1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150012001
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150012001
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
Freeman, William R.;Azen, Stanley P.;Kim, Jung W.;El-Haig, Wael;Mishell, Daniel R.;Bailey, Ian
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150013002pmid: 9006420
Abstract Objective: To prospectively assess the risks and benefits of vitrectomy surgery for eyes with stage 3 or 4 macular holes. Design: A multicentered, controlled, randomized clinical trial. Setting: Community- and university-based ophthalmology clinics. Patients: One hundred twenty patients (129 eyes) with stage 3 or 4 macular holes. Interventions: Standardized macular hole surgery vs observation alone. Main Outcome Measures: Four measures of bestcorrected visual function, standardized photographic evaluation of the extent of hole closure, evaluation of lens opacification, and determination of adverse events. Outcomes were determined at 6 months after randomization. Results: Compared with observation alone, a significant benefit due to surgery was found in the rate of hole closure (4% vs 69%, P<.001). After adjusting for baseline visual acuity, hole duration, and maximum hole diameter, a significant benefit due to surgery was found in visual acuity for the Bailey-Lovie Word Reading (P=.02) and the Potential Acuity Meter (P<.01) tests; a marginally significant benefit due to surgery was found in visual acuity for the Early Treatment Diabetic Retinopathy Study chart (P=.05) Although the proportion of eyes achieving a change in visual acuity of 2 or more lines on the Early Treatment Diabetic Retinopathy Study chart was significantly greater for the surgery group vs the observed group (11 [19%] of 59 eyes vs 3[5%] of 58 eyes, adjusted P=.05), 20(34%) of 59 eyes randomized to surgery had a loss in visual acuity of 1 or more lines. Compared with the observation group, eyes randomized to surgery had higher nuclear sclerosis scores (2.4 vs 1.3, P<.001). Fourteen adverse events were noted in the surgery group; none were noted in the observed group. Conclusions: Some visual benefit of vitrectomy surgery for macular holes exists, despite a notable incidence of adverse events. The large variability in visual acuity outcome in the surgical group may be because of complications or progressive cataract. A study of the longterm outcome after macular hole surgery is needed. References 1. Guyer DR. Green WR, de Bustros S, Fine SL. Histopathologic features of idiopathic macular holes and cysts . Ophthalmology . 1990;97:1045-1051.Crossref 2. Schocket SS, Lakhanpal V, Xiaoping M, Kelman S, Billings E. Laser treatment of macular holes . Ophthalmology . 1988;95:574-582.Crossref 3. Gass JDM. Idiopathic senile macular hole . Arch Ophthalmol . 1988;106:629-639.Crossref 4. Johnson RN, Gass JDM. Idiopathic macular holes: observations, stages of formation, and implications for surgical intervention . Ophthalmology . 1988;95:917-924.Crossref 5. Smiddy WE. Michels RG, Glaser BM, de Bustros S. Vitrectomy for impending idiopathic macular holes . Am J Ophthalmol . 1988;105:371-376.Crossref 6. de Bustros S, the Vitrectomy for Prevention of Macular Hole Study Group. Vitrectomy for prevention of macular holes: results of a randomized multicenter clinical trial . Ophthalmology . 1994;101:1055-1059.Crossref 7. Gass JDM, Joondeph BC. Observations concerning patients with suspected impending macular holes . Am J Ophthalmol . 1990;109:638-646. 8. Bartsch D-U, Intaglietta M, Bille JF, Dreher AW, Gharib M, Freeman WR. Confocal laser tomographic analysis of the retina in eyes with macular hole formation and other macular diseases . Am J Ophthalmol . 1989;108:277-287. 9. Shahidi M, Ogura Y, Blair NP, Rusin MM, Zeimer R. Retinal thickness analysis for quantitative assessment of diabetic macular edema . Arch Ophthalmol . 1991;109:1115-1119.Crossref 10. Kishi S, Shimizu K. Posterior precortical vitreous pocket . Arch Ophthalmol . 1990;108:979-982.Crossref 11. Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes: results of a pilot study . Arch Ophthalmol . 1991;109:654-659.Crossref 12. Wendel RT, Patel AC, Kelly NE, Salzano TC, Wells JW. Novack GD. Vitreous surgery for macular holes . Ophthalmology . 1992;100:1671-1676.Crossref 13. Glaser BM, Michels RG, Kuppermann BD, Sjaarda RN, Pena RA. Transforming growth factor β2 for the treatment of full thickness macular holes . Ophthalmology . 1992;99:1162-1173.Crossref 14. le D, Glaser BM, Thompson JT, Sjaarda RN, Gordon LW. Retreatment of fullthickness macular holes persisting after prior vitrectomy . Ophthalmology . 1993;100:1787-1793.Crossref 15. Smiddy WE, Glaser BM, Thompson JT, et al. Transforming growth factor-β2 significantly enhances the ability to flatten the rim of subretinal fluid surrounding macular holes . Retina . 1993;13:296-301.Crossref 16. Glaser BM, Michels RG, Kupperman BD, Sjaarda RN, Pena RA. Transforming growth factor-β2 for the treatment of full-thickness macular holes . Ophthalmology . 1992;99:1162-1172.Crossref 17. Celtrix shares plunge . San Francisco Chronicle . (November 1) , 1995:D-1. 18. Freeman WR. Vitrectomy surgery for full thickness macular holes . Am J Ophthalmol . 1993;116:233-235. 19. Ferris FL III, Kassoff A, Bresnick GH, Bailey I. New visual acuity charts for clinical research . Am J Ophthalmol . 1982;94:91-96. 20. Bailey IL, Bullimore MA. Raasch TW, Taylor HR. Clinical grading and the effect of scaling . Invest Ophthalmol Vis Sci . 1991;32:422-432. 21. Eliott DB, Bullimore MA, Bailey IL. Improving the reliability of the Pelli-Robson Contrast Sensitivity Test . Clin Vis Sci . 1991;6:471-475. 22. Bailey IL, Lovie JE. The design and use of a new near-vision chart . Am J Optom Physiol Opt . 1980;57:378-387.Crossref 23. Afifi AA, Azen SP. Statistical Analysis: A Computer Oriented Approach . 2nd ed. Orlando, Fla: Academic Press Inc; 1979. 24. Kitchin JE, Bailey IL. Task complexity and visual acuity in senile macular degeneration . Aust J Ophthalmol . 1981;63:235-242. 25. Tetz MR, Klein U, Volcker HE. Measurement of potential visual acuity in 343 patients with cataracts: a prospective clinical study . Ger J Ophthalmol . 1992;1:403-408. 26. Bradley A, Thibos L, Still D. Visual acuity measured with clinical Maxwellianview systems: effects of beam entry location . Optom Vis Sci . 1990;67:8101-8107.Crossref 27. Barrett BT, Davison PA, Eustace PE. Effects of posterior segment disorders on oscillatory displacement thresholds, and on acuities as measured using the potential acuity meter and laser interferometer . Ophthalmic Physiol Opt . 1994;14:132-138.Crossref
Wall, Michael;Jennisch, Charles S.;Munden, Paul M.
