CLINICAL CORNER – APRIL 2010

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UNTREATED POOR VISION LEADING TO ALZHEIMER’S. Elderly people with visual disorders that are left untreated are significantly more likely to develop Alzheimer’s disease, according to the University of Michigan Health System. Using Medicare data, the study showed that those with poor vision who visited an ophthalmologist at least once during the time of the study for an examination were 64% less likely to develop dementia. The types of vision treatment that were helpful in lowering the risk of dementia were surgery to correct cataracts and treatments for glaucoma, retinal disorders, and other eye-related problems.

HRT AND CATARACT RISK. Researchers from Sweden investigated the association between hormone replacement therapy (HRT) and the incidence of cataract extraction among postmenopausal women. A total of 30,861 women, aged 49 to 83, were followed from September 1997 through October 2005. The study found that postmenopausal women using HRT for a long period of time were at an increased risk for cataract extraction, especially those consuming more than one alcoholic drink daily.

OCULAR SHINGLES LINKED WITH STROKE. Taiwanese researchers identified 658 people diagnosed with ocular shingles and 1,974 without the infection. None of these people had a history of stroke at the beginning of the one-year study. After completion, it was discovered that people with shingles were 4.5 times more likely to have a stroke compared to people without shingles. Results were the same regardless of age, gender, high blood pressure, diabetes, heart disease, and medications.

SMOKING CONTRIBUTING TO EYE INFLAMMATION. Researchers from the University of California studied 564 patients with ocular inflammation seen in the Proctor Foundation uveitis clinic between 2002 and 2009, and 564 randomly selected patients seen in the eye clinic within the same period. The odds of a smoker having ocular inflammation were over twofold that of a patient who had never smoked. It was concluded that a history of smoking is significantly associated with all anatomic subtypes of uveitis and infectious uveitis.

IMPORTANCE OF TREATING OCULAR HYPERTENSION EARLY. The Ocular Hypertension Treatment Study compared earlier versus later treatment in preventing primary open-angle glaucoma (POAG) in individuals with ocular hypertension. The randomized, un-blinded study used 1,636 individuals with intraocular pressure of 24mm to 32mm Hg in one eye and 21mm to 32mm Hg in the other. Researchers initially assigned patients to either immediate treatment for ocular hypertension with standard topical medications or no treatment (with an option to accept treatment at a later date). Patients at high risk for glaucoma because of ocular hypertension appeared to benefit the greatest from early drug treatment.

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