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Giant Conjonctival Naevus: Case Report from Bamako
Seydou Bakayoko,
Seydou Diallo,
Rodrigue Romuald Elien Gagnan Yan Zaou Tou,
Adama Guindo,
Brainima Coulibaly,
Jean Michel Mbaïkoua,
Mahamat Adam Dicko,
Jean Marc Léré Tiama,
Mamasile Clement Bagouya,
Japhet Pobanou Thera
Issue:
Volume 4, Issue 4, December 2019
Pages:
63-65
Received:
24 August 2019
Accepted:
23 September 2019
Published:
9 October 2019
Abstract: Conjunctival nævus is a common tumour in the conjunctiva. It can appear clinically in childhood or adolescence. The juxta limbic location (on the temporal side and near the palpebral fissure) of the nævus is the most frequent. Its presence at the level of the lacrimal caroncula (inner angle of the eye) and the semi-lunar fold (outside the caroncula) is more rare. Their pigmentation varies with age. Thus, almost 25% of them are amelanotic (especially in children). The pigmentation varies according to several factors: the congenital character of these nævi; hormonal changes during pregnancy; intense exposure to the sun. In addition, a change in pigmentation can be observed in almost 25% of cases with inflammation, or in cases of intense activity of melanophages. The size of the nævi tends to increase with age. This is usually done after puberty. We report a case of a 2-year-old boy with a pigmented conjunctival nævus about 2 cm long, flat, limbal and bulbar juxta at the temporal side. The rest of the eye exam is normal. The child has been entrusted to the team of the orbito-palpebral surgery and the annexes for the continuation of the management. We will present its clinico-histological and therapeutic aspects.
Abstract: Conjunctival nævus is a common tumour in the conjunctiva. It can appear clinically in childhood or adolescence. The juxta limbic location (on the temporal side and near the palpebral fissure) of the nævus is the most frequent. Its presence at the level of the lacrimal caroncula (inner angle of the eye) and the semi-lunar fold (outside the caroncula...
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Optical Coherence Tomography Angiography to Detect and Differentiate Ischemic Optic Neuropathy from Papilledema - Systematic Review
Manuel Augusto Pereira Vilela,
Carina Graziottin Colossi
Issue:
Volume 4, Issue 4, December 2019
Pages:
66-70
Received:
1 August 2019
Accepted:
25 September 2019
Published:
10 October 2019
Abstract: Background: Optic disc is a region with a complex vascular stratification, with components from the posterior ciliary arteries and central retinal artery. Nonarteritic anterior ischemic optic neuropathy (NA-AION) and papilledema can produce disc edema and visual fields defects. Optical coherence tomography angiography (OCTA) can aid in the rapid differentiation of cases when signals overlap. Objective: The purpose of this systematic review is to discuss the current information concerning the signs in OCTA that eventually could help to differentiate these situations and analyze the best diagnostic evidence. Methods: A systematic search was conducted in the MEDLINE ("Medical Literature Analysis and Retrieval System Online") via Pubmed; Embase, Scopus, Web of Science, Google Scholar, BVS databases, in addition to a manual search on studies published, from inception until July 2019, with no language restriction. Results: Of the 20935 articles identified, eleven were included. Different methodologies, sample characteristics, types of equipment, potential artifacts, segmentation errors were the main arguments against formal meta-analysis. Conclusion: The main differentiation of papilledema from NA-AION is the vascular dropout. Density values in both retina and optic nerve head images were significantly lower in NA-AION. These vascular changes appears to precede detectable structural or visual field damage.
Abstract: Background: Optic disc is a region with a complex vascular stratification, with components from the posterior ciliary arteries and central retinal artery. Nonarteritic anterior ischemic optic neuropathy (NA-AION) and papilledema can produce disc edema and visual fields defects. Optical coherence tomography angiography (OCTA) can aid in the rapid di...
