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Masoud Soheilian

Publications and source records attributed to Masoud Soheilian.

11 recordsLinked to original sources
PubMed2006

Comparison of silicon oil removal with various viscosities after complex retinal detachment surgery.

BACKGROUND: Despite the progress in vitreoretinal surgery and the importance of silicone oil as an adjunct for the treatment of complex forms of retinal detachment, controversy still surrounds the issue of selecting the proper oil viscosity for clinical use. Herein, we evaluate the outcomes of retinal detachment (RD) surgery after removing silicone oils of different viscosities. METHODS: In this retrospective cohort study, eighty-two eyes with surgically re-attached retinas, of which 53 were filled with 5000 cs silicone oil and 29 with 1000 cs silicone oil were enrolled. We evaluated the outcomes and complications following silicone oil removal. Final anatomic success (stable re-attachment), final visual acuity (VA) and intraocular pressure (IOP)were recorded and analysed. RESULTS: Of 82 eyes, 41 had proliferative vitreoretinopathy (PVR), 24 were associated with intraocular foreign bodies, 10 had endophthalmitis and 7 had proliferative diabetic retinopathy with tractional retinal detachment. Prior to silicone oil removal, the retina was attached in all eyes, 29% had VA > or = 6/120 and 52% had IOP > or = 21 mmHg. After silicone oil removal, the retina remained attached in 59(72%) of the eyes, 34% had VA > or = 6/120 and 9% had IOP > or = 21 mmHg. Comparing 1000 cs and 5000 cs silicone oil filled eyes, redetachment occurred more frequently in the latter group especially in cases with associated PVR. Final VA worse than 6/120 was associated with initial VA < 6/120 (OR = 32.2 95%CI 7.4-140.2) and use of 5000 cs silicone oil (OR = 7.9 95%CI 1.9-32.2). No factor was significantly associated with final IOP > or = 21 mmHg. CONCLUSION: In complicated retinal detachment surgery, use of 5000 cs silicone oil may be associated with a poorer anatomic and visual outcome compared with 1000 cs silicone oil. However there was no difference between the two viscosities in IOP elevation. A randomized controlled study is necessary to further evaluate such a possibility.

Cohort Studies↗
PubMed2006

Management of pediatric Vogt-Koyanagi- Harada (VKH)-associated panuveitis.

PURPOSE: To assess the clinical course, determine the efficacy and safety of oral methotrexate in the control of intraocular inflammation, and evaluate the outcomes of lensectomy-vitrectomy and goniosynechiolysis on pediatric VKH-associated panuveitis. DESIGN: Retrospective non-comparative interventional case series. PARTICIPANTS: Ten patients (20 eyes) with pediatric VKH-associated panuveitis (onset of disease at age 14 years or younger). INTERVENTION: Stepwise medical treatment consisted of oral prednisolone (0.5-1 mg/kg), supplemented by oral methotrexate (5-7.5 mg/wk) in refractory cases. Surgical intervention was performed for complications such as visually significant cataracts and secondary glaucoma and included pars plana lensectomy-vitrectomy and peripheral anterior synechiolysis in a one-stage procedure. MAIN OUTCOME MEASURES: Control of inflammation, corticosteroid requirement, visual acuity, and intraocular pressure (IOP). RESULTS: Ten consecutive patients with a minimum follow-up duration of six months were analyzed. All patients were initially treated with oral corticosteroids; methotrexate was additionally required in six subjects. In all eyes, inflammation decreased and vision was preserved or improved. Side effects of methotrexate were mild and transient. Nine eyes of five patients underwent combined lensectomy and vitrectomy. The procedure was successful in all eyes without any exacerbation of inflammation. Eight eyes had elevated IOP, six of which underwent peripheral anterior synechiolysis at the time of lensectomy-vitrectomy. IOP was controlled after the procedure in all eyes with timolol only. Overall, final visual acuity was=20/40 in 30% of the eyes and<20/200 in only 20%. CONCLUSIONS: Pediatric VKH-associated panuveitis seems to follow an aggressive course; the development rate of cataracts and secondary glaucoma seems to be high. Oral methotrexate is a safe and effective adjunct and displays steroid-sparing properties in the control of inflammation. Surgical interventions including peripheral anterior synechiolysis in addition to pars plana lensectomy and vitrectomy may be effective in controlling IOP in eyes with cataract and glaucoma. PRECIS: Vision may be preserved in pediatric VKH panuveitis using steroids and methotrexate for the control of inflammation, lensectomy-vitrectomy for visual improvement, and synechiolysis for IOP control.

