Indian Journal of Ophthalmology最新文献

Purpose: This study aims to comprehensively characterize the clinical, demographic, and histopathological features of ocular adnexal lymphoma (OAL) and assess their impact on patients' survival outcomes.

Methods: A total of 123 patients were included in the study; of these, 93 patients were selected for survival analysis. Survival data were analyzed using the Kaplan-Meier test, and correlation was assessed through the log-rank test and Cox regression analysis.

Results: The median age at presentation was 56 years. Furthermore, 98% of patients had primary OAL. The orbit was the most common site of involvement. The majority of patients were of B-cell origin (98%), and only 2% of patients had T-cell lymphoma. In addition, 83% of patients were treated with chemotherapy, and with a median follow-up of 38 months, complete remission was achieved in 48% of patients. The median progression-free survival was 26.4 months. The presence of disseminated disease was strongly linked to an unfavorable prognosis ( P < 0.001) and reduced survival ( P = 0.037).

Conclusion: The 5-year overall survival of the entire study cohort was 81%. The prognosis for OAL is found to be favorable, but the presence of dissemination serves as a notable predictor for poor prognosis.

Plaque brachytherapy has been used in the management of small to medium-sized choroidal melanomas for the past few decades. As the inferior oblique muscle lies in close relation to the macula, the placement procedure of plaques often involves sacrificing the inferior oblique muscle, especially in cases of macular or perimacular choroidal melanomas. In this study, we have described a simple maneuver to preserve the inferior oblique muscle.

Context: Effect of serum ferritin on severity of coronavirus disease 2019 (COVID-19)-associated rhino-orbito-cerebral mucormycosis.

Purpose: To study the association between increased serum ferritin and severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis.

Settings and design: A cross-sectional study.

Methods: Hundred ( n ) out of 155 treatment-naive patients of COVID-19 infection presenting with the signs and symptoms of rhino-orbito-cerebral mucormycosis were enrolled in study. Based on the classification proposed by Honavar, the study patients were classified into four stages: Stage 1: involvement of the nasal mucosa ( n = 11), Stage 2: involvement of paranasal sinuses ( n = 14), Stage 3: involvement of the orbit ( n = 37), Stage 4: involvement of the central nervous system ( n = 38). Stage 3 was further divided into four substages: 3a: nasolacrimal duct, medial orbit, vision unaffected ( n = 4); 3b: diffuse orbital involvement (>1 quadrant or >2 structures), vision unaffected ( n = 15); 3c: central retinal artery occlusion or ophthalmic artery occlusion, superior ophthalmic vein thrombosis, involvement of superior orbital fissure, inferior orbital fissure, orbital apex, diminution or loss of vision ( n = 13); 3d: bilateral orbital involvement ( n = 5). Fasting blood sugar (FBS), postprandial blood sugar (PPBS), and inflammatory markers (serum ferritin, interleukin-6, C-reactive protein, and D-dimer) were assessed. Serum level of ferritin was analyzed by using chemiluminescence immunoassay method.

Results: Mean FBS (mg/dl) was 165.03 ± 70.43 for stage 1, 185.67 ± 64.82 for stage 2, 159.05 ± 68.60 for stage 3, and 158.20 ± 62.05 for stage 4. Mean PPBS (mg/dl) was 238.70 ± 141.29 for stage 1, 252 ± 103.69 for stage 2, 257.09 ± 103.48 for stage 3, and 229.53 ± 76.81 for stage 4. Mean serum ferritin (μg/l) was 302.67 ± 266.95 in stage 1, 444.19 ± 116.36 in stage 2, 504.85 ± 205.99 in stage 3, and 825.95 ± 777.30 in stage 4. A statistically significant increase in serum ferritin levels with severity of disease ( P = 0.005) was noted. Similar trend was observed in substages of stage 3. Pearson correlation analysis showed a positive correlation between serum ferritin and severity of disease ( P = 0.0007).

Conclusion: Increased serum ferritin was significantly independently associated with severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis.

Aim: This study aims to profile the ocular biometric parameters in a large group of children of South-Indian ethnicity who visited our outpatient children's department and were diagnosed with myopia.

Methods: Children <15 years old diagnosed with myopia (Jan 2022-Oct 2023) and who had ocular biometry readings recorded were included. Their demographics, axial length (AL), anterior chamber depth (ACD), spherical equivalent (SE), corneal radius of curvature (CR), and AL/CR ratio were analyzed.

Results: The study included 3728 myopic children; the mean age was 11.85 (4-15) years, and 52.8% were girls. Mean SE was -3.98 D. The mean (SD) AL, ACD, CR, and AL/CR ratio were 24.64 (1.32), 3.73 (0.40), 7.61 (0.27), and 3.24 (0.16), respectively. Female gender was associated with shorter AL, ACD, CR, and AL/CR ratios ( P < 0.001) across all age groups. There was a significant increase in ACD with age in both sexes ( P < 0.001). A 1-unit (mm) increase in AL was associated with an SE increase of -1.65 D (CL: -1.70 to -1.60). AL/CR ratio could explain 71% of the total variance in SE ( P < 0.001). SE showed a mild correlation with age (rho = 0.14, P < 0.001) and ACD (rho = -0.03, P = 0.041) and a stronger correlation with AL (rho = -0.68, P < 0.001) and AL/CR (rho = -0.83, P < 0.001).

Conclusion: In this hospital-based study, AL and AL/CR ratios strongly correlate with SE, and the AL/CR better explains the total variance in SE than AL alone in children with myopia.

Purpose: To document how acute cerebrovascular accidents (CVAs) present first to an ophthalmologist.

Methods: Retrospective, observational, unicentric hospital-based study. The electronic medical records of new patients who presented to the Neuro-ophthalmology department of a tertiary eye hospital in the month of August 2022 were reviewed. Those with symptoms suggestive of an acute stroke requiring urgent neuroimaging were chosen for further study.

Results: Out of the 710 new patients, 31 had a known CVA and presented with field defects (4.3%). We recognized nine new patients, subsequently diagnosed to have a CVA, initially presenting with ocular symptoms such as homonymous hemianopia in seven cases and two others as transient obscuration of vision and internuclear ophthalmoplegia.

Conclusion: Posterior circulation strokes commonly present first to an ophthalmologist, the early recognition of which is of utmost importance.

Purpose: To present a simple transconjunctival technique for the excision of intraconal orbital hydatid cysts.

Methods: This retrospective, non-comparative, clinical intervention case study was conducted between April 2018 and October 2023. The study included five patients presented to the Orbital unit of Assiut University Hospital with an intraconal orbital cyst, which histologically proved to be a hydatid cyst. In all cases, a conjunctival incision near the fornix was made depending on the cyst location as revealed by computed tomography (CT) or magnetic resonance imaging (MRI). A traction suture was applied to the two relevant recti muscles to guide the globe toward the desired direction. Blunt orbital dissection was made toward the cyst until exposing its anterior surface. A 20-gauge needle was introduced into the cyst and followed by aspiration of its content. The collapsed cyst was then removed by non-toothed forceps and followed by copious irrigation of the field. The follow-up period ranged from 11 to 58 months.

Results: The age of patients ranged from 11 to 44 years. Three were males and two were females. The cyst was iso-dense to the vitreous on CT and iso-intense to the vitreous on MRI. In all cases after aspiration of the content, the collapsed cyst was easily removed. None of the five patients developed recurrence during the follow-up period.

Conclusion: The removal of the collapsed orbital hydatid cyst in the intraconal space after the aspiration of its content via transconjunctival anterior orbitotomy is a simple, fast technique with early recovery and maximum cosmesis.