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Biomedical subjects

A F Winder

Publications and source records attributed to A F Winder.

At least 73 records · Page 4Linked to original sources
PubMed1983

Partial galactose disorders in families with premature cataracts.

Minor and major deficiencies of enzymes affecting galactose metabolism may be associated with cataracts of early onset. Results are presented for 10 such families with minor enzymatic disorders. Expression of the major disorders probably involves galactitol accumulation and osmotic lens damage but this mechanism is not obviously associated with minor disorders. The observed incidence of minor incomplete enzymatic disorders of galactose metabolism in families with an incidence of cataracts of early onset may be at least partly incidental.

Adolescent↗
PubMed1983

Relationship between corneal arcus and hyperlipidaemia is clarified by studies in familial hypercholesterolaemia.

In subjects with familial hypercholesterolaemia for whom integrated exposure to hyperlipoproteinaemia can be determined, arcus development correlates with age rather than extent or pattern of hyperlipoproteinaemia. This permissive effect whereby arcus development becomes progressively time-dependent rather than dose-dependent at increasing levels of hyperlipoproteinaemia may underlie difficulties in the interpretation of premature corneal arcus in less specific disorders. Arcus development is not apparently influenced by levels of high-density lipoprotein in plasma.

Adolescent↗
PubMed1982

Galactose intolerance and the risk of cataract.

Cataracts may arise in association with various major and minor disorders restricting galactose metabolism, and the risk is broadly associated with the degree of galactose intolerance. A family is described in which a girl presented at the age of 7 3/4 years with cataracts, galactosuria, and partial deficiencies of the enzymes galactokinase and galactose-1-phosphate uridyl transferase. Galactose intolerance as determined by an oral test was impaired and fluctuated with variation in activity of the above galactose enzymes. Minor defects were also present in the parents and a maternal half-brother. The child has a compound disorder of galactose metabolism differing from those previously described. Assessment of galactose tolerance may be useful in the investigation of families with an incidence of cataract.

Carbohydrate Metabolism, Inborn Errors↗
PubMed1982

Partial ileal bypass in treatment of familial hypercholesterolaemia.

The effects of partial ileal bypass have been studied in 7 patients with heterozygous familial hypercholesterolaemia. By the seventh to ninth postoperative day there was a significant fall in plasma cholesterol of 42.8% compared with levels at initial presentation. Thereafter, plasma levels of cholesterol rose by varying degrees, but had stabilized by 3 months with average values 29.5% lower than pretreatment. Debilitating diarrhoea or severe weight loss were not troublesome features of the operation in most patients.

Adult↗
PubMed1981

Laboratory screening in the assessment of human cataract.

Cataracts may clearly arise in association with systemic metabolic disorders, but most ophthalmologists do not request an extended laboratory assessment for patients presenting with cataracts who are otherwise in good health. This approach was not unreasonable in view of the very low yield of unsuspected abnormalities revealed by detailed screening, but should be reconsidered in view of recent advances particularly in the understanding of partial defects of galactose metabolism. Proposals for a laboratory screening policy in relation to metabolic cataracts are discussed.

Blood Glucose↗
PubMed1981

Retinal vascular abnormalities in the hyperlipidaemias.

Previous studies have suggested an association between hyperlipidaemia and retinal venous and arterial occlusion. To investigate this association further, the retinal arterial vasculature was studied by fluorescein angiography in forty hyperlipidaemic subjects, and clinical examination and biochemical investigations, including lipid profile, were performed in 99 patients with retinal vein occlusion and forty patients without retinal vein occlusion as a comparison group. Retinal arterial abnormalities were found on fluorescein angiography in eight patients with combined hypercholesterolaemia and hypertriglyceridaemia (type IV and V hyperlipidaemia). However no abnormalities were found in patients with familial hypercholesterolaemia (type II). Fluorescein angiography was repeated after 6 months hypolipidaemic therapy in four of the patients with retinal arterial abnormalities. Progression of retinal vascular closure was observed in two patients with poor hyperlipidaemic control and improvement in two other patients with good hyperlipidaemic control. There was a significantly higher incidence of hyperlipidaemia (P less than 0.001) and glucose intolerance (P less than 0.05) in the retinal vein occlusion group when compared to the control group, and a higher incidence of hypertension in patients with either central or branch retinal vein occlusion than in the normal population. We conclude that retinal arterial abnormalities occur in type IV and V hyperlipidaemias and that both central and branch retinal vein occlusion are associated with similar risk factors to large vessel disease.

Adult↗
PubMed1981

Problems with corneal arcus.

