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González Iglesias LG, Messaoudi S, Kalia YN. Non-Invasive Iontophoretic Delivery of Cytochrome c to the Posterior Segment and Determination of Its Ocular Biodistribution. Pharmaceutics 2022; 14:pharmaceutics14091832. [PMID: 36145581 PMCID: PMC9504550 DOI: 10.3390/pharmaceutics14091832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
The intact porcine eye globe model was used to demonstrate that transscleral iontophoresis could deliver a small protein, cytochrome c (Cyt c), to the posterior segment and to investigate post-iontophoretic biodistribution in the different ocular compartments. The effects of Cyt c concentration (1, 5, and 10 mg/mL), current density (3.5 and 5.5 mA/cm2), and duration of the current application (10 min and 1, 2, and 4 h) were evaluated. The data confirmed that transscleral iontophoresis enhanced the intraocular delivery of Cyt c under all conditions as compared to passive controls (same setup but without the current application). Increasing the Cyt c concentration resulted in a proportional enhancement in the Cyt c delivery. Increasing the current density from 3.5 to 5.5 mA/cm2 increased iontophoretic delivery at a Cyt c concentration of 10 mg/mL but did not appear to do so at 5 mg/mL; this was attributed in part to the effect of melanin binding. Short duration iontophoresis (10 min, 3.5 mA/cm2) of a 10 mg/mL Cyt c solution created a depot in the sclera. When this was followed by a 4 h incubation period, post-iontophoretic Cyt c diffusion from the sclera resulted in a different biodistribution, and Cyt c could be quantified in the posterior segment.
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Affiliation(s)
- Laura Gisela González Iglesias
- School of Pharmaceutical Sciences, University of Geneva, 1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1211 Geneva, Switzerland
| | - Siwar Messaoudi
- School of Pharmaceutical Sciences, University of Geneva, 1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1211 Geneva, Switzerland
| | - Yogeshvar N. Kalia
- School of Pharmaceutical Sciences, University of Geneva, 1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1211 Geneva, Switzerland
- Correspondence:
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Rimpelä AK, Reinisalo M, Hellinen L, Grazhdankin E, Kidron H, Urtti A, del Amo EM. Implications of melanin binding in ocular drug delivery. Adv Drug Deliv Rev 2018; 126:23-43. [PMID: 29247767 DOI: 10.1016/j.addr.2017.12.008] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 10/04/2017] [Accepted: 12/11/2017] [Indexed: 12/20/2022]
Abstract
Pigmented ocular tissues contain melanin within the intracellular melanosomes. Drugs bind to melanin at varying extent that ranges from no binding to extensive binding. Binding may lead to drug accumulation to the pigmented tissues and prolonged drug retention in the melanin containing cells. Therefore, melanin binding is an important feature that affects ocular drug delivery and biodistribution, but this topic has not been reviewed since 1998. In this review, we present current knowledge on ocular melanin, melanosomes and binding of drugs to pigmented cells and tissues. In vitro, in vivo and in silico methods in the field were critically evaluated, because the literature in this field can be confusing if the reader does not properly understand the methodological aspects. Literature analysis includes a comprehensive table of literature data on melanin binding of drugs. Furthermore, we aimed to give some insights beyond the current literature by making a chemical structure based classification model for melanin binding of drugs and kinetic simulations that revealed significant interplay between melanin binding and drug permeability across the melanosomal and plasma membranes. Overall, more mechanistic and systematic research is needed before the impact of melanin binding on ocular drug delivery can be properly understood and predicted.
