1. Indian J Ophthalmol. 2015 Aug;63(8):687. doi: 10.4103/0301-4738.169793.

Evaluation of choroidal thickness via enhanced depth-imaging optical coherence
tomography in patients with systemic hypertension.

Cheong KX, Tan CS(1).

Author information: 
(1)National Healthcare Group Eye Institute, Tan Tock Seng Hospital; Fundus Image 
Reading Center, National Healthcare Group Eye Institute, Singapore.

PMID: 26576532   [PubMed - in process]


2. Indian J Ophthalmol. 2015 Aug;63(8):684-6. doi: 10.4103/0301-4738.169784.

Primary orbital neuroblastoma with intraocular extension.

Vallinayagam M(1), Rao VA, Pandian DG, Akkara JD, Ganesan N.

Author information: 
(1)Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical
Education and Research, Puducherry, India.

Neuroblastoma is an undifferentiated malignancy of primitive neuroblasts.
Neuroblastoma is among the most common solid tumors of childhood. Orbital
neuroblastoma is typically a metastatic tumor. In this case report, we describe a
2-year-old child with a rapidly progressing orbital tumor. Computed tomography
revealed an orbital mass lesion with extraocular and intraocular components. An
incisional biopsy was done, and a histopathological examination showed features
suggestive of neuroblastoma. Systemic workup including ultrasonography of the
abdomen, chest roentgenogram, whole body computed tomography, and bone
scintigraphy showed no evidence of systemic involvement. The diagnosis of primary
orbital neuroblastoma was made, and the child was subjected to chemotherapy
followed by rapid melting of the tumor. Neuroblastoma should be considered in the
differential diagnosis of childhood orbital tumors.

PMID: 26576531   [PubMed - in process]


3. Indian J Ophthalmol. 2015 Aug;63(8):682-4. doi: 10.4103/0301-4738.169795.

Traumatic globe luxation: A case report.

Kumari E, Chakraborty S(1), Ray B.

Author information: 
(1)Department of Ophthalmology, Bankura Sammilani Medical College, Bankura, West 
Bengal, India.

Globe luxation is a rare clinical event. Most of the cases are usually traumatic,
although spontaneous globe luxation has also been reported. The majority of the
posttraumatic cases are usually associated with the injury or fracture of the
bony orbit. We report here a case of globe luxation that occurred per se without 
any injury to the orbital or maxillo-facial bony structures.

PMID: 26576530   [PubMed - in process]


4. Indian J Ophthalmol. 2015 Aug;63(8):680-1. doi: 10.4103/0301-4738.169791.

Lipoid proteinosis: A rare entity.

Mukherjee B, Devi PN(1).

Author information: 
(1)Department of Orbit, Oculoplasty, Reconstructive and Aesthetics, Sankara
Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India.

Urbach-Wiethe syndrome or lipoid proteinosis is a rare autosomal recessive
disorder characterized histologically by infiltration of Periodic acid
Schiff-positive hyaline material in the skin, upper aerodigestive tract, eyelids,
and internal organs. Classical clinical features include scarring of the skin,
beaded eyelid papules (moniliform blepharosis) and laryngeal infiltration leading
to hoarseness of voice. Lipoid proteinosis can lead to life-threatening
conditions such as acute respiratory distress and seizures. Awareness among
ophthalmologists about this rare entity is crucial for appropriate management of 
these patients.

PMID: 26576529   [PubMed - in process]


5. Indian J Ophthalmol. 2015 Aug;63(8):678-80. doi: 10.4103/0301-4738.169796.

Central retinal artery occlusion following orbital tumor resection: Is rapid
intervention effective?

Rajabi MT, Naderan M(1), Mohammadi SZ, Rajabi MB.

Author information: 
(1)Eye Research Center, Farabi Eye Hospital, Tehran University of Medical
Sciences, Tehran, Iran.

A 52-year-old male patient presented at our hospital with unilateral proptosis
and vision loss in his left eye. Imaging evaluations showed orbital tumor, so the
patient underwent surgery. About an hour later after tumor removal, patient
developed sudden vision loss and became no light perception. Fundus evaluation
revealed central retinal artery occlusion (CRAO). The patient was treated
immediately with ocular massage and anterior chamber paracentesis as well as
systemic therapy with mannitol and intravenous administration of acetazolamide.
After thirty minutes, he recovered perception to light and then hand motion and 2
h later, it was improved to 1 m counting finger. CRAO following orbital tumor has
not been reported before. We recommend ocular examination in all patients that
undergo orbital surgery immediately to 2-3 h after surgery.

