Indian Journal of Ophthalmology最新文献

{"title":"Real-world use of integrated intraoperative OCT in pediatric cataract.","authors":"Savleen Kaur, Jaspreet Sukhija, Ken K Nischal","doi":"10.4103/IJO.IJO_1478_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1478_24","url":null,"abstract":"<p><strong>Purpose: </strong>To study the utility of integrated intraoperative OCT (i2OCT) in pediatric patients with cataracts in the real world.</p><p><strong>Methods: </strong>It was a retrospective case series. We included patients aged 0-12 years with unilateral or bilateral cataracts who underwent cataract surgery or membranectomy for visual axis opacification between July 2022 and December 2023, where intraoperative OCT was used. We matched the clinical data with i2OCT images and tried to identify any useful information i2OCT provided. Intraoperative notes were reviewed to analyze any changes in the surgical plan or steps after doing i2OCT.</p><p><strong>Results: </strong>The mean age of the children undergoing surgery was 5.9 ± 2.4 years (range: 6 months-9 years). OCT provided valuable insights into the anterior, posterior capsule, and vitreolental surface morphology. The surgical decision was modified in 10 cases after doing the intraoperative OCT (31.3%).</p><p><strong>Conclusions: </strong>The study adds to the database of pediatric patients imaged using i2OCT in the real world. i2OCT complements the preoperative examination and aids intraoperative decision-making in cases of white cataracts with excellent real-time delineation of the vitreolental interface in children.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894122","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":"Current perspectives on topical antiallergics.","authors":"Nikhil S Gokhale","doi":"10.4103/IJO.IJO_1608_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1608_24","url":null,"abstract":"<p><strong>Abstract: </strong>Allergy is one of the most common diagnoses in an ocular surface clinic, and its treatment can range from a simple lubricant to the most complex combinations of medications belonging to several diverse classes. Antiallergics are the most commonly used medication overall in all forms of allergy. Several options are available, and it is important to understand how to start, select, and continue their use. Understanding the nature and severity of allergy is key to understand the effectiveness and limitations of this class of drugs in each patient. The article provides a brief overview of antiallergics in the for the busy practitioner.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894099","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":"Postoperative corneal remodeling after corneal allograft intrastromal ring segment (CAIRS) implantation for keratoconus: An OCT study.","authors":"Burcu Yakut, Cafer Tanriverdi, Fatma Feyza Nur Keskin Perk, Senay Asik Nacaroglu, Munise Altinbas, Aylin Kilic","doi":"10.4103/IJO.IJO_2107_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2107_24","url":null,"abstract":"<p><strong>Objectives: </strong>To demonstrate corneal remodeling after corneal allograft intrastromal ring segment (CAIRS) with an anterior-segment optical coherence tomography (AS-OCT).</p><p><strong>Design: </strong>A prospective observational single-center study.</p><p><strong>Methods: </strong>This observational study included keratoconus patients who underwent CAIRS implantation into a stromal tunnel. Topographical, refractive, and visual changes were obtained from the patient records. Epithelial thickness (ET), anterior stromal thickness (AST), allograft corneal ring thickness (ACRT), and posterior stromal thickness (PST) were measured on the first day and 1, 3, 6, and 12 months postoperatively using AS-OCT.</p><p><strong>Results: </strong>The study included 35 eyes of 27 patients with advanced keratoconus. The mean keratometry decreased from 48.26 ± 4.78 D to 44.50 ± 4.42 D at 1-year postoperatively (P = 0.004), mean corrected distance visual acuity increased from 0.29 ± 0.18 to 0.70 ± 0.24 (P < 0.001), and spherical equivalent (SE) decreased from -6.94 ± 4.32 D to -1.44 ± 4.44 D (P < 0.001). The mean AST decreased by 17.39 ± 5.78 μm in the postoperative 1st month compared to 1st day after surgery (P = 0.040). No statistically significant variations were observed in AST after the first month. There was no statistically significant difference in the mean ET, ACRT, and PST measurements between follow-up times. Significant negative correlations were found between SE change and ET (r = -0.543, P = 0.023) and between K1 change and ACRT (r = -0.548, P = 0.008).