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Cell and Tissue Banking Sep 2014We developed a non-invasive device to quantify transparency (T), clear corneal diameter (CCD) excluding arcus senilis, and scleral rim diameter (SRD) of stored corneas....
We developed a non-invasive device to quantify transparency (T), clear corneal diameter (CCD) excluding arcus senilis, and scleral rim diameter (SRD) of stored corneas. The T value (expressed in % on a relative scale), based on the modulation transfer function principle, referred to the ratio of local contrasts of a special LED backlit chart measured with and without cornea. CCD and SRD (in mm) were automatically calculated by morphologic operations. Firstly, we assessed measurement reproducibility. We then determined the agreement of T and CCD values with 3-level scores given independently by three experts on 179 scientific corneas. Thirdly, an eye bank was equipped with the device, and 358 consecutive organ-cultured (OC) corneas were tested for donor- and storage- related factors possibly influencing T and CCD. Reproducibility of T, CCD and SRD measurements was high, with intraclass correlation coefficients of 0.982, 0.886, and 0.999 respectively. Capacity to discriminate the three levels of transparency and arcus senilis was good, with T of 20.0 (10.0-33.6), 38.3 (24.3-75.4) and 57.9 (33.9-90.0) % respectively for T deemed poor, average, and good (P < 0.001), and CCD of 9.8 (7.3-10.6), 10.5 (8.2-11.5), and 11.1 (9.9-12.0) mm respectively for arcus senilis deemed prominent, moderate or absent (P < 0.001). T was correlated with neither donor age nor endothelial cell density nor storage time, but slightly worsened during OC for corneas assessed twice. In conclusion, the device, which can be easily integrated in the facilities of an eye bank, provides reliable objective measurement of T, CCD, and SRD. This could be a useful tool for standardizing quality assessment of stored corneas and consequently optimizing their selection for penetrating, endothelial or anterior lamellar keratoplasty.
Topics: Arcus Senilis; Cornea; Corneal Transplantation; Endothelium, Corneal; Eye Banks; Humans; Organ Preservation; Reproducibility of Results; Tissue Donors
PubMed: 24306057
DOI: 10.1007/s10561-013-9414-9 -
Indian Journal of Ophthalmology Dec 2013We report the case of a 12-year-old male who developed corneal arcus and multiple skin lesions with a 10-year history of xanthomas. The lesions appeared over his...
We report the case of a 12-year-old male who developed corneal arcus and multiple skin lesions with a 10-year history of xanthomas. The lesions appeared over his fingers, hands, elbows, knees, buttocks and feet. Laboratory studies showed a total serum cholesterol level of 752.1 mg/dL; a triglyceride level of 96.6 mg/dL; a low-density lipoprotein cholesterol level of 661.3 mg/dL. Findings were consistent with homozygous familial hypercholesterolemia. To our knowledge, this is the first such case to be reported from China.
Topics: Arcus Senilis; Child; China; DNA; DNA Mutational Analysis; Diagnosis, Differential; Homozygote; Humans; Hyperlipoproteinemia Type II; LDL-Receptor Related Proteins; Male; Mutation; Xanthomatosis
PubMed: 24088637
DOI: 10.4103/0301-4738.118456 -
Indian Journal of Medical Sciences 2012Familial hypercholesterolemia is a single gene disorder. It has autosomal dominant pattern of inheritance. We report a 28-year-old man who presented with acute...
Familial hypercholesterolemia is a single gene disorder. It has autosomal dominant pattern of inheritance. We report a 28-year-old man who presented with acute myocardial infarction. He had xanthomas and an elevated serum low density lipoprotein cholesterol (LDL-C). His only sibling, 32-year-old brother have similar cutaneous lesions and lipid profile. His mother and maternal uncle died at a young age due to myocardial infarction. This report is to emphasize the need to clinically recognize xanthomas and its familial inheritance with elevated LDL-C, premature atherosclerosis. Early diagnosis and early initiation of treatment will save the affected individual and the other family members.
Topics: Adult; Arcus Senilis; Cholesterol, LDL; Humans; Hyperlipoproteinemia Type II; Male; Myocardial Infarction; Skin Diseases; Xanthomatosis
PubMed: 23603625
DOI: No ID Found -
Ophthalmology May 2012To report the first described cases of peripheral yellow corneal rings secondary to vitamin supplementation for age-related macular degeneration (ARMD).
