Context:Role of Ozurdex in macular edema due to various posterior segment pathologies.AIM:The aim of this study is to report outcome of Ozurdex implant in macular edema (ME) secondary to various posterior segment pathologies.SETTINGS AND DESIGN:This was a single-center, retrospective, interventional study.SUBJECTS AND METHODS:Patients of ME were treated with one or more Ozurdex implants (0.7 mg). Data collection included demographic details, best-corrected visual acuity (BCVA), central foveal thickness (CFT), duration of efficacy, and record of adverse events (if any) within 24 weeks.STATISTICAL ANALYSIS USED:Paired sample t-test, Stata data analysis, and statistical software, version 12.1, StataCorp, College Station, TX, USA, were used in the study.RESULTS:One hundred and sixteen eyes of 104 patients were studied which had a diagnosis of diabetic ME (n = 46), retinal vein occlusion (n = 40), and uveitis (n = 30). The average age of patients (mean ± standard deviation) was 50.2 ± 21.9 years. Baseline mean ± SD (standard deviation) logMAR BCVA, CFT, and intraocular pressure (IOP) were 0.636 ± 0.4, 527.8 ± 210.1 μm, and 15.3 ± 3.8 mmHg, respectively. The reinjection interval was around 12–18 weeks. Ozurdex proved its efficacy in improving mean logMAR visual acuity and reduction of CFT from baseline till 12 weeks' follow-up period (0.414 ± 0.5 and 301.5 ± 278.5, respectively; P < 0.05), and after 12 weeks' follow-up, it started worsening (0.530 ± 0.9 and 444.8 ± 375.2, respectively; P > 0.05). The most common reported adverse event was significant rise of IOP (>5 mmHg), with a total of 12 cases followed by cataract 9 cases.CONCLUSION:Ozurdex implant leads to a significant improvement in BCVA and CFT values till 12 weeks, followed by a gradual decline for all the pathologies studied together. No new safety concerns were observed with the Ozurdex implant. The duration of efficacy was found to be <24 weeks.
Clinical baseline characteristics and the early treatment response were identified as possible predictors for long-term outcome and the need of adjunctive intravitreal therapy in MO secondary to BRVO/CRVO treated by DEX implant.
Proliferative vitreoretinopathy (PVR) is the leading cause of failed rhegmatogenous retinal detachment (RRD) surgery. Based upon the presence of clinical features and due to associated underlying risk factors, it is classified into various grades based upon its severity and extent of involvement. Despite excellent skills, flawless techniques, and high-end technology applied in the management of RRD, PVR still occurs in 5–10% of cases. Due to the advancements in wide angle viewing systems, advance vitrectomy machines and fluidics, early identification, use of long-term heavy silicon oil tamponades, high-speed cutters, small-gauge vitrectomies, use of perfluorocarbon liquid (PFCL), and small-gauge forceps and scissors, the success rate in the management of PVR has increased leading to improved anatomical outcomes. However, functional outcomes do not correlate well with improved anatomical outcomes. Various complications occur after RRD repair that are responsible for re-retinal detachment and recurrence of PVR. This article highlights causes, risk factors, classification, grading, diagnosis, and approach to management of PVR and post-PVR surgery complications.
Purpose:To evaluate and correlate the functional treatment response using microperimetry (MP3) with the morphological findings on optical coherence tomography angiography (OCTA) in wet AMD pre- and post-treatment with anti-vascular endothelial growth factor (VEGF). This was a single-centre prospective, interventional study.Methods:Patients with wet AMD were treated with 3 injections of intravitreal anti-VEGF at monthly intervals for 3 months and followed at 1, 2, 3, and 6 months postinjection. Using “overlay” features, morphologic characteristics of OCTA at the site of choroidal neovascular membrane (CNVM) lesion were analyzed and correlated functionally with MP3. Data were collected including visual acuity at presentation and follow-up with multimodal imaging features, treatment details, complications (if any), and treatment given for that complication. Descriptive observational analysis and paired t-test was used to compare the appearance of the neovascular network on OCTA imaging with retinal sensitivity on MP3.Results:OCTA in the pretreatment phase revealed CNVM as an abnormal vascular network arising from the choroid and invading the subretinal space. On MP3, decreased retinal sensitivity was observed corresponding to the area of CNVM. Post-treatment, OCTA revealed reduction in abnormal vascular network in 51 (91.07%) eyes that correlated with increased retinal sensitivity at the corresponding area on MP3. Statistical analysis showed baseline mean retinal sensitivity at the site of CNVM as 320.07 dB, which improved to 521.53 and 730.20 dB at 1 and 3 months postinjection follow-up, respectively.Conclusion:Combining the findings of OCTA and MP3 using “overlay” features gives us precise information of structure–function correlation at presentation and also in response to treatment. It also helps to improve patient's compliance, confidence to treatment, and their understanding of the disease process as well.
<span style="font-family:'Times New Roman','serif';font-size:10pt;">Subdural hematomas are often life-threatening when acute but chronic subdural hematomas, however, have better prog</span><span style="font-family:'Times New Roman','serif';font-size:10pt;">nosis if properly managed. Chronic subdural hematomas are common in the elderly due to shrinkage of brain tissue,</span><span style="font-family:'Times New Roman','serif';font-size:10pt;"> </span><span style="font-family:'Times New Roman','serif';font-size:10pt;">but in young patient mostly associated with head injury. It is seen also in young having various coagulopathies associated with blood disorders or drug-induced,</span><span style="font-family:'Times New Roman','serif';font-size:10pt;"> </span><span style="font-family:'Times New Roman','serif';font-size:10pt;">but it is very rare. Propylthiouracil (PTU) is an oral medication that is used in treatment of hyperthyroidism approved by FDA in </span><span style="font-family:'Times New Roman','serif';font-size:10pt;">J</span><span style="font-family:'Times New Roman','serif';font-size:10pt;">uly 1947. This medication may rarely cause very serious blood disorders (such as a low number of red cells, white cells, and platelets), especially during the first few months of treatment.</span><span style="font-family:'Times New Roman','serif';font-size:10pt;"> </span><span style="font-family:'Times New Roman','serif';font-size:10pt;">We are reporting a rare case of</span><span style="font-family:'Times New Roman','serif';font-size:10pt;"> </span><span style="font-family:'Times New Roman','serif';font-size:10pt;">PTU-induced</span><span style="font-family:'Times New Roman','serif';font-size:10pt;"> </span><span style="font-family:'Times New Roman','serif';font-size:10pt;">thrombocytopenia leading to chronic subdural haematoma,</span><span style="font-family:'Times New Roman','serif';font-size:10pt;"> </span><span style="font-family:'Times New Roman','serif';font-size:10pt;">which presented with established papilledema and signs of raised ICP in a hyperthyroid female and she responded well to surgical management<b>.</b></span>
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