bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of health education on preventive practices of breast cancer among women from rural field practice area of a Medical College in Hyderabad, Telangana State
Authors: Gogolla Bhagya Rekha , V. Kumari S. M. V. , Priyanka Sriramula
Published: May 2024

Background:

Breast cancer (BC) is the most prevalent cancer among Indian women. The Indian Council of Medical Research found 1.5 lakh new cases in 2016. In 2020, globally 2.3 million women were diagnosed; 685,000 deaths occurred. Lack of awareness about risk factors, signs, symptoms, and preventive practices is the main cause for its increasing incidence. Breast self-examination (BSE) has a role in the early detection of cancer. Its treatment is effective when diagnosed in the early stages.

Objective:

The objective of this study was to determine the impact of health education on preventive practices of BC among women.

Subjects and Methods:

A community-based interventional follow-up study was conducted in a rural field practicing area of government medical college, Hyderabad. Using multistage sampling, 260 women in the 20–50 years of age group were selected. Data regarding knowledge of BC were collected by pretested questionnaire in the preintervention phase. In the intervention phase, health education on BC and BSE was imparted through audiovisual aids and flip charts. In the postintervention phase, the impact of health education was assessed 2 weeks later using the same questionnaire. Data were entered in MS Excel and analyzed by Epi Info version 7.

Results:

In pre and postintervention phases, the knowledge regarding BSE practice increased from (5%) to (77.7%); obesity (20.8%) to (71.5%); breast lump (7.7%) to (71.2%); advancing age (5.8%) to (68.5%); nipple discharge (3.8%) to (63.1%); alcohol (6.6%) to (61.9%) and family history (13.5%) to (60%).

Conclusion:

The study highlights the importance of health education on preventive practices of BC in increasing knowledge.
Knowledge, attitude, and practice on cervical cancer and its screening among women of Mulugu Mandal
Authors: Ramyatha Kasha , Tubachi Aruna , Veera Bhadreshwara Anusha Doddoju , Anumolu Gopa Raju
Published: May 2024

Background:

Cervical cancer is the fourth-leading cause of death in females among noncommunicable diseases. Hence, knowledge of risk factors, symptoms, and screening in females, especially in rural areas is important to reduce the burden of disease.

Objective:

The objective of this study was to estimate the level of knowledge, attitude, and practice (KAP) regarding risk factors, symptoms, and preventive measures of cervical cancer, and screening the females by means of Papanicolaou test (PAP) smear.

Subjects and Methods:

A cross-sectional study was conducted among 30–65 years females of Mulugu Mandal from October 2021 to February 2022. After obtaining informed consent, 505 females were interviewed by house-to-house visit using a semistructured questionnaire with questions regarding KAP on risk factors, symptoms, and preventive measures of cervical cancer, and motivated female for PAP smear if willing, was brought to the institution. Data were analyzed using SPSS 22.

Results:

The mean age of the study participants was 47.46 ± 9.698. Good knowledge, positive attitude, and regular practice were 11.28%, 43.8%, and 14.1%, respectively, on cervical cancer. PAP smear acceptance rate was 14.059% result and showed 12.6% have atypical squamous cells of undetermined significance and 87.3% have an inflammatory smear.

Conclusion:

Knowledge on risk factors, symptoms and screening for cervical cancer is low, and the acceptance rate of PAP smear is very low.
Traditional practices of oral health care among tribals of India: A scoping review
Authors: Deshmukh Neeti , Ikhar Anuja , Paul Priyanka
Published: May 2024

Objective:

The scoping review aims to study the traditional practices of oral health care among tribals of India.

Search:

The Google Scholar database was searched using a search strategy for articles on traditional oral health-care practices among tribals of India and the composition and properties of medicinal plants used. Two hundred and forty-nine articles were reported in the search and screened for eligibility. Seven articles found suitable have been included in the review.

Results:

The results showed that 95 plant species were identified that were used for oral health by the tribal population in India. These species were mostly used as toothbrushes, for making toothpastes, and mouthwashes, relieving toothaches, treating bleeding gums, halitosis, and caries, and for whitening the teeth.

Conclusion:

The plants used have many medicinal properties, which may be why tribals use it.
Iselin's disease as an uncommon cause of foot pain
Authors: Dharmshaktu Ganesh Singh , Dharmshaktu Ishwar Singh , Agarwal Sundeep Kumar , Kamat Ajay
Published: May 2024

Iselin's disease is an uncommon cause of lateral foot pain in children and adolescents. Iselin's disease represents a stress-related injury to the base of the fifth metatarsal and associated apophysitis. The diagnosis requires careful clinical and radiological evaluation. The characteristic radiological features help in confirming the diagnosis and exclude the traumatic injury as a key differential diagnosis. This disorder, however, can be misdiagnosed in primary care or rural settings due to a lack of knowledge or limited experience of the health-care workers. Iselin's disease should be kept in the differential diagnosis in an adolescent with localized fifth metatarsal base pain and should be investigated for the appropriate treatment. We present a series of seven cases presenting with pain and characteristic radiological features of Iselin's disease. All were managed conservatively and recovered with good functional outcomes.
Patterns of tubercular lymphadenitis encountered in routine cytology reporting: An experience in a tertiary care center of Northeastern part of India
Authors: Bhuyan Geet , Deshpande Maheshri
Published: May 2024

Background:

Tuberculosis (TB) is the thirteenth leading cause of death and the second leading infectious killer after COVID-19 worldwide in 2020. Fine-needle aspiration (FNA) cytology is a simple and economic procedure for the diagnosis of TB at the initial stage. In this study, we tried to study the various cytomorphological patterns of tubercular lymphadenitis encountered in routine practice.

