Background: Diabetic retinopathy (DR) is an important microvascular consequence of long-term type 2 diabetes mellitus (T2DM), and it can lead to blindness if not properly diagnosed and managed. Nailfold video capillaroscopy (NVC) is a non-invasive technique for observing capillary microvasculature. Aim: We aimed to evaluate the nail folds capillaroscopic alterations in patients with T2DM by NVC and correlated the results to DR, and their relation to disease duration and hemoglobin A1c (HbA1c). Methods: This cross-sectional study enrolled 62 cases with T2DM (as per the American Diabetes Association criteria). All patients were subjected to NVC and ophthalmological assessment. Results: NVC revealed that Patients with DR showed significantly higher frequencies of tortuous capillaries, branched capillaries and precapillary edema versus non-DR patients with P < .05. The DR patients with longer disease duration (15-20) years had significantly higher frequencies of branched capillaries, tortuous capillaries, microhemorrhages, and dilated apical capillaries. The frequency of tortuosity and precapillary edema were significantly higher in patients with poor glycemic control. The increased capillary width and branched capillaries were detected as predictors of DR in multivariate analysis. Conclusion: NVC is a cost-effective, quick, safe, simple, non-invasive, and newly emerging tool to assess the capillaroscopic alterations in diabetic patients as an indicator of severity of DR.

Purpose: To assess the visual function in patients with thyroid associated ophthalmopathy (TAO) without clinical optic neuropathy by multifocal visual evoked potential (mfVEP) and to correlate the findings with Humphrey visual field (HVF) and optical coherence tomography (OCT). Methods: This observational case–control study recruited a consecutive group of euthyroid TAO patients (excluding those with optic neuropathy) and a healthy matched control group. Ophthalmological assessment was done followed by HVF test, OCT retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC), and mfVEP. For mfVEP, results were reported as mean signal-to-noise ratio (SNR) of upper and lower sectors of rings 5–6 (9.9°–22°). Results: Thirty patients were included in each group (TAO patients and controls). No significant differences were observed between the groups in RNFL thickness, GCC thickness, or upper/lower hemifield VF parameters. Analysis of the mfVEP revealed that, before multiple comparisons correction, SNR was lower in TAO patients. A repeated measures analysis of variance confirmed significant main effects for both patient group ( p = 0.004), and test location (comparing SNR in the upper vs. lower sectors of rings 5–6) ( p < 0.001), but no significant interaction. Conclusion: In this limited cohort, initial analysis of mfVEP results suggested reduction of the SNR in TAO patients without clinical optic neuropathy, but these findings did not remain statistically robust after adjustment for multiple comparisons. mfVEP alterations occurred despite normal OCT and visual field findings and warrant further evaluation in larger, longitudinal studies.

Background: To evaluate choroidal thickness (CT) in diabetic patients without diabetic retinopathy (DR) in relation to the urinary albumin excretion rate (UAER). Methods: This is a prospective case-control study that included a consecutive sample of 120 patients with type 2 diabetes without clinically evident DR and a group of 60 matched healthy controls. Diabetic patients were included in two groups according to their UAER (normoalbuminuria and microalbuminuria). Complete ophthalmological examination was performed followed by optical coherence tomography (SD-OCT) for retinal and choroidal assessment. Twenty-four-hour urine samples were collected for UAER and blood samples for HbA1c and serum creatinine were obtained. Results: The study included 180 eyes from 180 subjects in three groups. Patients with higher levels of albuminuria had a thinner choroid than normal controls, with decremental thinning as albuminuria progressed. Diabetics with normoalbuminuria showed no significant differences from controls. Choroidal thickness showed a significant moderate negative correlation with UAER (r = − 0.58, p < 0.001). Multiple regression analyses for diabetic patients with microalbuminuria demonstrated that UAER is the most important determinant of subfoveal choroidal thickness (SFCT) (p < 0.001). Conclusions: Decreased CT was significantly correlated with UAER in diabetic patients without retinopathy and otherwise normal kidney functions. This decrease in thickness might be a predictor of DR.

Purpose: To evaluate the indications, outcomes, and complications of the usage of Aurolab Aqueous Drainage Implant (AADI) using mitomycin-C. Methods: A retrospective case series of patients who underwent AADI placement using mitomycin-C between April 2018 and June 2020 at Ain Shams University Hospitals, Cairo, Egypt. The data was extracted from the records of the patients with a minimum of 1 year of follow-up. Complete success was defined as IOP ≥ 5 mmHg and ≤ 21 mmHg or reduction of IOP by ≥ 20% from baseline without antiglaucoma medications (AGMs). Qualified success was defined as reaching the same IOP range with the aid of AGM. Results: A total of 50 eyes of 48 patients were included. Neovascular glaucoma represented the commonest indication (13 patients, 26%). The mean preoperative IOP was 34.0 ± 7.1 mmHg, with a median number of AGM of 3 (mean ± SD = 2.84 ± 1), while the mean IOP after 12 months was 14.3 ± 4 with a median number of AGM of 0. (mean ± SD = 0.52 ± 0.89) (p < 0.001). Complete success was achieved in 33 patients (66%). Qualified success was achieved in 14 patients (28%). Thirteen eyes (26%) had variable postoperative complications; none of them required explantation of the device or affected the visual acuity (except one patient). Conclusion: AADI with using mitomycin-C and ripcord during the surgery is an effective and relatively safe method of control of IOP in refractory and advanced cases of glaucoma, with an overall success rate of 94%.