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BACKGROUND: Optic neuritis (ON) is an inflammatory demyelinating condition of the optic nerve, with various causes. Its incidence is higher in children and young adults than in older adults of both genders, but is more common in women than in men. ON is rarely associated with mydriasis, and it is seldom triggered by vaccines against tetanus and diphtheria. CASE REPORT: A 36-year-old Caucasian woman presented with bilateral ON that had started 18 days after administration of a booster dose of the double adult vaccine (dT) against diphtheria and tetanus. Bilateral mydriasis persisted after treatment and clinical resolution of the ON. She experienced severe headache, blurred vision, decreased visual acuity in the right eye and bilateral mydriasis, a diagnosis confirmed by imaging tests. Treatment with oral corticosteroids resulted in rapid resolution of the neuritis; however, mydriasis persisted for several months. CONCLUSION: This study describes a very unusual case of bilateral ON associated with prolonged mydriasis after vaccination against tetanus and diphtheria that regressed after treatment with oral corticosteroids. Prolonged mydriasis was the manifestation that differed from the other cases previously described.

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INTRODUCTION:Tonic pupil or Adie's pupil occurs due to parasympathetic denervation, and it is characterized by mydriasis with little or no response to light, with pupillary contraction to accommodation. It is caused by eye pathologies, such as infections, trauma, neoplasms, inflammatory diseases, and systemic diseases with autonomic dysfunction. Few cases have been reported of bilateral tonic pupils associated with migraine attacks. CASE REPORT: Our aimed to describe the case of a young female patient with a history of chronic migraine without aura, who presented acutely with bilateral pupillary mydriasis during a migraine attack, characterized as tonic pupil, and to discuss the possible causes of mydriasis during a migraine attack.

INTRODUÇÃO: A pupila tônica ou pupila de Adie ocorre devido à denervação parassimpática e é caracterizada por midríase com pouca ou nenhuma resposta à luz, com contração pupilar à acomodação. É causada por patologias oculares, como infecções, traumas, neoplasias, doenças inflamatórias e doenças sistêmicas com disfunção autonômica. Poucos casos foram relatados de pupilas tônicas bilaterais associadas a crises de enxaqueca. RELATO DE CASO: Nosso objetivo foi descrever o caso de uma paciente jovem, com história de enxaqueca crônica sem aura, que apresentou agudamente midríase pupilar bilateral durante uma crise de enxaqueca, caracterizada como pupila tônica, e discutir as possíveis causas da midríase durante uma crise de enxaqueca. ataque de enxaqueca.

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Aim: To compare pupil dilation achieved by a single microdose versus two microdoses of tropicamide-phenylephrine fixed combination (TR-PH FC) delivered by the Optejet®. Patients & methods: In this assessor-masked, crossover, noninferiority study, 60 volunteers underwent two treatment visits and received either one (∼8 µl) or two sprays (∼16 µl) of TR-PH FC to both eyes in randomly assigned order. Results: At 35 min postdose, mean change in pupil diameter was 4.6 mm and 4.9 mm following one or two sprays, respectively. The estimated treatment group difference was -0.249 mm (standard error: 0.036; 95% CI: -0.320, -0.177). No adverse events were reported. Conclusion: A single microdose was noninferior to two microdoses of TR-PH FC and achieved clinically significant mydriasis in a timely manner. Clinical Trial Registration: NCT04907474 (ClinicalTrials.gov).

Pupil dilation efficacy and efficiency were evaluated using microdosing via the Optejet^®. The Optejet^® is a new ophthalmologic drug device that utilizes piezoelectric technology to deliver a fine, controlled, horizontal microdroplet spray with precise volume (∼8 µl), spray pattern and velocity. A single spray versus two sprays of tropicamide-phenylephrine fixed combination (TR-PH FC) were administered to both eyes anesthetic free. Efficacy and safety were evaluated at specific time intervals. The primary end point was the mean change in pupil diameter at 35 min compared with baseline. At 35 min, clinically relevant dilation was observed, with a mean change of 4.55 mm ± 0.68 for one spray and 4.88 ± 0.60 for two sprays. The treatment group difference of one spray of TR-PH FC was noninferior to two sprays (p < 0.001). Rapid dilation was observed at 15 min, and the proportions of eyes that achieved a pupil diameter of ≥6.0 mm were 74% and 83% of patients at 15 min with one spray and two sprays, respectively. The mydriatic agent was well tolerated with the delivery system even in the absence of topical anesthetic, with no ocular or system adverse events reported. Mydriasis is a vital component of routine eye healthcare, and the current standard-of-care mydriatic eye drops potentially have limitations, including contamination, spillage and burning/stinging. Delivery of a mydriatic with the Optejet^® may improve patient care flow in the clinical office setting.

