Scleral patch grafting is very commonly in use for ophthalmic conditions like scleral melting post pterygium surgery, immune or infection-related scleral melt, localized staphyloma-related scleral thinning, for covering the tubes of Ahmed glaucoma valve implant, for covering the orbital implants post enucleation, etc. A review of literature revealed the use of sclera graft for corneal perforations, but these techniques have become obsolete now due to improvement in eye banking facilities across the country, eye donation awareness leading to easy accessibility to corneal donor tissue. However, under emergency conditions in case of unavailability of corneal donor tissue the technique of scleral patch grafts can be used as a decent alternative to corneal patch grafts. The scleral patch graft is equivalently sturdy and provides tectonic/therapeutic bridging over the perforation to help salvage the eye. In this case series, we have described three cases, two of whom had peripheral corneal perforations due to aggressive corneal ulcerations refractory to medical management. The last case had posterior corneal abscess with thinning which was also refractory to treatment; hence, scleral grafting (unavailability of therapeutic corneal graft) was performed to manage the case.
{"title":"Case series on scleral patch graft for peripheral corneal perforations","authors":"Ditsha Datta, Shweta Sharma","doi":"10.4103/jcor.jcor_28_23","DOIUrl":"https://doi.org/10.4103/jcor.jcor_28_23","url":null,"abstract":"Scleral patch grafting is very commonly in use for ophthalmic conditions like scleral melting post pterygium surgery, immune or infection-related scleral melt, localized staphyloma-related scleral thinning, for covering the tubes of Ahmed glaucoma valve implant, for covering the orbital implants post enucleation, etc. A review of literature revealed the use of sclera graft for corneal perforations, but these techniques have become obsolete now due to improvement in eye banking facilities across the country, eye donation awareness leading to easy accessibility to corneal donor tissue. However, under emergency conditions in case of unavailability of corneal donor tissue the technique of scleral patch grafts can be used as a decent alternative to corneal patch grafts. The scleral patch graft is equivalently sturdy and provides tectonic/therapeutic bridging over the perforation to help salvage the eye. In this case series, we have described three cases, two of whom had peripheral corneal perforations due to aggressive corneal ulcerations refractory to medical management. The last case had posterior corneal abscess with thinning which was also refractory to treatment; hence, scleral grafting (unavailability of therapeutic corneal graft) was performed to manage the case.","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"216 - 218"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47378407","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}
M. Moreker, A. Bansal, Sunila T. Jaggi, Sonali Shah, Asmita Sakle, Shilpa R. Moreker
Context: The diagnosis and management of ocular tuberculosis (OTB) is largely a mystery, and the fact that it is a great imitator of various ocular pathologies adds to the difficulty in the diagnosis of patients. Aims: The aim of this study was to assess the role of the Mantoux test in the diagnosis of OTB. Settings and Design: This was a retrospective chart review of patients who were diagnosed to have and treated as OTB in 1 year at our tertiary care center in Western India. Methods: The study population included 34 patients who presented to us and were diagnosed to have OTB, using standards published by the Department of Health Research, Ministry of Health and Family Welfare, Government of India, and the Indian Council of Medical Research. Results: A total of 34 patients were diagnosed to have OTB in the study period of 1 year between January 1, 2021, and December 31, 2021. Of these 34 patients; 14 were male and 20 were female. The Mantoux test had been done in 32/34 patients. It was positive in 26 patients and negative in six patients. Looking specifically at the six patients in whom the Mantoux was negative, apart from having ocular signs of tuberculosis (TB), they had positive findings suggestive of old/active TB on contrast-enhanced chest computed tomography scan. Of the 34 patients, only five patients were treated based only on the clinical signs of OTB with only a positive Mantoux test, but even they all showed a response to treatment. Conclusions: There is a definite role of the Mantoux test when interpreted considering the clinical phenotype and radiology findings in OTB.
