|Year : 2011 | Volume
| Issue : 1 | Page : 43-44
|Date of Web Publication||14-Mar-2011|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Selected Abstract. Oman J Ophthalmol 2011;4:43-4
Ophthalmologe. 2010 Jun 11. [Epub ahead of print]
Vitreoretinal surgery in Oman (Article in German)
A. A. Bialasiewicz, R. Shenoy, R. M. Al Saeidi, H. M. Al-Belushi
Department of Ophthalmology and School of Ophthalmic Technicians, Sultan Qaboos University College of Medicine and Health Sciences, Muscat, Oman, E-mail: [email protected]
Purpose: Vitreoretinal diseases in Middle Eastern countries currently rank in importance behind cataract, trachoma and glaucoma. This study reports on the most frequent causes of vitreoretinal diseases and the results of vitreoretinal surgery in Oman in order to gain insights into requirements in training and equipment. Materials and Methods: Demographic data and biomicroscopic examinations were performed over a 5-year period. Pars plana vitrectomies were carried out with the Accurus 800CS (Alcon) and EyeLite(R) 532 nm Laser (Alcon), endotamponade with silicone oil 5600 cs (adatomed) or C(3)F(8) Ispan (Alcon), oval silicone sponge scleral buckles 5.5.x7.5 mm type 507 (Geuder(R)) in adults and oval silicone sponge scleral buckles 3.0x5.0 mm type 506 (Geuder(R)) in children (up to 12 years) were sutured with Mersilene parallel to the limbus. Patients were followed after 4 weeks and 1 year. Evaluation of data was done by descriptive statistics (Fisher exact and Chi(2)-tests). Results: From 2002 to 2006, 2,910 vitreoretinal surgeries were performed on 784 adult and 101 pediatric eyes. Main indications were proliferative diabetic vitreoretinopathy (PDVR) (229/784 eyes=29%), followed by trauma (166/784=21%), and PVR retinal detachment (112/784=14.3%) in adults and in children the main indication was trauma (73/101 eyes=73%). The postoperative vision in adults with trauma, PVR retinal detachment, epiretinal gliosis and IOL extraction was significantly different and better ( p =0.003, p =0.044, p =0.029, p =0.001, respectively) and the postoperative vision in PDVR with uncontrolled diabetes mellitus II significantly different and worse ( p =0.001). Of the eyes with PDVR in uncontrolled diabetes mellitus 165 out of 229 (72%) lost distance vision ( p =0.00014). All patients with serious macular edema and an HbA(1c) of >/=9.5% lost 5 m distance in vision. The mean HbA(1c) in all patients who experienced postoperative blindness was 13.5%. Postoperative vision was significantly better in children operated for trauma complications ( p =0.046) whereby patients with contusion of the globe had a significantly better final result ( p =0.0302) than patients with penetrating injuries. Revision surgery was indicated most frequently after surgery for proliferative vitreoretinopathy due to prior retinal detachment surgery. Conclusions: The most frequent causes of preventable retinal blindness in Oman are pediatric trauma and advanced diabetic vitreoretinopathy. Eyes operated for trauma had a better outcome than PDVR in patients with uncontrolled diabetes mellitus. The large number of eyes with PDVR in the final stages and sequelae of trauma legitimates preventive medical measures and an expansion of vitreoretinal services with supportive external training of specialists and allied health professions.
Middle East Afr J Ophthalmol. 2009 Oct;16(4):260-2.
Efficacy of limbal-conjunctival autograft surgery with stem cells in pterygium treatment
W. M. Abdalla
Department of Ophthalmology, Magrabi Eye and Ear Center, Muscat, Sultanate of Oman.
Purpose: To determine the efficacy of limbal-conjunctival autograft surgery with stem cells in the management of primary and recurrent pterygium and determine the best corrected visual acuity after surgery. Materials and Methods: Surgical excision of pterygium and limbal-conjunctival transplantation with stem cells was of 40 eyes (of 31 patients) with pterygium. Thirty one cases were primary and nine cases were recurrent pterygia. Graft margins were secured to the recipient site while stem cells aspect was sutured to the limbus. Results: After one year of follow-up, 37 of 40 (92.5%) eyes were free of recurrence. One of the three recurrent cases was aggressive (recurrence occurred two months after surgery) and the other two showed 2 mm corneal extension at 12 months follow-up. In 24 patients, out of 40 (60%), best corrected visual acuity improved more than two lines. Conclusion: Limbal-conjunctival autograft surgery, including stem cells, appears to be an effective surgical technique in preventing pterygium recurrence and it can also help in improving the best corrected visual acuity.
