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  Citation statistics : Table of Contents
   2015| July-December  | Volume 3 | Issue 2  
    Online since December 17, 2015

 
 
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ORIGINAL ARTICLES
Study of the incidence, mechanism, various modes of presentation and factors responsible for the development of lens-induced glaucomas
Chandrasekhar Gujjula, Swapnil Kumar, U Varalakshmi, Mahaboob V Shaik
July-December 2015, 3(2):56-62
DOI:10.4103/1858-6538.172097  
Objectives: The present study undertaken to study the factors responsible for the development of lens-induced glaucomas (LIGs), factors, and various modes of presentation in LIGs. Methodology: A minimum of 50 cases of LIG were selected based on simple random sampling, who attended the Department of Narayana Medical College Hospital and were diagnosed with LIG. Based on the clinical findings, etiological diagnosis of LIG was made. Results: Out of the 50 cases, 34 cases (68%) were diagnosed as phacomorphic glaucoma, 12 cases (24%) were of phacolytic glaucoma, two each (4%) were lens-particle glaucoma and glaucoma secondary to subluxation/dislocation of lens. Conclusion: There was no influence of sex, religion, or occupation on the incidence or occurrence of LIGs. Majority of the patients had good vision in the other eye as a result of which they neglected the affected eye till they developed LIG leading to pain during the time of presentation. Hence, it is important to advice the patients regarding the early surgical treatment of cataract before they develop complications.
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Normal range values of ocular axial length in adult Sudanese population
Sahar Ibrahim Albashir, Mahgoub Saleem
July-December 2015, 3(2):31-38
DOI:10.4103/1858-6538.172098  
Background: The axial length is one of the essential ocular biometric parameters which is to be done prior to any cataract surgery based on ultrasound. These ocular axial length (OAL) values can be influenced by sex, age, race, ethnicity, genetics, and refractive errors. Objectives: The aim of this study is to determine the normal ranges values of OAL in adult Sudanese population and to define the effects of age, gender, and tribal ethnicity on axial length. Materials and Methods: This is descriptive multi-center hospital-based study, carried out over a period of 6 months from January 2015 to June 2015. The study takes place in five study areas: Three in Khartoum and two in Omdorman. These centers are Khartoum Eye Hospital, Makkah Eye Complex, Alwalidain Eye Hospital, and Omdurman Military Hospital and Sudan Eye Center. The study population was recruited from patients presenting to the mentioned five Hospitals Biometric Departments or volunteers who accepted to be enrolled in the study. One thousand Sudanese adults participants (n = 1000), 507 female and 493 male, with ages ranging from 18 to 105 years were included. Patients with vitreoretinal diseases, intraocular surgery, recent trauma and staphyloma were excluded. All participants underwent systematic OAL measurements by A-scan ultrasonography. Effect of age, gender, and tribal ethnicity on OAL was analyzed. Results: The study showed that the average axial length was 23.09 mm ranging from 18.13 mm to 29.09 mm. It was longer in males (average 23.29), ranging from 20.31 mm to 28.48 mm and shorter in females (average 22.81), ranging from 18.31 mm to 29.09 mm. In the four main Sudanese tribes, the Nubian group had the longest axial length (23.23 mm), followed by the African group (23.15 mm), and then the Arab group (23.09 mm). Bejja group had the shortest axial length (22.85 mm). Conclusion: OAL in Sudanese adults was within the international standard but with a wider range (18.13–29.09 mm). Males' OAL was longer than the OAL of females. No significant age OAL variations, but the tribal ethnicity factor was clear, so tribal ethnicity had a major influence on Sudanese OAL.
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CASE REPORTS
Recurrent sympathetic ophthalmitis
Mona Deshmukh, Chandan G Tiple
July-December 2015, 3(2):63-66
DOI:10.4103/1858-6538.172103  
Sympathetic ophthalmitis (SO) is a rare, bilateral granulomatous uveitis occurring after perforating eye injury or ocular surgical procedure to one eye. The pathophysiology of this entity is not clearly understood, but an autoimmune hypersensitivity reaction against exposed ocular antigens in the injured eye is believed to be responsible for this disease. In this article, we present a patient with clinical diagnosis of SO with it recurrence.
