bluuebunny/crossref_metadata_2025 huggingface dataset:
Modified scleral band buckle placement technique
Authors: Bhat Parvez Ahmad , Unnisa Arsalan
Published: February 2022

Background:

Scleral buckling is considered an art, which has a long learning curve compared to other surgical retina techniques. Unfortunately, this beautiful surgical technique is getting less attention as new retina surgeons don’t get much exposure to this age-old surgical technique, reason being less interest shown by young retina surgeons and tremendous advancement in micro-incision vitrectomy system.This video is a modification of the present technique of placement of band buckle, which uses science rather than art.The most important aspect in band buckle is getting the optimal buckle height which needs a lot of experience before one can achieve it. Most of the surgeons tend to tighten it more than needed that can lead to complications. This new technique is easy to learn and will give controlled reproducible buckle height and can be done safely by the trainees.

Purpose:

The aim of this video is to simplify the technique of scleral buckling which can produce controlled and reproducible buckle height and will reduce the complications associated with a tight band buckle.

Synopsis:

A 360-degree peritomy is made. Four recti muscles are identified and separated and traction sutures are passed under their insertions. A partial thickness scleral tunnel is made in all four quadrants. A silicone band (style#41 used in this video) is passed through the scleral tunnel and under the insertion of all four recti.The two ends of the silicone band are trimmed so that they are opposed to each other. Then a 12-mm strip is cut off from one end, and the two remaining ends are tied with a 5-0 nonabsorbable suture. This technique ensures a 2-mm optimal buckle height.

Highlights:

We present an elegant technique of placing the band buckle in retinal detachment surgery. Video link: https://youtu.be/9_dh6qsd-7A
A comparative analysis of topical corticosteroids and non-steroidal anti-inflammatory drugs to control inflammation and macular edema following uneventful phacoemulsification
Authors: Singhal Deepali , Nanda Ashok , Kanungo Sanghamitra , Sahoo Kalyani , Mohapatra Santosh
Published: February 2022

Purpose:

To compare the efficacy of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and prednisolone acetate in controlling inflammation and preventing cystoid macular edema (CME) after uneventful phacoemulsification.

Methods:

All patients who underwent uneventful phacoemulsification from December 2020 to Feb 2021 were included in the study. These were randomly assigned to receive any one anti-inflammatory agent among topical nepafenac (0.1%) [96 eyes], bromfenac (0.07%) [93 eyes], preservative-free ketorolac (0.4%) [94 eyes], nepafenac (0.3%) [96 eyes], or prednisolone acetate (1%) [91 eyes]. The efficacy of the drugs was evaluated by comparing the grade of anterior chamber (AC) cells, conjunctival hyperemia, pain score, visual acuity, intraocular pressure (IOP), and central macular thickness (CMT) at 1 and 6 weeks after surgery.

Results:

At 1 and 6 weeks, there was no significant difference in pain score, conjunctival hyperemia, AC cells, change in IOP, and visual acuity between the prednisolone and the NSAIDs groups, though nepafenac 0.3% was most effective. At 6 weeks, there was no significant difference in the number of patients developing subclinical CME in the prednisolone versus NSAID group. The mean increase in CMT was significantly lower in nepafenac 0.3% than prednisolone at 1 and 6 weeks (P = 0.003 and 0.004, respectively).

Conclusion:

NSAIDs used in isolation are comparable to prednisolone in preventing inflammation and pain after uneventful phacoemulsification. However, nepafenac 0.3% is most comparable to prednisolone and more efficacious in reducing the incidence of CME. We recommend that nepafenac 0.3% can be used as a sole anti-inflammatory agent in patients with uneventful phacoemulsification.
Orbital magnetic resonance imaging profile and clinicoradiological correlation in COVID-19-associated rhino-orbital-cerebral mucormycosis: A single-center study of 270 patients from North India
Authors: Hada Maya , Gupta Parul , Bagarhatta Meenu , Tripathy Koushik , Harsh Anita , Khilnani Kamlesh , Mendiratta Kuldeep , Agarwal Sunita , Chouhan Jugal Kishore , Bhandari Sudhir
Published: February 2022

Purpose:

To study the clinical profile and magnetic resonance imaging (MRI) features in patients of COVID-19-associated rhino-orbital-cerebral mucormycosis (CA-ROCM) with orbital involvement and perform a clinicoradiological correlation.

Methods:

A cross-sectional study was performed at a tertiary care center in north India from May 2021 to June 2021. Consecutive patients with clinical, nasal endoscopic, and/or microbiological evidence of CA-ROCM underwent MRI of paranasal sinuses, orbit, and brain as per the study protocol. Orbital MRI findings were studied in detail and were correlated with clinical signs.

Results:

Two hundred and seventy patients were studied. The mean age was 48.4 (± 16.82) years. A male predilection was noted (male:female = 1.77). Orbital involvement was seen in 146 (54%) patients on clinical evaluation and in 184 (68%) patients on MRI. Unilateral orbital involvement was more common (134; 92%). The most common presenting symptom was periorbital and/or facial pain (141; 52.2%) and the most common clinical sign was periorbital edema (116; 43%). The most common MRI finding was suggestive of orbital cellulitis (160; 59%). Orbital compartment syndrome was found in 17 (6.3%) patients. The inter-rater agreement between clinical and radiological assessments to detect the involvement of infraorbital nerve and frontal nerve was found to be 85.56%, (κ 0.621) and 93.70% (κ 0.776), respectively. The diagnostic accuracy, sensitivity, and specificity of MRI to detect medial orbital wall defect were found to be 87.9%, 65%, and 97%, respectively.

