ABSTRACT
Purpose: To describe the clinical characteristics and surgical outcomes of panuveitis over a 10-year period.Methods: Data were collected on panuveitis etiology, treatment, surgery and change in vision.Results: Overall, 308 patients (594 eyes) were evaluated, 54.9% with non-granulomatous and 45.1% with granulomatous uveitis. Fifty-four patients had infectious and 254 had non-infectious uveitis. In infectious panuveitis, vision remained unchanged at last visit. The most frequent diagnosis was presumed intraocular tuberculosis (PIOTB) uveitis (48.1%). In the non-infectious subgroup vision increased significantly by 2 lines at last visit (p = 0.020). The most common diagnose was Vogt-Koyanagi-Harada (VKH) disease (38.6%). Initial therapy was oral prednisone in 86.6% with non-infectious etiology followed by immunosuppressive agents. Surgery secondary to complications (mainly cataracts) was performed in 46.7% patients.Conclusion: In Saudi Arabia, panuveitis was mainly due to VHK. PIOTB was the most common etiology for infectious panuveitis. Immunosuppressive therapy and surgery maintained BCVA in non-infectious panuveitis.
Subject(s)
Disease Management , Forecasting , Panuveitis/therapy , Surveys and Questionnaires , Visual Acuity , Adolescent , Adult , Aged , Child , Female , Fluorescein Angiography/methods , Follow-Up Studies , Fundus Oculi , Humans , Incidence , Male , Middle Aged , Panuveitis/diagnosis , Panuveitis/epidemiology , Retrospective Studies , Saudi Arabia/epidemiology , Tomography, Optical Coherence/methods , Young AdultABSTRACT
PURPOSE: To describe the clinical characteristics and treatment outcomes of Vogt-Koyanagi-Harada (VKH) disease over a 12-year period. METHODS: A retrospective chart review was used to identify VKH patients, from January 1999 to December 2011. RESULTS: In total, 154 patients (308 eyes) were diagnosed with VKH. The mean age at diagnosis was 33.8 ± 13 years. Mean baseline best-corrected visual acuity (BCVA) was 20/125; (0.8 ± 0.6 logMAR). Recurrent episodes occurred in 107 (54%) patients. Oral prednisone was administered in all patients. At the last visit, the mean BCVA was 20/50 (0.4 ± 0.7 logMAR). The most common complications post-treatment were: glaucoma [104 (33.8%) eyes] and cataract [84 (27.2%) eyes]. CONCLUSIONS: In Saudi Arabia, VKH-related uveitis is predominant in young females. Bilateral panuveitis is the most common ocular manifestation and near 50% of eyes present with exudative retinal detachment. Oral prednisone was the primary treatment and the majority of eyes maintained 20/50 or better vision.
Subject(s)
Uveomeningoencephalitic Syndrome/diagnosis , Acute Disease , Administration, Oral , Adolescent , Adult , Aged , Antibiotics, Antitubercular , Child , Chronic Disease , Drug Therapy, Combination , Female , Fluorescein Angiography , Glucocorticoids/therapeutic use , Humans , Male , Middle Aged , Mycophenolic Acid/therapeutic use , Prednisolone/therapeutic use , Recurrence , Retrospective Studies , Tertiary Care Centers , Tomography, Optical Coherence , Treatment Outcome , Uveomeningoencephalitic Syndrome/drug therapy , Visual Acuity/physiologyABSTRACT
PURPOSE: To compare the incidence, microbial profile, management and outcomes of endophthalmitis after glaucoma drainage implant (GDI), or trabeculectomy over 2 separate time periods before and after the year 2000. METHODS: A chart review was performed for patients with endophthalmitis after trabeculectomy (trabeculectomy group) or GDI group between 1983 to 1999 (group 1) and 2000 to 2011 (group 2) at a tertiary care hospital. Data were compared between groups and time periods. RESULTS: There were 56 cases of endophthalmitis after trabeculectomy in group 1 and 17 cases in group 2. After GDI, there were 10 cases of endophthalmitis in group 1 and 1 case in group 2. The incidence of endophthalmitis after GDI decreased significantly from 0.0105% to 0.00074% in groups 1 and 2, respectively (P<0.05). The incidence of endophthalmitis decreased significantly after trabeculectomy from 0.007% in group 1 to 0.00197% in group 2 (P=0.0004). There were 26 culture-positive cases in group 1 and 10 in group 2. The most common isolates were Streptococcus species in group 1 and Staphylococcus species in group 2. Indicators of morbidity were lower in group 2. The final visual outcome in either group was not correlated to the type of surgery, microbes, or initial management. CONCLUSIONS: There was a greater incidence of endophthalmitis after trabeculectomy compared with GDI. The incidence of endophthalmitis decreased from 2001 to 2011 compared with 1983 to 1999, which is likely due to advances in surgical technique. However, significant visual morbidity does occur despite prompt treatment.
