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PubMed2004

Cataract extraction following penetrating keratoplasty.

OBJECTIVE: To assess the safety of cataract extraction following penetrating keratoplasty for corneal graft survival and to evaluate visual and refractive outcomes in corneal graft patients undergoing cataract extraction. METHODS: Retrospective chart review of 29 eyes of 24 patients with corneal grafts who underwent cataract extraction from January 1, 1993 to December 31, 2002, followed on the Cornea Service at Wills Eye Hospital. RESULTS: The mean time from penetrating keratoplasty to cataract extraction was 8.4 years (range 2 months to 36 years). Following cataract extraction, the corneal grafts remained clear in all but 1 eye (3%), during an average follow-up time of 44.5 months (range 3-118 months). All of the remaining patients benefited from improved visual acuity, with 15 of 28 patients having a postoperative best-corrected visual acuity of 20/30 or better. Patients also benefited from decreased absolute spherical refractive error, with a preoperative mean value of 6.6 +/- 3.4 D compared with 2.4 +/- 1.6 D postoperatively, while cylindrical refractive error remained relatively stable at 3.2 +/- 2.9 D preoperatively and 2.8 +/- 2.4 postoperatively. The patient who developed graft failure had 3 episodes of preoperative endothelial rejection and a clear corneal graft at the time of cataract surgery. CONCLUSIONS: Cataract surgery following penetrating keratoplasty is a safe and effective procedure, with a low but definite risk of corneal graft failure. In patients with clear grafts and visually significant cataracts, cataract extraction alone is preferred over repeat penetrating keratoplasty and cataract extraction.

Aged↗
PubMed2005

Effect of cataract surgery on cognitive function in older adults.

OBJECTIVES: To assess whether cataract surgery has an effect on cognitive function in older adults. DESIGN: Longitudinal. SETTING: Assessment of patients seen in eye clinics. PARTICIPANTS: Patients with no cataract (n=92), patients with cataract who elected surgery (n=122), and patients with cataract who declined surgery (n=87). MEASUREMENTS: At baseline and 1-year follow-up visits, the following information was obtained: demographic, health behavior, general health status, medication use, depressive symptoms, cognitive function, and visual function information. This information was compared within and between groups at baseline and follow-up visits. RESULTS: Mattis Organic Mental Syndrome Screening Examination scores at baseline and follow-up varied across the three groups, with the cataract/no surgery group having the highest scores (more cognitive impairment) and the no-cataract group having the lowest scores (less cognitive impairment). For the within-group analysis, at follow-up, the cataract/no surgery group and the cataract/surgery group had significantly less cognitive impairment (P<.001), whereas the no-cataract group experienced no change. For those with cataract, there were no associations between changes in visual function and cognitive function. CONCLUSION: Improvement in cognitive function may occur after cataract surgery but cannot be attributed to the cataract surgery per se or to improved visual function. Clinicians may find this information useful when discussing the nonvisual outcomes of cataract surgery with patients.

Aged↗
PubMed2006

Retrobulbar blood flow in patients with cataract.

OBJECTIVE: To investigate retrobulbar haemodynamics in patients with cataract. SUBJECTS AND METHODS: Colour Doppler imaging of the ophthalmic artery was carried out on the eye scheduled for surgery in 30 patients with cataract and in one randomly selected eye of 100 healthy controls. The peak systolic velocity, mean velocity, end diastolic velocity and resistivity index in the ophthalmic artery were computed and adjusted for the influence of age and mean arterial pressure. Cataract type was recorded and lens opacity was measured with an opacity lensmeter. Odds ratio (OR) for cataract was analysed in a logistic regression model, depending on the adjusted blood-flow parameters, age and smoking status. RESULTS: The mean (SD) age was 45.5 (17.7) and 67.6 (5.8) years in controls and patients with cataract, respectively (p<0.001). The female to male ratio was 54:46 and 13:17, respectively (p = 0.41). Significant predictors of cataract in a forward stepwise logistic regression analysis were age (OR = 1.194; 95% confidence interval (CI) = 1.103 to 1.292; p<0.001), smoking status (OR = 14.119; 95% CI = 2.753 to 72.398; p = 0.002) and mean blood-flow velocity in the ophthalmic artery (OR = 0.731; 95% CI = 0.607 to 0.881; p = 0.001). Adjusted mean velocity was significantly lower in patients with cataract, even when only age-matched (age >55 years) non-smokers (31 controls, 19 patients with cataract) were considered (p = 0.003). Lens opacity and the type of cataract had no influence on the present findings. CONCLUSION: High mean velocity in the ophthalmic artery may be associated with a reduced risk of cataract.

