17 research outputs found
A case of choroidal osteoma in a 10-year-old child
No full textMadhusmita Behera,1 Manmath Kumar Das2 1Rotary Narayana Nethralaya, Kolkata, India; 2Vitreo-Retina Services, CL Gupta Eye Institute, Moradabad, India Abstract: Choroidal osteoma is a rare, benign tumor, usually diagnosed in healthy adult women in their second or third decade of life. Though its etiology and pathogenesis are unclear, it is usually diagnosed due to its typical clinical features of yellowish-orange colored subretinal lesion at posterior pole and a dense echogenic plaque persisting even in lower gains on B-scan ultrasonography. Mostly unilateral (79%), the median age of diagnosis is 26 years. It is relatively rare in children. We report a case of choroidal osteoma in a 10-year-old boy. Keywords: choroidal osteoma, choroidal osseous choristoma, choroidal tumo
Retinopathy of prematurity like retinopathy in full-term infants
No full textPURPOSE: The purpose of this study is to assess clinical characteristics, risk factors, and management outcomes of retinal changes similar to retinopathy of prematurity (ROP), seen in full-term infants.
PATIENTS AND METHODS: This is a retrospective review of 46 eyes of 23 patients, born at full term or near full term and diagnosed to have active ROP-like retinopathy or sequelae of ROP-like retinopathy.
RESULTS: Mean birth weight (BW) and gestational age (GA) were 2342 ± 923 g (range, 1200–4160 g) and 38.5 ± 1.85 weeks (range, 37–40 weeks). Mean age at the time of diagnosis was 3.5 ± 8.75 years (range, 1 month–16 years). Stage 1 and 2 of retinopathy was seen in 10 eyes (21.7%), threshold disease with plus disease in 12 eyes (26%) and Stage 4 or 5 in 14 eyes (30.4%). Involutional sequelae were noted in 10 eyes (21.7%). Twenty-one eyes (45.6%) underwent appropriate treatment in the form of laser, cryotherapy, or retinal detachment surgery. Eight eyes (17.4%) with advanced sequelae such as total closed funnel retinal detachment and macular fold were not treated. Mean follow-up was 3 years (range, 1 month to 12 years). At the last follow-up, 29 eyes (63%) had a favorable structural outcome (P < 0.001). Among the patients in whom visual acuity could be assessed (16 eyes), favorable visual outcome was noted in 9 eyes (56.2%). Low BW (P = 0.038), multiple births (P = 0.013), respiratory distress syndrome (RDS) (P = 0.001), phototherapy (P = 0.001), and oxygen administration (P < 0.001) were significantly associated with the development of ROP-like retinopathy in these full-term infants.
CONCLUSIONS: ROP-like retinopathy can occur in full-term and near full-term infants and can potentially lead to permanent visual impairment. Screening of infants with risk factors such as oxygen administration, RDS, multiple births, and low BW, regardless of GA, may reduce visual impairment
Re: Toy et al.: Chronic vascular arrest as a predictor of bevacizumab treatment failure in retinopathy of prematurity ( Ophthalmology. 2016;123:2166-2175)
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Optimization of consolidation parameters of 18Cr-ODS ferritic steel through microstructural and microtexture characterization
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Distributed fault diagnosis with dynamic cluster-head and energy efficient dissemination model for smart city
No full textRETINOPATHY IN A CASE OF FAMILIAL HYPERCHOLESTEROLEMIA WITH DIABETES- A RARE CASE REPORT.
No full textBackground
Familial hyperlipidemia is a genetic disorder characterized by high levels of LDL cholesterol and is associated with an increased risk of sudden cardiac death. However, the majority of cases of familial hypercholesterolemia remain undiagnosed or diagnosed at a later stage. Hyperlipidemia per se plays a major role in the pathophysiology of diabetes and its complications. Lipid-lowering agents have a protective effect on the progression of diabetic retinopathy and reduce the risk of diabetic macular oedema. Hence in cases of familial hypercholesterolemia with diabetic retinopathy a combined and aggressive approach is vital for better visual outcome.
Case presentation
In this report, an unusual case of 54 years old male presented to the ophthalmology OPD of Kalinga Institute of Medical Sciences, Bhubaneswar with diabetic retinopathy which was unresponsive to conventional treatment. Upon thorough evaluation, he was diagnosed with a case of familial hypercholesterolemia, and lipid-lowering therapy was initiated along with intravitreal anti-VEGF injections to which he responded better and there was a significant improvement in visual acuity.
Conclusion
This case report emphasizes that all cases of diabetic retinopathy unresponsive to treatment should be thoroughly evaluated. Familial hypercholesterolemia is a grave disease with serious implications. Early diagnosis and timely intervention play a crucial role in improving visual prognosis and life expectancy in such patients
Comparison of Dexamethasone Implant and Anti-VEGF Agents in the Treatment of Naive Diabetic Macular Oedema: A Prospective Cohort Study
No full textIntroduction: Diabetic Retinopathy (DR) is one of the common
microvascular complications of diabetes. In patients with DR, the
most frequent cause of vision loss is Diabetic Macular oedema
(DME). In the present era, anti-Vascular Endothelial Growth Factor
(anti-VEGF) agents are the mainstay of treatment for managing
DME. A majority of patients show a good response to multiple
doses of these agents administered by a pro re nata regimen
at regularly spaced fixed intervals. However, the tendency of
DME to become chronic and resistant to these agents, as well
as the burden of repeated injections, necessitates considering
alternative treatment options with similar or better efficacy. As
steroids can address these drawbacks of anti-VEGF treatment,
the present study compared the efficacy of anti-VEGF agents
with dexamethasone implant in the treatment of naïve DME.
Aim: To compare the effectiveness of dexamethasone implant
with anti-VEGF agents in the treatment of naïve DME.
Materials and Methods: A prospective cohort study was
conducted in the Department of Ophthalmology at Kalinga
Institute of Medical Sciences and Pradyumna Bal Memorial
Hospital, Bhubaneswar, Odisha, India from September 2020
to September 2022. A total of 100 eyes with DME, newly
diagnosed patients aged 18 years and above, without other
macular oedema-causing diseases, were included. A total of
50 eyes in each group were treated with an anti-VEGF agent
(Group A) or dexamethasone implant (Group B), and Best
Corrected Visual Acuity (BCVA) and Central Foveal Thickness
(CFT) were monitored for six months. For statistical analysis,
paired t-test and independent t-test were used for within-group
and inter-group analysis, respectively. A p-value <0.05 was
considered statistically significant.
Results: In both groups, post-treatment BCVA showed marked
improvement, but there was no significant difference in mean
BCVA between the groups (p=0.89) at six months. However, the
mean CFT showed significant improvement in Group B at six
months. In Group A, the mean CFT reduced from 441.87±54.48
μm to 257.83±25.73 μm, and in Group B, the mean CFT
reduced from 464±109.44 μm to 207±22.51 μm at six months
(p<0.0001). Adverse events like cataracts and glaucoma were
seen in patients treated with the dexamethasone implant and
were managed by cataract surgery and topical anti-glaucoma
medications, respectively.
Conclusion: Dexamethasone implant and anti-VEGF agents
are equally effective in improving visual acuity; however,
dexamethasone stands superior in reducing macular thickness.
Needing fewer injections while treating with a dexamethasone
implant improves compliance. The progression of cataract remains
a major side-effect with the dexamethasone implant, which is not
a concern when treating DME in pseudophakic eye
