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  Citation statistics : Table of Contents
   2015| September  | Volume 63 | Issue 9  
    Online since December 3, 2015

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Ocular abnormalities in multi-transfused beta-thalassemia patients
Reza Jafari, Samira Heydarian, Hosein Karami, Mohammad Momeni Shektaei, Kiumars Noruzpour Dailami, Ahmad Ahmadzadeh Amiri, Majid Reza Sheikh Rezaee, Asad Allah Farrokh Far
September 2015, 63(9):710-715
DOI:10.4103/0301-4738.170986  PMID:26632126
Aims: The aim of this study was to assess ocular changes in thalassemia patients who have received multiple transfusions and chelate binding therapy in order to avoid iron accumulation. Settings and Design: A cross-sectional study. Subjects and Methods: A total of 54 thalassemia major patients were selected as case group, and 54 age- and sex-matched healthy subjects were regarded as a control group. Ocular examination included visual acuity, refraction testing, slit lamp examination, funduscopy, tonometry, perimetry, tear break-up time test, and color vision testing were performed for all the participants. We computed the frequency and duration of blood transfusion, the mean serum ferritin level, pretransfusion hemoglobin concentration, and type, duration, and daily dose of chelation therapy for thalassemia patients based on their records. Statistical Analysis Used: All data analysis was performed using SPSS, version 19. Results: All the thalassemic patients were asymptomatic, but abnormal ocular findings (dry eye (33.3%), cataract (10.2%), retinal pigment epithelium degeneration (16.7%), color vision deficiency (3.7%), and visual field defects (33.7%)) were seen in 68.5% of thalassemic group. The prevalence of ocular abnormalities in normal group was 19.4%, which was significantly lower than that in thalassemia patients (P = 0.000). No significant correlation was found between ocular abnormalities and mean serum ferritin level (P = 0.627) and mean hemoglobin concentration (P = 0.143). Correlation of number of blood transfusion with the presence of ocular abnormalities was found to be statistically significant (P = 0.005). Conclusions: As life expectancy for beta-thalassemia patients extends, regular ophthalmological evaluation to detect early changes in their ocular system is recommended.
  10 3,650 363
The effect of phacoemulsification surgery on intraocular pressure and anterior segment anatomy of the patients with cataract and ocular hypertension
Servet Cetinkaya, Zeynep Dadaci, Halil Ibrahim Yener, Nursen Oncel Acir, Yasemin Fatma Cetinkaya, Faik Saglam
September 2015, 63(9):743-745
DOI:10.4103/0301-4738.171020  PMID:26632135
We evaluated the effect of phacoemulsification surgery on intraocular pressure (IOP), anterior chamber depth (ACD), iridocorneal angle (ICA), and central corneal thickness (CCT) of the patients with cataract and ocular hypertension. The decrease in IO P values of the 1 st week, 1 st month, 3 rd month, 6 th month, and 1 st year was statistically significant, but that of the 2 nd year was not significant. The increase in ACD and ICA values of the 1 st week, 1 st month, 3 rd month, 6 th month, and 1 st year was statistically significant, but that of the 2 nd year was not significant. The increase in CCT values of 1 st week and 1 st month was statistically significant, but those of 3 rd month, 6 th month, 1 st year, and 2 nd year were not significant. In conclusion, phacoemulsification surgery decreases IOP and increases ACD and ICA in the short-term. However, in the long-term it does not cause any significant changes.
  8 2,593 298
The changing patterns of uveitis in a tertiary institute of Northeast India
Dipankar Das, Harsha Bhattacharjee, Kalyan Das, Prerana S Tahiliani, Pankaj Bhattacharyya, Gayatri Bharali, Manik Das, Apurba Deka, Rajashree Paul
September 2015, 63(9):735-737
DOI:10.4103/0301-4738.170973  PMID:26632132
Uveitis incorporates innumerable conditions, all of which are characterized by inflammation of the uveal tract. Study of etiological factors in uveitis in the population often give important disease-specific indications and changing pattern in subsequent studies are important to know further newer occurrences of various disease prevalence. Awareness of regional variation in disease configuration is essential to develop a region specific list of differential diagnoses and also for comparison with different sub-population of the country and the world. We report the changing pattern of uveitis in a tertiary institute in the Northeast India and found that tubercular uveitis had increased in hospital-based study.
