A study of evaluation of various risk factors of retinal vein occlusion

Background:A study of various ocular & systemic risk factors in Retinal Vein Occulation (RVO) at tertiary eye care centre.Methods:A prospective study included 50 eyes of 50 patients, in period of September 2010 to August 2012. Inclusion criteria: 1. Age >25 years, 2. All newly diagnosed cases of vein occlusion. Exclusion criteria: 1. Age <25 years 2. All other ocular diseases causing significant visual impairment. A detailed history, ophthalmic & systemic examinations with all necessary investigations-as and when required were done.Results: In our study, RVOs were more common in males – 26 (52%) & in 56-65 years of age group - 16 (32%). BRVO (Branch Retinal Vein Occlusion)s were more common than CRVO (Central Retinal Vein Occlusion) - Nonischemic (26%) >Ischemic (24%). In risk factors - most common was hypertension - in 38 (76%) patients. Followed by descending order, hyperlipidemia 27 (54%) >diabetes mellitus 16 (32%) >tobacco 14 (28%) >hyper homocystinemia 4 (8%) >severe alcohol 2 (4%). The complications were more in ischemic than Nonischemic-CRVO >BRVO - they were macular edema 43 (86%) >neovascularization at iris - 14 (28%) >neovascularization at angle - 10 (20%) >neovascular glaucoma – 4 (8%). Conclusion:RVOs are more common with increasing age, in males & most common risk factor is hypertensive. Most common cause for vision loss is macular edema - ischemic >non-ischemic.

Comparison between Ringer′s lactate and balanced salt solution on postoperative outcomes after phacoemulsfication: A randomized clinical trial

Aim: To compare the effects of balanced salt solution (BSS) and Ringer′s lactate (RL) on corneal thickness, endothelial morphology, and postoperative anterior chamber inflammation in eyes undergoing phacoemulsification. Setting: Iladevi cataract and IOL research center, Ahmedabad, India. Materials and Methods: This prospective randomized study comprised 90 consecutive patients with age-related cataract who were randomly assigned to either Group 1 (n = 45) with BSS or Group 2 (n = 45) with RL. Observations made included measurement of central corneal thickness (CCT), presence of anterior chamber flare and cells, endothelial cell loss, and change in coefficient of variation (CV). Data was analyzed using Mann Whitney test and test of proportion. Results: Mean increase in CCT on postoperative Day 1 was 58µm and 97µm in Groups 1 and 2 respectively ( P = 0.01). Increase in CCT at one month was 10µm and 11µm in Groups 1 and 2 respectively ( P = 0.99); increase in CCT at three months was 3µm and 6µm in Groups 1 and 2 respectively ( P = 0.86). Number of eyes with flare grades in a range of 0 to 3 was statistically higher in Group 2 on postoperative Day 1 ( P = 0.004, 0.016, < 0.001, 0.047 for Grade 0, 1, 2 and 3 respectively). Number of eyes with cells of Grade 3 on first postoperative day was significantly higher in Group 2 as compared to Group 1 ( P = 0.004). Three months postoperatively, endothelial cell loss was 5.5% and 7.8% in Groups 1 and 2 ( P = 0.21) and change in CV was 3 and 5.4 in Groups 1 and 2 ( P = 0.20) respectively. Conclusion: BSS offers a significant advantage over RL in terms of increase in corneal thickness and postoperative inflammation on the first postoperative day in patients undergoing phacoemulsification

Real-World Experience with Brolucizumab in Wet Age-Related Macular Degeneration: The REBA Study

International audienceThe aim of the present study was to determine the efficacy and safety of intravitreal brolucizumab therapy for neovascular age-related macular degeneration (AMD) in the real-world setting. The REBA study (real-world experience with brolucizumab in wet AMD) was a retrospective, observational, multicentric study that included 78 consecutive patients (105 eyes), with neovascular AMD, who received brolucizumab therapy. Both treatment-naive and switch-therapy patients were included. Switch therapy was based either on fluid recurrence, fluid recalcitrance, or inability to extend beyond q4/q6. All relevant data were collected. The primary outcome measure was change in best-corrected visual acuity (BCVA) over time. Secondary outcome measures included determination of change in central subfield thickness (CST) and complications. The mean baseline BCVA was 49.4 ± 5.4 letters and 40 ± 3.2 letters, and corresponding mean BCVA gain was +11.9 ± 3.9 letters (p = 0.011) and +10.4 ± 4.8 letters (p = 0.014) in the treatment-naive and switch-therapy groups, respectively. The change in CST was significantly decreased in the treatment-naive (p = 0.021) and the switch-therapy (p = 0.013) groups. The mean follow-up was 10.4 months in both groups. One patient in the switch-therapy group developed vascular occlusion and another a macular hole after the fifth brolucizumab injection. Both patients recovered uneventfully. In conclusion, patients showed a very good anatomical and functional response to brolucizumab therapy in the real world, regardless of prior treatment status, until the end of the follow-up period. Two significant untoward events were noted

Assessment of peripapillary retinal nerve fiber layer thickness using scanning laser polarimetry (GDx VCC) in normal Indian children

Purpose: To obtain reference values of RNFL thickness in normal Indian children and to study the association of RNFL thickness with central corneal thickness(CCT) and axial length(AL). Materials and Methods: 200 normal Indian children (mean age 8.6 ± 2.9 yrs) were examined on the GDxVCC. The inferior average (IA), superior average (SA), temporal-superior-nasal-inferior- temporal (TSNIT) average and nerve fiber index (NFI) values were recorded and compared between males and females as well as between the different age groups. The association of TSNIT average with AL and CCT was examined. Results: Values for the RNFL parameters were-SA: 64.9 ± 9.7, IA: 63.8 ± 8.8, TSNIT average: 53.5 ± 7.7 and NFI 21.5 ± 10.8. Superior, inferior and TSNIT averages did not differ significantly between males and females (P = 0.25, P = 0.19, P = 0.06 respectively; Mann-Whitney U test). No significant differences were found in TSNIT average across age groups. There was a statistically significant positive correlation between CCT and TSNIT average (r = 0.25, r = 0.06, P < 0.001). The correlation TSNIT average and AL(r = -0.12; r = 0.01) was not significant (P = 0.2). Conclusion: Reference values for RNFL parameters reported for Indian children are similar those reported in adults. There is a small correlation between central corneal thickness and RNFL as reflected in average TSNIT