فهرست مطالب

Ophthalmic & Vision Research - Volume:13 Issue:3, 2018
  • Volume:13 Issue:3, 2018
  • تاریخ انتشار: 1397/05/25
  • تعداد عناوین: 29
|
  • Mohammad Mehdi Parvaresh Page 217
  • Sarah M. Jacobs*, Raghu C. Mudumbai, Aj Amadi Page 219
    Purpose
    This study evaluates the radiographic appearance of lacrimal gland tissue after placement of a glaucoma drainage implant (GDI) to characterize the impact of the device on the gland's imaging patterns.
    Methods
    We performed retrospective chart review of departmental records at two urban academic medical centers, which were systematically searched using procedure codes to identify adult glaucoma patients who underwent unilateral superotemporal GDI from January 1995 to December 2015. Radiology records were cross-checked to identify the subset of patients who underwent postoperative orbital CT or MRI. Chart review collected data on glaucoma diagnosis, management, examination findings, and clinical complaints. Imaging studies were reviewed for orbital changes using qualitative assessment of the radiographic appearances and computer-guided calculations to quantify asymmetries.
    Results
    A review of all eye operations in the inclusion period identified 315 patients with GDI, 13 of whom were eligible for inclusion. Elapsed time from device placement to imaging averaged 41.9 months, and the average clinical follow-up was 56.4 months. Radiographic lacrimal gland changes were appreciable in 69% (9 of 13) of patients, most commonly with posterior displacement and flattening of the gland (7 of 13). ImageJ analysis revealed significantly smaller lacrimal glands in orbits with GDI (P = 0.04). No clear correlation was found between gland changes and clinical dry eye symptoms.
    Conclusion
    GDI placement was associated with radiographically-appreciable lacrimal gland changes in two-thirds of patients, with changes occurring in a predictable pattern of lacrimal gland flattening, posteriorization, and volume loss. Radiographic changes correlated with clinical symptoms in few patients.
    Keywords: Glaucoma Drainage Implants, Lacrimal Gland, Orbit
  • Shuai-Chun Lin, Cindy X. Zheng, Michael Waisbourd, Jeanne Molineaux, Lichuan Zeng, Tingting Zhan, Kamran Rahmatnejad, Arthur Resende, Anand V. Mantravadi, Lisa A. Hark, Marlene R. Moster, Joseph I. Markoff, George L. Spaeth, L. Jay Katz * Page 224
    Purpose
    We compare the prevalence of glaucoma in professional wind versus non-wind instrument players in the Philadelphia Orchestra. Visual field changes in individuals with glaucoma and glaucoma suspects were evaluated, and the results were correlated with cumulative practice time.
    Methods
    In this cross-sectional, observational study, fifty-one Philadelphia Orchestra musicians were enrolled and categorized as wind or non-wind instrument players. All study participants underwent screening fundus photography. Participants with optic discs suspicious for glaucoma underwent further evaluation, including standard automated visual field perimetry and a comprehensive eye examination by a glaucoma specialist.
    Results
    Of the 51 musicians enrolled, 9 of the 21 wind instrument players (43%) and 8 of the 30 non-wind instrument players (27%) were suspected of developing glaucoma in at least one eye (P = 0.25), with examinations performed on 12 of the 17 returning musicians (71%) for further confirmation. Wind instrument players exhibited significantly higher Octopus visual field mean defect scores (1.08 ± 1.5 dB) than non-wind instrument players (−0.43 ± 0.7 dB; P
    Conclusion
    Among members of the Philadelphia Orchestra, the difference in prevalence of glaucoma suspicious optic discs between wind and non-wind instrument players was not significant. The clinical significance of the greater visual field mean defect found in wind instrument players, and the association between the degree of visual field mean defect and the cumulative practice-time of playing wind instruments, needs further investigation.
    Keywords: Glaucoma, Visual Field, Wind Instruments
  • Mohammad Pakravan, Hamed Esfandiari *, Nassim Amouhashemi, Amir Veisi, Pooya Torkian, Shahin Yazdani Page 231
    Purpose
    To evaluate the safety and efficacy of clear corneal approach irido-zonulo-hyaloido-vitrectomy, which we named “mini-vitrectomy,” in the management of pseudophakic aqueous misdirection.
