S. Thulaseedharan, A. V. Raghavan, Ashwati Sankar, N. Sujatha, Sudha Vaikkakara, T. Krishna
To evaluate the efficacy of topical immunotherapy with Interferon α 2b [INF- α 2b] drops with a concentration of 3 million international units per millilitre (3 MIU/ml), in the treatment of noninvasive Ocular Surface Squamous Neoplasia (OSSN). A retrospective case record-based study of patients with noninvasive OSSN, who were treated with INF- α 2b drops (3 MIU/ml) during the period from January 2016 to January 2020 at a tertiary care centre in South India. The demographic details, clinical findings, slit lamp photographs, investigations, histopathological records, clinical course, mean duration of clinical and cytological resolution, any evidence of intolerance to treatment, failure to treatment, and recurrences were analysed. Fourteen eyes of 12 patients were studied. The majority of patients were male (83%) and aged more than 50 years (83%). 64.28% of cases became disease free clinically and histopathologically in 3 months. 21.4% of cases showed partial resolution. Topical immunotherapy is an effective mode of treatment for noninvasive OSSN. The 3 MIU/mL dose of topical IFN-α2b drops helped in faster resolution. No recurrences were reported. No severe surface toxicity or intolerance was observed.
{"title":"Efficacy of topical immunotherapy in the management of Ocular Surface Squamous Neoplasia (OSSN)– A retrospective analysis","authors":"S. Thulaseedharan, A. V. Raghavan, Ashwati Sankar, N. Sujatha, Sudha Vaikkakara, T. Krishna","doi":"10.4103/kjo.kjo_109_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_109_22","url":null,"abstract":"To evaluate the efficacy of topical immunotherapy with Interferon α 2b [INF- α 2b] drops with a concentration of 3 million international units per millilitre (3 MIU/ml), in the treatment of noninvasive Ocular Surface Squamous Neoplasia (OSSN). A retrospective case record-based study of patients with noninvasive OSSN, who were treated with INF- α 2b drops (3 MIU/ml) during the period from January 2016 to January 2020 at a tertiary care centre in South India. The demographic details, clinical findings, slit lamp photographs, investigations, histopathological records, clinical course, mean duration of clinical and cytological resolution, any evidence of intolerance to treatment, failure to treatment, and recurrences were analysed. Fourteen eyes of 12 patients were studied. The majority of patients were male (83%) and aged more than 50 years (83%). 64.28% of cases became disease free clinically and histopathologically in 3 months. 21.4% of cases showed partial resolution. Topical immunotherapy is an effective mode of treatment for noninvasive OSSN. The 3 MIU/mL dose of topical IFN-α2b drops helped in faster resolution. No recurrences were reported. No severe surface toxicity or intolerance was observed.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70823842","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}
Sahil Agrawal, S. Modaboyina, Saloni Gupta, D. Das
Tessier cleft-3 represents diverse clinical presentations, from simple notch in nasolabial groove to bilateral forms with cranial extensions. We report a 10-year-old child with facial features of Tessier cleft-3 and associated epiphora due to an abnormally dilated nasolacrimal duct on imaging. No previous associations of giant dacryocoeles have ever been reported.
