Eye injuries in badminton - players' perspective toward the usage of personal protective equipment.

OBJECTIVE: We conducted a survey between April to September 2021 to understand the perspective of badminton players on the usage of personal protective equipment to avoid eye injuries. METHODS: The survey was conducted online. It was disseminated through various social media platforms and via e-mail. The survey was initially shared with university-level badminton players. Both recreational and professional players were included. They were further encouraged to circulate the survey questionnaire among their colleagues. RESULTS: In total, the survey received 372 responses. After removing possible duplicates and incomplete responses (n = 28), 92.5% (n = 344) of the responses were included in the final analysis. Among the 344 included responses, recreational and professional players accounted for 77.6% (n = 267) and 22.4% (n = 77), respectively. The mean age ± SD of the recreational and professional players were 24.1 ± 6.3 years (range 14-60 years) and 25.7 ± 6.0 years (range 14-61 years), respectively. A significant difference was noted for self-reported eye injuries between recreational and professional players while playing badminton (χ2 value = 5.321, p = 0.02). Among the recreational and professional players, 93.6% (n = 250) and 88.3% (n = 68) did not use protective eyewear while playing badminton. Professional players were at higher risk of eye injuries than recreational players (OR = 2.9, 95% CI = 1.1-7.8). CONCLUSION: The majority of badminton players in both groups agreed that PPE usage would lower the risk of sustaining eye injuries; however, they are ambiguous about the usage of protective eyewear. In contrast, players with self-reported eye injuries were aware of its impacts and encouraged the usage of PPEs associated with badminton. Further studies are warranted to understand and educate badminton players about the causes and impacts of eye injuries in badminton.

Color vision abnormalities in type II diabetes: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study II report no 2.

PURPOSE: The purpose of this study is to assess color vision abnormalities in a cohort of subjects with type II diabetes and elucidate associated risk factors. METHODS: Subjects were recruited from follow-up cohort of Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study I. Six hundred and seventy-three eyes of 343 subjects were included from this population-based study. All subjects underwent detailed ophthalmic evaluation, including the Farnsworth-Munsell 100 hue test. RESULTS: The prevalence of impaired color vision (ICV) was 43% (CI: 39.2-46.7). Risk factors for ICV were higher heart rate (odds ratio [OR]: 1.043, [1.023-1.064]) and a higher intraocular pressure (IOP) (OR: 1.086, [1.012-1.165]). Subjects with clinically significant macular edema (CSME) had three times higher chance of having ICV. C1, C2, and C3 are the commonly found Early Treatment Diabetic Retinopathy Study (ETDRS) patterns. The moment of inertia method showed that the angle did not reveal any specific pattern of color vision defect. Although the major and minor radii were high in those with ICV, we did not observe polarity. Confusion index was high in subjects with ICV, indicating a severe color vision defect. CONCLUSIONS: The prevalence of ICV was 43% among subjects with type II diabetes. The most commonly observed patterns were increasing severities of the blue-yellow defect on ETDRS patterns, but no specific pattern was observed at the moment of inertia analysis. The presence of CSME, a higher heart rate, and IOP was significant risk factors for ICV. This functional impairment in color vision could significantly contribute to morbidity among subjects with diabetes.

Congenital preretinal arterial loop: Is it a misnomer?

We describe a case of recurrent spontaneous vitreous haemorrhage due to congenital retinal arterial loop. The pre-optical coherence tomography showed the loop to be intraretinal rather than pre retinal. Thus the term pre retinal arterial loop is a misnomer. The arterial loop is in the superficial layer of retinal nerve fiber layer. We also demonstrated preretinal posterior hyaloid tissue attached on the retinal arterial loop, which may be the cause of traction and spontaneous recurrent VH.

Incidence and Progression of Diabetic Retinopathy in Urban India: Sankara Nethralaya-Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS II), Report 1.

