Clinical manifestations and visual outcomes associated with ocular toxoplasmosis in a Brazilian population

AbstractOcular toxoplasmosis is the leading cause of posterior uveitis worldwide. We conducted an observational study of 262 consecutive individuals (n = 344 eyes) with ocular toxoplasmosis who were followed over a 34-month period. Most subjects were T. gondii IgG + /IgM- (n = 242; 92.4%; 317 eyes), and 140 eyes (40.7%) had active lesions. For eyes in which retinal lesions were active at recruitment and best-corrected visual acuity (BCVA) could be measured (n = 133), 21.0% (n = 28) remained blind (BCVA below 20/400) after inflammation resolved. In these eyes, atypical ocular toxoplasmosis (OR 4.99; 95% CI 1.14–22.85; p = 0.0330), macular lesion (OR 9.95; 95% CI 2.45–47.15; p = 0.0019) and any complication (OR 10.26; 95% CI 3.82–30.67; p < 0.0001) were associated with BCVA below 20/200. For eyes with only inactive lesions at recruitment and BCVA measured (n = 178), 28.1% (n = 50) were blind. In these eyes, having at least one lesion larger than one disc-diameter (OR 6.30; 95% CI 2.28–22.46; p = 0.0013) and macular lesion (OR 5.69; 95% CI 2.53–13.54; p < 0.0001) were associated with BCVA below 20/200. Older age (OR 1.02; 95% CI 1.00–1.05; p = 0.0493) and active disease at presentation (OR 4.74; 95% CI 1.95–12.91; p = 0.0011) were associated with recurrences. Additional clinical attention should be directed towards patients with risk factors for poor visual outcome.

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Efficacy of Burst Mode Torsional Phacoemulsification in Age-Related Cataract

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v15i1.48655 ◽

2020 ◽

Vol 15 (1) ◽

pp. 94-97

Author(s):

Md Abdullah Al Masum ◽

Md Kamrul Hasan Khan ◽

Zulfikar Hasan ◽

Natasha Kajmina

Keyword(s):

Visual Acuity ◽

Visual Outcome ◽

Posterior Capsule ◽

Burst Mode ◽

Corrected Visual Acuity ◽

Age Related ◽

Corneal Wound ◽

Descemet's Membrane ◽

Descemet’S Membrane ◽

Best Corrected Visual Acuity

Introduction: Torsional ultrasound energy and burst mode interrupted energy delivery system are recent advancementsin the technique of phacoemulsification surgery. It has been reported that both these advancementshelpto reduce corneal wound burn and thermal induced endothelial cell loss and thereby helps to achieve excellent early postoperative visual outcome Objectives: To evaluate the efficacy of burst mode torsional phacoemulsification surgery in age-related cataract. Materials and Methods: Prospective observational study of 120 cases that underwent phacoemulsificationcataract surgery in which torsional energy was used in burst mode. Phacoemulsification was performed by “vertical –chop” technique. Intraoperatively corneal wound burn, Descemet’s membrane detachment, posterior capsule ruptureetc.were evaluated. Postoperatively corneal oedema, best corrected visual acuity, cystoid macular oedema were evaluated. Postoperatively eyes were examined at day 1, 1 week, 6 weeks and 3 months. Results: Mean age of the patients was 57.28± 8.20 years. Most of the patients 81(67.5%) had nuclear sclerosis grade-II cataract.Intraoperatively, moderate wound burn occurred in 02(1.6%) eyes, localized Descemet’s membrane detachmentin 03(2.5%) eyes and posterior capsule rupture occurred in 03(2.5%) cases. Postoperatively, moderate and severe corneal edema was found in 06(5.0%) and 04(3.3%) eyes respectively at day 1. At the end of 3 months follow-up, 114(95%) eyes maintained a best corrected visual acuity of ≥ 6/18, of which 109(90.8%) eyes achieved ≥ 6/9. Conclusion: Burst mode torsional phacoemulsfication is a very effective and advanced technique of cataract surgery. Intraoperative complications are very less and visual outcome is excellent. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 94-97

