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Curative Effect of Cataract Phacoemulsification with Iris Posterior Synechia
Sun Tangsheng,
Chen Liangju,
Zhao Guangyu,
Liu Lijuan,
Hong Linyong
Issue:
Volume 6, Issue 4, December 2021
Pages:
181-186
Received:
14 September 2021
Accepted:
5 October 2021
Published:
15 October 2021
Abstract: Background: Uveitis can cause blindness if not be appropriately managed. Anterior segment is common and frequent site in uveitis, can result in different degrees iris posterior synechia, iris depigmentation and atrophy, earlier form of cataract, etc. Surgery of cataract is complicated and prone to inflammatory reaction, especially in patients who involve anterior and posterior segment. Better operation technique and gentle maneuver is very important in such surgery. Aim: To investigate the application of phacoemulsification with IOLs implantation in cataract surgery with posterior synechia of the iris, and analyze its clinical effect. Methods: 36 cases (45 eyes) were enrolled from March 2019 to October 2020, diagnosed with chronic uveitis complicated cataract, treated with phacoemulsification combined with implantation of intraocular lens. Postoperative visual acuity and complications during operation were recorded. Results: Postoperative day 1, the best corrected visual acuity (BCVA) of 25 eyes (55.6%) were no less than 0.5, 14 eyes (31.1%) were 0.3~0.5, 6 eyes (13.3%) were 0.1~0.25; Anterior chamber inflammation emerged in 9 eyes (20.0%), more severe and recurrence of iris posterior synechia in 8 eyes (17.8%), pigmentation lost on IOLs in 7 eyes (15.6%). Intraocular pressure (IOP) after operation was 14.35±9.43mmHg (11 eyes were above normal, 6.0~25.0mmHg), no significance difference with preoperation IOP (t=0.25, p=0.80). No infectious endopthalmitis was found. 1 week after operation, the BCVA of 30 eyes (66.7%) were no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. Anterior chamber inflammation disappeared in all cases, 4 eyes (8.9%) with iris posterior synechia couldn’t be debonded, 3 eyes (6.7%) with iris dystrophy. Average IOP was 11.27±6.81mmHg, no significance difference with preoperation IOP (t=0.46, p=0.65). 1 month after operation, the BCVA of 30 eyes (66.7%) no less than 0.5, 13 eyes (28.9%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (10.92±5.94mmHg) was stable, and no significance difference with preoperation IOP (t=0.51, p=0.61). 3 months after operation, the BCVA of 33 eyes (73.3%) were no less than 0.5, 10 eyes (22.2%) were 0.3~0.5, 2 eyes (4.4%) were 0.1~0.25. IOP (11.06±5.71mmHg) was no change as preoperation (t=0.67, p=0.51). 4 (8.9%) and 3 (6.7%) eyes with iris posterior synechia and iris dystrophy respectively. Conclusion: Phacoemulsification and intraocular lens implantaion may be effective in the cataract surgery with iris posterior synechia, and timely mangement of possible complications after surgery maybe helpful for clinical outcomes.
Abstract: Background: Uveitis can cause blindness if not be appropriately managed. Anterior segment is common and frequent site in uveitis, can result in different degrees iris posterior synechia, iris depigmentation and atrophy, earlier form of cataract, etc. Surgery of cataract is complicated and prone to inflammatory reaction, especially in patients who i...
