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Lingam Gopal

Publications and source records attributed to Lingam Gopal.

31 records · Page 2Linked to original sources
PubMed2002

Retinal detachment in Marfan syndrome: clinical characteristics and surgical outcome.

PURPOSE: To describe the clinical characteristics of retinal detachments in patients with Marfan syndrome and report the surgical outcome of vitreoretinal surgery. METHODS: Records relating to 53 eyes of 45 patients with Marfan syndrome who underwent surgery for rhegmatogenous retinal detachment were reviewed. Of the 53 eyes, 24 (45.3%) underwent scleral buckling as the first procedure and 29 (54.7%) underwent vitrectomy surgery with scleral buckle as the first procedure. Main outcome measures included clinical characteristics of retinal detachment, reattachment rates, and functional improvement in vision. RESULTS: Characteristic findings included total retinal detachment in 40 (75.5%) eyes, atrophic holes in 24 (45.3%) eyes, more than four retinal breaks in 21 eyes (39.6%), preequatorial and postequatorial breaks in 20 (37.7%) eyes, giant retinal tears in six (11.3%) eyes, and proliferative vitreoretinopathy (posterior, anterior, or both) in nine (17%) eyes. In 30 (56.6%) eyes, retinal breaks were located only in the temporal half of the retina. Of the 24 eyes with myopia, 13 (54.2%) had a myopic correction greater than 7 diopters. At the median follow-up of 10.7 months, complete retinal reattachment was obtained in 87.6% and 86.2% of patients undergoing scleral buckling (including additional procedures such as vitrectomy) and vitrectomy surgery, respectively. In eyes with reattached retinas, a final visual acuity of 20/200 or better was obtained in 81% of the patients after scleral buckling and in 56% of the patients after vitrectomy surgery (P = 0.07). CONCLUSIONS: Retinal detachment in Marfan syndrome is complete in 75% of the eyes. More than half (56%) the eyes had a retinal break only in the temporal half of the retina, and 83% had at least a break in the temporal half of the retina. Currently available vitreoretinal surgical techniques result in successful reattachment of the retina in approximately 86% of the eyes.

Adolescent↗
PubMed2002

Clinical profile and immunological status of cytomegalovirus retinitis in organ transplant recipients.

PURPOSE: Cytomegalovirus retinitis (CMV) is the most common ocular opportunistic infection in transplant recipients. This retrospective study attempts to report the differences in occurrence of cytomegalovirus retinetis in transplant recipients from those reported in patients with acquired immunodeficiency syndrome (AIDS). METHODS: 25 eyes of 15 transplant recipients (14 renal and one cardiac) with cytomegalovirus retinitis were retrospectively reviewed. Immunological profile included CD4+ and CD8+ T lymphocyte counts, CD4+/CD8+ cell ratio (5 cases) and serology for the viral antibodies (8 cases). RESULTS: A predominantly bilateral presentation (60%) was noted. Active cytomegalovirus retinitis (72%) in zone 2 (92%) of the inferotemporal quadrant (68%) was noted. The average cell counts were within normal limits (mean CD4 cell count-711/microliter), unlike in late stages of AIDS with cytomegalovirus retinitis (CD4 count < 50/microliter). Serology revealed an IgM positivity of 53%. Retinal detachment (52%) was the most common complication occurring after an average of 5.4 months. CONCLUSION: CMV retinitis in organ transplant recipients appears to differ from that in AIDS patients. CMV retinitis presents early and has different immunological profile, probably owing to differences in pathogenesis.

Adult↗
PubMed2002

Current approaches to diagnosis and management of ocular lesions in human immunodeficiency virus positive patients.

Human immunovirus infection in India is rapidly increasing. Ocular lesions due to highly active antiretroviral therapy have been well recognized. Acquired immunodeficiency syndrome can affect all parts of the eye. However, posterior segment lesions are the most common and of these, Human immunodeficiency virus retinopathy and cytomegalovirus retinitis predominate. Often clinical examination can establish the diagnosis of many ocular lesions in acquired immunodeficiency syndrome; therefore, ophthalmologists need to be aware of the more common ones. Various drugs in different routes can used to treat cytomegalovirus retinitis. Highly active antiretroviral therapy has remarkably reduced systemic and ocular morbidity among acquired immunodeficiency syndrome patients. To facilitate care of these patients aseptic precautions for ophthalmic care personnel are now well established and therefore ophthalmologist should not hesitate to provide ophthalmic care to acquired immunodeficiency syndrome patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Eales disease--an update.

