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Ahmad Kheirkhah

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https://www.readbyqxmd.com/read/29719651/combined-tenonplasty-and-scleral-graft-for-refractory-pseudomonas-scleritis-following-pterygium-removal-with-mitomycin-c-application
#1
Heidar Siatiri, Nima Mirzaee-Rad, Shruti Aggarwal, Ahmad Kheirkhah
Purpose: To report a surgical approach combining scleral patch graft and tenonplasty for successful management of refractory Pseudomonas scleritis following pterygium removal with mitomycin C application. Case Report: A 75-year-old diabetic woman with a history of prior pterygium excision and mitomycin C application developed infectious necrotizing scleritis caused by Pseudomonas aeruginosa . Owing to progression of scleritis despite medical management, the patient underwent surgery...
April 2018: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/29572107/reduced-efficacy-of-low-dose-topical-steroids-in-dry-eye-disease-associated-with-graft-versus-host-disease
#2
Jia Yin, Ahmad Kheirkhah, Thomas Dohlman, Ujwala Saboo, Reza Dana
PURPOSE: To compare the response of dry eye disease (DED) to treatment with topical steroid in patients with and without graft-versus-host disease (GVHD). DESIGN: Post-hoc analysis of a double-masked, randomized clinical trial. METHODS: This single-center study included 42 patients with moderate to severe DED associated with (N=21) or without (N=21) chronic GVHD. In each group, patients received either loteprednol etabonate 0.5% ophthalmic suspension or artificial tears twice daily for 4 weeks...
March 20, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29505774/subtarsal-fibrosis-is-associated-with-ocular-surface-epitheliopathy-in-graft-versus-host-disease
#3
Ahmad Kheirkhah, Giulia Coco, Vannarut Satitpitakul, Reza Dana
PURPOSE: To evaluate occurrence of subtarsal fibrosis in patients with graft-vs-host disease (GVHD) and to determine its association with ocular surface epitheliopathy. DESIGN: Cross-sectional study. METHODS: We enrolled 40 patients with moderate or severe dry eye disease, including 20 patients with chronic ocular GVHD and 20 patients without (as the control group). All patients had a comprehensive ophthalmic assessment including evaluation for subtarsal fibrosis, corneal and conjunctival staining, tear break-up time (TBUT), and Schirmer test...
May 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29305292/corneal-nerve-regeneration-after-herpes-simplex-keratitis-a-longitudinal-in-vivo-confocal-microscopy-study
#4
Hamid-Reza Moein, Ahmad Kheirkhah, Rodrigo T Muller, Andrea C Cruzat, Deborah Pavan-Langston, Pedram Hamrah
PURPOSE: To evaluate the long-term alterations of corneal nerves in patients with herpes simplex virus (HSV) keratitis using in vivo confocal microscopy (IVCM). DESIGN: Prospective, longitudinal, cross sectional. METHODS: This study included 16 patients with a history of HSV keratitis and 15 age-matched normal controls. Slit-scanning IVCM was performed in all subjects at baseline and then after a mean follow-up of 37.3 ± 1.7 months in the patient group...
April 2018: Ocular Surface
https://www.readbyqxmd.com/read/29303889/factors-influencing-the-diagnostic-accuracy-of-laser-scanning-in-vivo-confocal-microscopy-for-acanthamoeba-keratitis
#5
Ahmad Kheirkhah, Vannarut Satitpitakul, Zeba A Syed, Rodrigo Müller, Sunali Goyal, Elmer Y Tu, Reza Dana
PURPOSE: To determine the factors that influence the sensitivity and specificity of laser-scanning in vivo confocal microscopy (IVCM) for diagnosing Acanthamoeba keratitis (AK). METHODS: This retrospective, controlled study included 28 eyes of 27 patients with AK and 34 eyes of 34 patients with bacterial keratitis (as the control group). All patients had undergone corneal imaging with a laser-scanning IVCM (Heidelberg Retina Tomograph 3 with the Rostock Cornea Module)...
