Comparison of the effect of adjuvant 5-fluorouracil, low molecular weight heparin and daunomycin in combination with triamcinolone during vitrectomy in advanced retinal detachment

To compare the success rate of adjunctive 5-fluorouracil [5-FU] and low molecular weight heparin [LMWH], and daunomycin in combination with triamcinolone during vitrectomy in eyes with retinal detachment [RD] and proliferative vitreoretinopathy [PVR]. In this prospective randomized clinical trial, 69 eyes from 69 patients with RD and PVR [grade B or C] randomized to 3 groups. Group 1: received 5-FU and LMWH [200 microgram/ml 5-FU and 5 IU/ml LMWH, Fragmin]; group 2: received daunomycin [0.5 mg] in 500 cc infusion fluid; and group 3: control group. In all patients, 0.1 cc intravitreal triamcinolone was used during vitrectomy. The patients visited on day 1, week 1, month 1, 3 and 6. Best corrected visual acuity [BCVA] and retinal status compared in the 3 groups. Complete data were available for 60 out of 69 patients. Thirty five patients [58.3%] were male and 25 patients [41.7%] were female. The patient age range was 19-84 years and the mean age was 49. The groups did not have significant difference in age, sex, duration of detachment, severity of PVR, preoperative visual acuity [V/A], lens status, type of tamponade and encircling band and buckle. Postoperative V/A and retina status also was the same in the 3 groups. Perioperative infusion of 5-FU, LMWH and daunomycin does not significantly increase the success rate of patients with RD and PVR comparing to control group. Although visual acuity improvement and retina reattachment rate in group 1 and 2 were better than control group, but statistical analysis failed to show significant difference between the 3 groups

case series study of leber's congenital amaurosis: Clinical description and ERG findings

To evaluate the incidence of Leber's Congenital Amaurosis [LCA] in low vision children referred to electrophysiology ward of Farabi Eye Hospital, and review the clinical features of disease and Electroretiongraphy [ERG] test values to confirm the diagnosis and severity of the disease in Iran. Prospective observational case series. Two-hundred and fifteen cases of low vision infants and young children were referred to electrophysiology ward of Farabi Eye Hospital during 18 months. Clinical LCA diagnosis was made and ERG tests were done and LCA diagnosis was confirmed. The symptoms, signs and the results of eye examination and ERG findings were recorded. The mean age of the patients was 27.43 [range, 1-120 months]. Among low vision patients fourteen percent of patients had LCA. Fifty-four percent of the patients were female. Nystagmus and low vision were the two most common clinical manifestations of these patients. Hyperopia was the main refractive error [54.80%] and mild abnormalities in fundus examinations were found in 67.70% of cases. In nearly 90% of cases consanguinity was found. ERG was flat or unrecordable in more than 90% of cases, but in less than 10% of cases with recordable curves, severe decrease in amplitude of waves was encountered. ERG confirmed LCA diagnosis in 31 out of 37 patients [positive predictive value of 83.7%]. The incidence of LCA in low vision children is similar to other studies. ERG helped in confirmation of presence or absence of overall retinal dysfunction in the majority 31/37 [83.7%] of LCA patients. It can differentiate these cases from other cases with poor vision in infantile age but genetic testing is recommended