Glyxambi
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login
  • Users Online: 3785
  • Home
  • Print this page
  • Email this page
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
   Table of Contents - Current issue
Coverpage
October 2019
Volume 67 | Issue 10
Page Nos. 1517-1784

Online since Monday, September 23, 2019

Accessed 20,717 times.

PDF access policy
Journal allows immediate open access to content in HTML + PDF

EPub access policy
Full text in EPub is free except for the current issue. Access to the latest issue is reserved only for the paid subscribers.
View as eBookView issue as eBook
Access StatisticsIssue statistics
RSS FeedRSS
Hide all abstracts  Show selected abstracts  Export selected to  Add to my list
EDITORIAL  

To err is human, but errors can be prevented Highly accessed article p. 1517
Santosh G Honavar
DOI:10.4103/ijo.IJO_1728_19  PMID:31546468
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
ONE MINUTE OPHTHALMOLOGY Top

Eyelid chalazion or not? Highly accessed article p. 1519
Jerry A Shields, Sara E Lally, Tatyana Milman, Carol L Shields
DOI:10.4103/ijo.IJO_1620_19  PMID:31546469
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
PERSPECTIVE Top

When the ophthalmologists turn blind Highly accessed article p. 1520
Neeraj Nagpal, Nimisha Nagpal
DOI:10.4103/ijo.IJO_315_19  PMID:31546470
The cost of technology is high in ophthalmology but given the increasingly competitive environment and the social demand, there is a pressure to progressively lower the costs to the consumer. To keep costs down there is a tendency to do as many surgeries as possible in an assembly line fashion both in hospitals as well as in the charitable camps. This article provides ophthalmologists an insight into the legal pitfalls in practice of ophthalmology in India and the dangers of the constant lowering of costs of surgery as well as of free service. This lowering of costs would have been ideal in a Utopian world, but times have now changed and there is cost to be paid even for providing free service. In India the prevalent tradition of providing free service, has also resulted in a lowering of guard by the eye surgeons. These mass eye surgery assembly popularly called “free eye camps” has seen millions of people benefited. But recently there is an increase in number of cases where exorbitant penalty has been imposed by the courts, on these philanthropic surgeons for any deficiency in service, and this has destroyed the careers of many ophthalmologists. Time has now come to introspect and to factor the cost of litigation and compensations into the cost of surgeries so that we not only benefit the patients but also safeguard the ophthalmologists and help them fulfill their responsibilities towards their own dependents.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARIES Top

Commentary: The times have changed: Are we listening? Highly accessed article p. 1524
AK Grover
DOI:10.4103/ijo.IJO_1520_19  PMID:31546471
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Commentary: Playing it safe versus being responsible p. 1525
Thulasiraj Ravilla
DOI:10.4103/ijo.IJO_1628_19  PMID:31546472
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Commentary: Medico legal aspects in ophthalmology in India p. 1526
Divya Agarwal, Atul Kumar, Dheepak Sundar
DOI:10.4103/ijo.IJO_1510_19  PMID:31546473
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Commentary: Increasing cases of litigations against ophthalmologists: How can we minimize litigations during ophthalmic practice? p. 1527
Suresh K Pandey, Vidushi Sharma
DOI:10.4103/ijo.IJO_1551_19  PMID:31546474
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
REVIEW ARTICLES Top