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Endogenous Endophthalmitis by Candida Albicans Associated with a Primary Immunodeficiency Due to CARD9 Deficiency
Juliana Albano de Guimarães,
Maria Campos Pires,
Camillo Carneiro Gusmão,
Andrea Mara Simões Torigoe
Issue:
Volume 4, Issue 4, December 2019
Pages:
71-76
Received:
1 September 2019
Accepted:
4 October 2019
Published:
15 October 2019
Abstract: This report encopasses a case of endogenous endophthalmitis by Candida albicans in an otherwise healthy young adult patient, which led to the diagnosis of a primary immunodeficiency, CARD9 deficiency, associated with familial candidiasis. A 31-year-old female patient with a one-month history of low visual acuity (VA) in the right eye (RE) was referred after no response to treatment of toxoplasmosis and acute retinal necrosis. She presented no comorbidities, but a history of recurrent paronychia, oral candidiasis and tinea capitis since childhood. Her parents were first-degree cousins. Visual acuity was 20/2000 in the RE and 20/20 in the left eye (LE). There was an elevated exudative lesion occupying the retinal posterior pole, associated with fluffy white cotton balls in the adjacent posterior vitreous. Optical coherence tomography (OCT) showed macular lesions with the "rain cloud" sign. Fungal endogenous endophthalmitis was hypothesized. Imaging and laboratory examinations discarded other infections and eliminated involvement of other organs. Diagnostic vitreous puncture was performed in addition to Amphotericin B injection and intravenous Fluconazole. As culture results were negative, a vitreous biopsy was performed, in which Candida albicans was grown, followed by a second Amphotericin B injection. As there was no improvement, pars plana posterior vitrectomy, with placement of silicone oil, was performed. In spite of infection control, VA remained 20/2000. Due to a severe ocular condition with no other invasive sites of infection, associated with superficial recurrent fungal infections, a primary fungal specific immunodeficiency was suspected, resulting in referral to Immunology. An immunogenetic panel was performed, demonstrating heterozygosity for two CARD9 gene mutations, a molecule related to familial candidiasis. Follow-up in Ophthalmology and Immunology was maintained and oral Fluconazole was proposed to be taken for at least 6 months. Three months later, she presented with an oral abscess secondary to Candida, managed by the Otorhinolaryngology team. Fungal endogenous endophthalmitis is an important cause of morbidity and low visual acuity, especially in the population of immunocompromised patients. Early ophthalmological diagnosis should preferably be performed in order to prevent lesions from increasing, affecting noble areas such as the macula, and reaching the vitreous. When the fundus exam presents signs of fungal endophthalmitis in immunocompetent, young and healthy patients, diagnosis of primary immunodeficiencies should be considered.
Abstract: This report encopasses a case of endogenous endophthalmitis by Candida albicans in an otherwise healthy young adult patient, which led to the diagnosis of a primary immunodeficiency, CARD9 deficiency, associated with familial candidiasis. A 31-year-old female patient with a one-month history of low visual acuity (VA) in the right eye (RE) was refer...
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Ocular Complications of Diabetes Mellitus Except for Diabetic Retinopathy
Chantal Makita,
Charles Géraud Fredy Nganga Ngabou,
Eyissa Nzi Gombé,
Reinette Messe Ambia Koulimaya
Issue:
Volume 4, Issue 4, December 2019
Pages:
77-80
Received:
27 September 2019
Accepted:
29 October 2019
Published:
5 November 2019
Abstract: The Ocular complications of diabetes mellitus except for diabetic retinopathy have been poorly studied compared retinal complications, which are the main cause of blindness. We report the results of a prospective study reviewing the different ocular conditions encountered during diabetes. Four hundred (400) eyes of two hundred (200) patients with type 1 and type 2 diabetes were examined during a period of 8 months. All included patients underwent a complete ophthalmological examination. Fifty-seven diabetic patients were diagnosed of an ocular disease at a frequency of 28.5%. There were 42 male and 17 female patients with an average age of 57, 5 years old. The average duration of diabetes was 11.8 years. Non-insulin-dependent diabetes mellitus was present in 59.6% of cases. Cataracts were the most common ocular diseases diagnosed in 45.6% of cases followed by primary or chronic open-angle glaucoma in 22.9% and hyperopia in 12.3% of cases. Corneal sensitivity was decreased in 52% of cases and bilateral optic neuropathy was found in 3.4% of cases (two hundred eyes). The ocular complications of diabetes mellitus except for diabetic retinopathy, are dominated by cataracts and glaucoma. But there are also neuropathies that may cause blindness. These conditions should therefore also be systematically screened for evaluations and reviews of potential degenerative complications in patients with diabetes mellitus.
