Saudi Journal of Ophthalmology最新文献

{"title":"Re: A response to: Letter to the editor regarding research productivity of ophthalmology residents in Saudi Arabia: A comprehensive analysis.","authors":"Waleed K Alsarhani, Yahya Alyahya, Abeer Abdulghani Alkhodier, Ahmed Saad Al Zomia, Raed Alnutaifi, Motazz Alarfaj, Rahaf M Al Malawi, Hind M Alkatan","doi":"10.4103/sjopt.sjopt_351_25","DOIUrl":"10.4103/sjopt.sjopt_351_25","url":null,"abstract":"","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"40 1","pages":"105"},"PeriodicalIF":1.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of screen time and refractive errors on subjective and objective assessment of dry eye disease in young female subjects.","authors":"Noura Aldossary, Marwa Almesnad, Manal Alharbi","doi":"10.4103/sjopt.sjopt_104_25","DOIUrl":"10.4103/sjopt.sjopt_104_25","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the independent and combined effects of refractive errors (REs) and screen time on dry eye disease (DED) in young Saudi females.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 61 female students aged 18-26 years. Participants completed ocular surface index (OSDI) questionnaires and underwent RE measurement using an autorefractor/keratometer (NIDEK ARK-500A). Dry eye assessments included Schirmer's test for tear production and tear breakup time (TBUT) for tear film stability. Pearson's correlation and two-way ANOVA were used to analyze the relationships between RE, screen time duration, and DED parameters.</p><p><strong>Results: </strong>Screen time duration showed no significant associations with dry eye parameters, including OSDI (<i>P</i> = 0.14), Schirmer's test (<i>P</i> = 0.32), and TBUT (<i>P</i> = 0.70). In contrast, REs demonstrated a significant association with TBUT (<i>P</i> = 0.0014), while associations with OSDI (<i>P</i> = 0.49) and Schirmer's test (<i>P</i> = 0.97) were nonsignificant. This highlights a potential link between refractive status and tear film instability.</p><p><strong>Conclusion: </strong>This study suggests that REs may contribute to tear film instability, while screen time alone does not significantly affect dry eye symptoms or objective tear function. Further research is needed to enhance our understanding of DED risk factors in young adults.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"40 3","pages":"280-285"},"PeriodicalIF":1.1,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opposing pathophysiological concepts in multiple evanescent white dot syndrome: The great MEWDS schism.","authors":"Carl P Herbort, Ioannis Papasavvas, Abdulrahman F Albloushi, De-Kuang Hwang, Vania Lages, Wen-Jung Lo, Kazuichi Maruyama, Marina Papadia, Masaru Takeuchi, Yoshihiko Usui","doi":"10.4103/sjopt.sjopt_215_25","DOIUrl":"10.4103/sjopt.sjopt_215_25","url":null,"abstract":"<p><p>Multiple evanescent white dot syndrome (MEWDS) is a benign posterior uveitis involving the outer retina-choriocapillaris complex. The clinical picture, since its first description in 1984, is well-established. Classified at the benign end of the choriocapillaritis spectrum, including, among others, idiopathic multifocal choroiditis, serpiginous choroiditis, and acute posterior multifocal pigment epitheliopathy, a challenge to this classical choriocapillaritis classification of the disease was attempted, attributing the primary lesion process to a photoreceptoritis. The aim of this perspective and review article was to gather a sufficient body of evidence for a credible pathophysiological explanation of MEWDS. We reviewed the literature and integrated the results of some of our own studies on MEWDS. The crucial role of indocyanine green angiography (ICGA) and its correct interpretation is highlighted, giving clear indications that uptake failure of ICG by the retinal pigment epithelial (RPE) cannot explain ICGA hypofluorescence. In contrast to what is often claimed, ICGA hypofluorescence is already present in the early angiographic phases in MEWDS, speaking for a perfusion problem rather than the RPE nonuptake thesis. Hypoxic damage principally affects the photoreceptor cell but only minimally the RPE cell in MEWDS, explaining why primary photoreceptoritis has been privileged by some. The principles of optical coherence tomography angiography, being based on the presence of flow, it cannot detect the