Pub Date : 2021-12-31eCollection Date: 2021-07-01DOI: 10.4103/meajo.meajo_434_20
Ashraf Ahmed Nossair, Mona Kassem Kassem, Rasha Mounir Eltanamly, Yomna Amr Alahmadawy
Purpose: To evaluate biomechanical properties, corneal thickness, and intraocular pressure (IOP) in patients with rheumatoid arthritis (RA) and correlate them with rheumatoid activity.
Patients and methods: Forty RA eyes were enrolled in a cross-sectional study. Clinical Disease Activity Index (CDAI) was used to assess the rheumatoid activity by a rheumatologist. Corneal hysteresis (CH), corneal resistance factor (CRF), and IOP corneal compensated, IOP Goldmann corrected were assessed using ocular response analyzer (ORA), Corneal thickness was measured using optical coherence tomography, and IOP using Goldman applanation tonometer (IOP GAT).
Results: There was a positive correlation between CH and CRF (P < 0.001 and r = 0.818) and (P < 0.001 and r = 0.714) in the active and inactive groups respectively, also between CRF and central corneal thickness (CCT) (P value 0.05 and r = 0.0435) in Inactive Group only. No correlation was found between CDAI score and ORA parameters. There was a negative correlation between CDAI and CCT in Active Group only (P < 0.001 and r = -0.823).
Conclusion: Corneal biomechanical properties could be affected in rheumatoid patients in both active and remission phases, which may indicate that any corneal changes may be irreversible. These changes are of important significance regarding IOP measurement in rheumatoid patients. CCT may be a new parameter in the follow up of disease activity.
目的:评估类风湿性关节炎(RA)患者的生物力学特性、角膜厚度和眼内压(IOP)及其与类风湿活动的相关性。患者和方法:40只RA眼被纳入横断面研究。临床疾病活动指数(CDAI)被风湿病学家用来评估类风湿活动。使用眼反应分析仪(ORA)评估角膜迟滞(CH)、角膜阻力因子(CRF)、角膜代偿性IOP、IOP Goldmann矫正性IOP,使用光学相干断层扫描测量角膜厚度,使用Goldman眼压计(IOP GAT)测量IOP。结果:运动组与不运动组CH与CRF呈正相关(P < 0.001, r = 0.818),不运动组CH与CRF呈正相关(P < 0.001, r = 0.714),不运动组CRF与角膜中央厚度(CCT)呈正相关(P值0.05,r = 0.0435)。CDAI评分与ORA参数无相关性。仅活跃组CDAI与CCT呈负相关(P < 0.001, r = -0.823)。结论:类风湿患者活动期和缓解期的角膜生物力学特性都可能受到影响,这可能表明任何角膜变化都可能是不可逆的。这些变化对类风湿患者IOP测量具有重要意义。CCT可能成为疾病活动性随访的新参数。
{"title":"Corneal Hysteresis, Central Corneal Thickness, and Intraocular Pressure in Rheumatoid Arthritis, and Their Relation to Disease Activity.","authors":"Ashraf Ahmed Nossair, Mona Kassem Kassem, Rasha Mounir Eltanamly, Yomna Amr Alahmadawy","doi":"10.4103/meajo.meajo_434_20","DOIUrl":"https://doi.org/10.4103/meajo.meajo_434_20","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate biomechanical properties, corneal thickness, and intraocular pressure (IOP) in patients with rheumatoid arthritis (RA) and correlate them with rheumatoid activity.</p><p><strong>Patients and methods: </strong>Forty RA eyes were enrolled in a cross-sectional study. Clinical Disease Activity Index (CDAI) was used to assess the rheumatoid activity by a rheumatologist. Corneal hysteresis (CH), corneal resistance factor (CRF), and IOP corneal compensated, IOP Goldmann corrected were assessed using ocular response analyzer (ORA), Corneal thickness was measured using optical coherence tomography, and IOP using Goldman applanation tonometer (IOP GAT).</p><p><strong>Results: </strong>There was a positive correlation between CH and CRF (<i>P</i> < 0.001 and <i>r</i> = 0.818) and (<i>P</i> < 0.001 and <i>r</i> = 0.714) in the active and inactive groups respectively, also between CRF and central corneal thickness (CCT) (<i>P</i> value 0.05 and <i>r</i> = 0.0435) in Inactive Group only. No correlation was found between CDAI score and ORA parameters. There was a negative correlation between CDAI and CCT in Active Group only (<i>P</i> < 0.001 and <i>r</i> = -0.823).</p><p><strong>Conclusion: </strong>Corneal biomechanical properties could be affected in rheumatoid patients in both active and remission phases, which may indicate that any corneal changes may be irreversible. These changes are of important significance regarding IOP measurement in rheumatoid patients. CCT may be a new parameter in the follow up of disease activity.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39755427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31eCollection Date: 2021-07-01DOI: 10.4103/meajo.meajo_15_21
