Incidence of Optic Neuritis Among Omani Patients with Multiple Sclerosis at the Sultan Qaboos University Hospital, Muscat, Oman

Objectives: Multiple sclerosis (MS) is a chronic, multifaceted, heterogeneous autoimmune disease, with optic neuritis (ON) being a common early manifestation. This study aimed to estimate the incidence of ON among Omani patients with MS. Methods: This retrospective cross-sectional study included all Omani patients diagnosed with MS at the Sultan Qaboos University Hospital, Muscat, Oman, between January 1991 and December 2019. Data were collected from the neurology registry and electronic medical records. The data was analysed descriptively using univariant and multivariant statistical techniques. Results: Of the 185 patients diagnosed with MS during the study period, 170 were included in the analysis. The male-to-female ratio was 1:3 and the mean age was 28 years. The incidence of ON in the population was 28.8%, with 83.7% of ON patients presenting with relapse-remitting MS (RRMS). Overall, 28.6% presented with ON as an initial manifestation of MS, while 42.8% developed ON at a later stage. Most patients (49.4%) were from higher-latitude regions of Oman, like Muscat and Al Batinah. Conclusion: The incidence of both MS and ON increased over the study period. While the overall incidence was low in comparison with Western data, it was similar to rates reported elsewhere in the Arabian Peninsula. Overall, ON was the most common manifestation of MS in the cohort, with younger female patients more frequently presenting with both MS and ON. There was a significant association between the RRMS subtype and ON presentation. Keywords: Demyelinating Diseases; Optic Neuritis; Multiple Sclerosis; Multiple Sclerosis, Relapsing-Remitting; Incidence; Epidemiology; Oman

Optical Coherence Tomography: Clinical Applications in Medical Practice

Optical Coherence Tomography (OCT) is a success story of scientific and technological co-operation between a physicist and a clinician. The concept of cross-sectional imaging revolutionalized the applicability of OCT in the medical profession. OCT is a non-contact, topographic, biomicroscopic device that provides high resolution, cross-sectional digital images of live biological tissues in vivo and in real time. OCT is based on the property of tissues to reflect and backscatter light involving low-coherence interferometry. The spatial resolution of as little as 3 microns or even less has allowed us to study tissues almost at a cellular level. Overall, OCT is an invaluable adjunct in the diagnosis and follow up of many diseases of both anterior and posterior segments of the eye, primarily or secondary to systemic diseases. The digitalization and advanced software has made it possible to store and retrieve huge patient data for patient services, clinical applications and academic research. OCT has revolutionized the sensitivity and specificity of diagnosis, follow up and response to treatment in almost all fields of clinical practice involving primary ocular pathologies and secondary ocular manifestations in systemic diseases like diabetes mellitus, hypertension, vascular and neurological diseases, thus benefitting non-ophthalmologists as well. Systemically, OCT is proving to be a helpful tool in substantiating early diagnosis in diseases like multiple sclerosis and drug induced retinopathies by detecting early changes in morphology of the retinal nerve fiber layer

Valsalva retinopathy in pregnancy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Valsalva retinopathy is a unilateral or bilateral condition that occurs when increased intra-thoracic or intra-abdominal pressure transmitted to the eye causes a sharp rise in the intra-ocular venous pressure, and rupture of superficial retinal capillaries. The patient often gives a history of a recent strenuous physical act, which could have increased the intra-thoracic pressure. Pregnancy is known to be a risk factor for Valsalva retinopathy.</p> <p>Case presentation</p> <p>A 23-year-old woman in her seventh month of pregnancy presented with a history of decreased vision in her left eye of one-week duration. Examination of the affected eye showed best corrected visual acuity of 20/50, and fundus examination revealed a pre-retinal hemorrhage located in the macula. Based on clinical findings, the diagnosis of Valsalva retinopathy was made.</p> <p>Conclusion</p> <p>Retinal hemorrhages can be generated by Valsalva maneuvers. Pregnancy is a known risk factor for Valsalva retinopathy; however, the diagnosis should be made only after excluding other causes of retinal hemorrhages. It is a self-limited event. We report a case of Valsalva retinopathy complicating normal pregnancy and confirm that, to date, there is no evidence to indicate that there is a risk of recurrence following spontaneous vaginal delivery.</p

Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) of the orbit: a case report

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Visual outcome following extracapsular cataract extraction in mature cataracts with pseudoexfoliation syndrome: A retrospective study

Purpose/Objective: To report the best corrected visual acuity, at the end of one year, in 33 patients (35 eyes), who underwent extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens implantation (PC-IOL) for mature and hypermature cataracts, with pseudoexfoliation (PEX). Design: Retrospective, non-comparative, single-institutional (Sultan Qaboos University Hospital) study. Participants: Thirty-three patients with mature and hypermature cataracts, with PEX operated upon between January 2007 and December 2008, by one surgeon (AM). Materials and Methods: Retrospective study of thirty-three patients (35 eyes) with mature and hypermature cataracts, with ocular PEX, evaluating the visual outcome at the end of 12 months following ECCE with PC-IOL. Results: Thirty eyes (85.71%) showed improvement in the best corrected visual acuity (BCVA) ranging from 0.2 to 1.0 Snellen lines. Four eyes (11.43%) had unchanged BCVA from the baseline. There were no intraoperative complications in any patient. One eye (2.86%) that did not improve developed retinal detachment at three months follow-up, and was referred to the Vireoretinal Unit and follow-up has been lost. Conclusion: Extracapsular cataract extraction is a safe and effective technique in eyes with mature and hypermature cataracts with PEX

Alternating central serous chorioretinopathy in two consecutive pregnancies

To highlight the similarity in onset, clinical course, and resolution of central serous chorioretinopathy in two eyes, in two consecutive pregnancies in the same patient. A case report. Snellen visual acuity, slit-lamp examination, and optical coherence tomography (OCT). A 31-year-old female had central serous chorioretinopathy with sub-retinal exudates in left eye during the sixth month of her first pregnancy and later in right eye also during the sixth month of her second pregnancy two years later. Both eyes had spontaneous resolution of the lesions with final visual acuity of 1.0 each eye. To the best of our knowledge, there have been no reports of alternating CSCR with  sub-retinal exudates, occurring exactly in the sixth month of two consecutive pregnancies, two years apart, with spontaneous resolution after deliveries

Sturge-Weber Syndrome without Facial Nevus

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