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Biomedical subjects

H C Fledelius

Publications and source records attributed to H C Fledelius.

At least 73 records · Page 4Linked to original sources
PubMed1988

X-linked myopia in Danish family.

X-linked infantile myopia is described in a family of 273 members of whom 87 were examined in the National Eye Clinic. The disease may represent a new ocular syndrome, constituted by myopia combined with astigmatism, impaired vision, hypoplasia of the optic nerve heads, and deuteranopia. Obligate carriers presented slight retinal changes. Linkage studies are in progress.

Adolescent↗
PubMed1988

Refraction and eye size in the elderly. A review based on literature, including own results.

A review is given of the literature concerning refraction and eye size in the elderly. Information being sporadic, a picture has to be pieced together from cross-sectional studies of various authors. This implies differences from study to study regarding definitions, composition of samples, and methodology in particular. In Western communities, the main refractive change after the age of 50 is towards hypermetropia, but there are only few studies dealing with eye size. The secular trend--increasing bodily dimensions for each new generation--has possibly contributed to the concept of smaller eyes with old age, where this has been reported. Otherwise an impression is gained of eye size stability in the elderly. From a mechanistic point of view this seems probable, considering that intraocular pressure is maintained--or increased--in senescence. The usual non-pathology demand can hardly be fulfilled in studies of the elderly, clear lenses being the exception. Epidemiologically, cataract series can probably be used for eye size estimates, though refractively and eye-dimensionally it is not fully known whether skewness might apply to such samples.

Aging↗
PubMed1987

Ocular ethambutol toxicity. A case report with electrophysiological considerations and a review of Danish cases 1972-81.

A 76-year-old female with ocular ethambutol toxicity prompted two investigations. Firstly, she was followed electrophysiologically, with multichannel recorded pattern reversal visual evoked potential techniques using full-field, half-field, central-field and peripheral field stimulation, plus flash VEP and ERG. The examinations performed 2, 5 and 7 months after ethambutol withdrawal indicated damage to the papillomacular bundle, while a late follow-up after recovery showed potentials of near normal configuration. Secondly an epidemiological survey was attempted based on the 37 ethambutol toxicity cases registered to the Danish Board on Adverse Reactions 1972-81, making up 1% of those receiving antituberculous therapy. They showed a significant preponderance of elderly (24/37 greater than 65 years) and of females (29/37). There was only one foreigner in the series. A detailed analysis of visual function in a subsample of 22 cases (those registered 1977-81) showed that visual impairment lasted several months, and that usually recovery was not complete. Using the visual demands for driver's license as criterium, 20 fulfilled the demands prior to therapy, but only 12 after recovery.

Aged↗
PubMed1987

Diabetic myopia--is it lens-induced? An oculometric study comprising ultrasound measurements.

An oculometric study has been performed to evaluate features possibly being responsible for a (permanent) shift towards myopia in eyes of diabetics, a trend apparent from previous clinical investigations. Having excluded cases of transient refractive change associated with poor metabolic control, we are dealing with adult subjects with stable refractive levels, also including cases of adult-onset myopia. Out of 62 diabetic and 48 non-diabetic eyes (age 17-23, diabetes duration 2-38 years) a careful matching according to age, sex and refraction provided 26 eye-pairs from 52 subjects for analysis. In 23 matched pairs there was low myopia. The lenses of diabetics appeared significantly thicker than in non-diabetics (mean difference 0.2 mm), and a higher lens power came close to significance. Corneal curvature, anterior chamber depth and axial length did not differ. A subsequent analysis of degree of lens thickness increase in diabetics revealed a positive correlation with diabetes duration. A thicker lens does not of necessity imply a higher lens power, but from the present data this is the most likely explanation of diabetic myopia in adults.

Adolescent↗
PubMed1987

Intraocular lens calculation. An evaluation of Binkhorst and SRK estimates in 100 consecutive cataract extractions with 3M type 78 anterior chamber lens implantation.

Intraocular lens power prediction and final astigmatism were evaluated in 100 consecutive cataract patients (age 57-92 years, mainly with intracapsular extraction) 4-13 months after insertion of a 3M type 78 anterior chamber lens. The analysis was based on refractive recordings from the referring ophthalmologists who took care of post-operative controls. Ninety-two patients were accepted for the study. A Sonometrics DBR 400 ultrasound equipment and a Haag-Streit keratometer had been used for measuring eye length and corneal power, the Binkhorst programme and SRK formula for selecting IOL power, resulting in an IOL range of +12 to +23 D. Mainly, low myopia was intended. Nearly 50% fell within 0.5 D from predicted value; 90% were within +/- 1.5 D, by both calculating methods. SRK predictions appeared unaffected by eye size, while axial length (x) significantly influenced Binkhorst prediction (y): y = 8.08-0.35x (r = -0.40), the deviation being most marked in very short eyes. For eyes of midsize the two methods did not differ. Regarding astigmatism, 3 patients ended with values above 3D. In 83% it was less than 2D. Eighty per cent obtained a visual acuity of 0.5 or better. All things considered we feel that the calculation procedure should be standard when performing cataract surgery with IOL implantation.

