Nicotinic acid treatment for retinal vein occlusion

To evaluate the effect of nicotinic acid in management of retinal vein occlusions [CRVO or BRVO]. This prospective nonrandomized pilot study included 20 patients [21 eyes] with CRVO or BRVO that received nicotinic acid [3 g/day] for 3 months. A complete ophthalmologic examination uncorrected visual acuity [UCVA], best spectacle-corrected visual acuity [BSCVA], testing for a relative afferent pupillary defect [RAPD], slit-lamp examination, gonioscopy, intraocular pressure [IOP] measurement, fundoscopy and fundus photography was performed. Four patients did not appear for follow-up and hypersensitivity reaction to nicotinic acid and severe hyperglycemia happened in two patients. Therefore, the results of treatment in 16 eyes of 15 are reported. These patients had a mean age of 59.56 +/- 11.12 years. The average length of follow-up was 8.6 +/- 2.7 months. The mean BSCVA was 1.56 +/- 0.66 before treatment, 1.38 +/- 0.72 [p>0.05] at one month and 0.88 +/- 0.69 [p<0.01] at three months. The last BSCVA of all 16 eyes averaged 0.97 +/- 0.73 [p<0.01]. All patients had reduction of hemorrhagic events, cotton wool spots, edema in macula and disc, venous tortuosity, and dilation on basis of fundus photographs 3 months after treatment. Nicotinic acid usage provides enough time for development of collateral vessels, by induction of vasodilatation. Nicotinic acid use is tolerable and is related with mild systemic side effects.

Evaluation of sterile uveitis after iris-fixated phakic intraocular lens implantation

To evaluate the clinical features, and visual outcomes of sterile uveitis after iris-fixated phakic intraocular lens implantation [pIOLs] [Artisan-Artiflex and Verisyse-Veriflex]. Material and Methods: In this retrospective non-comparative case series, the medical records of 117 eyes implanted with Artisan-Artiflex [Ophtec BV, Groningen, Netherlands] and Verisyse-Veriflex [AMO, Santa Ana, CA] iris claw phakic IOLs were analyzed for postimplantation sterile uveitis. The mean age of the 87 patients included in the study was 27.2 +/- 7.4 years. Of these patients, 56 [64.3%] were men and 31 [35.6%] were women. Patient age, gender, IOL brand type, refractive error, optic diameter, unilateral vs bilateral implantation, and anterior chamber depth were analyzed. Features of uveitis, uncorrected and best corrected visual acuity [VA] at presentation and at follow-up visits were examined. The mean follow-up time was 14.6 months [range: 6-37 months]. Clinically significant uveitis was observed in 12 of 117 eyes [10.3%] in a total of ten patients. Of these ten patients, four [40%] were women and six [60%] were men, and the mean age was 25.1 +/- 5.3 years [range: 18-36 years]. Among those with bilateral implantation, 6.9% of patients developed bilateral uveitis, while 13.8% [4 of the 29 implanted bilaterally] developed unilateral uveitis. Foldable pIOL implantation was the only variable associated with the development of uveitis [P=.03]. Although the prognosis is usually benign, sterile uveitis occurred in 10.3% of patients after iris-fixated pIOL implantation. The implantation of a foldable pIOL was the only variable associated with sterile uveitis. Appropriate medical management can be effective treatment, without the need for pIOL replacement

Corneal crosslinking for keratoconus in Iranian patients: outcomes at 1 year following treatment

A retrospective, nonrandomized, single-center clinical study was designed to evaluate the outcomes of corneal collagen crosslinking [CXL] for progressive keratoconus in Iranian patients 12 months after CXL. This study was carried out at Navid Didegan Eye Center, a private clinic, Mashhad, Iran. Ninety-two eyes of 53 subjects with progressive keratoconus were evaluated in this study. All eyes completed 1-year follow-up. The outcome measures were uncorrected visual acuity [UCVA], best spectacle-corrected visual acuity [BSCVA], sphere and cylinder refraction, keratometry, and corneal thickness. Comparison of baseline and 1-year postoperative data is reported in this study. The Wilcoxon signed-ranked and Student's t-tests were used for statistical analyses. P < 0.05 was statistically significant. The mean age was 21.5 +/- 3.4 years [range, 16 -30 years]. Thirty-one [58.5%] of the subjects were men and 22 [41.5%] were women. Mean baseline UCVA and BSCVA were 0.61 +/- 0.31 and 0.06 +/- 0.12 logarithm of minimal angle of resolution [logMAR], respectively. One year postoperatively UCVA was 0.31 +/- 0.25 logMAR and BSCVA was 0.0 +/- 0.01 logMAR. UCVA and BSCVA were statistically higher postoperatively [P < 0.001, both parameters]. The mean astigmatism decreased by 0.78 +/- 1.49 diopter [D] with significant variation during the follow-up period [P < 0.001]. Mean baseline simulated keratometry [SIM K] was 46.94 +/- 2.37 D and decreased to 46.0 +/- 2.33 D on year postoperatively [P < 0.001]. Corneal CXL seems to be efficient in stabilization of progressive keratoconus progression in Iranian patients at 1 year of follow up