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Gudimetla J, Potti S, Shivaprasad S, Bhide M, Prabhakar V. Pterygium surgery using inferior rotational conjunctival autograft versus conventional conjunctival autograft with sutures - A comparative study. Indian J Ophthalmol 2023; 71:3646-3651. [PMID: 37991298 PMCID: PMC10788754 DOI: 10.4103/ijo.ijo_16_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/23/2023] [Accepted: 07/25/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To compare the outcomes of pterygium surgery by using an inferior rotational autograft and a conventional superior conjunctival autograft. METHODS This was a prospective interventional comparative study of 85 eyes of patients who were divided into two groups of 45 and 40. Standard techniques of both procedures were performed by a single surgeon. Astigmatism, recurrence rates, time taken, and other complications were compared. RESULTS All the subjects were in the age group 53 ± 7.56 (40-74) years. Demographic data and type of pterygium were comparable in the two groups. In the rotational group, the preoperative astigmatism was - 2.14 ± 1.36 D, which decreased in 1 week to 1.42 ± 1.11 D, in 1 month to - 1.13 ± 0.99 D, in 3 months to 0.91 ± 0.72 D, and in 6 months to 0.81 ± 0.85 D (P < 0.05 each). Preoperative astigmatism in the conventional group was - 2.63 ± 1.47 D, which decreased to - 1.43 ± 1.04 D in 1 week, -1.18 ± 0.85 D in 1 month, -1.07 ± 0.81 D in 3 months, and - 1.01 ± 0.78 D in 6 months (P < 0.05 each). There was no significant difference between the groups in terms of astigmatism at any follow-up visit (P < 0.05). Complications like dellen, graft edema, and superficial vascularization were seen in both groups. The rotational group had one recurrence (2.86%). No recurrence was noted in the conventional group. None of the complication rates was significantly different between the two groups (P < 0.05). CONCLUSION Inferior rotational conjunctival autografting is a good technique for management of pterygium. It has a profile similar to that of conventional conjunctival autograft.
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Affiliation(s)
| | - Sudhakar Potti
- Chief Medical Officer, Sankara Eye Hospital, Guntur, Andhra Pradesh, India
| | - Shyam Shivaprasad
- Junior Consultant, Keshava Netralaya, Harshamahal Road, Hassan, Karnataka
| | - Milind Bhide
- Hyderabad Eye Centre, Himayatnagar, Hyderabad, India
| | - Venkat Prabhakar
- Consultant, Agarwal's Eye Hospital, Tirupati, Andhra Pradesh, India
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Jain P, Nema N. Incidence of refractive surprise after phacoemulsification in patients of cataract with primary pterygium. Saudi J Ophthalmol 2023; 37:79-82. [PMID: 37492209 PMCID: PMC10365253 DOI: 10.4103/sjopt.sjopt_211_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 05/25/2022] [Accepted: 02/13/2023] [Indexed: 07/27/2023] Open
Abstract
PURPOSE The purpose of this study was to find the incidence of refractive surprise in patients of cataract with primary pterygium and compare it with patients of cataract without pterygium after phacoemulsification surgery. METHODS The present observational study included 30 patients who had cataract with pterygium and 30 patients of cataract without pterygium. A detailed ophthalmic examination was done in all the cases. Horizontal corneal encroachment of pterygium from the limbus was measured. Keratometry and biometric measurements were performed preoperatively to determine the target refraction which was kept between - 0.50D and + 0.50D. The achieved spherical equivalent (SE) and prediction error were calculated postoperatively. A difference of >± 1.00D SE from the targeted postoperative refraction was considered a refractive surprise. RESULTS The mean age of patients was 61 ± 8.32 years. The mean extension of pterygium on the cornea was 2.3 ± 0.91 mm. Refractive surprise was seen in 16.7% of cases of cataract with pterygium and 10% of cases of cataract without pterygium. CONCLUSION Only cataract surgery can be performed in patient having cataract with primary pterygium of up to 2.3 ± 0.91 mm horizontal corneal length, and the incidence of refractive surprise in these cases is comparable to that in patients of cataract without pterygium.
