JOURNAL OF CURRENT OPHTHALMOLOGY
Year:2000 | Volume:12 | Issue:1-2|Papers Count:13

Purpose: This study has been conducted to determine the effect of the time of beginning of appropriate treatment of ocular complications of Behcet's disease.Materials & Methods: The study has been performed on 200 patients with ocular Behcet's disease. In one group (35 patients) early treatment and in the other group late treatment (after 3 month) was undertaken. Visual acuity and ocular complications such as cataract, episcleritis, uveitis, retinal vasculitis, optic atrophy and macular edema was determined in each group and the result was statistically analyzed between two groups. Results: 58/5% of patients were male. The mean age of patients was 34 yr the duration of follow- up was from 3 month to 4 yr. with the mean of 32/5 month. The duration of ocular symptoms before the first visit was from 3 month to 26 years (with the mean of 59.4 month) 82.5% of patients had ocular symptoms before referring to ophthalmologist. There was a statistically significant relationship between visual acuity loss and the occurrence of cataract, retinal vasculitis, optic atrophy and macular edema with delayed treatment in ocular Behcet.Conclusion: Early treatment in ocular Behcet's disease can significantly improve the visual outcome and also can lower the incidence of ocular complications.

Aim: To investigate the effect of thymogen on the rate and the rapidity of the healing of ocular burns.Material and methods: The effect of the thymogen on the ocular burns of the 2-nd and 3-d degrees has been investigated on 80 patients. 78.7% presented chemical burns, 15% thermal and 6.3% thermochemical burns. The patients were divided in three groups: the first group received the intramuscular injection of thymogen, the second group received the intramuscular and subconjunctival injections of the thymogen, the third group received no thymogen, but the conventional therapy (control group).The immunological investigations included: the definitions of the relative and absolute common quantity of T-lymphocytes in the peripheral blood by the method of the spontaneous rosette formation with the sheep's erythrocytes, active T lymphocytes, T-theophylinesensitive E-POH1 possessing, by the suppressible and E-POH2- helper prosperities, relative and absolute numbers of B-Iymphocytes.Results: The use of the thymogen, increased the control of the immunocompetent cells, removed the lymphopenia, stimulated Tcelluar link of the immunity, increased the active T lymphocytes, normalized the B-cell content, restored the humeral immunity reaction. The combined application (intramuscular and subconjunctival) was more effective in reducing the healing terms of the corneal burn wound.Conclusion: Thymogen was effective in the rapidity and the rate of the burn healing. It was more effective when applied intramuscularly and via subcon-junctival injections.

Aim: To investigate the outcome of the retinal vasculitis in adults & children, men and women.Material & Methods: In this retrospective, descriptive study which has been conducted from 1996-98at the shariati hospital of Tehran behcet's unit), all the patients with complete behest's disease & ocular involvement who have consulted, the eye clinic have been investigated. The eyes have been examined. The files of the patients have been reviewed and summarized. The patients who could be completely examined and had at least one year of ocular manifestations were selected and 245 files were randomized. The findings were compared with student T test.Results: 81.22% of the patients had retinal vasculitis. In the adult population (over 20 years) 83.8% and in the young population (20 years or less) 73.3% of the 60 patients had vacuities. In the 146 males 85.2% & in the 99 females 73.7% had retinal vasculitis. In the adult-males (112 cases) 89.3% and in the adult-females (73 patients) 75.3% had retinal vacuities.The final vision in 34% of the eyes of the adults and 21% of the children, in 38% of the adult-males and 27% of the adult-females was less than 1/10 optic atrophy & vascular necrosis was more common in the eyes of the adult-males 30% compared with adult-females 16.3% these lesions were more frequent in adults 25% than children 20%. Conclusion: Retinal vasculitis was observed in 81.2% of the patients. Vasculitis was more frequent in adults than children P=<0.05 & it was more frequent in adult males than adult females P=<0.001 vascular necrosis and optic atrophy was more common in the adult-males compared with adult-females P=<0.01 normal macula and good vision was more common in the patients without vasculitis P=<0.002.

