فهرست مطالب

  • Volume:25 Issue: 4, 2014
  • تاریخ انتشار: 1392/11/15
  • تعداد عناوین: 11
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  • Dr. S., Farzad Mohammadi, Dr. Alireza Lashay, Elham Ashrafi, Behzad Damari, Alireza Mahdavi, Zahra Hashemidehaghi *, Dr. Hormoz Chams Pages 260-261
    The World Sight Day (WSD) is held on the 2nd Thursday of October to emphasize the importance of sight and impact of vision impairment. This observance is a joint initiative of the International Agency for the Prevention of Blindness (IAPB), the World Health Organization (WHO) and other international non-governmental organizations.1 The celebration resonates with Vision 2020 initiative for the control of avoidable blindness by the year 2020. It can promote professional as well as public awareness about sight and vision impairment. This is wise as we know that most cases of visual impairment are preventable or treatable; nonetheless there are more than 280 million people, including 19 million children, who live with visual impairment.2 This is much more a priority for the developing countries because they inhabit 90 % of the visually impaired.3 Epidemiological transition has already commenced in the developing world4-7 but they are not ready to take care of the age-related blinding conditions. Non- governmental and community organizations would probably be the ideal entities to organize and celebrate WSD on a national level. But participation from a wide range of state and humanitarian bodies and even leading figures and celebrities is conceivable and welcomed. This should culminate in community initiatives for wanting resources and fund raising, and should influence policy -makers to develop and implement blindness prevention programs. The WHO Action Plan 2013 on the prevention of avoidable blindness and visual impairment has suggested the theme ‘Universal Eye Health’ for WSD 2013. The plan seeks “integration of comprehensive eye care (from promotion to rehabilitation) services into health systems”, and expects to address equity challenge. The theme is so ambitious and encompassing that might continue as a consistent one in the next years, focusing on a different aspect of the theme each year. The call to action in 2013 was ‘Get your Eyes Tested’.1 This call will encourage the public to seek care and challenge the local eye healthcare facilities for eye care and services. WSD at Farabi Eye Hospital: During the past years, WSD has been held in Iran through a variety of events. Farabi Eye Hospital organized a celebration of the WSD 2013 in collaboration with the Ministry of Health and the National Institute for Health Research. The municipality socio-cultural department of the Hospital locality also organized the social aspects of the event. The scientific program titled ‘Ophthalmic Epidemiology & Eye Health Seminar’ was held for the 1st time in Iran. The scientific program comprised three symposia: evidence on eye health and diseases in Iran; policy making for eye health; and low vision and disability. We had 2 keynote lectures on ‘social determinants of eye health’ and ‘ universal access to eye health’. The morning sessions were concluded by articulating the Farabi Statement on the Prevention of Blindness and Eye Health 2013 by the event presidents (see Appendix, pages 322 323). In the afternoon, 2 workshops on diabetic retinopathy screening and artificial intelligence were held. Participants included ophthalmologists, optometrists, and community medicine, public health, and epidemiology experts, and young scholars. The social program offered free of charge optometry services for local senior citizens referred by the district Community Houses (i.e. Get Your Eyes Tested!). We also held a painting competition on the theme of sight for children younger than 10, and a best text message competition. The event received massive media coverage. Farabi Eye Hospital is now more than ever committed to public eye health.
  • Dr. Abbasali Yekta, Dr. Hassan Hashemi, Dr. Hadi Ostadimoghaddam, Shokrolah Shafaee, Reza Norouzirad, Somayeh Radaye, Moghaddam, Dr. Saman Mohazzab, Torabi, Mehdi Khabazkhoob * Pages 262-269
    Purpose
    To determine the prevalence of visual impairment, blindness, and low vision among the elderly population of Sari in northern Iran
    Methods
    Random cluster sampling of 1,185 selected individuals over 54 years of age, of whom 79.1% participated. Participants underwent eye examinations to test presenting visual acuity (VA), best corrected visual acuity (BCVA), and refraction.
    Results
    Based on their presenting VA, the prevalence of visual impairment, blindness, and low vision were 11.1% (95%CI: 9.1-13.1), 3.7% (95% CI: 2.5-5.0), and 7.4% (95% CI: 5.7-9.0), respectively. Based on the BCVA, the results were 3.7% (95% CI: 2.3-5.1), 1.0% (95% CI: 0.2-1.7), and 2.7% (95% CI: 1.5-3.9), respectively. Based on the presenting VA, the most common causes of visual impairment were refractive errors (68.6%) and cataracts (16.7%).
