A 56-year-old female presented with blurred vision in the right eye. Best corrected visual acuity was 6/18, N12 in the right eye and 6/6, N6 in the left eye. Fundus examination in both eyes showed significant tessellation. Spectral domain OCT revealed a split in the neurosensory retina at the level of Henle's layer nasal to fovea with schitic changes extending to fovea. En face OCT demonstrated a very characteristic half wheel or coral shaped pattern at the level of outer plexiform layer highlighting the complete extent of the retinoschisis [Figure 1] .

A 46-year-old male presented with best corrected visual acuity (BCVA) of 20/125 in his right eye. Fundus showed disc edema, multiple yellow outer retinal crops, macular edema and a live motile worm in the subretinal space. Diagnosis of diffuse unilateral subacute neuroretinitis (DUSN) was made and pattern scanning laser photocoagulation (PSLP) was performed along with administration of oral albendazole, diethylcarbamazine and corticosteroids. Complete disappearance of the worm was observed at 2 weeks. At last follow up, final BCVA improved to 20/30. Herein, we report role of PSLP in the management of DUSN.

Different nematodes have been associated with diffuse unilateral subacute neuroretinitis (DUSN) including Toxocara canis, Ancylostoma caninum, Strongyloides stercoralis, Ascaris lumbricoides , and Baylisascaris procyonis . [1] The clinical features of DUSN include subretinal tracks, small yellow-white spots on retina, altered internal limiting membrane (ILM) reflex, vitritis, vasculitis, retinal edema, live worm, alterations of the retinal pigment epithelium, narrowed retinal vessels, and optic disc atrophy especially in late phases. [2] The early signs of DUSN are often mistaken for entities that cause focal chorioretinitis, including toxoplasmosis, histoplasmosis, sarcoidosis, white dot syndromes, nonspecific optic neuritis, and papillitis. The late stage of DUSN is often ...

A 37-year-old man, diagnosed previously as a 'chorioretinal scar' in the macula, came for follow-up examination at our retina clinic. He had no ocular symptoms. Systemic history was normal. Eye examination revealed vision of 20/20 in both eyes. Anterior segment examination was normal in both eyes. Dilated fundus examination revealed pink and healthy optic nerves with normal physiologic cupping in each eye. Right eye macular examination revealed a classical, torpedo-shaped, hypopigmented chorioretinal lesion. Left eye macula was unremarkable. Peripheral retina was normal in both eyes. Multimodal imaging of the torpedo lesion was done with fundus autofluoroscence, fundus fluorescein angiography ...

Conjunctival chemosis is due to the presence of excess fluid in the conjunctival interstitium. It is caused by several conditions, including inflammation, allergy, infection, neoplasia, trauma, exposure, obstruction of lymphatic and venous outflow etc. This patient presented with unilateral diffuse non-resolving chemosis since one year. He had undergone extensive systemic investigations and imaging which were all negative and could not ascertain the cause of chemosis. An anterior segment optical coherence tomography (AS-OCT) confirmed the diagnosis as diffuse conjunctival lymphangiectasia. AS-OCT showed dilated lymphatic vessels as empty thin walled dark spaces of varying caliber in the sub-conjunctival space. Conjunctiva is elevated ...

An 80-year-old female presented with sudden decreased vision in the right eye (RE) since 6 h. Posterior segment examination of RE showed signs suggestive of nonarteritic central retinal artery occlusion (CRAO) with sparing of cilioretinal artery (CLRA) [Figure 1] a and [Figure 1] b. Spectral domain optical coherence tomography (SD OCT) done in macular area showed a middle hyper-reflective band (MHB) in the temporal perifoveal area and increased reflectivity of the inner retinal layers suggestive of ischemia. [1] , [2] The nasal perifoveal area showed normal inner retinal structure, without MHB, suggesting sparing of CLRA [Figure 1] c. The presence of ...

Simple limbal epithelial transplantation (SLET) is an emerging technique for treating unilateral limbal stem cell deficiency. We report the high-resolution, anterior segment optical coherence tomography (OCT) features of the first 2 weeks of a patient undergoing SLET for an old acid injury of the right eye, repeatedly from postoperative day 1 through day 14. Three out of 11 explants with the subjacent human amniotic membrane (hAM) and the overlaid bandage contact lens were imaged. The hAM was intact and of the same thickness throughout the study period; the sub-hAM space increased from day 3 to 9 and disappeared by day ...

A 48-year-old female presented with complaints of recent onset diminution of vision of the left eye (OS) for the past 2 months. She was highly myopic and was using glasses for the past 30 years. Ocular examination revealed presence of a myopic fundus with high axial lengths in both the eyes. Fundus examination of the OS revealed a myopic tessellated fundus with prominent choroidal vessels and a blunted foveal reflex. There was a small pale whitish lesion just superior to the foveal center. Optical coherence tomography (OCT) scans (both horizontal and vertical) confirmed presence of dome-shaped maculopathy. There was subretinal ...

