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Ravi Thomas

Publications and source records attributed to Ravi Thomas.

13 recordsLinked to original sources
PubMed2003

Five-year risk of progression of primary angle closure to primary angle closure glaucoma: a population-based study.

OBJECTIVE: To report the 5-year progression to primary angle closure glaucoma (PACG) in a population-based cohort of primary angle closure (PAC) subjects. METHODS: A total of 37 patients diagnosed as PAC during a population-based study in 1995 were invited for re-examination in 2000. Patients underwent a complete ophthalmic examination including ocular biometry. Progression to PACG was based on optic disc damage and field defects on automated perimetry. RESULTS: In all, 28 of 32 PAC subjects who could be contacted presented for examination. Eight (28.5%; 95% CI 12-45%) had progressed to PACG; two of seven with appositional and six of 21 with synechial closure. All were advised laser peripheral iridotomy (LPI) in 1995; one of the nine who underwent LPI progressed compared to seven of 19 who refused LPI. Four of those originally diagnosed with appositional closure developed peripheral anterior synechiae. One eye of a person previously diagnosed with appositional PAC was reclassified as a primary angle closure suspect (PACS). There was no significant difference in biometric parameters between those who progressed and those who did not. None developed acute PACG or blindness due to glaucoma. CONCLUSION: In this population-based study of primary angle closure, the 5-year incidence of PACG was eight patients (28.5%; 95% CI 12-45%). We were unable to identify any features that predicted progression.

Biometry↗
PubMed2003

Prevalence of glaucoma in treated multibacillary Hansen disease.

PURPOSE: To determine the prevalence of glaucoma in a population of patients with multibacillary Hansen disease who had completed treatment. PATIENTS AND METHODS: The authors examined 386 of 446 patients with treated multibacillary Hansen disease residing in a geographically limited area. A complete ophthalmic examination including slit-lamp, applanation tonometry, gonioscopy, ophthalmoscopy, and stereobiomicroscopic examination of the optic disc was performed in all subjects. Glaucoma suspects were invited to the base hospital for further examination including automated perimetry. RESULTS: The overall prevalence of glaucoma was 3.6% (CI 1.9-5.3); 1.3% had primary open-angle glaucoma, 7% were primary angle-closure suspects (occludable angles), 1.8% had primary angle-closure glaucoma, and 0.5% had secondary glaucoma. CONCLUSION: The prevalence of primary glaucoma in patients with treated multibacillary Hansen disease was similar to that in the general population, and secondary glaucoma was rare.

Adolescent↗
PubMed2003

Glaucoma in India.

Explore the source record for details and available documents.

Antihypertensive Agents↗
PubMed2003

Comparison between phacoemulsification and the Blumenthal technique of manual small-incision cataract surgery combined with trabeculectomy.

OBJECTIVE: To compare results of filtration combined with either phacoemulsification or the Blumenthal technique of manual small-incision cataract surgery. MATERIALS AND METHODS: Records of glaucoma "triple" operations from March 1997 to May 2000 were reviewed. Seventy-eight eyes (70 patients) that underwent phaco-triple were compared with 86 eyes (80 patients) that underwent the Blumenthal technique of manual small-incision cataract surgery combined with filtration (Blumenthal triple). Three minutes of 0.4 mgs/ml Mitomycin was used in all eyes. Posterior chamber IOLs were implanted through 5.5-mm incisions in both groups. Outcome measures were intraocular pressure (IOP) reduction and achievement of target IOP. Fourteen patients who underwent phacoemulsification-triple in one eye and Blumenthal triple in the other eye were also evaluated separately. RESULTS: The minimum follow-up period was 6 months (range 6-30 months). At last follow-up review, mean reduction in IOP was 17.7 mm Hg (+/- 9.3 mm Hg) in the phaco group and 17.1 mm Hg (+/- 10 mm Hg) in the Blumenthal group. At last visit, target IOP was achieved in 75.6% of the phaco group and 73% of the Blumenthal group. There was no significant difference between groups in IOP reduction or achievement of target IOP. In the 14 patients who had undergone phaco-triple in one eye and Blumenthal-triple in the other, there was no inter-eye difference in IOP reduction. CONCLUSIONS: In this small retrospective study we could not demonstrate a difference in IOP outcomes between the two procedures.

