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Journal of Ophthalmology 2015Anterior segment optical coherence tomography (AS-OCT) was recently developed and has become a crucial tool in clinical practice. AS-OCT is a noncontact imaging device... (Review)
Review
Anterior segment optical coherence tomography (AS-OCT) was recently developed and has become a crucial tool in clinical practice. AS-OCT is a noncontact imaging device that provides the detailed structure of the anterior part of the eyes. In this review, the author will discuss the various clinical applications of AS-OCT, such as the normal findings, tear meniscus measurement, ocular surface disease (e.g., pterygium, pinguecula, and scleromalacia), architectural analysis after cataract surgery, post-LASIK keratectasia, Descemet's membrane detachment, evaluation of corneal graft after keratoplasty, corneal deposits (corneal dystrophies and corneal verticillata), keratitis, anterior segment tumors, and glaucoma evaluation (angle assessment, morphological analysis of the filtering bleb after trabeculectomy, or glaucoma drainage device implantation surgery). The author also presents some interesting cases demonstrated via AS-OCT.
PubMed: 25821589
DOI: 10.1155/2015/605729 -
Ophthalmic Epidemiology Apr 2015To determine the prevalence and associated factors of pinguecula in a rural Chinese population aged ≥ 50 years in Eastern China.
PURPOSE
To determine the prevalence and associated factors of pinguecula in a rural Chinese population aged ≥ 50 years in Eastern China.
METHODS
This cross-sectional, population-based survey included an age-stratified random sample of 1108 residents living in Lvxiang Town of Jinshan District. Participants were requested to complete a comprehensive questionnaire to collect demographic data, history of systemic diseases and lifestyle details. The presence of pinguecula on slit lamp examination was recorded. The prevalence of pinguecula and its associated factors were investigated by logistic regression models.
RESULTS
Among 1108 eligible subjects, 959 participated in the study, with an average age of 65.1 ± 9.2 years (range 50-89 years). The overall age-adjusted prevalence of pinguecula in this population was 75.57% (95% confidence interval 71.79-79.35%). Logistic regression analysis revealed that age (p = 0.002) and working outdoors (daily sunlight exposure ≥ 2 hours; p = 0.001) were independent risk factors for pinguecula. In addition, sex, education level, alcohol intake, smoking and decreased tear break-up time did not have associations with the development of pinguecula after adjusting for age and outdoor work occupations.
CONCLUSIONS
The prevalence of pinguecula was 75.57% in this Chinese population aged ≥ 50 years from a coastal rural area of Shanghai, Eastern China, which was higher than the majority of previous findings. Age and working outdoors were independent risk factors for pinguecula.
Topics: Age Distribution; Aged; Aged, 80 and over; Asian People; China; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Pinguecula; Prevalence; Risk Factors; Rural Population; Sex Distribution; Surveys and Questionnaires
PubMed: 25777313
DOI: 10.3109/09286586.2015.1012269 -
Journal Francais D'ophtalmologie Jan 2015An ophthalmology consultation was carried out at the Hôtel-Dieu to facilitate eye care in underprivileged patients referred by the general medicine PASS (socialized...
INTRODUCTION
An ophthalmology consultation was carried out at the Hôtel-Dieu to facilitate eye care in underprivileged patients referred by the general medicine PASS (socialized health care) of the same hospital.
MATERIALS AND METHODS
The files of 150 consecutive patients examined by a single ophthalmologist between January 2012 and June 2013 were reviewed. A standard examination was performed in these patients, sent with a consult sheet, to which a response was sent to PASS. As necessary, prescriptions were also written for the patients.
RESULTS
Most patients (89/150) were immigrants from sub-Saharan Africa. Additionally, there were 25 Europeans with only 5 French, and 17 Asians. The mean age was 41 years with 90 men (mean age 43) and 60 women (mean age 36). The most common systemic diseases observed were hypertension, (13), diabetes (6), and hepatitis (6). The mean best-corrected visual acuity (129 patients) was a slightly more than 8/10 (16/20) (measurable in 143 patients). Refractive state (measured in 129 patients) was myopia (46), hyperopia (41), presbyopia (isolated in 12 cases), astigmatism (26), and emmetropia (28). Optical correction was prescribed in 87 patients. The main pathological conditions included pingueculae (19), cataracts (19), trauma (13) of which 4 patients were monocular, and pterygia (9).
