Retina & Vitreous

31–40 of 72 articles Page 4 of 8
All Cornea 36 Cataract 17 Glaucoma 14 Retina & Vitreous 72 Neurophthalmology 8 Oculoplasty 15 Uvea & Inflammatory Diseases 24 Miscellaneous 20 Oncology 9 Pediatric Ophthalmology 16
  1. 28 min read

    Optical Coherence Tomography- Evolution and Clinical Applications

    1. Introduction Optical coherence tomography (OCT) is a noninvasive imaging modality that has revolutionized the practice of clinical ophthalmology over the past decade. OCT provides high-resolution cross-sectional images of the retina, optic nerve head and retinal nerve fibre layer (RNFL) unobtainable by any other current modality, and enables qualitative and quantitative evaluation. As opposed to other retinal imaging modalities that provide én face images, it provides for sectional information, and in that sense is analogous to an in vivo “optical biopsy” (Figure 1). It is safe, fast, reproducible, does not require greatly skilled technicians, and has minimal, if any, interobserver issues. Several advances in recent times have contributed to vast improvements in resolution and speed of OCT devices, and expanded their applications manifold. In 2010, in the US alone, an estimated 16 million OCT procedures were done, amounting to $ 780 million in reimbursement.[1] Fig 1. Macular OCT wi

    Dr. Abhishek R. Kothari
  2. 8 min read

    Macular Buckle Indications, Technique and Challenges

    Macular Buckling (MB) is simply defined as a modified scleral buckle (SB) surgery where the sclera is remodeled to appose the retina to the sclero-choroidal complex thereby relieving the traction. Unlike conventional SB, where buckle element is placed circumferentially around the eyeball, MB element is placed behind the globe under macula indenting the sclera from posterior. MB has been tried by various surgeons for varied purpose. In general, situations, where MB has been attempted for a variety of posterior pole diseases, are as follows- Eyes with pathological myopia (PM) associated with posterior staphyloma (PS) Eyes with Optic Pit abnormalities Eyes requiring scleral remodeling posterior to the equator, where routine SB may not be effective In all practical situations, pathological myopia having posterior staphyloma associated macular changes is presently the most common indications for MB surgery. The other 2 situations have been very rarely attempted with MB surgery, with limited

    Dr. Pradeep Susvar · Dr. Kushal Delhiwala
  3. 7 min read

    Choroidal Neovascular Membrane

    Choroidal neovascular membrane (CNVM) is an ingrowth of new vessels from the choriocapillaris through a break in the outer aspect of Bruch’s membrane into the sub-pigment epithelial space. These new vessels are accompanied by fibroblasts, resulting in a fibrovascular complex that proliferates within the inner aspect of Bruch’s membrane. This fibrovascular complex can disrupt and destroy the normal architecture of the choriocapillaris, Bruch’s membrane, and the RPE. In addition, fibroglial and fibrovascular tissue can also disrupt and destroy the normal architecture of the photoreceptors and the remaining outer retina leading to the formation of a disciform scar. Within the subpigment epithelial space, the CNV can leak fluid and blood and may be accompanied by a serous or hemorrhagic detachment of the RPE. CNVM that remains restricted to the sub-RPE space is Type1 CNVM and when it becomes sub-retinal it is Type 2 CNVM. Clinical Features Symptoms of CNVM: Sudden onset of decreased vision

    Dr. Thomas Thachil
  4. 17 min read

    Epiretinal Membrane

    Epiretinal membranes(ERM) are acquired formation of semi-transparent cellular sheets on the macular surface, which are formed due to varied etiologies. These membranes have contractile properties, often leading to mechanical distortion of macula. The proliferation of ERM on the inner retinal surface along the internal limiting membrane was first described by Iwanoff in 1865 1. In 1971, Roth and Foos reported that in a series of autopsied eyes, ERM were present in 2 percent of patients aged 50 yr and in more than 20 percent of patients by age 75 yr2. Pearlstone reported an incidence of 6.4 percent in 1000 consecutive routine eye examinations in patients older than 50 yr, with 20 percent being bilateral 3,4. Other authors report bilateral involvement in 10 to 20% of cases5,6,7.The Los Angeles Latino Eye Study (LALES) found that of the participants with ERM, 19.9% had bilateral ERMs. The prevalence of ERM increased from 10.1% in persons 40 to 49 years of age to 35.7% in those aged 70 to 7

    Dr. Pravin Jain · Dr. P.N.Nagpal
  5. 25 min read

    Vitrectomy: A Review

    INTRODUCTION Pars plana vitrectomy as a technique has revolutionized retinal surgery since its advent and initial report by Machemer et al 1. It allowed the removal of traction by an internal method, essential in retinal detachment procedures, as well as provided an active management modality for vitreous haemorrhage and opened the door for surgical intervention in a myriad of retinal pathologies. Since that time, the evolution of vitrectomy surgery has seen experimentation and implementation of smaller surgical instruments aimed at greater functionality and minimalization of ocular trauma. The basis of a sutureless pars plana sclerotomy was to stabilize intraocular pressure (IOP) during surgery, with a truly closed system, as well as reduce surgical time by removing the need for sutured wound closure. Wound and suture related complications such as leakage, irritation, and scleral pigmentary changes could also be avoided. Concerns regarding wound competence in a sutureless procedure ha

