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Ophthalmic and Vision Research - Volume:8 Issue: 3, Jul-Sep 2013

Journal of Ophthalmic and Vision Research
Volume:8 Issue: 3, Jul-Sep 2013

  • تاریخ انتشار: 1392/07/27
  • تعداد عناوین: 17
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  • Mohsen Azarmina Pages 191-192
  • Aline Correa De Carvalho, Martin Schwarz, Givago Da Silva Souza, Bruno Duarte Gomes, Alexandre AntÔnio Marques Rosa, Ana Maria Revoredo Da Silva Ventura, JosÉ Maria De Souza, Luiz Carlos De Lima Silveira, Jan Kremers Pages 193-198
    Purpose
    To investigate changes in multifocal electroretinography (mfERG) parameters associated with high dose chloroquine therapy for treatment of malaria in the Amazonia region of Brazil.
    Methods
    Forty-eight subjects who had received chloroquine treatment for single or multiple malaria infections with a cumulative dose ranging from 1,050 to 27,000mg were included. The control group consisted of 37 healthy aged-matched subjects. Data was collected on amplitude and implicit time of the N1, P1 and N2 waves in the central macular hexagon (R1) and in five concentric rings at different retinal eccentricities (R2-R6).
    Results
    No significant difference was observed in any mfERG parameter between chloroquine treated patients and control subjects. A comparison with previous data obtained from patients with rheumatologic disorders in the same region of Brazil who had received larger cumulative doses of chloroquine and had displayed mfERG changes, indicated that retinal toxicity seems to be dependent on cumulative dose.
    Conclusion
    Lack of mfERG changes in the current study suggests that intensive high dose chloroquine therapy for treatment of malaria is not associated with retinal toxicity.
  • Ebrahim Jafarzadehpour, Fatemeh Radinmehr, Mohammad Pakravan, Ali Mirzajani, Shahin Yazdani Pages 199-206
    Purpose
    To explore retinal ganglion cell (RGC) dysfunction in glaucoma suspects and patients with early primary open angle glaucoma (POAG) using pattern electroretinography (PERG).
    Methods
    Twenty glaucoma suspects (glaucomatous optic disc appearance), 15 early POAG (based on abnormal discs and abnormal visual fields) and 16 normal controls were enrolled. Transient PERG was recorded in response to 0.8° and 16° black andwhite checkerboard stimuli. Amplitude and peak time (latency) of the P50 and N95 components of the PERG response, and the ratio of N95 amplitude in response to 0.8° and 16° checks were measured.
    Results
    N95 peak time (latency) was significantly increased in both early manifest POAG and glaucoma suspects as compared to normal controls (P)
  • Mozhgan Rezaei Kanavi, Bagher Hosseini, Fatemeh Javadi, Nasser Rakhshani, Mohammad, Ali Javadi Pages 207-212
    Purpose
    To report impression cytology findings in specimens obtained from eyes with clinical and confocal microscopic features of Acanthamoeba keratitis (AK).
    Methods
    In this interventional case series, impression cytology was obtained from corneas of patients with clinical and confocal microscopic features indicative of AK. Specimens were stained with Periodic acid-Schiff/Papanicolaou (PAS/PAP) and examined for the presence of PAS-reactive Acanthamoeba cysts and/or hyperchromatic pear-shaped trophozoites. All specimens were then decolorized and re-stained with calcofluor white (CFW) for the presence of chemofluorescent cysts.
    Results
    Fifty-six eyes of 50 patients with mean age of 25.5±9.3 (range, 17 to 78) years were evaluated. Forty-one (82%) cases were female and 51 (91.1%) eyes had history of contact lens wear. PAS-reactive Acanthamoeba cysts and/or hyperchromatic pear-shaped trophozoites were identified in 53 eyes (94.6%), 2 of which demonstrated only trophozoitelike structures. CFW staining was able to reveal the presence of chemofluorescent cysts in all 51 specimens (91.1%) in which cysts had been demonstrated with PAS/PAP staining. Trophozoites were not detected with CFW due to background staining of the cellulose acetate strip used for impression cytology.
    Conclusion
    Corneal impression cytology, stained with PAS/PAP or with CFW, successfully detects Acanthamoeba and can be employed for early noninvasive diagnosis of AK.