{"title":"Bilateral giant dacryocele in a case of Tessier cleft-3","authors":"Sahil Agrawal, S. Modaboyina, Saloni Gupta, D. Das","doi":"10.4103/kjo.kjo_221_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_221_21","url":null,"abstract":"Tessier cleft-3 represents diverse clinical presentations, from simple notch in nasolabial groove to bilateral forms with cranial extensions. We report a 10-year-old child with facial features of Tessier cleft-3 and associated epiphora due to an abnormally dilated nasolacrimal duct on imaging. No previous associations of giant dacryocoeles have ever been reported.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824115","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}
{"title":"Scientific publications: Much ado about nothing?","authors":"M. Sen, S. Honavar","doi":"10.4103/kjo.kjo_17_23","DOIUrl":"https://doi.org/10.4103/kjo.kjo_17_23","url":null,"abstract":"","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"35 1","pages":"3 - 4"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824138","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}
P. Ramesh, S. Parthasarathi, Abhinay Ashok, R. John
This study aimed to compare central corneal thickness (CCT) using ultrasound pachymetry (USP) (CCT apex) and specular microscopy (CCT vertex) and also to find out the intra-reading variability from the two instruments. A prospective, observational study was conducted in a tertiary eye care center in southern India. This study was conducted on 12 patients (24 eyes, 96 data set eyes, 768 data points in total) aged 20–50, in non-pathological corneas. Eight CCT measurements by specular microscopy and eight measurements by USP were taken by two different experienced observers on day 1, followed by repeating the same on day 2. The readings were averaged and compared by paired t-test. SPSS software was used for statistical analysis. Variability between the eight readings produced by the same instrument was calculated and coefficient of variation was plotted. Inter-examiner variability and intra-examiner variability of the two modalities were studied, and it was considered statistically significant if P < 0.05. The mean CCT by USP was 522.71 µm and the mean CCT by specular microscopy was 519.43 µm. The coefficient of variation of the eight readings varied significantly between the machines. On an average, the coefficient of variation was 0.4% compared to 0.8% in specular microscopy and USP, respectively. The intra-reading variability of ultrasound CCT is twice as that compared to specular microscopy. The clinical relevance of this spread is relevant and important in modern-day practice. Hence, it is better advisable that CCT readings from both the modalities, not be used interchangeably.
{"title":"Blind spot in ultrasound central corneal thickness measurement – Central corneal thickness of apex versus central corneal thickness of vertex","authors":"P. Ramesh, S. Parthasarathi, Abhinay Ashok, R. John","doi":"10.4103/kjo.kjo_42_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_42_21","url":null,"abstract":"This study aimed to compare central corneal thickness (CCT) using ultrasound pachymetry (USP) (CCT apex) and specular microscopy (CCT vertex) and also to find out the intra-reading variability from the two instruments. A prospective, observational study was conducted in a tertiary eye care center in southern India. This study was conducted on 12 patients (24 eyes, 96 data set eyes, 768 data points in total) aged 20–50, in non-pathological corneas. Eight CCT measurements by specular microscopy and eight measurements by USP were taken by two different experienced observers on day 1, followed by repeating the same on day 2. The readings were averaged and compared by paired t-test. SPSS software was used for statistical analysis. Variability between the eight readings produced by the same instrument was calculated and coefficient of variation was plotted. Inter-examiner variability and intra-examiner variability of the two modalities were studied, and it was considered statistically significant if P < 0.05. The mean CCT by USP was 522.71 µm and the mean CCT by specular microscopy was 519.43 µm. The coefficient of variation of the eight readings varied significantly between the machines. On an average, the coefficient of variation was 0.4% compared to 0.8% in specular microscopy and USP, respectively. The intra-reading variability of ultrasound CCT is twice as that compared to specular microscopy. The clinical relevance of this spread is relevant and important in modern-day practice. Hence, it is better advisable that CCT readings from both the modalities, not be used interchangeably.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70825599","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}
{"title":"Exploring the therapeutic potential of stem cells in glaucoma: A promising frontier for vision restoration","authors":"S. Dubey, N. Sinha","doi":"10.4103/kjo.kjo_93_23","DOIUrl":"https://doi.org/10.4103/kjo.kjo_93_23","url":null,"abstract":"","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70827306","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}
Congenital ptosis with ophthalmoplegia is a rare condition. We present a 17-year-old patient with congenital ptosis with severe restriction of ocular movements with poor Bell’s phenomenon. He was managed with silicone rod frontalis sling surgery. After 5 years, the sling is intact with no lagophthalmos and exposure keratopathy.
{"title":"Frontalis sling in a bilateral ptosis with external ophthalmoplegia and poor bell’s phenomenon: A 5-year follow-up","authors":"N. Latha, M. Vishnupriya","doi":"10.4103/kjo.kjo_187_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_187_21","url":null,"abstract":"Congenital ptosis with ophthalmoplegia is a rare condition. We present a 17-year-old patient with congenital ptosis with severe restriction of ocular movements with poor Bell’s phenomenon. He was managed with silicone rod frontalis sling surgery. After 5 years, the sling is intact with no lagophthalmos and exposure keratopathy.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824318","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}
Suchismita Mishra, Lipika Mehra, P. Panigrahi, Lulup K Sahoo
A 4-year-old female patient presented with drooping of the right upper eyelid of 10 days duration. There was a history of low grade fever 15 days ago which subsided with the use of oral paracetamol. Abnormal head posture with mild upper lid ptosis was noted on right side. Right pupil was fixed and mid-dilated. She was diagnosed with right-sided third cranial nerve palsy. Serum and cerebrospinal fluid samples were positive for IgM antibodies to herpes simplex virus-1. The patient was treated with systemic steroids and anti-virals. The patient responded well to treatment, and there was complete resolution of ocular signs 45 days after presentation.