PURPOSE
To report the first described cases of peripheral yellow corneal rings secondary to vitamin supplementation for age-related macular degeneration (ARMD).
DESIGN
Retrospective single-center case series.
PARTICIPANTS
The eyes of 4 patients taking vitamin supplementation for ARMD were examined at the University of Pittsburgh Medical Center Department of Ophthalmology between January 2010 and April 2011.
METHODS
We reviewed the medical records of 4 patients with peripheral corneal rings receiving vitamin supplementation for ARMD.
MAIN OUTCOME MEASURES
The presence of peripheral yellow corneal rings, skin findings, and serum carotene levels.
RESULTS
Each patient had circumferential, yellow, peripheral corneal rings and exhibited subtle yellowing of the skin most notable on the palms. Serum carotene levels were normal in 2 of the 3 patients and markedly elevated in the last patient in whom it was measured.
CONCLUSIONS
It is unclear at this time how to counsel patients with this ocular finding. We suspect that these rings are more common than generally appreciated because they may have a subtle appearance or be misdiagnosed as arcus senilis. We suggest that a formal study be performed on a cohort of patients taking vitamin supplementation for macular degeneration that specifically screens for yellow rings and measures serum carotene levels when they are identified.
Topics: Aged; Aged, 80 and over; Clinical Trials as Topic; Corneal Diseases; Corneal Stroma; Dietary Supplements; Female; Humans; Intraocular Pressure; Limbus Corneae; Macular Degeneration; Retrospective Studies; Visual Acuity; Vitamins; beta Carotene
PubMed: 22330962
DOI: 10.1016/j.ophtha.2011.10.032 -
International Ophthalmology Dec 2011Cornea plana is a rare disease in which the cornea is flattened with a low refractive power. In addition to these features, hypermetropia, deep central corneal...
Cornea plana is a rare disease in which the cornea is flattened with a low refractive power. In addition to these features, hypermetropia, deep central corneal opacities, hazy corneal limbus, peripheral scleralization of the cornea and early arcus senilis can also be seen. Closed-angle glaucoma may occur as a result of shallow anterior chamber and narrow angle; however, open-angle glaucoma has also been reported in these patients. Measuring the real intraocular pressure (IOP) value of such eyes is difficult since tonometers are affected by corneal curvature. Therefore, the diagnosis of glaucoma may be delayed for a long time. In this case report we aimed to present a case of cornea plana with early open-angle glaucoma and to investigate which tonometer was appropriate for measuring the correct IOP value in such eyes.
Topics: Adolescent; Corneal Diseases; Delayed Diagnosis; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Refractive Errors; Tonometry, Ocular
PubMed: 22160991
DOI: 10.1007/s10792-011-9490-4 -
Investigative Ophthalmology & Visual... Dec 2011To investigate the prevalence of corneal arcus and its associations.
PURPOSE
To investigate the prevalence of corneal arcus and its associations.
METHODS
The Central India Eye and Medical Study was a population-based study performed in rural Central India on 4711 subjects (age, 30+ years). Corneal arcus was assessed in corneal photographs.
RESULTS
The study included 952 randomly selected participants. Mean body mass index (BMI) was 19.8 ± 3.6 kg/m(2), with 786 (41.3%) subjects being underweight (BMI < 18.5 kg/m(2)). Corneal arcus of any degree was detected in 102 (10.7% ± 1.0%; 95% CI, 8.8-12.7) subjects. Corneal arcus was significantly associated with increasing age (P < 0.001). It was not significantly (all P > 0.10) associated with serum concentrations of high-density lipoproteins, cholesterol, creatinine, glucose, and glycosylated hemoglobin; with prevalence of arterial hypertension and diabetes mellitus; with body height, weight, and BMI; or with level of education, daily activities, nutrition, alcohol consumption, smoking, and blood pressure. In an intereye comparison, corneal arcus was significantly more marked in the eye with lower intraocular pressure (P = 0.006), thinner central cornea (P = 0.005), and more hyperopic refractive error (P = 0.003).
