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   2013| April  | Volume 61 | Issue 4  
    Online since May 17, 2013

 
 
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REVIEW ARTICLE
Indocyanine green angiography in posterior uveitis
Rupesh V Agrawal, Jyotirmay Biswas, Dinesh Gunasekaran
April 2013, 61(4):148-159
DOI:10.4103/0301-4738.112159  PMID:23685486
Literature review for indocyanine green angiography and evaluate the role of indocyanine green angiogram (ICGA) in patients with posterior uveitis seen at a tertiary referral eye care centre. Detailed review of the literature on ICGA was performed. Retrospective review of medical records of patients with posterior uveitis and dual fundus and ICGA was done after institutional board approval. Eighteen patients (26 eyes) had serpiginous choroiditis out of which 12 patients had active choroiditis and six patients had healed choroiditis, six patients (12 eyes) had ampiginous choroiditis, six patients (12 eyes) had acute multifocal posterior placoid pigment epitheliopathy, eight patients (10 eyes) had multifocal choroiditis, four patients (eight eyes) had presumed ocular histoplasmosis syndrome, four patients (eight eyes) had presumed tuberculous choroiditis, two patients (four eyes) had multiple evanescent white dot syndrome and two patients (four eyes) had Vogt Koyanagi Harada (VKH) syndrome. The most characteristic feature noted on ICGA was the presence of different patterns of hypofluorescent dark spots, which were present at different stages of the angiogram. ICGA provides the clinician with a powerful adjunctive tool in choroidal inflammatory disorders. It is not meant to replace already proven modalities such as the fluorescein angiography, but it can provide additional information that is useful in establishing a more definitive diagnosis in inflammatory chorioretinal diseases associated with multiple spots. It still needs to be determined if ICGA can prove to be a follow up parameter to evaluate disease progression.
  9,575 626 3
ORIGINAL ARTICLES
Assessment of metamorphopsia in patients with central serous chorioretinopathy
Sin Woo Bae, Ju Byung Chae
April 2013, 61(4):172-175
DOI:10.4103/0301-4738.112162  PMID:23685489
Background: To evaluate the presence and extent of metamorphopsia using M-CHARTS TM (Inami Co., Tokyo, Japan) in patients with central serous chorioretinopathy (CSC). Design: Retrospective consecutive medical record review in a university hospital. Materials and Methods: We examined 33 eyes of 33 consecutive CSC patients using M-CHARTS, which yields scores reflecting the severity of metamorphopsia. The condition was considered present when an M-CHARTS score was 0.3 or over. In all patients, optical coherence tomography (OCT) was performed, best-corrected visual acuity (BCVA) was assessed, and M-CHARTS scores were calculated at the first and the 1- and 3-month follow-up visits. The correlation between M-CHARTS scores and BCVA values was determined. We also sought to define relationships between the level of metamorphopsia and specific OCT findings. Results: Of 33 CSC patients, 15 showed symptoms of metamorphopsia, and all 15 had M-CHARTS scores of over 0.3. However, no correlation was evident between BCVA values and the extent of metamorphopsia as determined using M-CHARTS. In metamorphopsia patients, the incidence of focal retinal pigment epithelial detachment was notably greater than in the non-metamorphopsia group (P = 0.03). Conclusion: M-CHARTS is valuable for monitoring subjective symptom improvement during the clinical course of CSC. M-CHARTS serves as a useful adjunct to OCT.
  3,633 243 1
Glue-assisted intrascleral fixation of posterior chamber intraocular lens
Priya Narang, Samir Narang
April 2013, 61(4):163-167
DOI:10.4103/0301-4738.112160  PMID:23685487
Purpose: To analyze the visual outcome of patients undergoing glue-assisted intrascleral fixation of posterior chamber intraocular lens (IOL) in the absence of posterior capsular support. Materials and Methods: This retrospective study analyzes 25 eyes which underwent IOL implantation by the glued intrascleral fixation technique. The pre and post-operative uncorrected visual acuity (UCVA), pre and post-operative best corrected visual acuity (BCVA), intraocular pressure (IOP), IOL position, anterior chamber reaction and central macular thickness were assessed and recorded. Immediate and late post-operative complications were also recorded. Results: A total of 25 eyes of 22 patients were reviewed and analyzed over a period of one year. All eyes had a foldable three-piece IOL implanted. About 84% of the eyes had a gain of one or more lines, 12% had no gain, and 4% had a fall of three lines of BCVA on Snellen's visual chart, which was attributed to cystoid macular edema (CME). Postoperatively, there was a significant improvement in the UCVA (P < 0.05) and in the BCVA (P < 0.05). Postoperative complications included decentration in one case and vitritis with chronic macular edema in another case. Optical coherence tomography (OCT) demonstrated well placed IOL with no tilt. Conclusion: Although the results of one year follow-up of glued intrascleral fixation are promising, long term studies are recommended.