    Methods
    In this retrospective, non-comparative interventional case series, 24 eyes with diagnosis of pseudophakic aqueous misdirection were enrolled. Medical therapy with cycloplegics and laser therapy, including posterior capsulotomy and hyaloidotomy, was not effective in the management of the condition. The eyes underwent mini-vitrectomy, a simple technique in which iridotomy, zonulectomy, hyaloidectomy, and limited anterior vitrectomy were performed via a clear cornea incision. The main outcome measure was reformation of the anterior chamber, which was evaluated at day 1 and months 1, 3, 6, and 12.
    Results
    The mean age of patients was 75.3 ± 11.3 years (range, 47 to 90), and 13 (54.2%) patients were women. Anterior chamber was deep in 22 patients (91.7%) at the last follow-up visit. The mean intraocular pressure (IOP) was 30.31 ± 1.9 mm Hg at presentation on 2.67 ± 1.09 glaucoma medications. IOP decreased significantly to 14.5 ± 4.6 mm Hg at 12-month follow-up. (P = 0.001). The number of glaucoma medications at final visit was 2.2 ± 0.9 (P = 0.21).
    Conclusion
    Mini-vitrectomy is a simple, safe, and effective procedure in the management of pseudophakic aqueous misdirection, and it can be adopted by all ophthalmologists who are involved in glaucoma management and are not comfortable with the pars plana vitrectomy approach.
    Keywords: Aqueous Misdirection, Malignant Glaucoma, Mini?vitrectomy
  • Hossein Ashraf, Mansooreh Jamshidian, Mohammad Reza Khalili *, Mousa Zare, Anis Shamsi Page 236
    Purpose
    To investigate the therapeutic effect of clinically invisible subthreshold continuous wave autofluorescence-controlled laser treatment on visual acuity and macular status of patients with chronic central serous chorioretinopathy (CSCR).
    Methods
    In this prospective case series, patients with clinical and fluorescein angiographic (FA) findings of CSCR and chronic visual loss (>6 months) were included. Complete ocular examination, FA, and optical coherence tomography (OCT) tests were performed. Each eye was subjected to a direct laser treatment of leakage points by 532 nm continuous wave low energy laser pulses, which were kept invisible by reducing the power to 70% of the threshold test spot. Considering the lack of visible effect on the retinal pigment epithelium (RPE), the laser effect was monitored by pre- and post -treatment infrared and autofluorescence images.
    Results
    A total of 20 patients were included in this study, of whom 12 patients (9 male and 3 female patients) with an average age of 38 years had complete follow-up (Average: 3.5 months). The mean preoperative visual acuity was 20/80, which improved to 20/40 at the final visit. The mean preoperative central macular thickness (CMT) was 330 μm and the average final CMT in the last OCT test was 188 μm (P = 0.001).
    Conclusion
    Subthreshold continuous wave autofluorescence-controlled laser treatment may be a good treatment for chronic CSCR to avoid the risks of retinal damage by clinically suprathreshold laser therapy.
    Keywords: Autofluorescence, Chronic Central Serous Chorioretinopathy, Subthreshold Continuous Wave Laser
  • Jonathan B. Lin, Julia Sein, Gregory P. Van Stavern, Rajendra S. Apte * Page 241
    Purpose
    To determine 1) which components of retinal function are impaired after rhegmatogenous retinal detachment, 2) which outer retinal pathways (rod- or cone-driven) are more severely affected, and 3) whether there is concomitant inner retinal dysfunction.
    Methods
    We conducted a prospective observational study in a large academic institution. We performed preoperative electroretinography on eight patients to assess outer and inner retinal function. In all cases, a comparison between the eye with the detached retina and the control fellow eye was made.
    Results
    Eyes with a detached retina had significantly lower a-wave and b-wave amplitudes with respect to both rod- and cone-dominated testing parameters (P
    Conclusion
    Patients with rhegmatogenous retinal detachment have preoperative outer retinal dysfunction equally affecting both rod- and cone-driven pathways, and they have minimal inner retinal dysfunction.
