Nepalese Journal of Ophthalmology最新文献

{"title":"Clinical Profile of Patients Presenting with Corneal Foreign Bodies: A Cross-Sectional Study Conducted in a Tertiary Hospital in Nepal.","authors":"Tina Shrestha,&nbsp;Sanket Parajuli,&nbsp;Sadhana Sharma,&nbsp;Riyaz Shrestha,&nbsp;Prerana Singh","doi":"10.3126/nepjoph.v14i1.38010","DOIUrl":"https://doi.org/10.3126/nepjoph.v14i1.38010","url":null,"abstract":"<p><strong>Introduction: </strong>Corneal foreign bodies are one of the commonest forms of ocular trauma, the majority of which occur due to occupational exposure. The aim of this study was to study the profile of patients with corneal foreign bodies.</p><p><strong>Materials and methods: </strong>A hospital based prospective study was conducted among 60 patients presenting to the ophthalmology outpatient department in Dhulikhel Hospital-Kathmandu University Hospital (DH-KUH) over a time span of 6 months. Demographic data of patients, clinical characteristics of foreign bodies and associated complications were noted.</p><p><strong>Results: </strong>Most of the patients were males (n=55) belonging to the 21-30 age group (n=24). Majority of them were workers in metal industries (n=26). Welding and cutting metal were implicated as the most common mode of injury (n=53).</p><p><strong>Conclusion: </strong>By virtue of this study, we identified the high risks associated with sustaining this form of ocular trauma. The incidence and hence the prevalence of corneal foreign body can be gradually levelled down if we aware the people about the associated complications and advise them to use protective eye wears (PEW).</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"14 27","pages":"59-64"},"PeriodicalIF":0.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40631283","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":"Burden and Risk Factors of Diabetic Retinopathy Among Diabetic Patients Attending a Multispecialty Tertiary Eye Hospital in Nepal.","authors":"Arjun Shrestha,&nbsp;Rinkal Suwal,&nbsp;Rajan Shrestha,&nbsp;Deepak Khadka","doi":"10.3126/nepjoph.v14i1.39723","DOIUrl":"https://doi.org/10.3126/nepjoph.v14i1.39723","url":null,"abstract":"<p><strong>Introduction: </strong>As the number of people with diabetes mellitus is increasing because of urbanization and change in dietary habits and sedentary lifestyle, the number of diabetic retinopathy is also expected to increase in future. [1] [sa2] We aimed to find out the prevalence of diabetic retinopathy and associated risk factors among diabetic patients in the tertiary eye hospital.</p><p><strong>Materials and methods: </strong>This is the observational cross-sectional study enrolling 420 diabetic patients visiting the multispecialty tertiary eye hospital between March 2020 and February 2021. Anthropometry measurement, laboratory risk profiles and blood pressure were recorded Results: The prevalence of any diabetic retinopathy, proliferative diabetic retinopathy, and diabetic macular edema were 30.96 %, 6.19 %, and 5.95 % respectively. The duration of DM (p=0.001), hypertension (p=0.04), high SBP (p=0.023), abdominal obesity (p=0.015), high LDL(p=0.011) cholesterol, low HDL cholesterol(p=0.012), and creatinine (p=0.001) were associated with DR in our study.</p><p><strong>Conclusion: </strong>A holistic approach should target to control the modifiable risk factors like blood sugar, blood pressure, lipid profile, kidney function, and obesity to prevent DR. Anthropometric assessment of waist to height and waist circumference should be included in the holistic health promotion strategy in Nepal as BMI may not be risk factors for DR in Nepalese people.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"14 27","pages":"82-92"},"PeriodicalIF":0.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40631286","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":"Conjunctival Relaxing Incisions with a Bare Bed: An Overlooked Privilege in Contracted Sockets.","authors":"Deepthi Elizabeth Kurian,&nbsp;Jayanthi Peter,&nbsp;Satheesh Solomon T Selvin","doi":"10.3126/nepjoph.v14i1.29240","DOIUrl":"https://doi.org/10.3126/nepjoph.v14i1.29240","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of reconstruction of a contracted socket is to retain a satisfactory prosthesis. Simple procedures to modify the socket architecture as first line options could avoid multiple staged procedures, increased surgical time, harvesting tissues or use of allografts. The objective of this study was to evaluate the outcome of modifying the socket architecture by making conjunctival relaxing incisions leaving it bare to re-epithelialize and compare it to dermis-fat graft.