Topic

#Macular Diseases

38 articles
  1. Articles 1 Apr 2021 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
  2. Articles 1 Apr 2021 14 min read

    Coats Disease

    Introduction History In 1908 George Coats1 original description of the disease was based primarily on histopathologic examination of enucleated eyes and identified retinal vascular aneurysms, arteriovenous malformations, intra- and subretinal hemorrhages, and exudates. Coats categorized eyes with these characteristic morphologic findings into three groups: Group I demonstrated massive subretinal exudate alone, group II consisted of eyes with massive subretinal exudate, intra and subretinal hemorrhage, and retinal vascular dilatations, and group III included eyes with subretinal exudate and retinal arteriovenous malformations. Von Hippel2 later identified group III as a separate entity, angiomatosis retinae, which led to the exclusion of this group from the spectrum of Coats disease. In 1912, Theodor Leber3 described a disorder with similar retinal vascular abnormalities to Coats disease, but without massive subretinal exudate, hemorrhage, and serous retinal detachment. This became know

    Dr. Aditya Bansal · Dr. Vikas Khetan
  3. Articles 1 Apr 2021 26 min read

    Optical Coherence Tomography

    Introduction Optical Coherence Tomography is a powerful noninvasive imaging modality that performs high resolution, micron-scale, cross-sectional imaging of the retina. Originally developed in 1991 by Huang et al, [1] OCT technology has continually evolved and expanded within ophthalmology and has been explored in a wide range of clinical applications. With the introduction of Spectral/ Fourier Domain OCT (SD-OCT, FD-OCT) and Swept Source OCT (SS-OCT), there is greater tissue resolving power, significantly higher scan density, and faster data acquisition than original Time Domain OCT. Thus, OCT has revolutionized the practice of ophthalmology and, in particular the diagnosis and management of patients with retinal disease. This chapter describes the basics of OCT technology and its clinical applications in retinal disorders. OCT technology and working principle [2-8] OCTs operate on the principle of indirect low-coherence interferometry, in which a beam of light is directed into the re

    Dr. Remya Paulose · Dr. Jay Chhablani
  4. Articles 1 Apr 2021 9 min read

    How do we treat inflammatory CNVM ?

    Inflammatory choroidal neovascular membranes (CNVM) cause an acute and significant visual loss 1,2. Mostly affecting eyes with posterior or panuveitis, the chronic recurrent nature of inflammation further worsens the visual prognosis in these eyes, such as serpiginous like choroiditis, punctuate inner choroidopathy (PIC), multifocal choroiditis, Vogt-Koyanagi-Harada (VKH) disease, presumed ocular histoplasmosis syndrome, toxoplasma retinochoroiditis, etc,.3,4 . The angiogenic stimulus in inflammatory CNVM is driven by local inflammation and/or a degenerative breach in retinal pigment epithelium (RPE)-Bruch’s membrane complex4. An active intraocular inflammation induces the release of several inflammatory mediators including cytokines, chemokines, vascular endothelial growth factor (VEGF) and complement activation, which in turn promote retinal and choroidal neovascularization. Majority of inflammatory CNVM are classic (on fundus fluorescein angiography), and type 2 on spectral domain o

    Dr. Krinjeela Bazgain · Dr. Nitin Kumar · +1 other
  5. Articles 1 Apr 2021 18 min read

    Angioid Streaks

    Angioid streaks are visible irregular crack-like dehiscences in Bruch’s membrane that are associated with atrophic degeneration of the overlying retinal pigmented epithelium. Despite 50 % of cases being idiopathic, this condition grabs attention as it requires good history taking and workup to determine the cause. Historical background The first description of angioid streaks was provided in 1889 by Dr. Robert W. Doyne, an English ophthalmologist. He noticed irregular, jagged deeply pigmented lines especially around the discs of both eyes in a patient who sustained trauma in both eyes and attributed it to be due to the rupture of pigment layer of retina. [1] Because of their resemblance to blood vessels, Herman J. Knapp, a German-born American ophthalmologist coined and introduced the term "angioid streaks" in 1892. [2] They are also known as Knapp’s striae. Clinical examination with histopathological findings by Bock in 1938 in two patients with pseudoxanthoma elasticum confirmed that

    Dr. Remya Paulose · Dr. Bhavik Panchal · +1 other
  6. Articles 1 Apr 2021 17 min read

    Fundus Fluorescein Angiography and Indocyanine Green Angiography: Made Easy for the Postgraduates

