Background: This study was conducted to investigate associated systemic diseases, other risk factors, visual prognosis, treatment approach and central foveal thickness in retinal vein occlusion patients of different age groups.Methods: This single centre, retrospective record based hospital study included patients with retinal vein occlusion presenting to ophthalmic department. All the records of 30 patients were reviewed and data was abstracted and analysed. Initial and final clinical parameters e.g. visual acuity, central foveal thickness, age-group distribution, risk factors, therapeutic approach were analysed.Results: Out of 30 patients, 19 patients were of age-group >50 years and 11 were <50 years. In present study, most common type of retinal vein occlusion (RVO) was ST- BRVO in both the groups. Most common association of RVO in group >50 years was hypertension (84%), and <50 years was hypertension (27.3%), raised lipid level (TG, cholesterol) (27%) and raised serum homocysteine. Patients with uncontrolled DM and hypertension (in our study, 2 patients) required multiple injections even after 4 months of follow-up. Age-group <50 years had better visual acuity and central foveal thickness at initial and final presentation. Raised serum homocysteine level associated with RVO in age-group <50 years (27.3%) versus age-group >50 years (5%).Conclusions: Patients with good control of systemic disorders with RVO shows significantly improved (p value<0.05) visual acuity and central foveal thickness, in both the age-groups. Patients of age group >50 years were more associated with systemic disorder e.g., hypertension and DM. Patients of age group <50 years were more associated with medical condition e.g. hyperlipidemia, raised serum homocysteine. In present study, single patient in age-group <50 years was associated only with sudden and severe dehydration.
The aim of the study was to assess the efficacy and safety of individualized repeated injection of intravitreal anti-VEGF ranibizumab for preserving or improving vision (BCVA) and central foveal thickness (CFT) in macular edema secondary to retinal vein occlusion (RVO).25 eyes of 25 patients with RVO were included. General and systemic examination was done. IOP measurement, slit lamp, fundus examination, BCVA assessment and OCT was done. CFT was measured to assess macular edema. Injection intravitreal ranibizumab (0.5mg/0.05ml) was given in the affected eye, every 6 weeks, till week 18, if CFT>250 µm. Total 3 injections were given in each patient. Final follow-up visit was at week 36.Hypertension (72%), DM (20%) and altered lipid profile (16%) were associated comorbidities. There was significant reduction in mean CFT from baseline visit (516.08±35.21) to week 18 visit (203.32±4.97) with P<0.0001. There was no significant statistical difference between week 18 CFT and week 36 CFT (P=0.44). There was significant reduction in mean CFT from baseline visit (516.08±35.21) to week 36(251.60±23.17) with P<0.0001.There was significant improvement in mean BCVA from baseline visit (0.87±0.03) to week 18 visit (0.27±0.03). There was no significant statistical difference between week 18 BCVA and week 36 BCVA (P=0.76). There was a significant reduction in mean BCVA from baseline visit (0.87±0.03) to week 36(0.35±0.05) with P<0.0001.At week 36 follow up visit, 4 patients had recurrence of macular edema. 2 had uncontrolled hypertension, 2 had combined uncontrolled hypertension and DM. 21(84%) patients had stable CFT and BCVA. No significant ocular or systemic side-effects were seen.Individualized repeated intravitreal injection of ranibizumab showed improvement in BCVA and CFT in patients with macular edema secondary to RVO. For long term maintenance, control of systemic comorbidities is essential.
Visual rehabilitation in aphakia has been a challenge with a wide variety of surgical options available for ophthalmologist. We report the visual outcome with retropupillary iris claw lens secondary to intra operative complications and secondary implantation in aphakia. An interventional study on 4 eyes of 4 patients was conducted. Preoperative visual acuity, slit lamp examination and fundus examination were carried out. Anterior vitrectomy and retropupillary fixation of iris claw lens were done. The primary outcome measure was best-corrected visual acuity and secondary postoperative complication was recorded at various intervals. All patients had visual acuity of ≥6/18 postoperatively. Sutureless retropupillary iris claw intraocular lens implantation is a good alternative of scleral-fixated intraocular lenses in aphakic patients.
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