Background: This study evaluated and compared the effects of three airway management devices—the endotracheal tube (ETT), the i-gel supraglottic airway, and the laryngeal mask airway (LMA)—on hemodynamic changes and intraocular pressure (IOP) in children undergoing surgery for congenital glaucoma. The primary objective was to identify which technique minimized adverse physiological responses following device insertion. Methods: Seventy-five pediatric patients were systematically divided into three equal groups of 25. Group A received an LMA, Group B received an i-gel, and Group C underwent conventional direct laryngoscopy for endotracheal intubation. Results: A statistically significant difference in hemodynamic response was observed between the supraglottic device groups (A and B) and the endotracheal intubation group (C). In Group C, heart rate increased significantly after ETT insertion and remained elevated for two minutes. Mean blood pressure also showed a significant rise post-insertion in Group C (p < 0.05), remaining elevated for three minutes. Intraocular pressure increased significantly in Group C compared to Groups A and B after device insertion, persisting for three minutes. Following device removal, a slight, statistically insignificant increase in IOP was noted across all groups. The overall complication rate was low. Transient adverse events were more frequent in Group C, though inter-group differences were not statistically significant (p > 0.05). Conclusion: the findings indicated that both supraglottic devices (L MA, and the I gel) were superior to traditional endotracheal intubation. their use was associated with significantly attenuated hemodynamic responses (e.g., less profound hypertension and tachycardia) and more favorable stability in intraocular pressure following insertion. this suggests that LMA and I gel may be preferable airway techniques for this specific patient population and surgical procedure.
Purpose: To assess and compare the short-term effects of repeated intravitreal injection of ranibizumab vs bevacizumab on macular microvasculature in cases with diabetic macular edema (DME) applying optical coherence tomography angiography (OCTA). Methods: Prospective comparative study included 75 eyes of 56 cases with DME. Eyes were assigned to receive 3 consecutive monthly intravitreal injections of either ranibizumab (0.5 milligram) or bevacizumab (1.25 milligram). OCTA imaging was done at baseline and 1 month after the 3rd injection evaluating vessel density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), as well as foveal avascular zone (FAZ). We also assessed Best-corrected visual acuity (BCVA)and central macular thickness (CMT). Results: BCVA and CMT improved significantly in both groups following injection. However, OCTA analysis showed a decline in SCP vessel density and a mild rise in FAZ area in both groups. In the ranibizumab group, DCP vessel density showed a slight increase, whereas a reduction was observed in the bevacizumab group. A statistically insignificant difference was detected among ranibizumab and bevacizumab groups in post-injection BCVA, CMT, SCP, DCP, or FAZ measurements (p > 0.05). Also, BCVA showed significant correlations with OCTA parameters and CMT. Conclusion: Both ranibizumab and bevacizumab groups showed comparable short-term anatomical and functional enhancements in DME. Our study showed that OCTA remains a valuable non-invasive tool for assessing microvascular changes after anti-vascular endothelial growth factor (VEGF) treatment of DME.
