Inhibitory effects of regorafenib, a multiple tyrosine kinase inhibitor, on corneal neovascularization

<b>AIM:</b>To evaluate the inhibitory effects of regorafenib (BAY 73-4506), a multikinase inhibitor, on corneal neovascularization (NV).<b>METHODS:</b>Thirty adult male Sprague-Dawley rats weighing 250-300 g, were used. Corneal NV was induced by NaOH in the left eyes of each rat. Following the establishment of alkali burn, the animals were randomized into five groups according to topical treatment. Group 1 (<i>n </i>= 6) received 0.9% NaCl, Group 2 (<i>n </i>= 6) received dimethyl sulfoxide, Group 3 (<i>n </i>= 6) received regorafenib 1 mg/mL, Group 4 (<i>n </i>=6) received bevacizumab 5 mg/mL and Group 5 (<i>n </i>= 6) received 0.1% dexamethasone phosphate. On the 7d, the corneal surface covered with neovascular vessels was measured on photographs as the percentage of the cornea’s total area using computer-imaging analysis. The corneas obtained from rats were semiquantitatively evaluated for caspase-3 and vascular endothelial growth factor by immunostaining.<b>RESULTS:</b>A statistically significant difference in the percent area of corneal NV was found among the groups (<i>P </i>&lt;0.001). Although the Group 5 had the smallest percent area of corneal NV, there was no difference among Groups 3, 4 and 5 (<i>P </i>&gt;0.005). There was a statistically significant difference among the groups in apoptotic cell density (<i>P </i>= 0.002). The staining intensity of vascular endothelial growth factor in the epithelial and endothelial layers of cornea was significantly different among the groups (<i>P </i>&lt;0.05). The staining intensity of epithelial and endothelial vascular endothelial growth factor was significantly weaker in Groups 3, 4 and 5 than in Groups 1 and 2.<b>CONCLUSION:</b> Topical administration of regorafenib 1 mg/mL is partly effective for preventing alkali-induced corneal NV in rats

Locomotor differences in Mongolian gerbils with the effects of midazolam administration in the form of eye drops

Background: Midazolam is a sedative-hypnotic agent with amnestic and anticonvulsant properties that can be administrated to mammals through various routes, such as intravenous, intramuscular, oral, intrathecal, rectal, and buccal. Midazolam administration in the form of eye drops through the conjunctiva is not reported in the literature. Aim:This study aims to demonstrate the possible central nervous system effects of midazolam administration as eyes drops in Mongolian gerbils. Materials and Methods: Fourteen gerbils were randomly assigned to one of two equal sized groups. The active arm received 2 ml of 10 mg midazolam as eye drops in both eyes. Control group received a total of 2 ml of physiological saline(0.9% NaCl). We subjected the gerbils to an adapted “Open Field” to determine the possible effects on central nervous system of midazolam. Gerbils were allowed to move freely in the open field. Before and after the drug administration, locomotor activities of each gerbil have been recorded. Frequency of loss of righting reflex was quantified. Results: Conjunctival Midazolam administration resulted with the transient loss of righting reflex (p=0.017) and suppressed exploration motion (p=0.018) in the open field test compared to control subjects. Conclusions: In the present study, administration of conjunctival midazolam as an eye drop may affect gerbil’s locomotor activities and open field behaviors. We argue that, using a sedative and anticonvulsive drug such as midazolam via conjunctival route may be useful in some clinical situations. Therefore, it could be beneficial to develop a new conjunctival formulation of midazolam. Also, there is a need for trials in humans with pharmacokinetic studies.Keywords: Righting reflex; Conjunctival Midazolam; Gerbillinae; Midazolam; Eye drop; New administration routeAfrican Health sciences Vol 14 No. 1 March 201

Anterior chamber fixation of a posterior chamber intraocular lens: A novel technique

We aimed to evaluate the implantation of a posterior chamber intraocular lens (IOL) in the anterior chamber (AC) with the haptics passing through two iridectomies to the posterior chamber. A total of 33 eyes of 33 patients with inadequate posterior capsular support due to either previous aphakia or posterior capsular rupture during cataract extraction were included in the study. A double iridectomy was performed on all patients using a vitrectomy probe on the midperiphery of the iris. IOLs were implanted in the AC, and the haptics were passed through the iridectomies to the posterior chamber. The mean follow-up time was 25.3 months. AC hemorrhage occurred in five patients during the iridectomy procedure. Corneal edema was detected in eight of 14 patients with primary IOL insertions. Haptic dislocation was detected in only one patient. This technique may be a good alternative to scleral-fixated IOL implantation in eyes with aphakia

Contact lens impact on quality of life in keratoconus patients:rigid gas permeable versus soft silicone-hydrogel keratoconus lenses

<b>AIM:</b>To determine the impact of rigid gas permeable (RGP) and silicone-hydrogel keratoconus lenses on the quality of life (QoL) in keratoconus (KCN) patients using the self-reported results from the Contact Lens Impact on Quality of Life (CLIQ) Questionnaire.<b>METHODS:</b>From January 2013 to April 2013, 27 consecutive KCN patients who wore RGP contact lenses (conflexair100 UV KE Zeiss-Wöhlk) or soft silicone-hydrogel contact lenses (SHCLs) for KCN (KeraSoft IC- Bausch&Lomb or Hydrocone Toris K–Swiss lens) completed the CLIQ questionnaire.<b>RESULTS:</b>The mean age of 27 patients was 29.6±8.0y. Fifteen patients were RGP user. The groups were comparable with respect to the mean patient age, sex, and mean K values (<i>P</i>=0.1, <i>P</i>=0.8 and <i>P</i>=0.1, respectively). The mean CLIQperson measure was 42.8±5.5 in RGP group and 39.6±5.5 in SHCLs for KCN group (<i>P</i>=0.06). CLIQperson measure was positively correlated with steep K value (<i>r</i>=0.301, <i>P</i>=0.04). When eyes were stratified by visual acuity with contact lenses, the mean CLIQperson measure was 42.01±5.6 in eyes with a visual acuity of 20/20-20/25 (<i>n</i>=44) and 38.4±5.26 in eyes with a visual acuity of 20/32 or less (<i>n</i>=10; <i>P</i>=0.097).<b>CONCLUSION:</b>RGP lenses and SHCLs for KCN have similar impact on QoL