Over the past few years, visual prostheses (namely, Argus II retinal implant) and gene therapy have obtained FDA approval in treating blindness resulting from retinitis pigmentosa. Compared to gene therapy; Argus II is less costly with a demonstrated favorable outcome, though the vision is yet artificial. To obtain better results, expectation counseling and preoperative retinal assessment are critical. The global experience with Argus II has enrolled no more than 300 cases so far. The first Argus II retinal prosthesis in Iran was successfully implanted in Shiraz (October 2017). To date, Argus II artificial retina is implanted in four patients in Iran. Beside successful surgery and post-operative care, rehabilitation efforts with validated outcome measures including visual rehabilitation together with neurovisual, visuo-constructive and cognitive rehabilitation/empowerment approaches are expected to boost the functional outcome. A multidisciplinary approach within a cross-functional team would optimize strategies toward better patient outcomes. As such, establishing a collaborative network will foster organized research efforts to better define outcome assessment and rehabilitation strategies. This technology report paper has been an attempt to provide an overview of Argus-II retinal implant global experience as well as the clinical outcome of the so far cases in Iran. Insights from this report were communicated during the first “Brain Engineering and Computational Neuroscience Conference,” 31 January-2 February 2018 in Tehran.
PurposeTo assess the efficacy of oral azithromycin in the treatment of toxoplasmic retinochoroiditis.MethodsA randomized interventional comparative study was conducted on 14 patients with ocular toxoplasmosis who were treated with oral azithromycin and 13 patients who were treated with oral trimethoprim/sulfamethoxazole for 6–12 weeks. The achievement of treatment criteria in the two groups and lesion size reduction were considered as primary outcome measures.ResultsThe resolution of inflammatory activity, decrease in the size of retinochoroidal lesions, and final best corrected visual acuity (BCVA) did not differ between the two treatment groups. The lesion size declined significantly in all patients (P = 0.001). There was no significant difference in the reduction of the size of retinal lesions between the two treatment groups (P = 0.17).Within each group, there was a significant improvement in BCVA after treatment; BCVA increased by 0.24 logMAR in the azithromycin group (P = 0.001) and by 0.3 logMAR in the trimethoprim/sulfamethoxazole group (P = 0.001).ConclusionsDrug efficacy in terms of reducing the size of retinal lesions and visual improvement was similar in a regimen of trimethoprim/sulfamethoxazole or azithromycin treatment. Therefore, if confirmed with further studies, therapy with azithromycin seems to be an acceptable alternative for the treatment of ocular toxoplasmosis.
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