    Keywords: Clinical Electrophysiology, Electroretinography, Retinal Detachment
  • Hossein Ashraf, Samaneh Koohestani, M. Hossein Nowroozzadeh * Page 249
    Purpose
    To evaluate macular changes after cataract surgery in eyes with high myopia.
    Methods
    This prospective cohort enrolled patients with high myopia (axial length ≥26 mm) who underwent phacoemulsification with intraocular lens implantation. Spectral-domain optical coherence tomography (OCT) scans were obtained at baseline and 2 and 6 months after the operation. Postoperative macular changes on OCT scans were regarded as the main outcome measure.
    Results
    Thirty-four eyes of 31 patients with high myopia were included (age, 60 ± 10 years [mean ± SD]); of these, 14 patients (45.2%) were male. The mean axial length was 27.8 ± 1.5 mm. Epiretinal membrane (one eye, 2.9%), lamellar hole (one eye, 2.9%), myopic foveoschisis (2 eyes, 5.9%), and vitreomacular traction associated with foveoschisis (one eye, 2.9%) were notable findings at baseline examination; no eye showed cystoid macular edema (CME) at this time. At the 2-month examination, three eyes (8.8%) developed CME. At the 6-month follow-up, one eye with CME at 2 months improved, and a new case of CME (5.6%) was detected. The characteristics of epiretinal membrane, lamellar hole, vitreomacular traction, and foveoschisis did not change at the 2- and 6-month examinations and no new cases occurred.
    Conclusion
    Uncomplicated phacoemulsification had no significant effect on the prevalence or characteristics of pre-existing macular abnormalities in eyes with high myopia up to 6 months of follow-up. The incidence of CME 2 months after uncomplicated cataract surgery in eyes with high myopia was about 9%.
    Keywords: Cystoid Macular Edema, Epiretinal Membrane, Macular Hole, Myopia, Optical Coherence Tomography, Schisis, Vitreomacular Traction
  • Ali Lashgari, Majid Kabiri, Alireza Ramezani, Morteza Entezari, Saeed Karimi, Sajad Kakaei, Mehdi Yaseri, Homayoun Nikkhah* Page 253
    Purpose
    To determine the prognostic factors and visual and anatomic outcomes of pars plana vitrectomy (PPV) in patients with dropped nucleus following complicated phacoemulsification (PE).
    Methods
    The records of patients with complicated PE who underwent PPV to remove posteriorly dislocated nucleus fragments from January 2011 to December 2014 were retrospectively reviewed.
    Results
    Of 43 patients, 36 patients (36 eyes) were included with mean age of 73 ± 9.5 years and mean follow-up duration of 23.8 ± 15.3 (range 4–53) months. The mean interval between cataract surgery and PPV was 11.5 ± 9.6 (range 1–45) days. The pre-PPV mean best-corrected visual acuity (VA) was 1.04 ± 0.24 logMAR, which improved to 0.46 ± 0.18 logMAR (P
    Conclusion
    PPV for dropped nucleus was associated with improved VA. Better pre-PPV VA was associated with good visual outcome, while inserting IOL at the time of complicated PE, and complicated course after PPV were associated with poor visual outcome.
    Keywords: Dropped Nucleus, Phacoemulsification, Pars Plana Vitrectomy, Visual Outcome
  • Khalil Ghasemi Falavarjani *, Hamideh Shenazandi, Dariush Naseri, Pasha Anvari, Pegah Kazemi, Farzaneh Aghamohammadi, Feras Alissmail, Sayyed Amirpooya Alemzadeh Page 260
    Purpose
    To report the normal characteristics and correlations of the foveal microvascular networks using optical coherence tomography angiography (OCTA) in a healthy Iranian population.
    Methods
    Enface 3x3 OCTA images were obtained using the RTVue Avanti spectral-domain optical coherence tomography with AngioVue software (Optovue, Fremont, CA, USA). Foveal avascular zone (FAZ) area, central foveal point thickness and inner retinal thickness at the foveal center and the vascular density of the superficial retinal capillary plexus (SCP) and deep retinal capillary plexus (DCP) in the fovea were recorded.
