Ophthalmic Agents Research Articles

The Importance of Pre-Emptive Scarified Patch Testing to Identify Safe, Alternative Ophthalmic Agents: A Case of Phenylephrine Contact Dermatitis.

The Importance of Pre-Emptive Scarified Patch Testing to Identify Safe, Alternative Ophthalmic Agents: A Case of Phenylephrine Contact Dermatitis.

Review on Effects of Organophosphate Pesticides in Human Health and Way to Mitigates its Harmful Impacts

Due to increasing the human population day by day, for the control of the human population, needs to increase the agricultural productivity, for agricultural production is increasing we use pesticide. Pesticides not only kill the target pest species also affect non-target organisms. Pesticide pollution has become a significant problem all over the world. This is mainly due to the abuse and overuse of pesticides which remain in the soil for several years and leach into water bodies. Pesticides are chemical (synthetic or semi-synthetic) agents that control and destroy pest population. Organophosphate pesticides are major bulk that includes malathion, parathion, diazinon, fenthion, chlordecone, Imidacloprid, dichlorvos, chlorpyrifos, ethion, nerve gases (soman, sarin, tabun, VX), ophthalmic agents (echothiophate, isoflurophate), and antihelmintics (trichlorfon). Herbicides (tribufos or DEF, merphos) are tricresyl phosphate etc. Though various pesticides were banned due to its harmful impacts on human health and environment, but still some has been used in paddy fields, greenhouse culture, horticulture and even hydroponics. They persistent in nature (bio-accumulation and bio-magnification by the food chain, especially through pieces) and cause acute or chronic toxicity. They contain very noxious components that harm our neuronal system by cholinergic effects. Pesticide also has an unfavorable effect on aquatic organisms such as ataxia causing late maturation in fish. Various physical and chemical methods are used for the reduction the toxicity of pesticides, physically and chemically pesticide reduction process is costly and hazardous. One good strategy is applied for the remediation of pesticides is bioremediation, i.e- use of various modified strain of agricultural microbes especially bacteria.

Looking Back to Move Forward: The Current State of Research on the Clinical Applications of Camphor- and Menthol-Containing Agents.

Topically appliedcompounds containing camphor and mentholhave been used to alleviate pain, cold symptoms, and pruritus, historically predominantlyin East Asia. Being not studied well, they are less recognized in Western medicine. Given the commonality of pain, pruritus, and cold symptoms in addition to the growing need for non-opioid treatment options, the authors investigated clinical applications of such compounds for their over-counter usage. The purpose was to analyze current clinical research and applications regarding the use of these topical agents. This study involved a bibliometric analysis of peer-reviewed articles, published in English and indexed in PubMed from 2010 to 2022, pertaining to camphor- and menthol-containingcompounds. There were 103 results, of which 15 (14.6%) articles were related to the treatment of disorders related to health, such as upper respiratory infection, pain, and pruritus. Excluded were "non-research" articles (e.g., letters to the editor), articles that do not involve human subjects, reports of improper application or misuse (e.g., ingestion), and articles pertaining to intraoral, intranasal, and ophthalmic agents. Of these articles, the originating journals, respective journal impact factor scores, publication years, study designs, and study topics were identified. Underlying trends and themes regarding clinically relevant research on these compounds were subsequently discerned. Based on this analysis, topical agentscontaining camphor and mentholare potentially effective at treating pain, upper respiratory infection symptoms, and pruritus in addition to potentially functioning as an antimicrobial. However, with a limited number of studies addressing these compounds' uses in each application, no definitive recommendation can be made regarding their use. Given the promising results of earlier studies, the authors recommend that more primary research, particularly randomized, double-blind controlled studies, be done regarding clinical applications of thesesubstances.

Novel Peptides with Dual Properties for Treating Pseudomonas aeruginosa Keratitis: Antibacterial and Corneal Wound Healing.