PMID: 26576528   [PubMed - in process]


6. Indian J Ophthalmol. 2015 Aug;63(8):674-8. doi: 10.4103/0301-4738.169792.

Metastatic adenocarcinoma of the cervix presenting as a choroidal mass: A case
report and review of literature of cervical metastases to the eye.

Nair AG(1), Asnani HT, Mehta VC, Mehta SV, Pathak RS.

Author information: 
(1)Advanced Eye Hospital and Institute, Navi Mumbai; Aditya Jyot Eye Hospital;
Mehta Eye Clinic Pvt. Ltd., Mumbai, Maharashtra, India.

Cervical cancer is the most common cancer among females in India. Cervical cancer
usually spreads by local extension and through the lymphatic drainage to the
lymph nodes. Hematogenous spread, the mechanism responsible for distant
metastases, is rarely seen in cervical malignancies. In this communication, we
report a case of a 45-year-old woman who presented with unilateral decrease in
vision of 3 months duration. She was found to have a serous retinal detachment
with underlying diffuse, subretinal yellowish-cream colored infiltrates in the
right eye, suspicious of choroidal metastases. Systemic evaluation showed
disseminated systemic metastases arising from a primary adenocarcinoma of the
cervix. In this communication, we review all the documented cases of metastases
to the eye and adnexa arising from cervical cancer and their clinical
characteristics. Unilateral choroidal metastasis arising from an adenocarcinoma
of the cervix is extremely rare with only one previous documented case. Although 
uncommon, choroidal metastasis may be the presenting feature of primary cervical 
malignancy. Furthermore, cervical malignancy must be ruled out in women who
present with orbital or choroidal metastases arising from unknown primary.

PMID: 26576527   [PubMed - in process]


7. Indian J Ophthalmol. 2015 Aug;63(8):672-4. doi: 10.4103/0301-4738.169798.

Electron beam radiotherapy for the management of recurrent extensive ocular
surface squamous neoplasia with orbital extension.

Murthy R(1), Gupta H, Krishnatry R, Laskar S.

Author information: 
(1)Department of Oculoplasty and Ocular Oncology, Axis Eye Clinic, Pune, India.

Recurrent extensive ocular surface squamous neoplasia (OSSN) with orbital
invasion can be successfully managed with external radiotherapy using electrons
resulting in eye and vision salvage. We report a case of right eye recurrent OSSN
in an immunocompetent adult Indian male, with extensive orbital involvement. The 
patient had two previous surgical excisions with recurrent disease. At this
stage, conventionally exenteration is considered the treatment modality. However,
he was treated with 5040 cGy radiotherapy (15eV electrons) resulting in complete 
disease regression. At the end of 3 years follow-up, the patient was disease
free, maintained a vision of 20/25, with mild dry eye, well-managed with topical 
lubricants. Extensive OSSN with orbital invasion does not always need
exenteration. External beam electron radiotherapy provides a noninvasive cure
with organ and vision salvage and should be considered in extensive OSSN not
amenable to simple excision biopsies. Long-term studies to evaluate the effect of
radiation on such eyes are suggested.

PMID: 26576526   [PubMed - in process]


8. Indian J Ophthalmol. 2015 Aug;63(8):665-71. doi: 10.4103/0301-4738.169788.

Transplantation of cultured rhesus monkey vascular endothelial cells to
allogeneic cornea concomitant with stripping of Descemet's membrane.

Zhu Q, Wu M, Sun X, Zhang W, Hu Z(1), Liu H.

Author information: 
(1)Department of Ophthalmology, Fourth Affi liated Hospital of Kunming Medical
University (Second People's Hospital of Yunnan Province), Kunming, China.

