Oman Journal of Ophthalmology最新文献

Allergic conjunctivitis is a widely prevalent disease across the globe. Conjunctival congestion and papillae are the most common ocular manifestations. Limbal involvement in the form of limbitis is common but limbal cysts are very rare. We present a rare case of bilateral conjunctival inclusion cysts secondary to allergic conjunctivitis, successfully managed with neodymium-doped yttrium aluminum garnet (Nd: YAG) laser photodisruption. Unwilling for surgical excision, Nd: YAG laser was considered a minimally invasive, nonsurgical option to rupture the cysts. Over a follow-up period of seven months, all the cysts disappeared and the patient became symptom-free. This modality can be considered a minimally invasive alternative outpatient procedure to surgical excision with good outcomes, especially in cases with multiple small inclusion cysts as in our case.

Background: To evaluate the vision-related quality of life in keratoconus patients who had undergone intrastromal-corneal-ring-segment (ICRS) implantation using the Persian version of Vision-Function-Questionnaire-25.

Methods: In a cross-sectional study, 20 keratoconus patients, mean age 33.50 ± 5.50 years old, managed with bilateral ICRS implantation were included. Thirty age- and sex-matched normal individuals mean age of 30.00 ± 6.20 years old were included in the control group. The binocular visual acuity and vision-related quality of life were compared between the ICRS and control groups. The Persian version of Vision-Function Questionnaire-25 was applied.

Results: The mean binocular best corrected visual acuity in the keratoconus group was 0.06 ± 0.08 logarithm of the minimum angle of resolution (LogMAR), and in normal individuals was 0.00 ± 0.00 LogMAR, (P = 0.001). The mean total score of Vision-Function-Questionnaire-25 in the ICRS group was 81.00 ± 14.00, and in the control group was 90.50 ± 8.00 (P = 0.004). The ICRS group showed significantly lower scores in distance vision, near vision, peripheral vision, role limitation, and night-time driving, P < 0.05. The differences in the mean values of social function, dependency, day driving, ocular pain, and color vision were insignificant compared to normal individuals (P > 0.05).

Conclusion: ICRS implantation can improve some social functions of keratoconus patients to the level of normal individuals; however, visual functions and night driving remain affected compared to normal individuals.

Aims: The aim is to study the outcome of uveal coloboma patients undergoing manual small incision cataract surgery (MSICS) and intraocular lens (IOL) implantation.

Subjects and methods: The study included 14 patients with uveal coloboma who underwent small incision cataract surgery and IOL implantation between March 2022 and February 2023. The systemic analysis of preoperative, intraoperative, and postoperative data was done.

Results: The average patient age at the time of surgery was 58.5 years (range 45-74 years). Out of a total of 14 patients, 10 patients had unilateral coloboma and four patients had bilateral presentation. Of these, two patients had only one functioning eye, two had bilateral microcornea, and two had unilateral phacodonesis. Small incision cataract surgery was performed in all cases in one eye. Intraoperative zonular dialysis was noted in five cases where a capsular tension ring was used in two cases and IOL was placed in the bag and an iris-claw was tucked in three cases. Two patients had descemets membrane detachment, where DM repositioning was done with air. None of the cases underwent pupilloplasty.

Conclusions: The cataract patient with congenital iridochoroidal coloboma can be better managed with an MSICS. Although phacoemulsification is the treatment of choice nowadays, a small incision cataract surgery can be considered rescuer in a patient with a hard cataract and microcornea.

Background: Prevalence of retinal vascular occlusion is second to diabetic retinopathy and age-related macular degeneration. Various age-related local and systemic factors have been associated with retinal vein occlusion (RVO). Hemodynamic changes (venous stasis), degenerative changes of the vessel wall and blood hypercoagulability underlies the pathogenesis. The role of Vitamin D in modulating the inflammatory responses within the arterial wall, the capacity to attenuate the oxidative stress and direct effect of hypovitaminosis D on increased vascular resistance hints at a potential association of Vitamin D levels with disorders of retinal vasculature.

Aim: To estimate serum 25-hydroxyvitamin D (25 OH Vit D) level in patients of RVO and compare it with matched controls.

Materials and methods: Fifty patients of RVO as cases and 50 without RVO as controls underwent systemic and ocular examination including the estimation of serum 25 OH Vit D and other biochemical parameters.

Statistical analysis: Statistical Package for the Social Sciences (SPSS) software version 25 was used for the analysis. An alpha level of 5% was taken, that is P < 0.05 was considered statistically significant.

Results: Mean serum 25 OH Vit D level in cases of RVO was 21.82 nanogram/deciliters (ng/dL) compared to 30.71 ng/dL in the control group which was significantly lower in cases compared to control (P < 0.001). The odds ratio calculated for RVO cases versus controls was 1.137; 95% confidence interval (1.074-1.203).

Conclusion: A positive association of low serum 25 OH Vit D levels and RVO was found highlighting the importance of evaluating serum Vitamin D levels in all the cases of RVO. This correlation may have possible implications for prophylaxis and treatment of RVO, even though this part of our country gets abundant sunlight throughout the year.

