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Biomedical subjects

L T Chylack

Publications and source records attributed to L T Chylack.

At least 19 recordsLinked to original sources
PubMed1992

Indirect spectral transmission ratio measurements of the aging crystalline lens nucleus.

A new objective approach to characterize color and opalescence in the lens nucleus, using wavelength indexed transmission ratios (TR) is described. Transmission ratios, i.e. the transmissivity per unit lens thickness, for the whole visible spectral range (390-720 nm) were calculated using fast scanning spectral colorimetry (FSSC). The lowest transmission ratios values were obtained in the blue part of the spectrum in general and at 450 nm in particular. They inversely followed the subjectively determined LOCS II color grading. The difference between transmission ratios at the absorbed part of the spectrum (less than 500 nm) and the non-absorbed part (greater than 550 nm) also reflects the LOCS II color grading. The overall mean transmission ratios for all wavelengths in the spectrum gives an index that closely followed the nuclear opalescence grading of the LOCS II system. The transmission ratios are theoretically independent of the spectral characteristics of the incident light as long as it contains suprathreshold energies in the whole measured spectral range.

Absorption↗
PubMed1991

The Lens Opacities Case-Control Study. Risk factors for cataract.

The Lens Opacities Case-Control Study evaluated risk factors for age-related nuclear, cortical, posterior subcapsular, and mixed cataracts. The 1380 participants were ophthalmology outpatients, aged 40 to 79 years, classified into the following groups: posterior subcapsular only, 72 patients; nuclear only, 137 patients; cortical only, 290 patients; mixed cataract, 446 patients; and controls, 435 patients. In polychotomous logistic regression analyses, low education increased risk (odds ratio [OR] = 1.46) and regular use of multivitamin supplements decreased risk (OR = 0.63) for all cataract types. Dietary intake of riboflavin, vitamins C, E, and carotene, which have antioxidant potential, was protective for cortical, nuclear, and mixed cataract; intake of niacin, thiamine, and iron also decreased risk. Similar results were found in analyses that combined the antioxidant vitamins (OR = 0.40) or considered the individual nutrients (OR = 0.48 to 0.56). Diabetes increased risk of posterior subcapsular, cortical, and mixed cataracts (OR = 1.56). Oral steroid therapy increased posterior subcapsular cataract risk (OR = 5.83). Females (OR = 1.51) and nonwhites (OR = 2.03) were at increased risk only for cortical cataract. Risk factors for nuclear cataract were a nonprofessional occupation (OR = 1.96), current smoking (OR = 1.68), body mass index (OR = 0.76), and occupational exposure to sunlight (OR = 0.61). Gout medications (OR = 2.48), family history (OR = 1.52), and use of eyeglasses by age 20 years, which is an indicator of myopia (OR = 1.44), increased risk of mixed cataract. The results support a role for the nutritional, medical, personal, and other factors in cataractogenesis. The potentially modifiable factors suggested by this study merit further evaluation.

Adult↗
PubMed1991

Epidemiologic evidence of a role for the antioxidant vitamins and carotenoids in cataract prevention.

The relationship between antioxidant nutrient status and senile cataract was examined in 77 subjects with cataracts and 35 control subjects with clear lenses. Subjects with low (below the 20th percentile) and moderate (20th-80th percentiles) plasma nutrient and nutrient intake levels of vitamin C, vitamin E, and carotenoids were compared with subjects with high levels (above the 80th percentile). The odds ratio (OR) of cortical (CX) cataract among subjects with low plasma carotenoid levels was 7.2 (P less than 0.05) and the OR of posterior subcapsular (PSC) cataract for persons with low plasma vitamin C was 11.3 (P less than 0.10). Low vitamin C intake was associated with an increased risk of CX (OR = 3.7, P less than 0.10) and PSC (OR = 11.0, P less than 0.05) cataract. Subjects who consumed fewer than 3.5 servings of fruit or vegetables per day had an increased risk of both CX (OR = 5.0, P less than 0.05) and PSC cataract (OR = 12.9, P less than 0.01).

Adult↗
PubMed1990

Objective measurement of cortical and subcapsular opacification in retroillumination photographs.

