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Purpose: To elucidate changes in the neuro?sensory retina at the macula, using spectral?domain optical coherence tomography (SD?OCT) in type 2 diabetics without clinical signs of diabetic retinopathy, and compare with healthy subjects. Methods: This was a cross?sectional observational study, conducted at a tertiary eye institute from November 2018 to March 2020. Type 2 diabetics visiting the outpatient department with normal fundus (without any clinical signs of diabetic retinopathy) were taken as Group 1, and healthy subjects as Group 2. Both underwent recording of visual acuity, intraocular pressure (non?contact tonometry), slit?lamp anterior segment examination, fundus examination using an indirect ophthalmoscope, and macular SD?OCT. SPSS (Statistical Package for Social Sciences) version 20 [IBM SPSS statistics (IBM corp. Armonk, NY, USA released 2011)] was used to perform the statistical analysis of the data entered in the excel sheet. Results: Our study included 440 eyes of 220 subjects, divided equally into two groups. The mean age of patients with diabetes was 58.09 ± 9.42 years, and of controls 57.25 ± 8.91 years. The mean BCVA in group 1 and group 2 was 0.36 ± 0.37 and 0.21 ± 0.24 logMAR, respectively. SD?OCT showed thinning in all areas in group 1 compared to group 2, but statistically significant thinning was seen only in the central subfield (P = 0.0001), temporal parafoveal (P = 0.0001), temporal perifoveal (P = 0.0005), and nasal perifoveal areas (P = 0.023) in group 1. There was a significant inter?eye difference noted between the right and left eyes in nasal and inferior parafovea only in group 1 (P = 0.03). No significant difference was noted between males and females. Conclusion: There was significant macular thinning in diabetics compared with controls, which denotes the occurrence of neuronal damage in these eyes before clinical evidence of diabetic retinopathy.
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Purpose: To evaluate the prevalence of different types of peripheral retinal changes in a myopic population in North India and correlate them with axial length. Methods: This cross?sectional, hospital?based survey included 600 eyes of 300 myopic individuals, aged between 10 and 40 years, attending the outdoor ophthalmology clinic of a tertiary eye care hospital in North India were examined from July 2019 to July 2020. They were divided into mild, moderate, high, and severe myopia according to the spherical equivalent of refraction. Axial length was recorded. Peripheral retinal changes were examined by scleral indentation binocular indirect ophthalmoscopy. Standardized findings considered with their fundus location were lattice degeneration, white without pressure and white with pressure, snail?track degenerations, peripheral chorioretinal atrophy, retinal holes, tears, and detachment. The study was approved by the institutional ethics committee, and all participants provided informed consent. Results: Peripheral retinal degenerations were found in almost half (53%) of all myopes included in the study. The most common peripheral retinal degeneration found was lattice degeneration, followed by white without pressure, white with pressure, and chorioretinal atrophy. Most of the peripheral retinal degenerations were seen in the temporal quadrant of the fundus, either superotemporal or inferotemporal. There was a significant positive association between the prevalence of peripheral retinal degeneration with age, increased axial length, and severity of myopia. Conclusion: The results of our study indicate the necessity for careful peripheral fundus examinations of all myopes, irrespective of age and degree of myopia, for early diagnosis and better management of visual?threatening complications like retinal detachment.
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Background: Preeclampsia is one of the hypertensive disorders in pregnancy that contributes significantly to maternal and fetal morbidity and mortality, with the impact felt more in developing countries. It is characterized by endothelial dysfunction and vasospasm of vessels which can be observed by an ocular fundal examination. The aim of this study was to determine the ocular fundus findings of women with preeclampsia. Methods: This was a cross-sectional study, carried out at the University of Benin Teaching Hospital involving a total of 220 pregnant women. The women were divided into two groups of 110 pregnant women (A&B).Their Age and Gestational age was cross-matched and retinopathy graded according to Keith and Wagner classification. Group A was made up of Preeclamptic women and Group B was made up of healthy pregnant women. Visual acuity was measured using Snellens' chart, and the fundus was examined with direct ophthalmoscope. Results: This showed that the retinal changes observed in the preeclamptic women were associated with their age (P = 0.009), gestational age (P = 0.044), blood pressure (P = 0.001), Proteinuria (P = 0.001), Severity of the disease (P = 0.001), visual acuity (P = 0.035) as well as with the visual symptoms (P = 0.001) but not statistically significant with the gravida (P = 0.799). Conclusion: Our study highlights the importance of timely ophthalmoscopy which helps to assess severity of disease (pre-eclampsia) which affects the decision of induction of delivery to predict and prevent possible complications which in turn immensely helps in judicious management of disease. Also, the study revealed that preeclamptic women who are multigravida are more likely to have retinopathy than primigravid
Assuntos
Descolamento Retiniano , Eclampsia , Pacientes , Pré-Eclâmpsia , Retinaldeído , Retinopatia HipertensivaRESUMO
AIM: To determine the prevalence of retinal changes in pregnancy induced hypertension (PIH) patients and to correlate between retinal changes and the severity of disease.METHODS: A cross-sectional observation study was conducted in 100 PIH patients over a period of 6mo (Dec 2014-May 2015).Fundus examination was done in all patients.Fundus changes in right or left or both eyes, was taken as positive.The PIH graded as mild pre-eclampsia (BP >140/90 to 160/90 mmHg), severe pre-eclampsia (BP>160/90 mmHg) and eclampsia (severe pre-eclampsia and convulsions).RESULTS:Mean age was 23.05y(19-34y).Gestation period ranged from 28 to 41wk.Sixty-two were primi gravida and 38 were multigravida.62%, 26%, 12% of patients had mild, severe pre-eclampsia, eclampsia respectively.Retinal changes were identified in 8 patients.Grade Ⅰ, Grade Ⅱ, Grade Ⅲ, Grade Ⅳ hypertensive retinopathy (HTR), serous retinal detachment (SRD) and central serous chorioretinopathy (CSCR) observed in 1%, 0%, 2%, 2%, 1% and 2% of patients respectively.There was a statistically significant positive association of retinal changes and severity of the PIH (P=0.0001).CONCLUSION:Retinal changes were seen in 8% of patients with PIH and there is a positive correlation between retinal changes and severity of PIH.
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A 46-year-old man presented with visual disturbances in both eyes. His best corrected visual acuity was 0.7 (both eyes). Ptosis and limitation of ocular movement in every direction were observed. Slit lamp examination showed a bilateral iridescent cataract. Fundus examination showed peripheral depigmentation of the retinal pigment epithelium and pigmentary clumping in both eyes that agreed with blocked fluorescence and widow defects on fluorescein angiography. The amplitude of b-wave was decreased on electroretinography. Fourteen months later, the patient's best corrected visual acuity decreased to 0.3 due to increased lens opacity. Phacoemulsification and intraocular lens implantation were performed on both eyes. At the patient's final visit, retinal findings were stable with a best corrected visual acuity of 0.7 in both eyes. In conclusion, the visual disturbance could have been caused by both cataracts and retinal degeneration, meaning the fundus should be examined carefully in patients with myotonic dystrophy.