Indian Journal of Ophthalmology最新文献

{"title":"Pediatric endogenous endophthalmitis: Clinical features and treatment outcomes.","authors":"Ridham Nanda, Taraprasad Das, Tapas Ranjan Padhi, Krushna Gopal Panda, Marina Ger, Srikanta Kumar Padhy","doi":"10.4103/IJO.IJO_2298_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2298_24","url":null,"abstract":"<p><strong>Context: </strong>Forty-eight pediatric patients treated for endogenous endophthalmitis were analyzed. Redness and vitritis were the common symptom and sign, respectively; infection with Gram-negative bacilli was frequent. Children under 5 and with systemic illness had poorer visual prognosis.</p><p><strong>Purpose: </strong>To Analyze the demographics, clinical-microbiological profiles, and treatment outcomes of pediatric patients with endogenous endophthalmitis.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of electronic medical records covering 8 years from 2016 to 2023 at a tertiary eye care center in India, focusing on patients of age <18 years diagnosed with endogenous endophthalmitis. Data extraction included demographic variables, clinical presentations, microbiological analyses, therapeutic interventions, and visual outcomes.</p><p><strong>Results: </strong>The analysis included 48 patients with an average age of 5.4 ± 4.98 years and an equal gender ratio. During the study period, 48 children with endogenous endophthalmitis were treated; it was 5% (48 of 961) of all endophthalmitis patients and 20.8% (48 of 231) of pediatric endophthalmitis patients. Common symptoms included redness (62.5%), reduced vision (20.8%), leucocoria (27.08%), pain (22.91%), and watering/discharge (29.16%). Clinical signs included vitritis (89.58%) and anterior chamber exudates/hypopyon (47.91%). Vitreous culture positivity was 54.05%; common isolates were Gram-negative bacilli (35%), Gram-positive cocci (25%), and Gram-positive bacilli and fungi (20% each). Systemic infection was present in 72.9% (35 of 48) of patients, with respiratory tract infection being the most common (39.5%). All eyes received intravitreal antibiotic injections, and 28 (75.7%) received vitrectomy. Children under 5 with systemic illness had a worse visual prognosis. Unfavorable outcomes were associated with Gram-positive bacilli and fungal infection. Approximately 45% of eyes worsened to phthisis.</p><p><strong>Conclusions: </strong>Any redness in a child with systemic infection warrants prompt ophthalmic evaluation. Children under 5 with systemic illness are associated with a worse visual prognosis. Unfavorable outcomes are linked to Gram-positive bacilli and fungal infection.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 5","pages":"665-671"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idebenone vs. rAAV2-ND4 gene therapy in the treatment of Leber's hereditary optic neuropathy: An indirect comparison meta-analysis.","authors":"Amr K Hassan, Hashem Abu Serhan","doi":"10.4103/IJO.IJO_2898_23","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2898_23","url":null,"abstract":"<p><p>To compare the outcomes between idebenone oral therapy and rAAV2-ND4 intravitreal injection in the treatment of Leber's hereditary optic neuropathy. A systematic literature review was performed of publications from 1990 to 2023 in PubMed, Ovid MEDLINE, Cochrane CENTRAL, Google Scholar, Embase, CrossRef, OpenAlex, and Web of Science for studies evaluating the outcomes of idebenone or rAAV2-ND4 therapy in Leber's hereditary optic neuropathy. The primary outcome measure was improvement in visual acuity. Secondary outcome measures were improvement of retinal nerve fiber layer thickness, ganglion cell layer volume, and visual field mean deviation. There are no studies directly comparing the two interventions. Our analysis included 645 patients from 17 studies; 338 patients from nine studies received idebenone, and 307 patients from eight studies received rAAV2-ND4. When compared to each other, rAAV2-ND4 provided better visual improvement at 6 months with a mean difference of 0.07 (P = 0.8289), but idebenone provided better visual improvement at 1 year with a mean difference of 0.35 (P < 0.0001). At 2 years, the rAAV2-ND4 group's visual acuity improved from baseline by 0.18 (P = 0.08). There was no data for improvement at 2 years for idebenone, only for rAAV2-ND4. rAAV2-ND4 provides better visual acuity results at 6 months, and idebenone provides better visual acuity results at 1 year. Further studies are recommended to formulate a complete idea about the long-term results (>2 years).