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Introduction: To compare the optic nerve head (ONH) structure and microvasculature in patients with optic atrophy due to non-arteritic anterior ischemic optic neuropathy (NAION), compressive optic neuropathy (CON), methanol-induced optic neuropathy (MION), and traumatic optic neuropathy (TON) using optical coherence tomography angiography.Methods: In this comparative, cross-sectional study, 32 eyes with NAION, 18 eyes with CON, 32 eyes with MION, 23 eyes with TON, and 55 normal eyes were enrolled. Radial peripapillary capillary (RPC) vessel density, peripapillary retinal nerve fiber layer (RNFL) thickness, disc area, cup volume, and cup/disc area ratio were obtained using the RTVue XR Avanti system (Optovue Inc., Fremont, CA, USA).Results: RPC vessel density and peripapillary RNFL thickness in all patients were significantly lower than normal subjects. A positive correlation was found between the RPC vessel density and peripapillary RNFL thickness in normal subjects and all study groups. The positive correlation between the inside and outside disc RPC vessel density was only found in the NAION (r = 0.36, P = .042) and MION (r = 0.42, P = .018) groups. No significant difference was found among the groups in terms of peripapillary and inside disc vascular densities (all P > .05). Disc area and cup volume in patients with MION was larger than the values in patients with NAION (P = .018) and TON (P = .044) and normal subjects (P = .015). The discriminating features among the study groups were the larger cup volume and cup/disc area ratio in patients with MION, and lower RNFL thickness in patients with TON.Conclusions: There was a positive correlation between the RNFL thickness and peripapillary RPC vessel density regardless of the cause of optic disc pallor. Structural evaluation of the ONH seems to be a better way to differentiate the cause of optic nerve head atrophy than the microangiographic changes.

Purpose To investigate the efficacy of intravitreal injection of granulocyte colony-stimulating factor (G-CSF) for the treatment of non-arteritic anterior ischemic optic neuropathy (NAION).Methods:...

Purpose: To evaluate the role of intrasilicone oil injection of methotrexate (MTX) at the end of vitrectomy surgery for rhegmatogenous retinal detachment (RRD) associated with proliferative vitreor...

Granulocyte colony-stimulating factor (G-CSF) has potential ocular neuroprotective effects. The aim of this study was to evaluate the retinal toxicity of intravitreal G-CSF in rabbit eye.Eight New Zealand albino rabbits, weighing between 2 and 3 kg, were selected for this study. The initial concentration of G-CSF (300 µg/0.5 ml) was titrated to obtain different concentrations of 45 μg, 30 μg, 15 μg, and 7.5 μg in 0.1 ml. Each concentration was injected into two rabbit eyes. For each dose, dextrose was injected in one contralateral eye and the other fellow eye remained non-injected. Electroretinographic (ERG) testing was performed before and 4 weeks after injections. The rabbits were euthanized and the eyes were enucleated 4 weeks after injections and examined using light microscopy and immunohistochemistry.One rabbit with the injected dosage of 7.5 µg died at the first post-injection day. No sign of intraocular toxicity was found in clinical examination in other rabbits. A significant decrease in at least one of the a- or b-wave measurements of scotopic or photopic responses was found in 45 µg, 15 µg, and 7.5 µg injected eyes. Eyes with an intravitreal injection dosage of 30 µg G-CSF did not have significant changes compared to the baseline values. Histologic and immunohistochemistric studies were unremarkable for pathologic changes in all injected eyes.While histologic and immunohistochemistric examinations revealed no toxicity in all G-CSF-injected eyes, significant ERG changes were observed in all doses except for the dose of 30 µg/0.1 ml.

To report the efficacy of mycophenolate mofetil (MMF) as adjunctive therapy for the treatment of multiple sclerosis (MS)-associated uveitis.In this retrospective, interventional case series, patients with MS-associated uveitis who were treated by MMF as an adjunct therapy to systemic corticosteroid were studied. Patients' demographics, clinical course, response to treatment, and complications were assessed.A total of 30 eyes of 15 patients with a mean age of 34.5 ± 8.3 years were studied. In three patients (20%), onset of uveitis preceded the diagnosis of MS. The course of MS was relapsing-remitting in 11 patients (73.3%) and secondary progressive in four patients (26.7%). At 1 year after institution of MMF, all the patients were on oral prednisolone ≤ 7.5 mg/day, all eyes were quiet without macular edema, and 53.3% of eyes gained visual improvement. Supplemental periocular and intraocular injections were needed during the first 6 months after starting MMF therapy. The systemic adverse effects were transient and minor in severity.MMF had beneficial effects on vision and intraocular inflammation with an acceptable safety profile.

To evaluate the effect of Topcon spectral domain optical coherence tomography (OCT) image quality on macular thickness measurements and the error rate in healthy subjects and patients with clinically significant diabetic macular edema (CSME).In this prospective, comparative case series, macular thickness measurements, and the rate of decentration and segmentation errors were evaluated before and after reducing the image quality factor (QF). The measurements were evaluated again after correcting the decentration and segmentation errors. To reduce the image QF below 45, tetracycline eye ointment was applied on the corneal surface.Forty eyes of 40 subjects including 18 healthy eyes and 22 eyes with CSME were included. In both groups, the difference in central subfield thickness measurements before and after reducing the image QF was not statistically significant both before and after error correction (all P0.05). The rate of decentration error was statistically similar before and after reducing image QF in normal and CSME eyes (P=0.50, P=0.69, respectively). However, the rate of segmentation error was statistically significantly higher after reducing image QF both in normal and CSME eyes (P=0.008 and P=0.004, respectively). In both groups, eyes with a segmentation error had higher image QF reduction (both P=0.01).Reducing image quality results in a higher rate of the segmentation error in normal eyes and in eyes with CSME.

To report the clinical characteristics, antibiotic susceptibilities, and visual outcomes for eyes with endophthalmitis caused by Pseudomonas aeruginosa.In this retrospective, non-comparative case series, medical records of eyes with culture-proven Pseudomonas aeruginosa endophthalmitis, who were treated from April 2005 to April 2015 at a referral center in Tehran were reviewed. Clinical features, antibiotic susceptibilities, and visual outcomes were assessed.In total, 20 eyes of 19 patients were identified. The clinical settings included cataract surgery (85%), pars plana vitrectomy (5%), endogenous source (5%), and intravitreal bevacizumab injection (5%). Presenting visual acuity ranged from 20/120 to no light perception. Pars plana vitrectomy with intravitreal antibiotic injection was performed as the initial treatment in 16 eyes (80%). The organisms were sensitive to ciprofloxacin and imipenem in 100%; amikacin in 88.3%; ceftazidime in 83.4%; and tobramycin in 83.4% of isolates tested. Final visual acuity was hand motions or worse in 18 eyes (90%). Evisceration was performed in five eyes (20%).Susceptibility to ciprofloxacin and imipenem was found in all isolates tested. Despite appropriate treatment, visual and anatomic outcomes were generally poor.