Publications by authors named "Nikoo Hamzeh"

8 Publications

  • Page 1 of 1

Ahmed glaucoma valve implantation with and without subconjunctival bevacizumab in refractory glaucoma.

Int Ophthalmol 2021 Feb 9. Epub 2021 Feb 9.

Farabi Eye Hospital, Tehran, Iran.

Purpose: To evaluate the effects of subconjunctival bevacizumab injection on intraocular pressure (IOP), hypertensive phase, and failure and success rates of Ahmed Glaucoma Valve (AGV) implantation.

Methods: A total of 63 eyes of 63 patients (30 cases in control and 33 cases in bevacizumab group) were included in this randomized masked prospective clinical trial. Pre- and postoperative BCVA, IOP, number of medications, complications and success rates were compared between AGV + bevacizumab and AGV alone group.

Results: Both groups showed statistically significant reductions in IOP in all their follow-up visits (P < 0.05). The mean IOP was lower in the AGV + Bevacizumab group than AGV group in all follow-up visits. However, the difference was only significant at the 3rd month (17.3 ± 6.2 vs. 20.7 ± 4.6, p = 0.04). The number of medications was not differed significantly between the two groups at their last visit (p value = 0.84) Complete success rate was higher in AGV + Bevacizumab. However, the difference was not significant (p = 0.73). The qualified and overall success rate, failure rate and the need for second tube were not statistically different between the two groups. The hypertensive phase was not statistically significant between the 2 groups (33.3% in AGV + Bevacizumab group and 50% in AGV group, p = 0.06) CONCLUSION: Adjunctive use of Bevacizumab during AGV implantation is beneficial in controlling hypertensive phase and IOP control and may lead to higher success rates and lower failure rates after AGV implantation. However, whether it's clearly beneficial or its exact role remains to be investigated.
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February 2021

Optic nerve head vessel density in different stages of pseudoexfoliation disease.

Br J Ophthalmol 2020 Nov 27. Epub 2020 Nov 27.

Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, University of California at San Diego Department of Ophthalmology at the Shiley Eye Institute, La Jolla, California, USA

Purpose: To evaluate the superficial vascular density of the optic nerve head in different stages of pseudoexfoliation disease using optical coherence tomography angiography (OCTA).

Methods: In this cross-sectional study, 57 normal eyes, 41 eyes with pseudoexfoliation syndrome (PXS), 82 eyes with pseudoexfoliation glaucoma (PXG) and 27 non-glaucomatous fellow eyes of PXG (NL-PXG) that had OCTA were included. Circumpapillary RNFL (cpRNFL) thickness and circumpapillary capillary density (cpCD) were compared among the groups after adjusting for confounders using linear-mixed model.

Results: PXG eyes had thinner global RNFL and lower cpCD (74.2±14.3 µm and 36.7±10.0%) than control (103.3±8.6 µm and 52.5±2.3%), PXS (96.8±8.8 µm and 51.5±2.3%), and NL-PXG eyes (96.3±11.1 µm and 50.1±3.9%) (p<0.001). After adjustment for age, gender and signal strength index, global cpRNFL thickness was comparable among control, PXS and NL-PXG. NL-PXG had the lowest cpCD (p=0.045) and sectoral cpCD compared to PXS and control eyes. Although cpCD was comparable between control and PXS (p=0.425) eyes, sectoral differences (p=0.009 and 0.004, for inferonasal and temporal-inferior cpCD, respectively) were detectable between the two groups. AUROC for differentiating NL-PXG eyes from normal were better for cpCD (0.78) compared to cpRNLF (0.69).

Conclusions: OCTA can detect reduced capillary density before significant changes in cpRNFL in fellow eyes of PXG patients. This can enable earlier detection of glaucomatous loss in pseudoexfoliation disease and enhance management of the disease.
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November 2020

Cystoid macular edema with prostaglandin analogue use after uneventful cataract surgery in glaucoma patients.

J Cataract Refract Surg 2019 10;45(10):1436-1445

Farabi Eye Hospital, Tehran University of Medical Sciences, Iran.

Purpose: To evaluate the effect of postoperative latanoprost administration on central macular thickness (CMT) after uneventful cataract surgery in glaucoma patients.

Setting: Farabi Eye Hospital, Tehran, Iran.

Design: Prospective randomized clinical trial.

Methods: In this single-masked trial, glaucoma patients treated with latanoprost who had no other risk factor for the development of pseudophakic macular edema were randomly allocated to continuation of latanoprost or discontinuation of the drop after uneventful cataract surgery. At baseline and postoperatively at 1 month and 3 months, patients had complete ocular examinations and CMT measurements using optical coherence tomography. The main outcome measure was the change in the CMT between baseline measurements and postoperative measurements at 1 month and 3 months.

