Purpose. To compare the efficacy and safety of suprachoroidal and intravitreal injection of triamcinolone acetonide in pseudophakic patients with refractory diabetic macular edema (DME) due to epiretinal membrane (ERM). Study Design. This study is a randomized clinical trial (RCT). Participants. Twenty-three nonvitrectomized pseudophakic eyes of 23 subjects (9 M and 14 F with mean age: 54.8 years) with refractory DME due to ERM. Methods. The eyes were randomized to suprachoroidal triamcinolone acetonide injection 4 mg/0.1 ml (SCTA) (n = 13 eyes) or intravitreal triamcinolone acetonide 4 mg/0.1 ml (IVTA) (n = 10 eyes) and were evaluated at baseline and 1 and 3 months after injection to assess outcome measures. Main Outcome Measures. Changes in best-corrected visual acuity (BCVA) (primary outcome), central foveal thickness (CFT) by optical coherence tomography (OCT), and intraocular pressure (IOP) measurement (secondary). Results. Baseline median BCVA (logMAR) was 1.0 (range 0.8–1.0) in both groups, improved within the SCTA group to 0.8 on the 1st and 3rd months, while in the IVTA group, median BCVA changed to 0.8 and 0.9 on the 1st and 3rd months, respectively. No significant differences were noted between groups regarding BCVA at baseline ( P = 0.927 ), and 1st ( P = 0.605 ) and 3rd months ( P = 0.313 ). Regarding mean CFT, no significant differences were observed at baseline ( P = 0.353 ) and at the first month ( P = 0.214 ) between both groups, while at the third month, CFT was significantly higher in the IVTA group (385 um) than in the SCTA group (323 um) ( P = 0.028 ). Mean IOP was significantly higher in the IVTA group (15 mmHg) on 1st month than in the SCTA group (12 mmHg) ( P = 0.011 ); after 3rd month, IOP was significantly higher within the IVTA group (18 mmHg) than SCTA (14 mmHg) ( P = 0.028 ). No significant difference was noted between both groups at baseline IOP ( P = 0.435 ). Conclusions. Both SCTA and IVTA are effective in reduction of CFT and improvement of patients’ visual acuity, but with a higher recurrence rate and rise in IOP after IVTA when compared to SCTA. Both treatments have temporary effects with the possibility of recurrence of DME and the need for retreatment.

Purpose To assess the efficacy and safety of Suprachoroidal triamcinolone acetonide injection [SCTA] as an adjunctive therapy in management of Vogt-Koyanagi Harada [VKH] serous retinal detachment. Design Prospective parallel group study. Participants 12 eyes of 6 patients with bilateral multiple serous retinal detachment of VKH in acute phase on systemic steroids. Methods Each patient was received single SCTA injection (SCTA group, n = 6 eyes) and the other non-injected eye (Standard treatment group, n = 6 eyes), patients were followed for 1, 3, and 6 months to assess changes in best corrected visual acuity [BCVA], central foveal thickness [CFT] and intraocular pressure [IOP] between both groups. Main outcome measures The primary end point was changes in BCVA from baseline till 6th months follow-up. Secondary end points were changes in CFT and IOP from baseline to 6 months of follow-up. Results BCVA at one and three months was significantly better in eyes received SCTA than in non-injected eyes (p-value = 0.026 for each). CFT at one and three months was significantly higher in non-injected eyes than in eyes received SCTA (p-value = 0.028 for each). IOP showed no significant differences between both groups. Conclusions SCTA is an effective adjuvant treatment for VKH serous retinal detachment, without any serious ocular adverse effects or increase in IOP and causing significant reduction in CFT and rapid improvement in BCVA when combined with oral steroids.

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In context, migraines are main headaches characterised by recurrent, episodic throbbing pain that may last anywhere from a few hours to a few days. More than a billion people (nearly 14 percent of the global population) suffer from migraines, making it one of the leading causes of disability and a major social and economic burden, as reported by the Global Burden of Disease Study 2016. The primary purpose of this research was to analyse the incidence rate and clinical features of migraine. Methods: The research was conducted as a cross-sectional, prospective, observational study in the Ophthalmology clinic of the Kafr-El Sheikh university hospital. Based on the International Classification of Headache Disorders, Third Revision (ICHD-3) criteria for migraine with aura and migraine without aura classified considering MIDAS into 3 groups, 90 patients (15-50 years old) were included in the research. A total of 30 patients who only experience minor headaches made up Group [1]. Thirty people who suffer from mild migraines make up Group [2]. Migraine sufferers, n = 30 (Group 3). The results of this research showed that demographic or other patient factors were not significantly related to migraine severity. In this dissertation, we showed that the frequency of migraine attacks, the prevalence of chronic migraine, and the length of illness all increased significantly with the intensity of the headache. All of these correlations were statistically significant at the 0.001 level. When looking at instances with a p-value 0.001, it was discovered that migraine symptoms occurred in a significantly larger proportion of the extreme cases. The proportion of patients with status migrainosus lasting more than 72 hours rose significantly with the severity of migraine, as did the frequency of migraine attacks, the number of years a patient had been suffering from migraines, and the total time he or she had been sick from migraines. In extreme circumstances, the migraine symptoms were more common.

Purpose To evaluate the association between OCT-angiography (OCTA) and photopic negative response (PhNR) in open angle glaucoma (OAG) patients and assess the diagnostic accuracy of these parameters in early detection of glaucoma. Methods A total of 152 eyes were enrolled in this study, 28 eyes with mild POAG (group I), 44 eyes with moderate-severe POAG (group 2) & 80 eyes of healthy subjects (control group). Full ophthalmological examination, OCTA and PhNR measurements were underwent for all participants. RNFL, GCC thicknesses, PhNR (implicit time and amplitude) were recorded. The superficial and deep capillary plexus vessel density (SCP-VD%, DCP-VD%) were measured by using 6 × 6 mm macula OCTA scans. The peripapillary vessel density (RPC-VD %) were measured by using 4.5 × 4.5 mm optic disk head OCTA scans. Results There were reduction of the median Interquartile range (IQR) thickness of the GCC and RNFL in OAG eyes versus normal (P < 0.001). RPC-VD%, SCP-VD % and DCP-VD% were significantly reduced in OAG eyes versus normal (P < 0.001). Increased OAG severity was associated with more reduction in PhNR amplitude and increased implicit time. Reduced PhNR amplitude and prolonged latency were significantly correlated with reduced vascular parameters. The RCP-VD and PhNR amplitude demonstrated higher diagnostic accuracy (98.7) with the largest AUC and higher sensitivity and specificity (100% & 98.7%, respectively), followed by the PhNR implicit time with (AUC = 0.995) with a diagnostic accuracy 98.7. The SCP-VD, RNFL and GCC thickness had a diagnostic accuracy of (75.0, 81.6 & 84.2), respectively (P < 0.001). Conclusions OCTA vascular parameters displayed significant positive correlation with PhNR amplitude and significant negative correlation with PhNR implicit time. OCTA and PhNR parameters showed a high diagnostic accuracy for detection of glaucoma, and both may provide promising insight in early detection of glaucoma. This study was retrospectively registered on ClinicalTrials.gov (identifier, NCT05104294).