Raised intraocular pressure following Intravitreal Triamcinolone Acetonide in diabetic versus non-diabetic patients

Objective: To determine the frequency of an increase in intraocular pressure [IOP] after intravitreal triamcinolone acetonide [IVTA] in diabetic versus non-diabetic patients with various chorio-retinal disorders

Methods: This prospective, interventional comparative case series was conducted at Isra Postgraduate Institute of Ophthalmology, Al-Ibrahim Eye Hospital, Karachi from May 2012 to April 2014. Two hundred thirty seven eyes of 180 patients were enrolled with 90 patients each in diabetic and non-diabetic group, requiring IVTA. IVTA 4mg/0.1ml was injected and IOP was measured at one week, one month, three months and six months in both groups of patients

Results: In diabetic group, 43 patients were male [47.8 percent] and 47 were female [52.2 percent], while in non-diabetic group, 56 [62.2 percent] patients were male and 34 [37.8 percent] were female. Mean age of patients in diabetic group was 52.21 +/- 9.6 years and in non-diabetic group was 51.13 +/- 10.75 years. The mean preoperative IOP was 13.6 +/- 2.8 mmHg and 14.1 +/- 2.4 mmHg in diabetic and non-diabetic group respectively. In diabetic group, mean [+/-SD] IOP was 16.4 +/-4.9 mmHg, 14.6 +/-3.6 mmHg, 17.6 +/- 9.7 mmHg and 15.5 +/- 7.09 mmHg at one week, one month, three months and 6 months post injection. While in non-diabetic cases, mean [+/-SD] IOP was 14.8 +/- 3.33 mmHg, 15.9 +/- 4.2 mmHg, 15.5 +/- 4.2 mmHg and 14.1 +/- 3.2 mmHg at one week, one month, three months and 6 months follow up. The raised IOP was observed in 117 eyes [49 percent] in both groups of patients, with 78 eyes [65 percent] in diabetic group and 39 eyes [33 percent] in non-diabetic group

Conclusion: After IVTA, an IOP rise was observed more in diabetics than non-diabetic patients

Giant trichobezoar mimicking gastric tumour

Abstract: We present a case of giant gastric trichobezoar retrieved through a long gastrotomy in a 40 years old married women from rural Sindh with unreported psychological disturbance. Trichobezoar almost exclusively occur in females with an underlying psychiatric disorder. It has an insidious development of symptoms which accounts for its delayed presentation and large size at the time of diagnosis. They are associated with trichophagia [habit of compulsive hair eating] and are usually diagnosed on CT Scans or upper GI Endoscopy. They can give rise to complications like gastroduodenal ulceration, haemorrhage, perforation, peritonitis or obstruction with a high rate of mortality. The treatment is endoscopic, laparoscopic or surgical removal and usually followed by psychiatric opinion