Conclusion:

Orbital imaging features of a cohort of ROCM patients have been presented with clinicoradiological correlation.
Impact of moderate and severe primary open-angle glaucoma on quality of life due to activity limitation
Authors: Nayyar Shifali , Kumar Suresh , Rehman Obaidur , Ichhpujani Parul , Singla Ekta
Published: February 2022

Purpose:

To study the impact of moderate and severe primary open-angle glaucoma (POAG) on the quality of life (QoL) due to activity limitation using glaucoma-specific questionnaires.

Methods:

This cross-sectional study enrolled 122 participants, 50% (n = 61) being controls and 50% were diagnosed cases of moderate/severe POAG. Three orally administered glaucoma-specific QoL instruments were used: Glaucoma Activity Limitation (GAL-9), Glaucoma Quality of Life (GQL-15), and Viswanathan questionnaires. The questions related to activity limitation were identified and analyzed for each questionnaire separately.

Results:

The mean age of the participants was 61.04 ± 9.88 years and a majority were males (64.8%, n = 79). The mean scores in controls, moderate glaucoma, and severe POAG patients for GAL-9 questionnaire were 9.77 ± 1.36 (P = 0.44), 13.75 ± 4.76 (P < 0.001), and 23.45 ± 5.62 (P < 0.001), for GQL-15, these were 16.39 ± 2.18 (P = 0.5), 22.75 ± 7.89 (P < 0.001), and 39.34 ± 9.42 (P < 0.001), respectively, while for the Viswanathan questionnaire, they were 9.49 ± 0.94 (P = 0.38), 7.91 ± 1.59 (P < 0.001), and 4.41 ± 2.20 (P < 0.001), respectively. The GQL-15 and GAL-9 questionnaires concluded that activity limitation pertaining to dark adaptation-related tasks affected the QoL the most in moderate as well as severe POAG (P < 0.001). Using the Viswanathan questionnaire, it was observed that the peripheral vision-related activity limitation was most significant for the decrease in QoL in moderate POAG while near vision-related activity limitation affected the QoL the most in severe POAG (P < 0.001).

Conclusion:

All three questionnaires concluded that the activity limitation due to moderate and severe glaucoma has a negative impact on the QoL. The limitation of the tasks involving dark adaptation/glare and peripheral vision has the most significant impact on the QoL in moderate glaucoma. As the disease progresses to a severe category, the limitation of activities requiring central and near vision causes the most significant worsening in QoL.
Ocular signs, visual and general developmental outcome in Indian children with radiologically proven periventricular leukomalacia
Authors: Vijayalakshmi Perumalsamy , Flora Jeyaseeli , Shah Gargi , Sahithya Bhaskaran , Gilbert Clare
Published: February 2022

Purpose:

Owing to the paucity of literature on Indian children with periventricular leukomalacia (PVL), this retrospective study aimed to describe the visual and associated developmental abnormalities in a series of affected children attending a tertiary level eye care facility.

Methods:

Children with radiologically confirmed PVL who attended the Pediatric Department of a tertiary eye hospital were included and underwent a detailed ocular and general developmental assessment.

Results:

Of the 75 children, the mean age was 2.3 years, the mean follow-up was 3.1 years, 68% were males and 43% were born preterm. Grade I PVL was identified in 13 children (17%), Grade 2 PVL in 39 (52%), and Grade 3 PVL in 23 (31%). Premies with ≤2 kg (72.5%) and term babies with >2 kg (75%) had a greater association of PVL occurrence with a preponderance to severe PVL; 46% of the children were visually impaired which was significantly higher in the children with Grade 3 PVL (74%) than those with Grade 2 PVL (15%). Strabismus was common (80%) with a change in deviation over time. Seventy-one percent of the children had a refractive error, frequently myopic astigmatism. All the children except two had a delay in one or more general developmental milestones.

Conclusion:

PVL occurrence is observed both in the babies born at term and premies, resulting in significant ocular and systemic morbidities. We recommend a system in place for early identification and referral to initiate an early intervention program which goes a long way toward improving the quality of life in these children.
Occurrence of vernal keratoconjunctivitis in children infected with human immunodeficiency virus
Authors: Une Vaishali L , Jadhav Sourabh M
Published: February 2022

Purpose:

To study the occurrence of vernal keratoconjunctivitis (VKC) as an ocular manifestation of human immunodeficiency virus (HIV) in pediatric patients.

Methods:

A retrospective study was done on the observations of cases of HIV-positive children. All seropositive patients from the Anti-Retroviral Therapy clinic were referred to the department of ophthalmology for evaluation. Retrospective correlation of CD4 count with active cases of VKC was done. All patients underwent a comprehensive ophthalmic evaluation including visual acuity, slit lamp and dilated fundus examination.

Results:

A total of 72 children were included, 70 males and 2 females. Of these, 63 (87.5%) had VKC, three (4.2%) had cataract, two (2.8%) had cytomegalovirus retinitis retinitis, and four (5.5%) had no ophthalmic findings.

Conclusion:

There is a an evident association of HIV, VKC cases, and reduced CD4 count. More research is required on this topic.
Biofilm formation and its effect on the management of culture-positive bacterial endophthalmitis
Authors: Lodha Dimple , Karolia Roshni , Sharma Savitri , Joseph Joveeta , Das Taraprasad , Dave Vivek P
Published: February 2022

Purpose:

To compare the clinicomicrobiological features and outcomes in patients with infectious endophthalmitis caused by biofilm-positive (BP) and biofilm-negative (BN) bacteria.

