فهرست مطالب

Journal of Ophthalmic and Vision Research
Volume:17 Issue: 4, Oct-Dec 2022

  • تاریخ انتشار: 1401/09/06
  • تعداد عناوین: 23
|
  • Mehlan Juliane, Lehman Anne-Isabel, Cichocki Myriam, Druchkiv Vasyl, Katz Toam, Stephan J Linke Pages 453-461
    Purpose

    To compare the results of the current gold standard, laser interferometry, and keratometry by the IOL-Master, with a newly developed Galilei G6 using raytracing software Okulix for intraocular lens (IOL) power calculations.

    Methods

    For comparison of the IOL-power calculation of both devices, we analyzed the difference between the actual one-month postoperative subjective refraction and the theoretically calculated target refraction before cataract surgery. The IOL was selected according to the IOL Master recommendation aiming for emmetropia after surgery. We analyzed the differences of the measurements of the basic biometric data in 205 healthy eyes by each device.

    Results

    Our study included 205 healthy, unoperated eyes from 117 patients (61 women, 56 men) aged 20 to 75 years. Twenty-two eyes of cataract patients were also included in this retrospective study design. The mean difference between the prediction of the postoperative refraction and the refraction actually achieved was 0.03 D for the IOL Master and –0.23 D for the Galilei G6. The difference was not statistically significant (P = 0.059). The difference between the IOL power calculation of the IOL Master and the calculation of the G6 was not statistically significant (P = 0.064). The difference between the predicted refraction of the G6 and the refraction achieved after one month was also not statistically significant (P = 0.12) and neither was the difference between the predicted refraction of the IOL Master and the achieved refraction (P = 0.39). The mean axial length was calculated as 24.21 ± 0.80 mm using the IOL Master and 24.27 ± 0.82 mm using the Galilei G6 device. The mean value regarding anterior chamber depth (ACD) of the IOL master was 3.46 ± 0.23 mm and for the Galilei was G6 3.51 ± 0.25 mm. When comparing the white to white (WTW) values of the IOL master, it showed mean values of 12.32 ± 0.31 and Galilei showed mean values of G6 12.21 ± 0.28. All of these differences (between Galileo and IOL Master measurements) were statistically significant (P < 0.001).

    Conclusion

    Both the laser interferometry/keratometry performed by the IOL Master and the interferometry/raytracing biometry strategy performed by the Galilei G6 demonstrated equal results when executing the IOL power calculation before cataract surgery in eyes with no prior ocular surgery.

    Keywords: Cataract Surgery, IOL Calculation, Ray Tracing
  • Tomislav Kuzman, Ana Meter, Miro Kalauz, Sanja Masnec, Ivan Škegro, Ivana Jonjić Pages 462-469
    Purpose

    Conventional Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) is a corneal transplantation procedure where the patient’s inner dysfunctional layer is replaced with donor lamella. The data currently present in the literature about the correlation between lamellar thickness and visual acuity is sometimes contradictory and lacks clarity.

    Methods

    Study included 55 eyes that underwent the conventional DSAEK procedure. Patients had no other comorbidities that could affect visual acuity. Data about lamellar thickness and visual acuity were measured six months after surgery with anterior segment optical coherent tomography (A5-OCT).

    Results

    The results show that visual acuity before surgery improved from 0.82 to 0.25 logMAR after surgery. Better visual acuity of 0.20 logMAR was achieved with postoperative lamellas thinner than 124 μm, while statistically significantly lower visual acuity of 0.29 logMAR was gained with postoperative lamellas thicker than 124 μm.

    Conclusion

    Our results suggest that the goal after conventional DSAEK is to have postoperative lamellas thinner than 124 μm in the eye, as this will result in better postoperative visual acuity. This value represents the optimal thickness for conventional DSAEK surgery that could minimize tissue loss for eye banks and surgeons may experience fewer problems during surgery, while obtaining good final visual acuity.

    Keywords: Cornea, Corneal Transplantation, Descemet Stripping Endothelial Keratoplasty, Fuchs’s Endothelial Dystrophy
  • Ali Sharifi, Naser Naisiri, Majid Shams, Meraj Sharifi, Hamid Sharifi Pages 470-478
    Purpose

    To assess the adverse drug reactions (ADR) of tetracaine among patients referred to an eye emergency department in the southeast of Iran.

