Open Access Case Report

Spontaneous Evolution of Lamellar Macular Hole into Full Thickness Macular Hole, and Resolution of the Same, Followed by Optical Coherence Tomography

Jelena Paović, Predrag Paović

Ophthalmology Research: An International Journal, Page 1-7
DOI: 10.9734/OR/2016/25581

Aim: Aim of this study is to, with the aid of optical coherence tomography, follow and evaluate spontaneous evolution of lamellar macular hole into full thickness macular hole, and vice versa.

Methods: A 70-year-old female with metamorphopsia and decreased central vision was examined and followed both clinically and with the aid of high-resolution optical coherence tomography. Idiopathic lamellar macular hole on the right eye and epiretinal membrane on the left eye were noted. Both, evolution of lamellar macular hole and epiretinal membrane were followed over a 2 year period.

Results: Over a period of 6 months lamellar macular hole had progressed into full thickness macular hole only to later ‘close’ and resolve into lamellar macular hole. High-definition optical coherence tomography confirmed that one of the mechanisms responsible for lamellar macular hole was opening of cystic spaces on the edges of lamellar macular hole. Loss of IS/OS juncture, or in other words, defects in the photoreceptor layer could be responsible for poor visual outcome. During the course of follow-up examinations of the left eye, there was partial separation of the epiretinal membrane without subsequent development of macular hole.

Conclusion: Lamellar macular hole slowly progresses and rarely evolves into a full thickness macular hole, and vice versa.

 

Open Access Case study

Bilateral Combined Retinal Vascular Occlusion: An Ocular Presentation in Central Nervous System Re-relapse of Non-Hodgkins Lymphoma

Amrita Chakrabarti, Priyanka Samal, Joydeep Chakrabartty

Ophthalmology Research: An International Journal, Page 1-5
DOI: 10.9734/OR/2016/26848

Aim: We describe an atypical case of central nervous system (CNS) involvement in non-Hodgkins lymphoma (NHL), presenting with ocular manifestations.

Presentation: Here we present an extremely rare case of a 63 year old male with past history of relapsed NHL in remission with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy, primarily presenting with bilateral sequential acute loss of vision without any systemic manifestations of relapse. On ophthalmological evaluation, he was found to have mixed central retinal artery and central retinal vein obstruction (CRAO & CRVO). CSF (cerebro-spinal fluid) evaluation revealed large B cell lymphoma cells. Management was initiated with triple intrathecal chemotherapy.

Discussion: NHL is the commonest type of ocular lymphoma, which is often the first manifestation of systemic relapse in cases of previous therapy. However, CRVO secondary to NHL is extremely rare. To the best of our knowledge, there are no previous reports of bilateral CRVO as a result of re-relapse of DLBCL presenting with features of ophthalmoplegia.

Conclusion: Re-relapse as isolated CNS lymphoma at second remission in a patient with systemic NHL is quite rare. Although unlikely, bilateral combined CRAO & CRVO may be the first manifestation of relapsed CNS lymphoma. Hence, clinicians should have a raised index of suspicion in cases of NHL presenting primarily with sudden, total loss of vision.

 

Open Access Original Research Article

Validity of Novel Microsoft Excel Software for Calculating Surgically Induced Astigmatism

Prabhakar Srinivasapuram Krishnacharya, Anuj Kumar Singal, A. Shamsiya Naaz, Raghavender Reddy Arra, Pooja A. Angadi, Ashwini Chandramouli

Ophthalmology Research: An International Journal, Page 1-9
DOI: 10.9734/OR/2016/22108

Purpose: To investigate validity and predictability of a new software calculator for surgically induced astigmatism quantification.

Techniques and Methods: A new astigmatic calculator was designed, based on Pythagorean principle and trigonometric functions using Microsoft office excel 2007. Astigmatic magnitude was quantified in diopters and axis direction was depicted in degrees. Calculator was applied, investigated and analyzed on 30 pseudophakic eyes that underwent temporal scleral incision surgery with in the bag intraocular lens implantation. Pre and postoperative anterior corneal curvature was measured with Bausch and Lomb keratometer. Similarities and differences were compared with the existing version 1.1 and 2.1 calculators and statistical analysis was performed using Microsoft excel.

Results: Mean pre and postoperative astigmatic magnitude was calculated as 62.67 (+/- 2.40) and 62.83 (+/- 2.29) diopters. Mean pre and postoperative astigmatic axis was 89.74 (+/- 1.37) and 89.51 (+/- 1.37) degrees. Pearson’s coefficient (r) was calculated as 0.91 and 0.83; coefficient of determinations (R2) was calculated as 0.82 and 0.68 for astigmatic magnitudes and axes respectively. Student chi-square test was used to calculate T values, which were 0.39 and 0.26 for astigmatic magnitude and axis respectively. P value less than 0.05 was considered as statistically significant (p 0.16). Validity was compared with existing surgically induced astigmatism calculators 1.1 and 2.1 versions and predictability was assessed by y=2.83+0.95x for astigmatic magnitude and y=15.28+0.83x equations for astigmatic axis.