CONTEXT: In cases of damaged corneal endothelium cells (CECs) of the eye,
transplantation of cultured vascular endothelial cells (VECs) may be a viable
method to restore transparency.
AIMS: To evaluate the viability of replacing damaged primate CECs with cultured
allogeneic VECs.
SUBJECTS AND METHODS: Rhesus monkey VECs (RMVECs) were cultured and proliferating
cells were labeled with bromodeoxyuridine (BrdU) in vitro. RMs of the
experimental group (n = 6) underwent manual Descemettt membrane stripping with
transplantation of RMVECs labeled with BrdU; those in the control group received 
manual Descemetnt membrane stripping without transplantation. Postoperative
evaluations included the transparency and appearance of the corneal graft;
distribution and ultrastructural changes of RMVECs on the inner surface of the
cornea using scanning and transmission electron microscopy, and
immunohistological identification of BrdU.
RESULTS: At 90 days postsurgery, the corneal grafts of the monkeys in the
experimental group retained better transparency than those of the controls,
without corneal neovascularization or bullous keratopathy. A layer of cells with 
positive BrdU staining was found on the posterior surface of the treated corneas 
in the experimental group, while there was no VEC structure in corneal grafts
from the monkeys of the control group.
CONCLUSIONS: RMVECs can grow on the posterior surface of the cornea without
Descemet's membrane. Cultured and transplanted RMVECs appeared similar in
ultrastructure. VECs can provide a barrier to maintain corneal dehydration and
transparency to some extent.

PMID: 26576525   [PubMed - in process]


9. Indian J Ophthalmol. 2015 Aug;63(8):659-64. doi: 10.4103/0301-4738.169789.

Ophthalmic manifestations of acute and chronic leukemias presenting to a tertiary
care center in India.

Koshy J(1), John MJ, Thomas S, Kaur G, Batra N, Xavier WJ.

Author information: 
(1)Department of Ophthalmology, Christian Medical College, Ludhiana, Punjab,
India.

CONTEXT: Screening for ocular manifestations of leukemia, although not a routine 
practice, is important as they may antedate systemic disease or form an isolated 
focus of its relapse.
AIMS: This study evaluates the spectrum of ocular manifestations in acute and
chronic leukemias presenting to a tertiary care center in India.
SETTINGS AND DESIGN: Subjects of leukemia presenting to a tertiary care center in
India.
SUBJECTS AND METHODS: A prospective, cross-sectional study looking at the
spectrum of ocular manifestations in all inpatients of acute or chronic leukemia.
STATISTICAL ANALYSIS USED: The collected data were analyzed using the Statistical
Package for Social Sciences for Windows software, version 16 (SPSS Inc., Chicago,
Illinois, USA).
RESULTS: The study subjects (n = 96) comprised 61 males and 35 females whose age 
ranged from 18 months to 91 years (mean = 39.73, ±22.1). There were 79 adults and
17 children, 53 new and 43 existing patients, 68 acute and 28 chronic, 61 myeloid
and 35 lymphoid patients. Ocular lesions were found in 42 patients (43.8%). The
ocular manifestations of leukemia were significantly (P = 0.01467) more frequent 
in acute 35/68 (51.9%) than chronic 7/28 (25%) leukemias. Primary or direct
leukemic infiltration was seen in 8 (8.3%) subjects while secondary or indirect
involvement due to anemia, thrombocytopenia, hyperviscosity, total body
irradiation, and immunosuppression were seen in 42 (43.8%) subjects. Ocular
changes were present in 37/79 (46.8%) adults and 5/17 (29.4%) children (P =
0.09460). Twenty-eight males (28/61) 45.9% and 14/35 (40%) females had ocular
manifestations (P = 0.2874). The ocular manifestations were significantly (P =
0.01158) more frequent in myeloid leukemias 32/61 (52.9%) than lymphoid leukemias
10/35 (28.6%).
CONCLUSIONS: Leukemic ophthalmic lesions were found in 42/96 (43.8%) patients.
Ocular involvement is more often seen in adults, acute and myeloid leukemias. All
the primary leukemic manifestations were seen in males. A periodic ophthalmic
examination should be mandatory for all leukemic patients, as ocular changes are 
often picked up in asymptomatic patients.

PMID: 26576524   [PubMed - in process]


10. Indian J Ophthalmol. 2015 Aug;63(8):654-8. doi: 10.4103/0301-4738.169790.

Changing pattern of utilization of human donor cornea in India.

Gogia V, Gupta S, Agarwal T, Pandey V, Tandon R(1).

Author information: 
(1)Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic
Sciences, All India Institute of Medical Sciences, New Delhi, India.