</p><p><strong>Conclusion: </strong>CAIRS is an effective treatment method to improve visual acuity and keratometry measurements and does not cause significant changes in graft thickness or recipient corneal epithelial and stromal thicknesses during the 1-year follow-up period. The observed correlations between SE, keratometry, and corneal thickness suggest that epithelial and stromal remodeling play crucial roles in postoperative outcomes of CAIRS.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894114","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":"Pterygium extended removal followed by minor ipsilateral simple limbal epithelial transplantation (PERMISLET): An innovative technique for recurrent pterygium.","authors":"Alok Sati, Sanjay Kumar Mishra, Sarvadarshi Shukla, Deepesh Unni, Sonali V Kumar, Sanjay Kumar Dhar, Jaya Kaushik, Vijay Kumar Sharma, Anju Pannu","doi":"10.4103/IJO.IJO_1413_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1413_24","url":null,"abstract":"<p><strong>Abstract: </strong>We describe a novel technique for recurrent pterygium and assess the advantage of properties of extended tenonectomy, amniotic membrane transplantation, and limbal epithelial transplantation in terms of recurrence rate, postoperative symptoms, postoperative orthoptics, and other complications. A total of nine eyes with recurrent pterygium underwent PERMISLET, i.e., pterygium extended removal (PER) (removal of tenon capsule with fibrovascular tissue around medial rectus from limbus till medial canthus) followed by minor ipsilateral limbal epithelial transplantation (coverage of bare sclera with amniotic membrane graft and placement of ipsilateral limbal pieces at the affected limbus). The patients were reviewed on day 1, day 7, and day 30 and at third, sixth, and twelfth month after surgery, and none of the eyes (0/9) showed recurrence of pterygium on to the cornea. Time taken for surgery was 53.88 ± 8.74 minutes (range, 45 to 75 minutes). Postoperative discomfort (pain, irritation, foreign body sensation, and lacrimation) persisted mainly for day 1 after the surgery. However, lacrimation persisted till day 7 in two of the patients. Intraoperative complications were seen in none of the eyes. A total of 1/9 patients had granuloma formation, and 1/9 had dellen formation in postoperative period with successful management. Moreover, none of the eyes (0/9) developed ocular motility restrictions in postoperative period. PERMISLET, an innovative surgical technique for recurrent pterygium, is a viable option with zero rate of recurrence and minimal complications, a boon for patients with limited healthy conjunctiva or a potential for future glaucoma drainage procedures.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894118","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":"Comparison of peripapillary and macular Optical Coherence Tomography parameters between children and young adults.","authors":"Gazella B Warjri, Harsha L Rao, Virender Sachdeva, Sirisha Senthil","doi":"10.4103/IJO.IJO_889_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_889_24","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer thickness, central subfield thickness (CSFT), and parafoveal and perifoveal thickness in children of different age groups with young adult controls by using spectral-domain optical coherence tomography.</p><p><strong>Methods: </strong>This cross-sectional study included children aged 6-17 years and adult controls (18-22 years) - group 1: 6-9 years (57 eyes), group 2: 10-13 years (116 eyes), group 3: 14-17 years (66 eyes), and group 4 (controls): 18-22 years (61 eyes). A mixed-effects model was used to compare the OCT parameters among the groups, along with multivariable analysis.</p><p><strong>Results: </strong>Analysis of 300 eyes of 152 patients was done. Group 2 (99.7 ± 1.1 μm, P = 0.03) and group 3 (100.4 ± 1.5 μm, P = 0.03) had thicker RNFL on average as compared to group 4 (95.6 ± 1.6 μm) on multivariable analysis. In pairwise comparison, group 2 (129.8 ± 2.5 μm, P = 0.02) and group 3 (132.6 ± 2.4 μm, P = 0.004) had thicker inferior RNFL compared to adult controls (122.4 ± 2.5 μm); superior RNFL was thicker in group 2 (129.6 ± 2.0 μm, P = 0.01) and group 3 (131.2 ± 2.6 μm, P = 0.008) compared to group 1 (120.9 ± 2.8 μm). On multivariable analysis, adult controls had thicker CSFT (236.5 ± 2.6 μm) than group 1 (222.7 ± 3.1 μm) and group 2 (229.6 ± 2.3 μm). Similarly, on pairwise comparison, adult controls had thicker parafoveal superior quadrants (320.5 ± 2.5 μm) and inferior quadrants (317.5 ± 2.3 μm) when compared with groups 1 and 2.</p><p><strong>Conclusion: </strong>RNFL thickness seems to increase up to 17 years and then starts reducing, unlike CSFT, which increases with age from 6 to 22 years. A differential growth occurs in the different quadrants of RNFL and macula with age with some quadrants increasing in thickness as compared to the others.