معصومه اقتداری

To evaluate study of corneal the frequency of re-graft during 5 years at Khalili hospital, Shiraz. In this retrospective observational study, all corneal re-grafts during 5 years (2009-2014) were assessed at Khalili Hospital, Shiraz. Demographic data of 76 cases, out of total of 1 190 transplants, were retrieved, including age, area of residence, primary disease, type of graft, cause of re-graft, and associated eye systemic diseases; then, the data were analyzed. The number of re-grafts during 5 years was 76 cases (6.38%). The most common procedure was penetrating keratoplasty and the most successful ones were deep anterior lamellar keratoplasty. The shortest interval to the next procedure was observed in cases of fungal infections and, then, in failed endothelial keratoplasties. The main causes of graft failure were endothelial dysfunction, infection, immunologic rejection, and recurrence of primary disease (14 cases). Male gender, type of primary disease, and associated ocular surface abnormalities were among risk factors. Considering high and fast rate of re occurrence of infection in grafts and the importance of controlling inflammation, treatment of surface abnormalities and infections as well as assessment of donor tissue before proceeding to surgery seem crucial.

In order to investigate the effect of particles size of sorghum silage mixed with alfalfa and concentrate levels on digestibility of nutrients, rumen parameters and dietary intake behavior, four male Raeini goat (BW, 30.1±3.0 kg) were used in chageover designs experiment to measure feed intake and nutrients digestibility, ruminal fermentation parameters and feed intake behaviors. To prepare silage, 800 kg of sorghum forage with different particles size (15 and 30 mm) were ensiled using special nylon bags .The experimental diets were: 1) diet contains 40% of the coarse sorghum silage and alfalfa hay and 60 % concentrate 2) diet contains 60% of the coarse sorghum silage and alfalfa hay and 40% concentrate 3) diet contains 40% of the fine sorghum silage and alfalfa hay and 60 % concentrate 4) diet contains 60% of the fine sorghum silage and alfalfa hay and 40% concentrate. The consumption of dry and organic matter was affected by experimental rations (1.20, 1.05, 1.37, 1.24 and 1.07, 1.02, 1.27 and 1.12 kg respectivily) and increased with decreasing sorghum silage particles size (P <0.05), but particles size of sorghum silage did not affect digestibility of nutrients. Population of cellulolytic protozoa species and the production of microbial protein were influenced by the particles size of sorghum silage and concentrate levels (P<0.05). Eating, ruminanting and total chewing activating were increased by increasing sorghum silage particles size. The results showed that sorghum silage with high or low concentrate lvels can be fed without any negative impact on small ruminants like Raeini goats.

The objective of the present study was to investigate the clinical and histopathological effects of intravitreal injection of pentoxifylline (PTX) the management of an experimental model of uveitis. Fifty-two rabbits were divided randomly into six intravitreal treated groups as below: 1) Balanced salt solution (BSS), 2) Salmonella typhimurium lipopolysaccharide endotoxin (LPS) BSS, 3) LPS PTX 100 μg, 4) LPS PTX 500 μg, 5) BSS PTX 100 μg and 6) BSS PTX 500 μg. Inflammation was evaluated by clinical examinations using slit lamp on days 1, 3, 5 and 7 post injections and histopathological examinations were also performed at the end of the study. Clinical examinations demonstrated a statistically significant difference between group 1 and group 2 on day 5 and day 7. Moreover, the comparison of clinical severity scores of group 1 with groups 3, 4, 5 and 6, on third, fifth and seventh post-injection days showed statistically significant differences. The mean histopathological inflammation intensity score in groups 5 and 6 was significantly higher than group 1. The mean histopathological inflammation intensity score in groups 3, 4, 5 and 6 was significantly higher than group 2. Intravitreal injection of PTX in an experimental model of uveitis in rabbits not only does not reduce inflammation but also leads to inflammation when used alone or in combination with LPS.

