ABSTRACT
PURPOSE: To measure the visual acuity and to determine the etiological causes of visual impairment in the elderly residing in nursing homes. METHODS: 219 elderly persons residing in nursing homes were examined in the residence. The ophthalmological examination consisted in a visual acuity measurement, a slit-lamp examination and a fundus examination. RESULTS: This study included 145 women and 74 men. Mean age was 79.1 years (range 41-101 years). Visual acuity could be measured in 181 subjects (82.6%): it was 1/10 or worse in the better eye in 23 of them (13%) and 2/10 to 3/10 in 36 patients (20%). In 21 (17.6%) out of the 119 patients aged over 74 years, visual acuity was 1/10 or worse in the better eye. Visual impairment significantly increased with age (p < 0.05). There was no difference between men and women in the prevalence of visual impairment. Among the 55 subjects with visual impairment, the main causes of vision loss were: cataract in 36 patients (66%), age-related macular degeneration in 9 patients (16%) and optic neuropathies in 5 patients (9%). Only one (2.8%) out of the 36 patients with cataract could be operated. CONCLUSION: The rate of visual impairment of people in nursing homes was higher than in corresponding age groups in the general population. The main cause of vision loss was cataract; however, only a few patients could benefit from an operation. These results confirmed that a systematic ophthalmologic examination should be performed before general health problems prevent patients from being operated.
Subject(s)
Aged , Eye Diseases/epidemiology , Nursing Homes , Visual Acuity , Adult , Aged, 80 and over , Blindness/epidemiology , Cataract/epidemiology , Female , France/epidemiology , Humans , Macular Degeneration/epidemiology , Male , Middle Aged , Optic Nerve Diseases/epidemiology , Prospective StudiesABSTRACT
BACKGROUND: Multiple, bilateral lesions of congenital hypertrophy of the retinal pigment epithelium (CHRPE) have been described in patients suffering from familial adenomatous polyposis (FAP) since 1980. This study aimed to determine a reliable diagnostic criterion, based on the size and number of retinal CHRPE lesions, allowing the screening of patient carriers of the gene responsible for FAP. METHODS: 32 control subjects and 144 patients belonging to 85 FAP families were studied, divided into 124 carriers of the genetic alteration and 20 non-carriers. RESULTS: In carriers of the deleted gene, multiple, bilateral retinal lesions were consistently observed. Lesion situation, size, shape, and degree of pigmentation were variable however. A positive criterion for FAP was defined as the presence of at least four lesions whatever their size, or at least two lesions one of which is large. This criterion showed a high sensitivity (0.68) and a maximal specificity (1). Within each family, the retinal phenotypic expression was homogeneous. CHRPE lesions were observed in two thirds of the FAP families and absent from the remaining third. CONCLUSION: By using this new positive diagnostic criterion, fundus examination allows early detection of those children carrying the gene responsible for FAP in families positive at ocular examination.
Subject(s)
Adenomatous Polyposis Coli/diagnosis , Pigment Epithelium of Eye/pathology , Adenomatous Polyposis Coli/genetics , Adolescent , Adult , Aged , Case-Control Studies , Female , Genetic Testing , Humans , Hypertrophy/congenital , Male , Middle Aged , Ophthalmoscopy , Pedigree , Sensitivity and Specificity , Single-Blind MethodABSTRACT
PURPOSE: Optic nerve pit is a rare congenital anomaly. In two third of the patients, the severity of the disease is increased by the apparition of a serous macular detachment, which may compromise the visual prognosis. The aim of this study is to propose a therapy appropriate to such complication. METHODS: A prospective study was performed including 10 patients with a serous macular detachment caused by optic nerve pit. All patients underwent intraocular surgery including vitrectomy, peripapillary photocoagulation and intravitreal injection of gas. The mean postoperative follow-up period was 9.5 months. RESULTS: Therapy success was based on anatomical and functional results. Serous macular detachment reattached in 7 patients out of 10 and a recurrence was observed in one case. Visual acuity improved from 0 to 18 lines of the EDTRS chart (mean increase: 6.7 lines). CONCLUSION: These results confirm that intraocular surgery including vitrectomy-photocoagulation-gas injection is a valuable treatment for serous macular detachment associated with optic nerve pit.
