Topic

#Vitreoretina

79 articles
  1. Interesting Reads 1 Apr 2021 16 min read

    Ten Clinical Trials in Retinal Diseases Every Postgraduate Should Know

    1. CATT (Comparison of Age-related Macular Degeneration Treatments Trials)1 Description A prospective, multicenter, single-blind, noninferiority randomized clinical trial. 1208 patients with neovascular AMD were enrolled from February 2008 and randomly assigned to receive intravitreal injections of ranibizumab (0.5 mg/0.05 ml) or bevacizumab (1.25 mg/0.05 ml) on either a monthly schedule or as needed with monthly evaluation. Patients aged ? 50 years with active, subfoveal CNV, fibrosis < 50% of total lesion area, visual acuity 20/25-20/320 and at least 1 drusen (>63?) in either eye or late AMD in fellow eye were eligible. The primary outcome was the mean change in visual acuity at 1 year, with a noninferiority limit of 5 letters on the eye chart. Results At one year, all four groups had similar improvements in visual acuity. Groups had similar rates of adverse events, though patients receiving bevacizumab had more occurrences of ?1 serious adverse event than those in the ranibizumab gr

    Dr. Neha Goel, MBBS MS MNAMS DNB FRCS (Glasgow)
  2. Articles 1 Apr 2021 13 min read

    A Beginner's Guide to Ultrasound Biomicroscopy

    Introduction: Anterior segment ocular imaging has gone through various inventions starting from the ultrasound in the 20th century to the recent AS- OCT.1 Ultrasound bio-microscopy, one of the ocular imaging devices is a high-resolution technique, which allows in vivo assessment of the structures of the anterior segment of the eye where cross-sectional images of ocular structures are obtained at microscopic resolution. 2The higher frequency of UBM ranging between 35 and 50 MHz, gives a depth of about 4 mm and an axial and lateral resolution of approximately 25 and 50 microns, respectively. 3 Being a non-invasive technique, efficient regardless of the clarity of the optical media and due to its portability can be performed both in adults and children with no complications.4 The internal acoustic characteristics of UBM, accompanied by the very fine backscatter speckle patterns, permit clear differentiation of ocular tissue at various levels.5 UBM imaging has been very useful in understan

    Dr. Sowkath Ali · Dr. Eunice Goh · +1 other
  3. Articles 1 Apr 2021 30 min read

    Clinical Applications of Multicolor Imaging

    Multicolor imaging (MCI) is a non-invasive retinal imaging modality available in the Spectralis platform (Heidelberg Engineering, Heidelberg, Germany). It simultaneously acquires three reflectance images of the retina using three individual lasers of different wavelengths: blue (488 nm), green (515 nm), and infrared (820 nm). These penetrate the tissue to different depths, simultaneously capturing and depicting information originating from different retinal structures. The infrared reflectance (IR) image visualizes structures at the level of the outer retina and choroid. The green reflectance (GR) image allows imaging of retinal blood vessels, hemorrhages, and exudates. The blue reflectance (BR) particularly provides details of the inner retina and the vitreoretinal interface such as epiretinal membranes, retinal nerve fiber layer (RNFL) thinning, and macular pigment changes. The information from these three images is integrated to form a composite multicolor image.1 Color fundus photo

    Dr. Sugandha Goel · Dr. Rupak Roy
  4. Articles 1 Apr 2021 13 min read

    Dos and Donts In Managing Cluster Endophthalmitis

    “Everything in life has some risk, and what you have to actually learn to do is how to navigate it.” -Reid Hoffman The above quote holds true for any surgical procedure whether minor or major. The biggest fear of any surgical intervention is that of infection postoperatively. Infection can occur in the best of hands and also in the most modern operating rooms. Cataract surgery is one of the most common intraocular surgeries performed in India and around 90% of postoperative endophthalmitis occurs after cataract surgery. 1 Acute endophthalmitis is severe intraocular inflammation presumed to be due to the entry of microbes into the eye during the perioperative period. It is identified usually in the initial weeks after surgery and could present as a red painful eye with severe anterior uveitis, often with fibrin and hypopyon, and vitritis. It is one of the most serious postoperative complications of intraocular procedures and, despite treatment, often results in a very poor visual outcom

    Dr. Dhaivat Shah · Dr. Meghna Jain
  5. Articles 1 Apr 2021 23 min read

    Scleral Fixated Intraocular Lens Implantation- A Comprehensive Review

    Introduction Ideally a cataract surgery should result in the placement of an intraocular lens (IOL) within the capsular bag. However, this desirable outcome might be averted due to either preexisting zonular deficit or intraoperative posterior capsular tear, resulting in aphakia. This necessitates the need for an alternate means of IOL implantation. The surgeon can exercise the options of an anterior chamber IOL or iris fixated IOL or a scleral fixated IOL. Developments in IOL designs and modifications in implantation techniques have rendered them safe and efficacious. Recent studies have reported no significant differences in the postoperative visual recovery or complications rate between the 3 approaches.1 However, each option should be analyzed not only in accordance with surgeon’s experience but also with patient’s age, local, and systemic comorbidities.2 Scleral fixated IOL (SFIOL) involves sutured/sutureless fixation of the IOL to the sclera. SFIOL’s position closely approximates

