To assess central macular thickness (CMT) in diabetics with or without diabetic retinopathy (DR) and compare it with various clinical grades of DR. All patients attending the ophthalmic OPD fulfilling the inclusion and met no exclusion criteria were enrolled in this study. All eyes underwent comprehensive and standardized ophthalmic examination. The CMT was measured using spectral domain optical coherence tomography using Cirrus HD OCT Model 500. The mean CMT in cases is significantly greater than controls. It is also significantly greater in diabetics with DR as compared to diabetics without DR and it significantly varies with various grades of DR. The mean CMT is also increased in patients with diabetic macular edema (DME) and panretinal photocoagulation (PRP) untreated DR as compared to diabetics without DME and PRP treated DR respectively. Central macular thickness can be used as an indicator to monitor individuals with diabetes as it increased in diabetics and the presence of macular edema decreased in PRP treated eyes. It also varies with various grades of DR.
为了评估伴有或不伴有糖尿病视网膜病变(DR)的糖尿病患者的中央黄斑厚度(CMT)，并将其与不同临床级别的DR进行比较。所有符合纳入标准且不符合排除标准的眼科OPD患者均被纳入本研究。所有眼均行全面规范的眼科检查。CMT测量使用光谱域光学相干断层扫描，使用Cirrus HD OCT Model 500。病例的平均CMT明显大于对照组。伴有糖尿病性黄斑水肿(DME)和全视网膜光凝(PRP)治疗的糖尿病患者的平均CMT也分别高于不伴有糖尿病性黄斑水肿(DME)和PRP治疗的糖尿病患者。黄斑中央厚度可以作为监测糖尿病患者的指标，因为糖尿病患者黄斑中央厚度增加，而PRP治疗后黄斑水肿减少。它也随DR的不同等级而不同。
{"title":"The relationship of central macular thickness with clinical grades of diabetic retinopathy","authors":"Manoj Tyagi, Shivani Gupta, Mukesh Singh Rajpoot, Shweta Aloney, Pritee Chouhan","doi":"10.18231/j.ijceo.2023.063","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.063","url":null,"abstract":"To assess central macular thickness (CMT) in diabetics with or without diabetic retinopathy (DR) and compare it with various clinical grades of DR. All patients attending the ophthalmic OPD fulfilling the inclusion and met no exclusion criteria were enrolled in this study. All eyes underwent comprehensive and standardized ophthalmic examination. The CMT was measured using spectral domain optical coherence tomography using Cirrus HD OCT Model 500. The mean CMT in cases is significantly greater than controls. It is also significantly greater in diabetics with DR as compared to diabetics without DR and it significantly varies with various grades of DR. The mean CMT is also increased in patients with diabetic macular edema (DME) and panretinal photocoagulation (PRP) untreated DR as compared to diabetics without DME and PRP treated DR respectively. Central macular thickness can be used as an indicator to monitor individuals with diabetes as it increased in diabetics and the presence of macular edema decreased in PRP treated eyes. It also varies with various grades of DR.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-15DOI: 10.18231/j.ijceo.2023.076
Chanchal Meena, Sanjeev K Nainiwal, Ram Swaroop Harsolia
Paediatric vitreoretinal surgery (PVRS) has unique set of challenges compared to surgery in adult eyes. An understanding of ocular growth and development is an important consideration in PVRS. Changes in ciliary body dimensions with age may affect how sclerotomies are placed, so as to avoid iatrogenic damage to the peripheral retina. To study the visual and anatomical outcomes after vitreoretinal surgery in paediatric age group after retinal detachment. In this prospective interventional study, 20 consecutive patients aged 18 years or younger undergoing vitreoretinal surgery for retinal detachment were included. A detailed ocular and systemic history was recorded from all patients. Pre and postoperative data were collected. All the evaluated eyes were followed up to 3 months. Outcome of surgery was measured in terms of improvement in visual acuity and retinal status. Twenty eyes of 20 patients were evaluated with male predominance (75%) and mean age of the patient was 16.4±2.01. Most common etiology was found to be trauma (65%) followed by myopia (30%). Pars plana vitrectomy (PPV) was done in 50% patients, lensectomy with vitrectomy was done in 15%, scleral buckle (SB) surgery was done in 25% cases, where as PPV-SB was done in 10% cases. Improvement in visual acuity was noted in 85% cases. Primary anatomical success was achieved in 80% cases. PPV was the major surgical procedure in our study due to complexity of RD. Postoperative visual rehabilitation was also done to fight amblyopia as far as possible.
