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Cureus May 2024Preeclampsia, a complex multisystem disorder predominantly impacting the kidneys and liver, manifests through hypertension and organ dysfunction in expectant mothers....
Preeclampsia, a complex multisystem disorder predominantly impacting the kidneys and liver, manifests through hypertension and organ dysfunction in expectant mothers. Preeclampsia can also cause ocular signs, but they are uncommon. Exudative retinal detachment (ERD) is one such unusual but dangerous consequence. A thorough clinical description and therapy of a patient who experienced exudative retinal detachment while experiencing preeclampsia are provided in this study. A 28-year-old Saudi female, with no medical or surgical history, underwent an emergency cesarean section (CS) due to severe preeclampsia and failed induction of labor. The patient complained of painless blurry vision, with central dark spot and decreased vision starting from labor daytime. The patient was admitted to the hospital for blood pressure monitoring and further investigations. The patient was started on hydralazine intravenous (IV) and labetalol PO to control BP. The patient was delivered by cesarean section for preeclampsia with severe features after the failure of labor induction, and she had improved her vision by four weeks postpartum. Retinal detachment as a consequence of preeclampsia is conservatively managed, with a generally favorable prognosis. Previous studies have consistently emphasized the critical importance of a multidisciplinary approach that fosters collaboration between obstetricians and ophthalmologists. This collaborative strategy not only ensures comprehensive care but also facilitates early detection, timely intervention, and improved management outcomes for conditions affecting both maternal health and ophthalmic well-being during pregnancy.
PubMed: 38910608
DOI: 10.7759/cureus.60866 -
Archivos de La Sociedad Espanola de... Jun 2024A survey conducted by the European Board of Ophthalmology (EBO) revealed significant differences in the surgical training of the ophthalmology residents in Europe,...
INTRODUCTION
A survey conducted by the European Board of Ophthalmology (EBO) revealed significant differences in the surgical training of the ophthalmology residents in Europe, including a disparity between the sexes and a variation in the experience on cataract surgery (CC) between them. This study is about the Spanish sub-cohort of the survey, and its objective is to present and analyse the peculiarities of ophthalmology training in Spain within the European context, as well as discussing ways to harmonise and improve that training throughout the EU.
METHODS
We analyse data of the Spanish participants in the EBO exams, defining subgroups by the Autonomous Communities existing in Spain.
RESULTS
93 of 135 requested participants (68.9%) responded. A 60.2% passed the EBO exam between 2021-2022, being mostly women (65.59%) aged 31 years old on average. The 91.4% were right-handed, coming from 13 of the 17 Spanish autonomous communities, although mostly from the Community of Valencia, Madrid and Catalonia. Respectively, 16.1%, 3.2% and 8.7% of the respondents said they have completed 10 or more training sessions on animal eyes, synthetic eyes and through the virtual reality simulator. This training was correlated with greater self-confidence in the management of a posterior capsular tear during surgery (p .025). All respondents manifested to have already performed stages of the CC. The average number of operations reported was 181.6 with regional disparities. A significant difference is observed between the sexes against women (-28.3%, p 0.03).
DISCUSSION
Ophthalmologists in Spain, much more than other European countries, have greater opportunities for surgical training, with surgical procedures during the residency, that nearly triples those made by the others. Spanish women refer, like their European colleagues, to be in disadvantage in learning opportunities about cataract surgery. The Simulation Based Medical Education (SBME) allows to respond to the training deficit and complements the training on the patient. Although we demonstrate a significant correlation between the number of procedures carried out and self-confidence to operate simple cases, the SBME would be a complementary tool in self-confidence in front of a complication like capsular rupture.
CONCLUSION
Spain massively adopts the model named by us "surgery for all", despite the underrepresentation of women in this area, emphasising a need for cultural change that the SBME could facilitate.
PubMed: 38909893
DOI: 10.1016/j.oftale.2024.06.009 -
BMC Medical Education Jun 2024To evaluate real-world utilization of gonioscopy for diagnosing glaucoma among ophthalmologists with diverse subspecialties, and understand current perceptions of...
Bridging gaps in ophthalmology residency programs: the link between practice, training and confidence in ocular examination and gonioscopy for diagnosing glaucoma, a blinding disease.
BACKGROUND
To evaluate real-world utilization of gonioscopy for diagnosing glaucoma among ophthalmologists with diverse subspecialties, and understand current perceptions of teaching, training, and confidence in gonioscopy.
METHODS
A nationwide anonymous online survey was conducted among practicing ophthalmologists, querying about demographics, professional experience, practice of routine ocular examination for glaucoma and perceptions of confidence in performing them.
