Middle East African Journal of Ophthalmology最新文献

Purpose: The purpose of this study was to determine the prevalence of keratoconus (KC) and keratoconus suspect (KCS) among patients seeking refractive surgery in Syria.

Methods: This is a retrospective multicenter screening study. The study was conducted in Damascus University, Tishreen University, and Tartous Specialist Eye Center (a private center). Data were collected from refractive surgery candidates referred for preoperative evaluation before laser in situ keratomileusis, photorefractive keratectomy, intrastromal corneal rings, and phakic intraocular lens implantation. Corneal parameters were obtained by Scheimpflug-Placido tomography, Sirius (CSO, Italy).

Results: A total of 1479 patients were included in this analysis. The prevalence rates of KC and KCS were 18.19% (269/1479) and 13.52% (200/1479), respectively. In addition, patients with KC were found to have higher percentages of eye rubbing and astigmatism than suspect and normal (P < 0.0001).

Conclusion: High prevalence rate of KC was found among patients seeking refractive surgery in Syria. Although this study was carried out on a highly selective population, it may reflect a high prevalence rate in a general population in Syria.

Purpose: The purpose of this study is to compare the quality of life (QoL) of medically treated versus surgically treated primary open-angle glaucoma (POAG) patients attending Lagos University Teaching Hospital, Lagos, Nigeria.

Methods: The study was a hospital-based, comparative cross-sectional study. Consecutive consenting POAG participants who met the inclusion criteria were recruited until the sample size was achieved. QoL of all participants was assessed using the glaucoma QoL-15 and National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) questionnaires. Analysis was done using the IBM statistical package for the social sciences version 25.0.

Results: The study involved 81 participants who were only on medical treatment for POAG and 81 age- and sex-matched POAG participants who had trabeculectomy surgery. Surgically treated participants had a lower mean intraocular pressure 11.68 mmHg when compared to the medically treated participants 14.82 mmHg. Medically treated participants however had a better overall mean glaucoma QoL using the glaucoma QoL-15 (medical 34.36 ± 10.4, surgical 39.11 ± 13.9 P = 0.015) and NEI-VFQ-25 questionnaires (medical 68.32 ± 15.0, surgical 62.44 ± 18.8 P = 0.029). Controlling for the severity of glaucoma using the glaucoma QoL-15 questionnaire, medically treated participants had a better QoL only among participants with severe POAG (medical 49.13 ± 5.9, surgical 54.06 ± 4.6 P = 0.003). While using the NEI-VFQ-25 questionnaire, medically treated participants had a significantly better QoL only among participants with moderate (medical 74.70 ± 6.6, surgical 67.07 ± 15.6 P = 0.012) and severe POAG (medical 54.52 ± 6.3, surgical 45.51 ± 10.0 P = 0.004).

Conclusion: The study demonstrated that although participants that had trabeculectomy had a lower mean intraocular pressure, their overall mean QoL was reduced compared to the medically treated participants.

Episcleritis is rarely reported to be associated with tuberculosis (TB). In this review, we highlight this underreported entity and elaborate on the natural history of the reported cases in the literature. Eighteen articles were found to describe numerous cases throughout the past century. Forty patients diagnosed with tuberculous episcleritis were found in the literature. The majority of the patients presented with a latent form of TB and fewer cases were linked with active/pulmonary disease. The natural history of episcleritis was found to have chronic and recurrent attacks refractory to traditional treatment, and the most commonly reported type was the nodular form. The described cases were eventually treated by quadruple antituberculous therapy, and fortunately, recurrence after treatment completion was not documented. It is imperative to highlight such entities that may be underreported in endemic countries, as successful therapy would decrease ocular morbidity and prevent potential unforeseen tuberculous complications.

Purpose: The purpose is to present the prevalence and risk factors of parents' perceptions of digital eye strain (DES) syndrome 1 year after virtual learning among Saudi students.

