Childhood pars planitis; clinical features and outcomes

To evaluate the demographic and clinical features of childhood pars planitis, and to determine the therapeutic and visual outcomes of the disease. Medical records of pediatric patients [less than 16 years of age at diagnosis] with pars planitis and at least 6 months of follow-up who were referred to Labbafinejad Medical Center, Tehran, Iran over a 22 year period were reviewed. Overall, 117 eyes of 61 patients including 51 [83.6%] male subjects were included. Mean age at the time of diagnosis was 7.8 +/- 3.2 [range, 3-16] years. Mean best corrected visual acuity [BCVA] was 0.88 +/- 0.76 logMAR at presentation which improved to 0.39 +/- 0.51 logMAR at final visit [P<0.001]. Endotheliitis was present in 23 [19.6%] eyes and was significantly more prevalent in subjects younger than 9 years [P=0.025]. Cataract formation [41.9%] and cystoid macular edema [19.7%] were the most prevalent complications. Univariate regression analysis showed that better baseline visual acuity [OR=0.38, 95%CI 0.21-0.70, P=0.002], age older than 5 years at disease onset [OR=0.36, 95%CI 0.14-0.9, P=0.029], absence of endotheliitis [OR=0.39, 95%CI 0.15-0.99, P-0.047] and female gender [OR=3.77, 95%CI 1.03-13.93, P=0.046] were significantly associated with final BCVA of 20/40 or better. Childhood pars planitis was much more common among male subjects. Endotheliitis may be a sign of inflammation spillover and is more prevalent in younger patients. Visual prognosis is favorable in most patients with appropriate treatment

Electroretinogram changes following silicone oil removal

To evaluate electroretinogram [ERG] changes after silicone oil removal. Scotopic and photopic ERGs, and best-corrected visual acuity [BCVA] were checked before and shortly after silicone oil removal in eyes that had previously undergone vitrectomy and silicone oil injection for complex retinal detachment. Pre- and postoperative ERG a- and b-wave amplitudes were compared. Twenty-eight eyes of 28 patients including 20 male and 8 female subjects with mean age of 39.3 +/- 0.06 [range, 12 to 85] years were studied. Mean interval from primary vitreoretinal surgery to silicone oil removal was 21.04 +/- 0.52 [range, 7 to 39] months. Mean duration from silicone oil removal to second ERG was 13.04 +/- 1.75 [range, 10 to 16] days. Before silicone oil removal, mean a-wave amplitudes in maximal combined response, rod response and cone response ERGs were 27.4 +/- 19.9, 7.2 +/- 4.5 and 5.5 +/- 3.4 micro v, respectively. These values increased to 48.8 +/- 31.9, 15.1 +/- 14.4 and 17.4 +/- 22.2 micro, respectively after silicone oil removal [P < 0.001]. Mean b-wave amplitudes in the same order, were 69.41 +/- 51, 41.2 +/- 30.4 and 25.1 +/- 33.9 microvolts before silicone oil removal, increasing to 165.6 +/- 102.5, 81.7 +/- 53.7 and 44.7 +/- 34.1 micro respectively, after silicone oil removal [P < 0.001]. Mean BCVA significantly improved from 1.10 +/- 0.34 at baseline to 1.02 +/- 0.33 logMAR after silicone oil removal [P < 0.001]. The amplitudes of ERG a- and b-waves under scotopic and photopic conditions increased significantly shortly after silicone oil removal. An increase in BCVA was also observed. These changes may be explained by the insulating effect of silicone oil on the retina

Increased latency of visual evoked potentials in healthy women during menstruation

To evaluate the latency of visual evoked potentials [VEPs] in healthy women during and after menstruation. Pattern and flash VEPs were performed in 15 healthy women aged 18 to 25 years on the maximum bleeding day [luteal phase] and 7 days after the menstrual cycle [follicular phase]. Mean latency was 119.6 msec on the maximum bleeding day and 100.8 msec one week after menstruation on pattern VEP [P < 0.001]. Corresponding values for flash VEP were 124.5 msec and 112.7 msec, respectively [P < 0.001]. Prolonged VEP latency on the maximum bleeding day indicates that high progesterone levels may have an inhibitory effect on optic nerve conduction velocity

Outcomes of surgical treatment for retinal detachment in highly myopic eyes with macular hole

To determine the type and outcome of surgery for retinal detachment resulting from macular hole in highly myopic eyes. This retrospective analysis was performed on the medical records of highly myopic patients who underwent surgery for retinal detachment [RD] resulting from macular hole at Labbafinejad Hospital, Tehran-Iran from 1992 to 2001. Variables included age, gender number and type of operations, visual acuity before and after the procedures and surgical success rate. Overall, 28 eyes of 27 patients [26 female and one male] with mean age of 59.8 +/- 11 years were included. Main follow-up was 17.3 [range 3-72] months. Mean axial length was 29 +/- 2.74mm [range: 24 to 35mm] and mean degree of myopia was -16.4 +/- 3.1 D [range -10 to -22 D]. Posterior staphyloma was present in 20 eyes [71%]. Seven eyes had undergone failed scleral buckling as the primary procedure prior to referral. lntravitreal SF[6] injection was the primary procedure in 12 eyes with localized detachments; the retina became attached in 5 [41.6%] of these eyes, however redetachment occurred in 7 [584%] eyes. Overall, 23 eyes [including 7 failed scleral buckling cases, 7 redetachments following SF[6] injection and 9 cases of primary surgery] underwent vitrectomy with use of high viscosity silicone oil. No major complications occurred during the operations. Overall, final anatomical success was 92.9% and visual improvement occurred in 85.7% of the eyes. In highly myopic eyes with RD due to macular hole, less invasive procedures such as SF[6] injection seem to be appropriate for eyes with localized detachment. In cases of total or subtotal RD and posterior staphyloma, pars plana vitrectomy and silicone oil tamponade seem to be the preferred procedure

Outcomes of lensectomy in hereditary lens subluxation

To evaluate the results of pars plana lensectomy in patients with hereditary lens subluxation. Hospital records of patients with hereditary lens subluxation who had undergone pars plana lensectomy at Labbafinejad Medical Center, Tehran-Iran from 1996 to 2003 were reviewed. Patients with more than 6 months of follow up were included. Underlying disorders, best corrected visual acuity [BCVA] before and after surgery, intraocular pressure [IOP], postoperative refraction and complications were evaluated. Overall, records of 87 eyes of 49 patients including 27 male and 22 female subjects were reviewed. Mean follow up duration was 20 +/- 18 months. Underlying disorders leading to lens subluxation included Marfan syndrome [79.5%], Weill-Marchesani syndrome [82%], simple ectopia lentis [8.2%], and homocystinuria [4.1%]. The most common indication for surgery was non-correctable refractive error [92.1%]. Mean BCVA was 1.13 LogMAR [20/250] preoperatively, which improved to 0.26 LogMAR [20/30-20/40] postoperatively [P<0.001]. BCVA >/= 20/40 was achieved in 82.8% of cases after surgery. Angle-supported anterior chamber intraocular lens [ACIOL] was implanted in 85.1% of the eyes. Prophylactic band was applied in 63 eyes [72.4%]. Retinal detachment developed in four eyes [4.6%] and was successfully treated. Lensectomy/anterior vitrectomy with implantation of an angle-supported ACIOL in patients with hereditary lens subluxation improves vision significantly without considerable complications