Relationship between intraocular pressure and body mass index

To determine the relationship of intraocular pressure [IOP] with body mass index [BMI]. A cross-sectional comparative study. Armed Forces Institute of Ophthalmology, Rawalpindi, from February 2010 to July 2010. Three hundred subjects meeting inclusion and exclusion criteria were enrolled. IOP was recorded. Height and weight were measured and BMI was calculated. IOP showed positive relationship with BMI. A BMI change by 1 kg/m[2] corresponded with a change in IOP by 0.23 mmHg [p<0.01] in males and 0.14 mmHg [p=0.004] in females. A positive relationship was found between IOP and BMI in both genders

Comparison of pressure lowering effects of timolol/dorzolamide combined preparation versus latanoprost in primary open angle glaucoma

To compare the intraocular pressure [IOP] lowering effect of Timolol/Dorzolamide combined preparation to that of Latanoprost in eyes with primary open angle glaucoma. Randomized control trial [RCT]. The Eye department, Military Hospital, Rawalpindi, over six months, from 9th June 2008 to 8th December 2008. Eighty Six patients included were divided into two equal groups. Initial IOP measurement was taken for every patient using Goldmann Applanation Tonometer with Fluorescein. Topical Antiglaucoma therapy was started in patients of either group. Group A patients were administered timolol/dorzolamide combined preparation where as latanoprost was administered to group B patients. Follow up IOP measurements were recorded at 4 week and 8 week interval for every patient and findings were endorsed on a pre-designed proforma. Data were analyzed using SPSS version 11.0. Eight week follow up IOP of Group A [14.51 +/- 2.54] was significantly lower than the initial IOP [19.37 +/- 2.49] [p<0.05]. For Group B, difference between initial IOP [19.53 +/- 2.69] and 8 week follow up IOP [14.09 +/- 2.23] was also statistically significant. The difference between mean IOP of the two groups at 4 week [p=0.284] and at 8 week [p=0.419] follow up was not statistically significant. Frequency of cases with >/= 4 mm Hg drop at 4 week follow up was 26 [60.46%] in group A as against 29 [67.44%] in group B [p=0.50], whereas at 8 week follow up it was 31 [72.09%] for group A and 34 [79.07%] in group B [p=0.451]. The results suggest that latanoprost monotherapy and timolol/dorzolamide combined therapy is equally effective in controlling IOP in patients with POAG.

Comparison between loss variance of tendency-oriented perimetry and normal strategy perimetery using octopus 32 program

To compare the values of loss variance [LV] obtained by a faster strategy- Tendency oriented perimetry [TOP] with those obtained by a standard stair casing strategy i.e. normal test strategy using OCTOPUS 32 program. Cross-sectional comparative study. Eye Department of Military Hospital Rawalpindi from February 15, 2007 to October 10, 2007. A total of 61 eyes were included in the study. Thirty with normal ocular examination and 31 with ocular pathologies producing visual field defects. Each eye was analysed with the normal [stair casing] test strategy and TOP strategy using 32 programs on Octopus 311 perimeter. LV was compared for two strategies. There was statistically significant difference between LV obtained from TOP and Normal strategy [p = 0.001]. TOP strategy tends to obtain fields with less pathological results especially for the calculation of the extent and depth of each scotoma in comparison with the normal strategy

Amniotic membrane transplantation in primary pterygium compared with bare sclera technique

To compare the excision of primary pterygium by bare sclera technique and excision combined with amniotic membrane transplantation [AMT]. An experimental study. Eye Department, Military Hospital, Rawalpindi, presently known as Armed Forces Institute of Ophthalmology, Rawalpindi, from May 2007 to July 2008. A pilot study of 70 patients was conducted. Patients were divided in two groups. In group I, pterygium excision was done by bare sclera technique while in group II, AMT was done after excision. Patients were followed for 6 months. Proportion of recurrence of pterygium was noted in each group and compared with chi-square test with significance at p < 0.05. Number of patients who presented with recurrence of pterygium in group-I were 12 [37.5%] and in group-II were 4 [12.9%]. Chi-square tests showed that there was a statistically significant difference in frequency of recurrence between the two groups [p = 0.025]. AMT after excision of pterygium appeared to be safe and effective way of treating primary pterygium as compared to bare sclera technique due to lesser recurrence at 6 months

Comparison of preoperative and intraoperative mitomycin C in prevention of pterygium recurrence and postoperative complications

