven to ten days is obtained in about 70% of eyes. The pressure increase ranged from 12 to 30 mm Hg. Biomicroscopic and histologic examinations evidenced an uveitis-like reaction in the first week after treatment. Neoprene casts evidenced an impaired vascularization in the ciliary processes and choroid. Topical and parenteral administration of the most commonly used antiglaucomatous drugs showed how well this hypertension responded to hypotonizing agents. The occurrence of producing an ocular hypertension in the untreated fellow eye following repeated intra-cameral injections of small dosage (1 microgram) of Triethyltin, every two days for more than one month, in the other eye is described. Hypertension resulted in 40% of eyes.

Studies on experimental ocular toxoplasmosis in the rabbit. II. Attempts to stimulate recurrences by local trauma, epinephrine, and corticosteroids - Nozik, R A; O'Connor, G R (Arch Ophthalmol, 1970)

Effect of naphazoline on acute iridocyclitis; effect of naphazoline on episcleritis; effect of naphazoline on contusion of the eyeball and on some other eye diseases (conjunctivitis, keratitis herpetica) - Von Nordheim, R W (Ophthalmologica, 1956)
Keywords: IRIDOCYCLITIS/therapy; SYMPATHOMIMETICS/therapeutic use; EYE DISEASES/therapy; SCLERA/diseases

Granulomatous anterior uveitis associated with 0.2% topical brimonidine - Cates, C A; Jeffrey, M N (Eye (Lond), 2003)

[Post-inflammatory glaucoma--methods of treatment] - Zemba, M; Popescu, Monica; Bobeico, Veronica; Brătulescu, M; Ciucă, Corina (Oftalmologia, 2002)
We show the mechanisms of postinflammatory secondary glaucoma and the possibilities of treatment of this, all of this concerning to an individual case. We evaluate the benefits and risks for every kind of therapeutical approach and we show our choice.

Retinal arteritis complicating herpes zoster ophthalmicus - Brown, R M; Mendis, U (Br J Ophthalmol, 1973)

GLAUCOMA SECONDARY TO LOCAL STEROID THERAPY - Riffenburgh, R S; Ward, H J (Calif Med, 1965)
Keywords: GLAUCOMA; DRUG THERAPY; PHENYLEPHRINE; TOXICOLOGIC REPORT; IRITIS; DEXAMETHASONE; ATROPINE

Glauline (metipranolol) induced uveitis and increase in intraocular pressure - Kinshuck, D (Br J Ophthalmol, 1991)

Intraolar pressure following penetrating keratoplasty - Irvine, A R; Kaufman, H E (Am J Ophthalmol, 1969)

Platelet function in Behçet's disease - Haim, S; Brook, J G; Gilhar, A; Friedman-Birnbaum, R; Markel, A; Aviram, M; Marmur, A; Youdin, M (J Dermatol, 1984)

A presentation of longstanding toxoplasmosis chorioretinitis - Hall, Brian R; Oliver, Gary E; Wilkinson, Mitchell (Optometry, 2009)
BACKGROUND: Toxoplasmosis gondii is the most common cause of focal necrotizing retinitis in healthy individuals. This case report describes a presentation of toxoplasmosis chorioretintis and reviews the current management options. CASE REPORT: A 10-year-old Hispanic girl presented with complaints of decreased vision in her right eye for 3 weeks. The patient had presumed ocular toxoplasmosis chorioretinitis with secondary granulomatous panuveitis. She was treated successfully with Bactrim (Roche Laboratories, Nutley, New Jersey) and topical steroids and cylcoplegics. CONCLUSION: Ocular toxoplasmosis is a self-limiting disease in immunocompetent individuals; however, proper diagnosis and early intervention improves visual outcome.

[Effects of topical prostaglandin analogues on the aqueous flare intensity in rabbit eyes at an early phase of endotoxin-induced uveitis] - Kiuchi, Y; Itaya, H; Shiotani, Y; Nakae, K; Ishimoto, I; Hori, Y; Sato, S; Fukui, K; Kubo, M; Hayashida, Y; Ohnishi, T; Tsukamoto, Y; et al. (Nippon Ganka Gakkai Zasshi, 2001)
PURPOSE: We examined the effects of prostaglandin analogues on the blood-aqueous barrier(BAB) permeability in rabbit eyes at an early phase of endotoxin-induced uveitis(EIU). SUBJECTS AND METHODS: One drop of 0.005% latanoprost or 0.12% unoprostone were applied to rabbit eyes. Escherichia coli lipopolysaccharides were injected to induce uveitis. The changes in flare intensity in normal eyes and EIU eyes after application of eye drops were evaluated. The effect of cyclooxygenase inhibitor on the flare intensity changes caused by the application of unoprostone was also examined. RESULTS: Flare intensity increased significantly after a single instillation of unoprostone, and the increase was not prevented by pretreatment with cyclooxygenase inhibitor. In eyes with EIU, unoprostone caused an additional increase of flare intensity to uveitis induced flare change. Latanoprost had no effects on BAB in eyes with normal and with uveitic conditions. CONCLUSION: Latanoprost and unoprostone did not cause an excessive inflammatory reaction in rabbit eyes at an early phase of EIU.

[Treatment of hypertensive uveitis and of post-inflammatory glaucoma] - Weekers, R (Ann Ocul (Paris), 1969)

Comparison of corticosteroid uveitis activity and effects on outflow facility in the rabbit - Baldwin, H A; Leaders, F E (Exp Eye Res, 1972)

Gaucoma following keratoplasty - Thoft, R A; Gordon, J M; Dohlman, C H (Trans Am Acad Ophthalmol Otolaryngol, 1974)

[Immunological and biochemical factors in the pathogenesis and in the basis of the therapy of uveitis] - Zaĭtseva, N S; Rysaeva, A G; Murav'eva, T V; Liudogovskaia, L A; Katsnel'son, L A (Vestn Oftalmol, 1980)

Acute effects of anti-inflammatory drugs on neodymium:yttrium aluminum garnet laser-induced uveitis in dogs - Millichamp, N J; Dziezyc, J; Rohde, B H; Chiou, G C; Smith, W B (Am J Vet Res, 1991)
Dogs were treated with flunixin meglumine, a cyclooxygenase inhibitor; L-651,896, a 5-lipoxygenase inhibitor; and matrine, a herbal anti-inflammatory drug. Acute inflammation was induced in the eyes by disruption of the anterior lens capsule, using a neodymium:yttrium aluminum garnet laser. Intraocular pressure, pupil diameter, and eicosanoid production in the aqueous humor were measured. Statistically significant effects were seen in the eyes of flunixin meglumine-treated dogs where mydriasis was maintained and aqueous prostaglandin E2 concentration was reduced.

Chronic anterior uveitis in leprosy: an insidious cause of blindness - Espiritu, C G; Gelber, R; Ostler, H B (Br J Ophthalmol, 1991)
Chronic low grade anterior uveitis is the commonest cause of blindness in leprosy. It is usually asymptomatic until the late stages, and often patients seek help only after irreversible visual impairment has occurred. We present herewith several cases of this entity to emphasise the insidious nature of the disease, the extent of ocular damage it can cause, and the importance of early detection and treatment.

Bilateral anterior uveitis associated with a brand of metipranolol - Watanabe, T M; Hodes, B L (Arch Ophthalmol, 1997)