Purpose: To investigate mfERG outcomes following PACK-CXL compared with conventional antimicrobial medication in infectious keratitis, and to compare retinal function changes between low-fluence and high-fluence PACK-CXL protocols. Methods: Prospective, comparative, non-randomized controlled trial (NCT05881187) at Sohag University Hospital, April 2023–April 2025. Thirty-nine eyes: 21 in Group A (PACK-CXL plus antimicrobials: low-fluence 9 mW/cm²×10 min = 5.4 J/cm² [n=10]; high-fluence 18 mW/cm²×4 min = 7.2 J/cm² [n=11]); 18 in Group B (antimicrobials alone). mfERG recorded 5 rings (R1–R5) and 4 quadrants (Q1–Q4) at baseline and day 30. Results: No significant between-group differences in preoperative mfERG. Post-treatment, CXL group showed statistically significant improvements in Ring 2 (P=0.02) and Ring 5 (P=0.04). The high-fluence subgroup showed significant improvement across all rings; the low-fluence subgroup showed non-significant trends. Between-subgroup significant differences: Ring 5 (P=0.048) and Quadrant 3 (P=0.006). Medication group showed significant improvement only in Ring 1, Ring 4, and Quadrant 1. Conclusion: PACK-CXL, especially the high-fluence protocol, was associated with greater improvement in mfERG retinal function compared with medical therapy alone, without evidence of retinal toxicity. High-fluence PACK-CXL is recommended for infectious keratitis of all severities
Background: Pterygium is a common ocular surface disorder with variable prevalence across popu-lations, often associated with ultraviolet light exposure. While conjunctival autograft (CAG) following excision is considered the gold standard surgical technique for reducing recurrence, there is limited data on its outcomes in Yemen. This study aimed to assess the visual, refractive, and recurrence outcomes of pterygium excision with CAG among patients in Sana’a City, Yemen. Methods: A retrospective study was conducted among 185 patients who underwent pterygium excision with CAG between 2020 and 2024 at two eye centres in Sana’a. Demographic and clinical data were collected, including pre- and postoperative visual acuity, refractive errors, and recurrence rates. Categorical data were described using frequencies and percentages. Results: Of 185 patients included in the study, the majority of pterygia were located nasally (98.4%), with only 1.6% presenting as kissing lesions. The right and left eyes were affected in 50.8% and 43.3% of cases, respectively, while bilateral involvement was observed in 5.9% of patients. Preoperatively, 76.5% (140/183) of patients had normal refraction, while 23.5% exhibited refractive errors; astigmatism (9.8%) and hypermetropic astigmatism (8.2%) were the most frequent, followed by hypermetropia and myopia (2.7% each). Postoperatively, 27.9% of patients with preoperative refractive errors showed visual improvement, whereas 72.1% had no change. The recurrence rate of pterygium following CAG was 6.5%. Conclusion: Pterygium excision with CAG using sutures demonstrates a low recurrence rate and offers modest improvement in refractive status among affected patients in Yemen. These findings support its continued use as a preferred surgical approach in similar settings and warrant prospective long-term studies to assess recurrence and refractive outcomes following this procedure
Background: High myopia is when a person's myopia has progressed to a point where a spherical correction of −6 diopters or more is required although the definitions used to grade myopia vary. The prevalence of myopia is increasing worldwide. It's predicted that by 2050, high myopia will affect 9.8% of the global population, a total of 938 million people. The prevalence of myopia is highest in younger adults, especially in urbanized East and Southeast Asian countries. Objective: To evaluate the macular vascular density and related factors in high myopia patients without pathological myopic maculopathy in the outpatient clinic in Sohag Teaching Hospital using OCTA. Patients and Methods: This was a cross sectional observational study that include 50 patients, attending ophthalmology outpatient clinic at Sohag Teaching Hospital. Results: A correlation analysis was performed to assess the relationship between central macular thickness (CMT) and macular vessel density (MVD) in Superficial Retinal Capillary Plexus (SRCP )and Deep retinal capillary plexus (DRCP) regions. No significant correlation was observed between CMT and MVD in the central zone, superior paramacular, superior perimacular, inferior paramacular, inferior perimacular, nasal paramacular, nasal perimacular, temporal paramacular or temporal perimacular regions in DRCP and most of the macular regions of SRCP (p > 0.05). Conclusion: The results demonstrated no significant correlation between central macular thickness and MVD across most of the macular regions of Superficial Retinal Capillary plexus and all regions of Deep Retinal Capillary Plexus. These findings suggest that retinal structural changes, as reflected by macular thickness, may occur independently of microvascular alterations in highly myopic individuals. This highlights the multifactorial nature of retinal changes in high myopia and suggests that macular thinning alone may not be a reliable indicator of microvascular compromise.
Aim: This Study Aimed to assess whether exposure to light emitted from smartphone and computer screens can induce structural or functional damage to retinal cells using Electroretinography on medical students. Patients and Methods: This was analytical cross-sectional research at Ophthalmology Hospital of Shebin Elkom, was conducted on (300) eyes of (150) participants of young adults (medical students at Menoufia university) divided into heavy users (>6 hours/day) and light users (<2 hours/ day). In period between (April 2025 to April 2026). All participants underwent a structured question-naire for assessment of visual symptoms, followed by Electroretinography (ERG) evaluation. Results: Heavy users showed a significantly higher prevalence of visual symptoms, including blurred vision (52.0% vs 30.7%), eye strain (52.0% vs 0%), and dry eye (65.3% vs 14.7%). Pattern ERG (PERG) revealed a statistically insignificant variances among the groups. In contrast, full-field ERG (ffERG) demonstrated a highly significant reduction in both a-wave and b-wave amplitudes in heavy users compared to light users (P < 0.001). Conclusions: Prolonged smartphone use is associated with significant visual symptoms and functional impairment primarily affecting the outer retina, particularly photoreceptors and bipolar cells, likely due to oxidative stress and phototoxic effects of blue light, while ganglion cell function remains preserved in early stages.
