ABSTRACT
Purpose: To assess the efficacy of 3 days of topical moxifloxacin in combination with povidone-iodine (PVI) versus moxifloxacin/PVI alone in eliminating conjunctival bacterial flora in patients scheduled to undergo intravitreal injections (IVI). Patients and Methods: A prospective randomized comparative study in which 120 patients scheduled to undergo IVI at a tertiary care hospital in New Delhi were selected. Study patients were randomized into two groups. Both the groups received self-administration of moxifloxacin for 3 days prior to injection, except in Group B where it was preceded by PVI. Cultures were obtained at different time intervals, such as in Group A before and after applying moxifloxacin (for 3 days) and once again after applying PVI just before the procedure in the operating room, whereas in Group B first two samples were taken before and after applying PVI and the last sample was taken on the day of the procedure after 3 days of moxifloxacin application. Results: A statistical significance was seen between moxifloxacin prophylaxis and resistant coagulase-negative Staphylococcus (CoNS) (P = 0.0001), which implies that frequent use of antibiotic prophylaxis will ultimately lead to the formation of resistant organisms in the conjunctival flora, especially when repeated IVI are given. Conclusion: We could not establish any additional benefits of topical moxifloxacin prophylaxis with regard to a reduction in conjunctival flora when compared with PVI 5%. PVI can be used as an efficient monotherapy in patients undergoing repeated IVI.
ABSTRACT
PURPOSE: Polypoidal choroidal vasculopathy is a major cause of visual disability in a vast majority of Asian population due to exudative maculopathy. Although it is a distinctive disease entity with characteristic pathophysiology, genetics, immunology and clinical features, but it is still misdiagnosed as neovascular age related macular degeneration as both the diseases are a part of pachychoroid spectrum and have some similar features. Also, there are varied options for the management of this disease, but there are no clear recommendations. So, a detailed review of the literature has been done along with special attention to the recent therapeutic advances to help the readers get a better understanding of the disease and its current management practices. METHOD: Detailed review of literature regarding polypoidal choroidal vasculopathy was done. The disease pathophysiology, genetics, risk factors, diagnostic modalities along with current treatment guidelines were extensively studied and compiled. RESULT: A comprehensive clinical update on polypoidal choroidal vasculopathy was compiled with special emphasis on the recent diagnostic modalities and treatment guidelines. CONCLUSION: Polypoidal choroidal vasculopathy is a distinct clinical entity which can be diagnosed based on indocyanine green angiography and optical coherence tomography. Treatment includes various options like photodynamic therapy, anti VEGF agents and thermal laser ablation. A review of literature has been done and recent diagnostic modalities with management practices have been compiled for the better understanding of the disease.
