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   Table of Contents      
Year : 2014  |  Volume : 62  |  Issue : 11  |  Page : 1043-1044

Innovative ophthalmology

Editor, Indian Journal of Ophthalmology, Chairman, Managing Director, Aditya Jyot Eye Hospital Pvt. Ltd, Wadala (W), Mumbai, Maharashtra, India

Date of Web Publication10-Dec-2014

Correspondence Address:
Sundaram Natarajan
Editor, Indian Journal of Ophthalmology, Chairman, Managing Director, Aditya Jyot Eye Hospital Pvt. Ltd, Wadala (W), Mumbai, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0301-4738.146706

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How to cite this article:
Natarajan S. Innovative ophthalmology. Indian J Ophthalmol 2014;62:1043-4

How to cite this URL:
Natarajan S. Innovative ophthalmology. Indian J Ophthalmol [serial online] 2014 [cited 2021 Jan 25];62:1043-4. Available from: https://www.ijo.in/text.asp?2014/62/11/1043/146706

"Synergy and serendipity often play a big part in medical and scientific advancements."

-Julie Bishop

Seasonal Greetings!!!

Choroid, the most important vascular tissue of the eye, has not been extensively researched in Indian context. With the advent of enhanced depth imaging, it has become possible for us to conduct in-depth research studies on choroidal structures. [1] Choroidal thickness (CT) is a very important predictor of glaucoma, [2] visual acuity in myopia, [3] diabetic retinopathy [4] and age-related macular degeneration. [5] Although previous studies [6],[7] have evaluated some degree of CT in healthy individuals, Indian data is found to be scarce. Besides, the scare data available included individuals with extreme axial lengths that bias the study results. Chhablani et al. in this issue has published a study where they have assessed the CT in healthy individuals without any retinal or choroidal abnormalities with normal axial lengths in different age groups. The authors evaluated CT from various loci and it was found to correlate well with age. This data serves as a reference for other researchers to compare the CT in various chorioretinal disorders in Indian population of different age groups.

Retinoblastoma, the most common primary ocular malignancy in children is one of the most aggressive tumors that metastasise. [8] Various high-risk histopathologic risk factors (HRFs) that have been identified as indicators of metastatic spread of the tumor include optic nerve invasion, particularly retro laminar or to the transection line, and choroidal, scleral, and extra scleral (orbital) involvement. The published rate of occurrence of these factors show a wide range: 7-56% for invasion into the retro laminar optic nerve and from the optic nerve to the transaction line; 12-42% for choroidal involvement; and 3-30% for scleral and extra scleral spread. [9],[10],[11],[12],[13],[14],[15] However, recently the incidence of HRFs has declined over time, possibly because of earlier detection of cases. Seema et al. in this issue has published a retrospective study where the authors have evaluated HRF in Indian retinoblastoma patients and correlated these with p53 gene expression. p53 gene expression has been observed in 50-60% of patients with retinoblastoma. [16] In the present study, the authors found necrosis (70.5%), calcification (64.7%), and retinal detachment (58.8%) as common HRFs. Additionally, the incidence of various morphological parameters such as anterior chamber seeding, ciliary body involvement, iris involvement, choroid involvement, scleral invasion, extra scleral invasion and optic nerve infiltration were found ranging between 11% and 58% in the study participants. p53 expression was present in four out of 13 cases (30.7%) and showed significant association with choroid invasion. Although the authors found a higher incidence of HRFs in Indian patients with retinoblastoma that dictates the use of adjuvant chemotherapy, the study in general stresses the importance of looking into all these HRFs in patients by the treating physicians.

Goldmann applanation tonometer (GAT) has been the gold standard for measurement of intraocular pressure in glaucoma patients. [17] Despite being the gold standard calibration method, errors have been frequently reported to occur with GAT [18],[19] especially a high proportion in a recent Indian study. [20] Choudhari et al. in this issue explored the possibility of a new self-taught technique to rectify such calibration errors in GAT from a pilot study and found to be promising. However, a large adequately powered study is required before recommendation of this technique. Additionally, Dada et al. in this issue published an in-depth analysis of the use of scanning laser polarimetry in the diagnosis and monitoring of glaucomatous optic neuropathy that may help detect the changes earlier than the conventional methods. This issue also emphasises my firm belief that one should publish or perish. The article gives an overview of key steps to good manuscript preparation and the need to have a research based outlook even when engrossed in clinical practice.

Let us synergize this new year, learn and share.

Read loads this new year, Happy Reading!!!

