Glyxambi
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login
  • Users Online: 999
  • 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
July 2019
Volume 67 | Issue 7
Page Nos. 981-1255

Online since Tuesday, June 25, 2019

Accessed 5,051 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  

It's a doc's life – Workplace violence against doctors Highly accessed article p. 981
Mrittika Sen, Santosh G Honavar
DOI:10.4103/ijo.IJO_1166_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
GUEST EDITORIAL Top

Machine learning in clinical care: Quo vadis? Highly accessed article p. 985
Vasant G Honavar
DOI:10.4103/ijo.IJO_1167_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ONE MINUTE OPHTHALMOLOGY Top

The second time around Highly accessed article p. 987
Li‐Anne L Lim, Md K Hasanuzzaman, Carol L Shields
DOI:10.4103/ijo.IJO_1018_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
REVIEW ARTICLES Top

Robotics and ophthalmology: Are we there yet? Highly accessed article p. 988
Suresh K Pandey, Vidushi Sharma
DOI:10.4103/ijo.IJO_1131_18  
Ophthalmology is a field that is now seeing the integration of robotics in its surgical procedures and interventions. Assistance facilitated by robots offers substantial improvements in terms of movement control, tremor cancellation, enhanced visualization, and distance sensing. Robotic technology has only recently been integrated into ophthalmology; hence, the progression is only in its initial stages. Robotic technologies such as da Vinci Surgical System are integrated into the field of ophthalmology and are assisting surgeons in complex eye surgeries. Ophthalmic surgeries require high accuracy and precision to execute tissue manipulation, and some complex ocular surgery may take few hours to complete the procedures that may predispose high-volume ophthalmic surgeons to work-related musculoskeletal disorders. A complete paradigm shift has been achieved in this particular field through the integration of advanced robotic technology, resulting in easier and more efficient procedures. Where robotic technology assists the surgeons and improves the overall quality of care, it also projects several challenges including limited availability, training, and the high cost of the robotic system. Although considerable studies and trials have been conducted for various robotic systems, only a few of them have made it to the commercial stage and ophthalmology, on its own, has a long way to go in robotics technology.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Computer-assisted navigation in orbitofacial surgery p. 995
Priti Udhay, Kasturi Bhattacharjee, P Ananthnarayanan, Gangadhar Sundar
DOI:10.4103/ijo.IJO_807_18  
The purpose of this systematic review is to investigate the most common indications, treatment, and outcomes of computer-assisted surgery (CAS) in ophthalmological practice. CAS has evolved over the years from a neurosurgical tool to maxillofacial as well as an instrument to orbitofacial surgeries. A detailed and organized scrutiny in relevant electronic databases, journals, and bibliographies of the cited articles was carried out. Clinical studies with a minimum of two study cases were included. Navigation surgery, posttraumatic orbital reconstruction, computer-assisted orbital surgery, image-guided orbital decompression, and optic canal decompression (OCD) were the areas of interest. The search generated 42 articles describing the use of navigation in facial surgery: 22 on orbital reconstructions, 5 related to lacrimal sac surgery, 4 on orbital decompression, 2 articles each on intraorbital foreign body and intraorbital tumors, 2 on faciomaxillary surgeries, 3 on cranial surgery, and 2 articles on navigation-guided OCD in traumatic optic neuropathy. In general, CAS is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients were related to trauma. Treatment of complex orbital fractures was greatly improved by the use of CAS compared with empirically treated control groups. CAS seems to add a favourable potential to the surgical armamentarium. Planning details of the surgical approach in a three-dimensional virtual environment and execution with real-time guidance can help in considerable enhancement of precision. Financial investments and steep learning curve are the main hindrances to its popularity.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Artificial intelligence in diabetic retinopathy: A natural step to the future p. 1004
Srikanta Kumar Padhy, Brijesh Takkar, Rohan Chawla, Atul Kumar
DOI:10.4103/ijo.IJO_1989_18  
Use of artificial intelligence in medicine in an evolving technology which holds promise for mass screening and perhaps may even help in establishing an accurate diagnosis. The ability of complex computing is to perform pattern recognition by creating complex relationships based on input data and then comparing it with performance standards is a big step. Diabetic retinopathy is an ever-increasing problem. Early screening and timely treatment of the same can reduce the burden of sight threatening retinopathy. Any tool which can aid in quick screening of this disorder and minimize requirement of trained human resource for the same would probably be a boon for patients and ophthalmologists. In this review we discuss the current status of use of artificial intelligence in diabetic retinopathy and few other common retinal disorders.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARIES Top

