Reham F.M. Sayed, A. M. Shafik, Dina E. AbdelAziz, Maged M. Salib
To document changes in the peripapillary vascular network and retinal vascular plexuses in patients with optic neuritis (ON) due to multiple sclerosis (MS) and compare it with healthy individuals. A prospective comparative case–control study performed at the Ophthalmology Department of a tertiary-level university hospital, between November 2020 and November 2022. In all, 26 eyes of 26 patients with ON caused by MS and 26 eyes of 26 sex-matched and age-matched healthy controls. We used optical coherence tomography AngioVue Enhanced Microvascular Imaging System aiming to quantify and compare microvasculature changes in the macula and peripapillary region between the two groups. We found a statistically significant decrease in the superficial and deep vessel density in the macular area in patients with ON compared with the healthy controls. Superficial vessel density in the macular area in the healthy ones was 49.90±3.4, while in those with MS was 44.09±4.9 (P<0.001). Deep vessel density in the macular area in patients without MS was 51.71±6.8 while in patients with MS was 45.51±5.7 (P<0.001). There is a decrease in superficial and deep vessel density and radial peripapillary vessel density in patients with ON caused by MS in comparison to healthy controls.
{"title":"Changes in peripapillary and macular vasculature measured by optical coherence tomography angiography and their clinical correlation in patients with optic neuritis due to multiple sclerosis","authors":"Reham F.M. Sayed, A. M. Shafik, Dina E. AbdelAziz, Maged M. Salib","doi":"10.4103/ejos.ejos_10_24","DOIUrl":"https://doi.org/10.4103/ejos.ejos_10_24","url":null,"abstract":"\u0000 \u0000 To document changes in the peripapillary vascular network and retinal vascular plexuses in patients with optic neuritis (ON) due to multiple sclerosis (MS) and compare it with healthy individuals.\u0000 \u0000 \u0000 \u0000 A prospective comparative case–control study performed at the Ophthalmology Department of a tertiary-level university hospital, between November 2020 and November 2022.\u0000 \u0000 \u0000 \u0000 In all, 26 eyes of 26 patients with ON caused by MS and 26 eyes of 26 sex-matched and age-matched healthy controls. We used optical coherence tomography AngioVue Enhanced Microvascular Imaging System aiming to quantify and compare microvasculature changes in the macula and peripapillary region between the two groups.\u0000 \u0000 \u0000 \u0000 We found a statistically significant decrease in the superficial and deep vessel density in the macular area in patients with ON compared with the healthy controls. Superficial vessel density in the macular area in the healthy ones was 49.90±3.4, while in those with MS was 44.09±4.9 (P<0.001). Deep vessel density in the macular area in patients without MS was 51.71±6.8 while in patients with MS was 45.51±5.7 (P<0.001).\u0000 \u0000 \u0000 \u0000 There is a decrease in superficial and deep vessel density and radial peripapillary vessel density in patients with ON caused by MS in comparison to healthy controls.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To assess Dexmedetomidine’s effect as an adjuvant to peribulbar anesthesia on the retinal vasculature in patients with glaucoma undergoing cataract extraction surgery via optical coherence tomography angiography (OCT-A). Thirty-nine glaucoma participants planned for phacoemulsification were allocated into two groups. A 10 ml mixture of peribulbar anesthesia was administered to group I. This anesthetic mixture consisted of 4.5 ml of lidocaine 2% mixed with 4.5 ml of bupivacaine 0.5%,1 ml of dexmedetomidine (50 µg), and 150 IU hyaluronidase. Group II was administered a peribulbar anesthetic mixture consisting of 4.5 ml of lidocaine 2% combined with 4.5 ml of bupivacaine 0.5%,150 IU of hyaluronidase, and 1 ml of normal saline, totaling 10 ml. Optical coherence tomography angiography was used 10 mi before and 10 min after injection to scan optic disc total vessel density, foveal superficial deep capillary plexuses (DCP) density, radial peripapillary capillary network density, and total vessel density plus foveal avascular zone (FAZ) diameter. We also checked the intraocular pressure (IOP) before and 10 min after the anesthetic injection. After the administration of the peribulbar anesthetic, group II demonstrated a notably higher significance in the DCP fovea median percent change (–43.7%) compared with group I (-2%) (P<0.001). Additionally, group II experienced a considerably greater median percent change in DCP total density (–22.4%) postinjection compared to group I (–0.8%) (P value < 0.001). The postinjection median percent changes in foveal total vessel density and superficial vessel density were −16.2% and −56.8% in group II, and −1% and −2.4% in group I, respectively, with a P value less than 0.001. Moreover, following the injection, the median percentage change in the diameter of the foveal avascular zone was significantly higher in group II (–40.6%) than in group I (–2.3%) (P value < 0.001). Additionally, there was a noteworthy increase in the optic disc’s total vessel density and the median percentage shift in radial peripapillary capillary network density in group II (–13.1 and −13.7%, respectively) compared with group I (–1.2 and −1%, respectively, P value < 0.001). IOP before and after injecting the anesthesia was insignificantly different between the studied groups (P =0.198 and 0.069, respectively). The addition of dexmedetomidine to the peribulbar anesthesia demonstrates a protective effect on the retinal microvasculature against the ischemic impact of anesthetic drugs with no significant effect on the IOP. This effect holds significant implications for glaucoma patients.
