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Eye (London, England) Mar 2011To determine the prevalence of pinguecula and pterygium and to investigate their associations in a general adult population in North-Western Spain.
PURPOSE
To determine the prevalence of pinguecula and pterygium and to investigate their associations in a general adult population in North-Western Spain.
METHODS
An age-stratified random sample of 1155 subjects ≥ 40 years was selected in O Salnés (Spain). From 937 eligible subjects, 619 (66.1%) participated (mean age (SD): 63.4 (14.5) years, range: 40-96 years, 37.0% males). An interview to collect history of systemic diseases and lifestyle details and a comprehensive ophthalmic evaluation in which pinguecula and pterygium were recorded was carried out. The prevalence of pinguecula and pterygium and their relationship with lifestyle factors and ocular and systemic diseases was investigated.
RESULTS
The prevalence of pinguecula was 47.9% (95% confidence interval (CI): 43.9-51.9). This prevalence increased significantly with aging (P = 0.002) and was higher in men (56.4%; 95% CI: 50.0-62.7) than in women (42.7%; 95% CI: 37.8-47.8) (P=0.001). The prevalence of pterygium was 5.9% (95% CI: 4.3-7.9). This prevalence also increased significantly with aging (P = 0.005) and was 4.8% (95% CI: 2.6-8.4) in men and 6.5% (95% CI: 4.5-9.3) in women (P = 0.346). After controlling for age and sex, pinguecula was associated with alcohol intake (adjusted odds ratio (OR(a)): 3.08; 95% CI: 1.60-5.95), pterygium with fluorescein staining (OR(a): 2.64; 95% CI: 1.08-6.46) and both disorders with outer activity (OR(a): 2.07; 95% CI: 1.36-3.15 and 2.28; 95% CI: 1.04-4.98, respectively).
CONCLUSIONS
Pinguecula is far more common than pterygium. Alcohol consumption is strongly associated with pinguecula. Fluorescein staining is highly prevalent in subjects with pterygium. Both disorders increase with age and are associated with outer activity.
Topics: Adult; Aged; Aged, 80 and over; Conjunctival Diseases; Cross-Sectional Studies; Female; Humans; Life Style; Male; Middle Aged; Odds Ratio; Prevalence; Pterygium; Risk Factors; Spain
PubMed: 21183945
DOI: 10.1038/eye.2010.204 -
Acta Ophthalmologica Aug 2012To study the morphological patterns of pterygia and pingueculae using high-resolution anterior segment spectral domain optical coherence tomography (SD-OCT).
PURPOSE
To study the morphological patterns of pterygia and pingueculae using high-resolution anterior segment spectral domain optical coherence tomography (SD-OCT).
METHODS
Prospective cross-sectional study of 25 eyes presented with pterygia and pingueculae was conducted, and the eyes were examined by anterior segment SD-OCT.
RESULTS
We examined 25 eyes, including 13 eyes with primary pterygia, six eyes with recurrent pterygia, one case with a pseudopterygium and five eyes with pingueculae. Primary pterygia revealed elevation of the corneal epithelium by a wedge-shaped mass of tissue separating the corneal epithelium from the underlying Bowman's membrane, which became wavy and interrupted. We found satellite masses of pterygium tissue advanced under the epithelium beyond the clinically seen pterygium margins. In recurrent pterygia, we detected that the central tip of the pterygium was more advanced and creeping beneath the basal corneal epithelium than the primary pterygium. In pseudopterygium, the SD-OCT images showed that the overgrowing membrane was not really attached to the underlying cornea. In cases of pingueculae, SD-OCT revealed a wedge-shaped mass that was nearly similar in pattern to that of the pterygia but stopped at the limbal region. Immediately after removal of pterygia, we noticed many remnants of the pterygia masses over the corneal stroma in spite of the clinically clear appearance of cornea.
CONCLUSIONS
SD-OCT provided us with high-resolution images of the pterygium and the pinguecula and showed clearly the anatomical relationship between the corneal tissues and these lesions. The use of this new modality of imaging may help to decrease the current recurrence rates after pterygium excision through using the anterior segment SD-OCT in the evaluation of these lesions.