    Methods

    In this case series study, we assessed 31 eyes of 24 patients who were referred due to adverse effects of ocular anesthetics during 2017–2020. We collected the data, including age, sex, job, how the medicine was obtained, symptoms, examination results, and ADR.

    Results

    Of 24 patients, 22 (91.7%) were male. The mean (standard deviation) age of the patients was 32.6 (1.9) years. Twenty-two patients obtained the medicines without a prescription and a general practitioner prescribed the medicine to two patients. In the first interview, the most common symptoms were: photophobia, reduced vision, ocular pain, and redness. The main signs of persistent epithelial defect, patchy or diffuse corneal stromal infiltration, ring infiltration, and Descemet’s folds were noticed in the examinations. Finally, 51.6% (n =16) of the eyes had decreased vision, 45.2% (n =14) had corneal opacity, 16.1% (n = 5) had elevated intraocular pressure that needed long-term anti-glaucoma therapy, and 6.5% (n = 2) had corneal pannus. Corneal perforation and phthisis bulbi were the final results in one eye.

    Conclusion

    ADR related to the use of ophthalmic topical anesthetics could cause sightthreatening severe morbidities. It seems that some general practitioners are not careful regarding the prescription of these kinds of medicine. Moreover, the over-the-counter availability of tetracaine eye drops should be managed.

    Keywords: Adverse Drug Reactions (ADR), Case Series, Ophthalmic Anesthetic, Tetracaine
  • Farnaz Ahmadpour, Yalda Nahidi, Ramin Daneshvar Pages 479-485
    Purpose

    To compare the frequency of dermatological manifestations between patients with pseudoexfoliative glaucoma and those with primary open-angle glaucoma.

    Methods

    A cross-sectional study was done on all consecutive pseudoexfoliative glaucoma (PEXG) and primary open-angle glaucoma (POAG) patients evaluated in a tertiary eye hospital during the study period. Eligible patients were referred to the dermatology department for complete skin, hair, nail, and mucosal examinations.

    Results

    Twenty-one patients in the PEXG group and 26 patients in the POAG group were included in this study. The most common skin manifestations in the study were seborrheic dermatitis, dry skin, and cherry angioma. The frequency of lentigines was significantly higher in the PEXG patients than in the POAG group (P = 0.013). More than half of the study population had seborrheic dermatitis (57.1% and 61.5% in the PEXG and POAG groups, respectively); however, the difference between the groups was not statistically significant (P = 0.775). Similarly, the frequencies of skin dryness, cherry angioma, nevus, psoriasis, contact dermatitis, itching, seborrheic keratoses, notalgia paresthetica, and vitiligo in the two groups were not statistically significantly different (P > 0.1 for all comparisons). There was no significant association between the frequency of the investigated skin manifestations and patients’ age, visual acuity, intraocular pressure, and cup-todisc ratio.

    Conclusion

    Integumentary system disorders are pervasive in glaucoma patients, and dermatologic evaluation in glaucoma patients should be considered for diagnostic and therapeutic purposes.

    Keywords: Dermatitis, Dermatologic Finding, Glaucoma, Open-angle Glaucoma, Pseudoexfoliation
  • Kiana Hassanpour, Mozhgan Rezaei Kanavi, Narsis Daftarian, Azadeh Samaeili, Fatemeh Suri, Mohammad Pakravan, Azadeh Doozandeh, Sasha Afsar Aski, MaryamFakhri, Afrooz Moghaddasi, Hamid Ahmadieh, Hamed Esfandiari Pages 486-496
    Purpose

    To compare the efficacy of subconjunctival injection of an anti-connective tissue growth factor antibody (anti-CTGF) versus mitomycin-C (MMC) and placebo in reducing scar formation in a rabbit model of trabeculectomy.

