Journal of Current Ophthalmology
Volume:20 Issue: 2, Jun 2008

Being mindful of the possibilities for types of scientific communications can help a researcher in choosing the right format for presentation and reporting. Original research articles, case reports, and review articles are the most common types of manuscripts submitted to and published by Iranian medical journals. But not all of the scholarly communications could necessarily be fit into these kinds of manuscripts; for instance:-Journal editors/reviewers or experts of a field may wish or be invited to elaborate on a peer-reviewed and accepted paper and put it in a broader context. This kind of commentary which is published as the leading article in an issue of the journal is titled an ‘Editorial.’-Readers of a journal article may decide to comment on a published paper and/or seek clarifications; authors of the related original work would respond to those comments. This type of correspondence is known as ‘Letter to the Editor’. Due to its independent nature, this kind of scientific exchange frequently provides invaluable insights into the subject of published research.-Editorial boards and/or peer-reviewers frequently encounter manuscripts which have inherent limitations in the scope, relevance, priority, or originality, yet they find them otherwise integrated, polished, well-organized, and based on formal data collection. The journal may thus decide to publish an abridged version of the work. Authors are then expected to revise and summarize their work in the form of a short communication or ‘Brief Report’....

To determine the nerve fiber layer and macular thickness by optical coherence tomography (OCT) in emmetropic, high-myopic and high-hyperopic eyes One hundred five eyes of 55 randomly selected healthy subjects between 20 and 30 years old were included in this study. The eyes were categorized in three groups (high-myopic, emmetropic and high-hyperopic) according to their cycloplegic refraction and axial length (AL). The retinal nerve fiber layer (RNFL) and macular thickness was measured using three circumferential peripapillary scans and six radial scans of the macula by optical coherence tomography (OCT model 2010, Zeiss). Average RNFL thickness in the peripapillary region and macular thickness was measured and compared in these three groups. Mean age of participants was 24.3±2.6 years. Average RNFL thickness was 107.9±8.3 µ, 131.1±3.2 µ and 145.8±2.8 µ in high-myopic, emmetropic and high-hyperopic groups, respectively. There was a high correlation between RNFL thickness and AL (r= -0.91, p<0.001). Average inner macular thickness was 221.6±13.2 µ, 246±10.5 µ and 255.9±15.0 µ and average outer macular thickness was 207.6±9.7 µ, 230.1±7.4 µ and 239.7±13.0 µ in high-myopic, emmetropic and high-hyperopic groups, respectively. The difference of RNFL thickness was statistically significant between these three groups. High-hyperopic eyes had significantly thicker average RNFL thickness than emmetropic and high-myopic eyes; while emmetropic eyes had thicker average RNFL thickness than high-myopic eyes. There is a strong negative correlation between AL and average NFL thickness.

To determine the efficacy of fibrin glue in corneal perforations up to 3 mm in diameter A case series study was performed on corneal perforations up to 3 mm who were admitted at Farabi Hospital- Tehran. Age, visual acuity, presence and size of corneal thinning, corneal epithelial defect, size and depth of corneal infiltration, site and size of corneal perforation, corneal vascularization, anterior chamber depth and reaction and the etiology of corneal perforation were recorded. Then corneal perforation was sealed by using of fibrin glue and soft contact lens and the patients were followed for at least 3 months. Of 18 patients, 8 patients were female and 10 patients were male. Mean age was 52±25.7 years. Size of corneal perforations were 0.6 to 3 mm (mean=1.88 mm). The etiologies of corneal perforation were postinfectious in 11 and noninfectious in 7 cases. Fifteen eyes (83.3%) had successful healing of corneal perforation after 3 months. All the cases who failed had corneal perforation greater than 2 mm in diameter. Success rate was significantly lower in corneal perforation > 2 mm in diameter. No case developed giant papillary conjunctivitis or secondary glaucoma. Only one (5.6%) eye showed a significant increase in deep corneal vascularization. Fibrin glue is effective in the closure of corneal perforations up to 2 mm in diameter. Corneal perforation > 2 mm in diameter may not respond well. It provides fast healing with low rate of corneal vascularization.

To investigate the risk factors and causes for blindness in Behcet’s disease (BD). In this preliminary retrospective case series we have investigated 27 BD patients (54 eyes), legally blind (vision 0.1 or less) at least in one eye at the last visit (2006), and compared them with 54 eyes of 27 non-blind patients (control group), matched individually and consequently in terms of duration of BD follow-up and treatment. Eighteen (66.6%) of our blind patients were male versus thirteen (48%) of the control group (p=0.167). Low vision (0.1 or less) at the first consultation, 23 eyes (42.6%) in the blind group versus three eyes (5.6%) in the control group (p=0.001), higher number of uveitis in the main group 51 eyes (94.4%) versus 35 eyes (64.8%) in the control group (p=0.007), Longer duration of uveitis (10.3±4.8 vs. 5.1±3.97years, p<0.001), longer duration of retinal vacuities (10.9±5.1 vs. 5.6±3.7 years, p<0.001) in the blind group under investigation were the four major risk factors in the poor outcome of ocular disease, P≤0.000 in all cases. At the last visit 42 eyes (77.8%) of the main group were legally blind. The main cause of blindness was chorioretinal vasculitis in 32 eyes (20 patients), and its consequences: optic atrophy, macular scar, chorioretinal atrophy and vascular necrosis. In ten remaining blind eyes the causes for impaired vision were: 3 retinal detachments, 3 optic atrophies ± macular scars, 1 macular scar, 1 macular and disc edema, 1 phthisis bulbi, 1 disc neovascularization and vitreous hemorrhage. Higher frequency of uveitis and longer duration of uveitis and retinal vasculitis, and also the initial low vision at the presentation were the main blinding risk factors and the main cause of blindness was retinal vasculitis and its consequences.

