siamak akbarzadeh

In this study, the thickness of the retinal nerve fibers layer(RNFL) was compared among patients with mild cognitive impairment, Alzheimer's dementia, and healthy individuals (controls) using Optical Coherence Tomography (OCT) device.

This case-control study was conducted on 30 patients diagnosed with mild cognitive impairment and 31 healthy subjects undergoing neurological examination. The examinations included minimal mental state examination a comprehensive assessment of ophthalmology and performance of OCT using a Spectralis device. Both eyes were selected for analysis, and the differences in the thickness of retinal nerve fibers layer between patients with mild cognitive impairment and healthy subjects were investigated.

In this study, the mean age scores of the patients and healthy individuals were 66.00±8.56 and 60.25±7.50 years, respectively. According to the results of the ordinal logistic regression model, after controlling the effects of other variables, the severity of cognitive impairment increased by 1.26 times in the right eye and by 1.30 times in the left eye (P<0.001). Similarly, for each micrometer increase in the thickness of the retinal nerve layer in the superior quadrant of the right and left eyes, the severity of the cognitive impairment decreased by 4% and 5%, respectively.

These results indicated that superior and inferior retinal nerve fiberslayer thickness was reduced in patients with mild cognitive impairment and Alzheimer's dementia, compared to the healthy subjects, and it can be an element to detect and track this pathology.

One of the most common extracutaneous complications in psoriasis patients is ocular complications, which is controversial concerning its effect on choroidal thickness. This study aimed to compare the psoriasis patients with healthy individuals in terms of the thickness of the choroidal layer using the optical coherence tomography technique.

In this case-control study, 30 psoriasis patients were compared with 32 healthy individuals who were matched for gender and age. Choroidal thickness was measured in both groups using the optical coherence tomography technique. Furthermore, the relationship of the choroidal thickness with the severity and duration of the disease was assessed in patients.

The mean choroidal thickness of the left eye (312.1±12.0 mµ vs. 296.3±20.8 mµ), right eye (310.6±12.5mµ vs. 297.5±17.5mµ), and regardless of the left or right eye (311.3±12.2 mµ vs. 296.9±19.1mµ) was significantly higher in patients, compared to the control group (P=0.001 for all three mean values). No significant relationship was found between disease duration and severity with choroid thickness. Moreover, the patients with multiple limb involvement had a higher mean choroid thickness; however, it was not statistically significant.

According to the results of the present study, patients with psoriasis have a greater choroidal thickness, compared to healthy individuals, which is not related to the severity, type of involvement, and duration of the disease.

Diabetic retinopathy is one of the most important and debilitating complications of diabetes with an increasing prevalence in most countries. It has a dramatic effect on peoplechr('39')s quality of life and increases the symptoms of anxiety and depression in patients with diabetes. Therefore, the present study aimed to determine the prevalence of depression in patients with diabetic retinopathy.

This descriptive/ cross-sectional study was conducted on 245 patients with retinopathy referred to the ophthalmology clinic of Farshchian Hospital in Hamadan during 2019- 2020. They were selected via available and consecutive sampling method and were evaluated for depression with the 21-item Beck questionnaire. Data were analyzed in SPSS software (version 16) at a 95% confidence level.

The mean scores of patientschr('39') age and duration of diabetes were reported as 54.47± 8.5 and 8.5 ± 4.15 years, respectively. In terms of gender, the majority of participants (58.7%) were female. The prevalence of depression in patients with diabetic retinopathy was obtained at 49.8% and in proliferative and non-proliferative retinopathy were 68.2% and 43%, respectively (P<0.001). The prevalence rates of depression in men and women were reported as 45.9% and 51.5% (P=0.428). Moreover, in patients treated with insulin and without insulin, the prevalence rates of depression were obtained at 50.4% and 49.2% (P=0.846). The correlation coefficients of depressive disorder with age and duration of diabetes were calculated at 0.123 (P=0.054) and 0.369 (P<0.001), respectively.