January 4, 2018: Cornea
https://www.readbyqxmd.com/read/29128574/conjunctivochalasis-a-systematic-review
#6
REVIEW
Anna Marmalidou, Ahmad Kheirkhah, Reza Dana
Conjunctivochalasis (CCH) is a conjunctival condition characterized by loose, redundant conjunctival folds, most typically in the inferior bulbar conjunctiva of both eyes. Although CCH is a common cause of ocular irritation and discomfort, especially in the elderly, it is often overlooked in clinical practice. CCH may be associated with various ocular and nonocular conditions; however, the most important risk factor is aging. Although often asymptomatic, CCH may cause symptoms related to tear film instability and/or delayed tear clearance...
November 9, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28528121/determinants-of-ocular-pain-severity-in-patients-with-dry-eye-disease
#7
Vannarut Satitpitakul, Ahmad Kheirkhah, Alja Crnej, Pedram Hamrah, Reza Dana
PURPOSE: To quantify the severity of ocular pain in patients with dry eye disease (DED) and evaluate factors associated with pain severity. DESIGN: Cross-sectional study. METHODS: Eighty-four patients with DED were asked to score their severity level of ocular pain using a 10-point scale, with 10 indicating the most severe pain. All patients also had a comprehensive ophthalmic assessment including a detailed history, Ocular Surface Disease Index (OSDI) questionnaire, and ocular surface examination...
July 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28481835/patients-perceived-treatment-effectiveness-in-dry-eye-disease
#8
Ahmad Kheirkhah, Alja Crnej, Ai Ren, Andrew Mullins, Vannarut Satitpitakul, Pedram Hamrah, Debra Schaumberg, Reza Dana
PURPOSE: Patients' perceptions of the effectiveness of a treatment, or perceived treatment effectiveness (PTE), play an important role in medicine. This study aimed to evaluate patients' PTE in dry eye disease (DED) and investigate factors contributing to these patients' perceptions. METHODS: This cross-sectional study included 66 patients with DED. At enrollment, all patients had comprehensive ophthalmic assessment. In addition, to evaluate the patient's PTE, they were asked to use a 10-point scale ranging from "strongly disagree (score 1)" to "strongly agree (score 10)" to score their views on whether their DED treatments had been effective...
August 2017: Cornea
https://www.readbyqxmd.com/read/28445703/sensitivity-and-specificity-of-laser-scanning-in%C3%A2-vivo-confocal-microscopy-for-filamentous-fungal-keratitis-role-of-observer-experience
#9
Ahmad Kheirkhah, Zeba A Syed, Vannarut Satitpitakul, Sunali Goyal, Rodrigo Müller, Elmer Y Tu, Reza Dana
PURPOSE: To determine sensitivity and specificity of laser-scanning in vivo confocal microscopy (LS-IVCM) for detection of filamentous fungi in patients with microbial keratitis and to evaluate the effect of observer's imaging experience on these parameters. DESIGN: Retrospective reliability study. METHODS: This study included 21 patients with filamentous fungal keratitis and 24 patients with bacterial keratitis (as controls). The etiology of infection was confirmed based on the response to specific therapy regardless of culture results...
July 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28445193/a-pilot-randomized-trial-on-safety-and-efficacy-of-a-novel-topical-combined-inhibitor-of-janus-kinase-1-3-and-spleen-tyrosine-kinase-for-gvhd-associated-ocular-surface-disease
#10
RANDOMIZED CONTROLLED TRIAL
Ahmad Kheirkhah, Antonio Di Zazzo, Vannarut Satitpitakul, Merle Fernandez, Daniel Magilavy, Reza Dana
PURPOSE: Janus kinase (JAK) and spleen tyrosine kinase (SYK) play critical functions in T-cell activation and in inflammation. Because of their antiinflammatory effects, JAK and SYK inhibitors have recently been evaluated in several immunopathogenic disorders. This pilot study was designed to assess the safety and efficacy of a topical combined JAK/SYK inhibitor, R348, ophthalmic solution for treatment of ocular surface disease in graft-versus-host disease (GVHD). METHODS: This phase 2, double-masked, randomized, pilot trial included 30 patients with ocular surface disease due to GVHD who were randomized to receive topical 0...