  • Huseyin Serdarogullari, Mehmet Tetikoglu, Hatice Karahan, Feyza Altin, Mustafa Elcioglu Pages 213-219
    Purpose
    To determine the prevalence of keratoconus (KCN) and subclinical KCN among subjects with two or more diopters (D) of astigmatism, and to compare Pentacam parameters among these subjects.
    Methods
    One hundred and twenty eight eyes of 64 subjects with astigmatism? 2D were included in the study. All subjects underwent a complete ophthalmic examination which included refraction, visual acuity measurement, slit lamp biomicroscopy, retinoscopy, fundus examination, conventional corneal topography and elevation-based topography with Pentacam. The diagnosis of KCN and subclinical KCN was made by observing clinical findings and topographic features; and confirmed by corneal thickness andelevation maps of Pentacam. Several parameters acquired from Pentacam were analyzed employing the Mann-Whitney U Test.
    Results
    Mean age of the study population was 29.9±9.8 (range 15-45) years which included 39 (60.9%) female and 25 (39.1%) male subjects. Maximum corneal power, index of vertical asymmetry, keratoconus index and elevation values were significantly higher and pachymetry was significantly thinner in eyes with clinical or subclinical KCN than normal astigmatic eyes (P< 0.05).
    Conclusion
    The current study showed that subjects with 2D or more of astigmatism who present to outpatient clinics should undergo corneal topography screening for early diagnosis of KCN even if visual acuity is not affected. Pentacam may provide more accurate information about anterior and posterior corneal anatomy especially in suspect eyes.
  • Hassan Hashemi, Mehdi Khabazkhoob, Mohammad Miraftab, Mohammad Hassan Emamian, Mohammad Shariati, Tahereh Abdolahi, Nia, Akbar Fotouhi Pages 220-226
    Purpose
    To determine the distribution of axial length (AL) to corneal radius of curvature (CRC) ratio and to evaluate its association with refractive errors in an Iranian population.
    Methods
    In this cross sectional study, multistage cluster sampling was used to select subjects 40-64 years of age residing in Shahroud, northern Iran. All subjects underwent manifest and cycloplegic refraction, and biometry using the Allegro Biograph (WaveLight AG, Erlangen, Germany). Individuals with a history of intraocular surgery, extensive pterygia and ocular trauma were excluded.
    Results
    Of a total of 6,311 patients, 5190 (82.2%) participated in the study. We excluded 247 patients to adhere with study criteria and 132 patients due to missing data. Mean AL/CRC was 3.034 [95% confidence interval (CI), 3.031-3.037]. AL/CRC was 3.028 and 3.042 in female and male subjects, respectively (P)
  • Hossein Ziaei, Marzieh Katibeh, Reza Solaimanizad, Sara Hosseini, Hamid, Reza Gilasi, Faegheh Golbafian, Mohammad, Ali Javadi Pages 227-236
    Purpose
    To determine the prevalence of refractive errors in Yazd, central Iran.
    Methods
    This population-based study was performed in 2010-2011 and targeted adults aged 40 to 80 years. Multi-stage random cluster sampling was applied to select samples from urban and rural residents of Yazd. Manifest refraction, visual acuity measurement, retinoscopy and funduscopy were performed for all subjects. Myopia, hyperopia, astigmatism and anisometropia were defined as spherical equivalent (SE) +0.50 D, cylindrical error >0.5 D and SE difference? 1 D between fellow eyes, respectively.
    Results
    From a total of 2,320 selected individuals, 2,098 subjects (90.4%) participated out of which 198 subjects were excluded due to previous eye surgery. The prevalence (95% confidence interval) for myopia, hyperopia, astigmatism, anisometropia, -6 D myopia or worse, and 4 D hyperopia or worse was 36.5% (33.6-39.4%), 20.6% (17.9- 23.3%), 53.8% (51.3-56.3%), 11.9% (10.4-13.4%), 2.3% (1.6-2.9%) and 1.2% (0.6-1.8%), respectively. The prevalence of hyperopia, astigmatism and anisometropia increased with age. The prevalence of myopia was significantly higher in female subjects. The prevalence of with-the-rule, against-the-rule and oblique astigmatism was 35.7%, 13.4% and 4.6%, respectively. The prevalence of against-the-rule astigmatism increased with age (P)
  • Nasrin Rafati, Mohsen Azarmina, Farid Zaeri, Shahin Yazdani, Roham Soheilian, Masoud Soheilian Pages 237-243
    Purpose
    In a study complementing a previous multicenter randomized clinical trial on prophylactic injection of intraocular antibiotics during primary repair of penetrating eye injuries (PEIs), we sought to determine whether needle entrance and injection of balanced salt solution (BSS), per se, could increase the rate of acute post-traumatic bacterial endophthalmitis (APBE).
