Retinal Pigment Epithelial Adenoma: Initial Treatment Outcomes following Episcleral Brachytherapy.

Introduction: We aim to explore the safety and efficacy of episcleral brachytherapy as a primary management option for eyes with retinal pigment epithelial (RPE) adenoma. Methods: Retrospective chart review of the demographic, clinical, ancillary, and postoperative outcome data of patients with RPE adenoma in 2 tertiary referral centers. Tumor regression, final visual acuity, and complications were assessed. Results: Five patients (3 females and 2 males) were included. Four of the 5 eyes had peripheral and mid-peripheral lesions, while one tumor was juxtapapillary. Three eyes were treated with ruthenium-106 (100 Gray), and 2 received iodine-125 episcleral plaques (85 Gray). All eyes showed clinical and imaging-based evidence of regression. Four eyes had stable or improved visual acuity, while 1 eye exhibited one line loss of visual acuity due to radiation retinopathy. Local recurrence was not observed in any eye over a median follow-up of 24 (range 6-112) months. Conclusions: Episcleral brachytherapy is an effective management option for select cases of RPE adenoma that is capable of achieving tumor regression while maintaining favorable visual acuity. The initial safety profile of brachytherapy is good without significant vision-compromising complications.

Post COVID-19 Retinal Evaluation Using Optical Coherence Tomography Angiography: A Case Control Study.

PURPOSE: To study the effect of coronavirus disease of 2019 (COVID-19) on retinal vasculature by Optical Coherence Tomography Angiography (OCTA). METHODS: Macular OCTA images of patients recovered from COVID-19 infections were studied including foveal avascular zone (FAZ), capillary vascular densities (CVD) of the superficial and deep capillary network (SCP, DCP), and central foveal thickness (CFT). RESULTS: The FAZ area was significantly larger in post COVID-19 cases compared to the healthy controls (p=0.032). Post COVID-19 cases had significant lower CVDs in perifoveal quadrants of the SCP. They also had lower CVD in the whole area, parafoveal, temporal and inferior perifoveal areas in the DCP. The parafoveal DCP area showed a positive correlation with disease duration (r=0.249, p-value=0.018). The whole SCP was significantly larger in cases with lymphopenia (p-value=0.004). CONCLUSION: This study found asymptomatic retinal vascular affection in post COVID-19 eyes showing a relation with disease clinical and laboratory features.

CHANDELIER-ASSISTED VERSUS STANDARD SCLERAL BUCKLING FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT: A Randomized Clinical Study.

PURPOSE: To compare anatomical outcomes, functional outcomes, and rate of complications of standard scleral buckling (SSB) versus chandelier-assisted scleral buckling (CSB) in phakic eyes with rhegmatogenous retinal detachment. METHODS: Patients were randomly assigned to either SSB or CSB. Surgical success/failure rate, corrected distance visual acuity, surgical operating time, and rate of intraoperative and postoperative complications including epiretinal membranes by spectral domain optical coherence tomography were compared between groups. RESULTS: A total of 50 eyes of 49 patients were included. At 6 months, there was no statistically significant difference between groups in primary success, or final anatomical success ( P > 0.9); mean corrected distance visual acuity at any visit ( P values >0.05); or mean surgical time: 120.3 ± 39.05 and 102.48 ± 43.76 minutes for the SSB and CSB, respectively ( P = 0.1). The CSB had a higher rate of postoperative complications (34.8%) compared with the SSB (3.8%) ( P < 0.05). On spectral domain optical coherence tomography, CSB had a statistically significant higher rate of epiretinal membranes compared with SSB (44% vs. 19% [ P < 0.05]) and showed vitreous entrapment in the chandelier sclerotomy site on the ultrasonic biomicroscopy. CONCLUSION: Chandelier-assisted scleral buckling surgery does not offer encouraging advantages over SSB. On the contrary, we detected a higher rate of complications with CSB especially epiretinal membranes development.

Long-term changes in ocular rigidity following scleral buckling for rhegmatogenous retinal detachment.