{"title":"Demystifying the role of the Mantoux test in ocular tuberculosis","authors":"M. Moreker, A. Bansal, Sunila T. Jaggi, Sonali Shah, Asmita Sakle, Shilpa R. Moreker","doi":"10.4103/jcor.jcor_62_23","DOIUrl":"https://doi.org/10.4103/jcor.jcor_62_23","url":null,"abstract":"Context: The diagnosis and management of ocular tuberculosis (OTB) is largely a mystery, and the fact that it is a great imitator of various ocular pathologies adds to the difficulty in the diagnosis of patients. Aims: The aim of this study was to assess the role of the Mantoux test in the diagnosis of OTB. Settings and Design: This was a retrospective chart review of patients who were diagnosed to have and treated as OTB in 1 year at our tertiary care center in Western India. Methods: The study population included 34 patients who presented to us and were diagnosed to have OTB, using standards published by the Department of Health Research, Ministry of Health and Family Welfare, Government of India, and the Indian Council of Medical Research. Results: A total of 34 patients were diagnosed to have OTB in the study period of 1 year between January 1, 2021, and December 31, 2021. Of these 34 patients; 14 were male and 20 were female. The Mantoux test had been done in 32/34 patients. It was positive in 26 patients and negative in six patients. Looking specifically at the six patients in whom the Mantoux was negative, apart from having ocular signs of tuberculosis (TB), they had positive findings suggestive of old/active TB on contrast-enhanced chest computed tomography scan. Of the 34 patients, only five patients were treated based only on the clinical signs of OTB with only a positive Mantoux test, but even they all showed a response to treatment. Conclusions: There is a definite role of the Mantoux test when interpreted considering the clinical phenotype and radiology findings in OTB.","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"194 - 198"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48331124","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}
N. Apoorva, HMohan Kumar, Shreya, B. Rachana, Sana Rasheed, Jyotsana Soni
Aims and Objectives: The aim is to compare the accuracy of the SRK T and HOFFER Q formulas in intraocular lens (IOL) power calculation in long eyes by noting the postoperative visual outcome. Introduction: Senile cataract is a leading cause of blindness in India. Cataracts are managed by cataract extraction with implantation IOL. Before surgery, IOL power is calculated by biometry. IOL power calculation is the main key to obtaining a good refractive outcome after cataract surgery. Materials and Methods: A hospital-based study was conducted prospectively to evaluate IOL power using SRK T and HOFFER Q formulae in patients undergoing phacoemulsification with posterior chamber intraocular lens in long eyes over a period of 18 months. Thirty patients were studied based on inclusion criteria. A detailed clinical examination, pre- and postoperative visual acuity, anterior chamber depth (ACD), and refraction were done on day 30 postsurgery. Results: The study included 30 cases with 15 patients in either group, of which 63% were male and 37% were female; 95% of the patients were aged above 50 years; the maximum number of patients in either group had an axial length in the range of 24.5–25 mm; the maximum preoperative ACD was between 3 and 4.5 mm and the maximum postoperative ACD was between 4 and 4.5 mm in both groups; 40% of the patients in either group had 6/6 vision; spherical refractive error postoperative was seen in 73% in the SRK T group and 68% in the HOFFER Q group; and cylindrical refractive error was seen in 27% in SRK T group and 32% in HOFFER Q group. Conclusion: Either formula can be used for IOL power calculation in eyes up to 26.5 mm, as not much difference in postoperative refractive error was observed. Both formulas had a lesser degree of spherical error and an equally good visual outcome postoperatively. Careful biometry is important to prevent postoperative surprises.