PURPOSE: To evaluate the 4-year incidence and progression of and risk factors for diabetic retinopathy (DR) in an Indian population. METHODS: From a cross-sectional study of 1425 subjects with diabetes, 911 (63.9%) returned for 4-year follow-up. After excluding 21 with ungradable retinal images, data from 890 subjects were analyzed. Participants underwent examinations based on a standard protocol, which included grading of retinal photographs. RESULTS: The incidences of DR, diabetic macular edema (DME), and sight-threatening diabetic retinopathy (STDR) were 9.2%, 2.6%, and 5.0%, respectively. In subjects with DR at baseline, the incidence of DME and STDR had increased (11.5% and 22.7%, respectively). 1-step and 2-step progressions of DR were seen in 30.2% and 12.6% of participants, respectively, and 1-step and 2-step regressions were seen in 12.0% and 1.8%, respectively. Incident DR, DME, and STDR were associated with higher systolic blood pressure (odds ratio, OR, 1.21, 2.11 and 1.72, respectively, for every 10 mmHg increase). Incident DR and DME were associated with increasing duration of diabetes (OR 2.29 and 4.77, respectively, for every 10-year increase) and presence of anemia (OR 1.96 and 10.14, respectively). Incident DR was also associated with higher hemoglobin A1c (OR 1.16 for every 1% increase). Variables associated with 1-step progression were every 10 mg/dL increase in serum total cholesterol (OR 15.65) as a risk factor, and 10 mg/dL increase in serum triglyceride (OR 0.52) as a protective factor. CONCLUSIONS: The incidences of STDR and DME were higher in people with pre-existing DR than in those without DR at baseline.

Retinal sensitivity changes associated with diabetic neuropathy in the absence of diabetic retinopathy.

PURPOSE: To explore any relationship between the markers of early retinal neuronal damage and peripheral diabetic neuropathy in subjects with no diabetic retinopathy (DR). METHODS: A cross-sectional study in which type 2 diabetic subjects (n=743) without DR were studied. Visual functions including visual acuity, contrast sensitivity, colour vision, retinal sensitivity using microperimeter and retinal thicknesses by spectral domain optical coherence tomography were measured. Vibration perception thresholds of greater than or equal to 20 µV, measured by sensitometer using a biothesiometer probe, were defined as having peripheral diabetic neuropathy. Statistical analyses were performed using independent t-test, multivariate logistic regression and Pearson's correlation. RESULTS: Of 743 subjects who had no DR, 24.9% had diabetic neuropathy. Independent comparisons among subjects who had diabetic neuropathy compared with those who did not showed statistically significant retinal nerve fibre layer thinning (p=0.01), reduced contrast sensitivity (p=0.0001), reduced retinal sensitivity (p=0.03), impaired colour vision (p=0.04) and reduced visual acuity (p=0.0001). Multivariate analysis showed significant association between the mean retinal sensitivity (measured using a microperimeter) and diabetic neuropathy (adjusted OR (95% CI): 0.76 (0.60 to 0.95), p=0.01). CONCLUSIONS: Significant association of neuroretinal dysfunction with the presence of diabetic neuropathy was noted among subjects with no DR.

Incidence, Progression, and Associated Risk Factors of Posterior Vitreous Detachment in Type 2 Diabetes Mellitus: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS II, Report No. 7).

PURPOSE: To report the incidence and progression of posterior vitreous detachment (PVD) and factors influencing the same in a cohort of patients with type 2 diabetes in a South Indian population. METHODS: A subset of 615 subjects from Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study II were included in this study. All of the subjects underwent detailed ophthalmic evaluation including stereo fundus photography. The status of PVD was assessed using B-scan ultrasonography. A p value of <0.05 was considered statistically significant. RESULTS: The incidence of either incomplete PVD (IPVD) or complete PVD (CPVD) from no PVD at baseline visit was 80.8%. Of them, 32.63% converted to CPVD from IPVD at baseline. High prevalence of emmetropia was observed in subjects with stable No PVD. Risk factors associated with the conversion of CPVD from no PVD and IPVD at baseline were age (OR: 1.04, p = 0.002), myopia (OR: 2.14, p = 0.009), and increase in axial length (OR: 1.35, p = 0.004). Subjects undergoing cataract surgery were at 2.32 times higher risk of converting to CPVD (p = 0.038). CONCLUSION: Independent risk factors for the progression of PVD were increase in age, myopia, increased axial length, and cataract surgery.

