Purpose To investigate the effect of anterior chamber maintainer (ACM) usage during phacoemulsification on the occurrence of pseudophakic retinal detachment (PRD) in high myopia. Design A retrospective nonrandomized comparative interventional study was conducted. Participants A total of 632 high myopic eyes of 501 patients who had eventless phacoemulsification with in-the-bag intraocular lens implantation in the period between March 2013 and December 2018. Methods Patients were divided into two groups according to the use of ACM during cataract surgery: (a) ACM group, and (b) no-ACM group. Patients were followed at 6, 12, 18, 24, 30, and 36 months after surgery for detection of PRD. The time-related cumulative incidence of RD in each group was evaluated by means of Kaplan–Meier survival curves. Results In the ACM group, the 3-year cumulative incidence of RD was 2.4% compared with 5.9% in the other group (P=0.039). Regarding age, the 3-year cumulative incidence of RD increased significantly in the younger age group when the ACM was not used (P=0.023), whereas it was not when the ACM was used. Using the ACM increased the 3-year cumulative survival ratio from 86.2 to 92% in patients with a posterior staphyloma (P=0.03). Conclusion ACM is a potential prophylactic intraoperative tool against PRD in highly myopic eyes.
{"title":"Role of anterior chamber maintainer in preventing pseudophakic retinal detachment in highly myopic eyes","authors":"Ahmed Khater, Taher K Eleiwa, I. Elsaadani","doi":"10.4103/ejos.ejos_35_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_35_22","url":null,"abstract":"Purpose To investigate the effect of anterior chamber maintainer (ACM) usage during phacoemulsification on the occurrence of pseudophakic retinal detachment (PRD) in high myopia. Design A retrospective nonrandomized comparative interventional study was conducted. Participants A total of 632 high myopic eyes of 501 patients who had eventless phacoemulsification with in-the-bag intraocular lens implantation in the period between March 2013 and December 2018. Methods Patients were divided into two groups according to the use of ACM during cataract surgery: (a) ACM group, and (b) no-ACM group. Patients were followed at 6, 12, 18, 24, 30, and 36 months after surgery for detection of PRD. The time-related cumulative incidence of RD in each group was evaluated by means of Kaplan–Meier survival curves. Results In the ACM group, the 3-year cumulative incidence of RD was 2.4% compared with 5.9% in the other group (P=0.039). Regarding age, the 3-year cumulative incidence of RD increased significantly in the younger age group when the ACM was not used (P=0.023), whereas it was not when the ACM was used. Using the ACM increased the 3-year cumulative survival ratio from 86.2 to 92% in patients with a posterior staphyloma (P=0.03). Conclusion ACM is a potential prophylactic intraoperative tool against PRD in highly myopic eyes.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"99 - 104"},"PeriodicalIF":0.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44038336","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}
M. Eissa, A. Abdullatif, M. Attya, H. El-Saied, H. Makled
Objectives To investigate the changes in ophthalmological practice between the first and current waves of the coronavirus disease 2019 (COVID-19) pandemic as well as to evaluate the pattern of ophthalmology practice following COVID-19 vaccination. Patients and methods This is a cross-sectional observational analytical study of ophthalmologists working in different hospitals in Cairo, Egypt. The data were collected through a self-administered questionnaire that included separate sections about (a) demographic data, (b) experience with COVID-19 infection, (c) current ophthalmologists’ and patients’ concerns, (d) experience with COVID-19 vaccination, (e) current changes of practice, (f) current safety measures, and (g) current flow of cases. Results The questionnaire was sent to 200 ophthalmologists, with a 77% response rate. Since the onset of the pandemic in Egypt, ∼60% of the participants (83% were below 45 years of age) have been infected with COVID-19. When compared with the first wave, more than two-thirds of respondents expressed less psychic concern but the same economic concern about the pandemic. Although 90% of the participants have been vaccinated against COVID-19, more than 50% still feel unsafe regarding new infection. In comparison with the first wave, 45% of participants have reduced clinical safety measures. Participants also found that their patients’ psychological concern was significantly lower compared with the first wave and patients’ flow increased to approach prepandemic levels. Conclusion Concerns among ophthalmologists and patients have decreased significantly since the first COVID-19 wave, but economic concerns remain high.
