Somesh Aggarwal

Abstract

Introduction: Penetrating ocular injuries with intraocular foreign bodies may result in severe visual loss. The posterior segment IOFBs are best treated by pars plana vitrectomy. Aims: To correlate the shape, size and location of posterior segment intraocular foreign bodies with visual outcome and its prognostic factors. Setting and Design: Tertiary care center of ophthalmology, Ahmedabad , India Materials and Methods: This is a prospective study of 40 eyes of 40 patients who underwent Pars Plana Vitrectomy for the removal of posterior segment intraocular foreign bodies in Regional Institute of India. We studied the following parameters: age, gender, wound site, IOFB characteristics (shape, size, location), initial and final visual acuity. Results: Among the study participants, 19 worked in factories, 6 were housekeepers, 7 were farmers and the remaining 5 patients were either unemployed or retired at the time of the injury. The foreign body was embedded in the surface of the retina (32.5%), located in the vitreous (55%) and in the sclera (12.5%). Nine patients (22.5%) developed delayed Retinal Detachment, which was the largest single cause of blindness in this group. Conclusion : Our study concludes that the larger the size of posterior segment IOFB, presence of preexisting or secondary RD, vitreous hemorrhage poorer the prognosis. We also emphasize the use of protective eye equipments at workplace in preventing this disability caused by penetrating ocular injury. Keywords: Intraocular foreign body, Pars plana Vitrectomy, Penetrating ocular injury, Industrial hazards.

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Abstract

Objective: This study is aimed at establishing the incidence of different morphological types of diabetic macular edema on OCT in the Western Indian population. Design: The study was a retrospective, observational, cross-sectional study based on hospital records. Setting: M and J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, India. Subjects: 206 eyes of 105 patients were studied, out of which 65 were men (61.90%) and 40(39.10%) were women. The age of patients ranged from 30-80 years (mean 56 years). Intervention: No intervention was done for the purpose of the study. Main outcome and Measures: The incidence of different morphological types of macular edema on OCT was calculated. Results: The incidence of various types of ME was same across all age groups as well as both gender groups. The incidence was as follows: no macular edema in 18.93% patients, focal macular thickening in 13.1%, diffuse non cystoid macular edema in 12.13%, diffuse cystoid macular edema in 24.75%, tractional macular edema due to posterior hyaloid traction in 2.91%, tractional edema due to epiretinal membrane in 8.73%, both posterior hyaloid traction and epiretinal membrane in 3.39% and macular serous retinal detachment in 16% patients. Conclusion: With the availability of the geographical distribution of different types of DME, treatment of DME can be tailored to the population. Also, the causes of such a difference in incidence of various patterns of DME in different populations can be established with further studies. Keywords: Diabetic macular edema (DME), Optical coherence tomography (OCT).

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Abstract

Objective: The aim of this study is to compare the sensitivities of chart 1 and chart 7 of the Amsler grid in early detection of metamorphopsia suggestive of diabetic macular edema. Design: It was a randomized, prospective, analytical study. Eighty patients were divided into two equal groups- A and B. Group A patients were given Amsler chart 1 and group B patients given Amsler chart 7.Regular 3 monthly follow up was done for 2 years with Optical Coherence Tomography (OCT) to detect DME on every follow up. Setting: Retina Unit, M And J Western Regional Institute Of Ophthalmology, Civil Hospital, Asarwa, Ahmedabad, Gujarat, India. Subjects: 80 eyes of 80 patients were enrolled, equally divided into 2 groups of 40 patients each. Intervention: No intervention was done for purpose of study. DME was treated as per clinical guidelines. Main outcome and Measures: Sensitivity and Specificity of both Amsler chart were calculated and compared using statistical analysis. Results: The sensitivity of Chart 1 of Amsler grid in detecting metamorphopsia was 56.25 percent, whereas the sensitivity of Chart 7 of Amsler grid was 76.47 percent. The difference was statistically significant (P< 0> Conclusion: Amsler grid type 7 is a superior tool in detecting metamorphopsia due to macular edema than type 1 conventional Amsler grid. Keywords: Amsler grid, Diabetic macular edema

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