Do it yourself smartphone fundus camera - DIYretCAM.

This article describes the method to make a do it yourself smartphone-based fundus camera which can image the central retina as well as the peripheral retina up to the pars plana. It is a cost-effective alternative to the fundus camera.

Spontaneous relief of vitreomacular traction and regression of neovascularization in eales disease after intravitreal injection of bevacizumab.

PURPOSE: To report the use and sequelae of intravitreal injection of bevacizumab (Avastin; Roche) in Eales disease with persistent active neovascularization and vitreomacular traction. METHODS: Intravitreal injection of bevacizumab was used to treat Eales disease with a persistent large neovascular frond, vitreous hemorrhage, and vitreomacular traction. RESULTS: After the injection, there was spontaneous relief of the vitreomacular traction and improvement in visual acuity. Rapid regression of the neovascular frond resulted in a traction retinal break, which was successfully managed with barrage laser photocoagulation. CONCLUSION: Intravitreal injection of bevacizumab seems to be a good option in managing persistent neovascularization in Eales disease. These patients need regular follow-up to recognize the complications that may arise due to the rapid regression of neovascularization.

Physicochemical properties and antibacterial activity of the precipitate of vancomycin and ceftazidime: implications in the management of endophthalmitis.

OBJECTIVE: To study the physicochemical properties, bioavailability, and microbicidal activity of vancomycin and ceftazidime in the precipitate formed by the drugs in mixture. METHODS: The precipitation of the drugs prepared in buffers in the pH range of 5.8 to 8.9, in normal saline, in balanced salt solution (BSS), and in Ringer lactate, was studied by light scatter analysis. Bioavailability and antibacterial activity of the precipitate and the supernatant were estimated using high-performance liquid chromatography (HPLC) and microbiologic assay respectively. RESULTS: The scatter analysis showed precipitation of vancomycin alone at pH 7.5 and in BSS. When mixed together precipitation was observed in the mixture of the two drugs within the pH range of 6.8 to 8.0 and in all solutions. HPLC of both supernatant and precipitate showed the presence of active drugs and the microbiologic assay confirmed its inhibitory activity against bacteria. The precipitate had greater activity against Gram-positive bacteria while the supernatant showed greater activity against Gram-negative bacteria. CONCLUSIONS: Vancomycin's pH dependent precipitation occurs regardless of the presence of ceftazidime. The precipitate as well as the supernatant retains significant antibacterial activity thus confirming the efficacy of combination therapy with vancomycin and ceftazidime in the management of bacterial endophthalmitis.

25 gauge vitrectomy under topical anesthesia: a pilot study.

AIMS: To evaluate the safety and efficacy of transconjunctival 25 gauge vitrectomy under topical anesthesia. SETTINGS AND DESIGN: A pilot study of consecutive cases which underwent 25 gauge vitrectomy under topical anesthesia. MATERIALS AND METHODS: Seven eyes of 7 patients underwent 25 gauge vitrectomy under topical anesthesia with a pledget soaked in anesthetic, for vitreous hemorrhage (2 eyes), retained cortex (1 eye) and postoperative endophthalmitis (4 eyes). Subjective pain and discomfort were graded from 0 (no pain or discomfort) to 4 (severe pain and discomfort). Patients underwent an immediate postoperative assessment, followed by day one and one week postoperative evaluation. RESULTS: All patients had grade 0 pain during the surgery. Five patients had grade 2 pain during the placement of the sclerotomies. None of the patients required any sedation during the procedure. No inadvertent eye movements were noted during surgery. Except one patient, none required postoperative analgesics. Five eyes had a favorable outcome. No eyes in this pilot study had any procedure-related complications. CONCLUSION: With appropriate case selection, topical anesthesia is a safe and effective alternative to infiltrative anesthesia for 25 gauge vitrectomy. A larger series of patients with a longer follow-up is required to validate the findings of this pilot study.

Digital video recording and archiving in ophthalmic surgery.

