Nischala Balakrishna

Abstract

Introduction: Oguchi disease also called congenital stationary night blindness is an autosomal recessivegenetic condition first identified in Japan with a few cases reported in other countries like Europe, America, India and Pakistan. We report one such case exhibiting the Mizuo-Nakamura phenomenon with a reduced amplitude on the b-wave of the rod electroretinogram advocating this diagnosis. Case Report: A 40-year-old man presented with complaints of non-progressive decrease in vision as the day progressed for 6 months with normal vision during the day in both eyes. There was no history of trauma or any other ocular or systemic disease. His parents had a second-degree consanguineous marriage and his father experienced similar symptoms. Visual acuity for distance was 6/6 and N6 for near in both eyes. His anterior segment and posterior segments were normal. When the patient was put to dark adaptation for 3 hours, there was a change in his fundus background colour from grey to red (Mizuo-Nakamura phenomenon). The b-wave amplitude was decreased on the rod electroretinogram. The cone electroretinogram on the other hand was normal. All this was confirmed by his genetic study which favoured this diagnosis. Conclusion: This disease presents with features similar to retinitis pigmentosa in terms of mutations in the SAG gene. This highlights the importance of the Mizou-Nakamura phenomenon in formulating a confirmatory diagnosis and treatment protocol. Keywords: Congenital stationary night blindness, Mizuo-Nakamura phenomenon, Oguchi disease, Rod electroretinogram.

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Purpose: To study the outcome of amniotic membrane graft versus conjunctival autograft after primary pterygium excision surgeries amongst various genders and age groups and to compare recurrences, complications and pre and post-operative astigmatism in various grades of nasal and temporal pterygium. Materials and Methods: A total of 90 eyes of 90 patients with previously unoperated primary pterygium were enrolled in a randomised control trial. The patients had a follow-up of 6 months during analysis and the results were compared retrospectively with patients who had pterygium excision surgeries with conjunctival autografts performed by the same surgeon. Results: A higher proportion of males underwent grafting with amniotic membrane while more females underwent conjunctival autografting. The p value =0.011 was significant. A higher proportion of patients were between the ages of 31-40 years and the p value=0.001 was significant. A majority of patients from both groups had nasal pterygium with p value=0.026 being significant. The overall astigmatism pre operatively from both groups=0.431 and 0.143 postoperatively. Conclusion: Amniotic membrane grafting in primary pterygium surgery led to fewer complications, recurrences and astigmatism postoperatively and was more useful in patients who may have lesser amounts of conjunctiva for future surgeries. Keywords: Pterygium excision, Amniotic membrane graft, Conjunctival autograft.

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Aims: To study the statistics of the epidemiology, co-morbidities, clinical presentations, management and prognosis of the study group. Materials and Methods: This is a retrospective study conducted in a tertiary care hospital in South India, among 100 subjects, between May 2021 and August 2021 when the Mucor mycosis cases were frequently being diagnosed and treated amongst COVID-19 infected patients. The results showed that 34.0% were between 51-60 years with 100% patients confirmed COVID positive through RTPCR tests. 86.0% had confirmed mucor on CT scan. 50.0% had both eyes vision of 6/60 on presentation. 67.% had periorbital swelling with 51% having prior co-morbidities.63.0% patients received tablet Posaconazole 30mg as medical treatment and 60.0% required no surgical management.10.0% required orbital exenteration and 21.0% required partial maxillectomy.2% experienced orbital apex syndrome as associated complications.97.0% were discharged post treatment with 3% mortality. There was a positive correlation of medical management with respect to anterior segment and posterior segment findings P Conclusion: This study shows that immune suppression is directly related to infectivity by mucor mycosis. In order to contain symptomatology and grave prognosis amongst patients, early diagnosis, affordable treatment and follow-up including patient education about the etiology and pathogenesis of the disease must be available.   Keywords: Mucor mycosis, Corona virus, Rhino­orbito­cerebral mucor mycosis, Black Fungus, Immune suppression

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