Subconjunctival orbital fat herniation is a rare occurrence. These masses can be easily mis-diagnosed as more sinister lesions. We present a unilateral case of this condition and a useful, previously undescribed clinical sign, which obviated the need for orbital imaging.
Aim: To report an unusual case of orbital emphysema secondary to high pressure water jet injury.
Presentation of Case: A 26-year-old Indian male sustained a two-centimeter facial laceration after a compressed water jet hit the left infra-orbital region. Ophthalmic examination showed extensive inferior commotio retinae without any clinical signs of conjunctival laceration or globe rupture. Computed tomography showed orbital emphysema with undisplaced fracture of the orbital floor. Follow-up examination 1 month after the injury showed total resolution of orbital emphysema.
Discussion and Conclusion: Our case illustrates the dangers of water jet injuries and the unique injury provides supporting evidence of our current existing orbital fracture theory. This injury is most peculiar and to our knowledge, not previously reported in the literature.
Aim: To understand the potential of evaluating the thickness of the retinal nerve fiber layer (RNFL) and macular volume in patients with schizophrenia, using Optical Coherence Tomography (OCT), and its possible application to monitor this disorder.
Study Design and Participants: Cross-sectional study that included two groups, one with 20 patients diagnosed with schizophrenia and a control group with 20 healthy volunteers. Patients with schizophrenia were divided into two subgroups, one with less than 5 years of illness duration and the other with more than 5 years. Both groups underwent OCT. The study was conducted between April 2014 and July 2014, with the collaboration of the Ophthalmology and Psychiatry departments.
Results: Schizophrenic patients showed a significant decrease in all measurements of the macula, volume and thickness, when compared to the control group (p<0.05). No differences were found between groups regarding RNFL thickness, although there was a correlation between disease duration and decreased overall RNFL thickness (r=-0.338; p=0.033). Comparison between the group with schizophrenia for less than five years and the group with more than 5 years, revealed statistically significant differences in volume (p=0.021) and thickness (p=0.018) of the temporal outer ring of the macula.
Conclusion: Results suggest that there are differences in the retina in patients with schizophrenia. These data support the hypothesis of a neurodegenerative component of the disorder. OCT is a noninvasive exam that, although non-specific, can be useful either to diagnose or monitor disease progression.
Aim: To evaluate the therapeutic efficacy of intravitreal bevacizumab (Avastin)® on visual acuity and macular edema in patients with parafoveal telangiectasia type II complicated by choroidal neovascular membrane and/or cystoid macular edema.
Methods: Study conducted over a period of 12 months, at a tertiary eye care hospital including forty eyes of 25 patients (11 male, 14 female) suffering from type II parafoveal telangiectasia with choroidal neovascular membrane and/or cystoid macular edema who fulfilled the inclusion criteria. These were treated with intravitreal bevacizumab (Avastin). Each of the 40 eyes was enrolled into one of two groups, namely group 1: Eyes with parafoveal telangiectasia type II with choroidal neovascular membrane and group 2: Eyes with parafoveal telangiectasia type II with presence of cystoid macular edema but without choroidal neovascular membrane .All the patients underwent best corrected visual acuity slit lamp bimicroscopy, direct and indirect ophthalmoscopy, intra ocular pressure (IOP), clinical fundus photography, fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Follow up of patients was done at the first, third and sixth months after presentation.
Results: 2 groups, in group1-11 patients with equal male and female ratio, mean age 56.27±8.49 years, group 2-18 patients with female preponderance, mean age 53.5±7.18 years. In group1, no significant improvement in mean BCVA before inj. Bevacizumab 0.121±0.06 and after injection 0.147±0.06 (p=0.051), while statistically significant improvement noticed in mean CFT, before inj. 469±89.67 and after injection 310.78±85.61 (p=0.001). Similarly in group 2, no significant improvement in mean BCVA before inj. Bevacizumab 0.224±0.16 and after injection 0.254±0.09 (p=0.453), while statistically significant improvement noticed in mean CFT, before inj. 356.77±43.22 and after injection 253±42.59 (p=0.001). Transient hyperemia and subconjunctival hemorrhage were noticed in 2 patients in both group 1 and 2, while increase in blood pressure were observed in 2 patients in group 1 and 4 in group 2. None of the patients reported deterioration of vision following the injection.
Conclusion: In parafoveal telangiectasis type II complicated by choroidal neovascular membrane there is definite short-term improvement in the visual acuity (approaching statistical significance) and definite significant reduction of central foveal thickness following intravitreal injection of bevacizumab. In patients suffering from parafoveal telangiectasis type II complicated by cystoid macular oedema, there is definite significant reduction of central foveal thickness but no significant improvement in the visual acuity following intravitreal injection of bevacizumab. Bevacizumab is safe and well tolerated in eyes with parafoveal telangiectasis type II complicated by choroidal neovascular membrane and/or cystoid macular edema. No severe ocular or systemic adverse effects were encountered in this study.
Purpose: To evaluate ease of fashioning of 25G cannula, safety and efficacy of injection of heavy liquid using this fashioned cannula during Vitrectomy for simple Rhegmatogenous Retinal Detachment.
Methods: This is a prospective non-comparative case series including 28 cases of simple Rhegmatogenous Retinal Detachment (without PVR, with PVR A, B, and C1). A 25G cannula was fashioned by unbending of a 25G Healon cannula. This cannula was applied on the nozzle of a 5 cc syringe filled with perfluorocarbon liquid, and then the heavy liquid was injected inside the vitreous cavity to reattach a detached retina. The outcome measures were: ease of fashioning of the cannula (no cutting off of the shaft), ease of injection (no resistance), need to replace by a back flush needle, iatrogenic retinal breaks / hemorrhage, retinal reattachment.
Results: The cannula was fashioned easily without cutting off of the shaft in all cases (100%). There was no resistance or interruption of the stream of heavy liquid through the cannula during injection in all cases, and thus no need to replace by an industrialized back flush needle in any case (100%). No iatrogenic retinal breaks or hemorrhages in any case. Complete intraoperative retinal reattachment in all cases (100%).
Conclusion: Fashioned 25G cannula is safe and effective for injection of heavy liquids for reattachment of the retina during Vitrectomy for Rhegmatogenous Retinal Detachment. However, further studies are required to evaluate suction function using this fashioned cannula.