sa .rasoulinejad

Diabetic macular edema (DME) is one of the common complications of diabetes which significantly accounts for preventable visual impairment and blindness. Central macular thickness (CMT) is a feature found in DME patients. This study aims to determine the relationship between optical coherence tomography (OCT)-measured CMT and visual acuity (VA) in patients with DME before and after intravitreal injection of bevacizumab.

This cross-sectional study was conducted on 100 patients with diabetic macular edema with involvement of both eyes referred to the Ophthalmology Department of Rouhani Hospital in Babol who underwent intravitreal injection of Bevacizumab. VA (measured by Snellen chart), CMT (measured by OCT), clinical and paraclinical factors (including the duration of diabetes, glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), hypertension, and smoking history data) were evaluated and compared among all patients just before and 45 days after Bevacizumab injection.

Before the injection of Bevacizumab in 200 eyes, the mean value of VA (letter score) and mean value of CMT (µm) were 36.83±12.73 and 425.48±85.18 µm, respectively (p<0.001, 95% CI=12.5 – 17.5 and 95% CI=-71.5 – -55.5, respectively). 45 days after Bevacizumab injection, the mean value of absolute VA changes was 15.24±10.16, and the mean value of absolute CMT changes was -67.83±43.08 µm (coefficient=-0.18, 95% CI=-0.39 – 0.05).

Although VA was correlated moderately with CMT and the polynomial regression model enhanced the predictive ability, it remains fully obvious that CMT and clinical factors could play an essential role as VA surrogates.

</span> Retinopathy of Prematurity (ROP), as a retinal vasoproliferative disease, is affected by the incomplete development of the respiratory system of premature babies. Since premature babies suffering from ROP have a lower level of partial pressure of oxygen (PO2</sub>), the present study was conducted to investigate the effect of PO2</sub> and venous oxygen saturation in treatment response of ROP patients.</span></span></span>
</span> This retrospective cohort study (2010-2020) was conducted in the neonatal intensive care unit of Ayatollah Rouhani hospital in Babol among 502 premature babies (less than 34 weeks of pregnancy and with a birth weight of less than 2500 grams). ROP was diagnosed and determined by an ophthalmologist based on the ICROP index on the first day of birth. Data related to PO2</sub> and venous oxygen saturation were collected from patients' files. After receiving standard treatment for ROP, patients were examined and compared in two groups of “completely cured” and “other patients” (including partial recovery, no change, and disease progression) in terms of the effect of PO2</sub> and venous oxygen saturation on the decrease or increase in stage (I to IV) and zone (I, II, III).</span></span></span>
</span> Of the 502 babies examined, 193 had stage I, 232 had stage II, 76 had stage III, 1 had stage IV, and 55 had zone I, 245 had zone II, and 202 had zone III involvement. The mean level of PO2</sub> and oxygen saturation between the two groups of “completely cured” patients and “other patients” did not have a statistically significant difference. The mean level of PO2</sub> and oxygen saturation between the three groups of patients with partial recovery, patients with no change and patients with disease progression did not show a statistically significant difference. Furthermore, the levels of PO2</sub> and venous oxygen saturation were not related to the change of stage and zone in patients with ROP.</span></span></span>
</span></span> The results of the study showed that lack of oxygen is effective in causing ROP and oxygen therapy has an effective role in the treatment of ROP patients, but the amount of oxygen at the beginning of ROP diagnosis is not related to the treatment process of ROP.</span></span></span></div>

Epidemiological data show a strong correlation between vitamin D deficiency and the incidence of diabetes mellitus. Many studies have reported hypovitaminosis D in patients with diabetic retinopathy, and it is possible that the deficiency of this vitamin plays a role in the pathogenesis of this diabetic complication. Therefore, the aim of this study is to investigate the serum levels of vitamin D in patients with diabetic retinopathy and its relationship with the prevalence of diabetic retinopathy.

In this review article, we searched Scopus, Google Scholar, and PubMed databases using the keywords vitamin D deficiency, serum vitamin D levels, vitamin D supplement, diabetes, and diabetic retinopathy. No time limit was considered for the search. Articles written in English were included in this study. Original and complete articles in English about vitamin D deficiency, diabetes and retinopathy were reviewed. Review articles and animal studies were excluded from this study. The data obtained from these findings were extracted and evaluated by two reviewers.

