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Annals of Medicine and Surgery (2012) Nov 2023Systemic sclerosis is a connective tissue condition presented with clinical manifestations, including ocular involvement in a small percentage. A few cases of uveitis...
INTRODUCTION
Systemic sclerosis is a connective tissue condition presented with clinical manifestations, including ocular involvement in a small percentage. A few cases of uveitis were described in the literature, especially in CREST syndrome.
CASE PRESENTATION
The authors reported a case of a 48-year-old male with a blurred vision in his left eye that diagnosed with recurrent uveitis in the setting of CREST syndrome, treated with prednisolone, methotrexate, and golimumab, with improvement.
DISCUSSION
Ocular manifestations of systemic sclerosis include palpebral alterations, keratoconjunctivitis, sicca syndrome, cataracts, pinguecula, and blepharitis. To our knowledge, this is the fifth case of uveitis in a setting of CREST syndrome in the literature, and the first one in sex involvement, as the previous cases were females, and in its treatment by golimumab, an anti-tumor necrosis factor inhibitor.
CONCLUSION
Although this association is low, we believe that it should be taken into consideration when treating these situations to obtain better treatment results. Collaboration between rheumatologists and ophthalmologists is necessary in deciding on treatment.
PubMed: 37915625
DOI: 10.1097/MS9.0000000000001282 -
International Medical Case Reports... 2017To describe an unusual case of unilateral, chronic symptoms and signs of dry eye, and recurrent episodes of ocular irritation related to pinguecula, which were...
PURPOSE
To describe an unusual case of unilateral, chronic symptoms and signs of dry eye, and recurrent episodes of ocular irritation related to pinguecula, which were refractory to prior medical treatments, successfully treated with argon laser photocoagulation.
METHODS
A 36-year-old man presented with an elevated yellowish mass on his conjunctiva in his left eye, which was associated with dry eye symptoms and general discomfort, such as "tightening sensation" and "stiffness". On clinical assessment, the left eye revealed a mild conjunctival injection, a fluorescein break-up time (FBUT) of 3.5 s, an abnormal fluorescein staining, and a Schirmer test of 5 mm. Optical coherence tomography (OCT) imaging evidenced a height at the most elevated point of the pinguecula of 740 µm. The patient underwent argon-laser photocoagulation.
RESULTS
After 2 weeks postoperatively, no residual of pinguecula or focal injection of the conjunctiva was detected by slit-lamp biomicroscopy and there was a significant improvement of clinical symptoms and signs: Schirmer test and FBUT increased to 12 mm and >10 s, respectively, and fluorescein staining was absent. OCT imaging revealed a smooth structure of conjunctival contour, with a height of 404 µm. According to an ex juvantibus line of reasoning, definitive diagnosis was pinguecula-related dry eye disease.
CONCLUSION
Based on the concept that tear film instability and inflammation are two key components of the pathogenesis of dry eye, we coined the term "pinguecula-related dry eye disease," which can be successfully treated by a complete, accurate removal of the lesion with argon laser photocoagulation.
PubMed: 28769593
DOI: 10.2147/IMCRJ.S138786 -
The Ocular Surface Jul 2015To evaluate the use of a commercially available, high-resolution, spectral-domain optical coherence tomography (HR-OCT) device in the diagnosis of corneal and... (Review)
Review
PURPOSE
To evaluate the use of a commercially available, high-resolution, spectral-domain optical coherence tomography (HR-OCT) device in the diagnosis of corneal and conjunctival pathologies, with a focus on malignant lesions.
METHODS
Eighty-two eyes of 71 patients were enrolled in this prospective case series, including 10 normal eyes, 21 with ocular surface squamous neoplasia (OSSN), 24 with a pterygium or pingueculum, 3 with lymphoma, 18 with pigmented conjunctival lesions (nevus, flat melanosis, or melanoma), and 6 with Salzmann nodular degeneration. Subjects were imaged using photography and HR-OCT (RTVue, Optovue, Fremont, CA). When clinically indicated, surgery was performed and histopathologic specimens were correlated with OCT images.
