Abstract
Abstract: :
Purpose: To determine if long lasting treatments, particularly those with phototoxic drugs, are able to increase the blood–retinal barrier breakdown after cataract surgery. Methods: 56 patients with an age–related cataract, without any uveitis or retinopathy, and no previous ocular traumatism or surgery, were enrolled for a prospective study. Long lasting treatments, race, colour of hair and eyes, systemic hypertension, cholesterol levels, previous infarctus, angor or stroke, eye axial lenght, were noted. Phacoemulsification was performed in all cases with a standardized light intensity. The day after the surgery, the fluorophotometry of the Posterior Vitreous (PV), Medium Vitreous (MV), and Anterior Vitreous (AV) was measured just before, 10 mn and 60 mn after fluorescein 10% intravenous injection (7 mg/kg). The fluorophotometer was the FM–2 Fluorotron (TM) Master (Ocumetrics–USA). Results: Blood–retinal barrier breakdown was estimated by the [PV – MV] index. 37 different families of drugs were listed. [PV – MV] was significavely increased only with thiazide diuretics (Kruskal and Wallis test, Chi2 = 4.95, p<0.03) Conclusions: 20% of the persons suffering from high blood pressure are treated with thiazide diuretics in France. These drugs are strong photosensitizers, absorbing the near UV and the blue visible light. They may be concentrated in the retina after long lasting treatment. Therefore they may increase light induced retinal damages during and after cataract surgery.
Keywords: retinal pigment epithelium • drug toxicity/drug effects • cataract