Mai Nasser Elmohsen, Amr Khaled Abouaggour, Maha Youssef, Mohammad Aboulfotouh
Purpose This study aimed to investigate the impact of the COVID-19 pandemic and its consequences on the clinical condition of patients with Behçet’s uveitis and compare this with the pre-pandemic state. Patients and methods This retrospective observational study included patients with Behçet’s uveitis who had adequate follow-up before the pandemic (three visits before March 2020) and during the pandemic (two visits between March 2020 and September 2021). We compared uveitis activity, complication rates, and treatment changes during the pandemic with their preCOVID data. Patients who met the inclusion criteria were contacted by phone to confirm previous COVID-19 exposure and vaccination status. Results The study included 59 eyes of 30 patients with Behçet’s uveitis. There was a statistically significant difference between the preCOVID and COVID eras with respect to visual acuity, with median values changed from 1.033 to 1.3 (P=0.003). There was an increase in secondary glaucoma (16.9% to 30.5%, P=0.039), with a corresponding increase in antiglaucoma topical eye drops (20.3–35.6%) (P=0.012). The use of subtenon injections and systemic steroids decreased during the COVID-19 pandemic, but the difference was not statistically significant (P=0.687 and P=0.481, respectively). However, the average steroid dose and the number of subtenon injections per patient showed a statistically significant decrease during the pandemic (20 and 26.7 mg per day, respectively) compared to the preCOVID era (0 and 1 injection per patient) (P=0.007 and 0.027, respectively). Conclusion The COVID-19 pandemic did not result in increased uveitis activity, but a decrease in follow-up frequency led to more complications, mainly secondary glaucoma.
{"title":"Behçet’s disease and COVID-19, retrospective analysis","authors":"Mai Nasser Elmohsen, Amr Khaled Abouaggour, Maha Youssef, Mohammad Aboulfotouh","doi":"10.4103/ejos.ejos_15_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_15_23","url":null,"abstract":"Purpose This study aimed to investigate the impact of the COVID-19 pandemic and its consequences on the clinical condition of patients with Behçet’s uveitis and compare this with the pre-pandemic state. Patients and methods This retrospective observational study included patients with Behçet’s uveitis who had adequate follow-up before the pandemic (three visits before March 2020) and during the pandemic (two visits between March 2020 and September 2021). We compared uveitis activity, complication rates, and treatment changes during the pandemic with their preCOVID data. Patients who met the inclusion criteria were contacted by phone to confirm previous COVID-19 exposure and vaccination status. Results The study included 59 eyes of 30 patients with Behçet’s uveitis. There was a statistically significant difference between the preCOVID and COVID eras with respect to visual acuity, with median values changed from 1.033 to 1.3 (P=0.003). There was an increase in secondary glaucoma (16.9% to 30.5%, P=0.039), with a corresponding increase in antiglaucoma topical eye drops (20.3–35.6%) (P=0.012). The use of subtenon injections and systemic steroids decreased during the COVID-19 pandemic, but the difference was not statistically significant (P=0.687 and P=0.481, respectively). However, the average steroid dose and the number of subtenon injections per patient showed a statistically significant decrease during the pandemic (20 and 26.7 mg per day, respectively) compared to the preCOVID era (0 and 1 injection per patient) (P=0.007 and 0.027, respectively). Conclusion The COVID-19 pandemic did not result in increased uveitis activity, but a decrease in follow-up frequency led to more complications, mainly secondary glaucoma.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"58 1","pages":"159 - 166"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364921","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}
Purpose The aim was to compare the anatomical and functional success between combined scleral buckling with pars plana vitrectomy (PPV) and PPV with heavy silicone oil (HSO) tamponade in treating inferior proliferative vitreoretinopathy (PVR) grade C in primary rhegmatogenous retinal detachment. Patients and methods A nonrandomized comparative study was performed on 33 eyes of 33 patients presenting with inferior PVR grade C complicating primary rhegmatogenous retinal detachment. Sixteen eyes underwent PPV with the HSO tamponade namely Densiron 68 that were classified as the heavy-oil group; 17 eyes underwent combined PPV with an encircling 240-band that were classified as the buckle-vitrectomy group. The aim was to achieve anatomical retinal reattachment in the absence of intraocular tamponade. Silicone oil (SO) was removed after 8 weeks in both groups. All patients were evaluated for best corrected visual acuity (BCVA) and intraocular pressure by the end of the first week, first and second months in oil-filled eyes; by the end of the first and third months post-SO removal was achieved. Results Successful primary retinal reattachment was achieved in 87.5% in the heavy-oil group and in 94.1% in the buckle-vitrectomy group, which showed no statistical difference (P=0.47) in these groups. Both groups showed a statistically significant improvement in BCVA after surgery. A significant difference in BCVA in the two groups on the eighth follow-up week after primary surgery (P=0.015) and on the 4th follow-up week after SO removal (P=0.031) was found; but at the 12th week post-SO removal there was no significant difference found between both groups (P=0.056). The mean surgical time was 96.25±13.478 and 116.47±12.4 min for the heavy-oil and buckle-vitrectomy groups, respectively, with a P value less than 0.001. Conclusion Managing inferior PVR either by PPV and HSO or by PPV and an encircling band achieved the same anatomical and functional reuslts. Although the surgical time was much faster in the heavy-oil group, the surgical costs were much higher.