Materials and Methods:

This is a retrospective study that was carried out in a tertiary care setting in north eastern India between 2019 and 2022. We retrieved 305 cases of tubercular lymphadenitis and classified them into 4 morphological patterns. These were: pattern A-Epithelioid granuloma without necrosis; pattern B-Epithelioid granuloma with necrosis; pattern C-Necrosis without epithelioid granuloma and with numerous neutrophilic infiltrate; and pattern D-Cases with numerous macrophages.

Results:

In our study, pattern C was the most common (44%) followed by pattern (23%); pattern B was seen in 80 cases (26%); and pattern D was seen in only 22 cases (7%). Among patients with HIV infection, the most common pattern was pattern D (80%).

Conclusion:

This study shows that TB lymphadenitis is a disease with various morphological patterns. And understanding it can aid in the accurate diagnosis of tubercular lymphadenitis.
Adoption of a comprehensive approach to minimize the occurrence of birth defects in low- and middle-income nations
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2024

Birth defects refer to those conditions that exist right from the time of birth and account for structural alterations in one or more parts of the newborn. It has been reported that 0.24 million and 0.17 million newborns have lost their lives within the first 28 days of life and between the ages of 1 month to 5 years respectively on an annual basis. Apart from deaths, birth defects have been linked to long-term disability, which accounts for significant impairment in the quality of life of individuals, their families, the community, and the health care delivery system. This calls for the need to take specific measures to ensure the prevention of birth defects either via eliminating the potential risk factors or through reinforcement of protective measures. To conclude, birth defects are a global public health concern linked to morbidity, disability, and mortality. Acknowledging the fact that most birth defects are either preventable or treatable, it is the need of the hour to take comprehensive and prompt measures to improve the existing scenario and thereby ensure improvement in the quality of life of individuals, families, and community.
Generalized anxiety causing globus pharyngeus
Authors: Thejas Saai Ram , Sharanya Jangili , Rajamohan Ganganamoni
Published: May 2024

Background:

Globus is a feeling of a sensation of a lump in the throat. A variety of explanations (physical and psychological) have been proposed in its etiology, but it is nonspecific nature and high incidence makes a causative association hard to establish or refute.

Objective:

To associate the role of Anxiety in the etiology of globus pharyngeus.

Materials and Methods:

A prospective study was conducted in a rural private hospital in South India. One hundred and ninety-three patients with a sensation of lump in the throat were assessed after obtaining consent. A strict inclusion and exclusion criteria meant only 54 made it to the final study. A pan endoscopy was conducted to rule out local lesions. In each patient with absence of a local lesion, Hamilton-A Anxiety (HAM-A) Scale was issued for the levels of anxiety (values between 0 and 56) and the visual analog scale (VAS) for uneasiness experienced (values between 1 and 10) before and after 12-weeks treatment. Management included oral escitalopram and clonazepam.

Results:

At the end of the study, the average score for HAM-A Scale was 13.96 compared to 26.17 before treatment, an improvement of 46.65%. The average values before and after treatment in the VAS before and after treatment were 7.43 and 3.33, an improvement of 55.18%.

Conclusion:

In the absence of a local cause, the diagnosis of globus should be looked at from psychological viewpoints. Undiagnosed or untreated anxiety can cause globus and it is more commonly seen in women in the age group of 36–45 years. The P value was significant in this study where we treated anxiety leading to globus (<0.05). Thus, we infer that treatment of anxiety as an entity can help in the management of globus.
Nomophobia in the students of a medical college using smartphones
Authors: Kiran Epari Ravi , Vijaya Karri , Ashwini Mangu Rama
Published: May 2024

Background:

Mobile Information and Communication Technologies have led to the rise in dependence on smartphones worldwide and nomophobia (NMP) which is the fear of being out of mobile phone contact.

Objectives:

The objectives of the study were to assess smartphones usage among the medical students, to estimate the prevalence of NMP, it's gradation and it's association of different variables with grade of NMP.

Methods:

A community-based, analytical cross-sectional study was conducted among medical students selected by the systematic random sampling technique. A questionnaire comprising smartphone ownership/usage variables and questions on NMP Questionnaire was used.

Results:

Female students (70.9%) were more compared to males (29.1%). Majority (44.7%) were in the age group of 19–20 years. 52.4% of them had received ≤3 E-mails/day. 56.4% of them had installed ≤20 apps in their smart phones in their smartphones. Sixty-eight percent of them had installed ≤3 newer apps in last month. The prevalence of NMP was found to be 100% with the maximum (63.1%) having moderate grade of NMP. It was found that the associations of the community, possession of smartphone, average monthly mobile phone bill including internet usage, and number of E-mails sent per day with the difference in the grade of NMP were found to be statistically significant, (P = 0.04), (P = 0.04), (P = 0.01), and (P = 0.04), respectively.

Conclusions:

The high prevalence of NMP can be attributed to the use of smartphones for online classes due to the COVID-19 pandemic.
Endoscopic cyclophotocoagulation for glaucoma compared to alternative procedures –A Systematic review
Authors: Alasbali Tariq
Published: May 2024

INTRODUCTION:

Despite many recent developments, preference in the choice of surgical treatment of uncontrolled intraocular pressure (IOP) remains a challenge.

OBJECTIVE:

This study compares the clinical efficacy and safety of endoscopic cyclophotocoagulation (ECP) to alternative surgical procedures, for all types of glaucoma.

