bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Malignant Glaucoma
Authors: Sadeghi Reza , Momeni Ali , Fakhraie Ghasem , Eslami Yadollah , Zarei Reza , Vahedian Zakieh , Safizadeh Mona , Tabatabaei Seyed Mehdi
Published: June 2024

Purpose:

To compare the outcomes of various invasive and noninvasive approaches to the treatment of malignant glaucoma.

Methods:

Glaucoma-related keywords were looked up in PubMed and Google Scholar, and related articles up to 2022 were used to put together this review article.

Results:

Numerous surgical methods and techniques have been introduced in the past few years. This review outlined current knowledge regarding the nonsurgical and surgical management of malignant glaucoma. In this regard, we first briefly outlined the clinical presentation, pathophysiology, and diagnosis of this disorder. Then, the current evidence on the management of malignant glaucoma was reviewed. Finally, we discuss the need for treatment of the other eye and the factors that might affect the outcome of surgical intervention.

Conclusions:

Fluid misdirection syndrome, or malignant glaucoma, is a severe disorder that can occur spontaneously due to surgical intervention. The pathophysiology of malignant glaucoma is complicated, and numerous theories exist about the underlying mechanisms that may contribute to the disease. Malignant glaucoma can be treated conservatively using medications, laser therapy, or surgery. Laser treatments and medical treatments have been adequate for the treatment of glaucoma, but the effects have generally been short-lived, and surgical treatment has proved to be the most effective. There have been a variety of surgical methods and techniques introduced. Still, none have been studied in a large proportion of patients as a control case to compare effectiveness, outcomes, and recurrence. Pars plana vitrectomy with irido-zonulo-capsulectomy still seems to have the best results.
Comparison of the Sedative, Hemodynamic, and Anesthetic Effect of Dexmedetomidine, Ketamine, and Etomidate on Cataract Surgery by Phacoemulsification Method
Authors: Moghisseh Bardia , Modir Hesameddin , Moshiri Esmail , Motaghinia Zahra , Bozorgmanesh Mohammadreza
Published: June 2024

Purpose:

To compare dexmedetomidine, ketamine, and etomidate in the induction of sedation and hemodynamic changes in patients undergoing cataract surgery by phacoemulsification method.

Methods:

This was a double-blind clinical trial study carried out on 128 patients. Using the block randomization method, the patients were divided into four equal groups (dexmedetomidine, ketamine, etomidate, and control). Mean arterial pressure, heart rate, and arterial oxygen saturation, Ramsay Sedation Score were recorded every 5 min intraoperatively, in recovery, and 1, 2, 4, and 6 h postoperatively. Moreover, the Aldrete score was measured in recovery time for discharge from the recovery room.

Results:

The mean age of participants was found to be 63.16 ± 6.07 years, and there was no statistically significant difference between the groups in terms of age, sex, and body mass index, SpO2, and heart rate (P > 0.05). From 15 min after the start of surgery to 6 h postoperatively, the mean arterial pressure in the dexmedetomidine group was significantly lower than that in the other three groups, including ketamine, etomidate, and control (P < 0.05). The mean sedation score (Ramsay) during recovery and 1 h postoperatively was higher in the dexmedetomidine group compared with that in the control group, whereas the recovery time in the dexmedetomidine group was higher than that in the other groups (P < 0.001). In addition, the amount of propofol consumption in the two groups of dexmedetomidine and ketamine was significantly less than that in the etomidate and control groups (P < 0.001).

Conclusions:

According to the results, dexmedetomidine caused better hemodynamic changes with more reduction in blood pressure and heart rate, and patients in the dexmedetomidine group did not require any specific medical treatment. Moreover, higher patient satisfaction and longer recovery duration were observed in the dexmedetomidine group than in the other study groups. As such, it is suggested that dexmedetomidine be used as an adjuvant in cataract surgery for more sedation, analgesia, and optimal intraoperative conditions.
Corneal Biomechanical Changes after Corneal Cross-Linking in Patients with Keratoconus
Authors: Hamid Adel , Jahadi-Hosseini Hamidreza , Khalili Mohammad Reza , Jahanbani-Ardakani Hamidreza
Published: June 2024

Purpose:

To evaluate the changes in biomechanical properties of the cornea using the Corvis ST device after the treatment of keratoconus patients with ultraviolet-A/riboflavin corneal cross-linking (CXL).

Methods:

Thirty-seven eyes from 37 consecutive patients with progressive keratoconus were included in this prospective observational case series. Corneal biomechanical parameters including the length of the applanated cornea (L1 and L2), corneal movement velocity during applanation (V1 and V2) at the moment of the first and second applanation, deformation amplitude (DA), distance between bending points of the cornea points of the cornea (PD), and concave radius of curvature (R) at the point of the highest concavity were recorded using the Corvis ST at baseline, 3 months, and 1 year after CXL.

Results:

The mean age of the patients was 23.27 years (range, 19–31 years). Among CorVis ST corneal biomechanical parameters, L1, DA, PD, and R at the point of the highest concavity did not change significantly. The length of the applanated cornea at the moment of second applanation (L2) showed a significant change 3 months after CXL, but no significant difference was found between the 3-month and 1-year values of this parameter. Corneal movement velocity during applanation (V1 and V2) did not change 3 months after doing CXL, but the changes in these parameters were significant 1 year after CXL.

