A 46-year-old diabetic male presented with acute painless visual loss in his left eye (OS). Visual acuity was 6/36 OS with an unremarkable anterior segment examination (OU). Posterior segment showed a swollen left optic disc with large diffuse macular edema and moderate nonproliferative diabetic retinopathy (NPDR). The right eye fundus showed only mild NPDR. Optical coherence tomography and fundus fluorescein angiography were performed which revealed left macular edema and a hyperfluorescent left optic disc. Computerized tomography scan orbit and brain was normal. The patient received an intravitreal bevacizumab injection OS followed by focal laser photocoagulation 1 month later. His optic disc swelling and the macular edema subsided rapidly after the injection and his visual acuity improved to 6/6 with disc pallor.
Pilomatricoma usually presents as a solitary hard nodule located deep in the dermis. However, a variant termed anetodermic is often seen in the elderly. Instead of a hard nodule, a rapidly growing bullous lesion is seen. The authors report a 60-year-old man who presented with an erythematous bullous lesion at the left medial canthus. The lesion started as a small 3-mm papule and grew significantly to a 12-mm lesion in 5 weeks. Histopathologically, the tumor was composed of basophilic and keratinized shadow cells typical of pilomatricoma. Anetodermic changes could also be seen, represented by intralesional hemorrhage, dilated blood and lymphatic vessels, and disruption of dermal collagen fibers. The anetodermic variant of pilomatricoma was described in 1943 and accounts for only 2% of cases. Compression of vessels by the neoplastic process and peritumoral inflammatory infiltration are the proposed pathogenic mechanisms underlying the atypical findings.
Aim:To study the outcome of repair of rhegmatogenous retinal detachment (RRD) in a tertiary center.Materials and Methods:Review of electronic medical records within a period of 29 months of consecutive patients who underwent surgical repair for RRD in Sultan Qaboos University Hospital (SQUH).Results:We included 33 consecutive patients (36 eyes). Males constituted 70% of them. The average age was 47 years. Seven eyes out of the 36 had macula-on RRD at presentation. The primary success rate with a single procedure was 86%. However, redetachment occurred in five eyes (14%). Visual acuity was either same as preoperative or better in 81% of the eyes. Giant retinal tear was found in three eyes (8%). The average follow-up period for all patients was 10.25 months (range: 3-25 months).Conclusion:Rhegmatogenous RD is not uncommon disorder. It occurs more frequently in males. However, it has a good prognosis if an intervention was performed in early stages.
AIM:This study aims to study the incidence of corneal epithelial defect (CED) after pars plana vitrectomy (PPV) and associated patient-related risk factors. The incidence of other immediate postoperative complications was also in the scope of this study.DESIGN:Retrospective descriptive case series study.METHODS:Review of electronic medical records of all patients who underwent PPV alone or combined with cataract surgery and/or scleral buckle in a tertiary hospital by one retinal surgeon. All demographic data, surgery notes, and immediate postoperative findings were obtained for all patients.RESULTS:The cohort of the included cases was composed of a total of 168 procedures that were performed in 121 eyes of 106 patients over 5 years. CEDs occurred in 19 eyes (15.7%) of 19 patients (17.9%). Males were affected more than females (90% vs. 10%). Patients with postoperative CED were found to have longer duration of surgery when compared to patients without postoperative CED (P = 0.0038). All cases of CED had a complete resolution of the defects after supportive therapy. Immediate intraocular hypertension (IOH) was found in 30 eyes (24.8%). IOH was controlled in all cases with medical therapy only. Post-PPV immediate complications, other than CED and IOH, occurred in 10.7% of the eyes. These included vitreous hemorrhage, choroidal detachment, corneal edema, anterior chamber fibrin, and hyphema.CONCLUSION:Development of CED is not uncommon after PPV. This complication is more common in males and may be related to prolonged duration of surgery. It also develops more in older patients. CED after PPV can be managed with conservative treatment with good outcome.
Aim:To find out statistical data regarding intravitreal injections in an outpatient department setup at a tertiary center in Oman.Design:Retrospective chart review.Methods:Data collection of patients who underwent intravitreal injections from November 2009 to May 2013 at Sultan Qaboos University Hospital.Results:Throughout a period of 42 months, a total of 711 intravitreal injections were performed. That included 214 patients (275 eyes). Around one-third of the eyes received two injections or more. The injected agents were bevacizumab (59.8%), ranibizumab (32.3%), triamcinolone (7.5%), and very few patients with endophthalmitis received intravitreal antibiotics and antifungal agents. The three most common indications for the injection therapy were diabetic macular edema (50.9%), choroidal neovascularization (24.3%), and retinal vein occlusive diseases (11.5%). Serious adverse events were rare, and they occurred as ocular (0.9% per patient) and systemic (3.3% per patient). There were 42 eyes received intravitreal triamcinolone, and 24% of them developed intraocular hypertension that required only medical treatment.Conclusion:Different intravitreal agents are currently used to treat many ocular diseases. Currently, therapy with intravitreal agents is very popular, and it carries a promising outcome with more efficiency and safety.
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