Trans-tenon's retrobulbar infusion of triamcenalone for treatment of intermediate uveitis

To find out the efficacy and complications of triamcenalone acetonide injection given in transtenon retrobulbar space for treatment of intermediate uveitis. Department of Opthalmology, Ganga Ram Hospital Lahore, from January 2005 to December 2006. Twenty eyes of twenty patients with intermediate uveitis uncontrolled with systemic corticosteroids were injected with 20 mg of triamcenalone acetonide in trans-tenon retrobulbar space using long, round tip cannula via incision through conjunctiva and tenon's space. Results were analyzed for visual outcome and any side effects. Follow up was at one week post injection, followed by monthly interval for three consecutive months. At one week post injection, there was no change in visual acuity [except one patient which showed improvement]. Mean visual acuity improvement was observed in sixteen eyes one month after triamcenalone injection, while one eye showed worsening and remaining two eyes showed no change in vision. No patient was repeated with triamcenalone injection during the three month follow up. All patients systemic steroids were discontinued after trans-tenon injection. Complications like cataract and raised intra-ocular pressure were not observed in any patients during the study period. This study demonstrates that trans-tenon [retrobulbar] injection of triamcenalone acetonide to be effective treatment for decreased visual acuity associated with intermediate uveitis. Systemic steroids may be discontinued and there is a high level of patient acceptability for this technique. Further follow up is required to demonstrate its long-term efficacy

Frequency of retinopathy among diabetics admitted in a teaching hospital of Lahore

Diabetic retinopathy is a complication of diabetes that affects the blood vessels of the retina and leads to blindness. Although 4 ' 8 million diabetics exist in Pakistan, very little work has been done on this complication of diabetes. The present study was undertaken to estimate the frequency of retinopathy among diabetics admitted in a teaching hospital of Lahore. Every patient of diabetes mellitus, admitted in departments of Medicine, Surgery, Ophthalmology and Obstetrics and Gynecology at Sir Ganga Ram Hospital, Lahore between June 2001 and September 2001 was included in the study. After adequate mydriasis, detailed fundus examination using indirect opthalmoscope was carried out to determine the presence of diabetic retinopathy and its type. Out of 4414 admissions, 540 patients ' 340 females and 196 males were diabetics. Among 540 diabetics, 132 had Type-1 diabetes [24.4%] while 408 had Type-2 diabetes [75.6%]. The duration of diabetes ranged from 10 to 12 years. The prevalence of diabetes among admitted patents was 12.2%. Among these 540 diabetics, 180 had diabetic retinopathy showing a prevalence of 33.3%. Non-proliferative retinopathy was present in 21.5% diabetics and proliferative retinopathy among 11.8% diabetics. The prevalence of retinopathy was significantly higher [P<0.001] among males [42.8%] as compared to females [27.9%]. The prevalence was similar [33.3%] among both Type-1 as well as Type-2 diabetes as well as similar to that reported from other countries. Since 33.3% of our diabetic population is suffering from retinopathy ' a condition amenable to timely and cost-effective treatment, every diabetic should be made aware of the importance of regular ophthalmologic examination