ABSTRACT
PURPOSE: To describe the study protocol and baseline characteristics of the African Descent and Glaucoma Evaluation Study (ADAGES) III. DESIGN: Cross-sectional, case-control study. PARTICIPANTS: Three thousand two hundred sixty-six glaucoma patients and control participants without glaucoma of African or European descent were recruited from 5 study centers in different regions of the United States. METHODS: Individuals of African descent (AD) and European descent (ED) with primary open-angle glaucoma (POAG) and control participants completed a detailed demographic and medical history interview. Standardized height, weight, and blood pressure measurements were obtained. Saliva and blood samples to provide serum, plasma, DNA, and RNA were collected for standardized processing. Visual fields, stereoscopic disc photographs, and details of the ophthalmic examination were obtained and transferred to the University of California, San Diego, Data Coordinating Center for standardized processing and quality review. MAIN OUTCOME MEASURES: Participant gender, age, race, body mass index, blood pressure, history of smoking and alcohol use in POAG patients and control participants were described. Ophthalmic measures included intraocular pressure, visual field mean deviation, central corneal thickness, glaucoma medication use, or past glaucoma surgery. Ocular conditions, including diabetic retinopathy, age-related macular degeneration, and past cataract surgery, were recorded. RESULTS: The 3266 ADAGES III study participants in this report include 2146 AD POAG patients, 695 ED POAG patients, 198 AD control participants, and 227 ED control participants. The AD POAG patients and control participants were significantly younger (both, 67.4 years) than ED POAG patients and control participants (73.4 and 70.2 years, respectively). After adjusting for age, AD POAG patients had different phenotypic characteristics compared with ED POAG patients, including higher intraocular pressure, worse visual acuity and visual field mean deviation, and thinner corneas (all P < 0.001). Family history of glaucoma did not differ between AD and ED POAG patients. CONCLUSIONS: With its large sample size, extensive specimen collection, and deep phenotyping of AD and ED glaucoma patients and control participants from different regions in the United States, the ADAGES III genomics study will address gaps in our knowledge of the genetics of POAG in this high-risk population.
Subject(s)
Black or African American/genetics , Glaucoma, Open-Angle/genetics , Polymorphism, Single Nucleotide , Aged , Body Constitution , Case-Control Studies , Cross-Sectional Studies , Female , Gene-Environment Interaction , Genome-Wide Association Study , Genotype , Glaucoma, Open-Angle/diagnosis , Humans , Intraocular Pressure/physiology , Male , Middle Aged , Phenotype , Research Design , Visual Acuity/physiology , Visual Fields/physiology , White People/geneticsABSTRACT
PURPOSE: To determine the predictors of Bruch membrane opening (BMO) location accuracy and the visibility of the BMO location in glaucoma and healthy individuals with and without axial high myopia. DESIGN: Cross-sectional study. METHODS: Healthy eyes and eyes with glaucoma from an American study and a Korean clinic population were classified into 2 groups: those with no axial high myopia (axial length [AL] <26 mm) and those with axial high myopia (AL ≥26 mm). The accuracy of the automated BMO location on optic nerve head Spectralis optical coherence tomography radial scans was assessed by expert reviewers. RESULTS: Four hundred thirty-eight non-highly myopic eyes (263 subjects) and 113 highly myopic eyes (81 subjects) were included. In healthy eyes with and without axial high myopia, 9.1% and 1.7% had indiscernible BMOs while 54.5% and 87.6% were accurately segmented, respectively. More than a third (36.4%) and 10.7% of eyes with indiscernible BMOs were manually correctable (respectively, P = .017). In eyes with glaucoma with and without high myopia, 15.0% and 3.2% had indiscernible BMOs, 55.0% and 38.2% were manually corrected, and 30.0% and 58.7% were accurately segmented without the need for manual correction (respectively, P = .005). Having axial high myopia, a larger AL, a larger BMO tilt angle, a lower BMO ovality index (more oval), and a glaucoma diagnosis were significant predictors of BMO location inaccuracy in multivariable logistic regression analysis. CONCLUSIONS: As BMO location inaccuracy was 2.4 times more likely in eyes with high axial myopia regardless of diagnosis, optical coherence tomography images of high myopes should be reviewed carefully, and when possible, BMO location should be corrected before using optic nerve head scan results for the clinical management of glaucoma.