Commentary: Rise of machine learning and artificial intelligence in ophthalmology Highly accessed article p. 1009
John Davis Akkara, Anju Kuriakose
DOI:10.4103/ijo.IJO_622_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Commentary: AI for an eye leaves the whole world… p. 1011
Ashwin Mohan, Rashmin Gandhi
DOI:10.4103/ijo.IJO_624_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Tribal Odisha Eye Disease Study (TOES) report # 5: Comparison of prevalence and causes of visual impairment among tribal children in native and urban schools of Odisha (India) p. 1012
Lapam Panda, Suryasmita Nayak, Vivekanand Uttamrao Warkad, Taraprasad Das, Rohit Khanna
DOI:10.4103/ijo.IJO_1995_18  
Purpose: To compare the prevalence and causes of blindness and visual impairment in tribal school students in the rural day-care and in a residential urban school. Methods: This was a cross-sectional comparative study. The 4-Stage screening in the native habitat of the tribal students performed in the school and hospital involved the trained school teachers, optometrists, comprehensive ophthalmologist, and pediatric ophthalmologist. The 2-Stage screening in the urban school involved only the optometrists and pediatric ophthalmologist. In both instances, vision (presenting and best corrected) was recorded and refraction performed. In addition, fundus photo was taken in all students in the urban school using a non-mydriatic fundus camera. Results: The comparison of blindness, visual impairment, and ocular anomalies were between tribal children (153,107 children; mean age 9.3 ± 2.7 years) examined in the native school and tribal children (10,038 children; mean age 8.8 + 1.64 years) in an urban residential school. Mild and moderate visual impairment was higher in the urban settings (P < 0.05), but severe visual impairment and blindness were similar in both settings. Refractive error, amblyopia, and posterior segment anomaly were detected more often in an urban settings (P < 0.05). Vitamin A deficiency (Bitot's spot) was detected only in children studying in the native schools (P < 0.05). Conclusion: The location, urban or rural, did not influence the visual impairment profile of tribal children. The food habit and environment seem to impact nutritional status.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Analysis of macular, foveal, and retinal nerve fiber layer thickness in children with unilateral anisometropic amblyopia and their changes following occlusion therapy p. 1016
V Kavitha, Mallikarjun M Heralgi, Patel Deep Harishkumar, Sneha Harogoppa, HM Shivaswamy, H Geetha
DOI:10.4103/ijo.IJO_1438_18  
Purpose: To analyze macular thickness (MT), foveal thickness (FT), and retinal nerve fibre layer thickness (RNFLT) in children with unilateral anisometropic amblyopia and their changes following occlusion therapy. Methods: A prospective, longitudinal, and comparative study of 60 children aged between 5 and 18 years consisted of two groups, group 1: 30 children with unilateral anisometropic amblyopia; group 2: 30 normal children. Best corrected visual acuity (BCVA), a detailed ocular examination, spectral domain optical coherence tomography for MT, FT, and RNFLT in both eyes were done at visit one (baseline) and every 3 months for a year following occlusion therapy (initiated one month after first visit) in group 1. Results: Mean BCVA, MT, FT, and RNFLT in amblyopic eyes at first visit were 0.63 ± 0.405, 286.9 ± 6.522 μm, 195.90 ± 8.462 μm, and 100.87 ± 6.240 μm, respectively and at last visit after occlusion therapy were 0.50 ± 0.318, 248.9 ± 11.681 μm, 169.47 ± 10.941 μm, and 99.43 ± 5.722 μm, respectively. At first visit, mean BCVA, MT, FT, and RNFLT in nonamblyopic eyes (group 1) were 0 ± 0, 240 ± 10.447 μm, 159.27 ± 9.285 μm, 98.63 ± 4.723 μm and in normal eyes (group 2: average of right and left eyes) were 0 ± 0, 239.8 ± 4.294 μm, 143.6 ± 4.61 μm, 100.5 ± 2.895 μm, respectively. Conclusion: MT and FT, which were more in amblyopic eyes as compared to normal fellow eyes and group 2, decreased with improvement in BCVA after occlusion therapy. However, there was no difference in RNFLT between amblyopic eyes and normal fellow eyes and group 2 before and after occlusion therapy.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Analysis of macular, foveal and retinal nerve fiber layer thickness in children with unilateral anisometropic amblyopia and their changes following occlusion therapy p. 1023
Virender Sachdeva
DOI:10.4103/ijo.IJO_615_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Comparison of higher order aberrations in amblyopic and non-amblyopic eyes in pediatric patients with anisometropic amblyopia p. 1025
Abhishek Hoshing, Monica Samant, Seema Bhosale, Anaya M Naik
DOI:10.4103/ijo.IJO_1625_18  
Purpose: To compare the ocular higher order aberrations (HOAs) for the physiologic pupil size in amblyopic and non-amblyopic eyes of patients with anisometropic amblyopia in pediatric age group. Methods: Children between 5 and 15 years age having treatment naïve anisometropic amblyopia; after a detailed examination by a pediatric ophthalmologist; underwent assessment of wavefront aberrations for both amblyopic and non-amblyopic eyes at their physiologic pupil sizes using i-Trace ray tracing wavefront aberrometer. The axial lengths were also measured using IOL Master 500. The RMS values of the total ocular higher order aberrations (HOAs) and those arising from internal and corneal components of the two eyes were tabulated and compared to look for differences. Comparison of total ocular aberrations for pre-determined refractive error groups was also done for amblyopic and non-amblyopic eyes separately. Results: Eighty-eight eyes of 44 subjects were included for analysis. Mean pupil size was comparable in between amblyopic and non-amblyopic eyes (3.98 mm vs. 4.07 mm, P = 0.346). The mean axial lengths of the two eyes were comparable (amblyopic eyes 23.13 mm vs. non-amblyopic eyes 22.88 mm, P = 0.419). Significant differences in total HOAs and those arising from the internal optics (except spherical aberrations) of the eye were noted between the two eyes. There were no differences in the corneal HOAs. The total HOAs were comparable amongst the various refractive error groups for amblyopic and non-amblyopic eyes individually. Conclusion: There are significant differences in ocular HOAs between amblyopic and non-amblyopic eyes in children with anisometropic amblyopia.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Comparison of higher order wavefront aberrations with four aberrometers p. 1030
William H Cook, James McKelvie, Henry B Wallace, Stuti L Misra
DOI:10.4103/ijo.IJO_1464_18  
Purpose: To evaluate the agreement of selected higher order aberration measurements between aberrometers based on three different wavefront technologies. Methods: Twenty-three eyes of 23 participants were compared between Zywave, OPD-Scan III, and iDesign aberrometers, for total ocular aberrations. Participants were between 19 and 69 years of age, and exclusion criteria were previous ocular surgery or trauma, contact lens wear within the preceding 2 weeks, and ocular or systemic disease. Corneal aberrations were compared between the OPD-Scan III and GALILEI™ G2 aberrometers. Zernike coefficients of vertical and oblique trefoil, vertical and horizontal coma, and spherical aberration were analyzed in R software. Results: In all, 276 scans were captured in total, with a male-to-female ratio of 11:12. Total ocular vertical coma [mean difference (MD) = 0.026 μm, P < 0.005], vertical trefoil (MD = 0.033 μm, P < 0.05), and spherical aberration (MD = 0.022 μm, P < 0.05) differed significantly between the iDesign and OPD-Scan III. Differences in total vertical (MD = 0.072 μm, P < 0.05) and oblique trefoil (MD = 0.058 μm, P < 0.05) were demonstrated between the Zywave and OPD-Scan III, and spherical aberration (MD = 0.030 μm, P < 0.005) between iDesign and Zywave. iDesign corneal horizontal coma (MD = 0.025 μm, P < 0.05) and spherical aberration (MD = 0.043 μm, P < 0.005) measurements were significantly different between the GALILEI™ G2 and the OPD-Scan III. Conclusion: Zywave, iDesign, and OPD-Scan III, and GALILEITM G2 and OPD-Scan III may be used interchangeably for their total ocular and corneal wavefront functions, respectively; however, care must be taken if using these devices for guiding ablation or monitoring corneal disease.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A comparative study of preoperative and postoperative changes in corneal astigmatism after pterygium excision by different techniques p. 1036
Pragya Garg, Anshu Sahai, Mohd. Abid Shamshad, Lokendra Tyagi, Yamini Singhal, Shalini Gupta
DOI:10.4103/ijo.IJO_1921_18  
Purpose: To study the changes in corneal astigmatism before and after pterygium excision as well as with differences between various surgical techniques (bare sclera, conjunctival autograft, amniotic membrane graft). Methods: The study population included 71 patients with primary pterygium who underwent surgery. The surgical techniques used differed among the study population. All the patients were preoperatively assessed for visual acuity, anterior and posterior segments, autorefraction, and autokeratometry. After surgery, the patients were assessed for visual acuity, autorefraction, and autokeratometry on day 5, 1 month, and 3 months and the results were analyzed. Paired and unpaired t-tests were used to compare the variables. The probability level of 0.05 was considered as statistically significant. Results: The reduction in the mean preoperative astigmatism of 3.47 ± 1.74 Diopters (D) to 1.10 ± 0.78 D 3 months after surgery was statistically significant (P < 0.0001). Bare sclera, conjunctival autograft, and amniotic membrane graft techniques exhibited changes in astigmatism amounting to 1.85 ± 0.88 D, 2.55 ± 1.26 D, and 2.67 ± 1.44 D, respectively. Pterygium excision surgeries using amniotic membrane graft and conjunctival autograft techniques were more effective than pterygium excision surgery using bare sclera technique in reducing astigmatism. Conclusion: Pterygium excision results in significant reduction in astigmatism which leads to improvement in visual acuity. Amniotic membrane graft and conjunctival autograft are better surgical techniques than bare sclera as far as reducing astigmatism is concerned.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Evaluation of multiplex real-time polymerase chain reaction for the detection of herpes simplex virus-1 and 2 and varicella-zoster virus in corneal cells from normal subjects and patients with keratitis in India p. 1040
Sai Jeevana Madhuri Guda, Bhavani Sontam, Bhupesh Bagga, Konduri Ranjith, Savitri Sharma, Joveeta Joseph
DOI:10.4103/ijo.IJO_1700_18  
Purpose: To determine the presence of herpes simplex virus and varicella zoster virus (HSV 1 and 2, VZV) in the cornea of normal subjects by multiplex real time quantitative (qPCR) assay and evaluate its utility in the diagnosis of viral keratitis. Methods: Corneal epithelial cells from 33 eyes of 22 patients undergoing photorefractive keratectomy surgery (controls) and 50 corneal scrapings from 50 patients with suspected HSV keratitis were analyzed for the presence of HSV1 by conventional PCR and for presence of HSV1 and 2 and/or VZV by multiplex real-time PCR. Corneal scrapings of patients were also tested for HSV1 antigen by immunofluorescence assay (IFA). The results were compared and clinical records reviewed. Results: HSV1 and VZV DNA were detected in 8/33 controls (mean-14.3 ± 7.96, range: 3-29.1 copies/mL) and 2/33 controls (mean-10.7 ± 10.9, range 3-18.5 copies/ml) respectively. HSV2 was not detected in any of the controls. Copy numbers above the mean + 1SD of controls were considered significant for viral load in patient samples. Significantly higher number of corneal scrapings (39/50, 78%) from patients were positive for HSV1 (1.2 × 106 copies/mL ± 3.7 × 106 copies/mL) by real time qPCR compared to IFA (11/48, 23%, P value 0.0001) and conventional PCR (20/50, 40%, P value 0.0002). Double infection with HSV-1 (1.5 × 107 copies/ml) and HSV-2 (3.57 × 104 copies/ml) in one case and VZV infection (1.03 × 102 copies/ml) in another was also detected by the multiplex real-time PCR. Conclusion: Multiplex real-time PCR reliably detects HSV1 and 2 and VZV DNA and is ideal for the diagnosis of HSV and VZV keratitis in an ocular microbiology laboratory.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Herpes keratitis: A diagnostic challenge p. 1046
Manisha Acharya, Abhishek Dave, Javed Hussain Farooqui
DOI:10.4103/ijo.IJO_396_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLE Top

Causative fungi and treatment outcome of dematiaceous fungal keratitis in North India p. 1048
Ajit Kumar, Ashi Khurana, Mohit Sharma, Lokesh Chauhan
DOI:10.4103/ijo.IJO_1612_18  
Purpose: The aim of the study is to identify risk factors, clinical characteristics, causative fungi, and treatment outcome of dematiaceous fungal keratitis in North India. Methods: Consecutive cases of culture-proven dematiaceous fungal keratitis between January 2012 and June 2017 were retrieved from the medical record department. Risk factors, clinical signs, and outcome were registered. Results: Eighty-three patients were included. Identified dematiaceous fungal organism were Curvularia sp. (n = 55/83; 66.3%), Alternaria sp. (n = 12/83; 14.5%), Ulocladium sp. (n = 5/83; 6%), Bipolaris sp. (n = 5/83; 6.1%), Scedosporium sp. (n = 3/83; 3.6%), Acremonium sp. (n = 2/83; 2.4%), and Epicoccum sp. (n = 1/83; 1.2%). Male preponderance was reported. The most common predisposing factor was corneal trauma (67.4%). In cases associated with corneal trauma due to vegetative matter, sugarcane was the most common cause. In all, 89% of the patients were more than 30 years of age. The median infiltrate size was 8 mm2. The median time of antifungal therapy was 4.2 weeks (interquartile range [IQR]: 1-25 weeks). Complications were seen in 14 (n = 14/65; 21.5%) patients. Complete resolution of dematiaceous fungal keratitis was present in 27 (n = 27/65; 41.5%) eyes. Conclusion: Curvularia sp. and Alternaria sp. were the predominant pathogenic genera causing dematiaceous fungal keratitis. Among the causative fungi, infections due to Scedosporium sp. were associated with the worst outcomes. Ulocladium sp. and Epicoccum sp. were also identified. Both the species are not reported previously as a causal organism of dematiaceous fungal keratitis from North India.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARIES Top

Commentary: Dematiaceous fungal keratitis: Importance of ocular microbiology p. 1053
Joveeta Joseph
DOI:10.4103/ijo.IJO_359_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Commentary: Dematiaceous fungal keratitis: Is it different? p. 1054
Ritu Arora
DOI:10.4103/ijo.IJO_877_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLE Top

Procurement, storage and utilization trends of eye banks in India p. 1056
Namrata Sharma, Tarun Arora, Deepali Singhal, Prafulla K Maharana, Prashant Garg, Ritu Nagpal, Somasheila Murthy, Srinivas Gunnam, Aditya Arora, Venkatesh Prajna, Revathi Rajaraman, Prema Padmanabhan, Arvind Kumar, Rajiv Kumar, Swati Tomar, Anila Thomas, Rekha Gyanchand, Ritu Arora, Bani Biswas, Samar Basak
DOI:10.4103/ijo.IJO_1551_18  
Purpose: To study the trends in collection, storage and utilization of donor corneas in eye banks in India. Methods: The data was collected from 12 eye banks in India that collected more than 1000 corneas per year. The retrospective analysis of the parameters like characteristics of the donor and the host, storage media used, number of eyes collected, number of eyes utilized, causes of non-utilization of the tissue and the procedures performed was done. Results: A total of 20,564 eyes were collected by the 12 eye banks during the year 2013–2014. Voluntary eye donation (VED), and hospital cornea retrieval program (HCRP) contributed to 59.6% and 40.4% of tissue procurement respectively. Whole globe enucleation (52.3%) was more commonly performed as compared to in-situ excision of the donor corneas. The most commonly used storage media at all eye banks was McCarey-Kaufman (MK) media (83.3%). The utilization rate of the donor eyes was 50.5%. The most frequent indication for corneal transplantation was infection (active infection - 33.13%, healed infection - 10.78%) followed by Pseudophakic bullous keratopathy (PBK) (13.57%). Full thickness keratoplasty (optical penetrating keratoplasty - 47.23%, therapeutic penetrating keratoplasty - 31.74%) was performed most often followed by endothelial keratoplasty (12.41%) in the developing country. Conclusion: VED still contributes to majority of the donor tissue retrieval in India. The majority of the eye banks still utilize whole globe enucleation technique and store tissues in MK media. Trends from previous years showed a change towards HCRP, in-situ excision technique and preservation in the long-term storage media.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Procurement, storage and utilization trends of eye banks in India p. 1060
N Venkatesh Prajna
DOI:10.4103/ijo.IJO_438_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLE Top

