Cirugía del desprendimiento de retina en el Departamento de Oftalmología de la Hamad Medical Corporation en Doha, Qatar / Retinal detachment surgery in the Ophthalmological Department of the Hamad Medical Corporation in Doha, Qatar

Objetivo: describir las características relacionadas con el desprendimiento de retina regmatógeno de los pacientes atendidos en el Servicio de Oftalmología de la Hamad Medical Corporation en Doha, Qatar. Métodos: se realizó un estudio descriptivo, retrospectivo de series de casos retrospectivas no comparativo de todos los pacientes (114) quienes experimentaron la reparación de desprendimiento de retina regmatógeno por 2 años (entre enero del año 2011 y diciembre 2012) en el Departamento de Oftalmología de la Hamad Medical Corporation. La demografía de los pacientes, el resultado visual, las complicaciones y las tasas de fracaso fueron identificados y registrados. Resultados: la replicación de la retina sucedió en el 95,3 por ciento de los pacientes y la mejor agudeza visual posoperatoria corregida de 6/36 a 6/6 fue alcanzada en el 59,7 por ciento. Los probables factores de riesgo fueron el desprendimiento de retina en paciente miope en el 39,4 por ciento; el desprendimiento de retina posoperatorio en el 14,9 por ciento y el desprendimiento de retina traumático en el 22,8 por ciento. El desprendimiento por la degeneración retiniana periférica fue de 9,6 por ciento y la causa no visible se registró en el 13,2 por ciento. Conclusiones: el estudio ha revelado un resultado alentador para la reparación de desprendimiento de retina en el Departamento de Oftalmología de la Hamad Medical Corporation en Doha Qatar(AU)

Objective: to describe the characteristics related to the rhegmatogenous retinal detachment in patients seen at the ophthalmological service of Hamad Medical Corporation in Doha, Qatar. Methods: a retrospective, descriptive, non-comparative case-series study was conducted in 114 patients who underwent the repair of the rhegmatogenous retinal detachment during two years (January 2011 to December 2012) at the ophthalmological department of Hamad Medical Corporation. Patient's demographic information, visual outcomes, complications and rates of failure were identified and registered. Results: retinal replication occurred in 95.3 percent of patients and postoperative best corrected visual acuity from 6/36 to 6/6 was reached in 59.7 percent of cases. The probable risk factors were retinal detachment in myopic patient in 39.4 percent; postoperative retinal detachment in 14.9 percent and traumatic retinal detachment in 22.8 percent of cases. Detachment caused by peripheral retinal degeneration was 9.6 percent and the invisible cause was recorded in 13.2 percent of patients. Conclusions: the study has revealed encouraging results for the retinal detachment repair in the ophthalmological department of Hamad Medical Corporation in Doha, Qatar(AU)

Cirugía del desprendimiento de retina en el Departamento de Oftalmología de la Hamad Medical Corporation en Doha, Qatar / Retinal detachment surgery in the Ophthalmological Department of the Hamad Medical Corporation in Doha, Qatar

Objetivo: describir las características relacionadas con el desprendimiento de retina regmatógeno de los pacientes atendidos en el Servicio de Oftalmología de la Hamad Medical Corporation en Doha, Qatar. Métodos: se realizó un estudio descriptivo, retrospectivo de series de casos retrospectivas no comparativo de todos los pacientes (114) quienes experimentaron la reparación de desprendimiento de retina regmatógeno por 2 años (entre enero del año 2011 y diciembre 2012) en el Departamento de Oftalmología de la Hamad Medical Corporation. La demografía de los pacientes, el resultado visual, las complicaciones y las tasas de fracaso fueron identificados y registrados. Resultados: la replicación de la retina sucedió en el 95,3 por ciento de los pacientes y la mejor agudeza visual posoperatoria corregida de 6/36 a 6/6 fue alcanzada en el 59,7 por ciento. Los probables factores de riesgo fueron el desprendimiento de retina en paciente miope en el 39,4 por ciento; el desprendimiento de retina posoperatorio en el 14,9 por ciento y el desprendimiento de retina traumático en el 22,8 por ciento. El desprendimiento por la degeneración retiniana periférica fue de 9,6 por ciento y la causa no visible se registró en el 13,2 por ciento. Conclusiones: el estudio ha revelado un resultado alentador para la reparación de desprendimiento de retina en el Departamento de Oftalmología de la Hamad Medical Corporation en Doha Qatar(AU)

