Distribution of cup-disc ratio in a Swedish population

Background

Increased cup-disc ratio (CDR) is a hallmark of open-angle glaucoma (OAG), an age-related neurodegenerative disease of significant importance for public health. There are few studies on the distribution of CDR in the Nordic populations.

Methods

The distribution of CDR was studied in 749 subjects aged 65-74 years in a population survey in the rural district of Tierp, Sweden, from 1984 to 86. The optic discs were assessed with binocular ophthalmoscopy at a slit lamp. Drawings of the discs were made in the protocol and used for the calculation of vertical CDRs. Odds ratios, adjusted for age and sex, according to Mantel-Haenszel (ORMH), were determined to estimate predictors of increased CDR, defined as a ratio in the upper quartile. For these analyses, the eye with the most advanced OAG or the highest pressure was chosen. Automated perimetry was used to identify OAG.

Results

The distribution of vertical CDR was fairly close to that of other European-derived populations. The mean CDR was 0.45 in both eyes, with no difference between women and men. An increased ratio was associated with the age ≥70 years, a positive family history of OAG and intraocular pressure ≥20 mmHg. OAG increased the risk 8-fold (ORMH 8.06; 95% CI 4.12-15.8).

Conclusions

In this study, the distribution of CDR was fairly close to that of other European-derived populations. As expected, OAG increased the risk of having a CDR in the upper quartile. The CDR increased with age.

Marble brain syndrome: osteopetrosis, renal acidosis and calcification of the brain

Cerebral calcification in children is frequently associated with systemic metabolic disease. We present a case of "marble brain syndrome", which showed this abnormality.

[A magnetic tomography study: 3 out of 4 HIV-I infected men suffer subcortical pathologic changes]

Forty HIV-1-sero-positive and 15 HIV-1 antibody negative homosexual or bisexual men were examined by means of magnetic resonance imaging (MRI) and 20 neuropsychological tests. Subcortical, mainly frontal cerebral pathological aberrations were detected in 75 per cent of the patients on examination with ultra low field MRI computer assisted classification. No such changes were found among controls. The extent of the subcortical aberrations detected correlated with severity of immune deficiency, stage of infection (CDC classification), duration of infection, and reported neuropsychological symptoms. Neuropsychological testing showed impairment in memory function, concentration capacity, and fine motor control in the patients but not in the controls.