RESULTS
HR-OCT was useful in differentiating among various lesions based on optical signs. Specifically, in OSSN, HR-OCT findings included epithelial thickening and hyper-reflectivity, whereas pterygia and pinguecula showed a subepithelial mass under thinner epithelium. In lymphoma, a hypo-reflective, homogenous subepithelial mass was observed. Differentiating between pigmented lesions with HR-OCT was more difficult, but certain characteristics could be identified. Eyes with nevi and melanoma both displayed intensely hyper-reflective basal epithelial layers and discrete subepithelial lesions, but could be differentiated by the presence of cysts in nevi and intense shadowing of sublesional tissue in most melanomas.
CONCLUSION
We found that a commercially available HR-OCT was a useful noninvasive adjunctive tool in the diagnosis of ocular surface lesions.
Topics: Conjunctiva; Conjunctival Diseases; Cornea; Corneal Diseases; Humans; Image Processing, Computer-Assisted; Tomography, Optical Coherence
PubMed: 26045235
DOI: 10.1016/j.jtos.2015.02.001 -
Transplantation Proceedings Sep 2017The aim of the study was to perform complete ophthalmic examinations in patients after renal transplantation to determine ocular alterations and condition of the eyes....
The aim of the study was to perform complete ophthalmic examinations in patients after renal transplantation to determine ocular alterations and condition of the eyes. Moreover, ophthalmic findings were correlated with certain clinical characteristics related to transplantation such as post-operative renal functions and immunosuppressive regimen. The study was performed on 84 eyes of 42 patients who had received a renal transplant at least 6 months earlier. All patients underwent a complete ophthalmologic examination. In addition, in 33 (78.6%) patients peripapillary retinal nerve fiber layer (RNFL) thickness was determined using optical coherence tomography (Stratus OCT, Zeiss, Germany), which is a unique finding among renal transplantation patients. Recipients received immunosuppressive therapy consisting of tacrolimus, mycophenolate mofetil, and corticosteroid. Of 42 patients, 19 (45%) were women and 23 (55%) were men. The age of the patients ranged from 26 to 74 years, the mean age was 53.4 years. At least one ocular abnormality could be detected in 37 patients (88%), including impaired visual acuity (n = 31, 74%), keratoconjunctivitis sicca (n = 6, 14.3%), pinguecula (n = 3, 7.1%), arcus lipoides (n = 1, 2.4%), cataracts (n = 24, 57.1%), glaucoma (n = 2, 5%), retinal drusen (n = 6, 14.3%), and hypertensive or atherosclerotic retinopathy (n = 22, 52.4%). Twenty-five patients (75.8%) have reduced RNFL thickness. Cataract formation was positively correlated with age and usage of methylprednisolone. Moreover, RNFL thickness loss was correlated with transplantation duration and postoperative infections. Our study suggests that ocular disorders are frequent among renal transplantation patients. Besides immunosuppression and postoperative infection, aging is a high-risk factor in such cases.
Topics: Adult; Aged; Cross-Sectional Studies; Eye Diseases; Female; Humans; Immunosuppression Therapy; Kidney Transplantation; Male; Middle Aged; Nerve Fibers; Optic Nerve; Postoperative Complications; Retina; Tomography, Optical Coherence
PubMed: 28838433
DOI: 10.1016/j.transproceed.2017.06.016 -
Scientific Reports Dec 2021Recently, it has been recommended that population-based studies report not only frequencies of vision impairment and blindness but also any ocular abnormalities that...