METHODOLOGY:

The methodology adheres to the preferred reporting items for systematic reviews and meta-analyses guidelines for systematic review reporting. Studies reporting ECP and alternative surgeries in treating refractory glaucoma, neovascular glaucoma, aphakic glaucoma, filtering surgical failure-induced glaucoma, congenital or juvenile glaucoma, and secondary glaucoma such as uveitis glaucoma, traumatic glaucoma, secondary glaucoma postcorneal transplantation, etc. were included. The efficacy was evaluated from the number of IOP-lowering drugs, and mean change in pre- and post-IOP were the outcomes assessed in ECP and non-ECP groups in this review. Evaluations of the postoperative complications revealed the safety assessment of the procedure.

RESULTS:

In total, 11 relevant studies were selected in this study with a total of 5418 eyes, including 763 eyes in the ECP group and 4655 in the non-ECP group. This review observed that both ECP and non-ECP procedures had been successful in reducing postoperative IOP.

CONCLUSION:

It can be deduced from this review, that all types of glaucoma can be treated efficiently with significantly higher success rates with ECP and ECP demonstrates lowest postoperative complications when compared to non ECP procedures. This review provides updated scientific evidence which caters to support clinical decisions for surgical treatment of glaucoma.
Chronic myelogenous leukemia in a child following treatment for bilateral retinoblastoma
Authors: Al-Mahrouqi Haitham Hilal , Ganesh Anuradha , Al-Rawas Abdulhakim , Khetan Vikas , Al-Zuhaibi Sana
Published: May 2024

A 3-year-old child was incidentally found to have chronic myelogenous leukemia (CML) during an admission for a routine ophthalmic examination under anesthesia. The child had received systemic chemotherapy and focal treatment for Groups C and D retinoblastoma in the right and left eye, respectively, when she was 7 months old. CML was treated with dasatinib, and the child attained a major molecular response. The child is now 3 years after treatment of CML, and the retinoblastoma remains inactive. CML following treatment of retinoblastoma is a rare occurrence. Long term and close monitoring of retinoblastoma patients who received systemic chemotherapy using serial blood tests is essential.
Monotherapy with topical Natamycin to treat Scedosporium keratomycosis: A rare case from Central India
Authors: Khan Lubna , Keche Archana Y. , Kumar Aseem
Published: May 2024

Keratomycosis is common in Indian subcontinent. Diagnosis of the causal agent and successful management is a challenge for the clinician. Scedosporium is a rare fungus species, and it is relatively rare in causing keratomycosis. We report the case of a 29-year-old male who presented with complaints of redness, watering, and white lesion over his left eye. He sustained an injury in the left eye with vegetative matter. Corneal scraping was sent for potassium hydroxide staining and culture; fungal colony was seen in culture. Colony characters on Sabouraud dextrose agar and lactophenol cotton blue enabled a diagnosis of Scedosporium species. The patient was treated with topical Natamycin 5%, and complete resolution was seen at the end of 4 weeks. This case report highlights good response of keratitis caused by Scedosporium to topical Natamycin therapy.
Knowledge, attitude, and practice on digital eye strain during coronavirus disease-2019 lockdown
Authors: Jain Sneha , Das Oindrila , Roy Aindrila , Das Abhisekh
Published: May 2024

BACKGROUND:

Computer vision syndrome is a group of eye and vision-related problems that result from prolonged computer use. The worldwide pandemic of coronavirus disease-2019 (COVID-19) lockdown has led to an increase in the digital screen exposure as jobs as well as academic learning have majorly shifted online. This has caused an increase in digital eye strain (DES) globally. The aims and objectives of this study were to compare the knowledge, attitude, and practices among medical and nonmedical professionals with regard to DES in a background of COVID-19 lockdown.

MATERIALS AND METHODS:

A cross-sectional, observational, online questionnaire-based research survey analysis was conducted among medical professionals with age- and sex-matched nonmedical professionals. Responses were collected over a week and analyzed. The level of significance was set at a P < 0.05. Statistical Package for the Social Sciences software version 23.0 was used for the result analysis.

RESULTS:

Our study included 353 (50.4%) medical and 347 (49.6%) nonmedical personnel. It was noted that 266 (75.4%) of medical professionals and 268 (77.2%) of nonmedical professionals experienced eye problems after prolonged digital screen exposure. A significant proportion of respondents experienced an increase in symptoms following COVID-19 lockdown with 140 (52.6%) being medical professionals and 163 (60.8%) nonmedical professionals (P = 0.015).

CONCLUSIONS:

DES is a preventable lifestyle-associated disorder. Awareness among the masses can reduce the adverse effects. Proper lighting, adequate viewing distance, voluntary blinking, and using lubricating eye drops are a few ways to reduce the chances of DES. Further studies are needed to formulate standardized guidelines for the management of DES.
Pegylated interferon-alpha-2a for the treatment of ocular surface squamous neoplasia
Authors: Nuruddin Murtuza , Roy Soma Rani , Hoque Fahmida
Published: May 2024

Ocular surface squamous neoplasia (OSSN) is the most common nonpigmented ocular surface neoplasm. Interferon-alpha (IFNα)-2b has been proved to be an effective immunotherapeutic agent to treat OSSN. We have used intralesional and topical (36 μg/ml) pegylated (peg) IFNα-2a to treat a recurrent surgically failed case of OSSN instead of IFNα-2b. In this case report, we have shared our initial experience with the novel use of peg-IFNα-2a to treat OSSN. According to our brief clinical experience, peg-IFNα-2a is nontoxic to ocular surface and has a promising role to treat OSSN.
Complications associated with the use of two types of silicone oil in vitreoretinal surgeries
Authors: Al-Abri Mohamed , Al-Hinai Ahmed , Al-Musalami Adil , Al-Ghaithi Huda
Published: May 2024

OBJECTIVES:

The objective of this study is to describe complications associated with the use of two types of silicone oil (SO) (1000 centistokes [cs] and 5000 cs) in vitreoretinal surgery in Oman.

