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Toxic keratopathy associated with abuse of topical anesthetics and amniotic membrane transplantation for treatment

International Journal of Ophthalmology(English edition) 2015年第5期8卷 938-944页

作者： Ozlem Yalcin Tok Levent Tok Inci Meltem Atay Tugba Cakmak Argun Nazire Demirci alime gunes Department of Ophthalmology Süleyman Demirel University Research and Education Hospital Department of Psychiatry Süleyman Demirel University Research and Education Hospital

AIMTo evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT).METHODSFifteen eyes of 10 patients with abuse of topical anesthetics were included in this study. The data collected included patients' demographic information, initial best corrected visual acuity (BCVA), clinical findings, time to AMT, duration of epithelization, additional treatments, posttreatment BCVA, and the results of psychiatric *** patients were male, with the mean age of 37.9±5.4y. The patients had received 0.5% proparacaine hydrochloride due to pain resulting from foreign bodies, such as welding flash burns and car battery explosions, for a mean of 18.2±12.4d. The mean initial BCVA of the patients was 0.069±0.100. All patients had persistent epithelial defects, stromal infiltration, ring ulcer, and corneal edema. Initially, medical treatment was attempted in all cases. Because of severe pain, persistent epithelial defects and progressing stromal thinning did not improve with medical treatment, thus, the patients underwent AMT. The mean posttreatment BCVA of the patients was 0.33±0.27. All of them, except for two patients, showed improved visual acuity. One patient underwent evisceration for corneal melting and endophthalmitis in another center, and one patient underwent evisceration for severe pain of unknown origin. All 5 patients who consented to a psychiatric examination had depression, had personality disorder, and used *** appears to be an effective method for pain relief, rapid epithelial and stromal healing; however, visual prognosis is still poor despite medical and surgical interventions.

关键词： amniotic membrane transplantation ring stromal infiltration topical anesthetic abuse toxic keratopathy

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Transfer of single dose of intravitreal injection of ranibizumab and bevacizumab into milk of sheep

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International Journal of Ophthalmology(English edition) 2017年第7期10卷 1069-1075页

作者： Tugba Cakmak Argun Ozlem Yalcin Tok Levent Tok Gulsen Yilmaz Fatma Meric Yilmaz alime gunes Mehmet Argun Osman Butuner Department of Ophthalmology Hatay Dortyol State Hospital Faculty of Medicine Ophthalmology Suleyman Demirel University Ministry of Health Ankara HospitalBiochemistry Biochemistry Department Faculty of MedicineYildirim Beyazit University The Management of Veterinary Service

AIM： To investigate whether single-dose intravitreal injections of bevacizumab and ranibizumab transfer into milk. METHODS： This study included lactating 12 sheep and a single 3-month old suckling lamb of each sheep. Two groups consisting of 6 sheep and their lambs were constituted; the ranibizumab group and the bevacizumab group before the administration of intravitreal injections, blood and milk samples were obtained from all sheep and, following the injections, blood and milk samples of all sheep and blood samples of all lambs were collected at regular time points. Serum and milk concentrations of bevacizumab and ranibizumab were measured using an enzyme-linked immunosorbent assay（ELISA） kit. The limit of determination was 0.9 ng/m L for bevacizumab and 0.62 ng/m L for ***： At 6h after intravitreal injections, bevacizumab concentration was above the limit of determination in the blood of all sheep. At 3wk, when the study was terminated, bevacizumab concentrations were high in 4 sheep. Even though bevacizumab concentrations in milk showed fluctuations, the drug transferred into the milk of all sheep at detectable concentrations. Ranibizumab drug concentrations in the blood and milk of sheep and those in the blood of lambs were below the limit of determination by the ELISA ***： This sheep model study demonstrate that intravitreal injection of ranibizumab, which did not transfer into the milk of sheep and suckling lambs, is safer than bevacizumab during lactation period.

关键词： bevacizumab ranibizumab lactation milk vascular endothelial growth factor

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