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   Table of Contents - Current issue
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January-March 2020
Volume 113 | Issue 1
Page Nos. 1-32

Online since Friday, May 15, 2020

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ORIGINAL ARTICLES  

Vision-related quality of life in children cured of retinoblastoma p. 1
Samar S Hammad, Sherif Elwan, Azza M.A Said, Yousra A.T Farweez
DOI:10.4103/ejos.ejos_61_19  
Purpose The aim was to assess visual functions in patients with retinoblastoma (Rb) after treatment and complete cure and the effect of this on quality of life by means of visual functioning questionnaire-39 (VFQ-39). Patients and methods A cross-sectional study was carried out in the period from July 2017 to February 2018 in Ophthalmology Department, Ain Shams University Hospital, Retinoblastoma Clinic. A total of 30 patients were recruited at least after 1 year of complete cure from Rb. They were classified into two groups: group I included unilateral cases (15 patients), and group II included bilateral cases (15 patients). All children were subjected to detailed history, and ophthalmological examination included best-corrected visual acuity (BCVA), binocular and color vision assessment, and dilated fundus examination. Scoring of VFQ-25 and VFQ-39 subscales was conducted by the parents. Results Mean overall vision-related quality of life scores were 90.5±10.45 (range: 60.9–100) and 89.1±8.59 (range: 76.1–100) in groups I and II, respectively, with no difference of statistical significance being found between them (P=0.86), with marked affection of mental health in group II. A highly statistically significant negative correlation was found between each of BCVA (logMAR) and duration of therapy and the mean total score (r: −0.57, P=0.001, and (r: −0.41, P=0.04, respectively). Conclusion High scores regarding VFQ-25 and VFQ-39 subscales were achieved in older children with Rb, with no difference between unilateral and bilateral cases. BCVA and duration of therapy had a big influence on the results.
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Effect of adding of dexmedetomidine to local anesthesia in external dacryocystorhinostomy patients p. 9
Mohamed A Nassef, Ahmed F Gabr, Sameh A Ahmed
DOI:10.4103/ejos.ejos_47_19  
Purpose The aim was to study the efficacy and safety of addition of dexmedetomidine to local anesthesia (LA) for patients undergoing external dacryocystorhinostomy (DCR). Patients and methods A total of 70 adult patients who presented for external DCR were included in this prospective double-blinded study. They were randomly distributed into two equal groups. All patients received LA with 8 ml mixture, composed of 3.5 ml of lidocaine 2% without epinephrine and 3.5 ml of plain bupivacaine 0.5%. Either 1 ml normal saline (0.9%) or that containing 20 µg dexmedetomidine was added to the mixture for each group. The onset and the duration of sensory blockade as well as perioperative sedation were verified. Visual analog score was evaluated in the postoperative period till 12 h postoperatively. Anesthesia-related perioperative complications and patient satisfaction were also reported. Results Dexmedetomidine added to a LA block in external DCR significantly decreased the onset of anesthesia to 2.23±2.11 min (P=0.015) and increased the duration of sensory block to 200.45±37.98 min (P=0.0001). In addition, it significantly decreased the postoperative pain score 6–8 h postoperatively (P<0.05). Moreover, increased sedation level and patient satisfaction were noted (P<0.05), without significant increase in the incidence of adverse effects or complications. Conclusion Addition of low-dose dexmedetomidine to LA infiltration in external DCR hastens the onset and prolongs the effective period of the sensory block. Enhancement of postoperative analgesia, increased perioperative sedation. and improved satisfaction of the patients were achieved without significant complications.
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Electrophysiological findings of Bardet–Biedl syndrome: a case series p. 14
Marwa A Tabl
DOI:10.4103/ejos.ejos_73_19  
