Efficacy Evaluation of Comprehensive Preformed Physical Factors Application against Retinal Complications in the Early Postoperative Period after Cataract Surgery on Eyes with High Myopia

Currently, modern high-tech methods of cataract surgery do not always guarantee high visual acuity after surgery, and are not always insured against the development of early postoperative complications in the eyes with concomitant ocular pathology. Aim. Development and analysis of the preformed physical factors comprehensive application efficacy against retinal complications in the early postoperative period after cataract surgery in patients with high myopia. Material and methods. The study involved 75 patients (75 eyes) with high myopia, aged 58 to 79 years with developing macular edema on the second day after cataract surgery. Patients from the first group (25 people) received standard medical treatment, the second group (25 people) additionally received low-frequency magnetotherapy course, and the third group received extended standard treatment with combined application of low-frequency magnetotherapy and endonasal electrophoresis with pentoxifylline. Assessment of treatment efficacy was performed according to visual acuity data and morphometric parameters of the central retinal zone using optical coherence tomography. The results of Statistica 12.0 (StatSoft, USA) program was used for statistical analysis. Results and discussion. Immediate results of treatment and long-term results up to one month in all groups were objectively confirmed by the morphometric parameters of the central retinal zone. Macular edema reduction in height and area of distribution was significantly different in the third group compared with the first and second groups immediately after treatment and with the continuation of positive dynamics after a month. In the third group, high clinical results were objectively confirmed by the restoration of normal parameters of the central retinal zone after one month of observation. In the first and second groups, lower treatment results were confirmed by the preservation of morphometric signs of edema in the macular region, that required the continuation in the patients’ rehabilitation. Conclusion. Combination of complex application of preformed physical factors with standard medical therapy of exudative processes in the macula after cataract surgery reliably increases functional (visual) result of treatment and reduces rehabilitation period in the majority of patients with high-grade myopia. Thus, the expediency of physiotherapeutic support in relief of retinal edema in the early postoperative period of cataract surgery on eyes with high degree myopia has been substantiated.

RETINAL CHANGES IN MYOPIC PATIENTS AT A TERTIARY CARE CENTRE IN EASTERN INDIA

Background: Myopia is a major cause of visual impairment in both the developed and the developing world. Its prevalence ranges between 83% to 97% and the prevalence of high myopia ranges between 7% and 22%. Individuals with high myopia have increased risk of retinal complications which can be potentially sight threatening. Aims And Objectives: To determine the prevalence and types of retinal changes in patients with myopia and the relationship of the retinal changes with the severity of myopia. Materials And Methods: Patients attending the outpatient department having myopia and age more than 8 years were selected for the study. They underwent dilated fundoscopy (direct and indirect ophthalmoscopy) to record the various retinal changes. Results: Tessellated fundus (58.5%) and peripapillary atrophy (40.5%) were the most common ndings. Temporal crescent (21.5%), lattice degeneration (16.5%), white with or without pressure (11%), retinal tears (4%) and retinal detachment (2%) were also seen. No changes were observed in 22% of the eyes. Conclusion: Myopic individuals should be educated on the symptoms of various complications and seek care immediately if symptoms arise

Chorioretinal Side Effects of Therapeutic Ocular Irradiation: A Multimodal Imaging Approach

Radiation chorioretinopathy, radiation maculopathy, and radiation optic neuropathy are the major complications of ophthalmic radiotherapy. Optical coherence tomography (OCT) and OCT angiography (OCTA) are revolutionary imaging methods, allowing the visualization of the retinal cellular architecture and the retinal vascular system, respectively. In recent years this multimodal imaging approach has been applied to several retinal disease, but its role in the clinical characterization of retinal complications secondary to ophthalmic radiotherapy has not yet been defined. The purpose of this review is to critically evaluate the role of OCT and OCTA in the clinical assessment of radiation-induced chorioretinopathy, maculopathy, and optic neuropathy.

A Prospective Study On The Prevalence Of Retinal Lesions Among The Hypertensive Patients

To estimate the prevalence of retinal lesions among patients with hypertension. Hypertensive patients of both the genders above 18 years of age, who were willing to participate in the study, were included and patients who were having diabetes, previous retinal abnormalities and below 18 years of age were excluded from this study. The hypertensive patients were screened for the presence of retinal lesions and were categorised based on the severity of damage to the retinal arterioles and veins.In this study, about 876 patients who were diagnosed with hypertension were recruited and screened for retinal lesions. After screening, around 125 (14.3%) patients were observed with retinal lesions. In case of severity of retinal lesions in the hypertensive patients, most of the patients were found to be in Grade-I (40.8%) followed by Grade-II (37.6%). After treating with various types of treatment approaches, about 40 patients who were observed with retinal lesions of Grade-I severity were returned to a healthy state, and about 27 patients who were with retinal lesions of Grade-II severity were recovered to Grade-I. About six patients with retinal lesions of Grade-III was improved to Grade-II, and no patient recovered with the retinal lesions of Grade-IV severity.In this study, the prevalence of retinal lesions among the hypertensive patients was observed to be 14.3%, and the males were found to be more predominant with retinal lesions when compared to the females. The elevated blood pressure for a prolonged duration in hypertensive patients impacts the severity of retinal lesions increasing the risk of retinopathy. It is the responsibility of the clinical pharmacist to create awareness among the hypertensive patients regarding the occurrence of hypertensive retinopathy as it may cause severe complications if left untreated. Hence, regular follow-ups are required for hypertensive patients, which may help to prevent retinal complications.

Retinal Detachments Related to Pathological Myopia

High myopia or pathological myopia is associated with globe elongation and a refractive error of at least -6.0 diopters (D) and/or axial length of greater than 25.5 mm. Excessive axial elongation of the globe in high myopia can cause mechanical stretching and thinning of the choroid and retinal pigment epithelium layers, resulting in various retinal degenerative changes. It is well known that individuals with pathological myopia have increased risks of retinal complications such as peripheral retinal degenerations, retinal tears, and retinal detachment. This article will review these complications and discuss the current concepts relating to these complications.

Case Report: Pseudoxanthoma elasticum

Pseudoxanthoma elasticum (PXE) is a rare inherited disorder, characterised by a progressive mineralization and fragmentation of elastic fibres of the skin, retina and cardiovascular system. At an initial stage, the skin usually exhibits distinctive lesions and subsequently extra-dermal manifestations. The diagnosis is based on clinical manifestations, histological analysis of the lesions and genetic analysis. This is a case report of a 12-year-old child complaining of painless, mildly itchy yellow papules in the cervical region with 1 year of evolution. PXE is currently an incurable disease and has a favourable prognosis when cardiovascular and retinal complications are prevented and monitored.