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2.
Indian J Ophthalmol ; 70(3): 1007-1012, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35225562

RESUMO

Purpose: To study the use of teleophthalmology as a tool to manage patients with uveitis and to describe the experience of teleconsultation for uveitis at a tertiary eye care hospital in India during the two waves of the COVID-19 pandemic. Methods: A prospective observational case series of uveitis patients seeking teleconsultations during the first (March 25-May 2020) and second lockdown (April 27 to June 21, 2021) in a tertiary eye care center were analyzed. Results: There were 79 teleconsultations in the first and 89 teleconsultations in the second lockdown. A majority of the patients presented in the age group of 41-60 years in both the lockdowns. There were both new or primary consultations and follow-up patients (6% vs. 94%) in the first lockdown, and similarly in the second lockdown (8% new vs. 92% follow-up). The majority of patients resided in Bengaluru city (78% in the first and 76% in the second lockdown). After evaluation through video consultation, only 15% required a hospital referral in the first lockdown, whereas in the second lockdown, 21.3% were referred to the hospital. During the second lockdown, 20% presented with COVID-19 infection-related ailments. Conclusion: Based on our preliminary experience using a customized smartphone-based application for teleconsultation, we found it to be an alternative option to provide continuation of ophthalmic care to uveitis patients. Given the current COVID-19 situation, it can help avoid physical visits of uveitis patients to the hospital.


Assuntos
COVID-19 , Oftalmologia , Consulta Remota , Telemedicina , Uveíte , Adulto , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Uveíte/epidemiologia
6.
Indian J Ophthalmol ; 68(11): 2569-2572, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33120695

RESUMO

We present the case of a 32-year-old Indian male one-eyed individual with a history of unilateral panuveitis with HLA B 27 positive spondyloarthropathy on systemic immunosuppressant (Adalimumab). He developed recurrent inflammation in the same eye in a span of 2 years, later complicated with retinal vasculitis. On evaluation, he was diagnosed with tubercular uveitis and started on antitubercular treatment along with systemic steroids. Inview of Increased IOP due to steroid response, Inj. Secukinumab ( IL 17 A inhibitor) was started and significant improvement was noted.


Assuntos
Espondilite Anquilosante , Uveíte , Adalimumab , Adulto , Anticorpos Monoclonais Humanizados , Humanos , Masculino , Espondilite Anquilosante/complicações , Espondilite Anquilosante/diagnóstico , Espondilite Anquilosante/tratamento farmacológico , Uveíte/complicações , Uveíte/diagnóstico , Uveíte/tratamento farmacológico
10.
Am J Ophthalmol Case Rep ; 16: 100553, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31650082

RESUMO

PURPOSE: To report a case of bilateral acute necrotising retinitis due to cytomegalovirus infection (CMV) in an Asian Indian infant. OBSERVATIONS: An Asian Indian infant born with a birth weight of 1000 g at 26 week of gestation acquired cytomegalovirus infection from repeated blood transfusion for anemia. During the routine course of ROP screening, both eyes were detected with Type 1 ROP (stage 3 in zone 1 with plus disease) and treated with laser photoablation at 39 + 2 weeks post menstrual age. The disease responded to the laser and showed signs of regression. Four weeks after laser therapy (PMA 43 + 3 weeks), both eyes presented with vitritis, inferior vitreous condensation and white lesions in the lower nasal retina and temporal retina overlying the lasered retinal bed associated with white fluffy hemorrhagic lesions resembling necrotising retinitis. As the infant was seropositive for CMV earlier, Necrotising retinitis due to CMV was suspected. The CMV DNA was repeated and was detected in serum. Infant was treated with anti-CMV medication (oral valgancyclovir) for six weeks. The retinal lesions resolved completely. CONCLUSION AND IMPORTANCE: Bilateral acute necrotising retinitis may present in an infant on post lasered retina as early as 16 weeks after birth. CMV may also present as acute necrotising retinitis in unusual cases therefore high index of suspicion and early management can result in a successful outcome.

