Pub Date : 2024-02-20DOI: 10.4103/tjo.tjo-d-23-00169
Itay Lavy, N. Erdinest, Jamel Corredores, Denise Wajnsztajn, David Smadja
This study aimed to evaluate the efficacy of ripasudil in managing various corneal edema conditions. This single-center retrospective analysis was conducted at Hadassah Medical Center and involved 16 patients with 17 eyes. Patients were selected based on diagnostic criteria, primarily corneal edema. The conditions were as follows, listed by frequency: postcataract surgery (31.25%), postpenetrating keratoplasty (25%), post-Descemet’s membrane endothelial keratoplasty (18.75%), Fuchs’ endothelial corneal dystrophy (12.5%), status post-Ahmed glaucoma valve (6.25%), and status posttrabeculectomy (6.25%). The treatment regimen involved topical administration of ripasudil hydrochloride hydrate (Glanatec® 0.4%), administered three times a day or tailored to condition severity. Efficacy was assessed using pre- and posttreatment measurements of best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC), along with slit-lamp and optical coherence tomography examinations. The average duration of ripasudil treatment was approximately 4.9 ± 2.2 months. Significant improvements were observed in BCVA, changing from a pretreatment value of 1.106 ± 0.817 logMAR to a posttreatment value of 0.56 ± 0.57 logMAR (P = 0.0308). CCT also showed a significant reduction, from 619.50 ± 56.36 μm pretreatment to 572.5 ± 75.48 μm posttreatment (P = 0.0479). ECC showed a marginal but not statistically significant increase, from 849.00 ± 570.72 cells/mm² pretreatment to 874.75 ± 625.59 cells/mm² posttreatment (P = 0.9010). The study provides robust evidence supporting the use of ripasudil in managing corneal edema. Significant improvements in key ocular metrics such as BCVA and CCT were observed, enhancing the overall quality of life for patients suffering from various forms of corneal edema.
{"title":"Evaluating the efficacy of Rho kinase inhibitor eye drops in the management of corneal edema: A single-center retrospective cohort study","authors":"Itay Lavy, N. Erdinest, Jamel Corredores, Denise Wajnsztajn, David Smadja","doi":"10.4103/tjo.tjo-d-23-00169","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00169","url":null,"abstract":"\u0000 \u0000 \u0000 This study aimed to evaluate the efficacy of ripasudil in managing various corneal edema conditions.\u0000 \u0000 \u0000 \u0000 This single-center retrospective analysis was conducted at Hadassah Medical Center and involved 16 patients with 17 eyes. Patients were selected based on diagnostic criteria, primarily corneal edema. The conditions were as follows, listed by frequency: postcataract surgery (31.25%), postpenetrating keratoplasty (25%), post-Descemet’s membrane endothelial keratoplasty (18.75%), Fuchs’ endothelial corneal dystrophy (12.5%), status post-Ahmed glaucoma valve (6.25%), and status posttrabeculectomy (6.25%). The treatment regimen involved topical administration of ripasudil hydrochloride hydrate (Glanatec® 0.4%), administered three times a day or tailored to condition severity. Efficacy was assessed using pre- and posttreatment measurements of best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC), along with slit-lamp and optical coherence tomography examinations.\u0000 \u0000 \u0000 \u0000 The average duration of ripasudil treatment was approximately 4.9 ± 2.2 months. Significant improvements were observed in BCVA, changing from a pretreatment value of 1.106 ± 0.817 logMAR to a posttreatment value of 0.56 ± 0.57 logMAR (P = 0.0308). CCT also showed a significant reduction, from 619.50 ± 56.36 μm pretreatment to 572.5 ± 75.48 μm posttreatment (P = 0.0479). ECC showed a marginal but not statistically significant increase, from 849.00 ± 570.72 cells/mm² pretreatment to 874.75 ± 625.59 cells/mm² posttreatment (P = 0.9010).\u0000 \u0000 \u0000 \u0000 The study provides robust evidence supporting the use of ripasudil in managing corneal edema. Significant improvements in key ocular metrics such as BCVA and CCT were observed, enhancing the overall quality of life for patients suffering from various forms of corneal edema.\u0000","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140446939","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 : 2024-01-31DOI: 10.4103/tjo.tjo-d-23-00108
Nimesh C. Patel, Yi-Ting Hsieh, Chung M Yang, M. Berrocal, F. Dhawahir-Scala, Paisan Ruamviboonsuk, RajeevReddy Pappuru, V. Dave
Diabetic retinopathy is one of the most severe forms of retinopathy and a leading cause of blindness all over the world. Of a greater concern is proliferative diabetic retinopathy which leads to vitreous haemorrhage and tractional retinal detachment in such cases. A majority of these cases require a surgical intervention to improve vision and prevent further vision loss. Surgical manouevers in these cases require a complex combination of vitrectomy, membrane dissection, judious usage of endodiathermy, endolaser, vital dyes, bimanual dissection and usage of intraoperative and post-operative tamponades. Each case presents a unique challenge and necessitates an appropriate combination of the steps mentioned above. In the current review we present the current understanding of the need for surgery in diabetic retinopathy, various surgical approaches and a summary of current literature on the same. Multiple surgical video clips demonstrating these steps are also included in this review.