Topics: Adult; Aged; Anterior Eye Segment; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Pinguecula; Prospective Studies; Pterygium; Recurrence; Tomography, Optical Coherence
PubMed: 21040504
DOI: 10.1111/j.1755-3768.2010.01994.x -
International Journal of Cancer Jul 2010HIV increases the risk of OSSN. Here we investigate other factors in a case-control study from Uganda with 318 cases (48 CIN I, 66 CIN II, 81 CIN III and 123 with... (Comparative Study)
Comparative Study
HIV increases the risk of OSSN. Here we investigate other factors in a case-control study from Uganda with 318 cases (48 CIN I, 66 CIN II, 81 CIN III and 123 with invasive disease) and 762 controls. Initial analyses were stratified by HIV serostatus (204 cases and 202 controls were HIV seropositive), but since findings were similar in infected and uninfected people, the combined results are presented here. The risk of OSSN increased with increasing time spent in direct sunlight (p(trend) = 0.003, adjusted for age, sex, residential district and HIV serostatus): compared to those who reported spending up to 1 hr a day in direct sunlight, the risk was 1.7 (95% Confidence Interval [CI] 1.2-2.4) in those reporting 2-4-hr exposure and 1.8 (95% CI 1.1-3.1) in those reporting 5+ hr. The risk was also increased among people reporting a previous injury to the affected eye (OR 2.4, 95% CI 1.2-4.5). Pinguecula in the nasal quadrant of the unaffected eye were evident on clinical examination for 98% of cases (293/300) and for 91% of the same quadrant in the right eye (246/271) of controls (OR = 6.4, 95% CI 2.5-16.1). We confirm associations with exposure to solar ultraviolet radiation and with the presence of pinguecula and report a role for previous ocular trauma in the aetiology of OSSN. We did not identify any additional factors that point to an underlying infectious cause, although this is an area of on-going research.
Topics: Adolescent; Adult; Carcinoma in Situ; Case-Control Studies; Conjunctival Neoplasms; Corneal Diseases; Environmental Exposure; Eye; Eye Neoplasms; Female; HIV Infections; Humans; Male; Middle Aged; Risk Factors; Sunlight; Uganda; Ultraviolet Rays; Young Adult
PubMed: 19908234
DOI: 10.1002/ijc.25040 -
Indian Journal of Ophthalmology 2007
Topics: Conjunctival Diseases; Conjunctival Neoplasms; Diagnosis, Differential; Humans; Male; Melanoma; Middle Aged
PubMed: 17189904
DOI: 10.4103/0301-4738.29517 -
Clinical & Experimental Optometry Nov 2005Corneal irradiation with high doses of ultraviolet-B (UVB) has been shown to damage the corneal endothelium in animals. Human occupational exposure to ultraviolet...
BACKGROUND
Corneal irradiation with high doses of ultraviolet-B (UVB) has been shown to damage the corneal endothelium in animals. Human occupational exposure to ultraviolet radiation (UVR) in welding is considered a risk for endothelial damage but the evidence for such an effect is limited.
METHODS
External eye photographs and non-contact specular micrographs (Topcon SP2000-P) were obtained from 102 white males aged between 32 and 62 years, 51 being arc welders (with 24 +/- 7 years experience) and 51 office workers. Most welders reported repeated occupational exposure to UVR (that is, welder's 'flashes').
RESULTS
Welders reported a higher level of ocular symptoms and a higher prevalence of pingueculae (47 versus 12 per cent), but only one case with pterygium. The average endothelial cell areas were the same in welders and office workers (398 +/- 55 microm(2) versus 400 +/- 56 microm(2); p = 0.868) as were the endothelial cell density (ECD) values (2,555 +/- 342 cells/mm(2) versus 2,541 +/- 308 cells/mm(2); p = 0.825). ECD decreased with years of welding experience (p < 0.01) but not faster than the decrease in ECD due to age.
CONCLUSIONS
Repeated occupational ultraviolet radiation exposure through welding is not associated with any obvious differences in the corneal endothelium. No differences were observed in either ECD or cell polymegethism. Despite the periodic welding flashes, the exposure levels are below those needed to cause damage to the corneal endothelium.
Topics: Adult; Anterior Eye Segment; Cell Count; Endothelium, Corneal; Eye Diseases; Eyeglasses; Humans; Incidence; Male; Medical Records; Middle Aged; Occupational Exposure; Ultraviolet Rays; Vision, Ocular; Welding
PubMed: 16329747
DOI: 10.1111/j.1444-0938.2005.tb05105.x -
Acta Ophthalmologica Scandinavica Oct 2002To investigate exfoliation syndrome (ES) in order to elucidate gender distribution and the roles of genetic and climatic factors in its manifestation.
