Large spot transpupillary thermotherapy: A quicker laser for treatment of high risk prethreshold retinopathy of prematurity - A randomized study.

To compare structural and functional outcome and time efficiency between standard spot sized conventional pulsed mode diode laser and continuous mode large spot transpupillary thermotherapy (LS TTT) for treatment of high risk prethreshold retinopathy of prematurity (ROP). Ten eyes of five preterm babies having bilateral symmetrical high risk prethreshold ROP were included in this study. One eye of each baby was randomized to get either standard spot sized conventional pulsed mode diode laser or continuous mode LS TTT. There was no significant difference between structural or functional outcome in either group. The mean time taken for conventional diode laser was 20.07 minutes, while that for LS TTT was 12.3 minutes. LS TTT was 40% more time efficient than the conventional laser. It may be better suited for the very small fragile premature infants as it is quicker than the conventional laser.

Severe aseptic orbital cellulitis with subtenon carboplatin for intraocular retinoblastoma.

Retinoblastoma is a rare intraocular tumor of childhood. Chemoreduction followed by laser or cryotherapy is the treatment of choice. Subtenon carboplatin injection is also an accepted treatment modality for vitreous seeds, along with systemic chemotherapy. Transient periocular edema, optic neuropathy and fibrosis of orbital tissues are the known side effects of subteneon carboplatin injection. We report a case of severe aseptic orbital cellulitis with necrosis and prolapse of the conjunctiva 48 h after the injection, which resolved well on only conservative management.

In vivo growth of retinoblastoma in a newborn infant.

Retinoblastoma is a rare malignancy of the retina seen exclusively in children. It is known to cause rapid growth inside the eye and hence treatment should be started as soon as it is diagnosed. We report a case in a five-day-old infant in whom treatment (chemotherapy) was delayed by a month due to high bilirubin levels secondary to physiological jaundice, which gave us the unique opportunity to measure the growth of the tumor over a month. This case emphasizes that immediate treatment is warranted once this rare disease is diagnosed.

Severe retinopathy of prematurity in big babies in india history repeating itself.

Objective. To describe the characteristics of babies with severe retinopathy of prematurity (ROP) attending a tertiary referral eye hospital in South India. Methods. Data on consecutive preterm infants with severe ROP presenting between July 2002 and October 2007 were retrieved from medical records. Severe ROP was defined as high risk prethreshold disease or worse. Results. 144 babies with severe ROP were divided into two groups: group 1 had high risk prethreshold or threshold ROP while group 2 had stages 4 or 5 ROP. The overall mean gestational age was 30.7 weeks (range 25–35 weeks) and the mean birth weight was 1410 g (range 650–2310 g). Most babies had received unmonitored supplemental oxygen (ascertained through discussion with the treating pediatricians). Conclusion. More bigger and mature babies are developing severe ROP in South India than in industrialized countries. The characteristics of babies affected are similar to those seen during the first epidemic of ROP which occurred during the 1950s in Europe and North America. Guidelines on oxygenation and screening policies should be jointly developed by pediatricians and ophthalmologists to end this epidemic of avoidable blindness in India.

Aicardi syndrome: The importance of an ophthalmologist in its diagnosis.

Aicardi syndrome is a rare genetic disorder. The salient features of this syndrome include agenesis of corpus callosum, chorioretinal lacunae and infantile spasms. Of these three, chorioretinal lacunae is the most constant feature present. This case highlights the importance of fundus findings by an ophthalmologist in making the diagnosis of this rare syndrome.