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Al Jarallah OJ, Alsakran WA, Galvez A. Risk Factors and Visual Sequel of Non-Arteritic Ischemic Optic Neuropathy in Saudi Arabia. J Pharm Bioallied Sci 2023; 15:S1075-S1078. [PMID: 37694050 PMCID: PMC10485508 DOI: 10.4103/jpbs.jpbs_215_23] [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: 03/06/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 09/12/2023] Open
Abstract
Objective To provide the demographic data, risk factors, and visual prognosis of patients from a Saudi population diagnosed with non-arteritic anterior ischemic optic neuropathy (NAION). Materials and Methods A retrospective observational case series of 120 patients (146 eyes) with NAION from the King Khaled Eye Specialist Hospital or King Abdulaziz University Hospital from 1998 to 2015. Patients with other retinal pathology or glaucoma were excluded from the study. Additionally, a subgroup analysis was performed to compare the long-term assessment between diabetic and non-diabetic patients and its effects on NAION. Results The mean duration of follow-up was 1.7 ± 2.4 years. The mean age of the study population was 55.0 ± 10.1 years. NAION was present in the fellow eye of 26 patients, and the median time for involvement was less than 1 year from the presentation. There was no significant difference in the best-corrected visual acuity between diabetics and non-diabetics at presentation or last visit (P = 0.868, P = 0.599, respectively). Conclusions The majority of patients with NAION also had coexisting diabetes mellitus. Diabetes mellitus had no significant effect on NAION during the presentation, follow-up, and last visit.
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Affiliation(s)
- Othman Jarallah Al Jarallah
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of ophthalmology, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Wael A. Alsakran
- Department of ophthalmology, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Alberto Galvez
- Department of Ophthalmology, University of Alberta, Edmonton, Canada
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Aljohani S, AlJaloud A, Alsakran WA, AlZaid A. INADVERTENT GLOBE PENETRATION AND SUBRETINAL INJECTION OF BOTULINUM TOXIN IN A PATIENT WITH OCULOCUTANEOUS ALBINISM. Retin Cases Brief Rep 2023; 17:302-304. [PMID: 34001765 DOI: 10.1097/icb.0000000000001160] [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] [Indexed: 04/26/2023]
Abstract
PURPOSE To present a case of localized retinal detachment and mild vitreous hemorrhage in a patient with oculocutaneous albinism after accidental intraocular injection of botulinum toxin A. METHODS Botulinum toxin A injection was administered to a 5-year-old patient with oculocutaneous albinism with esotropia and resulted in an ocular penetration. Dilated fundus examination indicated a nasal retinal tear causing a mild vitreous hemorrhage and a localized retinal detachment. RESULTS No treatment was required for the retinal detachment, and we observed the patient at regular intervals. On Day 1, the detachment resolved spontaneously without sequelae. On follow-up, scarring at the lesion site was detected at one month after the incidence, and the patient's vision was stable. CONCLUSION In this instance, observation was sufficient for our patient with complete resolution of retinal detachment and no long-term complication. Botulinum toxin A did not seem toxic to intraocular tissues. However, intramuscular botulinum toxin A injection should be administered carefully. Oculocutaneous albinism did not seem to affect the final outcome in our case.
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Affiliation(s)
- Saud Aljohani
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Imam Abdulrahman Bin Faisal University, Ophthalmology Department, Dammam, Saudi Arabia; and
| | - Ahmad AlJaloud
- Pediatric Ophthalmology Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Wael A Alsakran
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Abdulrahman AlZaid
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Alsakran WA, Nowilaty SR, Ghazi NG, Alzahrani Y, AlZaid A, Mura M, Arevalo JF, Abboud EB, Alsulaiman SM. Adjunctive Intravitreal Triamcinolone Acetonide for Exudative Retinal Detachment in Coats Disease. Journal of VitreoRetinal Diseases 2022; 6:54-62. [PMID: 37007720 PMCID: PMC9976219 DOI: 10.1177/24741264211018957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose: This work aims to assess the value of intravitreal triamcinolone acetonide (IVTA) as an adjunctive therapy in advanced Coats disease with exudative retinal detachment (ERD). Methods: A retrospective review was conducted of patients with Coats disease stage 3 or higher who received IVTA to decrease subretinal fluid (SRF), facilitate retinal ablative therapy, and avoid surgical drainage. Primary outcomes were SRF resolution and avoidance of surgical SRF drainage. Results: Seventeen eyes of 17 patients (mean, [SD] age, 3.9 [3.4] years) met the inclusion criteria. ERD configuration was bullous in 7 and shallow in 10 eyes. Following a single IVTA injection, ablative therapy was achieved after a mean (SD) of 2.1 (3.0) weeks. Complete SRF resolution was observed in 13 eyes (76.4%) after a mean of 1.3 IVTA injections and a mean of 2 (SD, 1.27) laser sessions, and none of these eyes required SRF drainage up to last follow-up (mean [SD], 50.5 [26.24] months). In 4 eyes with bullous ERD at presentation, SRF persisted ( P = .015) despite additional measures including surgical drainage. Final visual acuity ranged from 20/100 to no light perception. Cataract developed in 12 of the 17 eyes (70.5%). None developed an increase in intraocular pressure at final follow-up. Conclusions: IVTA injection can be a helpful adjunctive modality to address SRF in advanced Coats disease. It may obviate the need to surgically drain SRF to effectively treat the condition, particularly when the ERD is not highly bullous.
