Rhinosporidiosis, a granulomatous disease caused by Rhinosporidium seeberi, is widely prevalent in Sri Lanka and southern parts of India. Besides the eye, the lacrimal passage and nasal cavity are affected. The most common ocular involvement is a subconjunctival bleeding mass. Our case, a 9-year-old girl from a rural background with a history of pond water bathing, presented with a marginal chalazion involving the left lower lid. She had a history of chalazion involving the same site three months earlier which was managed by incision and curettage. A decision of surgical exploration was made and the evacuated mass was examined histologically showing evidence of rhinosporidiosis. This type of clinical presentation for ocular rhinosporidiosis (as recurrent chalazion) has not been reported earlier in the literature. This case emphasises that the clinicians from this part of the world must consider ocular rhinosporidiosis as differential diagnosis in cases with recurrent chalazion especially in a rural background with a habit of pond water bathing.
Aim: To evaluate the role of intravitreal Ranibizumab injection at monthly interval for six doses along with single dose of intravitreal dexamethasone implant at first sitting of Ranibizumab in patients with refractory diabetic macular edema (DME).Methodology: Thirty eyes of 30 patients were selected in our Malda medical college with refractory DME. After proper history taking and required systemic examinations, each patient underwent detailed ophthalmic examination, including best corrected visual acuity (BCVA), intraocular pressure measurement, slit lamp examination, fundal evaluation by indirect ophthalmoscopy, 78D, 90D lens. Spectral domain optical coherence tomography (SD-OCT) has been used to evaluate central macular thickness (CMT) in each patient. After proper informed consent, 0.05 mg Ranibizumab along with 0.7 mg dexamethasone implant were injected intravitreally in each patient at first sitting, followed by intravitreal Ranibizumab for five more doses at one month interval, and all baseline investigations were repeated at one month after the first sitting as well as one month after the last dose of intravitreal Ranibizumab.Results: Postoperatively, 21 patients out of 30 had shown encouraging results as far as both improvement in BCVA and reduction in central macular thickness (CMT) were concerned.Conclusion: Intravitreal Ranibizumab combined with intravitreal dexamethasone implant might be a useful tool to deal with refractory diabetic macular edema (DME).
Purpose: To report the clinico-demographic profile of rhino-orbito-cerebral mucormycosis (ROCM) in patients during the “second wave” of the COVID-19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute. Methods: Cross-sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID-19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0. Results: A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID-19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty-six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation. Conclusion: Our data from eastern India reinforces the relationship between COVID-19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications.
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