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Purpose: Retinopathy of prematurity (ROP) is the main cause of blindness in premature infants. Despite developments in neonatal care and management guidelines, ROP is becoming increasingly prevalent worldwide. Hence, the identification of risk factors for ROP is critical to diminish the burden of the disease. Methods: This cross-sectional study included all infants with gestational age ≤ 36 weeks referred to the ophthalmology clinic at Shafa hospital, Kerman, Iran from 2014 to 2015. Ophthalmologic examinations were performed followed by demographic and ophthalmic data collection and analysis. Results: A total of 579 preterm neonates were screened including 325 boys and 254 girls. The incidence of ROP was 17.96%. Mean birth weight (BW) and gestational age (GA) were 1668.0 grams and 31.2 weeks, respectively. The results indicated that BW, GA, duration of hospitalization and oxygen therapy were significantly related to the development of ROP, however, after multivariate logistic regression analysis, only BW and duration of hospitalization remained significant. There were no significant associations between gender, type of delivery, or assisted reproductive technologies, and ROP (P = 0.461, 0.461, and 0.826, respectively). Conclusion: BW and duration of hospitalization were significant risk factors for ROP in the current study. BW was also strongly associated with the need for therapy.
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BACKGROUND: To investigate the adjunctive effect of an intravitreal ROCK inhibitor (fasudil) in combination with intravitreal bevacizumab (IVB) on refractory macular edema secondary to retinal vein occlusion (RVO). METHODS: In this prospective interventional case series, 17 eyes of 17 patients (10 men, 7 women) with refractory RVO-related macular edema underwent three consecutive intravitreal injections of bevacizumab plus fasudil. Monthly evaluation was continued up to 12 months and IVB injection was performed if needed during the follow-up. Changes in the best corrected visual acuity (BCVA) was the primary outcome measure. The secondary outcome measures included central macular thickness (CMT) changes and any adverse events. RESULTS: BCVA significantly improved (mean change: -0.15 LogMAR; P = 0.017) after 3 consecutive intravitreal injections of fasudil in combination with bevacizumab. CMT significantly decreased (mean change: -206 µm; P = 0.028). The anatomical and functional improvement was maintained during the 12 month follow-up. No adverse effects were noticed. CONCLUSION: Intravitreal ROCK inhibitors may break the resistance to anti-VEGF therapy and improve the RVO induced macular edema via affecting the VEGF-independent pathways.
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We report a rare case of bilateral central serous chorioretinopathy (CSCR) after COVID-19 management with steroids. The patient was a 49-year-old female who presented with bilateral blurred vision three months after the COVID-19 infection. She had been treated with intravenous Remdesivir and Dexamethasone. After her recovery from the disease, she developed gradual visual impairment in both her eyes. Upon examinations and optical coherence tomography, bilateral CSCR was revealed. She was treated with eplerenone (25 mg/day) and propranolol (20 mg/day), and the symptoms were improved after two months. Post-COVID-19 associated CSCR can occur due to steroids administration. Therefore, patients and physicians should be aware of these possible complications and seek an ophthalmology consultation as early as possible.
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PURPOSE: To evaluate the effects of repeated intra-silicone oil (SO) injections of methotrexate (MTX) on the outcomes of surgery for rhegmatogenous retinal detachment (RRD) with grade C proliferative vitreoretinopathy (PVR-C). METHODS: In this prospective pilot case series, eyes with RRD and PVR-C underwent pars plana vitrectomy and intraocular injection of SO. At the conclusion of the procedure, 250 µg of MTX was injected into the SO-filled vitreous cavity. Intra-SO injection was repeated at weeks 3 and 6; the minimum follow-up period was 6 months. The main outcome measure was retinal reattachment rate. RESULTS: Eleven eyes of 11 patients (mean age, 52.73 ± 18.01 years) were included. The mean follow-up period was 9 ± 3 months (range, 6-15 months). Total retinal detachment with anterior and/or posterior PVR-C was present in all eyes before surgery. Mean preoperative best-corrected visual acuity (BCVA) was 2.62 ± 0.04 logMAR. All operated eyes exhibited retinal reattachment posterior to the equator during the follow-up period. Mean postoperative BCVA was significantly improved to 1.02 ± 0.51 logMAR (p = 0.003). No ocular or systemic side effects were observed. CONCLUSION: Repeated intra-SO injection of MTX as an adjunctive therapy for RRD complicated by PVR showed promising results and was not associated with adverse effects. Further studies are needed to confirm its possible beneficial effects on the final anatomic and functional outcomes in these cases.
