Search PubMed⌕ Search

Biomedical subjects

Paul Mitchell

Publications and source records attributed to Paul Mitchell.

At least 181 records · Page 10Linked to original sources
PubMed2003

A phase I study of recombinant human leukemia inhibitory factor in patients with advanced cancer.

PURPOSE: Leukemia inhibitory factor (LIF) is a pleiotropic molecule of the interleukin 6 family of cytokines. We aimed to examine the safety, pharmacokinetics, and biological effects of recombinant human LIF (rhLIF, emfilermin) in patients with advanced cancer. EXPERIMENTAL DESIGN: In stage 1 of the study, 34 patients received rhLIF or placebo (3:1 ratio) at doses of 0.25-16.0 micro g/kg/day or 4.0 micro g/kg three times daily for 7 days. In stage 2, 40 patients received rhLIF or placebo, either once daily for 14 days commencing the day after chemotherapy (0.25-8.0 micro g/kg/day) or for 7 days commencing the day before chemotherapy (4.0 micro g/kg three times daily). The chemotherapy was cisplatin 75 mg/m(2) and paclitaxel 135 mg/m(2). RESULTS: In stage 1, platelet counts increased in most patients, including those who received placebo. Blood progenitor cells increased in response to rhLIF. In stage 2, platelet recovery to baseline levels was earlier for patients receiving higher doses of rhLIF (>/=4.0 micro g/kg/day; P = 0.02). The neutrophil nadir after chemotherapy was less severe in patients receiving >/=4.0 micro g/kg/day of rhLIF. In stages 1 and 2, increases in C reactive protein were seen at higher doses. Several patients developed evidence of autonomic dysfunction, in particular impotence and episodic hypotension. The dose-limiting toxicities were hypotension and rigors. Pharmacokinetic studies demonstrated a short half-life (1-5 h) independent of dose. CONCLUSIONS: We demonstrated a biological effect of rhLIF on blood progenitor cells, C reactive protein levels, and hemopoietic recovery after chemotherapy.

Adult↗
PubMed2003

Targeting primary human Ph(+) B-cell precursor leukemia-engrafted SCID mice using radiolabeled anti-CD19 monoclonal antibodies.

UNLABELLED: The Philadelphia chromosome translocation (Ph(+)) confers a poor prognosis in patients with acute lymphocytic leukemia (ALL). CD19 is highly expressed (CD19(+)) on ALL cells and is an attractive target for antibody-based therapies. CLB-CD19 is an IgG1kappa murine monoclonal antibody (mAb) directed against an epitope on the CD19 antigen. METHODS: Radiolabeled CLB-CD19 antibody was evaluated for targeting ALL in a severe combined immunodeficient (SCID) mouse model engrafted with primary human leukemia cells. Lodgment of CD19(+) ALL cells in spleen and liver was confirmed using immunohistochemistry analyses. Circulating CD19(+) ALL cells in blood were also detected by flow cytometry. RESULTS: Antibody was labeled directly with the radiohalogen (125)I and radiometal (111)In via the bifunctional metal ion chelate CHX-A"-diethylenetriaminepentaacetic acid (DTPA) with retention of immunoreactivities. After intravenous injection of radioconjugates, biodistribution studies showed rapid localization of the (111)In-conjugate to leukemia-infiltrated spleen, reaching a maximum (mean +/- SD) of 72.78 +/- 13.67 % injected dose per gram of tissue (%ID/g) by 24 h after injection. In contrast, peak localization of coinjected (125)I-CLB-CD19 occurred by 4 h and was significantly lower (11.41 +/- 12.79 %ID/g) (P < 0.001). Uptake of (111)In-conjugate in the liver containing tumor was also evident but not in other normal tissues. Uptake of radiolabeled CLB-CD19 in tumor-bearing organs was specific, as uptake of radiolabeled isotype-matched antibody control was low. Gamma-camera imaging detected the uptake of (111)In-CHX-A"-DTPA CLB-CD19 in enlarged tumor-bearing spleen of engrafted mice. A single injection of 32 micro g CLB-CD19 mAb had a delayed suppressive effect on the level of circulatory leukemia cells in surviving mice and extended the median survival from 48.5 to 58 d (n = 8; P = 0.03). CONCLUSION: The radiolabeled anti-CD19 antibody showed specific targeting and rapid internalization in ALL cell-engrafted SCID mice and may also be used for selective intracellular delivery of cytotoxic radionuclides with beta-, Auger, or alpha-emissions.

