Purpose: To examine the distribution of cortical opacification of the lens by lens quadrant in a ... more Purpose: To examine the distribution of cortical opacification of the lens by lens quadrant in a longitudinal study. Methods: In 1990, a follow-up assessment of a cohort of Chesapeake Bay watermen, initially studied in 1985, was performed. Four hundred thirty-seven subjects (834 eyes) had gradable cortical photographs for at least one eye in both 1985 and 1990. Cortical photographs were graded by both estimating total area and determining the quadrant with the greatest degree of cortical opacification. Results: The prevalence and severity of cortical opacification increased with age with a high degree of concordance (84%) between eyes. For the 47 eyes with cortical opacification > or = 1/8 at baseline, the principal locations of opacification were: inferonasal 63.8%, inferotemporal 17.0%, superonasal 6.4%, and superotemporal 12.8% (P < 0.001, compared with equal distribution by quadrant). Five-year development of new cortical opacification and five-year progression of existing cortical opacification showed even greater preferential occurrence in the inferonasal quadrant of the lens. Conclusions: In this population, the inferonasal quadrant of the lens is the principal site of cortical opacification in both cross-sectional and longitudinal assessment. This finding is consistent with the hypothesis that sunlight exposure is a significant risk factor for cortical opacification.
To examine the relationships between smoking and the 5-year incidence of new nuclear opacities an... more To examine the relationships between smoking and the 5-year incidence of new nuclear opacities and between smoking and the progression of nuclear opacities in a prospective study of a cohort of Chesapeake Bay watermen. A total of 442 men (age, &amp;amp;gt; or = 30 years in 1985) with paired, gradable lens photographs in at least one eye in both 1985 and 1990 were studied. Photographs were graded by two readers who used the grading scheme of the Wilmer Institute, Baltimore, Md, with severity ranging in decimal units between 0.0 and 4.0. Data on the smoking history of the subjects were collected by personal interviews that were conducted in 1985 and updated in 1990. The incidence and progression of opacities increased with age. A nonsignificant association was observed between smoking (for both current and ex-smokers) and the incidence of a nuclear opacity. The risk of progression of nuclear opacities of less than grade 3 at baseline to grade 3 or worse was 2.4-fold higher among current smokers in 1985, compared with that among ex-smokers and nonsmokers (95% confidence limits: 1.0, 6.0) after adjustment for age, baseline opacity status, and alcohol use. An 18% increased risk of progression was significantly associated with each pack-year that a subject smoked between 1985 and 1990. These data confirm previous findings that smoking is associated with a nuclear opacity, particularly with progression to severe opacities.
Retina-the Journal of Retinal and Vitreous Diseases, 1997
Quantitative features of pars plana development in humans are not well characterized. Knowledge o... more Quantitative features of pars plana development in humans are not well characterized. Knowledge of the dimensions of this region is important for our understanding of the anatomy of infant eyes for the purposes of surgery. The purpose of this study was to provide a morphometric description of pars plana growth in relation to 1) postconceptional age and 2) axial length. We reviewed histologic specimens from 204 human eyes of postconceptional ages ranging from 10 weeks to 5 years. Axial length and temporal pars plana width were measured directly with a reticule system. The relationships among pars plana width, axial length, and postconceptional age were examined. The most rapid phase of pars plana growth occurred between 26 weeks and 35 weeks gestation. A linear relationship between pars plana width and axial length existed once the axial length reached 12 mm (correlation coefficient = 0.918; P = 0.0001). In infants of 38-42 weeks postconceptional age, mean pars plana width was 1.87 mm (range, 0.9-2.8 mm; standard direction = 0.48 mm), and mean axial length was 17.7 mm (range, 15-23 mm; standard direction = 1.9 mm). After the age of 62 weeks postconception, all eyes had a temporal pars plana width &gt; or = 3 mm and an axial length &gt; or = 19 mm. The estimated age at which there was a 95% chance of the pars plana width being &gt; or = 3 mm was 64.4 weeks (95% fiducial confidence limits, 60.8-86.2 weeks). The pars plana first develops during the second trimester of gestation. A rapid growth phase occurs between 26 weeks and 35 weeks postconception. The dimensions of the pars plana are correlated closely with axial length and postconceptional age. Assuming that a pars plana width of 3 mm is required for surgery to be performed via a pars plana approach, we estimate that pars plana vitreous surgery can be performed when the patient is at least 62 weeks old (postconception), which is a 6-month-old full-term infant.
