ABSTRACT
PURPOSE: To evaluate the diagnostic ability of pachymetric indexes obtained with Spectral Domain Optical Coherence Tomography (SD-OCT) for early detection of keratoconus (Kc). METHODS: 64 patients with Kc in at least one eye (95 eyes, 46 men and 18 women, average age 27.84 ±13.50), 59 healthy control subjects (100 eyes, 28 men and 31 women, average age 27.15 ±16.14). All patients underwent detailed clinical examination, topography and anterior segment OCT. 37 subjects (37 eyes, 27 men and 10 women, average age 24.23 ± 14.24) having one eye with manifest Kc and the fellow eye without clinical signs of Kc were identified. We studied two groups of pachymetric indexes: C1-C2, M1-M2, pCLMI, Pmin-P2 (Group 1 indexes) and PPD, PSD, PSSD and PASD (Group 2 indexes). A ROC (Receiver Operating Characteristic) curve was developed to compare the diagnostic accuracy, relative sensitivity and specificity for each index. RESULTS: In manifest keratoconus, C1-C2, M1-M2, and pCLMI are significantly higher compared to the control group (P<0.0001); for suspect keratoconus, all Group 1 indexes are significantly higher compared to healthy subjects (P<0.0001) excluding M1-M2 obtained using a constant area circle (P = 0.02). Furthermore, for manifest and suspect keratoconus, PPD, PSD, PSSD and PASD are significantly higher compared to the control group (P <0.0001). CONCLUSION: The studied pachymetric indexes in patients with Kc have high diagnostic accuracy and are statistically significant when compared with healthy subjects (p<0.0001) and can provide a useful tool for keratoconus screening.
Subject(s)
Cornea/diagnostic imaging , Corneal Pachymetry/methods , Corneal Topography/methods , Keratoconus/diagnosis , Mass Screening/methods , Physical Examination/methods , Tomography, Optical Coherence/methods , Adolescent , Adult , Aged , Aged, 80 and over , Child , Early Diagnosis , Female , Healthy Volunteers , Humans , Italy , Male , Middle Aged , ROC Curve , Sensitivity and Specificity , Young AdultABSTRACT
PURPOSE: The aim of the study was to investigate the epidemiological trends of ocular diseases using hospital discharge forms as our data source. MATERIALS AND METHODS: We examined official Italian Statistical Institute (ISTAT) data concerning patients discharged from ophthalmologic wards. Our analysis was limited to the years when ISTAT managed health service data (1986, 1990 and 1994); whilst currently this duty has been transferred to the Ministry of Health. RESULTS: The diseases encountered most frequently were cataract, glaucoma and retinal detachment. Patients over 65 years of age represented 54% in 1986 and 67% in 1994. We observed a general trend toward shorter hospital stays (10.5 days in 1986 and 6.4 days in 1994). We applied an indirect analysis that included masculinity and chi 2 homogeneity that were aimed to evaluate results de spite the questionable reliability of ISTAT gross data. CONCLUSIONS: The results of indirect analysis (masculinity and chi 2 homogeneity, of data combined with the significant number of charts presenting incomplete diagnostic information strongly question the reliability of official documentation. The increase of hospitalisation for ophthalmic surgery and a higher average age of affected subjects were confirmed. We observed a reduction of mean hospital stay per admission, indicating a positive achievement in terms of cost reduction.
Subject(s)
Cataract/epidemiology , Glaucoma/epidemiology , Retinal Detachment/epidemiology , Adult , Aged , Aged, 80 and over , Epidemiologic Methods , Humans , Italy/epidemiology , Middle Aged , PrevalenceABSTRACT
The authors analysed accidents of ophthalmological interest obtaining information from the database of the INAIL (National Insurance Institute for Professional Casualties) concerning the period of 1986-1991. The INAIL registers all casualties that cause work disabilities exceeding 3 days. The investigation included all job types grouped into two major categories: agriculture (16% of all insured labour) and industry/craftsmanship (84%). Over 78% of the cases examined were in the industry/craftsmanship category. Approximately 22% of the cases were in the agriculture category. Every year in Italy, about 6% of regularly employed workers suffer casualties. The incidence of casualties of ocular interest has been a stable 0.37% in the years examined; 2.88% of these casualties produce permanent consequences (1/10,000 workers per year). The risk in 3 times higher in agriculture.
