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Purpose: To investigate the prevalence and associated factors of pseudoexfoliation syndrome (PEX) in an Iranian elderly population. Methods: This study, a population-based cross-sectional study conducted on individuals ≥60 years in Tehran, the capital of Iran in 2019 using a multi-stage stratified random cluster sampling. All study participants underwent complete ocular examination (including measurement of uncorrected and best-corrected visual acuity, refraction, slit-lamp biomicroscopy). The PEX was diagnosed based on the presence of white fluffy dandruff-like pseudoexfoliative material on the pupillary margin, on the anterior lens capsule, and/or the trabecular meshwork. Results: Of the 3791 invitees, 3310 participated in the TGES (response rate: 87.3%). After applying exclusion criteria, the data of 3274 individuals were analyzed for this report. The overall prevalence of PEX was 3.63% (95% CI:2.67–4.58) in this study. 81.1% of PEX cases were bilateral. The prevalence of PEX increased significantly with advancing age in a linear trend from 2.38% (95%: 1.27–3.48) in the age group 60–64 years to 6.48% (95%: 2.02–10.95) in the age group ≥80 years (OR = 1.05, p = 0.008). According to the multiple logistic regression model, advancing age (OR: 1.06, p = 0.002) and the presence of cataract (OR: 5.02, p < 0.001) were significantly associated with increased odds of PEX. Conclusion: The results showed a lower prevalence of PEX in the Iranian elderly compared to previous studies on the elderly population. Advancing age and cataracts were the only associated factors of PEX in the present study. [ABSTRACT FROM AUTHOR]

To determine the distribution of keratometry and corneal astigmatism (CA) and their association with demographic factors, systemic parameters, anthropometric measures, ocular biometric indices, and refractive errors in people aged 60 years and above. In this cross-sectional study, 160 clusters were randomly selected from Tehran city (Iran) using the multi-stage cluster sampling method. All participants underwent optometric examinations including testing uncorrected and best-corrected distance visual acuity, non-cycloplegic autorefraction, and subjective refraction. Pentacam imaging for all participants was carried out using Pentacam AXL. Keratometry and CA were reported based on Pentacam's data. The average, standard deviation (SD) and 95% confidence interval (CI) of flat keratometry (Kf), steep keratometry (Ks), mean keratometry (mean K), and CA were 44.02 ± 1.58 D (95% CI 43.94–44.1), 44.86 ± 1.67 D (95% CI 44.78–44.94), 44.44 ± 1.58 D (95% CI 44.36–44.52), and 0.84 ± 0.74 D (95% CI 0.81–0.87), respectively. The 95% and 99% percentiles of mean K were 47.1 and 48.6 D, respectively. According to the multiple generalized estimating equation model, the mean K was significantly higher in males, in myopes, and in those with higher systolic blood pressure. Moreover, the mean K was inversely related to the axial length, height, anterior chamber depth (ACD), corneal diameter, and central corneal thickness (CCT). The prevalence of various types of CA based on a cut-off > 0.50 D was as follows; with-the-rule: 32.5% (95% CI 30.6–34.4), against-the-rule: 18.2% (95% CI 16.7–19.7), and oblique: 10.0% (95% CI 9.1–11.0). The present study investigated the normal distribution of keratometry and CA in individuals ≥ 60 years, and results can be used in clinical matters, especially in intraocular lens power calculation. Sex, systolic blood pressure, height, and some biometric components such as ACD, corneal diameter, and CCT were significantly related to keratometry and should be considered. [ABSTRACT FROM AUTHOR]

Evaluating factors affecting corneal higher-order aberration component has a very important role in interpreting the characteristics of the formed image on the retina. To determine the relationship between ocular biometric components and corneal higher-order aberrations in an elderly population. This report is related to a subsample of the Tehran Geriatric Eye study (TGES), a population-based cross-sectional study that was conducted on individuals aged 60 years and above in Tehran city, Iran using multistage stratified random cluster sampling. All study participants underwent ocular examinations including visual acuity measurement, refraction and slit-lamp biomicroscopy. Anterior segment imaging and corneal aberrometry were performed using Pentacam AXL. In the present study, 644 eyes of 415 individuals (56.9% female) with mean age of 66.36 ± 4.70 years were evaluated. According to a multiple generalised estimating equation model, the root mean square of total higher-order aberrations was related to age (β = 0.081, p = 0.002), crystalline lens thickness (β = 0.08, p < 0.001), and corneal diameter (β = -0.04, p = 0.014). The root mean square of total coma aberration was directly related to the female sex (β = 0.02, p = 0.05), and crystalline lens thickness (β = 0.06, p < 0.001). There was a direct relationship between the root mean square of third- and fourth-order higher-order aberrations and crystalline lens thickness (p < 0.001). Spherical aberration was directly related to the male sex (β = -0.02, p = 0.004), axial length (β = 0.05, p < 0.001) and central corneal thickness (β = 0.001, p = 0.025), and was inversely related to anterior chamber depth (β = -0.07, p = 0.031) and crystalline lens thickness (β = -0.25, p < 0.001). Ocular biometric components are related to corneal aberrations in the elderly. These factors need to be considered in respect of medical and surgical procedures required for the elderly. [ABSTRACT FROM AUTHOR]

