Journal of Current Ophthalmology
Volume:28 Issue: 1, Mar 2016

To review the current literature on ocular application of erythropoietin (EPO).
A comprehensive search was performed on Pubmed and Scopus databases. All selected articles were reviewed thoroughly by the authors to review current applications of the EPO in ocular diseases.
Various aspects of administration of EPO for different ischemic, traumatic, vascular, and degenerative disorders have been explained. The articles are generally preclinical with few small studies reporting clinical outcomes.
EPO has been used for the treatment of different ophthalmic conditions with promising results. Further studies are needed to elaborate the role of EPO in management of ocular diseases.

Akreos AO and Kontur AB are two commonly used intraocular lenses (IOLs) in Iran. This study was designed to evaluate the visual performance of these lenses.
In a comparative interventional study, 35 patients (70 eyes) were recruited, and each IOL was implanted in one eye of the patients, randomly. Best corrected visual acuity (BCVA), contrast sensitivity, aberrometric analysis, and depth of focus were evaluated 1 month and 3 months postoperatively. A visual quality questionnaire was also filled for each eye, and the results were compared.
Mean age of the patients was 60.97 ± 7.00 years. BCVA was not significantly different between the two eyes, before, 1 month, and 3 months postoperatively (p > 0.05 for all). Photopic and mesopic contrast sensitivity was not different between the two lenses instead of photopic 18 cycles per degree, 3 months postoperatively and in mesopic 6 cycles per degree 1 month postoperatively (p ¼ 0.034 and p ¼ 0.002, respectively). Aberrometric factors including HoRMS, Total RMS, and Higher order without Z(4,0) were not significantly different between the two lenses (p > 0.05 for all), but they were slightly lower for Akreos AO. Post-operative distance-corrected visual acuity for intermediate and near vision were not different between the two groups (p > 0.05, respectively).
Visual performance of Akreos AO and Kontur AB is similar. However, contrast sensitivity and aberrometric parameters are slightly better for Akreos AO IOL.

Stereopsis, as a part of visual function, is the ability of differentiating between the two eye's views (binocular disparity), due to the eye's different positions. The aim of this study was to compare stereoscopic vision before and after photorefractive keratectomy (PRK) in myopia.
In a prospective interventional case series study clinical trial, forty-eight myopic individuals (age range: 18e34 years) who had undergone PRK surgery by a Bausch & Lomb Technolas 217z excimer laser were included. In all patients, stereoscopic vision was assessed using TNO test charts at 40 cm distance preoperatively and at 3 and 6 months postoperatively.
A total of 48 cases (96 eyes, 69% female) with a mean age of 26.70 ± 4.89 years (range: 18e34 years) were treated. Uncorrected visual acuity (UCVA) was improved and refraction was corrected significantly after PRK surgery. The stereoscopic vision in patients was 246.56 ± 98.43 s of arc before PRK surgery. Postoperatively, the stereoacuities were recorded as 365.38 ± 112.65 s of arc and 343.51 ± 88.96 s of arc at 3 and 6 months, respectively. These differences were statistically significant (p PRK was successful and safe in improving refractive error and UCVA, but it may deteriorate the stereoscopic vision. It may be due to an increase in higher order aberrations.

To determine pachymetric, aberrometric, and topometric indices in patients with definite and subclinical keratoconus and the validity of these indices in the diagnosis of keratoconus.
We evaluated 262 keratoconic and 97 healthy eyes in this study. Pentacam HR examination was performed for all participants, and the data of all pachymetric, aberrometric, and topometric indices was extracted for the study population.
The average of all evaluated pachymetric and topometric indices and the 3rd and 5th order vertical coma aberrations showed a significant difference between the study groups (p Simultaneous evaluation of BAD_D, 5th order vertical coma aberration, IVA, and ISV, especially when the pattern of the corneal curvature is normal, can detect subclinical keratoconus with high sensitivity and specificity. As for definite keratoconus, each of the BAD_D, mean keratometry, and 3rd order vertical coma aberration indices has a desirable diagnostic validity. However, the aforementioned indices do not negate the importance of widely recognized and acceptable indices like keratometry and central corneal thickness.

To evaluate visual results, comfort of use, safety, and efficacy of mini scleral contact lenses in optical management in patients with traumatic aphakia and severe concomitant irido-corneal injury.
In a case series, eight eyes with post traumatic aphakia and severe concomitant irido-corneal injury that were evaluated at the Contact Lens Clinic of Farabi Eye Hospital, Tehran, Iran for contact lens fitting and could not be corrected with conventional corneal RGP contact lenses were fitted with miniscleral contact lenses. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), and BCVA (Best corrected visual acuity) with miniscleral lens were recorded. Slit lamp examination, comfortable daily wearing time, and any contact lens-related complication were documented in each follow-up visit.
The mean UCVA and BSCVA of the cases was >2.7 and 0.41 LogMAR, respectively (BSCVA could not be assessed in one case due to severe corneal irregularity). The mean final BCVA with the miniscleral lens was 0.05 LogMAR (range from 0.4 to
0.04 LogMAR). The mean follow-up period was 14.6 months. The mean comfortable daily wearing time (CDWT) was 11.6 h, ranging from 8 to 16 h. The only contact lens-related complication was mild redness and irritation that was observed in 2 patients during the follow-up visits. All patients were comfortable with handling these lenses.
Miniscleral contact lenses can be considered a safe and effective option in aphakia patients with concurrent corneal scarring secondary to ocular injury for whom surgical intervention would be complicated.

