Clinical management of hyphaema

Hyphaema is the presence of red blood cells in the anterior chamber. A minimal amount of tiny red blood cells suspended in the aqueous humour is termed a microhyphaema. Microhyphaema may be visible only with the slit lamp, in the form of eryth-rocytes floating and circulating in the aqueous humour. Slightly larger amounts of red blood cells settle as variously shaped masses on the surface of the iris, lens or vitreous. Still larger volume of red blood cells gravitates to the anterior aspect of the interior chamber, producing a grossly visible layered hyphaema, which may be partial or complete. The management of hyphaema can present a challenge to a clinician, because medical treatment is of little value for hyphaema itself but is useful for complications. South African Family Practice Vol. 48 (10) 2006: pp. 60-6

Effect of Maternal HIV-1 Status and Antiretroviral Drugs on Haematological Profiles of South African Infants in Early Life

Maternal HIV-1 status and antiretroviral drug exposure may influence the haematological profiles of infants. We recruited infants from 118 uninfected control women and from 483 HIV-1 infected women who received no antiretroviral drugs (n=28), or received single-dose Nevirapine (sdNVP) (n=424) or triple-drug combination therapy (n=31) to reduce HIV-1 transmission. Blood was drawn from infants within 24 hours of delivery or 6-12 weeks post-delivery and full blood counts performed using a fully automated AcT-5-diff haematology analyser and reference controls. Exposed uninfected (EU; no NVP) differed from control infants only in having lower basophil counts and percentages. In all infant groups, leukocyte profiles showed characteristic quantitative changes with age in the first 6 weeks of life. HIV-1 infected infants displayed by 6 weeks elevations in white blood cells, lymphocyte, monocyte and basophil counts, and monocyte and basophil percentages, when compared to EU infants. At birth EU NVP-treated infants exhibited elevated monocyte percentages and counts and basophil counts that did not persist at 6 weeks. Interestingly, EU newborns of mothers with high CD4 counts (> 500 cells/μl) that had taken sdNVP had significantly elevated white blood cell, monocyte and basophil counts when compared to newborn infants of mothers with similar CD4 counts that had not taken sdNVP; this was not evident in infants of mothers with CD4 counts <200 cells/μl. These previously undescribed features may affect immune response capability in early life and clinical consequences of such changes need to be further investigated

Poor final visual outcome after traumatic hyphema: A retrospective study of associated factors

OBJECTIVES: To determine the factors associated with a poor final visual outcome following a non-perforating traumatic hyphema. METHODS: The in-patient records of all traumatic hyphema patients admitted to the Department of Ophthalmology of the Hamad Medical Centre (HMC) in Doha, Qatar, were retrospectively reviewed for a four-year period from January 2004 to March 2008. One hundred and seventeen patients who did not meet the exclusion criteria were divided into two groups based on their final visual outcome post-treatment. Group 1 (good outcome) consisted of 100 patients with a visual acuity (VA) of 6/18 or better and group 2 (worse outcome) consisted of 17 patients with a VA of less than 6/18. The two groups were compared to determine the factors associated with a poor final visual outcome. RESULTS: Group 2 patients had an 82.3% incidence of complications after a traumatic hyphema compared with a 21% incidence in group 1. Of these complications, secondary glaucoma and rebleeding were significantly associated with a worse final visual outcome. Trauma from projectiles or blows did not differ significantly in their effect on the final visual outcome, although blow injuries had a greater impact on the final visual outcome. Posterior segment injuries were associated with a worse visual outcome. CONCLUSION: It was concluded that secondary glaucoma, rebleeding, and posterior segment injuries are factors associated with a poor final visual outcome