{"title":"A comparative study to assess the accuracy of the SRK T and HOFFER Q formulas in the intraocular lens calculation of long eyes undergoing phacoemulsification with posterior chamber intraocular lens in a tertiary care center","authors":"N. Apoorva, HMohan Kumar, Shreya, B. Rachana, Sana Rasheed, Jyotsana Soni","doi":"10.4103/jcor.jcor_29_23","DOIUrl":"https://doi.org/10.4103/jcor.jcor_29_23","url":null,"abstract":"Aims and Objectives: The aim is to compare the accuracy of the SRK T and HOFFER Q formulas in intraocular lens (IOL) power calculation in long eyes by noting the postoperative visual outcome. Introduction: Senile cataract is a leading cause of blindness in India. Cataracts are managed by cataract extraction with implantation IOL. Before surgery, IOL power is calculated by biometry. IOL power calculation is the main key to obtaining a good refractive outcome after cataract surgery. Materials and Methods: A hospital-based study was conducted prospectively to evaluate IOL power using SRK T and HOFFER Q formulae in patients undergoing phacoemulsification with posterior chamber intraocular lens in long eyes over a period of 18 months. Thirty patients were studied based on inclusion criteria. A detailed clinical examination, pre- and postoperative visual acuity, anterior chamber depth (ACD), and refraction were done on day 30 postsurgery. Results: The study included 30 cases with 15 patients in either group, of which 63% were male and 37% were female; 95% of the patients were aged above 50 years; the maximum number of patients in either group had an axial length in the range of 24.5–25 mm; the maximum preoperative ACD was between 3 and 4.5 mm and the maximum postoperative ACD was between 4 and 4.5 mm in both groups; 40% of the patients in either group had 6/6 vision; spherical refractive error postoperative was seen in 73% in the SRK T group and 68% in the HOFFER Q group; and cylindrical refractive error was seen in 27% in SRK T group and 32% in HOFFER Q group. Conclusion: Either formula can be used for IOL power calculation in eyes up to 26.5 mm, as not much difference in postoperative refractive error was observed. Both formulas had a lesser degree of spherical error and an equally good visual outcome postoperatively. Careful biometry is important to prevent postoperative surprises.","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"158 - 162"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49335933","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}
Purpose: The purpose was to study the effect of pupil dilation on biometric measurements and intraocular lens (IOL) power calculation using IOLMaster 500. Materials and Methods: A prospective observational study on 52 eyes of 52 cataract patients. The patients were examined with IOL Master 500 before and after pupil dilation. Axial length (AL), corneal power, anterior chamber depth (ACD), and the corresponding IOL power with Haigis and Sanders, Retzlaff, and Kraff (theoretical formula) (SRK/T) formula were compared. Results: There was no statistically significant difference in AL (+0.005 mm; P = .467) and corneal power (+0.001 D; P = .889) before and after dilation. The ACD increased significantly after dilation (+0.12 ±0.35 mm; P < 0.01). IOL power calculation based on SRK/T formula (−0.02 ±0.16, P = 0.20) was not affected, whereas a significant change in the calculation was found using the Haigis formula (+0.07 ±0.54, P = 0.03). Conclusion: There is no clinically significant effect of pupil dilation on the IOL Master 500 measurements of AL, corneal power, and IOL power calculated using the SRK/T formula. However, a significant increase in ACD and IOL power calculation is found using the Haigis Formula.
