Early Diagnosis of Glaucoma By Optical Coherence Tomography: A Systematic Review and Network Meta-analysis Azadeh Doozandeh, Mohammadmehdi Hatami, Zahra Khorrami, Ali Sadatmoosavi, Mohammad Farjami, Ghazale Soltani Journal of Ophthalmic and Vision Research, 2026 Optical coherence tomography (OCT) diagnostic technology is increasingly being integrated into clinical practice and is evolving rapidly. Performing a meta-analysis of these advancements can provide valuable insights to clinicians and healthcare decision-makers and help identify gaps that need further research and development. We conducted a systematic review and network meta-analysis (NMA) comparing the diagnostic accuracy of three key OCT-derived parameters in identifying early glaucoma: peripapillary retinal nerve fiber layer (RNFL) thickness, macular metrics, and optic nerve head (ONH) characteristics. We systematically searched PubMed, Embase, Web of Science, and Scopus for studies published from January 2004 through March 2024, and identified 47 eligible studies. These studies comprised 12,723 eyes from 8177 participants, including patients with mild primary open-angle glaucoma, pre-perimetric glaucoma (PPG), and ocular hypertension, as well as healthy controls. Our NMA summarized the existing evidence on the diagnostic performance of these parameters. The highest diagnostic accuracies for glaucoma detection were observed for average and inferior RNFL parameters, both achieving an accuracy of 0.77 and macular GLV parameter with an accuracy of 0.76. These were followed by inferotemporal GCIPL and two ONH parameters—rim area and cup-to-disc ratio—each with an accuracy of 0.75. In conclusion, the overall diagnostic accuracy was comparable across all three categories of OCT parameters. The results also suggest the potential benefits of combining two or three of these parameters in a single report, along with the application of artificial intelligence. This approach could significantly enhance the diagnostic accuracy of OCT in detecting glaucoma at its earliest stages, ultimately improving patient outcomes through earlier intervention.
Retinal vascular density in different refractive errors assessed by optical coherence tomography angiography Hemn Baghban Jaldian, Zhale Rajavi, Parva Pourbagherkhah, Hossein Mohammad-Rabei, Mohammadmehdi Hatami, Mohammad Farjami, Hamideh Sabbaghi Photodiagnosis and Photodynamic Therapy, 2025 • Myopic eyes exhibit higher deep capillary plexus foveal vessel density than hyperopic eyes. • Significant positive correlation between anterior chamber depth and superficial capillary plexus vessel density in hyperopia. • Negative correlation of age with superficial capillary plexus foveal vessel density in myopic eyes. • The foveal avascular zone area negatively correlates with anterior chamber depth in hyperopic and control eyes. • Optical Coherence Tomography Angiography offers novel insights into vascular changes in refractive errors. To compare retinal vascular density (VD) in individuals with different refractive errors using Optical Coherence Tomography Angiography (OCTA) and evaluate the correlation between VD and ocular biometric parameters. This study included 56 participants with moderate myopia and hyperopia, along with 33 controls with lower levels of refractive errors. The mean age of participants was 28.95 ± 6.92 years for the case group and 31.18 ± 6.81 years for the controls. Among the participants, 51.7 % were female. All subjects underwent OCTA imaging using the RTVue XR Avanti system to measure VD in the superficial and deep capillary plexuses. The foveal avascular zone (FAZ) area was also assessed. Myopic eyes exhibited a significantly higher deep capillary plexus (DCP) foveal VD compared to hyperopic eyes ( P = 0.031). In hyperopic eyes, there was a significant positive correlation between anterior chamber depth (ACD) and superficial capillary plexus (SCP) VD ( P < 0.001), while in myopic eyes, age was negatively correlated with SCP foveal VD ( P = 0.009). Additionally, the FAZ area showed a negative correlation with ACD in both hyperopic and control eyes ( P < 0.05). Myopic eyes demonstrated higher DCP foveal VD compared to hyperopic eyes, suggesting distinct vascular characteristics among different refractive errors. OCTA provides valuable insights into microvasculature changes in eyes with refractive errors.