DISCUSSION AND CONCLUSION
Refractive errors were the main abnormality observed in these underprivileged patients. Apart from cataract as a pathologic condition observed in the general population, more characteristic of this sub-Saharan population were pinguecula, pterygium and trauma. This study highlights the more general question of access to eye care for all underprivileged patients.
Topics: Adolescent; Adult; Africa South of the Sahara; Aged; Aged, 80 and over; Cardiovascular Diseases; Catchment Area, Health; Chronic Disease; Communicable Diseases; Comorbidity; Diabetes Mellitus; Diagnosis-Related Groups; Emigrants and Immigrants; Europe; Eye Diseases; Female; General Practice; Humans; Male; Mental Disorders; Middle Aged; Nervous System Diseases; Paris; Poverty; Retrospective Studies; Urban Population; Vision Disorders; Vulnerable Populations; Young Adult
PubMed: 25577432
DOI: 10.1016/j.jfo.2014.07.009 -
International Journal of Ophthalmology 2014To investigate the relationship between pinguecula and the use of tandoor ovens.
AIM
To investigate the relationship between pinguecula and the use of tandoor ovens.
METHODS
A total of 539 women, ranging in age from 20 to 86y who attended an outpatient clinic were enrolled. All the patients were asked whether they used tandoor ovens. Women exposed to tandoor ovens (n=286) were accepted as participants in the study group and they were compared with participants in the control group (n=253). The age, presence of pinguecula, duration of exposure to tandoor ovens as years and occupations were recorded for all the subjects.
RESULTS
Mean duration for exposure to tandoor was 20.26y (range 1-62y) in the study group. The rate of pinguecula in the study group was 82.2% (235/286), and the rate in the control group was 37.5% (95/253); this difference was statistically significant (P<0.05). Pinguecula was seen in 61.2% (330/539) of all the participants.
CONCLUSION
Pinguecula is strongly associated with exposure to tandoor ovens.
PubMed: 25540757
DOI: 10.3980/j.issn.2222-3959.2014.06.19 -
American Journal of Ophthalmology Feb 2015To evaluate whether the handheld in vivo reflectance confocal microscopy that has been recently developed for the study of skin tumors is suitable for the diagnosis of... (Observational Study)
Observational Study
PURPOSE
To evaluate whether the handheld in vivo reflectance confocal microscopy that has been recently developed for the study of skin tumors is suitable for the diagnosis of conjunctival tumors.
DESIGN
Prospective study, observational case series.
METHODS
We prospectively evaluated the reflectance confocal microscopy features of 53 conjunctival lesions clinically suspicious for tumors of 46 patients referred to the University Hospital of Saint-Etienne (France) by using the handheld device. Twenty-three lesions were excised (3 nevi, 10 melanomas, 5 squamous cell carcinoma, 2 lymphomas, and 3 pinguecula/pterygium) while the other 30, presenting no reflectance confocal microscopy malignant features, were under follow-up for at least 1 year. Clinical reflectance confocal microscopy and histologic diagnosis were compared.
RESULTS
In vivo reflectance confocal microscopy diagnosis was in agreement with the histologic diagnosis in all cases and none of the lesions that were not excised show any clinical progression under follow-up.
CONCLUSION
In vivo reflectance confocal microscopy with a handheld dermatology-dedicated microscope can play a role in the noninvasive diagnosis of conjunctival lesions. Further studies should be performed to better define the diagnostic ability of this technique.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Conjunctival Neoplasms; Female; Humans; Lymphoma; Male; Melanoma; Microscopy, Confocal; Middle Aged; Nevus; Prospective Studies; Young Adult
PubMed: 25447117
DOI: 10.1016/j.ajo.2014.10.031 -
Clinical Ophthalmology (Auckland, N.Z.) 2014To evaluate the clinical characteristics of patients with conjunctivochalasis (CCh).