{"title":"Anatomical and visual outcomes after vitreoretinal surgery in paediatric retinal detachment","authors":"Chanchal Meena, Sanjeev K Nainiwal, Ram Swaroop Harsolia","doi":"10.18231/j.ijceo.2023.076","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.076","url":null,"abstract":"Paediatric vitreoretinal surgery (PVRS) has unique set of challenges compared to surgery in adult eyes. An understanding of ocular growth and development is an important consideration in PVRS. Changes in ciliary body dimensions with age may affect how sclerotomies are placed, so as to avoid iatrogenic damage to the peripheral retina. To study the visual and anatomical outcomes after vitreoretinal surgery in paediatric age group after retinal detachment. In this prospective interventional study, 20 consecutive patients aged 18 years or younger undergoing vitreoretinal surgery for retinal detachment were included. A detailed ocular and systemic history was recorded from all patients. Pre and postoperative data were collected. All the evaluated eyes were followed up to 3 months. Outcome of surgery was measured in terms of improvement in visual acuity and retinal status. Twenty eyes of 20 patients were evaluated with male predominance (75%) and mean age of the patient was 16.4±2.01. Most common etiology was found to be trauma (65%) followed by myopia (30%). Pars plana vitrectomy (PPV) was done in 50% patients, lensectomy with vitrectomy was done in 15%, scleral buckle (SB) surgery was done in 25% cases, where as PPV-SB was done in 10% cases. Improvement in visual acuity was noted in 85% cases. Primary anatomical success was achieved in 80% cases. PPV was the major surgical procedure in our study due to complexity of RD. Postoperative visual rehabilitation was also done to fight amblyopia as far as possible.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: To report the clinical efficacy and safety of the intravitreal ranibizumab biosimilar molecule, Razumab® (IVRz) as an economic alternative to the innovator molecule (Lucentis) in macular diseases under real-world conditions. : A single‑ center, prospective study of 100 consecutive eyes undergoing three-monthly IVRz between April 2020 to March 2021 for a variety of macular disorders including diabetic macular edema (DME), neovascular age‑related macular degeneration (nAMD), retinal vein occlusion (RVO), and myopic choroidal neovascular membrane (mCNVM). The main outcome measures were changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), intraretinal-fluid (IRF), and subretinal-fluid (SRF) along with a safety analysis at weeks 4, 8, and 12 respectively. : Of the 100 eyes of 100 patients undergoing IVRz, a majority had DME (39 eyes; 39%) followed by RVO (34 eyes; 34%), nAMD (21 eyes; 21%), and mCNVM (6 eyes; 6%). Mean BCVA improved from baseline to weeks 4, 8, and 12 (P<0.001). A significant reduction in CST from the baseline was also noted at all the visits (P<0.001). On qualitative analysis, resolution of SRF and IRF was observed in 61.47% and 61.71% of eyes respectively. No serious ocular or systemic adverse events were noted. : Our real-world data suggests that IVRz therapy is safe and efficacious for the management of varied macular pathologies. The cost-effectiveness and systemic and ocular safety of this regulatory-approved biosimilar makes it a suitable alternative to the branded drug. Further comparative studies into the benefit-cost analysis of these biosimilar and branded agents are warranted to better understand the health economics of anti-vascular endothelial growth factor (anti-VEGF) therapy in chorioretinal disorders.
