Double combined pigment epithelial and retinal hamartomas in a single eye: an optical coherence tomographic study.

Combined retinal pigment epithelial and retinal hamartomas are focal malformations composed of overgrowth of mature glial, vascular and pigmented cells. They are usually solitary and unilateral. In addition there are only a few optical coherence tomographic reports of the same. We report a rare case of twin hamartomas in the same eye and their unique optical coherence tomographic findings that are different from previous reports.

Electroretinographic assessment and diagnostic reappraisal of children with visual dysfunction: a prospective study.

PURPOSE: To assess the presence or absence of a retinal cause of visual impairment using electroretinography (ERG) in children with no obvious discernable cause on ocular examination. DESIGN: Prospective observational case series. MATERIALS AND METHODS: A prospective study was carried out involving 120 children with the mean age 4.4+/-3.2 years with visual dysfunction. All children underwent ERG under general anesthesia using a special handheld mini-Ganzfeld (Kurbisfeld) dome. RESULTS: Fifty-two (43.3%) children were male and 68 (56.7%) were female. The clinical diagnosis was as follows: Leber's congenital amaurosis (LCA) (n=47), achromatopsia (n=25), congenital stationary night blindness (CSNB) (n=9) and others (unclassifiable, n=39). The visual acuity ranged from perception of light (PL) to PL with projection in children with LCA. In the rest (n=73), some sort of visually guided behavior was discernable. Following ERG, a diagnostic reappraisal resulted as follows: LCA (n=49), achromatopsia (n=28), CSNB (n=4), cone-rod dystrophy (n=22), rod-cone degeneration (n=7), normal (n=8) and others (unclassifiable, n=2). Except for the two unclassifiable cases, ERG was successful in the diagnosis or exclusion of retinal dysfunction in the rest. By Pearson Chi-square test, there was a statistically significant association between the clinical and ERG diagnosis (P < 0.001). CONCLUSION: LCA was the commonest cause of visual dysfunction in our series. A statistically significant correlation between clinical and electrophysiological diagnosis was seen. ERG helped in firmly establishing the presence or absence of global retinal dysfunction in the majority (118/120) of pediatric patients with visual dysfunction.

Retinitis pigmentosa associated with blepharophimosis, blue dot cataract and primary inferior oblique overaction: a new syndrome complex?

A 15-year-old girl with retinitis pigmentosa, blepharophimosis, blue dot cataract and primary overaction of inferior oblique muscle in both the eyes is being reported. Computerized search using Medline did not reveal any such previously reported association.

Pigmented epiretinal membranes caused by RPE migration: OCT-based observational case reports.

Epiretinal membranes are cellular sheets on the retinal surface that are formed due to varied etiologies. We present two observational case reports to demonstrate the transretinal migration of the retinal pigment epithelium in pigmented idiopathic epiretinal membranes using optical coherence tomography.

Intravitreal injection of triamcinolone acetonide for diabetic macular edema: principles and practice.

Diabetic retinopathy is fast emerging as a leading cause of newly diagnosed legal blindness amongst the working population. Macular edema, as it is commoner, accounts for more vision impairment than neovascular proliferation in diabetic patients. Laser photocoagulation, which is the standard treatment of macular edema, is associated with significant complications and an improvement in visual acuity is unsatisfactory. Intravitreal injection of corticosteroids (especially triamcinolone acetonide) is an emerging treatment modality in the management of diabetic macular edema. This article presents an overview of the principles, technique and complications associated with this procedure.

Atypical manifestations of acute posterior multifocal placoid pigment epitheliopathy.

We report four patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) with atypical features which were unilaterality, serous detachment of the neurosensory retina, retinal vasculitis and papillitis. All patients responded well to oral corticosteroids. We suggest that systemic corticosteroids could be useful in selected cases of APMPPE with atypical clinical features.

Clinico-microbiological profile and visual outcomes of post-traumatic endophthalmitis at a tertiary eye care center in South India.

PURPOSE: To analyze the clinical and microbiological characteristics of eyes with post-traumatic endophthalmitis and factors influencing the visual outcomes in these cases. METHODS: We performed a retrospective chart analysis of the clinical and microbiological data of 97 consecutive patients with post-traumatic endophthalmitis presenting to a tertiary eye care hospital in South India. RESULTS: Thirty-nine (40.2%) cases were culture-positive, gram-positive cocci (n=24/42, 57.1%) being the commonest isolates. Staphylococcus epidermidis and Pseudomonas aeuruginosa were the commonest single isolates (n=10; 23.8%). Majority of the organisms were sensitive to chloramphenicol (n=27) or ciprofloxacin (n=26). Susceptibility to vancomycin (n=3) and amikacin (n=4) was poor. Cases with negative cultures at presentation were more likely to have improvement in visual acuity compared with culture-positive cases (on multivariate analysis, OR: 3.2, 95% CI: 1.1, 9.0). CONCLUSIONS: In this series of post-traumatic endophthalmitis, a high prevalence of resistance of the culture isolates to vancomycin and amikacin was observed.

Premacular haemorrhage associated with arteriovenous communications of the retina induced by a valsalva-like mechanism: an observational case report.

A 26-year-old woman presented with sudden defective vision in the right eye following lifting a heavy bucket of water. Examination showed a dense premacular subhyaloid haemorrhage associated with arteriovenous communications of the retina (AVCRs). Spontaneous absorption of the premacular haemorrhage with consequent improvement in the visual acuity was seen after two months. The possible aetiopathogenesis of the case is also discussed.

Double prepapillary arterial loops associated with superior branch macular artery occlusion.

Prepapillary arterial loops are congenital vascular anomalies that have been noted to cause arterial occlusions. We report a case of superior branch macular artery occlusion in an eye with two independent prepapillary arterial loops, following a Valsalva-like mechanism.

Persistent depot of triamcinolone acetonide after a single intravitreal injection.

The persistence of depot of triamcinolone at four months following a single intravitreal injection is described.