Masih Hashemi - Academia.edu (original) (raw)

Papers by Masih Hashemi

Pakistan Journal of Medical Sciences, 2016

To evaluate the results of photorefractive keratectomy (PRK) with mitomycin C in myopia correctio... more To evaluate the results of photorefractive keratectomy (PRK) with mitomycin C in myopia correction after five years. This is a cross sectional study which included 145 eyes of 74 patients in 18 to 51 years age group that were undergoing Photorefractive keratectomy with mitomycin C using Allegretto Wave Eye-Q 400-Hz excimer laser platform in Markazi Eye Center, Tehran, Iran. All the surgical procedures were performed by the same surgeon. After five years follow-up evaluation including BCVA, UCVA, Refractive error measurement and external eye examination was performed. The mean diopter of spherical equivalent before surgery was -3.40±1.73. The following findings were obtained after 5 years follow up visit: The mean spherical equivalent value: -0.08±0.40, the mean: Log MARUCVA: 0.02±0.07, the mean Log MAR BCVA: 0.00±0.04. PRK is an effective, safe and predictable method used to correct myopia. The wave front-optimized algorithm of the Allegretto Wave Eye-Q 400-Hz excimer laser platform demonstrated good refractive and visual results. Presence of variables such as gender, age and astigmatism before operation have no significant impact on the result of this operation.

Journal of Ophthalmic Vision Research, Feb 8, 2014

Journal of Ophthalmic Vision Research, Jul 1, 2009

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 2015

To evaluate the rate of acute endophthalmitis after resident-performed intravitreal bevacizumab (... more To evaluate the rate of acute endophthalmitis after resident-performed intravitreal bevacizumab (IVB) injections and to compare the results with those performed by attending retina surgeons. Retrospective comparative case series. Eight thousand thirty-seven patients treated with intravitreal injection of bevacizumab. A retrospective chart review of the resident-performed IVB injections at Rassoul Akram Hospital and attending-performed IVB injections at a private eye clinic between 2011 and 2014 was undertaken. Cases of clinical endophthalmitis were identified. During the study interval, the overall incidence rate of postinjection endophthalmitis was 0.01% (1/8037). Antibiotic eye drops were prescribed after IVB injection for 2771 eyes (34.5%). The single case of acute endophthalmitis occurred after a resident-performed injection, and vitreous culture showed growth of Staphylococcus epidermidis. The incidence rate of acute endophthalmitis after resident-performed IVB injection was 0....

Journal of ophthalmic & vision research, 2014

To determine the frequency of complement factor H (Y402H) and age related macular degeneration su... more To determine the frequency of complement factor H (Y402H) and age related macular degeneration susceptibility gene 2 (A69S) single nucleotide polymorphisms in patients with age-related macular degeneration (AMD) and in matched non-AMD controls in an Iranian population. Seventy patients with AMD and 86 age- and sex-matched controls were recruited and examined. Peripheral blood sample was obtained from all subjects for DNA extraction and direct sequencing of Y402H and A69S genes. Odds ratios (ORs) with 95% confidence intervals (CIs) for the association of Y402H and A69S polymorphisms with AMD were determined. The frequencies of both homozygous and heterozygous genotypes were significantly higher in cases than controls for both Y402H and A69S polymorphisms. In comparison to the wild genotypes, OR for AMD associated with Y402H and A69S polymorphisms were 1.9 (95% CI, 1.1-3.2) and 2.2 (95%CI, 1.6-3.1), respectively. Joint risk analysis considering both genes revealed a higher risk of AMD...

Journal of ophthalmic & vision research, 2008

To compare the efficacy and safety of 1.25 mg versus 2.5 mg intravitreal bevacizumab (IVB) for tr... more To compare the efficacy and safety of 1.25 mg versus 2.5 mg intravitreal bevacizumab (IVB) for treatment of choroidal neovascularization (CNV) associated with agerelated macular degeneration (AMD). In this randomized clinical trial, consecutive patients with active CNV associated with AMD received 1.25 mg or 2.5 mg IVB. Best corrected visual acuity (BCVA), foveal thickness and side effects of therapy were evaluated one and three months after intervention. Overall 86 subjects were enrolled and completed the scheduled follow-up. Forty seven and 39 patients received 1.25 and 2.5 mg IVB respectively. The study groups were balanced in terms of baseline characteristics such as age, BCVA and foveal thickness. Mean improvement in BCVA was 0.06±0.3 logMAR in the 1.25 mg group and 0.07±0.34 logMAR in the 2.5 mg group (P=0.9). Mean decrease in foveal thickness was 49±36 μm in the 1.25 mg group and 65±31μm in the 2.5 mg group (P=0.6). Three cases of vitreous reaction and one case of massive sub...

Journal of ophthalmic & vision research, 2012

To report the outcomes of pars plana vitrectomy (PPV) and intravitreal phacoemulsification in pat... more To report the outcomes of pars plana vitrectomy (PPV) and intravitreal phacoemulsification in patients with dropped nuclei/nuclear fragments following complicated cataract surgery. In this retrospective case series, charts of patients who had undergone PPV and intravitreal phacoemulsification for removal of dislocated nuclei/lens fragments were reviewed. After standard PPV, a conventional phacoemulsification probe with an amputated sleeve was used for grasping and emulsifying the nucleus/nuclear fragments in mid/anterior vitreous cavity. Pre- and postoperative visual acuity, and intra- and postoperative complications were recorded. A total of 22 patients with mean age of 71.1±8.2 years were studied. Mean interval between complicated cataract surgery and PPV was 26.6±36.5 (range: 0-120) days. Patients were followed for a mean of 105.5±57.5 days. Preoperatively, best corrected visual acuity was 2.4±0.6 logMAR which was improved to 1.4±0.6 logMAR at final follow-up (P<0.001). Intrao...