Recently, it has been recommended that population-based studies report not only frequencies of vision impairment and blindness but also any ocular abnormalities that might lead an individual to seek for eyecare services. The current study aimed to determine prevalence of ocular findings regardless of visual acuity (VA) status in older adults from the Brazilian Amazon Region. Disturbances were grouped into: Eyelids; Anterior Segment; Posterior Segment; Increased intraocular pressure; and Overall Globe. The presence of an ocular finding was considered positive when any abnormality was noted, regardless of VA. Refractive errors were not considered. A total 2384 eligible persons were enumerated and 2041 (85.6%) examined. The prevalence of ocular disturbances in either eye was 87.0% and was associated with male gender, older age, lower education, and rural residence. Overall, main findings were pterygium, cataract, and pinguecula, occurring in 58.8%, 45.4% and 17.4%, respectively. Among individuals with 20/20 VA in both eyes, the most frequent findings were pterygium, pinguecula, and glaucoma cupping, occurring in 47.4%, 31.2% and 6.5%, respectively. The high prevalence of ocular findings observed in this population reinforces that different conditions might not immediately decrease VA but can indicate risk and/or discomfort symptoms and should be considered when planning public health ophthalmic services.
Topics: Age Factors; Aged; Aged, 80 and over; Brazil; Eye Diseases; Female; Geriatric Assessment; Humans; Male; Middle Aged; Population Surveillance; Prevalence; Risk Factors; Visual Acuity
PubMed: 34887482
DOI: 10.1038/s41598-021-03172-4 -
Contact Lens & Anterior Eye : the... Aug 2017To estimate the prevalence of Meibomian gland dysfunction (MGD) and determine the associated factors in the general population in Iran.
PURPOSE
To estimate the prevalence of Meibomian gland dysfunction (MGD) and determine the associated factors in the general population in Iran.
METHODS
This cross-sectional study is based on the data from the second phase of the Shahroud Eye Cohort Study conducted in 2014. Of the 4737 participants of the second phase, data was available for 4700 people; their mean age was 55.9±6.2 years and 2768 (58.9%) were women. Diagnosis of MGD was made based on the classification of the International Workshop on MGD as judged by the examining ophthalmologist. The prevalence of MGD was summarized as percentage and 95% confidence intervals (CI), and related factors were studied through simple and multiple logistic regressions.
RESULTS
The diagnosis of MGD in at least one eye was recorded for 1235 (26.3%) participants; the prevalence of unilateral and bilateral MGD was 26.3% (95% CI: 24.5-28.1) and 26.1% (95% CI: 24.3-27.9), respectively. In the multiple logistic regression analyses, MGD significantly correlated with pinguecula [odds ratio (OR)=1.3, 95% CI: 1.12-1.50], hypertension (OR=1.34, 95% CI: 1.11-1.61), high-density lipoprotein (HDL) level (OR=0.0992, 95% CI: 0.986-0.999), diabetes mellitus (OR=0.83, 95% CI: 0.71-0.97), and years of education (OR=0.98, 95% CI: 0.96-0.99).
CONCLUSIONS
MGD prevalence in this study was lower than the rates reported in other studies on Asian populations. Besides HDL level, MGD is associated with another ocular surface disorder, namely pinguecula, as well as certain systemic diseases such as hypertension and diabetes mellitus. These associations should be taken into consideration when diagnosing MGD.
Topics: Adult; Age Distribution; Aged; Cross-Sectional Studies; Eyelid Diseases; Female; Humans; Iran; Male; Meibomian Glands; Middle Aged; Ophthalmoscopy; Population Surveillance; Prevalence; Retrospective Studies; Sex Distribution; Tears
PubMed: 28501443
DOI: 10.1016/j.clae.2017.05.003 -
Indian Journal of Dermatology,... 2018Psoriasis is a common disorder worldwide. The prevalence of psoriasis in Egypt, an African country with a Caucasian population, ranges 0.19-3%. Despite this relatively...
BACKGROUND
Psoriasis is a common disorder worldwide. The prevalence of psoriasis in Egypt, an African country with a Caucasian population, ranges 0.19-3%. Despite this relatively high prevalence of psoriasis, there are no epidemiologic data regarding the burden of associated eye affection. Determining the magnitude of the problem could help in offering better integrated health services.
AIM
The purpose of this study was to evaluate eye involvement in a sample of Egyptian psoriatic patients.