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150028003pmid: 9006421
Abstract Objective: To determine whether patients with ocular hypertension (OHT) have elevated motion perimetry thresholds. Design: Motion perimetry uses a customized computer graphics program to detect the ability to identify a coherent shift in position of 50% of dots in a defined circular area against a background of fixed dots. Motion size threshold is defined as the smallest circular area in which dot motion is detected. Subjects respond by touching the area of the computer monitor with a light pen where motion stimuli are perceived. Reaction times (milliseconds) to stimuli and localization error (number of pixels from target center) are also obtained for each trial. Setting: University hospital ophthalmology clinic. Patients or Other Participants: Twenty-seven patients with OHT and 27 age-matched normal subjects. One eye was tested in each subject. Main Outcome Measures: Random dot motion stimuli size thresholds and total deviation probability plot data, reaction times, and spatial localization errors. Results: The patients with OHT had more abnormal test points in the total deviation probability plot analysis compared with the controls (P<.001,×2). The abnormal test points were concentrated in the superior and inferior nasal regions. Six subjects had nerve fiber bundlelike defects to motion stimuli. Six subjects (5 overlapping with the probability plot analysis) had abnormal glaucoma hemifield test results. The patients with OHT also had significantly greater localization errors. Conclusion: Motion threshold perimetry may be a more sensitive method to detect visual field abnormalities in OHT than conventional automated perimetry. References 1. Johnson CA, Adams AJ, Casson EJ, Brandt JD. Blue-on-yellow perimetry can predict the development of glaucomatous visual field loss . Arch Ophthalmol . 1993;111:645-650.Crossref 2. Hart WM Jr, Gordon MO. Color perimetry of glaucomatous visual field defects . Ophthalmology . 1984;91:338-346.Crossref 3. Phelps CD. Acuity perimetry and glaucoma . Trans Am Ophthalmol Soc . 1984;82:753-791. 4. Drum B, Breton M, Massof R, et al. Pattern discrimination perimetry: a new concept in visual field testing . Doc Ophthalmol Proc Ser . 1987;49:433-440. 5. Wanger P, Persson HE. Pattern-reversal electroretinograms and high-pass resolution perimetry in suspected or early glaucoma . Ophthalmology . 1987;94:1098-1103.Crossref 6. Kardon RH, Kirkali PA, Thompson HS. Automated pupil perimetry; pupil field mapping in patients and normal subjects . Ophthalmology . 1991;98:485-495.Crossref 7. Quigley HA, Dunkelberger GR, Green WR. Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma . Am J Ophthalmol . 1989;107:453-464. 8. Tuulonen A, Lehtola J, Airaksinen JP. Nerve fiber layer defects with normal visual fields: do normal optic disc and normal visual field indicate absence of glaucomatous abnormality? Ophthalmology . 1993;100:587-598.Crossref 9. Quigley HA, Dunkelberger GR, Green WR. Chronic human glaucoma causing selectively greater loss of large optic nerve fibers . Ophthalmology . 1988;95:357-363.Crossref 10. Glovinsky Y, Quigley HA, Dunkelberger GR. Retinal ganglion cell loss is sizedependent in experimental glaucoma . Invest Ophthalmol Vis Sci . 1991;32:484-491. 11. Chaturvedi N, Hedley-Whyte ET, Dreyer EB. Lateral geniculate nucleus in glaucoma . Am J Ophthalmol . 1993;116:182-188. 12. Schiller PH, Logothetis NK, Charles ER. Functions of the colour-opponent and broad-band channels of the visual system . Nature . 1990;343:68-70.Crossref 13. Nakayama K, Silverman GH. Serial and parallel processing of visual feature conjunctions . Nature . 1986;320:264-265.Crossref 14. Treisman A, Souther J. Search Asymmetry: a diagnostic for preattentive processing of separable features . J Exp Psychol Gen . 1985;114:285-310.Crossref 15. Corbetta M, Miezin FM, Dobmeyer S, Shulman GL, Petersen SE. Selective and divided attention during visual discriminations of shape, color, and speed: functional anatomy by positron emission tomography . J Neurosci . 1991;11:2383-2402. 16. Rumelhart DE, McClelland JL, and the PDP research group. Parallel Distributed Processing: Explorations in the Microstructure of Cognition Foundations . Boston, Mass: The MIT Press; 1986;1:472. 17. Wall M, Ketoff KM. Random dot motion perimetry in glaucoma patients and normal subjects . Am J Ophthalmol . 1996;120:587-596. 18. Wall M, Montgomery EB. Using motion perimetry to detect visual field defects in patients with idiopathic intracranial hypertension: a comparison with conventional automated perimetry . Neurology . 1995;45:1167-1175.Crossref 19. Nawrot M, Steinman SB. Real-time color-frame animation for visual psychophysics on the Macintosh computer . Behav Res Methods Instr Comput . 1994;24:439-452. 20. Fredericksen RE, Verstraten FA, van de Grind WA. Spatial summation and its interaction with the temporal integration mechanism in human motion perception . Vision Res . 1994;34:3171-3188.Crossref 21. Chauhan BC, House PH. Intratest variability in conventional and high-pass resolution perimetry . Ophthalmology . 1991;98:79-83.Crossref 22. Wall M, Lefante J, Conway M. Variability of high-pass resolution perimetry in normals and patients with idiopathic intracranial hypertension . Invest Ophthalmol Vis Sci . 1991;32:3091-3095. 23. van de Grind WA, Koenderink JJ, van Doom AJ, Milders MV, Voerman H. Inhomogeneity and anisotropies for motion detection in the monocular visual field of human observers . Vision Res . 1993;33:1089-1107.Crossref 24. House P, Schulzer M, Drance S, Douglas G. Characteristics of the normal central visual field measured with resolution perimetry . Graefes Arch Clin Exp Ophthalmol . 