Association between iron and zinc deficiency and retinopathy of premature: A Narrative Review

Context: Retinopathy of prematurity (ROP) is known as the abnormal growth of retinal blood vessels in premature and very low birth weight (VLBW) infants that can be caused by exposure to high oxygen pressure through oxidative damage and inflammation. Evidence Acquisition: In this review, the keywords zinc deficiency, iron deficiency, and retinopathy of premature was first searched in databases including Scopus, Google Scholar, and PubMed. There were no time limitations for the search. Full-text articles in the English language were included in this study. Searching with these keywords did not yield any results. In the next step, preterm neonate, preterm infant and VLBW infants were added to the keywords. Findings: The results showed that iron and zinc deficiencies are very common in premature and VLBW infants. VLBW and preterm birth are also risk factors for ROP. In addition, the use of zinc and iron supplements in low birth weight and premature infants is also commonly necessary to maintain normal growth and development. Conclusion: It can be concluded that premature infants receiving high doses of zinc and adequate doses of iron inhibited not only inhibit oxidative damage and inflammation caused by hypoxia but also vascular endothelial growth factor (VEGF) expression. In support of this mechanism, our results showed that premature infants receiving high doses of zinc and adequate doses of iron significantly reduce the ROP process. Therefore, monitoring serum zinc and iron levels and normalizing them may play an important preventive role in the development of ROP

Clinical Presentation and Microbial Analyses of Contact Lens Keratitis; an Epidemiologic Study

Introduction: Microbial keratitis is an infective process of the cornea with a potentially and serious visual impairments. Contact lenses are a major cause of microbial keratitis in the developed countries especially among young people. Therefore, the purpose of the present study was to evaluate the frequency and microbiological characteristic of CLK in patients referred to the emergency department (ED) of teaching hospitals, Babol, Iran. Methods: This is a cross-sectional study of all patients with contact lens induced corneal ulcers admitted to the teaching hospitals of Babol, Iran, from 2011- 2013. An ophthalmologist examined patients with the slit-lamp and clinical features of them were noted (including pain, redness, foreign body sensation, chemosis, epiphora, blurred vision, discomfort, photophobia, discharge, ocular redness and swelling). All suspected infectious corneal ulcers were scraped for microbial culture and two slides were prepared. Data were analyzed using SPSS software, version 18.0. Results: A total of 14 patients (17 eyes) were recruited into the study (100% female). The patients’ age ranged from 16-37 years old (mean age 21.58±7.23 years). The most prevalent observed clinical signs were pain and redness. Three samples reported as sterile. The most common isolated causative organism was pseudomonas aeroginosa (78.6%), Staphylococcus aureus 14.3%, and enterobacter 7.1%, respectively. Treatment outcome was excellent in 23.5%, good in 47.1%, and poor in 29.4% of cases. Conclusion: Improper lens wear and care as well as the lack of awareness about the importance of aftercare visits have been identified as potential risk factors for the corneal ulcer among contact lens wearers. Training and increasing the awareness of adequate lens care and disinfection practices, consulting with an ophthalmologist, and frequent replacement of contact lens storage cases would greatly help reducing the risk of microbial keratitis

Association of Diabetic Retinopathy and Sleep Quality

Sleep disorders are more common in diabetes mellitus (DM) cases rather than normal ones. In addition, this condition could be associated with diabetic retinopathy (DR) development with more inflammatory indices in circulation. In the present study, we have evaluated the association between DR and sleep quality. This cross-sectional study is a part of the second phase of the study of the elderly cohort of Amirkola City, which was conducted in 2015-2016 on all people aged 60 and higher. Of all diabetic cases, 44 cases had retinopathy and were selected as the case group. To compare two control groups, 135 diabetic patients without retinopathy and 135 people without diabetes were randomly selected. The presence and type of retinopathy were determined based on an eye physical examination by an ophthalmologist. In addition, sleep quality was evaluated based on the Pittsburgh Questionnaire. The obtained data were analyzed by ANOVA, t-test, and linear regression tests. In the present study, there was a significant difference in the score of the Pittsburgh questionnaire between people with DR (45.5±68.2) compared to diabetic people without retinopathy (76.5±48.2) and people without diabetes (95.4±36.2) (P=0.470), but diabetic people without retinopathy had significantly worse sleep quality than people without diabetes (P=0.019). Also, sleep quality in women with DR was worse than in men (P=014). In the linear regression analysis, it was observed that age, gender, diabetes, and history of depression significantly affect the sleep quality of the evaluated cases (P<0.05 for all). According to the results of the present study, DR does not negatively influence the quality of sleep, and DR is not related to sleep disorders

Age-Specific Distribution of Intraocular Pressure in Elderly Iranian Population and Its Associated Factors

