Tolba, D. A., S. Mamdouh, A. Magdy, and R. Hussien, "corneal epithelial profile on psoraisis patients with and without dry eye disease", Delta, vol. 23, issue 3, pp. 141-148, 2022.
Nageeb Louz, R. E., M. A. Salah Eddin, T. A. Macky, and D. A. A. Tolba, "Post COVID-19 Retinal Evaluation Using Optical Coherence Tomography Angiography: A Case Control Study.", Ocular immunology and inflammation, vol. 31, issue 6, pp. 1175-1183, 2023. Abstract

PURPOSE: To study the effect of coronavirus disease of 2019 (COVID-19) on retinal vasculature by Optical Coherence Tomography Angiography (OCTA).

METHODS: Macular OCTA images of patients recovered from COVID-19 infections were studied including foveal avascular zone (FAZ), capillary vascular densities (CVD) of the superficial and deep capillary network (SCP, DCP), and central foveal thickness (CFT).

RESULTS: The FAZ area was significantly larger in post COVID-19 cases compared to the healthy controls (p=0.032). Post COVID-19 cases had significant lower CVDs in perifoveal quadrants of the SCP. They also had lower CVD in the whole area, parafoveal, temporal and inferior perifoveal areas in the DCP. The parafoveal DCP area showed a positive correlation with disease duration (r=0.249, p-value=0.018). The whole SCP was significantly larger in cases with lymphopenia (p-value=0.004).

CONCLUSION: This study found asymptomatic retinal vascular affection in post COVID-19 eyes showing a relation with disease clinical and laboratory features.

Tolba, D. A., R. H. Amin, A. M. AlOrbani, and S. M. Esmat, "Retinal vascular assessment in psoriatic patients with and without metabolic syndrome using optical coherence tomography angiography.", Scientific reports, vol. 12, issue 1, pp. 16720, 2022. Abstract

To evaluate the retinal vasculature in psoriasis patients and detect if metabolic syndrome is an additional risk factor. This cross-sectional analytic study was carried out on 80 eyes of 80 subjects; 28 eyes with psoriasis only (PS group), 12 eyes with additional metabolic syndrome to psoriasis (PMS group) and 40 eyes healthy controls (HS). The retinal capillary plexuses were evaluated by OCTA. The disease activity was evaluated by the Psoriasis Area and Severity Index (PASI) score and extent. The superficial capillary plexus (SCP) vascular density was significantly lower in PS group than HS while in PMS it was significantly lower only in whole image and superior and temporal perifoveal areas (p-value = 0.020, 0.030, 0.001 respectively). The changes correlated with the disease duration. The vascular density of the deep capillary plexus (DCP) was significantly lower in both PS and PMS groups (p-value < 0.001). Psoriatic patients are at a higher risk of developing retinal vascular complications even without evident clinical ocular disease. It was noted that the presence of metabolic syndrome contributes as an additional risk factor in possible visual loss secondary to ischemic changes that are likely to start in the DCP and progress to involve all levels.

Fathy, M., A. Noureldine, H. M. Elmofty, and D. A. Tolba, "The effect of postmenopausal hormonal drop on optic nerve head and peripapillary perfusion using optical coherence tomography angiography (OCTA).", Scientific reports, vol. 12, issue 1, pp. 18185, 2022. Abstract

We studied the effect of menopause with subsequent estrogen drop on optic nerve head structure and peripapillary vasculature. This cross-sectional analytic study was carried out on 100 eyes of 100 patients; patients were divided into a premenopausal group (50 eyes) and a postmenopausal group (50 eyes). Optical coherence tomography was done to evaluate retinal nerve fiber layer thickness (RNFLT) and optical coherence tomography angiography (OCTA) to assess the peripapillary capillary vessel density. RNFLT as well as the peripapillary vessel density (VD) were significantly lower in the postmenopausal group (P value < 0.001) with increasing age, hormonal drop, and higher intraocular pressure (IOP), specifically in the inferior quadrant. However, the negative correlation between IOP and VD (r = - 0.541) was stronger than its negative correlation with RNFLT (r = - 0.318). Postmenopausal hormonal changes lead to a significant rise in IOP-although still not glaucomatous- and a decrease in the RNFLT and perfusion of the optic nerve. This confirms the relation between hormonal drop and glaucoma in postmenopausal women. Changes in peripapillary vascular density were more evident than RNFL in correlation with IOP and age changes. So, OCTA can be used to detect early optic nerve affection.

Abd Elghaffar Shehata, M., M. H. Hosny, D. A. Tolba, and M. Attya, "Evaluation of Postoperative Total Ocular Aberrations After Bilateral Implantation of Monofocal IOL with Extended Depth of Focus in Phacoemulsification.", Clinical ophthalmology (Auckland, N.Z.), vol. 16, pp. 4257-4261, 2022. Abstract

PURPOSE: To evaluate postoperative visual performance and total ocular aberration in cataract patients after implantation of the TECNIS Eyhance™ intraocular lens (IOL).

METHODS: Our study is a prospective interventional non-comparative study that was conducted on 34 eyes of 17 patients who underwent phacoemulsification and Eyhance IOL implantation. Postoperative corrected and uncorrected near and far visual acuity and total ocular aberration were assessed 3 months after surgery.