Incidence and Risk Factors for Intraoperative Complications in Resident-performed Phacoemulsification Surgery Hossein Mohammad-Rabei, Homayoun Nikkhah, Zhale Rajavi, Mohammadmehdi Hatami, Mohammadsadegh Haghparast, Hamed Esfandiari Journal of Ophthalmic and Vision Research, 2025 Purpose: To investigate the incidence and risk factors of intraoperative complications during phacoemulsification surgery performed by ophthalmology residents at an academic training center. Methods: This comparative case series included 1121 eyes of 821 patients that underwent phacoemulsification cataract surgery by ophthalmology residents from March 2020 to March 2021. Patients’ medical records were reviewed for demographics, systemic and ophthalmic comorbidities, biometric data, surgical details, anesthesia type, residents’ training year, and the occurrence of any intraoperative complications. Multivariate models were used to identify potential risk factors for intraoperative complications. Results: Intraoperative complications were observed in 63 eyes (5.6%). From the most to the least frequent, they included posterior capsular rupture with vitreous loss in 29 eyes (2.6%), anterior capsular tear in 21 eyes (1.9%), nucleus drop in 8 eyes (0.7%), zonular dehiscence in 3 eyes (0.3%), and posterior capsular rupture without vitreous loss in 2 eyes (0.2%). On univariate analysis, mature or brunescent cataracts (OR = 3.096, P = 0.031), residents’ training year (OR = 2.238, P = 0.017), and pseudoexfoliation (OR = 2.247, P = 0.049) were associated with vitreous loss. Multivariate data analysis indicated that mature or brunescent cataracts (OR = 4.046, P = 0.009) and residents’ training year (OR = 3.238, P = 0.005) were independent risk factors for vitreous loss. Conclusion: We observed a higher rate of intraoperative complications in eyes with mature or brunescent cataracts or in procedures performed by less experienced residents. Proper case selection and direct attending supervision are crucial in preventing intraoperative complications at ophthalmology training centers.
Bulbar Conjunctival Thickness in Eyes with Pseudoexfoliation Measured by Anterior Segment OCT Mahla Shadravan, Shahin Yazdani, Bahareh Kheiri, Farideh Sharifipour, Azadeh Doozandeh, Mohammad Mehdi Hatami, Neda Einollahi Journal of Ophthalmic and Vision Research, 2025 Purpose: Eyes with pseudoexfoliation demonstrate fragile intraocular structures. The current study evaluated conjunctival thickness in pseudoexfoliation eyes as compared to a control group. Methods: In this cross-sectional study, patients with pseudoexfoliation and an age-matched control group underwent measurement of bulbar conjunctival thickness in the superior and temporal quadrants, 1, 2, and 3 mm posterior to the limbus using anterior segment OCT. Results: A total of 140 eyes of 140 subjects including 68 eyes of 68 patients with pseudoexfoliation and 72 eyes of 72 control subjects without pseudoexfoliation were studied. Both study groups were divided into two subgroups – those using glaucoma drops versus medication-free eyes. Total conjunctival thickness in pseudoexfoliation eyes was significantly lower than control eyes across all comparisons. Conjunctival thickness in the superior quadrant 1, 2, and 3 mm from the limbus was 177.62 ± 41.30, 235 ± 48.41, and 231.40 ± 49.81 μm, respectively in the pseudoexfoliation group versus 207.49 ± 48.92, 265.67 ± 52.66, and 262.74 ± 59.43 μm in the control group (P <0.001, <0.001, and 0.001, respectively). In the temporal quadrant, conjunctival thickness 1, 2, and 3 mm from the limbus was 193.62 ± 46.97, 198.19 ± 54.67, and 178.59 ± 57.90 μm, respectively in the pseudoexfoliation group versus 213.76 ± 47.06, 224.50 ± 56.24, and 210.26 ± 63.70 μm in the control group (P = 0.012, 0.006, and 0.003, respectively). Conclusion: Conjunctival thickness was significantly less in pseudoexfoliation eyes than an age-matched control group which supports clinical observations of thinner and more fragile conjunctiva in these eyes with implications for glaucoma surgery.
The Relationship between Serous Choroidal Detachment and the Ahmed Glaucoma Valve Failure Maryam Yadgari, Ahmad Shojaei Baghini, Fatemeh Vafaei, Behnoosh Attarian, Mohammadmehdi Hatami, et al. Journal of Current Ophthalmology, 2024 Abstract Purpose: To investigate the effect of serous choroidal detachment (SCD) on the success of Ahmed glaucoma valve (AGV) implantation. Methods: Patients who underwent AGV implantation and developed SCD were included in the case group. The control group was matched based on age, sex, baseline intraocular pressure (IOP), glaucoma type, and the number of glaucoma medications. The patient data were retrospectively extracted from available records. The primary outcome measure was an AGV success rate based on 5 < IOP <18 and a 20% reduction from baseline. Results: Seventeen patients were enrolled in the case group and 38 in the control group. Preoperative visual acuity of patients was 1.17 ± 0.43 and 1.16 ± 0.37 logMAR in the case and control groups, respectively. The patients in the case group showed higher mean IOP at all time intervals compared to controls. However, the mean IOP only reached a statistically significant difference at 3 months (17.94 ± 6.78 mmHg vs. 13.39 ± 3.09 mmHg, P = 0.003). The mean survival duration was significantly shorter in patients with SCD (10.4 ± 0.7 months vs. 11.7 ± 0.2 months for controls log-rank = 4.1, P = 0.04). The cumulative probability of success was 76.5% in patients with SCD and 94.7% in the control group after 12 months. Conclusions: SCD after AGV implantation could be a risk factor for failure. A larger prospective study with a longer follow-up duration is required to confirm the present study results.