Moustafa S Magliyah, Abdullah M Khan, Mohammed AlShamrani, Patrik Schatz, Hassan A Dhibi
Blau syndrome (BS) is a rare granulomatous disease with autosomal dominant inheritance. It is characterized by a triad of dermatitis, arthritis, and recurrent uveitis. This case presents the onset of panuveitis in BS after intraocular surgery. A 10-year-old boy presented to the outpatient clinic with retinal detachment in the left eye after 6 years following early-onset cataract surgery. Bilateral panuveitis occurred 3 weeks after surgical repair and resulted in a total visual loss in the left eye and was persistent to conventional treatment in the right eye. Genetic testing revealed a mutation in NOD2 gene. The addition of adalimumab to the treatment regimen resulted in long-term uveitis control and maintenance of 20/70 vision in the right eye. We propose that NOD2-mediated inflammatory cascade can be activated by intraocular surgery and results in the manifestation of BS.
{"title":"Manifestation of Panuveitis after Intraocular Surgery in a Child with Blau Syndrome.","authors":"Moustafa S Magliyah, Abdullah M Khan, Mohammed AlShamrani, Patrik Schatz, Hassan A Dhibi","doi":"10.4103/meajo.meajo_15_21","DOIUrl":"https://doi.org/10.4103/meajo.meajo_15_21","url":null,"abstract":"<p><p>Blau syndrome (BS) is a rare granulomatous disease with autosomal dominant inheritance. It is characterized by a triad of dermatitis, arthritis, and recurrent uveitis. This case presents the onset of panuveitis in BS after intraocular surgery. A 10-year-old boy presented to the outpatient clinic with retinal detachment in the left eye after 6 years following early-onset cataract surgery. Bilateral panuveitis occurred 3 weeks after surgical repair and resulted in a total visual loss in the left eye and was persistent to conventional treatment in the right eye. Genetic testing revealed a mutation in <i>NOD2</i> gene. The addition of adalimumab to the treatment regimen resulted in long-term uveitis control and maintenance of 20/70 vision in the right eye. We propose that NOD2-mediated inflammatory cascade can be activated by intraocular surgery and results in the manifestation of BS.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39770200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31eCollection Date: 2021-07-01DOI: 10.4103/meajo.meajo_96_21
Waseem Aalam, Maan Barry, Majed Alharbi, Shadi Tamur, Ahmad Wazzan, Deepak P Edward
Purpose: The purpose of the study was to determine knowledge, practice, and resources available to primary care physicians to diagnose and manage corneal abrasion in Saudi Arabia.
Methods: This cross-sectional survey was held in 2017. Family physicians and emergency physicians attending an international conference were surveyed. The questions related to demography, invagination, and tools available in their institute were collected. The questionnaire on how to diagnose and how they manage case of corneal abrasion was also collected using tablet-based software.
Results: Two hundred and twenty-five participants participated in the survey. Exposure to eye patients in two-third of participants was too low (93; 39.6%). Resources for diagnosing corneal abrasion were available in limited centers (51; 21.7%). The rate of good practice to manage corneal abrasion was 21.2% (95% confidence interval 16.0; 26.5). Certified emergency physicians (P < 0.001) and western and central regions (P < 0.001) were positively associated with good practice. Availability of slit lamp (P = 0.2) was not significantly associated with the level of practice to manage corneal abrasion. Fluorescein staining and use of cobalt blue light are essential for diagnosing corneal abrasion as per 40% of participants. About 44.7% of participants replied that antibiotics and lubricants should be used to treat. Nearly one-fourth of participants suggested urgent reference to the ophthalmologist. Use of specific antibiotic varied widely; however, ofloxacin was the main choice of antibiotic in treating corneal abrasion.
Conclusion: The knowledge and practice among physicians about corneal abrasion were low. Integrating primary eye care into emergency services through provision of required resources and training physicians is recommended.
