Improvement of pseudophakic cystoid macular edema with subconjunctival injections of interferon α2b:a case report.

Purpose: To report a patient with resistant cystoid macular edema after an uneventful phacoemulsification cataract surgery who responded to subconjunctival interferon α2b injections. Observations: This report describes a 60-year-old male patient with pseudophakic cystoid macular edema that was unresponsive to multiple courses of topical non-steroidal anti-inflammatory drugs and steroids during the follow-up period. Weekly subconjunctival interferon α2b (5 MIU/ml) was administered four times. Cystoid macular edema completely resolved after the 4th injection.During a six-month follow-up period, cystoid macular edema did not recur. No adverse local and systemic side effects were observed. Conclusions and importance: Weekly subconjunctival interferon α2b injections might be a safe and effective treatment modality in the treatment of stubborn pseudophakic cystoid macular edema to conventional treatment.

Prevalence of Uncorrected Refractive Error and Its Risk Factors; Tehran Geriatric Eye Study (TGES).

PURPOSE: To determine the age-sex-standardized prevalence of uncorrected refractive error and its determinants. METHODS: This population-based cross-sectional study was conducted on 3310 people aged≥ 60 years in Tehran, Iran in 2019. Need for spectacles was defined as uncorrected visual acuity worse than 20/40 in better eye that could be corrected to more than 20/40 with suitable spectacles. Met need was defined as proportion of individuals with need for spectacles whose visual acuity was 20/40 or better with current spectacles. Unmet need was defined as proportion of individuals with need for spectacles who needed but did not have spectacles or their visual acuity was worse than 20/40 with current spectacles while suitable spectacles improved their visual acuity to 20/40 or better. RESULTS: The age-sex-standardized prevalence of need for spectacles, met need, and unmet need was 16.67% (95% CI: 15.33-18.09), 7.81% (95% CI: 6.95-8.78), and 8.85% (95% CI: 7.77-10.07), respectively. Myopic subjects had the highest prevalence of need for spectacles (24.06%, 95% CI: 21.47-26.87). The odds ratio of met and unmet need in subjects≥ 80 years versus those aged 60-65 years was 0.36 (p-value: 0.009) and 2.34 (p-value: <0.001), respectively. The odds ratio of met and unmet need in subjects with a university education versus illiterate subjects was 1.72 (p-value: 0.045) and 0.42 (p-value: 0.007), respectively. CONCLUSION: The prevalence of uncorrected refractive error was lower in this study compared to previous studies. The met need rate was lower in subjects with older age and lower education levels.

Age- and Sex-Standardized Prevalence of Age-Related Cataract and Its Determinants; Tehran Geriatric Eye Study (TGES).

PURPOSE: To determine the prevalence of cataract and its relationship with some determinants in individuals above 60 years. METHODS: Of 3792 subjects that were invited, 3310 participated in the study (response rate = 87.31%). All subjects underwent full optometric, slit lamp, and fundoscopic examinations. Then, their lenses were evaluated according to the World Health Organization cataract grading system after pupil dilation. RESULTS: Age- and sex-standardized prevalence with 95% confidence interval (CI) of nuclear, cortical, posterior subcapsular cataracts (PSC), any type cataract, and all lens change was 53.09% (49.80 to 56.35), 23.02% (20.87 to 25.32), 5.57% (4.62 to 6.70), 58.78% (55.65 to 61.83), and 72.49% (70.14 to 74.71), respectively. Any type, nuclear, cortical, and PSC cataracts, had a positive association with age and an inverse association with education. Moreover, the prevalence of cortical and PSC cataract had an inverse association with economic status. Among all variables, age was the strongest determinant for cataract and its subtype. CONCLUSION: This study found a higher prevalence of cataract compared to some previous studies such that about two-thirds of the geriatric population had cataract in the past or at the time of the study. Considering the association of cataract with variables such as economic status and education level, it seems that training and increased awareness and knowledge of the elderly population regarding the importance of eye care by physicians plays an important role in reducing the burden of cataract.

Meibomian gland dysfunction in geriatric population: tehran geriatric eye study.