Comparative analysis of clinical outcomes between two types of posterior chamber phakic intraocular lenses for correction of myopia and myopic astigmatism p. 1061
Gitansha Shreyas Sachdev, Shivangi Singh, Shreyas Ramamurthy, Narayan Rajpal, Ramamurthy Dandapani
DOI:10.4103/ijo.IJO_1501_18  
Purpose: To compare clinical outcomes following implantation of two types of posterior chamber phakic intraocular lenses: Visian™ Implantable Collamer Lens with Centraflow (ICL, V4C Staar Surgical, Nidau, Switzerland) and Implantable Phakic Contact Lens (IPCL, V1, Caregroup Sight Solution, India) for the correction of myopia and myopic astigmatism. Methods: This retrospective case series included eyes which underwent phakic intraocular lens implantation with a minimum follow-up period of 1 year. Visual outcomes including safety, efficacy, refractive predictability, and stability were compared at 1 week and at 1, 6, and 12 months' postoperative visit. Complications and adverse events were analyzed. Results: The study included 119 and 203 eyes in the IPCL and ICL groups, respectively. At 1-year postoperative visit, median corrected distance visual acuity was 0.10 (interquartile range [IQR] 0,0.10) and 0 (IQR 0,0) in the IPCL and ICL cohorts, respectively (P = 0.066). An uncorrected visual acuity of 20/32 or better was achieved in 86.5% and 88.67% of the eyes, respectively (P = 0.574). Ninety and 94% of the eyes achieved a postoperative manifest spherical equivalent within ± 0.5D (P = 0.169, χ2 test). Three eyes (2.52%) in the IPCL group versus one eye (0.49%) in the ICL group developed visually significant cataract requiring surgical intervention (P = 0.113). No vision-threatening complications were noted in either cohort. The mean follow-up period was 94.69 ± 32.45 and 102.67 ± 61.82 weeks, respectively. Conclusion: Both groups demonstrated similar efficacy and safety profile. The IPCL is an effective and economically viable option for the correction of myopia.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Expanding indications of newer and economically viable phakic posterior chamber intraocular lens designs p. 1066
Suresh K Pandey, Vidushi Sharma
DOI:10.4103/ijo.IJO_173_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Biometric changes in Indian pediatric cataract and postoperative refractive status p. 1068
Sudarshan Kumar Khokhar, Ankit Tomar, Ganesh Pillay, Esha Agarwal
DOI:10.4103/ijo.IJO_1327_18  
Purpose: To prospectively evaluate the biometric changes in Indian pediatric cataract and postoperative refractive status. Methods: A total of 147 patients were recruited into three groups: age <6 months, age between 7 months and 18 months, and age between 19 and 60 months and prospectively observed for 6 months. Exclusion criteria were preterm birth, microphthalmia, microcornea, megalocornea, uveitis, glaucoma, and traumatic or complicated cataract. Axial length and keratometry, the primary outcome measures, were taken preoperatively under general anesthesia before surgery. These children were followed up for 6 months to look for refractive and biometric changes. T-test and linear regression with the logarithm of independent variables were done. Results: All unilateral cataractous eyes (n = 25) and randomly selected bilateral cases (n = 122) were included in the analysis, for a total of 147 eyes. Mean age was 17.163 ± 13.024 months; axial length growth was 0.21, 0.18, 0.06 mm/month, and keratometry decline was 0.083, 0.035, 0.001 D/month in age groups 0–6, 7–18, and 19–60 months, respectively. The visual acuity improved in log MAR from 1.020 to 0.745 at 6 months postoperatively. There was statistically significant (Spearman's correlation coefficient = –0.575, P < 0.001) between age and postoperative refraction. There were no intraocular lens (IOL)-related complications seen in the immediate postoperative period. Peripheral opacification was seen in 102 eyes and central opacification in 1 eye at a 6-month follow-up. Conclusion: Indian eyes have a lower rate of axial length growth and keratometry change in comparison with western eyes implying smaller undercorrection in emmetropic IOL power for Indian pediatric eyes to achieve a moderate amount of hyperopia.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Evaluation of complications and visual outcome in various nucleus delivery techniques of manual small incision cataract surgery p. 1073
Unnati Sharma, Bhavana Sharma, Kavita Kumar, Salil Kumar
DOI:10.4103/ijo.IJO_1261_18  
Purpose: To evaluate various methods of nucleus delivery in manual small incision cataract surgery, with reference to visual outcome, intraoperative, and postoperative complications. Methods: In this prospective randomized interventional study, five groups of 40 cases each were constituted, with reference to nucleus delivery technique: (a) phacosandwich, (b) fishhook, (c) irrigating vectis, (d) viscoexpression, and (e) anterior chamber maintainer (ACM). Visual outcome, intraoperative, and postoperative complications were evaluated in detail. Follow-up was done on first and seventh postoperative days (PODs) and then at fourth and eighth postoperative weeks. Results: The most common intraoperative complication was intraoperative miosis, followed by intraoperative hyphema, seen more in phacosandwich and irrigating vectis groups. The most common postoperative complication was striate keratopathy followed by transient postoperative corneal edema and AC inflammatory response, seen more in phacosandwich and fishhook groups. With reference to visual acuity, on the first POD 95% cases of ACM group achieved visual acuity >+0.5 logMAR unit. The difference in the visual outcome among groups was statistically significant. On fourth and eighth postoperative weeks, best-corrected visual acuity among various groups was comparable. Conclusion: ACM and viscoexpression are effective techniques for early visual rehabilitation. Fishhook has limited utility in softer nuclear grades and black cataracts. Phacosandwich is more suitable for nuclear sclerosis Grades 3–4. Irrigating vectis, viscoexpression, and ACM technique are effective techniques for all grades of nucleus Postoperative surgical-induced astigmatism was comparable in all techniques.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Evaluation of complications and visual outcomes in various nucleus delivery techniques of manual small incision cataract surgery p. 1078
Abhishek Hoshing
DOI:10.4103/ijo.IJO_137_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Midterm outcome of mitomycin C augmented trabeculectomy in open angle glaucoma versus angle closure glaucoma p. 1080
Devendra Maheshwari, Swathi Kanduri, Mohideen A Kadar, Rengappa Ramakrishnan, Madhavi R Pillai
DOI:10.4103/ijo.IJO_1328_18  
Purpose: The purpose of this study is to evaluate the efficacy and safety of Trabeculectomy with Mitomycin C in Open angle glaucoma versus Angle closure glaucoma. Methods: The medical records of patients who underwent Trabeculectomy with Mitomycin C were reviewed and followed for three years, divided into two groups: group 1: Open Angle Glaucoma (n = 41) and group 2: Angle Closure Glaucoma (n = 67). Success criterion was measured as Intraocular Pressure ≤21 mmHg with (qualified) or without (complete) use of Antiglaucoma medications. Results: A total number of 108 eyes of 137 patients were undertaken. Mean preoperative Intraocular pressure in group 1 was 31.4 ± 10.5 mmHg and in group 2 was 33.1 ± 9.4, which reduced to 10.5 ± 3.4, 10.5 ± 2.6, 11.6 ± 3.6, 11.0 ± 2.7, 11.0 ± 2.7 in group 1 and 10.9 ± 2.8, 12.0 ± 3.8, 12.8 ± 4.9, 12.4 ± 3.9, 12.4 ± 3.7 in group 2 with P value = 0.566, 0.032, 0.168, 0.049, 0.049 at three, six months, one, two, three years, respectively, with P < 0.001 at each visit. The number of Antiglaucoma medications was reduced from 0.75 ± 0.89 to 0.43 ± 0.55 at 3 yrs (P = 0.002). At 36 months follow-up, overall, 50.0% and 48.2% of eyes achieved complete and qualified success, respectively. Sub-group analysis showed that the success rate was higher in group 1 (68.3%) compared to group 2 (55.2%). Overall, complications such as hypotony (1.8%), choroidal detachment (2.8%), encapsulated bleb (2.8%), and bleb leakage (1.8%) were encountered. Conclusion: Primary Trabeculectomy with Mitomycin C is a safe and effective means of controlling Intraocular Pressure in both groups with good success and low rates of sight-threatening complications.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Lamina cribrosa surface position in idiopathic intracranial hypertension with swept-source optical coherence tomography p. 1085
Isil Pasaoglu, Banu Satana, Cigdem Altan, Ozgur Artunay, Berna Basarir, Funda E Onmez, Asli Inal
DOI:10.4103/ijo.IJO_1736_18  
Purpose: The purpose of this study is to compare the thickness and depth measurements of the lamina cribrosa (LC) obtained using a swept-source optical coherence tomography (SS-OCT) device in idiopathic intracranial hypertension (IIH) patients and healthy subjects. Methods: This retrospective, cross-sectional observational study included 16 eyes with IIH and 20 control eyes. The LC measurements with serial horizontal B scans of the optic nerve head were obtained using SS-OCT (Topcon 3D DRI OCT Triton). The anterior lamina surface (ALS) depth, posterior lamina surface (PLS) depth, and LC thickness measurements were evaluated. Results: In patients with IIH, the mean ALS depth was 225.00 ± 58.57 μm and the mean PLS depth was 449.75 ± 63.50 μm. In the IIH control group, the corresponding values were 359.40 ± 105.38 and 570.10 ± 99.41 μm (P < 0.05). The difference in LC thickness between the IIH and control subjects was not statistically significant. Conclusion: LC can be evaluated using an SS-OCT device. LC was displaced anteriorly in patients with IIH compared with normal controls. The assessment of LC level with SS-OCT in IIH cases is a valuable and reproducible adjunctive imaging method in terms of diagnosis and follow-up.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Clinical validation of RIA-G, an automated optic nerve head analysis software p. 1089
Digvijay Singh, Srilathaa Gunasekaran, Maya Hada, Varun Gogia
DOI:10.4103/ijo.IJO_1509_18  
Purpose: To clinically validate a new automated glaucoma diagnosis software RIA-G. Methods: A double-blinded study was conducted where 229 valid random fundus images were evaluated independently by RIA-G and three expert ophthalmologists. Optic nerve head parameters [vertical and horizontal cup–disc ratio (CDR) and neuroretinal rim (NRR) changes] were quantified. Disc damage likelihood scale (DDLS) staging and presence of glaucoma were noted. The software output was compared with consensus values of ophthalmologists. Results: Mean difference between the vertical CDR output by RIA-G and the ophthalmologists was − 0.004 ± 0.1. Good agreement and strong correlation existed between the two [interclass correlation coefficient (ICC) 0.79; r = 0.77, P < 0.005]. Mean difference for horizontal CDR was − 0.07 ± 0.13 with a moderate to strong agreement and correlation (ICC 0.48; r = 0.61, P < 0.05). Experts and RIA-G found a violation of the inferior–superior NRR in 47 and 54 images, respectively (Cohen's kappa = 0.56 ± 0.07). RIA-G accurately detected DDLS in 66.2% cases, while in 93.8% cases, output was within ± 1 stage (ICC 0.51). Sensitivity and specificity of RIA-G to diagnose glaucomatous neuropathy were 82.3% and 91.8%, respectively. Overall agreement between RIA-G and experts for glaucoma diagnosis was good (Cohen's kappa = 0.62 ± 0.07). Overall accuracy of RIA-G to detect glaucomatous neuropathy was 90.3%. A detection error rate of 5% was noted. Conclusion: RIA-G showed good agreement with the experts and proved to be a reliable software for detecting glaucomatous optic neuropathy. The ability to quantify optic nerve head parameters from simple fundus photographs will prove particularly useful in glaucoma screening, where no direct patient–doctor contact is established.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Optical coherence tomography angiography versus fluorescein angiography in diagnosing choroidal neovascularization in chronic central serous chorioretinopathy p. 1095
Reema Bansal, Mohit Dogra, Samyak Mulkutkar, Deeksha Katoch, Ramandeep Singh, Vishali Gupta, Mangat Ram Dogra, Amod Gupta
DOI:10.4103/ijo.IJO_1238_18  
Purpose: Diagnosis of choroidal neovascular membrane (CNVM) is difficult in chronic central serous chorioretinopathy (CCSC) due to overlapping features of both on conventional dye angiography. Optical coherence tomography angiography (OCTA) allows a quick and noninvasive detection of CNVM in these eyes. We compared the fluorescein angiography (FA) features of CNVM with those of OCTA to assess the role of FA in detecting CNVM in CCSC eyes. Methods: Patients with CCSC undergoing FA, spectral domain (SD)-OCT, and OCTA were identified (March 2015–June 2015). Four retina specialists individually reviewed FA images (without OCTA and SD-OCT) to determine whether CNVM was present. In parallel, two other retina specialists reviewed all images (FA/SD-OCT/OCTA) for CCSC features and confirmed whether CNVM was present using OCTA as the gold standard. The inter- and intraobserver variability was measured by Kappa (k) coefficient. The FA features of CNVM were compared and correlated with those on OCTA. Results: Of 43 eyes (26 patients, mean age 45.6 ± 8.5 years, all males), a definite CNVM (detected by OCTA) was present in nine (20.9%) eyes. FA alone detected CNVM in 13 (30.2%) eyes [sensitivity 44.4% (95% confidence interval (CI): 11.9–76.9), specificity 73.5% (95% CI: 58.7–88.3), positive and negative predictive values 30.8% and 83.3%, respectively, and accuracy 67.44% (95% CI: 53.4–81.4)]. Conclusion: When compared with OCTA, the FA was unable to characterize CNVM in CCSC (with a very low sensitivity and moderate specificity) as none of the specific dye leakage patterns on FA correlated with CNVM seen on OCTA, limiting its usefulness and accuracy in detecting CNVM in these eyes.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Clinical presentations and comparative outcomes of primary versus deferred intraocular lens explantation in delayed-onset endophthalmitis p. 1101
Vivek P Dave, Avinash Pathengay, Savitri Sharma, Vishal Govindhari, Roshni Karolia, Rajeev R Pappuru, Taraprasad Das
DOI:10.4103/ijo.IJO_1494_18  
Purpose: To describe clinical presentations and comparative outcomes of primary versus deferred intraocular lens (IOL) explantation in delayed-onset endophthalmitis. Methods: In this retrospective study, a total of 77 eyes of 77 patients that were diagnosed clinically as delayed-onset endophthalmitis and underwent IOL explantation from January 1990 to January 2018 were included undiluted vitreous biopsy and IOL were subjected to microbiologic evaluation. Duration of symptoms, presenting visual acuity, organisms isolated, time to IOL explantation, time to endophthalmitis, resolution after explantation, number of repeat intravitreal injections, and final visual acuity were compared in the primary and the deferred IOL explantation groups. Results: There were primary and deferred IOL explantations. Interval between inciting event and endophthalmitis, between onset of symptoms to presentation, total follow-up, complication rate, and final visual acuity was comparable between the two groups. Median time to IOL explantation in the deferred group was 70 days. Between the primary and deferred IOL explantation groups the number of repeat intravitreal injections was 0.58 ± 0.86 and 2.62 ± 1.78 respectively, (P < 0.0001, 95% confidence interval, CI 2.00–2.22); the number of days to resolution after IOL explantation was 35.16 ± 14.26 and 55.5 ± 8.24 respectively, (P < 0.0001, 95% CI 15.22–25.45). Conclusion: Early IOL explantation in delayed-onset endophthalmitis causes faster clinical resolution and reduces the number of repeat intravitreal injections. Final visual improvement, however, may be unaffected.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Comparison of ranibizumab alone versus ranibizumab with targeted retinal laser for branch retinal vein occlusion with macular edema p. 1105
Siddhi Goel, Atul Kumar, Raghav D Ravani, Parijat Chandra, Mahesh Chandra, Vinod Kumar
DOI:10.4103/ijo.IJO_1364_18  
Purpose: To determine the effect of ultra-widefield fluorescein angiography (UWFFA)-guided targeted retinal photocoagulation (TRP) in branch retinal vein occlusion (BRVO) with macular edema after intravitreal Ranibizumab (RBZ). Methods: 33 eyes of 32 treatment naïve patients diagnosed as BRVO with macular edema were prospectively randomized to 0.5 mg Ranibizumab only (RBZ group) (n = 17) or Ranibizumab with UWFFA-guided laser (RBZ + TRP group) (n = 16). Both groups received three injections at monthly intervals and PRN henceforth. RBZ + TRP group additionally underwent UWFFA-guided TRP of peripheral capillary nonperfusion areas 1 week post injection. Outcome measures included improvement in visual acuity, central subfoveal thickness (CST), and the number of injections required with a minimum follow-up of 9 months. Results: Both groups showed significant improvement in mean BCVA (25.7 ± 8.19 letters, P < 0.001 vs. 23.38 ± 7.56 letters, P < 0.001; in RBZ and RBZ + TRP group, respectively) and reduction in mean central subfoveal thickness (379.12 ± 242.7 μm, P < 0.001 vs. 253.75 ± 137.9 μm, P < 0.001 in RBZ and RBZ + TRP group, respectively) at 9 months. The number of injections in the RBZ group (5.76 ± 1.3) was significantly greater than RBZ + TRP (4.06 ± 0.99) (P < 0.001). Both groups had significant improvement in contrast sensitivity and mean deviation on visual fields; however, the difference between the groups was not significant (P = 0.62 and P = 0.79, respectively). Conclusion: UWFFA-guided TRP reduced the number of injections of Ranibizumab in patients having BRVO with macular edema, while maintaining similar benefits in the improvement of BCVA, central subfoveal thickness without deleterious effect on the visual field, and contrast sensitivity.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bevacizumab versus ziv-aflibercept in branch retinal vein occlusion p. 1109
Imoro Z Braimah, Sumit Randhir Singh, Bhushan Uplanchiwar, Ahmad M Mansour, Jay Chhablani
DOI:10.4103/ijo.IJO_1532_18  
Purpose: To compare the effectiveness of treatment with intravitreal bevacizumab (IVB) and ziv-aflibercept (IVZ) in patients with macular edema (ME) post-branch retinal vein occlusion (BRVO). Methods: Patients with treatment naïve ME post-BRVO were included retrospectively if they received either IVB (0.05 ml/1.25 mg) or IVZ (0.05 ml/1.25 mg) monotherapy with a follow up of 12 months. Results: Thirty-two and 17 eyes received IVB and IVZ, respectively. The mean improvement in best corrected visual acuity (BCVA) was 0.36 ± 0.3 logarithm of minimum angle of resolution (logMAR) in the IVB group and 0.27 ± 0.3 in the IVZ group (P = 0.35). The mean change in central macular thickness was 178.9 ± 180.9 and 173.5 ± 344.4 μm in IVB and IVZ groups, respectively (P = 0.94). The mean number of injections was higher in the IVB group (4.0 ± 1.8) compared with 1.82 ± 0.8 in the IVZ group (P < 0.0001). The IVZ group had significantly fewer number of visits (P < 0.0001) and longer maximum treatment-free intervals (P = 0.0081). Conclusion: IVZ appears to be cost-effective with the similar visual outcome and less number of visits in comparison to IVB.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Comparison of intravitreal ziv-aflibercept and bevacizumab monotherapy in treatment-naive polypoidal choroidal vasculopathy p. 1114
Sumit Randhir Singh, Niroj Kumar Sahoo, Nallamasa Rohit Goud, Jay Chhablani
DOI:10.4103/ijo.IJO_638_18  
Purpose: To report the visual and anatomical outcomes of intravitreal ziv-aflibercept (IVZ) and bevacizumab (BVZ) monotherapy in treatment-naive polypoidal choroidal vasculopathy (PCV). Methods: This was a retrospective case series of 16 eyes (8 eyes each in IVZ and BVZ groups). The study period was from January 2016 to March 2018. The inclusion criteria were treatment-naive PCV patients who were treated with either IVZ or BVZ monotherapy on pro re nata protocol and followed up monthly for 6 months. The change in best-corrected visual acuity (BCVA), central macular thickness (CMT), and pigment epithelial detachment (PED) height was measured at baseline and 6 months. Results: A total of 16 eyes were studied. IVZ group had an improvement in BCVA by 0.15 logarithm of minimum angle of resolution (logMAR; approximately 1.5 lines) at 6 months, whereas BVZ group had a reduction in BCVA by 0.21 logMAR (approximately 2 lines) (P = 0.027). Five patients and one patient in IVZ and BVZ groups, respectively, had ≥5 letters gain of BCVA. IVZ group had significant reduction in PED height (P = 0.048), whereas the change in CMT was not significant at 6 months (P = 0.681). The mean number of injections (2.87 ± 0.83 in IVZ and 2.25 ± 0.89 BVZ group; P = 0.168) and longest treatment-free interval (3.00 ± 2.20 months in IVZ and 2.12 ± 1.96 months in BVZ group; P = 0.41) were not significantly different. Conclusion: The visual and anatomical outcomes in terms of PED reduction in treatment-naive PCV patients were better in IVZ group compared with BVZ. IVZ monotherapy is a viable, cost-effective alternative in these patients with good safety profile.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Ziv-aflibercept: An alternative antivascular endothelial growth factor agent for polypoidal choroidal vasculopathy p. 1119
Kumar Anshuman, Dhanashree Ratra
DOI:10.4103/ijo.IJO_204_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLE Top