    Methods

    A total of 14 rabbits were included. Nine rabbits underwent trabeculectomy with subconjunctival injections of either anti-CTGF antibody, MMC, or balanced salt solution (BSS), each administered in three eyes, before peritomy. The anti-CTGF group received a repeated dose of the antibody five days after surgery. All nine rabbits were euthanized on day 14; the globes were stained with hematoxylin & eosin, Masson’s Trichrome, and immunohistochemistry for detecting alpha-smooth muscle (α-SMA) actin. RNA extraction was performed on five eyes of the remaining rabbits which included one eye without any surgery, one eye 5 hr after trabeculectomy without any injection, one eye five days after trabeculectomy without any injection, and two eyes five days after trabeculectomy with administration of MMC and BSS, respectively.

    Results

    The mean bleb area in the anti-CTGF, MMC, and control groups was 3.8 ± 1.45, 5.9 ± 1.4, and 3.5 ± 1.9 mm2 , respectively. Collagenous tissue was found to occupy the bleb area by 13.7%, 13.5%, and 18.5%, respectively. This ratio was significantly higher in the BSS group (P = 0.04). The expression of CTGF mRNA after 5 hr and five days in eyes undergoing trabeculectomy were significantly more pronounced as compared to the unoperated eye. The mean H-SCORE of α-SMA-immune reactive cells calculated as the grade of staining multiplied by the percentage of immune stained cells was 14.6, 10.22, and 140.58 in the anti-CTGF, MMC, and control groups, respectively. While the control eyes had a significantly higher score (Ps < 0.001), the anti-CTGF and MMC groups were comparable (P = 0.87).

    Conclusion

    Based on the results of this animal study, the anti-CTGF antibody injection resulted in a significant reduction in collagenous tissue and myofibroblast cells after trabeculectomy.

    Keywords: Anti-connective Tissue Growth Factor, CTGF, Mitomycin-C, Trabeculectomy
  • Mohammad Pakravan, Azadeh Samaeili, Hamed Esfandiari, Kiana Hassanpour, SadidHooshmandi, Shahin Yazdani, Farideh Sharifipour, Azadeh Doozandeh, BahramEinollahi, Parastou Pakravan, MohammadHasan Shahriari, Bahareh Kheiri Pages 497-504
    Purpose

    To investigate the effect of static accommodative tasks on intraocular pressure (IOP) of glaucomatous and normal eyes.

    Methods

    Four groups of subjects categorized as primary open-angle glaucoma (POAG), primary angle-closure suspects (PACS), normal age-matched controls, and normal young adults (NYA; age <40 years) were enrolled. The baseline IOPs were measured after the subjects were looking at a distant target for 15 min. Static accommodation was obtained by execution of near vision tasks (reading at 33 cm in daylight [300 lux] for 60 min). IOPs were measured at 15, 30, 45, and 60 min intervals while accommodating and then measured again after 15 min of relaxing accommodation while looking at a distant target.

    Results

    One-hundred and eighteen eyes of 98 subjects were recruited. The study groups consisted of the following categories: 25 POAG (46 eyes), 24 PACS (47 eyes), 25 matched controls (50 eyes), and 24 NYA (48 eyes). Within all groups, the mean IOP decreased throughout the accommodation period at all time points. Maximum IOP reduction after accommodation was detected at the 30-min time among the POAG subjects, at the 45-min time in the PACS and matched control groups, and at 15 min after the relaxation of accommodation in the NYA group. IOP reduction levels showed no statistically significant difference among POAG, PACS, and the normal matched groups in their response to accommodation. However, NYA had significantly lower IOP and greater IOP reduction after the resting period (relaxation of accommodation).

    Conclusion

    Static accommodative tasks can significantly reduce IOP in normal, POAG, and PACS individuals. Encouraging glaucoma patients to practice periodical near vision tasks could be viewed as an adjunctive measure for glaucoma management.

    Keywords: Accommodation, Accommodative Tasks, Intraocular Pressure, Primary Openangle Glaucoma
  • Dhruven Shah, Rita Dhamankar, Vijay Shetty, Suhas S Haldipurkar, Prakash Chipade, Shabnam Tanwar, Prachi Sankhe, Devendra Venkatramani, Paresh Mhatre, M. Optom, Maninder Singh Setia Pages 505-514
    Purpose

    Presence of diabetes in glaucoma patients may influence findings while documenting the progression of glaucoma. We conducted the study to compare individual and combined effects of diabetes and glaucoma on macular thickness and ganglion cell complex thickness.