Animals↗
PubMed2002

Hormone replacement therapy, reproductive factors, and the incidence of cataract and cataract surgery: the Blue Mountains Eye Study.

The authors aimed to assess the relation between endogenous and exogenous female hormones and the incidence of age-related cataract and cataract surgery. The Blue Mountains Eye Study examined 2,072 women aged 49 years or older during 1992-1994, of whom 1,343 (74.0% of survivors) were reexamined after 5 years, during 1997-1999. Information on reproductive factors and use of hormone replacement therapy was collected using an interviewer-administered questionnaire. Lens photographs were graded for the presence of cortical, nuclear, and posterior subcapsular cataract at baseline and follow-up. Women who had ever used hormone replacement therapy had a decreased incidence of cortical cataract affecting any eye compared with never users (odds ratio = 0.7, 95% confidence interval: 0.4, 1.0). However, this was not statistically significant (odds ratio = 0.7, 95% confidence interval: 0.4, 1.1) when using the first affected eye. Older age at menarche was associated with an increased incidence of cataract surgery (odds ratio = 2.6, 95% confidence interval: 1.2, 5.7) and a significant trend for increasing incidence of nuclear cataract (p = 0.04). There was also a significant trend for decreasing incidence of cataract surgery with increasing duration of reproductive years (p = 0.009). These epidemiologic data provide some evidence that estrogen may play a protective role in reducing the incidence of age-related cataract and cataract surgery.

Age Factors↗
PubMed2002

Smoking and the 5-year incidence of age-related maculopathy: the Blue Mountains Eye Study.

OBJECTIVE: To assess the relationship between baseline smoking and the 5-year incidence of late and early age-related maculopathy (ARM) in an older population cohort. METHODS: The Blue Mountains Eye Study examined 3654 participants aged 49 years or older during 1992 to 1994 and then 2335 survivors (75.1%) after 5 years. Retinal photographs were graded using the Wisconsin Age-Related Maculopathy Grading System. Those with any ARM lesions at either examination were regraded in detail using a side-by-side method similar to that developed for the Beaver Dam Eye Study. We also used similar definitions for incident ARM lesions. Smoking status was recorded at interview. RESULTS: Age-standardized incidence rates for any late ARM lesions were 3.1%, 1.2%, and 1.4%, respectively, among baseline current, past, or never smokers. Corresponding age-standardized incidence rates for early ARM were 10.6%, 8.2%, and 9.3%, respectively. The mean age for cases with incident late ARM was 67 years for baseline current smokers, 73 years for past smokers, and 77 years for those who had never smoked (P =.02). After adjusting for age, current smokers, compared with never smokers, had an increased risk of incident geographic atrophy (age-adjusted relative risk [RR], 3.6; 95% confidence interval [CI], 1.1-11.3) and any late ARM lesions (RR, 2.5; 95% CI, 1.0-6.2). Current smokers had an increased risk of incident retinal pigmentary abnormalities (RR, 1.7; 95% CI, 1.1-2.7), with the risk higher in men (RR, 2.8; 95% CI, 1.4-5.6). OUTCOME MEASURES: Five-year incidence of early ARM, late ARM, and ARM lesions. CONCLUSIONS: In this cohort, persons who were current smokers had an increased risk of 5-year incident late ARM lesions and retinal pigmentary abnormalities. Current smokers developed late ARM at a significantly earlier age than never or past smokers.