{"title":"Vitrectomy for diabetic retinopathy: A review of indications, techniques, outcomes, and complications","authors":"Nimesh C. Patel, Yi-Ting Hsieh, Chung M Yang, M. Berrocal, F. Dhawahir-Scala, Paisan Ruamviboonsuk, RajeevReddy Pappuru, V. Dave","doi":"10.4103/tjo.tjo-d-23-00108","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00108","url":null,"abstract":"\u0000 Diabetic retinopathy is one of the most severe forms of retinopathy and a leading cause of blindness all over the world. Of a greater concern is proliferative diabetic retinopathy which leads to vitreous haemorrhage and tractional retinal detachment in such cases. A majority of these cases require a surgical intervention to improve vision and prevent further vision loss. Surgical manouevers in these cases require a complex combination of vitrectomy, membrane dissection, judious usage of endodiathermy, endolaser, vital dyes, bimanual dissection and usage of intraoperative and post-operative tamponades. Each case presents a unique challenge and necessitates an appropriate combination of the steps mentioned above. In the current review we present the current understanding of the need for surgery in diabetic retinopathy, various surgical approaches and a summary of current literature on the same. Multiple surgical video clips demonstrating these steps are also included in this review.","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140476097","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 : 2024-01-30DOI: 10.4103/tjo.tjo-d-23-00146
N. S. Lee, Keith Ong
The purpose of this study was to evaluate the changes in corneal endothelial cell density (CECD) occurring after cataract phacoemulsification surgery and identify factors associated with cell loss. This was a retrospective study involving patients who underwent cataract phacoemulsification surgery between January 1, 2018, and December 31, 2018, at two private hospitals. Demographic data and biometric parameters were obtained preoperatively. Ultrasound metrics were recorded for each operation, including total on time (TOT), total equivalent power in position 3, and cumulative dissipated energy (CDE). Using corneal specular microscopy, CECD was measured preoperatively and postoperatively at 12, 24, and 36 months. Factors associated with decreased CECD were identified. This study included 223 eyes of 133 patients. The mean CECD was 2530.03 ± 285.42 cells/mm2 preoperatively and significantly decreased to 2364.22 ± 386.98 cells/mm2 at 12 months (P < 0.001), 2292.32 ± 319.72 cells/mm2 at 24 months (P < 0.001), and 2242.85 ± 363.65 cells/mm2 at 36 months (P < 0.001). The amount of cell loss was associated with age, gender, preoperative CECD, preoperative anterior chamber depth, lens thickness, TOT, and CDE. Using multivariate analysis, age, preoperative CECD, and TOT were identified as independent predictors for CECD loss 12 months after surgery. The greatest decrease in CECD occurred during the first year after cataract surgery, and the amount of cell loss was influenced by both baseline patient characteristics and ultrasound metrics. Longer-term prospective studies in a larger cohort may yield more information.
