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PubMed1996

Correlation of lens thickness with blood glucose control in diabetes mellitus.

The aim of this study was to verify if lens thickness in insulin-dependent diabetic patients is greater than in non-diabetics, and to establish which parameters affect the thickness of the lens age, diabetes duration, glycaemic control, insulin dose. Ultrasound biometry and blood glucose measurements were taken in 87 patients three times a day: fasting 2 and 4 h after lunch. The patient sample was divided into three groups: 30 with no retinopathy, 30 presented background retinopathy and 27 with proliferative retinopathy; 30 normal subjects with a similar age to the diabetic group, comprised the control group. No correlation was found between biometric values and blood glucose in the three groups (p < 0.05). A significant difference in lens thickness was found in the four groups, even after adjusting for age (p < 0.05). Significant differences in lens thickness were seen between proliferative retinopathy and the other groups, after adjusting for age and duration of diabetes (p < 0.05); lens thickness was shown to correlate with diabetes duration (p < 0.05).

Adult↗

PubMed2006

Type 2 diabetes and periodontal indicators: epidemiology in France 2002-2003.

BACKGROUND AND OBJECTIVE: Diabetes and periodontal disease have been associated in the literature. In the present study, the periodontal heath of noninsulin-dependent diabetic adults was compared with that of a general population of nondiabetic patients. MATERIAL AND METHODS: In France, 2144 adults (age: 35-65 years) were examined for life habits (tobacco, alcohol), biological diagnosis (type II diabetes, arterial hypertension), biometry (weight, size) and biochemistry. Dental and periodontal data included plaque index, gingival index, probing depth, and clinical attachment loss. RESULTS: Descriptive and multifactorial analysis evidenced a more severe periodontal disease in diabetic patients. Moreover, when the plaque index was held constant, the gingival index was more elevated in diabetics. In nondiabetics, age, gender, glycemia, alcohol, and tobacco smoking were identified as significant risk factors for periodontal disease. In contrast, in diabetic subjects, only tobacco smoking was a significant risk factor. CONCLUSION: In type II diabetics, the diabetes factor is probably more significant than periodontal risk factors, age, and gender.

Adult↗

PubMed2006

Effects of oral L-arginine on the foetal condition and neonatal outcome in preeclampsia: a preliminary report.

Estimation of the influence of oral supplementation with low dose of L-arginine on biophysical profile, foeto-placental circulation and neonatal outcome in preeclampsia. Randomized, placebo-controlled, double-blind, clinical trial. Oral therapy with 3 g of L-arginine daily or placebo as a supplement to standard therapy. Eighty-three preeclamptic women, randomly assigned to the L-arginine (n=42) or placebo (n=41) groups; [n=30 (L-arginine) and n=31 (placebo) ended the study, respectively]. Foetal gain chances due to ultrasound biometry, biophysical profile, Doppler velocimetry of pulsatility indices of umbilical and middle cerebral arteries, cerebro-placental ratio, as well as differences in duration of pregnancy and clinical data of newborn. L-arginine treatment transitory accelerated foetal gain and improved biophysical profile. Starting from 3rd week of therapy, the umbilical artery pulsatility indices values were significantly lower in L-arginine than in placebo group. Moreover, treatment with L-arginine caused significant increase of middle cerebral artery pulsatility indices and cerebro-placental ratio values. Latency was longer in L-arginine group. Neonates delivered in the L-arginine group revealed higher Apgar score. Supplementary treatment with oral L-arginine seems to be promising in improving foetal well-being and neonatal outcome as well as in prolonging pregnancy complicated with preeclampsia. However, these benefits require confirmation in more-powered, larger studies.

Administration, Oral↗

PubMed1986

Complications and visual outcome 4 months after extracapsular cataract extraction with implantation of posterior chamber lenses. A prospective clinical study.

Sixty-seven patients were examined 3 to 5 1/2 (mean 4) months after intended extracapsular cataract extraction with implantation of the 3 M, style 83, posterior chamber lens. A visual acuity greater than or equal to 0.5 was recorded in 58 (86.6%) of the patients. The complications were: one (1.5%) case of acute iritis, one case of pupillary capture and two (3.0%) cases of capsulotomy-requiring early secondary cataract. There were no posterior segment complications. None of the patients were treated with anti-glaucomatous medication, and none had intraocular pressure above 20 mmHg. Pre-operatively, biometry was performed, and the SRK-formula was employed in estimating the post-operative spherical equivalent refraction: The actually measured refraction differed less than 2 diopters from the predicted refraction in 84.5% of the cases.