Journal of ophthalmic & vision research, 2012

Cystoid macular edema (CME) is a major cause of decreased vision after complicated or uncomplicat... more Cystoid macular edema (CME) is a major cause of decreased vision after complicated or uncomplicated cataract surgery. This paper reviews the use of intravitreal bevacizumab (IVB) injection for treatment of pseudophakic CME. In a literature search of all articles available on Medline and Scopus databases, 11 studies including one prospective and 4 retrospective studies, 4 case reports, one letter to editor and one review article were identified. All articles except one, reported the use of IVB for chronic CME unresponsive to at least one conventional treatment modality. The level of evidence for all studies was categorized as low or very low. Although intravitreal bevacizumab might be effective for many cases of pseudophakic CME, its use should be reserved for eyes unresponsive to conventional treatment modalities.

Journal of ophthalmic & vision research, 2009

To evaluate quality of life (QOL) before and after corticosteroid therapy for thyroid eye disease... more To evaluate quality of life (QOL) before and after corticosteroid therapy for thyroid eye disease (TED) and to determine the impact of the disease on QOL. A modified TED-QOL questionnaire was completed by consecutive patients before and at least 6 months after steroid therapy. All patients were clinically and biochemically euthyroid during the course of the study. QOL was assessed in subscales of visual function, psychosocial, and educational/counseling; TED was classified by severity score (NOSPECS) and Mourits' clinical activity score. Overall, 61 patients including 18 (29.5%) male and 43 (70.5%) female subjects with mean age of 37.3±13.7 (range, 18-33) years were enrolled. Mean duration of thyroid dysfunction and TED were 40.1±44.8 and 26.5±38.2 months, respectively. Mean disease severity and activity significantly decreased, and visual and psychosocial function scores significantly improved following corticosteroid therapy for TED. Psychosocial score was significantly worse ...

European journal of ophthalmology

To evaluate the use of preoperative intravitreal bevacizumab (IVB) injection in patients undergoi... more To evaluate the use of preoperative intravitreal bevacizumab (IVB) injection in patients undergoing pars plana vitrectomy for complications of proliferative diabetic retinopathy (PDR). In this prospective surgeon-masked randomized clinical trial, 40 eyes of 40 diabetic patients who were candidates for vitrectomy were randomly assigned to receive 2.5 mg IVB 3-5 days before operation (injected group) or no injection before operation (noninjected group). A preoperative complexity score (CS) was recorded. Best-corrected visual acuity, number of endodiathermy applications, backflush needle applications, duration of surgery, and postoperative vitreous hemorrhage were recorded. Twenty-two patients with a CS of 6+/-0.95 in the injected group and 18 patients with a CS of 5.7+/-1.1 in the noninjected group (p=0.3) were studied. Postoperative visual acuities were significantly better than preoperative visual acuities. Preoperative and 3-month postoperative visual acuities were the same for bot...

International ophthalmology

To report ocular perforation that occurred during retrobulbar injection in 7 highly myopic eyes. ... more To report ocular perforation that occurred during retrobulbar injection in 7 highly myopic eyes. Seven patients with a diagnosis of globe injury during retrobulbar injection for ocular anesthesia before cataract surgery were managed by vitreoretinal surgery. All injections were performed by ophthalmologists. The surgeon recognized the perforation in 4 cases at the time of injection. The preoperative vision was hand motion perception in 4 eyes and light perception in 3 eyes. All patients underwent vitreoretinal surgery because of the presence of vitreous hemorrhage and/or retinal detachment diagnosed by funduscopy or ultrasonography. At the time of surgery, all eyes had vitreous hemorrhage and 4 eyes had rhegmatogenous retinal detachment. The number of vitreoretinal procedures performed was: 1 procedure in 4 patients, 2 procedures in 2 patients, and 3 procedures in 1 patient. The period of follow-up ranged from 4 months to 4 years, averaging 20 months. At the end of the follow-up per...

Iranian Journal of Ophthalmology

Purpose : To compare the intraocular pressure (IOP) lowering effect and side effects of Xalatan w... more Purpose : To compare the intraocular pressure (IOP) lowering effect and side effects of Xalatan with generic Latanoprost (Xalabiost) in adults with open-angle glaucoma or ocular hypertension Methods : This was a two-center prospective randomized, crossover clinical trial. Eligible patients with open-angle glaucoma or ocular hypertension were sequentially randomized to two parallel study groups receiving Xalatan and Xalabiost in two periods. The primary efficacy outcome was change in the mean of IOP between baseline and end of each treatment period, and secondary outcomes included differences between treatment groups in mean percent change in IOP from baseline and in proportions of patients reaching specified target mean IOP levels. Results : Nineteen patients in BX group (receiving Xalabiost in first and passing to Xalatan in second treatment period) and 22 patients in XB group (receiving Xalatan in first period and Xalabiost in second treatment period) completed both treatment peri...