Aged↗
PubMed2002

Causes of incident visual impairment: the Blue Mountains Eye Study.

OBJECTIVE: To describe the causes of 5-year incident visual impairment and doubling of the visual angle in a population-based cohort. METHODS: Of the 3654 participants aged older than 50 years who participated in the Blue Mountains Eye Study (BMES I, 1992-1994), 543 died and 2335 were reexamined between 1997 and 1999 (BMES II). Visual acuity was measured using a logMAR chart before and after refraction. Pupils were dilated, and a detailed eye examination was performed. For participants with incident visual impairment or doubling of the visual angle, an ophthalmologist attributed and proportioned causes. Primary causes were defined as those responsible for 50% or more of the impairment. RESULTS: After refractive correction, the proportion of incident bilateral impairment worse than 20/40, worse than 20/70, and worse than 20/200 that were caused primarily by cataract decreased from 51.4% (n = 19) to 40.0% (n = 6) to 0%; while the proportion of cases caused primarily by age-related maculopathy increased from 24.3% (n = 9) to 33.3% (n = 5) to 100.0% (n = 2). Similarly, the corresponding proportions of incident unilateral impairment caused primarily by cataract decreased from 53.7% (n = 72) to 36.9% (n = 31) to 13.6% (n = 6); meanwhile, the proportion of cases caused primarily by age-related maculopathy increased from 19.4% (n = 26) to 32.1% (n = 27) to 54.5% (n = 24). The proportions of persons with incident bilateral impairment worse than 20/40, worse than 20/70, and worse than 20/200 that could be improved with refraction were 79.4% (n = 143), 73.6% (n = 42), and 0%, respectively. The corresponding proportions of incident unilateral impairment improved by refraction were 66.7% (n = 269), 59.0% (n = 121), and 21.4% (n = 12). CONCLUSION: This study has documented the 5-year incidence and causes of visual impairment in an older Australian population.

Age Distribution↗
PubMed2002

Population prevalence of tilted optic disks and the relationship of this sign to refractive error.

PURPOSE: To assess the prevalence of tilted disks and its association with refractive error and visual field defects. DESIGN: Population-based cohort study. METHODS: The Blue Mountains Eye Study examined urban Australians aged 49 years or older between 1992-1994. Of 4,433 eligible participants, 3,654 (82.4%) participated. The eye examination included logMAR visual acuity, standardized refraction, cover testing, stereoscopic optic disk photography, and Humphrey automated perimetry. Inferior or nasal optic disk tilting was graded from stereoscopic photographs. RESULTS: Of 3,583 participants with gradable photographs, inferior or nasal optic disk tilting was observed in 77 eyes of 56 participants (1.6%). The prevalence of tilted disks increased from 0.4% in eyes with astigmatism < 1.0 diopters to 17.9% in eyes with astigmatism >or= 5.0 diopters. The mean astigmatic error was 2.2 diopters in eyes with tilted disks compared with 0.7 diopters in eyes with normal disk appearance, P <.001. Myopia was present in 66.2% of eyes with tilted disks compared with 12.4% of eyes with a normal disk appearance, P <.001. The most common associated features were astigmatism (93.5%), pallor, and tessellation of the adjacent chorioretinal tissues (74.0%), situs inversus of the retinal vessels (70.1%), beta-peripapillary atrophy (64.9%), strabismus (30.4%), visual field defects (19.4%), posterior staphyloma (18.2%), inferonasal pigmentary accumulation (9.1%), and chorioretinal atrophy (5.2%). Superotemporal (33.3%) and superior (25.0%) visual field defects were most frequent. CONCLUSIONS: A tilted disk appearance was not a rare finding in our study population and was strongly associated with astigmatism and higher levels of spherical refractive error, particularly myopia. The tilted disk and its associated visual field defect should be distinguished from other sinister causes.

Age Distribution↗
PubMed2002

Iris color and incident cataract and cataract surgery: the Blue Mountains Eye Study.

