Mohamed Elshafie, Abdulrahman Radi, M. Abdelmawla, Hussein El-Ansarey
{"title":"Paracentral acute middle maculopathy after isotretinoin","authors":"Mohamed Elshafie, Abdulrahman Radi, M. Abdelmawla, Hussein El-Ansarey","doi":"10.4103/erj.erj_2_23","DOIUrl":"https://doi.org/10.4103/erj.erj_2_23","url":null,"abstract":"Paracentral acute middle maculopathy (PAMM) can be caused by a variety of retinal, ocular, iatrogenic, and systemic factors. Patients with PAMM typically have a sudden onset of paracentral scotomata, difficulty focusing, and/or blurred central vision. Isotretinoin is associated with multiple ocular side effects, including eye dryness and loss of night vision. In this study, we present a case of PAMM after 13 months of isotretinoin treatment with no evidence of other causes or relevant medical history.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114444071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Fathalla, Khaled Abdelazeem, S. Kedwany, T. Mohamed, Mahmoud Abdel-Radi, M. Mostafa, E. Wasfi, D. El-Sebaity
{"title":"Single-session prophylactic pan-retinal photocoagulation in moderate nonproliferative diabetic retinopathy in low-resource settings","authors":"Ahmed Fathalla, Khaled Abdelazeem, S. Kedwany, T. Mohamed, Mahmoud Abdel-Radi, M. Mostafa, E. Wasfi, D. El-Sebaity","doi":"10.4103/erj.erj_1_23","DOIUrl":"https://doi.org/10.4103/erj.erj_1_23","url":null,"abstract":"Purpose: To study patient's acceptability and safety of offering a prophylactic early single session of pan-retinal photocoagulation (PRP) for moderate nonproliferative diabetic retinopathy (NPDR) in selected patients. Settings and Design: Mixed observational and interventional study. Patients and Methods: The observational study included 82 eyes of 68 patients presenting with proliferative diabetic retinopathy (PDR) or its complications and the interventional study included 48 eyes of 48 patients with moderate NPDR who were offered a single session PRP because they were unlikely to comply with the follow-up protocol and were at higher risk of diabetic retinopathy (DR) progression. Results: The observational study showed that nearly 51% of patients had no idea about the DR screening protocols, 47.5% of included eyes presented with vitreous hemorrhage, 30.5% with tractional retinal detachment, and 22% with retinal neovascularization. The interventional study showed that minor patients' complaints were reported such as night vision problems, flashes, and peripheral field defects. There was no significant change in the mean preoperative logarithm of the minimum angle of resolution (logMAR) corrected distance visual acuity (CDVA) over time throughout the study (P = 0.951). At the end of follow-up, 89.5% of included eyes showed no loss of any lines of their preoperative logMAR CDVA and 10.5% lost only one line. All eyes remained in the same stage of moderate NPDR with no signs of progression to severe or very severe NPDR or proliferative DR. Conclusion: Prophylactic early PRP is an acceptable, safe, and satisfactory procedure for patients with moderate NPDR in low-resource settings.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134358470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khaled Abdelazeem, D. El-Sebaity, Esraa Mokhtar, E. Wasfi, Momen Mohammad Aly
{"title":"Comparison of manual versus automated choroidal thickness measurements using swept-source optical coherence tomography","authors":"Khaled Abdelazeem, D. El-Sebaity, Esraa Mokhtar, E. Wasfi, Momen Mohammad Aly","doi":"10.4103/erj.erj_3_23","DOIUrl":"https://doi.org/10.4103/erj.erj_3_23","url":null,"abstract":"Purpose: The purpose of this study was to compare the automated and manual choroidal thickness (CT) measures in normal eyes using swept-source optical coherence tomography (SS-OCT). Patients and Methods: This prospective study included 80 eyes from 40 normal volunteers. CT was measured manually and automatically in all eyes using Topcon deep-range imaging-1 SS-OCT. Automatically calculated measures, which are shown as a colored topographic map with nine subfields, defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) style grid, compared to manual measures at the subfoveal area, at four points 1 mm around the fovea as well as at four points 3 mm around the fovea. Results: The mean subfoveal CT (SFCT) was 271.77 ± 78.78 μm for the automatically measured ETDRS map and 282.81 ± 83.74 μm for the manual SFCT measurements. The difference between manual and automated measurement was the smallest in SFCT at 11.03 ± 35 μm and the greatest in the outer temporal area at 48.36 ± 49.83 μm. Manually measured CT was significantly higher (P < 0.001) in all nine areas compared to automated ETDRS map measurements. Conclusions: Manual measurement of CT is significantly higher than automated measurements. In addition, they cannot replace automated methods.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117031422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ashraf, Michael Gilbert, Abdulrahman M. Rageh, A. Souka, Jennifer K. Sun