Retina, 2009

To compare the safety and efficacy of intravitreal injections of 1.25 and 2.5 mg bevacizumab for ... more To compare the safety and efficacy of intravitreal injections of 1.25 and 2.5 mg bevacizumab for treatment of choroidal neovascularization associated with age-related macular degeneration. In this prospective, randomized, comparative clinical trial, 86 patients with active choroidal neovascularization associated with age-related macular degeneration were studied. Baseline best-corrected visual acuity in the study eye was from 20/40 to 20/2000. Patients were randomly assigned to receive intravitreal injections of 2.5 (39 patients) or 1.25 mg (47 patients) of intravitreal bevacizumab. Best-corrected visual acuity measurement and clinical ocular examination were performed at 1 week, 1 month and then monthly for 5 months. Fluorescein angiography and optical coherence tomography were performed at 1 month and 3 months after each injection. The mean change in best-corrected visual acuity was -0.06 +/- 0.3 logMAR in 1.25 mg and -0.07 +/- 0.34 in 2.5 mg groups in 3 months (P = 0.9) and -0.06 +/- 0.27 logMAR in 1.25 mg and -0.09 +/- 0.28 in 2.5 mg groups in 5 months (P = 0.6). There was no significant difference in visual acuity between the two groups at any time point during the study. The mean change in foveal thickness was -49 +/- 36 micro in 1.25 mg and -65 +/- 31 micro in 2.5 mg group (P = 0.6). In 2.5 mg group, three cases of vitreous reaction and one case of massive subretinal hemorrhage were observed. Intravitreal injection of 2.5 mg bevacizumab has the same efficacy as 1.25 mg, but may be associated with a higher rate of adverse events.

Retina, 2013

To assess the rate of infectious endophthalmitis in a single clinical center in Iran and to compa... more To assess the rate of infectious endophthalmitis in a single clinical center in Iran and to compare the rate of endophthalmitis in patients receiving postinjection antibiotics with those who did not. A retrospective chart review of patients who received intravitreal injections of bevacizumab was undertaken. Cases of clinical diagnoses of endophthalmitis were reviewed. Bevacizumab was obtained at the time of injection from a commercially available vial after aseptic cleansing of the rubber cover. Five patients (six eyes) developed clinical endophthalmitis after the intravitreal bevacizumab injection. The risk per injection was 0.10% (6/5,901). One culture-positive case was found overall. Postinjection antibiotic drops were prescribed for 68% of eyes. All endophthalmitis cases were among those who received postoperative antibiotic eye drops. The difference in the rates of endophthalmitis between those receiving postinjection antibiotics and those who did not was not statistically significant (P = 0.18). A low risk of endophthalmitis consistent with the range of previous studies was observed notwithstanding the usage of multiple use of a single vial. Postinjection antibiotic drops may not be necessary.

Orbit, 2010

To compare the anatomical pattern of lacrimal drainage system obstruction (LDSO) associated with ... more To compare the anatomical pattern of lacrimal drainage system obstruction (LDSO) associated with topical anti-glaucoma medications (AGM) with a control group. In a cross-sectional controlled study, case group included patients on topical anti-glaucoma medications and control group included patients with no history of glaucoma, free of ocular disease, and not using topical medications. Data recording, eye examination, and categorization of patients into case and control groups were performed by a senior ophthalmology resident. Diagnostic probing and irrigation test was performed by an oculoplastic surgeon who was masked to the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; data. Chi-square (X(2)) and tests were used to assess the effect of sex and systemic diseases, as well as logistic regression analysis with intra-cluster correlation for the effect of topical anti-glaucoma medications on lacrimal drainage system, and then independent sample t-tests to compare the mean ages, plus the binary logistic regression test for the effect of increasing age on LDSO. There were 128 eyes of 96 patients in the case and 277 eyes of 172 patients in the control group. Two groups were similar regarding to the age, sex, and associated systemic disorders (0.3&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.5). There was a significantly more LDSO in the case than control group (P = 0.008). Upper LDSO was observed in 76.92% (20/26) of the cases, and 37.5% (9/24) of the control group (P = 0.01). Nasolacrimal duct obstruction was also found in 19.23% of case group. Although punctum and canaliculus are the main anatomical sites of LDSO associated with topical AGM, common canaliculus and nasolacrimal duct separately or in association with punctum and canaliculus may also be involved.

Orbit, 2003

To assess the success rate of external dacryocystorhinostomy (Ext-DCR) and factors affecting it i... more To assess the success rate of external dacryocystorhinostomy (Ext-DCR) and factors affecting it in a university hospital. In a retrospective interventional non-comparative case series, records of 276 Ext-DCRs in 274 patients in a 9-year period were reviewed. &amp;amp;amp;amp;amp;amp;amp;amp;#39;Complete success&amp;amp;amp;amp;amp;amp;amp;amp;#39; was defined as patent system on irrigation (objective) and absence of symptoms (subjective). Patent system on irrigation with minimal postoperative symptoms was considered as partial success. The chi-square and Fisher&amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact tests with 95% confidence interval (CI) were used to analyze the data (SPSS release version 9.0, Chicago). The age range was 3-84 years (mean: 41.5, SD: 17.7). The majority of the patients (66.7%) were female. The most common presumed etiology was primary acquired nasolacrimal duct obstruction (PANLDO) (227/276, 82.2%). A silicone tube was inserted in 111 patients (40.2%). Follow-up was from 6 to 89 months (mean: 11.5, SD: 10.4). Overall complete success rate was 89.1% (246/276). It was 92% (209/227) in PANLDO, 72.7% (16/22) in congenital NLDO (P: 0.01, 95% CI: 0.024-0.030), 71.4% (10/14) in traumatic NLDO (P: 0.001, 95% CI: 0.012-0.017), 90% (9/10) in previous failed DCR (P: 0.6, 95% CI: 1), and two out of three patients with previous nasal/sinus surgery. Gender, type of presenting symptoms, duration of preoperative symptoms, silicone tube insertion in PANLDO, and associated canalicular stenosis did not have a significant effect on the success. Ext-DCR is an effective and highly successful procedure for the treatment of NLDO regardless of the etiology.