Pachydrusen in polypoidal choroidal vasculopathy in an Indian cohort p. 1121
Sumit Randhir Singh, Renuka Chakurkar, Abhilash Goud, Mohammed Abdul Rasheed, Kiran Kumar Vupparaboina, Jay Chhablani
DOI:10.4103/ijo.IJO_1757_18  
Purpose: To report the prevalence of pachydrusen and their relationship with subfoveal choroidal thickness (SFCT) and large choroidal vessel layer thickness (SF-LCVT) in eyes with polypoidal choroidal vasculopathy (PCV) and their fellow eyes. Methods: The case records of 50 patients (99 eyes; 59 PCV and 40 fellow eyes) were retrospectively analyzed for the presence of pachydrusen and other drusen types such as soft drusen. The diagnosis was established using colour fundus photography and optical coherence tomography (OCT). SFCT and SF-LCVT were measured and correlated with the different types of drusen. Results: The mean age of the study cohort was 62.26 ± 10.67 years and included 27 males and 23 females. Pachydrusen and soft drusen were seen in 14 (PCV: 8 and fellow eyes: 6) and 8 eyes (PCV: 2 and fellow eyes: 6) respectively. The mean SFCT and SF-LCVT in the eyes with and without pachydrusen was not significanty different (280.29 ± 103.11 μ vs. 292.63 ± 87.17 μ; P = 0.63 and 180.57 ± 59.20 vs. 173.73 ± 54.86 μ; P = 0.67, respectively). The pachydrusen were most commonly located near the vascular arcades and showed scattered distribution pattern. Though SFCT and SF-LCVT was lower in the eyes with soft drusen compared to eyes with pachydrusen, it failed to reach statistical significance (SFCT, P = 0.1 and SF-LCVT, P = 0.06). Conclusion: The prevalence of pachydrusen in PCV and their fellow eyes is lower in Indian population suggestive of ethnic variations. SFCT and SF-LCVT was not noted to vary signifcantly in eyes with and without pachydrusen in this study cohort.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Pachydrusen in polypoidal choroidal vasculopathy in an Indian cohort p. 1126
Giridhar Anantharaman
DOI:10.4103/ijo.IJO_648_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Screening for Charles Bonnet syndrome: Should the definition be reconsidered? p. 1127
PremNandhini Satgunam, Rebecca Sumalini, Gayathri Chittapu, Gunasree Pamarthi
DOI:10.4103/ijo.IJO_1533_18  
Purpose: Charles Bonnet syndrome (CBS) is a condition in which individuals with visual impairment (VI) and with no cognitive deficits experience visual hallucinations, typically with no other sensory hallucinations. Although few isolated case reports of CBS from India have been published, the prevalence for CBS in India is largely unknown. The primary aim of this study was to estimate CBS prevalence in patients with vision impairment visiting a tertiary eye care center. Methods: The study was conducted in two phases. In phase 1, patients with VI, age ≥40 years with presenting visual acuity worse than 20/63 were enrolled. In phase 2, patients with presenting visual acuity worse than 20/63 and/or with binocular visual field loss, age ≥18 years were recruited. A CBS survey was administered only to those who passed a screening test for cognition impairment. Results: A total of 218 patients were screened (phase 1 = 113 and phase 2 = 105). Two-hundred ten patients (mean age ± standard deviation = 49.2 ± 17.3 years, males = 139) were found eligible to complete the CBS survey. Fourteen patients were found to have visual hallucinations. In addition, three other patients had visual hallucinations with associated auditory input to the visual imagery. All patients had complete insight about their hallucinations. Conclusion: Depending on the inclusion criteria, we found the prevalence for CBS in patients with VI to vary between 6.7% to 8.1% (if including patients with auditory input). More investigation is needed to assess the associated role of other sensory inputs (e.g. auditory) with the visual imagery experienced in CBS.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Botulinum toxin A in the early treatment of sixth nerve palsy in type 2 diabetes p. 1133
Sandra Ganesh, Sasikala Elizabeth Anilkumar, Kalpana Narendran
DOI:10.4103/ijo.IJO_1267_18  
Purpose: Our study aims at evaluating the efficacy and safety of botulinum toxin A in the early treatment of sixth nerve palsy in type 2 diabetic patients. Methods: This study is a prospective and interventional clinical case series of patients presenting with acute onset of sixth cranial nerve palsy, who received injection botulinum toxin A. Results: Thirty-one cases were included in the study. 58% of the study subjects had incomplete palsy at presentation (abduction deficit -1 to -3) and 42% had complete palsy (-4 and -5). The median dosage of injection was 5 U (range 3--6 U). The median follow-up period is 2 months. The P value shows that there is statistically significant improvement in head turn, ocular deviation in primary position, and improvement in abduction between baseline and 1 week (P-value <0.001), 1 month (P-value <0.001) and 2 month (P-value <0.001) postinjection follow-up visits. 90.3% of patients had full resolution of symptoms in the last follow-up visit. 83.9% of patients were successfully treated. Conclusion: Early injection of botulinum toxin A in select patients with acquired sixth nerve palsy due to diabetes is a safe and efficient treatment option in alleviating symptoms, restoring function and quality of life and reducing need for surgical interventions in future.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Nasal endoscopic features and outcomes of nasal endoscopy guided bicanalicular intubation for complex persistent congenital nasolacrimal duct obstructions p. 1137
Manpreet Singh, Manjula Sharma, Manpreet Kaur, Aditi Mehta Grewal, Deepti Yadav, Sabia Handa, Sonam Yangzes, Zoramthara Zadeng, Pankaj Gupta
DOI:10.4103/ijo.IJO_1819_18  
Purpose: To study the clinical presentation, nasal endoscopic features, and outcomes of nasal endoscopy guided (NEG) bicanalicular intubation (BCI) in children with complex persistent congenital nasolacrimal duct obstruction (pCNLDO). Methods: A prospective, interventional study including eligible children (age ≤ 12 years) having complex pCNLDO. The demographics, number of previous probings, nasal endoscopy findings, and outcomes; were noted in all children who underwent NEG-BCI with Crawford's stents. Matting of eyelashes (MoE, upper, and lower eyelid), tear-film height (TFH), and fluorescein dye disappearance test (FDDT) was assessed pre and postoperatively. The minimum stent in-situ period was 12 weeks, and the minimum follow-up was 6 months (after stent removal). Results: Total 32 children (36 eyes) including 18 females (56.25%) were studied. At a mean age of 4.9 years, all children had epiphora and discharge with MoE (both upper and lower), raised TFH and positive FDDT. Previously, all children underwent conventional probing (s)- once in 12 (33.3%), twice in 18 (50%) and thrice in 6 (16.7%) eyes. The general ophthalmologists performed the majority (n = 21, 58.33%) of those. The BCI was performed under GA in all eyes, and at a mean follow-up of 8.5 months, the “complete” success was noted in 29 eyes (80.5%), 'partial' success in 4 (11.1%) and failure in 3 (8.3%). The stent prolapse was seen in three. Conclusion: NEG-BCI may provide a satisfactory resolution to complex pCNLDO after single or multiple failed probings. NEG provides confident and efficient management of coexistent intranasal complexities related to the inferior turbinate and meatus.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

