bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing Suspected Temporal Arteritis without a Temporal Artery Biopsy
Authors: ONG Keith Soo Keat , ONG Lawrence Tsng Chze , ONG Lillian Beatrice 
Published: January 2021

MANAGING SUSPECTED TEMPORAL ARTERITIS WITHOUT A TEMPORAL ARTERY BIOPSY Keith Ong, Ophthalmologist, University of Sydney, RNSH, Ryde Hospital, Dalcross Adventist Hospital Lawrence Tsng Chze Ong, Immunology Registrar, Westmead Hospital Lillian Beatrice Ong, JMO, Prince of Wales Hospital We would like to report 2 cases of suspected temporal arteritis which were managed without routine temporal artery biopsy. The gold standard diagnostic test for temporal arteritis, the temporal artery biopsy (TAB), is highly specific for a diagnosis of temporal arteritis, but is only positive in up to 82% of temporal arteritis cases (with sensitivities reported as low as 20%). This figure has been shown to decrease even further (12%) following corticosteroid therapy. Although it is a relatively minor procedure, the risks of TAB are not trivial and include facial nerve injury, infection, haemorrhage, incisional alopecia, scar widening and foreign body reaction to entrapped hairs. Furthermore, the need for theatre time and skilled personnel in a procedure with a significant number of false negatives makes TAB questionable. Even if TAB were performed, a high index of suspicion would have led to commencement of corticosteroid therapy regardless of the biopsy result. The only drawback in not conducting a TAB appears to be the lack of additional conclusive evidence supporting temporal arteritis. The two cases presented here illustrate how a trial of corticosteroid therapy is a reasonable and practical option for patients who elect not to have TAB. The strength and duration of corticosteroid therapy will still be guided by clinical progress as well as biochemical markers such as ESR and CRP.
Diabetic Macular Edema Estimation Using Slit Lamp Biomicroscopy Versus That Using Oct.
Authors: Sharma Trisha , DSouza Susan , Kamath Manjunath 
Published: January 2021

Purpose: Comparison of Diabetic macular edema estimation using slit lamp biomicroscopy versus that using OCT.Materials and Methods: We performed a retrospective analysis of 121 patients (154 eyes) with established Type 2 diabetes mellitus, divided into three groups. Group I consisted of 62 eyes with NPDR, Group II ,27 eyes with PDR and Group III ,66 eyes with CSME. Diagnosis of CSME was made as per ETDRS protocol, using slit lamp stereoscopic biomicroscopy. DME was defined on OCT as central foveal thickness greater than 250µm .OCT scanning was performed through the macula of each eye after pupillary dilatation. Results: The mean age of patients included was 60.70 ± 9.20years and 61.98% were males. Only 66 eyes were classified as having DME clinically as opposed to 109 eyes by OCT, leading to a significant sub-estimation of 39.44% eyes. The mean macular thickness in the CSME patients identified by slit lamp biomicroscopy was 399.59±105.31µm.The mean central macular thickness in the sub-estimated cases was 290.58 ±28.92 µm overall, 290.10±26.19 µm in the PDR group and 290.95± 31.46µm amongst NPDR patients.Conclusion: Mild macular thickening on OCT may not correspond to overt edema clinically and has been termed sub-clinical macular edema by some authors. We report a sub- estimation of DME in 39.44% eyes in our study. The emerging importance of monitoring of these vulnerable patients and early detection of their conversion to overt CSME must be realised. In conclusion, assessment of diabetic macular edema with OCT is probably more objective and reliable.
Comparasion of efficacy and safety of Difluprednate 0.05% and Nepafenac 0.1% in reducing macular thickness and volume after cataract surgery
Authors: Katiyar Vishal , Yadav Ankur , Gupta Sanjiv , Kishore Poonam , Phadikar Prateep 
Published: January 2021