Depression is one of the most serious problems in patients with diabetic retinopathy. As evidenced by the results of the present study, the prevalence ofdepression is significantly correlated with the severity of retinopathy and duration of diabetes.

Uveitis and erythema induratum are two uncommon extrapulmonary manifestations of tuberculosis (TB). In most circumstances, we cannot isolate mycobacterium from those sites, so diagnosis is difficult. In the presented case, panuveitis, erythema induratum, and persistent anogenital warts were found concurrently in a 19‑year‑old girl who had a history of pulmonary TB 10 years ago. Assessment of her immune condition ruled out any immunodeficiency state. Extrapulmonary TB and persistent warts responded dramatically to anti‑TB drugs and interferon‑gamma, respectively. Our case reveals that a constellation of these clinical manifestations may also occur in immunocompetent individuals.

This study investigated the difference between patients with mild cognitive impairment and healthy controls using Optical Coherence Tomography (OCT) regarding Retinal Nerve Fiber Layer (RNFL) thickness.

In total, 20 patients with mild cognitive impairment and 20 healthy controls were subjected to neurological examination in this case-control study. The examinations included Minimal Mental State Examination test, comprehensive examination of the eye, and OCT using SPECTRALIS®. The data were analyzed to evaluate the thickness of RFNL through descriptive and analytical statistics. Both eyes were selected for analysis, and the patients with mild cognitive impairment were compared with the healthy controls regarding the RFNL thickness.

The mean age of the patients was 61.4±3.4 years (age range: 53-65 years), and the mean RNFL thickness in patients was 100±10.1 μm. Moreover, the mean values of RNFL thickness in the lower, upper, nasal, and temporal quadrants were 128±18.9, 119±12.2, 87±14.06, and 68±10.3 μm, respectively. There was no difference between females (99±13.2) and males (103±5.6) regarding the RNFL thickness. In addition, no significant difference was observed between the male and female age groups in terms of the RNFL thickness. Additionally, there was no significant difference between the patients (100±10.1) and control group (104±8.7) regarding the RNFL thickness. The chance of developing mild cognitive impairment is increased by 1.45 times with increasing age. It should be noted that this relationship was statistically significant (P<0.001).

The results of this study indicate that patients with mild cognitive impairment had reduced RNFL thickness, compared to healthy controls. However, since this difference was not significant, it cannot be regarded as a proper approach for diagnosis and follow up of the patients.

Retinopathy of prematurity (ROP) is an evolutionary disorder in the retina of premature infants. Nowadays, the prevalence rate of retinopathy has increased due to the advancement of medical facilities and the increased survival of preterm infants. The aim of this study was to determine the prevalence rate of ROP and its related risk factors among infants admitted to and examined at neonatal intensive care unit (NICU) affiliated to Fatemieh Hospital in Hamadan. This descriptive cross-sectional study was conducted on all premature infants selected with census sampling methods and with a gestational age of fewer than 34 weeks who were hospitalized in NICU for four weeks or more. The premature infants were investigated regarding the incidence of retinopathy and its risk factors. Out of 80 neonates under study, 24 (30%) cases suffered from ROP, of which 16 and 8 neonates were in stage I and II of ROP, respectively.  Moreover, the mean gestational age of newborns was 29.71±2.16 weeks, and more than 75% of ROP were observed in neonates under 29 weeks' gestational age. In addition, the results revealed that ROP correlated significantly with gestational age, low birth weight, 1st and 5th minute Apgar scores, the need to resuscitation, the use of inotropic drugs, and duration of oxygen therapy. However, there was a significant relationship between low birth weight and retinopathy based on the results obtained from logistic regression. The prevalence rate of ROP stands on average regarding the results obtained from Iranian and foreign published data. Among the independent variables that affect retinopathy, low birth weight was the only significant variable affecting the incidence of retinopathy.