{"title":"Combined vitrectomy and scleral buckle versus vitrectomy with heavy silicone oil tamponade in the management of primary rhegmatogenous retinal detachment with inferior proliferative vitreoretinopathy","authors":"Mahmoud Abdel Hafez, Nahla Borhan, Mohamed Attya, Mohamed Zayed","doi":"10.4103/ejos.ejos_1_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_1_23","url":null,"abstract":"Purpose The aim was to compare the anatomical and functional success between combined scleral buckling with pars plana vitrectomy (PPV) and PPV with heavy silicone oil (HSO) tamponade in treating inferior proliferative vitreoretinopathy (PVR) grade C in primary rhegmatogenous retinal detachment. Patients and methods A nonrandomized comparative study was performed on 33 eyes of 33 patients presenting with inferior PVR grade C complicating primary rhegmatogenous retinal detachment. Sixteen eyes underwent PPV with the HSO tamponade namely Densiron 68 that were classified as the heavy-oil group; 17 eyes underwent combined PPV with an encircling 240-band that were classified as the buckle-vitrectomy group. The aim was to achieve anatomical retinal reattachment in the absence of intraocular tamponade. Silicone oil (SO) was removed after 8 weeks in both groups. All patients were evaluated for best corrected visual acuity (BCVA) and intraocular pressure by the end of the first week, first and second months in oil-filled eyes; by the end of the first and third months post-SO removal was achieved. Results Successful primary retinal reattachment was achieved in 87.5% in the heavy-oil group and in 94.1% in the buckle-vitrectomy group, which showed no statistical difference (P=0.47) in these groups. Both groups showed a statistically significant improvement in BCVA after surgery. A significant difference in BCVA in the two groups on the eighth follow-up week after primary surgery (P=0.015) and on the 4th follow-up week after SO removal (P=0.031) was found; but at the 12th week post-SO removal there was no significant difference found between both groups (P=0.056). The mean surgical time was 96.25±13.478 and 116.47±12.4 min for the heavy-oil and buckle-vitrectomy groups, respectively, with a P value less than 0.001. Conclusion Managing inferior PVR either by PPV and HSO or by PPV and an encircling band achieved the same anatomical and functional reuslts. Although the surgical time was much faster in the heavy-oil group, the surgical costs were much higher.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"14 1","pages":"175 - 180"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365806","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}
Maram Elashmawy, M. Elsaadany, H. Hasby, Hazem A Elbedewy
Background The objective of refractive surgery is to lessen the patient’s reliance on contact lenses or glasses for everyday activities. Photorefractive Keratectomy (PRK) is a popular surgical procedure that reshapes the cornea in individuals with refractive errors in order to enhance their vision. PRK differs from previous laser-based eye operations in that there are no corneal incisions created during the procedure. Objective To compare the visual and refractive outcomes following PRK and femto-small-incision Lenticule extraction (SMILE) for myopic patients. Patients and methods This retrospective comparative research was conducted in Ophthalmology Department, Faculty of Medicine–Tanta University on 80 eyes (of 40 cases) who underwent Corneal Refractive Surgery. They were equally allocated into two groups; PRK group and 2- femto-SMILE group. They were compared before surgery and 6 months after surgery for clinical and topographical outcomes. Results There was a significant difference between both groups as regard of Postoperative UCVA, Degree of Myopia before and after surgery, and Analysis of thinnest location. There were no significant difference between both groups as regard of demographic data or degree of Astigmatism. Conclusion After 6 months of surgery, the visual outcome of PRK was better than femto-SMILE, however, femto- SMILE was more effective in astigmatic correction compared with PRK.
