Comparison of oral propranolol, oral rifampicin, and intravitreal anti-VEGF in central serous chorioretinopathy.

Purpose: To compare the efficacy of oral propranolol, oral rifampicin, and intravitreal anti-VEGF therapies on resolution-time and visual outcome in patients with central serous chorioretinopathy (CSCR). Methods: A total of 30 patients with CSCR were randomized into three groups of 10 patients. Group A was given oral propranolol, Group B was given oral rifampicin 4 weeks each, and Group C was given 0.05 ml intravitreal injection of anti-VEGF. Comparisons of mean BCVA, contrast sensitivity, and central macular thickness (CMT) performed between baseline and follow-up at 4 weeks, 6 weeks, and 3 months. Results: Statistically significant improvement in BCVA and contrast sensitivity was noted among all three groups. Complete resolution of SRF as indicated by CMT was seen at the end of 4 weeks in Group C, whereas there was a steady decline in CMT until 3 months in Groups A and B. Conclusion: Intravitreal anti-VEGF therapy shows a significantly faster SRF resolution. However, oral propranolol and oral rifampicin could prove as a useful, cost-effective treatment of CSCR.

Clinical study of retinal changes in pregnancy induced hypertension / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To determine the prevalence of retinal changes in pregnancy induced hypertension (PIH) patients and to correlate between retinal changes and the severity of disease.METHODS: A cross-sectional observation study was conducted in 100 PIH patients over a period of 6mo (Dec 2014-May 2015).Fundus examination was done in all patients.Fundus changes in right or left or both eyes, was taken as positive.The PIH graded as mild pre-eclampsia (BP >140/90 to 160/90 mmHg), severe pre-eclampsia (BP>160/90 mmHg) and eclampsia (severe pre-eclampsia and convulsions).RESULTS:Mean age was 23.05y(19-34y).Gestation period ranged from 28 to 41wk.Sixty-two were primi gravida and 38 were multigravida.62%, 26%, 12% of patients had mild, severe pre-eclampsia, eclampsia respectively.Retinal changes were identified in 8 patients.Grade Ⅰ, Grade Ⅱ, Grade Ⅲ, Grade Ⅳ hypertensive retinopathy (HTR), serous retinal detachment (SRD) and central serous chorioretinopathy (CSCR) observed in 1%, 0%, 2%, 2%, 1% and 2% of patients respectively.There was a statistically significant positive association of retinal changes and severity of the PIH (P=0.0001).CONCLUSION:Retinal changes were seen in 8% of patients with PIH and there is a positive correlation between retinal changes and severity of PIH.

Potential for Hospital Based Corneal Retreival in Hassan District Hospital.

CONTEXT: In developing countries, corneal diseases are the second leading cause of blindness. This corneal blindness can be treated through corneal transplantation. Though the present infrastructure is strong enough to increase keratoplasty numbers at a required rate, India has largest corneal blind population in the world. So a constant supply of high quality donor corneal tissue is the key factor for reduction of prevalence of corneal blindness. Considering the magnitude of corneal blindness and shortage of donor cornea, there is a huge gap in the demand and supply. AIM: To study the potential for hospital based retrieval of donor corneal tissue in Hassan district hospital after analysing the indicated and contraindicated causes of deaths, so that hospital corneal retrieval program in Hassan district hospital can be planned. MATERIALS AND METHODS: The cross-sectional, retrospective and record-based study included all hospital deaths with age group more than two years occurred during one year period (January 2014 to December 2014). Data regarding demographic profile, cause of death, treatment given and presence of any systemic diseases were collected. The causes of deaths which are contraindicated for the retrieval of corneas were analysed and noted. The contraindications were based on the NPCB guidelines for standard of eye banking in India 2009. RESULTS: Out of 855 deaths, number of deaths in males (565) was greater than females (290). Numbers of deaths were highest between 41-60 years age group (343). Deaths due to HIV, septicaemia, meningitis, encephalitis, disseminated malignancies were contraindicated for corneal retrieval. Corneas could be retrieved from 736 deaths out of 855. Potential for corneal retrieval in a period of one year in Hassan District hospital was 86%. CONCLUSION: Hospital corneal retrieval program has got a great potential to bridge the gap between the need for the cornea and actually collected corneas which will contribute enormously in eliminating corneal blindness. In present study there was 86% potential for corneal retrieval among the hospital deaths.

Ocular Manifestations in Patients with HIV Infection/AIDS who were Referred from the ART Centre, Hassan, Karnataka, India.

BACKGROUND: Ocular involvement in HIV infection/AIDS is very common and it includes various clinical presentations which may be asymptomatic or atypical or they may be the initial manifestations of the underlying disease. The severity of these lesions increases as the immune competency decreases, leading to visual impairment or blindness. OBJECTIVE: The purpose of this study was to determine the prevalence and the types of HIV associated ocular conditions and their effect on the vision in patients with HIV/AIDS. METHODS: This cross sectional study was based on the patients with HIV infection/AIDS, who were referred to the Ophthalmic OPD, District hospital, Hassan. These patients were referred from the District ART Centre for a complete ophthalmic evaluation, irrespective of their immune status and the presence or absence of symptoms. All the patients underwent a complete ophthalmic examination, which included both anterior and posterior segment evaluation and colour vision assessment. RESULTS: Out of the 553 patients, 66% belonged to the age group of 21-40 years. 87% of the patients had a BCVA of >6/18, whereas 4.7% had very poor vision. 37.6% of the patients had ocular manifestations. Anterior segment, posterior segment and neuro-ophthalmic manifestations were seen in 7%, 9.94% and 5.79% of the patients respectively. The most common anterior segment manifestation was recurrent lid infections, while HIV microangiopathy was the most common posterior segment manifestation. The other unusual findings included an abnormal colour vision in 6.3% of the patients and bilateral lid retraction in 8.5% of the patients. CONCLUSION: Since ocular manifestations are very common and as they can occur at any time during the course of HIV infection, an awareness on various patterns of the ocular disease and the screening of all the patients with HIV infection/AIDS is a must.