PATIENTS AND METHODS
This case-control study included 100 patients with psoriasis and 100 age and sex matched healthy controls. Psoriasis extent and severity was graded by psoriasis area and severity index (PASI). Complete ophthalmological examination and tests for dry eye were performed to all subjects.
RESULTS
The mean age of the psoriasis group was 50.7 ± 14.3 years. Thirty eight percent of the cases were females. The mean duration of psoriasis was 10.1 ± 7.5 years. Psoriasis patients had more conjunctival injection (n = 40, P = 0.035), more pinguecula (n = 38, P = 0.048) than controls. Ocular surface disease index (OSDI), tear breakup time (TBUT), Schirmer I, and Rose Bengal staining showed statistically significant positive results in the psoriasis group.
CONCLUSION
This is the first report on the prevalence of eye comorbidities in Egyptian psoriatic patients. Dry eyes were more common with psoriasis, particularly the erythrodermic type. Other ocular findings were not statistically significantly different except for conjunctival injection and pinguecula.
Topics: Adult; Aged; Aged, 80 and over; Case-Control Studies; Dry Eye Syndromes; Egypt; Eye Diseases; Female; Humans; Male; Middle Aged; Prevalence; Psoriasis; Young Adult
PubMed: 29067934
DOI: 10.4103/ijdvl.IJDVL_1239_15 -
Eye & Contact Lens Sep 2018To determine the prevalence of conjunctivochalasis and its determinants in a middle-aged Iranian population.
OBJECTIVES
To determine the prevalence of conjunctivochalasis and its determinants in a middle-aged Iranian population.
METHODS
This population-based study was conducted in the context of the second phase of Shahroud Eye Cohort Study in 2014. Of 4,737 participants aged 45 to 69 years who participated in the second phase, the data of 4,702 participants were available for this report. A diagnosis of conjunctivochalasis was made based on the physician's judgment on ophthalmic examinations.
RESULTS
Diagnosis of conjunctivochalasis in at least one eye was confirmed in 295 (6.2%) participants. The prevalence of unilateral and bilateral conjunctivochalasis was 0.7% and 5.5%, respectively. Older age (odds ratio [OR] = 1.96, 95% confidence interval [CI]: 1.22-3.15), use of Losartan (an angiotensin II receptor antagonist) (OR=1.47, 95% CI: 1.05-2.08), Meibomian Gland Dysfunction (OR=2.32, 95% CI: 1.78-3.03), Pinguecula (OR=0.57, 95% CI: 0.42-0.77), and blepharitis (OR=0.24, 95% CI: 0.07-0.77) had a significant association with conjunctivochalasis.
CONCLUSION
The prevalence of conjunctivochalasis in our study was less than other reports from Asian population. Conjunctivochalasis has a significant association with some eyelid disorders and the use of Losartan which should be noted when diagnosing and treating this disease.
Topics: Adult; Age Distribution; Conjunctival Diseases; Eyelid Diseases; Female; Humans; Incidence; Iran; Male; Middle Aged; Population Surveillance; Prevalence; Prognosis; Risk Assessment; Risk Factors; Sex Distribution
PubMed: 28346280
DOI: 10.1097/ICL.0000000000000379 -
South African Medical Journal =... Oct 2023The pattern of HIV-associated eye disease has changed with ongoing advancements in highly active antiretroviral therapy (HAART). HIV-infected individuals now live...
BACKGROUND
The pattern of HIV-associated eye disease has changed with ongoing advancements in highly active antiretroviral therapy (HAART). HIV-infected individuals now live longer, enabling us to observe the long-term effects of HIV and HAART on the eye. There are few recent studies on HIV-related ocular disease in sub-Saharan Africa.
OBJECTIVES
To describe the ocular manifestations of HIV in patients attending the Nthabiseng HIV clinic at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
METHODS
A cross-sectional study was conducted in 2021 and 2022 using convenience sampling of patients at the HIV clinic. The participants' clinical history was taken, their files were reviewed, and they underwent ocular examination. Correlation between eyes was managed by taking disease in one eye as the presence of disease in the participant. Descriptive statistics were used to summarise participant characteristics. Univariate and multivariate logistic regression models were used to assess the odds ratio (OR) of developing HIV-associated ocular diseases, and a p-value of <0.05 was used to define statistical significance.
