Pub Date : 2023-10-10eCollection Date: 2023-01-01DOI: 10.24926/iip.v14i1.5444
Insaf Mohammad, Alyssa Poyer, Roukia Hamoud, Julie George
ABSTRACT Background: Literature has shown the positive impact of ambulatory care pharmacists on diabetes management, yet additional research on clinical outcomes compared to traditional care models is warranted. Objective: The objective of this study is to evaluate the impact of an ambulatory care pharmacist on glycemic control over two years compared to patients who received usual care. Methods: This retrospective cohort study matched patients with a baseline hemoglobin A1c (HgbA1c) ≥8% managed by the ambulatory care pharmacist to patients who received usual care. The primary outcome was the mean change in HgbA1c over two years. The secondary outcomes were to evaluate the difference in (1) the proportion of patients achieving HgbA1c <8%, (2) the proportion of patients achieving blood pressure <130/80 mmHg, (3) mean LDL, (4) the proportion of patients prescribed SGLT2 inhibitors, GLP-1RA, and sulfonylureas, and (5) severe hypoglycemia after two years. Results: Data for 180 patients was analyzed over two years. The mean HgbA1c was 10% at baseline vs 8.2% after two years (adjusted mean change -1.92) among pharmacist-managed patients, compared to 9.9% vs 9% respectively for usual care patients (adjusted mean change -0.98) (p=0.004). Among pharmacist-managed patients, 53.5% achieved HgbA1c <8% compared with 34.2% of usual care patients (p=0.014). There were no statistically significant differences in proportion of patients at goal blood pressure, mean LDL, or hypoglycemia between the two groups. After two years, 18.3% of pharmacist-managed and 5.8% of usual care patients were on an SGLT2 inhibitor (p=0.008), and 46.7% of pharmacist-managed and 9.2% of usual care patients were on a GLP-1RA (p<0.001). No difference was found in sulfonylurea utilization. Conclusion: Patients with HgbA1c >8% managed by an ambulatory care pharmacist had twice the HgbA1c reduction and significantly more utilization of GLP-1RA and SGLT2 inhibitors as compared to controls provided usual care.
{"title":"Impact of Ambulatory Care Pharmacist-Led Management on Hemoglobin A1c Values among Patients with Uncontrolled Diabetes in a Primary Care Clinic vs Usual Care over Two Years.","authors":"Insaf Mohammad, Alyssa Poyer, Roukia Hamoud, Julie George","doi":"10.24926/iip.v14i1.5444","DOIUrl":"10.24926/iip.v14i1.5444","url":null,"abstract":"ABSTRACT Background: Literature has shown the positive impact of ambulatory care pharmacists on diabetes management, yet additional research on clinical outcomes compared to traditional care models is warranted. Objective: The objective of this study is to evaluate the impact of an ambulatory care pharmacist on glycemic control over two years compared to patients who received usual care. Methods: This retrospective cohort study matched patients with a baseline hemoglobin A1c (HgbA1c) ≥8% managed by the ambulatory care pharmacist to patients who received usual care. The primary outcome was the mean change in HgbA1c over two years. The secondary outcomes were to evaluate the difference in (1) the proportion of patients achieving HgbA1c <8%, (2) the proportion of patients achieving blood pressure <130/80 mmHg, (3) mean LDL, (4) the proportion of patients prescribed SGLT2 inhibitors, GLP-1RA, and sulfonylureas, and (5) severe hypoglycemia after two years. Results: Data for 180 patients was analyzed over two years. The mean HgbA1c was 10% at baseline vs 8.2% after two years (adjusted mean change -1.92) among pharmacist-managed patients, compared to 9.9% vs 9% respectively for usual care patients (adjusted mean change -0.98) (p=0.004). Among pharmacist-managed patients, 53.5% achieved HgbA1c <8% compared with 34.2% of usual care patients (p=0.014). There were no statistically significant differences in proportion of patients at goal blood pressure, mean LDL, or hypoglycemia between the two groups. After two years, 18.3% of pharmacist-managed and 5.8% of usual care patients were on an SGLT2 inhibitor (p=0.008), and 46.7% of pharmacist-managed and 9.2% of usual care patients were on a GLP-1RA (p<0.001). No difference was found in sulfonylurea utilization. Conclusion: Patients with HgbA1c >8% managed by an ambulatory care pharmacist had twice the HgbA1c reduction and significantly more utilization of GLP-1RA and SGLT2 inhibitors as compared to controls provided usual care.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73869770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/tjosr.tjosr_101_22
Divya Karuppannasamy, P. Sundaram, B. Pandian, G. Lawanya
We report a rare case of leukaemic retinal infiltrates in a patient with chronic myeloid leukaemia (CML) in the chronic phase. A 52-year-old male, a known case of CML, presented with a sudden, painless decrease in vision in both eyes of 4 days duration. Fundus examination revealed a normal optic disc and vessels, multiple retinal haemorrhages, and Roth spots along with discrete retinal infiltrates in the macula and mid-periphery in both eyes. Peripheral smear examination revealed anaemia, thrombocytopenia, and neutrophilic leucocytosis with 1% blast cells, suggestive of CML in the chronic phase. Treatment with oral imatinib resulted in haematological recovery as well as resolution of retinal infiltrates. Leukaemic retinal infiltrates can occur uncommonly in chronic phase of CML, and their recognition as a sign of possible extra-medullary disease is vital. Prompt ophthalmic evaluation and treatment may reduce visual morbidity as well as prevent systemic relapse.
{"title":"Leukemic retinal infiltrates – Report of an uncommon clinical presentation and review of literature","authors":"Divya Karuppannasamy, P. Sundaram, B. Pandian, G. Lawanya","doi":"10.4103/tjosr.tjosr_101_22","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_101_22","url":null,"abstract":"We report a rare case of leukaemic retinal infiltrates in a patient with chronic myeloid leukaemia (CML) in the chronic phase. A 52-year-old male, a known case of CML, presented with a sudden, painless decrease in vision in both eyes of 4 days duration. Fundus examination revealed a normal optic disc and vessels, multiple retinal haemorrhages, and Roth spots along with discrete retinal infiltrates in the macula and mid-periphery in both eyes. Peripheral smear examination revealed anaemia, thrombocytopenia, and neutrophilic leucocytosis with 1% blast cells, suggestive of CML in the chronic phase. Treatment with oral imatinib resulted in haematological recovery as well as resolution of retinal infiltrates. Leukaemic retinal infiltrates can occur uncommonly in chronic phase of CML, and their recognition as a sign of possible extra-medullary disease is vital. Prompt ophthalmic evaluation and treatment may reduce visual morbidity as well as prevent systemic relapse.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"225 - 227"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42889429","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 : 2023-04-01DOI: 10.4103/tjosr.tjosr_6_23
Devendra Maheshwari, L. Biswal, R. Madhavi, Ramakrishnan Rengappa
We present an ophthalmic photo essay of intravitreal triamcinolone acetonide (TA)-induced acute rise of intraocular pressure. Deposition of triamcinolone crystals was noted over the cornea, iris, anterior chamber, and angles. This highlights the importance of gonioscopy in providing insight into different mechanisms involved in intraocular pressure elevation.