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Affiliation(s)
- Pragati Jain
- Department of Ophthalmology, Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh, India
| | - Nitin Nema
- Department of Ophthalmology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India
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Tandon R, Vashist P, Gupta N, Gupta V, Yadav S, Deka D, Singh S, Vishwanath K, Murthy GVS. The association of sun exposure, ultraviolet radiation effects and other risk factors for pterygium (the SURE RISK for pterygium study) in geographically diverse adult (≥40 years) rural populations of India -3rd report of the ICMR-EYE SEE study group. PLoS One 2022; 17:e0270065. [PMID: 35862365 PMCID: PMC9302760 DOI: 10.1371/journal.pone.0270065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 06/03/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose To determine the prevalence and risk factors for pterygium in geographically diverse regions of India. Methods A population-based, cross-sectional multicentric study was conducted in adults aged ≥40 years in plains, hilly and coastal regions of India. All participants underwent a detailed questionnaire-based assessment for sun exposure, usage of sun protective measures, exposure to indoor smoke, and smoking. Detailed ocular and systemic examinations were performed. Pterygium was diagnosed and graded clinically by slit-lamp examination. Association of pterygium with sociodemographic, ophthalmological, and systemic parameters was assessed. Physical environmental parameters for the study period were estimated. Results Of the 12,021 eligible subjects, 9735 (81% response rate) participated in the study. The prevalence of pterygium in any eye was 13.2% (95% CI: 12.5%-13.9%), and bilateral pterygium was 6.7% (95% CI: 6.2–7.2). The prevalence increased with age (<0.001) irrespective of sex and was highest in those aged 60–69 years (15.8%). The prevalence was highest in coastal (20.3%), followed by plains (11.2%) and hilly regions (9.1%). On multi-logistic regression, pterygium was positively associated with coastal location (P<0.001), illiteracy (P = 0.037), increasing lifetime sun exposure (P<0.001), and negatively associated with BMI ≥25 kg/m2 (P = 0.009). Conclusion Pterygium prevalence is high in the rural Indian population. The association of pterygium with several potentially modifiable risk factors reflects its multifactorial etiology and provides targets for preventive measures.
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Affiliation(s)
- Radhika Tandon
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
- * E-mail:
| | - Praveen Vashist
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Noopur Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Vivek Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Saumya Yadav
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Dipali Deka
- Regional Institute of Ophthalmology, Guwahati, India
| | | | - K. Vishwanath
- Pushpagiri Vitreo Retina Institute, Secunderabad, Telangana, India
| | - G. V. S. Murthy
- Indian Institute of Public Health, Hyderabad, India
- Clinical Research Department, Public Health Eye Care & Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Krishnamoorthy S, Selvaraj R, Soubramanianae U, Vaithianathan V, Tipandjan A. Prevalence of aqueous deficient dry eye and common ocular surface changes among salt workers. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2022. [DOI: 10.4103/tjosr.tjosr_145_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Reproductive risk factors of pterygium in postmenopausal women: a nationwide study in the Republic of Korea. Sci Rep 2021; 11:12473. [PMID: 34127737 PMCID: PMC8203797 DOI: 10.1038/s41598-021-91968-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/01/2021] [Indexed: 12/04/2022] Open
Abstract
This study is to elucidate the associations between female reproductive factors and pterygium. A total of 1,339,969 postmenopausal women in a retrospective cohort of Korean National Health Insurance Service data on ages 40 and above in 2009 was included. Cox proportional hazards regression was conducted to assess the hazard ratio (HR) for pterygium according to reproductive factors. Late menarche, early menopause, short reproductive period, increasing parity (≥ 2 children), breastfeeding (≥ 6 months), and no use of hormone replacement therapy (HRT) or oral contraceptive (OC) were significantly associated with risk of pterygium. In multivariate analysis, the HR for pterygium was 1.764 (95% confidence interval [CI], 1.529–2.035) for menarche age ≥ 17 years (reference: menarche age < 12 years). The HR of menopause age ≥ 55 years was 0.782 (95% CI, 0.724–0.845) (reference: menopause age < 40 years). The HR of parity ≥ 2 was 1.261 (95% CI, 1.148–1.385) (reference: nulliparity). The HR of breastfeeding ≥ 1 year was 1.663 (95% CI, 1.564–1.768) (reference: no breastfeeding). The HRs of HRT and OC use for any length of time were lower than those for the non-user groups (reference). Reproductive factors that increase estrogen exposure have protective effects against pterygium in females.
