Real-world experience of full-thickness traumatic macular hole among young patients.

OBJECTIVE: To describe the demographics, clinical, and imaging characteristics, and visual outcomes in young patients with full-thickness traumatic macular hole (TMH). METHODS: This retrospective hospital-based study included patients with full-thickness TMH who presented between August 2010 and June 2021. Demographic data, clinical findings, and imaging characteristics were extracted from an electronic medical record system. Regression analyses were performed to determine significant associations among variables and to identify predictors of visual outcomes. RESULTS: 144 (0.005%) patients among 2,834,616 were diagnosed with Full thickness TMH. The majority of them were male (89.58%; odds ratio [OR] = 6.71) and the holes were unilateral. The mean age at presentation was 23.37 ± 8.19 years. Ball were the most common cause of injuries (22.22%), followed by stick (14.58%) and firecracker (12.50%). The mean LogMAR visual acuity (VA) at presentation was 1.18 ± 0.72, with 25.69% of eyes having VA < 20/400. The mean minimum hole diameter was 619.34 ± 336.16 µm. Sub-retinal fluid was present in 44.44%, followed by intraretinal fluid in 34.03% of eyes. Macular holes closed after vitrectomy in 66.67% of eyes, with mean final VA of 1.07 ± 0.85. Baseline VA was a strong predictor of final VA (R2 = 0.677; p = 0.000168). CONCLUSION: Traumatic macular hole is a unilateral condition with significant visual impairment that is mainly seen in males during the third decade of life. Surgery is successful in most cases but improvements in VA are modest.

Clinical Profile, Demographic Distribution and Risk Factors of Parafoveal Telangiectasia: An Electronic Medical Record-Driven Big Data Analytics from a Multitier Eye Care Network.

OBJECTIVE: To describe the demographics and clinical profile of parafoveal telangiectasia (PFT) and compare risk factors for diabetic retinopathy (DR) among PFT and non-PFT patients. METHODS: This cross-sectional hospital-based study included 2,834,616 new patients presenting to a multi-tier ophthalmology hospital network in India between August 2010 and June 2021. Patients with a clinical diagnosis of PFT in at least one eye were included as cases. The data were collected using an electronic medical record system. RESULTS: Overall, 2,310 (0.081%) patients were diagnosed with PFT. Most of the patients were female (62.42%) with (odds ratio [OR] = 2.08), and had bilateral (84.85%) affliction. The most common age group at presentation was during the sixth decade of life with 825 (35.71%) patients. The overall prevalence was higher in patients from an upper socio economic status (0.242%) presenting from the metropolitan geography (0.113%; OR = 2.37). Systemic history of diabetes mellitus (DM) with a mean duration of 122.03 ± 95.59 months was seen in 849 (36.75%) and hypertension in 609 (26.36%) patients. Of the 4,270 eyes, 2,441 (57.17%) eyes had a visual impairment of mild or no visual impairment (<20/70) followed by moderate visual impairment (>20/70-20/200) in 1022 (23.93%) eyes. The risk of sight threatening diabetic retinopathy (STDR) among PFT patients was higher (OR = 1.43) compared to non-PFT cohort. Choroidal neovascular membrane (CNVM) was observed in 481 (11.26%) eyes. CONCLUSION: PFT is more common in females and is predominantly bilateral. PFT is more common in upper socio economic status and majority of the eyes had mild or moderate visual impairment. Diabetes and Hypertension are associated risk factors in PFT.

Clinical profile and demographic distribution of Stargardt disease phenotypes: An Electronic medical record-driven big data analytics from a multitier eye care network.