    Results
    Seventy normal eyes of 70 subjects (range, 9 to 71 years) were studied. Mean FAZ area was 0.32 ± 0.11 (range, 0.13-0.67) mm2 in SCP and 0.50 ± 0.13 (range, 0.19-0.94) mm2 in DCP. Mean SCP vessel density was 29.6 ± 4.7 (range, 16.3-40.3) % in the fovea. Mean DCP vessel density was 27.0 ± 5.9 (range, 15.0-45.2) % in the fovea. The FAZ area at SCP level was negatively correlated to the central subfield thickness (P
    Conclusion
    In this study, central foveal subfield thickness was a major determinant of the FAZ size and foveal vessel density. Age was a determinant for FAZ area and whole image vessel density in DCP.
    Keywords: Central Foveal Subfield Thickness, Deep Capillary Plexus, Foveal Avascular Zone, Optical Coherence Tomography Angiography, Superficial Capillary Plexus, Vessel Density
  • Dulceria Costa Da Silva, Bianca Nery Benevides Gadelha, Alex Felipe Barbosa Feitosa, Rafaela Gomes Da Silva, Tarsila Livia Paz E. Albuquerque, DEbora Christina Pereira Fernandes Santos, Diego Nery Benevides Gadelha, Bruno Luiz Fonseca Schamber-Reis * Page 266
    Purpose
    To screen visual system homeobox 1 (VSX1) gene in Brazilian subjects affected with keratoconus (KCN).
    Methods
    Seventy-three patients with KCN and 106 healthy controls were enrolled in this study. Patients were diagnosed with KCN based on eye examination and corneal topographic features according to Rabinowitz's criteria (K > 47.2, I-S > 1.4 and KISA > 100%). DNA from blood samples was extracted from donors, and the exons and exon-intron boundaries of VSX1 were sequenced. The potential impact of the identified amino acid changes was assessed with Poly-Phen2, SIFT, and PMUT analysis tools. Genotyping was confirmed by RLFP technique, which was also applied to genotype non-affected individuals.
    Results
    We found three non-synonymous substitutions (L68H, R131S, and D105E) in VSX1 exon 1, with L68H mutation as a novel variation in this gene. In silico analysis indicated that all variations found were predicted to be probably damaging to VSX1 structure and function. Examination of R131S and L68H variations segregating in one family suggested a strong effect of these variations in increasing disease severity in the proband, which presented bilateral KCN leading to corneal grafting before the age of sixteen. We found a novel synonymous substitution (P79P) and two previously described exonic polymorphisms, with unknown roles in VSX1 pathogenesis.
    Conclusion
    VSX1 polymorphisms found in the Brazilian population support a genetic component in KCN pathogenesis. L68H is a novel mutation, and the phenotypic data suggest that this mutation might enhance disease severity when combined with other polymorphisms. However, further investigations are needed.
    Keywords: Cornea, Keratoconus, Polymorphism, VSX1
  • Darshini A. Ganatra, Abhay R. Vasavada, Nair G. Vidya, Devarshi U. Gajjar, Sankaranarayanan Rajkumar * Page 274
    Purpose
    Adherens junctions and polarity markers play an important role in maintaining epithelial phenotype but get altered during the epithelial-mesenchymal transition (EMT). Alterations of these markers during EMT of lens epithelial cell (LEC) can lead to vision compromising conditions. The aim of this study was to examine if Trichostatin-A (TSA), a histone deacetylase inhibitor, can prevent EMT by restoring the adherens junction complex in LEC.
    Methods
    Fetal human lens epithelial cell line (FHL124) was used. Cells were treated with 10 ng/ml TGF-β2 in the presence or absence of TSA. Real time-PCR and western blotting were carried out for HDAC1, HDAC2, CDH1 (E-cad), TJP1 ( ZO-1) and CTNNB1 (β-cat). Level of histone acetylation was analyzed by western blotting. Chromatin Immunoprecipitation was carried out to study the level of acetylated histone H4 and HDAC2 at the promoter regions of CDH1, TJP1, and CTNNB1. E-cad, ZO-1, and β-cat were localized using immunofluorescence. Kruskal-Wallis test was used for statistical analysis.
