Central corneal endothelial guttae and age-related macular degeneration: is there an association?

The similarities between the corneal endothelium and retinal pigment epithelium in terms of their embryology, barrier function and predilection to age-related degeneration prompted this investigation into a possible association between central corneal guttae (CCG) and age-related macular degeneration (ARMD). 50 patients with clinically significant CCG were prospectively evaluated for the presence of ARMD. 51 age-matched patients attending for unrelated ailments who did not have CCG were also evaluated for the presence of drusen and other signs of ARMD. Of the 50 patients with CCG, 23 had bilateral ARMD and 4 had unilateral ARMD. In the control group, 9 patients had bilateral and 4 had unilateral ARMD. There was significant difference in the prevalence of ARMD between patients with CCG and those with no CCG (p = 0.017 and p < 0.001 for right and left eyes respectively). We found an association between CCG and ARMD. The presence of CCG in a patient may imply increased risk for the presence of ARMD. In a patient with CCG requiring cataract or corneal surgery, the successful outcome may be compromised by the presence of ARMD.

Psychosocial study of leukemic children and their parents.

Psychosocial assessment was carried out in 35 children with acute lymphatic leukemic, an equal number with non-leukemic chronic illness and their parents. Psychological dysfunction existed more frequently in parents of leukemic children. Depression as an initial reaction on being conveyed the diagnosis, was seen in 85.8% whilst anger was observed in 42.8%. Majority (89.7%) entertained doubts about whether a correct diagnosis has been established. Understanding of the disease, its possible course and the need for prolonged treatment, was appreciated by about 65.7% of parents. The disease imposed serious social, financial and occupational burdens on the family. Measures used to cope with such stresses included meeting close friends and relatives and finding solace in religious activities. When comparing psychopathology in leukemic children with that in chronically ill non-leukemic counterparts, significant differences were observed in certain specific syndrome scores. Conduct disorder, anxiety, depression and psychotic symptoms were more prevalent in leukemic children. This study emphasizes the necessity of active psychosocial intervention in the total care of childhood leukemia.