{"title":"Effect of pupil dilation on biometry measurements and intraocular lens power calculation formula with intraocular lens master 500","authors":"Suchitra Kumari, Antabha Bandyopadhyay, Taruni Kumari","doi":"10.4103/jcor.jcor_43_23","DOIUrl":"https://doi.org/10.4103/jcor.jcor_43_23","url":null,"abstract":"Purpose: The purpose was to study the effect of pupil dilation on biometric measurements and intraocular lens (IOL) power calculation using IOLMaster 500. Materials and Methods: A prospective observational study on 52 eyes of 52 cataract patients. The patients were examined with IOL Master 500 before and after pupil dilation. Axial length (AL), corneal power, anterior chamber depth (ACD), and the corresponding IOL power with Haigis and Sanders, Retzlaff, and Kraff (theoretical formula) (SRK/T) formula were compared. Results: There was no statistically significant difference in AL (+0.005 mm; P = .467) and corneal power (+0.001 D; P = .889) before and after dilation. The ACD increased significantly after dilation (+0.12 ±0.35 mm; P < 0.01). IOL power calculation based on SRK/T formula (−0.02 ±0.16, P = 0.20) was not affected, whereas a significant change in the calculation was found using the Haigis formula (+0.07 ±0.54, P = 0.03). Conclusion: There is no clinically significant effect of pupil dilation on the IOL Master 500 measurements of AL, corneal power, and IOL power calculated using the SRK/T formula. However, a significant increase in ACD and IOL power calculation is found using the Haigis Formula.","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"190 - 193"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43656902","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":"Head and facial anthropometry of South Indian pediatric population","authors":"M. Al-Mendalawi, M. Al-Khalidi","doi":"10.4103/jcor.jcor_93_23","DOIUrl":"https://doi.org/10.4103/jcor.jcor_93_23","url":null,"abstract":"","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"228 - 228"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49241758","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 : 2023-09-01DOI: 10.4103/jcor.jcor_147_21
Gayathri Mahadevan, Ajay Hatti, P. Shashikala, Shanthala Kumar, Renuka Barki
Context: Diabetes mellitus (DM) is the most common endocrine disorder and is a significant cause of ocular morbidity, unstable refraction, corneal abnormalities, neovascular glaucoma, nerve palsies, and diabetic retinopathy (DR); it is being increasingly recognized that even the ocular surface is adversely affected in diabetic patients. Aims: The present study was undertaken to analyze the conjunctival surface changes by conjunctival impression cytology (CIC) and correlate them with glycosylated hemoglobin (HBA1c) levels. Settings and Design: Known cases of DM satisfying the inclusion criteria were included in this nonrandomized prospective study, which was undertaken after ethical clearance was obtained from our institutional ethical review board. Subjects and Methods: Eighty patients with DM who presented to the Department of ophthalmology at our center were included in the study; they were divided into Group 1 (HbA1c ≤6.5%) and Group 2 (HbA1c >6.5%). A detailed history, general physical examination, complete ophthalmological examination, and CIC were performed in all of the participants. Statistical Analysis Used: Data were analyzed using Chi-square test and statistical software EPI INFO Version 6 and Microsoft Excel. P < 0.05 was considered statistically significant. Results: CIC technique revealed that, after age and gender adjustment, there was a significantly higher percentage of uncontrolled diabetic patients (77.7%) who had lower goblet cell density and higher Nelson grades of conjunctival squamous metaplasia. This difference was significant for all age groups and both sexes (P < 0.001), and it was also significantly related to the duration of DM. In addition, there was a positive correlation between DR and decreased corneal sensation when associated with poor glycemic control (HbA1c >6.5%). Conclusions: Dry eye disease and ocular surface disorders are increasingly recognized in patients suffering from DM. The ocular surface evaluation must be included in the routine examination of all diabetic patients. CIC is a safe, minimally invasive procedure with no side effects and can serve as one of the diagnostic tools for the evaluation of the ocular surface.
背景:糖尿病(DM)是最常见的内分泌疾病，是眼部疾病、不稳定屈光、角膜异常、新生血管性青光眼、神经麻痹和糖尿病视网膜病变(DR)的重要原因;越来越多的人认识到，即使是糖尿病患者的眼表也会受到不良影响。目的:本研究通过结膜印象细胞学(CIC)分析结膜表面变化及其与糖化血红蛋白(HBA1c)水平的相关性。背景和设计:这项非随机前瞻性研究纳入了符合纳入标准的已知DM病例，该研究是在获得我们机构伦理审查委员会的伦理许可后进行的。对象与方法:80例就诊于我中心眼科的糖尿病患者纳入研究;分为1组(HbA1c≤6.5%)和2组(HbA1c≤6.5%)。对所有参与者进行了详细的病史、一般体格检查、完整的眼科检查和CIC。统计分析使用:数据分析采用卡方检验，统计软件EPI INFO Version 6和Microsoft Excel。P < 0.05为差异有统计学意义。结果:CIC技术显示，在调整年龄和性别后，未控制的糖尿病患者中杯状细胞密度较低、结膜鳞状化生Nelson分级较高的比例(77.7%)明显较高。这一差异在所有年龄组和性别中都是显著的(P < 0.001)，并且与糖尿病的持续时间也显著相关。此外，当血糖控制不良(HbA1c >6.5%)时，DR和角膜感觉下降之间存在正相关。结论:干眼病和眼表疾病在糖尿病患者中被越来越多地认识到，眼表评估必须纳入所有糖尿病患者的常规检查。CIC是一种安全、无副作用的微创手术，可作为评估眼表的诊断工具之一。
