Susac syndrome is an autoimmune microangiopathy characterized by a triad of encephalopathy, sensori-neural hearing loss and varying degrees of branch retinal artery occlusion. A young male patient is described with features of focal neurological lesions and small superficial retinal haemorrhages and areas of retinal arteriolar endothelial inflammation appearing as Gass plaques. Susac syndrome presents with varying features involving brain, inner ear and retina. Fundus Fluorescein angiography should be performed in all patients with an unexplained encephalopathy to look for characteristic arteriolar wall changes.
Vernal keratoconjunctivitis (VKC) is an unusually severe sight-threatening allergic eye disease, occurring mainly in children. Children with VKC present with severe ocular symptoms, that is, severe eye itching and irritation, constant tearing, red eye, eye discharge, and photophobia. Though medically treated, some complications of the disease like ptosis may require surgical intervention, thus identifying the association of ptosis with VKC is of utmost importance. This study was done to see the relation between long-standing VKC and acquired ptosis in young adults.This was a hospital based non-comparative, observational study, conducted in the department of Ophthalmology, SKIMS Medical College Hospital, and Srinagar from March 2020 to May 2022. 60 patients upto the age of 40 years with any form of VKC were included in the study. Ocular examination included visual acuity testing, slit lamp biomicroscopic examination to evaluate corneal and conjunctival involvement, proper history and evaluation of ptosis.Mean age of cases was 16.23± 6.97. Out of 60 patients maximum were in the age group of 10-15 years (31.66%), followed by the age group of 15-20 years (21.66%). Out of total 60 cases 46(76.66%) were male and 14(23.33%) were female. Palpebral form of the disease was seen to be in most of the cases 53.33%, followed by mixed form of the disease in 28.33% and bulbar disease in 18.33% of the cases. Presence of acquired ptosis as a complication due to VKC was seen in 9(15%) patients. Out of these 9 patients 7 patients presented with unilateral ptosis and 2 patients presented with bilateral ptosis. Average duration of symptoms in these patients was 5.0±1.8 years, indicating that ptosis is a complication of long standing VKC. All these patients had palpebral or mixed form of VKC, none had bulbar form of the disease.Our study revealed that prolonged severe VKC may induce a lower position of the upper eyelid and eventually lead to ptosis, which is a non-reversible complication of VKC and requires surgical correction. Thus better primary eye care for the management of VKC in children may prevent this complication.
Background : The introduction of anti-VEGF therapy has had a greater effect on the world of retina than any other advance in the past few decades. This study was conducted to see whether anti-VEGF agents have any kind of brotic effect for the development of vitreomacular interface abnormalities, in diabetic eyes without pre-existing brotic membranes. Materials and Methods: This study was a Hospital based retrospective observational study, conducted in the Department of Ophthalmology, SKIMS Medical College Hospital, Srinagar.100 eyes were included in the study. Patients with DME followed at least 9 months were reviewed. Patients were divided into two groups: 50 eyes in anti-VEGF group that had DME and received intravitreal injections and 50 eyes in control group without signicant central DME. The groups were comparable in terms of diabetes duration and HbA1c. Results: Atotal of 100 eyes were taken in the study that met the inclusion criteria. Vitreomacular interface abnormalities (VMIA) (ERM, VMT and Macular hole) developed in 11 (22%) of the eyes during a follow up period of 36 weeks as compared to 2 eyes (4%) of the control group. This difference is statistically signicant (p = 0.015). Poor baseline vision was found to be a risk factor for VMIAdevelopment. Conclusion: Our study revealed that patients with clinically signicant DME who underwent intravitreal injections had a rate of vitro macular interface abnormalities formation in 22% of eyes during a follow up period of 9 months as compared to 4% eyes of the control group. This difference was statistically signicant. VMIA changes in the eyes was associated with initial poor vision. Improvement of BCVA and Central Macular Thickness at the nal visit compared with baseline in eyes treated with intravitreal anti-VEGFs was statistically signicant.
Background: The study was conducted to evaluate the role of fundus fluorescein angiography (FFA) and spectral domain-optical coherence tomography (SD-OCT) in choroidal neo-vascularisation (CNV).Methods: This was a hospital based prospective study carried out in the post-graduate department of ophthalmology, SKIMS medical college, Bemina, Srinagar, Jammu and Kashmir. All patients diagnosed with CNV fulfilling the criteria during the study period w.e.f. October 2018 to March 2020 were enrolled. Visual acuity and pinhole test using Snellen’s chart for literate and E chart for illiterate patient, slit lamp biomicroscope for anterior segment examination, ophthalmoscopy, including stereoscopic examination of the posterior pole, 90D examination of the fundus, Intra-ocular pressure measurement, FFA and SD-OCT was done in these patients.Results: Diagnostic accuracy of OCT was observed with a sensitivity 79.1% (95% confidence interval (CI): 67.3-90.7), specificity 84.3% (95% CI: 74.5-92.9), positive and negative predictive values 78.7% and 85.4%, respectively, (95% CI: 65.5-95.6) and (74.8-93.4) and diagnostic accuracy of FFA was observed with a sensitivity 81.4% (95% confidence interval (CI): 70.6-93.5), specificity 82.31% (95% CI: 71.9-89.3), positive and negative predictive values 79.9% and 83.7%, respectively, (95% CI: 68.8-92.9) and (70.3-91.2).Conclusions: FFA is the gold standard procedure for screening ARMD and detection of dry ARMD, but OCT is more specific diagnostic tool in detecting early subretinal neovascular membrane and also to assess the extent, location and activity of the neovascular membranes. This study concludes that SDOCT is highly sensitive for identifying AMD, CNV, and CNV activity and due to its non-invasive nature with no adverse effects and less time consuming can be used as 1st line of diagnostic modality and FFA be reserved for cases where SD-OCT is not helpful.
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