Imaging drusens using Spectral Domain Optical Coherence Tomography.

PURPOSE: The purpose was to evaluate pathological changes of photoreceptor layer and retinal pigment epithelium in eyes with drusens using Spectral Domain Optical Coherence Tomography (SD-OCT). METHODS: Twenty-nine eyes of 29 patients with (drusens) dry age-related macular degeneration and 43 eyes of 43 controls were included in this study. All subjects underwent complete ophthalmic examination including SD-OCT. Central foveal thickness (CFT), photoreceptor layer (PRL) thickness and retinal pigment epithelial (RPE) thickness were measured and compared between the groups. P value < 0.05 was considered statistically significant. RESULTS: Best corrected visual acuity (BCVA) ranged between 20/20 and 20/200. RPE (36.10 ± 5.48 µm Vs 39.27 ± 4.30) and PRL thickness (53.93 ± 7.36 µm Vs 61.20 ± 4.50 µm) were significantly reduced in patients with drusens compared to controls. Increase in age was a significant risk factor for drusens (OR: 1.22, p < 0.001) and increased PRL thickness was a protective factor (OR: 0.720, p = 0.002). PRL thickness was significantly associated with BCVA (p = 0.019). CONCLUSION: With an increased resolution of SD-OCT, the involvement of the outer retinal layers was more clearly defined. SD-OCT may allow for the early detection of exudative changes.

Diabetic retinopathy: An epidemic at home and around the world.

Prevention of blindness due to diabetic retinopathy (DR) requires effective screening strategies, for which eye care providers need to know the magnitude of the burden and the risk factors pertinent in their geographical location. It is estimated that around 72 million of the global adult population (around 8.2%) has diabetes and about one-fifth of all adults with diabetes lives in the South-East Asia. In India, around 65 million people have diabetes. As the global prevalence of diabetes increases, so will the number of people with diabetes-related complications, such as DR; nearly one-third of them are likely to develop this complication. This article reviews the present status of diabetes and DR in India, the current situation of DR services and the projections on the load of morbidity associated with retinopathy. The article compiles the Indian studies elucidating the risk factors for DR.

Quantitative spectral domain optical coherence tomography thickness parameters in type II diabetes.

PURPOSE: To elucidate the changes in retinal thickness and individual layer thickness in subjects with diabetic retinopathy (DR) using spectral domain optical coherence tomography (SDOCT). MATERIALS AND METHODS: A total of 251 eyes from 170 subjects were included in this study. The study sample was subdivided into nondiabetic subjects; subjects with diabetes but no DR; subjects with mild, moderate, and severe nonproliferative DR (NPDR); and proliferative DR. Various retinal thickness parameters were assessed using SDOCT. RESULTS: The mean age of the study population was 55.34 ± 9.02 years (range: 32-80 years) and 56.6% of the subjects were males. Men had significantly greater central foveal thickness, central subfield thickness, retinal nerve fiber layer thickness, and retinal thickness in all the quadrants of 3 mm and 6 mm zones compared to women (P < 0.001). Superior (293.11 ± 25.46 vs. 285.25 ± 19.17; P = 0.044) and temporal (282.10 ± 25.26 vs. 272.46 ± 16.21; P = 0.011) quadrants showed an increased retinal thickness in any DR group when compared with diabetic subjects without DR. Photoreceptor layer thickness was significantly reduced in diabetic subjects with no DR when compared with nondiabetic subjects and also in cases of severe NPDR when compared with mild and moderate NPDR. CONCLUSION: Here, we analyze the quantitative retinal thickness parameters in diabetic subjects using SDOCT. Neuronal degenerative changes such as photoreceptor and retinal pigment epithelial thinning in case of DR are also reported.

