Aliya Sultana

Aim: Purpose is to study the various typical and atypical manifestations of the retinoblastoma presented to our department. Study Design: Prospective study. Duration of the Study: 2 years, January 2020 to December 2021. Methodology: All children presented with various signs and symptoms and cases with tumour suspicious manifestations were evaluated. Detailed birth history from parents, slit lamp examination, indirect ophthalmoscopy, B Scan, CT Scan Orbit (plain and contrast), MRI Orbit (plain and contrast) when tumour extension was suspected and documentation done in all cases. Results: Atypical manifestations requires proper evaluation to exclude Pseudo retinoblastomas. Many clinical conditions will masquerade the tumour and cause confusion in diagnosis. Pseudo retinoblastomas which reported in our study were commonly PHPV and Coats disease. One case of Retinoblastoma was also presented like Ocular cysticercosis with inflammatory signs in anterior and posterior segment, oral steroids were given, vitreous seeds which were present in anterior chamber disappeared after steroids and fundus showed creamish white lesion filling the entire vitreous cavity. Masquerades will cause delay in the diagnosis, which can lead to extension of tumour. Conclusion: Diagnosis is not easy, most of the times in children particularly when media is not clear, delay in diagnosis may require enucleation where globe salvage may not be possible, sometimes intracranial extension of the tumour will increase the mortality.   Keywords: Calcification, PHPV, Coats disease, Orbital inflammation, Leukocoria, Retinoblastoma.

Purpose: Aim of our study is to study the various ocular manifestations and management in hypertensive patients. Materials and Methods: This was retrospective interventional study conducted over a period of 5 years from January 2016 to December 2020. All patients of all age group having primary and secondary hypertension, referred from physicians for screening were included. Exclusion criteria: Patients with associated diabetes mellitus were excluded. 421 patients who presented to our retina clinic underwent detail ocular and systemic examination. BCVA, slit lamp examination, fundus examination, B scan, OCT, FFA and documentation done in all cases. Patients presented with various ocular manifestations were managed based on the clinical status. Consent was taken for the management. Results: Patients with ischemic retina showed poor outcome, patients with early presentation showed good outcome. Conclusion: Hypertension is one comorbidity which is responsible for eye problems, need frequent screening, fundus examination is non-invasive procedure which helps in detecting the vascular changes early.   Keywords: Hypertension, RVO, RAO, AION, OIS, RAM, CKD, SLE, PRE Eclampsia

Aim: To study the various causes, clinical presentation, management and outcome of the retinal vasculitis cases at tertiary eye care centre. Source of Study: Tertiary eye care centre, Telangana State, South India. Study Design: Retrospective Interventional Study. Duration of Study: Jan 2016 to Dec 2020. Materials and Methods: Fifty one patients of retinal vasculitis presented with various clinical manifestations were examined in detail and managed. Data collected from medical records. All young patients of different age group presented with retinal vascular changes are included in the study. Patients underwent examination and laboratory workup. Few patients showed ocular and systemic investigations were with in the normal limits. These patients were considered as idiopathic cases. BCVA, slit lamp examination, fundus examination, FFA, OCT, B SCAN in hazy media and documentation done in all cases. Bilateral presentation was common, some presented with aggressive disease in both eyes (early and delayed presentation). Common presentation was blurred vision and sudden drop of vision. Few patients showed tuberculin skin test positive and managed as presumed ocular tuberculosis. Patients who were HIV positive managed with HART, prognosis was poor in these patients. Medical and surgical management done based on the stage of presentation, oral steroids, laser therapy, anti VEGF followed by pars plana vitrectomy with or with silicone oil tamponade done. Oral steroids were started after physician clearance and tapered based on the activity of the disease. Patients followed regularly every month till the activity ceases in medically managed cases and in operated cases we followed till the silicone oil is removed from the eye. Few patients presented with the reactivity of the disease were managed again based on the presentation. Results: Results were good in idiopathic cases, patients presented with inflammatory and ischemic stages also showed good outcome. Patients presented with proliferative stage showed fair outcome, patients presented with severe proliferative stage showed poor prognosis. Conclusion: Retinal vasculitis is one of the ocular condition which can cause vision loss in young adults, if present in early stage, can be managed medically. Prognosis is good in early stages. Recurrent vitreous haemorrhage, tractional retinal detachment, combined retinal detachment were common presentations. Infective cases showed more proliferative changes. Risk of neovascular glaucoma is one of the cause of blindness.   Keywords : Retinal vasculitis (RV), Neo vascular glaucoma (NVG), Pan retinal photocoagulation (PRPC).