Methods:

This was a prospective, interventional, comparative, nonrandomized, consecutive case series. Culture-positive bacterial endophthalmitis cases from August 1, 2018 to July 31st 31, 2019 were included. All vitreous samples were tested for biofilm using crystal violet plate and XTT (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) methods and classified as BN and BP. The antibiotic susceptibility of all organisms was determined. Anatomic and functional success was defined as intraocular pressure >5 mm Hg and final best-corrected vision ≥20/400, respectively, at last visit.

Results:

There were 50 eyes in the BN group and 33 eyes in the BP group. BN group eyes required 2.86 ± 1.45 surgical interventions, and BP group eyes needed surgical 6.36 ± 2.89 interventions, P < 0.0001, 95% Confidence Interval, CI: 2–4. Median follow-up was 6 and 5 months, respectively (P = 0.33). Final logMAR vision was a median of 1.2 and 1.9 respectively; P = 0.0005, 95% C.I.: 0.4–1.7. Functional success was achieved in 44% and 21.2% (P = 0.03, 95% C.I.: 1.86%–40.08%) and anatomic success was achieved in 68% and 42.42%, respectively (P = 0.02, 95% C.I.: 3.85%–45.47%). The antimicrobial resistance patterns between the two groups were comparable.

Conclusion:

Endophthalmitis caused by the biofilm-forming bacteria needs a greater number of surgical interventions. The anatomic and functional outcomes are poorer than non-biofilm-forming bacterial endophthalmitis. The increased virulence and poorer outcomes can be hypothesized to be due to the physical barrier effect of the biofilm on the antibiotics.
Visual impairment and blindness among children from schools for the blind in Maharashtra state, India: Changing trends over the last decade
Authors: Kulkarni Sucheta , Gilbert Clare , Giri Nilesh , Hankare Pravin , Dole Kuldeep , Deshpande M
Published: February 2022

Purpose:

To determine the causes of severe visual impairment and blindness in children in schools for the blind in Maharashtra, India.

Methods:

Children aged <16 years, enrolled in the schools for the blind in Maharashtra state, India were examined between October 2018 and December 2019. The anatomical sites and etiology for blindness were recorded using the World Health Organization’s standard reporting form. Causes of blindness were compared among different regions of the state and also by different age groups.

Results:

Of the 1,969 students examined from 39 schools for the blind, 188 children (9.5%) had severe visual impairment and 1,666 children (84.6%) were blind. Whole globe anomalies (794, 42.8%) were the most common anatomical site of vision loss in children, followed by corneal (289, 15.6%) and retinal abnormalities (280, 15.2%). Corneal causes were second most common in the poorer districts of Vidarbha (15.3%) and Marathwada (14.6%), whereas retinal causes were second most common in the wealthier regions of western Maharashtra (18.3%) and Khandesh (24.1%). Nearly one-third (593, 32%) of children were blind from potentially avoidable causes. Preventable blindness consisting of corneal causes and retinopathy of prematurity was seen in 281 (15.2%) cases, whereas treatable causes comprising of lens-related causes, glaucomas, refractive errors, amblyopia, and uveitis accounted for another 311 (16.8%). Among the younger children (≤10 years), the proportion of corneal blindness was lower (83/623, 13.3% vs. 206/1232, 16.7%) and that of retinal blindness was higher (119/623, 19% vs. 163/1232, 13.2%) than the older children.

Conclusion:

Whole globe anomalies constitute a major cause of SVI and blindness in Maharashtra. There seems to be an increase in the proportion of retinal blindness, especially retinopathy of prematurity, suggesting a need for increased screening coverage.
Prevalence of incidental and total human immunodeficiency virus, hepatitis B and hepatitis C seropositivity among patients posted for cataract surgery at a tertiary care center in India
Authors: Mishra Deepak , Singh Hemendra , Gogate Parkshit , Bhushan Prashant , Singh M K , Srivastav Tanmay , Gogate Bageshri , Gaur Smriti
Published: February 2022

Purpose:

To study the prevalence of human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV) viral seropositive among the patients posted for cataract surgery at a tertiary care center in north India.

Methods:

It was a cross-sectional study done for 30 months duration. All the patients posted for cataract surgery underwent comprehensive ophthalmic evaluation followed by routine hematological workup, including viral markers for HIV, Hepatitis B surface antigen (HBsAg), and anti-HCV. Data were analyzed by the Statistical Package for Social Science (SPSS Version 20).

Results:

A total of 7,316 individuals underwent cataract surgery from Jan 2016 to August 2018, 4,073/7,316 (55.7%) were males. The prevalence for HIV was 58/7,316 (0.8%), HBsAg was 151/7,316 (2.1%), and HCV was 11/7,316 (0.1%); 28/58 (48.3%) HIV positives were unaware of their seropositivity till testing, as were 37/151 (24.5%) of HBsAg positives, and 4/11 (36.4%) HCV positives. There was a significant relationship between the mean age in the patients with HIV (P = 0.002) and anti-HCV (P = 0.045). A majority of the seropositive patients were found to be illiterate (45.6%), followed by educated up to high school level (29.1%), and graduate (25.0%).