1991;229:8-12.Crossref 25. Wirtschafter JD, Becker WL, Howe JB, Younge BR. Glaucoma visual field analysis by computed profile of nerve fiber function in optic disc sectors . Ophthalmology . 1982;89:255-267.Crossref 26. Wall M, Conway MD, House PH, Allely R. Evaluation of sensitivity and specificity of spatial resolution and Humphrey automated perimetry in pseudotumor cerebri patients and normal subjects . Invest Ophthalmol Vis Sci . 1991;32:3306-3312. 27. Katz J, Sommer A, Gaasterland DE, Anderson DR. Comparison of analytic algorithms for detecting glaucomatous visual field loss . Arch Ophthalmol . 1991;109:1684-1689.Crossref 28. Asman P, Heijl A. Glaucoma hemifield test: automated visual field evaluation . Arch Ophthalmol . 1992;110:812-819.Crossref 29. Asman P, Heijl A. Evaluation of methods for automated hemifield analysis in perimetry . Arch Ophthalmol . 1992;110:820-826.Crossref 30. Silverman SE, Trick GL, Hart WM Jr. Motion perception is abnormal in primary open-angle glaucoma and ocular hypertension . Invest Ophthalmol Vis Sci . 1990;31:722-729. 31. Bullimore MA, Wood JM, Swenson K. Motion perception in glaucoma . Invest Ophthalmol Vis Sci . 1993;34:3526-3533. 32. Trick GL, Steinman SB, Amyot M. Motion perception deficits in glaucomatous optic neuropathy . Vision Res . 1995;35:2225-2233.Crossref 33. Johnson CA. Selective versus nonselective losses in glaucoma . J Glaucoma . 1994;3( (suppl) ):32-44. 34. Johnson CA, Marshall D, Eng KM. Displacement threshold perimetry in glaucoma using a Macintosh computer system and a 21-inch monitor . In: Mills RP, Wall M, eds. Perimetry Update 1994/1995 . Amsterdam, the Netherlands: Kugler Publications; 1995:103-110. 35. Ruben S, Fitzke F. Correlation of peripheral displacement thresholds and optic disc parameters in ocular hypertension . Br J Ophthalmol . 1994;78:291-294.Crossref 36. Sample PA, Taylor JDN, Martinez G, Lusky M, Weinreb RN. Short-wavelength color visual fields in glaucoma suspects at risk . Am J Ophthalmol . 1993;115:225-233. 37. Mateeff S, Gourevich A. Brief stimuli localization in visual periphery . Acta Physiol Pharmacol Bulg . 1984;10:64-71. 38. Aitsebaomo AP, Bedell HE. Psychophysical and saccadic information about direction for briefly presented visual targets . Vision Res . 1992;32:1729-1737.Crossref 39. Bartz AE. Eye-movement latency, duration, and response time as a function of angular displacement . J Exp Psychol . 1962;64:318-324.Crossref 40. Brito CF. Age-related Changes in the Detection and Classification of Motion in the Periphery of the Visual Field. Iowa City: University of Iowa; 1994. Thesis.
Soparkar, Charles N. S.;Wilhelmus, Kirk R.;Koch, Douglas D.;Wallace, Gary W.;Jones, Dan B.
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150036004pmid: 9006422
Abstract Objective: To describe patterns of conjunctivitis caused by ophthalmic decongestants. Design: Case series. Setting: Outpatient eye clinic. Patients: We selected patients with conjunctival inflammation who were using nonprescription decongestant eyedrops, who had no other cause for conjunctivitis, and whose conditions improved after discontinuing the incriminated preparations. Main Outcome Measures: Clinical characteristics of conjunctival inflammation and time to resolution of symptoms and signs after discontinuing the use of eyedrops. Results: Seventy patients (137 eyes) were identified. Preparations containing the vasoconstrictors naphazoline, tetrahydrozoline, or phenylephrine were associated with 3 clinical patterns of conjunctivitis: conjunctival hyperemia (50 cases), follicular conjunctivitis (17 cases), and eczematoid blepharoconjunctivitis (3 cases). Decongestants were used daily for a median of 3 years (range, 8 hours to 20 years) prior to presentation. The median time to resolution of symptoms and signs was 4 weeks (range, 1-24 weeks), and patients remained asymptomatic for a median follow-up of 6 months (range, 0-12 years). Conclusion: Nonprescription decongestant eyedrops can produce acute and chronic forms of conjunctivitis by pharmacological, toxic, and allergic mechanisms. Once recognized, conjunctival inflammation often takes several weeks to resolve. References 1. Abelson MB, Allansmith MR, Friedlaender MH. Effects of topically applied ocular decongestant and antihistamine . Am J Ophthalmol . 1980;90:254-257. 2. Abelson MB. Paradis A, George MA, Smith SM. Maguire L, Burns R. Effects of Vasocon-A in the Allergen challenge model of acute allergic conjunctivitis . Arch Ophthalmol . 1990;108:520-524.Crossref 3. Abelson MB, Yamamoto GK, Allansmith MR. Effects of ocular decongestants . Arch Ophthalmol . 1980;98:856-858.Crossref 4. Friedlaender MH. Current concepts in ocular allergy . Ann Allergy . 1991;67:5-10. 5. Gordon DM. Ocular decongestants . Am J Ophthalmol . 1959;48:395-396. 6. Hurwitz P. Local antihistamine agents in ophthalmology . Ill Med J . 1950;98:113-116. 7. Hurwitz P, Thompson JM. Uses of naphazoline (privine) in ophthalmology . Arch Ophthalmol . 1950;43:712-717.Crossref 8. Miller J, Wolf EH. Antazoline phosphate and naphazoline hydrochloride, singly and in combination for the treatment of allergic conjunctivitis: a controlled, double blind clinical trial . Ann Allergy . 1975;35:81-86. 9. Nemeth L. Antihistamines in ophthalmology . Br J Ophthalmol . 1949;33:665-669.Crossref 10. Salem H. Dunn BJ. Loux JJ. Conjunctival temperature: a measure of ocular decongestant and anti-inflammatory activity . Ann Ophthalmol . 1975;7:819-824. 11. Smith JP, Lanier BQ, Tremblay N, Ward RL, deFaller JM. Treatment of allergic conjunctivitis with ocular decongestants . Curr Eye Res . 1982;2:141-147.Crossref 12. Mertins PS. Excessive self-medication with naphazoline hydrochloride (privine hydrochloride) . JAMA . 