Pulmonary artery systolic hypertension is common and associated with increased mortality among adult sickle cell disease (SCD) patients in the United States. Although the prevalence of SCD is highest in subSaharan Africa, the frequency of pulmonary artery systolic hypertension and the risk factors for the development of pulmonary hypertension have not been reported from Africa. We studied 208 hydroxyurea naïve Nigerian SCD patients at steady state and 94 healthy controls. Pulmonary artery systolic hypertension was defined prospectively as tricuspid regurgitant jet velocity ≥2.5 m/sec. Results were compared with a previously published US prospective SCD cohort. Only 7% of Nigerians compared with 46% of US adults with SCD were >35 years. Tricuspid regurgitant jet velocity was ≥2.5 m/sec in 25% of Nigerian SCD patients. Higher jet velocity was associated with greater serum globulin (P 5 0.002), blood urea nitrogen (P 5 0.019) and lactate dehydrogenase concentrations (P 5 0.026) and with inability to walk >300 m in 6 min (P 5 0.042). Compared with the US cohort, Nigerian patients had more hemolysis as indicated by lower hemoglobin and higher lactate dehydrogenase concentrations (P ≤ 0.003). Pulmonary hypertension is common among Nigerian SCD patients. The public health implication of this finding is significant considering the potential number of individuals at risk for this complication. Better understanding of the long term outcome of pulmonary hypertension and causes of death in SCD and the institution of preventive measures are major public health challenges for Africa. The inclusion of African sites in sickle cell pulmonary hypertension clinical trials should be encouraged. Am. J. Hematol. 83:485-490, 2008. V

Exotropia appearing immediately after surgery is most likely the result of an individually overdosed operation. This conclusion is not sufficient for delayed exotropia. Motor and sensory instabilities, such as those in patients needing a faden operation with simultaneous shortening of the anterior muscle segment for the treatment of convergence excess with no deviation at far or in patients showing cerebral palsy, seem to increase the risk of delayed consecutive exotropia. The mean interval between the initial surgery and the manifestation of consecutive exotropia is lower than is known from other surgical procedures.

Compared to patients with Fuchs' dystrophy the results of grafting after eye injuries are significantly worse. This relates to BCVA, astigmatism, frequency of secondary glaucoma and graft rejection.

Objective: Assessment of the macular ganglion cells function in myopic subjects using pattern electroretinogram (PERG) in comparison with healthy controls to help in diagnosing of retinal diseases, and studying the relationship of the changes seen in PERG with the axial length (AL) of the eye. Methods: The study was cross sectional, included 62 subjects (121 eyes). Three groups were examined: group 1: controls or emmetropics; group 2: mild myopics; group 3: moderate myopics. For all participants, a detailed pathological story was taken, a comprehensive eye examination was performed, AL was measured, and PERG was recorded, then the variables of the recorded waves (peak time and amplitude) were analyzed. Results: A statistically significant decrease in mean amplitudes of (P50, N95) waves was observed in group 2 (36 eyes) and 3 (25 eyes) compared to group 1 (60 eyes) (P-value <0.01), and a statistically significant elongation of mean N95 peak time was observed in (group 2 and 3) compared to group 1 (P-value <0.01) without being associated with elongation of mean P50 peak time. By studying the relationship between AL and each of peak time and amplitude of (P50, N95) waves, we have found that when AL increased, amplitudes decreased and peak times prolonged in a statistically significant way (P-value <0.01). Conclusion:The decreased amplitude of P50 wave may indicate a functional impairment of the macula in myopic subjects, and the decreased amplitude of N95 wave may be due to a functional impairment of their ganglion cells. The elongation of P50 peak time with increasing of AL may be due to a delay of the synaptic transmission between photoreceptors, bipolar cells, and ganglion cells.

Aim: To evaluate intraocular pressure changes after intravitreal injection of Bevacizumab alone or in combination with Triamcinolone Acetonide. Method: Our study included 63 eyes from the ophthalmology department at Tishreen University Hospital who had vascular retinal diseases. The patients were divided into two groups according to the indication of injection. The first group was injected with bevacizumab (B) at a concentration of 2.5mg / 0.1 ml and the second group was injected with the combination treatment of Triamcinolone Acetonide at a concentration of 2mg / 0.05ml with bevacizumab (B+TA) at a concentration of 1.25mg/ 0.05ml. Intraocular pressure was monitored on the Goldman applanation tonometry and values were recorded as follows: before injection, the second injection day, a week after injection, a month after injection and after three months. Results: The mean values of the intraocular pressure mean increased from the second day of injection in the study groups (B) and (B+TA) and the mean of the IOP values before injection (13.34-13.31 mmHg) respectively, and the IOP values showed the maximum in both groups after a week of the injection (17.81-17.31 mmHg) then began to decrease after a month and three months later to (17.34-17.06mmHg) and (17.6-16.75mmHg) mercury respectively, but they remained higher than they were before the injection, and the number of injections had no effect on intraocular pressure. Conclusion: intravitreal injections with both bevacizumab alone or in combination with triamcinolone acetonide resulted in a rise in intraocular pressure, and differences in pressure values were statistically significant within the same group during the studied time periods but were not statistically significant between the two groups, and the number of injections had no effect on intraocular pressure.