deoxycholic-acid and Cataract

To describe the clinical courses of patients who received intravitreal injections of highly concentrated amphotericin B deoxycholate for suspected fungal endophthalmitis.. Retrospective medical record review of 3 cases of intraocular toxicity from highly concentrated amphotericin B.. The first patient developed posttraumatic endophthalmitis and received an undiluted dose (500 μg) of amphotericin B. He developed severe intraocular inflammation and required a pars plana lensectomy, vitrectomy, and scleral buckle after developing a cataract and retinal detachment. Six years later, his visual acuity stabilized at 20/30. The second patient developed endogenous endophthalmitis and was treated with 5 intravitreal injections of amphotericin B and underwent 3 surgical procedures. The surgeon later discovered that the patient had received 55 μg of amphotericin B during the second injection. Three months after the injection, the patient's visual acuity was 20/60. The third patient developed chronic postoperative endophthalmitis following cataract extraction. He received 160 μg of amphotericin B and was immediately treated with a vitreous washout. Two years later, his visual acuity improved to 20/30. The vitreous culture results were negative in each case. A key finding was that the amphotericin B solution appeared to be yellow instead of nearly colorless.. We present 3 cases of intraocular toxicity from highly concentrated amphotericin B. In every case, the overly concentrated amphotericin B solution was yellow in color. Although severe noninfectious panophthalmitis resulted in every case, the visual acuity outcomes were good. Physicians should examine the color of amphotericin B solution prior to intraocular administration. If the solution appears to be yellow, the medication should not be injected.

Topics: Aged; Amphotericin B; Antifungal Agents; Cataract; Child; Deoxycholic Acid; Drug Combinations; Endophthalmitis; Eye Infections, Fungal; Humans; Intravitreal Injections; Male; Middle Aged; Mycoses; Retinal Detachment; Retrospective Studies; Visual Acuity; Vitreous Body

Hereditary cataractous rat lenses showed significantly higher specific activity for transglutaminase than the normal lenses of comparable age. Transglutaminase activity of normal lenses was distributed predominantly in the buffer-soluble fraction. The buffer-insoluble fraction showed 14% of total activity. The cortical and nuclear fractions of the normal lens showed 43% and 57% distribution of total activity, respectively. Protein solubilizing agents enhanced the activity of the enzyme in the lens homogenate in the following order: Triton X-100 greater than Tween 20 greater than Sodium dodecyl sulfate greater than Sodium deoxycholate greater than Sodium cholate greater than NaSCN greater than KI. Transglutaminase was purified 15 fold by hydrophobic affinity chromatography employing omega-amine octylagarose matrix. The purified enzyme was activated by calcium and inactivated by iodoacetamide and upon freeze-drying. Lens crystallins served as exogenous substrate for transglutaminase, with gamma-crystallin as the most effective amine acceptor.

Topics: Animals; Calcium; Cataract; Cholic Acids; Deoxycholic Acid; gamma-Glutamyltransferase; Iodoacetamide; Lens, Crystalline; Octoxynol; Polyethylene Glycols; Polysorbates; Potassium Iodide; Rats; Rats, Inbred Strains; Sodium Dodecyl Sulfate; Thiocyanates