Cataract Extraction↗

PubMed1993

Secondary implantation of flexible open loop anterior chamber IOLs.

Secondary implantation of flexible, open loop anterior chamber IOLs was performed on 20 aphakic eyes between January 1990 and May 1992. In 3 cases anterior vitrectomy was necessary. No other complications were encountered during surgery. The patients were followed up for 4 months postoperatively. Seventeen eyes achieved a corrected visual acuity of 5/5 or better. Fourteen eyes achieved the same visual acuity as preoperatively, and 5 ended with an improved visual outcome. In one case the visual acuity became worse than preoperatively due to cystoid macular edema. No other serious postoperative complications occurred. The postoperative refraction was within 1 diopter of emmetropia in 16 eyes compared to the estimated (biometry) 19 eyes. We conclude that implantation of flexible open loop anterior chamber IOLs is a safe procedure in properly selected cases.

Adult↗

PubMed2007

Management of fetal growth restriction.

Fetal growth restriction (FGR) is challenging because of the difficulties in reaching a definitive diagnosis of the cause and planning management. FGR is associated not only with a marked increased risk in perinatal mortality and morbidity but also with long-term outcome risks. Combinations of fetal biometry, amniotic fluid volume, heart rate patterns, arterial and venous Doppler, and biophysical variables allow a comprehensive fetal evaluation of FGR. However, no evidence supports that the use of cardiotocography or the biophysical profile improves perinatal outcome. Therefore, obstetricians aim to identify fetuses with early FGR so delivery can be planned according to gestational age and severity of the condition. The balance of risks and the need for the availability of services mean that the involvement of neonatologists in FGR management is vital. In this review, the focus is on the pathophysiology and management of FGR caused by placental diseases.

Arteries↗

PubMed2004

Childhood myopia and parental smoking.

AIM: To examine the relation between exposure to passive parental smoke and myopia in Chinese children in Singapore. METHODS: 1334 Chinese children from three schools in Singapore were recruited, all of whom were participants in the Singapore Cohort study Of the Risk factors for Myopia (SCORM). Information on whether the father or mother smoked, number of years smoked, and the number of cigarettes smoked per day during the child's lifetime were derived. These data were correlated with contemporaneously obtained data available in SCORM. The children's cycloplegic autorefraction, corneal curvature radius, and biometry measures were compared with reported parental smoking history. RESULTS: There were 434 fathers (33.3%) and 23 mothers (1.7%) who smoked during their child's lifetime. There were no significant trends observed between paternal smoking and refractive error or axial length. After controlling for age, sex, school, mother's education, and mother's myopia, children with mothers who had ever smoked during their lifetime had more "positive" refractions (adjusted mean -0.28 D v -1.38 D) compared with children whose mother did not smoke (p = 0.012). CONCLUSIONS: The study found no consistent evidence of association between parental smoking and refractive error. There was a suggestion that children whose mothers smoked cigarettes had more hyperopic refractions, but the absence of a relation with paternal smoking and the small number of mothers who smoked in this sample preclude definite conclusions about a link between passive smoking exposure and myopia.

Child↗

PubMed2006

Axial length and optic disc size in normal eyes.

AIM: To investigate the relationship between optic disc area and axial length in normal eyes of white and black people. METHODS: Consecutive eligible normal subjects were enrolled. Ocular biometry was obtained using A-scan ultrasonography, and reliable images of the optic disc were obtained using a confocal scanning laser ophthalmoscope. The relationship between optic disc area and axial length was assessed using univariate and multivariate models. RESULTS: 281 eyes of 281 subjects were enrolled. Black subjects (n = 157) had significantly larger discs (mean (SD) disc area, 2.12 (0.5) mm(2)) than white subjects (n = 124; 1.97 (0.6) mm(2); t test, p = 0.02). Optic disc area increased with axial length (Pearson's correlation coefficient, r = 0.13, p<0.035) for the entire study population. Multivariate regression models including race, disc area and axial length showed that a significant but weak linear relationship exists between axial length and disc area (partial correlation coefficient 0.14; p<0.024), and with race and disc area (partial correlation coefficient 0.19; p<0.017) when adjusted for the effects of other terms in the model. CONCLUSION: Increased disc area is associated with longer axial length measurements and African ancestry. This may have implications for pathophysiology and risk assessment of glaucoma.

Adolescent↗

PubMed1988

Pre- and postoperative refraction after cataract extraction with implantation of standard power IOL.

