Original Articles


Evaluating the Effect of Botulinum Toxin on Visual Pathway Measured by Visual Evoked Potential Using Flash and Pattern Reversal Checkerboard Stimulation Techniques

Nasim Eslampoor , Seyed Mohammad Masoud Shushtarian, Maryam shiehmorteza

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 3 (2023), 17 July 2024, Page 1-4
https://doi.org/10.22037/joos.v7i3.45808

Purpose: The aim of the present study was to investigate possible side effects of botulinum toxin on the visual pathway, measured by visual evoked potentials using two stimulation techniques: flash and pattern reversal checkerboard.

Patients and Methods: Twenty-six eyes from thirteen female subjects, aged between 40 and 52 years, who received botulinum toxin injections for cosmetic purposes in the upper face area, comprised the case group. Visual evoked potentials using two stimulation techniques (flash and pattern reversal checkerboard) were measured in this group. The obtained results were compared with those of 26 eyes from 13 healthy females with no history of botulinum toxin, who formed the control group.

Results: A significant difference was observed in the latency of the flash visual evoked potential P100 peak between the case and control groups (P<0.001) when using the flash stimulation technique.

Conclusion: Botulinum toxin may affect the visual pathway of patients, which can be measured using flash visual evoked potentials.

Predicting the Risk of Cardiovascular Diseases Based on Retinal Fundus Images Using a Deep Learning Model

Shohreh Nazari , Mohammad Jafar Tarokh

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 3 (2023), 17 July 2024, Page 5-10

Purpose: To develop a deep learning model to predict the risk of cardiovascular diseases (CVDs) events based on features found in fundus images.

Materials and Methods: We developed a predicting model for cardiovascular diseases based on retinal fundus images using the deep learning method. We trained our model using 2,091 retinal fundus images obtained from 211 patients. Our dataset included demographic information of each person, conventional CVD risk factors, CVD risk estimated number (calculated using the Framingham method), strokes and heart attack incidents during 5 years (patients who were referred to the ICU or CCU), and  retinal fundus images for each person. We used receiver operating characteristic (ROC) analysis to assess the accuracy of our classification model.

Results: Our proposed algorithm was able to identify high-risk individuals from no-risk individuals with 83 % accuracy and a high confidence level (AUC = 0.91, P value< 0.0001). The results also showed that our model could predict cardiovascular events such as stroke with a probability of 72 % (AUC = 0.83, P value< 0.0001). In comparing our model's ability to predict CVD risk with the Framingham risk score, the Framingham model's accuracy was 65 % in our dataset (with a best AUC of 0.78).

Conclusion: Our deep learning prediction model developed based on retinal fundus image findings to predict the risk of CVD, showed a relatively high accuracy. Its accuracy was higher than traditional prediction models like the Framingham model and comparable to other models based on fundus images for predicting CVD.

Indications and Outcomes of Intraocular Lens Exchange in a Cohort of Pseudophakic Iranian Patients

Sadronesa Norouzi , Hossein Mohammad-Rabie , Parviz Maleki Far , Mohammadmehdi Hatami , Homayoun Nikkhah

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 3 (2023), 17 July 2024, Page 11-17

Purpose: To investigate the indications and outcomes of intraocular lens (IOL) exchange surgery in a cohort of pseudophakic Iranian patients.
Patients and Methods: This retrospective cross-sectional study evaluated the indications and outcome of IOL exchange surgery among pseudophakic Iranian patients. The study included adult patients (age > 18 years) who underwent IOL exchange surgery at Torfeh and Imam Hussein Hospitals, Tehran, Iran, from April 2020 to April 2021. Post-surgical metrics such as best-corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), and intraocular pressure (IOP) were extracted from the medical files.
Results: The study encompassed 36 eyes from 36 patients. The mean age of the patients was 47.3 ± 11.1 years. The most common indication for IOL exchange was lens dislocation, observed in 26 patients (72.2 %), followed by IOL-induced uveitis-glaucoma-hyphema syndrome in 6 patients (16.7 %), unexpected IOL power ("IOL surprise") in 3 patients (8.3 %), and calcified IOL in 1 patient (2.8 %). There was a significant postoperative improvement in the mean UCVA and BCVA (Pvalue < 0.001 for both) compared to pre-surgical readings. The mean IOP before IOL exchange was 16.30 ± 3.89 mmHg, which decreased to 15.05 ± 4.32 mmHg after lens exchange; however, this improvement was not statistically significant (P = 0.42).
Conclusion: Consistent with prior studies, the most prevalent reason for IOL exchange among our patients was IOL dislocation. Our study also indicates an improvement in visual acuity post-surgery, in line with other research findings.

