|Year : 2009 | Volume
| Issue : 3 | Page : 151-153
|Date of Web Publication||28-Oct-2009|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Selected Abstracts. Oman J Ophthalmol 2009;2:151-3
Ophthalmic Surg Lasers Imaging. 2009 Jul-Aug;40(4):354-60.
Visual rehabilitation by scleral fixation of posterior chamber intraocular lenses in Omani children with aphakia.
Ganesh A, Al-Zuhaibi S, Mitra S, Sabt BI, Ganguly SS, Bialasiewicz AA.
Department of Ophthalmology, Sultan Qaboos University College of Medicine and Health Sciences, Muscat, Oman.
Background and Objective: To report indications and outcomes of scleral-fixated posterior chamber intraocular lenses (PC IOLs) in Omani children with aphakia. Patients and Methods: Patients with aphakia who were younger than 16 years, unsuitable for spectacle or contact lens correction, and without capsular support underwent an anterior vitrectomy and 10-0 polypropylene inside-out scleral fixation ofa PC IOL. Results: Scleral-fixated PC IOLs were implanted in 28 eyes of 24 patients. Group A comprised 10 (36%) eyes with congenital cataract and 3 (11%) eyes with ectopia lentis and group B comprised 15 (53%) eyes with traumatic cataract. The mean age at implantation was higher in group A (10.5 years) than in group B (7.3 years). Visual acuity improved in 17 of 28 (61%) eyes and remained at the preoperative levels in 11 of 28 (39%) eyes. Mean postoperative refraction was within +/- 2.0 diopters of the predicted refraction in 19 of 28 (68%) eyes. Complications included temporary intraocular pressure increase, vitreous hemorrhage, and iris capture with lens malposition. Conclusion: Scleral-fixated PC IOLs are beneficial for children with aphakia without posterior capsular support who are lacking other means for visual rehabilitation. Patients with traumatic cataract and lens dislocation are more likely to experience an improvement in visual acuity postoperatively than patients with congenital cataract. However, this procedure is technically more difficult than routine PC IOL implantation and potentially carries greater risks.
Diabetes Technol Ther. 2009 Sep;11(9):601-7
Magnitude and determinants of ocular morbidities among persons with diabetes in a project in Ahmedabad, India
Vyas U, Khandekar R, Trivedi N, Desai T, Danayak P
1 Honorary Physician, British Columbia Center for Epidemiologic and International Ophthalmologist, University of British Columbia, Vancouver, British Columbia, Canada.
Background: Visual disabilities due to diabetes are on the rise, especially in urban areas of developing countries. Proper health planning will need evidence-based information. Study Design and Methods: We estimated the prevalence and identified the determinants of eye complications among persons with diabetes screened in Ahmedabad, India, during 2007-2008. This was a review of the data from a health institution-based project. Physicians collected information on diabetes, and ophthalmologists examined the patients for visual acuity, diabetic retinopathy (DR), glaucoma, and cataracts. World Health Organization-recommended grading of DR was used. Frequencies, prevalence, and 95% confidence interval (CI) values were calculated. Results: Of 40,919 persons who we examined for diabetes, 9,246 (66.6%) persons knew that they had diabetes, whereas 4,641 (33.4%) persons were detected with diabetes for the first time. The prevalence of DR, early cataract, and glaucoma among those who knew that they had diabetes was 14.6% (95% CI 13.9-15.3), 44.4% (95% CI 43.4-45.4), and 5.4% (95% CI 4.9-5.9), respectively. The prevalence of DR among persons with diabetes (new and old) was 10.1% (95% CI 9.6-10.6). Although poor vision was positively associated with DR (chi(2) = 706), 40% of those with DR had vision better than 20/60. Male sex (odds ratio [OR] = 1.31), longer duration of diabetes (chi(2) = 1,808), hypertension (OR = 1.13), good sugar control (OR = 0.09), and nephropathy (OR = 2.16) were the factors associated with DR. Regression analysis suggested that longer duration of diabetes and poor control of diabetes were the predictors of DR. Conclusions: The prevalence of DR was low. Long duration of diabetes, poor control of blood sugar, presence of nephropathy, and hypertension were associated with DR. Good vision could mislead about the severity of DR.
Mol Vis. 2009 Jul 8;15:1325-31.
Molecular analysis of CYP1B1 in Omani patients with primary congenital glaucoma: A pilot study.
