Purpose The aim of this study was to compare the corneal hysteresis (CH) and corneal resistance factor (CRF) after small-incision lenticule extraction (SMILE) and photorefractive keratectomy (PRK). Patients and methods Fifty-six eyes of 28 patients were included in this study. The study eyes had myopia or myopic astigmatism with spherical equivalent less than or equal to −6 D. They were divided into two groups: group I (28 eyes of 14 patients) was corrected using the SMILE technique and group II (28 eyes of 14 patients) was corrected using the PRK technique. CH and CRF were measured in all eyes preoperatively and postoperatively using the ocular response analyzer instrument. Best-corrected visual acuity, spherical equivalent, and central corneal thickness were documented preoperatively and postoperatively in each follow-up visit. All patients were followed up at 3, 6, and 12 months postoperatively. Results The mean patients’ age was 23.8±4.2 years in group I and 24.1±4.7 years in group II (P=0.85). In the SMILE group, CH changed from 10.57±0.38 preoperatively to 8.6±0.26 at 12 months postoperatively (P<0.001), whereas in the PRK group it decreased from 10.7±0.4 to 8.7±0.26 (P<0.001). CRF changed from 10.21±0.1 to 8.4±0.2 and from 10.2±0.11 to 8.5±0.22 after SMILE and PRK, respectively (P<0.001). There were no significant changes in corneal biomechanical factors between SMILE and PRK after 12 months (P=0.1). Conclusion CH and CRF decreased after SMILE and PRK. There were no differences between SMILE and PRK treatments in postoperative CH or CRF values.

Purpose The aim of this study was to compare the efficacy and safety of intraoperative infiltration versus topical application of 5-fluorouracil (5-FU) as an adjuvant drug in pterygium treatment. Design The study design was a prospective interventional comparative case series. Patients and methods A total of 100 consecutive cases of pterygia in 95 patients (64 primary and 36 recurrent) were subjected to pterygium excision with the bare sclera technique. The cases were equally divided into two groups (A and B) according to the method of application of the adjuvant 5-fluorouracil (5-FU). Group A included fifty eyes and received intraoperative infiltration of 0.5 ml of 5-FU (50 mg/ml) at the end of the surgical procedure. Group B included fifty eyes and received intraoperative topical application of 5-FU (50 mg/ml) for 5 min during the surgical procedure. Postoperative follow-up was carried out at days 1, 7 and 14, and monthly thereafter for at least 6 months. Postoperative regrowth of fibrovascular tissue crossing the limbus was defined as recurrence. Data were evaluated and statistically analyzed. Results All the pterygia were in a nasal location and all the treated pterygia extended 2 mm or more into the cornea. Postoperatively, pterygium recurrence was observed in 14% in group A and 20% in group B, a statistically insignificant difference (P>0.05). With regard to postoperative complications, the difference was also statistically nonsignificant (P>0.05). Conclusion Infiltration of 5-FU rather than topical application as an adjuvant to pterygium surgery is easy, time saving, and does not necessitate copious irrigation with saline as with topical application with comparable results and postoperative complications.

Purpose The purpose of this paper is to evaluate differences between IOL master and A-scan regarding axial length (AXL) and predicted IOL power in different types of cataract. Patients and methods Forty eyes of 40 patients underwent examination by IOL master and A-scan, where average K-reading, AXL and predicted IOL power were compared. Results Forty eyes of 40 patients were included. The mean AXL measured by IOL master was higher (26.18±2.92 mm) than that with A-scan (26.02±2.99 mm) with a mean difference of 0.2±0.44 mm (P=0.07). The mean predicted IOL power was 11.61±8.33 D with IOL master versus 12.01±8.23 D with A-scan (P=0.03). However, no statistically significant difference was found regarding average K-readings and predicted postoperative refraction (P=0.4 and 0.7, respectively). Bland–Altman plots showed almost perfect agreement between both methods regarding AXL and predicted IOL power. Further subgroup analysis revealed a statistically significant difference in AXL between both devices only in nuclear cataract with no significant difference in cases with complicated cataract to myopia or silicone oil (P=0.013, 0.2 and 0.1, respectively). No statistically significant difference was found between the three groups regarding the calculated IOL power (P=0.34, 0.13 and 0.15, respectively). Bland–Altman analysis showed almost perfect agreement for the mean difference of AXL and IOL power in the three subgroups. Conclusion There is no significant difference between IOL master and A-scan biometry, with the noncontact IOL master being preferred by patients; however, there exists certain situations where A-scan is still mandatory.