Ophthalmic Plastic & Reconstructive Surgery, 2008

To compare the sensation recovery, scar formation, and histopathologic aspects of upper blepharop... more To compare the sensation recovery, scar formation, and histopathologic aspects of upper blepharoplasty eyelid incision performed with radiofrequency or scalpel. In a prospective, randomized, blind, comparative, interventional study, 46 eyelids from 23 subjects underwent upper blepharoplasty using radiofrequency incision on one side and a scalpel on the other side. Exclusion criteria were diseases resulting in peripheral neuropathy such as diabetes mellitus, previous upper eyelid surgery or trauma, and history of skin disease. Eyelid sensation was measured preoperatively and 1 week, 1 month, and 6 to 7 months after surgery by a masked observer. Eyelid scar was evaluated by 2 masked observers at final follow-up. Histologic examination for zone and depth of tissue damage, hemorrhage, and inflammatory cell reaction was performed in a masked fashion on 16 eyelids. The mean patient age was 52 years (SD, 5.48 years). Mean aesthesiometry reading significantly decreased in both groups at all follow-up visits in comparison with preoperative measurement (p = 0.000). Mean sensation recovery was insignificantly (0.2 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.6) higher in the radiosurgery group at all follow-up visits. Mean scar score was insignificantly (p = 0.055 for observer 1, and 0.241 for observer 2) less in the radiosurgery group. The scar score was not significantly different between Fitzpatrick skin types 3 and 4, scored by either observer. The zone and depth of tissue damage on histopathologic examination was greater in the radiofrequency group. However, the hemorrhage and infiltration of inflammatory cells were the same. There was no significant difference between radiofrequency and scalpel incision in upper blepharoplasty with regard to sensation recovery and scar formation. Histologic zone and depth of tissue damage were greater in the radiofrequency group.

Middle East African Journal of Ophthalmology, 2013

To evaluate the visual and anatomic results and determine the prognostic factors after pars plana... more To evaluate the visual and anatomic results and determine the prognostic factors after pars plana vitrectomy and posterior segment intraocular foreign body (IOFB) removal. This retrospective study reviews the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; charts of 48 consecutive patients with posterior segment IOFB who underwent pars plana vitrectomy and IOFB removal over a 4-year period, recently. Association between visual outcome and various preoperative, operative, and postoperative variables was statistically analyzed. Data were analyzed with the paired t-test and the chi square test. Statistical significance was indicated by P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05. The mean interval between the time of injury and IOFB removal was 24 ± 43.1 days and 27 (53%) eyes underwent IOFB removal within 7 days of the injury. Nine (19.1%) patients achieved a visual acuity of 20/40 or better. An improvement of visual acuity of at least three lines occurred in 21 (44.6%) eyes and the vision remained unchanged in 15 (31.9%) eyes. Postoperative retinal detachment occurred in five (10.6%) eyes. Visual improvement was more likely to occur in eyes with lower levels of presenting visual acuity (P = 0.2). Visual improvement was not associated with an entry site and IOFB location, lens injury, time to surgery, and pre- and post-operative retinal detachment. At the end of follow up, anatomical success was achieved in 97.9% of eyes. High anatomical success could be achieved after the removal of posterior segment IOFBs by vitrectomy, despite a delay in surgery. Poor visual outcome may be mainly due to the initial ocular injury.

Middle East African Journal of Ophthalmology, 2013

The purpose of this study was to evaluate the anterior segment measurements according to refracti... more The purpose of this study was to evaluate the anterior segment measurements according to refractive status in a sample of the Iranian population. Rassoul Akram Hospital, Tehran University of Medical Sciences. IN THIS STUDY, REFRACTIVE SURGERY CANDIDATES WERE ASSIGNED ACCORDING TO THE REFRACTIVE ERROR TO ONE OF THREE GROUPS : emmetropia, myopia, and hyperopia. Myopic eyes were further divided to four subgroups : simple myopic group, simple myopic astigmatism group, high myopic group, and high myopia with astigmatism group. Anterior segment measurements with the Pentacam Scheimpflug system were performed in the right eye of all subjects. The study sample was comprised of 283 subjects with a mean age of 29.1 ± 7.5 (standard deviation) years. Mean keratometry reading, Anterior chamber depth (ACD) and volume measurements were significantly higher in the myopic group and mean keratometry reading and anterior chamber angle measurements were significantly lower in the hyperopic group (P &amp;amp;amp;amp;lt; 0.05, all comparisons). Maximum anterior elevation (AEmax) and maximum posterior elevation (PEmax), Q value, progression index, minimum corneal thickness, and corneal volume measurements were similar for all groups (P &amp;amp;amp;amp;gt; 0.05, all comparisons). In the myopic subgroups, AEmax and PEmax and maximum keratometry (Kmax) were significantly higher, and ACD was lower in the astigmatic groups (P &amp;amp;amp;amp;lt; 0.05, all comparisons). The Q value was less negative in low myopia (P &amp;amp;amp;amp;lt; 0.05). Myopic eyes had steeper corneas than hyperopic eyes and anterior chamber measurements were significantly higher in the myopic eyes. In myopic eyes, AEmax and PEmax and Kmax measurements were higher, and ACD measurements were lower in the astigmatic groups.