{"title":"Visual and refractive outcomes after photorefractive keratectomy (PRK) and femto-SMILE (small-incision lenticule extraction) for Myopia","authors":"Maram Elashmawy, M. Elsaadany, H. Hasby, Hazem A Elbedewy","doi":"10.4103/ejos.ejos_37_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_37_23","url":null,"abstract":"Background The objective of refractive surgery is to lessen the patient’s reliance on contact lenses or glasses for everyday activities. Photorefractive Keratectomy (PRK) is a popular surgical procedure that reshapes the cornea in individuals with refractive errors in order to enhance their vision. PRK differs from previous laser-based eye operations in that there are no corneal incisions created during the procedure. Objective To compare the visual and refractive outcomes following PRK and femto-small-incision Lenticule extraction (SMILE) for myopic patients. Patients and methods This retrospective comparative research was conducted in Ophthalmology Department, Faculty of Medicine–Tanta University on 80 eyes (of 40 cases) who underwent Corneal Refractive Surgery. They were equally allocated into two groups; PRK group and 2- femto-SMILE group. They were compared before surgery and 6 months after surgery for clinical and topographical outcomes. Results There was a significant difference between both groups as regard of Postoperative UCVA, Degree of Myopia before and after surgery, and Analysis of thinnest location. There were no significant difference between both groups as regard of demographic data or degree of Astigmatism. Conclusion After 6 months of surgery, the visual outcome of PRK was better than femto-SMILE, however, femto- SMILE was more effective in astigmatic correction compared with PRK.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"42 1","pages":"145 - 149"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364685","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}
Mahmoud Mohamed El Morsy, Ezz El Dein Galal Mohamed, Assad A. Ghanem, Ismail Ahmed Omar, Rasha Elhiny
Purpose To assess parameters of corneal topography and higher order aberrations (HOAs) data in the apparently normal contralateral eyes of unilateral keratoconus (KC) cases in comparison with normal eyes of healthy individuals. Patients and methods This observational case-control study included 70 eyes divided into two equal groups; group A was the fellow eyes of unilateral keratoconus patients and group B included the normal control eyes. They were examined by Schimpflug camera to extract the study parameters (keratometry indices, the inferior-superior(I-S) difference at 4 mm, posterior elevation (PE), front and back difference, thickness progression index, corneal pachymetry, multimetric D index (D index), topometric indices and Zernike analysis). Results In comparing the study data between Groups A and B, we demonstrated that ISV, IVA, and CKI had no difference between the two groups. But other topometric parameters showed statistically significant differences between the two groups. Assessment of corneal aberrations revealed that the RMS HOA, vertical coma, and spherical aberrations were associated with significant increases in the apparently normal eyes of unilateral KC cases in comparison with healthy individual eyes (P<0.001). Conclusion Fellow eyes of unilateral KC cases seem not to be totally normal. And so, it is recommended to regularly examine these eyes at close intervals to catch up any abnormality and to avoid KC progression.
{"title":"Evaluation of corneal topography and higher order aberrations of the fellow eye in unilateral keratoconus","authors":"Mahmoud Mohamed El Morsy, Ezz El Dein Galal Mohamed, Assad A. Ghanem, Ismail Ahmed Omar, Rasha Elhiny","doi":"10.4103/ejos.ejos_36_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_36_23","url":null,"abstract":"Purpose To assess parameters of corneal topography and higher order aberrations (HOAs) data in the apparently normal contralateral eyes of unilateral keratoconus (KC) cases in comparison with normal eyes of healthy individuals. Patients and methods This observational case-control study included 70 eyes divided into two equal groups; group A was the fellow eyes of unilateral keratoconus patients and group B included the normal control eyes. They were examined by Schimpflug camera to extract the study parameters (keratometry indices, the inferior-superior(I-S) difference at 4 mm, posterior elevation (PE), front and back difference, thickness progression index, corneal pachymetry, multimetric D index (D index), topometric indices and Zernike analysis). Results In comparing the study data between Groups A and B, we demonstrated that ISV, IVA, and CKI had no difference between the two groups. But other topometric parameters showed statistically significant differences between the two groups. Assessment of corneal aberrations revealed that the RMS HOA, vertical coma, and spherical aberrations were associated with significant increases in the apparently normal eyes of unilateral KC cases in comparison with healthy individual eyes (P<0.001). Conclusion Fellow eyes of unilateral KC cases seem not to be totally normal. And so, it is recommended to regularly examine these eyes at close intervals to catch up any abnormality and to avoid KC progression.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"5 1","pages":"193 - 198"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365908","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}
H. Makled, Shaza ElZawahry, A. Albalkini, Ayman Khattab, Ashraf Nossair
