Serum cortisol and testosterone levels in idiopathic central serous chorioretinopathy

<b>Context</b> : The preferential occurrence of idiopathic central serous chorioretinopathy (ICSC) in males with a typical Type A personality and behavior and a relative absence in females is a possible indicator towards the role of serum cortisol and /or the male sex hormone testosterone. <b> Aims</b> : To study levels of cortisol and testosterone in ICSC. <b> Settings</b> <b> and</b> <b> Design</b> : Case-control study in a tertiary care teaching hospital. <b> Materials</b> <b> and</b> <b> Methods</b> : The study was conducted on 23 cases of ICSC. Twelve patients with unilateral sudden painless loss of vision of less than one month duration served as controls. Serum cortisol and testosterone levels at 8.00 a.m. were estimated by radioimmunoassay in both groups. <b> Statistical</b> <b> analysis</b> <b> used</b> : Statistical analysis was done using SPSS 13.0 software. Independent Sample t-test was applied to analyze statistical significance between the two groups. <b> Results</b> : Mean age of patients with ICSC was 37.1 &#177; 9.7 years and 96&#x0025; of the patients were males. Mean serum cortisol levels were significantly higher (<i>P</i>=0.002) in patients with ICSC i.e., 495.02 &#177; 169.47 nano moles/liter (nmol/L) as compared to controls i.e., 362.25 &#177; 51.54 nmol/L. Mean serum testosterone levels were 3.85 &#177; 1.81 nano grams/ml (ngm/ml) and 4.23 &#177; 1.89 ngm/ml in cases and controls respectively and the difference was not statistically significant (<i>P</i>=0.58). <b>Conclusions</b> : ICSC is associated with elevated 8.00 a.m. serum cortisol levels. However, mean serum testosterone levels in both patients of ICSC and controls were within normal range

Risk Factors for Decreased Visual Acuity in Preschool Children

OBJECTIVE: To investigate risk factors associated with unilateral or bilateral decreased visual acuity in preschool children. DESIGN: Population-based cross-sectional prevalence study. PARTICIPANTS: Population-based samples of 6504 children ages 30-72 months from California and Maryland. METHODS: Participants were preschool African-American, Hispanic, and non-Hispanic white children from Los Angeles, California, and Baltimore, Maryland. Data were obtained by a parental interview and a detailed ocular examination. Logistic regression models were used to evaluate the independent associations between demographic, behavioral and clinical risk factors with unilateral and bilateral decreased visual acuity. MAIN OUTCOME MEASURES: Odds ratios (ORs) for various risk factors associated with inter-ocular difference (IOD) in visual acuity (VA) of 2 or more lines with 20/32 or worse in the worse eye, or bilateral decreased VA worse than 20/40 or worse than 20/50 if younger than 48 months of age. RESULTS: In multivariate logistic regression analysis, 2-line IOD with VA 20/32 or worse was independently associated with Hispanic ethnicity (OR 2.05); esotropia (OR 8.98); spherical equivalent (SE) anisometropia (ORs ranging between 1.5 and 39.7 for SE anisometropia ranging between 0.50 to <1.00 diopters and ≥2.00 diopters); and aniso-astigmatism in J0 or J45 (ORs ranging between 1.4 and ≥5.3 for J0 or J45 differences ranging between 0.25 to <0.50 D and ≥1.00 D). Bilateral decreased VA was independently associated with lack of health insurance (OR 2.9); lower primary caregiver education (OR 1.7); astigmatism (OR 2.3 and 17.6 for astigmatism 1.00 to <2.00 D and ≥2.00 D); and SE hyperopia ≥4.00 D (OR 10.8). CONCLUSIONS: Anisometropia and esotropia are risk factors for IOD in visual acuity. Astigmatism and high hyperopia are risk factors for bilateral decreased visual acuity. Guidelines for the screening and management of decreased visual acuity in preschool children should be considered in light of these risk associations