Middle East African Journal of Ophthalmology最新文献

The aim was to describe the three eyes of three patients with severe firework-related ocular injuries. The three eyes of three patients with firework injuries were studied. All patients were men aged 5, 11, and 31 years. All underwent a complete ocular examination, and two had surgical intervention. Two eyes received surgical treatment. One eye had evisceration, and the other eye had lens aspiration with a posterior chamber intraocular lens. Final visual acuity was no light perception, light perception, and 20/50. Ocular trauma from fireworks can cause a significant ocular morbidity, especially in children. Public health education on the hazards of fireworks is crucial to prevent a permanent visual loss.

Sporotrichosis is a chronic granulomatous fungal infection caused by Sporothrix schenckii. Inoculation of the fungus through breached skin or mucosa typically results in nodular ulceration of the cutaneous and subcutaneous tissue as well as its draining lymphatic nodules. However, reports on ocular involvement have recently increased. We describe a severe case of diffuse granulomatous conjunctivitis involving bulbar and palpebral conjunctiva, resulting in inevitable damage to the limbal stem cells. Isolation of S. schenckii from a conjunctival swab confirmed the diagnosis of sporotrichosis. A 6-month course of oral antifungal therapy was given through which the patient fully recovered. However, extensive corneal conjunctivalization secondary to total limbal stem cell deficiency has caused almost complete blindness in the affected eye. Clinical suspicion of this zoonotic disease is essential for early diagnosis and prompt treatment to prevent ocular surface complication and blindness.

Purpose: The purpose of this study was to address disparities between male and female Iraqi ophthalmologists in terms of personal circumstances, professional profiles, and attitudes toward work and family life.

Methods: A Google Form-based questionnaire was released on a social media platform including 500 ophthalmologists between September 1, and December 1, 2021. The survey included three domains: (1) demographic characteristics, (2) clinical practice profile, and (3) career satisfaction and work/family balance.

Results: The study included a total of 209 specialists, with a response rate of 45.5%. About 69.4% of them were 45 years and younger. The female-to-male ratio was 1:1.6, 188 (90%) were married and 186 (88.9%) had children. Women ophthalmologists worked fewer hours, days, and operations than male ophthalmologists (P = 0.091). Moreover, women ophthalmologists in private practice were considerably underrepresented. General ophthalmologists represented 77%. The number of women ophthalmologists with subspecialty degrees was far less 9 (11.5%) than males 38 (29.2%), P = 0.003, and they performed significantly fewer operations than male ophthalmologists (P = 0.001). Family duties were the biggest deterrent for female ophthalmologists. For males, the private clinic is an obstacle to acquiring a specialty degree in 45.6%, but for women, it is just 25.7%. Overall satisfaction was 65.1%. Women respondents were less satisfied with their practice (P = 0.009) and thought that they are facing more challenges (0.007). Men believed they had less time to spend with family, implying that women sacrifice working time/income to satisfy family obligations and expectations. Work-life balance is achieved by limiting work hours and including family members.

Conclusion: Women ophthalmologists in Iraq might be facing greater obstacles to their professional advancement than their male counterparts. Female doctors were working fewer hours and doing fewer surgical procedures, and they were less likely to pursue subspecialty certification.

Purpose: The purpose of this study was to estimate the rate and review determinants of successful therapy for unilateral amblyopia in children.

Methods: This prospective cohort consisted of Saudi children aged 6-12 who received amblyopia therapy between 2020 and 2022. Best-corrected visual acuity (BCVA) in the amblyopic eye improved to reach the BCVA of the fellow eye at follow-up visits, or BCVA in the amblyopic eye improved and remained stable over three follow-up visits. Demographic and ocular characteristics were associated with the outcome.

Results: In 30 children, the median BCVA at presentation and the last follow-up was 0.8 logMAR (interquartile range [IQR]: 0.6; 1.0) and 0.45 logMAR (IQR: 0.3; 0.6), respectively. The success rate of amblyopia therapy was 80% (95% confidence interval: 65.7; 94.3). It was 100%, 76.5%, and 77.8% in eyes with anisometropic, strabismic, and mixed types of amblyopia, respectively. Amblyopia grade (P = 0.177), type of amblyopia (P = 0.96), and spectacles as therapy in the past (P = 0.09) were not significantly associated with the successful out. The duration of follow-up was significantly longer in those with unsuccessful outcomes (P = 0.05). Excellent compliance for occlusion was observed in 62.5% of children with successful outcomes. In 14 (46.7%) children, BCVA was ≤0.3 logMAR BCVA at the last follow-up. Two-line improvement in amblyopic eyes was in 26 (86.7%) children at the last follow-up compared to BCVA at presentation.

