فهرست مطالب farzan kianersi

The aim of this study was to evaluate ultra‑widefield (UWF) fundus fluorescein angiography (FFA) findings in patients with Fuchs’ uveitis syndrome (FUS).

This cross‑sectional study was conducted in patients with FUS. All the patients underwent a complete ophthalmologic examination, and FFA was carried out with Optos UWF retinal imaging. Standard FFA and image acquisition consisted of early phase (15–45 s) images, and late‑phase (5–10 min) images were also obtained for both eyes.

Forty eyes from twenty unilateral FUS patients, including 11 females (55%), who had a mean age of 38.50 ± 6.97 years, were enrolled. Eighty‑five percent of the FUS eyes had optic disc hyperfluorescence (ODH) in the FFA. A significant relationship was observed between ODH and iris heterochromia (P = 0.004). ODH was seen in all the patients with iris heterochromia (n = 16). Peripheral vascular leakage (PVL), capillary nonperfusion, chorioretinal scar, and vascular sheathing were observed in 3, 3, 2, and 8 of the patients’ eyes, respectively.

UWF FFA imaging seemed to be mandatory for evaluating the prognosis of the FUS patients, and another investigation may require to be conducted to evaluate the effect of antivascular endothelial growth factor agents for the management of PVL in these patients.

There are numerous sophisticated studies which have investigated risk factors of breast cancer (BC). The purpose of this paper is to use benefits of Bayesian modeling to involve such prior information in determining factors affecting the survival of women with BC in Yazd city.

The checklist included the characteristics of the patients and the factors studied. Then, from the records of patients referred to Radiotherapy Center of Shahid Ramezanzadeh, who had BC, from April 2005 to March 2012, the survival of 538 persons was recorded in the census. Data were analyzed by R software version 3.4.2, and 0.05 was considered the significance level.

The mean age of BC diagnosis was 48.03 ± 11016 years. The Bayesian Cox regression showed that surgery (hazard ratio [HR] =1.631 95% PI; 1.102–2.422), ki67 (HR = 3.260. 95% PI; 1.6308–6.372), stage (HR = 5.620, 95% PI; 4.079–7.731), lymph node (HR = 1.765, 95% PI; 1.127–2.790), and ER (HR = 2. 600 95% PI; 2.023–3.354) were significantly related to survival time.

The parametric and cox models were compared with standard error, and Cox model was selected as an optimal model. Accordingly, stage, ki67, lymph node, ER, and surgery variables had a positive effect on death hazard.

The inevitable material and material effects of low vision and blindness in developing and even developing societies, reduction of preventable and avoidable burden of disease and its inability necessitate extensive research. The purpose of this study was to explain the health policy transformation policy model in the field of prevention of diabetic retinopathy. A sample of 32 health system experts and senior experts was selected through purposeful sampling and semi-structured interviews were conducted. The data are categorized by the basis of the data theory of the foundation. Findings of this paper are presented in the context of a paradigm model including: causal conditions (universal education, proper patient guidance), pivotal phenomena (preventive policy making), strategies (reducing obesity and preventing weight gain and diabetes, reducing laser percentages). Ophthalmic, Intraocular Injection Reduction, Voluntary Increase in Preventive Follow-Ups), Areas (Media Role, Non-Governmental Role, Law Enforcement Guarantees), Intervening Conditions (Economic, Cultural, Benefits,, Treatment-Focused Attitude) Government) and the consequences (sustainable human-based sustainable development, holistic and holistic health system, health system) Date and knowledge-based, targeted health system) has analyzed. Each program in the field of prevention of retinopathy has two criteria. Performance criterion and effectiveness criterion. We often do poorly in the field of effectiveness and inference. In my opinion, the positions should be specified in the formulation and implementation.