{"title":"How ophthalmology practice changed over 2 years of coronavirus disease 2019 pandemic: an Egyptian perspective","authors":"M. Eissa, A. Abdullatif, M. Attya, H. El-Saied, H. Makled","doi":"10.4103/ejos.ejos_38_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_38_22","url":null,"abstract":"Objectives To investigate the changes in ophthalmological practice between the first and current waves of the coronavirus disease 2019 (COVID-19) pandemic as well as to evaluate the pattern of ophthalmology practice following COVID-19 vaccination. Patients and methods This is a cross-sectional observational analytical study of ophthalmologists working in different hospitals in Cairo, Egypt. The data were collected through a self-administered questionnaire that included separate sections about (a) demographic data, (b) experience with COVID-19 infection, (c) current ophthalmologists’ and patients’ concerns, (d) experience with COVID-19 vaccination, (e) current changes of practice, (f) current safety measures, and (g) current flow of cases. Results The questionnaire was sent to 200 ophthalmologists, with a 77% response rate. Since the onset of the pandemic in Egypt, ∼60% of the participants (83% were below 45 years of age) have been infected with COVID-19. When compared with the first wave, more than two-thirds of respondents expressed less psychic concern but the same economic concern about the pandemic. Although 90% of the participants have been vaccinated against COVID-19, more than 50% still feel unsafe regarding new infection. In comparison with the first wave, 45% of participants have reduced clinical safety measures. Participants also found that their patients’ psychological concern was significantly lower compared with the first wave and patients’ flow increased to approach prepandemic levels. Conclusion Concerns among ophthalmologists and patients have decreased significantly since the first COVID-19 wave, but economic concerns remain high.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"138 - 143"},"PeriodicalIF":0.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42052599","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}
Marwa Abuelwafa, A. Tabl, Mona Shaarawy, Hamdy A A Elgazzar, A. El.shahed
Purpose To evaluate changes that occur in foveal avascular zone (FAZ) in diabetic hypertensive patients by optical coherence tomography angiography (OCTA). Patients and methods OCTA was performed for 60 eyes of 35 diabetic hypertensive patients. This study was done in Benha University Hospital between February and June 2021. FAZ area was measured by a frame that was centered around it. Moreover, the vessel density was measured also by detecting the superficial vessel density (SVD) and the deep vessel density (DVD). Results In diabetic hypertensive (60 eyes of 35 patients) with average age 55.52 (±6.88) years and mean duration of the disease 12.17 (±7.15) years, the mean value of the FAZ was 0.37 (±0.54) mm, denoting enlargement of the FAZ diameter. In addition, the vessel density showed that there is decreasing in the SVD (43.9±5.89) and it was correlated to the best-corrected visual acuity and age of the patients (P<0.05), while it was highly correlated to the DVD (P<0.001). On the other hand, there was a decrease in DVD with a mean of 43.17±7.44, which was statistically significant with the age of the patients (P<0.05), but there was no significant relationship with duration of the disease, glycated hemoglobin, and best-corrected visual acuity. Conclusion OCTA is a noninvasive technique to image the retinal and choroidal vasculature. The study concluded that diabetic retinopathy in the presence of systemic hypertension leads to increasing of the FAZ area. Moreover, it leads to decreasing in both the SVD and DVD. Also, it allows for early detection and easy follow-up of the disease.
