Causes of blindness in a pediatric age group at a tertiary healthcare center in the eastern province of Saudi Arabia.

OBJECTIVES: To describe causes of blindness and visual impairment (VI) in children in Eastern province, Saudi Arabia. Methods: A record-based descriptive cross-sectional study was conducted. Medical records of patients aged 2 to 16 years who were following up in the Pediatric Ophthalmology Clinics, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia between September and December 2018 were reviewed. Causes of vision loss according to visual acuity (VA) with best correction were recorded. Blindness was defined as VA less than 20/400, VI as VA from 20/400 to 20/60, and visual loss as VA of ≤20/60. RESULTS: Of 818 patients, 39% had visual loss, 22.9% were blind, and 71.2% had VI. Common etiologies of bilateral blindness were retinal dystrophy disease and Leber's congenital amaurosis, whereas unilateral blindness was most common due to trauma and refractive error (RE). Common etiologies of bilateral VI were RE, esotropia, and retinal dystrophy. Unilateral VI was mainly due to RE, cataract, congenital esotropia, and trauma. Of all patients, 58.8% had treatable causes, 22.6% had preventable causes, and 19.5% had non-preventable and non-treatable causes; mostly genetic or congenital (59.7%) rather than acquired (40.2%). CONCLUSION: Genetic or congenital causes are major factors causing blindness. Most causes are treatable and preventable, emphasizing on early detection and treatment of those causes.

Pars plana vitrectomy with juxtapapillary laser photocoagulation versus vitrectomy without juxtapapillary laser photocoagulation for the treatment of optic disc pit maculopathy: the results of the KKESH International Collaborative Retina Study Group.

BACKGROUND/AIMS: To compare the functional and anatomic outcomes of pars plana vitrectomy (PPV) with juxtapapillary laser photocoagulation (JLP) versus vitrectomy without JLP in optic disc pit maculopathy. METHODS: This was a multicentre, retrospective study of 46 consecutive patients with optic disc pit maculopathy presenting at tertiary eye centres between 1992 and 2012. Indications for surgery included distorted or decreased vision. Surgical intervention included PPV, posterior vitreous detachment, with or without gas tamponade. Twenty-four patients received laser photocoagulation at the temporal edge of the optic disc pit (group A) and 22 patients had no laser (group B). Postoperative best-corrected visual acuity (BCVA) and optical coherence tomography findings were the main outcome measures. RESULTS: Mean follow-up was 44 months (range 12-98 months). BCVA in group A improved significantly from 0.7 logMAR (20/100) preoperatively to 0.5 logMAR (20/60) postoperatively (p=0.017). In group B, BCVA improved from 0.7 logMAR (20/100) preoperatively to 0.4 logMAR (20/40) postoperatively (p=0.014). The difference in final BCVA between groups was not statistically significant (p=0.693). The mean central macular thickness (CMT) in group A improved significantly from 750 µm preoperatively to 309 µm at last follow-up (p<0.0001). The mean CMT in group B improved from 616 µm preoperatively to 291 µm at last follow-up (p=0.028). The difference in final CMT between groups was not statistically significant (p=0.747). CONCLUSIONS: PPV with JLP for optic disc pit maculopathy had similar functional and anatomic outcomes compared with vitrectomy without JLP.

Lymphocytic leukemia presenting as acute Vogt-Koyanagi-Harada disease.

Leukemia commonly involves eyes and adnexae. It is unusual, however for leukemia to present with visual complaints. There are only rare case reports of a leukemic patient presenting with bilateral exudative retinal detachment. This report describes a case of bilateral exudative retinal detachment associated with prodromal symptoms simulating the presentation of acute Vogt-Koyanagi-Harada disease that was eventually diagnosed as acute lymphocytic leukemia. There was rapid settling of the exudative detachment and improvement in vision when the patient received chemotherapy. Bilateral exudative retinal detachment associated with neurologic and auditory abnormalities may be a presenting sign of acute lymphocytic leukemia in an otherwise healthy young adult. Clinicians should be aware of the possibility of leukemia in such patients. A simple blood investigation such as complete blood profile confirms the diagnosis.