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Structural and Perfusional Study of Successfully Repaired Diabetic Tractional Retinal Detachment Involving the Macula
Miguel Angel Quiroz-Reyes,
Erick Andres Quiroz-Gonzalez,
Felipe Esparza-Correa,
Jennifer Hyuna Kim-Lee,
Alejandra Nieto-Jordan,
Boris Moreno-Andrade,
Jorge Morales-Navarro,
Federico Graue-Wiechers
Issue:
Volume 6, Issue 4, December 2021
Pages:
187-198
Received:
17 September 2021
Accepted:
8 October 2021
Published:
15 October 2021
Abstract: Purpose: Severe visual sequelae can be frequently observed in patients with diabetic tractional retinal detachment (TRD) involving the macula. We analyzed the postoperative structural spectral-domain (SD)-OCT and optical coherent tomography angiography (OCT angiography) findings in four selected eyes that were enrolled after successful anatomical diabetic macular detachment repair. These diabetic macular tractional detachments were evolved within 16 weeks. We also correlated the postoperative mean best-corrected visual acuity with the postoperative SD-OCT and OCT angiographic findings. Methods: This case series included 4 selected eyes of 4 patients with a mean diabetes evolution period of 18.4±4.8 years SD. Vitrectomy techniques were successfully used for TRD involving the macula. Postoperative SD-OCT, and final postoperative functional evaluations, including BCVA and OCT angiographic evaluation were performed at the final postoperative follow-up visit. Results: The mean difference between the preoperative (0.87±0.15) and final postoperative (0.35±0.21) BCVA was significant (p<0.05). The mean duration of vision loss before surgery was 11.6±2.3 weeks. The mean time for postoperative macular detachment resolution was 3.6±1.7 weeks SD. A mean follow-up evaluation of 13.1±2.7 SD months. Final postoperative imaging tests demonstrated multiple abnormalities of the foveal avascular zone and different areas of non-perfused macula on OCT angiography. The presence of disorganization of the retinal inner layers (DRIL) and chronic ischemic macular edema changes in 3 eyes (75.0%) as well as the OCT angiography abnormal findings in 3 (75.0%) were analized and correlated. Conclusion: In successfully reattached macula, postoperative microcirculatory abnormalities consistent with superficial and deep plexuses deficiencies and vessel densities alterations were detected as well as persistent DRIL, EZ and ELM line abnormalities.
Abstract: Purpose: Severe visual sequelae can be frequently observed in patients with diabetic tractional retinal detachment (TRD) involving the macula. We analyzed the postoperative structural spectral-domain (SD)-OCT and optical coherent tomography angiography (OCT angiography) findings in four selected eyes that were enrolled after successful anatomical d...
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Childhood Eyelid Pilomatricoma Mimicking Recurrent Chalazion
Asma Zaghdoudi,
Riadh Messaoud,
Molka Khairallah,
Sana Khochtali,
Rym Hadhri,
Sameh Mbarek,
Fatma Abid,
Wafa Ammari,
Anis Mahmoud,
Moncef Khairallah
Issue:
Volume 6, Issue 4, December 2021
Pages:
199-202
Received:
13 September 2021
Accepted:
5 October 2021
Published:
16 October 2021
Abstract: Pilomatricoma is a rare benign subcutaneous childhood tumor first described in 1880. It has no gender predilection. The exact etiology of this disease is still unknown. However, association with mutation in the CTNNB1 gene was reported. The most frequent location is the neck, although the upper eyelid is an uncommon site of involvement. The diagnosis of pilomatricoma is clinically challenging, and is based on histopathologic examination, after complete surgical excision, which is the radical treatment. It shows foreign body reaction that surrounds nucleated basophilic cells and islands of enucleated calcified ghost cells. The tumor may have diverse clinical presentations and aspects. It commonly manifests as an asymptomatic, solitary subcutaneous mass. Some clinical signs are specific such as the tend sign and the teeter-totter sign. Squamous and basal cell carcinoma are the main clinical differential diagnoses, and should be routinely ruled out. Radiologic investigations (ultrasonography and Magnetic resonance imaging: MRI) may enhance diagnosis accuracy in atypical cases. Ultrasonography shows hyperechoic and heterogeneous mass. MRI is more specific for diagnosis showing homogeneous well-defined mass on T1-weighted scans and high signal intensity on T2-weighted images. Pilomatricoma of the upper eyelid may be misdiagnosed and treated as recurrent chalazion. Recurrence and malignant transformation of pilomatricoma are rare after complete surgical excision. This case report is about a 14-year-old healthy boy who exhibited large pilomatricoma in the upper eyelid initially misdiagnosed and mistreated as chalazion.
Abstract: Pilomatricoma is a rare benign subcutaneous childhood tumor first described in 1880. It has no gender predilection. The exact etiology of this disease is still unknown. However, association with mutation in the CTNNB1 gene was reported. The most frequent location is the neck, although the upper eyelid is an uncommon site of involvement. The diagnos...
