Echocardiography is an excellent non-invasive tool for cardiac evaluation in systemic lupus erythematosus (SLE) patients. The aim of this study was to assess the signs of systolic and diastolic left ventricular dysfunction at a subclinical stage and to compare the different results obtained with a control population. This study was conducted at the Adult Cardiology Department of Rabta Hospital in Tunisia. It is a prospective case-control study that included a total of 90 participants divided in two groups, 50 SLE asymptomatic patients (group 1), and 40 healthy subjects (goup 2) randomly selected. Both members of the groups underwent a comprehensive transthoracic echocardiography (TTE) performed by the same operator, using a Vivid E9 Ultrasound Machine, then echocardiographic parameters were compared to each other. The main results of our study showed that, for SLE patients, septal and posterior wall thickness were significantly greater, Tei index was significantly higher, peak systolic velocity at mitral annulus (S) and global strain rate were lower than the control group. Early diastolic velocity peak at the mitral annulus (Ea) was clearly reduced. The ratio of early trans-mitral velocity to tissue Doppler mitral annular early diastolic velocity (E/Ea ratio) as well as the ratio of peak E-wave velocity to flow propagation velocity (E/VP), left atrium volume and tricuspid regurgitation peak velocity, were higher in group 1. The time difference between the duration of pulmonary vein (PV) flow and mitral inflow during atrial contraction (Am-Ap) was higher for the control group. Our study outlined that LV dysfunction in SLE can be detected at a subclinical stage. Therefore, regular echocardiographic evaluation in asymptomatic SLE patients is necessary to assess any changes in LV function.

Chronic Obstructive Pulmonary Disease (COPD) leads to pulmonary arterial hypertension at severe stage and so often affects the right ventricle but left ventricular function can also be impaired. Investigate the impact of pulmonary arterial hypertension (PAH) observed in COPD patients on the LV function. A case control study including 45 patients followed for chronic obstructive pulmonary disease with PAH constituting (group 1 and 30 healthy control subjects (group 2). All patients included are free from diabetes, hypertension, ischemic heart disease, valvular heart disease, cardiomyopathy and are all in sinus rhythm. The 2 groups have a comparable average age. Both group underwent an echocardiography exam (left ventricular mass, the systolic function of the LV, the Tei index, the peak velocity of the S wave of the mitral annulus at the tissue Doppler, the strain left ventricle, mitral profil and protodiastolic Emitral/Ea velocities ratio were assessed) and compared to each other. There is no significant difference between the 2 groups regarding the left ventricular mass, the systolic function of the LV, the Tei index, the peak velocity of the S wave of the mitral annulus at the tissue Doppler and the strain left ventricle rate. However, the analysis of the diastolic function shows a significant decrease in the velocity of the protodiastolic Ea wave of the mitral annulus in group 1 (7.1 ± 1.4 cm/s vs. 12.8 ± 1.7 cm/s; P < 0.01) as well as a significant elevation of the protodiastolic Emitral/Ea velocities ratio (14.4 ± 1.9 vs. 8.1 ± 1.2; P < 0.01) suggesting the presence of severe diastolic dysfunction. This study shows that pulmonary arterial hypertension in COPD patients affects especially LV diastolic function. LV/RV interdependence is probably the main cause.

