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Kabaalioglu Guner M, Guner ME, Oray M, Tugal-Tutkun I. Correlation between Widefield Fundus Fluorescein Angiography Leakage Score and Anterior Chamber Flare in Behçet Uveitis. Ocul Immunol Inflamm 2024; 32:54-61. [PMID: 36538808 DOI: 10.1080/09273948.2022.2152700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022]
Abstract
AIMS To investigate the correlation between widefield fundus fluorescein angiography (WF-FA) and anterior chamber laser flare photometry (LFP-flare) in Behçet uveitis (BU). METHODS Patients with BU who underwent Heidelberg WF-FA between March 2016 and March 2018 were included. Demographics, ocular findings, LFP-flare, central macular thickness were retrospectively analyzed. RESULTS Eighty-six patients (162 eyes) were included. There was a high correlation between WF-FA leakage score and LFP-flare (rho: 0.691, p < .001). For a flare value of 5.75 ph/ms or higher, the sensitivity for predicting angiographic leakage was 70% and the specificity was 94% (AUC: 0.897, p < .001). Flare values that were equal or above 7.6 ph/ms were found to be 100% specific for leakage in the WF-FA. CONCLUSION A strong correlation was found between WF-FA leakage and LFP-flare in patients with BU. High LFP-flare levels indicate subclinical posterior segment inflammation in clinically inactive BU.
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Affiliation(s)
- Melis Kabaalioglu Guner
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Eren Guner
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Merih Oray
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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2
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Evereklioglu C, Polat OA, Gulmez Sevim D, Gahramanov K, Sener H, Sonmez HK, Arda H, Er Arslantas E, Horozoglu F. Choroidal vascularity index and submacular choroidal thickness in patients with Behçet disease assessed with enhanced-depth OCT. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023:S0008-4182(23)00274-0. [PMID: 37748755 DOI: 10.1016/j.jcjo.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/02/2023] [Accepted: 09/01/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE To investigate changes in the choroid using the choroidal vascularity index (CVI) and choroidal thickness (ChT) in patients with ocular (OBD) and non-ocular Behçet disease (non-ocular BD). METHODS Sixty-eight OBD patients, 40 non-ocular BD patients, and 40 healthy control subjects were included. ChT was measured using optical coherence tomography (OCT) in enhanced-depth imaging (EDI) mode (EDI-OCT; sub-foveal ChT at 1000 μm, nasal ChT at 1000 μm temporal ChT). The CVI value (%) was calculated by dividing the luminal area by the sub-foveal total choroidal area. RESULTS The mean sub-foveal ChT (297 ± 68 µm), nasal ChT (261 ± 66 µm), and temporal ChT (272 ± 68 µm) in eyes with OBD and the mean sub-foveal ChT (286 ± 31 µm), nasal ChT (266 ± 29 µm), and temporal ChT (269 ± 32 µm) in eyes with non-ocular BD were significantly decreased compared with those regions in healthy control subjects (333 ± 69, 301 ± 75, and 312 ± 70 µm, respectively). Additional subgroup analysis was performed for active OBD, inactive OBD, non-ocular BD, and the control group, and in pairwise comparisons, the CVI value was significantly decreased in both active (64.3 ± 3.1) and inactive OBD groups (64.2 ± 4.5) compared with healthy control subjects (67.2 ± 3.6; p = 0.026 and p < 0.001, respectively). There was no significant difference between non-ocular BD (65.9 ± 3.4) and control subjects (67.2 ± 3.6) for CVI measurements (p > 0.05). CONCLUSIONS Decreased CVI values in OBD suggest that uveitis affects the choroidal vasculature and that perfusion is affected by uveitis, whereas systemic inflammation in non-ocular BD does not affect them. In addition, the choroid in uveitis is affected by the chronicity of the disease rather than disease activity. ChT measurements and CVI values may be a novel and robust prognosticating biomarker to evaluate choroidal vasculature and to monitor disease progression in OBD patients because EDI-OCT is a non-invasive imaging modality. However, CVI does not seem to be a biomarker for monitoring of disease activity or treatment efficacy.
