Vitreopapillary traction in nonarteritic anterior ischemic optic neuropathy

Purpose: To describe the association between vitreous traction on the optic disc and nonarteritic anterior ischemic optic neuropathy (NAION). Methods: Eighty three eyes of 83 patients with NAION were evaluated by optical coherence tomography (OCT) for detecting vitreous adhesion to the optic nerve head with separation from the adjacent retina (partial posterior vitreous detachment). Eyes which were negative for such adhesion underwent ultrasonography to detect complete posterior vitreous detachment (PVD). Results: Fifty male and 33 female subjects with mean age of 51.9±10 years were studied. Partial PVD with optic nerve head adhesion was found in 54 patients (65.1) using OCT. Ultrasonography detected complete PVD in all other eyes with optically empty spaces on OCT. Conclusion: Vitreous traction on the optic nerve head from partial PVD may play a causative role in some cases of NAION. This traction may impair vascular supply and/or axoplasmic flow leading to signs and symptoms of NAION

Scleral buckling surgery for rhegmatogenous retinal detachment with subretinal proliferation

PurposeTo evaluate the outcome of scleral buckling surgery in patients with rhegmatogenous retinal detachment (RRD) with subretinal proliferation.MethodsIn this retrospective study, a chart review of all patients with RRD associated with subretinal proliferation who were primarily treated with scleral buckling procedure, from April 2007 to April 2014, was undertaken. Main outcome measures were anatomical retinal reattachment and visual acuity.ResultsForty-four eyes of 43 patients including 24 males and 19 females with a mean age of 26.5±13.1 years were evaluated. Immediately after the surgery, retina was reattached in all eyes. However, five eyes (11.3) needed additional surgery for retinal redetachment. Single surgery anatomical success rate was 88.7. Four eyes (9.1), needed pars plana vitrectomy for the treatment of redetachment associated with proliferative vitreoretinopathy and scleral buckle revision surgery was successfully performed in the other eye. Best corrected visual acuity improved from 1.5±0.9 logMAR before surgery to 1.1±0.7 logMAR after surgery (P2 lines was found in 23 eyes (52.2) and worsening of best corrected visual acuity of >2 lines was observed in 2 eyes (4.5).ConclusionsScleral buckling surgery is highly successful in eyes with RRD associated with subretinal proliferation. © 2015 Macmillan Publishers Limited All rights reserved

Removal of dye from synthetic textile wastewater using agricultural wastes and determination of adsorption isotherm

Reactive dyes have been applying extensively in textile industries. The treatment of textile industry waste waters is one of the main concerns of environmental health experts due to having excessive dyes and pollution. The aim of this study was to remove the Reactive Black 5 (RB5) dye from synthetic textile waste waters using agricultural wastes and determination of adsorption isotherm. In this research, Glycyrrhiza glabra root ash was prepared in laboratory condition and graded by standard sieve. The reactive Black 5 dye removals from textile synthetic wastewater using this adsorbent were tested. The effect of some parameters such as contact time (10–180 min), initial dye concentration (20, 40 and 60 mg/g) adsorbent dosage (0.2–2 g) and pH (2–12) were evaluated. Measurements were performed using an ultra violet-visible spectrophotometer at a wavelength of 597 nm and adsorption isotherm analyses were carried out. The results showed that data follow better the Langmuir adsorption model and the RL = 0.1123 was in the range of 0 to 1. Adsorption efficiency was reduced with increasing initial dye concentration and decreasing the adsorbent dosage. According to the results, the remaining root as an agricultural waste showed proper efficiency economically for the removal of dyes from textile industry wastewate

Two different doses of intravitreal bevacizumab for treatment of choroidal neovascularization associated with age-related macular degeneration

