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Evaluation of risk factors and assessment of socio-demographic factors affecting retinopathy of prematurity in a tertiary care centre of central India 印度中部三级保健中心影响早产儿视网膜病变的危险因素评估和社会人口因素评估
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_9_23
Rakshit Agrawal, Vijay Bhaisare
Aim: Retinopathy of prematurity is a multifactorial vasoproliferative disease whose incidence increases with a decrease in gestational age. It is characterized by the development of abnormal blood vessels in the premature infant’s developing retina due to incomplete vascularization of the retinal tissue brought on by hyperoxia, which also causes endothelial cell death and VEGF (vascular endothelial growth factor) downregulation. We targeted to study the Risk factors and assess the socio-demographic factors affecting retinopathy of prematurity in the population of central India. Materials and Methods: This study was conducted in A tertiary care eye center in central India from March 2020 to March 2021. The Institutional Review Board approved the study, and informed consent was obtained from all the subjects’ parents before participating. Some of the consents were taken in the local language to ensure validity. The patients’ parents were free to withdraw from the study and were assured that their withdrawal would not affect the quality of the care provided to their children. Patients (infants) with a history of preterm birth come to the outpatient. Results: The most prevalent risk factor associated with ROP in our study was Prolonged exposure to Oxygen (>7 days), followed by sepsis and RDS. The risk factors that showed a statistically significant association with ROP were Prolonged Oxygen exposure, RDS, Sepsis, Fungal sepsis, and IUGR. Twin birth, Anemia, Blood Transfusion, Neonatal Jaundice, Phototherapy, and ABO Incompatibility were also associated with ROP, but the association was not statistically significant. (P > 0.05). In our study, among the preterms who had ROP, male children accounted for 46.4%, while females were 53.4%. The association between the gender of the neonate and the occurrence of ROP was found to be non-significant. (P > 0.05). In our study, among the preterms who had ROP, male children accounted for 46.4%, while females were 53.4%. The association between the gender of the neonate and the occurrence of ROP was found to be non-significant. (P > 0.05). Most of the neonates with ROP in our study were of the gestational age of 29-32 weeks. (48.9%) The association between the child’s gestational age and the occurrence of ROP was found to be statistically significant. (P = 0.001, P < 0.05). Conclusion: The incidence of ROP has been on the rise over the years due to the advancements and improvements in the management of preterm neonates in the NICU which have drastically improved the survival of these high-risk neonates which earlier often succumbed to various complications related to premature birth. This has presented as a challenging and uphill task to screen, diagnose and treat neonates who are at risk and develop Retinopathy of Prematurity so that ROP-related blindness can be prevented.
