Original Articles

Visual Evoked Potential Findings in Patients with Dyslexia

Seyed Mohammad Masoud Shushtarian, Seyedeh Yasamin Jazayeri , Ali Vafaei

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 1 (2023), 16 March 2024, Page 1-4

Purpose: The aim of this study was to compare the Visual Evoked Potential (VEP) findings in patients with dyslexia and in normal individuals.
Patients and Methods: In this case-control study, we evaluated 26 eyes from 13 dyslexic patients over the period of 2018-2022. The control group consisted of 26 eyes from 13 age- and sex-matched healthy individuals. VEP was recorded for both the case and control groups. We compared the latency (in milliseconds) and amplitude of the VEP P100 peak between the patients and the controls.
Results: The mean latency of the VEP P100 peak was significantly higher in the patient group, measuring 108.92 ± 3.84 milliseconds, compared to 97.46 ± 2.8 milliseconds in the control group (P < 0.01). Additionally, the mean amplitude of the VEP, P100 peak in the case group was significantly lower, at 2.96 ± 1.12 microvolts, in contrast to 6.38 ± 1.6 microvolts observed in the control group (P < 0.01).
Conclusion: Based on the findings of this study, it is concluded that dyslexia may influence the visual pathway of the visual system, leading to changes that could potentially be evaluated using VEP testing.

Short Term Efficacy of Ectropion Management Using Plasma Assisted Non-Invasive Surgery (PANIS)

Shima Eghtedari , Farhad Nejat

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 1 (2023), 16 March 2024, Page 5-10

Purpose: To investigate the feasibility of using the Plasma-Assisted Non-Invasive Surgery (PANIS) technique for managing ectropion in an office-based setting.
Patients and Methods: Ectropion was treated in six eyes of six patients using local anesthesia and the PANIS technique, performed in an office setting with the assistance of a slit-lamp. Plasma spots were generated using the PLEXR PLUS device (GMV Srl, Rome, Italy) to sublimate the palpebral conjunctiva by pulling the lower eyelid outward. Treatments were conducted in two sessions spaced one month apart. Visual parameters, dry eye tests, Ocular Surface Disease Index (OSDI) questionnaire results, and patient satisfaction were evaluated before and six months after the second PANIS session.
Results: The study included six patients (2 females and 4 males) with a mean age of 70.17 years. Uncorrected Visual Acuity (UCVA) improved by one line in four cases. Best Corrected Visual Acuity (BCVA) showed improvement in two patients after six months. Changes in Intraocular Pressure (IOP) were not significant. The mean improvement in Tear Meniscus Height (TMH) was 0.085 mm. In terms of ectropion grade improvement, two cases showed a three-grade improvement, three cases showed a one-grade improvement, and one case showed a two-grade improvement. No patients required further surgical treatment.
Conclusion: The PANIS method might offer a minimally invasive office-based procedure for both cosmetic and functional treatment of ectropion. Future studies with a higher number of participants and longer follow-up duration, are needed to provide more data regarding the long-term results of this method and its safety profile.

Intraocular Lens Power Calculation among Patients with a History of Keratorefractive Surgery: Comparison of Historical and Non-Historical Methods

Ali Moradi, Mohammad Aghazadeh-Amiri, Ahmad Shojaei, Hossein Mohammad Rabei , Mehdi Tabatabaeem , Farsad Noorizadeh, Zahra Pirasteh

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 1 (2023), 16 March 2024, Page 11-17

Purpose: To compare the accuracy of historical and non-historical methods in intraocular lens (IOL) power calculation among patients undergoing cataract surgery with a history of keratorefractive surgery.
Patients and Methods: In this cross-sectional study, patients undergoing cataract surgery were divided into two groups: the first group consisted of patients with available previous data regarding their history of keratorefractive surgery, and the second group included patients without any previous data. Corneal power was corrected using the clinical history method (CHM) in the first group and the Shammas no history method (SNHM) in the second group. IOL power for both groups was calculated using the Holladay I formula for implanting an SA60AT or SN60WF lenses. The main outcome measure was the mean refractive error three months after cataract surgery.
Results: One hundred twenty-nine eyes from 104 cataract patients with a history of myopic keratorefractive surgery were included in this study. The IOL calculation in 64 eyes was performed using the CHM method, and in 65 eyes using the SNHM method. The mean refractive error after cataract surgery was -0.17 ± 1.09 D in the CHM group and -0.09 ± 0.75 D in the SNHM group, indicating no statistically significant difference between the two methods (P = 0.62).
Conclusions: The SNHM showed no significant difference compared to the CHM in terms of post-surgical mean refractive error. Given the ease of performing the SNHM and the similarity in post-surgical refractive outcomes, it suggests that the SNHM can serve as an alternative to the CHM.

