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Torres M.-D.,Ophthalmology Service | Andaluz A.,Autonomous University of Barcelona | Garcia F.,Autonomous University of Barcelona | Fresno L.,Autonomous University of Barcelona | Moll X.,Autonomous University of Barcelona
Veterinary Record | Year: 2012

The objective of this prospective study was to determine the effects of a single intravenous bolus of alfaxalone in 2-hydroxypropyl-β-cyclodextrin and propofol on the intraocular pressure (IOP) in sheep. Ten Ripollesa sheep with a bodyweight of 48.5 (6.8) kg (mean [sd]) were used in the study. Twenty-four hours before the experimental procedure, a complete ophthalmic examination was performed in all animals. The day of the study, intravenous alfaxalone (2 mg/kg) or propofol (6 mg/kg) was randomly administered in a cross-over design, with a washout period of two weeks. Measurements of IOP, globe position and pupil size were obtained at basal time, before induction (time 0) and at two, five, 10, 15, 20, 30, 45, 60, 90 and 120 minutes after drug administration. Occasional side effects and time to standing were also noted. Intravenous administration of alfaxalone and propofol in sheep resulted in no alteration of IOP. Nevertheless, a decrease in the pupil size was observed in both groups. This present study shows that alfaxalone and propofol, administrated as a single intravenous bolus, are good options for maintaining IOP during anaesthesia in sheep, although marked miosis was observed after administration.

Nieto J.,Consultores en Cirugia Oculoplastica | Zapata M.A.,Ophthalmology Service
Indian Journal of Nephrology | Year: 2010

Patients under chronic dialysis treatment suffer from atherosclerotic disease and anemia more frequently than the normal population. This, together with the frequent hypotension, put these patients at increased risk for anterior ischemic optic neuropathy (AION), which may be bilateral and blinding. We present two cases of patients under chronic dialysis who developed bilateral AION after hypotensive events. Bilateral involvement is not unusual in renal replacement patients who suffer from AION. Efforts should be focused on prevention of this complication by improving anemia and blood pressure control because once established, treatment will probably be ineffective.

Perez-Munuzuri A.,University of Santiago de Compostela | Fernandez-Lorenzo J.,University of Santiago de Compostela | Couce-Pico M.,University of Santiago de Compostela | Blanco-Teijeiro M.,Ophthalmology Service | Fraga-Bermudez J.,University of Santiago de Compostela
Acta Paediatrica, International Journal of Paediatrics | Year: 2010

Objective: To ascertain whether insulin-like growth factor 1 (IGF1) is associated with retinopathy of prematurity (ROP) and is a useful predictor of the disease. Although its aetiopathogenesis is multifactorial, development of the disease appears to be related to a deficiency in IGF1, a hormone that acts together with vascular endothelial growth factor in the normal angiogenesis in the retina. Design: Prospective study for a 30-month period. Participants: A total of 74 premature newborn babies, of less than 1500 g and/or 32 weeks' gestational age or less. Testing: To determine the development and severity of ROP. Main outcome measures: Serum levels of IGF1 were measured once a week from birth until 40 weeks corrected gestational age in each subject. Results: Of our subjects, 32.4% developed some form of ROP, and all those ROP patients had the following characteristics at birth (median ± standard deviation scores): low weight (1098 ± 188 vs. 1393 ± 285 g), short length (36.74 ± 1.77 vs. 38.89 ± 3.08 cm), small cranial perimeter (26.03 ± 1.74 vs. 27.93 ± 1.81 cm) and young gestational age (29.7 ± 1.78 vs. 31.3 ± 1.79 weeks) (p < 0.05). Other factors previously associated with ROP that were also observed with statistically significant frequency in our ROP patients were bronchopulmonary dysplasia, intracranial haemorrhage, the need for erythrocyte transfusion or treatment with erythropoietin and sepsis (all p < 0.05). Levels of IGF1 at the 3rd week post-partum, independent of gestational age at birth, were clearly lower in the group who developed ROP (29.13 vs. 43.16 ng/mL, p < 0.05). A value of 30 ng/mL of IGF1 in the third week post-partum was found to have a 90% sensitivity in the diagnosis of ROP. A rapid rise in IGF1 levels between the 3rd and 5th weeks appeared to be related to the development of a higher stage of ROP. Conclusion: Determination of IGF1 serum levels in the 3rd week post-partum, independent of gestational age at birth, provides a sufficient and reliable prognostic tool and allows the identification of a group of patients at high risk of developing the disease. © 2010 Foundation Acta Pædiatrica.