Subject(s)
Glaucoma , Myopia , Bruch Membrane , Cross-Sectional Studies , Glaucoma/diagnosis , Humans , Intraocular Pressure , Myopia/diagnosis , Nerve Fibers , Republic of Korea , Retinal Ganglion Cells , Tomography, Optical Coherence/methods , Visual FieldsABSTRACT
Las enfermedades transmitidas por vectores registran altas tasas de morbilidad y mortalidad para las personas. Los vectores biológicos son aquellos organismos capaces de transportar y transmitir un patógeno a otro organismo animal u hombre. Los más comunes son los insectos. El Culex quinquefaciatus es un vector de importantes enfermedades. Tiene un amplio desarrollo en nuestro país por las condiciones favorables climatológicas para su reproducción. El objetivo de este estudio fue presentar un caso portador de una larva de mosquito. Se describen las características más importantes del cuadro clínico, su diagnóstico, manejo. Las manifestaciones oculares secundarias a la infección por el mosquito C. quiquefasciatus en nuestro país son poco frecuentes, gracias a la campaña de erradicación del Aedes Aegiyptis en Cuba. En nuestro caso, se debió a las malas condiciones higiénicas del paciente y a la mala disposición de los desechos líquidos. Tal ambiente favoreció el depósito del huevo del mosquito en el ojo del paciente y que se desarrollara hasta la larva en el espacio subconjuntival del mismo(AU)
Vector-borne diseases have high morbidity and mortality rates for people. Biological vectors are those organisms capable of transporting and transmitting a pathogen to another animal organism or man, the most common being insects. Culex quinquefaciatus is a vector of important diseases, it is widely developed in our country due to the favorable weather conditions for its reproduction. A case carrying a mosquito larva is presented. The most important characteristics of the clinical picture, its diagnosis and management are described. Ocular manifestations secondary to infection by the Cx quiquefasciatus mosquito in our country are rare. Thanks to the campaign to eradicate Aedes Aegiyptis in Cuba. In our case, it was due to poor hygienic conditions of the patient and poor disposal of liquid waste. What favored the deposit of the mosquito egg in the patient's eye and that it developed into a larva in its subconjunctival space(AU)
Subject(s)
Humans , Vector Borne Diseases/mortalityABSTRACT
OBJECTIVE: To determine whether baseline confocal scanning laser ophthalmoscopy (CSLO) optic disc topographic measurements are associated with the development of primary open-angle glaucoma (POAG) in individuals with ocular hypertension. METHODS: Eight hundred sixty-five eyes from 438 participants in the CSLO Ancillary Study to the Ocular Hypertension Treatment Study with good-quality baseline CSLO images were included in this study. Each baseline CSLO parameter was assessed in univariate and multivariate proportional hazards models to determine its association with the development of POAG. RESULTS: Forty-one eyes from 36 CSLO Ancillary Study participants developed POAG. Several baseline topographic optic disc measurements were significantly associated with the development of POAG in both univariate and multivariate analyses, including larger cup-disc area ratio, mean cup depth, mean height contour, cup volume, reference plane height, and smaller rim area, rim area to disc area, and rim volume. In addition, classification as "outside normal limits" by the Heidelberg Retina Tomograph classification and the Moorfields Regression Analysis classifications (overall, global, temporal inferior, nasal inferior, and superior temporal regions) was significantly associated with the development of POAG. Within the follow-up period of this analysis, the positive predictive value of CSLO indexes ranged from 14% (Heidelberg Retina Tomograph classification and Moorfields Regression Analysis overall classification) to 40% for Moorfields Regression Analysis temporal superior classification. CONCLUSIONS: Several baseline topographic optic disc measurements alone or when combined with baseline clinical and demographic factors were significantly associated with the development of POAG among Ocular Hypertension Treatment Study participants. Longer follow-up is required to evaluate the true predictive accuracy of CSLO measures.