AIM:To identify topographic determinants of the anterior chamber angle(ACA)in patients with keratoconus(KCN).METHODS:Four hundred and ten eyes of 294 patients with KCN were recruited for this study.First,complete ocul...AIM:To identify topographic determinants of the anterior chamber angle(ACA)in patients with keratoconus(KCN).METHODS:Four hundred and ten eyes of 294 patients with KCN were recruited for this study.First,complete ocular examinations were performed for all patients,including visual acuity measurement,refraction,and slit-lamp biomicroscopy.Then,all participants underwent corneal imaging by the Oculus Pentacam HR.RESULTS:The mean age of the participants was 32.40±8.52y(15-60y)and 69.5%of them were male.The mean ACA was 38.47°±5.75°(range:14.40°to 56.50°)in the whole sample,38.24°±6.00°in males,and 38.98°±5.11°in females(P=0.447).The mean ACA was significantly different among different groups of cone morphology,as patients with nipple cones showed the lowest mean ACA.Moreover,there were statistically significant differences in the mean ACA among different groups of cone locations,with patients having central cones exhibiting the lowest mean ACA(P<0.001).Anterior and posterior Q values were significantly,directly correlated with ACA(anterior Q:r=0.122,P=0.014,posterior Q:r=0.192,P<0.001).CONCLUSION:This study provides critical insights into the risk factors for ACA narrowing in KCN patients,which is essential for planning intraocular surgeries.Patients with nipple and central cones exhibited the most significant ACA narrowing.Additionally,more negative Q-values are associated with increased ACA narrowing,highlighting the need for targeted diagnostic and therapeutic strategies.展开更多
AIM:To examine whether rs2472493 and rs248032 in the ABCA1 gene,rs3785176 in the PMM2 gene,and rs11827818 in the ARHGEF12 gene contribute to primary open angle glaucoma(POAG)in an Iranian population.METHODS:Totally 82...AIM:To examine whether rs2472493 and rs248032 in the ABCA1 gene,rs3785176 in the PMM2 gene,and rs11827818 in the ARHGEF12 gene contribute to primary open angle glaucoma(POAG)in an Iranian population.METHODS:Totally 82 POAG patients and 172 healthy controls were enrolled.The selected gene polymorphisms were analyzed using TaqMan SNP Genotyping Assay using deoxyribonucleic acid(DNA)extracted from blood samples.Allelic and genotypic frequencies were evaluated using the Chi-square test.The association between the genotypes of single nucleotide polymorphisms(SNPs)and POAG was assessed using multiple logistic regression models.The linkage disequilibrium and haplotype block structure were assessed using the Haploview 4.2 software.RESULTS:The results showed a significant association between allele frequencies of rs2472493 in the ABCA1 gene locus and POAG[odds ratio(OR)=1.58,95%confidence intervals(CI)=1.04-2.39,P=0.031].The rs3785176 in the PMM2 gene was also associated with POAG in additive and over dominant genotypes.Moreover,haplotype analysis showed a significant association of two estimated haplotypes of rs2472493/rs2487032 with POAG.The AA haplotype showed a reduction in POAG risk(OR=0.41,95%CI=0.202-0.834,P=0.012),while the GG haplotype was associated with the disease.In addition,this study could not discover any association between genotype and allele frequency of rs248032 in the ABCA1 gene,and rs11827818 in ARHGEF12 gene and POAG.CONCLUSION:rs2472493 in the ABCA1 gene can be considered a genetic susceptibility locus for POAG.The haplotype constructed with ABCA1 gene SNPs(rs2472493/rs2487032)is associated with POAG.展开更多
AIM:To determine the diagnostic ability of various visual functions in patients with multiple sclerosis(MS)with and without optic neuritis(ON).METHODS:In this cross-sectional study,we assessed and compared refractive ...AIM:To determine the diagnostic ability of various visual functions in patients with multiple sclerosis(MS)with and without optic neuritis(ON).METHODS:In this cross-sectional study,we assessed and compared refractive error,visual acuity(VA),and contrast sensitivity(CS)between patients with MS and a matched control group of healthy individuals.The MS patients were further categorized into those with ON and those without.RESULTS:A total of 133 eyes from 133 participants were assessed,including 66 individuals diagnosed with MS.The mean ages for the MS group and the healthy control group were 37.5±4.27y and 38.45±4.60y,respectively(P=0.346).Among the 66 patients with MS,18 had ON.The presence of MS was associated with a decrease in best-corrected visual acuity(BCVA)and spherical component of refractive error(P<0.05),whereas ON did not lead to any further decline in these parameters(P>0.05).MS was linked to decreased CS at spatial frequencies of 6 and 18 cycles per degree(CPD;P<0.05),while ON in MS patients resulted in an additional decrease in CS at 3 CPD(P=0.03).The most significant sensitivity for distinguishing MS patients from healthy individuals as well as MS patients with ON from those without ON was found with cylindrical component[associated criterion(AC)>-0.75 D;71.21%]and CS at spatial frequency of 6 CPD(AC≤1.56;72.22%),respectively.Conversely,the highest specificity for these diagnostic measures was associated with BCVA(AC>0 logMAR;97.01%)and CS at a spatial frequency of 12 CPD(AC≤0.60;93.75%),respectively.CONCLUSION:MS significantly affects refractive error and CS,with ON further reducing CS.Assessing these visual parameters can improve MS monitoring and management.展开更多
Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships,mechanics,and function of the visual system.This review aimed to investigate the changes ...Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships,mechanics,and function of the visual system.This review aimed to investigate the changes in corneal biomechanical parameters with age and sex.The articles published in PubMed between 2000 and 2021 were investigated and critiqued,and valid scientific evidence was collected,reviewed and concluded according to the inclusion and exclusion criteria.Most studies showed that corneal biomechanical changes occur infrequently in children up to the age of 20y,and with increasing age and wider age range,there was a significant decrease in corneal biomechanical indices,especially corneal hysteresis.In children and adults,most studies have shown that these biomechanical indicators,especially corneal resistance factor,were higher in females.Although hormonal changes may contribute to this finding,the role of axial length and other biometric indicators should not be ignored.The axial length,the intraocular pressure,and the corneal thickness are other factors associated with biomechanical parameters that should be taken into account in clinical diagnosis and management especially for patients undergoing refractive surgery as well as keratoconus patients.展开更多
This study aimed to differentiate between the therapeutic and purely cosmetic aspects of keratopigmentation by examining the results of previous studies.Corneal opacity,corneal leukoma,and iris abnormalities represent...This study aimed to differentiate between the therapeutic and purely cosmetic aspects of keratopigmentation by examining the results of previous studies.Corneal opacity,corneal leukoma,and iris abnormalities represent the primary reasons for keratopigmentation in therapeutic settings.In therapeutic contexts,the most commonly reported adverse effects included inflammation,foreign body sensation,light sensitivity,reduced intraocular pressure,and neovascularization.The side effects most frequently noted in purely cosmetic applications were photophobia and ectasia.In therapeutic scenarios,patients who experience pre-operative vision impairment often report not only the absence of visual loss post-procedure but also an enhancement in visual acuity,accompanied by alleviation of symptoms such as glare.In purely cosmetic procedures,visual acuity tends to remain stable.Research indicates that dissatisfaction with keratopigmentation results is more prevalent in studies aimed at therapeutic interventions compared to cosmetic enhancements.Furthermore,instances of discoloration and fading are more frequently observed in therapeutic cases than in cosmetic ones,including the need for retouching.The use of keratopigmentation in both therapeutic and cosmetic settings produces positive and acceptable results,especially in cosmetic applications.Nevertheless,complications are more commonly observed in therapeutic situations,which underscores the importance of candidate selection for keratopigmentation procedures.展开更多
AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 ...AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 to Jan 2020.Selected subjects were interviewed and subjected to optometric and ophthalmic examinations.RESULTS:The age and sex standardized prevalence of pterygium and pinguecula was 3.64%[95%confidence interval(CI):2.94%–4.49%]and 55.57%(95%CI:52.89%–58.22%),respectively.The prevalence of pterygium was 4.52%(95%CI:3.5%–5.81%)in men and 2.79%(95%CI:1.97%–3.94%)in women and the prevalence of pinguecula was 64.56%(95%CI:60.92%–68.03%)in men and 46.72%(95%CI:43.74%–49.72%)in women.According to the results of multiple logistic regression,pinguecula had a significant correlation with male sex[odds ratio(OR):2.21,95%CI:1.63–2.99]and education level(OR:0.52,95%CI:0.35-0.77)and pterygium had a significant relationship with male sex(OR:2.2,95%CI:1.38–3.52),socioeconomic status(SES,OR:0.5,95%CI:0.26–0.97),education level(OR:0.22,95%CI:0.08–0.61).CONCLUSION:The prevalence of pinguecula and pterygium in this study are lower than other studies.Sex,SES,and education level are the risk factors of the prevalence of pinguecula and pterygium.展开更多
AIM:To compare the subjective refraction data with autorefraction findings in high astigmatisms.METHODS:In a cross-sectional study,sampling was done from in different geographic regions in Iran using a multistage rand...AIM:To compare the subjective refraction data with autorefraction findings in high astigmatisms.METHODS:In a cross-sectional study,sampling was done from in different geographic regions in Iran using a multistage random cluster sampling method.All study participants underwent cycloplegic auto-refraction and subjective refraction using the red-green test.RESULTS:In this study,277 eyes of 158 students aged 8 to 15y were analyzed.According to the results,the mean difference between subjective refraction and autorefraction in measuring sphere,cylinder,spherical equivalent,J0,and J45 was-0.18±0.76,-0.36±0.40,-0.36±0.79,0.15±0.20,and 0.05±0.21 respectively.The correlation of these two refraction methods in measuring the aforementioned indices was 0.963,0.898,0.960,0.931,and 0.948 respectively.The 95%limits of agreement of the two methods in measuring the above indices were-1.66 to 1.31,-1.14 to 0.42,-1.91 to 1.19,-0.24 to 0.54,and-0.36 to 0.47 respectively.The agreement between the two methods decreased with increasing cylinder power,and the best agreement was found in myopic individuals.CONCLUSION:The measurements obtained by autorefractometer have a significantly higher cylinder average compared to subjective refraction.However,in the cylinder range of 4–5 diopters,the values of J0 and J45 do not have a high correlation.展开更多
AIM:To compare the visual and optical outcomes following femtosecond laser in situ keratomileusis(FS-LASIK)using an aberration neutral profile with asymmetric offset(AO)and pupil center(PC)treatments.METHODS:In this r...AIM:To compare the visual and optical outcomes following femtosecond laser in situ keratomileusis(FS-LASIK)using an aberration neutral profile with asymmetric offset(AO)and pupil center(PC)treatments.METHODS:In this randomized double-blind clinical trial study,48(24 cases)and 38 eyes(19 cases)underwent myopic astigmatism and hyperopic astigmatism LASIK.One eye of each individual was randomly assigned to AO centration and the fellow eye underwent the PC-centered method.The clinical outcomes including uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),safety and efficacy indexes,subjective spherical equivalent(SE)and corneal high-order aberrations(HOAs)were measured at baseline and 6mo postoperatively.RESULTS:In the myopic group,the mean preoperative SE and astigmatism were-4.12±0.87(-2.88 to-6.00)diopter(D)and-0.88±0.79(0 to-2.75)D,respectively.In the hyperopic group,the mean preoperative SE and astigmatism were 0.93±0.59(-0.25 to 2.25)D and-0.73±1.00(0 to-4.25)D,respectively.At 6mo postoperatively,the safety and efficacy indexes were similar for centration in myopic and hyperopic LASIK groups.In the myopic group,significant changes were found in horizontal trefoil(P=0.041)and oblique trefoil(P=0.031)in favor of AO centration treatment.CONCLUSION:Femtosecond-LASIK is a safe and efficacious procedure for treatment of myopic and hyperopic astigmatism.AO-centered and PC-centered approaches provide similar visual and refractive outcomes.Myopic astigmatism LASIK with AO centration leads to slightly better corneal aberration outcomes.展开更多
Telemedicine is an emerging field in recent medical achievements with rapid development. The ＂smartphone＂ availability has increased in both developed and developing counffies even among people in rural and remotes ...Telemedicine is an emerging field in recent medical achievements with rapid development. The ＂smartphone＂ availability has increased in both developed and developing counffies even among people in rural and remotes areas. Telebased services can be used for screening ophthalmic diseases and also monitoring patients with known diseases. Electronic ophthalmologic records of the patients including captured images by smartphones from anterior and posterior segments of the eye will be evaluated by ophthalmologists, and if patients require further evaluations, they will be referred to experts in the relevant field. Eye diseases such as cataract, glaucoma, age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity are the most common causes of blindness in many countries and beneficial use of teleophthalmology with smartphones will be a good way to achieve the aim of VISION 2020 all over the world. Numerous studies have shown that teleophthalmology is similar to the conventional eye care system in clinical outcomes and even provides more patient satisfaction as it saves time and cost, This review explains how teleophthalmology helps to improve patient outcomes through smartphones.展开更多
AIM:To review recent innovations,challenges,and applications of small incision lenticule extraction(SMILE)extracted lenticule for treating ocular disorders.METHODS:A literature review was performed in the PubMed datab...AIM:To review recent innovations,challenges,and applications of small incision lenticule extraction(SMILE)extracted lenticule for treating ocular disorders.METHODS:A literature review was performed in the PubMed database,which was last updated on 30 December 2021.There was no limit regarding language.The authors evaluated the reference lists of the collected papers to find any relevant research.RESULTS:Due to the simplicity and accuracy of modern femtosecond lasers and the extensive development of SMILE surgery,many healthy human corneal stromal lenticules were extracted during surgery,motivating some professionals to investigate the SMILE lenticule reusability in different ocular disorders.In addition,new approaches had been developed to preserve,modify,and bioengineer the corneal stroma,leading to the optimal use of discarded byproducts such as lenticules from SMILE surgery.The lenticules can be effectively re-implanted into the autologous or allogenic corneas of human subjects to treat refractive errors,corneal ectasia,and corneal perforation and serve as a patch graft for glaucoma drainage devices with better cosmetic outcomes.CONCLUSION:SMILE-extracted lenticules could be a viable alternative to human donor corneal tissue.展开更多