RESULTS: Our study included 34 eyes of 17 patients. At the third postoperative month, the mean spherical equivalent (SE) was -0.32 diopters (D) (SD ±0.62), and the mean distance-corrected near visual acuity (DCNVA) was 0.33 (SD ±0.15) and 0.42 (SD ±0.17) decimal notation (DN) monocular and binocular, respectively. The mean near distance with maximum visual acuity was 79.47 cm (SD ±7.70) and 74.76 cm (SD ±7.90) monocular and binocular, respectively. The mean postoperative minimum reading addition (add) was 1.6 D (SD ±0.47). The mean spherical aberration (SA) was 0.13 µm (SD ±0.09). The correlation of amount of spherical aberration with power of minimum reading add at 40 cm was not statistically significant (=0.324).

CONCLUSION: The TECNIS Eyhance IOL provides good intermediate visual acuity and decreases the power of the reading add needed after phacoemulsification.

Abd Elghaffar Shehata, M., M. H. Hosny, D. A. Tolba, and M. Attya, "Evaluation of Postoperative Total Ocular Aberrations After Bilateral Implantation of Monofocal IOL with Extended Depth of Focus in Phacoemulsification.", Clinical ophthalmology (Auckland, N.Z.), vol. 16, pp. 4257-4261, 2022. Abstract

PURPOSE: To evaluate postoperative visual performance and total ocular aberration in cataract patients after implantation of the TECNIS Eyhance™ intraocular lens (IOL).

METHODS: Our study is a prospective interventional non-comparative study that was conducted on 34 eyes of 17 patients who underwent phacoemulsification and Eyhance IOL implantation. Postoperative corrected and uncorrected near and far visual acuity and total ocular aberration were assessed 3 months after surgery.

RESULTS: Our study included 34 eyes of 17 patients. At the third postoperative month, the mean spherical equivalent (SE) was -0.32 diopters (D) (SD ±0.62), and the mean distance-corrected near visual acuity (DCNVA) was 0.33 (SD ±0.15) and 0.42 (SD ±0.17) decimal notation (DN) monocular and binocular, respectively. The mean near distance with maximum visual acuity was 79.47 cm (SD ±7.70) and 74.76 cm (SD ±7.90) monocular and binocular, respectively. The mean postoperative minimum reading addition (add) was 1.6 D (SD ±0.47). The mean spherical aberration (SA) was 0.13 µm (SD ±0.09). The correlation of amount of spherical aberration with power of minimum reading add at 40 cm was not statistically significant (=0.324).

CONCLUSION: The TECNIS Eyhance IOL provides good intermediate visual acuity and decreases the power of the reading add needed after phacoemulsification.

, "Retinal vascular assessment in psoriatic patients with and without metabolic syndrome using optical coherence tomography angiography", Retinal vascular assessment in psoriatic patients with and without metabolic syndrome using optical coherence tomography angiography, 2022.
Tolba, D., A. A. Rahman, H. Hamdy, and S. Esmat, "Clinical characteristics and interventions in neovascular glaucoma cases: a study from the glaucoma care clinic at Cairo University Hospitals", Delta Journal of Ophthalmology, vol. 22, issue 3, pp. 208 - 213, 2021/7/1. AbstractWebsite

Aim The aim of this study was to report the epidemiology, clinical characteristics, causes, management, and outcome of neovascular glaucoma (NVG) in a tertiary facility in Egypt (Glaucoma Care Clinic at Cairo University Hospitals).
Patients and methods The demographic and clinical data of 251 eyes diagnosed with NVG were retrospectively studied. The antiglaucoma medications and interventions used for management were reviewed with analysis of the outcome in the form of success rate, final visual acuity (VA) and intraocular pressure (IOP). Complete success was defined as an IOP between 6 and 21 mm Hg without topical or systemic glaucoma medications with preservation of presenting VA.
Results NVG was diagnosed in 7.9% of all glaucoma patients in our clinic. The prevalence was more in men (58.8%), and the mean age was 56.5±11 years. Diabetic retinopathy was the most common cause for NVG (61.4%), followed by central retinal vein occlusion (21.4%). The presenting VA was light perception (LP) or less in 45% of the eyes. Diode laser cyclophotocoagulation was the most common treatment modality used (57%), followed by antiglaucoma medications only in 28% and finally surgery in 15% of the patients. Complete success in the diode group was achieved in 73.43% of the cases compared with 68.42% in the surgery group, with no statistically significant difference (P=0.522). The effect of an intravitreal injection of antivascular endothelial growth factor on the final IOP was significant (P=0.024).
Conclusions NVG has a high prevalence in our glaucoma patients. The patients presented very late, with nearly half of the patients having VA of LP or less. This led to decreased resort to surgical intervention. Diode laser cyclophotocoagulation was the main treatment modality used, with significant control of the IOP.

Mamdouh, S., M. Refaat, M. Ezzelarab, S. Abdalgeleel, and D. Tolba, The Role of Infection Control Measures in Ophthalmology: Do They Prevent COVID-19 Infection Among Ophthalmologists in Egypt? A Survey-Based Study, , vol. Volume 15, pp. 4347 - 4355, 2021/10/01. Abstract
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