The Ocular Pathological Findings in Professional Baseball Players
Main Article Content
Abstract
This article highlights the eye findings uncovered among 800 professionals, with no visual complaints. Methods: During their yearly sports vision screenings between 2004 and 2011 these retinal and anterior segment pathologies were detected and documented using a Kowa-Optimed (Hawthorne, CA) non-mydriatic fundus camera. Results: Twelve athletes (1.5%) were found to have ocular pathology in the posterior pole or anterior portion of the eye. The findings were categorized into five groups, nevi, hemorrhages, retinal scars and abnormalities, optic nerve changes, and vascular changes. Conclusion: This work illustrates the importance of eye health screenings as an integral part of a comprehensive sports vision evaluation.
Downloads
Download data is not yet available.
Article Details
Section
Articles
References
1. Gottleib JL, Sahel JA, Albert DM. Choroidal nevi. In: Ryan SJ, ed. Retina. 4th ed. Philadelphia: Elsevier/ Mosby; 2006:679-690.
2. Sahel JA, Marcus DM, Albert DM. Nevus and melano-cytoma. In: Albert DM, Jakobiec FA, eds. Principles and practice of ophthalmology : clinical practice. Vol 5. Philadelphia: Saunders; 1994:3244-3251.
3. Sumich P, Mitchell P, Wang JJ. Choroidal nevi in a white population: the Blue Mountains Eye Study. Arch Ophthalmol 1998;116(5):645–50.
4. Naumann GOH, Hellner K, Naumann LR. Pigmented nevi of the choroid: clinical study of secondary changes in the overlying tissues. Trans Am Acad Ophthalmol Otolaryngol. 1971;75:110–23.
5. Ganley JP, Comstock GW. Benign nevi and malig-nant melanomas of the choroid. Am J Ophthalmol 1973;76(1):19–25.
6. Deutsch TA, Jampol LM. Large druse-like lesions on the surface of choroidal nevi. Ophthalmology 1985;92(1):73–76.
7. Gass JD. Problems in the differential diagnosis of cho-roidal nevi and malignant melanoma. XXXIII Edward Jackson Memorial lecture. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol 1977;83(1):19–48.
8. Tamler E, Maumenee AE. A clinical study of choroidal nevi. A.M.A. Arch Ophthalmol 1959;62(2):196–202.
9. Augsburger JJ, Schroeder RP, Territo C, Gamel JW, Shields JA. Clinical parameters predictive of en-largement of melanocytic choroidal lesions. British
J Ophthalmol 1989;73(11):911–17.
10. Shields CL, Mashayekhi A, Materin MA, et al. Opti-
cal coherence tomography of choroidal nevus in 120 patients. Retina (Philadelphia, Pa.). 2005;25(3):243–52.
11. Seddon JM, Moy CS. Epidemiology of uveal mela-noma. In: Ryan SJ, ed. Retina. 3rd ed. St. Louis: Mosby; 2001:664–72.
12. Holly EA, Aston DA, Char DH, Kristiansen JJ, Ahn DK. Uveal melanoma in relation to ultraviolet light exposure and host factors. Cancer Res 1990;50(18):5773–77.
13. Singh AD, Rennie IG, Seregard S, Giblin M, McKenzie J. Sunlight exposure and pathogenesis of uveal melanoma. Survey Ophthalmol 2004;49(4):419–28.
14. Lowenstein JI. Retinopathy associated with blood anomalies. In: Albert DM, Jakobiec FA, eds. Principles and practice of ophthalmology : clinical practice. Vol 2. Philadelphia: Saunders; 1994:995–1000.
15. Mimura T, Yamagami S, Usui T, et al. Location and extent of subconjunctival hemorrhage. Ophthal-mologica. Journal international d’ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde. 2010;224(2):90–95.
16. Sowka JW, Gurwood AS, Kabat AG. Subconjunctival hemorrhage. Handbook of Ocular Disease Manage-ment. 12 ed: Review of Optometry; 2010:18A–19A.
