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Purpose: Assessment of the pattern visual evoked potential (PVEP) responses in different areas of visual fields in individuals with normal vision. Methods: This study was conducted on 80 eyes of normal subjects aged 18-35 years. All participants underwent refraction and visual acuity examination. Visual evoked potential (VEP) responses were recorded in different areas of field. The repeated measure test was used to compare the P100 latency and amplitude of PVEP among different areas. Results: The repeated measures analysis of variance showed a statistically significant difference among different areas in terms of amplitude and latency of P100 (P = 0.002 and P < 0.001, respectively). According to the results, the highest and lowest amplitude of P100 was observed in inferior-nasal and superior areas, respectively. The highest and lowest latency of P100 was related to the temporal and inferior-nasal areas, respectively. Conclusion: This study partially revealed the details of local PVEP distribution in the visual field and there was a significant difference in the amplitude and latency of PVEP wave in different areas of the visual field. [ABSTRACT FROM AUTHOR]

Objectives: Decreased static pupil size due to accommodation is a common clinical finding; however, changes in pupillary dynamic responses after near-work activities such as reading a book and using a smartphone are not well understood. Methods: The present study was performed on 76 right eyes of 76 volunteers (mean age: 20.95±2.34 years) who had ocular near activity more than 4 h per day. The participants were divided into two groups based on the dominant activity, reading a book (Group 1) or using a smartphone (Group 2). Evaluation of dynamic and static parameters of the pupil was performed before and after 1 h of continuous routine eye activity in both groups and compared. Results: Near work reduced pupil diameter (PD) in all static components (p<0.001) and the amount of change in the min PD (p=0.039) and mesopic PD (p=0.043) were different between two groups and were higher in Group 1 (both, p<0.05). Dynamic elements showed a decrease in initial diameter, amplitude and velocity of contraction and dilation, and an increase in other components so that the changes after using smartphone were significant in all dynamic parameters (all, p<0.05), but reading the book only made a significant difference in the initial diameter, amplitude, and velocity of contraction and duration of dilation (all, p<0.05); the changes were only different in the initial diameter between the two studied groups, which was higher in Group 1 (p=0.047). Conclusion: The present study showed that reading a book and using smartphone cause changes in the pupil components, which were decreasing in diameter components and velocity of changes and increasing in latency of changes; the type of ocular work may affect the changes. [ABSTRACT FROM AUTHOR]

Background: Many studies show that congenital defects in infants conceived by assisted reproductive techniques (ART) are more than infants of normal conception (NC). The aim of this study is to determine the frequency of congenital anomalies in ART infants from Royan Institute and to compare congenital anomalies between two ART techniques. Methods: In a cross-sectional descriptive study, 400 ART infants from Royan Institute who resided in Tehran were selected by non-random, consecutive sampling. Infants were examined twice (until 9 months of age) by a pediatrician. Infants' congenital anomalies were described by each body system or organ and type of ART. Data were analyzed by SPSS version 16 and Fisher's exact test. Results: The frequency of different organ involvement in the two examinations were: 40 (10%) skin, 25 (6.2%) urogenital system, 21 (5.2%) gastrointestinal tract, 13 (3.2%) visual, and 8 (2%) cardiovascular system. Major congenital defects in infants conceived by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) were hypospadiasis, inguinal hernia, patent ductus arteriosus plus ventricular septal defect (PDA + VSD), developmental dysplasia of the hip, lacrimal duct stenosis during the first year of life, hydronephrosis and urinary reflux over grade III, undescending testis, ureteropelvic junction stenosis, and torticoli. Conclusions: Two-thirds of ART infants had no defects. A total of 7% of IVF and ICSI infants had one of the major above mentioned congenital anomalies. This rate was higher than NC infants (2%-3%). There was no difference between the ICSI and IVF group. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to investigate the change rate of astigmatism and axial, myopia, and hypermetropia in trabeculectomy and shunt surgery., Patients and Methods: In this comparative study, two groups of 16 patients with an average age of 52.4±8.9 and 94.6±6.7 respectively underwent trabeculectomy and shunt surgery. The changes of reactive error were compared before the surgery and 1 week, 1 month, and 3 months after the surgery. Data from the two groups were analyzed via Friedman and Mann-Whitney tests., Results: Average of intraocular pressure (IOP) before, and 1 week, 1 month, and 3 months after trabeculectomy is 31.31±7.6, 9.8±2.8, 10.5±1.29, 10.9±1.26 ( P <0.05) and shunt is 36.06±10.32, 13.5±3.3, 11.68±2.21, 11.18±1.27 ( P <0.05). Average astigmatism in trabeculectomy is -1.00±0.59, -6.00±1.9, -2.21±1.18, -1.37±0.62 ( P <0.05) and in shunt it is -0.89±0.46, -1.56±1.62, -1.51±1.46, -1.07±0.85 ( P >0.05). Percent WRT astigmatism in trabeculectomy is 37.5, 100, 37.5, 31.25 and in shunt it is 43.75, 50, 50, 56.25 and average of spherical equivalence (SE) in trabeculectomy is -0.31±1.49, 1.43±1.94, 0.27±1.74, 0.04±1.46 ( P <0.05) and in shunt it is 0.65±1.5, 1.03±2.03, -0.70±1.64, 0.62±1.54 ( P <0.05). Astigmatism and axial comparisons between trabeculectomy and shunt with Mann-Whitney test were significant ( P <0.05), but SE was not significant ( P >0.05)., Conclusion: The surgeries induced hypermetropia and reduction with the passing of time but astigmatism amount and percent of with-the-rule astigmatism in trabeculectomy were more than in shunt surgery., Competing Interests: The authors report no conflicts of interest in this work., (© 2020 Dehghanian Nasrabadi et al.)

