فهرست مطالب parya abdolalizadeh

To compare Pentacam indices in normal eyes with different corneal thicknesses.

It is a retrospective observational study. Ninety‑six normal eyes of 96 patients who were referred for refractive surgery in a tertiary university‑based hospital from October 2015 to April 2019 were recruited consecutively. Corneal keratometry as well as Pentacam’s software Belin‑Ambrósio Enhanced Ectasia Display (BAD) parameters including pachymetry progression indices (PPIs), maximum Ambrosio’s relational thickness (ART‑max), corneal elevations, normalized deviations, BAD total deviation value (BAD‑D), and anterior surface indices were measured by Pentacam HR (Type 70900). The included were classified as thin (26 eyes), average (45 eyes), and thick (25 eyes) corneas with the thinnest point thickness of ≤496 µm, 497–595 µm, and ≥596 µm, respectively. The specificities of all parameters were calculated based on routine cut-off values.

The refraction, keratometry, and elevations were not different (P > 0.05). All PPIs (minimum, average, and maximum) of thick corneas were significantly lower than average and thin corneas (P < 0.001). ART‑max increased by thickening of the cornea (P < 0.001). BAD‑D score and normalized indices of pachymetric parameters decreased with the increase of thickness (P < 0.001), while specificities of all indices increased with corneal thickening. More than 96% of thick corneas were classified as normal PPI‑max (24/25), ART‑max (25/25), and BAD‑D (25/25), while nearly <54% of thin corneas (14/26 for PPI‑max, 9/26 for ART‑max, and 12/26 for BAD‑D) were normal.

The pachymetry‑related indices and BAD‑D were different among normal corneas with various thicknesses. The specificities of PPIs, ART‑max, and BAD‑D of thin corneas were lower than in thick corneas.

To assess postoperative changes in central retinal thickness (RT) following trabeculectomy and combined phaco‑trabeculectomy using spectral domain‑optical coherence tomography.

In a prospective interventional comparative study, 64 consecutive glaucoma patients who underwent trabeculectomy (32 eyes) or phaco‑trabeculectomy (32 eyes) were included. A macular thickness map using the Early Treatment Diabetic Retinopathy Study circles of 1 mm, 3 mm, and 6 mm was the standard to evaluate the 9‑subfield thickness preoperatively and again at 1 and 3 months after surgery. Four subfields in each of the 3 mm and 6 mm rings were considered parafoveal and perifoveal regions, respectively.

Preoperative measurements were similar in the two groups, except patients in the combined group which were older (P = 0.002). The mean RT in the combined phaco‑trabeculectomy group at month 1 was significantly higher than baseline measurements at central subfield retinal thickness (CSRT) (P = 0.01), temporal (P = 0.001), and inferior (P = 0.04) parafoveal and temporal (P = 0.01), superior (P = 0.02), and nasal (P < 0.001) perifoveal quadrants; however, RT changes in the trabeculectomy‑only group were not statistically significant at months 1 and 3 (P > 0.05). The increase in the temporal perifoveal RT of the combined phaco‑trabeculectomy group persisted at month 3 (P = 0.01), while the RT in other sectors returned to preoperative values. The two treatment groups did not differ in terms of changes in the CSRT over time (P = 0.37). In addition, no difference was observed between the treatment groups regarding the parafoveal RTs at each time points (0.06 ≤ P ≤ 0.29).

There was no significant difference in the pattern of changes of CSRT and parafoveal RT between trabeculectomy and combined phaco‑trabeculectomy treatment groups up to 3 months after surgery. Some detectable increase in RT in the combined phaco‑trabeculectomy will reverse to baseline values 3 months after surgery, except in the temporal perifoveal region.

To systematically review the role of antioxidants in management of patients with thyroid eye disease (TED).

A literature search of the electronic databases was performed without restrictions on the date of publication till the end of March 2021, using the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses guidelines. Clinical trials, case–control studies, cohorts, case series, case reports, and experimental (including in vitro) studies in the English language were included. The primary outcome in human studies was improvement in severity, activity scores, and/or quality of life scores. There was a decrease in the level of H2 O2 ‑dependent oxidative stress, Hyaluronic acid release, reactive oxygen species, cell proliferation, or antifibrotic/antiproliferative actions in the in vitro studies.