{"title":"Safety and efficacy of ranibizumab biosimilar (Razumab®) as a cost-effective alternative to the innovator molecule for macular disorders in real-world","authors":"Sonal Paliwal, Riddhima Deshpande, Prerna Upadhyay","doi":"10.18231/j.ijceo.2023.062","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.062","url":null,"abstract":": To report the clinical efficacy and safety of the intravitreal ranibizumab biosimilar molecule, Razumab® (IVRz) as an economic alternative to the innovator molecule (Lucentis) in macular diseases under real-world conditions. : A single‑ center, prospective study of 100 consecutive eyes undergoing three-monthly IVRz between April 2020 to March 2021 for a variety of macular disorders including diabetic macular edema (DME), neovascular age‑related macular degeneration (nAMD), retinal vein occlusion (RVO), and myopic choroidal neovascular membrane (mCNVM). The main outcome measures were changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), intraretinal-fluid (IRF), and subretinal-fluid (SRF) along with a safety analysis at weeks 4, 8, and 12 respectively. : Of the 100 eyes of 100 patients undergoing IVRz, a majority had DME (39 eyes; 39%) followed by RVO (34 eyes; 34%), nAMD (21 eyes; 21%), and mCNVM (6 eyes; 6%). Mean BCVA improved from baseline to weeks 4, 8, and 12 (P&#60;0.001). A significant reduction in CST from the baseline was also noted at all the visits (P&#60;0.001). On qualitative analysis, resolution of SRF and IRF was observed in 61.47% and 61.71% of eyes respectively. No serious ocular or systemic adverse events were noted. : Our real-world data suggests that IVRz therapy is safe and efficacious for the management of varied macular pathologies. The cost-effectiveness and systemic and ocular safety of this regulatory-approved biosimilar makes it a suitable alternative to the branded drug. Further comparative studies into the benefit-cost analysis of these biosimilar and branded agents are warranted to better understand the health economics of anti-vascular endothelial growth factor (anti-VEGF) therapy in chorioretinal disorders.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-15DOI: 10.18231/j.ijceo.2023.086
H Shafeeq Ahmed, Chinmayee J Thrishulamurthy, Vidya Eswaran, Dayananda S Biligi
Conjunctival melanoma is an uncommon malignancy particularly in the pigmented races. We report an interesting association of risk factors involved in this rare tumour in a South Indian population. A retrospective, interventional case series of three patients diagnosed with conjunctival melanoma on the basis of clinical and histopathological evaluations between the year 2017 and 2022. Among the three patients, one patient had Xeroderma pigmentosa, one patient had carcinoma of the ovary and one patient had a pre-existing nevus. Conjunctival melanoma is a rare tumour in pigmented races and Xeroderma pigmentosa, pre-existing nevus and another malignancy predispose to a conjunctival melanoma.
