ABSTRACT
A late adolescent with tuberous sclerosis (TS) presented with reduced vision in one eye to our tertiary care university hospital 4 years ago. Fundus examination revealed multiple retinal astrocytic hamartomas (RAHs) in both eyes. His younger sibling, who also had TS, was found to have RAH on retinal screening. The swept-source optical coherence tomography (SS-OCT) findings were typical of RAH. We further noted that some of the RAH lesions showed segmental whitening of the outer walls of the arterioles, which traversed through them. The segmental whitening may suggest the enveloping of normal retinal vessels by the tumour. En-face and B-scan SS-OCT angiography of patients with TS showed vascularity within the tumour. The vessels within the tumour appeared to be in continuity with the retinal vasculature. Both siblings were reviewed annually. At the end of 4 years, there was no change in visual acuity, tumour size, number, vascularity and behaviour.
Subject(s)
Astrocytoma , Fundus Oculi , Retinal Neoplasms , Siblings , Tomography, Optical Coherence , Tuberous Sclerosis , Humans , Tuberous Sclerosis/complications , Tuberous Sclerosis/diagnosis , Male , Astrocytoma/diagnosis , Astrocytoma/complications , Astrocytoma/diagnostic imaging , Tomography, Optical Coherence/methods , Retinal Neoplasms/diagnosis , Retinal Neoplasms/diagnostic imaging , Adolescent , Follow-Up Studies , Fluorescein Angiography/methods , Visual AcuityABSTRACT
PURPOSE: The purpose of this study was to compare the outcomes of pre-Descemet endothelial keratoplasty (PDEK) and Descemet membrane endothelial keratoplasty (DMEK) in cases of endothelial decompensation. METHODS: This was a prospective, randomized, interventional study conducted at a tertiary eye hospital in North India. Thirty eyes of 28 patients with corneal decompensation were randomly subjected to PDEK (n = 15 eyes) and DMEK (n = 15 eyes). Preoperative demographic details, surgical indications, uncorrected distance visual acuity, corrected distance visual acuity, contrast sensitivity, anterior and posterior segment details, intraocular pressure, central corneal thickness, endothelial cell count, and corneal aberrometry tracing on wavefront analysis were recorded. Patients were followed up for 6 months postsurgery. Visual and graft survival outcomes were assessed. RESULTS: Intraoperatively, a surgeon reported better ease of preparation and intracameral handling with PDEK grafts. Both groups showed comparable improvement in visual acuity, contrast, and high-order aberrations. A decrease in central corneal thickness was significantly higher in DMEK (196 ± 26 vs. 140 ± 14 µm) patients. DMEK grafts were significantly thinner than PDEK grafts at the 6-month follow-up (16 ± 2.17 vs. 27.2 ± 1.93 µm). Endothelial cell loss (35% in DMEK vs. 33.4% in PDEK, P = 0.48) and rise of intraocular pressure (from 15.33 ± 2.85 mm Hg to 15.53 ± 2.2 mm Hg in the DMEK group vs. from 14.6 ± 1.99 mm Hg to 16.2 ± 1.43 mm Hg in the PDEK group) were comparable. Rebubbling rates were higher in the DMEK group (3/15, 20%) compared with the PDEK group (1/15, 6.66%; P = 0.165). CONCLUSIONS: DMEK and PDEK were comparable for both quantitative and qualitative visual outcomes and anatomically for graft survival at the 6-month follow-up.
Subject(s)
Corneal Diseases , Descemet Stripping Endothelial Keratoplasty , Fuchs' Endothelial Dystrophy , Humans , Descemet Membrane/surgery , Corneal Endothelial Cell Loss/diagnosis , Corneal Endothelial Cell Loss/surgery , Prospective Studies , Corneal Diseases/surgery , Retrospective Studies , Endothelium, Corneal/transplantation , Fuchs' Endothelial Dystrophy/surgeryABSTRACT
BACKGROUND: Coronavirus disease (COVID-19)-related scientific publications have increased exponentially during the present pandemic but their influence on biomedical literature is not known. The characteristics of highly cited articles help us to identify important advances and their scientific impact. OBJECTIVES: In the present study, we have identified and analyzed the top 100 most highly-cited articles of COVID-19 research published in the year 2020. METHODS: A cross-sectional bibliometric analysis was using the search terms "severe acute respiratory syndrome-coronavirus-2," "COVID," "nCoV," "Coronavirus," and "HCoV" querying the Google Scholar database using the program "Publish or Perish." The first 100 English language articles with the maximum number of citations were identified and evaluated in detail. RESULTS: The top 100 COVID-19 articles in 2020 had citations ranging from 1147 to 20,440. The median (interquartile range [IQR]) number of citations was 1970 (1456-2939). The number of authors ranged from 1 to 79 (median 10; IQR 5.25-19). The majority of first authors was from China (58%), followed by the United States of America (16%) and the United Kingdom (7%). The top three journals in terms of the number of published articles (37%) were the New England Journal of Medicine, Journal of the American Medical Association, and The Lancet. Most of the top-cited COVID-19 literature were descriptive studies focusing on epidemiology (48%) and clinical course (60%) of COVID-19. CONCLUSION: Clinical course and epidemiology have been the predominant areas of research interest in COVID-19 in 2020. Citation analysis of COVID-19 literature helps us to map out the most important focus for research in this pandemic and to identify gaps in knowledge which would guide further research.