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Joshi RS, Pendke SS, Marewar S. Comparison of intraocular lens power calculation in simultaneous and sequential pterygium and cataract surgery. Rom J Ophthalmol 2021; 65:157-162. [PMID: 34179581 PMCID: PMC8207870 DOI: 10.22336/rjo.2021.31] [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] [Indexed: 11/21/2022] Open
Abstract
Objective: To evaluate the effect of pterygium excision on intraocular lens (IOL) power and refraction. Methods: The present study was carried out on patients with combined cataract and pterygium excision (combined group) and pterygium surgery first and cataract surgery after one month (sequential group). Parameters such as mean keratometry (K) values, axial length, IOL power, and corneal astigmatism were compared pre and postoperatively in the combined and sequential groups. Results: 70 eyes of 70 patients were included in the present study. The mean age of the participants in the combined group was 70.46±10.12, whereas that in the sequential group was 68.68±11.22 (p=0.243). The mean horizontal length of the pterygium in the combined group was 2.64±0.17 mm and 2.57±0.17 mm in the sequential group. The mean postoperative K values (p=0.03) and IOL power (p=0.04) in the combined group were significantly higher than the preoperative values. The estimated postoperative refractive error in the combined group was -0.50±1.00 D and 0.25±0.5 D in the sequential group (p=0.04). On the other hand, the postoperative refraction in the sequential group was predictable. Corneal visibility was diminished on the nasal side in almost all the patients in the combined group as compared to the sequential group. Conclusion: The postoperative refraction errors were positively correlated with the length of pterygium in the combined group. The unpredictability of these errors recommends sequential surgery in cases with concurrent pterygium and cataract.
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Affiliation(s)
- Rajesh Subhash Joshi
- Department of Ophthalmology, Vasantrao Naik Government Medical, College, Maharashtra, India
| | - Sudhir Sudhakar Pendke
- Department of Ophthalmology, Vasantrao Naik Government Medical, College, Maharashtra, India
| | - Shobha Marewar
- Department of Ophthalmology, Vasantrao Naik Government Medical, College, Maharashtra, India
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Örnek N, Oğurel T, Kısa Ü. Tear Fluid and Serum Vitamin D Concentrations in Unilateral Pterygium. Optom Vis Sci 2021; 98:170-174. [PMID: 33534378 DOI: 10.1097/opx.0000000000001640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Vitamin D has antiangiogenic, anti-inflammatory, and antifibrotic properties, which may play an inhibitory role on pterygium formation. Vitamin D concentration was measured in few studies, and contradictory results have been reported. There is no study investigating tear fluid concentration of vitamin D in pterygium patients. PURPOSE This study evaluated tear fluid and serum vitamin D concentrations of pterygium patients in comparison with healthy controls. METHODS Thirty-five (21 male, 14 female) patients with unilateral pterygium and 25 (18 male, 7 female) healthy controls were included in this case-control study. After full ophthalmic examination, blood samples were taken, and basal tear fluid was collected using glass microcapillary tubes. Tear fluid and serum vitamin D concentrations were analyzed using enzyme-linked immunosorbent assay and analyzed statistically. RESULTS The mean ± standard deviation age of patients was 51.7 ± 16.7 years in the study group and 50.6 ± 18.7 years in the control group, respectively (P = .82). The mean tear fluid vitamin D concentration was statistically significantly higher than the mean serum concentration in the study groups (P < .0001). The mean tear fluid (P = .76) and serum vitamin D concentrations (P = .53) did not reveal statistically significant difference between patients and controls. There was no statistically significant difference for tear fluid vitamin D concentration between pterygium eyes and fellow eyes (P = .93). The difference in concentrations was compared within the pterygium subgroups, and it was found that the mean serum vitamin D concentration trended toward lower values as the stage of pterygium increased, and the mean tear fluid vitamin D concentration trended toward higher values as the stage of pterygium increased, although these differences were not statistically significant (all, P > .05). CONCLUSIONS Tear fluid and serum vitamin D concentrations do not seem to have a role in pterygium pathogenesis.
