1
|
Ji MH, Uwaydat SH, Sallam AB. Reply. Ophthalmol Retina 2024; 8:e17. [PMID: 38456875 DOI: 10.1016/j.oret.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Marco H Ji
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sami H Uwaydat
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Ahmed B Sallam
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| |
Collapse
|
2
|
Georgiou M, Robson AG, Uwaydat SH, Ji MH, Shakarchi AF, Pontikos N, Mahroo OA, Cheetham ME, Webster AR, Hardcastle AJ, Michaelides M. RP2-Associated X-linked Retinopathy: Clinical Findings, Molecular Genetics, and Natural History in a Large Cohort of Female Carriers. Am J Ophthalmol 2024; 261:112-120. [PMID: 37977507 DOI: 10.1016/j.ajo.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE RP2-associated retinopathy typically causes severe early onset retinitis pigmentosa (RP) in affected males. However, there is a scarcity of reports describing the clinical phenotype of female carriers. We tested the hypothesis that RP2 variants manifest in female carriers with a range of functional and anatomic characteristics. DESIGN Retrospective case series. METHODS Females with disease-causing variants in RP2 were identified from investigation of pedigrees affected by RP2 retinopathy. All case notes and results of molecular genetic testing, retinal imaging (fundus autofluorescence imaging, optical coherence tomography (OCT)), and electrophysiology were reviewed. RESULTS Forty pedigrees were investigated. Twenty-nine pedigrees had obligate carriers or molecularly confirmed female members with recorded relevant history and/or examination. For 8 pedigrees, data were available only from history, with patients reporting affected female relatives with RP in 4 cases and unaffected female relatives in the other 4 cases. Twenty-seven females from 21 pedigrees were examined by a retinal genetics specialist. Twenty-three patients (85%) reported no complaints and had normal vision and 4 patients had RP-associated complaints (15%). Eight patients had normal fundus examination (30%), 10 had a tapetal-like reflex (TLR; 37%), 5 had scattered peripheral pigmentation (19%), and the 4 symptomatic patients had fundus findings compatible with RP (15%). All asymptomatic patients with normal fundus, TLR, or asymptomatic pigmentary changes had a continuous ellipsoid zone on OCT when available. The electroretinograms revealed mild to severe photoreceptor dysfunction in 9 of 11 subjects, often asymmetrical, including 5 with pattern electroretinogram evidence of symmetrical (n = 4) or unilateral (n = 1 subject) macular dysfunction. CONCLUSIONS Most carriers were asymptomatic, exhibiting subclinical characteristics such as TLR and pigmentary changes. However, female carriers of RP2 variants can manifest RP. Family history of affected females with RP does not exclude X-linked disease. The phenotypic spectrum as described herein has prognostic and counselling implications for RP2 carriers and patients.
Collapse
Affiliation(s)
- Michalis Georgiou
- From the Moorfields Eye Hospital (M.G., A.G.R., N.P., O.A.M., A.R.W., M.M.), London, United Kingdeom; University College London Institute of Ophthalmology (M.G., A.G.R., N.P., O.A.M., M.E.C., A.R.W., A.J.H., M.M.), University College London, London, United Kingdom; Jones Eye Institute (M.G., S.H.U., M.H.J., A.F.S.), University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Anthony G Robson
- From the Moorfields Eye Hospital (M.G., A.G.R., N.P., O.A.M., A.R.W., M.M.), London, United Kingdeom; University College London Institute of Ophthalmology (M.G., A.G.R., N.P., O.A.M., M.E.C., A.R.W., A.J.H., M.M.), University College London, London, United Kingdom
| | - Sami H Uwaydat
- Jones Eye Institute (M.G., S.H.U., M.H.J., A.F.S.), University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Marco H Ji
- Jones Eye Institute (M.G., S.H.U., M.H.J., A.F.S.), University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ahmed F Shakarchi
- Jones Eye Institute (M.G., S.H.U., M.H.J., A.F.S.), University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nikolas Pontikos
- University College London Institute of Ophthalmology (M.G., A.G.R., N.P., O.A.M., M.E.C., A.R.W., A.J.H., M.M.), University College London, London, United Kingdom
| | - Omar A Mahroo
- From the Moorfields Eye Hospital (M.G., A.G.R., N.P., O.A.M., A.R.W., M.M.), London, United Kingdeom; University College London Institute of Ophthalmology (M.G., A.G.R., N.P., O.A.M., M.E.C., A.R.W., A.J.H., M.M.), University College London, London, United Kingdom
| | - Michael E Cheetham
- University College London Institute of Ophthalmology (M.G., A.G.R., N.P., O.A.M., M.E.C., A.R.W., A.J.H., M.M.), University College London, London, United Kingdom
| | - Andrew R Webster
- From the Moorfields Eye Hospital (M.G., A.G.R., N.P., O.A.M., A.R.W., M.M.), London, United Kingdeom; University College London Institute of Ophthalmology (M.G., A.G.R., N.P., O.A.M., M.E.C., A.R.W., A.J.H., M.M.), University College London, London, United Kingdom
| | - Alison J Hardcastle
- From the Moorfields Eye Hospital (M.G., A.G.R., N.P., O.A.M., A.R.W., M.M.), London, United Kingdeom; University College London Institute of Ophthalmology (M.G., A.G.R., N.P., O.A.M., M.E.C., A.R.W., A.J.H., M.M.), University College London, London, United Kingdom
| | - Michel Michaelides
- From the Moorfields Eye Hospital (M.G., A.G.R., N.P., O.A.M., A.R.W., M.M.), London, United Kingdeom; University College London Institute of Ophthalmology (M.G., A.G.R., N.P., O.A.M., M.E.C., A.R.W., A.J.H., M.M.), University College London, London, United Kingdom.
| |
Collapse
|
3
|
Chauhan MZ, Ali AA, Healy J, Elhusseiny AM, Phillips PH, Sallam AB, Uwaydat SH. The impact of the COVID-19 pandemic on ocular trauma in American infants and toddlers. J AAPOS 2024; 28:103864. [PMID: 38458597 DOI: 10.1016/j.jaapos.2024.103864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/10/2023] [Accepted: 11/11/2023] [Indexed: 03/10/2024]
Abstract
PURPOSE To assess the impact of the COVID-19 pandemic on infant and toddler ocular trauma in the United States. METHODS This retrospective analysis of ocular injury data for children ≤3 years of age focused on epidemiologic trends in pediatric ocular injuries in the United States caused by consumer products from 2017 to 2021 and compared differences between pre-pandemic (2017-2019) and pandemic (2020-2021) time periods. Data were collected from the US Consumer Product Safety Commission National Electronic Injury Surveillance System, which includes emergency department visits caused by consumer product-related injuries from a nationally representative sample of hospitals. RESULTS The national-level estimate of ocular injuries in infants and toddlers was 51,250 (95% CI, 30471-72030). Most injuries occurred at home. We found a significant decline in the proportion of projectile ocular injuries from 0.89% (95% CI, 0.35-2.25) to 0.12% (95% CI, 0.03-0.45) (P = 0.037). The proportion of patients diagnosed with chemical-burn-related injuries increased significantly, from 23.34% (95% CI, 19.73-27.38) in the pre-pandemic period to 31.63% (95% CI, 26.98-36.69) in the pandemic period (P = 0.048), with 71.75% (95% CI, 65.25-77.46) due to cleaning products. After adjusting for confounding variables, the odds of sustaining a chemical-burn-related injury in the post-pandemic period were 1.51 times higher than in the pre-pandemic period (95% CI, 1.10-2.08). CONCLUSIONS The proportion of children diagnosed with chemical-burn-related injuries increased significantly in the post-pandemic period, with a large portion due to cleaning products.
Collapse
Affiliation(s)
- Muhammad Z Chauhan
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Arsalan A Ali
- Burnett School of Medicine at Texas Christian University, Fort Worth, Texas
| | - Jack Healy
- Burnett School of Medicine at Texas Christian University, Fort Worth, Texas
| | - Abdelrahman M Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Paul H Phillips
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Ahmed B Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sami H Uwaydat
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| |
Collapse
|
4
|
Ercanbrack CW, Elhusseiny AM, Sanders RN, Santos Horta E, Uwaydat SH. Belzutifan-induced regression of retinal capillary hemangioblastoma: A case-series. Am J Ophthalmol Case Rep 2024; 33:102011. [PMID: 38374949 PMCID: PMC10875190 DOI: 10.1016/j.ajoc.2024.102011] [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: 10/26/2023] [Revised: 12/24/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
Purpose To report a series of three patients with von Hippel-Lindau (VHL) disease who demonstrated regression of their retinal hemangioblastomas (RH) using belzutifan in conjunction with photocoagulation therapy. Observations Patient 1, a 23-year-old female, presented with multiple RHs in her right eye (OD) that were lasered. Her left eye (OS) revealed a large inferotemporal RH that measured approximately 2.1 mm2. Systemic belzutifan was administered. Four months after initiation of treatment, the lesion regressed to 1.4 mm2, but belzutifan was not well-tolerated and was discontinued due to side effects. At the date of belzutifan discontinuation, the lesion measured about 1.1 mm2. Focal laser photocoagulation was applied. The lesion regressed to around 0.6 mm2. Two additional laser treatments were applied one month later. On the most recent follow-up, the lesion was completely fibrosed.Patient 2, a 32-year-old male, presented with one RH OD and two RHs OS. Belzutifan was administered for one month before the patient began experiencing side effects of the medication. Consequently, the dose of belzutifan was decreased. After one month with the lowered dose, laser coagulation was applied to OS. In the most recent follow-up, five months after the initial presentation, the lesions remain less vascularized and reduced in size.Patient 3, is a 44-year-old male with a large RH OD. Following seven months of belzutifan daily, there was a significant reduction in the RH size. Conclusions Belzutifan, a hypoxia-inducible factor inhibitor, is an FDA-approved medication for VHL disease associated with renal cell carcinoma, central nervous system hemangioblastomas, or pancreatic neuroendocrine tumors that do not require immediate surgical resection. Because of the high incidence of VHL-associated RHs, adjuvant laser photocoagulation therapy when belzutifan is suspended or withheld can allow for the regression of large lesions. In this case series, we also propose a reproducible and technically simple method to measure RH lesions size, using Optos fundus imaging.