Objective- To evaluate and compare efficacy and safety of topical Difluprednate ophthalmic emulsion 0.05% with Nepafenac ophthalmic suspension 0.1% in patients of uneventful cataract surgery with respect to postoperative macular thickness and volume.
Design- A prospective, single centric, tertiary care centre based, comparative, interventional study from August 2013 to July 2014
Subjects- Total 206 ( Group N=106, Group D=100) patients were followed up who completed their 12 weeks follow up
Methodology- Surgery was performed by phacoemulsification technique by clear corneal incision with foldable PCIOL implantation by a single surgeon having 10 years of surgical experience. Post operative patients were divided into 2 groups. Group N were given topical treatment with Nepafenac ophthalmic suspension 0.1% TID starting 24 hours before surgery and continued post-op 4 weeks. Group D were given Difluprednate ophthalmic emulsion 0.05% QID post surgery for 2 weeks followed by BID for 2 weeks.
Main outcome measures: Postoperative assessment of patients were done on 1st day and on 1st, 8th and12th weeks after the surgery for best corrected visual acuity (BCVA) by logMAR, intraocular pressure by Applanation tonometry and macular thickness and volume by SD-OCT. Statistical test used was sample Unpaired and paired ‘t’ test and statistical analysis was done with SPSS 20.0 ( IBM, USA).
Results- There was increase in the measured mean central subfield thickness( CST) at 8 and 12 weeks as compared to 1 week , in both the study groups (P<0.05). On comparing the volume (in mm3) and average thickness (in µm) at 1 week, it was observed that thickness of group N (266.82±25.06 µm) was statistically higher than that of group D (253.14±22.21µm) (P= 0.03). The comparison of best corrected visual acuity (LogMAR) and the intraocular pressure recordings showed no difference between the patients of two studied groups recorded at 1 week and 8 weeks and 12weeks.
Conclusion- Both Nepafenac ophthalmic suspension 0.1% and Difluprednate ophthalmic emulsion 0.05% are equally effective in controlling macular thickness change after uneventful cataract surgery.
Bilateral simultaneous acute angle closure in an adult Nepalese woman
Authors: Sahu Sabin , Puri Lila Raj 
Published: January 2021

Purpose: To report a case of bilateral simultaneous angle closure in an adult Nepalese woman without any known secondary cause.
Methods: Observational case report.
Results: A 50-year-old Nepalese woman presented with decreased vision, pain, redness, and watering in both eyes with associated coloured haloes, nausea, and vomiting for 10 days. At presentation, her visual acuity was 20/400 in the right eye and hand motions close to face with accurate projection of rays in the left eye. Intraocular pressure was 38 mmHg in the right eye and 48 mmHg in the left eye without any antiglaucoma medications. A slit-lamp examination revealed bilateral circum-corneal conjunctival congestion, corneal edema, and shallow anterior chambers. Both pupils were mid-dilated and non-reactive to light. Gonioscopy showed closed angles in all four quadrants bilaterally. Posterior segment examination revealed normal optic disc with cup-disc-ratio of 0.3 in the right eye, and blurring of disc margin with cup-disc-ratio of 0.3 in the left eye. The patient was started on systemic acetazolamide 250 mg 4 times a day, topical brimonidine 0.2% and timolol 0.5% 2 times a day, and topical dexamethasone 6 times a day in both eyes, following which IOP reduced to 11 and 12 mmHg, respectively, the corneal edema subsided, but the anterior chamber remained shallow. Laser peripheral iridotomy was performed in the right eye and surgical peripheral iridectomy was performed in the left eye. After two weeks, vision improved to 20/30 in both eyes with normal intraocular pressure off antiglaucoma medications. Anterior chambers deepened significantly with clear corneas bilaterally. Gonioscopy at this stage showed essentially open angles with appositional closure in superior and temporal quadrants in the right eye and open angles in all four quadrants in the left eye. Posterior segment evaluation revealed normal optic disc in both eyes.
Conclusions: Bilateral simultaneous acute angle closure is a rare presentation with very few reported secondary causes. We report a case of bilateral simultaneous angle closure in an adult Nepalese woman without any known secondary cause. The case was successfully managed with laser peripheral iridotomy in the right eye and surgical peripheral iridectomy in the left eye.
Prevalence of glaucoma in first-degree relatives of patients with primary open-angle glaucoma and normal-tension glaucoma
Authors: Gupta Preeti , Pai. H. Vijaya 
Published: January 2021

Objective: To determine the prevalence of glaucoma in first-degree relatives of patients with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG).
Methods: Observational study of first-degree relatives of patients with POAG and NTG who were screened for glaucoma.
Results: A total of 66 first-degree relatives of patients with glaucoma (POAG/NTG) were included in the study. We found a prevalence rate of 16.6%: 13.6% were diagnosed to have the disease and 3% were newly detected to have glaucoma during the study. We found that although 66.7% of the subjects were aware of the family history of glaucoma, only 36.4% were aware that they were at increased risk of developing glaucoma.
Conclusion: In our study, we found high prevalence of glaucoma in first-degree relatives of patients with glaucoma. This highlights the importance of selective screening of high-risk groups such as first-degree relatives of patients with POAG/NTG.
Primary nasal pterygium excision with sutureless and glue-free technique of conjunctival autograft
Authors: Dhany Rini Kusumawar 
Published: January 2021

