1
|
Pterygium and Ocular Surface Squamous Neoplasia: Optical Biopsy Using a Novel Autofluorescence Multispectral Imaging Technique. Cancers (Basel) 2022; 14:cancers14061591. [PMID: 35326744 PMCID: PMC8946656 DOI: 10.3390/cancers14061591] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/07/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023] Open
Abstract
In this study, differentiation of pterygium vs. ocular surface squamous neoplasia based on multispectral autofluorescence imaging technique was investigated. Fifty (N = 50) patients with histopathological diagnosis of pterygium (PTG) and/or ocular surface squamous neoplasia (OSSN) were recruited. Fixed unstained biopsy specimens were imaged by multispectral microscopy. Tissue autofluorescence images were obtained with a custom-built fluorescent microscope with 59 spectral channels, each with specific excitation and emission wavelength ranges, suitable for the most abundant tissue fluorophores such as elastin, flavins, porphyrin, and lipofuscin. Images were analyzed using a new classification framework called fused-classification, designed to minimize interpatient variability, as an established support vector machine learning method. Normal, PTG, and OSSN regions were automatically detected and delineated, with accuracy evaluated against expert assessment by a specialist in OSSN pathology. Signals from spectral channels yielding signals from elastin, flavins, porphyrin, and lipofuscin were significantly different between regions classified as normal, PTG, and OSSN (p < 0.01). Differential diagnosis of PTG/OSSN and normal tissue had accuracy, sensitivity, and specificity of 88 ± 6%, 84 ± 10% and 91 ± 6%, respectively. Our automated diagnostic method generated maps of the reasonably well circumscribed normal/PTG and OSSN interface. PTG and OSSN margins identified by our automated analysis were in close agreement with the margins found in the H&E sections. Such a map can be rapidly generated on a real time basis and potentially used for intraoperative assessment.
Collapse
|
2
|
Stevenson LJ, Mackey DA, Lingham G, Burton A, Brown H, Huynh E, Tan IJ, Franchina M, Sanfilippo PG, Yazar S. Has the Sun Protection Campaign in Australia Reduced the Need for Pterygium Surgery Nationally? Ophthalmic Epidemiol 2020; 28:105-113. [PMID: 32729768 DOI: 10.1080/09286586.2020.1797120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Slip! Slop! Slap! Sunsmart safety campaign was an Australian initiative implemented in the 1980s. To assess this campaign's effect on pterygium, we examined the rate of pterygium surgery across Australia and described the prevalence and associations of pterygium in Perth, Australia's sunniest capital city. METHODS The rate of pterygium surgery was examined using Australian Medicare data. A cross-sectional analysis of the Generation 1 (Gen1) cohort of the Raine Study was performed to investigate the prevalence of pterygium in Perth. We investigated the association between pterygium and conjunctival ultraviolet autofluorescence (CUVAF) area, an objective biomarker of sun exposure, and demographics and health variables derived from a detailed questionnaire. RESULTS Between 1994 and 2017, the rate of Medicare funded pterygium surgery in Western Australia fell 11%, well below the national average decline of 47%. Of the 1049 Gen1 Raine Study participants, 994 (571 females; mean age 56.7 years, range = 40.9-81.7) were included in the analysis. The lifetime prevalence of pterygium was 8.4% (n = 83). A higher prevalence of pterygium was associated with outdoor occupation (p-trend = 0.007), male sex (p-trend 0.01) and increasing CUVAF area (p-value <0.001). CONCLUSIONS The effect of Australia's Slip! Slop! Slap! Sunsmart safety campaign on pterygium been mixed. Since 1994, the rate of private pterygium surgery has declined significantly in all Australian states except Western Australia. Perth, Western Australia, has the highest pterygium prevalence of any mainland-Australian cohort. Higher CUVAF area, male sex, and outdoor occupation were associated with an increased risk of pterygium.