</p><p><strong>Materials and methods: </strong>A retrospective review of all socket reconstruction surgeries in our hospital over a period of 10 years (July 2009 to June 2019) was done. The two procedures which were compared were dermis-fat graft (DFG) and conjunctival relaxing incisions (CRI) without a graft. In the latter, the split conjunctiva was left bare under a conformer and temporary tarsorrhaphy. The conjunctiva was allowed to re-epithelialize under cover of topical antibiotic and steroid.</p><p><strong>Results: </strong>The patients included had a mean age of 24 years (n=8) in the DFG group and 36 years (n=10) in the CRI group. The most common cause of anophthalmic socket was enucleation for tumour and evisceration for trauma in the two groups, respectively. Six patients (75%) in the DFG group and six (60%) in the CRI group achieved good prosthesis retention (P = 0.51). None had post-operative infection.</p><p><strong>Conclusion: </strong>Transverse conjunctival relaxing incisions with tissue stretching can be a safe first line option to rehabilitate a contracted socket.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"14 27","pages":"112-121"},"PeriodicalIF":0.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40631289","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":"Macular Corneal Dystrophy in an Adolescent Managed with Deep Anterior Lamellar Keratoplasty.","authors":"Puspa Giri,&nbsp;Leena Bajracharya,&nbsp;Sudha Ranabhat","doi":"10.3126/nepjoph.v14i1.39633","DOIUrl":"https://doi.org/10.3126/nepjoph.v14i1.39633","url":null,"abstract":"<p><strong>Introduction: </strong>Macular corneal dystrophy (MCD) is a rare autosomal recessive stromal dystrophy. The prevalence of inherited diseases varies in different communities. It is not commonly observed in Nepal.</p><p><strong>Case: </strong>A 14-year male presented with bilateral gradual and painless blurred vision with photophobia of three years duration. Cornea of both eyes showed focal grayish opacities in anterior and mid stroma with intervening stromal haze. There was no history of consanguinity in the family. Anterior segment ocular coherence tomography showed thinning of cornea and deposits in corneal stroma. Macular corneal dystrophy was the clinical diagnosis and the patient underwent deep anterior lamellar keratoplasty in the right eye. Histopathological examination and histochemical staining with Alcian Blue supported the diagnosis.</p><p><strong>Conclusion: </strong>Significant improvement in vision was observed in the operated eye. MCD may be present in communities without evidence of consanguinity. It can cause visual impairment at an early age. Timely intervention improves vision and quality of life.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"14 27","pages":"204-209"},"PeriodicalIF":0.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40633144","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":"Et tu Mucor?","authors":"Anadi Khatri,&nbsp;Gunjan Prasai,&nbsp;Mukesh Pandey,&nbsp;Muna Kharel,&nbsp;Dikshya Bohara,&nbsp;Madhav Panthi","doi":"10.3126/nepjoph.v13i2.39751","DOIUrl":"https://doi.org/10.3126/nepjoph.v13i2.39751","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, the Indian subcontinent has been hard hit by the second wave of COVID-19. Along with it, the region has become a hot spot for mucormycosis infection in patients with COVID-19. The aim of this paper is to provide a scientific overview on the status of mucormycosis in pre-COVID-19 era and on how COVID-19 could have directly or indirectly expose the hidden burden of mucormycosis globally.</p><p><strong>Materials and methods: </strong>This paper is structured as a narrative review and is based on relevant published literature on both COVID-19 and mucormycosis.</p><p><strong>Conclusion: </strong>Mucormycosis in the pre-COVID-19 era was almost a neglected entity. It was because the risk factors for both - More severe COVID-19 infections and Mucormycosis are almost similar - COVID-19 might have helped to expose the true magnitude of the mucormycosis and flagging it as a major public health concern requiring a revisit by medical science.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"13 24","pages":"177-185"},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40649087","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":"Choroidal Osteoma with Choroidal Neovascular Membrane treated with Anti- vascular Endothelial Growth Factor: A Rare Case with Review of Literatures.","authors":"Phuntsho Dorji,&nbsp;Nor Tshering Lepcha,&nbsp;Raba Thapa","doi":"10.3126/nepjoph.v13i2.33218","DOIUrl":"https://doi.org/10.3126/nepjoph.v13i2.33218","url":null,"abstract":"INTRODUCTION Choroidal osteoma, usually unilateral, is a rare benign tumor of choroid. It is predominantly seen in young females. CASE We report a case of a 35-year-old female with unilateral choroidal osteoma associated