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Biomedical subjects

L Vijaya

Publications and source records attributed to L Vijaya.

At least 19 recordsLinked to original sources
PubMed2006

OPTN gene: profile of patients with glaucoma from India.

PURPOSE: Optineurin gene (OPTN) mutations are reported in primary open angle glaucoma patients (POAG) from different populations. The coding and noncoding regions of OPTN were screened for mutations in 100 Indian high tension glaucoma patients (HTG). The frequency of the OPTN M98K mutation in an additional 120 patients (70 HTG and 50 normal tension glaucoma [NTG]) was analyzed by restriction enzyme digestion. METHODS: The HTG patients (about 40 years of age) were characterized by open angles on gonioscopy, with raised intraocular pressure (IOP) more than 21 mmHg (<21 mmHg on office diurnal phasing for NTG), and typical glaucomatous disc changes with corresponding visual field defects in the absence of any secondary cause. One hundred HTG patients and controls were screened for OPTN mutations by direct sequencing using an ABI prism 310/3100 Avant genetic analyzer. The M98K status was analyzed by restriction enzyme digestion with StuI. A genotype/phenotype correlation was also attempted for OPTN sequence alterations with clinical parameters such as age at diagnosis, intraocular pressure, cup:disc ratio, etc. The putative change in the transcription factor binding site for the IVS7 +24G>A polymorphism was attempted with AliBaba software (version 2.1). RESULTS: Six sequence alterations were observed in the 100 POAG patients by direct sequencing. The M98K substitution was observed in a total of 10 patients (7/170 HTG and 3/50 NTG) contributing to 4.1% in HTG and 6% in the NTG group and not in the controls. The IVS7+24G>A nucleotide change showed a significant difference in the HTG group (7/100) when compared to the control group (0/100) and found to be associated with increased IOP at diagnosis (p=0.03). The IVS7+24G>A polymorphism resulted in the creation of binding sites for transcription factors NF-1 and CPE that were not present in the wild type. CONCLUSIONS: The current study suggests a possible role of SNPs rather than mutations in OPTN in POAG pathology in the Indian population.

Adenine↗
PubMed2006

Influence of tobacco use on cataract development.

AIM: To study the influence of tobacco use on cataract formation in a rural South Indian population. METHODS: 3924 subjects from the Chennai Glaucoma Study conducted in rural south India underwent a comprehensive eye examination, including Lens Opacities Classification System II grading. Information on tobacco use, type of tobacco (smoking and smokeless), duration and quantity of use was collected. RESULTS: 1705 (male:female (M:F) 1106:599) people used tobacco and were significantly older (mean (standard deviation (SD)) age 55.80 (10.64) years) than non-users (52.23 (10.51); p<0.001). 731 (M:F 730:1) people smoked, 900 (M:F 302:598) used smokeless tobacco, and 74 (M:F, 74:0) used tobacco in both forms. The unadjusted and adjusted (age and sex) odds ratio (OR) for a positive history of tobacco use and cataract was 1.72 (95% confidence interval (CI) 1.51 to 1.96) and 1.39 (95% CI 1.15 to 1.68), respectively. The unadjusted OR for smokers and smokeless tobacco users was 1.04 (95% CI 0.88 to 1.23) and 2.74 (95% CI 2.31 to 3.26), respectively. The adjusted OR was 1.19 (95% CI 0.89 to 1.59) and 1.54 (95% CI 1.22 to 1.95), respectively. No significant association was noted between smoking and any particular type of cataract. Smokeless tobacco use was found to be significantly associated with nuclear cataract even after adjusting for age and sex (OR 1.67, p = 0.067, 95% CI 1.16 to 2.39). CONCLUSION: Tobacco use was significantly associated with cataract. Smoking was not found to be significantly associated with cataract formation; however, smokeless tobacco use was more strongly associated with cataract.

Age Distribution↗
PubMed2006

Prevalence and causes of blindness in the rural population of the Chennai Glaucoma Study.

