Background. Ocular surface disease (OSD) is a multifactorial and highly frequent problem. Inadequ... more Background. Ocular surface disease (OSD) is a multifactorial and highly frequent problem. Inadequate or unstable tear film is the main cause, which leads to visual impairments. One of the primary causes of OSD is meibomian gland dysfunction (MGD), with a prevalence of 3.5 to 70%. The aim of this work was to compare the efficacy of azithromycin topical eye drops versus oral doxycycline in MGD individuals. Methods. This prospective comparative cohort research was carried out on 56 patients of both sexes of any age with symptomatic MGD. Randomly, patients were classified into two equal groups: Group 1 was treated twice daily for 4 weeks with topical azithromycin 1% eye drops, while group 2 received oral doxycycline 100 mg capsules twice daily for 4 weeks. Results. In the 1st follow-up, there was a significant difference between the studied groups in pain and discomfort degree ( P value = 0.024) as group 1 showed a higher number of patients with a mild pain degree ( P value = 0.013) whi...
Purpose: To report unprompted closure of spontaneous macular hole secondary to inadvertent subfov... more Purpose: To report unprompted closure of spontaneous macular hole secondary to inadvertent subfoveal perfluorocarbon after vitrectomy surgery.Patients& Methods: We present a case of a retained large single subfoveal PFCL droplet following vitrectomy and silicone oil injection for subtotal rhegmatogenous retinal detachment (RRD) that showed spontaneous release 4 weeks postoperatively, with subsequent development of full thickness macular hole (FTMH) which completely closed later on after silicone oil removal without internal limiting membrane peeling.Results: Marvelous anatomic and visual improvement after spontaneous closure of MH.Discussion: Few complications have been associated with use of PFCLs. The most common is postoperative residual PFCL in vitreous cavity or in the anterior chamber. Subretinal retention of PFCL has been reported and it has the most significant ocular toxicity but spontaneous release of subfoveal PFCL without surgical interference has rarely been reported.Co...
Background To assess and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in n... more Background To assess and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in normal thin (NT) healthy corneas with central corneal thickness (CCT) 470-500 µm with matched thickness in keratoconus (KC) and keratoconus suspect (KCS) eyes. Methods A total of 66 eyes in three groups were included prospectively: NT, KCS and KC groups based on clinical examination and topography. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured by the ocular response analyzer. CH and CRF were compared between the three groups and statistically analyzed by variances test. Results The three groups consisted of 32 NT, 19 KCS, and 15 KC. The mean CH measured was 8.55± 1.77, 9.03± 1.119 and 8.06 ± 0.85 mm Hg in NT, KCS and KC eyes, respectively. The mean CRF was 8.39 ± 1.47, 8.27 ± 1.09 and 7.24 ± 1.27 mm Hg in NT, KCS and KC eyes, respectively. Within range of central corneal thickness (470 – 500 µm), only mean CRF was statistically significantly different between t...
Objective To compare surgical and clinical outcomes of pediatric retinal detachment repair using ... more Objective To compare surgical and clinical outcomes of pediatric retinal detachment repair using 23 G and 25 G vitrectomy. Background The introduction of microincisional vitrectomy surgery induced a paradigm shift in management of vitreoretinal diseases. Vitrectomy in pediatric age group represents a major challenge owing to its unique anatomical and pathological considerations. Patients and methods This was a prospective, comparative case series study. A total of 50 patients were recruited for the study and divided into two groups. The first group included 25 patients who underwent 23-G vitrectomy, and the second group included 25 patients who underwent 25-G vitrectomy. The main outcome measures were the actual vitrectomy time and need to suture a sclerotomy and the early postoperative hypotony rate. Results The actual time for vitreous removal was 22.00 ± 5.71 min in 23-G group compared with 24.13 ± 5.97 min in 25 G group (P = 0.273). A significant difference was noted between bot...
Background: Silicone oil (SO) is used as an intravitreal tamponade agent in vitreoretinal surgery... more Background: Silicone oil (SO) is used as an intravitreal tamponade agent in vitreoretinal surgery for rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy or with large, multiple retinal tears. Usually, SO is left in the eye for at least 3 months. Although its use can lead to well-known complications, intraocular SO is generally well tolerated. Some studies have reported unexpected central vision loss after SO use or removal. Objective: To investigate and analyze the reason for visual loss after the use or removal of intraocular SO in patients who underwent vitrectomy surgeries for RRD. Patients and Methods: A retrospective observational case series of 12 patients with macula-on RRD who reported visual loss after the use or removal of SO was reviewed. Investigations carried out included fundus fluorescein angiography, optical coherence tomography (OCT) of the macula and optic disc, perimetry, and electrophysiological study. Electrolyte levels were m...
