Optical Coherence Tomography: Clinical Applications in Medical Practice

Optical Coherence Tomography (OCT) is a success story of scientific and technological co-operation between a physicist and a clinician. The concept of cross-sectional imaging revolutionalized the applicability of OCT in the medical profession. OCT is a non-contact, topographic, biomicroscopic device that provides high resolution, cross-sectional digital images of live biological tissues in vivo and in real time. OCT is based on the property of tissues to reflect and backscatter light involving low-coherence interferometry. The spatial resolution of as little as 3 microns or even less has allowed us to study tissues almost at a cellular level. Overall, OCT is an invaluable adjunct in the diagnosis and follow up of many diseases of both anterior and posterior segments of the eye, primarily or secondary to systemic diseases. The digitalization and advanced software has made it possible to store and retrieve huge patient data for patient services, clinical applications and academic research. OCT has revolutionized the sensitivity and specificity of diagnosis, follow up and response to treatment in almost all fields of clinical practice involving primary ocular pathologies and secondary ocular manifestations in systemic diseases like diabetes mellitus, hypertension, vascular and neurological diseases, thus benefitting non-ophthalmologists as well. Systemically, OCT is proving to be a helpful tool in substantiating early diagnosis in diseases like multiple sclerosis and drug induced retinopathies by detecting early changes in morphology of the retinal nerve fiber layer

Alternating central serous chorioretinopathy in two consecutive pregnancies

To highlight the similarity in onset, clinical course, and resolution of central serous chorioretinopathy in two eyes, in two consecutive pregnancies in the same patient. A case report. Snellen visual acuity, slit-lamp examination, and optical coherence tomography (OCT). A 31-year-old female had central serous chorioretinopathy with sub-retinal exudates in left eye during the sixth month of her first pregnancy and later in right eye also during the sixth month of her second pregnancy two years later. Both eyes had spontaneous resolution of the lesions with final visual acuity of 1.0 each eye. To the best of our knowledge, there have been no reports of alternating CSCR with  sub-retinal exudates, occurring exactly in the sixth month of two consecutive pregnancies, two years apart, with spontaneous resolution after deliveries

Sebaceous gland carcinoma of the eyelid

Sebaceous gland carcinoma, commonly arises in the periocular area, is an uncommon condition. It represents 1-5.5% of eyelid malignancies and is considered to be the third most common eyelid malignancy after basal cell and squamous cell carcinomas, although few reports placed this tumor as second most common after basal cell carcinoma. It usually affects elderly women and characterized by high rate of local recurrence, regional, and distant metastases. A delay in diagnosis, which can be attributed primarily to ability of this tumor to masquerade as more benign conditions, often leads to inappropriate management with increased morbidity and mortality rates. In this study, the authors discuss key elements of the primary disease and therapeutic options available to treat such devastating problem

Cerebro-rhino orbital mucormycosis: An update

Summary: Mucormycosis is an uncommon fungal infection which can lead to fulminant necrotizing infection under optimal host condition. Fungi have the ability to invade blood vessels and can affect different parts of the body. The most common, though the most aggressive, form is cerebro-rhino-orbital mucormycosis that occurs in debilitated patients, in conjunction with sinus or para-sinus involvement.Due to increased number of newly diagnosed cases of mucormycosis world-wide resulting from uncontrolled metabolic conditions, this paper intends to widen the reader's scope and knowledge about the nature of the disease and its multicomplexity that require a collaborative effort for careful management. Patients who are at risks both at the onset of the disease and during its management have been identified in the paper. Keywords: Mucoromycosis, Cerebral, Orbital, Hyperbaric oxygen, Antifungal agent

Culture Negative Confoscan Positive Acanthamoeba Keratitis: A relentless course

Acanthamoeba keratitis is a protozoal infection of the eye, mainly due to the use of non-sterile solutions, like saline for disinfecting contact lenses. We report a case where delay in the diagnosis of acanthamoeba keratitis due to inadequate laboratory investigations and clinical management led to an excruciatingly painful course of the disease. The importance of non-invasive imaging techniques of confocal microscopy in the diagnosis of acanthamoeba keratitis, in the absence of positive culture reports, is highlighted in this case

Fibrous histiocytoma as first presentation in systemic lupus erythematosus and sero-positive Sjögren's syndrome

Purpose: To describe a triad of fibrous histiocytoma, Systemic Lupus Erythematosus and Sero-positive Sjögren's Syndrome. Observations: This case was diagnosed first as bilateral fibrous histiocytoma of cheeks, which on further investigations proved to be a triad of Systemic Lupus Erythematosus, Fibrous histiocytoma and Sero-positive Sjögren's Syndrome. Conclusions and importance: Association between fibrous histiocytoma, Systemic Lupus Erythematosus and Sero-positive Sjögren's Syndrome has been known before, but fibrous histiocytoma as first presentation in the triad has not been reported. Keywords: Fibrous histiocytoma, Systemic lupus erythematosus, Sjogren's syndrom