1947;134:1175.Crossref 13. Caputo AR, Schnitzer RE. Systemic response to mydriatic eye drops in neonates: mydriatics in neonates . J Pediatr Ophthalmol Strabismus . 1979;15:109-122. 14. Fraunfelder FT, Scafidi AF. Possible adverse effects from topical ocular 10% phenylephrine . Am J Ophthalmol . 1978;85:447-453. 15. Meyer SM, Fraunfelder FT. Phenylephrine hydrochloride . Ophthalmology . 1980;87:1177-1179.Crossref 16. Lansche RK. Systemic reactions to topical epinephrine and phenylephrine . Am J Ophthalmol . 1966;61:95-98. 17. Mindlin RL. Accidental poisoning from tetrahydrozoline eyedrops . N Engl J Med . 1966;275:112. 18. Rogers GW. Safe use of eye drops . N Engl J Med . 1966;275:447. 19. Heath P. Neosynephrine hydrochloride: some uses and effects in ophthalmology . Arch Ophthalmol . 1936;16:839-846.Crossref 20. Rosales T, Isenberg S, Leake R, Everett S. Systemic effects of mydriatics in low-weight infants . J Pediatr Ophthalmol Strabismus . 1981;18:42-44. 21. Hanna C, Brainard J. Allergic dermatoconjunctivitis caused by phenylephrine . Am J Ophthalmol . 1983;95:703-704. 22. Mathias CGT. Maibach HI, Irvine A, Adler W. Allergic contact dermatitis to echothiophate iodide and phenylephrine . Arch Ophthalmol . 1979;97:286-287.Crossref 23. Epstein DL, Boger WP III, Grant WM. Phenylephrine provocative testing in the pigmentary dispersion syndrome . Am J Ophthalmol . 1978;85:43-50. 24. Rumelt MB. Blindness from misuse of over-the-counter eye medications . Ann Ophthalmol . 1988;20:26-30. 25. Weiss DI, Shaffer RN. Mydriatic effects of one-eighth percent phenylephrine: a potential cause of angle-closure glaucoma . Arch Ophthalmol . 1962;68:41-43. 26. Komi T, Maeda I, Uno Y, Otsuka H. Inhibitory effect of sodium chondroitin sulfate on epithelial keratitis induced by naphazoline . Nippon Geka Gakkai Zasshi . 1964;68:154-158. 27. Lisch K. Conjunctival alterations by sympathomimetic drugs . Klin Monatsbl Augenheilkd . 1978;173:404-406. 28. Saraux H, Offret H, de Rancourt de Mimerand E. Pseudo-pemiphigus oculaire induit par les collyres: a prpos de 3 observations . Bull Soc Ophthalmol Fr . 1980;80:41-45. 29. Herman DC, Bartley GB. Corneal opacities secondary to topical naphazoline and antazoline (Albalon-A) . Am J Ophthalmol . 1987;103:110-111. 30. Aronson SB, Yamamoto EA. Ocular hypersensitivity to epinephrine . Invest Ophthalmol . 1966;5:75-80. 31. Hill K. What's the angle on mydriasis? Arch Ophthalmol . 1968;79:804.Crossref 32. Lee PF. The influence of epinephrine and phenylephrine on intraocular pressure . Arch Ophthalmol . 1958;60:863-867.Crossref 33. Cohen SC. Antistene eyedrops . Am J Ophthalmol . 1952;35:1704-1705. 34. Wilson FM. Adverse external ocular effects of topical ophthalmic medications . Surv Ophthalmol . 1979;24:57-88.Crossref 35. Isenberg SJ, Green BF. Effect of phenylephrine hydrochloride on conjunctival Po2 . Arch Ophthalmol . 1984;102:1185-1186.Crossref 36. Kully BM. The use and abuse of nasal vasoconstrictor medications . JAMA . 1945;127:307-310.Crossref 37. Feinberg SM, Friedlaender SJ. Nasal congestion from frequent use of privine hydrochloride . JAMA . 1945;128:1095-1096.Crossref 38. Fennenbaum JI. Allergic rhinitis . Paterson R, ed. Allergic Diseases: Diagnosis and Management . 2nd ed. Philadelphia, Pa: JB Lippincott; 1980:87. 39. Schiller IW. Deleterious effects of privine hydrochloride . N Engl J Med . 1945;232:333-335. 40. Sternberg L. The abuse of vasoconstrictors in hay fever and vasomotor rhinitis . N Y State J Med . 1944;44:1573-1574. 41. Shaffer RN. Autonomic ocular drugs . Invest Ophthalmol . 1964;3:498-499. 42. Abelson MB, Butrus SI, Weston JH, Rosner B. Tolerance and absence of rebound vasodilation following topical ocular decongestant usage . Ophthalmology . 1984;91:1364-1367.Crossref 43. Grossmann EE, Lehman RH. Ophthalmic use of tyzine: a clinical study of this new vasoconstrictor . Am J Ophthalmol . 1956;42:121-123. 44. Menger HC. New ophthalmic decongestant, tetrahydrozoline hydrochloride: clinical use in 1,156 patients with conjunctival irritation . JAMA . 1959;170:178-179.Crossref 45. Stokes JJ. Clinical evaluation of tetrahydrozoline ophthalmic solution . J Med Assoc Ga . 1958;47:540-541. 46. Mamelok AE. Allergic conjunctivitis . Cutis . 1976;17:244-248. 47. Spector SL, Raizman MB. Conjunctivitis medicamentosa . J Allergy Clin Immunol . 1994;94:134-136.Crossref 48. Liesegang TJ. Bulbar conjunctival follicles associated with dipivefrin therapy . Ophthalmology . 1985;92:228-233.Crossref 49. Fisher AA, Pascher F, Kanof NB. Allergic contact dermatitis due to ingredients of vehicles: a 'vehicle tray' for patch testing . Arch Dermatol . 1971;104:286-290.Crossref 50. Fisher AA, Stillman MA. Allergic contact sensitivity to benzalkonium chloride: cutaneous, ophthalmic, and general medical implications . Arch Dermatol . 1972;106:169-171.Crossref 51. Gasset AR, Ishii Y, Kaufman HE. Cytotoxicity of ophthalmic preservatives . Am J Ophthalmol . 1974;78:98-105. 52. Lemp MA, Zimmerman LE. Toxic endothelial degeneration in ocular surface disease treated with topical medications containing benzalkonium chloride . Am J Ophthalmol . 1988;105:670-673. 53. Sussman JD, Friedman M. Irritation of rabbit eye caused by contact-lens wetting solutons . Am J Ophthalmol . 1969;68:703-706. 54. Theodore FH, Schlossman A. Ocular Allergy . Baltimore, Md: Williams & Wilkins; 1958:64-77. 55. Raymond JZ, Gross PR. EDTA: preservative dermatitis . Arch Dermatol . 1969;100:436-440.Crossref 56. IMS America Ltd staff. Ophthalmic decongestants, in US pharmaceutical market: drug store and hospital purchases. Presented at the Plymouth Meeting of IMS America Ltd; January 1990-June 1991; Plymouth, Pa.