Background: Diabetic macular edema (DME) treatment plans should incorporate hypertension, dyslipidemia, smoking cessation, weight loss (if needed), and effective control of diabetes mellitus and HbA1c readings. Both sleep apnea and renal illness treatment are crucial. The primary goal of this research is to examine the impact of intravitreal aflibercept injection on dyslipidemia. Methods: This study encompassed 50 eyes from 32 patients diagnosed with type II diabetes mellitus exhibiting center-involving diabetic macular edema, defined by a central foveal thickness above 280 μm, and featured three successive monthly intravitreal injections of anti-VEGF (Aflibercept) from January 2024 to June 2025. We assessed the macular health using optical coherence tomography (OCT), measured the subjects' best-corrected visual acuity before and after the injection, and checked their lipid profiles before the injection. Results: A total of 28 individuals with dyslipidemia and 22 individuals with normal lipid profiles were included in the analysis. No significant difference was seen between the two groups on parameters of gender, age, and HbA1c. Very little variation was seen across the groups with respect to visual acuity and macula OCT findings, which include central macular thickness, average thickness, and total volume. Macula OCT readings do not correlate well with cholesterol levels when it comes to triglyceride, HDL, and LDL levels. Conclusion: Lipid profile measurements (total cholesterol, trigl-ycerides, LDL, and HDL) did not correlate substantially with the response to intravitreal injection of aflibercept, according to data analysis.
Background: Cataract is a leading cause of vision loss in developing countries and despite the benefits of cataract surgery, many patients remain dissatisfied due to the development of dry eye symptoms and although this condition is particularly common after extracapsular cataract extraction, there are reports on the occurrence of dry eye following phacoemulsification. Aim: We aim to evaluate dry eye disease after uneventful phacoemulsification whether it is worsened or not in patients with no dry eye disease prior to the operation. Methods: This study is a prospective, observational, nonrandomized, noncomparative study conducted in Sohag ophthalmic diagnostic center in Sohag university hospital on 100 cataract patients, with age above 40 years old who underwent uncomplicated phacoemulsif-ication surgery. Complete ophthalmic assessment, Ocular Surface Disease Index (OSDI), Schirmer Test-1, Non-invasive tear film break up time, Tear Meniscus Height, Meibomian gland's function, Lipid layer thickness, Eyelid margin and conjunctival hyperemia was analyzed and compared before and after the surgery on different intervals using SPSS v25. Results: Our study showed that dry eye parameters (OSDI), Schirmer’s test, TBUT, tear meniscus height, lipid layer thickness, and conjunctival hyperemia) showed a transient postoperative deterioration peaking at two weeks with gradual recovery to near or baseline levels by six months, no significant change in meibomian gland function. Conclusion: normal watering condition of eye pre-operative cataract surgery will remain with normal condition after surgery with strict follow up and maintaining good medication regimen. Our study showed development of dry eye two weeks post-operative and improvement of condition four weeks post-operative.