El-Gayar S, Ganesh A, Chavarria-Soley G, Al-Zuhaibi S, Al-Mjeni R, Raeburn S, Bialasiewicz AA
Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman
Purpose: To screen cytochrome P4501B1 (CYP1B1) for causative mutations in Omani patients with a clinical diagnosis of primary congenital glaucoma (PCG). Methods: Nine PCG families were recruited for the study. All patients underwent detailed clinical examinations to confirm the diagnosis of PCG. The families of index patients were also examined. Genealogical information was obtained by pedigree analysis. The primary candidate gene, CYP1B1, was amplified from genomic DNA, sequenced, and analyzed in patients to identify the disease-causing mutations. Results: Eight of the nine PCG families were consanguineous (89%). Molecular analysis of CYP1B1 showed three distinct mutations, p.G61E, p.D374N, and p.R368H, in seven of nine unrelated PCG index patients (78%). Six patients had homozygous mutations and one had a compound heterozygous mutation. Causative mutations were not identified in two families. In family 4, the index patient was found to be heterozygous for the p.E229K variant. In family 6, although affected individuals were found to be homozygous in the CYP1B1 region, no mutation could be identified. Conclusions: This study indicates that CYP1B1 could be the predominant cause of PCG in the Omani population (78%). Omani PCG patients show allelic heterogeneity. Further studies are needed to delineate the spectrum of CYP1B1mutations in Omani PCG families and to identify new or modifier genes contributing to the manifestations of PCG in this region.
Indian J Ophthalmol. 2009 Jul-Aug;57(4):293-8.
Diabetic retinopathy, visual impairment and ocular status among patients with diabetes mellitus in Yemen: A hospital-based study
Bamashmus MA, Gunaid AA, Khandekar RB
British Columbia Center for Epidemiologic and International Ophthalmology, University of British Columbia, Vancouver, Canada, E-mail: firstname.lastname@example.org.
Background: We present a series of patients with diabetes mellitus (DM) who attended an eye hospital in Sana, Yemen during 2004. Aim: To determine the magnitude and risk factors of diabetic retinopathy (DR). Design: Cross-sectional study. Materials and Methods: Ophthalmologists assessed vision, ocular pressure, ocular media and posterior segment to note ocular manifestations among patients with DM. DR was graded by using bio-microscope and Volk lens. The prevalence and 95% confidence interval of ocular complications of DM were calculated. Risk factors of DR like age, sex, duration of diabetes and hypertension were evaluated. Statistical Analysis: Univariate and multivariate analysis. Results: Our series comprised 350 patients suffering from DM. The duration of diabetes was ³15 years in 101 (29%) patients. Physician was treating 108 DM patients with insulin. The prevalence of DR was 55% (95% CI 49.6-60.1). The proportions of background diabetic retinopathy (BDR), preproliferative diabetic retinopathy (PPDR), proliferative diabetic retinopathy (PDR) and diabetic macular edema were 20%, 13%, 17% and 22% respectively. The prevalence of blindness among DM patients was 16%. The prevalence of cataract and glaucoma was 34.3% and 8.6%. Duration of DM was the predictor of DR. One-fifth of the patients had sight-threatening DR and needed laser treatment. Conclusions: DR was of public health magnitude among our patients. An organized approach is recommended to address DR in the study area.
Saudi Med J. 2009 Jul;30(7):961-3.
Acute unilateral third nerve palsy as an early manifestation of central nervous system relapse in a patient with acute myeloid leukemia
Al-Mujaini AS, Al-Dhuhli HH, Dennison DJ
Department of Ophthalmology, Sultan Qaboos University Hospital, Al-Khod, Muscat, Saltanate of Oman.
The reported incidence of central nervous system (CNS) involvement by acute myeloid leukemia (AML) ranges widely from less than 10-30%. Acute unilateral third nerve palsy is an unusual first manifestation of such an event. We describe a rare ophthalmologic manifestation of CNS relapse in a 25-year-old patient with AML who had undergone allogeneic stem cell transplant, and demonstrate the value of MRI in the early diagnosis.
SQU Med J 2009;9(2):157-161, Epub 30 th June 2009
A Female Child with Skin Lesions and Seizures: Case report of Incontinentia Pigmenti
Sana Al-Zuhaibi, Anuradha Ganesh, Ahmed Al-Waili, Faisal Al-Azri, Hashim Javad and Amna Al-Futaisi
Departments of Ophthalmology, Dermatology, Medical Imaging and Child Health, Sultan Qaboos University Hospital, Muscat, Oman.