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Clinical Profile of COVID Patients During Recovery Phase at Tertiary Eye Care Centre in South India
Aliya Sultana,
Sana Fathima,
Amatul Raheem Sara
Issue:
Volume 6, Issue 4, December 2021
Pages:
203-208
Received:
22 September 2021
Accepted:
11 October 2021
Published:
21 October 2021
Abstract: BACK GROUND: Though Corona virus -19 first reported in china, Indian population in urban as well as rural areas were badly effected during second wave with involvement of various ocular structures, some patients lost vision due to retinal vascular occlusions, some patients required enucleation and orbital exenteration due to fungus infections of the eye. Patients reported with different ocular disorders were documented and intervened, were included in this study. We tried to understand whether these manifestations were due to Corona Virus or due to immune compression because of systemic disorders in Corona patients treated with oral steroids and unsterile oxygen support. Aim: Purpose is to study the various clinical manifestations noted in COVID-19 patients during second wave after treatment while recovering from the acute illness. Methods: Retrospective interventional study done at tertiary eye care centre. Duration of the study is 3months from April 2021 to June 2021.500 patients were presented to our tertiary eye care centre with various clinical manifestations. All patients underwent detailed systemic and ocular examination. Patients after treatment for COVID-19 at various hospitals across the country were presented to our institute with many opportunistic infections. Apart from history BCVA, Slit Lamp examination, fundus examination, OCT, Fundus Fluorescein Angiography and B Scan done in patients where media was hazy, documentation done in all cases. Systemic examination and other investigation like RT PCR for corona virus was done in all patients. Patients presented with orbital involvement were advised CT Scan orbit. Results: Most of the patients were badly effected with many ocular complications, very few patients could maintain normal visual acuity. Many patients developed diabetes mellitus, probably they were pre diabetics manifested after use of oral steroids. Conclusion: Second wave in India increased the mortality and also effected the quality of the life in survivors. Fatality was high due to various ocular complications in all individuals irrespective of age and immune status.
Abstract: BACK GROUND: Though Corona virus -19 first reported in china, Indian population in urban as well as rural areas were badly effected during second wave with involvement of various ocular structures, some patients lost vision due to retinal vascular occlusions, some patients required enucleation and orbital exenteration due to fungus infections of th...
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Pattern of Manifest Strabismus in Children Seen in a Tertiary Hospital in Rivers State, Nigeria
Henrietta Nwachukwu,
Adedayo Omobolanle Adio,
Godswill Inye Nathaniel,
Kareem Olatunbosun Musa
Issue:
Volume 6, Issue 4, December 2021
Pages:
209-214
Received:
19 July 2021
Accepted:
9 September 2021
Published:
28 October 2021
Abstract: Objectives: Manifest strabismus in children is a major cause of suboptimum visual experience with attendant impact on their development. This study aims to determine the pattern of manifest strabismus among children attending the Paediatric Ophthalmology clinic of the University of Port Harcourt Teaching Hospital, Rivers State. Materials and method: One hundred and twenty-five (125) children, aged 6 months to 18 years with manifest strabismus were consecutively selected and examined out of one thousand eight hundred and ninety-seven (1897) children seen at the Paediatric ophthalmology clinic of the University of Port Harcourt Teaching Hospital over a period of 18 months. Severely ill children with manifest strabismus, children with phoria, pseudo-strabismus and microtropia were excluded. Results: There were sixty-nine females (55.2%) and 56 males (44.8%). The male to female ratio was 1: 1.2. The prevalence of manifest strabismus was 6.6%. Eighty-two (4.3%) children had esotropia, 38 (2.0%) had exotropia while 5 (0.27%) had vertical deviation. Infantile (congenital) esotropia 34 (27.2%) was the most common type of esotropia observed, followed by accommodative esotropia 13 (10.4%), while infantile (congenital) exotropia 19 (15.2%) was the predominant type of exotropia. Conclusion: The prevalence of Manifest strabismus among children attending the Paediatric Ophthalmology clinic is high. Esotropia was the commonest form of Manifest strabismus seen.
Abstract: Objectives: Manifest strabismus in children is a major cause of suboptimum visual experience with attendant impact on their development. This study aims to determine the pattern of manifest strabismus among children attending the Paediatric Ophthalmology clinic of the University of Port Harcourt Teaching Hospital, Rivers State. Materials and method...