The corneal epithelium is a layer in the anterior part of eye that contributes to light refraction onto the retina and to the ocular immune defense. Although an intact corneal epithelium is an excellent barrier against microbial pathogens and injuries, corneal abrasions can lead to devastating eye infections. Among them, Pseudomonas aeruginosa-associated keratitis often results in severe deterioration of the corneal tissue and even blindness. Hence, the discovery of new drugs able not only to eradicate ocular infections, which are often resistant to antibiotics, but also to elicit corneal wound repair is highly demanded. Recently, we demonstrated the potent antipseudomonal activity of two peptides, Esc(1-21) and its diastereomer Esc(1-21)-1c. In this study, by means of a mouse model of P. aeruginosa keratitis and an in vivo corneal debridement wound, we discovered the efficacy of these peptides, particularly Esc(1-21)-1c, to cure keratitis and to promote corneal wound healing. This latter property was also supported by in vitro cell scratch and ELISA assays. Overall, the current study highlights Esc peptides as novel ophthalmic agents for treating corneal infection and injury, being able to display a dual function, antimicrobial and wound healing, rarely identified in a single peptide at the same micromolar concentration range.

Офтальмологические средства с компонентами внеклеточного матрикса. Их эффективность в процессе репарации роговицы при нейротрофических, герпетических, рецидивирующих кератитах и эрозиях

Introduction. One of the topical issues of modern ophthalmology is the widespread prevalence of corneal blindness among the working-age population. The cause of this condition in most cases are infectious and inflammatory diseases of the anterior segment of the eye, the outcome of which is a violation of the architectonics of the extracellular matrix (ECM) of the cornea, clinically manifested by edema of the stroma, its fibrosis. Purpose. Comparative analysis of the effectiveness of existing ophthalmic agents based on biomimetics of ECM to stimulate the processes of reparative regeneration in neurotrophic, herpetic, recurrent keratitis and corneal erosions. Material and methods. Our literature review has shown the great importance of the components in maintaining corneal homeostasis, its transparency, strength, shape stability, as well as differentiation, proliferation, migration and growth of cellular structures of the ECM, and therefore the need to maintain its physiological architectonics in the treatment of infectious and inflammatory pathology. Results. The range of ophthalmic medicines and medical devices based on biomimetics of ECM is quite diverse. The active substances of such ophthalmic agents are the main components of the ECM, namely, glycosaminoglycans (GAG), glycoproteins, collagen, hyaluronic acid, heparin. Conclusion. Among the many biomimetics, we can single out the multicomponent hydrogel composition «Corneal Epithelium gel Protector (CEGP) SPHERO ® oko (JSC «BIOMIR Service», Russia), designed to restore the corneal epithelium, which includes both the main components of ECM and other biologically active substances, including peptides, amino acids, uronic acids, monosaccharides, growth factors, etc. The multicomponent composition of SPHERO ® oko provides the microenvironment necessary for the cells of the eye tissues, contributing to the processes of their proliferation and differentiation and, as a final result, to the acceleration of reparative regeneration of tissues damaged as a result of injury or infectious-inflammatory process. And also SPHERO ® oko demonstrates anti-inflammatory, decongestant, tear-substituting action, contributes to reducing neovascularization. Key words: SPHERO ® oko, extracellular matrix, keratitis, erosion, herpes, dry eye disease, cornea

Contact Allergens in Over-the-Counter Topical Antihistamine and Mast Cell Stabilizer Ophthalmic Agents.

Contact Allergens in Over-the-Counter Topical Antihistamine and Mast Cell Stabilizer Ophthalmic Agents.

Contact Allergens in Prescription Topical Ophthalmic Medications.

Both active and inactive ingredients in topical ophthalmic agents may cause allergic contact dermatitis. Here, we examined ingredients in prescription topical ophthalmic medications available in the United States. A comprehensive list of topical ophthalmic medications was generated using AccessPharmacy. Categories included antiglaucoma, antibiotic, antibiotic/corticosteroid, corticosteroid, antiviral, antifungal, mydriatic, and miotic agents. For each formulation, ingredients were investigated using the National Institutes of Health US National Library of Medicine database and/or manufacturer websites. Counts and proportions were calculated for inactive ingredients, including those in the American Contact Dermatitis Society (ACDS) Core 90 Allergen Series. Two hundred sixty-four unique prescription ophthalmic medications met the inclusion criteria. The most common ACDS Core 90 allergen/cross-reactor inactive ingredient was benzalkonium chloride (68.1%, 180/264), followed by sorbates (11.7%, 31/264), parabens (6.8%, 18/264), sodium metabisulfite (3.8%, 10/264), propylene glycol (3.0%, 8/264), and lanolin (3.0%, 8/264). Approximately 21% (20.8%, 55/264) of products had no ACDS Core 90 allergens/cross-reactor inactive ingredients. The most common ACDS Core 90 allergen/cross-reactor active ingredients were aminoglycoside antibiotics, bacitracin/polymyxin B, and corticosteroids. Important non-ACDS Core 90 allergens included inactive ingredients, such as EDTA 28.0% and thimerosal 2.7%, as well as active ingredients, especially β-blockers. Benzalkonium chloride, sodium metabisulfite, propylene glycol, and lanolin were common inactive ingredient allergens. Most ophthalmic categories had low allergen formulations available for patients with contact allergy.