Purpose To study the incidence and sequelae of macular edema after Panretinal photocoagulation (PRP) for the treatment of proliferative diabetic retinopathy (PDR). Patients and Methods A prospective interventional clinical study included 42 eyes treated by PRP, for proliferative diabetic retinopathy over three sessions on three consecutive weeks. Baseline and 1-month postoperative data were collected including best-corrected visual acuity, detailed fundus examination and Spectral Domain Optical Coherence Tomography Macula (SD-OCT); to assess the Central Subfield Macular Thickness (CSMT) using the ETDRS Map. Results Forty-two eyes of 31 patients were included in the study with mean duration of diabetes of 16.9±5.7 years and mean HbA1c of 9.1±1.4. Mean pre-PRP vision was 0.44±0.2 log units, which improved to 0.41±0.2 log units (P=0.6). Mean pre-laser CSMT was 245.6±25.5 µm, which increased to 265.5±33.5 µm at 1-month follow-up after PRP (P=0.003). Four eyes (9.5%) had CSMT more than 300 µm with intraretinal edema. The mean change and percentage of change from baseline in CSMT between those patients and remaining patient were statistically insignificant (P=0.055 and 0.115 respectively). Changes in CSMT and changes in Log MAR BCVA at 4-week follow-up were inversely correlated. Conclusion Macular edema can be an unavoidable side effect of PRP especially in cases with baseline increased macular thickness. Vision is mostly not affected by PRP, however, changes in vision may be directly affected by macular thickness post-PRP.
{"title":"Incidence and Sequelae of Macular Edema Post Pan-retinal Photocoagulation for Proliferative Diabetic Retinopathy","authors":"H. Makled, Shaza ElZawahry, A. Albalkini, Ayman Khattab, Ashraf Nossair","doi":"10.4103/ejos.ejos_73_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_73_22","url":null,"abstract":"Purpose To study the incidence and sequelae of macular edema after Panretinal photocoagulation (PRP) for the treatment of proliferative diabetic retinopathy (PDR). Patients and Methods A prospective interventional clinical study included 42 eyes treated by PRP, for proliferative diabetic retinopathy over three sessions on three consecutive weeks. Baseline and 1-month postoperative data were collected including best-corrected visual acuity, detailed fundus examination and Spectral Domain Optical Coherence Tomography Macula (SD-OCT); to assess the Central Subfield Macular Thickness (CSMT) using the ETDRS Map. Results Forty-two eyes of 31 patients were included in the study with mean duration of diabetes of 16.9±5.7 years and mean HbA1c of 9.1±1.4. Mean pre-PRP vision was 0.44±0.2 log units, which improved to 0.41±0.2 log units (P=0.6). Mean pre-laser CSMT was 245.6±25.5 µm, which increased to 265.5±33.5 µm at 1-month follow-up after PRP (P=0.003). Four eyes (9.5%) had CSMT more than 300 µm with intraretinal edema. The mean change and percentage of change from baseline in CSMT between those patients and remaining patient were statistically insignificant (P=0.055 and 0.115 respectively). Changes in CSMT and changes in Log MAR BCVA at 4-week follow-up were inversely correlated. Conclusion Macular edema can be an unavoidable side effect of PRP especially in cases with baseline increased macular thickness. Vision is mostly not affected by PRP, however, changes in vision may be directly affected by macular thickness post-PRP.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"51 1","pages":"206 - 213"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364556","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}
Islam Metwally, Mostafa Bahgat, Ahmed F. El-Shahed
Aim The aim of this study is to clinically investigate the challenges and pitfalls of normal-tension glaucoma (NTG) diagnostic methods by ophthalmic clinical and investigative examinations. Setting This study was conducted at Al-Agouza Police Authority Hospital and Badr University Hospital. Methods A cross-sectional comparative study between the diagnosis of normal nonglaucoma patients and NTG. It included 40 normal nonglaucoma patients’ eyes as controls and 40 NTG patients’ eyes who met inclusion criteria. They were assessed by a complete ophthalmic exam., visual field (VF), and optical coherence tomography (OCT) variables between January 2022 and September 2022. Results The median age of the control group was 38 years old, while that of glaucomatous patients was 41 years old. The mean intraocular pressure (IOP) for the normal group was 15.53 mmHg (±1.935), while that for the glaucomatous group was 16.85 mmHg (±1.703). The intraocular pressure was considerably higher in the NTG group compared with the control (P = 0.0017). The mean deviation (MD) in dB of VF loss was considerably higher in the NTG group compared with the control (P = 0.0001). Also, the mean standard deviation (MSD) was considerably varied between the two groups (P < 0.0001). The average Retinal Nerve Fiber Layer (RNFL) in the NTG group, with a mean of 72.3 սm (±10.239) was significantly lower than in the control group with a mean of 102.025 սm (±7.454), P = 0.0001. Optic Disc Parameters: The Cup Area (mm2) was significantly wider in the NTG group with a mean of 1.62 (±0.476) than in the control with a mean of 1.297 (±0.44), P = 0.0024. Also, the Rim Area was significantly smaller in the NTG group with a mean of 0.614 (±0.342) than in the control with a mean of 1.135 (±0.319), P = 0.0024. The Cup/disc ratio was significantly larger in the NTG group than in the control group (P < 0.0001). The average Ganglion cell complex (GCC) was considerably thinner in the NTG patients in comparison to the controls (P = 0.0001). Conclusion The effects of NTG on VF and optic nerve seems to be more intensive. More focal notches and disc hemorrhage were noted in NTG. In the NTG group, the Cup Area was potentially wider, the rim area was significantly thinner, and the Cup/disc ratio was significantly larger.