AIM: To study the prevalence and causes of blindness in a rural south Indian population. METHODS: 3924/4800 enumerated (81.75%) subjects, aged 40 years or more from rural Tamil Nadu, underwent comprehensive ophthalmic examination-visual acuity, refraction, intraocular pressure, gonioscopy, cataract grading (LOCS II), retinal examination, and SITA Standard where indicated. Blindness was defined using WHO criteria as best corrected visual acuity of less than 3/60 and/or visual field of less than 10 degrees in the better eye. The influence of age, sex, literacy, and occupation was assessed using multiple logistic regression. RESULTS: 753 subjects (19.2%; 321 males, 432 females) presented with a visual acuity of <3/60; 132 subjects (3.36%, 95% CI: 2.80 to 3.93) were diagnosed to be blind. Cataract was responsible in 74.62% of eyes; glaucoma, cystoid macular oedema, optic atrophy, and corneal scars accounted for 3.79% each. Bilateral causes of blindness were cataract (78.63%), glaucoma (4.29%), optic atrophy (3.42%), cystoid macular oedema, and corneal scars (2.56% each). In 19 eyes (7.2%) the blindness was probably related to cataract surgery. Blindness was positively associated with increasing age (p<0.0001). CONCLUSION: 3.36% of the studied rural population was bilaterally blind, with cataract being the single most important cause.

Adult↗
PubMed2005

Comparison of pulsatile ocular blood flow in Indians and Europeans.

PURPOSE: To compare pulsatile ocular blood flow (POBF) in Europeans and Indians and provide reference values for a group of healthy Indians. PATIENTS AND METHODS: Measurement with the POBF Tonograph was performed on healthy Indian subjects in India (n=252). A further 80 subjects (40 of Indian descent and 40 Europeans) underwent measurements in Cambridge, England. The instrument used for measurement was the same for both the studies. RESULTS: The mean POBF in the Indians in India was found to be 1176 microl/min. The mean POBF value in the Europeans was found to be 1033 microl/min and that for Indians in England was 1061 microl/min. The difference between the POBF within groups was significant (one-way ANOVA P<0.05) with the POBF of Indians in India being higher than Europeans and Indians in the UK. The difference between the Europeans and Indians in the UK did not reach statistical significance. CONCLUSIONS: POBF values in Indians living in India were found to be considerably higher than the previously published normal value of 650 microl/min in European studies and other studies for other racial groups. The reason for this apparent difference may be instrument-related rather than genetic because such a large difference was not observed when a comparison was performed in the UK. In addition, the results for both groups in our comparative study were still considerably higher than reported in previous studies. The POBF of Indians in India is slightly higher than the POBF of people of Indian ethnic origin in England.

Adolescent↗
PubMed2005

Glaucoma in aphakia and pseudophakia in the Chennai Glaucoma Study.

AIM: To determine the prevalence of glaucoma among aphakes and pseudophakes in a rural population of southern India. METHODS: 3924 subjects aged 40 years or above underwent complete ophthalmic examination. Glaucoma in aphakia/pseudophakia was diagnosed using International Society of Geographical and Epidemiological Ophthalmology criteria in aphakic/pseudophakic people. RESULTS: 54 subjects (37 aphakes, 17 pseudophakes) (1.38% of 3924 subjects, 11.2% of 482 aphakes/pseudophakes) had glaucoma in aphakia/pseudophakia. Aphakia, age, intraocular pressure (IOP), pseudoexfoliation, and peripheral anterior synechiae greater than or equal to 180 degrees of the angle were risk factors for glaucoma on univariate analysis. On multivariate analysis, IOP and aphakia were independent risk factors for glaucoma. 39 people (72.22%) with glaucoma had normal IOP at presentation. None of the people with glaucoma were aware of the disease. Blindness in one or both eyes was seen in 12 subjects (10 unilateral and two bilateral)-that is, 22.22% of people with glaucoma in aphakia/pseudophakia. CONCLUSIONS: Glaucoma is an important cause of ocular morbidity among aphakes and pseudophakes in this rural population of south India. This glaucoma, responsible for unilateral or bilateral blindness in 22.2% of those affected, was entirely undetected in this study population.

Adult↗
PubMed2005

Efficacy and safety of latanoprost for glaucoma treatment: a three-month multicentric study in India.

