RESUMO
The first reports about pterygium date back to Hippocrates, and this disease still threatens vision health around the world. Pterygium is a formation of fibrous tissue consisting of highly vascularized epithelial and subepithelial tissue that grows excessively and with an abnormal shape on the cornea. Many physical and biological factors are associated with the pathogenesis of pterygium, including heat, dust, and other particles in the atmosphere, and immunological mechanisms, mechanisms involving extracellular matrix reorganization, growth factors, cytokines, apoptosis, and angiogenesis. The aim of this study was to further investigate the association between polymorphisms in GSTM1 and the formation of pterygium. We collected peripheral blood samples from 90 patients diagnosed with pterygium and from 23 subjects with-out the disease in order to perform molecular analysis of the GSTM1 gene. Subjects with one or two copies of the GSTM1 allele had a normal genotype while those without any copies of the allele had a null geno-type. The chi-square test or the Fisher exact test was performed in order to investigate possible associations between the molecular analysis and the risk of pterygium. A significant difference between the frequency of the GSTM1-null genotype in patient and control groups was identified. However, sub-group analysis found that the GSTM1-null genotype was statistically significant in men, but not in women, and in Caucasians, but not in Brown or Black groups. Furthermore, the GSTM1-null geno-type was not related to any of the risk factors analyzed: cases in family, occupational exposure, smoking, hypertension, and diabetes.
Assuntos
Glutationa Transferase/genética , Polimorfismo Genético , Pterígio/etnologia , Pterígio/genética , População Branca/genética , Brasil/etnologia , Estudos de Casos e Controles , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Fatores SexuaisRESUMO
Pterygium is an inflammatory and degenerative ocular surface disease in which the conjunctiva on the cornea grows to form a fibrous tissue in the shape of a triangle. The disorder may be characterized by cell proliferation, inflammatory processes, fibrosis, angiogenesis, and destruction of the extracellular matrix. The anomaly is considered a degenerative eye disease and is erroneously confused with cataract. It displays similar features to those of tumors, such as local invasion, metaplasia of epithelial cells, presence of oncogenic viruses (human papilloma virus), inactivation of tumor suppressor genes (e.g., p53), and loss of heterozygosity. The treatment of pterygium is based on factors such as the evolution and progression of the disease, risk factors, symptoms, and patient age. Considerations about the best technique for the surgical removal of pterygium remain controversial, and complications and recurrence are very common. The development of new surgical techniques and adjuvant drugs is thus necessary. This study aims to analyze and compare the frequency of the GSTT1 genotypes in relation to pterygium through statistical analyzes in order to build a genotypic profile for the Replicon patients. The genotypic profile of the GSTT1-null polymorphism in Goiânia showed no significant difference when the frequency of the null genotype was compared between the control and experimental groups. The null genotype was more frequent in the population studied. Furthermore, the GSTT1 genotype was not related to the analyzed risk factors for pterygium, namely gender, ethnicity, family history, occupational exposure, smoking, hypertension, and diabetes.
Assuntos
Glutationa Transferase/genética , Polimorfismo Genético , Pterígio/genética , Brasil , Estudos de Casos e Controles , Diagnóstico Diferencial , Feminino , Estudos de Associação Genética , Genótipo , Humanos , Masculino , Pterígio/etnologia , Fatores de RiscoRESUMO
PURPOSE: To evaluate the prevalence and characteristics of pterygium in small communities along the Solimões and Japurá rivers, State of Amazonas, Brazil. Design: cross-sectional study. METHODS: This study was carried out on populations of the Brazilian Amazon rainforest. Data were collected by two separate ophthalmologists in three expeditions, covering 55 local communities. A total number of 1295 patients were examined, of which 659 were over 18 years old. The patients diagnosed with pterygium answered a questionnaire addressing gender, age and outdoor activity. Pterygium lesion sizes were graded as grade 1 (lesion covers until limbus), grade 2 (lesion covers cornea by 2 mm), grade 3 (lesion surrounds the pupil) and grade 4 (lesion crosses the pupil). RESULTS: Pterygium prevalence was 21.2 percent for the overall population and 41.1 percent in those over 18 years old. Patients between 40-50 years old were most affected by pterygium. Pterygium data distribution by gender showed that 57.8 percent were men. The majority of the patients diagnosed with pterygium was active outdoors (89.5 percent). Subjects affected in both eyes were 75.6 percent. Of the total population positive to pterygium the majority was grade 1 (44 percent) and 2 (48.7 percent). Most of the patients (85 percent) developed nasal pterygium. CONCLUSION: This study shows one of the highest prevalences of pterygium in the world, covering a Brazilian region never studied before.
