Optical Coherence Tomography Based Choroidal Thickness and Its Determinants in Healthy Saudi Population: A Cross-Sectional Study.

Purpose To study choroidal thickness (CT) and its determinants based on optical coherence tomography (OCT) in the healthy adult Saudi population. Materials and methods This cross-sectional study was conducted in 2021 at a tertiary eye hospital in Saudi Arabia. The autorefractor-based refractive status (spherical equivalent) of each eye was documented. CT was measured from the enhanced depth OCT images at the fovea to the 1500 µm nasal and temporal to the fovea. CT was defined as the distance from a hyper-reflective line representing retinal pigment epithelium (RPE)-Bruch's membrane to the choroid-scleral junction. The CT was correlated with demographic and other variables. Results The study sample included 288 eyes of 144 participants (mean age 31.5±8.3 years; males 94, 65.3%). Emmetropia, myopia, and hypermetropic spherical equivalent were noted in 53 (18.4%), 152 (52.5%), and 83 (28.8%) eyes, respectively. The mean sub-foveal (SFCT), nasal, and temporal CT were 329.4±56.7µm, 302.3±63.5 µm, and 312.8± 56.7µm, respectively. CT varied significantly by location (p <0.001). CT was negatively correlated with age (r = -0.177, P <0.001). CT in emmetropic and myopic eyes was 319.7±53 µm and 313.1±53 µm, respectively. The difference in CT based on refractive status (p = 0.49) or sex was non-significant (p = 0.6). Regression analysis suggested that age (p <0.001), refractive error (p = 0.02), scanning time (p <0.001), and scanning location (p = 0.006) were significant predictors of CT. Conclusion CT measurements of the eyes of healthy Saudis can be used as reference values for studies evaluating CT changes due to various chorioretinal diseases.

Patients seen at the Dermatology ambulatory office in a tertiary care center in Qassim region, Saudi Arabia.

BACKGROUND: In Saudi Arabia where there is lack of dermatologists in primary health care centers, patients with simple or minor skin conditions have to attend to hospitals to be treated. We analyzed the data of patients with cutaneous disorders attending the tertiary referral hospital in Qassim region of Saudi Arabia, with the aim to identify the most common conditions that patients complain of, in order to define the areas where the education of General Practitioners in Dermatology must focus. METHODOLOGY: All patients seen at the Dermatology ambulatory office in the Emergency Department of Qassim University affiliated hospital from January 2011 to December 2011 were included in this retrospective analysis. The medical records of the patients (history, physical examination and laboratory investigations) were analyzed to ascertain the diagnosis and the management of cases. All patients were evaluated by qualified dermatologists. RESULTS: A total of 1147 patients attended the Dermatology ambulatory office. Most patients were young adults in the age group 21-30 years (34.4%). Allergic skin diseases (65.2%), mostly dermatitis (48.8%) and urticaria (10.5%) were the most common for attendance, followed by infectious diseases (25.8%) and inflammatory and autoimmune disorders (5.3%). The management of the vast majority of cases (94.1%) consisted of systemic treatment and 58.2% patients required topical treatment. A reevaluation plan as outpatients was planned in 9.0% patients while only 0.3% of patients required admission in the hospital. CONCLUSION: Allergic and infectious skin diseases were the most common cutaneous diseases in patients attending this tertiary University hospital, while the management of most patients did not require specialized care. On the basis of the present data, the training of primary health care providers in Dermatology should emphasize these common conditions, with the aim of improving primary care and alleviating the burden on hospital care.

Skin manifestations in diabetic patients attending a diabetic clinic in the Qassim region, Saudi Arabia.

OBJECTIVE: To investigate the prevalence of skin manifestations in diabetic patients attending a diabetic clinic in the Qassim region, Saudi Arabia. SUBJECTS AND METHODS: A prospective observational study was performed on 320 patients (174 males and 146 females) attending the diabetic clinic. A detailed dermatological examination was carried out by a consultant dermatologist and the cutaneous findings were recorded. RESULTS: The overall prevalence of skin manifestations was 91.2%. Cutaneous lesions were seen in 12 patients (34.3%) of type 1 diabetes mellitus (DM) and 280 (98.2%) of type 2 diabetics. There was a statistically significant difference (p < 0.001) in skin manifestations between type 1 and type 2 DM patients. For those patients having diabetes of less than 5 years' duration, the incidence of skin manifestations was 80.6%; for those having had diabetes for more than 5 years, the incidence was 98%. This difference was statistically significant (p < 0.001). The skin manifestations that had a statistically significant difference (p < 0.05) in prevalence between the 2 durational groups were gangrene, diabetic dermopathy, paresthesia, diabetic feet, diabetic bullae and fungal infections. CONCLUSION: Diabetics had a greater prevalence of skin manifestations in type 2 than type 1, and as the duration of diabetes increased, the likelihood of developing skin manifestations also increased. Early referral to the dermatologist may help to detect complications of the skin in diabetes at an early stage and may prevent disability caused by these complications.

Genetic background of psoriasis.

Psoriasis is a chronic inflammatory dermatosis that contributes to approximately 1-5% of all skin disorders in Saudi Arabia. The genetic basis of psoriasis is supported by family based investigations; population based epidemiological studies, association studies with human leucocyte antigens (HLAs), genome-wide linkage scans, and candidate gene studies within and outside the major histocompatibility complex. Psoriasis represents a complex disease at the cellular, genomic and genetic levels, with infiltration of many types of leukocytes into the skin, altered growth and differentiation of skin-resident cells, and altered expression of more than 1,300 genes in psoriatic lesions. It is also apparent that there is considerable overlap between the molecular pathways that are involved in psoriasis and those that lead to other inflammatory or autoimmune diseases in humans. In this review article, we describe the immune-genetic basis of psoriasis, the molecular pathways of pathogenic inflammation and the potential role of the genes that confer increased susceptibility to psoriasis.