with choroidal neovascular membrane (CNVM). The diagnosis was confirmed with clinical examination, ocular ultrasonography, fundus fluorescein angiography and macular optical coherence tomography. Choroidal neovascular membrane improved with 3 doses of bevacizumab, an anti-vascular endothelial growth factors (Anti-VEGF). CONCLUSION Anti-VEGF monotherapy can be a cost effective primary modality of treatment for choroidal neovascular membrane secondary to choroidal osteoma.","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"13 24","pages":"196-201"},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40633134","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":"Tuberculosis related Neuroretinitis and Retinal Vasculitis in an Immunocompetent Patient.","authors":"Neha Goel","doi":"10.3126/nepjoph.v13i2.31212","DOIUrl":"https://doi.org/10.3126/nepjoph.v13i2.31212","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to describe the occurrence of bilateral neuroretinitis and retinal vasculitis in an immunocompetent female with disseminated tuberculosis.</p><p><strong>Case description: </strong>A 25 year old female diagnosed with disseminated tuberculosis presented with sudden painful loss of vision bilaterally. On examination she was found to have bilateral neuroretinitis and retinal periphlebitis involving the posterior pole. She was prescribed systemic steroids in addition to the anti-tuberculous therapy that she was receiving. The fundus lesions gradually resolved over four months with modest improvement in visual acuity. There were no recurrences in the follow up period of 14 months.</p><p><strong>Conclusions: </strong>Ocular involvement in the form of neuroretinitis with concomitant retinal vasculitis can occur in patients with disseminated tuberculosis. Addition of systemic steroids to anti-tuberculous therapy leads to anatomical resolution with improvement in visual acuity.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"13 24","pages":"219-224"},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40633138","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":"Comparison of Percent Tissue altered in Topography Guided and Wavefront Optimized Laser-assisted in situ Keratomileusis using Zeiss MEL 80 Excimer Laser.","authors":"Shwetambari Singh,&nbsp;Neha Shilpy,&nbsp;Dipali Purohit,&nbsp;Zalak Shah","doi":"10.3126/nepjoph.v13i2.26665","DOIUrl":"https://doi.org/10.3126/nepjoph.v13i2.26665","url":null,"abstract":"<p><strong>Introduction: </strong>Laser-assisted in situ Keratomileusis (LASIK) is the most commonly performed refractive surgical procedure. The amount of tissue ablated in LASIK affects the safety and long-term outcome. The objective of this study was to compare the percent tissue altered (PTA) in topography guided (TG) and wavefront optimized (WFO) LASIK using Zeiss MEL 80 excimer laser.</p><p><strong>Materials and methods: </strong>This retrospective observational study was conducted at a tertiary eye center. Patients with moderate myopia who underwent LASIK between June 2016 and January 2019 were divided into two groups (Group I: TG LASIK, 69 eyes; Group II: WFO LASIK, 70 eyes). The groups were compared for preoperative parameters [spherical equivalent (SE), keratometry and pachymetry], intraoperative parameters [ablation depth (AD), PTA and residual stromal bed thickness (RSBT)] and postoperative parameters (vision, SE).</p><p><strong>Results: </strong>Among preoperative parameters, SE and keratometry were similar while thinnest pachymetry was significantly less in group I. Among the intraoperative parameters, PTA (P < 0.01) and AD (P < 0.01) were significantly less in group I while RSBT (P = 0.54) was not significantly different. Postoperatively at 6 months, 92.75% (64) eyes in group I and 90% (63) eyes in group II had visual acuity of 6/6 or better (P = 0.57). 98.55% (68) and 97.14% (68) eyes in group I and group II respectively had SE refraction within ± 0.5 dioptres.</p><p><strong>Conclusion: </strong>TG LASIK induces less tissue alteration for given refractive error with similar visual outcome as compared to WFO LASIK which makes TG apparently safer and is the preferred technique for borderline thin corneas.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"13 24","pages":"69-76"},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40632721","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":"Arrugas Bone Trephine Assisted Flapless Dacryocystorhinostomy with Circumosteal - Mitomycin C Versus External Dacryocystorhinostomy: A Hospital Based Comparative Study.","authors":"Gyan Bhaskar,&nbsp;Anita Ambastha,&nbsp;Nilesh Mohan,&nbsp;Shalini Sinha,&nbsp;Srishti Shree","doi":"10.3126/nepjoph.v13i2.30264","DOIUrl":"https://doi.org/10.3126/nepjoph.v13i2.30264","url":null,"abstract":"<p><strong>Introduction: </strong>Primary acquired nasolacrimal duct obstruction is a common ophthalmic condition and has conventionally been managed by external dacryocystorhinostomy. However this procedure is time consuming and involves making mucosal flaps. The aim of this study was to compare the surgical outcome in Arrugas bone trephine-assisted flapless dacryocystorhinostomy with Circumosteal - Mitomycin C versus conventional external dacryocystorhinostomy.