Metronidazole-Induced Irreversible Optic Neuropathy

Metronidazole-induced optic neuropathy is a rare complication. Most patients have excellent visual recovery. In this study, we report a patient who presented with a sudden onset of severe visual loss after a 1-week course of metronidazole. Myelitis developed simultaneously. The vision and the accompanying neurological deficiency of the patient did not improve even after metronidazole was discontinued immediately and various treatments were given

Antitumor Agents. 272. Structure−Activity Relationships and In Vivo Selective Anti-Breast Cancer Activity of Novel Neo-tanshinlactone Analogues

Neo-tanshinlactone (1) and its previously reported analogs, such as 2, are potent and selective in vitro anti-breast cancer agents. The synthetic pathway to 2 was optimized from seven to five steps, with a better overall yield. Structure–activity relationships studies on these compounds revealed some key molecular determinants for this family of anti-breast agents. Several derivatives (19-21 and 24) exerted potent and selective anti-breast cancer activity with IC50 values of 0.3, 0.2, 0.1 and 0.1 μg/mL, respectively, against the ZR-75-1 cell lines. Compound 24 was two- to three-fold more potent than 1 against SK-BR-3 and ZR-75-1. Importantly, 21 exhibited high selectivity; it was 23 times more active against ZR-75-1 than MCF-7. Compound 20 had an approximately 12-fold ratio of SK-BR-3/MCF-7 selectivity. In addition, analog 2 showed potent activity against a ZR-75-1 xenograft model, but not PC-3 and MDA-MB-231 xenografts, as well as high selectivity against breast cancer cell line compared with normal breast tissue-derived cell lines. Further development of lead compounds 19-21 and 24 as clinical trial candidates is warranted

Assessment the factors associated with the acceptance of retinal screening among patients with diabetes in Taiwan

Diabetic retinopathy (DR) is one of the leading causes of blindness in the world. Early detection and timely management of DR can reduce vision loss from this disease. The aim of this study is to explore possible factors associated with the receipt of a DR exam within the past two years in patients with diabetes in Taiwan. I developed a survey, guided by the Health Belief Model. Patients who visited the eye clinic of Shin-Kong Memorial Hospital from January to June 2009 were invited to take part in this study and complete the survey. Chi-square and Mann-Whitney U test were used to examine for differences between participants with and without a DR exam during the past two years. Logistic multivariate regression was used to determine significant factors related to reported receipt of DR exam. A total of 313 patients were recruited to participate. Participants with missing responses for more than three questions (38) were excluded. Thus, the final sample size was 275. Sixty percent (165/275) of patients reported that they had a DR exam in the past two years. The most common reason patients provided for not having an exam was that they did not know it was necessary (43.2%). Worry about vision (P = 0.011), having a belief that diabetes could damage vision (P = 0.023), and being a housewife versus working full time (P = 0.041) were significantly associated with having a recent DR exam. The findings confirmed that perception of threat is important to promote DR exams. These factors should be considered when developing and implementing policies to encourage DR screening

Assessment the Factors Associated with the Acceptance of Retinal Screening among Patients with Diabetes in Taiwan

Diabetic retinopathy (DR) is one of the leading causes of blindness in the world. Early detection and timely management of DR can reduce vision loss from this disease. The aim of this study is to explore possible factors associated with the receipt of a DR exam within the past two years in patients with diabetes in Taiwan. I developed a survey, guided by the Health Belief Model. Patients who visited the eye clinic of Shin-Kong Memorial Hospital from January to June 2009 were invited to take part in this study and complete the survey. Chi-square and Mann-Whitney U test were used to examine for differences between participants with and without a DR exam during the past two years. Logistic multivariate regression was used to determine significant factors related to reported receipt of DR exam. A total of 313 patients were recruited to participate. Participants with missing responses for more than three questions (38) were excluded. Thus, the final sample size was 275. Sixty percent (165/275) of patients reported that they had a DR exam in the past two years. The most common reason patients provided for not having an exam was that they did not know it was necessary (43.2%). Worry about vision (P = 0.011), having a belief that diabetes could damage vision (P = 0.023), and being a housewife versus working full time (P = 0.041) were significantly associated with having a recent DR exam. The findings confirmed that perception of threat is important to promote DR exams. These factors should be considered when developing and implementing policies to encourage DR screening

Novel Role for the Delta-Opioid Receptor in Hypoxic Preconditioning in Rat Retinas