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Objetivo: Evaluar la seguridad ocular y sistémica de una combinación de lidocaína 2 por ciento y fenilefrina 1 por ciento administrada por vía intracameral para provocar midriasis intraoperatoria en la cirugía de catarata. Métodos: Se realizó un estudio prospectivo de serie de casos en 70 ojos de igual número de pacientes sometidos a facoemulsificación con implante de lente intraocular. El grupo midriasis intraoperatoria en la cirugía lo conformaron 35 pacientes dilatados con una inyección intracameral de lidocaína y fenilefrina antes de la cirugía, mientras otros 35 ojos se dilataron de manera tradicional, con un colirio midriático previo. Para la seguridad ocular se evaluaron múltiples parámetros del examen oftalmológico pre- y posoperatorio. Resultados: La presión intraocular, el espesor corneal central, la densidad celular del endotelio corneal y el edema corneal posoperatorio como hallazgo del segmento anterior se comportaron de manera similar en ambos grupos de estudio. Se reportó una complicación transoperatoria en el grupo de manera tradicional y un caso con edema quístico macular posoperatorio en el grupo midriasis intraoperatoria en la cirugía que no representaron diferencias significativas. Conclusión: La inyección de lidocaína más fenilefrina intracameral es una opción segura tanto ocular como sistémica para provocar midriasis durante la facoemulsificación(AU)

Objective: Evaluate the ocular and systemic safety of a combination of 2 percent lidocaine and 1 percent phenylephrine administered intracamerally to achieve intraoperative mydriasis in cataract surgery. Methods: A prospective study was conducted of a case series of 70 patients (70 eyes) who underwent phacoemulsification with intraocular lens implantation. The intraoperative mydriasis group was composed of 35 patients dilated with an intracameral injection of lidocaine and phenylephrine before surgery, whereas another 35 eyes were dilated by the conventional method, with mydriatic eye drops. Ocular safety evaluation was based on the analysis of a wide variety of pre- and postoperative ophthalmological examination parameters. Results: Intraocular pressure, central corneal thickness, corneal endothelial cell density and postoperative corneal edema as an anterior segment finding, behaved in a similar manner in both study groups. An intraoperative complication was reported in the conventional method group and a case with postoperative cystoid macular edema in the intraoperative mydriasis group group, neither of them exhibiting significant differences. Conclusion: Intracameral lidocaine plus phenylephrine injection is a safe ocular and systemic option to achieve mydriasis during phacoemulsification(AU)

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The objective of this study was to determine changes on intraocular pressure (IOP) and pupil diameter (PD) in healthy cats anesthetized with isoflurane, and premedicated with acepromazine alone or in combination with tramadol. Thirty cats were allocated in two groups (n=15/each) and were treated with acepromazine (AG) or acepromazine/tramadol (ATG). PD and IOP were assessed before and following 30 (PM1), and 40 minutes (PM2) of treatments. Anesthesia was induced with propofol, and IOP and DP were recorded (A10) at 10 minute intervals until the end of anesthesia (A40). IOP decreased in AG and ATG, when comparing baseline with PM1. IOP decreased only in AG, in comparisons between baseline and PM2. During anesthesia, IOP did not change within and between groups. Comparisons between baseline with those recorded at PM1 and 2 showed that PD increased in the ATG. During anesthesia, PD decreased significantly in AG and ATG. Both protocols maintained the IOP within the reference range to perform corneal or intraocular surgery in healthy cats but did not sustain pre-anesthetic pupil dilation observed in ATG.(AU)

O objetivo do presente artigo é determinar possíveis alterações na pressão intraocular (PIO) e no diâmetro pupilar (DP) em gatos saudáveis anestesiados com isoflurano e pré-medicados com acepromazina isolada ou em combinação com acepromazina/tramadol. Trinta gatos saudáveis foram distribuídos aleatoriamente em dois grupos (n=15/cada) e tratados com acepromazina (GA) ou acepromazina/tramadol (GAT). DP e PIO foram avaliadas antes (basal) e após 30 (PM1) e 40 minutos (PM2) dos tratamentos. A anestesia foi induzida com propofol, e a PIO e o DP foram registrados (A10) a cada 10 minutos até o final da anestesia com isoflurano (A40). Ao se compararem os valores obtidos no basal com PM1, a PIO diminuiu em GA e GAT; com PM2, a PIO reduziu apenas no GA. Durante a anestesia, a PIO não diferiu dentro e entre os grupos. Comparações entre os valores basais e os registrados em PM1 e em PM2 mostraram que a DP aumentou significativamente no GAT. Durante a anestesia, o DP diminuiu significativamente em GA e GAT. Ambos os protocolos mantêm a PIO dentro dos valores de referência para realizar cirurgias corneanas ou intraoculares em gatos saudáveis, mas não sustentam a dilatação pupilar pré-anestésica observada em GAT.(AU)

