Retinopathy in a diabetic population.

AIMS AND OBJECTIVES: The study was conducted with the aim to find out the prevalence of diabetic retinopathy among diabetics on treatment, to find out the presence of associated risk factors and to determine the knowledge of diabetic retinopathy among patients with diabetic mellitus. METHODOLOGY: Cross sectional screening of 316 diabetic patients on treatment presenting to Kalimati Diabetic Clinic and Kathmandu Medical College was done over a period of 8 months for the presence of diabetic retinopathy, associated risk factors and the knowledge of diabetic retinopathy. RESULTS: 21% of the known diabetics had evidence of various grades of diabetic retinopathy although 75.3% of the enrolled patients had history of diabetes mellitus of less than 10 years. Associated risk factors were present in 66.46%. However, only 50% diabetics had the knowledge of diabetic retinopathy. CONCLUSION: As 21% of the diabetic patients on treatment had various grades of diabetic retinopathy and 50% of the diabetic patients were not aware of diabetic retinopathy, emphasis has to be given for the awareness of ocular involvement in diabetes mellitus such that blindness from retinopathy can be prevented. The responsibility lies on treating physicians or Diabetic Centres for referral of diabetic patients for ophthalmic evaluation. Similarly, control of associated risk factors like hypertension, hyperlipidemia is equally important.

Visual outcome of laser treatment in diabetic retinopathy.

OBJECTIVE: To determine the visual outcome of laser treatment in diabetic retinopathy. DESIGN: Prospective, non-comparative case series. MATERIALS AND METHODS: A total of 80 eyes of 50 patients with diabetic retinopathy in different stages were photocoagulated using diode green laser. Focal laser only was given in 46 eyes and pan retinal photocoagulation only was given in 29 eyes while 3 eyes received focal laser and pan retinal photocoagulation. One eye was given grid laser only and one eye received both grid and focal laser. The best corrected visual acuity was noted and fundus examination was carried out prior to laser therapy and at the last follow-up and results were compared. RESULTS: Non- proliferative diabetic retinopathy was present in 76%. Following laser treatment, best corrected visual acuity improved in 52.50%, remained static in 35% and deteriorated in 12.5%. Maculopathy improved in 52%, remained static in 6% and deteriorated in 2% in right eyes while there was no maculopathy in 40% in right eyes. Similarly, maculopathy improved in 38% and remained same in 10% while 52% had no maculopathy in left eyes. After laser treatment, NVD (OD) regressed in 6% and remained unchanged in 4%. Similarly, NVE (OD) regressed in 18% and remained unchanged in 4% and NVE (OS) regressed in 18% and remained unchanged in 2% following laser therapy. CONCLUSION: Timely and adequate laser treatment helps in saving the vision in patients with diabetic retinopathy.

Intermediate uveitis: a hospital based study.

Intermediate uveitis affecting pars plana, peripheral retina and underlying choroid affects primarily healthy children and young adults. OBJECTIVE: To study the components of intermediate uveitis at Nepal Eye Hospital in the year 2003 August to 2004 March. MATERIALS AND METHODS: A prospective study was done in patients with intermediate uveitis visiting Nepal Eye Hospital. Sample size was 50. Specially designed proforma of intermediate uveitis was used to collect particulars of the patients, history, clinical examination findings, investigation reports, management protocols used and the final visual outcome. RESULTS: Intermediate uveitis was seen more in 20 to 29 years age group (38%) and more prevalent in males (52%). Among the study population farmers constituted maximum proportion (36%) and Mongoloid origin was mostly affected (30%). High number of patients were from the central development region with highest proportion from Dhading district (34%). Anterior segment affection with keratic precipitates and anterior chamber cells were noted in 72% of involved eyes. Vitreous cells were noted in all affected eyes while 4% had vitreous snow banking and 3% had vitreous snow balls. Most of the patients (52%) received between topical steroid and posterior subtenon injection of Triamcinolone. Visual Acuity was improved in 52% of cases and remained static in 46%.while deteriorated in 2%. CONCLUSION: Significantly high number of patients with intermediate uveitis has been reported from the central development region mainly from Dhading Kathmandu and Nuwakot districts People in their third decade were found to be commonly involved and Mongloid origin were more commonly affected Anterior chamber spill over was seen in higher percentage of patients than described in literature As the patients presented in milder forms visual acuity improved is of cases with the treatment protocol followed.

Case of xeroderma pigmentosum with well differentiated squamous cell carcinoma in the eye.

A seven year old female child presented with complaints of increased freckling over the face since the age of two years and a rapidly growing mass over the right eye. She underwent excisional biopsy of the mass over the eye which on histopathological examination was diagnosed as squamous cell carcinoma.

Analysis of 400 cases of posterior segment diseases visiting retina clinic of Nepal Eye hospital.

OBJECTIVE: To determine the disease pattern of 400 patients attending Nepal Eye Hospital for strategic planning. MATERIALS AND METHODS: A retrospective hospital based analysis of 400 cases visiting Retina Clinic of Nepal Eye Hospital (NEH) over a period of one year was carried out in order to know the disease pattern for planning purpose. RESULTS: Males slightly outnumbered females (58% versus 42%). The diseases were more common in age group 50 to 59 years. Diabetes mellitus with or without retinopathy was the commonest cause (20.25 %) for attendance in retina clinic followed by hypertensive retinopathy and venous occlusive disorders.