Structural Characteristics of the Lens in Presenile Cataract

The purpose of this work is to examine the structure of the anterior lens epithelial cells (aLECs) of presenile idiopathic cortical cataract to investigate the possible structural reasons for its development. The anterior lens capsules (aLCs: basement membrane and associated lens epithelial cells) were obtained from routine uneventful cataract surgery of 5 presenile cataract patients (16 and 41 years old women and 29, 39, and 45 years old men). None of the patients had family history of cataract, medication, or trauma and they were otherwise healthy. In addition, the patients did not have any other abnormal features in the ocular status except cataract. The aLCs were prepared for scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The most prominent abnormal features observed by SEM for all 5 studied presenile cataract patients were the changes of the aLECs structure with the dents, the selective concavity of some LECs, at their apical side centrally toward the nucleus. In addition, TEM showed the thinning of the lens epithelium with the segmentally concave cells and the compressed and elongated nuclei. Abnormal and distinguishable structural features were observed in the anterior lens epithelium aLECs in all 5 patients with presenile cataract. Disturbed structure of aLECs, regularly present in presenile cataract type is shown that might be associated with water accumulation in the presenile idiopathic cortical cataract lens.

Risk Factors and Types of Presenile Cataract in Patients Attending a Tertiary Care Hospital in Kerala- A Retrospective Study

Background: Cataract is a major cause of blindness worldwide with a greater prevalence in developing countries like India. Presenile cataract refers to an onset of this disease below 50 years of age. Objectives: To study the factors associated with development of presenile cataract among the total cataract patients who attended out-patient clinic of Ophthalmology department from January 2016 to July 2017 and to find out the proportion of different types of presenile cataract. Method: The study includes patients who had undergone cataract surgery in the Department of Ophthalmology Government Medical College, Ernakulam from January 2016 and June 2017. Data was retrospectively entered and analysed. Results: There were 100 (49 males and 51 females) patients between the age 30 and 50 years. Around 70 study participants had co-morbidities. The average axial length was 22.5532mm, the average haemoglobin content was 13.01 g/dL, average total count was 8590.85, average BL urea was 22.755 mg/dL, average serum creatinine concentration was 0.9611 mg/dL and average GRBS concentration was 131.43 mg/dL. Drug history of 69 patients was observed in the current study. Conclusion: The most common type of cataract seen was posterior subcapsular cataract followed by mature cataract. Diabetes mellitus was the predominant risk factor in posterior subcapsular cataract. Keywords: Presenile cataract; Risk factors; Posterior subcapsular cataract.

Clinical Characteristics of Presenile Cataract: Change over 10 Years in Southern Taiwan

Purpose. The purpose of this study is to investigate the clinical characteristics of presenile cataract and compare that to ten years ago in southern Taiwan. Methods. The subjects who received cataract surgeries aged 30 to 54 years were recruited in Kaohsiung Chang Gung Memorial Hospital during September 2015 and August 2016. Patients with uveitis or those who received combined cataract surgeries were excluded. Retrospective chart review was performed in this study. Results. A total number of 2439 cataract surgeries were performed, and 302 (12.38%) eyes were having presenile cataract. Mean age was 47.55 ± 5.64 years old, and mean axial length was 26.00 ± 2.89 mm. Among 302 presenile cataract eyes, the leading cause was high myopia (defined as mean axial length ≥ 26 mm, 47.02%), followed by diabetes mellitus (26.82%). In types of lens opacity analysis, 67.55% of the patients were nuclear sclerosis dominant. Compared to the previous study 10 years ago, the leading cause of presenile cataract changed from idiopathy to high myopia, whereas the lens opacity types changed from posterior subcapsular opacity dominant to nuclear sclerosis dominant. Conclusions. High myopia has become the most important clinical characteristic associated with presenile cataract in a myopia epidemic area, and the most common type of lens opacity was nuclear sclerosis. With the increasing prevalence of high myopia, we should pay more attention to the management of presenile cataracts in high myopes to avoid complications.

ACHILLES TENDINOUS XANTHOMAS WITH NEUROLOGICAL ABNORMALITIES IN CASE OF PRESENILE CATARACT: A CLUE TO CEREBROTENDINOUS XANTHOMATOSIS

A 34 years old female presented with gradual painless loss of vision in right eye and ataxia with past history of being operated for cataract 12 years ago in left eye. On examination clini-cal examination, she had painless xanthomas of bilateral Achilles tendon, with ataxia and mild to moderate mental retardation and behavioral problems and further enquiring had histo-ry of intractable diarrhea during infancy. Magnetic resonance imaging of brain showed bilat-eral and almost symmetrically increased T2 signal intensity in the cerebellar and periventricu-lar white matter, basal ganglia, dentate nuclei and brainstem along with cerebellar and bilat-eral frontal lobe atrophy.

Diverse presentations of phenytoin toxicity-presenile cataract, encephalopathy and peripheral neuropathy: a case series

<p class="abstract">One of the most commonly used antiepileptic drugs, phenytoin, has a narrow therapeutic index, high plasma protein binding, non-linear pharmacokinetics and inter-individual variability. It can also present with adverse drug reactions due to phenytoin toxicity with diverse presentations mimicking symptoms of other diseases thus causing diagnostic predicament. This case series reports three such cases of uncommon presentation of phenytoin toxicity like presenile cataract, fluctuating encephalopathy with diurnal variation and peripheral neuropathy. Monitoring of serum drug levels in such cases aids in confirming drug toxicity. Adverse drug reaction monitoring helps in early detection and appropriate management of drug related morbidity.</p>