The pre- and postoperative refraction results are reported in 99 patients receiving an anterior chamber lens of standard 19.0 D power after intracapsular cataract extraction. The mean refraction after the operation was -0.76 D, SD 2.13. Apart from eight patients with suspected lenticular myopia, 5% of the patients ended up with a refraction that differed more than +/- 5D from the preoperative value. This variation was due to variation in the power of the biological lens removed at surgery, the mean value of which was 22.8 D, SD 3.3. As a measure of the aniseikonia induced at surgery, the ocular magnification was calculated to increase 2.7%, SD 4.2%, as compared with the preoperative value. The variation should be considered in the discussion of whether a preoperative biometry and calculation of appropriate IOL power are recommended or not.

Aged↗

PubMed1989

Computerised intraocular lens calculation: clinical results and predictability.

The predictability of a theoretical, computer-assisted IOL calculation method and of the Sanders-Retzlaff-Kraff (SRK) method was evaluated from pre- and postoperative biometry in 110 cataractous patients subjected to a routine IOL calculation. With the theoretical method and the preoperative data the refraction was on the average 0.72 D (SD 0.78) more myopic than expected, an error which could be corrected for by (1) substituting the assumed postoperative chamber depth by the actual mean value and (2) adding 0.16 mm to the preoperative axial length. With the postoperative data the error was 0.05 D (SD 0.78) (p greater than 0.05). By the SRK method the refraction was 0.15 D (SD 0.71) and 0.37 D (SD 0.69) more hyperopic than expected with the pre- and the postoperative data respectively. These offset errors could be corrected for in either case by adjusting the assumed A constant in the SRK formula. With appropriate empirical corrections for offset errors the theoretical and the SRK method were similar in accuracy, that is, about 82% of the predictions within +/- 1 D, 99% within +/- 2 D, and 100% within +/- 3 D error. The variation in postoperative refraction after computerised IOL calculation was about one-third of the variation previously seen after implantation of standard power IOL.

Aged↗

PubMed1998

Vertical cup/disc ratio in relation to optic disc size: its value in the assessment of the glaucoma suspect.

AIMS: The vertical cup/disc ratio (CDR) has long been used in the assessment of the glaucoma suspect, though the wide range of CDR values in the normal population limits its use. Cup size is related physiologically to disc size and pathologically to glaucomatous damage. Disc size can be measured at the slit lamp as the vertical disc diameter (DD). The ability of the CDR, in relation to DD, to identify glaucomatous optic discs was investigated. METHODS: 88 normal, 53 early glaucoma, and 59 ocular hypertensive subjects underwent stereoscopic optic disc photography and clinical biometry. Photographs were analysed in a masked fashion by computer assisted planimetry. The relation between vertical cup diameter and DD was explored by linear regression, and expressed in terms of CDR. The upper limit of normal was defined by the 95% prediction intervals of this regression (method 1) and by the upper 97.5 percentile for CDR (method 2). The sensitivity and specificity of CDR to identify an optic disc as glaucomatous was tested with these disc size dependent and disc size independent cut offs in small, medium, and large discs. RESULTS: The CDR was related to DD by the equation CDR = (-1.31 + (1.194 x DD))/DD. The sensitivity in small, medium, and large discs was 80%, 60%, and 38% respectively for method 1 and 33%, 67%, and 63% respectively for method 2. Specificity was 98.9% (method 1) and 97.7% (method 2). CONCLUSIONS: The CDR, relative to disc size, is useful clinically, especially to assist in identifying small glaucomatous discs.

Diagnosis, Computer-Assisted↗

PubMed1998

Measurement of optic disc size: equivalence of methods to correct for ocular magnification.

AIMS: To compare methods available to correct the magnification of images that result from the optics of the eye and identify errors, and source of error, of the methods. METHODS: 11 methods were applied to ocular biometry data from three independent cohorts. Each method was compared with the method of Bennett, which uses most biometric data. The difference between each method and Bennett's is the "error" of the method. The relation between the error and axial length, ametropia, and keratometry was explored by linear regression analysis. RESULTS: Methods using axial length had the lowest mean (+0.5 to +2.6%) and standard deviation (0.6 to 1.2%) of errors. Of methods using keratometry and ametropia only, the lowest mean (-1.4% to +4.4%) and standard deviation (2.9 to 4.3%) of errors was found for a new method described in this paper, and that used by the Heidelberg retina tomograph (HRT). The highest mean error (+2.2 to +7.1%) was found for Littmann's method. Littmann's correction was larger than the HRT's by 3.5 to 3.7%. The mean difference between the new and HRT methods and the "abbreviated axial length" method of Bennett is -1.3 to +2.0%. The error of the "keratometry and ametropia" methods is related to axial length. CONCLUSIONS: Methods using axial length are most accurate. The abbreviated axial length method of Bennett differs little from more detailed calculations and is appreciably more accurate than methods using keratometry and ametropia alone. If axial length is unknown, the new and the HRT methods give results closest to the abbreviated axial length method.

