DOAJ (DOAJ: Directory of Open Access Journals), Oct 1, 2020
Comparing results of the current study with previous ones, we concluded that color blindness has ... more Comparing results of the current study with previous ones, we concluded that color blindness has a lower prevalence in our study population (4%), in comparison with the general population (8%). Moreover, obtained results about patients' insight into their disease showed that a considerable percentage of cases (25%) had no insight to their disease, which indicates the importance of conducting color blindness screening test for medical students due to the importance of color vision in the field of medicine.
Perimetry is one of the mainstays in glaucoma diagnosis and treatment. Various strategies offer d... more 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.
In this research study, to investigate teratogenic effect of intravitreal injection of bevacizuma... more In this research study, to investigate teratogenic effect of intravitreal injection of bevacizumab in pregnant rat model, twenty seven female Wistar rats were inseminated. Pregnant rats were divided into 6 groups (three groups as case and three as control groups). Each case and control groups were divided according to the day of intravitreal injections (day 2, 10 and 18). Rats in the case groups received 4 µL intravitreal injection of bevacizumab and the control groups received the same volume of distilled water. The tail and umbilical cord length in case groups 1, 2, and 3 did not display any significant differences compared to their control groups. The fetal weight was significantly lower in the case groups 1 (p>0.001) and 2 (p>0.001) compared to their control groups. Furthermore, the placental weight was only lower in the case group 1 (p>0.001). Case group 2 had a shorter crown rump length in comparison with its control group (p=0.029). Morphological investigations showed two abnormal cases of gastroschisis in group 1 and a case of a cleft in the skull in one of the rats in case group 2. The results show that intravitreal bevacizumab has developmental effect when administered in the early stages of pregnancy; but it is safe when administered in the last week of pregnancy in rats.
Purpose: Pterygium is a pathologic process with angiogenic and tumor cell like characteristics. C... more Purpose: Pterygium is a pathologic process with angiogenic and tumor cell like characteristics. Chemokine and chemokine receptors may contribute to the formation and growth of pterygia. The aim of this study was to assess the expression of stromal cell derived factor (SDF)-1, as an angiogenic chemokine, and its receptors, CXCR4 and CXCR7, gene transcripts in pterygia. Methods: RNA was extracted from tissue samples of 33 patients with primary pterygium and 35 volunteers with conjunctiva as the control group. Then the mRNA expression of SDF-1, CXCR4, and CXCR7 was assessed through quantitative Real Time PCR method using appropriate primers. Results: SDF-1 and both receptors transcripts had significantly higher expression in pterygia samples compared to the control group (P < 0.05). The ratio of CXCR7 transcript expression to CXCR4 was 26.4 in patients while it was 11 in controls. Conclusion: As SDF-1 and its receptors, CXCR4 and CXCR7, were up-regulated in pterygia, SDF-1/CXCR4/CXCR7 axis may contribute to pterygium formation which can be possibly restrained by down-regulating this signaling pathway.
Purpose. Early diagnosis of keratoconus disease (KCN) is the first priority in the preoperative e... more Purpose. Early diagnosis of keratoconus disease (KCN) is the first priority in the preoperative evaluations of refractive surgery (RS). e aim of this study was to investigate the correlation between findings of Belin Ambrosio enhanced ectasia display (BAD) software and conventional corneal imaging (Orbscan and topography) in the early diagnosis of KCN. Methods. For conducting this cross-sectional study, a total of 1000 eyes were selected from 500 patients that underwent the myopic photorefractive keratectomy surgery and were compared in four study groups during the years 2017-2018. In group 1, all topography, Orbscan, and BAD criteria were normal (65.8%).In contrast, in Group 2, at least one of the topography or Orbscan criteria as well as at least one BAD criterion (12.6%) were abnormal. In Group 3, the eyes had normal Orbscan and topography criteria with at least one abnormal BAD criterion (18.5%). Also, in Group 4, the patients had at least one abnormal Orbscan or topography criterion, but all BAD criteria (3.1%) were normal. ickness of the thinnest point (TP) of cornea was compared in Pentacam and topography. Data analysis was done by SPSS software (version 21). Results. BAD criteria were normal in 78.5% of all eyes with normal topography and Orbscan criteria (specificity). BAD criteria were also abnormal in 80.2% of eyes (sensitivity). ere was also no significant difference between TP in Orbscan and Pentacam. Conclusions. BAD criteria had a relatively acceptable sensitivity and specificity, compared with conventional Orbscan and topography criteria. us, BAD criteria can be more effective in the early diagnosis of KCN.
International Journal of Health Sciences (IJHS), Jul 4, 2022
Background: Keratoconus is a degenerative and progressive of corneal disease. Unlike other countr... more Background: Keratoconus is a degenerative and progressive of corneal disease. Unlike other country, studies about epidemiology of keratoconus are limited in the Iran. Aim of the study is survey of keratoconus epidemiology in the eastern Iran. Methods: For doing the cross-sectional study, patients were evaluated at the ophthalmology center of Mashhad County, during 2015-2016 year. Firstly, medical history was obtained from all new patients. Ocular examination was done for detection of keratoconus signs including Scissor reflex, Rizzuti sign, Fischer ring, Vogt striae and any sign of previous hydrops. For all suspicious patient's topography was done. Also, the required demographic data were recorded. The data were analyzed using SPSS software (version 18). Results: Totally, 90 eyes from 45 patients were studied. The average age of patients was 25.1 ± 6 years and the average age of onset of the disease was 17.72 ± 7.76 years. More than half of patients (55.6%) were female. One-sided Keratoconus was found in 11.1 %. In 10 patients (10 eyes), there was history of penetrating keratoplasty due to advanced keratoconus. Average corneal power of patients was 49.4 ±6. Also, there was Fischer ring, Vogt striae and signs of previous hydrops in the 52%, 21% and 10.7 % of patient, respectively. Conclusion: Overall, the disease must be considered as a cause of unusual and non-correctable gradual visual loss, especially in the young women and age group of less than 20 years in the Iran. Also, many of keratoconus risk factors that were previously reported were not found in the study.