{"title":"Diagnosis and Management of Corneal Abrasion Perception of (Primary Health Care Physicians and Emergency Physicians) and its Determinants in Saudi Arabia - A Survey.","authors":"Waseem Aalam, Maan Barry, Majed Alharbi, Shadi Tamur, Ahmad Wazzan, Deepak P Edward","doi":"10.4103/meajo.meajo_96_21","DOIUrl":"https://doi.org/10.4103/meajo.meajo_96_21","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to determine knowledge, practice, and resources available to primary care physicians to diagnose and manage corneal abrasion in Saudi Arabia.</p><p><strong>Methods: </strong>This cross-sectional survey was held in 2017. Family physicians and emergency physicians attending an international conference were surveyed. The questions related to demography, invagination, and tools available in their institute were collected. The questionnaire on how to diagnose and how they manage case of corneal abrasion was also collected using tablet-based software.</p><p><strong>Results: </strong>Two hundred and twenty-five participants participated in the survey. Exposure to eye patients in two-third of participants was too low (93; 39.6%). Resources for diagnosing corneal abrasion were available in limited centers (51; 21.7%). The rate of good practice to manage corneal abrasion was 21.2% (95% confidence interval 16.0; 26.5). Certified emergency physicians (<i>P</i> < 0.001) and western and central regions (<i>P</i> < 0.001) were positively associated with good practice. Availability of slit lamp (<i>P</i> = 0.2) was not significantly associated with the level of practice to manage corneal abrasion. Fluorescein staining and use of cobalt blue light are essential for diagnosing corneal abrasion as per 40% of participants. About 44.7% of participants replied that antibiotics and lubricants should be used to treat. Nearly one-fourth of participants suggested urgent reference to the ophthalmologist. Use of specific antibiotic varied widely; however, ofloxacin was the main choice of antibiotic in treating corneal abrasion.</p><p><strong>Conclusion: </strong>The knowledge and practice among physicians about corneal abrasion were low. Integrating primary eye care into emergency services through provision of required resources and training physicians is recommended.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39755423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31eCollection Date: 2021-07-01DOI: 10.4103/meajo.meajo_234_21
Fadwa Al Adel, Abdulrahman F AlBloushi
There has been an emergence of permanent macular injury due to the misuse of handheld laser pointers. The clinical phenotype of laser-induced maculopathy can mimic hereditary retinal dystrophies. This report describes the clinical phenotype and the results of multimodal imaging in a 27-year-old woman who was referred with a bilateral progressive decrease in vision over 2 months. She was initially diagnosed elsewhere with hereditary macular dystrophy. Examination of her fundus showed bilateral creamy-to-gray irregular lesions in the posterior pole. The results of multimodal imaging of her retina suggested self-inflicted laser-induced maculopathy. The patient was referred to a psychiatrist with a working diagnosis of factitious disorder. A high index of suspicion and the utilization of multimodal imaging allowed early and correct diagnosis and prevented further loss of vision.
{"title":"Laser-Induced Maculopathy Masquerading as Hereditary Macular Dystrophy.","authors":"Fadwa Al Adel, Abdulrahman F AlBloushi","doi":"10.4103/meajo.meajo_234_21","DOIUrl":"https://doi.org/10.4103/meajo.meajo_234_21","url":null,"abstract":"<p><p>There has been an emergence of permanent macular injury due to the misuse of handheld laser pointers. The clinical phenotype of laser-induced maculopathy can mimic hereditary retinal dystrophies. This report describes the clinical phenotype and the results of multimodal imaging in a 27-year-old woman who was referred with a bilateral progressive decrease in vision over 2 months. She was initially diagnosed elsewhere with hereditary macular dystrophy. Examination of her fundus showed bilateral creamy-to-gray irregular lesions in the posterior pole. The results of multimodal imaging of her retina suggested self-inflicted laser-induced maculopathy. The patient was referred to a psychiatrist with a working diagnosis of factitious disorder. A high index of suspicion and the utilization of multimodal imaging allowed early and correct diagnosis and prevented further loss of vision.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39770196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-25eCollection Date: 2021-04-01DOI: 10.4103/meajo.meajo_24_21
Tesfahun Ejigu, Asamere Tsegaw
Purpose: Diabetic retinopathy (DR) is one of the most serious complications of diabetes mellitus (DM). It is the most common cause of blindness among the working age group in the developed world and the fifth leading cause of global blindness. In Sub-Saharan Africa, 2.8% of all blindness is caused by DR. Studies addressing the prevalence of DR and associated factors are scarce in Ethiopia. The objective of this study was to determine the Prevalence and associated factors of DR development among DM patients attending University of Gondar, Tertiary Eye Care and Training center.