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Intra-operative Management of Torn Grafts and Small Grafts in Eyes Undergoing Pterygium Excision with Conjunctival Autografting
Shreesha Kumar Kodavoor,
Soundarya Balajee,
Ramamurthy Dandapani
Issue:
Volume 6, Issue 4, December 2021
Pages:
215-218
Received:
20 September 2021
Accepted:
2 November 2021
Published:
10 November 2021
Abstract: AIM-To demonstrate intraoperative techniques in managing torn grafts and small grafts in pterygium excision with conjunctival autografting (CAG). METHODS-Fifteen eyes that had graft tear during nasal pterygium excision with CAG and six eyes with small inadequately sized grafts during double head pterygium excision with split conjunctival grafting were included in the study. The graft tears occurred during dissection and the torn grafts were placed as separate pieces to cover the defect completely and in cases of double head pterygia with small graft on one side, a part of the graft from the other side (nasal or temporal) was used to cover the remaining defect. All the grafts were secured using tissue adhesives. RESULTS-Clinical outcomes in all cases were good. The recurrence rate was found to be 4.6%, with recurrence seen in one eye at four months post operatively. Other complications like graft edema and graft necrosis were also similar to those reported in previous literature for routine single head and double head pterygium surgeries. CONCLUSION- In complications like graft tear or small grafts, it is important to utilize the torn graft and part of the other graft in cases of split grafts and carefully resurface the bare area with proper orientation to give an adequate cover, in order to minimize recurrence.
Abstract: AIM-To demonstrate intraoperative techniques in managing torn grafts and small grafts in pterygium excision with conjunctival autografting (CAG). METHODS-Fifteen eyes that had graft tear during nasal pterygium excision with CAG and six eyes with small inadequately sized grafts during double head pterygium excision with split conjunctival grafting w...
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Optical Coherence Tomography as an Alternative for Diagnosing Polypoidal Choroidal Vasculopathy in Developing Countries
Armando Bautista-Barba,
Erick Andres Quiroz-Gonzalez,
Miguel Angel Quiroz-Reyes,
Mario Leon-Meza,
Alan Chew-Bonilla,
Danna Alexandra Alvirde-Ayala,
Federico Graue-Wiechers
Issue:
Volume 6, Issue 4, December 2021
Pages:
219-224
Received:
25 October 2021
Accepted:
11 November 2021
Published:
19 November 2021
Abstract: Introduction: Polypoidal choroidal vasculopathy (PCV) is a variant of neovascular age-related macular degeneration (nAMD). In clinical practice, PCV is frequently differentiated from nAMD or other retinal diseases using imaging modalities like optical coherence tomography, especially in ophthalmology clinics and hospitals which do not have access to indocyanine green angiography (ICGA), the gold standard in diagnosing PCV. As such, definite diagnosis of PCV is not possible in some cases and the actual prevalence of PCV remains unknown. Case series presentation: We have described a report of four patients without significant past medical history who presented with acute central or paracentral scotoma caused by PCV. Our approach to diagnosing PCV relied on the clinical manifestations of fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography imaging (SS-OCT). Conclusion: In the absence of ICGA and OCT angiography in developing countries, it is essential to distinguish PCV from other retinal diseases, especially neovascular age-related macular degeneration as the treatment and prognosis of PCV differs from that of other retinal diseases. We believe that the key features observed in FFA and SS-OCT can potentially be equivalent to the findings on ICGA in accurate diagnosis of PCV, which is essential in tailoring patient treatment plans, set expectations, and find more effective and precise solutions.
Abstract: Introduction: Polypoidal choroidal vasculopathy (PCV) is a variant of neovascular age-related macular degeneration (nAMD). In clinical practice, PCV is frequently differentiated from nAMD or other retinal diseases using imaging modalities like optical coherence tomography, especially in ophthalmology clinics and hospitals which do not have access t...
