Objective: To compare the reliability of Bruch Membrane Opening-Minimum Rim Width (BMO-MRW) Optical Coherence Tomography (OCT) with Retinal Nerve Fibre Layer (RNFL) in myopic patients.
Objective: To determine the effectiveness of macular hole index (MHI) as a predicting factor of visual outcome after full thickness macular hole surgery. Methods: This quasi-experimental study was conducted at LRBT Free Base Eye Hospital, Karachi from January 2018 to March 2019. Total 45 eyes of 45 patients with full thickness macular hole (FTMH) underwent preoperative Best Corrected Visual Acuity (BCVA) assessment with logMar chart and Optical Coherence Tomography (OCT) scanning, with measurement of base diameter and macular hole height. Values were calculated for the macular hole index (MHI), which was taken as the predictive factor. All patients had undergone 25+G trans-conjunctival three ports pars plana vitrectomy, internal limiting membrane peeling, and endo-tamponade of C3F8 (14%). The final visual outcome of all the patients was noted. Results: Forty-five patients were included for the study, out of which 10 (22.2%) were male and 35 (77.7%) were female. Age ranged from 45-70 years (mean age 57.20±6.47 years). The mean pre-operative visual acuity was 2.46±1.15 logMar and was 3.88±2.00 logMar, post-operatively. Moreover, 27(60.0%) out of 45 patients achieved BCVA (gain of 2 lines of the logMar chart). The average macular hole index was 1.55±0.50 and out of 45, 25 patients had MHI ≥0.5. It was found that patients with macular hole index ≥0.50 showed clinically significant improvement in BCVA in comparison to those who have macular hole index <0.50. Conclusion: Macular hole index can be used to predict functional success in macular hole surgery. doi: https://doi.org/10.12669/pjms.36.5.1995 How to cite this:Feroz L, Rizvi SF, Naz S, Khan MTH. Pre-operative predicting factor in visual outcome after macular hole surgery. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1995 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To assess the anatomical and functional outcomes of treating chronic persistent large macular hole by macular hole hydrodissection technique in a tertiary eye care hospital. Methods: This interventional case series study was conducted in the Vitreoretinal department of LRBT Tertiary Teaching Eye Hospital, Karachi, from October 2017 to March 2018, with follow-ups till February 2019. The study included eighteen cases of chronic (symptoms of loss of central vision ≥ 2years), persistent (previously failed macular hole surgery), large (aperture diameter of ≥ 400µm) macular hole. Out of the eighteen patients, eight (44.4%) were males and ten (55.6%) were females. All operated patients underwent macular hole hydrodissection by balanced salt solution using a silicone soft tip extrusion cannula. Patients were followed up post operatively to assess post-operative complications and surgical results. Results: Among eighteen patients with a mean aperture diameter of 477.1±102.9 µm and basal diameter of 849.4± 92.6µm, complete anatomical closure was achieved in sixteen (88.8%). Five (27.7%) out of the eighteen patients achieved best corrected visual acuity improvement of 6/36, whereas seven (38.8%) patients reached up to a BCVA of 6/60, with maximum improvement of two lines. The mean post-operative follow-up was 332.3± 46.7 days. Conclusion: Macular hole hydrodissection is a relatively new emerging technique with promising results for the closure of chronic persistent large macular hole. doi: https://doi.org/10.12669/pjms.37.4.3618 How to cite this:Khan TH, Rizvi SF, Mahmood SA, Feroz L. Treatment of Chronic Large and Persistent Macular Hole by a new technique in a Tertiary Care Hospital. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3618 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To find the effectiveness of sub-threshold (810nm) micropulse diode laser treatment (SMT) in chronic central serous retinopathy (CSR). Study Design: Interventional case series. Place and Duration of Study: Layton Rahmatulla benevolent trust eye hospital, from April 2019 to July 2020. Methods: The patients of chronic CSR (≥ 6 months) participated in the study. We used Spectral Domain Optical coherence tomography (SD-OCT) to record baseline central retinal thickness (CT). Best corrected visual acuity (BCVA) was recorded with Snellen’s chart and converted to Log MAR for statistical analysis. All patients underwent treatment with sub-threshold laser (810nm) in micropulse mode with 5% duty cycle (DC). Results: Twenty five eyes with chronic CSR were enrolled in the study. The patients were treated with laser and final assessment was made at 6 months. Mean BCVA at presentation was 0.46 Log MAR ± 0.12 and a mean baseline CT of 362.2 μm ± 32.6µm. At final follow-up there was a mean decrease in CT of 97.2 μm ± 21.8 from the baseline. After treatment mean BCVA was 0.33 Log MAR ± 0.12 and mean CT was 266 μm ± 20.9. Nineteen out of twenty-five eyes (76%) achieved a gain of vision between 1 to 3 lines and gain of 3 lines was achieved in 8% of cases. At the final follow-up there was incomplete resolution of sub retinal fluid in 4 eyes (16%) with no improvement in BCVA. Conclusion: SMT (810 nm) is an effective and minimally invasive treatment modality for chronic CSR. Key Words: Sub-Threshold micropulse laser, Central serous retinopathy, Central retinal thickness, sub retinal fluid.
Purpose: To find out correlation between visual acuity and deep capillary plexus (DCP) in foveal avascular zone (FAZ) area using OCTA in patients with retinal vein occlusion (RVO). Study Design: Descriptive observational study. Place and Duration of Study: Layton Rehmatullah Benevolent trust free Eye Hospital, from September 2018 to December 2019. Methods: This observational study included 50 eyes of 50 patients, who were treated with intra-vitreal anti-VEGF for macular edema secondary to retinal vein occlusion. We excluded patients with macular edema due to other ocular diseases. OCTA was performed in every patient to measure the size of foveal avascular zone. FAZ area of 0.6mm2 or less was taken as normal and any value above that was considered to be larger FAZ. IBM SPSS version 25 was used to analyze the data. Frequencies with percentages were used to present qualitative variables and mean ± SD were calculated for the quantitative variables. P-value ≤ 0.005 was taken as significant. Results: Mean age was 58.38 ± 7.51 years. There were 28 males and 22 females. Mean best-corrected visual acuity was 0.62 ± 0.26 logMar. The patients with normal FAZ area in DCP showed a mean BCVA of 0.51 ± 0.265 logMAR in comparison to those who had larger FAZ in DCP, where the mean BCVA was 0.75 ± 0.204 logMAR. DCP was larger in patients with CRVO than BRVO. Conclusion: OCTA is a good diagnostic tool for qualitative and quantitative evaluation of the deep capillary plexus. Improvement in visual acuity is related with the size of the DCP in FAZ. Key Words: Retinal vein occlusion, Foveal avascular zone, Optical Coherence Tomograghy Angiography.
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