Journal of Ophthalmic and Optometric Sciences

Purpose: To identify the microorganisms responsible for the posttraumatic endophthalmitis and evaluate their resistance to seven antibiotics.

Patients and Methods: Aqueous and vitreous samples were obtained from 49 patients who underwent vitrectomy for posttraumatic endophthalmitis and were inoculated into blood agar, chocolate agar, and Sabouraud agar media. Susceptibility testing was performed using the Kirby-Bauer disk diffusion method for seven antibiotics (vancomycin, ceftazidime, ciprofloxacin, oxacillin, azithromycin, imipenem, and rifampin).

Results: Twenty patients (40.8 %) had intraocular foreign bodies. The cultures were positive in 18 patients (36.7 %). In all patients (except for one case), one species was isolated. The most frequent isolated microorganism was staphylococcus epidermidis in 9 patients (47.4 %), followed by staphylococcus aureus, bacillus species, streptococcus viridans, streptococcus pneumonia, enterococcus, diphtheroid species, and pseudomonas aeruginosa. No case with fungal growth was found. Microorganisms showed higher sensitivity to different antibiotics: all gram-positive cocci were sensitive to vancomycin and 71.4 % were sensitive to ceftazidime or rifampin. All gram-positive bacilli were sensitive to vancomycin, ciprofloxacin and azithromycin. The gram-negative bacillus (pseudomonas) was sensitive to ceftazidime, ciprofloxacin, imipenem, and rifampin.
Conclusion: No single antibiotic was effective against all groups of bacteria present in patients undergoing vitrectomy for posttraumatic endophthalmitis. The conventional intravitreal regimen (vancomycin + ceftazidime) seems to be still valuable in treatment of bacterial endophthalmitis among this group of patients.

Keywords: Endophthalmitis; Microorganisms; Posttraumatic; Drug resistance.

Purpose: To evaluate the probable toxic effects of amiodarone on retina, using electrooculography (EOG) and electroretinography (ERG) testing methods.

Patients and Methods: Fifty participants in the present study included 25 patients with a history of amiodarone treatment as the case group and 25 age, sex and visual acuity matched healthy volunteers with healthy visual system as the control group.  All the participants underwent EOG and ERG examinations on their both eyes. The results obtained in two groups were compared to look for possible changes among patients undergoing treatment with amiodarone compared to the control group.

Results: There was no statistically significant difference between the case and control groups regarding the age, sex, and visual acuity. Out of 50 eyes in the case group 9 eyes showed abnormal ERG including 7 eyes showing abnormal b-wave peak latency and 5 eyes showing abnormal b-wave peak amplitude. Three eyes had both abnormal latency and amplitude. In comparison, only one eye in the control group showed abnormal latency. The difference between the two groups in number of participants showing abnormal b-wave peak latency (P = 0.022) or amplitude (P =  0.027) were both statistically significant. Regarding the EOG testing 15 eyes among patients and 10  eyes from controls showed abnormal EOG Arden index indicating no statistically significant difference (P = 248).

Conclusion: Based on the results of the present study we can conclude that amiodarone has toxic effects on retina, which might be detected and followed using ERG b-wave latency and amplitude.

Keywords: Amiodarone; Retina; Electrooculography; Electroretinography.

Purpose: To evaluate the efficacy and safety of Ahmed glaucoma valve (AGV) implantation for glaucomatous eyes in short, intermediate, and long term follow up periods.

Patients and Methods:  In this retrospective study 76 eyes of 76 patients who underwent AGV insertion in Imam Hossein Medical Center, Tehran, Iran, between January 2008 and March 2017 with at least three years of followup were included. At each visit complete ophthalmic examination was performed and the success rate of surgery was assessed. Surgical success  was defined  as  5 ≤ IOP ≤ 21  mmHg  and  at  least  20 %  reduction  in  IOP without any glaucoma medication (complete success), or with the use of anti glaucoma medication (qualified success). The sum of complete and qualified success was reported as cumulative success.