Purpose: The purpose of this study is to compare the thickness and depth measurements of the lamina cribrosa (LC) obtained using a swept-source optical coherence tomography (SS-OCT) device in idiopathic intracranial hypertension (IIH) patients and healthy subjects. Methods: This retrospective, cross-sectional observational study included 16 eyes with IIH and 20 control eyes. The LC measurements with serial horizontal B scans of the optic nerve head were obtained using SS-OCT (Topcon 3D DRI OCT Triton). The anterior lamina surface (ALS) depth, posterior lamina surface (PLS) depth, and LC thickness measurements were evaluated. Results: In patients with IIH, the mean ALS depth ...

Purpose: Diagnosis of choroidal neovascular membrane (CNVM) is difficult in chronic central serous chorioretinopathy (CCSC) due to overlapping features of both on conventional dye angiography. Optical coherence tomography angiography (OCTA) allows a quick and noninvasive detection of CNVM in these eyes. We compared the fluorescein angiography (FA) features of CNVM with those of OCTA to assess the role of FA in detecting CNVM in CCSC eyes. Methods: Patients with CCSC undergoing FA, spectral domain (SD)-OCT, and OCTA were identified (March 2015–June 2015). Four retina specialists individually reviewed FA images (without OCTA and SD-OCT) to determine whether CNVM was ...

A 65-year-old white woman was referred to us to rule out a nematode infestation in the right eye. She was asymptomatic, and best-corrected visual acuity was 20/20 in both eyes. On examination, there were no signs of active inflammation in either eye, and intraocular pressure was 15 mmHg in both eyes. Past medical history was unremarkable and the patient denied recent travel to endemic areas. Fundus examination revealed a deep serpentine shaped subretinal track at the posterior pole of the right eye. Multimodal retinal imaging, including fundus autofluorescence, enhanced-depth imaging optical coherence tomography (EDI-OCT), fluorescein angiography (FA), and indocyanine ...

Retained intraocular graphite foreign bodies are uncommon and generally remain inert in the eye. A 16-year-old girl complained of a black spot on her right eye since 3 months following pencil tip trauma. Examination revealed a subconjunctival greyish-black nodular mass with a metallic sheen on the 5 O' clock limbus with involvement of the adjacent corneal stroma and endothelium [Figure 1] a. Optical coherence tomography revealed subconjunctival [ [Figure 1] b arrow], corneal stromal, and endothelial [ [Figure 1] b arrowhead] hyporeflective material with intense backshadowing. This visual impression will help differentiate pigmented conjunctivo--corneal lesion from other reported mimickers such as melanoma ...

Montage techniques using SD-OCT have been tried in idiopathic macular holes, [1] normal subjects, diabetic retinopathy and Vogt-Koynagi-Harada disease. [2] We present a wide-field montage image from macula to the fundus periphery in a case of polypoidal choroidal vasculopathy (PCV) by using spectral domain optical coherence tomography (SD-OCT) [Figure 1] a. While the SD-OCT features in the macula for PCV are well defined [Figure 1] b and [Figure 1] c, there is a paucity of data concerning the peripheral SD-OCT changes. Merging the SD-OCT the scan length obtained was 26 mm. This enables us to visualize the pathology in relation ...

LETTER TO THE EDITOR

This special issue of the Indian Journal of Ophthalmolog y on pediatric retina has been carefully curated to bring you the hot topics in this niche field of ophthalmology. By far the most common etiology that comes to mind when we imagine the pediatric retina is retinopathy of prematurity (ROP) which has been dealt with in great detail in this issue, including its epidemiology, pathogenesis, risk factors, imaging, screening, treatment, and outcomes by some of the masters in this field. In addition, pediatric tumors such as retinoblastoma, medulloepithelioma, and diseases inherently common in children such as Coats disease have been ...

Purpose: To compare different macular thickness parameters and peripapillary retinal nerve fiber layer (RNFL) thickness between recently diagnosed cases of multiple sclerosis (MS) without optic neuropathy (ON) and healthy individuals. Methods: This cross-sectional study was performed between June 2014 and June 2015. All subjects underwent ocular and retinal examination. Spectral domain optical coherence tomography (SD-OCT) was used to measure the thickness of different layers of the retina at macular and peripapillary regions and at different quadrants. Between groups comparison was performed with P < 0.05 indicating statistical significance. Results: There were 32 eyes in the MS group and 74 eyes ...