External dacryocystorhinostomy conventional surgery versus Pawar implant: A comparative study p. 1143
Deepak Mishra, Prashant Bhushan, Bibhuti P Sinha, Gyan Bhaskar, Raksha Rao
DOI:10.4103/ijo.IJO_1889_18  
Purpose: External dacryocystorhinostomy (DCR) surgeries are cost-effective with excellent success rates. The present study was designed to compare the safety and efficacy of conventional external DCR versus external DCR using Pawar silicone implant in chronic dacryocystitis. Methods: This is a prospective, comparative, interventional case series over a period of 18 months with patients managed by external DCR surgery with and without Pawar implant. Institutional review board approval was obtained before the study. The success of the surgery was objectively measured by sac patency on syringing at the last follow up. Results: A total of 65 patients with chronic dacryocystitis were included in the study. The mean age of patients in the series was 41.43 years (median, 41 years; range, 12 years-60 years). All patients presented with epiphora (100%) and underwent external DCR and were chosen for conventional surgery (n = 33, 51%, group 1) or Pawar silicone implant surgery (n = 32, 49%, group 2) on a random basis. The mean duration of the surgery from the time of skin incision to skin closure for group 1 was 27.7 minutes (median, 26 minutes; range, 21-30 minutes) while in group 2, it was 75.5 minutes (median, 75 minutes; range, 60-88 minutes), which was statistically significant (P < 0.01). The success rate of the procedure done in group 1 was 90% which increased to 97% after the management of failed cases as compared to the success rate in group 2 of 91% and 94%, before and after the management of failed cases, respectively. Conclusion: External DCR using Pawar implant is a safe surgery which is faster than conventional external DCR with almost equal success rates between both the procedures
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Risk factors for orbital implant exposure after evisceration: A case control study of 93 patients p. 1148
Roshmi Gupta, Parvathi Hari, Bhawna Khurana, Anjali Kiran
DOI:10.4103/ijo.IJO_1813_18  
Purpose: The study aims to analyze risk factors for exposure of orbital implants after evisceration by comparison of patients with and without exposure of implants. Methods: This is a case control study in retrospective interventional case series; Group A- implant exposures after evisceration, Group B - Patients on follow up after evisceration with implant, without exposure, with matched duration of follow up. The sample size is calculated for a power of 80. Results: Group A comprised 32 sockets with implant exposure, presenting at median 18 months after surgery; Group B included 61 eviscerated sockets, without implant exposure, with follow up median 36 months. Odds Ratio (OR) was calculated; infected eyes -OR 1.3, P = 0.6; phthisical eye - OR 1.4, P = 0.43; multiple prior surgeries- OR 1.55, P = 0.33. Group A had 59.3% porous implants, Group B 55.7%, - OR 1.3, P = 0.5. Mean implant size in Group A 19.06 mm, Group B 18.78 mm- showed no statistical difference. Multiple logistic regression analysis showed no significant risk factor for exposure. Surgeon factor was not analyzed since there were multiple surgeons. Conclusion: This is the first study with calculated sample size, comparing implant exposure patients to a control group. Porous implant material, presence of infection, phthisical scleral shell, and prior surgery showed higher trend of exposure (Odds ratio >1), but none was conclusive. Larger size of implant was not a risk factor for exposure. Eliminating the role of several factors in implant exposure allows the surgeon to make better surgical choices: such as place an implant of appropriate size, of a material of surgeon's choice, and do primary placement of implant in a patient with evisceration post-corneal ulcer or endophthalmitis. A hypothesis and a recommendation is that meticulous attention be paid to surgical technique.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Analyzing the factors causing implant exposure in evisceration p. 1152
Raj Anand
DOI:10.4103/ijo.IJO_616_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
SURGICAL TECHNIQUES Top

