Bilateral congenital agenesis of lacrimal glands in a Tunisian family.

BACKGROUND: Chronic corneal ulcers still pose etiological and therapeutic challenge. They are serious complications and often associated with poor functional prognosis. AIM: We report the case of a patient with bilateral and chronic corneal ulcer revealing a rare   familial   form   of   bilateral   agenesis   of   the   lacrimal   gland. CASES REPORT: A 39-year-old man was referred to our department for bilateralchronic and sterile ulcer. The tear break-up time was less than one second and the schirmer test detected no wetting in 5 minutes. He mentioned that lacrimation had been totally absent even when crying as was the case of his brother and his sister. Orbital echography showed absence of lacrimal gland. Orbital magnetic resonance imaging revealed absence of both lacrimal glands. Our patients were treated with permanent topical artificial tears. We performed also permanent occlusion of lower lachrymal poncti to preserve basic tear flow. CONCLUSION: Congenital lacrimal gland agenesis is rare. We report, to ourknowledge, the first case of Tunisian family with three patients suffering from bilateral lacrimal gland agenesis and the first documented familiarly cases diagnosed in adulthood.

Characteristics of Astigmatism in a Population of Tunisian School-Children.

PURPOSE: To evaluate the characteristics of astigmatism in a cross-sectional study of schoolchildren in Tunisia. MATERIALS AND METHODS: A random cluster design was used to recruit children from primary schools across urban and rural settings in Tunisia, from 2008 to 2010. A total of 6192 students aged 6-14-years old were enrolled. All students whose uncorrected visual acuity was worse than 20/20 underwent a complete ophthalmic examination. Astigmatism was defined as the cylinder power of 0.75 diopter (D) or greater. RESULTS: The prevalence of astigmatism was 6.67%. Mean cylinder power was - 1.89 ± 0.79D. The prevalence of astigmatism increased statistically significantly with age (P = 0.032). The prevalence of astigmatism was not significantly related to gender (P = 0.051). Of those with cylinder, 63.6%, 17.8%, and 18.6% schoolchildren had with with-the-rule, against-the-rule, and oblique astigmatism, respectively. ATR astigmatism was significantly higher in males (P = 0.033). There was no significant association between the student's area of residence and astigmatism (P = 0.059). CONCLUSION: Comparisons with other studies show that the prevalence of astigmatism in Tunisia is higher than in some countries. The prevalence of astigmatism increased with age but not gender. The majority of schoolchildren had with-the-rule astigmatism.

[Epidemiologic study of hyperopia in schoolchildren in Tunisia]. / Profit épidémiologique de l'hypermétropie en milieu scolaire primaire en Tunise: à propos de 6192 enfants.

AIM: To study the epidemiological profile and the degree of severity of hyperopia in Tunisia primary school and to assess its effect on school performance. METHODS: A cross-sectional, descriptive survey was conducted among 6-14 aged Tunisian children attending primary urban and rural schools. A total of 6192 children were selected using stratified random cluster sampling. Cycloplegic refractive error was measured among all children with uncorrected visual acuity less than 9/10 or signs of astheniopia. Hyperopia was defined as spherical equivalent (SE) 2.0 diopters (D). We have also searched a possible relation between degree of severity of hyperopia and school performance. RESULTS: The prevalence of hyperopia was 2.61%. The spherical equivalent mean was + 3.73 ± 0.94 D. The mean age was 9.67 ± 0.44 years. This prevalence was 2.77% in boys and 2.47% in girls. 3.13% of students were living in urban areas and 1.42% in rural areas. The hyperopia rate decreased significantly with age (p = 0.021), but it was not significantly related to gender (p=0.54). The difference in the prevalence of hyperopia between urban and rural areas was not statistically significant (p = 0.067). There was no significant association between the degree of severity of hyperopia and school performance (p=0.41). CONCLUSION: In our study, the prevalence of hyperopia among schoolage children in Tunisia was 2.61%.The identification of this refractive error and its correction as soon as possible would ensure these children better visual comfort and a better education.

Bevacizumab injection in patients with age-related macular degeneration associated with poor initial visual acuity.

Purpose. To evaluate functional and anatomic effects of intravitreal bevacizumab in patients with neovascular AMD and initial low visual acuity. Methods. Retrospective case series of 38 eyes with neovascular AMD and initial visual acuity of 20/200 or less, treated with intravitreal bevacizumab injection. Results. Mean followup was 14.1 months ± 7.1 (range: 5 to 24 months). Mean logMAR vision at baseline was 1.38 logMAR ± 0.33, at 6 months was 1.14 logMAR ± 0.37 (P = 0.001) and at 12 months was 1.22 logMar ± 0.33 (P = 0.004). Mean baseline central retinal thickness was 431 µm ± 159.7 at 6 months was 293.43 µm ± 122.79 (P = 10(-4)) and at 12 months was 293.1 µm ± 130 (P = 0.004). Visual acuity improved in both patients with or without prior PDT treatment. Conclusions. Intravitreal bevacizumab injection may increase the chance of visual acuity gain in neovascular AMD even in cases with initial low visual acuity.