To explore any association between human papilloma virus (HPV) infection and ocular surface squamous neoplasia. Forty pathological specimens including 20 cases of conjunctival intra-epithelial neoplasia grade I (CIN I) and 20 cases of CIN III and invasive squamous cell carcinoma (SCC) together with 20 pterygium samples (controls) were analyzed by polymerase chain reaction (PCR) to find any evidence of HPV infection. The examinations were performed on cut sections of paraffin embedded tissue blocks from our laboratory archive. Mean age of patients at the time of sampling was 568 (range, 30-86) years in the CIN I group; 61.79 (range, 43-82) years in the CIN III and SCC group and 41.510 (range, 24-67) years in the pterygium group. All specimens were negative for HPV. No association was found between HPV infection and ocular surface neoplasia in our series.

The purpose of this study was to evaluate the effects of different time combinations of dexamethasone and acetylcysteine on experimentally induced corneal ulcers in dogs. Experimental corneal wounds were created surgically to the anterior one third of the cornea in the center of all eyes of 15 mixed breed dogs. The eyes were divided into five groups according to planned post-operative medications: group 1, one drop of N-acetylcysteine 3% and one drop of dexamethasone 0.1% immediately after surgery; group 2, two drops of N-acetylcysteine 3% from day 1, one drop of N-acetylcysteine 3% and one drop of dexamethasone 0.1% from day 15; group 3, two drops of N-acetylcysteine 3%; group 4, two drops of dexamethasone 0.1%; group 5 (control), two drops of normal saline. When applied immediately after corneal ulceration, dexamethasone 0.1% (group 4) decreased corneal haze significantly and did not delay corneal wound healing. Addition of dexamethasone 0.1% to N-acetylcysteine 3% from day 15 (group 2) significantly suppressed opacity at two months after the beginning of the study, but when dexamethasone 0.1% associated to N-acetylcysteine 3% immediately after corneal ulceration (group 1), significant delay in corneal wound healing was induced. It is concluded that combination of dexamethasone 0.1% and NAC 3% immediately after surgery may delay corneal wound healing, also use of these drugs individually, has no obvious clinical effect on corneal haze. On the other hand, use of these drugs in combination with each other may reduce the corneal haze in later months after discontinuation of drugs. However, further studies using larger groups of animals are needed to demonstrate the effectiveness of these pharmacological modulators following experimentally induced corneal wounds in dogs.

Many studies have been performed on validity of different methods for Amblyopia screening and this one was designed to assess the reliability of the TNO test for that purpose. This is a diagnostic value study. Visual acuity and stereo acuity of 100 patients with Amblyopia caused by refractive errors, strabismus with wide angle, or micro strabismus were measured and compared with the stereo acuity of 300 normal students using TNO test. Statistical analysis carried out to determine sensitivity, specificity, and diagnostic value. Then, positive and negative predictive values were calculated by considering 120 seconds of arc stereopsis as the cut off point. Ninety five percent of students had good stereopsis (120 second of arc or better). Patients group showed limited stereopsis. The most common cause of amblyopia in patients group was refractive errors (62%). The most defective stereopsis was clearly associated with wide angle strabismus. In this study TNO test had missed (underestimated) 8% of cases with Amblyopia and had 5% over referral rate but had sufficient power to detect patients with moderate to severe Amblyopia. Its sensitivity and specificity were 85.9% and 97.2% respectively. TNO test seems to be useful for screening purposes of Amblyopia. It is reliable and can be performed without having special skills. Lack of monocular clues, also, increases its value.