通过光学相干断层血管造影术（OCT-A）评估右美托咪定作为围术期麻醉的辅助药物对接受白内障摘除手术的青光眼患者视网膜血管的影响。 39名计划接受超声乳化手术的青光眼患者被分为两组。I 组使用 10 毫升的混合麻醉剂，其中包括 4.5 毫升的 2% 利多卡因与 4.5 毫升的 0.5% 布比卡因、1 毫升的右美托咪定（50 微克）和 150 IU 透明质酸酶。第 II 组使用的是布巴周围麻醉混合物，包括 4.5 毫升 2% 利多卡因、4.5 毫升 0.5% 布比卡因、150 IU 透明质酸酶和 1 毫升生理盐水，共计 10 毫升。注射前 10 mi 和注射后 10 min 使用光学相干断层血管造影术扫描视盘总血管密度、眼窝浅层深毛细血管丛（DCP）密度、径向毛细血管周围网络密度和总血管密度加眼窝无血管区（FAZ）直径。我们还检查了注射麻醉剂前和注射后 10 分钟的眼压（IOP）。 注射眼周麻醉剂后，II 组的 DCP 眼窝中位百分比变化（-43.7%）明显高于 I 组（-2%）（P<0.001）。此外，与 I 组（-0.8%）相比，II 组注射后 DCP 总密度的中位百分比变化（-22.4%）要大得多（P 值<0.001）。注射后，II 组眼窝总血管密度和浅层血管密度的中位百分数变化分别为-16.2%和-56.8%，I 组分别为-1%和-2.4%，P 值均小于 0.001。此外，注射后，II 组眼窝无血管区直径变化的中位百分比（-40.6%）明显高于 I 组（-2.3%）（P 值小于 0.001）。此外，与第一组（分别为-1.2%和-1%，P值<0.001）相比，第二组的视盘总血管密度和径向毛细血管周围网络密度变化的中位百分比（分别为-13.1%和-13.7%）也有显著增加。各研究组在注射麻醉剂前后的眼压差异不大（P =0.198 和 0.069）。 在眼周麻醉中加入右美托咪定可保护视网膜微血管免受麻醉药物的缺血影响，而对眼压无明显影响。这种效果对青光眼患者具有重要意义。
{"title":"Impact of dexmedetomidine as an adjuvant to peribulbar anesthesia on the retinal vasculature in glaucoma patients: an optical coherence tomography angiography study","authors":"Mohamed A. Awwad, M. Elhadad, Mohamed Masoud","doi":"10.4103/ejos.ejos_1_24","DOIUrl":"https://doi.org/10.4103/ejos.ejos_1_24","url":null,"abstract":"\u0000 \u0000 To assess Dexmedetomidine’s effect as an adjuvant to peribulbar anesthesia on the retinal vasculature in patients with glaucoma undergoing cataract extraction surgery via optical coherence tomography angiography (OCT-A).\u0000 \u0000 \u0000 \u0000 Thirty-nine glaucoma participants planned for phacoemulsification were allocated into two groups. A 10 ml mixture of peribulbar anesthesia was administered to group I. This anesthetic mixture consisted of 4.5 ml of lidocaine 2% mixed with 4.5 ml of bupivacaine 0.5%,1 ml of dexmedetomidine (50 µg), and 150 IU hyaluronidase. Group II was administered a peribulbar anesthetic mixture consisting of 4.5 ml of lidocaine 2% combined with 4.5 ml of bupivacaine 0.5%,150 IU of hyaluronidase, and 1 ml of normal saline, totaling 10 ml. Optical coherence tomography angiography was used 10 mi before and 10 min after injection to scan optic disc total vessel density, foveal superficial deep capillary plexuses (DCP) density, radial peripapillary capillary network density, and total vessel density plus foveal avascular zone (FAZ) diameter. We also checked the intraocular pressure (IOP) before and 10 min after the anesthetic injection.\u0000 \u0000 \u0000 \u0000 After the administration of the peribulbar anesthetic, group II demonstrated a notably higher significance in the DCP fovea median percent change (–43.7%) compared with group I (-2%) (P<0.001). Additionally, group II experienced a considerably greater median percent change in DCP total density (–22.4%) postinjection compared to group I (–0.8%) (P value < 0.001). The postinjection median percent changes in foveal total vessel density and superficial vessel density were −16.2% and −56.8% in group II, and −1% and −2.4% in group I, respectively, with a P value less than 0.001. Moreover, following the injection, the median percentage change in the diameter of the foveal avascular zone was significantly higher in group II (–40.6%) than in group I (–2.3%) (P value < 0.001). Additionally, there was a noteworthy increase in the optic disc’s total vessel density and the median percentage shift in radial peripapillary capillary network density in group II (–13.1 and −13.7%, respectively) compared with group I (–1.2 and −1%, respectively, P value < 0.001). IOP before and after injecting the anesthesia was insignificantly different between the studied groups (P =0.198 and 0.069, respectively).\u0000 \u0000 \u0000 \u0000 The addition of dexmedetomidine to the peribulbar anesthesia demonstrates a protective effect on the retinal microvasculature against the ischemic impact of anesthetic drugs with no significant effect on the IOP. This effect holds significant implications for glaucoma patients.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wesam S. Elsayed, M. Nassar, Asmaa M.A. Ibrahim, Mohammed S.A. El-Aziz
To assess macular vessel density (VD) in open-angle glaucoma (OAG), normal tension glaucoma (NTG), ocular hypertension (OHT), and normal participants by using optical coherence tomography angiography (OCTA). This observational case–control study was conducted at Menoufia University, Faculty of Medicine, Department of Ophthalmology. Patients who received OCTA were already diagnosed with glaucoma and were divided into four groups: OAG group, NTG group, OHT group, and normal participants’ group. The ophthalmic parameters, which include best-corrected visual acuity, intraocular pressure, visual field mean deviation, retinal nerve fiber layer thickness, and ganglion cell complex thickness, were recorded. About the macula, the superficial VD, deep VD, and foveal avascular zone (FAZ) were evaluated via OCTA and analyzed by utilizing the default VD analysis program in the same OCTA. This study was conducted on 152 eyes, 38 eyes with OAG, 38 eyes with NTG, 38 eyes with OHT, and 38 normal participant eyes. Significant decrease in retinal nerve fiber layer thickness and ganglion cell complex thickness were noticed in OAG and normal tension groups cases. The OAG and NTG groups revealed a reduction in superficial VD and a reduction in deep VD compared to the OHT and the controls. No difference in the FAZ was noticed among all the studied groups. Impaired macular circulation was demonstrated in the OAG and NTG patients compared to OHT patients and normal participants. No difference in FAZ among the glaucoma cases and normal individuals.
{"title":"Evaluation of macular vessel density among patients with glaucoma, ocular hypertension, and normal participants","authors":"Wesam S. Elsayed, M. Nassar, Asmaa M.A. Ibrahim, Mohammed S.A. El-Aziz","doi":"10.4103/ejos.ejos_5_24","DOIUrl":"https://doi.org/10.4103/ejos.ejos_5_24","url":null,"abstract":"\u0000 \u0000 To assess macular vessel density (VD) in open-angle glaucoma (OAG), normal tension glaucoma (NTG), ocular hypertension (OHT), and normal participants by using optical coherence tomography angiography (OCTA).\u0000 \u0000 \u0000 \u0000 This observational case–control study was conducted at Menoufia University, Faculty of Medicine, Department of Ophthalmology.\u0000 \u0000 \u0000 \u0000 Patients who received OCTA were already diagnosed with glaucoma and were divided into four groups: OAG group, NTG group, OHT group, and normal participants’ group. The ophthalmic parameters, which include best-corrected visual acuity, intraocular pressure, visual field mean deviation, retinal nerve fiber layer thickness, and ganglion cell complex thickness, were recorded. About the macula, the superficial VD, deep VD, and foveal avascular zone (FAZ) were evaluated via OCTA and analyzed by utilizing the default VD analysis program in the same OCTA.\u0000 \u0000 \u0000 \u0000 This study was conducted on 152 eyes, 38 eyes with OAG, 38 eyes with NTG, 38 eyes with OHT, and 38 normal participant eyes. Significant decrease in retinal nerve fiber layer thickness and ganglion cell complex thickness were noticed in OAG and normal tension groups cases. The OAG and NTG groups revealed a reduction in superficial VD and a reduction in deep VD compared to the OHT and the controls. No difference in the FAZ was noticed among all the studied groups.\u0000 \u0000 \u0000 \u0000 Impaired macular circulation was demonstrated in the OAG and NTG patients compared to OHT patients and normal participants. No difference in FAZ among the glaucoma cases and normal individuals.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of the study is to assess the knowledge, attitude and practice patterns regarding eye donation, eye banking and corneal transplantation in patients attending the outpatient department of a tertiary care hospital. This cross-sectional study/survey was carried out at the Department of Ophthalmology of a tertiary care medical college hospital. The study included 380 participants who were at least 18 years old and willing to take part. A total of 39.5% of the study participants believed there is an age limit for eye donation while around 70% of the participants responded that a history of cataract/glaucoma is a contraindication for donating eyes while 17.1% of them responded that eye donation was against their religious belief. Still, 292(76.8%) people pledged to donate their eyes. Our survey found that 86.3% of participants were aware of eye donation. The fact that doctors were the main source of information on eye donation shows how important their job is. Amongst society average knowledge was present regarding eye donation. Moreover, two-thirds of the patients expressed their willingness and commitment to donate their eyes. Although the awareness level regarding eye donation and the pledge rate is high, still there is a significant information gap about the donation as well as the eye bank.