Adult↗
PubMed2002

Relation of ocular trauma to cortical, nuclear, and posterior subcapsular cataracts: the Beaver Dam Eye Study.

BACKGROUND: The consequences of minor ocular trauma in the general population are unclear. The relation of self reported ocular trauma to cortical, nuclear, and posterior subcapsular cataracts is described in a defined population. METHODS: Population based, cross sectional study involving all people aged 43 to 86 years, living in Beaver Dam, Wisconsin (n=4926). Ocular trauma was ascertained by interview and cataract was graded from lens photographs. The relation of ocular trauma to cortical, nuclear, and posterior subcapsular cataracts was examined. RESULTS: People with a history of ocular trauma were more likely to have cortical (odds ratio (OR): 1.5; 95% confidence interval (CI): 1.0 to 2.2) and posterior subcapsular (OR: 1.7; 95% CI: 1.0 to 3.1) cataracts, compared to people without a history of trauma. These associations were stronger for people with previous trauma caused by a blunt object (OR: 3.3; 95% CI: 1.6 to 6.9 for cortical cataract, and OR: 4.1; 95% CI: 1.5 to 10.8 for posterior subcapsular cataracts). However, in analyses comparing the frequencies of cataract between traumatised and non-traumatised eyes among people with unilateral ocular trauma, the ocular trauma association for cortical cataract was no longer present, although the association for posterior subcapsular cataract persisted (OR: 2.4; 95% CI: 0.8 to 7.8). CONCLUSION: The data provide evidence of a possible association between self reported ocular trauma and posterior subcapsular cataract.

Adult↗
PubMed2002

Increased mortality in women with cataract: a population based follow up of the North London Eye Study.

BACKGROUND/AIMS: In diabetics, cataract is associated with higher risk of death. In non-diabetics the data are conflicting, but some indicate an association between one type of cataract (nuclear) and increased mortality. The aim of this study was to estimate and compare age and sex specific mortality for elderly people with and without cataract in a population based cohort. METHODS: A random sample drawn from a defined population of elderly people (age 65 and older) registered with 17 general practice groups in north London formed the study cohort and were followed up for 4 years. The age and sex specific mortality from various causes was estimated and compared in those with and without cataract. RESULTS: In non-diabetics (n=1318), cataract (lens opacity at baseline) was significantly associated with higher mortality in women. The age standardised death rate per 1000 was 39.8 and 24.8 in women with and without cataract, respectively (age adjusted hazard ratio 1.7, confidence limits 1.1 to 2.7, p=0.032). This was not the case in non-diabetic men (hazard ratio 0.9, confidence limits 0.6 to 1.5, p=0.782). The excess mortality in women with cataract was consistent for cardiovascular, respiratory, and other non-cancer causes of death. There was no association between cataract and mortality from cancer. CONCLUSIONS: This study has shown, for the first time, that cataract is associated with higher mortality in women but not in men, among the non-diabetic population. This sex effect suggests that women may be exposed to risk factors that increase both the risk of cataract and mortality, and that men may have little or no exposure to these "sex specific" factors. Possible risk factors that warrant further investigation may be those associated with some pregnancy and childbearing experience.

