JOURNAL OF CURRENT OPHTHALMOLOGY
Year:2000 | Volume:12 | Issue:3|Papers Count:14

Aims: Our aims are to investigate the extension of the unilateral retinoblastomaby the clinical, paraclinical and the anatomopathological means, at the moment of the first medic surgical intervention.Materials & methods: In this retrospective study conducted from 1989to 1999, for ten years, all patients with a unilateral retinoblastoma who have been operated at the Farabi Eye Hospital of Tehran have been investigated.A complete ocular examination under general anesthesia, sonography, CT Scan, bone marrow Cerebral spinal fluide (C.S.F) and then a complete anatomopathological examination has been conducted.Results: 139patients with unilateral retinoblastomahave been operated during these 10 years (enucleation, exoneration). 80 patients were males and 59 females. The mean-age of the pateints at the time of the intervention was 34.98±21.95 months (ranged between I month to 120 months). The duration of the first symptoms observed by the parents until the intervention was 5.24%6.96months (ranged between 2 days to 36 months). The first symptoms observed by the parents have been: leukocoria 79%, red eye 10.5% Strabismus 40.8%, exophthalmos 2.4%, buphthalmos 1.6%.At the fundi examination, in 97.1% of the cases more than half of the retina was occupied by the turnor (stage V of Reese-Ellsworth), in 11.5% of the eyes vitreous seedings was observed, 7.9% of the eyes had exophthalmos, 70.9% had buphthalmos, 4 patients had hypopion or iris metastasis, 2 patients had head and face metastasis.93.5% of our patients were enucleated and 6.05% exenterated. The anatomopathological results revealed 58.3% of undifferentiated tumors, in 35.97% of the cases the optic nerve was involved and in 15.8% of the cases the extensionof the tumor had reached up to the surgical resection line of the optic nerve. In 41% of the cases choroid, in 25.83% ciliary-body, in 12.2% iris, in 702% sclera and in 10.1% of the patients the orbit was occupied. The bone marrow was involved in 5.03% of the cases and the CSF in 3.6% of cases.Discussion and conclusion: In Iran, patients having unilateral retinoblastoma consult at a very late stage of the tumor, 97.1% of the stage Reese V of-Ellswortb, and in 35.97% of the cases the optic nerve and orbit were involved. 30.9% of the patients were four years old or more. The main causes of the late consultation in our country is mainly the ignorance of the parents, the social and religious believes of the parents, the actual therapeutic protocols should be modified according to the extension of the tumors.

Background and Objective: In regard with prevalence of Age related- macular degeneration and the role of serum lipids & cholesterol in pathogenesis of the disease.This research was designed to determine serum. Triglycerds & cholesterol level in patients referring to Farabi Eye Hospital during 1997- 1998.Materials and Methods: This descriptive study was carried out on 105 cases of Neovascular AMD. Sequentially referred to Farabi Eye Hospital. Diagnosis was based on indiretect and Goldmantri mirrors lens fundoscopy and fluoresecin angiography.Clinical finding, ages, sexes, and paraclinical finding of the patients including serum triglyceride, cholesterol; low Density lipoprotein (LDL) & High density cholesterol (HDL) were investigated.Results: There were elevated serum triglyceride in 52 cases (49.5%, 95% Cl 40-60), elevated serum cholesterol in 48 cases (45.7%, 95 Cl 36-55), Elevated serom LDL in 31 case (29.5%, 95% Cl 20-38) and elevated LDL in 20 cases (19.4%, 95 CI=12-27) ofneovascular AMD.Conclusion: 1- There was an association between high levels of serm triglycerides, cholestrol, LDL and HDL with neovascular (Exudative) AMD.2- An analytic research specially prospective cohort study is recommended.

Purpose: The aim of this study was the evaluation of pathologic reports of orbital tumor biopsies in Farabi Hospital for 11years (1367 - 1377) to determine prevalence of benign and malignant tumors in relation with age and sex and also the evaluation of the result of therapy and prognosis after surgery.Method and material: The research was done over 499 orbital tumors that referred to Farabi hospital, Incisional and exisional biopsies were done. The evaluating of benign and malignant tumors in relation with age and sex was performed.Results: A statistical evaluation on the result of pathological studies of specimens was done, to determine epidemiological incidence of various tumor in different patients. The incidences of the five more common tumors are as follower: dermoid 282 cases (%56.5), (the most common benign orbital tumor), rabdomyosarcoma 39 cases (%7.8) (the most common malignant tumors), pseudo turnor 22 cases (4,4%), hemanfioma 18 cases (3.6%), meningioma 18 cases.