OBJETIVO: Avaliar a prevalência e as características do pterígio em comunidades ribeirinhas dos rios Solimões e Japurá, estado do Amazonas, Brasil. MÉTODOS: Foi realizado um estudo observacional, em comunidades ribeirinhas dos rios Solimões e Japurá. Os dados foram coletados por dois avaliadores em três expedições médico oftalmológicas, num período de 9 meses, que abrangeram 55 comunidades ribeirinhas, totalizando 1295 pacientes examinados, sendo 659 maiores de 18 anos. Os portadores de pterígio foram analisados através de um questionário abrangendo sexo, idade e atividade laborativa ao sol ou não. O tamanho da lesão foi quantificado em graus. RESULTADOS: A prevalência do pterígio na população geral foi de 21.2 por cento. A prevalência entre os maiores de 18 anos foi de 41.1 por cento. A faixa etária mais acometida foi a de 41 a 50 anos. Dos portadores, 42.2 por cento eram do sexo feminino e 57.8 por cento do sexo masculino. 89.5 por cento dos pacientes acometidos pela lesão trabalhavam ao ar livre. Dos portadores, 75.6 por cento apresentavam acometimento de ambos os olhos. Dos pacientes acometidos, 48.7 por cento possuíam pterígio grau 2, 44.0 por cento apresentavam a lesão de grau 1, 5.4 por cento de grau 3 e 1.8 por cento de grau 4. Dos olhos acometidos, 85.0 por cento apresentavam somente pterígio nasal, 2.9 por cento apresentavam somente pterígio temporal e 14.5 por cento apresentavam pterígio temporal e nasal. CONCLUSÃO: Nosso estudo, nos rios Solimões e Japurá, revelou a existência de uma das maiores taxas de pterígio do mundo, em uma região que nunca havia sido avaliada.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Pterígio/epidemiologia , Raios Ultravioleta/efeitos adversos , Brasil/epidemiologia , Pterígio/diagnóstico , Pterígio/etnologia , Prevalência , Estudos Transversais , Inquéritos e Questionários , Fatores de Risco , Microscopia com Lâmpada de FendaRESUMO
PURPOSE: To present 9-year incidence data and associated risk factors for pterygium among black participants in the Barbados Eye Studies. DESIGN: Population-based incidence study. PARTICIPANTS: A total of 1888 black participants, aged 40 to 84 years, who were free of pterygium at baseline and received an ophthalmologic study examination at the 9-year follow-up. METHODS: Age and sex-specific 9-year incidence of pterygium is presented. Risk factors were initially identified using Mantel-Haenszel analyses, and significant factors (P<0.10) were subsequently included in multivariate logistic regression models. Odds ratios (OR) and 95% confidence intervals (CI) are provided. MAIN OUTCOME MEASURES: Development of pterygium, defined as the presence of a raised fleshy growth that crosses the limbus and encroaches onto the clear cornea. RESULTS: The 9-year incidence of pterygium was 11.6% (95% CI, 10.1-13.1), with no clear pattern with increasing age and no statistically significant differences between genders. Multivariate logistic regression analyses indicated that having a lifetime outdoor job location was positively associated with the development of pterygium (OR = 1.51; 95% CI, 1.05-2.16), whereas darker skin color (OR = 0.67; 95% CI, 0.46-0.97) and use of any prescription lenses (OR = 0.58; 95% CI, 0.42-0.81) were found to be protective factors. CONCLUSIONS: The incidence of pterygium was high in this population, for an average of 1.3% per year. Working outdoors increased the risk 1.5-fold, whereas having a darker skin complexion and using eyewear for either reading or distance substantially decreased the risk of developing pterygium. These data suggest that absorption of ultraviolet light plays a role in this condition and that preventive strategies are needed to decrease the burden of pterygium development in this and other populations. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.
Assuntos
População Negra/etnologia , Pterígio/etnologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Barbados/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Ocupações , Razão de Chances , Pterígio/etiologia , Fatores de Risco , Distribuição por Sexo , Fatores de TempoRESUMO
PURPOSE: To compare the prevalence of pterygium and cataract in four indigenous populations of the Brazilian Amazonian rain forest (Arawak, Tukano, Maku, and Yanomami) with different ethnic and social behaviour backgrounds. METHODS: A cross-sectional pterygium and cataract survey was performed in 624 adult Indians of the Brazilian rain forest belonging to four different ethnic groups. The Indians were classified according to their social behaviour in two groups: Arawak and Tukano (group 1) and Maku and Yanomami (group 2). Slit-lamp biomicroscopy was employed to examine the entire sample. All subjects were classified as 1 or 0 according to the presence or absence pterygium and cataract. Sex and age were also recorded. RESULTS: chi(2)-tests revealed that the prevalence of pterygium and cataract differed significantly between groups 1 and 2. For pterygia: 36.6% (97/265) and 5.0% (18/359), respectively (chi(2)=101.2, P<0.0001), and for cataracts: 24.5% (65/265) and 13.7% (49/359) respectively (chi(2)=12.09, P=0.0005). Gender was not associated with pterygium (P=0.1326) and cataract (P=0.2263) in both groups. Elderly subjects showed a significantly higher prevalence of cataract (P<0.0001). The prevalence of pterygia did not increase with age (P=0.8079) in both groups. CONCLUSION: Indians of group 1 have higher prevalence of pterygia and cataract than Indians of group 2. Social behaviour, especially the rate of sun exposure, appears to be the main factor for the different rates of pterygium and cataract displayed by these indigenous people of the Brazilian rain forest.