Collapse
Affiliation(s)
- Carson W. Ercanbrack
- University of Arkansas for Medical Sciences, College of Medicine, Little Rock, AR, USA
| | - Abdelrahman M. Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Riley N. Sanders
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Erika Santos Horta
- Department of Medical Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sami H. Uwaydat
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
5
|
Yao T, Chauhan MZ, Uwaydat SH. Effect of Oral Prednisone on the Prevention and Management of Proliferative Vitreoretinopathy After Open-Globe Injury. J Vitreoretin Dis 2024; 8:168-172. [PMID: 38465352 PMCID: PMC10924585 DOI: 10.1177/24741264241229262] [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] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Purpose: To determine the impact of oral prednisone on the final visual acuity (VA) and prevention of proliferative vitreoretinopathy (PVR) in patients having pars plana vitrectomy (PPV) for globe injuries. Methods: A retrospective chart review was performed of all globe injuries with an initial repair and subsequent PPV between 2009 and 2018. Data included the initial VA, zones of injury, initial closure date, time to secondary intervention (PPV), oral prednisone (1 mg/kg/day) use, the final VA, and enucleation rate. Multivariable regression models were used to assess the impact of oral prednisone use on anatomic and functional outcomes. Results: The mean (±SD) patient age was 46.25 ±18.56 years (range, 13-92); 131 (83.9%) were men. Oral prednisone intake was recorded in 81 patients (52.3%). The prednisone group had significantly more zone 3 involvement (P = .001), worse initial VA (2.28 vs 1.92 logMAR; P = .003), and a greater mean number of surgeries (P = .020) than the no-steroids (control) group but an equivalent final logMAR VA (1.57 vs 1.52; P = .881). The prednisone group had significant VA improvement (P = .025); however, oral prednisone use did not predict the development of PVR (29.23% vs 12.90%; odds ratio [OR], 2.81; 95% CI, 0.89-8.85) or retinal detachment (27.27% vs 29.58%; OR, 0.59; 95% CI, 0.23-1.56). Conclusions: Despite a worse initial clinical presentation, patients who received oral prednisone had significant visual improvement compared with the control group. However, oral prednisone (1 mg/kg/day) use at the time of injury did not decrease the PVR rate.
Collapse
Affiliation(s)
- Tianyuan Yao
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Muhammad Z. Chauhan
- Harvey & Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sami H. Uwaydat
- Harvey & Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
6
|
Ji MH, Uwaydat SH, Sallam AB. "Plungerless" Diagnostic Anterior Chamber Paracentesis Technique. Ophthalmol Retina 2024; 8:136. [PMID: 38108676 DOI: 10.1016/j.oret.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/12/2023] [Accepted: 11/16/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Marco H Ji
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sami H Uwaydat
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Ahmed B Sallam
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| |
Collapse
|
7
|
Georgiou M, Fujinami K, Robson AG, Fujinami-Yokokawa Y, Shakarchi AF, Ji MH, Uwaydat SH, Kim A, Kolesnikova M, Arno G, Pontikos N, Mahroo OA, Tsang SH, Webster AR, Michaelides M. RBP3-Retinopathy-Inherited High Myopia and Retinal Dystrophy: Genetic Characterization, Natural History, and Deep Phenotyping. Am J Ophthalmol 2024; 258:119-129. [PMID: 37806543 DOI: 10.1016/j.ajo.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE To examine the genetic and clinical features and the natural history of RBP3-associated retinopathy. DESIGN Multi-center international, retrospective, case series of adults and children, with moleculraly confirmed RBP3-asociated retinopathy. METHODS The genetic, clinical, and retinal imaging findings, including optical coherence tomography (OCT) and fundus autofluorescence (FAF), were investigated both cross-sectionally and longitudinally. The results of international standard full-field electroretinography (ERG) and pattern electroretinography (PERG) were reviewed. RESULTS We ascertained 12 patients (5 female and 7 male) from 10 families (4 patients previously reported). Ten novel disease-causing RBP3 variants were identified. Ten patients were homozygous. The mean age (±SD, range) of the group was 21.4 years (±19.1, 2.9-60.5 years) at baseline evaluation. All 12 patients were highly myopic, with a mean spherical equivalent of -16.0D (range, -7.0D to -33.0D). Visual acuity was not significantly different between eyes, and no significant anisometropia was observed. Mean best-corrected visual acuity (BCVA) was 0.48 logMAR (SD, ±0.29; range, 0.2-1.35 logMAR); at baseline. Eleven patients had longitudinal BCVA assessment, with a mean BCVA of 0.46 logMAR after a mean follow-up of 12.6 years. All patients were symptomatic with reduced VA and myopia by the age of 7 years old. All patients had myopic fundi and features in keeping with high myopia on OCT, including choroidal thinning. The 4 youngest patients had no fundus pigmentary changes, with the rest of the patients presenting with a variable degree of mid-peripheral pigmentation and macular changes. FAF showed variable phenotypes, ranging from areas of increased signal to advanced atrophy in older patients. OCT showed cystoid macular edema at presentation in 3 patients, which persisted during follow-up in 2 patients and resolved to atrophy in the third patient. The ERGs were abnormal in 9 of 9 cases, revealing variable relative involvement of rod and cone photoreceptors with additional milder dysfunction post-phototransduction in some. All but 1 patient had PERG evidence of macular dysfunction, which was severe in most cases. CONCLUSIONS This study details the clinical and functional phenotype of RBP3-retinopathy in the largest cohort reported to date. RBP3-retinopathy is a disease characterized by early onset, slow progression over decades, and high myopia. The phenotypic spectrum and natural history as described herein has prognostic and counseling implications. RBP3-related disease should be considered in children with high myopia and retinal dystrophy.
Collapse
Affiliation(s)
- Michalis Georgiou
- From Moorfields Eye Hospital (M.G., K.F., A.G.R., G.A., N.P., O.A.M., A.R.W., M.M.), London, UK; UCL Institute of Ophthalmology (M.G., K.F., A.G.R.m G.A., N.P., O.A.M., A.R.W., M.M.), University College London, London, UK; Jones Eye Institute (M.G., A.F.S., M.H.J., S.H.U.), University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kaoru Fujinami
- From Moorfields Eye Hospital (M.G., K.F., A.G.R., G.A., N.P., O.A.M., A.R.W., M.M.), London, UK; UCL Institute of Ophthalmology (M.G., K.F., A.G.R.m G.A., N.P., O.A.M., A.R.W., M.M.), University College London, London, UK; Laboratory of Visual Physiology (K.F., Y.F.-Y.), Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Anthony G Robson
- From Moorfields Eye Hospital (M.G., K.F., A.G.R., G.A., N.P., O.A.M., A.R.W., M.M.), London, UK; UCL Institute of Ophthalmology (M.G., K.F., A.G.R.m G.A., N.P., O.A.M., A.R.W., M.M.), University College London, London, UK
| | - Yu Fujinami-Yokokawa
- Laboratory of Visual Physiology (K.F., Y.F.-Y.), Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; Department of Health Policy and Management (Y.F.-Y.), Keio University School of Medicine, Tokyo, Japan
| | - Ahmed F Shakarchi
- Jones Eye Institute (M.G., A.F.S., M.H.J., S.H.U.), University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Marco H Ji
- Jones Eye Institute (M.G., A.F.S., M.H.J., S.H.U.), University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sami H Uwaydat
- Jones Eye Institute (M.G., A.F.S., M.H.J., S.H.U.), University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Angela Kim
- Jonas Children's Vision Care (A.K., M.K., S.H.T.), Departments of Ophthalmology, Pathology & Cell Biology, Columbia Stem Cell Initiative, Columbia University, and Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, New York, USA
| | - Masha Kolesnikova
- Jonas Children's Vision Care (A.K., M.K., S.H.T.), Departments of Ophthalmology, Pathology & Cell Biology, Columbia Stem Cell Initiative, Columbia University, and Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, New York, USA
| | - Gavin Arno
- From Moorfields Eye Hospital (M.G., K.F., A.G.R., G.A., N.P., O.A.M., A.R.W., M.M.), London, UK; UCL Institute of Ophthalmology (M.G., K.F., A.G.R.m G.A., N.P., O.A.M., A.R.W., M.M.), University College London, London, UK
| | - Nikolas Pontikos
- From Moorfields Eye Hospital (M.G., K.F., A.G.R., G.A., N.P., O.A.M., A.R.W., M.M.), London, UK; UCL Institute of Ophthalmology (M.G., K.F., A.G.R.m G.A., N.P., O.A.M., A.R.W., M.M.), University College London, London, UK
| | - Omar A Mahroo
- From Moorfields Eye Hospital (M.G., K.F., A.G.R., G.A., N.P., O.A.M., A.R.W., M.M.), London, UK; UCL Institute of Ophthalmology (M.G., K.F., A.G.R.m G.A., N.P., O.A.M., A.R.W., M.M.), University College London, London, UK
| | - Stephen H Tsang
- Jonas Children's Vision Care (A.K., M.K., S.H.T.), Departments of Ophthalmology, Pathology & Cell Biology, Columbia Stem Cell Initiative, Columbia University, and Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, New York, USA
| | - Andrew R Webster
- From Moorfields Eye Hospital (M.G., K.F., A.G.R., G.A., N.P., O.A.M., A.R.W., M.M.), London, UK; UCL Institute of Ophthalmology (M.G., K.F., A.G.R.m G.A., N.P., O.A.M., A.R.W., M.M.), University College London, London, UK
| | - Michel Michaelides
- From Moorfields Eye Hospital (M.G., K.F., A.G.R., G.A., N.P., O.A.M., A.R.W., M.M.), London, UK; UCL Institute of Ophthalmology (M.G., K.F., A.G.R.m G.A., N.P., O.A.M., A.R.W., M.M.), University College London, London, UK.
