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Current Ophthalmology - Volume:26 Issue: 4, 2014 Dec

Journal of Current Ophthalmology
Volume:26 Issue: 4, 2014 Dec

  • تاریخ انتشار: 1393/12/21
  • تعداد عناوین: 10
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  • Dr. Hormoz Chams * Pages 176-177
    The aim of the Iranian Journal of Ophthalmology (IrJO), published since 1947 has been to promote the quality of the journal, and to have a small part in the progression of the ophthalmic sciences in the world. We do expect and demand our colleagues from Iran and abroad to help us to achieve this precious goal. We are thankful to all those who have so far cooperated with us, our professional staff, editorial board, reviewers and particularly the faithful authors who have done their best to nourish our journal.
  • Dr. Hassan Hashemi, Dr. Abdolreza Babamahmoodi, Dr. Akbar Fotouhi, Soheila Asgari * Pages 178-182
    Purpose
    To compare the educational model and complication rates of cataract surgery performed by ophthalmology residents in Iran with other countries and present suggestions for improvement
    Methods
    We reviewed a number of studies that investigated the complications of cataract surgery in relation to curriculum modifications from 2009 to 2011. Review: Complication rates are higher in our country compared to others. In Iran, two studies in 2009 and 2011 reported high complication rates among residents. In the USA, the rate of Posterior capsular rupture (PCR) in resident-performed surgeries had a decreasing trend from 2001 to 2011, and the rate of Vitreous loss (VL) reached zero in 2011 after a substantial decrease in 2002 and small variations thereafter. The two Asian and European studies in 2006 and 2009 also reported lower complication rates than Iranian studies. Suggestion: Simulation and wet lab training, exposure to the operating room, providing a portfolio, research shifts, evidence-based discussions with experienced surgeons could improve knowledge and experience of Iranian residents.
    Keywords: Cataract Surgery, Training Curriculum, Quality Improvement, Residency, Iran
  • Masoud Khorrami Nejad, Dr. Mohammad Reza Akbari, Mahsa Ranjbar Pazooki, Mohammad Aghazadeh Amiri, Farshad Askarizadeh *, Mohammad Reza Moeini Tabar, Dr. Alireza Jafari Pages 183-188
    Purpose
    The association between deafness and ocular abnormalities is well established; however the nature and prevalence of these problems are diverse across the globe.
    Methods
    A team of optometrists and social worker visited one hundred fifty eight deaf boy students at their schools and those who needed more detailed evaluation were referred to the Farabi Eye Hospital''s strabismus clinic. These students in selected schools underwent detailed visual acuity testing, refraction, binocular examination, color vision and fundoscopy.
    Results
    The percentage of ocular abnormalities in the deaf boys included in this study was 52.8%. The frequency of refractive errors in the present study was 39.9%. Astigmatism was the leading refractive anomaly (31%). Hypermetropia was found in 13.2% of the children and myopia was found in 12.6%. Anisometropia was detected in thirty children (19%) and amblyopia was found in 22 children (13.9%). A disturbance of ocular motility was present in 18 cases (11.3%). In 44 (28%) cases stereopsis was reduced, and in six (3.8%) cases it was absent. Majority of the students (89.9%) had congenital hearing loss. 6.3% children had color vision deficiency. Seventy four deaf boys (46.8%) had a normal eye examination, while 84 (53.2%) cases had ocular problems, and 20 (12.65%) of them had more than one problem. The prevalence of refractive error, amblyopia, and strabismus was found to be significantly increased compared to the general population. In addition, the prevalence of ocular abnormalities generally increased with the severity of the hearing loss.
    Conclusion
    We recommended that screening for ocular abnormalities should be made mandatory in hearing-impaired children and parents must be aware of high prevalence of ocular abnormalities in deaf children, as they need appropriate visual sense to compensate their poor auditory sense.
    Keywords: Deafness, Hearing Impairment, Ocular Abnormalities, Refractive Errors, Strabismus
  • Mostafa Mohammadian, Dr. Hassan Hashemi, Dr. Ebrahim Jafarzadehpur *, Dr. Mahmoud Jabbarvand, Dr. Ali Mirzajani, Dr. Abbasali Yekta, Dr. Mehdi Khabazkhoob Pages 189-192
    Purpose
    Comparing the optical coherence tomography (OCT) pachymetry patterns in keratoconus suspect and normal people
    Methods
    Thirty-two keratoconus suspects and 36 healthy eyes were selected within the age range of 20-30 yrs. Their pachymetry pattern was obtained through OCT Visante in the minimum thickness spot, upper and lower corneal difference (I-S), lower temporal, and upper nasal thickness (IT-SN), withdrawal or non-withdrawal of the minimum thickness area of cornea from 0-2 central zone using the output map.
    Results
    In all measured parameters a significant difference was observed between the two groups (p<0.0001). The Keratoconus suspects had a thinner cornea and showed more changes in corneal thickness than the normal group.
