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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 -
Korean Journal of Ophthalmology : KJO Dec 2013To analyze the autofluorescence (AF) properties of pinguecula using cobalt-blue and yellow filters and to investigate the nature and pathogenesis of pingueculae using...
PURPOSE
To analyze the autofluorescence (AF) properties of pinguecula using cobalt-blue and yellow filters and to investigate the nature and pathogenesis of pingueculae using histochemical and immunohistochemical staining.
METHODS
Fifty pingueculae in 40 patients were included in this study. AF of the pingueculae was observed and analyzed using a cobalt-blue filter with an additional yellow filter on a slit-lamp. Hematoxylin-eosin and immunohistochemical stainings were performed on surgical specimens of pingueculae that were prepared from each patient. Immunohistochemical staining included Congo red, Oil Red O, periodic acid-Schiff (PAS), Masson's trichrome, transglutaminase-2 (TG-2), mesenchymal stem cell markers CD29 (β-1-integrin), and CD34.
RESULTS
AF images revealed hyper-AF in the pinguecula area. The AF lesions of pingueculae showed superficial punctuate erosions and avascular lesions. Deposition of eosinophilic and amorphous materials in the subepithelial layer of the pinguecula were observed on hematoxylin-eosin staining. Historeactivities to Congo red, PAS, Oil Red O, alcian blue, and Masson's trichrome were not detected, but immunoreactivities to CD29, CD34, and TG-2 were detected in the pingueculae with AF. However, CD29, CD34, and TG-2 were not detected in the pingueculae without AF.
CONCLUSIONS
The AF of pingueculae may be related to CD29, CD34, and TG-2. We suggest that pingueculae with AF have a different pathogenesis compared to pingueculae without AF.
Topics: Aged; Coloring Agents; Female; Fluorescence; Follow-Up Studies; Hematoxylin; Humans; Immunohistochemistry; Male; Microscopy, Confocal; Middle Aged; Pinguecula; Retrospective Studies
PubMed: 24311926
DOI: 10.3341/kjo.2013.27.6.416 -
Acta Medica Iranica 2012While pterygium is considered a common eye disorder, the etiology and pathogenesis is still not known. The aim of this study was to describe the prevalence of pterygium...
While pterygium is considered a common eye disorder, the etiology and pathogenesis is still not known. The aim of this study was to describe the prevalence of pterygium and pinguecula in the over 40 population of Shahroud and assess associated factors. The present study is part of the phase one of the Shahroud Eye Cohort Study conducted in 2009, in which the target population was people between 40 and 64 years of age. Ophthalmic examinations were performed by two ophthalmologists who made the diagnosis of pterygium and pinguecula. We used Chi-square tests, analysis of variance, and multiple logistic regression tests to examine associations. Of the 6311 invitees, 5190 people participated in the study (response rate: 82.2%). The prevalence of pterygium in at least one eye was 9.4% (95% CI, 8.6-10.3), while 2.9% (95%CI, 2.4-3.3) had bilateral pterygium. The prevalence was significantly higher in men (11.4% vs. 8.0%), and remained relatively constant with age, while the prevalence in women significantly increased with age. The prevalence of pinguecula was 61.0% (95%CI, 59.1-62.9) in at least one eye, and 49.0% (95%CI, 47.1-50.9) in both eyes. The age difference between those with and without pinguecula was significant and the prevalence was significantly higher among men than women (70.6% vs. 53.8%). The prevalence of pterygium in our study was lower than reported rates in the world but higher than Tehran and was significantly associated with age, gender, working outdoors, and the level of education. The prevalence of unilateral and bilateral pinguecula falls in the mid range and was significantly associated with age, male gender, smoking, working outdoors, and level of education.
Topics: Adult; Age Distribution; Analysis of Variance; Astigmatism; Cohort Studies; Educational Status; Female; Humans; Iran; Male; Middle Aged; Occupations; Pinguecula; Prevalence; Pterygium; Sex Distribution; Smoking; Urban Population; Visual Acuity
PubMed: 23275285
DOI: No ID Found -
International Journal of Ophthalmology 2012To determine the influence of the dialysis time before kidney transplantation on postoperative ophthalmic complications.
AIM
To determine the influence of the dialysis time before kidney transplantation on postoperative ophthalmic complications.
METHODS
One hundred and eighty three patients who were given the follow-up after kidney transplantation were selected, including 124 males and 59 females. The dialysis time before kidney transplantation was (2.9±2.1) years. Among them, there were 93 cases having cadaveric renal transplantation and 90 cases having living relative renal transplantation. The conditions of ophthalmic complications in all the patients after kidney transplantation were investigated and the incidence rate on ophthalmic complications having different dialysis time before kidney transplantation was given Chi-square test and Chi-square linear trend test.