目的:早产儿视网膜病变是一种多因素血管增生性疾病,其发病率随胎龄的降低而增加。其特点是由于高氧导致视网膜组织血管化不完全,导致早产儿视网膜发育过程中血管发育异常,同时导致内皮细胞死亡和血管内皮生长因子(VEGF)下调。我们的目标是研究危险因素,并评估影响印度中部早产儿视网膜病变的社会人口因素。材料与方法:本研究于2020年3月至2021年3月在印度中部的一家三级保健眼科中心进行。机构审查委员会批准了这项研究,并在参与前获得了所有受试者父母的知情同意。有些同意是用当地语言签署的,以确保有效。患者的父母可以自由退出研究,并被保证他们的退出不会影响为他们的孩子提供的护理质量。有早产史的患者(婴儿)来到门诊。结果:在我们的研究中,与ROP相关的最常见危险因素是长时间暴露于氧气(>7天),其次是败血症和RDS。与ROP有统计学意义相关的危险因素是长时间氧暴露、RDS、脓毒症、真菌脓毒症和IUGR。双胞胎、贫血、输血、新生儿黄疸、光疗和ABO血型不合也与ROP相关,但相关性无统计学意义。(p > 0.05)。本研究中发生ROP的早产儿中,男婴占46.4%,女婴占53.4%。新生儿性别与ROP发生的关系不显著。(p > 0.05)。本研究中发生ROP的早产儿中,男婴占46.4%,女婴占53.4%。新生儿性别与ROP发生的关系不显著。(p > 0.05)。本组ROP患儿以胎龄29-32周为主。(48.9%)患儿胎龄与ROP的发生有统计学意义。(p = 0.001, p < 0.05)。结论:近年来,由于NICU早产儿管理的进步和改善,ROP的发生率呈上升趋势,大大提高了这些早期往往死于早产相关并发症的高危新生儿的生存率。筛查、诊断和治疗有风险并发生早产儿视网膜病变的新生儿,以预防rop相关性失明,这是一项具有挑战性和艰巨的任务。
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引用次数: 0
Medico-legal aspects in ophthalmology in India 印度眼科的医学法律方面
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_77_23
Mohana Sinnasamy, Murali Ariga, NirmalThomas Fredrick, VG Madanagopalan, V Subashini, Tarun Murali
The practice of ophthalmology has advanced exponentially due to technology. This has raised the bar of medical care from acceptable visual acuity to the highest precision in acuity. In such an era, it is the need of the hour to be aware of the medico-legal implications in ophthalmology to avert any lawsuits. Lawsuits can be due to breach of confidentiality, inadequate consent, negligence, unmet expectations in a procedure, etc. The majority of lawsuits are related to cataract and corneal surgeries, but the instances of lawsuits related to retinal conditions are on the rise, especially those related to screening of Retinopathy of prematurity resulting in huge sums of compensations. The awareness of regulations can guide the healthcare professionals in such instances. These include the knowledge of laws governing every step of practice and the rights of both healthcare professionals and patients. In addition, clear communication regarding the risks, benefits, and outcomes of the procedure, strict adherence to guidelines, and meticulous documentation are effective tools to avoid litigations. This review article aims to describe various regulations governing the practice of ophthalmology, implications in everyday practice, and steps to safeguard against lawsuits.
由于技术的发展,眼科的实践呈指数级发展。这提高了医疗保健的标准,从可接受的视力到最高精度的视力。在这样一个时代,这是需要时刻意识到医学法律的影响,在眼科避免任何诉讼。诉讼可能是由于违反保密,不充分的同意,疏忽,未达到预期的程序等。大多数诉讼是与白内障和角膜手术有关,但与视网膜疾病有关的诉讼案件正在增加,特别是与早产儿视网膜病变筛查有关的诉讼导致巨额赔偿。在这种情况下,法规意识可以指导医疗保健专业人员。这些知识包括管理每一步实践的法律知识以及医疗保健专业人员和患者的权利。此外,关于风险、收益和结果的清晰沟通,严格遵守指导方针,以及细致的文件是避免诉讼的有效工具。这篇综述文章旨在描述管理眼科实践的各种法规,在日常实践中的含义,以及防止诉讼的步骤。
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引用次数: 0
The momentary deposits behind the phakic intraocular lens: The rationale! 晶状体后的瞬时沉积:原理!
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_68_22
V. Anitha, M. Ravindran, Aditya Ghorpade
To report a unique case of spontaneous resolution of momentary, non-inflammatory phakic intraocular lens implantation (pIOL) deposits, in a 24-year-old female underwent phakic IOL implantation in both eyes for high myopia. Surprisingly, multiple, whitish, refractile, non-inflammatory deposits were noted in the immediate postoperative period on the posterior surface of the pIOL in the right eye. A quick recap of surgical steps identified the rationale for the lens deposits, circumventing similar incident in the fellow eye.