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Affiliation(s)
- Nurgül Örnek
- Department of Ophthalmology, School of Medicine, Kırıkkale University, Kırıkkale, Turkey
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Prasad S, Goudinho S, Isaac S, Sumangala S. Sutureless versus suture technique for conjunctivolimbal autografting in primary pterygium excision: A prospective study. Middle East Afr J Ophthalmol 2021; 28:208-210. [PMID: 35719283 PMCID: PMC9198530 DOI: 10.4103/meajo.meajo_533_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 12/26/2021] [Accepted: 02/13/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE: Conjunctivolimbal autograft is proposed to be the best treatment for pterygium and autograft can be fixed either with sutures or without. This study was undertaken to assess and compare the efficacy of sutureless versus suture techniques for conjunctivolimbal autografting in primary pterygium. METHODS: A prospective observational study was conducted in the department of ophthalmology in a tertiary care center from March 2018 to September 2019. Twenty consecutive patients in the age group of 20 to 70 years with primary pterygium were included. Ten patients underwent suture technique for autograft placement, whereas ten patients underwent sutureless technique. Comparison of both the groups was done in terms of duration of surgery and postoperative symptoms. Data were entered into Microsoft Excel software and analyzed using SPSS software. RESULTS: In the first group, the mean duration of surgery was 48 min and it was 38 min in the second group. The difference was statistically significant (P = 0.000). Postoperatively, foreign-body sensation was present in nine patients in the first group, whereas it was absent among the patients in the second group. The difference was statistically significant (P = 0.000). Four patients in the first group and two patients in the second group had postoperative hyperemia and only one patient in the first group had conjunctival chemosis. A graft-related complication was present in one patient in the second group. CONCLUSION: Sutureless technique is a better technique as compared to conventional suture technique.
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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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Das AV, Podila S, Prashanthi GS, Basu S. Clinical profile of pterygium in patients seeking eye care in India: electronic medical records-driven big data analytics report III. Int Ophthalmol 2020; 40:1553-1563. [PMID: 32096104 DOI: 10.1007/s10792-020-01326-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/15/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the clinical profile of pterygium in patients presenting to a multi-tier ophthalmology hospital network in India. METHODS This cross-sectional hospital-based study included 1,610,843 new patients presenting between 2010 and 2019. Patients with a clinical diagnosis of pterygium in at least one eye were included as cases. The data were collected using an electronic medical record system. Multiple logistic regression analysis with odds ratios (OR) was performed to identify the associated risk factors. RESULTS Overall, 168,807 (10.5%) new patients were diagnosed with pterygium, of which 43,692 (26%) patients complained about the lesion. The prevalence rates were 0.7% in children and 12.6% in adults. Majority of patients were female (54.5%) and had unilateral (57%) affliction. Among the 241,631 affected eyes, the pterygia were primary in 99.6%, nasally located in 94%, and were grade I-II in 84.8%. Four in 5 eyes did not have any cylindrical refractive error, and 44% had coexistent cataract. Pterygium surgery was indicated in 10.3% eyes. Female sex (OR 1.37), increasing age (OR 19.5), rural residence (OR 1.21), agriculture work (OR 2.19), manual labor (OR 2.05), low socioeconomic status (OR 2.14) and geographical location closer to the equator (OR 3.4) were identified as the risk factors for developing pterygium. CONCLUSION About one-tenth of individuals seeking eye care in India have pterygium in at least one eye. It rarely impacts vision, is commonly unilateral and nasal and usually does not require surgery. It is associated with increasing age, females, outdoor work, low income and geographical location closer to the equator.
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Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sahitya Podila
- School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Gumpili Sai Prashanthi
- Department of eyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sayan Basu
- The Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India. .,Center for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India.
