Indian Journal of Private Psychiatry

Register      Login

VOLUME 11 , ISSUE 2 ( July-December, 2017 ) > List of Articles

REVIEW ARTICLE

Clozapine-resistant Schizophrenia: Strategies for the Busy Clinician

Citation Information : Clozapine-resistant Schizophrenia: Strategies for the Busy Clinician. Ind J Priv Psychiatry 2017; 11 (2):17-23.

DOI: 10.5005/jp-journals-10067-0004

License: CC BY-ND 3.0

Published Online: 01-04-2013

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Introduction: Schizophrenia is a debilitating psychiatric illness where relapse and nonrecovery are common. Clozapine has been heralded as a management option for treatmentresistant schizophrenia (TRS). The aim of the current review is to provide a clinical overview of strategies that may be used in the management of patients that fail to show an adequate response to clozapine. The term clozapine-resistant schizophrenia and its implications are discussed along with a description of various pharmacological and nonpharmacological strategies for the management of clozapine-resistant cases or partial responders to clozapine. The evidence is discussed and the strategies are presented. There is a need for emerging strategies to augment clozapine therapy in the absence of response or in case of partial response in patients.


PDF Share
  1. Insel TR. Rethinking schizophrenia. Nature 2010 Nov; 468(7321):187-193.
  2. Kerwin RW, Bolonna A. Management of clozapine-resistant schizophrenia. Adv Psychiatr Treat 2005 Mar;11(2):101-106.
  3. Lehman AF, Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB, Goldberg R, Green-Paden LD, Tenhula WN, Boerescu D, Tek C, et al. The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2003. Schizophr Bull 2004;30(2):193-217.
  4. Hasan A, Falkai P, Wobrock T, Lieberman J, Glenthoj B, Gattaz WF, Thibaut F, Möller HJ. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, part 1: update 2012 on the acute treatment of schizophrenia and the management of treatment resistance. World J Biol Psychiatry 2012 May;13:318-378.
  5. Conley RR, Kelly DL. Management of treatment resistance in schizophrenia. Biol Psychiatry 2001 Dec;50(11):898-911.
  6. Kane J, Honigfeld G, Singer J, Meltzer H. Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine. Arch Gen Psychiatry 1988 Sep;45(9): 789-796.
  7. Davies LM, Drummond MF. Economics and schizophrenia: the real cost. Br J Psychiatry (Suppl) 1994 Nov;25:18-21.
  8. Porcelli S, Balzarro B, Serretti A. Clozapine resistance: augmentation strategies. Eur Neuropsychopharmacol 2012 Mar;22(3):165-182.
  9. Perry PJ, Miller DD, Arndt SV, Cadoret RJ. Clozapine and norclozapine plasma concentrations and clinical response of treatment-refractory schizophrenic patients. Am J Psychiatry 1991 Feb;148(2):231-235.
  10. Potkin SG, Bera R, Gulasekaram B, Costa J, Hayes S, Jin Y, Richmond G, Carreon D, Sitanggan K, Gerber B, et al. Plasma clozapine concentrations predict clinical response in treatment-resistant schizophrenia. J Clin Psychiatry 1994 Sep;55(Suppl B):133-136.
  11. Buchanan RW, Kreyenbuhl J, Kelly DL, Noel JM, Boggs DL, Fischer BA, Himelhoch S, Fang B, Peterson E, Aquino PR, et al. The 2009 schizophrenia PORT psychopharmacological treatment recommendations and summary statements. Schizophr Bull 2009 Dec;36(1):71-93.
  12. Dold M, Leucht S. Pharmacotherapy of treatment-resistant schizophrenia: a clinical perspective. Evid Based Ment Health 2014 May;17(2):33-37.
  13. Josiassen RC, Joseph A, Kohegyi E, Stokes S, Dadvand M, Paing WW, Shaughnessy RA. Clozapine augmented with risperidone in the treatment of schizophrenia: a randomized, double-blind, placebo-controlled trial. Am J Psychiatry 2005 Jan;162(1):130-136.
