Clinical profile and demographic distribution of band shaped keratopathy in India: A study of 8801 patients.

Purpose: To describe the clinical profile and demographic distribution of band-shaped keratopathy (BSK) in patients presenting to a multitier ophthalmology hospital network in India. Methods: This cross-sectional hospital-based study included 2,664,906 new patients presenting between January 2011 and January 2021 (10-year period). Patients with a clinical diagnosis of BSK in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 8801 (0.33%) patients were diagnosed with BSK. The prevalence rates were 0.47% in children (age: <16 years) and 0.31% in adults. The majority of patients were males (62.87%) with unilateral affliction (85.21%). The mean age of the patients was 40.43 ± 23.14 years. The majority (16.93%) of the patients were in the age bracket of 11-20 years. A larger proportion of the patients were from higher socioeconomic status (60.46%) and the urban region (45.9%). Of the 10,103 eyes affected with BSK, the common ocular comorbidities were status post-vitreoretinal surgery (20.55%) and uveitis (12.7%) in children and corneal scar (41.23%) and spheroidal degeneration (13.7%) in adults. Most of the eyes had mild or no visual impairment (24.74%). Among the eyes that needed surgical intervention, chelation with ethylenediaminetetraacetic acid (EDTA) was the most performed surgical procedure (1.68%) along with phototherapeutic keratectomy (0.32%). Conclusion: BSK commonly affects adult males and is unilateral in nature. The majority of the patients in this cohort belonged to higher socioeconomic strata and urban geography. At initial presentation, visual impairment was mild to moderate in a vast majority of the patients, and the most common surgical intervention performed was chelation with EDTA during the study period.

Clinical profile and demographic distribution of pellucid marginal corneal degeneration in India: A study of 559 patients.

PURPOSE: The aim of this study was to describe the clinical profile and demographic distribution of pellucid marginal corneal degeneration (PMD) in patients presenting to a multitier ophthalmology hospital network in India. METHODS: This cross-sectional hospital-based study included 2,470,793 new patients presenting between September 2012 and September 2020 (~8 years period). Patients with a clinical diagnosis of PMD in at least one eye were included as cases. The data were collected using an electronic medical record system. RESULTS: Overall, 559 (0.02%) new patients were diagnosed with PMD. The prevalence rates were 0.004% in children (age <16 years) and 0.03% in adults. The majority of patients were males (70.13%) with the bilateral affliction (77.1%). The mean age of the patients was 37.91 ± 13.19 years. The majority (30.23%) of the patients were between 31 and 40 years of age. A significant number of patients were from higher socioeconomic status (93.74%) and from the urban region (45.08%). Of the 990 eyes, the most common clinical signs were ectasia/thinning (58.99%), corneal scar (17.47%), and corneal hydrops (1.01%). The majority of the eyes (87.97%) were managed with either spectacles or contact lenses. Among those who had surgical intervention, collagen cross-linking was the most performed procedure (5.25%) followed by cataract surgery (4.14%). CONCLUSION: PMD is a rare disease affecting patients seeking eye care in India. It commonly affects adult males and is bilateral in nature. The disease progression is slow and usually occurs beyond 3 years. Conservative management is more common than surgical intervention.

Comparing the Structure-Function Relationship at the Macula With Standard Automated Perimetry and Microperimetry.

PURPOSE: To compare the structure-function relationship between ganglion cell-inner plexiform layer (GCIPL) thickness measurements using spectral-domain optical coherence tomography (SDOCT) and visual sensitivities measured using standard automated perimetry (SAP) and microperimetry (MP) at the macula in glaucoma. METHODS: In a prospective study, 45 control eyes (29 subjects) and 60 glaucoma eyes (45 patients) underwent visual sensitivity estimation at the macula (central 10°) by SAP and MP, and GCIPL thickness measurement at the macula by SDOCT. Structure-function relationships between GCILP thickness and visual sensitivity loss with SAP and MP at various macular sectors were assessed using the Hood and Kardon model. To compare structure-function relationship with SAP and MP, we calculated the number of data points falling outside the 5th and the 95th percentile values of the Hood and Kardon model with each of the perimeters. RESULTS: The number of points falling outside the 5th and 95th percentile values of the Hood and Kardon model ranged from 28 (superior sector) to 48 (inferonasal sector) with SAP and 33 (superior sector) to 49 (inferonasal sector) with MP. The difference in the number of points falling outside the 5th and 95th percentile values with SAP and MP was statistically insignificant (P > 0.05, χ(2) test) for all the sectors. CONCLUSIONS: Visual sensitivity measurements of both SAP and MP demonstrated a similar relationship with the GCIPL measurements of SDOCT at the macula in glaucoma.

Structure-Function Relationship in Glaucoma Using Ganglion Cell-Inner Plexiform Layer Thickness Measurements.

PURPOSE: To evaluate the structure-function relationship between ganglion cell-inner plexiform layer (GCIPL) thickness at the macula and 10-2 standard automated perimetry (SAP) in glaucoma and to evaluate the relationship using a recently proposed linear model. METHODS: In a cross-sectional analysis, structure-function relationship was determined in 50 glaucomatous eyes (40 patients, mean deviation: -15.4 ± 7.5 dB) and 21 control eyes (13 subjects, mean deviation: -3.4 ± 3.0 dB), which had undergone 10-2 SAP and GCIPL imaging on the same day. Functional loss was derived from total deviation numerical values on 10-2 SAP and calculated on both a linear (reciprocal of Lambert) and a decibel scale after accounting for the retinal ganglion cell displacement at the macula. Strength of relationship was reported as coefficient of determination (R2) of the linear regression models fitted to the data separately for different sectors. The relationship was also evaluated using a linear model. RESULTS: The R2 for the associations between GCIPL thickness sectors and the corresponding sector SAP total deviation values ranged from 0.19 (for superonasal GCIPL sector) to 0.60 (for average GCIPL thickness) when functional loss was calculated on the decibel scale and 0.16 (for superonasal sector) to 0.54 (for inferior sector) on the linear scale. All associations were statistically significant (P < 0.05). The linear model fitted the data reasonably well. CONCLUSIONS: Significant structure-function associations were found between GCIPL thickness measurements at the macula and the functional loss measured on 10-2 SAP in glaucoma. Best fit was found for the inferior and average GCIPL sector thickness. The linear model was useful to study the structure-function relationship.