Cataract is a common cause of vision loss and blindness in humans. After surgical management of c... more Cataract is a common cause of vision loss and blindness in humans. After surgical management of cataract, all efforts should be focused on reducing postoperative astigmatism thus providing an excellent vision to patients. To determine the relationship between corneal incision and refraction changes before and after phacoemulsification surgery in 300 patients undergoing cataract surgery in Khatam hospital in Mashhad, Iran from January 2017 to April 2018. Three hundred patients (144 women and 156 men) with cataract undergoing phacoemulsification surgery were recruited in this cross-sectional study. Refraction, keratometry and visual acuity measurement were performed before surgery. Then, a steep-based incision in the cornea was made without stitches. A 3.2 mm corneal incision was made at two supratemporal and temporal sites. The patients were followed-up for one and six months, and one year after surgery monitoring their vision and refraction, and performing keratometric measurements. The mean age of the patients was 65.7±9.54 years (age range, 42-84 years). No major complications were observed. The greatest mean of changes in corneal power was in the supratemporal incision (1.28±0.6). Keratometry had a significant relation with the incision (p<0.04). Conclusions: An incision made along the steepest meridian leads to flatness of this meridian, this effect being more pronounced at the supratemporal incision. A temporal incision is recommended in cases where there is little difference in the keratometry of the two axes.
Endophthalmitis is one of the most serious complications of intraocular surgeries, and Candida al... more Endophthalmitis is one of the most serious complications of intraocular surgeries, and Candida albicans constitutes the majority of cases of post penetrating keratoplasty (PK) endophthalmitis. The presenting case is a 21-year-old woman with known case of advanced keratoconus and vernal keratoconjunctivitis who underwent PK, and developed recalcitrant anterior uveitis and subsequent whitish lesion on the superonasal of the lens. She was on topical steroids with possible impression of Uretts Zavalia syndrome versus phacoantigenic uveitis following traumatic cataract up to the 50 th day of post operation that manifested symptoms of frank endophthalmitis; and underwent deep vitrectomy, lensectomy, localized iridectomy and irrigation with diluted Imipenem and Amphotericin-B. Microbiologic study of a vitreous sample revealed growth of Candida albicans, however optisol culture was negative and donor rim was not evaluated. One week later, intravitreal Amphotericin-B was administered. The patient remained aphakic with clear graft in the 6 th month follow up. Due to great correlation of positive donor rim culture with fungal endophthalmitis and the devastating effect of delayed diagnosis, routine donor rim culture is recommended, to aid us in earlier diagnosis in the presence of nonspecific early signs of fungal endophthalmitis.
Purpose. e biomechanical properties of ecstatic cornea undergo changes. is study evaluates the bi... more Purpose. e biomechanical properties of ecstatic cornea undergo changes. is study evaluates the biomechanical changes of ecstatic cornea after implantation of two types of intracorneal stromal ring (ICR). Methods. For doing this prospective crosssectional study, 32 patients with keratoconus (KCN) were randomly divided into two 16-member groups (group I: MyoRing, group II: KeraRing). e main inclusion criteria were transparent cornea with no scar in the central part, corneal thickness >450 µ in the incision region, keratometry within 48-52 diopters, and progressive course of corneal thinning. Biomechanics of the cornea was evaluated by "ORA" and "Corvis" devices. All of the data were recorded and analyzed before implantation of the rings and 6 months thereafter. Results. e mean ages of patients of groups I and II were 26 ± 6.55 and 33.86 ± 8.5, respectively. e postoperative change of sphere refraction was significant in both groups. However, reduction in the astigmatism was significant only in group I. In addition, the change of flat meridian keratometry (Kf ) was significant before and after ring implantation in group I, unlike group II. e changes in CH and CRF parameters (ORA) were not significant in either group before and after the operation. Besides, only HRC parameter (Corvis) decreased significantly in both groups before and after the operation. Conclusion. Both MyoRing and KeraRings have positive effects on the biomechanics of cornea at least during the first year after implantation. Comparison of these two types of ICR did not show significant differences in Corvis and ORA parameters.
Background: Pterygium is a common degenerative eye disease. Despite various surgical methods to t... more Background: Pterygium is a common degenerative eye disease. Despite various surgical methods to treat pterygium, recurrence is the main complication. The main issue is finding a surgical method with the lowest recurrence. Objective: to compare the complications, recurrence rate and the cosmetic effects of two surgical techniques, namely conjunctival rotation autograft (CRA) and conjunctival autograft (CA), in treating pterygium. Methods: This randomized clinical trial was conducted at Khalili Hospital in Shiraz, Iran, from January to August 2015. Forty-five eyes from 45 patients were studied. The patients were randomly divided into two groups using the blocking method. The patients of one group were operated on by the CRA technique, while the other group was operated on by the CA method. The patients were checked for the recurrence of pterygium, and other complications at the end of the first, third, and sixth month. Finally, the data were analyzed using SPSS version 21. The mean age of the patients was 42.5 years. The recurrence of pterygium was not observed in any of the patients 6 months after the surgery. Following 6 months after the operation, graft retraction occurred during the first week for one patient (4.5%) in the CA group, and five patients (21.7%) in the CRA group. The prevalence rate of graft injection among the patients of the CA and CRA groups 6 months after the operation was 9.1% and 65.2%, respectively. There was a significant correlation between injection intensity and the dissatisfaction of the patients with the operation's outcome (p=0.017). Conclusion: CRA with mitomycin is considered as an effective method to reduce the recurrence of pterygium after operation. This technique can be used as an acceptable method for pterygium operation, especially for patients with insufficient conjunctiva.
