ABSTRACT
Background: Chronic corneal ulcers still pose etiological and therapeutic challenge. They are serious complications and often associated with poor functional prognosis
Aim: We report the case of a patient with bilateral and chronic corneal ulcer revealing a rare familial form of bilateral agenesis of the lacrimal gland
Cases report: A 39-year-old man was referred to our department for bilateralchronic and sterile ulcer. The tear break-up time was less than one second and the schirmer test detected no wetting in 5 minutes. He mentioned that lacrimation had been totally absent even when crying as was the case of his brother and his sister. Orbital echography showed absence of lacrimal gland. Orbital magnetic resonance imaging revealed absence of both lacrimal glands. Our patients were treated with permanent topical artificial tears. We performed also permanent occlusion of lower lachrymal poncti to preserve basic tear flow
Conclusion: Congenital lacrimal gland agenesis is rare. We report, to our knowledge, the first case of Tunisian family with three patients suffering from bilateral lacrimal gland agenesis and the first documented familiarly cases diagnosed in adulthood
ABSTRACT
Background: Maculopathy is a common complication of retinitis pigmentosa [RP], and compromise the visual acuity of RP patients even in the less advanced stages
Aim: To report the morphological macular findings detected by spectral domain optical coherence tomography [SD-OCT] and to determine their prevalence in patients with retinitis pigmentosa [RP]
Methods: SD-OCT scans from 100 patients [196 eyes] affected by RP were reviewed
Results: We noted a normal macula appearance in 48.5%, macular edema in 14.5% and macular atrophy in 37%. Mean central macular thickness was 167.79 microns and we did not note any statistically significant correlation between visual acuity and foveal thickness. Visual acuity was statistically better in eyes with a larger number of hyper-reflective layers [p<0.001] and in eyes with photoreceptor inner/outer [IS/OS] segment junction distinct [p<0.001]. We have identified three types of tomographic macular edema: a cystoids macular edema in 6.8%, a tractional edema in 8.2% and mixed edema in 1%. We identified two tomographic types of macular atrophy: a central- foveal atrophy in 34 eyes [11.6%] and diffuse atrophy in 38 eyes [12.9%]. Epiretinal membrane was present in 24 eyes [8.2%]
Conclusions: The OCT contributes to the analysis of epidemiological and morphological of different macular involvement in RP. OCT has a prognostic value, which essentially depends on the morphology of the IS/OS line and number of hyper-reflective layers
ABSTRACT
To study the epidemiological profile and the degree of severity of hyperopia in Tunisia primary school and to assess its effect on school performance. A cross-sectional, descriptive survey was conducted among 6-14 aged Tunisian children attending primary urban and rural schools. A total of 6192 children were selected using stratified random cluster sampling. Cycloplegic refractive error was measured among all children with uncorrected visual acuity less than 9/10 or signs of astheniopia. Hyperopia was defined as spherical equivalent [SE] >/= 2.0 diopters [D]. We have also searched a possible relation between degree of severity of hyperopia and school performance. The prevalence of hyperopia was 2.61%. The spherical equivalent mean was + 3.73 +/- 0.94 D. The mean age was 9.67 +/- 0.44 years. This prevalence was 2.77% in boys and 2.47% in girls. 3.13% of students were living in urban areas and 1.42% in rural areas. The hyperopia rate decreased significantly with age [p = 0.021], but it was not significantly related to gender [p=0.54]. The difference in the prevalence of hyperopia between urban and rural areas was not statistically significant [p = 0.067]. There was no significant association between the degree of severity of hyperopia and school performance [p=0.41]. In our study, the prevalence of hyperopia among schoolage children in Tunisia was 2.61%.The identification of this refractive error and its correction as soon as possible would ensure these children better visual comfort and a better education
ABSTRACT
To describe optical coherence tomography [OCT] findings in a patient with Berlin's edema following blunt ocular trauma. A 26-year-old man presented with acute loss of vision in his left eye following blunt trauma. He underwent a complete ophthalmologic examination and OCT. Fundus examination revealed abnormal yellow discoloration in the macula. OCT disclosed thickening of outer retinal structures and increased reflectivity in the area of photoreceptor outer segments with preservation of inner retinal architecture. Re-examination was conducted one month later at the time which OCT changes resolved leading to a surprisingly normal appearance. OCT can be a useful tool in the diagnosis and follow-up of eyes with Berlin's edema and may reveal ultrastructural macular changes