Prevalence and Risk Factors of Diabetic Retinopathy among Diabetic Patients in Sistan and Baluchestan Province, Iran

Mojgan Jamalzehi

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 3 (2023), 17 July 2024, Page 18-25

Purpose: This study aimed to examine the demographic and ocular characteristics of patients with diabetes mellitus in Sistan and Baluchestan province, Iran. It also aimed to identify the risk factors of diabetic retinopathy among this population.
Patients and Methods: From April 2020 to 2022, diabetic patients from Sistan and Baluchestan province, Iran, completed a standardized questionnaire to collect demographic characteristics. Diabetes was diagnosed as per World Health Organization criteria. Additionally, laboratory tests and ophthalmic examinations were performed for the enrolled patients.
Results: A total of 1,008 patients were evaluated. The mean age of patients was 58.13 ± 8.26 years. The most prevalent ocular pathology among patients entering the study was diabetic retinopathy (403 patients, 40 %), followed by glaucoma (312 patients, 31 %) and age-related macular degeneration (223 patients, 22.1 %). Age (P = 0.048), duration of diabetes (P = 0.012), male sex (P = 0.049), hypertension (P = 0.048), presence of diabetic neuropathy (P = 0.041), presence of diabetic nephropathy (P = 0.048), and presence of diabetic foot ulcer (P = 0.041) were correlated with the presence of diabetic retinopathy. Patients with retinopathy also had significantly higher intraocular pressure (P < 0.01), fasting blood sugar (P < 0.001), serum total cholesterol (P < 0.001), serum triglyceride (P < 0.01), and HbA1c (P < 0.001).
Conclusion: Diabetic retinopathy was observed in a higher percentage of diabetic patients from Sistan and Baluchestan province compared to the global average, but its prevalence was in line with the mean prevalence reported in Iran.

Review Articles


Sustained Drug Delivery Systems for Treatment of Age Related Macular Degeneration: A Review

Nader Nassiri, Mansoor Shahriari , Arvin Porkar Rezaeyeh , Sara Kavousnezhad

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 3 (2023), 17 July 2024, Page 26-32

The number of people with age-related visual problems, such as macular degeneration, has increased in recent decades due to population aging. Currently, many pharmacologic therapies exist for age-related macular degeneration (AMD), however none have satisfactory results. This underlines the need for novel drug delivery systems to improve pharmacological drug concentrations at specific locations, thereby boosting treatment effects. This study includes the current findings on sustained drug delivery systems focused at improving treatment results for patients with AMD.

Case Reports


Management of Corneal Melting after Keratoprosthesis: A Case Report Highlighting Successful Corneal Patch Graft and Review of Management Strategies

Mohammadreza Arzaghi , Kiana Hassanpour , Amirreza Veisi , Zahra Karjou , Farid Karimian

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 3 (2023), 17 July 2024, Page 33-38

Corneal melting is a vision-threatening complication after keratoprosthesis (KPro) surgery, potentially leading to KPro extrusion and visual loss. A 37-year-old man with severe ocular and facial thermal burns underwent multiple lid reconstruction surgeries, culminating in KPro surgery. Corneal melting occurred adjacent to the optical cylinder, necessitating a corneal patch graft. Postoperatively, corneal thinning and the epithelial defect improved significantly. Rigorous monitoring and a tailored treatment regimen were crucial for optimal healing and the prevention of further complications. It seems that proactively patching areas of KPro corneal melting and optimizing ocular surface status is imperative. This approach may potentially obviate the need for more aggressive interventions, such as repeat KPro procedures.

Electrophysiological Eye Examination of a Patient Suffering from Tuberous Sclerosis and Probable Retinal Dystrophy

Seyed Mohammad Masoud Shushtarian, Farhad Mahvelati Shams Abadi, Farhad Adhami-Moghadam

Journal of Ophthalmic and Optometric Sciences, Vol. 7 No. 3 (2023), 17 July 2024, Page 39-41
https://doi.org/10.22037/joos.v7i3.46390

A twelve-year-old girl suffering from tuberous sclerosis complex was referred to Basir Eye Clinic, Tehran, Iran, for electrophysiological eye examinations, including visual evoked potential (VEP) and electroretinography (ERG). The patient's medical history showed that she experienced seizures at the age of ten, for which treatment with vigabatrin was initiated. Her field of vision was abnormal, potentially due to the side effects of vigabatrin. The ERG results were also abnormal.