Introduction: Basic anatomical parameters in ophthalmology are variable in different countries ac... more Introduction: Basic anatomical parameters in ophthalmology are variable in different countries according to ethnic groups, genetics and some environmental factors. The aim of this study was to determine the relationship between axial length (AL), anterior chamber depth (ACD) and intraocular lens power (IOL) in a referral center from eastern Iran among patients who had cataract surgery, in comparison to studies from other regions of the world. Methods: In a cross-sectional retrospective study from 2011 to 2013, the records of 698 cataract patients referring to Khatam Al Anbia general hospital in Mashhad, Iran were evaluated. We divided patients, based on their AL and ACD, into three separate groups and compared their results. The SPSS software was used for data analysis. The Chi-Square test and the Independent-samples t-test were used to compare qualitative and quantitative data between two groups, respectively. The Kendall and the Pearson product-moment correlation tests were used to assess the relationship between AL and ACD. The linear Regression model was used to obtain a mathematical model to estimate ACD, using AL, age and sex. Results: Among individuals who had normal AL (between 22-24.5mm), there was a positive correlation between AL and ACD (p<0.001, r=0.17), however, among individuals with short (AL<22mm) or long sightedness (AL>24.5mm), no significant correlation was detected. We also found that older people have shorter AL (p=0.001 and r=-0.287). Men have an average longer AL (23.7±2.4mm vs. 22.9±2.1mm; p<0.001) and deeper ACD compared to women (2.93±0.45mm vs. 2.82±0.42mm, p=0.002). Conclusion: Our findings were mostly similar to previous literature from other regions of the world and although some anatomical variations may exist regarding ophthalmic anatomy, factors like race and geographical area have little effect on the relationship between ACD, AL and IOL power calculation, furthermore our results support the use of third and fourth generation formulas for IOL power calculation.
Background. To investigate the association of glutathione s-transferase omega 2 (GSTO2) (142N > D... more Background. To investigate the association of glutathione s-transferase omega 2 (GSTO2) (142N > D) and transforming growth factor-β1 (TGF-β1) (869T > C) gene polymorphisms on the pathogenesis of two common types of glaucoma (including primary open-angle glaucoma (POAG) and chronic angle-closure glaucoma (CACG)) in the Iranian population. Methods. A total of 100 glaucoma patients (60% males and 40% females with an age mean ± SD of 34.66 ± 14.25 years; 56 cases of POAG and 44 cases of CACG) were enrolled in this study. GSTO2 (142N > D) and TGF-β1 (869T > C) polymorphisms were evaluated by PCR-based methods in patients and controls. Results. At locus GSTO2 (142N > D), the odds of ND genotype with respect to DD and NN genotypes were 1.55 and 2.08 times higher in POAG and CACG patients compared to those of patients in the control group (95% CI 1 : 0.80-2.98; 95% CI 2 : 1.00-4.33) which was statistically significant in CACG patients. However, the odds of DD and NN genotypes against the reference genotype in two patients group were not statistically significant as compared to those of patients in the control group. ere was a significant association between the ND genotype and male patients (OR � 2.28, 95% CI: 1.06-4.92). e analysis of TGF-β1 (869T > C) polymorphisms showed no significant difference between the genotypes of TGF-β1 (869T > C) polymorphisms in patients and control groups; however, the CT genotype of TGF-β1 significantly differed between female controls and patients (OR � 0.42, 95% CI: 0.18-0.96). Conclusion. e presented results revealed that there was a significant association between the ND genotype of GSTO2 and the pathogenesis of glaucoma. Furthermore, this genotype can be considered as a sex-dependent genetic risk factor for the development of glaucoma. In contrast, the CT genotype of TGF-β1 is suggested to be a protective genetic factor against the pathogenesis of glaucoma.
: Curcumin is the main active constituent of the medicinal plant Curcuma longa L., used tradition... more : Curcumin is the main active constituent of the medicinal plant Curcuma longa L., used traditionally as a medicinal spice in several ancient civilizations. Different preclinical and clinical studies support the anti-inflammatory properties of curcumin in various inflammatory diseases. As inflammation has an essential role in the pathophysiology of many ocular diseases, curcumin has been suggested as a promising therapeutic agent with anti-inflammatory properties. Based on the extent of experimental and clinical evidence, curcumin can exert protective effects against the corneal, uveal, retinal, optic nerve, orbital, and lacrimal gland inflammatory disorders. Herein, the available literature on the beneficial effects of curcumin in inflammatory eye diseases is reviewed. The limitations and future directions of these investigations are also discussed.
Middle East African Journal of Ophthalmology, 2020
PURPOSE: To evaluate the effectiveness of ultraviolet (UV)-A/Riboflavin corneal cross-linking (CX... more PURPOSE: To evaluate the effectiveness of ultraviolet (UV)-A/Riboflavin corneal cross-linking (CXL) for the treatment of the refractory cases of fungal keratitis. METHODS: In this prospective interventional study, 9 patients with the diagnosis of fungal keratitis that were referred to our emergency eye center were included. These patients were resistant to conventional treatment and underwent therapeutic UV-A/Riboflavin CXL. Response to the treatment was considered as good if rapid epithelialization and rapid decrease in stromal infiltration was occurred after PACK-CXL, and poor when the emergency transplantation was necessary to eradicate the infection. RESULTS: Nine patients treated with CXL due to recalcitrant fungal keratitis. Culture of the corneal scrapings showed Aspergillus species in 4 patients, Candida albicans in 1 patient and Fusarium species in the remainder of them. CXL was performed from 1 to 20 days after the presentation of corneal ulcers (Mean: 9.12 ± 4.02; range: 5–20 days). Postoperatively, the mean time to epithelialization was 14.25 ± 2.38 days, and mean time to resolution of stromal infiltration was 22.5 ± 7.29 days, in responsive cases. Four out of 9 eyes showed good response, and five patients showed no response, and corneal transplantation was performed to eradicate the infection. There was no statistically significant difference in mean depth of infiltration and mean size of ulcer between responsive and unresponsive patients (P = 0.86 and 0.08, respectively). CONCLUSION: Although UV-A/Riboflavin CXL is not a definite treatment for all of the fungal keratitis, it seems promising in the management of some refractory cases.
