possible correlation of plica-limbal distance with the presence of primary medial pterygium

TRANSLA TIONAL BIOMEDICI NE iMedPub Journals 2010 Vol.1 No. 2:4 doi: 10:3823/41 1 Possible correla tion of plica-limbal distance with the presence of primary medial pterygium Herman Christiaan Izaak Themen 1,2 , Dennis Ricardo August Mans 3 , Robbert Bipat 4 , Denise Judith Doelwijt 1 , Dineshpersad Jiawan 1 , Annemarie Thelma Bueno de Mesquita-Voigt 1,2, 1Department of Ophthalmology , Academic Hospital Paramaribo , Paramaribo, Suriname; 2Department of Ophthalmology, Facu lty of Medical Sciences, Anton de Kom University of Suriname; 3Department of Pharmacology, F aculty of Medical Sciences, Anton de Kom University of Suriname; 4Department of Physiology, F aculty of Medical Sciences, Anton de Kom University of Suriname Running title: Plica-limbal distance and pterygium Key words: primary medial pterygium; plica-limbal distance; inverse correlation Correspondence to: H. Themen, MD, Department of Ophthalmology, Academic Hospital Paramaribo, Flustraat 1, Paramaribo, Suriname. Tel: 597 442222 # 585. Fax: 597 441071. E-mail: [email protected] om Introduction Pterygium is a common surface lesion of the conjunctiva that often encroaches onto the cornea and is usually located me- dially at the limbus. The overgrowth of conjunctival tissue is presumably triggered by inflammation caused by chronic irritation. Although in general asymptomatic, it may progress to an inflammatory, invasive, and proliferative lesion, particularly after recurrent surgical excision. The result is loss of bulbar conjunctival tissue and restriction of bulbar motility [1]. For these reasons, pterygium is among the most complex and difficult- to-manage common diseases of the conjunctiva. The exact cause of pterygium is unknown. Howev er, long-t erm exposure to direct and reflected sunlight - especially ultraviolet © Under License of Creative Commons Attribution 3.0 License This article is available from: http://www.transbiomedicine.com B (UV-B) rays - as well as chronic eye irritation caused by wind- blown dust, sand, ice, and snow, presumably play an important role in its development [2]. This may account for the relatively high prevalence of pterygium in areas near the equator and in diverse groups such as Australian Aboriginals, Pacific Islanders, and Eskimos [3]. No incidence rates are available, but worldwi- de prevalence rates are between 3 and 10% [3]. Reports on the male-to-female distribution are conflicting [6-11], but elderly people seem to be more susceptible than younger individuals [6-11], with onset most common in individuals aged between 20 and 30 years [3-8]. Converging lines of evidence suggest the involvemen t of seve - ral anatomical and mechanical changes and the generation of tractional forces in the development of pterygium. Firstly, the Abstract Background: Loss of elastic properties, the introduction of tractional forces, and shortening of the plica-limbal distance (the distance between the nasal limbus and the semilunar plica bottom in full abduction) are common anatomical ab- normalities in eyes of patients with primary medial pterygium. In this study, we assessed whether, and to which degree the latter phenomenon correlated with the presence of pterygium. Methods and findings : Plica-limbal distance was measured using a slit lamp in individuals who came for routine eye examination, and was related to pterygium size, as well as to patients’ gender and age. Data were expressed as means (95% CI). Eighty-three males and 118 females were enrolled in the study. There were 49 eyes from patients with uni- lateral pterygium, 84 from patients with bilateral pterygium, and 220 from individuals who did not suffer from either uni- or bilateral pterygium. The mean plica-limbal distance in eyes with pterygium (7.3 mm, 95% CI: 6.9 – 7.7 mm) was significantly shorter than that in eyes without pterygium (9.9 mm, 95% CI: 9.7 – 10.1 mm). Plica-limbal distance correlated inversely with pterygium size (r2 = 0.32, p < 0.0001), was not related to gender, but decreased with increasing age in both individuals with and without pterygium. Conclusion: Our results suggest that plica-limbal distance correlated inversely with the presence of pterygium. This finding may have important consequences for the identification of individuals at risk, as well as for improvement of the treatment of this condition.

possible correlation of plica-limbal distance with the presence of primary medial pterygium

Documents