mohsen farvardin

To evaluate vision-related quality of life in two sets of patients after routine cataract surgery implanting with traditional versus multifocal intraocular lens (IOLs).

In a cross-sectional prospective study, 58 and 33 candidates for cataract surgery were divided into traditional (Acrysof SN60WF, Alcon Laboratories, Inc) and multifocal IOL (AcrySof IQ PanOptix IOL TFNT00, Alcon Laboratories, Inc.) groups, respectively. The primary outcome was VFQ-25 scores. The secondary outcomes were making comparisons between the two IOL types in the near vision and the driving items.

The mean patients’ age in traditional and multifocal IOL groups was 60.85 ± 7.40 (55% female) and 59.85 ± 8.95 (36% female) years, respectively. The mean VFQ-25 total scores in traditional and multifocal IOL groups before and after surgery were 63.69 ± 4.95 and 72.15 ± 9.66, and 98.08 ± 0.70 and 95.70 ± 1.30, respectively (P = 0.001 & 0.001). The mean scores of night driving in traditional and multifocal IOL groups were 38.79 ± 20.50 and 44.35 ± 21.12 (P = 0.1) before surgery which improved to 97.41 ± 7.68 and 56.45 ± 11.12 after surgery, respectively (P = 0.001). The mean scores of near vision in traditional and multifocal IOL groups were 46.83 ± 10.56 and 50.53 ± 8.58 (P = 0.2) before surgery which improved to 89.94 ± 4.87 and 100.00 ± 0.00 after surgery, respectively (P = 0.001).

Vision-related quality of life after cataract surgery with either type of traditional or multifocal (PanOptix) IOLs improved to an excellent level. Traditional IOLs provided more satisfaction in nighttime driving while multifocal IOLs provided increased satisfaction in near and intermediate vision.

To investigate possible links between thyroid dysfunction and prevalence of wet age‑related macular degeneration (AMD).

The present case–control study enrolled a total number of 90 patients with wet AMD and 90 sex‑, and age‑matched controls through a convenient sequential sampling method. Thyroid hormones were profiled in serum assay. Statistical measures were done to compare means between groups.

Our findings showed a significant difference in free T4 levels between wet AMD and control groups (P = 0.002), but the mean values of total T3 and Thyroid‑stimulating hormone levels were similar between the two groups. In addition, there were no differences in serum lipid profile between groups. Although no significant difference in the history of hypertension and hyperlipidemia between wet AMD and control groups was found, the history of smoking was higher in controls (P = 0.039).

Thyroid hormone abnormalities may be associated with wet AMD.

This study was performed to determine the association amongst serum leptin level and anthropometric measures with the severity of Diabetic Retinopathy (DR) in subjects with type 2 Diabetes Mellitus (DM). This case-controlled study was conducted within a one-year period, during year 2016, at outpatient retina ophthalmology clinics of Shiraz, southern Iran. Eighty-three patients with type 2 DM, referring for ophthalmoscopy evaluation, were included. Anthropometric measures, serum leptin level, and baseline laboratory assessment was performed for all subjects. Patients were categorized as group 1, consisting of patients with severe Non-Proliferative Diabetic Retinopathy (severe NPDR) and Proliferative Diabetic Retinopathy (PDR) (n = 44), and group 2, consisting of patients without Diabetic Retinopathy (no DR) or mild/moderate NPDR (n = 39). The serum leptin level and anthropometric measures were compared between the two study groups. The correlation between these variables was also assessed. The mean age of the participants was 59.3 ± 6.9 years old. The two study groups were comparable regarding baseline characteristics. Cases of group 1 had significantly higher Erythrocyte Sedimentation Rate (ESR) (P = 0.049) and Systolic Blood Pressure (P = 0.025) when compared with those of group 2. The serum level of leptin was found to be significantly higher in cases of group 1 when compared to those of group 2 (P = 0.003). However, anthropometric measures, including Body Mass Index (BMI) (P = 0.167), Body Adiposity Index (BAI) (P = 0.061), and Waist to Hip Ratio (WHR) (P = 0.220) were comparable between the two study groups. Serum leptin level was positively correlated with BMI (r = 0.819; P < 0.001) and BAI (r = 0.630; P < 0.001) in group 1. Increased serum levels of leptin were associated with advanced stages of DR in subjects with type 2 DM. Serum leptin level might be a better indicator of the effects of obesity on DR, compared to anthropometric measures (BAI or BMI).

To study the outcomes of redo macular hole surgery using light silicone oil tamponade.
In this study, medical charts of consecutive patients who underwent redo pars plana vitrectomy, extended dye-assisted internal limiting membrane peel, and light silicone oil tamponade for failed previous macular hole surgery (from January 2010 to June 2014) were retrospectively reviewed. Best spectacle corrected visual acuity and anatomical closure rates were regarded as outcome measures.
Overall, data from 13 patients was recorded and analyzed. The mean (±SD) age of patients was 66 ± 7 years, and four (30.7%) were male. Mean interval between the primary and redo surgeries was 3.7 ± 2.0 months (range, 1 to 8 months). During redo surgeries, 11 (84.6%) subjects underwent additional internal limiting membrane peeling. Mean interval between the redo surgery and silicone oil removal was 5.9 ± 2.1 months (range, 3 to 10 months). After silicone oil removal, patients were followed for 21.8 ± 14.2 months (range, 3 to 51 months). Mean best spectacle corrected visual acuity improved from 20/452 before redo surgery to 20/121 in the last follow-up examination (P Redo pars plana vitrectomy with light silicone oil tamponade is an effective method for restoration of macular anatomy and function in patients with persistent macular holes.