Conclusion: Occlusion therapy complemented using glasses in older children also significantly improved visual recovery in amblyopic eyes.

Purpose: This is a retrospective multicenter study to report the incidental discovery of keratoconus (clinical and subclinical) in a screening of laser vision correction (LVC) surgery candidates.

Methods: This retrospective multicenter study was conducted on patients presenting for LVC in four Egyptian governorates (Cairo-Giza-6^th of October-Beni Suef) during the year 2018. The patients were examined using the Pentacam HR (OCULUS Optikgeräte GmbH, Wetzlar, Germany) or Sirius (Costruzione Strumenti Oftalmici, Italy). The following parameters were evaluated: the axial curvature map, keratometry (Kmax and K2 on the posterior surface), minimum corneal thickness, anterior elevation, posterior elevation, Baiocchi-Calossi -Versaci index (Sirius), index of height decentration, and BAD-D (Pentacam). The prevalence of keratoconus cases was reported and data were analyzed.

Results: A total of 46 out of 782 candidates presenting for LVC in 2018 were incidentally discovered as clinical or subclinical keratoconus cases and were excluded from performing the LVC procedure.

Conclusion: Screening of LVC candidates for keratoconus is a crucial tool to detect the incidence of the disease in the Egyptian population.

Purpose: Platelets have a major role in the regulation of angiogenesis. Platelets have proangiogenic factors like vascular endothelial growth factor, which causes neovascularization of immature retina. However, there is no conclusive evidence to show that platelet indices have a role in retinopathy of prematurity (ROP). This study is aimed at assessing the role of platelet indices in the occurrence and need for treatment of ROP.

Methods: This prospective cohort study included the screening of preterm babies (<37 weeks of gestation with birth weight <2000 g). The samples of platelet indices (mean platelet volume [MPV], platelet count [PLT], plateletcrit [PCT], and platelet distribution width [PDW]) collected within 1^st week of life were obtained from the electronic medical records and correlated to ROP status. Statistical analysis was done using SPSS version 22, and the Chi-square test and odds ratio were used for analysis.

Results: A total of 300 preterm babies were screened, of whom, 55 (18.3%) babies had ROP changes. The association of the presence of ROP changes and platelet indices was not statistically significant (P value being MPV [0.22], PLT [0.58], PCT [0.98], and PDW [0.17]). Similarly, the requirement of treatment for ROP (Type I ROP) could not be correlated with abnormal platelet indices (odds ratio at 95% confidence interval - MPV [6 (0.44-81.44)], PLT [1.7 (0.25-11.37)], PCT [3 (0.44-20.90)], and PDW [0.32 (0.33-3.05)]).

Conclusion: Abnormal platelet indices did not show any significant risk with the occurrence or need for treatment of ROP.

Purpose: The purpose of this study was to compare glaucoma therapy escalation (GTE), graft survival, vision, and glaucoma following penetrating keratoplasty (PK group) and Descemet stripping automated endothelial keratoplasty (DSAEK group) to treat pseudophakic bullous keratopathy (PBK).

Methods: This cohort included cases of PBK managed with PK from 2009 to 2014. We compared the incidences and determinants of GTE, graft survival, and visual disability. P < 0.05 was statistically significant.

Results: There were 58 eyes in the PK group and 117 eyes in the DSAEK group. The incidence of GTE in the PK and DSAEK groups at the last follow-up was 34.2% (95% confidence interval [CI]: 19.5-48.9) and 46.6% (95% CI: 27.7-65.4), respectively. The risk of GTE was similar between the groups (relative risk [RR] = 1.36 [95% CI: 0.94-1.98], P = 0.12). GTE was significantly associated with graft survival in the PK group (RR = 3.25 [95% CI: 1.5-7.0], P < 0.001) and the DSAEK group (RR = 3.77 [95% CI: 2.6-5.6], P < 0.001). Glaucoma (P = 0.001) and previous keratoplasty (P < 0.001) were significant predictors for GTE. At the final follow-up visit, severe visual disability was not significantly different between the groups (RR = 0.9 [95% CI: 0.3-2.9], P = 0.88). There was a statistically significant improvement in vision after DSAEK (P < 0.001) but not after PK (P = 0.67).

