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1.
Diabetes Res Clin Pract ; 149: 170-178, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30763599

RESUMEN

AIMS: To analyze contrast sensitivity of intravitreal bevacizumab injections with optimizing glycemic control versus optimizing glycemic control (in combination with sham injections) in eyes with Diabetic Macular Edema (DME). DESIGN: Prospective, interventional, masked, randomized controlled trial. METHODS: Forty-one eyes of 34 patients with type 2 diabetes mellitus and DME with glycated hemoglobin (HbA1c) < 11% received either intravitreal bevacizumab injection (Group 1) or sham injection (Group 2) at 0 and 6 weeks along with optimizing glycemic control. Mean change in best-corrected visual acuity (BCVA), contrast sensitivity (CS), optical coherence tomography (OCT)-measured by central macular thickness (CMT) were compared and correlated at baseline, 2, 6 and 12 weeks. RESULTS: The study showed a mean CS improved in group 1 from 1.14 ±â€¯0.36 logCS to 1.32 ±â€¯0.24 logCS and also in group 2 from 1.11 ±â€¯0.29 logCS to 1.18 ±â€¯0.29 logCS at 12 weeks (P = 0.12). CS and CMT promptly decreased in group 1 compared to group 2 at 2 weeks (ΔCS = 0.15 ±â€¯0.25 vs. 0.03 ±â€¯0.15 logCS; P = 0.04; ΔCMT = 116 ±â€¯115 vs. 17 ±â€¯71 µm; P = 0.01). There was a mean reduction of approximately 0.5% in HbA1c levels in both groups at 12 weeks (P = 0.002). CONCLUSION: The use of bevacizumab in combination with optimizing glycemic control results in earlier improvement of contrast sensitivity in type 2 diabetes patients with DME. However, the optimizing glycemic control itself has shown also to be effective at 12 weeks. ClinicalTrials.gov Identifier: NCT02308644.


Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Bevacizumab/uso terapéutico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Inyecciones Intravítreas/métodos , Edema Macular/tratamiento farmacológico , Anciano , Inhibidores de la Angiogénesis/farmacología , Bevacizumab/farmacología , Sensibilidad de Contraste , Diabetes Mellitus Tipo 2/patología , Femenino , Humanos , Edema Macular/patología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento
2.
Clinics (Sao Paulo) ; 68(4): 557-62, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23778345

RESUMEN

OBJECTIVES: Chemical pleurodesis is an important therapeutic tool to control recurrent malignant pleural effusion. Among the various sclerosing agents, iodopovidone is considered effective and safe. However, in a recent study, ocular changes were described after iodopovidone was used in recurrent pneumothorax. The aim of the study was to evaluate the efficacy and morbidity of iodopovidone pleurodesis in an experimental model. METHODS: New Zealand rabbits were submitted to intrapleural injection of iodopovidone at concentrations of 2%, 4% and 10%. Biochemical (lactic dehydrogenase, proteins, triiodothyronine, free thyroxine, urea and creatinine) and immunological (Interleukin-8 [IL-8], VEGF and TGFß) parameters were measured in the pleural fluid and blood. After 1, 3, 7, 14 and 28 days, groups of animals were euthanized, and macro- (pleura) and microscopic (pleura and retina) analyses were performed. RESULTS: An early pleural inflammatory response with low systemic repercussion was observed without corresponding changes in thyroid or renal function. The higher concentrations (4% and 10%) correlated with greater initial exudation, and maximum pleural thickening was observed after 28 days. No changes were observed in the retinal pigment epithelium of the rabbits. CONCLUSION: Iodopovidone is considered to be an effective and safe sclerosing agent in this animal model. However, its efficacy, tolerance and safety in humans should be further evaluated.


Asunto(s)
Derrame Pleural Maligno/terapia , Pleurodesia/métodos , Povidona Yodada/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Animales , Citocinas/sangre , Ensayo de Inmunoadsorción Enzimática , Modelos Animales , Pleura/efectos de los fármacos , Povidona Yodada/efectos adversos , Conejos , Epitelio Pigmentado de la Retina/efectos de los fármacos , Soluciones Esclerosantes/efectos adversos , Factores de Tiempo
3.
Clinics ; 68(4): 557-562, abr. 2013. tab, graf
Artículo en Inglés | LILACS | ID: lil-674244

