History Of Ophthalmology Research Articles

Association between myopia and sleep duration among primary school students in minority regions of Southwest China: a school-based cross-sectional research.

To investigate the relationship between sleep duration and myopia among primary school students in minority regions of Southwest China. The school-based, cross-sectional study was conducted from October 2020 to January 2021. All participants underwent a comprehensive ocular examination and completed a questionnaire on demographic characteristics, ophthalmological history and major environmental factors for myopia. Spherical equivalent (SE) and ocular biometric parameters were measured after cycloplegia, with myopia being defined as SE ≤-0.5 D (Diopter). Multivariate regression models were used to examine the association of sleep duration with myopia, SE and axial length (AL). A total of 857 students from grades 2 to 4 were included in the analysis, of which 63.6% were myopic and 62.0% belonged to ethnic minorities. Boys had a slightly higher prevalence of myopia compared with girls (66.7% vs 60.6%, p=0.06). Myopic students had longer AL, deeper anterior chamber depth and thinner central corneal thickness compared with non-myopic students (all p<0.05). There was no significant association between sleep duration and myopia in both boys and girls (p=0.319 and 0.186, respectively). Moreover, girls with a sleep duration of 8-9 hour/day had higher SE and shorter AL compared with those with less than 8 hour/day of sleep (β=0.41 and -0.32, respectively, all p<0.05). This cross-sectional study did not find a significant association between sleep duration and myopia. However, it suggests that 8-9 hours of sleep per day may have a protective effect on SE progression and AL elongation in girls. Future studies with objectively measured sleep duration are needed to validate the findings.

Bilateral Granular Macular Dystrophy Associated with Bilateral Cataracts: About a Case

Macular granular dystrophy is an autosomal recessive genetic disease characterized by corneal opacities responsible for a decrease in visual acuity. We report a case of bilateral granular dystrophy associated with cataract in a young adult seen at Zinder National Hospital. This is a 51-year-old patient with no significant personal or family ophthalmological history who consulted the ophthalmology department of the National Hospital of Zinder for progressive and bilateral visual acuity decline that has been evolving for several years. The ophthalmological examination of the day noted a decrease in visual acuity at a distance in bilateral., corneal deposits in stain and a grade II cortico-nuclear cataract was noted. Immediate bisequential cataract surgery was performed using the phacoAlternative technique with simple postoperative follow-up and good visual recovery. Keywords: Groenouw II, cataract, Zinder

DIAGNOSTIC YIELD OF AN INHERITED RETINAL DISEASE GENE PANEL IN RETINOPATHY OF UNKNOWN ORIGIN.

Evaluating the presence of class 3, 4, and 5 genetic variants in inherited retinal disease (IRD) genes in patients with retinopathy of unknown origin (RUO). Multicentric retrospective study of RUO cases diagnosed between January 2012 and February 2022. General and ophthalmologic history, complete ophthalmologic examination, antiretinal antibodies, and IRD gene panel results were analyzed in every patient. Four RUO categories were defined: nonparaneoplastic autoimmune retinopathy, unilateral pigmentary retinopathy, asymmetrical pigmentary retinopathy, and acute zonal occult outer retinopathy. The authors included 12 patients (9 females) across these four RUO categories. Mean age at inclusion was 45.6 years (20-68 years). Seven patients demonstrated class 3 variants in IRD genes. Of these, two also demonstrated class 5 variants in other IRD genes. The remaining five patients had negative panel results. IRD gene panel analysis allowed diagnosis refinement in 1 (8.3%) nonparaneoplastic autoimmune retinopathy patient in the RUO cohort. When considering the nonparaneoplastic autoimmune retinopathy subpopulation only, a higher diagnostic yield of 20% (1/5 patients) was achieved. Every suspected nonparaneoplastic autoimmune retinopathy patient should benefit from gene panel testing to not overlook undiagnosed IRDs. By contrast, unilateral pigmentary retinopathy, asymmetrical pigmentary retinopathy, and acute zonal occult outer retinopathy subpopulations did not benefit from genetic testing in this study.

Risk factors and treatment window in arteritic anterior ischaemic optic neuropathy: a case study

A 76-year-old NZ European man presented with sudden onset visual loss in his left eye after experiencing intermittent temporal aches and blurry vision for over a month. He had a history of stroke and hyper- tension but no past ophthalmological history. A pale optic disc, raised inflammatory markers, and temporal artery biopsy confirmed a diag- nosis of acute arteritic anterior ischaemic optic neuropathy secondary to giant cell arteritis. High-dose intravenous methylprednisolone was administered within 24 hours of presentation, but the likelihood of vision loss reversal was unlikely.