Clinical applications of the retinal functional imager: A brief review p. 1531
Chaitra Jayadev, Nimesh Jain, Ashwin Mohan, Naresh K Yadav
DOI:10.4103/ijo.IJO_1824_18  PMID:31546475
The advances in treating blinding conditions often depends on the development of new techniques that allows early detection, treatment, and follow-up of the disease. Functional changes often precede structural changes in many retinal disorders. Therefore, detecting these changes helps in early diagnosis and management, with the intention of preventing permanent morbidity. The Retinal Functional Imager (RFI) is a non-invasive imaging system that allows us to assess the various functional parameters of the retina. The RFI quantitatively measures the retinal blood-flow velocity, oxygen saturation, metabolic demand and generates a non-invasive capillary perfusion map that provides details similar to a fluorescein angiography. All of these parameters correlate with the health of the retina, and are known to get deranged in retinal disease. This article is a brief review of published literature on the clinical utility of the RFI.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Understanding low functioning cerebral visual impairment: An Indian context p. 1536
Niranjan K Pehere, Namita Jacob
DOI:10.4103/ijo.IJO_2089_18  PMID:31546476
For several reasons, cerebral visual impairment (CVI) is emerging as a major cause of visual impairment among children in the developing world and we are seeing an increasing number of such children in our clinics. Owing to lack of early training about CVI and it being a habilitation orientated subject, we need to become equipped to optimally help the affected children. In this paper we have explained our pragmatic approach in addressing children who present with low functioning CVI. Initially we explain briefly, how vision is processed in the brain. We then present what should be specifically looked for in these children in regular clinics as a part of their comprehensive ophthalmic examination. We discuss the process of functional vision evaluation that we follow with the help of videos to explain the procedures, examples of how to convey the conclusions to the family, and how to use our findings to develop intervention guidelines for the child. We explain the difference between passive vision stimulation and vision intervention, provide some common interventions that may be applicable to many children and suggest how to infuse interventions in daily routines of children so that they become relevant and meaningful leading to effective learning experiences.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Cerebral visual impairment is a major cause of profound visual impairment in children aged less than 3 years: A study from tertiary eye care center in South India p. 1544
Niranjan K Pehere, Asa Narasaiah, Gordon N Dutton
DOI:10.4103/ijo.IJO_1850_18  PMID:31546477
Purpose: The purpose of this study was to evaluate causes for profound visual impairment in children ≤3 years of age at a tertiary eye care center in Andhra Pradesh, India. Methods: A retrospective study was conducted for all the children (≤3 years) who attended the pediatric ophthalmology service between January 2012 and February 2017. Results: A total of 428 severely visually impaired children aged ≤3 years were seen during the study period: 264 (62%) of them were boys and I64 (38%) were girls. The average age at presentation was 14.02 months. The causes of visual impairment were cerebral visual impairment (CVI) 142 (33%), a combination of CVI and ocular visual impairment (OVI) 48 (11%), and OVI only 236 (56%), which included congenital cataract 56 (13.1%), retinopathy of prematurity 52 (I2.6%), optic atrophy 17 (4.5%), congenital nystagmus (4.4%), congenital globe anomalies 2I (5.2%), and high refractive errors - 10 (2.8%). Delays in different areas of development were seen in 103 out of 142 children with CVI (72.5%), which included motor delay 53 (51.5%), cognitive delay 15 (14.6%), speech delay in 3 (2.9%), and delay in multiple areas of development (like combination of motor, cognitive, and speech delay) in 32 (31.1%). Conclusion: In children under 3 years of age, CVI is a major cause of profound visual impairment in our area and the majority of them manifest delay in several areas of development.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Awareness, utilization and barriers in accessing assistive technology among young patients attending a low vision rehabilitation clinic of a tertiary eye care centre in Delhi p. 1548
Suraj Singh Senjam, Allen Foster, Covadonga Bascaran, Praveen Vashist
DOI:10.4103/ijo.IJO_197_19  PMID:31546478
Purpose: People with visual disability need assistive technology to improve their body functioning and performance. The purpose of the present study was to understand the awareness, use and barriers in accessing the assistive technology among young patients attending visual rehabilitation clinic of a tertiary eye care hospital in Delhi. Methods: A cross-sectional study was conducted on consecutively recruited patients registered for the first time in visual rehabilitation clinic of the community ophthalmology department of the tertiary eye centre during June and July 2018. A study tool consisting of 42 assistive technologies was developed. Patients were screened for distance visual acuity both presenting and binocular pinhole vision using an 'E' chart with two optotype (6/18, 6/60). Results: 85 patients (69.4% male) were enrolled from the VR clinic. 83.5% of the patients had a best corrected binocular vision acuity <6/18 to 1/60. There was good awareness of only 2 of the 42 devices (>67% of the participants): near optical magnifiers, walking long canes. There was moderate awareness of 10 devices (34-66% of the participants) and poor awareness of the rest (<33%). Likewise, participants reported moderate usage of 3 out of the 42 devices and poor usage of the remaining devices. Non-availability of devices was the most frequently reported barrier in the study. Conclusion: The awareness and utilization of assistive technologies for visual disability was poor in patients attending visual rehabilitation clinic. Hospitals could procure assistive technologies and introduce strategies to improve awareness as well as promote utilization.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Comparison of Plusoptix S12R photoscreener with cycloplegic retinoscopy and autorefraction in pediatric age group p. 1555
Varun Saini, Usha K Raina, Anika Gupta, Jawahar Lal Goyal, Raffat Anjum, Pallavi Saini, Shantanu Kumar Gupta, Prateeksha Sharma
DOI:10.4103/ijo.IJO_1465_18  PMID:31546479
Purpose: To compare refractive measurements of noncycloplegic photoscreener Plusoptix S12R with cycloplegic retinoscopy, noncycloplegic autorefractor, and cycloplegic autorefractor in children. Methods: The study population (200 eyes of 100 children) was divided into two groups: Group 1 (age 3–7 years) and Group 2 (age 8–15 years). In Group 1, Plusoptix was compared with cycloplegic retinoscopy. In Group 2, Plusoptix was compared with cycloplegic retinoscopy and autorefraction. The second group was made because the younger group was found to be uncooperative for autorefraction. Paired t-test and Pearson's correlation were used for statistical analysis. Results: The mean difference in sphere (DS), spherical equivalent (DSE), and cylinder (DC) between cycloplegic retinoscopy and Plusoptix in Group 1 was 0.68 ± 0.55 (P < 0.001), 0.77 ± 0.61 (P < 0.001), and 0.18 ± 0.28 (P < 0.001), respectively. In Group 2, DS, DSE, and DC between cycloplegic retinoscopy and Plusoptix were 0.86 ± 0.49 (P < 0.001), 0.97 ± 0.51 (P < 0.001), and 0.23 ± 0.28 (P < 0.001); between cycloplegic autorefractor and Plusoptix were 0.69 ± 0.47 (P < 0.001), 0.74 ± 0.49 (P < 0.001), and 0.10 ± 0.31 (P = 0.002); and between noncycloplegic autorefractor and Plusoptix were − 0.25 ± 0.39 (P < 0.001), −0.19 ± 0.41 (P < 0.001), and 0.11 ± 0.31 (P < 0.001), respectively. Pearson's correlation coefficients of S, SE, and C between Plusoptix and cycloplegic retinoscopy were 0.948, 0.938, and 0.924 in Group 1 and 0.972, 0.972, and 0.946 in Group 2, and these values were statistically significant. Bland–Altman plots showed good agreement between cycloplegic retinoscopy and Plusoptix in both groups. Plusoptix gave axis values within 10° of cycloplegic retinoscopy in 81.56% of eyes in Group 1 and in 71.44% of eyes in Group 2. Conclusion: Plusoptix photoscreener can be used for prescription of axis of cylinder in children; however, other refractive measurements must be refined by cycloplegic retinoscopy.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Smartphone photography for screening amblyogenic conditions in children p. 1560
Richa Gupta, Siddharth Agrawal, Rajat M Srivastava, Vinita Singh, Vishal Katiyar
DOI:10.4103/ijo.IJO_2090_18  PMID:31546480
Purpose: To validate the smartphone photography as a screening tool for amblyogenic conditions in children. Methods: Children between 5 to 8 years attending eye out patient department (OPD) were photographed (by an optometrist) with a smartphone to capture their pupillary red reflexes followed by clinical examination by the principal investigator (PI). The PI on the basis of clinical examination identified children with significant amblyogenic conditions and, subsequently, two ophthalmologists independently categorized the photographs on the basis of color, symmetry, and shape of the pupillary reflex into normal or abnormal. The identification of amblyogenic conditions on clinical examination was compared to that on photography. Refractive errors <3D and anisometropia <2D were excluded. Sensitivity, specificity, positive predictive value, and negative predictive value of smartphone photography screening were determined. Results: In all, 250 children were screened. Clinically 23.6% were harboring amblyogenic conditions. The mean sensitivity and specificity of screening by smartphone were 94% and 91%, respectively. Conclusion: Smartphone photography is a reliable tool for detection of amblyogenic conditions in children.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Estimation Dynamic Distance Direct Ophthalmoscopy (eDDDO): A novel, objective method for the quantitative assessment of accommodation in young children p. 1564
Mihir Kothari, Yash Jain, Daneshwar Verma, Vivek Rathod, Rishika Jain, Nitu Khadse
DOI:10.4103/ijo.IJO_1935_18  PMID:31546481
Purpose: To describe estimation dynamic distance direct ophthalmoscopy (eDDDO) and compare it with the monocular estimation method of dynamic retinoscopy (eDR) for the assessment of accommodation in children. Methods: In this prospective observational cohort study, an ophthalmologist performed eDDDO followed by eDR in children with normal eyes, and then under the partial effects of cyclopentolate and tropicamide to assess performance of eDDDO with eDR under the condition of pharmacologically induced accommodation failure. Only one eye of each child was recruited in the study. To study the inter-observer variation, two masked pediatric ophthalmology fellows performed eDDDO in the similar manner. Results: For the comparison of eDDDO with eDR, 60 eyes of 60 patients were recruited. The mean age of the patients was 10.4 years. The mean accommodation on eDDDO was 3.0D, 5.1D, 9.8D, and 11.3D at 40 cm, 25 cm, 10 cm, and 8 cm, respectively and 3.0D, 5.0D, 9.5D, and 11.0D on eDR. The eDDDO overestimated accommodation by a mean 0.17D (95% CL 0-0.48D, P = 0.5). The correlation of eDDDO with eDR was excellent (Pearson r 0.98, T value 76.0). The inter-observer difference with eDDDO was not significant (mean 1D, 95% CL 0-2.6D, P = 0.9) and the correlation between two observers was excellent (Pearson r 0.9, T value 12.7). The eDDDO and eDR were also performed on 12 eyes of 6 children with a mean age of 8.5 years (range 8-12 years) under the partial effect of cyclopentolate and tropicamide, where eDDDO overestimated the accommodation by a mean 0.3D (95% CL 0- 1.2D, P = 0.7) and the correlation was excellent (Pearson r 1.0, T value 45). Conclusion: eDDDO is a simple, reliable, quantitative, and objective technique of accommodation assessment for children. Further studies with larger sample are required to assess its performance in disorders of accommodation affecting younger children and in children with ocular comorbidities.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Eye donation in north India: Trends, awareness, influences and barriers p. 1570
Manisha Acharya, Javed Hussain Farooqui, Abhishek Dave, Deepali Chaku, KK Ganguly, Animesh Das, Umang Mathur
DOI:10.4103/ijo.IJO_2151_18  PMID:31546482
Purpose: To understand trends, awareness, influences and barriers to eye donation in Indian society. Methods: This cross sectional study was conducted in Delhi from March 2017 to February 2018. About 10 hospitals collaborated with the Eye Bank under Human Cornea Retrieval Program (HCRP). Eye Bank recruited Eye Donation Counselors (EDCs) to approach family members of the deceased. A pretested questionnaire was used for this study. Irrespective of whether the next of kin of the deceased consented for eye donation or not, the option of participating in the survey was given. Results: Out of 473 potential donors identified, 407 (86%) next of kin consented to participate in the study. Of these, 388 (95.3%) were males and 19 (4.7%) were females. About 168 (41%) consented for eye donation and were assigned to donor group, while 239 (59%) participants refused eye donation and were assigned to non-donor group. Majority of the participants were siblings 170 (41.8%) of the deceased and the mean age of the deceased was 42.71 ± 17.56 years. The foremost concern before decision-making was transparency in how the cornea would be used (32.25%). The concern with regards to whether the body would remain intact after eye donation significantly decreased the probability of consent for eye donation. Conclusion: The study highlights that barriers to eye donation in India are not cultural or religious but more due to misinformation and proper utilization of the donated tissue. This study also emphasizes the pivotal role of EDC's in facilitating the eye donation movement.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Central corneal thickness and corneal diameter in preterm and term newborns and preterm neonates at term p. 1575
Prateek Sehrawat, Sarita Beri, Rajiv Garg, Vikram Datta, Anurag Shandil
DOI:10.4103/ijo.IJO_1988_18  PMID:31546483
Purpose: To record central corneal thickness and corneal diameter in preterm and term newborns within first week of their birth and in preterm neonates at term age. Methods: Babies born at ≤34 weeks of gestation period (n = 100), term babies who have a gestation period of >37 weeks (n = 100) and preterm neonates at term age (38-42 weeks) who were born at ≤34 weeks (n = 100) were included in this hospital based observational descriptive study. Corneal diameter was taken by Castroviejo Calipers. Central corneal thickness was measured using portable ultrasonic pachymeter (Pachette 3). Refractive status of the eyes was measured using streak Wellch Allyn retinoscope under cyclopentolate cycloplegia. Results: Measure of central corneal thickness and corneal diameter in preterm newborns was found to be 633.5 ± 2.8 μm and 8.1 ± 0.6 mm, in full term newborns it was 555.1 ± 2.7 μm and 9.5 ± 0.6 mm, and in preterm neonates at term age, it was 563.5 ± 2.5 μm and 9.6 ± 0.5 mm, respectively. Mean central corneal thickness was found to be more in preterm newborns 633.5 um then term newborns 555.1 um and the difference was statistically significant (P =0.001). Mean corneal diameter was found to be maximum (9.6 mm) in preterm neonates at term age. Conclusion: Preterm babies have thick corneas and small corneal diameters. This study is useful with respect to the analysis of glaucoma in children and using preterm corneas as donor corneas in penetrating keratoplasty.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Comparison of structural integrity and functional status of corneal endothelium stored in Cornisol and Optisol-GS p. 1579
Yogapriya Sundaresan, Ganesh Govardhan Gaikwad, Kishan Anilkumar Prajapati, N Venkatesh Prajna, Gowri Priya Chidambaranathan
DOI:10.4103/ijo.IJO_2026_18  PMID:31546484
Purpose: To compare the structural integrity and functional status of the donor corneas stored in Cornisol and Optisol-GS. Methods: Fifteen optical grade corneal donor buttons (6 pairs; 3 individual) obtained from Rotary Aravind International Eye Bank were used for the study. The left eye of the paired sample was preserved in Cornisol and the right in Optisol-GS. The three individual buttons were used for the baseline data. The corneas were assessed with slit lamp and specular microscope before and after storage time (7, 10, or 14 days). They were then immunostained for markers of structural integrity (ZO-1, Phalloidin) and functionality (Na+/K+ ATPase). The images were acquired using confocal microscope and analyzed using ImageJ software. Results: There was no difference in the clinical evaluation of the corneal layers between the two media. No marked variation was observed in the immunostaining data with reference to the storage period. Intact cellular integrity was identified in 91% (51%, 98%) [Median (min, max)] of cells in Cornisol and 94% (38%, 98%) cells in Optisol based on ZO-1 staining, comparable to the baseline data [87% (76%, 97%)]. Stress fibers were detected in 42.5% (1%, 88%) cells in Cornisol stored corneas and in 55% (11%, 94%) in Optisol when stained for actin cytoskeleton, which correlated with the presence of epithelial defect before storage and vacuolated endothelial cells after storage. No difference was observed between the two media based on the staining pattern for Na+/K+ ATPase. Conclusion: Cornisol and Optisol-GS are equivalent in maintaining the structural integrity and functionality of the donor corneas.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Comparison of structural integrity and functional status of corneal endothelium stored in Cornisol and Optisol-GS p. 1584
Prema Padmanabhan
DOI:10.4103/ijo.IJO_1107_19  PMID:31546485
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Repeat keratoplasty in failed Descemet stripping automated endothelial keratoplasty p. 1586
Manpreet Kaur, Jeewan S Titiyal, Meghal Gagrani, Farin Shaikh, Tushar Agarwal, Rajesh Sinha, Namrata Sharma
DOI:10.4103/ijo.IJO_1729_18  PMID:31546486
Purpose: To evaluate the clinical factors associated with repeat Descemet stripping automated endothelial keratoplasty (DSAEK) or penetrating keratoplasty (PKP) in cases of failed DSAEK. Methods: Retrospective observational study of cases with failed DSAEK admitted to our center for a repeat keratoplasty over 5 years (January 2013–Decemeber 2017) was undertaken. Demographic and perioperative details of all cases and type of repeat keratoplasty were recorded. Logistic regression analysis was performed to analyze the factors affecting the type of repeat keratoplasty. Results: total of 94 eyes with failed DSAEK were evaluated. Repeat DSAEK was performed in 66% and PKP in 34% of cases. Significantly increased odds for requiring PKP were observed in association with stromal scarring [odds ratio (OR) = 2.9, P = 0.018)], trainee surgeons (OR = 4.05, P = 0.008), intraoperative complications (OR = 4.58, P = 0.003), scleral fixated intraocular lens or anterior chamber intraocular lens in situ (OR = 33.8, P < 0.001), secondary glaucoma (OR = 3.02, P = 0.015), peripheral anterior synechiae (OR = 8.6, P < 0.001), preoperative corneal thickness (OR = 1.01, P < 0001), time to primary surgery (OR = 1.03, P = 0.03), post-DSAEK host thickness (OR = 1.01, P < 0.001), and time interval from graft failure to regraft (OR = 1.18, P < 0.001). All eyes with congenital hereditary endothelial dystrophy, bee-sting-induced corneal decompensation, Axenfeld-Rieger syndrome, and multiple failed grafts underwent secondary PKP. All cases (nine eyes) that required surgical intervention for secondary glaucoma underwent secondary PKP (P < 0.001). Conclusion: Repeat DSAEK is feasible in up to two-third of cases of failed DSAEK. A PKP is required in one-third of cases, and various preoperative, intraoperative and postoperative factors are associated with unsuitability for repeat DSAEK.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Demographic and socioeconomic barriers and treatment seeking behaviors of patients with infectious keratitis requiring therapeutic penetrating keratoplasty p. 1593
Hem Shah, Naveen Radhakrishnan, Shivaa Ramsewak, Stephan Chiu, Sanil Joseph, Jennifer Rose-Nussbaumer, N Venkatesh Prajna
DOI:10.4103/ijo.IJO_1821_18  PMID:31546487
Purpose: To understand demographic and socioeconomic barriers and treatment-seeking behaviors of patients with infectious keratitis requiring therapeutic penetrating keratoplasty (TPK) in a developing country. Methods: This prospective non-comparative questionnaire- based study included all patients presenting to Aravind Eye Hospital, Madurai with infectious keratitis that eventuated to TPK between November 2015 and October 2016. A structured questionnaire was administered on post-operative day 3 to collect data on the demographic details, predisposing factors, prior treatment received, and treatment expenditures. Results: In total, 227 patients underwent TPK between November 2015 and October 2016 for infectious keratitis. The majority of patients were males (n = 132, 58.1%), illiterate (n = 129, 56.8%), and had a family monthly income of less than INR 6000 (n = 142, 62.5%). Most of the patients (n = 163, 71.8%) had prior treatment with an ophthalmologist before presenting to our hospital. The mean distance travelled to reach our centre was 269.2 ± 298.5 km. The mean duration of disease before the presentation was 20.3 ± 21.1 days. Corneal smear was positive for fungus in 163 (88.1%) and Aspergillus was the most commonly isolated fungi in 55 (41.3%) cultures. The mean total cost of treatment was INR 8752.87 ± 7615.39 per patient. There was a positive correlation between the duration of the disease (rho 0.19, P = 0.0034) and the costs of treatment (rho 0.2, P = 0.0024) with the distance travelled by the patient. Conclusion: Patients who travelled a farther distance had a delayed onset of presentation and spent significantly more than their respective counterparts.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Outcomes of therapeutic penetrating keratoplasty in 198 eyes with fungal keratitis p. 1599
Jyothi Mundra, Rohit Dhakal, Ashik Mohamed, Govinda Jha, Joveeta Joseph, Sunita Chaurasia, Somasheila Murthy
DOI:10.4103/ijo.IJO_1952_18  PMID:31546488
Purpose: To study the outcomes of therapeutic penetrating keratoplasty in fungal keratitis. Methods: This retrospective, observational, interventional case series involved an audit of 198 consecutive eyes that underwent therapeutic penetrating keratoplasty (ThPK) for fungal keratitis at L V Prasad Eye Institute between January 2008 and December 2010 was performed. The data on demographics, clinical characteristics, intraoperative, and late postoperative complications were noted. The primary outcome measure was eradication of infection and postoperative anatomical success. Secondary outcome measures were graft survival, risk factors, clinical features, and management of recurrent fungal keratitis post ThPK. Results: Mean follow-up after ThPK was 24 ± 17 months. A total of 178 (89.9%) eyes had complete eradication of fungal infection, whereas 20 (10.1%) eyes developed recurrence. Anatomical restoration was achieved in majority of cases (192 eyes; 97%). Larger infiltrate size was associated with a higher risk of recurrence of infection. The median graft survival rate was 5.9 months. The graft survival was better for grafts <8 mm versus those with >8 mm (P = 0.026) and not found significantly related to the species of fungus. Twenty-seven eyes underwent re-grafting: penetrating keratoplasty in 14 eyes, and Descemet's stripping endothelial keratoplasty in 13 eyes. Conclusion: As larger infiltrate prior to therapeutic keratoplasty had much higher risk of recurrences; timely surgical intervention should be considered in cases not responding to medical therapy. Alternative strategies of management of postoperative inflammation need to be considered to prevent graft failures.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Timing of therapeutic keratoplasty p. 1606
N Venkatesh Prajna, Komal Sangoi
DOI:10.4103/ijo.IJO_793_19  PMID:31546489
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Diurnal variation of central corneal thickness and intraocular pressure in eyes with pseudoexfoliation Highly accessed article p. 1607
Zeeshan Syed, Krishnagopal Srikanth, Swathi Nagarajan
DOI:10.4103/ijo.IJO_1899_18  PMID:31546490
Purpose: Pseudoexfoliation syndrome (PXS) is an age related microfibrillopathy characterized by deposition of whitish flaky material over various ocular tissues. PXS eyes are known to have thinner corneas and thus can lead to an underestimation in intraocular pressure measurement. The purpose of this study was to find if there is any variation in central corneal thickness and intraocular pressure in PXS eyes and if there was any relationship between them. Methods: A prospective observational study was done on 141 eyes of 85 patients with PXS without glaucoma between November 2015 to April 2017 in the department of Ophthalmology in a tertiary hospital. CCT and IOP were measured by a handheld ultrasonic pachymeter (DGH Technology INC. Pachette 2, USA) and Goldmann applanation tonometer respectively at 4 different times during office hours. Results: A significant reduction of about 10 μm in mean CCT and 1.4 mmHg in mean IOP was noted over the 4 sessions which was statistically significant (P < 0.001). A significant correlation exists between IOP and CCT in PXS eyes at all times during the day (P < 0.001). Conclusion: The CCT measurements show significant thinning throughout the day, similar drop in IOP was also noted. Our study shows that there is a significant correlation between diurnal variation of CCT and IOP. Hence, it is prudent to measure CCT along with IOP at all times.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Uveitis and deficient lens capsules: Effect of glued intraocular lens on the visual outcome and the reactivation of inflammation p. 1610
Dhivya Ashok Kumar, Amar Agarwal, Wasim Raja Kader Ali
DOI:10.4103/ijo.IJO_20_19  PMID:31546491
Purpose: To evaluate the visual outcome and complication profile after glued intraocular lens (IOL) in post uveitic eyes. Methods: Patients with history of uveitis who had glued IOL with 3 months antecedent quiet anterior chamber (AC) were included in this prospective observational case series. Visual acuity, slit-lamp examination, fundus evaluation, optical coherence tomography, intraocular pressure, specular count and AC inflammation were analyzed before and after glued IOL procedure. Glued IOL eyes were also compared with their fellow normal capsular bag IOL. Results: Overall 17 eyes (50.7 ± 16.1 years) were analyzed. It included 41.8%, 23.5%, and 35.29% anterior, posterior, and pan uveitis, respectively. The etiologies were tuberculosis (23.53%), toxoplasmosis (11.77%), Fuch's heterochromic cyclitis (5.88%), HLA B27 (11.77%), psoriatic arthritis (5.88%), Rheumatoid arthritis (5.8%), sarcoidosis (11.77%), herpetic kerato-uveitis (5.88%), and idiopathic (17.65%). Cataractous subluxated lens (35.3%), aphakia (23.5%), decentered IOL (23.5%) and intraoperative capsular rupture (17.6%) were the surgical indications. A significant improvement in the mean uncorrected and best corrected visual acuity (P < 0.001) was recorded. The complications were IOL pigment dispersion (47%), macular edema (41%), and epiretinal membrane (24%). There was significant rise in AC reaction on day 1 (P < 0.001) and normal AC was attained by 88.2% eyes at 6 months. AC inflammation reactivation was noted in 11.7% of eyes. Though inflammatory reactivation was similar to the normal IOL, macular edema was higher in glued IOL. Conclusion: Glued IOL can cause inflammation in uveitis eyes which can be managed medically with minimal complications.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Management of coexistent cataract and uveitis – Techniques and challenges p. 1616
Bhavana Sharma
DOI:10.4103/ijo.IJO_1157_19  PMID:31546492
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLE Top

