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   2006| January-March  | Volume 54 | Issue 1  
 
 
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ORIGINAL ARTICLE
Retinal nerve fibre layer thickness measurements in normal Indian population by optical coherence tomography
R Ramakrishnan, Saurabh Mittal, Sonal Ambatkar, Mohideen A Kader
January-March 2006, 54(1):11-15
DOI:10.4103/0301-4738.21608  PMID:16531664
Purpose: To obtain retinal nerve fibre layer thickness measurements by optical coherence tomography (OCT) in normal Indian population. Materials and Methods: Total of 118 randomly selected eyes of 118 normal Indian subjects of both sex and various age groups underwent retinal nerve fiber layer thickness analysis by Stratus OCT 3000 V 4.0.1. The results were evaluated and compared to determine the normal retinal nerve fiber layer thickness measurements and its variations with sex and age. Results: Mean + standard deviation retinal nerve fiber layer thickness for various quadrants of superior, inferior, nasal, temporal, and along the entire circumference around the optic nerve head were 138.2 + 21.74, 129.1 + 25.67, 85.71 + 21, 66.38 + 17.37, and 104.8 + 38.81 m, respectively. There was no significant difference in the measurements between males and females, and no significant correlation with respect to age. Conclusion: Our results provide the normal retinal nerve fiber layer thickness measurements and its variations with age and sex in Indian population.
  14,995 897 20
Clinical outcome of autologous cultivated limbal epithelium transplantation
Virender S Sangwan, Himanshu P Matalia, Geeta K Vemuganti, Anees Fatima, Ghazala Ifthekar, Shashi Singh, Rishita Nutheti, Gullapalli N Rao
January-March 2006, 54(1):29-34
DOI:10.4103/0301-4738.21611  PMID:16531667
Purpose: To report the clinical outcome of autologous cultivated limbal epithelial transplantation. Methods: Eighty-six patients' records and their clinical photographs were reviewed for demographics, primary etiology, type of limbal transplantation, ocular surface stability, visual acuity, final outcome, and possible factors affecting outcome and complications. Results: Eighty-eight eyes of 86 patients with limbal stem cell deficiency (LSCD) underwent autologous cultivated limbal epithelium transplantation between March 2001 and May 2003, with a mean follow-up of 18.3 months. The etiology of LSCD was alkali burns in 64% patients. Sixty-one eyes had total LSCD. Thirty-two of the 88 eyes had undergone amniotic membrane transplantation and 10 eyes had previously undergone limbal transplantation with unfavorable outcome. Nineteen eyes underwent penetrating keratoplasty, of which 11 grafts survived at the final follow-up. Finally, 57 eyes (73.1%, 95% CI: 63.3-82.9) had a successful outcome with a stable ocular surface without conjunctivalization, 21 eyes (26.9%, 95%CI: 17.1-36.7) were considered failures, and 10 patients were lost to follow-up. Conclusion: LSCD can be successfully treated by autologous cultivated limbal epithelium transplantation in majority of the cases.
  13,055 2,344 77
OPHTHALMIC PRACTICE
Digital video recording and archiving in ophthalmic surgery
Biju Raju, N S. D. Raju, Anju S Raju, CP Sudhakaran, Abdul Razak
January-March 2006, 54(1):53-57
DOI:10.4103/0301-4738.21619  PMID:16531675
Currently most ophthalmic operating rooms are equipped with an analog video recording system [analog Charge Couple Device camera for video grabbing and a Video Cassette Recorder for recording)]. We discuss the various advantages of a digital video capture device, its archiving capabilities and our experience during the transition from analog to digital video recording and archiving. The basic terminology and concepts related to analog and digital video, along with the choice of hardware, software and formats for archiving are discussed.
