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Extreme climate events and precipitation depths are assessed for Iran with minimal uncertainties, considering three sources of uncertainty: general circulation models (GCMs), future scenarios, and downscaling method. The frequency, duration, severity, and intensity of extreme events, along with extreme precipitation depths for 2- to 50-year return periods, are evaluated for the baseline period (1980–2014) and three Shared Socioeconomic Pathways (SSPs): SSP1-1.9, SSP2- 4.5, and SSP5-8.5 (2021–2080). Daily precipitation and temperature data from multi-model ensemble of the Coupled Model Inter-comparison Project phase 6 are statistically downscaled for 51 stations across Iran. Extreme precipitation depths increase under SSP1-1.9, whereas the precipitation anomaly depends on location under SSP2-4.5 and SSP5-8.5. The southern coastal and southeastern regions (remaining stations) will experience more-frequent shorter (less-frequent longer) extreme events. The GCM and downscaling method are the main sources of uncertainty in projected precipitation, while climate scenario significantly contributes to the uncertainty in projected temperature. [ABSTRACT FROM AUTHOR]

Clinical relevance: This study was conducted to evaluate five-year outcomes of MyoRing implantation in patients with keratoconus. The results showed that MyoRing implantation is a minimally invasive procedure and is safe and effective for improving visual acuity and refraction in most patients with keratoconus.Background: The long-term effects of MyoRing implantation on corneal features were studied.Methods: A total of 48 keratoconic eyes of 43 consecutive patients who had undergone MyoRing implantation using the Pocket Maker microkeratome (Dioptex, gmbh, Linz, Austria) and who had completed five years of follow‑ups were included in this retrospective study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction and keratometry (K) readings were measured and assessed pre-operation, and five years post-operatively. As well, post-operation satisfaction was assessed using a validated questionnaire.Results: Five years post-operatively, there was a significant improvement in UDVA, CDVA, K readings, spherical equivalent (SE), and manifest sphere and cylinder (p < 0.001). Mean UDVA was 1.20 logMAR before the surgery and 0.42 after the surgery (p < 0.001). Mean CDVA was 0.63 logMAR before the surgery and 0.20 logMAR after the surgery (p < 0.001). SE was improved from -6.53 dioptres (D) before the surgery to -2.23 D after the surgery (p < 0.001). Moreover, the results show that the mean K was reduced by 2.82 D after the surgery (p = 0.001). Overall, 81% of patients were moderately to highly satisfied five years after surgery.Conclusion: MyoRing implantation was found to be a minimally invasive procedure, and is safe and effective for improving visual acuity and refraction in most patients with keratoconus. [ABSTRACT FROM AUTHOR]

The study area, with arid to semi-humid climates, is located in northern Fars Province, southern Iran. Daily precipitation and temperature data from 22 models of the Coupled Model Inter-comparison Project Phase 5 (CMIP5) are used to study climate change for period 2026–2085 under RCP2.6, RCP4.5, and RCP8.5. Daily outputs of each CMIP5 model are downscaled to climatic stations over the study area using LARS-WG tool and transient change factors approach. Daily precipitation is downscaled to seven climatic stations while daily temperature downscaled to two stations. Downscaling results indicate that temperature will increase by + 1.85, + 2.5, and + 3.45 °C under the RCP2.6, RCP4.5, and RCP8.5, respectively, while precipitation will reduce by 14, 22, and 20.8%, respectively, within the study area. Standardized precipitation index (SPI) analysis, performed for 3-, 6-, 9-, and 12-month time scales, shows that frequency (duration) of normal periods will increase (decrease) under climate change, however, 12-month SPI analysis shows decreased frequency and increased duration for normal periods. Frequency, duration, severity, and intensity of wet periods may increase, decrease, or not change under climate change, depending on the SPI time scale. The study area will experience more frequent, longer-duration, severed, intensified droughts in the future due to global warming. Extreme storm analysis shows that precipitation depth of most frequent storms (2-year return period storms) will increase, but precipitation depth of less frequent storms (10- and 20-year return period storms) will decrease under climate change. Temperature enhancement, precipitation reduction, and longer-duration, severed, intensified droughts will increase water shortage in the future, resulting in water crisis and reduced security of food production over northern Fars Province. [ABSTRACT FROM AUTHOR]