Conclusions:

Although the CorVis ST device may detect changes in some biomechanical properties of cornea after the treatment of keratoconus patients with CXL, many parameters remain unchanged, and this device cannot readily be used to find the effects of CXL.
Comparison of Visual Field Measurements in Glaucomatous Eyes using Oculus and Metrovision Perimeters
Authors: Daneshvar Ramin , Ehsaei Asieh , Moghadas Sharif Nasrin , Pato Zahra
Published: June 2024

Purpose:

To investigate the agreement between the Oculus and Metrovision perimeters in the visual field evaluation of glaucoma patients.

Methods:

In this cross-sectional study, 41 consecutive glaucoma patients were enrolled. After detailed clinical examinations, visual field testing was performed for all patients using the Oculus and Metrovision perimeters. The interval time between the two visual field examinations was 30 min.

Results:

A total of 22 participants were male (53.7%) and the mean ± standard deviation (SD) age was 58.6 ± 9.1 years. The absolute average of the mean deviation (MD) in the oculus perimeter (8.24 ± 4.92 dB) was higher compared to the Metrovision perimeter (4.02 ± 4.62; P < 0.001). This difference was also evident in the Bland–Altman graph. The loss variance (pattern SD) values of Oculus perimeter (28.58 ± 16.40) and Metrovision perimeter (28.10 ± 28.45) were not significantly different; although based on the Bland–Altman plots in the lower MDs, the agreement is better and the data dispersion is lower, and in the higher MDs, the agreement is lower. The parameters of four visual field quadrants were also compared and showed poor correlations (P < 0.001).

Conclusion:

The Oculus and Metrovision perimeter devices have good agreement in lower MDs; however, they cannot be used interchangeably.
Efficacy and Safety of Iris-Claw Intraocular Lens in Pediatric Ectopia Lentis: A Literature Review
Authors: Yulia Dian Estu , Soeharto Diajeng Ayesha
Published: June 2024

Purpose:

To review current evidence regarding the use of iris-claw intraocular lens (IOL) in terms of its efficacy and safety in the population of pediatric ectopia lentis.

Methods:

A comprehensive literature search of six electronic databases (PubMed-NCBI, Medline-OVID, Embase, Cochrane, Scopus, and Wiley) and secondary search through reference lists was conducted using keywords selected a priori. All primary studies on the use of iris-claw in pediatric ectopia lentis that evaluated visual acuity (VA), complications, and endothelial cell density (ECD) were included and critically appraised using the Newcastle–Ottawa Scale.

Results:

Ten studies were eligible for inclusion with an overall sample size of 168 eyes of children with ectopia lentis, and the majority of studies evaluated anterior iris-claw IOL. All studies reported improvement in postoperative VA. The most commonly reported complication across studies was IOL decentration. All studies reported decreasing ECD, and this was observed in both anterior and retropupillary iris-claw IOL.

Conclusion:

Current evidence shows that iris-claw IOL is effective in terms of improving VA in pediatric ectopia lentis. Due to the lack of long-term evidence of its safety in children, one must remain cautious regarding potential endothelial cell loss. Further high-quality, interventional, long-term studies are needed.
The Effect of Post-Coronavirus Disease 2019 Infection on the Retinal Microvasculature
Authors: El-Haddad Nermien Salah El-Dien Mohammed , Abd El-Wahed Elham , Abd El-Wahab Adel , Shalaby Sawssan , Farag Mona Mohammad Aly , Mohammed Nesma Sied , Shawky Shrief
Published: June 2024

Purpose:

To evaluate the short-term microvasculature changes of the macula and optic disc following coronavirus disease 2019 (COVID-19).

Methods:

This study included 150 eyes (50 eyes of healthy controls and 100 eyes of patients) during the 1st month following COVID-19 recovery, as evidenced by two negative polymerase chain reactions. A complete ophthalmic examination and optical coherence tomography angiography were performed to detect the deep and superficial macular vessel density (VD). In addition, the VD of the optic disc was evaluated.

Results:

Deep VD (DVD) showed a statistically significant decrease in post-COVID-19 patients, particularly those with severe COVID-19. This reduction occurred in the whole image, parafoveal, and perifoveal VD (P = 0.002, P = 0.002, and P < 0.001, respectively). Concerning the superficial VD (SVD), only the superior hemisphere of the whole image density was statistically significantly reduced (P = 0.037). There was no statistically significant difference in foveal VD (both deep and superficial vessel) among the study groups (P = 0.148 and P = 0.322, respectively). Regarding the foveal avascular zone (FAZ), there was no statistically significant among groups (P = 0.548). Regarding the optic disc, the whole image VD and redial peripapillary capillary VD demonstrated a highly significant decrease, particularly in cases of severe COVID-19. Conversely, inside disc VD showed a nonsignificant change among the study groups.

Conclusions:

According to the findings of the current study, retinal microvasculature was affected in the 1st month following recovery from COVID-19. DVD was significantly reduced more than SVD. In addition, peripapillary VD decreased, whereas the FAZ was unaffected.
Microspherophakia and Lens Subluxation in Klinefelter Syndrome: A Case Report
Authors: Van Laeken Jana , Leysen Laura , Keer Karel Van
Published: June 2024

Purpose:

To report a rare case of microspherophakia and lens subluxation in a young patient with Klinefelter syndrome who underwent cataract surgery, emphasizing the importance of a thorough general health assessment and anamnesis prior to cataract surgery.

Methods:

The case concerns a 52-year-old male referred for phacoemulsification under general anesthesia. A review of literature was performed.

Results:

Preoperative assessment revealed a corticonuclear cataract in both eyes, with dislocation of the crystalline lens in the left eye in an area of zonular dehiscence. Upon careful examination, both eyes showed a microspherophakic lens with an increased lens thickness and the lens equator being visible over 360° in the left eye. The patient denied any trauma or medical conditions. His medical health record revealed the coexistence of Klinefelter syndrome (47, XXY). The association between Klinefelter syndrome and microspherophakia has only once been reported in the literature. Intraoperatively, a more cautious approach was withheld and a capsular tension ring was used. Postoperative outcome was successful with good visual outcome and no interoperative complications.