To evaluate histopathological changes induced by 0.02% mitomycin-C (MMC) in rabbits corneas. This study was performed on 48 corneas of 24 rabbits (Dutch type, Albino). Under general anesthesia, lamellar keratectomy was performed and either MMC 0.02 % (MMC group) or balanced salt solution (control group) was applied to the stromal bed for one minute. Sixty days later, light microscopic examination was performed on corneal buttons after authentication, corneal tissue fixation and staining with Hematoxylin-Eosin, periodic acid Schiff and Congo red as needed. One of the MMC cases showed decreased keratocyte count. Other findings such as interface scaring, keloid formation, stromal interface vascularization, stromal and flap edema, epithelial hyperplasia over the incision and flap occurred with the same frequency in MMC and control groups. Stromal scaring was less in the MMC group (zero vs two). There was faint eosinophilic staining in the interface in two and epithelial thinning over the flap in eyes of the control group. The endothelium was normal in all samples. Application of MMC 0.02% to the stromal interface in rabbit corneas led to decreased stromal keratocyte count and fibrosis but apparently had no adverse effect on interface healing, epithelial cell regeneration and the endothelium.

To evaluate the etiology of cataracts in children less than 3 years of age particularly the association of rubella virus infection and galactosuria with congenital cataracts at Khalili Hospital, Shiraz-Iran from 2003 to 2006. This prospective study included 46 patients less than 3 years undergoing lensectomy for the management of significant cataracts. Lens aspirate specimens were obtained from some cases. Serum samples for detection of anti-rubella IgM and IgG antibodies and urine samples for detection of galactose were also obtained. Out of 46 patients, 78.3% had congenital cataracts and 21.7% had traumatic cataracts. Patients with congenital cataracts were male in 45% and female in 55% with mean age of 5.12±5.23 months at the time of diagnosis. In the congenital cataract group, 2.8% had history of failure to thrive and 16.7% had low birth weight; 80.6% had bilateral and 19.4% had unilateral cataracts; 77.8% had isolated cataracts, 16.7% were associated with other ocular disorders and 5.6% were associated with systemic diseases; 11.1% had family history of congenital cataracts and 10.5% had galactosuria. Rubella virus was isolated from one (5.3%) of 19 cultured lens aspirates. No cases had anti-rubella IgM antibody. Congenital cataract is the most common type of cataracts in children under age 3 years in our area and most of them are idiopathic. The prevalence of rubella induced cataract in our country is less than developing countries but more than developed countries.

To determine the correlation between hand dominancy and eye dominancy with visual acuity and refraction in subjects with refractive errors. This cross-sectional study includes 620 patients undergoing LASIK. Their refractive error (dry and cycloplegic), hand dominancy, eye dominancy (by hole-in-the-hand method) and visual acuity were determined. Exclusion criteria were monocularity, patient's inability to perform hole-in-the-hand test, and amblyopia. Overall, 585 patients met the inclusion criteria for this study. Age range was 21-43 years (mean= 33.7 years), 58% were female and 42% were male. The right hand was dominant in 90.9% and the right eye was dominant in 77.9% of the subjects. Right eye dominancy was observed in 79.1% of right handed individuals and in 66.1% of left handed patients. Cross eye-hand dominancy was observed in 38.3% and uncrossed eye-hand dominancy in 61.7%. Visual acuity was better in dominant eyes in 68.2% (P=0.03, t=0.89). The non dominant eyes had higher refractive errors than dominant eyes (P=0.01, t=0.88). In both groups of right handed and left handed individuals, the right eye was more often dominant and uncrossed dominancy was more prevalent than crossed dominancy. Better visual acuity or smaller refractive error may influence eye dominancy.

To report a case of spinal cord tumor with visual symptoms and papilledema due to increased intracranial pressure.Patient and A 24-year-old woman was referred because of recent blurred vision in both eyes. Visual acuity was 20/25 and 20/20 in the right and left eyes, respectively. Fundoscopy revealed bilateral papilledema. Other ophthalmic examinations were normal. Visual fields showed blind spot enlargement and brain CT scan revealed dilated ventricles. Ventriculoperitoneal shunt was inserted for the patient with a diagnosis of hydrocephalus. Ten weeks later, she returned with low back pain and lower extremity weakness. Lumbosacral MRI revealed a tumor in the region of L1-L4. The patient underwent surgical removal of the tumor and histopathologic study showed mixopapillary ependymoma. Increased intracranial pressure and papilledema without evidence of a space occupying intracranial lesion may be the presenting sign of spinal cord tumors.