Positioning of a morbidly obese patient during retinal surgery p. 1153
Chinmay Nakhwa, Sonali Verma
DOI:10.4103/ijo.IJO_1951_18  
A body mass index (BMI) ≥35 kg/m2 is classified as obese, and a BMI ≥40 kg/m2 is classified as morbidly obese. Obese people are at a higher risk for developing cardiovascular complications like ischemic heart diseases, congestive cardiac failure, hypertension, type 2 diabetes mellitus and obstructive sleep apnea (OSA) among other health issues. Central obesity can also increase the pleural pressure and cardiac filling pressures, thus increasing the intracranial (ICP) and intraocular pressure (IOP). These clinical co-morbidities can make retina surgeries, which require patient in supine position for 45-90 minutes, a challenging task. We present our experience in the intraoperative positioning of such a patient who underwent surgery for retinal detachment.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Silicone band loop myopexy for myopic strabismus fixus p. 1155
Savleen Kaur, Mohit Dogra, Jaspreet Sukhija, Mangat R Dogra
DOI:10.4103/ijo.IJO_1703_18  
Myopic strabismus fixus causes inability of the eye to elevate and abduct in the setting of a myopic superotemporally herniated globe. We report a novel surgical technique to manage an 18-year-old male with myopic strabismus fixus. Radiological imaging demonstrated a nasally deviated superior rectus (SR) and inferiorly displaced lateral rectus (LR). Silicone band assisted myopexy of SR and LR was done along with anchoring them to the sclera with a dacron suture. The patient had satisfactory alignment postoperatively and did not require any intervention over 1-year follow-up.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
PHOTO ESSAY Top

Ocular cystinosis: Rarity redefined p. 1158
Mayuresh P Naik, Harinder S Sethi, Smriti Dabas
DOI:10.4103/ijo.IJO_1467_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Isolated microspherophakia with retinitis pigmentosa p. 1160
Gaurav Gupta, Parul Chawla Gupta, Anchal Thakur, Bala Murugan, Jagat Ram
DOI:10.4103/ijo.IJO_1093_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Intercalary staphyloma in Marfan syndrome: A dreaded complication of scleral incision p. 1161
Pranita Sahay, Suman Dhanda, Prafulla K Maharana, Jeewan S Titiyal
DOI:10.4103/ijo.IJO_1672_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Ciliochoroidal melanoma presenting as bleeding anterior staphyloma: Report of a case and review of literature p. 1162
Md. Shahid Alam, Andrea Tongbram, Subramanian Krishnakumar, Bipasha Mukherjee
DOI:10.4103/ijo.IJO_1559_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Giant retinal pigment epithelium rip in a patient with peripheral exudative hemorrhagic chorioretinopathy p. 1164
Vinod Kumar, Ruchir Tewari
DOI:10.4103/ijo.IJO_827_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Choroidal neovascularization in an eye with foveal hypoplasia associated with albinism p. 1165
Vishal Raval, Avadhesh Oli, Srinivas Rao, Taraprasad Das
DOI:10.4103/ijo.IJO_1621_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Multicolor imaging in retinal astrocytoma p. 1167
Sugandha Goel, Debmalya Das, Kumar Saurabh, Rupak Roy
DOI:10.4103/ijo.IJO_1372_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Choroidal macrovessel: Optical coherence tomography angiography and imaging features p. 1168
Giuseppe Casalino, Luca De Simone, Antonio Scialdone, Carlos Pavesio
DOI:10.4103/ijo.IJO_2085_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Multimodal imaging in non-paraneoplastic autoimmune retinopathy p. 1171
David Kasongole, Vishal Raval, Prithvi Mruthyunjaya, Raja Narayanan
DOI:10.4103/ijo.IJO_1416_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Multimodal imaging to differentiate myopic macular pit and localized deep staphyloma in high myopia p. 1173
Jaya Prakash Vadivelu, Amravi Shah, Vikas Khetan, Gopal Lingam
DOI:10.4103/ijo.IJO_1577_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
OPHTHALMIC IMAGES Top