{"title":"Foveal Avascular Zone in diabetic hypertensive patients","authors":"Marwa Abuelwafa, A. Tabl, Mona Shaarawy, Hamdy A A Elgazzar, A. El.shahed","doi":"10.4103/ejos.ejos_33_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_33_22","url":null,"abstract":"Purpose To evaluate changes that occur in foveal avascular zone (FAZ) in diabetic hypertensive patients by optical coherence tomography angiography (OCTA). Patients and methods OCTA was performed for 60 eyes of 35 diabetic hypertensive patients. This study was done in Benha University Hospital between February and June 2021. FAZ area was measured by a frame that was centered around it. Moreover, the vessel density was measured also by detecting the superficial vessel density (SVD) and the deep vessel density (DVD). Results In diabetic hypertensive (60 eyes of 35 patients) with average age 55.52 (±6.88) years and mean duration of the disease 12.17 (±7.15) years, the mean value of the FAZ was 0.37 (±0.54) mm, denoting enlargement of the FAZ diameter. In addition, the vessel density showed that there is decreasing in the SVD (43.9±5.89) and it was correlated to the best-corrected visual acuity and age of the patients (P<0.05), while it was highly correlated to the DVD (P<0.001). On the other hand, there was a decrease in DVD with a mean of 43.17±7.44, which was statistically significant with the age of the patients (P<0.05), but there was no significant relationship with duration of the disease, glycated hemoglobin, and best-corrected visual acuity. Conclusion OCTA is a noninvasive technique to image the retinal and choroidal vasculature. The study concluded that diabetic retinopathy in the presence of systemic hypertension leads to increasing of the FAZ area. Moreover, it leads to decreasing in both the SVD and DVD. Also, it allows for early detection and easy follow-up of the disease.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"111 - 116"},"PeriodicalIF":0.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46281060","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}
Aim To evaluate the visual outcome of implantable phakic contact lens (IPCL) in high myopia. Setting Al-Mashreq Eye Center, Cairo, Egypt. Patients and methods Thirty eyes of 17 patients underwent surgery to correct high myopia using IPCL (Care Group-India) with a central hole (V2.0). Visual acuity, spherical equivalent, and intraocular pressure (IOP) were evaluated 6 months postoperatively. Anterior chamber parameters Anterior chamber volume (ACV), Anterior chamber depth (ACD), Anterior chamber angle width (ACAW) were measured using Pentacam. Results After 6 months, spherical equivalent decreased from −14.19±4.2 to −0.18±0.66 D, all cases were within ±1.00 D of intended correction. Best corrected visual acuity (BCVA) remained unchanged in 13% of cases, 13% gained one line, and 74% gained two or more lines. ACV, ACD, and ACAW decreased from 189.77±20.19 mm3, 3.15±0.27 mm, and 37.31±5.63° to 131.4±14.01 mm3, 3.05±0.29 mm, and 23.94±4.81°, respectively. Changes in IOP between preoperative and 6 months postoperatively were statistically insignificant. Conclusion IPCL is a safe, effective, and predictable surgery to correct high myopia. Most cases gained one or more lines of BCVA. Reduction of ACV did not induce IOP rise during 6 months of follow-up.
目的评价植入式有晶状体接触镜（IPCL）治疗高度近视的疗效。设置Al Mashreq眼科中心，埃及开罗。患者和方法17例患者中的30眼接受了使用IPCL（Care Group India）中心孔矫正高度近视的手术（V2.0）。术后6个月评估视力、球当量和眼压。使用Pentacam测量前房参数前房容积（ACV）、前房深度（ACD）、前房角宽度（ACAW）。结果6个月后，球形当量从−14.19±4.2降至−0.18±0.66 D，所有病例均在预期矫正的±1.00 D范围内。最佳矫正视力（BCVA）在13%的病例中保持不变，13%的病例增加了一条线，74%的患者增加了两条或两条以上线。ACV、ACD和ACAW分别从189.77±20.19 mm3、3.15±0.27 mm和37.31±5.63°降至131.4±14.01 mm3、3.05±0.29 mm和23.94±4.81°。术前和术后6个月间眼压的变化具有统计学意义。结论IPCL是一种安全、有效、可预测的高度近视矫正手术。大多数病例获得一条或多条BCVA线。在6个月的随访中，ACV的降低并未引起眼压升高。
{"title":"Visual outcome of implantable phakic contact lens","authors":"Mohamed Mostafa, Ashraf El-Shayeb, A. El.shahed","doi":"10.4103/ejos.ejos_32_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_32_22","url":null,"abstract":"Aim To evaluate the visual outcome of implantable phakic contact lens (IPCL) in high myopia. Setting Al-Mashreq Eye Center, Cairo, Egypt. Patients and methods Thirty eyes of 17 patients underwent surgery to correct high myopia using IPCL (Care Group-India) with a central hole (V2.0). Visual acuity, spherical equivalent, and intraocular pressure (IOP) were evaluated 6 months postoperatively. Anterior chamber parameters Anterior chamber volume (ACV), Anterior chamber depth (ACD), Anterior