Conclusions:

This case report highlights the importance of proper preoperative assessment before cataract surgery, especially in unusual cases such as early-onset cataract and/or lens subluxation. In addition, it stresses the importance of a systemic and/or genetic evaluation in patients with microspherophakia and an ophthalmological examination in patients with Klinefelter syndrome.
Risk of Missed Diagnosis of Primary Open-Angle Glaucoma by Eye Care Providers
Authors: Doozandeh Azadeh , Yazdani Shahin , Pakravan Mohammad , Ghasemi Zohreh , Hassanpour Kiana , Hatami Mehdi , Ansari Iman
Published: June 2024

Purpose:

To evaluate the efficacy of opportunistic case finding in glaucoma detection and to determine factors associated with failure of glaucoma detection by eye health providers.

Methods:

This study was conducted on 154 new definite primary open-angle glaucoma (POAG) patients presenting to our glaucoma clinic. A questionnaire was prepared to determine if these subjects had sought eye care up to 12 months before presentation. The type of eye care provider and the principal reason for the visit were probed. The primary outcome measure was the frequency of a correct glaucoma diagnosis in their index visit. The secondary outcomes were factors associated with missed POAG diagnosis.

Results:

The great majority of study subjects (132 cases, 85.7%) had sought at least one ocular examination within 1 year before presentation. Among these patients, 73 cases (55.3%) had remained undiagnosed after the examination. Among the probed variables, age, gender, visual acuity, visual field defects, intraocular pressure, cup/disc ratio, nerve fiber layer thickness of the worse eye at presentation, and family history of glaucoma were comparable between correctly diagnosed and missed POAGs. The only factors significantly associated with missed POAG diagnosis were lack of significant refractive errors and visiting an optometrist rather than an ophthalmologist.

Conclusions:

The efficacy of opportunistic case finding for POAG seems to be less than ideal in our settings. Lack of a significant refractive error and visiting an optometrist rather than an ophthalmologist were associated with a missed diagnosis of POAG. These observations reflect the need to adopt policies to improve glaucoma screening by eye care providers.
Supracor Multifocal Corneal Laser-Assisted In Situ Keratomileusis Procedure for the Correction of Presbyopia in Hyperopic Eyes
Authors: Hashemian Seyed Javad , Hadi Yasaman , Es’haghi Acieh , Jafari Mohammad Ebrahim
Published: June 2024

Purpose:

To investigate the outcomes of unilateral Supracor treatment to enhance near vision while maintaining good distance vision in hyperopic eyes.

Methods:

This prospective interventional study includes consecutive hyperopic patients with presbyopia. All eyes underwent femtosecond laser-assisted in situ keratomileusis treatment for hyperopia with an additional Supracor multifocal treatment algorithm in nondominant eyes. Monocular and binocular uncorrected and spectacle-corrected distance visual acuity (UCDVA and SCDVA), monocular and binocular uncorrected near visual acuity (UNVA), and distance-corrected near visual acuity at 40 cm and high-order aberration changes and complications were evaluated for 6 months.

Results:

Sixty-four patients with a mean age of 51.91 ± 3.64 were enrolled. After 6-month follow-up, the mean binocular UCDVA and UNVA were 0.03 ± 0.05 and 0.04 ± 0.06 logMAR, respectively. UCDVA (logMAR) of nondominant and dominant eyes was 0.30 ± 0.18 and 0.03 ± 0.05, respectively. Preoperative and postoperative mean ± standard deviation manifest refraction spherical equivalent was +1.84 ± 0.75 and −0.48 ± 0.57, respectively, in nondominant eyes and +1.77 ± 0.69 and +0.12 ± 0.33, respectively, in dominant eyes. No complications were observed.

Conclusion:

Supracor procedure in nondominant eyes may improve functional near, intermediate, and distance vision without significant photic phenomena in presbyopic patients with low and moderate hyperopia.
Agreement between a Spectral-Domain Ocular Coherence Tomography Biometer with a Swept-Source Ocular Coherence Tomography Biometer and an Optical Low-Coherence Reflectometry Biometer in Eyes with Cataract
Authors: Zarei-Ghanavati Siamak , Nikpayam Majid , Namdari Maral , Bakhtiari Elham , Hassanzadeh Samira , Ziaei Mohammed
Published: June 2024

Purpose:

To assess the agreement between biometric parameters measured by a spectral-domain optical coherence tomography optical biometer device (Optopol Revo NX) with a validated swept-source biometer (IOLMaster 700) and a validated optical low-coherence reflectometry biometer (Lenstar LS 900), in cataract surgery candidates.

Methods:

In this prospective comparative study, 100 patients (100 eyes) who were eligible for cataract surgery were involved. Bland–Altman plots were used to assess agreement between devices for biometric parameters including axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT).

Results:

AL measurements were successful in 82 eyes (82.0%) with Revo NX, in 91 eyes (91.0%) with Lenstar LS 900, and in 97 eyes (97.0%) with IOLMaster 700. When Revo NX was compared to IOL Master 700 and Lenstar LS 900, the mean differences were as follows: −0.02 ± 0.02 mm and −0.02 ± 0.03 mm (P = 0.313, P = 0.525) for AL, 0.01 ± 0.03 mm and 0.10 ± 0.03 mm (P = 0.691, P = 0.002) for ACD, −0.15 ± 0.03 mm and 0.001 ± 0.04 mm (P < 0.001, P = 0.95) for LT, and −2.29 ± 0.92 μm, and 0.73 ± 1.43 μm (P = 0.015, P = 0.612) for CCT. Three devices were highly correlated for AL, ACD, LT, and CCT (interclass correlation coefficient > 0.75). Bland–Altman plots showed a narrower 95% limit of agreement (−0.35 to 0.31) between Revo NX and IOLMaster 700 in measuring AL.

