Open Access Case study

The Importance of Optical Coherence Tomography and Autofluorescence in the Documentation of Papillary Colobomatous Fossette

Thiago Sande Miguel, Vinicius Sande Miguel, Tais Cristina Rossett, Daniel Almeida da Costa, Maurício Bastos Pereira

Ophthalmology Research: An International Journal, Page 19-23
DOI: 10.9734/or/2021/v15i330214

Aims: To describe the importance of optical coherence tomography and autofluorescence in the documentation of papillary colobomatous fossette.

Presentation of Case: F.D.O. A 14-year-old male student is referred for evaluation of the fundus of the eye due to an alteration in the optic disc noticed by another professional who did not feel safe in the follow-up. The patient was completely asymptomatic at the time of the consultation and did not claim previous visual complaints.

She denied systemic and ocular comorbidities and did not use any systemic and topical medication.

Discussion: The congenital optic disc pit is a rare and typically unilateral congenital anomaly, consisting of a retinal herniation that extends into the subarachnoid space through a lamina cribrosa defect. 8,13,15,16

Although this condition, in most cases, does not present complications and remains asymptomatic, it can sometimes worsen with a significant decrease in visual acuity. This more serious condition can be characterized by important macular alterations, such as serous retinal detachment, cystic degenerations and degenerative pigmentary alterations. 14,16,17,18 The patient in the present report did not have any visual complaints and did not present severe structural and functional retinal damage, which highlights the importance of early diagnosis.

Conclusions: The colobomatous papilla pit is characterized by the presence of isolated cavities in the optic disc head secondary to a developmental disorder of the primitive epithelial papilla.

Its incidence is 1:10,000 people without sexual or racial predilection. It presents, in most cases, asymptomatic, unilateral in 85-95% of cases and rarely with more than one pit per disc.

Open Access Case study

Correction of Pre-Existing Astigmatism with Phacoemulsification Using Spherical Intraocular Lens and Wave front Guided Surface Ablation: A Retrospective Case Series

Ahmed El-Shehawy, Ahmed El-Massry, Mohamed El- Shorbagy, Mohamed Atef, Moataz Sabry

Ophthalmology Research: An International Journal, Page 24-29
DOI: 10.9734/or/2021/v15i330215

Objective: To evaluate safety and efficacy of using spherical intraocular lens followed by wavefront guided surface ablation in correction of preexisting regular corneal astigmatism.

Methods: This retrospective case series study included 20 eyes of 16 patients having visually significant cataracts and co-existing regular corneal astigmatism. The patients underwent phacoemulsification with spherical intraocular lens and wavefront guided PRK three months later. 

Results: There was a statistically significant difference for Uncorrected Visual Acuity UCVA, Best Corrected Visual Acuity BCVA, Manifest Refraction Spherical Equivalent MRSE, and refractive astigmatism postoperatively regarding all these parameters (P˂0.05).

Conclusion: Astigmatism correction during or even after cataract surgery is a safe and effective method to improve visual outcomes. Longer period of follow up are required to evaluate stability of this technique and possibility of regression.

Open Access Case study

Internal Angular Dermoid Indenting on the Globe

Suwarna Suman, Hemant Uttamrao Rathod, Arushi Kumar, Virendra K. Pal

Ophthalmology Research: An International Journal, Page 30-34
DOI: 10.9734/or/2021/v15i330216

Angular dermoid cysts are common periorbital tumours in children. They are tumours of embryonic origin that arise along bony sutures as a result of abnormal ectodermal sequestration during development. Angular dermoid cysts usually present in early childhood, are characteristically small benign and slow growing lesion. External angular dermoid present in the superotemporal quadrant is more common compared to internal angular dermoid in the superonasal quadrant. Early surgical excision is recommended and performed in the majority of cases, particularly to restore facial cosmesis.

Here we report an unusual case of a large internal angular dermoid cyst indenting the globe in a 3-year-old girl presented with left upper eyelid mass at medial angle since one year of age. The cyst was excised completely by anterior orbitotomy through a small superior lid crease incision.