{"title":"Conjunctival impression cytology and its varying patterns in controlled and uncontrolled diabetic patients","authors":"Gayathri Mahadevan, Ajay Hatti, P. Shashikala, Shanthala Kumar, Renuka Barki","doi":"10.4103/jcor.jcor_147_21","DOIUrl":"https://doi.org/10.4103/jcor.jcor_147_21","url":null,"abstract":"Context: Diabetes mellitus (DM) is the most common endocrine disorder and is a significant cause of ocular morbidity, unstable refraction, corneal abnormalities, neovascular glaucoma, nerve palsies, and diabetic retinopathy (DR); it is being increasingly recognized that even the ocular surface is adversely affected in diabetic patients. Aims: The present study was undertaken to analyze the conjunctival surface changes by conjunctival impression cytology (CIC) and correlate them with glycosylated hemoglobin (HBA1c) levels. Settings and Design: Known cases of DM satisfying the inclusion criteria were included in this nonrandomized prospective study, which was undertaken after ethical clearance was obtained from our institutional ethical review board. Subjects and Methods: Eighty patients with DM who presented to the Department of ophthalmology at our center were included in the study; they were divided into Group 1 (HbA1c ≤6.5%) and Group 2 (HbA1c >6.5%). A detailed history, general physical examination, complete ophthalmological examination, and CIC were performed in all of the participants. Statistical Analysis Used: Data were analyzed using Chi-square test and statistical software EPI INFO Version 6 and Microsoft Excel. P < 0.05 was considered statistically significant. Results: CIC technique revealed that, after age and gender adjustment, there was a significantly higher percentage of uncontrolled diabetic patients (77.7%) who had lower goblet cell density and higher Nelson grades of conjunctival squamous metaplasia. This difference was significant for all age groups and both sexes (P < 0.001), and it was also significantly related to the duration of DM. In addition, there was a positive correlation between DR and decreased corneal sensation when associated with poor glycemic control (HbA1c >6.5%). Conclusions: Dry eye disease and ocular surface disorders are increasingly recognized in patients suffering from DM. The ocular surface evaluation must be included in the routine examination of all diabetic patients. CIC is a safe, minimally invasive procedure with no side effects and can serve as one of the diagnostic tools for the evaluation of the ocular surface.","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"140 - 145"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47295666","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}
Context: In India, late preterm babies are susceptible to retinopathy of prematurity (ROP). This study is done to assess the incidence of ROP and also to analyze the risk factors involved in the development of ROP in preterm babies between 34 and 36 weeks of gestation. Aims: Risk factor analysis of ROP in late preterm babies. Settings and Design: This is a prospective observational study done in a tertiary-level multispecialty hospital between January 2020 and January 2022. Materials and Methods: Two hundred and eleven preterm babies born between 34 and 36 weeks of gestation were included in the study. Their systemic comorbidities were identified after reviewing their hospital records. They were followed up till their retina reached maturity. Statistical Analysis: It was carried out using SPSS software version 17. Results: The incidence of ROP was 6.2%. Twelve (92.3%) babies belonged to type 2 ROP. All these babies had a spontaneous resolution of ROP and did not require any intervention. One (7.7%) baby born at 36 weeks of gestation with a birth weight of 1.5 kg, presented at 52 weeks of gestation with Stage 5B of ROP in both eyes. Using univariate regression analysis, SGA status, pleural effusion, chylothorax, congestive cardiac failure, congenital diaphragmatic hernia, hypoxic–ischemic encephalopathy, and any intervention were found to be statistically significant. On multivariate analysis, SGA status and hypoxic–ischemic encephalopathy were statistically significant. Conclusions: All preterm babies born before 37 weeks of gestation should have at least one ROP screening to prevent the development of sight-threatening ROP.
