Comparison of astigmatism after cataract surgery with separate & running sutures

عمل جراحی آب مراورید یکی از رایج ترین اعمال جراحی است و در تمام دنیا از جمله کشور ایران شایع ترین تکنیک جراحی روش خارج کپسولی (Extra Capsular Cataract Extraction= ECCE) است که نیاز به برش قرنیه در ناحیه لیمیوس و در آخر عمل بخیه دارد. یکی از فاکتورهای موثر در بهبود دید بیمار بعد از جراحی در این روش کاستن از میزان آستیگماتیسم ناشی از بخیه ها می باشد. چون بخیه ها به دو روش ممتد (Running (R)) و جدا از هم (Separate (s)) زده می شوند بر آن شدیم که مقایسه ای بین آستیگماتیسم حاصله از این دو روش انجام دهیم. در تحقیق فوق 157 بیمار که تحت جراحی آب مراورید به روش ECCE قرار گرفتند و بخیه آنها به دو روش R و S زده شده بود انتخاب و میزان آستیگماتیسم ایجاد شده روز بعد از عمل، هفته اول، دوم، چهارم، ششم و سه ماه بعد با روش کراتومتری تعیین و با آستیگماتیسم موجود قبل از عمل مقایسه گردیدند. بخیه زدن ها در 104 مورد (3/66) به روش ممتد و در 53 مورد (7/33) به صورت جدا از هم بودند. متوسط آستیگماتیسم روز بعد از عمل 19/5 دیوپتر (در گروه R 7/4 و در گروه S 7/5 دیوپتر)، سه ماه پس از عمل 58/1 دیوپتر (در گروه R 12/1 و در گروه s 05/2دیوپتر) بود. از هفته چهارم تفاوت معنی دار آماری بین دو روش R، S مشاهده شد (05/0

Single-dose Intravitreal Bevacizumab after Complete Panretinal Photocoagulation in Proliferative Diabetic Retinopathy: an Effective Adjunctive Treatment

Patients with proliferative diabetic retinopathy (PDR) who are refractory to complete panretinal photocoagulation (PRP) have a high risk of severe vision loss. The aim of this study was to evaluate the effectiveness of single-dose intravitreal bevacizumab (IVB) after complete PRP in patients with refractory PDR. Patients with retinal neovascularization (NV) secondary to diabetes mellitus and refractory to complete PRP were enrolled in this study. All patients received a single dose of 1.25 mg IVB at 3 months after completing the PRP. Patients underwent complete ophthalmic evaluation and fluorescein angiography (FA) at baseline and 1 month after injection. The main outcome measure was a reduction in the areas of leakage (mm2) on FA. All patients were evaluated at baseline and on every visit at 1 day, 1 week, and 1 month after the injection. A total of 21 consecutive patients (32 eyes) with PDR completed this study. Thirteen (61.9%) patients were female. The mean ± standard deviation (SD) age was 64.1 ± 5.6 years. Complete and partial response of angiographic leakage of NV was noted in 7 (21.9%) and 18 (56.2%) of 32 eyes after a single IVB injection, respectively. No satisfactory response of retinal NV was observed in 7 eyes (21.9%) at 1 month after the injection. There was a significant difference in age between response groups (partial and complete; 61.9 ± 4.4 years) versus the no-satisfactory response group (67.7 ± 5.9 years) (P = 0.007). No significant ocular or systemic adverse events were observed. A single-dose of IVB could be associated with a satisfactory response of retinal NV, secondary to PDR, in patients who are refractory to complete PRP.Â

Intravitreal vascular endothelial growth factor (VEGF) inhibitor injection in unrecognised early pregnancy

The use of intravitreal vascular endothelial growth factor (VEGF) inhibitor medications has widened considerably to include indications affecting females of reproductive age. Our patient was inadvertently exposed to bevacizumab within the first trimester when placental growth and fetal organogenesis take place and patient suffered pregnancy loss. There is insufficient information to suggest that such use is safe, nor is there definitive evidence to suggest that it causes harm. We advise that ophthalmologists discuss pregnancy with women of childbearing age undergoing intraocular anti-VEGF injections and in pregnant woman counselling is needed to explain the potential risks and benefits