Incontinentia Pigmenti (IP), (OMIM # 308300), is a rare X-linked dominant condition. It is a multisystemic disease with neuroectodermal findings involving the skin, eyes, hair, nails, teeth, and central nervous system. It is usually lethal in males; the disease has variable expression in an affected female. We report the case of a 6 month old girl who presented at Sultan Qaboos University Hospital, Oman, with neonatal seizures and hypopigemented/hyperpigmented skin lesions. She had multiple ophthalmic abnormalities and neurological manifestations which are discussed in this report.
SQU Med J 2009;9(2):184-195; Epub 30 th June 2009
Bacterial Keratitis: Perspective on Epidemiology, Clinico-Pathogenesis, Diagnosis and Treatment
Abdullah Al-Mujaini, Nadia Al-Kharusi, Archana Thakral and Upender K Wali
Department Sultan Qaboos University Hospital, Muscat, Oman.
Bacterial keratitis is an acute or chronic, transient or recurrent infection of the cornea with varying predilection for anatomical and topographical parts of the cornea like marginal or central. It is a potentially sight-threatening corneal infection in humans that is generally found in eyes with predisposing elements, the most common of which is contact lens wear. The epidemiological data reveals the universal occurrence of this disease. With advances in the understanding of its pathogenesis, laboratory investigations like immunohistochemistry, fluorescent microscopy, enzyme immunoassays and molecular biology, and the availability of fourth generation antibiotics, the overall visual outcome in bacterial keratitis has improved with time. Particular attention should be given to this condition as it can progress very rapidly with complete corneal destruction occurring within 24-48 hours. Early diagnosis, which is primarily clinical and substantiated largely by microbiological data, and prompt treatment are needed to minimise the possibility of permanent visual loss and reduce structural damage to the cornea.
Middle East Afr J Ophthalmol 2009;16:92-6
Traditional medicine in Oman: Its role in ophthalmology.
Radha Shenoy, Alexander Bialasiewicz 1 , Rajiv Khandekar 2 , Badar Al Barwani1, Habiba Al Belushi 3
Department of Ophthalmology, Armed Forces Hospital, Sultanate of Oman, Oman, 1 Department of Ophthalmology, Al Ahli Hospital, Doha, Qatar, 2 Institute of Health Sciences, Ministry of Health, Sultanate of Oman, Oman, 3 Department of Ophthalmology, Sultan Qaboos University, Sultanate of Oman, Oman
Aim: To present three patients with ocular disease who developed a range of complications following use of traditional medications. Settings and Design: Case series. Methods: Three patients who were examined in the Ophthalmic department of a tertiary care teaching hospital in the Sultanate of Oman between 2003 and 2004, seeking care following use of traditional medicines and or healing practices for various ophthalmic problems described below. Results: The first patient was a computer professional with a chalazion; the patient used a plant extract from 'Calotropis procera' as a part of the treatment. He developed corneal edema with decrease in vision in his left eye following application of the plant extract. Treatment with topical steroids and antibiotics resulted in a complete clinical and visual recovery. The second patient developed a fungal corneal ulcer (dermatophyte - Trichophyton mentagrophyte) after sustaining injury with an animal tail to the right eye and used honey for pain relief prior to presentation. She responded poorly to anti-fungal treatment, underwent a penetrating keratoplasty with recurrence of infection in the graft that resulted in a vascularized corneal scar. The third patient was a five-year-old child who was treated with 'wasam' on the occiput for intraocular inflammation following bilateral uncomplicated cataract extraction. Following this treatment the topical steroid was discontinued. The "Wasam" treatment indirectly resulted in exacerbation of the intraocular inflammation and secondary glaucoma and poor vision as well as 'Wasam ulcers' on the occiput. Despite treatment of the intraocular inflammation, the visual outcome was poor. Conclusion: Traditional medicine in Oman is sought by many for variable reasons. Lack of evidence-based scientific data on its safety or efficacy does not deter the Omanis from flocking the traditional healers. However, when applied in the treatment of ocular diseases, traditional medicine and healing practices seem to cause more harm than benefit for the patient.
Middle East Afr J Ophthalmol 2009;16:55-6
The importance of structured scientific enquiry: A priority for the MEAJO editorial board
British Columbia Center for Epidemiologic and International
Ophthalmology, University of British Columbia, Vancouver, Canada.
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