Conclusion:

Viral seropositivity was significant among the patients posted for cataract surgery. The eye care providers could refer these patients for counseling and further management for the patient’s and their caretaker’s benefit.
A modified Tenons sling annular graft for advanced peripheral ulcerative keratitis with an hourglass cornea
Authors: Anitha Venugopal , Ghorpade Aditya , Ravindran Meenakshi
Published: February 2022

Systemic tuberculosis mostly affects the lungs and ocular involvement is rare. The ocular manifestations are varied, and rarely peripheral ulcerative keratitis (PUK) occurs either due to direct invasion of the microorganism or due to immune reaction. We present a case of advanced PUK in a 28-year-old male patient diagnosed with pulmonary TB in the right eye with hourglass cornea. The ulcer was progressing circumferentially with necrosis of corneal stroma and undermined margins similar to Moorens ulcer, and was not responding to anti-tuberculosis treatment and topical steroids. We describe a modified novel surgical technique using tenons sling annular patch graft to manage the progressive advanced PUK with hourglass cornea to optimize visual and structural outcome in our patient.
A modified model of glaucoma filtering surgery in Sprague-Dawley rats
Authors: Pandav Surinder Singh , Akella Madhuri , Thattaruthody Faisal
Published: February 2022

Animal models are useful in glaucoma research to study tissue response to wound healing. Smaller animals such as rats offer additional advantages in terms of availability of detection antibodies and microarrays with cheaper maintenance costs. In this study, we describe a glaucoma filtering surgery (GFS) model in adult Sprague–Dawley rats by performing a sclerostomy using a 26-G needle and additionally placing a silicone tube (27 G) connecting the anterior chamber to the subconjunctival space to maintain a patent fistula for the flow of aqueous humor, thus providing a more definitive bleb. This technique will be useful in identifying and modifying newer targets in the wound healing process in order to improve surgical outcomes following GFS.
Half Minimally Invasive Strabismus Surgery (MISS): A single para-muscular approach to horizontal muscle strabismus surgery
Authors: Parveen Attiya , Kauser Farnaz , Amitava Abadan K , Akhtar Naheed
Published: February 2022

Purpose:

Minimally invasive surgeries are gaining popularity. We compared two different approaches to rectus muscles: namely the standard para limbal (SPL) and the single para-muscular (SPM).

Methods:

Thirty-six patients planned for monocular horizontal strabismus surgery were block randomized to SPL and SPM approach. SPM approach involved a single para-muscular 10-mm conjunctival incision levelled at the inferior border of rectus muscle. We compared the post-operative grades of redness, congestion, chemosis, foreign body sensation, and drop intolerance at day 1, 2 weeks, and 6–8 weeks; scar visibility and success rates at 6–8 weeks and operation duration in minutes. We compared the results using Mann–Whitney U-test for inflammatory grades, Fisher’s exact test for proportions, and t-test for parametric measures. Significance was set at P < 0.05.

Results:

On postoperative follow-up at any time point, no significant difference was found on comparing inflammatory grades, scar visibility, and success rates. In terms of duration, SPL approach was on an average 21.5 minutes quicker than SPM (P = <0.001).

Conclusion:

The SPM is comparable to the SPL approach in terms of postoperative comfort and appearance, but takes significantly longer to accomplish.
Clinical profile, multimodal imaging, and treatment response in macular serpiginous choroiditis
Authors: Madaan Sushant , Magesan Kowsigan , Verma Aditya , Biswas Jyotirmay
Published: February 2022

Purpose:

To describe the clinical profile, multimodal imaging, and treatment response in macular serpiginous choroiditis (MSC).

Methods:

Clinical records of 16 eyes (14 patients) with MSC presenting to a tertiary eye care institute between 2015 and 2019 were analyzed retrospectively.

Results:

Mean age of 14 patients presenting with MSC was 33 ± 13 yrs with 64% males and 36% females. Mean visual acuity of the eyes with MSC at presentation was 0.43 ± 0.46 (logMAR) improving to 0.16 ± 0.28 (logMAR) at final visit. Thirteen eyes (81.3%) had active lesion at presentation. Mantoux test was positive in seven patients (50%) and QuantiFERON TB gold test positive in 10 patients (71%). HRCT chest showed latent tuberculosis in seven patients (50%). All patients underwent multimodal imaging. All patients received oral steroids as treatment therapy; 11 patients also received immunosuppressives, nine patients received additional anti-tubercular therapy (ATT). Mean duration of follow-up for the patients was 18 ± 10 months. A total of eight (50%) eyes had recurrence of lesions after an average duration of 14 ± 14 (3-36) months and were restarted on the treatment as per the requirement. At final follow-up, all eyes showed a good response to treatment and had healed lesions. Comparing the final BCVA to the initial BCVA, 38% (n = 6) showed improvement, 56% (n = 9) remained stable, and 6% (n = 1) eyes worsened at the final follow-up.

