Aim The FDA approved isotretinoin for moderate and severe nodulo-cystic acne, in which it proved effective. However, this misled the dermatologists into using isotretinoin for mild cases as well. This misuse increased the risk of developing adverse effects, especially on the ocular system. These adverse effects vary from mild reversible eye dryness to severe irreversible loss of night vision. Also, it causes contact lens intolerance and corneal ulcer on top. Both ophthalmologists and dermatologists have different perceptions of the drug. Purpose To evaluate dermatologists’ knowledge and attitude toward ocular adverse effects of isotretinoin in Egypt. Methods This cross-sectional study was conducted via an online questionnaire. The questionnaire had three parts: 1) demographic data, 2) knowledge about isotretinoin dry eye disorders, contact lens intolerance, and refractive surgery precautions and 3) dermatologists’ management of a case on isotretinoin therapy. We contacted 111 participants from Facebook dermatologists’ groups between March and April 2021. Results We surveyed 111 dermatologists. One hundred and five (94.6%) reported their knowledge about ocular side effects. One hundred of them (90.1%) informed their patients about the drug’s adverse effects. Eighty-three (74.8%) reported their knowledge about contact lens intolerance. Forty-one dermatologists (36.9%) screened their patients for recent refractive surgery before isotretinoin therapy. Nearly, all dermatologists routinely prescribed lubricant eye drops for the patients, and 63 (56.8%) dermatologists sometimes referred their patients to an ophthalmologist. We found an association between knowledge about contact lens intolerance and years of experience ( p =0.012). As well, we found that the academic degree of dermatologists is directly proportional with warning patients about ocular side effects ( p =0.003) and refractive surgery ( p =0.039). Conclusion Egyptian dermatologists were knowledgeable about the effects of isotretinoin on eyes with inappropriate clinical practice.
Background: retinoblastoma (RB) is a rare inherited eye disease. Leukocoria is the first presenting sign of this disease. Early diagnosis is important to gain better life outcomes. We aim to assess Kafr Elsheikh university medical students' knowledge about retinoblastoma. Methodology: A cross-sectional study was performed using a web-based questionnaire to collect data. We analyzed the data using the SPSS program. Results: we survived 235 medical students and graduates at Kafr Elsheikh university. Most participants (n=131, 55.7%) had sufficient knowledge about retinoblastoma, while 78 (33.2%) had poor knowledge. Only 26 (11.1%) had a proficient level. Almost all participants (99.6%) detected that the abnormal eye was due to disease. Nearly two-thirds (63%) thought that it was a life-threatening leukocoria. While (96.6%) knew that an ophthalmologist referral was the right thing to do. We found no significant differences between academic grades and test results (H= 1.093, P=.779). As well, no correlation was found between academic grades and results (r=.033, p=.086). Conclusion: Retinoblastoma is a fatal disease that needs attention in developing countries. Early detection of RB is the key to successful management with a higher survival rate. All healthcare providers, particularly those who have direct contact with children, should receive comprehensive education to improve their clinical screening skills.
Aims: The aim is to use of optical coherence tomography angiography to quantify vessel density throughout the different stages of diabetic macular edema progression. Study design: prospective, cross sectional, observational study Place and Duration of Study:University Hospitals in the period between March 2017 to March 2019. Methodology:OCTA images were obtained using the AngioVue (Optovue Inc., CA, USA). For quantitative analysis of the VD with the help of the manufacturer’s automated software. Results: The study included 160 eyes of 135 diabetic patients, 61 (45%) females and 74 (55%) males. The values of VD of the SCP were significantly affected more than the DCP very early in the diabetic course (No DR stage) (P=0.040). Moving one stage more in the disease (mild to moderate NPDR with no edema stage) the deep layer got significantly more affected than the superficial layer (P=0.038). In the more advanced stages of the disease and as the macular edema develop and progress (spongy edema and CME) the two plexuses showed decreased VD values nearly to the same degree with the deep plexus affected slightly more (low VD values) than the superficial plexus. Conclusion: Using the OCTA machine with AngioAnalytics parameters (vessel density) aided in the objective quantification of macular perfusion in diabetic eyes with and without macular edema.
Objective Diabetic macular edema (DME) is the most common cause of visual impairment in patients with diabetes mellitus. The pathogenesis of DME is complex and multifactorial. DME can be diagnosed using noncontact stereoscopic biomicroscopy, contact lens biomicroscopy, Fundus fluorescein angiography (FFA), and Optical Coherence Tomography (OCT). Intravitreal anti-vascular endothelial growth factor (VEGF) agents have been investigated in the treatment of DME. This study aims to investigate safety of intravitreal anti VEGF during six-month follow up. Methods Sixty patients with type I or II diabetes mellitus complaining from central involved DME were recruited for this longitudinal study. All patients were subjected to full history taking, complete ophthalmological examination, systemic evaluation, FFA and OCT imaging. Patients were subdivided into three groups, 20 patients each: Ranibizumab group, Bevacizumab group and Aflibercept group. Results After 6-month follow-up, the ranibizumab group showed slightly higher systemic cardiovascular and cerebrovascular accidents rates, while the Bevacizumab group showed insignificant higher risk of ocular inflammation and endophthalmitis, aflibercept has the least incidence of ocular adverse effects. Conclusion Anti VEGF intravitreal injections are relatively safe for treatment of DME. Aflibercept showed the least incidence of ocular side effects. The current study suggested that intravitreal anti-VEGF could be administered safely to diabetic patients with decreased glomerular filtration rate (GFR).
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