Kerala Journal of Ophthalmology最新文献

{"title":"Presumed silicone oil droplets following intravitreal bevacizumab injection","authors":"P. Panigrahi, Jasmita Satapathy, Y. Srija","doi":"10.4103/kjo.kjo_9_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_9_21","url":null,"abstract":"A 67-year-old male presented with loss of vision in the right eye of 3-month duration. He was diagnosed as superotemporal branch retinal vein occlusion with macular edema and was treated with 4 monthly intravitreal bevacizumab injections. Following the fourth injection, multiple tiny presumed silicone oil droplets were noted in the vitreous. The patient was asymptomatic, and the oil droplets stayed stable during the follow-up period.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70827046","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}

{"title":"Clinical and microbiologial profile of bacterial and fungal keratitis: A comparison of patients with and without diabetes mellitus","authors":"J. Paul, P. Jyothi","doi":"10.4103/kjo.kjo_92_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_92_21","url":null,"abstract":"The aim of the study was to evaluate the predisposing factors, clinical features, causative microorganism, and response to treatment, among persons of infective keratitis, with and without diabetes mellitus and to determine differences between the two groups. This prospective study enrolled 26 patients of infective keratitis who had diabetes mellitus and 52 patients without diabetes mellitus, by consecutive sampling who attended the ophthalmology department at a tertiary care institute. Detailed clinical evaluation and microbiological evaluation were done. Treatment was initiated according to clinical diagnosis. The patients were followed up at 2 weeks, 1 month, and 3 months. Statistical testing was done using Chi-square test and Fisher’s exact test for qualitative variables. Quantitative variables were expressed as means and standard deviations. The variables between the two groups were compared using Student’s t-test and Wilcoxon test, where appropriate. Shapiro–Wilk test was used to test normality of data. Analysis was done using the SPSS software. Urban population, monsoon season, and outdoor work were associated more commonly with microbial keratitis. Ocular trauma (69.2%) was the most common risk factor. A greater proportion of patients with diabetes (46.2%) did not have a history of ocular injury compared to those without (23.8%). Poor glycemic control increased severity of keratitis (P = 0.023). Redness and pain were the most common symptoms in both groups. Corneal sensations were significantly reduced in patients with diabetes mellitus. Diabetes mellitus was significantly associated with central ulcers (46.2%), hypopyon (50%) in anterior chamber, and fungal keratitis (35%). Hypopyon and depth of ulcer were significant predictors (P = 0.018 and 0.006) of the time taken for the infective keratitis to heal. Pseudomonas aeruginosa (19.2%) was the most common bacteria isolated in diabetic patients and Methicillin-sensitive Staphylococus aureus (10.3%) among nondiabetic patients. Fusarium was the most common fungus isolated among both groups. Ulcers healing with leukomatous opacities were higher, and the frequency of perforated corneal ulcers was also higher among diabetic patients (P = 0.026). Posttreatment visual acuity showed a statistically significant improvement only in patients without diabetes mellitus. Significant differences existed between the two groups regarding clinical and microbiologial profile. Aggressive treatment, strict glycemic control, and high index of suspicion for fungal keratitis are important in managing microbial keratitis patients with diabetes mellitus.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70827258","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}