Retinal sensitivity in subjects with type 2 diabetes mellitus: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS II, Report No. 4).

AIM: To evaluate retinal sensitivity (RS) in subjects with diabetes in a population-based study and to elucidate associated risk factors for abnormal RS. METHODS: A subset of 357 subjects from Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study-II was included in this study. All subjects underwent detailed ophthalmic evaluation including microperimetry and spectral domain optical coherence tomography. RESULTS: The prevalence of abnormal mean retinal sensitivity (MRS) was 89.1%. MRS was significantly reduced in subjects with diabetes but no retinopathy when compared with non-diabetic subjects. MRS was reduced in moderate non-proliferative diabetic retinopathy (DR) and macular oedema (ME) at 8° (p=0.04, p=0.01, respectively) and in ME at 10° (p=0.009) and 12° (p=0.036) compared with no DR. Significant negative correlation was found between MRS and best corrected visual acuity, duration of diabetes, glycosylated haemoglobin and central foveal thickness. Increased retinal thickness remained a significant risk factor (OR, 1.02; p=0.044) for abnormal MRS. Altered inner retinal layers and foveal contour were associated with reduced MRS among subjects with DR and presence of epiretinal membrane, altered foveal contour and altered retinal pigment epithelium were associated with reduced MRS. CONCLUSIONS: Reduced RS in those subjects with diabetes but no retinopathy suggests the early neuronal damage in type 2 diabetes mellitus.

Morphological and functional outcomes following modified early treatment diabetic retinopathy study laser in diabetic macular edema.

AIM: The aim was to report morphological and functional outcomes following modified early treatment diabetic retinopathy study (ETDRS) laser in diabetic macular edema (DME). MATERIALS AND METHODS: Structural and functional changes using spectral domain optical coherence tomography (OCT) and microperimetry (MP) were studied before and 4 months after laser in 37 eyes with clinically significant macular edema (ME) requiring modified ETDRS laser treatment. Paired t-test was used to compare pre and postlaser outcomes P < 0.05 was considered statistically significant. RESULTS: Central foveal thickness showed a significant reduction after laser P = 0.004. There was a significant reduction in mean retinal thickness (MRT) and retinal volume in all the quadrants of ETDRS except for the temporal and nasal quadrants in outer 6 mm ring. Maximum reduction in MRT was seen in eyes with DME having neurosensory detachment (382.66 µ to 292.61 µ). Retinal sensitivities reduced in all quadrants following laser, however, fixation patterns showed improvements. The change in VA was positively correlated to change in MRT (r = 0.468, P = 0.032). CONCLUSION: Laser not only causes structural benefits such as reduction of retinal thickness and volume, it also causes improvement of fixation patterns.

Retinal Sensitivity over Hard Exudates in Diabetic Retinopathy.

PURPOSE: To evaluate retinal sensitivity over hard exudates in correlation with the spectral domain optical coherence tomography (SD-OCT) findings in eyes with diabetic retinopathy. METHODS: Twelve eyes of 10 patients with hard exudates associated with diabetic retinopathy were enrolled in this study. All subjects underwent a complete ophthalmic examination including SD-OCT (Copernicus, Zawiercie, Poland) and microperimetry (MP1; Nidek Technologies, Padova, Italy). Retinal sensitivity was measured, over the areas with hard exudates and compared to corresponding locations devoid of hard exudates, using a semi-automatic program. The size of the hard exudate plaque was measured using the measurement software in the microperimeter. Retinal thickness in the area of the hard exudates and foveal thickness were measured using SD-OCT. RESULTS: Mean retinal sensitivity over hard exudates was 4.97 ± 4.17 dB which was significantly (P = 0.0001) reduced as compared to locations devoid of hard exudates. No significant correlation (r=-0.23, P = 0.45) was found between the size of the hard exudates and retinal sensitivity. A significant negative correlation was found between retinal sensitivity and retinal thickness at the area of the hard exudates (r=-0.65, P = 0.05), and between retinal sensitivity and foveal thickness (r=-0.91, P = 0.001). CONCLUSION: In eyes with diabetic retinopathy, retinal sensitivity was reduced due to the presence of hard exudates in the outer retinal layers and retinal thickening but this was not correlated with the size of the hard exudates.