Using Bruckner's test for gross keratometry screening p. 1175
Amber Amar Bhayana
DOI:10.4103/ijo.IJO_2142_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Molluscum-related keratoconjunctivitis p. 1176
Manisha Singh, Manisha Acharya, Arpan Gandhi, Ujjwal Prakash
DOI:10.4103/ijo.IJO_1808_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Multifocal phlyctenular conjunctivitis in association with pulmonary tuberculosis p. 1177
Monika Balyan, Chintan Malhotra, Arun Kumar Jain
DOI:10.4103/ijo.IJO_1657_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Corneal graphite deposit on anterior segment optical coherence tomography p. 1178
VS Vijitha, Anasua Ganguly Kapoor, Mansoor Mohammed, Aravind Roy
DOI:10.4103/ijo.IJO_1915_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Traumatic corneal cyst p. 1179
Ashis Ghosh, Naveen Radhakrishnan, Venkatesh N Prajna
DOI:10.4103/ijo.IJO_1822_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Berlin nodule in sarcoidosis p. 1180
Padmamalini Mahendradas, Rwituja Thomas, Ankush Kawali, Bhujang K Shetty
DOI:10.4103/ijo.IJO_1756_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Glimpsing intraocular lens through intact iris p. 1181
Gunjan Deshpande, Prashant Bawankule, Richa Gupta
DOI:10.4103/ijo.IJO_1939_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Subluxated Soemmering ring in retinitis pigmentosa p. 1182
Deepanshu Agrawal, Deepshikha Agrawal, Samrat Chatterjee
DOI:10.4103/ijo.IJO_171_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Ophthalmic artery occlusion following blunt trauma p. 1183
Kumar Anshuman, Varshini Ramesh, Daleena Dalan, Dhanashree Ratra
DOI:10.4103/ijo.IJO_1835_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Wide-field montage image of spectral domain optical coherence tomography in polypoidal choroidal vasculopathy p. 1184
PC Ranjith, Anantharaman Giridhar, Mahesh Gopalakrishnan
DOI:10.4103/ijo.IJO_92_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Multimodal imaging of pre-macular subhyaloid hemorrhage managed with Nd:YAG laser hyaloidotomy p. 1185
Manisha Agarwal, Chanda Gupta, Richa Ranjan, Brajesh Kumar, Ankita Shrivastav, Sumit Kumar
DOI:10.4103/ijo.IJO_1863_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Melanocytoma of the optic disc - Clinical spectrum p. 1186
Simar Rajan Singh, Aditi Mehta, Mohit Dogra, Mangat Ram Dogra
DOI:10.4103/ijo.IJO_61_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Double ring sign in optic nerve head hypoplasia p. 1187
Amit Kumar Deb, Naresh Babu Kannan, Kim Ramasamy, Chitaranjan Mishra
DOI:10.4103/ijo.IJO_1622_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Subretinal pigment epithelium cleft: A sign of caution p. 1188
Naresh Babu, Vedang Shah, Piyush Kohli, Pratik K Shah
DOI:10.4103/ijo.IJO_1851_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Nasal retinoschisis in a case of high myopia p. 1189
Vinod Kumar, Shreyans Jain
DOI:10.4103/ijo.IJO_1837_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Simultaneous squamous cell carcinoma and malignant melanoma of the conjunctiva in a teenager with xeroderma pigmentosum: Case report p. 1190
Ever Rodriguez Caso, Allexya AA Marcos, Melina Morales, Rubens N Belfort
DOI:10.4103/ijo.IJO_1106_18  
Xeroderma pigmentosum (XP) is an autosomal recessive disease with ophthalmic, dermatologic, and neurologic manifestations. Ophthalmological changes are described in up to 100% of XP patients. We report a young XP patient that presented with bilateral conjunctival masses. She was treated by surgical excision with supplemental cryotherapy. The histopathological analysis revealed squamous cell carcinoma with melanosis on right eye and conjunctival melanoma on the left eye. These patients need to be followed by dermatologists and ophthalmologists to identify malignant lesions as soon as possible and also to prevent unnecessary surgery that increases mutilation.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Subconjunctival bevacizumab and argon laser photocoagulation for preexisting neovascularization following deep lamellar anterior keratoplasty p. 1193
Meena Lakshmipathy, Pradeep Susvar, Kshama Popet, Rama Rajagopal
DOI:10.4103/ijo.IJO_1583_18  
We report a rare case of deep anterior lamellar keratoplasty (DALK) neovascularization managed with combination of subconjunctival bevacizumab and argon laser photocoagulation. A 24 year old male underwent Deep anterior lamellar keratoplasty for corneal stromal opacity following presumed viral keratitis. Deep corneal neovascularization was observed postoperatively which was successfully managed using a combination of subconjunctival bevacizumab and argon laser photocoagulation within one week of DALK. The neovascularization resolved by 3 months and at 2 years follow up, patient maintained good visual acuity of 6/12 Snellen's without recurrence of vascularization. A combination of bevacizumab and argon laser may be an effective approach to manage neovascularisation in the immediate postoperative phase (Post DALK) and improve graft survival.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Mushroom keratoplasty and contact lens application: Strategy for management of a pediatric eye injury p. 1195
Saverio V Luccarelli, Stefano Lucentini, Francesco Bonsignore, Paolo Nucci
DOI:10.4103/ijo.IJO_1665_18  
We show the challenging visual rehabilitation of a penetrating eye injury in a child with wide central corneal scar and aphakia. A 9-year-old male patient underwent combined surgery, including membranectomy with pupilloplasty and mushroom penetrating keratoplasty. Corneal transparency was restored; aphakia and irregular astigmatism were corrected first with a rigid gas-permeable contact lens (CL) and then, successfully, with hybrid CL. We discuss the surgical treatment used to restore corneal transparency and the choice of the best CL to overcome irregular astigmatism and aphakia.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Use of Tachosil® as an adjuvant therapeutic option in neurotrophic keratopathy in order to prevent perforation p. 1198
Miriam Rahhal-Ortuño, Alex S Fernández-Santodomingo, Rodrigo D Molina-Pallete, Mercedes Hurtado-Sarrió, Ángel L Cisneros-Lanuza
DOI:10.4103/ijo.IJO_1573_18  
We present two cases of women who suffered from neurotrophic keratopathy (one of them had undergone penetrating keratoplasty) which had led to corneal thinning. Tachosil® was used as an adjuvant treatment after topical medication by itself failed in both cases. To our knowledge, there are no reported cases of the use of Tachosil® in corneal grafts.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

In-the-bag dislocation of polyfocal full-optics accommodative intraocular lens: A case report p. 1200
You Hyun Lee, Yu Cheol Kim
DOI:10.4103/ijo.IJO_1552_18  
Herein, we report a case of in-the-bag dislocation of a WIOL-CF® polyfocal full-optics intraocular lens (IOL), without a history of trauma. A 56-year-old man was referred to our hospital with the chief complaint of sudden-onset visual disturbance in his left eye. He had undergone uneventful phacoemulsification with WIOL-CF® IOL implantation in the left eye at the local clinic 7 years prior. In fundus examination, IOL-capsular bag complex dislocated into the posterior vitreous was observed. We believe this is the first report of in-the-bag dislocation of a WIOL-CF® IOL that has been subluxated or dislocated in a characteristic pattern, not an in-the-bag pattern.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Association between hypertriglyceridemia and open angle glaucoma: A case report p. 1202
Mayuri Bakulesh Khamar, Arpita P Sthapak, D Vijayevarshcini, Priyanka M Patel
DOI:10.4103/ijo.IJO_1618_18  
Hypertriglyseridemia is a metabolic disorder that can cause vascular dysfucntion and be causally associated with glaucoma. Herein we present the case of a 16-year-old boy with hypertriglyseridemia with open-angle glaucoma.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Management of recurrent aqueous misdirection by anterior segment surgeon after failed pars plana posterior vitrectomy p. 1204
Vanita Pathak Ray, Varun Malhotra
DOI:10.4103/ijo.IJO_1430_18  
Aqueous misdirection (AM) is a dreaded complication, but fortunately quite rare. It usually occurs after intervention for angle closure glaucoma. When pharmacotherapy and/or laser interventions are unsuccessful, then the surgical management hitherto most commonly undertaken is pars plana posterior vitrectomy. We describe the management of recurrent AM via the anterior route, when it occurred following relapse as pars plana posterior vitrectomy failed to result in long-term normalization of anterior chamber and intraocular pressure. Anterior vitrector with anterior vitrectomy settings was used by a glaucoma specialist to carry out the procedure.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Malignant Glaucoma - Have we finally found an answer? p. 1206
Sushmita Kaushik
DOI:10.4103/ijo.IJO_134_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Immune-mediated tuberculous uveitis - A rare association with papulonecrotic tuberculid p. 1207
Prince Yuvraj Singh, Preema Sinha, Sukriti Baveja, Aradhana Sood
DOI:10.4103/ijo.IJO_1550_18  
The tuberculids are a group of distinct clinicopathological form of skin lesions representing hypersensitivity reaction to hematogenous dissemination of Mycobacterium tuberculosis or its antigen from an underlying active or a silent focus of tuberculosis elsewhere in the body in an individual with a strong antituberculous cell-mediated immunity and by definition do not show bacilli on special stains and are culture-negative. Ocular involvement can occur in tuberculosis, both due to direct invasion by the bacilli as well as an immune-mediated reaction; however, immune-mediated tuberculous uveitis occurring as a hypersensitivity response in association with PNT has hardly been reported in the literature. Here we report one such rare case.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

An unusual case of tuberculous optic neuropathy associated with choroiditis p. 1210
Anindya K Majumder, Siddharth Sheth, Vidya Dharani, Parthopratim Dutta Majumder
DOI:10.4103/ijo.IJO_1707_18  
Tuberculous optic neuropathy that includes papillitis, neuroretinitis, and optic nerve tubercle is a rare presentation of ocular tuberculosis. Though contagious spread from choroid following the hematogenous dissemination of the bacilli has been implicated in the optic nerve involvement, unlike neuroretinitis, optic nerve and choroidal involvement are usually considered as two separate clinical entities. We report a case of optic nerve involvement in a 33-year-old male who had concurrent choroidal involvement at present and also in the past. A strong history of contact with patients of pulmonary tuberculosis, positive tuberculin skin test, interferon gamma release assay, and high-resolution computed tomography helped us to clinch the diagnosis. Patients responded to systemic corticosteroid therapy and anti-tuberculosis treatment. Choroidal involvement in a case of inflammatory optic neuropathy should arise suspicion of tuberculous etiology.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Tuberculosis in neuro ophthalmology - How different it is? p. 1212
Sivaraman Bala Murugan, Priya Sundaralakshmi
DOI:10.4103/ijo.IJO_531_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Fulminant scleral abscess secondary to infected scleral buckle with Moraxella species p. 1214
Aashish Gangrade, Swapnil M Parchand, Samrat Chatterjee, Anil Gangwe, Deepshika Agrawal
DOI:10.4103/ijo.IJO_43_19  
We here report a case of scleral buckle infection with fulminant scleral abscess secondary to Moraxella species. A 54-year-old chronic alcoholic male with a history of retinal detachment repair, with scleral buckle 8 years prior, presented with complaints of severe pain, redness, and swelling in the right eye since 2 weeks. The patient was diagnosed with scleral buckle infection, the buckle was removed, and cultures revealed Moraxella species. The postoperative course included fulminant scleral abscess treated with dual antibiotic therapy that included ceftriaxone and moxifloxacin. All systemic antibiotics were discontinued after 3 weeks, retina remained attached, and no recurrence occurred over a 1-year follow-up. Moraxella, though commonly associated with bacterial keratitis, can also lead to buckle infection, especially in chronic alcoholic and immunocompromised patients. In buckle infection, infected buckle along with sutures should be immediately removed without damaging underlying compromised sclera. Lastly, culture and drug sensitivity play a very important role in buckle infections.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Clinicopathological and immunohistochemistry correlation in a case of Vogt-Koyanagi-Harada disease Highly accessed article p. 1217
Dipankar Das, Anusha Boddepalli, Jyotirmay Biswas
DOI:10.4103/ijo.IJO_1800_18  
Vogt-Koyanagi-Harada (VKH) disease is a systemic disorder causing bilateral panuveitis. Histopathological documentation along with molecular diagnostic evidence in VKH eye is a rarity. We present a 46-year-old woman with VKH with several ocular complications and subsequently enucleation of the right eye was done because of painful blind eye. Patient had clinical complications of VKH and some of the complications were observed in histopathology. Pathology of the case showed nongranulomatous uveitis, indicating the disease in chronic recurrent stage. Immunohistochemistry showed predominant T-cell involvement in this case. The case showed clinicopathological and immunohistochemistry correlation in a case of VKH disease.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
COMMENTARY Top