Conclusion:

Clinical profile and presentation of MSC is similar to that of CSC, and combination treatment with intravenous methyl prednisolone (IVMP), steroids, immunosuppressives, and ATT can salvage vision. A high suspicion of associated tuberculosis in endemic regions should be kept in mind.
Bilateral sequential non-arteritic optic neuropathy post-COVID-19
Authors: Sanoria Abhilasha , Jain Parul , Arora Ritu , Bharti Nisha
Published: February 2022

Corona virus disease 2019 (COVID-19) has been documented to have a spectrum of neuro-ophthalmic manifestations. However, bilateral non-arteritic anterior ischemic optic neuropathy (NAION) post-COVID-19 has not been reported in the literature. We studied the case of a 45-year-old male who presented to our outpatient department (OPD) with bilateral blurring of vision following an episode of COVID-19, 1 month back. Examination and investigations were conclusive of a bilateral NAION. The patient was given a trial of oral steroids. However, the vision loss could not be recovered. Thus, through this case report, we would like to highlight the importance of a close follow-up of patients following COVID-19 infection to detect any sequelae.
Optic neuritis following COVID-19 vaccination: Coincidence or side-effect? - A case series
Authors: Roy Madhurima , Chandra Anuradha , Roy Sangeeta , Shrotriya Charuta
Published: February 2022

The whole world waiting for the elimination of COVID-19. This is a short series of three cases that presented with optic neuritis. On further inquiry, all had received the Covishield vaccine within 5–12 days just before the presentation, with no history of COVID-19 positive RT-PCR. The range of age was 27–48 years. All patients improved after pulse steroid therapy and are still under follow-up. After being plagued by COVID-19 for nearly 2 years, the whole world wishes for little more than complete eradication of the disease. Our country commenced the much-awaited vaccination drive from Jan 2021. Ophthalmic manifestations have appeared in many forms post-COVID-19, among which neuro-ophthalmic manifestations are infrequent. To the best of our knowledge, this is the first report of a short case series from our country presenting with optic neuritis after COVID-19 vaccination, without any sign of active infection.
Eye bank versus surgeon prepared Descemet stripping automated endothelial keratoplasty tissues: Influence on adhesion force in a pilot study
Authors: Romano Vito , Parekh Mohit , Kazaili Ahmed , Steger Bernhard , Akhtar Riaz , Ferrari Stefano , Kaye Stephen B , Levis Hannah J
Published: February 2022

Purpose:

To evaluate and compare the biomechanical properties of the eye bank-prepared and surgeon prepared Descemet stripping automated endothelial keratoplasty (DSAEK) tissues.

Methods:

In this laboratory study, corneal tissues for research were randomly allocated in the following groups: a) surgeon-cut DSAEK and b) eye bank-prepared (pre-cut and pre-loaded) DSAEK. Endothelial cell loss (ECL), immunostaining for tight junction protein ZO-1, elastic modulus, and adhesion force were investigated.

Results:

ECL was not found to be significantly different between surgeon-cut DSAEK (7.8% ±6.5%), pre-cut DSAEK (8.6% ±2.3%), and pre-loaded DSAEK (11.1% ±4.8%) (P = 0.5910). ZO-1 was expressed equally across all groups. Surgeon-cut DSAEK grafts showed a significantly higher elastic modulus compared to pre-cut and pre-loaded DSAEK groups (P = 0.0047 and P < 0.0001, respectively). Adhesion force was significantly greater in the surgeon-cut DSAEK compared to pre-cut (P < 0.0001) or pre-loaded DSAEK groups (P = 0.0101).

Conclusion:

The laboratory data on the biomechanics of DSAEK grafts suggests that surgeon-cut DSAEK grafts present higher elastic modulus and adhesion force compared to eye bank-prepared DSAEK grafts.
Early changes in host and donor lenticule thickness after Descemet stripping endothelial keratoplasty
Authors: Yien Bandana , Ghosh Arnav , Priyadarshini Smruti R , Sahu Srikant K , Padhy Debananda , Ali Mohammad Hasnat , Das Sujata
Published: February 2022

Purpose:

To analyze the early changes in host and donor lenticule thickness after Descemet Stripping Endothelial Keratoplasty (DSEK).

Methods:

DSEK was performed on 32 eyes of 31 patients. Pre- and post- operative slit lamp examination and anterior segment Optical Coherence Tomography (OCT) was done on day-1, day-7, 1 month, and 3 months.

Results:

There were significant changes in host, lenticule, and total corneal thicknesses between day-1 and day-7, and day-7 and 1 month. There were significant changes in host thickness and total corneal thickness between 1 month and 3 months. Thickness changes were significant between day-1 and day-7, and 1 month and 3 months for thick and thin host, respectively, whereas these changes were observed both for thick and thin host between day-7 and 1 month. Similarly, significant changes were observed between day-7 and 1 month, and day-7 and 1 month in thin lenticule whereas in case of thick lenticule, it was observed till the 3 months follow-up period. There was a significant improvement in visual acuity till the 3 months follow-up period. No significant correlation was observed between visual acuity and host and lenticule thickness.

Conclusion:

The thicknesses of host and lenticule decrease continuously. Lenticule thickness stabilizes before host. Thinner cornea stabilizes earlier compared to thicker cornea.
Significance of non-intraocular pressure (IOP)-related factors particularly in normal tension glaucoma: Looking beyond IOP
Authors: Dinakaran Shoruba , Mehta Parin , Mehta Rahul , Tilva Bhavin , Arora Devanshu , Tejwani Sushma
Published: February 2022

Purpose:

To study the relationship between intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) in patients with POAG and NTG. The secondary objective was to identify other contributory ischemic factors.

Methods:

This was an observational cross-sectional study from a tertiary eye hospital in patients who underwent full-day diurnal variation of tension (DVT). Blood pressure (BP) and IOP measurements were done every 3 h over 24 h. Mean arterial pressure (MAP) and MOPP were calculated. The nocturnal dip in BP was assessed; patients were classified as non-dippers, dippers, and over-dippers. The circadian MOPP fluctuation (CMF) was calculated using the Kruskal–Wallis test, and its relationship with type and severity of visual field was assessed.

