Environmental factors and myopia.

PURPOSE: The aim of the work was to assess the impact of environmental factors on the prevalence of myopia. MATERIAL AND METHODS: The work presents and discusses contemporary literature on the environmental determinants of myopia. RESULTS: In the existing works it was demonstrated that environmental factors lead to higher prevalence of myopia. It is assumed that the higher incidence of myopia in people living in the city and in individuals with higher levels of education is a consequence of intensive visual near work, especially in reading, writing and visual work at the computer. This dependence may be associated with changes in the shape of the cornea or accommodation. CONCLUSIONS: Environmental factors influence the prevalence of myopia. Most probably it is the consequence of intensive visual near work: reading, writing, visual work at the computer.

Associations between HLA molecules and ophthalmologic diseases.

The aim of this review was to analyze associations between HLA (human leukocyte antigens) alleles described thus far and an array of ophthalmologic disorders. Highly polymorphic HLA molecules play a crucial role in immunological response to various pathogens. Due to environmental pressures exerted mostly by infectious factors in the past, population frequencies of particular alleles differ greatly and modulate immunological response in various diseases. Associations between HLA alleles and over 500 pathologies, mainly autoimmune, infective and inflammatory diseases, have been previously described. In the course of certain HLA-related diseases described so far, eye manifestations are present. In this paper we review the structure, function and linkage between HLA antigens, ophthalmologic diseases and systemic disorders with eye involvement.

Etiopathogenesis and management of high myopia. Part II.

High myopia (HM) is defined as refractive error above -6.0 D (-8.0 diopters) with axial eyeball length above 26 mm, and is connected with the process of excessive myopisation. HM is not a homogenous disease. HM is considered to be inherited in 3 different patterns: dominant, autosomal recessive, and X-linked. Many genetic mutations linked to the development of HM have been described, including high grade myopia, and MYP1-16; different patterns of inheritance may reflect different types of HM. Over 150 genetic syndromes are associated with HM. The clinical state of the HM eyeball may also depend on environmental risk factors influencing the progression of refractive error. The complexity of etiopathogenesis makes it difficult to distinguish to what extent the development of HM is related to genetics versus exposure to environmental factors. HM remains a leading cause of visual loss. HM and its complications are considered to be one of the most significant causes of blindness and visual impairment in young, professionally active people, becoming an important social problem. Contemporary data concerning genetic factors, family aggregation, and epidemiological data of visual impairment connected with HM are presented in this paper. Therapeutic options for this refractive error are presented as well.

Etiopathogenesis and management of high-degree myopia. Part I.

High-degree myopia (HM) is defined as a refractive error above -6 D (-8 diopters). An axial eyeball length above 26 mm and is also connected with excessive myopisation. Mechanical stretching and thinning of the choroids may lead to the development of irreversible degenerative changes in the eyeball and visual impairment. HM prevalence varies significantly by geographical area, ranging from 1.7-3.3%, while in highly urban regions of South-East Asia it affects up to 24% of university students. HM is not a homogenous disease. It is considered to be inherited in different patterns: dominant, autosomal recessive, and X-linked. Many genetic mutations linked to HM development have been described and the different patterns of inheritance may reflect different types of HM. Moreover, the clinical state of the HM eyeball may result from both genetic and environmental risk factors influencing the progression of the refractive error. The development and progression of HM is connected with sustained prolonged near work involving accommodation-convergence imbalance leading to retinal blur, the years spent at school, the amount of near work, especially writing and reading, which is related to slight chronic under-accommodation, and improper light stimuli in early childhood. Contemporary definitions of HM, views on etiopathogenesis, excessive axial elongation, and pathological changes within the eyeball in the course of HM leading to visual impairment are presented here. Genetic and environmental risk factors influencing the progression of HM, its significantly different prevalence in various geographical areas, and therapeutic options for the refractive error are also presented.

Prevalence of myopia and hyperopia among urban and rural schoolchildren in Poland.