摘要报告一例24岁女性高度近视患者双眼晶状体植入术后瞬间、非炎性晶状体植入术(pIOL)沉积物自发消退的独特病例。令人惊讶的是,术后立即在右眼pIOL后表面发现了多发、白色、屈光性、非炎症性沉积物。手术步骤的快速回顾确定了晶状体沉积的基本原理,避免了在另一只眼睛发生类似事件。
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引用次数: 0
Paediatric injury- A case report 儿科损伤- 1例报告
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_21_22
V. Maneksha, Kavya Setty, Naveena Saseendran
Ocular trauma is the leading cause of monocular blindness among children.Paediatric ocular trauma has a significant impact on the future quality of life of children. Here, we report a case of a 3 year old child who presented with swelling in upper lid following fall from bed. The symptoms got worse the next day. On repeated probing, grandmother gave a history of child holding pen when the fall occurred. Computerized tomography of orbit was done and it showed an intra orbital foreign body. Anterior orbitotomy was done under general anesthesia and foreign body was removed. Patient recovered with excellent visual prognosis. This report highlights importance of history taking, high suspicion of intra orbital foreign body, and need for imaging whenever indicated.
眼外伤是儿童单眼失明的主要原因。儿童眼外伤对儿童未来的生活质量有重大影响。在这里,我们报告了一个3岁的孩子从床上摔下来后出现上眼睑肿胀的病例。第二天症状加重了。经过反复探查,祖母讲述了孩子摔倒时拿着钢笔的历史。对眼眶进行了计算机断层扫描,结果显示眼眶内有异物。在全身麻醉下进行前眼眶切开术,并取出异物。患者恢复良好,视力预后良好。本报告强调了病史采集的重要性、对眶内异物的高度怀疑以及必要时进行成像。
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引用次数: 0
Acute anterior non-granulomatous uveitis in COVID-19—A case series COVID-19急性前部非肉芽肿性葡萄膜炎——病例系列
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_57_22
Priyadarshini Parthasarathi, S. Sankar, Suriya Djeamoorthy, H. Prasanth
We present a series of three covid positive cases of ages 7, 31, and 53 years, respectively. Among them, one patient had active symptoms of COVID-19, and two patients were in a recovery phase. All three cases presented to ophthalmology out patient department (OPD) with complaints of redness and pain. One of the cases had bilateral involvement, while the other two had unilateral involvement. On ocular examination, all three patients had BCVA 6/6 in both eyes. The anterior segment revealed circumcorneal congestion with moderate anterior chamber reaction. The rest of the anterior segment and fundus were within normal limits. Patients were started on topical steroids and improved symptomatically. Ophthalmic manifestations can develop at any stage of COVID-19 disease, conjunctivitis being the most common feature. Uveitis is a rarely documented manifestation, and ophthalmologists should be aware of this manifestation.
我们报告了三个新冠肺炎阳性病例,年龄分别为7岁、31岁和53岁。其中,一名患者出现新冠肺炎活动性症状,两名患者处于康复阶段。这三个病例都以红肿和疼痛的症状出现在眼科门诊部。其中一个案件涉及双边,另外两个案件涉及单方面。在眼部检查中,三名患者的双眼均出现BCVA 6/6。眼前段显示角膜周围充血,伴有中度前房反应。其余的前段和眼底均在正常范围内。患者开始局部服用类固醇,症状有所改善。新冠肺炎疾病的任何阶段都可能出现眼科表现,结膜炎是最常见的特征。葡萄膜炎是一种很少被记录的表现,眼科医生应该意识到这种表现。
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引用次数: 0
Study of retinal nerve fiber layer in patients with type 2 diabetes mellitus 2型糖尿病患者视网膜神经纤维层的研究
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_64_22
R. Kapoor, G. Kaur, N. Batra
Purpose: (1) To assess the Retinal nerve fiber layer (RNFL) thickness in patients with type 2 diabetes mellitus (DM). (2) To assess the correlation of RNFL thickness with duration of DM and HbA1c levels. Methods: The study included 200 patients divided into three groups. Group A included 50 patients with type 2 DM without diabetic retinopathy (DR), group B included 50 patients with type 2 DM with mild to moderate NPDR, and group C included 100 age- and gender-matched controls. The duration of DM and HbA1c values were recorded. Optical coherence tomography scanning was performed, and the RNFL thickness was obtained. Results: The thickness of RNFL was less among diabetics than non-diabetics for the whole of the optic disc as well as for every quadrant except nasal quadrant. This difference was statistically significant only in the inferior quadrant (p = 0.035). The correlation coefficient between RNFL thickness of the whole of the optic disc and duration of DM and HbA1c level was -0.139 and 0.114, respectively. Conclusion: We conclude that the RNFL thickness is reduced in diabetic patients as compared to non-diabetic subjects. This may be beneficial for diabetic patients for early diagnosis of diabetic retinopathy irrespective of duration of DM or HbA1c levels.