  14. Weiner E, Conley RR, Ball MP, Feldman S, Gold JM, Kelly DL, Wonodi I, McMahon RP, Buchanan RW. Adjunctive risperidone for partially responsive people with schizophrenia treated with clozapine. Neuropsychopharmacology 2010 Oct;35(11):2274-2283.
  15. Honer WG, Thornton AE, Chen EY, Chan RC, Wong JO, Bergmann A, Falkai P, Pomarol-Clotet E, McKenna PJ, Stip E, et al. Clozapine alone versus clozapine and risperidone with refractory schizophrenia. N Engl J Med 2006 Feb;354(5): 472-482.
  16. Akdede BB, Anil Ya cio lu AE, Alptekin K, Turgut T., Tumuklu M, Yazici MK, Jayathilake K, Tunca Z, Go. u. A, Meltzer HY. A double-blind study of combination of clozapine with risperidone in patients with schizophrenia: effects on cognition. J Clin Psychiatry 2006 Dec;67(12):1912-1919.
  17. Fleischhacker WW, Uchida H. Critical review of antipsychotic polypharmacy in the treatment of schizophrenia. Int J Neuropsychopharmacol 2012 Jul;17(7):1083-1093.
  18. Chang JS, Ahn YM. Aripiprazole augmentation in clozapinetreated patients with refractory schizophrenia: an 8-week, randomized, double-blind, placebo controlled trial. J Clin Psychiatry 2008 May;69(5):720-731.
  19. Srisurapanont M, Suttajit S, Maneeton N, Maneeton B. Efficacy and safety of aripiprazole augmentation of clozapine in schizophrenia: a systematic review and meta-analysis of randomized-controlled trials. J Psychiatr Res 2015 Mar;62: 38-47.
  20. Henderson DC, Kunkel L, Nguyen DD, Borba CP, Daley TB, Louie PM, Freudenreich O, Cather C, Evins AE, Goff DC. An exploratory open-label trial of aripiprazole as an adjuvant to clozapine therapy in chronic schizophrenia. Acta Psychiatr Scand 2006 Feb;113(2):142-147.
  21. Genc Y, Taner E, Candansayar S. Comparison of clozapineamisulpride and clozapine-quetiapine combinations for patients with schizophrenia who are partially responsive to clozapine: a single-blind randomized study. Adv Ther 2007 Jan;24(1):1-13.
  22. Zink M, Knopf U, Henn FA, Thome J. Combination of clozapine and amisulpride in treatment-resistant schizophrenia. case reports and review of the literature. Pharmacopsychiatry 2004 Jan;37(1):26-31.
  23. Kreinin A, Novitski D, Weizman A. Amisulpride treatment of clozapine-induced hypersalivation in schizophrenia patients: a randomized, double-blind, placebo-controlled cross-over study. Int Clin Psychopharmacol 2006 Mar;21(2):99-103.
  24. Kuwilsky A, Krumm B, Englisch S, Dressing H, Zink M. Long-term efficacy and tolerability of clozapine combined with ziprasidone or risperidone. Pharmacopsychiatry 2010 Aug;43(6):216-220.
  25. Zink M, Kuwilsky A, Krumm B, Dressing H. Efficacy and tolerability of ziprasidone versus risperidone as augmentation in patients partially responsive to clozapine: a randomised controlled clinical trial. J Psychopharmacol 2009 May;23(3):305-314.
  26. Wen RH, Liu S. A comparative study of clozapine combined with ziprasidone or quetiapine for treatment resistant schizophrenia. Med J Chinese People's Health 2015;27(2)4-6.
  27. Zoccali R, Muscatello MR, Bruno A, Cambria R, Mico U, Spina E, Meduri M. The effect of lamotrigine augmentation of clozapine in a sample of treatment-resistant schizophrenic patients: a double-blind, placebo-controlled study. Schizophr Res 2007 Jul;93(1):109-116.
  28. Tiihonen J, Wahlbeck K, Kiviniemi V. The efficacy of lamotrigine in clozapine-resistant schizophrenia: a systematic review and meta-analysis. Schizophr Res 2009 Apr;109(1-3):10-14.