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894098","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 adnexal lymphoma - A single-center observational study of survival outcomes.","authors":"Karuvel Kannan Saraswathi, Pragya Saini, Radhakrishnan Santhi, Veerappan Muthukkaruppan, Ayyasamy Vanniarajan, Usha Kim","doi":"10.4103/IJO.IJO_110_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_110_24","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to comprehensively characterize the clinical, demographic, and histopathological features of ocular adnexal lymphoma (OAL) and assess their impact on patients' survival outcomes.</p><p><strong>Methods: </strong>A total of 123 patients were included in the study; of these, 93 patients were selected for survival analysis. Survival data were analyzed using the Kaplan-Meier test, and correlation was assessed through the log-rank test and Cox regression analysis.</p><p><strong>Results: </strong>The median age at presentation was 56 years. Furthermore, 98% of patients had primary OAL. The orbit was the most common site of involvement. The majority of patients were of B-cell origin (98%), and only 2% of patients had T-cell lymphoma. In addition, 83% of patients were treated with chemotherapy, and with a median follow-up of 38 months, complete remission was achieved in 48% of patients. The median progression-free survival was 26.4 months. The presence of disseminated disease was strongly linked to an unfavorable prognosis (P < 0.001) and reduced survival (P = 0.037).</p><p><strong>Conclusion: </strong>The 5-year overall survival of the entire study cohort was 81%. The prognosis for OAL is found to be favorable, but the presence of dissemination serves as a notable predictor for poor prognosis.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894110","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":"miR-124, miR-126-3p, and miR-200b: Potential therapeutic targets for VEGF-mediated complications in proliferative diabetic retinopathy.","authors":"Irfan Akaray, Sadık Altan Ozal, Hilal Sancar, Ece Ozal, Lokman Ayaz","doi":"10.4103/IJO.IJO_1791_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1791_24","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate alterations in intravitreal microRNA and vascular endothelial growth factor (VEGF) levels in patients with proliferative diabetic retinopathy (PDR) as these factors are implicated in PDR pathogenesis.</p><p><strong>Methods: </strong>Fifty-two participants, including 26 patients with PDR and 26 controls without diabetes, were included in this study. VEGF levels were assessed using ELISA, and seven microRNAs (miRNAs) (miR-19a, miR-20b, miR-27a, miR-124, miR-126-3p, miR-146a, and miR-200b) were analyzed using quantitative real-time PCR.</p><p><strong>Results: </strong>PDR patients exhibited significantly higher miR-124 and miR-126-3p levels in the vitreous material compared to controls (P < 0.05). Conversely, miR-200b levels were significantly lower in the PDR group (P < 0.05). VEGF-A levels were markedly elevated in PDR patients compared with controls (P < 0.05). A nonsignificant positive correlation was found between miR-124 and miR-126-3p levels and VEGF levels (r = 0.361, P = 0.076 and r = 0.168, P = 0.422, respectively), whereas a nonsignificant negative correlation was observed between miR-200b and VEGF levels (r = -0.145, P = 0.488).</p><p><strong>Conclusion: </strong>Our study demonstrated a significant upregulation of miR-124 and miR-126-3p, along with a downregulation of miR-200b, in vitreous samples from patients with PDR, accompanied by elevated VEGF-A levels. These findings provide valuable insights into the pathogenesis of PDR. Further research is needed to evaluate the potential diagnostic and therapeutic implications of these molecular changes and to explore their viability as potential therapeutic targets.