PURPOSE
To investigate exfoliation syndrome (ES) in order to elucidate gender distribution and the roles of genetic and climatic factors in its manifestation.
MATERIAL AND METHODS
We studied the gender distribution of ES and the association between ES and the appearance of certain climatically induced disorders (pterygium, climatic droplet keratopathy) and the size of pingueculae in populations living in the Arctic region, in temperate regions and in tropical regions. This involved a total of 11 samples taken in eight different countries, comprising 2206 persons of both genders over the age of 50 years.
RESULTS
A total of 1051 males were investigated for ES and 147 of them (14.0%) were found to have it. The corresponding figures for females were 1093 and 177 (16.2%). After standardization according to age, no systematic difference between the genders was found in the study. The frequency of ES varied greatly. It was not observed at all in the Inuit (Eskimos) but was found most frequently (about 30%) among the Saami (Lapps), Aland Islanders, Finns, Icelanders and Russians over 70 years of age. After the age of 50, the frequency of ES increases rapidly with age in all populations. However, the curves for ES in people living in the tropics show a delay of about 10 years. In contrast, the frequency of climatically caused changes (pterygium, climatic keratopathy and pronounced pinguecula) mostly peaks at the age of 50 years and is highest in the tropics and in the Arctic. Males in these regions tended to be more affected by climatically caused changes than females. Likewise, in tropical climates, where radiation from the sun is strong, and in Lapland and Novosibirsk, where there is radiation from snow, males showed more evidence of ES than females. However, examination of 506 patients from a private practice in South Finland, who were under observation for glaucoma or for risk of glaucoma, showed females to be in the majority of those with ES.
CONCLUSIONS
As a rule, climate does not appear to influence the occurrence of ES. However, in tropical countries, where radiation from the sun is strong, ES was more common among males than among females. In the light of its peculiar population distribution, even when climatic factors are considered, there would appear to be an important genetic factor involved in the manifestation of ES.
Topics: Age Distribution; Aged; Aged, 80 and over; Climate; Conjunctival Diseases; Corneal Diseases; Environmental Exposure; Exfoliation Syndrome; Female; Genetics, Population; Geography; Humans; Male; Middle Aged; Prevalence; Pterygium; Sex Distribution
PubMed: 12390157
DOI: 10.1034/j.1600-0420.2002.800504.x -
Acta Ophthalmologica Scandinavica Jun 2001To investigate the tear flow, tear film stability and condition of mucus in patients with pinguecula. (Clinical Trial)
Clinical Trial Randomized Controlled Trial
PURPOSE
To investigate the tear flow, tear film stability and condition of mucus in patients with pinguecula.
METHODS
The Schirmer I and ferning tests were performed and break-up time (BUT) was determined in 57 patients with pinguecula [random eyes; 34 males and 23 females, 18 to 70 years of age (mean +/- SD: 39.1 +/- 13.5 years)] and in 57 age-matched subjects (control) [random eyes; 35 males and 22 females, 11 to 70 years of age (mean +/- SD: 37.8 +/- 15.2 years)], and the test results were statistically analysed.
RESULTS
The mean Schirmer test value was 22.72 +/- 12 mm in the eyes with pinguecula and 22.7 +/- 8.5 mm in the control eyes. There was no statistically significant difference (t = 0.01, p = 0.99) between the groups. The mean BUTs were 11.42 +/- 6.89 s in the eyes with pinguecula and 15.46+/-5.85 s in the control eyes. Comparison of BUTs between the groups revealed a statistically significant difference (t = 3.37, p = 0.0010). Also, ferning types were found to be significantly abnormal in the eyes with pinguecula (p < 0.01).
CONCLUSION
The alteration in the mucin layer is a possible change inducing pinguecula formation, or it may reflect an already existing pathology in the cells on the ocular surface.
Topics: Adolescent; Adult; Aged; Child; Conjunctival Diseases; Diagnostic Techniques, Ophthalmological; Female; Humans; Male; Middle Aged; Mucus; Prospective Studies; Tears
PubMed: 11401635
DOI: 10.1034/j.1600-0420.2001.790310.x -
Industrial Health Jul 1997Pinguecula and pterygium are speculated to be associated with corneal and conjunctival microtrauma from exposure to sunlight and/or dust. Occupational motorcycle driving...
PURPOSE
Pinguecula and pterygium are speculated to be associated with corneal and conjunctival microtrauma from exposure to sunlight and/or dust. Occupational motorcycle driving is suspected to be associated with such exposure, so we investigated the prevalence of pingueculae and pterygia in motorcycle policemen.