Evaluation of collagen derived antiangiogenic factors and matrix metalloproteinases in anterior lens epithelial cells of pediatric eyes with persistent fetal vasculature p. 1618
Devarshi U Gajjar, Abhay R Vasavada, Priyanka Patel, Mamidipudi R Praveen, Sajani R Shah
DOI:10.4103/ijo.IJO_185_19  PMID:31546493
Purpose: To measure levels of collagen-derived antiangiogenic factors (arresten, canstatin, tumstatin, endostatin) and matrix metalloproteinases (MMP-2 and MMP-9) in anterior lens epithelial cells (LECs) and anterior capsules of children with cataract and persistent fetal vasculature (PFV) as cases and cataract without PFV as controls. Methods: Anterior capsules harboring LECs were collected from pediatric cataract patients with (n = 13) and without PFV (n = 13) during surgery. Samples were immediately subjected to RNA extraction and cDNA preparation. Quantitative real time PCR was performed to determine the mRNA levels of antiangiogenic factors and matrix metalloproteinases. GAPDH (Glyceraldehyde 3-Phosphate Dehydrogenase) and β Actin were used as the housekeeping control. The mRNA levels were expressed as a ratio, using the delta-delta method for comparing the relative expression results between controls and cases. The non-parametric Mann-Whitney U test was applied for statistical evaluation. P values < 0.05 were statistically significant. Results: The relative mRNA levels of arresten, canstatin, tumstatin, endostatin, MMP-2 and MMP-9 in cases were 6.20E-03 ± 0.003, 1.49E-01 ± 0.02, 1.70E-01 ± 0.007, 3.20E-03 ± 0.003, 1.11E-03 ± 0.0009 and 3.72E-04 ± 0.0001. The mRNA levels of arresten was 1.6 times lower (P = 0.01) while mRNA levels of MMP-2, tumstatin and canstatin were 4, 2.5, and 2.3 times higher in cases than in controls. No change was observed in mRNA levels of MMP-9 and endostatin (P = 0.82). Conclusion: A significant difference in the levels of arresten, canstatin, tumstatin, and MMP-2 was found in LECs with PFV.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Understanding angiogenic factors in pathogenesis of persistent fetal vasculature p. 1622
Sudarshan Khokhar, Chirakshi Dhull
DOI:10.4103/ijo.IJO_1156_19  PMID:31546494
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLE Top

