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[PMID]:28140772
[Au] Autor:Stevens CE; Bennion JL; Caldwell MC; Townley JR; Apsey DA; Schwertner HA
[Ad] Endereço:1 San Antonio Military Medical Center , San Antonio, Texas.
[Ti] Título:Dose Uniformity of Topical Corticosteroids: A Simulated Trial of Fluorometholone Acetate 0.1% and Loteprednol Etabonate Gel 0.5.
[So] Source:J Ocul Pharmacol Ther;33(2):111-114, 2017 Mar.
[Is] ISSN:1557-7732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of the study was to determine the concentrations of Flarex and Lotemax when shaken and not shaken. Many patients fail to shake or inappropriately shake suspensions of corticosteroids before instillation as directed. This study was designed to help determine what concentration of corticosteroid these patients are receiving. In addition, independent confirmation of loteprednol etabonate ophthalmic gel dose uniformity was determined and compared as a possible alternative. METHODS: Drug concentrations of shaken versus unshaken Flarex and Lotemax were determined over a 20-day simulated tapered course in our institutional laboratory. Collected samples were analyzed by reversed-phase high-performance liquid chromatography with photodiode array detection at 240 nm. RESULTS: Flarex had a mean concentration of 93.7% of the declared concentration when shaken and 7.25% when not shaken. The difference between these groups was statistically significant (P = 0.0001). Lotemax had a mean concentration of 96.74% of the declared concentration when shaken and a mean concentration of 98.97% when not shaken. The difference between these groups was not statistically significant (P = 0.194). CONCLUSIONS: Flarex maintains dose uniformity when shaken. When not shaken, it has poor dose uniformity. Lotemax was consistent whether shaken or not in our study and can be considered to eliminate the variability of poor patient compliance with shaking. The manufacturers of both drugs recommend shaking before application.
[Mh] Termos MeSH primário: Acetatos/análise
Antialérgicos/análise
Fluormetolona/análise
Etabonato de Loteprednol/análise
Soluções Oftálmicas/análise
[Mh] Termos MeSH secundário: Acetatos/administração & dosagem
Antialérgicos/administração & dosagem
Cromatografia Líquida de Alta Pressão
Embalagem de Medicamentos
Fluormetolona/administração & dosagem
Géis/administração & dosagem
Géis/análise
Seres Humanos
Etabonato de Loteprednol/administração & dosagem
Soluções Oftálmicas/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Acetates); 0 (Anti-Allergic Agents); 0 (Gels); 0 (Ophthalmic Solutions); SV0CSG527L (Fluorometholone); YEH1EZ96K6 (Loteprednol Etabonate)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.1089/jop.2016.0151


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[PMID]:28017421
[Au] Autor:Miyazaki D; Fukushima A; Ohashi Y; Ebihara N; Uchio E; Okamoto S; Shoji J; Takamura E; Nakagawa Y; Namba K; Fujishima H
[Ad] Endereço:Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University, Tottori, Japan. Electronic address: dm@grape.med.tottori-u.ac.jp.
[Ti] Título:Steroid-Sparing Effect of 0.1% Tacrolimus Eye Drop for Treatment of Shield Ulcer and Corneal Epitheliopathy in Refractory Allergic Ocular Diseases.
[So] Source:Ophthalmology;124(3):287-294, 2017 Mar.