目的:(1)评估2型糖尿病(DM)患者视网膜神经纤维层(RNFL)的厚度。(2) 评估RNFL厚度与DM持续时间和HbA1c水平的相关性。方法:将200例患者分为三组。A组包括50名无糖尿病视网膜病变(DR)的2型糖尿病患者,B组包括50例轻度至中度NPDR的2型DM患者,C组包括100名年龄和性别匹配的对照组。记录糖尿病的持续时间和HbA1c值。进行光学相干断层扫描,并获得RNFL厚度。结果:糖尿病患者的RNFL厚度在整个视盘以及除鼻象限外的每个象限均小于非糖尿病患者。这种差异仅在下象限具有统计学意义(p=0.035)。整个视盘的RNFL厚度与DM持续时间和HbA1c水平之间的相关系数分别为-0.139和0.114。结论:与非糖尿病受试者相比,糖尿病患者的RNFL厚度减少。这可能有利于糖尿病患者早期诊断糖尿病视网膜病变,而与糖尿病持续时间或HbA1c水平无关。
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引用次数: 0
Myopia management: What we know till now 近视治疗:我们目前所知道的
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_62_23
Smita Kapoor, Rajesh Prabu, Swarna Udayakumar
Myopia is increasing across the world and is a serious health problem today. Environmental and genetic factors have been implicated in myopia progression. Research has been done on pharmacological and optical treatments and many options are now available. The final choice of treatment should be made after a discussion with the parents and their child, keeping in mind that the treatment may need to be taken for a couple of years.
近视在世界范围内呈上升趋势,是当今一个严重的健康问题。环境和遗传因素与近视的发展有关。药理学和光学治疗方面的研究已经完成,现在有很多选择。治疗的最终选择应该在与父母和孩子讨论后做出,记住治疗可能需要持续几年。
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引用次数: 0
Complete clinical spectrum of melkersson–Rosenthal syndrome with bilateral temporal optic disc pallor – A case report melkersson–Rosenthal综合征伴双侧颞视盘苍白的完整临床谱——一例报告
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_134_20
Henal Javeri, Dipankar Das, Shahinur Tayab, Gayatri Bharali, H. Bhattacharjee, Suklengmung Buragohain
Melkersson Rosenthal syndrome (MRS) is a very rare neuro-mucocutaneous disease, the aetiology of which is not well defined. It is classically characterised by recurring facial paralysis, swelling of face, lips and presence of a furrowed tongue. The presentation is usually oligosymtomatic, with only about one-fourth of cases showing the classical triad. Here, we present a 32-year-old female with MRS, showing the complete clinical triad of symptoms. We report for the first time, an association of MRS with bilateral optic nerve involvement. A standard criterion for diagnosis and management is lacking. It is important to increase awareness of such a rare syndrome with various associated manifestations, so that it can be accurately identified and treated.