chamber angle width (ACAW) were measured using Pentacam. Results After 6 months, spherical equivalent decreased from −14.19±4.2 to −0.18±0.66 D, all cases were within ±1.00 D of intended correction. Best corrected visual acuity (BCVA) remained unchanged in 13% of cases, 13% gained one line, and 74% gained two or more lines. ACV, ACD, and ACAW decreased from 189.77±20.19 mm3, 3.15±0.27 mm, and 37.31±5.63° to 131.4±14.01 mm3, 3.05±0.29 mm, and 23.94±4.81°, respectively. Changes in IOP between preoperative and 6 months postoperatively were statistically insignificant. Conclusion IPCL is a safe, effective, and predictable surgery to correct high myopia. Most cases gained one or more lines of BCVA. Reduction of ACV did not induce IOP rise during 6 months of follow-up.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"105 - 110"},"PeriodicalIF":0.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44757442","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}
G. Youssef, A. Sharawy, A. Saeed, Mohamed Elsayed, A. A. Abdel Latif
Aim To evaluate how micropulse transscleral diode laser cyclophotocoagulation (MP-TSCPC) is a safe and effective procedure, in reducing intraocular pressure (IOP) in different glaucoma patients among the Egyptian population. Study design Prospective, noncomparative interventional study. Patients and methods This study assessed the effect of MP-TSCPC laser on patients with different types of glaucoma. Forty eyes of 40 patients were included in our study. Patients were recruited from Benha University Hospital and Egyptian Eye Academy, and the procedure was done during the period between January 2020 and July 2021. Results The mean±SD baseline IOP was 27.72±8.6 mmHg, which showed significant reduction at postsurgical month 6, becoming 16.28±6.38 mmHg (P=0.001). The mean number of IOP-lowering agents was 2.35±1.03 preoperatively, which dropped significantly to 1.50±1.24 at 6 months. Postoperative logMAR best-corrected visual acuity was not significantly reduced from baseline. There was no development of significant postoperative complications. Conclusion MP-TSCPC is an efficient, safe, and simple technique with promising results in lowering IOP and can be used in patients with different types of glaucoma.
{"title":"Micropulse transscleral diode laser cyclophotocoagulation as a treatment modality for glaucoma patients","authors":"G. Youssef, A. Sharawy, A. Saeed, Mohamed Elsayed, A. A. Abdel Latif","doi":"10.4103/ejos.ejos_37_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_37_22","url":null,"abstract":"Aim To evaluate how micropulse transscleral diode laser cyclophotocoagulation (MP-TSCPC) is a safe and effective procedure, in reducing intraocular pressure (IOP) in different glaucoma patients among the Egyptian population. Study design Prospective, noncomparative interventional study. Patients and methods This study assessed the effect of MP-TSCPC laser on patients with different types of glaucoma. Forty eyes of 40 patients were included in our study. Patients were recruited from Benha University Hospital and Egyptian Eye Academy, and the procedure was done during the period between January 2020 and July 2021. Results The mean±SD baseline IOP was 27.72±8.6 mmHg, which showed significant reduction at postsurgical month 6, becoming 16.28±6.38 mmHg (P=0.001). The mean number of IOP-lowering agents was 2.35±1.03 preoperatively, which dropped significantly to 1.50±1.24 at 6 months. Postoperative logMAR best-corrected visual acuity was not significantly reduced from baseline. There was no development of significant postoperative complications. Conclusion MP-TSCPC is an efficient, safe, and simple technique with promising results in lowering IOP and can be used in patients with different types of glaucoma.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"123 - 129"},"PeriodicalIF":0.