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AIM AND OBJECTIVE: To present a case of bilateral delayed-onset hyphema following the administration of a 1% tropicamide and 2.5% phenylephrine fixed combination ophthalmic agent, in the late follow-up period of a gonioscopy-assisted transluminal trabeculotomy (GATT) combined with cataract extraction. BACKGROUND: Gonioscopy-assisted transluminal trabeculotomy consists on a 360° trabeculotomy through an ab interno approach that may also be combined with cataract surgery. Delayed-onset hyphema has been reported with trabecular minimally invasive glaucoma surgery (MIGS) procedures. Some proposed mechanisms are ocular compression and decompression during sleeping on the surgical side and episcleral venous pressure rise after physical activity. CASE DESCRIPTION: We describe the case of a 68-year-old female patient with ocular hypertension (OHT) and bilateral cataracts who underwent uncomplicated combined GATT and cataract extraction surgery. Postoperatively, 8 months after the left eye (OS) surgery and 3 months after the right eye (OD) surgery, patient came for routine evaluation. After induced mydriasis, slit-lamp evaluation revealed the presence of 3+ OD and 4+ OS erythrocytes in the anterior chamber (AC). Prednisolone acetate was prescribed q.i.d. and remission of hyphema was achieved after 2 weeks. Subsequently, 4 months later, the pupil dilation was again induced showing 4+ erythrocytes in both eyes (OU), layered hyphema in the inferior quadrant OS, and intraocular pressure (IOP) spike OU. The intraocular pressure was controlled after oral acetazolamide was prescribed. Topic prednisolone was initiated, and after 1 week, the hyphema was resolved in OU. CONCLUSION: Delayed-onset microhyphema may occur following induced mydriasis even months after the uncomplicated GATT procedure. Ophthalmologists should be aware of the possibility of microhyphema after induced mydriasis and the risks that this might represent with noteworthy and repeated IOP spikes which may eventually require treatment. CLINICAL SIGNIFICANCE: Delayed-onset hyphema and IOP spikes may occur following the pupil dilation with fixed combination of phenylephrine and tropicamide ophthalmic agent after the uncomplicated GATT procedure. HOW TO CITE THIS ARTICLE: Espinoza G, Rodriguez-Una I, Pedraza-Concha A. A Case of Bilateral Delayed-onset Hyphema Following Pupil Dilation after Gonioscopy-assisted Transluminal Trabeculotomy. J Curr Glaucoma Pract 2020;14(2):72-75.

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ABSTRACT Despite the recent developments in modern cataract surgery and the application of a vast array of new devices and machines, late in-the-bag intraocular lens dislocation remains a devastating, albeit rare, complication. Various nonsurgical and surgical techniques have been used to manage this complication. We report a case of spontaneous repositioning in the left eye of an anteriorly subluxated in-the-bag intraocular lens. The spontaneous repositioning may have been caused by antagonistic effects related to the topical administration of brimonidine and prednisolone. The dislocation was treated without aggressive manipulation or surgical intervention.

RESUMO Apesar dos recentes avanços na cirurgia moderna de catarata e da aplicação de uma ampla gama de novos dispositivos, o deslocamento tardio de uma lente intraocular dentro do saco capsular continua a ser uma complicação devastadora, ainda que rara. Várias técnicas cirúrgicas e não cirúrgicas têm sido usadas para tratar esta complicação. Este é o relato de um caso de reposicionamento espontâneo de uma lente intraocular sub-luxada anteriormente dentro do saco capsular do olho esquerdo. Este reposicionamento pode ter sido causado pelos efeitos opostos da aplicação tópica simultânea de brimonidina e prednisolona. O deslocamento foi tratado sem manipulação agressiva ou intervenção cirúrgica.

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RESUMEN Objetivo: Evaluar la eficacia de una combinación de lidocaína 2 por ciento y fenilefrina 1 por ciento administrada intracameralmente para provocar midriasis intraoperatoria en la cirugía de catarata. Métodos: Realizamos un estudio prospectivo, comparativo, de serie de casos en 70 ojos de igual número de pacientes quienes fueron sometidos a cirugía de catarata mediante facoemulsificación con implante de lente intraocular, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" entre septiembre del año 2017 y febrero de 2018. 35 pacientes fueron dilatados con una combinación de fenilefrina y lidocaína inyectada en la cámara anterior justo antes de la cirugía (grupo midriáticos intracamerales) y otros 35 ojos se dilataron con un colirio midriático como se realiza cotidianamente y de manera tradicional (grupo midriáticos tópicos). La eficacia se evaluó mediante la medición del diámetro pupilar (pupilometría) realizada con un compás quirúrgico en diferentes momentos de la cirugía en ambos grupos de estudio. Los resultados de ambos grupos se compararon entre sí. Resultados: En ambos grupos de pacientes se lograron diámetros pupilares superiores a los 7 mm justo antes de la capsulorrexis, aunque fueron ligeramente mayor en el grupo midriáticos tópicos (8,17 vs. 7,55 mm). En las mediciones posteriores todas las pupilometrías del grupo midriáticos intracamerales fueron superiores y se mantuvieron por encima de los 7 mm, mientras las del grupo midriáticos tópicos sufrieron una reducción paulatina hasta el final de la cirugía (5,68 mm). Conclusiones: La combinación de lidocaína más fenilefrina aplicada de manera intracameral es efectiva para provocar una midriasis adecuada y mantenida durante la cirugía de catarata(AU)