{"title":"Global and sectoral retinal nerve fiber layer thickness in glaucoma suspects and primary open-angle glaucoma patients attending a tertiary care center in South India","authors":"Sreeniya Sreedharan, V. Sudha, Sujatha Nambudiri, S. Thulaseedharan","doi":"10.4103/kjo.kjo_38_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_38_21","url":null,"abstract":"Background: Spectral-domain optical coherence tomography (OCT) can identify the presence of localized glaucomatous structural damage. The peripapillary retinal nerve fiber layer (RNFL) thickness is a popular OCT parameter used for glaucoma diagnosis and monitoring progression. Aim: To measure the peripapillary RNFL thickness, the pattern of RNFL defect, and association of RNFL with the severity of glaucoma using Spectralis Spectral Domain – OCT in patients with primary open-angle glaucoma (POAG) at a glaucoma clinic in a tertiary care teaching hospital in south India. Methods: Cross-sectional study design. Peripapillary RNFL thickness of 109 glaucomatous eyes of 56 patients aged 40–75 years having POAG, ocular hypertension, or suspected to have glaucoma but without visual field (VF) defects were included in the study. The cross-sectional thickness of RNFL using a 3.46 mm circle centered around the disc in 6 segments were measured and defects in the RNFL were identified by comparing measurements from each patient with the normative database. Results: The study included 109 eyes with 51 (46.79%) preperimetric eyes and 58 (53.21%) POAG eyes (with field defects). The average global thickness in the study population was 91.31 ± 12.81 μm for preperimetric eyes and 67.76 ± 17.33 μm for eyes with glaucoma. There was significant thinning in all segments between eyes with POAG and normal eyes with the mean difference highest in the inferotemporal segment (mean difference of 73.05) and the superotemporal segment (mean difference of 55.85). The global RNFL thickness had a coefficient of − 0.015 (standard error [SE] 0.003, 95% confidence interval [CI]: −0.02–−0.009, R2 = 0.29) for mild glaucoma, −0.010 (SE 0.004, 95% CI: −0.02–−0.003, R2 = 0.12) for moderate and − 0.18 (SE: 0.001, 95% CI: −0.022–−0.014, R2 = 0.60) for severe glaucoma compared to preperimetric eyes in a linear regression model that adjusted for age and gender. Global and sector-wise RNFL thickness also had a significant area under Receiver Operator Characteristic (0.84, 95% CI: 0.78. 0.91) that showed the ability to discriminate between preperimetric and glaucomatous eyes. Possible “floor effect” of RNFL thickness was shown by 7 eyes with advanced glaucoma cases. Conclusion: RNFL thinning can be used as a parameter to assess glaucomatous structural loss that can aid in early diagnosis and monitoring of disease progression, to grade the severity of the disease in primary open-angle glaucoma, and when VFs cannot be done.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"35 1","pages":"24 - 31"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45738044","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}

{"title":"Missed feeder vessel induced recurrent and refractory arteriovenous vascular malformation in the upper eye lid","authors":"P. Ramesh, S. Ramesh, JGanesh Kumar, R. Rajasekaran, M. Ramesh","doi":"10.4103/kjo.kjo_36_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_36_21","url":null,"abstract":"A 25-year-old male presented with recurrent swelling in the left upper eyelid despite multiple surgeries in the past 6 years. He was initially misdiagnosed as capillary hemangioma elsewhere, for which multiple surgical excision procedures were done. In 2020, he presented to us for a second opinion regarding the same painless swelling which recurred at the same site. Clinical examination and Doppler ultrasound shifted the diagnosis in favor of arteriovenous malformation (AVM). Computed tomography of the brain and cerebral angiogram (three-dimensional reconstructed) images confirmed the AVM in the left upper eyelid with an arterial feeder from the left ophthalmic artery branch. The patient had multiple recurrences due to the inadvertent misdiagnosis and missed management of the feeder vessel from the ophthalmic artery. We highlight this case, to bring to light the deceptive diagnosis and management of recurrent and refractory AVM due to a feeder vessel from the ophthalmic artery.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"35 1","pages":"100 - 102"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44598255","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}

{"title":"Aicardi syndrome","authors":"M. Greeshma, M. Nair, S. Salim","doi":"10.4103/kjo.kjo_107_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_107_22","url":null,"abstract":"Aicardi syndrome is a rare neurodevelopmental disorder occurring primarily in female children. It is thought to have X-linked dominant inheritance and the affected male foetuses do not survive to term. A 3-year-old girl child with refractory infantile spasms and corpus callosal agenesis was found to have chorioretinal lacunae in the left eye on fundus examination. A clinical diagnosis of Aicardi syndrome was made which was confirmed with intracranial imaging.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"88 8","pages":"83 - 85"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41312336","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}

{"title":"Malignant glaucoma: A therapeutic challenge","authors":"A. Anuradha, M. Devi, Rose Mary George, N. M. Kumar, P. Gupta","doi":"10.4103/kjo.kjo_198_20","DOIUrl":"https://doi.org/10.4103/kjo.kjo_198_20","url":null,"abstract":"Malignant glaucoma is a rare condition characterized by an acute rise of intraocular pressure rise with a very shallow anterior chamber, generally following anterior segment surgery. The mechanism leading to malignant glaucoma is that in an anatomically predisposed eye, the anterior rotation of the ciliary body induces misdirection of aqueous flow into or behind the vitreous body, increasing vitreous volume, resulting in anterior displacement of the iris–lens diaphragm, axial and peripheral anterior chamber flattening, and secondary angle closure. The aim of this article is to report a case of malignant glaucoma to discuss about the risk factors involved and therapeutic approaches that are useful in managing such cases.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70824322","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}