The impact of climate change on hydrology and water salinity of a valuable coastal wetland (Anzali) in northern Iran is assessed using daily precipitation and temperature data from 19 models of Coupled Model Inter-comparison Project Phase 5. The daily data are transiently downscaled using the Long Ashton Research Station Weather Generator to three climatic stations. The temperature is projected to increase by +1.6, +1.9 and +2.7°C and precipitation to decrease by 10.4%, 12.8% and 12.2% under representative concentration pathway (RCP) scenarios RCP2.6, RCP4.5 and RCP8.5, respectively. The wetland hydrology and water salinity are assessed using the water balance approach and mixing equation, respectively. The upstream river flow modelled by the Soil and Water Assessment Tool is projected to reduce by up to 18%, leading to reductions in wetland volume (154 × 106 m3), area (57.47 km2) and depth (2.77 m) by 34%, 21.1% and 20.2%, respectively, under climate change, while the mean annual total dissolved solids (1675 mg/L) would increase by 49%. The reduced volume and raised salinity may affect the wetland ecology. [ABSTRACT FROM AUTHOR]

Background: To identify pre-operative factors that influence post-operative performance of a full-ring intra-corneal implant (MyoRing) for the management of keratoconus.Method: In a retrospective study, medical records of 70 keratoconus eyes of 70 consecutive surgical patients with a mean age of 28.54 ± 6.52 years, who underwent MyoRing implantation using the PocketMaker microkeratome (Dioptex GmbH), were included and analysed before implantation and for visual outcome. Variables assessed included age, gender, keratoconus shape, uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent and keratometry reading. After the last follow-up, the eyes were graded for MyoRing implantation performance into worst, moderate and best subgroups.Results: The mean values of uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, manifest sphere and cylinder improved significantly post-operatively (p < 0.05). A statistically significant difference was found in the mean spherical equivalent (p = 0.046) and uncorrected distance visual acuity (p = 0.001) between moderate and best subgroups. No statistically significant correlation was found between age, sex, keratoconus shape, keratometric values, corrected distance visual acuity and visual outcome.Conclusions: According to this new grading system for MyoRing implantation performance, pre-operative uncorrected distance visual acuity and spherical equivalent are considered as the most important indicators for surgical performance in MyoRing treatment of keratoconus. [ABSTRACT FROM AUTHOR]

Exposure to mustard gas can lead to variations in the proteome of corneal epithelium cells and after a latency period produces delayed symptoms in the eyes of chemical victims. Hence, a comparative proteome analysis was conducted between the corneal epithelial cells of chemical victims from Iran-Iraq war (1980–1988) and healthy donors. To this end, corneal epithelium samples from victims and healthy individuals were collected, and the proteome of these samples were prepared for two-dimensional electrophoresis and the analysis of spots by statistical software. Selected spots were further analyzed by matrix-assisted laser desorption/ionization time-of-flight/time-of-flight mass spectrometry. Twenty four proteins were identified of which eighteen proteins showed downregulation while six proteins were upregulated in the victims in comparison to the normal individuals. Also, six protein spots were confirmed by western-blot analysis. In conclusion, all the twenty-four identified proteins are involved in pathways which their up- or down-regulation leads to the accumulation of undesired substrates, cell death and apoptosis. Bioinformatics' tools indicated that these identified proteins were involved in various metabolic processes, DNA damage response, immune response and etc. The present study provides a suitable platform for further clinical studies. [ABSTRACT FROM AUTHOR]