  29. Dursun SM, Deakin JF. Augmenting antipsychotic treatment with lamotrigine or topiramate in patients with treatmentresistant schizophrenia: a naturalistic case-series outcome study. J Psychopharmacol 2001 Dec;15(4):297-301.
  30. Sommer IE, Begemann MJ, Temmerman A, Leucht S. Pharmacological augmentation strategies for schizophrenia patients with insufficient response to clozapine: a quantitative literature review. Schizophr Bull 2012 Mar;38(5):1003-1011.
  31. Vayisoğlu S, Yağcioğlu AE, Yağcioğlu S, Karahan S, Karc. O, Gürel ŞC, Yazici MK. Lamotrigine augmentation in patients with schizophrenia who show partial response to clozapine treatment. Schizophr Res 2013 Jan;143(1):207-214.
  32. Tiihonen J, Halonen P, Wahlbeck K, Repo-Tiihonen E, Hyvarinen S, Eronen M, Putkonen H, Takala P, Mehtonen OP, Puck M, et al. Topiramate add-on in treatment-resistant schizophrenia: a randomized, double-blind, placebo-controlled, crossover trial. J Clin Psychiatry 2005 Aug;66(8):1012-1015.
  33. Afshar H, Roohafza H, Mousavi G, Golchin S, Toghianifar N, Sadeghi M, Talaei M. Topiramate add-on treatment in schizophrenia: a randomised, double-blind, placebo-controlled clinical trial. J Psychopharmacol 2009 Mar;23(2):157-162.
  34. Hahn MK, Cohn T, Teo C, Remington G. Topiramate in schizophrenia: a review of effects on psychopathology and metabolic parameters. Clin Schizophr Relat Psychoses 2013 Jan;6(4):186-196.
  35. Mizuno Y, Suzuki T, Nakagawa A, Yoshida K, Mimura M, Fleischhacker WW, Uchida H. Pharmacological strategies to counteract antipsychotic-induced weight gain and metabolic adverse effects in schizophrenia: a systematic review and meta-analysis. Schizophr Bull 2014 Nov;40(6):1385-1403.
  36. Kelly DL, Conley RR, Feldman S, Yu Y, McMahon RP, Richardson CM. Adjunct divalproex or lithium to clozapine in treatment-resistant schizophrenia. Psychiatr Q 2006 Spring;77(1):81-95.
  37. Bender S, Linka T, Wolstein J, Gehendges S, Paulus HJ, Schall U, Gastpar M. Safety and efficacy of combined clozapine– lithium pharmacotherapy. Int J Neuropsychopharmacol 2004 Mar;7(1):59-63.
  38. Small JG, Klapper MH, Malloy FW, Steadman TM. Tolerability and efficacy of clozapine combined with lithium in schizophrenia and schizoaffective disorder. J Clin Psychopharmacol 2003 Jun;23(3):223-228.
  39. Praharaj SK, Arora M. Amitriptyline for clozapine-induced nocturnal enuresis and sialorrhoea. Br J Clin Pharmacol 2007 Jan;63(1):128-129.
  40. Lu ML, Lane HY, Lin SK, Chen KP, Chang WH. Adjunctive fluvoxamine inhibits clozapine-related weight gain and metabolic disturbances. J Clin Psychiatry 2004 Jun;65(6):766-771.
  41. Zoccali R, Muscatello MR, Cedro C, Neri P, La Torre D, Spina E, Di Rosa AE, Meduri M. The effect of mirtazapine augmentation of clozapine in the treatment of negative symptoms of schizophrenia: a double-blind, placebo-controlled study. Int Clin Psychopharmacol 2004 Mar;19(2):71-76.
  42. Delle Chiaie R, Salviati M, Fiorentini S, Biondi M. Add-on mirtazapine enhances effects on cognition in schizophrenic patients under stabilized treatment with clozapine. Exp Clin Psychopharmacol 2007 Dec;15(6):563-568.
  43. Zoccali R, Muscatello MR, La Torre D, Malara G, Canale A, Crucitti D, D’Arrigo C, Spina E. Lack of a pharmacokinetic interaction between mirtazapine and the newer antipsychotics clozapine, risperidone and olanzapine in patients with chronic schizophrenia. Pharmacol Res 2003 Oct;48(4):411-414.
