Medical Hypothesis, Discovery & Innovation (MEHDI) Journals
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A Modified Pseudoisochromatic Ishihara Colour Vision Test Based on Eastern Arabic Numerals
Get PDFCongenital colour vision defects affect about 8% and 0.5% of the male and female population, respectively. Pseudoisochromatic Ishihara plates have shown to be successful in an early diagnosis of colour vision defects. This commonly used colour vision test was initially intended to identify those who suffered from red-green aspect of congenital colour blindness; however, it may be of use to reveal acquired colour vision defects as well. Despite the Ishihara plates’ value, there are a number of shortcomings in their current layout. We proposing a new colour plate modified from original Ishihara test. To best assist illiterates who are not able to read English, standard Ishihara plates have been translated to Eastern Arabic numerals, which are used in most parts of the Middle East, Central Asia and Africa populations. The purpose of the present modification was to present the new plates to these regions, but more research and study is required to work on the validity, reliability, and repeatability of these new plates
Review of En-Face Choroidal Imaging Using Spectral-Domain Optical Coherence Tomography
Get PDFInvestigations of choroidal vasculature have been of particular interest given choroidal vascular dysfunction are thought to be related with a number pathologic conditions such as central serous chorioretinopathy and various forms of AMD, including polypoidal choroidal vasculopathy. On the other hand, en face imaging of the choroid allows an exceptional alternative to histopathologic evaluation of the choroid, and can be used to quantify choroidal vascular structures. Our former study verified differences in the macular choroid in AMD and control patients previously noted on histopathologic studies. The use of phase-resolved approaches in larger population longitudinal studies reveal the sequence of RPE and choroidal changes in the pathogenesis of various AMD subtypes, which cannot be done using histopathology. Issues with lateral resolution of the OCT system in measuring choriocapillaris size could be solved by incorporating the axial dimension of the choriocapillaris into choriocapilaris diameter assessment (assuming the choriocapillaris are round in vivo), and by correcting for anisometric pixel resolution. Forthcoming studies are required to determine whether areas of choriocapillaris correlate with areas of RPD lesions
Visual Improvement Following Ozonetherapy in Dry Age Related Macular Degeneration; a Review
Get PDFThe dry form of ARMD is becoming a serious problem because of the rise in the number of old individuals. No effective therapy is available in dry ARMD except for the illusory oral administration of antioxidant vitamins. Despite scepticism in the medical community, the therapeutic effect of ozonetherapy had been evaluated since 1996. This evaluation has been based on specific biochemical, molecular and pharmacological reactions. Nevertheless a number of visual scientists continue to ignore ozonetherapy conservatively and prescribe only antioxidant vitamins. Two small clinical studies involving 217 patients have been performed at the University of Siena showing that ozonetherapy can stop the progression of the disease while improving the visual acuity and the well-being of the patient. Moreover, it seems that ozonetherapy is a safe procedure and tends to have an excellent compliance
Intracorneal Rings (INTACS SK) Might be Beneficial in Keratoconus; A Prospective Nonrandomized Study
Get PDFIn order to determine the effect of intracorneal rings (Intacs SK), when implanted in keratoconic patients, on corneal curvature, Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA) and on the progression of the cone through three years follow-up period. In this prospective nonrandomized study 114 eyes of 71 keratoconic patients (38 females and 33 males) were implanted with Intacs SK. Incisions were always made in the steep meridian. UCVA, BCVA, Corneal Topography (TMS) were measured pre and postoperatively and at intervals of 1, 3, 6 & 12 months then yearly for 3 consecutive years. Preoperative mean k-reading was 52.53 and 48.18, 49.56, 49.17, 48.51, 48.15 & 48.01 at 1, 3, 6, 12, 24 & 36 months postoperatively (P‹0.01). In terms of UCVA, 15.64% of patients gained more than 3 lines and 69.73% gained 1-3 lines with a total of 85.37% of patients gaining lines compared to their preoperative