17. Kabat AG, Sowka JW. Something for ‘nothing’ Part 2. Review of Optometry. 2006;143(11):131–32.
18. Fukuyama J, Hayasaka S, Yamada K, Setogawa T. Causes of subconjunctival hemorrhage. Ophthal-mologica. Journal international d’ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde. 1990;200(2):63–67.
19. Skorin L. Subconjunctival hemorrhages: not all of them are benign. Opto Today 2006:32–34.
20. Shields CL, Guzman JM, Shapiro MJ, Fogel LE, Shields JA. Torpedo maculopathy at the site of the fetal “bulge”. Arch of Ophthalmol 2010;128(4):499–501.
21. Teitelbaum BA, Hachey DL, Messner LV. Torpedo maculopathy. Journal of the American Optometric Association. 1997;68(6):373-376.
22. Angioi-Duprez K, Maalouf T. [Torpedo maculopathy]. Journal francais d’ophtalmologie. 2000;23(2):200.
23. Rigotti M, Babighian S, Carcereri De Prati E, Marchini G. Three cases of a rare congenital abnormality of the retinal pigment epithelium: torpedo maculopathy. Oph-thalmologica. Journal international d’ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde. 2002;216(3):226-227.
24. Mahieu L, Mathis A. [“Torpedo” maculopathy]. Journal francais d’ophtalmologie. 2003;26(5):533.
25. Yang IL. Differentials of chorioretinal scarring. Clin Eye Vision Care 1994;6(4):192–202.
26. Institute MCsB. Cherry red spot. https://braininstitute. mch.com/wiki/Cherry_red_spot - Pseudo_cherry_red_ spot. Accessed November 21, 2012.
27. Ospina LH, Lyons CJ, McCormick AQ. “Cherry-red spot” or “perifoveal white patch”? Can J Ophthalmol 2005;40(5):609–610.
28. Ehlers JP, Shah CP. Central retinal artery occlusion. In: Ehlers JP, Shah CP, eds. The Wills Eye Manual : Office And Emergency Room Diagnosis and Treatment of Eye Disease. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008:282–84.
29. Ozdemir H, Karacorlu S, Karacorlu M. Optical coherence tomography findings in central retinal artery occlu-sion. Retina (Philadelphia, Pa.). 2006;26(1):110–112.
30. Sarks SH, Arnold JJ, Killingsworth MC, Sarks JP. Early drusen formation in the normal and aging eye and their relation to age related maculopathy: a clinicopathological study. The British J Ophthalmol 1999;83(3):35868.
31. Bressler NM, Bressler SB, West SK, Fine SL, Taylor HR. The grading and prevalence of macular degenera-tion in Chesapeake Bay watermen. Arch Ophthalmol 1989;107(6):847–52.
32. Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology 1992;99(6):933–43.
33. Klein R, Klein BE, Tomany SC, Meuer SM, Huang GH. Ten-year incidence and progression of age-related maculopathy: The Beaver Dam Eye Study. Ophthal-mology 2002;109(10):1767–79.
34. Munch IC, Sander B, Kessel L, et al. Heredity of small hard drusen in twins aged 20-46 years. Investigative ophthalmology & visual science. 2007;48(2):833–38.
35. Sanfilippo PG, Hewitt AW, Hammond CJ, Mackey DA. The heritability of ocular traits. Survey Ophthalmology 2010;55(6):561–83.
36. Hammond CJ, Webster AR, Snieder H, Bird AC, Gilbert CE, Spector TD. Genetic influence on early age-related maculopathy: a twin study. Ophthalmology 2002;109(4):730–36.
37. Kesler A, Kotas-Neuman R, Kott E, Assia E. Evalua-tion of patients with large Cup: Disc ratio of the optic nerve head. Ann Ophthalmol 2000;32(1):46–49.