Contact Allergens in Over-the-Counter Topical Vasoconstricting Ophthalmic Agents.

Contact Allergens in Over-the-Counter Topical Vasoconstricting Ophthalmic Agents.

Ophthalmic agents in the prevention and treatment of computer vision syndrome

Ophthalmic agents in the prevention and treatment of computer vision syndrome

The in vitro effect of antiseptics on epithelial cells of human cornea and conjunctiva

in vitro evaluation of the effect of antiseptic eye drops on corneal and conjunctival epithelial cells. Antiseptic eye drops «Bactavit», «Vitabact» and «Ocomistin» were the object of the study. Immortalized human corneal epithelial cell lines (HCE) and human conjunctiva (Chang Conjunctiva, Clone 1-5c-4) were used as the test systems. The viability of the cells was assessed by their metabolic activity and morphology using the MTT test and phase-contrast microscopy. Antiseptic eye drops belonging to different groups of chemical compounds induced cytotoxic effects on the cells of corneal epithelium (HCE) and human conjunctiva (Chang Conjunctiva, Clone 1-5c-4) of varying degrees, leading to morphological and functional changes in those cells. The study confirms the possibility of using cultured cells for the in vitro comparative assessment of the cytotoxic effect of antiseptic ophthalmic agents.

Ophthalmic Drug Discovery in the United States over the past Two Decades

ABSTRACT Purpose Pharmaceutical development has slowed since the turn of the century and there has been recent legislation passed that aims to accelerate drug approval. Ophthalmic drug discovery has unique challenges that may benefit from these legislative changes. We report original pharmaceutical approvals for ophthalmic indications in order to determine whether ophthalmic drug approvals are similarly decreasing. Methods This observational study extracted all original drug approvals for ocular use from the publicly available Drugs@FDA database from January 1st, 2000 through December 31st, 2019. Drug approvals included new molecular entities, biologic license applications, as well as reformulations, combinations and new indication approvals. Data mined from each approval included: approval date, active ingredient, manufacturer, new drug application classification type, priority or standard review, and orphan drug status. Data were analyzed in four 5-year time periods. Results A total of 99 ophthalmic agents were approved for ocular use during the study period. On average, drug approvals rose by 2.2 approvals per 5-year quartile. Out of these, new molecular entities and biologics constituted 22% of all drug approvals and fell at an average rate of 0.4 approvals per quartile. Conclusion The majority of ophthalmic drug approvals represented reformulations of prior pharmaceuticals. In line with the overall industry, new molecular entities and novel biologics fell on average during the study period. Legislation that aims to ease challenges to drug approval may be beneficial to increase novel therapeutic development but should be weighed against the risks of decreased patient safety or drug efficacy.

Ocular allergy: update on clinical trials.

The purpose of this article is to provide an update on the advances made through recent clinical trials regarding the treatment of the signs and symptoms of allergic conjunctivitis and its associated conditions. Recent studies have demonstrated significant advancement in the various forms of immunotherapy treatments. Nutritional interventions such as probiotics have surfaced as a viable complementary treatment option. Novel delivery methods such as contact lenses have been further studied along with a new tacrolimus formulation to improve ocular levels of the drug. Currently, the primary advances in treatment for allergic conjunctivitis has shifted from new ophthalmic agents to immunotherapy and improvement of drug delivery. This includes the classic subcutaneous and sublingual and the novel epicutaneous and intralymphatic immunotherapy delivery systems as well as an edible rice vaccine. New targets for treatment have spurred research into new antagonist drugs such as (OC000459), a prostaglandin D2 antagonist. The Marinosolv formulation using tacrolimus shows promise and may be considered for other ophthalmic agents in the future. Other nonpharmacological treatments such as stenting and mechanical barrier gel have demonstrated their usefulness in treating ocular symptoms.

In Vitro Evaluation of the Inhibitory Effect of Topical Ophthalmic Agents on Acanthamoeba Viability.