Purpose: To review current non-surgical management methods of intermittent exotropia (IXT) which is one of the most common types of childhood-onset exotropia., Methods: A search strategy was developed using a combination of the words IXT, divergence excess, non-surgical management, observation, overcorrecting minus lens therapy, patch/occlusion therapy, orthoptics/binocular vision therapy, and prism therapy to identify all articles in four electronic databases (PubMed, Web of Science, Google Scholar, and Scopus). To find more articles and to ensure that the databases were thoroughly searched, the reference lists of the selected articles were also reviewed from inception to June 2018 with no restrictions and filters., Results: IXT is treated when binocular vision is impaired, or the patient is symptomatic. There are different surgical and non-surgical management strategies. Non-surgical treatment of IXT includes patch therapy, prism therapy, orthoptic sessions, and overcorrecting minus lens therapy. The objective of these treatments is to reduce the symptoms and the frequency of manifest deviation by decreasing the angle of deviation or enhancing the ability to control it., Conclusions: Evidence of the efficacy of non-surgical management options for IXT is not compelling. More comprehensive randomized controlled trial studies are required to evaluate the effectiveness of these procedures and detect the most effective strategy., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Current Ophthalmology.)

Graft Versus Host Disease (GVHD) is an inflammatory immune disease, mediated by the donor's immune cells and can arise after allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for the treatment of hematologic malignancies. It can lead to destructive manifestations in various tissues, particularly dermatological, gastrointestinal, and ocular tissues. The most common ocular morbidity is dry eyes, which is often the first manifestation of GVHD. Regulatory T cells (Tr) can be broadly classified as natural or adaptive (induced). After Bone-Marrow Transplantation (BMT), excessively increased levels of type 1 Tr (Tr1) are generally observed with absence of a GVHD, while low levels are seen with severe GVHD. Treatment of patients, undergoing BMT with Interleukin-10 (IL-10)-anergized donor T cells, led to immune reconstitution without the development of GVHD, which resulted in protection against infection and against the return of the cancer. Surprisingly, in both naive syngeneic mouse models of skin and cardiac allografts, graft retention was augmented after infusion of in vitro generated double-negative Tr (DN Tr). In addition, GVHD was reduced in mice with a genetic deficiency in the IL-27 receptor (IL-27R-/-) and in mice treated with anti-IL-27p28-specific antibody. Considering above mentioned findings we would suggest carrying out experiments, using animal models of GVHD, in order to evaluate the potential role of Tr, as an innovative approach to overcome severe ocular morbidity caused by ocular GVHD., Competing Interests: Ethical issues have been completely observed by the authors. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published. No conflict of interest has been presented.