{"title":"Challenges and difficulties in diagnosis of normal-tension glaucoma","authors":"Islam Metwally, Mostafa Bahgat, Ahmed F. El-Shahed","doi":"10.4103/ejos.ejos_30_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_30_23","url":null,"abstract":"Aim The aim of this study is to clinically investigate the challenges and pitfalls of normal-tension glaucoma (NTG) diagnostic methods by ophthalmic clinical and investigative examinations. Setting This study was conducted at Al-Agouza Police Authority Hospital and Badr University Hospital. Methods A cross-sectional comparative study between the diagnosis of normal nonglaucoma patients and NTG. It included 40 normal nonglaucoma patients’ eyes as controls and 40 NTG patients’ eyes who met inclusion criteria. They were assessed by a complete ophthalmic exam., visual field (VF), and optical coherence tomography (OCT) variables between January 2022 and September 2022. Results The median age of the control group was 38 years old, while that of glaucomatous patients was 41 years old. The mean intraocular pressure (IOP) for the normal group was 15.53 mmHg (±1.935), while that for the glaucomatous group was 16.85 mmHg (±1.703). The intraocular pressure was considerably higher in the NTG group compared with the control (P = 0.0017). The mean deviation (MD) in dB of VF loss was considerably higher in the NTG group compared with the control (P = 0.0001). Also, the mean standard deviation (MSD) was considerably varied between the two groups (P < 0.0001). The average Retinal Nerve Fiber Layer (RNFL) in the NTG group, with a mean of 72.3 սm (±10.239) was significantly lower than in the control group with a mean of 102.025 սm (±7.454), P = 0.0001. Optic Disc Parameters: The Cup Area (mm2) was significantly wider in the NTG group with a mean of 1.62 (±0.476) than in the control with a mean of 1.297 (±0.44), P = 0.0024. Also, the Rim Area was significantly smaller in the NTG group with a mean of 0.614 (±0.342) than in the control with a mean of 1.135 (±0.319), P = 0.0024. The Cup/disc ratio was significantly larger in the NTG group than in the control group (P < 0.0001). The average Ganglion cell complex (GCC) was considerably thinner in the NTG patients in comparison to the controls (P = 0.0001). Conclusion The effects of NTG on VF and optic nerve seems to be more intensive. More focal notches and disc hemorrhage were noted in NTG. In the NTG group, the Cup Area was potentially wider, the rim area was significantly thinner, and the Cup/disc ratio was significantly larger.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"18 1","pages":"138 - 144"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365663","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}
Background To evaluate safety and efficacy of dual focal laser (DFL) followed by a single intravitreal ranibizumab injection for exudative retinal artery macroaneurysms (RAM). Methods Retrospective review of records of eyes with RAM; treated between February 2012 and November 2020; was done, to collect and analyze the following data: Treatment details, features of RAM, associated retinal disease, best-corrected visual acuity (BCVA), central macular thickness (CMT), signs of RAM involution, and possible complications. We enrolled cases that had been treated by Direct and perilesional focal laser, followed by a single intravitreal ranibizumab injection a few days later, and had been followed-up for at least 6 months. Outcome measures included: change in BCVA, change in CMT, and complications. Results 14 patients were enrolled. All cases were isolated RAM (without other retinal disease) with macular edema±hard exudates (100%). 12 cases (85.7%) were exudative, and 2 cases (14.3%) also had a hemorrhagic component (mixed type). Hemorrhagic macroaneurysms without exudation were not included in the study. RAM was fusiform in 12 cases (85.7%) and saccular in 2 cases (14.3%). RAM involved the upper temporal arcade in 10 cases (71.4%) and the lower temporal arcade in 4 cases (28.6%). RAM involved second order arteries in 10 cases (71.4%) and third order arteries in 4 cases (28.6%). Logarithm of the minimum angle of resolution (LogMAR) BCVA improved from an initial 0.71±0.35 to 0.27±0.26 at final follow-up. CMT was reduced from 417±82 μ to 285±31 μ at final follow-up. The mean interval between laser and ranibizumab injection was 3.2±2.9 days. The mean follow-up duration was 8.0±2.6 months. Involution/thrombosis- fibrosis of RAM was induced in all cases (100%). Conclusion Combined dual focal laser coagulation and single intravitreal ranibizumab injection for RAM are safe and effective, and may eliminate the need for repeated intravitreal injections. Isolated exudative macroaneurysms may be suitable for this combined approach.
