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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Increased cupping of the optic disc is considered to be an indication of pressure-related damage of the optic nerve. This paper explores the relationship of intraocular pressure and cupping in persons with diabetes mellitus, a group of people whose optic nerves may be more susceptible to the effects of intraocular pressure. Stereoscopic fundus photographs of the seven standard fields were obtained in all persons participating in the Wisconsin Epidemiologic Study of Diabetic Retinopathy at the time of the initial prevalence survey. Measurements of disc and cup diameters in the vertical and horizontal meridia were made by two trained graders. Cup-to-disc ratios were computed for both diameters of each eye and the mean of the two gradings was used. A history of glaucoma was significantly associated with larger cup-to-disc ratios at the prevalence examination. Cup-to-disc ratios were not larger in those with high IOP, nor in those who had panretinal photocoagulation.
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PMID:Optic disc cupping: prevalence findings from the WESDR. 291 58

The relationship of survival to systemic and ocular factors in diabetic persons was studied using data collected as part of the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Six years after the baseline examination, 9.5% of 996 insulin-taking people who were younger than age 30 years when their diabetes was diagnosed (younger onset) had died. Of 1370 people whose diabetes was diagnosed after age 30 years (older onset), 35.3% had died. After adjusting for age and sex, longer duration of diabetes, presence of proteinuria, a history of cardiovascular disease, higher blood pressure, diuretic use, a history of smoking, poorer visual acuity, and more severe retinopathy were significantly associated with decreased survival in both groups. Glaucoma was associated with decreased survival in the younger onset group and cataract in the older onset group. These findings suggest that some ocular complications are important risk indicators for death. Their presence in diabetic patients suggests the need for frequent examinations to detect systemic complications and to intervene to minimize their effect.
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PMID:Relation of ocular and systemic factors to survival in diabetes. 291 72

In 375 patients aged 68.5 +/- 9.4 years (mean +/- 1 SD) with primary glaucoma subdivided by irido-corneal angle configuration into closed-angle glaucoma (123 cases), ocular hypertension (186 cases), and open-angle glaucoma (66 cases), diabetic status was determined by standard 75 g oral glucose tolerance tests. In 63 patients with impaired glucose tolerance who were retested one year later, 16% had progressed to diabetes mellitus. The results confirm a significant association between non-insulin dependent diabetes mellitus and primary glaucoma which may result from autonomic dysfunction in parasympathetic tone causing anterior chamber angle closure.
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PMID:Progression of impaired glucose tolerance to diabetes mellitus in patients with primary glaucoma and ocular hypertension. 295 Nov 74

Five eyes of three patients developed generalized corneal decompensation after undergoing argon laser iridectomy for angle closure glaucoma. Factors possibly associated with corneal decompensation include episodes of angle closure glaucoma with pressure elevations and inflammation, corneal guttate, diabetes, and the need for multiple treatments requiring a high-laser energy. It is important for ophthalmologists to inform their patients of the rare risk of developing bullous keratopathy after argon laser iridectomy and to consider obtaining prelaser specular microscopy to document the corneal status in high-risk patients.
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PMID:Corneal decompensation after argon laser iridectomy. 305 53