An image analysis system has been developed for the objective analysis of cortical opacification. Lens photographs are obtained using a Neitz CTR retroillumination camera. The images are digitized using an IBM-PC-based imaging system. We have developed a program, called OPAC, through which the computer analyzes the image using a circular grid consisting of 93 sectors. The program outputs the percent of lens area which is opaque. Ninety-eight photographs, previously classified by the Lens Opacities Classification System (LOCS II), were analyzed using OPAC as well as a manual, square-grid counting system (GRID). The results show a linear correlation between OPAC and GRID with a correlation coefficient of 0.94. The results obtained with OPAC are also linearly correlated with the LOCS II classifications.

Cataract↗
PubMed1990

Recent studies on photodamage to the eye with special reference to clinical phototherapeutic procedures.

The use of light in clinical procedures for diagnosis and treatment has raised the possibility of adverse side effects of light on the eye. Recent studies on photobinding of sensitizers to ocular tissue, photo-oxidation of lens proteins and the role of intrinsic and extrinsic photosensitizers in cataract formation are discussed. Aspects of light damage to the retina of significance in clinical phototherapeutic procedures are outlined. Future studies that may aid in documenting and minimizing the damaging effects on the eye of long-term phototherapeutic procedures are suggested.

Crystallins↗
PubMed1989

Lens opacities classification system II (LOCS II)

The Lens Opacities Classification System, version II (LOCS II), uses a set of colored slit-lamp and retroillumination transparencies to grade different degrees of nuclear, cortical, and subcapsular cataract. The system uses four nuclear standards for grading nuclear opalescence and color, five cortical standards, and four subcapsular standards. The LOCS II can be used to grade patients' cataracts at the slit lamp or to grade slit-lamp and retroillumination photographs; it is easy to learn and can be applied consistently by different observers. We obtained very good interobserver reproducibility of the clinical gradings at the slit lamp, excellent intraobserver reproducibility, very good to excellent interobserver reproducibility of photographic gradings, and good agreement between clinical and photographic gradings. The LOCS II is potentially useful for both cross-sectional and longitudinal studies of cataract.

Cataract↗
PubMed1989

Regional sensitivity to hypoglycemia within the rabbit lens epithelium.

Paired rabbit lenses were kept in organ culture; one of the lenses was subjected to hypoglycemia, and the other served as control. The lens changes were followed and examined by photomacrography, light microscopy of the intact lens, and light and electron microscopy at different time intervals. The possibility of reversing the morphological changes was evaluated at different times by replacing the hypoglycemic medium with a normal glycemic one. The central zone of the lens epithelium was affected first through the formation of large extracellular vacuoles. These changes were reversible. Subsequently, the central lens epithelial cells showed severe swelling and breakdown of the lens membranes. These changes were not reversible. With time the epithelial changes spread from the central zone towards the equator. Lens fiber swelling followed the severe epithelial damage. These findings show that there is a regional sensitivity to hypoglycemia within the lens epithelium. The results are discussed in relation to hexokinase activity.

Animals↗
PubMed1989

Allopurinol use and the risk of cataract formation.

Several reports have suggested an association between chronic allopurinol ingestion and cortical and subcapsular cataract formation. To examine this possibility we identified 51 allopurinol users and compared their lenses with those of 76 patients who did not use allopurinol. The existence of lens opacities and the level of visual acuity were assessed by review of medical records or by prospective ophthalmic examinations; in both phases of the study the examiners were blinded as to the patient's use or non-use of allopurinol. Three different outcomes were considered: formation of any cataract, formation of a posterior subcapsular cataract, and formation of a cataract contributing to a corrected visual acuity of 20/30 or worse. The risk ratio for the formation of any cataract was 1.3 (95% confidence interval: 0.8, 2.0), the risk ratio for the formation of a posterior subcapsular cataract was 0.9 (0.3, 2.0), and the risk ratio for the formation of a cataract contributing to a loss of visual acuity was 1.3 (0.6, 2.9). None of these risk ratios was changed appreciably after controlling for age, sex, hypertension, or diabetes. Thus, after a mean of 6.9 years of allopurinol use, we found no evidence to confirm that allopurinol users were at higher risk of acquiring cataracts.

Allopurinol↗
PubMed1989

An enriched set of features of nuclear cataract identified by multidimensional scaling.