Anti-vascular Endothelial Growth Factor for Choroidal Neovascularization Associated with Toxoplasmosis: A Case Series

The purpose of the study was to evaluate the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) in treatment of choroidal neovascularization (CNV) secondary to toxoplasmic retinochoroiditis in five patients. After six months the CNV resolved as confirmed by fluorescein angiography and optical coherence tomography (OCT) in all patients. The visual acuity improved from mean 20/400 to 20/80 and Central Macular Thickness (CMT) decreased from 390 μm to 253 μm, which was maintained till the last follow-up visit

Intravitreal vascular endothelial growth factor (VEGF) inhibitor injection in patient during pregnancy

Purpose: To report the clinical course of a woman treated with intravitreal bevacizumab during pregnancy. Case report: A 27-year-old female with poorly controlled diabetes and a history of two previous miscarriage was referred to our hospital with sudden deterioration in visual acuity (VA) in her right eye. Ocular findings revealed severe Proliferative Diabetic Retinopathy (PDR) complicated with preretinal hemorrhages in her right eye, and after maximal Panretinal Photocoagulation (PRP) bilaterally, she was treated with intravitreal injection of bevacizumab (IVB) into the right eye. Twenty four hours after the bevacizumab injection, she reported vaginal bleeding, and ultrasound confirmed a 12-week pregnancy of which the patient was unaware. The patient suffered from pregnancy loss. Conclusion: Use of intravitreal anti-VEGF by pregnant woman may only be justified if the potential benefit outweighs the potential risk to the fetus and only if clearly needed. Intravitreal bevacizumab during pregnancy in women with a history of miscarriage should be used with caution

Rhegmatogenous retinal detachment: an analysis of 2315 eyes over a six-year period

Background: Rhegmatogenous retinal detachment (RRD) is a form of retinal detachment caused by passage of fluid from the vitreous cavity into the space between the neurosensory retina and the retinal pigment epithelium via a retinal break or full-thickness defect. At our tertiary referral center, we evaluated the clinical and epidemiological features of RRD, and we herein report the frequency of related risk factors. Methods: In this retrospective study, we reviewed the records of patients with a final diagnosis of RRD at an academic ophthalmological referral center in Isfahan, Iran, over a six-year period. We retrieved and reviewed data from the medical records of all eligible participants, including sex, age, laterality, lens status, macular status, type of RRD, location and number of breaks, type of surgery, rate of re-operation during the first year after initial surgery, and documented clinical risk factors for RRD. Clinical risk factors were categorized as the presence of myopic refractive error, ocular trauma, history of cataract surgery, history of other ocular surgeries, history of uveitis, or undetermined. Results: We included 2315 eyes of 2229 patients with a mean (standard deviation [SD]) age of 51.1 (16.9) years and a male-to-female ratio of 1.8:1. The most common quadrants containing retinal breaks were the superotemporal quadrant (34.1%), inferotemporal quadrant (23.4%), and superonasal quadrant (10.7%). Macula-involved RRD was seen in 90% of eyes (n=2083 eyes). The most frequently identified risk factors were cataract surgery (32.9%) and myopia (22.3%) in adults, and myopia (35.0%) and ocular trauma (27.4%) in the pediatric group. Most eyes underwent pars plana vitrectomy (51.3%), whereas pneumatic retinopexy (0.7%) was the least commonly selected. Conclusions: Our results indicate that cataract surgery and myopia are the most common risk factors for RRD in adults. Myopia and ocular trauma are the most common risk factors in pediatric patients. As observed in many studies, the characteristics of the study population, including middle age, male sex, myopia, and ocular trauma, may be associated with RRD at different rates. Further population-based longitudinal studies with larger sample sizes are required to verify these preliminary observations

Retinal findings of COVID-19 patients using ocular coherence tomography angiography two to three months after infection: Ocular appearance recovered COVID-19 patient