PURPOSE: To evaluate the short-term efficacy and safety of 0.005% topical latanoprost in Indian eyes. DESIGN: Prospective non-randomised open-label multicentric trial. METHODS: One hundred and fifty patients with ocular hypertension (OHT), primary open-angle, pseudoexfoliation or pigmentary glaucoma were enrolled at four centers. Each center contributed at least 20 patients. Following baseline measurements, 0.005% latanoprost was applied topically once daily in the evening for three months. Patients were examined at 2, 6 and 12 weeks. The primary outcome measure was mean intraocular pressure (IOP) reduction. The mean diurnal variation of IOP (difference between highest and lowest IOP) at baseline and at 12-weeks was compared. RESULTS: One hundred and thirty of 150 enrolled patients completed the study. One randomly selected eye of each patient was included for analysis. At three months, latanoprost reduced the mean IOP from 24.9 (+/- 3.16) mmHg at baseline to 16.10 (+/- 2.7) mmHg, a reduction of 35.25%. 83% had a reduction in IOP of > 25%. The IOP reduction was maintained throughout the study period, and was not affected by gender or age of the patient. One eye did not show any response to the drug. Daytime diurnal variation of IOP was reduced from 4.5 to 2.9 mmHg. 20 patients had conjunctival hyperemia. Six patients had side effects requiring withdrawal from the study. CONCLUSIONS: In this short-term multicentric study, latanoprost effectively reduced IOP and stabilised the diurnal curve in Indian eyes. There were no clinically significant ocular or systemic adverse effects.

Adult↗
PubMed2004

Low frequency of myocilin mutations in Indian primary open-angle glaucoma patients.

Glaucoma is one of the major causes of blindness in the Indian population. Mutations in the myocilin (MYOC) gene have been reported in different populations. However, reports on MYOC mutations in Indian primary open-angle glaucoma (POAG) patients and juvenile open-angle glaucoma (JOAG) patients are sparse. We therefore screened 100 unrelated POAG/JOAG patients for MYOC mutations. Patients with POAG/JOAG were clinically diagnosed. Genomic DNA from such patients was collected and studied for MYOC mutations by direct sequencing. Nucleotide variations were compared with unrelated healthy controls by restriction enzyme digestion. Secondary structure prediction for the sequence variants was performed by Chou-Fasman method. A novel mutation in exon 1 (144 G-->Alpha) resulting in Gln48His substitution was observed in 2% of the patients. Four other polymorphisms were also observed. The novel mutation was seen in four other affected family members of a JOAG patient. The novel mutation was found to alter the secondary structure in the glycosaminoglycan initiation site of the protein. MYOC mutations were found in 2% of the population studied. MYOC gene may not be playing a significant role in causing POAG in the Indian population.

Adolescent↗
PubMed2004

Effect of corneal parameters on measurements using the pulsatile ocular blood flow tonograph and Goldmann applanation tonometer.

AIMS: To investigate the effect of central corneal thickness and corneal curvature on intraocular pressure measurements using the pulsatile ocular blood flow tonograph and the Goldmann applanation tonometer, and to assess the agreement between the pulsatile ocular blood flow tonograph and the Goldmann applanation tonometer in intraocular pressure measurement. METHODS: 479 subjects underwent intraocular pressure measurements with the Goldmann applanation tonometer and the pulsatile ocular blood flow tonograph. Of these, 334 patients underwent additional measurement of central corneal thickness with an ultrasonic pachymeter and corneal curvature measurement with a keratometer. RESULTS: The intraocular pressure measurements obtained with both the Goldmann applanation tonometer and the pulsatile ocular blood flow tonograph varied with central corneal thickness and mean keratometric reading. Intraocular pressure measured using the Goldmann applanation tonometer increased by 0.027 mm Hg per micro m increase in central corneal thickness. Intraocular pressure measured using the pulsatile ocular blood flow tonograph increased by 0.048 mm Hg per micro m increase in central corneal thickness. For an increase of 1 mm of mean corneal curvature there was rise in intraocular pressure of 1.14 mm Hg measured by the Goldmann applanation tonometer and of 2.6 mm Hg measured by the pulsatile ocular blood flow tonograph. When compared to the Goldmann applanation tonometer, the pulsatile ocular blood flow tonograph underestimated at low intraocular pressure and overestimated at higher intraocular pressure. CONCLUSION: Central corneal thickness and corneal curvature affected measurements obtained with the pulsatile ocular blood flow tonograph more than they affected measurements obtained with the Goldmann applanation tonometer.

