Recent decade has seen a shift in the causes of childhood blinding diseases from anterior segment to retinal disease in both developed and developing countries. The common retinal disorders are retinopathy of prematurity and vitreoretinal infections in neonates, congenital anomalies in infants, and vascular retinopathies including type 1 diabetes, tumors, and inherited retinal diseases in children (up to 12 years). Retinal imaging helps in diagnosis, management, follow up and prognostication in all these disorders. These imaging modalities include fundus photography, fluorescein angiography, ultrasonography, retinal vascular and structural studies, and electrodiagnosis. Over the decades there has been tremendous advances both in ...

Purpose: Obtaining a better understanding of the pathogenesis of primary angle-closure disease (PACD) still requires studies that provide measurements of anterior and posterior biometric characteristics together and that assess the relationship between them. Methods: In total, 201 eyes were enrolled in this cross-sectional study: 50 normal controls, 49 primary angle-closure suspect (PACS), 38 primary angle closure (PAC), and 64 primary angle-closure glaucoma (PACG) eyes. The anterior and posterior structural features were measured by anterior segment optical coherence tomography and swept-source optical coherence tomography. Results: All PACD groups had smaller anterior chamber depth (ACD), anterior chamber area (ACA), anterior chamber volume ...

Purpose: To describe the changes along nucleo-epinuclear and the opacity-capsular junction during hydrodelineation and the entire period of phacoemulsification using intraoperative optical coherence tomography (iOCT). Methods: A total of 12 eyes of 12 patients with clinically confirmed posterior polar cataract, who underwent cataract surgery by a single surgeon under the direct guidance of iOCT. The changes along nucleo-epinuclear junction and opacity-capsular junction during/following hydrodelineation and the changes along the opacity-capsular junction following nucleus removal, capsular changes before the opacity removal, and its dynamic changes throughout the surgical procedure were studied. Results: The mean age of patients was 48.25 ...

Purpose: The aim of this study was to compare SD-OCT parameters between disc suspects and “pre-perimetric” glaucomatous discs classified on disc photos. Methods: Disc photos of suspicious discs with normal Humphrey visual fields (HVF) were graded as normal or pre-perimetric glaucomatous based on the consensus of three masked glaucoma specialists. RNFL and GCL-IPL maps of SD-OCT (Cirrus OCT) of these eyes were studied. Quantitative RNFL parameters were compared. Both groups were also compared with respect to parameters being classified as abnormal (at the 1% level), and the pattern of GCL-IPL and NFL maps were assessed qualitatively and classified as normal ...

Purpose: This study aimed to evaluate the optic coherence tomography (OCT) findings in patients with toxoplasmic retinochoroiditis (TRC). Methods: A total of 12 eyes of 12 patients with active TRC were included in the study. At baseline, at the first-month follow-up, at the sixth-month follow-up and at the 1-year follow-up, the TRC lesion OCT and macula OCT were evaluated. Results: Hyperreflectivity of the inner retinal layers and an increase in retinal thickness were observed on the OCT examinations of all the patients with an active TRC lesion. The retinal thickness decreased and the reflectivity of retinal layers was disorganized in ...

Purpose: The aim of this study was to estimate and compare the differences in ocular biometric measurements (OBMs), central macular thickness (CMT), and retinal nerve fiber layer thickness (RNFLT) between children with refractive errors and those with emmetropia. Methods: A cross-sectional observational study of 205 children (334 eyes) aged between six and 18 years consisting of four groups (emmetropia, hypermetropia, myopia, and astigmatism) was carried out. Best-corrected visual acuity (BCVA), a detailed ocular examination, OBMs, spectral-domain optical coherence tomography (SD OCT) for RNFLT and CMT in both eyes were evaluated for each child. Results: Mean age of 205 children was ...

Vishal Raval, Rajeev Reddy, Swathi Kaliki, Taraprasad Das, Arun D Singh Indian Journal of Ophthalmology 2021 69(2):332-336 Purpose: The objective of this study was to identify the diagnostic features of optic nerve head melanocytoma (ONH-MCT) on spectral domain optical coherence tomography (SD OCT) and OCT angiography (OCT-A).

Purpose: To compare the standard and “innovative wide-field” optical coherence tomography images in assessment of vitreoretinal interface in proliferative diabetic retinopathy. Methods: Fifty consecutive eyes of 25 patients with proliferative diabetic retinopathy underwent 12 × 12 mm radial swept source-optical coherence tomography (OCT) imaging using standard technique and innovative wide-field (+90D) technique. The image expansion ratio was calculated using Image J software. Results: Out of the 50 eyes, only in four eyes with +90 D were minimally misaligned or were having quality less than grade 2 as compared to standard OCT. The mean age group was 51 ± 4.5 years. The ...