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Adult Coats Disease Presenting as Subfoveal Nodule

Case Reports in Ophthalmology ◽

10.1159/000487707 ◽

2018 ◽

Vol 9 (1) ◽

pp. 232-237 ◽

Cited By ~ 1

Author(s):

Salim Z. Asaad ◽

Nazimul Hussain

Keyword(s):

Retinal Vessel ◽

Fundus Fluorescein Angiography ◽

The Third ◽

Macular Lesion ◽

Corrected Visual Acuity ◽

Coats Disease ◽

The Right ◽

Lost To Follow Up ◽

Best Corrected Visual Acuity

A 21-year-old female presented with decreased vision in the right eye. Best corrected visual acuity was 6/60 in the right eye and 6/6 in the left eye. Funduscopy of the right eye revealed a subfoveal nodule with surrounding exudates and temporal peripheral retinal vessel telangiectasia with exudation. The patient underwent retinal laser in the areas of telangiectatic vessels and capillary non-perfusion as seen on fundus fluorescein angiography. It was combined with an intravitreal injection of bevacizumab which was repeated twice at monthly intervals. The macular lesion and peripheral vessels along with subretinal exudates showed resolution during the course of treatment. However, the patient was lost to follow-up and returned 5 months later when examination revealed increased macular fibrosis. In the literature, the reported presentation of subfoveal nodule in Coats disease is during the first decade. It progresses to macular fibrosis within a few months. This case illustrates that subfoveal nodule before macular fibrosis in Coats disease may present later, even up to the third decade.

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Retro-pupillary iris fixated intraocular lens: A boon to aphakia

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.082 ◽

2021 ◽

Vol 7 (2) ◽

pp. 415-418

Author(s):

Subramanya K Giliyar ◽

Ravi Bypareddy ◽

Kamakshi N Moger ◽

Vinutha Moger ◽

Deeksha Bekal

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Intraocular Lens ◽

Simple Procedure ◽

Visual Outcome ◽

Secondary Outcome ◽

Corrected Visual Acuity ◽

Corneal Decompensation ◽

Best Corrected Visual Acuity ◽

Capsular Support

To evaluate post operative visual outcome and complications of retro-pupillary iris fixated Intracoular lens (IOL) in aphakia. This is a prospective interventional case study conducted at our tertiary eye care centre from March 2018 to February 2019 All monocular aphakias secondary to any cause with no capsular support, good iris diaphragm support and BCVA of better than 6/60 were included. Patients who required combined procedures like trabeculectomy and retinal procedure were excluded. Patients with poor endothelial count/ corneal decompensation, any posterior segment pathologies, pre existing glaucoma and any form of uveitis were also excluded from the study. Pre operative visual acuity, slit lamp examination and fundus examination were carried out. Anterior vitrectomy and retropupillary fixation of iris claw lens were done. The primary outcome was to assess the post operative visual acuity and secondary outcome was to analyse post operative complications at various intervals up to 6 months after surgery. Our study comprised of thirty eyes of 30 aphakic patients. RPIFIOL was inserted as primary intraocular lens in 18 patients (%) and secondary intraocular lens in 12 patients(%). Baseline best corrected visual acuity was 0.831±0.66 logMAR. Four patients had light perception at baseline. The mean best corrected visual acuity was 0.77±0.35 logMAR at month 1, 0.64±0.36logmAR at month 3 and 0.53±0.33logmAR at month 6 respectively. Mean intraocular pressure at baseline was 16mmHg. Mean intraocular pressure at month 1, 3 and 6 were 17mmHg, 16mmHg, and 16mmHg. Among the complications, twelve eyes (40%) had significant ovalisation of pupil at post operative month 1 which persisted at month 6, two eyes(6.66%) had transient ocular hypertension (OHT), and none of the eyes progressed to glaucoma. Choroidal detachment was noted in 2 eyes (6.66%), CME in 3 eyes (9.99%), 1 eye (3.33%) had retinal detachment and 2 eyes (6.66%) had one haptic disenclavation. Among the complications, ovalisation of pupil was the most common observed one. Retro-pupillary Iris fixated IOL is an effective, safe and simple procedure for management of aphakia in eyes with no posterior capsular support.