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Affiliation(s)
- Cem Evereklioglu
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye.
| | - Osman Ahmet Polat
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Duygu Gulmez Sevim
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Kamran Gahramanov
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Hidayet Sener
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Hatice Kubra Sonmez
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Hatice Arda
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Elif Er Arslantas
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
| | - Fatih Horozoglu
- Department of Ophthalmology, Division of Uvea-Behçet Unit, Erciyes University Medical Faculty, Kayseri, Türkiye
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3
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Agrawal R, Weng RC, Fonollosa A, Giralt L, Artaraz J, Yang P, Huang F, Tan B, Schmetterer L, Sen A, Gupta V, Xin W. Outcome Measures for Disease Monitoring in Intraocular Inflammatory and Infectious Diseases (OCTOMERIA): Understanding the Choroid in Uveitis with Optical Coherence Tomography (OCT). Ocul Immunol Inflamm 2023; 31:374-392. [PMID: 35201909 DOI: 10.1080/09273948.2022.2026414] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare imaging modalities for the choroid of the eye, and evaluate various choroidal changes in uveitides entities. METHODS A comprehensive systematic literature review was conducted looking at current imaging modalities available to assess choroid architecture and commonly used parameters available to qualify and quantify choroidal changes, before looking at specific uveitides entities with choroidal involvement which have been broadly separated into non-infectious and infectious in etiology. RESULTS We describe the various modalities currently available to evaluate the choroid of the eye such as Ultrasound B Scan, ICGA, and OCT. Choroidal changes in various ocular and systemic diseases such as Behcet's Disease, Sarcoidosis, Syphillis, Tuberculosis, and many more have been reported and published. CONCLUSION Multiple choroidal tomographic and angiotomographic findings have been demonstrated for evaluation in uveitis. These findings can manifest in multiple ocular and systemic diseases, and can be illustrated using the various imaging modalities at present. Future advancements in choroidal imaging would help to adapt these findings into parameters for clinical practice to properly evaluate these ocular and systemic diseases.
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Affiliation(s)
- Rupesh Agrawal
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Duke NUS Medical School, Singapore, Singapore
| | - Rei Chern Weng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Alex Fonollosa
- Department of Ophthalmology, BioCruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain.,Retina Department, Instituto Oftalmológico Bilbao, Bilbao, Spain
| | - Lena Giralt
- Department of Ophthalmology, BioCruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain
| | - Joseba Artaraz
- Department of Ophthalmology, BioCruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Fanfan Huang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Bingyao Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore.,School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore.,School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore.,Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.,Ocular Imaging Department, Singapore Eye Research Institute, Institute of Molecular and Clinical Ophthalmology Basel Switzerland
| | - Alok Sen
- Department of Vitreo-Retina Services, Sadguru Netra Chikitsalaya, Chitrakoot, India.,The Bodhya Eye Consortium, India
| | - Vishali Gupta
- Department of Vitreoretina, Post Graduate Institute of Medical Education and Research, Chitrakoot, India
| | - Wei Xin
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
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4
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Tappeiner C, Heiligenhaus A. The Value of Laser Flare Photometry as a Monitoring Tool for Uveitis. Klin Monbl Augenheilkd 2022; 240:662-668. [PMID: 36257601 DOI: 10.1055/a-1962-7422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Laser flare (LF) photometry (P) is used to quantify the protein concentration in the aqueous humor, and therefore assess the blood-aqueous humor barrier. LFP is more reliable than the clinical assessment of the Tyndall effect, and is thus especially useful in the follow-up of uveitis patients. In active uveitis, LFP correlates well with the anterior chamber cell grading. Various studies have shown that high LF values are associated with an increased risk of uveitic complications, such as macular edema, glaucoma, and posterior synechiae. LFP can also be used to assess the response to anti-inflammatory treatments as well as the optimal timing and selection of the surgical technique for intraocular surgeries.
