Our findings suggest that young age, recurrent type of pterygia, and larger pterygial tissue are risk factors for pterygium recurrence after surgical excision. Hence, early excision of pterygium is recommended to decrease the recurrence rate.

The present study was undertaken to compare the pterygium recurrence rates after treatment with two different concentrations of topical bevacizumab in those who had undergone a primary pterygium excision. The 90 patients who underwent pterygium excision were enrolled in this prospective, placebo-controlled double-blinded interventional case series. The participants were randomly categorized into 3 groups each consisting of 30 subjects. 24 h after surgery, Group II and Group III received a total of 5 and 10 mg/mL dose of topical bevacizumab, respectively; whereas patients in Group I were administered only a placebo starting a day after surgery. Participants were instructed to instill their topical medicines 4 times a day for 1 week. The patients were examined for pterygium recurrence and complications at postoperative 1, 7, and 14 days as well as each month during the following year. Pterygia recurred in 14 patients (46.7 %) in Group I and in 4 patients (13.3 %) in Group II. No recurrence was observed in Group III during the follow-up period. The Kaplan-Meier survival analysis disclosed a significantly better outcome for those who had been treated with 10 mg/mL concentrations of bevacizumab (Mantel-Cox log rank analysis, P < 0.001). The mean recurrence time was not significantly different between Group I and Group II. No ocular or systemic complication developed till the end of follow-up. Thus, 10 mg/mL concentration of topical bevacizumab was more efficacious than 5 mg/mL dose in preventing pterygium recurrence.

Hydroxychloroquine (HCQ) is an antimalarial drug used extensively in treatment of autoimmune diseases such as rheumatoid arthritis. Retinal toxicity is the most important side effects of this drug. Even after the drug is discontinued, retinal degeneration from HCQ can continue to progress. Consequently, multiple ophthalmic screening tests have been developed to detect early retinopathy. The aim of the current study was to evaluate the value of central 2-10 perimetry method in early detection of retinal toxicity. This prospective cross-sectional investigation was carried out on 60 rheumatoid arthritis patients, who had been receiving HCQ for at least 6 months and still were on their medication (HCQ intake) at the time of enrollment. An ophthalmologist examined participants using direct and indirect ophthalmoscopy. Visual field testing with automated perimetry technique (central 2-10 perimetry with red target) was performed on all included subjects twice in 6 months interval: The first one at the time of enrollment and the second one 6 months later. Males and females did not show any significant difference in terms of age, duration of therapy, daily and cumulative HCQ dose, anterior or posterior segment abnormalities, hypertension, body mass index, and best corrected visual acuity. Anterior segment was abnormal in 9 individuals including 3 subjects with macular pigmentary changes, 4 individuals with cataract and 2 cases with dry eyes. Moreover, 12 subjects had retinal pigmented epithelium (RPE) in their posterior segments. After 6 months, depressive changes appeared in 12 subjects. Additionally, HCQ therapy worsened significantly the perimetric results of 5 (55.6%) patients with abnormal anterior segment. A same trend was observed in perimetric results of 6 (50.0%) subjects with abnormal posterior segments (P=0.009). The daily dose of HCQ (P=0.035) as well as the cumulative dose of hydroxychloroquine (P=0.021) displayed statistically significant associations with perimetric results. Central 2-10 perimetry is a useful method for early detection of HCQ retinal toxicity, but more comprehensive studies, with larger sample size, longer-term follow-up and more precise techniques are mandatory to confirm HCQ retinal toxicity.

Background: Gamma glutamyl transferase (GGT) is a liver enzyme that is involved in oxidative stress. The association between GGT levels and diabetes complications such as microalbuminuria, retinopathy, and peripheral polyneuropathy is a challenging subject. Objectives: In this study we compared GGT levels in orally treated DM type 2 patients with and without retinopathy. Methods: In this cross-sectional study that was done between the years of 2011 and 2012, 208 patients with Type 2 DM, aged 30 -86 years old, who had received oral agents, and referred to the Endocrine clinic of Emam Khomeini hospital of Urmia city were enrolled. In all patients blood pressure, body mass index, and biochemical tests including fasting blood sugar (FBS) and GGT levels were measured and an ophthalmologic exam was done. Results: From 208 patients with Type 2 DM, 26 subjects (12.5%) had diabetic retinopathy; however, 182 subjects (87.5%) did not have it. Both systolic and diastolic blood pressures were significantly higher in DM 2 patients with retinopathy than those without retinopathy (P values = 0.003 and 0.022, respectively). The mean of GGT level significantly increased in diabetic patients with retinopathy compared those DM 2 patients who did not have retinopathy (P value < 0.001). Prevalence of GGT levels greater than 45 U/l was 61.5% (n = 16) and 10.4% (n = 19) in diabetic patients with and without retinopathy, respectively (P value < 0.001). Conclusions:We suggest that diabetic retinopathy might have an association with higher GGT levels.