Purpose: To compare 2 corneal biomechanical parameters—corneal hysteresis (CH) and corneal resistance factor (CRF)—before and after collagen crosslinking (CXL) for keratoconus. Setting: Eye Research Center of Mashhad University of Medical Sciences, Khatam-al-Anbia Eye Hospital, Mashhad, and Department of Ophthalmology, Baqiyatallah University of Medical Science, Tehran, Iran. Design: Case series study. Methods: Topical riboflavin was applied to the deepithelialized cornea every 3 minutes for 30 minutes and every 5 minutes during ultraviolet-A irradiation of the cornea. Corneal hysteresis and CRF were measured by biomechanical waveform analysis (Ocular Response Analyzer) before and 6 months after CXL. The values were compared using the paired Student t test. Results: The study comprised 51 patients (56 eyes). The mean age of the patients was 23.27 years ± 6.3 (SD). Before CXL, the mean CH was 7.9 ± 1.5 mm Hg and the mean CRF was 7.3 ± 1.4 mm Hg. Six months after CXL, the mean values were 8.20 ± 1.5 mm Hg and 7.59 ± 1.5 mm Hg, respectively. The changes in CH and CRF were not statistically significant (P>.05). The changes in central corneal thickness and Goldmann-correlated intraocular pressure (IOP) between preoperatively and postoperatively were not statistically significant, although the change in corneal-compensated IOP was (P<.05). Conclusion: Although previous in vitro studies found a change in corneal rigidity, this study found no significant change in CH or CHF measured by biomechanical waveform analysis. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. [ABSTRACT FROM AUTHOR]

The Iraqi government used a range of chemical weapons, including blistering and nerve agents, against Iraqi Kurdish civilians in the 1980s. Few data exist about the long-term respiratory consequences of this exposure. In this study, Kurdish subjects with a history of exposure to chemical weapons were invited to attend a clinical assessment, including a review of their history, physical examination, and a high-resolution computed tomography (CT) of the thorax. Blistering at the time of exposure was used to define significant exposure to mustard gas. Results were compared between two groups of blistering and nonblistering. Four hundred seventy-nine subjects were studied; 45.7% male and 54.3% female. The mean age and standard deviation (mean ± SD) of the cases was 43.1 ± 13.7. Spirometry was abnormal in 15.2% of subjects and air trapping was present on CT scan in 46.6% and did not differ between patients with ( n = 278) or without a history of blistering. Respiratory symptoms, including dyspnea, cough, and sputum production, were more common in subjects with a history of blistering (all p < .005) and blistering was also associated with a lower forced expiratory volume in one second (FEV1) ( p < .0001). Severe complications were most common in subjects from Halabja who also made up the majority of participants. These results show that objective abnormalities are common in people with symptoms attributed to prior exposure to chemical agent. Blistering at the time of exposure was associated with more respiratory symptoms and worse lung function, but not with CT appearances. The high proportion of severe cases in comparison to reports from Iran may reflect the historical absence of effective early treatment, including strategies to reduce prolonged early exposure in this population. [ABSTRACT FROM AUTHOR]

• Equilibration phase of atomic structures via Molecular Dynamics study. • Fluid flow and heat transfer of the two-phase solid/liquid mixture. • Atomic value effects of Carbon Nano Tubes in a microchannel. Carbon nanotube (CNT) effects on H 2 O (basefluid) are described in our computational study. Molecular Dynamics (MD) method are used in our study with a LAMMPS simulation package. Technically, H 2 O/CNT nanofluid simulated with DREIDING and Tersoff force fields in which this selection is appropriate for the atomic study of these structures. For the atomic manner of H 2 O/CNT nanofluid, we reported quantities, such as total temperature, energy, atomic density, atomic velocity, and atomic temperature profiles of the simulated nanofluid. The nanoparticles cause the phase change in lower simulation time steps. Numerically, this phenomenon time varies from 701,000 to 512000-time steps when CNT nanoparticles are added to H 2 O base fluid. Additionally, this nanoparticle causes to increase the density, velocity, and maximum temperature values. Our calculations indicate that CNT nanoparticles affect the base fluid physical properties and can be used for thermal conductance procedures with high efficiency. [ABSTRACT FROM AUTHOR]