Out of 374 initially screened articles, 157 studies were selected, the full texts of 82 were reviewed, and 14 papers were finally included. There were 4 clinical and 10 in vitro studies from 1993 to 2018. While β‑carotene, retinol, Vitamin E, Vitamin C, melatonin, resveratrol, N‑acetyl‑l‑cysteine, and quercetin showed some efficacy in in vitro studies; allopurinol, nicotinamide, pentoxifylline, and selenium (Se) were effective in both clinical and experimental reports. Se was the only recommended antioxidant based on one high‑level randomized controlled trial.

While different antioxidants could potentially be effective in the management of TED, no strong recommendation for any or combination of antioxidants could be made to be implemented in the daily practice.

To assess the long‑term visual and refractive stability and ocular biometric changes in low to moderate myopic subjects treated by laser‑assisted subepithelial keratomileusis (LASEK).

It is a prospective, interventional study. Included were 70 eyes of 35 patients who underwent LASEK for correction of ≤6 diopters (D) myopia. The uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest refractions, and ocular biometric indices (by Lenstar‑LS900, Haag‑Streit AG, Koeniz, Switzerland) including keratometry, anterior chamber depth (ACD), aqueous depth (AD), axial length (AL), central corneal thickness (CCT), and lens thickness (LT) were assessed preoperatively and after 6 months and 8 years.

Mean preoperative spherical equivalent was −3.99 (standard deviation [SD] =1.38) D which improved to 0.02 (SD = 0.27, P < 0.001) D and −0.10 (SD = 0.31, P < 0.001) D at 6 months and 8 years, respectively. The preoperative AL was not different from postoperative measures at 6 months (P = 0.15) and 8 years (P = 0.47). The ACD and AD decreased during 8 years, while LT increased (all P ≤ 0.001). The changes of LT inversely correlated with changes of ACD (rs = −0.67, P = 0.001 at 6 months and rs = −0.87, P < 0.001 at 8 years) and AD (rs = −0.76, P < 0.001 at 6 months and rs = −0.86, P < 0.001 at 8 years). The CCT and keratometry values reduced at 6 months postoperatively (all P < 0.001) and then did not change up to 8 years (0.21 ≤ P ≤ 0.87).

The post‑LASEK myopic regression is 0.1 D over 8 years. Ocular biometric values like keratometry, CCT, ACD, AD, and LT have been changed for a long period after LASEK in low to moderate myopia except AL.

To investigate the frequency of persistent postoperative ptosis (PP) following trabeculectomy or Ahmed glaucoma valve (AGV) implantation and to analyze the associated factors.

It is a prospective observational study on glaucoma patients who underwent trabeculectomy or AGV implantation from October 2015 to June 2017 in a tertiary center. Margin reflex distance 1 and 2 (MRD1 and 2) and levator function were measured before and at least 6 months, postoperatively. Clinically significant ptosis was defined as ≥2 mm drop of MRD1.

One hundred and fourteen patients (124 eyelids) including 76 patients (87 eyelids) with trabeculectomy and 35 patients (37 eyelids) with AGV implantation were included. The mean age was 55.50 (standard deviation = 17.54) years. Most of the surgeries were performed under general anesthesia (87.9%, 109/124) between 30 and 60 min (53.2%, 66/124) by residents (39.5%, 49/124). Trabeculectomy and AGV groups did not differ in terms of pre, intra, and postoperative variables (0.1≤ P ≤0.9) except duration of surgery (P = 0.01) and sex (P = 0.04). Clinically significant persistent PP was observed in 12.9% (16/124) in total, 13.7% (12/87) in the trabeculectomy group, and 10.8% (4/37) in the AGV group (P = 0.6). Male gender (ß coefficient = 2.56, 95% confidence interval (CI) = 4.76–0.36, P = 0.02) and a higher preoperative MRD1 (ß coefficient = 1.24, 95% CI = 0.52–1.95, P = 0.001) were the only factors affecting the frequency of clinically significant PP.

Postoperative blepharoptosis occurred in 12.9% of eyes after glaucoma procedures. Male gender and higher preoperative MRD1 were significantly associated with a higher frequency of postglaucoma surgery blepharoptosis.

To report the clinical outcome of rhuthenium-106 plaque radiotherapy in acquired retinal pigment epithelial (RPE) tumors.

