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Zhang J, Qin B, Liu B, Sun D, Liang C, Wang S, Yang M, Zhu R. Prevalence and associated factors for pterygium in a Chinese rural population with type 2 diabetes in a cross-sectional study: Jiangsu Diabetic Eye Disease Study (JDEDS). Int Ophthalmol 2023; 43:411-422. [PMID: 35947253 DOI: 10.1007/s10792-022-02438-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 07/05/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE To investigate the pterygium prevalence and evaluate risk factors of pterygium in rural type 2 diabetic (D2M) patients aged 50 years and above in Funing Country, Jiangsu Province, China. METHODS A cross-sectional ophthalmic survey was conducted in type 2 diabetes mellitus (D2M) patients aged ≥ 50 years in Funing County, Jiangsu Province, China, which was named Jiangsu Diabetic Eye Disease Study (JDEDS). All participants underwent a comprehensive questionnaire and ocular examination. Pterygium was diagnosed by slit lamp examination. The risk factors associated with pterygium were evaluated with logistic regression models. RESULTS The prevalence of pterygium was 22.37% (n = 427) and 95% confidence interval (CI) (20.50-24.24%) in D2M patients aged 50 years and above in JDEDS. The prevalence of pterygium was 18.32% (95% CI 15.33-21.32%) in men and 24.43% (95% CI 22.06-26.80%) in women. Women had a higher prevalence than men (p = 0.001). Multivariate analysis showed, for male participants with D2M, pterygium was independently associated with increasing age [70-79 years: OR and 95% CI 2.49(1.20-5.18), p = 0.014; ≥ 80 years: 4.84(2.04-11.47), p < 0.001], while cigarette smoking was the protective factors, especially in current smoker [OR and 95% CI 0.79(0.67-0.92); p = 0.003]. For female participants with D2M, age [60-69 years OR and 95% CI 1.68(1.07-2.62), p = 0.023; 70-79 years: 2.62(1.69-4.06), p < 0.001; ≥ 80 years:3.24(1.70-5.90), p < 0.001], hypertension [OR and 95% CI 1.40(1.05-1.87), p = 0.024], BMI 24-27.9 [OR and 95% CI 1.20(1.00-1.44), p = 0.047], higher HbA1c [(5.6-7.9) % OR and 95% CI 1.42(1.10-1.82), p = 0.006; (8.0-9.9) %: 1.32(1.10-1.58), p = 0.003] were risk factors. CONCLUSIONS D2M patients aged over 50 years has a high prevalence of pterygium in JDEDS. The pterygium prevalence is higher in female D2M participants. Diabetes and related factors may be risk factors of pterygium in female D2M patients. Further studies are needed to explore the gender difference in the pathogenesis of pterygium in D2M subjects.
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Affiliation(s)
- Junfang Zhang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Bai Qin
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Bihong Liu
- Funing Shizhuang Eye Hospital, Yancheng, 224000, China
| | - Dajun Sun
- Funing Shizhuang Eye Hospital, Yancheng, 224000, China
| | - Congkai Liang
- Funing County Center for Disease Prevention and Control, Yancheng, 224000, China
| | - Shiyi Wang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Mei Yang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Rongrong Zhu
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, 226001, China.