July 2017: Cornea
https://www.readbyqxmd.com/read/28299010/systemic-immunomodulatory-strategies-in-high-risk-corneal-transplantation
#11
REVIEW
Tulio B Abud, Antonio Di Zazzo, Ahmad Kheirkhah, Reza Dana
The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin...
January 2017: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/28060067/patients-with-dry-eye-disease-and-low-subbasal-nerve-density-are-at-high-risk-for-accelerated-corneal-endothelial-cell-loss
#12
Ahmad Kheirkhah, Vannarut Satitpitakul, Pedram Hamrah, Reza Dana
PURPOSE: To evaluate changes in corneal endothelial cell density over time in patients with dry eye disease (DED) and to correlate endothelial cell loss with corneal subbasal nerve density. METHODS: This retrospective study included 40 eyes of 20 patients with DED. Laser in vivo confocal microscopy had been performed in the central cornea of both eyes at an initial visit and repeated after a mean follow-up of 33.2 ± 10.2 months. The densities of corneal endothelial cells and subbasal nerves were measured in both visits and compared with 13 eyes of 13 normal age-matched controls...
February 2017: Cornea
https://www.readbyqxmd.com/read/28012874/management-of-high-risk-corneal-transplantation
#13
REVIEW
Antonio Di Zazzo, Ahmad Kheirkhah, Tulio B Abud, Sunali Goyal, Reza Dana
The cornea is the most commonly transplanted tissue in medicine. The main cause of corneal graft failure is allograft rejection. The incidence of graft rejection depends on the presence of high-risk characteristics, most notably corneal neovascularization. Although corneal grafting has high success rates in the absence of these risk factors, high-risk keratoplasty is associated with low success rates because of a high incidence of immune-mediated graft rejection. To improve the survival of high-risk corneal transplantation, various preoperative, intraoperative, and postoperative measures can be considered; however, the key step in the management of these grafts is the long-term use of local and/or systemic immunosuppressive agents...
November 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/27994801/histopathology-of-conjunctivochalasis-compared-to-normal-conjunctiva
#14
Hesam Hashemian, Mirgholamreza Mahbod, Fahimeh A Amoli, Mohammad Y Kiarudi, Mahmoud Jabbarvand, Ahmad Kheirkhah
PURPOSE: To evaluate the histopathologic changes in the conjunctiva of patients with conjunctivochalasis (CCh) compared to age-matched controls. METHODS: This cross-sectional, controlled study included 27 eyes of 27 patients with CCh and 16 eyes of 16 age-matched controls. A biopsy of the bulbar conjunctiva was performed along the temporal lower lid margin before cataract surgery in both groups. Histopathologic evaluation of the specimens was done with light microscopy using staining with hematoxylin/eosin, periodic acid Schiff, and van Gieson elastic stain...
October 2016: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/27811567/patients-with-dry-eye-disease-and-low-subbasal-nerve-density-are-at-high-risk-for-accelerated-corneal-endothelial-cell-loss
#15
Ahmad Kheirkhah, Vannarut Satitpitakul, Pedram Hamrah, Reza Dana
PURPOSE: To evaluate changes in corneal endothelial cell density over time in patients with dry eye disease (DED) and to correlate endothelial cell loss with corneal subbasal nerve density. METHODS: This retrospective study included 40 eyes of 20 patients with DED. Laser in vivo confocal microscopy had been performed in the central cornea of both eyes at an initial visit and repeated after a mean follow-up of 33.2 ± 10.2 months. The densities of corneal endothelial cells and subbasal nerves were measured in both visits and compared with 13 eyes of 13 normal age-matched controls...
