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Biomedical subjects

J M Sparrow

Publications and source records attributed to J M Sparrow.

At least 73 records · Page 4Linked to original sources
PubMed1992

Factors related to the incidence of secondary haemorrhage in 462 patients with traumatic hyphema.

In a retrospective study of 462 in-patients with traumatic hyphema, secondary haemorrhage occurred in 8.7% of patients. A multivariate analysis demonstrated that the size of hyphaema on presentation and the presence of retinal damage did not affect the probability of secondary haemorrhage. The incidence of secondary haemorrhage was found to decrease by approximately half with the use of topical steroid (p = 0.005), but did not appear to be influenced by the use of cycloplegics. These data indicate in an unselected sequential population of patients, the therapeutic importance of topical steroid in the treatment of blunt ocular trauma.

Administration, Topical↗
PubMed1992

The relationship between central nuclear scatter and perinuclear retrodots in the human crystalline lens.

Retrodots are common perinuclear features of age-related cataract. Clinical observation suggested that retrodots were associated with increased nuclear scatter. To test this hypothesis, retrospective data were analysed from 78 non-diabetic subjects (118 eyes), of at least 50 years of age, who had neither subscapsular nor axial spoke opacities. Retrodots were graded using the Oxford Clinical Cataract Classification and Grading system and central nuclear scatter was assessed by image analysis of Scheimpflug photographic negatives. Regression analysis in groups was performed according to the "intra-class correlation model" either considering retrodots as a graded feature (grades 0-5) or as a dichotomous variable (present or absent). After adjusting for age (treated as a co-variate), a highly significant association (P < 10(-6) was found between retrodots and increased nuclear scatter in each analysis. It is suggested that the co-existence of these two cataract types may reflect a common cataractogenic mechanism, possibly oxidative stress.

Aged↗
PubMed1992

Biometry and auto-fluorescence of the anterior ocular segment in diabetics with and without autonomic neuropathy: a case control study.

The biometry and auto-fluorescence of the anterior ocular segment were examined in a case control study of two populations of diabetics. Cases, with diabetic autonomic neuropathy, and controls without neuropathy (forty in each group) were selected from a community based diabetic population and matched individually for age, sex, and type of diabetes. Scheimpflug and auto-fluorescence anterior segment photography were performed and analysed by digital image analysis in a masked fashion. There were differences between the groups in axial lens thickness, front radius of curvature of the lens, anterior chamber depth and lenticular auto-fluorescence. These findings are discussed in the context of the known association between autonomic neuropathy and narrow angle glaucoma, and possible common mechanisms of tissue damage in diabetes.

Aged↗
PubMed1992

Autofluorescence of the crystalline lens in early and late onset diabetes.

Blue/green autofluorescence (excitation around 420 to 430 nm, emission around 520 nm) of the crystalline lens has been studied by an in vivo photographic method in two populations of diabetics and controls. The populations consisted of a geographically based survivor group of 161 mixed early and late onset diabetics (and 133 non-diabetic controls) and a second group of 104 early onset insulin dependent diabetics (and 138 non-diabetic controls), the latter all with non-cataractous lenses. Powerful associations (p less than 10(-6) were found between the presence of diabetes and increased lenticular autofluorescence in both populations. Among the mixed diabetics diabetic type was a significant factor after accounting for the effects of age and diabetic duration. In the early onset group (clear lenses) a powerful association existed between autofluorescence and diabetic duration (p = 0.000011) after allowing for the effect of age, while in a subgroup of late onset diabetics with clear lenses this effect was modest (p = 0.015). In the early onset diabetic group diabetic retinopathy (p = 0.0064) was associated with increased lenticular autofluorescence after allowing for the effects of age and diabetic duration. In addition a powerful interaction between diabetic duration and the presence of diabetic retinopathy (p less than 10(-6) was found in this subgroup. Among the geographically based population of diabetics, increased nuclear brunescence was powerfully associated (p less than 10(-6) with increased autofluorescence after allowing for the effects of age, diabetic duration, and type of diabetes. This association was not found in the non-diabetic population. Non-enzymatic glycosylation of lens proteins should be considered as a possible mechanism of production of the fluorogen with emission around 520 nm.

Adolescent↗
PubMed1992

Biometry of the crystalline lens in late onset diabetes: the importance of diabetic type.

