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AlSemari MA, AlZahrani F, Ahad M, AlHussain HM, AlSulaiman H, AlThagib R, Strianese D, AlSheikh O. Clinical use of cryopreserved ultra-thick human amniotic membrane for anophthalmic socket contracture. Eur J Ophthalmol 2024; 34:672-677. [PMID: 37710983 DOI: 10.1177/11206721231202540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
PURPOSE To study the use of ultra-thick human amniotic membrane for management anophthalmic socket contracture. METHODS A prospective study done at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Thirty-six patients (45 eyelids) were involved. Contracted socket caused by trauma, previous surgery or radiotherapy, delay in use of prosthesis, Congenital Anophthalmia/Microphthalmia, and Anophthalmia secondary to Enucleation/Evisceration were included in the study. RESULTS Thirty-three patients (42 eyelids) underwent fornix reconstruction with cryopreserved ultra-thick human amniotic membrane. Mean ± SD age at surgery was (40.90 ± 17.32) years. Mean follow up was 10.5 months. Grade II fornix contracture was the most common type in 23 (54.8%) eyelids. The most common involved primary diagnosis was Anophthalmia secondary to Enucleation/Evisceration (n = 13). The incidence of pyogenic granuloma (PG) after surgery was seen in 8 eyelids (19.0%). CONCLUSION Anophthalmic contracted socket secondary to significant history of multiple PG excision (> 5 times) and secondary to enucleation/evisceration were associated with good surgical outcome. Cryopreserved ultra-thick human amniotic membrane is an ideal material for the management of anophthalmic socket contracture.
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Affiliation(s)
- Mohammad A AlSemari
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Fatimah AlZahrani
- Eye Bank Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Muhammad Ahad
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hailah M AlHussain
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hamad AlSulaiman
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Rawan AlThagib
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Diego Strianese
- Department of Neuroscience, School of Medicine and Surgery, University of Naples Federico II, Italy
| | - Osama AlSheikh
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Alsheikh O, Alzaaidi S, Vargas JM, Al-Sharif E, Alrajeh M, AlSemari MA, Alhommadi A, Alsaati A, Aljwaiser N, Alshahwan E, Abdulhafiz M, Elsayed R, Müller-Lierheim WGK. Effectiveness of 0.15% hylan A eye drops in ameliorating symptoms of severe dry eye patients in Saudi Arabia. Saudi J Ophthalmol 2022; 35:293-298. [PMID: 35814996 PMCID: PMC9266482 DOI: 10.4103/sjopt.sjopt_218_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/02/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of the HYLAN A study was to investigate if symptoms and/or signs of patients suffering from severe dry eye disease (DED) in Saudi Arabia can be improved by substituting individually optimized artificial tear therapy by high molecular weight hyaluronan (HMWHA) eye drops. METHODS The HYLAN M study, a multicenter prospective randomized open-label study, was performed in 11 centers in eight countries. Patients suffering from severe DED were electronically randomized in two parallel arms. patients with symptoms of at least ocular surface disease index (OSDI) 33 and corneal fluorescein staining (CFS) of at least Oxford grade 3 were included . The patients in the control group continued with their individual optimized therapy as by the time of inclusion. The patients in the hylan A group replaced their individual lubricant eye drops by preservative-free eye drops containing 0.15% hylan A. The total OSDI scores as well as the OSDI subscores for pain and for visual disturbances of each patient at baseline, at 4 weeks, and at 8 weeks of treatment was used to analyse the improvement of symptoms. We focus and report the results obtained at the two study centers in Riyadh ,Saudi Arabia (King Khaled Eye Specialist Hospital and Riyadh Military Hospital). RESULTS A total of 13 patients were included in the study. The majority of the study participants were middle aged (40-65 years). Overall, female patients accounted for 76.9% of all study participants. At the initiation of the study, both hylan A and control groups had relatively similar total OSDI scores together with pain and vision subscores. At 4-week follow-up, both groups demonstrated a noticeable decrease in all study variables. Nevertheless, the OSDI scores improved significantly in the group of patients treated with hylan A eye drops at 8 weeks, whereas the scores increased in the control group. CONCLUSION Saudi Arabia has a very high prevalence of patients with severe dry eye disease. Ethnicity, climate, and a high incidence of diabetes mellitus may contribute to this situation. Lubricant eye drops frequently do not provide adequate relief from ocular pain and instable vision in severe chronic ocular surface disease. High molecular weight hyaluronan (HMWHA) eye drops provide superior relief of symptoms of patients suffering from severe DED. This includes ocular pain as well as unstable vision.
