Our study provided experimental evidence that levels of bimatoprost in relevant ocular tissues, and not only aqueous humor, are needed to understand the mechanisms by which bimatoprost lowers intraocular pressure (IOP) in human subjects. The data suggest that bimatoprost reached the target tissues favoring the conjunctival/scleral absorption route. Findings of intact bimatoprost in the target ciliary body indicated its direct involvement in reducing IOP. However, bimatoprost acid may have only a limited contribution on the basis that bimatoprost has greater/similar IOP-lowering efficacy than latanoprost, yet bimatoprost acid levels were a fraction of latanoprost acid levels in the aqueous humor and cornea and only sporadically detectable in the ciliary body. In this report, human ocular tissues were examined concurrently with aqueous humor for the in vivo distribution of bimatoprost, bimatoprost acid, latanoprost, and latanoprost acid.
Examination of the peripheral fundus may reveal discrete pearllike structures at the furthest extent of the retina. They occur throughout the ora serrata region, but only where a tongue of retina tissue in the form of a dentate process overlies the pars plana. In the later stages, the pigment epithelial covering is lost, exposing the pearl as a glistening bead. To our knowledge, the clinical significance and precise composition of these structures have not been described, although there is suggestion that they consist of drusenlike material. In this study, scanning electron microscopy with energy dispersive x-ray spectroscopy (SEM-EDS) was applied in conjunction with classic histochemical staining techniques to characterize the elemental content of these pearls. Methods | A formalin-fixed enucleated globe was submitted for routine pathological examination and found to contain 3 pearls at the region of the ora serrata. Sections of the gross specimen were photographed, dissected
Retinoblastoma is usually diagnosed during the first three years of life, with an average age of diagnosis of 18 months. It is almost never found at birth except when there is a positive family history which prompts an early fundus examination. We report a case of unilateral nonfamilial retinoblastoma which was so advanced at birth that it had already produced a perforated globe. Despite enucleation, radiation, and chemotherapy, massive orbital recurrence developed which necessitated a modified orbital exenteration. In spite of this aggressive therapy the child died of metastatic retinoblastoma at age eight months.
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