Eur J Ophthalmol. 2010 Jun 29. pii: 31971C10-8A6E-4219-8A11-F4E72E4B6056. [Epub ahead of print]
Prevalence and determinants of diabetic retinopathy among persons =40 years of age with diabetes in Qatar: a community-based survey
M. Elshafei, H. Gamra, R. Khandekar, M. Al Hashimi, A. Pai, M. F. Ahmed
Department of Ophthalmology, Hamad Medical Corporation, Doha - Qatar
Purpose: We present the prevalence and determinants of diabetic retinopathy (DR) in persons 40 years and older with diabetes in Qatar. Materials and Methods: This community-based survey was held in 2009 at 49 randomly selected clusters. Demographic details and history of diabetes mellitus (DM) and its management were collected by nurses. Ophthalmologists examined the retina by slit-lamp biomicroscopy using +90 D lens and/or indirect ophthalmoscopy. Digital photographs of retina were obtained. The best-corrected visual acuity of each eye was noted. Diabetic retinopathy was graded as mild, moderate, or severe nonproliferative DR, proliferative DR, or diabetic macular edema. Results: We examined 540 (97.3%) participants with DM. Diabetes mellitus status of 487 persons could be confirmed from medical records. The age- and sex-adjusted prevalence of DR among the diabetic population 40 years and older was 23.5% (95% confidence interval [CI] 19.7-27.3), with 8192 cases of DR among patients with DM. Longer duration of diabetes (odds ratio 1.14 (95% CI 1.10-1.19)) and poor glycemic control (odds ratio 1.12 (95% CI 1.02-1.23)) were risk factors for DR. Awareness of regular eye checkup was found in 62% of participants. Only 20% of persons with sight-threatening DR had undergone laser treatment in at least 1 eye. Visual acuity in the better eye was 6/6 to 6/18 in 90% of persons with DR. Conclusions: Universal and periodic eye screening of patients with diabetes is recommended in Qatar. Health promotion for primary prevention and resource review are needed for early detection and management of sight-threatening DR.
Indian J Ophthalmol. 2010 Jul-Aug;58(4):313-20.
Prevalence and determinants of blindness, low vision, deafness and major bone fractures among elderly Omani population of Nizwa Wilayat (Nizwa elderly population study-2005)
R. Khandekar, A. Al Riyami, M. Attiya, M. Morsi
Eye and Ear Health Care, Ministry of Health, Oman
Aim: We conducted a survey in 2005 to estimate the prevalence and determinants of visual and hearing impairment in a population aged 60 years and above, from the Nizwa Wilayat of Oman. We also correlated them with major bone fracture. Study Design: Cross-sectional survey. Materials and Methods: Vision was tested on Snellen's 'E' chart. Persons with vision less than 20/200 were reexamined by an ophthalmologist to find cause of impairment. Hearing was tested by a screening audiometer. Self-reported information on fracture of major bones was confirmed by review of case records. The prevalence, 95% confidence intervals (CI), and number of visually impaired individuals were calculated. Statistical Analysis: Univariate method and parametric tests were used for analysis. Results: We examined 1,639 (80.3%) Omani persons aged 60 years and above. The prevalence of blindness (vision less than 20/200 in the better eye) was 37.4% (95% CI 35.7-39.1). Blindness was significantly higher in females (Odd's Ratio = 2.1) but was similar in urban and rural Nizwa (OR = 0.73). The prevalence of vision impairment (20/60 to 10/200) was 36.0% (95% CI 34.3-37.7). Cataract was the principal cause in 50% of the blind. The prevalence of glaucoma, corneal opacity, and chronic trachoma was 3.1%, 66.8%, and 53.2%, respectively. Among participants, 36.1% had diabetes. Hearing impairment was noted in 33.5% and profound hearing loss was noted in 3.6% of participants. In the past year, 1.4% of participants had a major bone fracture. Conclusion: Visual and hearing impairment and blinding eye diseases were common among senior Omani citizens.
Clin Ophthalmol 2010:4 905-912
Topical ganciclovir in the treatment of acute herpetic keratitis
Khalid F. Tabbara, Noorjehan Al Balushi 1
The Eye Center and The Eye Foundation for Research in Ophthalmology, Riyadh, Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia,1 The Wilmer Ophthalmological Institute of The Johns HopkinsUniversity School of Medicine, Baltimore, Maryland, USA
Herpetic keratitis is caused by herpes simplex virus (HSV) and is a common causeof corneal blindness. Following a primary ocular herpetic infection, latency of the virus occurs,followed by subsequent recurrences of herpetic keratitis. Such recurrences may lead to structuraldamage of the cornea. Recurrent herpetic keratitis is a common indication for corneal transplantation.
Recurrences of herpetic keratitis in the corneal graft may lead to corneal graft rejection.Several antiviral agents for HSV are available, including the thymidine analogs. Prolonged useof thymidine analogs may lead to toxicity of the ocular surface, including epithelial keratitis,corneal ulcers, follicular conjunctivitis, and punctal occlusions. Availability of topical antiviral agents that are safe and effective in the treatment and prophylaxis of herpetic keratitis is highlydesirable. Ganciclovir is a potent inhibitor of members of the herpes virus family. The drug hasbeen used systemically for the treatment of cytomegalovirus (CMV) retinitis. Its hematologictoxicity secondary to systemic administration led to its limited use in herpetic infections. On the other hand, topical ganciclovir has been shown to be as safe and effective as acyclovir in thetreatment of herpetic epithelial keratitis. Furthermore, topical ganciclovir can reach therapeuticlevels in the cornea and aqueous humor following topical application. Several clinical trialshave shown that topical ganciclovir 0.15% ophthalmic gel is safe and effective in the treatment and prophylaxis of herpetic epithelial disease. Long-term use of ganciclovir ophthalmic gel inpatients with penetrating keratoplasty following herpetic keratitis has prevented recurrences ofthe disease. Topical ganciclovir ophthalmic gel is well tolerated, does not cause toxic effectson the ocular surface, and does not cause hematologic abnormalities. Clinical studies have underscored the potential role of ganciclovir ophthalmic gel in the treatment and prophylaxisof herpetic epithelial keratitis. Future randomized, controlled, multicenter, prospective clinicaltrials are needed to assess the long-term safety and efficacy of topical ganciclovir in the treatmentand prevention of herpetic keratitis and uveitis.
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