Schaiquevich P.,CONICET | Ceciliano A.,Interventional Neuroradiology Service | Millan N.,Hematology Oncology Service | Taich P.,Clinical Pharmacokinetics Unit | And 4 more authors.
Pediatric Blood and Cancer | Year: 2013

Background: Treatment of eyes with retinoblastoma failing systemic chemoreduction and external beam radiotherapy is seldom efficacious. This study compares the efficacy and toxicity of intra-arterial ophthalmic artery chemotherapy (IAO) to our historical cohort of sequential periocular and systemic chemotherapy in such patients. Patients and Methods: Eighteen eyes (15 consecutive patients) were retrospectively evaluated. Eight eyes received IAO for a median of four cycles (range: 2-9) including melphalan alone (n=3) or after topotecan and carboplatin (n=4) or topotecan and carboplatin without melphalan (n=1). Ten eyes received a median of two cycles (range: 1-3) of periocular topotecan (n=9) or carboplatin (n=1) followed by intravenous topotecan and cyclophosphamide in three patients if at least stable disease was achieved. Both groups were comparable for disease extension and prior therapy. Results: No extraocular dissemination or second malignancy occurred and all patients are alive. The probability of enucleation-free eye survival at 12 months was 0.87 (95% CI: 0.42-0.97) for the IAO group, compared to 0.1 (95% CI: 0.06-0.35) for the periocular group (P<0.01). Ocular toxicity was mild and similar in both groups (mostly mild orbital edema). Systemic toxicity was low for IAO and periocular injection, but children who received sequentially intravenous chemotherapy (n=12 cycles) had five episodes of grade 4 neutropenia, three of which resulted in hospitalizations. No case in the IAO group presented these complications. Conclusions: IAO is significantly superior to sequential periocular-intravenous topotecan-containing regimens in eyes with relapsed intraocular retinoblastoma with a more favorable toxicity profile. © 2012 Wiley Periodicals, Inc.

Lopez-Garcia J.S.,Ophthalmology Service | Garcia-Lozano I.,Ophthalmology Service
Ophthalmology | Year: 2012

Objective: To assess the effect of the use of containers with an adapted sterilizing filter on the contamination of autologous serum eyedrops. Design: Prospective, consecutive, comparative, and randomized study. Participants: Thirty patients with Sjögren syndrome. Methods: One hundred seventy-six autologous serum containers used in home therapy were studied; 48 of them included an adapted filter (Hyabak; Thea, Clermont-Ferrand, France), and the other 128 were conventional containers. Containers equipped with a filter were tested at 7, 14, 21, and 28 days of use, whereas conventional containers were studied after 7 days of use. In addition, testing for contamination was carried out in 14 conventional containers used during in-patient therapy every week for 4 weeks. In all cases, the preparation of the autologous serum was similar. Blood agar and chocolate agar were used as regular culture media for the microbiologic studies, whereas Sabouraud agar with chloramphenicol was the medium for fungal studies. Main Outcomes Measures: Microbiologic contamination of containers with autologous serum eyedrops. Results: Only one of the containers with an adapted sterilizing filter (2.1%) became contaminated with Staphylococcus epidermidis after 1 month of treatment, whereas the contamination rate among conventional containers reached 28.9% after 7 days of treatment. The most frequent germs found in the samples were coagulase-negative Staphylococcus (48.6%). With regard the containers used in the in-patient setting, 2 (14.3%) became contaminated after 2 weeks, 5 (35.7%) became contaminated after 3 weeks, and 5 (50%) became contaminated after 4 weeks, leaving 7 (50%) that did not become contaminated after 1 month of treatment. Conclusions: Using containers with an adapted filter significantly reduces the contamination rates in autologous serum eyedrops, thus extending the use of such container by the patients for up to 4 weeks with virtually no contamination risks. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2012 American Academy of Ophthalmology.

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