  11,487 421 5
LETTER TO EDITOR
Intravenous methylprednisolone could salvage vision in methyl alcohol poisoning
Manoj Shukla, Imran Shikoh, Akbar Saleem
January-March 2006, 54(1):68-69
DOI:10.4103/0301-4738.21628  PMID:16531683
  10,423 671 9
ORIGINAL ARTICLE
Screening for retinopathy of prematurity-a comparison between binocular indirect ophthalmoscopy and RetCam 120
Parag K Shah, V Narendran, VR Saravanan, A Raghuram, Abhijit Chattopadhyay, Maithreyi Kashyap
January-March 2006, 54(1):35-38
DOI:10.4103/0301-4738.21612  PMID:16531668
Aim: To compare the photographic screening for retinopathy of prematurity (ROP) using RetCam 120 with binocular indirect ophthalmoscope (BIO), which is the current gold standard. Setting and Design: Prospective, comparative study. Materials and Methods: A total of 87 RetCam examinations were performed on 27 premature babies. They were stored in a separate file after deleting the identifying information. At the same visit using the BIO with scleral depression, an experienced vitreoretinal surgeon evaluated the fundus in detail. A masked examiner then evaluated the RetCam photographs for presence or absence of ROP, the stage and zone of the disease, and the presence or absence of plus disease. These data were then compared with the BIO findings to determine the sensitivity, specificity, and the positive and negative predictive values of the method. Results: ROP was detected in 63 of 87 examinations by BIO and in 56 of 87 RetCam examinations. Nine RetCam examinations were false-negative and two were false-positive. Sensitivity of RetCam was 85.71% (54/63) and specificity was 91.66% (22/24). The positive and negative predictive values were 96.43% and 70.97% respectively. Conclusion: Nine cases having ROP were missed by the RetCam. All these cases were either in zone 3 or the outer part of zone 2, which later regressed. These were missed mostly because of the restricted mobility of the camera head caused by its size and the barrier caused by the lid speculum arms. No case of threshold ROP was missed. RetCam may replace BIO for screening of ROP.
  8,641 753 23
Clinico-microbiological profile and visual outcomes of post-traumatic endophthalmitis at a tertiary eye care center in South India
Vasumathy Vedantham, Praveen K Nirmalan, Kim Ramasamy, Karthik Prakash, Perumalsamy Namperumalsamy
January-March 2006, 54(1):5-10
DOI:10.4103/0301-4738.21607  PMID:16531663
Purpose: To analyze the clinical and microbiological characteristics of eyes with post-traumatic endophthalmitis and factors influencing the visual outcomes in these cases. Methods: We performed a retrospective chart analysis of the clinical and microbiological data of 97 consecutive patients with post-traumatic endophthalmitis presenting to a tertiary eye care hospital in South India. Results: Thirty-nine (40.2%) cases were culture-positive, Gram-positive cocci (n=24/42, 57.1%) being the commonest isolates. Staphylococcus epidermidis and Pseudomonas aeuruginosa were the commonest single isolates (n=10; 23.8%). Majority of the organisms were sensitive to chloramphenicol (n=27) or ciprofloxacin (n=26). Susceptibility to vancomycin (n=3) and amikacin (n=4) was poor. Cases with negative cultures at presentation were more likely to have improvement in visual acuity compared with culture-positive cases (on multivariate analysis, OR: 3.2, 95% CI: 1.1, 9.0). Conclusions: In this series of post-traumatic endophthalmitis, a high prevalence of resistance of the culture isolates to vancomycin and amikacin was observed.
  8,544 521 13
Herpes simplex keratitis and visual impairment: A case series
Amit Kabra, Prajna Lalitha, Kannan Mahadevan, Namperumalsamy Venkatesh Prajna, Muthaiah Srinivasan
January-March 2006, 54(1):23-27
DOI:10.4103/0301-4738.21610  PMID:16531666
Purpose: T o record the natural history of herpes simplex keratitis and estimate visual impairment in eyes of patients diagnosed with herpes simplex keratitis Materials: This was a retrospective, descriptive case study for five years of the eyes of patients with clinically diagnosed herpes simplex keratitis. These patients had presented to the cornea services and a cornea specialist carried out the ocular examination under slit-lamp magnification. The medical records were reviewed by the authors. Visual acuity at presentation and clinical details on examination were recorded and, diagnosis of the stage of disease given in the case record was noted. Statistical analysis was done using chi-square-test and Fisher exact test. Results: Of a total of 212 patients (220 eyes), there were 144 males and 68 females; 118 eyes presented with stromal lesions, 44 eyes with epithelial lesions, 39 eyes with epithelial and stromal lesions, and 19 eyes with endothelitis. The improvement in visual acuity to more than 20/40 in the four clinical groups was 23 out of 44 eyes with epithelial lesion (52.27%), 83 out of the 118 eyes with stromal lesions (70.33%), 23 out of 39 eyes with epithelial and stromal lesions (58.97%), and 8 out of the 19 eyes with endothelitis (42.10%). The mean improvement in visual acuity was 3.44 lines (SD 4.06). Conclusion: Most patients had mild disease. The majority of the patients attained the final visual acuity of 6/12 or better in the affected eye. Thus, there was only a temporary visual morbidity with fairly good functional visual outcome in majority of the patients.