To evaluate the agreement of dry, and cycloplegic autorefraction and wavefront-based refraction w... more To evaluate the agreement of dry, and cycloplegic autorefraction and wavefront-based refraction with subjective refraction. Method: 83 subjects aged 19---57 years were included in this cross-sectional study. Refractive status was determined using four methods including subjective refraction, wavefront-based refraction, dry and cycloplegic autorefraction. Refractive data were recorded as sphere, cylinder and spherical equivalent (SE). Power vector components were used to compare the astigmatism obtained using the different methods of refraction. Results: The more negative spherical, cylindrical and SE components were obtained using dry autorefraction, wavefront-based refraction and dry autorefraction, respectively. The less negative spherical, cylindrical and SE components were obtained using cycloplegic autorefraction, subjective refraction and cycloplegic autorefraction, respectively. Considering the spherical component, there was a statistically significant hyperopic shift (0.12 ± 0.29 D, p = 0.001) with cycloplegic autorefraction and a significant myopic shift (-0.17 ± 0.32 D, p < 0.001) with dry autorefraction compared to subjective refraction, while the difference between wavefrontbased and subjective refraction was not significant statistically (p = 0.145). The calculated cylindrical component using subjective refraction showed statistically significant difference with dry auto-refraction (p < 0.001), cycloplegic auto-refraction (p = 0.041) and wavefront refraction (p < 0.001). The highest correlation with subjective refraction in sphere, cylinder and SE was observed for cycloplegic auto-refraction (r s = 0.967), dry auto-refraction (r s = 0.983) and cycloplegic auto-refraction (r s = 0.982), respectively.
To evaluate the agreement of dry, and cycloplegic autorefraction and wavefront-based refraction w... more To evaluate the agreement of dry, and cycloplegic autorefraction and wavefront-based refraction with subjective refraction. Method: 83 subjects aged 19---57 years were included in this cross-sectional study. Refractive status was determined using four methods including subjective refraction, wavefront-based refraction, dry and cycloplegic autorefraction. Refractive data were recorded as sphere, cylinder and spherical equivalent (SE). Power vector components were used to compare the astigmatism obtained using the different methods of refraction. Results: The more negative spherical, cylindrical and SE components were obtained using dry autorefraction, wavefront-based refraction and dry autorefraction, respectively. The less negative spherical, cylindrical and SE components were obtained using cycloplegic autorefraction, subjective refraction and cycloplegic autorefraction, respectively. Considering the spherical component, there was a statistically significant hyperopic shift (0.12 ± 0.29 D, p = 0.001) with cycloplegic autorefraction and a significant myopic shift (-0.17 ± 0.32 D, p < 0.001) with dry autorefraction compared to subjective refraction, while the difference between wavefrontbased and subjective refraction was not significant statistically (p = 0.145). The calculated cylindrical component using subjective refraction showed statistically significant difference with dry auto-refraction (p < 0.001), cycloplegic auto-refraction (p = 0.041) and wavefront refraction (p < 0.001). The highest correlation with subjective refraction in sphere, cylinder and SE was observed for cycloplegic auto-refraction (r s = 0.967), dry auto-refraction (r s = 0.983) and cycloplegic auto-refraction (r s = 0.982), respectively.
Background To determine the prevalence of keratoconus in Shiraz University of Medical Sciences Em... more Background To determine the prevalence of keratoconus in Shiraz University of Medical Sciences Employees and the related risk factors including oxidative stress biomarkers. Methods 2546 subjects’ mean age ± SD, 40.35 ± 6.70 (46% male) were recruited. All participants underwent objective refraction using auto-refractometer and retinoscopy, followed by subjective refraction, and bio-microscopy. Pentacam imaging was performed for the detected keratoconus patients. The prevalence of keratoconus and frequency of the visual impairment among keratoconus cases were evaluated. Potential risk factors of sex, age, family history of keratoconus, body mass index ≥ 30 kg/m2, serum levels of glucose ≥ 100 mg/d, low-density-lipoprotein-cholesterol (LDL) ≥ 110 mg/dL, high-density-lipoprotein-cholesterol ≤ 40 mg/d, and triglycerides ≥ 150 mg/dL in the blood were evaluated. Results The prevalence of keratoconus at least in one eye was 0.98% (95% CI: 0.6- 1.4%). The best corrected visual acuity in the ...
Purpose: To determine a safer mode using two different frequencies (10 and 60 pulses per second)... more Purpose: To determine a safer mode using two different frequencies (10 and 60 pulses per second) in pulse mode phacoemulsification in moderate to severe cataract. Study Design: Quasi experimental study. Place and Duration of Study: Khatam-Al-Anbia Hospital, Mashhad, Iran, from 2017 to 2018. Methods: We enrolled 145 patients with moderate and severe cataracts according to lens opacities classification system III (LOCS III). They were allocated to two different groups with different frequencies of pulse mode (10 PPS and 60 PPS) phacoemulsification. Post-operative parameters, including best-corrected visual acuity, corneal edema, endothelial cell density, central corneal thickness, and effective phaco time, were compared between the groups. Results: Patients who had undergone surgery using 10 PPS pulse mode had better vision than those in the 60 PPS pulse mode group. Pulse mode with 10 PPS caused 0.112 reductions in log MAR in best-corrected visual acuity compared with the 60 PPS ...
: Curcumin is the main active constituent of the medicinal plant Curcuma longa L., used tradition... more : Curcumin is the main active constituent of the medicinal plant Curcuma longa L., used traditionally as a medicinal spice in several ancient civilizations. Different preclinical and clinical studies support the anti-inflammatory properties of curcumin in various inflammatory diseases. As inflammation has an essential role in the pathophysiology of many ocular diseases, curcumin has been suggested as a promising therapeutic agent with anti-inflammatory properties. Based on the extent of experimental and clinical evidence, curcumin can exert protective effects against the corneal, uveal, retinal, optic nerve, orbital, and lacrimal gland inflammatory disorders. Herein, the available literature on the beneficial effects of curcumin in inflammatory eye diseases is reviewed. The limitations and future directions of these investigations are also discussed.
