ABSTRACT
Traumatic glaucomas are a very heterogeneous group of entities due to a variety of mechanisms which increase the intraocular pressure in the early or late phase after traumatic injury. Glaucoma after closed globe injury is a major concern because many cases may go unnoticed and are diagnosed many years later as having irreversible glaucomatous optic nerve damage.[1,2] Angle recession is one of the causes for late onset posttraumatic glaucoma; this condition may be underdiagnosed because the onset is often delayed and because a history of eye injury may be distant or forgotten.
ABSTRACT
Purpose: To study the efficacy of dexamethasone (DEX) intravitreal implant followed by macular laser after 1-month for diffuse diabetic macular edema (DDME). Methods: Interventional case series of 49 eyes of 33 patients with DDME attending the retina clinic from November 2013 to December 2014. All patients underwent detailed ophthalmic evaluation followed by fluorescein angiography and optical coherence tomography. The sequential macular laser was done after 1-month after DEX implant. All patients had a minimum follow-up of 6 months. Results: Mean age was 58.33 years ± 9.4 years, mean best corrected visual acuity (VA) was 0.5418 logMAR units at presentation improved to 0.4748 at 1-month and maintained 0.4385 at 3 months and 0.4376 at 6 months follow-up (P = 0.01). Mean Central macular thickness was 529.2 μ at presentation reduced to 285.4 μ at 1-month and maintained 296.1 μ at 3 months and 321.1 μ at 6 months follow-up (P = 0.0001). Total macular volume was 11.78 mm3 at presentation reduced to 7.78 mm3 at 1-month and maintained 7.97 mm3 at 3 months and 8.1 mm3 at 6 months follow-up (P = 0.0001). Conclusion: DEX intravitreal implant followed by macular laser showed favorable results by decreasing macular edema and improving VA in DDME, where the role of laser alone is limited.
ABSTRACT
Purpose: The purpose was to compare the ocular perfusion pressure (OPP) and the pulsatile ocular blood flow (POBF) in normal and systemic hypertensive patients. Materials and Methods: Totally, 121 individuals (normal n = 60, systemic hypertension patients n = 61) were enrolled in this prospective age-matched comparative study. Intraocular pressure (IOP) and systemic arterial pressure were measured in seated position with 2 min interval between the measurements using Goldmann applanation tonometer (GAT) and tycos sphygmomanometer, respectively. The OPP was calculated as 2/3 of mean arterial pressure (MAP) minus IOP. After 5 min in the seated position POBF measurements were taken with the ocular blood flow (OBF) tonograph. Results: Mean age was 57.5 years (range 35-72 years) in the normal group and 59.6 years (range 36-78 years) in the hypertensive group; majority of the patients were female (68.5% and 71% respectively in each group). Measured parameters in both the groups showed, systolic blood pressure (BP) (143.6 ± 20.5 mmHg vs. 121.9 ± 17.5 mmHg), diastolic BP (90.7 ± 13.5 mmHg vs. 80.1 ± 9.9 mmHg), MAP (108.4 ± 14.2 mmHg vs. 94.2 ± 11.2 mmHg), and OPP (57.6 ± 14.6 vs. 48.7 ± 10.6 mmHg) were significantly greater (P = 0.001) in systemic hypertensive patients in comparison to normals. However, there was no difference in OBF tonograph values in both groups. The IOP measured by the OBF tonograph was higher than GAT in both groups, but the difference was not statistically significant (P = 0.41). Conclusion: Systemic hypertensive patients have a higher OPP in comparison to normal patients, but they do not have higher POBF. More studies are required to evaluate the role of the OPP in different ocular pathologies affecting the POBF.
ABSTRACT
Purpose: The purpose was to assess the incidence of strabismus, relationship of strabismus with type, and width of the scleral buckle (SB) after SB surgery for retinal detachment. Methods: Retrospective analysis of 360 eyes of 344 patients, treated for rhegmatogenous retinal detachment with SB surgery between January 2008 and January 2013 was done. Results: The mean age of patients was 38.45 ± 18.12 years (range: 7-89 years) was detected in 48 out of 344 (13.95%) patients at 6 weeks after SB surgery. Horizontal deviation was the most common type. Incidence of strabismus was higher after repeat SB surgery (4/9, 44.4%) compared to patients who had single SB surgery (44/335, 13.1%) (P = 0.02). Strabismus was observed in 18.5% of patients with implants, compared to 11.3% of patients who received explants (P = 0.02). Strabismus surgery was performed on 2 (4.1%) cases. Conclusion: Horizontal strabismus is common after SB surgery for repair of retinal detachment. Repeat scleral buckling and use of implants resulted in a higher incidence of strabismus in the post-operative period. Majority of these cases resolve with conservative management.