Age Distribution↗
PubMedDate not supplied

Correlation of human age-related cataract with some blood biochemistry constituents.

PURPOSE: The causes of age-related cataract are multifactorial and particular consideration has been given to the role of nutritional factors in cataract formation. The purpose of this study was to determine the levels of certain blood biochemistry constituents in cataract patients and controls and evaluate their potential, if any, as identifying risk factors in cataractogenesis. METHODS: This is a case-control study where 155 cataract patients and 155 matched controls were chosen for evaluation. Cataract subjects were further divided into subgroups depending on the location of the cataract. All underwent routine eye examinations and blood samples were taken from each one for blood biochemistry analysis including serum levels of glucose, urea, cholesterol, triglycerides, total protein, albumin, bilirubin, calcium, sodium and potassium and the enzymes aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase. RESULTS: Mean levels of total protein, bilirubin, calcium, sodium, alanine aminotransferase and alkaline phosphatase differed significantly between patient and control groups. Patients with posterior subcapsular cataract had significantly higher glucose levels (p = 0.05) compared with patients with other types of cataract. It was also found that those patients with a cortical cataract had the highest level of urea, differing significantly from other subgroups and controls. CONCLUSIONS: The mean levels of all constituents under study fell within normal body range. However, the levels of several important factors demonstrated a positive and significant correlation with cataract. While we do not presume to present these results as conclusive, it is possible that a gradual and constant variation in these parameters may be predisposing factors in cataractogenesis.

Adult↗
PubMed1990

Lenticular rubidium uptake and plasma renin activity in weanling cataract-prone salt-sensitive rats.

Our earlier studies of cataracts in Dahl salt-sensitive (DS) rats suggested the possibility of altered lens ion transport as a contributing factor in cataractogenesis in this genetic model. We also observed that those weanling DS rats with the greatest pressor response to a high salt diet eventually developed cataracts, and that changes in salt intake modified cataract formation. In the present studies, we measured lens 86Rb uptake as an index of sodium-potassium adenosine triphosphatase [(Na+,K+)-ATPase] activity in weanling DS rats before the development of cataracts or sustained hypertension. Additionally, plasma renin activity was measured to indirectly assess our hypothesis that the difference between cataract-prone DS rats and DS rats unlikely to develop cataracts might be a difference in degree of salt sensitivity. At the age of 4 weeks, 50 DS and 25 salt-resistant (DR) rats were given a high sodium diet for 2 weeks, at which time the rats were divided into three groups based on the systolic blood pressure response, that is, cataract-prone DS rats with systolic blood pressure equal to or greater than 155 mm Hg, DS rats unlikely to develop cataracts with systolic blood pressure less than or equal to 125 mm Hg, and DR rats. Lens and aqueous humor Na+ and K+, lens dry weight, and water content were not significantly different among the three groups of weanling rats. Plasma renin activity was lowest in cataract-prone DS rats and low in DS rats unlikely to develop cataracts when compared with values in DR rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2003

Impact of age and sex in ultraviolet radiation cataract in the rat.

PURPOSE: The purpose of this study was to determine the influence of age and sex on the development of ultraviolet radiation (UVR) cataract in rats. Current safety limits for lens damage due to UVR do not consider age or sex. METHODS: Four age groups of Sprague-Dawley rats (3, 6, 17, and 52 weeks) were exposed to 300-nm UVR at either 5 or 8 kJ/m(2), delivered during 15 minutes. The interval between irradiation and cataract assessment was 1 or 8 weeks. Moreover, two groups of 6-week-old male and female rats were exposed to 5 kJ/m(2) UVR, with cataract assessment after 1 week. The severity of cataract was quantified by measurement of forward light-scattering in isolated lenses. RESULTS: The youngest age group showed development of anterior subcapsular, equatorial, and nuclear cataract, whereas the three older groups exhibited the first two types. The two younger age groups had significantly more cataract than the other groups. The degree of cataract increased from 1 to 8 weeks after irradiation. There was no difference in cataract severity between sexes. CONCLUSIONS: Young rats are more sensitive to UVR than old rats. Nuclear UVR cataract develops in young rats but not in adult rats. With the chosen waveband and dose, the time for maximum cataract development to occur is longer than 1 week. There is no difference in UVR sensitivity between the sexes.

