Divya Raichandani

Abstract

Introduction: The retinal nerve fibre layer is a most crucial indicator of optic nerve damage in glaucoma as it advances visual field loss. Thickness of the RNFL can be measured using high resolution OCT. We conducted this study to evaluate the alterations in retinal nerve fibre layer thickness measured by SD- OCT in ametropes and to find various factors affecting RNFL thickness. Aim: Study of retinal nerve fibre layer thickness (RNFL) by Optical Coherence Tomography (OCT) in ametropes in tertiary care hospital of central India. Setting and Design: Hospital based prospective observational study included 300 eyes of 150 participants. Visiting ophthalmology outpatient department Gandhi medical college and fulfilling the inclusion and exclusion criteria. Materials and Methods: Patients were divided into five groups of 60 eyes each on the basis of refractive status of eyes into emetropia, low hypermetropia, moderate hypermetropia, low mypopia and moderate mypopia. Subjects were subjected to OCT scan and RNFL thickness was measured. All groups were evaluated and observations were noted and results were analysed. Statistical Analysis used: To find the association between degree of ametropia and RNFL thickness one way ANOVA test was used. Correlation between axial length and RNFL was assesed by pearson correlation coefficient. p value Result: RNFL thickness in different groups followed ISNT rule with inferior quadrant showing the greatest thickness followed by the superior, nasal and temporal quadrants. The average RNFL thickness in emmetropics, Low hyperopic, Moderate hyperopic, Low myopic, Moderate myopic was 111.90?m, 110.58 ?m, 114.59 ?m, 103.33 ?m, 93.33 ?m respectively, wheras average axial length was 23.85mm, 22.36mm, 21.33mm, 24.72mm, 25.63mm. Conclusion: With the help of OCT, we can differentiate the changes in RNFL thickness in various refractive errors. So, the refractive status of the eye should be kept in mind before making any ocular diagnosis in which the RNFL is a diagnostic criteria.   Keywords: Spectral domain optical coherence tomography (SD-OCT), Retinal nerve fibre layer (RNFL) thickness, Refractive errors (RE).

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Abstract

Introduction: The study aimed to assess the prevalence of ocular involvement in children 6 months to 5 years attending tertiary care centre with Severe Acute Malnutrition and to detect the associated risk factors for ocular morbidity in severe acute malnutrition. Methodology : This hospital based observational study was carried out at Gandhi Medical College, during the study period of 2 years on children diagnosed with SAM belonging to 6 months to 5 years of age. Detailed history was obtained and physical, systemic and ocular examination was done. Results: A total of 100 severe acute malnourished children were included. Prevalence of ocular involvement in severe acute malnourished children was 72%. Conjunctival pallor was observed in 71.5% eyes and retinal hemorrhages were most common posterior segment finding. Vitamin A deficiency signs were observed in 17 eyes (8.5%). Higher birth order and number of sibling was significantly associated with higher incidence of ocular manifestations (p0.05). Conclusion: Training should be given to health workers at the primary health care level and health centers on counseling mothers on feeding, growth monitoring, the preventable eye blinding diseases and hygiene during the vaccination sessions and early referral of children with eye signs to hospitals. Also education of couple regarding proper nutrition of mother and child should be encouraged and couples should be insisted to have not more than two children.   Keywords: Anterior segment, Ocular morbidity, Prevalence, Sam, Vitamin a deficiency

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