</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 5","pages":"656-664"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral refraction is no longer peripheral to myopia management.","authors":"Swati Phuljhele","doi":"10.4103/IJO.IJO_967_25","DOIUrl":"https://doi.org/10.4103/IJO.IJO_967_25","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 5","pages":"621"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presence of pseudoexfoliation-like material in young patients.","authors":"Gazella Bruce Warjri, Anthony Vipin Das, Yashas Goyal, Aparna Rao, Sirisha Senthil","doi":"10.4103/IJO.IJO_1998_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1998_24","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the demographics and clinical profile of pseudoexfoliation-like (PXFL) material in young patients.</p><p><strong>Methods: </strong>In this cross-sectional, hospital-based study, the participants were children aged ≤16 years who were observed to have PXFL material in at least one eye. The data of patients presenting between August 2010 and December 2021 were collected using an electronic medical record system and analyzed.</p><p><strong>Results: </strong>Seventy-five patients (87 eyes) aged ≤16 years were observed to have PXFL material. Unilateral involvement was seen in 72.4% of the eyes. Moreover, 96.5% of the eyes had undergone an intraocular procedure, with 49.4% having undergone a single intraocular procedure and 50.5% multiple intraocular procedures. Appearance of the PXFL material was noted 260 (4-728) weeks after the primary surgery. Glaucoma was seen in 26.4% of the eyes. The most common location of the PXFL material was the pupillary margin (72.4%) followed by the rest of the iris (27.5%).</p><p><strong>Conclusion: </strong>Appearance of PXFL material in young patients has a close association with an intraocular procedure, with one-fourth of the cases having glaucoma. Stress should be laid on careful anterior segment examination of young patients who have undergone an intraocular procedure. The pathophysiology and prognosis are still unknown.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 5","pages":"764-768"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of effect of postoperative padding versus no padding after strabismus surgery.","authors":"Amit Kumar, Rohit Saxena, Medha Sharma, Renu Sinha, Swati Phuljhele, Radhika Tandon, Pradeep Sharma","doi":"10.4103/IJO.IJO_2573_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2573_24","url":null,"abstract":"<p><strong>Introduction: </strong>Padding of the eye after Strabismus surgery is a routine procedure; however, its role after surgery is not clear.</p><p><strong>Objective: </strong>To compare postoperative pain and other physiological parameters in padded versus nonpadded eyes after strabismus surgery under general anesthesia.</p><p><strong>Design: </strong>Prospective, randomized, observational study.</p><p><strong>Participants: </strong>One hundred and twelve patients (224 eyes) in the age group of 5-15 years were enrolled over 18 months. However, 12 patients were lost to follow-up.</p><p><strong>Methods: </strong>Eyes were randomly distributed to either the padding group or the nonpadding group. Parameters studied on day 1, at 1 week, and at 4 weeks postoperatively included pain, congestion, conjunctival chemosis, subconjunctival hemorrhage, and lid edema.</p><p><strong>Results: </strong>In the early postoperative period, pain and conjunctival congestion were significantly higher in the padded eye compared to the nonpadded eye (P = 0.001). There was no significant difference in other parameters. No complications, such as dellen formation, wound gaping, or infection, were noted in any patient. Surgery on the inferior oblique muscle was associated with more pain and congestion compared to other muscles.</p><p><strong>Conclusion: </strong>Postoperative padding of the eye after strabismus surgery results in greater pain and conjunctival congestion.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 5","pages":"754-757"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pattern of visual impairment in the spectrum of hypoxic ischemic encephalopathy.","authors":"Swati Phuljhele, Niranjana Balasubramaniam, Gunjan Saluja, Rohit Saxena, Pradeep Sharma, Pavan Kumar, Sanjay Kusiyait, Sheffali Gulati","doi":"10.4103/IJO.IJO_2082_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2082_24","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the relationship between visual impairment, social maturity, and clinical severity of hypoxic-ischemic encephalopathy (HIE) in the Indian population.