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43985292","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 To evaluate the outcomes of early pars-plana vitrectomy (PPV) in the management of acute onset endophthalmitis after cataract surgery. Study design Retrospective observational study. Patients and methods We collected data from 11 patients who were diagnosed as acute infectious endophthalmitis within 6 weeks after cataract surgery, from January 2015 to December 2020 and had undergone early 23-G PPV and were followed up for 3 months. We analyzed factors that may affect prognosis and final visual outcomes. Results The mean age was 58±5 years, there was male predominance (72.7%). The mean axial length was 24.76±1.58 mm. The baseline best-corrected visual acuity was 2.3 logMAR and was improved to 1.2 logMAR at the third month (P<0.001). Mixed air/fluid intraocular tamponade was used in 63.6% of patients. About half of the cases had positive cultures (54.5%), and the most frequent organism was Staphylococcus aureus (66.7%). Retinal detachment was reported in 36.4% of patients. The preoperative factors correlated with final best-corrected visual acuity were posterior vitreous detachment and intraocular tamponade. Conclusions Early PPV for acute-onset endophthalmitis after cataract surgery aided in improving final visual outcome and preserving structural and functional integrity of the globe, thus preventing late complications that could affect patients’ quality of life. Factors that influence the final visual outcome were intraocular tamponade and posterior vitreous detachment.
{"title":"Outcomes of early vitrectomy for endophthalmitis after cataract surgery in delta population, Egypt, 2015–2020","authors":"A. Tabl, M. Masoud, G. Abdelhalim, M. Tabl","doi":"10.4103/ejos.ejos_14_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_14_22","url":null,"abstract":"Purpose To evaluate the outcomes of early pars-plana vitrectomy (PPV) in the management of acute onset endophthalmitis after cataract surgery. Study design Retrospective observational study. Patients and methods We collected data from 11 patients who were diagnosed as acute infectious endophthalmitis within 6 weeks after cataract surgery, from January 2015 to December 2020 and had undergone early 23-G PPV and were followed up for 3 months. We analyzed factors that may affect prognosis and final visual outcomes. Results The mean age was 58±5 years, there was male predominance (72.7%). The mean axial length was 24.76±1.58 mm. The baseline best-corrected visual acuity was 2.3 logMAR and was improved to 1.2 logMAR at the third month (P<0.001). Mixed air/fluid intraocular tamponade was used in 63.6% of patients. About half of the cases had positive cultures (54.5%), and the most frequent organism was Staphylococcus aureus (66.7%). Retinal detachment was reported in 36.4% of patients. The preoperative factors correlated with final best-corrected visual acuity were posterior vitreous detachment and intraocular tamponade. Conclusions Early PPV for acute-onset endophthalmitis after cataract surgery aided in improving final visual outcome and preserving structural and functional integrity of the globe, thus preventing late complications that could affect patients’ quality of life. Factors that influence the final visual outcome were intraocular tamponade and posterior vitreous detachment.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"59 - 65"},"PeriodicalIF":0.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45975633","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}
Clinical relevance Early detection of keratoconus (KC) progression and timing for retreatment. Background Q value (coefficient of corneal asphericity) reflects the shape of the cornea, its refractive power, and spherical aberration. In this study, we aimed to analyze the correlation between changes in Q value and progression of KC in children. Patients and methods In this retrospective cross-sectional study, clinical data of 18 eyes of nine children that were diagnosed as bilateral progressive KC (four boys, five girls: mean age of 11.3±1.6 years) were extracted from a Scheimpflug camera (Pentacam) for analysis before (baseline) and annually after bilateral transepithelial corneal collagen cross-linking (TE-CXL) up to 5 years of follow-up. Results At all follow-up visits up to 5 years, Kmax improved significantly (mean change at 5 years was 1.6 D) (P<0.001); uncorrected visual acuity and best-corrected visual acuity showed significant changes at all follow-up visits (P<0.001). In seven (38.8%) eyes, KC had progressed by more than 1.0 D by the last follow-up visit, despite corneal cross-linking. In the last visit, there was a significant negative correlation between mean Q value and Kmax in both 6 and 8 mm anterior corneal zones (Pearson correlation coefficient, r=−0.847, P<0.001, r=−0.605, P<0.001, respectively). Conclusion There is significant negative correlations between changes in corneal asphericity and progression of KC in children, which could be considered with other parameters in early detection of disease progression and timing for retreatment after transepithelial corneal collagen cross-linking.