Aim: To evaluate the efficacy and complication of sutureless and glue-free conjunctival autograft for the management of primary pterygium over a period of one year.
Methods: Prospective, interventional, hospital-based study. Twenty-four eyes of 24 patients with primary nasal pterygium were graded, and excision was performed by a single surgeon. To prevent recurrence, a free conjunctival autograft was taken from the superior quadrant from the same eye and the bare sclera was covered without the use of sutures or fibrin glue, allowing natural autologous coagulum of the recipient bed to act as a bioadhesive. The eye was patched for 24 hours. Postoperatively, patients were put on topical eye drops (polymixin 0.5%, neomycin 0.5%, and dexamethasone 1%) four times daily for four weeks, and oral antibiotics and methyl prednisolone 3x4 mg per day for 5 days. Patients were followed up postoperatively on day 1, 1 week, 6 weeks, 6 months, and 12 months. They were examined for haemorrhage, wound gape, graft shrinkage, granuloma, graft dehiscence, recurrence, or any other complication.
Results: The mean age of the patients was 56.96 ± 11.51 years (range 35-81 years). There were 18 females (75%) and 6 males (25%). The following complications were noted: granuloma in three eyes (12.5 %), overriding graft onto the cornea in three eyes (4.17%), and recurrence in one eye (4.17%). No other complications were noted. Average surgical time was 16 ± 2 minutes.
Conclusion: Sutureless and glue-free limbal conjunctival autografting is a treatment modality for primary nasal pterygium with no additional cost and has only one recurrence case in 24 cases.
Difference in prevalence of diabetes and diabetic retinopathy among low-altitude dwellers vs. high-altitude dwellers in North India
Authors: Chauhan Anil , Verma Anil Kumar , Sharma Deepak , Gupta Lalit , Kumar Dinesh , Sharma Gaurav , Grover Ashoo 
Published: January 2021

Background: Type-2 diabetes mellitus (DM) is one of the leading lifestyle-related chronic disease as its prevalence is expected to rise up to 24.0% in the world by 2025, which was only 6.3% in year 2003.
Objective: To understand the high-altitude and low-altitude differentials for DM and diabetic retinopathy (DR) prevalence in a sub-Himalayan state of North India.
Methods: The study was carried out in the Shahpur block of Kangra district (altitude 2,404 feet) and the Spiti block of Lahaul and Spiti district (altitude 12,500 feet) of Himachal Pradesh.
Results: Among diabetics, the prevalence of DR was observed to be high (18.1%) in low landers and low (5.0%) in high landers. DM was more of a problem among low landers with a prevalence of 12.3% when compared to high landers (7.2%). Overall, the odd ratio of DR was twice as high (2.2; 95% confidence interval [CI]: 1.1-2.3) among patients with an unsatisfactory level of HbA1c (>8.0%) adjusted for gender, age group, smoking status and hypertension.
Conclusion: Differential did exist, as DM and DR were significantly lower in high-altitude areas when compared to low-altitude areas.
Prophylactic corneal cross-linking in LASIK surgery: effects on visual outcome and recovery time
Authors: Oh Dominique Clare , Chan Yiong Huak , Lee Sao Bing , See Jovina Li Shuen 
Published: January 2021