MATERIALS AND METHODS:

This is a retrospective descriptive study on all patients who underwent vitreoretinal surgeries in which SO injection or removal was done. The study was conducted at Sultan Qaboos University Hospital between January 1, 2010, and December 31, 2017. Demographic data, lens status of the eye at the time of SO injection, type of SO used (1000 cs or 5000 cs), and complications associated with SO were collected.

RESULTS:

A total of 107 eyes of 103 patients were included in the study. SO 1000 cs was used in 66 eyes and SO 5000 cs was used in 41 eyes. A total of 29 eyes (27%) developed SO-related complications, which included SO emulsification in 14 eyes (13.1%), raised intraocular pressure (IOP) >21 mmHg in 19 eyes (17.8%), and band keratopathy in 4 eyes (3.7%). SO emulsification was seen in eight eyes (12.1%) in whom SO 1000 cs was used and in five eyes (12.2%) in whom SO 5000 cs (P = 1.000).

CONCLUSION:

SO was found to be a relatively safe adjunct in vitreoretinal surgery. SO-related complications such as SO emulsification, raised IOP, and band keratopathy were observed in less than one-third of study eyes. No difference was noted in emulsification rate between SO 1000 cs and SO 5000 cs. Further studies with larger sample size and longer follow-up period are warranted.
Outcome of cataract surgery in pediatric uveitis (experience at King Khalid Eye Specialist Hospital)
Authors: AlAmeer Ahmad Mohammed , Al Shamrani Mohammed
Published: May 2024

BACKGROUND:

Cataract is a major complication of uveitis in children that requires timely management to restore good vision and prevent amblyopia. In surgical management of uveitic pediatric cataracts, published literature has shown a variety of clinical factors affecting the final visual outcome. The aim of this study is to investigate and report the clinical outcomes of cataract surgery and contributing factors impacting such outcomes in children with uveitis.

MATERIALS AND METHODS:

A retrospective case series of all pediatric patients (<18 years) who were diagnosed with uveitis and had cataract surgery at a tertiary eye institutions, between January 2000 and October 2016. Outcomes measures include best-corrected visual acuity (BCVA) and postoperative complications. Success was defined as BCVA of ≥20/60. Factors related to successful outcome were analyzed.

RESULTS:

The study sample was comprised of 26 patients (39 eyes). The median postoperative follow-up was 6.4 years. At the last follow-up, only 2 eyes had active uveitis, 3 eyes were controlled without medications, and 34 eyes were controlled with systemic or topical medications. At the last follow-up, 64% of eyes had BCVA ≥20/60. Anterior uveitis and postoperative aphakia were two determinants, in statistically significant manner, found to be positively related to clinical success (P = 0.01 and 0.04, respectively). Etiology of uveitis and use of preoperative intravenous methylprednisolone were not related to the success of obtaining BCVA ≥20/60 (P = 0.5 and 0.99, respectively).

CONCLUSIONS:

Cataract surgery improves the visual function of children with clinically significant uveitic cataracts. In this study, we found diagnosis of anterior uveitis and postoperative aphakia to be associated with better final postoperative visual outcomes.
Childhood hypertension, sixth nerve palsy, and renal artery stenosis
Authors: Madan Siddharth , Chaudhuri Zia
Published: May 2024

This short report demonstrates an uncommon presentation of intracranial bleeding and sixth nerve palsy in a child with systemic hypertension due to long-standing unilateral renal artery stenosis of unknown etiology that resulted in contracture of the affected kidney and compensatory hypertrophy of the contralateral kidney. Structural renal damage and cardiac ventricular hypertrophy suggested the pathology and ensuing hypertension to be long-standing; however, renal function tests were normal at presentation. The importance of routine outpatient evaluation of systemic blood pressure in children, similar to adults, so as to diagnose and treat secondary hypertension and its causes early, before further systemic and neurological complications set in, is emphasized. The primary neuro-ophthalmological clinical presentation of the child with subsequent confluence of major pediatric domains of medicine, surgery, neurology, cardiology, nephrology, interventional radiology, and ophthalmology toward optimum multidisciplinary etiological and symptomatic management of the condition and its sequelae and subsequent rehabilitation is described.
Clinical profile, treatment, and visual outcome of scleritis
Authors: Magesan Kowsigan , Patnaik Gazal , Majumder Parthopratim Dutta , Biswas Jyotirmay
Published: May 2024

PURPOSE:

The purpose of this study was to analyze the clinical profile of patients with scleritis managed by a single ophthalmologist in a tertiary eye care center.

METHODS:

This was a retrospective analysis of 107 eyes of 96 patients with scleritis from January 2007 to December 2018.

RESULTS:

Female predominance (68%) with a relatively young-onset (46 ± 14 years) of scleritis was observed. Diffuse anterior scleritis (41%) was the most common subtype of scleritis, and the most common systemic association was rheumatoid arthritis (18%). Three-fourth of patients received immunosuppressive treatment (74%) along with corticosteroids. The mean follow-up period was 3 ± 2.5 (range: 0.6–10) years. Necrotizing scleritis was at a 3.5 times higher risk of developing ocular complications. Eighty percent of patients maintained the same vision. Recurrence of scleritis was noted in 25 eyes (23%).

