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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There are many unanswered questions about chronic glaucoma which cannot be investigated in the available animal models. The present experiments were designed to develop a rabbit model of chronic intraocular hypertension with characteristics similar to human chronic glaucoma by ligating vortex veins or by making single or multiple intraocular injections of 0.5% or 1% alpha-chymotrypsin, 20% chondroitin sulphate, 2% hydroxypropyl methylcellulose, 2% sodium carboxymethylcellulose or 1% or 2% methylcellulose. Evaluation was based on the clinical findings, intraocular pressure and the retrograde axoplasmic transport function of the optic nerve using a horseradish peroxidase histochemical technique. Most methods either failed to produce moderate chronic intraocular hypertension or were associated with other complications. However, a reliable and relatively long period (eight weeks) of intraocular hypertension was developed by a series of four intra-anterior chamber injections of 1% or 2% methylcellulose. This model has been proved suitable for the study of structural and functional damage to the retina and optic nerve caused by chronic glaucoma.
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PMID:Development of experimental chronic intraocular hypertension in the rabbit. 144 75

Between January 1986 and December 1989 we prospectively studied 125 patients with central retinal vein occlusion (CRVO). Documented by fundus photography and fluorescein angiography clinical and angiographic findings were analysed. The age of the patients was between 22 and 89 years with a mean of 60 years. 74 (59%) were male and 51 (41%) female. 63 (50.4%) right and 62 (49.6%) left eyes were affected. Arterial hypertension was found in 34 (37.2%) and diabetes mellitus in 18 (14.4%) of the patients. Glaucoma was present in 14 (11.2%). 11 (8.8%) patients had bilateral CRVO. Preretinal neovascularisation was found in 5 (4%), vitreous hemorrhage in 6 (4.8%) and a retinal detachment in 2 (1.6%) patients. Iris neovascularisation at time of first presentation was found in 8 (6.4%) of all patients, related to the number of ischemic type of CRVO in 17.7%. Cystoid macular edema was found in 77 (61.6%), ischemic maculopathy in 24 (19.2%) patients, and a combination of cystoid and ischemic maculopathy in 11 (8.8%). Mean visual acuity was 20/100. A non ischemic type was present in 80 (64%) an ischemic in 45 (36%) of patients. Mean visual acuity in the non ischemic type was 20/60 and highly significant better (p < 0.0001) than in the ischemic type with a mean visual acuity of 20/400 (Mann-Whitney test). The density of intraretinal hemorrhages (p = 0.0005) and type of maculopathy (p < 0.0001) were highly significant related to the ischemia type (chi-square method).
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PMID:[Clinical and fluorescein angiography changes in patients with central retinal vein occlusion. A unicenter study of 125 patients]. 147 86

"Diabetes 2000" will parallel a major diabetic retinopathy public information campaign recently announced by the National Eye Institute. The NEI's National Eye Health Education Program (NEHEP), which targets both diabetic retinopathy and glaucoma, is fashioned along the lines of earlier federal initiatives against smoking and high blood pressure. By continuously updating our medical knowledge and skills related to this multisystem disorder, and by forging partnerships between physicians in the effective and efficient management of diabetic patients, we have a unique and important opportunity--we can reduce preventable blindness from diabetes by the year 2000.
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PMID:Elimination of preventable blindness from diabetes by the year 2000. 151 75