Conclusion: Present Microsoft excel calculator application was valid as the values for astigmatic magnitude and axis were comparable with existing SIA calculators and can be used for astigmatic predictability.

 

Open Access Original Research Article

Screening for Ophthalmic Disorders among Deaf School Children in Nigeria- A Neglected Population

I. O. Chukwuka, A. O. Adio, N. E. Chinawa

Ophthalmology Research: An International Journal, Page 1-6
DOI: 10.9734/OR/2016/24160

Background: The visual and auditory systems are vital for the optimal development of a child. However recent studies have shown that the incidence of visual problems in the deaf is higher than in their hearing counterparts. This study is aimed to find out if this is so in our locality.

Aim: To screen for ocular abnormalities among students in a deaf school in Nigeria.

Materials and Methods: A cross sectional survey of students in a school for the deaf was carried out. Demographics as well as visual acuity, penlight eye examination, intraocular pressure, dilated fundoscopy and refraction of consenting respondents were documented where applicable.

Results: A total of 114 deaf students were seen comprising 48(42.1%) males and 66(57.9%) females. Mean age was 15.14±3.91 .A total of 110 (96.5%) subjects had vision ≥6/18 while the rest (n=4; i.e.3.5%) had low vision between < 6/18 and 6/60. Significant causes of low vision include optic atrophy of unknown cause, cupped discs from untreated chronic glaucoma and macular scarring.

Conclusion: There should be routine eye evaluation for all hearing-impaired and deaf persons so that timely treatment can be offered for treatable conditions in order to avoid loss of vision, which is the sense heavily relied upon in this group of individuals. No significant plans are in place to address this at the moment. It is encouraged that policy makers should please seek prompt and adequate delivery of these services to this population.

 

Open Access Original Research Article

Comparison between Ultrasonic Pachymetry and Scheimpflug Based Pentacam for Assessment of Central Corneal Thickness in Myopic Persons of Indian Sikh Origin

Renuka Mahey, Jyotiranjan Mallick, Lily Devi

Ophthalmology Research: An International Journal, Page 1-8
DOI: 10.9734/OR/2016/26503

Aims: To compare the central corneal thickness (CCT) measurements between Ultrasound Pachymetry and by the Scheimpflug based Pentacam in myopic persons of Indian Sikh origin.

Methodology: In a prospective study, 100 eyes of 50 myopic persons of Indian Sikh origin (aged 16 to 45 years) were subjected to CCT measurement with two methods Ultrasonic Pachymetry and Pentacam HR. Pentacam HR readings were recorded first. CCT readings obtained by both the methods were compared and analysed statistically using unpaired t-test.

Results: Mean Pachymetry reading with Ultrasound Pachymeter was 557.9 (SD 9.727) micrometers and with Pentacam was 562.34 (SD 9.91) micrometers. The correlation coefficient (r) between measurements using both instruments was 0.974. There was a tendency of overestimation of CCT measurements with Pentacam with a statistically significant difference between both methods (P<0.001). However, the amount of overestimation seems to be of little clinical importance (4.44 μm). The mean difference was was -4.44 micrometers (95% LOA -0.108 to -8.77 micrometers).

Conclusion:

1.     CCT measurements obtained with either the non contact Pentacam HR or contact Ultrasonic Pachymeter are close to each other with tendency of obtaining slightly higher readings with Pentacam HR.

2.     Pentacam was more convenient to the patient with excellent agreement to the readings by Ultrasonic Pachymeter which is considered the gold standard method of CCT measurement.

 

Open Access Original Research Article

To Study the Role of Conservative Management and to Evaluate Effectiveness of Syringing and Probing in Children with Congenital Nasolacrimal Duct Obstruction in a Tertiary Care Institution of Kashmir

Asif Amin Vakil, Ejaz Akbar Wani

Ophthalmology Research: An International Journal, Page 1-4
DOI: 10.9734/OR/2016/26236

The study aimed to find the role of conservative management and to evaluate effectiveness of syringing and probing in children with congenital nasolacrimal duct obstruction in a tertiary care institution of Kashmir. The prospective study was carried on 150 cases of congenital nasolacrimal  duct obstruction to rationalize its treatment by observing the response to Criggler’s massage in infants and by syringing and probing in children above 1 year of age. It was observed that the success rate of conservative management in infants is 78.16%. The success rates of syringing and probing is observed to decrease with increasing age of patient with highest success rate was in the age group of 13-18 months. Criggler’s massage is highly successful during first year of life therefore the infants presenting with congenital NLDO should be managed conservatively and observed. In children presenting after 1 year of age Probing is highly successful procedure when done early after 1 year of life.