In this study, out of 52 studies found, 15 articles were reviewed according to the inclusion criteria. The results showed that vitamin D deficiency is very common in people with diabetes and diabetic retinopathy and there is a strong inverse relationship between vitamin D deficiency and diabetic retinopathy. In addition, the use of its supplements is also necessary to prevent the progression of diabetic retinopathy.

The results of this study suggest that the reduction of vitamin D serum levels is very common in patients with diabetic retinopathy and can be one of the risk factors for developing retinopathy. Its plasma level can have a high diagnostic value in order to prevent and control the onset of this complication.

Central serous retinopathy (CSR) is an idiopathic retinal disease that causes visual impairment and metamorphopsia. Due to the unknown etiology of CSR, the present study was conducted to investigate the role of metabolic disorders such as hyperlipidemia, diabetes, hypothyroidism, and hypertension (as a cardiovascular disease) in the treatment outcome of CSR patients.

This cross-sectional study was performed on 55 CSR patients whose problem was approved by ophthalmologic examinations in the Ophthalmology center of Ayatollah Rouhani Hospital, Babol, Iran. The patients were then treated with intravitreal injection of 1.25 mg/0.05 ml bevacizumab (Avastin®) 3 to 4 millimeters away from limbus under sterile conditions. Based on having and not having hypertension, diabetes, hypothyroidism and obesity, all patients underwent ophthalmological examination, including visual acuity (VA) and central macular thickness (CMT) by optical coherence tomography (OCT) before injection and one month after that.

The mean age of CSR patients (32 men and 23 women) was 42±11.50 years. After treatment, the CMT value in hypertensive patients (328.66±34.00 µm) was significantly higher than non-hypertensive patients (302.56±41.79) (p=0.025). The CMT value after treatment was considerably lower in non-diabetic patients (306.08±42.49 µm) compared to diabetic patients (336.77±17.42 µm) (p=0.039). Neither VA nor CMT was significantly different between hyperlipidemic patients and non-hyperlipidemic patients. In addition, there were no significant differences in VA and CMT between patients with hypothyroidism and without hypothyroidism.

The results of this study showed that hypertension and diabetes are important factors in CSR patients’ response to bevacizumab injection.

Central retinal vein occlusion (CRVO) is a common age-related vascular retinal disorder and is a condition in which the main vein of the retina is blocked partially or completely. This leads to macular edema (ME) and can cause blurred vision and loss of visual function. The aim of this study is evaluating the prognostic factors of visual acuity (VA) and macular thickness (MT) changes in response to intravitreal bevacizumab therapy.

In this historical cohort study, 107 patients with CRVO were examined and their hypertension, hyperlipidemia and diabetes mellitus status were recorded. All of the patients were treated with an intravitreal injection of 1.25 mg/0.05 ml bevacizumab. Visual acuity and macular thickness were examined at baseline and at all follow-up visits. Follow-up examinations were performed for three months and then VA and MT changes were analyzed.

After the intervention with bevacizumab, there was significant improvement in MT (0.104±0.13 versus 0.296±0.22) and VA (425.41±64 versus 325.94±51.82) (p<0.001, for both). The improvement of MT in response to bevacizumab therapy in hyperlipidemic patients was significantly less than patients with normal lipid profile (p=0.035). No significant relationship was found between MT reduction and hypertension or diabetes mellitus. Also, no significant relationship was observed between VA improvement and hyperlipidemia, hypertension, diabetes mellitus, age and gender.

Bevacizumab therapy was effective to successfully improve VA and MT. Hyperlipidemia has prognostic value in bevacizumab therapy in CRVO patients.

With the spread of coronavirus disease 2019, secondary ocular manifestations were observed as common complications in COVID-19 patients, which can challenge the diagnosis and treatment of ocular diseases. The aim of this study is to investigate the association between laboratory parameters and ocular diseases and to determine their specificity and sensitivity in the diagnosis of ocular diseases in COVID-19 patients admitted to the intensive care unit.