CONCLUSIONS
In this adult rural Central Indian population with low mean BMI, the prevalence of corneal arcus was 10.7% ± 1.0%. The only systemic parameter associated with corneal arcus was increasing age (P < 0.001). Corneal arcus was not associated with dyslipidemia, diabetes mellitus, arterial hypertension, alcohol consumption, or smoking. In this population with low BMI, corneal arcus was not a clinical biomarker for major metabolic disorders. The intereye associations between corneal arcus and low intraocular pressure, thin central cornea, and hyperopia may be of importance in the ophthalmic examination.
Topics: Adult; Aged; Aged, 80 and over; Aging; Arcus Senilis; Blood Glucose; Body Mass Index; Cholesterol; Creatinine; Female; Humans; Hypertension; India; Intraocular Pressure; Male; Middle Aged; Photography; Prevalence; Risk Factors; Rural Population
PubMed: 22110074
DOI: 10.1167/iovs.11-8404 -
BMJ (Clinical Research Ed.) Sep 2011To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population.
OBJECTIVE
To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population.
DESIGN
Prospective population based cohort study.
SETTING
The Copenhagen City Heart Study.
PARTICIPANTS
12,745 people aged 20-93 years free of ischaemic vascular disease at baseline and followed from 1976-8 until May 2009 with 100% complete follow-up.
MAIN OUTCOME MEASURES
Hazard ratios for myocardial infarction, ischaemic heart disease, ischaemic stroke, ischaemic cerebrovascular disease, and death; odds ratios for severe atherosclerosis.
RESULTS
563 (4.4%) of participants had xanthelasmata and 3159 (24.8%) had arcus corneae at baseline. During 33 years' follow-up (mean 22 years), 1872 developed myocardial infarction, 3699 developed ischaemic heart disease, 1498 developed ischaemic stroke, 1815 developed ischaemic cerebrovascular disease, and 8507 died. Multifactorially adjusted hazard/odds ratios for people with versus those without xanthelasmata were 1.48 (95% confidence interval 1.23 to 1.79) for myocardial infarction, 1.39 (1.20 to 1.60) for ischaemic heart disease, 0.94 (0.73 to 1.21) for ischaemic stroke, 0.91 (0.72 to 1.15) for ischaemic cerebrovascular disease, 1.69 (1.03 to 2.79) for severe atherosclerosis, and 1.14 (1.04 to 1.26) for death. The corresponding hazard/odds ratios for people with versus those without arcus corneae were non-significant. In people with versus those without both xanthelasmata and arcus corneae, hazard/odds ratios were 1.47 (1.09 to 1.99) for myocardial infarction, 1.56 (1.25 to 1.94) for ischaemic heart disease, 0.87 (0.57 to 1.31) for ischaemic stroke, 0.86 (0.58 to 1.26) for ischaemic cerebrovascular disease, 2.75 (0.75 to 10.1) for severe atherosclerosis, and 1.09 (0.93 to 1.28) for death. In all age groups in both women and men, absolute 10 year risk of myocardial infarction, ischaemic heart disease, and death increased in the presence of xanthelasmata. The highest absolute 10 year risks of ischaemic heart disease of 53% and 41% were found in men aged 70-79 years with and without xanthelasmata. Corresponding values in women were 35% and 27%.
CONCLUSION
Xanthelasmata predict risk of myocardial infarction, ischaemic heart disease, severe atherosclerosis, and death in the general population, independently of well known cardiovascular risk factors, including plasma cholesterol and triglyceride concentrations. In contrast, arcus corneae is not an important independent predictor of risk.
Topics: Adult; Aged; Arcus Senilis; Atherosclerosis; Body Mass Index; Brain Ischemia; Chi-Square Distribution; Confidence Intervals; Denmark; Eye Diseases; Female; Humans; Kaplan-Meier Estimate; Lipids; Male; Middle Aged; Myocardial Infarction; Myocardial Ischemia; Proportional Hazards Models; Prospective Studies; Risk Factors; Sex Factors; Statistics, Nonparametric; Xanthomatosis
PubMed: 21920887
DOI: 10.1136/bmj.d5497 -
BMJ (Clinical Research Ed.) Sep 2011
Topics: Arcus Senilis; Brain Ischemia; Eye Diseases; Female; Humans; Male; Myocardial Ischemia; Xanthomatosis
PubMed: 21920886
DOI: 10.1136/bmj.d5304 -
American Journal of Ophthalmology Nov 2011To examine the association of corneal arcus to cardiovascular disease (CVD) in an adult, ethnic Indian population.