Methods: A cross-sectional study was carried out from March 2019 to February 2020 involving all consecutive diabetes patients who visited the center during the study period. Data were collected using a semi-structured questionnaire and data extraction check list and entered into SPSS version 20 and analyzed. Univariate and multivariable logistic regression analysis were done to identify predictors of DR. Statistical significance was determined with 95% confidence interval (CI) using odds ratio and P < 0.05.
Results: A total of 225 DM patients with a mean age of 55.4 ± 13.5 years were studied, of whom 95 (42.2%) had DR. Duration of diabetes ≥6 years (AOR = 2.91: 95% CI; 1.01-8.35) and baseline age < 60 years (AOR = 3.2: 95% CI; 1.19-8.63) were significantly associated with DR. DR was significantly associated with the form of therapy. Those on insulin (P = 0.025) and oral hypoglycemic agents (OHA) with insulin combination (P = 0.014) had statistically significantly associated with the development of DR. Patients with systolic blood pressure of <140 mmHg were 3.6 times (AOR = 0.28: 95% CI: 0.09-0.82) less likely to have DR. A majority of patients had nonproliferative DR without diabetic macular edema (DME) (34.2%). DME and proliferative DR were seen in 5.7% and 3.6% of the patients, respectively. Vision threatening DR (VTDR) was seen in 10.7% of patients. There was a significant association between age <60 years and VTDR (AOR = 4.19: 95% CI; 1.23-14.35).
Conclusion: The prevalence of DR among our study patients was very high. Longer duration of diabetes, higher systolic blood pressure, baseline age <60 years, use of insulin alone, and use of combination of insulin with OHA were independently associated with DR. Health education, early screening, and treatment are recommended.
{"title":"Prevalence of Diabetic Retinopathy and Risk Factors among Diabetic Patients at University of Gondar Tertiary Eye Care and Training Center, North-West Ethiopia.","authors":"Tesfahun Ejigu, Asamere Tsegaw","doi":"10.4103/meajo.meajo_24_21","DOIUrl":"https://doi.org/10.4103/meajo.meajo_24_21","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic retinopathy (DR) is one of the most serious complications of diabetes mellitus (DM). It is the most common cause of blindness among the working age group in the developed world and the fifth leading cause of global blindness. In Sub-Saharan Africa, 2.8% of all blindness is caused by DR. Studies addressing the prevalence of DR and associated factors are scarce in Ethiopia. The objective of this study was to determine the Prevalence and associated factors of DR development among DM patients attending University of Gondar, Tertiary Eye Care and Training center.</p><p><strong>Methods: </strong>A cross-sectional study was carried out from March 2019 to February 2020 involving all consecutive diabetes patients who visited the center during the study period. Data were collected using a semi-structured questionnaire and data extraction check list and entered into SPSS version 20 and analyzed. Univariate and multivariable logistic regression analysis were done to identify predictors of DR. Statistical significance was determined with 95% confidence interval (CI) using odds ratio and <i>P</i> < 0.05.</p><p><strong>Results: </strong>A total of 225 DM patients with a mean age of 55.4 ± 13.5 years were studied, of whom 95 (42.2%) had DR. Duration of diabetes ≥6 years (AOR = 2.91: 95% CI; 1.01-8.35) and baseline age < 60 years (AOR = 3.2: 95% CI; 1.19-8.63) were significantly associated with DR. DR was significantly associated with the form of therapy. Those on insulin (<i>P</i> = 0.025) and oral hypoglycemic agents (OHA) with insulin combination (<i>P</i> = 0.014) had statistically significantly associated with the development of DR. Patients with systolic blood pressure of <140 mmHg were 3.6 times (AOR = 0.28: 95% CI: 0.09-0.82) less likely to have DR. A majority of patients had nonproliferative DR without diabetic macular edema (DME) (34.2%). DME and proliferative DR were seen in 5.7% and 3.6% of the patients, respectively. Vision threatening DR (VTDR) was seen in 10.7% of patients. There was a significant association between age <60 years and VTDR (AOR = 4.19: 95% CI; 1.23-14.35).</p><p><strong>Conclusion: </strong>The prevalence of DR among our study patients was very high. Longer duration of diabetes, higher systolic blood pressure, baseline age <60 years, use of insulin alone, and use of combination of insulin with OHA were independently associated with DR. Health education, early screening, and treatment are recommended.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-25eCollection Date: 2021-04-01DOI: 10.4103/meajo.meajo_134_21
Joanna S Saade, Rachid Istambouli, Marwan AbdulAal, Rafic Antonios, Rola N Hamam
Purpose: The topical nonsteroidal anti-inflammatory drug bromfenac 0.09% has a potential benefit in uveitic macular edema (UME) with a safe side effect profile. The aim of the study is to assess the efficacy of bromfenac sodium solution in the treatment of UME.