Subject(s)
Endophthalmitis/epidemiology , Eye Infections, Bacterial/epidemiology , Glaucoma Drainage Implants/adverse effects , Glaucoma/surgery , Postoperative Complications , Trabeculectomy/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Bacteria/isolation & purification , Child , Endophthalmitis/drug therapy , Endophthalmitis/microbiology , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/microbiology , Female , Humans , Incidence , Intraocular Pressure/physiology , Male , Middle Aged , Retrospective Studies , Saudi Arabia/epidemiology , Tertiary Care Centers , Visual Acuity/physiologySubject(s)
Eye Injuries/surgery , Fluorocarbons , Retina/pathology , Retinal Detachment/surgery , Silicone Oils , Vitrectomy , Wounds, Nonpenetrating/surgery , Adolescent , Endotamponade , Humans , Male , Retina/injuriesABSTRACT
A case report of a 52 year old male who received intravitreal bevacizumab and developed culture positive endophthalmitis. Vitreous culture indicated that endophthalmitis was caused by Staphylococcus epidermidis. The patient was initially managed with intravitreal injection of ceftazidime and vancomycin, followed by pars plana lensectomy, pars plana vitrectomy with intravitreal injection of 1 mg/0.1 ml vancomycin, 2.25 mg/0.1 ml ceftazidime, 5 mg/0.1 ml fortified amphotericin-B and 4 mg/0.1 ml dexamethasone. Postoperatively the patient improved significantly. However, vision improved from hand motion to counting fingers secondary to severe retinal ischemia. Acute endophthalmitis can develop after intravitreal bevacizumab injections and cause profound visual loss. A review of literature was also performed for similar cases.
ABSTRACT
PURPOSE: To establish a standard of normal central corneal thickness (CCT) in normal full-term Saudi newborn. These values could be used as a reference in the early diagnosis and control of the fairly common primary congenital glaucoma in Saudi newborns. METHODS: The CCT was measured in 100 normal full-term Saudi newborns (200 eyes) during the first 6 days of the postnatal period. All measurements were carried out by one investigator using ultrasonic pachymeter DGH-1000. RESULTS: The mean CCT of 200 eyes (right and left) was 616 ± 61 µm. The mean CCT of the right and left eyes was similar (CCTRE was 617 ± 62 µm, and mean CCTLE was 616 ± 60 µm), with no statistically significant difference (p = 0.417). The mean CCT for males was 631 ± 66 µm and for females 600 ± 50 µm. This difference was statistically significant (p = 0.01). The mean CCT decreases significantly by age [day-1: 626 ± 65 µm, day-2: 601 ± 48 µm and day-3: 574 ± 45 µm (p = 0.049)]. No correlations were found between CCT and gestational age, birth weight, birth length and head circumference. CONCLUSION: The average CCT in full-term Saudi newborns was found to be 616 ± 61 µm. The mean CCT in males was significantly higher than in females. There was no correlation between CCT and gestational age, birth weight, birth length and head circumference. There were borderline significant differences between CCT in 1-day-, 2-day-, and 3-day-old babies.