{"title":"“A study of knowledge, attitude and practice patterns regarding eye donation, eye banking and corneal transplantation in tertiary care hospital”","authors":"Shivangi Bora, O.K. Radhakrishnan, Megha Kotecha, Madhav Pai, Varsha Singh, Mayur Patil","doi":"10.4103/ejos.ejos_13_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_13_23","url":null,"abstract":"\u0000 \u0000 The aim of the study is to assess the knowledge, attitude and practice patterns regarding eye donation, eye banking and corneal transplantation in patients attending the outpatient department of a tertiary care hospital.\u0000 \u0000 \u0000 \u0000 This cross-sectional study/survey was carried out at the Department of Ophthalmology of a tertiary care medical college hospital. The study included 380 participants who were at least 18 years old and willing to take part.\u0000 \u0000 \u0000 \u0000 A total of 39.5% of the study participants believed there is an age limit for eye donation while around 70% of the participants responded that a history of cataract/glaucoma is a contraindication for donating eyes while 17.1% of them responded that eye donation was against their religious belief. Still, 292(76.8%) people pledged to donate their eyes.\u0000 \u0000 \u0000 \u0000 Our survey found that 86.3% of participants were aware of eye donation. The fact that doctors were the main source of information on eye donation shows how important their job is. Amongst society average knowledge was present regarding eye donation. Moreover, two-thirds of the patients expressed their willingness and commitment to donate their eyes. Although the awareness level regarding eye donation and the pledge rate is high, still there is a significant information gap about the donation as well as the eye bank.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariam R. Fadel, Shereen H. AboulNaga, Nehal ElGhobashy, Sally S. Mohamed
Behçet’s syndrome is a multisystem inflammatory disease characterized by recurrent oral aphthous ulcers, genital ulcers, skin lesions, and uveitis. Ocular involvement, occurring roughly in 50% of patients, is one of the most feared complications of Behçet’s syndrome. Recurrent severe uveitis leads to irreversible severe vision loss. The main goals in the management of patients with Behçet’s uveitis are rapid resolution of intraocular inflammation, prevention of recurrent attacks, and achievement of complete remission and preservation of vision. Corticosteroids are generally used for the treatment of acute episodes of inflammation. According to the updated EULAR recommendations for the management of BS ‘any patient with BS and inflammatory eye disease affecting the posterior segment should be on a treatment regime such as azathioprine, cyclosporine-A, interferon alpha or monoclonal tumor necrosis factor alpha antagonists. Infliximab has been increasingly used in the treatment of Behçet’s syndrome patients with uveitis when they are refractory to conventional immunosuppressive therapy. However, there is no consensus on the best time to start anti- tumor necrosis factor alpha therapy. In our study we evaluated the outcome of early initiation of infliximab for refractory uveitis in cohort of Egyptian Behçet’s syndrome patients. Early administration of Intravenous Infliximab therapy for severe sight-threatening uveitis and chorioretinitis in Egyptian Behçet’s syndrome patients has a favorable value regarding BCVA. Multidisciplinary approach in managing Behçet’s uveitis is mandatory to reach better functional visual outcome.
{"title":"Early versus late initiation of infliximab for refractory uveitis in a cohort of Egyptian BD patients","authors":"Mariam R. Fadel, Shereen H. AboulNaga, Nehal ElGhobashy, Sally S. Mohamed","doi":"10.4103/ejos.ejos_7_24","DOIUrl":"https://doi.org/10.4103/ejos.ejos_7_24","url":null,"abstract":"\u0000 \u0000 Behçet’s syndrome is a multisystem inflammatory disease characterized by recurrent oral aphthous ulcers, genital ulcers, skin lesions, and uveitis. Ocular involvement, occurring roughly in 50% of patients, is one of the most feared complications of Behçet’s syndrome. Recurrent severe uveitis leads to irreversible severe vision loss.\u0000 \u0000 \u0000 \u0000 The main goals in the management of patients with Behçet’s uveitis are rapid resolution of intraocular inflammation, prevention of recurrent attacks, and achievement of complete remission and preservation of vision. Corticosteroids are generally used for the treatment of acute episodes of inflammation. According to the updated EULAR recommendations for the management of BS ‘any patient with BS and inflammatory eye disease affecting the posterior segment should be on a treatment regime such as azathioprine, cyclosporine-A, interferon alpha or monoclonal tumor necrosis factor alpha antagonists.\u0000 \u0000 \u0000 \u0000 Infliximab has been increasingly used in the treatment of Behçet’s syndrome patients with uveitis when they are refractory to conventional immunosuppressive therapy. However, there is no consensus on the best time to start anti- tumor necrosis factor alpha therapy. In our study we evaluated the outcome of early initiation of infliximab for refractory uveitis in cohort of Egyptian Behçet’s syndrome patients.\u0000 \u0000 \u0000 \u0000 Early administration of Intravenous Infliximab therapy for severe sight-threatening uveitis and chorioretinitis in Egyptian Behçet’s syndrome patients has a favorable value regarding BCVA. Multidisciplinary approach in managing Behçet’s uveitis is mandatory to reach better functional visual outcome.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this study is to understand the impact of COVID 19 on patients’ view of and willingness to seek ophthalmic services in Egypt. It analyzes if there were changes in their eye care habits and under which conditions they would seek advice or undergo elective procedures. It is a cross sectional observational study using a questionnaire that was sent online. The questionnaire included 29 questions. All questions were closed ended questions, provided with a list of optional answers (single answer or multiple answer options). Patients were divided according to age (below 60 years and 60 and above). A follow up survey was done 2 months later and included 13 questions to compare their answers with the initial questionnaire. This study included the responses of 596 participants, who answered our questionnaire fully and 198 participants answered the follow-up questionnaire. The vast majority of the participants claimed they would not visit an ophthalmologist during the pandemic, would not undergo any elective surgery and relied on social media for information. On follow- up, the participants were more willing to visit an eye doctor, continue routine follow-ups, took more safety precautions and relied more on medical sources for information. Age, contact with vulnerable groups, presence of the chronic diseases and duration of the pandemic significantly affect the patients’ willingness to seek ophthalmic services. Changes in populations’ information and doctor practice are needed in this pandemic.