Background: Choroidal neovascularization (CNV) is a leading cause of vision loss in age-related macular degeneration (AMD) and pathological myopia. Accurate detection and evaluation of CNV morphology are crucial for management. Aim: To compare choroidal neovascular membrane criteria in AMD and pathological myopia using optical coherence tomography (OCT) and OCT angiography (OCTA). Methods: This observational, comparative, prospective study included 100 eyes (50 AMD, 50 high myopia) examined at Sohag Ophthalmic Diagnostic Centre. Complete ophthalmic assessment, OCT, and OCTA were per-formed. Parameters analyzed included CNV type, location, activity, intraretinal edema, subretinal fluid, configurations, central macular thickness, and macular volume. Data were analyzed using SPSS v27. Results: Subfoveal location and intraretinal edema were more common in AMD, whereas extrafoveal location and minimal edema characterized myopic CNV. AMD-related CNV showed larger lesion size, more frequent exudative changes, and increased central macular thickness and macular volume compared to myopic CNV. OCTA vascular patterns were significantly correlated with CNV activity in both groups. Conclusion: OCTA is an effective, non-invasive tool for detecting and monitoring CNV. Evaluation of lesion morphology, vascular patterns, and ancillary signs provides insight into activity, supporting tailored management strategies for AMD and myopic CNV.
Background: Pediatric strabismus should be addressed promptly to enhance the likelihood of achiev-ing binocular vision and to reduce the chances of amblyopia. The treatment objectives involve ensuring clear vision in both eyes (absence of amblyopia) and alignment of the eyes (Orthotropia). Both of these factors are essential for developing stereopsis, which is an additional objective. Objective: To assess all children referred to the Strabismus Clinic within the Ophthalmology Department at Sohag University Hospital during the study period, specifically those diagnosed with convergent squint (esotropia), and to document the treatment results for these children. Patients and Methods: This interventional study, which is prospective and consists of a series of cases, was designed to assess all children who attended the Strabismus Clinic in the Ophthalmology Department at Sohag University Hospital due to convergent squint (esotropia), as well as to document the outcomes of their treatment. The research included 40 infants and children who were 12 years old or younger. In this study, pediatric esotropia was categorized into three primary groups: Group 1: Congenital (or infantile) esotropia, Group 2: Accommodative eso-tropia, and Group 3: Non- Accommodative esotropia. Results: Twelve non-accommodative esotropia cases were seen in this study. The median age of onset was 5 years, the mean preoperative angle of deviation was 40 PD. Regarding the type of surgery, 8 of 12 children (66.66%) underwent bilateral medial rectus recession, and 4 (33.33%) underwent bilateral medial rectus recession and inferior oblique myectomy. At the end of postoperative follow up examinations, 8 of 12 children (66.66%) were orthotropic, 2 (16.66%) had residual esotropia, and 2 (16.66%) had consecutive exotropia. Conclusion: Congenital (infantile) esotropia can either be present at birth or develop within the first six months of life. Cases of acquired esotropia typically emerge during early childhood. This study advocates for early surgical intervention for congenital (infantile) esotropia, showing a successful outcome in the majority of cases. Post-operative alignment within 10 prism diopters (PD) of being straight is considered a significant marker of success. Fully accommodative esotropia cases were completely remedied with hypermetropic correction (glasses) after conducting cycloplegic refraction, eliminating the need for surgery. Surgery was performed on partially accommodative esotropia cases to address the remaining angle while the patient wore glasses.
Background: Corneal collagen cross-linking is an established intervention for halting keratoconus progression. Accelerated protocols have emerged to shorten treatment time, yet the optimal irradiation mode remains debatable. Pulsed-light delivery may enhance oxygen diffusion and improve cross-linking efficiency, compared with continuous irradiation. Aim: To evaluate the visual, refractive, tomographic, pachymetric, and topometric outcomes of pulsed-light accelerated epithelium-off corneal cross-linking in patients with progressive mild-to-moderate keratoconus, and to assess the stromal demarcation line as an indicator of treatment penetration. Methods: This prospective interventional case-series study included 25 eyes of keratoconus patients who underwent pulsed-light accelerated cross-linking (30 mW/cm², 1-second on/1-second off, 8 minutes, total energy 7.2 J/cm²). Comprehensive assessments—including corrected distance visual acuity, refractive error, Pentacam-derived keratometric and tomo-graphic parameters, pachymetry, and topometric indices—were conducted preoperatively and at 12 months. Demarcation line depth was evaluated using anterior-segment OCT at 3 months postoperatively. Results: Significant postoperative improvements were observed in cylindrical refractive error and corrected distance visual acuity. Flattening of keratometry readings was significant only in the maximum keratometry (Kmax). Seven out of eight topometric indices demonstrated significant postoperative impr-ovement. The mean demarcation line was 173.56 ± 13.76 μm. Conclusion: Pulsed-light accelerated cross-linking produced favorable visual, refractive, and tomographic outcomes and achieved a deep stromal demarcation line, supporting enhanced oxygen-mediated treatment efficacy. These findings indicate that pulsed protocols may offer biomechanical advantages in early keratoconus management. Larger, long-term comparative trials are warranted.