ABSTRACT Objective: Evaluate the efficacy of the combination 2 percent lidocaine / 1 percent phenylephrine administered intracamerally to achieve intraoperative mydriasis in cataract surgery. Methods: A prospective comparative study was conducted of a case series of 70 patients (70 eyes) who underwent cataract surgery by phacoemulsification with intraocular lens implantation at Ramón Pando Ferrer Cuban Institute of Ophthalmology from September 2017 to February 2018. Of the total eyes, 35 were dilated with a combination of phenylephrine and lidocaine injected into the anterior chamber just before surgery (MIC group), whereas the remaining 35 were dilated with mydriatic eye drops in the habitual traditional manner (MT group). Efficacy was evaluated in the two study groups measuring the pupil diameter (pupilometry) with a surgical compass at several moments during the surgery. The results for each group were compared. Results: In both groups patients achieved pupil diameters above 7 mm just before capsulorhexis, though values were slightly higher in the MT group (8.17 vs. 7.55 mm). Later measurement showed that in the MIC group all pupilometries were higher, remaining above 7 mm, whereas in the MT group they underwent gradual reduction until the end of surgery (5.68 mm). Conclusions: The combination of lidocaine and phenylephrine administered intracamerally is effective to achieve appropriate, sustained mydriasis during cataract surgery(AU)

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PURPOSE: Self-administration of topical ophthalmic therapies remains challenging for many patients as errors due to improper technique are common. The aim of the current studies was to evaluate a novel electromechanical topical ocular drug delivery device designed to facilitate precise dosing and accurate delivery with substantially lower drug exposure than conventional eye drops. PATIENTS AND METHODS: Two randomized Phase 1 studies were performed to evaluate the efficacy and safety of a single dose of a topical ophthalmic solution administered as a ~9 µL microfluid stream via the test device compared with a ~30-40 µL drop delivered via conventional dropper in healthy subjects (Trial 1) and glaucoma patients (Trial 2). In Trial 1, a 1% tropicamide/2.5% phenylephrine solution was administered via the test device in one eye and by conventional dropper in the contralateral eye. Pupil dilation was measured at 30 min intervals post-instillation and subject comfort was assessed using a visual analogue scale (range, 0-100). In Trial 2, patients were randomized to receive latanoprost 0.005% via the test device or conventional dropper. Intraocular pressure was measured at baseline and 4-8 hrs post-instillation. RESULTS: In Trial 1 (N=20), mean (SD) pupil diameter 30 mins post-instillation increased by 3.4 (0.9) and 3.5 (1.0) mm in the test and control eyes, respectively. The mean comfort score was 81.7 for the test device versus 57.3 for conventional dropper delivery. In Trial 2 (N=18), the mean change in intraocular pressure following administration of latanoprost was -5.0 (1.8) and -4.3 (3.3) mm Hg in the test and control groups, respectively. No serious adverse events were observed in either study. CONCLUSION: Administration of a single dose of topical ophthalmic therapy via an electromechanical drug delivery device resulted in comparable effects on pupil dilation and intraocular pressure with lower drug exposure and increased patient comfort compared with conventional dropper delivery.

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BACKGROUND: Notwithstanding the significant advances in automated imaging techniques in the past 2 decades, subjective evaluation of the optic disc still remains an important part of glaucoma propaedeutic. In places with limited resources and a high demand for ophthalmic care, anatomical evaluation of glaucoma cases often relies solely on slit-lamp-based fundus biomicroscopic examination, which is frequently performed without mydriasis. OBJECTIVE: The aim of this study was to compare metrics related to fundus biomicroscopy examination of the optic nerve head and peripapillary retinal nerve fiber layer (pRNFL) with and without mydriasis. MATERIAL AND METHODS: Healthy individuals, patients with early glaucoma, and glaucoma suspects were prospectively enrolled. Patients were examined before and after mydriasis by three glaucoma specialists, who estimated patients' vertical cup-to-disc ratio (CDR) and evaluated the presence of glaucomatous signs: laminar dot sign, disc hemorrhage, disc saucering, disc notching, peripapillary atrophy, localized pRNFL defect, and loss of the ISNT pattern. Main outcome measures were the intra-observer comparison, the inter-observer agreement, and the abilities to identify glaucomatous signs before and after mydriasis. RESULTS: Thirty patients (60 eyes) were enrolled (mean age, 62.3 ± 11.6 years). Considering the evaluation of the three examiners, the mean vertical CDR increased from 0.41 to 0.44 (p = 0.02), and the median of the coefficient of variation of the measures was reduced from 0.24 to 0.11 (p = 0.01) after mydriasis. Regarding the inter-observer agreement evaluation, the kappa coefficient values ranged from 0.64 to 0.72 before mydriasis and from 0.71 to 0.77 after mydriasis. Dot sign and disc notching were better identified through fundoscopic examination with mydriasis compared to the nonmydriatic examination (p < 0.01). CONCLUSION: Our results suggest that fundus biomicroscopy should be performed with mydriasis whenever possible, as it yells a better intra- and inter-observer agreement and improves the detection of glaucomatous signs. Moreover, examiners seem to underestimate CDR values without mydriasis. Further investigation is warranted to validate these findings by general ophthalmologists and in different populations.

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ABSTRACT Intraoperative and postoperative cataract surgery in eyes with anterior megalophthalmos are challenging procedures. Herein we describe the case of a 53-year-old male with anterior megalophthalmos who developed unilateral Urrets-Zavalia Syndrome following cataract surgery.

