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Biomedical subjects

Vinay A Shah

Publications and source records attributed to Vinay A Shah.

At least 19 recordsLinked to original sources
PubMed2006

Ultrasonographic characteristics and treatment outcomes of surgery for vitreous hemorrhage in idiopathic polypoidal choroidal vasculopathy.

PURPOSE: To describe the ultrasonographic characteristics and treatment outcomes of surgery in vitreous hemorrhage (VH) associated with idiopathic polypoidal choroidal vasculopathy (IPCV). DESIGN: Retrospective interventional and observational case series. METHODS: Clinical, ultrasound, and surgical data of 10 consecutive patients operated for VH due to IPCV in a tertiary eye institute was studied by chart review. Data were analyzed to determine the clinical features, ultrasonographic characteristics, and surgical outcomes. An additional five patients with IPCV without VH were evaluated by ultrasound in various stages of the disease. RESULTS: Between January 1998 and March 2005, 10 eyes of 10 patients underwent vitreous surgery for VH associated with IPCV. Characteristic ultrasonographic features that helped the diagnosis preoperatively included focal choroidal thickening without excavation or acoustic hollowing with associated low reflective echoes of dispersed VH, or diffuse choroidal thickening and low-intensity echoes of dispersed hemorrhage on either side of the retinal spike, often without vitreous detachment spike. Oral corticosteroids were provided preoperatively to patients with associated exudative retinal detachment. Indocyanine green angiography (ICGA) confirmed IPCV postoperatively. Focal lesions were treated with laser photocoagulation. Anatomical success was seen in nine of 10 eyes. Visual acuity improved in five of 10 eyes but was limited by macular pathology in other five eyes. The most common complication was iatrogenic tears. Some eyes had recurrent IPCV lesions in follow-up. CONCLUSIONS: Characteristic ultrasonographic features could identify IPCV in eyes with VH. Anatomical and visual outcomes of our management approach were encouraging and need further study.

Adult↗
PubMed2006

Idiopathic macular hole surgery with low-concentration infracyanine green-assisted peeling of the internal limiting membrane.

PURPOSE: To evaluate the efficacy of pars plana vitrectomy with infracyanine green (IFCG)-assisted internal limiting membrane peeling for the treatment of idiopathic macular hole. DESIGN: Prospective, noncomparative interventional case series. METHODS: Thirty-eight consecutive eyes of 35 patients with idiopathic macular hole were included in the study. Patients underwent early treatment diabetic retinopathy (ETDRS) visual acuity examination, dilated ophthalmoscopy, and optical coherence tomography before treatment and during follow-up. Fluorescein angiography was done in selected cases. Patients underwent a three-port pars plana vitrectomy with complete posterior hyaloid and epiretinal membrane removal. The internal limiting membrane (ILM) was stained with 0.5 cc of IFCG (0.5 mg/ml, 308 mOsm) and peeled up to the vascular arcades. Perfluoropropane gas (C(3)F(8)) 10% was used as tamponade. RESULTS: Mean follow-up duration was 10 +/- 5 months (range, 3 to 24 months). Six eyes had stage 2 macular hole, 15 eyes stage 3, and 16 eyes stage 4. Overall, 37 of 38 macular holes closed after a single surgery. Median visual acuity was 20/100 (range, 20/400 to 20/50) before surgery and 20/50 (range, 20/640 to 20/25) after surgery. Visual acuity after surgery was 20/50 or better in 24 of 38 (63.1%) eyes. Twenty-five (65.8%) eyes improved by 2 or more lines, nine (23.7%) eyes were stable, and four (10.5%) eyes worsened by 2 or more lines. CONCLUSIONS: This study suggests that IFCG (0.05%) effectively stains the ILM with apparent safety, and that IFCG-assisted peeling of the ILM may be useful in the treatment of idiopathic macular hole.

Aged↗
PubMed2006

Magnetic resonance imaging of third cranial nerve palsy and trigeminal sensory loss caused by herpes zoster.

A 44-year-old man with right-sided herpes zoster ophthalmicus (HZO) developed ipsilateral third and sixth cranial nerve palsies and first-division trigeminal (fifth cranial nerve) sensory loss. MRI revealed contrast enhancement of the cisternal and cavernous portions of the third cranial nerve and high signal on a FLAIR sequence within the ipsilateral medulla at the presumed location of the trigeminal nucleus and tract. To our knowledge, this is the first report of the combination of these imaging findings in HZO.

Adult↗
PubMed2005

Two-piece, dual-purpose comprehensive contact lens for vitreous surgery.

PURPOSE: To describe a dual-purpose lens that can be used both as a planoconcave direct-image lens and wide-angle lens. This lens provides good resolution, is autoclavable and self-stabilizing. DESIGN: New instrument design. METHOD: This lens has two components (lenses): the inferior element is a modification of the standard, self-stabilizing planoconcave, one-piece acrylic lens with 4 footplates and is used in a similar manner; the superior part is a biconvex glass lens in a high-temperature-resistant plastic casing. The superior plastic casing is screwed on the inferior lens to convert it into a wide-angle lens. The lens is used as a self-stabilizing, planoconcave or wide-angle lens and is sterilized by autoclaving. RESULT: The planoconcave direct-image inferior lens gives a high-resolution image with a field of view of 20 degrees. The wide-angle lens on assembly of the inferior and superior parts gives a static field of view of 80 degrees and a dynamic field of view of 98 degrees. CONCLUSION: The two-piece dual-purpose contact lens is an inexpensive substitute for both planoconcave and traditional wide-angle lens without compromising the stability and quality of the fundus image.

