PurposeOcular rosacea in adult is a rare condition that may be responsible for palpebral, cunjonctival and corneal complications with severe visual functional prognosis in some cases. The purpose of this study is to determine the nature and prognosis of corneal complications in this disease through our study and literature reviewMethodsWe report seven patients (14 eyes) with severe ocular rosacea requiring hospitalization.ResultsThe mean age of our patients was 59.6 years. Six patients (85.6%) were female. Visual acuity was <1/10 in 10 eyes. The complications were keratitis in 7 eyes, corneal ulcerations in 5 eyes, corneal perforation in 5 eyes, and catarrhal infiltrates in 6 eyes. Limbal neovascularization was noted in 11 eyes. Only one patient has ocular‐cutaneous form. All patients were treated with oral cycline, topical steroids in acute phase, artificial tears and eyelid hygiene. A bandage contact lens was applied to 4 eyes. Three eyes required penetrating keratoplasty. They were successfully treated with improvement of symptoms and cicatrisation of corneal lesions. One case of corneal graft failed secondary to infectious keratitis.ConclusionsThe diagnosis of ocular rosacea is difficult because it often occurs without skin involvement. Ocular rosacea is the only complication of cutaneous rosacea. Diagnosis should be as early as possible because ocular complications are possible, with blinding potential. The best treatment is prevention with regular eyelid hygiene.
Purpose to measure macular choroidal thickness (CT) using spectral domain optical coherence tomography (OCT) and to investigate the correlation between CT and age, degree of myopia, and a history of macular choroidal neovascularization (CNV). Methods a cross sectional study was performed in 191 eyes of 106 patients with spherical equivalent (SE) refractive error of 6 diopters (D) or more, between early January 2010 and early June 2010. The choroid was imaged using the spectral domain OCT (OCT TOPCON 2000) by changing the reference position from the vitreous to the choroid without inverting the image. CT was measured from the outer border of the hyperreflective line corresponding to the retinal pigment epithelium (RPE) to the inner scleral border. Results the mean age of the 106 patients was 47,9 years ( ± 14,89 years; range, 18 to 81 years), 32 were men and 74 were women, the mean SE refractive error was 13,73 D (±5,74 D), and the mean subfoveal CT was 100,42 µm (±60,15µm; range, 23‐278). CT was correlated negatively with age (p= 0,01), and refractive error (p=0,01). Fourty eyes had a history of CNV, the mean CT was 52,02 ± 17,65 µm, and this was significantly thinner than the subgroup without CNV (p<0,10‐6 ). Conclusion in highly myopic eyes, the choroid is thin and undergoes further attenuation with increasing age and increasing myopia. In addition, these findings suggest that the choroid may play a role in the pathogenesis of choroidal neovascularization.
To evaluate a possible association between the complement factor H (CFH) Y402H polymorphism and susceptibility to age-related macular degeneration (AMD) in the Tunisian population, as well as the impact of the genotype distribution among different phenotypes and the response to treatment with intravitreal bevacizumab, exon 9 of CFH was analyzed for the Y402H polymorphism by direct sequencing in 135 healthy controls and 127 sporadic unrelated AMD patients classified into the following groups: 12 atrophic AMD (group G1), 115 exudative AMD (G2) and 10 AMD patients who had fibrovascular scarring (G3) that did not allow a precise grading of the phenotype. Seventy patients in G2 were treated with 1.25 mg intravitreal bevacizumab at 6-week intervals until choroidal neovascularization (CNV) was no longer active. The frequency of the CFH 402H allele was significantly higher in AMD patients than in controls (p = 2.62 × 10–16). However, subgroup analysis does not reveal any association between the variant allele H and phenotypes of AMD or CNV. Also, there was no significant difference in response to bevacizumab treatment according to Y402H CFH genotype (p = 0.59). A strong association of the 402H allele with susceptibility to AMD in the Tunisian population was confirmed; however, this variant does not appear to be involved in the clinical progression of this disease or in the postintravitreal bevacizumab response.
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