Voluntary testing for COVID-19: perceptions and utilization among the inhabitants of Saudi Arabia

Objectives@#Voluntary testing (VT) plays a crucial role in the prevention and control of infectious diseases. The present study investigated the perceptions and utilization of VT services for coronavirus disease 2019 (COVID-19) among the inhabitants of Saudi Arabia. @*Methods@#In total, 3,510 adult participants from all provinces of Saudi Arabia were recruited via a national online survey. @*Results@#Of the 3,510 participants, 88.9% were aware of the testing services available to them and of those, more than half (59.5%) had used the VT services and 96.1% were satisfied with the services. Contact with a positive COVID-19 case was the top reason for accessing VT, while a lack of awareness about the availability of VT services was the top perceived limiting factor. A history of chronic health conditions, anxiety and/or depression, and previous symptoms suggestive of COVID-19 were found to be predictors of the utilization of VT services (OR 1.55, 95% CI 1.22−1.96; OR 1.48, 95% CI 1.16−1.88; OR 3.31, 95% CI 2.77−3.95; and OR 1.62, 95% CI 1.34−1.96; respectively), respectively. @*Conclusion@#The awareness of voluntary COVID-19 testing services was satisfactory among the Saudi Arabian population, but can be improved. Sociodemographic and health history predictors of the utilization of VT services were identified.

Cocktail of Theileria equi antigens for detecting infection in equines

Objective: To use two diagnostic antigens belonging to the frequently associated in Theileria domain, Theileria equi (T. equi) protein 82 (Te 82) and T. equi 104 kDa microneme-rhoptry antigen precursor (Te 43), to diagnose T. equi infection in horses as compared with equi merozoite antigen-2 (EMA-2). Methods: In the current study, we applied a cocktail-ELISA containing two antigens (EMA-2 + Te 82) to diagnose T. equi infection either in experimentally infected horses or in field infection. Results: Our findings have revealed that a cocktail formula of EMA-2 + Te 82 provided a more practical and sensitive diagnostic candidate for diagnosing T. equi infection in horses as compared with Te 82 or Te 43 alone. Conclusions: The ELISA technique using a cocktail formula of EMA-2 + Te 82 offers a practical and sensitive diagnostic tool for diagnosing T. equi infection in horses and using of this promising cocktail formula will be applicable for epidemiological surveys and will help control the infection in horses.

Glaucoma after open globe injury at a tertiary care university hospital in central Saudi Arabia; cumulative incidence and risk factors

Objectives: To investigate the incidence and risk factors of glaucoma after open globe injury [OGI]

Methods: The medical records of all patients admitted with the diagnosis of OGI at the Department of Ophthalmology, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia and had undergone primary repair from January 1996 to December 2011 were retrospectively reviewed

Results: For the 15-year study period, 775 patients who underwent repair of an OGI were identified. The overall risk of post-traumatic glaucoma was 5.3% [41/775] with a mean +/- SD follow-up period of 12+/-6.5 months. Univariate analysis revealed that Zone II injury [p=0.027], penetrating ocular injury [p=0.0008], lens injury [p=0.011], vitreous hemorrhage [p=0.002], and presence of intraocular foreign body [p<0.0001] were significantly associated with glaucoma. Age of more than 18 years was critical [p=0.054]. Following logistic regression, penetrating ocular injury [p=0.019], lens injury [p=0.002], and vitreous hemorrhage were significant [p=0.037]

Conclusion: Glaucoma after OGI is not uncommon. Zone II injury, penetrating ocular injury, lens injury, presence of vitreous hemorrhage, and presence of an intraocular foreign body were significant risk factors for developing post-traumatic glaucoma

Frequency of retinal detachment after cataract surgery in highly myopic patients

To determine the potential risk factors for retinal detachment after cataract surgery. In this retrospective cohort study, medical records of patients operated on between 2000 and 2010 at the Department of Ophthalmology, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia were retrospectively reviewed for both demographic and clinical data. Cases were identified as having an ocular axial length >/=25 mm, while a control group of 500 eyes [axial length range; 22-24 mm] was sampled. Data were analyzed to compare both groups, and to assess potential risk factors for post-cataract retinal detachment. We reviewed 852 eyes of 721 patients; 352 eyes with documented high myopia were compared with 500 control eyes. After a mean follow up of 45.1 +/- 27.9 months, the postoperative mean LogMAR visual acuity significantly differed; 0.51 +/- 0.48 for cases and 0.38 +/- 0.41 for controls [p<0.0001]. Controls showed significantly better postoperative vision as measured by LogMAR [0.92 +/- 0.7] than cases [0.71 +/- 0.61] [p<0.0001]. Twelve eyes [1.4%] had retinal detachments postoperatively. The RD prevalence was significantly higher among cases [10 [2.8%]] than controls [2 [0.4%]] [p=0.007]. High axial length was the only significant risk factor for retinal detachment [p=0.005] even after multivariate adjustment [p=0.019]. High axial length among myopic cataract patients may increase the risk of postoperative retinal detachment