Melkersson Rosenthal综合征(MRS)是一种非常罕见的神经-皮肤粘膜疾病,其病因尚不明确。它的典型特征是反复发作的面瘫,面部、嘴唇肿胀,舌头有皱纹。表现通常是少症状的,只有大约四分之一的病例表现出经典的三联征。在这里,我们提出一个32岁的女性与MRS,显示完整的临床三合一症状。我们首次报道了MRS与双侧视神经受累的关系。缺乏诊断和治疗的标准标准。重要的是要提高对这种具有各种相关表现的罕见综合征的认识,以便准确识别和治疗。
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引用次数: 0
Ocular injuries due to shuttlecock: A case series 羽毛球引起的眼部损伤:一个病例系列
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_67_22
Debolina Deb, L. Daniel
For decades badminton has been a leisure sport, with a majority of players being non-professional players and playing without protective eyewear. We report a retrospective case series of three patients who presented at a suburban eye clinic in south India with various ocular signs post injury while playing with shuttlecock. On a detailed slit-lamp examination, anterior uveitis, bilateral angle recession, commotio retinae, and retinal hole were the varied presentations. Early diagnosis, prompt treatment and long-term follow-up is important in these patients especially in the event of angle recession and retinal pathologies post shuttlecock injury. We recommend strict sports regulations to implement wearing of protective eyewear while playing the sport.
几十年来,羽毛球一直是一项休闲运动,大多数运动员都是非专业运动员,打球时不戴防护眼镜。我们报告了一个回顾性的病例系列的三个病人谁提出了在郊区眼科诊所在印度南部的各种眼部体征后受伤,而玩毽子。在详细的裂隙灯检查中,不同的表现是葡萄膜前炎、双侧角退缩、视网膜移位和视网膜裂孔。早期诊断,及时治疗和长期随访对这些患者非常重要,特别是在羽毛球损伤后发生角度衰退和视网膜病变时。我们建议严格的运动规定,在运动时佩戴防护眼镜。
{"title":"Ocular injuries due to shuttlecock: A case series","authors":"Debolina Deb, L. Daniel","doi":"10.4103/tjosr.tjosr_67_22","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_67_22","url":null,"abstract":"For decades badminton has been a leisure sport, with a majority of players being non-professional players and playing without protective eyewear. We report a retrospective case series of three patients who presented at a suburban eye clinic in south India with various ocular signs post injury while playing with shuttlecock. On a detailed slit-lamp examination, anterior uveitis, bilateral angle recession, commotio retinae, and retinal hole were the varied presentations. Early diagnosis, prompt treatment and long-term follow-up is important in these patients especially in the event of angle recession and retinal pathologies post shuttlecock injury. We recommend strict sports regulations to implement wearing of protective eyewear while playing the sport.","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"111 - 114"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42698677","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}
引用次数: 0
New age cost-effective teleophthalmology with innovative frugal ophthalmic imaging - Anterior segment photography with intraocular lens (ASPI) and trash to treasure retcam (T3R) 新时代的低成本远距眼科成像技术——人工晶状体前段摄影(ASPI)和垃圾转宝摄像头(T3R)
Pub Date : 2023-01-01 DOI: 10.4103/tjosr.tjosr_109_22
P. Ramesh, P. Chandrakanth, S. Ramesh, A. Devadas, Prajnya Ray, K. Chandrakanth, M. Ramesh, R. Rajasekaran
{"title":"New age cost-effective teleophthalmology with innovative frugal ophthalmic imaging - Anterior segment photography with intraocular lens (ASPI) and trash to treasure retcam (T3R)","authors":"P. Ramesh, P. Chandrakanth, S. Ramesh, A. Devadas, Prajnya Ray, K. Chandrakanth, M. Ramesh, R. Rajasekaran","doi":"10.4103/tjosr.tjosr_109_22","DOIUrl":"https://doi.org/10.4103/tjosr.tjosr_109_22","url":null,"abstract":"","PeriodicalId":34180,"journal":{"name":"TNOA Journal of Ophthalmic Science and Research","volume":"61 1","pages":"147 - 149"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44306317","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}
引用次数: 0
期刊
TNOA Journal of Ophthalmic Science and Research
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