Perfluorocarbon liquid migration into the subarachnoid space in a patient with morning glory syndrome

Purpose: To report a case of perfluorocarbon liquid (PFCL) migration into the subarachnoid space at the time of vitreoretinal surgery in a patient with morning glory syndrome associated retinal detachment. Case report: A 9-year-old girl underwent pars plana vitrectomy and silicone oil injection for retinal detachment associated with morning glory syndrome. PFCL was used for retinal stabilization before endolaser photocoagulation. The retina detached, and repeated vitrectomy and silicone oil injection was performed. Postoperative magnetic resonance imaging revealed PFCL in the subarachnoid space. Conclusion: The migration of perfluorocarbon into the subarachnoid space is a rare complication of vitrectomy in patients with morning glory syndrome. © 2015 Iranian Society of Ophthalmology

Monosomy 3 by chromogenic in situ hybridization (CISH) in Iranian patients with uveal melanoma

Purpose: The aim of this study was to investigate the rate of monosomy 3 by CISH technique in Iranian patients with uveal melanoma (UM) and its correlation with clinical and histopathological features. Method: Archival formalin fixed, paraffin-embedded material from 50 patients who had undergone enucleation for large uveal melanomas was obtained. Monosomy of chromosome 3 alteration by chromogenic in situ hybridization (CISH) was investigated. Clinical and histopathological features of tumors were collected. Results: The patients had a mean age of 56.6±7.6 years. Mean basal diameter and thickness of tumors were 14.1 mm and 10.2 mm, respectively. Four patients (8) were identified to harbor monosomy of chromosome 3. In the mean follow-up of 5.3 years (range, 3.2-9.5 y), only one case with monosomy 3 died of UM metastasis. The most common type of cellularity was mixed cell (86).There was not any statistically significant correlation between monosomy of chromosome 3 and type of cellularity, ciliary body involvement, and largest basal diameter. Conclusion: The low rate of monosomy chromosome 3 and the consequent low rate of mortality may be indicative of good prognosis in Iranian patients with uveal melanoma. © 2015 Iranian Society of Ophthalmology

Half-dose photodynamic therapy for chronic central serous chorioretinopathy

Purpose: To report the outcomes of half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (CSC). Methods: A chart review of patients with chronic CSC who had received half-dose verteporfin PDT (3 mg/m2) was performed. The main outcome measures were resolution of subretinal fluid and best corrected visual acuity (BCVA). Results: Fifty-three eyes of 51 patients with mean age of 45.01 ± 8.9 years were studied. Three, 6 and 12 months after half-dose PDT, subretinal fluid was completely resolved in 51 eyes (96.2). In 2 eyes (one patient), subretinal fluid decreased at 3 months but one year later, an increase in subretinal fluid was detected on optical coherence tomography (OCT) which completely resolved following additional PDT. Another patient with recurrence of subretinal fluid rejected further treatment. Mean baseline central subfield thickness was 385 ± 113.0 μm which was decreased to 235 ± 39.7, 247 ± 49.7, and 244 ± 49.52 μm after 3, 6 and 12 months, respectively (all P-values < 0.001). Mean BCVA was 0.33 ± 0.27 LogMAR before PDT and 0.11 ± 0.18, 0.11 ± 0.17, 0.17 ± 0.26 and 0.10 ± 0.23 LogMAR, 3, 6 and 12 months and at final visit (up to 60 months) after PDT, respectively (all P-values < 0.001). Improvement �2 lines in BCVA occurred in 20 eyes (37.7). Statistically significant correlations were found between improvement in BCVA and baseline BCVA, baseline central subfield thickness and central subfield thickness after resorption of subretinal fluid (P < 0.001, P= 0.04 and P= 0.01, respectively). No complications attributed to PDT were observed. Conclusion: Half-dose PDT is effective for treatment of patients with chronic CSC. © 2016 Journal of Ophthalmic and Vision Research