Childhood microbial keratitis

To evaluate risk factors for pediatric microbial keratitis and to describe the clinical picture, microbial spectrum, treatment modalities, posttreatment sequelae, and visual outcome in cases with pediatric microbial keratitis. All cases of microbial keratitis that occurred in children 16 years or younger who had an initial examination between January 2000 and December 2010 at a tertiary referral eye hospital in Riyadh, Saudi Arabia, were identified. A retrospective review of medical records was conducted using a computer-based diagnosis code. Demographic data, predisposing factors, clinical course, microbial culture results, and visual outcomes were recorded. Sixty-eight eyes were included in this study. Predisposing factors were identified in 63 eyes [92.6%]. All patients had unilateral microbial keratitis. The mean +/- SD age was 4.5 +/- 4.8 years and 57.4% were male. Trauma was the leading cause [27 eyes [39.7%]], followed by systemic diseases [14 eyes [20.6%]], contact lens wear [11 eyes [16.1%]], and ocular diseases [11 eyes [16.1%]]. Corneal scraping was performed in all cases. Five patients needed general anesthesia to carry out the corneal scraping. Thirty-four [50.0%] eyes showed positive cultures. Gram-positive bacteria accounted for 67.8% and gram-negative bacteria for 38.2% of isolates. Streptococcus pneumoniae was the most commonly isolated organism [8 eyes [25.8%]], followed by Staphylococcus epidermidis [7 eyes [22.7%]]. Pseudomonas aeruginosa was the most commonly isolated gram-negative [6 eyes [17.6%]] organism. One eye had corneal perforation and required surgical intervention. Forty-five of 68 eyes [66.2%] had a best-corrected visual acuity evaluation at the last follow-up and 28 eyes [62.2%] of them had a best-corrected visual acuity of 20/40 or better. Children with suspected microbial keratitis require comprehensive evaluation and management. Early recognition, identifying the predisposing factors and etiological microbial organisms, and instituting appropriate treatment measures have a crucial role in outcome. Ocular trauma was the leading cause of childhood microbial keratitis in our study

Development and validation of an Arabic version of the visual functioning index VF-14 for cataract patients

To develop and validate an Arabic version of the Visual Functioning Index [VF-14] for patients with cataracts. The VF-14 was translated into Arabic by an epidemiologist and an ophthalmologist, both fluent in Arabic and English. The VF-14 was administered to patients diagnosed with cataract at two hospitals in Egypt and two hospitals in Saudi Arabia. Patients were also administered three other forms; the cataract symptoms score [CSS]; global measure of vision; and cataract medical form. Internal reliability and external validity were measured. Index sensitivity to visual acuity was detected and potential effective factors were investigated. Correlation analyses were performed. A p value less than 0.05 was considered statistically significant. The translated VF-14 was consistent and reliable [sigma = 0.763, p < 0.0001]. It was also statistically significantly sensitive to vision [p < 0.0001]. The mean calculated index was 62.18 +/- 19.34, and was highly correlated with; CSS and other scores [p < 0.0001, all cases]. Factors that may affect the index are; age, sex, vision, wearing glasses, type, position, and severity of cataract. The Arabic VF 14 is a reliable and valid tool for evaluation of both visual functioning and quality of visual life among cataract patients. It is also sensitive to changes in visual acuity, demographic, and clinical characteristics

Compliance to patching in the treatment of amblyopia

To evaluate compliance of amblyopic patients to patching, and to identify reasons of poor compliance and suggest methods to overcome the problem. We conducted a cross-sectional, retrospective study that included 37 families with a child diagnosed with unilateral amblyopia [age range 3-16 years] and attending the Pediatrics Ophthalmology clinic at the King Abdulaziz University Hospital [a tertiary eye hospital]. Data were collected through interviews and from hospital charts. In the interviews we asked questions that sought information with regard to four aspects [domains]; knowledge, attitude, insight and community's effect. A score representing each domain was given to every family then we correlated these scores with family's compliance percentage. Results: When correlated with compliance, the insight and attitude domains showed a statistically significant correlation; p-value 0.002 and 0.004, respectively. However, the knowledge and community's effect domains were not; p-value 0.084 and 0.114, respectively. Other qualitative factors affecting compliance were identified with open questions. Quotes from families of what they think can improve compliance are shown. To improve compliance, merely educating patients is not sufficient and more efforts should be undertaken toward ensuring true sense of the problem and its impact. Factors affecting compliance due to the physical properties in the patch itself should be addressed too [heat, irritation, poor adhesive material and design]

profile of glaucoma in a tertiary ophthalmic university center in Riyadh, Saudi Arabia