Light exposure from microscope versus intracameral illumination during cataract surgery p. 1624
Yu Jeong Kim, Dong Heun Nam, Young Jae Kim, Kwang Gi Kim, Seong-Woo Kim, Tae-Young Chung, Sung Jin Lee, Kyu Hyung Park
DOI:10.4103/ijo.IJO_316_19  PMID:31546495
Purpose: To evaluate light exposure from microscope versus intracameral illuminations to patient's and surgeon's retina during cataract surgery. Methods: Thirty consecutive patients who had cataract surgery using microscope and intracameral illuminations. At the point of the ocular of an operating microscope, optical illuminance and irradiance from the microscope illumination (60, 40, 20% intensity) and the intracameral illumination (60% intensity) were measured using a light meter and a spectrometer at a pause after lens capsule polishing in cataract surgery. Results: Average illuminance (lux) was 1.46, 0.66, 0.27, and 0.1 from 60%, 40%, 20% intensity microscope illuminations and 60% intracameral illumination. Average total spectral irradiance (μW/cm2) was 1.25, 0.65, 0.26, and 0.03 from 60%, 40%, 20% intensity microscope illuminations and 60% intracameral illumination. Conclusion: Microscope ocular illuminance and irradiance during cataract surgery were higher in the microscope illumination than in the intracameral illumination. It suggests that light exposure reaching patient's and surgeon's retina during cataract surgery is lower in the intracameral illumination than in the microscope illumination.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Intracameral illumination for cataract surgery p. 1627
Lakshey Dudeja
DOI:10.4103/ijo.IJO_1143_19  PMID:31546496
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Bimanual irrigation-aspiration for ectopia lentis and use of a small incision for 4-point scleral-sutured foldable intraocular lens and anterior vitrectomy in patients with Marfan syndrome p. 1629
Zhenmao Wang, Yan Lu, Kailin Xiao, Ying Gao, Jing He, Shaobin Zhang, Geng Wang, Mingzhi Zhang
DOI:10.4103/ijo.IJO_250_19  PMID:31546497
Purpose: This study evaluated bimanual intracapsular irrigation-aspiration for ectopia lentis with use of a small incision for 4-point scleral fixation of a foldable posterior-chamber intraocular lens (IOL) and anterior vitrectomy in patients with Marfan syndrome. Methods: We performed a retrospective study of 18 eyes from 10 patients with Marfan syndrome who underwent surgical intervention for ectopia lentis at our clinic between July 2012 and September 2018. In this study, intraoperative and postoperative complications, uncorrected visual acuity, best-corrected visual acuity, spherical equivalent, intraocular pressure, and endothelial cell density were evaluated. Results: No intraoperative complications were reported. In all cases, early postoperative evaluation revealed a clear cornea, round pupil, and well-centered IOL. Mean logMAR uncorrected visual acuity improved from 1.09 preoperatively to 0.56 postoperatively (P < 0.05). Mean logMAR best-corrected visual acuity improved from 0.45 preoperatively to 0.17 postoperatively (P < 0.05). Aside from transient ocular hypertension, no postoperative complications were reported. Conclusion: The combined surgical technique presented above yields excellent visual outcomes with an extremely low incidence of complications. This approach is simple, safe, and effective in the treatment of ectopia lentis in patients with Marfan syndrome.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Impact of fluidic parameters during phacoemulsification on the anterior vitreous face behavior: Experimental study p. 1634
Vaishali Vasavada, Samaresh Srivastava, Viraj Vasavada, Shail Vasavada, Abhay R Vasavada, Aditya Sudhalkar, Alper Bilgic
DOI:10.4103/ijo.IJO_465_19  PMID:31546498
Purpose: To evaluate the eff ect of different aspiration flow rates (AFR) and bottle heights (BH) on vitreous face (AVF) during phacoemulsifi cation. Methods: Experimental study in 20 porcine eyes. Transzonular viscodissection was performed between the posterior capsule(PC) and AVF to dissect out the Berger's space. Triamcinolone acetonide was injected into this space to aid visualization with ultrasound B-Scan(USG). Realtime USG was performed during phacoemulsifi cation. Eyes were divided randomly into–Group I: Low parameters(AFR = 20 cc/min, BH = 90 cm, vacuum = 400 mmHg),and Group II: High parameters (AFR = 40 cc/min, BH = 110 cm, vacuum=650 mm Hg). Results: 15 eyes were analysed (8 in Group I; 7 in Group II). In all eyes, forward and backward movement of the PC was seen when going from foot position 0 to 1, or on occlusion break. Amplitude of these movements was much greater in Group II compared to Group I. There was no PC rupture in either group. In 2 of the 7 eyes in Group II, USG showed a sudden, spontaneous dispersion appearance of sono-opaque echoes in the vitreous cavity alongwith disappearance of the well-defi ned, crescentic stained space despite an intact PC. This suggests rupture of the AVF, leading to dispersion of the triamcinolone into the entire vitreous cavity. No AVF rupture was seen in Group I. Conclusion: We report a rarely described entity of AVF rupture with intact PC. The use of high AFR and BH may have clinically invisible detrimental consequences to the anterior vitreous face.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Correlation of iris collagen and in-vivo anterior segment structures in patients in different stages of chronic primary angle-closure in both eyes p. 1638
Chuchen Chung, Miaomiao Dai, Jialiu Lin, Zhonghao Wang, Hailiu Chen, Jingjing Huang
DOI:10.4103/ijo.IJO_1406_18  PMID:31546499
Purpose: To compare the density of iris collagen and anterior segment parameters in eyes with chronic primary angle closure glaucoma (CPACG) and their fellow eyes with confirmed or suspected primary angle closure (PAC/PACS). Methods: Nineteen patients with CPACG in one eye and PAC/PACS in the fellow eye requiring trabeculectomy in the CPACG eye and iridectomy in the fellow eye were recruited. Anterior segment optical coherence tomography (AS-OCT) measurements were conducted under light and dark conditions. Iris specimens, obtained by iridectomy/trabeculectomy, were analyzed by sirius red polarization for quantifying type I/III collagen density. AS-OCT parameters and type I/III collagen densities were compared between the two eyes. Results: The iris curvatures were flatter in CPACG eyes in light and dark conditions (P < 0.05). The iris areas in light condition and iris thicknesses in dark condition were smaller in CPACG eyes (P < 0.05). The density of collagen type I in CPACG eyes was lower (P = 0.048). The light-to-dark changes in CPACG eyes and PAC/PACS eyes, respectively, were −0.679 ± 0.701 and −1.627 ± 0.802 mm for pupil diameters, and 0.069 ± 0.113 and 0.258 ± 0.157 mm2 for iris areas, which differed significantly (P < 0.001). With the decrease of type I collagen, anterior chamber width increased and iris areas decreased in dark condition. Conclusion: Dynamic changes in pupil diameter and iris areas differed significantly between CPACG eyes and their fellow PAC/PACS eyes. Decreased type I collagen density in iris tissue was associated with decreased iris area and increased anterior chamber width, which may contribute to disease progression.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Evaluation of the vitreous chamber depth: An assessment of correlation with ocular biometrics p. 1645
Brijesh Takkar, Nripen Gaur, Gunjan Saluja, Anubha Rathi, Bhavana Sharma, Pradeep Venkatesh, Atul Kumar
DOI:10.4103/ijo.IJO_56_19  PMID:31546500
Purpose: The mechanism of ocular growth eludes us and research on vitreous chamber depth (VCD) is lacking. The purpose of this study was to evaluate the role of VCD and its ratio to axial length (AL) in relation to ocular biometry. Methods: This retrospective study of patients planned for cataract surgery was performed at a tertiary center. Data regarding AL, anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT) of 640 eyes was noted. Anterior segment (AS) was measured as sum of CCT, ACD, and LT, while VCD was calculated as the difference between AL and AS. Correlation of VCD and VCD: AL with ocular biometry was the primary outcome measure. Three groups were formed on the basis of AL and Pearson correlation coefficient (R) was applied. Results: Mean VCD was 15.38+/−1.14 mm. Mean VCD: AL was 0.66+/−0.02. VCD had a very strong relation with AL (R = 0.9, P < 0.001) only, whereas VCD: AL had a good--strong relation with AL (R = 0.5, P < 0.001), AS (R = 0.7, P < 0.001), ACD (R = 0.3, P < 0.001), and LT (R = 0.5, P < 0.001). The relation of VCD: AL with AS was very strong across all groups (R ≤ -0.8, P < 0.001 in all groups). 85% of eyes in group with AL <22 mm had VCD: AL <0.67, conversely 85% of eyes with AL >24.5 mm had VCD: AL >0.67. Conclusion: We found VCD to have the strongest relation with AL. VCD: AL was more consistent and showed a strong relation to ocular biometry across all ALs. This suggests the possible utility of the ratio VCD: AL while evaluating ocular growth, refractive status, and myopia-related complications.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Pattern of steroid misuse in vernal keratoconjunctivitis resulting in steroid induced glaucoma and visual disability in Indian rural population: An important public health problem in pediatric age group p. 1650
Pradhnya Sen, Swapnil Jain, Amit Mohan, Chintan Shah, Alok Sen, Elesh Jain
DOI:10.4103/ijo.IJO_2143_18  PMID:31546501
Purpose: To know the pattern of presentations and management outcome of steroid induced glaucoma in vernal keratoconjunctivitis (VKC). Methods: Children of VKC using steroid with two of the following criteria were enrolled: Intraocular pressure (IOP) >21 mm Hg, glaucomatous optic disc and visual field defects. Misused topical steroids were classified in 4 groups; A- Highly potent drugs (dexamethasone, betamethasone), B- Moderate (prednisolone), C- Weak (loteprednol, fluorometholone), D- Unknown drugs. Active/conservative interventions were done to control IOP. Corrected distance visual acuity (CDVA), IOP, anterior segment and fundus examinations were noted. One-way ANOVA test and post hoc Tukey HSD test were used to compare the groups. Results: Out of 1423 VKC patients, 240 were using topical steroid without prescriptions. 92 eyes of 47 patients had steroid induced glaucoma. Hence prevalence of this complication was 3.30% in this study population. Mean age was 14.1 ± 3.8 years. Mean IOP was 38 ± 12 mm of Hg and mean vertical cup disc ratio was 0.67 ± 0.25. IOP was controlled by withdrawal of steroids (9 eyes), with antiglaucoma medications (27), trabeculectomy (57) and glaucoma drainage device (1). Mean CDVA at presentation was better in group C (0.23 log MAR). Mean IOP was highest in group A (43.1 mm Hg) followed by group D (40.5 mm Hg). At presentation 17 were blind (CDVA <3/60). Post treatment marginal improvement in CDVA was found (P = 0.46). However, statistically significantly improvement was noticed in IOP (P < 0.00001). Conclusion: Injudicious use of steroids leads to vision threatening complications like ocular hypertension and glaucoma in children of VKC. Weak steroids like loteprednol or fluorometholone should be used instead of higher potency drugs. Vision and IOP should be monitored fortnightly in children using topical steroids to detect steroid responders at the earliest.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Blindness from glaucoma associated with steroid abuse in children p. 1655
R Krishnadas
DOI:10.4103/ijo.IJO_946_19  PMID:31546502
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Structural evaluation of perimetrically normal and affected hemifields in open angle glaucoma p. 1657
Gunjan Deshpande, Prashant Bawankule, Dhananjay Raje, Moumita Chakraborty, Richa Gupta
DOI:10.4103/ijo.IJO_1755_18  PMID:31546503
Purpose: To study macular ganglion cell layer--inner plexiform layer complex (GCL + IPL) in relation to peripapillary retinal nerve fiber layer (RNFL) in glaucomatous eyes with superior or inferior hemifield defects (HD) and to study structural configuration in normal hemifield. Methods: This was an observational cross-sectional study. Data from consecutive 45 superior HD (SHD) and 50 inferior HD (IHD) eyes were analyzed. Each patient underwent detailed ocular examination, standard automated perimetry, and spectral domain optical coherence tomography (SD-OCT). After adjusting for age, gender, and signal strength, area under receiver operating characteristic curve (AUC) was calculated to determine diagnostic ability of GCL + IPL and peripapillary RNFL. Apparently normal hemifield was compared with true normal hemifield. Data were analyzed with SPSS, analysis of variance, t-test, Chi-square test, and receiver operating curve. Results: In the SHD glaucoma group, best parameters for discriminating normal eyes from glaucomatous eyes were inferotemporal GCL + IPL thickness (0.935) and inferior quadrant RNFL thickness (0.971). For IHD glaucoma, average GCL + IPL thickness (0.877) and average RNFL thickness (0.950) had best AUC values. When evaluating apparently normal hemifield in both groups, statistically significant difference was found in inferior GCL + IPL sector (0.865) and inferior quadrant RNFL (0.883) in IHD and superonasal GCL + IPL (0.725) and superior quadrant RNFL (0.842) in SHD groups. Conclusion: SD-OCT may be a useful ancillary diagnostic tool for evaluation of early macular and circumpapillary structural changes in glaucomatous eyes with localized visual field defects. Apparently normal hemifields show structural damage and should be considered in management of glaucoma.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Clinical, ultrasonographic and optical coherence tomography correlation of optic nerve head cupping in glaucoma patients p. 1663
Amar Pujari, Deepa R Swamy, Harathy Selvan, Divya Agarwal, Ramanjit Sihota, Sikha Gupta, Nikita Gupta, Tanuj Dada
DOI:10.4103/ijo.IJO_24_19  PMID:31546504
Purpose: To ascertain if ultrasound (USG) B-scan examination of the optic nerve head (ONH) can be a useful tool to diagnose and quantify glaucomatous cupping. Methods: A cross-sectional observational study of 48 eyes of 48 patients with clear ocular media and cup-disc ratio of (CDR) ≥0.6 were included. The disc was studied by + 90D examination, USG B-scan and ONH Optical coherence tomography (OCT) by three masked observers. Observer-1 assessed the clinical CDR, observer-2recordedopticcup diameter on USG B-scan and observer-3performed ONH OCT to note the software computed average CDR. Measurements of cupping obtained by these 3 methods were compared and their relative strengths determined. The interdependency between variables was further studied using regression analysis. Results: Clinically assessed disc ratios of 0.6, 0.7, 0.8, 0.9, and total corresponded to USG cup measures of 1.02 ± 0.11 mm, 1.23 ± 0.14 mm, 1.35 ± 0.072 mm, 1.45 ± 0.084 mm, 1.75 ± 0.15 mm and OCT average CDR of 0.62 ± 0.087, 0.68 ± 0.060, 0.75 ± 0.078, 0.81 ± 0.036, 0.89 ± 0.038, respectively. There was an excellent correlation between the three arms, with Pearson's co-efficient (r) of 0.87, P < 0.001 between clinical and USG cupping; r = 0.89, P < 0.001 between clinical and OCT cupping; and r = 0.88, P < 0.001 between USG and OCT cupping. A relation of y = 1.64x + 0.03 was obtained between them, where y stands for USG cup diameter and x stands for the observed clinical CDR. Conclusion: Ultrasonographic measurement of optic cup diameter corresponds well to clinical ONH cupping. Therefore, it can reliably be used in quantifying ONH cupping in cases of media opacities which preclude optic disc visualization.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Diurnal variation in subfoveal and peripapillary choroidal vascularity index in healthy eyes p. 1667
Sumit Randhir Singh, Mohammed Abdul Rasheed, Abhilash Goud, Niroj Kumar Sahoo, Kiran Kumar Vupparaboina, Jay Chhablani
DOI:10.4103/ijo.IJO_2063_18  PMID:31546505
Purpose: To report the diurnal variation in choroidal vascularity index (CVI) in subfoveal (SF-CVI) and peripapillary area in healthy eyes. Methods: The study was a cross-sectional study including 12 healthy subjects. Swept-source optical coherence tomography scans were taken at 9 am, 11 am, 1 pm, 3 pm, and 5 pm. Subfoveal choroidal thickness (SFCT) and CVI were calculated using automated segmentation techniques and previously validated algorithms. Systemic parameters including systolic blood pressure (SBP), diastolic blood pressure, mean arterial pressure, and mean ocular perfusion pressure were calculated and correlated with SFCT and CVI. Results: A total of 12 eyes (right eye) of 12 patients (mean age: 26 ± 3.77 years) were analyzed. The mean (±standard deviation) amplitude of SFCT and SF-CVI variation was 35.91 ± 14.8 μm (range, 15–69 μm) and 0.05 ± 0.02 (range, 0.02–0.08). The mean CVI showed a significant diurnal variation in the temporal quadrant of the peripapillary region (P = 0.02). Conclusion: SFCT and SF-CVI showed a significant diurnal variation in amplitude (peak–trough analysis) and SF-CVI correlated well with SBP suggestive of a direct influence of blood pressure on choroidal vascularity. The mean peripapillary CVI in the temporal quadrant also showed a significant diurnal variation with no significant change in other quadrants.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Morphometric analysis of retinal arterioles in control and hypertensive population using adaptive optics imaging p. 1673
Ruchir A Mehta, Mukund C Akkali, Chaitra Jayadev, Aishwarya Anuj, Naresh K Yadav
DOI:10.4103/ijo.IJO_253_19  PMID:31546506
Purpose: To measure the wall-to-lumen ratio (WLR) and the vascular wall cross-sectional area (WCSA) of retinal arterioles by an Adaptive Optics (AO) retinal camera using semi-automated software and comparing them between control and hypertensive population. Methods: This was a cross-sectional observational study including a hypertensive group and a control group. Subjects were examined and their medical history recorded. Retinal arteriolar morphometry was assessed by rtx1 AO retinal camera using AOdetect Artery semiautomated software. Main Outcome Measures: WLR and WCSA were measured on the basis of retinal arteriolar wall thickness (W1, W2), lumen diameter (LD) and vessel diameter (VD). Influence of age and arterial hypertension on the WLR and WCSA were examined. Results: A total of 150 human subjects were included out of which 110 were controls and 40 were hypertensives under treatment. There was statistically significant difference in the age, systolic and diastolic blood pressures between the control and hypertensive groups (P < 0.01). We found no significant correlation between age and WLR (R2 = 0.049, P > 0.05) or age and WCSA (R2 = 0.045, P > 0.05). We observed a significant difference in WLR and WCSA measurements between control and hypertensive groups (P < 0.01). On measuring intra-observer variability (IOV) we found excellent consistency. Conclusion: AO retinal imaging allows a direct measurement of the retinal vessel wall and LD with excellent IOV. WLR and WCSA reflect the remodelling process and can be used to further aid the early detection and monitoring of systemic hypertension.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Treatment outcomes of pachychoroid neovasculopathy with photodynamic therapy and anti-vascular endothelial growth factor p. 1678
Rupak Roy, Kumar Saurabh, Dhaivat Shah, Sugandha Goel
DOI:10.4103/ijo.IJO_1481_18  PMID:31546507
Purpose: To describe treatment outcomes of eyes with pachychoroid neovasculopathy (PNV) with PDT and anti-(vascular endothelial growth factor) VEGF therapy. Methods: Retrospective interventional case series. Records of six consecutive cases of PNV were reviewed. Four cases were treated with PDT+ inj ranibizumab. Two cases underwent only PDT. Final visual outcomes and functional outcome including macular status and choroidal thickness were assessed. Results: We analysed six eyes of six patients with PNV. There were four males and two females. Mean age of the patients was 56.5 years. Mean duration of follow up was 8.2 months. All patients received reduced fluence PDT. Four patients received ranibizumab along with PDT; mean BCVA at presentation was 0.41 log MAR units and mean BCVA at final follow up was 0.44 log MAR units. There was significant improvement at final follow up (P = 0.03). Mean subfoveal choroidal thickness (SFCT) at presentation was 445 microns and mean SFCT at final follow up was 293 microns. There was a significant reduction at final follow up (P = 0.02). Conclusion: PDT with or without ranibizumab appears to be an effective treatment modality for PNV.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
SURGICAL TECHNIQUE Top