AIM:To evaluate the diagnostic ability of topographic and tomographic indices with Pentacam and Sirius as well as biomechanical parameters with Corvis ST for the detection of clinical and subclinical forms of keratoco...AIM:To evaluate the diagnostic ability of topographic and tomographic indices with Pentacam and Sirius as well as biomechanical parameters with Corvis ST for the detection of clinical and subclinical forms of keratoconus(KCN).METHODS:In this prospective diagnostic test study,70 patients with clinical KCN,79 patients with abnormal findings in topography and tomography maps with no evidence on clinical examination(subclinical KCN),and 68 normal control subjects were enrolled.The accuracy of topographic,tomographic,and biomechanical parameters was evaluated using the area under the receiver operating characteristic curve(AUC)and cross-validation analysis.The Delong method was used for comparing AUCs.RESULTS:In distinguishing KCN from normal,all parameters showed statistically significant differences between the two groups(P<0.001).Indices with the perfect diagnostic ability(AUC≥0.999)were Sirius KCN vertex of back(KVb),Pentacam random forest index(PRFI),Pentacam index of height decentration(IHD),and Corvis integrated tomographic/biomechanical index(TBI).In distinguishing subclinical KCN from normal,Sirius symmetry index of back(SIb;AUC=0.908),Pentacam inferior-superior difference(IS)value(AUC=0.862),PRFI(AUC=0.847),and Corvis TBI(AUC=0.820)performed best.There were no significant differences between the highest AUCs within keratoconic groups(De Long,P>0.05).CONCLUSION:In clinical KCN,all topographic,tomographic,and biomechanical indices have acceptable outcomes in terms of sensitivity and specificity.However,in differentiating subclinical forms of KCN from normal corneas,curvature-based parameters(SIb and IS value)followed by integrated indices(PRFI and TBI)are the most powerful tools for early detection of KCN.展开更多
·AIM: To collect and present updated evidence about epidemiological aspects of retinoblastoma(Rb) in the world.·METHODS: A comprehensive search without the time and language restrictions was conducted in int...·AIM: To collect and present updated evidence about epidemiological aspects of retinoblastoma(Rb) in the world.·METHODS: A comprehensive search without the time and language restrictions was conducted in international databases, including MEDLINE, Scopus, Web of Science, and Pub Med. The search keywords were “retinoblastoma” OR “retinal Neuroblastoma” OR “retinal glioma” OR “retinoblastoma eye cancer” OR “retinal glioblastoma”.·RESULTS: The worldwide incidence of Rb is 1 in 16 000-28 000 live births, but was higher in developing compared to developed countries. Several attempts for improving early detection and treatment had increased the Rb survival rate from 5% to 90% in developed countries over the past decade, but its survival was lower in developing countries(about 40% in low-income countries) and the majority of mortalities occurred in developing countries. The etiology of Rb could be viewed as genetics in the heritable form and environmental and lifestyle factors in the sporadic form. Some environmental risk factors such as in vitro fertilization;insect sprays;father’s occupational exposure to oil mists in metal working, and poor living conditions might play a role in the occurrence of the disease. Although ethnicity might affect Rb incidence, sex has no documented effect and the best treatment approaches were now ophthalmic artery chemosurgery and intravitreal chemotherapy.·CONCLUSION: Determining the role of genetics and environmental factors helps to accurately predict the prognosis and identify the mechanism of the disease, which can reduce the risk of tumor development.展开更多
Purpose:To investigate the correlation between vestibular hydrops(VH),cochlearhydrops(CH),vestibular aqueduct non-visibility(VANV),and visually increased perilymphatic enhancement(VIPE)with the findings of pure-tone a...Purpose:To investigate the correlation between vestibular hydrops(VH),cochlearhydrops(CH),vestibular aqueduct non-visibility(VANV),and visually increased perilymphatic enhancement(VIPE)with the findings of pure-tone audiometry(PTA)in Meniere’s disease(MD)patients.Methods:In this cross-sectional study,53 ears belonging to 48 patients were divided into two groups and evaluated.In group“MD patients,”there were 24 ears of 19 patients diagnosed with the definite MD(14 patients with unilateral and 5 patients withbilateral involvements).The“control group”consisted of 29 non-symptomatic ears belonging to patients diagnosed with unilateral sudden sensory-neural hearing loss or unilateral schwannoma.All the patients underwent 2 sessions of temporal bone MRI using the same 3T system:an unenhanced axial T1,T2,and 3D-FLAIR MRI,an intravenous gadoliniumenhanced axial T1 fat-sat,and 4 h after the injection,an axial 3D-T2 cube and 3D-FLAIR session.VH,CH,VANV,and VIPE were assessed.Subsequently,the correlation between EH indices and PTA findings(in three frequency domains of low,middle,and high)were evaluated,and the predictive value of MRI was calculated.Results:VH was significantly correlated with the hearing threshold in the low,middle,and highfrequency domains.CH was also correlated with the hearing threshold in the low and middle domains.Contrarily,VIPE was not associated with hearing thresholds,and VANV was only correlated with the hearing threshold in low frequencies.Conclusion:The grade of VH,CH,and VANV were significantly correlated with the hearing thresholds in PTA.展开更多
AIM:To compare the subjective refraction data with non-cycloplegic auto-refraction findings in the geriatric population above 60 years of age according to the different crystalline lens conditions.METHODS:This report ...AIM:To compare the subjective refraction data with non-cycloplegic auto-refraction findings in the geriatric population above 60 years of age according to the different crystalline lens conditions.METHODS:This report is a part of the Tehran Geriatric Eye Study(TGES)that was conducted from January 2019 to January 2020 on elderly population 60 years of age and above in Tehran.The samples were selected by multistage stratified random cluster sampling.Of 3791 individual invitees,3310(response rate:87.3%)participated in this study.All study participants underwent non-cycloplegic autorefraction(auto-refractometer/keratometer Nidek ARK-510)and subjective refraction.RESULTS:Regarding the sphere,eyes with mixed cataract had the worst limits of agreement(LoA:-1.24 to 0.87)and the best agreement was related to the pseudophakic eyes(LoA:-0.83 to 0.54).The highest(0.27±0.31 D)and lowest(0.21±0.27 D)differences between the two methods regarding the cylinder power were observed in eyes with cortical cataract and normal eyes,respectively.The worst LoA between the two methods in measuring the cylinder power was related to the eyes with mixed cataract(LoA:-0.44 to 0.96).Regarding the J0(horizontal/vertical components of astigmatism),the mean values of J0 obtained by auto-refraction were tended more toward against the rule direction in all crystalline lens conditions,and the two methods had the greatest difference in cortical cataract cases(0.05±0.17 D).Regarding the J45(oblique components of astigmatism),the lowest(0±0.11 D)and highest(-0.01±0.12 D)differences were observed in normal eyes and eyes with cortical cataract,respectively.CONCLUSION:The auto-refractometer/keratometer Nidek ARK-510 results in the elderly with different phakic and pseudophakic conditions do not correspond well with subjective refraction findings.This discrepancy in spherical findings is more pronounced in individuals with mixed cataract than in other cases.展开更多
AIM:To determine the normative distribution of axial length(AL),anterior chamber depth(ACD),anterior chamber volume(ACV),anterior chamber angle(ACA),and some of their associated factors in subjects aged 60 and over.ME...AIM:To determine the normative distribution of axial length(AL),anterior chamber depth(ACD),anterior chamber volume(ACV),anterior chamber angle(ACA),and some of their associated factors in subjects aged 60 and over.METHODS:In this cross-sectional study,160 clusters were sampled using multi-stage cluster sampling in Tehran,Iran.After a preliminary interview,the participants underwent optometric examinations including visual acuity and refraction measurement followed by slit lamp biomicroscopy.Finally,ocular imaging was done using the Pentacam AXL to measure AL,ACD,ACV,and ACA.RESULTS:A total of 4519 eyes of 2436 participants were evaluated,of whom 58.0%(n=1412)were female.The mean age of the subjects was 67.32±6.05y(range:60-95y).The mean AL,ACD,ACV,and ACA was 23.22 mm(23.18-23.27 mm),2.61 mm(2.59-2.62 mm),126.56 mm3(125.08-128.04 mm3),and 30.61°(30.3°-30.92°),respectively.In the multivariable model,after adjusting for the effect of both eyes,the longest and shortest AL was seen in myopic and hyperopic subjects,respectively.AL,ACD,ACV and ACA were significantly larger in men compared to women(P<0.001).Except ACA,other evaluated parameters showed an inverse correlation with age(P<0.001),however,this correlation was insignificant for AL(P=0.623).CONCLUSION:Normative value of AL,and other biometric parameters are specific for each ethnicity,age and sex group.Any alteration in these parameters and their effect on refraction should be considered in this age group,especially in case of cataract surgery.展开更多