  8 2,592 295
Comparability and repeatability of pachymetry in keratoconus using four noncontact techniques
Mukesh Kumar, Rohit Shetty, Chaitra Jayadev, Debarun Dutta
September 2015, 63(9):722-727
DOI:10.4103/0301-4738.170987  PMID:26632128
Purpose: To compare and determine the repeatability of central corneal thickness (CCT) measurements using four noncontact pachymetry instruments in eyes with keratoconus. Materials and Methods: The CCT of consecutive patients with keratoconus was measured during a single visit using the swept source optical coherence tomography (SS-OCT, Casia SS-1000°CT, Tomey, Nagoya, Japan), a rotating Scheimpflug camera system (Pentacam, Oculus Optikgerate GmbH, Wetzlar, Germany), scanning slit topographer (Orbscan IIz topography, Baush and Lomb Surgical Inc., San Dimas, CA, USA), and a hand-held spectral domain OCT (HHSD-OCT, Bioptigen Inc., Durham, North Carolina, USA). Test-retest variability, correlation between measurements and interdevice agreement were analyzed. Results: Fifty eyes of 25 participants were analyzed in this study. All measurement methods correlated well with each other (r > 0.9, P < 0.001). Mean ± standard deviation CCT measured by HHSD-OCT, Orbscan IIz, SS-OCT, and Pentacam was 462 ± 41 mm, 458 ± 41 mm, 454 ± 40 mm, and 447 ± 42 mm, respectively. While the HHSD-OCT over-estimated the CCT (P < 0.001), there was a good correlation between the measurements obtained from the other three devices. However, the numerical difference was high and this trend was seen in all the paired comparisons.Conclusions: Though the measurements by different devices correlated well, the numerical agreement may be inadequate for their interchangeable use in clinical practice.
  8 3,350 332
Sympathetic ophthalmitis following vitreoretinal surgery: Does antecedent trauma make a difference?
Ekta Rishi, Pukhraj Rishi, Bindu Appukuttan, Jaydeep Walinjkar, Jyotirmay Biswas, Tarun Sharma
September 2015, 63(9):692-698
DOI:10.4103/0301-4738.170980  PMID:26632123
Background: Sympathetic ophthalmitis (SO) has been reported following vitrectomy; however, there is a lack of data on the role of antecedent penetrating ocular trauma impacting the disease manifestation in eyes developing SO following vitrectomy. Aim: To report differences in the presentation and outcomes of SO in eyes with or without a history of antecedent penetrating trauma; SO being diagnosed after vitreoretinal (VR) surgery. Design: Comparative case series. Methods: Seventeen consecutive patients presenting with SO following VR surgery, diagnosed between 1995 and 2011 were included. Eyes with and without prior penetrating injury were included in Group I (n = 7) and Group II (n = 10), respectively. All Group I patients had received systemic steroids prior to presentation. Demographic and clinical parameters were evaluated. Results: Differences were observed between Group I and Group II mainly with regards to time interval between VR surgery and diagnosis of SO (1.5 months vs. 8 months, P = 0.10), presence of neurosensory detachments (100% vs. 30%, P = 0.01), and the inciting eye vision at presentation (nil light perception in 28.5% vs. 80%, P = 0.049). Other differences observed though not statistically significant were optic disc and retinal vessel involvement (42% vs. 70%, P = 0.28), Dalen-Fuchs nodules (localized vs. diffuse) and leaks on fundus fluorescein angiography (pin-head vs. pin-point leak). Conclusion: SO in patients with antecedent penetrating ocular trauma present early with the central serous chorioretinopathy-like picture. Prior use of systemic steroids might have a bearing on the differences in presentation and the visual acuities between the two groups.
  7 3,648 328
Tests for color vision deficiency: Is it time to revise the standards?
Nidhi Pandey, AK Chandrakar, ML Garg
September 2015, 63(9):752-753
DOI:10.4103/0301-4738.170975  PMID:26632139
  5 5,470 465
Successful delayed treatment of the traumatic orbital apex syndrome by nasal endoscopic decompression surgery
Yuhua Tong, Guohai Chen, Fangzheng Jiang, Wencan Wu
September 2015, 63(9):728-730
DOI:10.4103/0301-4738.171005  PMID:26632129
To report a patient with traumatic orbital apex syndrome, who fully recovered visual and extraocular function following surgery. A 34-year-old male presented with visual and extraocular function disorders in his right eye following traffic accident, who was referred to our hospital 5 weeks after accident. The patient underwent endoscopic optic nerve and orbital apex decompression with topical and systemic application of nerve growth factor and steroids after a failed trial of mega-dose intravenous corticosteroids. Visual acuity improved to 20/20 at 3 weeks after surgery, and the right eye globe moved in most directions at 1 year, which remained stable at 3 years. Surgical decompression should be considered even when symptoms have been present for over a month.
