Open Access Case study

Topical Steroids, HIV Status, CD4 Cells and Corneal Health

Emmanuel Olu Megbelayin, Stephen Mbosowo Ekpenyong, Chiedozie Kingsley Ojide

Ophthalmology Research: An International Journal, Page 9-12
DOI: 10.9734/OR/2015/12301

A 36 year old patient presented with a history of pain and progressive loss of vision in the right eye which had lasted for 2 months. He was on topical steroids for about one year before presentation with a CD4 cell of 200cells/μL. Examination reviewed a perforated cornea with a huge uveal prolapse. Topical steroids were immediately discontinued and patient placed on topical and systemic antibiotics. Following resolution of the clinical signs, Gunderson’s flap was raised to cover the prolapsed uvea. By 6th week post-op, a vascularised pseudo cornea had covered the exposed uvea resulting in cessation of pain in the eye. Conclusion: Gunderson’s flap is a viable option for a prolapsed uvea in an immuno-incompetent patient.


Open Access Original Research Article

The Relationship of HLA-B27 and HLA-B51 on Non-Behcet Uveitis

Ercument Cavdar, Abdullah Ozkaya, Hande Mefkure Ozkaya, Sınan Bılgın, Ozge Elmastas Gultekin, Mustafa Alparslan Babayigit

Ophthalmology Research: An International Journal, Page 1-8
DOI: 10.9734/OR/2015/13047

Aims: The aim of this study was to investigate the relationship of human leukocyte antigen (HLA)-B27 and HLA-B51 on the clinical characteristics, demographic features, localization, laterality, treatment modalities and visual prognosis in non-Behcet uveitis patients

Study Design: Retrospective study.

Place and Duration of Study: Tepecik Eye Training and Research Hospital. January 1999 and March 2009.

Methodology: A total of 143 non-Behcet uveitis patients were included. Socio-demographic data and clinical features of the patients were reviewed. The patients were divided into four groups according to HLA-B27 and B-51 positivity which were as follows; HLA B-27 (-) B-51 (-), HLA B-27 (+) B-51 (-), HLA B-27 (-) B-51 (+), and HLA B-27 (+) B-51 (+) groups.

Results: Bilateral uveitis and posterior uveitis were more frequent in males in HLA-B27 (+) B51 (+) group, the baseline BCVA values were significantly lower in HLA-B27 (+) B51 (+) group, and also systemic steroid and immunosuppressive treatment were more frequently required to control uveitis attacks in this group. Anterior uveitis was more frequent in the HLA-B27 (-) B51 (-), and HLA-B27 (+) B51 (-) group.

Conclusion: The positivity of both HLA-B27 and HLA-B51 was related with worse visual outcomes in non-Behcet uveitis patients associated with requirement of more aggressive treatment. The negativity of both HLA-B27 and HLA-B51 seemed to be related with better visual outcomes and less number of attacks in non-Behcet uveitis patients.


Open Access Original Research Article

Comparison of Ocular and Developmental Outcomes in Laser-and Bevacizumab-treated Infants with Retinopathy of Prematurity

Lingkun Kong, Kimberly L. Dinh, Sid A. Schechet, David K. Coats, Robert G. Voigt, Ann B. Demny, Paul G. Steinkuller

Ophthalmology Research: An International Journal, Page 13-22
DOI: 10.9734/OR/2015/13281

Purpose: To compare vision and developmental outcomes in infants who were treated with intravitreal bevacizumab injection (IVB) versus laser for retinopathy of prematurity (ROP).

Methods: Forty-two infants were enrolled in this study and treated with either IVB at 0.625 mg per eye, per dose (22 patients, 43 eyes), or laser (20 patients, 37 eyes) for type I ROP. Systemic complications were compared between these two groups. Structural examinations and cycloplegic refractions were performed at age 1 year. Body weight gains were collected from birth to 36 weeks of postnatal age. Neurodevelopmental assessment was done at 1 year chronological age.

Results: At 1 year of age, four eyes (10.8%) in the laser-treated group and none (0.0%) in the IVB-treated group had unfavorable structural outcome; ten (30%) eyes in the IVB-treated group and 17 (53%) eyes in the laser-treated group were myopic, p =0.03; the mean spherical equivalent was -0.03 diopter (D) in the IVB-treated group and -2.94 D in the laser-treated group, p=0.02. The mean visual acuity in LogMar was 0.54 (SD, 0.34) and 0.58 (SD, 0.52) in the IVB- and laser-treated groups, respectively (p=0.31). The average weekly weight gain continued at normal rates in both groups after treatment. Seven of ten patients (70%) in the IVB-treated group and six of nine patients (67%) in the laser-treated group were categorized as severely developmentally delayed. 

Conclusions: Bevacizumab intravitreal injection had similar short-term efficacy compared to laser treatment with regard to treatment of type I ROP but was associated with a lower prevalence of high myopia.


Open Access Original Research Article

Barriers to Free Cataract Surgery in Yaoundé

Kagmeni Giles, Domngang Noche Christelle, Noa Noatina Blaise

Ophthalmology Research: An International Journal, Page 23-27
DOI: 10.9734/OR/2015/12706

Purpose: To identifying barriers to massive turnout for free cataract surgery campaigns in Yaoundé

Methods: We prospectively interviewed 68 patients who radically refused free cataract surgery at the University Teaching hospital (UTH) Yaoundé between January 2008 and December 2010. The questionnaire aimed at addressing: the knowledge of the cataract and its surgical treatment, the awareness of government’s subvention for free cataract operation, the reasons for refusal. Patient demographic data were also analyzed.

Results:  A total of 68 patients (41 males and 27 females), mean age was 57.20 ± 11 years were enrolled in this study. Forty three patients (63.23%) were civil servants with fixed salaries, 25 (36.77%) were workers in the informal sector. 80% of the participants had a good knowledge of cataract and its surgical treatment. 58,82 % of the patients were aware of the ongoing government  subsidized campaign. Refusal reasons included: fear 38 (55.88%), awaiting of foreign NGO campaign 20 (29.42%), religious convictions 6(8.82%) wish for surgery abroad 4 (5.58%)

Conclusion:  Fear and awaiting for foreign NGO surgery campaign were the main barriers for free cataract surgery in Yaoundé. Therefore, sporadic free cataract campaigns organized by foreign NGO appear to become a new barrier to cataract surgery.


Open Access Original Research Article

A Comparative Study of Pterygium Excision Using Autologous Blood versus Sutures; a Study from Remote Eastern Bihar, India

P. Peeush, S. Sarkar

Ophthalmology Research: An International Journal, Page 28-32
DOI: 10.9734/OR/2015/12466

Aims: The study was undertaken to assess the surgical modalities for treatment of Pterygium in rural population.

Study Design:  Prospective study.

Place and Duration of Study: Study was conducted in the Department of Ophthalmology for a period of July to December 2013.

Methodology: All the grade 1 and 2 patients between age group 25-50years without any history of diabetes and /or oral anticoagulant agent intake were included in this study while others were excluded. The patients were randomly divided into two groups for pterygium excision with autograft using either autologous blood or sutures. Post operatively, these patients were then observed for presence of pain, irritation and graft failure on day 1, day 7 and 1month.

Results: The surgical rate of success was better for sutures compared with autologous blood in rural eastern population.

Conclusion: Autologous conjunctival graft with sutures was found to have better outcome in terms of surgical success when compared with a new approach of autologous blood especially in the areas with patients of poor compliance.