RESUMO O intraoperatório e o pós-operatório de cirurgia de catarata em olhos com megaloftalmo anterior é desafiador. Descrevemos o caso de um homem de 53 anos com megaloftalmo anterior que desenvolveu a Síndrome de Urrets-Zavalia unilateral após cirurgia de catarata.

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Abstract Prone position though is commonly used for better access to surgical site, but may be associated with a variety of complications. Perioperative Visual Disturbances or loss is rare but a devastating complication that is primarily associated with spine surgeries in prone position. In this case we report a 42 year old ASA-II patient who developed anisocoria with left pupillary dilatation following lumbar microdiscectomy in prone position. Following further evaluation of the patient, segmental pupillary palsy of the left pupillary muscles was found to be the possible cause of anisocoria. Anisocoria partially improved but persisted till follow up.

Resumo O posicionamento em decúbito ventral, embora comumente usado para melhorar o acesso ao local cirúrgico, pode estar associado a uma variedade de complicações. Distúrbios ou perda visual no Perioperatório é uma complicação rara, mas devastadora, que está principalmente associada à cirurgia de coluna vertebral em decúbito ventral. Relatamos aqui o caso de um paciente de 42 anos de idade, ASA - II, que desenvolveu anisocoria com dilatação pupilar esquerda após microdiscetomia lombar em decúbito ventral. Após uma avaliação adicional do paciente, observamos que a paralisia segmentar dos músculos pupilares esquerdos seria a possível causa de anisocoria. A anisocoria melhorou parcialmente, mas persistiu até o acompanhamento.

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Prone position is commonly used for better access to surgical site, but may be associated with a variety of complications. Perioperative Visual Disturbances or loss is rare but a devastating complication that is primarily associated with spine surgeries in prone position. In this case we report a 42 year old ASA-II patient who developed anisocoria with left pupillary dilatation following lumbar microdiscectomy in prone position. Following further evaluation of the patient, segmental pupillary palsy of the left pupillary muscles was found to be the possible because of anisocoria. Anisocoria partially improved but persisted till follow up.

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RESUMEN Durante la cirugía de catarata, la inducción de la dilatación de la pupila (midriasis) y el mantenimiento de un grado adecuado de esta a lo largo de toda la operación son elementos críticos para la eliminación y el reemplazo exitoso del cristalino. Una pupila pequeña o un cierre pupilar durante la cirugía hacen que esta sea un desafío desde el punto de vista técnico y aumente el riesgo de complicaciones transquirúrgicas, por lo que una midriasis adecuada y mantenida ha permanecido hasta nuestros días como un pilar fundamental para maximizar la seguridad y los resultados refractivos de la cirugía de catarata moderna. Esta midriasis se consigue habitualmente con la aplicación previa de colirios anticolinérgicos y simpaticomiméticos, con los cuales el tiempo de espera para la dilatación pupilar es frecuentemente más largo que el procedimiento quirúrgico; tienen una significativa absorción sistémica que pueden aumentar el riesgo de efectos secundarios cardiovasculares, y el efecto midriático tiende a desaparecer durante la cirugía. Con el objetivo de acceder a la información actualizada sobre los fármacos midriáticos más usados de modo intracameral, sus dosis y formas de aplicación durante la cirugía de catarata, se realiza el presente trabajo de revisión(AU)

ABSTRACT In cataract surgery, induction and maintenance of an adequate degree of pupil dilation (mydriasis) throughout the operation are critical elements for the successful removal and replacement of the crystalline lens. A small pupil or pupil closure during surgery pose a technical challenge and increase the risk of intraoperative complications. This is the reason why adequate, maintained mydriasis has remained to this day a fundamental pillar to maximize both safety and satisfactory refractive results in modern cataract surgery. Mydriasis is normally achieved with the previous application of anticholinergic and sympathomimetic eye drops, for which the waiting time for pupil dilation is often longer than the surgical procedure, they have significant systemic absorption which may increase the risk of cardiovascular side effects, and the mydriatic effect tends to vanish during surgery. A bibliographic review was conducted with the purpose of accessing updated information about the most commonly used intracameral mydriatic drugs, their doses and modes of application during cataract surgery(AU)

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The aim of this study was to investigate the acute effects of atracurium besylate on cellular damage in corneal endothelium of chickens. Twenty healthy chicken eyes were assigned to the following groups: Group 1 (G1), experimental group (n=10); and Group 2 (G2), control (n=10). Excised corneoscleral buttons were immediately placed on glass microscopy slides with endothelial region faced up. Corneal endothelium of eyes in G1 were covered with AB (0.2mL, 10mg/mL) for 3 min and then rinsed with balanced salt solution (BSS), while the corneal endothelium of eyes in G2 were covered with BBS for 3 min. Corneas from both groups were stained with alizarin red/trypan blue and visualized by light microscopy. Ten random photographs were taken from each cornea. The area of cellular damage was measured by software in all samples and cell loss of each group was averaged and compared. Endothelial area of denudation and Descemet's membrane exposure were higher in G1 than G2. In conclusion, atracurium besylate induced an acute damage on corneal endothelium of chickens.(AU)'

