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Sherwin J Isenberg - One of the best experts on this subject based on the ideXlab platform.
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a double application approach to Ophthalmia neonatorum prophylaxis
British Journal of Ophthalmology, 2003Co-Authors: Sherwin J Isenberg, M Del Signore, Stephen Gichuhi, N G BermanAbstract:Aims: To investigate if a second drop of 2.5% povidone-iodine ophthalmic solution placed within the first postnatal day would achieve better prophylaxis against Ophthalmia neonatorum than a single drop applied at birth. Methods: A masked, prospective, controlled trial was conducted over a 2 year period in a Kenyan hospital. Randomisation was achieved by alternating weeks of one or two eye drop application to both eyes. All 719 neonates received one drop of the povidone-iodine solution to both eyes at birth, while 317 received a second drop at hospital discharge or 24 (SD 4) hours after delivery, whichever was first. All infants developing conjunctivitis within a month after birth underwent microbiological analysis using Gram and Giemsa stains, direct fluorescent antibody assay for Chlamydia trachomatis, and culture. Results: Of the neonates receiving the one eye drop application, 18.4% returned with a red eye with discharge, 4.0% had organisms found on the initial smear, and 8.2% had a positive culture. The corresponding proportions for the multidrop group were 24.3%, 4.7%, and 10.4%. Of those returning with an inflamed eye, there were no cases of Neisseria gonorrhoeae, 4.2% in the single dose group and 3.9% in the double dose group were positive for C trachomatis, and 5.4% and 6.5% respectively for Staphylococcus aureus. At discharge, the eyelid oedema score of the double dose group was mildly greater than the single dose group (1.4 (0.67) v 1.2 (0.73), p = 0.0002). There was no statistically significant difference between the groups in any other category. Conclusion: There is no advantage to administering povidone-iodine prophylaxis against Ophthalmia neonatorum twice in the first postnatal day over a single application at birth.
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the influence of perinatal infective factors on Ophthalmia neonatorum
Journal of Pediatric Ophthalmology & Strabismus, 1996Co-Authors: Sherwin J Isenberg, Mark WoodAbstract:Background: Ophthalmia neonatorum still blinds approximately 10 000 babies annually worldwide. Identification of contributory maternal perinatal factors could possibly predict which babies are at greater risk for this disease. Methods: In a randomized prospective study of Ophthalmia neonatorum in Kenya, we studied the effect of prophylaxis with povidone-iodine, silver nitrate, and erythromycin in 3117 neonates. Four perinatal factors that may promote Ophthalmia neonatorum were investigated: maternal vaginitis, birth in a nonsterile environment, presence of meconium at birth, and postnatal development of endometritis. Results: No significant difference in the general Ophthalmia neonatorum rate was found for any of the four factors (P>.14 by Fisher exact test). However, with regard to venereal Ophthalmia neonatorum, the 26 infants born to mothers with vaginitis had a relative risk 5.1 times that of the rest of the infants (P=0.0013). Their relative risk to develop gonococcal Ophthalmia neonatorum in particular was 24.9 times the rest of the neonates (P=0.0000031). Prophylaxis was with povidone-iodine in 12 infants, silver nitrate in two, and erythromycin in 12. The frequency of Ophthalmia neonatorum was 25%, 100%, and 33%, respectively (differences not significant). Conclusion: Neonates born to mothers with vaginitis should be carefully observed for the first postnatal month for the development of Ophthalmia neonatorum, even though a prophylactic agent has been used.
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a controlled trial of povidone iodine as prophylaxis against Ophthalmia neonatorum
The New England Journal of Medicine, 1995Co-Authors: Sherwin J Isenberg, Mark WoodAbstract:Background Neonatal conjunctivitis (Ophthalmia neonatorum) continues to cause blindness, because the agents used prophylactically to prevent this condition are not completely effective and are not widely available in many parts of the world. Povidone–iodine ophthalmic solution is an effective antibacterial agent with broad antibacterial and antiviral activity to which no bacteria are known to be resistant, and it is far less expensive and less toxic than the agents currently used to prevent neonatal conjunctivitis. Methods We conducted a masked, prospective trial involving 3117 infants born over a period of 30 months in a hospital in Kenya. Shortly after birth each infant received a 2.5 percent solution of povidone–iodine (n = 1076), a 1 percent solution of silver nitrate (n = 929), or 0.5 percent erythromycin ointment (n = 1112) in both eyes. Randomization was achieved by rotating the three medications after each was used for a week. Results Of the neonates treated with povidone–iodine, 13.1 percent had ...