Risk of missed diagnosis of primary open-angle glaucoma by eye care providers A. Doozandeh, S. Yazdani, M. Pakravan, Zohreh Ghasemi, K. Hassanpour, Mehdi Hatami, Iman Ansari Journal of Current Ophthalmology, 2022 Purpose: To evaluate the efficacy of opportunistic case finding in glaucoma detection and to determine factors associated with failure of glaucoma detection by eye health providers. Methods: This study was conducted on 154 new definite primary open-angle glaucoma (POAG) patients presenting to our glaucoma clinic. A questionnaire was prepared to determine if these subjects had sought eye care up to 12 months before presentation. The type of eye care provider and the principal reason for the visit were probed. The primary outcome measure was the frequency of a correct glaucoma diagnosis in their index visit. The secondary outcomes were factors associated with missed POAG diagnosis. Results: The great majority of study subjects (132 cases, 85.7%) had sought at least one ocular examination within 1 year before presentation. Among these patients, 73 cases (55.3%) had remained undiagnosed after the examination. Among the probed variables, age, gender, visual acuity, visual field defects, intraocular pressure, cup/disc ratio, nerve fiber layer thickness of the worse eye at presentation, and family history of glaucoma were comparable between correctly diagnosed and missed POAGs. The only factors significantly associated with missed POAG diagnosis were lack of significant refractive errors and visiting an optometrist rather than an ophthalmologist. Conclusions: The efficacy of opportunistic case finding for POAG seems to be less than ideal in our settings. Lack of a significant refractive error and visiting an optometrist rather than an ophthalmologist were associated with a missed diagnosis of POAG. These observations reflect the need to adopt policies to improve glaucoma screening by eye care providers.
Glaucoma in ectropion uveae syndrome: A case report and literature review Mohammadmehdi Hatami, Azadeh Doozandeh, Mohadeseh Feizi Journal of Ophthalmic and Vision Research, 2019 Purpose: To report a case of advanced childhood glaucoma secondary to congenital ectropion uveae (CEU).
 Case Report: The patient was a seven-year-old boy with unilateral glaucoma secondary to CEU and facial asymmetry, mild unilateral ptosis, and proptosis in the left eye. The intraocular pressure (IOP) was 28 mmHg and cup-to-disc ratio was 0.8 in the left eye. After starting glaucoma medication, IOP decreased to 21 mmHg. In view of the uncontrolled IOP with medication and high cup-to-disc ratio and increased axial length of the left eye, mitomycin-C (MMC)-augmented trabeculectomy was planned. Despite sub-tenon MMC injection and bleb needling, the bleb failed after six months, and we had to perform a shunt procedure to control the IOP.
 Conclusion: Although CEU is rare, ophthalmologists should be familiar with this syndrome because of the high frequency of glaucoma and its challenging management during childhood.
Clinicopathological study of lacrimal sac specimens obtained during DCR Hossein Salour, Mohammad-Mehdi Hatami, Mahmood Parvin, Ahmad Ali Ferdowsi, Mohammad Abrishami, Abbas Bagheri, Maryam Aletaha, Shahin Yazdani Orbit, 2010 Purpose: To determine the histopathologic characteristics of lacrimal sac specimens in adult patients undergoing external dacryocystorhinostomy (DCR) for acquired nasolacrimal duct obstruction. Methods: A total of 471 lacrimal sac biopsies were obtained from 449 patients undergoing external DCR for symptoms or signs of acquired nasolacrimal duct obstruction and examined histopathologically. Results: A total of 449 subjects including 283 (63%) female and 166 (37%) male subjects with mean age of 50.02 years underwent DCR and histopathologic examination of specimens. Presenting symptoms were epiphora in 411 patients (91%), history of acute dacryocystitis in 17 patients (4%) and obstruction revealed during ophthalmic examinations in 21 patients (5%). Histopathologic findings included: chronic inflammation in 450 patients (95.5%), fibrosis in 18 patients (3.8%), lymphoma in two patients (0.4%) and reactive lymphoid hyperplasia in one patient (0.2%). Lacrimal sac appearance during surgery was grossly abnormal in two cases: one case of lymphoma and one instance of reactive lymphoid hyperplasia. Conclusions: Chronic inflammation and fibrosis are the most common histopathologic findings in lacrimal sac specimens obtained during DCR. Only two cases of lymphoma (0.4%) were encountered in the series, one of which had a suspicious lacrimal sac appearance during surgery while the other case (0.2% of all specimens) was unsuspected. The rate of malignant etiology for NLD obstruction is low enough to justify lacrimal sac biopsy only in suspicious cases.