Methods: This web-based survey was conducted in December 2021 in Qassim, Saudi Arabia. Sixteen symptoms of DES were inquired. Parents responded to the frequency and severity of DES symptoms in their wards. The DES score assessed by the parents/guardian was associated with different determinants.

Results: The survey included 704 students. The prevalence of DES was 59.4% (95% confidence interval 55.0; 63.8). Severe (scoring 18+) and moderate (score 12-18) grades of DES were found in 24% and 14% of students, respectively. Headache (20.9%), deterioration of vision (14.5%), difficulty focusing (12.5%), watering/tearing of eyes (10.1%), and blurred vision (10.8%) were noted as main DES symptoms. Girls, intermediate school students, students with spectacles, those with more than 4 h daily screen time or who position devices 25 cm or less from their eyes, and those attending virtual class for more than 4 h a day were found to have significantly severe DES grades. Females (P = 0.16), having outdoor activities of 1+ h (P = 0.02), 2+ h of daily screen time (P = 0.24), and attending virtual class for 4+ h (P = 0.001) were significant predictors of moderate and severe DES. Poor eye health and lower scholastic status were associated with severe DES.

Conclusion: DES in students after 1 year of virtual studying was high. Risk factors need to be addressed to avoid DES and its impact on students.

An 8-year-old male child who underwent an anterior approach left upper lid levator resection to correct congenital ptosis. After 6 months, he developed mechanical ptosis secondary to a painless cystic mass on his upper lid. Magnetic resonance proved a postseptal circumscribed cystic mass. The lesion was excised and a histopathology examination confirmed a conjunctival inclusion cyst (CIC). CIC is common benign lesions of conjunctiva but rarely detected as a complication of levator muscle surgery.

A 48-year-old woman with a history of dermatomyositis (DMS) presented with 2 weeks of worsening myalgias, weakness, and diffuse edema following cessation of her systemic immunosuppression and subsequently developed severe bilateral vision loss consistent with bilateral frosted branch angiitis. Multimodal imaging was performed, and the patient was successfully treated with pulse-dose steroids and intravenous immunoglobulin, as well as intravitreal aflibercept. Ophthalmic involvement of DMS is typically limited to episcleritis, conjunctivitis, and uveitis. We present an uncommon case of bilateral occlusive retinal vasculitis with frosted branch angiitis in a patient with DMS. The significant improvement anatomically and in visual acuity in our patient suggests a role of combined anti-vascular endothelial growth factor and systemic immunosuppression in the management of DMS -related frosted branch angiitis. We suggest that retinal vasculitis should be considered in patients with known DMS and acute vision loss, with prompt referral for ophthalmologic evaluation.

We report the two cases in which femtosecond laser (FSL) technology used to manage visually significant retained host's Descemet's membrane (RHDM) after penetrating keratoplasty (PKP). FSL-assisted descemetorhexis was done first, then membrane removal with intraocular forceps. Both patients had advanced keratoconus and were managed with PKP. In the first patient, FSL descemetorhexis of RHDM was incomplete. It was augmented manually, and then, the removal of the retained membrane was done with an intraocular forceps, whereas, a complete and central 5.5 mm FSL descemetorhexis was created in the second case. Then, it was pulled out with intraocular forceps. Postoperatively, the best-corrected visual acuity was 20/40, with an intraocular pressure (IOP) of 18 mmHg. In the second case, best-corrected visual acuity and IOP were 20/70 and 16 mmHg, respectively. In conclusion, FSL technology can be an alternative to manual or neodymiumdoped yttrium - aluminum garnet membranotomy for the management of RHDM after PKP.

Purpose: To determine the effect of smoking on the response to anti-vascular endothelial growth factor (anti-VEGF) therapy treatment in patients with diabetic macular edema (DME).

