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Biomedical subjects

Parul Sony

Publications and source records attributed to Parul Sony.

At least 19 recordsLinked to original sources

Classifying patterns of localized glaucomatous visual field defects on automated perimetry.

AIM: To classify the classic patterns of glaucomatous visual field defects on automated perimetry and to study their proximity to fixation. STUDY DESIGN: Cross-sectional observational study. MATERIALS AND METHODS: About 1120 full threshold 30-2 reliable visual fields of glaucoma patients were analyzed by 2 glaucomatologists. Classically described patterns of visual field defects were identified on the pattern deviation plot and definitions proposed. Interreader agreement between 3 independent (not involved in the classification) readers was determined. Proximity to fixation of the different patterns was assessed. RESULTS: Interreader agreement with 3 readers was found to be 93% or more between any 2 readers using the present system of classification. Central fixation was seen to be involved in 45% of the glaucomatous visual field defects studied overall. CONCLUSIONS: The proposed definitions of topographical glaucomatous field defects based on the pattern deviation probability plot are simple to use in clinical practice with good interreader agreement.

Cross-Sectional Studies↗

Effect of laser in situ keratomileusis and laser-assisted subepithelial keratectomy on retinal nerve fiber layer thickness.

PURPOSE: To evaluate and compare the influence of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) on the peripapillary retinal nerve fiber layer (RNFL) thickness. SETTING: Observational case series. METHODS: Twenty nonglaucomatous patients with mild to moderate myopia were included. One eye in each patient was randomly selected to have LASIK (Group 1, n = 20), and LASEK was performed in the fellow eye (Group 2, n = 20). The RNFL thickness measurements were performed using optical coherence tomography (OCT) preoperatively and 1 day and 1 month postoperatively. The RNFL thickness parameters were compared using repeated-measures 1-way analysis of variance (ANOVA) followed by multiple comparison tests in both groups. The main outcome parameter was RNFL thickness as determined by OCT before and after LASIK and LASEK. RESULTS: The mean age of the patients was 21 years +/- 3.2 (SD). The mean preoperative spherical equivalent was -4.23 +/- 1.71 diopters (D) in Group 1 and -4.16 +/- 1.68 D in Group 2. The mean ablation depth was 73.35 +/- 27.85 microm and 66.35 +/- 23.64 microm in groups 1 and 2, respectively. In Group 1, the mean average RNFL thickness, inferior average, superior average, temporal average, and nasal average were 98.2 +/- 5.6 microm, 128.6 +/- 11.9 microm, 120.38 +/- 10.2 microm, 65. 8+/- 7.1 microm, and 80.5 +/- 18.8 microm, respectively. None of the RNFL thickness parameters or RNFL ratios were found to have a significant change after surgery. In Group 2, the average RNFL thickness, inferior average, superior average, temporal average, and nasal average were 98.47 +/- 5.9 microm, 128.38 +/- 14.3 microm, 125.1 +/- 8.8 microm, 66.4 +/- 8.2 microm, 73.6 +/- 15.8 microm, respectively. No significant change was observed in any of the parameters following surgery. No significant alterations were noted in the RNFL parameters following LASIK or LASEK. CONCLUSIONS: Laser in situ keratomileusis and LASEK did not significantly affect the RNFL thickness parameters postoperatively.

Adult↗

Optical coherence tomography findings in commotio retina.

A 16-year-old boy presented with diminished visual acuity of 6/60 following blunt trauma to his right eye with a cricket ball. Fundus examination showed commotio retinae. Optical coherence tomography (OCT) demonstrated increased reflectivity with small optically clear spaces in the area corresponding to the photoreceptor outer segment. At 2-month follow up the visual acuity improved to 6/6. A small area of retinal opacification persisted nasally, and OCT of the corresponding area continued to show increased reflectivity in the area of photoreceptor outer segment. Increased reflectivity on OCT in eyes with commotio retinae probably denotes photoreceptor outer segment disruption and seems to be reversible to a variable extent.

Adolescent↗

Diagnostic capability of optical coherence tomography in evaluating the degree of glaucomatous retinal nerve fiber damage.