[Is] ISSN:1549-4713
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To evaluate the effects of 0.1% topical tacrolimus alone or in combination with steroids for the treatment of shield ulcers and corneal epitheliopathy in patients with refractory allergic ocular diseases. DESIGN: Open cohort study. PARTICIPANTS: Patients with refractory allergic conjunctivitis epitheliopathy, shield ulcers, or corneal plaques (N = 791). METHODS: The 791 patients were treated with topical tacrolimus alone or in combination with topical or oral steroids. The effectiveness of the treatments was determined by a corneal epitheliopathy score during the 3-month follow-up period. The clinical signs were rated on a 4-grade scale. Corneal epitheliopathy with no corneal staining was graded as 0, and shield ulcers or plaques were graded as 3, the highest grade. The effects of tacrolimus with and without topical steroids on the epitheliopathy scores were assessed after adjustments for the severity of the clinical signs and characteristics. MAIN OUTCOME MEASURES: Changes in the corneal epitheliopathy score. RESULTS: Adjusted mean epitheliopathy score at the baseline was 1.73 (95% confidence interval [CI], 1.65-1.81) for patients treated with tacrolimus alone, and this was significantly reduced by -0.93 at 1 month. The reduction of the score by topical and oral steroids was -0.02 for fluorometholone, 0.02 for betamethasone, and -0.02 for oral steroids, and these reductions were not significant compared with the reduction effect of topical tacrolimus alone at -0.93. The 238 patients with shield ulcer (score 3) were analyzed with adjustments, and the mean epitheliopathy score at 1 month was reduced to 1.38 with tacrolimus alone (95% CI, 1.24-1.51), 1.41 (95% CI, 1.26-1.56) with adjuvant fluorometholone, and 1.46 (95% CI, 1.32-1.61) with adjuvant betamethasone. No significant difference was observed in the adjunctive topical steroids. The presence of severe palpebral conjunctival symptoms, including giant papillae, was a significant resisting factor for topical tacrolimus. CONCLUSIONS: The significant effects of topical tacrolimus alone on shield ulcers and corneal epitheliopathy suggest that it may be used without the need for steroids.
[Mh] Termos MeSH primário: Inibidores de Calcineurina/uso terapêutico
Conjuntivite Alérgica/tratamento farmacológico
Úlcera da Córnea/tratamento farmacológico
Epitélio Anterior/efeitos dos fármacos
Glucocorticoides/uso terapêutico
Tacrolimo/uso terapêutico
[Mh] Termos MeSH secundário: Administração Oral
Administração Tópica
Adolescente
Betametasona/administração & dosagem
Betametasona/uso terapêutico
Inibidores de Calcineurina/administração & dosagem
Criança
Estudos de Coortes
Conjuntivite Alérgica/diagnóstico
Úlcera da Córnea/diagnóstico
Quimioterapia Combinada
Epitélio Anterior/patologia
Feminino
Fluormetolona/administração & dosagem
Fluormetolona/uso terapêutico
Glucocorticoides/administração & dosagem
Seres Humanos
Masculino
Soluções Oftálmicas
Estudos Retrospectivos
Tacrolimo/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Calcineurin Inhibitors); 0 (Glucocorticoids); 0 (Ophthalmic Solutions); 9842X06Q6M (Betamethasone); SV0CSG527L (Fluorometholone); WM0HAQ4WNM (Tacrolimus)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161227
[St] Status:MEDLINE


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[PMID]:27565784
[Au] Autor:Ono T; Mori Y; Nejima R; Tokunaga T; Miyata K; Amano S
[Ad] Endereço:Miyata Eye Hospital, 6-3 Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan.
[Ti] Título:Long-term follow-up of transplantation of preserved limbal allograft and amniotic membrane for recurrent pterygium.
[So] Source:Graefes Arch Clin Exp Ophthalmol;254(12):2425-2430, 2016 Dec.
[Is] ISSN:1435-702X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To conduct a long-term follow-up study evaluating the efficacy and safety of transplantation of preserved limbal allograft and amniotic membrane for recurrent pterygium. METHODS: This was a retrospective, non-comparative, interventional case series conducted at a private eye hospital. Eighty-four eyes of 80 patients with recurrent pterygium were included in the study. The mean number of previous surgeries for pterygium was 1.36 ± 0.98 (range, 1-8). All subjects received transplantation of preserved limbal allograft and amniotic membrane. RESULTS: The mean follow-up period was 73.0 ± 38.1 months (range, 12-154 months). Pterygium recurred in 10 eyes (11.9 %). The mean period to recurrence was 16.3 ± 11.3 months (range, 5-33 months). Symblepharon was cured in 21 eyes, persisted in 2 eyes, and newly occurred in 3 eyes. Diplopia was cured in eight eyes, persisted in five eyes, and newly occurred in one eye. As for complications, intraocular pressure elevations over 21 mmHg were recognized in ten eyes of nine cases, in which the intraocular pressure was controlled by reduction of topical steroid in four eyes and by addition of topical prostaglandin derivatives in six eyes. Twenty-four eyes (28.6 %) gained two lines or more of Landolt best spectacle-corrected visual acuity (BSCVA), 56 eyes (66.7 %) stayed within one line from preoperation, and four eyes (4.8 %) lost two lines or more. There were no major complications and no graft rejection. CONCLUSIONS: Transplantation of preserved limbal allograft and amniotic membrane is a safe and effective procedure for recurrent pterygium.
