This is a Case Control Study that was conducted among 100 Type 2 DM (Diabetes Mellitus) patients who attended the OP and the wards of Ophthalmology Department at Government Rajaji Hospital, Madurai, to assess the prevalence of thyroid dysfunction among Type 2 DM patients and whether thyroid dysfunction is associated with increased risk of retinopathy in Type 2 diabetes patients. Patients diagnosed with Type 2 DM on treatment for more than 5 years of diabetes mellitus and over 12 years of age were taken up for this study. Patients with known history of thyroid disorder, patients on drugs known to affect thyroid function like lithium, amiodarone, oral contraceptive pills, etc., pregnant mothers, systolic blood pressure more than 150 mm of Hg and diastolic more than 90 mm of Hg, with nephropathy and those patients for whom fundus examination was not possible, patients not consenting for this study were excluded from this study. Data and blood samples will be collected from subjects and serum shall be extracted for thyroid profile. All the study patients will undergo a detailed ocular examination for grading of Diabetic Retinopathy (DR) as per the Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines. RESULTSOdds Ratio (OR) for determining association between risk factor and disease was 5.06, with an upper 95% Confidence Limit of 15.051 and a lower confidence limit of 1.703, which means the odds of a diabetic patient with thyroid dysfunction (subclinical and overt hypothyroidism) developing retinopathy is 5.06 times that of a diabetic patient without thyroid dysfunction. According to this study the prevalence of thyroid dysfunction among the 100 Type 2 Diabetes Mellitus patients studied was 23% with the most common problem being Subclinical Hypothyroidism (SCH) at 21% among the study population followed by overt hypothyroidism at 2%. As expected the prevalence of thyroid dysfunction 3 among females (32%) was much more than among males (14%), the odds ratio being 5.06. Chi-Square statistic applied to our data revealed P-value of <0.005. CONCLUSIONOur study showed a significant association between subclinical and overt hypothyroidism with development of diabetic retinopathy in this study population.
BACKGROUND There has been an increasing interest among ophthalmologists to study the management algorithms of lacrimal gland lesions. Unlike other ophthalmic conditions, lacrimal gland lesions have difficulty in clinical examination, diagnosis and surgical approach, as final diagnosis cannot be accurately predicted. Occurrence of these lesions can have relationship with age, gender, demographic and other socioeconomic factors. Aims and Objectives: To study the demographic profile, clinical features, treatment options and outcome of lacrimal gland lesions; to determine demographic profile, clinical presentation, management algorithm and treatment outcomes of patients with various lacrimal gland lesions.
BACKGROUND The prevalence of glaucoma blindness is about 8% of global blindness and in India is about 4.4%. The Intraocular Pressure (IOP) is a single major modifiable risk factor in glaucoma. In order to integrate IOP and CCT as a single risk factor, a new index 'Pressure-to-Cornea Index' (PCI) was proposed. But studies regarding the fact that the increased values of PCI will be a risk factor for glaucoma are limited. This study attempts to describe the role of PCI as a predictive risk factor in clinical POAG. The aims and objectives of this study are to determine the PCI values in POAG, OHT and NTG and to determine whether PCI can be used as a predictive value in clinical Primary Open Angle Glaucoma (POAG). MATERIALS AND METHODS This observational, cross-sectional type of study was conducted over a period of six months, in 478 eyes of patients attending the outpatient at Govt. Rajaji Hospital, Madurai, who satisfied the inclusion-exclusion criteria. IOP estimation by GAT and CCT measurement by Ultrasound Pachymetry was done in all of them. After routine glaucoma evaluation, they were segregated as Group 1: Normotensives (374), Group 2: Ocular Hypertension (29), Group 3: Normal Tension Glaucoma (28) and Group 4: Primary Open Angle Glaucoma (47). Data collected were entered in Master Chart and statistical analysis was done using software IBM SSPS Ver 21.0 (Armonk, NY) by our statistician. The study groups without clinical POAG are Group 1 and Group 2 (mean PCI value of 92 and 117). The study groups with clinical POAG are Group 3 and Group 4 (mean PCI value of 134 and 171). This study demonstrates a significant correlation between PCI levels and glaucomatous changes in eyes. The PCI value may be also useful in the management of glaucoma for setting a target IOP. RESULTS The obtained 'P' value is < 0.001 which is statistically significant says that there is a difference in the IOP measurements and CCT measurements between the 4 groups (Normal, Ocular Hypertension, Normotensive Glaucoma and Primary Open Angle Glaucoma). CONCLUSION The value of PCI is significantly increased in glaucomatous (POAG and NTG) eyes. This emphasises that PCI can be used as a predictive index in development of glaucomatic changes in optic disc in the population.
BACKGROUND Pseudoexfoliation syndrome is an age-related systemic disease manifesting itself primarily in the eyes and is characterised by the accumulation of microscopic granular amyloid-like protein fibres. Pseudoexfoliation is the most commonly seen identifiable cause of secondary glaucoma. The significance is that, it has a more aggressive clinical course with higher IOP readings and is difficult to treat due to poor response to medications. Aim-To find out the distribution of PCI in patients with Pseudoexfoliation (PXF) and to find out whether PCI can be taken as a predictor for clinical open angle glaucoma (OAG) secondary to pseudoexfoliation. MATERIALS AND METHODSOurs was a non-randomised, cross-sectional observational study conducted over a period of 6 months among 112 eyes of patients above 40 years of age with pseudoexfoliation. The eyes were categorised into the following 4 groups: Group 1-Pseudoexfoliation syndrome; Group 2 -Eyes with pseudoexfoliation with normal corrected IOP but with glaucomatous disc and visual field changes; Group 3 -Eyes with pseudoexfoliation with raised IOP, but with normal disc and visual field; Group 4 -Pseudoexfoliative glaucoma. All the statistical analysis was done using statistical software IBM SPSS Ver. 21.0 (Armonk, NY). RESULTS49 eyes PXS as Group 1, 19 eyes in group 2, 16 eyes in group 3 and 28 eyes in Group 4. Kruskal-Wallis test was used to compare the IOP, CCT and PCI measurements between the groups -P value is <0.001 which is statistically significant. The mean, SD and range in non-glaucomatous and glaucomatous eyes were compared using Rank sum, Mann-Whitney U test -P value <0.001 is statistically significant. This study shows that PCI can differentiate between glaucomatous and non-glaucomatous eyes better than the IOP levels in eyes with Pseudoexfoliation. This can be highly helpful in PXS patients with high PCI, to have a close followup schedule and for early diagnosis and treatment of pseudoexfoliative glaucoma, so that further damage to optic nerve head can be prevented. CONCLUSIONIncreased PCI values in PXG patients can more accurately indicate the severity of glaucoma.
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