  44. Dold M, Li C, Gillies D, Leucht S. Benzodiazepine augmentation of antipsychotic drugs in schizophrenia: a meta-analysis and Cochrane review of randomized controlled trials. Eur Neuropsychopharmacol 2013 Sep;23(9):1023-1033.
  45. de Lucena D, Fernandes BS, Berk M, Dodd S, Medeiros DW, Pedrini M, Kunz M, Gomes FA, Giglio LF, Lobato MI, et al. Improvement of negative and positive symptoms in treatment- refractory schizophrenia: a double-blind, randomized, placebo-controlled trial with memantine as add-on therapy to clozapine. J Clin Psychiatry 2009 Oct;70(10):1416-1423.
  46. Kulkarni J, Gavrilidis E, Wang W, Worsley R, Fitzgerald PB, Gurvich C, Van Rheenen T, Berk M, Burger H. Estradiol for treatment-resistant schizophrenia: a large-scale randomizedcontrolled trial in women of child-bearing age. Mol Psychiatry 2015 Jun;20(6):695-702.
  47. Goff DC, Leahy L, Berman I, Posever T, Herz L, Leon AC, Johnson SA, Lynch G. A placebo-controlled pilot study of the ampakine CX516 added to clozapine in schizophrenia. J Clin Psychopharmacol 2001 Oct;21(5):484-487.
  48. Kupchik M, Spivak B, Mester R, Reznik I, Gonen N, Weizman A, Kotler M. Combined electroconvulsive-clozapine therapy. Clin Neuropharmacol 2000 Jan-Feb;23(1):14-16.
  49. Masoudzadeh A, Khalilian AR. Comparative study of clozapine, electroshock and the combination of ECT with clozapine in treatment-resistant schizophrenic patients. Pak J Biol Sci 2007 Dec;10(23):4287-4290.
  50. Kho KH, Blansjaar BA, de Vries S, Babuskova D, Zwinderman AH, Linszen DH: Electroconvulsive therapy for the treatment of clozapine nonresponders suffering from schizophrenia: an open label study. Eur Arch Psychiatry Clin Neurosci 2004 Dec;254(6):372-379.
  51. Havaki-Kontaxaki BJ, Ferentinos PP, Kontaxakis VP, Paplos KG, Soldatos CR. Concurrent administration of clozapine and electro convulsive therapy in clozapine-resistant schizophrenia. Clin Neuropharmacol 2006 Jan-Feb;29(1):52-56.
  52. Petrides G, Malur C, Braga RJ, Bailine SH, Schooler NR, Malhotra AK, Kane JM, Sanghani S, Goldberg TE, John M, et al. Electroconvulsive therapy augmentation in clozapineresistant schizophrenia: a prospective, randomized study. Am J Psychiatry 2014 Dec;172(1):52-58.
  53. Tharyan P, Adams CE. Electroconvulsive therapy for schizophrenia. Cochrane Database Syst Rev 2005 Apr;2:CD000076.
  54. Kales HC, Dequardo JR, Tandon R. Combined electroconvulsive therapy and clozapine in treatment-resistant schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 1999 Apr;23(3):547-556.
  55. Rosa MO, Gattaz WF, Rosa MA, Rumi DO, Tavares H, Myczkowski M, Sartorelli MC, Rigonatti SP, Elkis H, Cabral SB, et al. Effects of repetitive transcranial magnetic stimulation on auditory hallucinations refractory to clozapine. J Clin Psychiatry 2007 Oct;68(10):1528-1532.
  56. Slotema CW, Blom JD, van Lutterveld R, Hoek HW, Sommer IE. Review of the efficacy of transcranial magnetic stimulation for auditory verbal hallucinations. Biol Psychiatry 2014 Jul;76(2):101-110.
  57. de Jesus DR, Gil A, Barbosa L, Lobato MI, Magalhães PV, Favalli GP, Marcolin MA, Daskalakis ZJ, Belmonte-de-Abreu PS. A pilot double-blind sham-controlled trial of repetitive transcranial magnetic stimulation for patients with refractory schizophrenia treated with clozapine. Psychiatry Res 2011 Jul;188(2):203-207.
