The prevalence of depressive symptoms and related risk factors among diabetic patients with retinopathy attending the Jordan University Hospital.

OBJECTIVES: To investigate the prevalence of depressive symptoms among diabetic patients suffering from retinopathy, and to identify crucial risk factors that affect patients' quality of life and whether social support mediates the relationship between retinopathy and depression. METHODS: The sample comprises 155 participants with diabetic retinopathy recruited from the Jordan University Hospital during the year 2017. Arabic versions of all study tools were employed as follows: the Beck Depression Inventory; the short form of the health survey; the Berlin social support scale; ophthalmic examinations; patients' records; and a demographic questionnaire. ANALYSES: Descriptive statistics, the Pearson correlation, linear regression using SPSS, and mediation analysis using the Sobel test were applied. In addition, the odds ratio analysis and qualitative analyses for the open-ended questions were included. RESULTS: In general, 13 (8.9%) of our patients did not manifest any symptoms of depression while 42 (27.1%) had a mild mood disturbance, 26 (16.8%) were on the borderline of clinical depression, 47 (30.3%) had moderate depression, 22 (14.2%) with severe depression, and 5 (3.2%) had extreme depression. The results indicate a nonsignificant positive correlation between social support and health-related quality of life and a nonsignificant positive relationship between retinopathy severity and depression. Meanwhile, our results revealed a significant negative relationship between depression and social support and a nonsignificant negative relationship between retinopathy severity and social support. CONCLUSION: Our findings suggest that diabetic patients with retinopathy have a higher risk of developing depression. Hence, psychological interventions are highly needed to meet the mental health needs of these patients.

Topographic characteristics of keratoconus among a sample of Jordanian patients.

AIM: To identify topographic characteristics of keratoconus in a Jordanian sample. METHODS: This study characterized 210 corneas affected with keratoconus presenting to Jordan University Hospital. Patients were diagnosed based on clinical examinations and Pentacam imaging. Eyes of males (n=101) were of a similar proportion to females (n=109). All of the 111 patients were affected bilaterally. Ages ranged between 13 and 44y with a mean age of 25.2y. RESULTS: Results revealed significant differences between males and females at the level of the flat curvature power, basement membrane thickness and size of the anterior chamber. Eyes were arranged in three groups based on severity levels: mild, moderate and severe determined by the mean curvature power (Km). Results show that the flat (K1) and steep (K2) curvature powers, corneal asphericity coefficient (QV), thinnest point, pachy apex and basement membrane thickness are significantly different among the three groups, but not the corneal and anterior chamber volumes. Morphological analyses, based on sagittal maps, show no differences in keratometric values between eyes with different sagittal patterns except for the vertical location of the pachy apex relative to the pupil center and the thinnest point. Eyes with the island front elevation map are significantly more affected than eyes with the U shape and the ridge pattern. CONCLUSION: All keratometric values measured except for corneal and anterior chamber volumes vary significantly with disease severity. The vertical pachy apex location correlates well with severity levels while the horizontal location seems to have no effect. Our study also indicates that front elevation maps may be a better predictor of the severity of keratoconus than sagittal maps.

Ferrara ring segments implantation for treating keratoconus.

AIM: To investigate the efficacy of Ferrara rings (FR) implantation in the treatment of keratoconus. METHODS: It was a retrospective case series descriptive study. The sample was comprised of 50 patients 79 eyes diagnosed with progressive keratoconus. This included 24 (48%) males and 26 (52%) females between the age of 13 and 44 years. All participants underwent surgical implantation of FR in the period between January 2009 and September 2010 at Jordan University Hospital. Thorough ophthalmologic examinations were applied to measure vital variables for each pathological condition before and after surgery. RESULTS: Findings indicated an overall significant postoperative improvement in both uncorrected visual acuity (UCVA) and best spectacle corrected visual acuity (BSCVA) throughout follow up visits. Moreover, results illustrated a significant decrease in spherical equivalent (SE) and keratometric readings (lower, higher and the average). CONCLUSION: Surgical intervention strategies are being frequently developed to meet the needs of patients with keratoconus. The implantation of Ferrara rings has proven to be a safe and feasible alternative procedure for the treatment of mild-moderate keratoconus especially for patients with contact lenses intolerance. We have found that this procedure has improved visual outcomes in all eyes studied. Nevertheless, further research is needed to investigate long term outcomes.