Age Factors↗
PubMed2005

Risk factors for idiopathic congenital/infantile cataract.

PURPOSE: To investigate maternal, demographic, and pre- and perinatal risk factors for idiopathic congenital/infantile (ICI) cataract. METHODS: Based on national registries, a cohort of all children born in Denmark and aged 0 to 17 years during 1977 to 2001 was established, and congenital/infantile cataract cases were identified. Cases of unknown/idiopathic cause were included in the study. Associations between maternal, demographic, and pre- and perinatal factors with the development of cataract were investigated. RESULTS: In a cohort of 2.9 million children, 1027 cases of congenital/infantile cataract were identified. Of the children in those cases, 629 were born in Denmark and had ICI. Bilateral isolated cataract cases were male dominated (62%; 95% confidence interval [CI], 56%-69%) but not unilateral isolated cases (40%; 95% CI, 34%-47%). Older age (> or =40 years) of mothers at delivery and caesarean section increased the risk of ICI cataract. Low birth weight (< 2000 g) was associated with a 10.6-fold (95% CI, 6.99-16.10) increased risk of bilateral, but not unilateral, ICI cataract. No significant associations were found with birth order, month/place of birth, or cigarette smoking during pregnancy. CONCLUSIONS: Variables indicative of environmental influence were not associated with ICI cataract. Low-birth-weight children (< 2000 g) had a significantly increased risk of bilateral ICI, whereas no strong risk factors were found for unilateral cataract. Together with the sex difference, this suggests that the etiologies of bilateral and unilateral cataract are different.

Adolescent↗
PubMed2005

Critical flicker frequency as a potential vision technique in the presence of cataracts.

PURPOSE: Potential vision testing attempts to predict the visual outcome that might be expected as a result of a cataract operation. This report details the clinical utility of critical flicker frequency (CFF) as a potential vision test (PVT). METHODS: CFF thresholds were determined in 31 subjects with age-related idiopathic cataract and no other eye disease, 19 subjects with macular disease (MD) and clear ocular media, and 24 age-matched control subjects. In addition, the CFF technique was administered before cataract surgery in 52 patients and compared with the information provided by presurgical case history and ocular examination alone (ophthalmological judgment [OJ]) and results from two commonly used PVTs (the retroilluminated pinhole and the potential acuity meter). RESULTS: CFF thresholds obtained in the nonsurgical cataract group were unrelated to cataract severity and were similar to those in the control group. In contrast, CFF scores were significantly related to visual acuity (VA) in the MD group. In the pre- and postsurgical studies, OJ predicted postoperative VA very well in patients with moderate cataract and normal fundi and better than all the PVTs. OJ performed less well in patients with comorbid eye disease and dense cataracts, when information from the PVTs would probably have been useful. CFF provided the most accurate predictions of postoperative VA in the small sample of patients with dense cataracts. CONCLUSIONS: CFF was unaffected by cataract, yet sensitive to MD, and provided useful information about the postoperative visual outcome beyond that obtained through history and ocular examination in patients with dense cataracts.

Aged↗
PubMed2003

Analysis of nuclear fiber cell compaction in transparent and cataractous diabetic human lenses by scanning electron microscopy.