UCVA (P‹0.01) while 14.63% of cases did not gain any lines at 1 month postoperative. At three months postoperatively, 12.64% gained more than 3 lines, 71.15% gained 1-3 lines with a total of 83.79% while 16.21% did not gain any lines. Three years postoperative 11.82% of cases gained more than 3 lines, 73.23% gained 1-3 lines with a total of 85.05% while 14.95% did not gain any lines (P‹0.01). With regard to BCVA, 19.73% gained more than 3 lines, 68.26% gained 1-3 lines with a total of 87.99% of cases gaining lines compared to their preoperative BCVA (P‹0.01) while 12.01% did not gained any lines at 1 month postoperative. At three months postoperatively, 14.96% gained more than 3 lines, 70.19% gained 1-3 lines with a total of 85.15% while 14.85% did not gain any lines. Three years postoperative, 12.17% gained more than 3 lines, 71.78% gained 1-3 lines with a total of 83.95% (P‹0.01) while 16.05% did not gain any lines. No eyes lost any lines as it pertained to UCVA & BCVA. Despite the fluctuation of k-readings, UCVA and BCVA in the first 3 months, which may represent the time needed to stabilize the cone, UCVA and BCVA were improved and maintained throughout the study. Patient selection remains the key point for the success of intacs in keratoconic patients
Combination of Intravitreal Bevacizumab and Peripheral Photocoagulation: An Alternative Treatment in Eales Disease
Get PDFTo report the efficacy of combination therapy (bevacizumab and photocoagulation) in a case of Eales Disease this study has been performed. Bevacizumab (Avastin, 1.25 mg/0.05 ml) was injected intravitreously for the treatment of iris and retinal neovascularization in a 56-year old Hispanic female with photocoagulation treatment to control the recurrence of vitreous haemorrhage. Our results revealed that stabilization of the disease and improvement in visual acuity were achieved without any signs of recurrence. Intravitreal bevacizumab in combination with photocoagulation treatment of ischemic retinal areas may be a good alternative for patients with recurrent vitreous haemorrhage due to Eales disease
Instability in X chromosome inactivation patterns in AMD: a new risk factor?
Get PDFYears ago, it was thought that a genetic component was the fundamental cause of a number retinopathy diseases including age related macular degeneration (AMD). Since then, information has emerged about novel genes that contribute to various forms of AMD and other retinopathies that have been eluding researchers for years. In the genetic sense, only the APOE 2 and 4 genes have been found to be a risk factor for sporadic AMD. But, a recent Genome wide association study (GWAS) revealed that an alteration of five SNIPs on the X chromosome in a gene named DIAPH2 may be a susceptibility gene for AMD. Furthermore, the gene DIAPH2 showed to have a polygenic pleiotropy for premature ovarian failure (POF) and AMD in a cohort of women. POF is highly associated with X chromosome skewing, an epigenetic alteration of the inactivation process of the X chromosome. These findings suggest a hypothesis that an epigenetic alteration on the inactivation centres of the X chromosome (or skewing) relates not only to aging, but might be a novel property that affects women with AMD more often than men
Stem Cell Therapy: a Novel Approach for Vision Restoration in Retinitis Pigmentosa
Get PDFUnfortunately, at present, degenerative retinal diseases such as retinitis pigmentosa remains untreatable. Patients with these conditions suffer progressive visual decline resulting from continuing loss of photoreceptor cells and outer nuclear layers. However, stem cell therapy is a promising approach to restore visual function in eyes with degenerative retinal diseases such as retinitis pigmentosa. Animal studies have established that pluripotent stem cells when placed in the mouse retinitis pigmentosa models have the potential not only to survive, but also to differentiate, organize into and function as photoreceptor cells. Furthermore, there is early evidence that these transplanted cells provide improved visual function. These groundbreaking studies provide proof of concept that stem cell therapy is a viable method of visual rehabilitation among eyes with retinitis pigmentosa. Further studies are required to optimize these techniques in human application. This review focuses on stem cell therapy as a new approach for vision restitution in retinitis pigmentosa
Significance of Novel Ideas to Solve Challenges Facing Today's Ophthalmology
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