Purpose:
This purpose of this study was to find the association between severity of visual impairment and retinal nerve fiber layer (RNFL) thickness loss in different demyelinating diseases using optical coherence tomography (OCT) and, simultaneously, assess the fellow eye for subclinical RNFL thickness loss.
Methods:
This cross-sectional, observational study included 60 eyes of 30 patients above the age of 20 years with diagnosed cases of multiple sclerosis (MS), neuromyelitis optica (NMO), and clinically isolated syndrome (CIS) who had history of (h/o) optic neuritis (ON) attack were included. Participants included in the study group underwent best-corrected visual acuity (BCVA) measurement, color perception, swinging flashlight test, slit-lamp examination, and dilated fundus examination (DFE). RNFL thickness was measured using spectral domain OCT (SD-OCT) (Optovue RTVue-V6.11 A Fourier). Intergroup analysis of RNFL thickness was done using a Chi-square test (
P
< 0.05 was considered significant). Spearman’s rank correlation coefficient (Spearman’s ρ) was used for association (ρ < 0.963 was considered significant).
Results:
RNFL thickness was significantly reduced in patients with NMO than MS, while all patients of CIS had the highest RNFL thickening (
P
= 0.00048). Lower visual function scores correlated with reduced average overall RNFL thickness, and this association was statistically significant in affected (
R
= 0.942) and fellow eyes (
R
= 0.963).
Conclusion:
The severity of visual impairment significantly correlated with the severity of axonal loss in affected as well as the fellow eye. NMO is associated with more widespread axonal injury in the affected optic nerve. Hence, RNFL thickness is an indicator of the progression of visual impairment in demyelinating diseases and OCT can help distinguish the etiology and, therefore, may be useful as a surrogate marker of axonal involvement in demyelinating diseases.
To study the clinical profile of anterior uveitis in patients attending the Ophthalmology department of tertiary health centre of central India A cross-sectional, observational study was done in the department of Ophthalmology of tertiary health centre from January 2017 to July 2019. A total of 199 cases of anterior uveitis were studied to assess their clinical presentation and etiology. After thorough history taking, demographic data and clinical pattern were documented. Comprehensive ophthalmic evaluation, necessary laboratory investigations and radiological imaging were performed to establish the etiology. The maximum number (n=79; 39.7%) of patients were in the age group of 21-40 years and the mean age of the study subjects was 36.9+21.8 years. The male to female ratio was 1:1.42 (117 females, 82 males). Uniocular disease was found in 91.95% cases and majority (n=175; 87.93%) of the patients had acute presentation with 95.47% cases having non granulomatous uveitis. A specific diagnosis could not be made in 62.8% cases. Trauma (21.7%) was the most common cause in patients with a specific diagnosis. Persistent posterior synechiae was the most frequently seen complication (21.08%) although majority of the patients (66.8%) did not reveal any major complications.Patients with anterior uveitis most commonly had acute presentation. The disease was rarely bilateral and was mostly non-granulomatous in presentation. It was mostly idiopathic and among the known etiological factors, trauma was the most common cause.
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