{"title":"Risk factors for corneal endothelial cell loss after phacoemulsification","authors":"N. S. Lee, Keith Ong","doi":"10.4103/tjo.tjo-d-23-00146","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00146","url":null,"abstract":"\u0000 \u0000 \u0000 The purpose of this study was to evaluate the changes in corneal endothelial cell density (CECD) occurring after cataract phacoemulsification surgery and identify factors associated with cell loss.\u0000 \u0000 \u0000 \u0000 This was a retrospective study involving patients who underwent cataract phacoemulsification surgery between January 1, 2018, and December 31, 2018, at two private hospitals. Demographic data and biometric parameters were obtained preoperatively. Ultrasound metrics were recorded for each operation, including total on time (TOT), total equivalent power in position 3, and cumulative dissipated energy (CDE). Using corneal specular microscopy, CECD was measured preoperatively and postoperatively at 12, 24, and 36 months. Factors associated with decreased CECD were identified.\u0000 \u0000 \u0000 \u0000 This study included 223 eyes of 133 patients. The mean CECD was 2530.03 ± 285.42 cells/mm2 preoperatively and significantly decreased to 2364.22 ± 386.98 cells/mm2 at 12 months (P < 0.001), 2292.32 ± 319.72 cells/mm2 at 24 months (P < 0.001), and 2242.85 ± 363.65 cells/mm2 at 36 months (P < 0.001). The amount of cell loss was associated with age, gender, preoperative CECD, preoperative anterior chamber depth, lens thickness, TOT, and CDE. Using multivariate analysis, age, preoperative CECD, and TOT were identified as independent predictors for CECD loss 12 months after surgery.\u0000 \u0000 \u0000 \u0000 The greatest decrease in CECD occurred during the first year after cataract surgery, and the amount of cell loss was influenced by both baseline patient characteristics and ultrasound metrics. Longer-term prospective studies in a larger cohort may yield more information.\u0000","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140480473","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 : 2024-01-29DOI: 10.4103/tjo.tjo-d-23-00152
Yang Pan, Takeshi Iwata
Age-related macular degeneration (AMD) is one of the leading causes of severe irreversible blindness worldwide in the elderly population. AMD is a multifactorial disease mainly caused by advanced age, environmental factors, and genetic variations. Genome-wide association studies (GWAS) have strongly supported the link between ARMS2/HTRA1 locus on chromosome 10q26 and AMD development, encompassing multiple variants, rs10490924 (c.205G > T, p.A69S in ARMS2), insertion/deletion (del443/ins54 in ARMS2), and rs11200638 (in HTRA1 promoter region). In this comprehensive review, we provide an overview of the role played by ARMS2/HTRA1 risk alleles in neovascular AMD pathogenesis, covering GWAS, in vitro studies, and animal models, shedding light on their underlying molecular genetic mechanisms. Further extensive research is also imperative, including confirmation of these findings, identifying novel treatment targets, and advancing primary and secondary prevention strategies for AMD.