{"title":"Predisposing factors in conjunctival melanoma in a south Indian population and its management - A retrospective interventional case series","authors":"H Shafeeq Ahmed, Chinmayee J Thrishulamurthy, Vidya Eswaran, Dayananda S Biligi","doi":"10.18231/j.ijceo.2023.086","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.086","url":null,"abstract":"Conjunctival melanoma is an uncommon malignancy particularly in the pigmented races. We report an interesting association of risk factors involved in this rare tumour in a South Indian population. A retrospective, interventional case series of three patients diagnosed with conjunctival melanoma on the basis of clinical and histopathological evaluations between the year 2017 and 2022. Among the three patients, one patient had Xeroderma pigmentosa, one patient had carcinoma of the ovary and one patient had a pre-existing nevus. Conjunctival melanoma is a rare tumour in pigmented races and Xeroderma pigmentosa, pre-existing nevus and another malignancy predispose to a conjunctival melanoma.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-15DOI: 10.18231/j.ijceo.2023.066
Syed Wajahat Ali Rizvi, Ziya Siddiqui, Sheerin Fatima, Adeeb Alam Khan, Humayoun Ashraf
As the cataract surgery has taken the quantum leaps, so does the advancements in various anaesthetic techniques, aiming to provide a safer, painless and comfortable surgery. Topical anaesthesia is a less invasive anaesthetic option which provides adequate analgesia with wide margin of safety. We aimed to evaluate the efficacy of topical anaesthesia as a routine in a standard phacoemulsification surgery. A total of200 patients scheduled for routine phacoemulsification were enrolled in a prospective, non-randomized comparative clinical study. Patients were then distributed to either topical anaesthesia group (TA) or peribulbar anaesthesia group (PA) to evaluate for patient and surgeon satisfaction, and intraoperative complications. The study groups were comparable demographically. Pain scores were higher during late stages of surgery in TA (p<0.01), while higher scores were noticeable in PA (p<0.01) during administration and in the postoperative periods. Significantly higher rate of chemosis was seen in PA (p<0.01). The patients in the TA had an overall better surgical experience as compared to the PA (p<0.01).Though surgeon does note higher per-operative pain perception (p=0.027) and ocular motility (p<0.01) in the TA there was no significant difference as far as ease of surgery was concerned. Despite higher per-operative pain perception most of the patients describe their surgical experience with topical anaesthesia as satisfactory. In view of its minimally invasive nature, topical anaesthesia is a safer alternative to peribulbar anaesthesia practically avoiding all block related complications especially in at risk eyes, and thus can be safely administered as a routine in phacoemulsification surgery.
{"title":"Patient’s pain perception and surgeon satisfaction with topical anaesthsia in phacoemulsification surgery","authors":"Syed Wajahat Ali Rizvi, Ziya Siddiqui, Sheerin Fatima, Adeeb Alam Khan, Humayoun Ashraf","doi":"10.18231/j.ijceo.2023.066","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.066","url":null,"abstract":"As the cataract surgery has taken the quantum leaps, so does the advancements in various anaesthetic techniques, aiming to provide a safer, painless and comfortable surgery. Topical anaesthesia is a less invasive anaesthetic option which provides adequate analgesia with wide margin of safety. We aimed to evaluate the efficacy of topical anaesthesia as a routine in a standard phacoemulsification surgery. A total of200 patients scheduled for routine phacoemulsification were enrolled in a prospective, non-randomized comparative clinical study. Patients were then distributed to either topical anaesthesia group (TA) or peribulbar anaesthesia group (PA) to evaluate for patient and surgeon satisfaction, and intraoperative complications. The study groups were comparable demographically. Pain scores were higher during late stages of surgery in TA (p&#60;0.01), while higher scores were noticeable in PA (p&#60;0.01) during administration and in the postoperative periods. Significantly higher rate of chemosis was seen in PA (p&#60;0.01). The patients in the TA had an overall better surgical experience as compared to the PA (p&#60;0.01).Though surgeon does note higher per-operative pain perception (p=0.027) and ocular motility (p&#60;0.01) in the TA there was no significant difference as far as ease of surgery was concerned. Despite higher per-operative pain perception most of the patients describe their surgical experience with topical anaesthesia as satisfactory. In view of its minimally invasive nature, topical anaesthesia is a safer alternative to peribulbar anaesthesia practically avoiding all block related complications especially in at risk eyes, and thus can be safely administered as a routine in phacoemulsification surgery.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-15DOI: 10.18231/j.ijceo.2023.081
Lalit Pawaskar, Mayuresh Kiran, Amit Sharma, Mayuresh Kiran
To determine the comparative efficacy and safety of Investigational Product – 1 (combination of Vitamin C, Vitamin E, Lutein, Zeaxanthin, Zinc and Copper) with Investigational product 2 (combination of Astaxanthin, L-Glutathione and Lutein (contains Zeaxanthin)) in patients for the indication of dry age-related macular degeneration (AMD). It was an academic, prospective, open labelled, parallel, randomized, multicentric, comparative post-marketing surveillance study. The study was conducted at 5 clinical trial sites with 40 patients at each site. Patients with confirmed diagnosis of dry AMD in right or left or both eyes who met study inclusion and exclusion criteria were recruited for the study. The study duration was of 365 days and during the same patients were asked to visit the clinical trial site on day 30, 180 and 365 for the safety and efficacy assessment. Visual acuity, vision related quality of life and visual impairment questionnaire were the efficacy assessment parameters evaluated. Total 181 patients completed the study. It was found that there was statistically significant difference in the patients treated with the investigational product 1 and 2 for the efficacy assessment parameter, visual acuity (p value 0.0102) and vision related quality of life (p value 0.0013) and for visual impairment questionnaire score, no statistically significant difference was found (p value 0.0747). Investigational product 1 was found to be more efficacious as compared to investigational product 2 for the efficacy assessment parameters visual acuity and vision related quality of life. Whereas for visual impairment questionnaire score i.e. vision required for the daily work, both products were found to be equally efficient.
