Sulphamate drugs, widely prescribed for various systemic conditions, are reported to have rare ocular adverse-effects, usually within weeks of initiation of treatment. Medical and drug history in such cases are of pivotal importance in reaching a proper diagnosis. This study reports three cases, which developed topiramate-induced ocular side effects. In one of the cases, although the angles were narrow in both eyes, yet intra-ocular pressure (IOP) was not high. Also, in the third case, there were no macular striae. Topiramate was immediately withheld and all cases were improved without any permanent ocular damage.
Objective: To assess the relationship between capillary perfusion of retinal vessels and severity of diabetic retinopathy with the help of Optical Coherence Tomography angiography. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Feb 2020 to Apr 2021. Methodology: Seventy-three eyes of 37 subjects suffering from diabetes had their imaging done with Rtvue Avanti OCT angio system. Socio-demographic and clinical data was gathered. Subjects were divided into three groups depending upon the severity of diabetes. The perfusion index (PI) was taken as percent area coverage by retinal vessels with the flow. Results: Out of a total of 73 eyes, 31 (42.5%) had none to mild Non-Proliferative Diabetic Retinopathy, 19 (26%) with moderate to severe Non-Proliferative Diabetic Retinopathy and 23 (31.5%) with Proliferative Diabetic Retinopathy. The mean age of the participants was 58.09 ± 10.32 years, with best corrected visual acuity as 0.35 ± 0.35 and Blood Sugar Random as 200.46 ± 70.71. BCVA showed a significant positive correlation with Perfusion Index (p=0.026). No significant association/relationship was found between the severity of diabetic retinopathy and perfusion index in this data (p=0.26). Conclusion: No statistically significant relationship was found between Perfusion Index (PI) and severity of diabetic retinopathy.
Objective: To evaluate the normal macular thickness and how it varies with age in the eyes of healthy subjects using macular map protocol on Spectral-Domain Optical Coherence Tomography (SD-OCT). Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Jun 2020 to Sep 2021. Methodology: Our study included one thousand seven hundred and four eyes (1704) of healthy subjects. They underwent imaging with macular thickness map protocol using Topcon Spectral-Domain Optical Coherence Tomography (SD-OCT). According to the macular thickness map, protocol macular area was subdivided into nine ETDRS fields. Measurement of macular thickness and its variations with age were determined. Pearson correlation was applied to identify the relationship between age and macular thickness of layers. Results: Our study revealed a negative relationship which was statistically significant between macular thickness and age for all the ETDRS regions. Results showed a mean macular thickness of 274.90 ± 15.18. The female gender was found to have greater macular thickness than males (p-value 0.002). Conclusion: This study concluded a significant decrease in macular thickness with age. This is the first normative study using Topcon SD-OCT and macular map protocol for macular thickness measurement done in the Pakistani population.
Posterior scleritis is an underdiagnosed condition due to its rarity and is frequently misdiagnosed due to its varied presentation.1 Therefore, it is imperative to know that it can present clinically as exudative retinal detachment, proptosis, disc oedema, choroidal folds, subretinal mass, and myositis. We report a case of 48-year female who presented with gradual, progressive loss of vision in left eye. There were multiple exudative retinal detachments with choroidal folds and disc oedema. Ultrasonography (USG) B scan and contrast enhanced magnetic resonance imaging (MRI) orbit revealed the classic T-sign. With oral steroids, she improved clinically. Posterior scleritis is a painful condition, but the patient did not report any pain in or around the globe, which makes this case a unique experience.
A process in which drug comes out from drug product and exposed to ADME and finally become accessible for pharmacological activity is known as drug release and mechanism involves the study of its rate and factors influencing its rate. Factors influencing the rate of drug release are drug related, polymer related and formulation variables. Drug delivery systems are discriminated on the basis of way drug is delivered, which are immediate release and modified release. Parenteral dosage forms are the most prominent among different dosage forms. The mechanisms involved in drug release are diffusion and dissolution-controlled processes. Nasal disposal basically depends on the particle size, its geometry and rate of airflow. Nasal sprays are commonly used than powders and gels. Buccal and sublingual systems show more effective drug release mechanisms than oral and transdermal systems. Main focus of paper is to elaborate different mechanisms performed by drug delivery systems for drug release.
Objective: To determine the effect of amblyopia patching therapy on visual outcome in young and adults at 6th and 12th week. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi, Pakistan, from Sep 2018 to Jan 2020. Methodology: Out of 110, follow up was successfully completed by 91 eyes. Subjects were divided into young and adult based on age. Age ranging from 5-12 years included in the young group and adult group included those ranging from 13-20 years. Anisometropic amblyopia was considered. Amblyopia due to any other disease were excluded. Subjects were advised patching therapy daily for 4 hours in the affected eye. Follow up was 3 weekly for 12 weeks and the effect of patching therapy was assessed by visual improvement. Statistical analysis was done with SPSS version 21. Result: Out of 91 eyes with amblyopia, 51 (56.6%) were included in the young group while 40 (43.4%) were included in the adult group. In the young group, visual improvement was seen in 40 (78.4%) while in the adult group 24 (60%) showed improvement in vision. Mean visual improvement in young was 1.66 ± 1.099 while 1.03 ± 0.944 in the adult group. Maximum visual improvement in both groups was seen till the 6th week of patching. Conclusion: Patching therapy is effective even at later ages too. However, continuing patching for more than 6 weeks doesn’t show much improvement in vision.
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