Abstract: The Ocular complications of diabetes mellitus except for diabetic retinopathy have been poorly studied compared retinal complications, which are the main cause of blindness. We report the results of a prospective study reviewing the different ocular conditions encountered during diabetes. Four hundred (400) eyes of two hundred (200) patients with t...
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Relationship Between Consanguineous Marriages and Incidence and Severity of Refractive Errors: A Cross-sectional Study
Issue:
Volume 4, Issue 4, December 2019
Pages:
81-87
Received:
7 October 2019
Accepted:
26 October 2019
Published:
5 November 2019
Abstract: Congenital and genetic ocular disorders are linked to parental consanguinity. The aims was to investigate the effects of consanguineous marriages on the refractive errors of preschool-aged and adolescent patients. Two sample groups were recruited: the preschooler group (3–6 years; 335 participants) and the adolescent group (12–20 years; 998 participants). The required sample size was calculated using a sample size estimation software. Visual acuity was measured using the 15-line Lea symbols chart in the pre-school aged group and non-illuminated ETDRS VA chart in the adolescent group. Spherical equivalent refractive errors were noted with near-retinoscopy technique in young children and with the ARK-30 autorefractor in the adolescent group. In order to explore the impact of consanguineous marriages, the data were analyzed separately based on the age group using SPSS version 21 software. In the preschooler group, myopia was found in 4.2%, hyperopia in 8.1%, and astigmatism in 20%. Three children had high myopic scores (-10.00 D, -13.50 D and -17.50 D). In the adolescent group, 45.6% participants were myopic, 3.8% were hyperopic, and 22.3% were astigmatic. Despite the higher frequency of RE in those 15 years and older in the cousins group and the consanguineous parents of the three preschool-aged children with high myopia, there were no statistically significant (p>0.05) evidence that consanguineous marriages impact the refractive errors of their children. In conclusion, despite previous studies showing a link between ocular genetic or congenital disorders and consanguinity, no such link could be established with regard to refractive errors.
Abstract: Congenital and genetic ocular disorders are linked to parental consanguinity. The aims was to investigate the effects of consanguineous marriages on the refractive errors of preschool-aged and adolescent patients. Two sample groups were recruited: the preschooler group (3–6 years; 335 participants) and the adolescent group (12–20 years; 998 partici...