Pakistan Journal of Medical Sciences, 2016

To evaluate the results of photorefractive keratectomy (PRK) with mitomycin C in myopia correctio... more To evaluate the results of photorefractive keratectomy (PRK) with mitomycin C in myopia correction after five years. This is a cross sectional study which included 145 eyes of 74 patients in 18 to 51 years age group that were undergoing Photorefractive keratectomy with mitomycin C using Allegretto Wave Eye-Q 400-Hz excimer laser platform in Markazi Eye Center, Tehran, Iran. All the surgical procedures were performed by the same surgeon. After five years follow-up evaluation including BCVA, UCVA, Refractive error measurement and external eye examination was performed. The mean diopter of spherical equivalent before surgery was -3.40±1.73. The following findings were obtained after 5 years follow up visit: The mean spherical equivalent value: -0.08±0.40, the mean: Log MARUCVA: 0.02±0.07, the mean Log MAR BCVA: 0.00±0.04. PRK is an effective, safe and predictable method used to correct myopia. The wave front-optimized algorithm of the Allegretto Wave Eye-Q 400-Hz excimer laser platform demonstrated good refractive and visual results. Presence of variables such as gender, age and astigmatism before operation have no significant impact on the result of this operation.

Journal of Ophthalmic Vision Research, Feb 8, 2014

Journal of Ophthalmic Vision Research, Jul 1, 2009

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 2015

To evaluate the rate of acute endophthalmitis after resident-performed intravitreal bevacizumab (... more To evaluate the rate of acute endophthalmitis after resident-performed intravitreal bevacizumab (IVB) injections and to compare the results with those performed by attending retina surgeons. Retrospective comparative case series. Eight thousand thirty-seven patients treated with intravitreal injection of bevacizumab. A retrospective chart review of the resident-performed IVB injections at Rassoul Akram Hospital and attending-performed IVB injections at a private eye clinic between 2011 and 2014 was undertaken. Cases of clinical endophthalmitis were identified. During the study interval, the overall incidence rate of postinjection endophthalmitis was 0.01% (1/8037). Antibiotic eye drops were prescribed after IVB injection for 2771 eyes (34.5%). The single case of acute endophthalmitis occurred after a resident-performed injection, and vitreous culture showed growth of Staphylococcus epidermidis. The incidence rate of acute endophthalmitis after resident-performed IVB injection was 0....

Journal of ophthalmic & vision research, 2014

To determine the frequency of complement factor H (Y402H) and age related macular degeneration su... more To determine the frequency of complement factor H (Y402H) and age related macular degeneration susceptibility gene 2 (A69S) single nucleotide polymorphisms in patients with age-related macular degeneration (AMD) and in matched non-AMD controls in an Iranian population. Seventy patients with AMD and 86 age- and sex-matched controls were recruited and examined. Peripheral blood sample was obtained from all subjects for DNA extraction and direct sequencing of Y402H and A69S genes. Odds ratios (ORs) with 95% confidence intervals (CIs) for the association of Y402H and A69S polymorphisms with AMD were determined. The frequencies of both homozygous and heterozygous genotypes were significantly higher in cases than controls for both Y402H and A69S polymorphisms. In comparison to the wild genotypes, OR for AMD associated with Y402H and A69S polymorphisms were 1.9 (95% CI, 1.1-3.2) and 2.2 (95%CI, 1.6-3.1), respectively. Joint risk analysis considering both genes revealed a higher risk of AMD...

Journal of ophthalmic & vision research, 2008

To compare the efficacy and safety of 1.25 mg versus 2.5 mg intravitreal bevacizumab (IVB) for tr... more To compare the efficacy and safety of 1.25 mg versus 2.5 mg intravitreal bevacizumab (IVB) for treatment of choroidal neovascularization (CNV) associated with agerelated macular degeneration (AMD). In this randomized clinical trial, consecutive patients with active CNV associated with AMD received 1.25 mg or 2.5 mg IVB. Best corrected visual acuity (BCVA), foveal thickness and side effects of therapy were evaluated one and three months after intervention. Overall 86 subjects were enrolled and completed the scheduled follow-up. Forty seven and 39 patients received 1.25 and 2.5 mg IVB respectively. The study groups were balanced in terms of baseline characteristics such as age, BCVA and foveal thickness. Mean improvement in BCVA was 0.06±0.3 logMAR in the 1.25 mg group and 0.07±0.34 logMAR in the 2.5 mg group (P=0.9). Mean decrease in foveal thickness was 49±36 μm in the 1.25 mg group and 65±31μm in the 2.5 mg group (P=0.6). Three cases of vitreous reaction and one case of massive sub...

Journal of ophthalmic & vision research, 2012

To report the outcomes of pars plana vitrectomy (PPV) and intravitreal phacoemulsification in pat... more To report the outcomes of pars plana vitrectomy (PPV) and intravitreal phacoemulsification in patients with dropped nuclei/nuclear fragments following complicated cataract surgery. In this retrospective case series, charts of patients who had undergone PPV and intravitreal phacoemulsification for removal of dislocated nuclei/lens fragments were reviewed. After standard PPV, a conventional phacoemulsification probe with an amputated sleeve was used for grasping and emulsifying the nucleus/nuclear fragments in mid/anterior vitreous cavity. Pre- and postoperative visual acuity, and intra- and postoperative complications were recorded. A total of 22 patients with mean age of 71.1±8.2 years were studied. Mean interval between complicated cataract surgery and PPV was 26.6±36.5 (range: 0-120) days. Patients were followed for a mean of 105.5±57.5 days. Preoperatively, best corrected visual acuity was 2.4±0.6 logMAR which was improved to 1.4±0.6 logMAR at final follow-up (P<0.001). Intrao...