To report and analyze the phenomenon of sticky silicone oil on the retina at the time of its remo... more To report and analyze the phenomenon of sticky silicone oil on the retina at the time of its removal. Silicone oil has been used for more than 25 years as a long-term retinal tamponade in the surgical management of patients with complex retinal detachments. When a decision to remove silicone oil was made at the end of the tamponade period, the system involved a number of different materials: silicone oil, aqueous solution with or without remnants of perfluorocarbon liquid plus the material of the cannula used to aspirate Silicone oil. This, in effect, may lead to an abnormal adherence of large bubbles of residual silicone oil to the posterior pole of the retina. A retrospective, interventional case study was performed. We consecutively reviewed 796 patients of silicone oil removal (5,000 or 5,500 centistokes) after primary pars plana vitrectomy at one vitreoretinal center operated by a single surgeon (HG). Chart review was performed to identify potential patients or procedural factors that could predispose to sticky silicone oil formation at the macular area. Large silicone oil bubbles were sticky to the macula in eight out of 796 silicone oil removal procedures between January 2014 and August 2015. The use of perfluorooctane was related to the occurrence of the phenomenon (P < 0.001). The sticky silicone oil bubble at the macular region was not related to internal limiting membrane peeling, epiretinal membrane, viscosity, duration, or brand of silicone oil used, but to the use of perfluorooctane.
Purpose. To report unprompted closure of spontaneous macular hole secondary to inadvertent subfov... more Purpose. To report unprompted closure of spontaneous macular hole secondary to inadvertent subfoveal perfluorocarbon liquid (PFCL) after vitrectomy surgery. Observations. We present a case of a retained large single subfoveal PFCL droplet following vitrectomy and silicone oil injection for subtotal rhegmatogenous retinal detachment that showed spontaneous release 3 weeks postoperatively, with subsequent development of full thickness macular hole (FTMH) which completely closed later on after silicone oil removal without internal limiting membrane peeling with marvelous anatomic and visual improvement after spontaneous closure of MH. Conclusions. Different fates of subfoveal PFCL droplets may happen. Spontaneous release of subfoveal PFCL without surgical interference has rarely been reported.
Objective The aim was to evaluate the value of subjective eccentric viewing (EV) training in visi... more Objective The aim was to evaluate the value of subjective eccentric viewing (EV) training in vision rehabilitation in patients with central scotoma. Background EV, also known as eccentric fixation, involves identifying a functioning area of the retina that has reasonable sensitivity, and is as close to the fovea as possible, and to learn to use it effectively, which is known as preferred retinal locus. Materials and Methods The direction of EV was monitored in 33 low-vision patients with bilateral central scotomas, the preferred retinal locus was identified, and the preserved visual field was found. The patients were divided randomly into two groups regarding their use of optical low-vision devices with EV training. After 2 months of training, changes in near and far best-corrected visual acuity (BCVA) and reading speed were evaluated. Results After 2 months of EV training, near BCVA and mean reading speed significantly improved. Regarding the use of low-vision devices, the group th...
Objectives The aim of this study was to evaluate and compare corneal hysteresis (CH) and corneal ... more Objectives The aim of this study was to evaluate and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in healthy eyes with a central corneal thickness of 470–500 μm with matched keratoconus (KC) and keratoconus suspect (KCS) cases. Background The ocular response analyzer is a device developed in recent years that reveals the biomechanical properties of the cornea. It reflects certain biomechanical properties of the cornea, such as CH and CRF. Patients and methods A total of 66 eyes in three groups were included prospectively based on clinical examination and topography: the normal (NL), KC, and KCS groups. CH and CRF were measured using the ocular response analyzer. CH and CRF were compared between the three groups using the analysis of variances test. Results The three groups consisted of 32 NL, 15 KC, and 19 KCS eyes. The mean CH measured was 8.55 ± 1.77, 9.03 ± 1.119, and 8.06 ± 0.85 mmHg in NL, KCS, and KC eyes, respectively. The mean CRF was 8.39 ± 1.47, 8.27...