Foveal slope measurements in diabetic retinopathy: Can it predict development of sight-threatening retinopathy? Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS II, Report no 8).

AIM: The aim was to assess the foveal slope configuration in subjects with type 2 diabetes in a population-based study. MATERIALS AND METHODS: A subset of 668 subjects from Sankara Nethralaya Diabetic Retinopathy (DR) Epidemiology and Molecular Genetics Study II, a population-based study, were included in the current study. All the subjects underwent comprehensive ophthalmic evaluation including spectral domain optical coherence tomography. Foveal thickness was assessed in five central early treatment DR study quadrants from the three-dimensional scan and foveal slope was calculated in all the four quadrants. RESULTS: Subjects with sight-threatening DR (STDR) had significantly shallow foveal slope in inferior quadrant (STDR: 7.33 ± 6.26 vs. CONTROLS: 10.31 ± 3.44; P = 0.021) when compared to controls and in superior (STDR: 7.62 ± 5.81 vs. no DR: 9.11 ± 2.82; P = 0.033), inferior (STDR: 7.33 ± 6.26 vs. no DR: 8.81 ± 2.81; P = 0.048), and temporal quadrants (STDR: 6.69 ± 5.70 vs. no DR: 7.97 ± 2.33; P = 0.030) when compared to subjects with no DR. Foveal slope was significantly shallow among the older age groups in subjects with no DR (P < 0.001) and non-STDR (P = 0.027). Average foveal slope in the diabetic subjects was independently and significantly correlated with increase in age (r = -0.241; P < 0.001) and central subfield thickness (r = -0.542; P < 0.001). CONCLUSION: Changes in foveal slope were seen with increasing age; however, in diabetes these segmental slope changes can be seen in late DR (STDR).

Fixation characteristics among subjects with diabetes: SN-DREAMS II, Report No. 5.

OBJECTIVE: To evaluate fixation and scotoma characteristics among subjects with diabetes in a population-based study. DESIGN: Cohort study. PARTICIPANTS: A subset of 357 subjects was recruited from follow-up cohort of Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study I. METHODS: All subjects underwent detailed ophthalmic evaluation including microperimetry and spectral domain optical coherence tomography. Fixation parameters such as stability of fixation, fixation location, and presence of scotoma were evaluated. A p value less than 0.05 was considered statistically significant. RESULTS: The mean age of the study sample was 56.86 ± 8.63 years. Relatively unstable fixation was observed in 73 and poor central fixation in 25 subjects. Among subjects with poor central fixation, 72% (18 subjects) had relatively unstable fixation. Poor central and relatively unstable fixation were significantly associated with best corrected visual acuity (BCVA; p = 0.002 and p = 0.017, respectively). Prevalence rate of scotoma was 24.4%, which was highly prevalent in females (p = 0.035) and among subjects with reduced BCVA (p < 0.001), reduced contrast sensitivity (p < 0.001), cataract (p < 0.001), impaired retinal sensitivity (p < 0.001), and presence of sight-threatening diabetic retinopathy (STDR; p < 0.001). Presence of scotoma was significantly associated with abnormal foveal contour (p = 0.046) and altered inner retinal layers (p < 0.001). CONCLUSIONS: We report that fixation characteristics are independent of ocular characteristics except for BCVA. Female sex, reduced visual acuity and contrast sensitivity, cataract, and STDR were significantly associated with presence of scotoma.

Impairment of Colour Vision in Diabetes with No Retinopathy: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SNDREAMS- II, Report 3).

