Anterior Hyaloidal Fibrovascular Proliferation (AHFVP) in a Diabetic after Cataract Extraction, Resulting in Hyphaema and Vitreous Haemorrhage during YAG Laser Capsulotomy

Aim: To report a rare case of anterior hyaloidal fibrovascular proliferation (AHFVP) which occurred after cataract surgery on a non-vitrectomized diabetic eye. This complication resulted in vitreous haemorrhage and hyphaema following a YAG laser capsulotomy procedure.Method: A case report of a patient managed at the above eyedepartment. Clinical records as indicated in the patient’s case note were reported.Conclusion: Anterior hyaloidal fibrovascular proliferation is a complication which an eye surgeon should bear in mind when attending to diabetic eyes after cataract surgery. The potential danger of vitreous haemorrhage following YAG laser capsulotomy should also be borne in mind, as more centres inthe country aspire to acquire a YAG laser machine to performcapsulotomy

Ciliary Body Tumour Occurring in a Nigerian - A case report

Objective: To report the rare case of a 33-year-old female Nigerian who presented to our retina clinic with a chronic total retinal detachment and visual acuity of no light perception in her left eye. Re-attachment surgery in the eyewas not attempted as prognosis for return of vision was poor. She was later noted to harbor a progressively enlarging ciliarybody mass in the inferotemporal quadrant. Method: An observational case report was performed, withdocumentation of findings as patient was seen in the clinic.Conclusion: This is the first report of a ciliary body mass lesionin a Nigerian. The ciliary body mass could be a ciliary melanoma (ciliary body lesion being rarer than a choroidal mass) but other benign differential diagnoses must be borne in mind. Enucleation and histological assessment of the specimen will give the definitive diagnosis. Difficulties with patientacceptance of enucleating a non seeing eye though harboring a potentially harmful disease still abound in our environment

Outcome of Lens-Sparing Vitrectomy for Infantile Post-Traumatic Amblyogenic Vitreous Haemorrhage: A case report

The visual outcome after bilateral lens-sparing 3-port pars planavitrectomy in a case of post-traumatic vitreous haemorrhagein an infant is reported. Although it is possible to perform avitrectomy procedure via a pars plana approach in infantswithout compromise to the lens for the treatment ofamblyogenic vitreous opacity, such as vitreous haemorrhage,the visual outcome could be poor in cases associated withtrauma owing to possible structural damage to the macular,the optic nerve and other more posterior visual pathway

Comparison of the techniques of Trabeculectomy in intraocular pressure control - a 5 year review

Aims and Objectives: To review the effectiveness of the various techniques of trabeculectomy used at the Eye Foundation Hospital Lagos. Materials and Methods: A retrospective study of all consecutive trabeculectomies done from 1995 to 2000 was carried out. 183 eyes of 130 patients were classified into 4 groups, based on the type of technique used. Group A: Trabeculectomy using a fornix or limbal-based conjuctival flap and scleral flap without 5-fluorouracil (5-FU). Group B: Trabeculectomy with 5-fluorouracil. (5-FU). Group C: Modification of trabeculectomy by triangular sclerectomy from the lateral sides of the scleral flap with 5-FU (modified trabeculectomy with 5-FU). Group D: Modified trabeculectomy without 5-FU. The number of eyes in each group was: Group A - 20, Group B - 113, Group C - 18 and Group D - 32. The information obtained formed the database for analysis using EpiInfo 6. Main Outcome Measures: Intraocular pressure maintained below 15mmHg is classified as absolute success. Intraocular pressure between 16 and 20mmHg, with or without medication, is classified success, while over 20mmHg is considered as failure. The other outcome measures are mean intraocular pressure and the number of anti-glaucoma drugs used post-operatively. Results: During the five-year period, the mean intraocular pressure was consistently lowest in group C, followed by group D, group B, and group A, in order of increasing mean intraocular pressure. The mean intraocular pressure was lower than 15mmHg in all the groups at the end of the 5-year period. The number of patients on medication was reduced from 173 preoperative to 42 (0.23%) postoperatively. Conclusions: Modification of the scleral flap yielded a better intraocular-pressure lowering effect. Long-term drainage was further improved by 5-fluorouracil enhancement. Key words: trabeculectomy, intraocular oressure, 5-fluorouracil, sclerectomy Nigerian Journal of Ophthalmology Vol 12(2) 2004: 56-5

Mitapivat in adult patients with pyruvate kinase deficiency receiving regular transfusions (ACTIVATE-T): a multicentre, open-label, single-arm, phase 3 trial.

Mitapivat, an oral activator of pyruvate kinase (PK) in red blood cells (RBCs), has shown significant improvements in haemoglobin and haemolysis among patients with pyruvate kinase deficiency who were not receiving regular transfusions. We aimed to evaluate the efficacy and safety of mitapivat in adults with pyruvate kinase deficiency receiving regular transfusions. ACTIVATE-T was an open-label, single-arm, phase 3 trial conducted in 20 centres across Europe, North America, and Asia. Eligible participants were adults (aged ≥18 years) with a clinical laboratory confirmation of pyruvate kinase deficiency receiving regular transfusions (at least six episodes in the previous year). Participants received oral mitapivat during a 16-week dose-optimisation period (5 mg, 20 mg, 50 mg twice daily) and 24-week fixed-dose period. The primary endpoint was a reduction in transfusion burden (≥33% reduction in number of RBC units transfused during the fixed-dose period, compared with the participant's individual historical transfusion burden, standardised to 24 weeks). Efficacy and safety were assessed in all participants who received at least one dose of mitapivat. This trial is registered with ClinicalTrials.gov, NCT03559699, and is complete. Between June 26, 2018, and Feb 4, 2020, 27 participants (20 [74%] female and seven [26%] male; 20 [74%] White, three [11%] Asian, and four [15%] not reported) were enrolled and received at least one dose of mitapivat. Median duration of exposure to mitapivat was 40·3 weeks (IQR 40·0-41·3). A reduction in transfusion burden by at least 33% was found in ten (37%) participants (95% CI 19-58; p=0·0002). The most common treatment-emergent adverse events were increase in alanine aminotransferase (ten [37%] participants), headache (ten [37%]), increase in aspartate aminotransferase (five [19%]), fatigue (five [19%]), and nausea (five [19%]). Two grade 3 treatment-emergent adverse events were related to study treatment: joint swelling (one participant [4%]) and an increase in aspartate aminotransferase (one participant [4%]). Three participants had serious treatment-emergent adverse events, none related to the study treatment: increased blood triglycerides, ovarian cyst, and renal colic (each in one participant [4%]). No treatment-related deaths were observed. Mitapivat represents a novel therapy that can reduce transfusion burden in some adults with pyruvate kinase deficiency receiving regular transfusions, and is the first disease-modifying agent approved in this disease. Agios Pharmaceuticals