PURPOSE: To evaluate the role and ability of optical coherence tomography (OCT) to detect differences in peripapillary retinal nerve fiber layer (RNFL) thickness between normal and glaucomatous eyes and also between different severities of glaucoma. METHOD: This cross-sectional observational study included 160 eyes of 160 healthy subjects and 134 eyes of 134 patients with primary open-angle glaucoma (POAG). Peripapillary RNFL thickness was measured on OCT using the fast RNFL thickness protocol. The RNFL thickness parameters used for evaluation included average RNFL thickness and inferior, superior, nasal, and temporal RNFL thickness. The glaucomatous eyes were subdivided into three subgroups on the basis of visual field defects and a fourth subgroup of eyes blinded by glaucoma. RNFL thickness parameters were compared among the normal eyes and the glaucoma subgroups. Correlation of global visual field indices with RNFL thickness parameters was also performed. RESULTS: The average RNFL in control subjects, early glaucoma, moderate glaucoma, severe glaucoma, and blind glaucoma were 102.30 +/- 10.34, 77.68 +/- 15.7, 66.07 +/- 15.5, 53.65 +/- 14.2, and 44.93 +/- 4.95 microm, respectively. There was a significant difference in all RNFL thickness parameters between normal and all glaucoma subgroups (P < 0.001). Average and inferior RNFL thicknesses showed the highest area under the receiver operating characteristic curve, with 0.905 and 0.862 for normal versus early glaucoma, 0.705 and 0.722 for early versus moderate glaucoma, 0.737 and 0.717 for moderate versus severe glaucoma, and 0.635 and 0.584 for severe versus blind glaucoma. Both mean deviation (MD) and corrected pattern standard deviation (CPSD) showed a significant correlation with all the RNFL thickness parameters in eyes with glaucoma (P < 0.001). CONCLUSIONS: RNFL thickness measured on OCT may serve as useful adjuncts in accurately and more objectively distinguishing normal from glaucomatous eyes, even in the early stages of glaucoma and may help to differentiate various severities of glaucoma. Average and inferior RNFL thicknesses are among the most efficient parameters for distinguishing such a differentiation. RNFL thicknesses in eyes blinded by glaucoma provide an estimate of the component of the RNFL thickness, which is not related to visual function.

Adult↗

Inter-instrument agreement and influence of central corneal thickness on measurements with Goldmann, pneumotonometer and noncontact tonometer in glaucomatous eyes.

PURPOSE: This study was conducted to compare the intraocular pressure (IOP) measurements by the Goldman applanation tonometer (GAT), non contact tonometer (NCT) and the ocular blood flow (OBF) pneumotonometer in different IOP ranges in glaucomatous eyes. The effect of central corneal thickness (CCT) on IOP measurement in chronic glaucomatous eyes using the three different tonometers was also evaluated. MATERIALS AND METHODS: IOP measurements of 130 eyes of primary glaucoma patients were performed using GAT by an ophthalmologist while NCT and OBF-pneumotonometer measurements were performed by an experienced optometrist. The IOP values were compared amongst the three instruments in the three different IOP ranges (0-18 mmHg, > 18 to 25 mmHg, > 25 mmHg). CCT was also measured in all patients. RESULTS: The mean of paired difference between GAT and NCT was 0.9 +/- 3.1 mmHg while that between GAT and OBF-pneumotonometer was 0.3 +/- 3.4 mmHg. The OBF-pneumotonometer and NCT were more affected by corneal thickness (0.41 mmHg and 0.4 mmHg / 10 micro corneal thickness respectively) while GAT was the least affected by corneal thickness (0.3 mmHg / 10 micro corneal thickness) though the difference was not statistically significant ( P =0.42). CONCLUSION: With appropriate correction for corneal thickness the NCT and OBF-pneumotonometer can be used as reliably as GAT in following up glaucomatous patients.

Adult↗

Limbal patch graft in surgically induced scleral necrosis.

BACKGROUND: Surgically induced scleral necrosis (SINS) is a rare consequence of ocular surgery. Various graft materials have been recommended for the repair of scleral necrosis. We report use of fresh cadaveric limbal graft for the same purpose. METHOD: A 42-year-old female presented with severe pain and buckle extrusion following external segmental buckling surgery for inferior retinal detachment. Buckle removal performed under general anesthesia revealed an area of scleral necrosis with uveal prolapse. Due to non-availability of other donor material a fresh cadaveric limbal graft remnant after keratoplasty was used for the repair after obtaining informed consent. RESULTS: Successful uptake of graft was observed and the globe integrity was restored. CONCLUSION: The case suggests that a fresh limbal graft may provide adequate tectonic support in eyes with SINS and can serve as an option for donor graft tissue in emergency situations.

Female↗

Macular hole and sub-hyaloid hemorrhage following filtering surgery with mitomycin C.

BACKGROUND: We report the occurrence of a macular hole with sub-hyaloid hemorrhage following filtering surgery with mitomycin C. METHODS: Combined trabeculotomy and trabeculectomy with mitomycin C was performed in the left eye for primary congenital glaucoma. RESULTS: Two weeks postoperatively the fundus showed a macular hole with subretinal and retinal hemorrhage along with sub-hyaloid bleeding. Optical coherence tomography confirmed the presence of a full-thickness macular hole. CONCLUSION: A full-thickness macular hole with subretinal and retinal hemorrhage is reported as a complication of glaucoma filtering surgery.