{"title":"Validity of focal laser photocoagulation followed by a single intravitreal ranibizumab injection for retinal artery macroaneurysm","authors":"W. Ewais, L. Ali, Ashraf Nossair","doi":"10.4103/ejos.ejos_35_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_35_23","url":null,"abstract":"Background To evaluate safety and efficacy of dual focal laser (DFL) followed by a single intravitreal ranibizumab injection for exudative retinal artery macroaneurysms (RAM). Methods Retrospective review of records of eyes with RAM; treated between February 2012 and November 2020; was done, to collect and analyze the following data: Treatment details, features of RAM, associated retinal disease, best-corrected visual acuity (BCVA), central macular thickness (CMT), signs of RAM involution, and possible complications. We enrolled cases that had been treated by Direct and perilesional focal laser, followed by a single intravitreal ranibizumab injection a few days later, and had been followed-up for at least 6 months. Outcome measures included: change in BCVA, change in CMT, and complications. Results 14 patients were enrolled. All cases were isolated RAM (without other retinal disease) with macular edema±hard exudates (100%). 12 cases (85.7%) were exudative, and 2 cases (14.3%) also had a hemorrhagic component (mixed type). Hemorrhagic macroaneurysms without exudation were not included in the study. RAM was fusiform in 12 cases (85.7%) and saccular in 2 cases (14.3%). RAM involved the upper temporal arcade in 10 cases (71.4%) and the lower temporal arcade in 4 cases (28.6%). RAM involved second order arteries in 10 cases (71.4%) and third order arteries in 4 cases (28.6%). Logarithm of the minimum angle of resolution (LogMAR) BCVA improved from an initial 0.71±0.35 to 0.27±0.26 at final follow-up. CMT was reduced from 417±82 μ to 285±31 μ at final follow-up. The mean interval between laser and ranibizumab injection was 3.2±2.9 days. The mean follow-up duration was 8.0±2.6 months. Involution/thrombosis- fibrosis of RAM was induced in all cases (100%). Conclusion Combined dual focal laser coagulation and single intravitreal ranibizumab injection for RAM are safe and effective, and may eliminate the need for repeated intravitreal injections. Isolated exudative macroaneurysms may be suitable for this combined approach.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"43 1","pages":"150 - 158"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366027","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}
Mohammed A Al-Naimy, T. Habeeb, Yasmine A Deiaeldin
Purpose This study aimed to investigate the course of uveal manifestations in a cohort of patients who underwent surgery for ulcerative colitis (UC), highlighting the diverse spectrum of associated eye disorders and alerting clinicians of their significance. Patients and methods A retrospective observational study was conducted on 40 UC patients with ocular manifestations who underwent one-stage laparoscopic restorative proctocolectomy according to the European Crohn’s and Colitis Organization (ECCO) guidelines. Ophthalmic examinations were performed preoperatively and postoperatively during the 6-month follow-up period. Anterior uveitis attacks were graded based on the presence of cells or flares, vitreous haze indicates intermediate uveitis while posterior uveitis was indicated by retinitis or choroiditis, or both. Recurrence was a Standardization of Uveitis Nomenclature (SUN) grading system score greater than or equal to 2+ for anterior chamber cells or vitreous haze. Results Postoperatively, uveitis regression was observed in ∼60% of the patients, 25% showed a stationary course, and 15% exhibited progression. After surgery, more patients had lower Standardization of Uveitis Nomenclature grades for anterior chamber cells, flares, and vitreous haze than at baseline. Conclusion Ulcerative colitis can manifest with various ophthalmic manifestations ranging from nonspecific to severe, affecting visual prognosis or remaining asymptomatic. In our study most patients who underwent colonic surgery got benefits in the form of not only decreasing the severity of disease activity but also a decrease in the recurrence rate postsurgical.