    Methods

    The present study is a cross-sectional analysis of 172 eyes of 114 individuals. The groups were categorized according to the following conditions: glaucoma, diabetes mellitus, both glaucoma and diabetes (‘both’ group), and none of these conditions (‘none’ group). Patients with diabetes did not have diabetic retinopathy (DR). We compared retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, foveal loss of volume (FLV), and global loss of volume (GLV) among the groups. We used random effects multivariate analysis to adjust for potential confounders.

    Results

    The mean (SD) age of these individuals was 60.7 (10.1) years. The total average RNFL and GCC were significantly lower in the glaucoma group (RNFL: -36.27, 95% confidence intervals [CI]: -42.79 to -29.74; P <0.05, and GCC: -26.24, 95% CI: -31.49 to -20.98; P<0.05) and the ‘both’ group (RNFL: -24.74, 95% CI: -32.84 to -16.63; P<0.05, and GCC: -17.92, 95% CI: -24.58 to -11.26; P<0.05) as compared with the ‘none’ group. There were no significant differences in the average RNFL values and total average GCC between the diabetes group and the ‘none’ group. The values of FLV and GLV were significantly higher in the ‘glaucoma’ group and the ‘both’ group as compared with the ‘none’ group. The foveal values were not significantly different across these four groups. Among the glaucoma cases, 25% were mild, 30% were moderate, and 45% were severe; there was no significant difference in the proportion of severity of glaucoma between the ‘glaucoma only’ and ‘both’ groups (p=0.32). After adjusting for severity and type of glaucoma, there were no statistically significant differences in the values of average RNFL (6.6, 95% CI: -1.9 to 15.2; P=0.13), total average GCC (3.6, -95% CI: -2.4 to 9.6; P=0.24), and GLV (-3.9, 95% CI: -9.5 to 1.6; P=0.16) in the ‘both group’ as compared with the glaucoma only group.

    Conclusion

    We found that diabetes with no DR did not significantly affect the retinal parameters in patients with glaucoma. Thus, it is less likely that thickness of these parameters will be overestimated in patients with glaucoma who have concurrent diabetes without retinopathy.

    Keywords: Glaucoma, Diabetes, Combined Effects, Macular Thickness, Ganglion Cell ComplexThickness
  • Arash Maleki, Amanda Colombo, Sydney Look-Why, Peter Y Chang, Stephen DAnesi, C. Stephen Foster Pages 515-528
    Purpose

    To study whether rituximab and bortezomib combination therapy is more effective than rituximab monotherapy in the treatment of nonparaneoplastic autoimmune retinopathy (npAIR).

    Methods

    Retrospective case series involving six patients with npAIR, taking either rituximab and bortezomib combination therapy (three cases) or rituximab monotherapy (one case and two historical patients).

    Results

    Patients on both treatment regimens showed stability in most of the visual function parameters during the one year of follow-up. Combination therapy resulted in improvement of scotopic combined rod and cone a-wave and b-wave amplitudes in all eyes where they were available (four eyes); however, rituximab monotherapy resulted in only two eyes with stable scotopic combined rod and cone a-wave and b-wave amplitudes, while four eyes showed a decrease in both a- and b-wave amplitudes. The average improvement in b-wave amplitude (50.7% ± 29.4% [range, 25–90%]) was higher than the average improvement in awave amplitude (35.7% ± 9.74 [range, 25–63%]). No severe adverse effects were reported.

    Conclusion

    Rituximab and bortezomib combination therapy may not be more effective than rituximab monotherapy in npAIR patients for most of the visual function parameters; however, this combination therapy may be more effective in improving scotopic combined rod and cone a- and b-wave amplitudes. This may indicate the higher efficacy of combination therapy when there is involvement of the inner retina.

    Keywords: Autoimmune Retinopathy, Bortezomib, Electroretinography, Nonparaneoplastic AIR, Rituximab, Visual Field
  • Hassan Hashemi, Payam Nabovati, Abbasali Yekta, Ali Borojerdi, HamidrezaFallahkohan, Farhad Rezvan, Mehdi Khabazkhoob Pages 529-535
    Purpose

    To determine the relationship between road accidents with visual acuity, refractive errors, visual field, and contrast sensitivity.