Combination of capsular tension ring and capsular tension segment for the management of lens coloboma >4 clock hours p. 1684
Deepika Dhingra, Chintan Malhotra, Vaneet Jakhar, Vikash Rohilla, Avinash Negi, Arun Kumar Jain
DOI:10.4103/ijo.IJO_1762_18  PMID:31546508
Lens colobomas extending more than 4 clock hours and causing visual impairment require lens extraction along with capsular support devices with scleral fixation for adequate centration of the capsular bag and for prevention of capsular fornix aspiration with inadvertent extension of zonular dialysis intraoperatively. In this case series, we describe a technique for the management of isolated lens colobomas involving 4–5 clock hours by clear lens extraction and intraocular lens implantation using a combination of a capsular tension ring with a capsular tension segment (CTS) for the centration and stability of the capsular bag. Hoffman's corneoscleral pocket and half-bow sliding knot technique were used for scleral fixation of the CTS.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Extraocular muscle surgery on goats' eye: An inexpensive technique to enhance residents' surgical skills p. 1688
Amar Pujari, Shabeer Basheer, Vaishali Rakheja, Meghal Gagrani, Rohit Saxena, Swati Phuljhele, Pradeep Sharma
DOI:10.4103/ijo.IJO_89_19  PMID:31546509
Hands-on resident surgical training for various ocular procedures is essential to impart good surgical skills to the budding ophthalmologists. Here in this report, we demonstrate a simple and inexpensive technique of performing extraocular muscle surgery on goats' eye. These animal eyes possess soft tissue resemblance to that of human eyes to a greater extent in terms of scleral rigidity, muscle elasticity, its width, thickness, and its insertion onto the sclera. Therefore, rectus muscle recession, resection, and plication surgeries can be performed repeatedly to improve an individual's orientation and practical experience before performing the procedure on human eyes.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
INNOVATION Top