INTRODUCTION: Myopia and hyperopia have a significant clinical meaning as they can be the cause of low visual acuity or even blindness. Therefore, there is a high demand for all clinical investigations regarding the development of the eye and the creation of refractive errors. Nevertheless, not many papers have been published around the world which compared the prevalence of myopia as well as hyperopia among metropolitan and provincial schoolchildren. Whereas, in Poland there was not a single paper yet published concerning this topic. That is why the aim of this paper is to describe the prevalence of myopia and hyperopia among urban and rural schoolchildren in Poland. MATERIAL AND METHODS: 2206 students were examined 1155 boys and 1051 girls, aged 10-14 years, mean age 11.9 (SD = 1.4). 614 boys in the age of 11.8 years (SD = 1.4) lived in the city, as 541 boys in the age of 11.9 years (SD = 1.4) lived in the countryside. 586 girls in the age of 11.8 years (SD = 1.5) lived in the city, as 465 girls in the age of 11.9 years (SD = 1.4) lived in the countryside. The examined students were Caucasian and lived in Szczecin, Poland or in villages located near Szczecin. The examination included retinoscopy under cycloplegia. The refractive error readings were expressed as spherical equivalent (SE). Myopia was defined as SE of at least -0.5 D, hyperopia as SE of at least +1.5 D. Astigmatism among students with myopia and hyperopia was smaller than 1 DC. Data analysis was performed using chi2 test. P values of less than 0.05 were considered statistically significant. RESULTS: It was observed that myopia occurred more frequently among children living in the city than in the countryside. 13.9% urban and 7.5% rural schoolchildren had myopia (p < 0.001)--table 1. Furthermore, it was found that hyperopia is less frequent among children living in the city than in the countryside. 7.1% urban and 30.8% rural students had hyperopia (p < 0.001)--table 2. It was determined that the average refractive error is lower among children from the city than the countryside--table 3. CONCLUSION: Living in an urban or a rural environment may have an influence on the occurrence of myopia and hyperopia among schoolchildren.

Prevalence of myopia and hyperopia in a population of Polish schoolchildren.

PURPOSE: The aim of this study was to determine the prevalence of myopia and hyperopia in a population of Polish schoolchildren. METHODS: A total of 4422 students were examined (2107 boys and 2315 girls, aged 6-18 years, mean age 11.1, S.D. 3.5). The examination included retinoscopy under cycloplegia induced with 1% tropicamide. Myopia was defined as a spherical equivalent (SE) of at least -0.5 dioptres (D), and hyperopia as a SE of at least +1.0 D. Data analysis was performed using Spearman's rank correlation coefficients and chi-squared test; p-values of <0.05 were considered statistically significant. RESULTS: It was observed that 13.3% of Polish students in the age group ranging from 6 to 18 years were myopic while 13.1% of students were hyperopic. Furthermore, a positive correlation was found between the prevalence of myopia and age (p < 0.001) and a negative correlation between prevalence of hyperopia and age (p < 0.001). It was observed that the prevalence of myopia increases substantially between 7 and 8 years of age (p < 0.01). Moreover, it was determined that with age the average refractive error among schoolchildren becomes more myopic (p < 0.001). CONCLUSIONS: The occurrence, degree and progress of myopia and hyperopia in Poland is similar to that in other European countries with a predominantly Caucasian population.

[The role of biological agents in dermatology]. / Rola leków biologicznych w dermatologii.

Biological agents belong to a novel therapy method. Their immunomodulatory activity is used in treating some of the severe and chronic skin diseases. This paper presents the structure and activity of biological agents, enumerates preparations most commonly used in dermatology, their side effects and contraindications.

[Sunscreens--chemical structure and application]. / Srodki swiatloochronne--budowa i zastosowanie.

In the paper chemical structures and classification of active ingredients of sunscreens as physical or chemical filters are presented. Adequately selected to skin phototype sunscreen protects body against sunburn and prolonged sunlight exposure skin changes, induced by harmful ultraviolet radiation.

[Association between HLA-DQA1, HLA-DQB1 alleles and risk of early pregnancy loss]. / Zwiazek miedzy allelami HLA-DQA1, HLA-DQB1 a ryzykiem niepowodzenia ciazy.

AIM: The aim of the study is to identify HLA-DQA1, HLA-DQB1 allele and to assess the risk of early pregnancy loss of women, couples with reproductive failure in the first trimester of pregnancy in comparison with fertile women, couples. The study group (B) enrolled 61 couples with reproductive failure and the control group (C) enrolled 20 fertile couples with at least 2 children. METHOD: HLA-DQA1 gene typing was performed using PCR-sequence-specific primer (SSP) on the high resolution level according to established procedure of labeling and using the detection kit (FASTYPE DQASSP Typing, FASTYPE DQA "High Resolution" Typing Sheet) purchased from Bio-Synthesis (USA). RESULTS: In female patient the highest risk quotient was associated with alleles HLA-DQA 01101/0105 OR 7.19 (95% CI 1.18-5.23; p=0.03) and HLA-DQB5 OR 3.67 (95% CI=1.11-12.0; p=0.037). The lowest but statistically significant risk of pregnancy failure in this group was related to allele HLA-DQB6 OR 0.48 (95% CI=0.22-1.04; p=0.087). In patient and control couples the significantly increased risk of pregnancy failure was related to the frequency of HLA-DQB5 allele OR 2.3 (95% CI 1.09-4.82; p=0,035). The lowest risk quotient in the patient couples was associated with HLA-DQ 0302/0303 allele OR 0.44 (95% CI 0.14-1.36; p=ns). SUMMARY: HLA-DQA and HLA-DQB allele might influence pregnancy outcome in the Polish population, but further studies are necessary in this regard.