Aged↗
PubMed1987

Refractive change in diabetes mellitus around onset or when poorly controlled. A clinical study.

For generations it has been taught that myopic change is the principal response to hyperglycaemia in diabetes mellitus. Recently, however, a hyperopic concept has been advanced, to suggest that a change towards hypermetropia has possibly become the more frequent finding in diabetics with unstable refraction. The present sample comprises 32 cases of newly discovered diabetes and 40 cases of long duration, most cases being insulin-dependent. Of the former 47% showed a refractive change around the recognized onset of diabetes, in some cases prior to detection and admission, but mostly after institution of insulin therapy; in 14/15 the change was towards hypermetropia. Of the longstanding cases 20% showed refractive change (while 80% did not) in association with poor metabolic control, equally towards myopia/hypermetropia. It was not possible to point out an association with specific patterns of metabolic dysregulation. The results are further discussed in relation to previous refraction studies demonstrating an increased myopia prevalence in diabetics in general, as compared to non-diabetics. Apparently this cannot be explained merely by a possibly overlooked transient refractive change under periods of poor metabolic control.

Adolescent↗
PubMed1986

Myopia and diabetes mellitus with special reference to adult-onset myopia.

A significant preponderance of myopia has been reported in adult Danish diabetics as compared to non-diabetics. This suggestion of a special type of diabetic myopia is evaluated in the present study. Comparing myopia pattern (degree and age at onset) in diabetics and non-diabetics, 80 of each, the assessment is based mainly on personal information about refractive history, gained through interviews of patients referred from other departments for routine eye examination. With a concise memory as inclusion criterion, the resulting sample is hardly representative, and the significant findings are to be considered tendencies only. In the whole sample there were more cases of late myopia onset and progression than expected from textbooks; 31% were of adult onset, i.e. after the age of 20 year. Most late-onset cases were of a low order, a type more prevalent in diabetics (40%) than in the non-diabetic controls (22.5%). Otherwise there was no indication of a special type of diabetic myopia.

Adult↗
PubMed1986

Changes in eye position during growth and adult life as based on exophthalmometry, interpupillary distance, and orbital distance measurements.

The association between eye position and age is analysed in a material comprising 267 subjects aged 5-20 years and 187 aged 21-80. The study was prompted by a previous longitudinal finding of a 3 mm increase in exophthalmometry value from age of 10 to 18 years, and by a literature almost devoid of similar investigations in young age groups. The increase in Hertel value during growth could be confirmed. An adult mean value of 16.0 mm in females and 16.6 mm in males was achieved in late teen-age years, the level being stable after that. The adult range was 11-23 mm. After a similar marked increase in the young, interpupillary distance and orbital width also showed some slight trends in adults. A suggested decrease in orbital width towards old age was consistent with a secular trend, while a concomitant increase in interpupillary distance was unexpected, the combined result being a more divergent (relative) eye position with age (P less than 0.01). There was no significant correlation between exophthalmometry and refractive value. Fixed upper Hertel value limits of normal are hard to give; clinically it is the changes that matter. Modelling of facial bony structures and soft tissue contours is discussed.

Adolescent↗
PubMed1986

Changes in refraction and corneal curvature during growth and adult life. A cross-sectional study.

A cross-sectional analysis was performed regarding refractive value (spherical equivalent) and keratometry in a sample comprising 454 subjects aged 5-80 years. The refractive range was + 5.5 to -6.75D. According to the requirements of a parallel study of eye position and age, eyes with excessive ametropia had been excluded, but otherwise the sample was considered refractively unselected. Concerning refractive distribution, the present data supplement previous investigations of adults by the first author. Myopia increased from 6% in the age group 5-10 years to a peak level about 35% in adults aged 20-40, with a subsequent decrease towards old age, where hypermetropia showed a significantly increasing share. Concerning corneal curvature radius, male and female mean values (7.93 and 7.75 mm) showed no variation through the age span under study, however with a tendency of decreasing at old age (significantly in males only). The possible association with refractive change by age is discussed. Corneal astigmatism showed the established shift from predominantly with-rule in the very young to more against-rule and oblique astigmatism cases in older subjects.