Methods: The charts of 10 patients with macular edema due to noninfectious uveitis treated with bromfenac 0.09% were reviewed retrospectively. The main outcomes studied were the best-corrected visual acuity (BCVA) and the central retinal thickness (CRT) compared 4 months before bromfenac initiation, at the time of its initiation, and 4 months later.
Results: Twelve eyes of 10 patients were included. BCVA and CRT were unchanged 4 months befoew bromfenac compared to the time of bromfenac initiation (P = 1.0 and P = 0.2, respectively). There were a significant improvement in BCVA after 4 months of bromfenac treatment (P = 0.043) and a significant decrease in CRT (P = 0.002). Subretinal fluid resolved completely in 8/9 eyes, and 4/9 eyes had a complete resolution of cystoid macular edema at 4 months.
Conclusion: Bromfenac may be a useful addition to the treatment of UME.
{"title":"Bromfenac 0.09% for the Treatment of Macular Edema Secondary to Noninfectious Uveitis.","authors":"Joanna S Saade, Rachid Istambouli, Marwan AbdulAal, Rafic Antonios, Rola N Hamam","doi":"10.4103/meajo.meajo_134_21","DOIUrl":"https://doi.org/10.4103/meajo.meajo_134_21","url":null,"abstract":"<p><strong>Purpose: </strong>The topical nonsteroidal anti-inflammatory drug bromfenac 0.09% has a potential benefit in uveitic macular edema (UME) with a safe side effect profile. The aim of the study is to assess the efficacy of bromfenac sodium solution in the treatment of UME.</p><p><strong>Methods: </strong>The charts of 10 patients with macular edema due to noninfectious uveitis treated with bromfenac 0.09% were reviewed retrospectively. The main outcomes studied were the best-corrected visual acuity (BCVA) and the central retinal thickness (CRT) compared 4 months before bromfenac initiation, at the time of its initiation, and 4 months later.</p><p><strong>Results: </strong>Twelve eyes of 10 patients were included. BCVA and CRT were unchanged 4 months befoew bromfenac compared to the time of bromfenac initiation (<i>P</i> = 1.0 and <i>P</i> = 0.2, respectively). There were a significant improvement in BCVA after 4 months of bromfenac treatment (<i>P</i> = 0.043) and a significant decrease in CRT (<i>P</i> = 0.002). Subretinal fluid resolved completely in 8/9 eyes, and 4/9 eyes had a complete resolution of cystoid macular edema at 4 months.</p><p><strong>Conclusion: </strong>Bromfenac may be a useful addition to the treatment of UME.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-25eCollection Date: 2021-04-01DOI: 10.4103/meajo.meajo_103_21
Shatha Alfreihi, Hebatallah Ammar
Purpose: This study aims to identify the use of limbal versus fornix incisions among strabismus surgeons in Saudi Arabia and the preferred approach to teaching trainees with the shortest learning curve.
Methods: Two designed questionnaires were sent to local strabismus surgeons and ophthalmology trainees.
Results: A total of 127 participants responded to our survey: fifty-nine consultants (53% Saudi nationals and 43% expat ophthalmologists) and 68 trainees. The limbal approach was the preferred approach for all settings, including the primary pediatric procedure (30, 55.9%), pediatric reoperation (40, 64.7%), adult primary procedure (32, 55.9%), and reoperation (40, 70%). The reason was attributed to better exposure. As for fornix incision, the most commonly cited reason was less pain and discomfort. For the adjustable suture technique, 29 (49.2%) did not use adjustable sutures, and 22 (37.3%) prefer the limbal approach. When we compared Saudi versus non-Saudi surgeons, 26 (83.87%) Saudi surgeons were trained to perform the limbal method, whereas 16 (57.14%) non-Saudi surgeons were trained to perform the fornix approach. Of the trainees, 35 (51%) were trained on the limbal approach. When asked about the learning curve for different methods, 41 (60.3%) noted a faster learning curve with the limbal approach.