Aim The aim of this study was to evaluate the fundus changes in thalassemic patients in Giza and Fayoum Governorates. Patients and methods Thirty thalassemic patients recruited from the Pediatric Hematology Clinic in Fayoum University Hospital, Misr University Hospital, and NILES Pediatric Clinic were included in the present study. All patients underwent complete ophthalmic examination and laboratory investigations. Results The mean age was 10.7±5.9 (6–36) years. There were 20 male patients (66.7%), with a mean duration of disease of 7.1±7.1 years (3 months to 36 years). Patients were classified on the basis of hemoglobin (Hb) level into two groups: 7 g/dl or less (thalassemia major) and greater than 7 g/dl (thalassemia intermediate and thalassemia minor). There was a significant correlation between cup/disc (C/D) ratio and Hb level (P<0.05) and a nonsignificant correlation with color vision defect, retinal venous tortuosity, and arteriovenous (A–V) crossing changes. A highly significant correlation between serum ferritin and color vision defect (P=0.001), increased cup/disc ratio (P=0.001), venous tortuosity (P=0.001), and A–V crossing changes (P=0.002) was found. Conclusion The majority of the ocular changes depend on the course and severity of thalassemia. Ocular complications can be prevented or delayed by reducing serum iron and ferritin levels with iron-chelating agents.

Purpose The aim of this study was to compare the macular thickness and each retinal layer thickness of the amblyopic eyes with their normal fellow eyes in patients with unilateral amblyopia using the Spectralis spectral domain optical coherence tomography new segmentation software. Patients and methods A total of 20 patients with unilateral amblyopia were enrolled in this study. Seventeen patients (85%) had anisometropic amblyopia, and three (15%) had combined amblyopia (strabismic and anisometropic). Best-corrected visual acuity was measured and converted to the logarithm of the minimum angle of resolution (logMAR). Patients underwent a comprehensive ophthalmic examination, including Spectralis spectral domain optical coherence tomography scanning. The mean of each of the three macular thickness map circles and the mean thickness of each of the retinal layers at the fovea and at 1000 μm circle and the 2500 μm circle were automatically extracted using Spectralis new segmentation software. Results There was a statistically significant increase in the macular thickness at the central subfield region of the early treatment diabetic retinopathy study (ETDRS) map in the amblyopic eyes (288.65±22.61 μm) compared with the fellow normal eyes (281.1±22.6 μm). In addition, there was a statistically significant increase in the outer nuclear layer thickness at the fovea of the amblyopic eyes (114.7±13.93 μm) compared with the fellow normal eyes (104.4±15.63 μm). There was also a statistically significant increase in the thickness of the retinal nerve fiber layer at the outer circle of the amblyopic eyes (33.03±3.816 μm) compared with the fellow normal eyes (30.76±3.75 μm). However, there was a statistically significant decrease in the thickness of the ganglion cell layer at the outer circle in the amblyopic eyes (36.38±5.27 μm) compared with the fellow normal eyes (39.09±6.19 μm). Conclusion The increase in the thickness of the central subfield region in the macular thickness map and the outer nuclear layer at the fovea implies that the photoreceptors may be affected by amblyopia.

Objectives To evaluate macular morphological changes in patients with retinitis pigmentosa (RP) by spectral domain optical coherence tomography (SD-OCT) and to assess their correlation with visual acuity. Setting and design A prospective observational comparative study was conducted in Tiba Eye Center (T. E. C.), Assiut, Egypt, from August 2013 to July 2014. Patients and methods A total of 13 consecutive patients experiencing RP (26 eyes) were recruited. An age-matched control group of 13 healthy volunteers was also recruited. All patients and volunteers underwent SD-OCT evaluation by SPECTRALIS OCT. Results Overall, 26 (13 patients) eyes in the RP group and 26 (13 volunteers) eyes in the control group were included. In RP group, the mean central macular thickness (CMT) at 1 mm was 180.6±22.18 µm, whereas the mean best-corrected visual acuity (BCVA) was 0.11±0.08. In the control group, the mean CMT was 222.6±10.9 µm, whereas the mean BCVA was 0.9±0.11. By SD-OCT, foveal atrophy was found in 14 (53.8%) eyes, cystoid macular edema in five (19.2%) eyes, epiretinal membrane in six (23.1%) eyes, and lamellar macular hole in one (3.8%) eye in patients with RP. In nine (34.6%) eyes, there was interruption of the inner segment-outer segment junction and the external limiting membrane in the subfoveal region. There was a statistically significant positive correlation between CMT and BCVA among the RP group (r=0.813, P=0.000). BCVA categories among RP group were significantly associated with foveal atrophy (P=0.003) and inner segment-outer segment junction interruption (P=0.000). Conclusion SD-OCT is an important tool in the evaluation of macular morphological changes in patients with RP.