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Chu WK, Choi HL, Bhat AK, Jhanji V. Pterygium: new insights. Eye (Lond) 2020; 34:1047-1050. [PMID: 32029918 DOI: 10.1038/s41433-020-0786-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/19/2019] [Accepted: 01/23/2020] [Indexed: 12/12/2022] Open
Abstract
Pterygia are common conjunctival degenerations with well-documented risk factors but an unclear pathogenesis. Better understanding of the pathogenesis of pterygium could lead to improved surgical outcomes and decreased postoperative recurrence. Currently, pterygium excision with conjunctival autograft remains the preferred surgical technique to decrease pterygium recurrence. Many adjuvant therapies have been used in pterygium surgery to varying degrees of success. Topical cyclosporine, an immunosuppressive medication, in conjunction with conjunctival autograft was found to be most successful in decreasing pterygium recurrence according to a recent meta-analysis. Other adjuvant therapies such as mitomycin-C (MMC), 5-fluorouracil (5-FU), and beta-irradiation have also been used, though usage of these may cause multiple adverse effects. Recent research indicates that interactions between mouse double minute 2 (MDM2) and p53 could play a role in the occurrence of pterygium. Nutlin, an MDM2 antagonist, was found to have significantly less toxicity in conjunctival cells when compared with MMC on laboratory analysis of pterygium samples.
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Affiliation(s)
- Wai Kit Chu
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Hiu Lam Choi
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Molecular Biotechnology Programme, School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Amar K Bhat
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Vishal Jhanji
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong. .,Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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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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Bikbov MM, Zainullin RM, Kazakbaeva GM, Gilmanshin TR, Salavatova VF, Arslangareeva II, Nikitin NA, Panda-Jonas S, Zaynetdinov AF, Kazakbaev RA, Nuriev IF, Khikmatullin RI, Uzianbaeva YV, Yakupova DF, Aminev SK, Jonas JB. Pterygium Prevalence and Its Associations in a Russian Population: The Ural Eye and Medical Study. Am J Ophthalmol 2019; 205:27-34. [PMID: 30849347 DOI: 10.1016/j.ajo.2019.02.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To assess the prevalence of pterygia and its associations in a population in Russia. DESIGN Population-based cross-sectional study. METHODS The Ural Eye and Medical Study was performed in a rural and urban area in Ufa/Bashkortostan 1300 km east of Moscow. Out of 7328 eligible individuals aged 40+ years, 5899 (80.5%) individuals participated and underwent an ocular and systemic examination. Pterygia, defined as conjunctival extensions onto the clear cornea, were diagnosed upon slit-lamp examination and on corneal photographs. RESULTS Mean pterygium prevalence (per individual) was 138/5888 (2.3%; 95% confidence intervals [CI]:2.0, 2.7), with bilateral occurrence in 45 individuals (32.6% of patients with pterygium; 0.8% of study population). Pterygium prevalence increased from 0.8% (95% CI: 0.02, 1.6) in the age group from 40 to <45 years to 3.6% (95% CI: 2.1, 5.1) in the age group of 75+ years. In multivariable analysis, higher pterygium prevalence was associated with older age (P = .006; odds ratio [OR]: 1.03; 95% CI: 1.01, 1.04), rural vs urban region of habitation (P < .001; OR: 2.33; 95% CI: 1.57, 3.46), and lower level of education (P = .03; OR: 0.89; 95% CI: 0.81, 0.99), while the pterygium prevalence was statistically independent of sex (P = .34), Russian vs non-Russian ethnicity (P = .59), presence of diabetes mellitus (P = 1.00), arterial hypertension (P = .86), vegetarian vs mixed diet (P = 1.00), blood lipid concentration (P > .30), history of cardiovascular disease (P = .49), or axial length (P = .52). CONCLUSIONS In this rural and urban, typically multiethnic Russian study population aged 40+ years, a higher pterygium prevalence (mean: 2.3%) was correlated with older age, rural region of habitation, and lower educational level, while it was statistically independent of most other systemic or ocular parameters. A pterygium was not a biomarker for an internal medical disease.