Results:

In total, 149 patients were evaluated; 109 were classified as NTG, and 40 were classified as POAG. A nocturnal dip in BP was noted in 20% of NTG and 17.5% of POAG. The MAP was found to be lower in patients with NTG than POAG. In the NTG subgroup, we found that 20% of patients were over-dippers, 32% were dippers, and 48% were non-dippers. The CMF showed a greater fluctuation for over-dippers (P = 0.004 for the RE and 0.003 for the LE) than dippers and non-dippers. A weak positive correlation of CMF with the severity of fields was found.

Conclusion:

A 24-h monitoring of IOP, BP, MOPP, and assessment of systemic risk factors for primary glaucoma acts as an invaluable tool for the comprehensive management of NTG despite the limitations posed by DVT and BP recording.
Digitally assisted vitreoretinal surgery: A unique surgical teaching tool for beginners
Authors: Arthur Dhipak , Babu Kannan Naresh , Sen Sagnik , Ramasamy Kim
Published: February 2022

Purpose:

To study the role of digitally assisted vitreoretinal surgery (DAVS) as a learning and teaching tool compared to that of the standard binocular side-scope of the conventional analog microscope (CAM).

Methods:

This was a cross-sectional, observational study conducted at a tertiary eye care center and teaching institute in South India. Postgraduate residents and clinical fellows observed a predecided set of retinal surgical procedures using both DAVS and CAM. A detailed questionnaire was used to compare the participants’ subjective scoring of both the platforms in terms of level of comfort, clarity of image and stereopsis, level of understanding, and overall impression.

Results:

Thirty-six participants, including 20 residents and 16 fellows, took part in this study. DAVS obtained a higher score for all 15 questions compared to CAM and the differences were statistically significant. DAVS obtained a mean score of 4.80 (median: 5) whereas CAM obtained a mean score of 3.14 (median: 3) on a grading scale of 1–5 with regard to the overall experience of surgical viewing through either platform (P < 0.01).

Conclusion:

DAVS is a better learning and teaching tool compared to the side scope of the CAM from a learner’s perspective. Thus, DAVS can help beginners in the field of vitreoretinal surgery obtain a better understanding of the surgical steps prior to the initiation of hands-on training.
Erroneous assumption of ocular hypertension in patients with elevated intraocular pressure
Authors: Rewri Parveen , Ali Wazid
Published: February 2022

Purpose:

To determine the proportion of erroneously assumed ocular hypertension (OHT) among referred patients of elevated intraocular pressure (IOP) seen in glaucoma clinic of a teaching hospital in Northern India.

Methods:

Retrospective review of case records of referred, diagnosed patients of OHT or unspecified glaucoma seen between January 2019 and March 2020. Using an algorithmic clinical approach, including gonioscopy, Goldmann applanation tonometry (GAT), and pachymetry, underlying cause for elevated-IOP was amended and proportion of erroneously assumed OHT was calculated.

Results:

Of 276 patients diagnosed either as OHT or unspecified glaucoma before being seen at our glaucoma clinic, 44 (16%) had IOP within normal range (10–21 mmHg) on GAT. In 97 (35%) cases elevated-IOP was associated with angle closure. The central corneal thickness (CCT) was >550 μm in 39 (14%) patients with elevated-IOP. The proportion of erroneously assumed OHT was 70% in this study.

Conclusion:

The elevated-IOP does not imply with OHT unless evident through comprehensive clinical examination and appropriate investigations.
Assessment of stereopsis in pediatric and adolescent spectacle-corrected refractive error – A cross-sectional study
Authors: Elamurugan Vignesh , Shankaralingappa Pragathi , Aarthy G , Kasturi Nirupama , Babu Ramesh K
Published: February 2022

Purpose:

To assess the level of stereopsis in school children with spectacle-corrected refractive errors using Titmus fly and Randot stereo tests, evaluate the factors associated with the level of stereopsis, and determine the level of agreement between the two tests.

Methods:

A cross-sectional study was done on 5- to 18-year-old school-children wearing spectacles for at least 1-month duration. Visual acuity was assessed using Snellen’s visual acuity chart, and their spectacle correction being used currently was measured using an auto lensmeter. The level of stereopsis was assessed using Randot and Titmus fly stereo tests. Data were entered using Microsoft Excel and analyzed using IBM-SPSS version 20, Chicago, IL. The associations between stereopsis and type of refractive error, visual acuity, age, and gender were analyzed. An agreement between Randot and Titmus fly test was done using Kappa statistics.

Results:

A total of 222 children (101 boys and 121 girls; mean age 13 years) were assessed. Astigmatism was the most prevalent refractive error (60.4%), followed by myopia (24.8%) and hypermetropia (1.4%). Thirty children (13.5%) had anisometropia. All hyperopes had normal stereopsis. Children with spherical myopia had better stereopsis, followed by astigmatism and anisometropia in the same order (P = 0.036). Children with anisometropia ≤1.5 D had better stereopsis than anisometropia more than 1.5 D. Stereopsis was also found to have no correlation with the age and visual acuity at the time of testing or the age at which the child first started wearing spectacles. Stereopsis values obtained from Randot and Titmus fly stereo tests showed moderate agreement with Kappa value 0.581.

Conclusion:

Anisometropia and astigmatism are the most critical factors determining the level of stereopsis in refractive errors.
Bone invasion in oral squamous cell carcinoma
Authors: Shah Jigna S. , Dubey Jaya , Rathva Yogesh Kumar
Published: February 2022

Aims and Objective:

To compare the bone invasion in orthopantomogram (OPG) and technetium 99 m bone scan in oral squamous cell carcinoma (OSCC).