RESULTS
136 ophthalmologists participated in the survey, with various levels of experience from residency to over twenty years of ophthalmology practice. Glaucoma specialists comprised 23 (16.9%) of the participants. Of the non-glaucoma-specialist respondents, only 33 (29.2%) expressed being highly confident in interpreting gonioscopic findings, which correlated significantly with their self-reported inadequate level of training in gonioscopy during residency (p < 0.001) and even more so with their low frequency of implementing gonioscopy in routine examinations (p < 0.001). The commonly cited reasons for the low practice of gonioscopy were insufficient time allotted to examinations and lack of experience, knowledge or equipment.
CONCLUSIONS
Gonioscopy is fundamental to the detection of glaucoma. This study reveals underutilization of gonioscopy in the practice of ophthalmology and its association with lower training opportunities, calling for expedited changes in the residency's curriculum, alongside measures to promote its use in clinical practice.
Topics: Humans; Ophthalmology; Glaucoma; Internship and Residency; Gonioscopy; Clinical Competence; Male; Female; Surveys and Questionnaires; Adult; Middle Aged; Ophthalmologists
PubMed: 38907194
DOI: 10.1186/s12909-024-05665-y -
PloS One 2024Several studies have reported the efficacy of traditional Chinese medicine (TCM) for central serous chorioretinopathy (CSC), while some ophthalmologists are concerned... (Meta-Analysis)
Meta-Analysis
Several studies have reported the efficacy of traditional Chinese medicine (TCM) for central serous chorioretinopathy (CSC), while some ophthalmologists are concerned that TCM may be a risk factor for CSC as some chinese herbs contain hormonal ingredients. This study aimed to evaluate the efficacy and safety of TCM in treating patients with CSC. Randomized controlled trials (RCTs) and observational studies of TCM for CSC were searched up to July 10, 2023 on the following biological databases without language and publication time restrictions: PubMed, Ovid Medline, Embase, Cochrane Library, The Chinese National Knowledge Infrastructure Database (CNKI), Technology Periodical Database (VIP), Wanfang, and Chinese Biomedical Literature Service System (SinoMed). Review Manager V.5.4.1 and Stata 14 software were used for data analysis. Finally, thirty-eight studies were finally included including 23 RCTs and 15 cohort studies. The meta-analysis showed that compared with the routine treatment alone, the combination of TCM can not only reduce the recurrence rate (OR = 0.29, 95% CI: 0.21,0.40; I2 = 0%) and central retinal thickness (CRT) (MD = - 35.63, 95% CI: - 45.96,-25.30; I2 = 89%) of CSC, but improve patients' best corrected visual acuity (BCVA) (SMD = 0.86, 95% CI: 0.62,1.11; I2 = 77%); additionally, it has no obvious side effects compared with routine treatment (OR = 0.72, 95% CI: 0.39,1.34; I2 = 10%). Overall, this study shows that the use of TCM does not increase the risk of CSC recurrence; on the contrary, the combination of TCM may reduce the recurrence of CSC and improve BCVA and CRT in patients with CSC compared with conventional treatment.
Topics: Central Serous Chorioretinopathy; Humans; Medicine, Chinese Traditional; Drugs, Chinese Herbal; Treatment Outcome; Randomized Controlled Trials as Topic; Visual Acuity
PubMed: 38905170
DOI: 10.1371/journal.pone.0304972 -
Respiratory Medicine Case Reports 2024We analyzed the issue of a young woman who wanted our opinion regarding uncontrolled hypertension. Her hypertension was discovered to have a highly unusual origin, but...
We analyzed the issue of a young woman who wanted our opinion regarding uncontrolled hypertension. Her hypertension was discovered to have a highly unusual origin, but it is fairly prevalent in nations like India. A 19-year-old woman who complained of blurred vision was presented to an ophthalmologist, who diagnosed her with grade IV hypertensive retinopathy. Her 2D ECHO was normal, hence a thorough screening for secondary hypertension was carried out. A left paravertebral tumor that may have squeezed the left renal artery and contributed to her hypertension was discovered during the workup by a CECT chest and abdomen scan. She also exhibited widespread lymphadenopathy; a condition known as granulomatous pathology. She was started on anti-TB medication, and after six months of treatment, her radiological and clinical conditions improved. This case highlights a rare instance of TB causing excessively elevated blood pressure.
PubMed: 38903655
DOI: 10.1016/j.rmcr.2024.102063 -
Cureus May 2024Retinopathy of prematurity (ROP) affects premature low birth-weight infants with potentially blinding complications. Early diagnosis and treatment for indicated cases...
