Evaluation of Corneal High Order Aberrations in Post Laser-Assisted in Situ Keratomileusis versus Photorefractive Keratectomy in Myope

Background Aberrations of the eye are the difference between two surfaces: the ideal and the actual wave front. Higher order aberrations are a relatively small component, comprising about 10% of the eye’s total aberrations. High order aberrations increase with age and minor symmetry exists between the right and the left eyes. Aim and objectives To Compare corneal high order aberrations in post laser-assisted in situ keratomileusis with corneal high order aberrations in post Photorefractive keratectomy in myope. Subjects and methods this study was designed as a prospective randomized intervention study that conducted on 40 myopic eyes. The eyes divided into two randomized groups. Group A: 20 myopic eyes corrected with laser-assisted in situ keratomileusis and Group B: 20 myopic eyes corrected with Photorefractive keratectomy. Cases were collected for LASIK and PRK at operative theater in Beni-Suef University Hospital and clear vision laser center in Cairo, from May 2019 till January 2022. Result There was clinically significant difference between pre- and post-operative visual acuity, vertical trefoil and vertical coma of LASIK group and there was clinically significant between pre- and post-operative visual acuity, vertical trefoil and vertical coma of PRK group. But there was no significant difference between LASIK and PRK in visual acuity, spherical aberration, higher order 5 mm and 6 mm, vertical coma and Vertical trefoil. Conclusion There is non-significant increase in higher order aberration and spherical aberration post LASIK and post PRK with lesser amount in PRK

The Effectiveness of Intraocular Methotrexate in the Treatment of Posterior Uveitis in Behçet’s Disease Patients Compared to Retrobulbar Steroids Injection

Aim of Work. To evaluate the efficacy of intravitreal methotrexate (MTX) compared to retrobulbar triamcinolone acetonide (TAA), in controlling posterior segment involvement and inducing remissions among Behçet’s disease (BD) patients. Study Design. This is a cross-sectional nonrandomized comparative study. Patients and Methods. 31 adult BD male patients with a mean disease duration of 5.45 years who presented with bilateral posterior segment involvement were included. Each patient received intravitreal injection of 400 μg/0.1 mL (MTX) for the right eye (Group A) and 1 mL of retrobulbar 40 mg/mL TAA for the left eye (Group B). Results. 90% of eyes showed complete improvement of anterior chamber reaction, whereas an improvement in vitreous activity in 77% with no significant differences between both groups (p≤0.1). BCVA improved in 77.4% eyes (Group A) compared to 87.1% (Group B) (p≤0.4). Relapses were noted in 11 eyes (35.5%), in group A, with the mean duration of remission being 19.1 weeks ± 2.13 compared to 7.35±2.8 in 20 eyes (64.5%) in group B (p≤0.1). Conclusion. No statistical differences were found between both treatment modalities; however, based on clinical observations, intravitreal MTX may ensure better control of inflammatory reaction and may encourage longer remission as compared to retrobulbar TAA in BD patients

Endoscopic-Assisted Scleral Fixated IOL in the Management of Secondary Aphakia in Children

Purpose. To evaluate the short-term postoperative outcomes in endoscopic-assisted sclera fixation intraocular lens (IOL) for the management of secondary aphakia in children. Methods. This is a prospective study, whereas 40 aphakic eyes with absence of a good capsular support were implanted by endoscopy-assisted sclera fixation technique. Results. No major intraoperative complications were recorded. All cases were followed up for 6 months. Only transient ocular hypertension occurred in 10 (25%) eyes. Lens decentration and/or tilting were clinically detected in 2 eyes (5%). Ultrasonic biomicroscopic (UBM) examination revealed lens tilting in 2 (5%) of the operated eyes, despite the proper haptics positioning in the ciliary sulcus. Postoperative vitreous hemorrhage was reported in 5 eyes (12.5%) in the early postoperative period and retinal detachment in one eye. A postoperative refractive astigmatism ranging from 0.75 D to 3.75 D (mean 1.7 D ± 0.79) was recorded, as compared to mean preoperative values of 2.00 D, with no statistically significant differences being recorded (p≥0.05). An improvement of BCVA, 1-2 lines on Snellen chart at the end of the follow-up period, was detected in 23 eyes (57.5%) with a mean of 0.6±0.08 SD, as compared to a preoperative mean values of 0.5±0.07 SD (p≥0.05). Conclusion. Using an endoscope for transscleral suturing of intraocular lenses in aphakic pediatric eyes might be considered as being an effective technique that can reduce surgical complications, especially postoperative lens decentration