| |
Collapse
|
8
|
Chauhan MZ, Elhusseiny AM, Kishor KS, Sanvicente CT, Ali AA, Sallam AB, Bhattacharya SK, Uwaydat SH. Association of Primary Open-Angle Glaucoma with Diabetic Retinopathy among Patients with Type 1 and Type 2 Diabetes: A Large Global Database Study. Ophthalmology 2024:S0161-6420(24)00052-6. [PMID: 38215989 DOI: 10.1016/j.ophtha.2024.01.016] [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] [Received: 08/12/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024] Open
Abstract
PURPOSE To assess the correlation between primary open-angle glaucoma (POAG) and the risk of developing diabetic retinopathy (DR) in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). DESIGN A retrospective cohort study leveraging the global patient database of TriNetX Research Network. PARTICIPANTS The study included 44 359 patients with diabetes mellitus (DM) with POAG and 4 393 300 patients with DM without any glaucoma ≥ 18 years of age. Propensity score matching harmonized the cohorts to 39 680 patients each, covering diagnoses from January 1, 2005, to January 1, 2023. METHODS We analyzed data using specific International Classification of Diseases, 10th Revision (ICD-10) codes for DM and glaucoma. We matched the cohorts using propensity score matching, adjusting for age, sex, race/ethnicity, blood markers, relevant medical history, and ophthalmic service use. MAIN OUTCOME MEASURES The primary outcome was the first-time occurrence of DR, including nonproliferative DR (NPDR) and proliferative DR (PDR), in patients with DM with and without glaucoma at 1-, 5-, and 10-year intervals from their individual index dates. RESULTS At 10 years, patients with T1DM with POAG exhibited a heightened risk for any DR (adjusted risk ratios [RRs], 4.12; 95% confidence interval [CI], 3.05-5.57, P < 0.0001) and PDR (RR, 7.02; 95% CI, 3.62-13.61, P < 0.0001). Patients with T2DM and POAG also faced an increased 10-year risk for any DR (RR, 2.47; 95% CI, 2.28-2.68, P < 0.0001) and PDR (RR, 3.82; 95% CI, 3.09-4.70, P < 0.0001). The combined association of POAG on DR risk in those with T1DM and T2DM at 10 years was found to be significantly higher among patients with POAG (5.45%) compared with those without glaucoma (2.12%) (adjusted hazard ratio [aHR], 2.33; 95% CI, 2.14-2.53). The cumulative incidence of DR was significantly higher in the POAG group compared with nonglaucoma counterparts after a decade (log-rank P < 0.001). CONCLUSIONS Our findings underscore a substantial association between POAG and DR development in both T1DM and T2DM patients, emphasizing the need for vigilant screening and comprehensive management in glaucomatous patients with DM to mitigate the risk of DR. Future research should delve into elucidating the causal mechanisms driving these observed associations. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Muhammad Z Chauhan
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Abdelrahman M Elhusseiny
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Krishna S Kishor
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida
| | - Carina T Sanvicente
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Arsalan A Ali
- Anne Burnett Marion School of Medicine, Fort Worth, Texas
| | - Ahmed B Sallam
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sanjoy K Bhattacharya
- Miami Integrative Metabolomics Research Center, Bascom Palmer Eye Institute, University of Miami, Miami, Florida
| | - Sami H Uwaydat
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| |
Collapse
|
9
|
Mansour AM, Uwaydat SH, Hamam R, Salti HI. Sclerectomy Reverses Nanophthalmic Optic Neuropathy. Case Rep Ophthalmol 2024; 15:284-291. [PMID: 38566820 PMCID: PMC10987180 DOI: 10.1159/000537829] [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: 10/09/2023] [Accepted: 01/16/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Nanophthalmos is characterized by a short axial length, a thick choroid, and a thick sclera. Unilateral symptomatic disc swelling in nanophthalmos presents both a diagnostic and a therapeutic challenge. Case Presentation A healthy 59-year-old man reported a two-week-long abrupt vision reduction in his right eye. 20/100 best spectacle (+17.25 diopter) corrected visual acuity, unilateral widespread disc enlargement, central scotoma, and a slight color vision disruption without an afferent pupillary defect were among the positive findings in the right eye. Workup for neuro-ophthalmology was negative. Numerous consultations did not suggest any form of treatment for the patient. Review of the optical coherence tomography (OCT) indicated a small, crowded optic nerve head and substantial diffuse choroidal thickening with dome-shaped temporal peripapillary area with choroidal expansion. In addition to circumferential anterior four-quadrant 95%-deep sclerectomy from recti insertion to the vortices, radial nasal posterior sclerotomy reaching the optic nerve sheath was performed on the patient. After the procedure, 2 weeks later, the patient's vision returned, and it persisted until the 6-month follow-up. By OCT, the two eyes were comparable as far as disc contour and nerve fiber layer thickness. Conclusion This form of sclerectomy, which aims at decompressing the oncotic choroidal pressure, is an effective treatment for compressive optic neuropathy in the context of nanophthalmos. Could sclerectomy assist in treating other optic neuropathies associated with peripapillary pachychoroid?
Collapse
Affiliation(s)
- Ahmad M. Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Sami H. Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Rola Hamam
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | | |
Collapse
|
10
|
Chacko JA, Phillips PH, Ramakrishnaiah RH, Schaefer GB, Uwaydat SH. Diagnosis of Charcot-Marie-Tooth Disease in a Patient With Decreased Vision From Optic Atrophy and No Other Neurological Symptoms. J Neuroophthalmol 2023; 43:e146-e148. [PMID: 35427283 DOI: 10.1097/wno.0000000000001520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Joseph A Chacko
- Jones Eye Institute (JAC, PHP, SHU), University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas; Department of Ophthalmology (PHP), Arkansas Children's Hospital, Little Rock, Arkansas; and Departments of Radiology (RHR) and Genetics (GBS), UAMS & Arkansas Children's Hospital, Little Rock, Arkansas
| | | | | | | | | |
Collapse
|
11
|
Mansour AM, López-Guajardo L, Belotto S, Lima LH, Charbaji AR, Schwartz SG, Wu L, Smiddy WE, Ascaso J, Jürgens I, Foster RE, Elnahry AG, Sinawat S, Pinilla I, Pérez-Salvador García E, Suarez Leoz M, Olivier Pascual N, Zago Ribeiro L, Arroyo Castillo R, Navea A, Kadayifcilar S, Ellabban AA, Rey A, Mansour HA, Tripathy K, Kozak I, Uwaydat SH, Valero MS, Cobo-Soriano R, Díaz-Barreda MD, Monje Fernández L, González Del Valle F, López Liroz I, Vazquez Cruchaga E, Fonollosa A, Esteban Floria O, Relimpio Lopez MI, Shah G, Wingelaar MJ, Ravani R, Donate-López J, Rubio Velázquez E, Parodi M. Recovery course of persistent posterior subretinal fluid after successful repair of rhegmatogenous retinal detachment. Eur J Ophthalmol 2023:11206721231210693. [PMID: 37901895 DOI: 10.1177/11206721231210693] [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: 10/31/2023]
Abstract
PURPOSE To investigate best corrected visual acuity (BCVA), subretinal fluid (SRF) absorption time or ellipsoid zone (EZ) restoration time and various variables in patients with persistent SRF after successful primary repair of rhegmatogenous retinal detachment (RRD). METHODS This retrospective multicenter study allowed independent analysis of the healing pattern by two observers based on composite of serial cross-sectional macular optical coherence tomography (OCT) scans. Univariate and multivariate analyses were implemented. RESULTS One hundred and three cases had persistent SRF after pars plana vitrectomy, scleral buckling, or pneumatic retinopexy. By univariate analysis, SRF resolution time correlated positively with the number of retinal breaks (p < 0.001) and with increased myopia (p = 0.011). Using multivariate analysis, final BCVA (log MAR) correlated positively with age, duration of RRD, initial BCVA (OR = 3.28; [95%CI = 1.44-7.47]; p = 0.015), and SRF resolution time (OR = 0.46 [95%CI 0.21-1.05]; p = 0.049). EZ restoration time was longer with increasing number of retinal tears (OR = 0.67; [95%CI 0.29-1.52]; p = 0.030), worse final BCVA, and presence of macula-off RRD (OR = 0.26; [95%CI 0.08-0.88]; p = 0.056). SRF resolution time correlated marginally with prone position. CONCLUSIONS Residual posterior SRF is more common in eyes with multiple breaks or in myopic eyes. Final BCVA is better in younger subjects and in eyes with shorter duration of RRD. Persistent SRF is a self-limited disorder with a mean resolution of 11.2 months with good visual prognosis improving from a mean baseline logMAR of 1.08 to 0.25 at one year.
Collapse
Affiliation(s)
- Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
- Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon
| | | | | | - Luiz H Lima
- Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Abdul Razzak Charbaji
- Department of Applied Statistics & Research Methods, Lebanese American University, Beirut, Lebanon
| | | | - Lihteh Wu
- Asociados de Macula Vitreo y Retina de Costa Rica, San José, Costa Rica
| | - William E Smiddy
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | - Javier Ascaso
- Department of Surgery, University of Zaragoza, Zaragoza, Spain
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain
| | | | | | - Ayman G Elnahry
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Cairo, Egypt
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Isabel Pinilla
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain
| | | | - Marta Suarez Leoz
- Department of Ophthalmology, Hospital Universitario de Burgos, Burgos, Spain
| | - Nuria Olivier Pascual
- Department of Ophthalmology, Complejo Hospitalario Universitario de Ferrol, Galicia, Spain
| | - Lucas Zago Ribeiro
- Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Rosa Arroyo Castillo
- Department of Ophthalmology, Complejo Hospitalario Universitario de Ferrol, Galicia, Spain
| | | | - Sibel Kadayifcilar
- Department of Ophthalmology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Abdallah A Ellabban
- Department of Ophthalmology, Suez Canal University, Ismaïlia, Egypt
- Department of Ophthalmology, Hull University Teaching Hospitals, Hull, UK
| | - Amanda Rey
- Institut Català de Retina, Barcelona, Spain
| | - Hana A Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Koushik Tripathy
- Department of Ophthalmology, ASG Eye Hospital, Kolkata, West Bengal, India
| | | | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas Medical School, Little Rock, Arkansas, USA
| | | | - Rosario Cobo-Soriano
- Department of Ophthalmology, Hospital Universitario del Henares, Universidad Francisco de Vitoria, Madrid, Spain
| | - María Dolores Díaz-Barreda
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain
| | - Laura Monje Fernández
- Department of Ophthalmology, Complejo Asistencial Universitario de León, León, Spain
| | | | | | | | - Alex Fonollosa
- Department of Ophthalmology, BioCruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain
| | - Olivia Esteban Floria
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
| | | | | | | | - Raghav Ravani
- Department of Ophthalmology, ASG Eye Hospital, Kolkata, West Bengal, India
| | | | | | - Maurizio Parodi
- Department of Ophthalmology, University Vita-Salute Milan, Milan, Italy
| |
Collapse
|
12
|
M Mansour A, Parodi M, H Uwaydat S, Charbaji S, Ascaso J, A Mansour H, Tripathy K, Marcelo Barbante Casella A. Idiopathic Macular Hole: Algorithm for Nonsurgical Closure Based on Literature Review. J Ophthalmic Vis Res 2023; 18:424-432. [PMID: 38250231 PMCID: PMC10794794 DOI: 10.18502/jovr.v18i4.14555] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/25/2023] [Indexed: 01/23/2024] Open
Abstract
Our purpose is to review the closure time and optical coherence tomography (OCT) biomarkers that result in the non-surgical repair of idiopathic full-thickness macular holes (IFTMH). Our methodology consisted of a comprehensive literature review of the nonsurgical resolution of IFTMH followed by the calculation of the estimated closure time using the structural equation model. Forty-nine studies were found eligible yielding 181 eyes with IFTMH: 81.1% being small holes (< 250 µm) with a median diameter of 166 µm. Final vision (mean 20/41) was related to initial vision (mean 20/65) and mean age (67 years). The hole diameter was correlated with initial vision and closure time (mean 3.9 months). Closure time was related to hole diameter and initial vision in the following algorithm: Closure time (month)= - 0.057 + 0.008 diameter (µm) + 0.021 age (year) + 2.153 initial vision (logMAR). Biomarkers by OCT for self-closure included in decreasing frequency: pointed edge, de-turgescence of cystic macular edema (CME) with reversal of bascule bridge, and vitreomacular traction (VMT) release. The crucial function of Muller cell bridging in sealing the hole attests to its exceptional capacity for regeneration. After the hole has begun to close; however in less than 5%, a delayed restoration of the ellipsoid layer or a persistent outer foveal defect may prevent visual recovery and reopening of the hole is possible. In conclusion, eyes with small-size IFTMH and good baseline vision can have the additional option of close OCT monitoring for biomarkers of self-sealing biomarkers. When rehabilitative activity seems to be lacking, surgery is therefore mandatory.
