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1.  The relationship between HLA‐DRB1 alleles and optic neuritis in Irish patients and the risk of developing multiple sclerosis 
The British Journal of Ophthalmology  2007;91(10):1288-1292.
Aims
To investigate the role of the major histocompatibility complex in Irish patients with optic neuritis (ON) and determine whether HLA‐DRB1 genotypes are a risk factor for the development of multiple sclerosis (MS) in such patients.
Method
All patients were Caucasian, had Irish ancestry and had MRI of brain and optic nerves within 2–3 weeks of presentation. Patients were referred to a neurologist if MRI findings were consistent with a diagnosis of MS. HLA‐DRB1 allele and phenotype frequencies for 78 patients with a clinical diagnosis of acute ON were compared with those for 250 healthy bone marrow donors.
Results
An ON/MS positive patient was 3.4 times more likely than an ON/MS negative patient to be DRB1*15 positive. No difference in age profile was detected between ON/MS positive and ON/MS negative patients or between the ON male and female subgroups. No gender or HLA‐DRB1 association was identified for ON/MS negative patients. Female gender was significantly increased among ON/MS positive patients with a p value of 0.0053.
Conclusions
DRB1*15 is a significant predisposing factor for ON. This ON patient cohort has also provided an opportunity to evaluate the relationship of HLA genotype with the risk of MS development. The findings of this study indicate that Irish individuals presenting with ON and who are HLA DRB1*15 positive have a higher risk than HLA DRB1*15 negative patients of presenting with MRI findings indicative of MS. This study has also demonstrated that female gender is a risk factor for developing MS in the Irish population.
doi:10.1136/bjo.2006.109371
PMCID: PMC2001012  PMID: 17895416
optic neuritis; multiple sclerosis; HLA typing; demyelination
3.  Prevalence of blindness and low vision in Malaysian population: results from the National Eye Survey 1996 
Background: A national eye survey was conducted in 1996 to determine the prevalence of blindness and low vision and their major causes among the Malaysian population of all ages.
Methods: A stratified two stage cluster sampling design was used to randomly select primary and secondary sampling units. Interviews, visual acuity tests, and eye examinations on all individuals in the sampled households were performed. Estimates were weighted by factors adjusting for selection probability, non-response, and sampling coverage.
Results: The overall response rate was 69% (that is, living quarters response rate was 72.8% and household response rate was 95.1%). The age adjusted prevalence of bilateral blindness and low vision was 0.29% (95% CI 0.19 to 0.39%), and 2.44% (95% CI 2.18 to 2.69%) respectively. Females had a higher age adjusted prevalence of low vision compared to males. There was no significant difference in the prevalence of bilateral low vision and blindness among the four ethnic groups, and urban and rural residents. Cataract was the leading cause of blindness (39%) followed by retinal diseases (24%). Uncorrected refractive errors (48%) and cataract (36%) were the major causes of low vision.
Conclusion: Malaysia has blindness and visual impairment rates that are comparable with other countries in the South East Asia region. However, cataract and uncorrected refractive errors, though readily treatable, are still the leading causes of blindness, suggesting the need for an evaluation on accessibility and availability of eye care services and barriers to eye care utilisation in the country.
PMCID: PMC1771293  PMID: 12185113
prevalence; blindness; low vision; Malaysian
4.  Optical coherence tomography imaging of severe commotio retinae and associated macular hole 
PMCID: PMC1771101  PMID: 11914221
optical coherence tomography; commotio retinae; macular hole
5.  Primary polypseudophakia for cataract surgery in hypermetropic eyes: refractive results and long term stability of the implants within the capsular bag 
The British Journal of Ophthalmology  2001;85(10):1198-1202.
AIM—To determine the long term visual and refractive results, and stability and complications of primary polypseudophakia using poly(methylmethacrylate) (PMMA) intraocular lenses (IOLs) for cataract surgery in hypermetropic eyes.
METHODS—Prospective study of 15 short or hypermetropic eyes undergoing phacoemulsification with primary polypseudophakia with two PMMA IOLs implanted within the capsular bag.
RESULTS—The spherical equivalent was reduced from a mean +4.87 (SD 3.00) dioptres (D) to −0.12 (1.40 D), and the deviation from the intended refraction was +0.005 (1.30) D, 23.6 (12.36) months post-implantation. The deviation from intended refraction was not statistically significant (p = 0.989; paired t test). Postoperative best corrected visual acuity (BCVA) was 6/12 or better in all eyes without macular or optic nerve co-morbidity. Interlenticular opacification (ILO) in the form of peripheral Elschnig pearls was seen in four (26.67%) eyes. A new type of ILO in the form of usually pigmented deposits in the central interface developed in five (33.33%) eyes and resulted in the appearance of Newton's rings in three. None of the eyes with ILO had any loss of BCVA or hyperopic shift. Six (40%) eyes were within 1 D from the intended refraction and 14 (93.33%) within 2 D. There was no statistically significant difference in the accuracy of the two intraocular lens calculation formulas used (SRK II and SRK/T).
CONCLUSION—Peripheral Elschnig pearl-type ILO can occur as a late complication of primary in the bag implantation of two PMMA IOLs. A new type of ILO is described. Both types of ILO have not to date resulted in deterioration of visual acuity in our cohort. Use of appropriate biometry techniques and IOL calculation formulas may yield more accurate refractive results.


doi:10.1136/bjo.85.10.1198
PMCID: PMC1723740  PMID: 11567964
6.  Phenotype of autosomal recessive congenital microphthalmia mapping to chromosome 14q32 
BACKGROUND—Congenital microphthalmia (OMIM: 309700) may occur in isolation or in association with a variety of systemic malformations. Isolated microphthalmia may be inherited as an autosomal dominant, an autosomal recessive, or an X linked trait.
METHODS—Based on a whole genome linkage analysis, in a six generation consanguineous family with autosomal recessive inheritance, the first locus for isolated microphthalmia was mapped to chromosome 14q32. Eight members of this family underwent clinical examination to determine the nature of the microphthalmia phenotype associated with this locus.
RESULTS—All affected individuals in this family suffered from bilateral microphthalmia in association with anterior segment abnormalities, and the best visual acuity achieved was "perception of light". Corneal changes included partial or complete congenital sclerocornea, and the later development of corneal vascularisation and anterior staphyloma. Intraocular pressure, as measured by Schiotz tonometry, was greatly elevated in many cases.
CONCLUSIONS—This combination of ocular defects suggests an embryological disorder involving tissues derived from both the neuroectoderm and neural crest. Other families with defects in the microphthalmia gene located on 14q32 may have a similar ocular phenotype aiding their identification.


PMCID: PMC1723146  PMID: 10413693
9.  Factors influencing visual outcome after cataract extraction among Arabs in Kuwait. 
Of 409 consecutive Arab patients in Kuwait who had extractions for idiopathic (senile and presenile) cataract 385 were followed up for a minimum period of one year. Among these the final visual outcome was 6/12 or better in 208 eyes (54%) but visual acuity was 6/18 or less in 177 eyes (46%). Of these 177 eyes 127 eyes (71.8%) had poor vision due to preoperative ocular disorders and 31 (17.5%) due to surgical complications. The main ocular conditions which limited visual recovery were the presence of corneal opacities, hypermaturity of cataract, advanced glaucoma, senile macular degeneration, diabetic retinopathy, and postoperative retinal detachment in this order of frequency. The prevalence of these disorders in cataract patients among the Arab population was identified and is discussed.
PMCID: PMC1041199  PMID: 3620426

Results 1-9 (9)