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1.
Pakistan Journal of Medical Sciences. 2017; 33 (1): 142-145
in English | IMEMR | ID: emr-185493

ABSTRACT

Objective: To compare effectiveness of pan-retinal photocoagulation alone versus panretinal photocoagulation combined with intravitreal bevacizumab on visual acuity and central macular thickness in patients presenting with proliferative diabetic retinopathy


Methods: This Randomized controlled trial was carried out at Armed Forces Institute of ophthalmology, Pakistan from Jan 2016 to Aug 2016. Seventy six eyes of 50 patients having proliferative diabetic retinopathy and diabetic macular edema were included in the study. All the patients were subjected to detailed clinical examination that included Uncorrected visual acuity [UCVA], best corrected visual acuity [BCVA], slit lamp examination of anterior and posterior segments. Optical coherence tomography [OCT] and fundus fluorescein angiography [FFA] were carried out and patients were divided in two groups [GP and GI]. Three monthly sessions of Pan retinal photocoagulation [PRP] using Pattern Scan Laser [PASCAL] alone was performed in group GP while PRP along with three monthly intravitreal bevacizumab [IVB] was performed in group GI. BCVA and CMT was recorded 04 weeks after the third PRP session in both the groups


Results: Seventy six eyes of 50 patients [38 in each group] were treated with three sessions of PRP alone and PRP with IVB in Group GP and GI respectively. Mean age of the patient in group GP was 57.47 +/- 6.08 years while that in group GI was 55.69 +/- 6.58. The magnitude of induced change in BCVA was 0.09 +/- 0.15 in GP while 0.22 + 0.04 in GI groups while mean induced change in CMT after treatment was 77.44 +/- 92.30 um and 117.50 +/- 93.82 um in group GP and GI


Conclusion: Laser PRP combined with IVB has superior visual and anatomical outcome than PRP alone in patients with combined presentation of PDR and DME

2.
Pakistan Journal of Medical Sciences. 2017; 33 (5): 1101-1105
in English | IMEMR | ID: emr-189757

ABSTRACT

Objective: To compare post-operative pain relieving effect of topical diclofenac 0.1 0,5% in Corneal Collagen Cross Linking [CXL] for patients diagnosed with keratoconus


Methods: This randomized controlled trial was carried out for six months from October 2016 to March 2017. We included young patients having keratoconus with k-readings greater than 47D and central corneal thickness more than 400 microns. All the patients received single dose one drop of topical diclofenac 0.1% to [Group-A] and ketorolac 0.5% to [Group-B] 30 minutes in advance of the corneal collagen cross linking [CXL] procedure. The CXL was performed with topical 0.1% riboflavin eye drops in 20% dextran as a photo sensitizer. After 36 hours of the CXL procedure, the postoperative intensity of pain was assessed verbally by patients with the help of visual analog scale [VAS] numbers from zero to five where 0 designated no pain 6 5 symbolized worst pain


Results: The study comprised sixty eyes of forty one patients. Out of total 16 were male while 25 female patients. The mean age of the patients was 24.27 +/- 2.93 years [range 20 to 29 years]. In the conclusive analysis, diclofenac 0.1% was used on 30 patients in Group-A and ketorolac 0.5% on 30 subjects in Group-B. Pain relieving scores in Group-A [diclofenac 0.1%] was 2.57 +/- 0.67 while in Group-B [ketorolac 0.4% treated arm] was 3.20 +/-0.61


Conclusion: Topical diclofenac 0.1% is statistically comparable to topical ketorolac 0.5% in precluding severity of pain after corneal collagen cross linkage operation


Subject(s)
Humans , Male , Female , Adult , Keratoconus/diagnosis , Narcotics , Diclofenac , Pain, Postoperative , Ketorolac
3.
Pakistan Journal of Medical Sciences. 2016; 32 (5): 1158-1163
in English | IMEMR | ID: emr-183246

ABSTRACT

Objectives: To evaluate the effect of half adult dose of oral Rifampicin on mean change in best corrected visual acuity and central macular thickness in patients with central serous chorioretinopathy


Methods:Thirty-eight eyes of 31 patients with idiopathic central serous chorioretinopathy [CSCR] were registered. Unaided Visual acuity, best corrected visual acuity was documented and detailed slit lamp examination along with dilated ophthalmoscopy was performed. All subjects were treated with oral Rifampicin 300 mg [half adult dose] daily for 03 months. Patients underwent a complete ocular and systemic examination as well as central macular thickness [CMT] measurement by optical coherence tomography [OCT] every month after starting treatment until four months. Fundus fluorescein angiography [FFA] was performed in recurrent cases. Liver function tests were carried out prior to the treatment and during follow up period


Results:A total of 38 eyes of 31 patients [24 males, 07 females] were included in the study. Mean age of patients was 36.16+/-3.19 years [range 30-44]. Mean best corrected visual acuity [BCVA] before treatment was 0.56+/-0.11 and improved to 0.47+/-0.14 at 04 weeks [P<0.001] of treatment. The mean CMT at the time of presentation was 494.39+/-96.29 um and was decreased to 306.90+/-50.71 um after 04 weeks of treatment [P<0.001]. The mean induced reduction in CMT was 187.48+/-122 um [P<0.001] while that in BCVA 0.41+/-0.16 at 04 weeks of treatment [P<0.001]. Liver function tests were within normal range before and after the treatment


Conclusion:Half adult dose rifampicin [300mg] is effective and safe in treatment of central serous chorioretinopathy without causing any systemic imbalance

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