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Affiliation(s)
- Wael A. Alsakran
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Sawsan R. Nowilaty
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Nicola G. Ghazi
- Lebanese American University, School of Medicine and the Lebanese American University Medical Center, Beirut, Lebanon
| | - Yahya Alzahrani
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Abdulrahman AlZaid
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Marco Mura
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - J. Fernando Arevalo
- The Wilmer Eye Institute, Retina Division, Johns Hopkins University, Baltimore, MD, USA
| | - Emad B. Abboud
- Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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AlZaid A, Alsakran WA, Alsulaiman SM, Mura M. Comparison of heads up three dimensional visualization system to conventional microscope in retinopathy of prematurity related tractional retinal detachment. Sci Rep 2021; 11:22356. [PMID: 34785740 PMCID: PMC8595344 DOI: 10.1038/s41598-021-01806-1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/14/2021] [Indexed: 11/09/2022] Open
Abstract
To report the outcomes, advantages and disadvantages of a heads-up three-dimensional (3D) visualization system compared to the conventional microscope in pediatric tractional retinal detachment (TRD) surgery secondary to advanced stage retinopathy of prematurity (ROP). Medical records of patients with ROP stage 4 or 5 who underwent surgery for tractional retinal detachment at King Khaled Eye Specialist Hospital between September 2017 and July 2019 were identified and reviewed. Eyes were divided into 2 groups, eyes that underwent surgery with a 3D heads-up platform (3D group) and eyes that underwent surgery with a conventional microscope (conventional group). Data were collected on neonatal history, visual acuity, intraoperative complications and success rates between groups.Eighteen eyes of 14 patients who underwent surgical repair of TRD related to ROP. Postoperative outcomes were compared between 10 eyes (7 patients) in the 3D group and 8 eyes (7 patients) in the conventional group There was no statistically significant difference in success rate between both groups (75% conventional group vs 70% 3D group). Partial or complete reattachment was achieved in 7 eyes in 3D group compared to 6 eyes in conventional group. Lower postmenstrual age at the time of the first surgery and presence of retinal breaks were associated with poorer surgical outcome. Heads up 3D visualization system is feasible in tractional retinal detachment related to ROP with similar success rate and no increased risk of complications when compared to conventional microscope. This system may be advantageous in advanced pediatric tractional retinal detachment surgeries.
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Affiliation(s)
- Abdulrahman AlZaid
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, 11462, Saudi Arabia
| | - Wael A Alsakran
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, 11462, Saudi Arabia
| | - Sulaiman M Alsulaiman
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, 11462, Saudi Arabia
| | - Marco Mura
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh, 11462, Saudi Arabia. .,Department of Translational Medicine, University of Ferrara, Ferrara, Italy. .,Department of Ophthalmology, University of Illinois, Chicago, USA.
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Albabtain B, Mura M, Schatz P, Alsulaiman SM, Alsakran WA, Semidey VA. Comparison of Posterior Hyaloid Assessment Using Preoperative Optical Coherence Tomography and Intraoperative Triamcinolone Acetonide Staining During Vitrectomy. Clin Ophthalmol 2021; 15:3939-3945. [PMID: 34616138 PMCID: PMC8488048 DOI: 10.2147/opth.s331700] [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: 07/30/2021] [Accepted: 09/16/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the specificity of diagnosing posterior vitreous detachment (PVD) using preoperative optical coherence tomography (OCT) versus intraoperative triamcinolone acetonide (TA) staining in patients undergoing vitrectomy. Patients and Methods This retrospective cohort study included patients undergoing pars plana vitrectomy for diverse retinal pathologies. Intraoperatively, surgeons evaluated the posterior hyaloid status with TA staining and compared it with preoperative OCT findings. Results One hundred six patients underwent intraoperative assessments of posterior hyaloid status, with 72% (76/106) of the eyes showing positive staining. Sixty-two patients had also undergone preoperative OCT. Of the patients diagnosed with PVD on preoperative OCT, 50% (15/30) showed positive TA staining intraoperatively. The sensitivity of preoperative OCT assessment was 83.3%, and its specificity was 65.9%. Conclusion Preoperative OCT imaging is associated with lower sensitivity and specificity for diagnosing PVD when compared to intraoperative TA staining.
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Affiliation(s)
- Budoor Albabtain
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology, Prince Sultan Medical Military City, Riyadh, Saudi Arabia
| | - Marco Mura
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Patrik Schatz
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology, Clinical Sciences, Skane County University Hospital, Lund University, Lund, Sweden
| | | | - Wael A Alsakran
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Valmore A Semidey
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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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.
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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
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