OCT (optical coherence tomography) of corneal layers was generated to analyze the remodeling of the epithelium and stroma after photorefractive keratectomy (PRK). Myopic PRK was performed in 15 patients. One eye underwent manual scraping of epithelium while the other was treated with Epi clear. Epi clear allowed a gentler removal of the epithelium compared to manual scraping. Scheimpflug (Pentacam, OCULUS Optikgerate Gmbh, Wetzlar, Germany) and OCT (RTVue, Optovue Inc., Fremont, California, USA) scans of the cornea were performed before and after PRK (3 months). The OCT scanner and Pentacam acquired 8 and 25 radial 2-D scans of the cornea, respectively. The results showed similar topographic changes on the anterior corneal surface between Scheimpflug and OCT imaging. The curvature of the underlying anterior surface of the stroma after PRK was similar to the anterior corneal surface (air-epithelium interface), when measured with OCT. Aberrometric changes were mostly similar between Scheimpflug and OCT. However, Scheimpflug imaging reported greater changes in spherical aberration and corneal higher order aberrations than OCT after PRK. This is the first study to quantify the curvatures of the stromal layers with OCT after PRK. New insights were gained, which could be useful for refinement of surgical ablation algorithms, refractive procedures and detection of ectasia.

Purpose:To evaluate safety and efficacy of intravenous pulse cyclophosphamide (CyP) in acute macular serpiginous choroiditis (SC).Methods:Patients with acute macular SC with lesions threatening and/or involving fovea were enrolled. All patients received CyP (1 g/m2 ) for 3 days followed by high-dose oral steroids (1.5 mg/kg) tapered over 6 months and monitored for visual acuity, response to treatment and systemic side effects.Results:Eight patients (seven unilateral and one bilateral) with median age of 27 years (range: 13–40 years) were recruited. Mean visual acuity at presentation was 0.71 ± 0.35 logarithm of the minimum angle of resolution while postpulse visual acuity was 0.40 ± 0.32. Final mean visual acuity at 1-year was 0.31 ± 0.23 (P ≤ 0.05). Three eyes had recurrence and 3 patients developed transient hair loss with no other adverse effect.Conclusion:Intravenous CyP provides rapid resolution of lesion activity and thereby helps in maintaining good functional acuity.

Purpose: To report the prevalence of keratoconus (KCN) in patients presenting for refractive surgery in western India. METHODS: A cross-sectional, observational, retrospective study performed at a tertiary eye care center. A total of 2902 cases, aged 18–40 years who presented in the refractive surgery department between January 2014 and December 2018 were included. Records of all the included cases were reviewed. Patients showing KCN pattern on topography were noted and divided into KCN and KCN suspects. Annual and overall 5-year prevalence were calculated at 95% confidence interval (CI). Demographic details of KCN and non-KCN participants were compared. RESULTS: Of the 2902 cases, 25 (0.86%) had clinical KCN and 22 (0.76%) were KCN suspects. The combined 5-year prevalence of all these 47 KCN cases was 1.61% (95% CI: 1.15%-2.07%), with an annual prevalence range of 0.97%–2.43%. The mean age of non-KCN cases was 24.60 ± 4.91 years and KCN cases was 24.62 ± 5.37 years ( P = 0.98). Among the KCN cases, there were more females (30; 63.83%), and the gender ratio was significantly different than non-KCN cases ( P = 0.004). CONCLUSION: The prevalence of KCN in refractive surgery cases was 1.61% which is higher than those found in the western population and lower than those found in the Middle East (Saudi Arabia and Iran). Furthermore, topographic examination performed during the routine screening of patients for refractive surgery can be a useful tool to diagnose new cases of KCN in asymptomatic patients.

SIGNIFICANCE:The article highlights various topographic patterns and their prevalence in a large spectrum of ectatic corneal diseases (ECDs). Knowledge of these patterns can help clinicians for quicker diagnosis and selection of appropriate contact lens design.PURPOSE: This study aimed to determine various corneal topography patterns and their prevalence in patients with ECDs who visited a tertiary eye hospital in western India.METHODS: Keratoconus, pellucid marginal degeneration, keratoglobus, and post-refractive surgery progressive corneal ectasia are considered under ECDs. This cross-sectional retrospective study reviewed records of 632 consecutive patients with clinical ECDs at their first presentation. The right eye was considered for pattern analysis. In cases with suspected or forme fruste ectasia in the right eye, the fellow eye was considered. A sagittal map with standard scale of Atlas 9000 topographer (Carl Zeiss Meditec AG, Jena, Germany) was used for pattern analysis. They were classified into 18 categories and grouped under five groups. The prevalence of these patterns was calculated and assessed with 95% confidence interval (CI). RESULTS:The mean ± SD age of patients was 23.6 ± 8.2 years. The highest prevalence was of asymmetric patterns (39.6% [95% CI, 35.7 to 43.5%]; asymmetric bowtie [AB] with steepest radial axis index [SRAX], 18.8%; AB with inferior steep, 16.0%; AB with superior steep [SS], 3.2%; symmetric bowtie with SRAX, 1.6%) and of central or paracentral patterns (28.6% [95% CI, 25.1 to 32.3%]; inferior steep, 12.2%; heart, 7.4%; oval, 4.1%; symmetric bowtie, 2.4%; round, 1.6%; irregular, 0.9%) followed by advanced patterns (17.3% [95% CI, 14.4 to 20.4%; nonmeasurable, 5.4%; globus, 4.9%; indiscriminate, 7.0%). The peripheral patterns were 11.7% (95% CI, 9.3 to 14.4%) (claw, 6.3%; junctional, 3.2%; butterfly, 1.9%; SS, 0.3%). Rare patterns were 2.8% (95% CI, 1.7 to 4.5%) (superior [junctional, claw, and heart], AB with SS with SRAX, and AB with SRAX located temporally).CONCLUSIONS: Asymmetric and central or paracentral are the most common patterns in our study. The higher prevalence of advanced patterns indicates the need for earlier diagnosis of ECDs in our population. The peripheral patterns also have significant prevalence.

Introduction: Dry eye disease (DED), as defined by the dry eye work shop (DEWS II) guidelines, is a multi factorial disease with various etiologies ranging from instability and hyperosmolarity of the tear film, inflammation and damage of the ocular surface and neurosensory abnormalities. Study was done with the purpose to report the prevalence of dry eye disease (DED) in western India. Material and Methods: This was a cross sectional study conducted from April 2018 to March 2019. Patients from outpatient department > 18 years of age were selected based on systematic random sampling. The ocular surface disease index (OSDI) questionnaire was explained to the patients and asked to fill-up and the total OSDI score was calculated. Based on the OSDI scoring, DED prevalence was calculated. Demographic details of the patients were noted and compared between all patients and those with DED. Results: Of the 578 patients included in the study, 198 patients (34.26%) had DED. Of those, 95 (47.98%) patients had mild DED, 63 (31.82%) had moderate DED and 40 (20.20%) had severe DED. The mean age of patients with DED was 50.63±18.69 years. Females (54.04%) were more commonly affected compared to males (45.96%). There was significant difference in mean age among the total patients and DED patients (P= 0.03). The gender ratio was not significantly different among total patients and DED patients (P=0.17). Conclusion: The hospital-based prevalence of DED in western India is 34.26%. The disease is more common in elderly females.