Pubblicazione del lavoro - Miodesopsie

Fawzi AA, Vo B, Kriwanek R, Ramkumar HL, Cha C, Carts A, Heckenlively JR, Foos RY, Glasgow BJ.
Department of Ophthalmology, Jules Stein Eye Institute, The David Geffen School of Medicine, University of California at Los Angeles, USA.
OBJECTIVES: To study the prevalence and associations of asteroid hyalosis (AH) in a series of autopsy eyes. METHODS: Retrospective review of the University of California at Los Angeles (UCLA) autopsy eye database from 1965 to 2000 yielded 10,801 patients. The patients' medical histories were reviewed for evidence of diabetes mellitus, hypertension, hyperlipidemia, alcohol abuse, hypercalcemia, hypothyroidism, and chronic renal failure. Autopsy records were searched for evidence of optic atrophy, macular degeneration, posterior vitreous detachment, atherosclerosis, and chronic renal failure. Asteroid hyalosis was diagnosed by examination of the autopsy eyes. Univariate and multivariate statistical methods were used to analyze our data. RESULTS: The prevalence of AH was 1.96% in this autopsy population. By chi(2) analysis, AH was significantly correlated with age (P<.001), male sex (P = .006), age-related macular degeneration (P = .02), hypertension (P = .03), atherosclerosis (P<.001), and posterior vitreous attachment (P<.001). After adjusting for age in a multivariate logistic regression analysis, statistical significance was found only for posterior vitreous attachment (P = .002) and male sex (P = .046). No statistically significant association was found with diabetes mellitus or alcohol abuse by univariate or multivariate analysis. Analysis of the odds ratio showed a strong age effect that increased from 5.0 (95% confidence interval, 2.2-11.3) in age group 41 to 50 years, compared with 25.4 (95% Wald confidence interval, 8.2-77.9) in the age group of patients older than 90 years. CONCLUSIONS: A unique epidemiological autopsy cohort study of AH and its systemic associations yielded a higher prevalence of AH than previous studies. Asteroid hyalosis was strongly correlated with age and inversely correlated with posterior vitreous detachment. Unlike some previous reports, we found no statistically significant correlation between AH and diabetes mellitus

In sintesi si tratta di uno studio retrospettivo,per documentare la prevalenza e l’associazione della ialosi asteroide (HA) con altre patologie in 10.801 reperti autoptici oculari durante un periodo osservazionale di 35 anni dal 1965 al 2000
Alta è stata la prevalenza di ialosi asteroide , pari a 1,96%, nella popolazione studiata.
La storia clinica dei pazienti esaminati ha dimostrato la presenza di diabete,ipertensione,iperlipidemia,ipercalcemia,etilismo,ipotiroidismo ed insufficienza renale cronica.
I risultati autoptici hanno evidenziato la presenza di atrofia ottica, degenerazione maculare,distacco posteriore di vitreo,aterosclerosi e insufficienza renale cronica.
La ialosi asteroide era correlata all’età,al sesso maschile,alla degenerazione maculare senile, ipertensione,aterosclerosi e in misura inversamente proporzionale al DPV. Mentre non era stata trovata nessuna correlazione significativa con il diabete

Qualche cenno esplicativo su questa degenerazione vitreale:

La ialosi asteroide è un processo degenerativo,la cui patogenesi non è ancora chiarita, caratterizzato da addensamento di lipidi ( grassi) con precipitazione di calcio in agglomerati sferici od ovalari simili a granelli di sabbia, in genere interessanti un occhio e asintomatici ma possono essere densi e posizionati anteriormente nel vitreo (dietro il cristallino) e pertanto ridurre la vista e necessitare dell’intervento di vitrectomia ( n.d.r.)

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