Purpose: To determine the anatomic and functional results of giant retinal tear (GRT) surgery by using perfluorocarbon liquids (PFCL) and silicone oil (SO) tamponade.Materials & Methods: 20 eyes of 20 patients with GRT have undergone classic three port pars plana deep vitrectomy by using PFCL & SO tamponade by the authors during 1996-1999 periods in Farabi Eye Hospital. Five cases were related to high myopia, three had a history of penetrating trauma, five cases had blunt trauma, and in one case GRT occurred after cataract extraction. All the patients were followed for 2 to 36 months after surgery.Results: Anatomic success rate was 80% after one operation & 95% at the end of the study. Redetachment rate was not related to GRT extension or history of trauma, rather it was related to preoperative PVR. Better visual function (visual acuity of 5.200 or better) was seen in 17 patients.Conclusion: Pars plana deep vitrectomy by using PFCL & SO tamponade has a promising result in curing the GRT. PVR is the main factor for redetachment.

Background - Aim: Recently small incision cataract extraction with phacoemulsitication and implantation of foldable I.O.L , using new technique of topical anesthesia has evaluated to decrease cardio respiratory arrests . retrobulbar hemorrhages and globe perforation due to general anesthesia or periocular injections.Materials & Methods: In this study 3 methods of anesthesia (general, local, topical) were investigated on 92 cataractous eyes of patients, at Emam Hossein Medical center in 1994-1995.Results: During routine E.C.C.E, lid and globe movements, globe sensation, miosis and vitrous buldge, were more observedin topical anesthesia than other techniques, but serious complications such as posterior capsule rupture and vitrous loss were not seen.Conclusion: For the sake of less systemic and local complications of topical anesthesia and rapid return of vision and possibility of out patient surgery in cooperative patients without any risks, this method should be considered as an alternative technique to local and general anesthesia.

Introduction: Full vertical rectus muscles transpositions have been shown to be an effective treatment for lateral rectus palsy and type I Duane syndrome. This operation is usually accompanied by mechanical or botulinum toxin treatment of one or both medial rectus muscles, resulting in reduction of adduction & increasing diplopia in that gaze. This serie evaluates the effect of augmented transposition in 22 patients.Methods: Transposition of the vertical rectus muscles to the lateral rectus muscle insertion with augmenting suture was performed in 24 eyes of 22 patients. A lateral fixation suture of 5-0 Dacron polyester filament was placed in the sclera 16mmposteriorto the limbus and adjucent to the lateral rectus muscle, incorporating one fourth of the transposed muscle. Of the 22 pateints, eigth had typel Duane syndrome with a face turn & esotropia in the primary position, three had bilateral lateral rectus muscle palsy, nine had unilateral lateral rectus muscle palsy and one had mobius syndrome.One had recurrent esotropia after the last vertical muscle transposition.Results: In most patients (17.22 patients), alignment was achived or deviation was remained less than 10 prism-diopter of esotropia. Among the patients with type I Duane syndrome the average amount of deviation was reduced to 85%, in bilateral lateral rectus palsy to 96%, in unilateral lateral rectus palsy to 87.5%, in mobius syndrome & delayed augmenting suturing to 100%, face turn in all patients with type I Duane syndrome was decreased. Diplopia- free visual field was increased in all of the patients & no limitation of adduction was seen. Usually abduction tonic force increased+1 to +2. Induced vertical deviations in primary position were uncommon (4.22 patients). Significant lid fissure changes were not seen. Botulinum toxin injecting to the ipsilateral medial rectus muscle was not a limitation for augmented Trans position operation.Conclusion: Vertical rectus muscles transposition to the insertion of the lateral rectus muscle with augmenting suture in type I Duane syndrome, unilateral& bilateral lateral rectus palsies& mobius syndrome improves tonic abduction force & decreases angle of deviation without compromising adduction.