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Zang S, Chen Y, Guo H, Zhang M, Zhang G, Zhang L, Zhang L, Liu Q, Zeng J, Lo CH, Cui Y, Meng Q. High HDL-C and high LDL-C are risk factors of pterygium in a population-based cross-sectional study in Southern China: the Dongguan Eye Study. BMJ Open 2022; 12:e058649. [PMID: 36691254 PMCID: PMC9171277 DOI: 10.1136/bmjopen-2021-058649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/12/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To investigate the relationship between serum lipids and pterygium in a large-scale rural population aged 40 years or older from Southern China. STUDY DESIGN The Dongguan Eye Study was a cross-sectional population-based study from September 2011 to February 2012. SETTING The area was set in the rural area of Dongguan, Southern China. PARTICIPANTS Adult rural population aged 40 or older. METHODS Participants underwent physical, haematological and ophthalmic examinations. PRIMARY AND SECONDARY OUTCOME MEASURES The frequency and risk factors of pterygium. RESULTS A total of 11 357 participants were eligible for inclusion and 8952 (78.8%) participants were enrolled for the systemic and ophthalmic examinations. The prevalence of pterygium was 17.3% after adjusting the sex and age distribution, 22.0% in participants with hypercholesterolaemia (total cholesterol ≥6.22 mmol/L (240 mg/dL)) and 21.8% in those with low-density lipoprotein-cholesterol (LDL-C) ≥4.14 mmol/L (160 mg/dL), respectively. After adjusting for multiple confounding factors, higher level of high-density lipoprotein-cholesterol (HDL-C) (OR: 1.23, 95% CI: 1.06 to 1.41) and LDL-C (OR: 1.13, 95% CI: 1.06 to 1.20) were positively associated with the risk of pterygium. The ORs for HDL-C or LDL-C with pterygium were significantly greater in participants aged 40-49 years than those aged 50 years or above (P for interaction <0.001). Furthermore, increased HDL-C showed greater association with pterygium in normal body mass index (BMI) group compared with overweight group (P for interaction=0.002). CONCLUSION Increased HDL-C and LDL-C are risk factors of pterygium, especially in people <50 years or those with normal BMI level. Strict control of HDL-C and LDL-C may be a new prevention method in reducing the risk of pterygium.
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Affiliation(s)
- Siwen Zang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yanlei Chen
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Haike Guo
- Department of Ophthalmology, Shanghai Peace Eye Hospital, Shanghai, China
| | - Min Zhang
- Department of Ophthalmology, Dongguan People's Hospital, Dongguan, Guangdong, China
| | - Guanrong Zhang
- Statistics Section, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Lixin Zhang
- Department of Ophthalmology, Hengli Hospital, Dongguan, Guangdong, China
| | - Liang Zhang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Qingyang Liu
- Department of Ophthalmology, Dongguan People's Hospital, Dongguan, Guangdong, China
| | - Jin Zeng
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Chun-Han Lo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ying Cui
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Qianli Meng
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
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Computer-Assisted Pterygium Screening System: A Review. Diagnostics (Basel) 2022; 12:diagnostics12030639. [PMID: 35328192 PMCID: PMC8947201 DOI: 10.3390/diagnostics12030639] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/25/2022] [Accepted: 03/04/2022] [Indexed: 12/10/2022] Open
Abstract
Pterygium is an eye condition that causes the fibrovascular tissues to grow towards the corneal region. At the early stage, it is not a harmful condition, except for slight discomfort for the patients. However, it will start to affect the eyesight of the patient once the tissues encroach towards the corneal region, with a more serious impact if it has grown into the pupil region. Therefore, this condition needs to be identified as early as possible to halt its growth, with the use of simple eye drops and sunglasses. One of the associated risk factors for this condition is a low educational level, which explains the reason that the majority of the patients are not aware of this condition. Hence, it is important to develop an automated pterygium screening system based on simple imaging modalities such as a mobile phone camera so that it can be assessed by many people. During the early stage of automated pterygium screening system development, conventional machine learning techniques such as support vector machines and artificial neural networks are the de facto algorithms to detect the presence of pterygium tissues. However, with the arrival of the deep learning era, coupled with the availability of large training data, deep learning networks have replaced the conventional networks in screening for the pterygium condition. The deep learning networks have been successfully implemented for three major purposes, which are to classify an image regarding whether there is the presence of pterygium tissues or not, to localize the lesion tissues through object detection methodology, and to semantically segment the lesion tissues at the pixel level. This review paper summarizes the type, severity, risk factors, and existing state-of-the-art technology in automated pterygium screening systems. A few available datasets are also discussed in this paper for both classification and segmentation tasks. In conclusion, a computer-assisted pterygium screening system will benefit many people all over the world, especially in alerting them to the possibility of having this condition so that preventive actions can be advised at an early stage.