Water balance as a common approach has been used so far to qualitatively judge the water resources management in which unsustainability is referred for depleted groundwater storage and reduced river flow. Lack of a clearly defined path, universal methodology and specificity of a concept in literature to quantify the level of water resources management, applicable for different spatio-temporal scales, under supported environmental flow requirement are main criticisms for sustainable water resources management. Thus, this study aims to present a physical metric, based on water availability and supply concepts, to overcome mentioned challenges. It quantifies the level of management (either for surface or ground water) using the ratio of residual volume of available water (available water minus water supply) to initial available water in a given area. Management of nine rivers and Fumanat aquifer in Gilan Province of northern Iran (adopting as a case study) is quantified for the baseline period (1989–2012) and two future (2020–2050) scenarios, S1 (climate change) and S2 (simultaneous land-use and climate changes), under alternatives of available and improved water use efficiencies. The Soil and Water Assessment Tool is used to simulate river flow under two scenarios S1 and S2. Climate change study under three Shared Socio-economic Pathways (SSP1-1.9, SSP2-4.5, SSP5-8.5) indicates that temperature (precipitation) will increase (decrease) by 1.4–2.1 °C (2.9%–12.31%). Quantified management of rivers and groundwater is minimum in spring (−4.43 to 0.66) and summer (−0.613), respectively, and is maximum in autumn-winter (1) and winter (0.491), respectively. Quantified annual management in rivers (groundwater) is −1.278 to 1 (−0.07) and −0.772 to 1 (0.104) under available and improved water use efficiencies, respectively. Climate and land-use changes will reduce the level of management over the study area in which the reduction is higher for a greater level of warming and scenario S2. Quantified annual management of rivers (groundwater) in scenario S2 under available water use efficiency is −1.34 to 1 (−0.379), −1.45 to 1 (−0.654) and −1.55 to 1 (−0.947) for the SSP1-1.9, SSP2-4.5 and SSP8.5, respectively. Efficiency improvement increases management level under scenario S2; however, three rivers and groundwater will still suffer from mismanagement in the future. • Here, a physical metric is presented to quantify surface and ground water management. • It uses water availability and supply concepts under supported ecosystem flow requirement. • It can quantify impact of climate and land-use changes on water resources management. • It is highly recommended to use proposed metric for sustainable water management. [ABSTRACT FROM AUTHOR]

Objective: Recent studies imply extensive applications for the human amniotic membrane (hAM) and its extract in medicine and ophthalmology. The content of hAM meets many requirements in eye surgeries, such as refractive surgery as the most important and commonly used method for treating the dramatically increasing refractive errors. However, they are associated with complications such as corneal haziness and corneal ulcer. This study was designed to evaluate the impact of amniotic membrane extracted eye drop (AMEED) on Trans-PRK surgery complications. Materials and Methods: This randomized controlled trial was performed during two years (July 1, 2019-September 1, 2020). Thirty-two patients (64 eyes), including 17 females and 15 males, aged 20 to 50 years (mean age of 29.59 ± 6.51) with spherical equivalent between -5 to -1.5 underwent Trans Epithelial Photorefractive Keratectomy (Trans-PRK) surgery. One eye was selected per case (case group) and the other eye was considered as control. Randomization was done using the random allocation rule. The case group was treated with AMEED, and the artificial tear drop every 4 hours. The control eyes received artificial tear drops instilled every 4 hours. The evaluation continued for three days after the Trans-PRK surgery. Results: A significant decrease in CED size was found in the AMEED group on the second day after surgery (P=0.046). Also, this group had a substantial reduction in pain, hyperemia, and haziness. Conclusion: This study showed that AMEED drop can increase the healing rate of corneal epithelial lesions after TransPRK surgery and reduce the early and late complications of Trans-PRK surgery. Researchers and Ophthalmologists should consider AMEED as a selection in patients with persistent corneal epithelial defects and patients who have difficulty in corneal epithelial healing. We understood AMEED has a different effect on the cornea after surgery; therefore, the researcher must know AMEED’s exact ingredients and help expand AMEED uses (registration number: TCTR20230306001). [ABSTRACT FROM AUTHOR]

This report describes a lamellar macular hole formation subsequent to intravitreal bevacizumab injection for the treatment of choroidal neovascularization (CNV) by age-related macular degeneration. A 67-year-old woman with bilateral CNV underwent 3 monthly intravitreal bevacizumab injections in her both eyes. One month after the third bilateral injection, vision loss happened. Optical coherence tomography performed for further evaluation that showed reduction of intra- and sub-retinal fluid associated with lamellar macular hole development in both eyes. Although macular hole formation, especially bilateral form, is a rare complication of intravitreal injections, surgeons should consider macular hole development in cases with vision deterioration following intravitreal bevacizumab injection. [ABSTRACT FROM AUTHOR]