Corneal arcus presents many puzzling features. The correlation between its incidence and serum lipid levels is poor and, using immunoelectrophoresis, we have only been able to identify low-density lipoprotein inconsistently in corneae containing this deposition. Infrared thermography has shown us that arcus commences in the warmest regions of the cornea. We have considered the possible relevance of our biochemical and thermographic findings to other problems with corneal arcus such as its irreversibility, anatomical distribution, and clear zone.

Aged↗
PubMed1980

Penetration of mercury from ophthalmic preservatives into the human eye.

Single corneas of nine patients about to undergo full-thickness corneal keratoplasty were exposed to thiomersal by application of a hydrophilic gel contact lens preserved with this mercurial agent. These lenses were removed at operation 4 h later, and the lenses, corneal buttons, and samples of aqueous were taken for determination of total mercury by wet digestion and flameless atomic absorption. The contact lenses contained little residual mercury, but mercury was readily detected in the corneal buttons and in the samples of aqueous over the range of 1--60 ng/ml. Five control samples of aqueous obtained without exposure to mercurial preservatives contained less than 1 ng/ml mercury. Although specific effects on ocular function are not described, the use of these preservatives is associated with penetration of mercury into the aqueous in concentration similar to those reported with systemic poisoning by organic mercurials.

Aqueous Humor↗
PubMed1980

Ophthalmological complications of the hypertriglyceridaemias.

Hypertriglyceridaemia is an inappropriate elevation in plasma of chylomicrons, very low density lipoprotein, or both, functioning in the transport of exogenous and endogenous neutral fat respectively (lewis, 1976; Miller, 1979). The elevation may be due to rare genetically-determined defects or to a specific imbalance between triglyceride production and utilization, either secondary to or accentuated by other metabolic disturbances such as obesity or diabetes mellitus. Various surveys indicate that some degree of hypertriglyceridaemia affects more than 10 per cent of the adult population, with a male preponderance and a reduced expression during childhood (Lewis, 1976). Ophthalmological complications of hypertriglyceridaemia include eruptive and other forms of xanthomata including xanthelasmata, corneal arcus, lipaemia retinalis, effects on retinal blood flow, and lipid emboli affecting vision. The clinical features overlap those of hypercholesterolaemia and these features may lead to initial presentation and diagnosis of either disorder. Recognition of the underlying disorder is important since with treatment the incidence of major cardiovascular and other problems such as pancreatitis may be reduced, and with familial disorders other affected members may then be sought.

Adult↗
PubMed1978

Ocular hypertension and systemic responses to the water-drinking test.

Osmolal, electrolyte, and other responses in peripheral blood were recorded after water loading of patients with ocular hypertension and chronic simple glaucoma, and with a small group of younger normal subjects. The osmolal responses of the ocular hypertensive group were significantly greater than for the glaucoma group, and further differences in plasma potassium concentration were also found. Drinking habits may exert a significant influence in ocular hypertension. The relative contributions to the diagnostic category of the variables recorded was evaluated by discriminant analysis, and the application of this retrospective approach to the assessment of new patients is discussed.

Adult↗
PubMed1977

Circulating lipoprotein and blood glucose levels in association with low-tension and chronic simple glaucoma.

Circulating lipoprotein and blood glucose levels were determined for 53 patients with low-tension glaucoma and 39 patients with chronic simple glaucoma. The incidence of hypercholesterolaemia was significantly higher in the low-tension group than in the chronic simple glaucoma group and control data obtained elsewhere. Preliminary follow-up results of the effects of treatment are also reported. The incidence of raised fasting blood glucose levels was not significantly increased in either group.

Adult↗
PubMed1977

Tear calcium levels and contact lens wear.

Hydrophilic contact lens spoliation can be associated with the deposition of calcium salts. The relationship between the concentration of calcium in tear fluid and contact lens use has been studied in healthy volunteers and in patients using various forms of hard and soft contact lenses, tear samples being collected with Schirmer strips and with lenses in situ. Methods are suggested for correcting data on calcium per strip to concentration when this cannot be directly determined. Further data were obtained by direct extraction of freshly removed soft contact lenses. The collected results indicate some variation in tear calcium concentrations, but values are unrelated to use of contact lens and type of lens fitted, and to the rates of tear flow with our procedures for collection. Local calcium concentrations are unlikely therefore to be a significant primary factor in soft contact lens spoliation, but the enlargement of the tear pool associated with the use of a soft contact lens does greatly increase the amount of calcium present, and this may be a factor in secondary deposition.

Adult↗