CONCLUSION:

Diffuse scleritis is the most common scleritis in our population. Tuberculosis was commonly seen with diffuse scleritis. The likelihood of developing ocular complications (cataract and glaucoma) was higher in necrotizing scleritis, thus requiring periodic monitorization.
Role of preoperative anterior segment optical coherence tomography in identifying intraoperative posterior capsular dehiscence in posterior polar cataract
Authors: Sarkar Shreyasi , Das Sayan
Published: May 2024

INTRODUCTION:

The presence of preoperative posterior capsular dehiscence in posterior polar cataracts (PPCs) increases the chances of intraoperative posterior capsular rent. Our study aims to demonstrate the efficacy of preoperative anterior segment optical coherence tomography (ASOCT) to predict intraoperative posterior capsular rupture (PCR) in PPC.

MATERIALS AND METHODS:

This was an observational study including patients within 25–75 years of age, having PPC, undergoing phacoemulsification. ASOCT was done for evaluating preoperative posterior capsular status and was graded as “intact” or “dehiscent, and eventually ,intraoperative-posterior capsular status was noted.

STATISTICAL ANALYSIS:

SPSS (version 27.0) was used, and P value of ≤ 0.05 was considered statistically significant.

RESULTS:

ASOCT of 44 eyes had 9 (20.5%) dehiscent posterior capsules and 35 (79.5%) intact. Out of these 9 eyes, 7 (77.8%) had intraoperative PCR and 2 (22.2%) did not. Out of these 35, 34 (97.1%) were actually intact intraoperatively and 1 (2.9%) had intraoperative PCR. The sensitivity and specificity of ASOCT for detecting dehiscence were 94.4% and 87.5%, respectively. The positive and negative predictive values were 97.1 and 77.8, respectively. The diagnostic accuracy of the test was 95.45% with a Chi-square value of 27.01 (P < 0.0001). The diagnostic validity of ASOCT grading for detecting preoperative dehiscence was confirmed. The association between intraoperative PCR and preoperative dehiscence was statistically significant (Chi-square test – P < 0.0001). Our objective was established.

DISCUSSION AND CONCLUSION:

The demographics and clinical parameters were comparable with other studies. Two eyes with preoperative dehiscence on ASOCT had intact posterior capsule during surgery. The cause can be a dense opacity with increased optical density causing an obscured a clear capsule view on ASOCT, an artifact defect, giving a false impression of dehiscence. One eye who had nondehiscent PC on ASOCT was found to have PCR on the table, which can be due to an extremely thin PC or tightly adherent polar opacity to the capsule. According to our study, the diagnostic accuracy of ASOCT for detecting preoperative dehiscence was 94.4% (sensitivity)and of nondehiscence was 87.5%(specificity). 97.1% of eyes with dehiscence on ASOCT, had actual posterior capsular rent (positive predictive value). To conclude, ASOCT can be used as a reliable diagnostic modality.
Occult globe perforation during posterior sub-tenon injection diagnosed by ultrasound biomicroscopy
Authors: Priya Sweksha , Kumar Amitabh , Alam Md. Shahid
Published: May 2024

Inadvertent globe perforation during posterior sub-tenon (PST) injection is rare, and the use of ultrasound biomicroscopy (UBM) in the diagnosis of occult globe perforation is not reported yet in the literature. We hereby intend to discuss the case of a 42-year-old male who presented with left eye loss of vision following PST triamcinolone acetate (TA) injection. On examination, right eye vision was 20/20 and it was 20/120 for the left eye. Fundus examination of the left eye showed a whitish fluffy mass like preretinal lesion over the macula with vitreous haze. The patient was thoroughly investigated for intermediate and posterior uveitis. However, all reports turned out to be within the normal limits. The 360° UBM scan of the left eye showed well-defined hypoechoic scleral tract suggestive of globe perforation at 2 o’clock position. The, whitish preretinal mass in the left eye was suspected to be intravitreal TA deposit following an inadvertent globe perforation during the posterior sub-tenon TA injection. UBM can be considered important diagnostic aid in ruling out possibility of occult globe perforation in certain circumstances.
Evaluation of macular perfusion in eyes with proliferative diabetic retinopathy using optical coherence tomography - Angiography following panretinal photocoagulation
Authors: Shah Shraddha , Venkataraman Anusha , Appaji Abhishek , Prabhushanker Mahalingam , Ganesan Geetha
Published: May 2024

AIM:

The aim of this study is to evaluate the effect of panretinal photocoagulation (PRP) on macular perfusion using optical coherence tomography–angiography (OCT-A) in eyes with proliferative diabetic retinopathy (PDR) by assessing the vessel density (VD) and the size of the foveal avascular zone (FAZ) of the superficial capillary plexus (SCP) and the deep capillary plexus (DCP), before and after PRP.

SETTINGS AND DESIGN:

Prospective interventional study.

SUBJECTS AND METHODS:

Twenty-nine eyes of 17 patients with PDR underwent a measurement of best-corrected visual acuity (BCVA) and were imaged using OCT and OCT-A at baseline and 6-months of follow-up. Patients received three sittings of PRP using frequency-doubled neodymium-doped yttrium aluminum garnet laser.

STATISTICAL ANALYSIS USED:

The OCT-A variables were analyzed using generalized estimating equations.

RESULTS:

BCVA was unchanged at 6-months follow-up (P = 0.09). FAZ of SCP and DCP (P = 0.28 and 0.89, respectively), VD at foveal SCP (P = 0.08), foveal DCP (P = 0.05), parafoveal SCP (P = 0.13), and parafoveal DCP (P = 0.07) showed no statistically significant difference at 6 months post PRP.

