Topic

#Vitreoretina

79 articles
  1. Students Gallery 2 Apr 2021 6 min read

    Documentation & Drawing in Ophthalmology

    Anterior segment finding Documentations From the days of Hippocrates documentation has been a cornerstone of clinical science. But somewhere down the line this has become a lost art rarely ever practiced by many of us. We tend to ignore or to say correctly run away from it under many pretexts like its time consuming, it’s of no use, etc. And surprisingly this resistance to document is prevalent not only among juniors but spans across the whole spectrum of practitioners. So at times we really ponder is documentation really necessary? The answer is an emphatic yes – the reasons being It’s a standard clinical practice worldwide Follow up is possible only if you can compare it with your previous records. Will help you medico legally Last but not the least unless you are documenting it you have not probably seen it correctly(you think you have seen it all but the moment you come to draw it you find that you don’t remember where the break was it at 1 o’clock or 3 o’clock position and so on).

    Dr. Parthopratim Dutta Majumder
  2. Articles 2 Apr 2021 35 min read

    Idiopathic Macular Hole

    Introduction Recent advances in the pathogenesis, classification, and surgical intervention of idiopathic macular holes have generated a renewed interest in this entity. Better indicators of the visual outcome, as well as refinements in the surgical technique, have led to improvements in the success of macular hole surgery. Clinical characterization and theories on the pathogenesis of macular hole have continued to evolve. Although originally thought to be the result of trauma, it is now recognized that most macular holes occur in the absence of antecedent injury and are referred to as idiopathic. Theories for the pathogenesis of idiopathic macular holes have included progressive thinning of the foveal tissue and pre hole cyst formation. The primary pathogenic role of the vitreous was suggested by studies that indicated a low relative risk for macular hole formation in eyes with complete posterior vitreous detachment. Gass proposed a theory whereby shrinkage of adherent cortical vitreo

    Sandeep Saxena, M.S., MAMS
  3. Articles 2 Apr 2021 6 min read

    Malarial Retinopathy: A Diagnostic Clue

    Introduction Malaria is the most important of parasitic diseases of humans and remains today, as it has been for centuries a large burden on tropical communities. Cerebral malaria is the most important complication of falciparum malaria and also the leading cause of death in malaria 1. It is defined as an acute, symmetric encephalopathy associated with sequestration of parasite-infected erythrocytes in the cerebral vessels and capillaries in patients with falciparum malaria 2. WHO Criteria for Diagnosis The World Health Organization has laid down definite guidelines for diagnosis and management of cerebral malaria 3. This definition requires the presence of unarousable coma using the Glasgow Coma Scale (GCS), exclusion of other encephalitides, especially bacterial meningitis and if possible, locally prevalent encephalitis and the presence of asexual forms of P. falciparum in the blood film. Retinal Involvement in Cerebral Malaria Eye being an extension of the brain, retina provides a u

    Sandeep Saxena, M.S., MAMS · Shaili Misra, MBBS · +1 other
  4. 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
  5. 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
  6. Articles 2 Apr 2021 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
  7. 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
  8. Articles 2 Apr 2021 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
  9. Articles 2 Apr 2021 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
  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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