Tehran University Medical Journal

Background: One common symptom of diabetes is diabetic retinopathy, if not timely diagnosed and treated, leads to blindness. Retinal image analysis has been currently adopted to diagnose retinopathy. In this study, a model of hierarchical self-organized neural networks has been presented for the detection and classification of retina in diabetic patients.
Methods: This study is a retrospective cross-sectional, conducted from December to February 2015 at the AJA University of Medical Sciences, Tehran. The study has been conducted on the MESSIDOR base, which included 1200 images from the posterior pole of the eye. Retinal images are classified into 3 categories: mild, moderate and severe. A system consisting of a new hybrid classification of SOM has been presented for the detection of retina lesions. The proposed system includes rapid preprocessing, extraction of lesions features, and finally provision of a classification model. In the preprocessing, the system is composed of three processes of primary separation of target lesions, separation of the optical disk, and separation of blood vessels from the retina. The second step is a collection of features based on various descriptions, such as morphology, color, light intensity, and moments. The classification includes a model of hierarchical self-organized networks named HSOM which is proposed to accelerate and increase the accuracy of lesions classification considering the high volume of information in the feature extraction.
Results: The sensitivity, specificity and accuracy of the proposed model for the classification of diabetic retinopathy lesions is 98.9%, 96.77%, 97.87%, respectively.
Conclusion: These days, the cases of diabetes with hypertension are constantly increasing, and one of the main adverse effects of this disease is related to eyes. In this respect, the diagnosis of retinopathy, which is the same as identification of exudates, microanurysm and bleeding, is of particular importance. The results show that the proposed model is able to detect lesions in diabetic retinopathy images and classify them with an acceptable accuracy. In addition, the results suggest that this method has an acceptable performance compared to other methods.

Background: Intrauterine infections (TORCH) lead to the involvement of various organs of the body of the fetus, including the eye. The aim of this study was to determine the frequency and clinical response of eye lesions to specific drugs, in infants with confirmed TORCH induced ocular lesions.
Methods: This historical cohort study from 2011 to 2017, had done in Pediatrics and Ophthalmology Department of Rasoul Akram Hospital, Tehran, Iran. Cases included; 78 infants with confirmed intrauterine infection (TORCH) with ophthalmologic disorders (glaucoma, cataract, and retinitis), 3 cases died (without any treatment). The cases with incomplete diagnosis, no treatment or without follow-up excluded from study. Out of 74 children with confirmed TORCH induced ophthalmologic disorders, finally 37 children (25 cytomegalovirus, 12 toxoplasma) were treated with specific drugs, and clinical response to treatment was followed-up to 1 year by ophthalmologic examination.
Results: From 12 cases with ophthalmologic disorders due to congenital toxoplasmosis, 5 cases had full treatment, 4 cases had complete response. One case had not any improvement. From 25 cases with congenital cytomegalovirus (CMV), 18 patients continued treatment, 9 cases with complete clinical response, 9 cases had not response to antiviral treatment, indeed most non responder cases had central nervous system involvement from birth. The best response observed in CMV infected cases accompanied with sensory hearing loss (without CNS involvement).
Conclusion: Good clinical response of ophthalmic diseases in 80% of congenital toxoplasma; and 50% of congenital cytomegalovirus infected cases. Probably with initial diagnosis and rapid treatment of cases with TORCH induced ophthalmic disorders (especially cases without CNS involvement) it would lead to stopping ocular lesions.