    Conclusion
    Refractive errors and cataracts were the main causes of visual impairment in the elderly population of Sari. Correcting refractive errors and cataracts could reduce 85% of visual impairment, depending on the presenting VA.
    Keywords: Visual Impairment, Iran, Elderly People, Cross, Sectional Study
  • Dr. Xiaohong Liu, Dr. Bingqian Liu, Dr. Huiling Hu, Dr. Ying Liu, Dr. Fei Deng, Dr. Jian Ge * Pages 270-277
    Purpose
    To investigate the effects of MTP-131 on trabeculum cells cultured under hydrostatic pressure
    Methods
    Glaucomatous human trabecular meshwork (GTM3) cells were divided into three groups: the MTP-131 group, the hydrostatic group, and the normal group. The MTP-131 group was pretreated with 1 µM MTP-131, and the cells were then cultured under 80 mmHg pressure for 24 hours. The normal group was cultured under normal atmospheric pressure for 24 h, and the hydrostatic group was cultured under 80 mmHg pressure for 24 h. The change in the mitochondrial membrane potential the generation of reactive oxygen species (ROS) and the release of cytochrome c from the mitochondria were analyzed with confocal microscopy. The generation of ROS and apoptosis were detected by flow cytometry. The expression of caspase-3 was detected by western blot analysis.
    Results
    In GTM3 cells, culturing under hydrostatic pressure resulted in a decrease in the mitochondrial membrane potential, an elevation of intracellular ROS and a release of cytochrome c from the mitochondria. Pretreatment with MTP-131 prevented the mitochondrial depolarization, decreased the intracellular ROS, prohibited the release of cytochrome c from the mitochondria and inhibited apoptosis. The path of apoptosis is caspase-3 independent.
    Conclusion
    MTP-131 can protect cultured trabecular cells from the damage caused by hydrostatic pressure.
    Keywords: Glaucoma, Trabecular Meshwork, Mitochondria, Targeted Peptide, Hydrostatic Pressure, Apoptosis
  • Dr. Mohammad Taher Rajabi *, Dr. Sedigheh Kohansal, Dr. Syed Ziaeddin Tabatabaie, Dr. Mohammad Bagher Rajabi, Dr. Seyedeh Simindokht Hosseini Pages 278-283
    Purpose
    To evaluate the adequacy and efficiency of training programs of ophthalmology residency in Iran for achieving the planned objectives in their program, as well as to evaluate the proficiency of such programs in preparing residents to enter independent clinical practice as a general ophthalmologist.
    Methods
    A closed-ended questionnaire was distributed between 89 residents or recently graduated ophthalmologists of Farabi Eye Hospital in Iran to measure their level of satisfaction about outpatient clinics and training in the operating rooms and scientific programs in the four-year long course of residency.
    Results
    Subjects generally expressed high amount of satisfaction with their programs in the residency era. The most frequently expressed weakness in their training was in the field of didactic and intellectual teaching. Most of the subjects proclaimed that the time for didactic teaching should be increased in nearly all subspecialty fields. All of the subjects declared to have plans for a post-residency fellowship. In the aspect of number of surgical procedures, and suitability of course duration for different subspecialty fields, subjects were satisfied in all fields but retina, that some of them believed it is longer than needed.
    Conclusion
    Residents in Farabi Eye Hospital retain a high level of satisfaction in achieving many of the key competencies for practice. Modification of current curricula in terms of quality is needed to improve the educational experiences of newly trained ophthalmologists.
    Keywords: Ophthalmology Residency, Training Curriculum, Resident Satisfaction
  • Rana Sorkhabi *, Amir Ghorbanihaghjo, Mehrnoosh Ghasemi, Alireza Khabazi, Mohammadhosein Ahoor Pages 284-287
    Purpose
    The main ocular manifestation of rheumatoid arthritis is dry eye. Lacritin is a secreted glycoprotein of tear and when applied topically in rabbits, it increased the volume of basal tear secretion. So the aim of this study was to compare Lacritin level in rheumatoid arthritis (RA) and control group.