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Development and Preliminary Evaluation of a System to Rapidly Measure Coefficient of Friction on Soft Contact Lenses
Daniel Joseph Hook,
Charles Phillip Lusignan,
Katarzyna Aneta Wygladacz,
Jeffery Merrill Schafer,
Robert Brian Steffen,
William Thomas Reindel,
Gary Michael Mosehauer
Issue:
Volume 4, Issue 4, December 2019
Pages:
88-96
Received:
2 October 2019
Accepted:
22 October 2019
Published:
14 November 2019
Abstract: This study was undertaken to 1. develop an apparatus to rapidly measure coefficient of friction (COF) on soft contact lenses; 2. determine if COFs measured on two daily-disposable lens models before and after wear are consistent with changes in lens surface morphology observed in parallel atomic force microscopy (AFM) images. Methods: A stress rheometer was adapted to measure COF on a soft contact lens by custom fabrication of a rapid-mount sample stage for increased throughput. Five subjects were randomly assigned to wear daily disposable nesofilcon A and delefilcon A contact lenses bilaterally for 4 hours, after which time lenses were removed. Static and kinetic COFs of lenses worn on left eyes was measured, while lenses worn on right eyes were imaged in parallel by AFM in tapping mode. Root mean square (RMS) surface roughness was calculated for all lenses to determine the effect of wear on surface topography. Results: Both static and kinetic COFs measured on unworn delefilcon A silicone hydrogel lenses were greater than on nesofilcon A traditional hydrogel lenses. Static COF on nesofilcon A increased significantly after wear, while kinetic COF trended higher but did not change significantly. Similarly, static COF on delefilcon A also increased significantly after wear, and kinetic COF trended higher but did not change significantly, both remaining greater than on worn nesofilcon A. Parallel AFM analysis demonstrated that nesofilcon A lenses are smoother than are delefilcon A out of the package. Both lenses attracted deposits during wear, but the nesofilcon A surface was less altered by on-eye wear than was the delefilcon A surface. Conclusion: A system to rapidly measure static and kinetic COFs was successfully developed. Static and kinetic COFs measured on delefilcon A were greater than on nesofilcon A lenses. More deposits and greater surface roughness were observed after wear on delefilcon A relative to nesofilcon A. Parallel AFM images of worn and unworn lenses were not predictive of measured COFs, but increased roughness visible by AFM was consistent with observed increases in COF, although not all increases were statistically significant.
Abstract: This study was undertaken to 1. develop an apparatus to rapidly measure coefficient of friction (COF) on soft contact lenses; 2. determine if COFs measured on two daily-disposable lens models before and after wear are consistent with changes in lens surface morphology observed in parallel atomic force microscopy (AFM) images. Methods: A stress rheo...
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Clinical Observation of Treating Infantile Ophthalmic Hemangioma by Oral Propranolol
Issue:
Volume 4, Issue 4, December 2019
Pages:
97-100
Received:
1 October 2019
Accepted:
21 October 2019
Published:
19 November 2019
Abstract: To evaluate the clinical efficacy and safety by oral propranolol in treating infantile ophthalmichemangioma (IH). A prospective analysis of 66 infantile outpatients with ophthalmic hemangioma from Feb 2016 to Apr 2018. According to the initial dose, the order of maintenance dose and drug withdrawal of oral propranolol prescription, the tumor size, color change and adverse reactions were studied and analyzed, and the clinical efficacy and safety were evaluated. The tumors became weak within 1 week in 83.3% outpatients (55 cases). 4 (6.1%) outpatients received Grade I efficacy (ineffective), 7 (10.6%) Grade II (poor), 9 (13.6%) Grade III (improvement) and 46 (69.7%) Grade IV (cured). The average prescribed medication treatment time was 6.9 months. The curative effect of the long course groups was better than the short ones, and 4-12 months group was the best. No obvious side effect was detected except 1 diarrhea. There was no significant difference in curative effect between left and right eyes or sex (P>0.05). Propranolol was used in outpatients to treat IH, the indications and contraindications were strictly controlled and the clinical efficacy and safety were relatively satisfactory.
Abstract: To evaluate the clinical efficacy and safety by oral propranolol in treating infantile ophthalmichemangioma (IH). A prospective analysis of 66 infantile outpatients with ophthalmic hemangioma from Feb 2016 to Apr 2018. According to the initial dose, the order of maintenance dose and drug withdrawal of oral propranolol prescription, the tumor size, ...