{"title":"The effect of the coronavirus disease 2019 pandemic on ophthalmologic practice from the egyptian population’s point of view","authors":"Marrie Ayah, Hassan Lameece, Elessawy Kareem Bakr","doi":"10.4103/ejos.ejos_43_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_43_22","url":null,"abstract":"\u0000 \u0000 The aim of this study is to understand the impact of COVID 19 on patients’ view of and willingness to seek ophthalmic services in Egypt. It analyzes if there were changes in their eye care habits and under which conditions they would seek advice or undergo elective procedures.\u0000 \u0000 \u0000 \u0000 It is a cross sectional observational study using a questionnaire that was sent online. The questionnaire included 29 questions. All questions were closed ended questions, provided with a list of optional answers (single answer or multiple answer options). Patients were divided according to age (below 60 years and 60 and above). A follow up survey was done 2 months later and included 13 questions to compare their answers with the initial questionnaire.\u0000 \u0000 \u0000 \u0000 This study included the responses of 596 participants, who answered our questionnaire fully and 198 participants answered the follow-up questionnaire. The vast majority of the participants claimed they would not visit an ophthalmologist during the pandemic, would not undergo any elective surgery and relied on social media for information. On follow- up, the participants were more willing to visit an eye doctor, continue routine follow-ups, took more safety precautions and relied more on medical sources for information.\u0000 \u0000 \u0000 \u0000 Age, contact with vulnerable groups, presence of the chronic diseases and duration of the pandemic significantly affect the patients’ willingness to seek ophthalmic services. Changes in populations’ information and doctor practice are needed in this pandemic.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Rashid, Mahmoud A Al Aswad, A. K. Awadallah, Mohamed M. Mohamed
To investigate the impact of internal limiting membrane (ILM) peeling during vitrectomy for diabetic tractional retinal detachment (TRD) on postoperative central macular thickness, foveal contour, and creation or reformation of epiretinal membranes. In a randomized trial, patients aged 40–65 years old with TRD were recruited from the outpatient clinic in Suez Canal University Hospital from August 2020 to February 2022. Patients were randomized into two groups: group 1 did vitrectomy with ILM peeling, while group 2 did vitrectomy without ILM peeling. At 1, 3, and 6 months after surgery, optical coherence tomography (OCT) was carried out to investigate the central macular thickness (CMT), foveal contour, and epiretinal membrane’s presence. For categorical variables, the Chi-squared test or Fisher’s exact test was performed, while the Student’s t-test was used to assess differences in continuous data. Thirty-two patients (16 in each group) completed the required follow-up. There was no significant difference between both groups concerning the affected eye (P=1.00). There was no statistically significant difference regarding the CMT recorded via optical coherence tomography at any point of follow-up in the two groups (P=0.289). Also, there was no statistically significant difference regarding the presence of foveal depression at any point of follow-up in the two groups (P=0.680). On the other hand, the percentage of patients who showed no presence of epiretinal membranes in the ILM peeling group was statistically significant when compared with the non-ILM peeling group (P<0.001). ILM peeling decreases the incidence of epiretinal membrane proliferation following diabetic vitrectomy.