Treatment exit options for non-infectious uveitis registry: participant characteristics at 3 years

PurposeThe Treatment exit Options For non-infectious Uveitis (TOFU) registry documents disease courses for non-anterior non-infectious uveitis entities with and without treatment to generate more evidence for clinical management recommendations including...

The impact of elevated lipoprotein a levels on retinal vein occlusion in young individual: Case report with 7 months follow‐up

Aims/Purpose: Branch retinal vein occlusion (BRVO) occurs when a branch of the retinal vein becomes obstructed. The aim of this study case was to provide insights into the potential role of Lipoprotein (Lp) (a) in the pathogenesis of BRVO.Methods: Case of a 47‐year‐old woman with no significant ophthalmological or general medical history, except the use of oral contraception and smoking habits. Presented to the emergency care after 5 days of experiencing a sudden vision loss in her right eye.Results: The ophthalmological examination revealed a visual acuity of 10/10 on the left (OS) and VBLM/10 on the right eye (OD). Slit lamp and Fundus examination showed on OD a relative afferent pupillary defect and the classic features of acute retinal branch vein occlusion, including tortuous veins, capillary occlusion, papillary and macular oedema and haemorrhages. While all was normal in OS. A comprehensive ophthalmic examination was conducted, including fluorescein angiography and optical coherent tomography that showed no abnormal vessel growth at this stage. Then, the indication for a dexamethasone intravitreal implant has been made along with panretinal photocoagulation (PRP) in the ischaemic areas. More, discontinuing oral contraception, the serum concentrations of specific antibodies, as anticardiolipin and antiphospholipids, as well as homocysteine and Lp (a) levels. The blood tests yielded negative results except for the abnormal plasma level of lipoprotein (a), which was measured at 900 mg/L. After 2 months of follow‐up. The visual acuity in OD was measured at 9/10. Moreover, the restoration of normal macular thickness after 4 months. However, at 6 months follow‐up, the appearance of a neovascularization adjacent to the previously laser‐treated area. As a result, a series of closely spaced PRP was performed along with an intravitreal anti‐vascular endothelial growth factor. After 1 month, a complete disappearance of the neovascularization was observed.Conclusions: Identification of independent and highly predictive risk factors for BRVO is still a big challenge. The main goals are the preservation of visual acuity and the prevention of relapses. This case report emphasizes the importance of incorporating a systematic Lp (a) testing into clinical practice, even in young individual.

Emergency treatment approaches for central retinal artery occlusion

Aims/Purpose: Central retinal artery occlusion (CRAO), which can be likened to a stroke in the eye, is considered a critical condition requiring immediate attention. The aim of this case was to assess whether anterior chamber paracentesis has a notable impact on the ultimate visual acuity in eye experiencing acute CRAO.Methods: We present the case of a 62‐year‐old man with no significant ophthalmological history, only hypertension under treatment. Presented to the emergency care within an hour after experiencing a sudden decrease in visual acuity in his left eye, whose visual prognosis improved after an urgent ocular chamber paracentesis.Results: The ophthalmological examination revealed a visual acuity of 10/10 on the right (OD) and positive light perception/10 on his left eye (OS). The intraocular pressure was normal in both eyes. Slit lamp and fundus examination showed on OS a positive reflex afferent pupillary defect and a whitish appearance of the retina, with narrowed retinal blood vessels and a cherry red spot in the macula while all was normal on OD. In this case an anterior chamber paracentesis was conducted, involving the removal of 0.3 mL of aqueous fluid from the anterior chamber using a small (30 gauge) needle. By decreasing the intraocular pressure through medical means (acetazolamide 250 mg 1cp 3 times a day for 7 days) and performing the anterior chamber paracentesis, the aim is to optimize the conditions for promoting the movement of any potential embolus away from the central retina and along the vessel. After one week, significant improvement was observed. The visual acuity in the OS was measured at 9/10, and the intraocular pressure was 10 mmHg. Ophthalmoscopic examination revealed the disappearance of the previously observed whitish retina, with a granular appearance of the macula. Despite these positive changes, impairment in the visual field has been noted and still persistent even after six months of follow‐up.Conclusions: Paracentesis, by reducing intraocular pressure, can enhance retinal arterial perfusion pressure, vasodilatation and the dislodgement of thrombi or emboli. Despite the prognosis often being poor, it is essential to take quick action and implement appropriate management strategies to prevent permanent vision loss.