Collapse
Affiliation(s)
- Louis J Stevenson
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, New South Wales, Australia
| | - David A Mackey
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Gareth Lingham
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Alex Burton
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Holly Brown
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Emily Huynh
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Irene J Tan
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Maria Franchina
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Victoria, Australia
| | - Seyhan Yazar
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia
| |
Collapse
|
3
|
Jaki Mekjavic P, Tipton MJ, Mekjavic IB. The eye in extreme environments. Exp Physiol 2020; 106:52-64. [DOI: 10.1113/ep088594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/05/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Polona Jaki Mekjavic
- University Medical Centre Ljubljana Eye Clinic Ljubljana Slovenia
- Faculty of Medicine University of Ljubljana Ljubljana Slovenia
- Department of Automation Biocybernetics and Robotics Jozef Stefan Institute Ljubljana Slovenia
| | - Michael J. Tipton
- School of Sport Health and Exercise Science University of Portsmouth Portsmouth UK
| | - Igor B Mekjavic
- Department of Automation Biocybernetics and Robotics Jozef Stefan Institute Ljubljana Slovenia
- Department of Biomedical Physiology and Kinesiology Simon Fraser University Burnaby British Columbia Canada
| |
Collapse
|
4
|
Downs NJ, Parisi AV, Schouten PW, Igoe DP, De Castro-Maqueda G. The Simulated Ocular and Whole-Body Distribution of Natural Sunlight to Kiteboarders: A High-Risk Case of UVR Exposure for Athletes Utilizing Water Surfaces in Sport. Photochem Photobiol 2020; 96:926-935. [PMID: 31883381 DOI: 10.1111/php.13200] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/20/2019] [Indexed: 12/18/2022]
Abstract
Kiteboarding is an aquatic sporting discipline that has not yet been considered in the literature to date in terms of solar ultraviolet radiation (UVR) measurement. Kiteboarders need to look upward and are placed obliquely relative to the horizon when towed behind an overhead kite over a reflective water surface. This research defines the typical body surface orientation of a kiteboarder in motion through video vector analysis and demonstrates the potential risk to ocular and skin surface damage through practical measurement of solar UVR using a manikin model. Video analysis of 51 kiteboarders was made to construct skeletal wireframes showing the surface orientation of the leg, thigh, spine, humerus, lower arm and head of a typical kiteboarder. Solar UVR dosimeter measurements made using a manikin model demonstrate that the vertex and anterior surfaces of the knee, lower leg and lower humerus received 89%, 90%, 80% and 63% of the available ambient UVR, respectively, for a typical kiteboarder who is tilted back more than 15° from vertical while in motion. Ocular (periorbital) exposures ranged from 56% to 68% of ambient. These new findings show that the anterior skin surfaces of kiteboarders and the eye are at elevated risk of solar UVR damage.
Collapse
Affiliation(s)
- Nathan J Downs
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Alfio V Parisi
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Peter W Schouten
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Damien P Igoe
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | | |
Collapse
|
5
|
Hirst LW, Battistuta D. Eight-year trends in the Australian surgical approach to pterygium removal. Clin Exp Ophthalmol 2018; 47:15-19. [DOI: 10.1111/ceo.13351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 05/22/2018] [Accepted: 06/20/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Lawrence W Hirst
- The Australian Pterygium Centre; Brisbane Australia
- Queensland Eye Institute; South Brisbane Australia
- The University of Queensland; St Lucia Australia
| | - Diana Battistuta
- Institute of Health and Biomedical Innovations, Queensland University of Technology; Kelvin Grove Australia
| |
Collapse
|
6
|
Surgical techniques and adjuvants for the management of primary and recurrent pterygia. J Cataract Refract Surg 2017; 43:405-419. [DOI: 10.1016/j.jcrs.2017.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/03/2016] [Indexed: 01/31/2023]
|
7
|
