[Clinical evaluation of drug induced acute angle closure glaucoma]

To evaluate all cases of drug induced angle closure glaucoma cases who presented to Feiz Hospital, Isfahan during 2008-2010. In this retrospective case series, we present 7 cases of drug induced angle closure glaucoma after administration of Topiramate. All patients were female. The average age of patients was 33.28 years old [ranging from 19 to 44]. With sufficient corneal clarity, mean BCVA was 20/400 and mean refractive error was -6.50 [rang -3.00 to-12.00] diopters. Mean intraocular pressure was 44.71 [rang 34 to 60] mmHg. Mean time normalization of intraocular pressure was 12.30 [rang 8 to 23] hours. Acute myopia and acute angle closure glaucoma are serious adverse effects of Topiramate, both of which are reversible with immediate discontinuation of the drug. So, taking a complete drug history and thinking about culprit drugs is critical in the evaluation of such cases

[Postoperative pain after cooling PRK]

To compare post-operative pain with cooling photorefractive keratectomy [PRK] versus conventional PRK. A prospective clinical trial was performed on 94 eyes from 47 patients scheduled for PRK. Patients were randomly assigned to either cooling or conventional PRK. Pain was evaluated 6, 12, 24 and 48 hours post-operation using a visual analogue scale [VAS]. Corneal haze, conjunctival and palpebral edema, and complications were also assessed. Mean age of the patients was 24.8 +/- 4.5 [range: 18-36 years] and mean refractive error was 3.6 +/- 1.6 diopters. Median pain score in the cooling group at 6 and 12 hours was 15 and 10, respectively and zero at 24 and 48 hours. Median pain score in the conventional group at 6 and 12 hours was 30 and 15 and was zero at 24 and 48 hours. There was no adverse effect in either of the groups. Cooling PRK effectively reduces post-operative pain after PRK without any additional adverse effect

Correlation between red blood cell membrane fatty acids and plasma lipids with clinical severity of retinitis pigmentosa

Retinitis pigmentosa [RP] is an inherited retinal dystrophy caused by the loss of photoreceptors and characterized by retinal pigment deposits visible on fundus examination. Low red blood cell membrane fatty acid content e.g. docosahexaenoic acid [DHA] in retinitis pigmentosa may influence retinal function. The aim of this study was to evaluate red blood cell membrane fatty acid content and plasma lipid levels and determine their associated effects on the severity of disease. In a comparative cross-sectional study, 35 males and 16 females with RP [mean age= 35.7 years] were evaluated. Red blood cell membrane fatty acid content [DHA] and plasma lipid levels were measured as well as visual acuity and field. Both visual acuity and visual field were significantly associated with red blood cell membrane fatty acid content [DHA] [P<0.05]. However, the plasma lipid levels, except of total cholesterol, were not associated with visual acuity and visual field of RP patients [NS]. Current survey showed a significant association between severity of RP and fatty acid content [DHA]

[Stereoacuity after LASIK]

To evaluate the effect of laser in situ keratomileusis [LASIK] on stereoacuity [SA]. In this prospective study, 200 patients scheduled for LASIK were evaluated for SA preoperatively and one week and one and three months postoperatively by Random Dot test. Patients with preoperative SA worse than 480 sec/arc were excluded. Patients included 138 female [69%] and 62 male [31%] subjects. Spherical equivalent was between -0.5 and -12.0 D. Mean preoperative SA was 124.80 +/- 124.64 [range 480-15] sec/arc which deteriorated to 138.30 +/- 126.48 sec/arc one week after surgery [P= 0.158] and improved to 111.30 +/- 112.15 sec/arc [P=0.002] one month and 103.65+112.20 sec/arc [P=0.001] three months postoperatively. Patients with anisometropia had lower SA. Eventually, SA increased in 5 nonamblyopic anisometropic patients. Overall, stereoacuity decreased in 9.5%, increased in 32.5% and remained unchanged in 58% of patients [P=0.007]. Despite the overall improvement in mean SA after LASIK, a considerable number of patients experienced decreased SA. It seems that anisometropic patients without amblyopia have a higher chance for improvement in SA