Romanian journal of ophthalmology最新文献

{"title":"Atypical Delayed-Onset Endophthalmitis Following Intravitreal Dexamethasone Implant Managed Without Implant Removal: A Rare Case Report and Literature Review.","authors":"Amit Nandan Tripathi, Vipin Rana, Sandepan Bandopadhyay, Jaya Kaushik, Pradeep Kumar","doi":"10.22336/rjo.2024.64","DOIUrl":"10.22336/rjo.2024.64","url":null,"abstract":"<p><strong>Objective: </strong>To report a case of atypical delayed-onset endophthalmitis following intravitreal dexamethasone (DEX) implantation, managed successfully without implant removal.</p><p><strong>Case presentation: </strong>A 72-year-old Asian woman with recurrent macular edema due to central retinal vein occlusion (CRVO) received an intravitreal DEX implant. Two weeks post-injection, she experienced blurred vision but no pain or redness. Best-corrected visual acuity (BCVA) had dropped to hand movements near the face (HMCF). Examination revealed 3+ anterior chamber cells and a 1.5 mm hypopyon, with significant vitreous haze obscuring retinal details. A diagnosis of acute endophthalmitis was made. Initial treatment with intravitreal vancomycin and ceftazidime was followed by pars plana vitrectomy (PPV) without implant removal. Microbiological tests were negative, and vision improved significantly, with BCVA returning to 6/12 after two weeks.</p><p><strong>Discussion: </strong>Endophthalmitis following DEX implantation is rare, and its management is not well-defined. While implant removal is often recommended, favorable outcomes can be achieved without it. The negative culture results and atypical presentation suggested a possible non-infectious etiology. Intraocular steroids may obscure typical signs of infection.</p><p><strong>Conclusion: </strong>Atypical delayed-onset endophthalmitis following DEX implantation can be successfully treated with prompt vitrectomy and intravitreal antibiotics without implant removal, underscoring the need for individualized management in such cases.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"343-348"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features and Epidemiological Insights of Acute Epidemic Conjunctivitis: A Multicentric Cross-Sectional Study in North Central India.","authors":"Ankita Aishwarya, Amit Agarwal, Deepti Saxena, Vaibhav Jain, Adarsh Singh, Rachna Agarwal","doi":"10.22336/rjo.2024.68","DOIUrl":"10.22336/rjo.2024.68","url":null,"abstract":"<p><strong>Purpose: </strong>To gain epidemiological insights by investigating the age, risk factors, and clinical features of individuals affected by the conjunctivitis outbreak.</p><p><strong>Methods: </strong>The study was conducted at various ophthalmic centers, involving participants with clinical symptoms of acute conjunctivitis within one week from 15 June 2024 to 15 July 2024. Demographic information, clinical features, signs, and symptoms were recorded and analyzed using SPSS version 21.0 and MedCalc software.</p><p><strong>Results: </strong>The study included 920 patients (1722 eyes), 56% males and 44% females, and most cases were bilateral (94%). Among the affected groups, hospital staff (43%) were the most affected, followed by school-going children (31%), those in direct contact with infected individuals (17%), or others (11%). The median age of onset was 26 years, with a range spanning from 2 to 76 years. The age group most affected was 19-49 years (52%), followed by <18 years (34%) and the elderly group (14%). The most common and first symptom was foreign body sensation (92%), and additional symptoms included ocular itching (81%) and watering (80%). The most prevalent signs were conjunctival congestion (99%), follicles (96%), subconjunctival bleeding (43%), eyelid swelling (51%), chemosis (39%), and pre-auricular lymph node enlargement (6%). Corneal involvement was not observed.</p><p><strong>Discussions: </strong>Acute Epidemic Conjunctivitis (AEC) outbreaks have significant implications for public health, particularly regarding healthcare resource utilization, economic burden, and disruption of daily life. Timely identification, effective communication, and coordinated response strategies are essential to managing AEC outbreaks and preventing their escalation.</p><p><strong>Conclusion: </strong>This study provides crucial insights into epidemic conjunctivitis in North Central India. The study findings can guide targeted interventions and healthcare resource allocation to manage the outbreak effectively.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"372-378"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symblepharon as Ocular Manifestation Post Stevens-Johnson Syndrome: A Rare Case.","authors":"Edy Wibowo, Regina Vika Maharani, Nadya Adiwijaya Sutikno","doi":"10.22336/rjo.2024.84","DOIUrl":"10.22336/rjo.2024.84","url":null,"abstract":"<p><strong>Background: </strong>Stevens-Johnson syndrome (SJS) is a life-threatening condition resulting from a severe reaction to the use of certain drugs, with the highest incidence found in children. It manifests as a triad of skin, orifice, and ocular mucosa lesions. Ocular manifestations most commonly involve the conjunctiva and eyelids. This case report further discusses symblepharon as an ocular manifestation of SJS.