Yazar S, Cuellar-Partida G, McKnight CM, Quach-Thanissorn P, Mountain JA, Coroneo MT, Pennell CE, Hewitt AW, MacGregor S, Mackey DA. Genetic and environmental factors in conjunctival UV autofluorescence. JAMA Ophthalmol 2015; 133:406-12. [PMID: 25590795 DOI: 10.1001/jamaophthalmol.2014.5627] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
IMPORTANCE Conjunctival UV autofluorescence (CUVAF) photography was developed to detect and characterize preclinical sunlight-induced ocular damage. Ocular sun exposure has been related to cases of pterygia and was recently negatively correlated with myopia. Hence, CUVAF has excellent potential as an objective biomarker of sun exposure. However, much variation in CUVAF has been observed, and the relative contributions of genes and environment to this variation have not yet been identified. OBJECTIVE To investigate sources of variation in CUVAF in relation to its potential clinical relevance. DESIGN, SETTING, AND PARTICIPANTS We performed a cross-sectional analysis of 3 population-based cohort studies in the general community, including the Twins Eye Study in Tasmania, the Brisbane Adolescent Twin Study, and the Western Australian Pregnancy Cohort (Raine) Study. The twin studies were conducted between 2001 and 2009, and the 20-year follow-up of the Raine Study was completed between March 2010 and February 2012. We included genotypic and phenotypic data from 295 Australian families in the Tasmanian and Brisbane twin studies and from 661 participants in the 20-year follow-up of the Raine Study. We compared CUVAF levels in the 3 cohorts and performed a classic twin study to partition variation in CUVAF. We also conducted a genome-wide association analysis to identify specific genetic variants associated with CUVAF. MAIN OUTCOMES AND MEASURES The total area of CUVAF, heritability of CUVAF, and single-nucleotide polymorphisms (SNPs) associated with CUVAF from the genome-wide association study. RESULTS Within twin cohorts, individuals living closer to the equator (latitude, 27.47° S) had higher levels of CUVAF compared with individuals from southern regions (latitude, 42.88° S) (median [interquartile range], 45.4 [26.8-68.5] vs 28.7 [15.0-42.3] mm2; P < .001). The variation in CUVAF explained by the additive genetic component was 0.37 (95% CI, 0.22-0.56), whereas the variation due to the common environment was 0.50 (95% CI; 0.29-0.71). The SNP rs1060043, located approximately 800 base pairs away from the SLC1A5 gene, a member of the solute carrier family 1, had a genome-wide significant association with a P value of 3.2 × 10-8. Gene-based analysis did not improve our power to detect association with other genes. CONCLUSIONS AND RELEVANCE Our findings confirm that, although a large environmental component to CUVAF (equivalent of sun exposure) exists, genes also play a significant role. We identified a SNP (rs1060043) as being significantly associated with CUVAF; replication of this finding in future studies is warranted.
Collapse
Affiliation(s)
- Seyhan Yazar
- Centre for Ophthalmology and Vision Science/Lions Eye Institute Perth, University of Western Australia, Perth, Australia
| | | | - Charlotte M McKnight
- Centre for Ophthalmology and Vision Science/Lions Eye Institute Perth, University of Western Australia, Perth, Australia
| | - Piriya Quach-Thanissorn
- Centre for Ophthalmology and Vision Science/Lions Eye Institute Perth, University of Western Australia, Perth, Australia
| | - Jenny A Mountain
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Minas T Coroneo
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Craig E Pennell
- School of Women's and Infants' Health, University of Western Australia, Perth, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, Melbourne University, Melbourne, Australia
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - David A Mackey
- Centre for Ophthalmology and Vision Science/Lions Eye Institute Perth, University of Western Australia, Perth, Australia6Centre for Eye Research Australia, Melbourne University, Melbourne, Australia
| |
Collapse
|
8
|
