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Biomedical subjects

Mani Baskaran

Publications and source records attributed to Mani Baskaran.

8 recordsLinked to original sources

Comparison of the scanning peripheral anterior chamber depth analyzer and the modified van Herick grading system in the assessment of angle closure.

PURPOSE: To compare the performance of the scanning peripheral anterior chamber depth analyzer (SPAC) and the modified van Herick grading system in the assessment of angle closure, using gonioscopy as the reference standard. DESIGN: Prospective comparative study. PARTICIPANTS: One hundred twenty phakic subjects (53 with primary angle closure and 67 with open angles) with no history of laser or intraocular surgery. METHODS: The modified van Herick grading system was used to grade the peripheral anterior chamber depth (ACD) clinically. The SPAC was used to assess ACD, and this was graded categorically as S (suspect angle closure), P (potential angle closure), or N (normal) and numerically from 1 to 12. One randomly selected eye of each subject underwent examination with the modified van Herick grading, SPAC, Goldmann applanation tonometry, optic disc examination, and gonioscopy. The SPAC measurements, modified van Herick grades (0%, 5%, 15%, 25%, 40%, 75%, and > or =100% of corneal thickness), and gonioscopy (graded as narrow or open) were correlated using the Spearman correlation coefficient. The receiver operating characteristics of the 2 methods to detect angle closure also were compared. MAIN OUTCOME MEASURES: Grading of ACD by the SPAC, the modified van Herick system, and gonioscopic grading of the angle. RESULTS: The SPAC results correlated well with the modified van Herick grading system (categorical grade, r = 0.527; numerical grade, r = 0.542; P<0.0001). For eyes graded as having narrow angles by gonioscopy, the area under the curve (AUC) for SPAC categorical grade S or P was 0.790; sensitivity and specificity were 84.9% and 73.1%, respectively. For the modified van Herick grading system, using a cutoff of peripheral ACD < or = 25% corneal thickness, the AUC was 0.872 and sensitivity and specificity were 84.9% and 89.6%. Compared with gonioscopy that found 53 of 120 cases of narrow angles, the SPAC graded more eyes as having narrow angles (63/120) than the modified van Herick system (52/120). CONCLUSIONS: The SPAC correlated well with the modified van Herick system in grading peripheral ACD. However, the SPAC appeared to overestimate the proportion of eyes with narrow angles relative to gonioscopy and the modified van Herick grading system.

Adult↗

Intraocular pressure changes and ocular biometry during Sirsasana (headstand posture) in yoga practitioners.

PURPOSE: To study the intraocular pressure (IOP) changes in Sirsasana (headstand posture) done by experienced yoga practitioners and correlate the ocular biometric parameters with the IOP changes, and to screen for the prevalence of ocular hypertension in this group of subjects. DESIGN: Prospective case observational series. PARTICIPANTS: Seventy-five subjects (50 Asian Indians and 25 Caucasians) from a yoga training institute volunteered for the study. METHODS: All participants underwent a detailed ophthalmic examination along with ocular biometry and corneal pachymetry. Intraocular pressure was recorded using a Tonopen before, during, and after the Sirsasana. Changes were compared using the paired t test. Age, axial length, anterior chamber depth, lens thickness, corneal curvature, corneal thickness, race, and the length of time for which the practitioner was performing yoga were correlated with the induced IOP difference in a randomly selected eye using Pearson's correlation coefficient with Bonferroni correction for multiple comparisons. MAIN OUTCOME MEASURES: Ocular biometry and induced IOP difference. RESULTS: The mean increase in IOP at baseline and immediately after assuming Sirsasana was 15.1+/-4.1 mmHg (R = 0.07; P = 0.999) and after 5 minutes was 15.8+/-4.6 mmHg (R = -0.25; P = 0.357). The induced increase in IOP during the posture was twice the baseline IOP. There was no correlation between age, ocular biometry, and ultrasound pachymetry when compared with the induced IOP difference. One subject (1.33%) was found to have baseline IOP of more than 21 mmHg. CONCLUSION: There was a uniform 2-fold increase in the IOP during Sirsasana, which was maintained during the posture in all age groups irrespective of the ocular biometry and ultrasound pachymetry. We did not demonstrate a higher prevalence of ocular hypertensives in this cohort of yoga practitioners nor did the risk factors contributing to glaucoma show any correlation with magnitude of IOP raise during the posture.

Adult↗

Changes in the optic disc after acute primary angle closure.