RESULTS
Among 183 patients with kidney transplantation, 95 patients (51.9%) had at least one ophthalmic complication and the rest 88 patients (48.1%) had no significant abnormality at the eye region. The most common ophthalmic complications were pinguecula/conjunctival degeneration (31 cases), the following was caligo lentis (24 cases). The main manifestations were grayish white granule and plaque turbidity occurred in posterior capsule at the posterior pole of crystaline lens. The angulus iridocornealis of 5 patients (5.3%) with cataract and glaucoma were all open-angle through the detection by gonioscope. Through visual field examination, there were 2 patients with paracentral scotoma, 2 patients with arcuate scotoma and one case with nasal step.
CONCLUSION
The experiments verify that the incidence of glaucomawas relates to the dialysis time before kidney transplantation, and the incidence rate might be higher if the dialysis time is longer.
PubMed: 22773990
DOI: 10.3980/j.issn.2222-3959.2012.03.23 -
Clinics (Sao Paulo, Brazil) 2012The aim of this study was to report the type and frequency of ocular manifestations in Brazilian psoriatic arthritis patients.
OBJECTIVES
The aim of this study was to report the type and frequency of ocular manifestations in Brazilian psoriatic arthritis patients.
METHODS
We conducted a cross-sectional study in a Brazilian tertiary hospital. The test group included 40 patients who had psoriatic arthritis according to the Classification Criteria for Psoriatic Arthritis. A control group of 40 individuals was matched for age and gender. All of the patients underwent ophthalmic evaluation, which included best-corrected visual acuity, slit lamp and fundus examinations, and dry eye diagnostic tests (Schirmer I, tear breakup time and rose bengal). Demographic parameters were also evaluated.
RESULTS
The mean age of the patients was 53.9±13.1 years; the mean disease duration was 8±10.5 years. Most of the patients were women (60%), and the majority had polyarticular disease (57.5%). Several ocular abnormalities were found, including punctate keratitis, pinguecula, blepharitis, pterygium, cataract, glaucoma, uveitis, and retinal microvascular abnormalities. There were no significant differences in the rates of these abnormalities compared with the control group, however. The Keratoconjunctivitis sicca and dry eye diagnostic tests were more often positive in the patients with psoriatic arthritis than in the control group.
CONCLUSIONS
In this study, keratoconjunctivitis sicca was the most common ocular finding related to psoriatic arthritis. Therefore, we recommend early ophthalmologic evaluations for all psoriatic arthritis patients who complain of eye symptoms.
Topics: Arthritis, Psoriatic; Brazil; Epidemiologic Methods; Female; Humans; Keratoconjunctivitis Sicca; Male; Middle Aged
PubMed: 22473406
DOI: 10.6061/clinics/2012(03)08 -
Ophthalmology and Eye Diseases 2012The focus of this study was to evaluate the visual status of mine workers who were directly involved in mining and/or are exposed to the mining environment.
OBJECTIVE
The focus of this study was to evaluate the visual status of mine workers who were directly involved in mining and/or are exposed to the mining environment.
METHODS
A hospital based cross-sectional study was conducted. Four hundred and six (406) workers were conveniently sampled for the study. Information on their socio-demographic data was also collected. In addition, all participants underwent ophthalmic examination.
RESULTS
The mean age of the workers was 41.1 years. Visual impairment was found in 114 (28.1%) of the study population of which refractive error (56.8%) was the major cause. Presbyopia was also observed in 45.5% of the workers with only 30.3% of them wearing near correction. The prevalence of eye diseases were pterygium/pingueculae (25.8%), conjunctivitis (26.8%), suspected glaucoma (15.3%), and cataract (7.4%).
CONCLUSIONS
Visual impairment and eye diseases were found among the miners.
PubMed: 23650456
DOI: 10.4137/OED.S9204 -
Eye (London, England) Nov 2011To introduce a novel technique to treat necrotic scleral calcification caused by previous regional conjunctivectomy using conjunctival autografting and amniotic membrane...
PURPOSE
To introduce a novel technique to treat necrotic scleral calcification caused by previous regional conjunctivectomy using conjunctival autografting and amniotic membrane inlay filling, and to evaluate the clinical outcome.
METHODS
Ten patients (11 eyes, 12 regions) who had undergone regional conjunctivectomy with postoperative mitomycin C (MMC) for pterygia or pingueculae were included. Scleral calcification was removed using a bevel-down crescent knife. After the conjunctival donor tissue was harvested from the upper bulbar conjunctiva, the tissue was grafted to the scleral defect and secured with sutures. Amniotic membrane was inserted randomly into spaces between the conjunctival graft and the scleral bed. Protective amniotic membrane was transplanted over the graft, with stromal side up.
