ABSTRACT
Objective: To determine the mean visual improvement after internal limiting membrane [ILM] peeling assisted with brilliant blue staining of ILM in macular hole, and stratify the mean visual improvement in different stages of macular hole. Study Design: Quasi-experimental study. Place and Duration of Study: Eye outpatient department [OPD], Lahore General Hospital, Lahore from October 2013 to December 2014
Methodology: Patients with macular hole underwent measurement of best corrected visual acuity [BCVA] and fundus examination with indirect slit lamp biomicroscopy before surgery. The diagnosis of all patients was confirmed on optical coherence tomography. All patients had 23G trans-conjunctival three ports pars plana vitrectomy, ILM peeling, and endotamponade of SF6. The mean visual improvement of different stages of macular hole was noted. Paired t-test was applied
Results: There were 30 patients, 15 males and 15 females [50%]. The mean age was 62 +/-10.95 years. They presented with low mean preoperative visual acuity [VA] of 0.96 +/-0.11 logMar. The mean postoperative VA was 0.63 +/-0.24 logMar. The mean visual increase was 0.33 +/-0.22 logMar [p <0.001]. In patients with stage 2 macular hole, mean visual increase was 0.35 +/-0.20 logMar [p < 0.001]. In patients with stage 3 macular hole, mean visual increase was 0.44 +/-0.21 logMar [p <0.001], and in patients with stage 4 macular hole it was 0.13 +/- 0.1 logMar [p = 0.004]
Conclusion: ILM peeling assisted with brilliant blue is a promising surgery for those patients who have decreased vision due to macular hole, in 2 - 4 stages of macular hole
ABSTRACT
To evaluate and manage the patients presenting with vitreous hemorrhage and intracranial hemorrhage simultaneously. Prospective observational study. A total of 6 patients presenting with vitreous hemorrhage were included in this case series. Study was conducted at Department of Ophthalmology Lahore General Hospital, Lahore. Detailed ocular examination including visual acuity, slit lamp examination and dilated fundus examination was done. Ultrasound B scans and CT brain was done in all patients. According to the clinical findings a management plan was formulated. Findings were recorded on a proforma for analysis. A total of 12 eyes of 6 patients [all males, age range 25-60 years were included in the study. Vision improved in two cases by conservative management and in one case by 23G pars plana vitrectomy. Vision remained the same on in one case, deteriorated in one and one patient was lost to follow up. Ocular complications in Terson's syndrome can have good outcome if treated conservatively and/or surgically
ABSTRACT
To evaluate visual outcome of patients diagnosed with Harada Disease. A prospective observational study A total of 4 patients presenting with exudative retinal detachment were included in this case series. Study was conducted in Department of Ophthalmology Lahore General Hospital, Lahore. Detailed ocular exam including visual acuity, slit lamp examination and dilated fundus examination was done. Fundus photos and Optical Coherence Tomography pre and post treatment was done in almost all patients. Patient A, 37/F, presented with VA CF OD and CF in OS and B/L exudative retinal detachment. After 4 weeks of treatment B/L retina was flat and BCVA was improved to 6/6 in Right eye and 6/9 in Left eye. Patient B, 35/F, presented with VA CF in both eyes and exudative retinal detachment. After 4 weeks of treatment B/L retina was flat and BCVA of both eyes was 6/6P.Patient C, 38/F, presented with BCVA 6/60 in both eyes and exudative retinal detachment. After 8 weeks of treatment B/L retina was flat and BCVA was 6/6 in both eyes. Patient D 20/F presented with VA CF in both eyes and B/L exudative retinal detachment. At 2nd follow-up visit [Post treatment 14 days] B.C.V.A. was 6/6P OD and 6/9 in OS. Patient is still under treatment and follow-ups. The visual prognosis is good for patients with Harada disease and the disease may manifest itself with minimum neurological features
ABSTRACT
To evaluate the role of polymerase chain reaction [PCR] for detection of Mycobacterium tuberculosis in the vitreous humor samples obtained from eyes with active uveitis. A total of 15 patients were included in the study with the signs of anterior, intermediate or posterior uveitis. Study was conducted in Department of Ophthalmology Lahore General Hospital, Lahore. Detailed ocular examination including visual acuity using Snellen's chart, slit lamp examination and detailed dilated fundus examination was done. All patients were advised complete blood count with ESR, Mantoux test and chest x-ray. Vitreous fluid samples were taken and sent for polymerase chain reaction for Mycobacterium tuberculosis [MTB] DNA. Vitreous samples from 15 [15-45 +/- 5yrs] patients, 9 male and 6 female, with signs of anterior, intermediate or posterior uveitis on slit lamp examination were taken and sent for Mycobacterium tuberculosis DNA on PCR. In 4 out of 15 samples [26.6%] Mycobacterium tuberculosis DNA on PCR was detected. Out of the 15 patients, 6 were females [15-45 years] with 1 [16.6%] positive PCR and 9 [15-40years] males with 3 [33.3%] positive PCR for Mycobacterium tuberculosis DNA. 2 of the male patients were positive for Toxoplasma and one of them was also positive for Cytomegalo virus on TORCH test. PCR can be effectively used for the diagnosis of intraocular tuberculosis in the presence of clinically identified cases of uveitis