Adolescent↗
PubMed1985

Femoxetine and eye function. A study of possible anticholinergic side effects.

A pilot study of the possible anticholinergic side effects of femoxetine comprised eight depressive patients (age 42-65), followed up for a month, and five healthy volunteers (age 26-39), who received medication for a week. As judged primarily from ophthalmic parameters (accomodation, lacrimation, pupil size, intraocular pressure, exe motility, visual acuity and visual fields, slit lamp examination and ophthalmoscopy), there was no indication of anticholinergic side effects of the drug. According to Schirmer-1-test (tear wetting), the rather dry eyes of depressive patients even improved somewhat during medication.

Adult↗
PubMed1984

Prevalences of astigmatism and anisometropia in adult danes. With reference to presbyopes' possible use of supermarket standard glasses.

A report is given of astigmatism and anisometropia prevalences in an adult hospital sample considered refractively unselected. Astigmatism of at least 0.75 cyl value (by subjective trial) appeared in 20% (n = 600), or in 16% of all eyes (some cases being unilateral). Twenty per cent of astigmatic eyes had an oblique axis. Inverse astigmatism (against rule) showed increasing frequency with age. In a sample analysed for anisometropia (n = 1.200) 9% had a side difference of 1 D or more, while 75% had strict isometropia. Eyes with astigmatism and anisometropia are grouped mainly towards the ametropic ends of the refractive distribution curve, away from emmetropia. The data are used for assessing to what extent the presbyopic population can expect benefit from some newly introduced supermarket standard reading-glasses (+1 to +4 D). Probably, about two thirds can use them. Having had a tradition of individual prescription in our country, the offer of standard glasses without professional trial may eventually result in fewer ophthalmic disorders being diagnosed 'by chance'.

Adolescent↗
PubMed1984

Late keratopathy due to intraocular sand particles. A case history with misleading tests for allergy.

After nine years, a boy was cured for his presumed allergic eye disease by microsurgical removal of intraocular sand particles, left in the anterior chamber after a childhood trauma. Sand being considered inert, together with seasonal variation in symptoms and misleading positive tests for allergy were to explain the doctor's delay. Involutive keratopathy eventually developed, with vessel ingrowth, severe photophobia and lacrimation, low intraocular pressure, and a visual acuity of only 1/60. Eight years after surgery there is a clear cornea and a corrected visual acuity of 6/12. The axial length of the diseased eye has remained longer than that of the healthy eye.

Child↗
PubMed1983

Is myopia getting more frequent? A cross-sectional study of 1416 Danes aged 16 years+.

A hospital material considered refractively unselected is made up by adult patients referred for general eye examination from other (non-ophthalmic) departments (n = 1416; 2832 eyes). Thirty per cent of all eyes had negative refractive value. The highest myopia prevalence, about 40%, was seen in the age group 26-45 years. Glass-demanding myopia (of at least -0.75 D) occurred in 14% of the elderly (66 years +) against 27-28% in younger adults. Up to the age of 45, more females were myopic than males. The present prevalences are considerably higher than expected from previous Danish studies. It is discussed to what extent this increase is real. The diabetes of the sample (representing 762 eyes) show a shift towards negative refractive values (37.9% with myopia) as compared to non-diabetics (27.5%). The diabetic surplus is due to low degree myopia cases. The association between myopia and (well-controlled) diabetes seems to be a new observation.

Adolescent↗
PubMed1982

Inhibited growth and development as permanent features of low birth weight. A longitudinal study of eye size, height, head circumference, interpupillary distance and exophthalmometry, as measured at age of 10 and 18 years.

A 10-year assessment of ocular function eye size and other anthropometric parameters indicated a negative influence of low birth weight (LBW). The sample consisted of 302 children with BW less than 2000 g and 237 full-term controls. The former had smaller eyes and there were deficits regarding height, head circumference, interpupillary distance and exophthalmometry readings. Based on an 18-year follow-up study comprising 137 of the above 539, the various LBW deficits have proven to be permanent, and due not only to delayed development around the age of 10. The menarche appeared later in LBW girls (13 1/2 years of age) than in controls (13 years). Exophthalmometry readings have led to rejection of one of the presumed classical permanent stigmata of prematurity: ocular protrusion. The findings indicate that low birth weight is an impediment to the overall development of the individual. It also seems to interfere with some of the usual correlations between growth parameters. In addition, the results confirm the well-known feature: that males have a more marked growth spurt at puberty than females.

Body Height↗