The influence of low birth weight on the prevalence of refractive errors among schoolchildren.

PURPOSE: The aim of the study was to determine in a large population whether low birth weight has an influence on the prevalence of refractive errors among schoolchildren. MATERIAL AND METHODS: 3663 schoolchildren were examined (1738 boys and 1925 girls, aged 6-17 years, mean age 11.1, SD = 3.2). The weight at birth was 1500-2500 grams (mean 2184, SD = 271) in 254 and more than 2500 grams (mean 3398, SD = 441) in the remaining 3409 children. Skiascopy with cycloplegia was done and refractive error readings were reported as the spherical equivalent (SE). Myopia was defined as SE < or = -0.5 D, hyperopia as SE > or = +1.5 D. Anisometropia was diagnosed when the difference in the refraction of both eyes was > 1.0 D. The parents completed a questionnaire on the child's weight and term of birth. Data analysis was performed using chi-square test. P values of less than 0.05 were considered statistically significant. RESULTS: Hyperopia was observed more frequently in 6-7 year-old children whose birth weight was > 2500 grams (p < 0.05) - table 1. Additionally, it was found that anisometropia was less frequent in 10-11 year-old children whose birth weight was > 2500 g (p < 0.05) - table 2. CONCLUSION: Low birth weight may have an effect on the prevalence of refractive errors among schoolchidren.

[Analysis of the causes of visual disability based on medical court opinions]. / Analiza przyczyn inwalidztwa wzrokowego na podstawie opinii sadowo-lekarskich.

PURPOSE: To determine visual invalidity causes based on medical-court opinions. MATERIAL AND METHODS: An analysis of 337 medical-court opinions requested by the Public Insurance Department of the State Court in Szczecin has been carried out. The opinions concerned 189 men and 148 women at the age ranging from 23 to 96 years old. The average age was 52 years. The causes of appeals have been analyzed as well as admitted welfare assistance due to disablement and none self-reliance. RESULTS: It was found that a trauma of an eye was the most frequent cause of applying a request for acknowledgment of partial disablement (13.4%) or complete disablement (25.8%). The most frequent reason of being not self-reliant was glaucoma (16.4%). It has been observed that the most often accepted by court cause of partial disablement was the undergoing of an eye injury (22.8%). Glaucoma was the most often accepted by court cause of complete disablement (17%) and none self-reliance (15.4%).

Development of the human eyeball and orbit during the fetal life.

PURPOSE: The aim of this paper was to describe the development of the human eyeball and orbit during fetal life. MATERIAL AND METHODS: Eighteen human fetuses (36 eyes and 36 orbits) with gestational age ranging from 17 to 28 weeks were examined. Fetuses died in the first hours of life due to immaturity and did not reveal any developmental anomalies. The axial and equatorial diameters of the eyeballs as well as the depth and width of the orbits were measured. The data was analyzed statistically with Student's t-test and Pearson's correlation coefficients. RESULTS: It was found that the axial length (p < 0.005) and equatorial diameter (p < 0.001) of the eyeballs, as well as the depth (p < 0.001) and width (p < 0.001) of the orbit increase with age. Furthermore, growth of the axial length of the eye is paralleled by increase in orbital depth (p < 0.001) while growth of the equatorial diameter coincides with increasing orbital width (p < 0.001). It was ascertained that growth of the human eye during fetal life is correlated with growth of the orbit.

[Protection of the skin from harmful ultraviolet radiation]. / Ochrona skóry przed szkodliwym dzialaniem promieniowania ultrafioletowego.

Ultraviolet radiation from the sun or artificial sources can exert beneficial and/or damaging effect on human skin. Excessive UV radiation has been implicated in the increased incidence of skin malignancies and accelerated skin photoaging. Thus, the skin requires adequate protection and sunscreens are useful for this purpose. Physical (inorganic) and chemical (organic) filters protect the skin from the action of both UVA and UVB. Apart from sunscreens, avoidance of excessive exposure to sunlight is the most important recommendation to protect the skin.

An evaluation of selected human eye dimensions at different periods of the foetal life.

In the course of myopia many anatomical changes in the structure of the eyeball take place. These changes surface during early childhood. It is unclear if these changes form during the stage of foetal life. The aim of the paper was to examine whether changes which predestine to the formation of myopia occur during the prenatal period. 26 eyeballs of humans aged between 4 and 8 months of foetal life, fixed in a 10% solution of formalin were examined. The axial, equatorial and corneal dimensions were measured with Vernier calipers. The data were elaborated statistically by the Student t test, the significance level being p < 0.05. It was observed that in the course of maturation the axial length, equatorial and corneal diameter of the foetal eye increase. It was also observed that the dimensions of the eyeball expand symmetrically in all directions. This indicates that there is no predisposition to the development of myopia in the period of prenatal life.