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   2015| May  | Volume 63 | Issue 5  
    Online since July 2, 2015

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Fundus autofluorescence applications in retinal imaging
Andrea Gabai, Daniele Veritti, Paolo Lanzetta
May 2015, 63(5):406-415
DOI:10.4103/0301-4738.159868  PMID:26139802
Fundus autofluorescence (FAF) is a relatively new imaging technique that can be used to study retinal diseases. It provides information on retinal metabolism and health. Several different pathologies can be detected. Peculiar AF alterations can help the clinician to monitor disease progression and to better understand its pathogenesis. In the present article, we review FAF principles and clinical applications.
  9,143 989 -
Multimodality imaging in macular telangiectasia 2: A clue to its pathogenesis
Lihteh Wu
May 2015, 63(5):394-398
DOI:10.4103/0301-4738.159864  PMID:26139799
Macular telangiectasia type 2 also known as idiopathic perifoveal telangiectasia and juxtafoveolar retinal telangiectasis type 2A is an acquired bilateral neurodegenerative macular disease that manifests itself during the fifth or sixth decades of life. It is characterized by minimal dilatation of the parafoveal capillaries with graying of the retinal area involved, a lack of lipid exudation, right-angled retinal venules, refractile deposits in the superficial retina, hyperplasia of the retinal pigment epithelium, foveal atrophy, and subretinal neovascularization (SRNV). Our understanding of the disease has paralleled advances in multimodality imaging of the fundus. Optical coherence tomography (OCT) images typically demonstrate the presence of intraretinal hyporeflective spaces that are usually not related to retinal thickening or fluorescein leakage. The typical fluorescein angiographic (FA) finding is a deep intraretinal hyperfluorescent staining in the temporal parafoveal area. With time, the staining may involve the whole parafoveal area but does not extend to the center of the fovea. Long-term prognosis for central vision is poor, because of the development of SRNV or macular atrophy. Its pathogenesis remains unclear but multimodality imaging with FA, spectral domain OCT, adaptive optics, confocal blue reflectance and short wave fundus autofluorescence implicate Müller cells and macular pigment. Currently, there is no known treatment for this condition.
  4,673 515 -
Clinical applications of choroidal imaging technologies
Jay Chhablani, Giulio Barteselli
May 2015, 63(5):384-390
DOI:10.4103/0301-4738.159861  PMID:26139797
Choroid supplies the major blood supply to the eye, especially the outer retinal structures. Its understanding has significantly improved with the advent of advanced imaging modalities such as enhanced depth imaging technique and the newer swept source optical coherence tomography. Recent literature reports the findings of choroidal changes, quantitative as well as qualitative, in various chorioretinal disorders. This review article describes applications of choroidal imaging in the management of common diseases such as age-related macular degeneration, high myopia, central serous chorioretinopathy, chorioretinal inflammatory diseases, and tumors. This article briefly discusses future directions in choroidal imaging including angiography.
  4,419 516 -
En-face optical coherence tomography in the diagnosis and management of age-related macular degeneration and polypoidal choroidal vasculopathy
Tiffany Lau, Ian Y Wong, Lawrence Iu, Jay Chhablani, Tao Yong, Koizumi Hideki, Jacky Lee, Raymond Wong
May 2015, 63(5):378-383
DOI:10.4103/0301-4738.159860  PMID:26139796
Optical coherence tomography (OCT) is a noninvasive imaging modality providing high-resolution images of the central retina that has completely transformed the field of ophthalmology. While traditional OCT has produced longitudinal cross-sectional images, advancements in data processing have led to the development of en-face OCT, which produces transverse images of retinal and choroidal layers at any specified depth. This offers additional benefit on top of longitudinal cross-sections because it provides an extensive overview of pathological structures in a single image. The aim of this review was to discuss the utility of en-face OCT in the diagnosis and management of age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). En-face imaging of the inner segment/outer segment junction of retinal photoreceptors has been shown to be a useful indicator of visual acuity and a predictor of the extent of progression of geographic atrophy. En-face OCT has also enabled high-resolution analysis and quantification of pathological structures such as reticular pseudodrusen (RPD) and choroidal neovascularization, which have the potential to become useful markers for disease monitoring. En-face Doppler OCT enables subtle changes in the choroidal vasculature to be detected in eyes with RPD and AMD, which has significantly advanced our understanding of their pathogenesis. En-face Doppler OCT has also been shown to be useful for detecting the polypoid lesions and branching vascular networks diagnostic of PCV. It may therefore serve as a noninvasive alternative to fluorescein and indocyanine green angiography for the diagnosis of PCV and other forms of the exudative macular disease.