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Lai CC, Tseng SH, Hsu SM, Huang YT, Shieh CC. Conjunctival Expression of Toll-Like Receptor 3 Plays a Pathogenic Role in the Formation of Ultraviolet Light-Induced Pterygium. Invest Ophthalmol Vis Sci 2021; 62:6. [PMID: 34369985 PMCID: PMC8354036 DOI: 10.1167/iovs.62.10.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Toll-like receptor 3 (TLR3), as a damage-associated molecular pattern sensor, can detect self-RNA released from necrotic cells induced by ultraviolet B (UVB) radiation exposure. Pterygium formation is believed to be a tumorigenesis-like process induced by UVB exposure. In this study, we aimed to investigate the expression pattern of TLR3 in pterygium specimens and cultured pterygial epithelial cells (PECs). Methods Human pterygium and ipsilateral pterygium-free conjunctiva from the same patients were used in this study. The expression of TLR3 and nuclear factor-kappa B (NF-κB) was investigated in these specimens. PECs were exposed to UVB radiation to determine the effect of UVB on the expression of TLR3 and the activation of NF-κB. Results The immunofluorescence study showed stronger TLR3 expression in superficial epithelial cells in the pterygial epithelium in comparison with the normal conjunctival epithelium. The expression of TLR3 decreased in intensity from the superficial epithelium toward the basal cell layer, implying a correlation between UVB exposure and TLR3 expression. Differential TLR3 expression patterns in pterygial and conjunctival tissues were also found in quantitative PCR analyses. PECs after UVB irradiation had higher protein levels of TLR3 and phospho-NF-κB than those of the PECs without irradiation. Immunofluorescence studies showed that UVB irradiation induced the nuclear translocation of NF-κB in the PECs. In PECs with the targeted TLR3 gene silencing, the expression of phospho-NF-κB was not induced by UVB irradiation. Conclusions Our results indicate that UVB exposure, TLR3 expression, and NF-κB activation may be a critical sequence that leads to the formation of pterygium.
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Affiliation(s)
- Chun-Chieh Lai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sung-Huei Tseng
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Min Hsu
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yin-Ting Huang
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Chang Shieh
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Shah SU, Ahmed T, Badar A, Shafique M, Malik S, Aaqil B. Efficacy of 5-Fluorouracil in the Treatment of Pterygium. Cureus 2021; 13:e12652. [PMID: 33489629 PMCID: PMC7805499 DOI: 10.7759/cureus.12652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective To determine the efficacy of 5-Fluorouracil (FU) in the treatment of pterygium. Methodology After meeting the inclusion criteria 101 patients were enrolled in this study. Informed consent and demographic information was taken from all the patients. Patients underwent ophthalmic clinical examination that included slit lamp examination to grade pterygium. Before starting 5-FU injections, all topical medication was stopped. After four weeks the effects of 5-FU and its efficacy was noted. The patients were reviewed again after six months to note any recurrence. All the collected data was entered and analyzed on Statistical Package for Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY). Results In our study the mean age of the patients was 37.74 ± 10.15 years, male to female ratio of the patients was 1.06:1. The primary type of pterygium was noted in 54 (53.5%) and recurrent was noted in 47 (46.5%) patients. The efficacy achieved in 88 (87.13%) patients, four had recurrence of pterygium and of 101 patients 26 underwent surgical excision. Conclusion The use of 5-FU is safe and effective for the treatment of pterygium and it can be implemented as a primary treatment especially in the hot temperate zone where it is very common and aggressive with high recurrence rate. 5-FU not only halts its progression but also reduces the size and vascularity thus decreasing the need for surgery and steroid use and preventing recurrence.