This paper presents epidemiological data on the prevalence of 26 common (i.e., having a lifetime prevalence of more than 1 per 10(4) individuals in the population) multifactorial diseases in Hungary and estimates of detriment associated with them. The detriment is expressed using 3 indicators, namely years of lost life (LL), potentially impaired life (PIL) and actually impaired life (AIL). The total prevalence of these diseases in Hungary has been estimated to be about 6500 per 10(4) individuals in the population. This estimate is in agreement with published data for other parts of the world. On the basis of clinical severity, these diseases have been split into 3 groups, namely (1) very severe (schizophrenia, multiple sclerosis, epilepsy, acute myocardial infarction and related conditions, and systemic lupus erythematosus); (2) moderately severe and/or episodal or seasonal (15 entities including Graves' disease, diabetes mellitus, gout, affective psychoses, essential hypertension, peptic ulcers, asthma, etc.); and (3) less severe than those in the first 2 groups (varicose veins, allergic rhinitis, atopic dermatitis, Scheuermann disease and adolescent idiopathic scoliosis). The essential clinical and genetic aspects of these diseases are briefly discussed. With the exception of epilepsy, none of the diseases included in our list causes mortality between ages 0 and 19. However, they are among the leading causes of death between ages 20 and 69 and thereafter. A sizeable proportion of those with essential hypertension, diabetes mellitus, rheumatoid arthritis, etc. survive to 70 years and beyond, as do those with gout, glaucoma, allergic rhinitis, psoriasis, etc. Overall, about 16% of all deaths that occur in Hungary every year (all age groups) can be attributed to these diseases. The mean number of years of PIL covers a wide range (about 20-40, 12-70 and 40-60 for groups 1, 2 and 3, respectively), the overall mean being about 24 years. However, the nature and degree of impairment and the impact on the life quality of those afflicted differ for the different diseases. Likewise, the mean number of years of AIL (for which the interval between the mean age at premature retirement and mean age at death was used as a rough index) also spans a wide range from 16 to 45, and the overall mean is about 20 years. At the population level, the diseases considered in this paper cause about 2700 years of LL, 96,000 years of PIL and about 5800 years of AIL per 10(4) individuals in the population. Relative to Mendelian diseases as a whole, these multifactorial diseases are associated with much greater detriment (LL: 1.4 X; PIL: 30 X and AIL: 3.9 X).
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PMID:The load of genetic and partially genetic diseases in man. II. Some selected common multifactorial diseases: estimates of population prevalence and of detriment in terms of years of lost and impaired life. 305 77

Case notes of 1113 consecutive new patients referred to a consultant ophthalmologist at a district general hospital were reviewed to determine the source and efficacy of referrals and the current screening practices of general practitioners and ophthalmic opticians. General practitioners initiated referral in 546 cases (49%) and ophthalmic opticians referral in 439 (39%). Visual loss or visual disturbance was the most important single reason for referral (345 cases; 31%), followed by suspected glaucoma (145 cases; 13%), abnormalities of binocular vision (140; 12.5%), disorders of eyelids or ocular adnexa (127; 11%), and red eye (86; 8%). General practitioners referred many more patients with disorders of the eyelids and adnexa and ophthalmic opticians many more patients with suspected glaucoma. Ophthalmic opticians were far more likely than general practitioners to refer patients with suspected glaucoma correctly. A total of 180 patients (16%) were referred from ocular screening, in 149 cases by ophthalmic opticians and in 10 by general practitioners. Seventy patients had glaucoma or incomplete features of glaucoma, all of them referred by ophthalmic opticians. Of eight diabetic patients referred by ophthalmic opticians, three had asymptomatic disease and in two diabetes was diagnosed as a result of ocular screening. No patient was referred for asymptomatic diabetic retinopathy from screening by general practitioners. Ophthalmic opticians were more likely than general practitioners to diagnose retinopathy requiring photocoagulation. Use of a community based service to screen for glaucoma could save unnecessary consultant outpatient appointments. A similar service could facilitate detection of diabetic retinopathy at a stage when treatment is most effective.
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PMID:Referral patterns to an ophthalmic outpatient clinic by general practitioners and ophthalmic opticians and the role of these professionals in screening for ocular disease. 314 31