  4,295 547 -
Look what else we found - clinically significant abnormalities detected during routine ROP screening
Chaitra Jayadev, Anand Vinekar, Noel Bauer, Shwetha Mangalesh, Padmamalini Mahendradas, Vasudha Kemmanu, Ashwin Mallipatna, Bhujang Shetty
May 2015, 63(5):373-377
DOI:10.4103/0301-4738.159859  PMID:26139795
Purpose: The purpose of this study was to report the spectrum of anterior and posterior segment diagnoses in Asian Indian premature infants detected serendipitously during routine retinopathy of prematurity (ROP) screening during a 1 year period. Methods: A retrospective review of all Retcam (Clarity MSI, USA) imaging sessions during the year 2011 performed on infants born either <2001 g at birth and/or <34.1 weeks of gestation recruited for ROP screening was performed. All infants had a minimum of seven images at each session, which included the dilated anterior segment, disc, and macula center and the four quadrants using the 130° lens. Results: Of the 8954 imaging sessions of 1450 new infants recruited in 2011, there were 111 (7.66%) with a diagnosis other than ROP. Anterior segment diagnoses seen in 31 (27.9%) cases included clinically significant cataract, lid abnormalities, anophthalmos, microphthalmos, and corneal diseases. Posterior segment diagnoses in 80 (72.1%) cases included retinal hemorrhages, cherry red spots, and neonatal uveitis of infective etiologies. Of the 111 cases, 15 (13.5%) underwent surgical procedures and 24 (21.6%) underwent medical procedures; importantly, two eyes with retinoblastoma were detected which were managed timely. Conclusions: This study emphasizes the importance of ocular digital imaging in premature infants. Visually significant, potentially life-threatening, and even treatable conditions were detected serendipitously during routine ROP screening that may be missed or detected late otherwise. This pilot data may be used to advocate for a possible universal infant eye screening program using digital imaging.
  4,278 395 -
Rhinosporidiosis of the tarsal conjunctiva
Akshay Gopinathan Nair, Mohammad Javed Ali, Swathi Kaliki, Milind N Naik
May 2015, 63(5):462-463
DOI:10.4103/0301-4738.159897  PMID:26139814
Rhinosporidiosis is a rare infection caused by Rhinosporidium seeberi, an organism classified in its own class, mesomycetozoea. It commonly affects mucus membranes namely the nasal mucosa, pharynx and the conjunctiva. We present the case of an 8-year-old female who presented with a flat, red, vascular, fleshy, pedunculated mass arising from the tarsal conjunctiva of the right upper eyelid. The mass was completely excised. On histopathological examination, multiple sporangia were seen in various stages of degeneration, consistent with rhinosporidiosis. The diagnosis of rhinosporidiosis is based solely on its microscopic features, and the treatment is surgical excision. This condition is endemic in the temperate regions of the Indian subcontinent, but it has been known to occur even in the colder regions of North America and Eastern Europe. Although a rare clinical entity, the possibility of rhinosporidiosis must be borne in mind when evaluating any polypoidal conjunctival mass.