38. Min KH, Seong GJ, Hong YJ, Kim CY. Optic nerve head topographic measurements and retinal nerve fiber layer thickness in physiologic large cups. Korean J Ophthalmol: KJO 2005;19(3):189–94.
39. Leibowitz HM, Krueger DE, Maunder LR, et al. The Framingham Eye Study monograph: An ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973–1975. Survey Ophthalmol 1980;24(Suppl):335–610.
40. Jonas JB, Naumann GOH. The optic nerve in glaucoma: its embryology, histology, and morphology. In: Varma R, Spaeth GL, Parker KW, eds. The Optic Nerve In Glaucoma. Philadelphia: J.B. Lippincott; 1993:3–26.
41. Airaksinen PJ, Tuulonen A, Werner EB. Clinical evalu-ation of the optic disc and retinal nerve fiber layer. In: Ritch R, Shields MB, Krupin T, eds. The Glaucomas. St. Louis: Mosby; 1989:3–26.
42. Quigley HA, Miller NR, George T. Clinical evalu-ation of nerve fiber layer atrophy as an indicator of glaucomatous optic nerve damage. Arch Ophthalmol 1980;98(9):1564–71.
43. Jonas JB, Bergua A, Schmitz-Valckenberg P, Papastatho-poulos KI, Budde WM. Ranking of optic disc variables for detection of glaucomatous optic nerve damage. Investigat Ophthalmol Vis Sci 2000;41(7):1764–73.
44. Taarnhoj NC, Munch IC, Sander B, et al. Straight versus tortuous retinal arteries in relation to blood pressure and genetics. British J Ophthalmol 2008;92(8):1055–60.
45. Williams TD. Quantification of arteriolar tortuosity in two normotensive age groups. American J Optometry Physiolog Optics 1982;59(8):675–79.
46. de Margerie J, Boyd TA. A statistical investigation of the correlation of retinal arteriolar tortuosity with blood pressure and age. Trans Canadian Ophthalmologic Soc 1961;24:6-17.
47. Wolffsohn JS, Napper GA, Ho SM, Jaworski A, Pollard TL. Improving the description of the retinal vasculature and patient history taking for monitoring systemic hypertension. Journal British Coll Ophthalmic Opti-cians 2001;21(6):441–49.
48. Fahrni R, Thalmann J, Weber J, von Muralt G, Sidi-ropoulos D, Bracher D. Central retinal arteries in the full-term newborn: decrease in width and tortuosity during uneventful adaptation. Helvetica paediatrica acta 1981;36(2):107–21.
2. Sahel JA, Marcus DM, Albert DM. Nevus and melano-cytoma. In: Albert DM, Jakobiec FA, eds. Principles and practice of ophthalmology : clinical practice. Vol 5. Philadelphia: Saunders; 1994:3244-3251.
3. Sumich P, Mitchell P, Wang JJ. Choroidal nevi in a white population: the Blue Mountains Eye Study. Arch Ophthalmol 1998;116(5):645–50.
4. Naumann GOH, Hellner K, Naumann LR. Pigmented nevi of the choroid: clinical study of secondary changes in the overlying tissues. Trans Am Acad Ophthalmol Otolaryngol. 1971;75:110–23.
5. Ganley JP, Comstock GW. Benign nevi and malig-nant melanomas of the choroid. Am J Ophthalmol 1973;76(1):19–25.
6. Deutsch TA, Jampol LM. Large druse-like lesions on the surface of choroidal nevi. Ophthalmology 1985;92(1):73–76.
7. Gass JD. Problems in the differential diagnosis of cho-roidal nevi and malignant melanoma. XXXIII Edward Jackson Memorial lecture. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol 1977;83(1):19–48.
8. Tamler E, Maumenee AE. A clinical study of choroidal nevi. A.M.A. Arch Ophthalmol 1959;62(2):196–202.
9. Augsburger JJ, Schroeder RP, Territo C, Gamel JW, Shields JA. Clinical parameters predictive of en-largement of melanocytic choroidal lesions. British
J Ophthalmol 1989;73(11):911–17.