Conclusions:

Despite the higher measurement failure rate in eyes with cataract, the Revo NX showed very good agreement with the IOLMaster 700 and Lenstar LS 900 optical biometers in measuring AL, ACD, LT, and CCT. However, ACD and LT measurements cannot be considered interchangeable between these devices.
A Giant Mass in the Eyelid: Peripheral T-Cell Lymphoma, Not Otherwise Specified
Authors: Yuksel Nilay , Koc Sule Idaci , Can Ferda , Dilek Imdat
Published: June 2024

Purpose:

To report a case with an unusual giant mass in the eyelid which was diagnosed as peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS).

Methods:

A 40-year-old woman was referred with a 1-year history of rapidly and constantly growing eyelid mass.

Results:

The patient underwent an incisional biopsy and histopathological examination revealed a PTCL-NOS. After achieving regression by the combination of cyclophosphamide, hydroxydoxorubicin, vincristine (oncovin), etoposide, and prednisolone therapy, the remaining crusts were debrided, the eyelids were separated, and the wound was left to heal by secondary intention. Cicatricial ectropion of the lower eyelid occurred during follow-up and it was corrected with a free skin graft successfully.

Conclusion:

PTCL-NOS is uncommon but it may reach massive dimensions in the eyelid region.
Plateau Iris: A Review
Authors: Tabatabaei Seyed Mehdi , Fakhraie Ghasem , Ansari Shabnam , Hamzeh Nikoo , Safizadeh Mona , Beikmarzehei Alireza
Published: June 2024

Purpose:

To review the concept of plateau iris and summarize the recent evidence on its diagnosis and management.

Methods:

This is a narrative review on the plateau iris. A literature review was conducted in PubMed, Google Scholar, and Scopus databases using keywords: angle-closure glaucoma, glaucoma, nonpupillary block glaucoma, plateau iris, and plateau iris management.

Results:

This review defined the current knowledge about plateau iris. First of all, the anatomy and epidemiology were discussed. Then, we outlined the available evidence on the diagnosis of plateau iris and its differential diagnosis. Conclusively, the treatment options were mentioned.

Conclusions:

Plateau iris is a condition in which nonpupillary block mechanisms are responsible for intraocular pressure elevation and angle closure attack when a patent peripheral iridotomy has removed the relative pupillary block. An anteriorly positioned ciliary body causes mechanical obstruction of trabecular meshwork in these patients. It is usually seen in younger patients with angle closure and is diagnosed by gonioscopic examination and imaging modalities such as Ultrasound biomicroscopy. Despite the known mechanism of plateau iris, there is no consensus over treatment. Low-dose pilocarpine and Argon laser peripheral iridoplasty are nonsurgical treatments for these patients, but their effects are short-term. Cataract extraction with/without endocyclophotocoagulation (ECP), endocycloplasty, excisional goniotomy, and transscleral cyclophotocoagulation are alternative treatments. Patients should be examined periodically for further progression or recurrence of plateau iris. In cases of glaucoma unresponsive to conventional medical treatments, surgical treatments such as trabeculectomy and drainage devices should be considered.
Retinal Optical Coherence Tomography Angiography Findings following Retinoblastoma Treatment by Chemotherapy
Authors: Riazi-Esfahani Hamid , Shamouli Hadi , Pour Elias Khalili , Fadakar Kaveh , Khodabandeh Alireza , Masoomian Babak , Hatami Vahid , Ghassemi Fariba
Published: June 2024

Purpose:

To investigate the macular microvascular changes after different kinds of chemotherapy in patients with extramacular retinoblastoma (RB).

Methods:

In this study, 28 eyes of 19 patients with bilateral RB treated with intravenous systemic chemotherapy (IVSC group) and 12 eyes of 12 patients with unilateral RB treated with intra-arterial chemotherapy (IAC group) were compared with 6 normal fellow eyes of 6 patients with unilateral RB treated with IVSC (IVSC fellow eye group), and 7 normal fellow eyes of 7 unilateral RB patients treated with IAC (IAC fellow eye group), as well as 12 age-matched normal eyes. Enhanced depth imaging optical coherence tomography measurements of central macular and subfoveal choroidal thickness (CMT and SFCT) as well as optical coherence tomography angiography measurements such as retinal superficial capillary density (SCD), deep capillary density (DCD), and choriocapillaris density were documented.

Results:

Images of 2 eyes in the IVSC group and 8 eyes in the IAC group were excluded from the final image analysis due to severe retinal atrophy. Overall, 26 eyes with bilateral RB treated with IVSC and 4 eyes of 4 patients with unilateral RB treated with IAC were compared with the mentioned control groups. Best-corrected visual acuity was 1.03 logMAR in the IAC patients compared to 0.46 logMAR in the IVSC group at the time of imaging. While the CMT and SFCT were lower in the IAC group in comparison with the IAC fellow eye and normal groups (P < 0.05 for all), no remarkable difference was observed between the IVSC group and the control groups based on the mentioned parameters. Although the SCD showed no significant difference between the IVSC and control groups, this parameter was significantly lower in the eyes receiving IAC relative to the corresponding fellow eye group (P = 0.042) and normal control eyes (P = 0.047). The mean DCD was considerably lower in both the treatment groups compared to the control groups (P < 0.05 for all).