Purpose: To determine the association between ABO and Rh blood groups with retinal structural indices including macular thickness and peripapillary retinal nerve fiber layer (RNFL) thickness. Methods: This cross-sectional study was conducted using convenience sampling in a tertiary referral eye hospital in Tehran, Iran. Study participants were referred to the hospital laboratory to test their blood group. Ocular examinations were performed including measurement of visual acuity, auto-refraction, subjective refraction, and slit-lamp biomicroscopy. Retinal imaging was carried out using Spectral-domain OCT under dilated papillary conditions. Results: Three hundred and twenty-eight individuals were recruited in this study. Of these, 219 (60.7%) were female and the mean age of the participants was 63.29 ± 5.57 years (range: 56 to 83 years). According to the multiple linear regression model, the global peripapillary RNFL thickness [coefficient: -3.05 (95% CI: -5.30 to -0.74); P = 0.010] and peripapillary RNFL thickness in the superior [coefficient: -4.65 (95% CI: -8.40 to -0.89), P < 0.001] and inferior [coefficient: -4.00 (95% CI: -7.81 to -0.19); P = 0.040] quadrants were significantly thinner in individuals with blood type B compared to those with other ABO blood groups. The average [coefficient: 12.69 (95% CI: 4.12–21.64); P = 0.004) and central [coefficient: 16.21 (95%: 6.44–25.97); P = 0.001) macular thicknesses were significantly thicker in AB group compared to other blood groups. The average macular thickness was significantly thinner in Rh + compared to the Rh- group [coefficient: -8.33 (95% CI: -15.4 to -1.25); P = 0.021]. Conclusion: Retinal structural indices may be related to blood groups implying a genetic linkage. Considering the lack of consistency among various studies, larger trials are needed to explore the effect of ABO and Rh grouping on peripapillary RNFL and macular thicknesses. [ABSTRACT FROM AUTHOR]

Knowing normative corneal optical density (COD) values is important for identifying pathologic corneal changes. The aim of this work is to determine the distribution and associated factors of COD in the elderly population. This report is a part of a cross-sectional population-based study conducted on the elderly population (≥60 years) of Tehran, Iran from Jan 2019 to Jan 2020. Using a multi-stage stratified random cluster sampling method, a total of 160 clusters were randomly selected from 22 districts of Tehran city. Study participants underwent a complete ocular examination including measurement of visual acuity, refraction, and slit-lamp biomicroscopy. Corneal densitometry was evaluated using the Pentacam HR. Generalized estimating equation (GEE) models were used to investigate associations of COD with study variables. A total of 3633 eyes from 2068 individuals were analysed. Of these, 1256 (60.7%) were female, and the mean age of the individuals was 66.42 ± 5.28 (60 to 95) years. The mean entire COD was 21.96 ± 4.45 greyscale unit (GSU) (95% CI: 21.57–22.34). There was a statistically significant difference in the mean COD between the anterior, central, and posterior layers (p < 0.001); the highest and lowest average COD was related to the anterior and posterior corneal layers, respectively. The lowest and highest mean COD were observed in the 0–2 mm [17.21GSU (95% CI:16.87–17.55)], and 10–12 mm annular zones [31.4 GSU (95% CI: 30.89–31.91)], respectively (p < 0.001). According to the multiple GEE model, the COD had a statistically significant direct relationship with age, central corneal thickness, and mean keratometry, while it was significantly inversely associated with female sex, anterior chamber depth, white-to-white distance, and corneal volume. These normal values of COD in the present study could be used as reference data in older adults. The associated factors of COD should be taken into account to avoid misinterpretation of physiologic changes as pathologic processes. [ABSTRACT FROM AUTHOR]