Open Access Case study

Is the Diagnosis of Acute Posterior Multifocal Placoid Pigment Epitheliopathy with Fatal Cerebral Stroke Correct? A Case Report

Omer Takes, Aylin Yaman, Tolga Koroglu, Handan Guleryuz, A. Osman Saatci

Ophthalmology Research: An International Journal, Page 136-140
DOI: 10.9734/OR/2015/17164

Aim: To reiterate the fatal cerebral stroke in association with acute posterior multifocal placoid pigment epitheliopathy (AMPEE).

Report of a Case: A previously healthy 9-year-old girl developed acute visual loss in her left eye and was diagnosed to have unilateral acute posterior multifocal placoid pigment epitheliopathy (AMPEE) elsewhere and received systemic steroid treatment with topical steroid drops. She was seen a month later by us as no visual improvement was noted by the family. The patient was hospitalized  for a routine  systemic work-up as the diagnosis seemed  unconvincing. Three days after the hospitalization, she suffered a cerebral stroke and died in the hospital despite extensive treatment in the intensive care unit.

Conclusion: The neurologic changes including cerebral stroke can be seen in cases with AMPEE and high suspicion should be present in clinicians whenever a case with AMPEE diagnosed.


Open Access Case study

Scleral Repair by Biodegradable Collagen Implant in Strabismus Surgery

Momen Mahmoud Hamdi, Islam Mahmoud Hamdi

Ophthalmology Research: An International Journal, Page 141-146
DOI: 10.9734/OR/2015/17686

Aim: To evaluate biodegradable collagen implant as a patch for scleral defect.  

Case Presentation: A 3 years old girl was subjected to scleral rupture during lateral rectus (LR) advancement for correction of consecutive esotropia. A scleral defect accidentally occurred  with uveal exposure of an area 4x6 mm  posterior to the original insertion of the lateral rectus muscle The defect was covered by a patch of biodegradable collagen matrix (CM) implant  Ologen™ (Aeon Astron Europe B.V., Leiden, The Netherlands) measuring 12 mm diameter x 1mm thickness. Conjunctiva was meticulously closed over it. A follow up of 1 year was performed regarding ocular alignment and globe integrity which was assessed by slit lamp, fundus examination, photography and B-scan ultrasonography (U/S).

Results: Both eyes remained aligned. Scleral defect was well covered, healed by the collagen implant which was incorporated in the surrounding scleral tissues. During postoperative follow up, no uveal exposure and intact retina (no retinal breaks) were detected.

Discussion and Conclusion: Scleral rupture is a potential serious problem that can be managed by patching with collagen matrix biodegradable implant before closing the conjunctiva.


Open Access Original Research Article

RTVue Optical Coherence Tomography as an Imaging Modality for Scleral Thickness

Stephanie K. Cramer, Kristin Biggee, Robert Beardsley, Nicholas Schubach, Eric B. Suhler, Christina J. Flaxel

Ophthalmology Research: An International Journal, Page 95-99
DOI: 10.9734/OR/2015/14477

Purpose: To examine RTVue (Optovue, Inc) optical coherence tomography (OCT) as a method for measuring scleral thickness.

Methods: A prospective, single-center study of eyes with a variety of ocular diseases (no scleral diseases) was performed to image scleral thickness utilizing the RTVue OCT. Repeated measurements of scleral thickness were performed using a line scan 3 mm from the limbus in the inferior nasal and inferior temporal quadrants of each eye. Obtained values were analyzed statistically.

Results: A total of 25 eyes in 14 subjects were measured. An average of 3 measurements per location per eye were taken. The mean scleral thickness 3 mm from the limbus was 654.22 µm. The average standard deviation of the measurements from each location was 30.88 µm. The boundary of the conjunctiva and sclera was easily distinguishable.

Conclusion: The results of this study suggest that RTVue high-resolution OCT is a user-friendly modality for measuring scleral thickness.


Open Access Original Research Article

Relationship between Petrochemical Pollution and Oculo-Visual Health in Onelga Region of the Niger Delta

Desmond Eberechukwu Ihekaire

Ophthalmology Research: An International Journal, Page 100-128
DOI: 10.9734/OR/2015/14591

Common sense and simple economics suggest that countries endowed with an abundance of natural resources should prosper. Yet over many years, it has been observed that developing nations rich in oil, gas or mineral resources have been disadvantaged in the drive for economic growth. It is rather unfortunate that, after over fifty years of oil exploration and exploitation in Nigeria, the basic infrastructures seem to be in decay (as roads for instance, are now death traps, power supply is epileptic, poverty is an endemic problem as most of the erstwhile fertile lands in Niger Delta region is infertile and devastated by pollution, which invariably affects the health in general and the oculo-visual health in particular, of inhabitants of that region. The research design of this study was anchored on document analysis, which was based on an examination of records from three private eye clinics in Ogba, Egbema, Ndoni Local Government Area (ONELGA) of Rivers State, Nigeria. The population of this study comprised children, young adults, and workers living in and around ONELGA. The age range of the subjects is 6 months to 70 years. The study revealed that no significant relationship was found between oculo-visual health and general well-being of the citizens. The study concludes that in spite of the fact that there is no significant relationship between petrochemical pollution and oculo-visual health, there is the need to protect the vulnerable in the society from the harmful effects of petrochemicals on oculo-visual well-being.

Open Access Original Research Article

Repeated Intravitreal Bevacizumab Injections versus Single Combined Intravitreal Bevacizumab and Posterior Subtenon Triamcinolone Injections for Treatment of Diabetic Macular Edema

Amin F. Ellakwa, Sameh S. Mandour, Nermeen M. Badawi

Ophthalmology Research: An International Journal, Page 129-135
DOI: 10.9734/OR/2015/15827

Aim: To compare efficacy of combined intravitreal bevacizumab and subtenon triamcinolone versus three intravitreal injections of bevacizumab at one month interval for reducing foveal thickness.

Methods: Sixty eyes of 30 diabetic patients with bilateral diabetic macular edema were randomly enrolled in two groups, group A eyes treated with three intravitreal injections of Bevacizumab of 1 month apart, and group B eyes treated with a single intravitreal injection of Bevacizumab combined with a subtenon triamcinolone in the same operative session. Pre and postoperative clinical data were measured and followed up over 6 months.

Results: Difference between pre-treatment and post-treatment clinical data for each parameter in the same group was highly statistically significant.  However, on comparing results of post treatment BCVA, IOP and CMT in both groups, there was no statistically significant difference.

Conclusion: Combination of subtenon triamcinolone and intravitreal bevacizumab is a safe and effective choice to treat DME.