Materials and Methods:

Clinically and histopathologically proven 30 cases of OSCC were randomly selected. OPG and Tech 99m bone scan was carried out in all selected patients. The results were analyzed according to age, sex, and site of involvement. OPG findings and bone scanning uptake were also compared according to site, grade, and difference of uptake.

Results:

Group of patients which showed definite bone invasion in OSCC were positive in radionuclide uptake imaging while another group of patients which showed no changes in OPG had some patients which were positive on radionuclide uptake imaging while few were negative on both OPG and bone scanning.

Conclusion:

Combination of OPG and Tech 99m bone scan was more accurate in detecting bone invasion in OSCC than OPG and bone scan alone.
The impact of digital game addiction on musculoskeletal system of secondary school children
Authors: Cankurtaran F , Menevşe Ö , Namlı A , Kızıltoprak HŞ , Altay S , Duran M , Demir EB , Şahan AA , Ekşi C
Published: February 2022

Background:

The widespread use of digital devices causes adolescents to spend long periods of time in front of the screen.

Aims:

This study aimed to analyze the impacts of digital game addiction on the musculoskeletal system of secondary school children in Kayseri.

Patients and Methods:

A total of 1000 healthy children have been included. A questionnaire, which has been prepared by the researchers and questions children's socio-demographic knowledge, sport habits, durations of study, types of digital tools they use to play games, using positions and durations of use, has been applied to the children. A visual analog scale was used to assess pain intensity. Game addiction has been evaluated through Computer Game Addiction Scale for Children.

Results:

Between computer and phone use and neck pain, a significant correlation has been found (P < 0.05). Between game addiction and wrist, back and low back pain, a significant correlation has been detected. While males use more computer, tablet and are more addicted to games, the scores of head, wrist and back pain in females have been found out to be significantly high.

Conclusions:

As they cause musculoskeletal problems, the higher the time children consume in front of digital devices and the more they use it in wrong posture; the more the complaints about pain are.
Effect of Framework's Manufacturing Technique on Screw's Preload of Implant Supported Prosthesis
Authors: Alshehri H , Alotaibi H , Alshareef N , Alsenani N , Aljuma'ah L , Alshhrani Waled , Alsahhaf A
Published: February 2022

Background:

Implant supported prosthesis is a common treatment modality. Nowadays, new manufacturing techniques are available to fabricate them.

Aims:

To evaluate the effect of different manufacturing techniques of implant supported frameworks (ISF) on the preload of abutment's screws.

Materials and Methods:

A mandibular edentulous acrylic model with four dental implants temporarily stabilized in the interforaminal area was used. One ISF was fabricated using the conventional technique; implants were removed from the model and reassembled into the framework; this framework served as the passively fitting framework (PF). Three additional frameworks were constructed: conventional cast framework (CF), milled framework (MF) and 3D-printed framework (3D-PF). The gap between the frameworks and the neck of the implants were recorded in microns using a digital microscope. A tightening torque (TT) of 35 N·cm was applied to all the four abutments' screws and the screw's preload was recorded using two methods, by strain gauges (SGs) that were attached to the neck of each implant and fed into a stain book in microstrain (μ[Latin Small Letter Open E]) and by removal torque (RT) using a digital torque meter.

Results:

The frameworks' gap means from the lowest to the highest were PF, CF, 3D-PF, and MF. The RT was significantly lower than the TT in all frameworks (P ≤ 0.05). One-way analysis of variance (ANOVA) revealed that the PF had the lowest RT, while the CF and the 3DPF both had the highest RT, and those differences were found to be statistically significantly (P ≤ 0.05). When preload of the frameworks was recorded by SGs, one-way ANOVA revealed that PF had the highest preload value, while both 3D-PF and MF had the lowest preload values, those differences were also found to be statistically significant (P ≤ 0.05).

Conclusion:

The fabrication of implant-supported frameworks using milling or selective laser melting computer aided design/computer-aided manufacturing technologies did not necessarily enhance the screw's preload. This lack of enhancement could be attributed to the great amount of marginal gap in the frameworks fabricated by both techniques.
Dentists' knowledge and practices about infective endocarditis antibiotics prophylaxis among children in aseer region, Southwestern Saudi Arabia
Authors: Shati Ayed A.
Published: February 2022

Background:

Infective endocarditis (IE) is a disease endangering human lives. Therefore, several prophylactic measures are required to improve the protection of endocarditis-prone patients from bacteremia resulting from various dental actions. These measures range from developing the dental hygiene to trials of different antimicrobial agents.

Objectives:

To examine the knowledge and practices of dentists in Aseer Region, Saudi Arabia, regarding antibiotic prophylaxis against IE.

Design:

Cross-sectional study.

Setting:

Aseer Region, Saudi Arabia.

Patients and Methods:

The participants were interviewed at their workplaces and the data collection sheet was constructed based on the guidelines of the American Heart Association/American College of Cardiology (AHA/ACC, 2017).

Main Outcome Measures:

The examination of the data gathered was calculated using Statistical Package for Social Sciences (SPSS, version 25) such as to test the significance of variation in dentists' mean knowledge scores as per their personal characteristics. An output with P values <0.05 was statistically significant.