    Conclusion
    It seems that an OCT system of anterior segment can be utilized to assess patients prior to refractive surgery or Keratoconus screening, along with equipments such as Pentacam, and Orbscan.
    Keywords: Optical Coherence Tomography, Keratoconus, Pachymetry
  • Dr. Hamidreza Jahadihosseini *, Dr. Hossein Jamali, Dr. Sajad Namvar Pages 193-198
    Purpose
    To compare outcomes and recurrence rates of amniotic membrane transplantation (AMT) plus intraoperative mitomycin C (MMC) and conjunctival rotational autograft (CRA) plus intraoperative MMC in pterygium surgery
    Methods
    Ninety-two eyes of 92 patients with primary nasal pterygium were enrolled. All patients were randomized to undergo either AMT or CRA. Forty-three patients underwent AMT plus intraoperative MMC (AMT group), and 49 patients CRA plus intraoperative MMC (CRA group). Patients were followed-up at 1 day, 1 week, 2 week, 1, 3, 6, and 12 months postoperatively. The main outcome measurement was a recurrence rate after surgery.
    Results
    A total of 92 eyes of 92 patients were included in the study. In AMT group 22 patients were male and 21 patients were female. In CRA group 25 patients were male and 24 patients were female (p=0.923). Mean age in AMT group was 46.4 and in CRA group was 47.7 years (p=0.634). Mean pterygium size in AMT group was 3.4 mm and in CRA group was 3.3 mm (p=0.320). Mean follow-up time in AMT group was 10.5 months and in CRA group was 10.8 months (p=0.535). Nine of 43 eyes (20.93%) in the AMT group developed recurrence compared with four of 49 eyes (8.16%) in the CRA group (p=0.145).
    Conclusion
    Although no statistically significant difference was present between the two groups, however the recurrence rate seems to be clinically less in the CRA group.
    Keywords: Pterygium, Amniotic Membrane Transplantation, Conjunctival Rotational Autograft, Mitomycin C
  • Mohammad Reza Sedaghat, Mojtaba Abrishami * Pages 199-202
    Purpose
    To compare fusional vergence amplitudes in patients with symptomatic and asymptomatic near exophoria
    Methods
    This cross-sectional study included 102 patients with near exophoria and asthenopia and 86 with asymptomatic near exophoria, all of whom were aged 15-35 years and had best corrected far visual acuity better than 20/25. Far and near fusional vergence amplitudes were evaluated in all patients. The subjects were not hyperopic.
    Results
    We observed significant between group differences in near negative fusional vergence (NFV) break (15.91±4.90 PD vs. 14.73±4.60 PD, p=0.013), near NFV recovery (12.33±3.90 PD vs. 13.79±3.97PD, p=0.009), and far NFV recovery (5.58±3.50 PD vs. 4.50±2.70 PD, p=0.019). Other vergence amplitudes did not differ significantly.
    Conclusion
    Although previously it was assumed that asthenopia is related to convergence insufficiency (CI), it seems that asthenopia in patients with near exophoria may be related to increased amplitudes of negative vergence.
    Keywords: Fusional Vergence Amplitudes, Asthenopia, Near Exophoria
  • Dr. Hassan Hashemi, Dr. Elina Ghafari, Dr. Mehdi Khabazkhoob, Dr. Jila Noori, Dr. Arash Taheri, Dr. Arash Eshghabadi, Dr. Alireza Khodabandeh, Dr. Mohammad Hassan Emamian, Dr. Mohammad Shariati, Dr. Akbar Fotouhi * Pages 203-211
    Purpose
    To determine the prevalence and determinants of age-related macular degeneration (AMD) in a 40-64 year old Iranian population
    Methods
    In a cross-sectional study, 6,311 people were randomly selected from Shahroud. For all participants, visual acuity, refraction, slit-lamp examination and fundus photography were conducted under pupil dilation.
    Results
    Results of this study are based on analysis of 4,387 high quality photographs. The prevalence of AMD in this study was 4.7% (95% confidence interval (CI): 4.1-5.4). Multiple logistic regression analysis revealed that only older age [odds ratio (OR)=1.07] and hyperopia (OR=1.12) significantly correlated with AMD. Associations with biometric components and spherical equivalent were studied in another model and older age (OR=1.08), male sex (OR=1.54), and ocular axial length (OR=0.66) significantly correlated with AMD.
    Conclusion
    AMD prevalence in this population was lower compared to Western countries and higher in comparison to East Asian countries. In agreement with other studies, age strongly correlated with AMD. Regarding the correlation between AMD and ocular axial length; the incidence is more likely to occur in people with short axial lengths.