Application of the suture needle retrograde threading method in scleral fixation of intraocular lenses

BackgroundHere we described a new threading technique for the universal fixation of any posterior chamber intraocular lens (IOL).MethodsTwenty-seven eyes of 27 patients whose surgery done by Surgeon A with the needle-guided method or the suture needle retrograde threading (SNRT) method for intrascleral IOL fixation were enrolled in the first group. Thirty-four eyes of 34 patients whose surgery done by Surgeon A, Surgeon B or Surgeon C with the SNRT method for intrascleral IOL fixation were grouped into three sub-groups by surgeon. Information regarding age, sex, best-available visual acuity (BCVA), intraocular pressure (IOP), past ophthalmological history, threading time (from puncturing to externalizing suture) and complications during and after the surgery were gathered.ResultsThe analysis showed that the threading time was less in the SNRT group than needle-guided group by Surgeon A. There was one eye with suture needle slipping from the guide needle when guiding out of the eye. The threading procedure was completed one time without suture ruptures or loop slippage in the SNRT group operated by Surgeon A. And using the SNRT method, Surgeon A, Surgeon B, and Surgeon C did not show any significant difference in threading time. No complications (e.g., vitreous hemorrhage, hyphemia, retinal detachment, suprachoroidal hemorrhage, or hypotony) were observed during surgery or postoperatively in all cases. No leakage occurred at the site of the puncture after the operation.ConclusionsThe described technique appears to be a safe, simple, easy-to-learn, and universal surgical method, which is suitable for various types of IOLs.

Etiological Factors of Ocular Trauma in Children and Adolescents Based on 200 Cases at the Pediatric Ophthalmology Unit of the Bouaké University Hospital

Background: Eye trauma is serious and very often has a poor prognosis in our environment. The aim of this study was to contribute to improving the prevention of ocular trauma in children and adolescents in central and northern Côte d’Ivoire. Methods: This was a cross-sectional study with a descriptive aim on 200 patient files received at the pediatric ophthalmology unit of the ophthalmology department of the Bouaké University Hospital from January 6, 2021, to July 7, 2023. In these patients, the questioning and clinical examination revealed ocular lesions linked to trauma. The parameters studied were socio-demographic characteristics (age, sex, origin, educational status), reason for consultation, ophthalmological history and etiological factors (circumstances of occurrence, vulnerating agent and mechanism of occurrence). Data analysis was carried out using epi-info 7.0 software. Findings: The average age of the patients was 8.45 ± 4.62 years with a range of 1 to 19 years. Boys were the most affected (71%) and this male predominance was found in all age groups. The 5-9-year-old age group was the most represented (31%). Children in primary school were the most numerous (40%), followed by those in secondary school (26%) and those not in school (25%). Almost all the children came from urban areas (75%). Ocular trauma was the main reason for consultation (75%) and the most common ophthalmological history (80%). The circumstances of occurrence were dominated by gaming accidents (48.50%), domestic accidents (19.50%) and brawls (15.50%). The most common damaging agent found was metallic (25%) followed by the stone used as a projectile (18.50%) and the punch (17%). The mechanism of trauma was dominated by the reception of a moving object or liquid on the eye (96%). Conclusion: Given the high proportion of school boys who are victims of eye trauma, school programs should include raising awareness among children at school about the risks of accidents and in particular eye trauma and the means of preventing them. Action should also be taken in rural areas and through the Chamber of Trades of Côte d’Ivoire with a view to preventing eye trauma in children and adolescents in farming activities and in craft workshops where those are often in apprenticeship.

Severe fusarium oxysporum keratomycosis: About 2 Cases

Fungal keratitis is a destructive ocular infection, representing a serious diagnostic and therapeutic problem, difficult to treat and with poor results. It can cause irreversible damage. Keratomycoses are rare and may be under-diagnosed. Direct microscopic examination and culture are essential for early specific diagnosis and must be taken into consideration to establish the most effective treatment and avoid serious complications. The pathogenesis of this infection is based on three factors: colonization, tissue damage and immunosuppression. We report 2 cases of Fusarium oxysporum keratomycosis treated with amphotericin B. The diagnosis of corneal abscess was made after ophthalmological examination in 2 adult males with no previous ophthalmological history, referred to the Omar Drissi hospital in Fez for decreased visual acuity, photophobia, redness and intense pain in the right/left eye. Corneal scrapings were taken for microbiological analysis, and after initial mycological results, local and systemic antifungal treatment was initiated with amphotericin B and natamycin eye drops. The evolution was marked by a corneal perforation with a tenon patch graft for the first patient, and healing for the 2nd