This research was undertaken to study the common presenting features, possible management options... more This research was undertaken to study the common presenting features, possible management options, and outcome results in a series of patients with intraorbital and extraorbital vascular disorders. Vascular lesions constitute up to 10–15 % of all orbital tumors. The shape, color, and invasiveness differ within each group: from bright red to deep blue and from a well-demarcated lesion to a more infiltrative tumor within the surrounding orbital tissue. Intraorbital vascular lesions can be categorized into arteriovenous, venous, and lymphatic disorders, each category have different clinical presentation, imaging characteristics, and management strategy. A retrospective non comparative case series study was conducted at ophthalmology department, Menoufia University Hospital, Egypt. Records of 10 patients diagnosed with orbital vascular disorders in the period from May 01, 2011 to December 31, 2013 were reviewed as regard to their diagnostic and therapeutic findings. Data of ten patients...
Background To evaluate and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in... more Background To evaluate and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in normal thin (NT) healthy corneas with central corneal thickness (CCT) of 470–500 μm with matched thickness in keratoconus suspect (KCS) and keratoconus (KC) eyes. Methods A total of 103 eyes in three groups were included prospectively: NT, KCS, and KC groups based on clinical examination and Pentacam findings. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using the ocular response analyzer (ORA). CCT, CH, and CRF were compared between the three groups and statistically analyzed by variance tests. Results The three groups consisted of 44 NT, 26 KCS, and 33 KC. The mean CH measured was 8.689 ± 1.775, 9.051 ± 1.1190, and 8.129 ± 0.8539 mmHg in NT, KCS, and KC eyes, respectively. The mean CRF was 8.441 ± 1.663, 8.337 ± 1.114, and 7.2422 ± 1.3110 mmHg in NT, KCS, and KC eyes, respectively. Within the range of central corneal thickness (470–500 μm), only mean CRF w...
Background Eccentric viewing (EV), also known as eccentric fixation, involves identifying a funct... more Background Eccentric viewing (EV), also known as eccentric fixation, involves identifying a functioning area of the retina that is as close to the fovea as possible and to learn to use it effectively, which is known as the preferred retinal locus. Objective The aim of this study was to evaluate the value of subjective EV training in vision rehabilitation in patients with central scotoma. Patients and methods The direction of EV was monitored in 33 low-vision patients with bilateral central scotomas. The preferred retinal locus was identified, and the preserved visual field was found. The patients were divided randomly into two groups regarding their use of optical low-vision devices with EV training. After 2 months of training, changes in near and far best-corrected visual acuity (BCVA) and reading speed were evaluated. Results After 2 months of EV training, the near BCVA and mean reading speed significantly improved, whereas the far BCVA did not significantly improve (0.1 LogMar on...
Background. Ocular surface disease (OSD) is a multifactorial and highly frequent problem. Inadequ... more Background. Ocular surface disease (OSD) is a multifactorial and highly frequent problem. Inadequate or unstable tear film is the main cause, which leads to visual impairments. One of the primary causes of OSD is meibomian gland dysfunction (MGD), with a prevalence of 3.5 to 70%. The aim of this work was to compare the efficacy of azithromycin topical eye drops versus oral doxycycline in MGD individuals. Methods. This prospective comparative cohort research was carried out on 56 patients of both sexes of any age with symptomatic MGD. Randomly, patients were classified into two equal groups: Group 1 was treated twice daily for 4 weeks with topical azithromycin 1% eye drops, while group 2 received oral doxycycline 100 mg capsules twice daily for 4 weeks. Results. In the 1st follow-up, there was a significant difference between the studied groups in pain and discomfort degree ( P value = 0.024) as group 1 showed a higher number of patients with a mild pain degree ( P value = 0.013) whi...
Purpose: To report unprompted closure of spontaneous macular hole secondary to inadvertent subfov... more Purpose: To report unprompted closure of spontaneous macular hole secondary to inadvertent subfoveal perfluorocarbon after vitrectomy surgery.Patients& Methods: We present a case of a retained large single subfoveal PFCL droplet following vitrectomy and silicone oil injection for subtotal rhegmatogenous retinal detachment (RRD) that showed spontaneous release 4 weeks postoperatively, with subsequent development of full thickness macular hole (FTMH) which completely closed later on after silicone oil removal without internal limiting membrane peeling.Results: Marvelous anatomic and visual improvement after spontaneous closure of MH.Discussion: Few complications have been associated with use of PFCLs. The most common is postoperative residual PFCL in vitreous cavity or in the anterior chamber. Subretinal retention of PFCL has been reported and it has the most significant ocular toxicity but spontaneous release of subfoveal PFCL without surgical interference has rarely been reported.Co...