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A Higher-energy Accelerated Corneal Collagen Cross-linking Method for Keratoconus: A Retrospective, Observational Cohort Study
Minhui Wu,
Jing Yang,
Sheng Zhou
Issue:
Volume 6, Issue 4, December 2021
Pages:
225-230
Received:
3 November 2021
Accepted:
17 November 2021
Published:
23 November 2021
Abstract: Introduction: Primary keratoconus is a non-inflammatory corneal ectasia disease with an unknown cause. Nowadays, the most widely used treatment method is corneal collagen crosslinking based on the Dresden protocol. Due to the long surgery time, we have been searching for a new method which cost less time in surgery. Methods: A retrospective, observational cohort study was used. A total of 31 participants (59 eyes) with primary keratoconus were collected. Twelve of them (24 eyes) used the standard Dresden protocol, and the remaining 19 (35 eyes) used a higher-energy accelerated corneal collagen cross-linking method. Application of riboflavin solution to the de-epithelialized cornea for 10 min, then the cornea is UVA irradiated (wavelength, 365 nm and power, 30 mW/cm2) for another 3.55 min, and the total irradiation energy is 6.4J/cm2. Participants were followed up for 12 months after surgery and underwent complete examinations at 3, 6, and 12 months in predetermined windows of time. The examinations items include routine ophthalmological examination, uncorrected vision acuity (UCVA), best corrected visual acuity (BCVA), refraction, corneal curvature, the elevation of the thinnest point on front surface and back surface (F Ele Th, B Ele Th), the thickness of the thinnest point of the cornea (CT), and the density of the corneal endothelial cells (ECD). The independent sample t-test method was used to compare the changes of the parameters of the standard Dresden protocol and the higher-energy accelerated corneal collagen cross-linking. Results: In the A-CXL treatment group, the maximum keratometry value decreased by 1.48D from baseline, UCVA improved by an average of 0.07 logarithm of the minimum angle of resolution (logMAR) units, BCVA improved by an average of 0.15 logarithm of the minimum angle of resolution (logMAR) units. All of those are similar to standard Dresden protocol group. There were no significant changes in endothelial cell count and thickness of cornea 1 year after treatment. Conclusions: In this study, we found that accelerated corneal collagen cross-linking under 6.4J energy has a similar surgical effect as corneal collagen cross-linking under the Dresden protocol, and did not cause more adverse events.
Abstract: Introduction: Primary keratoconus is a non-inflammatory corneal ectasia disease with an unknown cause. Nowadays, the most widely used treatment method is corneal collagen crosslinking based on the Dresden protocol. Due to the long surgery time, we have been searching for a new method which cost less time in surgery. Methods: A retrospective, observ...
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Prevalence of Choroidal Melanoma in a Hill Population of Northern India
Deepesh Arora,
Anuj Sharma,
Devesh Sharma,
Bhavna Tiwari,
Abhishek Kumar,
Kanika Gupta,
Rohan Mehra,
Abhinav Arora,
Dinesh Sharma
Issue:
Volume 6, Issue 4, December 2021
Pages:
231-246
Received:
5 November 2021
Accepted:
29 November 2021
Published:
9 December 2021
Abstract: Aim: To assess prevalence and presentation of choroidal melanoma in a hill population of northern India along with its demographics, features, diagnostics, treatment and outcome with comparison to western population. Method: Choroidal melanoma constitutes most common intraocular malignancy with early appearance in Asian population. This is the 1st case series from a hill state of Uttarakhand, northern India involving medium to large size tumour with extraocular extension. In this retrospective study we assessed the prevalence, clinical presentation, diagnostic modalities, treatment plan, disease outcome, prognosis with survival and mortality. The study was carried out in time duration from February 2019- March 2021. Results: Data shows the presence of five patients, four male and 1 female in age range of 47-77 years, with median age at 62 years. Patient presented with visual equity in range of 6/18 to perception of light in time range of six months to 2 years. Fundus examination revealed presence of medium to large size choroidal mass with surface pigmentation and serous detachment. Neovascular glaucoma was present in three patients. Three patients underwent brachytherapy with I 125 and Ru 106, two cases responded well to therapy, one case presented with recurrence of tumour and neovascular glaucoma, underwent preenucleation radiation with external beam radiation therapy (EBRT) and the eye was lost following enucleation. Among five patients three underwent enucleation and thereafter were referred to surgical oncology for enlarged regional and cervical chain of lymph nodes for suspected metastasis. Histopathology via fine needle aspiration cytology (FNAC) or biopsy from whole specimen showed two cases of spindle cell, one of mixed cell variety and two of epitheloid cell type. Two cases of eitheloid cell type and one of spindle cell type needed EBRT as there was extraocular extension. All cases with enucleation were adviced an ocular implant. A diligent post treatment follow was maintained to look out for local recurrence and distant metastasis. Conclusion: Hill states have poor accessibility to healthcare. Our study shows existence of choroidal melanoma may be much larger than anticipated and cases could have been missed, hence making the need for dilated fundus examination a requirement and necessity. Histopathology, serology and imaging are much needed tools for diagnosis and staging of disease along with treatment of choroidal melanoma eventually indicating prognosis, survival and mortality. Treatment modalities as brachytherapy and EBRT are more frequently being used, indicating a shift in treatment more towards organ salvaging and preservation so as to maintain best visual function.