To compare the frequency of recurrence and corneoscleral complications with pre-operative and intraoperative mitomycin C when used with excision of primary pterygium by bare sclera technique. Quasi experimental study. Armed Forces Institute of Ophthalmology Rawalpindi. Ten months [October 2006 to July 2007]. A total of 70 cases with primary pterygium were selected and divided equally into group A and B. in cases of group A, 0.1cc of 0.15 mg/ ml of MMC was injected sub-conjunctivally and pterygium excision with bare sclera technique, a sponge soaked in 0.04% MMC was applied over the bare sclera for three minutes intraoperatively. The patients were followed up to see recurrence and corneoscleral complications for three months. A total of 70 cases, 35 in each group were analyzed statistically. Mean age of group A was 40.83 +/- 12.655 years whereas that of group B was 44.57 +/- 13.718 years. Group A had 28 [80%] males and 7 [20%] females. Group B had 23 [65.7%] males and 12 [34.3%] females. Number of patients who presented with recurrence in group A was 1 [2.9%] and group B were 4 [11.4%]. In group A no patient presented with corneoscleral complications during the study whereas in group B these complications were seen in 7 [20%]. Chi-square test revealed no significant difference in recurrence [P=0.356] whereas it showed significant difference in corneoscleral complications between the groups [P=0.011]. Preoperative MMC is as effective as intraoperative MMC in preventing recurrence but it is much safer than intraoperative MMC causing less corneoscleral complications

frequency of preclinical nephropathy in patients of type II diabetes mellitus with diabetic retinopathy

Objective: To determine the frequency of preclinical nephropathy in patients with diabetic retinopathy and its correlation to the severity of retinopathy

Study Design: Prospective case study

Place and Duration of Study: Department of Ophthalmology, Military Hospital [MH], Rawalpindi for six months

Methods: Ninety [90] diabetic patients [thirty in each grade of retinopathy i.e. background, preproliferative and proliferative] with no known renal dysfunction were included in the study. They were investigated for albumin/creatinine ratio a sport urine sample. The outcome of renal function was described as either positive or negative. The cutoff value for albumin creatinine ratio was 200 mg/g. The various grades of retinopathy were compared to the values of urine albumin creatinine ratio, to find the correlation

Results: Five [17%] patients with background diabetic retinopathy had preclinical nephropathy. Seventeen [60%] patients with preproliferative diabetic retinopathy and 27 [90%] of patients with proliferative diabetic retinopathy had preclinical nephropathy. The frequency of nephropathy correlated to the severity of retinopathy [correlation co efficient, r value: 0.630] and p value of <0.001

Conclusion: it is important for ophthalmologists to carefully consider the renal status of any patient with retinopathy as this can influence the progression of retinopathy and its response to treatment

Interferon associated retinopathy

Interferon is an immunomodulating cytokine which is used to treat different diseases. Nowadays it is being commonly used for the treatment of chronic hepatitis C. Few patients develop ocular complications secondary to the use of Interferon. We report here a case in which a young soldier with no other risk factors developed retinopathy changes after five months of interferon alpha 2b therapy which included cotton wool spots at the posterior pole and dot-blot haemorrhages in both fundi. These changes gradually started resolving after cessation of treatment and completely disappeared after six months

Spontaneous resolution of direct carotid cavernous fistula

Proptosis due to carotid cavernous fistula is rare sequelae of head injury. We report a case of post-traumatic, direct high flow carotid cavernous fistula that resolved spontaneously 06 weeks after carotid angiography. It however, resulted in loss of vision due to delay in early treatment. In the cases of post-traumatic proptosis, carotid cavernous fistula should be kept in mind

effect of hyaluronidase on the quality of ocular akinesia in sub-tenons local anaesthesia in cataract surgery: a hospital based study

This prospective double blind study was conducted at Ophthalmology Department of Military Hospital Rawalpindi, to know the effect of hyaluronidase on the quality of ocular akinesia achived with sub Tenons local anaesthesia. A total of 200 patients scheduled for cataract surgery were randomized into study and control groups of 100 patients each. The study patients were given 3 ml 2% Lignocaine with adrenaline 1;200,000 and hyaluronidase 30 iv/ml, while the control group was given 3 ml Lignocaine 2% with adrenaline 1: 200,000 sub Tenons anaesthesia. Akinesia was measured 10 minutes after local anaesthetic injections were significantly better in the study group as compared to the control group. It shows that addition of hyaluronidse to local anaesthetic solution significantly improves the quality of ocular akinesia achieved with sub-Tenons local anaesthesia [p. less than 0.005]