Intravitreal bevacizumab in central serous chorioretinopathy

To evaluate the effect of intravitreal bevacizumab injection in patients with central serous chorioretinopathy [CSCR]. Quasi-experimental study. Layton Rehmatullah Benevolent Trust Eye and Cancer Hospital, Lahore, from July 2010 to April 2011. There were 43 eyes of 32 adult patients with CSCR. Patients with choroidal neovascularization, prior treatment for CSCR, history of thromboembolism, intraocular pressure more than 21 mmHg, history of retinal detachment, intraocular inflammation, and allergy to fluorescence were excluded from study. All patients had intravitreal injection of off label bevacizumab. At baseline and follow-up visits, patients had best corrected visual acuity [BCVA] and central macular thickness [CMT] measurement with optical coherence tomography. They were followed-up for 6 months. Outcome measures included BCVA and CMT. Wilcoxon Signed Ranks test was used for evaluation of BCVA and CMT. There were 26 [81.3%] males and 6 [18.7%] females with 21 [65.5%] cases of unilateral and 11 [34.5%] cases of bilateral involvement. Mean age was 39.09 +/- 8.49 years. Nineteen [59.4%] eyes showed less than 6 months involvement and 13 [40.6%] eyes showed more than 6 months involvement. Mean number of injections required was 2.37 +/- 1.24 in acute cases and 3.05 +/- 1.39 in chronic cases. Overall mean of required injections was 2.67 +/- 1.34. Median visual acuity at baseline was 0.25 and at 6 months was 0.7 [p < 0.001]. Median CMT at baseline was 557 micro and at 6 months was 286 micro [p < 0.001]. Intravitreal bevacizumab injection was associated with visual improvement and reduced neurosensory detachment

Brown-Mclean syndrome with keratoconus

We report a case of unilateral Brown-McLean syndrome [peripheral corneal oedema] with bilateral keratoconus. A 30 years old lady presented with decreased vision in her right eye for the last 2 years. There was no history of surgery or trauma. Patient had no systemic illness. There was peripheral concentric corneal oedema extending 2.5-3.5 mm from the limbus involving right eye. On topography, we found bilateral keratoconus. To the best of our knowledge, this combination of Brown-McLean syndrome and keratoconus has not been reported before

Bilateral loss of light reflex and accommodation following 360 peripheral retinal laser therapy

We report a case of bilateral loss of pupillary light reflex and accommodation following 360° peripheral retinal laser therapy. A 24 years old male underwent prophylactic laser barrage for peripheral retinal lattice degenerations. Soon after the procedure, he developed bilateral loss of pupillary light reflex and accommodation. The patient faced difficulty while doing near work. On instillation of 0.125% pilocarpine, both pupils demonstrated the phenomenon of denervation supersensitivity. Damage to the short ciliary nerves was the most likely mechanism responsible for this adverse outcome

Menstrual irregularities with excessive blood loss: a clinico-pathological correlation

To evaluate various histo-pathological features in endometrial curettings of patients complaining of menstrual irregularities with excessive blood loss and correlating them with clinical presentations. A total of 260 endometrial curettings were obtained by Dilatation and Curettage done at the Department of Gynecology and Obstetrics, Railway Hospital, Rawalpindi. All the preserved specimens were processed under standard conditions at the Pathology Department, Islamic International Medical College [IIMC]. The sections were studied after staining with Haematoxylin and Eosin stain. The patients presented with menorrhagia in 51.9%, metrorrhagia in 35.4%, polymenorrhoea in 9.2% and polymenorrhagia in 3.5% cases. History of hormonal intake was observed in 0.66% patients. Menstrual disorders were most common in 41-50 years age group accounting for 48% cases. Pathology was diagnosed in 40% of endometrial biopsies. The endometrial lesions included endometrial hyperplasia [24.7%], chronic nonspecific endometritis [13%], endometrial polyp [1.2%], pill pattern endometrium [2.3%] atrophic endometrium [0.8%] menopausal pattern endometrium, squamous metaplasia, squamous cell carcinoma and chorioncarcinoma [0.4% each]. The dilatation and curettage was found to be an appropriate approach with a good diagnostic yield. Fortunately frequency of endometrial malignancy appeared to be very low. Endometrial hyperplasia was the leading causes of excessive menstrual bleeding