Delta-opioid receptor (DOR) is an oxygen-sensitive protein whose function in the rat retina is unknown. We examined whether DOR is involved in hypoxic preconditioning (HPC)- mediated retinoprotection following intraocular pressure ( IOP) elevation. Rats were exposed to intermittent hypoxia ( 10% oxygen) to induce HPC. Unilateral retinal ischemia/ reperfusion injury was induced by elevating IOP to 100 mmHg for 1 h. HPC attenuated the loss of neuronal marker expression and increased pro- apoptotic caspase 3 activity in the IOP retina. Excess superoxide production and 8-iso- prostaglandin F2alpha accumulation caused by enhanced oxidant protein expression and reduced antioxidant enzyme level after IOP elevation were largely abrogated by HPC. HPC markedly increased the expression of hypoxia-inducible factor-1alpha (HIF-1alpha) and DOR, but intravitreal administration of HIF-1alpha-specific small interfering RNA abrogated the up-regulation of DOR. This suggested that DOR functions downstream of HIF-1alpha. However, the endogenous content of leucine enkephalin in retinas was not affected by HPC or IOP. Treatment of retinas with the DOR antagonist naltrindole attenuated the HPC-induced protection and activation of extracellular signal-regulated kinase. These results suggest a novel mechanism of HPC-mediated retinoprotection whereby HIF-1 alpha induces the expression of DOR, and DOR-mediated activation of extracellular signal- regulated kinase triggers cellular events that correct the redox imbalance in the post-ischemic retina

Haem Oxygenase-I Gene Transfer Protects Retinal Ganglion Cells from Ischaemia/Reperfusion Injury

RGC (retinal ganglion cell) death following ischaemic insult is the major cause of a number of vision-threatening diseases, including glaucoma. The aim of the present study was to evaluate the role of HO-I (haem oxygenase -I) in the retina against IR (ischaemia/reperfusion) injury. Adenovirus - mediated HO-I gene transfer (Adv-HO-I) was carried out by injection into the vitreous body to induce HO-I overexpression. At 3 weeks after transfection, levels of HO- I expression, as measured by Western blot analysis, immunohistochemical staining and activity assay, were drastically upregulated. Transient retinal ischaemia was induced by raising the intraocular pressure to 150 mmHg for 60 min. Untreated IR caused a significant decrease in RGC numbers at 3 and 7 days after reperfusion (76.1 and 67.2% of control eyes with sham IR respectively; P < 0.001). Eyes pretreated with Adv-HO-I had less RGC loss on day 3 and 7 following reperfusion compared with control eyes injected with Adv-GFP ( adenovirus containing a gene for green fluorescent protein; 94.3 and 88.2% respectively; P = 0.007 and 0.001). SnP (tin protoporphyrin), an HO-I inhibitor, counteracted the effects of Adv-HO-I. In conclusion, these findings provide evidence that augmentation of HO-I enzyme overexpression by intravitreal injection is able to protect RGCs against IR-induced damage

Ophthalmoparesis and Optic Neuropathy in a Woman with Catastrophic Antiphospholipid Syndrome

Antiphospholipid syndrome (APS), presence of antiphospholipid antibodies, is characterized by hypercoagulability and diverse related clinical manifestations. Here we showed a case to remind ophthalmologists to screen for this disease especially for patients with underlying risk

Retinal Nerve Fiber Layer Thickness Measured by Optical Coherence Tomography in Non-glaucomatous Taiwanese

Background/Purpose: Assessment of the peripapillary retinal nerve fiber layer (RNFL) is essential for neuroretinal diseases, especially for early prediction of glaucomatous damage. The purpose of this study wasto measure RNFL thickness by Stratus optical coherence tomography (OCT) in normal Taiwanese subjectsaccording to age group. Methods: The thickness of the RNFL around the disc of normal subjects was obtained, after pupil dilation, by means of 3.4 mm diameter fast mode circle OCT scan. Data for one randomly selected eye of each subjectwere used for statistical analysis. Differences in RNFL thickness were determined by ANOVA. Results: A total of 162 participants were evaluated: 61 male and 101 female, with mean age of 41.3 ± 20years (range, 6–74 years). Mean RNFL thickness was 108.7 ± 9.4 mm (range, 85.5–133.7 mm). The RNFLwas thickest in the inferior (135.8 ± 16.3 mm) and superior (133.9 ± 18.0 mm) quadrants, followed by thenasal (82.6 ± 16.0 mm) and temporal (82.4 ± 17.8 mm) quadrants (F = 551.9, p < 0.001). Conclusion: RNFL thickness was determined by OCT for a normal Taiwanese population aged 6–74 years. The normative data from this study may offer valuable information to enable comparisons of ocular diseasesinvolving RNFL across different populations