Child↗

Bilateral retinal venous occlusion in pigmentary glaucoma.

BACKGROUND: The association of central retinal vein occlusion with primary open angle glaucoma is well known. This communication reports the occurrence of branch retinal vein occlusion and central retinal vein occlusion in a case of pigmentary glaucoma. METHODS: A 32-year-old man presented with old branch retinal vein occlusion in one eye and resolving central retinal vein occlusion in the other eye. Examination revealed bilateral Krukenberg's spindle and hyperpigmented trabecular meshwork. Intraocular pressure was 30 mmHg OU. Topical antiglaucoma medication was prescribed. RESULTS: Intraocular pressure was controlled with topical antiglaucoma medication. CONCLUSION: The present report suggests that intraocular pressure monitoring is important in eyes even with branch retinal vein occlusion. Pigment dispersion may be the underlying cause for bilateral retinal vein occlusion, especially in young patients.

Adult↗

Amniotic membrane transplantation in refractory neurotrophic corneal ulcers: a randomized, controlled clinical trial.

PURPOSE: This study was designed to compare and evaluate the efficacy of amniotic membrane transplantation with the conventional management (tarsorrhaphy and bandage contact lens) in eyes with refractory neurotrophic corneal ulcers. METHODS: Thirty eyes of 30 patients (14 females and 16 males) with neurotrophic corneal ulcers refractory to medical management were included and divided randomly into group 1 (n = 15), who received conventional management with a tarsorrhaphy (n = 11) or bandage contact lens (n = 4), and group 2 (n = 15), who underwent Amniotic Membrane Transplantation. The outcome parameters evaluated were epithelialization time, duration of healing of corneal ulcers, and improvement in best corrected visual acuity. RESULTS: The mean age in our study was 37 +/- 14.71 years. At the end of 3 months follow-up, 10 of 15 patients (66.67%) in group 1 showed complete epithelialization and subsequent healing and 11 of 15 patients (73.33%) in group 2 showed complete epithelialization and healing (P > 0.05). The median time for complete epithelialization was 21 days in both groups. Both groups showed an improvement in the best-corrected visual acuity. CONCLUSIONS: Both amniotic membrane transplantation and conventional management (tarsorrhaphy or bandage contact lens) are effective treatment modalities for refractory neurotrophic corneal ulcers.

Adolescent↗

Indications of penetrating keratoplasty in northern India.

PURPOSE: To identify the indications for penetrating keratoplasty in northern India. METHODS: All the eye bank records of penetrating keratoplasties performed during the period from June 1997 to November 2003 at Rajendra Prasad Center for Ophthalmic Sciences were reviewed. RESULTS: During this period, 2022 penetrating keratoplasties were performed. The leading indications for penetrating keratoplasty were corneal scarring (38.03%) followed by acute infectious keratitis (28.38%), regrafting (11.5%), aphakic bullous keratopathy (7.27%), pseudophakic bullous keratopathy (6.18%), and corneal dystrophy (3.85%). Healed infectious keratitis (19.83%) was the most common subcategory among the eyes with corneal scarring followed by traumatic corneal scars (16.71%). Healed (19.83%) and active keratitis (28.38%) together accounted for the majority of keratoplasties (48.21%). In cataract-related corneal edema (13.45%), aphakic bullous keratopathy (7.27%) was almost as frequent as compared with pseudophakic bullous keratopathy (6.18%). CONCLUSIONS: Corneal infections either active or healed are the most common indication for keratoplasty in northern India.

Adolescent↗

Traumatic lenticele.

A 55-year-old woman presented with sudden diminution of vision in her left eye following trauma with her own finger. Examination revealed a firm subconjunctival swelling superiorly with aphakia and hypotony. Lens spike was absent on B-scan. Ultrasonic biomicroscopy showed thickened conjunctiva, a subconjunctival mass lesion with an underlying uveoscleral discontinuity. A surgical repair was performed with successful restoration of globe integrity. This case demonstrates that ultrasonic biomicroscopy may reveal the site and the extent of occult scleral rupture and help in precise surgical planning.

Cataract↗

Bilateral macular cysts following electric burn.

A 28-year-old man presented with bilateral acute loss of vision following a high-voltage injury. The visual acuity was 6/36 in the right eye and 6/24 in the left eye. Fundus examination revealed a well-defined round lesion simulating a full thickness macular hole in the right eye and yellow deposits in the macular area in the left eye. Optical coherence tomography (OCT) showed bilateral macular cysts, with intact outer and inner retinal layers. At 1 month follow up, OCT showed a persistent macular cyst in the right eye with spontaneous resolution of the macular cyst along with visual improvement in the left eye.

Adult↗