PURPOSE: To assess whether an association exists between iris color and the incidence of cataract and cataract surgery. DESIGN: Population-based cohort study. METHODS: The Blue Mountains Eye Study examined 3654 predominantly Caucasian participants aged 49+ years during 1992-1994, and then 2335 survivors (75.1%) after 5 years. Iris color was determined by comparison with four standard photographs. Slit-lamp and retro-illumination lens photographs were graded for presence and severity of cortical, nuclear, or posterior subcapsular cataract. Incident cataract surgery was recorded by history and from the photographs. RESULTS: Participants with dark brown iris color had an increased incidence of nuclear cataract, odds ratio (OR) 1.8, 95% confidence interval (CI) 1.2 to 2.8, and cataract surgery (OR, 2.5; CI, 1.4-4.2) in multivariate models, compared with participants with blue iris color. CONCLUSION: Incidence data from this study support previous cross-sectional findings linking dark brown iris color with age-related cataract.

Aged↗
PubMed2002

Correctable visual impairment in an older population: the blue mountains eye study.

PURPOSE: To describe temporal changes in the characteristics of older persons with visual impairment in their better eye correctable by refraction. DESIGN: Study of two cross sections of a community 6 years apart. METHODS: The Blue Mountains Eye Study examined 3654 persons aged 49 to 97 during 1992 to 1994 (cross-section 1) and 3509 persons (2335 cohort survivors plus 1174 persons who moved to the area and age group) during 1997 to 2000 (cross-section 2). Logarithm of minimal angle of resolution visual acuity was measured before and after refraction. Correctable visual impairment was defined as visual impairment < 20/40 in the better eye before refraction that improved after refraction to no impairment (>/= 20/40). Factors associated with correctable visual impairment and persistent correctable impairment were determined. RESULTS: Cross-sections 1 and 2 had similar age-gender distributions. In cross-section 1, 7.5% of participants had correctable visual impairment, 3.6% had noncorrectable visual impairment, and 88.9% had no impairment. Corresponding rates in cross-section 2 were 5.6%, 2.7%, and 91.7%. In both cross sections, similar proportions (around 68%) of those visually impaired had correctable visual impairment and similar sociodemographic measures predicted correctable visual impairment. Cross-section 1 participants who were married, owned their home, had high job prestige, gained qualifications after high school, or were current drivers were less likely to have correctable visual impairment after controlling for age and gender. Adjusted odds for correctable visual impairment increased in those living alone, using community support services, dependent on others, with myopia, wearing distance glasses, or with low perceived health and heart disease. Histories of stroke, cancer, and diabetes were similar between groups with correctable and no visual impairment. CONCLUSION: Socioeconomic parameters, myopia, wearing distance glasses, reported health problems, and poor perceived health were associated with correctable visual impairment in this older population.

Aged↗
PubMed2002

Prevalence and progression of myopic retinopathy in an older population.