Purpose: To compare the efficacy and safety of 1.25 mg versus 2.5 mg intravitreal bevacizumab (IVB) for treatment of choroidal neovascularization (CNV) associated with agerelated macular degeneration (A). Methods: In this randomized clinical trial, consecutive patients with active CNV associated with A received 1.25 mg or 2.5 mg IVB. Best corrected visual acuity (BCVA), foveal thickness and side effects of therapy were evaluated one and three months after intervention. Results: Overall 86 subjects were enrolled and completed the scheduled follow-up. Forty seven and 39 patients received 1.25 and 2.5 mg IVB respectively. The study groups were balanced in terms of baseline characteristics such as age, BCVA and foveal thickness. Mean improvement in BCVA was 0.06±0.3 logMAR in the 1.25 mg group and 0.07±0.34 logMAR in the 2.5 mg group (P=0.9). Mean decrease in foveal thickness was 49±36 μm in the 1.25 mg group and 65±31μm in the 2.5 mg group (P=0.6). Three cases of vitreous reaction and one case of massive subretinal hemorrhage were observed in the 2.5 mg group. Conclusion: Double dose (2.5 mg) IVB does not seem to be more effective than regular dose (1.25 mg) injections for treatment of CNV due to A and may lead to more complications

Endophthalmitis caused by Acinetobacter spp. as the presenting manifestation of diabetes mellitus

Purpose We describe a patient with endogenous endophthalmitis caused by Acinetobacter spp. as the first clinical presentation of diabetes mellitus. Method A 48-year-old otherwise healthy woman was referred with signs and symptoms of acute endophthalmitis in the left eye. Systemic work-up, vitreous tap, and intravitreal antibiotic injection were performed followed by pars plana vitrectomy. Results The laboratory tests confirmed the diagnosis of diabetes mellitus. Vitreous culture was positive for Acinetobacter spp., and the organism was sensitive to colistin. One month after surgery, vision was no light perception, and the eye was phthisical. Conclusion Diagnostic work-up should be performed even in otherwise healthy patients with endogenous endophthalmitis. © 2016 Iranian Society of Ophthalmolog

Diabetic retinopathy clinical practice guidelines: Customized for Iranian population

Purpose: To customize clinical practice guidelines (CPGs) for management of diabetic retinopathy (DR) in the Iranian population. Methods: Three DR CPGs (The Royal College of Ophthalmologists 2013, American Academy of Ophthalmology Preferred Practice Pattern 2012, and Australian Diabetes Society 2008) were selected from the literature using the AGREE tool. Clinical questions were designed and summarized into four tables by the customization team. The components of the clinical questions along with pertinent recommendations extracted from the above-mentioned CPGs; details of the supporting articles and their levels of evidence; clinical recommendations considering clinical benefts, cost and side effects; and revised recommendations based on customization capability (applicability, acceptability, external validity) were recorded in 4 tables, respectively. Customized recommendations were sent to the faculty members of all universities across the country to score the recommendations from 1 to 9. Results: Agreed recommendations were accepted as the fnal recommendations while the non-agreed ones were approved after revision. Eventually, 29 customized recommendations under three major categories consisting of screening, diagnosis and treatment of DR were developed along with their sources and levels of evidence. Conclusion: This customized CPGs for management of DR can be used to standardize the referral pathway, diagnosis and treatment of patients with diabetic retinopathy. © 2016 Journal of Ophthalmic and Vision Research

Intravitreal injection of anti-vascular endothelial growth factor agents for ocular vascular diseases: Clinical practice guideline

Purpose: To provide the clinical recommendations for the administration of intravitreal anti-vascular endothelial growth factor (VEGF) drugs especially bavacizumab for ocular vascular diseases including diabetic macular edema, neovascular age-related macular degeneration, myopic choroidal neovascularization, retinal vein occlusion and central serous chorioretinopathy. Methods: Twenty clinical questions were developed by the guideline technical committee. Relevant websites and databases were searched to find out the pertinent clinical practice guidelines to answer the questions. The technical committee provided possible answers (scenarios) according to the available evidences for each question. All scenarios along with their levels of evidence and the supported articles were sent to the experts for external review. If the experts did not agree on any of the scenarios for one particular clinical question, the technical committee reviewed all scenarios and their pertinent evidences and made the necessary decision. After that, the experts were asked to score them again. All confirmed scenarios were gathered as the final recommendations. Results: All the experts agreed on at least one of the scenarios. The technical committee extracted the agreed scenario for each clinical question as the final recommendation. Finally, 56 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their applications in the management of ocular vascular diseases. Conclusion: The implementation of this guideline can standardize the management of the common ocular vascular diseases by intravitreal injection of anti-VEGF agents. It can lead to better policy-making and evidence-based clinical decision by ophthalmologists and optimal evidence based eye care for patients. © 2018 Journal of Ophthalmic and Vision Research