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Affiliation(s)
- Christoph Tappeiner
- Augenklinik, Pallas Klinik, Olten, Schweiz.,Klinik für Augenheilkunde, Universitätsklinikum Duisburg-Essen, Essen, Deutschland.,Universität Bern, Schweiz
| | - Arnd Heiligenhaus
- Augenabteilung, St. Franziskus Hospital, Münster, Deutschland.,Universität Duisburg-Essen, Essen, Deutschland
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Güven YZ, Akay F, Akmaz B, Solmaz D, Gercik Ö, Akar S. Subclinical alterations in retinal layers and microvascular structures with OCTA in ANCA-associated vasculitides. Ocul Immunol Inflamm 2022; 31:520-525. [PMID: 35133921 DOI: 10.1080/09273948.2022.2038206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Using OCTA, investigate the capillary network and retinal layers in granulomatosis with ANCA associated vasculitis (AAV) patients who did not manifest apparent ocular involvement and compare the findings with healthy subjects. METHOD The present study, which is designed as a prospective and case-control study, includes 22 AAV patients and 35 control participants. OCTA parameters were noted. RESULTS In most of the regions, AMT, RNFL and GC-IPL thicknesses were significantly lower in the AAV group than in the control group. While the vascular indices were lower in the AAV group, except for the center 1 mm region, the FAZ parameters were similar between the two groups. CONCLUSION In AAV patients, subclinical changes in the retinal layers and superficial vascular plexus have been shown. In the future maybe a non-invasive method such as OCTA will become available in scoring systems for prognosis determination in AAV.
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Affiliation(s)
- Yusuf Ziya Güven
- Atatürk Educating and Research Hospital, Department of Ophthalmology, Izmir Katip Çelebi University, İzmir, Turkey
| | - Fahrettin Akay
- Atatürk Educating and Research Hospital, Department of Ophthalmology, Izmir Katip Çelebi University, İzmir, Turkey
| | - Berkay Akmaz
- Atatürk Educating and Research Hospital, Department of Ophthalmology, Izmir Katip Çelebi University, İzmir, Turkey
| | - Dilek Solmaz
- Atatürk Educating and Research Hospital, Department of Rheumatology, Izmir Katip Çelebi University, İzmir, Turkey
| | - Önay Gercik
- Atatürk Educating and Research Hospital, Department of Rheumatology, Izmir Katip Çelebi University, İzmir, Turkey
| | - Servet Akar
- Atatürk Educating and Research Hospital, Department of Rheumatology, Izmir Katip Çelebi University, İzmir, Turkey
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Baharani A, Errera MH, Jhingan M, Samanta A, Agarwal A, Singh SR, Reddy P RR, Grewal DS, Chhablani J. Choroidal Imaging in uveitis: an update. Surv Ophthalmol 2022; 67:965-990. [PMID: 35007618 DOI: 10.1016/j.survophthal.2022.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/27/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
An important goal of advancements in ocular imaging algorithms and devices has been to improve the image acquisition and resolution of deeper ocular tissues, namely the choroid and its vasculature that are otherwise inaccessible to direct clinical examination. These advancements have contributed to the understanding of the pathophysiology of a number of ocular inflammatory conditions. We focuse on the imaging characteristics of clinical conditions where imaging the choroid has improved or radically changed the understanding of the disease, has helped in differentiation of phenotypically similar but distinct lesions, and where imaging features have proven vital formonitoring disease activity. The last two decades have seen some major developments in ocular imaging relevant to uveitis. The current review addresses both the imaging characteristics and their interpretation on conventional modalities such as fundus photography, fluorescein angiography, indocyanine green angiography and fundus autofluorescence and the recent additions in the armamentarium including optical coherence tomography (OCT) with enhanced depth imaging, swept-source OCT, and OCT angiography.
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Affiliation(s)
- Abhilasha Baharani
- Uveitis Services, Neoretina Eyecare Institute, Ramchander House, Chapel Road, Nampally, Hyderabad, India. 500001
| | - Marie-Helen Errera
- Department of Ophthalmology, Department of Ophthalmology, University of Pittsburgh Medical Center, 203 Lothrop Street, Pittsburgh, PA, 15213
| | - Mahima Jhingan
- Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA
| | - Anindya Samanta
- Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Aniruddha Agarwal
- Department of Ophthalmology, Advanced Eye Center, PGIMER, Chandigarh, India
| | - Sumit Randhir Singh
- Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA
| | - Raja Rami Reddy P
- Retina Services, Neoretina Eyecare Institute, Ramchander House, Chapel Road, Nampally, Hyderabad, India. 500001
| | - Dilraj S Grewal
- Department of Ophthalmology, Duke University School of Medicine, 2351 Erwin Rd Durham, NC 27705-4699
| | - Jay Chhablani
- Department of Ophthalmology, Department of Ophthalmology, University of Pittsburgh Medical Center, 203 Lothrop Street, Pittsburgh, PA, 15213.