Conclusion: Despite the many advantages of the fornix incision, it remains uncommon in our region. Each technique of strabismus surgery has its advantages and disadvantages. Programs should teach all methods to trainees. One should add all styles to his armamentarium and choose the appropriate one for each patient.
{"title":"Limbal Versus Fornix Incision for Strabismus Surgery: Preferences from a Consultant to a Trainee Level in Saudi Arabia.","authors":"Shatha Alfreihi, Hebatallah Ammar","doi":"10.4103/meajo.meajo_103_21","DOIUrl":"https://doi.org/10.4103/meajo.meajo_103_21","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to identify the use of limbal versus fornix incisions among strabismus surgeons in Saudi Arabia and the preferred approach to teaching trainees with the shortest learning curve.</p><p><strong>Methods: </strong>Two designed questionnaires were sent to local strabismus surgeons and ophthalmology trainees.</p><p><strong>Results: </strong>A total of 127 participants responded to our survey: fifty-nine consultants (53% Saudi nationals and 43% expat ophthalmologists) and 68 trainees. The limbal approach was the preferred approach for all settings, including the primary pediatric procedure (30, 55.9%), pediatric reoperation (40, 64.7%), adult primary procedure (32, 55.9%), and reoperation (40, 70%). The reason was attributed to better exposure. As for fornix incision, the most commonly cited reason was less pain and discomfort. For the adjustable suture technique, 29 (49.2%) did not use adjustable sutures, and 22 (37.3%) prefer the limbal approach. When we compared Saudi versus non-Saudi surgeons, 26 (83.87%) Saudi surgeons were trained to perform the limbal method, whereas 16 (57.14%) non-Saudi surgeons were trained to perform the fornix approach. Of the trainees, 35 (51%) were trained on the limbal approach. When asked about the learning curve for different methods, 41 (60.3%) noted a faster learning curve with the limbal approach.</p><p><strong>Conclusion: </strong>Despite the many advantages of the fornix incision, it remains uncommon in our region. Each technique of strabismus surgery has its advantages and disadvantages. Programs should teach all methods to trainees. One should add all styles to his armamentarium and choose the appropriate one for each patient.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-25eCollection Date: 2021-04-01DOI: 10.4103/meajo.meajo_406_20
Bhargavi Pawar, Suneetha N Lobo, Mary Joseph, Sangeetha Jegannathan, Hariprasad Jayraj
Purpose: Diabetic retinopathy (DR) is one of the leading causes of vision loss globally, and early detection plays a significant role in the prognosis. Several studies have been done on the single field fundus photography and artificial intelligence (AI) in DR screening using standardized data sets in urban outpatient settings. This study was carried out to validate AI algorithm in the detection of DR severity using fundus photography in real-time rural setting.
Methods: This cross-sectional study was carried out among 138 patients who underwent routine ophthalmic examination, irrespective of their diabetic status. The participants were subjected to a single field color fundus photography using nonmydriatic fundus camera. The images acquired were processed by AI algorithm for image quality, presence and refer ability of DR. The results were graded by four ophthalmologists. Interobserver variability between the four observers was also calculated.
Results: Of the 138 patients, 26 patients (18.84%) had some stage of DR, represented by 47 images (17.03%) positive for signs of DR. All 26 patients were immoderate or severe stage. About 6.5% of the images were considered as not gradable due to poor optical quality. The average agreement between pairs of the four graders was 95.16% for referable DR (RDR). The AI showed 100% sensitivity in detecting DR while the specificity for RDR was 91.47%.
Conclusion: AI has shown excellent sensitivity and specificity in RDR detection, at par with the performance of individual ophthalmologists and is an invaluable tool for DR screening.