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povidone iodine for Ophthalmia neonatorum prophylaxis
American Journal of Ophthalmology, 1994Co-Authors: Sherwin J Isenberg, Robert Yoshimori, Rosemary D Leake, Roberta RichAbstract:Purpose The agents currently used to prevent Ophthalmia neonatorum are less than optimal, with reports indicating evidence of bacterial resistance, ineffectiveness, and toxicity. Povidone-iodine ophthalmic solution, which has been shown to be effective in the preoperative preparation of the eye, generates no resistance, is an effective antimicrobial agent, and has low toxicity. We evaluated the effectiveness and safety of povidone-iodine for Ophthalmia neonatorum prophylaxis. Methods A bacterial culture was taken from the conjunctiva of each eye of 100 infants within 30 minutes of birth. A drop of 2.5% povidone-iodine solution was then placed on one eye, while the other eye received either one drop of silver nitrate 1% ophthalmic solution or 0.5% erythromycin ointment. Conjunctival bacterial cultures were again taken two to four hours after birth. At each culture and at 24 hours after birth, the eyes were examined for toxic changes. To measure the effectiveness of the medications, the number of bacterial colony-forming units and species from each culture was compared. Results All three agents significantly reduced the number of colony-forming units, but povidone-iodine caused the most significant decrease. The number of species was reduced significantly by povidone-iodine (P = .00051) and silver nitrate (P = .007), with povidoneiodine yielding the most significant decrease. Erythromycin did not significantly reduce the number of species. Silver nitrate demonstrated more ocular toxicity at the 24-hour determination point than did either of the other two medications (P Conclusion Povidone-iodine 2.5% ophthalmic solution is an effective antibacterial agent on the conjunctiva of newborns and causes less toxicity than silver nitrate.
Roberta Rich - One of the best experts on this subject based on the ideXlab platform.
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povidone iodine for Ophthalmia neonatorum prophylaxis
American Journal of Ophthalmology, 1994Co-Authors: Sherwin J Isenberg, Robert Yoshimori, Rosemary D Leake, Roberta RichAbstract:Purpose The agents currently used to prevent Ophthalmia neonatorum are less than optimal, with reports indicating evidence of bacterial resistance, ineffectiveness, and toxicity. Povidone-iodine ophthalmic solution, which has been shown to be effective in the preoperative preparation of the eye, generates no resistance, is an effective antimicrobial agent, and has low toxicity. We evaluated the effectiveness and safety of povidone-iodine for Ophthalmia neonatorum prophylaxis. Methods A bacterial culture was taken from the conjunctiva of each eye of 100 infants within 30 minutes of birth. A drop of 2.5% povidone-iodine solution was then placed on one eye, while the other eye received either one drop of silver nitrate 1% ophthalmic solution or 0.5% erythromycin ointment. Conjunctival bacterial cultures were again taken two to four hours after birth. At each culture and at 24 hours after birth, the eyes were examined for toxic changes. To measure the effectiveness of the medications, the number of bacterial colony-forming units and species from each culture was compared. Results All three agents significantly reduced the number of colony-forming units, but povidone-iodine caused the most significant decrease. The number of species was reduced significantly by povidone-iodine (P = .00051) and silver nitrate (P = .007), with povidoneiodine yielding the most significant decrease. Erythromycin did not significantly reduce the number of species. Silver nitrate demonstrated more ocular toxicity at the 24-hour determination point than did either of the other two medications (P Conclusion Povidone-iodine 2.5% ophthalmic solution is an effective antibacterial agent on the conjunctiva of newborns and causes less toxicity than silver nitrate.
