Ocular Side Effects of Oral Treatment with Retinoids

2015 ◽  
pp. 315-326 ◽  
Author(s):  
A. B. Safran ◽  
B. Halioua ◽  
A. Roth ◽  
J. -H. Saurat
2018 ◽  
Vol 4 (1) ◽  
pp. 51-58
Author(s):  
Wilson S ◽  
Sharp CA ◽  
Davie MWJ

Purpose: Bisphosphonates are valuable in reducing the incidence of fracture. Side effects limit persistence with oral therapy and long term studies of pain relief are difficult to pursue. Intravenous bisphosphonates offer an alternative treatment to oral bisphosphonates and are tolerated over a longer period. The use of Pamidronate, an intravenously administered bisphosphonate, to benefit pain and reduce fracture incidence in the long term has not been extensively investigated. The study aimed to investigate the effect of Pamidronate on pain, vertebral fracture incidence and Bone Mineral Density over 6 or more years.Methods: Patients were offered intravenous Pamidronate if oral treatment with bisphosphonates or Hormone replacement therapy had failed due to side effects, fractures continued on oral treatment or oesophageal reflux led to cessation of oral treatment. Pain was assessed using the Nottingham health profile; radiographs were used to evaluate vertebral fracture and DXA measured bone mineral density.Results: The primary outcome was the pain domain. Median patient follow up was 9 years. Pain had improved significantly (p = 0.03) and in 68% pain had either improved or remained unchanged. Vertebral fractures occurred in 14% of patients in the first 3 years, 9.5% in years 4-6, but increased in years 7-9 to 27%. Bone mineral density increased in the lumbar spine (p < 0.001) but not at the femoral neck.Conclusions: Pamidronate had a beneficial effect on pain over the period of the study. Vertebral fracture incidence increased after 6 years of Pamidronate, although spine BMD increased significantly.


2021 ◽  
pp. 65-66
Author(s):  
(Lt Col) Rajnish Kumar ◽  
(Lt Col) Vaka Raja Sekhar Reddy ◽  
(Lt Col) Sumit Kumar Singh ◽  
Debarshi jana

Background/ Context: Corticosteroids, despite being a very effective line of treatment for various disorders is known to have a wide range of adverse effects. The use of systemic and topical steroids has been associated with cataract formation, however the ophthalmic side effects of application of steroid on skin away from the face has not been studied in depth. With increasing use of corticosteroids as rst line of therapy in treatment of various dermatological conditions, the ocular side effects, if any, of these preparations, cannot be overlooked. Aim: To study the incidence of cataract in patients using skin preparations of corticosteroids away from the face and also to correlate the dose and duration of steroid therapy to incidence of cataract. Materials & Methods: 50 patients with dermatological disorders who were being treated with dermatological steroids, on sites other than the face and periorbital region, for a period of more than six months consisted of the study group. The study group consisted of patients in the age group of 20 – 60 years. The study was conducted over a period of two years at a tertiary care hospital. Visual acuity, Slit lamp biomicroscopy, applanation tonometryand detailed fundus examination using 90D lens were carried out. Results: The incidence of cataract was signicantly higher in patients using dermatological steroids away from the face. Prolonged duration of use of these steroids also indicated a signicantly higher incidence of cataract. However, a larger population based study needs to be carried out to study the relationship between potency of steroid and incidence of cataract, although preliminary studies indicate a denite correlation between the two. Conclusions: Despite, steroids being used away from the face, there was a denite increase in the incidence of cataract. Before coming to any rm conclusions it would be advisable to reproduce the study in a larger population. However from the present pilot study it is prudent to advocate judicious use of innocuous looking steroid creams as they can cause signicant adverse effects


1975 ◽  
pp. 215-217
Author(s):  
J.L.C. MARTIN-DOYLE ◽  
MARTIN H. KEMP

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Nicholas M Boulis

Abstract INTRODUCTION Oral riluzole is the only approved treatment known to improve survival in patients with amyotrophic lateral sclerosis (ALS), with modest efficacy and dosing limited by hepatic toxicity and asthenia. We postulated that a continuous intrathecal (IT) delivery of low daily doses of riluzole could elevate spinal cord (SC) concentrations well above those achievable with oral treatment alone, without increasing side-effects. METHODS A 6-wk and a 24-wk GLP study were conducted to evaluate the safety of IT riluzole in purpose-bred hound dogs. Oral riluzole, equivalent to 50 mg BID in humans, was administered in combination with one of 3 IT doses given through continuous infusion. Plasma, SC, and brain concentrations of riluzole were measured, along with assessments of safety and tolerability. RESULTS In the 6-wk study, when combining the oral and IT routes, IT infusion significantly increased SC concentrations well above those achieved with oral drug administration alone, without increasing brain concentrations. All IT doses in combination with oral administration were well tolerated by the animals. In the 6-mo study, the lowest dose used in the 6-wk study was dropped and a higher dose was added. This highest dose of IT riluzole was not tolerated by the dogs and yielded SC and brain concentrations significantly higher than achieved in any of our previous studies. CONCLUSION Continuous IT administration of riluzole when combined with oral administration can increase the SC concentration of riluzole above those achievable with oral therapy, without increasing the risk for adverse events associated with systemic drug exposure or off-target side-effects in the brain. Therefore, IT riluzole infusion when used in conjunction with oral therapy may safely enhance lower motor neuron neuroprotection and improve the survival benefit of the drug through enhanced SC delivery, and, with a careful selection of IT doses, it could be implemented in patients with ALS.


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