McKnight CM, Sherwin JC, Yazar S, Forward H, Tan AX, Hewitt AW, Smith E, Turton D, Byrd P, Pennell CE, Coroneo MT, Mackey DA. Pterygium and conjunctival ultraviolet autofluorescence in young Australian adults: the Raine study. Clin Exp Ophthalmol 2014; 43:300-7. [PMID: 25307729 DOI: 10.1111/ceo.12455] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 10/02/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sun exposure is associated with several ophthalmic diseases, including pterygium which may develop in adolescence. This study reports the prevalence of pterygium and its associations in a large cohort of young Australian adults. Conjunctival ultraviolet autofluorescence, a biomarker of ocular sun exposure, has recently been characterized in some Australian populations. DESIGN Cross-sectional population-based study. PARTICIPANTS One thousand three hundred forty-four subjects aged 18-22 years in the Western Australian Pregnancy Cohort (Raine) Study. METHODS Standardized colour and ultraviolet autofluorescence photographs of the nasal and temporal conjunctiva were taken, and assessed for presence of pterygium and area of autofluorescence. Sun exposure and protective factors were assessed by structured questionnaire. MAIN OUTCOME MEASURES Area of conjunctival ultraviolet autofluorescence in square millimetre (mm(2)) and presence of pterygium. RESULTS Median total conjunctival autofluorescence was 44.2 mm(2) (interquartile range 20.2-69.8 mm(2)). Median conjunctival autofluorescence was higher in nasal than in temporal quadrants (23.8 mm(2) vs. 18.9 mm(2), P < 0.001), but did not differ according to age or gender. Higher body mass index was associated with lower levels of autofluorescence. Total autofluorescence increased with increasing time spent outdoors. Prevalence of pterygium was 1.2% (95% confidence interval 0.6-1.8%), and was associated with male gender (odds ratio 6.71, P = 0.012). Participants with pterygium had significantly more conjunctival autofluorescence than those without (median 73.4 mm(2) vs. 44.0 mm(2), P = 0.001). CONCLUSIONS Conjunctival ultraviolet autofluorescence is associated with increased time spent outdoors, and increased prevalence of pterygium. The association of this biomarker with other ophthalmohelioses, including cataract, ocular surface squamous neoplasia and eyelid malignancy, has yet to be determined.
Collapse
Affiliation(s)
- Charlotte M McKnight
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
| | - Justin C Sherwin
- Royal Victorian Eye and Ear Hospital, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Seyhan Yazar
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
| | - Hannah Forward
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
| | - Alex X Tan
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
| | - Alex W Hewitt
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.,Royal Victorian Eye and Ear Hospital, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Elliot Smith
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
| | - David Turton
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
| | - Pippa Byrd
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
| | - Craig E Pennell
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia.,School of Women's and Infants' Health, The University of Western Australia, Perth, Australia
| | - Minas T Coroneo
- Department of Ophthalmology, Prince of Wales Hospital, Sydney, Australia
| | - David A Mackey
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia
| |
Collapse
|
9
|
Klebe S, Callahan T, Power JHT. Peroxiredoxin I and II in human eyes: cellular distribution and association with pterygium and DNA damage. J Histochem Cytochem 2013; 62:85-96. [PMID: 24152995 DOI: 10.1369/0022155413508409] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Peroxiredoxin I and II are both 2-Cys members of the peroxiredoxin family of antioxidant enzymes and inactivate hydrogen peroxide. On western blotting, both enzymes appeared as 22-kD proteins and were present in the sclera, retina and iris. Immunohistochemistry showed strong cytoplasmic labeling in the basal cells of the corneal epithelial layer and the corneoscleral limbus. The melanocytes within the stroma of the iris and the anterior epithelial cells of the lens also showed strong cytoplasmic labeling. The fibrous structure of the stroma and the posterior surface of the ciliary body were also labeled. There was also strong labeling for both enzymes in the photoreceptors and the inner and outer plexiform layers of the retina. There was increased labeling of peroxiredoxin I and II in pterygium. In normal conjunctiva and cornea, only the basal cell layer showed labeling for peroxiredoxin I and II, whereas, in pterygia, there was strong cytoplasmic labeling in most cells involving the full thickness of the epithelium. Co-localization of the DNA oxidation product 8-hydroxy-2'-deoxyguanosine antibody with the nuclear dye 4',6'-diamidino-2-phenylindole dihydrochloride indicated that the majority of the oxidative damage was cytoplasmic; this suggested that the mitochondrial DNA was most affected by the UV radiation in this condition.