</p><p><strong>Methods: </strong>An observational study was conducted in children with HIE sequelae aged between 6 months and 5 years. Sixty diagnosed cases of perinatal HIE were recruited, with twenty children in each of clinical grades 1, 2, and 3 according to the Sarnat clinical staging. All children underwent cycloplegic refraction using atropine 1% eye ointment, visual Acuity (VA) testing by teller acuity cards (TAC), anterior and posterior segment examination, FLASH visual evoked response (VER), strabismus workup, and social maturity assessment using the vineland social maturity scale (VSMS).</p><p><strong>Results: </strong>Sixty children, including 14 preterm and 46 term infants, with a mean age of 26.11 ± 16.06 months were studied. Normal birth weight was observed in 54% of the cases, whereas 42% had low birth weight and 4% had very low birth weight. There was no statistically significant difference between birth weight and the clinical severity of HIE (P = 0.970). A significant relationship between VA and clinical severity (TAC- p < 0.0001) and between VA and social maturity was observed. Optic disc pallor was present in 85% of grade 3 HIE cases. Among the 37 children with strabismus, the convergent type was predominant (86.4%). Refractive error was comparable across all grades of HIE.</p><p><strong>Conclusion: </strong>Visual impairment was significantly related to the clinical severity of HIE and had a negative impact on the social maturity of these children.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 5","pages":"679-682"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular disease profile in neonates presenting to a tertiary care center.","authors":"Sarjak M Shah, Priya Prabhu, Muna Bhende, Sumita Agarkar, Sujani Sunkesula","doi":"10.4103/IJO.IJO_35_25","DOIUrl":"https://doi.org/10.4103/IJO.IJO_35_25","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 5","pages":"775-776"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular hemodynamics in multisystem inflammatory syndrome in children: A cross-sectional study.","authors":"Sule Gokcek Gurturk Icoz, Mucella Arıkan Yorgun, Gulsum Iclal Bayhan, Mehmet Icoz, Aysun Yahsi","doi":"10.4103/IJO.IJO_1527_24","DOIUrl":"10.4103/IJO.IJO_1527_24","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate retinal vascular changes by optical coherence tomography angiography (OCTA) in multisystem inflammatory syndrome in children (MIS-C).</p><p><strong>Methods: </strong>This cross-sectional study included 21 patients who were diagnosed with MIS-C and had a history of hospitalization, 20 pediatric outpatients with a coronavirus disease 2019 (COVID-19) diagnosis, and 26 healthy children. All patients underwent a detailed ophthalmologic examination and OCTA. In the MIS-C and pediatric COVID-19 groups, these evaluations were made 6 months after diagnosis. The vascular density values of the superficial, deep, and radial peripapillary capillary plexuses (SCP, DCP, and RPCP, respectively), foveal avascular zone (FAZ) parameters (area, perimeter, acircularity index, and foveal density), and outer retinal and choriocapillaris flow area values were recorded using OCTA.</p><p><strong>Results: </strong>No pathology was detected in the ophthalmologic examinations of the three groups with similar age and gender distributions. Although the vascular density values of SCP, DCP, and RPCP were found to be higher in most quadrants in the MIS-C group, there was no statistically significant difference among the three groups ( P > 0.05 for all). FAZ parameters and flow area measurements were similar in all three groups ( P > 0.05 for all).</p><p><strong>Conclusion: </strong>This is the first study to evaluate relatively long-term outcomes in patients with MIS-C and pediatric COVID-19 together. This study shows no changes in the SCP and DCP parameters in pediatric age group, which shows that ocular hemodynamic changes may not be reflected on OCTA after 6 months.