DOAJ (DOAJ: Directory of Open Access Journals), Oct 1, 2020
Comparing results of the current study with previous ones, we concluded that color blindness has ... more Comparing results of the current study with previous ones, we concluded that color blindness has a lower prevalence in our study population (4%), in comparison with the general population (8%). Moreover, obtained results about patients' insight into their disease showed that a considerable percentage of cases (25%) had no insight to their disease, which indicates the importance of conducting color blindness screening test for medical students due to the importance of color vision in the field of medicine.
Perimetry is one of the mainstays in glaucoma diagnosis and treatment. Various strategies offer d... more 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.
In this research study, to investigate teratogenic effect of intravitreal injection of bevacizuma... more In this research study, to investigate teratogenic effect of intravitreal injection of bevacizumab in pregnant rat model, twenty seven female Wistar rats were inseminated. Pregnant rats were divided into 6 groups (three groups as case and three as control groups). Each case and control groups were divided according to the day of intravitreal injections (day 2, 10 and 18). Rats in the case groups received 4 µL intravitreal injection of bevacizumab and the control groups received the same volume of distilled water. The tail and umbilical cord length in case groups 1, 2, and 3 did not display any significant differences compared to their control groups. The fetal weight was significantly lower in the case groups 1 (p>0.001) and 2 (p>0.001) compared to their control groups. Furthermore, the placental weight was only lower in the case group 1 (p>0.001). Case group 2 had a shorter crown rump length in comparison with its control group (p=0.029). Morphological investigations showed two abnormal cases of gastroschisis in group 1 and a case of a cleft in the skull in one of the rats in case group 2. The results show that intravitreal bevacizumab has developmental effect when administered in the early stages of pregnancy; but it is safe when administered in the last week of pregnancy in rats.
Purpose: Pterygium is a pathologic process with angiogenic and tumor cell like characteristics. C... more Purpose: Pterygium is a pathologic process with angiogenic and tumor cell like characteristics. Chemokine and chemokine receptors may contribute to the formation and growth of pterygia. The aim of this study was to assess the expression of stromal cell derived factor (SDF)-1, as an angiogenic chemokine, and its receptors, CXCR4 and CXCR7, gene transcripts in pterygia. Methods: RNA was extracted from tissue samples of 33 patients with primary pterygium and 35 volunteers with conjunctiva as the control group. Then the mRNA expression of SDF-1, CXCR4, and CXCR7 was assessed through quantitative Real Time PCR method using appropriate primers. Results: SDF-1 and both receptors transcripts had significantly higher expression in pterygia samples compared to the control group (P < 0.05). The ratio of CXCR7 transcript expression to CXCR4 was 26.4 in patients while it was 11 in controls. Conclusion: As SDF-1 and its receptors, CXCR4 and CXCR7, were up-regulated in pterygia, SDF-1/CXCR4/CXCR7 axis may contribute to pterygium formation which can be possibly restrained by down-regulating this signaling pathway.
Purpose. Early diagnosis of keratoconus disease (KCN) is the first priority in the preoperative e... more Purpose. Early diagnosis of keratoconus disease (KCN) is the first priority in the preoperative evaluations of refractive surgery (RS). e aim of this study was to investigate the correlation between findings of Belin Ambrosio enhanced ectasia display (BAD) software and conventional corneal imaging (Orbscan and topography) in the early diagnosis of KCN. Methods. For conducting this cross-sectional study, a total of 1000 eyes were selected from 500 patients that underwent the myopic photorefractive keratectomy surgery and were compared in four study groups during the years 2017-2018. In group 1, all topography, Orbscan, and BAD criteria were normal (65.8%).In contrast, in Group 2, at least one of the topography or Orbscan criteria as well as at least one BAD criterion (12.6%) were abnormal. In Group 3, the eyes had normal Orbscan and topography criteria with at least one abnormal BAD criterion (18.5%). Also, in Group 4, the patients had at least one abnormal Orbscan or topography criterion, but all BAD criteria (3.1%) were normal. ickness of the thinnest point (TP) of cornea was compared in Pentacam and topography. Data analysis was done by SPSS software (version 21). Results. BAD criteria were normal in 78.5% of all eyes with normal topography and Orbscan criteria (specificity). BAD criteria were also abnormal in 80.2% of eyes (sensitivity). ere was also no significant difference between TP in Orbscan and Pentacam. Conclusions. BAD criteria had a relatively acceptable sensitivity and specificity, compared with conventional Orbscan and topography criteria. us, BAD criteria can be more effective in the early diagnosis of KCN.
International Journal of Health Sciences (IJHS), Jul 4, 2022
Background: Keratoconus is a degenerative and progressive of corneal disease. Unlike other countr... more Background: Keratoconus is a degenerative and progressive of corneal disease. Unlike other country, studies about epidemiology of keratoconus are limited in the Iran. Aim of the study is survey of keratoconus epidemiology in the eastern Iran. Methods: For doing the cross-sectional study, patients were evaluated at the ophthalmology center of Mashhad County, during 2015-2016 year. Firstly, medical history was obtained from all new patients. Ocular examination was done for detection of keratoconus signs including Scissor reflex, Rizzuti sign, Fischer ring, Vogt striae and any sign of previous hydrops. For all suspicious patient's topography was done. Also, the required demographic data were recorded. The data were analyzed using SPSS software (version 18). Results: Totally, 90 eyes from 45 patients were studied. The average age of patients was 25.1 ± 6 years and the average age of onset of the disease was 17.72 ± 7.76 years. More than half of patients (55.6%) were female. One-sided Keratoconus was found in 11.1 %. In 10 patients (10 eyes), there was history of penetrating keratoplasty due to advanced keratoconus. Average corneal power of patients was 49.4 ±6. Also, there was Fischer ring, Vogt striae and signs of previous hydrops in the 52%, 21% and 10.7 % of patient, respectively. Conclusion: Overall, the disease must be considered as a cause of unusual and non-correctable gradual visual loss, especially in the young women and age group of less than 20 years in the Iran. Also, many of keratoconus risk factors that were previously reported were not found in the study.