In this series, we discuss the role of optical coherence tomography angiography (OCTA) in assessing response to treatment in intraocular vascular tumors. This is a series of two cases: Multiple retinal capillary hemangioblastoma (RCH) treated with laser photocoagulation and diffuse choroidal hemangioma (DCH) with radiotherapy. In large RCH and DCH, optical coherence tomography (OCT) showed significant reduction of subretinal and intraretinal fluid. But post-treatment mean tumor vascular density (MTVD) was slightly reduced. In one small RCH, vascular loop was seen suggesting minimal residual disease. So, OCTA helps in identifying treatment inadequacy and understanding alternate mechanism involved in treatment response in ...

Purpose: To determine the comparability of anterior chamber biometric measurements in primary angle closure disease (PACD) patients using two commercially available anterior segment optical coherence tomography machines (ASOCT): Visante and Casia. Methods: This was a cross-sectional observational study, which included clinically, diagnosed cases of PACD. Anterior segment biometric measurements were done using Casia and Visante ASOCT. Parameters studied were central corneal thickness (CCT), anterior chamber depth (ACD), nasal (N) and temporal (T) angle opening distance at 500 μm (AOD500) and 750 μm (AOD750), and N and T trabecular iris space area at 500 μm (TISA500) and 750 μm (TISA750). Results ...

Purpose: To evaluate the superficial retinal vascular plexus density using optical coherence tomography angiography (OCTA) in cases of strabismic amblyopia. Methods: Ten eyes of 10 patients with purely strabismic amblyopia underwent detailed ocular evaluation followed by the assessment of the superficial retinal plexus vascular density using OCTA (Topcon DRI OCT Triton, Swept Source OCT, Topcon, Japan). Ten contralateral normal eyes of the same patients were considered as control. All these 20 eyes underwent a 4.5 × 4.5 mm cube scan OCTA centered at the fovea. Using the Topcon propriety software all 20 eyes were assessed for the capillary plexus ...

We report the natural course of the accidental injection of trypan blue into the corneal stroma while performing a routine cataract surgery by a resident during a training session. The corneal staining resolved with conservative medical treatment over 7 weeks. This case describes the anterior segment optical coherence tomography (ASOCT) features of corneal staining. It emphasizes on the relatively benign nature of this dye and the follow-up course. Causes that may be responsible for this untoward complication are highlighted with the necessary preventive measures that need to be taken care are also discussed.

Retinal cavernous hemangiomas is a rare vascular tumor, isolated and non-progressive. This tumor is incidentally diagnosed on fundus examination and visual impairment can be rare presentation from vitreous hemorrhage, pre-retinal traction, hyphema, or macular scarring. The tumor has typical appearance of grape-like clusters of dilated vascular sacs with variable surface gliosis. Characteristic imaging findings aids in diagnosis. Newly emerged imaging tool is optical coherence tomography angiography (OCT A) which obtains high-resolution visualization of retinal vasculature in non-invasive fashion. In the present case report, we analyzed various diagnostic tool available for retinal cavernous hemangiomas; illustrating on the OCT A features.

Congenital hypertrophy of retinal pigment epithelium (CHRPE) is a benign, pigmented, flat lesion arising from the retinal pigment epithelium (RPE). In this study, we describe optical coherence tomography angiography (OCTA) features of two eyes with solitary CHRPE. We found that the retinal vasculature over CHRPE was normal in both cases. We observed that in solitary CHRPE, segmentation artifacts can interfere in the interpretation of retinal vasculature due to thinning of the outer retina. Visualization of the underlying choroidal vasculature was obscured to some extent by masking effect of the hyperpigmented RPE. The choroidal vasculature was better appreciated on en face ...

Purpose: To study the epiretinal membrane (ERM) profile on the spectral-domain optical coherence tomography (SDOCT) in eyes with uveitis. Methods: In this prospective observational study, macula of uveitic eyes were evaluated by SDOCT (Cirrus, model 5000) for ERM. ERM was quantified (in microns) and were followed up along with the best-corrected visual acuity (BCVA) and treatment profile for 1 year. ERM morphology (focal, global, or mixed) and characteristics (thickness at fovea, maximum thickness, and location of maximum thickness in relation to fovea) were documented. Changes in altered foveal contour, cystoid macular edema (CME), and central foveal thickness were also noted ...

Paracentral acute middle maculopathy (PAMM) refers to retinal lesions with changes in the inner nuclear layer on spectral domain optical coherence tomography (OCT). PAMM is associated with retinal vascular pathology involving the deep capillary plexus. We report two cases of PAMM in Indian subjects using multimodal imaging highlighting the OCT angiography (OCTA) findings. The first case is of a middle-aged female with a paracentral scotoma with SS-OCT (swept-source optical coherence tomography) and OCTA findings suggestive of “chronic” PAMM. The second case presented with sudden decreased vision, and multiple creamy white lesions suggestive of “acute” PAMM, imaging features depicting a possible ...