Abstract: Aim: To assess prevalence and presentation of choroidal melanoma in a hill population of northern India along with its demographics, features, diagnostics, treatment and outcome with comparison to western population. Method: Choroidal melanoma constitutes most common intraocular malignancy with early appearance in Asian population. This is the 1st ...
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Assessment of Inflammatory and Morphological Changes in the Conjunctival Cells in Relationship to the Degree of ProptosiS in Thyroid – Associated Ophthalmopathy
Mahmoud Elsamkary,
Heba Isaa,
Radwa Elsherif
Issue:
Volume 6, Issue 4, December 2021
Pages:
247-251
Received:
8 November 2021
Accepted:
3 December 2021
Published:
9 December 2021
Abstract: Aim: to evaluate the inflammatory and morphological changes in conjunctival cells and the relationship to the degree of proptosis for helping early diagnosis of thyroid -associated eye disease. Subjects and methods: cross sectional observational prospective study that included 40 patients complain from proptosis of thyroid eye disease attended to Ain shams university, Cairo, from May 2019 to November 2020 with control 40 normal person. Exclusion criteria included patients with History of surgical correction of thyroid eye disease, auto immune disease, Previous Lasik surgery, recent Intraocular surgery, diabetic patients and patients under steroid or immune suppressive treatment. All patients were subjected to History taking of thyroid disease with laboratory investigations to assess the thyroid functions, visual acuity measurement, intraocular pressure, Hertel's exophthalmometry for measurement of the degree of proptosis, color vision using Ishihara’s test, Funds examination and Conjunctival impression cytology. Images were taken using an Olympus CX31 microscope fitted with an Olympus E-620 camera. Results: The degree of inflammation in impression cytology showed that most of thyroid eye disease group is in moderate degree (80%) 32 cases, while the rest (20%) is between mild degree of inflammation (15%) 6 cases and severe degree of inflammation (5%) 2 cases. No statistically significant relation found between degree of proptosis and severity of inflammation of right and left eye with p-value = 0.650 and 0.331 respectively. Morphologically, most of thyroid eye disease group showed stage 2 in impression cytology results (65%) 26 cases, while the rest (35%) between stage 4, 3, 1 (5%, 15%, 15%, respectively). Conclusion: Detection of inflammatory and morphological changes occurring in conjunctiva of cases with thyroid –associated Ophthalmopathy by impression cytology can help in early diagnosis of thyroid-associated Ophthalmopathy patients even before appearance of other eye symptoms.
Abstract: Aim: to evaluate the inflammatory and morphological changes in conjunctival cells and the relationship to the degree of proptosis for helping early diagnosis of thyroid -associated eye disease. Subjects and methods: cross sectional observational prospective study that included 40 patients complain from proptosis of thyroid eye disease attended to A...