Journal of ophthalmic & vision research, 2012

Cystoid macular edema (CME) is a major cause of decreased vision after complicated or uncomplicat... more Cystoid macular edema (CME) is a major cause of decreased vision after complicated or uncomplicated cataract surgery. This paper reviews the use of intravitreal bevacizumab (IVB) injection for treatment of pseudophakic CME. In a literature search of all articles available on Medline and Scopus databases, 11 studies including one prospective and 4 retrospective studies, 4 case reports, one letter to editor and one review article were identified. All articles except one, reported the use of IVB for chronic CME unresponsive to at least one conventional treatment modality. The level of evidence for all studies was categorized as low or very low. Although intravitreal bevacizumab might be effective for many cases of pseudophakic CME, its use should be reserved for eyes unresponsive to conventional treatment modalities.

Journal of ophthalmic & vision research, 2009

To evaluate quality of life (QOL) before and after corticosteroid therapy for thyroid eye disease... more To evaluate quality of life (QOL) before and after corticosteroid therapy for thyroid eye disease (TED) and to determine the impact of the disease on QOL. A modified TED-QOL questionnaire was completed by consecutive patients before and at least 6 months after steroid therapy. All patients were clinically and biochemically euthyroid during the course of the study. QOL was assessed in subscales of visual function, psychosocial, and educational/counseling; TED was classified by severity score (NOSPECS) and Mourits' clinical activity score. Overall, 61 patients including 18 (29.5%) male and 43 (70.5%) female subjects with mean age of 37.3±13.7 (range, 18-33) years were enrolled. Mean duration of thyroid dysfunction and TED were 40.1±44.8 and 26.5±38.2 months, respectively. Mean disease severity and activity significantly decreased, and visual and psychosocial function scores significantly improved following corticosteroid therapy for TED. Psychosocial score was significantly worse ...

European journal of ophthalmology

To evaluate the use of preoperative intravitreal bevacizumab (IVB) injection in patients undergoi... more To evaluate the use of preoperative intravitreal bevacizumab (IVB) injection in patients undergoing pars plana vitrectomy for complications of proliferative diabetic retinopathy (PDR). In this prospective surgeon-masked randomized clinical trial, 40 eyes of 40 diabetic patients who were candidates for vitrectomy were randomly assigned to receive 2.5 mg IVB 3-5 days before operation (injected group) or no injection before operation (noninjected group). A preoperative complexity score (CS) was recorded. Best-corrected visual acuity, number of endodiathermy applications, backflush needle applications, duration of surgery, and postoperative vitreous hemorrhage were recorded. Twenty-two patients with a CS of 6+/-0.95 in the injected group and 18 patients with a CS of 5.7+/-1.1 in the noninjected group (p=0.3) were studied. Postoperative visual acuities were significantly better than preoperative visual acuities. Preoperative and 3-month postoperative visual acuities were the same for bot...

International ophthalmology

To report ocular perforation that occurred during retrobulbar injection in 7 highly myopic eyes. ... more To report ocular perforation that occurred during retrobulbar injection in 7 highly myopic eyes. Seven patients with a diagnosis of globe injury during retrobulbar injection for ocular anesthesia before cataract surgery were managed by vitreoretinal surgery. All injections were performed by ophthalmologists. The surgeon recognized the perforation in 4 cases at the time of injection. The preoperative vision was hand motion perception in 4 eyes and light perception in 3 eyes. All patients underwent vitreoretinal surgery because of the presence of vitreous hemorrhage and/or retinal detachment diagnosed by funduscopy or ultrasonography. At the time of surgery, all eyes had vitreous hemorrhage and 4 eyes had rhegmatogenous retinal detachment. The number of vitreoretinal procedures performed was: 1 procedure in 4 patients, 2 procedures in 2 patients, and 3 procedures in 1 patient. The period of follow-up ranged from 4 months to 4 years, averaging 20 months. At the end of the follow-up per...

Iranian Journal of Ophthalmology

Purpose : To compare the intraocular pressure (IOP) lowering effect and side effects of Xalatan w... more Purpose : To compare the intraocular pressure (IOP) lowering effect and side effects of Xalatan with generic Latanoprost (Xalabiost) in adults with open-angle glaucoma or ocular hypertension Methods : This was a two-center prospective randomized, crossover clinical trial. Eligible patients with open-angle glaucoma or ocular hypertension were sequentially randomized to two parallel study groups receiving Xalatan and Xalabiost in two periods. The primary efficacy outcome was change in the mean of IOP between baseline and end of each treatment period, and secondary outcomes included differences between treatment groups in mean percent change in IOP from baseline and in proportions of patients reaching specified target mean IOP levels. Results : Nineteen patients in BX group (receiving Xalabiost in first and passing to Xalatan in second treatment period) and 22 patients in XB group (receiving Xalatan in first period and Xalabiost in second treatment period) completed both treatment peri...

