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Purpose. Investigating the efficacy of intravitreal injection of erythropoietin (EPO) in managing indirect traumatic optic neuropathy (ITON) of different durations. Methods. A case series that included two groups of ITON patients: recent ITON group (<3 months trauma duration; 7 eyes) and old duration ITON group (3–36 months; 7 eyes). Diagnostic computerized tomography (CT) and baseline flash visual evoked response (VER) were performed at the presentation time. At the initial visit and each follow-up, all patients had undergone assessment of best-corrected visual acuity (BCVA), pupil reaction, and anterior and posterior segments. VER was repeated 1 and 3 months after injection. All patients received an intravitreal injection of 2000 IU EPO in 0.2 ml of commercially available sterile EPREX 4000 solution, Jansen Cilag, Zug, Switzerland. Five patients had received a second injection 3 months later. Results. Significant improvement was found in BCVA, VER amplitude, and latency (P<0.0001, 0.0154, and 0.0291, respectively). Initial values of BCVA, VER amplitude, and latency correlated significantly to the final values. Differences between recent and old trauma groups were insignificant in the three parameters. In patients who received second injection, further clinical but statistically insignificant improvement was noted in BCVA in 60% of patients, VER amplitude in 50% of patients, and in VER latency in 100% of patients. No complications were recorded. Conclusion. Intravitreal injection of EPO may be effective and safe in treatment of recent and old indirect traumatic optic neuropathy. [ABSTRACT FROM AUTHOR]

Objective. To measure the prevalence of amblyopia and amblyogenic factors among primary school children and to evaluate distance visual acuity (VA) as a screening test to detect amblyopia and define its cutoff value. Subjects and Methods. A cross-sectional study was conducted on primary school children in two schools in Central Cairo. Children underwent assessment of visual acuity using Landolt broken ring. Comprehensive ophthalmologic examination was performed for amblyopia suspects at the Ophthalmology Department of Ain Shams University Hospitals, including reassessment of best-corrected visual acuity (BCVA) using the same chart. Results. A total of 352 children were examined. Reduced screening VA (amblyopia suspect) was detected in 47 subjects (13.35%) proved amblyopia after comprehensive examination was 1.98% (7 cases). Refractive errors (REs) were present in all suspected and proved amblyopia cases (100%) but was only present in 11.6% of nonamblyopic students (P<0.05). The prevalence of hyperopia in the whole sample was 3.6%, and was 27.6% in subjects with RE. Thirty percent of hyperopic eyes were amblyopic. The prevalence of myopia was 9.3% of the whole sample and 70% of students with RE. Only 9% of myopic eyes were amblyopic. Mild to moderate amblyopia (VA better than 0.2log MAR) was 42.9%, while severe amblyopia represented 57.1%. Conclusion. This study emphasizes the importance of school-based eye care system targeting the detection of amblyopia by application of a fast screening distance VA test with a cutoff value of high sensitivity at log MAR 0.539 (Snellen′s VA equivalent 6/18). [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To study the pattern of ocular aberrations in amblyopic children, and evaluate a possible relation to etiology and treatment outcomes of amblyopia. Methods: The WaveScan Wavefront System (AMO, Santa Ana, CA, USA) aberrometer was used to assess 75 eyes (60 children) after instillation of 1% cyclopentolate eyedrops. There were 29 males and 31 females with a mean age of 9.23±2.55years (range, 5–14years). The study sample was subdivided into four groups; 16 emmetropic non-amblyopic eyes (control group); 24 pre-treatment newly diagnosed amblyopic eyes; 16 eyes of treated amblyopes and; 19 eyes with refractory amblyopia. Results: Amblyopes had statistically significant greater root mean square (RMS) values for whole eye aberrations, 2nd order aberrations, defocus ( ) and astigmatism ( ) compared to emmetropes (P <0.0001). The refractory amblyopic group showed statistically significant differences in whole eye RMS, 2nd order- aberrations, defocus ( ) and astigmatism ( ) when compared to treated amblyopic groups (P <0.0001). Apart from a statistically significant difference in 5th order RMS of pre-treated amblyopes versus the control group, no other significant differences were found in higher order aberrations (HOAs: coma, spherical, higher-order astigmatism, trefoil, or 3rd, 4th, 5th or 6th order terms) between emmetropes and any of the amblyopic groups. Conclusion: Lower order aberrations remain the major factor that affect retinal image quality and hence amblyopia development especially in ametropic eyes. This can be corrected optically. Studying HOA profile in amblyopic eyes failed to explain why refractory amblyopia does not respond to orthoptic treatments. This outcome indicates that theories of central problems in image processing and binocular interaction are likely the main cause of refractory amblyopia. [Copyright &y& Elsevier]