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Affiliation(s)
- Sobia U Shah
- Ophthalmology, Combined Military Hospital (CMH) Lahore Medical College, National University of Medical Sciences (NUMS), Lahore, PAK
| | - Tanveer Ahmed
- Ophthalmology, Combined Military Hospital (CMH) Lahore Medical College, National University of Medical Sciences (NUMS), Lahore, PAK.,Ophthalmology, Combined Military Hospital (CMH) Lahore, Lahore, PAK
| | - Anum Badar
- Ophthalmology, Combined Military Hospital (CMH) Rawalakot, Rawalakot, PAK
| | - Maeirah Shafique
- Ophthalmology, Combined Military Hospital (CMH) Abbottabad, Abbottabad, PAK
| | - Sidra Malik
- Ophthalmology, Pakistan Air Force (PAF) Faisal Base Karachi, Karachi, PAK
| | - Bushra Aaqil
- Ophthalmology, Ayub Medical College, Abbottabad, PAK
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Fekadu SA, Assem AS, Adimassu NF. Prevalence of pterygium and its associated factors among adults aged 18 years and above in Gambella town, Southwest Ethiopia, May 2019. PLoS One 2020; 15:e0237891. [PMID: 32881888 PMCID: PMC7470263 DOI: 10.1371/journal.pone.0237891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/04/2020] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION A pterygium is a wing-shaped fibro-vascular growth of conjunctiva on the superficial cornea/conjunctiva. It is an elastotic degeneration of conjunctival stroma mainly due to Ultraviolet light exposure. The prevalence of pterygium varies in different environmental conditions. Its magnitude varies widely from 1.1% to 53% globally and in Ethiopia, it reaches from 8.8% to 38.7%. OBJECTIVE To determine the prevalence of pterygium and its associated factors among adults aged 18 years and above in Gambella town, Southwest Ethiopia, 2019. METHODS AND MATERIALS A community based cross-sectional study was conducted from April 15 to May 3, 2019, in Gambella town. A total of 402 study participants were selected using a systematic random sampling technique. A pre-tested semi-structured questionnaire, torch, and magnifying loops were used to collect data. The data was entered into epidemiological information 7.1 and exported to statistical package for social science version 20 for analysis. The binary and multivariate logistic regression analysis model was fitted to identify factors associated with pterygium. Odds ratio with respected 95% CI was used to identify the direction and strength of association. RESULTS A total of 400 participants were examined with a response rate of 99.50%. The mean age of the study participants was 39.9±9.8years. The prevalence of pterygium among adults aged 18 years and above in Gambella town was 127(31.80%), (95% CI: 27.3, 36.3). male sex (AOR = 2.10 (95% CI: 1.26, 3.45), sunlight exposure (AOR = 6.86 (95% CI: 4.00, 11.79) and outdoor works (AOR = 2.10 (95% CI: 1.21, 3.60) were positively associated with pterygium whereas wearing sunglass/hat was a protective factor. CONCLUSION The prevalence of pterygium was high among adults living in Gambella town. Wearing sunglass/hat and reducing exposure time to the sun was important to reduce the development of pterygium in adults.
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Affiliation(s)
- Sofonias Addis Fekadu
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abel Sinshaw Assem
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyat Feleke Adimassu
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kassie Alemayehu T, Addis Y, Yenegeta Bizuneh Z, Mulusew Tegegne M, Alemayehu AM. Prevalence and Associated Factors of Pterygium Among Adults Living in Kolla Diba Town, Northwest Ethiopia. Clin Ophthalmol 2020; 14:245-255. [PMID: 32099312 PMCID: PMC6996295 DOI: 10.2147/opth.s239982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background Pterygium is a disfiguring disease that can potentially lead to blindness. It is more common in warm, windy and dry climates of tropical and sub-tropical regions of Africa. Globally, the prevalence ranging from 0.07% to 53%. Studies conducted on the prevalence of pterygium in developing countries were limited with a wider discrepancy between them. In this study, we aimed to assess the prevalence of pterygium and its associated factors among adults in Kolla Diba town. Methods A community-based cross-sectional study was done in Kolla Diba town from May 30-June 16, 2019. A systematic random sampling technique was used to select 627 study participants. The basic ophthalmic examination was performed using portable slit lamp, 3x magnifying loop with torch light and a pretested structured questionnaire was completed. The data entered into EPI INFO version 7 and analyzed using SPSS version 20. Descriptive statistics and binary logistic regression analysis were employed. P-values of <0.05 were considered statistically significant. Results A total of 605 study participants were involved with a response rate of 96.5%. Among them, 317 (52.4%) participants were males. The mean age of the respondents was 38.18 ± 15.56 with a range of (18–95) in years. The overall prevalence of pterygium was 112 (18.5% (95% CI (15.6–21.7)). Being widowed (AOR = 7.32 (95% CI: 2.88, 18.57)), outdoor occupation (AOR = 2.50 (95% CI: 1.46, 4.29)), sun exposure (AOR = 2.38 (95% CI: 1.28, 4.43)), wind exposure (AOR = 1.97 (95% CI: 1.04, 3.72)), alcohol drinking (AOR = 2.26 (95% CI: 1.48, 4.63)), and severe blepharitis (AOR = 2.45 (95% CI: 1.48, 4.05)) had statistically significant positive association with pterygium. Conclusion The prevalence of pterygium was relatively higher. Being widowed, outdoor occupation, sun exposure, wind exposure, alcohol drinking, and severe blepharitis were significantly associated with the development of pterygium.
