A24Thorax 2012;67(Suppl 2):A1-A204 Introduction and ObjectivesAlong with known associations with coronary heart disease, heart failure and stroke, there is increasing evidence to demonstrate a link between obstructive sleep apnoea (OSA) and chronic kidney disease (CKD). There is also growing evidence to suggest that intensive treatment of CKD can improve or even eliminate symptoms related to OSA. So far though, there is no evidence to support the association between OSA and CKD in a UK population. Our study aimed to quantify the risk of OSA in different severities of CKD for the first time in the UK Our secondary aim was to look for factors that increased or decreased this risk, including medications. Methods Using the renal database, 60 patients each at CKD stage 3b, 4 and 5, haemodialysis patients and renal transplant patients were identified, matched for age and sex and sent the Berlin questionnaire and a lifestyle questionnaire. The Berlin questionnaire was used to stratify patients into high-risk and low-risk groups for OSA. We used the lifestyle questionnaire along with up-to-date laboratory investigations to investigate variables that altered this risk within our sample. Results Of the 300 patients who were contacted, 111 (37%) responded. Of the 111 respondents, 78 (70.2%) were found to be at high-risk of OSA. This significant increase in risk was seen in all severities of CKD that were examined including in CKD 3b (80.8%). In contrast to the general population, where OSA is more common in men, our study found that 77.1% of women were at high-risk of OSA compared to 65.1% of men. We also found that renin-angiotensin system inhibitors (RASI) were associated with a reduced risk of OSA with 66.1% of users being at high risk compared to 74.5% of non-users. Conclusions Our study is the first to demonstrate the link between OSA and CKD in a UK population, a link that holds for milder forms of CKD. We noted that RASI use helped to reduce the risk of OSA, thus identifying a possible medical treatment for OSA in patients with CKD. Further study will clarify the importance of this treatment.

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ABSTRACT:Craniopharyngioma is a type of brain tumor derived from pituitary gland embryonic tissue. It is also known as Rathkes pouch tumor. It is usually a suprasellar neoplasm with variable ocular presentation. We report an interesting case of a 30 year male presented to us with craniopharyngioma with optic atrophy and hemianopia. MRI brain showed presence of craniopharyngioma, survival rate are usually good with early detection and proper management.

BACKGROUND To study the determinants of Age-Related Macular Degeneration in the 50 years and older population. Combating blindness has always been a challenge to all ophthalmologists all over the world. Age-related macular degeneration (ARMD) along with cataract and glaucoma, form a significant triad of aetiology associated with development of blindness. We wanted to study the determinants of age-related macular degeneration in the 50 years and older population. METHODS Ours was a comparative study of 218 patients. Patients were divided into 2 groups. 109 patients with Age-Related Macular Degeneration were in Group 1 whereas 109 patients without Age-Related Macular Degeneration were in Group 2 (Control Group). All patients underwent a comprehensive ocular examination as well as retinal evaluation. Detailed lab investigations further helped us in reaching to the probable factors associated with age-related macular degeneration. RESULTS 144 patients (66%) out of 218 patients were in the age group of 61-80 years. Our study had 115 females (52.8%) as compared to 103 males (47.2%). 76.1% patients were residing in rural areas, hypertension was associated in 36 (33%), smoking was seen in 28 (12.8%) patients. Dyslipidaemia, hypertension, renal diseases, alcohol intake, exposure to sunlight were other associated determinants of age-related macular degeneration in our study. CONCLUSIONS Results of our study shows that all elderly persons coming with diminution of vision should be screened for age-related macular degeneration and determinants of age-related macular degeneration should also be kept in mind while managing the patients of age-related macular degeneration.

BACKGROUND: Diabetes mellitus has protean manifestations in an individual and affects virtually every organ of the body. Diabetic retinopathy remains a leading cause of vision loss and blindness in people of working age-group. The present study was a hospital-based study designed to study the pattern of diabetic retinopathy and associated risk factors in diabetic individuals. MATERIAL AND METHODS: Our study was a prospective, hospital-based study of 200 cases of diabetes mellitus attending the Eye OPD at R.D. Gardi Medical College, Ujjain. All patients suffering from diabetes, irrespective of the duration of the disease, were included in the study. Each patient was subjected to a comprehensive ocular examination and the results were recorded and analyzed in detail. RESULTS: Our study included 200 diabetic patients. Out of these 111 (55.5%) were males and 89 (44.5%) were females. 108 (54%) patients were in the age group between 41-60 years. 109 (54.5%) patients in the study group had duration of diabetes > 5years. We found that 114 (28.5%) eyes had mild non-proliferative diabetic retinopathy (NPDR), 36 (9%) eyes had moderate non-proliferative diabetic retinopathy, and 14 (3.5%) eyes showed proliferative diabetic retinopathy (PDR). 61 (30.5%) patients had raised blood pressure in the study group which suggests hypertension as a significant risk factor for diabetic retinopathy. We found that 101 (50.5%) patients in the study group had HbA1c levels > 8gm% and 55 (27.5%) patients had dyslipidemia. 21 (10.5%) patients had hemoglobin levels < 8gm%. The prevalence of blindness in our study group was found to be 10.3%. CONCLUSION:The results of our study show that pattern of diabetic retinopathy in an individual is directly associated with risk factors such as duration of diabetes, hypertension, poor glycemic control, dyslipidemia and anaemia.