[Mh] Termos MeSH primário: Âmnio/transplante
Curativos Biológicos
Transplante de Córnea/métodos
Limbo da Córnea/cirurgia
Pterígio/cirurgia
[Mh] Termos MeSH secundário: Administração Tópica
Adulto
Idoso
Idoso de 80 Anos ou mais
Aloenxertos
Betametasona/administração & dosagem
Feminino
Fluormetolona/administração & dosagem
Seguimentos
Glucocorticoides/administração & dosagem
Rejeição de Enxerto/diagnóstico
Rejeição de Enxerto/tratamento farmacológico
Seres Humanos
Masculino
Meia-Idade
Pterígio/diagnóstico
Recidiva
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
Acuidade Visual
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 9842X06Q6M (Betamethasone); SV0CSG527L (Fluorometholone)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160828
[St] Status:MEDLINE


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[PMID]:27078005
[Au] Autor:Bohm KJ; Ciralsky JB; Harp JL; Bajaj S; Sippel KC
[Ad] Endereço:Departments of *Ophthalmology, †Dermatology, Weill Cornell Medical College, New York, NY; and ‡Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
[Ti] Título:Cicatrizing Conjunctivitis in a Patient Diagnosed With Drug Reaction With Eosinophilia and Systemic Symptoms/Drug-Induced Hypersensitivity Syndrome but With Features of Stevens-Johnson Syndrome.
[So] Source:Cornea;35(6):888-91, 2016 Jun.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Severe cutaneous adverse reactions to drugs (SCARs) such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome (DRESS/DIHS) serve as one of the main reasons for inpatient ophthalmic consultation. Although it is well-recognized that SJS/TEN is associated with severe ocular mucosal inflammation and cicatrizing, potentially blinding, sequelae, this association has not been described in relation to other SCARs. We present a patient fulfilling the diagnostic criteria for probable DRESS/DIHS but not for SJS/TEN, yet exhibiting the severe ocular surface involvement characteristic of SJS/TEN. METHODS: Case report. RESULTS: A 64-year-old man presented with bilateral pseudomembranous conjunctivitis and conjunctival denudation (sloughing) in the setting of a maculopapular rash, fever, liver dysfunction, and hematologic abnormalities 1 month after initiating several medications. A skin biopsy was not consistent with SJS/TEN. The patient was diagnosed with probable DRESS/DIHS and treated with high-dose systemic corticosteroids. The ocular surface inflammation was addressed with intensive topical corticosteroid ointment. The pseudomembranes resolved over a 6-week period, but the patient exhibited residual conjunctival scarring of all palpebral surfaces. CONCLUSIONS: The development of severe ocular surface mucosal inflammation and denudation with cicatrizing sequelae in a patient carrying a diagnosis of DRESS/DIHS has diagnostic and therapeutic implications for the ophthalmologist. Careful ophthalmic assessment is indicated in any SCAR patient with ophthalmic symptoms, regardless of formal diagnosis. Furthermore, the early therapeutic interventions recently recommended in SJS/TEN to limit the ophthalmic cicatricial sequelae, such as systemic or topical corticosteroids, may be indicated.
