Autonomic function, both activity and reactivity components of sympathetic and parasympathetic system, is impaired in patients with CSCR. Because autonomic supply modulates the choroidal blood flow, there may be a correlation between measures of autonomic function and the presence of CSCR.
Conventional scleral buckling was found to be a safe and effective technique in the primary management of uncomplicated, rhegmatogenous retinal detachments with unseen retinal breaks when the media is clear.
BackgroundTo evaluate the efficacy of diode laser photocoagulation in patients with central serous retinopathy (CSR) and to compare it with the effects of argon green laser.MethodsThirty patients with type 1 unilateral CSR were enrolled and evaluated on parameters like best corrected visual acuity (BCVA), direct and indirect ophthalmoscopy, amsler grid for recording scotoma and metamorphopsia, contrast sensitivity using Cambridge low contrast gratings and fluorescein angiography to determine the site of leakage.Patients were randomly assigned into 2 groups according to the statistical random table using sequence generation. In Group 1 (n = 15), diode laser (810 nm) photocoagulation was performed at the site of leakage while in Group 2 (n = 15), eyes were treated with argon green laser (514 nm) using the same laser parameters. Patients were followed up at 4, 8 and 12 weeks after laser.ResultsThe mean BCVA in group 1 improved from a pre-laser decimal value of 0.29 ± 0.14 to 0.84 ± 0.23 at 4 weeks and 1.06 ± 0.09 at 12 weeks following laser. In group 2, the same improved from 0.32 ± 0.16 to 0.67 ± 0.18 at 4 weeks and 0.98 ± 0.14 at 12 weeks following laser. The improvement in BCVA was significantly better in group 1 (p < 0.0001) at 4 weeks. At 4 weeks following laser, all the patients in group1 were free of scotoma while 6 patients in group 2 had residual scotoma (p < 0.05). The mean contrast sensitivity in group 1 improved from pre-laser value of 98.4 ± 24.77 to 231.33 ± 48.97 at 4 weeks and 306.00 ± 46.57 at 12 weeks following laser. In group 2, the same improved from 130.66 ± 31.95 to 190.66 ± 23.44 at 4 weeks and 215.33 ± 23.25 at 12 weeks. On comparative evaluation, a significantly better (p < 0.001) improvement was noted in group 1.ConclusionDiode laser may be a better alternative to argon green laser whenever laser treatment becomes indicated in patients with central serous retinopathy in terms of faster visual rehabilitation and better contrast sensitivity. In addition, diode laser also has the well-recognized ergonomic and economic advantages.
ABSTRACT.Purpose: To investigate and report the reliability of detection and grading of diabetic retinopathy by direct ophthalmoscopy through a dilated pupil by general physicians (non-ophthalmologists) and optometrists who have undergone a short period of training. Methods: A total of 400 eyes of 200 diabetes patients were examined by two non-ophthalmologists. Their observations were compared with an ophthalmologist's diagnoses for the same patients. Results: The diagnoses made by the general physician (kappa = 0.8381, SE = 0.041) and the optometrist (kappa = 0.7186, SE = 0.051) showed good rates of agreement with the ophthalmologist's diagnoses. Conclusions: The provision of appropriate screening protocols and follow-up parameters can enable primary care physicians and support personnel to reliably screen individuals for retinopathy in diabetes. This will reduce the workload of tertiary hospitals, and provide optimal services to the huge majority of the Indian population that has limited access to eye care services.
The aim of the present prospective controlled trial was to evaluate the adjuvant role of posterior subtenon triamcinolone in the treatment of diffuse diabetic macular edema (DDME). Thirty one (31) eyes with DDME were divided into an interventional group subjected to grid laser photocoagulation and 0.5 mL of 40 mg/mL posterior subtenon triamcinolone, and a noninterventional group subjected to grid laser photocoagulation only. Best-corrected visual acuity, contrast sensitivity, and intraocular pressures were assessed at presentation, and at 6, 12, and 24 weeks after intervention. The interventional group showed a statistically significant (p < 0.05) change in both mean best corrected visual acuity, from 20/160 to 20/100 (two-line increase on Early Treatment Diabetic Retinopathy Study (ETDRS)) (p = 0.024), and mean contrast sensitivity, from 0.9 to 1.09 (p = 0.01), at the end of 24 weeks. A significant rise in intraocular pressure was not described in any of the patients in either group. Posterior subtenon triamcinolone injection is a useful and safe adjunct to the conventional management of diabetic macular edema.
A 28-year-old man presented with bilateral acute loss of vision following a high-voltage injury. The visual acuity was 6/36 in the right eye and 6/24 in the left eye. Fundus examination revealed a well-defined round lesion simulating a full thickness macular hole in the right eye and yellow deposits in the macular area in the left eye. Optical coherence tomography (OCT) showed bilateral macular cysts, with intact outer and inner retinal layers. At 1 month follow up, OCT showed a persistent macular cyst in the right eye with spontaneous resolution of the macular cyst along with visual improvement in the left eye.
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