Anterior segment photography with intraocular lens Highly accessed article p. 1690
Prithvi Chandrakanth, P Nallamuthu
DOI:10.4103/ijo.IJO_52_19  PMID:31546510
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: The glued intraocular lens smartphone microscope p. 1692
John Davis Akkara, Anju Kuriakose
DOI:10.4103/ijo.IJO_986_19  PMID:31546511
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
PHOTO ESSAY Top

An interesting case of factitious pseudomembranous conjunctivitis p. 1693
Vinay Ramachandra Murthy, Roopashri Matada, Ajinkya Vivekrao Deshmukh, Lakshmi Samak, Vinay Vasanth Kulkarni
DOI:10.4103/ijo.IJO_223_19  PMID:31546512
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Target sign: An applanation epitheliopathy p. 1694
Reena Durai, Prabhakar Singh, Muralidhar Ramappa
DOI:10.4103/ijo.IJO_451_19  PMID:31546513
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Anterior segment optical coherence tomography in Terrien marginal degeneration p. 1695
Neha Goel, Gaurav Shukla, Aanchal Mehta, Jyoti Batra
DOI:10.4103/ijo.IJO_1962_18  PMID:31546514
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Swept source optical coherence tomography in globe perforation p. 1697
Devashish Dubey, Mahesh Shanmugam, Rajesh Ramanjulu, K C Divyansh Mishra, Bindiya Doshi
DOI:10.4103/ijo.IJO_738_19  PMID:31546515
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Spontaneous attachment of detached Descemet membrane following deep anterior lamellar keratoplasty p. 1698
Jitender Jinagal, Tanu Singh, Sudesh K Arya
DOI:10.4103/ijo.IJO_339_19  PMID:31546516
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Application of photoactivated chromophore for infectious keratitis-corneal collagen crosslinking for fungal phaco-tunnel infection p. 1700
Anchal Thakur, Amit Gupta, Sabia Handa
DOI:10.4103/ijo.IJO_123_19  PMID:31546517
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: PACK-CXL in fungal keratitis p. 1701
Rashmi Deshmukh
DOI:10.4103/ijo.IJO_993_19  PMID:31546518
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
PHOTO ESSAY Top

