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   Table of Contents - Current issue
July-September 2020
Volume 113 | Issue 3
Page Nos. 77-123

Online since Monday, September 7, 2020

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Effect of fasting on intraocular pressure in glaucomatous patients p. 77
Walid Abdelghaffar, Marwa Abdelshafy, Mohamed N Elmohamady
Purpose The aim of this study was to assess the effect of intermittent fasting and dehydration on intraocular pressure (IOP) in patients under glaucoma treatment. Patients and methods The present study was conducted on 36 glaucoma cases and 30 healthy controls of matched age and sex. IOP measurements with Goldmann applanation tonometer were taken 1 week before fasting (at 8.00 a.m.), during Ramadan fasting (first, second, third, and fourth week) (at 8.00 a.m. and 4.00 p.m.), and 1 week after Ramadan during the nonfasting period (at 8.00 a.m.). Results The study was conducted on 36 glaucoma cases; their mean age was 47.3 years. There were 12 (33.3%) men and 24 (66.7%) women and 30 healthy participants, their mean age was 47.7 years. There were 11 (36.7%) men and 19 (63.3%) women. There was gradual decrease in IOP with fasting, in both glaucomatous cases and control groups, with no significant differences in IOP between groups during fasting. Glaucoma cases showed significantly higher percentage change in IOP (either improvement or deterioration) when compared with the control group. Conclusion Our results showed that fasting during Ramadan has a lowering effect on IOP values in healthy controls and glaucomatous patients. Glaucoma cases showed significantly higher percentage change in IOP when compared with the control group.
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Sensitivity of optical coherence tomography and visual evoked potential in demyelinating optic neuritis p. 83
Youssef A.H Helmy, Emad A Sawaby, Mohammed A Awadalla, Shaymaa H Salah
Aim The aim of this study is to analyze the structural and functional abnormalities of the optic nerve in multiple sclerosis (MS) patients utilizing optical coherence tomography (OCT) and visual evoked potential (VEP). We compare between eyes with and without a history of neuritis. Patients and methods A cross-sectional study which compared 60 eyes of MS patients with 20 eyes of the healthy control group. MS patients were classified into MS with optic neuritis (MS-ON, n=44) and MS without optic neuritis (MS-NON, n=16). Both VEP and OCT were done. Results Both groups showed thinning in the retinal nerve fiber layer (RNFL), ganglion cell complex, and prolongation in latency (P100). The decrement in RNFL was more in the MS-ON group in superior RNFL, temporal RNFL, and average RNFL (P=0.002, 0.002, 0.03), respectively. In the MS-ON group, the average, temporal, and nasal RNFL showed significant negative correlation with latency of P100 (P=0.0001, 0.0001, 0.001), respectively. Latency of P100 showed higher sensitivity (52.3%) over temporal RNFL (43.2%) in detecting ON. Conclusion Both VEP and OCT have been proven to be sensitive tools in the detection of optic neuropathy in MS. Latency showed the highest sensitivity followed by the temporal RNFL. Temporal RNFL and average ganglion cell complex can be a biomarker for both axonal and neuronal loss in eyes with and without neuritis. This loss can precede the demyelination process.