  58. Slotema CW, Blom JD, Hoek HW, Sommer IE. Should we expand the toolbox of psychiatric treatment methods to include Repetitive Transcranial Magnetic Stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders. J Clin Psychiatry 2010 Jul;71(7):873-884.
  59. Nitsche MA, Cohen LG, Wassermann EM, Priori A, Lang N, Antal A, Paulus W, Hummel F, Boggio PS, Fregni F, et al. Transcranial direct current stimulation: state of the art 2008. Brain Stimul 2008 Jul;1(3):206-223.
  60. Brunoni AR, Nitsche MA, Bolognini N, Bikson M, Wagner T, Merabet L, Edwards DJ, Valero-Cabre A, Rotenberg A, Pascual-Leone A, et al. Clinical research with transcranial direct current stimulation (tDCS): challenges and future directions. Brain Stimul 2012 Jul;5(3):175-195.
  61. Andrade C. Transcranial direct current stimulation for refractory auditory hallucinations in schizophrenia. J Clin Psychiatry 2013 Nov;74(11):e1054-e1058.
  62. Brunelin J, Mondino M, Gassab L, Haesebaert F, Gaha L, Suaud-Chagny MF, Saoud M, Mechri A, Poulet E. Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia. Am J Psychiatry 2012 Jul;169(7):719-724.
  63. Barretto EM, Kayo M, Avrichir BS, Sa AR, Camargo MD, Napolitano IC, Nery FG, Pinto JA Jr, Bannwart S, Scemes S, et al. A preliminary controlled trial of cognitive behavioral therapy in clozapine-resistant schizophrenia. J Nerv Ment Dis 2009 Nov;197(11):865-868.
  64. Bellucci DM, Glaberman K, Haslam N. Computer-assisted cognitive rehabilitation reduces negative symptoms in the severely mentally ill. Schizophr Res 2003 Feb;59(2-3): 225-232.
  65. Turkington D, Sensky T, Scott J, Barnes TR, Nur U, Siddle R, Hammond K, Samarasekara N, Kingdon D. A randomized controlled trial of cognitive-behavior therapy for persistent symptoms in schizophrenia: a five-year follow-up. Schizophr Res 2008 Jan;98(1-3):1-7.
  66. Wexler BE, Bell MD. Cognitive remediation and vocational rehabilitation for schizophrenia. Schizophr Bull 2005 Jan;31(4):931-941.
  67. Solanki RK, Singh P, Munshi D. Current perspectives in the treatment of resistant schizophrenia. Indian J Psychiatry 2009 Oct-Dec;51(4):254-260.
  68. Miyamoto S, Jarskog LF, Fleischhacker WW. New therapeutic approaches for treatment-resistant schizophrenia: a look to the future. J Psychiatr Res 2014 Nov;58:1-6.
  69. Bandelow B, Zohar J, Kasper S, Möller HJ. How to grade categories of evidence. World J Biol Psychiatry 2008 Oct;9(4): 242-247.
  70. Palomba S, Falbo A, Orio F (Jr), Manguso F, Russo T, Tolino A, Colao A, Dale B, Zullo F. A randomized controlled trial evaluating metformin pretreatment and coadministration in nonobese insulin-resistant women with polycystic ovary syndrome treated with controlled ovarian hyperstimulation plus timed intercourse or intrauterine insemination. Hum Reprod 2005 Jun 15 (Epub ahead of print).
  71. Stadtmauer LA, Toma SK, Riehl RM, Talbert LM. Metformin treatment of patients with polycystic ovary syndrome undergoing in vitro fertilization improves outcomes and is associated with modulation of the insulin-like growth factors. Fertil Steril 2001;75:505-09.
  72. Stadtmauer LA, Toma SK, Riehl RM, Talbert LM. Impact of metformin therapy on ovarian stimulation and outcome in ‘coasted’ patients with polycystic ovary syndrome undergoing in vitro fertilization. Reprod Biomed Online 2002;5:112-16.