Patterns obtained in two-dimensional gel electrophoresis (2- DE) in the previously published articles suggest a varying number of proteins. To seek the cause of this variation, we investigated the effect of reduction power on the overall tear proteome maps. To this end, the buffers of two reducing agents, dithiothreitol ( DTT) at nine different concentrations and di-(2-hydroxyethyl) disulfide ( HED), were examined. The assay showed that HED clearly improved 2- DE resolution, increased the number of detectable protein spots, and offered well-resolved chain regions in comparison with those treated with DTT. Furthermore, this study introduced increasing the reduction power as a remedy to increase the reproducibility of two-dimensional human tear proteome maps. In addition, the results of our assessment showed that improved reduction efficiency was accompanied by increased procedure reproducibility from 42% to 89%. [ABSTRACT FROM AUTHOR]

Purpose: To measure the rate of corneal interface contamination during laser in situ keratomileusis (LASIK), determine probable sources of the contamination, and evaluate how the cornea reacts to the contamination. Setting: Department of Ophthalmology, Baqyatallah Hospital, Baqyatallah University, Tehran, Iran. Methods: In this case series, 200 eyes were evaluated for the corneal interface contamination at the end of LASIK. Cultures were taken from the upper and lower eyelid margins and the inferior fornices before surgery and from the corneal interface and the instrument at the end of surgery. Media were cultured at 37°C for 14 days under aerobic and anaerobic conditions. Bacteria from positive cultures were isolated and identified by biochemical procedures to determine the species of the organisms. Results: The rate of contamination was 24.5%. The most common retrieved organism was Staphylococcus epidermidis (43 cases, 87.7%). None of the contaminated or noncontaminated cases developed corneal ulcers; however, 2 eyes developed diffuse lamellar keratitis. Conclusion: The corneal stroma has the ability to clear introduced microorganisms during LASIK. [Copyright &y& Elsevier]

BACKGROUND: The aim of this study was to evaluate visual and refractive outcomes and quality of vision after implantation of the AT LISA tri 839MP intraocular lens (IOL). PATIENTS AND METHODS: This interventional clinical trial comprised 46 cataractous eyes of patients who underwent phacoemulsification with IOL implantation (mean age of 58.08 ± 11.01 years; range: 36–76 years old). Spherical equivalent (SE), uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), corrected intermediate visual acuity (CIVA), uncorrected near visual acuity (UNVA), and corrected near visual acuity (CNVA) were measured 1, 3, and 6 months after surgery. Contrast sensitivity (CS) was measured at 6 months. Subjective quality of vision and presence of dysphotopsia by a short questionnaire were evaluated postoperatively. RESULTS: At 6 months, the mean visual acuity was 0.08 ± 0.11, 0.03 ± 0.08, 0.07 ± 0.09, 0.02 ± 0.08, 0.05 ± 0.09, and 0.02 ± 0.08 LogMAR for UDVA, CDVA, UIVA, CIVA, UNVA, and CNVA, respectively. The mean values of SE were − 0.4728 ± 0.32D. These variables improved over time, yet significant changes were detected in UDVA (P = 0.009) and SE (P = 0.0001). The mean CS value was 1.74 ± 0.08. The mean scores (0% = no symptoms; 100% = strong symptoms/unable to perform activities) for glare and halos were 7.07 ± 0.22% and 8.70 ± 0.23%, respectively. These items were reduced over time. Patients' level of satisfaction mean score for performing activities was 96.66%. CONCLUSIONS: The AT LISA tri 839MP IOL provides excellent uncorrected distance, intermediate and near vision, and CS. This IOL showed a minimal level of photic phenomena and a high level of patient satisfaction. [ABSTRACT FROM AUTHOR]

Climate change involves increasing atmospheric carbon dioxide concentration which is driven by anthropogenic emissions. Afforestation, which is the establishment of forests on previously non‐forested lands, could be a suitable climate change mitigation strategy. The aim of this research is to evaluate the carbon sequestration capability of the Eucalyptus and Prosopis species in the Reza‐Abad afforestation park in western Iran. For this aim, three stands of any species were selected. For quantitative assessment, a transect was implemented at the length of 100 m. In trees located of transects, the general characteristics of species were measured. Also, for estimating the amount of litter, a sample plot has been measured at the center of the quadrate. These samples were taken from the afforested area, the control area inside the afforested area and another control area outside. In each stand, species were selected randomly and one‐eighth of the whole stand was taken for calculating the percentage of carbon and aerial biomass. Then the aboveground organs were weighted and after the transfer of different plant organs to the laboratory, the conversion factor of carbon sequestration of the plant organs was determined individually by combustion method. Also, soil samples were also collected from two depths of 0–15 and 15–30 cm in each of the cultivated and control parts. The results showed that there is a significant difference between the species and Prosopis has higher carbon sequestration than Eucalyptus. The carbon sequestration among different organs showed a significant difference, carbon sequestration was 19.24 t/ha for Eucalyptus and 18.43 t/ha for Prosopis. After an economic calculation, it was concluded that afforestation has a positive effect on the reduction of atmospheric carbon dioxide. Hence, these results allow decision makers to change land use from desert area to forest, and planting the Prosopis species is more recommendable than Eucalyptus for afforestation in such areas which are economically profitable. [ABSTRACT FROM AUTHOR]