Background:Evaluation of corneal biomechanical properties 3 months after using rigid gas permeable(RGP)contact lenses in keratoconus.Methods:In this prospective trial study,cases were 32 keratoconic eyes with no histo...Background:Evaluation of corneal biomechanical properties 3 months after using rigid gas permeable(RGP)contact lenses in keratoconus.Methods:In this prospective trial study,cases were 32 keratoconic eyes with no history of RGP lens wear.All eyes were examined with the Ocular Response Analyzer(ORA)and the Corneal Visualization Scheimpflug Technology(CORVIS-ST)to measure corneal hysteresis(CH),corneal resistance factor(CRF),deformation amplitude(DA),applanation velocity(AV)1 and 2,applanation length(AL)1 and 2,and peak distance before and 3 months after fitting aspheric RGP lenses.The effect of the correlation between contralateral eyes and maximum keratometry were controlled for in the analysis.Results were compared using repeated measures analysis of covariance.Results:At 3 months,neither the increases in mean CH(0.14±2.77 mm Hg,P=0.789),CRF(0.41±4.35 mm Hg,P=0.612),AV1(0.03±0.17 m/s,P=0.301),AV2(0.11±0.59 m/s,P=0.299),AL1(0.44±1.56 m/s,P=0.118),AL2(1.16±5.06 m/s,P=0.211),and peak distance(0.19±1.29 m/s,P=0.409),nor the decrease in mean DA(0.03±0.17 mm,P=0.402)was statistically significant.Conclusions:Results in our series of patients indicated that 3 months of RGP lens wear had no significant impact on corneal biomechanics,and perhaps non progression of keratoconus.Therefore,RGP lenses can be regarded safe and appropriate in keratoconic patients.展开更多
AIM:To compare central corneal thickness(CCT) and anterior chamber depth(ACD) measurements using rotating Scheimpflug imaging and partial coherence interferometry.·METHODS:As part of the first phase of Shahroud E...AIM:To compare central corneal thickness(CCT) and anterior chamber depth(ACD) measurements using rotating Scheimpflug imaging and partial coherence interferometry.·METHODS:As part of the first phase of Shahroud Eye Cohort Study with 5 190 subjects of 40 to 64 years of age,CCT and ACD were measured using Scheimpflug imaging with the Pentacam(Oculus,Inc.,Lynnwood,WA,USA) and partial coherence interferometry with the Allegro BioGraph(Wavelight,Erlangen,Germany).·RESULTS:After applying exclusion criteria,we had data of 4 387 subjects with a mean age of 50.7±6.2 years.Mean CCT with Pentacam and BioGraph were 528.6 ±33.2μm and 525.6 ±32μm respectively;the difference was statistically significant(P 【0.001),but the correlation was high(R=0.920).Mean ACD measurements using Pentacam and BioGraph were 2.68 ±0.35mm and 2.62 ±0.33mm respectively;the inter-device difference was significant(P 【0.001) with high correlation(R=0.944).The 95% limits of agreements between devices were-22.65μm to28.61μm and-0.16mm to 0.29mm for CCT and ACD measurements,respectively.·CONCLUSION:For both CCT and ACD,the BioGraph gave significantly lower values than the Pentacam(P 【0.05).Despite the high inter-device correlation,the 95%limits of agreements were wide,and this may limit their interchangeability in measuring the CCT and ACD.展开更多
AIM:To determine the prevalence of red-green(RG)color vision deficiency(CVD)in an elderly population and its related factors.METHODS:This report is a part of the Tehran Geriatric Eye Study:a cross-sectional population...AIM:To determine the prevalence of red-green(RG)color vision deficiency(CVD)in an elderly population and its related factors.METHODS:This report is a part of the Tehran Geriatric Eye Study:a cross-sectional population-based study that was conducted on the elderly population(≥60y)of Tehran,Iran using multi-stage stratified random cluster sampling.All study participants underwent complete ocular examination,including the measurement of uncorrected and bestcorrected visual acuity,objective and subjective refraction,and slit-lamp biomicroscopy.The color vision was tested using Ishihara plates with the near optical correction in place.RESULTS:Of the 3791 invitees,3310 participated in the study.The data of 2164 individuals were analyzed after applying the exclusion criteria.The prevalence of R-G CVD was 3.73%(95%CI:2.37%–5.09%)in the whole sample;the prevalence of protanomaly,protanopia,and deuteranopia was 1.51%,1.76%,and 0.45%,respectively.The prevalence of R-G CVD was significantly higher in males than in females.The prevalence of RG CVD increased with advancing age from 2.91%in the age group 60–64y to 5.8%in the age group≥80y(P=0.070).According to the multiple logistic regression model,male sex,and glaucoma were significantly related to RG CVD.Older age and hypertension also had a marginally significant relationship with RG CVD.CONCLUSION:Changes in color vision occur in the elderly due to the aging process and some physiological and pathological factors.Since the change in visual perception may affect the person’s performance,this aspect of the visual system’s function should also be taken into consideration in the examinations of the elderly.展开更多
AIMTo determine the distribution of intraocular pressure(IOP)and its determinants in an Iranian population.METHODSIn a cross-sectional survey,random cluster sampling was conducted from the 40-64 years old population o...AIMTo determine the distribution of intraocular pressure(IOP)and its determinants in an Iranian population.METHODSIn a cross-sectional survey,random cluster sampling was conducted from the 40-64 years old population of Shahroud,in the north of Iran.All participants had optometry and ophthalmic exams.IOP was determined using the Goldmann tonometry method and biometric components were measured.RESULTSOf the 6311 people selected for the study,5190(82.2%)participated.The mean age of the participants was 50.9±6.2y and 58.7%of them were female.Mean IOP was 12.87±2.27 mm Hg.In this study 0.3%of the participants had an IOP higher than 21 mm Hg.The multiple linear regression model revealed that sex(Coef=-0.30;95%CI:-0.43 to-0.17),diabetes(Coef=0.43;95%CI:0.19 to 0.67),high systolic blood pressure(Coef=0.02;95%CI:0.01 to 0.02),high body mass index(BMI)(Coef=0.03;95%CI:0.01 to 0.04),higher education(Coef=0.02,95%CI:0.01 to 0.04),thicker central corneal thickness(Coef=0.01;95%CI:0.01 to 0.02),and myopic shift in spherical equivalent(Coef=-0.14;95%CI:-0.18 to-0.10)significantly correlated with high IOP.CONCLUSIONThe IOP in this 40-64 years old population is low overall.In the north of Iran,average IOP is statistically significantly correlated with female sex,diabetes,higher BMI,systolic blood pressure,higher education,thicker cornea,and myopic refractive error.展开更多
AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES...AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES):a population-based crosssectional study conducted on individuals 60 years of age and above living in Tehran,Iran using the multi-stage stratified random cluster sampling method.Cognitive status was assessed using the Persian version of the Mini-Mental State Examination(MMSE).All study participants underwent complete ocular examination including measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,cover testing,NPC measurement,and slit-lamp biomicroscopy.RESULTS:The data of 1190 individuals were analyzed for this report.The mean age of the participants analyzed was 66.82±5.42(60-92y)and 728(61.2%)of them were female.Patients with MCI had a significantly more receded NPC compared to subjects with normal cognitive status(10.89±3.58 vs 7.76±2.71 cm,P<0.001).In the multivariable logistic regression model and in the presence of confounding variables,a receded NPC was statistically significantly associated with an increased risk of MCI(odds ratio:1.334,95%confidence interval:1.263 to 1.410,P<0.001).According to receiver operating characteristic(ROC)analysis,a cut point NPC>8.5 cm(area under the curve:0.764,P<0.001)could predict the presence of MCI with a sensitivity and specificity of 70.9%and 69.5%,respectively.CONCLUSION:A receded NPC can be clinically proposed as a predictor of MCI in older adults.It is recommended that elderly with a receded NPC>8.50 cm undergo detailed cognitive screening for a definite diagnosis of MCI.In this case,the necessary interventions can be carried out to slow down MCI progression to dementia.展开更多
基金Supported by Iranian University of Medical Sciences(code:IR.IUMS.REC.1401.371).