Cataract is a common cause of vision loss and blindness in humans. After surgical management of c... more Cataract is a common cause of vision loss and blindness in humans. After surgical management of cataract, all efforts should be focused on reducing postoperative astigmatism thus providing an excellent vision to patients. To determine the relationship between corneal incision and refraction changes before and after phacoemulsification surgery in 300 patients undergoing cataract surgery in Khatam hospital in Mashhad, Iran from January 2017 to April 2018. Three hundred patients (144 women and 156 men) with cataract undergoing phacoemulsification surgery were recruited in this cross-sectional study. Refraction, keratometry and visual acuity measurement were performed before surgery. Then, a steep-based incision in the cornea was made without stitches. A 3.2 mm corneal incision was made at two supratemporal and temporal sites. The patients were followed-up for one and six months, and one year after surgery monitoring their vision and refraction, and performing keratometric measurements. The mean age of the patients was 65.7±9.54 years (age range, 42-84 years). No major complications were observed. The greatest mean of changes in corneal power was in the supratemporal incision (1.28±0.6). Keratometry had a significant relation with the incision (p<0.04). Conclusions: An incision made along the steepest meridian leads to flatness of this meridian, this effect being more pronounced at the supratemporal incision. A temporal incision is recommended in cases where there is little difference in the keratometry of the two axes.
Endophthalmitis is one of the most serious complications of intraocular surgeries, and Candida al... more Endophthalmitis is one of the most serious complications of intraocular surgeries, and Candida albicans constitutes the majority of cases of post penetrating keratoplasty (PK) endophthalmitis. The presenting case is a 21-year-old woman with known case of advanced keratoconus and vernal keratoconjunctivitis who underwent PK, and developed recalcitrant anterior uveitis and subsequent whitish lesion on the superonasal of the lens. She was on topical steroids with possible impression of Uretts Zavalia syndrome versus phacoantigenic uveitis following traumatic cataract up to the 50 th day of post operation that manifested symptoms of frank endophthalmitis; and underwent deep vitrectomy, lensectomy, localized iridectomy and irrigation with diluted Imipenem and Amphotericin-B. Microbiologic study of a vitreous sample revealed growth of Candida albicans, however optisol culture was negative and donor rim was not evaluated. One week later, intravitreal Amphotericin-B was administered. The patient remained aphakic with clear graft in the 6 th month follow up. Due to great correlation of positive donor rim culture with fungal endophthalmitis and the devastating effect of delayed diagnosis, routine donor rim culture is recommended, to aid us in earlier diagnosis in the presence of nonspecific early signs of fungal endophthalmitis.
Purpose. e biomechanical properties of ecstatic cornea undergo changes. is study evaluates the bi... more Purpose. e biomechanical properties of ecstatic cornea undergo changes. is study evaluates the biomechanical changes of ecstatic cornea after implantation of two types of intracorneal stromal ring (ICR). Methods. For doing this prospective crosssectional study, 32 patients with keratoconus (KCN) were randomly divided into two 16-member groups (group I: MyoRing, group II: KeraRing). e main inclusion criteria were transparent cornea with no scar in the central part, corneal thickness >450 µ in the incision region, keratometry within 48-52 diopters, and progressive course of corneal thinning. Biomechanics of the cornea was evaluated by "ORA" and "Corvis" devices. All of the data were recorded and analyzed before implantation of the rings and 6 months thereafter. Results. e mean ages of patients of groups I and II were 26 ± 6.55 and 33.86 ± 8.5, respectively. e postoperative change of sphere refraction was significant in both groups. However, reduction in the astigmatism was significant only in group I. In addition, the change of flat meridian keratometry (Kf ) was significant before and after ring implantation in group I, unlike group II. e changes in CH and CRF parameters (ORA) were not significant in either group before and after the operation. Besides, only HRC parameter (Corvis) decreased significantly in both groups before and after the operation. Conclusion. Both MyoRing and KeraRings have positive effects on the biomechanics of cornea at least during the first year after implantation. Comparison of these two types of ICR did not show significant differences in Corvis and ORA parameters.
Background: Pterygium is a common degenerative eye disease. Despite various surgical methods to t... more Background: Pterygium is a common degenerative eye disease. Despite various surgical methods to treat pterygium, recurrence is the main complication. The main issue is finding a surgical method with the lowest recurrence. Objective: to compare the complications, recurrence rate and the cosmetic effects of two surgical techniques, namely conjunctival rotation autograft (CRA) and conjunctival autograft (CA), in treating pterygium. Methods: This randomized clinical trial was conducted at Khalili Hospital in Shiraz, Iran, from January to August 2015. Forty-five eyes from 45 patients were studied. The patients were randomly divided into two groups using the blocking method. The patients of one group were operated on by the CRA technique, while the other group was operated on by the CA method. The patients were checked for the recurrence of pterygium, and other complications at the end of the first, third, and sixth month. Finally, the data were analyzed using SPSS version 21. The mean age of the patients was 42.5 years. The recurrence of pterygium was not observed in any of the patients 6 months after the surgery. Following 6 months after the operation, graft retraction occurred during the first week for one patient (4.5%) in the CA group, and five patients (21.7%) in the CRA group. The prevalence rate of graft injection among the patients of the CA and CRA groups 6 months after the operation was 9.1% and 65.2%, respectively. There was a significant correlation between injection intensity and the dissatisfaction of the patients with the operation's outcome (p=0.017). Conclusion: CRA with mitomycin is considered as an effective method to reduce the recurrence of pterygium after operation. This technique can be used as an acceptable method for pterygium operation, especially for patients with insufficient conjunctiva.