Objective. Sulfur mustard (SM) is a highly reactive alkylating agent which produces ocular, respiratory, and skin damages. Eyes are the most sensitive organ to SM due to high intrinsic metabolic and rapid turnover rate of corneal epithelium and aqueous-mucous interfaces of the cornea and conjunctiva. Here we investigate underlying molecular mechanism of SM exposure delayed effects which is still a controversial issue after about 30 years. Materials and Methods. Following ethical approval, we have analyzed serum proteome of ten severe SM exposed male patients with delayed eye symptoms with two-dimensional electrophoresis followed by matrix-assisted laser desorption/ionization time-of-flight/time-of-flight mass spectrometry. The western blotting was used to confirm the proteins that have been identified. Results. We have identified thirteen proteins including albumin, haptoglobin, and keratin isoforms as well as immunoglobulin kappa chain which showed upregulation while transferrin and alpha 1 antitrypsin revealed downregulation in these patients in comparison with healthy control group. Conclusions. Our results elevated participation of free iron circulatory imbalance and local matrix-metalloproteinase activity in development of delayed ocular symptoms induced by SM. It demonstrates that SM induced systemic toxicity leads to some serum protein changes that continually and gradually exacerbate the ocular surface injuries. [ABSTRACT FROM AUTHOR]

We evaluate the efficacy and safety of Keraring 355° intrastromal corneal ring segment (ICRS) implantation aided by PocketMaker microkeratome for the correction of keratoconus. Patients underwent ICRS insertion using mechanical dissection with PocketMaker microkeratome and completed 6 months of follow-up. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, topographic findings, safety, efficacy index, and adverse events were reported for six months postoperatively. We evaluated 15 eyes of 15 patients (12 men) with a mean age of 28.87 ± 6.94 years (range 21–49 years). At final postoperative examination, there was a statistically significant reduction in the spherical equivalent refractive error compared to preoperative measurements (−5.46 ± 1.52 to −2.01 ± 1.63 D, P< 0.001). Mean preoperative UCVA (logMAR) before implantation was 0.79 ± 0.48, and postoperative UCVA was 0.28 ± 0.15, P= 0.001. Mean preoperative BSCVA (logMAR) before implantation was 0.36 ± 0.21; at final follow-up examination BSCVA was 0.18 ± 0.9, P= 0.009. Mean K decreased from 48.33 to 43.31 D, P< 0.001. All patients were satisfied with ICRS implantation; 86.7% were moderately to very happy with the results. No intraoperative or postoperative complications were demonstrated. This preliminary study shows that ICRS (Keraring 355°) implantation is an efficient, cost-effective, and minimally invasive procedure for improving visual acuity in nipple type keratoconic corneas. [ABSTRACT FROM AUTHOR]

Some studies have already addressed the effects of occupational organic solvent exposure on the visually evoked potentials (VEPs). Visual system is an important target for Sulphur Mustard (SM) toxicity. A number of Iranian victims of Sulphur Mustard (SM) agent were apprehensive about the delay effect of SM on their vision and a possible delay effect of SM on their visual cortex. This investigation was performed on 34 individuals with a history of chemical exposure and a control group of 15 normal people. The Toennies electro-diagnosis device was used and its signals were saved as the latencies. The mean of N75, N140 and P100 of victims of chemical warfare (VCWs) and control group indicated no significant results (P>0.05). The VCWs did not show any visual symptoms and there was no clear deficit in their VEPs. [ABSTRACT FROM AUTHOR]