</p><p><strong>Method: </strong>A case report.</p><p><strong>Case report: </strong>A 10-year-old boy came with decreased vision and an inability to produce tears. On examination, pseudomembranous conjunctivitis was found in both eyes, granulation tissue in the right eye, and erosion of the corneal epithelium in the left eye. The posterior segment could not be assessed due to symblepharon. It was known that the patient previously experienced SJS in early 2023. Symblepharectomy was carried out with the indication of separate adhesions caused by symblepharon.</p><p><strong>Discussion: </strong>Symblepharon is a rare, severe ocular manifestation of SJS (Stevens-Johnson syndrome). Previous studies found that severe ocular occurred in around 4% and 11.1% of cases. This happened because of ongoing chronic inflammation due to SJS. Symblepharon is an adhesion of eyelids and bulbar conjunctiva, which can harm the eye because it can cause cicatricial then disruption of the tear film meniscus, limit eye mobility, and cause visual disturbances.</p><p><strong>Conclusion: </strong>Symblepharon occurs due to prolonged inflammation, which can structurally and functionally disrupt the eye. Early discovery of symblepharon, especially in severe manifestations of SJS, can help prevent further damage to the eye.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"466-469"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Retinopathy Screening Adherence.","authors":"Pasha Anvari, Reza Mirshahi, Faezeh Hashemi Nezhad, Alireza Helal Birjandi, Kimia Daneshvar, Ramin Fakhar, Atefeh Ghomashi, Khalil Ghasemi Falavarjani","doi":"10.22336/rjo.2024.76","DOIUrl":"10.22336/rjo.2024.76","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the adherence rate of diabetic subjects to the retinopathy screening program and to identify the characteristics associated with non-compliance to regular screening.</p><p><strong>Methods: </strong>A cross-sectional study involving 240 patients with diabetes who attended outpatient non-ophthalmology clinics at four tertiary university hospitals between March 2020 and March 2021 was conducted. A validated questionnaire collected data that included socio-demographic variables, characteristics of diabetes, diabetes-related complications and comorbidities, knowledge and attitudes toward DR and its screening, and barriers to DR screening. Univariate and multivariate logistic regression was employed to identify the factors associated with adherence to the annual diabetic eye examination. Adherence was defined as a history of the dilated ophthalmic exam in the past year and subsequent follow-ups recommended by the ophthalmologist.</p><p><strong>Results: </strong>The participants had an average age of 59 ± 14.2 years, and 53% were females. The average duration of diabetes was 108 ± 89.62 months. Based on the last ophthalmic examination, 50.8% of patients were non-adherent to the suggested DR screening guidelines. A history of smoking (p-value=0.013, 95%CI for OR: 1.21-5.10), lower education levels (p-value=0.045, 95%CI for OR: 1.02-3.82), and not clarifying the necessity of ophthalmic examination by primary physicians (p-value < 0.001, 95%CI for OR: 2.19-12.35) were significantly associated with non-adherence. Among non-adherent subjects, 38% reported fear of the COVID-19 pandemic, 21.3% cited the lack of information regarding DR screening, 10.7% cited lack of access to the ophthalmologist, 5.7% cited financial problems, and 10.7% noted a lack of support from family and friends as the main reason for non-attendance to the annual eye care.</p><p><strong>Discussions: </strong>This study revealed a non-compliance rate with DR screening guidelines that surpasses pre-pandemic figures. Although younger participants demonstrated a higher likelihood of recent eye care, this correlation lost significance in multivariate analysis, potentially reflecting education and technology utilization disparities. Despite uniform insurance coverage, socioeconomic factors, such as transportation challenges, may impede adherence. Furthermore, individuals informed by healthcare providers about the necessity of eye exams exhibited greater compliance; however, many newly diagnosed patients remained unaware of the risks associated with DR. The COVID-19 pandemic emerged as a prominent barrier, with numerous patients citing it as a reason for their non-compliance due to disruptions in clinical care.</p><p><strong>Conclusions: </strong>Half of the diabetic subjects attending tertiary hospitals for non-ophthalmic complaints were non-adherent to recommended retinopathy screening. Lower education, smoking, and unawareness of the necessity of ann","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"421-426"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic Management of Descemet's Membrane Perforation During DALK in Advanced Keratoconus.","authors":"Alina Gabriela Gheorghe, Ancuța Georgiana Onofrei, Ana-Maria Arghirescu, Andrei Coleașă, Georgia-Denisa Tiran, Laura Ioana Dinu, Elena Veronica Toader","doi":"10.22336/rjo.2024.81","DOIUrl":"10.22336/rjo.2024.81","url":null,"abstract":"<p><strong>Objective: </strong>To report on the surgical treatment of advanced keratoconus (KC) with stromal scarring in a young male patient with asymmetric disease progression complicated by an intraoperative microperforation of Descemet's membrane (DM) during deep anterior lamellar keratoplasty (DALK).