Acta ophthalmologica. Supplementum最新文献

Two hundred and eleven patients with diabetic retinopathy were assigned to a multicentre prospective study on the effect of photocoagulation therapy. Twenty Swedish eye clinics took part in the trial. Good visual function and symmetrical diabetic retinopathy of the non-proliferative or proliferative type were required. No patients with advanced new vessels on the optic disc or widespread fibrous proliferations were included. Further criteria for inclusion were that at the time of entry into the study the patients would be in good general health, should have no other eye diseases and should be receiving no other treatment for diabetic retinopathy. One eye was randomly chosen for photocoagulation therapy. The patients were given mild treatment with the panretinal, focal or panretinal and focal techniques and in most cases the short-pulse, small-spot xenon arc or argon laser methods were used. The patients were examined before treatment, after 6 months and subsequently every year. All follow-ups included careful measurement of corrected visual acuity, tonometry, and evaluation of the optical media and fundus changes. A medical examination was performed every second year. Fundus photographs were taken at all examinations. The diabetic lesions were graded with the aid of a modified Airlie-House system. The classification of all diabetic lesions was checked by the author with the help of the fundus photographs. Visual acuity and morphological diabetic changes were analysed in the whole material and also in four subgroups, namely those with mild non-proliferative, moderate-severe non-proliferative, mild proliferative and moderate-severe proliferative retinopathy. This subgrouping was done with regard to the stage of retinopathy at entry into the trial. One hundred and eighty-five patients were followed up for 4 years and 138 for 5 years. Twenty patients died, most of them from diabetic complications. Forty-one control eyes were treated. The majority showed progression before treatment. Treated eyes had better average visual acuity and a lower rate of blindness than control eyes at late follow-up. The various stages of retinopathy differed greatly with respect to the visual outcome. Patients showing mild non-proliferative changes at the time of entry had good mean visual acuity and no eyes became blind during the follow-up period. Patients with moderate-severe non-proliferative changes had a better mean visual acuity in the treatment group at late follow-ups and more eyes became blind in the control group.(ABSTRACT TRUNCATED AT 400 WORDS)

The study was undertaken to determine if occupational exposure to infrared (IR) radiation increases the risk of developing cataract. The study includes epidemiologic investigations of two groups of workers exposed to IR radiation and two groups of non IR-exposed controls. The first investigation included 208 iron and steel workers and 208 controls. For each of the workers, the lifetime IR-exposure was calculated with the help of occupational interviews and measurements of the IR-exposure to their eyes in their jobs. Eye examinations including a detailed slit lamp examination of the lens were made. Exposed persons and controls were examined randomly. Wedge shaped opacities, a common type of senile lens opacity, were found in 32% of IR-exposed workers 60 years and older and in 12% of controls of the same age. In younger age groups there was no significant difference between exposed and controls regarding the presence of lens opacities. The second investigation included 209 IR-exposed glass workers and 298 controls. Workers over 50 years of age and with at least 20 years of occupational IR-exposure were included. Special care was taken to include retired workers. Exposure determinations and ophthalmological examinations were made in the same way as in the first study. The eye examinations of the glass workers showed that 16% of glass workers over 70 years of age had been operated for cataract compared to 1% of controls of the same age. In neither of the two studies was it possible to detect a dose-effect correlation. The exposure measurements showed that the maximal doses in both the iron and the glass industry are about the same. There are, however, a large number of jobs in the iron and steel industry that give low doses while most jobs in the glass works give high exposures. Cataract was found to be more common in the left than in the right eye. Measurements of the exposure to the two eyes separately also showed that the left eye in some working moments is exposed to higher irradiances than the right. A family history of cataract was found to increase the risk for the development of cataract in glass workers.