Administration, Oral↗
PubMed2005

Concomitant optic nerve transection and chorioretinitis sclopetaria.

BACKGROUND: Optic nerve transection and chorioretinitis sclopetaria may occur following blunt ocular trauma. However, simultaneous occurrence has not yet been reported. We report the first case of concomitant optic nerve transection and chorioretinitis sclopetaria. CASE PRESENTATION: A 12-year-old boy with history of BB gun injury to his right eye was referred for loss of vision. His visual acuity was counting fingers at one meter in the right eye and with 3+ relative afferent pupillary defect (RAPD). On slit lamp examination, the right eye appeared normal except for 1+ vitreous reaction. Fundus examination of the right eye revealed a pale disc with superior retinal scar and diffuse submacular fibrosis compatible with chorioretinitis sclopetaria. Orbital CT-scans showed transection of the optic nerve by the BB gun pellet, which was lodged at the orbital apex. CONCLUSION: BB gun injury may cause concomitant optic nerve transection and chorioretinitis sclopetaria.

Child↗
PubMed2005

Prospective randomized trial of trimethoprim/sulfamethoxazole versus pyrimethamine and sulfadiazine in the treatment of ocular toxoplasmosis.

OBJECTIVE: To compare the efficacy of the classic treatment of ocular toxoplasmosis (pyrimethamine, sulfadiazine, and prednisolone) with a regimen consisting of trimethoprim/sulfamethoxazole (co-trimoxazole) plus prednisolone. DESIGN: Prospective randomized single-blind clinical trial. PARTICIPANTS: Fifty-nine patients with active ocular toxoplasmosis were randomly assigned to 2 treatment groups: 29 were treated with pyrimethamine/sulfadiazine, and 30 patients received trimethoprim/sulfamethoxazole. INTERVENTION: Treatment consisted of 6 weeks' treatment with antibiotics plus steroids. Antitoxoplasmosis antibodies (immunoglobulin M [IgM] and IgG) were measured using an enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES: Changes in retinochoroidal lesion size after 6 weeks' treatment, visual acuity (VA) before and after intervention, adverse drug reactions during follow-up, and rate of recurrence. RESULTS: Active toxoplasmosis retinochoroiditis resolved in all patients over 6 weeks' treatment, with no significant difference in mean reduction of retinochoroidal lesion size between the 2 treatment groups (61% reduction in the classic treatment group and 59% in the trimethoprim/sulfamethoxazole group, P = 0.75). Similarly, no significant difference was found in VA after treatment between the 2 groups (mean VAs after treatment were 0.12 logarithm of the minimum angle of resolution [logMAR] [20/25] in the classic treatment group and 0.09 logMAR [20/25] in the trimethoprim/sulfamethoxazole group, P = 0.56). Adverse effects were similar in both groups, with one patient in each suffering from any significant drug side effects. The overall recurrence rate after 24 months' follow-up was 10.16%, with no significant difference between the treatment groups (P = 0.64). CONCLUSIONS: Drug efficacies in terms of reduction in retinal lesion size and improvement in VA were similar in a regimen of trimethoprim/sulfamethoxazole and the classic treatment of ocular toxoplasmosis with pyrimethamine and sulfadiazine. Therapy with trimethoprim/sulfamethoxazole seems to be an acceptable alternative for the treatment of ocular toxoplasmosis.

Adolescent↗
PubMed2003

Transvitreal optic neurotomy for nonarteritic anterior ischemic optic neuropathy.

PURPOSE: To evaluate the role of transvitreal optic neurotomy in the treatment of nonarteritic anterior ischemic optic neuropathy, a scleral outlet compartment syndrome, in which neurovascular compression at the prelaminar and laminar regions of the optic nerve head may play a major role. METHODS: Seven eyes of seven selected patients with severe vision loss (<20/800) from nonarteritic anterior ischemic optic neuropathy underwent transvitreal nasal radial optic neurotomy. The study was not masked and not randomized. Visual acuity and visual fields, when possible, were measured, and fluorescein angiography was performed preoperatively and postoperatively. RESULTS: Four male and three female patients had a mean age of 52.4 years; five had bilateral disease. The mean follow-up was 13 +/- 7 weeks. Mean preoperative visual acuity was 20/2400; mean postoperative visual acuity was 20/250, with an average of 10 lines of improvement. Six of seven patients showed visual improvement. One patient had peripapillary choroidal neovascularization. In two patients with sufficient visual acuity, preoperative visual fields could be obtained; these patients showed significant improvement in postoperative perimetry. Five patients had some loss of vision, which made it impossible to obtain preoperative visual fields. CONCLUSION: Relaxation of the scleral ring of the prelaminar and laminar regions of the optic nerve head reduces constriction and may prevent necrosis of salvageable but underperfused nerve fibers. Despite improvement of visual acuity in our patients, transvitreal optic neurotomy should be considered experimental, requiring a randomized clinical trial.

