Open Access Original Research Article

Paediatric Ocular Disoders in a Tertiary Care Rural Hospital of Central India (Birth to 15 Years)

Ojha Sushil, Jain Vaibhav, Tandon Anupama, Sharma Reena, Singh Brijesh

Ophthalmology Research: An International Journal, Page 1-6
DOI: 10.9734/OR/2016/20771

Introduction: This study was done to know the pattern of paediatric ocular disorders presenting in outpatient department (OPD) of rural tertiary care hospital of central India.

Methods: A cross sectional study of Paediatric ocular disorder done at UPRIMS and R (Uttar Pradesh Rural Institute of Medical Sciences and Research, Saifai, Etawah) pediatric patients attending the OPD from January 2015 to June 2015. The patients of birth to 15 years of age were included in the study. The patient particular were noted. The patient name, age, sex ,residence, visual acuity, type of refractive errors , mode and type of injury and diagnosis (Allergic Conjunctivitis, Refractive Error, Infective Conjunctivitis, Ocular Trauma, congenital NLD obstruction, Squint, Amblyopia, JOAG, Congenital Glaucoma, Corneal Ulcer, Conjunctival xerosis, Periorbital swelling) was made.

Result: The total number of 848 paediatric ocular disorder patients enrolled in the present study from eye OPD of UPRIMS &R, Saifai, UP from January 2015 to June 2015. The age of pediatric ocular disorder patients ranges from birth to 15 years of age. Out of these 542 patients (63.92%) were male and 306(36.08%) patients were female. The majority of Pediatric patients (406 childrens, 47.88%) seen in OPD were of 9-15 years. The most common ocular complain was allergic conjunctivitis in 277 cases (32.66%, 173 male,104 female), refractive error is seen in 260 cases (31.37%, 168 male, 92 female), infective conjunctivitis in 73 cases (8.60%, 40 male,33 female), ocular trauma in 71 cases (8.37%, 50 male, 21 female), congenital nasolacrimal duct obstruction(NLDO) in 53 cases (6.25%,35 males,18 female, bilateral in 32 cases and unilateral in 21 cases), squint in 31 cases (3.66%, 23 male, 8 female), amblyopia in 30 cases (3.53%,15 male, 15 female), Juvenile open angle glaucoma in 10 cases (1.17%, 5 male, 5 female), corneal ulcer in 10 cases (1.17%, 10 male), ocular swelling (with or without tumour) in 25 cases (2.95%, 20male, 5 female) , and conjuctival xerosis (Vit A deficiency) in 3 cases (0.35%,3 female), and congenital glaucoma in 5 cases (0.59%, 3 male,2 female).


Open Access Original Research Article

Evaluation of Effectivity of Laser Photocoagulation in Diabetic Retinopathy

Achyut N. Pandey, Parul Singh, Amit Vikram Raina, Ameeta Kaul, Anil Kakde

Ophthalmology Research: An International Journal, Page 1-9
DOI: 10.9734/OR/2016/21875

Aim: 1. To study the efficacy of laser photocoagulation in Diabetic Retinopathy. 2. To study the different laser protocols i.e. parameters used for treatment of Diabetic Retinopathy.

Materials and Methods: Retrospective study was conducted in the Dept. of ophthalmology in a tertiary eye care centre from April 2014 to July 2015. Patients presenting to the Retina Clinic with a diagnosis of Diabetic Retinopathy and undergoing laser photocoagulation were included in the study. Forty eyes of 20 patients with Diabetic Retinopathy undergoing laser were enrolled. All the patients underwent routine ophthalmological examination including FFA.