13.
Indian J Ophthalmol ; 66(9): 1342-1344, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30127167

RESUMO

A 36-year-old female presented with the complaints of pain, photophobia, redness, and sudden diminution of vision in both the eyes following topiramate for migraine treatment. On examination, there was panuveitis with angle-closure glaucoma in both the eyes with fibrinous exudate with pigments in the anterior chamber of the left eye. B scan revealed increased choroidal thickness in both the eyes. Serial anterior segment optical coherence tomography scans were done in the left eye to demonstrate the gradual resolution of the fibrin material from the anterior chamber. There was complete resolution of inflammation in both eyes following discontinuation of topiramate and treatment with systemic and topical steroids. There was an improvement in visual acuity in the left eye following complicated cataract surgery.


Assuntos
Segmento Anterior do Olho/diagnóstico por imagem , Frutose/análogos & derivados , Glaucoma de Ângulo Fechado/induzido quimicamente , Pressão Intraocular/efeitos dos fármacos , Pan-Uveíte/induzido quimicamente , Administração Oral , Adulto , Fármacos Antiobesidade/administração & dosagem , Fármacos Antiobesidade/efeitos adversos , Feminino , Frutose/administração & dosagem , Frutose/efeitos adversos , Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Fechado/fisiopatologia , Gonioscopia , Humanos , Microscopia Acústica , Pan-Uveíte/diagnóstico , Índice de Gravidade de Doença , Tomografia de Coerência Óptica/métodos , Topiramato , Acuidade Visual
14.
Indian J Ophthalmol ; 66(8): 1198-1200, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30038181

RESUMO

The purpose of this study was to demonstrate the usefulness of endoilluminator in pediatric cataract with hazy corneas. We describe a series of three cases of pediatric cataract where visualization of intraocular structures was inadequate under the operating microscope. The endoilluminator was held at the limbus with light directed obliquely to visualize the details of intraocular structures against the hazy cornea using oblique illumination. It allowed structures behind the hazy cornea to be seen with ease. A simple modification in surgical procedure of pediatric cataract using an endoilluminator helps in better visualization of intraocular structures in difficult situations.


Assuntos
Extração de Catarata/métodos , Córnea/cirurgia , Opacidade da Córnea/cirurgia , Implante de Lente Intraocular/métodos , Iluminação , Cirurgia Assistida por Computador/métodos , Acuidade Visual , Criança , Pré-Escolar , Córnea/patologia , Opacidade da Córnea/complicações , Opacidade da Córnea/diagnóstico , Feminino , Humanos , Lactente , Masculino , Microscopia com Lâmpada de Fenda
15.
Asia Pac J Ophthalmol (Phila) ; 6(6): 488-492, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29057640

RESUMO

PURPOSE: The aim of our study was to share our experience with anti-vascular endothelial growth factor (anti-VEGF) injections in the treatment of neovascular age-related macular degeneration (nAMD) in a real-world setting. DESIGN: A retrospective, observational study. METHODS: Patients of Indian origin with nAMD receiving anti-VEGF with a minimum follow-up of 12 months were enrolled in this study. In group 1, patients were treated on a pro re nata (PRN) basis; in group 2, patients received a loading dose (3 injecti Results: Overall, we observed that 77.31% (92/119 eyes) of patients either maintained or had improved visual acuity at 12 months' follow-up. Similar visual outcome was observed in both groups. The average number of injections given in group 1 was 4.98 and in group 2 was 3.7. CDVA at 12 months was significantly correlated with type of drug molecule, CSFT at 3 and 12 months, baseline visual acuity, and CDVA at 3 months. CONCLUSIONS: PRN treatment with significantly fewer injections achieved similar anatomical and functional outcomes when compared with the loading dose group. The results of this study need to be validated with a larger study group and a longer follow-up.


Assuntos
Bevacizumab/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Ranibizumab/uso terapêutico , Degeneração Macular Exsudativa/tratamento farmacológico , Adulto , Idoso , Neovascularização de Coroide/fisiopatologia , Feminino , Humanos , Índia , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia , Degeneração Macular Exsudativa/fisiopatologia
16.
J AAPOS ; 21(3): 254-257, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28558973

RESUMO

Lipemia retinalis is an unusual ocular finding associated with hypertriglyceridemia. We report the case of an infant treated for retinopathy of prematurity who later developed lipemia retinalis, with triglyceride levels of 4736 mg/dl. There was a paradoxical worsening of hypertriglyceridemia with the use of medium chain triglyceride supplement. On discontinuing the supplement, the triglycerides level drastically dropped, and retinal vasculature returned to a normal hue.