Cataract Extraction↗
PubMed2003

The incidence of vitreous loss and visual outcome in patients undergoing cataract surgery in a teaching hospital.

PURPOSE: To determine the incidence of vitreous loss in patients undergoing cataract surgery and the visual outcome in a tertiary teaching hospital. METHODS: Hospital records of 2095 consecutive patients undergoing cataract surgery between July 1999 and June 2000 were reviewed in this non-concurrent cohort study. Incidence and visual outcome of vitreous loss managed using standard vitrectomy techniques were assessed for different cataract surgical techniques (extracapsular, Blumenthal technique and phacoemulsification) as well as at different levels of surgical training. The outcome was compared with matched cases without vitreous loss (controls). RESULTS: Vitreous loss occurred in 160 of 2095 eyes (7.63%; CI -7 to 9.3): 8.3% for ECCE, 8.1% for the Blumenthal technique and 5% with phacoemulsification. Vision > or = 6/18 was achieved in 85% of cases and 95% of controls. For experienced surgeons, 95% of the cases and controls had vision > or = 6/18. 5.8% of cases and 0.7% of controls had vision < 6/60. One patient in each group was blind following cataract surgery; both had operable cataracts in the fellow eye. CONCLUSIONS: The vitreous loss rate in this tertiary teaching hospital is relatively high. This complication, managed with standard surgical techniques, is compatible with good visual outcome. In eyes with vitreous loss, the final visual acuity achieved by experienced surgeons was similar to that in uncomplicated cases.

Adult↗
PubMed2003

Comparison between latanoprost and brimonidine efficacy and safety in Indian eyes.

PURPOSE: To compare the short-term efficacy and safety of topical latanoprost and brimonidine in Indian eyes. MATERIALS AND METHODS: Twenty-eight patients with ocular hypertension, primary open-angle, pseudoexfoliation or pigmentary glaucoma were enrolled. Following baseline measurements, latanoprost was applied topically once daily in the evening for 12-weeks. After a washout period, brimonidine was applied twice daily in all patients for 6 weeks; 16 patients continued for 12 weeks. Patients were examined at 2, 6 and 12 weeks. The primary outcome measure was the difference in mean intra ocular pressure (IOP) reduction at 6 and 12 weeks. The mean diurnal variation of IOP at baseline and at 12 weeks was also compared. RESULTS: Twenty-six of 28 enrolled patients completed the study. One randomly selected eye of each patient was used for analysis. At 6 weeks, the mean IOP reduction was 11.2 mm Hg (+/- 2.9 mmHg) with latanoprost and 6 mmHg (+/- 3.3 mmHg) with brimonidine. At 12 weeks this was 10.8 mmHg (+/- 2.8 mmHg) and 6.9 mmHg (+/- 3.1 mmHg) respectively. At 6 weeks 85.7% (24) eyes obtained more than 25% reduction in IOP with latanoprost compared to 13 (46.4%) with brimonidine. IOP reduction was maintained with both drugs throughout the study period. Two eyes did not show any response to brimonidine. Latanoprost reduced the diurnal variation of IOP from 5.10 to 2.90 mmHg; brimonidine reduced it from 4.70 to 3.90 mmHg. Conjunctival hyperaemia was present in one patient on latanoprost and three patients on brimonidine. Two patients experienced drowsiness with brimonidine. Neither drug produced side effects necessitating withdrawal from the study. CONCLUSION: In this short-term study, both latanoprost and brimonidine effectively reduced IOP and stabilised the diurnal curve in Indian eyes. Latanoprost was more effective than brimonidine.

Adrenergic alpha-Agonists↗
PubMed2003

Five-year risk of progression of ocular hypertension to primary open angle glaucoma. A population-based study.