Eales disease, first described by Henry Eales in 1880, remains an enigma. The disease, observed more commonly in the Indian subcontinent than in the rest of the world, occurs in young healthy adult males, initially presenting as retinal periphlebitis and later as retinal ischemia that may lead to vascular alterations and neovascularization. Recurrent vitreous hemorrhage with or without retinal detachment is the common sequelae. In recent years, immunological, molecular biological, and biochemical studies have indicated the role of human leukocyte antigen, retinal autoimmunity, mycobacterium tuberculosis genome, and free radical mediated damage in the etiopathogenesis of this disease. However, its etiology appears to be multifactorial. The management depends on the stage of the disease and consists of medical treatment with oral corticosteroids in the active inflammatory stage and laser photocoagulation in the advanced retinal ischemia and neovascularization stages. The results of vitreoretinal surgery have been found to be satisfactory in case of vitreous hemorrhage with or without retinal detachment.

Diagnosis, Differential↗
PubMedDate not supplied

Primary vitrectomy for combined rhegmatogenous retinal detachment and choroidal detachment with or without oral corticosteroids: a pilot study.

PURPOSE: The occurrence of choroidal detachment (CD) in eyes with primary rhegmatogenous retinal detachment (RRD) is relatively uncommon (2%-4.5%). Recent reports suggest that primary vitrectomy yields better anatomic success than scleral buckling. However, for these inflamed eyes with low intraocular pressure, the influence of preoperative oral steroids on reattachment rates has not been elucidated yet. METHODS: Twenty eyes with combined RRD and CD that underwent primary vitrectomy were randomized to receive oral steroids (for 1 week) or no oral steroids before surgery. RESULTS: Preoperative clinical data such as mean age, lens status, Snellen visual acuity, duration of macular detachment, CD (size and extent), and retinal detachment characteristics (e.g., extent, number of retinal breaks, atrophic or tractional retinal break, size of retinal break, and location of retinal break) were similarly distributed in both groups. Single-operation anatomic success was 81.8% (9/11) among those patients who received preoperative oral steroids and was 66.7% (6/9) among those who did not receive preoperative oral steroids. After reoperation, anatomic success was 100% in both groups. The mean follow-up was 20.1 months. CONCLUSION: The results suggest that administration of oral steroids before primary vitrectomy in eyes with combined RRD and CD improves reattachment rates.

Administration, Oral↗
PubMedDate not supplied

Anterior chamber collapse following vitreoretinal surgery with gas tamponade in aphakic eyes: incidence and risk factors.

PURPOSE: To report the risk factors associated with occurrence of anterior chamber collapse in aphakic eyes that underwent vitrectomy with gas tamponade. METHODS: A total of 314 eyes of 314 patients who underwent vitrectomy with gas tamponade and who were aphakic or were made aphakic intraoperatively were studied prospectively. Factors such as iris and pupillary integrity, depth of anterior chamber, gonioscopic grading, behavior of the anterior chamber on the operation table during fluid-air exchange, removal of crystalline lens or intraocular lens during surgery, and type of internal tamponade were noted. The anterior chamber was assessed postoperatively in supine and sitting position and with head bent forward. Statistical methods were used to identify risk factors for development of postoperative anterior chamber collapse using SPSS soft ware. RESULTS: Anterior chamber collapse occurred in 13 eyes (3.14%). Presence of preoperative shallow anterior chamber, removal of intraocular lens as a part of the procedure, occurrence of intraoperative anterior chamber collapse, and use of sulfur hexafluoride (SF6) were associated with higher risk of anterior chamber collapse postoperatively. CONCLUSIONS: The identification of potential risk factors in a given eye can alert the surgeon to the possibility of development of anterior chamber collapse postoperatively.

Adolescent↗
PubMedDate not supplied

Pigmented malignant medulloepithelioma of the ciliary body.

Medulloepitheliomas are usually amelanotic. Pigmented medulloepitheliomas are unusual and only two cases have been reported. We report an additional case of pigmented malignant medulloepithelioma of the ciliary body with histopathologic correlation.

Child↗
PubMedDate not supplied

The clinical spectrum and treatment outcome of retinoblastoma in Indian children.

