Sensitivity and Specificity of Swedish Interactive Threshold Algorithm and Standard Full Threshold Perimetry in Primary Open-angle Glaucoma

Perimetry is one of the mainstays in glaucoma diagnosis and treatment. Various strategies offer different accuracies in glaucoma testing. Our aim was to determine and compare the diagnostic sensitivity and specificity of Swedish Interactive Threshold Algorithm (SITA) Fast and Standard Full Threshold (SFT) strategies of the Humphrey Field Analyzer (HFA) in identifying patients with visual field defect in glaucoma disease. This prospective observational case series study was conducted in a university-based eye hospital. A total of 37 eyes of 20 patients with glaucoma were evaluated using the central 30-2 program and both the SITA Fast and SFT strategies. Both strategies were performed for each strategy in each session and for four times in a 2-week period. Data were analyzed using the Student’s t-test, analysis of variance, and chi-square test. The SITA Fast and SFT strategies had similar sensitivity of 93.3%. The specificity of SITA Fast and SFT strategies was 57.4% and 71.4% respectively. The mean duration of SFT tests was 14.6 minutes, and that of SITA Fast tests was 5.45 minutes (a statistically significant 62.5% reduction). In gray scale plots, visual field defect was less deep in SITA Fast than in SFT; however, more points had significant defect (p < 0.5% and p < 1%) in pattern deviation plots in SITA Fast than in SFT; these differences were not clinically significant. In conclusion, the SITA Fast strategy showed higher sensitivity for detection of glaucoma compared to the SFT strategy, yet with reduced specificity; however, the shorter test duration makes it a more acceptable choice in many clinical situations, especially for children, elderly, and those with musculoskeletal diseases

Induced Myopia Secondary to Blunt Trauma

A 28-year-old young man presented with sudden and severe visual loss in the left eye, starting three days ago following blunt head trauma from a closed fist. Vision was not improved to better than 0.4 in the left eye. Slit lamp examinations revealed asymmetric anterior chamber depth (ACD) with shallow ACD in the left eye. The key learning in this report is the use of anterior segment optical coherence tomography (AS-OCT) to better document the anterior segment changes following the blunt trauma. AS-OCT was used to visualize the forward displacement of the iris-crystalline lens diaphragm secondary to ciliary body anterior rotation and ciliochoroidal effusion. There was a temporary myopic shift about 7.00D which resolved after 15 days

Larvicidal activity of essential oil and methanol extract of Nepeta menthoides against malaria vector Anopheles stephensi

AbstractObjectiveTo investigate the larvicidal activity of essential oil and methanol extract of the Nepeta menthoides (N. menthoides) against main malaria vector, Anopheles stephensi (An. stephensi).MethodsThe essential oil of plant was obtained by Clevenger type apparatus and the methanol extract was supplied with Percolation method. Larvicidal activity was tested by WHO method. Twenty five fourth-instar larvae of An. stephensi were used in the larvicidal assay and four replicates were tested for each concentration. Five different concentrations of the oil and extract were tested for calculation of LC50 and LC90 values.ResultsThe LC50 and LC90 values were determined by probit analysis. LC50 was 69.5 and 234.3 ppm and LC90 was 175.5 and 419.9 ppm for the extract and essential oil respectively.ConclusionsAccording to the results of this study methanolic extract of plant exhibited more larvicidal activity than essential oil. This could be useful for investigation of new natural larvicidal compounds

Effect of Genistein and L-Carnitine and Their Combination on Gene Expression of Hepatocyte HMG-COA Reductase and LDL Receptor in Experimental Nephrotic Syndrome

Background: Nephrotic syndrome is a disorder that leads to hyperlipidemia. L-carnitine and genistein can effect on lipid metabolism and the syndrome. In the present study, we have delved into the separate and the twin-effects of L-carnitine and genistein on the gene expressions of HMG-COA reductase and LDL receptor in experimental nephrotic syndrome. Methods: In this controlled experimental study, 50 male Sprague–Dawley rats were randomly divided into five groups: NC (normal-control), PC (patient-control), LC (L-carnitine), G (genistein), LCG (L-carnitine-genistein). Adri-amycin was used for inducing nephrotic syndrome and the spot urine samples and urine protein-to-creatinine ratio were measured. Hepatocytic RNA was extracted and real-time PCR was used for HMG-COA Reductase and LDL receptor gene Expression measurement. Results: The final weight of the patients groups were lower than the NC group (P=0.001), and weight gain of the NC group was higher than the other groups (P<0.001). The proteinuria and urine protein-to-creatinine ratio showed sig-nificant differences between PC group and LC, G and LCG groups at week 7 (P<0.001). The expression of HMG-COA Reductase mRNA down regulated in LC, G and LCG groups in comparison with PC group (P<0.001). ΔCT of LDLr mRNA showed significant differences between the PC group and the other patient groups (P<0.001). Conclusion: This study shows a significant decreasing (P<0.001) and non-significant increasing trend in HMG-COA Reductase and LDLr gene expression, respectively, and synergistic effect of L-carnitine and genistein on these genes in experimental nephrotic syndrome