PURPOSE: To review the changing pattern of donor, corneal utilization in an eye
bank at a Tertiary Care Center in Northern India by analyzing the trend in the
years 2003, 2008, and 2011.
METHODS: A retrospective review of eye bank records for 3 years (2003, 2008, and 
2011) was performed at the National Eye Bank. Details including a clinical grade 
of donor cornea, indication of corneal transplantation (therapeutic or optical), 
type of procedure (penetrating or lamellar keratoplasty [LK]), and clinical
diagnosis of the graft recipients were recorded. Primary outcome measure was to
observe any preference toward LK, judicious usage of donor corneal tissue, and
impact of lamellar corneal transplant in the usage of donor corneas. Secondary
outcomes included overall utilization rate and change in trend of indication for 
keratoplasty.
RESULTS: A total of 673, 745, and 864 corneas were retrieved in the years 2003,
2008, and 2011, respectively. The percentage of donor corneal utilization
increased significantly over time with the rate being 65.08%, 70.06%, and 68.29%,
respectively, in the years 2003, 2008, and 2011 (P = 0.014); however, this change
was reflected only in the usage of nonoptical grade corneas and not for the
optical grade corneas. There was an overall increase in lamellar corneal
procedures for any clinical grade of cornea (P = 0.0019); number of Descemet's
stripping automated endothelial keratoplasty (DSAEK) procedures increased
significantly (P < 0.001), particularly for pseudophakic corneal edema (PCE) (P =
0.0085) and failed graft (P = 0.002). Significant increase in the utilization of 
nonoptical grade corneas was observed over the years (P = 0.005), though the
utilization did not increase significantly for optical purposes viz., LK (P =
0.08).
CONCLUSIONS: Utilization rate of donor corneas increased over the years,
primarily due to increase in usage of nonoptical grade corneas for therapeutic
purposes. There was a procedural shift toward DSAEK for PCE and failed graft.
However, an increase in usage of nonoptical grade corneas for LK, a single donor 
corneal tissue for two recipients, and retrieval or utilization of optical grade 
cornea was not observed.

PMID: 26576523   [PubMed - in process]


11. Indian J Ophthalmol. 2015 Aug;63(8):649-53. doi: 10.4103/0301-4738.169797.

Transscleral fixation of closed loop haptic acrylic posterior chamber intraocular
lens in aphakic nonvitrectomized eyes.

Agrawal S(1), Singh V, Gupta SK, Misra N, Srivastava RM.

Author information: 
(1)Department of Ophthalmology, King George's Medical University, Lucknow, Uttar 
Pradesh, India.

PURPOSE: To evaluate the outcome of transscleral fixation of closed loop haptic
acrylic posterior chamber intraocular lens (PCIOL) in aphakia in nonvitrectomized
eyes.
MATERIALS AND METHODS: Patients with postcataract surgery aphakia, trauma with
posterior capsule injury, subluxated crystalline lens, and per operative
complications where sulcus implantation was not possible were included over a
1-year period. Scleral fixation of acrylic hydrophilic PCIOL was performed
according to the described technique, and the patients were evaluated on the day 
1, 3, 14, and at 3 and 12 months postoperatively for IOL centration,
pseudophakodonesis, change in best-corrected visual acuity (BCVA), and any other 
complications.
RESULTS: Out of twenty-nine eyes of 24 patients, who completed the study, 25
(86.2%) eyes had improved, 2 (6.9%) eyes showed no change, and 2 (6.9%) eyes had 
worsening of BCVA. Three (10.3%) eyes developed postoperative complications. A
significant improvement in mean BCVA (P < 0.0001) was observed after the
procedure. Mean duration of follow-up was 26.2 months (range 22-35 months).
CONCLUSION: The use of closed loop haptic acrylic IOL for scleral fixation
appears to be safe and effective alternative to conventional scleral fixated
polymethyl methacrylate intraocular lenses.

PMID: 26576522   [PubMed - in process]


12. Indian J Ophthalmol. 2015 Aug;63(8):645-8. doi: 10.4103/0301-4738.169785.

Sutureless scleral buckle in the management of rhegmatogenous retinal detachment.

Shanmugam PM(1), Singh TP, Ramanjulu R, Rodrigues G, Reddy S.

Author information: 
(1)Department of Vitreoretinal Services and Ocular Oncology, Sankara Eye
Hospital, Bengaluru, Karnataka, India.