    Results
    TSA down-regulated HDAC1 and HDAC2 and led to an increase in global acetylation. The mRNA and protein levels of E-cad, ZO-1, and β-cat decreased during EMT but were up-regulated by TSA treatment. TSA also helped in stabilizing these proteins at cell-cell junctions during EMT. TSA decreases association of HDAC2 at the promoter regions of adherens junction genes while increasing histone H4 acetylation status.
    Conclusion
    TSA increases histone acetylation and restores the adherens junction complex in LECs. TSA helps in preventing EMT and thus shows potential against lens fibrosis and vision compromising conditions.
    Keywords: E?cadherin, ??catenin, Epithelial?mesenchymal Transition, Trichostatin-A, ZO?1
  • Maedeh Raznahan, Mohammad Hassan Emamian, Hassan Hashemi, Hojjat Zeraati, Akbar Fotouhi * Page 284
    Purpose
    The present study was designed to determine the extent that horizontal inequity was realized regarding eye care utilization in a middle-aged population as well as factors affecting this equity.
    Methods
    Data were obtained from a population-based study (Shahroud Eye Cohort Study) in 2009 that included 5190 participants from 40 to 64 years of age. Horizontal inequity was determined based on the following variables: (i) economic status, (ii) eye care service needs, (iii) non-need variables, and (iv) eye care utilization (visiting an ophthalmologist or optometrist). Decomposition analysis of the concentration index based on a nonlinear model and indirect standardization was used to ascertain the contribution of each factor in inequity of eye care utilization.
    Results
    After adjusting for need variables, the results of our study demonstrated that horizontal inequity in eye care utilization in a middle-aged Iranian population remained positive and significant (horizontal inequity: 0.19; 95% confidence interval: 0.17–0.23) indicating that use of services was focused among participants with a better financial situation. Furthermore, decomposition analysis demonstrated that educational level and economic status had the greatest contribution (54.1% and 41.1%, respectively) in comparison to other variables.
    Conclusion
    This study demonstrated that horizontal inequity exists in eye care utilization among the middle-aged Iranian population.
    Keywords: Eye Care Utilization, Horizontal Inequity Index, Iran, Middle?aged Population
  • Mohammad Reza Talebnejad, Mohammad Hossein Nowroozzadeh, Hamideh Mahdaviazad *, Mohammad Reza Khalili, Masoumeh Beygom Masoumpour, Maryam Keshtkar, Elham Mohammadi, Zahra Tajbakhsh Page 293
    Purpose
    To describe the rationale, study design, methodology, and baseline characteristics of the Shiraz Pediatric Eye Study, a population-based survey of schoolchildren in Shiraz, Iran.
    Methods
    This population-based study included schoolchildren aged 6–12 years from all four educational districts of Shiraz who were recruited in years 2015–2016. Stratified random sampling was used to select 2400 participants from all districts. Data were recorded from a detailed interview and ocular evaluation of each eligible student. The eye examination comprised uncorrected and best corrected visual acuity measurement, refraction, external eye examination (including specific strabismus and lid evaluation tests), slit lamp biomicroscopy, intraocular pressure measurement, the Ishihara color vision test, and stereoacuity. Exophthalmometry, optical biometry, and optical coherence tomography were performed for a randomly selected subset of children. General characteristics and socioeconomic variables were also recorded to assess risk factors.
    Results
    From a total of 2400 selected students, 2001 (83.3%) participated in the study. The mean age of the students was 9.1 ± 1.6 years, and 59.7% were girls. Most children had at least one parent with a diploma or less than diploma (63.5%), and 2.2% had illiterate parents.
    Conclusion
    This study is expected to provide accurate estimates of the prevalence of visual impairments and their related determinants in Shiraz. In addition, it will identify children who should be targeted by blindness prevention programs.