RESUMEN

OBJECTIVES: Chemical pleurodesis is an important therapeutic tool to control recurrent malignant pleural effusion. Among the various sclerosing agents, iodopovidone is considered effective and safe. However, in a recent study, ocular changes were described after iodopovidone was used in recurrent pneumothorax. The aim of the study was to evaluate the efficacy and morbidity of iodopovidone pleurodesis in an experimental model. METHODS: New Zealand rabbits were submitted to intrapleural injection of iodopovidone at concentrations of 2%, 4% and 10%. Biochemical (lactic dehydrogenase, proteins, triiodothyronine, free thyroxine, urea and creatinine) and immunological (Interleukin-8 [IL-8], VEGF and TGFβ) parameters were measured in the pleural fluid and blood. After 1, 3, 7, 14 and 28 days, groups of animals were euthanized, and macro- (pleura) and microscopic (pleura and retina) analyses were performed. RESULTS: An early pleural inflammatory response with low systemic repercussion was observed without corresponding changes in thyroid or renal function. The higher concentrations (4% and 10%) correlated with greater initial exudation, and maximum pleural thickening was observed after 28 days. No changes were observed in the retinal pigment epithelium of the rabbits. CONCLUSION: Iodopovidone is considered to be an effective and safe sclerosing agent in this animal model. However, its efficacy, tolerance and safety in humans should be further evaluated. .


Asunto(s)
Animales , Conejos , Derrame Pleural Maligno/terapia , Pleurodesia/métodos , Povidona Yodada/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Citocinas/sangre , Ensayo de Inmunoadsorción Enzimática , Modelos Animales , Pleura/efectos de los fármacos , Povidona Yodada/efectos adversos , Epitelio Pigmentado de la Retina/efectos de los fármacos , Soluciones Esclerosantes/efectos adversos , Factores de Tiempo
4.
Curr Eye Res ; 37(1): 55-61, 2012 01.
Artículo en Inglés | MEDLINE | ID: mdl-22029458

RESUMEN

PURPOSE: To compare the intravitreal pharmacokinetic profile of a triamcinolone acetonide formulation containing the preservative benzyl alcohol (TA-BA) versus a preservative-free triamcinolone acetonide formulation (TA-PF), and evaluate potential signs of toxicity to the retina. METHODS: A total of 60 New Zealand male white rabbits, divided into two groups, were studied. In the TA-BA group, 30 rabbits received an intravitreal injection of TA-BA (4 mg/0.1 ml) into the right eye. In the TA-PF group, 30 rabbits received an intravitreal injection of TA-PF (4 mg/0.1 ml) into the right eye. The intravitreal drug levels were determined in 25 animals from each group by high-performance liquid chromatography (HPLC). The potential for toxicity associated with the intravitreal triamcinolone injections was evaluated in five randomly selected animals from each group by electroretinography (ERG) and by light microscopy. RESULTS: Median intravitreal concentrations of TA-BA (µg/ml) were 1903.1, 1213.0, 857.8, 442.0, 248.6 at 3, 7, 14, 21 and 28 days after injection. Intravitreal concentrations of TA-PF (µg/ml) were 1032.9, 570.1, 516.6, 347.9, 102.8 at 3, 7, 14, 21 and 28 days after injection. The median intravitreal triamcinolone concentration was significantly higher in the TA-BA compared to the TA-PF group at 7 days post-injection (p < 0.05). There was no significant difference between the two groups in median triamcinolone concentration at the other time points evaluated. There was no evidence of toxic effects on the retina in either group based on ERG or histological analyses. CONCLUSIONS: Following a single intravitreal injection, the median concentration of triamcinolone acetonide is significantly higher in the TA-BA compared to the TA-PF group at 7 days post-injection. No toxic reactions in the retina were observed in either group.


Asunto(s)
Degeneración Macular/tratamiento farmacológico , Retina/efectos de los fármacos , Triamcinolona Acetonida/farmacocinética , Cuerpo Vítreo/metabolismo , Animales , Cromatografía Líquida de Alta Presión , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Electrorretinografía/efectos de los fármacos , Inyecciones Intravítreas , Degeneración Macular/metabolismo , Degeneración Macular/fisiopatología , Masculino , Conejos , Retina/metabolismo , Retina/fisiopatología , Triamcinolona Acetonida/administración & dosificación , Cuerpo Vítreo/efectos de los fármacos
5.
Arq. bras. oftalmol ; 60(6): 604-7, nov.-dez. 1997. tab
Artículo en Portugués | LILACS | ID: lil-207949

RESUMEN

Introduçäo: os pacientes de tumores oculares podem ter pior prognóstico visual e sistêmico na ocorrência de atraso diagnóstico e tratamento empreendida por esses pacientes e descrever as características demográficas e clínicas dos mesmos. Material e métodos: entrevista com pacientes portadores de tumores oculares de diagnóstico recente atendidos em hospital universitário no período de maio/95 a maio/96. Resultados: foram avaliados 37 pacientes. Os tumores malignos encontrados com maior frequência foram retinoblastoma, carcinoma epidermoide de conjuntiva e melanoma de coróide. A trajetória desde o início do quadro ocular até a terapêutica desenvolveu-se em quatro etapas principais, com problemas diferentes relatados em cada uma delas. As etapas de 1 a 3, relacionadas ..


Asunto(s)
Humanos , Masculino , Femenino , Niño , Anciano , Persona de Mediana Edad , Adulto , Adolescente , Neoplasias del Ojo
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