PURPOSE: To study the clinical spectrum and treatment outcome of retinoblastoma in Indian children. PATIENTS AND METHODS: This retrospective study analyzed 488 eyes of 355 retinoblastoma patients treated at a tertiary care ophthalmic hospital in southern India during a 14-year period. RESULTS: Retinoblastoma involved one eye in 177 (50%) and both eyes in 178 (50%) patients. Mean age at presentation was 23.98 +/- 23.37.

Adolescent↗
PubMedDate not supplied

Results of vitrectomy in Terson syndrome.

BACKGROUND: To report visual results of vitrectomy in Terson syndrome MATERIALS AND METHODS: In 11 patients, 15 eyes underwent vitreous surgery for Terson syndrome. The mean follow up was 18.3 months. RESULTS: An incomplete posterior vitreous separation was noted in 10 eyes (66.7%). An epiretinal membrane was present in 4 eyes (26.7%), and in 3 eyes, a retinal fold along the arcade was noticed. Significant visual improvement occurred in all eyes; visual acuity of 20/40 or better was achieved in 14 eyes (93.3%). Only 3 eyes developed lens opacity after surgery. CONCLUSION: Vitrectomy in Terson syndrome provides excellent visual recovery. The complication rate, including the development of cataract, is low.

Adult↗
PubMedDate not supplied

Indocyanine green dye-enhanced transpupillary thermotherapy of classic subfoveal choroidal neovascularization.

BACKGROUND AND OBJECTIVE: To evaluate the efficacy of indocyanine green dye-enhanced transpupillary thermotherapy for the treatment of classic subfoveal choroidal neovascular membrane (CNVM) with differing etiologies. PATIENTS AND METHODS: Nine eyes of 9 patients with classic subfoveal CNVM with different etiologies that was treated with indocyanine green dye-enhanced transpupillary thermotherapy were prospectively studied. All patients underwent pretreatment fluorescein angiography. Three minutes after dye injection (25 mg of indocyanine green), transpupillary thermotherapy was delivered using a modified diode laser at 810 nm, with a variable spot size of 0.8 to 2 mm depending on the size of the CNVM. A power range between 100 and 800 mW was used and treatment was initiated in one spot for 60 seconds; the end point was a barely detectable light gray appearance of the lesion. The outcome measures were assessed by Snellen visual acuity chart and obliteration of the CNVM by fluorescein angiography. Mean follow-up was 16 months. RESULTS: Obliteration of the CNVM was seen in all patients during the last visit. Visual acuity improved in one eye and remained stable (+/-2 line change on Snellen chart) in three eyes. Three eyes revealed a moderate visual loss of 3 to 4 lines and two eyes had a severe decline (> 5 lines) in vision. None of the eyes exhibited recurrence of the CNVM during follow-up. CONCLUSIONS: Indocyanine green dye-enhanced transpupillary thermotherapy was highly effective in closing classic CNVM in all cases without any recurrence. Visual acuity was either stabilized or improved in 4 of 9 eyes (44.5%).

Adult↗
PubMedDate not supplied

Retinoblastoma: a diagnostic model for India.

PURPOSE: Molecular genetic diagnostics for retinoblastoma are prerequisite for accurate risk prediction and effective management. Developing a retinoblastoma diagnostic model to establish a flow for laboratory tests is thus a necessity for tertiary ophthalmic institutions. An efficient diagnostic model could reduce the overall health care costs, redirect the resources to the high risk group and also avoid unnecessary worry for families. To the best of our knowledge there has hitherto been no comprehensive diagnostic model for retinoblastoma implemented in any institution in India. METHODS AND DISCUSSION: The diagnostic model demonstrates the logical and practical flow of various genetics tests like karyotyping, loss of heterozygosity analysis, molecular deletion, linkage analysis (familial cases), mutation screening of -CGA exons first and then non-CGA exons, methylation screening of RB1 and essential promoter regions screening in a laboratory. CONCLUSIONS: The diagnostic model proposed offers acomprehensive methodology to identify the causative two-hits for retinoblastomas that could be used while genetic counseling families. This model is applicable in tertiary hospitals in India and neighboring countries, which have the highest incidence of retinoblastoma and fertility rates in the world. We suggest that this diagnostic model could also be applied with modification for other cancers.

Child↗