    Methods
    This cross-sectional study was done on 40 patients with RA and 48 healthy subjects as a control group. In all participants, tear break-up time (TBUT) and Schirmer test with anesthesia were accomplished. Tear samples were collected directly from the inferior lateral tear meniscus and were immediately stored at -80 ° C until use. Lacritin level of tears were assessed by enzyme- linked immunosorbent assay.
    Results
    The mean age of participants was 44.7±16.3 and 43.3±18 years, respectively (p=0.70). Lacritin level in RA group (19.6±23.1 ng/ml) was significantly lower (31.9±23.3 ng/ml) than control (p=0.008). Pearson correlation between Lacritin level and TBUT, Schirmer value, ESR, and high-sensitivity C-creative protein (hs-CRP) in RA patients were not significant with p=0.27, 0.67, 0.09 and 0.07 accordingly.
    Conclusion
    In early stages of RA in spite of normal tear production, Lacritin level decreased, however there is not any correlation between Lacritin level and TBUT, Schirmer value, ESR, and hs-CRP in these patients.
    Keywords: Lacritin, Rheumatoid Arthritis, Tear Film
  • Dr. Azam Asgari *, Dr. Ali Asghar Parach, Dr. Keykhosro Keshavarzi Pages 288-296
    Purpose
    The aim of this study was to investigate the effect of misalignment (tilt & decentration) of IOLs in cataract surgery using Liu-Brennan optical eye model in a simulation.
    Methods
    A phantom with the real eye parameters –Liu-Brennan model– and Tecnis Z9000 IOL were used for simulation.
    Results
    Results showed that with 0.4 mm decentration and more the modulation transfer function (MTF) and contrast were reduced continuously in the ±X Axes. IOL decentration in ±Y axes showed a symmetrical reduction of MTF and contrast with increasing the decentration. In the ±X and ±Y axes, 1º to 8º IOL tilts had no significant effect on the MTF and contrast of the eye.
    Conclusion
    It can be said that the decentration of Tecnis Z9000 IOL in the ±X and ±Y axes will reduce the optical quality of the person, specially for decentration more than 0.4 mm this effect is very significant. Therefore using the compensation methods for improvement of the optical quality is essential. But up to 8º IOL tilt in vertical and horizontal axes had no significant effect on the visual quality of the patient.
    Keywords: Intraocular Lens, Misalignment, Tecnis Z9000, Zemax, Modulation Transfer Function, Optical Quality
  • Dr. Firoozeh Rahimi, Dr. Seyed Mohsen Rafizadeh *, Dr. Amir Houshang Beheshtnejad, Dr. Mohammad Nasser Hashemian, Dr. Mohammad Ali Zare, Dr. Heidar Siatiri, Dr. Mohammad Reza Fallah, Dr. Mohammad Yaser Kiarudi, Dr. Mohammad Khak Pages 297-303
    Purpose
    Acanthamoeba keratitis (AK) is a sight-threatening corneal infection with a rapidly increased incidence since 1990s along with the growing popularity of contact lenses. In this study we aimed to study patients with AK and its associated risk factors in Farabi Eye Hospital of Tehran, focusing on those with more severe corneal involvement.
    Methods
    Patients with clinical or laboratory diagnosis of AK at the cornea clinic of Farabi Eye Hospital during April 2009 to March 2010 were studied regarding their demographics, and clinical characteristics, corneal infection risk factors, and suboptimal hygiene practices. Linear regression analysis was applied to determine factors affecting the stage of corneal involvement at presentation.
    Results
    Twenty five patients (4 males and 21 females) with 27 involved eyes were identified during the one year study. Cosmetic contact lenses accounted for the most common potential risk factor of AK (85.2%). Most of the patients (92.6%) reported a history of antibacterial treatment before the presentation. Only four patients (16%) did not report any suboptimal hygiene practice. In the linear regression model only the first visual acuity (VA) at presentation, and the duration of symptoms were independently associated with the stage of disease.
    Conclusion
    The high number of patients presented with AK in our study suggests a possible outbreak of the disease in Tehran, which is highly associated with cosmetic contact lenses.