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Melanin binding study of clinical drugs with cassette dosing and rapid equilibrium dialysis inserts. Eur J Pharm Sci 2017; 109:162-168. [DOI: 10.1016/j.ejps.2017.07.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 07/25/2017] [Indexed: 12/19/2022]
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Pelkonen L, Reinisalo M, Morin-Picardat E, Kidron H, Urtti A. Isolation of Intact and Functional Melanosomes from the Retinal Pigment Epithelium. PLoS One 2016; 11:e0160352. [PMID: 27551967 PMCID: PMC4994940 DOI: 10.1371/journal.pone.0160352] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 07/18/2016] [Indexed: 11/19/2022] Open
Abstract
Melanosomes of retinal pigment epithelium (RPE) have many vision supporting functions. Melanosome research would benefit from a method to isolate pure and characterized melanosomes. Sucrose gradient centrifugation is the most commonly used method for isolation of RPE melanosomes, but the isolated products are insufficiently characterized and their quality is unclear. Here we introduce a new gentle method for fractionation of porcine RPE that produces intact functional melanosomes with minimal cross-contamination from other cell organelles. The characterization of isolated organelles was conducted with several methods confirming the purity of the isolated melanosomal fraction (transmission electron microscopy, immunoblotting) and presence of the melanosomal membrane (fluorescence staining of melanosomal membrane, zeta potential measurement). We demonstrate that our isolation method produces RPE melanosomes with the ability to generate free phosphate (Pi) from ATP thereby proving that many membrane proteins remain functional after isolation. The isolated porcine RPE melanosomes represented V-type H+ATPase activity that was demonstrated with bafilomycin A1, a specific V-ATPase inhibitor. We anticipate that the isolation method described here can easily be optimized for the isolation of stage IV melanosomes from other pigmented cell types and tissues.
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Affiliation(s)
- Laura Pelkonen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Mika Reinisalo
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | | | - Heidi Kidron
- Centre for Drug Research, Division of Pharmaceutical Biosciences, University of Helsinki, Helsinki, Finland
| | - Arto Urtti
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
- Centre for Drug Research, Division of Pharmaceutical Biosciences, University of Helsinki, Helsinki, Finland
- * E-mail:
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Amrite A, Pugazhenthi V, Cheruvu N, Kompella U. Delivery of celecoxib for treating diseases of the eye: influence of pigment and diabetes. Expert Opin Drug Deliv 2010; 7:631-45. [PMID: 20205602 DOI: 10.1517/17425241003663236] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Age-related macular degeneration (AMD) and diabetic retinopathy (DR) are two major causes of blindness. In these disorders, growth factors such as vascular endothelial growth factor (VEGF) are upregulated, leading to either enhanced vascular permeability or proliferation of endothelium. While corticosteroid therapies available at present suffer from side effects including cataracts and elevated intraocular pressure, anti-VEGF antibody therapies require frequent intravitreal injections, a procedure that can potentially lead to retinal detachment or endophthalmitis. Thus, there is a need to develop safe, sustained release therapeutic approaches for treating AMD and DR. AREAS COVERED IN THIS REVIEW This review discusses the pharmacological basis for using celecoxib, an anti-inflammatory drug capable of selectively inhibiting cycloxygenase 2, in treating AMD and DR. In addition, this article discusses the safety, delivery advantage and efficacy of celecoxib by transscleral retinal delivery, a periocular delivery approach that is less invasive to the globe compared with intravitreal injections. WHAT THE READER WILL GAIN The reader will gain insights into the development of a pharmacological agent and a sustained release delivery system for treating DR and AMD. Further, the reader will gain insights into the influence of eye physiology including pigmentation and disease states such as DR on retinal drug delivery. TAKE HOME MESSAGE Transscleral sustained delivery of anti-inflammatory agents is a viable option for treating retinal disorders.