Objetivou-se avaliar os efeitos agudos do besilato de atracúrio sobre o endotélio corneano de galinhas. Vinte olhos saudáveis de galinhas foram aleatoriamente separados em dois grupos com 10 olhos cada, sendo G1 o grupo controle e G2 o grupo tratamento. Imediatamente após a excisão dos botões corneoesclerais estes foram colocados em lâminas de microscopia de vidro com o lado endotelial voltado para cima. No Grupo 1, o endotélio corneano foi recoberto com 0,2ml de besilato de atracúrio (10mg/ml) durante 3 minutos e depois lavado com solução salina balanceada. No Grupo 2, o endotélio corneano foi recoberto apenas com solução salina balanceada durante 3 min. As córneas de ambos os grupos foram coradas com vermelho de alizarina e azul de tripano e visualizadas com microscópio óptico. Foram obtidas dez fotografias aleatórias de cada amostra. As imagens foram analisadas e com auxílio de um software as áreas com ausência de células endoteliais calculadas. A perda celular endotelial foi significativamente maior no grupo tratamento comparativamente ao grupo controle. Com base nos resultados apresentados foi possível concluir que o besilato de atracúrio induziu dano agudo nas células do endotélio da córnea de galinhas.(AU)

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The aim of this study was to investigate the acute effects of atracurium besylate on cellular damage in corneal endothelium of chickens. Twenty healthy chicken eyes were assigned to the following groups: Group 1 (G1), experimental group (n=10); and Group 2 (G2), control (n=10). Excised corneoscleral buttons were immediately placed on glass microscopy slides with endothelial region faced up. Corneal endothelium of eyes in G1 were covered with AB (0.2mL, 10mg/mL) for 3 min and then rinsed with balanced salt solution (BSS), while the corneal endothelium of eyes in G2 were covered with BBS for 3 min. Corneas from both groups were stained with alizarin red/trypan blue and visualized by light microscopy. Ten random photographs were taken from each cornea. The area of cellular damage was measured by software in all samples and cell loss of each group was averaged and compared. Endothelial area of denudation and Descemet's membrane exposure were higher in G1 than G2. In conclusion, atracurium besylate induced an acute damage on corneal endothelium of chickens.(AU)'

Objetivou-se avaliar os efeitos agudos do besilato de atracúrio sobre o endotélio corneano de galinhas. Vinte olhos saudáveis de galinhas foram aleatoriamente separados em dois grupos com 10 olhos cada, sendo G1 o grupo controle e G2 o grupo tratamento. Imediatamente após a excisão dos botões corneoesclerais estes foram colocados em lâminas de microscopia de vidro com o lado endotelial voltado para cima. No Grupo 1, o endotélio corneano foi recoberto com 0,2ml de besilato de atracúrio (10mg/ml) durante 3 minutos e depois lavado com solução salina balanceada. No Grupo 2, o endotélio corneano foi recoberto apenas com solução salina balanceada durante 3 min. As córneas de ambos os grupos foram coradas com vermelho de alizarina e azul de tripano e visualizadas com microscópio óptico. Foram obtidas dez fotografias aleatórias de cada amostra. As imagens foram analisadas e com auxílio de um software as áreas com ausência de células endoteliais calculadas. A perda celular endotelial foi significativamente maior no grupo tratamento comparativamente ao grupo controle. Com base nos resultados apresentados foi possível concluir que o besilato de atracúrio induziu dano agudo nas células do endotélio da córnea de galinhas.(AU)

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OBJECTIVES: To investigate the effects of the intracameral injection of epinephrine and two doses of 2% lidocaine on pupil diameter (PD), intraocular pressure (IOP), heart rate (HR), and mean arterial pressure (MAP) in healthy cats. METHODS: Five treatment groups were formed (10 cats/each). Animals received 0.2 mL of epinephrine, 0.2 or 0.3 mL of 2% lidocaine, or 0.2 mL of BSS. Cats were anesthetized, and all solutions were injected intracamerally. PD, IOP, HR, and MAP were assessed at baseline, following anterior chamber paracentesis (T0), and at every 5 minutes, until anesthesia was terminated (T60). PD and IOP continued to be assessed for 2 additional hours during recovery from anesthesia. In another group, cats were not anesthetized and one of the eyes was treated with one drop of 0.5% tropicamide to check for maximal pupil diameter. RESULTS: Faster onset and longer duration of sufficient mydriasis (>10 mm) were observed in epinephrine treatment group, when comparing with cats treated with both doses of lidocaine. Eyes treated with epinephrine achieved the largest maximum pupil diameter (mm) when comparing with eyes treated with 0.3 mL of lidocaine (11.01 ± 0.16), tropicamide (10.66 ± 0.17), and 0.2 mL of lidocaine (10.23 ± 0.12) (P < .0001). In all groups, IOP decreased significantly at T0, but tended to return to baseline at T60. HR and MAP did not change significantly during time and among treatments. CONCLUSIONS: The intracameral injection of 0.2 mL of 1:100 000 epinephrine and 0.3 mL of 2% lidocaine can be used as an alternative to tropicamide in healthy cats. Both treatments produced satisfactory and long-lasting mydriasis without adverse effects on IOP, HR, and MAP.