Results: One hundred fifty-six eyes (latanoprost 76; discontinuation 80) finished the trial. There were no differences in baseline patient demographics or characteristics, including the CMT, between the two groups. There was transient increase in the mean CMT by 12 μm ± 49 (SD) in the latanoprost group at 1 month (P = .03); however, the value returned to baseline by 3 months (6 ± 55 μm; P = .27). The between-group difference in the mean change in the CMT from baseline was -3.1 μm (95% confidence interval [CI], -18.4 to 12.0; P = .68) after 1 month and -10.5 μm (95% CI, -26.6 to 5.5; P = .19) after 3 months; the differences were not significant.

Conclusion: Latanoprost administration after cataract surgery had no measurable effect on macular thickness.
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October 2019

Combined glaucoma and cataract surgery: Comparison of viscocanalostomy, endocyclophotocoagulation, and ab interno trabeculectomy.

J Cataract Refract Surg 2018 May;44(5):557-565

From the Hamilton Glaucoma Center (Moghimi, Bowd, Weinreb), Department of Ophthalmology, and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA; Tehran University of Medical Sciences (Moghimi, Hamzeh, Mohammadi, Khatibi), Tehran, Iran.

Purpose: To compare outcomes of phacoemulsification combined with viscocanalostomy, endocyclophotocoagulation (ECP), or ab interno trabulectomy for intraocular pressure (IOP) control and safety in eyes with open-angle glaucoma and visually significant cataract.

Setting: Farabi Eye Hospital, Tehran, Iran.

Design: Retrospective case series.

Methods: Medical records of patients who had combined surgery and were followed for at least 1 year were reviewed. Complete success, postoperative IOP, number of medications at each visit, and complications were evaluated and compared before and after adjustments for confounders.

Results: Forty-six eyes had combined phacoviscocanalostomy, 35 had phaco-ECP, and 28 eyes phaco-ab interno trabulectomy. The groups were matched for baseline IOP (P = .24). At the final follow-up (mean 17.2 months ± 5.5 [SD]), the phacoviscocanalostomy group had the lowest mean IOP (13.5 ± 4.7 mm Hg, 29% decrease) (P = .01). There was no significant difference in the final IOP between phaco-ECP and phaco-ab interno trabulectomy (16.4 ± 3.9 mm Hg, 20% decrease versus 15.8 ± 4.2 mm Hg, 15% decrease) (P = .88). The reduction in the number of medications was greater with phacoviscocanalostomy (77%) than with phaco-ECP (40%) and phaco-ab interno trabulectomy (44%) (P = .01). Phacoemulsification-ab interno trabulectomy had the fewest complications. Intraocular pressure spikes were more frequent in the phaco-ECP group (20%) than in the other groups (4%) (P = .05).

Conclusions: All procedures significantly lowered IOP. Phacoemulsification-ab interno trabulectomy resulted in fewest complications and phacoviscocanalostomy led to the largest IOP drop and largest reduction of medications.
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May 2018

Obesity, Heart Failure, and Obesity Paradox.

J Tehran Heart Cent 2017 Jan;12(1):1-5

Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

The incidence and prevalence of obesity are fast increasing worldwide. Various indices have been used to measure and assess obesity. The body mass index (BMI) is the most common and practical of these indices. Overweight and obesity exert considerable adverse effects on the cardiovascular system. These effects are mediated through various neurohormonal and cytokine pathways, most of which are inflammatory mediators. Systolic and / or diastolic heart failure is more prevalent among obese and overweight individuals than among normal weight people. The concept of the "obesity paradox" has been proposed by some previously published studies, in which the prognosis of obese patients with established cardiovascular diseases, especially heart failure, is better than that of their leaner counterparts. In this review, we discuss the obesity paradox and its possible pathophysiologic mechanisms.
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January 2017

Qualitative evaluation of anterior segment in angle closure disease using anterior segment optical coherence tomography.

J Curr Ophthalmol 2016 Dec 12;28(4):170-175. Epub 2016 Jul 12.

Koret Vision Center, University of California, San Francisco Medical School, San Francisco, CA, USA.

Purpose: To evaluate different mechanisms of primary angle closure (PAC) and to quantify anterior chamber (AC) parameters in different subtypes of angle closure disease using anterior segment optical coherence tomography (AS-OCT).

