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INTRODUCTION AND IMPORTANCE: The authors report a case of a 65-year-old male with corneal decompensation associated with poor vision with a recent history of cataract surgery. CASE PRESENTATION: A patient presented with complaints of poor vision in the left eye. The patient had undergone phacoemulsification surgery 4 months prior to presentation. The presenting best corrected vision was 20/400 in the left eye with the presence of corneal edema and central Descemet's membrane detachment (DMD) extending to the inferior two-thirds of the cornea with a fibrotic demarcation line separating detached Descemet's from intact, attached Descemet's. CLINICAL DISCUSSION: Anterior segment optical coherence tomography (AS-OCT) confirmed the diagnosis of Type 1 DMD. The patient was managed with femtosecond laser-assisted descematorrhexis with intraoperative AS-OCT, and a ready preloaded Descemet stripping endothelial keratoplasty graft. CONCLUSIONS: This report emphasizes that many technological advancements in the field can be employed to improve the outcomes of endothelial keratoplasty, especially when fibrosis is associated with the combined PDL and DMD.
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PURPOSE: To determine the earliest characteristics of retinal and optic disc alterations in diabetic children without diabetic retinopathy (DR) changes by using optical coherence tomography angiography (OCTA). SETTINGS AND DESIGN: This was a prospective, non-interventional case-control study that involved 25 patients with type 1 diabetes mellitus (T1DM) without clinical signs of DR and a demographically similar group of 25 healthy children as the control. METHODS: The retina and optic disc were examined using OCTA. STATISTICAL ANALYSIS USED: Correlations between the OCTA parameters and clinical predictors were evaluated. RESULTS: Twenty-five patients (median age: 14 years, interquartile range [IQR]: 13-15.9 years; 12/25 [48%] girls) with T1DM and 25 age-matched controls were enrolled. The patients had a tendency toward thinner fovea (232.5 Symbolm) as compared to the controls (244.3 Symbolm) (P = 0.142). Superficial vascular density was significantly lower in the DM group compared to the controls (48.90 ± 2.3 vs. 50.91 ± 3.1, P = 0.015). However, no such differences were observed at deeper vascular densities. The patients also had lower whole-disc (48.65 vs. 50.21, P = 0.029), disc interior (49.14 vs. 52.11, P = 0.044), superior (50.67 vs. 53.45, P = 0.039), and peripapillary capillary densities (50.49 vs. 52.68, P = 0.033). There was no statistical correlation between retinal/optic disc angiography parameters and clinical predictors. CONCLUSION: In diabetic children without visual impairment or DR, signs of microvasculopathy were found in the superficial macular vascular density and inside the disc.
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Introduction Hypothyroidism is a globally prevalent condition with a huge impact on health. It has been demonstrated that hypothyroidism is associated with negative health outcomes that have a significant impact on quality of life. The aim of this study is to assess the relative significance of various parts of quality of life satisfaction in adult patients with hypothyroidism. This study has never been done in Saudi Arabia. No previous research was conducted in our region to highlight the quality of life of these patients. From this, it is very important to acknowledge the impact of hypothyroidism on quality of life, to help improve their lives and reduce the burden of the disease. Method This is a case-control study conducted on patients with hypothyroidism presented to the family medicine clinic at King Abdulaziz University Hospital. The participants were divided into two groups: patients with primary hypothyroidism (cases) and euthyroid subjects of the same age without chronic illnesses (control group). We used the Short Form-12 questionnaire (SF-12) and a sociodemographic questionnaire as a tool to assess the quality of life. Results Compared to healthy euthyroid controls, patients with hypothyroidism had a significantly reduced quality of life regarding their physical (p<0.001) aspect, with mental health not being affected. Smoking, female gender, and BMI showed significant associations with their mental health status (p=0.021, p=0.001, and p=0.045) respectively. Conclusions Regarding the results of the current study, there is a reduced level of physical health in patients with hypothyroidism than in healthy controls, which adversely affects their QoL. Smoking, gender, and BMI were associated with lower mental health among patients with hypothyroidism, which adversely affected their quality of life. Health practices should include assessment of the quality of life, monitoring by specialized physicians, and educational programs for these patients.