{"title":"Post-marketing surveillance study to compare the efficacy and safety by investigating the combination of Vitamin C, Vitamin E, Lutein, Zeaxanthin, Zinc and Copper with the combination of Astaxanthin, L-Glutathione and Lutein (contains Zeaxanthin) in patients of dry age-related macular degeneration (AMD)","authors":"Lalit Pawaskar, Mayuresh Kiran, Amit Sharma, Mayuresh Kiran","doi":"10.18231/j.ijceo.2023.081","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.081","url":null,"abstract":"To determine the comparative efficacy and safety of Investigational Product – 1 (combination of Vitamin C, Vitamin E, Lutein, Zeaxanthin, Zinc and Copper) with Investigational product 2 (combination of Astaxanthin, L-Glutathione and Lutein (contains Zeaxanthin)) in patients for the indication of dry age-related macular degeneration (AMD). It was an academic, prospective, open labelled, parallel, randomized, multicentric, comparative post-marketing surveillance study. The study was conducted at 5 clinical trial sites with 40 patients at each site. Patients with confirmed diagnosis of dry AMD in right or left or both eyes who met study inclusion and exclusion criteria were recruited for the study. The study duration was of 365 days and during the same patients were asked to visit the clinical trial site on day 30, 180 and 365 for the safety and efficacy assessment. Visual acuity, vision related quality of life and visual impairment questionnaire were the efficacy assessment parameters evaluated. Total 181 patients completed the study. It was found that there was statistically significant difference in the patients treated with the investigational product 1 and 2 for the efficacy assessment parameter, visual acuity (p value 0.0102) and vision related quality of life (p value 0.0013) and for visual impairment questionnaire score, no statistically significant difference was found (p value 0.0747). Investigational product 1 was found to be more efficacious as compared to investigational product 2 for the efficacy assessment parameters visual acuity and vision related quality of life. Whereas for visual impairment questionnaire score i.e. vision required for the daily work, both products were found to be equally efficient.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135485985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: To evaluate the incidence of significant posterior segment abnormalities in eyes with white mature cataract and to assess association of vitreoretinal pathologies with different ocular and systemic disorders. This cross-sectional study was conducted on 100 patients with white mature cataract presenting for cataract surgery. Detailed relevant history was noted. Complete ocular examination done and B-scan performed. Percentage of patients with abnormal B-scan findings in various groups were calculated and association of systemic/ ocular factors with vitreoretinal pathologies were evaluated using paired chi square test. : Mean age of patients was 60.78±9.001 years with a female preponderance (58%). 92% cases had senile mature cataract, 3% were presenile, 3% were traumatic and 2% were complicated mature cataract. Most common pathological finding on B-scan was vitreous opacity seen in 16% cases, followed by posterior vitreous detachment seen in 6%. Vitreous hemorrhage was seen in 3% cases while 69% cases showed normal posterior segment. Patients were grouped into two categories- one comprised patients with relevant systemic and/ or ocular history (47%), while other category belonged to patients with no such history (53%). On comparing the number of patients with abnormal B-scan findings in the two categories, no statistical significance was noted. (p value=0.105). B-scan ultrasonography is an important presurgical investigation in patients with dense cataracts for diagnosing posterior segment pathologies that may influence post operative visual outcome.
