Retinal Nerve Fiber Layer Thickness in Patients with Schizophrenia and Its Relation with Cognitive Impairment.

Background: Schizophrenia is a chronic severe mental illness with heterogeneous clinical presentation, course, and outcome. Cognitive impairment is one of its core features. Retinal nerve fiber layer (RNFL) imaging using OCT (optical coherence tomography) could provide easy access for in vivo imaging of the retina, rendering it as a "window to the brain." Studies done on schizophrenia have shown RNFL thinning. This study attempts to look into the association between cognitive impairment, disease duration, and RNFL abnormality in patients with schizophrenia using OCT. Methods: Patients diagnosed with schizophrenia meeting DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria and who were confirmed to be in remission for at least six months clinically and scoring less than three on PANSS-8 (positive and negative symptom scale-8) remission scale were included. They were administered the Montreal Cognitive Assessment Scale (MoCA) for cognitive assessment. RNFL measures were taken using spectral domain-OCT. Variables were compared using Pearson's correlation test, one-way ANOVA test, and independent t-test as appropriate. Results: A total of 36 patients were studied. MoCA scores and RNFL thickness showed a positive correlation. Patients with schizophrenia had reduced average RNFL thickness and reduced RNFL thickness in superior, inferior, and temporal quadrants. Average RNFL thickness, Superior and inferior quadrant RNFL thickness showed a positive correlation with MoCA scores. No correlation was obtained between macular volume, macular thickness, duration of illness, and MoCA scores. Conclusion: Patients with schizophrenia have reduced average RNFL thickness. Patients with low MoCA scores have RNFL thinning.

Seasonal Variation in the Occurrence of Rhegmatogenous Retinal Detachment.

PURPOSE: Seasonal predilection is reported in the occurrence of various systemic and ocular diseases. An attempt was made to evaluate the existence of such an association in the development of rhegmatogenous retinal detachment (RRD). The aims of the study were to investigate the existence of seasonal variation in the occurrence of RRD and to analyze the predisposing factors for such variation. DESIGN: This was a retrospective review. METHODS: A retrospective review of all cases of RRD during a period of 2 years (June 2012 to May 2014) was carried out. The details regarding demographic profile, clinical features, and the month of occurrence of RRD were collected. Climatic parameters such as temperature, relative humidity, rainfall, and number of sun hours were noted. The various factors were compared with SPSS version 17.0, and χ test was used for statistical analysis. RESULTS: Of the 76 cases of RRD, 38.2% occurred in the hot humid summer months (P = 0.046) followed by 22.4% in the cool humid winter months. Subtotal retinal detachments were more common in summer (P = 0.015). Factors suggestive of vitreous dehydration such as posterior vitreous detachment, intraocular pressure, and intraocular pressure of fellow eye were not associated with this seasonal variation. The peak minimum temperature, peak maximum temperature, and sun hours were related to this finding. High relative humidity and low rainfall were also associated. CONCLUSIONS: Rhegmatogenous retinal detachment shows definite seasonal variation which peaks in the summer months. Meteorological parameters may further play a role in determining the onset of retinal detachment.

Ophthalmomyiasis externa by Musca domestica in a case of orbital metastasis.

Infestation of the living tissues of the eye, ocular adnexae or orbit by larvae of flies of the order Diptera is known as ophthalmomyiasis. Ophthalmomyiasis externa is a limited superficial infestation of external ocular structures such as conjunctiva and adnexae. A case of follicular carcinoma thyroid with orbital metastasis presenting as ophthalmomyiasis externa is reported. The patient presented with foul smelling ulcers of the medial and lateral orbital walls of the right eye extending into the lids and nose, teeming with maggots. Computerized Tomography (CT) showed widespread bone destruction with extension into surrounding sinuses. Over 200 maggots were manually removed after immobilisation with turpentine oil instillation. Entomological examination showed it to be a case of accidental myiasis caused by the common housefly Musca domestica. The patient was managed conservatively and the ulcer cavities filled up with healthy granulation tissue. This case is presented on account of its rarity.