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150040005
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
Lucas-Glass, Tina C.;Baratz, Keith H.;Nelson, Leif R.;Hodge, David O.;Bourne, William M.;Nelson,
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150042006pmid: 9006423
Abstract Objective: To evaluate the corneal endothelial morphometric measures of the contralateral, clinically uninvolved eye of patients with the iridocorneal endothelial (ICE) syndrome. Design: A retrospective review of the specular microscopic photographs of the contralateral corneal endothelium of all patients with ICE syndrome seen at Mayo Clinic, Rochester, Minn. Setting: Ophthalmology department, Mayo Clinic. Participants: Twenty-eight patients with unilateral ICE syndrome who had bilateral endothelial photographs (ICE group) and 28 normal, age-matched control subjects (control group). Main Outcome Measures: Percentage of hexagonal cells, coefficient of variation of cell area, and endothelial cell density. Methods: For each patient and control, 100 endothelial cells were digitized from projected endothelial photomicrographs of the central corneas in the uninvolved eyes. Results: A statistically significant decrease was noted in the mean percentage of hexagonal cells (ICE, 62%; control, 69%; P=.002), and an increase was noted in the mean coefficient of variation of cell area (ICE, 0.28; control, 0.25; P=.02) in the patients with ICE syndrome compared with normal, age-matched controls. The mean endothelial cell density did not differ significantly between the 2 groups (ICE, 2588; control, 2759; P=.10). Conclusion: Our data suggest that the clinically uninvolved, contralateral eyes in patients with ICE syndrome have subclinical endothelial abnormalities as evidenced by a relatively low percentage of hexagonal cells and a relatively high coefficient of variation of cell area. References 1. Shields MB. Progressive essential iris atrophy, Chandler's syndrome, and the iris nevus (Cogan-Reese) syndrome: a spectrum of disease . Surv Ophthalmol . 1979;24:3-20.Crossref 2. Cogan DG, Reese AB. A syndrome of iris nodules, ectopic Descemet's membrane, and unilateral glaucoma . Doc Ophthalmol . 1969;26:424-433.Crossref 3. Henderson JW, Benedict WL. Essential progressive atrophy of the iris . Am J Ophthalmol . 1940;23:644-650. 4. Scheie HG, Yanoff M. Iris nevus (Cogan-Reese) syndrome . Arch Ophthalmol . 1975;93:963-970.Crossref 5. Chandler PA. Atrophy of the stroma of the iris . Am J Ophthalmol . 1956;41:607-615. 6. Wood DJ. Melanosis of the iris and new formation of a hyaline membrane on its surface . Br J Ophthalmol . 1928;12:140-146.Crossref 7. Wilson MC, Shields MB. A comparison of the clinical variations of the iridocorneal endothelial syndrome . Arch Ophthalmol . 1989;107:1465-1468.Crossref 8. Bourne WM. Partial corneal involvement in the iridocorneal endothelial syndrome . Am J Ophthalmol . 1982;94:774-781.Crossref 9. Hirst LW, Quigley HA, Stark WJ. Specular microscopy of iridocorneal endothelial syndrome . Am J Ophthalmol . 1980;89:11-21. 10. Ullern M, Massin M, Pozzo J, Boureau C. Apport de la microscopie speculaire dans le diagnostic du syndrome endothelial irido-corneen . J Fr Ophthalmol . 1985;8:721-728. 11. Campbell DG, Shields MB, Smith TR. The corneal endothelium and the spectrum of essential iris atrophy . Am J Ophthalmol . 1978;86:317-324. 12. Eagle RC, Font RL, Yanoff M, Fine BS. Proliferative endotheliopathy with iris abnormalities . Arch Ophthalmol . 1979;97:2104-2111.Crossref 13. Eagle RC, Font RL, Yanoff M, Fine BS. The iris naevus (Cogan-Reese) syndrome: light and electron microscopic observations . Br J Ophthalmol . 1980;64:446-452.Crossref 14. Bahn CF, Falls HF, Varley GA, Meyer RF, Edelhauser HF. Classification of corneal endothelial disorders based on neural crest origin . Ophthalmology . 1984;91:558-563.Crossref 15. Eagle RC, Shields JA. Iridocorneal endothelial syndrome with contralateral guttate endothelial dystrophy . Ophthalmology . 1987;94:862-870.Crossref 16. Alvarado JA, Murphy CG, Maglio M, Hetherington J. Pathogenesis of Chandler's syndrome, essential iris atrophy and the Cogan-Reese syndrome . Invest Ophthalmol Vis Sci . 1986;27:853-882. 17. Tsai CS, Ritch R, Straus SE, Perry HD, Hsieh FY. Antibodies to Epstein-Barr virus in iridocorneal endothelial syndrome . Arch Ophthalmol . 1990;108:1572-1576.Crossref 18. Alvarado JA, Underwood JL, Green WR, et al. Detection of herpes simplex viral DNA in the iridocorneal endothelial syndrome . Arch Ophthalmol . 1994;112:1601-1609.Crossref 19. Fine M, Barkan H. Essential progressive iris atrophy . Am J Ophthalmol . 1937;20:277-280. 20. Gedda L, Berard-Magistretti DS. Atrofia ereditaria progressiva dell' iride . Acta Genet Med . 1959;8:39-64. 21. Blum JV, Allen JH, Holland MG. Familial bilateral essential iris atrophy (group 2) . Trans Am Acad Ophthalmol Otolaryngol . 1962;66:493-500. 22. Gassett AR, Worthen DM. Keratoconus and Chandler's syndrome . Ann Ophthalmol . 1974;6:819-820. 23. Cross HE, Maumenee AE. Progressive spontaneous dissolution of the iris . Surv Ophthalmol . 1973;18:186-199. 24. Kaiser-Kupfer M, Kuwabara T, Kupfer C. Progressive bilateral essential iris atrophy . Am J Ophthalmol . 1977;83:340-346. 25. Shields MB, Campbell DG, Simmons RJ. The essential iris atrophies . Am J Ophthalmol . 1978;85:749-759. 26. Kupfer C, Kaiser-Kupfer Ml, Datiles M, McCain L. The contralateral eye in the iridocorneal endothelial (ICE) syndrome . Ophthalmology . 1983;90:1343-1350.Crossref 27. Frangoulis MA, Sherrard ES, Kerr Muir MG, Buckley RJ. Clinical features of iridocorneal endothelial syndrome . Trans Ophthalmol Soc U K . 1985;104:775-781. 28. Blair SD, Seabrooks D, Shields WJ, Pillai S, Cavanagh HD. Bilateral progressive essential iris atrophy and keratoconus with coincident features of posterior polymorphous dystrophy: a case report and proposed pathogenesis . Cornea . 1992;11:255-261.Crossref 29. Hemady RK, Patel A, Blum S, Nirankari VS. Bilateral iridocorneal endothelial syndrome: case report and review of the literature . Cornea . 1994;13:368-372.Crossref 30. Laing RA, Sandstrom MM, Berrespi AR, Leibowitz HM. Changes in the corneal endothelium as a function of age . Exp Eye Res . 1976;22:587-594.Crossref 31. Carlson KH, Bourne WM, McLaren JW, Brubaker RF. Variations in human corneal endothelial cell morphology and permeability to fluorescein with age . Exp Eye Res . 1988;47:27-51.Crossref 32. Bland JM, Altman DG. Matching . BMJ . 1994;309:1128.Crossref 33. Kupfer C, Kaiser-Kupfer Ml. Observations on the developmental anomalies of the anterior chamber angle with reference to the pathogenesis of congenital glaucomas . Am J Ophthalmol . 1979;88:424-426. 34. Knudson AG. Genetics of human cancer . Ann Rev Genet . 1986;20:231-251.Crossref 35. Knudson AG. Retinoblastoma: a prototypic hereditary neoplasm . Semin Oncol . 1978;5:57-60. 36. Waring GO, Bourne WM, Edelhauser HF, Kenyon KR. The corneal endothelium . Ophthalmology . 1982;89:531-590.Crossref 37. Polack FM, Bourne WM, Forstot SL, Yamaguchi T. Scanning electron microscopy of posterior polymorphous corneal dystrophy . Am J Ophthalmol . 1980;89:574-584. 38. Henriquez AS, Kenyon KR, Dohlman CH, et al. Morphologic characteristics of posterior polymorphous dystrophy: a study of nine corneas and review of the literature . Surv Ophthalmol . 1984;29:139-147.Crossref 39. Waring GO. Posterior collagenous layer of the cornea . Arch Ophthalmol . 1982;100:122-134.Crossref 40. Johnson BL, Browns I. Posterior polymorphous dystrophy: a light and EM study . Br J Ophthalmol . 1978;62:89-96.Crossref 41. Rodrigues MM, Stulting RD, Waring GO. Clinical, electron microscopic and immunohistochemical study of the corneal endothelium and Descemet's membrane in the iridocorneal endothelial syndrome . Am J Ophthalmol . 1986;101:16-27.