RESULTS
Scleral calcification developed in ischaemic areas in 11 of the 12 regions; 50% of cases had a surface defect seen with a fluorescent dye. The grafted conjunctiva epithelialized successfully in all cases. In 10 regions, the epithelialization occurred in 1 or 2 weeks. In the remaining two regions, one region required another surgery because of graft failure, and epithelialization occurred in the last region in 9 weeks. Vascular growth into the graft from the surrounding tissue occurred in all cases in 1 to 10 weeks. The surgical wound stabilized 3 weeks postoperatively.
CONCLUSION
The combined technique had high success rates of graft survival and good revitalization of the necrotic area of scleral calcification, eliminated the need for invasive and time-consuming scleral autografting or allografting, and provided good cosmesis. Scleral ischaemia, which was caused by MMC, may induce scleral calcification.
Topics: Adult; Amnion; Calcinosis; Conjunctiva; Female; Humans; Male; Middle Aged; Necrosis; Sclera; Scleral Diseases; Transplantation, Autologous
PubMed: 21869832
DOI: 10.1038/eye.2011.209 -
Survey of Ophthalmology 2011Xeroderma pigmentosum is a rare, autosomal recessive disease caused by a defect in DNA repair. Patients with xeroderma pigmentosum often have cutaneous and ocular sun... (Review)
Review
Xeroderma pigmentosum is a rare, autosomal recessive disease caused by a defect in DNA repair. Patients with xeroderma pigmentosum often have cutaneous and ocular sun sensitivity, freckle-like skin pigmentation, multiple skin and eye cancers, and, in some patients, progressive neurodegeneration. Xeroderma pigmentosum predominantly affects the ultraviolet (UV) exposed ocular surface, resulting in eyelid atrophy and cancers, corneal dryness, exposure keratopathy, and conjunctival tumors. We report the clinical history and ocular pathology of two white women who had xeroderma pigmentosum with neurological degeneration: Case 1 (died at age 44 years) and Case 2 (died at age 45 years). Case 1, with mutations in the XPA gene, had more than 180 basal cell carcinomas of her skin and eyelids and died from complications of neurodegeneration. Case 2, with mutations in the XPD gene, was sun-protected and had three skin cancers. She died from complications of neurodegeneration and pneumonia. Both patients had bilateral pinguecula, corneal pannus, and exposure keratopathy. Case 1 had bilateral optic atrophy, and Case 2 had bilateral peripheral retinal pigmentary degeneration. Both patients developed retinal gliosis. The ophthalmic manifestations and pathology of xeroderma pigmentosum are discussed and reviewed with respect to this report and other cases in the literature. These cases illustrate the role of DNA repair in protection of the eyes from UV damage and neurodegeneration of the retina.
Topics: Adult; Ciliary Body; Fatal Outcome; Female; Hamartoma; Humans; Middle Aged; Neoplasms, Multiple Primary; Neurodegenerative Diseases; Retinal Degeneration; Skin Neoplasms; Uveal Diseases; Xeroderma Pigmentosum; Xeroderma Pigmentosum Group A Protein; Xeroderma Pigmentosum Group D Protein
PubMed: 21684361
DOI: 10.1016/j.survophthal.2011.03.001 -
Acta Ophthalmologica Dec 2012To assess the relationship between the prevalence and severity of conjunctivochalasis and pinguecula.
PURPOSE
To assess the relationship between the prevalence and severity of conjunctivochalasis and pinguecula.
METHODS
Cross-sectional, consecutive case study conducted at the university hospital of University of Tokyo Graduate School of Medicine. A total of 1061 patients aged from 1 to 94 years were enrolled. The grade and other parameters of conjunctivochalasis (classified into three locations: nasal, middle and temporal) and the grade of pinguecula located on the nasal or temporal conjunctiva were determined in all subjects. Patients were also divided into 5 or 10 age groups.
RESULTS
The severity of conjunctivochalasis affecting the nasal and temporal bulbar conjunctiva was significantly correlated with the grade of pinguecula located on the nasal and temporal conjunctiva in each age group (p < 0.05). Pinguecula was independently associated with conjunctivochalasis (nasal: odds ratio [OR] = 1.44; temporal: OR = 1.43) after adjustment for age.
CONCLUSION
This was the first assessment of the relation between the grade of conjunctivochalasis and pinguecula in a large consecutive series of patients. Our results suggest that the prevalence and severity of conjunctivochalasis are related to the presence of pinguecula.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aging; Child; Child, Preschool; Conjunctival Diseases; Cross-Sectional Studies; Female; Hospitals, University; Humans; Infant; Male; Middle Aged; Pinguecula; Prevalence; Severity of Illness Index; Young Adult
PubMed: 21518307
DOI: 10.1111/j.1755-3768.2011.02161.x