Retinal and choroidal microvasculature in early and three months post COVID-19: A case-control study.

To compare the retinal vascular density (VD), choroidal vascularity index (CVI), and choroidal thickness (CHT) between patients infected with COVID-19 and healthy subjects using non-invasive optical coherence tomography angiography (OCTA) and enhanced depth imaging OCT (EDI-OCT) technique. This case-control study was carried out on patients with COVID-19 and healthy controls. Patients' data were acquired immediately after active infection and three months later. The diagnosis was based on clinical symptoms and a positive PCR test. VDs in superficial and deep capillary plexuses (SCP and DCP) and CHT and CVI were measured and compared between groups. A total of 160 eyes from 80 patients (55% female, mean age 51 ± 13 years) and 80 controls (55% female, mean age 49 ± 12 years) were enrolled. In acute phase infection, the mean foveal avascular zone (FAZ) area was 0.28 ± 0.06 mm2 and 0.22 ± 0.05 mm2 in patient and control groups, respectively (P < 0.001). CVI was 61.06 ± 2.59 µm and 72.28 ± 3.84 µm in patients and control groups, respectively (P < 0.001). After three months, the mean FAZ area was 0.28 ± 0.06 mm2 and 0.23 ± 0.05 mm2 in the patient and control groups, respectively (P < 0.001). CVI was 60.93 ± 2.11 µm and 72.46 ± 3.80 µm in patients and control groups, respectively (P < 0.001). Subfoveal CHT was not significantly different between groups (P = 0.69). SCP and DCP VDs were significantly less in the patients' group (P < 0.001). In the patients' group, the VDs in the DCP of the whole images and parafoveal DCP (P < 0.001) were reduced significantly after three months in comparison to the acute phase, while the FAZ area, subfoveal CHT, and CVI were not significantly different. COVID-19 infection may be associated with acute and long-term changes of VDs in the retinal and choroidal vasculature without significant effect on the subfoveal CHT.

Investigating the effects of a blue-blocking software on the daily rhythm of sleep, melatonin, cortisol, positive and negative emotions.

Since the use of light and electronic devices is inevitable, the use of blue light filters (in various light sources, electronic devices or optical devices including intraocular lenses) has been shown to improve sleep quality, especially in later hours of the day and during night time. In this study, we examine the effect of the blue light on sleep and wakefulness rhythms and positive and negative emotions. This randomized clinical trial was conducted with 80 AJA University of Medical Sciences employees who use computers at least 2 h a day. All subjects were employees of the discharge unit of Imam Reza Hospital, which is located next to AJA University. The subjects were divided into two groups of 40 people, blue light filter software intervention and sham treatment. Pittsburgh Sleep Quality Index (PSQI), Positive and Negative Affect Schedule (PANAS), Visual Function Questionnaire (VFQ), Epworth Sleepiness Scale (ESS) and salivary melatonin and cortisol levels were assessed for both groups before and 3 months after the intervention. Data analysis was performed using IBM SPSS statistics for windows, version 21.0 (Armonk, NY: IBM Corporation). P value ≤ 0.05 was considered as statistically significant. The results showed that the Pittsburgh sleep scale after the intervention was significantly lower in the intervention group than in the control group. After the intervention, the VFQ was significantly lower in the intervention group than in the control group (P = 0.018). There was no significant difference in the Epworth Sleepiness Scale (ESS) between the two study groups after the intervention (P = 0.370). There was no significant difference in Positive and Negative Affect Schedule (PANAS) in the two study groups after the intervention (P = 0.140). After the intervention, cortisol levels were significantly higher in the intervention group than in the control group (P = 0.006). Also, the amount of cortisol increased significantly in the intervention group (P = 0.028). The amount of melatonin decreased significantly in the intervention group (P = 0.034). The sleep quality score after the intervention was significantly lower in the intervention group than in the control group. This indicates better sleep quality in the intervention group. The results also show that the level of visual fatigue in the intervention group decreased significantly. However, no significant change was detected regarding positive and negative emotions. After the intervention, cortisol levels were significantly higher in the intervention group than the control group. In addition, cortisol levels increased significantly and melatonin levels decreased significantly in the intervention group during the course of study.

Comparison of Manual Refraction Versus Autorefraction in 60 Diabetic Retinopathy Patients.

AIM: The purpose of the study was to evaluate the comparison of manual refraction versus autorefraction in diabetic retinopathy patients. MATERIAL AND METHODS: The study was conducted at the Be'sat Army Hospital from 2013-2015. In the present study differences between two common refractometry methods (manual refractometry and Auto refractometry) in diagnosis and follow up of retinopathy in patients affected with diabetes is investigated. RESULTS: Our results showed that there is a significant difference in visual acuity score of patients between manual and auto refractometry. Despite this fact, spherical equivalent scores of two methods of refractometry did not show a significant statistical difference in the patients. CONCLUSION: Although use of manual refraction is comparable with autorefraction in evaluating spherical equivalent scores in diabetic patients affected with retinopathy, but in the case of visual acuity results from these two methods are not comparable.

Frequency of Bacterial Samples from Patients with Chronic Acquired Nasolacrimal Duct Obstruction.

