Objective To describe the baseline characteristics of the Primary Open-Angle African-American Glaucoma Genetics (POAAGG) study cohort, the largest African-American primary open-angle glaucoma (POAG) population recruited at a single institution (University of Pennsylvania, Department of Ophthalmology, Scheie Eye Institute) to date. Design Population-based, cross-sectional, case-control study. Participants 2,520 African-American subjects 35 years and older, recruited from the greater Philadelphia, Pennsylvania area. Methods Each subject underwent a detailed interview and eye examination. The interview assessed demographic, behavioral, medical, and ocular risk factors. Current zip codes surrounding the University of Pennsylvania were recorded and United States census data were queried to infer socioeconomic status. The eye exam included measurement of visual acuity and intraocular pressure, a detailed anterior and posterior segment examination including gonioscopy, dilated fundus and optic disc examination, visual fields, stereo disc photography, optical coherence tomography imaging, and measurement of central corneal thickness. Main Outcome Measures The baseline characteristics of gender, age, and glaucoma diagnosis were collected. Body mass index (BMI), hypertension, diabetes, and alcohol and tobacco use, as well as ocular conditions including blindness, cataract, non-proliferative diabetic retinopathy, age-related macular degeneration, and use of ocular medication and surgery, were examined. Median population density, income, education level, and other socioeconomic measures were determined for the study cohort. Results Of the 2,520 African-Americans recruited to the POAAGG study to date, 2,067 (82.0%) including 807 controls and 1,260 POAG cases met all inclusion criteria and completed the detailed clinical ocular exam. Cases were more likely to have a lower BMI (p<0.01) and report a history of blindness (visual acuity of 20/200 or worse, p<0.001), while controls were more likely to have diabetes (p<0.001), have non-proliferative diabetic retinopathy (p=0.02), and be female (p<0.001). Study participants were drawn largely from predominantly African-American neighborhoods (African-American population 67.7-70.0%) of low income, high unemployment, and lower education, surrounding the University of Pennsylvania. Conclusions The POAAGG study has currently recruited over 2,000 African-Americans eligible for a POAG genetics study. Blindness and low BMI were significantly associated with POAG. This population was predominantly recruited from neighborhoods whose population income exists at or near the Federal Poverty Level.
Pediatric TED patients exhibit mild symptoms, such as proptosis and eyelid retraction without strabismus, vision loss, or optic neuropathy. Some children with TED have severe disfigurement and corneal exposure due to the disease and benefit from orbital decompression.
To the best of our knowledge, this is the first reported case of bilateral hemorrhagic conjunctival abrasion and corneal abrasion secondary to LSD. "Kissing" conjunctival lesions, which have been previously reported with heroin use, should raise suspicion for drug abuse.
Objective: To perform micro-incision, trans-iridal, aspiration-cutter-assisted biopsy for ciliary body tumours. Design: Retrospective, nonrandomized, observational, interventional case series. Methods: Five consecutive patients undergoing ciliary body tumour biopsy were clinically diagnosed using slit-lamp photography, gonioscopy, high-frequency ultrasound imaging, and systemic radiographic staging. A 1À2 mm clear cornea incision was placed opposite to the central clock hour of the ciliary body tumour. Viscoelastic was infused into the anterior chamber for stabilization and endothelial protection. Then, a 27-gauge aspiration cutter was used to make an iridotomy at the iris root and then extend through the iris into the tumour. Biopsy was performed using mechanical cutting starting at 300 cuts per minute and aspiration at 600 mm Hg. After withdrawal of the cutter from the eye, the effluent tube was flushed into a 3 cc syringe, inspected for specimen under the operating microscope and sent for pathology. Multiple biopsies were performed on each patient. Viscoelastic was removed and Seidel examination of the corneal wound performed.Results: Five eyes were biopsied. A mean 3.6 passes were used to obtain tumour tissue. Tumour cells and tissue were obtained in all cases. Cytologic, histopathologic, and immuno-histochemical analysis were performed (100%, n = 5/5). Diagnoses included melanoma (60%, n = 3/5), melanocytoma (20%, n = 1/5), and leiomyoma (20%, n = 1/5). Transient postoperative hyphemas cleared within 1 week (80%, n = 4/5). No secondary glaucoma, infection, or cataracts were noted.Conclusion: Aspiration-cutter biopsy through the iris root provided a minimally invasive, safe method for obtaining ciliary body tissue for cytology, histopathology, and immunohistochemical analysis.Objectif: Réaliser une biopsie micro-incisionnelle trans-iridienne par aspiration-section des tumeurs du corps ciliaire. Nature: Étude rétrospective d'observation et d'intervention non randomisée portant sur une série de cas. Méthodes: Cinq patients consécutifs devant subir une biopsie en raison d'une tumeur du corps ciliaire ont fait l'objet d'un diagnostic clinique reposant sur les techniques suivantes: photographie à la lampe à fente, gonioscopie, imagerie ultrasonore haute fréquence et stadification radiographique systémique. Une incision de 1-2 mm en cornée claire a été réalisée du côté opposé à l'heure de l'horloge du centre de la tumeur du corps ciliaire. On a alors procédé à l'injection d'un produit viscoélastique dans la chambre antérieure pour obtenir une stabilisation et pour protéger l'endothélium. Par la suite, un appareil à aspiration-section de calibre 27 a été utilise pour réaliser une iridotomie au niveau de la racine de l'iris, pour ensuite traverser l'iris et atteindre la tumeur. La biopsie a été faite aux réglages suivants: coupe mécanique à 300 coupes par minute (minimum) et aspiration à 600 mm Hg. Une fois le dispositif de coupe retiré de l'oeil, le contenu du tube d'effluents a été transféré dans une seringue de 3 ...
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