Lenticular and anterior chamber biometry were studied in non-cataractous eyes by means of Scheimpflug photography and digital image analysis. The study population consisted of 91 late onset diabetic subjects and 115 non-diabetic controls. Anteroposterior axial lens thickness, cortical thickness, nuclear thickness, anterior clear zone thickness, anterior chamber depth, and anterior and posterior lenticular curvatures were assessed. Age played an important role in determining lens biometry in all subjects, and small but significant differences were found between late onset diabetics and non-diabetics. In the late onset diabetic subgroup, apart from age, diabetic retinopathy was the only significant parameter found which determined lens biometry. These biometric findings in late onset diabetes are in marked contrast to the large overall effect of diabetes and the powerful effect of diabetic duration which we previously reported in early onset diabetes. Further analysis of the data from our previous study has been provided, which clearly demonstrates differences between the impact of early and late onset diabetes on the biometry of the anterior ocular segment.

Adult↗
PubMed1991

The acuityscope: a resolution test target projection ophthalmoscope.

The Acuityscope projects an image of a three bar resolution test target onto the patient's retina, where it is viewed and read by an observer. The test target consists of a series of three bar targets varying in size on a logarithmic scale. Individual targets are identified in the projected image by Bailey-Lovie log visual acuity equivalents. The projected image includes only those target sizes which are useful for estimating visual acuity. The Acuityscope is used for assessing the quality of retinal image formation, and is thus able to differentiate between poor visual acuity due to image degradation, (e.g. cataract or corneal disease) and poor visual acuity due to image handling defects (e.g. retinal or optic nerve disease). The use of the instrument is relevant to both clinical situations (e.g. pre-operative assessment of opacification of optical media) and experimental situations (e.g. clinical trials).

Equipment Design↗
PubMed1990

The Oxford modular cataract image analysis system.

A modular system of acquisition and analysis of Scheimpflug, retro-illumination and fluorescence images of the in vivo human crystalline lens is described. Image analysis is directed towards the following goals: Scheimpflug slit-images are analysed for: (1) The optical density of nuclear cataract present; (2) The dimensions of the lens and the lenticular zones; (3) The curvatures of the lens and lenticular zones. Retro-illumination images are analysed for: (1) The percentage area which is occupied by cataract; (2) A combined measure (weighted integral) describing both the amount of cataract present and its optical density. Lenticular auto-fluorescence images are analysed for the mean density (fluorescence) of the lens as a whole. A pilot study of the repeatability of the methods is presented.

Cataract↗
PubMed1990

Biometry of the crystalline lens in early-onset diabetes.

Lenticular biometry on non-cataractous lenses has been studied by means of Scheimpflug photography and digital image analysis in 153 patients with early-onset insulin-dependent diabetes and 153 non-diabetic controls. Anteroposterior axial lens thickness, cortical thickness, nuclear thickness, anterior and posterior lenticular curvatures, and anterior chamber depth were assessed. Highly significant differences between the lenses of the diabetic subjects and non-diabetic controls were found. After the effect of age had been accounted for within the diabetic subgroup, diabetic duration was found to be a highly significant determinant of lens dimensions, such that age-related dimensional changes for various biometric parameters were accelerated by between 52% and 121% after the onset of diabetes. Because the diabetic duration of the early-onset diabetic subjects studied in this work was accurately known, this report is the first in which a precise assessment of the effect of 'true' diabetic duration on lens biometry has been possible.

Adolescent↗
PubMed1990

The lens after renal transplantation.

A single masked observer examined 55 non-diabetic patients chosen randomly from a population of patients who had undergone renal transplant. The mean age was 41 years and mean time from transplant was 4.4 years (1-10 years). Fourteen patients were found to have a posterior subcapsular cataract (PSC). The axial thickness of the right lens of the renal transplant population, even in the presence of a PSC, was significantly larger than in a control population of 99 patients with clear lenses. The PSC of renal transplantation is readily distinguished from age related PSC because the opacity lies in the superficial cortex at a depth proportional to time from transplant and the lens maintains a normal anterior clear zone. It is proposed that this type of cataract be called 'recovering' PSC. It is concluded that the cataractogenic insult occurs mainly during the peritransplant period. Maintenance doses of immunosuppressives or steroids are therefore probably not cataractogenic.

Adult↗
PubMed1989

Dynamic nature of posterior subcapsular cataract.

Posterior subcapsular cataracts were studied in 10 patients (19 eyes) and were photographed at four to 12 weeks intervals by the Oxford Retroillumination Camera. Changes in the fine structure of PSC may occur in as short a time as four weeks. Posterior subcapsular cataracts are shown to be in a state of flux and are not, as might be assumed, slowly but relentlessly progressive. This could imply the existence of a repair mechanism in the lens.

Adult↗
PubMed1988

Human lens nuclear colour matching and brunescence grading in vivo.