Methods: This is a retrospective case - control study that included 60 eyes with DME. Smoking habits were obtained from hospital records and patient recall. Patients were divided into two groups: the ever-smoker group and the never-smoker group. All patients received Intravitreal ranibizumab with three loading doses followed by PRN protocol and all were followed up for at least 1 year. Outcome measures were best-corrected visual acuity (BCVA), central retinal thickness (CRT) at the fovea, and number of visits.

Results: Smoking was not associated with worse posttreatment visual acuity and was not found to influence the change in ocular coherence tomography measurement of central macular thickness and the change in BCVA (posttreatment minus pretreatment). There were no statistically significant differences in the duration of treatment or number of visits between two groups of patients the ever-smoker group and the never-smoker group (P > 0.05).

Conclusion: In this study, smoking status did not influence the treatment outcome of anti-VEGFs; however, smoking should be encouraged due to its well-known other systemic unwanted effects.

Purpose: The influence of central corneal thickness (CCT) on intraocular pressure (IOP) measurement by Diaton is debatable. We present a correlation of CCT to transpalpebral IOP (tpIOP) and its determinants in patients undergoing transepithelial photorefractive keratectomy (TPRK) in Saudi Arabia.

Methods: In this cross-sectional study held in 2022, the IOP of patients undergoing TPRK was measured by Diaton tonometer. The CCT was measured before and 1 week after refractive surgery. The correlation coefficient of CCT and IOP and its Pearson P value were estimated. The effects of gender, type of refractive error (RE), and corneal epithelial thickness (CET) on the correlation of IOP to CCT were reviewed.

Results: We studied 202 eyes in 101 patients (Male: Female, 47:53; age 25.7 ± 5.8 years). The tpIOP was 15.1 ± 2.8 mmHg before, 15.9 ± 2.8 mmHg 1 week after, and 15.7 ± 4.1 mmHg 1 month after TPRK. The CCT was significantly correlated with tpIOP before surgery (Pearson correlation 0.168, P = 0.017) and after tPRK (Pearson correlation 0.246, P < 0.001). Gender (P = 0.96), CET (P = 0.43), and type of RE (P = 0.99) were not significant determinants of correlation between CCT and tpIOP before TPRK. The correlation of tpIOP and CCT was not affected by gender (P = 0.07), CET (P = 0.39), and type of RE (P = 0.13).

Conclusion: CCT should be considered before interpreting tpIOP measured by with Diaton. Diaton could be a useful tool to monitor IOP changes in young patients undergoing refractive surgery.

Purpose: Evaluating the quality, dependability, and popularity of YouTube videos about trabeculectomy.

Methods: A simulated user search for trabeculectomy videos on YouTube was conducted using the keywords "trabeculectomy, trabeculectomy surgery for glaucoma, and trabeculectomy surgery." Hundred out of the one hundred and fifty videos met the criteria and were analyzed. To assess quality and reliability, each video was evaluated by two independent reviewers using the DISCERN (scale, 1-5), Journal of the American Medical Association (JAMA; scale, 0-4), and Global Quality (GQ; scale, 1-5) criteria. The popularity of the videos was evaluated by Video Power Index (VPI). Videos were further classified into three groups based on the source of their upload.

Results: Of the 100 analyzed videos, 50 were uploaded to the system by doctors, 40 by health institutions and 10 by patients. Fifty-seven percent are videos with surgical content. The mean DISCERN score was 44.84 ± 8.14 the mean JAMA score was 2.08 ± 0.67, and the mean Global Quality score was 2.02 ± 0.72. Although some videos provided adequate information, the majority of the videos were rated as fair. While the DISCERN, JAMA, GQS scores were statistically higher in videos uploaded by doctors than in videos uploaded by patients (P < 0.01), VPI was higher in videos uploaded by patients (P = 0.003). Nonsurgical videos had the highest rate of likes and comments (P < 0.05). No substantial difference in scoring was observed between the 2 independent reviewers (P < 0.05).

Conclusion: Videos with high popularity had low information quality and reliability. This situation presupposes video sharing in a more understandable language for patients.