Valvular heart disease and mainly rheumatic heart disease complicates about 1% of pregnancies. Among women with valvular heart disease, those with mitral stenosis (MS) carry the greatest potential for problems during pregnancy. The aim of the study is to assess the safety and efficacy of percutaneous mitral balloon commisurotomy (PMBC) in Tunisian pregnant women with sever mitral stenosis. We conducted a retrospective descriptive study including 50 pregnant women with the diagnosis of mitral stenosis and admitted in our department for evaluation of hemodynamic status between 2000 to 2019. We collected epidemiologic pregnancy related information and clinical symptoms about women who were assessed before and 24 hours after the procedure (PMBC) by transthoracic and trans esophageal echocardiography: Mitral valve area (MVA), transmitral valve gradient (MVG), mitral valve morphology was evaluated before the procedure. The mean age was 28 ± 8 years. The mean gestational age was 23 ± 7 weeks. Twenty women were presented with acute pulmonary oedema, 15 patients were on atrial fibrillation. Echocardiography showed a severe MS with mean surface area 1 ± 0.2 cm2 and a mean gradient of 16 ± 8 mmHg. No significant mitral regurgitation MR (< 2/4 grade), mean systolic pulmonary pressure 43 ± 12 mmHg, no comissural calcification nor auricular thrombus. Functional Tricuspid regurgitation (TR) were presented in 18 cases. Aortic regurgitation: mild to moderate in 3 cases. Echocardiographic findings after PMBC showed a mitral valve area increased from 1 ± 0.2 to 2 ± 0.35 cm2. Mean gradient MV decreased from 15.5 ± 5.4 to 3 ± 1.3 mmHg. PAP decreased from 43 ± 12 to 30 ± 15 mmHg. Residual MR > moderate only in 7 cases. No per procedural complication and no maternal, fetal death or abortion were observed. During pregnancy, physiological hemodynamic changes is considered one of the causes of mitral stenosis (MS) decompensation. PMBC, when it is feasible, is considered now the preferred method of treatment within pregnant woman with refractory symptoms.

Introduction Conversion disorder (CD) is largely managed by primary care physician. A good knowledge of this disorder and a mastery of adequate therapeutic means will allow patients to recover promptly and reduce recurrences. Objectives To evaluate the management of CD by primary care physicians. Methods This cross-sectional and descriptive study involved 90 primary care physicians in the region of Sfax (Tunisia). We submitted a self-administered anonymous questionnaire to physicians to explore their practice towards patients with CD. Results Among the 90 doctors contacted, 54 (60%) responded to our questionnaire. Their age ranged from 25 to 70 years, with a median of 41 years. The sex ratio was 0.92. The average number of years of practice was 15 years (SD = 9.7). Half of the physicians reported that the consultation of a patient with CD lasted between 15 and 30 minutes. Faced with a first episode of CD, 61.1% of the doctors decided to treat the patient alone and 18.5% preferred to take the advice of a psychiatrist. In the case of a recurrence, 59.2% chose to refer the patient immediately to a psychiatrist. The use of pharmacological treatment was indicated by 64.8% of participants. Half of the doctors stated that they had difficulties in managing patients with CD. Conclusions According to our results, the management of CD by primary care physicians remained restrictive and difficult. It is therefore necessary to encourage primary care physicians to express the difficulties they encounter and to turn to their psychiatric colleagues for help. Disclosure No significant relationships.

Introduction Alexithymia, the lack of words to express emotions, is a common problem in multiple sclerosis (MS) patients. Objectives To investigate the prevalence of alexithymia in patients with MS and to evaluate the factors related to it, including depression. Methods We conducted a cross-sectional, descriptive and analytical study, which took place in the neurology department in Sfax (Tunisia). It involved MS outpatients in remission phase. Data collection was done using a form exploring sociodemographic, clinical and radiological characteristics. We used the Expanded Disability Status Scale (EDSS) to evaluate neurological impairments, the Toronto Alexithymia Scale (TAS-20) to assess alexithymia, and the Hospital Anxiety and Depression Scale (HADS) to assess depressive symptoms. Results Our study included 93 patients. They were married in 57% of cases. The total number of relapses ranged from 1 to 30, with a median of 5. The EDSS score ranged from 0 to 8. A temporal lesion on brain imaging was found in 29% of cases. MS patients had alexithymia in 58.1% of cases and depression in 26.9% of cases. Alexithymia was more frequent in unmarried patients (p = 0.028). Among clinical and radiological factors, the number of relapses was higher (p = 0.035), and temporal lesion was more frequent in alexithymic patients (p = 0.045). In this study, alexithymic patients were more depressed (p < 10-3). Conclusions According to our results, depression and alexithymia were found to be significantly inter-related in MS. Future longitudinal studies might better clarify the nature of this relationship in MS patients. Disclosure No significant relationships.