Risk Factors Associated with Cystoid Macular Edema among Patients Undergoing Primary Repair of Rhegmatogenous Retinal Detachment

To investigate predictors of the development and resolution of cystoid macular edema (CME) after rhegmatogenous retinal detachment (RRD) repair. Retrospective cross sectional study. Patients who underwent primary repair of uncomplicated RRD. Demographics, ophthalmic history, visual acuity, RRD features, time to development/resolution of CME, OCT characteristics of CME/epiretinal membrane (ERM), type of surgery, and treatments were collected. Logistic regressions were used to identify predictors of CME development and resolution. Predictors of CME development and resolution. A total of 708 eyes were included, of which 55 (7.8%) developed CME. Factors associated with an increased risk of CME development included total number of retinal detachment surgeries (odds ratio [OR] 1.66 [1.24-2.23], P < 0.001), prior intraocular surgery (OR 4.43 [1.19-16.51], P= 0.03), and presence of ERM after surgery (OR 4.49 [2.30-8.74], P < 0.001). Patients undergoing pars plana vitrectomy (PPV) were more likely to develop CME compared with patients undergoing scleral buckling (SB; OR 3.09 [1.18-8.10], P= 0.02). A longer average time to CME detection was associated with lower CME resolution (OR 0.94 [0.89-0.998], P= 0.04). In patients who developed an ERM postsurgically, those who developed CME after ERM had a lower rate of resolution compared with those who developed CME before ERM (P= 0.03). Cystoid macular edema may be more likely to develop in patients undergoing PPV than SB, those who underwent more surgeries for RRD repair, those who had prior intraocular surgery, or those who developed an ERM after RRD repair. Resolution of CME may be affected by the time to detection of CME and ERM development. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

A Brief History Of Ophthalmology In Antioquia Department at the University of Antioquia (1960-2020)

This is a brief summary of the beginnings of Ophthalmology in Antioquia Department. I will cover from the last twenty years of XIX century until the last current years. Several outstanding medical professionals that were educated in Europe return to the city of Medellin capital of the Antioquia Department. These medical professionals have significant contributions to the field of Ophthalmology. Around 1960 Otorhinolaryngology and Ophthalmology became independent services and academic programs within the Faculty of Medicine of the University of Antioquia. The new independent academic program of Ophthalmology became one of the best programs at the University of Antioquia. A profile of the most outstanding Ophthalmologist of the last 60 years is presented, as well as the outstanding figures since the end of the 19th century. The Ophthalmologists that were and have been part of the faculty are remember for the knowledge that instilled to the present and future generations of Ophthalmologists.

Nationwide genetic analysis of more than 600 families with inherited eye diseases in Argentina

This study corresponds to the first large-scale genetic analysis of inherited eye diseases (IED) in Argentina and describes the comprehensive genetic profile of a large cohort of patients. Medical records of 22 ophthalmology and genetics services throughout 13 Argentinian provinces were analyzed retrospectively. Patients with a clinical diagnosis of an ophthalmic genetic disease and a history of genetic testing were included. Medical, ophthalmological and family history was collected. A total of 773 patients from 637 families were included, with 98% having inherited retinal disease. The most common phenotype was retinitis pigmentosa (RP, 62%). Causative variants were detected in 379 (59%) patients. USH2A, RPGR, and ABCA4 were the most common disease-associated genes. USH2A was the most frequent gene associated with RP, RDH12 early-onset severe retinal dystrophy, ABCA4 Stargardt disease, PROM1 cone-rod dystrophy, and BEST1 macular dystrophy. The most frequent variants were RPGR c.1345 C > T, p.(Arg449*) and USH2A c.15089 C > A, p.(Ser5030*). The study revealed 156/448 (35%) previously unreported pathogenic/likely pathogenic variants and 8 possible founder mutations. We present the genetic landscape of IED in Argentina and the largest cohort in South America. This data will serve as a reference for future genetic studies, aid diagnosis, inform counseling, and assist in addressing the largely unmet need for clinical trials to be conducted in the region.