{"title":"Validation of Artificial Intelligence Algorithm in the Detection and Staging of Diabetic Retinopathy through Fundus Photography: An Automated Tool for Detection and Grading of Diabetic Retinopathy.","authors":"Bhargavi Pawar, Suneetha N Lobo, Mary Joseph, Sangeetha Jegannathan, Hariprasad Jayraj","doi":"10.4103/meajo.meajo_406_20","DOIUrl":"https://doi.org/10.4103/meajo.meajo_406_20","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic retinopathy (DR) is one of the leading causes of vision loss globally, and early detection plays a significant role in the prognosis. Several studies have been done on the single field fundus photography and artificial intelligence (AI) in DR screening using standardized data sets in urban outpatient settings. This study was carried out to validate AI algorithm in the detection of DR severity using fundus photography in real-time rural setting.</p><p><strong>Methods: </strong>This cross-sectional study was carried out among 138 patients who underwent routine ophthalmic examination, irrespective of their diabetic status. The participants were subjected to a single field color fundus photography using nonmydriatic fundus camera. The images acquired were processed by AI algorithm for image quality, presence and refer ability of DR. The results were graded by four ophthalmologists. Interobserver variability between the four observers was also calculated.</p><p><strong>Results: </strong>Of the 138 patients, 26 patients (18.84%) had some stage of DR, represented by 47 images (17.03%) positive for signs of DR. All 26 patients were immoderate or severe stage. About 6.5% of the images were considered as not gradable due to poor optical quality. The average agreement between pairs of the four graders was 95.16% for referable DR (RDR). The AI showed 100% sensitivity in detecting DR while the specificity for RDR was 91.47%.</p><p><strong>Conclusion: </strong>AI has shown excellent sensitivity and specificity in RDR detection, at par with the performance of individual ophthalmologists and is an invaluable tool for DR screening.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-25eCollection Date: 2021-04-01DOI: 10.4103/meajo.MEAJO_441_20
Maryam Bunajem, Khabir Ahmad, Nazih Al Zaidi, Bedoor Al Bloushi, Yahya Al Zahrani
Purpose: The purpose of this study is to compare the anatomical and visual outcomes of scleral buckle (SB) surgery with the pars plana vitrectomy (PPV) in the management of chronic rhegmatogenous retinal detachment.
Methods: This cohort study included patients who underwent surgical repair SB group and PPV group for chronic retinal detachment during 2014-2018 at the King Khalid Eye Specialist Hospital, Riyadh. The anatomical and functional success rate at 12 months after surgery was compared in two groups. Cox regression and linear regression analysis were performed to identify the predictor of anatomical and functional outcomes, respectively. Need for second surgery was also evaluated.
Results: Our cohort had 68 eyes in SB and 64 eyes in PPV group. Eyes that underwent PPV were more likely to develop retinal detachment over 12 months than those that underwent SB surgery (adjusted heart rates 2.11, 95% confidence interval [CI], 0.95-4.64 P = 0.065). A multivariable linear regression analysis did not reveal a significant association between the surgery type and change in visual acuity (beta coefficient, 0.002; 95% CI,-0.184, 0.189 for specific bread volume; P = 0.979). A higher percentage of eyes in the PPV group compared with those in the SB surgery group required secondary surgery (39.1% vs. 22.1%; P = 0.034).
Conclusion: Scleral buckling surgery showed a better single surgery anatomic success rate as compared to PPV in the management of chronic primary rhegmatogenous retinal detachment. The functional outcome of the two procedures was comparable.
目的:本研究的目的是比较巩膜扣(SB)手术与平面部玻璃体切除术(PPV)治疗慢性孔源性视网膜脱离的解剖和视觉效果。方法:本队列研究纳入了2014-2018年在利雅得哈立德国王眼科专科医院接受手术修复SB组和PPV组治疗慢性视网膜脱离的患者。比较两组术后12个月解剖和功能成功率。分别采用Cox回归和线性回归分析来确定解剖和功能结局的预测因子。还评估了是否需要进行第二次手术。结果:SB组68眼,PPV组64眼。在12个月内,接受PPV手术的眼睛比接受SB手术的眼睛更容易发生视网膜脱离(调整心率2.11,95%可信区间[CI], 0.95-4.64 P = 0.065)。多变量线性回归分析未显示手术类型与视力变化之间存在显著关联(β系数,0.002;面包体积比95% CI,-0.184, 0.189;P = 0.979)。与SB手术组相比,PPV组需要二次手术的眼睛比例更高(39.1% vs 22.1%;P = 0.034)。结论:巩膜扣带术治疗慢性原发孔源性视网膜脱离的单次手术解剖成功率优于PPV手术。两种手术的功能结果具有可比性。
