[Photodynamic therapy for vasoproliferative tumors and capillary hemangiomas of the retina]

To evaluate the results of Verteporfin photodynamic therapy [PDT] in vasoproliferative tumors [VPT] of the retina and retinal capillary hemangiomas [RCH]. In a retrospective case series, 6 tumors in 5 eyes with VPT, and 3 RCH in 3 eyes underwent PDT which was performed using intravenous Verteporfin. Eyes were evaluated for tumor regression, final bestcorrected visual acuity [BCVA], and final retinal status. Patients were followed for a mean period of 7.1 +/- 3.9 months. Mean number of PDT sessions for each tumor was 1.33 [range 1-2]. Overall, mean BCVA improved from 1.7 +/- 1.06 to 0.88 +/- 0.8 logMAR [P=0.017]. Tumor thickness decreased from 3.53 +/- 0.83 to 1.73 +/- 0.73 mm [P<0.001]. Subgroup analysis revealed improvement in BCVA and tumor thickness in the VPT group [P=0.04]. However, in the RCH group, there was no statistically significant improvement in BCVA [P=0.43] despite significant reduction in tumor thickness [P=0.024]. A favorable outcome characterized by improved or unchanged visual acuity was achieved and the tumor regressed in all eyes. Subretinal fluid was absorbed in all eyes except for one eye with preoperative proliferative vitreoretinopathy. Vasoproliferative tumors and retinal capillary hemangiomas can be treated effectively by Verteporfin PDT and a favorable outcome can be expected

[Carotid wall thickness in patients with acute unilateral nonarteritic anterior ischemic optic neuropathy]

To compare ipsilateral and contralateral carotid wall thickness in patients with acute unilateral non-arteritic anterior ischemic optic neuropathy [NAION]. This prospective case series included 17 [10 male and 7 female] patients with unilateral NAION of less than 8 weeks' duration who underwent B-mode ultrasonography to measure intima-media thickness [IMT] in the common carotid and internal carotid arteries. IMT values of the affected side were compared with those on the contralateral side. Mean patient age was 59.6 +/- 10.8 [range 45-74] years. Mean interval between onset of NAION and measurements was 27.6 +/- 13.2 [range 10-45] days. Mean IMT of both common and internal carotid arteries on the affected side [1.19 +/- 0.14 and 1.41 +/- 0.29 mm, respectively] was significantly [P<0.001] higher than the noninvolved side [0.92 +/- 0.11 and 0.83 +/- 0.2, respectively]. NAION may be accompanied by increased carotid wall thickness. Carotid wall thickness measurement using ultrasound in patients with NAION may be useful to identify concomitant carotid artery disease

[Vitrectomy for complications of branch retinal vein occlusion]

To evaluate the outcomes of vitrectomy for complications of branch retinal vein occlusion [BRVO]. This retrospective study, included patients who underwent vitrectomy surgery due to the complications of BRVO over an 11-year period. Visual acuity and retinal condition were evaluated before and after surgery. The study included 30 eyes of 30 patients with mean age of 64.7 +/- 10.92 [range 41-85] years. Vitrectomy was performed for vitreous hemorrhage in 23 eyes [76.6%], for tractional macular detachment in 5 eyes [16.6%] and for combined tractional macular detachment and vitreous hemorrhage in 2 eyes [6.6%].The patients were followed for a mean of 15.43 +/- 12.5 months [range 6-60 months]. Visual acuity improved from 2.6 +/- 0.66 to 0.92 +/- 0.75 LogMAR after operation [P<0.001]. Visual improvement was significant in vitreous hemorrhage group [P<0.001], however, it was not significant in the other two groups [both Ps= 0.1]. Visual acuity remained unchanged in 2 patients and decreased in two other patients. The most common cause of vitrectomy for complications of BRVO was vitreous hemorrhage. Patients with tractional macular detachment with or without vitreous hemorrhage had less improvement in visual acuity in comparison to patients with vitreous hemorrhage alone

[Comparison of ophthalmic artery velocity in eyes with NAION and normal fellow eyes]

To compare ophthalmic artery velocity in eyes with nonarteritic anterior ischemic optic neuropathy [NAION] with that of normal fellow eyes. In this case-control study, 20 patients with unilateral NAION and disease onset less than 8 weeks, were enrolled. Using color Doppler imaging, mean, maximum systolic and end diastolic ophthalmic artery velocities were evaluated. The results were compared between the fellow eyes. Twelve men and 8 women with a mean age of 54.6 +/- 11.8 years were included. Mean interval between disease onset and velocity measurements was 27.5 +/- 12.8 days. Mean [18.5 +/- 0.8 vs 19.9 +/- 2.8], maximum systolic [37.9 +/- 4.09 vs 39.7 +/- 3.1] and end diastolic [10.3 +/- 2.1 vs 12.3 +/- 2.5] ophthalmic artery velocities in NAION eyes were significantly less than that of the normal fellow eyes [P=0.01, P=0.001 and P<0.001, respectively]. No significant difference was found in subgroup analysis of patients with and without diabetes, and with and without systemic hypertension. NAION seems to be associated with changes in ophthalmic artery velocity

[Evaluation of the safe dose of intravitreal bevacizumab in rabbit eyes]

To evaluate the safety of different doses of intravitreal bevacizumab in rabbit eyes. Twelve eyes of 6 rabbits underwent intravitreal injection of 5, 7.5 and 10 mg of bevacizumab. In each rabbit, one eye was considered for bevacizumab injection and the fellow eye served for either placebo injection or observation. All eyes were examined before and I, 2, 3, 7, 14 and 28 days after intravitreal injections. Electroretinography [ERG] was performed before and 14 days after the injections. 28 days after the injections, all eyes were enucleated and examined with light and electron microscopy. In the clinical examination, significant vitritis was observed in one of the 10 mg injected eyes from first post-injection which was eliminated by the 7th day. Cataract was seen in the same eye. Post-injection ERGs showed no significant changes. Increase in Muller-like cells was observed in the histological examination in the injected eyes. Intravitreal injection of 5 and 7.5 mg doses of bevacizumab was safe in rabbit eyes; however, the 10 mg dose was associated with intraocular inflammation