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Posterior dropped crystalline lens by a car battery explosion ocular trauma
Mahgoub Saleem
July-December 2015, 3(2):67-69
DOI:10.4103/1858-6538.172101  
To report a case of right posterior dropped crystalline lens by a car battery explosion ocular trauma, in which the diagnosis was missed on initial ocular B-scan ultrasonography. Ocular injuries can be severe enough to compromise the vision, temporarily or permanently, depending on the type and mode of trauma itself; besides the urgency and competency of their managements. They often happen due to cars, sport, bombings, work, or war-related accidents. They can be penetrating or nonpenetrating injuries due to sharp or blunt impact causes; both can damage the structures at the front or at the back of the eye, with deferent degrees of severity. The prompt and competent emergency actions are the ophthalmic surgeons' challenges to save the vision. One of the not-uncommon eye traumas is due to the car battery explosions, which can lead to crystalline lens anterior or posterior dislocation. This case study will report the presentation and management of a posterior dropped crystalline lens by a car battery explosion, in which the diagnosis was missed on initial ocular B-scan ultrasonography.
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ORIGINAL ARTICLES
Sensitivity and specificity of nassar color test in early detection of diabetic macular edema
Moustafa Kamal Nassar, Mohamed YS Saif, Ahmed TS Saif, Passant S Saif
July-December 2015, 3(2):39-43
DOI:10.4103/1858-6538.172102  
Purpose: To evaluate the sensitivity and specificity of Nassar color discrimination test in the presence of diabetic macular edema (DME) as a sensitive diagnostic tool for the detection of early functional changes. Design: A prospective, comparative case–control study. Setting: Multicenter study in the outpatient clinic of Beni Suef University, Fayoum University, and Misr University for Science and Technology. Methods: The study included 120 eyes with Type I diabetes recruited from the outpatient clinic. All patients were received ophthalmic exams and tested with Nassar color plate test, fluorescein fundus angiography (FFA), and optical coherence tomography (OCT). The main outcome measures are the presence of mild or moderate tritans indicating early DME changes that were documented in each group. Statistical Analysis Used: Student's t-test and ANOVA f-test were used for statistical analysis. P <0.05 were considered statistically significant. Results: The mean age of the patients was 41.15 ± 5.61 years (range 23–49 years) with the mean disease duration of 13.56 ± 2.59 years (range 10–20 years). All patient with dry macula (n = 60, 50%) were normal on Nassar color test while patients with DME showed normal (n = 6, 5%), mild tritan (n = 14, 11.66%), and moderate tritan (n = 40, 33.33%), respectively. Hence, the Nassar color test is 90% sensitive and 100% specific. Conclusions: The Nassar color plate is an affordable and effective for early detection of DME and recommended to be used in all primary ophthalmic examination especially in areas where no access to comprehensive ophthalmic exams such as OCT and FFA.