The association of the open-angle glaucoma and the retina venous occlusion constitutes an aggravating factor, the two affections influencing to each other. The study of a number of 168 venous obstructions of the retina, 56% of which being obstruction of the central vein and 44% of ramus, have evaluated appearing as edematous capillaropathy for 36% cases, ischemic capillaropathy for 44% and mixed forms for 20% ones. The retina venous occlusions have evaluated for 70% for masculine gender and 30% for feminine. From all the predisposed affections the hypertension and arteriosclerosis were for 58% all over the cases; dyslipidemias for 15%; hypercholesterolemia for 11%, diabetes for 8%. In the occlusion of the venous ramus the opened angle glaucoma, that has preceded thrombosis, was at the same frequency as for the general population, while in the obstruction of the central vein, the opened angle glaucoma has preceded thrombosis for 18% of all the cases, so it may be considered as a favourable factor by slowing down the sangvin flux. The opened-angle glaucoma hasn't influenced the appearing of the retina thrombosis. The second neurovascular glaucoma, an irreducible complication of the ischemic capillaropathy was for 22% of the studied cases. During the presence of a retina venous thrombosis is necessary a systematic examinations of the ocular tension, for finding an opened-angle glaucoma pre-existed to thrombosis.
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PMID:[The relation between retinal venous occlusions and glaucoma]. 152 45

The authors conducted a case-control study of risk factors for retinal vein occlusions using 87 patients with vein occlusions, chosen randomly from photographic files from their institution between 1985 and 1990, and a control group of 85 subjects 38 years of age (the youngest individual in the vein occlusion group) or older, who were randomly selected from the records of two general ophthalmologists in the authors' department. Certain risk factors for retinal vein occlusion were highly significant when subjects with retinal vein occlusion were compared with the control group. These risk factors included systemic hypertension (odds ratio [OR], 3.86; 95% confidence interval [Cl], 2.08 to 7.16), open-angle glaucoma (OR, 2.89; 95% Cl, 1.38 to 6.05), and male sex (OR, 2.61; 95% Cl, 1.43 to 4.79). Race, presence of diabetes mellitus, history of coronary artery disease or stroke, and family history of diabetes, glaucoma, coronary artery disease, or stroke were not significant risk factors in the population studied. Logistic analysis of the risk factors showed no interactions. Risk factors for branch retinal vein occlusion and central retinal vein occlusion were identical.
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PMID:Risk factors for retinal vein occlusions. A case-control study. 148 Mar 89

In order to elucidate the role of diabetes mellitus on the natural history of central retinal vein occlusion, we compared two groups of central retinal vein occlusion, one with diabetes mellitus (32 patients) and one without diabetes mellitus (113 patients). The two groups were quite similar with respect to age, sex, systemic hypertension and glaucoma. No fellow eye had proliferative diabetic retinopathy. The diabetic group had angiographically a more ischemic type of central retinal vein occlusion (72%) than the nondiabetic group (39%; p less than 0.002). Diabetics with central retinal vein occlusion should be closely monitored.
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PMID:Role of diabetes mellitus on the natural history of central retinal vein occlusion. 159 81

The vascular endothelial cells have the ability to modulate local vascular tone by releasing relaxing factors such as nitric oxide or the vasoconstrictor peptide endothelin-1. Although this regulatory system is found in all vertebrates, there is a great heterogeneity in the release of these endothelium-derived substances, from one organ to an other, between large and small vessels, and between different species. Therefore, observations made in certain vascular beds or animals do not necessarily apply to human ophthalmic circulation. The present study was designed to investigate endothelial mediators in the human ophthalmic artery. The results show that in the human ophthalmic artery, nitric oxide is released under basal conditions and that its production can be markedly stimulated by bradykinin, acetylcholine, and particularly histamine, which cause profound vascular relaxation. In contrast, endothelin-1 evoked potent contractions, which were unaffected by the calcium antagonist nifedipine. However, upon re-exposure of the blood vessels to the peptide, marked tachyphylaxis occurred. These findings demonstrate that in the human ophthalmic artery, endothelium-derived nitric oxide and endothelin are very potent modulators of vascular tone, suggesting that they play an important role in the regulation of local blood flow in the eye. Hence, endothelium dysfunction may represent a new pathogenetic mechanism in disease states associated with altered blood flow to the eye, such as diabetes, hypertension, and some forms of low-tension glaucoma.
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PMID:Nitric oxide and endothelin-1 are important regulators of human ophthalmic artery. 160 46

