Genotyping of Environmental Isolates of Acanthamoeba in Hamadan, West of Iran.

Background: Different genotypes of Acanthamoeba have been abundantly isolated in environmental samples such as water, soil, and dust, as well as in different hospital departments and eyewash stations. This protozoan is a potential hazard for immunocompromised patients and contact lens wearers. The aim of the present study was isolation and genotyping of environmental and corneal isolates of Acanthamoeba in Hamadan, west of Iran. Methods: During 2018-2020, a total of 104 environmental samples including, water, soil, and dust and 16 corneal scraping samples were collected and investigated for the presence of Acanthamoeba using morphological and molecular identification tools. Genotypes were determined using sequence analysis of the diagnostic fragment 3 (DF3) from Acanthamoeba-specific amplimer S1 (ASA.S1) gene. Phylogenetic tree was constructed with the MEGA7 software using Neighbor-Joining method. Results: The presence of Acanthamoeba spp. was determined in 87.5% of water, 53.1% of soil, and 25% of dust samples. From 30 dust samples collected from eight wards of three hospitals, 7 (23.3%) were contaminated with Acanthamoeba. Sequencing analysis of environmental samples revealed that the T4 genotype was the most prevalent (92.6%) one. Genotypes T2 (1.9%), T2/T6 (1.9%), and mixed T4 and T2/T6 (3.7%) were also identified in environmental samples. Acanthamoeba was seen in none of the examined corneal scraping samples from patients with suspected keratitis. Conclusion: The widespread occurrence of this potentially pathogenic amoeba in most hospital wards and environmental resources and areas of the region highlights a strong need to increase awareness regarding this ubiquitous amoeba among susceptible individuals, such as immunocompromised patients and contact lens wearers.

Non-linear associations between retinal nerve fibre layer (RNFL) and positive and negative symptoms among men with acute and chronic schizophrenia spectrum disorder.

BACKGROUND: Schizophrenia Spectrum Disorder (SSD) is a chronic psychiatric disorder with modest treatment outcomes. Changes in neuronal morphology may be associated with the symptomatology of SSD. In the present study, we compared the retinal nerve fibre layer thickness (RNFLT) of typically developed adults with that of individuals with SSD in both acute and chronic stages. METHODS: Fifteen healthy adult males (mean age: 36.40 years) and 30 individuals with SSD (mean age: 37.9 years) took part in the study. Among the latter, 15 had a chronic mean SSD for 15.33 years, while 15 were in an acute psychotic phase with a mean illness duration of 12.20 years. Experts rated positive and negative symptoms of SSD. Retinal nerve fibre layer thickness (RNFLT) of all participants was measured with optical coherence tomography (OCT). RESULTS: Compared to healthy controls, individuals with acute SSD had the lowest macula thickness in the right eye. For nerve fiber layer atrophy, participants with acute SSD showed the largest atrophy (right eye, inferior quadrant). For retinal thickness and macular volume cube, compared to healthy controls, participants with acute SSD had the lowest thickness in the subfield of the right eye. Non-linear associations were observed between RNFL and positive and negative symptoms: e.g., for macula central and subfoveal thickness (left and right eye) and for participants with both acute and chronic SSD, exclusively positive and exclusively negative symptoms (as opposed to prevalently negative with some positive symptoms or prevalently positive with some negative symptoms) were associated with lower volumes. In participants with acute SSD, a longer disease duration was associated with thicker RNFL, while in participants with a chronic SSD a longer disease duration was associated with a thinner RNFL. CONCLUSION: The present results confirm previous findings that specific neuronal morphological abnormalities can be observed among individuals with SSD. The non-linear associations between neuronal alterations and positive and negative symptomatology suggested that higher pronounced SSD severity appears to be particularly related to morphological changes. Disease duration and RNFL thickness were linearly associated, though, in opposite directions depending on the chronic or acute state.

Epidemiology and molecular diagnosis of acute conjunctivitis in patients attending Hamadan, west Iran ophthalmology clinics 2016-2017.