{"title":"Study of risk factors in the development of retinopathy of prematurity in late preterms","authors":"Silni Chandra, A. Ravi, S. Sija, Padma B. Prabhu","doi":"10.4103/jcor.jcor_37_23","DOIUrl":"https://doi.org/10.4103/jcor.jcor_37_23","url":null,"abstract":"Context: In India, late preterm babies are susceptible to retinopathy of prematurity (ROP). This study is done to assess the incidence of ROP and also to analyze the risk factors involved in the development of ROP in preterm babies between 34 and 36 weeks of gestation. Aims: Risk factor analysis of ROP in late preterm babies. Settings and Design: This is a prospective observational study done in a tertiary-level multispecialty hospital between January 2020 and January 2022. Materials and Methods: Two hundred and eleven preterm babies born between 34 and 36 weeks of gestation were included in the study. Their systemic comorbidities were identified after reviewing their hospital records. They were followed up till their retina reached maturity. Statistical Analysis: It was carried out using SPSS software version 17. Results: The incidence of ROP was 6.2%. Twelve (92.3%) babies belonged to type 2 ROP. All these babies had a spontaneous resolution of ROP and did not require any intervention. One (7.7%) baby born at 36 weeks of gestation with a birth weight of 1.5 kg, presented at 52 weeks of gestation with Stage 5B of ROP in both eyes. Using univariate regression analysis, SGA status, pleural effusion, chylothorax, congestive cardiac failure, congenital diaphragmatic hernia, hypoxic–ischemic encephalopathy, and any intervention were found to be statistically significant. On multivariate analysis, SGA status and hypoxic–ischemic encephalopathy were statistically significant. Conclusions: All preterm babies born before 37 weeks of gestation should have at least one ROP screening to prevent the development of sight-threatening ROP.","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"153 - 157"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43804092","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}
Amit Shankhwar, N. Shankhwar, Suraj Mathur, Anurag Ananthan, Pallavi Chaudhary
Background: Diabetic retinopathy (DR) is a microvasculature disorder of the retina. Color Doppler imaging is a new method that allows simultaneous two-dimensional anatomical and Doppler evaluation of hemodynamic characteristics of the retinal artery. Aim: The aim of the study is to compare retrobulbar vessel Doppler indices in DR and diabetic with no retinopathy (DNR) using color Doppler sonography. Materials and Methods: A time-limited, hospital-based study was conducted at a tertiary care hospital in Indore, Madhya Pradesh. The study included DR and DNR who were referred from the ophthalmology outpatient department to the radiology. Ophthalmologists performed baseline fundoscopy to categorize patients into different levels of retinopathy severity based on the International disease severity scale proposed by Wilkinson, which has five levels ranging from none to proliferative DR, indicating the risk of progression. Results: In the DR group, 26 (74.25%) patients had hemoglobin A1c (HbA1c) levels ranging from 7 to 7.9 and in the DNR group, 9 (26%) patients had HbA1c levels ranging from 6 to 6.9. Among 35 patients with DR, 25 (71%) patients and 7 (20%) had mild DR and moderate DR, respectively, and only 3 (8%) patients belonged to severe DR. The median resistive index (RI) of the ophthalmic artery in DR and DNR groups was 0.83 and 0.73, respectively. The median RI of the central retinal artery in DR and the DNR group was 0.8 cm/s and 0.6 cm/s, respectively. In the posterior ciliary artery, the median RI was higher in the DR group, i.e. 0.78, compared to the DNR group, i.e. 0.63. As RI depicted increased vascular resistance, it was higher in the DR group than in the DNR group. A weak positive correlation was found between HbA1c and peak systolic velocity, end-diastolic volume, and RI of all three arteries (ophthalmic artery, central retinal artery, and posterior ciliary artery) as inferred from the Spearman's rank correlation coefficient among both groups. Conclusion: Color Doppler ultrasonography can be used to assess these microvascular changes and provides the association between the altered ocular blood flow and the severity of retinopathy. It helps us to predict even before DR appearance, enabling early diagnosis of DR and early intervention.