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Affiliation(s)
- Osama Alsheikh
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia,Address for correspondence: Dr. Osama Alsheikh, Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. E-mail:
| | - Sultan Alzaaidi
- Department of Ophthalmology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia,Department of Medical Services, Ministry of Defense and Aviation, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Jose M. Vargas
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia,Department of Ophthalmology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Eman Al-Sharif
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia,Department of Ophthalmology, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mohammed Alrajeh
- Department of Surgery, Ophthalmology Division, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammad A. AlSemari
- Oculoplastics and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Anoud Alsaati
- Department of Ophthalmology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia,Department of Medical Services, Ministry of Defense and Aviation, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Nouf Aljwaiser
- Department of Ophthalmology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia,Department of Medical Services, Ministry of Defense and Aviation, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Eman Alshahwan
- Department of Ophthalmology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia,Department of Medical Services, Ministry of Defense and Aviation, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Mona Abdulhafiz
- Department of Ophthalmology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia,Department of Medical Services, Ministry of Defense and Aviation, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Rashad Elsayed
- Department of Ophthalmology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia,Department of Medical Services, Ministry of Defense and Aviation, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
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AlSemari MA, Strianese D, Abu Safieh L, Al Hussain H, Abedalthagafi M, Edward DP. Expression of Programmed Cell Death-L1 (PD-L1) Protein and Mismatch Repair Mutations in Orbital Tumours-a Pilot Study. Eur J Ophthalmol 2021; 32:3097-3102. [PMID: 34931541 DOI: 10.1177/11206721211066203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Programmed cell death protein 1 (PD-1) and DNA mismatch repair (MMR) deficiency play an important role in tumour progression and response to treatment.Both markers have been studied in some ocular tumours but little is known about these markers in orbital tumours. This pilot study reports on PD-L1 expression and MMR mutations using next generation sequencing (NGS) in specific orbital tumours. METHODS We reviewed surgical specimens from patients with rhabdomyosarcoma, adenoid cystic carcinoma (ACC), pleomorphic adenoma (PA) and biopsy negative tissue from orbital tumours used as a control. immunohistochemistry (IHC) was performed on Formalin fixed paraffin embedded tissue using a PD-L1 antibody. DNA was extracted for targeted gene panel NGS of the MMR genes PMS2, MLH1, MSH6 and MSH2. RESULTS The study included 17 orbital specimens. Scattered membrane PD-L1 staining was noted in 3/6 rhabdomyosarcoma specimens without an accompanying lymphocytic infiltrate. PD-L1 immunostaining was absent in 3/3 ACC, and 5/6 PA specimens. PD-L1 immunostaining was not detected in 2/2 control specimens. 4/17 samples shared the same pathogenic mutation in the MLH1 gene, including 3/6 rhabdomyosarcoma and 1/3 ACC samples. 1/6 PA samples had a mutation in MSH6. CONCLUSIONS Our study demonstrated scattered, non-quantifiable or absent PD-L1 staining in a limited sample of orbital tumours suggesting that PD-1/PD-L1 inhibitor therapy may not be useful in treatment of malignant orbital tumours (rhabdomyosarcoma and ACC) when refractory to conventional therapy. Our pilot study suggest that PD-L1/MMR axis might not play a major role in the pathogenesis of primary orbital tumour.
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Affiliation(s)
| | - Diego Strianese
- 46670King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Neuroscience, University of Naples Federico II School of Medicine and Surgery, Italy
| | - Leen Abu Safieh
- Genomic Research Department, 37849King Fahad Medical City, Riyadh, Saudi Arabia.,Saudi Human Genome Project, 83527King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | | | - Malak Abedalthagafi
- Genomic Research Department, 37849King Fahad Medical City, Riyadh, Saudi Arabia.,Saudi Human Genome Project, 83527King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Deepak P Edward
- 46670King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicine12247, Chicago, USA
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AlSemari MA, Al Owaifeer AM, AlMubarak F, Turjoman A, Osman EA. ExPress mini shunt device with trabeculectomy surgery in patients with uncontrolled glaucoma of Middle Eastern descent. Saudi J Ophthalmol 2021; 34:177-181. [PMID: 34085009 PMCID: PMC8081089 DOI: 10.4103/1319-4534.310416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 09/20/2020] [Accepted: 10/16/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE: The aim of this study is to assess the efficacy and safety of ExPress mini shunt in glaucoma patients of Middle Eastern descent. METHODS: This is a prospective cohort study. Uncontrolled glaucoma patients were subjected to ExPress mini-shunt implant. Pre- and post-operative glaucoma clinical indices were measured and compared. Both intra- and postoperative complications and surgical success rates were assessed. In addition to comparing a group of combined ExPress mini-shunt implant with cataract surgery versus ExPress mini-shunt implant alone. RESULTS: A total of 35 eyes of 31 patients were involved. The most common type of glaucoma was primary open-angle glaucoma in 13 eyes (37.1%). Fourteen eyes (40.0%) were combined ExPress device with cataract surgery. The mean intraocular pressure (IOP) (±standard deviation) at the last visit dropped from 24.6 mmHg (±8.3) to 13.9 mmHg (±4.5). There was a significant reduction in the number of postoperative glaucoma medications from 3.0 ± 0.5 to 1.3 (±0.7). In cases combined with cataract extraction, the patients required fewer anti-glaucoma medications. Complete success was achieved in 22 eyes (63%) and qualified success was achieved in 9 eyes (26%), whereas 4 eyes (11%) were considered a failure. The two most common complications encountered were hypotony (28.6%) and hyphema (11.4%). CONCLUSION: Among the studied population of patients, ExPress offers IOP reduction that is comparable to reported rates following standard trabeculectomy. Postoperative hyphema was encountered at a slightly higher rate.
