Efficacy of Pneumatic Retinopexy in Treating Rhegmatogenous Retinal Detachment at King Abdullah Medical City in Makkah, Saudi Arabia - A retrospective cohort study.

INTRODUCTION: The aim of this study was to present the clinical presentation and short-term outcomes of uncomplicated rhegmatogenous retinal detachment managed by pneumatic retinopexy at a tertiary eye hospital in western Saudi Arabia. MATERIALS AND METHODS: This one-armed retrospective cohort study evaluated selected cases of rhegmatogenous retinal detachment managed by pneumatic retinopexy between 2017 and 2018. Data were collected on patient demographics, preoperative ophthalmic assessment, surgical details, follow up at six months postoperatively, complications and the need for additional surgery. Anatomic success was defined as retinal attachment at 6 months and functional success was defined as vision >20/200 at six months postoperatively. The association of lens status and concomitant laser treatment to anatomical success rates were evaluated. RESULTS: The study sample consisted of 15 eyes with rhegmatogenous retinal detachment in the upper quadrant. In 14 cases, C3F8 gas was used. Anatomic and functional success was noted in 73.3% [95% confidence interval (CI) 51.0: 95.7] and 86.7% (95% CI 69.2; 100) of eyes, respectively. The association between anatomical success and lens status was not significant [RR = 4.5 (95% CI 0.6 ; 37.5), P=0.1]. There was no significant association between anatomical success and concomitant laser treatment. [RR = RR = 1.7 (95% CI 0.7 ; 4.0), P=0.2]. A 2nd retinal surgery was not required in 33.3% of eyes (95% CI 9.5 ; 57.2). CONCLUSION: If stringent selection criteria are used for managing rhegmatogenous retinal detachment with pneumatic retinopexy, anatomical and functional success by six months postoperatively is achieved in the majority of cases. Additional surgeries could further improve outcomes.

Indolent keratitis due to fungus of Malbranchea species. A case report.

INTRODUCTION: Keratitis caused by saprophytic fungi is on the rise in rural areas, often caused by ocular trauma with wooden objects. Early detection of causative organisms and sustained, supervised management can prevent visual disabilities. CASE PRESENTATION: A middle-aged patient from a rural, semi-arid region who presented with pain, redness, and a foreign-body sensation in his left eye resulting from a corneal ulcer induced by trauma from a wooden stick. Due to a history of uncontrolled diabetes and progression of his corneal lesions, he was admitted to our institution for treatment of infectious keratitis. Microbiological examination of corneal scrapings revealed thin, septate hyaline hyphae without conidia or conidiophores, and the patient was diagnosed with a fungal keratitis caused by a Malbranchea species. Though the patient initially responded to treatment with topical natamycin, his condition worsened. He was subsequently successfully treated with topical amphotericin B (1 mg/mL) twice hourly and systemic antifungals. Four months after discharge, the patient returned with symptom recurrence. CONCLUSION: We report the case of a patient with a Malbranchea species causing a rare and recurrent fungal keratitis with corneal infiltrates, subsequently cured by medical management with salvaging of his vision. In patients with a suspected fungal keratitis, early treatment is crucial and should be combined with tight glycemic control for as long as 6 months after presentation to avoid recurrence.

Prevalence and causative agents of allergic conjunctivitis and its determinants in adult citizens of Western Saudi Arabia: A survey.

