Skip to main content
Log in

Increased aqueous flare as a result of a therapeutic dose of mannitol in humans

  • Clinical Investigations
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

To evaluate the effects of mannitol on aqueous flare (aqueous protein concentration), we administered an intravenous clinical therapeutic dose to normal young adults (average age 20.1 years), to normal older adults (average age 61.5 years), and also to patients with diabetes mellitus, systemic hypertension, or pseudoexfoliation syndrome who were about to undergo intraocular surgery (average age 66.4 years). Protein and cell levels in the aqueous were determined with a device that measures laser light scatter in the aqueous. Mannitol increased the intensity of aqueous flare. In all subjects, the intensity of aqueous flare was greatest around 1 h following drug administration; the magnitude and duration of the aqueous flare increase were significantly greater in normal older adults than in normal young adults; the magnitude was essentially the same in older adults with and without disease. The effect reversed within 6 h of drug administration in normal subjects. We consider the findings to represent changes in actual aqueous protein concentration and discuss the possible causes of this phenomenon.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Adams RE, Kirschner RJ, Leopold IH (1963) Ocular hypotensive effect of intravenous administered mannitol. Arch Ophthalmol 65:55–58

    Google Scholar 

  2. Brooks AMV, Gilles WE (1983) Fluorescein angiography and fluorophotometry of the iris in pseudoexfoliation of the lens capsule. Br J Ophthalmol 67:249–254

    Google Scholar 

  3. Duncan LS, Ellis PP, Paterson CA (1970) Effect of hyperosmotic agents on vitreous osmolality. Exp Eye Res 10:129–132

    Google Scholar 

  4. Friedman B, Byron H, Turtz A (1962) Urea in cataract extraction. Arch Ophthalmol 67:421–423

    Google Scholar 

  5. Galin MA, Baras I (1961) Intravenous urea in retinal detachment surgery. Arch Ophthalmol 65:652–656

    Google Scholar 

  6. Galin MA, Aizawa F, McLean J (1959) Urea as an osmotic ocular hypotensive agent in glaucoma. Arch Ophthalmol 62:347–352

    Google Scholar 

  7. Galin MA, Nano H, Davidson R (1961) Aqueous and blood urea nitrogen levels after intravenous urea administration. Arch Ophthalmol 65:805–807

    Google Scholar 

  8. Galin MA, Davidson R, Shachter N (1966) Ophthalmological use of osmotic therapy. Am J Ophthalmol 62:629–634

    Google Scholar 

  9. Havener WH (1983) Osmotic agents. In ocular pharmacology Mosby, St. Louis, pp 539–564

    Google Scholar 

  10. Ishibashi T, Tanaka K, Taniguchi Y (1982) Disruption of the iridial blood-aqueous barrier in experimental diabetic rats: an electromicroscopic study. Acta Soc Ophthalmol Jpn 33:243–252

    Google Scholar 

  11. Kayawaza F, Miyake K (1984) Ocular fluorophotometry in patients with essential hypertension. Arch Ophthalmol 102:1169–1170

    Google Scholar 

  12. Kawasaki K, Yamamoto S, Yonemura D (1977) Electrophysiological approach to clinical test for the retinal pigment epithelium. Acta Soc Ophthalmol Jpn 81:1303–1312

    Google Scholar 

  13. Kraff MC, Sanders DR, Peyman GA, Lieberman HL, Tarabishy S (1980) Slit lamp fluorophotometry in intraocular lens patients. Ophthalmology 87:877–880

    Google Scholar 

  14. Krupin T, Waltman SR, Oestrich C (1978) Vitreous fluorophotometry in juvenile-onset diabetes mellitus. Arch Ophthalmol 96:812–814

    Google Scholar 

  15. Laties AM, Rapoport S (1976) The blood-ocular barriers under osmotic stress. Arch Ophthalmol 94:1086–1091

    Google Scholar 

  16. Miyake K (1982) Blood-retinal barrier in eyes with long-standing aphakia with apparently normal fundi. Arch Ophthalmol 100:1437–1439