{"title":"Correlation between changes in corneal asphericity and progression of keratoconus in children","authors":"A. Tabl, Mohamed Elsayed, M. Tabl","doi":"10.4103/ejos.ejos_11_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_11_22","url":null,"abstract":"Clinical relevance Early detection of keratoconus (KC) progression and timing for retreatment. Background Q value (coefficient of corneal asphericity) reflects the shape of the cornea, its refractive power, and spherical aberration. In this study, we aimed to analyze the correlation between changes in Q value and progression of KC in children. Patients and methods In this retrospective cross-sectional study, clinical data of 18 eyes of nine children that were diagnosed as bilateral progressive KC (four boys, five girls: mean age of 11.3±1.6 years) were extracted from a Scheimpflug camera (Pentacam) for analysis before (baseline) and annually after bilateral transepithelial corneal collagen cross-linking (TE-CXL) up to 5 years of follow-up. Results At all follow-up visits up to 5 years, Kmax improved significantly (mean change at 5 years was 1.6 D) (P<0.001); uncorrected visual acuity and best-corrected visual acuity showed significant changes at all follow-up visits (P<0.001). In seven (38.8%) eyes, KC had progressed by more than 1.0 D by the last follow-up visit, despite corneal cross-linking. In the last visit, there was a significant negative correlation between mean Q value and Kmax in both 6 and 8 mm anterior corneal zones (Pearson correlation coefficient, r=−0.847, P<0.001, r=−0.605, P<0.001, respectively). Conclusion There is significant negative correlations between changes in corneal asphericity and progression of KC in children, which could be considered with other parameters in early detection of disease progression and timing for retreatment after transepithelial corneal collagen cross-linking.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"78 - 85"},"PeriodicalIF":0.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45265717","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}
T. ElSadek, Abdelrahman Salman, A. Said, N. Elsherif, M. Saleh
Purpose To study the morphological changes in the foveal avascular zone (FAZ) in children diagnosed with sickle cell disease (SCD) via the optical coherence tomography angiography (OCTA). Patients and methods This was a prospective case–control study that was done in a tertiary hospital. A total of 15 children with SCD (confirmed with electrophoresis) and 15 matched healthy children were included. Ophthalmological assessment was done. RTVue XR Avanti was employed to obtain 6×6 macular OCTA scans. Foveal parameters including FAZ area (mm2), perimeter (mm) (PERIM), acircularity index (AI), and foveal density were analyzed. Pediatric assessment including the disease variant, sickling crisis, and current treatment was done. Results A total of 15 eyes of 15 children with SCD and 15 eyes of healthy children were included. Six eyes showed stage 1 retinopathy. Children with SCD had wider FAZ area (P=0.001) with larger PERIM (P=0.00) and higher AI (P=0.030) in comparison with the control children. No significant changes in the FAZ parameters between patients with SCD with stage 1 retinopathy and patients without retinopathy were found. Conclusion Children with SCD have a wide FAZ area with large PERIM and high AI in comparison with normal controls. OCTA macular changes might be an early predictor of sickle cell retinopathy. Further follow-up studies are recommended to understand the effect of early macular changes on the future development of retinopathy.