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150046007
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In the article titled "Changes in Descemet Membrane and Endothelium After Corneal Epithelial Abrasion Alone and With Photorefractive Keratectomy in Rabbits," published in the September Archives (1996;114:1105-1108), Figure 4 was faultily cropped during processing for publication. Figure 4 is reprinted correctly here. The journal regrets the error.
Maus, Todd L.;Larsson, Lill-Inger;McLaren, Jay W.;Brubaker, Richard F.
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150047008pmid: 9006424
Abstract Objective: To compare the efficacy of topical 2% dorzolamide hydrochloride (Trusopt) as a suppressor of aqueous humor flow in the human eye with the efficacy of systemically administered acetazolamide (Diamox). Design: A randomized, double-masked, placebo-controlled study of 40 human subjects in 2 academic centers. The effect of dorzolamide on aqueous humor flow was compared with that of acetazolamide as measured by the rate of clearance of topically applied fluorescein. Results: Acetazolamide reduced aqueous flow from 3.18±0.70 (mean±SD) to 2.23±0.48 μL per minute, a reduction of 30% (P<.001), and dorzolamide reduced the flow to 2.65±0.64 μL per minute, a reduction of 17% (P<.001). The difference between the effect of acetazolamine and dorzolamide was significant (P<.001). When acetazolamide is added to dorzolamide, the aqueous flow was reduced further to 2.21±0.47 μL per minute, an additional reduction of 16% (P<.001). When dorzolamide was added to acetazolamide, no additional reduction was observed (P=.73). Similar effects were observed for intraocular pressure. Acetazolamide reduced pressure from 12.5±2.2 (mean±SD) to 10.1±2.2 mm Hg, a decrease of 19% (P<.001) and dorzolamide reduced it to 10.8±2.1 mm Hg, or a decrease of 13% (P<.001). The greater effect of acetazolamide than dorzolamide was significant (P=.03). Conclusions: For reasons that are not known, the topically applied carbonic anhydrase inhibitor 2% dorzolamide hydrochloride is not as effective as systemically administered acetazolamide. Clinicians who prescribe dorzolamide should expect less of an ocular hypotensive effect than that experienced from systemically administered acetazolamide. References 1. Roblin RO, Clapp JW. The preparation of heterocyclic sulfonamides . J Am Chem Soc . 1950;72:4890-4892.Crossref 2. Miller WH, Dessert AM, Roblin RO Jr. Hererocyclic sulfonamide as carbonic anhydrase inhibitors . J Am Chem Soc . 1950;72:4893-4896.Crossref 3. Grant WM, Trotter RR. Diamox (acetazolamide) in treatment of glaucoma . Arch Ophthalmol . 1954;51:735-739.Crossref 4. Becker B. Decrease in intraocular pressure in man by a carbonic anhydrase inhibitor, Diamox: a preliminary report . Am J Ophthalmol . 1954;37:13-15. 5. Breinin GM, Gortz H. Carbonic anhydrase inhibitor acetazolamide (Diamox): a new approach to the therapy of glaucoma . Arch Ophthalmol . 1954;52:333-348.Crossref 6. Maren TH, Haywood JR, Chapman SK, Zimmerman TZ. The pharmacology of methazolamide in relation to the treatment of glaucoma . Invest Ophthalmol . 1977;16:730-742. 7. Wistrand PJ, Garg LCL. Evidence of a high-activity C type of carbonic anhydrase in human ciliary processes . Invest Ophthalmol Vis Sci . 1979;18:802-806. 8. Wistrand PJ, Schenholm M, Lonnerholm G. Carbonic anhydrase isoenzymes CA I and CA II in human eye . Invest Ophthalmol Vis Sci . 1986;27:419-428. 9. Maren TH, Jankowska L, Sanyal G, Edelhauser HF. The transcorneal permeability of sulfonamide carbonic anhydrase inhibitors and their effect on aqueous humor secretion . Exp Eye Res . 1983;36:457-480.Crossref 10. Stein A, Pinke R, Krupin T, et al. The effect of topically administered carbonic anhydrase inhibitors on aqueous humor dynamics in rabbits . Am J Ophthalmol . 1983;95:222-228.Crossref 11. Lewis RA, Schoenwald RD, Eller MG, Barfknecht CF, Phelps CD. Ethoxzolamide analogue gel . Arch Ophthalmol . 1984;102:1821-1824.Crossref 12. Schoenwald RD, Eller MG, Dixson JA, Barfknecht CF. Topical carbonic anhydrase inhibitors . J Med Chem . 1984;27:810-812.Crossref 13. Kalina PH, Shetlar DJ, Lewis RA, Kullerstrand U, Brubaker RF. 6-Amino-2-benzothiazole-sulfonamide: the effect of a topical carbonic anhydrase inhibitor on aqueous humor formation in the normal human eye . Ophthalmology . 1988;95:772-777.Crossref 14. Sugrue MF, Mallorga P, Schwam H, Baldwin JJ, Ponticello GS. A comparison of L-671,152 and MK-927, two topically effective ocular hypotensive carbonic anhydrase inhibitors, in experimental animals . Curr Eye Res . 