PURPOSE: To determine the prevalence of Meibomian gland dysfunction (MGD) and its risk factors in an elderly Iranian population METHODS: This cross-sectional study was conducted in 2019. The target population was the subjects aged 60 and over living in Tehran. Multistage cluster sampling was done to select the subjects from all Tehran districts. After an initial interview, all subjects underwent complete ophthalmic examinations including the measurement of visual acuity and refraction as well as slit lamp biomicroscopy to evaluate Meibomian glands. RESULTS: Of 3791 selected subjects, 3310 participated in the study. The data of 3284 participants were analyzed. The mean age of the subjects was 68.24 ± 6.53 years (range: 60-97 years) and 57.8% of them were female. The total prevalence of MGD was 71.2% (68.3-74.1), and 38.1% (8.35-40.4), 30.3% (27.4-33.2), and 2.8% (2-3.6) of the subjects had MGD stage 2, 3, and 4, respectively. The prevalence of MGD was significantly higher in men (p < 0.001) and increased with age from 64.4% in the age group 60-64 years to 82.4% in subjects aged 80 years and over. There was no significant difference in the prevalence of MGD between smokers and nonsmokers; however, severe MGD was more common in smokers. The prevalence of MGD was 76.3% and 68.52% in subjects with and without a history of ocular surgery, respectively. The prevalence of MGD stage 3 and 4 was higher in subjects with a history of ocular surgery. CONCLUSIONS: In line with the results of other studies in Asian countries, this study found a high prevalence of MGD in an elderly population of Iran. It was found that male gender and advanced age were risk factors of MGD and smoking and history of ocular surgery might worsen this disease in MGD patients.

Corneal endothelial assessment in xeroderma pigmentosum: a case-control study.

PURPOSE: To analyze and compare corneal endothelial mosaic in terms of endothelial cell population, morphology and irregularity in patients with xeroderma pigmentosum (XP) with clear corneas with normal age and sex matched subjects using specular microscopy. METHODS: Nine patients with XP without corneal involvement were evaluated in the study. An age and sex matched group of nine healthy subjects participated as control group. Evaluation of corneal endothelial layer was performed using specular microscopy. RESULTS: Each study group consisted of five males and four females with total mean age of 28 ± 11.3 years (12-46 years). Endothelial cell density was significantly lower in patients with XP in comparison with controls (P < 0.002). Maximum and minimum cell areas were significantly higher in XP group (P < 0.016 and P < 0.029, respectively). Although central corneal thickness was higher in controls, the difference was not statistically significant (P = 0.106). Furthermore, our study showed that the patients with XP had no difference with controls in terms of coefficient of variation of cell areas. CONCLUSIONS: This study showed that endothelial cell population can decrease in patients with XP, although other specular microscopic variables such as coefficient of variation and central corneal thickness may remain within normal values.

Effects of intracameral cefuroxime on corneal endothelial cell counts and its morphology after cataract surgery.

BACKGROUND: Endophthalmitis is one of the most important complications after cataract surgery and in case event can cause many symptoms, such as severe decrease in eyesight and/or even the loss of vision. Employing methods to reduce this problem is very important. The aim of this study was to evaluate the effect of intracameral cefuroxime after cataract surgery on corneal endothelial cell counts and its morphology. METHODS: In this study, 32 eyes of 30 patients underwent endothelial cell count and morphology assessment by ConfoScan III device before and 1 month after cataract surgery. All patients undertaken cataract surgery by one surgeon and by one method. Intracameral cefuroxime (1 mg/0.1 ml) was used as prophylaxis of postoperative endophthalmitis at the end of operation. RESULTS: In this study, the rate of corneal endothelial cell loss 1 month after cataract surgery was 8.4%, and the rate of endothelial cells polymegathism before and after cataract surgery did not differ statistically. During the follow-up period, there were no cases of endophthalmitis or other complications. CONCLUSION: With regard to the importance of the intracameral cefuroxime in a reduction in the rate of endophthalmitis after cataract surgery and that harmful effects on the endothelial cells were not seen, this method can be considered as a suitable method for endophthalmitis prophylaxis.

Monosomy 3 by chromogenic in situ hybridization (CISH) in Iranian patients with uveal melanoma.

PURPOSE: The aim of this study was to investigate the rate of monosomy 3 by CISH technique in Iranian patients with uveal melanoma (UM) and its correlation with clinical and histopathological features. METHOD: Archival formalin fixed, paraffin-embedded material from 50 patients who had undergone enucleation for large uveal melanomas was obtained. Monosomy of chromosome 3 alteration by chromogenic in situ hybridization (CISH) was investigated. Clinical and histopathological features of tumors were collected. RESULTS: The patients had a mean age of 56.6±7.6 years. Mean basal diameter and thickness of tumors were 14.1 mm and 10.2 mm, respectively. Four patients (8%) were identified to harbor monosomy of chromosome 3. In the mean follow-up of 5.3 years (range, 3.2-9.5 y), only one case with monosomy 3 died of UM metastasis. The most common type of cellularity was mixed cell (86%). There was not any statistically significant correlation between monosomy of chromosome 3 and type of cellularity, ciliary body involvement, and largest basal diameter. CONCLUSION: The low rate of monosomy chromosome 3 and the consequent low rate of mortality may be indicative of good prognosis in Iranian patients with uveal melanoma.