BACKGROUND: Compaction of human ocular lens fiber cells as a function of both aging and cataractogenesis has been demonstrated previously using scanning electron microscopy. The purpose of this investigation is to quantify morphological differences in the inner nuclear regions of cataractous and non-cataractous human lenses from individuals with diabetes. The hypothesis is that, even in the presence of the osmotic stress caused by diabetes, compaction rather than swelling occurs in the nucleus of diabetic lenses. METHODS: Transparent and nuclear cataractous lenses from diabetic patients were examined by scanning electron microscopy (SEM). Measurements of the fetal nuclear (FN) elliptical angles (anterior and posterior), embryonic nuclear (EN) anterior-posterior (A-P) axial thickness, and the number of EN fiber cell membrane folds over 20 microns were compared. RESULTS: Diabetic lenses with nuclear cataract exhibited smaller FN elliptical angles, smaller EN axial thicknesses, and larger numbers of EN compaction folds than their non-cataractous diabetic counterparts. CONCLUSION: As in non-diabetic lenses, the inner nuclei of cataractous lenses from diabetics were significantly more compacted than those of non-cataractous diabetics. Little difference between diabetic and non-diabetic compaction levels was found, suggesting that diabetes does not affect the degree of compaction. However, consistent with previous proposals, diabetes does appear to accelerate the formation of cataracts that are similar to age-related nuclear cataracts in non-diabetics. We conclude that as scattering increases in the diabetic lens with cataract formation, fiber cell compaction is significant.

Aged↗
PubMed1990

Nonosmotic diabetic cataracts.

It has been suggested that sugar cataracts associated with diabetes mellitus result from the accumulation of excess sorbitol within lens fibrils. Swelling of lens fibrils occurs when water moves in to maintain osmotic balance; the excess water causes disruption of fibrils and cataract formation. Other studies have indicated that more than sorbitol-induced osmotic stress is involved. Our study used lenses collected from rats after 21 or 44 d of streptozotocin diabetes. Cataracts formed in untreated 44-d streptozotocin diabetic rats, but were not apparent in the 21-d untreated diabetic animals. Lens sorbitol increased in the diabetic animals both before and after cataract formation. Lens taurine varied inversely with the sorbitol content in a fashion that resulted in no net change in total lens osmoles. Lens water did not increase in the diabetic animals with or without cataracts. The aldose reductase inhibitor Sorbinil prevented the increase in lens sorbitol in both the 21- and 44-d streptozotocin diabetic rats; cataract formation was prevented in the 44-d diabetic animals. The lens water in untreated diabetic animals with cataracts did not differ from lens water in the Sorbinil-treated diabetic animals that did not develop cataracts. Sorbinil treatment of diabetic animals was associated with normalization of both lens sorbitol and taurine levels. Taurine has been shown to serve both as an osmoregulator and as an antioxidant. The apparent increase in lens osmolality attributed to sorbitol was counterbalanced by an equimolar reduction in taurine concentration. The reciprocal relationship between taurine and sorbitol reduces the likelihood of an osmotic mechanism for sugar cataractogenesis; the reduced lens taurine, however, may increase the risk of lens protein oxidation and subsequent cataract formation. Thus in vivo sugar cataract formation may be an oxidative process rather than an osmotic phenomenon.

Aldehyde Reductase↗
PubMed1996

Suppression of hyperlipidemia-associated cataracts in diabetic rats with the lipoprotein lipase activator NO-1886.