    Dr. Dhanashree Ratra · Dr. Abhinav Dhami · +1 other
  6. Articles 1 Apr 2021 19 min read

    Peripheral Retinal Degenerations: A Ready Reckoner

    Introduction Peripheral retinal degenerations (PRD) are considered a risk factor for rhegmatogenous retinal detachment (RRD) [1, 2]. The annual incidence of RRD varies between 6.3 and 18.2 cases per 100,000. RRD develops when liquefied vitreous humor accelerated by rotary eye movements passes through retinal tears or retinal holes into subretinal space and detaches neurosensory retina from the underlying pigment epithelium. PRDs when missed during retinal examination can lead to vision threatening complications.3 Classification [3] Retinal detachment Retinal drusen Lattice with holes Full-thickness tear Honeycomb degeneration Preretinal fibrosis Retinal tuft Unifocal hypertrophy of the retinal pigment epithelium Hemorrhage Grouped congenital hypertrophy of the retinal pigment epithelium (“bear tracks”) Pearl degeneration Retinoschisis Atrophic retinal hole Snail-track degeneration Dark-without-pressure Snowflake degeneration White-without-pressure Flap tear Operculated retinal tear Pav

    Dr. Kartikey Singh.MS · Dr. Mridhula Sekar · +2 others
  7. Articles 1 Apr 2021 7 min read

    The Novice VR Surgeon -Ten mistakes to avoid

    Mastering vitreoretinal surgery is a slow and arduous process with each case being different from the other and it is just about possible to have only a “feel” of a kind of case during the fellowship, not mastery of it. The budding VR surgeon would necessarily have to hone her / his skills in the real world outside their alma mater and the following guidelines can aid mitigate the stress and angst. This is just a comprehensive list, not a complete one, an addendum or a reinforcement of what has been imparted at the fellow ship. 1. Not being familiar with the equipment Vitreoretinal surgery is machine dependent and an optimal surgical outcome is the result of efficient use of equipment, be it the microscope, vitrectomy machine, laser console etc., Knowing the equipment’s capabilities and limitations by reading the manuals will help exploit the machine’s capabilities to the maximum, resulting in an optimal surgical outcome and also minimize complications during surgery. Equipment at the

    Dr. P. Mahesh Shanmugam
  8. Interesting Reads 1 Apr 2021 11 min read

    Understanding Retinal Imaging

    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. Manish Nagpal Dr. Nagpal is practicing as a vitreoretinal consultant at Retina Foundation, Ahmedabad, since 1999. He completed his Ophthalmology training at M & J Institute of Ophthalmology, Ahmedabad in 1996 and further went on to accomplish the FRCS (Ed) at the UK in 1997. He is a recipient of the prestigious Distinguished Service Award of APAO in 2007, the Achievement award of APAO in 2012, the American Academy’s Achievement award

    Dr. Dhaivat Shah
  9. Articles 1 Apr 2021 4 min read

    Ten Things You Should Know about Brolucizumab

    1. Brolucizumab is a humanized, single-chain variable fragment (scFv) antibody with a molecular mass of approximately 26 kDa that inhibits VEGF-A.[1] (An scFv is an autonomous binding agent that is no longer dependent on a heavy molecular support structure but still retains the full binding capacity to its target). Mechanism of Action of Brolucizumab Unique Properties of Brolucizumab 2. The pharmacokinetics of a single intravitreal (IVT) injection of Brolucizumab in cynomolgus monkeys revealed a mean terminal half-life of 2.4 ± 0.3 days in all ocular compartments. It was cleared from the serum with a mean half-life of 51 hours (approximately 2 days).[2] Brolucizumab Bevacizumab Ranibizumab Aflibercept Molecule Short-chain variable fragment Full antibody (IgG) Monoclonal humanized antibody format Fusion protein Clinical dose in neovascular ARMD 6 mg 1.25 mg* 0.5 mg 2 mg Equivalent Molar dose 11.2-13.3 0.4-0.5 0.5-0.6 1.0 Table: Molecular properties of anti-VEGF agents (ARMD= Age-related

    Dr. Anmol Naik

Other topics

Review Top Ten Series Tips & Pearls Made Easy Macular Diseases Cornea and External Eye Diseases Must Read Preferred Practise Pattern Learn from Masters Treatment Uvea and Intraocular Inflammation Case Discussion Cataract Surgery i-File Pediatric Ophthalmology Glaucoma Imaging Grand Rounds infection