Results: Forty eyes of 20 patients with Diabetic Retinopathy undergoing laser were enrolled. There were 9 females and 11 male. Mean age was 58.4 years. 4 patients with a clinical diagnosis of Proliferative Diabetic retinopathy, 9 patients with Non Proliferative Diabetic Retinopathy, 7 patients with Non Proliferative Diabetic Retinopathy and Clinically Significant Macular Oedema. Visual acuity at presentation was more than 6/12 in 17 eyes, 6/60 to 6/18 in 21 eyes, less than 6/60 in 2 eyes. Sixteen eyes received Pan retinal Photocoagulation in 3 sittings while 16 eyes received Focal laser, 8 eyes received Grid laser, 8 eyes received Pan retinal Photocoagulation along with Focal laser, and 8  eyes received Pan retinal Photocoagulation along with Grid laser. Visual acuity after laser was during presentation was more than 6/12 in 32 eyes, 6/60 to 6/18 in 5 eyes, less than 6/60 in 3 eyes. Visual Acuity improved in 57.5% of eyes, remained same in 40% of eyes and worsened in 2.5% of eyes after laser photocoagulation.    

Conclusion: Most patients with Diabetic Retinopathy presented with good visual acuity. Pan Retinal Photocoagulation was effective in regressing new vessels in all eyes. Focal laser was more effective than grid laser in reducing macular edema.

4. Visual acuity improved in 57.7% of eyes, remained same in 49% of the eyes and worsened in 2.5% of the eyes.


Open Access Original Research Article

Visual Acuity Outcome in Diabetic Retinopathy after Diode Laser Therapy

Mohammad Reza Miri, Gholamhossein Yaghoobi, Golrokh Hariri

Ophthalmology Research: An International Journal, Page 1-5
DOI: 10.9734/OR/2016/20011

Background and Objective: Diabetic retinopathy as an important complication of diabetic mellitus is a common cause of blindness in diabetic people. The purpose of this study is to investigate the efficacy of the diode laser on visual acuity in patients with diabetic retinopathy.

Methods and Materials: In this cross-sectional study, patients with diabetic retinopathy who had clinically significant macular edema were candidates for laser therapy. High-risk diabetic patients with retinopathy that had also clinically significant macular edema were treated by a diode laser with wavelength of 810 nm. The visual acuity was evaluated 3, 6 and 12 months after the intervention and compared with the patient data before intervention. The data were collected with SPSS-15 and the distribution of descriptive data was indeed analyzed by the use of non-parametric test. Furthermore Wilcoxon and Mann-Whitney compared the mean log MAR before and after laser photocoagulation on visual acuity.

Results: This study was done on 50 patients (64 eyes) with diabetic retinopathy. Twenty seven (54%) of patients were males and 23 (46%) were females. The results of this trial showed clinically significant improvement on visual acuity from 1.21 log MAR before laser therapy to 0.83 log MAR 3 months after intervention (p=0.02). But this improvement was halted after 12 months of intervention and this does not show any statistically significant relation (p=0.07). Moreover, the different levels of visual acuity before intervention and at 12 months after, showed no significant relation to gender (P=0.23).

Conclusion: According to these results, the patients’ visual acuity recover at 3 and 6 months after intervention but it did not show any significant difference 12 months later. Retinal photocoagulations in patients with diabetic retinopathy have not led to a worsening of patients’ visual acuity in the long run.


Open Access Original Research Article

A Study of Selective Laser Trabeculoplasty as Adjunctive Treatment in Patients Affected by Open Angle Glaucoma for Control of Intraocular Pressure in Indian Eyes

Ojha Sushil, S. S. Pandav, Kaushik Sushmita, Raj Srishti

Ophthalmology Research: An International Journal, Page 1-11
DOI: 10.9734/OR/2016/22164

Background: Prospective Interventional Pilot study of selective laser trabeculoplasty as adjunctive treatment in patients affected by open angle glaucoma for control of intraocular pressure in Indian eyes.