PURPOSE: To report the progression of ocular hypertension (OHT) to primary open angle glaucoma (POAG) during a 5-year follow up of a population-based sample. METHODS: Twenty-nine patients diagnosed to have OHT and 110 randomly selected normals from a population-based study in 1995 were invited for ocular examination in 2000. All patients underwent a complete ophthalmic examination; including the daytime diurnal variation of intraocular pressure (IOP) and measurement of central corneal thickness (CCT). The "corrected" IOP was used for analysis. Progression to POAG was based on typical optic disc changes with corresponding field defects on automated perimetry. RESULTS: Twenty-five of the 29 persons with OHT who could be contacted were examined. After correcting for CCT, two persons were reclassified as normal. Four of 23 (17.4%; 95% CI: 1.95-32.75) had progressed to POAG. One person amongst the 110 normals progressed to normal tension glaucoma (NTG). The relative risk of progression amongst OHT was 19.1 (95% CI: 2.2-163.4). All those who progressed had bilateral OHT. The mean and peak IOP in those who progressed was 25.4 mm Hg and 29.3 mm Hg compared to 23.9 mm Hg and 25.7 mm Hg in those who did not. Those who progressed had more than 8 mm Hg diurnal variation. The diurnal variation was less than 6 mm Hg in those who did not progress. No patient developed blindness due to glaucoma. CONCLUSION: The 5-year incidence of POAG amongst OHT in this population was 17.4% (3.5% per year). Bilateral OHT, higher peak IOP and large diurnal variation may be the risk factors for progression.

Disease Progression↗
PubMed2002

Intracameral amphotericin B injection in the management of deep keratomycosis.

PURPOSE: To report the use of intracameral amphotericin B in the management of deep keratomycosis. METHODS: Four patients with deep keratomycosis unresponsive to conventional medical treatment underwent repeated intracameral injections of 5 microg amphotericin B in 0.1 mL 5% dextrose through a paracentesis. Three to 13 intracameral injections were given to each patient over 6 to 36 days. RESULTS: Three of the four patients had complete resolution of the ulcer. The fourth patient perforated and required evisceration. CONCLUSION: Preliminary experience suggests that intracameral injections of amphotericin B may have a role in the management of deep keratomycosis.

Adult↗
PubMed2002

Frequency doubling perimetry in glaucoma.

PURPOSE: To evaluate the validity of frequency doubling perimetry (FDP) in the detection of glaucomatous field defects. METHODS: Group I consisted of 85 eyes of 85 patients with established field defects in automated perimetry, classified by severity of defect. Group II consisted of 48 eyes of 48 control subjects. Both groups underwent Swedish Interactive Testing Algorithm (SITA) standard tests as well as FDP screening strategies (C20-1 and C20-5 and full threshold test). Sensitivity and specificity measures for the FDP tests were calculated using one new and two previously published algorithms. RESULTS: A described scoring system provided the best sensitivity (85.9%) and specificity (95.1%). For moderate and severe cases, the sensitivity improved to 91%. Quantification of the defect did not improve detection. CONCLUSIONS: FDP is a valid screening test for glaucoma. The scoring system described by Patel et al. provided the best results.

Adult↗
PubMed2002

Visual field defects in non-functioning pituitary adenomas.

PURPOSE: To report the prevalence and pattern of visual field loss in non-functioning pituitary adenomas and to study the relationship between the tumour size and severity of field defects. METHODS: Ninety-three patients with histologically confirmed pituitary adenomas, non-functional on hormonal assessment, underwent a complete ophthalmic assessment and automated perimetry using the HFA 30-2 programme. Defects with quadrantanopic or hemianopic characteristics, defined using criteria on the threshold/pattern deviation plots were considered typical. Typical defects were graded as mild, moderate and severe. All other defects were considered atypical. A neuroradiologist measured tumour size on a CT or MRI Scan. The Chi-square test for trend was used to test association of tumour volume with severity of typical defects. RESULTS: Eighty-eight (94.6%) of the 93 patients had a field defect. Typical field defects were seen in 69 (74.2%) patients and atypical in 19 (20.4%). A severe typical defect involving at least 3 quadrants in one or both eyes was the most common (24 patients or 25.80%). All 31 patients (33.3%) with a tumour size greater than 20 cc had field defects. Severity of field defect increased with tumour volume (Chi-square test for trends significant p = 0.0096). CONCLUSIONS: Field defects occurred in 95% of patients with non-functioning pituitary macroadenoma. A severe visual field loss involving at least 3 quadrants in one or both eyes was the most common. 20% of patients had atypical field defects. Severity of field defects increased with tumour volume.

Adenoma↗
PubMed2002

Population-based screening versus case detection.

India has a large burden of blindness and population-based screening is a strategy commonly employed to detect disease and prevent morbidity. However, not all diseases are amenable to screening. This communication examines the issue of "population-based screening" versus "case detection" in the Indian scenario. Using the example of glaucoma, it demonstrates that given the poor infrastructure, for a "rare" disease, case detection is more effective than population-based screening.

Blindness↗