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Ahmad Kheirkhah

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https://www.readbyqxmd.com/read/29128574/conjunctivochalasis-a-systematic-review
#1
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. Conjunctivochalasis may be associated with various ocular and non-ocular 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 8, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28528121/determinants-of-ocular-pain-severity-in-patients-with-dry-eye-disease
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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)...
November 1, 2016: 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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/26975024/two-dimensional-plane-for-multi-scale-quantification-of-corneal-subbasal-nerve-tortuosity
#16
Roberto Annunziata, Ahmad Kheirkhah, Shruti Aggarwal, Bernardo M Cavalcanti, Pedram Hamrah, Emanuele Trucco
PURPOSE: To assess the performance of a novel system for automated tortuosity estimation and interpretation. METHODS: A supervised strategy (driven by observers' grading) was employed to automatically identify the combination of tortuosity measures (i.e., tortuosity representation) leading to the best agreement with the observers. We investigated 18 tortuosity measures including curvature and density of inflection points, computed at multiple spatial scales. To leverage tortuosity interpretation, we propose the tortuosity plane (TP) onto which each image is mapped...
March 2016: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/26863496/corneal-patch-graft-a-new-approach-for-scleral-necrosis-secondary-to-plaque-radiotherapy
#17
Masood Naseripour, Hossein Aghaei, Ahad Sedaghat, Ahmad Kheirkhah, Ramin Jaberi, Zohreh Azma
PURPOSE: To evaluate the anatomical outcomes of corneal patch grafts in patients with progressive scleral necrosis secondary to plaque radiotherapy used for uveal malignant melanoma management. METHODS: In this case series, 4 patients with progressive scleral necrosis after Ru-106 plaque radiotherapy underwent corneal patch grafts with the anterior corneal button from Descemet stripping automated endothelial keratoplasty donor tissue to strengthen the sclera and to improve appearance of the eye...
April 2016: Cornea
https://www.readbyqxmd.com/read/26737575/combining-efficient-hand-crafted-features-with-learned-filters-for-fast-and-accurate-corneal-nerve-fibre-centreline-detection
#18
Roberto Annunziata, Ahmad Kheirkhah, Pedram Hamrah, Emanuele Trucco
We propose a new approach to corneal nerve fibre centreline detection for in vivo confocal microscopy images. Relying on a combination of efficient hand-crafted features and learned filters, our method offers an excellent compromise between accuracy and running time. Unlike previous solutions using sparse coding to learn small filter banks, we employ K-means to efficiently learn the high amount of filters needed to cope with the multiple challenges involved, e.g., low contrast and resolution, non-uniform illumination, tortuosity and confounding non-target structures...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/26606299/overestimation-of-corneal-endothelial-cell-density-in-smaller-frame-sizes-in-in-vivo-confocal-microscopy
#19
Ahmad Kheirkhah, Ujwala S Saboo, Anna Marmalidou, Reza Dana
PURPOSE: To evaluate the effect of frame size on the calculated corneal endothelial cell density (CECD) in images of laser scanning in vivo confocal microscopy (IVCM). METHODS: Forty-nine corneal endothelial images acquired by laser scanning IVCM (Heidelberg Retina Tomograph 3 with Rostock Corneal Module) with different endothelial cell densities were analyzed. In each image (160,000 μm), the CECD was calculated using the fixed-frame method by counting cells in the following frame sizes: 80,000 μm, 40,000 μm, 20,000 μm, 10,000 μm, 5000 μm, and 2500 μm...
March 2016: Cornea
https://www.readbyqxmd.com/read/26540656/corneal-epithelial-immune-dendritic-cell-alterations-in-subtypes-of-dry-eye-disease-a-pilot-in-vivo-confocal-microscopic-study
#20
Ahmad Kheirkhah, Raheleh Rahimi Darabad, Andrea Cruzat, Amir Reza Hajrasouliha, Deborah Witkin, Nadia Wong, Reza Dana, Pedram Hamrah
PURPOSE: To evaluate density and morphology of corneal epithelial immune dendritic cells (DCs) in different subtypes of dry eye disease (DED) using in vivo confocal microscopy (IVCM). METHODS: This retrospective study included 59 eyes of 37 patients with DED and 40 eyes of 20 age-matched healthy controls. Based on clinical tests, eyes with DED were categorized into two subtypes: aqueous-deficient (n = 35) and evaporative (n = 24). For all subjects, images of laser scanning in vivo confocal microscopy (IVCM) of the central cornea were analyzed for DC density and DC morphology (DC size, number of dendrites, and DC field)...
November 2015: Investigative Ophthalmology & Visual Science
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