ABSTRACT
To compare anterior segment and ocular biometric parameters of unaffected fellow eyes of patients with a previous attack of acute angle closure [AAC], primary angle closure suspect [PACS] eyes, and normal eyes; and to assess the risk of developing AAC in PACS. In this prospective comparative observational case series, 16 unaffected fellow eyes of patients with a previous attack of AAC [group I], 40 PACS eyes [group II] and 32 normal eyes [group III] were evaluated. Pentacam and A-scan echography were performed in all cases. Anterior chamber angle [ACA], anterior chamber volume [ACV], anterior chamber depth [ACD], central corneal thickness [CCT], keratometry [KR], lens thickness [LT] and axial length [AL] were measured in all eyes as main outcome measures. Age, CCT and LT were comparable among the study groups [all P values>0.05]. Mean ACA was 24.8, 22.9 and 35.4 in groups I, II, and III respectively [P<0.001]. Corresponding values for ACV were 72, 76 and 172 microl, respectively [P<0.001]. Central ACD measured from the endothelium was 1.80, 1.91, and 3.09 mm in groups I, II, and III respectively [P<0.001]. Using receiver operating characteristic [ROC] curves, ACV
ABSTRACT
To compare the success rate of mitomycin-C Versus bevacizumab for prevention of bleb failure following phacotrabeculectomy. In this study 74 eyes of 69 patients with uncontrolled IOP, progressive visual field loss and cataract were randomized in two groups. In the first group, after conjunctival peritomy at the sclera flap site, sponge pats soaked in mitomycin C with concentration of 0.25mg/ml were applied for 3 minutes. In the second group, bevacizumab with concentration of 1.25mg/0.5ml was injected adjacent to the bleb at the end of surgery. Seventy four eyes of 69 patients including 41 men and 28 women with mean age of 66.92 +/- 9.8 years and 64.57 +/- 8.8 years in either study group respectively were included. Data collected from 6 to 12 months after surgery were analyzed. Mean intraocular pressure in the bevacizumab group was significantly higher than the MMC group [15.91 +/- 4.9 mmHg vs 12.76 +/- 3.1 mmHg, P= 0.001] at 6 months and [15.76 +/- 3.26 mmHg vs 13 +/- 2.4 mmHg, P= 0.003] at the end of 12 months. Bleb characteristics including extension, elevation and vascularity showed no significant difference between two groups. [P values 0.94, 0.93, 0.41 after 6 months, and 0.56, 0.58, 0.89 after 1 year of follow up respectively]. One eye in the second group underwent trabeculectomy because of uncontrolled IOP despite using 3 antiglaucoma medication. One eye in each group underwent bleb revision due to failing bleb. No sides effects related to the medications were noted in any of the two groups. Mitomycin C is more effective than bevacizumab for IOP control after phacotrabeculectomy; however, there is no difference between the two agents in terms of bleb characteristics and side effects
ABSTRACT
Altered thyroid function in patients with non-thyrodial illness is a usuall finding and these biochemical changes called sick euthyroid syndrome [SES]. Our propose from this research is to estimate the relative frequency of SES and prognostic relevance of alteration in thyroid function indices in critically ill patients whom admitted in ICU. This prospective analitical study was preformd in Imam Reza Hospital intensive care unit patients. A specimen of venous blood was collected within the first 24 hours of admission for the evaluation of the baseline thyroid function indices and second specimen was collected at the time of patient death or discharge from ICU. T4, T3 [RIA] T[3] RU [RIA method], TSH [IRMA] and free T[4] [Direct one step RIA] were measured for all patients There were 29 males and 21 females, with age range of 16 to 83 years and mean age of 44 years [ 44+21.9]. Thirthy three patients [66%] showed evidence of SES and 17 patients [34%] were as non SES group. Mortality rate in SES and non -SES group was 24 and 3 patient respectively [72% vs. 17.6%, P < 0.01]. The commonest profile of thyroid indices was isolated low total T[3] [type I SES], and then combined low total T[3] and T[4] [Type II SES]. We found low [T3] [type I] in 51% of patients, and low T[3] and T[4] [type II] in 49% of them Relative morality rate have not any difference in two groups. Comparison of mean values of thyroid indices between single system and multi system illness groups showed statistical difference in TSH [P= 0.05] and FT4. [P=0.031] Comparison of thyroid indices between two survived and non survived group showed statistical difference in T3 [p = 0.047] and T[4] [P=0.036].Predictive value of normal T3 with good outcome measured 82% against 54% for normal T4. Relative frequency of SES in our patients was 66% and in them thyroid hormones have statistical relation with final outcome and severity of underling illness