Collapse
Affiliation(s)
- Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Maurizio Parodi
- Department of Ophthalmology, University Vita-Salute Milan, Milan, Italy
| | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas Medical School, Little Rock, Arkansas, USA
| | | | - Javier Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Hana A Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | | | | |
Collapse
|
13
|
Jabbehdari S, Uwaydat SH. Sequential Bilateral Paracentral Acute Middle Maculopathy in a Middle-Aged Woman. J Vitreoretin Dis 2023; 7:440-443. [PMID: 37706092 PMCID: PMC10496809 DOI: 10.1177/24741264231169872] [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] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Purpose: To present a case of sequential paracentral acute middle maculopathy (PAMM) in a middle-aged woman with no cardiovascular risk factors. Methods: A single case was evaluated. Results: A 53-year-old woman with a history of PAMM resulting from perfused central retinal artery occlusion in the left eye presented with PAMM in the right eye 3 years later. The patient had a medical history of treated anemia, stress disorder, and insomnia. Examination of the right eye showed a superior parafoveal crescent of translucent retina without associated edema or hemorrhage. Optical coherence tomography (OCT) showed hyperreflective band-like areas in the superior parafoveal and perifoveal regions. Fluorescein angiography revealed normal arterial filling. OCT angiography showed patchy filling of the middle capillary plexus with normal perfusion of the superficial capillary plexus in the right eye. Conclusions: Although bilateral sequential PAMM is rare, close monitoring in a case of PAMM in 1 eye should be considered.
Collapse
Affiliation(s)
- Sayena Jabbehdari
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sami H. Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
14
|
Georgiou M, Robson AG, Jovanovic K, Guimarães TACD, Ali N, Pontikos N, Uwaydat SH, Mahroo OA, Cheetham ME, Webster AR, Hardcastle AJ, Michaelides M. RP2-Associated X-linked Retinopathy: Clinical Findings, Molecular Genetics, and Natural History. Ophthalmology 2023; 130:413-422. [PMID: 36423731 PMCID: PMC10567581 DOI: 10.1016/j.ophtha.2022.11.015] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To review and describe in detail the clinical course, functional and anatomic characteristics of RP2-associated retinal degeneration. DESIGN Retrospective case series. PARTICIPANTS Male participants with disease-causing variants in the RP2 gene. METHODS Review of all case notes and results of molecular genetic testing, retinal imaging (fundus autofluorescence [FAF] imaging, OCT), and electrophysiology assessment. MAIN OUTCOME MEASURES Molecular genetic testing, clinical findings including best-corrected visual acuity (BCVA), qualitative and quantitative retinal imaging analysis, and electrophysiology parameters. RESULTS Fifty-four molecularly confirmed patients were identified from 38 pedigrees. Twenty-eight disease-causing variants were identified, with 20 not previously clinically characterized. Fifty-three patients (98.1%) presented with retinitis pigmentosa. The mean age of onset (range ± standard deviation [SD]) was 9.6 years (1-57 ± 9.2 years). Forty-four patients (91.7%) had childhood-onset disease, with mean age of onset of 7.6 years. The most common first symptom was night blindness (68.8%). Mean BCVA (range ± SD) was 0.91 logarithm of the minimum angle of resolution (logMAR) (0-2.7 ± 0.80) and 0.94 logMAR (0-2.7 ± 0.78) for right and left eyes, respectively. On the basis of the World Health Organization visual impairment criteria, 18 patients (34%) had low vision. The majority (17/22) showed electroretinogram (ERG) evidence of a rod-cone dystrophy. Pattern ERG P50 was undetectable in all but 2 patients. A range of FAF findings was observed, from normal to advanced atrophy. There were no statistically significant differences between right and left eyes for ellipsoid zone width (EZW) and outer nuclear layer (ONL) thickness. The mean annual rate of EZW loss was 219 μm/year, and the mean annual decrease in ONL thickness was 4.93 μm/year. No patient with childhood-onset disease had an identifiable ellipsoid zone (EZ) after the age of 26 years at baseline or follow-up. Four patients had adulthood-onset disease and a less severe phenotype. CONCLUSIONS This study details the clinical phenotype of RP2 retinopathy in a large cohort. The majority presented with early-onset severe retinal degeneration, with early macular involvement and complete loss of the foveal photoreceptor layer by the third decade of life. Full-field ERGs revealed rod-cone dystrophy in the vast majority, but with generalized (peripheral) cone system involvement of widely varying severity in the first 2 decades of life. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
- Michalis Georgiou
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom; Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Anthony G Robson
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Katarina Jovanovic
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Thales A C de Guimarães
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Naser Ali
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Nikolas Pontikos
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Omar A Mahroo
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Michael E Cheetham
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Andrew R Webster
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Alison J Hardcastle
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Michel Michaelides
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom.
| |
Collapse
|
15
|
Chauhan MZ, Elhusseiny AM, Rook BS, Samarah ES, Uwaydat SH, Sallam AB, Phillips PH. Socioeconomic and Racial Disparities in Vision Care Access and Impairment Among United States Children. Ophthalmology 2023:S0161-6420(23)00130-6. [PMID: 36828234 DOI: 10.1016/j.ophtha.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Affiliation(s)
- Muhammad Z Chauhan
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Abdelrahman M Elhusseiny
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Brita S Rook
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Esaa S Samarah
- College of Social Work, Florida State University, Tallahassee, Florida
| | - Sami H Uwaydat
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Ahmed B Sallam
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Paul H Phillips
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| |
Collapse
|
16
|
Chacko JA, Broyles HV, Chacko JG, Uwaydat SH. Documented Reperfusion of the Retina on Fluorescein Angiography after Administration of Intravenous Prostaglandin E1 for Central Retinal Artery Occlusion: A Case Report. Case Rep Ophthalmol 2023; 14:469-476. [PMID: 37901635 PMCID: PMC10601880 DOI: 10.1159/000533404] [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: 05/23/2023] [Accepted: 07/27/2023] [Indexed: 10/31/2023] Open
Abstract
Central retinal artery occlusion (CRAO) can result in devastating permanent vision loss. Presently, there is no evidence-based treatment for CRAO that is widely accepted. In the literature, multiple studies propose intravenous (IV) prostaglandin E1 (IV PGE1) as a potential treatment option for patients with CRAO. We illustrate 2 cases of CRAO successfully treated with IV PGE1. In both cases, our patients with vascular risk factors were diagnosed with CRAO of the left eye. They were started on twice daily IV 40 μg PGE1 in 100 mL normal saline, with each dose administered over 3 h. In the first case, we documented reperfusion of the retina on fluorescein angiography after administration of IV PGE1. In the second case, our patient improved from no light perception visual acuity (VA) to count fingers VA within 48 h of treatment with IV PGE1. Our study highlights the vasodilatory effect of IV PGE1. Due to its mechanism of action and safety profile, it should be considered a potential treatment option for CRAO. Further randomized controlled trials are necessary to determine the overall therapeutic effect of IV PGE1 for CRAO.
Collapse
Affiliation(s)
- J. Anthony Chacko
- Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Heather V. Broyles
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Joseph G. Chacko
- Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Sami H. Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| |
Collapse
|
17
|
Jabbehdari S, Tetelbom PS, Warner D, Uwaydat SH. Sealed Unilateral Full-Thickness Macular Hole with Amniotic Membrane Graft in a Patient with Alport Syndrome: A Case Report. Case Rep Ophthalmol 2023; 14:562-567. [PMID: 37901625 PMCID: PMC10601861 DOI: 10.1159/000533712] [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: 05/16/2023] [Accepted: 08/02/2023] [Indexed: 10/31/2023] Open
Abstract
We present a case of unilateral full-thickness macular hole (MH) successfully repaired with an amniotic membrane (AM) graft in a patient with Alport syndrome. A 58-year-old Asian female with past medical history of Alport syndrome diagnosed at early stage, presented with a 5-week history of vision loss in her right eye. Examination of her eyes showed normal retinal vessels and an MH measuring 1,300 μm in basal diameter, 806 μm in minimum linear diameter, and 490 μm in height in the right eye and macular thinning with laser scars inferiorly in the left eye. The patient underwent 23-g pars plana vitrectomy with intraocular lens explantation. After multiple unsuccessful attempts in inducing a posterior vitreous detachment around the optic nerve and in the posterior pole, a 1 mm AM graft placed on the MH and the edges tucked under the edges of the hole using a bimanual technique. Five months after surgery, the MH remained sealed with improved final vision. MHs are rare manifestations of Alport syndrome, and surgical treatment of Alport syndrome-associated MHs is challenging. However, further studies to explore new techniques using AM are needed.
Collapse
Affiliation(s)
- Sayena Jabbehdari
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pedro S Tetelbom
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - David Warner
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
18
|
Chauhan MZ, Chacko JG, Ghaffarieh A, Moulin CM, Pelaez D, Uwaydat SH, Bhattacharya SK. Mitochondrial Triglyceride Dysregulation in Optic Nerves Following Indirect Traumatic Optic Neuropathy. Biomolecules 2022; 12:biom12121885. [PMID: 36551313 PMCID: PMC9775509 DOI: 10.3390/biom12121885] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The purpose of this work is to identify mitochondrial optic nerve (ON) lipid alterations associated with sonication-induced traumatic optic neuropathy (TON). Briefly, a mouse model of indirect TON was generated using sound energy concentrated focally at the entrance of the optic canal using a laboratory sonifier (Branson Digital Sonifier 450, Danbury, CT, USA) with a microtip probe. We performed an analysis of a previously generated dataset from high-performance liquid chromatography-electrospray tandem mass spectrometry (LC-MS/MS). We analyzed lipids from isolated mitochondria from the ON at 1 day, 7 days, and 14 days post-sonication compared to non-sonicated controls. Lipid abundance alterations in post-sonicated ON mitochondria were evaluated with 1-way ANOVA (FDR-adjusted significant p-value < 0.01), debiased sparse partial correlation (DSPC) network modeling, and partial least squares-discriminant analysis (PLS-DA). We find temporal alterations in triglyceride metabolism are observed in ON mitochondria of mice following sonication-induced optic neuropathy with notable depletions of TG(18:1/18:2/18:2), TG(18:1/18:1/18:1), and TG(16:0/16:0/18:1). Depletion of mitochondrial triglycerides may mediate ON damage in indirect traumatic optic neuropathy through loss energy substrates for neuronal metabolism.