The relationship between the adequacy of hemodialysis and laboratory parameters

BACKGROUND: The present study was conducted in order to evaluate the factors affecting the adequacy of dialysis and determine the relationship of dialysis adequacy with laboratory parameters.METHODS: This descriptive study was performed on 60 hemodialysis patients of Razi Medical Center of Qaemshahr, Iran, with the history of more than 3 months of dialysis. The participants were selected using census method. Data collection was conducted through a researcher-made questionnaire. Blood samples were collected to evaluate laboratory parameters. The adequacy of dialysis was calculated through the Kt/V parameter. The obtained data were analyzed using descriptive statistical tests.RESULTS: According to the Kt/V criteria, the mean dialysis adequacy index was 1.6 ± 0.22 and 41.7% of the patients had the optimum dialysis adequacy (Kt/V of greater than 1.2), and 43.3% of patients had a dialysis adequacy which was close to the desirable level. There was a significant reverse relationship between dialysis adequacy and alkaline phosphatase (ALP), blood sugar, and body mass index (BMI). Nevertheless, there was no significant relationship between dialysis adequacy and parathyroid hormone ‎(PTH), cholesterol, triglycerides, alanine aminotransferase (ALT), aspartate aminotransferase (AST), calcium, phosphorus, and the number of dialysis sessions per week, duration of each dialysis session, and the history of dialysis (P > 0.05).CONCLUSION: In order to increase the adequacy of dialysis, the blood sugar level of patients should be controlled and patients should be advised to modify their weight using a suitable diet

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

Ruthenium-106 brachytherapy for thick uveal melanoma: Reappraisal of apex and base dose radiation and dose rate

Purpose: To evaluate the outcomes of ruthenium-106 (106Ru) brachytherapy in terms of radiation parameters in patients with thick uveal melanomas. Material and methods: Medical records of 51 patients with thick (thickness � 7 mm and < 11 mm) uveal melanoma treated with 106Ru brachytherapy during a ten-year period were reviewed. Radiation parameters, tumor regression, best corrected visual acuity (BCVA), and treatment-related complications were assessed. Results: Fifty one eyes of 51 consecutive patients including 25 men and 26 women with a mean age of 50.5 ± 15.2 years were enrolled. Patients were followed for 36.1 ± 26.5 months (mean ± SD). Mean radiation dose to tumor apex and to sclera were 71 (± 19.2) Gy and 1269 (± 168.2) Gy. Radiation dose rates to tumor apex and to sclera were 0.37 (± 0.14) Gy/h and 6.44 (± 1.50) Gy/h. Globe preservation was achieved in 82.4. Preoperative mean tumor thickness of 8.1 (± 0.9) mm decreased to 4.5 (± 1.6) mm, 3.4 (± 1.4) mm, and 3.0 (± 1.46) mm at 12, 24, and 48 months after brachytherapy (p = 0.03). Four eyes that did not show regression after 6 months of brachytherapy were enucleated. Secondary enucleation was performed in 5 eyes because of tumor recurrence or neovascular glaucoma. Tumor recurrence was evident in 6 (11.8) patients. Mean Log MAR (magnification requirement) visual acuity declined from 0.75 (± 0.63) to 0.94 (± 0.5) (p = 0.04). Best corrected visual acuity of 20/200 or worse was recorded in 37 of the patients at the time of diagnosis and 61.7 of the patients at last exam (p = 0.04). Non-proliferative and proliferative radiation-induced retinopathy was observed in 20 and 7 eyes. Conclusions: Thick uveal melanomas are amenable to 106Ru brachytherapy with less than recommended apex radiation dose and dose rates. © 2016, Termedia Publishing House Ltd. All rights reserved

Optical coherence tomography angiography (OCTA) applications in ocular oncology

Optical coherence tomography angiography (OCTA) is a revolutionary method in the visualization of the vascular system in different retinal and choroidal layers. During the last 4 years since the commercial availability of different OCTA devices, attempts have been made to utilize this technology in various aspects of ocular oncology from the differentiation of benign and malignant lesions to assisting in evaluation of post-treatment complications, such as radiation retinopathy. However, current OCTA technology is restricted by various artefacts and inherent limitations, some of which are more pronounced in the presence of elevated tumoural lesions. Imminent advancements in OCTA systems and image acquisition processes promise a great potential for application of OCTA in ocular oncology. © 2020, The Author(s), under exclusive licence to The Royal College of Ophthalmologists