PurposeTo compare the antimicrobial effect of topical anesthetics, antivirals, antibiotics, and biocides on the viability of Acanthamoeba cysts and trophozoites in vitro.MethodsAmoebicidal and cysticidal assays were performed against both trophozoites and cysts of Acanthamoeba castellanii (ATCC 50370) and Acanthamoeba polyphaga (ATCC 30461). Test agents included topical ophthalmic preparations of common anesthetics, antivirals, antibiotics, and biocides. Organisms were exposed to serial two-fold dilutions of the test compounds in the wells of a microtiter plate to examine the effect on Acanthamoeba spp. In addition, the toxicity of each of the test compounds was determined against a mammalian cell line.ResultsProxymetacaine, oxybuprocaine, and especially tetracaine were all toxic to the trophozoites and cysts of Acanthamoeba spp., but lidocaine was well tolerated. The presence of the benzalkonium chloride (BAC) preservative in levofloxacin caused a high level of toxicity to trophozoites and cysts. With the diamidines, the presence of BAC in the propamidine drops was responsible for the activity against Acanthamoeba spp. Hexamidine drops without BAC showed good activity against trophozoites, and the biguanides polyhexamethylene biguanide, chlorhexidine, alexidine, and octenidine all showed excellent activity against trophozoites and cysts of both species.ConclusionsThe antiamoebic effects of BAC, povidone iodine, and tetracaine are superior to the current diamidines and slightly inferior to the biguanides used in the treatment for Acanthamoeba keratitis.Translational RelevanceOphthalmologists should be aware that certain topical anesthetics and ophthalmic preparations containing BAC prior to specimen sampling may affect the viability of Acanthamoeba spp. in vivo, resulting in false-negative results in diagnostic tests.

Eye Drops: Must-Knows for Anesthesiology and Perioperative Care.

Eye drops such as topical β-blockers are widely used to treat glaucoma and other ocular diseases. We provide an overview of ophthalmic solutions, including β-adrenergic receptor antagonists, for anesthesiologists and others involved in perioperative care. We summarize current evidence about systemic effects of topical β-blockers and other commonly used ophthalmic agents such as parasympathomimetic eye drops, carbonic anhydrase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), and emerging products such as combinations of multiple substances. We call for careful preoperative assessment and perioperative management of individuals using eye drops, especially critically ill patients, children, or those undergoing major surgery.

Allergic contact dermatitis of both eyes caused by alcaftadine 0.25%: a case report

BackgroundTo report the first case of allergic contact dermatitis (ACD) associated with alcaftadine 0.25% ophthalmic solution.Case presentationThe patient was a 51-year-old woman with no previous history of side effects to ophthalmic antihistamine agents. She had been prescribed alcaftadine 0.25% for allergic conjunctivitis. On first application of the medication, she did not experience any cutaneous reaction. One day later, after the second alcaftadine 0.25% application, both eyelids became swollen, and erythematous changes were evident. On slit-lamp examination, conjunctival injection was noted in the absence of conjunctival swelling or any other findings. Fundus examination was unremarkable. To evaluate the cause of ACD, a patch test was performed and 48 h later was noted to be positive for alcaftadine 0.25%. Based on the positive patch test, the patient was diagnosed with ACD caused by alcaftadine 0.25%. After 9 days of treatment, the swelling and erythema completely resolved.ConclusionsAlthough there have been no previous reports of alcaftadine 0.25%-associated ACD, it should be suspected in patients with swelling and erythematous change of both eyes after using alcaftadine 0.25%.

Natamycin and Voriconazole Exhibit Synergistic Interactions with Nonantifungal Ophthalmic Agents against Fusarium Species Ocular Isolates.

The in vitro activities of two antifungal drugs in combination with four nonantifungal ophthalmic agents were evaluated using a broth microdilution method and a collection of eight Fusarium ocular isolates that exhibited resistance to both natamycin (MICs, 14 to 32 μg/ml) and voriconazole (MICs, 4 to >128 μg/ml). Synergistic and indifferent interactions were observed for natamycin and 5-fluorouracil and natamycin with timolol dependent on the Fusarium isolate tested. Isolate-dependent synergistic and indifferent interactions were also observed for natamycin with EDTA and natamycin with dorzolamide. Synergistic or indifferent interactions were observed for voriconazole with timolol and voriconazole with 5-fluorouracil depending on Fusarium isolate. Taken together, these data suggest that commonly used ophthalmic agents enhance the in vitro activity of antifungal drugs against drug-recalcitrant ocular fungal pathogens.