{"title":"A volcanic Eruption following intravitreal triamcinolone acetonide injection","authors":"Devendra Maheshwari, L. Biswal, R. Madhavi, Ramakrishnan Rengappa","doi":"10.4103/tjosr.tjosr_6_23","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_6_23","url":null,"abstract":"We present an ophthalmic photo essay of intravitreal triamcinolone acetonide (TA)-induced acute rise of intraocular pressure. Deposition of triamcinolone crystals was noted over the cornea, iris, anterior chamber, and angles. This highlights the importance of gonioscopy in providing insight into different mechanisms involved in intraocular pressure elevation.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"267 - 269"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47770562","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 : 2023-04-01DOI: 10.4103/tjosr.tjosr_10_23
K. Ashwini, Sahana Shankar, Dikshitha Rajbanshi, Srijana Paudel, Prathima Singh, K. Chandana, C. Varsha
Context: For an image to be viewed as a single image, the visual axes of the two eyes must be aligned so that the image strikes the corresponding retinal points. This occurs from the coordination of the sensory, motor, accommodative and convergence functions of both eyes. Prolonged near work affects the accommodation and vergence functions of the eye which are essential to maintain binocular single vision. Aims: To assess the short-term effects of mobile and computer gaming on binocular vision functions. Settings and Design: Prospective cross-sectional study design. Methods and Material: In this prospective study, a total 60 individuals were included in the study. A baseline binocular vision assessment was done for the included study subjects. The following day, participants were made to play 'Asphalt 8' game on mobile and on laptop for 1 h each after division into groups, and binocular vision assessment was reassessed. Statistical Analysis Used: Data analysis was done using paired t-test with the help of SPSS v23 software. Results: Sixty students of 18–25 age group with a mean age of 20.30 ± 1.95 were a part of this study. The result from the study showed that there was a statistically significant decrease in stereopsis after gaming on mobile. The motor component changes noted were clinically significant though not statistically significant. The result also showed that there was a statistically significant increase in the amplitude of accommodation (OS, OU) and accommodative facility (OD, OS and OU) after playing game on mobile. The decrease in amplitude of accommodation (OS) values was statistically significant between mobile and laptop gaming. The increase in near point convergence with an accommodative target was statistically significant after gaming on mobile. There was a statistically significant increase in NPC with an accommodative target with P value of 0.022 (break), NPC with a non-accommodative target with P value of 0.036 (break) and 0.047 (recovery) and VF (0.019), respectively, after playing game on laptop. There was statistically significant increase with P value of NPC with non-accommodative target 0.020 (break) and 0.040 (recovery) after playing game on laptop than on mobile. Conclusions: There were significant changes noted in stereopsis, accommodation, and convergence values after gaming on mobile and laptop. Hence, it is concluded that playing games on mobile and laptop for 1 h may harm binocular vision. There was no statistical difference in the binocular assessments between mobile and laptop.
{"title":"The consequences of gaming on mobile devices versus laptops on binocular visual functioning","authors":"K. Ashwini, Sahana Shankar, Dikshitha Rajbanshi, Srijana Paudel, Prathima Singh, K. Chandana, C. Varsha","doi":"10.4103/tjosr.tjosr_10_23","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_10_23","url":null,"abstract":"Context: For an image to be viewed as a single image, the visual axes of the two eyes must be aligned so that the image strikes the corresponding retinal points. This occurs from the coordination of the sensory, motor, accommodative and convergence functions of both eyes. Prolonged near work affects the accommodation and vergence functions of the eye which are essential to maintain binocular single vision. Aims: To assess the short-term effects of mobile and computer gaming on binocular vision functions. Settings and Design: Prospective cross-sectional study design. Methods and Material: In this prospective study, a total 60 individuals were included in the study. A baseline binocular vision assessment was done for the included study subjects. The following day, participants were made to play 'Asphalt 8' game on mobile and on laptop for 1 h each after division into groups, and binocular vision assessment was reassessed. Statistical Analysis Used: Data analysis was done using paired t-test with the help of SPSS v23 software. Results: Sixty students of 18–25 age group with a mean age of 20.30 ± 1.95 were a part of this study. The result from the study showed that there was a statistically significant decrease in stereopsis after gaming on mobile. The motor component changes noted were clinically significant though