PURPOSE: To investigate the long-term effect of scleral buckling on corneal biomechanics and the effect of change of scleral properties on intraocular pressure (IOP) measurements. METHODS: This is a prospective case series, patients with rhegmatogenous retinal detachment prepared for scleral buckling were included. Goldmann applanation tonometry was used to measure IOP (GAT IOP). Ocular Response Analyzer (ORA) was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), goldmann-corrected IOP (IOPg), and corneal-compensated IOP (IOPcc) preoperatively, and 1, 3, and 6 months postoperatively. RESULTS: Thirty-three eyes included in the final analysis, with an average age 38.4 ± 16.2 years. CH and CRF decreased significantly at first, third, sixth months post-scleral buckling; however, this effect decreased with time as follows; preoperative: 8.9 ± 1.5 and 8.5 ± 2.1, first month: 6.8 ± 1.6 and 7.1 ± 1.8 (P value = 0.00, 0.002), third month: 7.8 ± 1.5 and 7.6 ± 1.6 (P value = 0.001, 0.008), and sixth month: 7.7 ± 1.3 and 7.6 ± 1.7 (P value = 0.002, 0.055). IOP cc was 19.3 ± 3.6, 17.1 ± 4, and 17.6 ± 2.9 at 1, 3, and 6 months, and these readings were significantly higher than GAT (13.6 ± 7.6, 12.4 ± 5.1, and 12.1 ± 2.9, P values = 0.00) and IOPg (14.9 ± 3.6, 13.5 ± 4.1, and 13.9 ± 3.5, P values = 0.00). The change in CH at each visit is correlated with the difference between the IOPcc and GAT measurements. CONCLUSION: The conventional Goldmann applanation tonometry underestimates post buckle IOP measurements due corneal biomechanics changes. ORA might be an alternative and accurate method of measurement; however, further investigation is warranted.

MONTHLY INTRAVITREAL INFLIXIMAB IN BEHÇET'S DISEASE ACTIVE POSTERIOR UVEITIS: A Long-Term Safety Study.

PURPOSE: To study the safety of extended monthly intravitreal infliximab injections in patients with active posterior uveitis in Behcet's disease. METHODS: This is a prospective, interventional, noncomparative, open-label, pilot study of 9 monthly intravitreal infliximab injections (1 mg/0.05 mL) for 22 eyes of 16 patients with active posterior uveitis in Behcet's disease. Control of inflammation and visual outcomes were assessed, and ocular complications were monitored during the study period. RESULTS: Successful treatment was achieved in 7 eyes (35%), and failure was encountered in 13 eyes (65%). Only seven eyes of six patients (35%) had completed the study and achieved complete resolution of inflammation with improved best-corrected visual acuity and no complications. Failure was either because of inability to control the inflammation in nine eyes (45%) or development of exacerbation of inflammation in four eyes (20%). Four eyes developed severe immunological reaction from the drug after first (n = 1), second (n = 2), and third (n = 1) injections and had to discontinue the injections. Kaplan-Meier survival analysis showed that the mean estimated time to failure was 3.3 ± 0.2 months, and all failed eyes required revision of their systemic immunotherapy to control the ocular inflammation. CONCLUSION: Intravitreal infliximab for active posterior uveitis in Behcet's disease was associated with a high complication rate and failure to control inflammation in most eyes. It should not be considered a substitute to systemic therapy.

Extended Internal Limiting Membrane Peeling in Complex Pediatric Rhegmatogenous Retinal Detachment.