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RESUMEN

This study aimed to investigate the effects of the systemic administration of acepromazine, tramadol and the association of both on intraocular pressure (IOP) and pupil diameter (PD) in young healthy cats. Cats were randomly allocated into three groups (n=10/each) and intramuscular acepromazine (AG), tramadol (TG) or acepromazine combined with tramadol (ATG) were injected. PD (electronic caliper) and IOP (applanation tonometry) were assessed before (baseline) and following 15, 30, 60, and 120 minutes of treatments. It was verified that in AG, PD decreased significantly from time point 30 to 120 (P=0.002), but such reduction did not differ significantly from baseline (P=0.89). In TG, PD increased significantly from the first 15 minutes, until the last time point of evaluation (P 0.001). In ATG, PD increased significantly from time point 30 to 120 when compared to baseline (P 0.001); but significant differences from time point 30 to 120 were not seen (P=0.71). Comparisons among groups showed that PD values of TG and ATG were significantly higher than that of AG (P 0.05). IOP values, on the other hand, did not change significantly among time points and groups (P>0.05). It can be concluded that tramadol alone or in association with acepromazine produced significant mydriasis for up to 120 minutes, without changing IOP values in normal cats. Results of this study suggested that tramadol alone or in association with acepromazine caused significant mydriasis and did not change IOP values in normal cats. Therefore, it may be considered a satisfactory pre-anesthetic combination for ophthalmic surgery in cats. However, further studies are warranted on the use of such protocols in cats with ophthalmic diseases undergoing ocular or intraocular surgery.

Objetivou-se estudar os efeitos da administração sistêmica da acepromazina, do tramadol e da associação de ambos sobre a pressão intraocular (PIO) e o diâmetro pupilar (DP) em gatos saudáveis jovens. Os gatos foram aleatoriamente distribuídos em três grupos (n=10/cada) e tratados pela via intramuscular com acepromazina (GA), tramadol (GT) ou acepromazina combinada ao tramadol (GAT). O DP (paquimetria eletrônica) e a PIO (tonometria de aplanação) foram mensurados antes (basal) e após 15, 30, 60, e 120 minutos após a administração dos tratamentos. Constatou-se que no GA, o DP reduziu significativamente a partir do 30 até o 120 minuto de avaliação (P=0.02), mas sem diferir significativamente em relação ao basal (P=0,89). No GT, o DP se elevou significativamente desde 15 minuto, até o último período de avaliação (P0.001). No GAT, o DP se elevou de forma significativa do 30 ao 120 minuto em comparação ao basal (P 0,001), mas esse parâmetro não alterou significativamente do 30º ao 120º minuto (P=0.71). Comparações entre os grupos mostraram que o DP do GT e do GAT apresentaram valores significativamente mais elevados que aqueles do GA (P 0,05). A PIO, por sua vez, não se alterou de forma significativa nos períodos e entre os grupos avaliados (P>0,05). Conclui-se que o tramadol, administrado de forma isolada ou em associação à acepromazina, produz midríase de até 120 minutos, sem alterar os valores da PIO em gatos saudáveis. Dessa forma, esse protocolo pré-anestésico pode ser considerado uma alternativa para cirurgia oftálmica em gatos. Todavia, os resultados desse protocolo em gatos com doença oftálmica, que necessitem de cirurgia, devem ser avaliados em estudos futuros.

Asunto(s)

RESUMEN

This study aimed to investigate the effects of the systemic administration of acepromazine, tramadol and the association of both on intraocular pressure (IOP) and pupil diameter (PD) in young healthy cats. Cats were randomly allocated into three groups (n=10/each) and intramuscular acepromazine (AG), tramadol (TG) or acepromazine combined with tramadol (ATG) were injected. PD (electronic caliper) and IOP (applanation tonometry) were assessed before (baseline) and following 15, 30, 60, and 120 minutes of treatments. It was verified that in AG, PD decreased significantly from time point 30 to 120 (P=0.002), but such reduction did not differ significantly from baseline (P=0.89). In TG, PD increased significantly from the first 15 minutes, until the last time point of evaluation (P 0.001). In ATG, PD increased significantly from time point 30 to 120 when compared to baseline (P 0.001); but significant differences from time point 30 to 120 were not seen (P=0.71). Comparisons among groups showed that PD values of TG and ATG were significantly higher than that of AG (P 0.05). IOP values, on the other hand, did not change significantly among time points and groups (P>0.05). It can be concluded that tramadol alone or in association with acepromazine produced significant mydriasis for up to 120 minutes, without changing IOP values in normal cats. Results of this study suggested that tramadol alone or in association with acepromazine caused significant mydriasis and did not change IOP values in normal cats. Therefore, it may be considered a satisfactory pre-anesthetic combination for ophthalmic surgery in cats. However, further studies are warranted on the use of such protocols in cats with ophthalmic diseases undergoing ocular or intraocular surgery.(AU)