This study has been conducted to investigate the factors influencing the incidence of the diabetic retinopathy, such as the duration, preprondial glycemia hyperlipemia, age, use of tobacco, and type of the diabetes.264 patients (110 males, and 154females), having type I and II diabetes have been included in this study. The patients had been referred to the diabetes ophthalmologic clinic of the shariati hospital. To analyse the datas we have used the soft ware SPSS and chi-2, Fisher and calculation of the odd valuses.Among our patients 247 had type II and 17patients had type I diabetes.63 patients had diabetic retinopathy. The mean-age of the patients with retinopathy was 56.39 years and those without retinopathy was 50.58, p=0.006 and the mean preprendial glycemia in the first group was 224.83 mg and 198.19 mg in the second group, p=0.036, but there was no statistical difference in the diastolic pressure, H.D.L., L.D.L., Total chol., TG, chol/HDL.In this study has been showed that the men with more than five years of diabetes are more disposed to have retinopathy, and the longer the disease the resk of the retinopathy increases, and also this study confirms the influence of the glycemia, blood pressure, in the onset and progressionof the retinopathy.

Purpose: To identify demographic factors related to increased risk of ocular injuries presented to yazd (ED), planning and provision of eye health care and safety strategies for the prevention of eye trauma.Methods: A descriptive cross sectional study for 500 consecutive patients who presented with eye complaints to (ED) of Yazd Shahid Rahnemoon Hospital over a 4 months period. Common ocular diagnosis and associated variable were assessed.Results: From a total 500 patents 87.8% injuries occurred in men. With a peak age in third decades (29.4%) and highest incidence of work - related injuries in 19-29 years old. Mean age was 29.8 years (Range 1.25-92 years). Diagnosis was grouped as trauma with and without foreign body (77%) and non trauma (23%). The most common type of injury was superficial corneal foreign body (43%). Men had a higher incidence of eye injury than women across all ages.Conclusion: Ocular trauma remains an important cause of avoidable and predominantly mono ocular visual morbidity; and represented 15%wor related injury that is highly preventable by the correct use of safety eye- ware. Health education on the preventive aspects of ocular injuries in schools as well as in industrial working centers place should reduce the incidence of visual loss due to ocular injuries.

Introduction: The normal conjunctival flora consists of bacteria, viruses, protozoa I and fungi, among which bacterias are the most common.The normal flora and the host have a mutual relationship. Currentlythere is no data: available regarding normal conjunctival flora in our society.Material and methods: This discriptive study was done on 139eye of 139 patients that were admitted to farabi eye hospital for cataract surgery in the contralateral eye.Exclusion criteria were systemic disease, ocular disease, topical and systemic antibiotic usage. The conjunctival cultures of all cases were done by one laboratory.Findings: Out of 139 patiants 75(53.9%) were males and 64 (46.1) were females. 70 (50.3%) right eyes and 69 (49.7) left eyes were studied.Positive cultures were obtained in 72 (51.7%) the remainder 67 (48.3%) were culture negatives.The most common microorganisms in order of the frequency were staphylococcus epidermis, Diphteroids, a combination of Diphteroid and Staphylococus, Staphilococus aureus eye and Streptococus positive cultures were correlated with increased ages.Right and left eye had no significant difference in rate of positive cultures.Discussion and conclusion: Our results confirm to other retrences the most common organism was Staphylococcus epidermis.Sex and laterality did not affect the rate of positive cultures; however there was significant correlation between age and positive cultures.All patients underwent uncomplicated ECCE+PCIOL in the fellow eye.Mean post operative follow -up was one year and no complications related to the microorganism were observed. Considering this tast, we should question the source of such complications.

In the present paper we describe treatment of three patients with acute retinal necrosis syndrome.Three patients suffering from pain, redness and blurred vision referred to the emergency unit in Farabi Hospital.Initial examination in all patients revealed tenderness and marked inflammation, there was severe inflammation both in the anterior chamber and vitrious cavity. There was peripheral retinitis, vitritis and occlusive vasculitis in all patients.Optic nerve involvement and hypopion occurned in two patients. Three patients were treated with intravenous acyclovir (1500 mg/m2/day), oral corticosteroids and aspirin (500 mg/day). In two patients retinal detachment in occurred 1-2 months after initial presentation of the syndrome which treated with vitrectomy/ fluid gas exchange/ endolaser/ silicon injection.During the follow up period, three patients improved vision and the fellow eyes were not involved.