PURPOSE
To evaluate the clinical characteristics of patients with conjunctivochalasis (CCh).
METHODS AND MATERIALS
This retrospective study enrolled 30 subjects diagnosed with conjunctivochalasis. Complete ophthalmic examination, including visual acuity assessment, slit-lamp examination, applanation tonometry, dilated funduscopy, tear break-up time, Schirmer 1 test, and fluorescein staining were performed in all patients. Age, sex, laterality, ocular history, symptoms, and clinical findings were recorded.
RESULTS
The study included 50 eyes from 30 cases. Ages ranged from 45 to 80 years, with a mean age of 65±10 years. CChs grading were as follows: 30 (60%) eyes with grade 1 CCh; 15 (30%) eyes with grade 2 CCh; and five (10%) eyes with grade 3 CCh. CCh was located in the inferior bulbar conjunctiva in 45 (90%) eyes, and in the remaining five (10%) CCh was located in the superior bulbar conjunctiva. Ten (33.3%) patients had no symptoms. Dryness, eye pain, redness, blurry vision, tired eye feeling, and epiphora were the symptoms encountered in the remaining twenty (63.6%) patients. Altered tear meniscus was noted in all cases. The mean tear break-up time was 7.6 seconds. The mean Schirmer 1 test score was 7 mm. Pinguecula was found in ten patients.
CONCLUSION
Dryness, eye pain, redness, blurry vision, and epiphora were the main symptoms in patients with CCh. Dryness, eye pain, and blurry vision were worsened during downgaze and blinking. So CCh should be taken into consideration in the differential diagnosis of chronic ocular irritation and epiphora.
PubMed: 25210435
DOI: 10.2147/OPTH.S61851 -
Middle East African Journal of... 2014To describe the limitations of Fourier-domain optical coherence tomography (OCT) in imaging common conjunctival and corneal pathology.
PURPOSE
To describe the limitations of Fourier-domain optical coherence tomography (OCT) in imaging common conjunctival and corneal pathology.
MATERIALS AND METHODS
Retrospective, single-center case series of 40 patients with conjunctival and cornea pathology.
RESULTS
Fourier-domain OCT imaged laser in situ keratomileusis (LASIK) flaps in detail, including its relation to other corneal structures and abnormalities. Similarly, in infectious or degenerative corneal disorders, Fourier-domain OCT successfully showed the extent of infiltration or material deposition, which appeared as hyper-reflective areas. In cases with pterygium, the underlying cornea could not be imaged. All cases of common conjunctival pathologies, such as nevus or pinguecula, were successfully imaged in detail. Nevi, scleritis, pterygium, pinguecula, and subconjunctival hemorrhage were hyper-reflective lesions, while cysts and lymphangiectasia were hyporeflective. The details of the underlying sclera were not uniformly imaged in conjunctival pathologies. Fourier-domain OCT imaged the trabeculectomy bleb in detail, whereas the details of structures of the anterior chamber angle were not routinely visualized in all cases.
CONCLUSIONS
Light scatter through vascularized, densely inflamed, or thick lesions limits the imaging capabilities of Fourier-domain anterior segment OCT.
Topics: Adult; Aged; Conjunctival Diseases; Corneal Diseases; Corneal Surgery, Laser; Diagnostic Techniques, Ophthalmological; Female; Fourier Analysis; Humans; Male; Middle Aged; Retrospective Studies; Tomography, Optical Coherence; Young Adult
PubMed: 25100905
DOI: 10.4103/0974-9233.134673 -
Graefe's Archive For Clinical and... Jul 2014
Topics: Adult; Elastic Tissue; Female; Fibrillar Collagens; Humans; Pinguecula
PubMed: 24807233
DOI: 10.1007/s00417-014-2649-8 -
Nigerian Medical Journal : Journal of... Mar 2014Allergic conjunctivitis (AC) may follow seasonal or perennial pattern. There are climatic and racial risk factors involved in some types of AC. It is more prevalent in...