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Affiliation(s)
- Mohammad A AlSemari
- Glaucoma Division, King Khaled Eye Specialist Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Adi M Al Owaifeer
- Faculty of Ophthalmology, College of Medicine, King Faisal University, Al Hofuf, Al-Hasa, Saudi Arabia
| | - Faisal AlMubarak
- Department of Ophthalmology, Glaucoma Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulsalam Turjoman
- Department of Ophthalmology, Glaucoma Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Essam A Osman
- Department of Ophthalmology, Glaucoma Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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AlSemari MA, Perrotta M, Russo C, Alkatan HM, Maktabi A, Elkhamary S, Crescenzo RMD, Mascolo M, Elefante A, Rombetto L, Capasso R, Strianese D. Orbital myeloid sarcoma (chloroma): Report of 2 cases and literature review. Am J Ophthalmol Case Rep 2020. [PMID: 32775766 DOI: 10.1016/j.ajoc.2020.100806.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022] Open
Abstract
Purpose Myeloid sarcoma (MS) of the orbit is an uncommon condition in occurring in children, generally coupled to myeloproliferative neoplasms. Observations We describe two rare cases of orbital MS in young boys with aggressive local symptoms but without evidence of acute myeloid leukemia (AML), both patients underwent orbitotomy for gross-tumor resection and biopsy. At follow up, there was no evidence of recurrence nor evolution of the myeloproliferative neoplasms clinically and by radiological and laboratory work-up. We also provide a detailed description of the magnetic resonance imaging presentation, with an extensive pathological analysis correlation. Conclusions and importance A comprehensive revision of the literature on isolated orbital MS was carried out with particular emphasis on clues for differential diagnosis and treatment options, stressing the need to consider MS even in the absence of sign and symptoms of an underlying myeloproliferative disorders.
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Affiliation(s)
| | - Marianna Perrotta
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy
| | - Camilla Russo
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy
| | - Hind M Alkatan
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - A Maktabi
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - S Elkhamary
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Rosa Maria Di Crescenzo
- Department of Advanced Biomedical Sciences - Pathology Unit, University "Federico II", Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences - Pathology Unit, University "Federico II", Naples, Italy
| | - Andrea Elefante
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy
| | - Luca Rombetto
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University "Federico II", Naples, Italy
| | - Raffaella Capasso
- Department of Medicine and Health Sciences "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy
| | - Diego Strianese
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Institute of Ophthalmology, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
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AlSemari MA, Maktabi A, AlSamnan MS, Alrajeh MS, Strianese D. Conjunctival Pediatric Follicular Lymphoma: Case Report and Literature Review. Ophthalmic Plast Reconstr Surg 2019; 36:e14-e15. [PMID: 31876675 DOI: 10.1097/iop.0000000000001500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Follicular lymphoma (FL) is the second most commonly reported B-cell lymphoma and accounts for 6% of all orbital lymphomas. FL presentation in the pediatric population is rare. This study reported an 18-year-old male with a pink elevated lesion in the conjunctiva of the left eye and normal ocular parameters. Following a complete excisional biopsy, the lesion was oval and smooth grossly and showed dense proliferation with a high nuclear-cytoplasmic ratio microscopically. Immunohistochemical studies revealed positive CD20 and bcl-6 while bcl-2 was negative, which is a common feature for pediatric FL in contrast to bcl-2 positivity found by immunohistochemistry in FL occurring in adult patient population. No signs of recurrence were observed over 2 years of follow-up. This study adds a new case to the existing few reports. Interestingly, all reported cases were males including the patient, mean duration of onset was 5 months, and mean duration of follow-up was 18.4 months. The authors emphasize that total surgical excision with close monitoring is reasonable management of such clinical entity.Follicular lymphoma (FL) is a rare entity in pediatric patients. Six cases have been reported with conjunctival FL in the literature (age between 6 and 21 years). Interestingly, all of them were male including the patient.
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Affiliation(s)
| | | | | | - Mohammed S Alrajeh
- Department of Surgery, Ophthalmology Division, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Diego Strianese
- King Khaled Eye Specialist Hospital.,Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II., Naples, Italy
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