Conclusion:

Our study showed a substantial decrease in SCD, DCD, CMT, and choroidal thickness in the IAC group, which may explain the lower visual outcome in this group.
Comparison of Intraocular Lens Power Calculation between Standard Partial Coherence Interferometry-Based and Scheimpflug-Based Biometers: The Importance of Lens Constant Optimization
Authors: Sardari Sara , Khabazkhoob Mehdi , Jafarzadehpur Ebrahim , Fotouhi Akbar
Published: June 2024

Purpose:

To compare the intraocular lens (IOLs) power calculated with Haigis, Hoffer Q, Holladay 1, and SRK/T formulas between the IOLs Master 500 and Pentacam AXL according to the lens status.

Methods:

In this cross-sectional study, sampling was done in subjects above 60 years living in Tehran using multi-stage cluster sampling. All participants underwent optometric examinations including the measurement of visual acuity and refraction as well as slit-lamp biomicroscopy to determine the lens status. Biometric measurements and IOLs power calculation were done using the IOL Master 500 and Pentacam AXL. The order of imaging modalities was random in subjects. IOL power calculation was done according to optimized ULIB constants for the Alcon SA60AT lens. The IOL power was calculated according to a target refraction of emmetropia in all subjects.

Results:

After applying the exclusion criteria, 1865 right eyes were analyzed. The mean IOL difference between the two devices was −0.33 ± 0.35, −0.38 ± 0.39, −0.41 ± 0.43, and −0.51 ± 0.43 according to the SRK/T, Holladay, Hoffer Q, and Haigis formulas, respectively. The Pentacam calculated larger IOL power values in all cases. The 95% limits of agreement (LoA) between the two devices for the above formulas were −1.01 to 0.35, −1.14 to 0.39, −1.25 to 0.43, and −1.35 to 0.33, respectively. The best LoA were observed in normal lenses for all formulas. The difference in the calculated IOL power between the two devices using the four formulas had a significant correlation with axial length, mean keratometry reading, and anterior chamber depth. According to the results of the four formulas, mean keratometry reading had the highest standardized regression coefficient in all formulas.

Conclusion:

Although the difference in the calculated IOL power between IOL Master 500 and Pentacam AXL is not significant clinically, the results of these two devices are not interchangeable due to the wide LoA, especially for the Haigis formula; therefore, it is necessary to optimize lens constants for the Pentacam.
Unplanned Reoperation following Vitreoretinal Surgery
Authors: Akbarzadeh Ali , Zand Amin , Rahimi Masoud , Mirshahi Reza , Parvaresh Mohammad Mehdi , Falavarjani Khalil Ghasemi
Published: June 2024

Purpose:

To evaluate the incidence of unplanned return to the operating room following vitreoretinal surgery and assess the reasons.

Methods:

In this retrospective case series, medical records of all patients who underwent vitreoretinal surgery were reviewed to determine the incidence and reasons of early (<30 days postoperatively) and late (≥30 days postoperatively) unplanned reoperations after the surgery.

Results:

A total of 488 eyes of 468 patients with a mean age of 55.84 ± 18.23 years were included. Fourteen percent (68/488) of eyes required one or more unplanned reoperation following their primary surgery. These include 3.9% (19/488) for the early and 10.0% (49/488) for the late reoperation. The most common primary reason for baseline surgery was rhegmatogenous retinal detachment (RRD) without proliferative vitreoretinopathy (PVR, 38.2%), followed by RD with PVR (23.5%), and tractional RD (TRD, 19.1%). Unplanned reoperations were most common in RD with PVR (19.3%), RRD without PVR (17.2%), and TRD (14.4%). Overall, the most common reasons of the first unplanned reoperation were repeated RD with PVR (27.9%), repeated RD (19.1%), and the presence of silicone oil (SO) in the anterior chamber (AC) (10.3%). For early unplanned reoperations, SO in AC, postoperative endophthalmitis, and persistent hyphema were the most common causes. Repeated RD with PVR was the most prevalent cause of late unplanned reoperations (34.7%). In the multivariate analysis, preoperative best-corrected visual acuity (BCVA) was significantly lower in eyes with unplanned reoperation than in eyes without (P = 0.011).

Conclusions:

Unplanned reoperation following vitreoretinal surgery is not very common, and occurs mostly in the setting of PVR, RRD, and TRD. Lower preoperative BCVA may indicate an increased chance of future unplanned reoperation(s).
An Update on Anti-Vascular Endothelial Growth Factor Treatment for Retinopathy of Prematurity
Authors: Nowroozzadeh M. Hossein , Sadeghi Elham , Shahriari-Garaee Hossein , Badie Mohammad Reza , Banihashemi Javad , Garg Sunir J.
Published: June 2024

Purpose:

To present updated information on the role of anti-vascular endothelial growth factor (anti-VEGF) therapy for treating retinopathy of prematurity (ROP).

Methods:

We searched through PubMed and Scopus databases using the keywords of this article and gathered relevant published articles from the year 2005 to December 2022. The selected articles were classified and summarized, and reasonable conclusions were made accordingly.

Results:

Considering the current evidence, anti-VEGF agents are superior to laser therapy for the initial treatment of type 1 ROP in zone 1 or posterior zone 2. However, there is a substantial risk of reactivation or persistent avascular retina after solo treatment with anti-VEGFs, and many cases may require laser therapy within the following weeks or months. Thus, vigilant follow-up examinations are mandatory.

