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To present the efficacy of autologous neurosensory retinal transplantation in macular holes surgery with rhegmatogenous retinal detachment. Eleven eyes of 11 patients with rhegmatogenous retinal detachment associated to a large macular hole were enrolled between January 2019 and January 2021 in the Department A of the Hedi Rais Institute of Ophthalmology (Tunis, Tunisia). All patients underwent a 23 G pars plana vitrectomy. An autologous neurosensory retinal patch was placed inside the macular hole. Long-acting silicone tamponade was carried out. Clinical features of the macular area, best-corrected visual acuity (BCVA), fundus examination, and SD-OCT were recorded before surgery, at 1- and 3-month follow-up after surgery. The mean age of our population was 56.6 ± 10.33 years old, ranged from 45 to 76 years old. Final retinal reattachment was achieved clinically in all eyes. The Spectral domain-Optical Coherence Tomography (SD-OCT) follow-up showed the macular hole closure. The retinal patch was demonstrated by OCT at each control. BCVA improved from 1.52 ± 0.23 Logarithm of the Minimum Angle of Resolution (LogMAR) to 0.89 ± 0.16 LogMAR 3 months after surgery (p= 0.014). No adverse events were registered during the study. Autologous neurosensory retinal transplantation has been efficient to treat macular hole associated to rhegmatogenous retinal detachment. Further multicentric studies with a large number of patients are needed to establish the results of this technique in complex cases. [ABSTRACT FROM AUTHOR]

To describe a case of outer retinitis with frosted branch angiitis associated with mumps infection treated with hyperbaric oxygen (HBO) therapy. Observational case report A four-year-old boy with bilateral blindness was diagnosed with necrotizing outer retinitis with frosted branch angiitis associated with serologically confirmed mumps virus infection. He was treated with HBO therapy. Visual acuity subsequently improved to 20/40 in the right eye and to 20/320 in the left eye. Sequential follow-up optical coherence tomography examinations showed progressive recovery of the outer retinal layers in the right eye. HBO therapy appears to be a feasible and safe treatment that might improve the anatomical and functional outcome in patients with mumps retinitis. [ABSTRACT FROM AUTHOR]

To report the case of a surgical-induced necrotizing scleritis (SINS) following vitreoretinal surgery for rhegmatogenous retinal detachment, successfully managed by superficial muscle temporal fascia grafting. An 18-year-old teenager, with a history of a 23G vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment of the left eye, presented with intense left ocular pain, decreased visual acuity to counting fingers and eye redness. Split lamp examination showed: Conjunctival infiltration with silicone oil, circumferential sclera thinning with ectasia of the underling uvea. The fundus examination showed an attached retina. Necrotizing scleritis was the retained diagnosis. SINS was the final diagnosis. An immunosuppressive therapy was started. Superficial muscle temporal fascia grafting was performed to cover the necrotizing sclera. The patient did well postoperatively without sclera thinning or ectasia and the fascia grafting still intact without retraction after 6 months of follow-up. This is the first case in the literature that used the superficial temporal muscle fascia as a graft for sclera reinforcement in SINS. We propose new support to reinforce the deficient sclera. This graft must be associated with prompt immunosuppressive therapy at high doses. [ABSTRACT FROM AUTHOR]

To report the case of a surgical-induced necrotizing scleritis (SINS) following vitreoretinal surgery for rhegmatogenous retinal detachment, successfully managed by superficial muscle temporal fascia grafting. An 18-year-old teenager, with a history of a 23G vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment of the left eye, presented with intense left ocular pain, decreased visual acuity to counting fingers and eye redness. Split lamp examination showed: Conjunctival infiltration with silicone oil, circumferential sclera thinning with ectasia of the underling uvea. The fundus examination showed an attached retina. Necrotizing scleritis was the retained diagnosis. SINS was the final diagnosis. An immunosuppressive therapy was started. Superficial muscle temporal fascia grafting was performed to cover the necrotizing sclera. The patient did well postoperatively without sclera thinning or ectasia and the fascia grafting still intact without retraction after 6 months of follow-up. This is the first case in the literature that used the superficial temporal muscle fascia as a graft for sclera reinforcement in SINS. We propose new support to reinforce the deficient sclera. This graft must be associated with prompt immunosuppressive therapy at high doses., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Middle East African Journal of Ophthalmology.)