Six eyes of 4 patients with anterior megalophthalmos, 2 men and 2 women raining in age from 32 to 47 years, had extracapsular cataract extraction or phacoemulsification and standard posterior chamber intraocular lens implantation. All had a family history of anterior megalophthalmos.Follow-up was from 6 to 30 months. All patients had a preoperative visual acuity of worse than 20/60, which improved to 20/20 in 5 eyes. Zonular dehiscence was observed during surgery in 3 cases, leading to vitreous loss in I case that developed retinal detachment after 3 months.

Phacoemulsification (P.E) is being used increasingly for cataract surgery. To compare the result and complication of P.E. with standard extra capsular cataract extraction by nucleus expression technique and the role of patient selection resulting in complication during P.E. this study was under taken at a private clinic during 1995-1998. Material and method: The method of this study was Cohort study. In senile cataract patients the cataract was classified in to two groups. First group underwent standard cataract surgery and second by P.E. treatment and follow up schedule was same for both groups. Results: Three hundred and seven eyes were operated, two hundred and seven by nucleus expression and hundred eyes by P.E. average age of patients in group I was 70+/- years and group II, 57+/- years. Preoperative VA was 20/40 or less in 99% of group I patients and 100% of group II patients.Post-operative corrected VA in 71% of group I was 20/30 or more and in group 11,87% of patients had this VA. Pre-operative astigmatism in group I was 1.50 diopters and in group II, 0.95 diopterswhich at 4 months postoperative period was one and 1.10 diopters. The most common complication during surgery in group one was vitreous loss in 1% of patients, which did not occur in group II. Post-operative complication in group I included CME in 5%, sterile uveitis in 4%, endophthalimitis and retinal detachment in 0.5% of patients. In group II, CME and sterile  uveitis in 1% and no incidence of retinal detachment and endophthalmitis. Conclusion: P.E. and extra capsular cataract extraction by nuclear expression are both effective procedures with fewer complications for senile cataract. Patient selection during early clinical examination plays an important role in decreasing incidence of complications in P.E. the degree of astigmatism after four months of operation is almost equal in the two methods.

Background & Purpose: In previous studies success rates of BLRree. and R& R surgeries on. basic exotropic patients have been reported 43-79% and 82% respectively. The aim of ibis study was comparison of these two techniques of surgeons on our XT. patients at Imarn Hossein Medical Center.Method & Pantients: After filling up personal and family characteristics form, complete eye examinations (B.C.V.A- Cycloretfaction- EOM- XT at 6m and 33 cm - slit and funds exam) were performed. Measurements were repeated at least 1.5 months after surgeries. Because of lower vision in R&R group, 5 pd more surgery were done to stabilize the deviated eye after operation. The patients were matched (range of age, sex, S.E of reflection, sergeon, followup). The results were interpretated by T, paired T and x and fisher tests.Results: 26 patients were in BLRree. and 21 pts. Were in R&R group. Their ages were 9±7 and 19±9 years, preop xT were 29±8 and 36±17 which decreased to 5±7 and 5±10 pd respectively. Success rates of these techniques were not different statistically. In BLRree. Group 69%,ortho (+8 pd) 27% under and 4% over and In. P&R group 81% ortho, 14% under and 5% over were seen.Conclusion: In our study these two methods of surgeries had no different statistically. More success rate in R&R group (81%) was due to both effects of 5 pd more operation and stabilizing effect of MR Rec.against it's direct antagonist muscle recession.

Purpose: Considering the popularity of cataract surgery throughout the country and lack of ultrasound biometry facilities in some regions, this study was designed to compare results of IOL power calculations by refraction- based formulas with those obtained by ultrasonographic biometry as the gold standard.Patients & Methods: This is a diagnostic clinical trial performed at Farabi Eye Hospital on 100 eyes in 50 cases in whom refraction was feasible during 1999. Each patient underwent refraction, and ultrasound biometry.Thereafter IOL calculations were done based on the SRK II formula and the two following refraction-based formulas and finally compared.Formula I: PC IOL Power =20+45-MK-------------3+SE-----------3+2 (11.5-VID)MK=Mean keratometry SE = Spherical EquivalentVID= Visible Iris DiameterFormula II:PC IOL= 18±1.6 ( SE)            PowerResults: Mean difference between figures obtained by formula I and biometry was 1.30±0.90. Corresponding figure for formula II was 3.55±1.10 In emmetropic cases (with in ±0.5) of true emmetropia), average PC IOL calculation based on biometry was 21.20 D. Conclusion: Formula I yields better IOL calculations than formula II when compared with ultrasound biometry provided that the refractive status of the eye prior to cataract surgery is known.