    Introduction and Gross Anatomy: The retinal and choroidal circulatory system can be visualized in vivo in the presence of normal media clarity. Many important diseases of the retina are related to or associated with the changes in the vasculature of the retina and/or choroid. Hence, it is important to understand the circulatory systems involved to better recognize disease states of the posterior segment. The retinal and choroidal vascular anatomy can be basically divided into 3 parts: Retinal and choroidal vasculature Superficial and deep capillary plexus Inner and outer blood-retinal barriers A: Retinal and Choroidal Vasculature: The retina receives its nutrition from two discrete circulatory systems—the retinal and the choroidal blood vessels. Both are derived from the ophthalmic artery, which is the first branch of the internal carotid artery. The major branches of the ophthalmic artery are the posterior ciliary arteries, the central retinal artery, and the muscular branches. [1] Th

    Dr. Ramesh Venkatesh · Dr. Sajjan Sangai · +1 other
  7. Articles 1 Apr 2021 25 min read

    An Approach to a Case of Retinitis

    Inflammation of retinal tissue causes characteristic fundus findings depending on whether it is full-thickness or partial-thickness or outer or inner retinal involvement. Figure 1A: A case of epidemic retinitis: Bright yellow superficial fluffy lesion superiorly to the disc obscuring retinal vessels passing through it is typical of inner or full-thickness retinitis. 1B: A case of progressive outer retinal necrosis: Yellowish lesions with clear retinal overlying vasculature suggests outer retinitis. Full-thickness or inner retinal involvement produces bright yellow fluffy lesions with indistinct borders. (Figure 1A) Retinal vasculature passing through these lesions appears obscured. At times, such lesions can mimic cotton-wool spots and may produce moderate to severe vitritis. Outer retinal inflammatory lesions appear dull orange or yellow with indistinct borders, retinal vessels may remain clear over the lesions (Figure 1B) and vitritis could be mild-moderate. Differentiating retinitis

    Dr. Ankush Kawali · Dr. Sanjay Srinivasan · +1 other
  8. Articles 1 Apr 2021 42 min read

    Optical Coherence Tomography Angiography Made Simple

    Introduction Recent advances in ophthalmic imaging have opened new avenues for a more thorough and extensive understanding of various retinal diseases. Quite a few of these pathologies are attributed directly or indirectly to vascular abnormalities. This renders the need to develop technology capable of providing intricate data of the ocular vasculature. Amongst these is Optical Coherence Tomography Angiography or OCTA. It is a novel, non-invasive imaging modality which provides rapid visualization of the retinal and choroidal microcirculation. Being a dyeless procedure, it eliminates the potential side effects of conventional angiography - i.e Fundus Fluorescein Angiography (FFA)(1) and Indocyanine Green Angiography (ICGA) (2), which require an intravenous injection of a contrast agent. OCTA is a dyeless procedure OCTA derives both functional as well as structural details of the vasculature by detecting the intrinsic motion of the red blood cells within the vessels. (3) By detecting m

    Dr. Nasiq Hasan · Dr. Manasi Tripathi · +1 other
  9. Articles 1 Apr 2021 10 min read

    Binocular Indirect Ophthalmoscopy : The Beginner's Guide

    The technique of examining the fundus of the eye is called ophthalmoscopy. In direct ophthalmoscopy, a virtual and erect image of the fundus is seen. In indirect ophthalmoscopy, a real and inverted image is formed between the condensing lens and the observer. The advantage of stereopsis (depth perception) and a larger field of view makes indirect ophthalmoscope (IDO) more useful both in retina clinics and during posterior segment surgeries. Inventions and innovations The journey of developing ophthalmoscopy began with an idea by the great physicist, Hermann von Helmholtz, who described the optical principles of direct ophthalmoscopy in 1851 (Fig:1a). This was followed by series of innovations and methods of examination including the indirect method of ophthalmoscopy developed by Reute in 1852 (Fig:1b), binocular model by Marc-Antoine Giraud-Teulon (Fig:1c) and more practical hand-held reflex-free binocular ophthalmoscope by Allvar Gullstrand (Fig:1d). It was Charles Schepens who popula

    Dr. Nagesha CK
  10. Articles 1 Apr 2021 11 min read

    ILM Peeling Simplified - Ten Tips for the Beginners

    1 How to choose the right cases to start Idiopathic macular hole in non-myopic eye is a good case. ILM comes off as a single sheet and underlying retina is healthy. Same applies to traumatic macular holes. Beginners can also start peeling ILM in eyes with epiretinal membrane. Unsuccessful peeling may not jeopardize the long-term outcome significantly here. Peeling ILM for Myopic macular holes or in eyes with Diabetic Retinopathy needs more experience but can be achieved easily if one understands the basics of peeling. 2 Arrange your Inventory – Forceps is the key Lander's ring with Macular contact lens, Disposable ILM forceps and BBG dye serve as a formidable low-cost inventory for ILM peeling. A good ILM forceps should match your technique of ILM peeling. Because most of us initiate peel by "Pinch Technique", forcep is desired to have a structure that can "pinch". It needs to have fine teeth on opposing surfaces and good range of movement for its prongs. It should also be light weight

    Dr. Deependra V Singh · Prof. (Dr.) Yog Raj Sharma

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