Objective:To determine the efficacy of topical Nepafenac (0.1%), administered post-operatively in prevention of Macular Edema (ME), after cataract surgery in patients with Non-Proliferative Diabetic Retinopathy (NPDR).Methods:This randomized control trial was conducted at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from Sep 2015 to Sep 2016. Sixty eyes of 60 patients with NPDR underwent phacoemulsification with intraocular lens implantation. Group 1 received 0.1% Nepafenac, 8-hourly, in operated eye after cataract surgery for three months, along with routine post-operative medications. Group-2 received only routine post-operative medications. ME was defined as increase in Central Macular Thickness (CMT) of >10% from pre-operative baseline, measured using spectral domain optical coherence tomography.Results:Mean age of study population was 60.97±4.91 years. Out of 60 patients, 34 (56.7%) were males and 24 (43.3%) were females. Mean pre-operative CMT, 3 months post-operative CMT, mean change in CMT and mean frequency change in CMT of Group-1 was 226.5±10.86µm, 228.83±14.56 µm, 2.33±10.45 µm and 1.05% respectively. Mean pre-operative CMT, three months post-operative CMT, mean change in CMT and mean frequency change in CMT in Group-2 was 223.93±11.69µm, 236.17±16.16 µm, 12.23±12.40µm and 5.51% respectively. ME was observed in one patient (3.3%) in Group-1, and seven patients (23.3%) in Group 2. The difference of mean change in CMT and frequency change in CMT between groups was statistically significant (p<0.05).Conclusion:0.1% topical Nepafenac is effective in prevention of macular edema after cataract surgery in patients with non-proliferative diabetic retinopathy (NPDR).

Objective:To evaluate the correlation between Central Corneal Thickness (CCT) and Visual Field (VF) defect parameters like Mean Deviation (MD) and Pattern Standard Deviation (PSD), Cup-to-Disc Ratio (CDR) and Retinal Nerve Fibre Layer Thickness (RNFL-T) in Primary Open-Angle Glaucoma (POAG) patients.Methods:This cross sectional study was conducted at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from September 2015 to September 2016. Sixty eyes of 30 patients with diagnosed POAG were analysed. Correlation of CCT with other variables was studied.Results:Mean age of study population was 43.13±7.54 years. Out of 30 patients, 19 (63.33%) were males and 11 (36.67%) were females. Mean CCT, MD, PSD, CDR and RNFL-T of study population was 528.57±25.47µm, -9.11±3.07, 6.93±2.73, 0.63±0.13 and 77.79±10.44µm respectively. There was significant correlation of CCT with MD, PSD and CDR (r=-0.52, p<0.001; r=-0.59, p<0.001;r=-0.41, p=0.001 respectively). The correlation of CCT with RNFL-T was not statistically significant (r=-0.14, p=0.284).Conclusion:Central corneal thickness had significant correlation with visual field parameters like mean deviation and pattern standard deviation, as well as with cup-to-disc ratio. However, central corneal thickness had no significant relationship with retinal nerve fibre layer thickness.

Objective: To compare the therapeutic efficacy of topical Olopatadine 0.1% versus Ketotifen Fumarate among the patients diagnosed with allergic conjunctivitis at Armed forces institute of ophthalmology. Study Design: Prospective comparative study. Place and Duration of Study: Armed forces Institute of Ophthalmology, Rawalpindi, from Jan 2020 to Jan 2021. Methodology: Patients diagnosed with allergic conjunctivitis by consultant ophthalmologist fulfilling the exclusion/inclusion criteria were included in the study. They were divided into two groups by block randomization with group A receiving Olopatadine 0.1%, while group B just received the Ketotifen Fumarate. Symptoms were assessed on a symptom severity score upon diagnosis before the start of medication and then after 72 hours of treatment by a different consultant ophthalmologist who was unaware of the group of patients. Results: A total of 100 patients were included in each group. The mean age of the study participants was 30.944 ± 3.349 years. 148 (74%) patients were males while 52 (26%) were females. The difference in mean score of symptoms in group A was 5.76 ± 1.39 while in group B was 3.33 ± 2.51. Application of t-test revealed that topical Olopatadine 0.1% was superior to Ketotifen Fumarate in reducing the symptoms of acute allergic conjunctivitis on the third day of treatment (p-value<0.001). Conclusion: Seasonal allergic conjunctivitis was the commonest type of allergic conjunctivitis seen in our study participants. Topical Olopatadine 0.1% emerged as a better treatment option when compared to Ketotifen Fumarate for immediate management of acute allergic conjunctivitis among patients managed at a tertiary...................

Objective: To determine the mean change in central macular thickness after cataract surgery and to compare the mean change in central macular thickness after cataract surgery in non-diabetics and diabetics without diabetic retinopathy Study design: Case control   Study settings and duration: A case control study was carried out at Ophthalmology department, POF hospital, Wah Cantt. Study duration was 6 months (April 2019-September 2019)   Material and methods: A sample size of 60 patients was calculated by using Open Epi Software. We used non probability consecutive sampling. Patients were divided into two groups; Cases (Diabetic) and controls (non-Diabetic). All patients underwent phacoemulsification and observed after 4 weeks for macular thickness measurement using optical coherence tomography before and after surgery. Data analysis was done with SPSS version 20. Post stratification t test was applied. P value ≤0.05 was considered significant.   Results: Total 60 patients were included. Mean age of patients was 65.31 ±7. 63SD.There were 35 (58.3%) males and 25 (41.7%) female patients in the study. We found a significant increase in central macular thickness in cases and controls [(223.100±15.86SD vs 227.2667±17.9SD, p=0.000) and (221.200±12.16SD vs 226.289±16.7861SD, p =0.001)] before and after phacoemulsification in cases and controls respectively. However, no significant difference was found between the groups (p=0.486).   Conclusion: Central macular thickness was increased after uncomplicated phacoemulsification in both diabetics and non-diabetics without retinopathy for up to a follow-up period of 4 weeks but the thickness did not differ between the two groups.

Objective: To determine the diagnostic accuracy of PET/CT in detecting aggressiveness of lymphoma based on sub-uptake keeping bone marrow biopsy as the gold standard. Study Design: Prospective longitudinal study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi Pakistan, from Sep 2020 to Mar 2021. Methodology: One hundred thirty-eight patients of either gender, aged 20 to 80 years who were diagnosed with lymphoma (either Hodgkin’s or non-Hodgkin’s lymphoma) on initial PET/CT scan were enrolled in the study. All patients underwent PET/CT, and 18-FDG SUV was calculated. After obtaining values, all participants underwent bone marrow biopsy to determine the aggressiveness of lymphoma and findings were subjected to statistical analysis. Results: The mean age of the patients was 54.92±16.86, and the mean SUV value was 17.04±8.03. There were 77(55.8%) males and 61(44.2%) females. Hodgkin’s lymphoma was present in 28 (20.3%) patients and non-Hodgkin’s lymphoma in 110(79.7%). The sensitivity, specificity, PPV, NPV and diagnostic accuracy of 18 FDG PET/CT SUV were 92%, 92.2%, 93.2%, 90.9% and 92.1%, respectively. Conclusion: 18-FDG PET/CT SUV has high diagnostic accuracy and can detect aggressive lymphomas and further specify the areas for biopsy.