Commentary: Appraisal of histopathological correlations in Vogt-Koyanagi-Harada uveitis p. 1219
Sivaraman Bala Murugan
DOI:10.4103/ijo.IJO_409_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Rapidly reversing bilateral macular edema associated with fluid overload in a young type 1 diabetic p. 1221
Ramanuj Samanta, Athul S Puthalath, Neeraj Saraswat, Ajai Agrawal, Anupam Singh, Sanjeev Mittal
DOI:10.4103/ijo.IJO_1805_18  
We report a case of sudden onset bilateral diminution of vision in a young lady with type 1 diabetes. She was administered intravenous fluids for correction of diabetic ketoacidosis (DKA) prior to onset of her ocular symptoms. Dramatic resolution of macular edema was noted within a very short period after correction of fluid input–output ratio. Visual acuity was restored to baseline after 3 days without any active ocular intervention.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Retinal vascular abnormalities in Sturge-Weber syndrome p. 1223
Dhanashree Ratra, Hitesh Yadav, Daleena Dalan, Preet Kanwar Singh Sodhi, Vineet Ratra
DOI:10.4103/ijo.IJO_1840_18  
Sturge–Weber syndrome (SWS) includes facial, leptomeningeal and choroidal hemangioma. The retinal vasculature is essentially normal. Rare cases of retinal vascular tortuosity and arterio-venous malformations have been reported. We report two cases with rare concomitant retinal vascular abnormalities along with SWS. Both the patients had nevus flammeus, hemifacial hypertrophy, and choroidal hemangioma. In one case, retinal cavernous hemangioma was seen in the affected eye. The other case revealed retinal neovascularization secondary to proliferative diabetic retinopathy in the eye with choroidal hemangioma.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Molecular characterization of a rare phenotype of X-linked retinoschisis with angle-closure glaucoma p. 1226
Harathy Selvan, Anshul Sharma, Shweta Birla, Shikha Gupta, Bindu I Somarajan, Viney Gupta, Arundhati Sharma
DOI:10.4103/ijo.IJO_1407_18  
A 11-year-old boy presented with complaints of blurred vision and on evaluation was found to have X-linked retinoschisis (XLRS) with angle-closure glaucoma. Clinical and genetic evaluation of first-degree family members was done. His brother had a milder form of XLRS with shallow anterior chamber. Topical dorzolamide 2% and timolol 0.5% were used to control intraocular pressure. Genetic analysis revealed a novel three base pair deleterious mutation (c. 375_377 del AGA) in exon-5 of the RS1 gene in three members of the family.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Pulled into two syndrome (PITS) in a case of congenital fibrosis of the extraocular muscle p. 1229
Amar Pujari, Pradeep Sharma, Shabeer Basheer, Hameed Obedulla, Karthika Bhaskaran, Swati Phuljhele
DOI:10.4103/ijo.IJO_1542_18  
A four-year-old child with a clinical diagnosis of unilateral congenital fibrosis of extraocular muscles (CFEOM) was planned for inferior and medial rectus muscle recession surgery, adjusted with the status of forced duction test. Due to pathological changes within the muscles subsequent to innervational abnormality, intraoperatively the inferior rectus muscle was pulled into two following the insertion of muscle hook. Moreover, the snapped muscle fibers could not be identified, thus further surgery was abandoned and an observation was commenced. At the end of 6 weeks, there was a significant reduction in the amount of hypotropia but clinically significant perverted convergence with esotropia necessitated further surgical intervention. A second surgical intervention consisting of medial rectus transposition to superior rectus with 3 mm recession was performed to achieve acceptable results in the primary gaze.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Bilateral optic nerve aplasia with corpus callosum hypogenesis in an otherwise healthy child: Report of a rare case p. 1231
Renu P Rajan, Amit Kumar Deb, Naresh Babu Kannan, Kim Ramasamy
DOI:10.4103/ijo.IJO_1468_18  
Optic nerve (ON) aplasia is a rare congenital anomaly. It is characterised by the absence of optic nerve, nerve fibre layer, ganglion cells, and retinal blood vessels. ON aplasia is usually unilateral. Bilateral cases are very rare. We report such a rare case with bilateral ON aplasia and corpus callosum hypogenesis. An 11-month-old male child presented with a history of not seeing or following objects since birth. On examination, the child had microcornea and the absence of an optic disc in both the eyes. In addition, the right eye showed partial aniridia and few rudimentary retinal vessels in the posterior pole, while the left eye showed a chorioretinal coloboma but no evidence of any retinal blood vessels. Flash visual evoked potential was nonrecordable in both the eyes. MRI brain and orbit showed congenital aplasia of the ON on both sides with poorly developed optic chiasm, optic tract, and lateral geniculate body along with the features of corpus callosum hypogenesis. Child had no other systemic or endocrinological abnormalities.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Pediatric viral orbital cellulites secondary to H1N1 infection: A case report p. 1234
KS Smitha, Ajinkya Vivekrao Deshmukh, Fairooz P Manjandavida, Kalpana Babu
DOI:10.4103/ijo.IJO_1549_18  
A 10-year-old boy admitted for high-grade fever and pneumonia developed left preseptal and early orbital cellulitis, unresponsive to higher intravenous antibiotics. He received oseltamivir, on testing positive for H1N1 virus on the nasopharyngeal and throat swabs. There was dramatic improvement with resolution of orbital cellulitis within 24 h of starting oseltamivir. We report a very rare presentation of pediatric orbital cellulitis secondary to systemic H1N1 infection. Prompt investigations and timely treatment with oseltamivir aided in complete resolution, avoiding vision and life-threatening complications.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Non surgical management of unilateral lacrimal gland swelling in a paediatric patient of Rosai-Dorfman disease: A case report p. 1236
Sailie Shirodkar, Prachi Patil, Nagendra Shah
DOI:10.4103/ijo.IJO_1596_18  
A 10-year-old girl presented to us with inferonasally displaced, non-axial proptosis of oculus dexter (OD), with ipsilateral, painless massive cervical lymphadenopathy of ten weeks duration. After a detailed hematological work-up and imaging, the histological evidence obtained on cervical lymph node biopsy established the diagnosis of Rosai-Dorfman disease. Although, Rosai-Dorfman disease of unilateral lacrimal gland is extremely infrequent, a high degree of suspicion is warranted in a case of young patient presenting with unilateral isolated lacrimal gland swelling and associated lymphadenopathy, wherein no other cause is found. Treatment protocol should be individualized as per the extent of systemic involvement and functional disability.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Primary lacrimal gland teratoma in an adult: A clinicopathologic and radiological correlation p. 1238
Raksha Rao, Santosh G Honavar, Kaustubh Mulay
DOI:10.4103/ijo.IJO_1764_18  
A 20-year-old male presented with a gradually growing mass in the left lateral brow region for 2 years. On imaging, the mass appeared to arise from the lacrimal gland, was cystic, without any bony abnormality. With a diagnosis of dermoid cyst, an excision biopsy was performed. The histopathology revealed an epithelium-lined cyst, with the wall of the cyst comprising dermal adnexa and inflammatory cells. The wall also contained fragments of skeletal muscle, nerve bundles, adipose tissue, exocrine and secretory acini, few blood vessels with occasional hair shafts, with the lacrimal gland in the periphery of the tumor. There were no immature elements, atypia, and malignant cells, thus confirming the diagnosis of a mature cystic teratoma. Primary lacrimal gland teratoma is a rare diagnosis and its presentation in adults is extremely uncommon.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Solitary orbital myofibroma in a child: A rare case report with literature review p. 1240
Bejjanki Kavya Madhuri, Devjyoti Tripathy, Ruchi Mittal
DOI:10.4103/ijo.IJO_1553_18  
Myofibroma is a rare benign mesenchymal tumor of uncertain histogenesis. A six-year-old boy presented with a unilateral lower eyelid mass of six weeks' duration. MRI revealed a circumscribed mass in the inferolateral orbit with bony erosion. A systemic examination was unremarkable. Excision with histopathology revealed a partially infiltrative spindle cell tumor with bland nuclear morphology expressing smooth muscle actin and muscle-specific actin, compatible with myofibroma. Solitary myofibroma is a rare childhood orbital tumor and may clinico-radiologically closely mimic a malignancy. Histopathology and immunohistochemistry can help reach a definitive diagnosis. Systemic evaluation and close follow up are crucial in such cases.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
LETTERS TO THE EDITOR Top

Commentary: Refractive outcomes of a single step and a two-step approach for silicone oil removal and cataract surgery p. 1246
Gopal Lingam
DOI:10.4103/ijo.IJO_76_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Commentary: Role of alpha-2 agonists in regional ophthalmic anesthesia p. 1247
Simar R Singh, Vikas Saini, Avneet Singh, Mohit Dogra
DOI:10.4103/ijo.IJO_170_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Doctor, heal thyself: Addressing the shorter life expectancy of doctors in India p. 1248
Suresh K Pandey, Vidushi Sharma
DOI:10.4103/ijo.IJO_656_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Artificial intelligence in ophthalmology: Is it just hype with no substance or the real McCoy p. 1251
Santosh V Patil
DOI:10.4103/ijo.IJO_32_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Interocular asymmetry in choroidal thickness in healthy Indian population using swept-source optical coherence tomography p. 1252
Amber Amar Bhayana, Devesh Kumawat, Vinod Kumar, Mahesh Chandra, Parijat Chandra, Ramanjit Sihota, Atul Kumar
DOI:10.4103/ijo.IJO_8_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

The additional role of unmodified iPhone X as a direct ophthalmoscope p. 1253
Amar Pujari, Ashish Markan, Rohan Chawla, Meghal Gagrani
DOI:10.4103/ijo.IJO_90_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Comment: Clinical profile of uveitis patients developing central serous chorioretinopathy - An experience at a tertiary eye care center in India p. 1254
Aditya Aseem, Kushagra Jain, Naresh Kumar Yadav, Ramesh Venkatesh
DOI:10.4103/ijo.IJO_331_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

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