Collapse
Affiliation(s)
- Muhammad Z. Chauhan
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR 72205, USA
- Miami Integrative Metabolomics Research Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Joseph G. Chacko
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR 72205, USA
| | - Alireza Ghaffarieh
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR 72205, USA
| | - Chloe M. Moulin
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Daniel Pelaez
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Sami H. Uwaydat
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR 72205, USA
- Correspondence: (S.H.U.); (S.K.B.); Tel.: +305-482-4103 (S.K.B.)
| | - Sanjoy K. Bhattacharya
- Miami Integrative Metabolomics Research Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Correspondence: (S.H.U.); (S.K.B.); Tel.: +305-482-4103 (S.K.B.)
| |
Collapse
|
19
|
Chauhan MZ, Georgiou M, Al-Hindi H, Uwaydat SH. Outcomes of pars plana vitrectomy following ocular trauma at varying surgical time points. Int J Retina Vitreous 2022; 8:49. [PMID: 35879788 PMCID: PMC9310478 DOI: 10.1186/s40942-022-00399-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background The optimal timing of pars plana vitrectomy (PPV) following ocular trauma is an ongoing debate. Early vitrectomy post-trauma enables the rapid assessment of retinal disease by removing the scaffold that fosters proliferative vitreoretinopathy. On the other hand, late vitrectomy is less challenging as there is a lower risk of bleeding and posterior vitreous detachment induction is easier. The purpose of this work is to report the functional and anatomical outcomes following ocular traumatic injuries in a United States-based cohort, emphasizing the time of intervention. Methods This was a retrospective case series of 110 patients with traumatic ocular injuries who underwent PPV between 2008 to 2020. Patients were grouped into four timing categories: same day (0 days), early (1–7 days), delayed (8–14 days), and late (> 14 days). Multivariable regression models controlling for confounding were implemented to assess the impact of vitrectomy timing on anatomical and functional outcomes. Visual acuity (VA) at baseline and after surgery, proliferative vitreoretinopathy (PVR), and enucleation for each vitrectomy timing category were recorded. Results Patient demographics and severity of ocular trauma were comparable across timing categories. Final VA in LogMAR was found to have a stepwise worsening as the time of ocular trauma to vitrectomy was increased (p < 0.05). For every one-step increase in the vitrectomy timing category, there was an adjusted 0.24 (CI 0.04–0.44) increase in final VA. No patient in the same day vitrectomy group had an enucleation or PVR, while patients who had late vitrectomies had the largest number of both enucleations and PVR (44.4% and 52.0%, respectively). In adjusted analysis, there was 3.11 increased odds (CI 1.03–9.42) of developing PVR for a one-step increase in vitrectomy timing (p < 0.05). Conclusion Vitrectomy on the same day of injury has the best final VA, and the lowest incidence rates of PVR and enucleation in comparison to other timing categories, regardless of etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s40942-022-00399-9.
Collapse
|
20
|
Georgiou M, Chauhan MZ, Michaelides M, Uwaydat SH. IMPG2-associated unilateral adult onset vitelliform macular dystrophy. Am J Ophthalmol Case Rep 2022; 28:101699. [PMID: 36118280 PMCID: PMC9471960 DOI: 10.1016/j.ajoc.2022.101699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/13/2022] [Accepted: 09/01/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To present a case of unilateral IMPG2-associated adult onset vitelliform macular dystrophy (AVMD). Observations A 68 year-old female presented with best corrected visual acuity (BCVA) of 20/20 and 20/40 for the right and left eye respectively. The patient had a left subfoveal yellow lesion on dilated fundus examination. Optical coherence tomography showed hyper-reflective material accumulation below the fovea in the left eye only. The patient was followed for 10 years with stable BCVA, and evolution of the subretinal vitelliform lesion to a “vitelliruptive” stage. The right eye did not develop vitelliform lesion. Genetic testing identified a heterozygous likely disease-causing variant in IMPG2; c.3423–7_3423-4del. Conclusions and importance This is the first report of unilateral AVMD associated with IMPG2, expanding the phenotypic spectrum of IMPG2 retinopathy. We provide further evidence that IMPG2 variants can cause both autosomal recessive rod-cone dystrophy and autosomal dominant AVMD, with implications for patient counselling.
Collapse
Affiliation(s)
- Michalis Georgiou
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
- UCL Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK
| | - Muhammad Z. Chauhan
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Michel Michaelides
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
- UCL Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK
| | - Sami H. Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Corresponding author. Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, 4105 Outpatient Circle, Little Rock, AR, 72205, USA.
| |
Collapse
|
21
|
Hsu C, Uwaydat SH, Chacko JG. Toxoplasma Neuroretinitis. Case Rep Ophthalmol 2022; 13:751-755. [PMID: 36845446 PMCID: PMC9944202 DOI: 10.1159/000526682] [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: 06/06/2022] [Accepted: 08/05/2022] [Indexed: 11/19/2022] Open
Abstract
Neuroretinitis is an inflammatory condition with rapid unilateral vision loss, optic disc edema, and macular star formation. While neuroretinitis is commonly due to infectious causes such as Bartonella henselae, neuroretinitis due to toxoplasmosis is uncommon. A 29-year-old male presents to our neuro-ophthalmology clinic on December 7, 2021, at the University of Arkansas for Medical Sciences with symptoms of left eye pain and blurred vision. Subsequent workup led to the diagnosis and treatment of toxoplasma neuroretinitis. The fundus exam eventually demonstrated a notable macular star. Treatment was well tolerated, and the patient regained total visual acuity in the affected eye. Toxoplasma neuroretinitis is known for a characteristic appearance of optic disc edema prior to appearance of stellate maculopathy with vitreous inflammation and peripheral chorioretinal scars. Although loss of vision due to toxoplasmosis is rare, it should be included as part of the differential diagnosis with pertinent history.
Collapse
Affiliation(s)
- Christine Hsu
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sami H. Uwaydat
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | | |
Collapse
|
22
|
Uwaydat SH, Siddiqui MZ. Response to: 'Comment on: 'Incidence of chorioretinitis and endophthalmitis in hospitalized patients with fungemia". Eye (Lond) 2022; 36:1855. [PMID: 35046552 PMCID: PMC9391472 DOI: 10.1038/s41433-021-01906-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 11/17/2021] [Accepted: 12/14/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Sami H Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Mohammad Z Siddiqui
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
23
|
Mansour HA, Uwaydat SH, Parodi M, Jürgens I, Smiddy W, Ellabban AA, Schwartz SG, Foster RE, Ascaso J, Leoz MS, Belotto S, Mateo J, Olivier-Pascual N, Lima LH, Navea A, Neila EMR, Castillo RA, Alaman AS, Mansour AM. Correction to: Recovery course of foveal microstructure in the nonsurgical resolution of full-thickness macular hole. Graefes Arch Clin Exp Ophthalmol 2022; 260:3403. [PMID: 35648224 DOI: 10.1007/s00417-022-05712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Hana A Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas Medical School, Little Rock, AR, USA
| | - Maurizio Parodi
- Department of Ophthalmology, University Vita-Salute Milan, Milan, Italy
| | | | - William Smiddy
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Abdallah A Ellabban
- Vitreoretina Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
- Department of Ophthalmology, Suez Canal University Hospital, Ismailia, Egypt
| | - Stephen G Schwartz
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
- Bascom Palmer Eye Institute, Naples, FL, USA
| | | | - Javier Ascaso
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain
| | | | | | - Javier Mateo
- Department of Ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain
| | - Nuria Olivier-Pascual
- Department of Ophthalmology, Complejo Hospitalario Universitario de Ferrol, Galicia, Spain
| | - Luiz H Lima
- Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Rosa Arroyo Castillo
- Department of Ophthalmology, Complejo Hospitalario Universitario de Ferrol, Galicia, Spain
| | | | - Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.
| |
Collapse
|
24
|
Mansour HA, Uwaydat SH, Parodi M, Jürgens I, Smiddy W, Allabban AA, Schwartz SG, Foster RE, Ascaso J, Leoz MS, Belotto S, Mateo J, Olivier-Pascual N, Lima LH, Navea A, Neila EMR, Castillo RA, Alaman AS, Mansour AM. Recovery course of foveal microstructure in the nonsurgical resolution of full-thickness macular hole. Graefes Arch Clin Exp Ophthalmol 2022; 260:3173-3183. [DOI: 10.1007/s00417-022-05672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 11/04/2022] Open
|
25
|
Chauhan MZ, Chacko JG, Phillips PH, Siddiqui MZ, Uwaydat SH. Association of Acute Zonal Occult Outer Retinopathy With Multiple Sclerosis: A Report of 2 Cases. J Neuroophthalmol 2022; 42:e377-e380. [PMID: 34270517 DOI: 10.1097/wno.0000000000001283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Muhammad Z Chauhan
- Department of Ophthalmology (MZC), College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and Department of Ophthalmology (JGC, PHP, MZS, SHU), Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | | | | | | |
Collapse
|
26
|
Mansour HA, Chacko JA, Sanders RN, Schaefer GB, Uwaydat SH. Retinal Degeneration Associated With the G1606A Mitochondrial Mutation. Ophthalmic Surg Lasers Imaging Retina 2022; 53:116-119. [PMID: 35148219 DOI: 10.3928/23258160-20220121-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The guanine-to-adenine substitution at nucleotide 1606 (G1606A) mutation in the mitochondrial DNA transfer RNA-valine gene has been reported to cause sensorineural deafness, ataxia, myoclonus, seizures, and mental retardation. This study hereby presents a single case report of a new retinal phenotype associated with this mutation: a middle-aged woman with retinal pigment epithelium stippling, atrophy, and peripapillary (retinal pigment epithelium) dropout on fundus examination. The patient was administered an empiric trial of a mitochondrial cocktail with close monitoring of her systemic symptoms. This study identified a novel G1606A mutation to cause early-onset macular pathology resembling that previously described in the A3243G mutation. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:116-119.].
Collapse
|
27
|
Chauhan MZ, Mansour HA, Zafar MK, Uwaydat SH. Anti-Programmed Death Ligand-1 Induced Acute Vision Loss in a Patient With Cancer-Associated Retinopathy. Cureus 2022; 14:e21709. [PMID: 35145825 PMCID: PMC8803375 DOI: 10.7759/cureus.21709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2022] [Indexed: 12/02/2022] Open
Abstract
Cancer-associated retinopathy (CAR) is a potentially blinding disease triggered by autoimmunity to cancer antigens at distant sites. It may masquerade as immune-related adverse events from the use of immune checkpoint inhibitors (ICIs). We present a patient with an underlying tubby-related protein 1 (TULP1) cancer-associated retinopathy who lost vision following initiation of atezolizumab for small-cell lung cancer. This 75-year-old man presented with no light perception, paramacular and peripheral retinal pigmentary changes, attenuated outer retina, and extinguished rod and cone responses. The visual loss followed the induction of atezolizumab therapy. Possible atezolizumab-associated acute macular neuroretinopathy was considered, and atezolizumab was discontinued. Vision improved on oral corticosteroid and deteriorated when corticosteroid was tapered quickly. Retinal autoantibody serology testing was negative for both anti-recoverin and anti-enolase and was positive for anti-TULP1 autoantibodies. Re-induction of atezolizumab concomitant with high-dose oral and intravitreal corticosteroids resulted in visual recovery at the three-month follow-up. These findings suggest that ICI therapy for cancer can exacerbate the retinal dysfunction in a patient with underlying autoimmunity from cancer. Patients with a high risk of CAR may need to be evaluated for retinal autoantibodies before initiation of ICI.