[Mh] Termos MeSH primário: Cicatriz/etiologia
Conjuntivite/etiologia
Síndrome de Hipersensibilidade a Medicamentos/complicações
Eosinofilia/complicações
Síndrome de Stevens-Johnson/diagnóstico
[Mh] Termos MeSH secundário: Cicatriz/diagnóstico
Cicatriz/tratamento farmacológico
Conjuntivite/diagnóstico
Conjuntivite/tratamento farmacológico
Síndrome de Hipersensibilidade a Medicamentos/diagnóstico
Síndrome de Hipersensibilidade a Medicamentos/tratamento farmacológico
Eosinofilia/diagnóstico
Eosinofilia/tratamento farmacológico
Fluormetolona/uso terapêutico
Glucocorticoides/uso terapêutico
Seres Humanos
Masculino
Metilprednisolona/uso terapêutico
Meia-Idade
Síndrome de Stevens-Johnson/tratamento farmacológico
Triancinolona Acetonida/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); F446C597KA (Triamcinolone Acetonide); SV0CSG527L (Fluorometholone); X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160415
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000000845


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[PMID]:26983976
[Au] Autor:Price MO; Scanameo A; Feng MT; Price FW
[Ad] Endereço:Cornea Research Foundation of America, Indianapolis, Indiana. Electronic address: mprice@cornea.org.
[Ti] Título:Descemet's Membrane Endothelial Keratoplasty: Risk of Immunologic Rejection Episodes after Discontinuing Topical Corticosteroids.
[So] Source:Ophthalmology;123(6):1232-6, 2016 Jun.
[Is] ISSN:1549-4713
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To assess the risk of immunologic rejection episodes if topical corticosteroids are discontinued 1 year after Descemet's membrane endothelial keratoplasty (DMEK) compared with continued once-per-day use. DESIGN: Prospective, longitudinal, parallel-group study. PARTICIPANTS: A total of 400 eyes of 259 DMEK recipients, aged 23 to 90 years. METHODS: Patients were enrolled 1 year after DMEK and allowed to choose whether to stop or continue once-daily topical corticosteroids to maximize compliance. Fellow eyes were eligible for enrollment because the donor grafts were independent. Participants were examined at 1, 3, 6, and 12 months during the second year after DMEK. Results were assessed using Kaplan-Meier survival analysis. MAIN OUTCOME MEASURES: Incidence of immunologic rejection episodes. RESULTS: Steroids were discontinued in 277 eyes (no steroid group) and continued once per day in 123 eyes (steroid group). The subject demographics were well balanced across groups; 99% of the subjects were white, and 95% of the grafts were performed to treat Fuchs' dystrophy. The cumulative incidence of rejection episodes was significantly greater in the no steroid group (6% vs. 0% in the steroid group; P = 0.013). Thirteen of 14 rejection episodes (all in the no steroid group) resolved with resumption of topical corticosteroids. Overall, 1 of 277 grafts (0.4%) failed in the no steroid group, and none failed in the steroid group during the second year after DMEK (P = 0.49). The endothelial cell loss between 1 and 2 years was comparable in the no steroid and steroid groups (6.4%±12% vs. 5.6%±14%, respectively; P = 0.67). CONCLUSIONS: Continued once-per-day use of a topical corticosteroid, even a weak one, was protective against rejection episodes during the second year after DMEK, whereas 6% experienced a rejection episode when steroids were discontinued. Among the 364 eyes that completed 12 months' follow-up, only 1 graft (0.27%) failed.
[Mh] Termos MeSH primário: Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior
Glucocorticoides/administração & dosagem
Rejeição de Enxerto/epidemiologia
Suspensão de Tratamento
[Mh] Termos MeSH secundário: Administração Tópica
Adulto
Idoso
Idoso de 80 Anos ou mais
Contagem de Células
Perda de Células Endoteliais da Córnea/diagnóstico
Epitélio Posterior/patologia
Feminino
Fluormetolona/administração & dosagem
Distrofia Endotelial de Fuchs/cirurgia
Rejeição de Enxerto/imunologia
Rejeição de Enxerto/prevenção & controle
Sobrevivência de Enxerto/efeitos dos fármacos
Seres Humanos
Estudos Longitudinais
Etabonato de Loteprednol/administração & dosagem
Masculino
Meia-Idade
Soluções Oftálmicas
Prednisolona/administração & dosagem
Prednisolona/análogos & derivados
Estudos Prospectivos
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 0 (Ophthalmic Solutions); 8B2807733D (prednisolone acetate); 9PHQ9Y1OLM (Prednisolone); SV0CSG527L (Fluorometholone); YEH1EZ96K6 (Loteprednol Etabonate)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160318
[St] Status:MEDLINE


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[PMID]:26967110
[Au] Autor:Ma X; Lu Y
[Ad] Endereço:Department of Ophthalmology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
[Ti] Título:Efficacy of Intraductal Meibomian Gland Probing on Tear Function in Patients With Obstructive Meibomian Gland Dysfunction.