目的：研究在糖尿病牵引性视网膜脱离（TRD）的玻璃体切除术中剥离内缘膜（ILM）对术后黄斑中心厚度、眼窝轮廓以及视网膜外膜的形成或重构的影响。 在一项随机试验中，2020 年 8 月至 2022 年 2 月期间，苏伊士运河大学医院门诊部招募了 40-65 岁的 TRD 患者。患者被随机分为两组：第一组进行玻璃体切除术，同时进行ILM剥离；第二组进行玻璃体切除术，但不进行ILM剥离。术后1、3和6个月，进行光学相干断层扫描（OCT）检查黄斑中心厚度（CMT）、眼窝轮廓和是否存在视网膜外膜。对于分类变量，采用卡方检验（Chi-squared test）或费雪精确检验（Fisher's exact test）；对于连续数据，采用学生 t 检验（Student's t test）。 32 名患者（每组 16 人）完成了规定的随访。两组患者的患眼无明显差异（P=1.00）。通过光学相干断层扫描记录的 CMT，两组患者在随访的任何时间点均无统计学差异（P=0.289）。此外，两组患者在随访的任何时间点出现眼窝凹陷的情况也无统计学差异（P=0.680）。另一方面，与非 ILM 剥离组相比，ILM 剥离组中未出现视网膜外膜的患者比例具有统计学意义（P<0.001）。 ILM剥离可降低糖尿病玻璃体切除术后视网膜外膜增生的发生率。
{"title":"Effects of internal limiting membrane peeling versus non-internal limiting membrane peeling during vitrectomy for diabetic tractional retinal detachment on postoperative macular thickness, foveal contour, and formation of epiretinal membranes","authors":"A. Rashid, Mahmoud A Al Aswad, A. K. Awadallah, Mohamed M. Mohamed","doi":"10.4103/ejos.ejos_54_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_54_23","url":null,"abstract":"\u0000 \u0000 To investigate the impact of internal limiting membrane (ILM) peeling during vitrectomy for diabetic tractional retinal detachment (TRD) on postoperative central macular thickness, foveal contour, and creation or reformation of epiretinal membranes.\u0000 \u0000 \u0000 \u0000 In a randomized trial, patients aged 40–65 years old with TRD were recruited from the outpatient clinic in Suez Canal University Hospital from August 2020 to February 2022. Patients were randomized into two groups: group 1 did vitrectomy with ILM peeling, while group 2 did vitrectomy without ILM peeling. At 1, 3, and 6 months after surgery, optical coherence tomography (OCT) was carried out to investigate the central macular thickness (CMT), foveal contour, and epiretinal membrane’s presence. For categorical variables, the Chi-squared test or Fisher’s exact test was performed, while the Student’s t-test was used to assess differences in continuous data.\u0000 \u0000 \u0000 \u0000 Thirty-two patients (16 in each group) completed the required follow-up. There was no significant difference between both groups concerning the affected eye (P=1.00). There was no statistically significant difference regarding the CMT recorded via optical coherence tomography at any point of follow-up in the two groups (P=0.289). Also, there was no statistically significant difference regarding the presence of foveal depression at any point of follow-up in the two groups (P=0.680). On the other hand, the percentage of patients who showed no presence of epiretinal membranes in the ILM peeling group was statistically significant when compared with the non-ILM peeling group (P<0.001).\u0000 \u0000 \u0000 \u0000 ILM peeling decreases the incidence of epiretinal membrane proliferation following diabetic vitrectomy.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140524934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatma Salem, Ghada I. Gawdat, Yasmine El Sayed, Amanne F. Esmael
To identify the pattern(s) in using antiglaucoma medications following glaucoma surgery in children and compare their efficacies. Retrospective chart review of patients (≤12 years) receiving glaucoma surgery from January 2013 to December 2020. Partially responsive patients needing antiglaucoma medications to attain an Intraocular pressure (IOP) of at least 18 mmHg were divided into three groups: (A) received beta-blocker (β-Blockers); (B) received Prostaglandin analogues and (C) received fixed β-Blocker+ Carbonic anhydrase inhibitor (CAI) preparation. Data included demographics, clinical characteristics, IOP (before, after 1 month, and at last follow-up), and surgeries. Successful treatment attained IOP less than or equal to 18 mmHg on last follow-up. Side effects were recorded. Totally 200 eyes of 152 patients were included, (61%) presented within the first month of life, 54% were males, 31.6% had bilateral disease and (82.2%) had primary congenital glaucoma (PCG). Pre-treatment IOP was significantly higher in group C (P=0.009). The most common procedure performed was trabeculotomy (P=0.014). After a mean follow-up period of 20.12 months, all three groups showed a significant reduction in the IOP (P≤0.001), with the highest percent reduction attained in group C (43.7% vs. 33.4% and 33.1% in groups A and B, respectively) P=0.001. Final success rates were 41.2%, 83.3%, and 82.2% for groups A, B, and C, respectively. Dry eye was the most common side effect (32 eyes) mainly occurring in group A (21.6%). The most frequently used antiglaucoma medications following partially successful surgery are CAI+β-Blocker combinations. They seem to have the most potent effect and are usually used as a first line the higher the initial IOP is.
