Ocular Tonometry and Sporadic Creutzfeldt - Jakob Disease (sCJD): A Confirmatory Case-Control Study
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2014, Vol 4, Issue 12
Abstract
Aims: To evaluate the hypothesis that sporadic Creutzfeldt-Jakob disease (sCJD) may be transmitted through ocular tonometry. Background: The infectious agent of sCJD may be present in the cornea prior to clinical symptoms. Cornea infectiousness has been documented by cornea transplants in guinea pigs and humans. sCJD is resistant to complete inactivity by conventional sterilization techniques. Thus contact tonometry equipment is not disinfected sufficiently to kill sCJD. We previously hypothesized that contact tonometry is a sCJD risk factor. Study Design: Population-based case-control study. Place and Duration of Study: Department of Neurology, School of Medicine, Loma Linda University, Loma Linda, CA, USA; 4 years. Methodology: An 11-state case-control study of pathologically confirmed definite sCJD cases, individually matched controls, and a sample of control surrogates was conducted. Ocular tonometry histories were obtained from case-surrogates, controls, and a sample of control-surrogates. Results: The odds ratio (OR) for ever vs never having had an ocular tonometry test was statistically significant for matched and unmatched analyses for 15 through 3 years prior to disease onset, using both control self-responses and control surrogates: ORs were ∞ and 19.4 with 1-sided P-values <0.0001 and 0.003 and ORs=∞ and 11.1 with 1-sided P-values <0.003 and 0.02, respectively. ORs increased as the number of tonometry tests increased during this age period: trend test, 2-sided P-value < 0.0001. For ≥5 vs <5 tonometry tests, the OR was 5.8 (unmatched) and 3.7 (matched), 2-sided P-value<0.00005. Respondents generally could not specify the type of tonometry. There was no indication of increased tonometry testing among cases within 2 years of disease onset. Conclusions: The a priori hypothesis was supported. Contact tonometry, preferred by ophthalmologists, may be capable of transmitting sCJD. Consideration should be given to using disposable instrument covers after each use. The use the disposable covers or non-contact tonometry is preferable in the absence of effective disinfectant processes at this time.
Authors and Affiliations
Zoreh Davanipour, Eugene Sobel, Argyrios Ziogas, Carey Smoak, Thomas Bohr, Keith Doram, Boleslaw Liwnicz
Keywords
Related Articles
- EP ID EP348859
- DOI 10.9734/BJMMR/2014/7247
- Views 99
- Downloads 0
Effects of Body Mass Index and Age on Prostate Specific Antigen: A Study on Men Attending a Tertiary Hospital in Ghana
Background: Prostate specific antigen (PSA) is useful in the diagnosis of prostate adenocarcinoma. Aims: Our study sought to establish possible effect of age and BMI on serum PSA levels in Ghanaian men with genitourinary...
Unusual Presentation of Primary Hypothyroidism
Primary hypothyroidism may present with myriad of unusual presentation apart from typically described signs and symptoms. We report an unusual case of primary hypothyroidism clinically presenting as acute psychosis and r...
Birth Weight and Placental Weight Correlation of Fulani Ethnic Group Parturients in Nigeria
Aims: We aim to establish the relationship of birth weight to the placental weight of Fulani ethnic community which is an important population politically and economically not only in Nigeria but to West Africa in genera...
Radiographic Evaluation of Frontal Sinus Dimensions and Anatomic Variations
Aim: This study evaluated radiographic variations and measured dimensions of the non-pathologic frontal sinuses. Study Design: Retrospective. Place and Duration of Study: Orthodontics Department, Dental School, Shahid Be...
An Investigation of the Retinal Layers in an Experimental Model of Multiple Sclerosis; a Histopathological and Immunohistochemical Study
Background: Animal model of multiple sclerosis is a demyelinating and inflammatory disorder of central nervous system and eye. Histological evaluation in eyes in experimental autoimmune encephalomyelitis (EAE) models dem...