Hemodialysis (HD)‑associated ocular abnormalities are one of the causes of morbidity among people undergoing HD. This study evaluates the frequency of ocular abnormalities in end‑stage renal disease (ESRD) patients undergoing HD and their potential link to HD and demographic parameters. This cross‑sectional study examined 242 eyes of 121 patients with ESRD undergoing regular HD after excluding the ineligible subjects. The study was designed in two parts. Medical histories of each patient including age, gender, family history, medication history, past medical history, and duration of HD collected using a structured check list. All patients underwent complete ophthalmologic examination for evaluation of the best corrected visual acuity (BCVA), intraocular pressure (IOP), and anterior and posterior segments. In total, 121 patients, including 68 (56.2%) males and 53 (43.8%) females, were enrolled in the study. The mean ± SD age of the patients and their mean duration of dialysis were 51.59 ± 16.01 and 3.40 ± 2.75 years, respectively. The most prevalent etiology for HD was diabetes mellitus (39.67%), followed by hypertension (38.84%), and the most common ocular fndings included cataract (142 eyes; 58.7%) and ectopic calcifcation of the conjunctiva and cornea (78 eyes; %32.2). There was at least one abnormal ocular fnding in 89.3% of the cases. The BCVA was equal to or less than fnger count in 70 eyes (28.92%). There was a signifcant relationship between conjunctival calcifcation and the duration of dialysis (P = 0.02). There was signifcant association between etiology of HD and conjunctival calcifcation (adjusted odds ratio, 2.44; 95% CI, 1.05–5.67; and P value, 0.03). Such signifcant associations were present for corneal calcifcation (P = 0.009), cataract (P = 0.02), and optic atrophy (P = 0.01). Regular ophthalmologic examinations are recommended due to the prevalence of clinical ocular abnormalities in HD patients.

To report the simultaneous presentation of three ocular manifestations of granulomatosis with polyangiitis in one eye.
Case Report: A 42-year-old man with a confirmed diagnosis of granulomatosis with polyangiitis was referred to the emergency room with sudden blurred vision. Eye examination showed hyperemic conjunctiva due to necrotizing scleritis in the superior nasal quadrant of the left eye, a mass in the left superior lid, as well as central retinal artery occlusion in the same eye.

This case suggests that unilateral eye involvement may be a manifestation of underlying granulomatosis with polyangiitis.

In this study, we report a 26‑year‑old female case of Niemann–Pick disease type C in association with Fuchs heterochromic iridocyclitis who was admitted with the complaint of ocular pain and redness following trauma. She had mild inflammatory signs and also vertical ocular motility limitations.

Aim of this clinical trial is the evaluation of the effect of intravitreal injection of bevacizumab on acute central serous chorioretinopathy (CSC).

In a nonrandomized clinical trial, 36 CSC eyes (with <1‑month disease history) were examined. Initially, all the patients underwent posterior and anterior segment examinations as well as complete eye examination to evaluate the best spectacle‑corrected visual acuity (BSCVA). Then, optical coherence tomography was performed to confirm the diagnosis. The patients were divided to the two groups each of 18 subjects, which 18 patients received intravitreal injection of bevacizumab (1.25 mg) and the rest of them did not receive any treatment (control group). The patients were health checked by the end of the 1st and 3rd months. Significance level was considered as P < 0.05.

In the BSCVA, no significant difference in visual improvement was observed in baseline vision compared to each other (P = 0.481). There was also no significant difference in the vision of intervention and control groups 1 and 3 months after injection (P = 0.379 and P = 0.557). A significant decrement existed in the intervention group compared with the control group in the maximum central macular thickness at 1 month after injection (P = 0.001); however, the difference was not significant when comparing the two groups at baseline and 3 months after injection (P = 0.925 and P = 0.338).

In general, according to the results of this study, intravitreal injection of bevacizumab was not effective in improvement of patients with acute CSC, although it had no side effects.

