Anupama B

Abstract

Introduction: Preterm babies often suffer from various systemic illnesses and struggle for survival in the neonatal intensive care unit (NICU). These preterm babies are at risk of developing ROP which is a potentially blinding condition. The presence of predisposing maternal and neonatal factors contributes for the development of ROP. Determining the association of risk factors with the development of ROP is essential in improving the screening and management of ROP. Aim: To determine maternal, neonatal risk factors and influence of retinal immaturity at first screening for development of ROP. Settings and design: Prospective, observational study conducted at a level of 3 PICU & department of ophthalmology. Methods and Materials: All the preterm infants with gestational age ? 37 weeks admitted in NICU were first screened by 2 to 3 weeks of chronological age and followed up till the completion of retinal vascularization and regression of ROP following treatment. The zone of retinal vascularization at first screening and various maternal and neonatal risk factors were noted. Results: Out of 166 babies screened, 18.67% progressed to ROP. Of the 36 babies with immature retina 58% developed ROP, while 7.7% neonates with mature retina developed ROP. Gestational age, birth weight, retina immaturity, respiratory distress syndrome and anaemia of prematurity were statistically significant for ROP. Statistical analysis: Descriptive statistics was used to identify the association of risk factors with the development of ROP. Each risk factor was analyzed by univariate & multivariate logistic regression. Conclusions: Low birth weight, low gestational age, immature retina and neonatal risk factors have a significant influence on the development of ROP. Key Messages: Low birth weight, low gestational age and retinal immaturity are important risk factors for Retinopathy of prematurity. Keywords: Immature retina, Gestational age, Birth weight, Neonatal/maternal risk factors, Retinopathy of prematurity

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Abstract

Aims: This study is aimed to assess the effect of retinal photocoagulation on contrast sensitivity and visual acuity. Materials and Methods: In this prospective observational study,patients with diabetic retinopathy in either one or both eyes requiring retinal photocoagulation were included in the study. Eyes which were subjected to treatment for diabetic retinopathy were divided into 3 groups. Group 1 included eye which were subjected to pan retinal photocoagulation (PRP) alone, Group 2 included eyes which were subjected to PRP and macular laser (ML) and Group 3 included eyes which were subjected to ML alone. Assessment of visual acuity and contrast sensitivity were done before and three months post retinal photocoagulation.Descriptive statistics were used and where required. paired t test, One- way, ANOVA, Post HOC tests, Tukey HSD tests were used. The sample size was calculated to be 64 eyes. Results: Total of 64 eyes of 37 patients, underwent retinal photocoagulation for diabetic retinopathy. Out of the 37 patients, only 16 patients (29 eyes) came for follow up at the end of 3 months of laser photocoagulation. Number of eyes requiring PRP was more when compared to PRP with ML and ML alone. Pre-laser and post-laser visual acuity following PRP, remained unchanged. Improvement in visual acuity was seen in eyes that underwent ML alone. There was worsening of visual acuity in eyes that underwent combination of PRP and ML. However, p value was not significant. Pre-laser and post-laser contrast sensitivity, improved in eyes that underwent only PRP and macular laser alone. There was a reduction in CS when both forms of treatment were combined, though p value was not significant Conclusions: Eyes which underwent PRP alone, showed improvement in contrast sensitivity without any change in visual acuity. While reduction in visual acuity and contrast sensitivity was observed in eyes which underwent combination treatment (PRP and ML), there was improvement in visual acuity and contrast sensitivity in eyes which underwent macular laser alone. Key Messages: Contrast sensitivity is necessary component of visual function. Abnormal contrast sensitivity can affect day to day activities. Hence it is important to counsel patients about the possibility of contrast sensitivity being affected to some extent following laser treatment for diabetic retinopathy.   Keywords: Contrast sensitivity, Diabetic retinopathy, Pan retinal photocoagulation, Visual acuity

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Abstract

Introduction: Aim of the study was to measure the visual function and quality of life amongst cataract patients attending camps. Methodology: A cross sectional study was conducted among patients attending Ophthalmology camp and having impaired vision due to cataract. This study was approved by the Institutional Ethics Committee. After obtaining informed consent, validated questionnaires developed by Aravind Eye Hospital, to measure the Visual functioning (VF) and Quality of Life (QOL) were administered to the patient. Results: A total of 324 patients (201 males and 123 females) with mean age 54.33 years (SD=8.99) were interviewed. Nearly half (46.9%) of the patients had severe or grade IV visual impairment as per WHO criteria of visual impairment. Two-thirds participants admitted that impaired vision adversely affected activities of daily living. The various sub scales studied in QOL questionnaire were: self care, mobility, social and mental problems due to impaired vision. All of these were almost equally affected due to cataract. Total VF score differs significantly (p<0.0005) for various visual impairment categories, except between category 2 and 3, where there is no significant difference (p=.695). In the QOL score there exists significant difference (p<0.0005) between group 1 with respect to other groups of visual impairment. VF & QOL score had no statistically significant association with age, gender and socioeconomic class. Conclusion: The visual function score and the quality of life score worsen as the visual acuity deteriorates due to cataract. Hence we need to strengthen our outreach programs so that we diagnose and treat cataract early leading to better quality of life. Keywords: Visual function, Quality of life.

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