Assuntos
Catarata/etnologia , Pterígio/etnologia , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Catarata/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Pterígio/etiologia , Lesões por Radiação/etnologia , Lesões por Radiação/etiologia , Distribuição por Sexo , Luz Solar/efeitos adversosRESUMO
OBJECTIVE: To describe the distribution and risk factors for pterygium in the predominantly black population of the Barbados Eye Study, which was based on a random sample of Barbadian-born citizens between the ages of 40 and 84 years. METHODS: The standardized protocol included ophthalmic and other measurements, automated perimetry, lens gradings, fundus photography, and a detailed interview. A 10% systematic sample of participants and those meeting specific criteria also received a comprehensive ophthalmologic evaluation. RESULTS: The Barbados Eye Study included 4709 participants, of whom 2978 were referred for an ophthalmologic evaluation and 2781 (93%) completed the examination. Cases of pterygium were found among 23.4% of 2617 black, 23.7% of 97 mixed (black and white), and 10.2% of 59 white participants examined. In addition to African ancestry, logistic regression analyses indicated a positive association between pterygium and age (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.00-1.02), fewer years of education (OR, 1.43; 95% CI, 1.01-2.03), and an outdoor job location (OR, 1.87; 95% CI, 1.52-2.29). Having a darker skin complexion (OR, 0.66; 95% CI, 0.52-0.83), always using sunglasses outdoors (OR, 0.18; 95% CI, 0.06-0.59), and the use of prescription glasses (OR, 0.75; 95% CI, 0.60-0.93) were protective factors. CONCLUSIONS: Approximately one quarter of the black participants examined had pterygia, a frequency that was 2.5 to 3 times higher than among whites in the Barbados Eye Study and elsewhere. Pterygium was almost twice as frequent among persons who worked outdoors but was only one fifth as likely among those who always used sunglasses outdoors. Educational interventions to modify these potential exposures may assist in preventing pterygium.
Assuntos
População Negra , Pterígio/etnologia , População Branca , Adulto , Idoso , Idoso de 80 Anos ou mais , Barbados/epidemiologia , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Testes Visuais , Testes de Campo VisualRESUMO
OBJECTIVE: To describe the disrtibution and risk factors for pterygium in the predominantly black population of the Barbados Eye Study, which was based on a random sample for Barbadian-born citizens between the ages of 40 and 84 years. METHODS: The standardized protocol included ophtalmic and other measurements, automated perimetry, lens gradings, fundus photography, and a detailed interview. A 10 percent systematic sample of participants and those meeting specific criteria also received a comprehensive ophthalmologic evaluation. RESULTS: The Barbados Eye Study included 4709 participants, of whom 2978 were referred for an ophthalmologic evaluation and 2781 (93 percent) completed the examination. Cases of pterygium were found among 23.4 percent of 2617 black, 23.7 percent of 97 mixed (black and white), and 10.2 percent of 59 white participants examined. In addition to African ancestry, logistic regression analyses indicated a positive association between pterygium and age (odds ratio [OR], 1.01; 95 percent confidence interval [CI], 1.00-1.02), fewer years of education (OR, 1.43; 95 percent CI, 1.01-2.03), and an outdoor job location (OR, 1.87; 95 percent CI, 1.52-2.29). Having a darker skin complexion (OR, 0.66; 95 percent CI, 0.52-0.83), always using sunglasses outdoors (OR, 0.18; 95 percent CI, 0.06-0.59), and the use of prescription glasses (OR, 0.75; 95 percent CI, 0.60-0.93) were protective factors. CONCLUSIONS: Approximately one quarter of the black participants examined had pterygia, a frequency that was 2.5 to 3 times higher than among whites in the Barbados Eye Study and elsewhere. Pterygium was almost twice as frequent among persons who worked outdoors but only one fifth as likely among those who always used sun glasses outdoors. Educational interventions to modify these potential exposures may assist in preventing pterygium. (AU)