Abdulrahman Faisal Albloushi

Background/Objectives: The aim of this study was to investigate the effect of different auditory conditions on pattern-reversal visual evoked potential (PVEP) responses among healthy adults. Methods: This repeated-measure design with a fixed baseline and randomized order of the two auditory conditions was conducted at the Retina Clinic, Ophthalmology Department, Tertiary Hospital in Riyadh, Saudi Arabia. Healthy adults with no systemic or ocular diseases aged 20–60 years were included. All participants underwent comprehensive visual and ocular assessment, including best-corrected visual acuity (BCVA), slit-lamp examination, optical coherence tomography (OCT), screening audiometry, and a PVEP test conducted under three auditory conditions: silence, Quran recitation, and music exposure. P100 latency and amplitude were recorded using 1° and 0.25° stimulation sizes. Statistical analysis was performed using non-parametric statistics. A p-value of less than 0.05 was considered statistically significant. Results: Significant differences in PVEP amplitude responses were observed across auditory conditions, particularly at the 1° stimulation size. The Friedman test demonstrated significant amplitude differences at the 1° stimulation size (χ² = 16.379, p < 0.001), with silence producing adjusted significantly higher amplitudes compared with Quran recitation and music exposure (p = 0.001 and p = 0.003), respectively. Significant positive correlations were identified between BCVA and P100 amplitude at Quran exposure (r = 0.178, p < 0.05) only at the 0.25° stimulation size. Conclusions: The stimulus size can be sensitive in revealing auditory-related changes in different retinal areas of functional visual pathway alterations. In comparison to baseline (silence), which generally produces the highest amplitudes, both auditory conditions (Quran recitation and music) were associated with lower P100 amplitude, while no significant difference was observed between Quran recitation and music.

Background/Objectives: To investigate the effect of different sound types on pattern visual evoked potential (VEP) responses among healthy adults. Methods: This prospective cross-sectional trial was conducted at the Retina Clinic, Ophthalmology Department, tertiary Hospital in Riyadh, Saudi Arabia. Healthy adults with no systemic or ocular diseases aged 20-60 years were included. All participants underwent comprehensive visual and ocular assessment including best-corrected visual acuity (BCVA), slit-lamp examination, optical coherence tomography (OCT), screening audiometry, and pattern-reversal visual evoked potential (VEP) test conducted under three auditory conditions: silence, Quran recitation, and music exposure. P100 latency and amplitude were recorded using 1° and 0.25° stimulation sizes. Statistical analysis was performed using non-parametric statistical tests including the Friedman test and Bonferroni-corrected post-hoc comparisons. Results: Significant differences in VEP amplitude responses were observed across auditory conditions, particularly at the 1° stimulation size indicated 95% confidence intervals and exact P value for effects. The Friedman test demonstrated significant amplitude differences at the 1° stimulation size (χ²(2)=16.379, p<0.001), with silence producing significantly higher amplitudes compared with Quran recitation and music exposure (p=0.001). Significant positive correlations were identified between BCVA and P100 amplitude at music exposure (r=0.218, p<0.001) only at the 0.25° stimulation size. Conclusion: Different auditory stimulation significantly influenced VEP responses. Stimulation size could be sensitive in detecting the functional visual pathway in healthy adults, but it could be great sensitive for detecting abnormalities in ocular conditions. Further studies are required to assess the potential value of VEP as a non-invasive test for early neural dysfunction.

Introduction and importance: Uveal effusion syndrome (UES) is a rare condition characterized by fluid accumulation in the suprachoroidal space and is often associated with scleral thickening and impaired transscleral outflow. The management of UES is challenging. We present a case of UES successfully managed with a modified surgical technique involving double scleral flaps with mitomycin-C. Case presentation: A 43-year-old man presented with sudden, painless, decreased vision in his left eye. Clinical examination and imaging revealed bilateral optic disc swelling, choroidal thickening, and inferior exudative retinal detachment in the affected eye. The axial lengths were short, suggestive of nanophthalmos. After an unsuccessful trial of high-dose oral corticosteroids, the patient underwent surgery involving two inferior scleral windows using double scleral flaps, central sclerotomy, and intraoperative application of mitomycin-C. Histopathology revealed a thickened sclera without inflammation. The effusion resolved completely within 6 months postoperatively, with no recurrence over a 2-year follow-up. Discussion: UES remains a surgical challenge, particularly in patients with eyes that have thick sclerae, where conventional drainage is ineffective. The aim of our approach was to reduce scleral resistance to fluid egress while preserving structural integrity. Long-term patency of the scleral windows was likely maintained by the use of mitomycin-C, which helped prevent fibrosis. Compared with previously described techniques, this modification is effective, safe, and structurally conservative. Conclusion: Double scleral flaps combined with mitomycin-C can be an effective surgical option for managing UES. The long-term resolution achieved in this case supports the value of this technique.

Peripapillary pachychoroid syndrome (PPS) is a rare disease characterized by choroidal thickening around the optic disc. Visual acuity might be impaired secondary to the associated peripapillary intraretinal and/or subretinal fluids. We reported a case of a 70-year-old male patient who presented with a gradual bilateral decrease in vision. His best-corrected visual acuity was 20/60 in the right eye and 20/25 in the left eye. Dilated fundus examination showed yellowish peripapillary lesions and intraretinal fluid (IRF) surrounding the optic disc in both eyes. Optical coherence tomography showed that the outer retinal layers were disrupted, and IRF affected the nasal macula. A bilateral increase in the thickness of the choroid around the optic discs was found. The patient was successfully treated with a tapering dose of topical prednisolone acetate (1%). Three months after treatment, his vision improved to 20/25 in the right eye and 20/20 in the left eye. Topical steroid drops might be administered to treat PPS.

Anterior scleritis is rarely diagnosed with a peripheral amelanotic subretinal mass. We reported a rare case of a 31-year-old woman who was referred for suspected left eye choroidal melanoma. The patient had granulomatosis with polyangiitis with a history of treated left eye necrotizing anterior scleritis. Her left eye examination revealed 20/60 vision, superotemporal diffuse scleral injection, and thinning. Dilated fundus examination of the left eye showed a large peripheral amelanotic subretinal mass below the area of anterior scleritis, optic disc hyperemia, and subretinal fluid. The patient was successfully treated with intravenous methylprednisolone, rituximab infusions, and oral methotrexate. Two months after treatment, her vision improved to 20/20, with inactive anterior scleritis and a significant reduction in the subretinal mass with complete resolution of optic disc hyperemia and subretinal fluid. High index of suspicion of this atypical presentation of anterior scleritis is important to avoid aggressive modalities of treatment.