</p><p><strong>Methods: </strong>The surgical approach consisted of manual descemetic DALK (dDALK), further complicated with DM microperforation. Anterior segment ocular coherence tomography (AS-OCT) was used intraoperatively to locate the site and size of the tear. The surgeon decided not to convert to penetrating keratoplasty (PK), despite stromal scarring, significant ectasia, and variable corneal thickness, but rather to continue the dissection of the stromal bed with maximum precaution.</p><p><strong>Results: </strong>Postoperatively, visual results improved and reached the best corrected visual acuity of 20/20. Choosing a proper graft dimension and reaching anatomical separation up to the DM were the keys to obtaining such a positive refractive outcome.</p><p><strong>Discussions: </strong>DALK, the most advanced treatment for KC, was chosen as the ideal option for this young patient due to its advantages over PK: reduced rejection risk, fewer complications, quicker steroid tapering, and faster recovery. However, its steep learning curve remains a challenge for surgeons.</p><p><strong>Conclusions: </strong>Despite manual DALK being a more challenging and time-consuming procedure than PK, careful dissection of the stromal bed and diligent assessment of the affected DM can provide a better and safer outcome for selected patients. Even if initial postoperative visual results are impressive, the surgeon must pay attention to the patient's future check-ups to swiftly correct any possible complications.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"448-456"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty-four Hour Ambulatory Blood Pressure Monitoring in Open Angle Glaucoma Suspects: A cross-sectional descriptive study.","authors":"Mahesh Bharathi, Subashini Kaliaperumal, Sandhiya Selvarajan, Renuka Srinivasan, Mary Stephen","doi":"10.22336/rjo.2024.71","DOIUrl":"10.22336/rjo.2024.71","url":null,"abstract":"<p><strong>Purpose: </strong>To compare glaucoma suspects' 24-hour blood pressure pattern with healthy subjects and the Retinal Nerve Fibre Layer (RNFL) thickness among dippers and non-dippers.</p><p><strong>Materials and methods: </strong>We included 100 patients diagnosed as glaucoma suspects in the study group and 100 age and gender-matched controls. Twenty-four-hour ambulatory blood pressure (BP) was measured using an automated BP monitoring device for mean systolic BP (SBP), mean diastolic BP (DBP), and mean arterial pressure (MAP). We classified patients into non-dippers, dippers, and overt dippers based on reduction in nocturnal MAP. Structural damage to the optic nerve head was studied by measuring the superior, inferior, and average RNFL thickness on Optical Coherence Tomography (OCT).</p><p><strong>Results: </strong>Glaucoma suspects showed lower values of day, night, and mean SBP values but higher values of day, night, and mean DBP values when compared with controls, and these were statistically significant. ANOVA and Post Hoc test (Bonferroni) analysis among glaucoma suspects showed that overt dippers had statistically significant superior, inferior, and average RNFL thinning (average 86.20 ± 12.200 µm) as compared to non-dippers and dippers (average 105 ± 11.183 and 102.19 ± 9.582 µm respectively). Pearson's correlation, used to assess the relationship between the nocturnal dip in BP and average RNFL thickness, showed a negative correlation (r = -0.396, p < 0.001).</p><p><strong>Discussion: </strong>Our study found a statistically significant decrease in systolic blood pressure day and night and an increase in diastolic blood pressure day and night in glaucoma suspects compared to normal. Mean arterial pressure did not show any significant difference, and the data obtained is comparable with previous studies. The corresponding retinal nerve fiber layer changes noted in dippers and non-dippers were also similar to those in the existing literature. This study, however, has a shortcoming of not including intraocular pressure-related nerve head changes.</p><p><strong>Conclusion: </strong>Nocturnal BP reduction was associated with structural damage to the optic nerve head in glaucoma suspects, suggesting systemic vascular etiology in the damage progression. ABP monitoring can help detect those glaucoma suspects who are mainly likely to progress so that they can be on close follow-up.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"391-397"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic analysis of glaucoma patients regarding treatment options.","authors":"Adin Mahmuljin, Aida Pidro Gadzo, Ajla Pidro Miokovic, Selma Hasimbegovic, Amela Dzubur Alic","doi":"10.22336/rjo.2024.70","DOIUrl":"10.22336/rjo.2024.70","url":null,"abstract":"<p><strong>Objective: </strong>To present a socioeconomic analysis of glaucoma patients regarding glaucoma treatment options.