Læknablaðið - 15.06.1997, Blaðsíða 79

LÆKNABLAÐIÐ 1997; 83
431
A-12. Dilatation and stenting for naso-
lacrimal duct obstruction. The Inver-
clyde experience
Shankar J, Gupta SR, Walsh P
From The Departments of Ophthalmology and
Radiology, Inverclyde Royal Hospital, Greenock,
Scotland
Introduction: We describe our initial experi-
ence with a new procedure-dilatation and stent-
ing of the nasolacrimal duct.
Material and methods: Patients with anatom-
ical or functional blockage of the nasolacrimal
duct underwent dilatation and stenting under lo-
cal anaesthetic using a Teflon sheath guided by
fluoroscopy and digital subtraction techniques.
The sheath was placed with its Malecot shaped
head in the lacrimal sac and tail end protruding
out of the nasolacrimal duct into the inferior
meatus.
Results and conclusion: Stenting of the naso-
lacrimal duct is a viable and relatively non-in-
vasive alternative to conventional dacryocystor-
hinostomy for nasolacrimal duct obstruction.
A-13. Evaluation of a screening program
for diabetic eye disease
Einar Stefánsson, Harpa Hauksdóttir, Jóhannes
Kári Kristinsson, Friðbert Jónasson, Ingimundur
Gíslason
From The Department of Ophthalmology, Uni-
versity oflceland, Reykjavík, Iceland
Purpose: A screening program for diabetic eye
disease has been in effect in Iceland since 1980.
We studied the outcome of this program and per-
formed an epidemiological cross-sectional study
of the prevalence of retinopathy, low vision and
blindness in insulin dependent diabetics.
Material and methods: We reviewed patients
whose age at diagnosis of diabetes was less than
30 years, were insulin dependent and received
annual eye examinations.
Results: Three hundred and six patients partici-
pated, 133 (43.5%) female and 173 (56.5%) male.
Mean age was 31.5 years (4—75 years). Mean age
at diagnosis was 15.0 years (1-29 years). Meandu-
ration of diabetes was 16.4 years. 158 (51.6%) had
retinopathy, 135 (44.1%) had retinopathy in both
eyes and 23 (7.5%) had retinopathy in one eye.
Forty (13.1%) had proliferative retinopathy.
3.5% of those with diabetes for less than 20 years
had proliferative retinopathy and 30.8% of those
who had the disease for 20 years or more. Thirty
eight (12.4%) received panretinal photocoagula-
tion, 23 (7.5%) macular photocoagulation and 12
(3.9%) had vitrectomy. Six (2.0%) patients had
low vision (visual acuity less than 6/18 in the better
eye). Three of those had low vision for reasons
other than diabetes. One (0.3%) was blind (vi-
sion worse than 3/60 on the better eye).
Conclusion: Diabetics who participate in a reg-
ular screening program in Iceland have a low
prevalence of blindness and low vision compared
to neighboring countries, whereas the prevalence
of diabetic eye disease is similar.
A-14. The genetics of age-related mac-
ular degeneration in the west of Scot-
land. The search for candidate genes
Gavin MP*, Sutcliffe RG**, Hall N***, Wardrop
D***, Wykes WN***
From *The Tennent Institute of Ophthalmology,
Western Infirmary, Glasgow, **The Laboratory
of Genetics, University of Glasgow, Glasgow,
***The Department of Ophthalmology, Southern
General Hospital, Glasgow, Scotland
Introduction: Age-Related Macular Degener-
ation (ARMD) is the commonest cause of regis-
trable blindness in the UK.There is increasing
evidence that there is a familial component con-
tributing to its development. We set out to in-
vestigate the genetic contribution to ARMD in a
West of Scotland population and to locate poten-
tial candidate genes in affected individuals using
several micro-satellite markers.
Material and methods: Patients with ARMD
and available first degree relatives were included.
A randomly selected, age- and sex-matched con-
trol population was obtained. Patients and con-
trols had fundus images recorded using a scanning
laser ophthalmoscope and/or colour photogra-
phy. Fundal changes were graded by the author
and anindependent ophthalmologist. DNA sam-
ples have been examined using micro-satellite
markers to locate potential risk genes.
Results: To date, 43 propositi had relatives
(mainly siblings) available for study (a total of 86
subjects). The prevalence of ARMD amongst sib-
lings was significantly higher than in our control
group of 70 patients (p<0.0001; Yate’s corrected
Chi-square test) with a relative risk to a sibling of
an affected patient of 4.52.
Discussion: There is a significant genetic com-
ponent to ARMD in the population studied sup-
porting the logic behind searching for appropriate
candidate genes.We shall present the results of
our recently completed micro-satellite marker
analysis.