    Google Scholar 

  17. Miyake K (1991) Fluorophotometry in implant surgeries. Proceedings of the Fourth International Congress on Cataract and Refractive Microsurgery. Florence, Italy (in press)

  18. Miyake K, Asakura M, Kobayashi H (1984) Effect of intraocular lens fixation on the blood-aqueous barrier. Am J Ophthalmol 98:451–455

    Google Scholar 

  19. Miyake K, Asakura M, Maekubo K (1984) Consensual reaction of human blood-aqueous barrier to implant surgeries. Arch Ophthalmol 102:558–561

    Google Scholar 

  20. Miyake Y, Miyake K, Maekubo K, Kayazawa F (1989) Increase in aqueous flare by a therapeutic dose of mannitol in humans. Acta Soc Ophthalmol Jpn 93:1149–1153

    Google Scholar 

  21. Neuwelt EA, Frenkel EP, Rapoport S, et al (1980) Effect of osmotic blood-brain barrier disruption on methotrexate pharmacokinetics in the dog. Neurosurgery 7:36–43

    Google Scholar 

  22. Neuwelt EA, Barnett PA, Bigner DD, et al (1982) Effects of adrenal cortical steroids and osmotic blood-brain barrier opening on methotrexate delivery to gliomas in the rodent. The factor of the blood-brain barrier. Proc Natl Acad Sci USA 79:4420–4423

    Google Scholar 

  23. Okisaka S, Kuwabara T, Rapoport SI (1976) Effect of hyperosmotic agents on the ciliary epithelium and trabecular mesh-work. Invest Ophthalmol Vis Sci 15:617–625

    Google Scholar 

  24. Sanders DR, Kraff MC, Lieberman HL, Peyman GA, Tarabishy S (1982) Breakdown and reestablishment of blood-aqueous barrier with implant surgery. Arch Ophthalmol 100:588–590

    Google Scholar 

  25. Sawa M, Sakanishi Y, Shimizu H (1984) Fluorophotometric study of anterior segment barrier functions after extracapsular cataract extraction and posterior chamber intraocular lens implantation. Am J Ophthalmol 97:197–204

    Google Scholar 

  26. Sawa M, Tsurumaki Y, Tsuru T, Shimizu H (1988) New quantitative method to determine protein concentration and cell number in aqueous in vivo. Jpn J Ophthalmol 32:132–142

    Google Scholar 

  27. Shabo A, Maxwell D, Kreiger A (1976) Structural alterations in the ciliary process and blood-aqueous barrier of the monkey after systemic urea injections. Am J Ophthalmol 81:162–172

    Google Scholar 

  28. Tarter RC, Linn JG (1961) A clinical study of the use of intravenous urea in glaucoma. Am J Ophthalmol 52:323–331

    Google Scholar 

  29. Tornquist P, Ring A (1980) The influence of hyperosmotic stress on the blood-retinal barrier. Effects on the electroretinogram. Acta Ophthalmol 58:707–711

    Google Scholar 

  30. Tso MOM, Shih CY (1977) Experimental macular edema after lens extraction. Invest Ophthalmol Vis Sci 16:381–392

    Google Scholar 

  31. Unger WG, Cole DF, Hammond B (1975) Disruption of the blood-aqueous barrier following paracentesis in the rabbit. Exp Eye Res 20:255–270

    Google Scholar 

  32. Yamashita H, Uyama M, Sears ML (1981) Comparative study by electron microscopy of response to urea between ciliary epithelia of albino and pigmented rabbits — a function of the ciliary pigmented epithelium. Jpn J Ophthalmol 25:312–320

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Offprint requests to: K. Miyake

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miyake, K., Miyake, Y. & Maekubo, K. Increased aqueous flare as a result of a therapeutic dose of mannitol in humans. Graefe's Arch Clin Exp Ophthalmol 230, 115–118 (1992). https://doi.org/10.1007/BF00164647

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00164647

Keywords

Navigation