Conclusions:

The role of anti-VEGF agents in the treatment of ROP is indispensable. However, future studies are required to improve indications and dosage and determine long-term ocular and systemic safety.
Ab-interno Trabeculotomy Procedures: A Review
Authors: Meshksar Aidin , Razeghinejhad Mohammad Reza , Azimi Ali
Published: June 2024

Purpose:

To discuss the safety and efficacy of various forms of ab-interno trabeculotomy procedures.

Methods:

A comprehensive search in PubMed and Google Scholar was done using the keywords “glaucoma”, “microinvasive glaucoma surgery”, “complications”, “goniotomy”, and “trabeculotomy”. Publications discussing ab-interno trabeculotomy procedures were selected; furthermore, the relevant references in these articles were gathered and the search was updated during the article preparation. Since gonioscopy-assisted transluminal trabeculotomy was first introduced in 2014, we had no time restriction.

Results:

Ab-interno trabeculotomy procedures, as a type of minimally invasive glaucoma surgeries, facilitate the natural trabecular outflow and lower the intraocular pressure (IOP) while preserving the conjunctiva for possible future glaucoma surgeries. It can be done alone or in combination with cataract surgery and effectively lowers the IOP and the number of antiglaucoma medications in various forms of glaucoma.

Conclusion:

By appropriate patient selection, ab-interno trabeculotomy could be selected as a safe and effective procedure in the management of various forms of glaucoma either as an isolated procedure or in combination with cataract extraction.
Peripapillary Retinal Nerve Fiber Layer Thickness and its Ocular and Systemic Determinants in an Elderly Population: A Population-Based Study
Authors: Rafati Shokoofeh , Khabazkhoob Mehdi , Mortazavi Mehdi , Asharlous Amir
Published: June 2024

Purpose:

To determine the distribution, ocular, and systemic determinants of peripapillary retinal nerve fiber layer thickness (pRNFLT) using spectral-domain optical coherence tomography (SD-OCT) in an elderly population.

Methods:

This report is a part of the Tehran Geriatric Eye Study, a population-based cross-sectional study conducted in Tehran, the capital of Iran. The study population was all residents aged 60 years and above in Tehran. The sampling was performed using a multi-stage stratified random cluster sampling method. All study participants underwent ocular examination (including measurement of visual acuity, objective and subjective refraction, and slit-lamp biomicroscopy), anterior segment imaging using Pentacam HR, and ocular biometry using IOLMaster 500. The OCT imaging was performed for a random subsample (1307 individuals) using Spectralis SD-OCT.

Results:

Two thousand two hundred and forty-six eyes of 1189 individuals were analyzed for this report. Of these, 691 (58.1%) were female, and the mean age of the participants was 67.3 ± 5.9 years (60–94 years). The mean overall pRNFLT was 98.6 μ (95% confidence interval [CI]: 98.0–99.3). There was a statistically significant difference in pRNFLT between different quadrants; the highest and lowest mean pRNFLT was related to inferior and temporal quadrants, respectively (P < 0.001). The multiple generalized estimating equation model showed that older age (coefficient: −0.15 [95% CI: −0.24 to −0.06], P = 0.001), diabetes (coefficient: −1.69 [95% CI: −2.82 to −0.55], P = 0.004), and longer axial length (coefficient: −0.52 [95% CI: −0.83 to −0.22], P < 0.001) were significantly associated with a decreased overall pRNFLT. Higher body mass index was significantly related to an increased overall pRNFLT (coefficient: 0.19 [95% CI: 0.07 to 0.30], P = 0.002).

Conclusions:

The results of the present study can be used as a reference database for pRNFLT in the elderly population. Considering ocular and systemic determinants of pRNFLT is necessary for correct clinical interpretation of this parameter.
Epidemiology of Ocular Trauma in the Elderly: A Population-Based Study
Authors: Hashemi Alireza , Khabazkhoob Mehdi , Mehri Ahmad , Yekta Abbasali , Mortazavi Abolghasem , Hashemi Hassan
Published: June 2024

Purpose:

To determine the prevalence of different types of ocular trauma and their relationship with some factors in the elderly population.

Methods:

The present population-based cross-sectional study was conducted on the elderly population aged 60 years and above in Tehran, Iran, using multi-stage stratified random cluster sampling in 2019. After selecting the samples and their participation in the study, demographic information and history of ocular trauma were obtained through an interview. Psychological evaluation was performed using the Goldberg’s 28-question General Health Questionnaire. All study participants underwent optometric and ophthalmological examinations.

Results:

Three thousand three hundred and ten people participated in the study (response rate: 87.3%). Of these, 1912 individuals (57.8%) were female and the mean age of individuals was 68.25 ± 6.55 (from 60 to 97) years. 7.46% (95% confidence interval [CI]: 6.51–8.41) of the study participants reported a history of ocular trauma. Blunt and chemical traumas were the most and the least common types of ocular trauma, respectively (5.72% and 0.16%). 3.93% of cases visited an ophthalmologist for ocular trauma, 1.67% reported a history of hospitalization, and 1.47% underwent surgery. The prevalence of visual impairment in individuals with a history of ocular trauma was 12.53%. Visual impairment was more prevalent in people with a history of ocular trauma than those without a history of ocular trauma (P < 0.05). History of ocular trauma was only significantly related to low education level (odds ratio = 0.63, 95% CI = 0.40–0.99). Participants with a history of ocular trauma had more anxiety and higher mean psychological distress score than those without a history of ocular trauma (P = 0.035).