[So] Source:Cornea;35(6):725-30, 2016 Jun.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To assess the efficacy and safety of intraductal meibomian gland probing in patients with obstructive meibomian gland dysfunction who experienced little improvement with eyelid warming, massage, or artificial tears. METHODS: Forty-nine patients with obstructive meibomian gland dysfunction were randomly divided into 2 groups: intraductal meibomian gland probing with 0.1% fluorometholone (group I), and 0.1% fluorometholone alone (group II). Subjective symptom scores and objective signs, including lid margin abnormalities, meibum quality and expressibility, meibomian gland dropout, fluorescein staining, tear break-up time (TBUT), and Schirmer I test results, were recorded before treatment and after 1 day, 1 week, and 1 month posttreatment. RESULTS: Clinical subjective symptoms and objective signs including meibum grade, TBUT, lid margin abnormalities, and fluorescein staining demonstrated significant improvements in both groups after treatment over time (all P < 0.05), and group I was better than group II 1 month after treatment in meibum grade (6.1 ± 3.3 vs. 10.4 ± 4.9, respectively; P < 0.001), lid margin abnormalities (0.8 ± 0.1 vs. 1.3 ± 0.3, respectively; P < 0.001), and TBUT (8.2 ± 2.1 vs. 7.0 ± 3.0, respectively; P = 0.0293). Before applying any medications, 76% of patients obtained immediate symptom relief 1 day after probing. However, the Schirmer I test results and meibomian gland dropout were insignificant pre- and posttreatment in either group (P > 0.1, respectively). CONCLUSIONS: Intraductal meibomian gland probing demonstrated significant efficacy in symptom relief and tear film stabilization. Probing helped release accumulated meibum and could help increase the accessibility of diseased meibomian glands to topical corticosteroids.
[Mh] Termos MeSH primário: Cateterismo/métodos
Doenças Palpebrais/cirurgia
Obstrução dos Ductos Lacrimais/terapia
Glândulas Tarsais/cirurgia
Lágrimas/fisiologia
[Mh] Termos MeSH secundário: Idoso
Doenças Palpebrais/fisiopatologia
Feminino
Fluormetolona/administração & dosagem
Glucocorticoides/administração & dosagem
Seres Humanos
Obstrução dos Ductos Lacrimais/fisiopatologia
Masculino
Glândulas Tarsais/fisiopatologia
Meia-Idade
Estudos Prospectivos
Coloração e Rotulagem
Inquéritos e Questionários
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); SV0CSG527L (Fluorometholone)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160312
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000000777


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[PMID]:26938329
[Au] Autor:Badenoch PR; OʼDaniel LJ; Wise RP; Slattery JA; Mills RA
[Ad] Endereço:*Department of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia;†Department of Microbiology and Infectious Diseases, SA Pathology at Flinders Medical Centre, Bedford Park, South Australia, Australia; and‡Department of Microbiology and Infectious Diseases, SA Pathology at the Royal Adelaide Hospital, Adelaide, South Australia, Australia.
[Ti] Título:Corynebacterium propinquum Keratitis Identified Using MALDI-TOF.
[So] Source:Cornea;35(5):686-7, 2016 May.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To report a corneal infection due to Corynebacterium propinquum identified using the matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) method. METHODS: A 94-year-old woman presented with suppurative keratitis. Her ocular history included Fuchs corneal dystrophy, corneal transplantation, and glaucoma. A gram-stained smear revealed coryneforms. Colonies on bacterial culture media were assayed by MALDI-TOF. RESULTS: Identification of C. propinquum was confirmed by RNA polymerase ß subunit (rpoB) gene sequencing. The patient was treated with topical cefazolin, gentamicin, and fluorometholone, and her vision improved to 20/160 unaided when last seen. CONCLUSIONS: MALDI-TOF can correctly identify isolates that are both uncommon and difficult to distinguish from related species. The ease and low running costs of this method will improve the laboratory diagnosis of ocular infections.