{"title":"Herpes simplex virus-1 associated third cranial nerve palsy in pediatric age group","authors":"Suchismita Mishra, Lipika Mehra, P. Panigrahi, Lulup K Sahoo","doi":"10.4103/kjo.kjo_178_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_178_21","url":null,"abstract":"A 4-year-old female patient presented with drooping of the right upper eyelid of 10 days duration. There was a history of low grade fever 15 days ago which subsided with the use of oral paracetamol. Abnormal head posture with mild upper lid ptosis was noted on right side. Right pupil was fixed and mid-dilated. She was diagnosed with right-sided third cranial nerve palsy. Serum and cerebrospinal fluid samples were positive for IgM antibodies to herpes simplex virus-1. The patient was treated with systemic steroids and anti-virals. The patient responded well to treatment, and there was complete resolution of ocular signs 45 days after presentation.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824369","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}
Gnaneswaran Subramaniam, Murugan Kumarasamy, A. A. H. Siraja
Corneal blindness is estimated to be the second most prevailing cause of blindness in developing nations. Visual rehabilitation by corneal transplantation is the main choice for the restoration of vision in these cases. The corneal transplant success relies on the availability of high-quality donor eyes. At present, there is a gap between the demand and supply of donor corneal tissues in the developing world. Our study aims to assess the awareness and willingness to eye donation among undergraduate students, especially those from a non-medical background. A single-center, cross-sectional study was conducted on engineering undergraduate students studying in a reputed Multi-disciplinary Institution, located in rural Tamil Nadu during the period August 2018 to March 2019 (8 months). Using random sampling, 507 students were selected for the study. A structured questionnaire was administered to all the participants. For statistical analysis, SPSS software, version 22, was used. A total of 507 students participated in the study. The mean age of participants was 19 ± 2 years. In the study group, more than half (499) of the students had awareness about “eye donation,” but only 62.2% of students were willing to donate eyes. Among the study participants, 74% showed a poor attitude toward eye donation. Lack of knowledge regarding the process of eye donation was seen as the major cause attributing to this poor attitude. We conclude that if more intensive awareness program activities are carried out to make the younger generation, making them more aware of the process of eye donation, we can significantly increase the rate of eye donation in India.
{"title":"Awareness and attitude regarding eye donation among undergraduate students of an engineering institution and its implication in Tamil Nadu","authors":"Gnaneswaran Subramaniam, Murugan Kumarasamy, A. A. H. Siraja","doi":"10.4103/kjo.kjo_77_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_77_22","url":null,"abstract":"Corneal blindness is estimated to be the second most prevailing cause of blindness in developing nations. Visual rehabilitation by corneal transplantation is the main choice for the restoration of vision in these cases. The corneal transplant success relies on the availability of high-quality donor eyes. At present, there is a gap between the demand and supply of donor corneal tissues in the developing world. Our study aims to assess the awareness and willingness to eye donation among undergraduate students, especially those from a non-medical background. A single-center, cross-sectional study was conducted on engineering undergraduate students studying in a reputed Multi-disciplinary Institution, located in rural Tamil Nadu during the period August 2018 to March 2019 (8 months). Using random sampling, 507 students were selected for the study. A structured questionnaire was administered to all the participants. For statistical analysis, SPSS software, version 22, was used. A total of 507 students participated in the study. The mean age of participants was 19 ± 2 years. In the study group, more than half (499) of the students had awareness about “eye donation,” but only 62.2% of students were willing to donate eyes. Among the study participants, 74% showed a poor attitude toward eye donation. Lack of knowledge regarding the process of eye donation was seen as the major cause attributing to this poor attitude. We conclude that if more intensive awareness program activities are carried out to make the younger generation, making them more aware of the process of eye donation, we can significantly increase the rate of eye donation in India.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826505","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}