Development of an improved system for visual classification of cataracts requires a three-step procedure: first, to identify the full range of visible features of cataracts; second, to develop and test scales for the visual assessment of each feature; and third, to establish the epidemiological or clinical validity of each scale for cataract classification. This paper focuses on the first step, applying a powerful psychometric technique for identifying the visible features of nuclear cataracts. New visual features of nuclear cataract were identified using the psychometric procedure of multidimensional scaling (MDS). Each of 5 observers independently examined pairings of slitlamp photographs of 24 cases of pure nuclear cataract, making two different ratings of dissimilarity of each of the 276 possible pairs. The two dissimilarity ratings were, first, of nuclear color and, second, of nuclear structure. MDS analysis of the dissimilarity ratings of nuclear color revealed two major visual features underlying the judgments: one a combination of hue and saturation, and the other brightness. Analysis of the ratings of nuclear structure identified a total of nine features: one distinguishing between immature and mature cataracts, four describing features of the immature cataracts (aspect ratio, background haze, clarity of the embryonal nucleus, and clarity of the outer nuclear shell), and four describing features of the mature cataracts (opalescence, aspect ratio, color of the nucleus, and symmetry). We conclude that there are many more systematic distinctions to be made in the appearance of nuclear cataracts than are now recognized in clinical practice.

Cataract↗
PubMed1989

Elemental and structural studies of the rat galactose cataract.

A series of rat galactose lenses, from 1 to 20 days on the 50% galactose diet, were frozen in the whole eye, and fractured from pole to pole in the frozen state. Lyophilized half-lenses were prepared for analysis by energy dispersive spectrometry (EDS). Following elemental analysis, some specimens were embedded and sectioned for histological studies. Elemental X-ray maps, and/or profiles, were made for K, Na, Cl, Ca, P, and S. As early as two days on the galactose diet, a crescent-shaped region ("streak") of Cl, Na, and Ca gain, and K loss develops near the equatorial surface. Between this region and the equatorial surface are the nucleated differentiating fiber cells which maintain low Cl, Na, and Ca, and high K (viable equatorial zone, VEZ). With time the "streak" expands anteriorly, centrally and posteriorly, eventually (by 20 days) including most of the lens. The VEZ, including the epithelium, however, is non-reactive to the galactose diet, which is deleterious to the fully differentiated fiber cells. Eventually, the VEZ undergoes a characteristic morphological change, apparently due in part to changes in its physical environment.

Animals↗
PubMed1989

Strategies for measuring the rate of age-related cataract formation in vivo.

The Lens Opacities Classification System (LOCS II) has been tested as a method for detecting and grading longitudinal changes in cataract severity. The LOCS I and II systems have already been tested and validated for cross-sectional classification of human cataracts in vivo. 130 eyes (of 68 patients) were photographed at baseline and follow-up visits with Neitz CTR and Zeiss slit photography. The mean length of follow-up was 14.7 +/- 4.4 months. The severity of nuclear opalescence (NO), cortical (C) and posterior subcapular cataract (P) was graded in a masked fashion using the LOCS II standards. Side-by-side comparisons of baseline and follow-up photos were also done in a masked fashion to detect more subtle changes than might be evident in the LOCS II gradings. The annual percent progression in cataracts graded by LOCS II standards are: (NO): 12.4%, (C): 17.9%, and (P): 6.5%. The LOCS II standards are offered as a promising subjective method for longitudinal grading of human cataractous change in vivo.

Aged↗
PubMed1988

Evaluation of a Lens Opacities Classification System.

A simple system, based on standard photographs, has been developed to classify lens opacities. The system allows the definition of cataract cases and noncases according to the location of lens opacification (nuclear, cortical, posterior subcapsular) and its extent (early or more advanced). Evaluation of the system has shown good to excellent reproducibility for clinical and photographic classifications. Comparisons of clinical and photograph-derived gradings has shown generally good agreement in classifying the presence and type of cataract; this agreement is highest for nuclear cataract. Photographic gradings of posterior subcapsular and, to a lesser degree, cortical opacities tend to underestimate the extent of opacification found by clinical gradings. The Lens Opacities Case-Control Study system is simple, reproducible, and easy to implement; it is offered for use in case-control and other cross-sectional studies of cataract with compatible classification goals.