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Affiliation(s)
- Tibebu Kassie Alemayehu
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar City, Ethiopia
| | - Yezinash Addis
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar City, Ethiopia
| | - Zewdu Yenegeta Bizuneh
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar City, Ethiopia
| | - Mebratu Mulusew Tegegne
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar City, Ethiopia
| | - Abiy Maru Alemayehu
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar City, Ethiopia
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Wang Y, Shan G, Gan L, Qian Y, Chen T, Wang H, Pan X, Wang W, Pan L, Zhang X, Wang M, Ma J, Zhong Y. Prevalence and associated factors for pterygium in Han and Mongolian adults: a cross-sectional study in inner Mongolian, China. BMC Ophthalmol 2020; 20:45. [PMID: 32013911 PMCID: PMC6998068 DOI: 10.1186/s12886-020-1324-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 01/21/2020] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the prevalence of pterygium and associated factors in Han and Mongolian adults at four survey sites in Inner Mongolia, China. Methods We conducted a population-based, cross-sectional study as part of the China National Health Survey (CNHS). By means of a stratified sampling method, we finally included 2651 participants of 30 years of age or older from a total of 3468 eligible residents. Factors associated with pterygium were analysed by a univariate analysis and logistic regression models. Results The study population included 1910 Han and 741 Mongolian adults. The mean age ± standard deviation of the study cohort was 48.93 ± 11.06 years. The overall prevalence of pterygium was 6.4% (n = 169); 1.4% (n = 38) of the cases were bilateral and 4.8% (n = 128) were unilateral. The most common grade of pterygium was Grade 2. Based on the results of the univariate analysis, eleven factors were included in a multivariate analysis. The results indicated that age (P < 0.001), outdoor occupation (P = 0.026), and time spent in rural areas (P < 0.001) were significantly associated with pterygium. Sex and ethnicity were not identified as risk factors. Conclusions Our results indicated that outdoor occupation, old age and more time spent in rural areas were risk factors for pterygium in Inner Mongolia. At the same time, town as a survey site (Hohhot and Tsining District) was a protective factor for pterygium. Ethnicity, gender, smoking, diabetes and high blood pressure are not associated with pterygium.
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Affiliation(s)
- Yuhan Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Linyang Gan
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Yonggang Qian
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, Inner Mongolia Autonomous Region, China
| | - Ting Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Hailing Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, Inner Mongolia Autonomous Region, China
| | - Xiaodan Pan
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Wenrui Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, Inner Mongolia Autonomous Region, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xia Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China
| | - Meng Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Jin Ma
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China.
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, China.
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Kurtul BE, Kakac A, Karaaslan A. Bilateral Double-headed Recurrent Pterygium: A Case Presentation and Literature Review. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2020; 9:85-90. [PMID: 32490015 PMCID: PMC7134241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Pterygium is a frequent corneal disease characterized by growing of fibrovascular tissue from the bulbar conjunctiva onto the cornea. Although the causes of pterygium are not obvious, sun exposure is closely correlated with its development. Pterygium, especially double-headed pterygium is mostly seen in warm climate and in individuals who work outdoors. A minority of pterygium is double-headed (both temporal and nasal origins). Bilateral recurrent double-headed pterygium is a very rare condition. Here, we reported a 35-year-old male patient with bilateral recurrent double-headed pterygium. A brief review about the recent literature concerning the etiology, associated risk factors, operation types and management of patients with recurrent pterygium was also discussed. The patient was a field worker, smoker and had a family history of pterygium. There was no ocular surgery history except pterygium surgery 15 years ago in both eyes. A successful pterygium excision was performed under local anesthesia with the vertical split conjunctival autograft transplantation (CAT) in both temporal and nasal parts of the right eye (randomly) for cosmetic disfigurement and avoidance of recurrence. The pathological report was consistent with pterygium. At postoperative first week, first and 1.5th month visits, conjunctival autografts were in place and stable. No complications such as infection, corneal thinning or graft dislocation were seen. The patient was satisfied with his right eye and demanded the same surgery for his left eye. We suggest vertical split simultaneous CAT as a safe and useful surgical method for the treatment of recurrent double-headed pterygium; however, longer follow-up is required to confirm the outcome.