Introduction Primary care physicians tend to examine patients with conversion disorder (CD) first. A good knowledge of this disorder will allow an early diagnosis and avoid unnecessary investigations for the patient. Objectives To assess the knowledge of primary care physicians about patients with CD. Methods We conducted a cross-sectional and descriptive study among 90 primary care physicians in Sfax (Tunisia). We used an anonymous self-questionnaire for data collection. Results The response rate to our questionnaire was 60%. The participants’ age ranged from 25 to 70 years, with a median of 41 years. The sex ratio (M/F) was 0.92. The majority of physicians (75.9%) have practiced in the public sector. Among the respondents, 75.9% had theoretical training in CD, 14.8% had continuing medical education (CME), and 42.6% had hospital experience in a psychiatric department. The overall proportion of correct answers was 71.8%. The most recognised symptoms of CD were: dysphonia-aphonia, paresthesia or paresis. All doctors mentioned at least one criterion to distinguish CD from epileptic seizures and loss of consciousness. Conclusions There are some gaps in primary care physicians’ knowledge of CD. Thus, we propose to reconsider the conduct of CME, to favour small group training workshops with role-playing and to improve the collaboration between the psychiatrist and the primary care physician. Disclosure No significant relationships.

Introduction Covid-19 pandemic put parents under great pressure, and the most vulnerable parents may have become too overwhelmed to find appropriate ways to be supportive caregivers and to address children’s fears and insecurities. Objectives Assess the level of parental stress experienced by mothers during the COVID-19 pandemic and compare it with that experienced by fathers. Methods This was a descriptive and comparative analytical study, shared on social networks during the period from 8 to 20 April 2021, targeting mothers of children aged 2 to 18 years. The mother answered the questionnaire for herself and her child. The level of stress experienced by the mother in the parent-child relationship during the COVID-19 pandemic was assessed by the brief version of the Parental Stress Index (PSI-SF). Results The total number of participants was 65 mothers. Parental stress level in mothers was high in 58.5%, the average PSI score was 94.25; the mean score of the parental distress subscale was 34.06; the mean score of the dysfunctional child-parent interaction subscale was 27.86; and the average score of the child difficulty subscale was 32.32. The mean scores of the parental distress subscale, the child difficulty subscale, as well as the mean PSI total score were significantly higher in mothers than in fathers, with p= 0.010; p= 0.022 and p=0.017 respectively. Conclusions Our results highlight a higher level of stress in mothers than in fathers. This can be explained the parental, marital and professional responsibilities imposed on women, underlining the urgent need to provide mothers with adequate support. Disclosure No significant relationships.

Introduction Burnout is an occupational psychological syndrome induced by chronic stress defined by three dimensions: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Objectives Estimate burnout among residents and interns in Tunisia. Identify factors related to burnout. Methods We conducted a cross-sectional, descriptive, and analytical study between March 1 and April 15, 2021. Data collection among young physicians was done by a self-questionnaire published online. The assessment of the degree of burnout was done by the Maslach Burnout Inventory (MBI). Results The total number of participants was 56 of which 71.4% were women. The average age was 26.76 years. The pourcentage of the married was 21.4% of which 58.3% had children. 30.4% had parents in charge. Most of the participants worked in university hospitals and 75% of them in a medical department. Residents represented 64.3% of the participants. Number of working hours exceeded 40 hours per week in 60.7% of the cases with an average number of shifts per month estimated at 4.71±2.36. According to MBI, 94.6% of the participants had a score in favor of burnout, of which 19.6% was severe. The number of hours worked per week and the number of shifts per month were significantly associated with the presence of a burnout syndrome with respective correlation factors of 0.027 and 0.047. Conclusions Most residents and interns suffered from burnout with a variable degree of severity. The workload with a greater number of working hours and on-call duty favored the emergence of this burnout. Disclosure No significant relationships.