BACKGROUND: Viruses are considered the most common cause of infectious conjunctivitis. PCR has been approved as the best standard method to diagnose viral conjunctivitis. This study was conducted to investigate epidemiological patterns of conjunctivitis in Hamadan, west Iran. In addition, the frequency of the most important cause of infectious conjunctivitis diagnosed by PCR and its seasonal variations and association with certain socioeconomic and health factors were studied. METHODS: In this cross-sectional study, 125 patients with suspected viral conjunctivitis or keratoconjunctivitis in Hamadan, west Iran from July 2016 to June 2017 were examined for the presence of herpes simplex virus 1 (HSV1), HSV2, varicella-zoster virus (VZV), adenovirus. and Chlamydia trachomatis using multiplex real-time PCR. RESULTS: Adenoviruses were the most prevalent pathogens (94.4%). HSV1 was found in two (1.6%) patients. HSV2, VZV, and C. trachomatis were not seen in any patients. There was no difference in acquisition of conjunctivitis between men and women. A total of 55 (44%) patients attended the clinics in summer. CONCLUSION: This study demonstrated that adenoviruses were a much more common viral cause of conjunctivitis in the studied region compared to findings in other regions. In addition, the acquisition rate of eye infection is expected to decrease dramatically in this region through control of adenoviruses. Demographic variables ie, age, sex, and income level, were not significantly associated with acquisition of viral infection.

The burden of pure anisometropic amblyopia: a cross-sectional study on 2800 Iranians.

PURPOSE: To assess the proportion of pure anisometropic amblyopia in a sample Iranian (white) population. METHODS: A total of 2800 consecutive individuals who presented at a referral eye clinic for any reason were examined for the presence of pure anisometropic amblyopia. Anisometropia was reported when a spherical equivalent refraction difference of at least 1.0 D with or without a cylinder refraction difference of at least 1.0 D was present between the two eyes. Amblyopia was defined as the best-corrected visual acuity of 20/30 or worse or a two-line interocular visual acuity difference between eyes that could not be attributed to any structural ocular pathology or visual pathway abnormality. RESULTS: Subjects were 1528 females and 1272 males with a mean age of 30.25 ± 14.93 years (range, 5-65). Amblyopia was diagnosed in 192 cases (6.9%), significantly more frequent among females (7.9 vs. 5.7%, p = 0.02). Pure anisometropic amblyopia was present in 6.1% of the study population, significantly more common in patients with spherical hyperopic anisometropia (37.7%) compared to patients with spherical myopic anisometropia (21.3%), cylindrical myopic anisometropia (4.1%), and cylindrical hyperopic anisometropia (15%) (p < 0.001). CONCLUSIONS: Pure anisometropic amblyopia is a common finding in Caucasians seeking eye care, particularly when anisometropia is of spherical hyperopic subtype.

HIGH MYOPIA AND DIABETIC RETINOPATHY: A Contralateral Eye Study in Diabetic Patients With High Myopic Anisometropia.

PURPOSE: To examine an association between high myopia and diabetic retinopathy (DR) in diabetic patients with high myopic anisometropia. METHODS: A total of 116 white diabetic patients (232 eyes) with high myopia (spherical equivalent > -5.00 diopters, D) anisometropia (difference ≥ -6 D) were enrolled in this cross-sectional, contralateral eye study. The frequency of DR was compared between the high myopic and the contralateral eyes. RESULTS: Compared with the fellow eyes, DR was significantly less frequent in high myopic side (27.6% vs. 100%, P < 0.001; relative risk, 0.28 with 95% confidence interval of 0.21-0.37). Similar significant trends were found for the incidence of nonproliferative (27.6% vs. 69%, P < 0.001) and proliferative DR (0% vs. 31%, P < 0.001). Diabetic retinopathy was also less severe in the same group. CONCLUSION: Using a contralateral eye study design prevented the influence of potential confounding factors inherent in similar previous case-control studies. On this basis, a protective role for high myopia against DR was established.

In patients suffering from idiopathic central serous chorioretinopathy, anxiety scores are higher than in healthy controls, but do not vary according to sex or repeated central serous chorioretinopathy.