This study was designed to determine the success rate of goniotomy in primary congenital glaucoma. Additionally age, sex, family history and parent consanguinity were evaluated.25 patients (39 Eyes) were enrolled in this retrospective (existing data) study. All patients had clear corneas and were operated by 2 surgeons conforming to standard goniotomy from March 1993 to march 1998 at Farabi Eye Hospital.Results: Complete success was defined as IOP<21 mm Hg without medication, accordingly 12 eyes (30.7%) were well controlled with goniotomy performed once and 5 eyes (12.9%) with the procedure repeated a second time. The failure rate was 56.4% (22 Eyes) which led to trabeculectomy with mitomycin. Failure cases were mostlyless than 1 month or more than 1 year of age.The mean follow-up period was 24 months (range 4-60 months). There was a 3:2 male to female ratio. 20% of our cases had a positive family history of congenital glaucoma and in 20% the patients were related.Discussion: Compared to other studies, our success rate of 43.5% with goniotomy performed once or twice is much lower. There are two possible explanations. Either age related reasons, since 9 patients (23%) were under 1 month of age (failure rate 77.89) and 3 patients (12.8%) Were older than 1 year (60% failure rate), or differing angle anomalies in our series due to racial differences. The latter needs further investigations.

Purpose: To evaluate the effect of suture less frown cataract incision on induced astigmatism.Methods and materials: 54 eyes of 50 patients were examined preoperatively and at one week, 1 and 3 months after surgery in a clinical trial. Visual acuity, keratometry and refraction were obtained for all eyes at each visit. Results were analyzedm by paired t- test. P valueless than 0.05 were considered statistically significant.Results: preoperative astigmatism (calculated by subtraction method) was 0.62±0.55 D. and reached 0.72±0.56 D. at 3 months. Preoperative K reading was 44.68+1.64 D. @ 90 and 44.63±1.44 D. @ 180° Equivalent values 3 months after surgery were 44.10±1.56 D.@ 91° and 44.60±1.44 D. @ 183° Astigmatism, calculated by Naeser method was -0.008+0.009 which reached -0.44±0.61 at 3 months. Conclusion: small incision suture less cataract surgery via frown shaped scleral tunnel induces a small amount of against-the-rule astigmatism.

Objective: To introduce the clinical features of seven patients with diagnosis of retinal vasoproliferative tumors.Patients and Methods: Seven patients with clinically and angiographically confirmed retinal vasoproliferative tumors were included in the study.Results: Three patients with solitary mass of vasoproliferative tumors at peripheral retina and 1 patient with posterior pole vascular mass in coat's disease were treated with laser photocoagulation of ischemic retina and vasoproliferative tumor. One patient with chronic rhegmategonous retinal detachment developed peripheral vasoproliferative tumor. Clinical findings were inferior retinal dialysis with retinal macrocyst and demarcation line associated with localized retinal exudation around peripheral vasoproliferative retinal mass. two brothers with retinitis pigmentosa associated with vasoproliferative tumor are also reported.Conclusion: Retinal vasoproliferative tumors may be the cause of significant visual problem by macular exudation. It is a benign elevated lesion that may regress after treatment of underlying ocular disease.Proper diagnosis and differentiation of these masses from other retinal vascular lesions is clinically important.

Purpose: To report a case of bilateral choroidal osteoma with SRNM in a young female.Methods and Material: A 19 years old female presented with decreased visual acuity in the left eye. In funds examinational peripapillary: subretinal yellow-orange tumor was fund in both eyes. We found subretinal hemorrhage in left eye.Result: Echography showed typical findings usually described for choroidal osteoma in both eyes which are pseudo-optic nerve appearance in B Scan and high reflectively in A Scan. There was an ill-defined SRNM on fluoresecin angiography and rediopaqe density on C.T. Scan.Conclusion: Choroidal osteoma is an exceedingly rare tumor which usually involves unilaterally and has a female predilection. It usually has a minimal tendency for growth and qccasionally has neovascularization.This case was especially exceptional due to its bilaterally, its large size in one affected eye, and its neovascular characteristics.