CONCLUSIONS:

OCT-A parameters were not significantly affected by PRP at 6-months follow-up indicating no alteration in macular perfusion. Further analyses with larger samples and longer duration are warranted to confirm our results.
An association between bilateral keratoconus in a patient with spondyloocular syndrome and xylosyltransferase II gene mutation
Authors: Fathi-Nieto Sara , Butrón-Ruiz Rodrigo , García-Soler Enrique , Hervás-Ontiveros Ana , Ortiz-Seller Amparo
Published: May 2024

Spondyloocular syndrome (SOS) is a rare autosomal-recessive disorder. Since 2015, SOS has been linked to mutations in xylosyltransferase II (XYLT2) locus. Phenotypic features could affect multiple systems, such as sight, hearing, or bones. Herein, we report a case of SOS with multiple bone fractures without trauma, bilateral cataracts, and sensorineural hearing loss. Mutations in XYLT2 gene were detected, and the diagnosis of SOS was made. At the age of 8, the patient presented with progressive vision loss. Slit-lamp examination revealed inferior steepening, apical scarring, and thinning of the cornea. Due to keratoconus suspicion, a corneal tomography was done, confirming the diagnosis of keratoconus. We present the first case of bilateral keratoconus in a patient with SOS.
Analysis of choroidal structure and vascularity indices with image binarization of swept source optical coherence tomography images
Authors: Rishi Pukhraj , Akhtar Zeeshan , Agrawal Rupesh , Agrawal Ashutosh , Rishi Ekta
Published: May 2024

PURPOSE:

To evaluate choroidal vascularity index (CVI) among normal subjects using image binarization of swept source optical coherence tomography (SS-OCT).

MATERIALS AND METHODS:

Four hundred and sixty eyes of 230 normal participants were included. Total circumscribed choroidal area, luminal area, stromal area (SA), and CVI were derived from SS-OCT scans using open-source software (ImageJ) with the modified Niblack method. Both CVI and subfoveal choroidal thickness (SFCT) were correlated with age, refractive error, intraocular pressure, and mean ocular perfusion pressure (MOPP) using mixed linear model analysis. Pearson's correlation coefficient was used to determine the relationship between age and each dependent factor. Analyses were performed using the SPSS software version 20.0 (IBM Corp., Armonk USA) and statistical significance was tested at 5%.

RESULTS:

The mean age was 42.1 (±17.6) years. Mean SFCT was 307 ± 79 μm. Mean CVI was 66.80 (±3.8)%. There was statistically significant positive correlation between CVI and increasing age (r = 0.259, P < 0.0001) and statistically significant negative correlation between SFCT and age (r = −0.361, P < 0.0001). There was positive linear correlation between refractive error and CVI (r = 0.220, P < 0.0001) and negative correlation between SFCT and refractive error. There was no significant effect of MOPP on both CVI (P = 0.07) and SFCT (P = 0.7).

CONCLUSION:

CVI and SFCT are significantly correlated with age and refractive error in normal Indian eyes.
Characterization of red eye cases presented to the eye emergency clinic at a tertiary care hospital during COVID-19 Pandemic
Authors: Al Tamimi Haidar Faisal , Allawi Mohammed Nadhem , Hanumantharayappa Kishore
Published: May 2024

BACKGROUND:

The World Health Organization (WHO) was notified by China on December 31, 2019, of a pneumonia outbreak severe acute respiratory syndrome-associated coronavirus-19 virus infection in Wuhan. This outbreak was declared by the WHO from the Public Health Emergency of International Concern to formal declaration as a pandemic on March 11, 2020. Because the public health measures like lockdown, the eye care delivery system was markedly impacted. The aim of this study was to find out if any pattern change of red eye cases among patients who attended eye accident and emergency (A and E) in a tertiary care hospital during COVID-19 pandemic in 2020 compared to 2019 and 2018.

MATERIALS AND METHODS:

This was a cohort retrospective study which included all patients who presented to eye A and E clinic with red eye from March 1 to July 31 in 2018, 2019, and 2020. Data were analyzed using statistical tools in the SPSS software. Furthermore, the clinical records of 578 inpatients with proven COVID-19 were reviewed for any red eye problem.

RESULTS:

Out of 7895 eye patients attended eye A and E clinic during March–July of 2018, 2019, and 2020, 1573 (19.9%) patients had red eye. Males were slightly dominant with 59%, and unilateral cases were the majority among them. The most common causes of red eye in 2018 and 2019 were injury, conjunctivitis, and keratitis; whereas in 2020, a clear dominance of injury and keratitis cases was found. Only 10 (2.03%) patients out of the 493 outpatients with red eye during the 5-month period in 2020 reported a prior contact to a COVID-19 positive case; of whom nine patients had conjunctivitis, and one had a right eye open globe injury. Of the 578 inpatients with proven COVID-19, only 1 (0.17%) patient had red eye with the diagnosis of conjunctivitis.