Open Access Original Research Article

Prevalence and Risk Factors of Retinopathy of Prematurity (ROP): A Cross-Sectional Study

Kishan A. Makvana, Apurva H. Suthar

Ophthalmology Research: An International Journal, Page 1-6
DOI: 10.9734/or/2021/v15i330212

Background and Aim: Despite considerable progress made in the treatment of Retinopathy of prematurity (ROP), it is still a common cause of reduced vision in children in developed countries, and its prevalence is increasing. This is a preventable disease and responds to treatments appropriately if diagnosed at early stages, but in case of delayed diagnosis and treatment, it may lead to blindness. The aim of the present study is to describe the incidence, severity, and risk factors of ROP in a tertiary healthcare center.

Material and Methods: This was a prospective, observational, nonrandomized study conducted in a tertiary-level neonatal intensive care unit (NICU) of a teaching hospital in Gujarat. A total of 130 preterm neonates admitted in the NICU during the study period were screened for ROP as per the guidelines of NNF of India. Screening was done under topical anesthesia, and findings were documented according to the International Classification for Retinopathy of Prematurity recommendations. The data were analyzed for gestational age, birth weight, and systemic factors predisposing to ROP.

Results: Of the 130 neonates, 37 neonates were found to have ROP, with the incidence of ROP being 28.4%. The mean birth weight (1388 ± 312 g) and the mean gestational age (32.21 ± 2.50 wk) Out of the 37 neonates with ROP, 14 had a gestational age of > 32 weeks and/or birth weight of > 1500 g. ROP was classified into type 1 and type 2 as per the ETROP study, 14 (39.39%) neonates had type 1 or treatable ROP; there were no cases of APROP in our study; ROP regressed without any intervention in 13 neonates; 7 neonates were defaulters; and 11 neonates were treated with laser.

Conclusion: ROP is strongly associated with smaller, more immature, and sicker neonates. However, in our study, about 40% of neonates who developed ROP were of higher gestation (> 32 wk) and birth weight (> 1500 g). The analysis of risk factors for ROP development will help to understand and predict it in severe preterm infants.

Open Access Original Research Article

New Possibilities of Refractive Modeling of the Cornea by the Radiation of an Argon-fluorine Excimer Laser

I. M. Kornilovskiy

Ophthalmology Research: An International Journal, Page 7-18
DOI: 10.9734/or/2021/v15i330213

Purpose: To consider new possibilities of refractive modeling of the cornea by the radiation of an argon-fluorine excimer laser in ablative and subablative modes after saturation of the stroma with riboflavin.

Materials and Methods: Experimental (20 pork, 90 rabbit eyes) and clinical studies on photorefractive and phototherapeutic operations with saturation of the corneal stroma with riboflavin (610 operations) were analyzed. To activate riboflavin, secondary radiation induced by exposure to ablative and subablative energy densities was used. A quick transition to energy densities below the ablation threshold without additional calibrations was carried out using a “Microscan Visum-500” excimer laser (Optosystems, Russia). An objective assessment of the refractive keratomodelling effect and visual results was carried out according to the data of complex optometric studies.

Results: Experimental and clinical studies have shown the advantages of refractive keratomodeling by theradiation of an argon-fluorine excimer laser in ablative and subablative modes after saturation of the stroma with riboflavin. Isotonic 0.25% riboflavin solution did not affect the accuracy of refractive ablation and blocked the negative effect of induced secondary radiation on keratocytes and corneal nerves. This reduced the aseptic inflammatory response and the risk of developing an irreversible form of fibroplasia. Ablation with riboflavin initiated a damped crosslinking effect, which increased the photoprotective and strength properties of the thinned cornea. A refractive keratomodelling effect was found when energy densities were applied below the stromal ablation threshold. The magnitude of this refractive effect depended on the total radiation dose and the topography of the affected area. This approach made it possible to implement laser-induced refractive keratomodeling without ablation of the corneal stroma.

Conclusion: Refractive modeling of the cornea by the radiation of an argon-fluorine excimer laser in ablative and subablative modes after saturation of the stroma with riboflavin opens up new possibilities in laser correction of ametropia.