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Evaluation of ocular hypotensive effects of some drugs used in treatment of open angle glaucoma, at Alsaym Ophthalmic Hospital, Wad Medani, Sudan
MM Haitham, IM Tajeldin, Mamoun Mirghani Ahmed
July-December 2015, 3(2):44-49
DOI:10.4103/1858-6538.172099  
Introduction: Glaucoma is a neurodegenerative disease. It is presented by a triad of elevated intraocular pressure (IOP), progressive optic nerve damage, and constriction of the peripheral visual field. Objectives: The aim of this study is to assess the ocular hypotensive effects of some drugs used in treatment of open angle glaucoma (OAG) at Alsaym Ophthalmic Hospital, Wad Medani, Sudan. Methodology: A cross-sectional hospital-based study was conducted at specialized ophthalmological health setting. Patients (n = 200) diagnosed with OAG and treated with different anti-glaucoma drugs were selected randomly to participate in this study. The ocular hypotensive effects of anti-glaucoma drugs were evaluated monthly for 4 successive months, by measuring the diurnal IOP for each patient, using tonometer. The obtained data were collected in especial data collection form and analyzed by IBM SPSS Inc. (IBM SPSS Statistics) Software;Group's Business Analytics Portfolio. Results: Monotherapy of timolol (eye drops 0.5% and 0.1% eye gel), betaxolol 0.5% eye drops produced significant reductions in the total mean of IOP, ranged between 4.4 and 6.1 mmHg, while travoprost 0.004% eye drops showed a remarkable reduction of 7.3 mmHg. Combinations of travoprost with timolol and and/or dorzolamide 2% resulted in significant IOP lowering effects, ranged from 8.9 to 12.7 mmHg. Mono or combined therapy with travoprost was found to be superior to other anti-glaucoma monotherapy. Conclusion: The obtained results showed that travoprost produced clinical significant and superior ocular hypotensive effects when used alone or in combination with timolol and/or dorzolamide. It is thus recommended to use prostaglandin analogues in treatment of OAG because they are the most effective agents in reducing the mean diurnal IOP.
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Rate of diabetic retinopathy among the diabetic patients with a best corrected visual acuity of 6/9 or better
Mahmoud Abdalla Salim, Rawya Abdelhadi Diab, Sarah Abdelmoneim Elshafie
July-December 2015, 3(2):50-52
DOI:10.4103/1858-6538.172096  
Background: Diabetic retinopathy is one of the leading causes of blindness worldwide, broadly it is defined as a complication of diabetes that affects the retina; by damaging its blood vessels, which at first may be symptomless, though eventually can lead to serious and sight-threatening complications like hemorrhages, macular edema, and even blindness. Aim: The study aimed at detecting the presence of diabetic retinopathy in the diabetic patients having a best corrected visual acuity “BCVA” of 6/9 or better, attending Retina Clinic in Elsaiem Eye Hospital, to prove a hypothesis' that states: diabetic patients with a BCVA of 6/9 or better are unlikely to have a diabetic retinal complications, and if found they rarely need intervention. Results: Six hundred and eighteen eyes were included in the study; 59.2% of the eyes with BCVA 6/9, 75.6% of the eyes with BCVA of 6/6, and 86.2% of the eyes with BCVA 6/5 were found to have neither diabetic retinopathy nor maculopathy. Conclusion: As it can be stated out of the results; the better the visual acuity than 6/9 the lesser the prevalence of diabetic retinopathy, so visual acuity “among other factors” could be considered as one of the simple screening methods or predictors of the diabetic retinopathy that is of great importance in developing countries with minimal facilities and resource-poor settings.
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Ophthalmic disorder in patients with latent autoimmune diabetes in adult
Ahmed Bolad, Razan Abdelmageed, Abdelrahman Manofaly, Husham M Abdelrahim
July-December 2015, 3(2):53-55
DOI:10.4103/1858-6538.172100  
It is well known that about 90% of all cases of diabetes mellitus (DM) are type 2, which is characteristic for adults aged above 40 years. Ten percent is represented by type 1 DM, typical for children and young. Adult's onset diabetes represent a heterogeneous mixture of type 1 and type 2 DM, often difficult to differentiate between, those patients may have actually latent autoimmune diabetes in adults (LADAs), where beta-cell destruction is less aggressive, leading to a slower development of insulin dependency. Studies indicated that antibodies against glutamic acid decarboxylase 65 (GAD 65) are good marker for diagnosis of autoimmune diabetes in adults who are not responding to oral hypoglycemic and may be at risk for getting complications namely increased risk of diabetic retinopathy. GAD 65 is mainly expressed in beta-cells of Langerhans but also in nonbeta-cells. GAD is an enzyme required for gama-aminobutyric acid (GABA) synthesis that acts as neurotransmitter in neurons of central nervous system and in pancreatic islets. GABA is probably involved in controlling the release of insulin from secretary granules.
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