CONCLUSION:

There was relatively increased number of adults reporting with red eye in 2020. Eye injuries were the most common among all years, followed by conjunctivitis and keratitis. Ocular problems, however, might be a primary or secondary COVID-19 complaint and seem to be relatively uncommon in COVID-19 individuals.
A new pattern of bilateral cataracts associated with hypocalcemia secondary to uncontrolled hypoparathyroidism
Authors: Jafari Reza , Kamali Mahsa , Rad Marzieh Movahedi
Published: May 2024

Hypoparathyroidism is a disorder characterized by hypocalcemia. Premature cataract is one of the signs of hypoparathyroidism, but it is very rare. The present text is a case report of a rare case of a new pattern of bilateral cataracts associated with hypocalcemia secondary to uncontrolled hypoparathyroidism. The patient is a 30-year-old male with a chief complaint of progressive, painless vision loss and tearing in both eyes and photophobia in the left eye for the past 10 months and paresthesia, muscle spasms, and tingling for 2 years before referral. He had a history of hypoparathyroidism disorder that was undertreated with medication. Central posterior subcapsular cataract in both the eyes had been diagnosed. He underwent cataract surgery of the left eye under topical anesthesia. The visual acuity improved from 20/40 to 20/20 postoperatively, and the patient did not have any visual symptoms. This case is the first report of cataract with feathery opacity pattern reported with high-quality imaging from a patient. This feathery opacity pattern may explain the difference in the morphology of this patient's cataracts from others.
Incidence, risk factors, progression, and involution in retinopathy of prematurity at a tertiary care center in South India
Authors: Deb Debolina , Annamalai Radha , Muthukumar Muthayya
Published: May 2024

BACKGROUND:

Retinopathy of prematurity (ROP) is a vasculoproliferative disorder of immature retina, seen in preterm babies. Multiple risk factors attribute to this condition. Our aim was to correlate the role of any early neonatal surgeries with low gestational age (GA) and birth weight (BW) on preterm babies as a risk factor on the progression of ROP.

METHODS:

A prospective, cohort study conducted in a hospital in South India over 3 years, including 600 babies with GA <35 weeks and BW <2500 g. Babies were divided into Group A (ROP) and Group B (no ROP). Group A included A1 (severe ROP) and A2 (nonsevere ROP) based on early treatment of ROP classification. We compared various risk factors of ROP, specifically the association of any early neonatal surgery undergone by these babies, on progression of ROP. The Chi-square test, unpaired t-test, and one-way analysis of variance tests were used for the comparisons and considered statistically significant if P < 0.05.

RESULTS:

28.7% babies developed ROP, with 37.6% requiring treatment (Aggressive ROP in 2.1% of babies). Low GA and BW, longer duration on ventilator, respiratory distress syndrome, apnea of prematurity, Patent Ductus Arteriosus, sepsis, anemia, thrombocytopenia, history of blood transfusion, and history of early neonatal surgery under GA were associated with babies with ROP (P < 0.005), strongly with severe ROP. The most common surgeries undergone by the babies developing ROP were inguinal herniotomy under general anesthesia.

CONCLUSION:

The study predicts preterm babies undergoing early surgical interventions are at risk of progressing to severe ROP, hence warranting frequent follow-ups.
Clinical association and visual morbidity in uveitis with systemic diseases: An analysis from a tertiary ophthalmic center
Authors: Annamalai Radha , Mahesh Abhinav , Biswas Jyotirmay
Published: May 2024

AIM:

The aim of this study was to identify the incidence, etiology, most common presentations, complications, and the causes of visual loss in posterior uveitis (PU).

MATERIALS AND METHODS:

A retrospective study was conducted on a cohort of 125 patients with PU with a minimum follow-up of 6 months. Ocular evaluation consisted of slit-lamp examination, indirect ophthalmoscopy, tonometry, and refraction. Ancillary ophthalmic investigations such as fundus fluorescein angiography, optical coherence tomography, and B-scan ultrasonography were done. Laboratory tests were performed on blood on all patients and in aqueous humor samples obtained by anterior chamber paracentesis in cases of diagnostic dilemmas. All the data were analyzed using SPSS program.

RESULTS:

PU occurred in 61%. Infections were noted in 34% and autoimmune diseases in 27%. The most frequent presentation was choroiditis. The most common etiologies were tubercular uveitis in 50%, Toxoplasma retinochoroiditis in 23%, and autoimmune category of serpiginous choroiditis in 56% of patients. Complications occurred in 27% and were most commonly cystoid macular edema and macular scarring. Polymerase chain reaction (PCR), nested PCR, and real-time PCR on ocular fluids were required for diagnosis in 30%. A combination of laboratory investigations on blood and aqueous humor samples were confirmation in 88%.

CONCLUSION:

PU and its sequelae are known to be sight threatening and are associated with systemic diseases. They have diverse etiologies and presentations. Identification of etiology is important as management is diametrically opposite in infections and autoimmune diseases.
Is there a relationship between keratoconus and ocular Demodex mites?
Authors: Kurtul Bengi Ece , Kaya Ozlem Makbule , Kakac Ahmet , Cetinkaya Yasemin Fatma
Published: May 2024

BACKGROUND:

The background of this study was to evaluate the relationship between keratoconus (KC) occurrence and ocular Demodex infestation together with the effects of Demodex on the ocular surface.

METHODS:

Thirty-eight eyes of 20 KC patients (KC group) and 40 eyes of 20 age- and sex-matched healthy subjects (control group) were included in this cross-sectional study. Demodex species (folliculorum/brevis), clinical symptoms such as eye rubbing, Ocular Surface Disease Index (OSDI), corneal topography findings, tear break-up time (TBUT), and Schirmer test scores were evaluated. KC eyes were also divided into two subgroups according to KC severity and presence of Demodex. Demodex was detected using conventional light microscopy.