PURPOSE: To evaluate the changes in optic disc morphology in the first 4 months after an episode of acute primary angle closure (APAC) using stereoscopic optic disc photography and computer-assisted planimetry. DESIGN: Prospective observational case series. PARTICIPANTS: Forty-seven Asian subjects with unilateral APAC who were successfully treated with laser peripheral iridotomy (LPI). MAIN OUTCOME MEASURES: Cup-to-disc ratio (CDR) and optic cup and neuroretinal rim areas. METHODS: Stereoscopic optic disc photographs were taken 2 and 16 weeks after LPI, and the images were analyzed by computer-assisted planimetry. The overall, quadrantic, and 30 degrees sector areas of the optic disc, CDR, and neuroretinal rim area were analyzed by 2 independent masked graders, and the mean of the readings was used to calculate changes in optic disc parameters. RESULTS: The majority of the subjects were female (66%) and Chinese (90%), and the mean age was 67.6+/-11.2 years (range, 40-94). In APAC eyes from week 2 to week 16, the mean CDR increased from 0.56+/-0.05 to 0.59+/-0.03 (P<0.001), and the mean neuroretinal rim area decreased from 1.74+/-0.31 mm2 to 1.59+/-0.27 mm2 (P<0.001). Quadrantic and sector analysis showed preferential loss of neuroretinal rim area at the superotemporal and inferotemporal areas. There was no significant change in optic disc parameters in the fellow eyes over the study period. CONCLUSIONS: This study demonstrated changes in optic disc morphology from week 2 to week 16 after an episode of APAC. The pattern of optic nerve damage demonstrated in our study was comparable with that seen in primary open-angle glaucoma and experimental glaucoma models.

Acute Disease↗

Role of ultrasound biomicroscopy (UBM) in the detection and localisation of anterior segment foreign bodies.

INTRODUCTION: The aim of this study was to investigate the role of ultrasound biomicroscopy (UBM) in imaging anterior segment foreign bodies and compare it with conventional B-scan ultrasound and computed tomography (CT). MATERIALS AND METHODS: The charts of 18 eyes with anterior segment foreign bodies were reviewed. The rates of detection of foreign bodies using ultrasound, CT scan and UBM were compared. RESULTS: The foreign body detection rates were 36.5% by ultrasound, 88.9% by CT scan, and 94.4% by UBM. The diagnosis of presence of a foreign body using UBM was made based on high reflective echoes causing shadowing or reverberations. In 7 eyes, UBM detected injury to the zonules, guiding the operative procedure. In the 8 eyes for which all tests were performed, rates of detection of foreign bodies were 25% (2/8) with ultrasound, 87.5% (7/8) with CT, and 100% (8/8) with UBM. CONCLUSION: UBM is a valuable adjunct for the accurate localisation of small foreign bodies, including cilia. It offers a higher detection rate than that provided by ultrasound and CT scan.

Adolescent↗

Evaluation of tonometric correction factors.

PURPOSE: To investigate the efficacy of currently available correction factors in correcting intraocular pressure (IOP) measurements for the errors induced by the normal variations in corneal structural characteristics. MATERIALS AND METHODS: Central corneal thickness (CCT) and corneal radius of curvature were measured on 324 individuals (175 normal: group 1 and 149 had either open angle glaucoma or ocular hypertension: group 2). IOP was measured in all normal subjects with the Goldmann applanation tonometer and the highest recorded IOP was obtained from patient charts for subjects with either open angle glaucoma or ocular hypertension. Regression analysis was performed on IOP, CCT, and corneal radius of curvature. The corrected IOP was also calculated using the models proposed by Ehlers and Orssengo and Pye. Linear regression analysis was used to calculate the residual association between corneal parameters and corrected IOP. RESULTS: There was a significant positive correlation between IOP measured using Goldmann applanation tonometer and the CCT in both groups. There was no significant correlation between corneal radius of curvature and IOP in either group. There was a significant negative correlation in both the groups between CCT and corrected IOP calculated using the models of Ehlers and Orssengo and Pye. This indicates that the Ehlers and Orssengo and Pye models may significantly overestimate the effect of CCT on IOP measurement. CONCLUSION: The effect of CCT and IOP as observed in the present study and by other studies in literature is less than predicted by both the Ehlers formula and the Orssengo and Pye model. Correcting IOP for the effect of CCT using these models could be erroneous and lead to overcorrection of IOP, thus resulting in erroneously low corrected IOP eyes with thicker cornea and erroneously high corrected IOP in eyes with thinner cornea.

Adult↗

Prevalence of open-angle glaucoma in a rural south Indian population.