  3,190 337 1
Spectral domain optical coherence tomography for early detection of retinal alterations in patients using hydroxychloroquine
Yigit Ulviye, Tugcu Betul, Tarakcioglu Hatice Nur, Celik Selda
April 2013, 61(4):168-171
DOI:10.4103/0301-4738.112161  PMID:23685488
Objective: To determine whether early toxic effects from hydroxychloroquine (HCQ) could be detected by spectral-domain optical coherence tomography (SD-OCT) before symtomatic visual loss occured. Materials and Methods: Fifteen subjects with a history of the chronic use of hydroxychloroquine monotherapy for less than five years without fundus changes (group 1) and 15 visually normal healthy subjects (group 2) were enrolled in this study. All participants underwent systemic and ocular examination, visual field testing, and macular scan imaging using SD-OCT. Results: There were no significant differences in sex and ages between the groups (P > 0.05). Mean duration of HCQ usage in group 1 was 2.5 ± 1.34 (range:1-5) years. Visual field testing with central 10-2 threshold program was normal in all subjects. Inner retinal thickness in parafoveal and perifoveal area were found to be significantly lower in group 1 compared to group 2 (P < 0.01 for perifoveal, P < 0.05 for parafoveal retinal measurements). However, significant thinning was demonstrated only in full retinal thickness of perifoveal area in group 1 compared to group 2 (P: 0.013). Parafoveal and perifoveal inner retinal thickness measurements of inferior quadrants were significantly reduced in group 1 compared to group 2 (P < 0.01). Conclusion: Significant thinning of inner retinal layer especially in parafoveal and perifoveal areas in the absence of clinical fundus changes was observed in our study. We consider that SD-OCT may determine when inner retinal thinning starts in these patients and may contribute a quantitative approach to the early diagnosis and progression of retinal changes.
  3,068 348 1
Relation between platelet indices and branch retinal vein occlusion in hypertensive patients
Halil Ibrahim Onder, Ali Cagri Kilic, Murat Kaya, Serkan Bulur, Elif Onder, Murat Tunc
April 2013, 61(4):160-162
DOI:10.4103/0301-4738.111063  PMID:23619481
Backgroud: Branch retinal vein occlusion (BRVO) is the second most common retinal vascular disease after diabetic retinopathy. To date, the studies were unable to elucidate the mechanism of the thrombosis leading to the entity; particularly the relation between thrombocyte aggregation and retinal vein occlusion is still unclear. Mean platelet volume (MPV) is a determinant of rate of platelet production and activation, both of which are indices of function of platelets. The relation between MPV and BRVO has not been studied before. The aim was to evaluate MPV in BRVO. Materials and Methods: Forty patients were included in the study. Forty six age and sex matched hypertensive volunteers were recruited as the control group. Results: MPV values were significantly higher in BRVO patients compared with the control subjects (8.01 ± 0.79vs 7.52 ± 0.32fL, respectively; P < 0.001). Conclusion: MPV is significantly higher in patients hypertensive BRVO patients and further investigations regarding its potentially use as a prognostic biomarker in patients with BRVO are needed.
  2,351 352 4
BRIEF COMMUNICATIONS
Traumatic chorioretinal folds treated with intra-vitreal triamcinolone injection
Kook Young Kim, Hyung-Woo Kwak, Moosang Kim, Seung-Young Yu
April 2013, 61(4):179-182
DOI:10.4103/0301-4738.112165  PMID:23685492
A 34-year-old male visited the hospital due to decreased visual acuity in the left eye following an injury from a car accident. In the left eye, best-corrected visual acuity (BCVA) was hand motion and intraocular pressure (IOP) was 8 mmHg. Choroidal vasodilation and chorioretinal folds were observed by spectral domain-optical coherence tomography (SD-OCT). Topical and systemic steroid treatments did not improve the chorioretinal folds. Twelve months after the injury, intra-vitreal triamcinolone (4 mg/0.1 ml) was injected. Six months after intra-vitreal triamcinolone injection, BCVA in the left eye had improved to 20/100. Fundus examination showed improvement in retinal vascular tortuosity and SD-OCT revealed improvements in choroidal vasodilation and chorioretinal folds. Intra-vitreal triamcinolone injection (IVTI) was effective against traumatic chorioretinal folds with no recurrence based on objective observation by fundus photography and SD-OCT.
