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Volume 5, Number 32
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Monday, August 15, 2005
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| Incidence of
OAG in an Elderly Population: The Rotterdam Study This population-based cohort study by Dutch researchers
aimed to determine the incidence of open-angle glaucoma (OAG) in a general
elderly white population.
Participants were 55 years and older and were included in the Rotterdam Study, The Netherlands. Those at risk for incident OAG underwent at baseline (1990 to 1993) and follow-up (1997 to 1999) the same ophthalmic examination, including measurement of intraocular pressure (IOP), visual field testing and stereo optic disc photography. Investigators diagnosed probable or definite OAG using an algorithm based on optic disc parameters and on visual field testing, independent of IOP. In total, 3,842 participants were examined; participation rate at follow-up was 78 percent. After a mean follow-up time of 6.5 years, OAG developed in 87 participants (58 probable and 29 definite). The five-year risk of probable OAG was 1.2 percent, and that of definite OAG was 0.6 percent; the rate rose for both together from one percent at age 60 years to approximately three percent at age 80 years. Bilateral OAG occurred five times more often after age 75 than before. In participants with prevalent OAG in one eye, the five-year risk of OAG in the fellow eye was five times higher than in fellow eyes of non-OAG eyes. Only 37 percent of the incident cases received treatment for OAG at the time of the reexamination. Most of the patients with incident OAG were unaware of having the disease. |
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SOURCE: Voogd SD, Ikram MK, Wolfs RC, et al. Incidence of open-angle glaucoma in a general elderly population: the Rotterdam Study. Ophthalmol 2005;Jul 21 [Epub ahead of print]. |
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| Ethnicity, Race,
and Baseline Retinopathy Correlates in the VA Diabetes Trial The Veterans Affairs Diabetes Trial (VADT) cohort is enriched with approximately 20 percent Hispanics and 20 percent African Americans, affording a unique opportunity to study ethnic differences in retinopathy. Researchers at the Miami VA Medical Center in Florida report here on cross-sectional analyses on the baseline seven-field stereo fundus photos of 1,283 patients in the VADT. Diabetic retinopathy scores are grouped into four classes of increasing severity: none, 10 to 14; minimal nonproliferative diabetic retinopathy (NPDR), 15 to 39; moderate to severe NPDR, 40 to 59; and proliferative diabetic retinopathy, 60 or greater. These four groups have also been dichotomized to none or minimal (10 to 39) and moderate to severe diabetic retinopathy (40 or greater). The prevalence of diabetic retinopathy scores greater than 40 was higher for Hispanics (36 percent) and African Americans (29 percent) than for non-Hispanic whites (22 percent). The difference between Hispanics and non-Hispanic whites was significant; similarly, the prevalence of diabetic retinopathy scores greater than 40 was significantly higher in African Americans than in non-Hispanic whites. These differences could not be accounted for by an imbalance in traditional risk factors such as age, duration of diagnosed diabetes, HbA(1c) (A1C) and blood pressure. Diabetic retinopathy severity scores were also significantly associated with increasing years of disease duration, A1C, systolic and diastolic blood pressure, the degree of microalbuminuria, fibrinogen and the percentage of patients with amputations. Investigators found no relationship between retinopathy severity and the percentage of people who had strokes or cardiac revascularization procedures. They observed an inverse relationship between retinopathy severity and total cholesterol, triglycerides and plasminogen activator inhibitor-1, as well as an inverse relationship with smoking history. Diabetic retinopathy scores were not associated with age. The authors concluded that, in addition to many well-known associations with retinopathy, a higher frequency of severe diabetic retinopathy was found in the Hispanic and African-American patients at entry into the VADT that is not accounted for by traditional risk factors for diabetic retinopathy, and these substantial ethnic differences have yet to be explained. |
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SOURCE: Emanuele N, Sacks J, Klein R, et al. Ethnicity, race, and baseline retinopathy correlates in the veterans affairs diabetes trial. Diabetes Care 2005;28(8):1954-8. |
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| Sebaceous Carcinoma
of the Eyelid May Clinically Mimic Benign Conditions Sebaceous carcinoma of the eyelid can clinically mimic benign conditions, such as recurrent chalazion and inflammation and histopathologically squamous cell and basal cell carcinoma (BCC). This retrospective study attempted to improve the characterization and consequently the diagnosis of these tumors. Researchers performed a retrospective analysis on eyelid specimens diagnosed as sebaceous carcinoma retrieved from Henry C. Witelson Ophthalmic Pathology Registry, Canada, and Hospital Luis S. Bulnes Pathology Registry, Mexico. Two independent, masked pathologists reviewed the H&E microslides. Forty-four cases were retrieved, 31 from Canada and 13 from Mexico. The researchers observed cytoplasmic vacuoles in 48 percent of the cases, and 84 percent were classified as poorly differentiated lesions. Of these, 75 percent had features similar to squamous cell carcinoma, some with dyskeratosis (30 percent), and 7 percent resembled BCC. Researchers also saw solid growth pattern in 26.2 percent of the cases and lobular growth pattern in 26.2 percent. They saw superficial spread resembling Bowen-like disease in 33 percent of the cases, pagetoid features in 33 percent and comedocarcinoma in 31.8 percent. They concluded that sebaceous carcinoma presented as a poorly differentiated lesion in most cases in this study, and they believe that this suggests a possibility of misdiagnosis because of its similarities to squamous cell carcinoma. |
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SOURCE: Pereira PR, Odashiro AN, Rodrigues-Reyes AA, et al. Histopathological review of sebaceous carcinoma of the eyelid. J Cutan Pathol 2005;32(7):496. |
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| SITA and Full-Threshold
Standard Perimetry Compared to FDT Perimetry in Glaucoma Investigators at the University of CA at San Diego and Japan’s University of Tokyo conducted a retrospective analysis of data from a longitudinal prospective study to compare full-threshold (FT) and SITA algorithms for standard automated perimetry (SAP) with frequency-doubling technology perimetry (FDT) in glaucoma. The aim of the study was to help clinicians to relate results in patients who have had two or more of these tests during follow-up. The study included 104 eyes of 104 patients with glaucomatous optic neuropathy detected by optic disc stereophotographs. All patients had standard perimetry (SITA and FT) and FDT within three months of each other. The investigators compared global indices, abnormality and severity using two threshold algorithms of standard perimetry with FDT. More eyes (57) had normal visual fields by SAP-FT than by either SAP-SITA (42 eyes) or FDT (45 eyes), although SAP-FT agreed more closely with FDT (= 0.54 +/- 0.08) on the presence of a visual field defect than did SAP-SITA (= 0.34 +/- 0.08). Correlations of FDT to standard perimetry global indices were similar regardless of the threshold strategy used for standard perimetry. The authors of the study concluded that, despite many similarities of SAP-SITA and SAP-FT, switching the standard of comparison from SAP-FT to SAP-SITA changes the relationship to FDT with regard to visual field abnormality, but not correlations of global indices. FDT detected abnormal fields in more eyes than SAP-FT, but SAP-FT tended to detect a subset of eyes found abnormal by FDT. Visual field defects may be detected more often by FDT and SAP-SITA in eyes with early visual field loss, but these two tests may not agree on which eyes show field loss in patients who undergo both tests at follow-up. |
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SOURCE: Boden C, Pascual J, Medeiros FA. Relationship of SITA and full-threshold standard perimetry to frequency-doubling technology perimetry in glaucoma. Invest Ophthalmol Vis Sci 2005;46(7):2433-39. |
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BRIEFLY
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