{"title":"Role of ARMS2/HTRA1 risk alleles in the pathogenesis of neovascular age-related macular degeneration","authors":"Yang Pan, Takeshi Iwata","doi":"10.4103/tjo.tjo-d-23-00152","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00152","url":null,"abstract":"\u0000 Age-related macular degeneration (AMD) is one of the leading causes of severe irreversible blindness worldwide in the elderly population. AMD is a multifactorial disease mainly caused by advanced age, environmental factors, and genetic variations. Genome-wide association studies (GWAS) have strongly supported the link between ARMS2/HTRA1 locus on chromosome 10q26 and AMD development, encompassing multiple variants, rs10490924 (c.205G > T, p.A69S in ARMS2), insertion/deletion (del443/ins54 in ARMS2), and rs11200638 (in HTRA1 promoter region). In this comprehensive review, we provide an overview of the role played by ARMS2/HTRA1 risk alleles in neovascular AMD pathogenesis, covering GWAS, in vitro studies, and animal models, shedding light on their underlying molecular genetic mechanisms. Further extensive research is also imperative, including confirmation of these findings, identifying novel treatment targets, and advancing primary and secondary prevention strategies for AMD.","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140487673","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 : 2024-01-19DOI: 10.4103/tjo.tjo-d-23-00150
M. Bhate, A. Das, R. Kekunnaya, V. Sachdeva, Muralidhar Ramappa, V. Warkad, Debasmita Majhi
To study the clinical presentations, visual, and refractive profiles of children with congenital ectopia lentis in a large cohort of patients from a tertiary eye care network in India. A retrospective review of electronic medical records from December 2012 to December 2020 was conducted. Two hundred and ninety-seven consecutive children ≤18 years of age at presentation were identified and analyzed for demographic details, patient distribution, lens subluxation, visual, and refractive profiles before and after the interventions. Five hundred and ninety-four eyes of 297 (male 56%; n = 166) patients were analyzed. The mean age at presentation was 8.74 ± 3.89. Best-corrected visual acuity (BCVA) at presentation ranged from 0.3 logMAR to 3.5 logMAR; (Snellen: 6/9 – close to face [CF]) (mean 0.89 ± 0.68). High myopia (n = 201; 33.83%) and mild astigmatism (n = 340; 57.23%) were more frequent. Temporal (n = 108; 18.18%) subluxation was most common followed by superior. Lensectomy with limited vitrectomy was performed in 243 eyes of 127 patients (40.90%). Median preoperative BCVA was 1.0 (range: 0.3–3.5 logMAR; 20/40 - CF). Median postoperative BCVA was 0.5 logMAR (6/18) in the pseudophakic group and 0.6 logMAR (6/24) in the aphakic group. Spherical equivalent in myopic children reduced from −12.06 ± 6.84D to −1.57D (−0.25D to − 5.5D) in the pseudophakic group and +9.3D (+5.5D to 15.5D) in the aphakic group. This study is a large cohort of children presenting with ectopia lentis. Following intervention, an improvement in the median BCVA and refractive correction was noted in the entire cohort.
{"title":"Ectopia Lentis: Clinical profiles in a large cohort of children from a Tertiary Eye Care network in India","authors":"M. Bhate, A. Das, R. Kekunnaya, V. Sachdeva, Muralidhar Ramappa, V. Warkad, Debasmita Majhi","doi":"10.4103/tjo.tjo-d-23-00150","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00150","url":null,"abstract":"\u0000 \u0000 \u0000 To study the clinical presentations, visual, and refractive profiles of children with congenital ectopia lentis in a large cohort of patients from a tertiary eye care network in India.\u0000 \u0000 \u0000 \u0000 A retrospective review of electronic medical records from December 2012 to December 2020 was conducted. Two hundred and ninety-seven consecutive children ≤18 years of age at presentation were identified and analyzed for demographic details, patient distribution, lens subluxation, visual, and refractive profiles before and after the interventions.\u0000 \u0000 \u0000 \u0000 Five hundred and ninety-four eyes of 297 (male 56%; n = 166) patients were analyzed. The mean age at presentation was 8.74 ± 3.89. Best-corrected visual acuity (BCVA) at presentation ranged from 0.3 logMAR to 3.5 logMAR; (Snellen: 6/9 – close to face [CF]) (mean 0.89 ± 0.68). High myopia (n = 201; 33.83%) and mild astigmatism (n = 340; 57.23%) were more frequent. Temporal (n = 108; 18.18%) subluxation was most common followed by superior. Lensectomy with limited vitrectomy was performed in 243 eyes of 127 patients (40.90%). Median preoperative BCVA was 1.0 (range: 0.3–3.5 logMAR; 20/40 - CF). Median postoperative BCVA was 0.5 logMAR (6/18) in the pseudophakic group and 0.6 logMAR (6/24) in the aphakic group. Spherical equivalent in myopic children reduced from −12.06 ± 6.84D to −1.57D (−0.25D to − 5.5D) in the pseudophakic group and +9.3D (+5.5D to 15.5D) in the aphakic group.\u0000 \u0000 \u0000 \u0000 This study is a large cohort of children presenting with ectopia lentis. Following intervention, an improvement in the median BCVA and refractive correction was noted in the entire cohort.\u0000","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139524930","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 : 2024-01-11DOI: 10.4103/tjo.tjo-d-23-00144
Dolgormaa Budragchaa, Chun-Hsiu Liu
Managing third nerve palsy clinically can be challenging because it involves four of the six extraocular muscles. The palsy may be partial or complete, may cause partial or complete ptosis, and may spare or involve the pupil. A 25-year-old female with a history of suprasellar schwannoma had left partial third nerve palsy with 80 prism diopter (PD) exotropia and 20 PD hypertropia. In addition, adduction and infraduction of the left eye were limited. To address this, a lateral rectus (LR) muscle transposition procedure was performed, wherein the muscle was transposed between the inferior rectus muscle and the globe, passing behind the inferior oblique muscle and extending to the lower margin of the medial rectus (MR) muscle. Postoperatively, this procedure corrected the exotropia of 50–60 PD and hypertropia of 20 PD without inducing cyclotropia. Full-tendon transposition of the LR to the MR is a simple and effective procedure for managing partial third nerve palsy.