BACKGROUND
Allergic conjunctivitis (AC) may follow seasonal or perennial pattern. There are climatic and racial risk factors involved in some types of AC. It is more prevalent in warm climatic conditions and among Afro-Caribbeans, Arabs and Asians and less among the White populations. Clinical presentations also seem to follow climatic and genetic predisposition. The purpose of this study is to determine the prevalence of AC and its clinical presentations in a hospital setting in this region in people of all ages.
MATERIALS AND METHODS
This is a hospital-based retrospective study of new patients seen at Adoose Specialist Hospital, Jos the capital city of Plateau State in North Central Nigeria with clinical diagnosis of AC from 2000 to 2009.
RESULTS
There were 972 subjects, 474 (48.8%) males and 498 (51.2%) females with M:F ratio of 1:1.05. The most common symptom was itching followed by redness, pains, watery/mucoid discharge, sticky eyes, puffy eyes and photophobia. The presence of papillae in the upper tarsal or lower conjunctiva, a discrete or confluent gelatinous hypertrophy of the limbal conjunctiva (Trantas dots), hyperpigmentation, hyperemia/chemosis of the conjunctiva were the common signs. AC was more prevalent in those aged 1-16 years 38.4% decreasing to 4.9% in the age group above 50 years. The presentation followed perennial pattern, with a peak around July. The most prevalent ocular comorbid condition was refractive error (distant RE and presbyopia) in 15.4%, followed by pterygium/pinguecula 3.6%, bacterial conjunctivitis in 2.2%, glaucoma 2.1% and eyelid disorders 1.7%. Cataract was present in 1.3%, and keratopathy 1.1%. Other conditions such as episcleritis, dry eye, vitamin A deficiency and posterior segment disease were also present in decreasing order. Systemic association were few with generalised body atopy in 0.3%.
CONCLUSION
The prevalence of AC was 32% and is similar to what pertains in some of the African hospital studies, but differs in presentation from the Caucasians.
PubMed: 24791053
DOI: 10.4103/0300-1652.129664 -
Case Reports in Ophthalmology Jan 2014We report a case of a symptomatic, inflamed pterygium treated nonsurgically with topical dipyridamole and followed for 12 months.
PURPOSE
We report a case of a symptomatic, inflamed pterygium treated nonsurgically with topical dipyridamole and followed for 12 months.
CASE REPORT
A 35-year-old woman presented with a stage II to III, V3, C3, K2, P1 (using Johnston, Williams & Sheppard's classification) pterygium in her right eye. She complained of a foreign body sensation, dryness, burning, and persistent uncontrolled blinking. A raised lesion was observed on the nasal conjunctiva that was 1.5 mm in size. It extended slightly onto the nasal cornea. There was moderate vascularity of the lesion that obscured the underlying scleral vessels. Moderate conjunctival hyperemia was detected at and medial to the pterygium. The cornea, anterior chamber, and external anatomy were otherwise unremarkable. The eye was initially treated twice daily with a topical application of dipyridamole in a normal saline solution, which was later reduced to once daily.
RESULTS
There was a marked improvement in both the pterygium and the patient's symptoms. The tissue regressed from the limbal region of the cornea, had decreased in length from 1.5 to 1.0 mm, and decreased in height from approximately 1.0 to approximately 0.3 mm. Conjunctival hyperemia and vascularization resolved completely, and the underlying scleral vessels could once again be visualized. At 12 months, the pterygium was graded as stage 0 to I, V0, C2, K0, P0.
CONCLUSIONS
To our knowledge, this is the first case of successful management of a pterygium and associated symptoms using topical dipyridamole. Further investigation is required to clarify the potential role of dipyridamole in the treatment of pterygia and pingueculae.
PubMed: 24761148
DOI: 10.1159/000362113