Collapse
|
28
|
Siddiqui MZ, Gebhard GM, Ahmad KT, Sallam AB, Rosenbaum ER, Uwaydat SH. Incidence of chorioretinitis and endophthalmitis in hospitalized patients with fungemia. Eye (Lond) 2022; 36:206-208. [PMID: 33686234 PMCID: PMC8727606 DOI: 10.1038/s41433-021-01477-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/13/2021] [Accepted: 02/16/2021] [Indexed: 02/06/2023] Open
Abstract
AIM/PURPOSE Bloodstream candida infections can seed the eye via hematogenous spread and result in chorioretinitis or endophthalmitis. If undetected and untreated, this can result in permanent vision loss. Past studies evaluating incidence of ocular candidiasis among hospitalized patients with positive fungal blood cultures have demonstrated variable rates of occurrence, but recent studies have generally shown a lower incidence than was reported several decades ago. Given low rates of occurrence, the utility of screening patients with dilated fundus exams has been called into question. The primary aim of this investigation is to identify the rate of chorioretinitis and endophthalmitis based on dilated fundoscopy for patients with fungemia at a tertiary care hospital. METHODS This study was a retrospective chart review of adult patients admitted to the medical centre of the University of Arkansas for Medical Sciences (UAMS) between May 1, 2014 and December 31, 2017, who had positive fungal blood cultures during their hospitalization. RESULTS There were 324 positive fungal cultures in 290 patients. Of this initial group, there were 161 eye exams. Ocular examination identified 7 of 161 patients (4.3%) with chorioretinitis or endophthalmitis. DISCUSSION These outcomes along with previous studies support the current guidelines that screening with dilated fundus examination for these patients is appropriate and necessary.
Collapse
Affiliation(s)
- Mohammad Z. Siddiqui
- grid.241054.60000 0004 4687 1637Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Grant M. Gebhard
- grid.241054.60000 0004 4687 1637Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, AR USA ,Southwest Eye Consultants, Durango, CO USA
| | - Kinza T. Ahmad
- grid.241054.60000 0004 4687 1637Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Ahmed B. Sallam
- grid.241054.60000 0004 4687 1637Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Eric R. Rosenbaum
- grid.241054.60000 0004 4687 1637Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Sami H. Uwaydat
- grid.241054.60000 0004 4687 1637Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, AR USA
| |
Collapse
|
29
|
Fong JW, Coleman JP, Sanders RN, Henry WA, Uwaydat SH. Two Cases of Acute Globe Collapse Following Invasive Neurovascular Procedures. Can J Ophthalmol 2021; 57:e13-e14. [PMID: 34097880 DOI: 10.1016/j.jcjo.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Joseph W Fong
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - John P Coleman
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Riley N Sanders
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - William A Henry
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sami H Uwaydat
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| |
Collapse
|
30
|
Fong JW, Broyles HV, Atassi NY, Sallam AB, Uwaydat SH. Two Patients with Atypical Choroidal Detachment. Case Rep Ophthalmol 2021; 12:315-319. [PMID: 34054477 PMCID: PMC8136305 DOI: 10.1159/000513220] [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: 10/07/2020] [Accepted: 11/19/2020] [Indexed: 11/19/2022] Open
Abstract
Serous choroidal detachment that is caused by rhegmatogenous retinal detachment (RRD) may present a significant diagnostic challenge as delayed recognition and repair of the underlying RRD can severely impact the final anatomical and visual outcome. We report 2 consecutive patients with atypical choroidal detachments who were later found to have underlying RRDs. A 71-year-old female presented with a 1-week history of painful vision loss and floaters in the left eye. Examination revealed choroidal detachments in the nasal and temporal periphery and an overlying retinal detachment with shifting subretinal fluid. However, no retinal breaks were identified. An extensive laboratory workup and imaging of the orbits were unrevealing. She was treated with 80 mg oral prednisone daily for 2 weeks with subsequent resolution of the choroidals but persistence of the retinal detachment. Similarly, a 52-year-old male presented with a 3-week history of flashes and floaters followed by painful vision loss in the left eye 1 day prior to presentation. He had hand motion vision OS and the intraocular pressure was undetectable by hand-held tonometry OS. Dense brunescent cataract prevented adequate viewing of the posterior pole. B-scan ultrasonography revealed a funnel retinal detachment, with homogenous choroidal echogenicities suggestive of hemorrhagic choroidal detachment. Extensive laboratory workup was unrevealing. The patient was started on 60 mg oral prednisone and re-evaluated every 2 days, but ultrasonography revealed persistence of the choroidal detachment after 1 week. The diagnosis of RRD with an associated choroidal detachment should be considered, even in the absence of an identifiable causative retinal break.
Collapse
Affiliation(s)
- Joseph W Fong
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA
| | - Heather V Broyles
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA
| | - Nour Y Atassi
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA
| | - Ahmed B Sallam
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA
| | - Sami H Uwaydat
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA
| |
Collapse
|
31
|
Uwaydat SH, Mansour A, Ascaso FJ, Parodi MB, Foster R, Smiddy WE, Schwartz SG, Charbaji A, Belotto S, Jürgens I, Mateo J, Ellabban AA, Wu L, Figueroa M, Olivier Pascual N, Lima LH, Alsakran WA, Caliskan Kadayifcilar S, Sinawat S, Assi A, Mansour HA, Casella AM, Navea A, Neila ER, Saatci AO, Govindahari V, Esteban Floria O, Agarwal K, Bakkali El Bakkali I, Alaman AS, Larripa SF, Rey A, Pera P, Bruix L, Lopez-Guajardo L, Pérez-Salvador E, Lara Medina FJ, Hrisomalos FN, Chhablani J, Arevalo JF. Clinical characteristics of full thickness macular holes that closed without surgery. Br J Ophthalmol 2021; 106:1463-1468. [PMID: 33926863 DOI: 10.1136/bjophthalmol-2021-319001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/23/2021] [Accepted: 04/16/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To ascertain the anatomic factors that help achieve non-surgical sealing in full thickness macular hole (FTMH). METHODS Retrospective collaborative study of FTMH that closed without surgical intervention. RESULTS A total of 78 patients (mean age 57.9 years) included 18 patients with blunt ocular trauma, 18 patients that received topical or intravitreal therapies and 42 patients with idiopathic FTMH. Mean±SD of the initial corrected visual acuity (VA) in logMAR improved from 0.65±0.54 to 0.34±0.45 (p<0.001) at a mean follow-up of 33.8±37.1 months. FTMH reopened in seven eyes (9.0%) after a mean of 8.6 months. Vitreomacular traction was noted in 12 eyes (15.8%), perifoveal posterior vitreous detachment in 42 (53.8%), foveal epiretinal membrane in 10 (12.8%), cystoid macular oedema (CME) in 49 (62.8%) and subretinal fluid (SRF) in 20 (25.6%). By multivariate analysis, initial VA correlated to the height (p<0.001) and narrowest diameter of the hole (p<0.001) while final VA correlated to the basal diameter (p<0.001). Time for closure of FTMH (median 2.8 months) correlated to the narrowest diameter (p<0.001) and the presence of SRF (p=0.001). Mean time for closure (in months) was 1.6 for eyes with trauma, 4.3 for eyes without trauma but with therapy for CME, 4.4 for eyes without trauma and without therapy in less than 200 µm in size and 24.7 for more than 200 µm. CONCLUSION Our data suggest an observation period in new onset FTMH for non-surgical closure, in the setting of trauma, treatment of CME and size <200 µm.
Collapse
Affiliation(s)
- Sami H Uwaydat
- Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ahmad Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon .,Department of Ophthalmology, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Francisco J Ascaso
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.,Department of Ophthalmology, University of Zaragoza, Zaragoza, Spain
| | | | - Robert Foster
- Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | | | - Stephen G Schwartz
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, Florida, USA
| | - Abdulrazzak Charbaji
- Research and Applied Statistics, Lebanese American University, Beirut, Lebanon.,Research and Applied Statistics, CHARBAJI Consultants, Beirut, Lebanon
| | - Silvana Belotto
- Department of Ophthalmology, Institut Català de Retina, Barcelona, Spain
| | - Ignasi Jürgens
- Department of Ophthalmology, Institut Català de Retina, Barcelona, Spain
| | - Javier Mateo
- Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Abdallah A Ellabban
- Department of Ophthalmology, Hull University Teaching Hospitals, Hull, Yorkshire, UK.,Department of Ophthalmology, Suez Canal University, Faculty of Medicine, Ismailia, Egypt
| | - Lihteh Wu
- Department of Ophthalmology, Apdo 144-1225 Plaza Mayor, San Jose, Costa Rica
| | - Marta Figueroa
- Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Luiz H Lima
- Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Wael A Alsakran
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Suthasinee Sinawat
- Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - Alexandre Assi
- Department of Ophthalmology, Beirut Eye and ENT Specialist Hospital, Beirut, Lebanon
| | - Hana A Mansour
- Ophthalmology, American University of Beirut, Beirut, Lebanon
| | | | - Amparo Navea
- Department of Ophthalmology, Instituto de la Retina, Valencia, Spain
| | | | - A Osman Saatci
- Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey
| | | | - Olivia Esteban Floria
- Ophthalmology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain.,Department of Ophthalmology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
| | - Komal Agarwal
- Department of Ophthalmology, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | | | | | | | - Amanda Rey
- Department of Ophthalmology, Hospital Clinic, Barcelona, Spain
| | - Patricia Pera
- Department of Ophthalmology, Institut Català de Retina SL, Barcelona, Spain
| | - Lluís Bruix
- Department of Ophthalmology, Institut Català de Retina, Barcelona, Spain
| | | | | | | | - Frank N Hrisomalos
- Department of Ophthalmology, Indiana University, Indianapolis, Indiana, USA
| | - Jay Chhablani
- UPMC Eye Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
32
|
Siddiqui MZ, Ellabban AA, Soliman MK, Gini G, Kurup S, Uwaydat SH, Sallam AB. Survey of the use of laser protective eyewear among international retina specialists: a European vitreoretinal society study. BMJ Open Ophthalmol 2021; 6:e000647. [PMID: 33754128 PMCID: PMC7938992 DOI: 10.1136/bmjophth-2020-000647] [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: 10/29/2020] [Revised: 01/13/2021] [Accepted: 01/30/2021] [Indexed: 11/22/2022] Open
Abstract
Objective To report the trends for the use of eye protection methods during retinal laser in clinic and operating room. Methods and analysis Retrospective analysis of a 14-item survey questionnaire submitted to the European Vitreoretinal Society members. Results Responses from 630 members were analysed. Most of the respondents practised in Europe (52.7%), followed by North America (21.0%). The majority of respondents had laser filters in the microscope for the operating surgeon (92.1%), or used protective goggles (6.8%). Only 38.9% of respondents indicated that auxiliary staff in the operative room used protective goggles during laser treatment. Three-dimensional retina viewing system was used by only 22.5% of respondents, of those, 34.5% reported use of laser protection goggles by the operating surgeon. Rates of laser protection by auxiliary staff were 62.9% for indirect laser and 60.8% for slit lamp laser. We found a higher rate for use of laser protection by auxiliary staff in North America-based practices for endolaser (p<0.00001), laser indirect ophthalmoscope (p<0.00001) and slit lamp laser (p=0.00033) compared with the rest of the world. Conclusion The use of laser protection methods is routinely adopted by the physicians in the operating room and clinic, but less so by their assisting or auxiliary staff.
