Clinical utility of digital radiography dacryocystography for preoperative assessment in nasolacrimal duct obstruction prior to endoscopic dacryocystorhinostomy.

Purpose: To evaluate the clinical usefulness of digital radiography dacryocystography in patients with primary acquired nasolacrimal duct obstruction prior to endoscopic dacryocystorhinostomy. Methods: All dacryocystography images from 129 patients with primary acquired nasolacrimal duct obstruction were analyzed. Each group was assessed for postoperative epiphora severity using Munk's score via telephone follow-up three years post-surgery. Receiver operating characteristic (ROC) curve was plotted to obtain a suitable cutoff value of the transverse diameter of the lacrimal sac (LS), used to categorize LS size into small (≤4.350 mm) and large (>4.350 mm). Results: Analysis of the transverse diameter of the LS among 129 patients showed a negative correlation between it and Munk's score (r = -0.282, p = 0.001). There was a statistical difference between the surgical outcomes and the sizes of the LS (p = 0.041). The ROC curve analysis showed that the transverse diameter of the LS at 4.350 mm was the ideal cutoff value for the outcome of endoscopic dacryocystorhinostomy, with a sensitivity of 42.2 %, and specificity of 92.3 %. After adjusting for the age and sex, the small LS was associated with an increased risk of postoperative failed outcome (adjusted odds ratio [95 % CI]: 8.628 [1.074, 69.335]). Conclusion: The small LS was independently associated with the failed surgical outcome. Furthermore, the preoperative measurement of the LS transverse diameter serves as one of the reliable predictors for postoperative epiphora severity.

CT-Measured Angulation Between the Frontal Bone and Bony Nasolacrimal Duct: Variations in Obstructed and Healthy Lacrimal Ducts.

PURPOSE: The aim of this study was to analyze the characteristics of CT-measured intersection angle (FB-BNLD) between the frontal bone and bony nasolacrimal duct and to provide suggestions for treating primary acquired nasolacrimal duct obstruction (PANDO) patients in West China. METHODS: Three hundred and nine participants' CT were, respectively, evaluated with RadiAnt DICOM Viewer. We defined the FB-BNLD angle >0° as the anterior type and the FB-BNLD angle ≤0° as the posterior type. RESULTS: The mean FB-BNLD was -2.52° (95% CI, -3.16° to -1.88°) across all participants, of whom 37.2% were of the anterior type and 62.8% of the posterior type. Approximately 65.0% of the female patients had a posterior FB-BNLD type, and 54.2% of the male patients had an anterior FB-BNLD type (p = .002). Posterior FB-BNLD was the dominant type in the PANDO and control groups (p = .011), and the angle of FB-BNLD was statistically different in both groups (PANDO group, -2.54° to -0.71°; control group, -4.42° to -2.67°; p < .001). Among the male participants, the type of FB-BNLD differed between the two groups (p = .036), with differences in the angle of FB-BNLD (PANDO group, 0.59° to 5.13°; control group, -4.08° to 1.89°; p = .034). There was no difference in the type of FB-BNLD in female participants between the two groups (p = .051). CONCLUSION: The present study revealed individual differences in the type of FB-BNLD, with anterior-type majority in males and posterior-type dominance in females. Evaluating the FB-BNLD type on CT can provide a fast method for knowing the nasolacrimal duct condition during planning for lacrimal manipulation.

Clinical application of X-ray, B-scan, and CT in the diagnosis of ocular foreign bodies.

PURPOSE: To analyze the sensitivity and specificity of X-ray, B-ultrasound, and CT scan in diagnosing ocular foreign bodies, and to compare the accuracy of these three imaging tools in locating these foreign bodies. METHODS: A retrospective review was conducted of radiographic and clinical eye examination data from 62 patients (66 eyes), suspected of having ocular foreign bodies at time of first presentation to the Zhongshan Ophthalmic Center (Guangzhou, China) between August 2007 and October 2011. The sensitivity and specificity of X-ray, B-ultrasound and CT scan in the diagnosis of ocular foreign bodies were investigated and their accuracy in locating these foreign bodies was compared. RESULTS: A total of 75.8% (n = 47) subjects had ocular foreign bodies; 66% of these were metallic. Patients with intraocular, eye wall, and extraocular foreign bodies accounted for 46, 28, and 26% of the total, respectively. The sensitivities of X-ray, CT scan, and B-ultrasound in the diagnosis of ocular foreign bodies were 58.3%, 61.7%, and 75%, the specificityies were 63.3%, 100%, and 87.5%, and the accuracy in locating foreign bodies was 73.4%, 94.7%, and 86.5%, respectively. The properties of foreign bodies affected the diagnosistic accuracy of X-ray, but exerted little impact upon B-ultrasound and CT scan. CONCLUSION: A fairly high incidence of ocular foreign bodies was noted in patients suspected with ocular foreign bodies at their first presentations. X-ray combined with CT scan or X-ray in combination with B-ultrasound showed a relatively high sensitivity and specificity in diagnosing ocular foreign bodies. CT scan had the highest accuracy in locating ocular foreign bodies.

Fish intake and risk of heart failure: A meta-analysis of five prospective cohort studies.

The findings on the association between fish intake and the risk of heart failure (HF) have been inconsistent. The purpose of this study was to clarify this potential association. We searched for relevant studies in the PubMed database through January 2012 and manually reviewed references. Five independent prospective cohort studies involving 5,273 cases and 144,917 participants were included. The summary relative risk estimates (SRRE) based on the highest compared with the lowest category of fish consumption were estimated by variance-based meta-analysis. In addition, we performed sensitivity and dose-response analyses to examine the association. Overall, an absence of an association between fish intake and HF was observed (SRRE=1.00; 95% CI, 0.81-1.24). However, fried fish intake positively associated with HF (SRRE=1.40; 95% CI, 1.22-1.61). In addition, dose-response analysis of fried fish suggested that each increment of six fried fish per month corresponded to a 37% increase of HF rate (RR=1.37; 95% CI, 1.20-1.56). In conclusion, our findings suggest that there is no significant association between fish intake and risk of HF, with the exception of a possible positive correlation with individuals comsuming fried fish, based on a limited number of studies. Future studies are required to confirm these findings.