  4,107 316 -
Choroidal thickness changes after dynamic exercise as measured by spectral-domain optical coherence tomography
Nihat Sayin, Necip Kara, Gokhan Pekel, Hasan Altinkaynak
May 2015, 63(5):445-450
DOI:10.4103/0301-4738.159884  PMID:26139808
Purpose: To measure the choroidal thickness (CT) after dynamic exercise by using enhanced depth imaging optical coherence tomography (EDI-OCT). Materials and Methods: A total of 19 healthy participants performed 10 min of low-impact, moderate-intensity exercise (i.e., riding a bicycle ergometer) and were examined with EDI-OCT. Each participant was scanned before exercise and afterward at 5 min and 15 min. CT measurement was taken at the fovea and 1000 μ away from the fovea in the nasal, temporal, superior, and inferior regions. Retinal thickness, intraocular pressure, ocular perfusion pressure (OPP), heart rate, and mean blood pressure (mBP) were also measured. Results: A significant increase occurred in OPP and mBP at 5 min and 15 min following exercise (P ˂ 0.05). The mean subfoveal CT at baseline was 344.00 ± 64.71 μm compared to 370.63 ± 66.87 μm at 5 min and 345.31 ± 63.58 μm at 15 min after exercise. CT measurements at all locations significantly increased at 5 min following exercise compared to the baseline (P ˂ 0.001), while measurements at 15 min following exercise did not significant differ compared to the baseline (P ˃ 0.05). There was no significant difference in retinal thickness at any location before and at 5 min and 15 min following exercise (P ˃ 0.05). Conclusion: Findings revealed that dynamic exercise causes a significant increase in CT for at least 5 min following exercise.
  2,801 302 -
Intravitreal ziv-aflibercept for recurrent macular edema secondary to central retinal venous occlusion
Jay Chhablani
May 2015, 63(5):469-470
DOI:10.4103/0301-4738.159909  PMID:26139820
  2,389 274 -
Spectral domain optical coherence tomography changes following intravitreal dexamethasone implant, Ozurdex ® in patients with uveitic cystoid macular edema
Pooja Bansal, Aniruddha Agarwal, Vishali Gupta, Ramandeep Singh, Amod Gupta
May 2015, 63(5):416-422
DOI:10.4103/0301-4738.159870  PMID:26139803
Purpose: To correlate the structural and functional changes following intravitreal injection of dexamethasone 0.7 mg (Ozurdex ® ) implant in patients with recalcitrant uveitic cystoid macular edema (CME). Materials and Methods: In a prospective, interventional, nonrandomized study, 30 eyes (27 patients) with uveitic CME received Ozurdex ® implant and were followed-up for 24 weeks at periodic intervals to monitor structural alterations seen on spectral domain optical coherence tomography (SD-OCT). The outcome measures included change in central macular thickness (CMT) and best-corrected visual acuity (BCVA) as well as structural alterations seen on OCT such as change in the height of cystoid spaces (CSs) and sub-foveal serous retinal detachment (SSRD). The integrity of external limiting membrane and inner-outer segment junction was assessed at baseline and follow-up visits. Results: Mean age of the patients was 46.09 ± 15.66 years. The mean CMT decreased by 96 μm at 1-day, 231.64 μm at 1-week, 254.21 μm at 4 weeks and 249.14 μm at 12 weeks (P < 0.001) compared with baseline. BCVA improved from a baseline mean of 0.62 LogMAR units to 0.49 on day 1 to 0.31 at 24 weeks (P < 0.001). A decrease in the mean height of CS, that is, 133.28 μm from a baseline of 317.71 μm was noted on the 1 st day (P < 0.001). 4 eyes demonstrated the presence of CS at 4 weeks, 1 eye at 6 weeks and 3 eyes at 12 weeks. At baseline, 16 eyes (53.33%) demonstrated the presence of SSRD. Among these, 11 eyes showed resolution of SSRD on day 1. SSRD resolved in all patients at 4 weeks and was maintained up to 24 weeks. Conclusions: Ozurdex ® implant improves the visual outcome of patients with recalcitrant uveitic CME. Reversibility of retinal changes may be possible following treatment with dexamethasone implant. Thus final visual outcome may be independent of pretreatment CMT, the height of CS or SSRD.