    Dr. Gaurav Paranjpe · Dr. Pravin Jain · +1 other
  6. 18 min read

    Proliferative Diabetic Retinopathy

    Diabetic retinopathy (DR) is the leading cause of visual impairment worldwide. It almost accounts for 2.6% of treatable blindness globally (1). It is estimated that the overall prevalence of diabetic retinopathy is 34.6 % worldwide, while the prevalence of proliferative diabetic retinopathy (PDR) is 6.96% and that of vision-threatening DR (VTDR) is computed to be 10.2% (2). Currently, the prevalence of PDR in India is estimated to be 17% which is significantly higher compared to patients from other locations of Asia (3). Early detection and treatment is the only key to avoiding complications and risks of vision loss (4). But the major obstacle ahead of us in India is the failure to diagnose DR in early stages; as it is observed that only 18–35% of diabetics undergo ophthalmologic evaluation regularly (5). Pathogenesis Diabetic retinopathy is recognized as a neuro-vascular complication of diabetes. The triad of hyperglycemia, inflammation, and hypoxia along with retinal neurodegeneratio

    Dr. Aditya Kelkar · Dr. Mounika Bolisetty
  7. 42 min read

    Retinopathy of Prematurity

    Introduction First described in 1942, retinopathy of prematurity (ROP) is a vasoproliferative retinopathy affecting premature infants of low birth weight. As per the original description by Terry et al, this disease was labelled as retrolental fibroplasia (RLF) based on the hypothesis that it involved the proliferation of the embryonic hyaloid system[1] But Owens and Owens later described that in these infants, the hyaloid system was normal at birth and the RLF developed postnatally.[2] The term “retinopathy of prematurity” was coined later as the disease pathogenesis and clinical presentation got better understood. [3]In the 1950s, the association between supplemental oxygen and ROP pathogenesis was first established by controlled studies done in the neonatal intensive care units. {4,5] The spectrum of ROP ranges from mild cases that may resolve spontaneously with no visual impairment to advanced cases with bilateral irreversible blindness within the first few months of life. Epidemio

    Dr. Parveen Sen · Dr. Aditya Maitray
  8. 22 min read

    Bacterial Endophthalmitis - Where We Stand ?

    Endophthalmitis is a potentially devastating condition of intraocular procedures. It is an inflammation of internal coats of the eye along with inflammation of intraocular cavities i.e. aqueous and vitreous humour that occur as a result of intraocular colonization of microorganisms. It is one of the most feared complications of cataract extraction and other intraocular surgeries. Rarely, infectious endophthalmitis is the presenting feature of an underlying systemic infection. The incidence of endophthalmitis has sharply declined within two to three decades because of variations in surgical technique, scrupulous asepsis, and use of preoperative and post-operative broad-spectrum antibiotics. Classification Of Endophthalmitis: General categories include postoperative endophthalmitis (acute, delayed-onset, conjunctival filtering–bleb associated, glaucoma drainage devices associated), posttraumatic endophthalmitis (blunt or penetrating ocular trauma, foreign bodies), endophthalmitis associa

    Dr. Sugandha Goel · Dr. Ekta Rishi
  9. 20 min read

    Polypoidal Choroidal Vasculopathy

    Introduction Polypoidal Choroidal Vasculopathy (PCV), first described by Yannuzzi et al1 in 1982, is a distinct clinical entity characterized by persistent recurrent serous leakage and hemorrhage in the macula, and is seen in the elderly population. The disorder was poorly understood earlier and had been described by various authors as recurrent pigment epithelial detachment (PED) and posterior uveal bleeding syndrome.2.5 The primary abnormality, as described by Yannuzzi et al,1, 2, 6involves the choroidal circulation, and the characteristic lesion is an inner choroidal vascular network of vessels ending in an aneurysmal bulge visible clinically as a reddish-orange spheroidal polyp like structure. More recently with improvement in choroidal imaging using Enhanced Depth Imaging and Swept-Source optical coherence tomography (EDI-OCT and SS-OCT), PCV is regarded as a part of the Pachychoroid spectrum of diseases and a variant of Type I choroidal neovascularization.7, 8, 9 Epidemiology The

    Dr. Giridhar Anantharaman, MS, FVRS · Dr. Jay Sheth, DNB, FVRS
  10. 11 min read

    Drug Induced Maculopathy: A Quick Look

    Generally all the drugs are likely to have some side effects. For ophthalmologists, it is essential to know the drugs which affect the vision or involve the eye as a part of their side-effects. This is a summary of the drugs causing damage to the posterior segment of the eye. Patterns of retinal toxicity: Disruption of the retina and retinal pigment epithelium Vascular damage Retinal folds Phenoithiazine Qunine sulfate Thioridazine Clofazimine Cholopromazine Deferoxamine Chloroquine derivatives Corticosteroid Chloroquine Cisplatin& carmustine Hydroxychloroquine Cisplatin & carmustine Qunine sulfate Aminogycoside Interferon Ergot derivatives Talc Phenylpropanolamine Oral contraceptives Cystoid macular edema Epinephrine Latanoprost Nicotinic acid Sulfa derivatives Hydroxychlorothiazide Acetazolamide Triamterene Metronidazole Chlorthalidone Crystalline retinopathy Uveitis Tamoxifen Talc Canthaxanthine Nitrofurantoin Methoxyflurane Rifabutin Cidofovir Miscellaneous Digoxin Methanol CHLOROQ

    Dr. Jay Chhablani