Methods: This prospective Interventional pilot study included 29 eyes of 29 patients affected by open angle glaucoma, were treated with Selective laser trabeculoplasty (360 degree trabecular meshwork treated with 100 spots) for IOP control between January 2011 to December 2011. Of these 29 patients, 24 were males, 5 were females. Mean age was 58.96±18.19 years. Primary open Angle Glaucoma was diagnosed in 22 patients, Secondary Open Angle Glaucoma in 6, and Juvenile Open Angle Glaucoma in 1 patient. All patients underwent complete ophthalmic evaluation before SLT and at each follow up. This evaluation included visual acuity, IOP (GAT), slit lamp examination with 90D. The gonioscopy and visual field analysis was done at 6 &12 months. The IOP was measured on day 1, day 7, 1 month, 3 month, 6 month and at 1 year post SLT On GAT.

Results: Main outcome measure was lowering of intraocular pressure on Goldmann Applanation Tonometry. The mean IOP Pre SLT (Selective Laser Trabeculoplasty) was 24.62±6.38, IOP was reduced to 14.20±4.10 mmHg on Day 1 (42.32% reduction), on day 7 it was 15.96±4.731 mmHg (35.17% reduction), at 1 month it was 17.27±4.77 mmHg (29.82% reduction), at 3 months it was 19.41±4.40 mmHg (21.10% reduction), at 6 months it was 16.93±4.03 mmHg (31.23% reduction) and at 1 year it was 16.47±4.04 mmHg (31.3% reduction). After 3 months of follow up, 6 eyes out of 29 eyes, required Trabeculectomy with mitomycin C, for inadequate IOP control post SLT. These patients were considered as failures. In 2 patients topical medications decreased following SLT, remaining patients continued on same antiglaucoma medications. At follow up of 3 months 22 eyes (75.86%) out of 29 eyes maintained atleast 20% reduction from baseline IOP (Pre SLT IOP). At 6 months and 1 year of follow up 22 eyes out of 23 (95.65%), maintained atleast 20% reduction from baseline IOP (Pre SLT IOP). None of our patient had any complication or side effect following SLT.

Conclusion: Selective laser trabeculoplasty is effective and safe as a secondary/adjunctive treatment for lowering IOP in patients of open angle glaucoma not adequately controlled with medical therapy in Indian eyes. SLT has good compliance and affordability.


Open Access Review Article

Post-stroke Visual Impairment: A Systematic Literature Review of Types and Recovery of Visual Conditions

Lauren R. Hepworth, Fiona J. Rowe, Marion F. Walker, Janet Rockliffe, Carmel Noonan, Claire Howard, Jim Currie

Ophthalmology Research: An International Journal, Page 1-43
DOI: 10.9734/OR/2016/21767

Aim: The aim of this literature review was to determine the reported incidence and prevalence of visual impairment due to stroke for all visual conditions including central vision loss, visual field loss, eye movement problems and visual perception problems. A further aim was to document the reported rate and extent of recovery of visual conditions post stroke.

Methods: A systematic review of the literature was conducted including all languages and translations obtained. The review covered adult participants (aged 18 years or over) diagnosed with a visual impairment as a direct cause of a stroke. Studies which included mixed populations were included if over 50% of the participants had a diagnosis of stroke. We searched scholarly online resources and hand searched journals and registers of published, unpublished and ongoing trials. Search terms included a variety of MESH terms and alternatives in relation to stroke and visual conditions. The quality of the evidence was assessed using key reporting guidelines, e.g. STROBE, CONSORT.

Results: Sixty-one studies (n=25,672) were included in the review. Overall prevalence of visual impairment early after stroke was estimated at 65%, ranging from 19% to 92%. Visual field loss reports ranged from 5.5% to 57%, ocular motility problems from 22% to 54%, visual inattention from 14% to 82% and reduced central vision reported in up to 70%. Recovery of visual field loss varied between 0% and 72%, with ocular motility between 7% and 92% and visual inattention between 29% and 78%.

Conclusion: The current literature provides a range of estimates for prevalence of visual impairment after stroke. Visual impairment post stroke is a common problem and has significant relevance to the assessment and care these patients receive. Prospective figures regarding incidence remain unknown.