This cross-sectional study aims to determine the risk factors and correlation between diabetic retinopathy (DR) and diabetic nephropathy (DN) in type 2 diabetes mellitus in South India. A hospital-based analytical cross-sectional study was conducted on 200 type 2 diabetes mellitus patients and were assessed for diabetic retinopathy and nephropathy. Patients were classified into two groups: no-diabetic nephropathy (Group A) and diabetic nephropathy (Group B) based on eGFR. Fundoscopy was performed in all patients to look for DR. Multivariate regression analysis was used to determine risk factors associated with diabetic nephropathy. This study was approved by the institutional review board, and written informed consent was obtained from all participants. Statistical Package for Social Sciences (SPSS) version 20.0 for Windows was used. Descriptive statistical methods were used to outline the basic characteristics, and a P value less than 0.05 was considered statistically significant. Differences between the groups were analyzed using independent-sample t-test for continuous variables and χ2 test for categorical variables. In this study, 52% patients with DN had retinopathy when compared to 23% patients in no-DN (P < 0.001). The distribution of different types of retinopathies was 44% NPDR, 28% PDR, and 32% CSME in patients with DN and 31% NPDR, 8% PDR, and 7% CSME in the no-DN group (P < 0.001). The age, hypertension, duration of diabetes, serum creatinine, urine protein levels, and diabetic retinopathy gradings were found to be more positively correlated with DN; no diabetic retinopathy and insulin treatment data showed negative correlation. Multivariate regression analysis confirmed age, creatinine, eGFR, DR, and CSME as risk factors for progression to DN (P < 0.05). The results of our study suggest that diabetic nephropathy has a positive correlation with diabetic retinopathy in type 2 diabetes mellitus patients. We found that PDR and CSME were associated with diabetic nephropathy, and PDR and CSME were risk factors for DN. Hence, renal parameters can be used as a reliable predictor for diabetic retinopathy in type 2 diabetes mellitus patients and also contribute to prevention of DR.
{"title":"A cross-sectional study to determine the relationship between diabetic retinopathy and diabetic nephropathy in type 2 diabetes mellitus patients in South India","authors":"Anjali L. Roche, Rajashree S. Prabhu, Indu Govind","doi":"10.4103/kjo.kjo_69_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_69_22","url":null,"abstract":"This cross-sectional study aims to determine the risk factors and correlation between diabetic retinopathy (DR) and diabetic nephropathy (DN) in type 2 diabetes mellitus in South India. A hospital-based analytical cross-sectional study was conducted on 200 type 2 diabetes mellitus patients and were assessed for diabetic retinopathy and nephropathy. Patients were classified into two groups: no-diabetic nephropathy (Group A) and diabetic nephropathy (Group B) based on eGFR. Fundoscopy was performed in all patients to look for DR. Multivariate regression analysis was used to determine risk factors associated with diabetic nephropathy. This study was approved by the institutional review board, and written informed consent was obtained from all participants. Statistical Package for Social Sciences (SPSS) version 20.0 for Windows was used. Descriptive statistical methods were used to outline the basic characteristics, and a P value less than 0.05 was considered statistically significant. Differences between the groups were analyzed using independent-sample t-test for continuous variables and χ2 test for categorical variables. In this study, 52% patients with DN had retinopathy when compared to 23% patients in no-DN (P < 0.001). The distribution of different types of retinopathies was 44% NPDR, 28% PDR, and 32% CSME in patients with DN and 31% NPDR, 8% PDR, and 7% CSME in the no-DN group (P < 0.001). The age, hypertension, duration of diabetes, serum creatinine, urine protein levels, and diabetic retinopathy gradings were found to be more positively correlated with DN; no diabetic retinopathy and insulin treatment data showed negative correlation. Multivariate regression analysis confirmed age, creatinine, eGFR, DR, and CSME as risk factors for progression to DN (P < 0.05). The results of our study suggest that diabetic nephropathy has a positive correlation with diabetic retinopathy in type 2 diabetes mellitus patients. We found that PDR and CSME were associated with diabetic nephropathy, and PDR and CSME were risk factors for DN. Hence, renal parameters can be used as a reliable predictor for diabetic retinopathy in type 2 diabetes mellitus patients and also contribute to prevention of DR.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826771","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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