Car accidents are the second leading cause of mortality in Iran. For safe driving, drivers require minimum acceptable visual acuity. In Iran, the accepted routine test to take driving license is Snellen vision chart, which is not adequate for visual acuity determination in real and natural environment. It seems that introducing a more sensitive and specific screening test is necessary. In this survey, we studied whether adding contrast sensitivity test to the present screening protocol is valuable or not.
A cross-sectional study of 200 drivers presenting to the ophthalmologic clinic of Farshchian Hospital in Hamadan, Iran, was performed during 2014-2016. The participants were chosen using the census sampling method. Complete ophthalmologic examination, visual acuity evaluation, and contrast sensitivity test were carried out. Data were analyzed using SPSS, version 20.
The mean age of the participants was 39.6 years. The patients were allocated to a group with normal visual acuity and a normal corrected visual acuity group. The most common refractive errors were concurrent myopia and astigmatism. In normal visual acuity group, the percentages of abnormal contrast sensitivity (in increasing order of frequency) in appropriate lighting condition were 0, 8.3, 13.8, and 22.2 in the right eye and 0, 10.8, 16.21, and 18.91 in the left eye, and in reduced lighting condition, they were 0, 13.8, 33.3, 33.3, and 41.6 in the right eye and 0, 21.62, 21.62, 27.02, and 27.02 in the left eye. With normal corrected visual acuity, the percentages of abnormal contrast sensitivity test in normal lighting condition were 0, 14.28, 35.71, 64.28, and 64.28 in the right eye and 0, 7.69, 46.15, 53.84, and 84.61 in the left eye and 0, 50, 85.71, 92.85, and 92.85 and 0, 61.53, 76.92, 76.92, and 84.61, respectively, in low light condition.
It seems that contrast sensitivity test is a better predictor of visual ability in comparison with visual acuity, thus, it is recommended to be added to the vision-related driving license requirements.

Dry eye is a common problem amongst post-menopausal women. Cataract surgery may worsen symptoms of dry eye and this can influence the quality of life in patients. This study was performed to evaluate the incidence and severity of dry eye symptoms after phacoemulsification surgery.
This case-series study was performed on 43 women aged over 50 years during 2013-2014. Patients underwent phacoemulsification surgery on one eye. Symptoms of the operated and contra lateral eye were analyzed by c2 statistical test and SPSS software, preoperative and one month after the surgery.
One month after the surgery, the mean value of incidence and severity of dry eye in operated and non-operated eyes were 90.06 ± 3.5, 80.96 ± 3.55, 71.11 ± 3.52, and 63.51 ± 3.04, respectively. The difference between the two groups was significant (P Cataract surgery may lead to worsening of dry eye symptoms. Treatment of dry eye before cataract surgery is an important issue to prevent ocular surface damage.

Glaucoma is one of the leading causes of blindness, and its major risk factor is elevated intraocular pressure. Intraocular pressure measurement is a major examination in patients with glaucoma for diagnosis and treatment follow-up. This study was carried out with the purpose of comparing the accuracy of two types of conventional tonometers for measuring intraocular pressure. In this descriptive cross-sectional study, after complete ophthalmologic examinations, intraocular pressure was measured in 142 patients (284 eyes), two times at 5-minute intervals using both Goldmann and Keeler tonometers. The obtained results were analyzed with paired t-test and Pearson’s correlation test. Mean intraocular pressure in subjects that were in normal pressure range (<21mmHg) was obtained 14.03±2.35mmHg with Goldmann tonometer, and 14.28±3.05mmHg with Keeler tonometer. The mean difference of the two methods was 0.25±0.70 (p=0.015) and the correlation coefficient between two methods was calculated 0.83 (p<0.0001). Mean intraocular pressure in high intraocular pressure range (³21mmHg) was obtained 26.16±5.1mmHg with Goldmann tonometer, and 26.92±5.58mmHg with Keeler tonometer. The mean difference of the two methods was 0.76±0.44 (p=0.003), and correlation coefficient between two methods was calculated 0.97 (p<0.0001). Based on the results of this study, both used tonometry methods had acceptable accuracy in normal intraocular pressure range, but in high-risk cases such as glaucoma, Goldmann applanation tonometer is preferred as the gold standard.