Introduction: Basic anatomical parameters in ophthalmology are variable in different countries ac... more Introduction: Basic anatomical parameters in ophthalmology are variable in different countries according to ethnic groups, genetics and some environmental factors. The aim of this study was to determine the relationship between axial length (AL), anterior chamber depth (ACD) and intraocular lens power (IOL) in a referral center from eastern Iran among patients who had cataract surgery, in comparison to studies from other regions of the world. Methods: In a cross-sectional retrospective study from 2011 to 2013, the records of 698 cataract patients referring to Khatam Al Anbia general hospital in Mashhad, Iran were evaluated. We divided patients, based on their AL and ACD, into three separate groups and compared their results. The SPSS software was used for data analysis. The Chi-Square test and the Independent-samples t-test were used to compare qualitative and quantitative data between two groups, respectively. The Kendall and the Pearson product-moment correlation tests were used to assess the relationship between AL and ACD. The linear Regression model was used to obtain a mathematical model to estimate ACD, using AL, age and sex. Results: Among individuals who had normal AL (between 22-24.5mm), there was a positive correlation between AL and ACD (p<0.001, r=0.17), however, among individuals with short (AL<22mm) or long sightedness (AL>24.5mm), no significant correlation was detected. We also found that older people have shorter AL (p=0.001 and r=-0.287). Men have an average longer AL (23.7±2.4mm vs. 22.9±2.1mm; p<0.001) and deeper ACD compared to women (2.93±0.45mm vs. 2.82±0.42mm, p=0.002). Conclusion: Our findings were mostly similar to previous literature from other regions of the world and although some anatomical variations may exist regarding ophthalmic anatomy, factors like race and geographical area have little effect on the relationship between ACD, AL and IOL power calculation, furthermore our results support the use of third and fourth generation formulas for IOL power calculation.
Background. To investigate the association of glutathione s-transferase omega 2 (GSTO2) (142N > D... more Background. To investigate the association of glutathione s-transferase omega 2 (GSTO2) (142N > D) and transforming growth factor-β1 (TGF-β1) (869T > C) gene polymorphisms on the pathogenesis of two common types of glaucoma (including primary open-angle glaucoma (POAG) and chronic angle-closure glaucoma (CACG)) in the Iranian population. Methods. A total of 100 glaucoma patients (60% males and 40% females with an age mean ± SD of 34.66 ± 14.25 years; 56 cases of POAG and 44 cases of CACG) were enrolled in this study. GSTO2 (142N > D) and TGF-β1 (869T > C) polymorphisms were evaluated by PCR-based methods in patients and controls. Results. At locus GSTO2 (142N > D), the odds of ND genotype with respect to DD and NN genotypes were 1.55 and 2.08 times higher in POAG and CACG patients compared to those of patients in the control group (95% CI 1 : 0.80-2.98; 95% CI 2 : 1.00-4.33) which was statistically significant in CACG patients. However, the odds of DD and NN genotypes against the reference genotype in two patients group were not statistically significant as compared to those of patients in the control group. ere was a significant association between the ND genotype and male patients (OR � 2.28, 95% CI: 1.06-4.92). e analysis of TGF-β1 (869T > C) polymorphisms showed no significant difference between the genotypes of TGF-β1 (869T > C) polymorphisms in patients and control groups; however, the CT genotype of TGF-β1 significantly differed between female controls and patients (OR � 0.42, 95% CI: 0.18-0.96). Conclusion. e presented results revealed that there was a significant association between the ND genotype of GSTO2 and the pathogenesis of glaucoma. Furthermore, this genotype can be considered as a sex-dependent genetic risk factor for the development of glaucoma. In contrast, the CT genotype of TGF-β1 is suggested to be a protective genetic factor against the pathogenesis of glaucoma.
: Curcumin is the main active constituent of the medicinal plant Curcuma longa L., used tradition... more : Curcumin is the main active constituent of the medicinal plant Curcuma longa L., used traditionally as a medicinal spice in several ancient civilizations. Different preclinical and clinical studies support the anti-inflammatory properties of curcumin in various inflammatory diseases. As inflammation has an essential role in the pathophysiology of many ocular diseases, curcumin has been suggested as a promising therapeutic agent with anti-inflammatory properties. Based on the extent of experimental and clinical evidence, curcumin can exert protective effects against the corneal, uveal, retinal, optic nerve, orbital, and lacrimal gland inflammatory disorders. Herein, the available literature on the beneficial effects of curcumin in inflammatory eye diseases is reviewed. The limitations and future directions of these investigations are also discussed.
Middle East African Journal of Ophthalmology, 2020
PURPOSE: To evaluate the effectiveness of ultraviolet (UV)-A/Riboflavin corneal cross-linking (CX... more PURPOSE: To evaluate the effectiveness of ultraviolet (UV)-A/Riboflavin corneal cross-linking (CXL) for the treatment of the refractory cases of fungal keratitis. METHODS: In this prospective interventional study, 9 patients with the diagnosis of fungal keratitis that were referred to our emergency eye center were included. These patients were resistant to conventional treatment and underwent therapeutic UV-A/Riboflavin CXL. Response to the treatment was considered as good if rapid epithelialization and rapid decrease in stromal infiltration was occurred after PACK-CXL, and poor when the emergency transplantation was necessary to eradicate the infection. RESULTS: Nine patients treated with CXL due to recalcitrant fungal keratitis. Culture of the corneal scrapings showed Aspergillus species in 4 patients, Candida albicans in 1 patient and Fusarium species in the remainder of them. CXL was performed from 1 to 20 days after the presentation of corneal ulcers (Mean: 9.12 ± 4.02; range: 5–20 days). Postoperatively, the mean time to epithelialization was 14.25 ± 2.38 days, and mean time to resolution of stromal infiltration was 22.5 ± 7.29 days, in responsive cases. Four out of 9 eyes showed good response, and five patients showed no response, and corneal transplantation was performed to eradicate the infection. There was no statistically significant difference in mean depth of infiltration and mean size of ulcer between responsive and unresponsive patients (P = 0.86 and 0.08, respectively). CONCLUSION: Although UV-A/Riboflavin CXL is not a definite treatment for all of the fungal keratitis, it seems promising in the management of some refractory cases.
