Normal pulsed wave Doppler echocardiographic parameters of Turkmen horses of Iran

Turkmen horse is one of the oldest and purest breeds in the world, but there is no information on Doppler echocardiographic parameters in this horse. In the present study, pulsed-wave [PW] Doppler echocardiography was performed on 42 clinically normal 3- to 15-year-old racing Turkmen horses. No cardiac disease was detected with two-dimensional [2-D] real-time, M-mode, and colour flow mapping. Doppler echocardiographic parameters and indices of tricuspid, mitral, pulmonary and aortic flows were measured in this study. Tricuspid inflow velocities during rapid filling [E] and atrial contractions [A] were significantly higher than mitral inflow [P<0.05]. The Doppler waveforms, obtained from the aortic outflow, showed a significantly longer pre-ejection period [PEP] and shorter ejection time [ET] than the pulmonary artery waveforms [P=0.001 and P=0.028, respectively]. The time taken from the onset of the QRS complex to the onset of the A wave for tricuspid flow, pulmonary PEP, and pulmonary PEP/ET, had a significant positive correlation with age. These values can be used as standard and reference values for evaluation of cardiovascular disorders in Turkmen horse

Rupture of chorda tendineae of the tricuspid valve in a horse: a case report

A2-year-old cachectic cross-breed gelding was admitted to Veterinary Teaching Hospital of University of Tehran following the onset of a marked respiratory distress, coughing and ventral edema. Clinical examinations indicated harsh respiratory and expiratory sounds as well as jugular vein distention. The respiratory and heart rates were 35/min and 60 bpm, respectively. A grade III/IV pansystolic murmur with the PMI on the tricuspid valve, which could be heard on the left side, was detected. Sinus tachycardia was revealed by electrocardiography. Rupture of the chorda tendineae of the tricuspid valve, pulmonary artery regurgitation, pulmonary artery hypertension, tricuspid valve regurgitation, pulmonary artery, and right ventricular dilation were also found in echocardiography. These findings were confirmed at post mortem examinations. On the basis of the findings, chorda tendineae rapture of the tricuspid valve and right side heart failure due to primary pulmonary hypertension were diagnosed

Normal left ventricular systolic time intervals assessed by pulsed wave Doppler echocardiography in the Turkmen horse of Iran

The Turkmen horse is one of the oldest and purest breeds in the world. There is no information with regards to the normal echocardiographic parameters of this horse regarding to cardiac diseases. Pulsed-wave [PW] Doppler echocardiography was performed on 42 clinically normal 3-to 15-year-old racing Turkmen horses. There were 26 stallions and 16 mares. The left ventricular isovolumetric contraction time, pre-ejection period [PEP], and the left ventricular ejection time [LVET], were measured, and the values of the left ventricular total electromechanical systole [LVTES] and the PEP-to-LVET ratio were calculated. The most suitable window for the measurement of the aforementioned indices in PW Doppler echocardiography was the left parasternal window using the five-chamber apical view. The following values were acquired in PW Doppler echocardiography: PEP = 0.088 +/- 0.018 s; LVET = 0.445 +/- 0.031 s; LVTES - 0.533 +/- 0.032 s; and PEP-to-LVET = 0.199 +/- 0.046. These measurements can be used in the future as standard and reference values for the evaluation of cardiovascular disorders in the Turkmen horse

[Nd:YAG membranotomy in diabetic premacular hemorrhage]

To evaluate the success rate of Nd:YAG laser membranotomy in patients with diabetic premacular hemorrhage. This interventional case series included 24 eyes of 22 patients referred to retina clinic of Farabi Eye Hospital, Tehran, Iran during 2000-2007 with chief complaint of sudden loss of vision and clinical diagnosis of premacular hemorrhage due to proliferative diabetic retinopathy. All patients underwent complete ocular examination and color fundus photography. Nd:YAG laser membranotomy was performed in patients with >3 DD hemorrhage. Main outcome measures were success rate of membranotomy, improvement of visual acuity and the complications. Twenty-four eyes of 22 patients [68.2% female and 31.8% male] with diabetic premacular hemorrhage were enrolled. Mean age of patients was 56 +/- 6.5 years. Nd:YAG laser membranotomy was successful in 71% of patients resulting in release of trapped blood into the vitreous cavity which absorbed during 14.3 +/- 5.03 [range 8 to 27] days. Range of preoperative visual acuity was from hand motion to count finger at 4 m which improved to a range of 20/100 to 20/25 postoperatively. Patients complained of some visual disorders such as blurred vision and floater over 23-86 days [mean 43 days], postoperatively. Macular photocoagulation was performed in 11 eyes with macular edema before panretinal photocoagulation. Mean follow-up period was 34.7 +/- 18.3 [range 10-71] months. Nd:YAG laser membranotomy in diabetic premacular hemorrhage is a simple and inexpensive outpatient procedure which results in rapid visual recovery and is relatively safe. Further controlled clinical trials are recommended