Comparing morphologic features and complications of main clear corneal incision between junior and senior residents observed using anterior segment optical coherence tomography

Background: Wound construction is a critical step in phacoemulsification. Using anterior segment optical coherence tomography (AS-OCT), we compared the morphological features and complications of main incisions made by junior or senior residents during phacoemulsification. Methods: This cross-sectional comparative study included eyes with senile cataracts that underwent uneventful phacoemulsification with a clear corneal incision made by seven senior and eight junior ophthalmology residents. All eyes underwent postoperative image acquisition using AS-OCT on day one and at three months, examining for morphological features and potential complications of the main incision. Results: We included 50 eyes of 50 patients with a male-to-female ratio of 22 (44%) to 28 (56%); 26 (52%) were operated on by junior residents and 24 (48%) by seniors. The mean geometric features of the main incisions and the frequency of early and late wound complications were comparable between the two groups (all&nbsp;P&nbsp;&gt; 0.05). A significant correlation was found between the incision length and angle with the superior (r = + 0.80;&nbsp;P&nbsp;&lt; 0.001 and r = - 0.63;&nbsp;P&nbsp;&lt; 0.001, respectively) and inferior (r = + 0.84;&nbsp;P&nbsp;&lt; 0.001 and r = - 0.68;&nbsp;P&nbsp;&lt; 0.001, respectively) areas of the incision, as well as between the length and angle of incision (r = - 0.74;&nbsp;P&nbsp;&lt; 0.001). The number of planes in the wound architecture was not significantly different according to senior or junior resident status (P&nbsp;&gt; 0.05). Although the number of eyes with stromal hydration was significantly greater for junior residents than for seniors (P&nbsp;&lt; 0.001), the corneal thickness at the entrance to the cornea or the anterior chamber, presence of endothelial wound gaping, and Descemet’s membrane detachment were comparable between eyes with and without stromal hydration (all&nbsp;P&nbsp;&gt; 0.05). At three months, 29 (58%) patients returned for examination, in whom seven (24%) had late wound complications. Conclusions: This study found no significant differences in the performances of junior and senior residents in terms of wound construction or its associated complications. However, considering the overall rate of some observed wound-related complications, we recommended revision of the resident educational curriculum concerning the structure and complications of the main incision

The Correlation between Glucose and Lipid Biomarkers Variations with biometric characteristics and Intraocular Pressure Changes during Ramadan Fasting

Introduction: The aim of present study was to assess the correlation between glucose and lipid biomarkers variations with biometric characteristics and intraocular pressure changes following Ramadan fasting. Methods: A total of 100 healthy fasting volunteers were enrolled in the study. Of them, 89 subjects completed the study with respect to inclusion and exclusion criteria. Right eye ocular axial length and anterior chamber depth were determined using the IOLMaster, (Carl Zeiss Meditec, Jena, Germany). Following that, intraocular pressure of right eye was measured using a non-contact tonometer (Topcon, Computerized Tonometer CT-1/CT-1P, Tokyo, Japan). Blood samples were taken from all the participants and concentrations of the biomarkers, including Fast blood sugar, Triglyceride, Cholesterol, High-density lipoprotein and Low-density lipoprotein were measured using the Hitachi 717 analyzer (Hitachi, Tokyo, Japan). All assessments were obtained one week before and after Ramadan. Results:  Of 89 healthy Muslims who complete the study, 51 were men (mean age: 35.51±8.94 years) and 38 were women mean age: 34.26±9.41 years).The results indicated no significant relationship between the axial length with glucose and lipid biomarkers variations in the fasting individuals. The assessment of result showed only a slight correlation between anterior chamber depth and High-density lipoprotein changes during Ramadan, however, this was not statistically significant. Also, findings revealed only a slight correlation between intraocular pressure and cholesterol changes in healthy fasting individuals, however, this was not statistically significant. Conclusion: Our study revealed that ocular parameters changes during Ramadan fasting is probably independent to variation levels of glucose and lipid biomarkers

Changes in corneal biomechanical parameters in keratoconus eyes with various severities after corneal cross-linking (CXL)::A comparative study

Objectives To compare changes in corneal biomechanical parameters one year after corneal cross-linking (CXL) in keratoconus (KCN) eyes of different severities. Methods Seventy-five eyes with mild, moderate, and severe grades of KCN (n = 24, 31, and 20 eyes, respectively) that were treated with CXL, based upon the standard Dresden protocol, were included. The corneal biomechanical assessment was performed using Corvis ST and Ocular Response Analyzer (ORA). Changes in Corvis's dynamic corneal response (DCR) parameters and ORA's derived parameters (corneal hysteresis (CH), and corneal resistance factor (CRF)) were assessed whilst the corneal thickness and intraocular pressure were considered as covariates. Results There was no statistically significant difference in the corneal biomechanical parameters obtained using both devices after surgery separately in different KCN grades, except for the deformation amplitude (DA) in the severe KCN group (P = 0.017). Changes in the classic parameters of the highest concavity phase of Corvis ST (peak distance, radius, and DA) were more positive and in the newer parameters (integrated inverse radius (IIR), deformation amplitude ratio (DAR)) more negative in the severe group compared to the other groups. Also, the mean change in CH (P = 0.710), and CRF (P = 0.565), showed a negative shift in higher grades of KCN; however, there was no significant difference in the mean changes of all parameters between different groups. (P > 0.05) Conclusions Similar changes in the Corvis ST and ORA parameters in mild, moderate, and severe KCN indicate biomechanical stability and the effective role of CXL in stopping the progressive nature of keratoconus in eyes of varying severities one year after CXL