RESULTS:

The mean age was 25.90 ± 7.01 years in the KC group, and 26.52 ± 8.94 years in the control group (P = 0.731). While unexpectedly no Demodex were detected in the control group, Demodex were detected in the KC group, including 8 eyes (21.1%) with Demodex folliculorum, and 10 eyes with D. folliculorum + Demodex brevis (26.3%) (P < 0.001). As the KC severity worsened, the percentage of eyes with Demodex mites increased (43.8% in the mild/moderate subgroup and 66.7% in the severe subgroup, P < 0.001). The number of rubbing eyes and OSDI scores were significantly higher, and TBUT levels were significantly lower in the KC Demodex + and Demodex − subgroups than the control group (P < 0.001 for all), but there is no significant difference between the KC Demodex + and Demodex − subgroups regarding ocular surface parameters (P = 1.0).

CONCLUSIONS:

Although the number of patients is relatively small and there is no follow-up data after Demodex treatment, KC and ocular Demodex infestation seem to be associated. Demodex-related inflammation and associated eye rubbing may contribute to KC progression.
Diffuse choroidal hemangioma in pregnancy: Symptomatic diffuse choroidal hemangioma spontaneously resolving postpartum
Authors: Andron Aleza A. , Fabian Ido Didi , Vishnevskia-Dai Vicktoria
Published: May 2024

We present the case of a pregnant young woman with symptomatic diffuse choroidal hemangioma (CH), diagnosed with Sturge–Weber syndrome (SWS). Three months postpartum, there was full spontaneous resolution of the subretinal fluid and improvement in the visual acuity (VA). A 29-year-old, 31-week pregnant female with a coagulation disorder and enoxaparin (clexane) treatment, complained of a left visual disturbance of 2 weeks duration. On examination, the right eye was normal; left eye VA was 6/12 (20/40) with a left eyelid port-wine stain and on funduscopic examination there was a serous retinal detachment. On ultrasound, there was diffuse thickening of the choroid with a focus superior and nasal to the disc with active vascularization – a diagnosis of diffuse CH was made. Magnetic resonance imaging (MRI) and MR venography studies of the brain and orbit revealed engorged orbital vasculature, and the diagnosis of SWS was made. Three months after Cesarean section with birth of a healthy baby boy, VA returned to 6/9 with full resorption of subretinal fluid. On fundoscopic exam, there were no retinal or vein occlutions but there were tortuous blood vessels with A-V crossing. This is a rare case of newly diagnosed SWS with symptomatic diffuse CH in pregnancy. Postpartum, there was full resolution of the subretinal fluid. A watchful waiting approach can be considered in such cases.
A case of branch retinal artery occlusion postcataract surgery in an antiphospholipid syndrome patient
Authors: Bhatia Gagan , Kumar Sandeep , Shroff Daraius , Gupta Priyanka
Published: May 2024

A 46-year-old female with preoperative vision 6/18 N18 (LogMar 0.5) in re and posterior subcapsular cataract underwent an uneventful phacoemulsification surgery under a peribulbar block. On the postoperative day 2, she complained of no visual gain in the operated eye. The reported vision was counting fingers close to the face. Through multimodal imaging (MMI), a diagnosis of branched retinal artery occlusion (BRAO) was made. A detailed consultation and history taking with the patient revealed a concealed history of four miscarriages in the past. A detailed systemic blood workup revealed antiphospholipid antibody (APLA) positive. BRAO postuneventful cataract surgery is a devasting outcome for the surgeon and patient undergoing surgery. The report focuses on the importance of taking detailed past medical history and usage of MMI early to rule out and diagnose unexpected scenarios. We suggest BRAO in our patient was a result of emboli formation, which is a common element in APLA-positive patients.
Refractive outcomes following yttrium aluminum garnet laser (532 nm green laser) in severe retinopathy of prematurity
Authors: Jossy Ajax , Kasturi Nirupama , Madhukar Swapnil Parchand , Babu K Ramesh , Elias Salin
Published: May 2024

PURPOSE:

To assess the refractive outcomes in eyes with severe Retinopathy of prematurity (ROP) after treatment with the frequency-doubled neodymium-doped yttrium aluminum garnet (Nd-YAG) laser 532 nm (green laser) at 1–2 years of age and compare with eyes that underwent spontaneous regression of ROP and to identify the risk factors associated with the refractive outcomes in laser-treated eyes with severe ROP.

METHODOLOGY:

Infants who underwent laser treatment with green laser were enrolled in Group 1 and those who had spontaneous regression of ROP were enrolled in Group 2. All these children underwent a visual assessment, refraction using 1% cyclopentolate eye drops and indirect ophthalmoscopy at 1–2 years of age. Data regarding the gestational age, sex, birth weight, inborn (born in our institution) or outborn (born outside and referred to us), stage and zone of ROP and laser spots given were obtained from the treatment records. Data were analyzed using SSPS 19.0 software for Windows (SSPS Inc., Chicago, Illinois, USA).

RESULTS:

A total of 102 infants were enrolled, 51 in each group. Visual acuity ranged from 0.25–1 cycles per cm in both groups. Spherical equivalent (SE) ranged from − 8.25 D to + 5.50 D in Group 1 and −1.00D to +4.00D in Group 2. Group 1 had an incidence of 23.5% Myopia and 33.4% Astigmatism which was significantly more than Group 2. The linear regression model predicted a decrease in the SE by 0.658D if the number of laser spots increased by 1000 (P < 0.001). No other risk factors (gestational age/birth weight) were found to have a significant association with refractive errors in the lasered ROP group.

CONCLUSIONS:

Eyes with laser-treated severe ROP are frequently associated with myopia and astigmatism when compared to spontaneously regressed ROP. The number of laser spots delivered has a direct association with the amount of refractive error.