To obtain 5-year longitudinal data on age-related macular degeneration (AMD) that might be useful... more To obtain 5-year longitudinal data on age-related macular degeneration (AMD) that might be useful for disease prognosis, public health planning, and clinical trial development. Baseline (1985) and 5-year follow-up (1990) fundus photographs of 483 watermen over 30 years of age who participated in a cohort study conducted on the eastern shore of Maryland were graded independently in a reliable, standardized fashion. Eyes in which AMD appeared or disappeared also were graded in a side-by-side fashion. Development of definite choroidal neovascularization and/or disciform scarring occurred in one of 50 participants over 70 years of age, specifically one of 15 participants over 70 years of age with AMD-3 (defined as large or confluent drusen focal hyperpigmentation of the retinal pigment epithelium [RPE], and/or nongeographic atrophy of the RPE). Appearance of large drusen, focal hyperpigmentation, or AMD-3 was age related, occurring in 5%, 1%, and 7%, respectively, of participants aged 50 to 59 years; 17%, 3%, and 14%, respectively, of participants aged 60 to 69 years; and 17%, 9%, and 26%, respectively, of participants aged 70 years or more. Disappearance of large drusen, hyperpigmentation, or AMD-3 occurred in 16 (34%) of 47 participants, 11 (58%) of 19 participants, and 17 (28%) of 61 participants, respectively, who had each feature photographically present in 1985. Among the 47 eyes identified in which AMD-3 developed by independent gradings, 38 cases of AMD-3 (81%) were confirmed on side-by-side grading. Among the 16 eyes identified as having AMD-3 that disappeared, nine disappearances (56%) were confirmed. Borderline differences in appearance of pigment, drusen size, drusen location, or photographic quality may have accounted for disappearance in seven cases (44%). Prospective studies on the nonneovascular features of AMD (including large drusen and abnormalities of the RPE) must account for the appearance and disappearance of these features and support the idea that side-by-side gradings can complement independent gradings identifying appearance or disappearance of features of AMD.
Background/AimsTo characterise the ocular manifestations of Williams-Beuren syndrome (WBS) and co... more Background/AimsTo characterise the ocular manifestations of Williams-Beuren syndrome (WBS) and compare these to patients with isolated elastin mediated supravalvular aortic stenosis (SVAS).MethodsFifty-seven patients with a diagnosis of WBS and five with SVAS underwent comprehensive ophthalmic evaluation at the National Institutes of Health from 2017 to 2020, including best-corrected visual acuity, slit-lamp biomicroscopy, optical biometry, dilated fundus examination, optical coherence tomography and colour fundus imaging.ResultsMean age of the 57 WBS patients was 20.3 years (range 3–60 years). Best-corrected visual acuity ranged from 20/20 to 20/400 with mean spherical equivalent near plano OU. Twenty-four eyes (21.8%) had an axial length (AL) less than 20.5 mm and 38 eyes (34.5%) had an AL measuring 20.5–22.0 mm. Stellate iris and retinal arteriolar tortuosity were noted in 30 (52.6%) and 51 (89.5%) WBS patients, respectively. Novel retinal findings in WBS included small hypopigme...
Purpose: To examine the distribution of cortical opacification of the lens by lens quadrant in a ... more Purpose: To examine the distribution of cortical opacification of the lens by lens quadrant in a longitudinal study. Methods: In 1990, a follow-up assessment of a cohort of Chesapeake Bay watermen, initially studied in 1985, was performed. Four hundred thirty-seven subjects (834 eyes) had gradable cortical photographs for at least one eye in both 1985 and 1990. Cortical photographs were graded by both estimating total area and determining the quadrant with the greatest degree of cortical opacification. Results: The prevalence and severity of cortical opacification increased with age with a high degree of concordance (84%) between eyes. For the 47 eyes with cortical opacification > or = 1/8 at baseline, the principal locations of opacification were: inferonasal 63.8%, inferotemporal 17.0%, superonasal 6.4%, and superotemporal 12.8% (P < 0.001, compared with equal distribution by quadrant). Five-year development of new cortical opacification and five-year progression of existing cortical opacification showed even greater preferential occurrence in the inferonasal quadrant of the lens. Conclusions: In this population, the inferonasal quadrant of the lens is the principal site of cortical opacification in both cross-sectional and longitudinal assessment. This finding is consistent with the hypothesis that sunlight exposure is a significant risk factor for cortical opacification.
To examine the relationships between smoking and the 5-year incidence of new nuclear opacities an... more To examine the relationships between smoking and the 5-year incidence of new nuclear opacities and between smoking and the progression of nuclear opacities in a prospective study of a cohort of Chesapeake Bay watermen. A total of 442 men (age, &amp;amp;gt; or = 30 years in 1985) with paired, gradable lens photographs in at least one eye in both 1985 and 1990 were studied. Photographs were graded by two readers who used the grading scheme of the Wilmer Institute, Baltimore, Md, with severity ranging in decimal units between 0.0 and 4.0. Data on the smoking history of the subjects were collected by personal interviews that were conducted in 1985 and updated in 1990. The incidence and progression of opacities increased with age. A nonsignificant association was observed between smoking (for both current and ex-smokers) and the incidence of a nuclear opacity. The risk of progression of nuclear opacities of less than grade 3 at baseline to grade 3 or worse was 2.4-fold higher among current smokers in 1985, compared with that among ex-smokers and nonsmokers (95% confidence limits: 1.0, 6.0) after adjustment for age, baseline opacity status, and alcohol use. An 18% increased risk of progression was significantly associated with each pack-year that a subject smoked between 1985 and 1990. These data confirm previous findings that smoking is associated with a nuclear opacity, particularly with progression to severe opacities.