文摘AIM:To identify topographic determinants of the anterior chamber angle(ACA)in patients with keratoconus(KCN).METHODS:Four hundred and ten eyes of 294 patients with KCN were recruited for this study.First,complete ocular examinations were performed for all patients,including visual acuity measurement,refraction,and slit-lamp biomicroscopy.Then,all participants underwent corneal imaging by the Oculus Pentacam HR.RESULTS:The mean age of the participants was 32.40±8.52y(15-60y)and 69.5%of them were male.The mean ACA was 38.47°±5.75°(range:14.40°to 56.50°)in the whole sample,38.24°±6.00°in males,and 38.98°±5.11°in females(P=0.447).The mean ACA was significantly different among different groups of cone morphology,as patients with nipple cones showed the lowest mean ACA.Moreover,there were statistically significant differences in the mean ACA among different groups of cone locations,with patients having central cones exhibiting the lowest mean ACA(P<0.001).Anterior and posterior Q values were significantly,directly correlated with ACA(anterior Q:r=0.122,P=0.014,posterior Q:r=0.192,P<0.001).CONCLUSION:This study provides critical insights into the risk factors for ACA narrowing in KCN patients,which is essential for planning intraocular surgeries.Patients with nipple and central cones exhibited the most significant ACA narrowing.Additionally,more negative Q-values are associated with increased ACA narrowing,highlighting the need for targeted diagnostic and therapeutic strategies.
基金Supported by the Noor Ophthalmology Research Center and Shahroud University of Medical Sciences(No.9449)Shahroud University of Medical Sciences(No.9449)Shahroud Eye Cohort Study is supported by the Noor Ophthalmology Research Center and Shahroud University of Medical Sciences(No.8737).
文摘AIM:To examine whether rs2472493 and rs248032 in the ABCA1 gene,rs3785176 in the PMM2 gene,and rs11827818 in the ARHGEF12 gene contribute to primary open angle glaucoma(POAG)in an Iranian population.METHODS:Totally 82 POAG patients and 172 healthy controls were enrolled.The selected gene polymorphisms were analyzed using TaqMan SNP Genotyping Assay using deoxyribonucleic acid(DNA)extracted from blood samples.Allelic and genotypic frequencies were evaluated using the Chi-square test.The association between the genotypes of single nucleotide polymorphisms(SNPs)and POAG was assessed using multiple logistic regression models.The linkage disequilibrium and haplotype block structure were assessed using the Haploview 4.2 software.RESULTS:The results showed a significant association between allele frequencies of rs2472493 in the ABCA1 gene locus and POAG[odds ratio(OR)=1.58,95%confidence intervals(CI)=1.04-2.39,P=0.031].The rs3785176 in the PMM2 gene was also associated with POAG in additive and over dominant genotypes.Moreover,haplotype analysis showed a significant association of two estimated haplotypes of rs2472493/rs2487032 with POAG.The AA haplotype showed a reduction in POAG risk(OR=0.41,95%CI=0.202-0.834,P=0.012),while the GG haplotype was associated with the disease.In addition,this study could not discover any association between genotype and allele frequency of rs248032 in the ABCA1 gene,and rs11827818 in ARHGEF12 gene and POAG.CONCLUSION:rs2472493 in the ABCA1 gene can be considered a genetic susceptibility locus for POAG.The haplotype constructed with ABCA1 gene SNPs(rs2472493/rs2487032)is associated with POAG.
文摘AIM:To determine the diagnostic ability of various visual functions in patients with multiple sclerosis(MS)with and without optic neuritis(ON).METHODS:In this cross-sectional study,we assessed and compared refractive error,visual acuity(VA),and contrast sensitivity(CS)between patients with MS and a matched control group of healthy individuals.The MS patients were further categorized into those with ON and those without.RESULTS:A total of 133 eyes from 133 participants were assessed,including 66 individuals diagnosed with MS.The mean ages for the MS group and the healthy control group were 37.5±4.27y and 38.45±4.60y,respectively(P=0.346).Among the 66 patients with MS,18 had ON.The presence of MS was associated with a decrease in best-corrected visual acuity(BCVA)and spherical component of refractive error(P<0.05),whereas ON did not lead to any further decline in these parameters(P>0.05).MS was linked to decreased CS at spatial frequencies of 6 and 18 cycles per degree(CPD;P<0.05),while ON in MS patients resulted in an additional decrease in CS at 3 CPD(P=0.03).The most significant sensitivity for distinguishing MS patients from healthy individuals as well as MS patients with ON from those without ON was found with cylindrical component[associated criterion(AC)>-0.75 D;71.21%]and CS at spatial frequency of 6 CPD(AC≤1.56;72.22%),respectively.Conversely,the highest specificity for these diagnostic measures was associated with BCVA(AC>0 logMAR;97.01%)and CS at a spatial frequency of 12 CPD(AC≤0.60;93.75%),respectively.CONCLUSION:MS significantly affects refractive error and CS,with ON further reducing CS.Assessing these visual parameters can improve MS monitoring and management.
基金Supported by Noor Ophthalmology Research Center.
文摘Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships,mechanics,and function of the visual system.This review aimed to investigate the changes in corneal biomechanical parameters with age and sex.The articles published in PubMed between 2000 and 2021 were investigated and critiqued,and valid scientific evidence was collected,reviewed and concluded according to the inclusion and exclusion criteria.Most studies showed that corneal biomechanical changes occur infrequently in children up to the age of 20y,and with increasing age and wider age range,there was a significant decrease in corneal biomechanical indices,especially corneal hysteresis.In children and adults,most studies have shown that these biomechanical indicators,especially corneal resistance factor,were higher in females.Although hormonal changes may contribute to this finding,the role of axial length and other biometric indicators should not be ignored.The axial length,the intraocular pressure,and the corneal thickness are other factors associated with biomechanical parameters that should be taken into account in clinical diagnosis and management especially for patients undergoing refractive surgery as well as keratoconus patients.
基金Supported by Noor Ophthalmology Research Center.