A rare case of type 1 unilateral 'peripheral' Peters' anomaly p. 1702
Chintan Shah, Pradhnya Sen, Amit Mohan, Kriti Chandra, Elesh Jain
DOI:10.4103/ijo.IJO_725_19  PMID:31546519
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Vascular perfusion in persistent pupillary membrane of the iris p. 1704
Michael Chang, David Ancona-Lezama, Carol L Shields
DOI:10.4103/ijo.IJO_311_19  PMID:31546520
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Diagnosing the oil drop: A case report and review of the literature p. 1705
Riddhi J Chhapan, Revathi Yerramneni, Muralidhar Ramappa
DOI:10.4103/ijo.IJO_2022_18  PMID:31546521
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Sequelae of neglected hypermature senile cataract p. 1707
Pranita Sahay, Siddhi Goel, Prafulla K Maharana, Namrata Sharma, Jeewan S Titiyal
DOI:10.4103/ijo.IJO_578_19  PMID:31546522
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Intraocular lens biofilm formation supported by scanning electron microscopy imaging p. 1708
Dipankar Das, Harsha Bhattacharjee, Krishna Gogoi, Jayanta K Das, Puneet Misra, Pushkar Dhir, Apurba Deka
DOI:10.4103/ijo.IJO_467_19  PMID:31546523
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Brown-McLean syndrome after phacoemulsification p. 1710
MH Mallikarjun, V Kavitha, J Rajashekar, BV Roopasree, Ankit Deokar
DOI:10.4103/ijo.IJO_282_19  PMID:31546524
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Bilateral acute angle closure as presenting feature of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) p. 1711
Abhilasha Sanoria, Ritu Arora, Pallavi Dokania
DOI:10.4103/ijo.IJO_169_19  PMID:31546525
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Managing a recurrence of choroidal tuberculoma two years following primary therapy p. 1713
Rohan Chawla, M Dheepak Sundar, Arpith Sharma, Nasiq Hasan
DOI:10.4103/ijo.IJO_562_19  PMID:31546526
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Systemic sarcoidosis presenting as optic nerve head granuloma p. 1714
Srikanta Kumar Padhy, Vinod Kumar
DOI:10.4103/ijo.IJO_1979_18  PMID:31546527
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Optical coherence tomography angiography in situs inversus of the optic discs p. 1716
Gaurav Gupta, Simar R Singh, Vijay K Sharma, Mohit Dogra
DOI:10.4103/ijo.IJO_664_19  PMID:31546528
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Macular vortex vein with choroidal neovascularisation in pathologic myopia p. 1717
Ike M Schouten, Amit H Palkar, Muna Bhende
DOI:10.4103/ijo.IJO_130_19  PMID:31546529
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Multimodal imaging of benign concentric annular macular dystrophy p. 1719
Aarti Jain, Giridhar Anantharaman, Anubhav Goyal, Mahesh Gopalakrishnan
DOI:10.4103/ijo.IJO_1911_18  PMID:31546530
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Periorbital necrotizing fasciitis due to Klebsiella pneumoniae in an immunocompetent patient p. 1721
Rouli Sud, Pallavi Sharma, Gulshan Garg, Brijesh Takkar, Sumeet Khanduja
DOI:10.4103/ijo.IJO_360_19  PMID:31546531
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
OPHTHALMIC IMAGES Top

Double arcus cornealis p. 1723
Mohamed I Asif, Shreya Nayak, Amar Pujari, Namrata Sharma, Tushar Agarwal
DOI:10.4103/ijo.IJO_402_19  PMID:31546532
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Resolution of Kayser–Fleischer ring in Wilson disease p. 1724
Surbhi Khurana, Parul Chawla Gupta, Jagat Ram
DOI:10.4103/ijo.IJO_957_19  PMID:31546533
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Anterior segment optical coherence tomography to differentiate adenoviral subepithelial infiltrates and scars p. 1725
Nikhil S Gokhale
DOI:10.4103/ijo.IJO_926_19  PMID:31546534
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Spontaneous Amsler's sign - A unique presentation p. 1726
S Bala Murugan, Subhashini Manoharan, Kiruthika Devi Thiyagarajan
DOI:10.4103/ijo.IJO_393_19  PMID:31546535
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Bilateral segmental accessory iris membrane with narrow anterior chamber angle p. 1727
Bonnie Nga Kwan Choy, Ming Ming Zhu, Jonathan Cheuk Hung Chan
DOI:10.4103/ijo.IJO_68_19  PMID:31546536
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Spontaneous dislocation of a morgagnian nucleus p. 1728
Deepika Dhingra, Sushmita Kaushik, Surinder Singh Pandav
DOI:10.4103/ijo.IJO_2119_18  PMID:31546537
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Cataract with posterior capsule rupture following intravitreal injection p. 1729
Nawazish Shaikh, Vinod Kumar, Abhijeet Beniwal
DOI:10.4103/ijo.IJO_811_19  PMID:31546538
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

A case of anterior uveitis, macular cyst and retinal detachment following electric shock injury p. 1730
Ashish Mitra, Alok Sen, Pratik Shenoy
DOI:10.4103/ijo.IJO_144_19  PMID:31546539
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Unilateral giant macular hole in a case of Alport syndrome p. 1731
Bhavik Panchal, Shreyansh Doshi, Avinash Pathengay
DOI:10.4103/ijo.IJO_650_19  PMID:31546540
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Hemorrhagic macular intraretinal macrocyst in long-standing rhegmatogenous retinal detachment p. 1732
Bhavik Panchal, Hrishikesh Kaza, Shreyansh Doshi, Avinash Pathengay
DOI:10.4103/ijo.IJO_704_19  PMID:31546541
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Multimodal imaging of fovea plana in oculocutaneous albinism p. 1733
Simar R Singh, Sahil Jain, Savleen Kaur, Mohit Dogra
DOI:10.4103/ijo.IJO_889_19  PMID:31546542
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Bullous retinoschisis p. 1734
Sabia Handa, Atul Arora, Nitin Kumar, Reema Bansal
DOI:10.4103/ijo.IJO_193_19  PMID:31546543
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Optic disc coloboma: Glaucoma imitator p. 1735
Tarannum Mansoori, Sritha Vemuganthi, Satish Gooty Agraharam
DOI:10.4103/ijo.IJO_494_19  PMID:31546544
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Intraorbital paragonimus infection p. 1736
Yong Xia, Jun Chen, Long Yi Chen
DOI:10.4103/ijo.IJO_295_19  PMID:31546545
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