Introduction: Many victims of chemical warfare(VCW) manifest some degree of refractive errors which were not present before exposure. These refractive errors are presumably long-term(delayed) effects of sulfur mustard exposure. However, no related research studies have been done to confirm this. Myopia, hyperopia, and astigmatism are the refractive errors of the eye and prevalence of these errors depends on several factors such as hereditary factors, age, profession, and also several geographical factors. The effect of sulfur mustard on the eye may be very complex and relates basically to the intensity of the injury. Sulfur mustard targets the cornea resulting in early effects of exposure. The delayed effects of exposure are less documented and are discussed in this study. Materials and METHOD: In this study, cross-sectional study refractive errors were studied as one of the delayed effects of sulfur mustard in VCW. 2252 eyes of VCW and 2248 normal eyes were chosen as controls. The mean age of both groups were 34.3(SD = 9.1) and 32.1(SD = 10.1) respectively. Both groups went through an optometric and ophthalmic examination. The refractive errors were measured by autorefractometer(Topcon RM 2300). The Student t-test and chi-square test were used and P < 0.05 was considered significant. RESULTS: The prevalence of refractive errors in the VCW group was 89.8% which was higher than the control group of 72.6% p < 0.001. Astigmatism was the main refractive error in the VCW group and their prevalence(76.2%) was higher than the control group(47%) p < 0.001. The types of astigmatism found were“against” and“oblique.” Prevalence of myopic astigmatism in the VCW group was also higher than in the other types of astigmatisms. Discussion: There are three main causes for refractive errors. Change in anterior-posterior length of the eye or change in curvature of refractive surfaces and change in the index or combinations of them. All VCW have photophobia, dry eyes, and excessive blinking. They have narrow eye opening(narrow palpebral fissure). Eyelid pressure and excessive blinking, and dry eyes add gradual pressure on the cornea and in the long term lead to induce refractive errors such as astigmatism. Further studies will be needed however to confirm this. [ABSTRACT FROM AUTHOR]

Sulfur mustard (SM) intoxication produces local and systemic changes in the human body. In this study, the relationship between tear and serum matrix metalloproteinase (MMP)-9 and serum tissue inhibitors of metalloproteinases (TIMPs) are assessed in serious eye-injured SM-exposed casualties. A group of 128 SM-exposed patients with serious ocular injuries in three subgroups (19 mild, 31 moderate, and 78 severe cases) is compared with 31 healthy controls. Tear and ocular status and serum MMPs and MMP-9/TIMPs complex levels were evaluated using enzyme-linked immunosorbent assay (ELISA). Serum level of MMP-9 was significantly higher in the SM-exposed group compared to the control group (P = 0.009). Mean serum MMP-9 level in the SM-exposed group with ocular abnormalities was significantly higher than that in the SM-exposed group without ocular abnormalities. SM-exposed people with corneal calcification had significantly higher serum MMP-9/TIMP-1 level compared to the SM-exposed ones without this problem (P = 0.045). The SM-exposed group with severe ocular injuries had significantly higher MMP-9/TIMP-1 than the controls (P = 0.046). The SM-exposed group had significantly lower levels of MMP-9/TIMP-4 complex than the controls (P < 0.001). The SM-exposed group with tear meniscus and fundus abnormality had significantly higher MMP-9/TIMP-4 levels than the SM-exposed group without these problems (P = 0.009 and P = 0.020). Serum MMP-9 level had increased in SM-exposed groups with ocular problems, while TIMP-1 and TIMP-2 levels had remained unchanged. Serum TIMP-4 drastically decreased in SM-exposed group, which clearly explains the severity of the systemic and ocular damages. • Matrix metalloproteinases (MMPs) are involved in tissue damage, while tissue inhibitors of metalloproteinases (TIMs) inhibit their adverse effects. • Serum MMP-9 to MMP-9/TIMP-2 and MMP-9 to MMP-9/TIMP-4 complex are high in SM-exposed groups. • Serum MMP-9 levels increases in SM-exposed groups with ocular problems. • Serum TIMP-1 and TIMP-2 levels remain unchanged in SM-exposed groups with ocular problems. • Significant decrease in serum TIMP-4 matches the severity of the systemic and ocular damages in SM-exposed patients. [ABSTRACT FROM AUTHOR]