Retina-the Journal of Retinal and Vitreous Diseases, 1997
Quantitative features of pars plana development in humans are not well characterized. Knowledge o... more Quantitative features of pars plana development in humans are not well characterized. Knowledge of the dimensions of this region is important for our understanding of the anatomy of infant eyes for the purposes of surgery. The purpose of this study was to provide a morphometric description of pars plana growth in relation to 1) postconceptional age and 2) axial length. We reviewed histologic specimens from 204 human eyes of postconceptional ages ranging from 10 weeks to 5 years. Axial length and temporal pars plana width were measured directly with a reticule system. The relationships among pars plana width, axial length, and postconceptional age were examined. The most rapid phase of pars plana growth occurred between 26 weeks and 35 weeks gestation. A linear relationship between pars plana width and axial length existed once the axial length reached 12 mm (correlation coefficient = 0.918; P = 0.0001). In infants of 38-42 weeks postconceptional age, mean pars plana width was 1.87 mm (range, 0.9-2.8 mm; standard direction = 0.48 mm), and mean axial length was 17.7 mm (range, 15-23 mm; standard direction = 1.9 mm). After the age of 62 weeks postconception, all eyes had a temporal pars plana width &gt; or = 3 mm and an axial length &gt; or = 19 mm. The estimated age at which there was a 95% chance of the pars plana width being &gt; or = 3 mm was 64.4 weeks (95% fiducial confidence limits, 60.8-86.2 weeks). The pars plana first develops during the second trimester of gestation. A rapid growth phase occurs between 26 weeks and 35 weeks postconception. The dimensions of the pars plana are correlated closely with axial length and postconceptional age. Assuming that a pars plana width of 3 mm is required for surgery to be performed via a pars plana approach, we estimate that pars plana vitreous surgery can be performed when the patient is at least 62 weeks old (postconception), which is a 6-month-old full-term infant.
To obtain 5-year longitudinal data on age-related macular degeneration (AMD) that might be useful... more To obtain 5-year longitudinal data on age-related macular degeneration (AMD) that might be useful for disease prognosis, public health planning, and clinical trial development. Baseline (1985) and 5-year follow-up (1990) fundus photographs of 483 watermen over 30 years of age who participated in a cohort study conducted on the eastern shore of Maryland were graded independently in a reliable, standardized fashion. Eyes in which AMD appeared or disappeared also were graded in a side-by-side fashion. Development of definite choroidal neovascularization and/or disciform scarring occurred in one of 50 participants over 70 years of age, specifically one of 15 participants over 70 years of age with AMD-3 (defined as large or confluent drusen focal hyperpigmentation of the retinal pigment epithelium [RPE], and/or nongeographic atrophy of the RPE). Appearance of large drusen, focal hyperpigmentation, or AMD-3 was age related, occurring in 5%, 1%, and 7%, respectively, of participants aged 50 to 59 years; 17%, 3%, and 14%, respectively, of participants aged 60 to 69 years; and 17%, 9%, and 26%, respectively, of participants aged 70 years or more. Disappearance of large drusen, hyperpigmentation, or AMD-3 occurred in 16 (34%) of 47 participants, 11 (58%) of 19 participants, and 17 (28%) of 61 participants, respectively, who had each feature photographically present in 1985. Among the 47 eyes identified in which AMD-3 developed by independent gradings, 38 cases of AMD-3 (81%) were confirmed on side-by-side grading. Among the 16 eyes identified as having AMD-3 that disappeared, nine disappearances (56%) were confirmed. Borderline differences in appearance of pigment, drusen size, drusen location, or photographic quality may have accounted for disappearance in seven cases (44%). Prospective studies on the nonneovascular features of AMD (including large drusen and abnormalities of the RPE) must account for the appearance and disappearance of these features and support the idea that side-by-side gradings can complement independent gradings identifying appearance or disappearance of features of AMD.
Background/AimsTo characterise the ocular manifestations of Williams-Beuren syndrome (WBS) and co... more Background/AimsTo characterise the ocular manifestations of Williams-Beuren syndrome (WBS) and compare these to patients with isolated elastin mediated supravalvular aortic stenosis (SVAS).MethodsFifty-seven patients with a diagnosis of WBS and five with SVAS underwent comprehensive ophthalmic evaluation at the National Institutes of Health from 2017 to 2020, including best-corrected visual acuity, slit-lamp biomicroscopy, optical biometry, dilated fundus examination, optical coherence tomography and colour fundus imaging.ResultsMean age of the 57 WBS patients was 20.3 years (range 3–60 years). Best-corrected visual acuity ranged from 20/20 to 20/400 with mean spherical equivalent near plano OU. Twenty-four eyes (21.8%) had an axial length (AL) less than 20.5 mm and 38 eyes (34.5%) had an AL measuring 20.5–22.0 mm. Stellate iris and retinal arteriolar tortuosity were noted in 30 (52.6%) and 51 (89.5%) WBS patients, respectively. Novel retinal findings in WBS included small hypopigme...
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