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Sitompul R, Sungkar S. Hospital-based analysis of eye diseases at Karitas Hospital, Southwest Sumba, 2015. MEDICAL JOURNAL OF INDONESIA 2018. [DOI: 10.13181/mji.v27i3.2686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Background: This study aimed to determine the profile of eye diseases at Karitas Hospital in Southwest Sumba during 2015.Methods: The cross-sectional and descriptive study was conducted by analyzing medical records of 1706 patients who presented with eye complaints at Karitas Hospital, Southwest Sumba, in 2015. Complete medical records were recovered from 1363 patients, who served as subjects for this study.Results: Thirty-six percent of subjects were elderly (>55 years old) and 9.9% were children (<18 years old). Female patients comprised 56.4% of the study population and males 43.6%. Non-infectious eye diseases dominated (89.8%; 95%CI: 88.2%–91.4%) compared to infectious diseases (8.2%; 95%CI: 6.7%–9.7%) and mixed cases (2%; 95%CI: 1.3%–2.7%). Avoidable causes of blindness, cataract (34%), and refractive error (17.3%), were mostly found among non-infectious cases, while conjunctivitis (52.7%) and keratitis (17%) were the most commonly encountered infectious diseases.Conclusion: Eye diseases at Karitas Hospital in Southwest Sumba mostly comprised non-infectious diseases. The most commonly noted non-infectious diseases were cataracts and refractive errors, while conjunctivitis and keratitis were the most commonly found infectious diseases. Due to the high amount of patients seeking eye care within Southwest Sumba, ophthalmologists and proper equipment are needed at the Karitas Hospital.
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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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Wan Zaki WMD, Mat Daud M, Abdani SR, Hussain A, Mutalib HA. Automated pterygium detection method of anterior segment photographed images. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 154:71-78. [PMID: 29249348 DOI: 10.1016/j.cmpb.2017.10.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 09/21/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND BJECTIVE Pterygium is an ocular disease caused by fibrovascular tissue encroachment onto the corneal region. The tissue may cause vision blurring if it grows into the pupil region. In this study, we propose an automatic detection method to differentiate pterygium from non-pterygium (normal) cases on the basis of frontal eye photographed images, also known as anterior segment photographed images. METHODS The pterygium screening system was tested on two normal eye databases (UBIRIS and MILES) and two pterygium databases (Australia Pterygium and Brazil Pterygium). This system comprises four modules: (i) a preprocessing module to enhance the pterygium tissue using HSV-Sigmoid; (ii) a segmentation module to differentiate the corneal region and the pterygium tissue; (iii) a feature extraction module to extract corneal features using circularity ratio, Haralick's circularity, eccentricity, and solidity; and (iv) a classification module to identify the presence or absence of pterygium. System performance was evaluated using support vector machine (SVM) and artificial neural network. RESULTS The three-step frame differencing technique was introduced in the corneal segmentation module. The output image successfully covered the region of interest with an average accuracy of 0.9127. The performance of the proposed system using SVM provided the most promising results of 88.7%, 88.3%, and 95.6% for sensitivity, specificity, and area under the curve, respectively. CONCLUSION A basic platform for computer-aided pterygium screening was successfully developed using the proposed modules. The proposed system can classify pterygium and non-pterygium cases reasonably well. In our future work, a standard grading system will be developed to identify the severity of pterygium cases. This system is expected to increase the awareness of communities in rural areas on pterygium.
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Affiliation(s)
- Wan Mimi Diyana Wan Zaki
- Smart Engineering System Research Group (SESRG), Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, University Kebangsaan Malaysia, Selangor, Malaysia.