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The Relation Between Age Related Macular Degeneration and Thyroid Disorders
Mona Abdelkader,
Naglaa Abass
Issue:
Volume 4, Issue 4, December 2019
Pages:
101-105
Received:
16 September 2019
Accepted:
18 October 2019
Published:
20 November 2019
Abstract: The Purpose of the study was to evaluate the association between thyroid -stimulating hormone (TSH), free tri-iodothyronine (T3), free thyroxine (T4), hypothyroidism, hyperthyroidism and age related macular degeneration (ARMD) incidence. Nine hundred and fifty patients with thyroid disorders versus five hundred and thirty eu-thyroid subjects were included in the study during the period from January 2014 to February 2019. Blood pressure, blood sugar level and cholesterol, smoking state were estimated. TSH, T3&T4 were measured. Retinal photography and optical coherence tomography were performed. Patients with hyperthyroidism had increased incidence of ARMD. Patients using thyroxine had also increased incidence of ARMD than non using of thyroxine. There were statistically higher significant percent of marriage, educational level and smoking in patients with thyroid disorders with ARMD than euthyroid (p=0.03. 0.06, 0.001 respectively). In thyroid disorders patients, there were a significant differences between patients had ARMD or had not as regard diabetes, hypertension and cholesterol level (p=0.04, 0.09, 0.03 respectively). We concluded that there were increased incidence of ARMD in both hyperthyroidism, and patients use the thyroxine.
Abstract: The Purpose of the study was to evaluate the association between thyroid -stimulating hormone (TSH), free tri-iodothyronine (T3), free thyroxine (T4), hypothyroidism, hyperthyroidism and age related macular degeneration (ARMD) incidence. Nine hundred and fifty patients with thyroid disorders versus five hundred and thirty eu-thyroid subjects were i...
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Visual and Refractive Outcomes Following Simultaneous Phacoemulsification and Pterygium Excision with Conjunctival Autograft
Shreesha Kumar Kodavoor,
Soundarya B,
Ramamurthy Dandapani
Issue:
Volume 4, Issue 4, December 2019
Pages:
106-110
Received:
19 November 2019
Accepted:
16 December 2019
Published:
24 December 2019
Abstract: Purpose - This study aims at analyzing the visual and refractive outcomes following simultaneous phacoemulsification and pterygium excision with conjunctival autograft (CAG). Setting-Tertiary eye care hospital in South India. Design-Retrospective study. Methods-508 eyes that underwent simultaneous phacoemulsification with pterygium excision between 2011-2017 were included in the study. Exclusion criteria-Pre-operative astigmatism of > 2 D, grade 3 pterygia, recurrent or double head pterygia, traumatic or complicated cataract. Pre-operative evaluation-clinical examination, keratometry, IOL power calculation, retinoscopy and subjective refraction. Procedure-Phacoemulsification with foldable monofocal IOL followed by pterygium excision with conjunctival autografting using tissue glue. Post-operative follow up-Periodically up to 6 months. Results- Mean pre-operative best corrected visual acuity (LogMAR) was 0.41+/-0.46 with post-operative mean being 0.04+/-0.12 (p=0.001). Mean pre-operative and post operative astigmatism were -1.25+/-0.60 D and -0.73+/-0.58 D (p=0.001) respectively. Mean post-operative myopic spherical error was -0.85+/-0.48 D. 34.33% of the patients had a post-operative refractive error out of which 87.42% had myopia and 12.57% had a hypermetropic error (<1D). 63.27% of the eyes with myopic error had an error of < 1 D. Most commonly seen complication was sub conjunctival haemorrhage followed by graft retraction in 12 and 10 eyes respectively. Conclusion- The combined single step procedure of phacoemulsification with pterygium excision in indicated cases, is safe and effective with good visual outcomes. The post-operative myopic residual error can be anticipated and reduced by slightly under correcting the IOL power in patients with concurrent pterygium to optimize the visual outcome.
Abstract: Purpose - This study aims at analyzing the visual and refractive outcomes following simultaneous phacoemulsification and pterygium excision with conjunctival autograft (CAG). Setting-Tertiary eye care hospital in South India. Design-Retrospective study. Methods-508 eyes that underwent simultaneous phacoemulsification with pterygium excision between...
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