[Mh] Termos MeSH primário: Úlcera da Córnea/diagnóstico
Infecções por Corynebacterium/diagnóstico
Corynebacterium/isolamento & purificação
Infecções Oculares Bacterianas/diagnóstico
Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Antibacterianos/uso terapêutico
Cefazolina/uso terapêutico
Úlcera da Córnea/tratamento farmacológico
Úlcera da Córnea/microbiologia
Corynebacterium/genética
Infecções por Corynebacterium/tratamento farmacológico
Infecções por Corynebacterium/microbiologia
RNA Polimerases Dirigidas por DNA/genética
Quimioterapia Combinada
Infecções Oculares Bacterianas/tratamento farmacológico
Infecções Oculares Bacterianas/microbiologia
Feminino
Fluormetolona/uso terapêutico
Genes Bacterianos/genética
Gentamicinas/uso terapêutico
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Gentamicins); EC 2.7.7.6 (DNA-Directed RNA Polymerases); EC 2.7.7.6 (RNA polymerase beta subunit); IHS69L0Y4T (Cefazolin); SV0CSG527L (Fluorometholone)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160304
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000000787


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[PMID]:26619385
[Au] Autor:Kim YH; Jung JC; Jung SY; Yu S; Lee KW; Park YJ
[Ad] Endereço:*Cheil Eye Research Institute, Cheil Eye Hospital, Daegu, South Korea; and †Developmental Biology Laboratory, Department of Biology, College of Natural Sciences, Kyungpook National University, Daegu, South Korea.
[Ti] Título:Comparison of the Efficacy of Fluorometholone With and Without Benzalkonium Chloride in Ocular Surface Disease.
[So] Source:Cornea;35(2):234-42, 2016 Feb.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of this study was to compare the cytotoxicity and antiinflammatory effect of preserved and unpreserved 0.1% fluorometholone (FML). METHODS: Drug-induced morphological changes and cytotoxicity were examined in human corneal epithelial cells. Dry eye was induced in mice by treatment with 0.2% benzalkonium chloride (BAC) for the first 2 weeks, and then, the eyes (4 groups; Normal saline, BAC, preserved FML, and unpreserved FML) were treated thrice daily with each formulation for the next 2 weeks. Corneal tissues were embedded in paraffin and stained with hematoxylin and eosin for histopathological examination. Immunofluorescence staining was performed for tumor necrosis factor-α, interleukin-6, and human leukocyte antigen-DR. Terminal deoxynucleotidyl transferase dUTP nick end labeling assay was performed to evaluate drug-induced cytotoxicity. RESULTS: BAC and preserved FML caused cell shrinkage and detachment from the plate in a dose-dependent manner, and cell viability decreased significantly. However, cytotoxicity was reduced on treatment with unpreserved FML. Hematoxylin-eosin staining revealed surface desquamation, irregular surface, loss of cell borders, and stromal shrinkage in the group treated with BAC. On BAC exposure, tumor necrosis factor-α, interleukin-6, and human leukocyte antigen-DR were strongly detected, and cytotoxicity was markedly increased, as evidenced by a positive result in the terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Ocular surface damage and inflammation were slightly reduced on treatment with preserved FML. In comparison, unpreserved FML did not induce morphological changes; moreover, decreased cell cytotoxicity and ocular surface inflammation were observed. CONCLUSIONS: The cytotoxicity of antiinflammatory eye drops evaluated in this study was induced by the preservative BAC. Accordingly, unpreserved FML is more effective than preserved eye drops in decreasing ocular inflammation.
