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2004 newborns from three rural hospitals in a trachoma endemic area of Mexico were randomly assigned to receive either povidone‐iodine 2.5% eye drops (PIED) (n=1024) or chloramphenicol eye drops (n=974). Infectious conjunctivitis was confirmed by laboratory methods, including polymerase chain reaction assay for Chlamydia trachomatis. During the first two days and after day 16, there was no significant difference in the incidence of bacterial conjunctivitis among groups. From day 3 to day 15 PIED was 6% less effective in preventing infectious conjunctivitis (p=0.01). In addition, C trachomatis conjunctivitis was greater in those receiving PIED (RR=1.99, log‐rank p=0.029). Ramirez‐Ortiz et al conclude that topical prophylaxis with PIED is insufficient as a prophylaxis against chlamydial conjunctivitis.
See page 1430
A 12‐month active case ascertainment study was carried out via the British Ophthalmological Surveillance Unit (BOSU) reporting system to record cases of acute retinal necrosis (ARN). Thirty‐one cases that met the diagnostic criteria of the American Uveitis Society were included. Twenty‐two were males and the mean age was 54.3 years. Ninety percent of the cases were unilateral. An aqueous or vitreous biopsy was performed in only 18 patients. A majority of cases (85%) were treated with intravenous antiviral therapy whereas the remaining received oral antiviral therapy. Muthiah et al suggest that national guidelines should be formulated for management of patients with ARN.
See page 1452
Within the Rotterdam Study, a population‐based cohort of subjects aged 55 years (n=5220), including 192 persons with amblyopia (3.7%), a multi‐state lifetable, lifetime risk, and excess period spent with bilateral visual impairment (BVI, bilateral visual acuity <0.5) were determined. For amblyopic persons, the lifetime risk of BVI was 18% while they lived on average 7.2 years with BVI as compared with non‐amblyopic persons with 10% risk of BVI. As amblyopia nearly doubles the life‐time risk of BVI, van Leeuwen et al provide further evidence supporting cost‐effectiveness of amblyopia screening.
See page 1450
A matched case‐control study was conducted among 73 cases of non‐arteritic anterior ischaemic optic neuropathy (NAION) matched on age and gender to 73 controls. Information regarding sleep apnea syndrome (SAS) was obtained via a telephone questionnaire that used the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA‐SDQ). Patients with NAION were significantly more likely to report symptoms of SAS than controls (OR 2.62; 95% CI 1.03 to 6.60) after adjusting for medical and health behaviour characteristics. Li et al suggest that a larger population study is needed to confirm an association between SAS and NAION.
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Fundus autofluorescence and microperimetry were used to study sensitivity of the retina overlying drusen and pigment abnormalities in early age‐related macular degeneration in 13 patients with normal vision. Retinal sensitivity was found to be significantly decreased over large drusen and pigment abnormalities. Reduced sensitivity correlated with altered fundus autofluorescence. Microperimetry and fundus autofluorescence can be useful tools to monitor progression of age‐related macular degeneration.
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Eighty‐four paraffin‐embedded retinoblastomas were stained for C‐kit immunostaining and immunoreactivity was correlated with the presence or absence of invasion into the choroid and optic nerve and the degree of tumour differentiation. Overall, C‐kit expression was identified in 33/63 (52%) of the analysed specimen and the expression strongly correlated with histopathological features of worse prognosis such as optic nerve and choroidal invasion. Barry et al raise an interesting possibility of therapeutic use of imatinib mesylate, a compound that specifically inhibits C‐kit, currently used for treatment of gastrointestinal stromal tumours and chronic myelogenous leukaemia.
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