Objective: to describe the characteristics related to the rhegmatogenous retinal detachment in patients seen at the ophthalmological service of Hamad Medical Corporation in Doha, Qatar. Methods: a retrospective, descriptive, non-comparative case-series study was conducted in 114 patients who underwent the repair of the rhegmatogenous retinal detachment during two years (January 2011 to December 2012) at the ophthalmological department of Hamad Medical Corporation. Patient's demographic information, visual outcomes, complications and rates of failure were identified and registered. Results: retinal replication occurred in 95.3 percent of patients and postoperative best corrected visual acuity from 6/36 to 6/6 was reached in 59.7 percent of cases. The probable risk factors were retinal detachment in myopic patient in 39.4 percent; postoperative retinal detachment in 14.9 percent and traumatic retinal detachment in 22.8 percent of cases. Detachment caused by peripheral retinal degeneration was 9.6 percent and the invisible cause was recorded in 13.2 percent of patients. Conclusions: the study has revealed encouraging results for the retinal detachment repair in the ophthalmological department of Hamad Medical Corporation in Doha, Qatar(AU)

A study of diabetes complications in an endogamous population: an emerging public health burden.

AIM: The aims of this study were to determine the prevalence of diabetic complications namely neuropathy, nephropathy, and retinopathy among Qatari's DM patients; and to find associations between these complications and socio-demographic and clinical characteristics in a highly consanguineous population. DESIGN: It is an observational cohort study. SETTING: The survey was carried out at the Hamad General Hospital and Primary Health Care (PHC) centers in the State of Qatar. SUBJECTS: The study was conducted from May 2011 to January 2013 among Qatari nationals above 20 years of age. Of the 2346 registered with diagnosed diabetes attending Hamad General Hospital and PHC centers, 1633 (69.3%) agreed and gave their consent to take part in this study. METHODS: Questionnaire included socio-demographic variables, body mass index (BMI), consanguinity, lifestyle habits, family history of diabetes, blood pressure and development of diabetes complications such as retinopathy, nephropathy, and neuropathy were collected at regular intervals throughout the follow-up. Univariate and multivariate statistical analysis were performed. RESULTS: Out of 1633 diabetic patients, 842 (51.6%) were males. The prevalence of diabetic nephropathy 12.4% and retinopathy was 12.5% followed by neuropathy 9.5% among diabetic population. The proportion of diabetic neuropathy and nephropathy were significantly higher among diabetic patients with age 60 years and above as compared to younger age groups (p=0.010). Nephropathy was significantly higher among male diabetic (p=0.014) and smokers (p<0.001) while diabetic neuropathy was more common among diabetic hypertensive patients (p=0.028). Multivariate logistic regression showed that Age (p=0.025), being male (p=0.045), and having high blood pressure (p=0.006) were significant predictors of diabetic neuropathy. For diabetic retinopathy, family history of DM (p<0.001), consanguinity (p=0.010), having high blood pressure (p=0.042) and physical activity (p<0.001) were significant predictors of diabetic retinopathy. Meanwhile, for diabetic nephropathy, age (p<0.001), smoking (p=0.045), physical activity (p<0.001) hypertension (p<0.001) and gender (p=0.012) were the significant predictors. CONCLUSION: Diabetes exerts a significant burden in Qatar, and this is expected to increase. Many diabetic patients face significant challenges accessing diagnosis and treatment, which contributes to the high morbidity and mortality and prevalence of complications observed. The significant interactions between diabetes and associated complications highlight the need and opportunity for health planners to develop integrated responses to communicable and non-communicable diseases.