{"title":"Courses of uveal manifestations following surgical treatment of patients with ulcerative colitis in adults: Observation study","authors":"Mohammed A Al-Naimy, T. Habeeb, Yasmine A Deiaeldin","doi":"10.4103/ejos.ejos_42_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_42_23","url":null,"abstract":"Purpose This study aimed to investigate the course of uveal manifestations in a cohort of patients who underwent surgery for ulcerative colitis (UC), highlighting the diverse spectrum of associated eye disorders and alerting clinicians of their significance. Patients and methods A retrospective observational study was conducted on 40 UC patients with ocular manifestations who underwent one-stage laparoscopic restorative proctocolectomy according to the European Crohn’s and Colitis Organization (ECCO) guidelines. Ophthalmic examinations were performed preoperatively and postoperatively during the 6-month follow-up period. Anterior uveitis attacks were graded based on the presence of cells or flares, vitreous haze indicates intermediate uveitis while posterior uveitis was indicated by retinitis or choroiditis, or both. Recurrence was a Standardization of Uveitis Nomenclature (SUN) grading system score greater than or equal to 2+ for anterior chamber cells or vitreous haze. Results Postoperatively, uveitis regression was observed in ∼60% of the patients, 25% showed a stationary course, and 15% exhibited progression. After surgery, more patients had lower Standardization of Uveitis Nomenclature grades for anterior chamber cells, flares, and vitreous haze than at baseline. Conclusion Ulcerative colitis can manifest with various ophthalmic manifestations ranging from nonspecific to severe, affecting visual prognosis or remaining asymptomatic. In our study most patients who underwent colonic surgery got benefits in the form of not only decreasing the severity of disease activity but also a decrease in the recurrence rate postsurgical.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"26 1","pages":"199 - 205"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365418","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}
Hussein Mohamed Ahmed Ayoub, Amr Mousa, M. Hamdi, R. Mousa, M. A. Awad-Allah
Purpose To evaluate the effect of intrastromal injection of anti-vascular endothelial growth factor (Anti-VEGF) on corneal neovascularization using spectral domain Optical coherence tomography angiography imaging (OCTA). Patients and methods This is a pilot study that was conducted on 10 eyes of 10 patients with corneal neovascularization who were planned for keratoplasty or after keratoplasty. Intrastromal injection of 5 mg/0.2 ml [2.5%] bevacizumab using a 30 Gauge needle was performed. OCTA was done 48 h before the injection, 1 week and 1 month after the injection. OCTA images were compared to evaluate the effect of Anti-VEGF on corneal neovascularization. Results Comparing the OCTA pictures with the preoperative period, at 1 week period, 9 cases have shown decreased corneal neovascularization, with only 1 case that has not changed and seemed to be unresponsive to the single injection of Anti-VEGF. At 1 month period, 8 cases re-vascularized again but none of them reached the preoperative level, 1 case had decreased vascularization (completely disappeared) and 1 case remained the same with no change. Conclusion A single injection of bevacizumab has a temporal effect on corneal neovascularization. No local or systemic complications have been noted. OCTA was able to visualize vessels in 3-D image, even under vascularized corneal scars. OCTA was able to recognize subtle changes in corneal neovascularization that were not visible by slit lamp.