Aim: Needle perforations can present with various clinical manifestations, management depends on the clinical presentation. Our aim is to know the outcome in all cases of needle penetration with different clinical presentation. Study Design: We have done retrospective study of block related globe perforation cases who presented to the vitreo retina Department at Sarojini Devi Eye Hospital. We collected the data of these patients from the medical records who presented during January 2017 to December 2017. Materials and Methods: All patients who presented to our department underwent detailed ocular examination. Apart from history BCVA, slit lamp examination, fundus examination and b scan in patients with hazy media due to vitreous haemorrhage done. Results: Total 11 patients presented to our department, patients with retinal breaks barrage laser done, did not require any further procedure. These patients had good outcome due to peripheral retinal break. 1. Patients with retinal breaks and vitreous haemorrhage without retinal detachment also had good outcome; 2. Patients with retinal detachment and delayed presentation had poor anatomical and visual outcome; 3. Patients with pale retina and patients where retinal detachment (RD) associated with choroidal detachment (CD) had poor visual outcome. Conclusion: Iatrogenic ocular perforation is an ocular emergency, need to be treated immediately to prevent blindness. Keywords: CD, Globe perforation, Retinal break, PVR, RD, VH.

Aim: Aim of our study is to identify the peripheral retinal diseases in patients which is responsible for macular oedema causing visual loss in various age group of patients. Materials and Methods: In this retrospective study 30 patients of macular oedema presented to our department between January 2020 to December 2021 were examined in detail. Proper history taking, BCVA, slit lamp examination, fundus examination with indirect ophthalmoscopy, fundus fluorescein angiography (FFA), OCT to quantify macular oedema and documentation done in all cases. Patients were managed with pan retinal photo coagulation, intra vitreal steroids and anti vegf were given to treat macular oedema. Results: BCVA, fundus examination, FFA and OCT done in all cases, most of the patients showed good outcome with anti vegf, steroid injections and pan retinal photo coagulation, but reoccurrence of macular oedema noted in few cases after one year in cases where the cause of macular edema was not detected even after FFA. Conclusion: Peripheral examination of fundus is very important to diagnose these conditions, FFA has major role in studying the peripheral retina particularly in conditions where the clinical presentation is not apparent.   Keywords: FFA, Von hippel tumour, CH, PRVO, Intermediate and posterior uveitis (IU&PU), Retinitis pigmentosa (RP), Idiopathic peripheral retinal telangiectasia's (IPRT)

We report a case of middle aged immunocompromised female with cytomegalovirus retinitis presenting with green reflex in pupillary y area of Right eye, her chief complaints were diminished vision in both eyes since one month, she was on HART for 3 years, discontinued for one and half year and again started after the advice of physician, apart from history, systemic and ocular examination done in detailed. BCVA, slit lamp examination, indirect ophthalmoscopy, FFA, B Scan and documentation done, Right eye was observed to note the further changes in fundus where as Left eye was treated with intra vitreal injection Ganciclovir to preserve the vison. Patient treated with intra vitreal Ganciclovir 500 micro grams, twice weekly with interval of 3days for three weeks, once the activity is decreased, injections were given weekly once, same dose continued for three more weeks and advised to follow every month to observe the fundus changes in left eye. Every visit patient was examined in detail, BCVA, anterior segment, fundus and also OCT in left eye to see the central macular thickness. Documentation done in every visit, macular changes after intra vitreal injection was documented by taking both horizontal and vertical OCT.   Keywords: Immunocompromised