  References Top

Chhablani J, Barteselli G, Wang H, El-Emam S, Kozak I, Doede AL, et al. Repeatability and reproducibility of manual choroidal volume measurements using enhanced depth imaging optical coherence tomography. Invest Ophthalmol Vis Sci 2012;53:2274-80.  Back to cited text no. 1
Hirooka K, Tenkumo K, Fujiwara A, Baba T, Sato S, Shiraga F. Evaluation of peripapillary choroidal thickness in patients with normal-tension glaucoma. BMC Ophthalmol 2012;12:29.  Back to cited text no. 2
Nishida Y, Fujiwara T, Imamura Y, Lima LH, Kurosaka D, Spaide RF. Choroidal thickness and visual acuity in highly myopic eyes. Retina 2012;32:1229-36.  Back to cited text no. 3
Nagaoka T, Kitaya N, Sugawara R, Yokota H, Mori F, Hikichi T, et al. Alteration of choroidal circulation in the foveal region in patients with type 2 diabetes. Br J Ophthalmol 2004;88:1060-3.  Back to cited text no. 4
McLeod DS, Grebe R, Bhutto I, Merges C, Baba T, Lutty GA. Relationship between RPE and choriocapillaris in age-related macular degeneration. Invest Ophthalmol Vis Sci 2009;50:4982-91.  Back to cited text no. 5
Manjunath V, Taha M, Fujimoto JG, Duker JS. Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography. Am J Ophthalmol 2010;150:325-329.e1.  Back to cited text no. 6
Ikuno Y, Kawaguchi K, Nouchi T, Yasuno Y. Choroidal thickness in healthy Japanese subjects. Invest Ophthalmol Vis Sci 2010;51:2173-6.  Back to cited text no. 7
Gupta R, Vemuganti GK, Reddy VA, Honavar SG. Histopathologic risk factors in retinoblastoma in India. Arch Pathol Lab Med 2009;133:1210-4.  Back to cited text no. 8
Messmer EP, Heinrich T, Höpping W, de Sutter E, Havers W, Sauerwein W. Risk factors for metastases in patients with retinoblastoma. Ophthalmology 1991;98:136-41.  Back to cited text no. 9
Khelfaoui F, Validire P, Auperin A, Quintana E, Michon J, Pacquement H, et al. Histopathologic risk factors in retinoblastoma: A retrospective study of 172 patients treated in a single institution. Cancer 1996;77:1206-13.  Back to cited text no. 10
Shields CL, Shields JA, Baez K, Cater JR, De Potter P. Optic nerve invasion of retinoblastoma. Metastatic potential and clinical risk factors. Cancer 1994;73:692-8.  Back to cited text no. 11
Shields CL, Shields JA, Baez KA, Cater J, De Potter PV. Choroidal invasion of retinoblastoma: Metastatic potential and clinical risk factors. Br J Ophthalmol 1993;77:544-8.  Back to cited text no. 12
Magramm I, Abramson DH, Ellsworth RM. Optic nerve involvement in retinoblastoma. Ophthalmology 1989;96:217-22.  Back to cited text no. 13
Kopelman JE, McLean IW, Rosenberg SH. Multivariate analysis of risk factors for metastasis in retinoblastoma treated by enucleation. Ophthalmology 1987;94:371-7.  Back to cited text no. 14
Hungerford J. Factors influencing metastasis in retinoblastoma. Br J Ophthalmol 1993;77:541.  Back to cited text no. 15
Schwimer CJ, Prayson RA. Clinicopathologic study of retinoblastoma including MIB-1, p53, and CD99 immunohistochemistry. Ann Diagn Pathol 2001;5:148-54.  Back to cited text no. 16
Januleviciene I, Kuzmiene L, Sliesoraityte I. Comparison of intraocular pressure fluctuations measured by goldmann applanation tonometer and pulsatile ocular blood flow analyser. Int J Biomed Sci 2006;2:428-33.  Back to cited text no. 17
Sandhu SS, Chattopadhyay S, Birch MK, Ray-Chaudhuri N. Frequency of goldmann applanation tonometer calibration error checks. J Glaucoma 2005;14:215-8.  Back to cited text no. 18
Choudhari NS, George R, Baskaran M, Vijaya L, Dudeja N. Measurement of Goldmann applanation tonometer calibration error. Ophthalmology 2009;116:3-8.  Back to cited text no. 19
Choudhari NS, Jadhav V, George R, Vijaya L. Variability in the calibration error of the goldmann applanation tonometer. J Glaucoma 2011;20:492-6.  Back to cited text no. 20


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