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Visual outcome following scleral fixated intraocular lens implantation

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v16i2.18478 ◽

2017 ◽

Vol 16 (2) ◽

pp. 63-68

Author(s):

Chunu Shrestha ◽

Sabina Shrestha ◽

Aparajita Manoranjan

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Visual Outcome ◽

Posterior Chamber ◽

Visual Rehabilitation ◽

Post Surgery ◽

Corrected Visual Acuity ◽

The Common ◽

Best Corrected Visual Acuity ◽

Scleral Fixated Intraocular Lens

Introduction: Scleral fixated intraocular lens(SFIOL) implantation to correct aphakia offers superior visual rehabilitation in comparison to aphakic spectacles or contact lens. This study was done to evaluate a simplified technique of scleral fixation of posterior chamber intra-ocular lens (IOL) in terms of visual outcome and complications.Methods: This was a prospective study enrolling 23 eyes of 23 patients who underwent anterior vitrectomy followed by ab-externo sclera fixation of posterior chamber IOL using 10.0 polypropylene sutures from January 2016 to February 2017 in Nepal Eye Hospital.Scleral flap was made at 3 and 9'o clock meridian to cover the knots which prevent erosion of the knots through conjunctiva. Main outcome measures were post-operative best corrected visual acuity and post-operative complications.Result: Best corrected visual acuity were 6/6 - 6/18 in 86.9% (n=20), 6/24 - 6/60 in 8.7% (n=2) and worse than 6/60 in 4.3% (n=1)at six months followup. The mean spherical equivalent before surgery was +10.60 diopter and -1.14 diopter post-surgery. The common indicationsfor scleral fixated intraocular lens weretrauma in 60.86% (n=14), surgical aphakia in21.73% (n=5), spontaneous posterior dislocation of lens in 13.0% (n=3) and subluxated intraocular lens in 4.34% (n=1). The common complications were astigmatism in 91.30% (n=21), decentered IOL in 4.34% (n=1) and uveitis in 4.35% (n=1).Conclusion: Ab-externosclerated fixated intraocular lens is a safe and effective method for visual rehabilitation with low post-operative risk.

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Profile of Patients with Floaters in Saiful Anwar Hospital Malang

International Journal of Retina ◽

10.35479/ijretina.2018.vol001.iss002.31 ◽

2018 ◽

Vol 1 (2) ◽

Author(s):

Fenti Kusumawardhani Hidayah ◽

Nadia Artha Dewi ◽

Safaruddin Refa

Keyword(s):

Posterior Vitreous Detachment ◽

Descriptive Study ◽

Posterior Uveitis ◽

Posterior Segment ◽

Retinal Break ◽

Blurred Vision ◽

Common Cause ◽

Corrected Visual Acuity ◽

Eye Examination ◽

Best Corrected Visual Acuity

Introduction: To report the profile of patients with floaters as a subjective complain in Saiful Anwar Hospital from July 2012 until June 2013. Methods: an observasional descriptive study was conducted, collecting data on gender, age, subjective complain (floaters, flashes and subjective vision reduction), best corrected visual acuity and diagnose from patient’s medical record. Result: 169 patients (215 eyes) were included in this study. Female patients contributed a higher percentage than male with mean of age was 49 years old. The subjective complain was floaters (67%), floater with blurred vision (22%), floater with flashes (6%) and patients with floaters, flashes, and blurred vision was 5%. Myopia was the most common refraction problem. Diagnose recorded from this study were posterior vitreous detachment (PVD) (34%), no abnormalities (13%), PDR (10%), RRD (9%), peripheral retinal degeneration (14%) retinal break (6%), corpus vitreous degeneration (3%), vitreous haemorhage (3%), posterior uveitis (2%) and others (6%). Conclusion: The most common cause of floaters is PVD. Even it is usually a save condition but there are some condition with floater as a subjective complain which is threatening vision, so accurate eye examination from anterior to posterior segment were needed.