Background: Open globe injury (OGI) is an ocular emergency often associated with poor visual outcomes. Multiple factors, including injury mechanism and intraocular complications, influence prognosis. Aim: To identify Epidemiologiy, predictors of final visual outcome, common injury mechanisms, and evaluate postoperative complications and secondary surgical interventions. Methods: A prospective study was conducted on 111 patients aged ≥6 years with OGIs, who presented to Assiut University Hospital, Assiut, Egypt between December 2023 and December 2024. Injuries included penetrating, perforating wounds, ruptures, and intraocular foreign bodies. Best corrected visual acuity (BCVA) was assessed pre- and post-operatively. Results: Home was the most frequent injury location (38.7%), with penetrating trauma (62.2%) from sharp objects (67.6%) being most common. Uveal prolapse (68.5%), traumatic cataract (46.8%), and hyphema (40.5%) were prevalent findings. Median time to primary repair was 15 hours. Secondary surgeries were needed in 39% of patients, mainly for cataract extraction. Significant impr-ovement in vision was observed in patients with partial preoperative vision. Poor final BCVA was significantly associated with hyphema, traumatic cataract, vitreous hemorrhage, retinal detachment, and endophthalmitis. No significant association was found with injury zone or repair timing. IOFBs were linked to increased risk of endophthalmitis, retinal detachment, and atrophia bulbi. Firework injuries were associated with worse outcomes. The trauma mechanism and Ocular Trauma Score (OTS) were strong predictors of final vision. Conclusion: Visual prognosis in OGIs is significantly dependent on intraocular complications and injury mechanism, while injury zone and repair timing were not predictive. OTS and trauma type are valuable for outcome prediction.
Aim: The aim of the current study was to evaluate corneal topographic pattern & its correlation with refractive status of the eye. Patients and Methods: a prospective observational single-center hospital-based cross- sectional case-control clinical trial was conducted in the Future Center for refractive surgery, Sohag, Egypt from 1st January 2022 to 31st January 2024 among 130 eyes of 130 participants who attended for refractive surgery, the studied cases were divided into two groups according to Pent-acam finding into group A with normal findings and group B with abnormal findings. Results: Regarding demographic data, the mean age of the studied population was 28.93 ± 7.99 years and included 51 male cases (39.2%). Regarding refractive status, 66.2% of cases were astigmatism, myopia (26.9%), emmetropia (6.2%) and hyperopia (0.7%). Regarding to topographic patterns, the distribution was as followings: the highest frequent pattern was irregular (29.2%), followed by symmetric bowtie (26.2%), Asymmetric bowtie with superior steepening (15.4%). Assessment relation between topographic patterns of cornea and refractive status showed that the most common two topographic patterns associated with myopia were irregular and SB patterns (42.8% and 20%; respectively). Meanwhile, the most common two topographic patterns associated with astigmatism were SB and irregular patterns 31.3% and 23.2%; respectively). Conclusion: This study revealed that most common two topographic patterns associated with myopia were irregular and SB patterns (42.8% and 20%; respectively). Meanwhile, the most common two topographic patterns associated with astigmatism were SB and irregular patterns 31.3% and 23.2%; respectively).