[Mh] Termos MeSH primário: Compostos de Benzalcônio/toxicidade
Síndromes do Olho Seco/tratamento farmacológico
Epitélio Anterior/efeitos dos fármacos
Fluormetolona/toxicidade
Glucocorticoides/toxicidade
Conservantes Farmacêuticos/toxicidade
[Mh] Termos MeSH secundário: Administração Tópica
Animais
Linhagem Celular
Sobrevivência Celular
Relação Dose-Resposta a Droga
Síndromes do Olho Seco/metabolismo
Epitélio Anterior/metabolismo
Feminino
Técnica Indireta de Fluorescência para Anticorpo
Antígenos HLA-DR/metabolismo
Marcação In Situ das Extremidades Cortadas
Interleucina-6/metabolismo
Camundongos
Camundongos Endogâmicos C57BL
Soluções Oftálmicas
Resultado do Tratamento
Fator de Necrose Tumoral alfa/metabolismo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Benzalkonium Compounds); 0 (Glucocorticoids); 0 (HLA-DR Antigens); 0 (Interleukin-6); 0 (Ophthalmic Solutions); 0 (Preservatives, Pharmaceutical); 0 (Tumor Necrosis Factor-alpha); SV0CSG527L (Fluorometholone)
[Em] Mês de entrada:1608
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151201
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000000695


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[PMID]:26520171
[Au] Autor:Pinto-Fraga J; López-Miguel A; González-García MJ; Fernández I; López-de-la-Rosa A; Enríquez-de-Salamanca A; Stern ME; Calonge M
[Ad] Endereço:Instituto Universitario de Oftalmobiología Aplicada, University of Valladolid, Valladolid, Spain; Biomedical Research Networking Center on Bioengineering, Biomaterials and Nanomedicine, Zaragoza, Spain.
[Ti] Título:Topical Fluorometholone Protects the Ocular Surface of Dry Eye Patients from Desiccating Stress: A Randomized Controlled Clinical Trial.
[So] Source:Ophthalmology;123(1):141-53, 2016 Jan.
[Is] ISSN:1549-4713
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To assess the efficacy of topical 0.1% fluorometholone in dry eye disease (DED) patients for ameliorating the worsening of the ocular surface when exposed to adverse environments. DESIGN: Single-center, double-masked, randomized, vehicle-controlled clinical trial. PARTICIPANTS: Forty-one patients showing moderate to severe DED. METHODS: Patients randomly received 1 drop 4 times daily of either topical 0.1% fluorometholone (FML group) or topical polyvinyl alcohol (PA group) for 22 days. Corneal and conjunctival staining, conjunctival hyperemia, tear film breakup time (TBUT), tear osmolarity, and the Symptom Assessment in Dry Eye (SANDE) questionnaire scores were determined at baseline. Variables were reassessed on day 21 before and after undergoing a 2-hour controlled adverse environment exposure and again on day 22. MAIN OUTCOMES MEASURES: Percentage of patients showing an increase 1 point or more in corneal staining and a reduction of 2 points or more (0-10 scale) in SANDE score, after the controlled adverse environment exposure and 24 hours later. RESULTS: After 21 days of treatment, the FML group showed greater improvements in corneal and conjunctival staining, hyperemia, and TBUT than the PA group (P≤0.03). After the adverse exposure, the percentage of patients having a 1-grade or more increase in corneal staining was significantly (P = 0.03) higher in the PA group (63.1% vs. 23.8%, respectively). Additionally, the FML group showed no significant changes in corneal staining (mean, 0.86; 95% confidence interval [CI], 0.47-1.25; vs. mean, 1.05; 95% CI, 0.59-1.51, for visit 2 and 3, respectively), conjunctival staining (mean, 0.95; 95% CI, 0.54-1.37 vs. mean, 1.19; 95% CI, 0.75-1.63), and hyperemia (mean, 0.71; 95% CI, 0.41-1.02 vs. 1.14; 95% CI, 0.71-1.58) after the exposure, whereas for the PA group, there was significant worsening (P≤0.009) in these variables (corneal staining: mean, 1.95; 95% CI, 1.57-2.33 vs. mean, 2.58; 95% CI, 2.17-2.98; conjunctival staining: mean, 1.68; 95% CI, 1.29-2.08 vs. mean, 2.47; 95% CI, 2.07-2.88; hyperemia: mean, 1.95; 95% CI, 1.63-2.26 vs. mean, 2.84; 95% CI, 2.62-3.07). CONCLUSIONS: Three-week topical 0.1% fluorometholone therapy is effective not only in reducing ocular surface signs in DED patients, but also especially in preventing exacerbation caused by exposure to a desiccating stress.