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Perfusion Findings in Surgically Resolved Myopic Foveoretinal Detachment
Miguel Angel Quiroz-Reyes,
Erick Andres Quiroz-Gonzalez,
Jorge Morales-Navarro,
Boris Moreno-Andrade,
Alejandra Nieto-Jordan,
Federico Graue-Wiechers
Issue:
Volume 6, Issue 4, December 2021
Pages:
252-262
Received:
16 November 2021
Accepted:
3 December 2021
Published:
10 December 2021
Abstract: Purpose: Published data on long-term macular perfusional findings and qualitative vessel density (VD) evaluation of myopic foveoretinal detachment (FRD) are limited. This study aimed to evaluate the OCT angiographic findings after uncomplicated successful macular surgery in fully surgically resolved myopic FRD. Methods: Between October 2016 and April 2020, an interventional, single-surgeon case series was conducted involving three structurally fully resolved highly myopic eyes with FRD. Long-term postoperative spectral domain-optical coherence tomography (SD-OCT) and functional and follow-up perfusion evaluations with SD-OCT and OCT angiography were performed. The main outcome was long-term structural and macular perfusion status after successful surgical resolution of myopic FRD. Results: The mean evolution time of myopic FRD was 7.33 ± 3.68 months. The mean follow-up time was 59.3 ±12.20 months and the mean time for resolution of myopic FRD was 4.6 ± 1.98 weeks. Using a paired-samples permutation test, we observed that surgery was associated with a significant improvement in visual acuity: best-corrected visual acuity decreased from logMAR 0.88 ± 0.15 pre-surgery to 0.36 ± 0.20 post-surgery (P<0.0001). Qualitative VD evaluation patterns were lower in eyes post-surgery than in normal emmetropic and highly myopic eyes. The observed foveal avascular zone (FAZ) area was large and irregular in fully resolved myopic FRD. A lack of SD-OCT structural postoperative findings and better qualitative perfusion findings were associated with better final visual results. Conclusion: The results revealed postoperative microstructural abnormalities on SD-OCT with VD qualitative deficiencies in the superficial vascular complex of the macula with FAZ abnormalities in the three eyes.
Abstract: Purpose: Published data on long-term macular perfusional findings and qualitative vessel density (VD) evaluation of myopic foveoretinal detachment (FRD) are limited. This study aimed to evaluate the OCT angiographic findings after uncomplicated successful macular surgery in fully surgically resolved myopic FRD. Methods: Between October 2016 and Apr...
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Frequency of Refractive Errors in Squinting Eyes of Children from 4 to 16 Years Presenting at Tertiary Care Hospital
Issue:
Volume 6, Issue 4, December 2021
Pages:
263-266
Received:
10 November 2021
Accepted:
3 December 2021
Published:
24 December 2021
Abstract: Purpose: To determine the frequency of refractive errors in squinting eyes of children from 4 to 16 years presenting at tertiary care hospital. Study Design: A descriptive cross-sectional prospective study was done. Place and Duration: The study was conducted in Paedriatic Ophthalmology, Hayatabad Medical Complex, Peshawar. The duration of the study was 15th Sep to 15th Oct, 2021. Materials and Methods: Sample size was 146 keeping 41.45% proportion of refractive errors in children with squinting eyes, 95% confidence interval and 8% margin of error under WHO sample size calculations. Non-probability consecutive sampling was done. Result: Mean age was 8.57±2.66 years. Male were 89 (61.0%) and female were 57 (39.0%). Refractive error was present in 56 (38.4%), including 9 myopic, 32 hyperrmetropic, and 15 astigmatic children, and was absent in 90 (61.6%) patients. 57 positive parent refractive error patients, 21 (36.8%) showed refractive errors. However, In 89 patients without parent refractive errors, 35 (39.3%) showed refractive errors, p value 0.763. Early use of electric equipment against the refractive error showed that of total 56 patients with early use of electric equipment, 24 (42.9%) showed refractive errors. In 90 patient without the early use of electric equipment, 32 (35.6%) showed refractive errors There was no association of gender, age, parent refractive errors or early usage of electric equipment with the refractive errors. Conclusion: Prevalence of refractive errors is high in patient with strabismus. There is no association of age, gender, parent refractive errors or early usage of electric equipment in the occurrence of refractive errors. Further studies are recommended for confirmation of these.
Abstract: Purpose: To determine the frequency of refractive errors in squinting eyes of children from 4 to 16 years presenting at tertiary care hospital. Study Design: A descriptive cross-sectional prospective study was done. Place and Duration: The study was conducted in Paedriatic Ophthalmology, Hayatabad Medical Complex, Peshawar. The duration of the stud...