Objetivou-se estudar os efeitos da administração sistêmica da acepromazina, do tramadol e da associação de ambos sobre a pressão intraocular (PIO) e o diâmetro pupilar (DP) em gatos saudáveis jovens. Os gatos foram aleatoriamente distribuídos em três grupos (n=10/cada) e tratados pela via intramuscular com acepromazina (GA), tramadol (GT) ou acepromazina combinada ao tramadol (GAT). O DP (paquimetria eletrônica) e a PIO (tonometria de aplanação) foram mensurados antes (basal) e após 15, 30, 60, e 120 minutos após a administração dos tratamentos. Constatou-se que no GA, o DP reduziu significativamente a partir do 30 até o 120 minuto de avaliação (P=0.02), mas sem diferir significativamente em relação ao basal (P=0,89). No GT, o DP se elevou significativamente desde 15 minuto, até o último período de avaliação (P0.001). No GAT, o DP se elevou de forma significativa do 30 ao 120 minuto em comparação ao basal (P 0,001), mas esse parâmetro não alterou significativamente do 30º ao 120º minuto (P=0.71). Comparações entre os grupos mostraram que o DP do GT e do GAT apresentaram valores significativamente mais elevados que aqueles do GA (P 0,05). A PIO, por sua vez, não se alterou de forma significativa nos períodos e entre os grupos avaliados (P>0,05). Conclui-se que o tramadol, administrado de forma isolada ou em associação à acepromazina, produz midríase de até 120 minutos, sem alterar os valores da PIO em gatos saudáveis. Dessa forma, esse protocolo pré-anestésico pode ser considerado uma alternativa para cirurgia oftálmica em gatos. Todavia, os resultados desse protocolo em gatos com doença oftálmica, que necessitem de cirurgia, devem ser avaliados em estudos futuros.(AU)

Asunto(s)

RESUMEN

ABSTRACT: This study aimed to investigate the effects of the systemic administration of acepromazine, tramadol and the association of both on intraocular pressure (IOP) and pupil diameter (PD) in young healthy cats. Cats were randomly allocated into three groups (n=10/each) and intramuscular acepromazine (AG), tramadol (TG) or acepromazine combined with tramadol (ATG) were injected. PD (electronic caliper) and IOP (applanation tonometry) were assessed before (baseline) and following 15, 30, 60, and 120 minutes of treatments. It was verified that in AG, PD decreased significantly from time point 30 to 120 (P=0.002), but such reduction did not differ significantly from baseline (P=0.89). In TG, PD increased significantly from the first 15 minutes, until the last time point of evaluation (P<0.001). In ATG, PD increased significantly from time point 30 to 120 when compared to baseline (P<0.001); but significant differences from time point 30 to 120 were not seen (P=0.71). Comparisons among groups showed that PD values of TG and ATG were significantly higher than that of AG (P<0.05). IOP values, on the other hand, did not change significantly among time points and groups (P>0.05). It can be concluded that tramadol alone or in association with acepromazine produced significant mydriasis for up to 120 minutes, without changing IOP values in normal cats. Results of this study suggested that tramadol alone or in association with acepromazine caused significant mydriasis and did not change IOP values in normal cats. Therefore, it may be considered a satisfactory pre-anesthetic combination for ophthalmic surgery in cats. However, further studies are warranted on the use of such protocols in cats with ophthalmic diseases undergoing ocular or intraocular surgery.

RESUMO: Objetivou-se estudar os efeitos da administração sistêmica da acepromazina, do tramadol e da associação de ambos sobre a pressão intraocular (PIO) e o diâmetro pupilar (DP) em gatos saudáveis jovens. Os gatos foram aleatoriamente distribuídos em três grupos (n=10/cada) e tratados pela via intramuscular com acepromazina (GA), tramadol (GT) ou acepromazina combinada ao tramadol (GAT). O DP (paquimetria eletrônica) e a PIO (tonometria de aplanação) foram mensurados antes (basal) e após 15, 30, 60, e 120 minutos após a administração dos tratamentos. Constatou-se que no GA, o DP reduziu significativamente a partir do 30˚ até o 120˚ minuto de avaliação (P=0.02), mas sem diferir significativamente em relação ao basal (P=0,89). No GT, o DP se elevou significativamente desde 15˚ minuto, até o último período de avaliação (P˂0.001). No GAT, o DP se elevou de forma significativa do 30˚ ao 120˚ minuto em comparação ao basal (P<0,001), mas esse parâmetro não alterou significativamente do 30º ao 120º minuto (P=0.71). Comparações entre os grupos mostraram que o DP do GT e do GAT apresentaram valores significativamente mais elevados que aqueles do GA (P<0,05). A PIO, por sua vez, não se alterou de forma significativa nos períodos e entre os grupos avaliados (P>0,05). Conclui-se que o tramadol, administrado de forma isolada ou em associação à acepromazina, produz midríase de até 120 minutos, sem alterar os valores da PIO em gatos saudáveis. Dessa forma, esse protocolo pré-anestésico pode ser considerado uma alternativa para cirurgia oftálmica em gatos. Todavia, os resultados desse protocolo em gatos com doença oftálmica, que necessitem de cirurgia, devem ser avaliados em estudos futuros.