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"725-730"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular surface squamous neoplasia masquerades: Clinical profile and outcome.","authors":"Shirali Gokharu, Deepanjali Arya, Deepender Chauhan, Sima Das","doi":"10.4103/IJO.IJO_3391_23","DOIUrl":"https://doi.org/10.4103/IJO.IJO_3391_23","url":null,"abstract":"<p><strong>Purpose: </strong>The diagnosis of ocular surface squamous neoplasia (OSSN) is primarily clinical, confirmed through histopathology, cytology, or imaging. This study describes a series of OSSN patients with atypical clinical presentation masquerading non-neoplastic etiologies, identifies clinical features distinguishing OSSN from benign lesions, and thus aids clinicians in early diagnosis and prompt management.</p><p><strong>Methods: </strong>A retrospective review was conducted on medical records of OSSN patients, and patients initially diagnosed with anterior segment infection or inflammation were identified. Data collected included clinical presentation, initial diagnosis and treatment, response to treatment, final diagnosis, treatment type and outcome, and clinical clues to the diagnosis.</p><p><strong>Results: </strong>In the study period, 153 OSSN patients were identified from medical records of which 11 patients (7.2%) were initially diagnosed as anterior segment infection or inflammation. One patient presented with limbal stem cell deficiency, two with nodular episcleritis and necrotizing scleritis, and eight with various corneal involvement such as dendritic ulcer, corneal degeneration/dystrophy, corneal dermoid, exposure keratopathy, peripheral ulcerative keratitis, and perforated corneal ulcer. Three underwent extended enucleation due to intraocular spread, two required excision biopsies with adjuvant topical therapy, and the remaining patients were treated with topical therapy (Interferon α-2b 1% and/or mitomycin-C 0.04%). One patient was lost to follow up, one had a recurrence, and nine achieved complete resolution at mean follow-up of 18 months.</p><p><strong>Conclusion: </strong>OSSN can mimic ocular surface infection, inflammation, or degeneration. A meticulous anterior segment evaluation can provide clinical clues to diagnosis which can be confirmed on histopathology.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femtosecond laser-assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking (FILAC) in advanced keratoconus in Indian eyes: A prospective interventional study.","authors":"Rajesh Sinha, Shahnaz Anjum, Kartikeya Gupta, Tushar Agarwal, Namrata Sharma, Sridevi Nair, Shrishti Kapoor, Jeewan S Titiyal","doi":"10.4103/IJO.IJO_2139_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2139_24","url":null,"abstract":"<p><strong>Purpose: </strong>To study the outcomes of femtosecond laser-assisted intrastromal negative meniscus lenticule implantation with accelerated corneal collagen crosslinking (FILAC) in advanced keratoconus.</p><p><strong>Methods: </strong>A prospective, interventional study evaluated the outcomes of FILAC in eyes with progressive keratoconus of Amsler-Krumeich stage 4 with thinnest pachymetry of 320-400 microns. A total of 10 eyes of 10 patients were enrolled. A negative meniscus allogenic stromal lenticule of 8.5 mm diameter was implanted into a corneal pocket created by a femtosecond laser at 150 microns depth and simultaneous accelerated corneal collagen crosslinking (CXL). Outcomes assessed 12 months after the procedure included uncorrected distance visual acuity (UDVA) and best-corrected visual acuity (BCVA), subjective refraction, and corneal topography changes.</p><p><strong>Results: </strong>Mean UDVA improved from baseline to 12 months follow-up (1.43 ± 0.39 vs. 1.32 ± 0.31 logMAR, P = 0.49). Four patients did not accept contact lenses preoperatively, whereas all patients were successfully fitted with semi-scleral contact lenses postoperatively with a mean BCVA of 0.47 ± 0.14 logMAR at 12 months. Mean corneal topographic values showed improvement from baseline to 12 months follow-up: K1 (58.44 ± 5.59 to 55.57 ± 5.68), K2 (63.35 ± 6.86 to 59.35 ± 7.1), Kmax (71.07 ± 7.95 to 66.29 ± 7.54) and astigmatism (4.89 ± 3.35 to 3.88 ± 2.35) (P > 0.05). The mean thinnest pachymetry improved significantly from baseline to 12 months follow-up (354.9 ± 28.52 vs. 462.5 ± 36.30 microns, P = 0.0001). There was a non-significant improvement in subjective refraction and aberrometry.</p><p><strong>Conclusion: </strong>This technique effectively halts disease progression and improves visual outcomes in advanced keratoconus.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}