    Keywords: Age, related Macular Degeneration, Cross, Sectional Study, Middle East Region, Prevalence
  • Dr. Rosa Miri, Dr. Mohammad Hossein Harirchian, Dr. Abbas Tafakhori, Dr. Reza Shahsiah * Pages 212-216
    Purpose
    Neuromyelitis opitca (NMO) is an autoimmune disease that relates to deposition of anti-Aquaporin-4 (AQP4) IgG in the central nervous system (CNS). However, called seronegative NMO when patients are negative for AQP4 antibody. Nevertheless, NMO is most probably an antibody mediated disease. The aim of this study was to assess the association between seronegative NMO disease and variations in the AQP4 gene region.
    Methods
    A total of 24 seronegative NMO patients were enrolled in the study in 12 months. The frequency of neucleotide variations in 5’ untranslated region (5’-UTR), coding, noncoding, and 3’ untranslated region (3’-UTR) regions were found and compared with the corresponding rates reported previously.
    Results
    The frequencies of the studied variations showed no statistical difference with the rates reported previously. However, a variation was found in 7% of the alleles in the intronic region between exons 1 and 2 which has not been reported so far.
    Conclusion
    Nucleotide variation in different regions of AQP4 gene can affect antigenicity of AQP4 in different ways one of which is making a change in AQP4 isoform (M1/M23) expression ratio. While the variation found in this study in the intronic region of the gene can affect isoform expression ratio, further investigation is needed to determine its role.
    Keywords: Aquaporin, Neuromyelitis Optica, Devic's Disease, Single Nucleotide Polymorphisms, Sequencing, Orthogonal Arrays of Particle
  • Dr. Mehryar Taghavi Gilani, Dr. Mohammad Sharifi *, Dr. Mohammadghasem Etemadi Mashhadi Pages 217-222
    Purpose
    Oculocardiac reflex (OCR) is a frequent event during strabismus surgery. The aim of this study is to compare the preventive effect of intravenous lidocaine and hyoscine on OCR.
    Methods
    This prospective, randomized clinical trial was performed on 75 patients (5-63 years old) underwent strabismus surgery. Patients divided randomly into three groups. Intravenous hyoscine (0.2 mg/kg), lidocaine (1.5 mg/kg) and distilled water were injected before induction with propofol for each group respectively under standard monitoring. Heart rate, blood pressure and/or cardiac dysrrythmia were recorded immediately before/after injection and muscle hooking. Decrease of heart rate more than 20%, hypotension (decrease more than 20% in systolic or diastolic pressure) or any cardiac dysrrythmia were defined as OCR.
    Results
    One hundred and thirty-six muscles were hooked during strabismus surgery. OCR was observed in 44 hooked muscles (32.3%). Reflex was observed in hyoscine (34.2%), lidocaine (24.9%) and control (40.9%) groups (p=0.12). The most stretched muscles which caused OCR were medial rectus (56.8%) and lateral rectus (36.3%) muscles. OCR was greater in patients with age between 5-10 years (56%).
    Conclusion
    Intravenous lidocaine and N-buthylbromide hyoscine both could reduce OCR occurrence but the difference was not statistically significant compared to the control group. OCR was seen greater in young patients (5-10 years old). Some patients (specially children) need intervention to restore normal condition.
    Keywords: Hyoscine, Lidocaine, Oculocardiac Reflex, Strabismus
  • Dr. Mojtaba Abrishami *, Dr. Alireza Maleki, Dr. Ali Hamidian-Shoormasti, Dr. Mostafa Abrishami Pages 223-227
    Purpose
    To report a young patient with microphthalmos associated with bilateral papillomacular fold and severe hyperopia Case report: In this observational case report, a sixteen-year-old young man was referred with high hyperopia to Al-Zahra Eye Hospital, Zahedan University of Medicalf Sciences, Zahedan, Iran, for check up. Spherical error in right eye (RE) was +14.75 D and in the left eye (LE) was +15.00 D without astigmatism. Keratometry was reported 51.50, 52.25@113 in RE and 51.25, 52.25@65 in LE. Best corrected visual acuity (BCVA) was 20/25 in both eyes. Axial length in RE was 14.8 mm and 14.9 mm in LE. Also cornea diameter measured 9.9 for both eyes. In fundus exam, a papillomacular retinal fold extending from the center of the fovea toward the optic nerve head was present. In OCT exam, papillomacular fold with thickness of 322 microns in RE and 277 microns in LE were reported. In Pentacam exam, anterior chamber depth, central corneal thickness and anterior and posterior best fit sphere (BFS) were reported 2.34 mm, 565 microns, 6.54 mm and 5.39 mm in RE and 2.41 mm, 578 microns, 6.54 mm and 5.39 mm in LE. Intraocular pressure (IOP) was 13 mmHg in both eyes and there was no sign of angle closure glaucoma.
    Conclusion
    Microphthalmos may be associated with high hypermetropia, thick papillomacular fold, and steep cornea with a relative good vision.
    Keywords: Microphthalmos, Papillomacular Fold, Hyperopia