[Incidence, severity and risk factors for retinopathy of prematurity in premature infants with late retinal examination]

To determine the incidence, severity and risk factors for retinopathy of prematurity [ROP] in premature infants with late retinal examination at Farabi Hospital from 2001 to 2006. In a cross-sectional study, hospital records of premature infants who were examined later than 9 weeks after birth were reviewed for possible risk factors of ROP including gender, singleton or multiple gestations, gestational age [GA], birth weight [BW], oxygen therapy, blood transfusion, phototherapy, and respiratory distress syndrome [RDS], as well as the age at initial examination. From 693 infants referred for ROP screening, 191 [27.6%] had late retinal examination at mean age of 144.8 +/- 158.4 [range 64-1460] days. Of these 191 infants, 75 [39.3%] had different stages of ROP, 58 [30.4%] had stage 4 or 5 disease and 27 [14.1%] had stage 5 ROP in both eyes which were untreatable. GA and BW were associated with development of ROP [P<0.001]. The high prevalence of premature infants with late retinal examination and high incidence of severe ROP necessitates prompt intervention to optimize referral and early screening of premature infants

[Intravitreal triamcinolone for treatment of refractory diabetic macular edema]

To determine if intravitreal injection of triamcinolone acetonide is safe and effective in the treatment of diabetic macular edema unresponsive to prior laser photocoagulation. Fifty-four eyes of 38 patients with clinically significant macular edema which had received at least two sessions of laser photocoagulation according to Early Treatment Diabetic Retinopathy Study guidelines were enrolled in this study. At least four months after laser therapy; eyes with residual central macular thickness [CMT] greater than 250 microm on optical coherence tomography [OCT] and visual loss from baseline were offered intravitreal injection of 4 mg triamcinolone acetonide. Visual and anatomic responses as well as complications related to the injection procedure and corticosteroid medication were observed. Mean baseline best corrected visual acuity [BCVA] and CMT were 0.77 +/- 0.5 LogMAR and 443 +/- 138 microm, respectively. All patients completed one month of follow up and 39 of 54 eyes [72.2%] completed 6 months of follow up. Mean BCVA was 0.64 +/- 0.45, 0.56 +/- 0.48, and 0.79 +/- 0.55 LogMAR at months 1, 3, and 6, respectively. Central macular thickness measured by OCT decreased by 39% and 23.5%, at the third and sixth month visits, respectively. Intraocular pressure exceeded 21 mmHg in 36.3% of the eyes. Cataract progression was noted in 12.8% of phakic eyes. Intravitreal triamcinolone seems a promising therapeutic method for diabetic macular edema refractory to conventional laser photocoagulation without any significant complication, however the effect seems to be temporary. Further studies are warranted to assess the long-term efficacy and safety and also the need for retreatment

[Frequency and severity of retinopathy of prematurity: singleton versus multiple-births]

To determine the frequency and severity of retinopathy of prematurity [ROP] among singleton and multiple-birth neonates referred to Farabi Eye Hospital, Tehran-Iran. We reviewed the records of 99 consecutive neonates from multiple-gestation pregnancies including 68 twins, 26 triplets and 5 quadruplets who were screened for ROP during 2002-2004. The frequency, severity and risk factors of ROP were determined. The results were compared with a group of singletons who did not differ from the multiple-birth group regarding birth weight, gestational age, oxygen therapy, respiratory distress syndrome, transfusion, sepsis, phototherapy and gender. ROP was present in 12.1% of multiple-birth neonates compared to 15.1% in singletons [P=0.53]. Threshold ROP was present in 6.1% of multiple-birth neonates and 7.1% of singletons [P=0.62]. ROP was detected in 60% of quadruplets vs 9.6% of twins and triplets with threshold disease in 40% of quadruplets compared to 4.2% in twins and triplets. Logistic regression analysis revealed no statistically significant differences in frequency and severity of ROP among subgroups of multiple-gestation pregnancies [P= 0.79]. The higher frequency of ROP among multiple-birth neonates is due to lower birth weight and gestational age but there is no significant difference between multiple-births and singletons in terms of frequency and stages of ROP. Screening for ROP in multiple pregnancy births may be conducted according to the same standard protocols as for singletons

[Prevalence and risk factors of retinopathy of prematurity in very low birth weight or low gestational age infants]

To determine the incidence of retinopathy of prematurity [ROP] and to evaluate the possible neonatal risk factors for ROP. This cross-sectional study included all premature infants born at hospitals affiliated to Tehran Medical University, Tehran-Iran who were referred within 4-6 weeks after delivery to Farabi Eye Hospital from 2004 to 2005. Inclusion criteria were birth weight [BW] < 1500 g or gestational age [GA] 32 wk who may be at high risk for ROP should also be screened

[Diffuse lamellar keratitis induced by corneal foreign body 9.5 months after laser in situ keratomileusis]

To report a case of diffuse lamellar keratitis [DLK] 9.5 months after laser in situ keratomileusis [LASIK] associated with a corneal foreign body. A 32-year-old male developed DLK two days after removal of an intraepithelial corneal foreign body 9.5 months after noncomplicated LASIK. DLK was eliminated after two weeks of topical steroid application and visual acuity returned to the previous level. Post-LASIK eyes may develop DLK triggered by corneal foreign bodies for a long time after the procedure

Vitrectomy for diffuse refractory diabetic macular edema associated with a taut premacular posterior hyaloid

To evaluate the anatomic and visual results and complications of vitrectomy in eyes with diffuse refractory diabetic macular edema associated with a taut posterior hyaloid. This prospective interventional case series was conducted in 25 eyes of 22 patients with diffuse clinically significant diabetic macular edema, macular thickness greater than 250 microns on optic coherence tomography [OCT] and thickened posterior hyaloid. Best-corrected visual acuity [BCVA] and macular thickness measured by OCT were evaluated preoperatively and 3 and 6 months postoperatively. Macular perfusion was evaluated by fluorescein angiography, preoperatively. Mean BCVA was 1.14 +/- 0.51 LogMAR, preoperatively and 0.89 +/- 0.53 LogMAR 6 months postoperatively [P=0.005]. Mean preoperative macular thickness was 506 +/- 121.9 micro m which decreased to 318 +/- 90.5 micro m, postoperatively [P=0.001]. Vitrectomy with removal of the posterior hyaloid membrane appears to be beneficial in some cases of diffuse persistent diabetic macular edema with a taut premacular posterior hyaloid unresponsive to laser therapy. Careful selection of eyes with favorable preoperative clinical characteristics may improve surgical outcomes

Household ocular injuries: a case series

To determine the nature and types of household eye injuries. We prospectively analyzed data from 100 consecutive patients with household eye injuries [104 eyes] referred to emergency room of Farabi Eye Hospital during October2003. Standardized international classification of ocular trauma [Birmingham Eye Trauma Terminology] was used for classification. Household ocular trauma represented 4.85% of all ocular emergencies [2061 patients] referred to the emergency room during that period. Male to female ratio was 1.13 and mean age was 26 +/- 18 years [range, 1-73]. The cornea was involved in 50.0% and the sclera, lens, and retina each was involved in 4.8%. There was severe visual loss [best-corrected distance visual acuity <20/200 due to trauma] in 4% of the patients. The most frequent household ocular injury was globe injury [93.7%] including mechanical [72.1% closed and 4.8% open], chemical [14.4%] and thermal [1.9%] injuries. Closed mechanical injuries were the most common type of household ocular injury in our series. Considering the high rate of household eye trauma, more effective preventive measures should be taken at home