  73. Glueck CJ, Phillips H, Cameron D, Sieve-Smith L, Wang P. Continuing metformin throughout pregnancy in women with polycystic ovary syndrome appears to safely reduce firsttrimester spontaneous abortion: A pilot study. Fertil Steril 2001;75:46-52.
  74. Kocak M, Caliskan E, Simsir C, Haberal A. Metformin therapy improves ovulatory rates, cervical scores, and pregnancy rates in clomiphene citrate-resistant women with polycystic ovary syndrome. Fertil Steril 2002;77:101-06.
  75. Cole PA, Robinson CH. Mechanism and inhibition of cytochrome P-450 aromatase. J Med Chem 1990;33:2933-42.
  76. Akhtar M, Njar VC, Wright JN. Mechanistic studies on aromatase and related C-C bond cleaving P-450 enzymes. J Steroid Biochem Mol Biol 1993;44:375-87.
  77. Palter SF, Tavares AB, Hourvitz A, Veldhuis JD, Adashi EY. Are estrogens of import to primate/human ovarian folliculogenesis? Endocr Rev 2001;22:389-424.
  78. Weil S, Vendola K, Zhou J, Bondy CA. Androgen and follicle stimulating hormone interactions in primate ovarian follicle development. J Clin Endocrinol Metab 1999;84:2951-56.
  79. Vendola KA, Zhou J, Adesanya OO, Weil SJ, Bondy CA. Androgens stimulate early stages of follicular growth in the primate ovary. J Clin Invest 1998;101:2622-29.
  80. Giudice LC. Insulin-like growth factors and ovarian follicular development. Endocr Rev 1992;13:641-69.
  81. Mitwally MF, Casper RF. Aromatase inhibitors for the treatment of infertility. Expert Opin Investig Drugs 2003;12:353-71.
  82. Mitwally MF, Biljan MM, Casper RF. Pregnancy outcome after the use of an aromatase inhibitor for ovarian stimulation. Am J Obstet Gynecol 2005;192:381-86.
  83. Mitwally MFM, Casper RF. The use of aromatase inhibitor for induction of ovulation in cases of clomiphene citrate failure. Curr Opin Obstet Gynecol 2002;14:255-63.
  84. Mitwally MF, Casper RF. Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril 2001;75:305-09.
  85. Sammour A, Bijan MM, Tan SL, Tulandi T. Prospective randomised trial comparing the effects of letrazole (LE) and clomiphene citrate (CC) on follicular development, endometrial thickness and pregnancy rate in patients undergoing superovulation prior to intrauterine insemination (IUI). Fertil Steril 2001;76(Suppl 1):S110.
  86. Mitwally MF, Casper RF. Single-dose administration of an aromatase inhibitor for ovarian stimulation. Fertil Steril 2005;83:229-31.
  87. Fisher SA, Reid RL, Van Vugt DA, Casper RF. A randomized double-blind comparison of the effects of clomiphene citrate and the aromatase inhibitor letrozole on ovulatory function in normal women. Fertil Steril 2002;78:280-85.
  88. Fatemi HM, Kalibianakis E, Tournaye H, Camus M, Van Steirteghem AC, Devroey P. Clomiphene citrate vs letrozole for ovarian stimulation: A pilot study. Reprod Biomed Online 2003;7:543-46.
  89. Hu Y, Cortvrindt R, Smitz J. Effects of aromatase inhibition on in vitro follicle and oocyte development analyzed by early preantral mouse follicle culture. Mol Reprod Dev 2002;61: 549-59.
  90. Shetty G, Krishnamurthy H, Krishnamurthy HN, Bhatnagar S, Moudgal NR. Effect of estrogen deprivation on the reproductive physiology of male and female primates. J Steroid Biochem Mol Biol 1997;61:157-66.
  91. Mitwally MF, Casper RF. Aromatase inhibition reduces gonadotrophin dose required for controlled ovarian stimulation in women with unexplained infertility. Hum Reprod 2003;18:1588-97.
  92. Mitwally MF, Casper RF. Aromatase inhibition improves ovarian response to follicle-stimulating hormone in poor responders. Fertil Steril 2002;77:776-80.