  7,242 506 10
COMMUNITY OPHTHALMOLOGY
Blindness and visual impairment among the elderly in Ife-Ijesha zone of Osun State, Nigeria
BO Adegbehingbe, BR Fajemilehin, EO Ojofeitimi, LA Bisiriyu
January-March 2006, 54(1):59-62
DOI:10.4103/0301-4738.21620  PMID:16531676
Background: To provide information on the prevalence of visual impairment, blindness and the leading causes of visual changes among the elderly in Ife-Ijesha zone of Osun state in Nigeria. Design: A cross-sectional descriptive community based study Methods: All people aged 60years or older were gathered at various centres in Ife-Ijesha zone of Osun State, Nigeria. They were all screened for various medical problems including eye ailments and blindness according to World Health Organisation (WHO) definition. Information was retrieved and clinical examination conducted by the ophthalmologist in the team. Data collected were analyzed using descriptive statistical methods. Results: Out of the 681 elderly who presented for medical check up, 445 had eye problems. A few 25 (5.6%) were bilaterally blind while 202 (45.4%) were visually impaired according to the WHO definition of blindness and visual impairment. Blindness was twice as common in men as in women and the difference was statistically significant (P=0.0001). Cataract (42.3%), glaucoma (32.4%) and uncorrected aphakia (9.9%) were the leading causes of blindness in 69 eyes while 80% of visual impairment was due to cataract alone. Conclusions: The prevalence of blindness and visual impairment in this study population is high. These findings in a community where most of the elderly are fast losing traditionally accorded attention due to civilization and urban movement call for a great concern.
  7,167 494 10
BRIEF REPORTS
Recurrence of bilateral herpes simplex virus keratitis following bimatoprost use
Mihir Trilok Kothari, Bijal Kabir Mehta, Neetu Sandeep Asher, Kulin Jayantilal Kothari
January-March 2006, 54(1):47-48
DOI:10.4103/0301-4738.21617  PMID:16531673
A 76-year-old man presented with features of bilateral herpes simplex virus (HSV) keratitis. It was found to be recurrence of bilateral HSV keratitis following the use of Bimatoprost eye drops for uncontrolled intraocular pressure in a case of bilateral primary open-angle glaucoma.
  6,199 293 9
Bilateral dissociated vertical deviation in a case of congenital hereditary endothelial dystrophy
Rahul Bhola, Rohit Saxena, Harinder Singh Sethi, Pradeep Sharma, Anita Panda, Seema Sen
January-March 2006, 54(1):41-42
DOI:10.4103/0301-4738.21614  PMID:16531670
Dissociated vertical deviation (DVD) is an intermittent anomaly of the non-fixing eye. Although association of DVD with sensory visual deprivation owing to congenital or acquired opacities of the ocular media has been reported, its association with congenital hereditary endothelial dystrophy (CHED) has not been reported hitherto. We report a case having a bilateral asymmetric DVD, in a know case of bilateral CHED.
  5,938 267 2
Management of congenital bilateral subluxated cataract with Cionni ring
MR Praveen, Alpesh R Shah, Urvi D Jani, Shetal M Raj, Abhay R Vasavada
January-March 2006, 54(1):39-41
DOI:10.4103/0301-4738.21613  PMID:16531669
Use of Cionni ring helped in the successful intraocular lens (IOL) implantation in a 30-year-old patient with bilateral congenital subluxated cataracts. The IOL was stable, well-centered without any iridodonesis or pseudophakodonesis.
  5,735 365 1
Atypical manifestations of acute posterior multifocal placoid pigment epitheliopathy
Vasumathy Vedantham, Kim Ramasamy
January-March 2006, 54(1):49-52
DOI:10.4103/0301-4738.21618  PMID:16531674
We report four patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) with atypical features which were unilaterality, serous detachment of the neurosensory retina, retinal vasculitis, and papillitis. All patients responded well to oral corticosteroids. We suggest that systemic corticosteroids could be useful in selected cases of APMPPE with atypical clinical features.
  5,645 454 11
ORIGINAL ARTICLE
Role of frequency doubling technology perimetry in screening of diabetic retinopathy.
Rajul Parikh, Milind Naik, Annie Mathai, Thomas Kuriakose, JayaPrakash Muliyil, Ravi Thomas
January-March 2006, 54(1):17-22
DOI:10.4103/0301-4738.21609  PMID:16531665
Purpose: To study the ability of frequency-doubling technology perimetry (FDT) to detect sight-threatening diabetic retinopathy. Method: Fifty-eight eyes of fifty-eight patients with established diagnosis of diabetes mellitus with diabetic retinopathy, fifty-five eyes of fifty-five diabetic patients without retinopathy, and forty-one eyes of forty-one normals underwent FDT and dilated stereo-biomicroscopic fundus examination. The sensitivity and specificity of FDT in identification of "sight-threatening retinopathy" (severe and very severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy) and clinically significant macular edema (CSME) were determined. Results: For the detection of sight-threatening retinopathy, two abnormal adjacent points depressed to any level on the 20-1 screening program had a sensitivity of 90.5% and specificity of 97.6%. At (assuming a) 10% prevalence of sight-threatening retinopathy in a diabetic clinic, two abnormal adjacent points anywhere in the field depressed to any level has a positive predictive value (PPV) of 48% with a negative predictive value of 98.8%. Sensitivity and specificity for the detection of CSME was poor. Conclusions: The 20-1 screening program of the FDT is useful in the detection of sight-threatening diabetic retinopathy (PPV 48%). A normal 20-1 test rules out sight-threatening retinopathy. FDT was not useful in the detection of CSME.