PURPOSE: To assess the feasibility and investigate the anatomical and functional outcomes of extended internal limiting membrane (ILM) peeling with pars plana vitrectomy (PPV) for complex pediatric rhegmatogenous retinal detachment (RRD). METHODS: This was a retrospective interventional case series where children (≤18 years) with RRD and severe PVR (grade C) were included. All eyes underwent PPV with ILM peeling up to 2-disk diameter beyond the vascular arcades. The main outcome measures were assessment of feasibility of ILM peeling in the pediatric RRD and evaluation of the rate of complete retinal reattachment and corrected-distance visual acuity (CDVA) at the final follow-up. RESULTS: A total of 29 eyes (25 patients) were enrolled in this study. ILM peeling performed on these children was not more difficult than in adult eyes. After a mean follow-up of 18 months, the patients achieved final CDVA better than 20/200 in 37.9%. The initial retinal reattachment was 55.2% while the final anatomical success was 86.2%. CONCLUSION: Vitrectomy with ILM peeling is technically feasible in pediatric RRD, limiting epiretinal proliferation and achieving favorable anatomical outcomes in cases of complex pediatric RRD. The long-term effects of ILM peeling need further investigation.

Change in Ophthalmology Practice during COVID-19 Pandemic: Egyptian Perspective.

PURPOSE: To assess the impact of the COVID-19 pandemic on ophthalmology practice in the Cairo metropolitan area. METHODS: This is a cross-sectional observational analytic study among ophthalmologists practicing in different hospitals in the Cairo metropolitan area. The data were collected through a self-administered questionnaire covering general measures taken during practice. RESULTS: The questionnaire was sent to 250 ophthalmologists, with an 82% response rate. Most of the participants were concerned about the economic impact of the pandemic, as there is a 60-80% reduction in the flow of patients with a consequent 80-100% reduction in surgical cases. Most of the participants have access to personal protective equipment, and the safety protocols are followed, especially by the older ophthalmologists. Thus, the surgeons are willing to perform elective surgeries, adhering to strict safety protocols (70.8, 42.6, and 18.8% of the refractive surgeons, corneal surgeons, and retinal surgeons, respectively; p = 0.00). Furthermore, 63.9% of the participants, especially the young ophthalmologists, are willing to see COVID-19 patients and operate on them if needed. CONCLUSIONS: The COVID-19 pandemic could go on for months or even years with a significant impact on ophthalmology practice. Trying to keep a balance between safety and economic burden, the majority of ophthalmologists are willing to see elective patients and urgently operate on a COVID-19 patient, under adherence to the safety protocols.

The value of prednisolone acetate provocative test before intravitreal triamcinolone acetonide injections.

PURPOSE: The aim of this study was to investigate the diagnostic value of a topical prednisolone acetate 1% provocative test for steroid-induced ocular hypertension before intravitreal triamcinolone acetonide injection. METHODS: This is a prospective, single-center, randomized controlled study at Kasr El Aini Hospital, Cairo University. Patients scheduled for intravitreal triamcinolone acetonide were enrolled and randomly allocated in a ratio 2:1 to either Group A: received prednisolone acetate provocative test and those who did not develop SIOH proceeded with intravitreal triamcinolone acetonide or Group B: did not receive prednisolone acetate provocative test and proceeded directly to intravitreal triamcinolone acetonide. Intraocular pressures were measured weekly for 4 weeks following intravitreal triamcinolone acetonide. Steroid-induced ocular hypertension is defined as intraocular pressure increase of 5 mmHg or more from baseline after prednisolone acetate provocative test or intravitreal triamcinolone acetonide. RESULTS: A total of 66 eyes (66 patients) were included. Of which, 10 eyes (23.8%) showed prednisolone acetate provocative test steroid-induced ocular hypertension during the 4-week period. Intravitreal triamcinolone acetonide steroid-induced ocular hypertension was less likely to develop in Group A (prednisolone acetate provocative test non-steroid-induced ocular hypertension, n = 32, 31.25%) than in group B (n = 24, 54.2%) (p = 0.006, odds ratio: 0.178, 95% CI: 0.53-0.596). Our test achieved a negative predictive value of 68.75%. CONCLUSION: The topical prednisolone acetate provocative test may be a useful method to predict a steroid-induced ocular hypertension following intravitreal triamcinolone acetonide.

Intravitreal decorin preventing proliferative vitreoretinopathy in perforating injuries: a pilot study.