Background: to assess clinical factors that may influence the prognosis of malignant melanoma of the uvea, Methods: We conducted a retrospective study from January 1990 to December 2013, involving 80 patients suffering from malignant melanoma of the uvea. We determined the location, the size, the tumor thickness, the clinicopathological aspect, the degree of pigmentation of the uveal melanoma, and associated signs Results: Factors significantly associated with poor prognosis were: a tumor location (p = 0.01), the infiltrative or fungus aspect (p = 0.001), a diameter equal to or larger than 10 mm (p = 0.003), the thickness greater than or equal to 5 mm (p = 10-3), achromatic or hyperpigmented melanomas (p = 0.02) and retinal detachment (p = 10-3)., Conclusion: Clinical prognostic factors are important to know because they determine the evolutionary profile and the metastatic potential of the uveal melanoma.

Background: Thanks to the recent advances of the microsurgical techniques, the results of the congenital cataract surgery in children less than 5 years old have considerably improved. However, the age of implantation and the intraocular lens power calculation remain subjects of controversies., Aim: To evaluate the results of 2.2 mm micro-incision congenital cataract surgery in children less than five years old., Methods: Forty seven consecutive eyes of 26 children who had dense congenital cataract surgery were included in this retrospective study. All children had had the same surgical procedure: anterior approach through 2.2 mm corneal tunnel, posterior capsulorhexis associated to anterior vitrectomy and a primary foldable intraocular lens implantation. The final evaluation was at the same time anatomical and functional depending on the children age., Results: The median patient age of the children was of 23 months (6 to 54 months) and the sex ratio was 1.36 (15 boys / 11 girls). The cataract was bilateral in 77.7 % of the cases (21/27 children). The intraocular lens was implanted in the capsular bag in 93.6 % of the cases (44/47 eyes) and in the sulcus in 6.3 % of the cases (3/47 eyes). The postoperative complications were mild: inflammatory reaction limited to the anterior chamber in 17 % of the cases (8/47 eyes), opacification of the visual axis with a reproliferation of the epithelial cells behind the implant was observed in 4.25 % of the eyes (2/47 eyes). We noted no case of intraocular lens decentration or secondary glaucoma. The study of the refraction at last follow up showed a sphere average of 2.73 ± 1.21 diopters and mean astigmatism of 1.51 ± 0.82 diopters. The median best corrected distance visual acuity, evaluated in 12 children, was 5.2/10 ranging from 1/10 to 10/10. The amblyopia was also noted to 12/26 children (46.1 %). Among these children, 11/12 (91.6%) had a delay of surgery and 5/12 (41.6 %) had an unilateral cataract., Conclusion: Currently the anatomical prognosis of the congenital cataract surgery in children less than 5 years old is getting closer to that of the adult. However, the functional prognosis remains still unpredictable depending mainly on the deadline of surgery which remains very late in our series. Thanks to the improvement of the surgical techniques using microincision in cataract surgery and the new generation of foldable implants, the anatomical and functional prognosis of the congenital cataract have significantly improved.

Fungal keratitis is a serious disease involving the visual prognosis. This pathology is not well known in Tunisia. The aim of our study is to determine epidemiological data and clinical and mycological characteristics of fungal keratitis in the area of Tunis (North of Tunisia) and discuss its therapeutic modalities. This is a retrospective study including 19 cases of fungal keratitis collected over a period of 11 years (January 1998-December 2008). The diagnosis of keratomycosis was based on clinical and mycological data. Mycological examination interested corneal scraping including direct examination and culture. The cases of fungal keratitis concerned 13 men and 6 women with a mean age of 48.7 years. The most common risk factors was corneal trauma (47.4%). The mean delay between the first ophthalmic signs and consultation was 17.7 days. Most frequently fungal isolated fungi were Candida albicans (6 cases), followed by Aspergillus spp (5 cases) and Fusarium spp (4 cases). All patients received topical and systemical antifungal therapy. The evolution was favourable in six cases. Three patients retained corneal scars. The surgery was necessary in 7 cases, consisting of a penetrating keratoplasty (5 cases), an enucleating (1 case) and amniotic membrane transplantation (1 case). In conclusion, despite the improvement of diagnosis and treatment of fungal keratitis, its prognosis remains pejorative. This prognosis depends on early diagnosis and choice of antifungal therapy.

Introduction: Acanthamoeba keratitis is a rare but severe disease that can cause blindness. The objective of this study is to call attention to its severity and conditions of development and to emphasize the importance of early treatment., Case Report: We report a case of a 27-year-old woman. After wearing soft contact lenses for a month, she consulted for redness, pain and poor visual acuity in her left eye. The ophthalmological examination showed an epithelial corneal abscess measuring 2 mm in diameter in the left eye and very tiny epithelial corneal abscesses in the right eye. Microscopic examination and culture of samples from the contact lenses and the contact lens solution found Acanthamoeba spp. Rapid anti-amoeba treatment led to disappearance of the corneal abscesses and improvement of her vision., Conclusion: This case confirmed that the prognosis of Acanthamoeba keratitis depends on rapid diagnosis and early treatment.