Sample Size:

182 Dentists.

Results:

Dentists' mean knowledge score was 17.5 ± 3.7 (out of 24). The least correct responses regarding dental procedures that require prophylactic antibiotics were “root canal treatment” (30.8%). Regarding cardiac conditions that require prophylactic antibiotics, dentists' least correct responses were “heart failure” (50%). Dentists' mean knowledge scores differed significantly according to their age groups (P = 0.032), nationality (P = 0.002), education/qualification (P = 0.002). Mean knowledge scores differed significantly according to dentists' years of experience (P = 0.018) and sources of information (P < 0.001). Amoxicillin was the most regularly recommended antibiotic (90.7%), while 86.8% correctly stated 30--60 min. before the procedure as the time for prophylactic antibiotic administration.

Conclusions:

The knowledge of dentists in Aseer Region regarding the use of preventive drugs for the control and prevention of IE is suboptimal. The inclusion of the latest AHA guidelines into the dentistry curricula is highly recommended.

Limitations:

Outcome are simultaneously assessed.
A rare tumor case in an adult patient with neurofibromatosis
Authors: Yakar H , Ertuğrul B , Kaplan M
Published: February 2022

In patients with type 1 neurofibromatosis (NF1), there is an increased susceptibility to tumor development in the central nervous system due to the loss of neurofibromin, an inactivator of the protooncogene Ras. NF1 has a broad clinical spectrum,which includes spinal tumors. Although the most common intramedullary tumor of the spinal cord in adults is ependymoma, few patients with NF1 accompanied by spinal ependymoma have been reported to date, and the localization of the tumors is cervical and thoracic in these cases. In this study, we report the case of a patient with NF1 presenting to our clinic with low back pain and gait disturbance. The patient had an intradural extramedullary ependymoma at the L2-3 vertebra level. This report is the first case of NF1 with spinal ependymoma localized in the lumbar region.
Intensive care management in guillain barré syndrome accompanying prolonged Covid-19–A case report
Authors: Toy E , Kart K
Published: February 2022

One of the neurological complications associated with COVID-19 is Guillain Barre Syndrome (GBS). It is possible to be a complication of COVID19 due to the similarity of respiratory complication between both clinical entities. The aim of this case report is to present a case followed in the intensive care unit (ICU) with the coexistence of prolonged COVID-19 and GBS. The 68-year-old patient, whose COVID-19 symptoms had been going on for 5 weeks, was followed for 5 days in the ICU due to GBS diagnosis. During this period, the patient's symptoms regressed with IVIG treatment. ICU physicians should be careful that some neurological complications may accompany in some prolonged COVID-19 cases and that one of these may be GBS.
Holomorphic Cohomological Convolution and Hadamard Product
Authors: Dubussy Christophe , Schneiders Jean-Pierre
Published: February 2022

In this article we explain the link between Pohlen’s extended Hadamard product and the holomorphic cohomological convolution on

\mathbb{C}^*

. For this purpose we introduce a generalized Hadamard product, which is defined even if the holomorphic functions do not vanish at infinity, as well as a notion of strongly convolvable sets.
Geometric Realization of the Local Langlands Correspondence for Representations of Conductor Three
Authors: Imai Naoki , Tsushima Takahiro
Published: February 2022

We prove a realization of the local Langlands correspondence for two-dimensional representations of a Weil group of conductor three in the cohomology of Lubin–Tate curves by a purely local geometric method.
Holomorphic Frobenius Actions for DQ-Modules
Authors: Petit François
Published: February 2022

Given a complex manifold endowed with a

\mathbb{C}^\times

-action and a DQ-algebra equipped with a compatible holomorphic Frobenius action (F-action), we prove that if the

\mathbb{C}^\times

-action is free and proper, then the category of F-equivariant DQ-modules is equivalent to the category of modules over the sheaf of invariant sections of the DQ-algebra. As an application, we deduce the codimension-three conjecture for formal microdifferential modules from the one for DQ-modules on a symplectic manifold.
RELAÇÃO DAS VARIÁVEIS CONCERNENTES AO DESEMPENHO ACADÊMICO: UM ESTUDO COM ALUNOS DE GRADUAÇÃO EM CIÊNCIAS CONTÁBEIS
Authors: Martins Zilton Bartolomeu , Marinho Sidnei Vieira
Published: February 2022

Este estudo teve como objetivo analisar a relação entre as variáveis concernentes às dimensões corpo docente, corpo discente e IES com a variável desempenho acadêmico. Em relação ao método, este trabalho é classificado como quantitativo em função da utilização de técnicas estatísticas e descritivo decorrente do objetivo geral. Quanto aos procedimentos, classifica-se como pesquisa de levantamento por conta da aplicação de questionário e também como documental, devido ao uso de documentos como fonte de dados. Como instrumento de coleta de dados, utilizou-se um questionário com vinte questões fechadas, baseado nos autores Andrade e Corrar (2008), Souza (2008) e Ferreira (2015). A população deste estudo foi de 617 alunos, resultando em uma amostra de 361 respondentes. Para análise, utilizou-se técnicas estatísticas univariadas, como o Alfa de Cronbach, a prova Kolmogorov-Smirnov para o teste de normalidade e os coeficientes de correlação ponto-bisserial e de Spearman para a análise dos dados. Como principais resultados identificou-se que as variáveis estratégia ou método de ensino (dimensão corpo docente), status socioeconômico, absenteísmo, desempenho escolar anterior, horas de estudo e motivação (dimensão corpo discente) e ambiente de estudo e forma de ingresso (dimensão IES) possuem relação com a variável desempenho acadêmico.