{"title":"Full-tendon inferior nasal transposition of the lateral rectus muscle for partial third nerve palsy","authors":"Dolgormaa Budragchaa, Chun-Hsiu Liu","doi":"10.4103/tjo.tjo-d-23-00144","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00144","url":null,"abstract":"\u0000 Managing third nerve palsy clinically can be challenging because it involves four of the six extraocular muscles. The palsy may be partial or complete, may cause partial or complete ptosis, and may spare or involve the pupil. A 25-year-old female with a history of suprasellar schwannoma had left partial third nerve palsy with 80 prism diopter (PD) exotropia and 20 PD hypertropia. In addition, adduction and infraduction of the left eye were limited. To address this, a lateral rectus (LR) muscle transposition procedure was performed, wherein the muscle was transposed between the inferior rectus muscle and the globe, passing behind the inferior oblique muscle and extending to the lower margin of the medial rectus (MR) muscle. Postoperatively, this procedure corrected the exotropia of 50–60 PD and hypertropia of 20 PD without inducing cyclotropia. Full-tendon transposition of the LR to the MR is a simple and effective procedure for managing partial third nerve palsy.","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139533578","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 : 2024-01-11DOI: 10.4103/tjo.tjo-d-23-00084
Noriko Nishikawa, Miho Sato
Acute acquired comitant esotropia (AACE) is characterized by acute onset of esotropia without limitation of eye movements in children and adults. AACE has been considered relatively rare, and most previous reports were small case series. However, recently, there has been great interest in this disease because of the rapid increase in the number of cases speculated to be related to the use of digital devices. In a growing number of studies, disputes remain regarding its etiology, clinical features, management, and classification. Herein, we review the literature on the history, clinical features, possible etiologic classifications, and treatment strategies for AACE to provide a comprehensive and updated understanding of the disease.
{"title":"Acute acquired comitant esotropia: Current understanding of its etiological classification and treatment strategies","authors":"Noriko Nishikawa, Miho Sato","doi":"10.4103/tjo.tjo-d-23-00084","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00084","url":null,"abstract":"\u0000 Acute acquired comitant esotropia (AACE) is characterized by acute onset of esotropia without limitation of eye movements in children and adults. AACE has been considered relatively rare, and most previous reports were small case series. However, recently, there has been great interest in this disease because of the rapid increase in the number of cases speculated to be related to the use of digital devices. In a growing number of studies, disputes remain regarding its etiology, clinical features, management, and classification. Herein, we review the literature on the history, clinical features, possible etiologic classifications, and treatment strategies for AACE to provide a comprehensive and updated understanding of the disease.","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139533823","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 : 2024-01-09DOI: 10.4103/tjo.tjo-d-23-00110
Soumen Chakraborty, Satish Reddy Satty, Badal Kumar Sahu, Soumya Ray
A sudden surge of Mucormycosis cases during the second wave of Covid 19 was observed in certain parts of India. The reasons for this upsurge remain unknown. However its impact on the overall healthcare system was quite overwhelming. In this context this study was decided to estimate and assess the spectrum of orbital involvement in patients with Mucormycosis, to find its association with coexisting disease entities if any, and at the same time evaluate the therapeutic response to established treatment regimens. This descriptive longitudinal study was conducted over a period of six months. Patients presenting with symptoms of Mucormycosis were jointly evaluated by a multi speciality team. After confirmation of diagnosis, patients were treated with intravenous Amphotericin B, surgical debridement of affected sinuses and orbital exenteration when indicated. They were followed up for three months after discharge. Forty-three