Background: Objective imaging of the anterior chamber angle has been dominated by anterior segment optical coherence tomography (ASOCT) since its inception in 2003, when it supplanted ultrasonic bio-microscopy (UBM). However, the primary advantage of ASOCT does not lie in its higher axial resolution (18 μm) compared to 50 MHz UBM (25 μm). When scanning in the supine position in regular clinical settings, ASOCT's non-contact scanning approach is preferable to UBM, which requires a silicone or plastic eyecup with a coupling medium (methyl cellulose or saline solution). This makes the patient more comfortable and increases compliance. Objective: To compare between the ultrasound bio-microscopy (UBM) and anterior segment optical coherence tomography (AS-OCT) para-meters in assessment of glaucoma. Patients and Methods: This cross-sectional research enrolled fifty patients with primary open and angle closure glaucoma from March 1, 2023, to March 31, 2024, at Sohag University Hospital's Ophthalmology department. The purpose of the evaluation is to determine the use of UBM and AS-OCT parameters in glaucoma examination. Results: No statistically significant difference was observed between OCT and UBM when analyzing the angle of the anterior chamber while gazing at either eye. When comparing the OCT findings with the UBM measurements of AOD 500 in the temporal or nasal quadrants of the right and left eyes, no statistically significant difference was seen. When comparing OCT and UBM measurements of AOD 750 in the nasal and temporal quadrants of the right and left eyes, there was no statistically significant difference. When comparing OCT with UBM, the results from tests using TISA 500 and TISA 750 in the eyes' left and right temporal quadrants were identical. Conclusion: The results show that when comparing the two methods, AS-OCT and UBM measure very comparable characteristics in both eyes, including the angle of the anterior chamber, AOD500, AOD750, TIA500, TIA750, TISA500, and TISA750.
Aim: To compare phacotrabeculectomy to phacotrabeculotomy in secondary uveitic closed angle glaucoma in terms of safety and efficacy. Methods: This is prospective randomized interventional comparative study. Patients diagnosed with secondary uveitic angle closure glaucoma (uncontrolled with eye drops) associated with visually significant cataract were enrolled. Study subjects were randomly allocated to either phacotrabeculectomy (group A) or phacotrabeculotomy (group B). The primary outcome measure was the IOP control in both groups during one-year follow-up period. Secondary outcome measures included best corrected visual acuity (BCVA), and adverse events. Patients were evaluated at 1day, 1 week, 1month, 3 months, 6 months and 1 year postoperatively. Results: Fifty eyes from 50 cases were studied, 25 eyes in each group. IOP remained significantly lower, compared to preoperative IOP at all postoperative visits in both groups. Postoperative IOP was significantly lower in group A than group B only at 1month (p = 0.01); however, the difference was insignificant between both study groups afterwards until 12 months postoperatively (p = 0.06). Mean postoperative BCVA was significantly better in group B compared to group A at all study time points. No significant difference was observed regarding complication rate between both groups, except the incidence of hyphema (p=0.004), which was significantly higher in group B. Conclusions: Phaco-trabeculotomy is non inferior to standard phaco-trabeculectomy in secondary uveitic closed angle glaucoma
Purpose: To evaluate the safety and efficacy of a combined technique using propofol sedation with sub-Tenon’s anesthesia compared with general anesthesia for adult strabismus surgery. Methods: Sixty adult patients (ASA I–II), aged 20–65 years, were randomly allocated into either the general anesthesia group (GA, n=30) or the sedation group (n=30). The sedation group received intravenous fentanyl (25–100 μg) and a propofol bolus (1–2 mg/kg), followed by continuous propofol infusion (3–6 mg/kg/h) to maintain deep sedation. A nasal airway was inserted to prevent upper airway obstruction. Sub‑Tenon’s anesthesia was administered using a mixture of 2% lidocaine, and 150 IU hyaluronidase. The GA group received standard general anesthesia with endotracheal intubation. Clinical outcomes measured included surgical and anesthesia duration, oculo-cardiac reflex (OCR), arrhythmias, time to discharge, postoperative pain, postoperative nausea and vomiting (PONV), and patient and surgeon satisfaction scores. Results: The sedation group demonstrated significantly shorter anesthesia time, faster discharge, lower postoperative pain scores, reduced incidence of PONV, and fewer treated episodes of OCR and bradycardia compared with the GA group. Patient and surgeon satisfaction was significantly higher in the sedation group. Conclusion: the evidence indicates that, for adults undergoing primary strabismus surgery, including those with high anesthetic risk, a protocol of propofol sedation combined with a sub-Tenon’s injection is a safe and effective alternative to general anesthesia. Its advantages include excellent efficacy, a superior recovery profile, and enhanced patient comfort
Purpose: To evaluate the impact of smartphone usage under dark and illuminated conditions on intraocular pressure (IOP). Methods: A prospective randomized crossover design was employed, enrolling 30 healthy adults aged 20–40 years. Each participant underwent IOP assessment at baseline, after 15 minutes of smartphone viewing in a dim setting (5 lux), and after 15 minutes in a well‑lit setting (500 lux). Results: The mean baseline recorded intraocular pressure was 15.2 ± 2.1 mmHg, which increased to 16.6 ± 2.5 mmHg (p = 0.002) after smartphone use in the dark, and to 15.4 ± 2.2 mmHg (p = 0.15) after use in a bright condition. The rise in IOP was significantly greater following exposure to the dark env-ironment compared to bright conditions (p = 0.019). Conclusion: Smartphone use in low-light conditions may be associated with a transient rise in IOP. This study suggests that adequate ambient lighting during prolonged smartphone use may be a simple practice to minimize IOP fluctuations, especially in individuals at high risk of glaucoma progression.