Conclusions:

The development of preventive programs against the occurrence of ocular trauma can play an important role in reducing the psychological damage of affected patients while reducing visual disorders. These interventions should be especially considered in groups with a lower education level.
Vision-Related Quality of Life and Ocular Parameters in End-Stage Renal Disease Patients Undergoing Hemodialysis
Authors: Moshegov Sophia , Seth Ishith , Wawryk Olivia , Sandhu Sukhpal Singh , Lanteri Marc , Baird Paul N. , Sahebjada Srujana
Published: June 2024

Purpose:

To evaluate the vision-related quality of life (VRQoL) of patients receiving hemodialysis through the assessment of the impact of vision impairment (IVI) questionnaire and ocular parameters, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), and refraction as calculated by spherical equivalent (SE) of each eye.

Methods:

Fifty-one patients with end-stage renal disease undergoing hemodialysis at a single center were recruited, and a total of 77 eyes were evaluated. BCVA, IOP, and SE were evaluated before and after hemodialysis (within 30 min).

Results:

Of the 51 patients recruited, 13 (25%) were female, 37 (73%) were male, and one (2%) chose not to specify gender. The mean age was 61.85 ± 32 years. The mobility IVI score was correlated significantly with the presence of hypertension (P = 0.01), eye drop usage (P = 0.04), and gender (P = 0.04). Emotional IVI scores were correlated significantly with diabetes (P = 0.03) and hypertension (P < 0.01). IOP significantly correlated with the IVI overall score (P = 0.02), including the reading IVI subscale and the emotional IVI subscale. Several factors were associated with posthemodialysis ocular parameters, including predialysis ocular parameters, age, and hypertension (P < 0.05 for all).

Conclusions:

IOP significantly correlated with VRQoL in hemodialysis patients. Demographic variables such as diabetes status, hypertension, eye drop usage, and gender also significantly correlated with subsections of the IVI questionnaire. This study investigated the relationship between ocular parameters and VRQoL in hemodialysis patients, and future longitudinal research is needed to further elucidate the mechanisms.
Is Type 2 Macular Telangiectasia a Bilateral and Symmetrical Disease Entity?
Authors: Venkatesh Ramesh , Nahata Harshita , Reddy Nikitha Gurram , Mishra Pranjal , Mangla Rubble , Yadav Naresh Kumar , Chhablani Jay
Published: June 2024

Purpose:

To study the inter-eye asymmetry in cases diagnosed with type 2 macular telangiectasia (MacTel).

Methods:

Herein, type 2 MacTel cases were staged as per Gass and Blodi classification with multiple imaging techniques. Based on disease stage symmetry, two groups identified. Group 1: Symmetrical stage and Group 2: Asymmetrical stage MacTel disease. Prevalence, demography, and clinical features of MacTel cases showing inter-eye asymmetry were analyzed.

Results:

Two hundred and eighty eyes of 140 patients diagnosed clinically with type 2 MacTel (84-Group 1 and 56-Group 2) were evaluated. Eighty-nine (64%) were female, and the median age of the entire cohort was 62.5 years (inter-quartile range: 57.0–68.75). MacTel disease with asymmetric stage was seen in 56 (40%) of the 140 patients. At presentation, a two-stage difference was noted in 46% (n = 26) of the patients with asymmetrical MacTel disease. A 10% conversion from symmetrical to asymmetrical disease stage was noted at the final visit. Of the 280 eyes evaluated for type 2 MacTel disease, 12 (4%) eyes showed no findings suggestive of MacTel on clinical examination and fluorescein angiography, optical coherence tomography (OCT), and OCT angiography when available and were labeled as unilateral type 2 MacTel disease.

Conclusions:

Type 2 MacTel can show inter-eye disease stage asymmetry. Unilateral type 2 MacTel disease is a distinct stage in MacTel which would need further evaluation and consideration while staging.
Effects of Descemet Stripping Automated Endothelial Keratoplasty on Corneal Densitometry of Cases with Long-Standing Pseudophakic Bullous Keratopathy
Authors: Hashemian Mohammad-Naser , Latifi Golshan , Cheraqpour Kasra , Ghods Sepideh , Abdi Parisa , Ghochani Ghazal
Published: June 2024

Purpose:

To quantify the effects of Descemet stripping automated endothelial keratoplasty (DSAEK) on corneal clarity and densitometry of patients with long-standing pseudophakic bullous keratopathy (PBK) complicated with subepithelial fibrosis.

Methods:

Thirty-four eyes with PBK complicated with corneal edema for more than 6 months and subepithelial fibrosis were enrolled. All subjects underwent complete ophthalmic examination and corneal densitometry module of Pentacam HR, before and 1, 3, and 6 months after DSAEK.

Results:

Thirteen patients were excluded due to postoperative complications or missed to follow-up visits. Finally, twenty-one patients’ data were analyzed. Corneal densitometry measures significantly decreased in all three layers (anterior, central, and posterior) 3 and 6 months after surgery compared to preoperative values; however, the differences did not reach statistical significance in the 1st month. Moreover, densitometry measurements were significantly lower at month 6 compared to month 1, but not at month 3 compared to month 1. Corneal densitometry of the anterior layer was significantly higher than central and posterior layers in 2 mm and 6 mm zones preoperatively and at all postoperative visits. Corneal light backscatter of each three layers was not statistically different between 0–2 mm and 2–6 mm in all pre- and postoperative visits.

Conclusions:

Corneal densitometry in cases of PBK begins to improve after DSAEK in different layers in a slow and continued trend which takes up to 6 months for an effect to be seen. Interestingly, this improvement is possible even in complicated corneas with long-standing edema. Hence, corneal densitometry can be used as an objective method for quantification of the outcome of DSAEK in complicated cases of PBK.
Scientific Publications and Subject Clusters in the Field of Glaucoma: A Scientometric Analysis
Authors: Haseli-Mofrad Azadeh , Kalavani Arefeh , Shekofteh Maryam , Rajavi Zhale , Sabbaghi Hamideh , Safi Sare , Esfandiari Hamed
Published: June 2024

Purpose:

To analyze the glaucoma research in the Web of Science (WoS) and Scopus to determine the top features, trends, and subject clusters.

