Journal of Current Ophthalmology
Volume:26 Issue: 2, Jun 2014

To determine the distribution of axial length (AL), vitreous chamber depth (VCD), anterior chamber depth (ACD), lens thickness (LT), lens power (LP), radius of curvature (CR), and white-to-white corneal diameter (WTW) in the 14-20 year age range In a cross-sectional study, sampling was done from Aligoodarz high schools using multistage simple cluster sampling. For all students, visual acuity and non-cycloplegic refraction tests were performed. Biometric components were measured using Allegro Biograph (WaveLight AG, Erlangen, Germany). In this report, data from 434 cases was used in the analysis; of these 222 (51.2%) were females. Mean and 95% confidence intervals of AL, VCD, ACD, LT, LP, CR, and WTW in the studied sample were 23.4 mm (23.32 to 23.48), 16.82 mm (16.74 to 16.9), 3.14 mm (3.12 to 3.16), 3.44 mm (3.42 to 3.46), 22.65 diopter (22.47 to 22.83), 7.74 mm (7.72 to 7.76), and 12.26 mm (12.22 to 12.3), respectively. In the multiple regression model, AL, VCD, ACD, CR, and WTW was significantly higher in boys while mean LT and LP were significantly higher in girls. The distributions of AL, ACD, LT, and CR were significantly different from normal. The distributions of AL, LT, and CR were leptokurtic, unlike ACD which had a platykurtic distribution pattern. In this report, we describe the normal ranges of ocular biometric components in a sample population of 14-20 year old Iranians. ACD in this study was shorter and WTW was larger than previous studies and other components were in the midrange. More studies throughout Iran are needed to verify a shorter ACD and larger WTW. All components of ocular biometry showed significant inter-gender differences.

To assess orbital color doppler ultrasonography (CDU) parameters of patients with manifest hyperopia in comparison to the emmetropes Forty eyes of 40 patients presenting with manifest hyperopia was included into the study. Forty eyes of 40 emmetropes healthy volunteers also were examined as the control group. We have evaluated ophthalmic artery, central retinal artery, posterior ciliary artery, central retinal vein, and superior ophthalmic vein flow velocities and resistance indices. Resistance indices value in the ophthalmic artery and mean velocities in the superior ophthalmic vein were significantly higher in the group of manifest hyperopia. CDU parameters of the central retinal artery, central retinal vein, nasal and temporal posterior ciliary artery between hyperopic group and the control group were statistically insignificant. Doppler ultrasonography findings revealed that some orbital CDU parameters are altered in eyes with manifest hyperopia compared to emmetropia. Particularly, increased resistance indices suggested the possibility that increased choroidal vascular resistance may be associated with the pathological angiogenesis in the affected eye.

The goal of this study was to compare differences in the mean heterophoria and fusional amplitudes before and after photorefractive keratectomy (PRK) for myopia. In a prospective controlled study, myopic patients were treated with aspheric and wavefront-guided (personalized) PRK. The manifest refraction, visual acuity, fusional amplitudes and heterophoria were evaluated preoperatively and at three and six months postoperatively. Fusional amplitudes were measured at far (six meters) and near (40 centimeters) by rotary prism and heterophoria was evaluated at nearby Maddox wing. A total of 48 cases (96 eyes, 68.75% female) were treated, with a mean age of 26.70±4.89 years (18-34 years). In the fusional reserves, comparisons between preoperative and six months postoperative means showed that far and near convergence reserves (or base out recovery points) and near divergence (or base in recovery point) were decreased significantly (p-values were 0.013, 0.002 and 0.008, respectively). In heterophoria measurements, contrary to the rest of the deviations, exophoria was increased, but not significantly (p=0.063). Findings of this study imply that far and near convergence amplitude (or base out reserves) were decreased significantly after keratorefractive surgery. The other fusional reserves were similarly decreased at three months postoperatively and returned to the preoperative values at six months.

To evaluate the effect of successful surgical alignment on improvement of binocular vision in adults with childhood strabismus In a prospective interventional study, consecutive patients with childhood-onset, comitant, horizontal and constant strabismus who had successful postoperative alignment were enrolled. Preoperative and postoperative binocular vision testing was performed using the Bagolini striated lenses and the Worths 4-Dot test. Improvement of binocular vision was defined as conversion of suppression to fusion response in Bagolini test and conversion of suppression to fusion or monofixation response in Worth 4-Dot test at three months after surgery. A total of 34 patients (15 females and 19 males) were included. The mean age at the time of surgery was 26.08±10.53 years (range, 14-53 years). The mean angel of deviation was 40.29±14.35 prism diopter (range, 20-75 prism diopter). Binocular vision was improved in 20 of 34 patients (58.8%) in Bagolini test. Also, binocular vision was improved in 20 of 34 patients (58.8%) in Worth 4-Dot test. There was no significant correlation between duration of misalignment and sensory outcome (p=0.67). There was a statistically insignificant increase in improvement of binocular vision in exotropic group (65%) compared with esotropic group (50%) (p=0.48). Also, there was a statistically insignificant increase in improvement of binocular vision in nonamblyopic group (60.8%) compared with amblyopic group (54.5%) (p=0.5). The angel of preoperative deviation had no influence on improvement of binocular vision (p=0.08). Surgical realignment leads to improvements in binocular vision in 58.8% of adults with childhood strabismus regardless of the type and angle of preoperative deviation, duration of strabismus, or amblyopia.