PURPOSE:The purpose of this study is to compare the long-term outcomes of intravitreal bevacizumab (IVB) with a combination therapy including IVB/intravitreal triamcinolone acetonide (IVB/IVTA) in neovascular age-related macular degeneration (AMD).MATERIALS AND METHODS:This prospective, randomized clinical trial was conducted on 136 eyes of 136 patients with neovascular AMD. Eyes were randomly assigned to receive IVB alone (71 eyes) or in combination with IVTA (65 eyes). In the IVB group, three consecutive injections of 1.25 mg/0.05 ml of bevacizumab were administered 1 month apart, whereas in the IVB/IVTA group, 4 mg/0.05 mL of triamcinolone acetonide was added to bevacizumab in the first injection. Additional IVB injections were administered in eyes demonstrating active choroidal neovascularization. Best-corrected visual acuity (BCVA) and optical coherence tomography were performed at baseline as well as at all follow-up visits.RESULTS:No differences were seen between the patients receiving IVB and those receiving IVB/IVTA in terms of baseline BCVA (P = 0.97) and baseline central macular thickness (CMT) (P = 0.77). BCVA improved, and CMT reduced significantly in both study arms at almost all follow-up intervals. IVB/IVTA intervention, compared with IVB, was statistically more effective in improving BCVA (P = 0.01) and in reducing CMT (P = 0.02) after 12 months. The average number of reinjections was 1.25 ± 0.92 in the IVB group and 1.06 ± 1.01 in the IVB/IVTA group (P = 0.44).CONCLUSION:Our results suggest that the synergistic effect of intravitreal triamcinolone and IVB for treatment of neovascular AMD shows itself most apparently after 8 months of follow-up.

Introduction: Age-related cataract (ARC) is the principal causes of low vision and also the most prevalent type of cataract among the elderly population, particularly women. Objectives: To evaluate the association between serum concentration of vitamin D and risk of different subtypes of senile cataract. Patients and Methods: A total of 200 controls and 1241 patients with newly recognized ARC attending the ophthalmology ward of a major teaching hospital in Urmia, Iran, were included in this investigation. All included subjects aged 40 to 85 years. Cataracts were classified as pure nuclear cataract (NC) (n=216), pure cortical cataract (CC) (n=336), pure posterior sub-capsular cataract (PSC) (n=140) and mixed cataracts (549). Serum concentration of 25-hydroxyvitamin D was obtained from blood samples. All participants were administered by a questionnaires to collect data on demographic variables and risk factors. Results: On multivariate analysis, a marked negative association (P < 0.05) was found between vitamin D serum levels and the risk of NC (OR = 0.20; 95% CI: 0.09-0.75) or CC (OR = 0.25; 95% CI: 0.12-0.96) in females only. Other significant predictors of pure NC in women were higher education (OR = 0.51) and serum calcium levels (OR = 0.35). Apart from serum concentrations of vitamin D, postmenopausal status (OR = 2.26) was the other predisposing factor for pure cortical opacity in women. Conclusion: Our finding does not endorse a role for vitamin D in cataractogenesis among men. In women, however, serum levels of 25(OH)D were only inversely associated with the risk of NC and CC and not with PSC or mixed cataract. Providing sufficient vitamin D is possibly helpful in preventing senile cataract formation in females.

Amblyopia (lazy eye) is one of the significant complications of strabismus surgery. It is the most important cause of unilateral visual impairment in both children and adults. The current investigation was achieved to determine the postoperative amblyopia rate and to identify factors predisposing to amblyopia following exotropia surgery among patients who had been referred to Imam Khomeini Hospital in Urmia, Iran. The present investigation is a retrospective study that was conducted over three years (2008-2010). The study consisted of sixty patients who underwent their first strabismus surgery for treatment of horizontal deviation. Patients were followed up for at least 24 months, and the rate of postoperative amblyopia was measured. The preoperative deviation, strabismus type (exotropia vs. esotropia), visual acuity, age at surgery , and the number of operated muscles were analyzed as determining factors of postoperative development of amblyopia. Amblyopia was observed in 50% of cases during the follow-up period. No statistically significant differences were observed between amblyopic and non-amblyopic eyes in terms of sex, age at surgery, strabismus type, and visual acuity. But amblyopic eyes showed higher deviation angles compared to nonamblyopic eyes (<0.001). The Cox hazard model analysis revealed a significant contribution of deviation angle to postoperative development of amblyopia. A larger deviation angle has been identified as a positive predictor of postoperative development of amblyopia in our investigated population. Due to such a high rate of postoperative amblyopia, it seems better to initiate and complete amblyopia therapy before strabismus surgery.

No abstract