{"title":"Evaluation of retrobulbar circulation in diabetic patients using color Doppler imaging","authors":"Amit Shankhwar, N. Shankhwar, Suraj Mathur, Anurag Ananthan, Pallavi Chaudhary","doi":"10.4103/jcor.jcor_15_23","DOIUrl":"https://doi.org/10.4103/jcor.jcor_15_23","url":null,"abstract":"Background: Diabetic retinopathy (DR) is a microvasculature disorder of the retina. Color Doppler imaging is a new method that allows simultaneous two-dimensional anatomical and Doppler evaluation of hemodynamic characteristics of the retinal artery. Aim: The aim of the study is to compare retrobulbar vessel Doppler indices in DR and diabetic with no retinopathy (DNR) using color Doppler sonography. Materials and Methods: A time-limited, hospital-based study was conducted at a tertiary care hospital in Indore, Madhya Pradesh. The study included DR and DNR who were referred from the ophthalmology outpatient department to the radiology. Ophthalmologists performed baseline fundoscopy to categorize patients into different levels of retinopathy severity based on the International disease severity scale proposed by Wilkinson, which has five levels ranging from none to proliferative DR, indicating the risk of progression. Results: In the DR group, 26 (74.25%) patients had hemoglobin A1c (HbA1c) levels ranging from 7 to 7.9 and in the DNR group, 9 (26%) patients had HbA1c levels ranging from 6 to 6.9. Among 35 patients with DR, 25 (71%) patients and 7 (20%) had mild DR and moderate DR, respectively, and only 3 (8%) patients belonged to severe DR. The median resistive index (RI) of the ophthalmic artery in DR and DNR groups was 0.83 and 0.73, respectively. The median RI of the central retinal artery in DR and the DNR group was 0.8 cm/s and 0.6 cm/s, respectively. In the posterior ciliary artery, the median RI was higher in the DR group, i.e. 0.78, compared to the DNR group, i.e. 0.63. As RI depicted increased vascular resistance, it was higher in the DR group than in the DNR group. A weak positive correlation was found between HbA1c and peak systolic velocity, end-diastolic volume, and RI of all three arteries (ophthalmic artery, central retinal artery, and posterior ciliary artery) as inferred from the Spearman's rank correlation coefficient among both groups. Conclusion: Color Doppler ultrasonography can be used to assess these microvascular changes and provides the association between the altered ocular blood flow and the severity of retinopathy. It helps us to predict even before DR appearance, enabling early diagnosis of DR and early intervention.","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"186 - 189"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46066072","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":"Comment on efficacy and safety of intravitreal triamcinolone acetonide in the management of recalcitrant diabetic macular edema","authors":"Pradeep K Panigrahi, Manaswini Patro","doi":"10.4103/jcor.jcor_85_23","DOIUrl":"https://doi.org/10.4103/jcor.jcor_85_23","url":null,"abstract":"","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"227 - 227"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46900845","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}
Purpose: Inadequate knowledge of patients regarding postoperative home self-care can result in numerous complications and poor visual outcomes. We investigated the knowledge levels of patients on home self-care precautions postdischarge and suggested ways to improve these. Materials and Methods: This cross-sectional study used a random sample from six partner hospitals in north and west India. Patient's knowledge regarding postoperative home self-care was assessed in three domains (i) general eye care precautions (GECP), (ii) eye cleaning procedures (ECP), and (iii) instilling medications in the eye (IME). Data were collected using a structured questionnaire. Results: A total of 616 patients provided interviews and visual acuity (VA) assessments. The median ages were 65 and 63 years for males and females, respectively. Postsurgery, an overwhelming number had either very good or good VA (91.2%). Overall, the knowledge levels were “moderately adequate” for GECP at 57.9%. However, “inadequate” knowledge levels were found pertaining to ECP and IME domains with 69.8% and 84.3%, respectively. With multiple logistic regression, female patients (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.8–4.2) were significantly more likely to have moderate to adequate knowledge of GECP. Those attending both the postoperative review visits were significantly more likely to have moderate to adequate knowledge of ECP (OR 2.4, 95% CI 1.3–4.4) and IME (OR 1.5, 95% CI 0.8–2.7), respectively. Conclusion: Knowledge levels were moderately adequate for GECP, while inadequate for ECP and IME domains, respectively. Strategies to improve patient participation in postoperative review visits and improve patient education modalities are recommended and discussed.
