Study of association between use of complementary and alternative medicine and non-compliance with modern medicine in patients presenting to the emergency department.

Context: Complementary and alternative medicines (CAMs) are extensively used by the public. Noncompliance is an important cause of therapy failure.

Aim: This study was done to determine prevalence of emergency admission due to noncompliance with modern medicine following switching over to CAM and to identify any significant association for CAM use among noncompliers.

Estimation of systemic complement C3 activity in age-related macular degeneration.

Objectives: To determine the role of systemic complement activation in the pathogenesis of age-related macular degeneration and to examine whether serum C3a des Arg reflects systemic complement activation, independent of individual complement component levels.

Methods: Plasma complement C3a des Arg levels and a single nucleotide polymorphism at position 402 of the complement factor H gene (CFH) were determined in 3 groups of subjects: 42 subjects with early age-related maculopathy, 42 subjects with neovascular (wet) age-related macular degeneration, and a control group of 38 subjects with no clinical evidence of age-related changes at the macula.

Results: The median (range) of plasma complement C3a des Arg levels in the age-related maculopathy and neovascular age-related macular degeneration groups were 52.

Plasma levels of matrix metalloproteinase-2 and -9 (MMP-2 and MMP-9) in age-related macular degeneration.

Background: Several studies indicate that age-related macular degeneration (AMD) and atherosclerosis may share common pathogenetic pathways. The aim of this study was to determine the role of systemic matrix metalloproteinases (MMPs) in AMD, given that MMPs are implicated in the pathogenesis of atherosclerosis.

Methods: This study determined the plasma matrix metalloproteinases (MMP-2 and MMP-9) levels in three groups of subjects: group 1 included subjects with age-related maculopathy (ARM), group 2 included subjects with choroidal neovascularization (CNV) owing to AMD and group 3 consisted of age-matched controls.

Intravitreal steroids in the management of macular oedema.

The use of intravitreal corticosteroids in the management of macular oedema has recently gained widespread acceptance. New long-acting steroid preparations and methods of delivery have facilitated the use of these new modalities. This review describes the various types of macular oedema for which this therapeutic option is used and the results.

Blood pressure control in type II diabetics with diabetic retinopathy.

Background: Large clinical trials have emphasized that blood pressure control provides a major clinical benefit in reducing the risk of blindness in patients with diabetic retinopathy.

Methods: This audit was carried out to assess the quality of care for hypertension in 100 consecutive type II diabetics with diabetic retinopathy.

Results: The target blood pressure of 140/80 mmHg was achieved only in 38% of the patients.

Pulsatile ocular blood flow in asymmetric age-related macular degeneration.

Purpose: Ocular perfusion abnormalities have been proposed in the pathogenesis of age-related macular degeneration (AMD) with differences in pulsatile ocular blood flow (POBF) in eyes with asymmetric AMD in Japanese and Taiwanese patients. The purpose of our study was to observe POBF difference in the fellow eyes of Caucasians with asymmetric AMD.

Methods: This was a cross-sectional study comparing POBF in three groups of patients with asymmetric AMD in the fellow eyes: Group 1 (n=21) with drusen and active choroidal neovascularisation (CNV); Group 2 (n=18) with drusen and disciform scar; Group 3 (n=8) with CNV and disciform scar.

Changing from Snellen to LogMAR: debate or delay?

Visual acuity is the most commonly used test to assess visual function. The Snellen chart is the universally accepted tool for testing visual acuity despite its poor reliability and reproducibility. Newer logMAR charts are now available that have negated the disadvantages of the Snellen chart.

The complement system and age-related macular degeneration.

Purpose: Age-related macular degeneration (AMD) is the leading cause of blindness in the developed world. There are increasing evidences to suggest the complement system may play a significant role on the pathogenesis of AMD. In this review, we summarise the current research in this area.

Why is the moon white?

Land's Retinex theory is used to explain why we perceive the colour of the moon as white. The lightness values of coloured areas are computed and the energy at the particular area (moon) is compared with the surrounding area (space-vacuum).

Non-steroidal anti-inflammatory agents for cystoid macular oedema following cataract surgery: a systematic review.

Aim: To examine the effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of cystoid macular oedema (CMO) following cataract surgery.

Methods: Systematic literature review of randomised controlled trials (RCTs) that evaluated the effects of NSAIDs in the treatment of CMO following cataract surgery was done according to the Cochrane Collaboration methodology.

Results: Seven trials involving a total of 266 participants were included.

Bruch's membrane and the vascular intima: is there a common basis for age-related changes and disease?

Several clinical and epidemiological studies have concurrently illuminated established cardiovascular risk factors in age-related macular degeneration (AMD), raising the possibility that cardiovascular disease and AMD may share a similar pathogenic process. The vascular intima and the Bruch's membrane share several age-related changes and are the seat of many common molecules. Diseases of these structures may represent parallel responses to the tissue injury induced by multiple intercalated factors such as genetic variations, oxidative stress, inappropriately directed immune response or inflammatory disease complex.

Second eye of patients with unilateral neovascular age-related macular degeneration: Caucasians vs Chinese.

Purpose: To investigate the correlation between morphological features of choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD) in the first eye and the severity of age-related maculopathy (ARM) in the fellow eyes in two racial groups: Caucasians and Chinese.

Participants: A total of 135, fluorescein angiograms of patients with unilateral neovascular AMD and ARM in the fellow eyes were included in the study: 38 Caucasians from King's College Hospital, UK; 45 Caucasians from West Kent Eye Centre, UK; 52 Chinese from Hong Kong Eye Hospital, Hong Kong.

Main Outcome Measures: CNV subtype in the affected eye and ARM severity in the second eyes.

Serum elastin-derived peptides in age-related macular degeneration.

Purpose: Dysregulation of the extracellular matrix (ECM) plays an important role in the pathogenesis of age-related macular degeneration (AMD). Elastin is a fibrous protein constituent of the ECM, degradation of which may be detected by the presence of serum elastin-derived peptides (S-EDPs) in circulation. This study was undertaken to estimate levels of S-EDPs in patients with AMD compared with age-matched control subjects.

Does lesion size determine the success rate of photodynamic therapy for age-related macular degeneration?

Photodynamic therapy (PDT) is a new evidence-based treatment modality available for choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD). Eligibility for PDT is based on the morphological classification of the neovascular complex, the benefit being greater in classic with no occult lesions. Lesion size is also shown to be a predictive factor for treatment benefit.

Non-steroidal anti-inflammatory agents for treating cystoid macular oedema following cataract surgery.

Background: Cystoid macular oedema (CMO) is the accumulation of fluid in the central retina (the macula) due to leakage from dilated capillaries. It is the most common cause of poor visual outcome following cataract surgery. The exact cause is unclear.