  93. Goswami SK, Das T, Chattopadhyay R, Sawhney V, Kumar J, Chaudhury K, Chakravarty BN, Kabir SN. A randomized single blind controlled trial of letrozole as a low-cost IVF protocol in women with poor ovarian response: A preliminary report. Hum Reprod 2004;19:2031-35.
  94. Newkirk KM, Chandler HL, Parent AE, et al. Ultraviolet radiation-induced corneal degeneration in 129 mice. Toxicol Pathol 2007;35:819-26.
  95. Pettenati MJ, Sweatt AJ, Lantz P, et al. The human cornea has a high incidence of acquired chromosome abnormalities. Hum Genet 1997;101:26-29.
  96. Snibson GR. Collagen cross-linking: A new treatment paradigm in corneal disease—a review. Clin Experiment Ophthalmol 2010;38:141-53.
  97. Spoerl E, Raiskup-Wolf F, Kuhlisch E, Pillunat LE. Cigarette smoking is negatively associated with keratoconus. J Refract Surg 2008;24:S737-40.
  98. Rabinowitz YS, Nesburn AB, McDonnell PJ. Videokeratography of the fellow eye in unilateral keratoconus. Ophthalmology 1993;100:181-86.
  99. Goodrich DW, Lee WH. The molecular genetics of retinoblastoma. Cancer Surv 1990;9:529-54.
  100. Moodaley LC, Woodward EG, Liu CS, Buckley RJ. Life expectancy in keratoconus. Br J Ophthalmol 1992;76:590-91.
  101. Honein MA, Dawson AL, Petersen EE, Jones AM, Lee EH, Yazdy MM, Ahmad N, Macdonald J, Evert N, Bingham A, et al. Birth defects among fetuses and infants of US women with evidence of possible Zika virus infection during pregnancy. JAMA 2017 Jan 3;317(1):59-68.
  102. Chervenak FA, Jeanty P, Cantraine F, Chitkara U, Venus I, Berkowitz RL, Hobbins JC. The diagnosis of fetal microcephaly. Am J Obstet Gynecol 1984 Jul 1;149(5):512-517.
  103. Papageorghiou AT, Thilaganathan B, Bilardo CM, Ngu A, Malinger G, Herrera M, Salomon LJ, Riley LE, Copel JA. ISUOG Interim Guidance on ultrasound for Zika virus infection in pregnancy: information for healthcare professionals. Ultrasound Obstet Gynecol 2016 Apr;47(4):530-532.
  104. Chibueze EC, Parsons AJ, Lopes KD, Yo T, Swa T, Nagata C, Horita N, Morisaki N, Balogun OO, Dagvadorj A, et al. Diagnostic accuracy of ultrasound scanning for prenatal microcephaly in the context of Zika virus infection: a systematic review and meta-analysis. Sci Rep 2017 May 23;7(1):2310.
  105. Cordeiro MT. Zika virus: laboratory diagnosis. In: Zika in focus. Springer International Publishing; 2017. pp. 59-62.
  106. Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, Kolenc M, Resman Rus K, Vesnaver Vipotnik T, Fabjan Vodušek V, et al. Zika virus associated with microcephaly. N Engl J Med 2016 Mar 10;374(10):951-958.
  107. Zare Mehrjardi M, Keshavarz E, Poretti A, Hazin AN. Neuroimaging findings of Zika virus infection: a review article. Jpn J Radiol 2016 Dec;34(12):765-770.
  108. Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis AM. Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Ultrasound Obstet Gynecol 2016 Jan;47(1):6-7.
  109. Araujo AQ, Silva MT, Araujo AP. Zika virus-associated neurological disorders: a review. Brain 2016;139(8):2122-2130.
  110. Brasil P, Pereira JP Jr, Moreira ME, Ribeiro Nogueira RM, Damasceno L, Wakimoto M, Rabello RS, Valderramos SG, Halai UA, Salles TS, et al. Zika virus infection in pregnant women in Rio de Janeiro. N Engl J Med 2016 Dec 15;375(24):2321-2334.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.