    Methods

    This population-based case–control study was conducted on roads leading to Tehran Province, Iran. The case group comprised drivers who had met with accidents and were at fault for the accident. The cases were selected in an ongoing manner (incidence cases). The controls were drivers who were the opposing victims in the same. After an initial interview, optometric and ophthalmic examinations including the measurement of visual acuity, refraction, visual field assessment, contrast sensitivity measurement, and slit lamp biomicroscopy were performed for all study participants.

    Results

    In this study, 281 and 204 individuals were selected for the case and control groups. The mean uncorrected visual acuity was 0.05 ± 0.12 and 0.037 ± 0.10 logMAR in the case and control groups, respectively (P = 0.095). Of the participants in the case and control groups, 32.8% and 23% had a visual field defect in at least one eye, respectively (adjusted odds ratios [aOR] = 1.63, 95% confidence interval [CI]: 1.08–2.48; P = 0.021). Moreover, 16.2% of the cases and 8.3% of the controls had visual field defects in both eyes (aOR = 2.13, 95% CI: 1.17–3.86; P = 0.012). Contrast sensitivity was worse in the case group in all spatial frequencies under non-glare conditions. However, under glare conditions, the contrast sensitivity was significantly worse in the case group only in the spatial frequency of 12 cycles per degree (cpd).

    Conclusion

    Reduced contrast sensitivity, especially under non-glare conditions, and visual field defects are risk factors that influence the prevalence of road accidents. It is strongly advised that special attention be paid to these visual functions in legal assessments to apply the necessary interventions in individuals with these types of disorders.

    Keywords: Case–Control Study, Contrast Sensitivity, Road Traffic Injury, Visual Field
  • Selvamani Perumal, Surya Venkatramanan, Venkatramanan RJ, Jayanthi T, Jai Adithya, Anjaly Abraham, Henna Cherian Pages 536-542
    Purpose

    To evaluate the 3nethra aberro auto refractometer device as an alternative tool for quick and reliable measurement of refractive errors and to compare it with the gold standard subjective refractive error measurement.

    Methods

    Refractive errors were measured using both subjective refraction and the 3nethra aberro handheld autorefractometer. The refractive measurements were converted into equivalent vector notations of spherical equivalent and Jackson cross-cylinder measurements J0 & J45. The resultant power vectors were compared with subjective measurements.

    Results

    This clinical study comprised 60 subjects (22 male and 38 female; with a mean age of 34 ± 16 years). Data, when compared with the subjective refraction measurements, resulted in 90% of power vectors values in both left and right eyes being the same in the 3nethra aberro handheld autorefractometer and the subjective measurement. The refractive error measurements also had an agreement of 70% and 90% when the range of diopter was between ±0.25 and ±0.5D, respectively. When the Bland-Altman’s plot analysis was performed, about 98% of data lied within the ±2 standard deviation variation. An average correlation between the two methods of error measurement was 0.74, and the paired t-test showed P > 0.05 for all the power vectors except for the spherical equivalent in the right eye.

    Conclusion

    The 90% agreement between the error measurements done by two methods indicates that the 3nethra aberro handheld autorefractometer can function as an alternative for the time-consuming subjective refractive error measurement.

    Keywords: Aberro Autorefractometer, Non-mydriatic, Pupil Diameter, Refractive Index, Subjective Refractive Error, Vision, Wavefront Technology
  • Hamideh Sabbaghi, Masomeh Kalantarion, Mehdi Yaseri, Bahareh Kheiri, ZhaleRajavi, Sare Safi Pages 543-550
    Purpose

    To estimate the level of job satisfaction among ophthalmologists in Iran and determine the associated factors that may impact their overall job satisfaction.

    Methods

    In this cross-sectional study, 181 ophthalmologists (79.0% male) were interviewed by the Warr-Cook-Wall questionnaire with 7-point-Likert scale, which transformed responses from a 0 (most dissatisfied) to 100 (most satisfied). Questionnaires were randomly distributed among registered ophthalmologists at the 29𝑡ℎ Annual Congress of the Iranian Society of Ophthalmology in November 2019. Satisfaction under each scale was considered as a score of >60% of the total score.