Collapse
Affiliation(s)
- Sonja Klebe
- Departments of Anatomical Pathology and Human Physiology, School of Medicine, Flinders University, South Australia (SK, TC, JHP)
| | | | | |
Collapse
|
10
|
Chen CL, Lai CH, Wu PL, Wu PC, Chou TH, Weng HH. The epidemiology of patients with pterygium in southern Taiwanese adults: The Chiayi survey. Taiwan J Ophthalmol 2013. [DOI: 10.1016/j.tjo.2013.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
11
|
Sherwin JC, Hewitt AW, Kearns LS, Griffiths LR, Mackey DA, Coroneo MT. The association between pterygium and conjunctival ultraviolet autofluorescence: the Norfolk Island Eye Study. Acta Ophthalmol 2013; 91:363-70. [PMID: 22176664 DOI: 10.1111/j.1755-3768.2011.02314.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate the association between conjunctival ultraviolet autofluorescence (UVAF), a biomarker of ocular ultraviolet radiation (UVR) exposure, and prevalent pterygium. METHODS We conducted a cross-sectional study on Norfolk Island, South Pacific. All permanent residents aged ≥15 were invited to participate. Participants completed a sun exposure questionnaire and underwent autorefraction and slit lamp biomicroscope examination. Area of conjunctival UVAF (sum of temporal/nasal area in right and left eyes) was determined using computerized methods. Multivariate logistic and linear regression models were used to estimate the associations with pterygia and UVAF, respectively. RESULTS Of 641 participants, 70 people (10.9%) had pterygium in one or both eyes, and prevalence was higher in males (15.0% versus 7.7%, p = 0.003). Significant independent associations with pterygium in any eye were UVAF (per 10 mm(2)) [odds ratio (OR) 1.16, 95% confidence interval (CI) 1.16-1.28, p = 0.002], tanning skin phenotype (OR 2.17, 1.20-3.92, p = 0.010) and spending more than three-quarters of the day outside (OR 2.22, 1.20-4.09, p = 0.011). Increasing quartile of UVAF was associated with increased risk of pterygium following adjustment of age, sex and time outdoors (p(Trend) = 0.002). Independent associations with increasing UVAF (per 10 mm(2)) were decreasing age, time outdoors, skin type and male gender (all p < 0.001). UVAF area correlated well with the duration of outdoor activity (p(Trend) < 0.001). CONCLUSION Pterygium occurs in approximately one-tenth of Norfolk Islanders. Increasing conjunctival UVAF is associated with prevalent pterygia, confirming earlier epidemiological, laboratory and ray-tracing studies that pterygia are associated with UVR. Protection from the sun should be encouraged to reduce the prevalence of pterygium in the community.
Collapse
Affiliation(s)
- Justin C Sherwin
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Department of Ophthalmology, Melbourne, Vic., Australia
| | | | | | | | | | | |
Collapse
|
12
|
Sun LP, Lv W, Liang YB, Friedman DS, Yang XH, Guo LX, Peng Y, Wang NL, Wang JJ. The prevalence of and risk factors associated with pterygium in a rural adult Chinese population: the Handan Eye Study. Ophthalmic Epidemiol 2013; 20:148-54. [PMID: 23662799 DOI: 10.3109/09286586.2013.763991] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe the prevalence and risk factors for pterygium in a rural adult Chinese population. METHODS A total of 7557 people aged 30 years and over were randomly selected from 13 villages in a rural county, Yongnian, within Handan district, Hebei Province of China. All eligible subjects were invited to undergo a comprehensive eye examination. A slit-lamp was used to examine the anterior segment for evidence of pterygium. Pterygium was graded for severity (G1 to G3) by visibility of episcleral vessels. RESULTS Of 6685 participants (88.5% of 7557) included in this study, pterygium was present in 401 (6.0%). Using direct standardization to the 2000 China population census for rural residents, the prevalence of pterygium was 7.1% (95% confidence interval [CI], 6.5-7.8%) among subjects aged 40+ years, and 4.8% (95% CI 4.3-5.3%) when including those aged 30-39 years. Pterygium was more common in men than in women (age-adjusted odds ratio [OR] 2.0, 95% CI 1.4-2.8). Prevalence increased with age (OR 1.8, 95% CI 1.6-2.1 per decade increase in age). Current smoking appeared to be protective (OR 0.5, 95% CI 0.4-0.7). Of eyes with any pterygium, 4.6% (95% CI 1.9-7.3%) had low vision. CONCLUSION Approximately one in ten adults had pterygium in this rural Chinese population. Age and male sex were positively, and current smoking negatively associated with the prevalence of pterygium.