  2,303 264 -
Effect of ocular magnification on macular measurements made using spectral domain optical coherence tomography
Mohana Kuppuswamy Parthasarathy, Muna Bhende
May 2015, 63(5):427-431
DOI:10.4103/0301-4738.159877  PMID:26139805
Aim: The aim of the present study was to study the effect of ocular magnification on macular measurements made using spectral domain optical coherence tomography (OCT). Materials and Methods: One hundred and fifty-one subjects were included from the normative study of foveal morphology carried out at our hospital. Subjects underwent comprehensive eye examination and macular scanning using Cirrus high-definition OCT and axial length (AXL) measurement. Macular cube 512 × 128 scan protocol was used for scanning the macula. Automated measurements of the fovea namely foveal diameter, foveal slope (lateral measurements) and foveal depth (axial measurement) were taken. A correction factor for ocular magnification was done using the formula t = p × q × s, where "t0" is the corrected measurement, "p" is the magnification of OCT, "q0" is the ocular magnification, and "s" is the measurement on OCT without correction. The difference between corrected and uncorrected measurements was evaluated for statistical significance. Results: Mean AXL was 22.95 ± 0.78 mm. Refractive error ranged from −3D to +4D. Mean difference between measured and corrected foveal diameter, slope and depth was 166.05 ± 95.37 ΅m (P < 0.001), 0.81° ± 0.53° (P < 0.001) and 0.05 ± 0.49 ΅m (P = 0.178) respectively. AXL lesser than the OCT calibrated value of 24.46 mm showed an increased foveal diameter (r = 0.961, P < 0.001) and a reduced foveal slope (r = −0.863, P < 0.001) than the corrected value. Conclusion: Lateral measurements made on OCT varied with AXL s other than the OCT calibrated value of 24.46 mm. Therefore, to estimate the actual dimensions of a retinal lesion using OCT, especially lateral dimensions, we recommend correction for the ocular magnification factor.
  2,052 248 -
Real-time in vivo micromorphology and histopathology of choroidal osteoma using enhanced depth imaging
Rameez Hussain, Giridhar Anantharaman, Bindu Rajesh, Mahesh Gopalakrishnan
May 2015, 63(5):453-455
DOI:10.4103/0301-4738.159887  PMID:26139810
Choroidal osteoma is a usually unilateral benign tumor of the choroid composed of mature bone. Optical coherence tomography (OCT) has been used to image osteoma for several years. With the advent of enhanced depth imaging (EDI) feature of spectral-domain OCT (SD-OCT), better visualization of the morphology of choroidal lesions has been possible. Herein we present a case of choroidal osteoma in a 45-year-old woman, wherein in vivo morphology of the choroidal osteoma had been visualized using EDI technique of SD-OCT before and after performing photodynamic therapy. EDI OCT has proven to be a valuable noninvasive imaging modality, almost comparable to histopathological examination, for diagnosing choroidal osteomas and for providing an insight into the in vivo micromorphological changes occurring during the course of the disease.
  1,942 226 -
Future in retinal imaging for clinicians
Jay Chhablani, Chaitra Jayadev
May 2015, 63(5):370-372
DOI:10.4103/0301-4738.159857  PMID:26139794
  1,869 275 -
Evaluation of ExPress glaucoma filtration device in Indian patients with advanced glaucoma
Dewang Angmo, Reetika Sharma, Shreyas Temkar, Tanuj Dada
May 2015, 63(5):459-462
DOI:10.4103/0301-4738.159894  PMID:26139813
ExPress glaucoma filtration device (GFD) has recently become available in India as a surgical option for glaucoma patients. We retrospectively evaluated the outcome of ExPress GFD in 12 eyes with advanced glaucoma with intraocular pressures (IOPs) not controlled on maximal tolerable medical therapy. The mean preoperative IOP of 29.58 ± 7.13 mmHg decreased to 17.0 ± 2.67 and 17.40 ± 0.89 mmHg at 6 and 12 months after surgery. Absolute success (IOP ≤ 18 mmHg, with no additional glaucoma medications) was achieved in eight cases (66.7%) and qualified success (IOP ≤ 18 mmHg, with additional glaucoma medications) in two cases (16.7%) at 1-year after surgery. Early intervention was needed in 4 patients; two underwent anterior chamber reformation while the other two required needling. Two patients required resurgery. There was no significant change in the best corrected visual acuity postoperatively (P = 0.37). ExPress GFD does not seem to offer a benefit over standard trabeculectomy in patients with advanced glaucomatous disease in terms of IOP control or complication rate. However, due to the small sample size with a heterogeneous mixture of primary and secondary glaucoma's, we await further studies with a larger sample size and long-term follow-up, to see how the device performs.