presence or absence of flow in low-flow end-capillaries and is, therefore, an inappropriate imaging modality for MEWDS. There is a continuum between MEWDS and other choriocapillaritis entities, which are all based on inflammatory choroidal circulatory dysfunctions of diverse severity, including MEWDS. We found a substantial body of evidence indicating that end-choriocapillaris nonperfusion is at the origin of MEWDS with limited secondary hypoxic damage mainly to the vulnerable photoreceptors and functional preservation of the metabolically more resistant RPE cell. As only small end-choriocapillary vessels are involved in MEWDS, spontaneous resolution of the disease occurs mostly without sequels.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"39 4","pages":"329-336"},"PeriodicalIF":1.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenetics of Behçet's disease: Is there a link to recent phenotypic changes?","authors":"Yohei Kirino, Masaki Takeuchi, Ahmet Gül","doi":"10.4103/sjopt.sjopt_416_25","DOIUrl":"10.4103/sjopt.sjopt_416_25","url":null,"abstract":"<p><p>Over the past decade, advances in genetic and genomic analyses, including genome-wide association studies, have provided substantial insights into the pathogenesis of Behçet's disease (BD). These studies revealed potential pathogenic mechanisms such as the preparation and presentation of peptides by HLA Class I antigens, mainly HLA-B51, and endoplasmic reticulum aminopeptidase 1, recognition of presented peptides by CD8 T cells, dysregulated innate and adaptive immune response, including autoinflammation, activation of Th17 cells, natural killer cells, and M1-polarized macrophages, as well as disordered mucosal barrier defense. The genetic architecture of BD shares similarities with Crohn's disease, spondyloarthritis, as well as childhood-onset autoinflammatory diseases such as familial Mediterranean fever, A20 haploinsufficiency, periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis syndrome, or late-onset autoinflammatory diseases such as VEXAS syndrome and trisomy 8-related autoinflammatory diseases. This review summarizes the current understanding of the immunogenetic basis of BD, emphasizing how the interplay between changing environmental exposures and inherited or acquired genetic variants contributes to its heterogeneous and variable phenotypic expression.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"39 4","pages":"323-328"},"PeriodicalIF":1.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indocyanine green-enhanced transpupillary thermotherapy in treatment of retinoblastoma: Experience in Indian eyes.","authors":"Abhishek Das, Prema Subramanian, Puja Maitra, Parag K Shah, Ventatapathy Narendran","doi":"10.4103/sjopt.sjopt_206_23","DOIUrl":"10.4103/sjopt.sjopt_206_23","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to study the outcome of indocyanine green enhanced transpupillary thermotherapy (ICG-E TTT) in the treatment of reactivation of retinoblastoma (RB) showing poor response to standard TTT after 6 cycles of systemic chemotherapy in pigmented Indian eyes.</p><p><strong>Methods: </strong>After initial 6 cycles of standard-dose intravenous chemotherapy and focal consolidation with conventional TTT, ICG-E TTT was considered for reactivation of RB postchemotherapy when there was no response to 2 consecutive standard TTT or when there was minimal/inadequate response to 4 or more standard TTT. Examination under general anesthesia was done after 4 weeks, and process was repeated if required. Treatment success was described as achieving a treatment-free follow-up and decreasing the need for further chemotherapy.</p><p><strong>Results: </strong>Ten eyes of 8 babies (7 with bilateral RB) received ICG enhanced TTT. In 8 out 10 eyes, good regression was noted following ICG E TTT, for a mean of 2 times using a mean power of 350 mW. Seven out of 8 babies did not need re-starting systemic chemotherapy for recurrence. The mean treatment-free follow-up was 6.4 months.</p><p><strong>Conclusion: </strong>Using ICG-enhanced TTT, we achieved longer treatment-free follow-up and a decrease in the need for restarting systemic chemotherapy.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"39 4","pages":"366-370"},"PeriodicalIF":1.