Incidence of retinopathy of prematurity at two tertiary centers in Jeddah, Saudi Arabia

Purpose: to review the incidence and risk factors for retinopathy of prematurity [ROP] King Faisal Specialist Hospital and King Abdulaziz University Hospital in Jeddah, Saudi Arabia

Material and methods: In this prospective cohort study, preterm infants who were admitted to a neonatal intensive care unit from 2012 to 2013 were evaluated for ROP. Inclusion criteria were, preterm infants with gestational age <32 weeks and/or birth weight <1500 g. The risk factors that were assessed were intraventricular hemorrhage, patent ductus arteriosus [PDA], sepsis and hydrocephalus. The relative risk was used to measure the risk and logistic regression was used to adjust for confounding factors. Statistical significance was indicated by p < 0.05

Results: thirty-one of 92 [33.7%] preterm infants had unilateral or bilateral ROP. The mean gestational age was 26.7 weeks [range, 24-29 weeks] and mean birth weight was 0.843 kg [range, 0.606-1.450 kg]. There were 7 infants with stage 1 ROP, 10 infants with stage 2, 14 infants with stage 3 and no cases of stage 4 or 5. Twelve [13%] infants had plus disease and received laser therapy within 72 h of diagnosis. Statistically significant risk factors for ROP were PDA [p = 0.0005] and intraventricular hemorrhage [p = 0.0005]

Conclusion: the incidence of ROP was 33.7% and risk factors were PDA and intraventricular hemorrhage. Laser therapy was very effective for the treatment of plus disease and preventing progression of ROP. Clinicians should assess for potential risk factors when monitoring premature infants

Leber's miliary aneurysms

Leber's disease is a form of primary retinal telangiectasia characterized by the presence of abnormalities in the retinal vasculature. It is an idiopathic, unilateral condition with male predilection. It is not associated with any other systemic or ocular disease. The disease has a very slow progression and can be complicated by vascular dilatations, neovascularizations, thromboses, retrovitreal hemorrhages, and macular changes. We present a case of Leber's miliary aneurysms in an asymptomatic 22-year-old male patient. His fundus examination showed aneurysmal dilatations with lipid exudation. Intravenous fluorescein angiography showed early and late leakage as well as capillary dropout with late hypofluorescence. In this case, the patient was treated with laser photocoagulation of the retina.

Topical anesthesia in phacoemulsification

To evaluate the efficacy of topical anesthesia; topical Benoxinate 0.4% [Oxybuprocaine] and Xylocaine [Lidocaine] gel, in selected cataract patients as an alternative to peribulbar or retrobulbar block anesthesia during cataract surgery. Prospective non-comparative evaluation of patients' and surgeon's satisfaction at the end of the procedure. Three hundred patients [300 eyes] were included in the study. The procedure was explained to patients with details regarding what will happen and what to expect during surgery. All patients received topical anesthesia with Benoxinate 0.4% eye drops and Xylocaine gel 2%. All surgeries were done by the same surgeon using the same machine [updated LEGACY phacoemulsifier, Alcon] and approach [clear corneal incision] and followed by a foldable intraocular lens [IOL] implantation. None of the patients had severe pain during the procedure; only 2% [six of 300] required use of intravenous sedation [Propofol], both the surgeon's and the patients' satisfaction were high. Eye movements and blepharospasm were not significant problems, and no serious complications occurred. Rate of vitreous loss due to posterior capsule tear/rupture was within literature reported range and not different from our previous experience. Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon