Indian Journal of Ophthalmology最新文献

{"title":"Botulinum toxin A as a treatment modality for acute acquired comitant esotropia - An Indian perspective.","authors":"Akshay Badakere, Vibha Badrinath, Hennaav Kaur Dhillon, Abinaya Valliappan, Viswanathan Natarajan, Sumita Agarkar","doi":"10.4103/IJO.IJO_2198_23","DOIUrl":"10.4103/IJO.IJO_2198_23","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the outcomes of botulinum toxin A injection in acute acquired comitant esotropia (AACE).</p><p><strong>Methods: </strong>This is a retrospective study that included cases diagnosed as AACE between January 2022 and February 2023. Patients who were treated with Botox and completed a minimum 3 months follow-up were included in the study. All the patients underwent a complete ophthalmic, orthoptic examination and neuroimaging. The effects of age, onset of esotropia, screen time, deviation pre injection, mode of injection (transconjunctival/ open sky) and whether injection was administered in one/both eyes on successful outcome were analysed.</p><p><strong>Results: </strong>Twenty-seven patients (20 male, seven female) were included in the study. The median age was 10 years. The median deviation for distance and near preinjection was 35 and 40 prism diopters, respectively. Complete resolution of symptoms was noted in 18 patients (66.6%). Four patients needed prisms, two required repeat injections, and one each needed surgery and divergence therapy. Six patients developed ptosis. None of the risk factors seemed to affect outcomes.</p><p><strong>Conclusion: </strong>Botulinum toxin injected into the medial rectus is a safe and viable option for AACE. Preinjection counseling about ptosis, recurrence needing prisms, reinjection, or surgery is important.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"228-230"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072639","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":"Botulinum toxin-A in acute acquired comitant esotropia during COVID pandemic in children and young adolescents.","authors":"Neelam Pawar, Praveena Shyam, Meenakshi Ravindran, Fathima Allapitchai","doi":"10.4103/IJO.IJO_2540_23","DOIUrl":"10.4103/IJO.IJO_2540_23","url":null,"abstract":"<p><strong>Purpose: </strong>To study the effectiveness of botulinum toxin A (BTX-A) in the treatment of patients with acute acquired comitant esotropia (AACE) due to excessive use of mobile and laptops in the COVID era in the pediatric population and adolescents.</p><p><strong>Methods: </strong>This was a retrospective, interventional study of pediatric patients and young adults who presented with AACE and received unilateral or bilateral BTX-A. All the patients complained of binocular diplopia and sudden onset of esotropia with a history of mobile or laptop usage during the COVID era (2020-2023). Twenty-seven patients with acute-onset esotropia in 3 years (2020-2023) were included. All patients were administered 2.5-7.5 units of BTX-A (Botox, Allergan, India) into the unilateral or bilateral medial rectus muscle of the deviating eye under short general anesthesia or local anesthesia. The main outcome measures were pre- and post-injection angle of deviation, pre- and post-injection stereopsis, final level of stereopsis achieved, recurrence, and whether strabismus surgery was later required.</p><p><strong>Results: </strong>The mean age of patients was 12.85 ± 7.15 years (range: 4-25 years). The mean dosage of Botox was 6 U (2.5-7.5 U). The mean follow-up was 6 months (6 months-2 years). The mean preoperative angle of deviation (AOD) was 41.11 ± 10.9 prism diopters (PD) for distance and 41.67 ± 10.9 PD for near. The maximum effect of BTX-A was seen at 1 month; post-injection AOD was 13.65 ± 14.7 PD for distance and 14.87 ± 15.8 PD for near ( P < 0.001). Over half of the patients achieved optimal outcomes, with improvements in stereopsis and sensory fusion. Early intervention (within 3 months of symptom onset) significantly correlated with treatment success.</p><p><strong>Conclusion: </strong>While BTX-A therapy for acute-onset esotropia demonstrates efficacy, patient-specific considerations are essential. This study highlights the evolving nature in the digital age and early administration of BTX-A along with close follow-up to monitor residual and recurrence of esotropia. The surgical intervention can increase the final success rate.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"231-237"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286118","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":"Oncological principles in the management of ocular surface squamous neoplasia - A Review.","authors":"Rolika Bansal, Santosh G Honavar","doi":"10.4103/IJO.IJO_2340_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2340_24","url":null,"abstract":"<p><p>Ocular surface squamous neoplasia (OSSN) is the most common neoplasia of the anterior segment. Accurate and timely diagnosis, including detailed clinical assessment and imaging, is essential to ascertain the extent of the disease. The gold standard treatment for OSSN has evolved over the years, transitioning from wide-margin surgical excision using the \"no-touch\" technique to topical immunotherapy, plaque brachytherapy, and targeted immunotherapy. The choice of treatment modality depends on a tailored approach based on the initial presentation and progression of the disease. This review consolidates a comprehensive understanding of the variable clinical presentations of OSSN, diagnostic and imaging techniques, and available treatment options. It also provides a foundation for the oncologic principles of managing OSSN while offering insights into future therapeutic approaches.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 2","pages":"173-190"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033000","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 waxing and waning lacrimal fossa swelling.","authors":"Shirali Gokharu, Sima Das","doi":"10.4103/IJO.IJO_1640_24","DOIUrl":"https://doi.org/10.4103/IJO.IJO_1640_24","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 2","pages":"162-163"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033039","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":"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":"261-266"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","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":"Ophthalmic trauma - Grading, scoring, and classification - Has the orphan child grown up?","authors":"Gangadhara Sundar","doi":"10.4103/IJO.IJO_151_25","DOIUrl":"https://doi.org/10.4103/IJO.IJO_151_25","url":null,"abstract":"","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 2","pages":"157-161"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033014","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":"Inferior oblique sparing brachytherapy plaque placement for juxtafoveal peripapillary choroidal melanoma.","authors":"Neiwete Lomi, Deepsekhar Das, Bhavna Chawla, Ananya Herle","doi":"10.4103/IJO.IJO_2207_23","DOIUrl":"https://doi.org/10.4103/IJO.IJO_2207_23","url":null,"abstract":"<p><p>Plaque brachytherapy has been used in the management of small to medium-sized choroidal melanomas for the past few decades. As the inferior oblique muscle lies in close relation to the macula, the placement procedure of plaques often involves sacrificing the inferior oblique muscle, especially in cases of macular or perimacular choroidal melanomas. In this study, we have described a simple maneuver to preserve the inferior oblique muscle.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":"73 2","pages":"303-304"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032884","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":"Increased serum ferritin is associated with severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis: A quantitative analysis.","authors":"Shashi Tanwar, Nibha Mishra, Prachi Sharma, Apjit Kaur","doi":"10.4103/IJO.IJO_574_23","DOIUrl":"10.4103/IJO.IJO_574_23","url":null,"abstract":"<p><strong>Context: </strong>Effect of serum ferritin on severity of coronavirus disease 2019 (COVID-19)-associated rhino-orbito-cerebral mucormycosis.</p><p><strong>Purpose: </strong>To study the association between increased serum ferritin and severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis.</p><p><strong>Settings and design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>Hundred ( n ) out of 155 treatment-naive patients of COVID-19 infection presenting with the signs and symptoms of rhino-orbito-cerebral mucormycosis were enrolled in study. Based on the classification proposed by Honavar, the study patients were classified into four stages: Stage 1: involvement of the nasal mucosa ( n = 11), Stage 2: involvement of paranasal sinuses ( n = 14), Stage 3: involvement of the orbit ( n = 37), Stage 4: involvement of the central nervous system ( n = 38). Stage 3 was further divided into four substages: 3a: nasolacrimal duct, medial orbit, vision unaffected ( n = 4); 3b: diffuse orbital involvement (>1 quadrant or >2 structures), vision unaffected ( n = 15); 3c: central retinal artery occlusion or ophthalmic artery occlusion, superior ophthalmic vein thrombosis, involvement of superior orbital fissure, inferior orbital fissure, orbital apex, diminution or loss of vision ( n = 13); 3d: bilateral orbital involvement ( n = 5). Fasting blood sugar (FBS), postprandial blood sugar (PPBS), and inflammatory markers (serum ferritin, interleukin-6, C-reactive protein, and D-dimer) were assessed. Serum level of ferritin was analyzed by using chemiluminescence immunoassay method.</p><p><strong>Results: </strong>Mean FBS (mg/dl) was 165.03 ± 70.43 for stage 1, 185.67 ± 64.82 for stage 2, 159.05 ± 68.60 for stage 3, and 158.20 ± 62.05 for stage 4. Mean PPBS (mg/dl) was 238.70 ± 141.29 for stage 1, 252 ± 103.69 for stage 2, 257.09 ± 103.48 for stage 3, and 229.53 ± 76.81 for stage 4. Mean serum ferritin (μg/l) was 302.67 ± 266.95 in stage 1, 444.19 ± 116.36 in stage 2, 504.85 ± 205.99 in stage 3, and 825.95 ± 777.30 in stage 4. A statistically significant increase in serum ferritin levels with severity of disease ( P = 0.005) was noted. Similar trend was observed in substages of stage 3. Pearson correlation analysis showed a positive correlation between serum ferritin and severity of disease ( P = 0.0007).</p><p><strong>Conclusion: </strong>Increased serum ferritin was significantly independently associated with severity of orbital disease in COVID-19-associated rhino-orbito-cerebral mucormycosis.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"223-227"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579587","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 biometric parameters in South-Indian children with myopia - A hospital-based retrospective descriptive analysis.","authors":"Sandra Ganesh, Rebecca Claire Lusobya, Mohammed Sithiq Uduman, Reshma Rajan, Nisha Rajendran, Kripa Sanjeev, Kalpana Narendran","doi":"10.4103/IJO.IJO_546_24","DOIUrl":"10.4103/IJO.IJO_546_24","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to profile the ocular biometric parameters in a large group of children of South-Indian ethnicity who visited our outpatient children's department and were diagnosed with myopia.</p><p><strong>Methods: </strong>Children <15 years old diagnosed with myopia (Jan 2022-Oct 2023) and who had ocular biometry readings recorded were included. Their demographics, axial length (AL), anterior chamber depth (ACD), spherical equivalent (SE), corneal radius of curvature (CR), and AL/CR ratio were analyzed.</p><p><strong>Results: </strong>The study included 3728 myopic children; the mean age was 11.85 (4-15) years, and 52.8% were girls. Mean SE was -3.98 D. The mean (SD) AL, ACD, CR, and AL/CR ratio were 24.64 (1.32), 3.73 (0.40), 7.61 (0.27), and 3.24 (0.16), respectively. Female gender was associated with shorter AL, ACD, CR, and AL/CR ratios ( P < 0.001) across all age groups. There was a significant increase in ACD with age in both sexes ( P < 0.001). A 1-unit (mm) increase in AL was associated with an SE increase of -1.65 D (CL: -1.70 to -1.60). AL/CR ratio could explain 71% of the total variance in SE ( P < 0.001). SE showed a mild correlation with age (rho = 0.14, P < 0.001) and ACD (rho = -0.03, P = 0.041) and a stronger correlation with AL (rho = -0.68, P < 0.001) and AL/CR (rho = -0.83, P < 0.001).</p><p><strong>Conclusion: </strong>In this hospital-based study, AL and AL/CR ratios strongly correlate with SE, and the AL/CR better explains the total variance in SE than AL alone in children with myopia.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"292-296"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286153","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 intersection of ophthalmology and neurology: Diagnosing acute strokes through visual symptoms.","authors":"Ruhel Kurudamannil Chacko, Devu Krishna, Karthik Kumar, Virna M Shah","doi":"10.4103/IJO.IJO_2456_23","DOIUrl":"10.4103/IJO.IJO_2456_23","url":null,"abstract":"<p><strong>Purpose: </strong>To document how acute cerebrovascular accidents (CVAs) present first to an ophthalmologist.</p><p><strong>Methods: </strong>Retrospective, observational, unicentric hospital-based study. The electronic medical records of new patients who presented to the Neuro-ophthalmology department of a tertiary eye hospital in the month of August 2022 were reviewed. Those with symptoms suggestive of an acute stroke requiring urgent neuroimaging were chosen for further study.</p><p><strong>Results: </strong>Out of the 710 new patients, 31 had a known CVA and presented with field defects (4.3%). We recognized nine new patients, subsequently diagnosed to have a CVA, initially presenting with ocular symptoms such as homonymous hemianopia in seven cases and two others as transient obscuration of vision and internuclear ophthalmoplegia.</p><p><strong>Conclusion: </strong>Posterior circulation strokes commonly present first to an ophthalmologist, the early recognition of which is of utmost importance.</p>","PeriodicalId":13329,"journal":{"name":"Indian Journal of Ophthalmology","volume":" ","pages":"287-291"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286162","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}