Pathological Manifestations of the Iris in Primary Chronic Open-Angle Glaucoma

Nader Nassiri, Mansoor Shahriari , Zahra Sadaat Delavari , Arvin Porkar Rezaeyeh, Sara Kavousnezhad , Kourosh Sheibani

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 1 (2023), 16 March 2024, Page 18-23

Purpose: This study aims to assess the histopathological changes in the iris of patients diagnosed with primary chronic open-angle glaucoma (PCOAG) undergoing trabeculectomy surgery.
Patients and Methods: Conducted at the Imam Hossein Medical Center in Tehran, Iran, this study included 25 patients diagnosed with PCOAG scheduled for trabeculectomy. Exclusion criteria included patients with diabetes mellitus, systemic hypertension, uveitis, vascular lesions, central retinal vein occlusion, pseudoexfoliation, iris neovascularization, and previous prostaglandin usage. Following peripheral iridectomy, iris specimens were fixed in 10 % formalin, processed, and stained with hematoxylin and eosin for histopathological examination. The evaluation focused on vascular hyalinization, anterior border layer (ABL) thickness, stromal pigmentation, and pigmented epithelium characteristics.
Results: Twenty-five patients (mean age 64.4 ± 8.8 years) participated in the study. Notable findings included vascular hyalinization in 72 % of patients, ABL thickening in 48 %, severe stromal pigmentation in 40 %, and vacuolated or depigmented epithelium in 32 % and 4 % of patients, respectively. Intranuclear inclusions and nuclear invaginations were noted in 88 % of cases. The average number of glaucoma medications used per patient was 1.3 ± 1.1.Z
Conclusion: The present study results underscore the significant histopathological alterations in the iris in PCOAG patients. These changes are likely influenced by factors such as aging, patient ethnicity, and increased intraocular pressure. Gaining a deeper understanding of these changes is vital for advancing PCOAG management and treatment methodologies.

Case Reports

Congenital Bilateral Cryptophthalmos with Orbito-Palpebral Cyst and Microphthalmos

Mohammad Sadegh Dehghani, Shima Alsadat Dehghanpour Farashah, Afsaneh Yarmohamadi

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 1 (2023), 16 March 2024, Page 24-27

Microphthalmia is regarded as the most common congenital malformation of the eye, second only to congenital cataract. Its association with an intraorbital cyst, however, is exceedingly rare. Cryptophthalmos represents a rare anomaly characterized by the partial or complete absence of the eyebrow, palpebral fissure, eyelashes, and conjunctiva. In this condition, the partially developed adnexa are fused to the anterior segment of the globe, leading to severe ocular defects. In this report, we present a rare case of congenital bilateral cryptophthalmos accompanied by an orbitopalpebral cyst and microphthalmos and the treatment results for the patient.

Self-withdrawal of Levetiracetam in a Patient with Epilepsy Leading to Blindness

Seyed Mohammad Masoud Shushtarian, Reza Pour Mazar

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 1 (2023), 16 March 2024, Page 28-30

A 27-year-old female patient was referred to Basir Eye Clinic in Tehran, Iran, following sudden total blindness in both eyes. She had a history of receiving various medications for different illnesses, including epilepsy. She reported sudden self-withdrawal of Levetiracetam. Within one week after discontinuing the medication, she completely lost vision in both eyes. A complete examination of the patient including visual evoked potential examination led to a diagnosis of cortical blindness.

Review Articles

Ophthalmic Manifestations of COVID-19 Disease: A Systematic Review and Meta-Analysis

Mojgan Jamalzehi , Farhad Dadgar

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 1 (2023), 16 March 2024, Page 31-41

Purpose: The COVID-19 pandemic has posed significant challenges for ophthalmologists. The aim of this manuscript is to provide general guidance for ophthalmologists to understand the prevalence of ocular manifestations in patients with COVID-19.
Materials and Methods: Relevant studies published between November 1, 2019, and July 15, 2020, regarding ocular manifestations of COVID-19 or the presence of SARS-CoV-2 in the cornea, conjunctiva, tear sac, and tears were identified from PubMed, Medline, Cochrane Library, Web of Science, and ClinicalKey. The search keywords included "COVID-19," "ocular findings/symptoms/signs," "eye/ophthalmology," "2019-nCoV," and "SARS-CoV-2." The PRISMA guideline was utilized for this systematic review. The reference list of all identified articles was manually searched by two authors independently. Relevant abstracts were reviewed, and if eligible, full texts and related reference lists were further assessed for eligibility. Subsequently, a snowballing method, applied to retrieval sources, was used for the search.
Results: The pooled prevalence of ocular manifestations among COVID-19 patients was estimated at 7 % (95 % confidence interval: 3  % - 10  %). Conjunctivitis was the most common ocular manifestation in COVID-19. Ocular manifestations in COVID-19 patients usually involve surface eye symptoms.
Conclusion: Ocular manifestations in COVID-19 patients typically include surface eye symptoms, such as conjunctival congestion, foreign body sensation, and, rarely, subepithelial involvement of the cornea. As demonstrated in our meta-analysis, the prevalence of ocular manifestations among COVID-19 patients is relatively high, and it is essential for ophthalmologists and all healthcare professionals to be aware of these occurrences.