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Biomedical subjects

B Dhillon

Publications and source records attributed to B Dhillon.

At least 19 recordsLinked to original sources
PubMed2007

Quality of life and relative importance: a comparison of time trade-off and conjoint analysis methods in patients with age-related macular degeneration.

AIM: To investigate the relative priorities in quality of life (QoL) in patients with age-related macular degeneration (AMD). METHODS: Measures of visual function, QoL and utility associated with visual loss were obtained from 122 patients with AMD classified according to macular morphology. The two methods of utility assessment were time trade-off (TTO) and conjoint analysis (CA), which have been recommended by the UK's National Institute of Clinical Excellence as techniques for the assessment of healthcare priorities. RESULTS: Results show that the two methods for assessing utility are poorly related: TTO relates moderately to visual function and disease severity but CA does not. CA identified two different subgroups of patients: one with outdoor mobility and the other with reading as their main priority. CONCLUSION: Further work is needed and caution required in interpreting data obtained using these methodologies for determining their relative importance in vision-related QoL studies.

Activities of Daily Living↗
PubMed2006

Cellular retention on diagnostic contact lenses: an evaluation of current cleaning protocol.

AIMS: To compare cellular contamination of diagnostic contact lenses after two different cleaning methods. METHODS: Twenty-five used diagnostic contact lenses were cleaned by two different methods and the material retained on their contact surface examined for cells. Two diagnostic contact lenses were examined using electron microscopy and surface debris was subjected to x-ray photoelectron spectroscopy. RESULTS: Significantly more cells were present on used lenses compared with controls (P<0.001). There was no significant difference in total cell count between the lenses subjected to the two cleaning strategies but the lenses simply wiped clean retained marginally more nucleated cells than controls (P=0.039). Electron microscopy showed the majority of the debris on or close to the rim of the lens. X-ray photoelectron spectroscopy confirmed the presence of proteinaceous material. CONCLUSIONS: Regardless of cleaning method, significant cellular debris is retained on the surface of diagnostic contact lenses after use.

Cell Count↗
PubMed2006

"Worm in the eye": the rationale for treatment of DUSN in south India.

AIM: To discuss the rationale for different techniques of treatment for DUSN (diffuse unilateral subacute neuroretinitis) and their effectiveness in two patients from south India. METHODS: Two rare cases of live worms in DUSN from India are reported, where filarial Brugia malayi is endemic. Both cases presented with progressive unilateral loss of vision with no history of animal contact. They were 40 year old, apparently healthy men. In case 1, the worm (1500-2000 microm) was easy to identify with wriggling movements among crisscrossing diffuse subretinal tracks. The worm was destroyed by a single shot of laser to its advancing end, which was followed by oral steroid to control the inflammation caused by the dead worm. In case 2, the worm was small and difficult to identify. Initially diffuse neuroretinitis was diagnosed and treated with intravenous methylprednisolone and oral corticosteroid. A week later, a small live worm (400-600 microm) was found and subsequently destroyed by laser photocoagulation followed by a combination of anthelminthics. RESULTS: The patients' vision had improved to 6/60-6/36 from counting fingers after a few weeks. CONCLUSION: The role of a combination of laser treatment, systemic steroid, and anthelminthics is discussed.

Adult↗
PubMed2006

Superior forniceal conjunctival advancement pedicles (SFCAP) in the management of acute and impending corneal perforations.

OBJECTIVE/AIM: Corneal perforations can result from a wide variety of disorders and can lead to devastating visual sequelae. Various surgical procedures have been described to manage nontraumatic corneal perforation. Conjunctival flaps offer an important technique in dealing with such corneal emergencies. We report a modified conjunctival flap procedure referred to as superior forniceal conjunctival advancement pedicle (SFCAP) in the successful management of corneal perforation and impending corneal perforation. PATIENTS AND METHODS: Out of 20 patients who underwent SFCAP for non-traumatic corneal perforation and impending perforation, 16 had corneal perforations. Perforations were secondary to acne rosacea (2), advanced bacterial keratitis (6), corneal anaesthesia(2), multiple retinal procedures (2), previous corneal grafts with a compromised ocular surface (3), and advanced Mooren's ulcer (1). RESULTS: The globe was preserved in all patients. In 14 of the 16 eyes with perforated corneas the pedicle stabilised. One patient, who was a chronic alcoholic, rubbed the eye during sleep detaching the pedicle a week after surgery. However, the ulcer healed and the integrity of the globe was restored. None of these patients developed secondary glaucoma or ptosis. CONCLUSION: SFCAP is an appropriate procedure to manage corneal perforations and impending corneal perforations where donor material is not available and transplantation of such tissue is not suitable.

Acute Disease↗
PubMed2006

The aetiology and associations of conjunctival intraepithelial neoplasia.