Aged↗

PubMed1999

Audit of extracapsular cataract extraction and posterior chamber lens implantation as a routine treatment for age related cataract in east Africa.

AIMS: To evaluate the outcome of extracapsular cataract extraction (ECCE) and posterior chamber intraocular lens implantation (PC-IOL) in an African eye clinic during the transition from intracapsular cataract extraction to ECCE and PC-IOL. METHODS: A retrospective survey of 461 consecutive operations for age related cataract with a mean follow up of 52.9 weeks (range 0-275) and a minimum follow up of 4 weeks in 87.9% of eyes. RESULTS: A best corrected vision of 6/18 or better was obtained in 94.3% of eyes, and an uncorrected vision of 6/18 or better in 78.2% of eyes. Six eyes (1.5%) had a best corrected vision of less than 6/60. The visual acuity at 2 months was strongly predictive of the vision at 1 year or more after surgery. Preoperative biometry and IOL power calculation increased the proportion of eyes obtaining an uncorrected vision of 6/18 or better from 73.8% to 81.3%. Four eyes developed visually significant posterior capsule opacity. CONCLUSION: ECCE and PC-IOL can give very good results in an African setting. A better visual outcome should lead to increased demand for cataract surgery, which will eventually reduce the number of cataract blind people in Africa.

Aged↗

PubMed2001

Myopia and night lighting in children in Singapore.

AIM: To examine the role of night time lighting and myopia in children in Singapore METHODS: A cross sectional study was conducted on 1001 children in two Singapore schools. Cycloplegic refraction and A-scan biometry measurements were made in both eyes. A detailed questionnaire was completed by the parents to obtain information on night time lighting, near work activity, educational and demographic factors. RESULTS: There was no difference in myopia prevalence rates in children exposed to night time light (33.1%) compared with children who slept in the dark (31.4%) before age 2. In addition, vitreous chamber depth was not related to night light (p = 0.58) before age 2. These results remained even after controlling for near work. CONCLUSION: Myopia is not associated with night light in Asian populations.

Anterior Chamber↗

PubMed2001

Academic achievement, close up work parameters, and myopia in Singapore military conscripts.

AIM: To determine the relation of refractive error to environmental factors, including close up work, in Singapore military conscripts. METHODS: A cross sectional study was conducted on 429 Singapore military conscripts. Non-cycloplegic refraction and A-scan biometry were performed in both eyes. A detailed questionnaire was administered by in-person interview to obtain information about current and past near work activity, extra tuition lessons, educational experiences, and family demographics. RESULTS: Myopia associated with the conscript having been educated in the (gifted, special, or express) educational streams (adjusted odds ratio (OR) = 3.8, 95% confidence interval CI 2.0-7.3), and having completed pre-university education (OR=4.1, 95% CI 1.9-8.8). The reported close up work activity at age 7 years did correlate with age of onset of myopia (p<0.001). In parallel, supplemental tuition lessons in primary school has (OR=2.6, 95% CI 1.4-4.9) associated with conscript myopia. Parental myopia was positively associated with myopia (p<0.001), but this relation disappeared when adjusted for environmental factors. Current (p=0.83) and past close up work activity at age 7 years (p=0.13) did not correlate with myopia. CONCLUSION: Educational level and educational stream positively related to myopia. A relation was observed with reported close up work activity in early childhood and with tuition classes during elementary school, but not with current close up work activity. These results underscore the strong influence of environment in myopia pathogenesis but a role for close up work activity remains indeterminate.

Adult↗

PubMed2003

Sutureless cataract surgery with nucleus extraction: outcome of a prospective study in Nepal.