Purpose: To evaluate the prevalence of pterygium and its determinants in the underserved, rural population of Iran., Methods: In this cross-sectional study of 3851 selected individuals, 86.5% participated in the study, and the prevalence of pterygium was evaluated in 3312 participants. A number of villages were selected from the north and south of Iran using multistage cluster sampling. Pterygium was diagnosed by the ophthalmologist using slit-lamp examination., Results: The mean age of the study participants was 37.3 ± 21.4 years (2-93 years), and 56.3% (n = 1865) of them were women. The prevalence of pterygium was 13.11% [95%confidence interval (CI):11.75-14.47]. The prevalence of pterygium was 14.99 (95%CI:12.79-17.19) in men and 12.07 (95%CI:10.3-13.84) in women. Pterygium was not seen in children below the age of 5 years. The prevalence of pterygium increased linearly with age; the lowest and highest prevalence of pterygium was observed in the age group 5-20 years (0.19%) and 61-70 years (28.57%). Evaluation of the relationship between pterygium with age, sex, educational level, and place of living using a multiple model showed that age, living in the south of Iran, and low educational level were correlated with pterygium., Conclusion: The prevalence of pterygium was significantly higher in Iranian villages when compared with the results of previous studies. This finding may represent the effect of a rural lifestyle and its risk factors.

To compare the refractive and visual outcomes and higher order aberrations in patients with low to moderate myopia who underwent customized photorefractive keratectomy (PRK) or femtosecond laser in situ keratomileusis (Femto-LASIK) this research performed. This study includes data of 120 consecutive eyes of 60 patients with myopia between -3.00 D and -7.00 D with or without astigmatism in two surgery groups: PRK and Femto-LASIK. Refractive, visual, and aberration outcomes of the two methods of surgery were compared after 6 months of follow-up. After six months of follow-up, sphere and cylinder were found significantly decreased and there was no statistically significant difference between the two groups. The mean of uncorrected distance visual acuity in LogMar format for the PRK and Femto-LASIK groups was -0.03±0.07 and -0.01±0.08, respectively, which was not significantly different between the two groups. Higher orders and spherical aberrations increased in both groups significantly, while total aberrations decreased in both groups. After surgery, no differences were observed between the two groups in the amount of aberrations. In conclusion, Both PRK and Femto-LASIK are effective and safe in correcting myopia. In this study PRK induced more spherical and higher order aberrations than Femto-LASIK.

Purpose: To explore retinal ganglion cell (RGC) dysfunction in glaucoma suspects and patients with early primary open angle glaucoma (POAG) using pattern electroretinography (PERG)., Methods: Twenty glaucoma suspects (glaucomatous optic disc appearance), 15 early POAG (based on abnormal discs and abnormal visual fields) and 16 normal controls were enrolled. Transient PERG was recorded in response to 0.8° and 16° black and white checkerboard stimuli. Amplitude and peak time (latency) of the P50 and N95 components of the PERG response, and the ratio of N95 amplitude in response to 0.8° and 16° checks were measured., Results: N95 peak time (latency) was significantly increased in both early manifest POAG and glaucoma suspects as compared to normal controls (P<0.001). In early POAG, N95 amplitude in response to small (0.8°) checks and the small/large check ratio were reduced in comparison to normal eyes (P<0.05). However, in glaucoma suspects no significant N95 amplitude reduction was observed. No significant difference was observed among the study groups in terms of P50 amplitude or peak time., Conclusion: The N95 PERG response demonstrated uncoupled peak time and amplitude alterations in glaucoma. N95 peak time was significantly increased both in glaucoma suspects and early POAG; N95 amplitude reduction was present only in early POAG. PERG may detect RGC dysfunction (increased latency) before cell death (decreased amplitude) occurs.

Background: Many studies show that congenital defects in infants conceived by assisted reproductive techniques (ART) are more than infants of normal conception (NC). The aim of this study is to determine the frequency of congenital anomalies in ART infants from Royan Institute and to compare congenital anomalies between two ART techniques. , Methods: In a cross-sectional descriptive study, 400 ART infants from Royan Institute who resided in Tehran were selected by non-random, consecutive sampling. Infants were examined twice (until 9 months of age) by a pediatrician. Infants' congenital anomalies were described by each body system or organ and type of ART. Data were analyzed by SPSS version 16 and Fisher's exact test., Results: The frequency of different organ involvement in the two examinations were: 40 (10%) skin, 25 (6.2%) urogenital system, 21 (5.2%) gastrointestinal tract, 13 (3.2%) visual, and 8 (2%) cardiovascular system. Major congenital defects in infants conceived by in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) were hypospadiasis, inguinal hernia, patent ductus arteriosus plus ventricular septal defect (PDA + VSD), developmental dysplasia of the hip, lacrimal duct stenosis during the first year of life, hydronephrosis and urinary reflux over grade III, undescending testis, ureteropelvic junction stenosis, and torticoli., Conclusions: Two-thirds of ART infants had no defects. A total of 7% of IVF and ICSI infants had one of the major abovementioned congenital anomalies. This rate was higher than NC infants (2%-3%). There was no difference between the ICSI and IVF group.