{"title":"Wolf in sheep's clothing: Cough syrup-induced synergistic idiosyncratic mydriatic reaction precipitating a bilateral acute angle-closure attack in a predisposed hypermetropic patient","authors":"P. Ramesh, S. Ramesh, Prajnya Ray, R. Rajasekaran, M. Ramesh","doi":"10.4103/kjo.kjo_26_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_26_21","url":null,"abstract":"An uncommon ophthalmic emergency condition, bilateral acute angle-closure glaucoma (AACG), is a potentially sight-threatening adverse effect of several local and systemic drugs in high-risk individuals. The majority of cases with drug-induced pupillary block closed-angle glaucoma are preventable, if high-risk patients are recognized and treated prophylactically. We report one such case that highlights the risk factors and rare pathophysiological mechanism of developing bilateral AACG attack after consumption of an antitussive drug orally.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"35 1","pages":"96 - 99"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47577143","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}

{"title":"Clinical outcome of first hundred consecutive therapeutic penetrating keratoplasties done at a tertiary eye care centre in Eastern India","authors":"Nilesh Mohan, Mamta Singh, B. Sinha, Rakhi Kusumesh","doi":"10.4103/kjo.kjo_193_21","DOIUrl":"https://doi.org/10.4103/kjo.kjo_193_21","url":null,"abstract":"Aim: To analyze the clinical outcome of first 100 consecutive cases of therapeutic penetrating keratoplasty (TPK) done at a tertiary eye care centre in Eastern India. Materials and Methods: A retrospective analytical observational study of first 100 consecutive patients of TPK was done at RIO, IGIMS, Patna, Bihar for nonhealing keratitis with or without perforation with a minimum 1 year follow up examination. Patients with vitreous exudates were excluded from the study. Results: Organisms were isolated in 60% of cases of which 65% were fungi (Aspergillus), 20% were bacteria, (Staphylococcus aureus) and 15% had mixed infection. 17 cases required lens removal during surgery. Repeat graft infection was noticed in 23 cases of which 9 had fungi, 2 had bacterial isolate and rest was inconclusive preoperatively. A repeat TPK was performed in 7 patients out of the reinfected cases. Anatomical restoration could be achieved in 96% of cases. Graft clarity allowing clear view of anterior chamber could be seen in 26 cases. 4 cases of graft infection with posterior segment involvement finally required evisceration. 47 out of 100 TPK cases had raised intraocular pressure (IOP) of which 10 underwent glaucoma surgery for uncontrolled IOP despite medications. Conclusion: TPK is a challenging surgery still having definite role in management of nonresponding progressive keratitis. Maintaining graft clarity postoperatively is a difficult task in these cases therefore success should be measured in terms of infection eradication and anatomical restoration.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"35 1","pages":"60 - 65"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42593125","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}

{"title":"Visual outcome with sclerocorneal contact lens in case of a pellucid marginal degeneration","authors":"K. Husna","doi":"10.4103/kjo.kjo_63_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_63_22","url":null,"abstract":"A 40-year-old male presented with progressive dimness of vision in right eye. Slit-lamp microscopy revealed features of pellucid marginal degeneration in right eye. Corneal topography showed “crab-claw” pattern of thinning. His visual acuity in right eye improved well with sclerocorneal contact lens.","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"35 1","pages":"89 - 92"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47046861","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}

{"title":"Review of “A randomized trial evaluating efficacy of overminus lenses combined with prism in the children with intermittent exotropia”","authors":"Remya Edachery","doi":"10.4103/kjo.kjo_29_22","DOIUrl":"https://doi.org/10.4103/kjo.kjo_29_22","url":null,"abstract":"","PeriodicalId":32483,"journal":{"name":"Kerala Journal of Ophthalmology","volume":"35 1","pages":"109 - 110"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41735209","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}