The aim of this study was to evaluate the epidemiological characteristics of deep vitrectomy surgery at the Feiz Ophthalmology center in Isfahan, Iran.
This was a retrospective descriptive study on patients underwent deep vitrectomy in Feiz Medical Center during 2011 to 2015. Reviewing patient's medical records and information including demographic data was done and the data were analyzed.
Findings: In this study, 2437 patients undergoing deep vitrectomy were reviewed, with a mean age of 54.25 ± 17.40 years, of them, 56.4% were men. 35.2% and 37.2% of patients had visual acuity of hand motion and counting fingers, respectively. Vitrectomy was performed in right eye in 49.2% of the patients. The most common cause of vitrectomy was proliferative diabetic retinopathy (35.3%), followed by retinal detachment (29.3%). 7.5% of patients had a history of previous vitrectomy.
Deep vitrectomy surgery is common in ophthalmology centers and is more common in men, and in the age category of 50-70 years. Generally, proliferative diabetic retinopathy and retinal detachment were the most common causes of deep vitrectomy in this study.

The retinal laser photocoagulation is the gold standard treatment of the proliferative diabetic retinopathy. Nowadays, we can perform panretinal photocoagulation with single spot or pattern scan laser methods. This study aimed to compare the retinal ischemic changes and the retinal neovascularization regression between these two techniques. In a prospective clinical trial study, 146 eyes of 73 patients with proliferative diabetic retinopathy was enrolled. One eye of patients was treated with single spot laser photocoagulation randomly and other eye was preserved for pattern scan laser photocoagulation. The changes of retinal ischemia on the basis of noncapillary perfusion and the regression of neovascularization on the basis of amount of leakage on fluorescein angiography were compared between the two groups after 6 months. There was no significant difference in the retinal neovascularization regression of disc and elsewhere in eyes treated with pattern scan (P = 0.26) or single spot laser (P = 0.31). While the areas of the retinal ischemia progression was significantly higher (9 cases) in group treated with pattern scan in comparison to other group (2 cases) (P = 0.02). The areas of retinal ischemia progression were higher after treatment with pattern scan laser compared to single spot laser. Future researches are recommended to find a better modality than the pattern scan to induce regression of the retinal ischemia similar to the single spot laser technique.

In some studies, high intraocular pressure as a risk factor for ocular disorders such as diabetic retinopathy and optic nerve atrophy is discussed. In some studies, diabetes risk factor for increased intraocular pressure is raised. Given that previous studies regarding theme an intraocular pressure in diabetic patients compared with normal subjects is not available. Also notice to due to the increasing prevalence of diabetes, especially in our society and the role of intraocular pressure control in reducing complications, this study aimed to determine the relationship between intraocular pressure in patients with type II diabetes mellitus duration of grace referred to in 1390-1391was performed. In a descriptive analytical study, patients records with type 2 diabetes who admitted to Feyz hospital during 2013-2014 were studied and Demographic characteristics with the intra ocular pressure and duration of diabetes of patients were collected and analyzed by SPSS software. The mean ± standard deviation of duration of diabetes was 12.2 ± 5.6 (range: 1.25) years and the mean ± standard deviation of IOP in OD and OS was 15.6 ± 3.5 and 15.5 ± 3.5 respectively. Between duration of diabetes and IOP was significantly correlated with the rate of 8%, which was statistically significant (P = 0.006). Intraocular pressure in diabetic patients depend on many factors including age, sex, duration of diabetes and related disease. Also due to lack of proper control of diabetes, different parts of the body, especially the eyes are exposed to the destructive effects of diabetes and impaired performance. Because despite all the progress that has been made in the treatment of diabetic retinopathy, but prevention, is still the most appropriate way. Thus Sugar and blood pressure control, proper nutrition and regular physical activity can reduce the risk of diabetic retinopathy.

