BackgroundThe purpose of this paper is to study the etiology, clinical findings, and outcomes of management of cases of orbital cellulitis treated in Minia University Hospital in Upper Egypt over the period of 6 years from July 2009 to July 2015. One-hundred two patients diagnosed to have orbital cellulitis were admitted to the hospital and treated on inpatient basis from July 2009 to July 2015. All patients were subjected to full ophthalmological examination, systemic evaluation, and ear, nose, and throat (ENT) consultation. Axial and coronal CT scan and orbital echography were done for all patients. All patients received medical treatments, and 20 patients needed surgical intervention.ResultsThe source of infection was paranasal sinusitis in 66 patients, trauma in 14 cases, panophthalmitis in 6 patients, and dental infection in 2 cases, and no definite source was detected in 14 cases. Subperiosteal abscess (SPA) developed in 16 patients. The final best corrected visual acuity improved in 58% of the cases, decreased in 4%, and remained unchanged in 38% of cases. No intracranial complication was recorded.ConclusionsGood presenting visual acuity and appropriate medical treatment together with early surgical intervention in cases of SPA are important factors to achieve favorable outcomes in orbital cellulitis. All cases with SPA had paranasal sinusitis, and contrary to previous studies, superior SPA location was the most common followed by the medial location.
Purpose. To evaluate the anterior segment, the anatomical position of the implantable collamer lenses (ICL), and its relationship to adjacent ocular structures using Ultrasound Biomicroscopy (UBM). Methods. In a prospective study, 142 myopic eyes of 93 patients implanted with Visian ICL were subjected to UBM examination between March 2010 and January 2015. The relative position of ICL to the adjacent structure and the overall iris configuration were evaluated. The machine calibers were used to measure the minimum central distance between the ICL and anterior lens capsule (vault) and the vertical central distance between the corneal endothelium and the ICL (E-ICL). Results. The mean ICL vault was 376 ± 105 μm. The mean E-ICL was 2826 ± 331 μm. Contact between ICL and the posterior epithelium of the iris was present in all eyes. The overall iris configuration was flat in 89 eyes. Central anterior convexity was present in 41 eyes and mild peripheral iris bombe in 12 eyes. The haptics could be imaged in the ciliary sulcus in 112 eyes and at least one haptic resting on the lens periphery and zonules in 30 eyes. Conclusion. UBM can provide valuable anatomical information that allows detailed postoperative in vivo assessment of ICL.
Purpose To document the presentation of unilateral combined endophthalmitis and orbital cellulitis in patients with COVID-19 infection and study their prognosis. Patients and methods This interventional case series study included 9 patients referred to the Ophthalmology Department, Minia University Hospital with unilateral combined endophthalmitis and orbital cellulitis between April 2020 and March 2021. In addition to the COVID-19 work-up, all patients were subjected to full ophthalmological evaluation and managed according to their ophthalmic and systemic disease. Results The patients were 5 females and 4 males. They had clinical, laboratory and imaging findings that confirmed COVID-19 infection. All patients had unilateral endophthalmitis with orbital cellulitis and profound visual loss in the affected eye. Three patients died due to respiratory failure, while 6 patients recovered systemically. The survived patients developed atrophia bulbi in 4 patients and in 2 patients, the globe retained normal size but with complete visual loss. Conclusion Combined endophthalmitis and orbital cellulitis can be one of the early presentations of patients with COVID-19 infection with poor visual prognosis. Trial registration Clinical registration: clinicaltrials.gov identifier: NCT04456556.
Purpose: To evaluate the use of the resorbable polylactic acid polymer implants (Resorb X) in the management of orbital floor blow-out fractures as regards safety, cosmetic, and functional results. Methods: In a prospective, interventional case series, 22 patients with traumatic blow-out floor fractures underwent lower fornix transconjunctival repair using polylactic acid implant insertion over the defect without fixation. Orbital imaging was done preoperatively, at 1 month and 1 year postoperatively with orbital computed tomography with 2 mm cuts of axial, sagittal, and coronal scans. Outcome measures included the maximum vertical height of the orbit at the fracture plane and its changes over time. Results: At the final follow-up, both limitation of elevation and diplopia improved in 82% of cases, while 63.6% of cases showed improvement of enophthalmos. Radiological restoration of the orbital vertical height was recorded in 100% of cases without implant displacement at 1 month. However, after 1 year, a significant floor bowing was found in 45.5% of cases, which showed a strong positive correlation with preoperative defect size ( r = 0.820). Conclusions: Resorb X mesh plates can be a good option for the safe reconstruction of orbital floor blow-out fractures. Good anatomical and functional results were obtained in small orbital floor defects. Late bowing under pressure may limit their use in medium-sized floor defects.
Background Several SARS-CoV-2 variants with increased transmissibility and/or potential immune escape have emerged and rapidly spread worldwide. Ongoing surveillance analyses are performed worldwide to designate new variants of concern (VOC) of coronavirus. Main text This report identifies the first Egyptian patient with a confirmed SARS-CoV-2 omicron variant. The patient showed positivity on reverse transcriptase-polymerase chain reaction and full genome sequencing was performed to confirm the variant. The mutations found in the variant were compared with the GISAID reference strain hCoV-19/Wuhan/WIV04/2019. Genome BLAST showed the highest similarity to omicron variants isolated in South Africa. Phylogenetic analysis revealed that the variant belongs to the 21K clade. Conclusions The study indicates the importance of information-sharing among global public health partners. Moreover the importance of implementation of full genome sequencing to rapidly identify and track the new SARS-CoV-2 variants.
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