Retina, 2009

To compare the safety and efficacy of intravitreal injections of 1.25 and 2.5 mg bevacizumab for ... more To compare the safety and efficacy of intravitreal injections of 1.25 and 2.5 mg bevacizumab for treatment of choroidal neovascularization associated with age-related macular degeneration. In this prospective, randomized, comparative clinical trial, 86 patients with active choroidal neovascularization associated with age-related macular degeneration were studied. Baseline best-corrected visual acuity in the study eye was from 20/40 to 20/2000. Patients were randomly assigned to receive intravitreal injections of 2.5 (39 patients) or 1.25 mg (47 patients) of intravitreal bevacizumab. Best-corrected visual acuity measurement and clinical ocular examination were performed at 1 week, 1 month and then monthly for 5 months. Fluorescein angiography and optical coherence tomography were performed at 1 month and 3 months after each injection. The mean change in best-corrected visual acuity was -0.06 +/- 0.3 logMAR in 1.25 mg and -0.07 +/- 0.34 in 2.5 mg groups in 3 months (P = 0.9) and -0.06 +/- 0.27 logMAR in 1.25 mg and -0.09 +/- 0.28 in 2.5 mg groups in 5 months (P = 0.6). There was no significant difference in visual acuity between the two groups at any time point during the study. The mean change in foveal thickness was -49 +/- 36 micro in 1.25 mg and -65 +/- 31 micro in 2.5 mg group (P = 0.6). In 2.5 mg group, three cases of vitreous reaction and one case of massive subretinal hemorrhage were observed. Intravitreal injection of 2.5 mg bevacizumab has the same efficacy as 1.25 mg, but may be associated with a higher rate of adverse events.

Retina, 2013

To assess the rate of infectious endophthalmitis in a single clinical center in Iran and to compa... more To assess the rate of infectious endophthalmitis in a single clinical center in Iran and to compare the rate of endophthalmitis in patients receiving postinjection antibiotics with those who did not. A retrospective chart review of patients who received intravitreal injections of bevacizumab was undertaken. Cases of clinical diagnoses of endophthalmitis were reviewed. Bevacizumab was obtained at the time of injection from a commercially available vial after aseptic cleansing of the rubber cover. Five patients (six eyes) developed clinical endophthalmitis after the intravitreal bevacizumab injection. The risk per injection was 0.10% (6/5,901). One culture-positive case was found overall. Postinjection antibiotic drops were prescribed for 68% of eyes. All endophthalmitis cases were among those who received postoperative antibiotic eye drops. The difference in the rates of endophthalmitis between those receiving postinjection antibiotics and those who did not was not statistically significant (P = 0.18). A low risk of endophthalmitis consistent with the range of previous studies was observed notwithstanding the usage of multiple use of a single vial. Postinjection antibiotic drops may not be necessary.

Orbit, 2010

To compare the anatomical pattern of lacrimal drainage system obstruction (LDSO) associated with ... more To compare the anatomical pattern of lacrimal drainage system obstruction (LDSO) associated with topical anti-glaucoma medications (AGM) with a control group. In a cross-sectional controlled study, case group included patients on topical anti-glaucoma medications and control group included patients with no history of glaucoma, free of ocular disease, and not using topical medications. Data recording, eye examination, and categorization of patients into case and control groups were performed by a senior ophthalmology resident. Diagnostic probing and irrigation test was performed by an oculoplastic surgeon who was masked to the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; data. Chi-square (X(2)) and tests were used to assess the effect of sex and systemic diseases, as well as logistic regression analysis with intra-cluster correlation for the effect of topical anti-glaucoma medications on lacrimal drainage system, and then independent sample t-tests to compare the mean ages, plus the binary logistic regression test for the effect of increasing age on LDSO. There were 128 eyes of 96 patients in the case and 277 eyes of 172 patients in the control group. Two groups were similar regarding to the age, sex, and associated systemic disorders (0.3&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.5). There was a significantly more LDSO in the case than control group (P = 0.008). Upper LDSO was observed in 76.92% (20/26) of the cases, and 37.5% (9/24) of the control group (P = 0.01). Nasolacrimal duct obstruction was also found in 19.23% of case group. Although punctum and canaliculus are the main anatomical sites of LDSO associated with topical AGM, common canaliculus and nasolacrimal duct separately or in association with punctum and canaliculus may also be involved.

Orbit, 2003

To assess the success rate of external dacryocystorhinostomy (Ext-DCR) and factors affecting it i... more To assess the success rate of external dacryocystorhinostomy (Ext-DCR) and factors affecting it in a university hospital. In a retrospective interventional non-comparative case series, records of 276 Ext-DCRs in 274 patients in a 9-year period were reviewed. &amp;amp;amp;amp;amp;amp;amp;amp;#39;Complete success&amp;amp;amp;amp;amp;amp;amp;amp;#39; was defined as patent system on irrigation (objective) and absence of symptoms (subjective). Patent system on irrigation with minimal postoperative symptoms was considered as partial success. The chi-square and Fisher&amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact tests with 95% confidence interval (CI) were used to analyze the data (SPSS release version 9.0, Chicago). The age range was 3-84 years (mean: 41.5, SD: 17.7). The majority of the patients (66.7%) were female. The most common presumed etiology was primary acquired nasolacrimal duct obstruction (PANLDO) (227/276, 82.2%). A silicone tube was inserted in 111 patients (40.2%). Follow-up was from 6 to 89 months (mean: 11.5, SD: 10.4). Overall complete success rate was 89.1% (246/276). It was 92% (209/227) in PANLDO, 72.7% (16/22) in congenital NLDO (P: 0.01, 95% CI: 0.024-0.030), 71.4% (10/14) in traumatic NLDO (P: 0.001, 95% CI: 0.012-0.017), 90% (9/10) in previous failed DCR (P: 0.6, 95% CI: 1), and two out of three patients with previous nasal/sinus surgery. Gender, type of presenting symptoms, duration of preoperative symptoms, silicone tube insertion in PANLDO, and associated canalicular stenosis did not have a significant effect on the success. Ext-DCR is an effective and highly successful procedure for the treatment of NLDO regardless of the etiology.