  5,304 434 11
BRIEF REPORTS
Bilateral spontaneous hyphaema in juvenile xanthogranuloma
P Vijayalakshmi, Shashikant Shetty, Jitendra Jethani, TB Uma Devi
January-March 2006, 54(1):45-46
DOI:10.4103/0301-4738.21616  PMID:16531672
This report describes a rare occurrence of bilateral, spontaneous, nontraumatic hyphema in a 6 weeks old infant, associated with a small, multiple skin lesions. The diagnosis of juvenile xanthogranuloma was confirmed by histopathological examination of the cutaneous lesions. The hyphaema cleared gradually in 2 weeks time with conservative management.
  5,252 284 2
Relation between increased anaerobic glycolysis and visual acuity in long-standing type 2 diabetes mellitus without retinopathy
LK Mondal, KP Baidya, B Bhattacharya, A Giri, G Bhaduri
January-March 2006, 54(1):43-44
DOI:10.4103/0301-4738.21615  PMID:16531671
In long-standing diabetes mellitus, blood flow to essential organs including the retina is reduced owing to macrovascular and/or microvascular changes. Poor glycolytic pathway of glucose metabolism owing to tissue hypoxia caused by ischemia at capillary bed of essential organs produces excessive lactic acid and less of adenosine triphosphate, which lead to poor cellular function. The purpose of the study was to evaluate the relationship between increased anaerobic glycolysis and visual acuity in type 2 diabetes mellitus without retinopathy. Fifty patients of type 2 diabetes mellitus of 10-12 years duration, without retinopathy, constituted the study group. The controls were 50 age-matched healthy persons without diabetes mellitus. Blood lactate level and best-corrected visual acuity (BCVA) were measured in both the groups. The mean blood lactate level was 1.05 mM/l in the control group and 2.32 mM/l in the study group. BCVA of 20/20 (log MAR 0) was seen in 48 (96%) patients of the control group and in 27 (54%) patients of the study group. BCVA of 20/30 (log MAR 0.2) was seen in 23 (46%) patients in the study group and 2(4%) in the control group. Association of higher blood lactate level with decreased BCVA in the study group was statistically significant (P<0.001).
  5,174 273 1
LETTER TO EDITOR
Spontaneous bilateral giant retinal tears with near simultaneous occurrence.
Atul Kumar, Gunjan Prakash, Ritesh Gupta
January-March 2006, 54(1):67-67
DOI:10.4103/0301-4738.21627  PMID:16531682
  3,839 211 1
EDITORIAL
Editorial duty and misconduct - keeping an eye
Barun K Nayak
January-March 2006, 54(1):1-2
DOI:10.4103/0301-4738.21606  PMID:16531662
  3,722 216 -
LETTER TO EDITOR
Curvularia lunata endophthalmitis presenting with a posterior capsular plaque
Avinash Pathengay, Gaurav Yogesh Shah Shah, Taraprasad Das, Savitri Sharma
January-March 2006, 54(1):65-66
DOI:10.4103/0301-4738.21625  PMID:16531680
  3,585 227 8
Classification of amblyopia
Neela Patwardhan
January-March 2006, 54(1):64-64
DOI:10.4103/0301-4738.21623  PMID:16531679
  3,435 311 1
Utility of computed chest tomography in recurrent uveitis
Sanjay Kumar Teotia
January-March 2006, 54(1):63-63
DOI:10.4103/0301-4738.21621  PMID:16531677
  3,459 175 -
Bilateral vitreous hemorrhage in an elderly male
Vasumathy Vedantham, Koshal Ram Balasubramaniam
January-March 2006, 54(1):64-65
DOI:10.4103/0301-4738.21624  PMID:16531678
  3,318 194 -
A simple technique to fixate the bullet pipe and perform bimanual vitreous surgery.
Biju Raju, N S.D. Raju, Anju S Raju
January-March 2006, 54(1):66-67
DOI:10.4103/0301-4738.21626  PMID:16531681
  3,175 176 -
Author's reply
Salil Mehta
January-March 2006, 54(1):63-64
  2,036 111 -