Ravi Thomas - One of the best experts on this subject based on the ideXlab platform.
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incidence of hypotony and sympathetic Ophthalmia following trans scleral cyclophotocoagulation for glaucoma and a report of risk factors
Clinical and Experimental Ophthalmology, 2013Co-Authors: Jaskirat S Aujla, Stephen J Vincent, Ravi ThomasAbstract:Objective: To report the incidence and risk factors for hypotony and estimate the risk of sympathetic Ophthalmia following diode laser trans-scleral cyclophotocoagulation (TSCPC). Design: Retrospective study using data from a private tertiary glaucoma clinic and review of the literature. Participants: Seventy eyes of 70 patients with refractory glaucoma who received TSCPC treatment. Methods: Review of the records of consecutive patients who underwent TSCPC by a single ophthalmic surgeon and review of the literature. Main Outcome Measures: Hypotony (including phthisis bulbi), sympathetic Ophthalmia. Results: Seven eyes (10%; CI 5-19%) developed hypotony and included 4 eyes that developed phthisis. Higher total energy delivered during TSCPC treatment was associated with an increased risk of hypotony: eyes that developed hypotony received a mean total energy of 192.5±73.2 joules, compared to a mean of 152.9±83.2 joules in hypotony-free cases. The risk of sympathetic Ophthalmia estimated from a review of the published literature and current series was one in 1512, or 0.07% (CI 0.03%-0.17%). Conclusions: Total laser energy is one of several risk factors that act in a sufficient component cause-model to produce hypotony in an individual patient. The small sample size precluded inference for other individual putative risk factors but titrating laser energy may help decrease the occurrence of hypotony. The risk of sympathetic Ophthalmia calculated from the literature is likely an overestimate caused by publication bias.
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incidence of hypotony and sympathetic Ophthalmia following trans scleral cyclophotocoagulation for glaucoma and a report of risk factors
Faculty of Health; Institute of Health and Biomedical Innovation, 2013Co-Authors: Jaskirat S Aujla, Stephen J Vincent, Ravi ThomasAbstract:Background: To report the incidence and risk factors for hypotony and estimate the risk of sympathetic Ophthalmia following diode laser trans-scleral cyclophotocoagulation (TSCPC). Design: Retrospective study using data from a private tertiary glaucoma clinic and review of the literature. Participants: Seventy eyes of 70 patients with refractory glaucoma who received TSCPC treatment. Methods: Review of the records of consecutive patients who underwent TSCPC by a single ophthalmic surgeon and review of the literature. Main Outcome Measures: Hypotony (including phthisis bulbi), sympathetic Ophthalmia. Results: Seven eyes (10%; CI 5-19%) developed hypotony and included 4 eyes that developed phthisis. Higher total energy delivered during TSCPC treatment was associated with an increased risk of hypotony: eyes that developed hypotony received a mean total energy of 192.5 ± 73.2 joules, compared to a mean of 152.9 ± 83.2 joules in hypotony-free cases. The difference in mean energy delivered between the hypotony and non-hypotony group was 38.53 (95% CI: -27.57 to 104.63). The risk of sympathetic Ophthalmia estimated from a review of the published literature and current series was one in 1512, or 0.07% (CI 0.03% - 0.17%). Conclusions: Total laser energy is one of several risk factors that act in a sufficient component cause-model to produce hypotony in an individual patient. The small sample size precluded inference for other individual putative risk factors but titrating laser energy may help decrease the occurrence of hypotony. The risk of sympathetic Ophthalmia calculated from the literature is likely an overestimate caused by publication bias.
Gillian M. Keating - One of the best experts on this subject based on the ideXlab platform.
