Toktam Shahraki

Shahid Beheshti University of Medical Sciences

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Amir Arabi

Shahid Beheshti University of Medical Sciences

Amir Arabi

King Khalid University

Saeed Karimi

Shahid Beheshti University of Medical Sciences

Sare Safi

Shahid Beheshti University of Medical Sciences

Iman Ansari

Shahid Beheshti University of Medical Sciences

Saeed Karimi

Semnan University

Homayoun Nikkhah

Shahid Beheshti University of Medical Sciences

Sepehr Feizi

Shahid Beheshti University of Medical Sciences

Alireza Baradaran‐Rafii

University of South Florida

Hamed Esfandiari

Shahid Beheshti University of Medical Sciences

Cooperative Institutions

Shahid Beheshti University of Medical Sciences

Shahid Beheshti University

Imam Hossein Hospital

Isfahan University of Medical Sciences

Hospital Labbafinejad

Tehran University of Medical Sciences

Research Institute of Ophthalmology

Razi Hospital

Miami Dermatology and Laser Institute

University of Miami

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New advances in medical management of dry eye: optimizing treatment strategies for enhanced relief

International Ophthalmology (2024)

Toktam Shahraki Alireza Baradaran‐Rafii Ramesh S. Ayyala Amir Arabi John S Jarstad

Artificial tears

Meibomian gland

Pathophysiology

Review article

10.1007/s10792-024-02978-1

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Citations (0)

Corona virus disease 2019-associated Stevens-Johnson syndrome: a case report

BMC Ophthalmology (2021)

Toktam Shahraki Kiana Hassanpour Amir Arabi Iman Ansari Mohammad-Mehdi Sadoughi

To report Stevens-Johnson syndrome (SJS) in a patient with acute pneumonia secondary to SARS-CoV-2 infection.A 45-years-old woman with a diagnosis of acute pneumonia secondary to SARS-CoV-2 infection who had received azithromycin and naproxen. Three days after starting the medication, she appeared ill and developed ocular discomfort, photophobia, dysuria, and macular rashes on the trunk and the extremities. On ophthalmological examination, a total epithelial defect was seen in both eyes. According to the examination, Stevens-Johnson syndrome was diagnosed and the patient was admitted to receive systemic and ocular support and medical care. The patient's condition improved during the 3 weeks and recovered from both COVID-19 and SJS life-threatening complications but ocular complications, including the destruction of the meibomian glands, irregularity of the eyelid margin, and corneal scarring remained for the patient.Although, it is not clear whether the cause of Stevens-Johnson syndrome in COVID-19 patients is the virus itself or whether the use of medication, but patients with COVID-19, especially patients receiving medication, should be screened for symptoms of Stevens-Johnson syndrome.

10.1186/s12886-021-02033-y

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Citations (13)

Plaque brachytherapy in iris and iridociliary melanoma: a systematic review of efficacy and complications

Journal of Contemporary Brachytherapy (2021)

Saeed Karimi Amir Arabi Toktam Shahraki

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Karimi S, Arabi A, Shahraki T. Plaque brachytherapy in iris and iridociliary melanoma: a systematic review of efficacy and complications. Journal of Contemporary Brachytherapy. 2021;13(1):46-50. doi:10.5114/jcb.2021.103586. APA Karimi, S., Arabi, A., & Shahraki, T. (2021). Plaque brachytherapy in iris and iridociliary melanoma: a systematic review of efficacy and complications. Journal of Contemporary Brachytherapy, 13(1), 46-50. https://doi.org/10.5114/jcb.2021.103586 Chicago Karimi, Saeed, Amir Arabi, and Toktam Shahraki. 2021. "Plaque brachytherapy in iris and iridociliary melanoma: a systematic review of efficacy and complications". Journal of Contemporary Brachytherapy 13 (1): 46-50. doi:10.5114/jcb.2021.103586. Harvard Karimi, S., Arabi, A., and Shahraki, T. (2021). Plaque brachytherapy in iris and iridociliary melanoma: a systematic review of efficacy and complications. Journal of Contemporary Brachytherapy, 13(1), pp.46-50. https://doi.org/10.5114/jcb.2021.103586 MLA Karimi, Saeed et al. "Plaque brachytherapy in iris and iridociliary melanoma: a systematic review of efficacy and complications." Journal of Contemporary Brachytherapy, vol. 13, no. 1, 2021, pp. 46-50. doi:10.5114/jcb.2021.103586. Vancouver Karimi S, Arabi A, Shahraki T. Plaque brachytherapy in iris and iridociliary melanoma: a systematic review of efficacy and complications. Journal of Contemporary Brachytherapy. 2021;13(1):46-50. doi:10.5114/jcb.2021.103586.