PURPOSE: To estimate the prevalence of allergic conjunctivitis (AC) and its related allergic ailments among Saudi adults in the western region. METHODS: Adult population of Taif, Makkah, and Jeddah cities was surveyed from 2017 to June 2018. Subjective questionnaire was used to collect the response. Participants were asked about symptoms (redness, itching, watering, based diagnosis and details of AC, treatment taken in the pasts, and associated conditions, such as allergic asthma and rhinitis). The age-sex-adjusted prevalence, its determinants, and associations to other ailments were assessed. RESULTS: We surveyed 2187 participants (mean age 26.0 ± 9.1 years). The age-sex-adjusted prevalence of AC was 70.5% (95% confidence interval [CI] 68.6-72.4). There could be 2.1 million AC patients among 3.1 million adult populations in Western KSA. It was significantly higher in females compared to males (odds ratio [OR] = 1.7 [95% CI 1.4-2.2]). The risk of AC did not vary by age group (χ 2 = 2.5, df = 3, P = 0.1). The variation of AC in three provinces was not significant (χ 2 = 0.3, df = 3, P = 0.6). Dust (42.6%) and unknown (24.8%) allergens were the main causative agents of AC. AC was significantly associated to asthma (OR = 2.8) and allergic rhinitis (OR = 2.2). CONCLUSION: AC affects seven in ten adults in Western Saudi Arabia. AC is positively associated to allergic rhinitis and bronchial asthma. Public health policies at primary eye-care level should focus on early detection and care of persons with AC.

Prevalence and Determinants of Color Vision Defects among Preparatory University Students at Makkah, Saudi Arabia.

PURPOSE: To estimate the magnitude and determinants of color vision defects (CVD) among preparatory health science students. METHODS: A cross-sectional survey was conducted in 2017. Participants were assessed using 24-plate Ishihara's Test of Color Vision chart. If ≤9 plates were read correctly, the color vision was regarded as deficient. The CVD prevalence and its 95% confidence interval (CI) were calculated. CVD was associated with gender, family history of CVD, and other vision problems. RESULTS: We evaluated 1126 students (552, 49% males; mean age: 18.7 ± 0.7 years). The prevalence of CVD was 1.77% (95% CI: 1.0, 2.6). Among male students, it was 3.5% (95% CI: 1.9, 5.0). Only one female student had CVD. The Duran CVD was found in 18 (1.6%) students. However, only two students had Tritan CVD. Three among twenty CVD students knew that they suffer from CVD. CVD was positively associated to a family history of CVD (odds ratio [OR] = 3.8; 95% CI: 1.4, 10.1;P = 0.02) and male gender (OR = 20.4 [95% CI: 2.7, 153]). CVD was not significantly associated to other vision problems (OR = 0.8 [95% CI: 0.3, 2.0]). CONCLUSION: Eighteen in thousand health sciences students suffered from CVD. Ten percent of them had Tritan CVD. Duran CVD seems to be a male sex-related and/or a familial condition. Most of the CVD students seem to have adopted to this defect and were not aware of suffering from it. Screening for CVD is therefore debatable.

Long-term use of 0.003% tacrolimus suspension for treatment of vernal keratoconjunctivitis.

PURPOSE: To evaluate the safety and efficacy of 0.003% tacrolimus suspension for the treatment of refractory vernal keratoconjunctivitis (VKC). MATERIALS AND METHODS: This prospective study included 40 eyes of 20 patients with severe VKC. After discontinuing all other medications, patients were treated with varying doses of 0.003% tacrolimus suspension. All were followed for at least 24 months. Changes in signs and symptoms after treatment were evaluated; adverse events were assessed. The clinical response to the treatment was the most important measurement to achieve the conclusion. RESULTS: The mean age of the patients was 15.7 ± 1.4 years. Two patients discontinued treatment due to severe burning sensation and were excluded from the study. Significant improvements in all signs and symptoms, including itching, foreign body sensation, papillae, and Trantas dots, were seen in all patients 6 weeks after starting topical tacrolimus. Itching was the first symptom to improve. Treatment was gradually reduced, and intervals were increasing between applications. Recurrence occurred in all patients who attempted to discontinue treatment. No additional medications were required to provide relief, and no significant changes in visual acuity or refraction were seen. CONCLUSIONS: The safety and efficacy of 0.003% Tacrolimus suspension treatment for refractory VKC were achieved and it can be considered a useful option instead of steroids, despite the poor compliance in few patients due its adverse effects.