{"title":"The use of anti-glaucoma medications following pediatric glaucoma surgery: a report on efficacy and trends in Cairo University","authors":"Fatma Salem, Ghada I. Gawdat, Yasmine El Sayed, Amanne F. Esmael","doi":"10.4103/ejos.ejos_77_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_77_23","url":null,"abstract":"\u0000 \u0000 To identify the pattern(s) in using antiglaucoma medications following glaucoma surgery in children and compare their efficacies.\u0000 \u0000 \u0000 \u0000 Retrospective chart review of patients (≤12 years) receiving glaucoma surgery from January 2013 to December 2020. Partially responsive patients needing antiglaucoma medications to attain an Intraocular pressure (IOP) of at least 18 mmHg were divided into three groups: (A) received beta-blocker (β-Blockers); (B) received Prostaglandin analogues and (C) received fixed β-Blocker+ Carbonic anhydrase inhibitor (CAI) preparation. Data included demographics, clinical characteristics, IOP (before, after 1 month, and at last follow-up), and surgeries. Successful treatment attained IOP less than or equal to 18 mmHg on last follow-up. Side effects were recorded.\u0000 \u0000 \u0000 \u0000 Totally 200 eyes of 152 patients were included, (61%) presented within the first month of life, 54% were males, 31.6% had bilateral disease and (82.2%) had primary congenital glaucoma (PCG). Pre-treatment IOP was significantly higher in group C (P=0.009). The most common procedure performed was trabeculotomy (P=0.014). After a mean follow-up period of 20.12 months, all three groups showed a significant reduction in the IOP (P≤0.001), with the highest percent reduction attained in group C (43.7% vs. 33.4% and 33.1% in groups A and B, respectively) P=0.001. Final success rates were 41.2%, 83.3%, and 82.2% for groups A, B, and C, respectively. Dry eye was the most common side effect (32 eyes) mainly occurring in group A (21.6%).\u0000 \u0000 \u0000 \u0000 The most frequently used antiglaucoma medications following partially successful surgery are CAI+β-Blocker combinations. They seem to have the most potent effect and are usually used as a first line the higher the initial IOP is.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140522922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. S. Soliman, Ayah M. Barakat, T. E. Wasfy, Sally Abdelwanees
Spectacles are one of the corrective measures for different errors of refraction. A great proportion of people worldwide are blind due to having a high-refractive error while they neglect using the appropriate corrective measures. The aim is to study the prevalence of noncompliance to spectacle wear and its predisposing factors among adults with refractive errors in Menoufia and Gharbeya Governorates. A cross-sectional study performed in Menoufia and Gharbeya Governorates included 290 adults recruited from government and private ophthalmological centers. Data were collected through a predesigned questionnaire asking about personal data, ophthalmological data, measures of compliance, and predisposing factors to noncompliance. About 38% of the participants were noncompliant to eyeglasses wearing. Among noncompliant, personal causes represented 63.1%, followed by spectacle-related causes (22.5%) and financial causes (14.4%). Rural residence and illiteracy were significantly higher among noncompliant participants. Multivariate analysis revealed that secondary and higher education were independent protective factors against noncompliance. Noncompliance to spectacle wear was high and was significantly related to rural residence and higher levels of education.
{"title":"Noncompliance to spectacle wear among adults − Delta region, Egypt","authors":"S. S. Soliman, Ayah M. Barakat, T. E. Wasfy, Sally Abdelwanees","doi":"10.4103/ejos.ejos_66_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_66_23","url":null,"abstract":"\u0000 \u0000 Spectacles are one of the corrective measures for different errors of refraction. A great proportion of people worldwide are blind due to having a high-refractive error while they neglect using the appropriate corrective measures. The aim is to study the prevalence of noncompliance to spectacle wear and its predisposing factors among adults with refractive errors in Menoufia and Gharbeya Governorates.\u0000 \u0000 \u0000 \u0000 A cross-sectional study performed in Menoufia and Gharbeya Governorates included 290 adults recruited from government and private ophthalmological centers. Data were collected through a predesigned questionnaire asking about personal data, ophthalmological data, measures of compliance, and predisposing factors to noncompliance.\u0000 \u0000 \u0000 \u0000 About 38% of the participants were noncompliant to eyeglasses wearing. Among noncompliant, personal causes represented 63.1%, followed by spectacle-related causes (22.5%) and financial causes (14.4%). Rural residence and illiteracy were significantly higher among noncompliant participants. Multivariate analysis revealed that secondary and higher education were independent protective factors against noncompliance.\u0000 \u0000 \u0000 \u0000 Noncompliance to spectacle wear was high and was significantly related to rural residence and higher levels of education.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140516842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Basiony, Mohammad M. E. Mohammad Abdulfattah, Asmaa M. Ibrahim