patients were enrolled in this study. Thirty-seven (86.04%) were COVID positive. All of them had history of steroid exposure during COVID treatment. Ninety five percent of study participants had diabetes mellitus. Twenty-seven (62.79%) patients had orbital involvement. Most common clinical presentation was peri-orbital or facial pain and edema. Besides medical treatment, thirty-nine patients (90.69%) required sinus debridement and nine patients (20.9%) required orbital exenteration. Thirteen patients (30.23%) expired during the follow up period. With treatment disease regressed in twenty patients (46.51%). Diabetes and use of steroids to prevent anticipated cytokine storm may be the inciting factors for Orbital Mucormycosis in COVID patients. Early diagnosis, treatment and control of risk factors are keys for recovery and survival..
{"title":"Resurgence of orbital mucormycosis during COVID-19 pandemic: Study from a tertiary care center in Eastern India","authors":"Soumen Chakraborty, Satish Reddy Satty, Badal Kumar Sahu, Soumya Ray","doi":"10.4103/tjo.tjo-d-23-00110","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00110","url":null,"abstract":"\u0000 \u0000 \u0000 A sudden surge of Mucormycosis cases during the second wave of Covid 19 was observed in certain parts of India. The reasons for this upsurge remain unknown. However its impact on the overall healthcare system was quite overwhelming. In this context this study was decided to estimate and assess the spectrum of orbital involvement in patients with Mucormycosis, to find its association with coexisting disease entities if any, and at the same time evaluate the therapeutic response to established treatment regimens.\u0000 \u0000 \u0000 \u0000 This descriptive longitudinal study was conducted over a period of six months. Patients presenting with symptoms of Mucormycosis were jointly evaluated by a multi speciality team. After confirmation of diagnosis, patients were treated with intravenous Amphotericin B, surgical debridement of affected sinuses and orbital exenteration when indicated. They were followed up for three months after discharge.\u0000 \u0000 \u0000 \u0000 Forty-three patients were enrolled in this study. Thirty-seven (86.04%) were COVID positive. All of them had history of steroid exposure during COVID treatment. Ninety five percent of study participants had diabetes mellitus. Twenty-seven (62.79%) patients had orbital involvement. Most common clinical presentation was peri-orbital or facial pain and edema. Besides medical treatment, thirty-nine patients (90.69%) required sinus debridement and nine patients (20.9%) required orbital exenteration. Thirteen patients (30.23%) expired during the follow up period. With treatment disease regressed in twenty patients (46.51%).\u0000 \u0000 \u0000 \u0000 Diabetes and use of steroids to prevent anticipated cytokine storm may be the inciting factors for Orbital Mucormycosis in COVID patients. Early diagnosis, treatment and control of risk factors are keys for recovery and survival..\u0000","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443015","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 : 2024-01-09DOI: 10.4103/tjo.tjo-d-23-00100
Hwa-Shin Fang, Chang-Sue Yang, Cheng-Kuo Cheng, Yuangwei Wang
A 56-year-old female presented with bilateral progressive blurred vision over 1 month. She has no known malignancy before her initial visit to our ophthalmologic clinic. Her best-corrected visual acuity decreased to hand motion from 30 cm in both eyes. Optical coherence tomography exhibited parafoveal thinning of outer retinal layers bilaterally. Fluorescein angiography and indocyanine green angiography disclosed hypofluorescent spots in late phase in both eyes. The suspicion of cancer-associated retinopathy (CAR) prompted us to investigate and refer for further systemic disease including occult malignancy. The patient was diagnosed with small-cell carcinoma of the endometrium or cervix, which is an extremely rare and aggressive neuroendocrine tumor. The patient was treated with oral prednisone with improved visual acuity. The patient expired from sepsis 2 months after her initial visit to our ophthalmologic clinic. In selected cases, CAR may present before the diagnosis of primary cancer. It is essential to recognize its ophthalmic manifestation for early discovery of primary malignancy.