Choroidal Melanoma

10.5114/jcb.2021.103586

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Citations (9)

Axial or coronal CT scan; which is more accurate in detection of open globe injury?

Injury (2021)

Amir Arabi Toktam Shahraki Rezvan Nezam-slami Hamed Esfandiari Mehdi Tavakoli

Globe

10.1016/j.injury.2021.04.034

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Citations (3)

Intravitreal Bevacizumab (Avastin) as An Adjuvant Therapy for Choroidal Carcinoid Metastasis

Journal of Current Ophthalmology (2020)

Saeed Karimi Amir Arabi Toktam Shahraki

To report a case of choroidal carcinoid metastasis with neovascularization of the optic disc and macular edema that was treated with three sessions of intravitreal anti-vascular endothelial growth factor (anti-VEGF) as an adjuvant therapy with photodynamic therapy (PDT).A 16-year-old patient with a diagnosis of lung carcinoid tumor presented to an ophthalmology clinic with a complaint of decreased vision in his right eye. Fundus examination revealed choroidal carcinoid metastasis in addition to neovascularization of the optic disc. Macular optical coherence tomography revealed cystoid macular edema and subretinal fluid. The patient was treated with PDT in addition to three sessions of intravitreal anti-VEGF injections.Following the treatment, the new vessels regressed, and visual acuity improved. Furthermore, central retinal thickness reduced significantly. The tumor size reduced significantly over a follow-up period of 6 weeks.Choroidal carcinoid metastasis may be complicated by neovascularization of optic disc, which responds favorably to intravitreal injections of bevacizumab.

Fundus (uterus)

Adjuvant Therapy

10.4103/joco.joco_54_20

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Association of White Blood Cell Counts, Leukocyte Ratios, and Serum Uric Acid with Clinical Outcome of Intravitreal Bevacizumab in Diabetic Macular Edema

Korean Journal of Ophthalmology (2022)

Saeed Karimi Amir Arabi Toktam Shahraki Sare Safi

To investigate the role of serum uric acid and leukocyte counts and ratios as predictors of clinical outcomes of intravitreal bevacizumab in diabetic macular edema.In this prospective study, the patients were treated with three monthly intravitreal bevacizumab. The correlation of serum uric acid and immune cell indices with the changes of best-corrected visual acuity and central macular thickness at the end of month 3 were evaluated through univariate and multivariate linear regression analysis.A total of 80 eyes from 80 diabetic patients were included in the study. The difference of uric acid level and immune indices between groups with different retinopathy severity was not statistically significant (p > 0.05). Lower duration of diabetes (p = 0.045), monocyte count (p = 0.021), and uric acid level (p < 0.001) were correlated with larger improvement in visual acuity at 3-month visit. Higher logarithm of the minimum angle of resolution of baseline visual acuity (p = 0.007), lymphocyte count (p = 0.008), lymphocyte to neutrophil ratio (p < 0.001) and lymphocyte to platelet ratio (p < 0.001) were correlated with larger improvement in visual acuity at 3-month visits. According to multivariate analysis, baseline logarithm of the minimum angle of resolution (r = 0.125, p = 0.009), duration of diabetes (r = -0.216, p = 0.047), lymphocyte to neutrophil ratio (r = 0.712, p < 0.001), lymphocyte to platelet ratio (r = 0.238, p < 0.001), and uric acid level (r = -0.397, p < 0.001) were the significant predictors of changes in visual acuity in our subset of patients.Serum uric acid and leukocyte counts and ratios may predict the response of diabetic macular edema to intravitreal injection.

Univariate analysis

10.3341/kjo.2021.0041

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Predictive factors of stereopsis outcomes following strabismus surgery

Therapeutic Advances in Ophthalmology (2021)