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Clinical Study of Visual Outcome and Complications of Nd:YAG Laser Capsulotomy in Posterior Capsular Opacification Following Small Incision Cataract Surgery at a Tertiary Eye Care Centre in Rural Maharashtra - A Prospective Observational Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/268 ◽

2021 ◽

Vol 8 (19) ◽

pp. 1409-1413

Author(s):

Varsha Ramesh Dhakne ◽

Sourabh Hanumant Karad ◽

Samartha Babasaheb Waghambare ◽

Hanumant Tulshiram Karad ◽

Uttam Haribhau Nisale ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Nd:Yag Laser ◽

Visual Outcome ◽

Posterior Capsule Opacification ◽

Posterior Capsule ◽

Posterior Capsular Opacification ◽

Corrected Visual Acuity ◽

Nd:Yag Laser Capsulotomy ◽

Best Corrected Visual Acuity

BACKGROUND Posterior capsule opacification (PCO) is the most common delayed complication of cataract surgery. Nd:YAG (Neodymium yttrium aluminium garnet) laser posterior capsulotomy presents the advantages of a non-invasive, effective, relatively safe technique to manage intact posterior capsule that opacifies postoperatively. With this background we want to study the visual outcome and complications following Nd-YAG laser posterior capsulotomy in posterior capsular opacification following small incision cataract surgery (SICS). METHODS The study includes 64 patients attending outpatient department of a tertiary eye care hospital at Latur from June 2018 to May 2019 who have undergone SICS with PMMA PC IOL (polymethyl methacrylate posterior chamber intraocular lens) implantation and clinically diagnosed with posterior capsular opacification. 64 eyes with PCO were subjected to Nd:YAG laser posterior capsulotomy after detailed slit lamp bio microscopic examination pre- and post-capsulotomy. Follow-up was done at 1 hour, 1 week, 2 weeks and 4 weeks and patients were examined for visual outcome and any complications at each visit. RESULTS There were 16 males (25 %) and 48 females (75 %) with a mean age of 65 years. Posterior capsule opacification occurs within 3 years accounting for 46.9 % of the cases. Elschnig pearls type of PCO was more common when compared to fibrous type of PCO. Best corrected visual acuity (BCVA) before Nd:YAG laser capsulotomy was less than 6 / 60 in 35 patients (54.7 %) and within 6 / 60 to 6 / 24 in 23 patients (35. 9 %) with 6 patients (9.4 %) accounting for visual acuity between 6 / 24 to 6 / 18. After Nd - YAG Laser Capsulotomy, 46.9 % gained best corrected visual acuity of 6 / 18 or better, 39.1 % cases improved 6 / 12 and better and BCVA of 6 / 9, 6 / 6 was observed in 11 cases and 1 case respectively. Only 12 out of 64 patients had complications. Raised intraocular pressure (IOP) was found in 4 patients. Intraocular lens (IOL) pitting was found in 8 patients. CONCLUSIONS Nd:YAG laser capsulotomy is a safe, effective and a non-invasive procedure which avoids all the complications of surgical capsulotomy in patients of posterior capsule opacification. KEYWORDS Posterior capsule opacification (PCO), Nd:Yag Laser Capsulotomy, Best Corrected Visual Acuity (BCVA), Central Subfield Macular Thickness (CSMT)

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Visual outcome and factors influencing surgical outcome of horizontal strabismus surgery in a teaching hospital in Malaysia: a 5-year experience

10.21203/rs.2.140/v1 ◽

2018 ◽

Author(s):

Hussein Waheeda-Azwa ◽

Ibrahim Norihan ◽

Evelyn Li Min Tai ◽

Yee Cheng Kueh ◽

Ismail Shatriah

Keyword(s):