{"title":"Cancer-associated retinopathy as an initial presentation of gynecologic small-cell carcinoma","authors":"Hwa-Shin Fang, Chang-Sue Yang, Cheng-Kuo Cheng, Yuangwei Wang","doi":"10.4103/tjo.tjo-d-23-00100","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00100","url":null,"abstract":"\u0000 A 56-year-old female presented with bilateral progressive blurred vision over 1 month. She has no known malignancy before her initial visit to our ophthalmologic clinic. Her best-corrected visual acuity decreased to hand motion from 30 cm in both eyes. Optical coherence tomography exhibited parafoveal thinning of outer retinal layers bilaterally. Fluorescein angiography and indocyanine green angiography disclosed hypofluorescent spots in late phase in both eyes. The suspicion of cancer-associated retinopathy (CAR) prompted us to investigate and refer for further systemic disease including occult malignancy. The patient was diagnosed with small-cell carcinoma of the endometrium or cervix, which is an extremely rare and aggressive neuroendocrine tumor. The patient was treated with oral prednisone with improved visual acuity. The patient expired from sepsis 2 months after her initial visit to our ophthalmologic clinic. In selected cases, CAR may present before the diagnosis of primary cancer. It is essential to recognize its ophthalmic manifestation for early discovery of primary malignancy.","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443212","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 : 2024-01-09DOI: 10.4103/tjo.tjo-d-23-00106
Christina Wang, Arturo Castillo, Federico Cortes-Bejarano, Eduardo Lopez, Eduardo Cunha de Souza, Lihteh Wu
Dengue is the most common arboviral disease. It is typically spread by the bite of an infected female Aedes aegypti or Aedes albopictus mosquitoes. Dengue is endemic in subtropical and tropical regions, but its geographic reach keeps expanding. Ophthalmic manifestations of dengue are common and may present with a wide spectrum of ophthalmic findings. These may range from conjunctival petechiae, retinal hemorrhage, retinal vasculitis to panophthalmitis. Some of these may be vision threatening and may require urgent ophthalmic evaluation. The precise pathophysiologic mechanisms involved in dengue infection involve a complex interplay between host immune responses, virus, and host genes. There is no specific treatment for ocular dengue. Therefore, treatment is supportive. Despite the lack of proven efficacy, corticosteroids have been used in vision-threatening dengue-related ocular complications. Dengue must be considered in endemic areas, and a careful travel history needs to be elicited in nonendemic areas.
{"title":"An update on the ocular manifestations of dengue","authors":"Christina Wang, Arturo Castillo, Federico Cortes-Bejarano, Eduardo Lopez, Eduardo Cunha de Souza, Lihteh Wu","doi":"10.4103/tjo.tjo-d-23-00106","DOIUrl":"https://doi.org/10.4103/tjo.tjo-d-23-00106","url":null,"abstract":"\u0000 Dengue is the most common arboviral disease. It is typically spread by the bite of an infected female Aedes aegypti or Aedes albopictus mosquitoes. Dengue is endemic in subtropical and tropical regions, but its geographic reach keeps expanding. Ophthalmic manifestations of dengue are common and may present with a wide spectrum of ophthalmic findings. These may range from conjunctival petechiae, retinal hemorrhage, retinal vasculitis to panophthalmitis. Some of these may be vision threatening and may require urgent ophthalmic evaluation. The precise pathophysiologic mechanisms involved in dengue infection involve a complex interplay between host immune responses, virus, and host genes. There is no specific treatment for ocular dengue. Therefore, treatment is supportive. Despite the lack of proven efficacy, corticosteroids have been used in vision-threatening dengue-related ocular complications. Dengue must be considered in endemic areas, and a careful travel history needs to be elicited in nonendemic areas.","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443892","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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