AIM: To report the short and medium term outcome of a prospective series of sutureless manual extracapsular cataract extractions (ECCE) at a high volume surgical centre in Nepal. METHODS: Cataract surgery was carried out, on eyes with no co-existing diseases, in 500 consecutive patients who were likely to return for follow up. The technique involved sclerocorneal tunnel, capsulotomy, hydrodissection, nucleus extraction with a bent needle tip hook, and posterior chamber intraocular lens (PC-IOL) implantation according to biometry findings. Surgical complications, visual acuity at discharge, 6 weeks, and 1 year follow up, and surgically induced astigmatism are reported. RESULTS: The uncorrected visual acuity at discharge was 6/18 or better in 76.8% of eyes, and declined to 70.5% at 6 weeks' follow up, and 64.9% at 1 year. The best corrected visual acuity was 6/18 or better in 96.2% of eyes at 6 weeks and in 95.9% at 1 year. Poor visual outcome (<6/60) occurred in less than 2%. Intraoperative complications included 47 (9.4%) eyes with hyphaema, and one eye (0.2%) with posterior capsule rupture and vitreous in the anterior chamber. Surgery led to an increase in against the rule astigmatism, which was the major cause of uncorrected visual acuity less than 6/18. Six weeks postoperatively, 85.5% of eyes had against the rule astigmatism, with a mean induced cylinder of 1.41 D (SD 0.8). There was a further small increase in against the rule astigmatism of 0.66 D (SD 0.41) between 6 weeks and 1 year. The mean duration of surgery was 4 minutes and the average cost of consumables, including the IOL, was less than $10. CONCLUSION: Rapid recovery of good vision can be achieved with sutureless manual ECCE at low cost in areas where there is a need for high volume cataract surgery. Further work is required to reduce significant postoperative astigmatism, which was the major cause of uncorrected acuity less than 6/18.

Aged↗

PubMed2004

Pulmonary hypoplasia: prediction with use of ratio of MR imaging-measured fetal lung volume to US-estimated fetal body weight.

PURPOSE: To determine the ratio of fetal lung volume (FLV) to fetal body weight (FBW) by using ultrasonography (US) and magnetic resonance (MR) imaging and to evaluate the usefulness of this ratio in predicting pulmonary hypoplasia (PH) in fetuses at high risk. MATERIALS AND METHODS: MR imaging lung volumetry and US biometry were performed in 90 fetuses at 25-39 weeks gestation. In the control group of 73 fetuses, normal lung development was confirmed at neonatal follow-up and the normative ratio of MR imaging-measured FLV to US-estimated FBW (FLV/FBW) was determined. The high-risk group included 17 fetuses at risk for PH. The FLV/FBW was compared between the control and high-risk groups and with US parameters for predicting the development of PH in the high-risk group. Measurements 2 or more standard deviations below the mean control group measurement were considered abnormal. Comparisons of the FLV/FBW between groups were made by using the Student t test. The association between development of PH and measurement of each parameter was analyzed by using the Fisher exact probability test. RESULTS: In the control group, the FLV/FBW decreased with gestational age during the third trimester and had a normal distribution (mean ratio, 0.028 mL/g; range, 0.015-0.444 mL/g). The mean FLV/FBW for the nine fetuses with PH (0.012 mL/g +/- 0.008) was significantly lower (P <.001) than that for the control group (0.028 mL/g +/- 0.007). Fetuses with abnormal FLV/FBW values were at significantly greater risk (P <.05) for PH development. Abnormal FLV/FBW values had higher diagnostic accuracy than abnormal US parameters. Sensitivity of the FLV/FBW was 89% (eight of nine fetuses); specificity, 88% (seven of eight fetuses); positive predictive value, 89% (eight of nine fetuses); negative predictive value, 88% (seven of eight fetuses); and accuracy, 88% (15 of 17 fetuses). CONCLUSION: The FLV/FBW reflects the adequacy of intrauterine lung growth and can help predict PH.

Body Weight↗

PubMedDate not supplied

Frequency in allergy to proteins of latex in health care workers.

OBJECTIVE: The objective of this study is to evaluate allergy prevalence to latex proteins in health care workers at the Laboratory and Surgery Room of Hospital CIMA Chihuahua. METHODOLOGY AND RESULTS: A thorough clinical chart was recorded for all health care workers studied: hematic biometry, total IgE by ELISA method, specific IgE to latex antigen by ELISA (pharmacy CAP system), cutaneous tests with latex antigen (Aphi de México, Hevea Brasiliensis Biopal Inc. Spoken WA), through scarification, together with histamine and Evans (positive-negative control). The number included is 99 individuals. Specific IgE to latex in 4 cases was positive (4%) and in the cutaneous tests to latex, 24 cases (24%) resulted positive. CONCLUSIONS: The study reports a prevalence of (4%) when performing the specific IgE to latex and (24%) to the cutaneous test with antigen to total latex. This data allows us to continue evaluating the personnel at risk at the hospital, with better results in the administration of Labor Medicine at this medical institution.

Adult↗