In this interventional case series, two eyes of two patients with clinically diagnosed ocular-acquired RPE tumors including adenoma and adenocarcinoma underwent plaque radiotherapy with rhuthenium-106. The clinical findings and visual outcome of the patients were evaluated.

The first patient was a 44-year-old male, and the second was a 32-year-old female. The follow-up times were 24 and 32 months. The tumor was unilateral and hyperpigmented in both cases, located at juxtapapillary in one patient and on peripheral part of the retina in the other. Vitreous hemorrhage and peripheral exudation were obvious in one patient. Macular edema, epiretinal membrane, and retinal feeder vessels were also detected in the examination. The patients underwent plaque radiotherapy with rhuthenium-106 as the first step of management. The tumor has been stable until the last follow-up in both patients with globe preservation and acceptable visual acuity (5/10 for the first case and 4/10 for the second case).

Rhuthenium-106 plaque radiotherapy might be a conservative therapy in the management of acquired RPE tumors and prevent early enucleation.

To determine the changes in serum levels of free vascular endothelial growth factor (VEGF), insulin‑like growth factor‑1 (IGF‑1), and growth parameters in infants with retinopathy of prematurity (ROP) who received intravitreal injection of the bevacizumab (IVB).

A prospective interventional case series study, including 10 infants with Type 1 ROP was conducted. Using the enzyme‑linked immunosorbent assay, serum levels of VEGF and IGF‑1 were measured before, 1 month and 2 months after treatment with IVB in both eyes. Growth parameters, including weight, length, and head circumference and their Fenton’s z‑score, were also measured.

Serum VEGF levels were suppressed 1 month after IVB (P = 0.007) and then increased between 1 and 2 months (P = 0.064). Z‑scores of all growth parameters except weight z‑score decreased in the 1st and 2nd months.

Serum VEGF levels showed a transient reduction after IVB which lasted at least 2 months. Growth velocity of premature infants may be affected by anti‑VEGF therapy and should be followed with particular attention.

PurposeSince different subspecialties are currently performing a variety of upper facial rejuvenation procedures, and the level of knowledge on the ocular and periocular anatomy and physiology is different, this review aims to highlight the most important preoperative examinations and tests with special attention to the eye and periocular adnexal structures for general ophthalmologist and specialties other than oculo-facial surgeons in order to inform them about the fine and important points that should be considered before surgery to have both cosmetic and functional improvement.
MethodsEnglish literature review was performed using PubMed with the different keywords of “periorbital rejuvenation”, “blepharoptosis”, “eyebrow ptosis”, “blepharoplasty”, “eyelid examination”, “facial assessment”, and “lifting”. Initial screening was performed by the senior author to include the most pertinent articles. The full text of the selected articles was reviewed, and some articles were added based upon the references of the initial articles. Included articles were then reviewed with special attention to the preoperative assessment of the periorbital facial rejuvenation procedures.
ResultsThere were 254 articles in the initial screening from which 84 articles were found to be mostly related to the topic of this review. The number finally increased to 112 articles after adding the pertinent references of the initial articles.
ConclusionStatic and dynamic aging changes of the periorbital area should be assessed as an eyelid-eyebrow unit paying more attention to the anthropometric landmarks. Assessing the facial asymmetry, performing comprehensive and detailed ocular examination, and asking about patient's expectation are three key elements in this regard. Furthermore, taking standard facial pictures, obtaining special consent form, and finally getting feedback are also indispensable tools toward a better outcome.

Despite the advantages of dual peer mentoring, there are a few reports of implementing and evaluating such programs for medical students. This study aimed at exploring the perceptions of mentors and mentees about the dual peer mentoring program for the first year undergraduate medical students of Tehran University of Medical Sciences.
This qualitative study was conducted at the end of the first year of implementing the mentoring program. All mentees and mentors were invited to participate in focus group discussions. Data were analyzed using a qualitative content analysis.
All mentors (n= 12) and a group of mentees (n= 21) participated in focus group discussion sessions. We provided a variety of supports for the mentees including academic and psychosocial support and positive relationship; as a result, some developments occurred to the mentors We also explored participants’ views on some unique aspects of the program such as student-authorized, dual mentoring, and role model sessions.
Our participants found the mentoring program beneficial in various academic achievements and psychosocial supports for both the mentors and the mentees. Dual peer mentoring program can be an alternative to school administered programs