RESUMEN

BACKGROUND: To compare iodine-125 (125I) with ruthenium-106 (106Ru) episcleral plaque radiation therapy in terms of the effectiveness and non-inferiority for choroidal melanoma treatment. OBJECTIVE: To report the non-inferiority of new made iodine-125 (125I) compared with ruthenium-106 (106Ru) episcleral plaque radiation. PATIENTS AND METHODS: A retrospective, non-randomized comparative case series. In this series the patients treated with 125I and 106Ru episcleral plaques for choroidal melanoma between September 2013 and August 2017 at Farabi Hospital are compared. Local control of choroidal melanomas after 125I and 106Ru plaques implantation and vision changes are the main outcome measures. RESULTS: A total of 35 patients were identified (125I = 15, 106Ru = 20). No significant difference between two groups in visual acuity, diameter and thickness changes were observed after treatment. Multivariate linear regression (MLR) analysis showed that final diameter was only, independently and significantly, correlated with the pre-treatment diameter of the tumor (ß = 0.59, 95% confidence interval [CI]: 0.29, 1.34, P = 0.003). The same MLR analysis for the final thickness and visual acuity, after adjusting for age and sex showed no significant difference between two groups. A single patient treated with 106Ru had local tumor recurrence with no one in the 125I group. No statistical difference in the rate of ocular complications was observed. CONCLUSION: The treatment with our 125I plaques is as effective as 106Ru plaques in controlling choroidal melanoma tumor and preserving the vision during the two and half year of follow-up. The complication rates are alike. It means that the effectiveness of 125I is not only comparable to 106Ru but also superior when the outcome of the interest is the thickness of the tumors.

RESUMEN

PURPOSE: To evaluate ocular biometric parameters in different subtypes of angle-closure disease in the Iranian population and compare them with normal eyes. DESIGN: Prospective, cross-sectional. METHODS: In this clinic-based study, 189 eyes of 154 patients consisting of 40 acute angle-closure glaucoma (AACG) eyes, 40 fellow eyes of AACG, 42 chronic angle-closure glaucoma (CACG) eyes, 40 primary angle-closure suspect (PACS) eyes, and 27 normal eyes underwent complete examination including gonioscopy, A-scan biometry, and anterior segment optical coherence tomography. Only 1 eye of CACG, PACS, and control subjects were selected. Main outcome measures included angle opening distance and trabeculo-iris space area at 500 µm from the scleral spur (AOD500, TISA-500), anterior chamber angle, lens vault, lens thickness, anterior chamber depth (ACD), and lens position. RESULTS: Anterior chamber angle, AOD500, TISA500, ACD, and lens position were less and lens thickness and lens vault were greater in angle-closure than open-angle eyes. ACD was less in AACG than CACG and PACS (P < .001). It was also less in fellow eyes than PACS eyes (P = .04). Lens vault was highest in AACG eyes, followed by fellow eyes, PACS, and CACG. It was significantly more in AACG eyes than CACG and PACS eyes (P < .001 and P = .007, respectively). No difference was observed between AACG and fellow eyes. CONCLUSIONS: The anterior segment was crowded in closed-angle compared to open-angle eyes. Higher lens vault may play a role in the development of an acute attack of angle closure.

Asunto(s)

RESUMEN

PURPOSE: To present a case of unilateral Aspergillus endophthalmitis after bilateral anterior chamber phakic intraocular lens (IOL) implantation in a 26-year-old myopic patient. METHODS: Three days after bilateral phakic IOL implantation, the patient presented with complaints of pain and low vision in the left eye and was treated for uveitis. Four weeks later, the patient presented with complaints of pain and decreased vision. RESULTS: Culture results of the anterior chamber and IOL specimens were positive for Aspergillus. Anterior chamber washing, membrane removal, anterior chamber phakic IOL removal, lensectomy, and anterior vitrectomy along with administration of topical, systemic, and antifungal drugs and intracameral tissue plasminogen activator improved the patient's corrected distance visual acuity to 20/40 with +6.00 -2.00 × 130°. CONCLUSIONS: Although ocular inflammation occurring after IOL implantation responds to corticosteroids, intraocular infections should always be taken into consideration to prevent severe ocular morbidity.

Asunto(s)

RESUMEN

During intraocular surgery of a 44-year-old woman from Guilan Province in north Iran, a small flat parasite was removed from the anterior chamber angle of the left eye. According to morphological characterisation of the parasite, it was identified as Fasciola hepatica. The route of entry of the parasite was not identified. Meanwhile, stool and serology examinations of the patient for diagnosis of Fasciola infection were negative. In endemic areas of F. hepatica infection, ocular involvement should be considered in cases of uveitis, despite no other systemic involvement.

Asunto(s)