To evaluate the frequency of 12 single nucleotide polymorphisms (SNPs) of complement factor H (CFH) and LOC387715/ARMS2/ HRTA1 and their association with some of the presenting clinical features of neovascular age-related macular degeneration (AMD).
In this prospective non-comparative case series forty four naïve patients with neovascular AMD were genotyped using sequencing or Sequenom iPLEX technology. Descriptive tests were used for displaying the magnitude of each allele, gender distribution, and age at diagnosis. Fisher exact test was used to evaluate the correlation between visual acuity (VA) and different alleles. Also Kruskal-Wallis test was used for comparison between age at the time of diagnosis and different alleles.
The most frequent SNP among studied patients was rs1061147 with 100% frequency rate. The least common was rs2672598 with a frequency of 52.27%. Only the allele rs800292 of CFH locus on 1q32 was associated with VA better than 20/200 (p value ¼ 0.034). The frequency of this allele was 77.27% (34 patients) in this study. There was no significant association between any of alleles, and VA worse than 20/200(p > 0.05). Fifteen patients had bilateral exudative AMD (34.09%). There was no significant difference between alleles in bilateral neovascular AMD and unilateral disease. Also bilateral and unilateral patients were not different in terms of age, gender or VA (p value: 0.330, 0.764 and 0.456 respectively). There was also no significant association between any of SNPs and bilaterality of disease.
We designated the frequencies of SNPs of CFH and LOC387715/ARMS2/HRT 1 in neovascular AMD in a sample of Iranian patients. Only the allele rs800292 of CFH locus on chromosome 1q32 was associated with better VA.

To present a technique to improve the surgical treatment of frontal sinus mucocele and its recurrence.
Nine procedures performed on eight patients by a team of ENT and Ophthalmic orbital surgeons. Data collected included patient demographics, surgical details, pathological findings and complications. The surgical technique involved an external approach via the upper eyelid skin crease combined with an internal approach with a rigid 4 mm endoscope described below. Following evacuation of the mucocele the sinus was anastomosed to nasal cavity with insertion of silicon stent. All patients had preoperative and postoperative CT scans of the orbit and paranasal sinuses.
There were nine operations on eight patients (six males, two female patients, mean age of 57.25: range, 15e71). Two patients had inverted papillomas. All patients presented with non-axial proptosis and diplopia. The mean follow up period was 38.7 months (range 11e99). The only intraoperative complication noted was a cerebrospinal fluid (CSF) leak in a patient with a post traumatic mucocele. Post-operative complications included lid scarring in 2 patients. One of the patients had a fistula overlying the affected sinus at presentation. Both patients underwent dermis fat grafting as a second stage procedure and responded well. One patient presented with asymptomatic superior oblique weakness that could be attributed to trauma to the superior oblique intra operatively. There was no case of recurrence of mucocele in our series. One of the inverted papillomas had an early recurrence (within 6 months) that required repeat surgery.
Fronto nasal anastomosis restores the anatomy and reduces the chance of recurrence in our experience. The final cosmetic result is excellent and the patient's satisfaction is high.

To determine changes in cataract surgical rate (CSR) in Fars Province from 2006 to 2010 and identify the contributions of public and private sectors.
This descriptive report is part of the Iranian Cataract Surgery Survey. To determine the provincial CSR, weights of major (>3000 annual surgeries) and minor (
3000) centers were calculated based on the number of centers chosen for each year and multiplied by their numbers of surgeries. To determine public and private sector's contributions, the numbers of surgeries in each sector were estimated based on the number of sampled centers.
Overall, CSR improved by 25%; the number of CS decreased by 16% in the public sector and increased by 157% in the private sector. In 2006, the public sector contributed to 69% of the CSR, and by 2010, this rate had decreased to 43%.
The decreasing contribution of the public sector calls for studies to identify causes and remove potential barriers.

To present a case of iatrogenic Horner's syndrome seen together with the heterochromia in the post-thyroidectomy period.
A23-year-old female patient was admitted to our clinic with complaints of lowvision in the eye and difference in eye color that developed over the past two years. In the left eye, myosis and minimal ptosis (~1 mm) was detected, and the color of the iris was lighter than the right eye.
The pre-diagnosis of left iatrogenic Horner's syndrome was finalized after 0.5% topical apraclonidine test.
Heterochromia can be observed in iatrogenic Horner's syndrome.

We present spontaneous retrobulbar hemorrhage in a 52-year-old woman with history of breast cancer and tamoxifen intake which was first thought to be an orbital metastasis.
Case report: A 52-year-old woman with history of breast cancer and tamoxifen intake was referred due to severe proptosis and visual loss. Orbital imaging showed an intra-conal mass. After exploration, multiple fragments of dark brown mass in the retrobulbar area were excised. Microscopic diagnosis was blood clot. All of clinical signs and symptoms were improved 1 week after operation.
Spontaneous retrobulbar hemorrhage is a rare condition that may have unknown etiologies, and its symptoms may mimic orbital metastasis. Since both breast cancer and tamoxifen intake can cause coagulation disorders, they might be possible causes for retrobulbar hemorrhage in this case.