To evaluate the effect of topical anti-glaucoma medications on lacrimal drainage system (LDS). In a prospective controlled blind observational case series, 627 eyes of 384 patients (219 males, 165 females) were studied. Data recording (demographics and history taking), allocation into case (on topical anti-glaucoma medications) and control (no glaucoma) group, and examinations (eye examination and dye disappearance test) were performed by a senior ophthalmology resident. Exclusion criteria were: epiphora prior to onset of treatment with topical anti-glaucoma medication (just for case group), history of long term usage of topical medications (besides anti-glaucoma medications in the case group), previous intraocular surgery, lacrimal surgery, ocular or periocular trauma, radiation therapy, mucous membrane disorder, eyelid margin malposition, and untreated blepharitis. Diagnostic probing and irrigation of lacrimal drainage system were blindly performed by an oculoplastic surgeon. After exclusion, there were 130 eyes from 98 patients and 280 eyes from 178 patients in the case and control group, respectively. Case and control groups were matched. There were significantly more LDS obstruction (LDSO) in the case (26/130, 20%) than control (24/280, 8.57%) group (P=0.002). Upper LDSO was significantly more in the case group (P=0.018). Increasing age was associated with significantly more LDSO in just control group (P=0.029). Significant LDSO was found in the eyes taking Timolol + Dorzolamide (P=0.021) and Timolol + Dorzolamide + Pilocarpine (P=0.017) with duration of 2 weeks to 156 months. Patients on combination of topical anti-glaucoma medications are significantly at risk of developing LDSO. Upper LDSO is significantly more in patients on topical anti-glaucoma drugs.

To assess the efficacy and safety of sutureless punch trabeculectomy as substitute for conventional scleral flap trabeculectomy. In a prospective, randomized study, 44 eyes of 42 patients with primary open angle glaucoma (POAG) who were candidate of trabeculectomy were included and randomly assigned into two groups; sutureless punch trabeculectomy or conventional scleral flap trabeculectomy. Intraoperative complications and postoperative visual acuity, IOP, bleb status, and complications were evaluated for a follow-up period of 6 months. Mean IOP was 21.9±7.9 mmHg before surgery and 16.0±4.7 mmHg 6 months after surgery in sutureless group, and 22.7±10.2 preoperatively and 15.8±5.2 postoperatively in the control group. No significant difference in complication rate was noted between the two groups. The absolute success rate was 50% and 59% in study and control group, respectively (P=0.545), and qualified success rate was 86.3% and 90.9% in the study and control group, respectively (P=0.365). It appears that sutureless scleral tunnel trabeculectomy is a safe and effective drainage procedure for treating uncomplicated POAG, and can effectively substitute for conventional scleral flap trabeculectomy.

Choroidal melanoma is the most common primary ocular malignancy among the adult population. Authors investigated the clinical findings, histopathologic features, types of retinal detachment and the precise anatomic origin of enucleated eyes for primary ocular malignant melanoma in Shiraz University of Medical Sciences (SUMS) hospitals between 1990 and 2005. This was a cross sectional study in which medical records of patients with pathologically proven ocular malignant melanoma were reviewed; and then the relevant clinical data were gathered, based on the modified Callender classification for uveal melanomas. Over the 15-year period of this study, there were 40 patients with microscopically confirmed ocular melanoma at the pathology department of SUMS. Mean age at initial diagnosis was 45.9 years (range, 5-74 years). Women constituted 51.9% of patients. The most common histological type in uveal melanoma was mixed cell type and painless visual loss was the most frequent presenting complaint. Retinal detachment was seen in 88.8% of cases. In this study we found more epitheloid (malignant) cell type (11.1%) in Iranian population comparing to western countries (3%) and also there was more malignant cell type (epitheloid cells) in male comparing to female (m/f=2) which may be related to sex hormonal differences that should be investigated in future. Histopathologically, the more malignant cell types become more prevalent with advanced age groups.Keywords: malignant melanoma, epidemiology, histopathology, uvea, choroid, ocular tumors

To evaluate the results of anterior and nasal transposition (ANT) of the inferior oblique muscle (IO) in patients with the IO muscle overaction This retrospective case series included patients with IO muscles overaction, in whom ANT of the IO muscle was performed. In patient with simultaneous horizontal deviation, horizontal strabismus surgery was also performed. They were evaluated pre- and post-operatively for alignment and oculomotor examination. Seven patients with the mean age of 9.2±5.2 years were included for the study. Unilateral and bilateral ANT was performed in one and 6 patients respectively. Patients were followed for a mean of 32.5±9 months. IO muscle overaction was eliminated in all patients. Antielevation syndrome was developed in 2 patients. One patient needed further operation for residual horizontal deviation. It seems that ANT is useful for the treatment of patients with the IO overaction. However, the risk of antielevation syndrome should be considered.