    Keywords: Ocular Disease, Pediatric, Population?based Survey, Shiraz, Visual Impairment
  • Javad Heravian Shandiz, Abbas Riazi, Abbas Azimi Khorasani, Negareh Yazdani, Maryam Torab Mostaedi, Behrooz Zohourian* Page 301
    Purpose
    To evaluate the enhancing effects of vision therapy on eye–hand coordination skills in students with visual impairments.
    Methods
    Thirty-five visually impaired patients who underwent vision therapy comprised the treatment group, and 35 patients with impaired vision who received no treatment comprised the control group. Full ophthalmic examinations were performed, including biomicroscopy, retinoscopy, and assessments of subjective refraction and visual acuity. Eye–hand coordination was evaluated using the Frostig test. Vision therapy in the treatment group was performed using the Bernell–Marsden ball, perceptual-motor pen, random blink test, and random shape assessment.
    Results
    Data were analyzed for the 35 visually impaired patients and 35 control participants. The mean age was 11.51 ± 3.5 and 11.09 ± 3.1 years in the treatment and control groups, respectively. Female participants comprised 80% of the treatment group and 57% of the control group. Before treatment, the mean scores on the Frostig test were 22.74 ± 4.32 and 21.60 ± 4.10 in the treatment and control groups, respectively, and after treatment, the mean Frostig test scores were 24.69 ± 3.99 and 21.89 ± 3.92, respectively. Statistically significant intergroup differences were found in eye–hand coordination (P
    Conclusion
    The results demonstrated that vision therapy could significantly improve eye–hand coordination, but no enhancement was found in near or distance visual acuity.
    Keywords: Eye–hand Coordination, Eye Movement, Low Vision, Visual Impairment, Vision Therapy
  • Maryam Aletaha *, Farideh Daneshvar, Mahnaz Mosallaei, Abbas Bagheri, Mohammad Reza Khalili Page 307
    Purpose
    We compared the effectiveness of three active vision therapy approaches for convergence insufficiency (CI).
    Methods
    This randomized clinical trial included patients meeting the eligibility criteria and with symptomatic CI, who were allocated into three groups. In the home-based vision orthoptic therapy (HBVOT) group, patients performed the pencil push-up procedure 15 min/day for 5 days/week. In the office-based vision orthoptic therapy (OBVOT) group, patients underwent 60-min orthoptic therapy using a major amblyoscope twice weekly with additional home orthoptic therapy. In the augmented office-based vision orthoptic therapy (AOBVOT) group, patients performed orthoptic exercises using 3-diopter over-minus lenses and a base-out prism in addition to major amblyoscope therapy, and additional home reinforcement was prescribed during the same time period.
    Results
    All 84 subjects (mean age, 26.8 ± 8.3 years) showed a statistically significant improvement in near exophoria, positive fusional vergence (PFV) at near, near point of convergence (NPC), stereoacuity, and Convergence Insufficiency Symptom Survey (CISS) scores at follow-up. Exophoria decreased by 64%, 68%, and 85% in the HBVOT, OBVOT, and AOBVOT groups, respectively (P = 0.2). PFV increased by 68%, 100%, and 100% in the HBVOT, OBVOT, and AOBVOT groups, respectively (P
    Conclusion
    Our results showed that in adults with CI, the augmented office-based orthoptic treatment was relatively more effective than the other treatments.