Background The aim of this study was to describe optical coherence tomographic (OCT) patterns in patients with central serous chorioretinopathy and to correlate them with visual outcomes. Materials and methods In a prospective case study, 20 eyes of 20 patients diagnosed ophthalmoscopically as central serous chorioretinopathy were subjected to meticulous recording of visual acuity, ophthalmologic examination, fundus photography, fluorescein angiography, and spectral-domain optical coherence tomography. Results In the acute phase, subretinal fluid with an area of neurosensory retinal detachment was noted on OCT in all 20 eyes. OCT showed a retinal pigment epithelial (RPE) detachment corresponding to the fluorescein angiography leak site in three (15%) eyes. A total of 10 patients at the end of follow-up with no subretinal fluid had significantly lower mean foveal thickness. The logMAR best-corrected visual acuity (BCVA) improved from 0.63 (SD=0.30; range=1.00–0.18) at presentation to 0.23 (SD=0.24; range=0.78–0.00) at 6 months (P<0.05). The mean foveal retinal thickness was 346.8 µm (SD=111.87) at presentation (range=220–622) and 150.90 µm (SD=42.32) at 6 months (range=108–250) (P<0.001). Final OCT findings that associated significantly with good visual outcome (logMAR BCVA≤0.3) were preserved outer photoreceptor layer, inner and outer segment continuity, and bulging on the RPE layer/irregularity of RPE choroid band. The present study also showed no association of existent neurosensory retinal detachment with a final BCVA of logMAR BCVA of 0.3 or less (Fischer exact test, two-sided, P=0.087). No association was found between existent pigment epithelial detachment with a final BCVA of logMAR BCVA of 0.3 or less (Fischer exact test, two-sided, P=0.200). Conclusion Structural changes on OCT may be associated with different levels of visual function, and OCT findings could be important parameters of deciding follow-up and treatment.

Objectives This study was designed to evaluate the safety and efficacy of a single large dose (0.7 mg) of ranibizumab for treatment of macular edema secondary to nonischemic central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Setting and design A prospective interventional case series study was conducted at Tiba Hospital for Eye Surgery (private practice) in collaboration with the Ophthalmology Department, Assiut University, Egypt, from March 2013 till March 2014. Patients and methods A total of 10 eyes of patients having macular edema caused by nonischemic CRVO or BRVO were treated by intravitreal injection of a single large dose (0.7 mg) of ranibizumab. Fluorescein angiography and spectral-domain optical coherence tomography were done for every patient before treatment, and follow-up was done with spectral-domain optical coherence tomography after injection of ranibizumab at 1, 3, and 6 months. Results There was significant resolution of macular edema after intravitreal injection of a single large dose (0.7 mg) of ranibizumab (macular thickness was 535.5±214.7 µm at baseline compared with 281.3±145 μm at 6 months on follow-up; P=0.045) There was also significant improvement in best-corrected visual acuity (0.15±0.07 at baseline compared with 0.71±0.3 at 6 months on follow-up; P=0.007). There were no ocular or systemic adverse events documented during the 6-month follow-up period. Conclusion A single intravitreal injection of large dose (0.7 mg) of ranibizumab is a new promising regimen for managing macular edema secondary to nonischemic CRVO or BRVO.

Goldmann-Favre syndrome is a rare autosomal recessive vitreoretinal dystrophy that appears usually during childhood, and it manifests with progressive loss of visual acuity, night blindness, and poor color recognition. Fundus findings include degenerative pigmentary changes with macular edema and retinoschisis.