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Affiliation(s)
- Bengi Ece Kurtul
- Department of Ophthalmology, Mustafa Kemal University Tayfur Ata Sokmen Faculty of Medicine, Hatay, Turkey
| | - Ahmet Kakac
- Department of Ophthalmology, Mustafa Kemal University Tayfur Ata Sokmen Faculty of Medicine, Hatay, Turkey
| | - Abdulkerim Karaaslan
- Department of Ophthalmology, Mustafa Kemal University Tayfur Ata Sokmen Faculty of Medicine, Hatay, Turkey
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Pan Z, Cui J, Shan G, Chou Y, Pan L, Sun Z, Cui Z, Sun J, Cao Y, Zhao J, Ma X, Ma J, He H, Ma J, Zhong Y. Prevalence and risk factors for pterygium: a cross-sectional study in Han and Manchu ethnic populations in Hebei, China. BMJ Open 2019; 9:e025725. [PMID: 30796128 PMCID: PMC6398733 DOI: 10.1136/bmjopen-2018-025725] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AIMS To investigate the prevalence, ethnic differences and associated risk factors for pterygium in Han and Manchu populations aged 40-79 years in Hebei province, China. DESIGN Cross-sectional study, as a part of the China National Health Survey. SETTING Hebei province, China. PARTICIPANTS A multistage cluster sampling method with urbanisation level-based stratification was used to select participants for this study. A total of 4591 individuals over 40 years were recruited for this study. Inclusive criteria: (1) residents who had been living in Hebei for more than 1 year; (2) Han individuals with both parents being Han, or Manchu individuals with both parents being Manchu; (3) underwent ophthalmic examinations and (4) information in the questionnaire was complete. MAIN OUTCOME MEASURES Multiple logistic regression analysis was used to evaluate the association between pterygium prevalence and factors of interest. RESULTS A total of 3790 individuals (2351 Hans and 1439 Manchus) met the study criteria, of which 248 were diagnosed with pterygium (6.5%). There was no significant difference between the prevalence rates in Hans (6.2%) and Manchus (7.2%) (p=0.232). Multivariate analysis revealed that the risk factors for grade 2 or higher pterygium were increasing age (p<0.001) and rural residence (OR 1.83; 95% CI 1.11 to 3.02; p=0.018), while the protective factors include gender (female) (OR 0.58; 95% CI 0.37 to 0.88; p=0.011), cigarette smoking (OR 0.53; 95% CI 0.34 to 0.83; p=0.005) and myopia (OR 0.50; 95% CI 0.33 to 0.77; p=0.002). Premature menopause (OR 2.66; 95% CI 1.05 to 6.72; p=0.038) increased the risk of grade 2 or higher pterygium in females, while higher high-density lipoprotein (HDL) (OR 1.94; 95% CI 1.08 to 3.47; p=0.027) was a risk factor of grade 2 or higher pterygium in males. CONCLUSION The overall prevalence of pterygium in Han and Manchu population in Hebei, China was approximately 6.1%. There were no differences in the prevalence of pterygium between Hans and Manchus, and the race was not a risk factor. This is the first study to report on the positive association between premature menopause and pterygium in females and between higher HDL levels and pterygium in males.
