It is time for more colors!

Retinal drawing with a color-coding system brings uniformity in representation of fundus findings so that clinician can decipher various lesions on a two-dimensional drawing. Existing color coding addresses most of the common retinal pathologies including preretinal, intraretinal, and subretinal lesions. However, with the advent of various imaging modalities there is deeper understanding of microanatomy of retina and associated pathologies. With this, there appears further need of newer set of color coding to include the minute details of fundus findings clinically. Through this article, we discuss few common pathologies at different levels of retina layers with color-coding dilemma which calls for a better preciseness in its clinical representations

Optical coherence tomography angiography of fleeting macroaneurysm in retinal racemose angioma

We present a rare case of retinal racemose angioma complicated with fleeting macroaneurysm (MA). A 50-year-old female presented with diminution of vision in her right eye for 6 years. Fundus examination showed a racemose angioma with hemorrhagic MA temporal to the fovea in the right eye. On subsequent follow-ups, spontaneous thrombosis of MA was noted with the development of new MA inferior to the fovea, with intraretinal hemorrhage extending into the fovea. Focal laser to MA resulted in resolution of MA with improvement in vision. We report optical coherence tomography angiographic features of the fleeting MA in a case of racemose angioma.

Optical coherence tomography angiography features of choroidal hemangioma

This is an observational case series of four cases of choroidal hemangioma. All cases underwent OCT angiography with swept source OCTA (Topcon DRI OCT Triton plus) 6 mm * 6 mm protocol. OCTA at the level of large choroidal vessels demonstrated peculiar vascular pattern in all four eyes. Patterns observed were bag of worms, spaghetti like and vessels with terminal bulbs. In eye with diffuse choroidal hemangioma comparison of choroidal vascular pattern with the contralateral eyes showed significant difference in the vascular architecture. OCTA is an excellent non invasive tool in assessing the choroidal vascular pattern in eyes with choroidal hemangioma.

Effect of lanosterol on human cataract nucleus.

Aim: To study the effect of lanosterol on age‑related cataractous human lens nuclei. Materials and Methods: Forty age‑related cataractous nuclei removed during manual small incision cataract surgery were obtained and randomly immersed in 25 mM lanosterol solution or in control solution and stored at room temperature for 6 days. Pre‑ and post‑immersion photographs were graded by two masked observers and collated for the regression or progression of lens opacity. Results: Both lanosterol and control groups showed progression or no change in the lens opacity at the end of 6 days. Conclusion: Lanosterol 25 mM solution did not reverse opacification of human age‑related cataractous nuclei.

Sutureless scleral buckle in the management of rhegmatogenous retinal detachment.

Purpose: To evaluate the anatomical and functional outcomes of sutureless scleral buckling for the repair of rhegmatogenous retinal detachment (RD). Design: Retrospective interventional case series. Materials and Methods: Retrospective analysis of 50 eyes of 49 patients with rhegmatogenous RD, who underwent sutureless scleral buckling from January 2009 to March 2013. Results: Primary retinal re‑attachment rate of 86% was achieved with single surgery, but final anatomical success was 94% with additional interventions in the form of intravitreal gas, buckle revision, and/or pars plana vitrectomy. Best corrected logarithm of minimum angle of resolution visual acuity improved from 1.44 ± 1.01 preoperatively to 0.50 ± 0.40 at a mean follow‑up of 6.7 months. Conclusion: Sutureless scleral buckling achieves excellent anatomical and functional success in majority of the patients with rhegmatogenous RD.

Vascular tumors of the choroid and retina.

Vascular tumors of the retina and choroid can be seen occasionally. In the following article, the key clinical and diagnostic features of the major retinal and choroidal vascular tumors, their systemic associations, and the literature pertaining to the most currently available treatment strategies are reviewed.

Changing paradigms of anti-VEGF in the Indian scenario.

Anti-vascular endothelial growth factors (VEGF) agents have revolutionized the treatment of retinal diseases. Use of anti-VEGF agents in the Indian Scenario present some unique challenges considering the absence of compounding pharmacies, poor penetrance of health insurance and limited aff ordability of the citizens of a developing economy. To study the changing paradigms of anti-VEGF use in the Indian scenario, all articles published by Indian authors, data from web-based surveys amongst Indian vitreo-retinal specialists were reviewed. In the paucity of compounding pharmacies in India, fractionation and injection techniques diff er from those of developed countries. Frequent anti-VEGF monotherapy off ers the best anatomical and visual results, but economics of scale do not allow the same in the Indian scenario, resulting in PRN dosing and combination of anti-VEGF with laser photocoagulation, being the commonly employed treatment protocols.

Large Volume Osteosarcomas of the Femur Treated with Total Femoral Replacement

Patients with extensive malignancies involving the femur often require total femoral replacement when their limbs can be salvaged. Reported series are small and involve heterogeneity of tumours. We present nine patients with osteosarcomas of the femur treated at our institution between 2003 and 2010 with a mean follow-up of 27 (6 to 56) months. Their ages ranged from 9 to 17 (mean 14 years). They had large volume tumours (mean 911 cm3 ) and presented late with a mean of 5.5 months from the onset of symptoms to definitive treatment. All patients underwent resection and total femur replacement. Six patients have died and two are alive with good function at the time of this report. One was lost to follow-up. These patients require a high level of treatment care and have a guarded prognosis

Performance evaluation of common effluent treatment plant for tanneries at Pallavaram CETP.

The Pallavaram Tanners Industrial Effluent Treatment Company Limited has been a forerunner in ensuring cleaner and safe environment. The project was implemented by a company formed by the tanners of the Pallavaram area. Tamil Nadu Pollution Control Board (TNPCB) was the counterpart of UNIDO and took the overall responsibility for implementation of the project. The present study has been undertaken to evaluate performance efficiency of the treatment plant. Water samples were collected at different stages of treatment units and analysed for the major water quality parameters, such as pH, biological oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS) and total dissolved solids (TDS). The performance efficiency of each unit in treating the pollutants was calculated. The generated data presented evidence to that the common effluent treatment plant has been working with the norms of TNPCB and meeting the discharge standard limits.