PURPOSE: To determine the short-term safety of human recombinant decorin protein in preventing proliferative vitreoretinopathy (PVR) in perforating injuries. METHODS: This is a prospective, single-center, open-label, interventional case series. Single intravitreal injection of decorin 200 µg (n = 4) or 400 µg (n = 8) was given 48 h after injury. At the tenth day, pars plana vitrectomy was done whenever indicated. Flash electroretinogram (ERG) was done before and 3 months post-injection. We assessed ocular inflammation, ERG changes, and retinal layer integrity by optical coherence tomography (OCT). Systemic and vitreous pharmacokinetics were also evaluated. RESULTS: Twelve patients (12 eyes) with perforating globe injuries (zone III) were included and followed for a median of 6 months. Intravitreal decorin injection was well tolerated with no ocular or systemic safety adverse events. Decorin retinal safety was demonstrated anatomically by intact retinal layer by OCT, and functionally by flash ERG which did not show any significant worsening during the study and the final mean logMAR best-corrected visual acuity (BCVA) which was 1.15 (20/280) and 0.7 (20/100) for groups A and B, respectively, and ≥ 20/200 in 75% of all eyes. Decorin serum and vitreous levels were elevated following trauma, with higher and extended levels following intravitreal injection. CONCLUSIONS: No short-term safety concerns were detected after a single intravitreal injection of decorin in patients with perforating injuries. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02865031.

El efecto de la panfotocoagulación con láser en edema macular diabético con el fotocoagulador Pascal® versus el láser de argón convencional.

Objetivo: El objetivo de este estudio fue comparar el efecto de la panfotocoagulación (PFC) en el edema macular diabético (EMD) en pacientes con retinopatía diabética proliferativa (RDP) con el fotocoagulador Pascal® (FP) vs. un fotocoagulador con láser de argón convencional (FLAC). Métodos: Se aleatorizó el uso de FP o FLAC en ochenta ojos con RDP y EMD con afectación central de la mácula. Ambos grupos tuvieron una evaluación de base de mejor agudeza visual corregida y fueron examinados con tomografía de coherencia óptica y angiografía con fluoresceína. Resultados: El número medio de disparos de láser en los grupos de FP y FLAC fue 1.726,10 y 752,00 en la sesión 1 y 1.589,00 y 830,00 (p < 0,001) en la sesión 2, respectivamente. El grosor foveal central (GFC) medio antes de comenzar el estudio fue 306 ± 100 y 314 ± 98 en los grupos de FP y FLAC, respectivamente. A las 8 semanas, el GFC medio fue 332 ± 116 y 347 ± 111 en los grupos de FP y FLAC, respectivamente (p > 0,05). La MAVC media fue similar durante el periodo de estudio y no hubo ninguna diferencia significativa entre los grupos (p > 0,05). Conclusiones: El FP y el FLAC mostraron efectos similares en el EMD en ojos con RDP y fueron igualmente seguros sin un aumento significativo del GFC.

Retinal ganglion cell complex changes using spectral domain optical coherence tomography in diabetic patients without retinopathy.

AIM: To assess the ganglion cell complex (GCC) thickness in diabetic eyes without retinopathy. METHODS: Two groups included 45 diabetic eyes without retinopathy and 21 non diabetic eyes. All subjects underwent full medical and ophthalmological history, full ophthalmological examination, measuring GCC thickness and central foveal thickness (CFT) using the RTVue® spectral domain-optical coherence tomography (SD-OCT), and HbA1C level. RESULTS: GCC focal loss volume (FLV%) was significantly more in diabetic eyes (22.2% below normal) than normal eyes (P=0.024). No statistically significant difference was found between the diabetic group and the control group regarding GCC global loss volume (GLV%) (P=0.160). CFT was positively correlated to the average, superior and inferior GCC (P=0.001, 0.000 and 0.001 respectively) and negatively correlated to GLV% and FLV% (P=0.002 and 0.031 respectively) in diabetic eyes. C/D ratio in diabetic eyes was negatively correlated to average, superior and inferior GCC (P=0.015, 0.007 and 0.017 respectively). The FLV% was negatively correlated to the refraction and level of HbA1c (P=0.019 and 0.013 respectively) and positively correlated to the best corrected visual acuity (BCVA) in logMAR in diabetic group (P=0.004). CONCLUSION: Significant GCC thinning in diabetes predates retinal vasculopathy, which is mainly focal rather than diffuse. It has no preference to either the superior or inferior halves of the macula. Increase of myopic error is significantly accompanied with increased focal GCC loss. GCC loss is accompanied with increased C/D ratio in diabetic eyes.