</p><p><strong>Methods: </strong>This is a prospective, comparative cross-sectional study. One hundred twenty glaucoma patients were divided into three groups. In group one, 40 patients were treated with topical therapy; group two consisted of 40 patients who had previously undergone laser therapy for glaucoma treatment; and group three had 40 patients who had undergone glaucoma surgical therapy. Data were collected using questionnaires. The data obtained by the survey were entered into the database and analyzed in the statistical program \"SPSS\". The difference between the examined groups was analyzed using the \"Mann-Whitney test\", and the statistical significance of the difference was analyzed using the \"Hi-square test\".</p><p><strong>Results: </strong>Out of 120 patients, 65 were females, and 56 were males with a mean age of 55,6 ± 11,9 years with a range of 24-83 years. Based on the type of treatment, on average, the youngest were patients in group 2 (51.2 ± 8.3 years, range 31-66 years), followed by group 3 (55.2 ± 12.6 years, range 29-82 years), and the oldest were patients in group 1 (60.3 ± 12.6 years, range 24-83 years). Statistical analysis using the \"Man-Whitney U\" test showed that there was a statistically significant difference in the average age by type of treatment (p < 0.05). Other socioeconomic factors did not show statistically significant differences among groups.</p><p><strong>Discussion: </strong>Our study highlighted the interplay between socioeconomic factors and treatment choices in glaucoma management. Younger, more informed patients were more likely to opt for newer therapies like laser treatment, while older patients often relied on traditional methods. Identifying these patterns is crucial for tailoring screening programs, optimizing treatment protocols, and improving overall patient outcomes.</p><p><strong>Conclusion: </strong>Our study demonstrates few socioeconomic differences between patients in different types of glaucoma treatment.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"385-390"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Star Can Vac Capsulorhexis in White Total Cataracts - A Retrospective Interventional Analysis.","authors":"Kodavoor Shreesha Kumar, Raju Sumithra, S Tamilarasi, Dandapani Ramamurthy","doi":"10.22336/rjo.2024.73","DOIUrl":"10.22336/rjo.2024.73","url":null,"abstract":"<p><strong>Aim: </strong>Completing circular uniform anterior capsulorhexis in intumescent white cataracts is challenging for all cataract surgeons. Numerous techniques have been described to get a circular capsulorhexis and prevent perpendicular linear tears in the anterior capsule.</p><p><strong>Methods: </strong>570 cases of white total cataracts were selected for this retrospective clinical study. In this technique of Star CanVac rhexis, the anterior lens capsule was nicked using a 26 G cystotome, and multiple centripetal tears were made in the center to create a small star-shaped opening. A vacuum was used to develop capsulorhexis, and a 25 G flat tip cannula attached to a 5 ml syringe half filled with balanced salt solution (BSS) was used to build capsulorhexis. The piston of the 5 ml syringe was withdrawn to create a vacuum to hold the free capsular flap. It was then directed circularly to get a round capsulorhexis. Oozing liquefied cortex was aspirated simultaneously with the same cannula.</p><p><strong>Results: </strong>This technique was successfully executed in 564 eyes. Six eyes had anterior capsular tears, 2 of which extended into the posterior capsule.</p><p><strong>Discussion: </strong>Intumescent cataracts often complicate the rhexis procedure due to increased lens volume and pressure. Over time, different methods have been refined to handle the pressure variation between the anterior chamber and the intralenticular area, such as mini-rhexis, double rhexis, sewing needle capsulotomy, and phaco capsulotomy. The primary goal of these procedures is to first reduce the elevated intralenticular pressure. Star CanVac capsulotomy facilitates equal pressure between the anterior chamber and the lenticular compartment, effectively reducing the risk of accidental capsular tears. Advantages of this approach include completing rhexis in one step, removing the liquefied cortex simultaneously, and relying on easily accessible instruments.</p><p><strong>Conclusion: </strong>Star CanVac capsulorhexis is an effective, safe, and alternative technique to conventional capsulorhexis in total white cataracts.