IntroductionEmigration is the act of leaving one’s country of nationality or habitual residence to settle in another nation. In Tunisia, this phenomenon is increasing in particular for doctors.ObjectivesEvaluating the intentionality of emigration among interns and medical residents in Tunisia while studying the factors related to it.MethodsWe conducted a cross-sectional, descriptive and analytical study of interns and medical residents who participated in our study through the social network ’Facebook’ by an anonymous self-questionnaire. The level of satisfaction with the different aspects of life were assessed by a 5-point Likert scale, from “not at all satisfied” to “very satisfied”.ResultsThe total number of participants was 56 of which 64.3% were medical residents. More than 50% of the participants expressed dissatisfaction with the distribution of tasks and organization of work (66.1%), safety at work (53.6%), comfort (57.2%), time allocated to personal life (53.6%) and salary (69.6%). The political, health and educational situation in the country was considered unsatisfactory by the majority of participants (90% to 95%). Among our participants, 44.6% regretted having chosen the profession of medicine and 53.6% had plans to immigrate to work abroad. The intentionality of immigration was significantly higher among men (p=0.02), those with siblings abroad (p=0.047) and those without dependent relatives (p=0.040).ConclusionsYoung physicians are strongly looking for emigration. This decision could emanate from professional, personal and political factors. Further studies seem to be necessary to explain this emigration phenomenon.DisclosureNo significant relationships.

IntroductionAnxiety and depression are among the most common psychiatric comorbidities in multiple sclerosis (MS) patients. These disorders could lead to significant emotional disturbances.ObjectivesTo study the different dimensions of alexithymia in patients with MS and determine their relationship with anxiety and depression.MethodsOur study, descriptive and analytical, focused on patients followed for MS at the neurology department in Sfax (Tunisia). In addition to collecting sociodemographic data, we used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depressive symptoms and the Toronto Alexithymia Scale (TAS-20) to assess alexithymia and its three dimensions: difficulty identifying emotions (DIE), difficulty differentiating emotions (DDE), and externally oriented thinking (EOT).ResultsThis study included 93 patients followed for MS. Our results showed a prevalence of 58.1% for alexithymia, 38.7% for anxiety and 26.9% for depression. The median score of the dimension DIE was 22. The median score of the dimension DDE was 17. The mean score for the dimension EOT was 26.96 ± 4.18. Alexithymic patients were more anxious and depressed (p = 0,002 and p < 10-3, respectively). Both dimensions DIE and DDE were associated with anxiety (p = 0.001 and p = 0.022, respectively) and depression (p < 10-3 and p < 10-3, respectively). Non-depressed patients had a higher score on the EOT dimension (p = 0.003).ConclusionsOur results showed a relationship between depression, anxiety and alexithymia, hence the importance of looking for alexithymia in MS patients with anxiety or depressive symptoms.DisclosureNo significant relationships.

Introduction Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS). It can be defined as a subjective lack of physical and mental energy. Objectives To study the prevalence of fatigue in patients with MS and to determine the factors related to it, including depression. Methods This was a cross-sectional, descriptive and analytical study, which took place in the neurology department in Sfax (Tunisia). It focused on patients with MS in remission phase. We used the Expanded Disability Status Scale (EDSS) to determine the degree of disability caused by MS, the Chalder Fatigue Scale to evaluate the fatigue, and the Hospital Anxiety and Depression Scale (HADS) to assess depressive symptoms. Results The 93 patients included in the study had a mean age of 36.59 ± 10.69 years. The socio-economic level was low to medium in 52.7% of cases. The EDSS score ranged from 0 to 8 (median = 3.5). The total number of relapses ranged from 1 to 30 (median = 3.5). MS patients had fatigue in 72.4% of cases and depression in 26.9% of cases. Patients with a low to medium socio-economic level were more fatigued (p=0.027). High number of MS relapses, severity of disability on the EDSS, and presence of depression were associated with fatigue (p=0.014, p<10-3 and p=0.001, respectively). Conclusions In MS patients, fatigue is a common symptom. Patients with reduced physical activity and greater MS-related disability have more severe fatigue, which negatively affects psychosocial functioning, increasing the risk of depression. Disclosure No significant relationships.