10. Shields CL, Mashayekhi A, Materin MA, et al. Opti-
cal coherence tomography of choroidal nevus in 120 patients. Retina (Philadelphia, Pa.). 2005;25(3):243–52.
11. Seddon JM, Moy CS. Epidemiology of uveal mela-noma. In: Ryan SJ, ed. Retina. 3rd ed. St. Louis: Mosby; 2001:664–72.
12. Holly EA, Aston DA, Char DH, Kristiansen JJ, Ahn DK. Uveal melanoma in relation to ultraviolet light exposure and host factors. Cancer Res 1990;50(18):5773–77.
13. Singh AD, Rennie IG, Seregard S, Giblin M, McKenzie J. Sunlight exposure and pathogenesis of uveal melanoma. Survey Ophthalmol 2004;49(4):419–28.
14. Lowenstein JI. Retinopathy associated with blood anomalies. In: Albert DM, Jakobiec FA, eds. Principles and practice of ophthalmology : clinical practice. Vol 2. Philadelphia: Saunders; 1994:995–1000.
15. Mimura T, Yamagami S, Usui T, et al. Location and extent of subconjunctival hemorrhage. Ophthal-mologica. Journal international d’ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde. 2010;224(2):90–95.
16. Sowka JW, Gurwood AS, Kabat AG. Subconjunctival hemorrhage. Handbook of Ocular Disease Manage-ment. 12 ed: Review of Optometry; 2010:18A–19A.
17. Kabat AG, Sowka JW. Something for ‘nothing’ Part 2. Review of Optometry. 2006;143(11):131–32.
18. Fukuyama J, Hayasaka S, Yamada K, Setogawa T. Causes of subconjunctival hemorrhage. Ophthal-mologica. Journal international d’ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde. 1990;200(2):63–67.
19. Skorin L. Subconjunctival hemorrhages: not all of them are benign. Opto Today 2006:32–34.
20. Shields CL, Guzman JM, Shapiro MJ, Fogel LE, Shields JA. Torpedo maculopathy at the site of the fetal “bulge”. Arch of Ophthalmol 2010;128(4):499–501.
21. Teitelbaum BA, Hachey DL, Messner LV. Torpedo maculopathy. Journal of the American Optometric Association. 1997;68(6):373-376.
22. Angioi-Duprez K, Maalouf T. [Torpedo maculopathy]. Journal francais d’ophtalmologie. 2000;23(2):200.
23. Rigotti M, Babighian S, Carcereri De Prati E, Marchini G. Three cases of a rare congenital abnormality of the retinal pigment epithelium: torpedo maculopathy. Oph-thalmologica. Journal international d’ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde. 2002;216(3):226-227.
24. Mahieu L, Mathis A. [“Torpedo” maculopathy]. Journal francais d’ophtalmologie. 2003;26(5):533.
25. Yang IL. Differentials of chorioretinal scarring. Clin Eye Vision Care 1994;6(4):192–202.
26. Institute MCsB. Cherry red spot. https://braininstitute. mch.com/wiki/Cherry_red_spot - Pseudo_cherry_red_ spot. Accessed November 21, 2012.
27. Ospina LH, Lyons CJ, McCormick AQ. “Cherry-red spot” or “perifoveal white patch”? Can J Ophthalmol 2005;40(5):609–610.
28. Ehlers JP, Shah CP. Central retinal artery occlusion. In: Ehlers JP, Shah CP, eds. The Wills Eye Manual : Office And Emergency Room Diagnosis and Treatment of Eye Disease. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008:282–84.
29. Ozdemir H, Karacorlu S, Karacorlu M. Optical coherence tomography findings in central retinal artery occlu-sion. Retina (Philadelphia, Pa.). 2006;26(1):110–112.
30. Sarks SH, Arnold JJ, Killingsworth MC, Sarks JP. Early drusen formation in the normal and aging eye and their relation to age related maculopathy: a clinicopathological study. The British J Ophthalmol 1999;83(3):35868.