{"title":"Diabetic retinopathy clinical research retina network protocols in the management of diabetic macular edema","authors":"M. Ashraf, Michael Gilbert, Abdulrahman M. Rageh, A. Souka, Jennifer K. Sun","doi":"10.4103/erj.erj_4_22","DOIUrl":"https://doi.org/10.4103/erj.erj_4_22","url":null,"abstract":"The Diabetic Retinopathy Clinical Research Network (DRCR) retina network was formed in 2002 through a United States National Eye Institute and National Institute of Diabetes and Digestive and Kidney Diseases-sponsored cooperative agreement with the objective of creating a collaborative network for multicenter clinical trials focusing on diabetic retinopathy (DR) and its associated complications. The DRCR Retina Network has initiated and completed 30 multicenter studies in over 350 clinical sites. The goals of the DRCR was to design, implement, and report clinical studies that would answer important questions related to clinical practice and management of DR as well as DME. Diabetic macular edema (DME) is the leading cause of vision loss in the working age population and until the turn of the century the treatment options were limited to macular laser. This review aims to summarize the major DME studies completed by the DRCR The current review covers the major clinical trials that have helped help establish the current standard of care in the management of DME including protocols A, B, I, T, U and V.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128345047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optical coherence tomography biomarkers in diabetic macular edema","authors":"Amira Mostafa, M. Ashraf, A. Souka, K. Raafat","doi":"10.4103/erj.erj_3_22","DOIUrl":"https://doi.org/10.4103/erj.erj_3_22","url":null,"abstract":"Biomarkers are defined as measurable objective indicators that can be used to assess normal physiological process, pathological process and/or tissue response to pharmacological therapeutic agents. In this review article, we address the most notable structural changes encountered in DME patients and their impact on treatment planning and outcomes.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124570873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Review on surgical management of diabetic macular edema","authors":"Mostafa El Manhaly, A. Souka","doi":"10.4103/erj.erj_1_22","DOIUrl":"https://doi.org/10.4103/erj.erj_1_22","url":null,"abstract":"Literature review for surgical management for both tractional and non-tractional diabetic macular edema; with and without internal limiting membrane peeling. According to the DRCR prospective study, traction relaxation allowed vision gain and reduction in central foveal thickness in tractional diabetic macular edema. Also data from small scale and pilot studies about the role of pars plana vitrectomy for non-tractional CI-DME management, showed visual gain and edema resolution in both naive and refractory cases. It is concluded that pars plana vitrectomy has a role the management of DME; however, large scale trials are needed to define the role, optimum timing, and patients characteristics for the usage of vitrectomy in non-tractional DME management.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"270 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131584357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laser in diabetic macular edema","authors":"T. Macky","doi":"10.4103/erj.erj_2_22","DOIUrl":"https://doi.org/10.4103/erj.erj_2_22","url":null,"abstract":"Laser photocoagulation has been an integral part of the management of diabetic macular edema (DME) for decades. And despite the dramatic changes in retinal imaging and the availability of new treatment options over the years it is still has a role in the pharmacotherapy era. First, as a supplementary treatment in eyes with CI-DME inadequately responding to antiVEGFs and steroids; to reduce the number and frequency of injections. And secondly, it is the only scientifically proven option for eyes with non CIDME with CSME features.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124409252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Abdellaoui, M. El Bahloul, A. Bennis, F. Chraïbi, A. Najdi, I. Benatiya
{"title":"Safety and long-term outcomes of repeated dexamethasone intravitreal implant (OZURDEX®) for the management of macular edema: Real-life study","authors":"M. Abdellaoui, M. El Bahloul, A. Bennis, F. Chraïbi, A. Najdi, I. Benatiya","doi":"10.4103/erj.erj_8_21","DOIUrl":"https://doi.org/10.4103/erj.erj_8_21","url":null,"abstract":"Purpose: This study to assess the efficacy and the safety of repeated dexamethasone intravitreal implant (Ozurdex®) in vascular macular edema in real-life practice. Materials and Methods: This was a 22-month prospective study, including eyes with vascular macular edema according to the inclusion criteria. Baseline and follow-up visits included best-corrected visual acuity (BCVA) measurement, slit-lamp biomicroscopy, dilated fundoscopy, intraocular pressure (IOP) measurement, and central macular thickness (CMT) measurement with optical coherence tomography. Main outcomes included changes in BCVA and CMT at the 1st, 2nd, 4th, and 6th months; time to retreatment; and incidence of side effects. Results: A total of 31 eyes of 24 patients were included in the present study. After the first intravitreal injection, BCVA (baseline 0.940 ± 0.463 LogMAR) improved significantly to 0.483 ± 0.323 LogMAR at 2nd month (P = 0.000), 0.657 ± 0.357 at 4th month (P = 0.000), and 0.690 ± 0,448 at 6th month (P = 0.001). Mean CMT (baseline = 582.51 ± 148.20) decreased statistically significantly at 2nd month and 4th month after the first intravitreal injection (245.87 ± 103.86 and 456.68 ± 182.735, respectively, both P < 0.001 vs. baseline). At the 6th month, CMT was 407.93 ± 212.70 for the 16 eyes that had not been reinjected versus baseline CMT 576.93 ± 158.56 (P = 0.008). After other Ozurdex® injections, we had the same visual acuity gain and CMT reduction, an average of 2.03 ± 0.83 injections were done. The most common side effects were cataract development and rise in IOP. Conclusion: Ozurdex® implant is an effective treatment for vascular macular edema with a good safety profile; however, its effectiveness seems to decrease with time requiring repeated injections.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133669231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mostafa Abdelfattah, O. Ali, Gamal Othman, M. Hussein