  5 2,367 209
Unusual presentation of ocular trauma in sickle cell trait
Nidhi Pandey
September 2015, 63(9):738-740
DOI:10.4103/0301-4738.170985  PMID:26632133
Sickle cell trait is usually considered as a benign condition. However under certain adverse circumstances, it can give rise to vaso-occlusive features as in sickle cell disease. We present here two cases, both involving healthy young males, who developed retinal vaso-occlusive features following blunt ocular trauma. There was a rapid progression of the retinopathy with the development of proliferative changes in both patients and also vitreous hemorrhage in one patient, within 2 months of the trauma. The development of retinopathy was independent of raised intraocular pressure. Both patients were found to have sickle cell trait.
  4 2,726 437
Herpes zoster ophthalmicus presenting as orbital abscess along with superior orbital fissure syndrome: A case report
Poonam Lavaju, Badri Prasad Badhu, Sangeeta Shah
September 2015, 63(9):733-735
DOI:10.4103/0301-4738.171006  PMID:26632131
Orbital abscess and superior orbital fissure syndrome (SOFS) are rare manifestations of herpes zoster ophthalmicus. Herein, we report a case of orbital abscess along with SOFS in a 2.5-year-old-male child secondary to herpes zoster infection. He presented with a 5-day history of proptosis and ptosis of the right eye that had been preceded by vesicular eruptions on the right forehead and scalp. Computed tomography scan of the head and orbit showed orbital abscess and right cavernous sinus thrombosis. A diagnosis of orbital abscess with SOFS secondary to herpes infection was made. The condition subsequently improved following antiviral therapy, intravenous vancomycin and amikacin, and oral corticosteroids.
  3 2,956 222
Comparing sports vision among three groups of soft tennis adolescent athletes: Normal vision, refractive errors with and without correction
Shih-Tsun Chang, Yen-Hsiu Liu, Jiahn-Shing Lee, Lai-Chu See
September 2015, 63(9):716-721
DOI:10.4103/0301-4738.170974  PMID:26632127
Background: The effect of correcting static vision on sports vision is still not clear. Aim: To examine whether sports vision (depth perception [DP], dynamic visual acuity [DVA], eye movement [EM], peripheral vision [PV], and momentary vision [MV],) were different among soft tennis adolescent athletes with normal vision (Group A), with refractive error and corrected with (Group B) and without eyeglasses (Group C). Setting and Design: A cross-section study was conducted. Soft tennis athletes aged 10–13 who played softball tennis for 2–5 years, and who were without any ocular diseases and without visual training for the past 3 months were recruited. Materials and Methods: DPs were measured in an absolute deviation (mm) between a moving rod and fixing rod (approaching at 25 mm/s, receding at 25 mm/s, approaching at 50 mm/s, receding at 50 mm/s) using electric DP tester. A smaller deviation represented better DP. DVA, EM, PV, and MV were measured on a scale from 1 (worse) to 10 (best) using ATHLEVISION software. Statistical Analysis: Chi-square test and Kruskal–Wallis test was used to compare the data among the three study groups. Results: A total of 73 athletes (37 in Group A, 8 in Group B, 28 in Group C) were enrolled in this study. All four items of DP showed significant difference among the three study groups (P = 0.0051, 0.0004, 0.0095, 0.0021). PV displayed significant difference among the three study groups (P = 0.0044). There was no significant difference in DVA, EM, and MV among the three study groups. Conclusions: Significant better DP and PV were seen among soft tennis adolescent athletes with normal vision than those with refractive error regardless whether they had eyeglasses corrected. On the other hand, DVA, EM, and MV were similar among the three study groups.
  3 4,191 308
Prenatal genetic diagnosis of retinoblastoma – clinical correlates on follow-up
Srividya Neriyanuri, Rajiv Raman, Pukhraj Rishi, Kumaramanickavel Govindasamy, VL Ramprasad, Tarun Sharma
September 2015, 63(9):741-742
DOI:10.4103/0301-4738.170979  PMID:26632134
Retinoblastoma is the most common malignant intraocular tumor in pediatric age group if undetected leads to ocular mortality. Prenatal diagnosis is an emerging technology to detect fatal diseases in utero such that subsequent management is planned to reduce the ocular morbidity. We describe a case demonstrating the importance of prenatal diagnosis in a child with a strong family history of retinoblastoma and importance of a long-term clinical follow-up in these cases.
  2 2,194 233
Comparing two acromegalic patients with respect to central corneal thickness, intraocular pressure, and tear insulin-like growth factor levels before and after treatment
Kan Emrah, KiliÁ Kan Elif, Okuyucu Ali
September 2015, 63(9):731-732
DOI:10.4103/0301-4738.170984  PMID:26632130
The aim of the study was to compare the central corneal thickness (CCT), intraocular pressure (IOP), and tear insulin-like growth factor-1 (IGF-1) levels of 2 patients with acromegaly before and after the surgical treatment of the disease. CCTs, IOP levels, and tear IGF-1 values showed a decrease after the treatment in 2 patients. As we found higher CCT, IOP, and tear IGF-1 levels in the active phase of the disease in two acromegaly patients, detailed information about the activity of the disease may be important before the examination of these patients.
