Amod Hansdak

Abstract

Background: Hypertension is a leading cause of morbidity and mortality and is associated with the risk of cardiovascular, cerebrovascular disease, and target organ damage. The risk increases exponentially in individuals with diabetes. Hypertensive retinopathy is a marker for target organ damage, so screening for hypertensive retinopathy helps in cardiovascular risk stratification. This study was conducted with an objective to screen for hypertensive retinopathy among known diabetics using a portable non-mydriatic fundus camera to ascertain its prevalence. Materials and Methods: The study was conducted in three selected field practice areas of the Department of Community Medicine. A house-to-house survey was performed using a predesigned, pretested questionnaire among 302 known diabetics. The study participants were subjected to visual acuity examination using Snellen's chart and retinal fundus examination using a portable non-mydriatic Bosch Mobile Eye Care Solutions fundus camera. The fundus images were transferred to a laptop and were reviewed and graded by an experienced Ophthalmologist. Results: Among the 302 participants studied, 60 were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy among diabetic patients was 19.9 % (95% CI: 15.7% - 24.6%). The prevalence was found to be higher in ** (21.8%; 95% CI: 16% - 28.6%) as compared to ** (17.5%; 95% CI: 11.8% - 24.6%). Conclusion: Early detection of hypertensive retinopathy with cardiovascular risk stratification and initiation of prompt treatment among the high-risk individuals will help reduce the morbidity caused due to end-organ damage and premature mortality to a greater extent and will pave the way forward to achieving sustainable developmental goals.   Keywords: Hypertensive retinopathy, Non­mydriatic fundus camera, Prevalence

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Abstract

We present a case series of late-onset Pseudophakic cystoid macular edema who presented 10 years to 4 years after cataract surgery with recent-onset diminution of vision. Their vision in the affected eye ranged from 6/24 with an OCT macular map showing multiple cystoid spaces suggestive of cystoid macular edema. Other causes for CME were ruled out. The central macular thickness ranged from 577 to 557 microns. All the patients received a single dose of 0.1ml of 4mg/ml intravitreal triamcinolone acetonide. On the first postprocedure day, all the patient’s visual acuity had improved to 6/6 and OCT showed a significant reduction in central macular thickness to 387-301 microns. This improvement in vision and macular thickness persisted at 3 months follow up. Late-onset of pseudophakic cystoid macular edema is a rare cause of postoperative vision loss, economically and easily treatable with a single dose of intravitreal triamcinolone. Keywords: Intravitreal triamcinolone, Pseudophakic cystoid macular edema.

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Abstract

Introduction: This study was undertaken to find out the ocular manifestations of diabetes mellitus among diabetics reporting to a tertiary health care facility in Pondicherry. Materials and Methods: Seventy diabetic patients reporting to Ophthalmology outpatient department were studied during the months of August and September 2017. A predesigned questionnaire was used to interview the diabetics, anterior segment examination was carried out using torchlight and slit lamp, and +90D lens was used for fundus examination. The findings were recorded and analyzed using Microsoft Excel and Epidata respectively. Result: Most of the study subjects belonged to the age group 41-70 years, literate, employed, and middle income group. Cataract and retinopathy were found to be higher in those with more than 10 years’ duration of diabetes. Conclusion: Healthcare providers need to focus their efforts on preventive measures to delay the onset of complications of diabetes. The importance of screening for diabetes and diabetic retinopathy and regular follow-up cannot be overemphasized in order to reduce the burden of disease and its devastating consequences. Keywords: Diabetes mellitus, Diabetic retinopathy, Risk factors.

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