RECENT SCHOLAR PUBLICATIONS
Re: Saludares et al: A Phase I Randomized Trial of Topical Insulin for Glaucoma: Safety and Efficacy Outcomes (Ophthalmol Sci. 2026; 6 (2): 101032) M Hatami, M Zare Ophthalmology Science 6 (6) , 2026 2026
Early Diagnosis of Glaucoma By Optical Coherence Tomography: A Systematic Review and Network Meta-analysis A Doozandeh, M Hatami, Z Khorrami, A Sadatmoosavi, M Farjami, ... Journal of Ophthalmic & Vision Research 21, 10.18502/jovr. v21. 18852 , 2026 2026
Retinal vascular density in different refractive errors assessed by optical coherence tomography angiography HB Jaldian, Z Rajavi, P Pourbagherkhah, H Mohammad-Rabei, M Hatami, ... Photodiagnosis and Photodynamic Therapy 53, 104600 , 2025 2025 Citations: 2
Bulbar Conjunctival Thickness in Eyes with Pseudoexfoliation Measured by Anterior Segment OCT M Shadravan, S Yazdani, B Kheiri, F Sharifipour, A Doozandeh, ... Journal of Ophthalmic & Vision Research 20, 10.18502/jovr. v20. 15341 , 2025 2025
Incidence and Risk Factors for Intraoperative Complicationsin Resident-performed Phacoemulsification Surgery H Mohammad-Rabei, H Nikkhah, Z Rajavi, M Hatami, M Haghparast, ... Journal of Ophthalmic and Vision Research 20 , 2025 2025 Citations: 2
The Relationship between Serous Choroidal Detachment and the Ahmed Glaucoma Valve Failure M Yadgari, AS Baghini, F Vafaei, B Attarian, M Hatami, K Sheibani, ... Journal of Current Ophthalmology 36 (2), 129-135 , 2024 2024
Evaluating the Diagnostic Accuracy of the iCare Rebound Tonometer Compared to the Goldmann Applanation Tonometer MA Mohammadmehdi hatami Journal of Ophthalmic and Optometric Sciences 6, 21-26 , 2024 2024
Changes in the Thickness of Different Retinal Layers Following Intravitreal Injection of Bevacizumab in Patients with Diabetic Macular Edema and Its Association with post … H Nikkhah, M Valipoor, A Ramezani, S Karimi, M Entezari, MM Hatami, ... Journal of Ophthalmic and Optometric Sciences 8 (2), 20-32 , 2024 2024
Indications and Outcomes of Intraocular Lens Exchange in a Cohort of Pseudophakic Iranian Patients S Norouzi, H Mohammad-Rabie, PM Far, M Hatami, H Nikkhah Journal of Ophthalmic and Optometric Sciences 7 (3), 11-17 , 2023 2023
Risk of missed diagnosis of primary open-angle glaucoma by eye care providers A Doozandeh, S Yazdani, M Pakravan, Z Ghasemi, K Hassanpour, ... Journal of Current Ophthalmology 34 (4), 404-408 , 2022 2022 Citations: 6
Reviewing Microbial Contamination of Smokeless Tobacco Products. Tobacco and Health. 2024; 3 (1): 25-34 MM Hatami, MM Dalirifar, N Moosaei Baghestani, M Hassaniazad genesis 70, 102400 , 2021 2021
Glaucoma in ectropion uveae syndrome: a case report and literature review M Hatami, A Doozandeh, M Feizi Journal of Ophthalmic & Vision Research 14 (3), 370 , 2019 2019 Citations: 10
Ahmed glaucoma valve implantation: graft-free short tunnel small flap versus scleral patch graft after 1-year follow-up: a randomized clinical trial M Pakravan, M Hatami, H Esfandiari, S Yazdani, A Doozandeh, ... Ophthalmology Glaucoma 1 (3), 206-212 , 2018 2018 Citations: 13
Short-term Outcomes of Trabeculectomy with Intratenon Injection of MMC versus Conventional Method MM Hatami, M Pakravan, S Yazdani, A Douzandeh, M Yaseri BINA 23 (1), 13-21 , 2017 2017
Clinicopathological study of lacrimal sac specimens obtained during DCR H Salour, MM Hatami, M Parvin, AA Ferdowsi, M Abrishami, A Bagheri, ... Orbit 29 (5), 250-253 , 2010 2010 Citations: 56