Collapse
Affiliation(s)
- Mohammad Z Siddiqui
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arknasas, USA
| | - Abdallah A Ellabban
- Department of Ophthalmology, Suez Canal University, Ismailia, Egypt.,Department of Ophthalmology, Hull University Teaching Hospitals NHS Trust, Hull, Kingston upon Hull, UK
| | - Mohamed K Soliman
- Ophthalmology, University of Ottawa Eye Institute, Ottawa, Ontario, Canada.,Ophthalmology, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Giampaolo Gini
- Ophthalmology, Western Sussex NHS University Trust, Chichester, UK
| | - Shree Kurup
- Department of Ophthalmology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arknasas, USA
| | - Ahmed B Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arknasas, USA
| |
Collapse
|
33
|
Abstract
Background: Retinitis pigmentosa GTPase regulator (RPGR) gene mutations are a common cause of X-linked retinitis pigmentosa and X-linked cone-rod dystrophy. There have been no previous reports of association with crystalline retinopathy or pseudo-crystalline retinopathy.Materials and Methods: We describe the history, clinical findings, retinal imaging, and electrodiagnostic studies of a patient with a tapetal-like reflex (TLR) and pseudo-crystalline retinopathy secondary to RPGR mutation.Case Description: Asymptomatic TLR secondary to RPGR mutation was diagnosed in a 14-year-old African American female with a family history of retinal dystrophy and no other past ophthalmic or medical history. Pseudo-crystalline retinopathy was observed on the Optos scanning laser ophthalmoscopy (SLO) imaging system but not on color fundus photography (CFP). Evidence of a TLR secondary to RPGR mutation was confirmed by CFP, autofluorescence, and genetic testing.Conclusion: We present a case of pseudo-crystalline retinopathy seen on Optos imaging in a patient with a TLR secondary to RPGR mutation.
Collapse
Affiliation(s)
- David A Kilgore
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Tyler A Kilgore
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Suporn Sukpraprut-Braaten
- Department of Graduate Medical Education, Unity Health-White County Medical Center, Searcy, Arkansas, USA
| | - Gerald B Schaefer
- Department of Genetics, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Sami H Uwaydat
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
34
|
Gauldin D, Ahmad KT, Ferguson S, Uwaydat SH. Exposure of Contralateral Eyes to Laser Radiation during Retinal Photocoagulation. Curr Eye Res 2021; 46:1424-1427. [PMID: 33615938 DOI: 10.1080/02713683.2021.1884729] [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: 10/22/2022]
Abstract
Purpose/Aim: To investigate the risk of laser damage to the unprotected fellow eye of patients undergoing laser retinal photocoagulation with 532 nm diode pumped solid-state laser.Materials and Methods: A mannequin head was fitted with a Vega laser energy meter and PD10 photodiode laser measurement sensor. Lowest measurable energy for this sensor is 2 nJ at 900 nm. Simulated retinal laser treatments were performed on a model eye placed in one of the sockets of the mannequin head, while the laser sensor was placed in the opposite socket. Four simulated sessions of retinal photocoagulation were performed utilizing both slit lamp and indirect laser delivery systems. Each consisted of 10 applications of the laser directly into the model eye and 10 applications near but not directly into the sensor, utilizing various treatment settings.Results: No laser exposure was detected in the model eye during simulated retinal photocoagulation sessions aimed directly into the treatment eye. When the laser application was aimed near the sensor, no laser exposure was detected at the standard setting, however, in all sessions conducted at the higher laser power setting, the mean exposure detected was <6 µJConclusions: Laser exposure in the unprotected contralateral eye of patients undergoing retinal laser treatment with the PASCAL laser machine under standard PRP settings was found to be miniscule. However, we still recommend laser safety eyewear for the untreated eye to provide protection in the event of direct accidental laser exposure from surgeon error or laser malfunction, in accordance with the most current laser safety guidelines.
Collapse
Affiliation(s)
- Donald Gauldin
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kinza T Ahmad
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Scott Ferguson
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sami H Uwaydat
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
35
|
Sanders RN, Uwaydat SH. Simultaneous injection-aspiration technique of air/fluid exchange for in-office treatment of post-operative vitreous cavity hemorrhage. Int J Retina Vitreous 2021; 7:12. [PMID: 33593431 PMCID: PMC7885617 DOI: 10.1186/s40942-021-00282-z] [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: 08/12/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Post-operative vitreous cavity hemorrhage following pars plana vitrectomy is common. In-office drainage of the hemorrhage may be an option for some patients. TECHNIQUE A new method for office-based air fluid exchange is described. A 30-gauge needle with a 10-mm syringe filled with sterile air is inserted 3.5-mm posterior to the limbus in the superotemporal quadrant. A second 30-gauge needle is inserted 3.5 mm from the limbus at 6 o'clock and connected to an empty 10-mm syringe with intravenous catheter tubing. The plunger of the air-filled syringe is pushed while the plunger of the empty syringe is pulled, so that the rate of fluid aspiration matches the rate of air injection. DISCUSSION The method approximates conditions in pars plana vitrectomy, with balanced infusion and aspiration. Displaced vitreous cavity contents are collected in the aspiration syringe. The procedure is also cost effective. CONCLUSION The simultaneous syringe method is an easy, safe, and effective way of clearing post-operative vitreous cavity hemorrhage.
Collapse
Affiliation(s)
- Riley N Sanders
- Department of Ophthalmology, Jones Eye Institute, 4301 West Markham, Mail Slot 523, Little Rock, AR, 72205, USA
| | - Sami H Uwaydat
- Department of Ophthalmology, Jones Eye Institute, 4301 West Markham, Mail slot 526, Little Rock, AR, 72205, USA.
| |
Collapse
|
36
|
Kilgore DA, Behrens AW, Siddiqui MZ, Chancellor JR, Phillips PH, Uwaydat SH, Vonlanthen MG, Gonzalez-Krellwitz L, Sallam AB. Inflammatory choroiditis and papillitis from Crohn's disease in a child. J AAPOS 2021; 25:37-40. [PMID: 33127473 DOI: 10.1016/j.jaapos.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 11/29/2022]
Abstract
A 5-year-old boy had subacute painless visual loss in his left eye with disk edema, macular edema, and choroidal thickening. He was subsequently diagnosed with inflammatory papillitis and choroiditis from Crohn's disease. The disk and macular edema responded minimally to antivascular endothelial growth factor injections but significantly to intravitreal corticosteroids.
Collapse
Affiliation(s)
- David A Kilgore
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Alice W Behrens
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Mohammad Z Siddiqui
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - John R Chancellor
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Paul H Phillips
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| | - Sami H Uwaydat
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | | | - Ahmed B Sallam
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| |
Collapse
|
37
|
Abstract
BACKGROUND Clinical genetics has evolved significantly to become an efficient and effective means of diagnosing disease. Genetic treatments are now being developed which are showing promising results. However, ophthalmic patients are not utilizing genetic testing as part of their diagnostic workups. This paper explores the patient experience at the Ocular Genetics Clinic (OGC) at the University of Arkansas for Medical Sciences (UAMS) Jones Eye Institute and discusses reasons why patients continue to not pursue genetic testing. MATERIALS AND METHODS We performed a retrospective chart review to understand the main reasons why patients were referred to the OGC between 2009 and 2018, with a detailed analysis of why patients did not pursue genetic testing. RESULTS Patients mainly did not undergo testing due to the cost of testing. However, patient availability, patient interest, and diagnostic workup also drove a significant amount of this lack of testing. CONCLUSIONS Ocular genetic testing is becoming an increasingly beneficial tool for diagnosing ocular disease. However, to date, patients do not utilize this service fully. At the OGC, there are several main drivers for this lack of testing, namely finances, interest/availability, and diagnostic workup. As more ocular genetics clinics are established, it will be imperative to address reasons for forgoing genetic testing and to develop strategies to encourage patients to pursue this testing.
Collapse
Affiliation(s)
- R Scott Lowery
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences College of Medicine , Little Rock, AR, USA
| | - John R Dehnel
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences College of Medicine , Little Rock, AR, USA
| | - G Bradley Schaefer
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences College of Medicine , Little Rock, AR, USA
| | - Sami H Uwaydat
- Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences College of Medicine , Little Rock, AR, USA
| |
Collapse
|
38
|
Kirkland KA, Uwaydat SH, Siddiqui MZ, Chancellor JR, Soliman MK, Kurup S, Sallam AB. Outcome of Intravitreal Dexamethasone Implant Use in Uveitic Eyes Undergoing Pars Plana Vitrectomy Surgery. Ocul Immunol Inflamm 2020; 29:1126-1131. [PMID: 32142385 DOI: 10.1080/09273948.2020.1726970] [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: 10/24/2022]
Abstract
Purpose: To report the outcomes in eyes with noninfectious uveitis receiving dexamethasone implant at the time of pars plana vitrectomy (PPV).Methods: Retrospective analysis of visual acuity (VA), intraocular pressure (IOP), vitreous haze score (VHS), and central subfield thickness (CST) at baseline and follow-up visits.Results: Fourteen eyes received dexamethasone implant at the time of PPV. The CST was improved from 469 ± 182 µm at baseline to 320 ± 60 at 6 months (p = .0112) and 295 ± 46 at 12 months (p = .0728). Vitritis only recurred in 2 eyes at 6 months (18.2%) and 1 eye at 12 months (14.3%). The probability of VA improvement of ≥0.3 logMAR was 57% at 6 months and 66% at 12 months. Therapy for IOP rise was initiated in 6 eyes (42.9%).Conclusions: Local delivery of dexamethasone implant with PPV is a feasible method to counteract postoperative inflammation and macular thickening.
Collapse
Affiliation(s)
- Kyle A Kirkland
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mohammad Z Siddiqui
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - John R Chancellor
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mohamed K Soliman
- Department of Ophthalmology, Assiut University, Assiut, Egypt.,Department of Ophthalmology, University of Ottawa, Ottawa, Ontario, Canada
| | - Shree Kurup
- Department of Ophthalmology, University Hospital, Cleveland, Ohio, USA
| | - Ahmed B Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
39
|
Chancellor JR, Kilgore DA, Sallam AB, Allen RC, Uwaydat SH. A Case of Non-Resolving MEK Inhibitor-Associated Retinopathy. Case Rep Ophthalmol 2019; 10:334-338. [PMID: 31762764 PMCID: PMC6873042 DOI: 10.1159/000503414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 06/24/2019] [Accepted: 09/16/2019] [Indexed: 11/19/2022] Open
Abstract
The mitogen-activated kinase pathway plays an important role in cell survival, and its dysregulation is associated with cancers such as melanoma. Drugs designed to target this pathway have been associated with serous retinal detachments in a new entity termed MEK inhibitor-associated retinopathy (MEKAR). MEKAR has classically been described as self-limiting, with serous fluid often resolving without discontinuation of the drug. We present a case in which a patient undergoing treatment for metastatic melanoma with lacnotuzumab, a macrophage colony-stimulating factor inhibitor that blocks an upstream component of the mitogen-activated protein kinase pathway, developed serous retinopathy that did not resolve despite drug discontinuation.