Introduction: Collagen cross-linking is a useful adjunct in preventing corneal ectasia after laser-assisted in situ keratomileusis (LASIK). This study aimed to evaluate whether prophylactic cross-linking in IntraLase LASIK affects optimum visual outcome and recovery time in the immediate post-surgery period and is associated with any side effects.
Methods: This was a retrospective case study on the right eyes of 100 Chinese subjects aged 18 to 40 years who underwent IntraLase LASIK. Fifty subjects who underwentcross-linking after completing LASIK (Group A) were compared with 50 subjects who did not undergo LASIK (Group B). Cases were evaluated for pre- and post-operative spherical equivalent, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), recovery time and presence of side effects.
Results: At 1 week post-LASIK, mean (SD) UDVA of Group A subjects was poorer than Group B, at 1.05 (0.19) vs 1.17 (0.19) (p = 0.036); however, there was no significant difference in CDVA (p = 0.095). By 1 month post-LASIK, differences in both UDVA and CDVA were insignificant (p = 0.055, 0.106, respectively). Mean recovery time was 2.72 (95% confidence interval [CI] = 0.64-4.7) days longer in Group A (p = 0.010), although by 1 month post-LASIK, both groups were able to achieve CDVA equal to or better than that achieved pre-LASIK. Incidence of mild inflammation and dry eyes post-LASIK was similar in both groups (p = 1.00, 0.749, respectively); no other complications were observed.
Conclusion: No differences in visual outcomes at and occurrence of side effects at 1 month post-LASIK were observed between subjects who underwent cross-linking prior to refractive surgery and those who did not. However, the group that underwent cross-linking had a slightly longer mean recovery time. Our study supports prophylactic cross-linking as a safe procedure that does not affect immediate visual outcomes among the Chinese population when used in adjunct with LASIK surgery.
Intermediate-term outcome of placement of Baerveldt glaucoma implant for refractory glaucoma in a Malaysian population
Authors: Fang Clarissa Ern Hui , Fang Seng Kheong 
Published: January 2021

Objective: To report baseline characteristics and surgical outcomes of placement of Baerveldt glaucoma implant (BGI) in Asian eyes with considerably elevated intraocular pressure (IOP) despite maximal medical therapy.
Design: Retrospective case series of surgical cases from a single surgeon. Retrospective review of medical records of last clinic visits.
Participants: One hundred and ninety-seven eyes of patients underwent placement of 350-mm2 Baerveldt implant.
Methods: The medical records of consecutive patients who underwent placement of a Baerveldt 350-mm2 glaucoma drainage device (GDD) at the International Specialist Eye Centre from 2007 to 2014 were reviewed. Patients with a minimum 1-year follow-up were included. Baseline characteristics, pre-operative and post-operative IOP, number of glaucoma medications, visual acuity (VA) and complications were recorded. The pre-operative IOP is compared with the IOP at 1, 2, 3 and 5 years.
Measures: The IOP, VA, supplemental medical therapy, complications and success and failures were recorded.
Results: One hundred and ninety-seven patients were followed up at 1-year post-operation, 157 patients at 2 years, 120 at 3 years and 37 at 5 years. The mean baseline IOP of 29.2 ± 10.6 mmHg was significantly reduced at all time points post-operatively. Mean number of glaucoma medications was significantly lower at last follow-up than pre-operatively (1.8 vs. 2.7).
Conclusions: Placement of GDDs effectively reduces IOP without much long-term complication and may be useful in glaucomatous eyes with considerably elevated pre-operative IOP not well controlled with maximal medical therapy in the Asian population.
In vitro study on the effect of antibiotic combinations on Staphylococcus epidermidis biofilms
Authors: Kaur Bhupinder Pal , Ahmad Shamim , Ashraf Humayoun , Thachil Giby 
Published: January 2021

Purpose: Effect of combination of various antibiotics on Staphylococcus epidermidis biofilm.
Study design: Experimental study.
Methods: The biofilm-producing strains of S. epidermidis were isolated from 100 patients undergoing cataract surgery before instillation of any antibiotic. The strains were subjected to sensitivity test to various antibiotic combinations. The most effective agent was selected and its minimum inhibitory concentration was determined by broth dilution method. The statistics wereperformed using SPSS Version 23 (IBM Corp.) and Chi square test.
Results: A total of 22 biofilm-positive samples were obtained. The combinations of vancomycin with ceftazidime (p < 0.05) followed by moxifloxacin with cefuroxime (p < 0.05) were found to be the most effective. Antibiofilm activity was also shown by other antibiotic combination. The minimum inhibitory concentration of vancomycin and ceftazidime in 11 samples was 2.5 and 2.8 mg/ml, while in the rest of the samples, it was 2.5 and 5.6 mg/ml, respectively. The minimum inhibitory concentration of moxifloxacin and cefuroxime was 0.125 and 2.81 mg/ml, respectively.
Conclusion: In our study, we conclude that antibiotics are effective in eradicating biofilms.
Safety and efficacy of reconstituted atropine 0.01% eye drops for Indian children with myopic progression
Authors: C. Vidhya , Murali Kaushik , R. Sowmya 
Published: January 2021

