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 ...

Supernumerary puncta is an uncommon congenital anomaly where multiple puncta are present in one eyelid formed by multiple epithelial budding of lacrimal cord opening along canaliculus, caruncle, and conjunctiva during embryogenesis. [1] , [2] Slit-lamp examinations of left lower lid found presence of two puncta [Figure 1] a of a 44-year-old gentleman. Spectral domain anterior-segment OCT [SD-ASOCT] imaging of puncta [3] by RTVue model-RT100 CAM -system [Optovue Inc., Fremont CA, USA] showed two funnel shaped tissue gap corresponding cross-sectional image of supernumerary puncta [Figure 1] b. To the best of our knowledge, this is the first report of AS-OCT of supernumerary ...

A 47-year-old lady (index case) with diabetes and deafness showed multiple oval circumferential areas of perifoveal atrophy in both eyes. Autofluorescence revealed areas of hypoautofluorescence. Optical coherence tomography (OCT) showed depression of inner retinal surface, inner retinal hyporeflective spaces (pseudocysts), disorganization/thinning of outer retina, outer retinal tubulation, loss of external limiting membrane, ellipsoid and interdigitation zone, and thinning of the retinal pigment epithelium and choriocapillaris. The patient was evaluated using OCT angiogram. Retinal lesions of her mother (68-year-old) were very obvious on autofluorescence imaging. The result of A3243G mutation in MTTL1 gene was positive in the index case confirming ...

Purpose: To evaluate the potential clinical utility of wide-field swept source optical coherence tomography angiography (SS-OCTA) using a prototype device compared to a wide-field fundus autofluorescence (FAF) for analysis of the disease activity in eyes with tubercular serpiginous-like choroiditis (TBSLC). Methods: Using a prototype SS-OCTA device (PLEX Elite, Carl Zeiss Meditec, Dublin, CA), 17 eyes of 12 consecutive patients with TBSLC were imaged and multiple 12 mm × 12 mm OCTA scans were captured, which were montaged to create wide-field montage OCTA images scans. A wide- FAF (Eidon, CenterVue, Padova, Italy) was performed in the same sitting. Two masked graders independently ...

Purpose: To explore novel Optical Coherence Tomography (OCT) biomarkers and precursor lesions in Polypoidal Choroidal Vasculopathy (PCV). Methods: This retrospective cohort study included 76 treatment naïve fellow eyes of PCV. Focus was given to analyse the various morphological changes in the clinically unaffected fellow retina during the follow-up period. Results: 11 fellow eyes (14.47%) developed disease activity in the form of Sub Retinal Fluid (SRF) or Intra Retinal Fluid (IRF) within a mean follow-up of 17 months. All 11 eyes (100%) showed the presence of flat irregular pigment epithelial detachment (FIPED) and a peculiar property of lateral elongation ...

The study describes the technique of combining microscope-integrated optical coherence tomography (mi-OCT) and proportional reflux hydrodissection (PRH) during pars plana vitrectomy (PPV) in eyes with complex proliferative diabetic retinopathy (PDR) including tractional retinal detachment (TRD), combined retinal detachment (CRD), and taut posterior hyaloid membrane (TPHM). In this technique, PRH is used to create tissue planes between fibrovascular adhesions in areas identified using mi-OCT for insinuating the vitrector, enabling tissue dissection and release of traction. About 46 patients were operated using this technique. 34 eyes had TRD, 9 eyes had CRD, and 3 eyes were diagnosed with TPHM. A second instrument ...

Purpose: To describe the swept-source optical coherence tomography (SS-OCT) features of regressed macular retinoblastoma (RB). Methods: A cross-sectional observational study was carried out in 13 patients with regressed macular RB with good fixation in at least one eye. Fundus photography and SS-OCT were documented. High-resolution scans with good signal strength were selected. The types of clinical regression and SS-OCT characteristics of the regressed lesions (presence of vitreous detachment, intratumor schisis/cavitation, calcification, foveal dip, and OCT pattern) were noted. Results: Of the 13 eyes, 7 (53%) were group B, 4 (30%) were group C, and 2 (17%) were group D ...