    Methods
    Patients randomized to the BSS injection arm (n=167) of the Traumatic Endophthalmitis Trial, and eligible patients who had refused enrollment and received no intraocular injections during primary repair (n=111) were compared for the development of APBE.
    Results
    APBE occurred in 8 of 167 (4.8%) eyes in the BSS group and in 5 of 111 (4.5%) eyes in the non-injection group (P=0.91). Retained intraocular foreign bodies were present in 46 eyes including 25 (15%) eyes in the BSS injection group and 21 (18.9%) eyes in the non-injection group (P=0.38). Logistic regression analysis showed no significant difference between BSS injected and non-injected eyes in terms of APBE (P=0.69). However, the presence of intraocular foreign bodies was strongly associated with the risk of endophthalmitis (P)
  • Saeed Yadranji Aghdam, Nader Sheibani Pages 244-256
    The ubiquitin–proteasome system (UPS) is the mainstay of protein quality control which regulates cell cycle, differentiation and various signal transduction pathways in eukaryotic cells. The timely and selective degradation of surplus and/or aberrant proteins by the UPS is essential for normal cellular physiology. Any disturbance, delay or exaggeration in the process of selection, sequestration, labeling for degradationand degradation of target proteins by the UPS will compromise cellular and tissue homeostasis. High blood glucose or hyperglycemia caused by diabetes disrupts normal vascular function in several target organs including the retina and kidney resulting in the development of diabetic retinopathy (DR) and diabetic nephropathy (DN). We and others have shown that hyperglycemia and oxidative stress modulate UPS activity in the retina and kidney. The majority of studies have focused on the kidney and provided insights into the contribution of dysregulated UPS to microvascular damage in DN. The eye is a unique organ in which a semi-fluid medium, the vitreous humor, separates the neural retina and its anastomosed blood vessels from the semi-solid lens tissue.The complexity of the cellular and molecular components of the eye may require a normal functioning and well tuned UPS for healthy vision. Altered UPS activity may contribute to the development of retinal microvascular complications of diabetes. A better understanding of the molecular nature of the ocular UPS function under normal and diabetic conditions is essential for development of novel strategies targeting itsactivity. This review will discuss the association of retinal vascular cell UPS activity with microvascular damage in DR with emphasis on alterations of the PA28 subunits of the UPS.
  • Jost B. Jonas, Ningli Wang Pages 257-263
    Eyes with normal-pressure glaucoma and those with high-pressure glaucoma can show a similar optic nerve head appearance, while eyes with vascular optic neuropathies showa markedly different optic disc appearance. Factors in addition to intraocular pressure (IOP) may thus play a role in the pathogenesis of glaucomatous optic neuropathy. Clinical and experimental studies showed that (1) physiologic associations between cerebrospinal fluid (CSF) pressure, systemic arterial blood pressure, IOP and body mass index exist; (2) a low CSF pressure was associated with the development of glaucomatous optic nerve damage in cats; (3) patients with normal (intraocular) pressure glaucoma had significantly lower CSF pressure and a higher trans lamina cribrosa pressure difference when compared to normal subjects; and (4) patients with normalpressure glaucoma as compared with patients with high-pressure glaucoma have a significantly narrower orbital CSF space. A shallow orbital CSF space has been shown to be associated with a low CSF pressure. Due to anatomic reasons, the orbital CSF pressure and the optic nerve tissue pressure (and not the atmospheric pressure) form the retro-laminar counter-pressure against the IOP and are thus part of the trans-lamina cribrosa pressure difference and gradient. Assuming that an elevated trans-lamina cribrosa pressure difference and a steeper trans-lamina cribrosa pressure gradient are important for glaucomatous optic nerve damage, a low orbital CSF pressure would therefore play a role in the pathogenesis of normal-(intraocular) pressure glaucoma. Due to the association between CSF pressure and blood pressure, a low blood pressure could be indirectly involved.