1990;9:607-615.Crossref 15. Sugrue MF, Gautheron P, Schmitt C, et al. On the pharmacology of L-645,151: a topically effective ocular hypotensive carbonic anhydrase inhibitor . J Pharmacol Exp Ther . 1985;232:534-540. 16. Ponticello GS, Freedman MB, Habecker CN, et al. Thienothiopyran-2-sulfonamides: a novel class of water-soluble carbonic anhydrase inhibitors . J Med Chem . 1987;30:591-597.Crossref 17. Bron AM, Lippa EA, Hofmann HM, etal. MK-927: a topically effective carbonic anhydrase inhibitor in patients . Arch Ophthalmol . 1989;107:1143-1146.Crossref 18. Pfeiffer N, Hennekes R, Lippa EA, Grehn F, Garus H, Brunner-Ferber FL. A single dose of the topical carbonic anhydrase inhibitor MK-927 decreases IOP in patients . Br J Ophthalmol . 1990;74:405-408.Crossref 19. Matuszewski BK, Constanzer ML. Indirect chiral separation and analyses in human biological fluids of the stereoisomers of a thienothiopyran-2-sulfonamide (Trusopt), a novel carbonic anhydrase inhibitor with two chiral centers in the molecule . Chirality . 1992;4:515-519.Crossref 20. Kitazawa Y, Azuma I, Iwata K, et al. Dorzolamide, a topical carbonic anhydrase inhibitor: a two-week dose-response study in patients with glaucoma or ocular hypertension . J Glaucoma . 1994;3:275-279.Crossref 21. Lippa EA, Carlson L-E, Ehinger B, et al. Dose response and duration of action of dorzolamide, a topical carbonic anhydrase inhibitor . Arch Ophthalmol . 1992;110:495-499.Crossref 22. Lippa EA, Schuman JS, Higginbotham EJ, et al. MK-507 versus sezolamide: comparative efficacy of two topically active carbonic anhydrase inhibitors . Ophthalmology . 1991;98:308-313.Crossref 23. Gunning FP, Greve EL, Bron AM, et al. Two topical carbonic anhydrase inhibitors sezolamide and dorzolamide in Gelrite vehicle: a multiple-dose efficacy study . Graefes Arch Clin Exp Ophthalmol . 1993;231:384-388.Crossref 24. Wilkerson M, Cyrlin M, Lippa EA, et al. Four-week safety and efficacy study of dorzolamide, a novel, active topical carbonic anhydrase inhibitor . Arch Ophthalmol . 1993;111:1343-1350.Crossref 25. Yamazaki Y, Miyamoto S, Sawa M. Effect of MK-507 on aqueous humor dynamics in normal human eyes . Jpn J Ophthalmol . 1994;38:92-96. 26. The MK-507 Clinical Study Group. Long-term glaucoma treatment with MK-507, dorzolamide, a topical carbonic anhydrase inhibitor . J Glaucoma . 1995;4:6-10. 27. Strahlman E, Tipping R, Vogel R, the International Dorzolamide Study Group. A double-masked, randomized 1-year study comparing dorzolamide (Trusopt), timolol, and betaxolol . Arch Ophthalmol . 1995;113:1009-1016.Crossref 28. Wang R-F, Serle JB, Podos SM, Sugrue MF. MK-507 (L-671,152), a topically active carbonic anhydrase inhibitor, reduces aqueous humor production in monkeys . Arch Ophthalmol . 1991;109:1297-1299.Crossref 29. Johnson S, Coakes RL, Brubaker RF. A simple photogrammetric method of measuring anterior chamber volume . Am J Ophthalmol . 1978;85:469-474. 30. Brubaker RF. Clinical evaluation of the circulation of aqueous humor . In: Tasman W, Jaeger EA, eds. Duane's Clinical Ophthalmology . Philadelphia, Pa: JB Lippincott; 1990;3(chap 46):1-11. 31. Brubaker RF. Flow of aqueous humor in humans . Invest Ophthalmol Vis Sci . 1991;32:3145-3166. 32. Dixon WJ, Massey JF Jr. Introduction to Statistical Analysis . New York, NY: McGraw-Hill Book Co; 1969:516. 33. Dailey RA, Brubaker RF, Bourne WM. The effects of timolol maleate and acetazolamide on the rate of aqueous formation in normal human subjects . Am J Ophthalmol . 1982;93:232-237. 34. Topper JE, Brubaker RF. Effects of timolol, epinephrine, and acetazolamide on aqueous flow during sleep . Invest Ophthalmol Vis Sci . 1985;26:1315-1319. 35. McCannel CA, Heinrich SR, Brubaker RF. Acetazolamide but not timolol lowers aqueous humor flow in sleeping humans . Graefes Arch Clin Exp Ophthalmol . 1992;230:518-520.Crossref 36. Gharagozloo NZ, Relf SJ, Brubaker RF. Aqueous flow is reduced by the alpha-adrenergic agonist, apraclonidine hydrochloride (ALO 2145) . Ophthalmology . 1988;95:1217-1220.Crossref 37. Reiss GR, Brubaker RF. The mechanism of betaxolol, a new ocular hypotensive agent . Ophthalmology . 1983;90:1369-1372.Crossref 38. Lee DA, Topper JE, Brubaker RF. Effect of clonidine on aqueous humor flow in normal human eyes . Exp Eye Res . 1984;38:239-246.Crossref 39. Gaul GR, Will NJ, Brubaker RF. Comparison of a noncardioselective β-adrenoceptor blocker and a cardioselective blocker in reducing aqueous flow in humans . Arch Ophthalmol . 1989;107:1308-1311.Crossref 40. 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Szlyk, Janet P.;Fishman, Gerald A.;Alexander, Kenneth R.;Revelins, Beatrise I.;Derlacki, Deborah J.;Anderson, Robert J.