Marked increase in breast cancer incidence in young women : A 10-year study from Northern Iran, 2004-2013

Introduction: Breast cancer is the most frequent cancer among women worldwide. Breast cancer incidence in young women is a health issue of concern, especially in middle-income countries such as Iran. The aim of this study is to report the breast cancer incidence variations in Golestan province, Iran, over a 10-year period (2004-2013). Methods: We analyzed data from the Golestan Population-based Cancer Registry (GPCR), which is a high-quality cancer registry collecting data on primary cancers based on standard protocols throughout the Golestan province. Age-standardized incidence rates (ASRs) and age-specific incidence rates per 100,000 person-years were calculated. Time trends in ASRs and age-specific rates were evaluated using Joinpoint regressions. The average annual percentage change (AAPC) with correspondence 95% confidence intervals (95%CIs) were calculated. Results: A total of 2106 new breast cancer cases were diagnosed during the study period. Most cases occurred in women living in urban areas: 1449 cases (68%) versus 657 cases (31%) in rural areas. Statistically significant increasing trends were observed over the 10-year study period amongst women of all ages (AAPC = 4.4; 95%CI: 1.2-7.8) as well as amongst women in the age groups 20-29 years (AAPC = 10.0; 95%CI: 1.7-19.0) and 30-39 years (AAPC = 5.1; 95%CI: 1.4-9.0). Conclusion: The incidence of breast cancer increased between 2004 and 2013 in Golestan province amongst all age groups, and in particular amongst women aged 20-39 years. Breast cancer should be considered a high priority for health policy making in our community.Peer reviewe

Dysfunctional lens syndrome

Purpose: To report the pre- and post-operative findings of a case with dysfunctional lens syndrome. Methods: An adult patient was evaluated using iTrace aberrometer, Tomey topographer and slitlamp biomicroscopy to confirm dysfunctional lens syndrome. Results: A 45-year-old male patient presented with the chief complaint of poor visual quality; uncorrected visual acuity 20/40 in the right eye, best spectacle corrected visual acuity 20/25 in the right eye with refraction Plano/−1.50 × 80 (SE = −0.75D). Pre- and post-operative root-mean-square (RMS) of total higherorder aberrations in the entire eye, the internal optics and the cornea were 0.350 & 0.257, 0.311 & 0.236 and 0.214 & 0.191 micron (μ), respectively. Also, the magnitude of preoperative total, internal and corneal coma was 0.254 μ × 222°, 0.274μ×242° and 0.097μ × 131° and postoperative values were 0.170 μ × 162°, 0.131 μ × 177°, 0.054 μ × 125°, respectively. Conclusion: These results show that sometime the HOAs of the internal optics, mainly crystalline lens, are not compensated by the cornea and this may cause visual discomfort in the absence of any significant cataract, this situation is known as dysfunctional lens syndrome (DLS)

Biomechanically-Corrected Intraocular Pressure Compared To Pressure Measured With Commonly Used Tonometers In Normal Subjects.

PurposeTo compare the biomechanically-corrected intraocular pressure (bIOP) measured by the Corvis ST (Oculus, Wetzlar, Germany) with IOP measurements made by other commonly used tonometers; and to test the correlations between IOP measures and central corneal thickness.MethodsOne randomly-selected eye from each of 94 healthy subjects was assessed. The bIOP was determined by the CorVis ST and compared with the IOP measurements made by standard Goldmann Applanation Tonometer (GAT: Haag-Streit AG, Bern, Switzerland), the Icare (Icare Finland Oy, Vantaa, Finland), and the Ocular Response Analyzer (ORA-IOPcc: Reichert, New York, USA). Corneal thickness was assessed by the Oculus Pentacam. The correlation between bIOP and the other devices and between CCT were assessed using the Pearson correlation test or Spearman's rho test accordingly to the distribution of these values. The Bland-Altman method and intraclass correlation coefficients (ICC) were used to assess the agreement of bIOP results with IOP obtained with other techniques. The limits of agreement (LoA) were determined as the mean difference ±1.96 SD of the mean differences. In all tests, the significance level was considered to be 0.05.ResultsMean and SD of the bIOP were 16.11±1.66 mmHg. Significant differences were found between the bIOP and other IOP measurements (GAT, 3.02±2.60 mmHg, pConclusionThe Corvis bIOP has a higher correlation with the IOPcc by ORA, which are also compensated for the effects of corneal biomechanics and have less association with corneal thickness relative to the uncorrected GAT and Icare measurements