[Mh] Termos MeSH primário: Túnica Conjuntiva/efeitos dos fármacos
Córnea/efeitos dos fármacos
Desidratação/complicações
Síndromes do Olho Seco/tratamento farmacológico
Fluormetolona/administração & dosagem
[Mh] Termos MeSH secundário: Administração Tópica
Túnica Conjuntiva/patologia
Córnea/patologia
Desidratação/patologia
Relação Dose-Resposta a Droga
Método Duplo-Cego
Síndromes do Olho Seco/etiologia
Síndromes do Olho Seco/patologia
Feminino
Glucocorticoides/administração & dosagem
Seres Humanos
Masculino
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Glucocorticoids); SV0CSG527L (Fluorometholone)
[Em] Mês de entrada:1604
[Cu] Atualização por classe:151228
[Lr] Data última revisão:
151228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151102
[St] Status:MEDLINE


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[PMID]:25950662
[Au] Autor:Phillis CA; Bourke RD
[Ad] Endereço:*Griffith University School of Medicine, Gold Coast †Vision Eye Institute, Coolangatta, Qld, Australia.
[Ti] Título:Bilateral Subretinal Fluid Mimicking Subretinal Neovascularization Within 24 Hours After Selective Laser Trabeculoplasty.
[So] Source:J Glaucoma;25(2):e110-4, 2016 Feb.
[Is] ISSN:1536-481X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Selective laser trabeculoplasty (SLT), which is widely regarded as a safe procedure, is a frequently used treatment for open-angle glaucoma. Although it is presumed to be associated with an inflammatory cascade and possible postoperative inflammation, only 2 cases of SLT complicated by cystoid macular edema have been previously reported. Until now there are no previous reports of SLT causing subretinal fluid (SRF). METHODS/IMPORTANCE: Clinical examination, optical coherence tomography, and fluorescein angiography demonstrated a previously unreported clinical entity consisting of bilateral SRF, developing within 24 hours of bilateral inferior 180-degree SLT for open-angle glaucoma. RESULTS: Rapid bilateral, subjective loss of vision occurred within 24 hours post-SLT. This was associated with bilateral SRF resulting in 48 µm (OD) and 35 µm (OS) increase in macular thickness on optical coherence tomography. Fundus fluorescein angiography demonstrated profuse, well-demarcated subfoveal leakage. SRF resolved within 4 days, but eventual best corrected visual acuity was subjectively and objectively decreased. CONCLUSIONS: The sudden onset of loss of vision and the development of subfoveal SRF within 24 hours of SLT strongly suggests cause and effect. This previously unreported clinical entity of bilateral SRF within 24 hours of SLT may be secondary to an intraocular inflammatory cascade, similar to previous hypotheses regarding 3 cases of cystoid macular edema post-SLT. Given the dramatic initial loss of vision and compromised long-term visual outcome, clinicians and patients need to be informed of this new clinical entity of SLT associated with SRF and permanent retinal pigment epithelial changes.
[Mh] Termos MeSH primário: Glaucoma de Ângulo Aberto/cirurgia
Terapia a Laser/efeitos adversos
Neovascularização Retiniana/etiologia
Líquido Sub-Retiniano
Trabeculectomia/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Anti-Inflamatórios não Esteroides/uso terapêutico
Barreira Hematorretiniana
Paquimetria Corneana
Quimioterapia Combinada
Feminino
Angiofluoresceinografia
Fluormetolona/uso terapêutico
Glucocorticoides/uso terapêutico
Seres Humanos
Pressão Intraocular
Cetorolaco/uso terapêutico
Neovascularização Retiniana/diagnóstico
Neovascularização Retiniana/tratamento farmacológico
Tomografia de Coerência Óptica
Acuidade Visual
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Glucocorticoids); SV0CSG527L (Fluorometholone); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1605
[Cu] Atualização por classe:160202
[Lr] Data última revisão:
160202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150508
[St] Status:MEDLINE
[do] DOI:10.1097/IJG.0000000000000259



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