文摘This study aimed to differentiate between the therapeutic and purely cosmetic aspects of keratopigmentation by examining the results of previous studies.Corneal opacity,corneal leukoma,and iris abnormalities represent the primary reasons for keratopigmentation in therapeutic settings.In therapeutic contexts,the most commonly reported adverse effects included inflammation,foreign body sensation,light sensitivity,reduced intraocular pressure,and neovascularization.The side effects most frequently noted in purely cosmetic applications were photophobia and ectasia.In therapeutic scenarios,patients who experience pre-operative vision impairment often report not only the absence of visual loss post-procedure but also an enhancement in visual acuity,accompanied by alleviation of symptoms such as glare.In purely cosmetic procedures,visual acuity tends to remain stable.Research indicates that dissatisfaction with keratopigmentation results is more prevalent in studies aimed at therapeutic interventions compared to cosmetic enhancements.Furthermore,instances of discoloration and fading are more frequently observed in therapeutic cases than in cosmetic ones,including the need for retouching.The use of keratopigmentation in both therapeutic and cosmetic settings produces positive and acceptable results,especially in cosmetic applications.Nevertheless,complications are more commonly observed in therapeutic situations,which underscores the importance of candidate selection for keratopigmentation procedures.
基金Supported by National Institute for Medical Research Development(NIMAD)affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 to Jan 2020.Selected subjects were interviewed and subjected to optometric and ophthalmic examinations.RESULTS:The age and sex standardized prevalence of pterygium and pinguecula was 3.64%[95%confidence interval(CI):2.94%–4.49%]and 55.57%(95%CI:52.89%–58.22%),respectively.The prevalence of pterygium was 4.52%(95%CI:3.5%–5.81%)in men and 2.79%(95%CI:1.97%–3.94%)in women and the prevalence of pinguecula was 64.56%(95%CI:60.92%–68.03%)in men and 46.72%(95%CI:43.74%–49.72%)in women.According to the results of multiple logistic regression,pinguecula had a significant correlation with male sex[odds ratio(OR):2.21,95%CI:1.63–2.99]and education level(OR:0.52,95%CI:0.35-0.77)and pterygium had a significant relationship with male sex(OR:2.2,95%CI:1.38–3.52),socioeconomic status(SES,OR:0.5,95%CI:0.26–0.97),education level(OR:0.22,95%CI:0.08–0.61).CONCLUSION:The prevalence of pinguecula and pterygium in this study are lower than other studies.Sex,SES,and education level are the risk factors of the prevalence of pinguecula and pterygium.
基金Supported by Shahid Beheshti University of Medical Sciences.
文摘AIM:To compare the subjective refraction data with autorefraction findings in high astigmatisms.METHODS:In a cross-sectional study,sampling was done from in different geographic regions in Iran using a multistage random cluster sampling method.All study participants underwent cycloplegic auto-refraction and subjective refraction using the red-green test.RESULTS:In this study,277 eyes of 158 students aged 8 to 15y were analyzed.According to the results,the mean difference between subjective refraction and autorefraction in measuring sphere,cylinder,spherical equivalent,J0,and J45 was-0.18±0.76,-0.36±0.40,-0.36±0.79,0.15±0.20,and 0.05±0.21 respectively.The correlation of these two refraction methods in measuring the aforementioned indices was 0.963,0.898,0.960,0.931,and 0.948 respectively.The 95%limits of agreement of the two methods in measuring the above indices were-1.66 to 1.31,-1.14 to 0.42,-1.91 to 1.19,-0.24 to 0.54,and-0.36 to 0.47 respectively.The agreement between the two methods decreased with increasing cylinder power,and the best agreement was found in myopic individuals.CONCLUSION:The measurements obtained by autorefractometer have a significantly higher cylinder average compared to subjective refraction.However,in the cylinder range of 4–5 diopters,the values of J0 and J45 do not have a high correlation.
基金Supported by Noor Ophthalmology Research Center.
文摘AIM:To compare the visual and optical outcomes following femtosecond laser in situ keratomileusis(FS-LASIK)using an aberration neutral profile with asymmetric offset(AO)and pupil center(PC)treatments.METHODS:In this randomized double-blind clinical trial study,48(24 cases)and 38 eyes(19 cases)underwent myopic astigmatism and hyperopic astigmatism LASIK.One eye of each individual was randomly assigned to AO centration and the fellow eye underwent the PC-centered method.The clinical outcomes including uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),safety and efficacy indexes,subjective spherical equivalent(SE)and corneal high-order aberrations(HOAs)were measured at baseline and 6mo postoperatively.RESULTS:In the myopic group,the mean preoperative SE and astigmatism were-4.12±0.87(-2.88 to-6.00)diopter(D)and-0.88±0.79(0 to-2.75)D,respectively.In the hyperopic group,the mean preoperative SE and astigmatism were 0.93±0.59(-0.25 to 2.25)D and-0.73±1.00(0 to-4.25)D,respectively.At 6mo postoperatively,the safety and efficacy indexes were similar for centration in myopic and hyperopic LASIK groups.In the myopic group,significant changes were found in horizontal trefoil(P=0.041)and oblique trefoil(P=0.031)in favor of AO centration treatment.CONCLUSION:Femtosecond-LASIK is a safe and efficacious procedure for treatment of myopic and hyperopic astigmatism.AO-centered and PC-centered approaches provide similar visual and refractive outcomes.Myopic astigmatism LASIK with AO centration leads to slightly better corneal aberration outcomes.
文摘Telemedicine is an emerging field in recent medical achievements with rapid development. The ＂smartphone＂ availability has increased in both developed and developing counffies even among people in rural and remotes areas. Telebased services can be used for screening ophthalmic diseases and also monitoring patients with known diseases. Electronic ophthalmologic records of the patients including captured images by smartphones from anterior and posterior segments of the eye will be evaluated by ophthalmologists, and if patients require further evaluations, they will be referred to experts in the relevant field. Eye diseases such as cataract, glaucoma, age-related macular degeneration, diabetic retinopathy, and retinopathy of prematurity are the most common causes of blindness in many countries and beneficial use of teleophthalmology with smartphones will be a good way to achieve the aim of VISION 2020 all over the world. Numerous studies have shown that teleophthalmology is similar to the conventional eye care system in clinical outcomes and even provides more patient satisfaction as it saves time and cost, This review explains how teleophthalmology helps to improve patient outcomes through smartphones.
文摘AIM:To review recent innovations,challenges,and applications of small incision lenticule extraction(SMILE)extracted lenticule for treating ocular disorders.METHODS:A literature review was performed in the PubMed database,which was last updated on 30 December 2021.There was no limit regarding language.The authors evaluated the reference lists of the collected papers to find any relevant research.RESULTS:Due to the simplicity and accuracy of modern femtosecond lasers and the extensive development of SMILE surgery,many healthy human corneal stromal lenticules were extracted during surgery,motivating some professionals to investigate the SMILE lenticule reusability in different ocular disorders.In addition,new approaches had been developed to preserve,modify,and bioengineer the corneal stroma,leading to the optimal use of discarded byproducts such as lenticules from SMILE surgery.The lenticules can be effectively re-implanted into the autologous or allogenic corneas of human subjects to treat refractive errors,corneal ectasia,and corneal perforation and serve as a patch graft for glaucoma drainage devices with better cosmetic outcomes.CONCLUSION:SMILE-extracted lenticules could be a viable alternative to human donor corneal tissue.