Purpose: To investigate the structural and functional changes of the retina and optic nerve in amblyopia. Methods: Eighteen patients with unilateral anisometropic amblyopia and 27 age-matched healthy controls were involved in this study. All patients underwent optical coherence tomography angiography (OCTA), pattern visual evoked potential (pVEP), and flash electroretinogram (fERG). Results: There was no statistically significant difference in terms of the foveal avascular zone (FAZ), perifoveal superficial density, whole superficial density, parafoveal deep density, perifoveal deep density among the eyes ( P > 0 0.05). Significant differences were found only in superficial capillary plexus (SCP) vessel density in whole ( P = 0 ...

One of the leading challenges in refractive surgery today is the presence of underlying subclinical early-stage keratoconus (KC), which can lead to iatrogenic post laser in situ keratomileusis ectasia. Timely detection of this condition could aid the refractive surgeons in better decision-making. This includes being able to defer refractive surgery in subclinical cases as well as providing treatment for the same in the form of appropriate corneal collagen crosslinking treatments. Corneal topography is considered the gold standard for the diagnosis of corneal ectatic disorders. However, there is a likelihood that topographers are overlooking certain subclinical cases. The corneal epithelium is ...

Purpose: To study the morphological changes within mature senile cataracts on modified posterior segment optical coherence tomography (OCT). Methods: A cross-sectional observational study recruiting patients of mature cataracts admitted for elective cataract surgery in tertiary eye care. A modified OCT imaging of the lens was done and lenticular findings were noted by a single observer. Corresponding slit-lamp biomicroscopic findings and intraoperative experiences were also noted by a second observer and respective surgeons. Results: Forty-four eyes of 44 patients were included. The mean age of patients was 65 ± 5.7 years. The intralenticular findings were uniform in groups of eyes, and ...

Purpose: To describe the in-vivo pathology of indirect choroidal rupture (ICR) in patients with recent ocular trauma using swept-source optical coherence tomography (SSOCT). Methods: Retrospective observational study of the presenting and follow-up OCT images of four consecutive Asian patients with blunt trauma presenting over a period of 6 months and review of OCT descriptions in the literature. Results: The three patients who presented within 2 weeks of injury showed a gap in the Bruch's membrane (BM)/retinal pigment epithelial complex at the site of the ICR. The distance of the gap ranged from 103 to 465 μm. Blood from ...

Purpose: Serpiginous choroiditis (SC) is primarily an inflammation of choriocapillaris leading to nonperfusion. A quantitative assessment of choriocapillaris perfusion can be done by measuring the flow-density by OCT-Angiography (OCTA). This study measures a change in the flow-density of choriocapillaris with the resolution of inflammation. Methods: The OCTA images of a choriocapillaris slab of 30 eyes with active SC were subjected to binarization and vessel density was measured at baseline and final visits and compared. Results: Upon comparing the vessel density of the affected areas by OCTA of choriocapillaris-slab at baseline and final visits, there was statistically significant ( P < 0.0001 ...

A 32-year-old Asian Indian male presented with sudden-onset and painless decrease in vision in the right eye (OD) for the past 1 day. On examination, his best-corrected visual acuity was 6/24 in OD and 6/6 in the left eye (OS). Anterior segment was quiescent in both eyes. Fundus examination showed ill-defined yellowish subretinal lesions inferior to fovea with surrounding fluid reaching the inferior arcade in OD. A cystic lesion with well-defined borders was seen in the foveal center. Fluorescein angiography (FA) showed early hypofluorescence and late hyperfluorescence indicating active choroidal inflammation. Pooling of dye was appreciated in the ...

Multiple evanescent white dot syndrome (MEWDS) may be complicated with choroidal neovascularization (CNV) or simultaneous white dot diseases. [1] , [2] Here, we presented a case of MEWDS with an unusual pigment epithelial detachment (PED) with hyperreflective material. A 22-year old male presented with decreased vision in his left eye. Best corrected visual acuity was 20/20 in the right and 20/100 in the left with a myopic refraction of -2.50 D. He did not describe any viral prodrome. Funduscopic examination showed parafoveal yellowish lesions [Figure 1] .

A 45-year-old female developed a bilateral grade 4 anterior chamber (AC) inflammation after using topiramate 100 mg once daily for 1 week for her epilepsy. Her best-corrected visual acuity (BCVA) was counting fingers close to face (CFCF) in both eyes. Topiramate was discontinued [1] and she was started on intense topical steroids and cycloplegics. At 1 week, her BCVA improved to 20/60 and AC showed reduced reaction with retracting fibrin [Figure 1] a. An AS-OCT showed multiple hyperreflective dots [2] (cells) surrounded by a boundary of fused hyperreflective dots [Figure 1] b suggestive of enmeshed coagulum of fibrin (yellow ...

