·Color blindness is a common disorder in human. Congenital color blindness is a trait of X-linked recessive inheritance. In our study, one thousand and six hundred female students were selected by randomized group sampling and tested by "Ishihara pseudoisochromatic plates".Among this(0.63%) showed color vision deficiency; among these cases six girls (0.38%) had deuteranomaly and 4 girls (0.25%) had protanomaly.

·We report clinical manifestations,angiographic,and optical coherence tomography (OCT) findings of four cases with bilateral idiopathic cystoid rnacular edema (CME).All were male with age between 30 and 52 years.All of them had compliant of bilateral visual loss during the last week.Fundus examination of their eyes showed macular edema in the posterior pole bilaterally. Fluorescein angiography revealed no specific finding in one of them and "typical petaloid pattern" in others.OCT showed subretinal fluid in all of them.All patients were managed with diagnosis of idiopathic CME,and after 6 weeks they had improved visual acuity.

AIM: To evaluate correlation of retinopathy and diabetic peripheral neuropathy (DPN) as microvascular complications of diabetes and also to identify their risk factors in patients with type 2 diabetes.MEHTODS: We conducted a cross-sectional study in an outpatient diabetes clinic during an 18-month period. 100 patients (51 male and 49 female), all affected by non-insulin-dependent diabetes mellitus (NIDDM), were examined for the presence of diabetic neuropathy and diabetic retinopathy.RESULTS: 78.1% of patients with retinopathy had DPN; and 79.1% of patients with DPN had retinopathy. Analysis of the association between DPN and retinopathy showed no significant correlation between them. 90.9% of patients with proliferative diabetic retinopathy (PDR) had DPN; and 27.8 %of patients with DPN had PDR. Both the univariate analysis and multiple logistic regression analysis revealed significant correlation between them (r =0.42, P =0.02).CONCLUSION: A severe diabetic retinopathy is associated with diabetic neuropathy. Our study further supports that diabetic neuropathy might be used as a tell-tale sign of diabetic retinopathy, necessitating more intensive ophthalmic care, especially in long-lasting diabetes.

AIM:To determine the clinical characteristics of a prospective study of patients with Graves' ophthalmopathy.METHODS:We reviewed clinical manifestations,and medical records of 103 patients in whom Graves' ophthalmopathy WaS diagnosed between 2003 and 2005.RESULTS:Among 103 patients with Graves' ophthalmopathy,48(46.6%)male and 55(53.3%)female(F:M=1.1),with mean age of 45 (range;18-73) years,95 (92.2%)patients had Graves' hyperthyroidism,3(2.9%) had primary hypothyroidism,and 5 (4.8%) were euthyroid.The mean duration of ocular symptoms was 13.2 (range 2-95) months) while the mean duration of dysthyroid symptoms was 39.4(range 6-180) months.Unilaterality was occurred in 12 patients.Eyelid retraction was present in 90 patients (87%),whereas the approximate frequency of exophthalmos was 77.6%(80 patients);restrictive extraocular myopathy.29% (30 patients);evidence of extraocular enlargement on CT-scan in 52 patients of 70 patients (74%) that was evaluated,and optic nerve dysfunction,5.8%(6 patients).22(21%)patients hadglaucoma associated with Graves' ophthalmopathy that 7 (6.7%)of them were normal-tension glaucoma.CONCLUSION:Eyelid retraction Was the most common clinical sign of Graves' ophthalmopathy in our patients.Larger prospective studies are suggested to evaluate both the prevalenoe and possible racial difference in its dinical presentation in Iranian population.

ATM:To determine the tearing angle and tearing force,and effects of associated pressures in tearing of various materials and human lens capsule in continuous curvilinear capsulorhexis(CCC).METHODS:Tearing was done on different materials such as aluminum Iaminated paper,different types of thin transplant plastics and human Iens capsule with blunt tip needle.During the procedure,angle and direction of force were measured.Effects of increased underlying pressure on tearing of tearable materials and effect of anterior chamber depth and vitreous pressure on 24 postmortem hunlan eyes with different ages (range from10 to 75 years),was evaluated.RESULTS:Tearing angle in every material was unique for that material.Angle and force of tearing was decreased reversely with increasing age (from 85 degree in a 10-years-old to 10 degree in older than 50 years).Increasing vitreous pressure and decrease in AC depth causes higher pressure on point of tearing.Safe methods in controlling CCC are discussed jn the context.OONCLUSION:Understanding the physics and vector of forces during CCC is necessary in good performance and avoidance of radial tears.Onange in capsular properties between difierent ages and different type of cataract causes different tearing angle and tearing force that should be considered during CCC.

· AIM: We describe visual improvement after phacoemulsification with intraocular lens (IOL) implantation in 7 eyes with anterior lenticonus secondary to Alport syndrome.· METHODS: 7 eyes from 4 patients with Alport syndrome underwent phacoemulsification with IOL implantation due to anterior lenticonus.· RESULTS: All of the patients resumed excellent visual acuity after surgery.· CONCLUSION: We recommend the phacoemulsification with IOL implantation as a safe procedure in anterior lenticonus due to Alport syndrome.

