Topic

#Treatment

24 articles
  1. Articles 13 Sep 2021 30 min read

    Central Retinal Vein Occlusion: A Comprehensive Review

    Introduction: The clinical entity of Central Retinal Vein Occlusion (CRVO) has been known since 1878 (1), and it is a common visually disabling disorder that may cause significant ocular morbidity. It commonly affects men and women equally and occurs predominantly in persons over the age of 65 years (2-4). Associated systemic vascular disease, including hypertension and diabetes, are present in these population groups. The prevalence rates range from 0.1% to 0.5% in the older adult population. (3-5) Younger individuals may have an underlying hypercoagulable or inflammatory Etiology (6,7) CRVO is the second most common retinal vascular disorder after diabetic retinopathy and is considered to be an important cause of visual loss. (8) The annual risk of developing any type of retinal vascular occlusion in the fellow eye is approximately 1% per year, and it is estimated that up to 7% of persons with CRVO may develop CRVO in the fellow eye within 5 years of onset in the first eye (9-11). CR

    Dr. Priyanka Gupta · Dr. Sandeep Kumar · +1 other
  2. Articles 17 Aug 2021 5 min read

    Ten Mistakes to Avoid while Treating a Case of Diabetic Retinopathy

    Diabetic Retinopathy is a common retinal disorder that is seen, managed, and followed up by not only a retina specialist but all ophthalmologists. It is a disease that is easy to diagnose, but often difficult to manage in a long run. For achieving optimal results besides the role of an ophthalmologist, one needs to have the involvement of a physician. The single most important factor for achieving a good outcome is patient compliance, as the disease, diabetes needs lifelong care. Here are few mistakes we need to avoid while managing a case of DR. 1. I can detect DME clinically, I don’t need OCT OCT is not mandatory if there are no signs of DR, or in very mild retinopathy (1 D, Amblyopia, Unilateral elevated intraocular pressure, Complete posterior vitreous detachment, Unilateral carotid artery stenosis, and Chorioretinal scarring 5. Ignoring a rapid progression of milder NPDR to PDR A rapidly progressive NPDR to proliferative retinopathy in a span of a few months (4-6 months) is rare a

    Dr. Rajiv Raman
  3. Articles 16 Jun 2021 14 min read

    OCT-Angiography in Retinal Diseases Made Incredibly Simple For Post Graduates

    Introduction: Optical coherence tomography angiography (OCT-A) has emerged as a novel imaging technique for visualizing the retinal and choroidal microvasculature at the macula and optic disc.1 It provides in vivo 3D vascular information by analyzing the movement of flowing red blood cells and thereby enabling the visualization and quantification of functional vessel networks within microcirculatory tissue beds in a non-invasive manner without the use of dye injection.2 Understanding the anatomy of retinal and choroidal microvasculature (figure 1): Retinal microvasculature: Studies have identified 4 retinal vascular capillary networks at the macula which are broadly grouped into 2 vascular plexuses; superficial and deep.3 The superficial vascular plexus (SVP) consists of the superficial capillary plexus and radial peripapillary capillary plexus. The former is located in the ganglion cell layer and the latter in the retinal nerve fibre layer. The SVP receives its blood supply from the c

    Dr. Ramesh Venkatesh · Dr. Nikitha Gurram Reddy · +1 other
  4. Articles 2 Apr 2021 5 min read

    Intravitreal Injections -technique and tips

    Intravitreal injections involve injecting therapeutic agents (drugs/air/gases) inside the vitreous cavity through pars plana under aseptic precautions Surgical anatomy Site of injection: Pars plana Ciliary body: Consists of two parts a) anterior pars plicata b) posterior pars plana Pars plicata Circumferential zone 2.5mm in anteroposterior diameter Pars plana Varies in anteroposterior diameter nasally 3mm wide and temporally 4.5mm wide. This variation is because of the posterior globe on temporal side curves posteriorly & laterally more than on the nasal side. Pars plana extend from pars plicata anteriorly to ora serrata (termination of the retina) posteriorly. Blood vessels in pars plana are radially oriented but circumferential incisions across these vessels cause no bleeding. Also, lens zonules insert into ciliary body avoiding pars plana Thus, needle punctures 3.5 mm posterior to limbus enter globe through pars plana Not damaging lens Not puncturing the retina Not tethering / damag