We report a rare, severe case of traumatic globe avulsion and its assessment and management. A 60-year-old man was presented with complete globe avulsion following a facial trauma. Left globe was luxated out of the orbit. No direct or indirect light reflexes or any eye movement could be noted. CT-scan showed complete laceration of the left optic nerve, globe protrusion and multiple orbital bone fractures. After repositioning of the protruded globe tarsorrhaphy was performed. Although visual recovery cannot be achieved after severe orbital or optic nerve trauma, avoiding primary enucleation helps alleviate the psychological burden of the trauma. In case of the eventual development of phthisis bulbi, the patient will have a chance to be fitted with a prothesis over his own eye with a resulting better motility.

In a fellow-eye-controlled trial, we compared the posterior capsule opacification (PCO) rates of single-piece (SA60AT) and three-piece (MA60AC) hydrophobic acrylic intraocular lenses (IOL) in 54 pair-matched eyes of 27 age-related cataract patients who consecutively underwent bilateral (4-8 weeks apart) phacoemulsification; horizontal chopping performed through a capsulorrhexis of approximately 5-5.5 mm in diameter followed by in the bag fixation of the IOL. PCO grading was done according to Evaluation of Posterior Capsule Opacification (EPCO) system1 by two independent observers.At last follow up (mean: 6 months), 42.5, 42.5, 13, and 2% of the eyes had a PCO scores of 0, 1, 2, and 3, respectively and eyes with a single-piece IOL were tended to have higher PCO grades (odds ratio for a PCO grade of 1 or more: 2.9; P=0.08). PCO showed significant progression during the follow up (P<0.004). Last follow up means of best-corrected visual acuity (BCVA) were comparable (P=0.857). Despite significant progression of PCO, mean BCVA of month one and last follow ups were also comparable (P=0.859). Mean follow up for the two groups of eyes was comparable (P=0.396). Wallin et al2 demonstrated that there was a significantly more severe PCO with the SA30AL single-piece compared with the MA30BA three-piece IOL with two years of follow up. Sacu et al3 reported that the single-piece (SA30AL and SA60AT) IOLs showed slightly more severe PCO than the three-piece (MA30BA and MA60BA) IOLs at one year postoperatively. However, two years postoperatively PCO intensity was comparable.3 In a recent study, Nejima et al4 failed to show a significant difference in the degree of PCO between the IOL types evaluated in the current study at one year. In another study,5 they found no significant difference between SA30AL and MA30BA IOLs PCO severity at one year postoperatively. Bender et al6 also observed a similar percentage area of PCO for SA30AL single-piece and MA30BA three-piece IOLs at six months and one year postoperatively...

Instructions for authors1. All manuscripts submitted to the Iranian Journal of Ophthalmology (IrJO) should follow the style of the Vancouver agreement and must comply with “Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication” as presented at http://www.icmje.org/.2. Manuscripts are accepted for publication in the Journal on the understanding that the content has not been published or submitted for publication elsewhere. This must be stated in the covering letter. 3. Except where otherwise stated, manuscripts are peer reviewed by two or three anonymous reviewers. The editorial board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as material cannot be returned. 4. Manuscripts must be type–written on one side of ISO A4 paper (212 * 297 mm) using double-spacing throughout with 2.5 cm margins on all side of the paper.5. 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The titles of journals should be abbreviated according to the style used in Index Medicus.Journal Article - (If four or fewer authors, list all) Fishman GA, Alexander KR, Milam AH, Derlacki DJ. Acquired unilateral night blindness associated with a negative electroretinogram waveform. Ophthalmology 1996;103:96-104.Journal Article - (If five or more authors, list only the first three and add et al) Vail A, Gore SM, Bradley BA, et al. Clinical and surgical factors influencing corneal graft survival, visual acuity, and astigmatism. Ophthalmology 1996;103:41-9.Chapter in a Book - Parks MM, Mitchell PR. Cranial nerve palsies. In: Tasman W, Jaeger EA, eds. Duane''s Clinical Ophthalmology, revised ed. Philadelphia: JB Lippincott, 1993; v. 1, chap. 19.Book - Miller NR. Walsh and Hoyt''s Clinical Neuro-Ophthalmology, 4th ed. Vol. 4. Baltimore: Williams & Wilkins, 1991; 2102-14.10. 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