  2,556 142 -
Peristence of triamcinolone crystals after intra-vitreal injection: Benign crystalline hyaloidopathy
Rafik Zarifa, Saad Shaikh, Elizabeth Kester
April 2013, 61(4):182-183
DOI:10.4103/0301-4738.112166  PMID:23685493
We report a case of unusually long persistence of triamcinolone crystals after intra-vitreal injection. Crystals were noted on fundus examination predominantly confined to the posterior pole. Optical coherence tomography localized the crystals to the posterior hyaloidal surface. Over 6 years of follow-up the patient has retained good visual acuity and no observable changes in the retina. As the condition clinically resembles both crystalline maculopathy and asteroid hyalosis, we suggest the term 'drug-induced benign crystalline hyaloidopathy'.
  2,558 136 2
PHOTOESSAY
High altitude retinopathy
Muna P Bhende, Aashraya P Karpe, Bikramjit P Pal
April 2013, 61(4):176-177
DOI:10.4103/0301-4738.112163  PMID:23685490
High altitude retinopathy is a condition often seen among mountain climbers or among persons who reach high altitudes rapidly. In this report, we describe a case of a 57 year old healthy gentleman who presented with diminution of vision in both the eyes associated with retinal hemorrhages and the spontaneous resolution of the same.
  2,340 207 -
BRIEF COMMUNICATIONS
A case of Churg-Strauss syndrome and central retinal artery occlusion with good visual recovery
Yuki Kamata, Kouhei Hashizume, Muneyoshi Kaneko, Daijiro Kurosaka
April 2013, 61(4):178-179
DOI:10.4103/0301-4738.112164  PMID:23685491
Here we report a case of Churg-Strauss syndrome (CSS) and central retinal artery occlusion (CRAO), with good visual recovery. A 58-year-old Japanese man with CSS experienced acute painless loss of vision in his right eye. CRAO was diagnosed by fundoscopic findings (retinal whitening with a cherry-red spot). Steroid pulse therapy (methylprednisolone at 1 g daily for 3 days) followed by combined treatment with prednisolone (30 mg/day) and cyclophosphamide (150 mg/day) was administered; his visual acuity recovered to 20/30 in 1 month, and no recurrence has occurred for 1 year. Steroid pulse therapy may be effective for CRAO in CSS patients.
  2,305 182 -
EDITORIAL
Imaging in vitreoretinal diagnostics
Sundaram Natarajan
April 2013, 61(4):145-147
DOI:10.4103/0301-4738.112158  PMID:23685485
  1,601 250 -
LETTERS TO THE EDITOR
Pre-operative sub-conjunctival mitomycin C 24 hours before excision of recurrent pterygium
VP Gupta, Pragati Gupta
April 2013, 61(4):185-186
DOI:10.4103/0301-4738.112169  PMID:23685495
  1,498 149 -
Submacular hemorrhage from polypoidal choroidal vasculopathy after cataract surgery
Colin S H Tan, Wei Kiong Ngo, Louis W Lim, Kelvin Z Li
April 2013, 61(4):184-184
DOI:10.4103/0301-4738.112167  PMID:23685494
  1,401 122 -
Regarding comparison of different techniques of cataract surgery in bacterial contamination of the anterior chamber in diabetic and non-diabetic population
Kevin Michael Wells, Kapil G Kapoor, SK Gibran
April 2013, 61(4):186-186
DOI:10.4103/0301-4738.112170  PMID:23685496
  1,362 118 -
Assessing Framingham cardiovascular risk scores in subjects with diabetes and their correlation with diabetic retinopathy-Comment
Sachidanandam Vivekanandan
April 2013, 61(4):187-187
DOI:10.4103/0301-4738.112172  PMID:23685497
  1,203 114 -
Authors' reply
Moosang Kim, Jisang Han, Seung-Young Yu, Hyung-Woo Kwak
April 2013, 61(4):184-185
  1,074 79 -
Authors' reply
M Ashok Kumar, Sheen S Kurien, Stephen Selvaraj, Uma Devi, S Sevasundari
April 2013, 61(4):186-187
  978 82 -