IntroductionSchizophrenia, with its high prevalence, chronic progression and social impact, is a major challenge for health professionals. For this reason it is important to assess the impact of this disease on these patients, mainly on their quality of life.ObjectivesTo study the quality of life in patients with schizophrenia and determine the factors correlated with it.MethodsA cross-sectional, descriptive and analytical study of 28 patients with schizophrenia followed up at the psychiatric consultation in Hédi Chaker University Hospital of Sfax. Data collection was performed using a sheet exploring socio-demographic and clinical data. We used the Quality of Life Scale (Q-LES-Q-SF).ResultsThe average age of our patients was 40.61±6.27 years. The sex ratio (M/F) was1.15. The socioeconomic level was low in 71.4%. The average number of relapses was 3.04±1.4. Follow-up and compliance were good in 28.6% of cases. The average number of hospitalizations was 3.04±1.4. The average of quality of life in patients with schizophrenia was 21±5.74. The quality of life was affected with age (p=0.023), with the high number of relapses and with a higher number of hospitalizations in psychiatric hospital (p=0.008). Quality of life was improved with regular follow-up and good adherence to the treatment (p=0.000).ConclusionsThe quality of life in mental disorders was impaired mainly in schizophrenics, hence the need to evaluate in a codified way the quality of life of our patients in order to raise awareness among general practitioners as well as psychiatrists to improve the therapeutic and social care of patients.

IntroductionPsoriasis is a chronic inflammatory skin condition affecting diverse racial/ethnic groups throughout the world. It has a major impact on the patient’s quality of life, influencing career, social activities, family relationships, and all other aspects of lifeObjectives To evalue the quality of life in patients with psoriasisMethods Participants were outpatients of Hedi chaker University Hospital Center in sfax, Tunisia, recruited between January and July of 2017, diagnosed with psoriasis. A Demographic questionnaire and the Quality of life Questionnaire (SF-36) were administered in this study.Results44 patients were included in this study. They had with a mean age of 45.8 ±12.1. The majority of patients were married (70.5%), unemployed (40.5%), without medical heredity (84,6%). Psoriasis was in plaque (65.9%), guttate (20.5%) and pustular(13.6.5%). Its severity assessed by BSA, was mild to moderate in 72.7% of cases and associated arthropathy was noted in 29.5% of patients. The overall average SF-36 scale scores for all patients ranged from 4 to 98 with an average of 55.97. The quality of life of patients was impaired in 45.5% of casesQuality of life was significantly more impaired in patients with associated arthropathy (p=0.004). There is no significant differences for the different dimensions of quality of life regarding the clinical form of psoriasis.ConclusionsPsoriasis certainly has an impact on patients’ quality of life.So, dermatologists should give special attention to this subgroup of persons in order to prevent future psychopathology.

Introduction Benzodiazepines (BZD) are widely used in patients with bipolar disorder (BD) and their effectiveness is well documented. Therefore, there are major risks associated with BZD use including abuse and dependence. Those risks can be related to the patients’chacteristics, the particularities of BD and the prescribers.ObjectivesTo determine the factors associated with chronic use of BZD in patients with BD.MethodsWe conducted a cross-sectional, descriptive and analytical study among a sample of patients with BD (DSM-5) followed in psychiatric outpatient of Hedi Chaker university hospital in Sfax. We used the Benzodiazepine Cognitive Attachment Scale (ECAB) to determine dependent patientsResultsAmong the 61 included patients, 50 (82%) had a chronic use of BZD (> 3 months). They had a mean age of 49.3 years (± 14.02 years) and a low socio-economic level in 44%. The type of BD was dominated by type II (66%). Initial episode type was depressive in 78%. The average number of depressive episodes was 2.92±2.3. A rate of 65.5% of patients have already attempted BZD withdrawal. Chronic BZD use was significantly correlated with BZD dependence (p=0.000), low socioeconomic level (p=0.04), depressive type of the initial episode (p=0.011), the depressive recurrence (p=0.000) and the absence of any attempt to discontinue BZD (p=0.011).ConclusionsChronic use of BZD in patients with BD is prevalent. In order to minimize this problem in this population, it is important to enhance programs to improve psychiatrist-prescribing behavior and to use cognitive-behavioral therapies in combination with medication to help withdrawal.