Adolescent↗
PubMed2003

Pseudoexfoliation in South India.

AIM: To study the profile of pseudoexfoliation in a population based study. METHOD: 2850 consecutive subjects aged 40 years or older from a population based survey in a rural area of southern India underwent complete ophthalmic evaluation including history, visual acuity testing, refraction, slit lamp examination, applanation tonometry, gonioscopy, and dilated examination of the lens (including LOCS II grading of cataract), fundus, and optic disc. Patients with pseudoexfoliation syndrome were identified and their data were analysed with respect to age, sex, intraocular pressure, gonioscopic grading, cataract, and optic neuropathy. RESULTS: 108 subjects had pseudoexfoliation syndrome (3.8 %). There was a significant increase in prevalence with age but no sex predilection. The condition was unilateral in 53 cases (49.1%) and bilateral in 55 cases (50.9%). 18 cases with pseudoexfoliation (16.7%) had high intraocular pressure (>21 mm Hg), 16 cases (14.8%) had occludable angles, and 14 cases (13%) had pseudoexfoliation glaucoma. There was a significantly higher prevalence of cataract among people with pseudoexfoliation compared to those without pseudoexfoliation (p = 0.014). CONCLUSION: The prevalence of pseudoexfoliation syndrome in the rural population of south India was 3.8%. Raised intraocular pressure was seen in 16.7% of people with pseudoexfoliation and glaucoma was present in 13%.

Adult↗
PubMed2003

Ocular biometry in occludable angles and angle closure glaucoma: a population based survey.

AIM: To compare ocular biometric values in a population based sample of eyes with occludable angles, angle closure glaucoma, and normal subjects. METHOD: 2850 subjects from a population based glaucoma prevalence study underwent complete ocular examination including indentation gonioscopy. Ocular biometry was performed in all subjects classified to have occludable angles (n = 143); angle closure glaucoma (n = 22), and a random subgroup of 419 normal subjects. Ocular biometry readings between the groups were compared and statistically analysed using "t," "z," and Mann-Whitney U tests. RESULTS: The mean age among subjects with occludable angles (54.43 (SD 9.53) years) and angle closure glaucoma (57.45 (8.5) years) was significantly higher (p<0.001) than normal subjects (49.95 (9.95) years). Axial length was shorter (p<0.001) in the occludable angle group (22.07 (0.69) mm) compared to the normal group (22.76 (0.78) mm). Anterior chamber depth (ACD) was shallower (p<0.001) among subjects with occludable angles (2.53 (0.26) mm) than normal subjects (3.00 (0.30) mm). Lens thickness (LT) was greater (p<0.001) in people with occludable angles (4.40 (0.53) mm) compared to normal subjects (4.31 (0.31) mm). No significant difference was noted in axial length, ACD (p = 0.451), and LT (p = 0.302) between angle closure glaucoma and occludable eyes. CONCLUSION: South Indian eyes with angle closure glaucoma and occludable angles seem to have significantly shorter axial lengths, shallower anterior chambers and greater lens thickness compared to the normal group.

Adult↗
PubMed1999

Ultrasound Biomiscroscopy in the diagnosis and management of cyclodialysis clefts.

PURPOSE: To report the role of Ultrasound Biomicroscopy (UBM) as a tool in the diagnosis and management of cyclodialysis clefts. METHODS: Six eyes of 6 patients with hypotony and suspected or diagnosed cyclodialysis clefts underwent UBM evaluation. Post-treatment UBM was performed in four eyes to assess the effect of the treatment. RESULTS: Cyclodialysis clefts were accurately diagnosed and delineated in 6 eyes by UBM. Complete closure was documented after treatment in 3 eyes, and a residual cleft in one eye. These findings were compared to gonioscopic findings. CONCLUSIONS: UBM is a safe, accurate and noninvasive diagnostic tool in the diagnosis of cyclodialysis clefts and is of particular use when other conventional methods of diagnosis are inconclusive.

Adolescent↗
PubMed1998

The role of artificial drainage devices in glaucoma surgery.