Aged↗
PubMed1988

Lens Opacities Classification System.

The Lens Opacities Classification System (LOCS) is a simple system for classifying age-related human lens opacities at the slit lamp or in retroilluminated and slit-lamp photographs. The system employs a set of standard Neitz CTR retroilluminated black-and-white photographs for classification of cortical and posterior subcapsular cataracts and a single color slit-lamp photograph for classification of nuclear color and opalescence. We present a detailed description of the system.

Cataract↗
PubMed1988

Antioxidant status in persons with and without senile cataract.

The relationship between biochemical markers of antioxidant status and senile cataract was examined in 112 subjects aged 40 to 70 years. Seventy-seven of these subjects had a cataract in at least one lens. Antioxidant status was measured using erythrocyte superoxide dismutase, glutathione peroxidase, and glucose-6-phosphate dehydrogenase activity, and indexes that included these enzymes plus plasma levels of vitamin E, vitamin C, and carotenoids. Subjects were grouped by level (low, moderate, or high) of the enzymes and antioxidant indexes. Results suggest that subjects with high levels of at least two of the three vitamins (vitamin E, vitamin C, or carotenoids) are at reduced risk of cataract relative to subjects with low levels of one or more of these vitamins (odds ratio, 0.2). The erythrocyte enzymes, either individually or in combination, did not appear to differ between subjects with and without cataract.

Adult↗
PubMed1988

Glucose flux and the redox state of pyridine dinucleotides in the rat lens.

The concentration of alpha-glycerophosphate (GP) appeared to increase and readily reached a new steady state in lenses incubated with KCN or under hyperglucosic condition. This increase can be explained by the change in NADH/NAD ratio under each condition. The relative ratio of pyridine dinucleotides (NADH/NAD) was calculated from equilibrium equations of two NAD-linked enzymes, lactate dehydrogenase (LDH) and alpha-glycerophosphate dehydrogenase (GPDH). The change in NADH/NAD ratio based on biochemical assays correlates well with that estimated from GPDH reaction. This indicates that measurements of pyridine dinucleotides (e.g. in vivo redox fluorometry) can be used to demonstrate lens metabolic status.

Animals↗
PubMed1988

Nutritional status in persons with and without senile cataract: blood vitamin and mineral levels.

As part of an exploratory study of nutrition and senile cataract relationships between biochemical markers of nutritional status and senile cataract were examined in 112 subjects aged 40-70 y. Seventy-seven subjects had a cataract in at least one lens. Blood levels were determined for total carotenoids, vitamin A, vitamin D, vitamin E, vitamin C, riboflavin, thiamin, vitamin B-6, zinc, copper, selenium, and magnesium. Subjects were grouped into quintiles for each nutrient. Logistic regression was used to estimate the odds ratios (ORs) for cataract among subjects in the highest quintile and the middle three quintiles relative to subjects in the lowest quintile. ORs were adjusted for age, sex, race, and presence of diabetes. Results suggest that risk of cortical cataract was reduced for subjects in the highest quintile of vitamin D and total carotenoids and that persons with cataract may have lower levels of vitamin C and higher levels of vitamin B-6 and Se.

Adult↗
PubMed1988

Front surface fluorometric study of lens insoluble proteins.

Although the quantity of insoluble lens proteins increases with aging and cataracts, it is unknown whether the quality, such as protein structure, also changes correspondingly. In this study front surface fluorometry was used to study powdered samples of insoluble proteins isolated from young calf and old cow lenses, as well as from young clear and old cataractous human lenses. Tryptophan (Trp) fluorescence shows that there is a difference in protein conformation between young and old bovine samples. The old sample appears to have more open structure. This is demonstrated by a red shift in Trp emission maxima. The water-insoluble fraction shows 3-4 nm shift, while its urea-soluble and urea-insoluble fraction show 1-2 nm shift. The unfoldedness found in soluble crystallins is thus retained when they become insoluble. Both young and old human insoluble samples give a long Trp emission wavelength without showing any difference. Another major change that can be measured by fluorescence is the appearance of the 370/440 nm peak in old bovine insoluble powdered samples. Human samples also give this peak, and its position shifts to a longer wavelength in senile lenses.

Adult↗