Purpose:To report the incidence, clinical features and natural course of central serous chorioretinopathy (CSR) in pregnant women in Kuwait.Materials and Methods:Patients were actively recruited from a private maternity hospital. Out of the 17,000 pregnant women who visited the antenatal care clinics (Al-Orf Hospital, Kuwait) over 3 years, 900 had visual complaints. Patients with visual complaints underwent complete ophthalmological assessment. Medical records of patients with CSR were reviewed, and a full clinical ophthalmological assessment was performed including measurement of best corrected visual acuity, intraocular pressure, slit lamp biomicroscopy, dilated indirect ophthalmoscopy and Amsler grid screening, color and red free fundus photography and retinal optical coherence tomography. All patients were evaluated throughout the course of pregnancy and for 6 months after delivery.Results:Four patients had CSR among the 17,000 pregnant women reviewed over 3 years corresponding to an incidence of 0.008 % per year. Two patients (50%) had CSR with white subretinal exudates and 2 (50%) had no exudates. There was complete resolution in all patients (100%) within 3 months after delivery.Conclusions:In pregnant women, CSR can present with or without retinal exudates and completely resolves in either case. Further studies with a larger sample size are warranted to investigate the risk factors in pregnant women.
The clinical significance of partial chromosome 3 alteration in uveal melanoma is still not clear. Also, the reported frequencies vary considerably in the published literature from 0 to 48%. The aims of the following study were to identify the frequency, molecular pathology and potential clinical significance of partial chromosome 3 alteration in uveal melanoma. We studied 47 uveal melanomas with an average follow-up of 36 months. Of these, 14 had confirmed metastasis. Allelic imbalance/loss of heterozygosity was studied using microsatellite markers on chromosome 3 enriched in markers located in the previously reported smallest regions of deletion overlap. Chromosomal alterations were assessed by conventional cytogenetics or comparative genomic hybridization (CGH) in a subset of patients. Utilizing genotyping, partial chromosome 3 alteration was detected in 14/47 tumors (30%). In the 23 tumors with available cytogenetic/CGH, partial chromosome 3 alteration was detected in 8/23 (38%) and was caused by both gains (4/8) and losses (4/8) of chromosome 3 with high frequency of complex chromosome 3 aberrations detected by cytogenetics. Out of the 14 tumors with confirmed metastasis, only 1 showed partial chromosome 3 alteration and the remaining showed monosomy 3. By limiting the aggressive disease marker to monosomy 3, genotyping showed 93% sensitivity and 67% specificity for detection of aggressive uveal melanoma. In conclusion, partial chromosome 3 alterations are common in uveal melanoma and mostly caused by complex cytogenetic changes leading to partial gains and/or partial losses of chromosome 3. Partial chromosome 3 alteration is not likely to be associated with highly aggressive uveal melanoma that metastasizes within the first 3 years after treatment. Microsatellite-based genotyping of chromosome 3 is highly sensitive for detection of aggressive uveal melanoma.
Purpose Evaluation of using pigtail probe to detect and open severely stenosed lower lacrimal punctum followed by self-retaining bicanalicular intubation. Study design A prospective nonrandomized clinical study. Methods The study included 24 patients with severe lower punctal stenosis (grade 0 according to Kashkouli scale) attending at Menoufia University Hospitals. The upper punctum and canaliculus were patent. All patients were complaining of epiphora and had a thorough ophthalmological examination including dye disappearance test and slit-lamp examination. Pigtail probe was used from patent upper punctum to detect the lower stenosed punctum which was opened with a scalpel. Syringing of the lower lacrimal passages was done to confirm its patency, and self-retaining silicone bicanalicular stent was inserted. The silicone tube was left in place for 6 months before it was removed. Patients were then followed-up for 1 year after the surgery. Results One year after surgery, epiphora was absent (grade 0) in 16 eyes (66.7%) and was present only occasionally (grade 1) in 4 eyes (16.7%). The difference from preoperative epiphora was statistically significant. One year after surgery, fluorescein dye disappearance time was grade 1 (<3 minutes) in 20 cases (83.3%), and grade 2 (3–5 minutes) in 4 cases (16.7%). There was a statistically significant difference compared with preoperative results. Conclusion Using the pigtail probe is effective in treatment of severe punctal stenosis. Maintaining the punctal opening and prevention of restenosis can be achieved by using self-retaining bicanalicular stent after confirmation of nasolacrimal duct patency. This trial is registered with NCT03731143.
Sutureless scleral tunnel trabeculectomy exhibits potential as an alternative to conventional trabeculectomy surgery. Over 12 months of follow-up, sutureless sclera flap trabeculectomy was safe and effective with an IOP-lowering effect comparable to that achieved with the conventional technique, but with increased rate of postoperative transient hypotony.
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