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894109","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":"Pupilmate: A do-it-yourself frugal pupilometer.","authors":"Ruhel K Chacko, Prithvi Chandrakanth, Aniket Roy, Hirika Gosalia, Gargi Aggarwal, V Narendran","doi":"10.4103/IJO.IJO_859_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_859_24","url":null,"abstract":"<p><strong>Abstract: </strong>The pupillary direct and consensual reflex is an important non-invasive quick assessment of the neurological state of the eye. Currently, there is no cheap and affordable recording tool for screening and documentation of a relative afferent pupillary defect. We describe how to construct a frugal, do-it-yourself handheld scotopic binocular pupillometer device called Pupilmate. Two simple Wi-Fi-enabled board cameras fitted on both sides of the back of a rectangular cardboard box separated by a central paper divider, one side of the rectangular box was left open. An infrared red (IR) light source in the form of light-emitting diodes (LEDs) was fitted around each of the cameras. Two white light LEDs were fitted on either side of the box controlled by a two-way switch. A simultaneous video stream of both pupils could then be tuned in on any chosen device using the internet. Each pupil is manually illuminated for a desired time allowing recording of direct as well as consensual reflexes, which are objectively observed. Pupil reaction was easily recorded and repeatable using Pupilmate. It served as a good medium for initial screening in an outpatient department (OPD) setting, outreach programs, clinics, etc.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894119","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":"Trans-iris vertical intrascleral haptic fixation of IOL: The bypass technique in eyes with megalocornea.","authors":"Rajesh Sinha, Aafreen Bari, Shahnaz Anjum","doi":"10.4103/IJO.IJO_974_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_974_24","url":null,"abstract":"<p><strong>Abstract: </strong>Intrascleral haptic fixation of intraocular lens (IOL) is an extremely useful technique to provide visual rehabilitation in eyes with inadequate capsular support. It requires exteriorization of haptics along with tucking of haptics in the scleral groove preferably and conventionally in the horizontal meridian. In eyes with large corneal diameter, there is difficulty in tucking enough length of the haptics into the intrascleral groove, carrying the risk of slippage of haptics and decentration of IOL. To exteriorize a larger segment of haptic for tucking, we describe a novel technique that involves creation of scleral groove at the posterior limbus and exteriorization of haptic through a small peripheral iridectomy through the posterior limbus. This provides a larger segment of haptic to tuck into the groove that might prevent slippage and decentration of IOL in eyes with megalocornea.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894123","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":"Leber congenital amaurosis: A clinical and genetic study from a tertiary eye care center.","authors":"Abhishek Upadhyaya, Srikanta Kr Padhy, Nithin Teja, Goura Chattannavar, Shreya Dutta, Venkatesh Pochaboina, Jeyapoorani Balasubramanian, Chitra Kannabiran, Brijesh Takkar, Manjushree Bhate, Subhadra Jalali, Deepika C Parameswarappa","doi":"10.4103/IJO.IJO_545_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_545_24","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the clinical phenotypes and genetic mutations in patients with Leber congenital amaurosis (LCA) from a tertiary eye care center in India.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>The study includes patients with a clinical diagnosis of LCA who underwent genetic testing from January 2016 to December 2021. The clinical exome of the patients was analyzed by targeted next-generation sequencing. The genetic variants found were classified as per standard American College of Medical Genetics and Genomics (ACMG) criteria and ClinVar database.</p><p><strong>Results: </strong>There were 35 patients (19 females, 16 males) of LCA. Family history was positive in 29% (10/35) and a history of consanguinity was noted in 54% (19/35) of the patients. The mean presenting best-corrected visual acuity was 2.48 ± 0.59 logMAR. Retinal pigment epithelial abnormalities and macular involvement were seen in 83% (58/70) and 23% (16/70) of the eyes, respectively, at presentation. The most common causative genes for LCA in our cohort were: GUCY2D (20%, 7/35), CRB1 (14%, 5/35), RPE65 (11%, 4/35), RPGRIP1 (11%, 4/35), and LCA5 (9%, 3/35). Autosomal recessive inheritance was seen in 94% (33/35). Macular involvement at presentation was seen in CRB1 (3/5), NMNAT1 (2/2), and one each of RPE65, LCA5, and RDH12 patients. The genetic testing cost was reduced from 23,800 INR to 15,000 INR per test in the study duration.</p><p><strong>Conclusions: </strong>Genetic screening of LCA cases identified various genotypes, with GUCY2D being the most common. Increased awareness and reduced costs of genetic testing would benefit both patients and caregivers. With promising clinical trial outcomes, genotyping is crucial for better patient selection and treatment.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894107","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}