IntroductionThe recurrence of bipolar disorder due to poor treatment adherence can be explained by different factors.The poor awareness of the disorder seems to be the major cause.ObjectivesTo evaluate insight in patients followed for euthymic bipolar disorders and determine the factors correlated with it,mainly the self-esteem.MethodsA cross-sectional descriptive and analytical study of 33 euthymic subjects with bipolar I and II disorders (DSM 5) and followed up at the psychiatric consultation in Hédi Chaker university Hospital of Sfax.Data collection was performed using a sheet exploring socio-demographic and clinical data. We used Birchwood insight scale to assess the quality of insight and Rosenberg’s Self-Esteem scale.ResultsThe average age of our patients was 44,52±12,99 years old.The sex ratio =0.32.Patients were followed for bipolar I disorder(60.6%).The first episode of the disease was depressive in(51.5%) of cases.The average number of depressive episodes was1.97±1.87.The last episode was depressive in(57.6%) or manic in(42.4%).There were no psychotic characteristics in(42.4%) of cases.The patients had good insight in(54.5%).The average of self-esteem score was27±7.85and it was low in 51.5% of cases.Factors correlated with good insight were bipolar II disorder(p=0.001), high number of depressive episodes(p=0.013) and absence of psychotic characteristics(p=0.003) during the last episode.In addition,good insight was significantly associated with low self-esteem(p=0.023).ConclusionsOur study shows that a poor insight depends mainly on the clinical characteristics of bipolar disorders. Moreover,low self-esteem seems to be linked to it. For this reason, our attention should be focused on psychoeducation to improve insight, especially during episodes, in order to facilitate integration and increase patients’ self-esteem.

Mesurer en spectral domain OCT (OCT-SD), l'épaisseur choroïdienne fovéolaire chez les patients myopes forts présentant un glaucome primitif à angle ouvert et de la comparer à des yeux myopes forts sans glaucome. Nous avons mené une étude transversale qui a concerné 48 yeux myopes forts glaucomateux appariés selon l'âge, l'épaisseur cornéenne centrale et l'équivalent sphérique avec 48 yeux myopes forts non glaucomateux. Les examens en OCT ont été réalisés par l'appareil OCT spectral domain (OCT Topcon 2000). L'épaisseur choroïdienne fovéolaire a été mesurée manuellement entre la membrane de Bruch et la portion interne de la sclère. Dans le groupe sans glaucome, apparié avec le groupe avec glaucome selon l'âge (p = 0,57), l'épaisseur cornéenne centrale (p = 0,33) et l'ES (p = 0,10), l'épaisseur choroïdienne fovéolaire était de 96,32 μm ± 39,56 μm. Dans le groupe avec glaucome, l'épaisseur choroïdienne fovéolaire était de 50,44 μm ± 16,36 μm. L'épaisseur choroïdienne sous-fovéolaire était significativement plus basse dans les yeux myopes forts glaucomateux par rapport aux yeux myopes forts sans glaucome (p = 10−4). L'épaisseur choroïdienne fovéolaire est diminuée chez les myopes forts glaucomateux. L'amincissement choroïdien peut être un paramètre utile pour le diagnostic et le suivi des myopes forts glaucomateux. To measure macular choroidal thickness (CT) using spectral domain optical coherence tomography (OCT) in high myopic eyes with primary angle-open glaucoma (POAG), and to investigate whether the choroid is thinner in these eyes compared to high myopic eyes without glaucoma. We conducted a cross-sectional study of forty-eight eyes with high myopic glaucoma matched with 48 highly myopic eyes without glaucoma by age, central corneal thickness and axial length (AL). OCT scans were performed with the spectral domain OCT (Topcon 2000). The subfoveal CT was measured between the Bruch membrane and the internal aspect of the sclera. In the subgroup without glaucoma, matched with the subgroup with glaucoma (P = 0.57), by age, central corneal thickness (P = 0.33) and AL (P = 0.10), the mean subfoveal CT was 96.32 μm ± 39.56 μm. In the subgroup with glaucoma, the mean subfoveal CT was 50.44 μm ± 16.36 μm. The comparison between the two subgroups found a statistically significant difference in subfoveal CT (P < 10−4). Foveal choroidal thickness is reduced in highly myopic eyes with glaucoma. The choroidal thinning can be a useful parameter for the diagnosis and the follow-up of highly myopic patients with glaucoma.