文摘AIM:To evaluate the diagnostic ability of topographic and tomographic indices with Pentacam and Sirius as well as biomechanical parameters with Corvis ST for the detection of clinical and subclinical forms of keratoconus(KCN).METHODS:In this prospective diagnostic test study,70 patients with clinical KCN,79 patients with abnormal findings in topography and tomography maps with no evidence on clinical examination(subclinical KCN),and 68 normal control subjects were enrolled.The accuracy of topographic,tomographic,and biomechanical parameters was evaluated using the area under the receiver operating characteristic curve(AUC)and cross-validation analysis.The Delong method was used for comparing AUCs.RESULTS:In distinguishing KCN from normal,all parameters showed statistically significant differences between the two groups(P<0.001).Indices with the perfect diagnostic ability(AUC≥0.999)were Sirius KCN vertex of back(KVb),Pentacam random forest index(PRFI),Pentacam index of height decentration(IHD),and Corvis integrated tomographic/biomechanical index(TBI).In distinguishing subclinical KCN from normal,Sirius symmetry index of back(SIb;AUC=0.908),Pentacam inferior-superior difference(IS)value(AUC=0.862),PRFI(AUC=0.847),and Corvis TBI(AUC=0.820)performed best.There were no significant differences between the highest AUCs within keratoconic groups(De Long,P>0.05).CONCLUSION:In clinical KCN,all topographic,tomographic,and biomechanical indices have acceptable outcomes in terms of sensitivity and specificity.However,in differentiating subclinical forms of KCN from normal corneas,curvature-based parameters(SIb and IS value)followed by integrated indices(PRFI and TBI)are the most powerful tools for early detection of KCN.
文摘·AIM: To collect and present updated evidence about epidemiological aspects of retinoblastoma(Rb) in the world.·METHODS: A comprehensive search without the time and language restrictions was conducted in international databases, including MEDLINE, Scopus, Web of Science, and Pub Med. The search keywords were “retinoblastoma” OR “retinal Neuroblastoma” OR “retinal glioma” OR “retinoblastoma eye cancer” OR “retinal glioblastoma”.·RESULTS: The worldwide incidence of Rb is 1 in 16 000-28 000 live births, but was higher in developing compared to developed countries. Several attempts for improving early detection and treatment had increased the Rb survival rate from 5% to 90% in developed countries over the past decade, but its survival was lower in developing countries(about 40% in low-income countries) and the majority of mortalities occurred in developing countries. The etiology of Rb could be viewed as genetics in the heritable form and environmental and lifestyle factors in the sporadic form. Some environmental risk factors such as in vitro fertilization;insect sprays;father’s occupational exposure to oil mists in metal working, and poor living conditions might play a role in the occurrence of the disease. Although ethnicity might affect Rb incidence, sex has no documented effect and the best treatment approaches were now ophthalmic artery chemosurgery and intravitreal chemotherapy.·CONCLUSION: Determining the role of genetics and environmental factors helps to accurately predict the prognosis and identify the mechanism of the disease, which can reduce the risk of tumor development.
文摘Purpose:To investigate the correlation between vestibular hydrops(VH),cochlearhydrops(CH),vestibular aqueduct non-visibility(VANV),and visually increased perilymphatic enhancement(VIPE)with the findings of pure-tone audiometry(PTA)in Meniere’s disease(MD)patients.Methods:In this cross-sectional study,53 ears belonging to 48 patients were divided into two groups and evaluated.In group“MD patients,”there were 24 ears of 19 patients diagnosed with the definite MD(14 patients with unilateral and 5 patients withbilateral involvements).The“control group”consisted of 29 non-symptomatic ears belonging to patients diagnosed with unilateral sudden sensory-neural hearing loss or unilateral schwannoma.All the patients underwent 2 sessions of temporal bone MRI using the same 3T system:an unenhanced axial T1,T2,and 3D-FLAIR MRI,an intravenous gadoliniumenhanced axial T1 fat-sat,and 4 h after the injection,an axial 3D-T2 cube and 3D-FLAIR session.VH,CH,VANV,and VIPE were assessed.Subsequently,the correlation between EH indices and PTA findings(in three frequency domains of low,middle,and high)were evaluated,and the predictive value of MRI was calculated.Results:VH was significantly correlated with the hearing threshold in the low,middle,and highfrequency domains.CH was also correlated with the hearing threshold in the low and middle domains.Contrarily,VIPE was not associated with hearing thresholds,and VANV was only correlated with the hearing threshold in low frequencies.Conclusion:The grade of VH,CH,and VANV were significantly correlated with the hearing thresholds in PTA.
基金Supported by National Institute for Medical Research Development(NIMAD)affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To compare the subjective refraction data with non-cycloplegic auto-refraction findings in the geriatric population above 60 years of age according to the different crystalline lens conditions.METHODS:This report is a part of the Tehran Geriatric Eye Study(TGES)that was conducted from January 2019 to January 2020 on elderly population 60 years of age and above in Tehran.The samples were selected by multistage stratified random cluster sampling.Of 3791 individual invitees,3310(response rate:87.3%)participated in this study.All study participants underwent non-cycloplegic autorefraction(auto-refractometer/keratometer Nidek ARK-510)and subjective refraction.RESULTS:Regarding the sphere,eyes with mixed cataract had the worst limits of agreement(LoA:-1.24 to 0.87)and the best agreement was related to the pseudophakic eyes(LoA:-0.83 to 0.54).The highest(0.27±0.31 D)and lowest(0.21±0.27 D)differences between the two methods regarding the cylinder power were observed in eyes with cortical cataract and normal eyes,respectively.The worst LoA between the two methods in measuring the cylinder power was related to the eyes with mixed cataract(LoA:-0.44 to 0.96).Regarding the J0(horizontal/vertical components of astigmatism),the mean values of J0 obtained by auto-refraction were tended more toward against the rule direction in all crystalline lens conditions,and the two methods had the greatest difference in cortical cataract cases(0.05±0.17 D).Regarding the J45(oblique components of astigmatism),the lowest(0±0.11 D)and highest(-0.01±0.12 D)differences were observed in normal eyes and eyes with cortical cataract,respectively.CONCLUSION:The auto-refractometer/keratometer Nidek ARK-510 results in the elderly with different phakic and pseudophakic conditions do not correspond well with subjective refraction findings.This discrepancy in spherical findings is more pronounced in individuals with mixed cataract than in other cases.
基金Supported by National Institute for Medical Research Development(NIMAD)affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To determine the normative distribution of axial length(AL),anterior chamber depth(ACD),anterior chamber volume(ACV),anterior chamber angle(ACA),and some of their associated factors in subjects aged 60 and over.METHODS:In this cross-sectional study,160 clusters were sampled using multi-stage cluster sampling in Tehran,Iran.After a preliminary interview,the participants underwent optometric examinations including visual acuity and refraction measurement followed by slit lamp biomicroscopy.Finally,ocular imaging was done using the Pentacam AXL to measure AL,ACD,ACV,and ACA.RESULTS:A total of 4519 eyes of 2436 participants were evaluated,of whom 58.0%(n=1412)were female.The mean age of the subjects was 67.32±6.05y(range:60-95y).The mean AL,ACD,ACV,and ACA was 23.22 mm(23.18-23.27 mm),2.61 mm(2.59-2.62 mm),126.56 mm3(125.08-128.04 mm3),and 30.61°(30.3°-30.92°),respectively.In the multivariable model,after adjusting for the effect of both eyes,the longest and shortest AL was seen in myopic and hyperopic subjects,respectively.AL,ACD,ACV and ACA were significantly larger in men compared to women(P<0.001).Except ACA,other evaluated parameters showed an inverse correlation with age(P<0.001),however,this correlation was insignificant for AL(P=0.623).CONCLUSION:Normative value of AL,and other biometric parameters are specific for each ethnicity,age and sex group.Any alteration in these parameters and their effect on refraction should be considered in this age group,especially in case of cataract surgery.