31. Bressler NM, Bressler SB, West SK, Fine SL, Taylor HR. The grading and prevalence of macular degenera-tion in Chesapeake Bay watermen. Arch Ophthalmol 1989;107(6):847–52.
32. Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology 1992;99(6):933–43.
33. Klein R, Klein BE, Tomany SC, Meuer SM, Huang GH. Ten-year incidence and progression of age-related maculopathy: The Beaver Dam Eye Study. Ophthal-mology 2002;109(10):1767–79.
34. Munch IC, Sander B, Kessel L, et al. Heredity of small hard drusen in twins aged 20-46 years. Investigative ophthalmology & visual science. 2007;48(2):833–38.
35. Sanfilippo PG, Hewitt AW, Hammond CJ, Mackey DA. The heritability of ocular traits. Survey Ophthalmology 2010;55(6):561–83.
36. Hammond CJ, Webster AR, Snieder H, Bird AC, Gilbert CE, Spector TD. Genetic influence on early age-related maculopathy: a twin study. Ophthalmology 2002;109(4):730–36.
37. Kesler A, Kotas-Neuman R, Kott E, Assia E. Evalua-tion of patients with large Cup: Disc ratio of the optic nerve head. Ann Ophthalmol 2000;32(1):46–49.
38. Min KH, Seong GJ, Hong YJ, Kim CY. Optic nerve head topographic measurements and retinal nerve fiber layer thickness in physiologic large cups. Korean J Ophthalmol: KJO 2005;19(3):189–94.
39. Leibowitz HM, Krueger DE, Maunder LR, et al. The Framingham Eye Study monograph: An ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973–1975. Survey Ophthalmol 1980;24(Suppl):335–610.
40. Jonas JB, Naumann GOH. The optic nerve in glaucoma: its embryology, histology, and morphology. In: Varma R, Spaeth GL, Parker KW, eds. The Optic Nerve In Glaucoma. Philadelphia: J.B. Lippincott; 1993:3–26.
41. Airaksinen PJ, Tuulonen A, Werner EB. Clinical evalu-ation of the optic disc and retinal nerve fiber layer. In: Ritch R, Shields MB, Krupin T, eds. The Glaucomas. St. Louis: Mosby; 1989:3–26.
42. Quigley HA, Miller NR, George T. Clinical evalu-ation of nerve fiber layer atrophy as an indicator of glaucomatous optic nerve damage. Arch Ophthalmol 1980;98(9):1564–71.
43. Jonas JB, Bergua A, Schmitz-Valckenberg P, Papastatho-poulos KI, Budde WM. Ranking of optic disc variables for detection of glaucomatous optic nerve damage. Investigat Ophthalmol Vis Sci 2000;41(7):1764–73.
44. Taarnhoj NC, Munch IC, Sander B, et al. Straight versus tortuous retinal arteries in relation to blood pressure and genetics. British J Ophthalmol 2008;92(8):1055–60.
45. Williams TD. Quantification of arteriolar tortuosity in two normotensive age groups. American J Optometry Physiolog Optics 1982;59(8):675–79.
46. de Margerie J, Boyd TA. A statistical investigation of the correlation of retinal arteriolar tortuosity with blood pressure and age. Trans Canadian Ophthalmologic Soc 1961;24:6-17.
47. Wolffsohn JS, Napper GA, Ho SM, Jaworski A, Pollard TL. Improving the description of the retinal vasculature and patient history taking for monitoring systemic hypertension. Journal British Coll Ophthalmic Opti-cians 2001;21(6):441–49.
48. Fahrni R, Thalmann J, Weber J, von Muralt G, Sidi-ropoulos D, Bracher D. Central retinal arteries in the full-term newborn: decrease in width and tortuosity during uneventful adaptation. Helvetica paediatrica acta 1981;36(2):107–21.