A 5-year-old boy presented with gradually progressive painful proptosis of the left eye for 5 months. He had an incidental testicular swelling for which he underwent high inguinal orchidectomy and histopathology showed atypical lymphoid cells. His vision was 6/6, N6 in the right eye, and no perception of light in the left eye. Left eye examination revealed an inferior dystopia and total ophthalmoplegia with corneal exposure changes. A computerized tomography scan showed an isodense mass molding around the globe. An incision biopsy from the subconjunctival mass showed atypical large lymphocytes on histopathology which on immunohistochemistry confirmed a diagnosis of precursor B-cell lymphoblastic lymphoma (B-LBL). Bone marrow aspiration and biopsy were normal. The patient was started on oral steroids and high-risk acute LBL chemotherapy protocol to which he showed excellent response. Precursor B-LBL is a rare neoplasm of the pediatric and adolescent age group. A total of 22 cases involving the orbit have been reported to date of which 17 belonged to the pediatric age group. Early detection and prompt initiation of multiagent chemotherapy have shown good survival rates in these patients.

Background: Acute intraocular pressure (IOP) spike in acute primary angle closure (APAC) decreases ocular blood flow. It is not known if this is true in primary angle-closure (PAC) eyes without prior APAC who may have had subacute attacks. Hence, we aimed to assess the ocular perfusion using optical coherence tomography angiography (OCTA) characteristics in normal, PAC suspect (PACS), and PAC eyes without APAC.

Materials and methods: This was a prospective cross-sectional study, which determined patients' (40-80 years) optic nerve peripapillary perfusion, flux, and macular vessel density (6 mm × 6 mm and 3 mm × 3 mm) in the superficial retinal layer on OCTA.

Results: We included 135 eyes of 135 patients (45 per subgroup). The mean age was 59.7 ± 8.3 years. The mean peripapillary perfusion was 44.4% ±1.5% in normal, 44.2% ±1.7% in PACS, and 44.1% ±1.5% in PAC eyes. There was no significant difference between OCTA parameters among normal, PACS, and PAC eyes (P = 0.75 - peripapillary perfusion, 0.92 - flux, 0.58 - 6 × 6 and 0.09 - 3 mm × 3 mm). The maximum recorded IOP was significantly correlated with retinal nerve fiber layer thickness in the PAC group (P = 0.045) but not correlated with the perfusion parameters in any subgroup. The mean deviation on Humphrey visual field was significantly worse in PAC eyes compared to PACS eyes (P = 0.02).

Conclusion: Similar OCTA parameters were seen in normal, PACS, and PAC eyes without prior APAC, suggestive of absence of vascular factors in eyes without APAC in angle-closure disease. Functional impairment, despite similar structural and perfusion parameters in PAC eyes compared to PACS eyes, may be suggestive of ganglion cell dysfunction prior to loss.

Gyrate atrophy (GA) of the choroid and retina is a rare autosomal recessive inherited disease characterized by elevation of plasma ornithine levels due to deficiency of the mitochondrial enzyme ornithine aminotransferase resulting in progressive chorioretinal atrophy, nyctalopia, and possibly blindness. This report presents the case of a 7-year-old Vietnamese boy with no history of trauma and a complaint of sudden visual loss over the past 6 weeks. Fundus examination showed vitreous hemorrhage in the right eye and chorioretinal atrophy with hyperpigmented margins in the periphery retina of the left eye. Based on the high serum ornithine level and compound heterozygous mutations detected in the ornithine aminotransferase (OAT) gene of the patient, he was diagnosed with GA. The patient underwent a right eye vitrectomy and was supplemented with Vitamin B6 and an arginine-restricted diet. Four months after surgery, the patient's visual acuity was significantly improved, and there was no progression of chorioretinal atrophy or recurrent vitreous hemorrhage. GA is an extremely rare disease and difficult to diagnose, especially when accompanied by vitreous hemorrhage. Combining genetic tests with clinical examinations helped diagnose accurately, and prompt treatment could restore the patient's visual function.

Purpose: The purpose of this study was to report the incidence of bilateral photokeratitis in patrons of hair-cutting salons following inadvertent exposure to ultraviolet (UV) rays from germicidal sterilizing cabinets.

Materials and methods: It is a retrospective observational study of 30 patients who were diagnosed with UV-associated photokeratitis after a visit to a salon.

Results: Thirty patients presented between January 2019 and November 2023, with bilateral conjunctival congestion with superficial punctate epithelial erosions typical of photokeratitis. All of them were males, aged between 27 and 64 years (mean = 35 years; median = 33 years). All of them gave a history of a visit to a salon within 24 h before the onset of symptoms. The typical onset of symptoms was seen after a few hours of exposure, ranging from 4 to 12 (mean = 7.4; median = 6.5 h). They were treated with topical lubricants and antibiotics. Six of them were reviewed after 24 h when five were asymptomatic and one patient developed a corneal epithelial defect.

Conclusion: Germicidal UV lamps are used ubiquitously for disinfection in barbershops. This report highlights the risk of accidental exposure to such lamps and the need to increase awareness among the general public to prevent such accidents.