    Keywords: Convergence Insufficiency, Orthoptic Therapy, Vision Therapy
  • Grace Tsai, Touka Banaee, Felipe F. Conti, Rishi P. Singh * Page 315
    Optical coherence angiography (OCTA) is a noninvasive technique that has been introduced in recent years to detect ophthalmological pathology. The growing usage of OCTA to detect retinal abnormalities can be attributed to its advantages over the reference-standard fluorescein angiography (FA), although both of these techniques can be used in association. OCTA's advantages include its dye independency, its ability to produce depth-resolved images of retinal and choroidal vessels that yield images of different vascular layers of the retina, and the better delineation of the foveal avascular zone. OCTA's disadvantages include the lack of normalized patient data, artefactual projection issues, and its inability to detect low-flow lesions or pathologic conditions. Different OCTA platforms use unique algorithms to detect microvasculature, which are implemented in both spectral-domain (SD) and swept-source (SS) OCT machines. Microvascular changes in retinal vein occlusions (RVOs) are visible in both the superficial and deep capillary networks of the retina in OCTA. These visualizations include a decrease in foveal and parafoveal vascular densities, non-perfusion areas, capillary engorgement and telangiectasias, vascular tortuosity, microaneurysms, disruption of the foveal perivascular plexus, and formation of collateral vessels. The restricted field of view and inability to show leakage are important limitations associated with the use of OCTA in RVO cases. In this article, we present a brief overview of OCTA and a review of the changes detectable in different slabs by OCTA in RVO cases published in PubMed and Embase.
    Keywords: Macular Edema, Macular Ischemia, Optical Coherence Tomography Angiography, Retina, Retinal Vascular Disease, Retinal Vein Occlusion
  • Nasim Hashemi, Hamid Moghaddasi, Reza Rabiei, Farkhondeh Asadi *, Azadeh Farahi Page 333
    One of the important factors for achieving “Vision 2020” targets is the availability and accessibility of eye health information systems. This study aimed to describe eye health information systems in selected countries. The status of eye health information systems in Australia, the United States, and England was reviewed. Data were gathered from the PubMed, Scopus, and ScienceDirect databases. The main key terms used included, but were not limited to “National Action plan”, “Eye Health Information System”, “Database”, and “Registery”. Also, the websites of the World Health Organization, the International Agency for the Prevention of Blindness, and Departments of Health in the selected countries were accessed. Fifty documents and articles of 170 retrieved references related to the research goals were used in this study. In all three countries, the issue of eye health is considered to be a national health priority. Concerning data gathering, the most common point in these countries was data gathered directly (health information systems, eye registries) and indirectly (studies, projects, and surveillance systems) by the organizations that participated in eye health programs. Producing accessible, timely, and highly quality information about eye health is one of the most important goals in the formation of eye health information systems in the selected countries, which facilitates achievement of the goals of the “Vision 2020: The Right to Sight” initiative.
    Keywords: Eye Health Information System, Vision 2020, World Health Organization
  • Majid Moshirfar *, Yanning Ding, Tirth J. Shah Page 339
    Fuch's endothelial corneal dystrophy is a hereditary and progressive vision-threatening disease with a high prevalence in our adult population. In the past two decades, endothelial transplantation has dramatically changed the way we treat these patients. Back then, our limited surgical techniques often resulted in less than ideal outcomes. It was unimaginable for our patients to achieve near perfect visual acuity in such a short span of time. Over the years, we have tenaciously refined our surgical techniques to vastly improve patient outcomes, and with the recent advent of Rho-kinase inhibitors, we may even consider delivering a simple injection to our patients in the future. Our purpose is to take a historical perspective on how far we have come in treating this disorder and how rapidly this field will continue to evolve.
    Keywords: Corneal Transplant, Deep Lamellar Endothelial Keratoplasty, Descemet stripping automated Endothelial Keratoplasty, Descemet Stripping Endothelial keratoplasty, Penetrating Keratoplasty, Rho-kinase Inhibitor
  • Dhivya Ashok Kumar, Shana Sood, Amar Agarwal * Page 344
    Purpose
    To report the mouse-like configuration of detached endothelial keratoplasty graft observed on optical coherence tomographic imaging after pre-Descemet's endothelial keratoplasty (PDEK).
    Case Report: Three eyes of 3 patients who underwent PDEK and had graft detachment in the initial postoperative period of
    Conclusion
    Mouse sign in OCT imaging indicates the possibility of an inverted graft and predicts unsuccessful rebubbling. Graft exchange is required in such eyes.
