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Ординатура / Офтальмология / Английские материалы / Clinical Ocular Toxicology Drug-Induced Ocular Side Effects_Fraunfelder, Chambers _2008.pdf
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effects side ocular induced-Drug • 7 t Pa r

A B

Fig. 7.4d  A: Right eye with multiple retinal, intraretinal and preretinal hemorrhages surrounding the optic nerve head and the posterior

pole. B: An extensive premacular subhyaloid hemorrhage involving the left macular region due to oxygen-ozone therapy. Photo courtesy of Giudice GL, et al: Acute bilateral vitreo-retinal hemorrhages following oxygen-ozone therapy for lumbar disk herniation. Am J Ophthalmol 138: 175-177, 2004.

Clinical significance

Toxic ocular effects due to oxygen are more prominent in premature infants but may be found in any age group under hyperbaric oxygen therapy. Otherwise, ocular side effects secondary to oxygen therapy are rare. While ocular changes due to retrolental fibroplasia are irreversible, most other side effects are transient after use of oxygen is discontinued. Permanent bilateral blindness probably due to 80% oxygen during general anesthesia has been reported. It has been suggested that in susceptible people, severe retinal vasoconstriction or even direct retinal toxicity may occur from oxygen therapy. Bilateral retinal hemorrhages with permanent partial visual loss have been reported secondary to a sudden increase in cerebral spinal fluid pressure after an excessive volume of oxygen was used in a myelogram contrast study. A slow increase in myopia following prolonged hyperbaric oxygen has been seen in premature infants and adults. In addition, oxidative damage to the lens proteins has been postulated as a cause of nuclear cataracts in patients exposed to hyperbaric oxygen treatments.

In a single case report, Giudice et al (2004) described O2O3 injected spinal disc infiltration causing bilateral retinal hemorrhage.

Nissenkorn I, et al. Myopia in premature babies with and without retinopathy of prematurity. Br J Ophthalmol 67: 170, 1983.

Oberman J, Cohn N, Grand MG. Retinal complications of gas myelography. Arch Ophthalmol 97: 1905, 1979.

Palmquist BM, Philipson B, Barr PO. Nuclear cataract and myopia during hyperbaric oxygen therapy. Br J Ophthalmol 68: 113, 1984.

SECTION 5

Gastrointestinal Agents

Class: Agents Used to Treat Acid Peptic Disorders

Generic names: 1. Cimetidine; 2. famotidine; 3. nizatidine; 4. ranitidine.

Proprietary names: 1. Tagamet; 2. Pepcid; 3. Axid; 4. Zantac.

References and Further Reading

Anderson B Jr, Farmer JC Jr. Hyperoxic myopia. Trans Am Ophthalmol Soc 76: 116, 1978.

Ashton N. Oxygen and the retinal vessels. Trans Ophthalmol Soc UK 100: 359, 1980.

Campbell PB, et al. Incidence of retinopathy of prematurity in a tertiary newborn intensive care unit. Arch Ophthalmol 101: 1686, 1983.

Fisher AB. Oxygen therapy. Side effects and toxicity. Am Rev Respir Dis 122: 61, 1980.

Gallin-Cohen PF, Podos SM, Yablonski ME. Oxygen lowers intraocular ­pressure. Invest Ophthalmol Vis Sci 19: 43, 1980.

Giudice GL, Valdi F, Gismondi M, et al. Acute bilateral vitreo-retinal hemorrhages following oxygen-ozone therapy for lumbar disk herniation. Am J Ophthalmol 138: 175–177, 2004.

Handelman IL, et al. Retinal toxicity of therapeutic agents. J Toxicol Cut Ocular Toxicol 2: 131, 1983.

Kalina RE, Karr DJ. Retrolental fibroplasia. Ophthalmology 89: 91, 1982. Lyne AJ. Ocular effects of hyperbaric oxygen. Trans Ophthalmol Soc UK 98:

66, 1978.

Primary use

These histamine H2 receptor antagonists are used in the treatment of duodenal ulcers.

Ocular side effects

Systemic administration

Certain

1. Visual hallucinations

2. Photophobia

3. Eyelids or conjunctiva

a.Hyperemia

b.Erythema

c.Conjunctivitis – non-specific

d.Urticaria

e.Purpura

f.Photosensitivity reactions

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