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical insights into mitochondrial retinopathy: A case report on m.3243A>G mutation and macular dystrophy.","authors":"Nourelhouda Boussaid Othmani, Sebastian Mathew","doi":"10.4103/sjopt.sjopt_314_24","DOIUrl":"10.4103/sjopt.sjopt_314_24","url":null,"abstract":"<p><p>Mitochondrial disorders, particularly those associated with the m.3243A>G mutation in the MT-TL1 gene, can manifest with diverse systemic and ocular features, including mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and maternally inherited diabetes and deafness. Retinal involvement often presents as macular pattern dystrophy. A 65-year-old female with a known history of mitochondrial disease (m.3243A>G mutation) presented for evaluation of retinal findings. She had asymptomatic diabetes and deafness, with visual acuity measured at 0.12 bilaterally. Clinical examination revealed clear corneas, nonsignificant cataracts, and fundoscopic findings of patchy retinal and parafoveal atrophy with preserved foveal regions. Optical coherence tomography indicated a preserved fovea, but thinning of perifoveal layers. The findings suggest retinal dystrophy indicative of mitochondrial retinopathy, characterized by macular pattern dystrophy associated with the m.3243A>G mutation. Given the potential for varied clinical presentations linked to this mutation, multidisciplinary evaluations are essential to assess systemic involvement and facilitate appropriate management. This case underscores the importance of recognizing retinal manifestations in patients with mitochondrial disorders, particularly in those with the m.3243A>G mutation, and highlights the need for comprehensive monitoring and care.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"39 4","pages":"416-418"},"PeriodicalIF":1.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behçet disease: A unique systemic vasculitis with a distinct form of ocular involvement.","authors":"Ilknur Tugal-Tutkun, Ahmet Gül","doi":"10.4103/sjopt.sjopt_407_25","DOIUrl":"10.4103/sjopt.sjopt_407_25","url":null,"abstract":"","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"39 4","pages":"287-289"},"PeriodicalIF":1.1,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Nocardia</i> keratitis: Microbiological characteristics, antibiotic sensitivity, and clinical profile in a tertiary care setting.","authors":"Mehdi Aminizade, Ghazal Ghochani, Kosar Esmaili, Amirhossein Hashemi, Amirhossein Valizadeh, Mohamad Sanei, Jaron C Sanchez, Seyed A Tabatabaei, Morteza Karimi, Mohammad Soleimani","doi":"10.4103/sjopt.sjopt_157_25","DOIUrl":"10.4103/sjopt.sjopt_157_25","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the clinical characteristics, microbiological profile, and management strategies of <i>Nocardia</i> keratitis in patients referred to Farabi Eye Hospital, a tertiary care center.</p><p><strong>Methods: </strong>This retrospective study on culture-proven <i>Nocardia</i> keratitis (2014-2024) included biomicroscopic examinations, visual acuity assessments, and culture-based diagnoses. It analyzed risk factors, clinical features, and antibiograms, with treatments consisting of fortified antibiotics and surgical interventions.</p><p><strong>Results: </strong>A total of 38 patients were included in the study, with 16 requiring inpatient management and 22 managed as outpatients. The mean duration from symptom onset to presentation was 28.62 (median = 4.0) days, and the mean infiltration size was 2.7 ± 1.0 mm. Contact lens (CL) use was the most common risk factor, identified in eight patients (21.1%). There were no significant differences in age, infiltration size, presenting visual acuity (logMAR), or admission duration between CL users and nonusers (<i>P</i> > 0.05). The mean visual acuity was 1.56 logMAR at presentation and showed a slight, nonsignificant improvement to 1.49 logMAR at discharge (<i>P</i> = 0.3). Surgical intervention was required in eight patients (50% of admitted cases), with penetrating keratoplasty performed in five patients (31.3%). Three cases developed endophthalmitis. All isolates (100%) were susceptible to amikacin, while 91.7% were susceptible to imipenem.</p><p><strong>Conclusion: </strong><i>Nocardia</i> keratitis, though rare, can lead to vision-threatening complications with a prolonged course. Recognizing risk factors like CL use and ocular trauma is crucial, and while amikacin is the primary treatment, alternatives like imipenem may be effective in certain cases.