    Keywords: Acanthamoeba, Contact Lens, Cornea, Keratitis
  • Dr. Mohammad Javad Mohamadi, Dr. Reza Soltani Moghadam *, Dr. Hasan Behboudi, Atefeh Ghanbari, Dr. Soheila Hoseynzadeh Moghadam, Maryam Khoshbakht Pages 304-308
    Purpose
    To evaluate intraocular pressure (IOP) and anterior chamber depth (ACD) change after phacoemulsification with posterior chamber intraocular lens implantation
    Methods
    In this quasi-experimental study, 84 patients with senile cataract were included. All patients had normal IOP. Patients with traumatic and complicated cataract, any history of uveitis, glaucoma, or other ocular disease or surgery were excluded. Patients underwent phacoemulsification and intraocular lens implantation by the same surgeon. IOP, ACD, and lens thickness were measured and recorded before surgery. IOP was measured at 4, 8 and 12 postoperative weeks and ACD was measured 12 weeks after surgery.
    Results
    The mean preoperative ACD significantly increased from 2.93 mm to 3.54 mm postoperatively (p<0.0001). Mean preoperative IOP was 16.06 mmHg which decreased to 12.01 IOP mmHg, 12.57 mmHg and 12.90 mmHg at 4 weeks, 8 weeks and 12 weeks postoperatively, respectively (all p-values<0.0001). There was a correlation between lens thickness and changes of and ACD after the surgery. There was also a positive correlation between preoperative IOP and IOP reduction after the surgery.
    Conclusion
    Phacoemulsification decreases IOP specially in eyes with higher preoperative IOP and thicker lenses.
    Keywords: Phacoemulsification, Anterior Chamber Depth, Intraocular Pressure, Lens Thickness
  • Dr. Bahram Eshraghi, Dr. Hesam Hashemian *, Dr. Mona Safizadeh, Dr. Mohammadreza Akbari Pages 309-312
    Purpose
    To review periocular dermoid cysts to determine distribution of demographic factors, and tumor location
    Methods
    In this retrospective, observational case series in a tertiary-care hospital, we reviewed all cases of histopathologically verified periocular dermoid cysts at our institution between 2003 and 2011. The study endpoints included: age, gender, and tumor location.
    Results
    Two hundred and thirty-nine patients entered the study; whose mean age at the time of surgery was 11.8 years (range 6 months-48 years, 54% male). The frequencies of dermoid cysts in supranasal and supratemporal locations were fairly equal (46% and 49.4% respectively).
    Conclusion
    In contrast to previous reports, we reported fairly equal frequency of supranasal and supratemporal locations in an Iranian group of patients.
    Keywords: Orbital tumor, Dermoid Cyst, Periorbital Tumor
  • Dr. Bita Kiafar, Dr. Ahmad Reza Taheri, Dr. Vahid Mashayekhi, Dr. Malihe Nikandish * Pages 313-316
    Purpose
    To introduce a case of cutaneous and lid leishmaniasis in an immune suppressed woman Case report: We report an unusual clinical course of old world cutaneous leishmaniasis (OWCL) in an immune suppressed 51 years old women recipient of kidney transplant. She developed disseminated cutaneous leishmaniasis (DCL) with bilateral upper and lower eye lids lesions. Antimoniate compounds were not available and she did not tolerate amphotricin B. After replacing mycophenolate mofetil and cyclosporine by sirolimus, her Lesions though partially improved, were still persistent in the last visit after six months.
    Conclusion
    Ocular leishmaniasis should be considered in the differential diagnosis of modula or ulcerative of the eyelids specially in the endormic cases.
    Keywords: Disseminated Cutaneous Leishmaniasis, Ocular Leishmaniasis, Immunocompromised, Hordeolum, Conjunctiva
  • Dr. Hossein Aghaei, Dr. Kourosh Shahraki * Pages 317-319
    Purpose
    To report clinical and pathologic result of a young patient with isolated cavernous hemangioma of conjunctiva Case report: A 26-year-old man who presented with smooth، red، lobular surface mass was seen in the bulbar conjunctiva in temporal side with engorged episcleral and conjunctival vessels around the lesion. Excisional biopsy was performed. Pathologist confirmed the diagnosis of cavernous hemangioma of bulbar conjunctiva. Patient was followed-up for 18 months without recurrence and cosmetic feature was acceptable.
    Conclusion
    Ocular surface is an uncommon site of cavernous hemangioma and isolated conjunctival cavernous hemangioma is rare، but this tumor is considered as a differential diagnosis of conjunctival vascular tumors.
    Keywords: Conjunctival Cavernous Hemangioma, Vascular Tumor