To determine the prevalence and genotype of Acanthamoeba keratitis in patients referred to Farabi reference eye center In this study, corneal scraping specimens that obtained from keratitis patients examined for Acanthamoeba and its genotype identifications. Direct smears, cultivation in non-nutrient agar followed by PCR were chosen as the basic diagnostic methods. The positive patients checked by confocal microscopy. For genotypic identifications of isolates from keratitis patients, DF3 region of rRNA gene amplified in PCR. Five clinical specimens (5.6%) out of 89 collected samples showed positive by culture and PCR analysis. Then the results compared with confocal microscopy and all five patients confirmed for Acanthamoeba keratitis. The statistical analysis showed significance relation between infection with Acanthamoeba and wearing contact lenses (p=0.001). A logistic regression analysis showed, there is an inverse weak statistical relation between age and infection (p=0.07). Sequence analysis demonstrated that T4 is the predominant genotype in these isolates and the primary genotype in keratitis Acanthamoeba infections. All the patients complain from one eye only, and pain, redness, tearing, and light sensitivity were the common clinical symptoms among them. Genotypic identification of the microorganism helps epidemiologists and parasitologists to study the transmission routs of infection in different areas. The results of this study also showed that non-nutrient agar as diagnostic and economical method could be used in areas with low ophthalmic equipment such as confocal microscopy, but time consuming.

Rifampin which is an anti tuberculosis (TB) drug, can increase metabolism and thus reduce endogenous steroid. So it is mentioned as a probable drug for acute central serous chorioretinopathy (CSC) treatment. Therefore we have decided to evaluate its beneficial effects in CSC treatment. A non-randomized clinical trial involving 39 patients with acute CSC (less than two weeks) were studied. Initially, complete visual examinations including determination of spectacle best clear visual acuity (SBCVA) using Snellen Chart, anterior and posterior segment exam were performed on all patients. Fundus fluorescein angiography (FA) and ocular coherence tomography (OCT) also were performed to confirm the disease. Twenty-three patients were treated with 600 mg rifampin per day up to maximum 4 to 6 weeks (treatment group) and 17 patients did not receive any treatment (control group). In the treatment group, one of the patients suffered from severe headache a few days after using the drug. So the drug was discontinued and the patient was excluded from the study. The patients were examined once in two weeks and totally up to fourth or sixth weeks. In each time of examination, the best clear visual acuity determination and funduscopy were done, and if necessary (cases of obvious macular edema) OCT was performed at the end of 4th to 6th week. Primary gain was reduction in macular thickness (MT) and secondary gain was the SBCVA during the study. The mean age of patients was 38.5±6.7 years. The mean age of the treatment group (37.7±6.2 years) was not significantly different from control group (39.7±7.3). Gender distribution shows that 76.9% of samples were male. In the treatment group, the average MT changed from 339.9±44.36 µm at the beginning of treatment to 297.4±29.09 µm at the end of treatment and this reduction in MT was equal to 12.58% (p<0.001) and in the control group, the initial and final thickness were 310.06±20.31 and 296.71±17.22, µm respectively. The reduction was equals to 4.3% (p<0.003). In the treatment group MT reduction was significantly more than the control group (p<0.018). In the treatment group, average of SBCVA before and after treatment was 0.2±0.18 and 0.6±0.34 SV, respectively (p<0.0001) and in the control group, this average was 0.2±0.1 before and 0.37±0.35 SV after treatment (p<0.024). The difference in SBCVA between two groups was more or less important (p=0.055). At the end of study, macula in 45.5% of the treatment group and 29.4% of control group had dried out. (OR=2) (0.52-7.6, CI95%) (p<0.307). Rifampin has beneficial effects in the treatment of acute CSC. These early findings suggest a novel treatment of CSC and warranted further study.

To describe the clinical findings, preoperative radiologic findings and results of surgery in a patient with congenital bilateral hypoplasia of medial rectus muscleCase report: A 50-year-old man presented with large angle incomitant horizontal deviation with marked deficit of adduction of both eyes. MRI finding defined very thin medial rectus muscle. Intraoperatively medial rectus muscles were not found. Lateral rectus recess combined with partial vertical rectus muscle tendon transposition was carried out on both eyes. The patient had orthotropia in primary position and adduction improved in final follow-up. This case is the first case report of the Iranian population who had congenital hypoplasia of medial rectus muscle. MRI allowed effective surgical planning to correct congenital abnormality.