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Affiliation(s)
- Zhouxian Pan
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Eight year program of clinical medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiantao Cui
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuyu Chou
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zixi Sun
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ze Cui
- Hebei Center for Disease Prevention and Control, Shijiazhuang, China
| | - Jixin Sun
- Hebei Center for Disease Prevention and Control, Shijiazhuang, China
| | - Yajing Cao
- Hebei Center for Disease Prevention and Control, Shijiazhuang, China
| | - Jingjing Zhao
- Hebei Center for Disease Prevention and Control, Shijiazhuang, China
| | - Xinyan Ma
- Institute of Chronic Disease, Shijiazhuang Center for Disease Prevention and Control, Shijiazhuang, China
| | - Jifei Ma
- Institute of Chronic Disease, Baoding Center for Disease Prevention and Control, Baoding, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jin Ma
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Prevalence and risk factors of pterygium: a systematic review and meta-analysis. Surv Ophthalmol 2018; 63:719-735. [DOI: 10.1016/j.survophthal.2018.03.001] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 03/09/2018] [Accepted: 03/12/2018] [Indexed: 11/20/2022]
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Bamdad S, Kooshki AS, Yasemi M. Surgical outcome of conjunctival rotational autograft-mitomycin C (MMC) versus free conjunctival autograft-MMC for pterygium removal: A randomized clinical trial. Electron Physician 2017; 9:5877-5884. [PMID: 29560137 PMCID: PMC5843411 DOI: 10.19082/5877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 08/17/2017] [Indexed: 11/25/2022] Open
Abstract
Background Pterygium is a common degenerative eye disease. Despite various surgical methods to treat pterygium, recurrence is the main complication. The main issue is finding a surgical method with the lowest recurrence. Objective to compare the complications, recurrence rate and the cosmetic effects of two surgical techniques, namely conjunctival rotation autograft (CRA) and conjunctival autograft (CA), in treating pterygium. Methods This randomized clinical trial was conducted at Khalili Hospital in Shiraz, Iran, from January to August 2015. Forty-five eyes from 45 patients were studied. The patients were randomly divided into two groups using the blocking method. The patients of one group were operated on by the CRA technique, while the other group was operated on by the CA method. The patients were checked for the recurrence of pterygium, and other complications at the end of the first, third, and sixth month. Finally, the data were analyzed using SPSS version 21. Results The mean age of the patients was 42.5 years. The recurrence of pterygium was not observed in any of the patients 6 months after the surgery. Following 6 months after the operation, graft retraction occurred during the first week for one patient (4.5%) in the CA group, and five patients (21.7%) in the CRA group. The prevalence rate of graft injection among the patients of the CA and CRA groups 6 months after the operation was 9.1% and 65.2%, respectively. There was a significant correlation between injection intensity and the dissatisfaction of the patients with the operation’s outcome (p=0.017). Conclusion CRA with mitomycin is considered as an effective method to reduce the recurrence of pterygium after operation. This technique can be used as an acceptable method for pterygium operation, especially for patients with insufficient conjunctiva. Clinical trial registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016092119581N2. Funding The study was financially supported by Shiraz University of Medical Sciences (SUMS) (grants No. 8901).
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Affiliation(s)
- Shahram Bamdad
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anis Shamsi Kooshki
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Yasemi
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran.,Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Hashemi H, Khabazkhoob M, Yekta A, Jafarzadehpour E, Ostadimoghaddam H, Kangari H. The prevalence and determinants of pterygium in rural areas. J Curr Ophthalmol 2016; 29:194-198. [PMID: 28913510 PMCID: PMC5587244 DOI: 10.1016/j.joco.2016.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/05/2016] [Accepted: 09/05/2016] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate the prevalence of pterygium and its determinants in the underserved, rural population of Iran. Methods In this cross-sectional study of 3851 selected individuals, 86.5% participated in the study, and the prevalence of pterygium was evaluated in 3312 participants. A number of villages were selected from the north and south of Iran using multistage cluster sampling. Pterygium was diagnosed by the ophthalmologist using slit-lamp examination. Results The mean age of the study participants was 37.3 ± 21.4 years (2–93 years), and 56.3% (n = 1865) of them were women. The prevalence of pterygium was 13.11% [95%confidence interval (CI):11.75–14.47]. The prevalence of pterygium was 14.99 (95%CI:12.79–17.19) in men and 12.07 (95%CI:10.3–13.84) in women. Pterygium was not seen in children below the age of 5 years. The prevalence of pterygium increased linearly with age; the lowest and highest prevalence of pterygium was observed in the age group 5–20 years (0.19%) and 61–70 years (28.57%). Evaluation of the relationship between pterygium with age, sex, educational level, and place of living using a multiple model showed that age, living in the south of Iran, and low educational level were correlated with pterygium. Conclusion The prevalence of pterygium was significantly higher in Iranian villages when compared with the results of previous studies. This finding may represent the effect of a rural lifestyle and its risk factors.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Haleh Kangari