Topical and systemic steroids have proven to be invaluable agents in the treatment of a wide range of disorders, but their use is not without potential complications. Before initiation of therapy with systemic steroids, a personal or family history of cataracts, glaucoma, hypertension, diabetes, hyperlipidemia, renal stones, peptic ulceration, and current infection or pregnancy should be ascertained, because these patients have an increased risk of complications. Prior to long-term therapy with systemic steroids, blood pressure measurement, tuberculin skin test, and anergy panel are recommended. Monthly follow-up may include measurements of weight, blood pressure, electrolytes, and blood sugar and guaiac testing of the stool. To prevent the ocular complications of steroid therapy, routine screening is indicated (Table 1). Screening for cataracts, which occur most commonly as a sequela of continuous systemic steroid use, may be performed by slit-lamp examinations conducted three or four times a year for patients on long-term therapy and twice a year for patients taking intermittent topical ocular or systemic steroids. Glaucoma is more often associated with topical ocular or periocular steroids than with systemic steroids; recommended screening includes a baseline intraocular pressure measurement, then routine pressure measurements taken every few weeks initially, then every few months. Ocular rebound inflammation may develop secondary to rapid tapering or abrupt discontinuation of topical ocular steroid use and is best prevented with gradual tapering. Opportunistic infections of the eye include bacterial, viral, and fungal infections and are most often associated with the use of topical ocular steroids. Ophthalmologic evaluation is indicated promptly if patients treated with ocular steroids develop ocular discharge, pain, photophobia, or redness.
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PMID:Ocular effects of topical and systemic steroids. 161 9

60,000 women in France have received RU 486 and a prostaglandin to induce abortion. In the late 1980's, clinical researchers assessed the safety and effectiveness of 600 mg of oral RU 486 in 2040 French women. 2 days later, health workers either injected 0.25-0.5mg of sulprostone or inserted a 1mg vaginal suppository of gemeprost in 1964 women who had not yet aborted. 96% experienced complete abortions. Physicians needed to conduct either a vacuum aspiration of dilation and curettage on the other 4%. RU 486 was most successful with 0.5mg of sulprostone, but these women also experienced considerable vaginal bleeding and pain. Overall uterine bleeding occurred for 8.9 days. The researchers recommended that adequate medical facilities be accessible to women using this method. Mild side effects were nausea, vomiting, and diarrhea. Efficacy and safety matched those of other early abortion methods. In April 1991, a grand multiparous women who smoked heavily and received RU 486 and a prostaglandin died--the 1st reported RU 486 related death. RU 486 may be able to treat fibroids, endometriosis, premenstrual syndrome, meningioma, hypertension, adrenal cancer, glaucoma, some forms of Cushing's syndrome, and breast cancer. The US Food and Drug Administration forbade the commercial import of RU 486 in 1989, even though it deemed RU 486 safe and effective. FDA considered the antiabortion view of the Bush Administration when making this decision. It made this decision despite the fact that abortion was still legal. RU 486 should be available soon for use as an abortifacient in the UK, the Netherlands, Sweden, Norway, Denmark, and Finland. These countries do not intent providing it to US women, however. Further the manufacturer is not willing to provide it to US researchers because it is afraid of antiabortion repercussions which may jeopardize WHO's approval of RU 486.
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PMID:The RU 486 story: the French experience. 173 8

Persistent intraocular hypertension followed attack of acute angle-closure glaucoma in 87 eyes of 71 patients. After 1-12 days, averaging 2.1 days, they were treated with sublamellar sclerotomy for initial drainage of aqueous, and then sclerectomy and trabeculectomy were performed for longterm hypotensive effect. No intra- or post-operative serious complications occurred and the anterior chamber reformed within 48 hours, while in all 20 controls the filling of anterior chamber was delayed. This modality of treatment had the advantage of combining immediate relief of critical IOP with permanent aqueous filtration.
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PMID:[Treatment of persistent intraocular hypertension after attack of acute angle-closure glaucoma]. 181 21


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