Dermatologists' and Rheumatologists' Adherence to the Latest Recommendations for Screening of Hydroxychloroquine Retinopathy in Saudi Arabia: A Cross-Sectional Study.

INTRODUCTION:  Hydroxychloroquine (HCQ) is used to manage the symptoms of inflammatory rheumatic and dermatologic disorders. However, HCQ retinopathy is a serious side effect because even after the drug is discontinued, irreversible vision loss may occur and may continue to progress. According to the American Academy of Ophthalmology (AAO), the recent recommendation for HCQ dosing is ≤5 mg/kg of real body weight, with baseline ophthalmologic screening during the first year of HCQ treatment and yearly screening after five years of continuous use of HCQ medication, unless the patient is at high risk or symptoms have developed. Nonetheless, this study aims to assess dermatologists' and rheumatologists' adherence in Saudi Arabia to the 2016 AAO HCQ retinal toxicity guidelines. METHODS:  A questionnaire-based cross-sectional study was conducted on dermatologists and rheumatologists in Saudi Arabia. It was conducted between August and September 2022 and questionnaires were sent to dermatologists and rheumatologists via their professional emails or accounts. RESULTS: The collected sample consisted of 635 participants; males and females represented 54% and 46%, respectively; 47.6% were consultants; 50.1% were rheumatologists; and 49.9% were dermatologists. Approximately 28.2% of the participants reported treating one to three patients with HCQ in the previous year. Only 45.4% of the respondents stated that the ideal recommended HCQ dose for reducing the risk of retinopathy is "≤ 5 mg/kg of the real body weight." More than 50% of the respondents stated that systemic lupus erythematosus was the most common disease for which they used HCQ. Additionally, 36.5% of the physicians screened patients during the first year of HCQ treatment. We found significant associations between practice levels and specialty practice-related questions with a p-value of less than 0.05, except for the specialty practice-related question, "What is the most common disease for which you use HCQ?" with a p-value of 0.074. Also, we found significant associations between all demographic variables and screening-related variables with a p-value of less than 0.05, with two exceptions: no significant associations were found between specialty area and the screening-related question, "Do you recommend screening tests for all patients starting treatment with HCQ?" at p = 0.270, and gender and the screening-related question, "When would you recommend screening tests for a patient without risk?" at p = 0.142. CONCLUSIONS:  Dermatologists and rheumatologists in Saudi Arabia have shown poor adherence to the most recent AAO recommendations. Educating physicians and patients about the AAO guidelines is needed for HCQ to be used in a way that is both effective and safe.

Awareness of Keratoconus and Its Association With Eye Rubbing Among the Population in Aseer Province.

BACKGROUND: Keratoconus (KC), is a non-inflammatory, bilateral, asymmetrical, progressive disease characterized by ectasia, thinning, increasing corneal curvature, and loss of visual acuity. In Saudi Arabia, it was discovered that KC has been the main reason for corneal transplantation in the past 20 years. Eye rubbing is considered one of the most significant risk factors for KC based on available data. PARTICIPANTS AND METHODS: A cross-sectional study was conducted among adults in Aseer province, Saudi Arabia in 2023. Data were collected through a pre-designed online questionnaire consisting of 17 questions divided into three sections. The questionnaire was preceded by informed consent and insured to maintain the confidentiality of the data. RESULTS: A total of 498 respondents were included in this study. The majority of the study's participants were in the 18 to 25 age group and females made up the majority. The majority of participants had a university education. 41.6% of individuals reported experiencing an allergic disorder, 59.0% reported having knowledge about KC, and the overall participants' awareness regarding KC was poor at 85.74%, with the highest percentage of good awareness (22.2%) detected among the 18-25 age group. CONCLUSION: The study revealed a concerning lack of awareness about KC among the population in Aseer Province, Saudi Arabia. Additionally, a significant percentage of participants engaged in eye rubbing, a behavior associated with increased risk for KC. There is a need for increased awareness about KC and the importance of avoiding eye rubbing.

Psychological and Social Challenges Parents of Children With Strabismus Face in Qassim Region, Saudi Arabia: A Cross-Sectional Study.

Aim Strabismus or squint is when one eye is misaligned or looking in a different direction. Some people consider strabismus as a cosmetic problem, causing patients in this condition to be mishandled, especially children, which might affect their vision and their quality of life. This study aimed to evaluate the psychological and social challenges faced by parents of children with strabismus during the years 2020-2021. Subjects and methods This is a cross-sectional study conducted among parents who have children with strabismus onset from birth till the age of 16 years. A self-administered questionnaire was distributed among parents during their visits to the vision eye specialist center. The questionnaire included socio-demographic characteristics of patients with strabismus and a 12-item questionnaire to measure the psychological impact on the parents of children with strabismus. Results Out of the 105 respondents, 65.7% were fathers, and 55.2% had children aged six years old or less. The most prominent strabismus type was esotropia (where the eye turns inward; 38.1%), while the most common nature of strabismus was intermittent (76.2%). The mean total score of psychological impact was 36.2 (SD=8.15) out of 60 points, with 62.9% considered as having an average psychological impact. Moreover, 77.1% of the respondents believed that strabismus could be treated and improved. Conclusion There was a moderate psychosocial challenge among parents of children with strabismus. Out of all the subjects, mothers who had prior visits to government hospitals were noticed to be greatly affected psychologically as compared to other subjects.

Prevalence and determinants of burnout syndrome and depression among medical students at Qassim University, Saudi Arabia.

OBJECTIVES: To investigate the prevalence and determinants of burnout syndrome and depression among medical students at Unaizah College of Medicine (UCM), Qassim University, Qassim, Kingdom of Saudi Arabia (KSA). Methods: A cross-sectional study of all Saudi medical students studying at UCM, Qassim University, Al Qassim, KSA, between February to March 2020. Results: Of the total 305 students sampled, 153 (50.2%) fit the category of depression. Concerning burnout, only 5.6% of the total population met the Maslach Burnout Inventorydiagnostic criteria for burnout, with those determined to have burnout having ranked high on the emotional exhaustion and cynicism subscales, and low on the academic efficacy subscale. Male was strongly associated with burnout, while female gender and raising children were strongly associated with the presence of depression. Emotional exhaustion and high cynicism as determinants of burnout elevate the risk of depression. Conclusion: Our results highlight the high rate of depression and burnout, as well as the need for psychological intervention programs at medical schools to prevent the deterioration of student's mental health that has been associated with advancement in medical school.