{"title":"Ultrasonographic assessment of vitreoretinal pathologies in white mature cataract","authors":"Rishabh Rathi, Komal Jaiswal, Amisha Jain, Sonam Verma, SCL Chandravanshi, Nitin Nema, Rajendra Prakash Maurya","doi":"10.18231/j.ijceo.2023.056","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.056","url":null,"abstract":": To evaluate the incidence of significant posterior segment abnormalities in eyes with white mature cataract and to assess association of vitreoretinal pathologies with different ocular and systemic disorders. This cross-sectional study was conducted on 100 patients with white mature cataract presenting for cataract surgery. Detailed relevant history was noted. Complete ocular examination done and B-scan performed. Percentage of patients with abnormal B-scan findings in various groups were calculated and association of systemic/ ocular factors with vitreoretinal pathologies were evaluated using paired chi square test. : Mean age of patients was 60.78±9.001 years with a female preponderance (58%). 92% cases had senile mature cataract, 3% were presenile, 3% were traumatic and 2% were complicated mature cataract. Most common pathological finding on B-scan was vitreous opacity seen in 16% cases, followed by posterior vitreous detachment seen in 6%. Vitreous hemorrhage was seen in 3% cases while 69% cases showed normal posterior segment. Patients were grouped into two categories- one comprised patients with relevant systemic and/ or ocular history (47%), while other category belonged to patients with no such history (53%). On comparing the number of patients with abnormal B-scan findings in the two categories, no statistical significance was noted. (p value=0.105). B-scan ultrasonography is an important presurgical investigation in patients with dense cataracts for diagnosing posterior segment pathologies that may influence post operative visual outcome.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: To find a correlation of the disc damage likelihood scale (DDLS) scale with visual field indices and its diagnostic power in cases of glaucoma. : The study enrolled 198 patients suffering from primary open angle glaucoma. The patients were investigated using Humphreys perimetry and ocular coherence tomography (OCT). The DDLS scoring for each patient was done which was then correlated with visual field indices and the accuracy of DDLS in scoring different stages of glaucoma was studied. Single center, prospective, observational study. : The DDLS showed a strong correlation with cup-disc ratio, a good correlation with visual field index and mean deviation values and a weak correlation with foveal sensitivity. Also, the scale showed 68.9%, 82.6% and 100% diagnostic accuracy in cases of mild, moderate and severe glaucoma respectively. : The DDLS is a strong adjunctive diagnostic tool that has helped in the diagnosis of glaucoma.