Two Ocular Infections during Conventional Chemotherapy in a Patient with Acute Lymphoblastic Leukemia: A Case Report.

Viral retinitis due to cytomegalovirus (CMV) infection is rare in patients with acute leukemia who did not receive hematopoietic stem cell transplantation. We report a case of CMV retinitis that developed in a 49-year-old patient with acute lymphoblastic leukemia. The patient was treated with salvage chemotherapy using a hyper-CVAD regimen and did not receive hematopoietic stem cell transplantation. The incidence of CMV retinitis in this subgroup of patients is not described in literature. He had a very complicated course during chemotherapy but was successfully treated, with preservation of visual acuity, and to date he is in complete remission. Interestingly, prior to CMV retinitis, the patient had been diagnosed with and treated for candida retinitis. This case shows the importance of eye examination and care in patients diagnosed with hematological malignancies.

Pretreatment clinical variables associated with the response to intravitreal bevacizumab (Avastin) injection in patients with persistent diabetic macular edema.

BACKGROUND: The purpose of the study is to determine whether the pre-treatment clinical systemic variables and optical coherence tomography (OCT) findings are associated with the subsequent response to the intravitreal bevacizumab (IVB) in eyes with persistent diabetic macular edema (DME). DESIGN: Prospective, interventional non-comparative case series study. METHODS: 38 Patients (45 eyes) with refractory diabetic macular edema; 16 females, 22 males with a mean aged 57.5 year. All patients had persistent DME not responded to other forms of treatments. Complete eye examination; best corrected visual acuity (BCVA) (represented as LOGMAR for adequate statistical analysis), slit-lamp exam, intraocular pressure measurement, stereoscopic biomicroscopy of the macula, and morphologic patterns of diabetic macular edema demonstrated by OCT. All patients had intravitreal injection of 0.05 mL = 1.25 mg bevacizumab (Avastin; Genentech, Inc., San Francisco, CA), and were followed up for 3 months. The pre and post-injection follow-up data were analyzed by Student-t test and Mann-Whitney test for two main outcome measures; visual acuity (LOGMAR) and central foveal thickness (CFT) changes over a period of three months, and the data included demographic factors, type, duration and the control of diabetes mellitus (HbA1C%), grade of diabetic retinopathy, renal function (serum creatinine level), serum cholesterol, blood pressure control and previous treatment by focal laser and/or intravitreal triamcinolone injection. RESULTS: The LOGMAR and central foveal thickness (CRT) improved in 30/45 eyes (67%) and 32/45 eyes (72%), respectively during a mean follow-up time of three months. The mean LOGMAR visual acuities were 0.64 (SD ± 0.34), 0.61 (SD ± 0.31) and 0.60 (SD ± 0.32) at pre-injection, at 1 month post-injection and at 3 months post-injection, respectively; but this mean increase in vision was statistically not significant (P value = 0.099). The mean foveal thicknesses were 444.95 µm (SD ± 127.36), 394.95 µm (SD ± 138.03) and 378.32 µm (SD ± 112.01) at pre-injection, 1 month post-injection and 3 months post-injection, respectively, this decrease in the foveal thickness was statistically significant (P value <0.001). The pre and post-injections values of the variables for diabetic duration, diabetic control (HbA1c) and OCT pattern of macular edema showed significant statistical correlations (P < 0.05) with LOGMAR only, however the values of the variables for serum creatinine and cholesterol show statistical correlation (P < 0.05) with both LOGMAR and CFT. CONCLUSIONS: Chronicity and inadequate control of diabetes mellitus, nephropathy, hyperlipidemia and presence of vitreomacular attachment (VMA) are factors associated with poor vision progress after intravitreal bevacizumab injection.