Assuntos
Dieta Hiperlipídica/efeitos adversos , Hipertrigliceridemia/etiologia , Fotocoagulação a Laser , Doenças Retinianas/etiologia , Retinopatia da Prematuridade/cirurgia , Triglicerídeos/efeitos adversos , Feminino , Alimentos Formulados , Humanos , Hipertrigliceridemia/diagnóstico , Alimentos Infantis , Recém-Nascido , Doenças Retinianas/diagnóstico , Vasos Retinianos/patologia
18.
J Cataract Refract Surg ; 42(7): 955-60, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27492091

RESUMO

UNLABELLED: Scleral fixation of intraocular lenses (IOLs) is traditionally performed after conjunctival dissection and preparation of scleral flaps. The Hoffman pocket technique creates scleral pockets without conjunctival dissection. We describe a technique that uses a Hoffman pocket and 7-0 polytetrafluoroethylene (Gore-Tex) sutures for scleral fixation of a foldable posterior chamber IOL in patients with insufficient capsule support. The technique eliminates the need for conjunctival dissection, scleral cauterization, knot rotation, and sutured wound closure. The favorable properties of the suture material and the use of a small incision to insert a foldable IOL are additional advantages. FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.


Assuntos
Implante de Lente Intraocular , Politetrafluoretileno , Técnicas de Sutura , Humanos , Lentes Intraoculares , Esclera , Suturas
19.
J AAPOS ; 20(1): 88-90, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26917085

RESUMO

Upbeat nystagmus is usually a central vestibular nystagmus attributable to structural brainstem or cerebellar lesions. Adult-onset upbeat nystagmus calls for a thorough neurological evaluation. In children, however, it can occur as a transient phenomenon in healthy neonates or as a sensory form of nystagmus that usually transforms into horizontal nystagmus by 2 years of age. We report the case of 3.5-year-old boy with upbeat nystagmus. His ocular examination was within normal limits. Neurological evaluation was normal. Optical coherence tomography testing and Electroretinogram confirmed cone dysfunction. Over the next 6 months the upbeat nystagmus converted to horizontal nystagmus.


Assuntos
Nistagmo Patológico/diagnóstico , Células Fotorreceptoras Retinianas Cones/patologia , Doenças Retinianas/diagnóstico , Vias Visuais/patologia , Pré-Escolar , Consanguinidade , Eletrorretinografia , Humanos , Masculino , Refração Ocular , Tomografia de Coerência Óptica , Acuidade Visual
20.
Curr Eye Res ; 41(5): 643-52, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26237163

RESUMO

AIM: To demonstrate the uses and applications of a microscope integrated intraoperative Optical Coherence Tomography in Micro Incision Cataract Surgery (MICS) and Femtosecond Laser Assisted Cataract Surgery (FLACS). METHODS: Intraoperative real time imaging using the RESCAN™ 700 (Carl Zeiss Meditec, Oberkochen, Germany) was done for patients undergoing MICS as well as FLACS. The OCT videos were reviewed at each step of the procedure and the findings were noted and analyzed. RESULTS: Microscope Integrated Intraoperative Optical Coherence Tomography was found to be beneficial during all the critical steps of cataract surgery. We were able to qualitatively assess wound morphology in clear corneal incisions, in terms of subclinical Descemet's detachments, tears in the inner or outer wound lips, wound gaping at the end of surgery and in identifying the adequacy of stromal hydration, for both FLACS as well as MICS. It also enabled us to segregate true posterior polar cataracts from suspected cases intraoperatively. Deciding the adequate depth of trenching was made simpler with direct visualization. The final position of the intraocular lens in the capsular bag and the lack of bioadhesivity of hydrophobic acrylic lenses were also observed. CONCLUSIONS: Even though Microscope Integrated Intraoperative Optical Coherence Tomography is in its early stages for its application in cataract surgery, this initial assessment does show a very promising role for this technology in the future for cataract surgery both in intraoperative decision making as well as for training purposes.


Assuntos
Córnea/cirurgia , Terapia a Laser/métodos , Microscopia/instrumentação , Monitorização Intraoperatória/instrumentação , Facoemulsificação/métodos , Cirurgia Assistida por Computador/métodos , Tomografia de Coerência Óptica/instrumentação , Córnea/citologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes
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