We aimed to compare peak systolic velocity of central retinal artery (PSV.CRA) and peak systolic velocity of ophthalmic artery (PSV.OA) between patients with retinal detachment who were treated with segmental scleral bucking and scleral buckling with encircling procedure. This study was a descriptive-analytic cross sectional study that was performed in Isfahan university referral centers since April 2010 to April 2011. Of the patients who have undergone scleral buckling surgery, 20 patients belonging to two groups were randomly selected to enroll in the study. Study groups were, patients who have undergone segmental scleral buckling and the other group were patients who have undergone scleral buckling with encircling procedure. Patients were invited to perform color Doppler imaging. PSV-RA and PSV-OA were measured and documented in both operated and unoperated eyes. All of the Doppler’s performed at least three months after ophthalmic surgery. We found significant decrease in PSV.CRA among patients in both groups. In patients who had undergone scleral buckling with encircling procedure PSV.CRA was 11.03 ± 3.04 (cm/sec) and 14.83 ± 4.80 in operated and unoperated eye respectively (P = 0.03). In other hand, who treated with segmental scleral buckling these parameters were 11.02 ± 2.48 and 14.45 ± 4.69 (P = 0.03). PSV.OA did not change significantly in each method. The difference between mean PSV.CRA and PSV.OA in operated eye between two study groups was not significant. PSV.CRA reduced significantly in both surgery methods and PSV.OA changes was not significant. However, the mean PSV.CRA and PSV.OA changes did not show statistically significant difference between surgery methods.

To evaluate the intraocular pressure (IOP) rising effect of anterior versus posterior subtenon injection of triamcinolone in eyes with retinal vein occlusion This prospective nonrandomized study was performed on 57 eyes of 57 patients with macular edema due to retinal vein occlusion. 26 eyes received posterior subtenon injection of 40 mg triamcinolone acetonide [PSTT] and 31 eyes received anterior subtenon injection of 40 mg triamcinolone acetonide [ASTT]. IOP measurement was performed before the injection, and after the injection at one week, two weeks, one month and every month up to six months after the injection. IOP rise was treated accordingly by drops and filtering surgery. IOP rise was found in 8% of the PSTT, and 67% of the ASTT injected eyes (P=0.001). All eyes with IOP rise in the PSTT group were controlled medically. Only 50% of eyes with IOP rise in the ASTT group could be controlled medically and filtering surgery was necessary for 33% of patients in the ASTT group. Visual acuity (VA) improvement was the same for both groups. More patients may have IOP rise after ASTT injection compared to PSTT injections.

To evaluate the therapeutic effect of posterior sub-tenon methyl prednisolone in anterior ischemic optic neuropathy, No class 1 study has shown any conclusive medical or surgical treatment for non-arteritic anterior ischemic optic neuropathy (NAION). Efficacy of systemic or intravitreal steroids was suggested by some studies. This study was performed to evaluate the efficacy and safety of posterior sub-tenon injection of methyl prednisolone in eyes with acute NAION. In a double blind randomized clinical trial, forty patients with a recent onset NAION were randomly assigned into case and control groups. The case group received a single posterior sub-tenon injection of 40 mg methyl prednisolone; the control group received a sham injection. The patients had complete eye examination including visual field measurement and fluorescein angiography and systemic evaluation at the beginning. Eye examination was repeated at 2, 4, 6 and 8 week steps of the follow-up. Visual field was rechecked at the end of the follow-up. Statistical analysis used: SPSS 11.5 system, paired sample t-test; independent sample t-test, χ2, and ANOVA. Visual acuity (VA) improved 0.3 logMAR (three lines of Snellen chart) in the case group (P<0.030), no visual improvement was observed in the control group (P<0.589). Comparison between the two groups showed improvement in VA (P=0.021 at two weeks, and P=0.053 at 8 weeks), visual field pattern standard deviation (PSD), (P=0.034) and optic disc edema, (P=0.000) in the treatment group. No case of globe perforation or severe intraocular pressure (IOP) rise was detected. Posterior sub-tenon injection of methyl prednisolone was preferred to observation in acute NAION.

To report toxoplasmosis in triplet. Case Report: We report toxoplasmosis in triplet patient. Two of them presented with congenital toxoplasmosis with chorioretinal manifestation. One of this two has recurrence of chorioretinitis after complete and successful treatment with triplet antibiotic therapy. One of this triplet has no ocular or systemic manifestation of congenital toxoplasmosis. So it may be a case of bichorionic triplet with congenital toxoplasmosis. Due to sparing of one of the triplet, toxoplasmosis infected the one chorion of this bichorionic triplet.