    Parag K. Shah, DNB · Dr. Varsha V. Prabhu
  5. Articles 2 Apr 2021 10 min read

    Lattice degeneration of the retina

    Lattice degeneration is a vitreoretinal degenerative process of the peripheral retina with visible lesions that predispose to retinal tears and detachment. Vitreous traction at sites of significant vitreoretinal adhesion is responsible for most retinal breaks that lead to retinal detachment. GOALS of identifying the patients with risk of RD are: Identify patients at risk of RRD Examine patients with symptoms of acute PVD to detect and treat significant retinal breaks Manage patients at high risk of developing retinal detachment Educate high-risk patients about symptoms of PVD, retinal breaks, and retinal detachments and about the need for periodic follow-up. Natural history of precursors to rhegmatogenous retinal detachment Precursors to retinal detachments are PVD, symptomatic retinal breaks, asymptomatic retinal breaks, lattice degeneration, and cystic and zonular traction retinal tufts. Because spontaneous reattachment is exceedingly rare, nearly all patients with asymptomatic RRD w

    Dr. Manoj Khatri
  6. Articles 2 Apr 2021 55 min read

    Retinal vein occlusion

    Introduction Retinal vein occlusion (RVO) is the second most common retinal vascular disease to cause visual loss in adults after diabetic retinopathy. RVO has been classified into two main types, namely Central retinal vein occlusion (CRVO), Branch retinal vein occlusion (BRVO), the latter being more prevalent. Hemi-retinal vein occlusion has been classified separately since pathogenetically they are different as compared to the above two groups. In the following chapter a brief introduction to these variants of RVO, along with their epidemiology, clinicopathological profile, and treatment has been discussed. Epidemiology [1] The most recently published study summarizing 68,751 individuals from 15 studies, quoted that the prevalence of RVO was 5.20 per 1000 (for any form of RVO). The prevalence of BRVO alone was 4.42 per 1000 (95% CI 3.65–5.19) and that of CRVO was 0.80 per 1000. According to Hayreh et al, prevalence varied by ethnicity and increased with age, but do not differ by gen

    Dr. P. Mahesh Shanmugam · Divyansh Mishra · +1 other
  7. Articles 2 Apr 2021 13 min read

    Perfluorocarbons in Ophthalmology

    INTRODUCTION Perfluorocarbon liquids (PFCLs) were first developed in 1970s as possible substitutes to erythrocytes[1],[2] because of their capacity to dissolve relatively large amounts of oxygen. Initial trials with these compounds focused on their feasibility to be used as blood substitutes. These experiments proved the biocompatibility of these compounds. Based on their properties, they were then introduced for intraocular use, in what has become a milestone in vitreoretinal surgery. After animal studies confirmed the safety of PFCL compounds as vitreous substitutes, Chang et al in 1987 first described the successful intraocular use of low viscosity liquid fluorocarbons (perfluorotributylamine and perfluorodecalin) in four patients with complicated retinal detachments.[3],[4] Long-term tamponade in animal models demonstrated retinal atrophy and retinal necrosis at the perfluorocarbon aqueous interface after 4 weeks even when highly purified PFCL compounds (perfluorodecalin) were used

    Dr. Abhishek R. Kothari
  8. Articles 2 Apr 2021 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
  9. Articles 2 Apr 2021 10 min read

    Fun with Prisms in Ophthalmology

    What are prisms? Prisms are nothing but a portion of a refracting medium bordered by two plane surfaces that are inclined at a finite angle. Prisms have a thicker portion called the base of the prism and a tapering portion called the apex of the prism. Prisms are oriented with their apex towards the direction of deviation. What happens to light when it enters a prism? Light has particle and wave characteristics. When it travels through the thicker base of the prism, the particle form of light has to travel a longer distance than at the apex of the prism, this difference causes light to bend towards the base of the prism. The power of a prism to bend light is measured in prism diopters (PD). One prism diopter will shift light by 1 cm at 1m distance. Calibration of Prism Prisms made of glass are calibrated in Prentice position. They should be held with the back surface perpendicular to the line of sight. Plastic prisms and prism bars are calibrated by the angle of minimum deviation. They

    Dr. Manjula Jayakumar
  10. Articles 2 Apr 2021 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

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