Many growth factors and chemical agents were previously used to accelerate corneal epithelial wound healing and dry eye. One of the enriched substances is autologous blood introduced with multiple randomized controlled studies for those who are not responsive to conventional treatments. Vitreous body as a natural substance has some properties which seem to make it superior to authologous blood for the management of severe dry eye syndrome and even persistent epithelial defect. This theory is based on some clues listed as below:Vitreous contains a high amount of water and little macromolecules, the character suitable for a substance to be used for relieving symptoms of dry eye as a wetting effect. Moreover, it contains some growth factors such as insulin like growth factors and pigment epithelium-derived factor and high amount of viscous materials such as Chondroitin Sulfates and Hyaloronic acids, all are compounds seems to be effective in the management of dry eye and acceleration of epithelialization. It has also anti-inflammatory features. The most important unique feature of vitreous in comparison with blood is its immune privilege property documented by previous studies. Vitreous can be obtained from brain dead patients and also from eye banks easily. As with all transplanted material of human origin, it carries risks of prion transmission; however, for intractable severe dry eye, benefits may greatly exceed the risk.

To evaluate patients with advanced retinopathy of prematurity (ROP) among neonates referred to Poostchi ROP clinic in Shiraz from March 2006 to February 2008.

Among referred infants to Poostchi clinic for screening and management of ROP, medical records of patients with advanced ROP (stage 5) at initial examination or during disease progression were evaluated. Information regarding gestational age, time of diagnosis, follow-up programs and causes of delayed screening were recorded.

Overall, 20 patients (11 male, 9 female) out of 1024 reffered neonates had advanced ROP which was unilateral in 3 (15%) and bilateral in 17 (85%) patients. Advanced ROP was due to late diagnosis and treatment in 17 (85%) patients and treatment failure in 3 (15%) patients. Main causes of delayed diagnosis were uninformed parents in 10 (50%) patients, misdiagnosis by an ophthalmologist in 3 (15%) patients, socioeconomic problems and parental ignorance in 3 (15%) patients and poor systemic condition of the neonate in 1 (5%) patient.

The main cause of visual loss due to advanced ROP is uninformed parents and health care providers as well as absence of an organized screening program

To evaluate the demographic data, mechanisms of injury and complications of ocular trauma in patients over 60 year of age. We retrospectively reviewed the medical records of 91 patients older than 60 who were admitted and treated in the Ophthalmology Department of Khalili Hospital, between September 2002 and November 2008, due to ocular trauma. Data were retrieved from admission charts including demographic information, mechanisms of injury, site of penetrating or perforating trauma, associated injuries such as endophthalmitis and intraocular foreign bodies, complications of trauma, the time interval between trauma and referral to our center and the initial visual acuities. X2 analysis were performed using SPSS 11.5 program to analyze the data. Patient age ranged from 60 to 87 years with mean (±SD) of 69.6 (±7.8) years. 11 patients (21.1%) were monocular. 61 patients (67%) belonged to rural and 30 patients (33%) were from urban areas. Mean (±SD) time interval from trauma to referral was 102 (±130) hours (range: 1 to 480 hours). The most common mechanisms of trauma were trauma with tree spines (24.2%), sharp trauma with wood (22%), blunt trauma with wood (11%), blunt trauma with hand (11%) and falling down (9.9%). Three patients had intraocular foreign bodies and 14 eyes (15.4%) were complicated by endophthalmitis. The most common complications of trauma were corneal ulcer (27.5%), surgical wound dehiscence (22%) and corneal laceration (22%). There was significant correlation between corneal ulcer and also surgical wound dehiscence and profound visual loss. There was also significant correlation between referral later than 48 hours and profound visual loss. The results of this study provide some information about elderly eye trauma. These results may be valuable in planning, education, prevention programs and surveillance of this susceptible population of the community the community.

Glaucoma is a progressive optic neuropathy and is one of the leadingcauses of blindness worldwide. Different factors have been contributed in the pathogenesis of glaucoma including H. pylori infection. To determine the levels of anti-H. pylori IgG antibody in the aqueous humor of patients with pseudoexfoliation and primary open angle glaucoma، in comparison with age and sex matched cataract patients. This study was conducted on 41 cases of glaucoma (21 with pseudoexfoliation and 20 with primary open angle glaucoma) and 39 cases of cataract as control group. Aqueous humor was aspirated at the beginning of glaucoma or phacoemulsification cataract surgery in glaucoma and cataract patients، respectively. Anti-H. pylori IgG concentration was measured by means of an enzyme- linked immunosorbent assay. The aqueous levels of anti-H. pylori IgG in primary open angle glaucoma (0. 44±0. 64 U/ml) had no significant difference with cataract (0. 24±0. 52U/ml) and pseudoexfoliation glaucoma group (0. 63±0. 71U/ml) (P=0. 18 and 0. 44، respectively). However، the concentration of this antibody was higher in the aqueous humor of pseudoexfoliation glaucoma patients compared to the control group (p=0. 03). The results of this study did not support a relation between H. pylori infection and primary open angle glaucoma. The elevated concentration of anti-H. pylori IgG in pseudoexfoliation glaucoma compared to cataract patients may be due to the breakdown of blood-aqueous-barrier.