Conclusion: GTE was similar in eyes with PBK managed by PK or DSAEK. Glaucoma and previous keratoplasty were predictors of GTE post-keratoplasty. DSAEK gave better visual outcomes than PK for managing PBK.

To report a case of toxic keratopathy secondary to the self-application of seawater eye drops. A 60-year-old male who presented with unexplained unilateral decrease in vision and corneal thinning. Best-corrected visual acuity was 20/400 OD, slit-lamp examination indicated diffuse corneal edema with central thinning, intact sensation, and no vascularization. Laboratory analysis of the eye drops in conjunction with clinical symptoms and findings was consistent with toxic keratopathy. Toxic keratopathy can masquerade as the other forms of keratopathy, and a thorough history taking and laboratory analysis may help elucidate the diagnosis and avoid significant visual morbidity.

Purpose: Studies have shown that there are significant differences in the concepts of medical professionalism among residents. Very few studies have specifically evaluated the perception of medical professionalism in a specific specialty. The aim of the study is to evaluate the perception of medical professionalism among ophthalmology residents and to assess the differences in the concept of professionalism between junior and senior residents.

Methods: This cross-sectional study used a questionnaire to survey ophthalmology residents enrolled in different regions of Saudi Arabia in 2020. The ophthalmology residents included both junior and senior residents. In this study, "professionalism" concurred with the definition in the American Board of Internal Medicine's "Project Professionalism" and the Accreditation Council for Graduate Medical Education.

Results: A total of 167 participants were recruited in the study. Out of the 127 participants who completed the survey, 60 (47.24%) were junior residents and 67 (52.76%) were senior residents. The scores for the attributes varied markedly. The lowest score obtained was 6.54 ± 3.349 for the attribute "In an emergency putting the welfare of others over my own safety" in the "Altrusim" domain and the highest score obtained was 9.62 ± 0.854 for the attribute "respect for co-workers" in the "Respect for others" domain. Out of the total residents who completed the survey (n = 127), 84 (66.14%) agreed that professionalism is teachable through a residency curriculum and 85 (66.93%) thought that it is testable.

Conclusion: The characteristics of different attributes of professionalism varied significantly among the residents. The findings of the present study highlights that the conceptualization and perception of professionalism is changing and there is a need to focus on the resident curriculum to instill the values of professionalism. Targeted training is needed on the concepts of professionalism to develop behaviors consistent with medical professionalism and to evaluate the levels of professionalism among residents.

Purpose: The aim of the study was to determine the publication rates of abstracts presented at the annual Saudi Ophthalmology Society (SOS) Conferences from 2015 to 2018.

Methods: This is a cross-sectional study on abstracts collected from the scientific programs for the SOS meetings from 2015 to 2018. Titles and first authors' names were used in the search process on PubMed. A Chi-square test was conducted to compare between the categorical variables. Kruskal-Wallis test was used for nonnormally distributed variables.

Results: A total of 365 abstracts were presented in the SOS Conferences from 2015 to 2018. In the SOS meetings (2015-2018), the publication rate was 45.7%. Seventy-two (43.1%) of the published abstracts were published in journals with an impact factor. The mean impact factor was 1.4 ± 1.9. The median time to publication was 12.0 months (range: 0-60 months). On univariate analysis, basic science (P < 0.001), abstracts on rare diseases (P = 0.003), affiliation with eye hospitals (P < 0.001), and public hospitals (0.007) were associated with a higher publication rate. On multivariate analysis, basic science studies (odds ratio [OR]: 4.23, confidence interval [CI]: 1.77-10.12, P = 0.001), rare topic-related abstracts (OR: 2.03, CI: 1.22-3.38, P = 0.007), and eye center affiliation (OR: 1.67, CI: 1.03-2.68, P = 0.036) were associated with a better publication rate. The factors associated with publication in high impact factor journals were oral abstracts (P = 0.007) and noncase report abstracts (P = 0.023).

Conclusion: Basic science studies, rare topic-related abstracts, and first author affiliation with an eye center were all associated with a higher publication rate. Orally presented and noncase report abstracts increased the chance of publication in higher impact factor journals.