NR AXNW
AU Hamaguchi,T.; Noguchi-Shinohara,M.; Nakamura,Y.; Sato,T.; Kitamoto,T.; Mizusawa,H.; Yamada,M.
TI Ophthalmic Surgery in Prion Diseases
QU International Conference - Prion 2007 (26.-28.9.2007) Edinburgh International Conference Centre, Edinburgh, Scotland, UK - Book of Abstracts: Epidemiology, Risk Assessment and Transmission P04.15
IA http://www.prion2007.com/pdf/Prion Book of Abstracts.pdf
PT Konferenz-Poster
AB
Background: Ophthalmic surgery may have a role in transmission of prion diseases because eyes carry high prion infectivity. However, little information is available about ophthalmic surgery in patients with prion diseases.
Methods: We investigated the number and clinical features of the patients with ophthalmic surgery around or after the onset of prion diseases in 597 patients with definite or probable prion diseases registered by the Creutzfeldt-Jakob Disease Surveillance Committee in Japan from April 1999 through March 2005. For gathering information about the ophthalmic surgery, we mailed questionnaires to the ophthalmologists who operated on these patients.
Results: Eleven (1.8%) of 597 patients with prion diseases, comprising sporadic Creutzfeldt-Jakob disease (n=10) and Gerstmann-Sträussler-Scheinker disease (n=1), underwent ophthalmic surgery for cataract (n=10) or detached retina (n=1) around or after the onset of prion diseases. The sporadic Creutzfeldt-Jakob disease cases were characterized by atypical clinical features: visual impairment without dementia in the early phase of the disease (p=0.0004) and a long duration of the disease course (p=0.0004). All ophthalmologists re-used some surgical instruments, and the methods of cleaning instruments were incomplete sterilization methods for infectious prion protein.
Conclusions: Some patients with prion diseases may undergo ophthalmic surgery for often coexisting cataracts without diagnosis of prion diseases, and early visual impairment due to prion diseases would prompt ophthalmologists to perform surgery. To prevent transmission through ophthalmic surgery, ophthalmologists should pay attention to the possibility of prion diseases for their patients with visual symptoms, and the surgical instruments should be disposable.
AD T. Hamaguchi, M. Noguchi-Shinohara, M. Yamada, Kanazawa University Graduate School of Medical Science, Japan; Y. Nakamura, Jichi Medical University, Department of Public Health, Japan; T. Sato, Kohnodai Hospital, National Center for Neurology and Psychiatry, Japan; T. Kitamoto, Tohoku University Graduate School of Medicine, Japan; H. Mizusawa, Graduate School, Tokyo Medical and Dental University, Japan
SP englisch
PO Schottland