PURPOSE: To evaluate the anatomical and functional outcomes of sutureless scleral
buckling for the repair of rhegmatogenous retinal detachment (RD).
DESIGN: Retrospective interventional case series.
MATERIALS AND METHODS: Retrospective analysis of 50 eyes of 49 patients with
rhegmatogenous RD, who underwent sutureless scleral buckling from January 2009 to
March 2013.
RESULTS: Primary retinal re-attachment rate of 86% was achieved with single
surgery, but final anatomical success was 94% with additional interventions in
the form of intravitreal gas, buckle revision, and/or pars plana vitrectomy. Best
corrected logarithm of minimum angle of resolution visual acuity improved from
1.44 ± 1.01 preoperatively to 0.50 ± 0.40 at a mean follow-up of 6.7 months.XS
Conclusion: Sutureless scleral buckling achieves excellent anatomical and
functional success in majority of the patients with rhegmatogenous RD.

PMID: 26576521   [PubMed - in process]


13. Indian J Ophthalmol. 2015 Aug;63(8):641-4. doi: 10.4103/0301-4738.169786.

Effect of fluidics on corneal endothelial cell density, central corneal
thickness, and central macular thickness after phacoemulsification with torsional
ultrasound.

Das S, Nanaiah SG(1), Kummelil MK, Nagappa S, Shetty R, Shetty BK.

Author information: 
(1)Department of Cataract and Refractive Surgery, Narayana Nethralaya Super
Specialty Eye Hospital, Rajajinagar, Bengaluru; Lopamudra Medical Centre, Athur, 
Kodagu, Karnataka, India.

AIM: To study the relative effects of high and low fluidic parameters on
endothelial cell density (ECD), central corneal thickness (CCT), and central
macular thickness (CMT) after phacoemulsification with torsional ultrasound.
SETTINGS AND DESIGN: Prospective, randomized clinical trial based on a tertiary
eye hospital.
SUBJECTS AND METHODS: The study included 65 patients in each group. Patients were
randomized to either the high or the low flow group using a computerized random
number table. The study was patient and examiner masked. All patients underwent
phacoemulsification with torsional ultrasound. Visual acuity, ECD, CCT, and CMT
were measured for all patients preoperatively at 2 weeks and 6 weeks
postoperatively.
STATISTICAL ANALYSIS USED: The Shapiro-Wilks test was used to assess the
normality of the data. Mann-Whitney U-test with the P value set at 0.05 was used 
to compare the two groups.
RESULTS: Cumulative dissipated energy was significantly higher in the low flow
group (16.44 ± 9.07 vs. 11.74 ± 6.68; P = 0.002). No statistically significant
difference was noted between the two groups in the ECD, CCT, CMT, or corrected
distance visual acuity at the end of 6 weeks.
CONCLUSIONS: No significant difference was noted in the postoperative outcome
between high and low flow groups. Parameters can be modified to suit the
surgeon's preference, as both high and low flow parameters were found to have
comparable postoperative outcomes.

PMID: 26576520   [PubMed - in process]


14. Indian J Ophthalmol. 2015 Aug;63(8):630-40. doi: 10.4103/0301-4738.169787.

Anterior segment imaging in glaucoma: An updated review.

Maslin JS, Barkana Y, Dorairaj SK(1).

Author information: 
(1)Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida, USA.

Anterior segment imaging allows for an objective method of visualizing the
anterior segment angle. Two of the most commonly used devices for anterior
segment imaging include the anterior segment optical coherence tomography
(AS-OCT) and the ultrasound biomicroscopy (UBM). AS-OCT technology has several
types, including time-domain, swept-source, and spectral-domain-based
configurations. We performed a literature search on PubMed for articles
containing the text "anterior segment OCT," "ultrasound biomicroscopy," and
"anterior segment imaging" since 2004, with some pertinent references before 2004
included for completeness. This review compares the advantages and disadvantages 
of AS-OCT and UBM, and summarizes the most recent literature regarding the
importance of these devices in glaucoma diagnosis and management. These devices
not only aid in visualization of the angle, but also have important postsurgical 
applications in bleb and tube imaging.

PMID: 26576519   [PubMed - in process]


15. Indian J Ophthalmol. 2015 Aug;63(8):629. doi: 10.4103/0301-4738.169799.

Generally speaking!

Natarajan S(1).

Author information: 
(1)Editor, Indian Journal of Ophthalmology, Chairman, Managing Director, Aditya
Jyot Eye Hospital Pvt. Ltd., Wadala (W), Mumbai, Maharashtra, India.

PMID: 26576518   [PubMed - in process]