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#Vitreoretina

79 articles
  1. Articles 1 Apr 2021 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
  2. Articles 1 Apr 2021 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
  3. Articles 1 Apr 2021 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
  4. Articles 1 Apr 2021 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
  5. Interesting Reads 1 Apr 2021 19 min read

    Understanding Retinal Imaging : What Lies Ahead of Us?

    “Be careful, now that I can see the Inner You.” -Imaging modalities today Retinal imaging has come a long way today. From times of appropriately concentrating the fluorescein dye from scratch in the lab itself to times where we have a dye free angiography system, technology has covered vast boundaries. There is a platter of different modalities in the market today, each having their own ebb and flow. And what the future beholds for us is certainly inexplicable. To throw a light on these modalities, we have a special interview with someone who continues to extensively work on these technologies and modalities day in and out, Dr Muna Bhende. Dr. Muna Bhende is a senior consultant and deputy director of Shri Bhagwan Mahavir VR Services, Medical research foundation, Sankara Nethralaya, Chennai. eOphtha: There is a wide discussion on OCT Angiography (OCT-A) replacing FFA in the field of the medical retina in the near future. What is your take on that? How do you compare the clinical output

    Dr. Dhaivat Shah
  6. 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
  7. 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
  8. Articles 1 Apr 2021 15 min read

    The Effects & Techniques of Scleral Buckle in Treatment of Retinal Detachment

    Introduction: Scleral buckle surgery is indicated for uncomplicated rhegmatogenous retinal detachments. Scleral buckling indents the sclera and the overlying choroid retinal pigment epithelium complex towards the retinal break in the detached retina, resulting in retinal reattachment. Scleral buckle surgery evolved out of the works of Jules Gonin, who identified retinal breaks as the cause of retinal detachment, Custodis, Lincoff and Schepens who devised ways of using an epi / intrascleral implant to “buckle” the sclera inward to create the indent.1-3 Principles of scleral buckling: The aim of scleral buckling is to close all retinal breaks to achieve permanent reattachment of the retina. General principles of retinal detachment surgery- Search for the breaks, find all the breaks, seal all the breaks, and relieve vitro retinal traction. This is achieved by - Identification of the retinal break Retinopexy – creating a sterile inflammatory reaction that would result subsequently in chori

    Dr. P. Mahesh Shanmugam · Dr. Pradeep Sagar · +3 others
  9. Interesting Reads 1 Apr 2021 5 min read

    Ten Tips for Beginners to Start Vitreoretinal Practice

    1. Higher cause/vision and mission statement : Setting up a vitreoretinal surgery / medical retina practice should come with a higher calling apart from simply making a living. It is very important to have one to sail through tough initial months or years till your practice reached a break-even point. Till the business starts making money this higher calling will keep up your spirits high and motivate you to continue the journey. Having worked in for seven years in other eye hospitals where the primary interest was in cataract and refractive surgery and when the sustainability of stand-alone retina practice was questionable, for me the higher calling was to establish a center for excellence in diseases of vitreoretina and uvea. 2. Base building: It is always good to work in established hospitals or in group practices or with anterior segment surgeons for a couple of years to learn many things that are not taught in medical schools apart from building a base of your satisfied patients a

    Dr. Raja Rami Reddy P
  10. 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

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