PURPOSE: To assess impairment of colour vision in type 2 diabetics with no diabetic retinopathy and elucidate associated risk factors in a population-based cross-sectional study. METHODS: This is part of Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular-genetics Study (SN-DREAMS II) which was conducted between 2007-2010. FM 100 hue-test was performed in 253 subjects with no clinical evidence of diabetic retinopathy. All subjects underwent detailed ophthalmic evaluation including cataract grading using LOCS III and 45° 4-field stereoscopic fundus photography. Various ocular and systemic risk factors for impairment of colour vision (ICV) were assessed in subjects with diabetes but no retinopathy. P value of < 0.05 was considered statistically significant. RESULTS: The mean age of the study sample was 57.08 ± 9.21 (range: 44-86 years). Gender adjusted prevalence of ICV among subjects with diabetes with no retinopathy was 39.5% (CI: 33.5-45.5). The mean total error score in the study sample was 197.77 ± 100 (range: 19-583). The risk factors for ICV in the study were women OR: 1.79 (1.00-3.18), increased resting heart rate OR: 1.04 (1.01-1.07) and increased intraocular pressure OR: 1.12 (1.00-1.24). Significant protective factor was serum high-density lipoprotein OR: 0.96 (0.93-0.99). CONCLUSIONS: Acquired ICV is an early indicator of neurodegenerative changes in the retina. ICV found in diabetic subjects without retinopathy may be of non-vascular etiology.

Macular thickness measurements using Copernicus Spectral Domain Optical Coherence Tomography.

PURPOSE: To provide normal macular thickness measurements using Spectral Domain Optical Coherence Tomography (SDOCT, Copernicus, Optopol Technologies, Zawierci, Poland). METHODS: Fifty-eight eyes of 58 healthy subjects were included in this prospective study. All subjects had comprehensive ophthalmic examination including best-corrected visual acuity (BCVA). All the subjects underwent Copernicus SDOCT. Central foveal thickness (CFT) and photoreceptor layer (PRL) thickness were measured and expressed as mean and standard deviation. Mean retinal thickness for each of the 9 regions defined in the Early Treatment Diabetic Retinopathy Study was reported. The data were compared with published literature in Indians using Stratus and Spectralis OCTs to assess variation in instrument measurements. RESULTS: The mean CFT in the study sample was 173.8 ± 18.16 microns (131-215 microns) and the mean PRL thickness was 65.48 ± 4.23 microns (56-74 microns). No significant difference (p = 0.148) was found between CFT measured automated (179.28 ± 22 microns) and manually (173.83 ± 18.1 microns). CFT was significantly lower in women (167.62 ± 16.36 microns) compared to men (180.03 ± 18 microns) (p = 0.008). Mean retinal thickness reported in this study was significantly different from published literature using Stratus OCT and Spectralis OCT. CONCLUSION: We report the normal mean retinal thickness in central 1 mm area to be between 138 and 242 microns in Indian population using Copernicus SDOCT. We suggest that different OCT instruments cannot be used interchangeably for the measurement of macular thickness as they vary in segmentation algorithms.

Local anesthetic agents for vitreoretinal surgery: no advantage to mixing solutions.