Visual Acuity ◽

Surgical Outcome ◽

Age Of Onset ◽

East Asian ◽

Visual Outcome ◽

Strabismus Surgery ◽

Factors Influencing ◽

Corrected Visual Acuity ◽

Post Operative Period ◽

Best Corrected Visual Acuity

Abstract Background: The available data on strabismus surgery in South East Asian countries is scarce. This study aimed to identify visual outcome and factors influencing surgical outcome of horizontal strabismus surgery in a South East Asian cohort. Methods: A retrospective review of patients who underwent horizontal strabismus surgery between 2013 and 2017 in Hospital Universiti Sains Malaysia was conducted. Surgery was considered successful if the post-operative deviation was within 10 prism dioptres at six months post-operative period. Factors influencing outcome of surgery at six months were identified. Chi-square and Fisher exact test were used in data analysis. Results: 98 patients were included. Both genders were equally affected. Exotropia (58.2%) was the most common type. 65.3% of patients had alternating strabismus, while 51.0% had angle of deviation more than 45 prism diopters. Amblyopia was documented in 14.3% of patients. Those operated upon below 10 years of age comprised 64.3%. Ninety four patients completed follow-ups at six months after the surgery. The success rate was 81.6%. Approximately 92% of the patients had best corrected visual acuities of 6/12 and better at six months post-operative period. There was no significant association between age of onset, gender, presence of amblyopia, type of deviation, amount of deviation and post-operative best corrected visual acuity with surgical outcome at six months post-operative period (p>0.05). Conclusions: The success rate was good. Post-operative best corrected visual acuity was promising. Age of onset, gender, presence of amblyopia, type of deviation, amount of deviation and post-operative best corrected visual acuity did not influence the outcome of horizontal strabismus surgery in our review. Keywords: Visual outcome, horizontal strabismus surgery, factors influencing surgical outcome

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Phacoemulsification Without Hydro-procedure: A Novel Technique to Deal with Posterior Polar Cataracts.

10.21203/rs.3.rs-1142851/v1 ◽

2021 ◽

Author(s):

Narayan Bardoloi ◽

Sandip Sarkar ◽

Himanshu Das ◽

Pankaj Suresh Burgute

Keyword(s):

Visual Acuity ◽

Retrospective Study ◽

Visual Outcome ◽

Postoperative Outcomes ◽

Novel Technique ◽

Corrected Visual Acuity ◽

Study Population ◽

The Mean ◽

Best Corrected Visual Acuity ◽

Posterior Polar Cataract

Abstract Purpose: To describe a new phacoemulsification technique without hydro-procedures in patients of posterior polar cataract (PPC) and determine the posterior capsular rate (PCR) and postoperative outcomes.Methods: After capsulorhexis, we insert the phacoemulsification probe inside the eye and shave the cortex and epinucleus within the capsulorhexis area. Then the phaco probe is buried deep into the center, and an anteroposterior crack is fashioned. Then the probe is placed at 7’ o clock to chop away a triangular piece of the nucleus. A similar maneuver is done at a 4' o clock position to take out another piece. The phacoemulsification tip and the chopper are now positioned at the cracked site of the lower fragments. Using the 2 instruments, the fragments are now pushed away and easily emulsified.Results: We conducted a retrospective study with 115 eyes of 77 patients. The mean age of the study population was 51.87 + 14.19 years (range 22-87 years). Out of 77 patients, 39 (50.64%) patients had unilateral PPC, and 38 (49.35%) had bilateral PPC. PCR occurred in 9 eyes (7.82%). Two patients had fragment drop, and only 1 (0.87%) patient was left aphakic. Best-corrected visual acuity (BCVA) at postoperative day 30 was 20/20 or better in 102 (88.69%) eyes, 20/32-20/80 was in 11(9.56%) eyes, and BCVA 20/80-20/200 was in 2 (1.73%) eyes.Conclusion: Phacoemulsification without hydro-procedure is a novel technique that can be successfully implemented in PPC cases and expect an excellent visual outcome.