not statistically significant. The result also showed that there was a statistically significant increase in the amplitude of accommodation (OS, OU) and accommodative facility (OD, OS and OU) after playing game on mobile. The decrease in amplitude of accommodation (OS) values was statistically significant between mobile and laptop gaming. The increase in near point convergence with an accommodative target was statistically significant after gaming on mobile. There was a statistically significant increase in NPC with an accommodative target with P value of 0.022 (break), NPC with a non-accommodative target with P value of 0.036 (break) and 0.047 (recovery) and VF (0.019), respectively, after playing game on laptop. There was statistically significant increase with P value of NPC with non-accommodative target 0.020 (break) and 0.040 (recovery) after playing game on laptop than on mobile. Conclusions: There were significant changes noted in stereopsis, accommodation, and convergence values after gaming on mobile and laptop. Hence, it is concluded that playing games on mobile and laptop for 1 h may harm binocular vision. There was no statistical difference in the binocular assessments between mobile and laptop.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"207 - 214"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44842934","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 : 2023-04-01DOI: 10.4103/tjosr.tjosr_79_22
Shruti Kochar, S. Lahane, P. Mahendradas, Rwituja Thomas
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare form of ocular inflammation, with the only systemic manifestation being acute interstitial nephritis. We report a case of TINU that presented with ocular abnormalities after being diagnosed with interstitial nephritis. Our patient had an initial presentation of fever with chills and weakness at the time of presentation to their nephrologist. Blood investigations revealed elevated creatinine, proteinuria and increased β2 microglobulin, following which they were diagnosed with possible TINU syndrome as per Mandeville's diagnostic criteria. Our patients responded well to oral and topical steroids. She had recurrent episodes, which were subsequently managed. It is important to have a high index of suspicion for TINU as patients, even in the absence of a renal biopsy, as they have an excellent prognosis with timely treatment. TINU is a rare diagnosis and is most likely because it is often missed. However, patients with TINU syndrome require a customized multispecialty approach in order to diagnose, rule out other causes of uveitis and AIN and hence manage appropriately.
{"title":"Possible Tubulointerstitial Nephritis and Uveitis (TINU) syndrome","authors":"Shruti Kochar, S. Lahane, P. Mahendradas, Rwituja Thomas","doi":"10.4103/tjosr.tjosr_79_22","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_79_22","url":null,"abstract":"Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare form of ocular inflammation, with the only systemic manifestation being acute interstitial nephritis. We report a case of TINU that presented with ocular abnormalities after being diagnosed with interstitial nephritis. Our patient had an initial presentation of fever with chills and weakness at the time of presentation to their nephrologist. Blood investigations revealed elevated creatinine, proteinuria and increased β2 microglobulin, following which they were diagnosed with possible TINU syndrome as per Mandeville's diagnostic criteria. Our patients responded well to oral and topical steroids. She had recurrent episodes, which were subsequently managed. It is important to have a high index of suspicion for TINU as patients, even in the absence of a renal biopsy, as they have an excellent prognosis with timely treatment. TINU is a rare diagnosis and is most likely because it is often missed. However, patients with TINU syndrome require a customized multispecialty approach in order to diagnose, rule out other causes of uveitis and AIN and hence manage appropriately.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"220 - 222"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45608441","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 : 2023-04-01DOI: 10.4103/tjosr.tjosr_47_23
R. Muralidhar, D. Ramamurthy
Infantile nystagmus syndrome usually presents around 3–6 months of age, is usually horizontal across gazes and is often characterised by the presence of a null zone. If the null zone does not coincide with the primary position, patients adopt a face turn to optimise their visual acuity. This is utilised to our advantage in nystagmus surgeries that aim to make the null zone coincide with the primary position. However, for this to be successful, a careful evaluation has to be performed to weed out neurological causes of nystagmus and nystagmoid movements. The article aimed to give some tips to ophthalmologists for a comprehensive nystagmus evaluation. It also discusses the broad principles of nystagmus surgeries, viz the Kestenbaum–Anderson procedure, artificial divergence, tenotomy and reattachment and retroequatorial recession. An overview of potential complications is also presented.