Comparison of the Toxicity of Olopatadine Anti-allergic Ophthalmic Agents on Rabbit Conjunctival Cells

Comparison of the Toxicity of Olopatadine Anti-allergic Ophthalmic Agents on Rabbit Conjunctival Cells

Interprofessional Management of Allergic Conjunctivitis

Ocular allergies affect a large and increasing number of people in North America. Canada’s statistics are likely to mirror those of the U.S., where up to 40% of the population is affected by ocular allergies. The symptoms and signs of ocular allergies can greatly affect productivity and have a dramatic effect on overall quality of life (QoL). Over the years, many effective treatments have been developed for the management of ocular allergies. For allergic conjunctivitis, topical ophthalmic agents include antihistamines, mast-cell stabilizers, dual-activity agents, steroids, nonsteroidal anti-inflammatory drugs, and other immune-modulating drugs. Oral antihistamines are commonly chosen by patients for all forms of allergy, including allergic conjunctivitis. This review provides a summary of the forms of ocular allergy, with a particular focus on the symptoms and signs, diagnosis, current treatment options, and impact on QoL. More importantly, through multidisciplinary collaboration, a simplified treatment algorithm is proposed for Canadian clinical practice. This algorithm provides practitioners the best possible management strategies based on an individual patient presentation, thereby maximizing treatment efficacy and minimizing the effects on tasks of daily living and QoL.

Comorbidities and Prescribed Medications in Patients With or Without Dry Eye Disease: A Population-Based Study

To assess the proportion of comorbidities in patients with dry eye disease (DED) compared with matched patients without DED in a comprehensive US population. Retrospective case-control study. Healthcare records for insurance claims data, detailing medical services incurred by military personnel and their families and dependents in military and civilian facilities across the United States from January 1, 2003, to March 31, 2015, were obtained from the Department of Defense (DOD) Military Health System (MHS). Diagnostic and procedural codes related to DED from selected International Classification of Diseases, Ninth Revision (ICD-9) Current Procedural Terminology codes and prescriptions for cyclosporine A ophthalmic emulsion were used to identify patients with newly diagnosed and prevalent DED in the MHS database. Age, sex, and geographically matched patients without DED were also identified from healthcare claims records. Medication use and comorbidities in these patient populations were assessed and compared. In both the newly diagnosed and prevalent DED samples, the most common comorbidities were hypertension, cataracts, thyroid disease, type 2 diabetes, and glaucoma. All comorbidities were significantly higher in the DED vs non-DED groups (P < .001). Medication use (including, but not limited to, ophthalmic agents and drugs to treat comorbidities) was also significantly higher in the DED than in the non-DED groups (P < .001). The high proportions of patients with DED with a range of comorbidities and prescribed medications highlight the need for a multidisciplinary approach to the management of these patients.

Exploration of alternative test methods to evaluate phototoxicity of ophthalmic agents by using Statens Seruminstitut Rabbit Cornea cell lines and 3D human reconstituted cornea models.

Many chemicals have been reported to induce phototoxicity. The absorbance of light energy within the sunlight range is a common characteristic of phototoxicity. The 3T3 NRU phototoxicity test (PT) in 3T3 mouse skin fibroblasts has been used to identify the phototoxic potential induced by excited chemicals after exposure to ultra violet (UV). However, as phototoxicity may occur in ocular cells, it is necessary to develop a more suitable test for cornea-derived cells. In this study, we attempted to establish a new in vitro PT method in rabbit corneal cell lines (SIRC). We evaluated five ophthalmic agents, ciprofloxacin, levofloxacin, lomefloxacin, norfloxacin, and tetracycline, for their cytotoxic potential and in vitro phototoxicity. The results obtained using 3D human corneal models revealed that the UV-induced eye tissue toxicity by the test substances showed good correlation with those obtained using the in vitro phototoxicity test. However, the results from the 3D PT for ciprofloxacin, norfloxacin, and tetracycline in the 3D human cornea model were only partially comparable. Therefore, we suggest the SIRC cell line as a new phototoxicity test model; however, a sequential testing strategy, such as 3D PT, was also proposed to obtain relevant information for topical eye agents.