| | - Marizuana Mat Daud
- Smart Engineering System Research Group (SESRG), Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, University Kebangsaan Malaysia, Selangor, Malaysia
| | - Siti Raihanah Abdani
- Smart Engineering System Research Group (SESRG), Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, University Kebangsaan Malaysia, Selangor, Malaysia
| | - Aini Hussain
- Smart Engineering System Research Group (SESRG), Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, University Kebangsaan Malaysia, Selangor, Malaysia
| | - Haliza Abdul Mutalib
- Optometry and Vision Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Prevalence and associated factors of pterygium among adults living in Gondar city, Northwest Ethiopia. PLoS One 2017; 12:e0174450. [PMID: 28358813 PMCID: PMC5373563 DOI: 10.1371/journal.pone.0174450] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/09/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose The aim of this study was to assess the prevalence and associated factors of pterygium among adults living in Gondar city, Northwest Ethiopia. Methods A cross sectional design study was carried out in 390 participants in Gondar city from April 15 to May 7, 2016. Basic ophthalmic examination was performed using portable slit lamb, 3.5x magnifying loop with torch light and a pretested and structured questionnaire was completed. The raw data has been entered into EPI INFO 3.5.1 and analyzed by SPPSS version 20. Descriptive statistics was summarized descriptive data. Logistic regression was used to summarize the predictors of pterygium. The variables with p-value less than 0.05 were considered as significant risks of pterygium. Result The prevalence of pterygium among study participants was 151(38.7% (95%CI; 33.8–43.8)). Among those who have pterygium, 149(98.7%) were developed pterygium on the nasal side and 15(9.9%) on temporal side of the either eye and 13(8.6%) have both. Age between 41-60(AOR = 2.20(95%CI: 1.22, 3.39)), age between 61-86(AOR = 7.97(95%CI: 2.74, 23.17)), male sex (AOR = 2.20(95%CI: 1.28, 3.82)), outdoor working area(AOR = 3.75(95%CI: 2.18, 6.46)), the use of traditional eye medication (AOR = 2.55 (95%CI: 1.04, 5.90)) and family history of pterygium (AOR = 6.68(95% CI: 2.53, 17.60)) were positively associated with pterygium whereas use of sunglass/hat (AOR = 0.40(95%CI:0.20, 0.78)) was negatively associated. Conclusion There is a high prevalence of pterygium in Gondar city northwest Ethiopia. Old age, male sex, outdoor working area, utilization of traditional eye medication and family history of pterygium were statistically significant predictors of pterygium. The use of sunglass/hat was protective against pterygium.
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Song P, Chang X, Wang M, An L. Variations of pterygium prevalence by age, gender and geographic characteristics in China: A systematic review and meta-analysis. PLoS One 2017; 12:e0174587. [PMID: 28355301 PMCID: PMC5371366 DOI: 10.1371/journal.pone.0174587] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 03/01/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Pterygium is a common chronic ophthalmic condition, which may result in significant visual morbidity or lead to blindness in extreme cases. The prevalence of pterygium in China has not been reported at the sub-national level. METHODS In this study, we conducted a systematic review and meta-analysis to estimate the prevalence of pterygium in China. China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedicine Literature Database (CBM-SinoMed), PubMed, Embase and Medline were searched before September 2016. We performed a multilevel mixed-effect meta-regression based on the included studies, our results showed that age, gender and latitude were significantly associated with pterygium prevalence. Based on the final model, the age and gender-specific prevalence of pterygium in 31 Chinese provinces (except Hongkong, Macau and Taiwan) and the whole country was generated. RESULTS In 2010, the overall prevalence of pterygium in Chinese people aged 15-84 years was 9.84% (95% CI: 6.72-14.14), and the number of pterygium cases in China was 108.65 million (95% CI: 74.23-156.13). CONCLUSIONS In conclusion, the prevalence of pterygium in Chinese population in 2010 was estimated at both the national and provincial levels. The higher burden of pterygium across the country calls for efforts to advocate public health education encouraging people to take appropriate protective measures.
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Affiliation(s)
- Peige Song
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing, China
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Xinlei Chang
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing, China
| | - Manli Wang
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing, China
| | - Lin An
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing, China
- * E-mail:
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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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Abstract
Pterygium is a fibrovascular growth of the bulbar conjunctiva that crosses the limbus and extends over the peripheral cornea, in some cases resulting in significant visual morbidity. When treatment is indicated, surgery is necessary, and several management options exist. These include excision, conjunctival autografting, and the use of adjuvant therapies. This paper reviews the incidence and prevalence of pterygia and also describes the various techniques currently used to treat this condition. These management options are compared to the use of dry amniotic membrane grafting (AMG), specifically with regard to recurrence rates, time to recurrence, safety and tolerability, as well as patient factors including cosmesis and quality of life. AMG has been used in the treatment of ocular surface disease due to a variety of benefits, including its anti-inflammatory properties, as well as its ability to promote epithelial growth and suppress transforming growth factor-β signaling and fibroblast proliferation. However, rates of recurrence for AMG following pterygium excision still surpass other commonly used techniques, including conjunctival and limbal autografting. Nevertheless, there are circumstances in which AMG may be most beneficial to the patient, such as when preexisting conjunctival scarring is present, when the conjunctiva must be spared for future glaucoma filtering surgery, or in cases of large or double-headed pterygia. Therefore, surgeons should be prepared to offer this procedure as an option to their patients for the treatment of pterygia.