INTRODUCTION: Idiopathic central serous chorioretinopathy (CSCR) is a relatively common ophthalmic disorder characterized by the development of a serous detachment of the sensory retina. Psychophysiological factors may trigger or maintain CSCR, though, surprisingly, the association between CSCR and anxiety has yet to be studied. The aims of the present study were threefold: to determine whether 1) Iranian patients with CSCR have higher scores for anxiety, 2) anxiety is lower, if CSCR has been experienced twice, and whether 3) anxiety scores differ between sexes. METHODS: A total of 30 patients with CSCR and 30 healthy age-and sex-matched controls took part in the study. A brief face-to-face interview was conducted covering demographic variables and history and occurrence of CSCR and assessing anxiety. RESULTS: Compared to healthy controls, anxiety was significantly higher in both first-time and second-time CSCR patients. In CSCR patients, anxiety scores did not differ between sexes. CONCLUSION: Higher anxiety scores were observed in Iranian patients with CSCR, irrespective of whether this was the first or second occurrence of CSCR. This suggests there is no psychological adaptation in terms of reduced anxiety among patients with repeated CSCR.

Quality of sunglasses available in the Iranian market; a study with emphasis on sellers' license.

CONTEXT: Sunglasses should follow minimum requirements to sufficiently protect eyes. It is not known whether all items obtainable from the market are appropriately designed. AIMS: To compare ultraviolet (UV)-protective properties of commercially available sunglasses obtained from authorized and unauthorized Iranian sellers. Settings and Study Design: An analytic-descriptive study performed in a metropolitan area (Tehran). MATERIALS AND METHODS: Using a UV-visible standard spectrophotometer, the percentage transmittance was scanned between 280 and 400 nm in 348 pairs of nonprescription sunglasses (price range: 20-80 US$) obtained anonymously and randomly from authorized (permitted by the Ministry of Health, 189 pairs) and unauthorized (159 pairs) sellers in the Iranian capital city, Tehran. The Australian/New Zealand Standard (AS/NZS) and the American National Standards Institute [ANSI] standards were followed. STATISTICAL ANALYSIS: Chi-square test, independent samples t-test or Mann-Whitney U-test. Results UV-protective properties of the sunglasses obtained from authorized sellers complied with AS/NZS and ANSI guidelines in 92.6% and 95.2% of items, respectively. The corresponding rates for sunglasses obtained from unauthorized sellers were 0% and 8.2%, respectively (P < 0.001 for both). The rate of defective polarizing capability of lenses was 27.4% in sunglasses obtained from authorized sellers versus 90.4% in sunglasses obtained from unauthorized sellers (P < 0.001). Neither brand nor price played significant contributions to UV protection/lens polarizing capability of sunglasses obtained from authorized sellers. CONCLUSIONS: Sunglasses provided by unauthorized sellers are alarmingly unreliable and could be potentially hazardous for the eye. Brand and price do not guarantee optimal protection against UV radiation or polarizing performance of the lens.

Ocular involvement of brucellosis.

A 29-year-old male diagnosed with brucellosis a week earlier was referred to the ophthalmology clinic with visual complaints. On examination, visual acuity was 20/25, he had conjunctival injection on slit lamp examination. There was also bilateral optic disk swelling plus retinal hyperemia (optic disc hyperemia and vascular tortuosity) and intraretinal hemorrhage on funduscopy. The patient was admitted and treated with cotrimoxazole, rifampin, doxycycline and prednisolone for 2 months. Ocular manifestations subsided gradually within 6 months after treatment. Brucellosis can affect the eye and lead to serious ocular complications. Early diagnosis and prompt treatment should be considered in endemic areas.

Premature Loss of Permanent Teeth in Allgrove (4A) Syndrome in Two Related Families.

BACKGROUND: Allgrove syndrome is a rare autosomal recessive condition characterized by adrenal insufficiency, achalasia, alacrima and occasionally autonomic disturbances. Mutations in the AAAS gene, on chromosome 12q13 have been implicated as a cause of this disorder. CASE(S) PRESENTATION: We present various manifestations of this syndrome in two related families each with two affected siblings in which several members had symptoms including reduced tear production, mild developmental delay, achalasia, neurological disturbances and also premature loss of permanent teeth in two of them. CONCLUSION: The importance of this report is dental involvement (loss of permanent teeth) in Allgrove syndrome that has not been reported in literature.