    Results

    A total of 181 ophthalmologists with a mean age of 47.8 ± 12.1 years and 16 ± 12 years of practice participated in the present study. They were mostly satisfied with their job as a whole (88.1%, mean score: 60.6 ± 20.7) and dissatisfied with their income (55.9%, mean score: 47.6 ± 20.3). High levels of job satisfaction was found among ophthalmologists with longer duration of practice (P < 0.001) while lower levels of satisfaction were identified among those who worked in academic centers (P = 0.004).

    Conclusion

    In this study, high levels of job satisfaction were found among ophthalmologists with longer duration of practice while low levels of satisfaction were identified among ophthalmologists who worked in academic centers. The factors of salary and working hours accounted for the least levels of job satisfaction.

    Keywords: Associated Factors, Iran, Job Satisfaction, Ophthalmologists, Warr-Cook-WallQuestionnaire
  • Haniah A. Zaheer, Deepika C Parameswarappa, Myra A. Zaheer, Jay Chhablani, PreetiPatil-Chhablani Pages 551-573

    Identification of ocular manifestations in patients with sensorineural hearing loss (SNHL) can have a large impact on the outcome and treatment of pediatric patients. Due to the common co-incidence of ocular manifestations and SNHL in children, both ophthalmologic and hearing loss screening and routine examinations must be conducted to minimize adverse outcomes and worsening of pathology. Early evaluation and diagnosis is imperative for intervention and further development of the patient. Coincidence requires a thorough evaluation that includes a comprehensive history, examination, and diagnostic testing. In this article, a literature review was conducted to analyze the presentations of various diseases and syndromes, such as Alport Syndrome, Waardenburg Syndrome, Norrie Disease, Usher Disease, Stickler Syndrome, Marfan Syndrome, Congenital Rubella, and Hereditary Optic Neuropathies. We divided the various ocular pathologies into anterior and posterior segment presentations and associated systemic findings for better understanding. Additionally, this review aims to include an update on the management of patients with both ocular and hearing loss manifestations.

    Keywords: Developmental Effects, Neuro-ophthalmology, Ocular Manifestations, PediatricOphthalmology, Sensorineural Hearing Loss
  • Ayyad Zartasht Khan, Tor Paaske Utheim Pages 574-580

    Retinal pigment epithelium (RPE) is a monolayer of cells situated between photoreceptors and the underlying choroid. It is essential for normal retinal function. Damaged RPE is associated with diseases such as age-related macular degeneration, Stargardt’s macular dystrophy, and retinitis pigmentosa. RPE cells can easily be visualized in vivo, sustainable in vitro, and differentiated from stem cells with a relatively straightforward protocol. Due to these properties and the clinical significance of this epithelium in various retinal diseases, RPE transplantation as a treatment modality has gained considerable interest in the last decade. This paper presents the main techniques for RPE transplantation and discusses recent clinically relevant publications.

    Keywords: Retinal Pigment Epithelium, Retinal Pigment Epithelium Transplantation, Regenerative Medicine, Vitreoretinal Surgery, Tissue Engineering
  • Haythem El Mokh, Néjib Ben Yahia, Mustapha Bouzir, Walid Gattouf, Abdel majid Khabir Pages 581-586
    Purpose

    To present a case of intraocular schwannoma arising from the ciliary body with description of histological and immunophenotypic characteristics.

    Case Report: 

    A 32-year-old woman who was followed for glaucoma of the left eye and chronic renal failure at the stage of hemodialysis presented with buphthalmos and two weeks of blurry vision of the left eye. A magnetic resonance imaging exam was performed suspecting melanoma. Enucleation was rapidly performed. The histological examination after HE (Hematoxylin and Eiosin) and HEA50 (Hematoxylin and polychromatic solution EA 50) staining showed proliferation of mesenchymal monomorphic fusiform cells with eosinophilic cytoplasm and small oval nuclei which showed a tendency toward palisading. Some parts of the tumor were hypercellular with a fascicular arrangement (Antoni A pattern); other parts were weakly cellular with a myxoid arrangement (Antoni B pattern). Several Verocay bodies and a lot of hemorrhagic suffusions were described. Mitotic figures were very rare. Immunohistochemistry staining showed that tumor cells were positive for PS100 and vimentin.

