Purpose:
To describe the utility of RetCam ultra-wide-field fundus fluorescein angiography in pediatric retinal vascular diseases.
Methods:
A retrospective chart review was carried out in 43 eyes of 22 pediatric patients who were diagnosed or suspected to have a retinal vascular disease. Fluorescein angiography was carried out using the 130 degree lens of RetCam 3. Fluorescein angiography guided treatment (laser/cryotherapy) was carried out wherever required.
Results:
Diseases studied included - coats disease, familial exudative vitreoretinopathy, retinopathy of prematurity, congenital retinal folds, double optic nerve head, persistent fetal vasculature and incontinentia pigmenti. RetCam assisted fluorescein angiography was helpful in establishing a diagnosis in 4 patients (18%), in decision making regarding treatment in 18 patients (82%), in deciding need for retreatment in 5 patients (23%), helped in staging of disease in 5 patients (23%) and in detecting clinically subtle findings in 6 patients (27%).
Conclusion:
RetCam assisted FFA is extremely useful to document peripheral retinal vascular pathologies in pediatric patients and helps to take crucial therapeutic and retreatment decisions.
Buckling surgery is one of the common procedures performed by the retinal surgeons for visual rehabilitation at the earliest in cases of retinal detachment. The optimal surgical skill in this section can only be achieved with repeated practices and clinical experiences. Here, we describe an easy and inexpensive way to perform, practice, and refine surgical skills by demonstrating this complicated surgery in a simple manner on goat's eyes. The advantages of this technique are real-tissue handling experiences and repeatability of the procedure with almost similar practical implications. Thus, whenever feasible, every attempt should be made to refine the residents or budding ophthalmologists surgical skills by undertaking this technique in their routine curriculum.
Purpose: Spherophakia is a rare, debilitating congenital ocular disorder. Methods: This institution-based, retrospective, interventional study evaluated medical records of 16 patients with spherophakia with a median age of 19.5 years. Twenty-six eyes underwent scleral-fixated intraocular lens implantation. The technique involved 2 parallel-to-limbus scleral tunnels fashioned using a microincision vitrectomy blade, followed by lensectomy, core vitrectomy, externalization of haptics through 2 separate diametrically opposite sclerotomies, and tucking in of the haptics into the tunnels. Anterior and posterior segment examination, visual acuity, and intraocular pressure (IOP) were noted at baseline and final follow-up. Results: Baseline best-corrected visual acuity (BCVA) of all eyes was 0.49 ± 0.51 logarithm of the minimum angle of resolution (logMAR) (Snellen equivalent, 6/18). BCVA of more than 6/60 was present in 28 of 32 (87.5%) eyes, and 13 of 26 (50%) eyes that were operated on had a baseline BCVA of more than 6/18. Postoperative BCVA in 26 eyes improved from 0.43 ± 0.32 logMAR to 0.19 ± 0.21 logMAR (Snellen equivalent, 6/9) ( P = .002). Postoperative BCVA was more than 6/18 in 20 of 26 (76.9%) operated-on eyes ( P = .046), and all eyes had a final BCVA of more than 6/60. In 20 of 26 (76.9%) eyes, BCVA improved from preoperative status. Postoperatively, spherical equivalent improved from –9.55 ± 5.17 diopters to –0.29 ± 1.45 diopters ( P < .001). Apart from 2 patients with Marfan syndrome, 1 with Weill-Marchesani syndrome, and 1 with homocystinuria, the remaining patients had isolated spherophakia. Six eyes presented with an IOP greater than 21 mm Hg, and 50% of these eyes had a final IOP that decreased to less than 15 mm Hg after lensectomy. Conclusions: Lensectomy with pars plana vitrectomy and scleral-fixated intraocular lens is an effective method of refractive rehabilitation for patients with spherophakia presenting with visual disability.
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