moh g almaz moh s hasanein golnar moh fathy jof egy society for man of pain 17 9 1989
moh s hasanein magdi seliem ahmad saleh j eg society for mag of pain 7 9 1989
assiut medical j vol 17 no 2 march 1993 mohsen m abdellatif ibtisam m h elmileegy m s hasanein
To compare the visual, refractive and topographic outcomes of standard and accelerated corneal collagen cross-linking (CXL) in pediatric keratoconus patients.
Prospective, comparative observational study on 68 eyes of 35 pediatric keratoconus patients (<18 years). Patients were classified into two groups, group (I) included 34 eyes and received standard “Epi-Off” CXL (3 mW/cm2, 30 min.) and group (II) included 34 eyes and received accelerated “Epi-Off” CXL (9 mW/cm2, 10 min.). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), simulated keratometry (Sim K-1, Sim K-2, K-max, K-mean), cylindrical (CYL), pachymetry and Q-value were evaluated preoperatively and for 3 years postoperatively.
Postoperative UDVA and CDVA did not significantly change in both groups after 3 years. Postoperative SE was increased significantly in accelerated CXL (p=0.012) with no significant change in the postoperative cylinder in both procedures. Standard CXL had greater “significant” effect in decreasing Sim K-1, K-max and K-mean. The mean reduction in postoperative corneal pachymetry (at thinnest location) was significant in standard CXL (18.4 μm) (p=0.001). No significant change was noticed in postoperative Q-value.
Standard and accelerated CXL protocols are efficient in pediatric keratoconus management with better outcomes in the standard procedure.
Purpose. To provide quantitative measurements for the foveal avascular zone (FAZ) and to describe its morphological characteristics by optical coherence tomography angiography (OCT-A). Design. Cross-sectional observational case series. Methods. Healthy volunteers were recruited and evaluated using Triton-DRI SS-OCT Angiography. A 4.5 × 4.5 mm square was evaluated by OCT-A center around the fovea. Superficial and deep capillary plexus were identified, and different quantitative measurements were conducted along with categorization of the FAZ pattern. Results. Eighty-two eyes (41 volunteers) were evaluated. Mean age was 30.59 ± 7.6 years (23–42 years). Mean subcentral retinal thickness was 200.1 ± 5.66 um (192–210 um). The number of terminal vessels was variable (range, 8–11). Mean maximum terminal vessel-to-vessel intervening distance was 527.8 ± 60.3 um (471–674 um). Mean minimum terminal vessel-to-vessel intervening distance was 296.7 ± 45.8 um (233–373 um). Mean maximum horizontal diameter of FAZ (superficial) was 716.17 ± 124.09 um, while mean maximum vertical diameter of FAZ (superficial) was 667.76 ± 131.28 um. Mean maximum horizontal diameter of FAZ (deep) was 823.19 ± 144.92 um, while mean maximum vertical diameter of FAZ (deep) was 794.03 ± 150.28 um. OCT-A detected different FAZ patterns; horizontally oval configuration in 32 eyes (39%), rounded configuration in 24 eyes (29.3%), pentagon configuration in 14 eyes (17.1%), and vertically oval and nonspecific configuration in 6 eyes each (7.3%). Conclusion. OCT-A could efficiently provide both
Abstract:
Background: Hepatic steatosis has been shown to worsen the course of liver disease in chronic hepatitis C (CHC) patients, it may reduce the efficacy of antiviral therapy and accelerate disease progression. In this cross-sectional study, we aimed to evaluate the role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the quantitative assessment and grading of hepatic steatosis to evaluate the association between hepatic steatosis and fibrosis in Egyptian genotype 4-CHC (G4-CHC) patients.
Results: Histopathological hepatic steatosis was found in 70.3% of patients. No correlation was found between the CT ratio and pathological hepatic steatosis. Proton-density fat fraction, T1-fat fraction and fat percentage correlated with histological steatosis grading (r=0.953, p< 0.001; r=0.380,p=0.027 and r=0.384, p=0.025 respectively).An agreement between steatosis grading by histology and 1H-MRS was found in 74.2% of patients. Compared to other MRI modalities, proton-density fat fraction had the highest area under the receiver operating characteristic curve (AUC), with 0.910,0.931, and 0.975 for mild, moderate, and severe steatosis respectively. The cut-off with the best ability to predict steatosis was>4.95 for a proton-density fat fraction (AUC=0.958) with 95.8% sensitivity, 90% specificity, 78.5% positive predictive value and 96.1% negative predictive value.
Conclusion:1H-MRS had good diagnostic performance in predicting hepatic steatosis in G4-CHC patients and hence it may offer a useful-noninvasive quantitative modality for grading of steatosis with clinical applicability especially in those where a liver biopsy cannot be done.
Abstract:
Background: We Explored the strength and weaknesses of Multi-detector computed tomography (MDCT) and Magnetic resonance imaging (MRI) in preoperative evaluation of cochlear implant candidates.
Methods: A retrospective study including 13 adults and 38 pediatric patients who suffered from bilateral profound sensory neural hearing loss (SNHL) and underwent MDCT and MRI examination as a preoperative assessment for cochlear implant procedure. All patients underwent high-resolution spiral MDCT (128-slice) and 1.5 T MRI examination. Notes of history and physical ear examination, audiometry results, and operative data were collected and compared with imaging findings.
Results: MDCT was superior in demonstration of middle ear disease while MRI was more useful in delineation of the cochlear nerve and cochlear patency and detection of central causes of SNHL . Only 15% of adult patients had a positive clinical concern and showed positive imaging findings. All adult patient that had no clinical concern showed no significant imaging findings. About 36.8% of pediatric patients had a positive clinical concern and showed positive imaging findings. About 33.3% of pediatric patients who had no clinical concern showed positive imaging findings. The surgical plan was changed based on combined imaging findings in 15.4% of adult patients and 39.4% of pediatric patients.
Conclusion: Multi-detector computed tomography and Magnetic resonance imaging are useful in the evaluation of congenital anomalies of inner ear. MRI is superior in the evaluation of cochlear nerve ,early detection of labyrinthine fibrosis and detection of intrauterine causes of SNHL. MDCT is helpful in evaluation of middle ear pathology and enables detailed evaluation of osseous anatomy. Integrative employment of both modalities in preoperative assessment of cochlear implant candidates is recommended.
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