[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

[Intravitreal triamcinolone acetonide in chronic refractory uveitis]

To evaluate the effect of intravitreal triamcinolone acetonide injection for management of chronic refractory uveitis in terms of inflammation, visual acuity and macular thickness. This interventional case series was conducted on uveitic eyes with no remission despite proper administration of periocular and/or systemic steroids. After systemic and rheumatologic evaluations and confirmation of non-infectious nature of uveitis, 18 eyes of 10 patients underwent intravitreal injection of 4 mg triamcinolone acetonide. Changes in intraocular inflammation, bestcorrected visual acuity [BCVA], intraocular pressure [IOP] and macular thickness on optical coherence tomography were assessed during six months of follow-up. Mean BCVA increased from a baseline value of 0.81 +/- 0.29 to 0.35 +/- 0.33 LogMAR one week and to 0.17 +/- 0.07 LogMAR one month after the injection, respectively [P<0.001]. It decreased thereafter to 0.46 +/- 0.3 LogMAR at the sixth month visit, but was still significantly greater than the baseline value [P<0.001]. Mean IOP reached its maximum level one month post-injection with an increase of 7.36 +/- 0.48 mmHg compared to the baseline value, however only two eyes had IOP>22 mmHg which were successfully controlled using topical IOP-lowering medication. Mean central macular thickness decreased from 339.8 +/- 24.1 microm to its minimum value [197.18 +/- 12.7 microm] one month after the injection [P<0.001] and then increased to 203.57 +/- 9.06 microm at sixth month visit, still less than the baseline value [P< 0.001]. Intravitreal injection of triamcinolone acetonide in chronic refractory uveitis improves visual acuity and decreases central macular thickness which is sustained for at least six months. The only noticeable complication, transient IOP elevation can be controlled with topical medications

[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

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

[Posterior segment complications following laser assisted in situ keratomileusis [LASIK]: a report of 5 cases]

To report complications involving the posterior segment after laser assisted in situ keratomileusis [LASIK] in 5 myopic patients ranging in age from 26 to 38 years. Case on developed bilateral cilioretinal artery obstruction in association with ischemic optic neuropathy. Case two presented with nonsimultaneous bilateral delayed-onset optic neuropathy. In case three, aggravation of the symptoms and signs of Stargardt's maculopathy was noticed. Case four showed rapid progression and worsening of diabetic retinopathy in both her eyes. In case five, early onset unilateral macular hemorrhage was observed. The increased intraocular pressure LASIK surgery may disturb blood flow in posterior ciliary arteries and choroid. The deleterious effect of LASIK on ocular circulation may result in sight threatening complications in predisposed patients

[ case of proteus syndrome with new ophthalmic presentation]

To report a case of Proteus syndrome with new ophthalmic findings not reported elsewhere. The patient is an 18-year-old girl with red lesions on hand and foot from birth and disproportionate growth of right upper and lower limbs from the first year of life. On examination, the patient has enlargement of the right upper and lower limb, macrodactyly, vascular malformations on limbs, epidermal nevus on trunk, and kyphoscoliosis. On ophthalmic examination, the patient has posterior subcapsular cataract, dilation of inferior and nasal retinal veins, narrowing of the superior and temporal retinal veins, and macular hypoplasia in both eyes. The patient had general criteria, and two group B and one group C criteria of proteus syndrome. From ophthalmic presentation, only cataract has previously been reported in proteus syndrome and others are new