To evaluate the outcomes of internal tamponade using heavy silicone oil in complicated retinal detachment (RD) surgery. In this interventional case series, patients with complicated RD involving the inferior retina were enrolled. Inclusion criteria included RD secondary to proliferative vitreoretinopathy (PVR CP6 and/or CA6) involving the inferior retina, inferior or posterior tears, giant tears, penetrating trauma or RD combined with choroidal detachment. Heavy silicone (Oxan HD, Bausch & Lomb, USA) was injected at the end of surgery after peeling of retinal membranes or retinotomy. Follow-up examina-tions were scheduled one day, one week, one month and four months after surgery. Additional visits were made depending on the condition of the eye. Seventeen eyes of 17 patients with mean age of 45.4±12.2 (range 19-71) years underwent vitrectomy and heavy silicone oil tamponade. Mean follow-up was 11.4±3.5 (range 4-16) months. There was total RD in 10 cases, subtotal RD involving the inferior retina in 6 patients and RD associated with choroidal detachment in one. Best-corrected visual acuity (BCVA) before surgery was LP or HM in 13 eyes and counting fingers at 0.5 to 3 m in 4 eyes. During the follow-up period, the retina remained attached in 12 cases (70/5%) but 5 eyes needed further vitrectomy for reattachment. BCVA improved from 1.95±0.09 LogMAR preoperatively to 1.5±0.35 four months after the operation (P=0.045). After 4 months’ follow-up BCVA was HM in 4 eyes and 0.5 m to 20/200 in 13 eyes. Transient IOP rise occurred in one eye and silicone oil emulsification was seen in another eye. Heavy silicone oil tamponade had favorable results in terms of anatomical attachment of the retina and visual acuity.

To report a case of retinocytoma associated with bilateral retinoblastoma.Case Report: A 3-year-old girl presenting with left eye exotropia was referred to our ophthalmic oncology service for a second opinion. Funduscopy under general anesthesia revealed one prominent retinocytoma associated with five discrete retinoblastomas in the left eye and three discrete retino-blastomas in the right eye. Although retinocytoma is often a benign tumor, it may be associated with retinoblastoma. Therefore, periodic examination of the fundus is necessary in these patients

To evaluate the results of combined chemotherapy and periocular carboplatin injection to control advanced intraocular retinoblastoma (Rb). In this prospective interventional case-series, we included 8 eyes of 8 patients with advanced intraocular Rb (group C or D in International Intraocular Retinoblastoma Classification, IIRC). In these patients, periocular carboplatin was injected as a primary adjuvant therapy combined with chemotherapy (VEC regimen) or as a secondary treatment in patients who had recurrent disease or did not respond to primary chemotherapy and local modalities. All patients were examined under anesthesia (EUA) and fundus photography was done by Ret–cam before treatment. Fifteen miligrams of carboplatin was injected into subconjunctival or subtenon space in 3-4 weeks interval. Eight eyes of eight patients were enrolled. Five patients were male and three patients were female. Mean age of patients at the time of treatment was 34 months and the mean duration between initial presentation of Rb and beginning of treatment was 7.5 months. Mean injection of periocular carboplatin in each eye was 3.1 times. Past medical history in our patients before starting of this treatment included: External Beam Radiotherapy (EBRT) in 3 eyes, cryotherapy in 4 eyes, transpupillary thermotherapy (TTT) in 4 eyes and brachytherapy in 2 eyes. Four eyes were in group C and four eyes were in group D. In 3 patients carboplatin was injected as primary treatment and in five patients it was injected for tumor recurrence following initial treatment failure or relapse. Three patients had vitreous, one had sub-retinal and remaining four had both vitreous and sub-retinal seeding. The degree of seeding was low in two patients, moderate in two patients and severe in four patients. At the end of study, tumor was regressed in six eyes (75%), relapsed in one (12.5%) and recurred in another (12.5%). In both eyes with relapsed and recurrent tumors, enucleation was done. Combined chemotherapy and periocular carboplatin injection as well as focal treatment may be an effective method to control advanced intraocular Rb.