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Biomedical subjects

Nitin S Shetty

Publications and source records attributed to Nitin S Shetty.

8 recordsLinked to original sources
PubMed2004

Visual outcome after discontinuation of corticosteroids in atypical severe central serous chorioretinopathy.

PURPOSE: To elucidate the effect of discontinuation of corticosteroids in patients with atypical severe central serous chorioretinopathy (CSC) on retinal reattachment, resolution of retinal pigment epithelium (RPE) leaks, and improvement in visual acuity (VA). DESIGN: Prospective, noncomparative, observational case series. PARTICIPANTS: Twenty-four eyes of 17 patients who were being treated with corticosteroids for atypical severe CSC. Of these 17 patients, 16 were treated inappropriately with corticosteroids for their ocular condition; presumably, these patients' conditions were misdiagnosed, and they were thought to have choroiditis, Harada's syndrome, or similar entities, and not central serous chorioretinopathy. INTERVENTION: Observation or laser photocoagulation. MAIN OUTCOME MEASURES: Reattachment of the retina, obliteration of RPE leaks on fundus fluorescein angiography, and improvement in Snellen VA. RESULTS: Discontinuation of corticosteroids resulted in reattachment of the retina in 21 eyes (87.5%), with median time to reattachment of 49 days (range, 32-400); only 3 eyes required laser photocoagulation. Fundus fluorescein angiography showed obliteration of RPE leaks at a median period of 75 days (range, 32-400) in the observed eyes; the median VA improved from 20/80 to 20/30. The mean follow-up was 16.5 months. CONCLUSIONS: Discontinuation of corticosteroids in atypical CSC helped in obliteration of RPE leaks and retinal reattachment in 87.5% of the eyes without laser treatment, and improvement in VA was observed.

Adult↗
PubMed2003

Intraocular cysticercosis: clinical characteristics and visual outcome after vitreoretinal surgery.

PURPOSE: To report the clinical characteristics of, discuss the surgical options for, and analyze the factors affecting the anatomic and visual outcome of intraocular cysticercosis. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Forty-five eyes of 44 Indian patients with posterior segment intraocular cysticercosis. METHODS: The charts of 45 eyes, in which intraocular cysticercosis was removed by vitreoretinal surgery (either transscleral or transvitreal), were reviewed. MAIN OUTCOME MEASURES: These included the postoperative retinal status and the best-corrected Snellen visual acuity. RESULTS: Intraocular cysticercosis was present in the vitreous cavity of 27 eyes (60%) and in the subretinal space of 18 eyes (40%). Anterior segment inflammation was seen in 13 eyes (28.8%) and vitreous inflammation in 38 eyes (84.4%). Retinal detachment was observed in 22 eyes (48.8%), with proliferative vitreoretinopathy in 13 eyes (59.09%). Subretinal cysts anterior to the equator (4 eyes) were removed transsclerally, whereas subretinal cysts posterior to the equator and intravitreal cysts (41 eyes) were removed transvitreally. The mean follow-up was 10.5 months. At the last follow-up, the retina was attached in 39 eyes (86.6%); visual acuity of >/=5/200 was achieved in 67.5%. CONCLUSIONS: Current vitreoretinal surgical techniques enable removal of intraocular cysticercosis in all cases, with reattachment of the retina in 86.6% and recovery of ambulatory vision in approximately 67% of cases.

Adolescent↗
PubMed2003

Scleral buckling: implant versus explant.

PURPOSE: To compare the implant and explant techniques of scleral buckling. METHODS: This prospective, randomized clinical study compared the two techniques of scleral buckling. Variables such as size and extent of the buckle, duration of the surgery, complications, and anatomical and visual outcome were studied. The height of the buckle as measured by ultrasonography was also studied. RESULTS: No significant difference was found between the two groups for total duration of the surgery, complications, anatomical results, visual outcome, and buckle height. For the 1- to 2-quadrant buckles, duration of the surgery up to initiation of subretinal fluid drainage was found to be significantly shorter for the explant group. Serial ultrasonography showed significant reduction in buckle height over 6 months in both groups to an equal degree. CONCLUSIONS: Scleral buckling seems to be equally effective whether performed as an implant or explant.

Adult↗
PubMed2003

Endophthalmitis caused by Acinetobacter calcoaceticus. A profile.

PURPOSE: To report the clinical and microbiological profile of endophthalmitis caused by Acinetobacter calcoaceticus. METHODS: A retrospective study of case series of Acinetobacter calcoaceticus endophthalmitis. Outcome measures included ability to sterilise the eye, anatomical result (clear media and attached retina) and visual recovery (visual acuity > 6/60). RESULTS: Of the 20 cases studied, 10 were cases of postoperative endophthalmitis, 3 were posttraumatic, 6 were endogenous and one was bleb-related endophthalmitis. Specific features of interest observed were relative chronicity of presentation and absence of any obvious predisposing factor in endogenous endophthalmitis cases. All cases could be sterilised except one, which needed evisceration. Cases with postoperative endophthalmitis had better anatomical outcome (7/10 with attached retina and clear media) and visual outcome (4/10 regained vision > 6/18). Higher smear positivity was seen in vitreous samples (72.2%) compared to aqueous samples (37.5%). Culture positivity was higher from the vitreous cavity compared to aqueous. The organism was sensitive to ciprofloxacin in a high percentage (88.9%) of cases. CONCLUSIONS: Visual recovery in Acinetobacter calcoaceticus endophthalmitis is modest. Ciprofloxacin is the antibiotic of choice.

Acinetobacter Infections↗
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↗
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↗