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7
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Işık MU, Yalçındağ NF. Comparison of the efficacy of nepafenac 0.1% in quiescent Behçet's uveitis and non-uveitic healthy patients after phacoemulsification surgery. Int Ophthalmol 2020; 40:2345-2351. [PMID: 32419106 DOI: 10.1007/s10792-020-01419-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 05/05/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the efficacy of nepafenac on anterior chamber flare and intraocular pressure(IOP) in healthy (group 1) and uveitic eyes (group 2) undergoing cataract surgery. METHODS A retrospective, consecutive case series study. RESULTS Among 54 the patients, 14 had a history of uveitis. The groups were similar in age and gender. There were significant changes in flare values in both groups. When the temporal changes of flare values were compared, there was no difference between the two groups. There were no significant changes in IOP values in both group. When the temporal changes of IOP values were compared, there was no difference between the groups. CONCLUSIONS Nepafenac 0.1% has been shown to be effective in suppressing inflammation after cataract surgery in uveitic eyes as well as in healthy eyes. In addition, it has been observed that it does not increase intraocular pressure in both healthy and uveitic eyes and it is safe to use with this regard.
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Affiliation(s)
- Mehmed Uğur Işık
- Ophthalmology Department, Balıklıgöl State Hospital, Sanliurfa, Turkey.
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8
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Anterior segment parameters in Behçet's patients with ocular involvement. Int Ophthalmol 2020; 40:1387-1395. [PMID: 32067151 DOI: 10.1007/s10792-020-01304-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 02/07/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate anterior segment findings in Behçet's disease patients within the ocular involvement inactive period. METHODS One hundred twenty patients with Behçet uveitis in the inactive period (Behçet's disease group) and 121-age and sex matched healthy subjects (control group) were examined. Anterior segment parameters were assessed by Scheimpflug camera. RESULTS In Behçet's disease group, the mean age was 39.89 ± 10.16 years, and 55.8% of patients were male; in the control group, the mean age was 38.69 ± 14.08 years, and 56.2% of control subjects were male. Pachymetric measurements of corneal apex (523.84 ± 30.36 µ vs 540.73 ± 27.85 µ, p < 0.001) thinnest point (518.70 ± 30.75 µ vs 537 ± 28.66 µ, p < 0.001), mean corneal volume (57.90 ± 3.39 mm3 vs 59.57 ± 3.37 mm3, p < 0.001) were significantly lower and anterior elevation [5.0 (1.0-34.0) vs 2.0 (1.0-7.0) diopter(D), p < 0.001], posterior elevation [11.0 (1.0-66.0) vs 4.0 (0-22.0) D, p < 0.001)] and corneal astigmatism [1.1 (0-7.1) vs 0.7 (0.1-5.7) D, p = 0.005] were significantly higher in the Behçet's disease group than in control group. No significant difference was found in other anterior segment parameters between the Behçet's disease group and control group. Concurrent keratoconus was detected in two cases (1.7%). A statistically significant correlation was found between the corneal measurements and frequency of uveitis attacks. CONCLUSION The chronic inflammatory process associated with various proinflammatory cytokines, which play a role in the pathogenesis of keratoconus, may also contribute to a decrease in corneal thickness and corneal volume in Behçet's patients with ocular involvement.
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Abroug N, Zina S, Khairallah M, Ksiaa I, Kechida M, Ben Amor H, Khochtali S, Khairallah M. Diagnosing retinal vasculitis and its implications for treatment. EXPERT REVIEW OF OPHTHALMOLOGY 2019. [DOI: 10.1080/17469899.2019.1613153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Nesrine Abroug
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Sourour Zina
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Molka Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Imen Ksiaa
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Melek Kechida
- Internal Medicine Department, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Hager Ben Amor
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Sana Khochtali
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia
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