OBJECTIVE: To determine the prevalence and progression of myopic retinopathy in an older community-based population sample. DESIGN: Population-based epidemiologic study. PARTICIPANTS: Eligible residents aged 49 years or older (n = 3654) who attended the Blue Mountains Eye Study, west of Sydney, Australia. METHODS: Participants had a detailed eye examination including measurement of logarithm of the minimum angle of resolution (logMAR) visual acuity, standardized refraction, and retinal stereophotography. All patients were invited to attend follow-up examinations after 5 years. MAIN OUTCOME MEASURES: Myopic retinopathy was defined to include staphyloma, lacquer cracks, Fuchs' spot and myopic chorioretinal atrophy. beta-peripapillary atrophy was assessed separately. RESULTS: Signs of myopic retinopathy were found in 67 eyes from 44 participants (1.2%), a prevalence of 1.4% in women and 1.0% in men; this increased from 1% in right eyes with myopia <3 diopters to over 50% in right eyes with myopia > or =9 diopters. There was a nonsignificant age-related trend in prevalence. The average spherical equivalent refraction was -6.1 diopters and the average visual acuity was 20/40 in eyes with myopic retinopathy. Visual impairment (<20/40) was present in 38.8% of affected eyes. Myopic retinopathy was bilateral in 52% of cases. Staphyloma was present in 26 participants (0.7%), bilateral in 35%, with a strong concordance of staphyloma location. Lacquer cracks were seen in 8 participants (0.2%), Fuchs' spot in 3 (0.1%), and chorioretinal atrophy in 7 (0.2%). Forty-six eyes (68.7%) with myopic retinopathy were reexamined after 5 years; 8.7% had new or increased numbers of lacquer cracks and 15.2% had new or expanded areas of chorioretinal atrophy. In those eyes developing lacquer cracks or chorioretinal atrophy, best-corrected visual acuity decreased by a mean of two LogMAR lines. CONCLUSIONS: This study documented the age and sex-specific prevalence of myopic retinopathy and 5-year progression in an older white population.

Age Distribution↗
PubMed2002

Five-year incidence of age-related maculopathy lesions: the Blue Mountains Eye Study.

PURPOSE: To describe the 5-year incidence and progression of early and late age-related maculopathy (ARM) lesions. DESIGN: Population-based cohort study. PARTICIPANTS: Three thousand six hundred fifty-four noninstitutionalized residents, aged 49 years or older, living in the Blue Mountains area west of Sydney, Australia, participated in the study during 1992 to 1994. The cohort was reexamined after 5 years (1997-1999). Excluding 543 participants who died since the baseline, 2335 (75%) survivors attended 5-year follow-up examinations. METHODS: Retinal photographs from both examinations were graded using the Wisconsin ARM Grading System. Photographs of participants with any ARM lesions at either examination were regraded in detail using a modification of the side-by-side method developed for the Beaver Dam Eye Study. MAIN OUTCOME MEASURES: Incidence and progression of ARM lesions were defined in a similar manner to that used in the Beaver Dam Eye Study. RESULTS: Incidence rates for all ARM lesions increased significantly with age. For late ARM lesions (geographic atrophy and neovascular ARM), the overall 5-year incidence was 1.1%. The combined late ARM incidence was 0.0%, 0.6%, 2.4%, and 5.4% for participants aged 60 years and younger, 60 to 69 years, 70 to 79 years, and 80 years and older at baseline, respectively. After excluding participants with either early or late ARM in either eye at baseline, the overall 5-year incidence of early ARM was 8.7%, including 3.2%, 7.4%, 18.3%, and 14.8% for the corresponding age groups. The incidence of neovascular ARM in women was double that for men (P = 0.1). CONCLUSIONS: This study has documented the incidence of ARM lesions in an older Australian population. The slightly higher incidence of hyperpigmentation found in our population compared with the Beaver Dam Eye Study may be due to sample variability, or this could reflect real differences between the two populations. Our lower incidence of soft drusen could have resulted from our non-inclusion of intermediate soft drusen in the soft distinct and indistinct drusen categories.

Age Distribution↗
PubMed2002

Dietary antioxidant intake and incidence of early age-related maculopathy: the Blue Mountains Eye Study.