PURPOSE:To measure macular choroidal thickness (CT) using spectral domain optical coherence tomography (OCT) in high myopic eyes with primary angle-open glaucoma (POAG), and to investigate whether the choroid is thinner in these eyes compared to high myopic eyes without glaucoma. PATIENTS AND METHODS:We conducted a cross-sectional study of forty-eight eyes with high myopic glaucoma matched with 48 highly myopic eyes without glaucoma by age, central corneal thickness and axial length (AL). OCT scans were performed with the spectral domain OCT (Topcon 2000). The subfoveal CT was measured between the Bruch membrane and the internal aspect of the sclera. RESULTS:In the subgroup without glaucoma, matched with the subgroup with glaucoma (P=0.57), by age, central corneal thickness (P=0.33) and AL (P=0.10), the mean subfoveal CT was 96.32 μm ± 39.56 μm. In the subgroup with glaucoma, the mean subfoveal CT was 50.44 μm ± 16.36 μm. The comparison between the two subgroups found a statistically significant difference in subfoveal CT (P<10(-4)). CONCLUSIONS:Foveal choroidal thickness is reduced in highly myopic eyes with glaucoma. The choroidal thinning can be a useful parameter for the diagnosis and the follow-up of highly myopic patients with glaucoma.

Purpose To investigate the correlation of retinal thickness measured with SD OCT and visual acuity in eyes with diabetic macular edema ( DME ) before and after intravitreal injection of anti‐ VEGF Methods Seventy‐four patients (96 eyes) with DME who underwent three monthly intravitreal injection of bevacizumab ( IVB ) as their first treatment. Type of DM , duration, treatment, laboratory examinations, history of cardiovascular disease, hypertension, hyperlipidemia, diabetic nephropathy, were documented. Logarithm of the minimum angle of resolution (log MAR ) best corrected visual acuity ( BCVA ) was evaluated using the international vision test chart. Foveal thickness was measured by SD OCT . Results The correlation coefficients for visual acuity ( VA ) versus OCT center point thickness were 0.57 at baseline and 0.47, 0.38, and 0.40 at 1, 3, and 6 months post‐laser photocoagulation. A subset of eyes showed paradoxical improvements in VA with increased center point thickening (5–13% at the three time points) or paradoxical worsening of VA with a decrease in center point thickening (12–24% at the three time points). Conclusions There is modest correlation between OCT ‐measured center point thickness and VA , and modest correlation of changes in retinal thickening and visual acuity following focal laser treatment for DME . In addition, paradoxical changes in VA and retinal thickening may be observed. Indeed, retinal thickness only accounts for up to 27% of variability in concurrently measured VA suggesting that other factors are important determinants of VA in the presence of diabetic macular edema.

To investigate the correlation ofhyperreflective foci, photoreceptor integrity and visual acuity (VA) in patients with diabetic macular edema (DME). Seventy-eight patients (114 eyes) with DME were analyzed retrospectively with Spectral-domain optical coherence tomography (SD-OCT). SD-OCT showed that 28 eyes (24.5%) had hyperreflective foci in the inner retinal layers, and 66 eyes (57.9%) had hyperreflective foci in the outer retinal layers. The logMAR VA was significantly (P < .0001) worse in eyes with hyperreflective foci in the outer retinal layers than in eyes without them (0.478 ± 0.241 vs 0.133 ± 0.233, respectively). Disruption of the ellipsoid zone and ELM line on OCT were significantly (respectively P < .0001 and P < .0001) associated with both hyperreflective foci in the outer retinal layers and poor logMAR VA. The presence of hyperreflective foci in the outer retina is closely associated with a disrupted ELM and ellipsoid zone on SD-OCT images and decreased VA in DME.