Varicella zoster is known to be associated with vaso-occlusive pathologies, vasculitis, or optic neuritis, leading to profound visual loss. We report a case where a 13-year-old boy who initially presented to us with on and off diminution of vision in his right eye since 3 days and had normal ocular and OCT angiography findings followed up in 5 days with sudden painless diminution of vision in the same eye since one day this time revealing a pale macular region with rest of the retina being normal. Repeated OCT angiography showed loss of the capillary network around the perifoveal region suggesting cilioretinal artery occlusion.
BackgroundPrimary open-angle glaucoma (POAG) is a progressive optic neuropathy with numerous risk factors. Its severity with associated risk factors remains a widely debated topic.AimTo evaluate the severity of POAG in patients with hypertension (HTN) and diabetes or both.Patients and methodsThis hospital-based, cross-sectional descriptive study was conducted for a period of 18 months from January 2016 to June 2017. Diagnosed cases of POAG were evaluated for severity with associated risk factors.ResultsA total of 221 patients were enrolled in the study. The mean age of the patients was 54.4 (SD ± 15.9) years with a male to female ratio of 0.93:1. Of the 221 patients, 68 (31%) had a family history of POAG. Mean intraocular pressure was 15.8±4.87 mmHg, and mean central corneal thickness was 535.4±34.9 μm. A total of 81 (36%) patients had HTN, 21 (9.50%) had diabetes mellitus (DM), and 15 (6.80%) had both HTN and DM. Analysis using SPSS version 20 was done. The severity of POAG was found to be significantly higher in patients with HTN, DM, or both when evaluated on the basis of anatomical and functional loss.ConclusionPOAG patients with HTN, DM, or both were found to have more severe POAG. Patients with these risk factors could represent “high-risk patients” with POAG. Patients with HTN and DM, or both may require evaluations on a more frequent basis to access the progression/severity of POAG.
PurposeTo report a modified technique of sutureless intrascleral fixation of a posterior chamber intraocular lens with use of instruments of anterior segment surgery and its outcomes.DesignProspective, noncomparative, interventional case series.ParticipantsNinety-two eyes of 92 patients with aphakia and subluxated lens who underwent surgery were evaluated.Materials and methods27-gauge needles were introduced transclerally and guided by the viscocanula to externalize via the main wound. The haptics were loaded into the lumen and externalized from entry points. The haptics were then fixed in a scleral tunnel made by a 27-gauge needle. The best-corrected visual acuity (BCVA) and complications were determined.ResultsNinety two eyes which were operated and completed follow-up of 6 weeks were included in the study. The most common indications for scleral-fixated intraocular lens (SFIOL) were subluxated lens – 55 eyes (59%), and surgical aphakia – 31 eyes (34%). Sixty-nine eyes (75.7%) had a postoperative vision of uncorrected visual acuity of 6/18 on day 1. There was an improvement in mean logMAR BCVA (0.086±0.18) at 6 weeks as compared to preoperative visual acuity (p<0.05). BCVA of 6/12 or better was attained in 94% of the cases at 6 weeks. Special mentions need to be made for 6 (7%) of our cases. Three of the patients were cases of fully treated postoperative endophthalmitis who lacked capsular support. Two of the other cases had undergone pars plana vitrectomy for retinal detachment. Both had silicon oil removal done 1 month before the SFIOL procedure. One of the patients had Marfan’s syndrome.ConclusionOur procedure is safe, easy, less traumatic, and less resource-demanding with good visual outcomes and can be performed even in low-resource settings of developing countries. It may also be considered in patients who have had posterior segment surgeries previously.
A blunt trauma to a phthisical eye may elicit sympathetic ophthalmia. Non invasive imaging such as use of optical coherence tomography and angiography metrics of the retinal and choroidal vasculature can help monitor response to the treatment. K E Y W O R D Sangiography, autoantigens, imaging, ocular wounds, optical coherence tomography and angiography, phthisis, sympathetic ophthalmia, uveitis 150 | KHATRI eT Al.How to cite this article: Khatri A, Timalsena S, Khatri BK, et al. A rare entity: Sympathetic ophthalmia presumably after blunt trauma to the phthisical eye and optical coherence tomography angiography metrics to monitor response to treatment. Clin Case Rep.
AimSubthreshold lasers have gained popularity in the treatment of chorioretinopathy central serous chorioretinopathy (CSCR) and yellow (577 nm) lasers have completely revolutionized the treatment. However, there is very little literature regarding the use of a more common and conventional – green (532 nm) subthreshold laser for the treatment of chronic CSCR. We report the use of green (532 nm) laser for the treatment of chronic CSCR and its outcome.MethodsEyes with nonresolving CSCR were treated with green subthreshold laser and evaluated at the end of 5 months. Visual acuity, central macular thickness (CMT), and macular volume (MV) at baseline and at 5 months following treatment were evaluated.ResultsThirteen eyes with chronic CSCR were treated with green laser in SP-Mode™. The mean duration of CSCR was 7.64±3.77 months at the time of treatment. The median age of the patients was 41 (35–57) years. The baseline mean best-corrected visual acuity (BCVA) was 0.96 logMAR ± 0.17, with mean baseline CMT of 503.8 μm ± 181.9 and MV of 12.8 mm3 ± 3.81. The mean CMT at 5 months was 211 μm ± 31.7 and mean MV was 9.65 mm3 ± 0.60, correlating to a mean decrease of 292 μm ± 79 in CMT and mean decrease of 3.18 mm3 ± 1.87 in the MV from baseline (P<0.05). The mean BCVA after treatment was 0.18 logMAR±0.09 (P<0.05). Two cases of CSCR with pigment epithelial detachment (PED) also had complete resolution of both at 5 months.ConclusionSubthreshold green laser (532 nm) is a safe and effective modality for the treatment of chronic CSCR with very good and stable outcomes. It may also be beneficial in the treatment of PEDs.
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