    Keywords: Graft Detachment, Mouse Configuration in Endothelial Graft, Mouse Sign in OCT, Mouse Sign in PDEK, Mouse Sign, OCT Configuration of Inverted Graft, Pre-Descemet's Endothelial Keratoplasty
  • Ivan Yeu Ming Yip *, Akash Raj Page 348
    Purpose
    Latanoprost is known to have several ocular side effects, including redness of the eyelids, lengthening of the eyelashes, an increase in iris pigmentation, and dryness of the eyes that causes discomfort. There are also several rarer systemic side effects reported in the literature, including chest pain.
    Case Report: Here we report a rare case of a patient who developed a cutaneous blistering rash on both eyelids, both sides of the neck, and the dorsum of both hands after direct contact with latanoprost eye drops. The lesions cleared following withdrawal of the eye drops.
    Conclusion
    Topical latanoprost can cause severe blistering of the skin that could undermine a patient's confidence in the treating medical team. Reporting of an adverse effect is difficult when a generic topical medication is used.
    Keywords: Adverse Effects, Cutaneous, Latanoprost, Topical Prostaglandin Analogues
  • Alireza Dehghani, Leila Rezaei, Heshmatollah Ghanbari, Kobra Nasrollahi, Mehdi Tavakoli Page 351
    Purpose
    To describe a case of ophthalmic artery occlusion and complete ophthalmoplegia after intralesional injection of a sclerosing agent into a subcutaneous hemangioma on the forehead.
    Case Report: A 16-year-old girl underwent direct injection of 3 mL of sodium tetradecyl sulfate (Fibrovein) emulsion 1% (10 mg/mL) with a 23-gauge needle into a subcutaneous hemangioma on the forehead. Immediately after the injection, she developed sudden loss of vision and lid swelling of the left eye. Her visual acuity in the left eye became no light perception. Her left eye also developed a dilated pupil, ptosis, and complete external ophthalmoplegia. Funduscopy of the left eye revealed signs of central retinal artery occlusion. Magnetic resonance imaging of the orbit showed thickening of the medial and lateral rectus muscles of the left eye. Magnetic resonance venography of the brain was normal with no evidence of cavernous venous thrombosis. After 3 months, her ptosis and ophthalmoplegia resolved but her visual acuity remained no light perception.
    Conclusion
    Persistent total visual loss should be kept in mind as a disastrous complication of sclerosing therapy in a patient with facial hemangioma.
  • Anne Laure Bernat, Sophie Bonnin *, Moujahed Labidi, Nouman Aldahak, Damien Bresson, Schahrazed Bouazza, Sebastien Froelich Page 355
    Purpose
    To report on the medical management of meningioma with compression of the optic chiasm associated with the use of cyproterone acetate (CA).
    Case Report: A 65-year-old woman who was being treated with CA presented with a recent decrease in visual function, leading to discovery of a giant olfactory groove meningioma with compression of the optic chiasm. CA was discontinued immediately, and her visual function improved dramatically. At 13 months, in addition to a significant improvement in visual and neurocognitive symptoms, the tumor volume was reduced by 50%.
    Conclusion
    In meningiomas associated with CA, treatment cessation may result in prompt improvement in symptoms and a reduction in tumor volume, even if the tumor is large and causing neurologic impairments.
    Keywords: Compression, Cyproterone Acetate, Medical Treatment, Meningioma, Optic Apparatus
  • Mandeep Tomar *, Richa Dhiman, Gaurav Sharma, Nishita Yadav Page 359
  • Parul Chawla Gupta, Jagat Ram *, Tt Faisal, Aniruddha Agarwal, Sumeeta Khurana, Amber Prasad Page 361
  • Bruno Fortaleza De Aquino Ferreira*, Aline Lemos Barros Martins, Pedro Carlos Carricondo Page 363
  • Corneal thickness measurement after hyperopic photorefractive keratectomy
    Maddalena De Bernardo, Nicola Rosa Page 365
  • Mahmoud Jabbarvand, Farshad Askarizadeh *, Mohammad Reza Sedaghat, Hadi Ghadimi, Bahram Khosravi, Mohammad Aghazadeh Amiri, Foroozan Narooie-Noori Page 366
  • Koushik Tripathy * Page 368
  • Mohammad Hossein Jabbarpoor Bonyadi * Page 370