Currently most ophthalmic operating rooms are equipped with an analog video recording system [analog Charge Couple Device camera for video grabbing and a Video Cassette Recorder for recording)]. We discuss the various advantages of a digital video capture device, its archiving capabilities and our experience during the transition from analog to digital video recording and archiving. The basic terminology and concepts related to analog and digital video, along with the choice of hardware, software and formats for archiving are discussed.

Microbiologic spectrum and susceptibility of isolates in scleral buckle infection in India.

PURPOSE: To present the microbial spectrum and susceptibility of isolates in scleral buckle infections in India. DESIGN: Retrospective case series. METHOD: Seventy-three isolates from 55 eyes with scleral buckle infection were studied. RESULTS: The isolates included 30 gram-positive cocci (41.1%), 15 acid-fast bacilli (20.5%), 11 fungi (15.1%), 10 gram-positive bacilli (13.7%), and 7 gram-negative bacilli (9.6%). Eighteen eyes (32.7%) had polymicrobial infections. Gram-positive, gram-negative, and acid-fast isolates were most commonly susceptible to vancomycin (93%), ciprofloxacin (86%), and amikacin (80%), respectively. CONCLUSION: This large single-center study indicates the high prevalence of fungal, acid-fast organisms and polymicrobial organisms in buckle infections.

Modified high-performance liquid chromatography technique for detection of vancomycin in human vitreous.

PURPOSE: To standardize the technique and methodology for estimating the level of vancomycin in human vitreous using a modified high-performance liquid chromatographic method. METHODS: Sample preparation involved spiking the vitreous with known quantities of the drug followed by a brief treatment with 30% trichloroacetic acid. Samples were analyzed on a C18 reverse-phase column using a mobile phase of 50 mM phosphate buffer (pH 4.0) and 10% acetonitrile. RESULTS: Vancomycin was detected at 198 nm. It showed a retention time of 2.2 min in the vitreous. A linear increase in the area under the peak corresponding to the drug was observed with increase in concentration of vancomycin in the vitreous. The method was applied to detect the vancomycin levels in vitreous of 5 patients with exogenous endophthalmitis, 24-48 h after intravitreal injection of vancomycin 1 mg/0.1 ml. The mean concentration of vancomycin in these samples was 120.022 +/- 59.87 microg/ml (43.859-179.09 microg/ml). The present technique allowed a quantification limit of 1 microg/ml. CONCLUSION: This technique is suitable to estimate vancomycin levels in human vitreous in a variety of clinical and experimental studies. It has the added advantages of being less expensive, simple and rapid.

von Hippel angioma in South Indian subjects--a clinical study.

PURPOSE: To assess the management strategies for retinal capillary hemangioma in von Hippel-Lindau disease. STUDY DESIGN: A retrospective, nonconsecutive case series of 12 patients. METHODS: We reviewed the records of patients diagnosed with retinal capillary hemangioma from January 1996 to June 2002. Age at diagnosis, visual acuity, tumor pattern and location, associated clinical features, type of treatment, and visual and anatomical outcomes were analyzed. RESULTS: None of the patients had evidence of extraocular hemangiomas. The patients were observed for 2 to 24 months. Ten of 12 hemangiomas were endophytic. Subretinal exudation was present in all patients. Cryotherapy was the most common treatment option with successful anatomical (7 of 8 patients) and visual (5 of 8 patients) outcomes. Photocoagulation was successful in 1 of 2 patients. Two patients in the cryotherapy group and two in the photocoagulation group had complications, including macular scar, macular hole, epimacular membrane, and combined traction and rhegmatogenous retinal detachment. Two patients were lost to follow-up after cryotherapy. Seven of 10 patients with a minimum follow-up of 2 months had improved visual acuity. CONCLUSIONS: Endophytic peripheral retinal capillary hemangioma with subretinal exudation was the commonest presentation in this series. Although cryotherapy and photocoagulation regress the tumor, these treatment modalities are associated with complications that may require surgical intervention. Retinal detachments in this group of patients are amenable to surgical intervention.