Short wavelength automated perimetry can detect visual field changes in diabetic patients without retinopathy.

PURPOSE: The purpose of the following study is to compare short wave automated perimetry (SWAP) versus standard automated perimetry (SAP) for early detection of diabetic retinopathy (DR). MATERIALS AND METHODS: A total of 40 diabetic patients, divided into group I without DR (20 patients = 40 eyes) and group II with mild non-proliferative DR (20 patients = 40 eyes) were included. They were tested with central 24-2 threshold test with both shortwave and SAP to compare sensitivity values and local visual field indices in both of them. A total of 20 healthy age and gender matched subjects were assessed as a control group. RESULTS: Control group showed no differences between SWAP and SAP regarding mean deviation (MD), corrected pattern standard deviation (CPSD) or short fluctuations (SF). In group I, MD showed significant more deflection in SWAP (-4.44 ± 2.02 dB) compared to SAP (-0.96 ± 1.81 dB) (P = 0.000002). However, CPSD and SF were not different between SWAP and SAP. In group II, MD and SF showed significantly different values in SWAP (-5.75 ± 3.11 dB and 2.0 ± 0.95) compared to SAP (-3.91 ± 2.87 dB and 2.86 ± 1.23) (P = 0.01 and 0.006 respectively). There are no differences regarding CPSD between SWAP and SAP. The SWAP technique was significantly more sensitive than SAP in patients without retinopathy (p), but no difference exists between the two techniques in patients with non-proliferative DR. CONCLUSION: The SWAP technique has a higher yield and efficacy to pick up abnormal findings in diabetic patients without overt retinopathy rather than patients with clinical retinopathy.

Passive smoking as a risk factor of dry eye in children.

Purpose. Adult active smoking is a risk factor for dry eye. We hypothesize that passive smoking in children can also produce the same effects. Methods. We included 112 school children presenting with eye discomfort. Assessment of eye dryness and its severity levels depending on symptoms of dry eye, visual symptoms, tear breakup time (TBUT), Schirmer-1 test, and corneal fluorescein staining were done for all of them. Exposure to cigarette smoking was assessed by history-taking and urinary cotinine levels. Results. Dry eye was found in 80/112 children. Passive smoking was documented in 76/112 children. Number of cigarettes to which the child was exposed per day and the duration of exposure to passive smoking were significantly higher in children with dry eye compared to those without. Urinary cotinine, and cotinine/creatinine ratio (CCR) was significantly higher in children with dry eye compared to those without dry eye. Multiregression analysis showed that the most important determinants of dry eye were CCR and number of cigarettes/day. Conclusion. Passive smoking represents a significant risk factor of dry eye in children comparable to that shown with active adult smoking. Male children are more prone to this effect.

Comparison of ocular findings in patients with H1N1 influenza infection versus patients receiving influenza vaccine during a pandemic.

AIM: To evaluate ocular findings during the pandemic influenza A (H1N1) and after vaccination for the same strain. PATIENTS AND METHODS: This study was conducted on 89 patients with H1N1 influenza infection (group 1) and 28 subjects who received vaccination for H1N1 (group 2). All patients were subjected to history taking, ophthalmological examination, fundus examination, conjunctival impression cytology and conjunctival swabs. RESULTS: The patients' age ranged between 5 and 60 years (19.25 ± 11.70 years). Group 1 included 43 (48.1%) males and 46 (51.9%) females, while group 2 included 13 (46.43%) males and 15 (53.57%) females. The most common ocular finding of patients in group 1 was bilateral acute conjunctivitis in 58 cases (65.17%), while in group 2, we found 3 (10.71%) cases of mild conjunctivitis, and 2 (7.14%) cases of moderate conjunctivitis. Retinopathy, uveal affection, and optic neuritis were not statistically different between the 2 groups. Impression cytology of the conjunctiva for group 1 showed squamous metaplasia grade 3 with enlargement of epithelial cells, and fragmentation of the nucleus which is similar to virus-infected structural changes. CONCLUSION: Pandemic influenza H1N1 was able to induce different ocular manifestations including acute conjunctivitis, retinopathy, uveal effusion syndrome and optic neuritis.

Relation of dry eye to disease activity in juvenile rheumatoid arthritis.

PURPOSE: To study the frequency and severity of dry eye in patients with juvenile rheumatoid arthritis (JRA) and its relation to disease activity. PATIENTS AND METHODS: Evaluation for dry eye was done in 40 patients with juvenile rheumatoid arthritis referred for ocular assessment in the Ophthalmology Clinics, Faculty of Medicine, Ain Shams University. They were 28 girls and 12 boys with age range of 7-12 years. Medical history, clinical examination, and full ophthalmologic evaluation were performed for each patient. The dry eye tests included tear film break-up time, Schirmer-1 test, and corneal fluorescein staining. Dry eye severity grading was used. Twenty healthy, age- and sex-matched children were assessed for dry eye as a control group. RESULTS: Thirty patients (75%) showed findings consistent with the diagnosis of dry eye. Twenty patients (50%) showed first-degree dryness, 8 (20%) showed second-degree, and 2 (5%) showed third-degree. The score of dry eye severity was significantly lower in remission compared to disease activity. Multiregression analysis showed the only factor affecting dry eye parameters was the duration of illness. CONCLUSIONS: Dry eye is a common incident in children with JRA and should be screened for in all patients with this disease. Severity of eye dryness is highly correlated with the disease activity.