{"title":"Disc damage likelihood scale: its correlation with field indices and its accuracy in diagnosis of glaucoma","authors":"Siddharth Maanju, Kavita Gahanoliya, Ankur Kumar, Kishor Kumar","doi":"10.18231/j.ijceo.2023.064","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.064","url":null,"abstract":": To find a correlation of the disc damage likelihood scale (DDLS) scale with visual field indices and its diagnostic power in cases of glaucoma. : The study enrolled 198 patients suffering from primary open angle glaucoma. The patients were investigated using Humphreys perimetry and ocular coherence tomography (OCT). The DDLS scoring for each patient was done which was then correlated with visual field indices and the accuracy of DDLS in scoring different stages of glaucoma was studied. Single center, prospective, observational study. : The DDLS showed a strong correlation with cup-disc ratio, a good correlation with visual field index and mean deviation values and a weak correlation with foveal sensitivity. Also, the scale showed 68.9%, 82.6% and 100% diagnostic accuracy in cases of mild, moderate and severe glaucoma respectively. : The DDLS is a strong adjunctive diagnostic tool that has helped in the diagnosis of glaucoma.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Refractive error is an ocular condition whereby light rays do not focus onto the macula for visual processing when they enter the eye. The most prevalent type, myopia, often known as short sightedness, is brought on when light rays entering the eye are focused anterior to the macula, blurring distance vision. Though rare, there are few situations that can call for the introduction of performing objective ocular refraction under GA. Refractive testing under general anesthesia (GA) is more safely suited for patients with conditions like subjective difficulty with charts, poor testing cooperation, nonorganic visual impairment refractions, physically or developmentally disabled patients, and those with co-existing ophthalmic pathology. A 2-week prospective observational study was conducted in our hospital to look at the anesthetic methods used for ocular surgery at two sizable ophthalmic units. The anesthetist filled out a questionnaire for each case. The types of anesthetics used, the choice of ventilation or spontaneous respiration, the anesthetic agents used, the use and type of muscle relaxants, the presence of any significant ocular deviation, and any corrective actions taken, such as deepening anesthesia or giving a muscle relaxant, were among the information gathered. 90 procedures in all were surveyed within the 2-week period. 52.2% (47) of them anesthesia was provided by consultant anesthetist, 25.6% (23) provided by Anesthesia Post Graduate Trainee(PGT) and 22.2% (20) provided by specialist registrar anesthesia. 74% (23) of the patients with NDMR out of the total 59% (31) ventilated patients had NDMR. 42% (22) of the patients had surgery done while they were spontaneously breathing, and 14% (3) of them had muscle relaxants to help with intubation. Total intravenous anesthesia was administered to one patient. In the poll, 29% (15) of the patients chose atracurium as their preferred NDMR, whereas 21% (11) chose vecuronium. In total, 50% of the patients in the survey had no planned NDMR. In 8% (4) of patients, there was a significant ocular deviation. One of these four patients had total intravenous anesthesia (TIVA), while the other three were ventilated. None of them had taken NDMRs, or non-depolarizing muscle relaxants. In one case, the anaesthesia was deepened, and in two other cases, NDMR was administered as a remedy for the deviation. The prevalence of this condition was 18% in patients not receiving NDMR. The objective refraction values showed that myopia manifested as a result of general anesthesia. Under the same circumstances, corneal refractive values flatten, indicating that the primary cause of myopia was ciliary muscle contraction. We hypothesize that this alteration resulted from ciliary muscle contraction and parasympathetic dominance during general anesthesia.
{"title":"Effects of general anesthesia on ocular Refraction: An observational study","authors":"Plabon Hazarika, Prabir Pranjal Das, Bandana Mahanta, Deepankar Gogoi","doi":"10.18231/j.ijceo.2023.082","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.082","url":null,"abstract":"Refractive error is an ocular condition whereby light rays do not focus onto the macula for visual processing when they enter the eye. The most prevalent type, myopia, often known as short sightedness, is brought on when light rays entering the eye are focused anterior to the macula, blurring distance vision. Though rare, there are few situations that can call for the introduction of performing objective ocular refraction under GA. Refractive testing under general anesthesia (GA) is more safely suited for patients with conditions like subjective difficulty with charts, poor testing cooperation, nonorganic visual impairment refractions, physically or developmentally disabled patients, and those with co-existing ophthalmic pathology. A 2-week prospective observational study was conducted in our hospital to look at the anesthetic methods used for ocular surgery at two sizable ophthalmic units. The anesthetist filled out a questionnaire for each case. The types of anesthetics used, the choice of ventilation or spontaneous respiration, the anesthetic agents used, the use and type of muscle relaxants, the presence of any significant ocular deviation, and any corrective actions taken, such as deepening anesthesia or giving a muscle relaxant, were among the information gathered. 