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Affiliation(s)
- Aniruddha Amrite
- Quinitles, Inc., Clinical Pharmacology, Overland Park, KS 66211, USA
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Kadam RS, Kompella UB. Influence of lipophilicity on drug partitioning into sclera, choroid-retinal pigment epithelium, retina, trabecular meshwork, and optic nerve. J Pharmacol Exp Ther 2009; 332:1107-20. [PMID: 19926800 DOI: 10.1124/jpet.109.161570] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In vitro bovine eye tissue/phosphate-buffered saline, pH 7.4, partition coefficients (Kt:b), in vitro binding to natural melanin, and in vivo delivery at 1 h after posterior subconjunctival injection in Brown Norway rats were determined for eight beta-blockers. The Kt:b was in the order intact tissue, dry weight method >or= intact tissue, wet weight method corrected for tissue water and drug in tissue water >> intact tissue, wet weight method > homogenized tissue. In intact tissue methods, Kt:b followed the order choroid-retinal pigment epithelium (RPE) > trabecular meshwork > retina > sclera approximately optic nerve; propranolol > betaxolol > pindolol approximately timolol approximately metoprolol > sotalol approximately atenolol approximately nadolol. Intact tissue, wet weight log (Kt:b) correlated positively with log D for all tissues (R(2) of 0.7-0.9). Log (melanin binding capacity) correlated positively with choroid-RPE log (Kt:b) (R(2) of 0.5). With an increase in concentration, Kt:b decreased in trabecular meshwork for all beta-blockers and for some lipophilic beta-blockers in choroid-RPE and sclera. With an increase in drug lipophilicity, in vivo tissue distribution increased in choroid-RPE, iris-ciliary body, sclera, and cornea but exhibited a declining trend in retina, vitreous, and lens. In vitro bovine intact tissue, wet weight Kt:b correlated positively with rat in vivo tissue/vitreous humor distribution for sclera, choroid-RPE, and retina (R(2) of 0.985-0.993). In vitro tissue partition coefficients might be useful in predicting in vivo drug distribution after trans-scleral delivery. Less lipophilic solutes exhibiting limited nonproductive binding in choroid-RPE might exhibit greater trans-scleral delivery to the retina and vitreous.
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Affiliation(s)
- Rajendra S Kadam
- Department of Pharmaceutical Sciences, University of Colorado Denver, 12700 E 19th Ave., Aurora, CO 80045, USA
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Cheruvu NPS, Amrite AC, Kompella UB. Effect of eye pigmentation on transscleral drug delivery. Invest Ophthalmol Vis Sci 2008; 49:333-41. [PMID: 18172110 DOI: 10.1167/iovs.07-0214] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine the influence of eye pigmentation on transscleral retinal delivery of celecoxib. METHODS Melanin content in ocular tissues of both the strains was determined by sodium hydroxide solubilization METHOD The affinity of celecoxib to synthetic and natural melanin was estimated by co-incubating celecoxib and melanin in isotonic phosphate-buffered saline. The binding affinity (k) and the maximum binding (r(max)) for celecoxib to both natural and synthetic melanin were estimated. Suspension of celecoxib (3 mg/rat) was injected periocularly into one eye of Sprague-Dawley (SD, albino) and Brown Norway (BN, pigmented) rats. The animals were euthanatized at the end of 0.25, 0.5, 1, 2, 3, 4, 8, or 12 hours after the drug was administered, and celecoxib levels in ocular tissues (sclera, choroid-RPE, retina, vitreous, lens, and cornea) were estimated with an HPLC assay. In addition, celecoxib-poly(lactide) microparticles (750 microg drug/rat) were administered periocularly in SD and BN rats, and celecoxib levels in these eye tissues were assessed on day 8, to determine the effectiveness of the sustained release system. RESULTS The r(max) and k for celecoxib's binding to natural melanin were (3.92 +/- 0.06) x 10(-7) moles/mg of melanin and (0.08 +/- 0.01) x 10(6) M(-1), respectively. The affinity and the extent of celecoxib's binding to natural melanin were not significantly different from those observed with synthetic melanin. The concentrations of melanin in choroid-RPE, sclera, and retina of BN rats were 200 +/- 30, 12 +/- 4, and 3 +/- 0.2 mug/mg tissue, respectively. Melanin was not detectable in the vitreous, lens, and cornea of BN rats. In SD rats, melanin was not detected in all tissues assessed except in the choroid-RPE, wherein melanin-like activity was 100-fold less than in BN rats. The area under the curve (AUC) for tissue concentration versus time profiles for animals administered with celecoxib suspension was not significantly different between the two strains for sclera, cornea, and lens. However, the retinal (P = 0.001) and vitreal (P = 0.001) AUCs of celecoxib in the treated eyes were approximately 1.5-fold higher in SD rats than in BN rats. Further, the choroid-RPE AUC in the treated and untreated eyes, respectively, were 1.5-fold (P = 0.001) and 2-fold (P = 0.0001) higher in BN rats than in SD rats. With celecoxib-poly(lactide) microparticles, choroid-RPE, retina, and vitreous concentrations on day 8 exhibited similar trends in differences between the two strains, with the differences being greater than those recorded for the celecoxib suspension. CONCLUSIONS Transscleral retinal and vitreal drug delivery of lipophilic celecoxib is significantly lower in pigmented rats than in albino rats. This difference may be attributable to significant binding of celecoxib to melanin and its accumulation/retention in the melanin-rich choroid-RPE of pigmented rats. The hindrance of retinal and vitreal drug delivery by the choroid-RPE in pigmented rats is also true of sustained-release microparticle systems.