Purpose: This study aims to detect and compare the severity and pattern of dry eye occurrence after phacoemulsification and extra capsular cataract extraction surgeries. Methods: Twenty eyes of twenty patients in two groups, ten eyes planned for Phacoemulsification(phaco) and ten eyes planned for Extra Capsular Cataract Extraction (ECCE) enrolled in a prospective comparative study. All patients underwent full history taking and full ophthalmological clinical evaluation including (tear film meniscus height, Schirmer 1 test, tear break up time). Evaluations will be done one week before cataract surgery then three and six weeks after the surgery.Also, goblet cell count is measured twice, before and 6 weeks after the operation. Results: After both Phaco, andECCE, the changes between means of pre-operative, 3 weeks and 6 weeks visits were significant in tear film meniscus height (p ¼ 0.01) and were insignificant in both Schirmer 1 and tear break up time (p > 0.05). There was a significant deterioration after 3 weeks of surgery in tear film meniscus height followed by significant increase between 3rd and 6th weeks post-operative measurements (p ¼ 0.01). There was a significant difference between the 2 groups in the total change of Schirmer 1 and tear break up time between the6th weeks and the pre-operative measure with more deterioration in group 2. There was no significant difference between the 2 groups in tear film meniscus height 6 weeks post operation.The deterioration in goblet cell count was significantly worse in the ECCE group (mean difference of -22.168.5 and was -7.565.1 in the phaco group), (p ¼ 0.0005). Conclusions: Phacoemulsification surgery may aggravate the signs and symptoms of dry eye and affect dry eye test values in patients in short-term but less than ECCE. [ABSTRACT FROM AUTHOR]

Aim of the work: this study aimed to evaluate changes in photoreceptors, inner segment/outer segment (IS/OS) junction and external limiting membrane (ELM) following grid argon laser versus intravitreal injection of antivgef (Ranibizumab) in diabetic type2 patients affected by clinically significant macular edema. Methods: forty eyes of diabetic type 2 patients who were affected by clinically significant macular edema were randomly categorized into two groups(Group treated by argon grid laser and group treated by intravitreal injection of antivgef for the first time) both groups were investigated for best corrected visual acuity (BCVA) and the integrity of the photoreceptors, IS/OS and ELM as being (Continuous(+), interrupted(±) or Absent (-)) by spectral-domain optical coherence tomography (SD-OCT)(CIRRUS HD-OCT) before treatment, 1month, 2months and 3months after treatment. Other variables, included central macular thickness (CMT) and central macular volume (CMV) were evaluated. Results: significant difference was found between [photoreceptor, is/os] (+), photorecptor, is/os (+,-) and photoreceptor, is/os (-) groups in BCVA at baseline; it was 0.61,0.73, and 1 and after 6 months it was 0.48,0.73 and 1. Results were similar for ELM groups. Signiant difference was found between ELM (+), ELM (+,-) and ELM (-) groups in BCVA at baseline it was 0.59,0.72, and 1 and after 6 months it was 0.46,0.68 and 1 in lucentis group and signiant difference was found between photoreceptor, is/os (+) and photorecptor, is/os (+,-) groups in BCVA at baseline was(0.32and 0.3 and after 6 months it was 0.27 and 0.3. Results were similar for ELM groups. Signiant difference was found between ELM (+) and ELM (+,-) groups in BCVA at baseline it was 0.29 and 0.5 and after 6 months it was 0.25 and 0.4 in argon laser group. Conclusion: the more damage of outer retinal layers at the time of DME the lower visual acuity following DME resolution and the presence of intact of these layers is an important factor in determining final visual acuity. [ABSTRACT FROM AUTHOR]