The nuclear colour of in vivo human lenses has been investigated by means of a colour matching technique, using 'Munsell' colour samples. Observations covered an extended age range, and included all degrees of nuclear pigmentation. A positive correlation was noted between increasing nuclear pigmentation and age. The colour matching data generated was used as a basis for establishing a system of nuclear brunescence grading. The system of grading consists of a Grade 0 for absence of brunescence, and Grade 1 to Grade 5 for increasing brunescence. The 'Munsell' notation for samples representing these grades are: Grade 0 (5GY 6/1), Grade 1 (5Y 7/4), Grade 2 (2.5Y 7/8), Grade 3 (7.5YR 6/8), Grade 4 (5YR 4/6), and Grade 5 (2.5YR 2.5/2). Assessments of both inter- and intra-observer variability in the use of the derived scale have shown the new colour grading system to be reliable. The measure is simple to use during biomicroscopic slit-lamp examination of the lens, and has the potential for routine clinical application as well as for use in clinical trials where detailed documentation of lens morphology is required. The new colour scale may be used either as an isolated measure, or as part of a battery of lens measures in the Oxford Clinical Cataract Classification and Grading system.

Aging↗
PubMed1988

Inter-observer and intra-observer variability of the Oxford clinical cataract classification and grading system.

Intra-observer (within observers) and inter-observer (between observers) variability of the Oxford Clinical Cataract Classification and Grading System were studied. Twenty cataracts were examined and scored independently by four observers. On a separate occasion two of the observers repeated the assessments of the same cataracts in the absence of information from the initial observations. The chance corrected and weighted kappa statistics for observer agreement, both for inter-observer and intra-observer variability demonstrated satisfactory repeatability of the cataract grading system. The overall intra-observer mean weighted kappa was kappa w = +0.68 (range SE kappa = 0.012-0.052) and the overall inter-observer mean weighted kappa was kappa w = +0.55 (range SE kappa = 0.011-0.043).

Cataract↗
PubMed1988

Control of astigmatism in cataract surgery.

A study is reported on cataract surgery, with intraocular lens implant, with measurement of the preoperative astigmatism and of the postoperative astigmatism over 28 weeks. Nine interrupted 10/0 nylon sutures are used to close a limbal section. Preoperative astigmatism is compensated for in the method of suturing by the placement of additional sutures. Postoperatively sutures are cut in line with the plus cylinder axis in eyes showing excessive astigmatism with the rule. Final postoperative astigmatism is controlled within 2.25 D cyl. 68% of cases lie within 1.0 D cyl with the rule to 1.0 D cyl against the rule. The average case in which sutures are not cut is one having 1.51 D cyl with the rule at one week postoperatively, declining to zero at approximately 12 weeks, and having a final value of 0.17 D cyl against the rule. No significant change in cylinder is seen after 10 weeks. The final postoperative astigmatism is only weakly correlated with the preoperative astigmatism, showing that the surgical method is effective. The spherical equivalent error is shown to shift in the direction of myopia in the postoperative period.

Astigmatism↗
PubMed1988

Central compaction in the process of lens growth as indicated by lamellar cataract.

The lens growth through life is the net result of surface accretion partially offset by central compaction. Compaction has previously been shown to affect the cortex. The present study examines compaction in the nucleus by measuring the change in dimensions of congenital lamellar cataract with time and by comparing the different dimensions of dominantly inherited lamellar cataract in individuals of different ages in the same family. It is now shown that compaction affects the nucleus at a decreasing rate with increasing age and that the rate of compaction of lamellar cataracts is faster the greater diameter of the affected lamella. It is concluded that compaction of lens fibres towards the centre of the lens affects all regions of the cortex and nucleus in youth and that the compaction becomes largely or completely confined to the cortex in middle age and beyond. The shape of the lamellar cataract changes from a lenticular shape in youth to a rounded shape with increasing age. This accounts for the development of the peripheral divergence of the zones of discontinuity of the cortex, which allows the lens to remain emmetropic with increasing age in spite of changes in surface curvature.

Adolescent↗
PubMed1987

An estimate of the size and shape of the human lens fibre in vivo.

The size and shape of the lens fibres were estimated by specular reflex photography. The fibres were measured in three separate regions. Peripheral fibres have a mean width of 10.2 micron, the central fibres 11.9 micron, and the central fibres with suture 15.8 micron. Measurements were made of the taper (becoming narrower towards the suture) and flare (becoming wider towards the suture). The peripheral fibres have a mean taper of 0.3 micron per 100 micron. The central fibres have a mean flare of 0.6 micron per 100 micron, and the central fibres with suture have a mean flare of 2.4 micron per 100 micron. These differences are highly significant (p less than 10(-6]. From these measurements the overall shape of the average lens fibre was estimated. This fibre tapers as it passes forward from the equator to the peripheral extent of the lens sutures and then flares increasingly as the junction with the lens suture is approached. A mean increase in peripheral lens fibre width with age at 0.028 micron per year was demonstrated. This is significant (p = 0.042). No difference in fibre width was found in diabetics and non-diabetics.

Adolescent↗