- School of Rehabilitation, Shahid Beheshti University of Medical Science, Tehran, Iran
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Evaluation of LATS1 and LATS2 Promoter Methylation with the Risk of Pterygium Formation. J Ophthalmol 2016; 2016:5431021. [PMID: 26942001 PMCID: PMC4749796 DOI: 10.1155/2016/5431021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/26/2015] [Accepted: 12/29/2015] [Indexed: 01/08/2023] Open
Abstract
Purpose. Pterygium is a serious eye problem in countries with high exposure to UV. However, despite numerous studies, the molecular etiology of pterygium is unclear. Recent studies have indicated that LATS1 and LATS2 genes are involved in DDR signaling pathways against continuous UV exposure. Our aim was to evaluate the LATS1 and LATS2 promoter methylation with the risk of pterygium formation. Methods. We evaluated the promoter methylation status of LATS1 and LATS2 using methylation-specific PCR technique. Also, mRNA expression of LATS1 and LATS2 was assessed in 14 cases of pterygium and 14 normal specimens by real-time PCR. Results. Promoter methylation of LATS1 and LATS2 was detected significantly between pterygium tissues and normal tissues [LATS1; OR = 4.9; 95% CI: 1.54 to 15.48, P = 0.003; LATS2; OR = 7.1; 95% CI: 1.53 to 33.19, P = 0.004]. The gene expression analysis showed a statistically significant difference between pterygium tissues and healthy controls for both LATS1 and LATS2 (P < 0.05). Conclusions. The data of this study is the first report regarding the effect of promoter methylation of the LATS1 and LATS2 in the pterygium. To confirm these data, doing further studies in various genetic populations with large sample sizes using advanced molecular techniques is proposed.
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Lim CY, Kim SH, Chuck RS, Lee JK, Park CY. Risk Factors for Pterygium in Korea: The Korean National Health and Nutrition Examination Survey V, 2010-2012. Medicine (Baltimore) 2015; 94:e1258. [PMID: 26266358 PMCID: PMC4616703 DOI: 10.1097/md.0000000000001258] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study is to report general and age-specific risk factors for pterygium prevalence in the Korean population.This in an observational case series study.Data from total 24,812 participants (age 40 years or older) from the Korean National Health and Nutrition Examination Surveys conducted from 2010 to 2012 were retrieved. After applying exclusion criteria, data from 13,204 participants (821 with pterygium and 12,383 without) were used for univariate and multivariate analyses. General risk factors were identified and participants were grouped by decade: 40 s, 50 s, 60 s, 70 s, and 80+. Age-specific risk factors were investigated for each group.After univariate analysis, 2 multiple regression models were constructed. Model 1: age + sex + spherical equivalent (SE) + sun exposure hours + occupation (indoor vs outdoor) + residency area (rural vs urban) + education level; model 2: age + sex + SE + sun exposure hours. In model 1, older age (odds ratio [OR]: 1.05 95% confidence interval [CI]: 1.05-1.06), male gender (OR: 1.28, 95% CI: 1.01-1.61), and longer sun exposure hours (OR: 1.47, 95% CI: 1.11-1.94) were significant risk factors for pterygium prevalence whereas higher level of education (elementary school vs college, OR: 3.98, 95% CI: 2.24-7.06) and urban residency (vs rural residency, OR: 0.56, 95% CI: 0.45-0.70) were protective factors. Higher SE (OR 1.11, 95% CI: 1.03-1.19) refractive error was considered a risk factor when using model 2 for the analysis. Age-specific risk factors were different in each age group. Male gender was associated with higher pterygium prevalence in younger age groups while longer sun exposure (5+ hours/day) increased pterygium prevalence in older age groups.Previously characterized risk factors were also found in this large population study. However, we found that risk factors may vary according to the age group. Myopic eyes were found to have lower prevalence than hyperopic eyes.
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Affiliation(s)
- Chi-Yeon Lim
- From the Department of Biostatistics, Dongguk University Ilsan Hospital (C-YL); Department of Ophthalmology, Dongguk University, Ilsan Hospital, Goyang, Kyunggido, South Korea (S-HK, CYP); and Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA (RSC, JKL)
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Najafi M, Kordi-Tamandani D, Arish M. Evaluating the mRNA expression profile of APC in Pterygium. ACTA MEDICA INTERNATIONAL 2015. [DOI: 10.5530/ami.2015.3.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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