Iridoschisis is a rare condition of uncertain etiology characterized by a cleavage of the iris layers. We report four cases studied by fluorescein angiography to display possible occurrence of vascular abnormalities in the pathogenesis of the disease. Case 1: 80 year old woman with bilateral schisis of the peripheral iris, in the inferonasal quadrant in RE and inferotemporal in LE. A shallow anterior chamber was present in OU; IOP was 18 in RE and 15 in LE. No corneal abnormalities were present. Fluoroiridography showed a normal pattern filling of the iris vascularity, that was more visible in the schisis area. Case 2: 66 year old man with diabetes and open-angle glaucoma operated on for trabeculectomy five years previously. The examination showed a normal cornea, a shallow anterior chamber and miotic pupils for pilocarpine therapy. IOP was 12 in OU. The iridoschisis was present in RE in the lower sectors which were totally involved from the outer iris to the inner pupillary margin. Fluoroiridography indicated a normal vessel perfusion without any abnormality in the affected sectors. A slight bilateral pupillary dye leakage without any stromal diffusion was attributable to the patient's age. Case 3: 55 year old woman treated with miotics in RE for a glaucoma diagnosed after head trauma twenty years before, after which the vision in LE was reduced to 2/200 for post-traumatic optic nerve atrophy. No corneal abnormality was present. The anterior chamber was shallow and the ocular tension was 14 in RE and 10 in LE.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Fluoroiridographic aspects of iridoschisis]. 317 Oct 99

Extracapsular extraction with anterior-chamber lens implantation is a method which has a place in cataract surgery. We discuss 60 cases of cataract operated on by this method and its advantages. We had good results in cases without glaucoma, keratopathy, or diabetes mellitus, and depending on the ease with which a posterior capsulotomy was done, where this was imperative, without the risks of the YAG laser capsulotomy.
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PMID:Extracapsular extraction and anterior-chamber flexible lens implantation. 321 19

In the last five years, 500 one-eyed patients have undergone cataract surgery at the authors' hospital. A Simcoe-type posterior chamber lens was implanted in 425 of the eyes. An eye was defined as an only eye if corrected vision in the fellow eye was 1/60 or less, or better vision in cases of amblyopia. The main causes of loss of function in partner eyes were macular degeneration, amblyopia, and glaucoma. The rate of intraoperative and postoperative complications was the same as in the entire patient collective, and in absolute terms actually lower. There were four cases of intraoperative rupture of the posterior capsule (in two of which it subsequently proved possible to fit a posterior chamber intraocular lens (PCIOL], and one case each of corneal decompensation and excessive hemorrhage into the anterior chamber. PCIOLs were subsequently also implanted in both these eyes. Early postoperative complications included several cases of iris prolapse, all of which were easily rectified, and intermittent phases of endothelial decompensation associated with cornea guttata. In view of the low overall rate of intraoperative and postoperative complications, the authors advocate implantation of a PCIOL in remaining eyes with visual function, except those with proliferative retinopathies (primarily diabetes mellitus), pre-existing retinal detachments (particularly in young men with myopia and a history of detachment in the fellow eye), and unregulated glaucoma.
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PMID:[Cataract operations on the remaining eye]. 322 54

The major goal of rubella immunization is the prevention of the congenital rubella syndrome. As many as 20 per cent of women in the reproductive age group in the United States continue to be susceptible to rubella despite the immunization programs currently in place. Intensified efforts are therefore needed to identify persons at risk for infection and to vaccinate them. Women who develop a rubella-like illness during pregnancy should have the diagnosis confirmed serologically because a diagnosis based on clinical criteria alone is unreliable and because of the serious implications of gestational rubella infection. The rubella virus can infect the fetus at any stage of pregnancy, but defects are rarely noted when this occurs after the 16th week of gestation. The most common abnormalities in the congenital rubella syndrome are hearing loss, mental retardation, cardiac malformations, and eye defects. Diabetes mellitus, thyroid disease, glaucoma, and other delayed manifestations of congenital rubella syndrome are common, thereby necessitating long-term followup of these patients. The detection of rubella-specific IgM antibodies in fetal blood is helpful in establishing the diagnosis prenatally and can aid in the management of pregnancies complicated by this infection. Susceptible women identified through screening during pregnancy should be immunized in the immediate postpartum or postabortion period. Although the live, attenuated rubella vaccine is contraindicated during pregnancy, pregnant women who are inadvertently immunized are not candidates for pregnancy termination because no defects consistent with congenital rubella have been reported to date in the offspring of other similarly vaccinated women.
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PMID:Maternal rubella and the congenital rubella syndrome. 328 22


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