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Affiliation(s)
- Narayan P S Cheruvu
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Pitkänen L, Ranta VP, Moilanen H, Urtti A. Binding of betaxolol, metoprolol and oligonucleotides to synthetic and bovine ocular melanin, and prediction of drug binding to melanin in human choroid-retinal pigment epithelium. Pharm Res 2007; 24:2063-70. [PMID: 17546409 DOI: 10.1007/s11095-007-9342-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Accepted: 01/18/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE To characterize the binding of betaxolol, metoprolol and oligonucleotides to synthetic and bovine ocular melanin, and to predict the binding to melanin in human choroid-retinal pigment epithelium (RPE). MATERIALS AND METHODS The shape, size and specific surface area of synthetic melanin and isolated melanin granules from bovine choroid-retinal pigment epithelium (RPE) were characterized by SEM, laser diffractometry and BET. The binding of betaxolol, metoprolol, fluorescein isothiocyanate (FITC)-labeled phosphodiesther oligonucleotides and 6-carboxyfluorescein (6-CF) to melanin was determined. The binding of beta-blockers to melanin in human choroid-RPE was estimated based on binding parameters and the melanin content in human choroid-RPE. RESULTS Bovine melanin granules were round or oval with a mean diameter of ca. 1 mum. Synthetic granules were slightly smaller and irregular and had a two times higher specific surface area than bovine melanin. Synthetic melanin bound more betaxolol and metoprolol than bovine melanin and both melanin types showed a high affinity and a low affinity binding sites. The human choroid-RPE was predicted to contain 3-19 times more melanin bound drug than unbound drug at typical therapeutic concentrations (1-1,000 ng/ml). FITC-labeled oligonucleotides and 6-CF did not bind to melanin. CONCLUSIONS The binding of lipophilic drugs to biological melanin differs from that of synthetic melanin. Lipophilic beta-blockers are expected to bind significantly to melanin in human choroid-RPE: only a small fraction of the drug being in active free form. In contrast, phosphodiesther oligonucleotides do not seem to bind to melanin.
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Affiliation(s)
- Leena Pitkänen
- Department of Pharmaceutics, University of Kuopio, P.O. Box 1627, Kuopio, 70211, Finland.
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Tissié G, Sébastian C, Elena PP, Driot JY, Trinquand C. Alginic acid effect on carteolol ocular pharmacokinetics in the pigmented rabbit. J Ocul Pharmacol Ther 2002; 18:65-73. [PMID: 11858616 DOI: 10.1089/108076802317233225] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The effect of alginic acid addition to 1% or 2% carteolol solutions on the ocular penetration of the drug has been evaluated in the pigmented rabbit. During single dose studies, an increase in bioavailability ranging from 40% to 60% was observed in the aqueous humor and in the iris-ciliary body. During repeated dose studies, this increased ocular bioavailability of carteolol in the presence of alginic acid led to an equivalent concentration in the target tissue, although the dosage was only once a day compared with twice a day for the usual carteolol eyedrops. 14C-carteolol distribution studies demonstrated the binding of carteolol in pigmented ocular tissues. Thus, the presence of alginic acid as a new excipient supports a possible decrease in dosage regimen, while retaining sufficient ocular bioavailability to lower intraocular pressure.
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Affiliation(s)
- G Tissié
- Centre de Recherche, Laboratoire Bausch & Lomb/Chauvin, Montpellier, France.
