Possible correlation o plica-limbal distance with the presence o primarymedial pterygium
Herman Christiaan Izaak Themen
, Dennis Ricardo August Mans
, Robbert Bipat
, Denise JudithDoelwijt
, Dineshpersad Jiawan
, Annemarie Thelma Bueno de Mesquita-Voigt
Department o Ophthalmology, Academic Hospital Paramaribo, Paramaribo, Suriname;
Department o Ophthalmology, Faculty o Medical Sciences, Anton de Kom University o Suriname;
Department o Pharmacology, Faculty o Medical Sciences, Anton de Kom University o Suriname;
Department o Physiology, Faculty o Medical Sciences, Anton de Kom University o Suriname
: Plica-limbal distance and pterygium
: primary medial pterygium; plica-limbal distance; inverse correlation
: H. Themen, MD, Department o Ophthalmology, Academic Hospital Paramaribo, Flustraat 1, Paramaribo, Suriname. Tel: 597442222 # 585. Fax: 597 441071. E-mail: email@example.com
Pterygium is a common surace lesion o the conjunctiva thatoten encroaches onto the cornea and is usually located me-dially at the limbus. The overgrowth o conjunctival tissue ispresumably triggered by inammation caused by chronic irri-tation. Although in general asymptomatic, it may progress toan inammatory, invasive, and prolierative lesion, particularlyater recurrent surgical excision. The result is loss o bulbar con- junctival tissue and restriction o bulbar motility . For thesereasons, pterygium is among the most complex and dicult-to-manage common diseases o the conjunctiva. The exact cause o pterygium is unknown. However, long-termexposure to direct and reected sunlight - especially ultraviolet
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B (UV-B) rays - as well as chronic eye irritation caused by wind-blown dust, sand, ice, and snow, presumably play an importantrole in its development . This may account or the relativelyhigh prevalence o pterygium in areas near the equator and indiverse groups such as Australian Aboriginals, Pacic Islanders,and Eskimos . No incidence rates are available, but worldwi-de prevalence rates are between 3 and 10% . Reports on themale-to-emale distribution are conicting [6-11], but elderlypeople seem to be more susceptible than younger individuals[6-11], with onset most common in individuals aged between20 and 30 years [3-8].Converging lines o evidence suggest the involvement o seve-ral anatomical and mechanical changes and the generation o tractional orces in the development o pterygium. Firstly, the
Loss o elastic properties, the introduction o tractional orces, and shortening o the plica-limbal distance(the distance between the nasal limbus and the semilunar plica bottom in ull abduction) are common anatomical ab-normalities in eyes o patients with primary medial pterygium. In this study, we assessed whether, and to which degreethe latter phenomenon correlated with the presence o pterygium.
Methods and fndings
: Plica-limbal distance was measured using a slit lamp in individuals who came or routine eyeexamination, 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 emales were enrolled in the study. There were 49 eyes rom patients with uni-lateral pterygium, 84 rom patients with bilateral pterygium, and 220 rom individuals who did not sufer rom eitheruni- or bilateral pterygium. The mean plica-limbal distance in eyes with pterygium (7.3 mm, 95% CI: 6.9 – 7.7 mm) wassignicantly shorter than that in eyes without pterygium (9.9 mm, 95% CI: 9.7 – 10.1 mm). Plica-limbal distance corre-lated inversely with pterygium size (r2 = 0.32, p < 0.0001), was not related to gender, but decreased with increasing agein both individuals with and without pterygium.
: Our results suggest that plica-limbal distance correlated inversely with the presence o pterygium. Thisnding may have important consequences or the identication o individuals at risk, as well as or improvement o thetreatment o this condition.