AIM: To summarise the main causes and associations of conjunctival intraepithelial neoplasia (CIN) found in the literature to date. METHOD: Literature search using Ovid databases on the NHS Scotland E-library, Medline, and the Cochrane Library. The internet search engine Google Scholar was also used to identify relevant articles. RESULTS: The main causes and associations of CIN in the literature are sun exposure and distance from the equator; human papillomavirus infection, increased p53 expression, and HIV seropositivity. It has been found that in HIV positive individuals CIN is on the increase with people being affected with more aggressive tumours at younger ages. CONCLUSION: Given that CIN is becoming more common in HIV infected populations and that it has the potential to cause severe disability, it is important to improve our understanding of the condition. Early identification of CIN by an understanding of its aetiology and associations may enable the implementation of preventative measures to reduce its incidence and potentially lead to the diagnosis and further management of conditions such as HIV. Young people presenting with CIN in particular may benefit from HIV testing.

Carcinoma in Situ↗
PubMed2005

Evolving concepts on the pathogenic mechanisms of aniridia related keratopathy.

Heterozygosity for PAX6 deficiency (PAX6+/-) results in aniridia. Corneal changes in aniridia-related keratopathy (ARK) include corneal vascular pannus formation, conjunctival invasion of the corneal surface, corneal epithelial erosions and epithelial abnormalities, which eventually result in corneal opacity and contribute to visual loss. Corneal changes in aniridia have been attributed to congenital deficiency of corneal limbal stem cells. The aim of this paper is to review the potential mechanisms that may underlie the pathogenesis of aniridia related keratopathy. Current evidence, based on clinical observations and an animal model of aniridia suggest that the proliferative potential of the corneal limbal stem cells may not primarily be impaired. The corneal changes in aniridia may be related to an abnormality within the limbal stem cell niche. The mechanisms underlying progressive corneal pathology in aniridia appear multi-factorial and include: (1) abnormal corneal healing responses secondary to anomalous extracellular matrix metabolism; (2) abnormal corneal epithelial differentiation leading to fragility of epithelial cells; (3) reduction in cell adhesion molecules in the PAX6 heterozygous state, rendering the cells susceptible to natural shearing forces; and (4) conjunctival and corneal changes leading to the presence of cells derived from conjunctiva on the corneal surface.

Animals↗
PubMed2004

Delayed diagnosis of HIV infection in ophthalmic practice.

The introduction of potent antiretroviral drug combinations has transformed human immunodeficiency virus/acquired immunodeficiency disease syndrome (HIV/AIDS) from an intractable and rapidly fatal disease to a chronic manageable illness with prolonged life survival for many patients. This paper discusses the ophthalmic and medical histories of two young female patients who presented with 'atypical' optic neuropathy and toxoplasma gondii retinochoroiditis and were later found to be HIV infected. We discuss the need for increased vigilance in the ophthalmic community for suspecting HIV infection to allow optimal management of the ophthalmic and systemic manifestations of the disease spectrum associated with HIV/AIDS.

Adult↗
PubMed2004

Immunolocalisation of leukaemia inhibitory factor in the cornea.

AIM: Leukaemia inhibitory factor (LIF) is a pleotrophic cytokine expressed in a variety of cell types, and have shown to regulate stem cell proliferation, vascular genesis, inflammation, and immunity in various locations. Expression of LIF and its role in the cornea have not been studied previously. In this study, we examined the expression of LIF in the cornea. MATERIALS AND METHOD: Immunohistochemistry was performed using polyclonal LIF antibodies, and Avidin-Biotin ABC complex on cultured human corneal epithelium corneal fibroblasts and wild-type murine corneal epithelium. RESULTS: LIF was detected in the cytoplasm of murine corneal epithelium, cultured human corneal epithelium, and fibroblasts. The expression of LIF was mainly cytoplasmic. CONCLUSION: LIF is expressed in the corneal epithelium and fibroblasts. It may have an important role in the maintenance of homeostasis of the corneal epithelium and cornea stroma. Further studies are necessary to elucidate the role of LIF in the cornea.

Animals↗
PubMed2004

A prospective study of visual function and quality of life following PDT in patients with wet age related macular degeneration.

AIMS: (1) A prospective study to assess visual function measures and quality of life (QoL) in patients with wet age related macular degeneration (AMD) treated with photodynamic therapy (PDT). (2) To assess if PDT prevents severe visual loss (loss of six or more lines of distance visual acuity) in the treated eye. METHODS: 48 of 51 recruited patients with predominantly classic subfoveal choroidal neovascularisation (CNV) secondary AMD who were treated with PDT were followed up for 1 year. Assessment included distance and near visual acuity, contrast sensitivity, vision related quality of life and fluorescein angiography. Photodynamic therapy using Visudyne was carried out according to standard protocol. Patients were followed up every 3 months and treatment repeated if there was significant leakage from CNV. RESULTS: At the 12 month follow up, 71% (n = 34) of the patients lost less than three lines of best corrected distance visual acuity. Although there were significant decreases in some of the QoL items tested, patients were significantly less anxious and more independent outdoors at the 12 month follow up. CONCLUSION: This study is in keeping with published literature with PDT preventing severe visual loss in two thirds of treated patients with predominantly classic CNV.

Activities of Daily Living↗