In this cross-sectional study, 89 patients with COVID-19 admitted to the intensive care unit of Ayatollah Rouhani Hospital in Babol were examined from December 2020 to February 2021. Clinical examinations were performed according to the global standards for ophthalmology examinations for patients, and patients were examined in terms of intraocular pressure, cup-to-disc ratio, ocular manifestations, and ocular diseases. Routine hematology and biochemical laboratory tests were performed for all patients. Patients were compared in the group with an ocular disease (manifestation) and the group without that ocular disease (manifestation).

Out of 89 patients with COVID-19 hospitalized in the intensive care unit, 44 women and 45 men participated in the study and the mean age of the patients was 58.5±14.64 years. The number of white blood cells was significantly lower in COVID-19 patients with pinguecula compared to non-pinguecula patients (p=0.026). Furthermore, the relative percentage of lymphocytes was significantly lower (p=0.003) in COVID-19 patients with cataract (9.64±13.20%) compared to non-cataract patients (14.25±17.95%). The relative percentage of neutrophils was higher in COVID-19 patients with cataract compared to non-cataract patients (p=0.01). RBC is significantly reduced in COVID-19 patients with chemosis (p=0.024). For the relative percentage of neutrophils greater than or equal to 82.55%, cataract for COVID-19 patients admitted to the intensive care unit with 0.83% sensitivity and 66.7% specificity is positive.

The results of the study showed that blood cells and some biochemical parameters are associated with ocular diseases in COVID-19 patients admitted to the intensive care unit.

Retinopathy of Prematurity (ROP) is a vasoproliferative retinal disease in preterm infants that can lead to disorders and blindness throughout life if not diagnosed and treated at an early age. Therefore, this study was performed to investigate the relationship between retinopathy of prematurity and various maternal and neonatal diseases.

This case-control study was performed on 828 premature infants (303 infants with ROP and 525 infants without ROP as controls) born in Ayatollah Rouhani Hospital, Babol, Iran, in 2009-2019. All medical information about maternal and neonatal diseases was collected from patient files. Preliminary eye examinations and follow-up were performed based on the local ROP treatment and follow-up guide to diagnose the stage and zone of ROP. Then, neonates were compared based on retinopathy and lack of infection in both groups in terms of maternal and neonatal diseases including congenital heart defect, premature rupture of membranes, anemia, urinary tract infection, hypertension, sepsis, transient tachypnea of the newborn, respiratory distress syndrome, gestational diabetes and preeclampsia.

Out of 828 evaluated neonates, 303 had ROP, including infants with preeclampsia (odds ratio of 2.54, p<0.001), infants with respiratory distress syndrome (odds ratio of 2.2, p<0.001) and infants with congenital heart defects (odds ratio of 1.53, p=0.047) had a higher chance of developing ROP. Moreover, infants with transient tachypnea of the newborn (odds ratio of 0.7, p<0.001) and infants with anemia (odds ratio of 0.373, p<0.001) had a lower chance of developing ROP.

The results of the study showed that maternal preeclampsia, respiratory distress syndrome and congenital heart defects are among the diseases affecting the incidence of ROP.

Identifying and controlling the risk factors is necessary in order to prevent the failure in CBSE. So, this study was performed to determine the effective factors on the results of CBSE in the medical Alumni of Kaums. All of the alumni whose CBSE results were recorded in the files from 1986 till 2003 (n=305) were selected in this cross-sectional study. Data were gathered by a questionnaire including the results of CBSE, and educational and demographic data. The prevalence of failure in CBSE was calculated. Chi-square, Fisher exact test, independent t-test, multivariate stepwise linear regression, logistic regression, crude and adjusted odds Ratio were used to analyze the status of the probable risk factors. The prevalence of failure in the CBSE was 4.9%. Univariate analysis showed that temporary student transfers to other universities, delay in passing basic sciences courses, low GPA in basic sciences courses and high school, older age and non-regional quota increase the failure risk in CBSE; in this regard, multivariate logistic regression reported that GPA in basic sciences courses is the only significant effective factor. In addition, the basic sciences GPA was reported as the most important influential factor on the score of basic sciences exam. The risk factors of failure in CBSE should be controlled, so it is necessary to plan for the student's preparation, identifying the students at risk and supporting them.