Clinical Outcomes of 27-Gauge Pars Plana Vitrectomy for Diabetic Tractional Retinal Detachment Repair.

Purpose: To analyze the clinical outcomes of 27-gauge pars plana vitrectomy (PPV) repair of diabetic tractional retinal detachment (TRD) of various severities. Methods: This retrospective case series examined the outcomes of 27-gauge PPV to repair diabetic TRD from 2016 to 2020. The effect of medical and ophthalmologic history parameters and baseline detachment characteristics on visual acuity (VA) and retinal reattachment was analyzed. A grading system was established to stage the severity of the baseline vitreoretinal traction or detachment and compare the visual and anatomic outcomes between stages. Results: The study comprised 79 eyes (79 patients). The overall redetachment rate was 10.1% (8/79). The proportion of eyes with severe visual impairment (worse than 20/200) decreased from 81.0% (64/79) preoperatively to 56.9% (37/65) 6 months postoperatively (P < .001). Worse preoperative logMAR VA was associated with greater odds of redetachment (P = .017) and worse postoperative VA (P < .001). Insulin dependence was associated with better VA at 6 months (P = .017). A shorter known duration of diabetes (P = .026) and evidence of neovascularization of the iris (NVI) or angle (P = .004) were associated with worse visual outcomes. Eyes with detachment involving the posterior pole extending beyond the equator had worse VA at 6 months (P = .048). Conclusions: The primary reattachment rate after 27-gauge PPV was 89.9%. There was significant VA improvement, with a roughly 40% reduction in the number of eyes with severe visual impairment by the final follow-up. Insulin dependence, duration of diabetes, presence of NVI before surgery, and baseline posterior pole detachment extending beyond the equator were predictors of visual outcomes.

Reminiscing the past - A dive into the history of ophthalmology

Reminiscing the past - A dive into the history of ophthalmology

The first cataract extraction operations

Abstract.The first written record of cataract surgery dates back to 2250 BC, when King Hammurabi of Babylon created a law regarding the outcome of cataract surgery. The first detailed description of cataract surgery was written by an Indian ophthalmologist Maharishi Sushruta in the sixth century BC. Sushruta performed the first couching - reclining operations. "Couching" means that the blurred lens is embedded in the vitreous, or fundus of the eye. At that time, because the scientists had no idea about the structure of the lens and the pathogenesis of the cataract, they believed that the cataract was a membrane in the pupil area and tried to cut it. They wanted to enter the anterior camera with a sharp instrument and tear the "membrane". In the 10th century AD, the Iraqian ophthalmologist Ammar Al-Mawsili began using a new method in cataract surgery - the "suction" method. Ammar Al-Mawsili was the first to say that cataract is blurring of the lens. Ammar ibn Ali Al-Mawsili first invented a hollow thin metal needles with sharp points for syringes. Through that needle, Ammar entered the eye through the sclera behind the limbus and suctioned out the contents of the soft cataract. These operations performed by Ammar Al-Mawsili are considered to be the first successful extraction operations in the history of ophthalmology. In 1748, Jacques Daviel made a right-sided widely corneal incision, passed through the pupil with a small spatula, and extracted the lens from the posterior chamber. CONCLUSION. Cataract extraction, that is, operations based on removing the clouded lens from the eye rather than destroying it inside the eye, was first performed by Ammar ibn Ali Al-Mosuli. Today's cataract surgery is based on Jacques Daviell's extraction technique. But as modern ophthalmology advances, the ultimate goal of ophthalmic surgeons is to reduce the size of the incision for removing the cloudy lens to the size of a needle tip. This means that cataract surgery has progressed from the Daviel technique to the Ammar technique.

