In sickle cell disease (SCD), ocular lesions result from stasis and occlusion of small eye vessels by sickled erythrocytes. Vaso-occlusive disease of the retina can be responsible for nonproliferative (NPR) and proliferative retinopathy (PR). Patients are often asymptomatic until serious complications arise as, vitreous hemorrhage and retinal detachment. This work aimed to study the frequency and pattern of ocular manifestations in Egyptian children and young adults with SCD. In this cross-sectional study, 40 steady state patients (80 eyes) aged 2-28 years (30 children and 10 young adults) with established diagnosis of SCD (26 with homozygous SS and 14 with S/b thalassemia underwent complete ophthalmic examination with dilated fundoscopy. Fluorescein angiography was performed for patients C12 years old. The overall frequency of retinal lesions was 47.5 % (46.2 and 50 % of SS and S/b patients respectively). PR and NPR were evident in 32.5 and 27.5 % of all enrolled patients respectively (five patients having both). Peripheral retinal occlusion was a frequent ocular finding in both groups; the youngest patient showing PR was 15 years old. Older age, longer disease duration and splenectomy were significantly more prevalent among patients with PR. Despite lack of visual symptoms, children and young adults are at risk of PR. Frequency of retinal lesions was comparable in SS and S/b patients. Periodic ophthalmologic examination starting at the age of 12 years is recommended for timely-identification of retinal lesions thus minimizing the risk of sight threatening retinopathy.
Background: Outbreaks of post-cataract surgery endophthalmitis are often due to infection with Gram-negative organisms including Pseudomonas aeruginosa, which usually has poor visual prognosis due to its virulence factors and intrinsic resistance to antimicrobial agents. This work was concerned with investigation of outbreak of post phacoemulsification surgeries that took place at an eye care center, at 1-day period in Egypt. Retrospective case series study had been carried out with participants of six patients who underwent phacoemulsification surgeries. The clinical settings and treatment outcomes were described. Results: The results showed isolation of Pseudomonas aeruginosa, multidrug-resistant strain in all cases; five vitreous samples and one anterior chamber fluid sample. No evisceration or enucleation had to be done to any of these eyes in 8-month follow-up period. The source of outbreak was most probably the reused-reprocessed cassette of the phacoemulsifier machine. No pseudomonas strains could be isolated from other environmental samples. Conclusion: Early diagnosis and prompt recall of suspected cases and applying outbreak control measures helped to achieve good visual and anatomic outcomes. Reprocessing and reuse of single use devices should not be done, except after following the international regulations and the manufacturers' information on the appropriate decontamination process to allow reuse, including cleaning, disinfection, and method of sterilization.
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