Adult↗
PubMedDate not supplied

Surgical management of retinal detachment secondary to acute retinal necrosis: clinical features, surgical techniques, and long-term results.

PURPOSE: To describe the clinical features of complicated retinal detachment secondary to acute retinal necrosis (ARN) and to present the long-term results of vitreous surgery in these cases. METHODS: A retrospective study was conducted on 16 immunocompetent patients (18 eyes). The average follow-up period was 60 months. RESULTS: Proliferative vitreoretinopathy (PVR) grade C, with the predominance of anterior PVR, and characteristic changes in the vitreous base area were present in all cases before surgery. All eyes underwent vitrectomy, membrane peeling, endolaser photocoagulation, and intraocular tamponade without scleral buckling. Additional procedures were performed in 13 eyes. Retinal reattachment was achieved in the 18 eyes (100%) in the short term. Variable degrees of reproliferation occurred in all cases after surgery. Other delayed complications included ocular hypotony, macular pucker, peripheral retinal neovascularization, and severe preretinal fibrosis. Improvement of visual acuity occurred in 13 eyes (72.2%). Eleven eyes (61.1%) achieved final ambulatory visual acuity of 5/200 or better. CONCLUSIONS: Rhegmatogenous retinal detachment secondary to ARN has characteristic clinical features. Severe proliferative vitreoretinopathy with the predominance of anterior PVR develops rapidly. Reproliferation is the most important late postvitrectomy complication necessitating multiple surgical procedures in these cases. The visual results remain unfavorable due to the destructive nature of ARN.

Adult↗
PubMedDate not supplied

Management of magnetic intravitreal foreign bodies in 71 eyes.

BACKGROUND AND OBJECTIVE: To evaluate the management of a series of eyes with magnetic intravitreal foreign bodies. PATIENTS AND METHODS: This retrospective review examined consecutive cases of ocular injury associated with intraocular foreign bodies; 71 eyes included had a single metallic intraocular foreign body (< 5 mm) located in the vitreous cavity removed by external magnet or intraocular forceps. Variables included preoperative and postoperative visual acuity, retinal break formation, retinal detachment, presence of an afferent pupillary defect, intraocular pressure, entrance site, foreign body size, method of extraction, and time between occurrence and surgical extraction. RESULTS: Factors predictive of good visual outcome (visual acuity > 20/200) were: shortest interval between trauma and foreign body extraction, preoperative visual acuity of 20/200 or better, and absence of afferent pupillary defect. CONCLUSIONS: In this nonrandomized study, good visual results could be obtained in eyes undergoing prompt foreign body removal, especially those with good preoperative visual acuity and no afferent pupillary defect.

Adolescent↗
PubMedDate not supplied

Surgical management of non-metallic and non-magnetic metallic intraocular foreign bodies.

BACKGROUND AND OBJECTIVE: To identify clinical features and evaluate outcomes of vitreoretinal surgery in eyes with retained non-metallic and non-magnetic metallic intraocular foreign bodies (IOFBs). PATIENTS AND METHODS: Retrospective chart review. Thirty-two eyes (28 patients) with non-metallic and non-magnetic metallic IOFBs underwent removal of IOFBs with intraocular forceps, either via the pars plana in 30 eyes (93.9%) or a limbal approach in 2 eyes (6.25%). The main outcome measures were postoperative visual acuity, rate of retinal break formation, development of retinal detachment, and type of IOFB. RESULTS: IOFBs were non-metallic in 22 eyes (68.7%) and non-magnetic metallic in 10 eyes (31.1%). The average follow-up period was 7.5 months. Overall, final visual acuity was 20/40 or better in 10 eyes (31.1%) and 5/200 to 20/50 in 10 eyes (31.1%). A higher incidence of retinal break formation posterior to the sclerotomy was seen with glass IOFBs (P = .02). Retinal detachment was observed preoperatively in 4 eyes (12.5%) and postoperatively in 2 eyes (6.25%). CONCLUSION: Final visual outcome was independent of size and type of IOFB. Pars plana extractions may be associated with a higher rate of retinal break formation and subsequent retinal detachment, particularly with glass IOFBs.

Adolescent↗