Background: The purpose of this study was to determine the distribution of intraocular pressure (IOP) and assess its association with age, sex, systemic blood pressure, diabetes mellitus, body mass index (BMI) and tobacco smoking in Iranian elderly population. Methods: This cohort-based, cross-sectional study assessed elderly individuals aged 60-90 years in Amirkola, northern Iran, in 2016-2017. Past medical history, blood pressure, diabetes mellitus, BMI and tobacco smoking were recorded through an interview and physical examination. IOP was assessed using non-contact tonometry. Results: Total of 1377 individuals participated in this study, out of which 1346 IOP measurements were included for the final analysis. The mean age of participants was 69.4 &#177; 7.1 years and mean IOP was determined to be 16.7 &#177; 3.2 mmHg. Majority of the participants were males (56.1 vs 43.1), 73.8 of participants were overweight or obese, 6.1 smoked tobacco, 28.9 had diabetes mellitus and 84.9 had higher than normal blood pressure. Through multiple regression analysis, it was determined that age (&#946;=-0.132, p&#60;0.001) was negatively associated with IOP, and the presence of diabetes mellitus (&#946;=0.118, p&#60;0.001), systolic blood pressure (&#946;=0.101, p&#60;0.001), and BMI (&#946;=0.020, P=0.020) were positively associated with IOP. Conclusion: Mean IOP of individuals in this study was higher than average based on other studies. Age, was negatively and systemic blood pressure, BMI and presence of diabetes mellitus were positively associated with mean IOP of elderly Iranian population. Sex and tobacco smoking were not correlated with IOP. &#160

Evaluation of Retinopathy of Prematurity in Preterm Infants

Background: Retinopathy of Prematurity is aberrant developmental retinal Angiogenesis in preterm infants. For ophthalmologist diagnosis and management of this progressive disease remains a challenge. Objective: To investigate the retinopathy of prematurity in premature infants referred to the Eye Clinic of Ayatollah Rouhani Hospital in Babol in 2016. Methods: In this cross-sectional study, data on premature infants including risk factors for retinopathy and eye examinations were recorded and data were analyzed using Chi-square, single, and multiple logistic regression. Results: Among 100 premature infants with mean gestational age, 31. 83 (GA) weeks (2. 06SD) and birth weight 1686. 9 (g) (416. 4SD), retinopathy was 39% and severe in 14% of all specimens. In single-variable analysis, there was a significant relationship between Retinopathy of Prematurity and birth weight, gestational age, duration of oxygen therapy, duration of hospitalization and sepsis, while in multivariate logistic regression, birth weight and respiratory distress syndrome were independent predictors of retinopathy. 25 cases (64. 1%) had spontaneous regression and in 14 cases (35. 8%) treatment was required. The prognosis of treatment was desirable in all 14 cases. Conclusion: Timely screening and treatment in infants with severe retinopathy is very important in preventing progression of the disease to higher stages and poor vision prognosis. &nbsp

Retinopathy of prematurity progression and its related factors: A cohort study in preterm infant in northern Iran

Background and Objective: Retinopathy of Prematurity (ROP) is a vasoproliferative retinal disease in premature infants, causing lifetime visual impairment and blindness at an early age. The aim of this study was to investigate the impact of oxygen profile in the progression of ROP. Methods: This prospective cohort study (from 2010 to 2020) was applied in the Ophthalmology center of Ayatollah Rouhani Hospital in Babol (Babol University of Medical Sciences, Babol, Iran) included 828 infants (<37 weeks of gestation with a birth weight <2500 g). Moreover, the oxygen profile of infants (with/without ROP) was collected from their history profile in terms of arterial blood gas. Findings: The duration of oxygen therapy was significantly higher in ROP patients (9.19±14.33 days), compared to control (3.16±4.35 days), (P=0.002). The minimum level of PO2 was significantly lower in ROP infants (51.71±44.81 mmHg) compared to controls (92.75±65.45 mmHg, P<0.001). Furthermore, patient with zone 1 involvement had higher PO2 level than the patient with zone 2 involvement (P=0.029). The ventilation requirement was more frequent in ROP patients (39.27%) compared to controls (19.24%, P<0.001). Also, the CPAP requirement was more frequent in ROP patients (48.51%) compared to controls (32.95%, P<0.001). Conclusion: Our results have indicated that the duration of oxygen therapy and the minimum and maximum level of PO2 are indicators of ROP occurrence

Determination of serum lipid profile in patients with diabetic macular edema that referred to Shahid Beheshti and Ayatollah Rouhani Hospitals, Babol during 2011-2012

