Epidemiologic features of retinoblastoma in Shiraz, southern Iran

Retinoblastoma [RB] is the most common primary intraocular cancer of childhood. There is no published report on this affliction at our center as a referral center in southern Iran. This study aimed to perform a 15 years epidemiological assessment of RB, in Fars Province, Southern Iran. We retrospectively analyzed medical records of all patients with RB diagnosed in Khalili Hospital affiliated to Shiraz University of Medical Sciences in Shiraz, Southern Iran. All available pathologic slides were reviewed and staging of tumors were revised using the TNM classification of 2008. Sixty-seven patients were enrolled in this study [46.3% females and 53.7% males]. Among the cases, 71.6% had unilateral and 28.8% bilateral RB. The mean age of symptom presentation and diagnosis were 20.5 +/- 16.5 and 26.3 +/- 20.1 months, respectively, which were significantly lower in bilateral cases. Leukocoria was the most common presenting symptom [56.7%], followed by strabismus [10.4%]. The result of histopathological review showed that RB in 70% of patients was at T1, T2 and T3 stage, but 30% were at T4 stage. Demographic and clinical variables of RB under the present study are comparable with published reports but our patients were diagnosed at the later stage, leading to poorer prognosis. It is necessary to expand the existing organizations into a comprehensive population-based registry system to obtain a clearer picture of the epidemiology of RB in our region

epidemiology of orbital exentration in Southern Iran

Exentration is performed as an infrequent procedure for the treatment of locally invasive or potentially life threatening orbital neoplasm, when less invasive management are inadequate. This study was performed to report the epidemiological features of diseases treated by orbital exentration as well as surgical techniques used in south of Iran. In a retrospective study, records of all patients' undergone exentration of the orbit between years 1986 and 2006, at the Khalili Teaching Eye Hospital were reviewed. Correspondingly, records of pathology were also searched for the same cases to confirm the pre-operation diagnosis in the charts. There were 28 men and 20 women with a mean age of 50 +/- 23.9 years. Basal cell carcinoma [31%], squamous cell carcinoma [18%] and malignant melanoma [14%] were found to be the frequent ones. Consequently, eyelid was reported as the anatomic site for origin of tumors in 41.6% of patients. The exenterated cavity was left to heal by granulation tissue and epithelialization in 32 cases [66%], skin graft was placed in 13 cases [27%] and tissue flap were prepared for reconstruction in the remaining three cases. Basal cell carcinoma with secondary orbital involvement was the most common cause of orbital exenteration and healing by the granulation tissue was the main rout of reconstruction in our cases

[Cyanoacrylate tissue adhesive for management of exposed hydroxyapatite orbital implant]

To present our experience with cyanoacrylate tissue adhesive in eyes with exposed hydroxyapatite orbital implants. Cyanoacrylate tissue adhesive was used in 3 patients with hydroxyapatite orbital implant exposure defects. Cyanoacrylate glue was applied on the defective area of 3 patients presenting with small exposure [<4mm]. The patients were followed for 33 months [range: 20-58 months], no complication developed and the defect size was stable. In one patient after 12 months, the glue was removed and a mucous membrane graft was performed without any complications over a 9 month period. Cyanoacrylate tissue adhesive application is safe and easy to use; it can be used for treatment of exposed hydroxyapatite orbital implant in selected cases

[Conjunctival and lacrimal sac bacterial flora in adults with nasolacrimal duct obstruction in comparison with normal subjects]

To determine bacterial flora of the conjunctiva and lacrimal sac in adult patients with nasolacrimal duct obstruction [NLDO] in comparison with normal flora. This study included 40 consecutive adult patients with NLDO and 40 age- and sex matched healthy controls. Specimens for bacterial culture were obtained from the involved and normal conjunctiva preoperatively and from the lacrimal sac of the involved eye at the time of dacryocystorhinostomy in the patients as well as from the conjunctiva of the control group. Culture growth and colony count were determined in each group. Conjunctival cultures were positive in 100% of involved eyes and 97.5% of sound eyes in the patients as well as in 82.5% of controls. The most prevalent organisms were Staphylococcus epidermidis and S. aureus in both NLDO and control groups. The isolated organisms were the same in 90% of specimens obtained from the sac and conjunctiva of the involved eyes. Mean colony counts were significantly higher in the lacrimal sac and conjunctival culture of the involved eye as compared to the normal side and the control group. The predominant microorganism is S. epidermidis in normal ocular surface but S. aureus in eyes with NLDO. Conjunctival culture can be used as a predictor of lacrimal sac flora in cases with NLDO

evaluation of common visual disorders in primary school children in Fasa City

Population based data concerning the prevalence of visual impairment in children are not readily available in Iran. The purpose of this study was to estimate the prevalence of common visual disorders [ambtyopia, strabismus and refractive errors] in a group of primary school children and to compare the findings with similar studies. Ten percent of the primary school children in Fasa were selected by systematic random method. They enrolled into prospective vision screening program combining the identification arm [screening] and diagnostic/treatment arm [ophthalmic examination].The screening consisted of Snellen chart presented at 6 meters test distance. An ophthalmologist in ophthalmology clinic examined each child failing the vision screening. 1224 children were screened during the 1999-2000 academic year.196 [16%] failed the vision screening [VA

Primary malignant melanoma of eye in a 17 - ytear - old girl with acute lymphoblastic leukemia

Herein we describe a case of intraocular melanoma in a17-year old leukemic patient. The history, histological findings of the enucleated eye, blood and bone marrow of the patient were investigated. The enucleated eye contained epitheloid cell type melanoma instead of leukemic cell infiltration. We conclude that intraocular malignant melanoma can occur in acute lymphoblastic leukemia