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Fukuda M, Morita Y, Sasaki K, Yamamoto Y. Studies on the binding mechanism of fluoroquinolones to melanin. J Infect Chemother 2000; 6:72-6. [PMID: 11810538 DOI: 10.1007/pl00012154] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/1999] [Accepted: 03/15/2000] [Indexed: 10/25/2022]
Abstract
In order to elucidate the binding mechanism of melanin and fluoroquinolones (ofloxacin, norfloxacin, ciprofloxacin, lomefloxacin, levofloxacin), we investigated the interaction of fluoroquinolones with compounds such as l-beta-(3,4-dihydroxyphenyl) alanine (l-DOPA), l-tyrosine, 5-hydroxy-l-tryptophan, l-tryptophan, and l-phenylalanine, which possess the kind of functional groups that melanin does and are closely related to melanin. The recovery of drugs from the melanin-drug complexes by metal ions of Li, Na, Ka, Mg, Ca, Ba, Cu, Ni, and Fe was demonstrated. Smaller and highly charged cations were found to be more effective for this recovery, and magnesium ions were the most effective of all the ions investigated.
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Affiliation(s)
- M Fukuda
- Department of Ophthalmology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan.
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Sasaki H, Yamamura K, Nishida K, Nakamura J, Ichikawa M. Delivery of drugs to the eye by topical application. Prog Retin Eye Res 1996. [DOI: 10.1016/1350-9462(96)00014-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Brinchmann-Hansen O, Albrektsen T, Anmarkrud N. Pilocarpine drops do not reduce intraocular pressure sufficiently in pseudoexfoliation glaucoma. Eye (Lond) 1993; 7 ( Pt 4):511-6. [PMID: 8253229 DOI: 10.1038/eye.1993.111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The reason for the poorer prognosis of pseudoexfoliation syndrome glaucomas (PXSG) compared with primary open angle glaucomas (POAG) is not fully understood. An open, comparative, cross-over study was performed in 15 patients (= eyes) with POAG and 15 patients (= eyes) with PXSG. Two different pharmacokinetic principles of drug administration were applied to uncover possible differences in short-term (hours) response to topical antiglaucomatous treatment. Intermittent pilocarpine drop medication (2%) and continuous low-dose pilocarpine delivery by a membrane-controlled Ocusert unit (P40) were used. The 'carry-over' pressure reduction of an ordinary four times a day drop medication was significantly less effective in controlling the morning intraocular pressure (9 a.m.) in PXSG than in POAG. The duration of action of pilocarpine drops was reduced in PXSG. Defining 'normotensive' pressure as < or = 20 mmHg, only 1 of the 15 PXSG eyes (6.7%) reached a normotensive level in the morning, compared with 8 of the 15 POAG eyes (53.3%). Using a continuous supply of pilocarpine (Ocusert), no differences between POAG and PXSG eyes were found. The study demonstrates the insufficient control of intraocular pressure in PXSG, compared with POAG, by identical antiglaucomatous drop medications. This may suggest an insufficient depot function of topical drugs in PXSG. In consequence, pseudoexfoliation material (PXM) must be sought in eyes with glaucoma, as PXM eyes will probably benefit from a more intense medical treatment compared with eyes without PXM.
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Abstract
In a randomized, double-masked, placebo-controlled study, we evaluated the effect of levobunolol 0.5%, a nonselective beta-blocker, on intraocular pressure, volume amplitude, and ocular pulsatile flow in healthy individuals and patients with glaucoma. Volume amplitude and ocular pulsatile flow were derived from measurements of pulse amplitude with a pneumatonometer. Two hours after instillation of levobunolol, intraocular pressure decreased from 26.0 +/- 5.1 mm Hg to 17.8 +/- 3.9 mm Hg (28.3%) (P less than .001) in glaucomatous eyes and 20.2 +/- 3.6 mm Hg to 14.5 +/- 4.2 mm Hg (29.6%) (P less than .001) in healthy eyes. Ocular pulsatile flow was increased after treatment with levobunolol from 482.1 +/- 133.3 microliter/minute to 548.5 +/- 180.3 microliter/minute (13.3%) (P less than .006) in glaucomatous eyes and 457.6 +/- 178.2 microliter/minute to 528 +/- 223.8 microliter/minute (12.3%) (P greater than .05) in healthy eyes. There was no significant change in intraocular pressure, volume amplitude, or ocular pulsatile flow in placebo-treated eyes. The implication of these data for glaucoma therapy is not clear. Although we used an instrument that supposedly measures total pulsatile flow, it may be that optic nerve blood flow is dependent on total, both pulsatile and nonpulsatile, flow. Further, even though retinal blood flow is a small component of total ocular blood flow, it may be equally or more important than choroidal flow because of the necessity to maintain the perfusion of the retinal ganglion cells.