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Affiliation(s)
- Gelareh S Noureddin
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Sonia N Yeung
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
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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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Chen T, Ding L, Shan G, Ke L, Ma J, Zhong Y. Prevalence and racial differences in pterygium: a cross-sectional study in Han and Uygur adults in Xinjiang, China. Invest Ophthalmol Vis Sci 2015; 56:1109-17. [PMID: 25626966 PMCID: PMC4329945 DOI: 10.1167/iovs.14-15994] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/15/2015] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To understand the prevalence and associated risk factors of pterygium in Han and Uygur population in Xinjiang, China and to assess the racial differences. METHODS A cross-sectional study was conducted in two rural and three urban regions of Xinjiang. A multistage and stratified sampling method was used to select representative samples. Risk factors associated with pterygium were screened in logistic regression models. RESULTS Among 4617 participants aged 30 years and older, 2452 were Han and 2165 were Uygur Nationality adults. The overall prevalence of pterygium was 11.95% (n = 546), with 4.27% (n = 197) were bilateral and 7.56% (n = 349) were unilateral. Multivariate analysis indicated that race, age, and rural residence were significantly associated with any pterygium (P < 0.001 for all). The prevalence of pterygium (P < 0.01) in Han subjects was higher than that of Uygur subjects. Both age and rural residence were associated with any pterygium in Han and Uygur. Low education level had significant positive association with pterygium in Han population (P < 0.001). CONCLUSIONS Pterygium affects approximately one-ninth of Han and Uygur population. Compared with Uygur, Han ethnicity is a significant risk factor of pterygium. Our results indicated a higher prevalence of pterygium in rural areas of Xinjiang, China compared with urban cities. Age increase was also associated with presence of pterygium. Strategies are warranted to prevent the serious effects caused by pterygium.
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Affiliation(s)
- Ting Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lin Ding
- Department of Ophthalmology, Xin Jiang Uygur Municipal People's Hospital, Xinjiang, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Science, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Limujiang Ke
- Department of Ophthalmology, Xin Jiang Uygur Municipal People's Hospital, Xinjiang, 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 for pterygium in rural older adults in Shandong Province of China: a cross-sectional study. BIOMED RESEARCH INTERNATIONAL 2014; 2014:658648. [PMID: 25165711 PMCID: PMC4140101 DOI: 10.1155/2014/658648] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 05/26/2014] [Accepted: 05/26/2014] [Indexed: 11/18/2022]
Abstract
To investigate the prevalence and risk factors for pterygium in rural older adults in Shandong Province, eastern China, a population-based, cross-sectional study was performed from April to July 2008. By means of cluster random sampling methods, a total of 19,583 people aged 50 years or above were randomly selected from four rural counties. Out of 19,583 people, 1,767 residents were excluded mainly because they were migrant workers when this study was performed. Finally, 17,816 (90.98%) people were included as eligible subjects. They received a comprehensive eye examination and a structured questionnaire voluntarily. Patients with pterygium were defined as having pterygium at the time of survey or pterygium surgery had been performed. 1,876 people were diagnosed as pterygium, either unilateral (1,083) or bilateral (793), which is equivalent to a prevalence of 10.53% (95% CI, 10.08–10.98). The multivariate logistic regression analysis showed that pterygium was independently associated with older age, areas, outdoor time, educational level, and use of hat and/or sunglasses. The prevalence of pterygium increased with age and hours spent under sunshine per day. Meanwhile, the higher the educational level and the more use of hat and/or sunglasses, the lower the pterygium prevalence.
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