Orbital abscess surgery in a patient with odontogenic pansinusitis

AbstractPurpose: In orbital abscesses with sinus origin, the most frequent treatment is a endoscopic sinus surgery (ENSS), if there is a subperiosteal abscess that may compromise the vision, an external drainage should be performed, depending on the location of the abscess. We present an orbital abscess of odontogenic cause that required an orbital approach.Methods: We present an orbital abscess in a 44‐year‐old man with no relevant medical or ophthalmological history, who, after complicated dental extraction, suffered a left orbital cellulitis.Surgical technique: Ethmoidectomy was performed by endoscopic sinus surgery (ENSS), without resolution of the infection, requiring drainage of the abscess through an external orbital superomedial approach.Results: This abscess was located between the middle and superior rectus muscles. A superomedial incision was made, dissecting up to the periosteum and incising the periorbita, observing the exit of purulent material. A drainage was left in place. At the same time, ENSS was performed with exeresis of the lamina papyracea. The patient evolved torpidly, with productive drainage. Computed tomography (CT) shows two collections adjacent to the drainage and the thickening of the lateral rectus muscle. Reoperation was performed, draining the abscesses visualized and washing the area with hydrogen peroxide and metronidazole. New drainage was placed. The evolution was favourable.Conclusions: In orbital abscesses, antibiotic therapy is usually not sufficient, and surgical intervention is indicated. There are various types of procedures and surgical approaches for the drainage of orbital abscesses, the most common is ENSS, but in complex abscesses an external approach may be necessary. Imaging tests facilitate the location of the abscess, serving as a guide for surgery.

Successful DWEK in persistent corneal edema secondary to subacute unexplained endotheliitis: 6‐month follow‐up

AbstractPurpose: To present a case of persistent corneal edema after endothelial disease of unknown cause and with a severe decrease in the endothelial count and clinical improvement after DWEK (descemetorhexis without endothelial keratoplasty).Methods: A 61‐year‐old immunocompetent male patient, with no relevant ophthalmological or systemic history, who after multiple episodes of subacute endotheliitis with retrokeratic precipitates and diffuse iridian atrophy in his right eye, showed central persistent corneal edema, secondary to a marked decrease in endothelial count and severe decrease in best‐corrected visual acuity (0.2) after several months of inflammatory stability.Results: During flare‐ups of inflammation, treatment with corticosteroids, topical ganciclovir and oral acyclovir was prescribed, with a good clinical response. Aqueous humour samples were taken during the outbreaks without yielding results for herpesviruses. The endothelial count remained low at the central level several months later, although the peripheral count was good. The fellow eye showed a normal count. It was decided to perform DWEK in the endothelial zone of retrokeratic precipitates as a diagnostic measure. The analyses of the endothelial sample FOR THE HERPESVIRIDAE FAMILY do not show results, however, a progressive improvement in corneal edema and visual acuity was observed from the first month after DWEK. He is currently stable, with mild paracentral edema and a best‐corrected visual acuity of 0.7.Conclusions: DWEK is reserved for cases of slightly advanced endothelial dystrophy, in which the central endothelial denudation causes a centripetal migration of the peripheral endothelial reserve. In this case, the clinical findings suggest a viral aetiology of the endothelial loss, therefore, DWEK was considered as a diagnostic procedure, to obtain samples for PCR and as a first step prior to DMEK. The improvement after DWEK in the area of retrokeratic precipitates without the need for a subsequent transplant suggests localized endothelial involvement in cases of endothelial loss associated with localized inflammatory precipitates.

Effectiveness and Safety of Belantamab Mafodotin in Patients with Relapsed or Refractory Multiple Myeloma in Real-Life Setting: The ALFA Study