PURPOSE: To determine the prevalence of primary open-angle glaucoma (POAG) and the associated risk factors in a rural population in southern India. METHODS: Subjects aged 40 years or more (n = 3934) underwent a complete ophthalmic examination. Glaucoma was diagnosed according to the International Society of Geographical and Epidemiologic Ophthalmology classification. RESULTS: Complete data were available for 3924 subjects (response rate, 81.75%). In eyes with normal suprathreshold visual fields, the mean intraocular pressure was 14.29 +/- 3.32 mm Hg (97.5th and 99.5th percentiles, 21 and 25 mm Hg, respectively). The mean vertical cup-to-disc ratio was 0.39 +/- 0.17 (97.5th and 99.5th percentiles, 0.7 and 0.8, respectively). Sixty-four subjects had definite POAG (1.62%, 9.5% CI 1.42-1.82); 30 were men and 34 were women. Subjects with POAG (59.85 +/- 10.43 years) were older (P < 0.001) than the study population (53.78 +/- 10.71 years). In only one (1.5%) person was POAG diagnosed before the study. Two (3.12%) subjects were blind due to POAG; 21 (32.81%) subjects had a presenting IOP >21 mm Hg, and 43 (67.19%) had an IOP <21 mm Hg. The mean central corneal thickness in subjects with POAG (502.82 +/- 35.29 microm) was not different from that of the normal study population (505.93 +/- 31.11 microm). No association was found with diabetes mellitus, systemic hypertension, gender, and myopia. Increasing IOP (per mm Hg) was associated with the disease (OR 1.12; 95% CI, 1.08-1.16). The odds for POAG increased with advancing age after adjustment for gender. CONCLUSIONS: The prevalence of POAG in this population was 1.62%. The prevalence increased with age, and 98.5% were not aware of the disease.

Adult↗

Prevalence of refractive errors in a rural South Indian population.

PURPOSE: To report the prevalence of refractive errors in a rural south Indian population. METHODS: Four thousand eight hundred subjects (age, >39 years) from rural south India were enumerated for a population-based study. All participants underwent complete ophthalmic evaluation. Subjects who were phakic in the right eye with best corrected visual acuity of 20/40 or better were included for analysis. Association of refractive errors with age, sex, cataract, and diabetes mellitus were analyzed. RESULTS: Of the 3924 responders, 2508 were eligible. The unadjusted prevalence of emmetropia (spherical equivalent [SE], -0.50 to +0.50 diopter sphere [DS]), myopia (SE < -0.50 DS), high myopia (SE < -5.00 DS), and hyperopia (SE > 0.50 DS) were 50.60%, 26.99%, 3.71%, and 18.70% and age and gender adjusted for the rural Tamil Nadu population were 46.77%, 30.97%, 4.32%, and 17.94%, respectively. The prevalence of emmetropia decreased significantly with age (P < 0.0001), and the prevalence of myopia and high myopia increased significantly with age (P < 0.001) and were significantly associated with nuclear sclerosis (P < 0.001). The prevalence of hyperopia increased until 60 years of age and then decreased. Hyperopia was more common among women than men (P < 0.001) and was negatively associated with nuclear sclerosis (P < 0.001) and positively with diabetes mellitus (P = 0.008). Of the participants with astigmatism (cylindrical error greater than 0.50 DC), 9.80% had with-the-rule (WTR) and 77.44% against-the-rule (ATR) astigmatism. The prevalence of WTR and ATR astigmatism significantly decreased (P < 0.001) and increased (P = 0.006) with age, respectively. CONCLUSIONS: The pattern of refractive errors in this rural south Indian population is similar to those reported in other tropical regions of the world.

Adult↗

Anterior chamber angle assessment using gonioscopy and ultrasound biomicroscopy.

PURPOSE: Comparison of anterior chamber angle measurements using ultrasound biomicroscopy (UBM) and gonioscopy. METHODS: Five hundred subjects were evaluated for grading of angle width by the Shaffer method. UBM was done in the same group to document angle width, angle opening distance (AOD 500), and anterior chamber depth. Biometric parameters were documented in all subjects. UBM and gonioscopic findings were compared. RESULTS: A study was conducted in 282 men and 218 women with a mean age of 57.32 +/- 12.48 years. Gonioscopic grading was used to segregate occludable (slit-like, grades 1 and 2) from nonoccludable (grades 3 and 4) angles. Subjective assessment by gonioscopy resulted in an overestimation of angle width within the occludable group when compared with values obtained by UBM. This did not affect the segregation of occludable versus nonoccludable angles by gonioscopy. Biometric parameters in eyes with occludable angles were significantly lower in comparison with eyes with nonoccludable angles, except for lens thickness. AOD 500 correlated well with angle width. CONCLUSIONS: We concluded that clinical segregation into occludable and nonoccludable angles by an experienced observer using gonioscopy is fairly accurate. However, UBM is required for objective quantification of angles, and AOD 500 can be a reliable and standard parameter to grade angle width.

Adult↗