Collapse
|
13
|
Chandler H. Ultraviolet Absorption by Contact Lenses and the Significance on the Ocular Anterior Segment. Eye Contact Lens 2011; 37:259-66. [DOI: 10.1097/icl.0b013e3182240945] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
14
|
Abstract
The traditional concept of chronic UV exposure as a central factor in the pathogenesis of pterygium has been repeatedly confirmed by large epidemiological studies in recent years. Despite its high prevalence in some regions and populations, pterygium is only rarely a cause of blindness. In addition to the latitude of residence, risk factors include years of working outdoors, increasing age and male gender. Regular wearing of adequate sun protection is an economical and simple prophylaxis with proven effect and is recommended, as well as public education, in particular to groups of people who exercise their profession outdoors.
Collapse
|
15
|
Lucas RM, McMichael AJ, Armstrong BK, Smith WT. Estimating the global disease burden due to ultraviolet radiation exposure. Int J Epidemiol 2008; 37:654-67. [DOI: 10.1093/ije/dyn017] [Citation(s) in RCA: 179] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
|
16
|
Relationship between the morbidity of pterygium and the duration of ultraviolet rays exposure in Sanya, China. Chin Med J (Engl) 2006. [DOI: 10.1097/00029330-200608010-00013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
17
|
|
18
|
Mathur ML, Haldiya KR, Sachdev R, Saiyed HN. The risk of pterygium in salt workers. Int Ophthalmol 2006; 26:43-7. [PMID: 16783484 DOI: 10.1007/s10792-006-0001-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2004] [Accepted: 12/28/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE To find out if exposure to direct and reflected sunlight in brine pans (ground water rich in salt, kept in wide pans in open air for salt manufacturing), increases the risk of pterygium in exposed salt workers. METHODS It was a cross sectional observational study, in which 865 salt workers were examined in the Free Occupational Health Check-up camps held near salt sites; 304 persons from the same area engaged in other work were examined as controls. The prevalence of pterygium in different age groups was compared between brine workers (who worked in the brine pans), dry salt workers, (who were engaged in the loading, weighing, milling, packing or transportation of the dry salt but never worked in brine pans) and non-salt-worker controls. RESULTS The prevalence of pterygium was significantly higher in brine workers (21.0%) as compared to dry salt workers (9.1%) (Yates corrected chi(2) = 23.45, p = 0.000001) and non-salt-worker controls (9.4%) (Yates corrected chi(2) = 15.69, p = 0.00007). It increased with age and duration of employment in the salt industry. CONCLUSIONS Brine workers have a higher risk of developing pterygium probably due to their exposure to sunlight reflected both from the surface of brine and from the surface of salt crystals.
Collapse
Affiliation(s)
- Murli L Mathur
- Desert Medicine Research Centre (ICMR), New Pali Road, Jodhpur, 342005, India.
| | | | | | | |
Collapse
|
19
|
Taylor SL, Coates ML, Vallejos Q, Feldman SR, Schulz MR, Quandt SA, Fleischer AB, Arcury TA. Pterygium among Latino migrant farmworkers in North Carolina. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2006; 61:27-32. [PMID: 17503618 DOI: 10.3200/aeoh.61.1.27-32] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The authors describe the prevalence and severity of pterygium among Latino migrant farmworkers in North Carolina and delineate its risk factors. They selected a sample of 304 farmworkers working in eastern North Carolina in 2005. Digital photographs were taken of each farmworker, including a facial view showing the eyes. Two physicians independently rated each farmworker for the presence and severity of pterygia, with an initial intercoder agreement of 91%. Sixty-eight (23.3%) participants had a pterygium in at least 1 eye; 28 (9.5%) had bilateral pterygia. Age was significantly associated with pterygia (odds ratio = 1.07; 95% confidence interval = 1.03-1.11). Research on the causes of pterygium among farmworkers is needed. In the interim, improvements in farmworkers' preventive behaviors, such as wearing ultraviolet protective lenses and brimmed hats, are reasonable and inexpensive measures.