Background: Diabetes is a common metabolic disorder leading to the development of many complications, among which diabetic retinopathy and macular edema are the most significant. These complications can contribute to blindness if not diagnosed or treated properly, and several studies have been conducted to evaluate the methods for the prevention or slowing down their progression. Therefore, serum lipids, apparently play an effective role in the creation and acceleration of macular edema, we therefore determined the relationship of serum lipid level in patients with diabetic macular edema in the present study. Methods: 180 participants were selected from patients with the definite diagnosis of diabetes referred to the eye clinic of Shahid Beheshti and Ayatollah Rouhani Hospitals of Babol during 2011-2012, the patients with a history of taking lipid –lowering drugs and hypertension were excluded from the study. The study data were provided from the medical records of each patients. SPSS Version 18 was used for analyses. Results: In the present investigation, the mean age of participants was 53.22±with the age range of 18-77 years. Ninety patients with diabetic retinopathy and macular edema were compared with ninety patients with diabetic retinopathy without macular edema (control group) were compared. There was a significant difference in serum cholesterol and LDL-cholesterol between patients and groups (p<0.000). Conclusion: The results of this study indicate that high serum cholesterol and LDL-cholesterol is associated with severity of diabetic retinopathy particularly with macular edem

Prevalence of age related macular degeneration among elderly smokers results from AHAP study

Background: Age-related macular degeneration (AMD) is the leading cause of visual impairment and blindness in elderly population in the developing countries. Previous epidemiological studies revealed various potential modifiable risk factors for this disease. The purpose of this study was to evaluate the prevalence of AMD among elderly living in Babol, North of Iran.  Methods:  The study population of this cross-sectional study came from  the Amirkola Health and Ageing Project (AHAP), the first comprehensive cohort study of the health of people aged 60 years and over in Amirkola, North of Iran. The prevalence of AMD was estimated and its risk was determined using logistic regression analysis (LRA) with regard to variables such as smoking, hyperlipidemia, hypertension and diabetes. Results: Five hundred and five participants with mean age of 71.55±5.9 (ranged 60-89) years entered the study. The prevalence of AMD was 17.6%. There was a significant association between AMD and smoking (P<0.001) but no association was seen with AMD and age, level of education, history of hyperlipidemia, hypertension and diabetes. Multiple LRAs revealed that smoking increased AMD by odds ratio of 5.03 (95% confidence interval 2.47-10.23 p<0.001) as compared to nonsmokers Conclusion: According to our findings, the prevalence of AMD was relatively high and smoking increased the risk of AMD in the elderly population

Clinical Laboratory Parameters in Different Stages, Zones, and Remission/Progression statuses of Retinopathy of Prematurity

Background: Retinopathy of prematurity (ROP) is a vasoproliferative retinal disease in premature infants that causes lifetime visual impairment and blindness in the early ages. In this study, we investigated the differences in the values of clinical laboratory parameters between different ROP and its remission/progression statuses regarding stages and zones. Methods: This historical cohort study includes 828 infants divided into two groups after the first examination containing ROP infants and controls. The biochemical and hematological parameters of the two groups have been collected from the patient&#8217;s history. Results: In infants with ROP, the hematopoiesis-related parameters, including the mean level of hemoglobin, total bilirubin, potassium, calcium were significantly less than controls (P =0.039, P =0.001, P =0.001, and P=0.046, respectively). The percentages of reticulocyte and the levels of BUN in ROP patients were significantly higher than in normal infants (P=0.015 and p &#60;0.001, respectively). Moreover, the levels of hemoglobin and BUN were significantly different in the different zones of ROP (P=0.017 and P=0.001, respectively). Also, higher hemoglobin levels, total bilirubin, and CRP were observed in the reduced stages of ROP (P=0.041, P=0.045, and P=0.039, respectively). Conclusion: Laboratory parameters are different in different stages, zones and remission/progression ROP infants

Associated factors of diabetic retinopathy in patients that referred to teaching hospitals in Babol

Background: Information regarding the frequency and severity of eye involvement in diabetic patients and its risk factors can be useful for prevention and treatment. This study aimed to determine the prevalence of diabetic retinopathy and its associated risk factors in diabetic patients who referred to teaching hospitals in Babol, Mazandaran.  Methods: In this study a total of 1562 patients with the definite diagnosis of diabetes mellitus were chosen and referred to the eye clinic of Shahid Beheshti and Ayatollah Rouhani Hospitals of Babol during 2006-2010. Information about age, duration of diabetes, hypertension family history of diabetes, history of other organs involvement, BMI and laboratory findings were recorded. Retinopathy was classified according to early treatment of diabetic retinopathy study. Data were collected and analyzed.  Results: Of the 1562 patients, 357 (22.9%) were males and 1205 (77.1%) were females. The mean age was 54.6±10.6 years, diabetic retinopathy was found in 990 (64.1%) patients, the frequency of non-proliferative diabetic retinopathy was 37.3% and proliferative was 26.8%.Age, duration of diabetes, FBS, HbA1C, BUN, Cr, Hb were  significantly different between the patient’s with diabetic retinopathy and no diabetic retinopathy (p<0.05). No relationship was found between smoking, gender, hypertension and serum lipid profile.  Conclusion: Poor diabetes control anemia and nephropathy were the most associated factors of diabetic retinopathy but hypertension BMI smoking, dyslipidemia and gender showed no association