PURPOSE: To compare the efficacy of lidocaine, bupivacaine, and a mixture of both in patients undergoing peribulbar anesthesia for vitreoretinal surgery. DESIGN: Cross-sectional study. PARTICIPANTS: Ninety patients. METHODS: Patients who underwent vitreoretinal surgery were randomized into 3 groups based on the peribulbar injection they received: lidocaine, bupivacaine, or a combination of lidocaine and bupivacaine. MAIN OUTCOME MEASURES: Time of onset of analgesia, akinesia, and intraoperative pain, if any, was noted. The efficacy of the block was graded from 0 to 5 depending on the adequacy of anesthesia and akinesia and the need for local supplementation. RESULTS: Mean times of onset (± standard deviation) of sensory blockade for the lidocaine, bupivacaine, and combination groups were 2.14±0.18, 2.19±0.13, and 2.17±0.11 minutes, respectively (P = 0.103). Mean times of onset (± standard deviation) of motor blockade for the lidocaine, bupivacaine, and combination groups were 3.04±1.81, 4.04±2.68, and 3.38±2.48 minutes, respectively (P = 0.255). Mean time of onset of intraoperative pain for the bupivacaine group, 149.33±46.33 minutes, was prolonged significantly compared with that of the combination group, 115.83±34.49 minutes, and that of the lidocaine group, 94.17±49.86 minutes (P < 0.001). Adequate anesthesia and akinesia (grade 5) were achieved in 56.7% of the patients in the bupivacaine group compared with 23.3% in the lidocaine group and 30% in the combination group (P = 0.049). CONCLUSIONS: In peribulbar anesthesia, 0.5% bupivacaine solution provides better quality of anesthesia than does combination 2% lidocaine and 0.5% bupivacaine in patients undergoing vitreoretinal surgery.

Spectral domain optical coherence tomography characteristics in diabetic retinopathy.

PURPOSE: To report the appearance of diabetic retinopathy lesions using spectral domain optical coherence tomography (SD-OCT). MATERIALS AND METHODS: A total of 287 eyes of 199 subjects were included. All the subjects underwent complete ophthalmic examination including SD-OCT. RESULTS: The appearance of various lesions of diabetic retinopathy and the retinal layers involved were reported. In subjects with macular edema the prevalence of incomplete PVD was 55.6%. CONCLUSION: SD-OCT brings new insights into the morphological changes of the retina in diabetic retinopathy.

Retinal sensitivity in healthy Indians using microperimeter.

AIMS: To establish the retinal sensitivity values in healthy Indians using microperimeter. MATERIALS AND METHODS: In this prospective study, 144 healthy volunteers were included. All the participants underwent a comprehensive ophthalmic examination including contrast sensitivity. Microperimetry was performed in the central 20° of the macula using 76 stimulus points to assess the retinal sensitivity, and the fixation characteristics in the study population were assessed. RESULTS: The mean age of the study sample was 43.08 ± 10.85 years (range: 25-69). Mean retinal sensitivity was 18.26 ± 0.99 dB. Males had significantly increased retinal sensitivity (18.34 vs. 18.17 dB, P = 0.03). The linear regression analysis revealed a 0.04 dB per year age-related decline in mean retinal sensitivity. Contrast sensitivity was significantly correlated with the mean retinal sensitivity (r = 0.432, P < 0.001). Fixation stability in the central 2° and 4° were 69% and 89%, respectively. CONCLUSION: Microperimeter is an ideal tool to assess the retinal sensitivity and the fixation behavior. These normative values could help in drawing a meaningful conclusion in various retinal pathologies.

Prevalence of posterior vitreous detachment in the population with type II diabetes mellitus and its effect on diabetic retinopathy: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study SN-DREAMS report no. 23.

OBJECTIVE: To report the prevalence of posterior vitreous detachment (PVD), and predisposing factors to PVD and their effect on diabetic retinopathy. STUDY DESIGN: Population-based study. METHODS: The study included subjects with type II diabetes mellitus enrolled from a cross-sectional study. Participants underwent a biochemical examination, and a comprehensive ocular examination which included stereo fundus photography. Diabetic retinopathy was graded by use of Klein's classification and diabetic maculopathy was graded by use of the Early Treatment Diabetic Retinopathy Study (ETDRS) criteria. The status of the posterior vitreous was assessed by use of B-scan ultrasonography. RESULTS: The prevalence of PVD was 63.3 %. The risk factors for PVD included age, gender, sight-threatening diabetic retinopathy, and axial length. It was observed that incomplete PVD could lead to sight-threatening diabetic retinopathy. CONCLUSION: We report the prevalence and risk factors of PVD in subjects with diabetes mellitus. Incomplete PVD is a major risk factor for sight-threatening diabetic retinopathy.