Purpose: To describe the demographics and clinical profile of Stargardt disease in patients presenting a multitier ophthalmology hospital network in India. Methods: This cross-sectional hospital-based study was performed among 2,834,616 new patients presenting between August 2010 and June 2021 in our network. Patients with a clinical diagnosis of Stargardt disease in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 1,934 (0.069%) patients were diagnosed with Stargardt disease. Most of the patients were male (63.14%). The most common age group at presentation was during the second decade of life, with 626 (31.87%) patients. The overall prevalence was higher in patients from a higher socioeconomic status (0.077%), in those presenting from the urban geography (0.079%), and in students (0.197%). Systemic history of hypertension was seen in 56 (2.85%) patients, while diabetes mellitus was seen in (2.49%) patients. Of the 3,917 eyes, 1,910 (48.76%) eyes had moderate visual impairment (>20/70-20/200) followed by severe visual impairment (>20/200 to 20/400) in 646 (16.49%) eyes. The most commonly associated retinal signs were retinal flecks in 1,260 (32.17%) eyes, followed by RPE changes in 945 (24.13%) eyes. The most documented investigations were autofluorescence (39.85%), followed by optical coherence tomography (23.90). Cataract surgery was the commonest performed surgical intervention in (0.66%) eyes, followed by intravitreal injection in 4 (0.10%) eyes. The family history of parent consanguinity marriage was reported by 212 (10.79%) patients. Conclusion: Stargardt disease was seen more commonly in males presenting during the second decade of life. It is predominantly a bilateral disease, with the majority of the eyes having moderate visual impairment.

Clinical profile, demographic distribution, and outcomes of ocular siderosis: Electronic medical record-driven big data analytics from an eye care network in India.

Purpose: To describe the demographics, clinical profile, and outcomes of ocular siderosis in patients presenting to a multi-tier ophthalmology hospital network in India. Methods: This cross-sectional and hospital-based study included 3,082,727 new patients who presented between August 2010 and December 2021. Patients with a clinical diagnosis of ocular siderosis in at least one eye were included. Results: Overall, 58 eyes of 57 patients (0.002%) were diagnosed with ocular siderosis. The majority were men (96.49%) and had unilateral (98.25%) affliction. The most common age group at presentation was during the third decade of life with 24 patients (42.11%). A clear history of ocular trauma was documented in 47 patients (81.03%). Major clinical signs included corneal pigment deposition in nearly half of the eyes (27/58 eyes, 46.55%), corneal scar (20/58 eyes, 34.48%), cataract (22/58 eyes, 37.93%) and retinal detachment (11/58 eyes, 18.96%). The intraocular foreign body (IOFB) was anatomically localized in a majority of the eyes (i.e., 45/58 eyes, 77.59%). The most common location of the IOFB was in the posterior segment (22/58 eyes, 37.93%). The eyes that underwent a vitreoretinal surgery with removal of IOFB had a slightly better BCVA (1.0 ± 1.01) when compared to eyes with non-removal of IOFB (1.58 ± 1.00). Conclusion: Ocular siderosis is a rare sight-threatening entity, with half of the affected eyes exhibiting severe visual impairment. Majority of the eyes in ocular siderosis will have a detectable IOFB. Surgical removal of IOFB may lead to a better visual gain when compared to non-removal.

Clinical profile and demographic distribution of ophthalmia nodosa: An electronic medical record-driven big data analytics from a multitier eye care network.

Purpose: To describe the demographics and clinical profile of ophthalmia nodosa in patients presenting to a multitier ophthalmology hospital network in India. Methods: This cross-sectional, hospital-based study included 3,082,727 new patients presenting between August 2010 and December 2021. Patients with a clinical diagnosis of ophthalmia nodosa in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 434 (0.014%) patients were diagnosed with ophthalmia nodosa. Most of the patients were male (71.43%) and had unilateral (97.7%) affliction. The most common age group at presentation was during the third decade of life with 116 (26.73%) patients. The overall prevalence was higher in patients from a higher socioeconomic status (0.015%) presenting from the urban geography (0.019%) and in professionals (0.027%). The setae were identified and removed at presentation in 287 (66.13%) patients. The most common location of the setae was conjunctiva (45.72%) followed by cornea (39.64%). Most of the eyes (355; 79.95%) had mild or no visual impairment (<20/70). The most documented ocular signs were eye lid edema (35.81%), conjunctival congestion (73.87%), and corneal abrasion (29.05%). Less than one-tenth of the eyes required a surgical intervention for removal of the setae, corneal foreign body removal was performed in 10 (2.25%) eyes and conjunctival foreign body removal in four (0.90%) eyes. Conclusion: Ophthalmia nodosa more commonly affects males presenting during the third decade of life and is predominantly unilateral. The setae are most commonly lodged in the conjunctiva followed by the cornea, and the majority of the eyes have mild or no visual impairment.