INTRAVITREAL INFLIXIMAB IN REFRACTORY UVEITIS IN BEHCET'S DISEASE: A Safety and Efficacy Clinical Study.

PURPOSE: To assess the safety and efficacy of intravitreal infliximab (1 mg/0.05 mL) in patients with refractory posterior uveitis in Behcet's disease. METHODS: Twenty patients were included in this study. Best corrected visual acuity (BCVA), vitreous haze (graded 0-4), vasculitis, retinitis, and papillopathy (presence or absence) were assessed at baseline, Day 1 and Week 2, 4, 6, 8, 12, and 18. Optical coherence tomography (OCT) central foveal thickness, fluorescein angiography, and flash electroretinogram were done at baseline and 4, 12, and 18 weeks. RESULTS: Mean baseline logMAR BCVA was 0.94 (20/160), had improved significantly by Week 2 to 0.6 (20/80) (P < 0.0001), and reached 0.36 (20/40) by Weeks 18 with three injections (P < 0.0001). Mean central foveal thickness OCT decreased significantly from baseline 361 µm to 180 µm at the end of follow-up (P < 0.0001). Profound decrease in mean vitreous haze gradings from two to 0.2 by the end follow-up (P < 0.05). There was a significant reduction in the number of patients with vasculitis (15 at baseline to 1 weeks at 18 weeks), retinitis (nine at baseline to none at 4 weeks), and papillitis (two at baseline to none at 4 weeks) (P < 0.05). No significant electrophysiological changes or ocular adverse inflammatory reactions were observed during the study period. CONCLUSION: Intravitreal infliximab appeared to be safe and effective in treating uveitis in Behcet's disease and should be considered as an alternative to systemic therapies.

Epidemiological Features of Pediatric Ocular Trauma in Egypt.

Purpose. To review the epidemiology of serious pediatric ocular trauma presenting to Kasr El Aini Hospital, Cairo University. Methods. Children with serious ocular trauma during a six-month period were examined and their data was analyzed. Results. Eighty eyes of 75 patients were included in this study, with 64% males (P < 0.001) and average age of 5 years (5 months-15 years). There were 67 (83.75%) open globe injuries, 11 (13.75%) closed globe injuries, and 2 (2.5%) chemical injuries. Of the open globe injuries, 24 (30%) were ruptured globes and 43 (53.75%) were lacerations (31 penetrating injuries (38.75%), 6 IOFBs (7.5%), and 6 perforating injuries (7.5%)). Of the closed globe injuries, 3 had hyphema (3.75%), 5 had traumatic cataracts (6.25%), and 3 had vitreous hemorrhage with retinal detachment (3.75%). Forty-two patients (56%) presented within 24 hours, 28 patients (37.33%) presented between 24 hours and 1 week, and 5 patients (6.6%) presented after one week from the time of trauma. Seven eyes developed posttraumatic endophthalmitis (10% of open globe injuries). On leaving the hospital, 55 (68.75%) eyes had poor vision, 13 (16.25%) had moderate vision, and 12 (15%) had good vision. Conclusion. Children at a higher risk of trauma are males, >5 years, unsupervised, and involved in street activities. Immediate comprehensive primary management and secondary rehabilitation are mandatory in these cases.

Brinzolamide/timolol versus dorzolamide/timolol fixed combinations: A hospital-based, prospective, randomized study.