  1,837 235 -
Microscope-integrated optical coherence tomography: A new surgical tool in vitreoretinal surgery
Chaitra Jayadev, Supriya Dabir, Anand Vinekar, Urmil Shah, Tania Vaid, Naresh Kumar Yadav
May 2015, 63(5):399-403
DOI:10.4103/0301-4738.159865  PMID:26139800
Optical coherence tomography (OCT) has revolutionized imaging of ocular structures and various disease conditions. Though it has been used in the clinic for some decades, the OCT has only recently found its way into the operating theater. Early attempts at intraoperative OCT, hand-held and microscope mounted, have already improved our understanding of the surgical pathology and the role it might play in surgical decision-making. The microscope-integrated OCT now allows seamless, high-resolution, real-time imaging of surgical maneuvers from the incision to wound closure. Visualization of instruments and intraoperative tissue manipulation are possible with this in vivo modality and, therefore, help improve the outcome of surgery. In this article, we describe the advantages it offers during various vitreoretinal procedures.
  1,765 267 -
Axial length and cone density as assessed with adaptive optics in myopia
Supriya Dabir, Shwetha Mangalesh, Jan S A G Schouten, Tos T J M Berendschot, Mathew Kummelil Kurian, Anupama Kiran Kumar, Naresh K Yadav, Rohit Shetty
May 2015, 63(5):423-426
DOI:10.4103/0301-4738.159876  PMID:26139804
Aim: To assess the variations in cone mosaic in myopia and its correlation with axial length (AL). Subjects and Methods: Twenty-five healthy myopic volunteers underwent assessment of photoreceptors using adaptive optics retinal camera at 2° and 3° from the foveal center in four quadrants superior, inferior, temporal and nasal. Data was analyzed using SPSS version 17 (IBM). Multivariable regression analysis was conducted to study the relation between cone density and AL, quadrant around the fovea and eccentricity from the fovea. Results: The mean cone density was significantly lower as the eccentricity increased from 2° from the fovea to 3° (18,560 ± 5455-16,404 ± 4494/mm 2 respectively). There was also a statistically significant difference between four quadrants around the fovea. The correlation of cone density and spacing with AL showed that there was a significant inverse relation of AL with the cone density. Conclusion: In myopic patients with good visual acuity cone density around the fovea depends on the quadrant, distance from the fovea as well as the AL. The strength of the relation of AL with cone density depends on the quadrant and distance.
  1,811 199 -
Hypermetropia, accommodative and decompensated/partially accommodative esotropia and esotropic Duane's retraction syndrome in infants: Words impact understanding
Pramod Kumar Pandey, Vishaal Bhambhwani, Shagun Sood, Kartik Rana, Poonam Gupta, PC Ranjith
May 2015, 63(5):468-469
DOI:10.4103/0301-4738.159908  PMID:26139819
  1,686 187 -
Mucoepidermoid carcinoma of the conjunctiva with lung metastasis
Pukhraj Rishi, Rashi Sharma, Krishnakumar Subramanian, Nirmala Subramaniam
May 2015, 63(5):457-459
DOI:10.4103/0301-4738.159893  PMID:26139812
A 36-year-old lady presented with redness and decreased vision in right eye since 6 months. She was earlier diagnosed of cavitary lung lesion, presumed secondary to tuberculosis and treated with anti-tubercular treatment for 4 months. Examination of affected right eye revealed nil light perception, conjunctival congestion with an exuberant mass in the inferotemporal bulbar conjunctiva, proptosis, iris neovascularization, 360° closed angles, intraocular pressure of 48 mm Hg, exudative retinal detachment, uveal mass and orbital extension. A diagnostic needle biopsy of uveal mass revealed malignant cells. Computed tomography-guided lung biopsy revealed squamous cell carcinoma (SCC), indicating metastatic spread from the orbit. She underwent lid-sparing exenteration of the right eye. Histopathological examination of the orbital tissue revealed mucoepidermoid carcinoma arising from the conjunctiva with extensive invasion into the orbital tissue, muscle fibers, sclera, choroid and optic nerve. Multiple tumor emboli were seen in the lumen of orbital blood vessels. In conclusion, mucoepidermoid carcinoma of the conjunctiva is a rare, aggressive variant of SCC. Early intervention is essential to prevent intraocular invasion and systemic metastasis.