RESULTS
There were 182 participants (139 females and 43 males), with a mean (standard deviation) age of 48.9 (10.6) years. The most common anterior segment diagnoses were conjunctival microangiopathy (34.6%), pinguecula (31.3%) and cataracts (30.2%), while the most common posterior segment finding was peripheral retinal scarring with features in keeping of previous cytomegalovirus retinitis (24.2%). Notably, only 1.1% of patients had HIV retinopathy. A CD4 count <200 cells/μL showed an increased OR for cataracts (OR 4.24; p=0.003) and any anterior segment diagnoses (OR 10.05; p=0.029), while a CD4 count ≥200 cells/μL showed an increased risk of conjunctival microangiopathy (OR 2.14; p=0.017).
CONCLUSION
With the advent of HAART, ocular manifestations of HIV are changing and the incidence of severe ocular opportunistic infections and HIV retinopathy has decreased precipitously. Although this study has shown that patients with a CD4 count <200 cells/μL are at increased risk of developing anterior ocular manifestations of HIV, including cataracts, these diseases are relatively innocuous or easily treatable. Routine ocular screening of HIV patients seems to be substantially less important now than it was in the pre-HAART era.
Topics: Male; Female; Humans; Middle Aged; HIV Infections; South Africa; Cross-Sectional Studies; Retinal Diseases; Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Vascular Diseases; Cataract; Hospitals
PubMed: 37881908
DOI: 10.7196/SAMJ.2023.v113i10.950 -
Vestnik Oftalmologii 2020The ageing of population is accompanied by an increase in the frequency of chronic diseases, including ophthalmic. The progression of ophthalmologic disturbances has...
UNLABELLED
The ageing of population is accompanied by an increase in the frequency of chronic diseases, including ophthalmic. The progression of ophthalmologic disturbances has population specificity and its analysis in Russian population is relevant.
PURPOSE
To study the prevalence and age- and gender-related gradient of ophthalmic diseases (cataract, glaucoma, age-related macular degeneration, diabetic and hypertensive retinopathy) in the Russian population older than 50 years.
MATERIAL AND METHODS
A random population cohort (9360, aged 45-69 years) was examined in Novosibirsk in 2003/05 and re-examined in 2015/17 (the HAPIEE project). Ophthalmological parameters were studied in a random subsample (324 m/f, aged 55-84, 2015/17). Clinical and instrumental methods were applied to assess eye diseases: cataract, glaucoma, age-related macular degeneration (AMD), diabetic retinopathy (DR), hypertensive retinopathy (HR) and other ophthalmic diseases.
RESULTS
In the studied sample of men and women aged 55-84 years, the prevalence of cataract was 72.8%, AMD - 25.7%, glaucoma - 6.2%, DR - 2.1%, HR - 79.6%. The prevalence of other ophthalmic diseases (myopia, hyperopia, astigmatism, pterygium, pinguecula, dystrophy of cornea and retina, tumors and inflammatory diseases) was 13.5%. The frequency of cataract (<0.001) and AMD (=0.003) significantly increased with age. The frequency of glaucoma did not change substantially in the studied age range with insignificant increase in those older than 80 years (14.3%). The frequency of DR and HR were not consistently related to age.
CONCLUSIONS
In the studied population sample of men and women aged 55-84 years (Novosibirsk), the prevalence of cataract and HR is high; the prevalence of AMD is similar to populations with moderate frequency of diseases; the frequency of glaucoma is close to populations with high prevalence of this disease. The frequency of cataract and AMD increased with age. There was no consistent age gradient of the frequency of glaucoma, DR and HR in the age range of 55-84 years.
Topics: Aged; Aged, 80 and over; Eye Diseases; Female; Humans; Male; Middle Aged; Prevalence; Russia
PubMed: 32504485
DOI: 10.17116/oftalma2020136031106