MOST CITED SCHOLAR PUBLICATIONS
Clinicopathological study of lacrimal sac specimens obtained during DCR H Salour, MM Hatami, M Parvin, AA Ferdowsi, M Abrishami, A Bagheri, ... Orbit 29 (5), 250-253 , 2010 2010 Citations: 56
Ahmed glaucoma valve implantation: graft-free short tunnel small flap versus scleral patch graft after 1-year follow-up: a randomized clinical trial M Pakravan, M Hatami, H Esfandiari, S Yazdani, A Doozandeh, ... Ophthalmology Glaucoma 1 (3), 206-212 , 2018 2018 Citations: 13
Glaucoma in ectropion uveae syndrome: a case report and literature review M Hatami, A Doozandeh, M Feizi Journal of Ophthalmic & Vision Research 14 (3), 370 , 2019 2019 Citations: 10
Risk of missed diagnosis of primary open-angle glaucoma by eye care providers A Doozandeh, S Yazdani, M Pakravan, Z Ghasemi, K Hassanpour, ... Journal of Current Ophthalmology 34 (4), 404-408 , 2022 2022 Citations: 6
Retinal vascular density in different refractive errors assessed by optical coherence tomography angiography HB Jaldian, Z Rajavi, P Pourbagherkhah, H Mohammad-Rabei, M Hatami, ... Photodiagnosis and Photodynamic Therapy 53, 104600 , 2025 2025 Citations: 2
Incidence and Risk Factors for Intraoperative Complicationsin Resident-performed Phacoemulsification Surgery H Mohammad-Rabei, H Nikkhah, Z Rajavi, M Hatami, M Haghparast, ... Journal of Ophthalmic and Vision Research 20 , 2025 2025 Citations: 2
Re: Saludares et al: A Phase I Randomized Trial of Topical Insulin for Glaucoma: Safety and Efficacy Outcomes (Ophthalmol Sci. 2026; 6 (2): 101032) M Hatami, M Zare Ophthalmology Science 6 (6) , 2026 2026
Early Diagnosis of Glaucoma By Optical Coherence Tomography: A Systematic Review and Network Meta-analysis A Doozandeh, M Hatami, Z Khorrami, A Sadatmoosavi, M Farjami, ... Journal of Ophthalmic & Vision Research 21, 10.18502/jovr. v21. 18852 , 2026 2026
Bulbar Conjunctival Thickness in Eyes with Pseudoexfoliation Measured by Anterior Segment OCT M Shadravan, S Yazdani, B Kheiri, F Sharifipour, A Doozandeh, ... Journal of Ophthalmic & Vision Research 20, 10.18502/jovr. v20. 15341 , 2025 2025
The Relationship between Serous Choroidal Detachment and the Ahmed Glaucoma Valve Failure M Yadgari, AS Baghini, F Vafaei, B Attarian, M Hatami, K Sheibani, ... Journal of Current Ophthalmology 36 (2), 129-135 , 2024 2024
Evaluating the Diagnostic Accuracy of the iCare Rebound Tonometer Compared to the Goldmann Applanation Tonometer MA Mohammadmehdi hatami Journal of Ophthalmic and Optometric Sciences 6, 21-26 , 2024 2024
Changes in the Thickness of Different Retinal Layers Following Intravitreal Injection of Bevacizumab in Patients with Diabetic Macular Edema and Its Association with post … H Nikkhah, M Valipoor, A Ramezani, S Karimi, M Entezari, MM Hatami, ... Journal of Ophthalmic and Optometric Sciences 8 (2), 20-32 , 2024 2024
Indications and Outcomes of Intraocular Lens Exchange in a Cohort of Pseudophakic Iranian Patients S Norouzi, H Mohammad-Rabie, PM Far, M Hatami, H Nikkhah Journal of Ophthalmic and Optometric Sciences 7 (3), 11-17 , 2023 2023
Reviewing Microbial Contamination of Smokeless Tobacco Products. Tobacco and Health. 2024; 3 (1): 25-34 MM Hatami, MM Dalirifar, N Moosaei Baghestani, M Hassaniazad genesis 70, 102400 , 2021 2021
Short-term Outcomes of Trabeculectomy with Intratenon Injection of MMC versus Conventional Method MM Hatami, M Pakravan, S Yazdani, A Douzandeh, M Yaseri BINA 23 (1), 13-21 , 2017 2017