Keratoconus (KC) is an ectatic corneal disorder characterized by progressive corneal thinning with myopic astigmatism. Intrastromal corneal ring segments (ICRS) have been broadly selected as a surgical intervention for KC correction to delay the need of keratoplasty. The purpose of this study was to evaluate the corneal densitometry changes in the various annuluses and depths in KC corneas after intrastromal corneal ring segment (ICRS) implantation and to correlate those changes with the other optical and refractive outcomes. This was a prospective interventional study included 56 eyes of 40 patients with KC who underwent femtosecond laser-assisted Keraring ICRS implantation. The uncorrected and best-corrected visual acuities (UCVA and BCVA), refraction, keratometry, Q-value, thinnest corneal location thickness (TCLT), and corneal densitometry in all the annular zones were assessed preoperatively and 90 days after surgery. Following the ICRS implantation after 3 months, when compared to preoperatively, the UCVA, BCVA, improved significantly from 0.21±0.12 and 0.44±0.15 to 0.27±0.12 and 0.58±0.15 (P<0.001) and spherical equivalent (SE) decreased significantly, from −5.28±1.65 D to −4.05±1.24 D (P<0.001) whereas the K1, K2, Km, Kmax, reduced significantly from 47.67±4.10 D, 51.39±4.74 D, 49.44±4.28 D, and 57.78±7.35 D, to 44.28±2.86 D, 46.84±3.42 D, 45.45±2.98 D, and 53.89±5.49 D (P<0.001) respectively. Corneal astigmatism, and Q-value were markedly improved from 3.73±2.17 D and −0.99±0.5 to 2.55±2.08 and −0.28±0.5 (P<0.001) .As regard corneal densitometry there was a significant elevation in the mean density of 2–6 mm annulus for the anterior and posterior layers (P=0.001), of 2–6 mm and 6–10 mm annuluses and total diameter for the central layer (P<0.001, P=0.047, and P<0.001, respectively), and of 2–6 mm annulus and total diameter for the total corneal thickness (P<0.001 and P=0.014, respectively). In contrast, a significant decline in the densitometry readings was observed in the 10–12 annulus for the central, posterior, and total corneal layers (P=0.003, P<0.001, and P=0.008, respectively). The percentage changes in the corneal densitometry readings did not significantly correlate with the percentage changes in the UCVA, BCVA, SE, CA and Q value. The percentage changes in the central and total 2–6 mm annuluses densities correlated negatively with the percentage changes in the K1 (r=−0.30, P=0.025 and r=−0.29, P=0.029, respectively), K2 (r=−0.33, P=0.013 and r=−0.31, P=0.021, respectively), and Km (r=−0.34, P=0.010 and r=−0.33, P=0.014, respectively). The ICRS implantation results in significant changes in corneal densitometry specifically in the central corneal layer and in the 2–6 mm annulus, with an inverse correlation with keratometric values of the front corneal surface. Besides, ICRS leads to substantial improvements of refractive status, visual acuity and corneal keratometry and asphericity.
{"title":"Corneal densitometry changes in keratoconus patients after intrastromal corneal ring segments implantation","authors":"A. Basiony, Mohammad M. E. Mohammad Abdulfattah, Asmaa M. Ibrahim","doi":"10.4103/ejos.ejos_55_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_55_23","url":null,"abstract":"\u0000 \u0000 Keratoconus (KC) is an ectatic corneal disorder characterized by progressive corneal thinning with myopic astigmatism. Intrastromal corneal ring segments (ICRS) have been broadly selected as a surgical intervention for KC correction to delay the need of keratoplasty. The purpose of this study was to evaluate the corneal densitometry changes in the various annuluses and depths in KC corneas after intrastromal corneal ring segment (ICRS) implantation and to correlate those changes with the other optical and refractive outcomes.\u0000 \u0000 \u0000 \u0000 This was a prospective interventional study included 56 eyes of 40 patients with KC who underwent femtosecond laser-assisted Keraring ICRS implantation. The uncorrected and best-corrected visual acuities (UCVA and BCVA), refraction, keratometry, Q-value, thinnest corneal location thickness (TCLT), and corneal densitometry in all the annular zones were assessed preoperatively and 90 days after surgery.\u0000 \u0000 \u0000 \u0000 Following the ICRS implantation after 3 months, when compared to preoperatively, the UCVA, BCVA, improved significantly from 0.21±0.12 and 0.44±0.15 to 0.27±0.12 and 0.58±0.15 (P<0.001) and spherical equivalent (SE) decreased significantly, from −5.28±1.65 D to −4.05±1.24 D (P<0.001) whereas the K1, K2, Km, Kmax, reduced significantly from 47.67±4.10 D, 51.39±4.74 D, 49.44±4.28 D, and 57.78±7.35 D, to 44.28±2.86 D, 46.84±3.42 D, 45.45±2.98 D, and 53.89±5.49 D (P<0.001) respectively. Corneal astigmatism, and Q-value were markedly improved from 3.73±2.17 D and −0.99±0.5 to 2.55±2.08 and −0.28±0.5 (P<0.001) .As regard corneal densitometry there was a significant elevation in the mean density of 2–6 mm annulus for the anterior and posterior layers (P=0.001), of 2–6 mm and 6–10 mm annuluses and total diameter for the central layer (P<0.001, P=0.047, and P<0.001, respectively), and of 2–6 mm annulus and total diameter for the total corneal thickness (P<0.001 and P=0.014, respectively). In contrast, a significant decline in the densitometry readings was observed in the 10–12 annulus for the central, posterior, and total corneal layers (P=0.003, P<0.001, and P=0.008, respectively). The percentage changes in the corneal densitometry readings did not significantly correlate with the percentage changes in the UCVA, BCVA, SE, CA and Q value. The percentage changes in the central and total 2–6 mm annuluses densities correlated negatively with the percentage changes in the K1 (r=−0.30, P=0.025 and r=−0.29, P=0.029, respectively), K2 (r=−0.33, P=0.013 and r=−0.31, P=0.021, respectively), and Km (r=−0.34, P=0.010 and r=−0.33, P=0.014, respectively).\u0000 \u0000 \u0000 \u0000 The ICRS implantation results in significant changes in corneal densitometry specifically in the central corneal layer and in the 2–6 mm annulus, with an inverse correlation with keratometric values of the front corneal surface. Besides, ICRS leads to substantial improvements of refractive status, visual acuity and corneal keratometry and asphericity.\u0000","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140523969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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