METHOD
Silt lamp finding obtained by periodic eye checkup for policemen (783 motorcycle policemen and 207 control indoor workers) together with questionnaire were used for analyses. All pingueculae and pterygia were diagnosed under the definite criteria.
RESULTS
The overall prevalence of pingueculae was 590/1,566 eyes (37.7%) among motorcycle policemen against 127/414 eyes (30.6%) among the indoor workers (p < 0.01). Besides, with increasing age, the prevalence of pingueculae in the motorcycle policemen clearly exceeded those among the indoor controls. The prevalence of pterygia were very small to be analysed.
CONCLUSION
Our results exhibited a significant relationship between occupational motorcycle driving and the prevalence of pingueculae. Thus it is strongly suggested that they should wear eye protection equipment (goggles, face shield and so on) to prevent from developing these lesions.
Topics: Adult; Chi-Square Distribution; Conjunctival Diseases; Cross-Sectional Studies; Eye Protective Devices; Humans; Japan; Logistic Models; Male; Middle Aged; Motorcycles; Multivariate Analysis; Occupational Diseases; Prevalence; Pterygium; Surveys and Questionnaires; Ultraviolet Rays
PubMed: 9248214
DOI: 10.2486/indhealth.35.325 -
The British Journal of Ophthalmology Jun 1996To investigate the association of human immunodeficiency virus (HIV) infection and carcinoma of the conjunctiva in Africa, and the role of human papilloma virus type 16...
AIM
To investigate the association of human immunodeficiency virus (HIV) infection and carcinoma of the conjunctiva in Africa, and the role of human papilloma virus type 16 (HPV-16).
METHODS
Patients in Uganda and Malawi presenting to eye clinics with lesions suspicious of carcinoma were studied. Pathological confirmation of eye lesions was sought. HIV testing of patients who were biopsied and, in Uganda, of matched case control subjects was carried out as was testing of a sample of fixed biopsies for HPV-16 by polymerase chain reaction (PCR). The HIV-1 serology, histopathology of conjunctival biopsies (conjunctival intraepithelial neoplasia (CIN), invasive carcinoma, other lesions), and prevalence of HPV-16 infection were determined.
RESULTS
Of Ugandan patients, 27/38 (71%) with carcinoma (27 invasive carcinoma, 11, CIN) were HIV positive compared with 12/76 (16%) of controls (odds ratio 13, 95% confidence interval 5-38). The calculated population aetiological fraction of carcinoma associated with HIV was 66%. Of 32 Malawian patients (20 invasive carcinoma, 12 CIN), 25/29 tested (86%) were HIV positive. HPV-16 infection was found in 7/20 (35%) of carcinoma samples, 0/9 pingueculae, and 2/6 conjunctivitis samples.
CONCLUSIONS
HIV infection is strongly associated with an apparent increase in the incidence of conjunctival carcinoma in Africa. While ultraviolet light is probably the prime risk factor and HPV-16 is implicated in a proportion of cases, the interactions of ultraviolet light, HIV, HPVs, and other factors are unclear in the pathogenesis of carcinoma. The disease represents another model of multifactorial epithelial carcinogenesis.
Topics: AIDS-Related Opportunistic Infections; Adolescent; Adult; Aged; Carcinoma, Squamous Cell; Case-Control Studies; Conjunctival Neoplasms; Female; HIV; HIV Infections; Humans; Malawi; Male; Middle Aged; Odds Ratio; Papillomaviridae; Papillomavirus Infections; Polymerase Chain Reaction; Tumor Virus Infections; Uganda; Uterine Cervical Dysplasia
PubMed: 8759259
DOI: 10.1136/bjo.80.6.503 -
The British Journal of Ophthalmology Oct 1992Ninety two patients with porphyria cutanea tarda (PCT) were examined ophthalmically in a paired case control study. The incidence of pinguecula and of pterygium was 8...
Ninety two patients with porphyria cutanea tarda (PCT) were examined ophthalmically in a paired case control study. The incidence of pinguecula and of pterygium was 8 and 2 times higher respectively, in PCT patients than in the control group. The photodamage to the conjunctiva is considered to be a result of the photoactivity of uroporphyrin in the tissues.
Topics: Case-Control Studies; Conjunctiva; Conjunctivitis; Female; Humans; Male; Middle Aged; Porphyria Cutanea Tarda; Pterygium; Sunlight
PubMed: 1358193
DOI: 10.1136/bjo.76.10.592