Amphotericin B, 5-flucytosine (5-FC), and ketoconazole levels were estimated in vitreous and aqueous samples taken from four patients undergoing therapeutic vitrectomy for fungal endophthalmitis. The levels of amphotericin B in the vitreous of three patients were low (.04 - .17 microgram/ml). However, 5-FC was present in a concentration of 22.2 micrograms/ml in one patient. In another case the aqueous level of ketoconazole was 0.35 microgram/ml. The vitreous in the same patient contained 0.71 microgram/ml of the drug.

T he normally functioning mitral valve (MV) is complex; the saddle shape of the mitral annulus has been shown to influence leaflet deformation and to reduce stress on the valve leaflets. [1][2][3][4][5][6] The leaflets tissue properties and morphology are important as well. Myxomatous degeneration is the most common pathology in patients with mitral regurgitation (MR). 7 These organic MVs are characterized by alterations in collagen and cellular composition leading to thick and excess leaflet tissue, flattened and enlarged mitral annulus, and weak chordae. Consequently, leaflets may prolapse or flail, resulting in significant MR. MV deformation during the cardiac cycle can be variable within various regions of the normal MV and in valve disease states. The majority of previous studies evaluating MV strain were based on animal models, whereby crystals attached to the mitral apparatus and imaged with 3-dimensional (3D) cameras provided strain measurements. 1,2,[8][9][10][11][12][13] With recent technical advances in 3D echocardiography, dynamic volumetric imaging and tracking of the MV apparatus can now be performed in real time and enable direct computerized study of MV motion and deformation in humans, without the need for invasive instrumentation. The aim of the present study was, first, to quantitate patient-specific global and regional dynamic deformations of the MV apparatus in a normal patient population and, second, to evaluate whether patients with organic MR have significant alterations in the intensity of global strain and its regional distribution. See Editorial by WatanabeSee Clinical Perspective Methods Patient PopulationThe patient population was prospectively enrolled and included individuals with a normal heart by echocardiography who underwent a transesophageal echocardiogram for clinical reasons suchBackground-A paucity of data exists on mitral valve (MV) deformation during the cardiac cycle in man. Real-time 3-dimensional (3D) echocardiography now allows dynamic volumetric imaging of the MV, thus enabling computerized modeling of MV function directly in health and disease. Methods and Results-MV imaging using 3D transesophageal echocardiography was performed in 10 normal subjects and 10 patients with moderate-to-severe or severe organic mitral regurgitation. Using proprietary 3D software, patientspecific models of the mitral annulus and leaflets were computed at mid-and end-systole. Strain analysis of leaflet deformation was derived from these models. In normals, mean strain intensity averaged 0.11±0.02 and was higher in the posterior leaflet than in the anterior leaflet (0.13±0.03 versus 0.10±0.02; P<0.05). Mean strain intensity was higher in patients with mitral regurgitation (0.15±0.03) than in normals (0.11±0.02; P=0.05). Higher mean strain intensity was noted for the posterior leaflet in both normal and organic valves. Regional valve analysis revealed that both anterior and posterior leaflets have the highest strain concentration in the commissural zone, and the boundary zone near the annu...