M Eshaghi Amir Arabi Shahram Banaie Toktam Shahraki Sarvin Es haghi

Purpose: To determine the predictive factors of post-operative stereopsis in patients with strabismus. Method: In this retrospective study, records of patients who received surgical treatment for strabismus were reviewed. All types of strabismus were included. Pre- and post-treatment stereoacuity were measured using the Titmus Stereo Fly test, and predictive factors of stereopsis were evaluated. Results: A total of 194 patients (132 females and 62 males) with a mean age of 14.8 ± 8.4 years were included. There was a statistically significant improvement in stereopsis following surgery ( p value < 0.001). Patients with a higher amount of deviation at baseline had poorer stereopsis on the final examination ( p value < 0.001). Stereopsis improvement was more prominent in the pure horizontal strabismus group, compared to combined horizontal and vertical deviations. Baseline and the final stereopsis were higher in the “exotropia” group as compared to the “esotropia” group ( p value = 0.003 and 0.0155, respectively); however, the within group change of stereopsis was not significantly different between these two groups ( p value = 0.144). Post surgical residual deviation was associated with a poorer stereopsis ( p value = 0.002, r = 0.251). A longer duration of strabismus before surgery was associated with poorer final stereopsis levels ( p value = 0.026). The presence of amblyopia before surgery was associated with poorer stereopsis on last examination ( p value < 0.001 for both correlations). Conclusion: Based on the result of this study, final stereopsis after strabismus surgery could be affected by the type, duration, and the amount of deviation before surgery, amblyopia, and post operative ocular deviation.

Stereoscopic acuity

Esotropia

Strabismus Surgery

10.1177/25158414211003001

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Citations (7)

Development of Progressive Chiari I Malformation in a Child with Unilateral Sporadic Retinoblastoma

Journal of Current Ophthalmology (2021)

Saeed Karimi Amir Arabi Toktam Shahraki Iman Ansari Sare Safi

To report a case of progressive Chiari malformation type I (CIM) in a patient with unilateral sporadic retinoblastoma (RB) treated with intra-arterial chemotherapy (IAC) and enucleation.A 5-year-old male patient with a history of RB in his left eye treated with IAC and enucleation presented to our clinic for routine RB surveillance. Radiotherapy had not been used for the treatment of his RB.A progressive herniation of cerebellar tonsils through the foramen magnum was detected on follow-up magnetic resonance imaging (MRI). Brain and cervical MRI revealed no central nervous system mass, hydrocephalus, or syringomyelia. There was no history of head trauma.Progressive CIM may occur in unilateral sporadic RB.

Foramen magnum

Retinoblastoma

Chiari Malformation

Carboplatin

10.4103/joco.joco_166_20

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Novel treatments and genetics of age-related macular degeneration-a narrative review

Annals of Eye Science (2021)

Amir Arabi Toktam Shahraki

Narrative review

Degeneration (medical)

10.21037/aes-21-14

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Citations (1)

Update on Management of Non-proliferative Diabetic Retinopathy without Diabetic Macular Edema; Is There a Paradigm Shift?

Journal of Ophthalmic and Vision Research (2022)

Amir Arabi Ramin Tadayoni Hamid Ahmadieh Toktam Shahraki Homayoun Nikkhah

Diabetic retinopathy (DR) is the major cause of visual impairment and blindness in the working-age population. Conventional management for nonproliferative diabetic retinopathy (NPDR) without diabetic macular edema (DME) is derived from the findings of the Early Treatment Diabetic Retinopathy Study (ETDRS). Although the ETDRS protocol basically includes observation, selected cases of severe NPDR may undergo scatter laser photocoagulation. Post-hoc analysis of recent trials has shown that patients with NPDR receiving intravitreal anti-vascular endothelial growth factor (anti-VEGF) for DME would experience improvement in the DR severity scale (DRSS). In addition, recent randomized trials (PANORAMA and Protocol W) have revealed that early intervention with intravitreal aflibercept in eyes with moderately severe to severe NPDR is associated with significant improvement in DRSS and reduced vision-threatening complications of DR. Based on recent studies, it seems that the therapeutic approach to NPDR may undergo a substantial change and a paradigm shift toward considering early intervention with the administration of intravitreal anti-VEGF injections. However, the long-term results and the duration of adherence to anti-VEGF therapy for eyes with NPDR are not yet defined. It is also not apparent whether improvement in DRSS is a true disease modification. Studies showed that DRSS improvement is not associated with retinal reperfusion. In addition, DRCR.net Protocol W showed no visual acuity benefit with the early intravitreal aflibercept injection in moderate to severe NPDR as compared with performing observation plus intravitreal aflibercept applied only after progression to proliferative DR or vision-impairing DME. The cost–benefit ratio is also a challenge. Herein, we look at different aspects of early anti-VEGF application and discuss its pros and cons in the process of treating NPDR.

Aflibercept

Pegaptanib

10.18502/jovr.v17i1.10175

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Citations (14)