فهرست مطالب عادل قاسم پور

Microangiopathy and macroangiopathy frequently coexist in type 2 diabetes mellitus (T2DM). Both types of the vascular complications share traditional risk factors but it is not clear whether the presence of microangiopathy, such as diabetic retinopathy, constitutes a predictor of atherosclerosis in carotid arteries in patients with the disease. In this study we looked for the association between diabetic retinopathy and intima-media thickness in carotid arteries of patients with T2DM. In this case-control study we examined 100 consecutive patients with T2DM in Rasoul Akram Hospital in Tehran, Iran during 2009-2010. We assessed intima-media thickness of carotid arteries by ultrasonography. All patients underwent ophthalmo-logic examination. Diabetic retinopathy was found in 50 (50%) patients. Intima-media thickness was higher in patients with diabetic retinopathy than those without it (0.77±0.17 mm vs. 0.71±0.2 mm, respectively, P=0.041). Moreover, intima-media thickness was more prevalent in patients with proliferative diabetic retinopathy than patients with non-proliferative form of the disease (0.87±0.16 mm vs. 0.68±0.1 mm, respectively, P<0.001). Diabetic retinopathy seems to be associated with increased intima-media thickness of carotid arteries in T2DM. It may be a common denominator of pathogene-sis of microvascular complications and atherosclerosis in T2DM. Evaluations of carotid arteries are to be done by non-invasive methods such as color Doppler sonography for screening and preventing prospective cereberovascular accidents in patients with diabetic retinopathy, especially proliferative retinopathy, in routine ophthalmological examination of patients with T2DM.

To evaluate the safety of different doses of intravitreal bevacizumab in rabbit eyes. Twelve eyes of 6 rabbits underwent intravitreal injection of 5, 7.5 and 10 mg of bevacizumab. In each rabbit, one eye was considered for bevacizumab injection and the fellow eye served for either placebo injection or observation. All eyes were examined before and 1, 2, 3, 7, 14 and 28 days after intravitreal injections. Electroretinography (ERG) was performed before and 14 days after the injections. 28 days after the injections, all eyes were enucleated and examined with light and electron microscopy. In the clinical examination, significant vitritis was observed in one of the 10 mg injected eyes from first post-injection which was eliminated by the 7th day. Cataract was seen in the same eye. Post-injection ERGs showed no significant changes. Increase in Muller-like cells was observed in the histological examination in the injected eyes. Intravitreal injection of 5 and 7.5 mg doses of bevacizumab was safe in rabbit eyes; however, the 10 mg dose was associated with intraocular inflammation.

To evaluate the clera canal diameters at optic nerve head in patients with nonarteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography (OCT) and compare the results with fellow eyes and control group. In a prospective study, optic nerve head OCT was performed in acute phase of NAION. Horizontal and vertical diameters of the scleral canal at optic disc i.e. the termination of the retinal pigment epithelium, were recorded. The data was compared with fellow eyes and an age- and sex-matched normal control group. Thirty eyes of 30 patients and 20 eyes of 20 normal subjects were studied. Scleral canal diameters were the same for normal fellow eyes, optic atrophy fellow eyes and control eyes. Scleral canal diameters of NAION eyes were significantly greater than control and normal fellow eyes (P<0.001), however, the difference was not significant for optic atrophy fellow eyes. Although in the acute phase, the scleral canal diameters were greater in NAION eyes, no significant difference was found between normal fellow eyes and control eyes.

Diabetic retinopathy by inducing macular edema and proliferative diabetic retinopathy, is the most prevalent cause of visual loss in developed countries. Also, it is one of the most frequent causes of legal blindness in developing countries. The effective role of laser treatment has been proven in major randomized clinical trials. Scatter panretinal photocoagulation (PRP) in eyes with proliferative diabetic retinopathy and high-risk characteristics, decreases the risk of visual loss in >50% of eyes. Also, scatter PRP may have some benefits in nonproliferative diabetic retinopathy. In clinically significant macular edema, focal laser photocoagulation decreases the risk of moderate visual loss up to 50%. In this article, we describe the laser photocoagulation technique and characteristics in the management of diabetic retinopathy.

A high percentage of the patients at ENT or plastic surgery clinics have ENT abnormalities, either congenital or those developing later in life. Some are life threatening, while others cause disability and esthetic problems, with profound consequences for the affected child and the family. In addition, ENT abnormalities usually place stress on interpersonal relationships, causing social isolation, unhappiness and depression. The majority of these abnormalities is genetic and follows autosomal recessive pattern of inheritance. Geneticists believe that there is a higher frequency of autosomal recessive disorders among the offspring of consanguineous parents.