Introduction: Although the therapeutic landscape for multiple myeloma (MM) has expanded, MM is an incurable disease and treatment of patients (pts) with relapsed or refractory multiple myeloma (RRMM) remains challenging. Pts triple refractory to immunomodulators (IMIDs), proteasome inhibitors (PIs), and anti-CD38 antibodies have few therapeutic alternatives and poor prognosis. Belantamab mafodotin (blmf) is a first-in-class antibody-drug conjugate targeting B-cell maturation antigen (BCMA) and showed promising results in the DREAMM-2 trial. The aim of the ALFA study is to describe blmf effectiveness and safety in pts with RRMM in a real-life setting. Methods: ALFA is a non-interventional, retrospective study of pts with RRMM initiating blmf in 46 centers in France during early access programs from April 27, 2020, to June 30, 2021. Pts characteristics, overall response rate (ORR, ≥partial response [PR]), clinical benefit rate (CBR, ≥minimal response [MR]), ≥very good PR (VGPR) rate, progression-free survival (PFS), overall survival (OS), and safety were assessed. Subgroup analyses for PFS and OS were performed according to best response, CBR, cytogenetic risk, renal failure, age at blmf initiation, previous penta-exposition (at least 2 PIs, 2 IMIDs, and 1 anti-CD38 exposition), and number of prior lines of treatment. Results: Between April 2020 and June 2021 (median duration of follow-up 7.8 months [mo]), 184 pts initiated blmf. Median time from MM diagnosis to initiation of blmf was 6 years, and 107 pts (58%) had received ≥5 prior lines of therapy. At initiation, 53% were male, median age was 70 years with 30% of pts aged of 75 years or older; 49% had renal failure; 79% were penta-exposed; and 8% had extramedullary disease. Among pts with available data (n=156), 36.5% had an ECOG PS ≥2. Cytogenetic profiles at initial diagnosis were available for 87 pts (47%), among whom 27 (33%) had high cytogenetic risk defined as pts presenting either t(4;14) or del(17p) or t(14;16); 40% had ophthalmological history (cataract in 53%). Blmf was delivered by intravenous infusion in 21-days cycles according to SmPC. Median dose at initiation was 2.5 mg/kg (min max 1.6-3.0). The median number of blmf cycles received was 3 (Q1-Q3 2-7). The ORR was 35% (≥VGPR 21%, PR 14%) and 59 pts (39%) achieved clinical benefit; 25% had stable disease (SD) and 37% had progressive disease (PD). The median PFS (mPFS) for the whole population was 2.7 mo (95 CI% 1.9-3.3), and median OS (mOS) was 9.5 mo (95 CI% 7.2-11.9). For both OS and PFS, no differences were found in subgroups according to cytogenetic risk, renal failure, age at blmf initiation, penta-exposition, and number of prior lines. According to best response, mPFS was 20.6 mo (95 CI% 13.1 to not reached) in pts with ≥VGPR, 6.6 mo (95 CI% 5.1-7.7) in pts with PR or MR and 2.8 mo (95 CI% 2.1-3.7) in pts with SD; P<0.01 (Figure 1). mOS was not reached in pts with ≥VGPR (1-year survival rate 96.7% [95 CI% 90.2-100.0]), 17.5 mo (95 CI% 9.8 to not reached) in pts with PR or MR, 9.5 mo (95 CI% 5.4-12.2) in pts with SD, and 3.3 mo (95 CI% 2.5-5.8) in pts with PD; P<0.01 (Figure 2). In pts with a clinical benefit, mPFS was 9.7 mo (95 CI% 7.5-14.9) and mOS was not reached. Safety findings were consistent with the known profile of blmf. Adverse events (AEs) were reported in 159 pts (86.4%). Most frequent reported AEs were ocular AEs in 56.0% of pts (n=103), among whom 70 pts had keratitis/keratopathy, and thrombocytopenia in 13.0% of pts. Infusion reaction was reported in 2.7% of pts. Permanent discontinuation due to AEs occurred in 12.5% of pts. Ocular AEs led to dose modification, temporary interruption, and permanent discontinuation in 19.6%, 11.4%, and 12.0% of pts, respectively. Conclusions: The ALFA study confirms the results of belantamab mafodotin as reported in the DREAMM-2 trial. In the overall population, the ORR was 35% (21% with ≥VGPR), CBR was 39%, mPFS was 2.7 mo, and mOS was 9.5 mo. In patients with a clinical benefit, mPFS was 9.7 mo and mOS was not reached. No new safety concerns were identified. These data presented from the largest real-life study conducted to our knowledge confirm previous results. Funding: GSK (214820) Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Workplace Trauma with Massive Intraorbital Foreign Body, A Dramatic Outcome

Background: Intra-orbital foreign bodies [IOFB] are considered a rare condition, and an enormous challenge to surgeons, as it might be difficult to diagnose in some cases even with the current advances in imaging technology. Retained IOFB can be a cause of major visual morbidity and blindness, especially in the working population. Purpose: In this article, we report a case of IOFB that occurred as a result of workplace related trauma while drilling ceramic. Methods: Case report and literature review using PubMed. Case Presentation: we present a case of a 30 years old male, not known to have any medical illness, the patient presented to the emergency department after getting trauma while drilling ceramic. Orbital computed tomography [CT] showed multiple high-density objects situated in a circumferential pattern around the globe. Results: The patient underwent lateral canthotomy and cantholysis in the emergency department, followed by three exploratory operations to remove intraorbital foreign bodies [FBs] . Luckily, the patient in our case regained a 0.5 visual acuity, with an impressive improvement in the extraocular muscle motility, with only mild restriction in the upper and lower gazes. The patient was followed up for 2 years after the incident, he was stable during that period. Conclusions: IOFB is an ophthalmological emergency, careful history, examination, and investigations are important steps in diagnosing IOFB since it can be easily missed when depending solely on imaging. Timely management is crucial to prevent irreversible complications.