  • Arman Mashayekhi, Carol L. Shields, Jerry A. Shields Pages 264-267
    Purpose
    To report a case of peripheral exudative hemorrhagic chorioretinopathy (PEHCR) in an elderly patient.Case Report: A 74-year-old Caucasian woman, with a 20-year history of a stable choroidal nevus in her right eye, was referred for evaluation of two small hemorrhagic pigment epithelial detachments (PEDs) affecting the temporal peripheral fundus of the same eye. Nine months later, the lesions became larger and indocyanine green angiography revealed polypoidal choroidal vascular changes corresponding to the location of the ophthalmoscopically visible PEDs. Despite one session of verteporfin photodynamic therapy, the lesions continued to enlarge eventually resulting in thedevelopment of a large hemorrhagic PED, which failed to respond to two subsequent injections of intravitreal bevacizumab. The final ophthalmoscopic appearance of thelarge hemorrhagic PED was typical of PEHCR.
    Conclusion
    This case suggests that polypoidal choroidal vascular changes similar to that seen in our patient may underlie the development of PEHCR in some cases.
  • Retinitis Pigmentosa Associated with Vasoproliferative Tumors and Coats-like Fundus
    Fariba Ghassemi, Marjan Akbari, Kamrani Pages 268-270
    Purpose
    To report two cases of retinitis pigmentosa (RP) associated with vasoproliferative tumors (VPTs) and Coats-like fundus. Case Reports: Two patients with RP presented with recent loss of vision due to combined VPTs and Coats-like retinal vascular alterations. One patient had two VPTs with adjacent capillary nonperfusion, telangiectasia and aneurysmal vascular changes in one eye. The other patient had prominent VPT with Coats-like retinal vascular alterations in both eyes. These lesions received treatment resulting in improved vision in both patients.
    Conclusion
    Although rare, VPTs and Coats-like retinal vascular alterations includingretinal exudation associated with telangiectatic vessels, aneurysmal changes and capillary nonperfusion may occur in patients with RP.
  • Zhale Rajavi, Mohadasseh Feizi, Narges Haftabadi, Kourosh Sheibani Pages 271-273
    Purpose
    To report the clinical features of a rare case of hypotropic dissociated vertical deviation (DVD). Case report: A 25-year-old female was referred with unilateral esotropia, hypotropia and slow variable downward drift in her left eye. She had history of esotropia since she had been 3-4 months of age. Best corrected visual acuity was 20/20 in her righteye and 20/40 in the left one when hyperopia was corrected. She underwent bimedial rectus muscle recession of 5.25mm for 45 prism diopters (PDs) of esotropia. She was orthophoric 3 months after surgery and no further operation was planned for correction of the hypotropic DVD.
    Conclusion
    This rare case of hypotropic DVD showed only mild amblyopia in hernon-fixating eye. The etiology was most probably acquired considering hyperopia as a sign of early onset accommodative esotropia.
  • Mohammad-Reza Razeghinejad Pages 274-279
  • Ramin Nourinia, Bahareh Behdad, Talieh Montahaei Pages 280-281
  • Kyle V. Marra, Yoshihiro Yonekawa, Thanos D. Papakostas, Jorge G. Arroyo Pages 282-290
    The popularization of ophthalmic endoscopy has been promoted by recent technological advancements that increase the number of indications for endoscopy. These advancements have improved the endoscope’s capabilities in its two fundamental surgical advantages: (1) bypassing anterior segment opacities, and (2) visualizing anteriorly positioned structures such as the ciliary bodies and sub-iris space. In this article, the current state of the ophthalmic endoscope is reviewed alongside its growing number of applications in glaucoma, vitreoretinal, and ocular trauma surgery. We describe the role of endoscopy in endocyclophotocoagulation for glaucoma, cyclitic membrane peeling in hypotony, retinal detachment surgery, intraocular foreign body removal, severe endophthalmitis, and pediatric traumatic vitreoretinal surgery. This review examines both the pearls and limitations of the ophthalmic application of endoscopy. In doing so, we hope to provide guidelines for using the endoscope and also to highlight applications of endoscopy that merit further study.