To evaluate the agreement of dry, and cycloplegic autorefraction and wavefront-based refraction w... more To evaluate the agreement of dry, and cycloplegic autorefraction and wavefront-based refraction with subjective refraction. Method: 83 subjects aged 19---57 years were included in this cross-sectional study. Refractive status was determined using four methods including subjective refraction, wavefront-based refraction, dry and cycloplegic autorefraction. Refractive data were recorded as sphere, cylinder and spherical equivalent (SE). Power vector components were used to compare the astigmatism obtained using the different methods of refraction. Results: The more negative spherical, cylindrical and SE components were obtained using dry autorefraction, wavefront-based refraction and dry autorefraction, respectively. The less negative spherical, cylindrical and SE components were obtained using cycloplegic autorefraction, subjective refraction and cycloplegic autorefraction, respectively. Considering the spherical component, there was a statistically significant hyperopic shift (0.12 ± 0.29 D, p = 0.001) with cycloplegic autorefraction and a significant myopic shift (-0.17 ± 0.32 D, p < 0.001) with dry autorefraction compared to subjective refraction, while the difference between wavefrontbased and subjective refraction was not significant statistically (p = 0.145). The calculated cylindrical component using subjective refraction showed statistically significant difference with dry auto-refraction (p < 0.001), cycloplegic auto-refraction (p = 0.041) and wavefront refraction (p < 0.001). The highest correlation with subjective refraction in sphere, cylinder and SE was observed for cycloplegic auto-refraction (r s = 0.967), dry auto-refraction (r s = 0.983) and cycloplegic auto-refraction (r s = 0.982), respectively.
To evaluate the agreement of dry, and cycloplegic autorefraction and wavefront-based refraction w... more To evaluate the agreement of dry, and cycloplegic autorefraction and wavefront-based refraction with subjective refraction. Method: 83 subjects aged 19---57 years were included in this cross-sectional study. Refractive status was determined using four methods including subjective refraction, wavefront-based refraction, dry and cycloplegic autorefraction. Refractive data were recorded as sphere, cylinder and spherical equivalent (SE). Power vector components were used to compare the astigmatism obtained using the different methods of refraction. Results: The more negative spherical, cylindrical and SE components were obtained using dry autorefraction, wavefront-based refraction and dry autorefraction, respectively. The less negative spherical, cylindrical and SE components were obtained using cycloplegic autorefraction, subjective refraction and cycloplegic autorefraction, respectively. Considering the spherical component, there was a statistically significant hyperopic shift (0.12 ± 0.29 D, p = 0.001) with cycloplegic autorefraction and a significant myopic shift (-0.17 ± 0.32 D, p < 0.001) with dry autorefraction compared to subjective refraction, while the difference between wavefrontbased and subjective refraction was not significant statistically (p = 0.145). The calculated cylindrical component using subjective refraction showed statistically significant difference with dry auto-refraction (p < 0.001), cycloplegic auto-refraction (p = 0.041) and wavefront refraction (p < 0.001). The highest correlation with subjective refraction in sphere, cylinder and SE was observed for cycloplegic auto-refraction (r s = 0.967), dry auto-refraction (r s = 0.983) and cycloplegic auto-refraction (r s = 0.982), respectively.
Background To determine the prevalence of keratoconus in Shiraz University of Medical Sciences Em... more Background To determine the prevalence of keratoconus in Shiraz University of Medical Sciences Employees and the related risk factors including oxidative stress biomarkers. Methods 2546 subjects’ mean age ± SD, 40.35 ± 6.70 (46% male) were recruited. All participants underwent objective refraction using auto-refractometer and retinoscopy, followed by subjective refraction, and bio-microscopy. Pentacam imaging was performed for the detected keratoconus patients. The prevalence of keratoconus and frequency of the visual impairment among keratoconus cases were evaluated. Potential risk factors of sex, age, family history of keratoconus, body mass index ≥ 30 kg/m2, serum levels of glucose ≥ 100 mg/d, low-density-lipoprotein-cholesterol (LDL) ≥ 110 mg/dL, high-density-lipoprotein-cholesterol ≤ 40 mg/d, and triglycerides ≥ 150 mg/dL in the blood were evaluated. Results The prevalence of keratoconus at least in one eye was 0.98% (95% CI: 0.6- 1.4%). The best corrected visual acuity in the ...
Purpose: To determine a safer mode using two different frequencies (10 and 60 pulses per second)... more Purpose: To determine a safer mode using two different frequencies (10 and 60 pulses per second) in pulse mode phacoemulsification in moderate to severe cataract. Study Design: Quasi experimental study. Place and Duration of Study: Khatam-Al-Anbia Hospital, Mashhad, Iran, from 2017 to 2018. Methods: We enrolled 145 patients with moderate and severe cataracts according to lens opacities classification system III (LOCS III). They were allocated to two different groups with different frequencies of pulse mode (10 PPS and 60 PPS) phacoemulsification. Post-operative parameters, including best-corrected visual acuity, corneal edema, endothelial cell density, central corneal thickness, and effective phaco time, were compared between the groups. Results: Patients who had undergone surgery using 10 PPS pulse mode had better vision than those in the 60 PPS pulse mode group. Pulse mode with 10 PPS caused 0.112 reductions in log MAR in best-corrected visual acuity compared with the 60 PPS ...
: Curcumin is the main active constituent of the medicinal plant Curcuma longa L., used tradition... more : Curcumin is the main active constituent of the medicinal plant Curcuma longa L., used traditionally as a medicinal spice in several ancient civilizations. Different preclinical and clinical studies support the anti-inflammatory properties of curcumin in various inflammatory diseases. As inflammation has an essential role in the pathophysiology of many ocular diseases, curcumin has been suggested as a promising therapeutic agent with anti-inflammatory properties. Based on the extent of experimental and clinical evidence, curcumin can exert protective effects against the corneal, uveal, retinal, optic nerve, orbital, and lacrimal gland inflammatory disorders. Herein, the available literature on the beneficial effects of curcumin in inflammatory eye diseases is reviewed. The limitations and future directions of these investigations are also discussed.
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