BACKGROUND Most patients with cardiovascular disorders suffer from coronary artery diseases,which can be treated successfully using coronary artery bypass grafting(CABG).One of the unpleasant events following CABG is ...BACKGROUND Most patients with cardiovascular disorders suffer from coronary artery diseases,which can be treated successfully using coronary artery bypass grafting(CABG).One of the unpleasant events following CABG is postoperative vision loss(POVL).Vulnerability of retinal vessels to hemodynamic changes,an expectable event following CABG,may contribute to the development of POVL,which might be associated with the changes in the choroidal and retinal structures.AIM To investigate postoperative changes in chorioretinal and peripapillary nerve fiber layer(NFL)thickness,and progression of diabetic and hypertensive retinopathy after CABG.METHODS In this prospective,cross-sectional study,49 eyes in 25 candidates for CABG underwent both ophthalmic and cardiovascular examinations within 6 mo prior to and 9 mo after surgery.RESULTS Among the study participants,56%were male with a mean age of 62.84 years±10.49 years(range 33–80 years).Diabetes mellitus was observed in eight participants(32%).None of the patients suffered from postoperative anterior or posterior ischemic optic neuropathy,central retinal artery occlusion,and cortical blindness.The mean value of the preoperative best corrected visual acuity was 0.11±0.10 logMAR(range,0–0.4),which worsened to 0.15±0.08 logMAR(range,0–0.4)after CABG(P=0.031).No significant difference was observed between the preand postsurgical choroidal(P=0.853)and macular(P=0.507)thickness,NFL thickness in the subfoveal(P>0.999)and peripapillary areas(P=0.659),as well as the severity of diabetic and hypertensive retinopathy.CONCLUSION CABG may reduce visual acuity without affecting ocular structures.Postoperative vision reduction might be attributable to molecular or cellular variations,changes in visual pathway function,or central nervous system.展开更多
AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observation...AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.展开更多
AIM: To determine the safe dose of intravitreal clonidine(IVC), a potential drug for neuroprotection and angiogenesis inhibition in rabbits. METHODS: A total of 28 rabbits were divided into four groups. Three grou...AIM: To determine the safe dose of intravitreal clonidine(IVC), a potential drug for neuroprotection and angiogenesis inhibition in rabbits. METHODS: A total of 28 rabbits were divided into four groups. Three groups received IVC with concentrations of 15(Group A), 25(Group B), and 50(Group C) g/0.1 m L and the control group(Group D) received 0.1 m L balanced salt solution(BSS). To investigate IVC safety, electroretinography(ERG) was performed at baseline, then at 1, 4 and 8 wk after injection. After last ERG, all rabbits were euthanized, their eyes were enucleated and subjected to routine histopathological evaluation, immunohistochemistry for glial fibrillary acidic protein(GFAP) and terminal deoxynucleotidyl transferase d UTP nick end labeling(TUNEL) test.RESULTS: Based on ERG, histopathology, GFAP and TUNEL assay findings, 15 g IVC was determined as the safe dose in rabbit eyes. While, the results of routine histopathology and TUNEL assay were unremarkable in all groups, toxic effects attributed to 25 and 50 g IVC were demonstrated by ERG and GFAP tests. CONCLUSION: Totally 15 g clonidine is determined as the safe dose for intravitreal injection in rabbits. Contribution of IVC in neuroprotection and inhibition of angiogenesis deserve more studies.展开更多
文摘BACKGROUND Most patients with cardiovascular disorders suffer from coronary artery diseases,which can be treated successfully using coronary artery bypass grafting(CABG).One of the unpleasant events following CABG is postoperative vision loss(POVL).Vulnerability of retinal vessels to hemodynamic changes,an expectable event following CABG,may contribute to the development of POVL,which might be associated with the changes in the choroidal and retinal structures.AIM To investigate postoperative changes in chorioretinal and peripapillary nerve fiber layer(NFL)thickness,and progression of diabetic and hypertensive retinopathy after CABG.METHODS In this prospective,cross-sectional study,49 eyes in 25 candidates for CABG underwent both ophthalmic and cardiovascular examinations within 6 mo prior to and 9 mo after surgery.RESULTS Among the study participants,56%were male with a mean age of 62.84 years±10.49 years(range 33–80 years).Diabetes mellitus was observed in eight participants(32%).None of the patients suffered from postoperative anterior or posterior ischemic optic neuropathy,central retinal artery occlusion,and cortical blindness.The mean value of the preoperative best corrected visual acuity was 0.11±0.10 logMAR(range,0–0.4),which worsened to 0.15±0.08 logMAR(range,0–0.4)after CABG(P=0.031).No significant difference was observed between the preand postsurgical choroidal(P=0.853)and macular(P=0.507)thickness,NFL thickness in the subfoveal(P>0.999)and peripapillary areas(P=0.659),as well as the severity of diabetic and hypertensive retinopathy.CONCLUSION CABG may reduce visual acuity without affecting ocular structures.Postoperative vision reduction might be attributable to molecular or cellular variations,changes in visual pathway function,or central nervous system.
文摘AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.
文摘AIM: To determine the safe dose of intravitreal clonidine(IVC), a potential drug for neuroprotection and angiogenesis inhibition in rabbits. METHODS: A total of 28 rabbits were divided into four groups. Three groups received IVC with concentrations of 15(Group A), 25(Group B), and 50(Group C) g/0.1 m L and the control group(Group D) received 0.1 m L balanced salt solution(BSS). To investigate IVC safety, electroretinography(ERG) was performed at baseline, then at 1, 4 and 8 wk after injection. After last ERG, all rabbits were euthanized, their eyes were enucleated and subjected to routine histopathological evaluation, immunohistochemistry for glial fibrillary acidic protein(GFAP) and terminal deoxynucleotidyl transferase d UTP nick end labeling(TUNEL) test.RESULTS: Based on ERG, histopathology, GFAP and TUNEL assay findings, 15 g IVC was determined as the safe dose in rabbit eyes. While, the results of routine histopathology and TUNEL assay were unremarkable in all groups, toxic effects attributed to 25 and 50 g IVC were demonstrated by ERG and GFAP tests. CONCLUSION: Totally 15 g clonidine is determined as the safe dose for intravitreal injection in rabbits. Contribution of IVC in neuroprotection and inhibition of angiogenesis deserve more studies.