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 ...

A 7-year-old female presented with a diminution of vision in her right eye (RE) since birth, which was deteriorating further for the last few months. Her best-corrected visual-acuity (BCVA) was 20/400 in the RE and 20/20 in the left eye (LE). RE fundus showed funnel-shaped excavated optic disc (OD) suggestive of morning glory disc anomaly (MGDA) with an adjacent retinal detachment (RD), involving the macula. [Figure 1] a A retinal break could not be identified clinically. Radial swept source optical coherence tomography (SS-OCT) (DRI-Topcon) scans revealed preretinal floating vitreous opacities, central fibrotic glial membrane (FGM) over the OD ...

Purpose: To introduce a simple and inexpensive method using a fundus contact lens and a reticle, to measure retinal lesions comparing it with values obtained with high-definition optical coherence tomography (HD-OCT). This study considers optic disc as the object for comparison. Methods : Patients underwent routine ophthalmologic examination and their horizontal optic disc diameter was measured, both with the reticle and OCT. For measurement with reticle a simple equation was deduced, x = 0.7y, where x corresponds to the actual image size and y to the reticle scale reading in millimeters. Results : An aggregate of 127 eyes of 75 patients were ...

A 37-year-old female presented with sudden diminution of vision for 4 days in the left eye with best-corrected vision of 20/200 on Snellen's chart. The anterior chamber and vitreous cavity showed no signs of inflammation. The right eye was unremarkable [Figure 1] a, and the left eye had presence of multiple yellowish pigmentary alteration [Figure 1] b – blue arrow] just inferior to fovea and healed chorioretinal atrophic patch (CRA) along superior arcade. Fundus fluorescein angiography showed an early hypofluorescence [Figure 2] a, with linear hyperfluorescence [Figure 2] b and [Figure 2] c just inferior to fovea with no ...

Purpose: To evaluate the differences in vascular indices in different scan sizes of optical coherence tomography angiography (OCTA) images in normal persons versus persons with diabetic retinopathy. Methods: OCTA scans of diabetic patients and age-matched controls were performed by a single operator. Automated quantification of vascular indices of the superficial plexus was analyzed in two angiocubes of 3 × 3 mm and 6 × 6 mm, respectively. The agreement was analyzed with the intraclass correlation coefficient (ICC) and Bland–Altman plots. Results: Forty-eight eyes with DR, 36 eyes with no diabetic retinopathy (No DR), and 26 eyes of age-matched normals were scanned ...

Purpose: To evaluate age-related changes in macular vessels and their perfusion densities using optical coherence tomography angiography (OCTA). Methods: A total of 108 eyes of 54 healthy subjects between the age group of 11 to 60 years having unaided visual acuity of 20/20 were studied on spectral domain OCTS using 3 * 3 mm macula protocol. These subjects were divided into 5 groups; Group 1: 11–20 years, Group 2: 21–30 years, Group 3: 31–40 years, Group 4: 41–50 years, and Group 5: 51–60 years. An early treatment diabetic retinopathy study (ETDRS) grid overlay at the ...

Purpose: To describe the outcome of microscope integrated optical coherence tomography (MiOCT) guided removal of lenticulo-corneal adhesion and intralenticular lens aspiration (ILLA) in cases with anterior dislocation of the crystalline lens and corneal edema. Methods: MiOCT-guided ILLA was performed in three eyes of two cases of homocystinuria with spontaneous anterior dislocation of lens and corneal edema. Lenticulo-corneal adhesion was noted intraoperatively, which was not apparent pre-operatively. The lenticulo-corneal adhesion could be successfully peeled using intravitreal forceps and viscodissection with visco-dispersive viscoelastic under the guidance of MiOCT. Results: In all cases, the lenticulo-corneal adhesion could be successfully removed without any complication ...

A 33-year-old healthy man presented with defective vision in the left eye for 10 days. Visual acuity in the right (OD) and left eye (OS) was 6/6 and counting finger, respectively. Fundus examination OD was normal whereas OS showed a yellowish-white lesion at the macula and multiple discrete lesions in the periphery and mid-periphery. SDOCT (Heidelberg Engineering, Heidelberg, Germany) OS showed hyperreflectivity of inner retinal layers with extensive loss of retinal tissue suggestive of necrotizing retinitis [Figure 1] . Considering the differentials of tuberculosis, toxoplasma, syphilis, and viral infection, which can cause necrotizing retinitis, a thorough workup was done. While ...

Primary care provides a place to which people can bring a wide range of health problems – it is not acceptable that in low-income countries primary care would only deal with a few priority diseases. World Health Report 2008 . On the eve of 2019 World Sight Day (WSD), the World Health Organization (WHO) released the World Report on Vision (WRV). [1] This report is based on three earlier WHO resolutions – primary eye care, universal health coverage, and sustainable development goals (SDG). [2] , [3] , [4] Primary care, often the first contact for patients, provides appropriate, accessible, and affordable care that meets patients ...

Artificial intelligence (AI) has become popular in the recent years due to the increase in the computing power of devices, availability of massive amounts of training data via the Internet, and availability of less-expensive cloud data storage. With the emergence of autonomous vehicles, face recognition, and language processing, artificial intelligence has revolutionized our lives. In this manuscript, the authors have described a very robust AI algorithm for DR screening with good sensitivity and specificity using different fundus cameras to eliminate bias using predominantly mydriatic Fundus images. [1] Deep learning (DL) has the ability to identify intricate structures in datasets without ...

A 22-year-old boy presented to our center with subtotal rhegmatogenous retinal detachment (RRD). His best-corrected visual acuity (BCVA) was 20/1200 in the affected eye. Posterior segment examination revealed large superotemporal horse-shoe tear with multiple lattices [Figure 1] a and [Figure 1] b. The patient underwent vitreoretinal surgery with an encircling band and silicone oil tamponade using 3D heads-up visualization system. [Figure 1] c and [Figure 1] d Intraoperatively, brilliant blue G dye and PFCL (perflurocarbon liquid) were injected to peel the internal limiting membrane. However, microscope-integrated optical coherence tomography (mi-OCT) revealed subretinal fluid persistent at the posterior pole along ...