  1 1,801 159
Effects of dexmedetomidine for retrobulbar anesthesia in orbital ball implants after enucleation surgery
Weidi Ye, Zhiyong Hu, Xiuming Jin, Pei Wang
September 2015, 63(9):704-709
DOI:10.4103/0301-4738.170981  PMID:26632125
Background: Dexmedetomidine (DEX) can prolong the duration of local anesthetics, but the use of retrobulbar DEX has not been fully elucidated. This study was designed to determine the effects of adding DEX to lidocaine-bupivacaine for retrobulbar block in orbital ball implants after enucleation surgery. Materials and Methods: A total of 200 patients of both sexes aged 30–60 years of American Society of Anesthesiologists I and II, scheduled for orbital ball implants after enucleation surgery, were enrolled for the study. Patients were randomly assigned into one of the two groups: Control (n = 100) received lidocaine-bupivacaine retrobulbar block, DEX (n = 100) received lidocaine-bupivacaine plus 1 ug/kg DEX retrobulbar block. Hemodynamic data, duration of motor and sensory blocks, pain by visual analog scale, bispectral index (BIS), side effects, consumption of dezocine as a rescue analgesic, patient and surgeon satisfaction were recorded. Results: Duration of analgesia was prolonged in the DEX, compared with the control group ([258.35 ± 66.82 min] as [130.75 ± 29.52 min], [P < 0.05]). The median number of postoperative analgesic requests per patient during the first 24 h was decreased in the DEX group (P < 0.05). In the first 24 postoperative hours, DEX group consumed significantly less dezocine (P < 0.05). BIS values and mean arterial pressure remained lower in the DEX group, but within the safe range (P < 0.05). The side effect profile was similar between the two groups. Patients and surgeon satisfaction were higher in the DEX group (P < 0.05). Demographic characteristics were comparable in both groups (P > 0.05). Conclusion: Retrobulbar DEX reduces consumption of rescue analgesic, prolonged the duration of retrobulbar block, improved postoperative pain, provided better sedation effects, and increased patient and surgeon satisfaction after orbital ball implants after enucleation surgery.
  1 2,822 296
Orbital apex osteodural fistula - An unusual surgical access
Hemant Trehan, Rajeev Sivasankar, Sanjiv Agrawal, Merlin Saldanha, Nikita Sonawane, Rochan Pant, Shreyansh Doshi
September 2015, 63(9):746-749
DOI:10.4103/0301-4738.170972  PMID:26632136
Dural arteriovenous fistulas (DAVFs) are fistulas connecting the branches of dural arteries to dural veins or a venous sinus. Osteodural fistulas are a rare subset of this group of diseases. We wish to report a rare case of an osteodural arteriovenous fistula at the foot of the superior ophthalmic vein (SOV), treatment of which required an unusual surgical approach via the orbit and SOV. Though access for endovascular treatment via the SOV for treatment of caroticocavernous fistulas is reported, the external approach is relatively infrequently performed, outside Europe and the Americas, with this being the first reported procedure from the Indian subcontinent. We wish to explain the steps of this unusual surgical access and highlight the salient precautions and pitfalls in the technique.
  - 2,285 162
Letter writing: Reviving the lost art
Sundaram Natarajan
September 2015, 63(9):691-691
DOI:10.4103/0301-4738.170994  PMID:26632122
  - 2,394 274
Could Crocus sativus (saffron) be combined with conventional therapies for ocular diseases?
Prasan R Bhandari
September 2015, 63(9):750-750
DOI:10.4103/0301-4738.170978  PMID:26632137
  - 1,721 184
Comment on: Intravitreal ziv-aflibercept for recurrent macular edema secondary to central retinal venous occlusion
Alok Sen, Ashish Mitra, Pawan Puneet Malhotra, Sonal Gupta
September 2015, 63(9):751-751
DOI:10.4103/0301-4738.170982  PMID:26632138
  - 1,768 168
Author reply
Jay Chhablani
September 2015, 63(9):751-752
  - 1,031 127
Clinical outcomes of pars plicata anterior vitrectomy: 2-year results
Priya Narang, Amar Agarwal
September 2015, 63(9):699-703
DOI:10.4103/0301-4738.170976  PMID:26632124
Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV) were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA), early and late postoperative complications and intraocular pressure (IOP). Ultrasound biomicroscopic (UBM) evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT) was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow-up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR]) and CDVA (logMAR) was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061) and the mean CMT at 2 years was 192.5 ± 5.54 mm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8%) case and postoperative uveitis was seen in 2 (5.7%) cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate.
  - 2,890 258