AIM: To evaluate the clinical success of living related conjunctival limbal and amniotic membrane transplantation for treatment of chemical injury induced limbal stem cell deficiency.METHODS: From July 2005 to December 2007, 10 eyes of 9 male patients with chemical injury induced limbal stem cell deficiency were included in the study. All subjects underwent living related conjunctival limbal and amniotic membrane transplantation. Blepharorrhaphy was performed in two cases. Systemic immunosuppression with cyclosporine and prednisolone was initiated.RESULTS: Complete corneal epithelialization was observed in 3 eyes (30%). In one of the patients immunologic rejection and corneal melting led to perforation 1.5 months after surgery. The increasing dose of systemic immunosuppression was used to control it. Three eyes were described as primary failure because graft could not re-epithelialize the corneal surface. The remained four eyes showed partial re-epithelialization, but failed to cover the entire corneal surface with epithelium. Best corrected visual acuity ranged from hand movement to counting finger at 1 meter before the surgery and after the surgery was light perception to 20/80. Five eyes had visual improvement without any additional procedure. Dry eye and persistent inflammation were known as main causes of failure.CONCLUSION: Living related conjunctival limbal allograft and amniotic membrane transplantation can be a good option in the management of limbal stem cell deficiency in selected cases in which tear production and control of ocular inflammation are adequate.

AIM: To determine the frequency of HIV-related ocular involvement and to describe the characteristics of involvement in a special clinic in Tehran.METHODS: In this cross sectional study, 141 patients (125 male and 16 female, 282 eyes) of HIV-infected patients with various stages of HIV infection that were referred to Center of behavioral diseases were evaluated during a period of 7 months. Every patient had a complete profile including demographic data, method of HIV transmission, recent CD4 T cell lymphocyte count, serological studies for common sexual or blood-born viruses and toxoplasmosis, history of antiretroviral therapy, and associated systemic disease. RESULTS: A total of 141 patients were evaluated. HIV-related ocular involvement was detected in 15 patients (10.6%), including 3 mycobacterium tuberculosis-related choroiditis, 2 cytomegalovirus retinitis, 2 retinal toxoplasmosis, 2 herpes simplex virus-related lesions, 1 HIV-associated retinopathy, 1 herpes zoster ophthalmicus, 1 undetermined vitritis, and 3 cases of cranial nerve involvement including 2 cases of gaze palsy and 1 case of papilitis. In our study, mean CD4 T cell lymphocyte count was fewer in patients with ocular involvement than in patients without ocular involvement (204.7±123.8 vs 403.7±339.7, P=0.029), but there was no difference in other possible associated factors between two groups.lesions are the most common HIV-related ocular involvements in Tehran that is different from those of recent publications in developed countries.

A 30-year-old woman with a past medical history of autoimmune hemolytic anemia presented with fever. Blood cultures grew Campylobacter. Her medical history was significant for four prior episodes of Campylobacter gastroenteritis and bacteremia. She received ciprofloxacin for the index presentation, then Meropenem de-escalated to doxycycline 6 months later following recurrence of Campylobacter. This prompted investigation for an immunodeficiency disorder. She was found to have hypogammaglobulinemia. Her Campylobacter infections resolved following the administration of intravenous immunoglobulins every 3 weeks. She did not have recurrence of Campylobacter during 5 years of follow-up. A literature search revealed additional four case reports of six hypogammaglobulinemic adult individuals presenting with recurrent Campylobacter infections. Three patients were already on intravenous immunoglobulin (IVIG) when Campylobacter infection occurred, and two patients achieved clinical cure following therapy with imipenem and IVIG. This case report highlights the importance of suspecting hypogammaglobulinemia in patients with recurrent Campylobacter infections, as this is sometimes the first manifestation of the condition.

Cardiac failure is a clinical syndrome that may develop in children owing to cardiac dysfunction or underlying structural heart diseases. Considering the differences in diagnostic and therapeutic approaches for pediatric heart failure (PHF) and adult heart failure, we have reviewed the current literature on PHF. Relevant studies were extracted from MEDLINE/PubMed, Google Scholar, and Clinical Trial Registries using the terms “pediatric heart failure” or “heart failure in children” and “management” or “decongestive therapy.” Recent advances in diagnostic approaches, such as cardiac magnetic resonance, speckle-tracking echocardiography, tissue Doppler imaging, and molecular diagnostic techniques, have increased our under -standing of PHF. It is imperative that clinicians evaluate the interrelated factors responsible for the develop ment of PHF, including myocardial function, pulmonary and systemic blood flow, heart rhythm, valve function, and nutritional status. Although recent advances have demon strated the efficacy of many new drugs in adult heart failure trials, it cannot be concluded that these drugs will show similar efficacy in children, considering the heterogeneous nature of the underlying mechanisms and variable pharmacody-namics and pharmacokinetics. Therefore, the underlying pathophysiology of PHF and the mechanisms of action of different drugs should be considered when selecting appropriate therapies. Further trials are needed to establi sh the efficacy and safety of these drugs, and a combined mul-ti disciplinary strategy will help enhance PHF outcomes.