Collapse
Affiliation(s)
- Sarah L Taylor
- Department of Dermatology, Wake Forest University, Winston-Salem, North Carolina 27157, USA
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Akobundu E, Ju J, Blatt L, Mullins CD. Cost-of-illness studies : a review of current methods. PHARMACOECONOMICS 2006; 24:869-90. [PMID: 16942122 DOI: 10.2165/00019053-200624090-00005] [Citation(s) in RCA: 181] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The number of cost-of-illness (COI) studies has expanded considerably over time. One outcome of this growth is that the reported COI estimates are inconsistent across studies, thereby raising concerns over the validity of the estimates and methods. Several factors have been identified in the literature as reasons for the observed variation in COI estimates. To date, the variation in the methods used to calculate costs has not been examined in great detail even though the variations in methods are a major driver of variation in COI estimates. The objective of this review was to document the variation in the methodologies employed in COI studies and to highlight the benefits and limitations of these methods. The review of COI studies was implemented following a four-step procedure: (i) a structured literature search of MEDLINE, JSTOR and EconLit; (ii) a review of abstracts using pre-defined inclusion and exclusion criteria; (iii) a full-text review using pre-defined inclusion and exclusion criteria; and (iv) classification of articles according to the methods used to calculate costs. This review identified four COI estimation methods (Sum_All Medical, Sum_Diagnosis Specific, Matched Control and Regression) that were used in categorising articles. Also, six components of direct medical costs and five components of indirect/non-medical costs were identified and used in categorising articles.365 full-length articles were reflected in the current review following the structured literature search. The top five cost components were emergency room/inpatient hospital costs, outpatient physician costs, drug costs, productivity losses and laboratory costs. The dominant method, Sum_Diagnosis Specific, was a total costing approach that restricted the summation of medical expenditures to those related to a diagnosis of the disease of interest. There was considerable variation in the methods used within disease subcategories. In several disease subcategories (e.g. asthma, dementia, diabetes mellitus), all four estimation methods were represented, and in other cases (e.g. HIV/AIDS, obesity, stroke, urinary incontinence, schizophrenia), three of the four estimation methods were represented. There was also evidence to suggest that the strengths and weaknesses of each method were considered when applying a method to a specific illness. Comparisons and assessments of COI estimates should consider the method used to estimate costs both as an important source of variation in the reported COI estimates and as a marker of the reliability of the COI estimate.
Collapse
Affiliation(s)
- Ebere Akobundu
- Pharmaceutical Health Services Research Department, School of Pharmacy, University of Maryland, Baltimore, Maryland 21201, USA.
| | | | | | | |
Collapse
|
21
|
Abstract
PURPOSE The p63 gene has been identified as a marker of epithelial stem cells. Because pterygium may arise through an expansion of the proliferative capacity of the conjunctiva, we sought to document the expression of p63 in normal conjunctiva and pterygium specimens. METHODS Immunostaining for p63 expression was performed on 10 pairs of pterygium and normal conjunctiva using a monoclonal antibody directed against human p63. RESULTS Immunopositive reactions were seen in all samples. Levels of p63-positive cells were not statistically different between pterygium and normal conjunctivae (P = 0.7). CONCLUSION These results strongly support previous studies that indicate that pterygium arises as a result of incorrect control of cellular apoptosis rather than from an increase in proliferative capacity.
Collapse
Affiliation(s)
- Pornpilas Sakoonwatanyoo
- Molecular Pathology Laboratory, Institute of Molecular Biology and Genetics, Mahidol University, Salaya Campus, Nakorn Pathom, Thailand
| | | | | |
Collapse
|
22
|
Harrison M. Cost of pterygium. Clin Exp Ophthalmol 2002; 30:312. [PMID: 12121379 DOI: 10.1046/j.1442-9071.2002.00546.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|