90 procedures in all were surveyed within the 2-week period. 52.2% (47) of them anesthesia was provided by consultant anesthetist, 25.6% (23) provided by Anesthesia Post Graduate Trainee(PGT) and 22.2% (20) provided by specialist registrar anesthesia. 74% (23) of the patients with NDMR out of the total 59% (31) ventilated patients had NDMR. 42% (22) of the patients had surgery done while they were spontaneously breathing, and 14% (3) of them had muscle relaxants to help with intubation. Total intravenous anesthesia was administered to one patient. In the poll, 29% (15) of the patients chose atracurium as their preferred NDMR, whereas 21% (11) chose vecuronium. In total, 50% of the patients in the survey had no planned NDMR. In 8% (4) of patients, there was a significant ocular deviation. One of these four patients had total intravenous anesthesia (TIVA), while the other three were ventilated. None of them had taken NDMRs, or non-depolarizing muscle relaxants. In one case, the anaesthesia was deepened, and in two other cases, NDMR was administered as a remedy for the deviation. The prevalence of this condition was 18% in patients not receiving NDMR. The objective refraction values showed that myopia manifested as a result of general anesthesia. Under the same circumstances, corneal refractive values flatten, indicating that the primary cause of myopia was ciliary muscle contraction. We hypothesize that this alteration resulted from ciliary muscle contraction and parasympathetic dominance during general anesthesia.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Watering from the eyes is one of the common ocular complaints which leads to blurred vision. It has an impact on daily activities and the social life of the individual which is not studied much. Hence, we did this study with the aim to estimate the proportion of watery eye patients in whom the vision-related quality of life (VR-QOL) is affected. We conducted a cross-sectional questionnaire-based study. Patients who complained of watering for more than one month were included. All the patients were asked to fill a VR-QOL questionnaire. We considered VR-QOL status to be affected if the score for any of the activity listed in the questionnaire was more than or equal to one. We assessed the association of this VR-QOL status with various factors like age, gender, laterality, patency of nasolacrimal duct and Munk score. A total of 59 patients participated in our study. The mean age of study participants was 52.6 ± 13.8 years and 31 were males. VR-QOL was affected in 89.8% and blurring of vision was the most common impairment. The effect of gender and age on VR-QOL due to watering was not significant. We found that watering of eyes causes a significant blurring of vision (p value=0.031) and discomfort during outdoor activities (p-value 0.045). : Epiphora has a significant impact on VR-QOL. The lacrimal drainage system is the major cause of watery eyes. It is important to include the functional component in the outcome assessment of epiphora treatment.
{"title":"Assessment of the vision-related quality of life (VR-QOL) in patients with watery eyes","authors":"Bhagwati Wadwekar, Harini Tiruvengada Krishnan, Kandasamy Ravichandrann","doi":"10.18231/j.ijceo.2023.074","DOIUrl":"https://doi.org/10.18231/j.ijceo.2023.074","url":null,"abstract":"Watering from the eyes is one of the common ocular complaints which leads to blurred vision. It has an impact on daily activities and the social life of the individual which is not studied much. Hence, we did this study with the aim to estimate the proportion of watery eye patients in whom the vision-related quality of life (VR-QOL) is affected. We conducted a cross-sectional questionnaire-based study. Patients who complained of watering for more than one month were included. All the patients were asked to fill a VR-QOL questionnaire. We considered VR-QOL status to be affected if the score for any of the activity listed in the questionnaire was more than or equal to one. We assessed the association of this VR-QOL status with various factors like age, gender, laterality, patency of nasolacrimal duct and Munk score. A total of 59 patients participated in our study. The mean age of study participants was 52.6 ± 13.8 years and 31 were males. VR-QOL was affected in 89.8% and blurring of vision was the most common impairment. The effect of gender and age on VR-QOL due to watering was not significant. We found that watering of eyes causes a significant blurring of vision (p value=0.031) and discomfort during outdoor activities (p-value 0.045). : Epiphora has a significant impact on VR-QOL. The lacrimal drainage system is the major cause of watery eyes. It is important to include the functional component in the outcome assessment of epiphora treatment.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135486111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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