PURPOSE: To compare the efficacy and tolerability of brinzolamide/timolol (BT) and dorzolamide/timolol (DT) fixed combinations on intraocular pressure (IOP) reduction. METHODS: Patients with primary open angle glaucoma or normal tension glaucoma were randomized to receive either BT or DT. IOPs were measured at baseline, 2 weeks, and 1, 2, and 3 months. The primary outcome measures were the mean change in IOP from baseline at each visit. Secondary outcome measures included the tolerability of each fixed combination. RESULTS: Seventy-three patients (73 eyes) were included; 37 eyes in BT group and 36 eyes in DT group. Baseline mean IOP were 24.14 ± 4.5 and 29.53 ± 6 mmHg for BT and DT, respectively (P < 0.001). Both BT and DT provided statistically significant mean IOP reductions from baseline values within each group at all study visits (P < 0.001). DT provided greater mean IOP reductions from baseline than BT at each visit which was statistically significant at 2 weeks (P = 0.037). Mean percentage of IOP reduction was 24.35% and 46.33% at 2 weeks (P < 0.001), and 24.65% and 47% at 3 months (P < 0.001) for BT and DT, respectively. Patients' tolerability appeared to be better for DT than for BT with complete ocular comfort without any ocular adverse effects in 31 patients (81.1%) in DT group and 11 patients (29.7%) in BT group (P < 0.001). CONCLUSION: Both drops provide effective IOP reduction which was greater, and patients were more likely to achieve lower target pressures with DT than with BT.

The Effect of Laser Panretinal Photocoagulation on Diabetic Macular Edema Using the Pascal® Photocoagulator versus the Conventional Argon Laser Photocoagulator.

PURPOSE: The aim of this study was to compare the effect of panretinal photocoagulation for proliferative diabetic retinopathy (PDR) on diabetic macular edema (DME) using a Pascal® Photocoagulator (PP) or a conventional argon laser photocoagulator (CALP). METHODS: Eighty eyes with PDR and center-involving DME were randomized to PP or CALP. Both groups had baseline assessment of best-corrected visual acuity (BCVA) and were examined with optical coherence tomography and fluorescein angiography. RESULTS: The mean number of laser shots for the PP and CALP groups was 1,726.10 and 752.00 at session 1 and 1,589.00 and 830.00 (p < 0.001) at session 2, respectively. The mean central foveal thickness (CFT) at baseline was 306 ± 100 and 314 ± 98 for the PP and CALP groups, respectively. At 8 weeks, the mean CFT was 332 ± 116 and 347 ± 111 for the PP and CALP groups, respectively (p > 0.05). The mean BCVA was similar during the study period with no significant difference between the groups (p > 0.05). CONCLUSION: PP and CALP had similar effects on DME in PDR eyes and were equally safe with no significant increase in CFT.

Predicting postoperative visual outcomes in cataract patients with maculopathy.

PURPOSE: To assess the accuracy of the potential acuity meter (PAM) in predicting postcataract surgery visual acuity outcome in patients with healed inactive maculopathies. STUDY DESIGN: Prospective interventional clinical trial. PATIENTS AND METHODS: Patients scheduled for phacoemulsification had preoperative and 1 month postoperative best-corrected visual acuity (BCVA), PAM test, fluorescein angiography, and macular optical coherence tomography. Patients were grouped to following preoperative BCVA: PRE1: 0.29 and better, PRE2: 0.25-0.13, and PRE3: 0.1 or worse; age: G1 <60, G2 = 60-70, and G3 >70 years. PAM accuracy was divided into: Grade 1: Postoperative BCVA ≤1 or less line error of the PAM score, Grade 2: Between 1 and 2 lines error, and Grade 3: ≥3 lines or more error. RESULTS: This study enrolled 57 patients with a mean age of 71.05 ± 6.78 years where 34 were females. There were 21 (36.84%) patients with diabetic maculopathy and 36 (63.16%) with age-related macular degeneration. The mean preoperative BCVA was 0.198 ± 0.12 (0.1-0.5). The mean PAM score was 0.442 ± 0.24 (0.1-1.3). The mean postoperative BCVA was 0.4352 ± 0.19 (0.17-1.00). The PAM score was in Grade 1, 2, and 3 in 46 (80.7%), 54 (94.7%), and 56 (98.2), respectively. There was a highly significant correlation between the PAM score and the postoperative BCVA (P < 0.001, Chi-square test). There was no correlation between the PAM test accuracy and age, gender, diagnosis, and preoperative BCVA (P = 0.661, 0.667, 0. 0.991, 0.833, Chi-square test; respectively). CONCLUSION: The PAM is an accurate method of predicting postoperative visual acuity for eyes with nuclear cataracts Grade I and II and inactive maculopathies.

