Diabetes Mellitus Diabetic Macular Edema In Association With Diabetic Retinopathy In Patients Of Type 2 Diabetes Mellitus

Diabetic Retinopathy is an important cause of blindness with diabetic macular edema(DME) affecting 15% of patients 15yrs after diagnosis. The prevalence of diabetes mellitus(DM) is expected to approximately double globally between 2000 and 2030. The burden of DME is likely to increase as prevalence of DM is expected to rise by 50% globally, from 2000 to 2030. Therefore, is a major cause of concern. To study diabetic macular edema prevalence and pattern in association with severity of diabetic retinopathy in patients of type 2 diabetes mellitus. 300 patients with type 2 diabetes mellitus were included in anobservational cross sectional study. Clinical assessment was done by recording Visual acuity by Snellen's drum test, slit lamp examination, direct and indirect ophthalmoscope, fundus examination with +90 D lens, Goldman applanation tonometry, gonioscopy, Cirrus SD-OCT macula and fundus photography. Among 600 eyes, prevalence of DME was 14.0% and 24.3% in NPDR and PDR eyes respectively. Statistically, this difference was not significant (p=0.226).Among the categories of diabetic retinopathy, a significant increase in prevalence of DME was observed with increasing severity of NPDR (p<0.001). Among 87 eyes with DME, the pattern of DME was 59.8% with diffuse retinal thickening, 21.8% with cystoids macular edema and 18.4% with serous retinal detachment. Prevalence of DME was more in NPDR group increasing with severity of NPDR. The prevalence of DME pattern of diffused retinal thickening was most followed by cystoid macular edema and serous retinal detachment among those with diabetic retinopathy.

Drug Idiosyncrasy In Ophthalmic Practice

Idiosyncratic drug reactions, denoting non-immunological hypersensitivity to a substance, have been a neglected entity. The idiosyncrasy, more often than not, is confused with hypersensitivity, which is an undesirable reaction of normal immune system. The present article gives an insight of the various aspects of idiosyncrasy and idiosyncratic responses of drugs commonly used in ophthalmic practice.

Clinical profile of herpes zoster ophthalmicus.

Herpes zoster ophthalmicus was seen in 22 cases out of 195 cases of herpes zoster (11.3% incidence). It was affecting mainly adults (90.9%). Oedema over the lids (81.8%) was invariably present and lead to ptosis. Mucopurulent conjunctivitis, predominantly mucoid (72.7%) was the commonest manifestation associated with vesicles over the lid margins. Sectorial (22.7%) and diffuse (9.1%) episcleritis appeared in later part of first week, while nodular episcleritis was observed in one case only on 12th day of the disease. Nummular keratitis was seen in 31.8% of cases between 8-10 days. Iritis and iridocyclitis was seen in 45.4% of cases out of which 36.3% had secondary ocular hypertension (glaucoma). Neuroparalytic keratitis and internal ophthalmoplegia were detected in one patient each. Postherpetic neuralgia occurred in 22.7% of cases and was uncommon in younger age group (below 40 years, 4.5%). Carbamazepine was effective in relieving the herpetic pain.

Mechanism of haloperidol-induced miosis.

Haloperidol administration (iv) has been shown to produce miosis in dogs. In the present study on rabbits, haloperidol administration (iv) produced dose-related miosis but when administered intracerebroventricularly, it failed to produce any change in pupillary size. Higher degree of miosis was observed when haloperidol was administered directly into the anterior chamber of eye. Haloperidol pretreatment failed to significantly modify the mydriasis produced by phenylephrine or atropine. These observations suggest that the miosis produced by haloperidol is a peripheral effect, and also that the miosis is not mediated through the blockade of alpha adrenoceptors of radial muscles or stimulation of cholinoceptors of circular muscles of iris.