Diabetic cataracts are thought to be caused by hyperglycemia associated with disturbed glucose metabolism. Diabetes mellitus often involves abnormal lipid metabolism in addition to abnormal glucose metabolism. To date, however, very few studies have counted hyperlipidemia as a risk factor for diabetic cataracts. The present study was undertaken to determine whether this actually is a risk factor for diabetic cataracts and to confirm that the onset of cataracts associated with diabetes mellitus can be suppressed by correction of hyperlipidemia. When rats with streptozotocin (STZ)-induced diabetes mellitus were fed an ordinary diet, cataracts became evident at 9 weeks in 26.7% of animals, and increased to an incidence of 73.3% after 10 weeks of STZ treatment. However, in rats with STZ-induced diabetes mellitus that were fed a cholesterol rich diet to induce severe hyperlipidemia, cataracts were observed one week earlier, after 8 weeks of treatment, in 36.0% of animals, with an increase to a 52.0% incidence and a 76.0% incidence after 9 and 10 weeks of STZ treatment, respectively. Hyperlipidemia was therefore associated with an earlier onset and an elevated incidence of diabetic cataracts. When the lipoprotein lipase (LPL) activator NO-1886 was administered to diabetic rats which had developed severe hyperlipidemia, they showed a decrease in plasma total cholesterol, triglyceride and non-high density lipoprotein (non-HDL)-cholesterol levels and an increase in high density lipoprotein (HDL)-cholesterol level, and the onset of diabetic cataracts was markedly suppressed. The results of this study suggest that hyperlipidemia and low HDL-cholesterol levels may be risk factors for the onset of diabetic cataracts, and that this onset can be suppressed if measures are taken to alleviate these risk factors. The LPL activator NO-1886 may be useful in preventing the onset of diabetic cataracts.

Animals↗
PubMed2000

Development of glaucoma after cataract surgery in dogs: 220 cases (1987-1998).

OBJECTIVE: To examine postoperative ocular hypertension (POH) and other variables as predictors of the risk of developing glaucoma after cataract surgery in dogs. DESIGN: Retrospective study. ANIMALS: 220 dogs that had cataract surgery. PROCEDURE: Medical records of 220 dogs (346 eyes) that had extracapsular cataract removal or phacoemulsification of cataracts were reviewed. With respect to glaucoma development, 8 variables were analyzed, which included development of POH, breed, sex, age at time of surgery, eye (right vs left), phacoemulsification time, intraocular lens (IOL) placement (yes or no), and stage of cataract development. Eyes developed glaucoma within 6 or 12 months of surgery or did not have signs of glaucoma at least 6 or 12 months after cataract surgery. RESULTS: Of 346 eyes, 58 (16.8%) developed glaucoma after surgery. At 6 months, 32 of 206 (15.5%) eyes examined had glaucoma; at 12 months, 44 of 153 (28.8%) eyes examined had glaucoma. Median follow-up time was 5.8 months (range, 0.1 to 48 months). Mixed-breed dogs were at a significantly lower risk for glaucoma, compared with other breeds. Eyes with IOL placement were at a significantly lower risk for glaucoma, compared with eyes without IOL placement. Eyes with hypermature cataracts were at a significantly higher risk for glaucoma, compared with eyes with mature or immature cataracts. CONCLUSIONS AND CLINICAL RELEVANCE: Multiple factors appear to contribute to the onset of glaucoma in dogs after cataract surgery. Complications prohibiting IOL placement during cataract surgery may lead to a high risk of glaucoma development.

Animals↗
PubMed1984

Molecular mechanism of cataractogenesis: III. Toxic metabolites of oxygen as initiators of lipid peroxidation and cataract.

A free radical mechanism of cataractogenesis involving enzymatic and nonenzymatic reactions, is proposed. Supporting experimental evidence is briefly reviewed. H2O2, which is one of the toxic metabolites of oxygen, was significantly increased 2-3 fold in ocular humors in several experimental cataracts and in human senile cataract. Various cataractogenic agents were also found to increase H2O2 in ocular humors in vivo prior to cataract formation. Enzymatic defenses against O2-. and H2O2 provided by superoxide dismutase, catalase and glutathione peroxidase were impaired in cataracts. In some cataracts, catalase and superoxide dismutase were affected earlier. Malondialdehyde (MDA), a major breakdown product of lipid peroxides was significantly increased by 2-4-fold in human senile cataract, in cataracts induced in rabbit and rat, and in hereditary cataracts in mice. All the reactive species of O2 (O2-., H2O2, OH. and 1 delta gO2) may participate in initiating lipid peroxidation of lens in vitro. Various scavengers of these species were capable of preventing lenticular lipid peroxidation, amongst which OH. scavengers were found to be the most effective. Biological antioxidant, vitamin E afforded 44% prevention of lipid peroxidation in lens. The important observation was that vitamin E was therapeutically effective in about 50% of animals in arresting cataract induced in rabbit by 3-aminotriazole. In these rabbits, H2O2 and ascorbic acid of ocular humors and MDA of lens were close to normal. It is our working hypothesis that the carbonyl groups of MDA and amino groups of amino acids, proteins, nucleic acids and their bases, and phospholipids could interact in a cross-linking reaction producing high molecular weight aggregates by Schiff-base conjugate formation in addition to disulfide cross-linking of proteins, and finally resulting in cataract.