{"title":"Difference between diabetic macular edema and pseudophakic macular edema using optical coherence tomography","authors":"Mostafa Abdelfattah, O. Ali, Gamal Othman, M. Hussein","doi":"10.4103/erj.erj_4_21","DOIUrl":"https://doi.org/10.4103/erj.erj_4_21","url":null,"abstract":"Context: Macular edema (ME) is a common pathologic condition causing vision impairment. Diabetic retinopathy is a common cause of ME which can also develop after cataract surgery. Optical coherence tomography (OCT) is a noninvasive diagnostic technique that provides imaging of fine retinal details. Proper diagnosis of the underlying etiology shall affect the management. Aims: This study aims to differentiation between diabetic and pseudophakic ME (DME and PME) using OCT. Settings and Design: Cross-sectional study of 2 Groups; A: 30 eyes with DME and B: 20 eyes with PME. Subjects and Methods: Full clinical evaluation, OCT scanning, and data analysis were done for both groups. Statistical Analysis Used: SPSS software v. 16 was used for: Descriptive statistics, mean, range, and standard deviation. Student's t-test was used for comparison between means. Pearson correlation coefficient was used to assess correlation between variables. Results: Maximum macular thickness and central macular thickness were elevated in both groups but were higher in PME group (P = 0.042 and P = 0.00001, respectively). Macular thickness/volume ratio (TVR) was higher in PME group (P = 0.00001). Cystic changes had different distribution patterns; ganglion cell layer and retinal nerve fiber layer layers were free in PME(Pseudophakic macular edema) while inner nuclear layer and outer nuclear layer were affected in both groups (P = 0.0061). Epiretinal membranes were found much more in DME group (P = 0.0452). Dome-shaped macula was frequently noticed in PME group (P = 0.043). Conclusions: PME and DME have different OCT features; higher TVR, dome-shaped macula, absence of ERM suggest PME while lower TVR, presence of inner retinal cysts and/or ERM suggest DME.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121675537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ibrahim, Abdelrahman Salman, A. Said, Mariam Al-feky, M. Moustafa
{"title":"Efficacy of posterior sub-tenon's capsule injection compared to intravitreal injection of triamcinolone acetonide for treatment of diabetic macular edema: A systematic review and meta-analysis","authors":"M. Ibrahim, Abdelrahman Salman, A. Said, Mariam Al-feky, M. Moustafa","doi":"10.4103/erj.erj_15_20","DOIUrl":"https://doi.org/10.4103/erj.erj_15_20","url":null,"abstract":"Background: Diabetic macular edema (DME) is defined as a retinal thickening in one-disc diameter of the center of the macula. It is a number of microvascular retinal changes that lead to blood-retinal barrier disruption, causing leakage of fluid and plasma components into the inner and outer plexiform layers. Aim of the Work: To conduct a systematic review and a meta-analysis estimating the efficacy and complications of posterior sub-Tenon's capsule injection of triamcinolone acetonide (STTA) compared to intravitreal injection of triamcinolone acetonide (IVTA) for management of DME. Materials and Methods: A comprehensive literature search was conducted using the databases Google Scholar, PubMed, MEDS, web of science, EMBASE, and Cochrane Library for published studies from January 01, 2000 to September 01, 2019. This meta-analysis included ten studies. They were randomized controlled clinical trials, and about 343 patients with DME (469 eyes) participated in these studies. Results: This study demonstrated a statistically significant change in the mean of best-corrected visual acuity (BCVA) improvement and central macular thickness (CMT) reduction in both groups when comparing the baseline to 1- and 3-month follow-ups after the injection, though with no statistically significant difference in the IVTA compared to the STTA group. At a 6-month follow-up, both groups showed no significant differences in the BCVA and CMT compared to the baseline. Both groups showed no statistical differences in the BCVA or CMT over the follow-up periods. Regarding intraocular pressure (IOP) changes, the present study showed that the mean IOP was elevated in both groups at 1- and 3-month follow-ups after the injection compared to their baseline. There was a statistically significant difference between both groups at 1 and 3-months. The IOP was more elevated in the IVTA compared to the STTA group. At a 6-month follow-up, both groups showed no significant difference in the IOP elevation compared to the baseline. IOP elevation was the most reported adverse effect in all included studies. Cataract formation is also reported in some studies, though no other complications, such as endophthalmitis, vitreous hemorrhage, and/or retinal detachment, are reported in any of the studies. Conclusion: STTA injection has a comparable effect to the IVTA injection and carries a lower risk of intraocular complications. It is considered an easy, safe, and valid alternative to intravitreal injection for the treatment of DME.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116579339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}