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"404-408"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical study of immediate postoperative corneal edema in patients undergoing minor incision cataract surgery in a teaching hospital.","authors":"Anusha Aynala, Thanuja Gopal Pradeep","doi":"10.22336/rjo.2024.69","DOIUrl":"10.22336/rjo.2024.69","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Transient corneal edema is one of the most common complications observed after cataract surgery. If the center of the cornea is involved, it may result in impaired visual acuity in the immediate postoperative period. Hence, it concerns both the surgeon and the patient. Descemet's membrane detachment (DMD) is a less recognized cause of immediate corneal edema that can lead to long-term endothelial failure. Immediate recognition and surgical management may preserve vision in these patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To determine the proportion of corneal edema in subjects undergoing manual minor incision cataract surgery, grade them under slit-lamp examination and anterior segment optical coherence tomography, and correlate the findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We included patients who underwent manual small-incision cataract surgery (SICS) in the Department of Ophthalmology of a teaching hospital from November 2019 to May 2021. Postoperatively, all patients were subjected to detailed ophthalmic evaluation, and those with corneal edema underwent anterior segment OCT to determine the corneal edema and status of Descemet's membrane.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 922 patients who underwent manual SICS, 91 patients (9%) had corneal edema; the mean corneal thickness in the area of corneal edema on AS-OCT was found to be 726.92µm with an SD of 137.00µm and the mean CCT was 497.55 with an SD of 49.70. Seven patients (7.69%) had Descemet's membrane detachment (DMD) postoperatively, and the mean DMD at the highest point was 140.76µm. Five patients recovered with medical management; two were treated with anterior chamber air injection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussions: &lt;/strong&gt;Our study showed 9% corneal edema on postoperative day one, lower than other studies (18-44%). Diabetes mellitus type 2 was not associated with corneal edema in SICS cases, contrary to findings in phacoemulsification as reported in other studies. Pupillary manipulation was observed in only 2.2% of the cases, not being a risk factor. Surgeon experience significantly affected corneal edema, with trainee surgeons reporting more cases (44.5%, P=0.004). Hard cataracts (71.4%) caused higher endothelial damage, particularly in nuclear sclerosis grade NS5 (27.47%). The study underscores planning surgery based on cataract hardness, surgeon expertise, and proper intraoperative techniques to minimize complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Postoperative corneal edema following cataract surgery is a known complication usually resolved by medical management. More excellent surgical experiences with a shorter duration of surgery and proper instrumentation were associated with reduced early postoperative corneal edema. Early detection and classification of DMD with the help of AS-OCT for those requiring medical and surgical management aid recognize the clinically relevant DMD. Thus, a timely switch to surgical management help","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"379-384"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic orbital inflammatory disease - a diagnostic dilemma.","authors":"Sarita Lobo, Geover Joslen Lobo","doi":"10.22336/rjo.2024.83","DOIUrl":"10.22336/rjo.2024.83","url":null,"abstract":"<p><p>Orbital pseudotumor is nonspecific orbital inflammation (NSOI). It is a benign, non-infectious, space-occupying inflammatory lesion of the orbit. NSOI can affect various tissues in the orbit, such as the lacrimal gland and extraocular muscles. The most common classification is based on clinical presentation. Bacteria, viruses, fungi, or parasites can cause infectious orbital inflammation. It is a diagnosis of exclusion after ruling out inflammatory, infectious, and neoplastic causes. We present a case of a male in his sixties who presented with progressive pain, swelling, blurry vision, and forward protrusion of his right eye. He had no history of trauma or recent illness. His general physical and systemic examination was within normal limits. His ocular examination showed eyelid edema, erythema, eccentric proptosis, and a mature cataract in his right eye. His left eye showed a lenticular opacity. CT orbit revealed a homogenous isodense lesion observed without any globe distortion. A diagnosis of orbital pseudotumor was made. The patient was treated with oral corticosteroids, and an excision biopsy was done, resulting in symptomatic improvement and regression of inflammation at follow-up. In complex cases of inflammatory orbital pseudotumor, particularly those with granulomatous inflammation, some initial success has occurred with monoclonal antibodies against tumor necrosis factor (TNF)-alpha or with lymphocyte depletion using rituximab. Our patient, however, responded well to an excision biopsy and a course of oral steroids.</p>","PeriodicalId":94355,"journal":{"name":"Romanian journal of ophthalmology","volume":"68 4","pages":"462-465"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}