Aim: To evaluate safety and efficacy of reconstituted atropine 0.01% eye drops for Indian children with myopic progression.
Methods: Fifty children with progressive myopia with their spherical equivalent increasing at least 0.75 D in 6 months (0.75 to 1.50 D) were put on reconstituted atropine 0.01%. Ocular examination, including near vision, near point of accommodation (NPA), pupil size and axial length, was done. Subjective symptoms of glare and photophobia were noted. Systemic side effects were documented. Analysis was done using Microsoft Excel 2010.
Results: The average age of patients was 9.5 years (range 5 to 14 years) and they were followed up for 1 year. Average mesopic and photopic pupil size was 5 and 4 mm, respectively. Average NPA was 9 cm. Mean increase in spherical equivalence was 0.18 D over 6 months. Average increase in axial length was 0.12 ± 0.11 mm over 6 months and 0.2 ± 0.29 mm over 1 year. Average increase in spherical equivalent over 6 months was 0.07 ± 0.19 D and over 1 year was 0.32 ± 0.29 D. No systemic side effects were recorded.
Conclusion: Reconstituted atropine 0.01% eye drops is safe and efficacious in slowingthe progression of myopia in Indian children.
Improving the prediction of effective lens position for intraocular lens power calculations
Authors: Chui Juanita Noeline , Ong Keith 
Published: January 2021

Purpose: Achieving the desired post-operative refraction in cataract surgery requires accurate calculations for intraocular lens (IOL) power. Latest-generation formulae use anterior-chamber depth (ACD)—the distance from the corneal apex to the anterior surface of the lens—as one of the parameters to predict the post-operative IOL position within the eye, termed the effective lens position (ELP). Significant discrepancies between predicted and actual ELP result in refractive surprise. This study aims to improve the predictability of ELP. We hypothesise that predictions based on the distance from the corneal apex to the mid-sagittal plane of the cataractous lens would more accurately reflect the position of the principal plane of the non-angulated IOL within the capsular bag. Accordingly, we propose that predictions derived from ACD + ½LT (length thickness) would be superior to those from ACD alone.
Design: Retrospective cohort study, comparing ELP predictions derived from ACD to aproposed prediction parameter.
Method: This retrospective study includes data from 162 consecutive cataract surgery cases, with posterior-chamber IOL (AlconSN60WF) implantation. Pre- and postoperative biometric measurements were made using the IOLMaster700 (ZEISS, Jena, Germany). The accuracy and reliability of ELP predictions derived from ACD and ACD + ½LT were compared using software-aided analyses.
Results: An overall reduction in average ELP prediction error (PEELP) was achieved using the proposed parameter (root-mean-square-error [RMSE] = 0.50 mm), compared to ACD (RMSE = 1.57 mm). The mean percentage PEELP, comparing between eyes of different axial lengths, was 9.88% ± 3.48% and −34.9% ± 4.79% for predictions derived from ACD + ½LT and ACD, respectively. A 44.10% ± 5.22% mean of differences was observed (p < 0.001).
Conclusion: ACD + ½LT predicts ELP with greater accuracy and reliability than ACD alone; its use in IOL power calculation formulae may improve refractive outcomes.
Assessment of quality of life in glaucoma patients using the Glaucoma Quality of Life-15 questionnaire
Authors: Bhandary Sulatha V. , Kusumkar Pallak , Rao Lavanya G. , Abbagani Surabhi , Addoor Krishna Rao 
Published: January 2021

Purpose: The purpose of this study was to assess quality of life in glaucoma patients using the Glaucoma Quality of Life-15 (GQL-15) questionnaire. The GQL-15 questionnaire is a glaucoma-specific quality of life questionnaire used to assess the degree of functional disability caused by glaucoma.
Design: Cross-sectional, prospective study with comparison group at a tertiary care hospital.
Materials and methods: The GQL-15 questionnaire was used to evaluate the quality of 80 patients in the glaucoma group and 80 normal subjects in the control group. The data were analyzed by test of proportions and Chi-square test. A p-value of < 0.05 was considered significant.
Results: Glaucoma patients (mean age: 60.5 ± 9.2 years; range: 43–86 years) and comparison group (mean age: 58.9 ± 4.5 years; 52–72 years) were matched with respect to age (p = 0.18). Glaucoma patients had significantly worse quality of life compared to the non-glaucoma group (p < 0.001). Significant differences (p < 0.05) between the scores of the mild, moderate, and severe glaucoma groups were observed, suggesting poorer quality of life as the severity of glaucoma increases.
Conclusions: The GQL-15 revealed that quality of life worsens with increasing severity of glaucoma increases. This fact is important when educating patients about the disease course and its therapy.