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"40 2","pages":"183-188"},"PeriodicalIF":1.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of type 2 diabetes mellitus on anterior segment parameters.","authors":"Huzeyfe Ocal, Yasemin O Erol, Burcu Kazanci, Dilek O Soba, Mustafa S Karatepe, Jale Karakaya","doi":"10.4103/sjopt.sjopt_279_24","DOIUrl":"10.4103/sjopt.sjopt_279_24","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate the impact of type 2 diabetes mellitus (DM) on anterior segment parameters.</p><p><strong>Methods: </strong>A total of 90 patients with DM and 30 control subjects were included, and patients were divided into three groups (<i>n</i> = 30 for each) based on the presence and type of diabetic retinopathy (DR) including those with no DR (NDR), those with nonproliferative DR (NPDR), and those with proliferative DR (PDR). Anterior segment parameters obtained with a Pentacam HR device were compared between study groups as well as according to the duration of diabetes and glycated hemoglobin level.</p><p><strong>Results: </strong>In the NPDR, there was a statistically significant increase in the zone 3 lens density (LD) compared to the control and NDR (<i>P</i> = 0.030 and <i>P</i> = 0046, respectively). The anterior chamber volume was significantly lower in the PDR than in the NPDR (<i>P</i> = 0010). Anterior chamber depth was significantly lower in the PDR than in the control (<i>P</i> = 0023). Diabetes duration of ≥20 years was associated with a significantly higher zone 3 lens densitometry value compared to diabetes duration of <10 years (<i>P</i> = 0037).</p><p><strong>Conclusion: </strong>The detection of increased LD and other anterior segment changes in diabetic eyes using Pentacam may be an indicator in these patients that diabetes regulation should be controlled, even in the absence of clinical cataract development. It is noteworthy that the effects of DM on the anterior segment are not parallel to the effects on the retina.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"40 3","pages":"293-298"},"PeriodicalIF":1.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lacrimal sac tumors: A case series over 27 years.","authors":"Dalal Fatani, Shaima Alrefaie, Mashael AlKhayal, Hailah AlHussain","doi":"10.4103/sjopt.sjopt_123_25","DOIUrl":"10.4103/sjopt.sjopt_123_25","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to document and analyze the clinical characteristics, diagnostic approaches, and treatment outcomes of lacrimal sac tumors in a tertiary eye hospital in Saudi Arabia.</p><p><strong>Methods: </strong>A retrospective review was conducted of medical records from patients presenting with lacrimal sac tumors at King Khaled Eye Specialist Hospital between 1997 and April 2024. Demographic data, presenting symptoms, diagnostic imaging results, histopathological diagnoses, treatment modalities, and follow-up outcomes were analyzed.</p><p><strong>Results: </strong>A case series of 13 patients with histopathologically confirmed lacrimal sac tumors was included in the study. The cohort consisted of 6 males and 7 females, with a mean age of 42 years. The majority of tumors were benign (61.5%), with atypical lymphoid hyperplasia being the most common (46%). Malignant tumors comprised 38% of cases, including squamous cell carcinoma and various lymphomas. Common presenting symptoms were epiphora (92%) and medial canthal swelling (68.4%). Surgical excision was the primary treatment modality, supplemented by radiotherapy for lymphomas. The overall recurrence rate was 15%, with no direct tumor-related mortality observed.</p><p><strong>Conclusion: </strong>Lacrimal sac tumors in this population predominantly presented as benign lesions, with a lower malignancy rate compared to previous reports. The study highlights the importance of early diagnosis and individualized treatment strategies. Future research with larger sample sizes and longer follow-up periods is necessary to develop standardized management protocols and improve patient prognoses.</p>","PeriodicalId":46810,"journal":{"name":"Saudi Journal of Ophthalmology","volume":"39 3","pages":"238-242"},"PeriodicalIF":1.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12578426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}