Browsing by Author "Meyer, D."
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- ItemAbnormal serum lipoprotein levels as a risk factor for the development of human lenticular opacities(Clinics Cardiv Publishing, 2003-04) Meyer, D.; Parkin, D.; Maritz, F. J.; Liebenberg, P. H.Aim: To determine whether an association exists between the different plasma lipoprotein constituents and the prevalence of lenticular opacities in dyslipidaemic subjects. Methods: Adult patients (n = 115) of both genders were included if their fasting total serum cholesterol concentrations exceeded the 95th percentile of normal or their serum low-density lipoprotein (LDL) : high-density lipoprotein (HDL) ratios exceeded 5. Patients were excluded if they suffered from any condition known to cause, or predispose them to, elevated lipoprotein levels or lenticular opacification. Lenticular changes were assessed by means of a slit-lamp through the fully dilated pupil. Results: An extremely strong association (p < 0.0001) was found to exist between HDL cholesterol levels and the development of lens opacities. Below an HDL-C level of 1.5 mmol/l subjects had a seven-fold higher calculated probability of falling in the lens opacity subgroup than those with HDL-C levels above 1.5 mmol/l [odds ratio = 7.33 (95% CI = 2.06–26.10; p = 0.001)]. An equally strong association was found between high (>5) LDL:HDL ratios and the development of lens opacities (p < 0.0003). The risk of falling into the cataract subgroup if the individual’s LDL:HDL ratio exceeded 5 was 2.35 (95% CI = 1.09–5.04; p = 0.014). Conclusions: This study strongly suggests that an association exists between low levels of HDL cholesterol and high LDL:HDL ratios on one hand and the development of adult lens opacification on the other.
- ItemAstute and safe use of topical ocular corticosteroids in general practice : practical guidelines(Health and Medical Publishing Group (HMPG), 2013-04) Janse van Rensburg, E.; Meyer, D.Corticosteroids are the most effective way to treat ocular inflammation. They relieve symptoms rapidly and often prevent permanent damage. These medications, however, must be used with caution, as use of steroid-containing topical drops can lead to serious side-effects. In situations where resources are limited it is often difficult to decide if steroids can be given safely. The purpose of this article is to briefly review the most important features of topical steroids and provide a practical and safe guideline for their use in general practice
- ItemCortical lens opacities in the young patient - an indication for a lipogram?(Health & Medical Publishing Group, 2001) Meyer, D.; Maritz, F. J.; Liebenberg, P. H.; Parkin, D. P.; Burgess, L. J.Aim. To determine the characteristics and prevalence of lenticular opacification in patients with underlying dyslipidaemia. Methods. Eighty patients of both genders and all ages (18 - 90 years) were enrolled in the trial if they met the inclusion criteria for dyslipidaemia. Patients were included if their fasting serum cholesterol and triglyceride concentrations were > 5.2 mmol/1 and > 2.3 mmol/1, respectively, when measured on three separate occasions over a 1-month period. Patients were excluded if they suffered from any condition known to cause or predispose them to elevated lipid levels or lenticular opacification. Lenticular changes were assessed by means of a slit-lamp through the fully dilated pupil and other physical signs were documented subsequent to thorough physical evaluation. Results. In addition to the classic clinic signs of dyslipidaemia, 31% of patients had cortical lens opacities. Cortical opacities were twice as prevalent as Achilles tendon thickening (16.3%) in our study, the second most prevalent sign of elevated lipid levels. In the subgroup of patients aged under 50 years, 55% had lenticular opacities, predominantly cortical (80%). Conclusions. Cortical lens opacification was the most prevalent sign of dyslipidaemia and it occurred at a relatively young age in our trial population in those patients who were affected. Cortical lenticular opacification should be regarded as an indication for blood lipid profile evaluation.
- ItemHutchinson's sign as a marker of ocular involvement in HIV-positive patients with herpes zoster ophthalmicus(Health and Medical Publishing Group (HMPG), 2010) Van Dyk, M.; Meyer, D.Background. A positive Hutchinson's sign indicates an increased risk of ocular involvement in herpes zoster ophthalmicus (HZO). We examined the sensitivity of Hutchinson's sign as an indicator of ocular involvement in a consecutive series of patients presenting with HZO. Methods. We conducted a descriptive observational prospective study of patients ≥18 years old presenting with HZO and consenting to pre- and post-test counselling and HIV and CD4 testing. A full ophthalmological examination focused on the extent of ocular involvement, and the presence of Hutchinson's sign was confirmed by two clinicians. Results. Thirty-three patients were enrolled; 29 were HIV positive, of whom 18 (62%) had not been diagnosed with HIV prior to enrolment. Of the 29 HIV-positive patients, 21 (72%) were Hutchinson's sign positive (HSP), all of whom had intra-ocular involvement (95% confidence interval 88 - 100%). Of the 8 HIV-positive, Hutchinson's sign-negative (HSN) patients, 4 did and 4 did not display intra-ocular involvement. Neither the mean CD4 count nor the average age in the HSP group differed significantly from the HSN group. Conclusion. We confirmed that a Hutchinson's sign- and HIVpositive patient with HZO has a very high positive predictive value for intra-ocular involvement. Neither age nor CD4 count had predictive value for ocular involvement. Young adults presenting with HZO should be suspected of having HIV, and HIV-positive patients with HZO but HSN may still have ocular involvement. All patients with HZO should be seen by an ophthalmologist.
- ItemManagement of chemical ocular injuries – what every GP should know(Health and Medical Publishing Group (HMPG), 2013-04) Meyer, D.; Jansen van Rensburg, J.
- ItemOculomotor nerve palsy precipitating acute angle-closure glaucoma : a case report(Health & Medical Publishing Group, 1989) Mouton, D. P.; Meyer, D.A case of acute angle-closure glaucoma precipitated by oculomotor nerve palsy in a patient with shallow anterior chambers is reported. The different ways in which a palsy of the oculomotor nerve can influence the intra-ocular pressure are discussed.
- ItemSerum lipid parameters and the prevalence of corneal arcus in a dyslipidaemic patient population(Clinics Cardiv Publishing, 2004-08) Meyer, D.; Liebenberg, P. H.; Maritz, F. J.Aim: To determine whether an association exists between plasma lipoprotein constituents and the prevalence of corneal arcus in dyslipidaemic patients. Methods: Adult patients (n = 115) were included if their fasting total serum cholesterol concentrations exceeded the 95th percentile or their serum low-density lipoprotein (LDL) : high density lipoprotein (HDL) ratios exceeded 5. Slit-lamp assessment of the corneas was performed. Results: The study group divided into a subgroup with arcus 37% (43) and a subgroup without arcus 63% (72). Total serum cholesterol and triglyceride levels were not associated with corneal arcus. A significant difference was found (p < 0.05) between the mean levels of LDL cholesterol (LDL-C) in the group without arcus (5.61 ± 1.74 mmol/l) and the group with arcus (5.96 ±1.71 mmol/l). The mean serum HDL-cholesterol (HDL-C) in the group with corneal arcus was 1.04 ± 0.30 mmol/l as opposed to 1.31 ± 0.38 mmol/l in the group without arcus (p < 0.005 for difference). The mean LDL-C : HDL-C ratio in the group without arcus was 4.28 (SD: 1.99), and 5.73 (SD: 2.09) in the group with a corneal arcus (p < 0.05). Conclusions: Low HDL-C levels, high LDL-C levels and LDL-C : HDL-C ratios > 5 have been implicated as risk factors of numerous circulatory diseases. The observations in this study suggest that the presence of corneal arcus in the dyslipidaemic patient correlates strongly with these same risk indicators.