Dexamethasone intravitreous implant versus bevacizumab for central retinal vein occlusion-related macular oedema: a prospective randomized comparison.

BACKGROUND: To compare the efficiency of dexamethasone implants to bevacizumab injections in macular oedema secondary to central retinal vein occlusion. DESIGN: Randomized clinical trial at Cairo University Hospitals. PARTICIPANTS: Sixty eyes of 60 newly diagnosed patients with macular oedema secondary to central retinal vein occlusion with best corrected visual acuity 0.3 logMAR (6/12) to counting fingers, no evidence of retinal ischaemia and/or neovascularization on fluorescein angiography and central subfield thickness ≥300 µm on ocular coherence tomography. METHODS: Patients were randomly assigned (30 eyes each group) to either intravitreal dexamethasone implant or bevacizumab injections repeated whenever needed. Best corrected visual acuity and ocular coherence tomography were done at baseline and monthly for 6 months. MAIN OUTCOME MEASURES: Comparing best corrected visual acuity and central foveal subfield thickness between both groups during the 6-month period. RESULTS: There was no significant difference in best corrected visual acuity between the two groups during the 6 months (P-values > 0.05). The bevacizumab group had a statistically significant thinner central subfield thickness at 1 month (P-value 0.006) and no statistically significant difference for the rest of the 6 months (P-values > 0.05). There was a statistically significant higher intraocular pressure for dexamethasone implant group (compared with bevacizumab) at 3-6 months (P-values < 0.05), respectively. CONCLUSION: Both drugs provided effective best corrected visual acuity improvements and central subfield thickness reductions that showed no statistically significant difference between the two groups.

Bimatoprost/timolol versus travoprost/timolol fixed combinations in an Egyptian population: a hospital-based prospective randomized study.

PURPOSE: To compare the efficacy of bimatoprost/timolol (BTFC) or travoprost/timolol (TTFC) fixed combinations on intraocular pressure (IOP) reduction in an Egyptian population. METHODS: Patients with primary open angle glaucoma were randomized to receive either BTFC or TTFC. IOPs were measured at baseline, 2 weeks, and 1, 2, 4, and 6 months. The primary outcome measure was the mean change in IOP from baseline at each visit. Secondary outcome measures included the incidence of adverse events. RESULTS: Eighty patients (80 eyes) were included finally: 40 eyes in each group. Baseline mean IOPs were 24.78±3.53 and 25.26±3.51 mm Hg for BTFC and TTFC, respectively (P=0.344). Both drops provided statistically significant IOP reductions from baseline at all visits (P<0.001). BTFC provided greater significant mean IOP reductions from baseline than TTFC at each visit (P<0.001). Mean IOP reductions were 11.34 and 6.42 mm Hg at 2 weeks (P=0.000), and 11.17 and 7.89 mm Hg at 6 months (P=0.001) for BTFC and TTFC, respectively. IOPs at 2 weeks were ≤18 mm Hg in 36 (90.8%) versus 22 (55%) eyes and ≤16 mm Hg in 28 (70%) versus 16 (40%) eyes (P<0.001), and at 6 months, ≤18 mm Hg in 38 (95%) versus 28 (70%) eyes and ≤16 mm Hg in 30 (75%) versus 18 (45%) eyes for BTFC and TTFC, respectively (P<0.001). CONCLUSION: Both drops provided effective IOP reduction that was greater and patients were more likely to achieve lower target pressures with BTFC than with TTFC.