Clinical features of infectious uveitis in a Tunisian population.

INTRODUCTION: Infectious uveitis (IU), one of the main causes of ocular inflammation in Tunisia, has various etiologies and clinical presentations. AIM: To report the causes and clinical features of IU in a Tunisian population. METHODS: Patients with IU referred to our department from February 2019 to January 2022 were included in a retrospective observational study. Ophthalmic examination and appropriate ancillary tests were performed. RESULTS: Eighty eyes of 63 patients were included (37 female and 26 male). The mean age was 45 years. IU was unilateral in 43 cases, bilateral in 17, and unilateral alternating in three cases. Panuveitis was the most common anatomic location (35% of cases) followed by posterior (31%), anterior (18 eyes), intermediate (6 eyes) and anterior and intermediate uveitis (3 eyes). Non granulomatous uveitis (55%) occurred more frequently than granulomatous uveitis (45%). Etiologies were dominated by bacterial infections (29 patients; 46%), mainly tuberculosis (23 patients), followed by viruses (19 patients), mainly Herpes simplex virus. Fungal infection was found in one patient, while parasites accounted for 14 cases, mostly toxoplasmosis. Mean initial diagnostic delay was 16 months. The most common complications included occlusive retinal vasculitis (19 eyes), cataract (17 eyes), cystoid macular edema (17 eyes) and papilledema (15 eyes). CONCLUSION: This study highlighted the causes and clinical features of IU in our setting. Tuberculosis remains one of its most frequent etiologies in Tunisia. However, a larger multicenter national study would allow a more precise evaluation.

Attitudes of ophthalmologists towards pharmaceutical promotion.

INTRODUCTION: The interaction between physicians and pharmaceutical industry highlighted many issues lately concerning their influence on physician's attitude and their prescribing behavior. AIM: To evaluate the attitudes of Tunisian ophthalmologist towards pharmaceutical promotion. METHODS: Data was collected through an auto-administered anonymous questionnaire elaborated in French that was distributed to 160 ophthalmologists (residents and specialists) working in hospitals or private practices in four Tunisian governorates (Tunis, Sousse, Monastir and Sfax). RESULTS: One hundred and two valid responses were received. Twenty-nine respondents (28.43%) estimated the number of visits by pharmaceutical representatives (PR) at 11 to 20 times during the last year. Most physicians considered guides (94%), drug samples (88%), articles (86%), stationery (81%), sponsorship of overseas conferences (72%) and international trips to symposia organized by pharmaceutical industries (58%), as appropriate gifts. Over 80% of doctors agreed that promotional activities by drug companies were appropriate. Accepting sponsorship from a pharmaceutical company for a partner to attend a meeting was considered inappropriate by 79% of ophthalmologists. Eighty-eight percent of the respondents agreed that receiving gifts will increase their prescription of the company's drug. However, they perceived themselves to be less influenced than their colleagues (p=0.011). Eighty-six percent of ophthalmologists reported training about how to interact with PR to be insufficient. CONCLUSIONS: Despite the role of PR in supporting research, ethical issues may arise through their interactions with healthcare professionals. Training about pharmaceutical promotion and appropriate ways to deal with it are lacking in Tunisian medical schools' curricula, leaving future doctors unprepared to deal with pharmaceutical influences.