Purpose: To study optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) features of circumscribed choroidal hemangioma (CCH) following treatment with photodynamic therapy (PDT) and transpupillary thermotherapy (TTT). Methods: A retrospective chart review of consecutive patients treated for CCH over 2 years (May 2016–April 2018). The investigations, in addition to comprehensive eye examination, included color fundus photography, B-scan ultrasonography, OCT, and OCT-A. Results: The study included 16 eyes of 16 patients (9 males and 7 females). The mean age at presentation was 43.5 ± 9 years (range 33–62 years). Macula ( n = 6) and superior arcade ( n = 5 ...

In this case report, we demonstrate the use of optical coherence tomography angiography (OCTA) as a tool to evaluate intrinsic vasculature in a case of juxtapapillary melanoma which underwent ruthinium.106 plaque brachytherapy. In this case, OCTA could demonstrate a decrease in caliber and density of the intrinsic vasculature of the tumor post brachytherapy

A 33-year-old gentleman was presented with metamorphopsia in the left eye due to choroidal osteoma (CO) complicated by choroidal neovascular membrane (CNVM). Optical coherence tomography angiography (OCTA) proved to be a valuable, noninvasive tool in monitoring treatment response of CNVM. The tumor subsequently underwent decalcification over a period of 4 years. In addition, SS-OCT scans were instrumental in documenting the natural course of the tumor and focal choroidal excavations (FCE), which were found in correspondence with tumor decalcification. Close follow-up is warranted in FCE, secondary to decalcification of CO, as CNVM has been documented to occur on the slope or ...

Purpose: To compare foveal avascular zone (FAZ) area and circularity, ganglion cell layer (GCL) thickness, retinal perfusion density (PD), and vessel density (VD) in eyes with branch retinal vein occlusion (BRVO) after resolution of cystoid macular edema (CME) to fellow control eyes and to correlate these parameters with visual acuity (VA). Methods: SD-OCTA scans (Zeiss Angioplex; Carl Zeiss Meditec Version 10) obtained on 32 eyes with BRVO after resolution of the CME with their fellow eyes used as controls were retrospectively evaluated. Parameters analyzed were FAZ size and circularity, PD, and VD in the superficial capillary plexus measured in the ...

Purpose: To ascertain if ultrasound (USG) B-scan examination of the optic nerve head (ONH) can be a useful tool to diagnose and quantify glaucomatous cupping. Methods: A cross-sectional observational study of 48 eyes of 48 patients with clear ocular media and cup-disc ratio of (CDR) ≥0.6 were included. The disc was studied by + 90D examination, USG B-scan and ONH Optical coherence tomography (OCT) by three masked observers. Observer-1 assessed the clinical CDR, observer-2recordedopticcup diameter on USG B-scan and observer-3performed ONH OCT to note the software computed average CDR. Measurements of cupping obtained by these 3 methods were compared and ...

A 22-year-old male presented for a routine check up. Uncorrected visual acuity was 20/20 in both eyes. Slit lamp examination revealed superior yellow-white stromal opacities extending circumferentially from 9 o'clock to 3 o'clock in the right eye [Figure 1] a and [Figure 1] b and around 12 o'clock in the left eye [Figure 2] a and [Figure 2] b along with superficial vascularisation and lipid deposition at the leading edge of the corneal thinning. There was no epithelial defect. Intraocular pressure was 16 mmHg in both eyes using Goldmann applanation tonometry. A dilated fundus examination was ...

A 55-year-old lady was referred to the retina clinic, with history of globe hypotony post peribulbar anesthesia injection in the left eye (OS). Best corrected visual acuity (BCVA) in the right eye was 6/60 and in the left eye was light perception. Intraocular pressure OS was 6 mm of Hg. On examination, pupillary reactions were normal. Anterior segment examination revealed immature senile cataract in the right eye and pseudophakia in the left eye. Left eye fundus view was obscured owing to vitreous hemorrhage, whereas the right eye was normal. B-scan was done to rule out retinal detachment, and the ...