{"title":"Foveal avascular zone changes in children with sickle cell disease","authors":"T. ElSadek, Abdelrahman Salman, A. Said, N. Elsherif, M. Saleh","doi":"10.4103/ejos.ejos_21_22","DOIUrl":"https://doi.org/10.4103/ejos.ejos_21_22","url":null,"abstract":"Purpose To study the morphological changes in the foveal avascular zone (FAZ) in children diagnosed with sickle cell disease (SCD) via the optical coherence tomography angiography (OCTA). Patients and methods This was a prospective case–control study that was done in a tertiary hospital. A total of 15 children with SCD (confirmed with electrophoresis) and 15 matched healthy children were included. Ophthalmological assessment was done. RTVue XR Avanti was employed to obtain 6×6 macular OCTA scans. Foveal parameters including FAZ area (mm2), perimeter (mm) (PERIM), acircularity index (AI), and foveal density were analyzed. Pediatric assessment including the disease variant, sickling crisis, and current treatment was done. Results A total of 15 eyes of 15 children with SCD and 15 eyes of healthy children were included. Six eyes showed stage 1 retinopathy. Children with SCD had wider FAZ area (P=0.001) with larger PERIM (P=0.00) and higher AI (P=0.030) in comparison with the control children. No significant changes in the FAZ parameters between patients with SCD with stage 1 retinopathy and patients without retinopathy were found. Conclusion Children with SCD have a wide FAZ area with large PERIM and high AI in comparison with normal controls. OCTA macular changes might be an early predictor of sickle cell retinopathy. Further follow-up studies are recommended to understand the effect of early macular changes on the future development of retinopathy.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"72 - 77"},"PeriodicalIF":0.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47691778","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}
Ramy Elbassiouny, A. Ghaith, H. Farhad, M. Baddour, Sheta Eman, A. Elmassry
Background Accelerated photoactivated chromophore for keratitis–corneal collagen cross-linking (PACK-CXL) was investigated to be effective in the treatment of fungal keratitis in many studies. High-fluence CXL was used effectively in the treatment of progressive keratoconus but not tested in PACK-CXL for fungal infection. Aim To evaluate the antifungal efficacy of high-fluence CXL in the treatment of induced fusarium corneal ulcer in rabbits. Design This is an experimental interventional study. Patients and methods This is an experimental interventional study conducted on 16 eyes of eight rabbits for which fusarium corneal infection was induced by intrastromal corneal injection. The rabbits were divided into two groups: group A received no treatment and was left as a control group. Group B received a single high-fluence PACK-CXL session. All rabbits were followed up for 6 days and then the eyes were enucleated. Culture was performed for seven corneas and histopathology for the remaining cornea. Results There was statistically significant deterioration in group A (P=0.003), while a statistically significant clinical improvement was seen in group B (P<0.001). The median colony-forming units was more in group A (4×104) than in group B (2×102). Histopathological examination also revealed less inflammatory signs in high-fluence PACK-CXL-treated group. Conclusions High-fluence PACK-CXL total ultraviolet A fluence of 7.2 J/cm2 is effective in the treatment of mycotic keratitis.