November 2, 2016: Cornea
https://www.readbyqxmd.com/read/27811337/patients-with-multiple-sclerosis-demonstrate-reduced-subbasal-corneal-nerve-fibre-density
#16
Janine Mikolajczak, Hanna Zimmermann, Ahmad Kheirkhah, Ella Maria Kadas, Timm Oberwahrenbrock, Rodrigo Muller, Aiai Ren, Joseph Kuchling, Holger Dietze, Harald Prüss, Friedemann Paul, Pedram Hamrah, Alexander U Brandt
BACKGROUND: Many studies in multiple sclerosis (MS) have investigated the retina. Little, however, is known about the effect of MS on the cornea, which is innervated by the trigeminal nerve. It is the site of neural-immune interaction with local dendritic cells reacting in response to environmental stimuli. OBJECTIVE: This study aims to investigate the effect of MS on corneal nerve fibres and dendritic cells in the subbasal nerve plexus using in vivo confocal microscopy (IVCM)...
December 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/27607414/in-vivo-confocal-microscopy-in-dry-eye-disease-associated-with-chronic-graft-versus-host-disease
#17
RANDOMIZED CONTROLLED TRIAL
Ahmad Kheirkhah, Yureeda Qazi, Michael A Arnoldner, Kunal Suri, Reza Dana
PURPOSE: To compare densities of corneal epithelial dendritic cells (DCs), corneal subbasal nerves, and conjunctival epithelial immune cells (EICs) between patients with dry eye disease (DED) with and without graft-versus-host disease (GVHD) using in vivo confocal microscopy (IVCM). METHODS: This study included 54 patients who had moderate to severe DED either associated with (n = 33) or without (n = 21) chronic GVHD. In addition to evaluating clinical parameters of DED, images obtained by laser-scanning IVCM of the central cornea and superior tarsal conjunctiva were analyzed to measure densities of corneal epithelial DCs, corneal subbasal nerves, and conjunctival EICs...
September 1, 2016: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/27413494/correlations-between-histopathologic-changes-and-clinical-features-in-pterygia
#18
Hamid Safi, Ahmad Kheirkhah, Mirgholamreza Mahbod, Saber Molaei, Hassan Hashemi, Mahmoud Jabbarvand
PURPOSE: To investigate the correlations between clinical findings and histopathologic changes in eyes with pterygium. METHODS: This prospective study included 70 eyes with primary pterygia undergoing surgical excision. Prior to surgery, clinical features of the pterygia including extension over the cornea, redness, fleshiness (based on obscuration of the underlying episcleral vessels), and obliteration of the plica semilunaris were determined. Postoperatively, pterygium specimens were examined by hematoxylin-eosin and trichrome staining to evaluate histopathologic characteristics including vascular density, leukocytic infiltration, stromal elastosis, stromal fibrosis and subepithelial fibrosis...
April 2016: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/27395775/patients-perspectives-on-their-dry-eye-disease
#19
Alja Crnej, Ahmad Kheirkhah, Ai Ren, Andrew Mullins, Alenka Lavric, Kunal Suri, Pedram Hamrah, Reza Dana
PURPOSE: Although it has been known that patients' perspectives on their disease can significantly affect their level of functional disability as well as disease outcome, limited data are available on patients' perceptions of their dry eye disease (DED). The aim of this questionnaire-based study was to evaluate patients' perspectives on their DED. METHODS: This cross-sectional study included 91 patients with DED. In addition to clinical evaluation, all patients completed a questionnaire to evaluate their perspectives on their DED...
October 2016: Ocular Surface
https://www.readbyqxmd.com/read/27136674/a-fully-automated-tortuosity-quantification-system-with-application-to-corneal-nerve-fibres-in-confocal-microscopy-images
#20
Roberto Annunziata, Ahmad Kheirkhah, Shruti Aggarwal, Pedram Hamrah, Emanuele Trucco
Recent clinical research has highlighted important links between a number of diseases and the tortuosity of curvilinear anatomical structures like corneal nerve fibres, suggesting that tortuosity changes might detect early stages of specific conditions. Currently, clinical studies are mainly based on subjective, visual assessment, with limited repeatability and inter-observer agreement. To address these problems, we propose a fully automated framework for image-level tortuosity estimation, consisting of a hybrid segmentation method and a highly adaptable, definition-free tortuosity estimation algorithm...
August 2016: Medical Image Analysis
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