  1,526 261 -
Macular edema in Asian Indian premature infants with retinopathy of prematurity: Impact on visual acuity and refractive status after 1-year
Anand Vinekar, Shwetha Mangalesh, Chaitra Jayadev, Noel Bauer, Sivakumar Munusamy, Vasudha Kemmanu, Mathew Kurian, Padmamalini Mahendradas, Kavitha Avadhani, Bhujang Shetty
May 2015, 63(5):432-437
DOI:10.4103/0301-4738.159879  PMID:26139806
Purpose: To report the impact of transient, self-resolving, untreated "macular edema" detected on spectral domain optical coherence tomography in Asian Indian premature infants with retinopathy of prematurity (ROP) on visual acuity (VA) and refraction at 1-year of corrected age. Materials and Methods: Visual acuity and refraction of 11 infants with bilateral macular edema (Group A) was compared with gestational age-matched 16 infants with ROP without edema (Group B) and 17 preterms infants without ROP and without edema (Group C) at 3, 6, 9 and 12 months of corrected age using Teller Acuity Cards and cycloplegic retinoscopy. Sub-group analysis of the previously described pattern A and B macular edema was performed. Results: Visual acuity was lower in infants with macular edema compared with the other two control groups throughout the study period, but statistically significant only at 3 months. Visual improvement in these infants was highest between the 3 rd and 6 th month and plateaued by the end of the 1 st year with acuity comparable to the other two groups. The edema cohort was more hyperopic compared to the other two groups between 3 and 12 months of age. Pattern A edema had worse VA compared to pattern B, although not statistically significant. Conclusion: Macular edema, although transient, caused reduced VA as early as 3 months of corrected age in Asian Indian premature infants weighing <2000 g at birth. The higher hyperopia in these infants is possibly due to visual disturbances caused at a critical time of fovealization. We hypothesize a recovery and feedback mechanism based on the principles of active emmetropization to explain our findings.
  1,543 242 -
Optical coherence tomography and autofluorescence findings in chronic phototoxic maculopathy secondary to snow-reflected solar radiation
Dhananjay Shukla
May 2015, 63(5):455-457
DOI:10.4103/0301-4738.159889  PMID:26139811
A professional mountain trekker presented with gradual, moderate visual decline in one eye. The subnormal vision could not be explained by the examination of anterior and posterior segment of either eye, which was unremarkable. Optical coherence tomography and autofluorescence imaging revealed subtle defects in the outer retina, which correlated with the extent of visual disturbance. A novel presentation of retinal phototoxicity due to indirect solar radiation reflected from snow in inadequately protected eyes of a chronically exposed subject is reported.
  1,456 188 -
Sterile endophthalmitis following intravitreal triamcinolone acetonide in July 2010
Moosang Kim, Seung-Young Yu, Hyung-Woo Kwak
May 2015, 63(5):467-468
DOI:10.4103/0301-4738.159906  PMID:26139818
  1,435 184 -
Choroidal thickness profile in inherited retinal diseases in Indian subjects
Jay Chhablani, Ashraya Nayaka, Padmaja Kumari Rani, Subhadra Jalali
May 2015, 63(5):391-393
DOI:10.4103/0301-4738.159862  PMID:26139798
Purpose: To evaluate changes in choroidal thickness (CT) in inherited retinal diseases and its relationship with age, spherical equivalent, visual acuity, and macular thickness. Methods: Retrospective analysis of 51 eyes with features of retinal dystrophy of 26 subjects, who underwent enhanced depth imaging using spectral domain (SD) optical coherence tomography (OCT), were included. The CT measurements were made at the fovea and at 5 points with an interval of 500 microns in both directions, nasal and temporal from the fovea and were compared with age-matched healthy subjects. Step-wise regression was used to find the relationship between age, spherical equivalent, best-corrected visual acuity (BCVA), central macular thickness (CMT), and subfoveal CT. Results: Disease distribution was as follows: Stargardt's disease 18 eyes (9 subjects); Best disease 5 eyes (3 subjects); cone-rod dystrophy 26 eyes (13 subjects); and Bietti's crystalline dystrophy 2 eyes (1 subject). Mean subfoveal CT was 266.33 ± 76 microns. On regression analysis, no significant correlation was found between subfoveal CT and any other variable such as age (P = 0.9), gender (P = 0.5), CMT (P = 0.1), spherical equivalent (P = 0.3) and BCVA (P = 0.6). While comparing with age-matched healthy subjects, no significant statistical difference was noted (P < 0.05) among all age groups. Conclusion: Our study reports quantitative changes in CT in various common inherited retinal diseases seen in Indian populations. To validate changes in choroid, a longitudinal study with larger sample size is warranted.