{"title":"Scleral Buckle versus Pars Plana Vitrectomy in the Management of Primary Chronic Rhegmatogenous Retinal Detachment: A Comparison of Anatomical and Visual Outcomes.","authors":"Maryam Bunajem, Khabir Ahmad, Nazih Al Zaidi, Bedoor Al Bloushi, Yahya Al Zahrani","doi":"10.4103/meajo.MEAJO_441_20","DOIUrl":"https://doi.org/10.4103/meajo.MEAJO_441_20","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to compare the anatomical and visual outcomes of scleral buckle (SB) surgery with the pars plana vitrectomy (PPV) in the management of chronic rhegmatogenous retinal detachment.</p><p><strong>Methods: </strong>This cohort study included patients who underwent surgical repair SB group and PPV group for chronic retinal detachment during 2014-2018 at the King Khalid Eye Specialist Hospital, Riyadh. The anatomical and functional success rate at 12 months after surgery was compared in two groups. Cox regression and linear regression analysis were performed to identify the predictor of anatomical and functional outcomes, respectively. Need for second surgery was also evaluated.</p><p><strong>Results: </strong>Our cohort had 68 eyes in SB and 64 eyes in PPV group. Eyes that underwent PPV were more likely to develop retinal detachment over 12 months than those that underwent SB surgery (adjusted heart rates 2.11, 95% confidence interval [CI], 0.95-4.64 <i>P</i> = 0.065). A multivariable linear regression analysis did not reveal a significant association between the surgery type and change in visual acuity (beta coefficient, 0.002; 95% CI,-0.184, 0.189 for specific bread volume; <i>P</i> = 0.979). A higher percentage of eyes in the PPV group compared with those in the SB surgery group required secondary surgery (39.1% vs. 22.1%; <i>P</i> = 0.034).</p><p><strong>Conclusion: </strong>Scleral buckling surgery showed a better single surgery anatomic success rate as compared to PPV in the management of chronic primary rhegmatogenous retinal detachment. The functional outcome of the two procedures was comparable.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-25eCollection Date: 2021-04-01DOI: 10.4103/meajo.meajo_120_21
Huda Al-Ghadeer, Mohammed Al-Amry
The present paper reviewed the ocular complications resulting from the use of traditional eye medicine in Central Saudi Arabia. We performed a literature search of the PubMed database using the keywords "traditional medicine," "herbal medicine," "ocular injuries," and "visual impairments," covering all years available for peer-reviewed full-text articles, letters, and review chapters of books. An additional search was performed in Google Scholar. All published materials were in English. Several ocular symptoms and disorders, including conjunctival cicatrization, symblepharon formation, obliteration of the fornices and the canaliculi, keratinization of the cornea, dryness, central corneal thinning, and corneal epithelial defect, have been associated with the use of traditional herbal medicine. In addition, the use of traditional eye medicine may result in corneal edema, opacity, ulceration, and perforation. Early recognition of ocular injuries could avoid or at least delay long-term sequelae. Ophthalmologists should be aware of the side effects of traditional remedies. Furthermore, public education, early detection of symptoms, and timely intervention may prevent permanent damage to the eyes.
{"title":"Ocular Complications Resulting from the Use of Traditional Herbal Medicine in Central Saudi Arabia: A Review.","authors":"Huda Al-Ghadeer, Mohammed Al-Amry","doi":"10.4103/meajo.meajo_120_21","DOIUrl":"10.4103/meajo.meajo_120_21","url":null,"abstract":"<p><p>The present paper reviewed the ocular complications resulting from the use of traditional eye medicine in Central Saudi Arabia. We performed a literature search of the PubMed database using the keywords \"traditional medicine,\" \"herbal medicine,\" \"ocular injuries,\" and \"visual impairments,\" covering all years available for peer-reviewed full-text articles, letters, and review chapters of books. An additional search was performed in Google Scholar. All published materials were in English. Several ocular symptoms and disorders, including conjunctival cicatrization, symblepharon formation, obliteration of the fornices and the canaliculi, keratinization of the cornea, dryness, central corneal thinning, and corneal epithelial defect, have been associated with the use of traditional herbal medicine. In addition, the use of traditional eye medicine may result in corneal edema, opacity, ulceration, and perforation. Early recognition of ocular injuries could avoid or at least delay long-term sequelae. Ophthalmologists should be aware of the side effects of traditional remedies. Furthermore, public education, early detection of symptoms, and timely intervention may prevent permanent damage to the eyes.</p>","PeriodicalId":18740,"journal":{"name":"Middle East African Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39697434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}