Background Bardet–Biedl syndrome (BBS) is a very rare autosomal recessive genetic disease with multiple manifestations including the ocular system. Aim This study presents different electrophysiological and clinical findings in three female patients with BBS. Patients and methods 3 female patients (9, 10 and 16 years old) with BBS were complaining of progressive visual loss. Full ophthalmological examination, optical coherence tomography (OCT) and various electrophysiological tests were performed to the 3 cases. Results The fundoscopic findings in all three patients did not show evidence of obvious characteristic signs of retinitis pigmentosa. They presented clinically with atypical form of pigmentary retinal dystrophy. Flash electroretinogram showed severe form of Rod-cone dystrophy in the 3 cases associated with macular dysfunction evident by reduced amplitude and increased implicit time of P1 wave of the multifocal electroretinogram in all rings. The pattern electroretinogram was with poor formed P50 wave. Pattern visual evoked potential showed prolonged latency and reduced amplitude of P100 wave in large and small checks. Conclusion Very reduced flash and multifocal electroretinogram is a Characteristic electrophysiological finding in BBS, which may precede the funduscopic changes, electrophysiological tests may help in the early diagnosis of such cases.
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A comparative study of OCT findings in low and high myopia p. 22
Tarek M Abdalla, Amr I Elawamry, Ossama T Nada, Mariam R Helal
DOI:10.4103/ejos.ejos_26_19  
Aim This study aimed to compare macular findings between low and high myopia. Patients and methods In all, 60 myopic eyes were included in this study. They were divided according to refraction into low myopia of less than or equal −6 SD and high myopia of more than −6 SD. All patients were subjected to automated refraction, correction of vision, A-scan by Isa intra Ocular length (IOL) master for axial length, and optical coherence tomography (OCT) scan for macular mapping. Results The mean central macular thickness (CMT) of low myopic cases was 255.5±17.13, with all low myopic cases showing no complication by OCT while the mean CMT of high myopia was 262.10±67.51 with some complications. Regarding choroidal neovascularization (CNV), it was statistically significantly higher in the high myopic group when compared with the low myopic group, while macular hole showed no significance. Thinning of RPE and myopic contour showed high significant statistical difference to high myopic group. Discussion The mean CMT of low myopic cases was slightly thinner than in high myopic cases but with no statistical significance. Myopic CNV is more common with high myopia and may be related to sex. Thinning of RPE and myopic contour are mainly found in high myopia. Conclusions In our study, there was no significant correlation between CMT and axial length. Regarding CNV, it was statistically significantly higher in the high myopic group when compared with the low myopic group, while macular hole showed no significance. Thinning of RPE and myopic contour are mainly found in high myopia.
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Early detection of neurodegeneration in type 2 diabetic patients without diabetic retinopathy using electroretinogram and spectral-domain optical coherence tomography p. 26
Marwa A Tabl
DOI:10.4103/ejos.ejos_72_19  
Purpose The aim was to assess early functional and structural changes in the neural retina in type 2 diabetic patients with no clinical signs of diabetic retinopathy (DR). Patients and methods A total of 92 eyes of 48 patients were included, which were divided into the following groups: 30 eyes of 16 participants with type 2 diabetes mellitus without clinical DR, with a mean age of 48.75±3.09 years, as group 1; 30 eyes of 16 participants with type 2 diabetes mellitus with DR, with a mean age of 51.75±2.86 years, as group 2; and a control group of 32 eyes of 16 healthy age-matched and sex-matched participants, with a mean age of 49.88±4.26 years. After full ophthalmologic examination, spectral-domain optical coherence tomography scans, multifocal electroretinogram (Mf-ERG), pattern electroretinogram (PERG), and photonegative response (PhNR) were tested for all participants. Statistical analysis was performed to compare ganglion cell complex (GCC) thicknesses, multifocal electroretinogram, PERG, and phNR values between the groups. Results There were no statistically significant differences between the studied groups regarding age, sex, refraction, or intraocular pressure (P=0.056,0.72, 0.16, and 0.35, respectively). There were significant differences of total GCC thickness values among group 1 (107.13±7.04 μm), group 2 (97.27±10.97 μm), and control group (113.81±5.26 μm) (P<0.001). The superior and inferior quadrants of GCC were significantly thinner in the groups 1 and 2 in comparison with the control group. Mf-ERG foveal P1 wave amplitude was significantly reduced in groups 1 and 2 in comparison with control group (P<0.001). There were significant differences of PERG/N95, phNR amplitude, and implicit time between the studied groups. Conclusion The preclinical DR presents with neural loss in the macular area, evident by the reduction GCC thickness and impairments of mf-ERG, PERG, and phNR parameters. Neurodegenerative changes precede the microvascular damage in these patients.
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