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Risk factors for opaque bubble layer in femtosecond-laser-assisted laser in situ keratomileusis (an Egyptian study) p. 91
Ahmed S Abdel-Wanes, Abelrahman G Salman, Azza M.A Said, Basem F.A Riad, Marwa A Karim
Aim To determine the risk factors responsible for opaque bubble layer (OBL) formation in femtosecond-laser-assisted in situ keratomileusis (FSL-LASIK). Patients and methods A retrospective, comparative study was carried out from January 2015 to January 2017 in El-Watany Eye Hospital. Two hundred eyes who were eligible for FSL-laser-assisted in situ keratomileusis (FSL was done using FS200, wavelight, Germany SR/1025-1-380) were classified into two groups. Group I: the study group with OBL formation during surgery (100 eye) and group (II): the control group without OBL formation during surgery (100 eye). Preoperative best-corrected visual acuity, spherical equivalent, and dilated fundus examination were done and corneal tomography including keratometric readings: flat keratometric readings (K1), steep keratometric readings (K2), and central corneal thickness (CCT) measurements. Programmed flap parameters were collected. Statistical analysis Statistical analysis was done using IBM SPSS, version 24. Results Among the studied 101 patients, OBL occurs bilaterally in 58 eyes among 29 patients and OBL occurs unilaterally among 42 patients. There was a statistically significant difference between OBL and non-OBL regarding preoperative steep keratometry (K2) (P<0.01) and CCT (P=0.03), where the corneal pachymetry was more than 545 µm in 57 (57%) eyes of OBL group versus 42 (42.0%) eyes in non-OBL eyes. There was no statistically significant difference between both groups regarding canal length offset (P=0.123), corneal flap thickness (P=0.489), corneal flap diameter (P=0.064), and flap hinge angle (P=0.074). Conclusion Increased corneal thickness, corneal canal length offset, and steep keratometry were significant risk factors of OBL formation. Regarding regression analysis, CCT and corneal astigmatism were statistically significant independent predictors of OBL formation.
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The prevalence of different refractive errors in the Delta region of Egypt p. 97
Fatma Mohammed Ahmed Ali, Mervat Salah Mourad, Rafaat Ali Rehan, Mouamen Moustafa Seleet
Introduction Epidemiologic research on the types and the distribution of refractive errors (REs) enable efficient planning to improve access to care. Aim The aim was to fill the informational gap concerning the prevalence of REs in different age groups in the Delta region of Egypt and to introduce recommendations and key points for researchers. Patients and methods This is a cross-sectional descriptive study for the prevalence of REs in the Delta region of Egypt among different age groups. The population-based study included 800 eyes of 400 patients from different age groups, 400 eyes in the child age group and 400 eyes in adult age group. Results and discussion The prevalence of myopia was higher than the prevalence of hyperopia. The prevalence of astigmatism was higher than myopia, but also higher than other studies. The prevalence of myopia was higher in the adult age group than in the child age group, which was consistent with that of other East Asian countries. The prevalence of hyperopia was higher in the child age group than in the adult age group. The prevalence of astigmatism was very high and slightly similar in both groups. Conclusion Correcting REs can reduce ophthalmic problems. Improving family awareness and promoting screening programs can be effective in identifying these errors and preventing visual impairment.
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Optical coherence tomography study of macular structural changes in silicone oil-filled eyes p. 118
Amin E Nawar
Introduction Silicone oil (SO) has been used in complex cases of retinal detachment with proliferative vitreoretinopathy (PVR), giant retinal tear, and traumatic cases. This study aimed to assess macular structural changes in SO filled eyes after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment with PVR. Patients and methods This is a prospective interventional study that was conducted on 60 SO-filled eyes after successful PPV for rhegmatogenous retinal detachment with grade C PVR; SO was left in all eyes for a duration of 3 months. Thorough ophthalmic evaluation in Ophthalmology Department, Tanta University, Egypt was performed including best corrected visual acuity (BCVA), fundus examination, and anterior segment examination. Optical coherence tomography was done for all patients at presentation to assess the macular area. Results Epiretinal membrane (ERM) was detected in 14 (23.3%) eyes, cystoid macular edema (CME) in 21 (35%) eyes, photoreceptor disruption in 21 (35%) eyes, macular hole in one (1.7%) eye, and foveal thinning in 18 (30%) eyes. The BCVA was positively correlated with the presence of ERM, CME, and photoreceptor disruption and the results were statistically significant with ERM and photoreceptor nonintegrity with P values of 0.049 and 0.001 respectively. In addition, there is no significant correlation between changes in central retinal thickness and BCVA. Conclusion Visual loss after successful PPV in SO filled eyes can occur due to macular changes like CME, ERM, photoreceptor disruption, foveal thinning, and macular hole.
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