{"title":"A simplified approach to diagnosing and managing infantile nystagmus syndrome","authors":"R. Muralidhar, D. Ramamurthy","doi":"10.4103/tjosr.tjosr_47_23","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_47_23","url":null,"abstract":"Infantile nystagmus syndrome usually presents around 3–6 months of age, is usually horizontal across gazes and is often characterised by the presence of a null zone. If the null zone does not coincide with the primary position, patients adopt a face turn to optimise their visual acuity. This is utilised to our advantage in nystagmus surgeries that aim to make the null zone coincide with the primary position. However, for this to be successful, a careful evaluation has to be performed to weed out neurological causes of nystagmus and nystagmoid movements. The article aimed to give some tips to ophthalmologists for a comprehensive nystagmus evaluation. It also discusses the broad principles of nystagmus surgeries, viz the Kestenbaum–Anderson procedure, artificial divergence, tenotomy and reattachment and retroequatorial recession. An overview of potential complications is also presented.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"158 - 162"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42067624","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 : 2023-04-01DOI: 10.4103/tjosr.tjosr_73_22
Nanthene Rajmohan, Veni Sigamani, J. Justin Prashanth
Pseudotumor cerebri (PTC) or idiopathic intracranial hypertension (IIH) is described as a syndrome of headache, papilloedema and elevated pressure of the cerebrospinal fluid (CSF) beyond 200-mm H2O, normal neuroimaging and normal neurological examination in the presence of normal CSF composition. It is nearly always bilateral. PTC may be either primary or secondary to some conditions. Secondary causes of PTC may include some medications, endocrine abnormalities, autoimmune disorders, cranial venous outflow abnormalities and anaemia. Here, we report two cases of IIH, one due to vitamin B12 deficiency and other due to hypervitaminosis of vitamin A. Both the cases had anaemia. Exact pathogenesis for increase in intracranial pressure is obscure. Various mechanisms proposed in literature include increased cerebral venous pressure secondary to a relative hyperviscosity state and altered cerebral hemodynamics due to tissue hypoxia which increases brain capillary permeability and therefore causes raised ICP, ultimately leading to papilloedema. Early suspicion and prompt initiation of treatment help in preventing irreversible loss of vision in these patients.
{"title":"Micronutrients and IIH – A case series","authors":"Nanthene Rajmohan, Veni Sigamani, J. Justin Prashanth","doi":"10.4103/tjosr.tjosr_73_22","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_73_22","url":null,"abstract":"Pseudotumor cerebri (PTC) or idiopathic intracranial hypertension (IIH) is described as a syndrome of headache, papilloedema and elevated pressure of the cerebrospinal fluid (CSF) beyond 200-mm H2O, normal neuroimaging and normal neurological examination in the presence of normal CSF composition. It is nearly always bilateral. PTC may be either primary or secondary to some conditions. Secondary causes of PTC may include some medications, endocrine abnormalities, autoimmune disorders, cranial venous outflow abnormalities and anaemia. Here, we report two cases of IIH, one due to vitamin B12 deficiency and other due to hypervitaminosis of vitamin A. Both the cases had anaemia. Exact pathogenesis for increase in intracranial pressure is obscure. Various mechanisms proposed in literature include increased cerebral venous pressure secondary to a relative hyperviscosity state and altered cerebral hemodynamics due to tissue hypoxia which increases brain capillary permeability and therefore causes raised ICP, ultimately leading to papilloedema. Early suspicion and prompt initiation of treatment help in preventing irreversible loss of vision in these patients.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"217 - 219"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42156614","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 : 2023-04-01DOI: 10.4103/tjosr.tjosr_124_22
N. Senthil Kumar, A. Yogeswari, M. S. Prakash, T. Umamaheswari
Aim: To compare the accuracy and precision of measurement of axial proptosis using novel slit-lamp exophthalmometry [SLE] and compare it with gold standard methods of Hertel's exophthalmometry and computed tomography (CT)-based methods. Methods: Patients with axial proptosis were assessed with novel slit-lamp exophthalmometry and compared with Hertel's exophthalmometry and CT measurements [3 CT methods]. Results: Correlational analysis between slit-lamp exophthalmometry and CT exophthalmometry demonstrated an ICC value of 0.912 indicates 'excellent' agreement, and 95% CI indicated non-significant change between the techniques. Intracorrelation coefficient examined strength of agreement. Values >0.75 showed 'excellent reliability'. Bland–Altman plots charted for comparison of SLE with Hertels', and CT exophthalmometry showed all differences to lie within the 2 SD boundaries suggestive of excellent agreement between the methods. Discussion and Conclusion: Advantages include stability to examiner and patients. Instrument errors are eliminated. Three CT methods and Hertel had statistically significant relationships with SLE. Exophthalmometry values are important for diagnoses, follow-up and treatment decision-making. Hence, a simple, objective examination method like SLE is needed to measure exophthalmos.
