Recent developments in ocular therapeutics.

Triethylene thiophosphoramide, an alkylating agent of value as a palliative in cases of neoplastic disease and reticulosis, has been effective in preventing vascularization of the cornea when used locally. Since recurrent pterygium, a persistent clinical problem, particularly in the Western states, is preceded by corneal vascularization and fibroplastic proliferation, it is possible that this drug when used topically may be useful in obviating to some extent the use of radiation, which must be used with great caution to avoid the production of cataract. In the treatment of gram-negative bacterial infection, especially Pseudomonas aeruginosa, the drug colistin has been known to be effective in some cases which were not helped by other antibiotics, including polymixin B. In the field of virus infections, a major breakthrough may have come about by the discovery that 5-iodo-2-deoxyuridine (IDU) attacks the herpes cirrus in the cornea as a metabolic antagonist. Animal experiments and some clinical studies have confirmed its effectiveness as compared with other therapeutic measures in selected cases. In the treatment of ocular problems resulting from systemic disease fibrinolysin (plasmin) has apparently caused dissolution of the clot and restoration of circulation in some cases of retinal artery occlusion. Severe diabetic retinopathy in younger diabetic patients has been shown to regress in certain cases treated by hypophysectomy or radiation of the pituitary gland employing the cyclotron. This gland is also associated intimately with the exophthalmos of thyroid origin, and its action may be aggravated by the use of ACTH or steroids.