  1,421 198 -
Beyond the horizons
Sundaram Natarajan
May 2015, 63(5):369-369
DOI:10.4103/0301-4738.159856  PMID:26139793
  1,277 209 -
Positional accommodative intraocular lens power error induced by the estimation of the corneal power and the effective lens position
David P Piñero, Vicente J Camps, María L Ramón, Verónica Mateo, Rafael J Pérez-Cambrodí
May 2015, 63(5):438-444
DOI:10.4103/0301-4738.159882  PMID:26139807
Purpose: To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL) and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP). Materials and Methods: Clinical data from 25 eyes of 14 patients (age range, 52-77 years) and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb) were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (P IOLadj ) based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (n kadj ) for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELP adj ). P IOLadj was compared to the real IOL power implanted (P IOLReal , calculated with the SRK-T formula) and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas. Results: No statistically significant differences were found between P IOLReal and P IOLadj when ELP adj was used (P = 0.10), with a range of agreement between calculations of 1.23 D. In contrast, P IOLReal was significantly higher when compared to P IOLadj without using ELP adj and also compared to the values estimated by the other formulas. Conclusions: Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age.
  1,294 168 -
The role of central reading centers - current practices and future directions
Colin S Tan, Srinivas R Sadda
May 2015, 63(5):404-405
DOI:10.4103/0301-4738.159866  PMID:26139801
Central reading centers (CRCs) have several crucial roles in the conduct of clinical trials, providing key input during the study design, preparation of the operations manual, as well as site and photographer certification. They provide objective, standardized grading of images from study subjects, which determines study eligibility, and also evaluate lesion features at subsequent study visits. CRCs need to adhere strictly to Good Clinical Practice (GCP) guidelines, as well as the established standard operating procedures in order to ensure that images are graded properly. The role of CRCs will continue to evolve, and include the use of web-based image transmission and grading platforms.
  1,242 170 -
Bilateral optic disk metastasis from breast carcinoma
Pukhraj Rishi, Abhishek Dixit, Aditya Verma
May 2015, 63(5):451-452
DOI:10.4103/0301-4738.159886  PMID:26139809
  1,117 227 -
Re: Long-term results after primary intraocular lens implantation in children operated less than 2 years of age for congenital cataract
Jaspreet Sukhija, Jagat Ram, Nishant Gupta, Ashish Sawhney, Savleen Kaur
May 2015, 63(5):464-465
DOI:10.4103/0301-4738.159900  PMID:26139816
  1,051 185 -
Palmaris longus tendon assisted temporalis muscle transfer for lagophthalmos
Hasmukh Ajitray Buch
May 2015, 63(5):464-464
DOI:10.4103/0301-4738.159899  PMID:26139815
  1,003 166 -
Re: Scleral fixation of one piece intraocular lens by injector implantation
Ertugrul Can
May 2015, 63(5):466-467
DOI:10.4103/0301-4738.159905  PMID:26139817
  848 156 -
Author's reply
Hatice Arda, Hatice Tuba Atalay, Faruk Halim Orge
May 2015, 63(5):465-466
  551 114 -