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Affiliation(s)
- M E Bosem
- Department of Ophthalmology, University of California, San Diego
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Derick RJ, Robin AL, Tielsch J, Wexler JL, Kelley EP, Stoecker JF, Novack GD, Coleman AL. Once-daily versus twice-daily levobunolol (0.5%) therapy. A crossover study. Ophthalmology 1992; 99:424-9. [PMID: 1565455 DOI: 10.1016/s0161-6420(92)31957-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The authors executed a two-period, randomized, double-masked, crossover study comparing once-daily to twice-daily levobunolol hydrochloride (0.5%) in 20 patients with elevated intraocular pressure (IOP). Modified diurnal curves were performed at four times for each study arm: baseline, day 1, day 14, and day 28. The mean diurnal corrected decrease in IOP from baseline ranged from 16% +/- 11% to 22% +/- 9% when the subjects were treated twice daily, and from 14% +/- 10% to 18% +/- 8% when the same subjects were treated once daily. At day 1, patients had a significantly greater IOP lowering after twice-daily therapy than after once-daily therapy (P less than 0.05). At 14 and 28 days, there was no clinically significant difference between the two treatment regimens. The results of our crossover study suggest that once-daily treatment with levobunolol (0.5%) is as effective as twice-daily treatment.
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Affiliation(s)
- R J Derick
- Glaucoma Service, Wilmer Institute, Johns Hopkins Hospital, Baltimore, MD
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Kues HA, Monahan JC, D'Anna SA, McLeod DS, Lutty GA, Koslov S. Increased sensitivity of the non-human primate eye to microwave radiation following ophthalmic drug pretreatment. Bioelectromagnetics 1992; 13:379-93. [PMID: 1445419 DOI: 10.1002/bem.2250130505] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Previous studies in our laboratory have established that pulsed microwaves at 2.45 GHz and 10 mW/cm2 are associated with production of corneal endothelial lesions and with disruption of the blood-aqueous barrier in the non-human primate eye. In the study reported here we examined ocular damage in monkeys (M. mulatta and M. fascicularis) following topical treatment with one of two ophthalmic drugs (timolol maleate and pilocarpine) that preceded exposure to pulsed microwaves. Anesthetized monkeys were sham exposed or exposed to pulsed, 2.45 GHz microwaves (10 microseconds, 100 pps) at average power densities of 0.2, 1, 5, 10, or 15 mW/cm2 4 h a day for 3 consecutive days (respective SARs were 0.052, 0.26, 1.3, 2.6, and 3.9 W/kg). Immediately before microwave exposure, one or both eyes were treated topically with one drop of 0.5% timolol maleate or of 2% pilocarpine. Following administration of a drug, we observed a significant reduction in the power-density threshold (from 10 to 1 mW/cm2) for induction of corneal endothelial lesions and for increased vascular permeability of the iris. Diagnostic procedures (in vivo specular microscopy and fluorescein iris angiography) were performed following each exposure protocol. In addition, increased vascular permeability was confirmed with horseradish peroxidase tracer techniques. Although we did not measure intraocular temperatures in experimental animals, the results suggest that a mechanism other than significant heating of the eye is involved. Our data indicate that pulsed microwaves at an average SAR of 0.26 W/kg, if administered after pretreatment with ophthalmic drugs, can produce significant ocular effects in the anesthetized primate.
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Affiliation(s)
- H A Kues
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723
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Salazar-Bookaman M, Fowble J, Patil P. Stoichiometry of interaction between soluble (?)-dopa melanin and enantiomers of ephedrine by NMR spectroscopy. Chirality 1992. [DOI: 10.1002/chir.530040704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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