Correlation between optical coherence tomography angiography macular parameters with optical coherence tomography structural parameters in primary open angle glaucoma (a longitudinal descriptive study)

Background: There is growing evidence indicating that glaucoma pathogenesis is attributed to vascular dysfunction.Aim: compare the macular circulation in normal individuals and glaucomatous patients in the superficial as well as the deep retinal plexuses, to determine and characterize macular circulation deficits in glaucoma along with correlating them with structural macular OCT parameters Methods: descriptive study included 100 eyes of 100 participants who were selected randomly from attendants of ophthalmology outpatient clinic in Beni-suef university hospital Participants were subjected to 24-2 SITA- standard automated VF test using SAP ,OCT ONH examination and OCTA (Macula)  Results: IOP showed significant negative moderate to strong linear correlation with all the Macular Parameters in Glaucoma Participants. These correlations were highly significant; (p-values <0.001). All measurements of superficial and deep macular venues plexuses by studied macular OCTA was statistically significantly lower in glaucomatous as compared to non-glaucomatous participants; (p-values <0.001). Conclusion: There was a reduction in VD in particular that of superficial layer in POAG patients in macular region, according to OCTA measurements. Glaucomatous eyes have a significantly sparser superficial VD in the macula when compared to healthy eyes, and these VD assessments are significantly accompanied by the severity of VF destruction and OCT structural affection

Optical coherence tomography angiography versus fluorescein angiography in diagnosis of ischemic diabetic maculopathy

Objectives: To compare between the use of Fundus Fluorescein Angiography (FFA) and Optical Coherence Tomography Angiography (OCTA) in the diagnosis and quantification of diabetic macular ischemia (DMI) diagnosed according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification based on Foveal avascular zone (FAZ) parameters. Patients and Methods: The presented study is a prospective randomized observer blind observational study that included 40 eyes of 25 diabetic patients who were diagnosed as having ischemic diabetic maculopathy.  Diabetic patients (type 1 or type 2) having different severities of diabetic retinopathy with and without previous treatment (laser or intravitreal injections). FA and OCTA images were independently graded by 2 observers that reached agreement regarding quantitative DMI according to established protocols. Quantitative analysis of the FAZ area was performed using custom software. Results: Demographic data of the studied cases were comparable between groups. OCTA images closely correlated with FA regarding area of FAZ (mm2).&nbsp

The Effectiveness of Pre- and Postoperative Infliximab in Controlling Behçet’s Disease Posterior Uveitis in Patients Undergoing Vitrectomy: A Preliminary Study

Purpose. To evaluate the short-term effectiveness of infliximab in controlling ocular manifestations in Behçet’s Disease (BD) patients candidate for pars plana vitrectomy, if given in a regimen before and after the planned procedure. Patients and Methods. 30 eyes of 27 adult male BD patients with a mean age of 35.56 yrs presented with refractory posterior uveitis not responding to immunosuppressive drugs and candidate for vitrectomy were included. Infliximab was given in a dose of 5 mg/kg intravenous infusion once every two weeks for 3 treatment sessions before the intended vitrectomy followed by 3 treatment sessions at two-week intervals, after vitrectomy. Results. Improvement of ocular manifestations was noted in all eyes, with complete resolution in 26 eyes (87%). Visual acuity improved from 0.23 ± 0.11 to 0.38 ± 0.17 (p≤0.2), ESR decreased from 65.92 mm/hr ± 17.32 SD to 24.93 mm/hr ± 5.28 SD at the last treatment cycle (p≤0.1). The mean daily dose of systemic corticosteroids was tapered from 44.54 mg/d ± 2.89 to 8.48 mg/d ± 6.38 (p≤0.2), and no relapses were noted during the follow-up period. Conclusion. Infliximab may be safe and effective in controlling posterior uveitis and inducing remissions if given in a regimen before and after vitrecomy in BD patients