“Guitar pick sign” on MRI p. 1737
Venkatraman Indiran
DOI:10.4103/ijo.IJO_404_19  PMID:31546546
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Enterobious vermicularis induced infectious keratitis following penetrating keratoplasty p. 1738
Sabia Handa, Bruttendu Moharana, Vivek Jha, Suryaprakash Sharma, Manpreet Singh, Pankaj Gupta
DOI:10.4103/ijo.IJO_336_19  PMID:31546547
A 28-year-old man with a prior history of penetrating keratoplasty in the left eye for total corneal melt presented with a 3-day history of a red, painful left eye. On examination, he was found to have graft infiltrates. Microscopic examination of wet mount preparation of corneal scrapings revealed the presence of embryonated eggs of E. vermicularis. Cellophane (scotch) tape preparation from perianal region also revealed embryonated eggs of E. vermicularis as well as live adult worms. Ocular and adnexal involvement by E. vermicularis is extremely rare. Here, we report the first case of infection of a corneal graft with E. vermicularis.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Reversal of laser in situ keratomileusis interface fluid after Descemet stripping automated endothelial keratoplasty for pseudophakic bullous keratopathy p. 1740
Arjun Srirampur, Anupama Kalwad, Tarannum Mansoori, Satish Agraharam
DOI:10.4103/ijo.IJO_227_19  PMID:31546548
To report a case of interface fluid syndrome (IFS) after laser-assisted in situ keratomileusis (LASIK) in a patient with Anterior chamber intraocular lens (ACIOL) induced corneal decompensation treated with Descemet's stripping automated endothelial keratoplasty (DSAEK). At 6 months follow-up, the cornea became clear with improvement in visual acuity and resolution of interface fluid.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Arcuate keratotomy infiltration following uneventful femtosecond laser assisted cataract surgery p. 1742
Partha Biswas, Sumana Chatterjee, Sneha Batra, Aniket Ginodia, Preeyam Biswas
DOI:10.4103/ijo.IJO_72_19  PMID:31546549
An 84-year-old gentleman underwent uneventful femtolaser-assisted cataract surgery (FLACS) with an arcuate keratotomy (AK) in the left eye. On the 18th post-operative day, a corneal infiltrate developed involving the AK. Staphylococcus epidermidis was the organism isolated on culture. The infiltrate resolved with topical fortified vancomycin and amikacin eyedrops, and the patient regained a visual acuity of 6/6 after 12 weeks. This is the first case from south-east Asia reported in the literature of an infective infiltrate along a femtosecond laser AK. We propose strict peri-operative recommendations to be followed to prevent and treat such infections.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Challenges during femtosecond laser assisted cataract surgery with posterior chamber phakic intraocular lens p. 1744
Manas Nath, Prasanth Gireesh
DOI:10.4103/ijo.IJO_1852_18  PMID:31546550
Femtosecond laser-assisted cataract surgery was performed in a patient with high myopia, who had undergone posterior chamber phakic intraocular lens surgery (Implantable Collamer Lens, ICL). During docking the machine erroneously focused the laser on the anterior surface of ICL and laser for lens fragmentation was also defocused, which were correctly positioned before laser delivery. During laser application for capsulotomy, air bubbles were entrapped under the ICL prohibiting lens fragmentation. One must be careful during focusing the laser in eyes with ICL. Additionally, gas bubbles under the ICL may lead to difficulties in completion of nuclear disassembly.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Femtosecond laser assisted cataract surgery in cataract with phakic intraocular lenses in situ p. 1746
Jeewan S Titiyal, Manpreet Kaur
DOI:10.4103/ijo.IJO_1173_19  PMID:31546551
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Novel technique for traumatic cyclodialysis repair with phacoemulsification and Cionni's ring implantation p. 1748
Alok Sen, Rajesh Joshi, Rashmi Kashikar, Tanya Jain
DOI:10.4103/ijo.IJO_394_19  PMID:31546552
A 17-years-old boy presented with cataract, 360° choroidal effusion and disc oedema secondary to chronic hypotony. Gonioscopy and AS-OCT revealed 2 clock hours of cyclodialysis in the superonasal quadrant. The case was successively managed with phacoemulsification with foldable IOL in the bag and Cionni's ring sutured in the superonasal quadrant. Post surgery, the BCVA improved from counting finger 1 meter to 20/40. IOP returned to normal and there was resolution of choroidal effusion and fundus signs. The case highlights the use of Cionni's ring in management of small cyclodialysis cleft by providing internal compression.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Anterior segment dysgenesis and secondary glaucoma in Goldenhar syndrome p. 1751
Deepika Dhingra, Gunjan Joshi, Sushmita Kaushik, Surinder S Pandav
DOI:10.4103/ijo.IJO_301_19  PMID:31546553
A 3-year-old girl presented with a history of watering, haze and increase in the size of the right eye for two months. The child had bilateral preauricular skin tags, limbal dermoid and dermolipoma, consistant with the diagnosis of Goldenhad syndrome. In addition, her right eye manifested enlarged cornea, flat anterior chamber, atrophic iris and elevated intraocular pressure. This case report highlights a possible association of anterior segment dysgenesis and glaucoma with Goldenhar syndrome.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Leftover mitomycin-c sponge causing blebitis p. 1753
Mayuri Khamar, Deepak Bhojwani, Priyanka Patel, Abhay Vasavada
DOI:10.4103/ijo.IJO_1946_18  PMID:31546554
Trabeculectomy is the commonest surgical intervention performed worldwide for the treatment of open-angle glaucoma. However, the use of antimetabolites during trabeculectomy has been associated with various bleb related complications. We report this interesting case to highlight unique clinical presentation and management of a leftover mitomycin-C sponge causing blebitis.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Spontaneous formation and closure of full thickness macular hole after treatment with anti-vascular endothelial growth factor therapy in polypoidal choroidal vasculopathy p. 1756
Abhishek Sethia, Jay Sheth, Mahesh Gopalakrishnan, Giridhar Anantharaman
DOI:10.4103/ijo.IJO_1597_18  PMID:31546555
Full-thickness macular hole (FTMH) formation in Polypoidal choroidal vasculopathy (PCV) after intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment is a rare complication. Spontaneous closure of FTMH following anti-VEGF therapy has not been described in PCV till date. We present a case of Asian woman with PCV who developed a FTMH following treatment with intra-vitreal anti-VEGF injections which subsequently closed spontaneously on further course of treatment.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Macular hole following phakic intraocular lens implantation and its management p. 1758
Atul Kumar, Srikanta K Padhy, Rebika Dhiman, Prashant Kumar, Twinkle Parekh, Toshit Varshney
DOI:10.4103/ijo.IJO_126_19  PMID:31546556
A 28-year-old male presented to retina clinic with complains of blurring and distortion in right eye for past 1 week. There was history of implantation of phakic intraocular lens (pIOL) bilaterally 4 months back. Ophthalmic examination revealed a full-thickness macular hole in the right eye. Pars plana vitrectomy with inverted internal limiting membrane flap was planned. Post-operatively, patient had a good gain in vision (20/40) with closure of the hole. Macular hole is an unusual complication of pIOL. A detailed pre-operative fundus screening is indispensable. Early presentation and timely intervention can optimize the visual outcome.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Functional and morphological evaluation of autologous retinal graft in large traumatic macular hole p. 1760
Sumit R Singh, Raja Narayanan
DOI:10.4103/ijo.IJO_312_19  PMID:31546557
A 7-year-old boy presented with history of blunt trauma 1 month back. Best corrected visual acuity (BCVA) was 20/200 with optical coherence tomography (OCT) showing a large macular hole. Spontaneous closure of the macular hole seemed unlikely following a month of observation. Pars plana vitrectomy along with autologous retinal graft was performed. At subsequent follow up, hole appeared closed with nasal shrinkage of graft and BCVA improved to 20/100. OCT showed mechanical integration of the graft with adjoining retina. Autologous retinal graft is a feasible option in cases where conventional internal limiting membrane peeling shows lower anatomical success.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Case report on two diabetic donor eyes with no retinopathy: Clinicopathological and molecular studies p. 1762
Subramaniam Rajesh Bharathi Devi, Karunakaran Coral, Karthikeyan Gayathree, Muthuvel Bharathselvi, Shanmuganathan Sivasankar, Jyotirmoy Biswas, Pukhraj Rishi, Sundaram Natarajan, Sengamedu Srinivasa Badrinath, Narayanasamy Angayarkanni
DOI:10.4103/ijo.IJO_400_19  PMID:31546558
We were intrigued to analyze donor eyes of two individuals without retinopathy even after 40 years of type 2 diabetes mellitus. Targeted molecular factors associated with angiogenesis and the key antioxidant enzymes in retinal tissue were analyzed. Accordingly PEDF, Adiponectin and Paraoxonase 2 showed augmented mRNA expression in both the retina with no significant change in VEGF expression. Vitreous showed increased PEDF protein in donor 1 and Adiponectin in donor 2 with no change in VEGF protein. This study highlights the profile of specific molecular factors that contribute to the non-development of diabetic retinopathy changes in these individuals.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Ocular manifestations in patient with congenital erythropoietic porphyria p. 1765
C Isanta-Otal, G López-Valverde, A J Mateo Orobia, LE Pablo
DOI:10.4103/ijo.IJO_1776_18  PMID:31546559
We present the case of a 52-year-old woman referred to our service because of extreme ocular surface dryness. The patient showed corneal, conjunctival, and eyelid manifestations of ocular congenital erythropoietic porphyria (CEP). We started treatment with autologous serum, topical steroids, and cyclosporine twice a day, topical retinoids, and intense corneal lubrication. The patient referred significant improvement of ocular bothering and less discomfort since treatment was initiated. We describe the management of the herewith presented case of ocular CEP.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Reversible blindness in a patient with closantel toxicity p. 1768
Karthik Kumar, Chitaranjan Mishra, Rupa Anjanamurthy, Naresh Babu Kannan, Kim Ramasamy
DOI:10.4103/ijo.IJO_2070_18  PMID:31546560
To describe the optical coherence tomography (OCT) and electrophysiological changes in a case of closantel toxicity. A 25-year-old patient presented with sudden painless defective vision following intake of closantel. Visual acuity (VA) was counting fingers at 5 m in both eyes (BE). OCT revealed disruption of outer retinal layers and electroretinogram (ERG) and visual evoked potential (VEP) were subnormal in BE. The patient was treated with systemic corticosteroids, after which his VA improved to 6/9, OCT revealed preservation of central outer retinal layers, and ERG and VEP responses improved in BE. This is the first case report of successful treatment with systemic steroids for closantel-related reversible blindness.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Closantel – A lesser-known evil p. 1771
Ramesh Venkatesh, Arpitha Pereira, Aditya Aseem, Naresh Kumar Yadav
DOI:10.4103/ijo.IJO_1150_19  PMID:31546561
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Binasal hemianopia caused by pneumosinus dilatans of the sphenoid sinuses p. 1772
Won Jae Kim, Myung-Mi Kim
DOI:10.4103/ijo.IJO_1580_18  PMID:31546562
Bitemporal hemianopia is a significant pathological hallmark of a pituitary lesion; however, binasal hemianopia is rarely reported, except for its known association with other ocular diseases rather than with brain lesions. We report a 24-year-old male with binasal hemianopia caused by pneumosinus dilatans of the sphenoid sinuses.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Panophthalmitis associated with scleral necrosis in dengue hemorrhagic fever p. 1775
Deepanjali Arya, Sima Das, Gaurav Shah, Arpan Gandhi
DOI:10.4103/ijo.IJO_2050_18  PMID:31546563
Dengue is a mosquito-borne flavivirus disease affecting humans. The Aedes aegypti mosquito spreads it. Ophthalmic manifestations of dengue range from subconjunctival hemorrhage to optic neuropathy. Panophthalmitis in dengue fever is a rare finding. We report a case of a 22-year-old male having dengue fever, who presented with pain, redness, swelling and loss of vision in his right eye. He was diagnosed as panophthalmitis with subretinal hemorrhage and required right eye evisceration.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Dengue hemorrhagic fever: Panophthalmitis or sterile sclerocorneal melt? p. 1777
Ashok Kumar Grover, Shaloo Bageja, Shilpa Taneja Mittal
DOI:10.4103/ijo.IJO_1268_19  PMID:31546564
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
LETTERS TO THE EDITOR Top

Commentary: Aurolab aqueous drainage implant: Posterior versus anterior segment implantation p. 1779
Kiranmaye Turaga
DOI:10.4103/ijo.IJO_751_19  PMID:31546565
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Comparison of central corneal thickness measurements using different imaging devices and ultrasound pachymetry p. 1780
Ertugrul Can, Hilal Eser-Ozturk, Mustafa Duran, Tugba Cetinkaya, Nursen Arıturk
DOI:10.4103/ijo.IJO_764_19  PMID:31546567
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Comment on: Progressive posterior lenticonus with total lenticular opacity p. 1780
Nirupama Kasturi, Vignesh Elamurugan
DOI:10.4103/ijo.IJO_507_19  PMID:31546566
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Reply: Posterior lenticonus with persistent fetal vasculature p. 1782
Sudarshan Khokhar, Chirakshi Dhull, Karthikeyan Mahalingam, Pulak Agarwal
DOI:10.4103/ijo.IJO_900_19  PMID:31546568
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Comment on: The role of posterior vitreous detachment on the efficacy of anti–vascular endothelial growth factor intravitreal injection for treatment of neovascular age-related macular degeneration p. 1783
Upma Awasthi, Rohini Grover, Chetan Videkar, Abhishek Varshney
DOI:10.4103/ijo.IJO_160_19  PMID:31546569
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Reply: The role of posterior vitreous detachment on the efficacy of anti–vascular endothelial growth factor intravitreal injection for treatment of neovascular age-related macular degeneration p. 1784
Meira Neudorfer, Audelia E Fuhrer, Dinah Zur, Adiel Barak
DOI:10.4103/ijo.IJO_1097_19  PMID:31546570
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Subscribe this journal
Submit articles
Most popular articles
Joiu us as a reviewer
Email alerts
Recommend this journal