Sympathetic ophthalmia (SO) is often diagnosed when an inflammatory process appears to be advanced. Herein, the authors present the prospective optical coherence tomography (OCT) study of the onset of SO in the sympathizing eye. Prior to any signs of uveitis, we noted the mild disintegration of the retinal pigment epithelium (RPE) layer, the interdigitation zone (IZ), and the ellipsoid zone (EZ). The complete disruption of IZ and EZ was seen 12 weeks later. After 14 weeks, the uveal inflammation was present, and OCT imaging disclosed the formation of nodule-like lesions between the Bruch's membrane and the RPE layer. The ...

Post fever retinitis (PFR), characterized by multiple cotton wool spot like lesions in the posterior pole, is commonly reported following viral and bacterial infections. Retinal perfusion defects have been documented with the help of optical coherence tomography angiography (OCTA) in cases of PFR. But long term changes in such cases have not been reported earlier. In the following report, we have described the swept-source OCTA findings of two PFR patients at initial presentation and three years follow-up. Initial OCTA scans may not provide accurate information regarding the perfusion status due to associated retinal edema and inflammation. However, persisting perfusion defects ...

Purpose: To evaluate the RNFL thickness by optical coherence tomography (OCT) and correlate it with the axial length and refractive error in myopes. Methods: Patients with myopia −1D to −10D attending ophthalmology OPD at a tertiary hospital from October 2013 to April 2015 for evaluation underwent ophthalmic examination including refraction, axial length, and OCT RNFL thickness measurements. The patients were divided into two groups; group A included patients with AL ≤24 mm and group B AL >24 mm. Results : The study included 100 eyes with myopia ranging from −1D to −10D. The mean (±SD) age was 26.87 (±5.93 ...

Patients posted for phacoemulsification underwent initial steps of wound construction and a continuous curvilinear capsulorhexis in a routine manner. Following this, microscope-integrated intraoperative optical coherence tomography (MIOCT) was focused along with the posterior cortical-capsular interface [Figure 1] a and the surgeon performed a smooth hydro-dissection using a 27-gauge cannula mounted on a 2-cc syringe filled with balanced salt solution (BSS). The injected BSS jet traveled just underneath the anterior capsule and along with adjacent cortical matter till the equator. The dissection jet force then took a posterior course to reach the posterior pole of the cataractous lens. During this first ...

Purpose: To quantitatively assess anterior chamber and angle parameters by anterior segment optical coherence tomography (AS-OCT) in myopic eyes undergoing Implantable Collamer Lens (ICL V4c) implantation. Methods: Prospective noncomparative observational case series. Pre and postoperative (1 st and 3 rd month) AS-OCT angle parameters (anterior chamber depth [ACD], anterior chamber angle [ACA], Angle opening distance [AOD], trabecular iris space area [TISA], scleral spur angle [SSA]) were evaluated in 32 eyes (16 patients). SPSS version 20 with paired t -test for intragroup and Mann-Whitney U value test for intergroup comparisons. Results: It included 6 (37.5%) males and 10 (62.5 ...

A 13-year-old boy presented to our hospital with a diminution of vision in the left eye for 2 months after having blunt trauma with a cricket ball. The patient was having best-corrected visual acuity (BCVA) 20/320 with normal intraocular pressure. Slit-lamp examination showed iris cyst containing serous fluid in supero-temporal quadrant extending to the pupillary area [Figure 1] a and [Figure 1] b. Anterior margin of iris cyst was well-depicted on anterior segment optical coherence tomography (AS-OCT). [1] , [2] , [3] Drainage of fluid was done from the most prominent part of the cyst with help of 30G needle attached ...

Submacular hemorrhage (SMH) following ruptured retinal artery macro aneurysm (RRAM) has better prognosis as compared to other etiologies. Timely intervention from as early as 24 h to less than 7 days is known to provide better visual outcomes in such cases. A variety of surgical techniques have been described in the treatment of RRAM. In this case report, we describe the advantages of intraoperative optical coherence tomography-guided sub-retinal injection of a cocktail mixture consisting of recombinant tissue plasminogen activator, bevacizumab, and air. Faster visual recovery with an immediate displacement of sub-macular bleed can be achieved with this technique in cases ...

Purpose: This purpose of this study was to find the association between severity of visual impairment and retinal nerve fiber layer (RNFL) thickness loss in different demyelinating diseases using optical coherence tomography (OCT) and, simultaneously, assess the fellow eye for subclinical RNFL thickness loss. Methods: This cross-sectional, observational study included 60 eyes of 30 patients above the age of 20 years with diagnosed cases of multiple sclerosis (MS), neuromyelitis optica (NMO), and clinically isolated syndrome (CIS) who had history of (h/o) optic neuritis (ON) attack were included. Participants included in the study group underwent best-corrected visual acuity (BCVA) measurement ...