Controversy has recently risen about the presence of compensatory ocular countertorsion (COCT) after head tilt. This study was performed to define the functional range of this phenomenon. Cycloplegic autorefraction was performed on 80 eyes with regular astigmatism 2D. Objective autorefraction was performed in normal position, right and left head tilt positions of 5º, 10º, 15º, 20º, and 25º. Any change in astigmatic axis after head tilt was considered as COCT defect. The authors designed a tiltometer which was fixed over the patient's head without disturbing proper refractometry in various head positions. Enrolled eyes had no other ocular disease except refractive error. Seventy eyes completed the study process. Mean age of the patients was 26.5±10 (15-48) years. Mean amplitude of COCT was 1.87°±1.81 (0°-5°) at 5° and 6.91°±4.96 (0º-20°) at 25° head tilt angles. COCT values with left head tilt were significantly lower than COCT values with right head tilt (P<0.026). Incyclotorsional compensation in each eye was not necessarily equal to the excyclotorsional compensation of the fellow eye, but this torsional discrepancy was not overal significant (P>0.237). COCT was found to be an unreliable phenomenon. Any minimal head tilt can induce erroneous measurement of astigmatic axis during refractometry.

To determine the effect of intravitreal triamcinolone (IVT) injection on visual acuity in patients with ischemic central retinal occlusion (CRVO).

This randomized clinical trial was performed on patients with ischemic CRVO referred to the retina clinic at Feiz Hospital in 2007-2008. Inclusion criteria were: duration of CRVO less than one month, normal IOP, no sign of diabetic retinopathy or hypertensive retinopathy, no history of laser therapy and ocular surgery and vascular diseases. Patients were randomly allocated to two groups: intervention group (injection of 0.1cc IVT) and control group (no injection). Follow up examinations for all patients were scheduled 1, 2, 3 and 6 months after injection. The results were analyzed by SPSS13 and t-test.

Overall, 52 patients (22 male and 30 female) entered the study. Mean age was 60.5+9.7 (range: 30-80) years. Duration of signs was 21+5.5 days in the control group and 19+6 days in the IVT group (P= 0.66).All patients had signs of ischemic CRVO. Mean baseline visual acuity was 1.75+0.20 logMAR in the IVT group and 1.91+0.08 logMAR in the control group (P= 0.1). VA improvement in the IVT group was greater in comparison with the control group at one month (P= 0.019) however this difference was not significant at other follow-up examinations. In addition, the difference in IOP between before and after the injection was not significant (P= 0.802).

This study showed that in patients with CRVO, intravitreal injection of triamcinolone, has no significant long-term effect on visual acuity.

Central serous retinopathy (CSR) is a frequent disease often involves healthy men and causes visual disturbances. This study was undertaken to investigate the effects of propranolol tablet on improvement of CSR in referral cases to Farabi and Feiz hospitals in Isfahan in 2003-2004. This was a double-blind randomized controlled clinical trial. Patients with CSR referred to Farabi and Feiz hospitals were randomly divided into 2 groups: treatment group and control group, each one included 30 patients. Treatment group took propranolol tablets 20 mg twice a day, and control group took placebo tablets. Patients were examined weekly until complete improvement. Means of duration of disease and final visual acuity on the basis of lag mar were compared by t-test. Relative frequency of final visual acuity of 10/10 in the two groups was compared using chisquare tests. Two groups were comparable with respect to age, sex, involved eye, psychological tensions and clinical findings. The course of improvement in treatment group was 62 ± 29 days and in control group was 89 ± 44 days (P < 0.05). Means of final visual acuities were not significantly different between the two groups (0.98 ± 0.13 log mar in treatment group compared to 0.97 ± 0.18 log mar in control group). Relative frequency of vision < 10/10 was 30% in control group and 3.3% in treatment group (P < 0.01). Duration of disease and need to laser therapy in patients with CSR were decreased by the use of propranolol but it had no effect on the amount of final vision. Because the patients are mostly in the years of active life, propranolol use is recommended for these patients.