Aiyuan Xie

The relation between C reactive protein and age related macular degeneration in the Cardiovascular Health Study

Aim: To test the hypothesis that individuals with age related macular degeneration (AMD) have increased C reactive protein (CRP) levels. Methods: A cross sectional study design using data from the Cardiovascular Health Study (CHS), a longitudinal study that enrolled older adults from four communities in the United States from 1989 to 1990, was employed to investigate the existence of an association between AMD and CRP levels in this population. Fundus photographs from 1997 and 1998 were used to identify individuals with (n = 390) and without AMD (n = 2365). The association between AMD and CRP levels (measured at baseline) was compared, adjusting for the potentially confounding effect of demographic, lifestyle, and health related characteristics. Results: Among the 2755 CHS participants with gradable fundus photographs, 390 were identified as having AMD. Overall, median CRP levels among those with AMD (1.76 mg/l) were similar to those without AMD (1.77 mg/l). CRP levels were categorised into quartiles and compared between those with and without AMD. Relative to those in the lowest quartile (0.07–0.93 mg/l), the odds ratios (OR) in the higher quartiles, adjusted for demographic, lifestyle, and health related characteristics were increased but not statistically significant (0.94–1.77 mg/l: OR = 1.14, 95% CI 0.82 to 1.60; 1.78–3.04 mg/l: OR = 1.24, 95% CI 0.88 to 1.75; >3.04 mg/l: OR = 1.24, 95% CI 0.87 to 1.78). Conclusions: In the CHS, there is no evidence that CRP levels are associated with AMD. These data do not support the theory alleging non-specific systemic inflammation in the aetiology and natural history of this disease.

Axial length and optic disc size in normal eyes

Aim: To investigate the relationship between optic disc area and axial length in normal eyes of white and black people. Methods: Consecutive eligible normal subjects were enrolled. Ocular biometry was obtained using A-scan ultrasonography, and reliable images of the optic disc were obtained using a confocal scanning laser ophthalmoscope. The relationship between optic disc area and axial length was assessed using univariate and multivariate models. Results: 281 eyes of 281 subjects were enrolled. Black subjects (n = 157) had significantly larger discs (mean (SD) disc area, 2.12 (0.5) mm2) than white subjects (n = 124; 1.97 (0.6) mm2; t test, p = 0.02). Optic disc area increased with axial length (Pearson’s correlation coefficient, r = 0.13, p<0.035) for the entire study population. Multivariate regression models including race, disc area and axial length showed that a significant but weak linear relationship exists between axial length and disc area (partial correlation coefficient 0.14; p<0.024), and with race and disc area (partial correlation coefficient 0.19; p<0.017) when adjusted for the effects of other terms in the model. Conclusion: Increased disc area is associated with longer axial length measurements and African ancestry. This may have implications for pathophysiology and risk assessment of glaucoma.

Benign essential blepharospasm: risk factors with reference to hemifacial spasm.

Background: To identify risk factors associated with benign essential blepharospasm (BEB) with reference to hemifacial spasm (HFS). Persons with BEB and HFS experience similar physical symptoms, yet the two disorders have different etiologies. Methods: Patients with BEB (n = 159) or HFS (n = 91) were identified from two large neuro-ophthalmology clinics. Demographic, medical, behavioral, and psychological characteristics were obtained from chart review and a telephonic survey questionnaire. Results: The average age of BEB and HFS was 66 years. Most patients in both groups were retired, white, and female. BEB patients were more than two times as likely to meet the diagnostic criteria for generalized anxiety disorder than HFS patients (odds ratio, 2.13; 95% confidence interval, 1.22-3.72).There was no difference between the two groups regarding demographics, smoking, a family history of dystonia, Parkinson disease, Bell palsy, Tourette disorder, obsessive compulsive symptoms, history of head trauma, alcohol use, or caffeine consumption. Conclusions: As compared to HFS, BEB was significantly more often associated with generalized anxiety disorder. Given the similarity of other clinical features of these two disorders, it is reasonable to conclude that anxiety is a cause not a consequence of BEB. Contrary to previous studies, BEB was not associated with obsessive-compulsive symptoms, head trauma, Parkinson disease, Bell palsy, Tourette disorder, or lack of smoking.

Gun-related eye injury in the United States, 1993-2002.

Objective: To present the descriptive epidemiology of gun-related eye injury in the United States from 1993 through 2002. Methods: Data from the National Electronic Injury Surveillance System was used to estimate the number of patients treated in the United States for gun-related eye injury (GEI) (air guns and firearms), air gun-related eye injury (AEI) (BB/pellet guns and rifles) and firearm-related eye injury (FEI) (all powder discharge guns) during the time period 1993 through 2002. Rates were calculated according to age, gender, race, weapon type and circumstances surrounding the injury event (e.g., locale and intent). Results: The rate of gun-related eye injury in the United States declined to 7.5 per 1,000,000 in 2002 from 14.8 per 1,000,000 in 1993, representing a decline of approximately 5.4% per year (p = 0.0002), due primarily to a decline in the rate of FEI (6.7% per year, p = 0.029). The rate of AEI was relatively constant. GEI rates were highest among those aged 10–19 years, males, and Blacks. The overall rate of AEI was higher than the rate of FEI (6.0 per 1,000,000 and 5.1 per 1,000,000, respectively). According to race, the rate of FEI was higher than the rate of AEI in Blacks whereas the rate of AEI was higher than the rate of FEI in Whites and Hispanics. The majority of GEIs occurred at home and were unintentional. Conclusion: The rate of gun-related eye injury in the United States declined from 1993 through 2002 primarily due to a reduction in firearm-related eye injury, whereas the rate of air gun-related eye injury remained constant. Persons who were young, Black, and male were at highest risk for gun-related eye injury.