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Tafluprost Ophthalmic Solution 0.0015 %: A Review in Glaucoma and Ocular Hypertension
Clinical Drug Investigation, 2016Co-Authors: Gillian M. KeatingAbstract:Tafluprost ophthalmic solution 0.0015 % preserved with benzalkonium chloride (BAK) 0.001 % is available in several Asian countries, including Japan. In pivotal trials, BAK-preserved tafluprost ophthalmic solution 0.0015 % lowered intraocular pressure (IOP) more effectively than placebo in Asian patients with normal-tension glaucoma and was at least as effective as latanoprost ophthalmic solution 0.005 % in Asian patients with primary open-angle glaucoma or ocular hypertension. In other prospective studies in Asian patients with glaucoma or ocular hypertension, tafluprost ophthalmic solution 0.0015 % was at least as effective as latanoprost ophthalmic solution 0.005 % or travoprost ophthalmic solution 0.004 % in terms of IOP lowering, and was considered easier to use and/or store. The efficacy of tafluprost ophthalmic solution 0.0015 % was maintained in the longer term. Tafluprost ophthalmic solution 0.0015 % was generally well tolerated. In conclusion, BAK-preserved tafluprost ophthalmic solution 0.0015 % remains a useful option for the treatment of Asian patients with glaucoma and ocular hypertension.
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Diquafosol Ophthalmic Solution 3 %: A Review of Its Use in Dry Eye
Drugs, 2015Co-Authors: Gillian M. KeatingAbstract:Diquafosol ophthalmic solution 3 % (Diquas®) is a P2Y2 receptor agonist that promotes tear fluid and mucin secretion and is currently approved in Japan and South Korea for the treatment of dry eye. In randomized, double-blind, multicentre trials in patients with dry eye, significantly greater improvements in fluorescein and rose bengal staining scores were seen with diquafosol ophthalmic solution 3 % than with placebo, and diquafosol ophthalmic solution 3 % was noninferior to sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the fluorescein staining score and more effective than sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the rose bengal staining score. The efficacy of diquafosol ophthalmic solution 3 % in the treatment of dry eye was maintained in the longer term, with improvements also seen in subjective dry eye symptoms, and was also shown in a real-world setting. Diquafosol ophthalmic solution 3 % also demonstrated efficacy in various specific dry eye disorders, including aqueous-deficient dry eye, short tear film break-up time dry eye, obstructive meibomian gland dysfunction, dry eye following laser in situ keratomileusis surgery and dry eye following cataract surgery, as well as in contact lens wearers and visual display terminal users. Diquafosol ophthalmic solution 3 % was generally well tolerated in patients with dry eye, with eye irritation the most commonly reported adverse event. In conclusion, diquafosol ophthalmic solution 3 % is a useful option for the treatment of dry eye.
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diquafosol ophthalmic solution 3 a review of its use in dry eye
Drugs, 2015Co-Authors: Gillian M. KeatingAbstract:Diquafosol ophthalmic solution 3 % (Diquas®) is a P2Y2 receptor agonist that promotes tear fluid and mucin secretion and is currently approved in Japan and South Korea for the treatment of dry eye. In randomized, double-blind, multicentre trials in patients with dry eye, significantly greater improvements in fluorescein and rose bengal staining scores were seen with diquafosol ophthalmic solution 3 % than with placebo, and diquafosol ophthalmic solution 3 % was noninferior to sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the fluorescein staining score and more effective than sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the rose bengal staining score. The efficacy of diquafosol ophthalmic solution 3 % in the treatment of dry eye was maintained in the longer term, with improvements also seen in subjective dry eye symptoms, and was also shown in a real-world setting. Diquafosol ophthalmic solution 3 % also demonstrated efficacy in various specific dry eye disorders, including aqueous-deficient dry eye, short tear film break-up time dry eye, obstructive meibomian gland dysfunction, dry eye following laser in situ keratomileusis surgery and dry eye following cataract surgery, as well as in contact lens wearers and visual display terminal users. Diquafosol ophthalmic solution 3 % was generally well tolerated in patients with dry eye, with eye irritation the most commonly reported adverse event. In conclusion, diquafosol ophthalmic solution 3 % is a useful option for the treatment of dry eye.