Background: Myopia is the second most common cause of choroidal neovascularization (CNV) behind age-related macular degeneration, representing 5%-10% of all CNVs. Generally, myopic choroidal neovascularization in adolescents lead to an initial rapid deterioration of vision, sometimes acco-mpanied by metamorphopsia and central scotoma, or happening independently. Optical coherence tomography angiography (OCTA) has lately been incorporated into clinical practice. Optical coherence tomography angiography provides depth-resolved imaging of the retinal and choroidal arteries without the need of dye injection. Purpose: To analyze the ability of optical coherence tomography angiography (OCT-A) to detect the presence of myopic CNV and to describe structural features of myopic CNV on OCT-A. Methods: A randomized cross-sectional observational research was performed on 100 patients diagnosed with high myopia exhibiting clinically obvious choroidal neovascularization at the Department of Ophthalmology at Sohag University Hospitals from April 30, 2024, to December 1, 2024. Results: The average age of the studied patients was 45.15 ± 11.83 years, ranged from 24 to 68 years. The CNV status has been defined as active in 65 cases and inactive in 35 cases. A statistically significant augmentation in macular volume was seen in the active group vs to the inactive group (6.86±0.77 and 5.59±0.82 mm³). Moreover, there was a statistically significant elevation in macular thickness in the active group relative to the inactive group (324.26±78.22 and 220.43±51.36 μm). The active group had a significant increase in parafoveal and perifoveal thickness, along with retinal edema, relative to the inactive group; yet, the variations in location and type were minimal. Regarding OCTA features, active groups demonstrated a significant rise in the proportion of visible core relative to the inactive group (84.62% vs 28.57%). Moreover, there was a significant increase in the prevalence of Medusa and Sea fan among the active group (50.77% and 26.15%, respectively) in contrast to the lack of inst-ances in the inactive group. The active group exhibited a significant increase in the prevalence of vascular looping and anastomosis (89.23%), while the inactive group showed no instances of these phenomena. Conclusion: Multimodal imaging, including structural OCT, OCT-A, and fundus fluorescein angiography, is the benchmark for disease diagnosis and activity assessment.
Purpose: To evaluate and compare the morphological and perfusion changes of the macula following different endo tamponade methods in patients undergoing retinal detachment repair surgery. Methods: A retrospective cohort study of 120 patients with rhegmatogenous retinal detachment who underwent pars plana vitrectomy with different end tamponade agents between January 2022 and May 2025. Patients were divided into three groups: silicone oil (n=60), sulfur hexafluoride (SF6) gas (n=38), and perfluoropropane (C3F8) gas (n=22). Macular morphology was assessed using optical coherence tomography (OCT), and perfusion parameters were evaluated with OCT angiography (OCTA) at baseline, 1, 3, 6, and 12 months postoperatively. Primary outcomes included central macular thickness (CMT), macular volume, and perfusion density measurements. Results: Mean follow-up was 14.2 ± 3.8 months. At 12 months, the silicone oil group showed significantly greater CMT (287.4 ± 42.3 μm) compared to SF6 (251.8 ± 28.9 μm, p<0.01). Conclusions: Different endotamponade agents show distinct effects on macular morphology and perfusion following retinal detachment repair. Gas tamponades demonstrate superior outcomes in terms of macular thickness normalization and perfusion recovery compared to silicone oil, which could affect long-term visual outcomes.