Methods:

In this scientometric study, all glaucoma publications in Scopus and WoS were analyzed based on various characteristics such as authors, journals, and co-word analysis. Data analysis was conducted using both Excel and VOSviewer.

Results:

A gradual increase in the publication rate was found for articles in the field of glaucoma in both Scopus and WoS databases. In this regard, most publications were conducted in the USA and the University of California System. The co-word network was constituted of five clusters, including glaucoma, intraocular pressure, open-angle glaucoma, visual acuity, and optic disc. It showed that the top 10 highly cited articles were more addressed by epidemiologic studies.

Conclusions:

The findings of this study had a more precise vision of the previous research on the field of glaucoma. It also provided the possibility to discover hidden patterns and emerging events of a subject by explaining the most essential aspects of research and identifying the areas that need more research. The findings could be useful for authors and health policymakers in academia and countries.
Hypertension
Authors: Jung Eric E. , Ameri Hossein
Published: June 2024

Purpose:

To describe the case of a 67-year-old female with proliferative retinopathy secondary to uncontrolled hypertension.

Methods:

Retrospective case report including multimodal imaging.

Results:

A 67-year-old female presented with mild vitreous hemorrhage, retinal hemorrhage, hard exudate of the left eye and hard exudate, copper wiring of vessels, and retinal hemorrhages in the right eye. Optical coherence tomography depicted macular edema of both eyes. Fluorescein angiography revealed large areas of peripheral retinal ischemia and neovascularization with multiple areas of vascular leakage in both eyes.

Conclusions:

Proliferative hypertensive retinopathy has been rarely reported in the literature. Our patient exhibited findings consistent with proliferative retinopathy secondary to hypertensive retinopathy.
Bilateral Acute Iris Transillumination without Prior Systemic Antibiotics
Authors: Oraby Mohamed F. , Alrashidi Salah Aldin , Hagras Sherein Mahmoud
Published: June 2024

Purpose:

To describe a case of bilateral acute iris transillumination (BAIT) with no history of systemic infections or antibiotics intake before the attack.

Methods:

This study included the review of the clinical record of the patient.

Results:

A 29-year-old male was referred to the glaucoma clinic with presumed bilateral acute iridocyclitis with refractory glaucoma. Ophthalmic examination revealed bilateral pigment dispersion, marked iris transillumination, dense pigment deposition in the iridocorneal angle, and high intraocular pressure. The patient was diagnosed with BAIT and was followed for 5 months.

Conclusion:

The diagnosis of BAIT can be elicited even without a prior history of systemic infection or antibiotics intake.
Lacrimal Canalicular Bypass Surgery with Autologous Superficial Temporal Artery Graft
Authors: Jamshidian-Tehrani Mansooreh , Kashkouli Mohsen Bahmani , Ghahvehchian Hossein , Amini Mohammad
Published: June 2024

Purpose:

To describe superficial temporal artery graft as a new autologous tissue to reconstruct the upper lacrimal drainage system.

Methods:

We explain the history of a 30-year-old female with upper lacrimal drainage system obstruction, in whom conjunctivodacryocystorhinostomy (CDCR) failed to resolve epiphora. A superficial temporal artery graft was harvested, intubated with Masterka tube, and implanted between the conjunctiva and nasal cavity. Masterka was replaced with a thicker dummy tube 12 weeks postoperatively. The adequacy of the graft was checked with irrigation tests in follow-up visits from 1 to 26 months after the procedure.

Results:

Superficial temporal artery autograft successfully eliminated epiphora of the patient in whom (CDCR) with Jones tube failed to make her symptom free.

Conclusion:

Superficial temporal artery autograft as an autogenous tissue with adequate characteristics can be considered in selective patients of upper lacrimal obstruction to reconstruct the lacrimal drainage system.
Features and Frequency of Complications Among Pilgrims with Diabetes During Hajj
Authors: Yousuf Sanobia , Ahmedani Muhammad Y
Published: June 2024

Aim and Objective:

To observe the features and frequency of complications among pilgrims with diabetes during Hajj.

Materials and Methods:

This retrospective observational study was conducted at the Baqai Institute of Diabetology and Endocrinology (BIDE). People with diabetes who visited the outpatient department of BIDE after Hajj were invited to participate in the study between August and September 2018 and 2019, respectively. Those who were not willing to participate or perform Hajj have been excluded. The data collection was done by using a predesigned, close-ended questionnaire, including demographic and clinical parameters, practice compliance toward management, and the frequency of complications that occurred during Hajj.

Results:

In this study, a total of one hundred and forty-one people with diabetes participated with a mean age of 55.41 ± 10.6 years. Out of these, 111 (78.7%) had visited their health care professionals for pre-Hajj consultation and education, 134 (95%) received their recommended vaccination, and 92 (65.2%) of the people had checked their HbA1c before going to perform Hajj. Diabetic foot problems were recorded in 27 (19.1%), and respiratory diseases were found in 18 (12.8%). A total of 38 (27%) of the study population have reported hypoglycemia, and 51 (36.4%) have reported hyperglycemia.

Conclusion:

In this study, a higher frequency of glycemic as well as foot complications was observed among pilgrims with diabetes. Pre-Hajj education is mandatory to prevent these avoidable problems.