Purpose: To examine the incidence, clinical findings and management of pellet gun–related ocular injuries that occurred during protests in Kashmir region. Methods: This retrospective study included records from 777 patients diagnosed with pellet gun–related ocular injuries admitted to a tertiary hospital in Srinagar, India, between July and November 2016. By reviewing the clinical records, the following data were collected: demographics, clinical information pertaining to the injury, imaging reports including computer tomography and ultrasonography B-scan, management in the emergency setting, and follow-up treatment. Results: Mean age was 22.3 ± 7.2 years and majority patients were male (97.7%). In terms of laterality, 94.3% and 5.7% of the patients sustained monocular and binocular injuries, respectively. In terms of the nature of injury, 76.3% of the eyes had open globe injury while 23.7% of the eyes had closed eye injury. Emergency surgical exploration was performed in 67.7% of closed globe injuries while emergency primary repair was done in 91.1% of open globe injuries. The vast majority of patients (98.7%) who required surgery underwent surgical intervention on the day of admission or the next day. Final best-corrected visual acuity (BCVA) after treatment was counting fingers or worse in 82.4% of the eyes. Conclusion: Pellet gun–related ocular injuries resulted in significant ocular morbidity, mostly manifesting as open globe injuries. Treatment often required surgical interventions, but despite expeditious management, visual prognosis remained poor for most of the patients.
This study aimed to assess the severity of Macular Edema in patients with diabetic macular edema using Spectral Domain Optical Coherence Tomography (SD-OCT), a technique for high-resolution cross-sectional imaging of the retina and to describe various morphologic patterns of diabetic macular edema (DME) demonstrated by optical coherence tomography (OCT) and correlate them with visual acuity. METHODS: A total of 158 eyes of 100 patients with diabetic retinopathy were studied. Optical coherence tomograms were obtained in a radial spoke pattern centered on the fovea. Macular thickness was reported numerically as averages in each of nine regions. All patients with DME underwent OCT evaluation. The OCT scans were evaluated for the presence of diffuse retinal thickening (DRT), cystoid macular edema (CME), posterior hyaloidal traction (PHT), serous retinal detachment (SRD), and traction retinal detachment (TRD), the retinal thickness was measured and correlated with visual acuity. RESULTS: Optical coherence tomography was able to quantify the development of both foveal and extrafoveal macular thickening. The (Mean±SD) Central Macular thickness was (502.8±121.9) in eyes with NPDR and (534.3±152.1) in eyes with PDR. Foveal thickness measured by OCT was highly correlated with visual acuity. Two hundred two OCT scans of 158 eyes of 100 patients were identified. OCT revealed five morphologic patterns of DME: DRT (61.88%); CME (24.75%), SRD without PHT (6.93%); PHT without TRD (5.45%); PHT with TRD (0.99%).Increasing retinal thickness in all patterns was significantly correlated with worse visual acuity (P <0.05). CONCLUSIONS: Optical coherence tomography was a useful technique for quantifying macular thickness in patients with diabetic macular edema. DME exhibits five different morphologic patterns on OCT. There is a significant correlation between retinal thickness and visual acuity.
government medical college, srinagar. 2. Professor and Head, Department of ophthalmology government medical college, srinagar. 3. Registrar, Department of ophthalmology government medical college, srinagar. 4. Fellow, Department of ophthalmology government medical college, srinagar.
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