Purpose: The aim of this study was to evaluate the ocular disorders in COVID-19 patients, two to three months after infection. Methods: In this cross-sectional, historically controlled study, fifty-one COVID-19 patients were compared with thirty-seven age, and gender-matched healthy individuals. After complete ophthalmological examination, all participants underwent peripapillary and macular optical coherence tomography, and optical coherence tomography angiography (OCTA) measurements (OptoVue Inc, Freemont, CA, USA). Results: The time between the initial onset of symptoms, and ophthalmologic examination was 63.31±15.21 (40�95 days). Ophthalmic examination of all the recovered COVID-19 patients was within normal range. None of the peripapillary and macular OCTA parameters were significantly different between the two groups with pairwise comparisons, but after adjusting for age, gender, axial length, and signal strength index (SSI), recovered COVID-19 eyes showed a significant increase in peripapillary retinal nerve fiber (RNFL) thickness, superficial, and deep macular vessel densities in parafoveal and perifoveal regions compared with healthy control eyes (p<= 0.05). Inner retinal thickness overall is higher in recovered COVID-19 eyes compared to healthy eyes after adjustment. Conclusion: Patients with moderate-intensity SARS-CoV-2 pneumonia had altered peripapillary and macular vessel density compared to healthy subjects. Further investigation is warranted to analyze the correlation of these changes with disease severity as well as evolution of these changes over time

Bilateral Diffuse and Cluster Pigment Epithelial Detachment Associated with Diffuse Proliferative Glomerulonephritis

Retinal pigment epithelium detachment (PED) is an area of retinal pigment epithelium (RPE) elevation with minimal or no sensory retinal detachment resulting from the accumulation of sub-RPE fluid. There are many etiological factors that lead to the development of PED. PED may be observed as an isolated finding or in association with ocular and systemic conditions. In this case we report a 23-year-old male with bilateral cluster PED associated with diffuse proliferative glomerulonephritis (DPGN). The importance of current report is that development of PED and DPGN is more than a simple incidental event. Patients with DPGN should have regular fundus examinations, and follow-up should be conducted by an ophthalmologist who is aware of the possible presence of these diseases

The Effect Of Hesa-A (Nnatural Drug) On Visual Acuity In Age Related Macular Degeneration: A Randomized Double Blind Controlled Clinical Trial

We investigated the clinical efficacy and safety of HESA-A (a drug of herbal-marine origin) in the treatment of age related macular degeneration (AMD). In a randomized double blind clinical trial 280 eyes of 280 (157 F, 123 M) patients with wet and dry AMD were randomly assigned in treatment or placebo groups. Patients in treatment group received HESA-A tablet 25 mg/Kg twice a day orally and controls received placebo with the same method for 4 weeks. Visual acuity at baseline and after one month of treatment was measured and compared between two groups. All patients were followed up for 5 months after treatment. Mean patients’ age was 69.06±8.49 years. At the end of study visual acuity improved significantly from 1.69±0.65 LogMar to 1.03± 0.40 LogMar in treatment group but not in controls (P: 0.000 and P: 0.67 in treatment and control groups respectively). No drug reaction or recurrence was reported during the study and 5-month post treatment follow up period in HESA-A treated group. This study showed significant efficacy and safety of HESA-A in improvement of visual acuity in AMD patients in short term

The Effect of HESA-A (Natural Drug) on Visual Acuity in Age Related Macular Degeneration: A Randomized Double Blind Controlled Clinical Trial

We investigated the clinical efficacy and safety of HESA-A (a drug of herbal-marine origin) in the treatment of age related macular degeneration (AMD). In a randomized double blind clinical trial 280 eyes of 280 (157 F, 123 M) patients with wet and dry AMD were randomly assigned in treatment or placebo groups. Patients in treatment group received HESA-A tablet 25 mg/Kg twice a day orally and controls received placebo with the same method for 4 weeks. Visual acuity at baseline and after one month of treatment was measured and compared between two groups. All patients were followed up for 5 months after treatment. Mean patients' age was 69.06±8.49 years. At the end of study visual acuity improved significantly from 1.69±0.65 LogMar to 1.03± 0.40 LogMar in treatment group but not in controls (P: 0.000 and P: 0.67 in treatment and control groups respectively). No drug reaction or recurrence was reported during the study and 5-month post treatment follow up period in HESA-A treated group. This study showed significant efficacy and safety of HESA-A in improvement of visual acuity in AMD patients in short term