Results: The mean age of patients was 53.18 ± 16.92 years and the mean duration of follow up was 3.27 ± 2.36 years (range: 1-5 years). The complete surgical success rate was 20 % at 1 year, 18 % at 2 years, 16 % at 3 years, 15 % at 4 years, and 8 % at 5 years of followup and there was no medication free patient at more than 5 years followup. The cumulative success rate was 91 %, 88 %, 84 %, 80 %, and 77 % at 1 to 5 years of followup respectively.

Conclusion: Ahmed glaucoma valve (AGV) implantation for glaucomatous eyes results in acceptable IOP reduction and less medication need in short, intermediate, and long term follow up periods.

Key words: Glaucoma; Intraocular pressure; Ahmed glaucoma valve; Treatment outcome.

Purpose: To evaluate a new approach based on luminance changes by combining the scanning laser ophthalmoscopy and optical coherence tomography imaging techniques to acheive 3D segmentation of the retinal vessels and improve the retinal vasculature imaging.

Methods: A multifaceted process for the 3D segmentation of retinal blood vessels in optical coherence tomography slices of fundus ophthalmic images with the help of scanning laser ophthalmoscopy images was devised. The proposed algorithm has two distinct clauses, which include 2D segmentation of the retinal blood vessels and three-dimensional segmentation of these vessels based on the calculation of the 2D features of the blood vessels.

Results: Our method for three-dimensional segmentation of retinal vessels in optical coherence tomography images with the help of scanning laser ophthalmoscopy imaging achieved a better reconstruction of retinal vessels in optical coherence tomography image.

Conclussion: Our method was able to improve the imaging of retinal vesels. Further studies in the field of retinal imaging are recommended to achieve better imaging of retinal vesels. 

Keywords: Tomography; Optical coherence; ophthalmoscopy; Retinal vessels; Imaging.

Rosai-Dorfman is a usually benign disease which is characterized by over production and accumulation of a specific type of white blood cell in the lymph nodes, most often those of the neck region. Different organs including the central nervous system may be affected in rare cases. The aim of the present manuscript is to report visual pathway disturbances measured using in a case of Rosai-Dorfman with central nervous system involvement using electroretinography and visual evoked potential techniques.

Keywords: Histiocytosis; Sinus; Electroretinography; Evoked potentials; Visual.

Purpose: To report a rare case of ocular penetrating injury after blepharoplasty procedure.

Case report: Blepharoplasty is a frequent oculoplastic surgery with relatively infrequent complications. Penetrating injury of the eye due to blepharoplasty has been reported in few previous
studies. Here we report a 35-year-old woman presenting with visual loss in her left eye as a complication of blepharoplasty. In funduscopic examination, prominent retinal folds were found and optical coherence tomography (OCT) findings were compatible with macular hypotony caused by a neglected penetrating injury during oculoplastic surgery. She was admitted and underwent the primary repair of the scleral and limbal laceration. Her visual acuity and other symptoms improved significantly one week after surgery. After six months, her visual acuity for the injured eye was 20/20 without any other complications.

Conclusion: Hypotonic maculopathy, disproportionate pain, and visual loss can be alarming signs after cosmetic blepharoplasty pointing to a probable penetrating eye injury.

Trabeculectomy with mitomycin-C remains the gold standard for surgical glaucoma management; however, this technique includes some sight-threatening complications like avascular thin bleb, subsequent leakage and ultimately endophthalmitis.  To date, various non surgical methods have been reported for the management of bleb leakage, but surgical management frequently becomes necessary especially in frank leakages. The most common surgical approach includes excision of the avascular and necrotic leaking bleb combined with the advancement of adjacent healthy conjunctiva. The aim of the present review is to discuss avascular bleb and late bleb leakage after trabeculectomy including their histopathology, risk factors, prevention and management.

Keywords: Trabeculectomy; Mitomycin, Leakage, Avascular .