Ophthalmic Plastic & Reconstructive Surgery, 2008

To compare the sensation recovery, scar formation, and histopathologic aspects of upper blepharop... more To compare the sensation recovery, scar formation, and histopathologic aspects of upper blepharoplasty eyelid incision performed with radiofrequency or scalpel. In a prospective, randomized, blind, comparative, interventional study, 46 eyelids from 23 subjects underwent upper blepharoplasty using radiofrequency incision on one side and a scalpel on the other side. Exclusion criteria were diseases resulting in peripheral neuropathy such as diabetes mellitus, previous upper eyelid surgery or trauma, and history of skin disease. Eyelid sensation was measured preoperatively and 1 week, 1 month, and 6 to 7 months after surgery by a masked observer. Eyelid scar was evaluated by 2 masked observers at final follow-up. Histologic examination for zone and depth of tissue damage, hemorrhage, and inflammatory cell reaction was performed in a masked fashion on 16 eyelids. The mean patient age was 52 years (SD, 5.48 years). Mean aesthesiometry reading significantly decreased in both groups at all follow-up visits in comparison with preoperative measurement (p = 0.000). Mean sensation recovery was insignificantly (0.2 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.6) higher in the radiosurgery group at all follow-up visits. Mean scar score was insignificantly (p = 0.055 for observer 1, and 0.241 for observer 2) less in the radiosurgery group. The scar score was not significantly different between Fitzpatrick skin types 3 and 4, scored by either observer. The zone and depth of tissue damage on histopathologic examination was greater in the radiofrequency group. However, the hemorrhage and infiltration of inflammatory cells were the same. There was no significant difference between radiofrequency and scalpel incision in upper blepharoplasty with regard to sensation recovery and scar formation. Histologic zone and depth of tissue damage were greater in the radiofrequency group.

Middle East African Journal of Ophthalmology, 2013

To evaluate the visual and anatomic results and determine the prognostic factors after pars plana... more To evaluate the visual and anatomic results and determine the prognostic factors after pars plana vitrectomy and posterior segment intraocular foreign body (IOFB) removal. This retrospective study reviews the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; charts of 48 consecutive patients with posterior segment IOFB who underwent pars plana vitrectomy and IOFB removal over a 4-year period, recently. Association between visual outcome and various preoperative, operative, and postoperative variables was statistically analyzed. Data were analyzed with the paired t-test and the chi square test. Statistical significance was indicated by P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05. The mean interval between the time of injury and IOFB removal was 24 ± 43.1 days and 27 (53%) eyes underwent IOFB removal within 7 days of the injury. Nine (19.1%) patients achieved a visual acuity of 20/40 or better. An improvement of visual acuity of at least three lines occurred in 21 (44.6%) eyes and the vision remained unchanged in 15 (31.9%) eyes. Postoperative retinal detachment occurred in five (10.6%) eyes. Visual improvement was more likely to occur in eyes with lower levels of presenting visual acuity (P = 0.2). Visual improvement was not associated with an entry site and IOFB location, lens injury, time to surgery, and pre- and post-operative retinal detachment. At the end of follow up, anatomical success was achieved in 97.9% of eyes. High anatomical success could be achieved after the removal of posterior segment IOFBs by vitrectomy, despite a delay in surgery. Poor visual outcome may be mainly due to the initial ocular injury.

Middle East African Journal of Ophthalmology, 2013

The purpose of this study was to evaluate the anterior segment measurements according to refracti... more The purpose of this study was to evaluate the anterior segment measurements according to refractive status in a sample of the Iranian population. Rassoul Akram Hospital, Tehran University of Medical Sciences. IN THIS STUDY, REFRACTIVE SURGERY CANDIDATES WERE ASSIGNED ACCORDING TO THE REFRACTIVE ERROR TO ONE OF THREE GROUPS : emmetropia, myopia, and hyperopia. Myopic eyes were further divided to four subgroups : simple myopic group, simple myopic astigmatism group, high myopic group, and high myopia with astigmatism group. Anterior segment measurements with the Pentacam Scheimpflug system were performed in the right eye of all subjects. The study sample was comprised of 283 subjects with a mean age of 29.1 ± 7.5 (standard deviation) years. Mean keratometry reading, Anterior chamber depth (ACD) and volume measurements were significantly higher in the myopic group and mean keratometry reading and anterior chamber angle measurements were significantly lower in the hyperopic group (P &amp;amp;amp;amp;lt; 0.05, all comparisons). Maximum anterior elevation (AEmax) and maximum posterior elevation (PEmax), Q value, progression index, minimum corneal thickness, and corneal volume measurements were similar for all groups (P &amp;amp;amp;amp;gt; 0.05, all comparisons). In the myopic subgroups, AEmax and PEmax and maximum keratometry (Kmax) were significantly higher, and ACD was lower in the astigmatic groups (P &amp;amp;amp;amp;lt; 0.05, all comparisons). The Q value was less negative in low myopia (P &amp;amp;amp;amp;lt; 0.05). Myopic eyes had steeper corneas than hyperopic eyes and anterior chamber measurements were significantly higher in the myopic eyes. In myopic eyes, AEmax and PEmax and Kmax measurements were higher, and ACD measurements were lower in the astigmatic groups.