PURPOSE
To examine the association of corneal arcus to cardiovascular disease (CVD) in an adult, ethnic Indian population.
DESIGN
Population-based cross-sectional study.
METHODS
Population-based study of ethnic South Asian Indians 40 to 80 years of age in Singapore from June 2007 through March 2009. We obtained a 75.5% response rate (3397/4497). All participants underwent standardized interview and systemic and ocular examinations, followed by nonfasting blood sampling. Corneal arcus was detected using a standardized slit-lamp examination. The main outcome measure was CVD, defined from a self-reported history of previous myocardial infarction, angina, or stroke.
RESULTS
Corneal arcus, found in 1701 (50.1%) of 3397 participants, was associated with older age (odds ratio [OR], 3.07; 95% CI, 2.78 to 3.40; P < .001), male gender (OR, 2.17; 95% CI, 1.81 to 2.62; P < .001), higher levels of total cholesterol (OR, 1.14; 95% CI, 1.05 to 1.24; P = .002), hypertension (OR, 1.14; 95% CI, 1.05 to 1.24; P = .013), and cigarette smoking (OR, 1.59; 95% CI, 1.25 to 2.03; P < .001). Corneal arcus was associated with CVD (OR, 1.31; 95% CI, 1.02 to 1.7; P = .0038) independent of the above-named cardiovascular risk factors. Participants with low-risk Framingham scores were more likely to be associated with CVD if they had corneal arcus (men: OR, 2.02; 95% CI, 1.20 to 3.40; P = .008; women: OR, 2.78; 95% CI, 1.36 to 3.01; P < .001). Corneal arcus was associated with CVD independent of the Framingham score (men: Akaike information criterion, 1524.39 for Framingham Score and corneal arcus vs 1527.38 for Framingham Score alone; women: 1000.14 vs 1003.54, respectively).
CONCLUSIONS
Corneal arcus is associated with CVD, independent of risk factors in ethnic Indian adults, even in those at low risk for vascular disease.
Topics: Arcus Senilis; Asian People; Blood Glucose; Blood Pressure; Cardiovascular Diseases; Cholesterol; Cross-Sectional Studies; Female; Glycated Hemoglobin; Humans; India; Male; Prevalence; Risk Factors; Singapore; Surveys and Questionnaires
PubMed: 21742308
DOI: 10.1016/j.ajo.2011.04.014 -
Archives of Ophthalmology (Chicago,... Nov 2010To examine the association of corneal arcus with central corneal thickness (CCT), intraocular pressure (IOP), and the prevalence of primary open-angle glaucoma.
OBJECTIVES
To examine the association of corneal arcus with central corneal thickness (CCT), intraocular pressure (IOP), and the prevalence of primary open-angle glaucoma.
METHODS
This was a population-based cross-sectional study of Malay participants aged 40 to 80 years living in Singapore. Participants underwent a standardized interview and systemic and ocular examinations, including CCT, IOP, and corneal curvature radius measurements. Corneal arcus, assessed using a slitlamp, was defined as gray-white or yellow opacity located near the periphery of the cornea but separated from the limbus by a clear zone.
RESULTS
Corneal arcus was found in right eyes among 1747 (57.9%) of 3015 participants. After adjusting for age, sex, and systemic factors, IOP was higher (15.87 vs 14.86 mm Hg, P < .001) and CCT was thinner (540.6 vs 543.4 μm, P = .03) in eyes with vs without corneal arcus. In multiple linear regression models, eyes with corneal arcus had on average 1.14 mm Hg higher IOP than eyes without corneal arcus. In the presence of corneal arcus, the linear correlations of CCT × IOP and of corneal curvature radius × IOP were altered. The prevalence of ocular hypertension, but not primary open-angle glaucoma, was significantly higher among participants with corneal arcus than among participants without corneal arcus (P = .02).
CONCLUSIONS
Corneal arcus was associated with higher IOP and lower CCT independent of age, sex, and systemic and ocular factors. Further research is required to investigate the clinical implications of these findings for IOP assessment in eyes with corneal arcus.
Topics: Adult; Aged; Aged, 80 and over; Arcus Senilis; Asian People; Cornea; Cross-Sectional Studies; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Prevalence; Singapore; Tonometry, Ocular; Visual Fields
PubMed: 21060048
DOI: 10.1001/archophthalmol.2010.252