RESUMO
Introduction The aim of this study was to determine the prevalence and characteristics of glaucoma in patients presenting to the ophthalmology department in a tertiary hospital in Bahrain for the first time. Methods A retrospective study was conducted at the Salmaniya Medical Complex, Manama, Bahrain. The medical records of all patients who presented for the first time to an eye clinic between January and December 2019 were reviewed. Patients who were diagnosed with glaucoma were included in this study. Data regarding age, sex, ethnicity, type of glaucoma, previous treatment, best corrected visual acuity, cup-to-disc ratio, intraocular pressure, central corneal thickness, optical coherence tomography (OCT) retinal nerve fiber layer (RNFL), and visual field findings were collected. Results Of a total of 18,238 new patients in 2019, 173 patients (0.97%) had glaucoma. The mean age of patients with glaucoma was 59.6 ± 11.3 years and approximately 60% of them were males (n=103, 59.5%). In 93% of the cases, glaucoma involved both eyes (n=161). Primary open-angle glaucoma (n=97, 56.1%), normal tension glaucoma (n=28, 16.2%), and chronic angle closure glaucoma (n=15, 8.7%) were the most frequently encountered types of glaucoma. Approximately 16.76% (n=29) of the patients were blind in one or two eyes at the time of presentation. Conclusion There seems to be a low prevalence of glaucoma among the encountered cases on the first visit to ophthalmology clinics in Bahrain, with primary open-angle glaucoma being the most common type.
RESUMO
Purpose To study the causes of visual impairment among Bahraini patients registered as visually disabled. Materials and methods A retrospective descriptive study of all patients referred to the Ministry of Social Development for visual disability from January 2014 to December 2019 was performed. Information recorded were age, gender, the cause of the visual impairment, and visual acuity in the better eye. If a patient had multiple ophthalmic diseases, the untreatable disease causing visual impairment was recorded. Patients were considered to have visual impairment according to World Health Organization criteria. Results A total of 484 Bahraini patients were included in the study. The mean age was 57.3 years of age ranging from 3 to 100 years; 63% of the total cases were males. The most common cause of visual impairment was diabetic retinopathy (DR) 201 (41.53%), followed by glaucoma 161 (33.26%). This is followed by hereditary and congenital disorders 34 (7.02%), glaucoma combined with DR 21 (4.34%), other retinal diseases 17 (3.51), retinitis pigmentosa 14 (2.89), optic atrophy 9 (1.86), corneal disorders 8 (1.65%), age-related macular degeneration 8 (1.65%), and others 11 (0.83%). Conclusion DR and glaucoma are the major causes of visual impairment among adults. Complications leading to visual impairment of both disorders are avoidable. Prevention measures to be taken control these diseases and prevent their morbidity. Congenital and hereditary disorders are the most common causes of visual impairment among children.
RESUMO
Neovascular glaucoma (NVG) is a cause of blindness in patients with proliferative diabetic retinopathy (PDR) and remains a clinical challenge. It results from vascular endothelial growth factor (VEGF) expression, which occurs in cases of severe retinal ischemia. Early detection and immediate comprehensive management, including early surgical intervention, are essential to maintain good intraocular pressure (IOP) control and achieve the best visual outcome, as presented in this case. A 42-year-old male patient with bilateral NVG secondary to PDR received complex management with early Ahmed valve implantation surgery, followed by pan-retinal photocoagulation (PRP) and intravitreal bevacizumab injection. After 22 months of treatment and follow-up, we could achieve the best visual outcome for the patient. Early surgical intervention for uncontrolled NVG with a glaucoma filtration device combined with intravitreal anti-VEGF injections and adequate PRP showed beneficial effects in the IOP control with rapid resolution of iris neovascularization, thus achieving the best visual function.