OBJECTIVE: To investigate associations between dietary intake, including modest supplement intake, of antioxidant vitamins and zinc at baseline and the 5-year incidence of early age-related maculopathy (ARM). DESIGN: Population-based cohort study. PARTICIPANTS: From 1992 through 1994, 3654 persons aged 49 years or more (82% of those eligible) living in two postcode areas west of Sydney, Australia, were examined for the Blue Mountains Eye Study baseline. Five years later, 2335 persons (75% of known survivors) were reexamined. METHODS: A 145-item Food Frequency Questionnaire (FFQ) was used to assess nutrient intakes. Of the 2335 people who attended a follow-up visit, 1989 (85%) had completed a FFQ at baseline. The nutrients examined in this study included: alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein and zeaxanthin, lycopene, retinol, vitamin A, vitamin C, and zinc. MAIN OUTCOME MEASURES: Early ARM was assessed by masked grading of stereo retinal photographs. Definitions for incidence closely followed those used in the Beaver Dam Eye Study. RESULTS: Early ARM developed in 192 persons (8.7% 5-year incidence) who did not have either late or early ARM at baseline. Of these, 159 persons completed the FFQ at baseline. After adjusting for age, gender, family history of ARM, and smoking status at baseline, no associations, or any trends suggesting possible association, were found between baseline intake of the nutrients examined, apart from vitamin C, and the 5-year incidence of early ARM. Compared with the lowest quintile, increasing baseline intakes of vitamin C, from diet and supplements, was associated with an increased risk of incident early ARM (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.0-3.0; and OR, 2.3; 95% CI, 1.3-4.0 for the fourth and fifth quintiles, respectively). CONCLUSIONS: Our cohort study of an older population could not find evidence of protection associated with usual dietary antioxidant or zinc intakes (including use of supplements) on the 5-year incidence of early ARM.

Aged↗
PubMed2002

Outcome of patients admitted to the intensive care unit with newly diagnosed small cell lung cancer.

Patients with newly diagnosed small cell lung cancer (SCLC) may be considered for admission to an intensive care unit (ICU). Even though SCLC is highly responsive to chemotherapy, it is not clear whether patient outcomes justify the resource use of an ICU. This paper reports the results of a retrospective review of 20 newly diagnosed cases of SCLC who were admitted to one of three ICUs in Melbourne, Australia. Patients who had more than one negative prognostic factor did uniformly poorly, with no survivors beyond 4 months. Five patients were treated with chemotherapy whilst intubated and receiving mechanical ventilatory support. Two of these patients responded to chemotherapy and were extubated 4 days later. Both of these patients were alive and free of tumour recurrence 7 months later. In contrast, patients not treated with chemotherapy died early (within 40 days). We conclude that some patients with SCLC achieve a medium to long-term survival following treatment with chemotherapy instituted during or around the time of their admission to an ICU. The admission to an ICU of selected patients with SCLC may be justified, and prognostic indicators may be of benefit in making these difficult treatment decisions.

Adult↗
PubMed2002

The accuracy of self-reported fractures in older people.

Self-report is often used in large-scale studies. Therefore, it is important to determine the accuracy of self-report. In the Blue Mountains Eye Study, a population-based study of 3,654 older, community-dwelling Australians, subjects were asked about fracture history at the 5-year follow-up interview. All reported non-rib and vertebral fractures were radiologically confirmed. Hospital radiology records were searched for fracture records of people who reported no fractures in the 5-year period. Of 2,326 subjects who came to the interview, 272 subjects reported 318 fractures sustained since 1990. Overall, 34.6% of fracture reports could not be confirmed, mainly due to no record of treatment. Among self-reported fractures, false positive rates were 10.7% for all fractures and 4.8% for hip, 2.2% for wrist, 19.4% for ankle, and 6.6% for shoulder fractures. Sensitivity and specificity of fracture reports was high, with the lowest sensitivity for shoulder fractures (82.4%). Self-report of major osteoporotic fractures is reasonably accurate but may be improved by obtaining more details about treatment.

Aged↗
PubMed2002

Five-year outcome of correctable visual impairment: the Blue Mountains Eye Study.

This report aims to describe the outcome and socio-economic characteristics of older persons attending the Blue Mountains Eye Study (BMES) with persistent correct-able visual impairment (VI). The BMESI examined 3654 persons aged 49+ during 1992-1994 and re-examined 2335 survivors during 1997-1999 (BMES II). Visual acuity was measured before and after standardized refraction. Participants had correctable VI if their better eye was visually impaired <6/12 before refraction (with distance glasses if worn) and was unimpaired after refraction. In BMES I,274 persons (7.5%) had correctable VI, of whom 127 returned to BMES II. Of this group of 127, 34 had persistent correctable VI and 74 were no longer impaired. Fewer persons with correctable VI returned and more died prior to BMES II, compared to persons with no or non-correctable VI. This study showed that persistent correctable impairment was more frequent with increasing age, among women, in those living alone, using community support services,or with a history of heart disease.