INTRODUCTION: Dacryocystitis is an infection of lacremical sac due to obstruction of nasolacrimal duct which has primary or secondary causes. Idiopathic inflammatory obstruction is the primary cause. Trauma, infection, inflammation, neoplasia, and mechanical obstruction are secondary one. AIM: The objective of this study is determination of bacterial samples from patients with chronic acquired nasolacrimal duct obstruction. METHODS: This cross-sectional study was contained 90 patients with dacryocystitis from 2010 to 2011, in Besat hospital. Convenience sampling in sterile condition sampling was performed by sterile swab from the pus out of the lacrimal sac. Blood agar, EMB, chocolate agar, and thioglycolate broth were used for bacterial cultivation. Various antibiotics were used for antibiotic resistance study. Finally, statistical analysis was done by SPSS ver. 15. RESULTS: In this study, the mean age of participants was 49.36 ± 12.18 years. Number of male and female patients was equal and Sampling was performed in 53.3% of patients from the right eye. The most frequent bacteria were Staphylococcus, E. coli, and Enterobacteriaceae, respectively. Also, our results show most of bacteria obtained from patients eye pus are sensitive to chloramphenicol and the most antibiotic resistance was for co-trimoxazole. CONCLUSION: Our results illustrated gram-positive bacteria have an important role in dacryocystitis which is confirm previous studies. Although our results indicated chloramphenicol is the best choice for treatment process, but it is notable due to the variety of bacteria which can cause this disease, identification of bacterial contamination can be a great help to choose the best treatment process.

Efficacy of tightening of orbicularis oculi muscle in patients with functional nasolacrimal duct obstruction.

PURPOSE: To evaluate the efficacy of tightening of lateral portion of orbicularis oculi muscle in patients with functional nasolacrimal duct obstruction (FNLDO). METHODS: This is an interventional cross-section study for evaluation of effect of orbicularis oculi tightening procedure in patients with FNLDO. Patients with unexplained epiphora, open lacrimal system in syringing and evidences of lacrimal pump weakness in lacrimal scintigraphy underwent surgery. In this procedure, a stripe of preseptal and pretarsal orbicularis muscle was dissected, slightly resected and secured to the periosteum of lateral orbital rim. Each subject completed a questionnaire about the intensity of epiphora before surgery and 1, 3 and 6 months after surgery. Furthermore, fluorescein dye disappearance test (FDDT) was performed before surgery and repeated in the follow-up visits. At last visit, the pre- and post-operative data were analyzed and compared. RESULTS: Fifteen eyes of 12 patients (5 males and 7 females) with the mean age of 56.7 years included in the study. Severity of epiphora and tearing effect on daily life were significantly improved following the operation. FDDT result was improved significantly after 1 month follow-up in all eyes (15 eyes), at 3 months follow-up in 80% of eyes (12 eyes) and at the end of the 6th month in 66.7% of eyes (10 eyes). Subjective and objective success rates were 87% and 80%, respectively. No significant complications or side-effects were observed. CONCLUSION: Tightening of lateral portion of preseptal and pretarsal orbicularis muscle seems an effective, safe, and easy procedure to decrease epiphora in patients with FNLDO.

Clinical and Radiologic Characteristics of Inferior Rectus Muscle Sheath Entrapment in Orbital Blowout Fracture.

Blowout fracture is a common condition in the oculoplastics clinic. One of the indications for its repair is entrapment of the inferior rectus muscle within the fracture site. Herein, the authors present 3 patients of inferior rectus muscle sheath entrapment without entrapment of the muscle itself. The outcome of treatment was excellent in all patients. The aim of this report is to present the special clinical and radiologic findings in such patients.

Efficacy of intralesional bevacizumab injection in decreasing pterygium size.

PURPOSE: To evaluate the efficacy of intralesional bevacizumab injection in decreasing size of pterygium. METHODS: Seventeen patients with pterygium (14 with primary and 3 with recurrent pterygium) received intralesional injections of bevacizumab (2.5 mg/0.1 mL). Digital photographs were analyzed by image analysis software to determine the change of corneal involvement as a percentage of the total corneal surface. RESULTS: The mean age of the patients was 45.5 ± 15.8 years. The mean percentage size of lesions before injection was 17.2% ± 4.3% of corneal surface. The mean percentage size of lesions 1 week, 1 month, and 3 months after injection was 15.1% ± 4.3%, 13.4% ± 4.0%, and 14.1% ± 4.4% of corneal surface, respectively. The mean percentage decrease of lesion size was 3.97% ± 3.84%. There were statistically significant differences between percentage of lesion size before and 1 week (P < 0.001), 1 month (P < 0.001), and 3 months (P < 0.001) after injection of bevacizumab. There were neither postinjection ocular complications such as rise of intraocular pressure nor systemic adverse events. Visual acuity did not change after injection of bevacizumab. Despite statistically significant decrease in pterygium size, this decrease does not seem to be clinically significant. CONCLUSIONS: Intralesional bevacizumab injection is fairly effective in reducing the size of pterygium and is well tolerated; however, this effect is not clinically significant.