Collapse
Affiliation(s)
- John R Chancellor
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - David A Kilgore
- University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Ahmed B Sallam
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Richard C Allen
- Section of Ophthalmology, Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sami H Uwaydat
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
40
|
Singh SR, Fung AT, Fraser-Bell S, Lupidi M, Mohan S, Gabrielle PH, Zur D, Iglicki M, M López-Corell P, Gallego-Pinazo R, Farinha C, Lima LH, Mansour AM, Casella AM, Wu L, Silva R, Uwaydat SH, Govindahari V, Arevalo JF, Chhablani J. One-year outcomes of anti-vascular endothelial growth factor therapy in peripapillary choroidal neovascularisation. Br J Ophthalmol 2019; 104:678-683. [PMID: 31401554 DOI: 10.1136/bjophthalmol-2019-314542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/15/2019] [Accepted: 07/27/2019] [Indexed: 11/04/2022]
Abstract
PURPOSE To report the visual and anatomical outcomes in eyes with peripapillary choroidal neovascularisation (CNV) through 12 months. METHODS This was a multicentre, retrospective, interventional case series which included treatment-naïve cases of peripapillary choroidal neovascular membrane (CNVM) with a minimum follow-up of 12 months. Multimodal imaging which comprised optical coherence tomography (OCT), fluorescein angiography and/or indocyanine green angiography was performed at baseline and follow-up visits. OCT parameters included central macular thickness (CMT), subfoveal choroidal thickness (SFCT) and retinal and choroidal thickness at site of CNV. Patients were treated with anti-vascular endothelial growth factors (VEGF) on pro re nata protocol, photodynamic therapy, laser photocoagulation or a combination. Main outcome measures were change in best corrected visual acuity (BCVA) and OCT parameters. RESULTS A total of 77 eyes (74 patients; mean age: 61.9±21.8 years) with a mean disease duration of 9.2±14.1 months were included. BCVA improved significantly from 0.55±0.54 logMAR (20/70) at baseline to 0.29±0.39 logMAR (20/40) at 12 months (p<0.001) with a mean of 4.9±2.9 anti-VEGF injections. CMT, SFCT and retinal thickness at site of CNVM reduced significantly (p<0.001, <0.001 and 0.02, respectively) through 12 months. The most common disease aetiologies were neovascular age-related macular degeneration, and idiopathic, inflammatory and angioid streaks. Age (p=0.04) and baseline BCVA (p<0.001) were significant predictors of change in BCVA at 12 months. CONCLUSION Peripapillary CNVM, though uncommon, is associated with diverse aetiologies. Anti-VEGF agents lead to significant visual acuity and anatomical improvement in these eyes over long term irrespective of the aetiology.
Collapse
Affiliation(s)
- Sumit Randhir Singh
- Smt Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India.,Retina and Uveitis Department, GMR Varalakshmi Campus, LV Prasad Eye Institute, Hanumanthawaka Junction, Visakhapatnam, Andhra Pradesh, India
| | - Adrian T Fung
- Department of Ophthalmology, Westmead Hospital, Sydney, New South Wales, Australia.,Save Sight Institute, Sydney Eye Hospital, University of Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Samantha Fraser-Bell
- Department of Ophthalmology, Sydney University, Sydney, New South Wales, Australia
| | - Marco Lupidi
- Department of Ophthalmology, University of Perugia, Perugia, Italy
| | - Sashwanthi Mohan
- Academy for Eye Care Education, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pierre-Henry Gabrielle
- Ophthalmology, Centre Hospitalier Universitaire de Dijon, Dijon, France.,Eye and Nutrition Research Group, Centre des Sciences du Goût et de l'Alimentation, INRA Centre de Dijon, Dijon, France
| | - Dinah Zur
- Division of Ophthalmology, Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Matias Iglicki
- Private Retina Service, University of Buenos Aires, Buenos Aires, Argentina
| | - Paula M López-Corell
- Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Cláudia Farinha
- Ophthalmology Department, Coimbra University Hospital Center, Coimbra, Portugal.,Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Luiz H Lima
- Ophthalmology, Federal University of Sao Paulo, São Paulo, Brazil
| | - Ahmad M Mansour
- Deaprtment of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | | | - Lihteh Wu
- Vitreo-retinal Department, Instituto de Cirugia Ocular, San Jose, Costa Rica
| | - Rufino Silva
- Ophthalmology Department, Coimbra University Hospital Center, Coimbra, Portugal.,Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
| | - Sami H Uwaydat
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Vishal Govindahari
- Smt Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India.,Retina and Uveitis Service, L V Prasad Eye Institute, MTC Campus, Bhubaneswar, Odisha, India
| | - Jose Fernando Arevalo
- Retina Division, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jay Chhablani
- Smt Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India
| |
Collapse
|
41
|
Sanders RN, Warner DB, Adams LR, Sallam AA, Uwaydat SH. Ocular Complications from Retained Intraocular Ointment Discovered 33 Months after Cataract Surgery. Case Rep Ophthalmol 2019; 9:493-498. [PMID: 30687069 PMCID: PMC6341354 DOI: 10.1159/000495002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 09/17/2018] [Revised: 10/31/2018] [Indexed: 11/19/2022] Open
Abstract
Topical antibiotic and steroid ointments are sometimes used topically at the conclusion of intraocular surgery, and inadvertent entry into the eye has been reported. Dispersed ointment droplets or consolidated globules in the anterior chamber (AC) can sometimes be visualized on exam. Occasionally, intraocular ointment is found incidentally without apparent toxic effect, but retained ointment usually presents with early or delayed intraocular inflammation, pressure rise, macular edema, or corneal edema. The usual treatment for toxicity from retained ointment is removal of the ointment. While the complication of ointment-induced cystoid macular edema has been reported, there is paucity of literature on the anatomical response and eventual visual outcome of patients who have been treated for long-standing edema from retained ointment. We present a case of a patient who presented with history of poor vision since the time of cataract surgery 33 months prior, who had cystoid macular edema, reduced endothelial cell count, and apparent Maxitrol ointment (neomycin, polymyxin B sulfate, and dexamethasone in paraffin vehicle; Novartis Pharmaceuticals UK) floating in the AC. The patient was treated with AC washout and sub-Tenon injection of triamcinolone. His vision, retinal architecture by optical coherence tomography, endothelial cell count, and pachymetry has been followed for 9 months following this treatment.
Collapse
Affiliation(s)
- Riley N Sanders
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - David B Warner
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Lindsey R Adams
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ahmed A Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
42
|
Behrens AW, Uwaydat SH, Hardin JS, Sallam AB. Office-based Air-Fluid Exchange for Diabetic Post-Operative Vitreous Cavity Hemorrhage. Med Hypothesis Discov Innov Ophthalmol 2019; 8:104-109. [PMID: 31264998 PMCID: PMC6592311] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Post-operative vitreous cavity hemorrhage (POVCH) is observed in 6-75% of eyes undergoing pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). We describe our technique for office-based Air fluid exchange (AFX) in the treatment of POVCH. Sixteen eyes (15 patients) with PDR and POVCH undergoing office-based AFX between January 2006 and November 2016 were retrospectively identified. The pre- and post- procedure visual acuity (VA) and complications were compared between eyes with and without traction retinal detachment (TRD). Medicare charges for office-based AFX versus PPV were also analyzed. Mean (± standard deviation [SD]) age at the time of AFX was 55.31 (± 8.02) years. Nine eyes (56.25%) had TRD prior to PPV and 11 eyes (68.75%) were pseudophakic. The improvements in mean (±SD) logMAR VA at the last postoperative visit (3 - 8 months) were 1.38 (± 0.99), 0.82 (± 0.91) and 2.09 (± 0.53) in all eyes, TRD eyes and non-TRD eyes, respectively. Complications included cataract progression, hypotony, and recurrence of TRD and ghost cell glaucoma. The total cost of outpatient AFX was $1,409.59 less than that of PPV. Office-based AFX is a cost-effective alternative treatment for non-clearing diabetic POVCH with an acceptable risk profile.
Collapse
Affiliation(s)
- Alice W Behrens
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sami H Uwaydat
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Joshua S Hardin
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ahmed B Sallam
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
43
|
Light JG, Chancellor JR, Uwaydat SH, Meena N, Chen C, Sallam AB. Sarcoidosis Uveitis Mimicking the Presentation of Intraocular Lymphoma. J Med Cases 2019. [DOI: 10.14740/jmc3190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
44
|
Soliman MK, Hardin JS, Jawed F, Uwaydat SH, Faramawi MF, Chu CJ, Yang YC, Sallam AB. A Database Study of Visual Outcomes and Intraoperative Complications of Postvitrectomy Cataract Surgery. Ophthalmology 2018; 125:1683-1691. [DOI: 10.1016/j.ophtha.2018.05.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 05/26/2018] [Accepted: 05/30/2018] [Indexed: 11/29/2022] Open
|
45
|
Affiliation(s)
- Ryan Oliver
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Ahmed B. Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Sami H. Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| |
Collapse
|
46
|
Goyal S, Uwaydat SH. Epidermal Growth Factor Receptor Inhibitor Induced Trichomegaly and Poliosis. Ophthalmology 2018; 125:294. [PMID: 29389408 DOI: 10.1016/j.ophtha.2017.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 11/01/2017] [Accepted: 11/02/2017] [Indexed: 10/18/2022] Open
Affiliation(s)
- Sunali Goyal
- Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sami H Uwaydat
- Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| |
Collapse
|
47
|
Wang H, Hardin J, Kaintatzis A, Uwaydat SH, Sallam AB. Inadvertent Expulsion of Fluocinolone Acetonide Intravitreal Implant during Pars Plana Vitrectomy. Ophthalmol Retina 2018; 2:75-77. [PMID: 31047311 DOI: 10.1016/j.oret.2017.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 06/04/2017] [Accepted: 06/07/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Hans Wang
- Faculty of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Joshua Hardin
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Antonis Kaintatzis
- Department of Ophthalmology, Gloucestershire Hospitals NHS Trust, Cheltenham, United Kingdom
| | - Sami H Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Ahmed B Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| |
Collapse
|
48
|
Uwaydat SH, Sallam AB, Wang H, Goyal S. Retinal Indentation by a Dexamethasone Implant in a Gas-Filled Eye: Report of an Unusual Complication. JAMA Ophthalmol 2017; 135:1125-1127. [PMID: 28910428 DOI: 10.1001/jamaophthalmol.2017.3276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Sami H Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Ahmed B Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Hans Wang
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Sunali Goyal
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock
| |
Collapse
|
49
|
Affiliation(s)
- Sunali Goyal
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Cornea and External Diseases, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Joshua Hardin
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sami H. Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Retina, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - David B. Warner
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Cornea and External Diseases, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ahmed B Sallam
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Retina, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
50
|
Abstract
Background We report a case of reversal of an acute corneal graft rejection following multiquadrant subtenon triamcinolone injection. Case Presentation A 19-year-old woman who had acute corneal graft rejection failed to show resolution of the graft rejection after standard treatment with systemic, intravenous, and topical steroids. The graft rejection, however, responded to injection of triamcinolone in multiple subtenon quadrants. Conclusions For corneal graft rejection, multiquadrant subtenon triamcinolone injections may be a safe adjunct to systemic treatment.
Collapse
Affiliation(s)
- Sunali Goyal
- Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sami H Uwaydat
- Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|