</p><p><strong>Materials and methods: </strong>This is a retrospective non-randomized study of surgical outcome in patients of primary acquired nasolacrimal duct obstruction who underwent an Arrugas bone trephine assisted flapless dacryocystorhinostomy with Circumosteal - Mitomycin C (group A) versus those who underwent conventional external dacryocystorhinostomy (group B) in a teaching hospital in North India. Patients with previously failed dacryocystorhinostomy, lacrimal fistula, canalicular and common canalicular obstruction were excluded. Success was defined as patent syringing at the end of one year. Surgical time was calculated from skin incision to skin suturing.</p><p><strong>Results: </strong>There was complete resolution of epiphora with patent syringing in 43 out of 52 patients in group A, while in group B, 47 out of 55 patients had complete resolution of epiphora with patent syringing at the end of one year (p= 0.77). Mean surgical time was significantly lower in Group A than in Group B (p=<.05). Scarring and closure of the ostium was the most common cause of failure in both groups (Group A, n=5, 9.6%; Group B, n= 3, 5.45%).</p><p><strong>Conclusion: </strong>Arrugas bone trephine-assisted flapless dacryocystorhinostomy with Circumosteal - Mitomycin C is a viable alternative to conventional external dacryocystorhinostomy with comparable success rate and shorter surgical time and a faster learning curve.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"13 24","pages":"169-176"},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40633133","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":"Microbiological and Antibiotic Sensitivity Profile of Postoperative Endophthalmitis in a Tertiary Eye Care Hospital of North India.","authors":"Richa Ranjan,&nbsp;Manisha Agarwal,&nbsp;Shalini Singh,&nbsp;Rahul Mayor,&nbsp;Lagan Paul,&nbsp;Arpan Gandhi","doi":"10.3126/nepjoph.v13i2.29255","DOIUrl":"https://doi.org/10.3126/nepjoph.v13i2.29255","url":null,"abstract":"<p><strong>Introduction: </strong>We describe the microbiological profile of postoperative endophthalmitis from northern India and analyse the pattern of antibiotic sensitivity which may have changed due to development of resistance secondary to overuse of antimicrobial drugs.</p><p><strong>Materials and methods: </strong>This is a retrospective study of postoperative endophthalmitis from January 2011 to December 2017 in a tertiary eye hospital of northern India. Any patient developing endophthalmitis within one year of any intraocular procedure was included in the study. According to severity, treatment with a trial of intravitreal antibiotic injections or core vitrectomy was decided. Ocular samples were collected which were either anterior chamber tap or vitreous biopsy and sent for microbiological examination. The samples were stained with Gram's and KOH stain and cultured on chocolate agar, blood agar, brain heart infusion broth and Sabouraud dextrose agar.</p><p><strong>Results: </strong>A total of 545 patients of postoperative endophthalmitis were analysed which showed a male predilection (60.5%) with maximum patients between the age group 50-69 years. 292 patients (53.5%) were culture negative and 253 patients (46.4%) were culture positive. Most common organism identified was Staphylococcus in 73 patients followed by Pseudomonas in 48 patients. Staphylococcus species was most sensitive to vancomycin (97%) followed by amikacin (91%) followed by gentamicin and moxifloxacin (88% each). Pseudomonas was the second most common isolate which showed maximum sensitivity to imipenem (82%) followed by ciprofloxacin(60%). Polymicrobial infection was noted in 23 patients. The most common fungal isolate was aspergillus in 11 patients, followed by fusarium in 10 patients.</p><p><strong>Conclusion: </strong>Our study shows that gram positive bacteria are the most common organisms in postoperative endophthalmitis and are most sensitive to vancomycin, followed by gram negative bacteria which show increased sensitivity with imipenem than commonly used antibiotic - ceftazidime.</p>","PeriodicalId":44759,"journal":{"name":"Nepalese Journal of Ophthalmology","volume":"13 24","pages":"3-10"},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40631269","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}