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Diquafosol Ophthalmic Solution 3 %: A Review of Its Use in Dry Eye
Drugs, 2015Co-Authors: Gillian M. KeatingAbstract:Diquafosol ophthalmic solution 3 % (Diquas^®) is a P2Y_2 receptor agonist that promotes tear fluid and mucin secretion and is currently approved in Japan and South Korea for the treatment of dry eye. In randomized, double-blind, multicentre trials in patients with dry eye, significantly greater improvements in fluorescein and rose bengal staining scores were seen with diquafosol ophthalmic solution 3 % than with placebo, and diquafosol ophthalmic solution 3 % was noninferior to sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the fluorescein staining score and more effective than sodium hyaluronate ophthalmic solution 0.1 % in terms of the improvement in the rose bengal staining score. The efficacy of diquafosol ophthalmic solution 3 % in the treatment of dry eye was maintained in the longer term, with improvements also seen in subjective dry eye symptoms, and was also shown in a real-world setting. Diquafosol ophthalmic solution 3 % also demonstrated efficacy in various specific dry eye disorders, including aqueous-deficient dry eye, short tear film break-up time dry eye, obstructive meibomian gland dysfunction, dry eye following laser in situ keratomileusis surgery and dry eye following cataract surgery, as well as in contact lens wearers and visual display terminal users. Diquafosol ophthalmic solution 3 % was generally well tolerated in patients with dry eye, with eye irritation the most commonly reported adverse event. In conclusion, diquafosol ophthalmic solution 3 % is a useful option for the treatment of dry eye.
Mark Wood - One of the best experts on this subject based on the ideXlab platform.
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the influence of perinatal infective factors on Ophthalmia neonatorum
Journal of Pediatric Ophthalmology & Strabismus, 1996Co-Authors: Sherwin J Isenberg, Mark WoodAbstract:Background: Ophthalmia neonatorum still blinds approximately 10 000 babies annually worldwide. Identification of contributory maternal perinatal factors could possibly predict which babies are at greater risk for this disease. Methods: In a randomized prospective study of Ophthalmia neonatorum in Kenya, we studied the effect of prophylaxis with povidone-iodine, silver nitrate, and erythromycin in 3117 neonates. Four perinatal factors that may promote Ophthalmia neonatorum were investigated: maternal vaginitis, birth in a nonsterile environment, presence of meconium at birth, and postnatal development of endometritis. Results: No significant difference in the general Ophthalmia neonatorum rate was found for any of the four factors (P>.14 by Fisher exact test). However, with regard to venereal Ophthalmia neonatorum, the 26 infants born to mothers with vaginitis had a relative risk 5.1 times that of the rest of the infants (P=0.0013). Their relative risk to develop gonococcal Ophthalmia neonatorum in particular was 24.9 times the rest of the neonates (P=0.0000031). Prophylaxis was with povidone-iodine in 12 infants, silver nitrate in two, and erythromycin in 12. The frequency of Ophthalmia neonatorum was 25%, 100%, and 33%, respectively (differences not significant). Conclusion: Neonates born to mothers with vaginitis should be carefully observed for the first postnatal month for the development of Ophthalmia neonatorum, even though a prophylactic agent has been used.
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a controlled trial of povidone iodine as prophylaxis against Ophthalmia neonatorum
The New England Journal of Medicine, 1995Co-Authors: Sherwin J Isenberg, Mark WoodAbstract:Background Neonatal conjunctivitis (Ophthalmia neonatorum) continues to cause blindness, because the agents used prophylactically to prevent this condition are not completely effective and are not widely available in many parts of the world. Povidone–iodine ophthalmic solution is an effective antibacterial agent with broad antibacterial and antiviral activity to which no bacteria are known to be resistant, and it is far less expensive and less toxic than the agents currently used to prevent neonatal conjunctivitis. Methods We conducted a masked, prospective trial involving 3117 infants born over a period of 30 months in a hospital in Kenya. Shortly after birth each infant received a 2.5 percent solution of povidone–iodine (n = 1076), a 1 percent solution of silver nitrate (n = 929), or 0.5 percent erythromycin ointment (n = 1112) in both eyes. Randomization was achieved by rotating the three medications after each was used for a week. Results Of the neonates treated with povidone–iodine, 13.1 percent had ...