Methods: In this prospective study, 115 eyes of 115 patients with angle closure disease were included and categorized into three groups: 1) fellow eyes of acute angle closure (AAC; 40 eyes); 2) primary angle closure glaucoma (PACG; 39 eyes); and 3) primary angle closure suspect (PACS; 36 eyes). Complete ophthalmic examination including gonioscopy, A-scan biometry, and AS-OCT were performed. Based on the AS-OCT images, 4 mechanisms of PAC including pupillary block, plateau iris configuration, thick peripheral iris roll (PIR), and exaggerated lens vault were evaluated. Angle, AC, and lens parameter variables were also evaluated among the three subtypes.

Results: There was a statistically significant difference in the mechanism of angle closure among the three groups (p = 0.03). While the majority of fellow eyes of AAC and of PACS eyes had pupillary block mechanism (77.5% and 75%, respectively), only 48.7% of PACG eyes had dominant pupillary block mechanism (p = 0.03). The percentage of exaggerated lens vault and plateau iris mechanisms was higher in PACG eyes (25.5% and 15.4%, respectively). Fellow eyes of AAC had the shallowest AC (p = 0.01), greater iris curvature (p = 0.01), and lens vault (p = 0.02) than PACS and PACG eyes. Iris thickness was not significantly different among the three groups (p = 0.45).

Conclusion: Using AS-OCT, we found that there was a statistically significant difference in the underlying PAC mechanisms and quantitative AC parameters among the three subtypes of angle closure disease.
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December 2016

Lens thickness assessment: anterior segment optical coherence tomography versus A-scan ultrasonography.

Int J Ophthalmol 2015 18;8(6):1151-5. Epub 2015 Dec 18.

Koret Vision Center, San Francisco Medical School, University of California, San Francisco, CA 94143, USA.

Aim: To assess lens thickness measurements with anterior segment-optical coherence tomography (AS-OCT) in comparison with A-scan ultrasonography (A-scan US).

Methods: There were 218 adult subjects (218 eyes) aged 59.2±9.2y enrolled in this prospective cross-sectional study. Forty-three eyes had open angles and 175 eyes had narrow angles. Routine ophthalmic exam was performed and nuclear opacity was graded using the Lens Opacities Classification System III (LOCS III). Lens thickness was measured by AS-OCT (Visante OCT, Carl Zeiss Meditec, Dublin, CA, USA). The highest quality image was selected for each eye and lens thickness was calculated using ImageJ software. Lens thickness was also measured by A-scan US.

Results: Interclass correlations showed a value of 99.7% for intra-visit measurements and 95.3% for inter-visit measurements. The mean lens thickness measured by AS-OCT was not significantly different from that of A-scan US (4.861±0.404 vs 4.866±0.351 mm, P=0.74). Lens thickness values obtained from the two instruments were highly correlated overall (Pearson correlation coefficient=0.81, P<0.001), and in all LOCS III specific subgroups except in grade 5 of nuclear opacity. Bland-Altman analysis revealed a 95% limit of agreement from -0.45 to 0.46 mm. Lens thickness difference between the two instruments became smaller as the lens thickness increased and AS-OCT yielded smaller values than A-scan US in thicker lens (β=-0.29, P<0.001).

Conclusion: AS-OCT-derived lens thickness measurement is valid and comparable to the results obtained by A-scan US. It can be used as a reliable noncontact method for measuring lens thickness in adults with or without significant cataract.
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December 2015

Resistance to depression through interference of opioid and nitrergic systems in bile-duct ligated mice.

Eur J Pharmacol 2013 May 23;708(1-3):38-43. Epub 2013 Mar 23.

Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

This study was done to investigate the effects of opioid and nitrergic systems on depression in an experimental model of cholestasis in mice, since elevated levels of these substances are seen in cholestatic subjects. Bile duct ligated (BDL) and sham-operated mice were forced to swim individually and the immobility time in the last 4 min of the 6 min test was evaluated to determine the effects of cholestasis on depression. To assess the possible involvement of endogenous opioids and nitric oxide (NO), effective and sub-effective doses of naltrexone an antagonist of opioid receptors, and N-nitro-l-arginine methyl ester (L-NAME) a non-specific NO synthase inhibitor, were administrated acutely and chronically to BDL and Sham-operated mice and then their immobility time was measured in forced swimming test (FST). The immobility time significantly decreased after bile-duct ligation. Naltrexone and L-NAME significantly reversed antidepressant like effect of cholestasis. Co-administration of sub-effective doses of naltrexone and L-NAME also reversed antidepressant effect in FST in chronic administration. But acute drug administration did not reverse the anti-depressant effect of cholestasis. We have shown that elevated levels of endogenous opioids and NO in cholestatic mice induce an anti depressant like effect, causing a reduction in the mice immobility time in FST. And the study also showed the predominant effect of opioid system and NO modulation of that in anti-depressant like effect of cholestasis.
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May 2013