    Conclusion

    Although ciliary body schwannoma is extremely rare, it should be considered in the differential diagnosis of intraocular tumors.

    Keywords: Antoni A, B Patterns, Ciliary Body, Local Excision, Schwannoma
  • Farzad Pakdel, Hadi Ghadimi, Zohreh Nozarian, Fahimeh Asadi Amoli, NiloofarPirmarzdashti, Morteza Karimi, Mohammad Mehrpour Pages 587-591
    Purpose

    To report a 12-year-old patient with a rapid growing orbital mass and imaging findings suggestive of rhabdomyosarcoma that was found to be dirofilariasis after mass resection.

    Case Report: 

    We describe a 12-year-old patient with a rapid growing orbital mass involving medial part of orbit and medial rectus muscle and imaging findings suggestive of rhabdomyosarcoma. Histopathologic examination showed the mass to be composed of granulomatous inflammation and the thread-like object to be Dirofilaria repens. The patient was well post-operation without morbidity. In this paper, we describe distinct clinical features and imaging findings of this interesting case.

    Conclusion

    Deep orbital lesions due to dirofilariasis, as in our case, is extremely rare. It is important to add dirofilariasis to the differential diagnosis of orbital mass lesions. Attention to the imaging clues, as provided in this report, can be helpful.

    Keywords: Dirofilariasis, Parasitic Infection, Orbital Mass, Orbital Tumor, Zoonotic Infection
  • Fatemeh Abdi, Amin Zand, Arzhang Gordiz, Tahmineh Motevassel Pages 592-595
  • Tanuj Dada, Jyoti Shakrawal, Priyanka Ramesh, Anin Sethi Pages 596-600

    Trabeculectomy remains the most commonly performed surgery for medically uncontrolled glaucoma. Its success in primary open angle glaucoma is approximately 82% in the initial year after surgery and 64% at the end of five years. Lower success rates have been found in secondary glaucomas like neovascular glucoma, uvietic glaucoma, post-traumatic glaucoma, and for repeat surgeries. To illustrate improvement of the efficacy of trabeculectomy, enhancement with cyclodialysis has been introduced. This involves the creation of a cyclodialysis cleft in a controlled manner to allow additional suprachoroidal drainage of the aqueous. Cyclodialysis is the result of the separation of the longitudinal ciliary muscle fibers from the scleral spur, which creates an additional pathway for aqueous humor drainage. However, such a cleft often closes on its own due to associated inflammation caused by the filtration surgery. Deep sclerectomy is a non-penetrating surgery that involves dissection of a scleral patch and excision of a block of scleral tissue, retaining a thin membrane for aqueous drainage. In this study, we introduce a novel surgical technique of combining trabeculectomy with a limited deep sclerectomy and a cyclodialysis in two pseudophakic patients who developed secondary glaucoma after vitreo-retinal surgery with silicone oil insertion. In this technique the excised scleral tissue obtained after deep sclerectomy was utilized as a spacer to maintain the patency of the cyclodialysis cleft.

    Keywords: Refractory Glaucoma’s, Cyclodialysis Augmented Trabeculectomy, Deep Sclerectomy
  • Natasha F S Cruz, Katia S Santos, Mateus L Matuoka, Niro Kasahara Pages 603-604
  • Mahmoud Dehghan, Ramin Nourinia, Sahba Fekri, Seyed-Hossein Abtahi Pages 605-606
  • Ramesh Venkatesh, Kushagra Jain, Arpitha Pereira, MB Thirumalesh, Naresh Kumar Yadav Page 607
  • Ahmad Mirshahi, Reza Karkhaneh, Ramak Roohipour, Mohammadbagher Rajabi, Zakieh Vahedian, Fatemeh Bazvand Page 608
  • Majid Farvardin, Zahra Kalantari, Mohammadreza Talebnejad, Marzieh Alamolhoda, Amir Norouzpour Pages 609-610