Background To assess and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in n... more Background To assess and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in normal thin (NT) healthy corneas with central corneal thickness (CCT) 470-500 µm with matched thickness in keratoconus (KC) and keratoconus suspect (KCS) eyes. Methods A total of 66 eyes in three groups were included prospectively: NT, KCS and KC groups based on clinical examination and topography. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured by the ocular response analyzer. CH and CRF were compared between the three groups and statistically analyzed by variances test. Results The three groups consisted of 32 NT, 19 KCS, and 15 KC. The mean CH measured was 8.55± 1.77, 9.03± 1.119 and 8.06 ± 0.85 mm Hg in NT, KCS and KC eyes, respectively. The mean CRF was 8.39 ± 1.47, 8.27 ± 1.09 and 7.24 ± 1.27 mm Hg in NT, KCS and KC eyes, respectively. Within range of central corneal thickness (470 – 500 µm), only mean CRF was statistically significantly different between t...
Objective To compare surgical and clinical outcomes of pediatric retinal detachment repair using ... more Objective To compare surgical and clinical outcomes of pediatric retinal detachment repair using 23 G and 25 G vitrectomy. Background The introduction of microincisional vitrectomy surgery induced a paradigm shift in management of vitreoretinal diseases. Vitrectomy in pediatric age group represents a major challenge owing to its unique anatomical and pathological considerations. Patients and methods This was a prospective, comparative case series study. A total of 50 patients were recruited for the study and divided into two groups. The first group included 25 patients who underwent 23-G vitrectomy, and the second group included 25 patients who underwent 25-G vitrectomy. The main outcome measures were the actual vitrectomy time and need to suture a sclerotomy and the early postoperative hypotony rate. Results The actual time for vitreous removal was 22.00 ± 5.71 min in 23-G group compared with 24.13 ± 5.97 min in 25 G group (P = 0.273). A significant difference was noted between bot...
Background: Silicone oil (SO) is used as an intravitreal tamponade agent in vitreoretinal surgery... more Background: Silicone oil (SO) is used as an intravitreal tamponade agent in vitreoretinal surgery for rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy or with large, multiple retinal tears. Usually, SO is left in the eye for at least 3 months. Although its use can lead to well-known complications, intraocular SO is generally well tolerated. Some studies have reported unexpected central vision loss after SO use or removal. Objective: To investigate and analyze the reason for visual loss after the use or removal of intraocular SO in patients who underwent vitrectomy surgeries for RRD. Patients and Methods: A retrospective observational case series of 12 patients with macula-on RRD who reported visual loss after the use or removal of SO was reviewed. Investigations carried out included fundus fluorescein angiography, optical coherence tomography (OCT) of the macula and optic disc, perimetry, and electrophysiological study. Electrolyte levels were m...
To report and analyze the phenomenon of sticky silicone oil on the retina at the time of its remo... more To report and analyze the phenomenon of sticky silicone oil on the retina at the time of its removal. Silicone oil has been used for more than 25 years as a long-term retinal tamponade in the surgical management of patients with complex retinal detachments. When a decision to remove silicone oil was made at the end of the tamponade period, the system involved a number of different materials: silicone oil, aqueous solution with or without remnants of perfluorocarbon liquid plus the material of the cannula used to aspirate Silicone oil. This, in effect, may lead to an abnormal adherence of large bubbles of residual silicone oil to the posterior pole of the retina. A retrospective, interventional case study was performed. We consecutively reviewed 796 patients of silicone oil removal (5,000 or 5,500 centistokes) after primary pars plana vitrectomy at one vitreoretinal center operated by a single surgeon (HG). Chart review was performed to identify potential patients or procedural factors that could predispose to sticky silicone oil formation at the macular area. Large silicone oil bubbles were sticky to the macula in eight out of 796 silicone oil removal procedures between January 2014 and August 2015. The use of perfluorooctane was related to the occurrence of the phenomenon (P < 0.001). The sticky silicone oil bubble at the macular region was not related to internal limiting membrane peeling, epiretinal membrane, viscosity, duration, or brand of silicone oil used, but to the use of perfluorooctane.
Purpose. To report unprompted closure of spontaneous macular hole secondary to inadvertent subfov... more Purpose. To report unprompted closure of spontaneous macular hole secondary to inadvertent subfoveal perfluorocarbon liquid (PFCL) after vitrectomy surgery. Observations. We present a case of a retained large single subfoveal PFCL droplet following vitrectomy and silicone oil injection for subtotal rhegmatogenous retinal detachment that showed spontaneous release 3 weeks postoperatively, with subsequent development of full thickness macular hole (FTMH) which completely closed later on after silicone oil removal without internal limiting membrane peeling with marvelous anatomic and visual improvement after spontaneous closure of MH. Conclusions. Different fates of subfoveal PFCL droplets may happen. Spontaneous release of subfoveal PFCL without surgical interference has rarely been reported.