{"title":"Evaluation of the efficacy of high-fluence corneal collagen cross-linking in fusarium corneal ulcer in rabbits","authors":"Ramy Elbassiouny, A. Ghaith, H. Farhad, M. Baddour, Sheta Eman, A. Elmassry","doi":"10.4103/ejos.ejos_35_21","DOIUrl":"https://doi.org/10.4103/ejos.ejos_35_21","url":null,"abstract":"Background Accelerated photoactivated chromophore for keratitis–corneal collagen cross-linking (PACK-CXL) was investigated to be effective in the treatment of fungal keratitis in many studies. High-fluence CXL was used effectively in the treatment of progressive keratoconus but not tested in PACK-CXL for fungal infection. Aim To evaluate the antifungal efficacy of high-fluence CXL in the treatment of induced fusarium corneal ulcer in rabbits. Design This is an experimental interventional study. Patients and methods This is an experimental interventional study conducted on 16 eyes of eight rabbits for which fusarium corneal infection was induced by intrastromal corneal injection. The rabbits were divided into two groups: group A received no treatment and was left as a control group. Group B received a single high-fluence PACK-CXL session. All rabbits were followed up for 6 days and then the eyes were enucleated. Culture was performed for seven corneas and histopathology for the remaining cornea. Results There was statistically significant deterioration in group A (P=0.003), while a statistically significant clinical improvement was seen in group B (P<0.001). The median colony-forming units was more in group A (4×104) than in group B (2×102). Histopathological examination also revealed less inflammatory signs in high-fluence PACK-CXL-treated group. Conclusions High-fluence PACK-CXL total ultraviolet A fluence of 7.2 J/cm2 is effective in the treatment of mycotic keratitis.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"43 - 48"},"PeriodicalIF":0.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42532165","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}
Khaled Elbassiouny, T. Hafez, I. Osman, A. Elmassry
Background Intracorneal ring segment (ICRS) implantation in combination with corneal collagen cross-linking (CXL) has shown promising results in improving the visual acuity and reducing refractive errors, but long-term results are lacking. Aim To evaluate the long-term outcomes (>5 years) of simultaneous CXL and femtosecond laser-assisted intracorneal stromal ring segment implantation for management of keratoconus. Design This was a noncomparative, noncontrolled retrospective single-center study. Patients and methods The study included 50 eyes of 37 patients with keratoconus who underwent simultaneous CXL and ICRS implantation and were followed up for at least 5 years regarding visual acuity, refraction, and corneal imaging. Results Best-corrected visual acuity showed statistically significant improvement, with mean changed from 1.07±0.41 to 0.40±0.30 LogMAR. The results showed significant improvement also after 5 years. The spherical equivalent also was significantly improved from a mean of −4.61±4.37 D to a mean of −1.41±−1.49 D. Keratometric readings also showed improvement of both K1 and K2. The mean K1 improved from a mean of 49.6±6.76–47.78±6.17 D, and the mean K2 improved from 55.04±7.34 to 52.67±7.38. The results were stable, with no statistically significant change after 5 years. Conclusions Simultaneous CXL and femtosecond laser-assisted ICRS is effective and stable for both visual outcome and refraction in patients with keratoconus.
{"title":"Evaluation of long-term outcomes of simultaneous corneal collagen cross-linking and femtosecond laser-assisted intracorneal ring segment implantation for keratoconus","authors":"Khaled Elbassiouny, T. Hafez, I. Osman, A. Elmassry","doi":"10.4103/ejos.ejos_65_21","DOIUrl":"https://doi.org/10.4103/ejos.ejos_65_21","url":null,"abstract":"Background Intracorneal ring segment (ICRS) implantation in combination with corneal collagen cross-linking (CXL) has shown promising results in improving the visual acuity and reducing refractive errors, but long-term results are lacking. Aim To evaluate the long-term outcomes (>5 years) of simultaneous CXL and femtosecond laser-assisted intracorneal stromal ring segment implantation for management of keratoconus. Design This was a noncomparative, noncontrolled retrospective single-center study. Patients and methods The study included 50 eyes of 37 patients with keratoconus who underwent simultaneous CXL and ICRS implantation and were followed up for at least 5 years regarding visual acuity, refraction, and corneal imaging. Results Best-corrected visual acuity showed statistically significant improvement, with mean changed from 1.07±0.41 to 0.40±0.30 LogMAR. The results showed significant improvement also after 5 years. The spherical equivalent also was significantly improved from a mean of −4.61±4.37 D to a mean of −1.41±−1.49 D. Keratometric readings also showed improvement of both K1 and K2. The mean K1 improved from a mean of 49.6±6.76–47.78±6.17 D, and the mean K2 improved from 55.04±7.34 to 52.67±7.38. The results were stable, with no statistically significant change after 5 years. Conclusions Simultaneous CXL and femtosecond laser-assisted ICRS is effective and stable for both visual outcome and refraction in patients with keratoconus.","PeriodicalId":31572,"journal":{"name":"Journal of the Egyptian Ophthalmological Society","volume":"115 1","pages":"49 - 53"},"PeriodicalIF":0.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49099032","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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