Aged↗
PubMed2002

Refractive changes following cataract surgery: the Blue Mountains Eye Study.

This study aimed to assess refractive changes following cataract surgery in subjects attending the Blue Mountains Eye Study baseline examinations in 1992-1994 (3654 residents aged 49+ years),with 2335 (75.1%) survivors re-examined after 5 years. Participants underwent a standardized subjective refraction. History of cataract surgery was confirmed at examination and lens photograph grading. During follow up, 151 persons had cataract surgery (60 bilateral, 91 unilateral). After exclusions, data from 198 eyes(93 right, 105 left) were analysed. The proportions of eyes achieving postoperative spherical equivalent refraction (SER) -0.25 to +0.25 D, -0.50 to +0.50 D, -0.75 to +0.75 D and -1.00 to +1.00 D,were 32%, 44%, 60% and 74%,respectively. The magnitude and direction of refractive changes following cataract surgery were related to the preoperative refraction. Myopic eyes had a hyperopic shift (mean +2.76 D),hyperopic eyes a myopic shift (mean -1.77 D) and emmetropic eyes recorded little change (mean -0.13 D). Astigmatism (> or = 1.00 D cylinder) increased slightly postoperatively, from 47% to 56%, mostly 'against the rule' but with less oblique astigmatism. These findings indicate satisfactory refractive outcomes following current cataract surgery in a random older population.

Aged↗
PubMed2002

Relationship between age and intraocular pressure: the Blue Mountains Eye Study.

This study aimed to assess the influence of age on intraocular pressure(IOP) in a general population. The Blue Mountains Eye Study assessed 3654 residents aged 49+ years during 1992-1994. Intraocular pressure was measured using Goldmann applanation tonometry. Subjects with glaucoma, those currently on glaucoma medications and those with a history of cataract surgery were excluded. The IOP was reliably measured in 3260 subjects. Mean IOP was 16.0 mmHg with no significant difference found between men and women (P < 0.89). In univariate analyses, age was positively associated with IOP (P < 0.05). Systolic blood pressure (SBP) was strongly positively associated with IOP (P < 0.001). After adjusting for SBP, there was a trend for IOP to decrease with increasing age(P < 0.051). After further adjusting for other potential confounders (diabetes, glaucoma family history and myopia), age was no longer significantly associated with intraocular pressure (P < 0.29). In summary,no evidence was found of an independent age affect on IOP.

Aged↗
PubMed2002

Reliability of computer-assisted retinal vessel measurementin a population.

The purpose of the study was to assess the intergrader and intragrader reliability of computer-assisted retinal vessel dia-meter measurement in a defined, community-based population. Retinal photographs from participants in the Blue Mountains Eye Study were digitized using standard techniques. A grader identified all retinal vessels located 0.5-1.0 disc diameter from the optic disc margin,and a computer program measured the width of these vessels. Intergrader and intragrader reliability was assessed on a random sub-sample of 184 and 97 images, respectively, using quadratic weighted kappa(kappa) and correlation analysis (R2). Intergrader reliability was high for summary indices of retinal arteriolar (kappa = 0.85, R2 = 0.88)and venular (kappa = 0.90, R2 = 0.90)diameters, and their ratio, the arteriole-to-venule ratio (kappa = 0.75, R2 = 0.79).Intragrader reliability was also high, with kappa values ranging from 0.80 to 0.93 and from 0.80 to 0.92 for graders 1 and 2, respectively. It is concluded that the retinal vessel diameters could be reliably measured using computer-assisted software and may be used for population-based research.

Aged↗