فهرست مطالب mohammad hossein jabarpoor-bonyadi

To evaluate the distribution of TNF-alpha promoter -1031T/C and -308G/A polymorphisms in an Iranian population with Behcet disease and ocular manifestation. We investigated the distribution of TNF-alpha promoter -1031T/C and -308G/A polymorphisms in 53 patients with Behcet disease (BD) and 79 matched healthy controls, using the PCR-RFLP technique. All subjects were from an Iranian Azeri population. The frequency of the TNF-alpha -308G/A polymorphism was similar in BD patients and healthy controls (P= 0.234) whereas the frequency of the TNF-alpha-1031T/C polymorphism was different between two groups (P= 0.0006). The frequency of the CG haplotype was significantly higher (P< 0.0001), and that of the TA haplotype was significantly lower in BD patients than healthy controls. Different TNF--1031T/C and TNF--308G/A polymorphisms were not associated with ocular involvement. TNF-alpha is a susceptibility gene for BD in Iranian patients of Azeri ethnicity. There was no relation between different haplotypes in the investigated genetic region in this group of BD patients with ocular manifestation.

To investigate the outcomes of keratolimbal allograft (KLAL) for treatment of total limbal stem cell deficiency (LSCD). Patients with total LSCD and adequate tear production were included. A total of 27 KLAL procedures were performed in 21 eyes of 20 patients with LSCD. Immunosuppression was achived using mycophenolate and cyclosporine. Main outcome measure was improvement in vision; in addition, KLAL survival and post operative complications were studied. Mean follow up period was 22.14±11.83 months (range 6-39). Mean visual acuity improved from 2.53± 0.21 to 1.49±0.77 LogMAR (P<0.0001). Six KLALs never re-epithelialized and were considered as primary failures. Mean KLAL survival was 14.23±1.5 months. Graft survival rate was 61.9% at 1 year and 31% at 20 months. Complications included corneal ulcers in 6, glaucoma in 2 and scleral thining in 1 case. Keratolimbal allograft surgery is successful in the short term for visual rehabilitation of patients with total limbal stem cell deficiency.

To evaluate stem cell deficiency using impression cytology (IC) in patients with chronic and delayed-onset mustard gas keratopathy (MGK). A consecutive series of patients with MGK underwent IC. Thirty-five eyes of 18 patients (all male) with mustard gas keratopathy were included in this observational case series. Presence of goblet cells on the corneal side of specimens was considered to indicate stem cell deficiency. Corneal involvement was graded as mild, moderate and severe. Relation between IC findings and clinical grading was evaluated. There was limbal stem cell deficiency in at least one quadrant of the cornea in all 35 eyes (100% of cases). No differences was found between impression cytology findings (positive versus negative for corneal goblet cells) among different quadrants (p= 0.378). Clinical grading was the same between nasal and temporal quadrants (P=0.266) and between superior and inferior quadrants (P= 0.263). Combining the superior and inferior quadrants (vertical zone) and also the nasal and temporal quadrants (horizontal zone) together, clinical grading was more severe in horizontal versus vertical zones (p< 0.001). There was no correlation between stem cell deficiency and clinical corneal severity (p=0.893). Varying degrees of stem cell deficiency was demonstrated in all patients with chronic or delayed-onset MGK using IC. Clinical corneal manifestations are more severe in nasal and temporal quadrants. We found no correlation between stem cell deficiency and clinical manifestations. Other factors such as perilimbal conjunctival ischemia might play a role.