文摘Background:Evaluation of corneal biomechanical properties 3 months after using rigid gas permeable(RGP)contact lenses in keratoconus.Methods:In this prospective trial study,cases were 32 keratoconic eyes with no history of RGP lens wear.All eyes were examined with the Ocular Response Analyzer(ORA)and the Corneal Visualization Scheimpflug Technology(CORVIS-ST)to measure corneal hysteresis(CH),corneal resistance factor(CRF),deformation amplitude(DA),applanation velocity(AV)1 and 2,applanation length(AL)1 and 2,and peak distance before and 3 months after fitting aspheric RGP lenses.The effect of the correlation between contralateral eyes and maximum keratometry were controlled for in the analysis.Results were compared using repeated measures analysis of covariance.Results:At 3 months,neither the increases in mean CH(0.14±2.77 mm Hg,P=0.789),CRF(0.41±4.35 mm Hg,P=0.612),AV1(0.03±0.17 m/s,P=0.301),AV2(0.11±0.59 m/s,P=0.299),AL1(0.44±1.56 m/s,P=0.118),AL2(1.16±5.06 m/s,P=0.211),and peak distance(0.19±1.29 m/s,P=0.409),nor the decrease in mean DA(0.03±0.17 mm,P=0.402)was statistically significant.Conclusions:Results in our series of patients indicated that 3 months of RGP lens wear had no significant impact on corneal biomechanics,and perhaps non progression of keratoconus.Therefore,RGP lenses can be regarded safe and appropriate in keratoconic patients.
基金Noor Ophthalmology Research CenterShahroud University of Medical Sciences
文摘AIM:To compare central corneal thickness(CCT) and anterior chamber depth(ACD) measurements using rotating Scheimpflug imaging and partial coherence interferometry.·METHODS:As part of the first phase of Shahroud Eye Cohort Study with 5 190 subjects of 40 to 64 years of age,CCT and ACD were measured using Scheimpflug imaging with the Pentacam(Oculus,Inc.,Lynnwood,WA,USA) and partial coherence interferometry with the Allegro BioGraph(Wavelight,Erlangen,Germany).·RESULTS:After applying exclusion criteria,we had data of 4 387 subjects with a mean age of 50.7±6.2 years.Mean CCT with Pentacam and BioGraph were 528.6 ±33.2μm and 525.6 ±32μm respectively;the difference was statistically significant(P 【0.001),but the correlation was high(R=0.920).Mean ACD measurements using Pentacam and BioGraph were 2.68 ±0.35mm and 2.62 ±0.33mm respectively;the inter-device difference was significant(P 【0.001) with high correlation(R=0.944).The 95% limits of agreements between devices were-22.65μm to28.61μm and-0.16mm to 0.29mm for CCT and ACD measurements,respectively.·CONCLUSION:For both CCT and ACD,the BioGraph gave significantly lower values than the Pentacam(P 【0.05).Despite the high inter-device correlation,the 95%limits of agreements were wide,and this may limit their interchangeability in measuring the CCT and ACD.
基金Supported by National Institute for Medical Research Development(NIMAD)Affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To determine the prevalence of red-green(RG)color vision deficiency(CVD)in an elderly population and its related factors.METHODS:This report is a part of the Tehran Geriatric Eye Study:a cross-sectional population-based study that was conducted on the elderly population(≥60y)of Tehran,Iran using multi-stage stratified random cluster sampling.All study participants underwent complete ocular examination,including the measurement of uncorrected and bestcorrected visual acuity,objective and subjective refraction,and slit-lamp biomicroscopy.The color vision was tested using Ishihara plates with the near optical correction in place.RESULTS:Of the 3791 invitees,3310 participated in the study.The data of 2164 individuals were analyzed after applying the exclusion criteria.The prevalence of R-G CVD was 3.73%(95%CI:2.37%–5.09%)in the whole sample;the prevalence of protanomaly,protanopia,and deuteranopia was 1.51%,1.76%,and 0.45%,respectively.The prevalence of R-G CVD was significantly higher in males than in females.The prevalence of RG CVD increased with advancing age from 2.91%in the age group 60–64y to 5.8%in the age group≥80y(P=0.070).According to the multiple logistic regression model,male sex,and glaucoma were significantly related to RG CVD.Older age and hypertension also had a marginally significant relationship with RG CVD.CONCLUSION:Changes in color vision occur in the elderly due to the aging process and some physiological and pathological factors.Since the change in visual perception may affect the person’s performance,this aspect of the visual system’s function should also be taken into consideration in the examinations of the elderly.
文摘AIMTo determine the distribution of intraocular pressure(IOP)and its determinants in an Iranian population.METHODSIn a cross-sectional survey,random cluster sampling was conducted from the 40-64 years old population of Shahroud,in the north of Iran.All participants had optometry and ophthalmic exams.IOP was determined using the Goldmann tonometry method and biometric components were measured.RESULTSOf the 6311 people selected for the study,5190(82.2%)participated.The mean age of the participants was 50.9±6.2y and 58.7%of them were female.Mean IOP was 12.87±2.27 mm Hg.In this study 0.3%of the participants had an IOP higher than 21 mm Hg.The multiple linear regression model revealed that sex(Coef=-0.30;95%CI:-0.43 to-0.17),diabetes(Coef=0.43;95%CI:0.19 to 0.67),high systolic blood pressure(Coef=0.02;95%CI:0.01 to 0.02),high body mass index(BMI)(Coef=0.03;95%CI:0.01 to 0.04),higher education(Coef=0.02,95%CI:0.01 to 0.04),thicker central corneal thickness(Coef=0.01;95%CI:0.01 to 0.02),and myopic shift in spherical equivalent(Coef=-0.14;95%CI:-0.18 to-0.10)significantly correlated with high IOP.CONCLUSIONThe IOP in this 40-64 years old population is low overall.In the north of Iran,average IOP is statistically significantly correlated with female sex,diabetes,higher BMI,systolic blood pressure,higher education,thicker cornea,and myopic refractive error.
基金Supported by Iran University of Medical Sciences (IUMS)。
文摘AIM:To investigate the relationship between near point of convergence(NPC)and mild cognitive impairment(MCI)in the general elderly population.METHODS:The present report is a part of the Tehran Geriatric Eye Study(TGES):a population-based crosssectional study conducted on individuals 60 years of age and above living in Tehran,Iran using the multi-stage stratified random cluster sampling method.Cognitive status was assessed using the Persian version of the Mini-Mental State Examination(MMSE).All study participants underwent complete ocular examination including measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,cover testing,NPC measurement,and slit-lamp biomicroscopy.RESULTS:The data of 1190 individuals were analyzed for this report.The mean age of the participants analyzed was 66.82±5.42(60-92y)and 728(61.2%)of them were female.Patients with MCI had a significantly more receded NPC compared to subjects with normal cognitive status(10.89±3.58 vs 7.76±2.71 cm,P<0.001).In the multivariable logistic regression model and in the presence of confounding variables,a receded NPC was statistically significantly associated with an increased risk of MCI(odds ratio:1.334,95%confidence interval:1.263 to 1.410,P<0.001).According to receiver operating characteristic(ROC)analysis,a cut point NPC>8.5 cm(area under the curve:0.764,P<0.001)could predict the presence of MCI with a sensitivity and specificity of 70.9%and 69.5%,respectively.CONCLUSION:A receded NPC can be clinically proposed as a predictor of MCI in older adults.It is recommended that elderly with a receded NPC>8.50 cm undergo detailed cognitive screening for a definite diagnosis of MCI.In this case,the necessary interventions can be carried out to slow down MCI progression to dementia.