目的:患者对术后家庭自我护理的认识不足会导致许多并发症和视力不良。我们调查了患者出院后家庭自我护理注意事项的知识水平，并提出了改善这些知识的方法。材料和方法:本横断面研究使用了来自印度北部和西部六家合作医院的随机样本。患者对术后家庭自我护理的知识在三个方面进行了评估(i)一般眼科护理预防措施(GECP)， (ii)眼睛清洁程序(ECP)和(iii)向眼睛内灌注药物(IME)。使用结构化问卷收集数据。结果:616例患者接受了访谈和视力(VA)评估。男性和女性的中位年龄分别为65岁和63岁。术后绝大多数患者VA非常好或良好(91.2%)。总体而言，对GECP的知识水平为57.9%，为“中等”。然而，与ECP和IME领域相关的知识水平“不足”的比例分别为69.8%和84.3%。通过多元logistic回归，女性患者(优势比[OR]为2.7,95%可信区间[CI]为1.8-4.2)对GECP有中度至充分认识的可能性显著增加。参加两次术后复查的患者更有可能分别对ECP (OR 2.4, 95% CI 1.3-4.4)和IME (OR 1.5, 95% CI 0.8-2.7)有中度至充分的了解。结论:GECP知识水平适中，ECP和IME知识水平分别不足。建议并讨论了提高患者参与术后复查和改善患者教育模式的策略。
{"title":"Knowledge among patients about postoperative home self-care following cataract surgery in Northern and Western India","authors":"SG Prem Kumar, Shobhana Chavan, Dhanaji Ranpise, Pankaj Vishwakarma, E. Kurian","doi":"10.4103/jcor.jcor_47_23","DOIUrl":"https://doi.org/10.4103/jcor.jcor_47_23","url":null,"abstract":"Purpose: Inadequate knowledge of patients regarding postoperative home self-care can result in numerous complications and poor visual outcomes. We investigated the knowledge levels of patients on home self-care precautions postdischarge and suggested ways to improve these. Materials and Methods: This cross-sectional study used a random sample from six partner hospitals in north and west India. Patient's knowledge regarding postoperative home self-care was assessed in three domains (i) general eye care precautions (GECP), (ii) eye cleaning procedures (ECP), and (iii) instilling medications in the eye (IME). Data were collected using a structured questionnaire. Results: A total of 616 patients provided interviews and visual acuity (VA) assessments. The median ages were 65 and 63 years for males and females, respectively. Postsurgery, an overwhelming number had either very good or good VA (91.2%). Overall, the knowledge levels were “moderately adequate” for GECP at 57.9%. However, “inadequate” knowledge levels were found pertaining to ECP and IME domains with 69.8% and 84.3%, respectively. With multiple logistic regression, female patients (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.8–4.2) were significantly more likely to have moderate to adequate knowledge of GECP. Those attending both the postoperative review visits were significantly more likely to have moderate to adequate knowledge of ECP (OR 2.4, 95% CI 1.3–4.4) and IME (OR 1.5, 95% CI 0.8–2.7), respectively. Conclusion: Knowledge levels were moderately adequate for GECP, while inadequate for ECP and IME domains, respectively. Strategies to improve patient participation in postoperative review visits and improve patient education modalities are recommended and discussed.","PeriodicalId":33073,"journal":{"name":"Journal of Clinical Ophthalmology and Research","volume":"11 1","pages":"172 - 179"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45421368","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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