To report the pattern of glaucoma among Saudi patients who were presented to King Abdul Aziz University Hospital [KAUH]. All glaucoma or glaucoma suspect patients who were presented to KAUH from 2006 to 2008 were included; medical files of all patients were retrieved and evaluated through standardized international guidelines. Collected data included: age, sex, laterality, intraocular pressure, and cup/disk ratio. Prevalence of different glaucoma types [including 95% CI] was calculated, ANOVA and post hoc tests were applied to evaluate the difference in indices across different types. A total of 2296 eyes of 1236 patients were included. Primary angle closure glaucoma [PACG] was the predominant type [46.6%] followed by primary angle closure [PAC] [17.2%], then primary open angle glaucoma [POAG] [12.8%], and secondary glaucoma [13%]. Other types including [normal tension glaucoma [5.9%], childhood glaucoma [2.6%], and juvenile glaucoma [1.9%]] were also present but of lower prevalence. Primary angle closure glaucoma was the predominant form of glaucoma followed by PAC, and POAG suggesting that the pattern in Saudi Arabia could be quite different from that reported for primary glaucomas in the Western literature. In addition, pseudoexfoliation was the most common form of secondary open and closed angle glaucoma. These results indicate the need for a national intervention program for early detection and referral of glaucoma cases in order to prevent significant visual loss. There is also a need for a community based assessment to determine the prevalence of glaucoma as a baseline for future intervention

Controlled Cyclophotocoagulation with diode laser in refractory glaucoma and long term follow up at King Abdulaziz University Hospital, Riyadh

To evaluate the clinical efficacy and safety of controlled contact transscleral diode laser Cyclophotocoagulation [COCO] procedure in reducing the Intraocular Pressure [IOP] among patients with refractory glaucoma. Thirty two patients [35 eyes] with refractory glaucoma in prospective clinical studies were treated with trans-sclera diode laser in a controlled manner. The energy power used was 5 W in adults and 3 W in children, exposure time was 0.5 s, a total of 16 shots were applied over ciliary body and four shots in each quadrant. Pre and postoperative IOP were measured at different postoperative visits. Snellen visual acuity, the number of anti-glaucoma medications and associated complications were also recorded. Student Ttest was used to compare the pre and post intervention lOPs, while Wilcoxon Signed Ranks test was used, to detect significance change in medication dependency. The mean [SD] follow up time was 80.2[ +/- 9.6] months, range [36-84] m, where the mean IOP was significantly reduced from 35.1 mm Hg [ +/- 10.7] before intervention to 18.8 mm Hg [ +/- 7.3] after intervention, in the final visit [P < 0.0001]. Complete success was achieved in seven eyes [20%], 22 eyes [62.8%] showed qualified successes and complete failure was reported in six eyes [17.1%]. The overall success rate was 82.8% [95% CI: 70.4-95.3]. Visual acuity improved

Visual function of Egyptian children with low vision and the demographic determinants

To determine whether the LV Prasad-Functional Vision Questionnaire [LVP-FVQ] could be used to assess self-reported visual function and quality of visual life in Egyptian school aged children. The LVP-FVQ was used to assess the quality of visual function in school-age children. All subjects were students at the time of assessment. Subjects underwent a visual function assessment that included distance and near visual acuity, contrast sensitivity, color vision and visual field examination where possible. Data analysis were for both descriptive and inference statistics. AP< 0.05 was considered statistically significant. Fifty children aged 11.28 +/- 3.5 years [range, 5 years to 18 years] with moderate-to-severe visual impairment most of their lives were enrolled. Twenty-two subjects [44%] had albinism, 18 [36%] subjects had hereditary retinal dystrophy, 6 [12%] subjects had cone dystrophy, 2 [4%] subjects had bilateral amblyopia and 2 [4%] subjects had congenital coloboma without other disabilities. The four most difficult tasks were related to the following daily activities alluded to in the questionnaire such as reading a textbook at arms length, copying from the blackboard, seeing somebody across the road and identifying colors. There was no statistically significant association between the demographic variables and the level of visual functioning, sex, age, type of school, family history or consanguinity [P> 0.05 for all variables]. LVP-FVQ can be used to screen Egyptian children with visual impairment. Input and integration of the parents and the school teachers to evaluate the child s behavior at home and the school is essential to developing a balanced questionnaire

Role of infra-popliteal balloon angioplasty in the management of critical limb ischemia

The purpose of this study was to evaluate the patency rate and effectiveness of the percuatanous trans-luminal angioplasty [PTA] as a primary therapy for infra-popliteal occlusive disease. Twenty patients had angioplasty for Critical lower limb ischemia due to infra-popliteal disease between May 2005 - May 2007. We collected data on patient demography, symptoms, as will as pre and post procedure ankle - brachial pressure index [ABI] and angiographic findings. Thirteen men and 7 women had a mean age of 62 years. Risk factors included smoking in 70%, diabetes in 60%, hypertension in 40%, and end -stage renal disease in 1%. The indication for intervention were persistent rest pain in 50%, foot ulcer 30% and gangrene of foot or toes 20%. Immediate results were good in 19 patients with one case of technical failure .Three patients had restenosis at mean period of 7 months. There was one major and three minor amputations. Average follow up was11.2 months. The mean post procedural increase in ABI was 0.29. PTA of the infra-popliteal vessels has low morbiditiy, high success rate, and acceptable patency rate