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Unilateral Retinoblastoma Presentation in a Latin-American Teenager: A Case Report and Literature Review
Erick Andres Quiroz-Gonzalez,
Miguel Angel Quiroz-Reyes,
Cristina Gonzalez-Gonzalez,
Roberto Loaeza-Castrejon,
Luis Haro-Morlett,
Armando Bautista-Barba,
Emiliano Fulda-Graue,
Federico Graue-Wiechers
Issue:
Volume 6, Issue 4, December 2021
Pages:
267-272
Received:
2 December 2021
Accepted:
20 December 2021
Published:
29 December 2021
Abstract: Background: Retinoblastoma is the most common intraocular mass in children—typically presenting in infants under 5 years of age—with a mean age of 24 months in unilateral cases, and 12 months in bilateral cases. Late-onset retinoblastoma and its presentation in adults is extremely rare; however, it should always be considered for the differential diagnosis of an intraocular mass originating from the retina. Due to the life-threatening nature of this disease, early diagnosis and prompt treatment are crucial for a good prognosis. Objective: A tumor case presentation and multidisciplinary study of a female young adult. Method: A case presentation study of a Hispanic teenager with a unilateral retinoblastoma and vitreous exudation resembling a large snowbank. The patient underwent complete ophthalmological examination and subsequent enucleation, with histopathological confirmation of retinoblastoma accompanied by chemotherapy. Conclusion: Retinoblastoma presenting as an intraocular mass in a young adult should always be considered as a differential diagnosis. Echography is crucial to obtaining a diagnosis, as well as dictating precise and adequate treatment. We review the literature regarding cases of retinoblastoma, demonstrating that most exhibited differentiated characteristics and were sporadic in nature; in most cases, the eye could not be saved. Review of late-onset retinoblastomas was therefore conducted to enrich our existing knowledge, as well as to prevent making the same mistakes when facing a similar difficult diagnosis.
Abstract: Background: Retinoblastoma is the most common intraocular mass in children—typically presenting in infants under 5 years of age—with a mean age of 24 months in unilateral cases, and 12 months in bilateral cases. Late-onset retinoblastoma and its presentation in adults is extremely rare; however, it should always be considered for the differential d...
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Management and Outcomes of Retinoblastoma Cases Presenting to Children’s Hospital Westmead, Sydney Between 2008 and 2018
Julia Mary Starte,
Amir Taher,
Madeleine Powys,
Craig Donaldson,
Luciano Dalla-Pozza,
Bhavna Padhye,
Robyn Jamieson,
Michael Murray Jones
Issue:
Volume 6, Issue 4, December 2021
Pages:
273-280
Received:
30 November 2021
Accepted:
17 December 2021
Published:
29 December 2021
Abstract: This retrospective review reports on the management and outcomes of retinoblastoma in children treated at Children’s Hospital Westmead (CHW), Sydney. Results were compared to those of a previous retrospective review of RB cases presenting between 1974 and 2005 at the same centre, which was published in this journal. A retrospective review of all cases of retinoblastoma presenting to the Children’s Hospital Westmead Medical between 2008 and 2018 was conducted. 67 patients were included in the study with a mean age at presentation of 23.5-months and 9.2-months for unilateral and bilateral disease respectively. All patients in our cohort were offered genetic testing. The rate of germline RB1 mutation in our cohort was 29% for unilateral disease and 86% for bilateral disease. Mean follow-up period was 48 months. Globe salvage rates in patients with bilateral disease was 57%, compared to the previous study which was 47%. The most common treatment-related ocular complication was strabismus. Our cohort had only one patient develop metastatic disease and one patient who presented with trilateral disease, which was a case of delayed presentation and was the only mortality in the study. Morbidity and mortality rates in our cohort are on par with other tertiary centres internationally. There has been a significant improvement in globe salvage rate with our current management protocol. As intra-arterial chemotherapy is implemented into the treatment regime at CHW, these results will provide a benchmark to ensure that the excellent standards of care and outcomes are maintained.
Abstract: This retrospective review reports on the management and outcomes of retinoblastoma in children treated at Children’s Hospital Westmead (CHW), Sydney. Results were compared to those of a previous retrospective review of RB cases presenting between 1974 and 2005 at the same centre, which was published in this journal. A retrospective review of all ca...
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