BACKGROUND
Retinopathy of prematurity (ROP) affects premature low birth-weight infants with potentially blinding complications. Early diagnosis and treatment for indicated cases are essential to prevent unfavorable effects of the disease.
OBJECTIVES
To determine the awareness and the level of knowledge of ROP among pediatricians in all regions of Saudi Arabia who worked at neonatal intensive care units.
DESIGN AND SETTING
This was a cross-sectional study. This study was undertaken in the Kingdom of Saudi Arabia.
MATERIALS AND METHODS
A semi-self-structured online questionnaire was designed to study the awareness and knowledge of ROP. The questionnaire contained items related to demographic data, participants' level of understanding and knowledge of ROP, and items related to hospital facilities, the availability of a trained ophthalmologist, and the source of knowledge.
MAIN OUTCOME MEASURES
The awareness and knowledge of ROP among pediatricians of the Kingdom of Saudi Arabia.
SAMPLE SIZE
The study included 145 pediatricians.
RESULTS
Awareness of ROP was found in 138 participants (95.2%). Seven participants (4.8%) were not aware of ROP and were excluded from further analysis. Of the participants, 116 (84.0%), 127 (92.0%), and 130 (94.3%) had knowledge about the stages, treatment, and precautions of treatment of ROP, respectively. Of the participants, 77 (55.8%), 63 (45.7%), 113 (81.9%), and 56 (40.6%) gave the correct answer about the indications of fundus examination, exact time of the first fundus examination, place of fundus examination, and minimum number of screening fundus examination for ROP, respectively.
CONCLUSIONS
The awareness and knowledge of ROP among pediatricians of Saudi Arabia is good, but knowledge about the indications and proper time of first referral to an ophthalmologist should be improved.
PubMed: 38903318
DOI: 10.7759/cureus.60754 -
World Journal of Clinical Cases Jun 2024In addition to the non-specific symptomatology of ocular rosacea, currently, there are no reliable diagnostic tests for the disease, which may lead to its misdiagnosis....
BACKGROUND
In addition to the non-specific symptomatology of ocular rosacea, currently, there are no reliable diagnostic tests for the disease, which may lead to its misdiagnosis. Here, we report a case of ocular rosacea presenting with multiple recurrent chalazion on both eyelids.
CASE SUMMARY
A 63-year-old female patient presented with multiple chalazion and dry eyes in both eyes, with no facial erythema. Initial management done were application of steroid eye ointment on both eyelids, hot compresses, and eyelid margin cleaning; noting that there was no relief of symptoms. Surgical excision of the chalazion was done on both eyes, however, bilateral recurrence occurred post-operatively. The pathological studies showed infiltration of a small amount of fibrous tissue with many chronic inflammatory cells. Immunohistochemistry studies were positive for LL-37. Resolution of the chalazion occurred after oral administration of doxycycline and azithromycin.
CONCLUSION
Our findings show that ophthalmologists should recognize the ocular manifestations of skin diseases.
PubMed: 38898849
DOI: 10.12998/wjcc.v12.i17.3253 -
Scientific Reports Jun 2024Neovascular age-related macular degeneration (nAMD) is a prevalent cause of permanent vision loss and blindness in the elderly worldwide, with a significant impact on...
Neovascular age-related macular degeneration (nAMD) is a prevalent cause of permanent vision loss and blindness in the elderly worldwide, with a significant impact on patients' daily lives. However, burdens related to nAMD from the patients' perspective have not been well documented. Here we developed a new questionnaire after eliciting nAMD patients' daily challenges followed by a pilot survey. Seven daily life burden domains were identified, and a quantitative survey was conducted using the questionnaire in the real-world clinic. Of the total 153 participants (mean age, 76.3 ± 8.3 years), 67 (43.8%) had bilateral nAMD, and 79 (52.7%) were classified into severe nAMD according to the best-corrected visual acuity with cut-off value of 0.52 in logMAR. Patients with bilateral and severe nAMD had significantly higher burden scores across all domains. Network models for the bilateral and severe disease subgroups identified the interactions between "activity of daily living" and "hand-eye coordination" and between "use of electronic devices" and "face recognition" domains, which were considered to be important burdens for the patients. These results can advance ophthalmologists' understanding of the impact of nAMD on patients' daily lives and the importance of active and continuing treatment for patients with nAMD.
Topics: Humans; Female; Male; Aged; Activities of Daily Living; Aged, 80 and over; Surveys and Questionnaires; Macular Degeneration; Visual Acuity; Quality of Life; Cost of Illness
PubMed: 38898138
DOI: 10.1038/s41598-024-65089-y