Animals↗
PubMed1988

Standardization and analysis of digitized photographic data in the longitudinal documentation of cataractous growth.

Age-related cataract formation in man can be documented with slit and retroillumination photographs. With digitization and image analysis of such photographs a cataract may be characterized by a frequency distribution of picture elements over a 255 step gray scale spectrum. Transition from a clear to a cataractous lens may be manifested as a change from a unimodal, Gaussian to a multimodal, non Gaussian frequency distribution respectively. How should one compare and contrast these two distributions, so to accurately describe the extent and significance of a change in lens opacification? The in vitro system of cold cataract formation in the rabbit lens was used as a model of the much slower process of age-related cataract formation in man. As in the human lens undergoing progressive opacification, the frequency distribution (number of pixels vs. intensity of gray) for a digitized image of a clear lens at 26 degrees C is unimodal and Gaussian; that of a fully developed cold cataract at 10 degrees C is multimodal and non-gaussian. In spite of the increasing multimodality of the frequency distribution as the temperature dropped and the cataract grew in density and size, the mean gray density proved to be a valid and useful measure to characterize the distribution and to compare different unaligned images. The Wilcoxon Rank Sum Test proved to be useless in comparing the frequency distributions from cataract images because it proved to be too sensitive to subtle changes in the degree of opacification. Anomalous behavior of the opacification process--i.e. clarification as well as opacification of the lens during cold cataract formation caused all pairs to appear statistically significantly different when in appearance there was no difference. The mean of the frequency distribution is less sensitive to this anomalous behavior and is useful as a comparative index. The method of calculating the threshold of significant change in the mean density of a cataract image is presented.

Animals↗
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↗
PubMed2001

An epidemiological study of cataracts in seawater farmed Atlantic salmon Salmo salar.

Cataracts in farmed Atlantic salmon have been known for many years, but the aetiology and importance of the disease have not been clarified. A cross-sectional field study of 51 cages of Atlantic salmon at 49 randomly selected sea sites was performed during the summer of 1998. The target population was spring and autumn entry groups of the 1997 generation salmon. Approximately 15 fish from each cage, altogether 777 fish, were autopsied by the same person. Each eye of the fish was scored for cataracts on a scale from 0 to 4 using an otoscope lamp with magnification. The weight and length of each fish were measured. The prevalence of cataracts was 83 % and 79% in spring entry groups and autumn entry groups, respectively. The overall mean cataract index (mean score of both eyes) was 1.23, being significantly higher in the spring entry groups (1.36) than the autumn entry groups (0.85). The final results in the spring entry groups showed that the fish groups with higher weight at sea transfer also had a higher cataract index at inspection. The risk of development of cataracts varied significantly among the offspring from the 5 strains represented in the study. Fish from sites located in 2 counties in the southern part of Norway had a significantly higher cataract index than fish farmed in the northernmost county in the study. For the autumn entry groups none of the explanatory variables was significant. In the spring entry groups a significant negative relationship was observed between the cataract score and the weight of the fish at the time of inspection (Pearson's r = -0.17), while the corresponding correlation for the autumn released groups was r = -0.10. Among the spring entry groups the average weight of the fish with the highest cataract score was estimated to about a third of the weight of the fish with no visible cataracts.

Animals↗