Pars Plana Vitrectomy with Internal Limiting Membrane Peeling for Refractory Diffuse Diabetic Macular Edema

Purpose: To evaluate the effect of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for management of refractory diffuse diabetic macular edema (DME). Methods: In this prospective interventional case series, eyes with refractory diffuse DME unresponsive to macular photocoagulation and/or intravitreal bevacizumab, and best corrected visual acuity (BCVA) ≥20/200 and ≤20/60 underwent triamcinoloneassisted PPV with ILM peeling. Pre- and postoperative evaluations included a complete ophthalmologic examination, fluorescein angiography and optical coherence tomography (OCT). Main outcome measures were BCVA and central macular thickness (CMT). Results: Twelve eyes of 12 patients with mean age of 59.6±3.9 (range, 55-68) years were operated and followed for a mean period of 4.9±1.0 (range, 4-6) months. Mean BCVA at final examination was 0.82 ± 0.18 logMAR which was not significantly better than its preoperative value of 1.00 ± 0.80 logMAR (P=0.959). Visual acuity improved by at least 2 lines in 3 eyes (25%), remained stable in 7 eyes (58%) and decreased by at least 2 lines in 2 eyes (17%). Mean CMT at final examination was 315±95 μm, which was significantly less than its preoperative value of 467±107 μm (P=0.004). Complications included vitreous hemorrhage in 2 and cataract progression in 5 eyes. Conclusion: PPV with ILM peeling for refractory diffuse DME seems to reduce macular thickness, but does not significantly improve visual acuity as observed after an intermediate-term follow up of about 6 months

Comparative Study of Fatalism among Disabled and non-Disabled People in Yazd City

Fatalism is believing in the impact of superhuman power or external forces like chance/luck in life. This research was conducted for a comparative study of fatalism among disabled and non-disabled people. In this research, a survey method was used. 200 people with physical disabilities, cerebral palsy (CP) and blindness and 200 non-disabled people from Yazd in 2018 were selected. Available quote sampling method was used to select disabled people and systematic cluster sampling was used to select non-disabled people. Data collection tools include the responsibility scale of Ahmadi Akhorme et.al (1392), the ability of Peterson and Seligman (2004), Weissman & Beck`s (1978) dysfunctional attitudes and researcher questioner made by fatalism. Data were analyzed in two independent groups by statistical mean difference, T-test, Pearson correlation, ANOVA and multivariate regression test. The average fatalism is 48.3 in disabled people and 45 in non-disabled people. The result of hypothesis showed that the measure of fatalism is higher in disabled people. In disabled people, there was a significant/meaningful relationship between fatalism and the studied variables such as education (with meaningful level, age, severity of disability, inefficient attitudes, empowerment and responsibility. In non-disabled people, there was a meaningful relationship between fatalism and inefficient attitude variables and empowerment, but there wasn’t any significant relationship between fatalism and other studied variables. The result of regression analysis showed that inefficient attitude variables and ability had the greatest effect on fatalism in disabled and non-disabled people and only people and only 16 percent of Variance explains fatalism