Objective The aim was to evaluate the value of subjective eccentric viewing (EV) training in visi... more Objective The aim was to evaluate the value of subjective eccentric viewing (EV) training in vision rehabilitation in patients with central scotoma. Background EV, also known as eccentric fixation, involves identifying a functioning area of the retina that has reasonable sensitivity, and is as close to the fovea as possible, and to learn to use it effectively, which is known as preferred retinal locus. Materials and Methods The direction of EV was monitored in 33 low-vision patients with bilateral central scotomas, the preferred retinal locus was identified, and the preserved visual field was found. The patients were divided randomly into two groups regarding their use of optical low-vision devices with EV training. After 2 months of training, changes in near and far best-corrected visual acuity (BCVA) and reading speed were evaluated. Results After 2 months of EV training, near BCVA and mean reading speed significantly improved. Regarding the use of low-vision devices, the group th...
Objectives The aim of this study was to evaluate and compare corneal hysteresis (CH) and corneal ... more Objectives The aim of this study was to evaluate and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in healthy eyes with a central corneal thickness of 470–500 μm with matched keratoconus (KC) and keratoconus suspect (KCS) cases. Background The ocular response analyzer is a device developed in recent years that reveals the biomechanical properties of the cornea. It reflects certain biomechanical properties of the cornea, such as CH and CRF. Patients and methods A total of 66 eyes in three groups were included prospectively based on clinical examination and topography: the normal (NL), KC, and KCS groups. CH and CRF were measured using the ocular response analyzer. CH and CRF were compared between the three groups using the analysis of variances test. Results The three groups consisted of 32 NL, 15 KC, and 19 KCS eyes. The mean CH measured was 8.55 ± 1.77, 9.03 ± 1.119, and 8.06 ± 0.85 mmHg in NL, KCS, and KC eyes, respectively. The mean CRF was 8.39 ± 1.47, 8.27...
This research was undertaken to study the common presenting features, possible management options... more This research was undertaken to study the common presenting features, possible management options, and outcome results in a series of patients with intraorbital and extraorbital vascular disorders. Vascular lesions constitute up to 10–15 % of all orbital tumors. The shape, color, and invasiveness differ within each group: from bright red to deep blue and from a well-demarcated lesion to a more infiltrative tumor within the surrounding orbital tissue. Intraorbital vascular lesions can be categorized into arteriovenous, venous, and lymphatic disorders, each category have different clinical presentation, imaging characteristics, and management strategy. A retrospective non comparative case series study was conducted at ophthalmology department, Menoufia University Hospital, Egypt. Records of 10 patients diagnosed with orbital vascular disorders in the period from May 01, 2011 to December 31, 2013 were reviewed as regard to their diagnostic and therapeutic findings. Data of ten patients...
Background To evaluate and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in... more Background To evaluate and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in normal thin (NT) healthy corneas with central corneal thickness (CCT) of 470–500 μm with matched thickness in keratoconus suspect (KCS) and keratoconus (KC) eyes. Methods A total of 103 eyes in three groups were included prospectively: NT, KCS, and KC groups based on clinical examination and Pentacam findings. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using the ocular response analyzer (ORA). CCT, CH, and CRF were compared between the three groups and statistically analyzed by variance tests. Results The three groups consisted of 44 NT, 26 KCS, and 33 KC. The mean CH measured was 8.689 ± 1.775, 9.051 ± 1.1190, and 8.129 ± 0.8539 mmHg in NT, KCS, and KC eyes, respectively. The mean CRF was 8.441 ± 1.663, 8.337 ± 1.114, and 7.2422 ± 1.3110 mmHg in NT, KCS, and KC eyes, respectively. Within the range of central corneal thickness (470–500 μm), only mean CRF w...
Background Eccentric viewing (EV), also known as eccentric fixation, involves identifying a funct... more Background Eccentric viewing (EV), also known as eccentric fixation, involves identifying a functioning area of the retina that is as close to the fovea as possible and to learn to use it effectively, which is known as the preferred retinal locus. Objective The aim of this study was to evaluate the value of subjective EV training in vision rehabilitation in patients with central scotoma. Patients and methods The direction of EV was monitored in 33 low-vision patients with bilateral central scotomas. The preferred retinal locus was identified, and the preserved visual field was found. The patients were divided randomly into two groups regarding their use of optical low-vision devices with EV training. After 2 months of training, changes in near and far best-corrected visual acuity (BCVA) and reading speed were evaluated. Results After 2 months of EV training, the near BCVA and mean reading speed significantly improved, whereas the far BCVA did not significantly improve (0.1 LogMar on...
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