Prevalence and Major Causes of Visual Impairment in Iranian Adults: A Systematic Review.

PURPOSE: The purpose of this study is to provide a pooled estimate of moderate-to-severe visual impairment (MSVI) and blindness in Iran for people 50 years and over and to identify the major causes through systematic review. MATERIALS AND METHODS: International (PubMed, ISI Web of Science, and Scopus) and national databases (Scientific Information Database, Barakat Knowledge Network System, Iran Databank of Ophthalmology Research, and Magiran) databases were searched. Following relevance assessment and critical appraisal, eight studies were included. A funnel plot was drawn to explore the stability for estimation. Single-variable meta-regression analysis was applied for heterogeneity assessment, and a random effect model was used (but no significant source for the observed heterogeneity was found). RESULTS: Age-standardized pooled estimate of MSVI was 4.24% (95% confidence interval [CI]: 2.92-5.56); 3.98% (95% CI: 2.37-5.59) for men, and 4.08% (95% CI: 2.95-5.21) for women. Blindness (visual acuity <3/60) prevalence was 1.31% (95% CI: 1.23-1.39); 0.96% (95% CI: 0.89-1.03) for men, and 1.13% (95% CI: 1.06-1.20) for women. Causes of visual impairment (VI) were cataract (40.23%), amblyopia (12.03%), corneal opacity (9.63%), age-related macular degeneration (9.31%), diabetic retinopathy (4.94%), and glaucoma (3.67%). CONCLUSION: VI prevalence in the 50 years and older population in Iran seems significantly better than the corresponding global estimates. A rough 60% rate of treatable VI was estimated, mostly attributable to unoperated cataract.

A rare erosive orbital mass in a child: Case report of myofibroma.

PURPOSE: To present the clinical, histological, and radiographic findings of a case of orbital myofibroma in an unusual location. The literature is reviewed and the clinical relevance discussed. METHODS: A 5-year-old boy was examined with a 1.5-month history of progressive swelling in the left supraorbital region. RESULTS: Examination revealed a firm, painless mass in the supralateral region of the left orbit with slight reddish discoloration of the overlying skin. Computerized tomography (CT) scan images showed a well demarcated, homogenous, solid mass with extension to the lacrimal gland region and adjacent to frontal bone erosion. The mass was surgically excised and was confirmed to be myofibroma in diagnostic histological studies. There has been no evidence of recurrence in the first year after surgery. CONCLUSIONS: Clinical appearance and imaging findings are unspecific for this tumor, and histological examination still remains the definite method of diagnosis. Therefore, it is important to be able to differentiate myofibromas from other malignant tumors with a similar presentation in pediatric patients to avoid mismanagement.

Idiopathic Choroidal Neovascularization in a 23-Year-Old Girl.

A 23-year-old girl presented with blurred vision in her left eye since 2 months ago. Her past medical history was unremarkable. On presentation, her left best corrected visual acuity was 20/80. Anterior segment exam was unremarkable. Posterior segment exam showed an ill-defined green gray elevation in the fovea with surrounding subretinal fluid. The right eye exam was normal. Fluorescein Angiography and Optic Coherence Tomography of the left eye was compatible with Choroidal Neovascularization (CNV).

Orbital metastatic osteosarcoma.

At an estimated incidence of 2 cases per million persons per year, osteosarcoma is the most common primary malignant bone tumor in children and adults, excluding hematopoietic intraosseous tumors. Orbital metastases of osteosarcoma are very rare. Only 5 cases of orbital metastasis of osteosarcoma previously reported in the literature. We report the case of a 19-year-old man with known history of osteosarcoma of right distal femur who presented with acute visual loss and progressive protrusion of his left eye. Orbital CT scan and MRI revealed orbital mass eroding orbital walls and intracranial invasion. He underwent superotemporal orbitotomy for debulking of orbital mass. Histopathological examination (HPE) of the specimen was reported as metastatic osteosarcoma with extensive tumor necrosis. Then he underwent adjuvant chemotherapy and palliative radiotherapy. Although orbital metastasis of osteosarcoma is a rare event, it seems it has had an increasing trend recently. so, making efforts to palliate the patient's symptoms by multidisciplinary teamwork and proper interaction among ophthalmologist, orthopedic surgeons and oncologists is necessary.

Spontaneous closure of traumatic macular holes.

OBJECTIVE: To present a series of cases with spontaneous closure of traumatic macular hole. DESIGN: Case series. PARTICIPANTS: Six eyes of 6 patients with traumatic macular hole. METHODS: The characteristics of eyes with macular hole secondary to blunt trauma in which the macular hole closed spontaneously without surgical manipulation were reviewed. RESULTS: Patient age range was 13 to 55 years. There were 4 full-thickness and 2 lamellar macular holes. Spontaneous closure occurred after 1 to 6 months of observation. Best corrected visual acuity improved in 5 eyes and remained unchanged in the other eye. CONCLUSIONS: Spontaneous closure of traumatic macular holes may occur within 6 months after initial presentation.