The use of artificial drainage devices (ADDs) or "setons" in glaucoma surgery is generally restricted to patients with refractory glaucoma at high risk for failure from conventional filtration surgery. ADDs, both valved and nonvalved are currently available in this country. Recently, some of these devices have been propogated as primary treatment even for primary glaucomas. This article examines the role of ADDs in the modern management of the glaucomas. Specific indications for ADDs and methods to reduce the complication of overfiltration are discussed. The use of antimitotics, such as 5-fluorouracil or mitomycin, with traditional filtration has decreased the indications for ADDs. The literature and our experience confirm that currently there is no role for use of ADDs as a primary procedure in most glaucomas.

Animals↗
PubMed1997

In vitro effects of mitomycin C on human Tenon's capsule fibroblasts & correlation with surgical outcome in glaucoma patients.

The effects of mitomycin C (MMC, 1 microgram/ml for 5 min) on growth and morphology of six MMC 'sensitive' and four MMC 'resistant' human Tenon's capsule fibroblasts grown from 10 patients who had had trabeculectomy for glaucoma were studied. The surgical outcome of trabeculectomy in these patients were evaluated at the end of 8-10 wk. Both types of fibroblasts showed increase of growth up to 7 days. MMC 'sensitive' fibroblasts degenerated and declined to insignificant numbers in 47 days. MMC 'resistant' fibroblasts after a decline in growth up to 27 days showed remarkable recovery in morphology and growth by day 37. Surgical outcome positively correlated with in vitro results of 'sensitive' fibroblasts. A few clones of MMC 'resistant' fibroblasts survived and multiplied as MMC effect had worn off.

Antibiotics, Antineoplastic↗
PubMed1996

Results of intraoperative 5-fluorouracil in patients undergoing trabeculectomy--pilot trial.

To study the effect of 5-Fluorouracil (5-FU) in glaucoma filtration surgery, 13 eyes of 12 patients with glaucoma were subjected to trabeculectomy with intraoperative one minute exposure of 50 mg/ml 5-FU. The average age of patients was 36.42 +/- 18.78 years. Two of the patients had developed hypotony in the fellow eye following the use of Mitomycin C with trabeculectomy. The mean follow-up period was 9.54 +/- 5.17 weeks. Two patients developed a shallow anterior chamber with choroidals postoperatively which responded to conservative treatment. One patient developed an encysted bleb one month after surgery. Single one minute intraoperative exposure to 5-FU is a convenient and inexpensive method which appears to have no significant side effects. It may be a useful adjunctive treatment to optimise the results of glaucoma filtration surgery particularly in young and myopic patients. The long term effects, however, are not known.

Adolescent↗
PubMed1994

Single-plate Molteno implants in complicated glaucomas: results, survival rates, and complications.

Sixty-two single-plate single-stage Molteno implantations for complicated glaucomas were performed between March 1991 and November 1992. The charts of all these patients were reviewed to determine the intraocular pressure (IOP) control success rate (< 21 mm Hg with or without medications), visual success rate (retention or improvement of visual acuity from preoperative level) and the rate of complications encountered. A Kaplan-Meier life-table (survival) analysis was also performed. IOP control was obtained in 74.2% of cases. Mean postoperative IOP was 16.97 +/- 8.07 mm Hg (Mean +/- SD). Visual success was obtained in 51.6% of the eyes. Eyes with aphakia/pseudophakic glaucomas showed the best response with 80% of them achieving IOP control and 60% achieving visual success. The survival plot for IOP control revealed 75.81% and 74.19% success rates at 48 and 72 weeks, respectively. Complications encountered were either due to the early postoperative hypotony or were tube-related. These results were gratifying considering the severity of the glaucoma in these cases and they reaffirm the usefulness of the Molteno implant in the management of difficult glaucomas.

Adolescent↗
PubMed1994

Familial nanophthalmos: management and complications.

Nanophthalmos is a rare form of congenital hypermetropia, in which, the individual is at a high risk of developing angle-closure glaucoma. We report a family of nanophthalmos affecting a brother and sister, as confirmed by biometry. Genetic analysis revealed an autosomal recessive mode of inheritance. The sister developed angle-closure glaucoma, which was refractory to medical and laser therapy. She underwent surgical interventions which resulted in complications. The clinical presentation, management, and complications encountered are discussed.

Adult↗