[Correlation between Intracranial and Intraocular Pressures]

To evaluated the correlation between intracranial pressure [ICP] and intraocular pressure [IOP]. This interventional case series included 90 patients undergoing lumbar puncture [LP] for neurologist evaluation. IOP was measured before and 1 hour after the LP by using Goldmann tonometer. Patients were compared into two groups: patients with normal ICP [<20 cmH2O] and patients with high ICP [>/=20 cmH2O]. Patients included 29 male and 61 female subjects with mean age of 32.9 +/- 11.4 [range 13-62] years. Thirty-three patients had normal ICP and 57 patients had high ICP. There was a significant correlation between ICP and IOP such that 71.9% of the high ICP group had high IOP [>/=21 mmHg] and 28.1% of them had normal IOP [P<0.001]. Significant decrease in IOP occurred after LP in the high ICP group [P< 0.001]. It seems that there is a significant correlation between IOP and ICP

[Correlation between nerve fiber layer thickness on OCT and visual field in patients with optic atrophy]

To evaluate the correlation between retinal nerve fiber layer [NFL] thickness and visual field parameters in patients with optic atrophy. This study was performed on 35 eyes of 28 patients with optic atrophy. NFL thickness was measured by optic coherence tomography [OCT] and visual field analysis was performed by Humphrey perimetry. The correlation between NFL thickness and visual field parameters was evaluated. Mean NFL thickness was 44.9 +/- 27.5 micro which was significantly correlated with mean deviation of perimetry [r=0.493, P=0.003]; however, no significant difference was found between quadrant NFL thickness and corresponding visual field pattern standard deviation. No significant correlation was found between visual acuity and NLF thickness. Similar to visual field, OCT can be used as an objective diagnostic tool in optic atrophy suspected patients

[Standard full field electroretinography: normal values and variations with age in an Iranian population]

To determine normal values of standard full field electroretinography [ERG] and to evaluate variation with age in an Iranian population. The amplitudes and implicit times of ERGs from 170 normal subjects aged 1 to 80 years were recorded according to the International Society for Clinical Electrophysiology of Vision. Study participants included clients for spectacles, other patients' attendants and personnel of the hospital. Light-adapted ERG including single-white flash, 30-Hz flicker as well as dark-adapted ERG including rod, maximal darkadapted and cone responses were compiled. There were no significant differences between men and women, or between right and left eye in terms of amplitude or implicit times of ERG. An increase in amplitude and implicit time was observed in 70-80 year-old subjects as compared to younger individuals [P=0.04 and P=0.03, respectively]. ERG records are significantly diminished with advanced age. Our results are a suitable reference for evaluation of standard ERG responses

[Pupil dilation with intracameral lidocaine during phacoemulsification]

To evaluate pupil dilation with intracameral injection of preservative-free lidocaine 1% during phacoemulsification. This interventional case series included 31 consecutive senile cataract patients scheduled for phacoemulsification and intraocular lens [IOL] implantation. Pupil dilation was achieved using intracameral preservative-free lidocaine 1% without any preoperative or intraoperative mydriatics. Pupil diameter was measured by calipers immediately before and 90 seconds after intracameral injection of lidocaine. Patients included 16 male and 15 female subjects with mean age of 67.3 +/- 9.9 years. Four patients were diabetic and four cases had pseudoexfoliation. Pupil diameter increased from 2.63 +/- 0.3 mm preoperatively to 7.03 +/- 0.61 mm 90 seconds after intracameral injection of lidocaine with a mean increase of 4.39 +/- 0.53 mm [range 3.4-5.2, P<0.001]. Mean post-injection mydriasis was significantly greater in patients without pseudoexfoliation [7.1 mm vs 6.00 mm, independent t test and Mann-Whitney test, P<0.01]. There was no significant difference between diabetic and nondiabetic patients regarding of pre- and post-injection diameter of the pupil. Intracameral preservative-free lidocaine 1% provides rapid and effective mydriasis and can be a safe alternative to other topical and intracameral mydriatics used in phacoemulsification

[Central corneal thickness, endothelial characteristics and intraocular pressure in congenital cataract extracted eyes]

To investigate central corneal thickness [CCT], endothelial cell characteristics and intraocular pressure [IOP] in congenital cataract extracted eyes and to compare the results with eyes of normal age and sex matched controls. CCT and IOP measurements and specular microscopy were performed in 31 eyes of 17 cases of extracted congenital cataracts and 40 eyes of 20 age and sex matched subjects as control group. Mean of three pachymetry measurements of the central cornea was taken as CCT. IOP was measured using an applanation tonometer. Mean CCT was 632 +/- 45 microm in cataract extracted eyes vs 546 +/- 33 microm in the control eyes [P<0.001, independent t test and Mann Whitney test]. There was no significant difference in cell count, coefficient of variation, and mean cell area of the corneal endothelial cells between the two groups. Mean IOP was 22.1 +/- 3.9 mmHg in the cataract extracted eyes and 14.0 +/- 1.6 mmHg in the control group [P<0.001, independent t test]. Although the cornea was clinically clear and there was no significant difference in endothelial characteristics of congenital cataract extracted eyes compared to normal controls, central corneal thickness in operated eyes was significantly greater than that of controls. To differentiate actual glaucoma from artifactual IOP increase, CCT measurement should strongly be considered in these patients