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CLINICAL CHARACTERISTICS AND MANAGEMENT OF OCULAR TOXOPLASMOSIS

International Journal of Retina ◽

10.35479/ijretina.2019.vol002.iss002.96 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Ovi Sofia ◽

Rizqi Wahyu Hariyono

Keyword(s):

Medical Records ◽

Clinical Characteristics ◽

Visual Outcome ◽

Posterior Uveitis ◽

Ocular Toxoplasmosis ◽

High Seroprevalence ◽

Tertiary Referral Hospital ◽

Blurred Vision ◽

Outcome Type

Introduction: Ocular toxoplasmosis is a major cause of infectious posterior uveitis worldwide. There was no exact number of ocular toxoplasmosis prevalence in Indonesia, but Indonesia was considered to have high seroprevalence in Southeast Asian. This study is conducted to determine clinical characteristics and management of ocular toxoplasmosis at outpatient clinic of Dr. Saiful Anwar General Hospital, a tertiary referral hospital in Malang, East Java. Methods : This was retrospective study. We reviewed the medical records of patients with ocular toxoplasmosis and collected the data associated with age, sex, laterality, visual outcome, type of lesions, serum serological titers, therapeutic regimens, and complications. Result : There were 48 eyes from 38 patients included in this study, mostly were female (66%) with mean age was 33,5 years. Unilateral infection (71%) was more frequent than bilateral cases (39%). Active lesions were found more than cicatrical lesions (56,25%). Most patients with active diseases had unilateral lesion (87,5%). The most common presenting complain was blurred vision (73%). Most of lesions (22 eyes; 81,4%) were located on macular region. All of patients have positive IgG antitoxoplasma serum. There were 22 patients received oral Trimethoprim-Sulfamethoxazole and steroid. Visual acuity improved in 6 patients at the end of follow-up period. Complications of retinal detachment and choroidal neovascularization were found in 3 patients. Conclusion : Active ocular toxoplasmosis is more likely to be unilateral infection with main presenting complain is blurred vision. Most of our patients show good responses to oral trimethoprim-sulfamethoxazole and steroid.

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Cataract surgery in camp patients: a study on visual outcomes

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v3i2.5270 ◽

1970 ◽

Vol 3 (2) ◽

pp. 159-164

Author(s):

SG Pai ◽

SJ Kamath ◽

V Kedia ◽

K Shruthi ◽

A Pai

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Visual Outcome ◽

Posterior Chamber ◽

Small Incision Cataract Surgery ◽

Evaluation Team ◽

Visual Outcomes ◽

Corrected Visual Acuity ◽

Operative Complications ◽

Best Corrected Visual Acuity

Aim: To assess the complications and visual outcomes associated with cataract surgery in camp patients operated at a tertiary centre. Materials and methods: In a retrospective study, 206 outreach camp patients had undergone cataract surgeries with posterior chamber intraocular lens implantation under peribulbar anesthesia over a period of 6 months. Post-operative complications on Day 1 were graded as per Oxford Cataract Treatment and Evaluation Team (OCTET) definitions. One month postoperative complications, best corrected visual acuity and refractive errors were assessed. Results: 206 eyes underwent cataract extraction with PCIOL implantation. Small incision cataract surgery (SICS) was the commonest method (78.6%) used. The most common first post-operative day complication was mild iridocyclitis (26.2%). The complications were based on OCTET definitions, and showed that 33 % had Grade I and 3.4 % had Grade II complications. The major post-operative complication after 4 weeks of surgery was posterior capsular opacity. 89.8 % of the eyes had a 4 week-post-operative best corrected visual acuity of e” 6/24. The commonest refractive error was myopia with against the rule astigmatism, seen in 86 out of 150 cases. Conclusion: High quality cataract surgery with a low rate of intra-operative complications and good visual outcome can be attained in camp patients operated in the base hospitals, thus justifying more similar screening camps to clear the vast cataract backlog. Key words: cataract surgery, eye camp, visual outcomes DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5270 Nepal J Ophthalmol 2011; 3(2): 159-164

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