{"title":"Studying the effect of intrastromal anti-vascular endothelial growth factor injections on corneal neovascularization using optical coherence tomography angiography","authors":"Hussein Mohamed Ahmed Ayoub, Amr Mousa, M. Hamdi, R. Mousa, M. A. Awad-Allah","doi":"10.4103/ejos.ejos_41_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_41_23","url":null,"abstract":"Purpose To evaluate the effect of intrastromal injection of anti-vascular endothelial growth factor (Anti-VEGF) on corneal neovascularization using spectral domain Optical coherence tomography angiography imaging (OCTA). Patients and methods This is a pilot study that was conducted on 10 eyes of 10 patients with corneal neovascularization who were planned for keratoplasty or after keratoplasty. Intrastromal injection of 5 mg/0.2 ml [2.5%] bevacizumab using a 30 Gauge needle was performed. OCTA was done 48 h before the injection, 1 week and 1 month after the injection. OCTA images were compared to evaluate the effect of Anti-VEGF on corneal neovascularization. Results Comparing the OCTA pictures with the preoperative period, at 1 week period, 9 cases have shown decreased corneal neovascularization, with only 1 case that has not changed and seemed to be unresponsive to the single injection of Anti-VEGF. At 1 month period, 8 cases re-vascularized again but none of them reached the preoperative level, 1 case had decreased vascularization (completely disappeared) and 1 case remained the same with no change. Conclusion A single injection of bevacizumab has a temporal effect on corneal neovascularization. No local or systemic complications have been noted. OCTA was able to visualize vessels in 3-D image, even under vascularized corneal scars. OCTA was able to recognize subtle changes in corneal neovascularization that were not visible by slit lamp.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"13 1","pages":"167 - 174"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365409","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}
Mohamed El-Behaidy, Ezz Eldein Mohamed, S. Dabour, Mohammed Al-Naimy, Rasha Elhiny
Purpose To compare combined phacoemulsification and intravitreal Ranibizumab (RBZ) injection versus sequential Intravitreal Raibizumab injection and phacoemulsification on the progression of diabetic macular edema (DME) both clinically (through best corrected visual acuity) and by optical coherence tomography (OCT). Setting and design This observational study was conducted in October 6 University, Faculty of Medicine, Department of Ophthalmology. Patient and methods Patients with non-ischemic diabetic macular edema (DME); along with, clinically significant cataract were randomly divided into two groups. Both groups received three intravitreal 0.5 mg/0.05 ml RBZ injections on monthly basis. Group (I), received the first dose combined with phacoemulsification followed by the other two injections, one and two months postoperatively. Group (II), received the first dose two weeks before phacoemulsification followed by the other two injections, one and two months from the first one. Results The baseline mean central macular thickness (CMT) was comparable in both groups (P>0.05); however, the CMT one month after the third injection was 261±36 µm for Group (II) vs 320±65 µm for Group (I), which was statistically significant (P<0.001). Both study groups were comparable regarding the baseline mean best corrected visual acuity (BCVA) (P>0.05); however, the mean BCVA at the end of follow-up was 0.32±0.23 LogMAR for Group (II) vs 0.50±0.19 LogMAR for Group (I), which was statistically significant (P<0.001). Conclusion Intravitreal RBZ injection has a significant clinical improving effect on both CMT and BCVA in diabetic patients with diabetic macular edema (DME) undergoing phacoemulsification; although, it is preferred to inject a single intravitreal injection two weeks before phacoemulsification to reach its peak effect in counteracting the high levels of VEGF released during the surgery.
{"title":"Evaluation of diabetic macular edema by using optical coherence tomography in patients underwent combined phacoemulsification and intravitreal ranibizumab injection versus patients underwent sequential intravitreal ranibizumab injection and phacoemulsification: an observational study","authors":"Mohamed El-Behaidy, Ezz Eldein Mohamed, S. Dabour, Mohammed Al-Naimy, Rasha Elhiny","doi":"10.4103/ejos.ejos_40_23","DOIUrl":"https://doi.org/10.4103/ejos.ejos_40_23","url":null,"abstract":"Purpose To compare combined phacoemulsification and intravitreal Ranibizumab (RBZ) injection versus sequential Intravitreal Raibizumab injection and phacoemulsification on the progression of diabetic macular edema (DME) both clinically (through best corrected visual acuity) and by optical coherence tomography (OCT). Setting and design This observational study was conducted in October 6 University, Faculty of Medicine, Department of Ophthalmology. Patient and methods Patients with non-ischemic diabetic macular edema (DME); along with, clinically significant cataract were randomly divided into two groups. Both groups received three intravitreal 0.5 mg/0.05 ml RBZ injections on monthly basis. Group (I), received the first dose combined with phacoemulsification followed by the other two injections, one and two months postoperatively. Group (II), received the first dose two weeks before phacoemulsification followed by the other two injections, one and two months from the first one. Results The baseline mean central macular thickness (CMT) was comparable in both groups (P>0.05); however, the CMT one month after the third injection was 261±36 µm for Group (II) vs 320±65 µm for Group (I), which was statistically significant (P<0.001). Both study groups were comparable regarding the baseline mean best corrected visual acuity (BCVA) (P>0.05); however, the mean BCVA at the end of follow-up was 0.32±0.23 LogMAR for Group (II) vs 0.50±0.19 LogMAR for Group (I), which was statistically significant (P<0.001). Conclusion Intravitreal RBZ injection has a significant clinical improving effect on both CMT and BCVA in diabetic patients with diabetic macular edema (DME) undergoing phacoemulsification; although, it is preferred to inject a single intravitreal injection two weeks before phacoemulsification to reach its peak effect in counteracting the high levels of VEGF released during the surgery.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"262 1","pages":"188 - 192"},"PeriodicalIF":0.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365674","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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