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150055009pmid: 9006425
Abstract Objectives: To assess the level of perceived difficulty experienced by patients with retinitis pigmentosa (RP) in the performance of everyday activities and to determine the correlation between patients' self-reported difficulty and clinical measures of visual function. Methods: One hundred sixty-seven patients with typical RP and Usher syndrome type 2, with a wide range of disease severity, rated their difficulty in the performance of 33 activities. We obtained data on visual acuity and visual field area for all patients, and electroretinogram (ERG) recordings on a subgroup of 49 of these patients. Results from the questionnaire were analyzed with factor analysis, and patients' self-reports were compared with their clinical data using correlational analyses and multiple regression. Results: The patients' questionnaire responses clustered into 6 factors: activities involving central vision, miscellaneous activities (no discernible common factor), activities related to mobility, driving, negotiating steps, and eating meals. Of the clinical tests, visual acuity was most strongly related to the patients' ratings of their difficulty in performance. Visual field area also was related to patients' self-assessments but not as strongly as visual acuity. Because visual field area and the ERG measures were correlated, adding ERG information did not improve predictability. Conclusions: In patients with RP, perceived difficulty in performing common tasks was most strongly related to level of visual acuity and visual fields. Although certain ERG amplitude measures did show positive correlations with some self-reported activities, overall, the ERG amplitude measures showed the least relationship with patients' self-reports. Our results provide insight into RP patients' perceived difficulties in performing everyday activities and the clinical measures of visual function that most highly correlate with these difficulties. References 1. Massof RW, Dagnelie G, Benzschawel T, Palmer RW, Finkelstein D. First order dynamics of visual field loss in retinitis pigmentosa . Clin Vis Sci . 1990;5:1-26. 2. Massof RW, Finkelstein D. Two forms of autosomal dominant primary retinitis pigmentosa . Doc Ophthalmol . 1981;51:289-346.Crossref 3. Fishman GA. Retinitis pigmentosa: genetic percentages . Arch Ophthalmol . 1978;96:822-826.Crossref 4. Szlyk JP, Alexander KR, Severing K, Fishman GA. Assessment of driving performance in patients with retinitis pigmentosa . Arch Ophthalmol . 1992;110:1709-1713.Crossref 5. Berson EL, Rosner B, Sandberg MA, et al. A randomized trial of vitamin A and vitamin E supplementation for retinitis pigmentosa . Arch Ophthalmol . 1993;111:761-772.Crossref 6. Fishman GA, Farber MD. Derlacki DJ. X-linked retinitis pigmentosa: profile of clinical findings . Arch Ophthalmol . 1988;106:369-375.Crossref 7. Perlman JT. Retinitis pigmentosa: an improved clinical approach. In: Documenta Ophthalmologica Proceedings of the 14th ISCERG Symposium; May 10-14, 1976; Louisville, Ky. 8. Massof RW, Finkelstein D, Starr SJ, Kenyon KR, Fleischman JA, Maumenee IH. Bilateral symmetry of vision disorders in typical retinitis pigmentosa . Br J Ophthalmol . 1979;63:90-96.Crossref 9. Mangione CM, Phillips RS, Seddon JM, et al. Development of the Activities of Daily Vision Scale: a measure of visual functional status . Med Care . 1992;30:1111-1126.Crossref 10. Szlyk JP, Arditi A, Coffey-Bucci P, Laderman D. Self-report in functional assessment of low vision . J Vis Impairment Blindness . 1990;84:61-66. 11. International Standardization Committee. Standard for Clinical Electroretinography . Arch Ophthalmol . 1989;107:816-819.Crossref
Lyons, Jennifer L.;Rosenbaum, James T.
1997 Archives of Ophthalmology
doi: 10.1001/archopht.1997.01100150063010pmid: 9006426
Abstract Background: Inflammatory bowel disease (IBD) and spondyloarthropathy (SA) such as Reiter syndrome may be characterized by diarrhea, arthritis, stomatitis, and uveitis. Objective: To determine if the characteristics of the eye disease could help distinguish these 2 diagnoses. Design: Seventeen patients with uveitis and IBD referred to a university clinic were compared retrospectively with 89 patients with uveitis and SA referred to the same clinic. Results: Twelve (80%) of the 15 patients with evaluable IBD had Crohn disease. In marked contrast to patients with SA, patients with IBD were usually female (82%). Whereas uveitis with SA was predominantly anterior, unilateral, sudden in onset, and limited in duration, patients with IBD frequently had uveitis that was bilateral, posterior, insidious in onset, and/or chronic in duration. Results for 89% of the patients with SA who underwent HLA-B27 typing were positive, compared with only 46% of such patients with IBD. Episcleritis, scleritis, and glaucoma were more common among patients with IBD. Arthritis did not easily distinguish the 2 groups, as 13 (76%) of the patients with IBD had a history of joint disease. In 10 (59%) of the patients with IBD, the diagnosis of uveitis preceded that of IBD. Conclusion: The hallmarks of uveitis can often distinguish SA and IBD. References 1. Mielants H, Erick M, Veys RJ, Cuvelier C, De Vos M. Repeat ileocolonoscopy in reactive arthritis . J Rheumatol . 1987;14:456-458. 2. Simenon G, Van Gossum A, Adler M, Rickaert F, Appelboom T. Macroscopic and microscopic gut lesions in seronegative spondyloarthritis . J Rheumatol . 1990;17:1491-1494. 3. Hopkins DJ, Horan E, Burton IL, et al. Ocular disorders in a series of 332 patients with Crohn's disease . Br J Ophthalmol . 1974;58:732-737.Crossref 4. Billson FA, De Dombal FT, Watkinson G, Goligher JC. Ocular complications of ulcerative colitis . Gut . 1967;8:102-106.Crossref 5. Knox DL, Schachat AP, Mustonen E. Primary, secondary, and coincidental ocular complications of Crohn's disease . Ophthalmology . 1984;91:163-173.Crossref 6. Rosenbaum JT. Characterization of uveitis associated with spondyloarthritis . J Rheumatol . 1989;16:792-796. 7. Ellis PP, Gentry JH. Ocular complications of ulcerative colitis . Am J Ophthalmol . 1964;58:779-785. 8. Salmon JF, Wright JP, Murray ADN. Ocular inflammation in Crohn's disease . Ophthalmology . 1991;98:480-484.Crossref 9. Ernst B, Lowder C, Meisler M, Gutman F. Posterior segment manifestations of inflammatory bowel disease . Ophthalmology . 1991;98:1272-1280.Crossref 10. Soukiasian SH, Foster CS, Raizman MB. Treatment strategies for scleritis and uveitis associated with inflammatory bowel disease . Am J Ophthalmol . 1994;118:601-611. 11. Rothova A, Buntenhuis HJ, Christiaans BJ, et al. Acute anterior uveitis (AAU) and HLA-B27 . Br J Rheumatol . 1983;22:144-145.Crossref 12. Rothova A, Van Veenendaal WG, Linssen A, Glasius E, Kijlstra A, de Jong PTVM. Clinical features of acute anterior uveitis . Am J Ophthalmol . 1987;103:137-145. 13. Mallas EG, Mackintosh P, Asquith P, Cook WT. Histocompatibility antigens in inflammatory bowel disease . Gut . 1976;17:906-910.Crossref 14. Mielants H, Veys EM. HLA-B27 related arthritis and bowel inflammation, I: sulfasalazine (Salazopyrin) in HLA-B27 related reactive arthritis . J Rheumatol . 1985;12:287-293. 15. Mielants H, Veys EM, Verbaclan H, De Vos M, Cuvelier C. HLA-B27 positive idiopathic acute anterior uveitis: a unique manifestation of subclinical gut inflammation . J Rheumatol . 1990;17:841-842. 16. Banares AA, Jover JA, Fernandez-Gutierrez B, et al. Bowel inflammation in anterior uveitis and spondyloarthropathy . J Rheumatol . 1995;22:1112-1117. 17. Ruby AJ, Jampol LM. Crohn's disease and retinal vascular disease . Am J Ophthalmol . 1990;110:349-353. 18. Duker JS, Brown GC, Brooks L. Retinal vasculitis in Crohn's disease . Am J Ophthalmol . 1987;102:664-668. 19. Joung RSK, Hodes BL, Cruse RP. Orbital pseudotumor and Crohn's disease . J Pediatr . 1981;99:250-252.Crossref
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