{"title":"Comparing slit lamp exophthalmometry with Hertel's exophthalmometry and computed tomography imaging in quantification of axial proptosis – A prospective analytical study","authors":"N. Senthil Kumar, A. Yogeswari, M. S. Prakash, T. Umamaheswari","doi":"10.4103/tjosr.tjosr_124_22","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_124_22","url":null,"abstract":"Aim: To compare the accuracy and precision of measurement of axial proptosis using novel slit-lamp exophthalmometry [SLE] and compare it with gold standard methods of Hertel's exophthalmometry and computed tomography (CT)-based methods. Methods: Patients with axial proptosis were assessed with novel slit-lamp exophthalmometry and compared with Hertel's exophthalmometry and CT measurements [3 CT methods]. Results: Correlational analysis between slit-lamp exophthalmometry and CT exophthalmometry demonstrated an ICC value of 0.912 indicates 'excellent' agreement, and 95% CI indicated non-significant change between the techniques. Intracorrelation coefficient examined strength of agreement. Values >0.75 showed 'excellent reliability'. Bland–Altman plots charted for comparison of SLE with Hertels', and CT exophthalmometry showed all differences to lie within the 2 SD boundaries suggestive of excellent agreement between the methods. Discussion and Conclusion: Advantages include stability to examiner and patients. Instrument errors are eliminated. Three CT methods and Hertel had statistically significant relationships with SLE. Exophthalmometry values are important for diagnoses, follow-up and treatment decision-making. Hence, a simple, objective examination method like SLE is needed to measure exophthalmos.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"322 4","pages":"163 - 168"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41258835","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 : 2023-04-01DOI: 10.4103/tjosr.tjosr_24_23
Ilango Krishnamurthy
Low vision rehabilitation is not just magnifiers and magnification. It is multidimensional and multidisciplinary. This article is an attempt to enlighten the readers about the different aspects, models of vision rehabilitation. The vision impaired first point of contact is an ophthalmologist and when nothing more can be done at the clinical level these patients can be referred to an appropriate institution or individual where professional help can be offered.
{"title":"Beyond magnifiers and magnification","authors":"Ilango Krishnamurthy","doi":"10.4103/tjosr.tjosr_24_23","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_24_23","url":null,"abstract":"Low vision rehabilitation is not just magnifiers and magnification. It is multidimensional and multidisciplinary. This article is an attempt to enlighten the readers about the different aspects, models of vision rehabilitation. The vision impaired first point of contact is an ophthalmologist and when nothing more can be done at the clinical level these patients can be referred to an appropriate institution or individual where professional help can be offered.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"154 - 157"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49439986","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 : 2023-04-01DOI: 10.4103/tjosr.tjosr_112_22
P. Sathyan, A. Priya, P. Sathyan
Ophthalmic manifestations of Idiopathic thrombocytopenic purpura (ITP) are exceptionally rare. We report a life-threatening case of ITP, manifested with massive retinal haemorrhage. The core of this case report was to highlight the importance of systemic evaluation in ocular disease.
{"title":"Eye the mirror of the soul-idiopathic thrombocytopenic purpura-induced retinal hemorrhage","authors":"P. Sathyan, A. Priya, P. Sathyan","doi":"10.4103/tjosr.tjosr_112_22","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_112_22","url":null,"abstract":"Ophthalmic manifestations of Idiopathic thrombocytopenic purpura (ITP) are exceptionally rare. We report a life-threatening case of ITP, manifested with massive retinal haemorrhage. The core of this case report was to highlight the importance of systemic evaluation in ocular disease.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"239 - 241"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45538903","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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