Contact Lenses↗
PubMed2004

Successful management of cataract surgery associated vitreous loss with sutureless small-gauge pars plana vitrectomy.

PURPOSE: To investigate the efficacy of 25-gauge self-sealing sutureless pars plana vitrectomy (PPV) in the management of vitreous loss associated with phacoemulsification. DESIGN: Retrospective noncomparative case series. METHODS: We conducted a retrospective chart review of 29 patients who underwent a newly described surgical technique, self-sealing sutureless PPV for the management of vitreous loss during phacoemulsification. The 29 eyes included in the study were analyzed for age, sex, race, posterior segment pathology, systemic illness, laterality of the eye, type of anesthesia used during surgery, placement of intraocular lens, visual acuity (pre- and postoperative), and postoperative complications. All patients had a minimum follow-up of 3 months. Self-sealing sutureless PPV was not performed in eyes with visually significant posterior segment pathology, in monocular patients, or in eyes in which there was posterior dislocation of nuclear fragments during cataract surgery. RESULTS: The final best-corrected visual acuity was 20/40 or better in 96.5% of the patients. The complication rate compared favorably with previous studies of visual outcomes after cataract surgery. CONCLUSION: Self-sealing sutureless PPV is a safe, reliable adjunct for managing vitreous loss during phacoemulsification and leads to rapid visual recovery.

Adult↗
PubMed2004

Autoclavable wide-angle contact lens for vitreous surgery.

PURPOSE: To evaluate an autoclavable self-stabilizing wide-angle contact lens for vitrectomy. DESIGN: Observational study. METHOD: The wide-angle contact lens has two lens pieces within a high temperature-resistant (150 C) plastic casing. The inferior lens with footplates is made of acrylic and the superior of glass. During surgery the lens is used as the self-stabilizing wide-angle contact lens with improved stability on the eye. RESULT: The lens enables the surgeon to address the peripheral retina with less dependence on the assistant. The lens is sterilizable by autoclaving. The field of view of the wide-angle lens is 106 degrees static and 127 degrees dynamic view. CONCLUSION: The autoclavable self-stabilizing wide-angle lens reduces the cost and time for sterilization.

Fundus Oculi↗
PubMed2004

TTO utility scores measure quality of life in patients with visual morbidity due to diabetic retinopathy or ARMD.

PURPOSE: To evaluate the utility scores in patients with varying degrees of visual morbidity due to diabetic retinopathy or ARMD. METHODS: Patients with vision < or =20/40 in one eye due to diabetic retinopathy or ARMD were enrolled. Utility scores were measured by the time trade-off (TTO) method after stratifying the patient population with visual impairment in the better eye (group 1, 20/20 to 20/40; group 2, 20/50 to 20/100; group 3, 20/200 to no light perception). RESULTS: Sub-group analysis revealed that subjects in group 1 were willing to give up a median of 1 year as compared to 3 years by the subjects in group 3 for perfect bilateral visual acuity (P<0.05). The median utility score was 0.94 for group 1, 0.96 for group 2 and 0.80 for group 3. While the utility scores for groups 1 and 2 were comparable (P>0.05), there was a significant difference in the utility scores between groups 1 and 3 and between groups 2 and 3 (P<0.05). There was no significant effect on the utility scores of age, educational level or prior ocular surgery. CONCLUSION: Substantial visual loss secondary to diabetic retinopathy or ARMD is associated with a significant decrease in utility scores. However, TTO scores were not sensitive enough to demonstrate a difference between subjects with mild (group 1) and moderate (group 2) visual loss in the better eye secondary to diabetic retinopathy or ARMD.

Adult↗
PubMed2004

Self retaining contact lens system for vitreous surgery.

We describe the principle and desiign of a new self-retaining contact lens system for vitreous surgery. The system has three lenses: theplano-concave, prism and magnifying lens. This system is based on the principle of a direct imaging contact lens, designed for a 150-200mm focal length operating micrcroscope. The contact lenses are designed to have an inferior concave surface [radius of curvature (ROC) 7.7mm], modified by theaddition of four footplates to provide stability and centration during vitreous surgery. The lenses are used with a drop of viscoelastic material placed between the concave surface of the contact lens and cornea. This induces negative suction and helps retain the lens in position during surgery. These specially designed lenses provide a stable, well-centered, high-resolution, magnified view of the fundus. This system eliminates the need for a skilled assistant or for suturing the lens to the sclera during vitreous surgery.

Contact Lenses↗
PubMed2004

Liquid crystal display microperimetry in eyes with reduced visual acuity from macular pathology.

PURPOSE: To correlate fixation stability and retinal sensitivity measured by liquid crystal display (LCD) microperimetry to visual acuity in eyes with macular pathology. DESIGN: Retrospective chart review METHODS: The cohort included 26 eyes of 26 patients, divided into two groups according to visual acuity (Group 1 eyes 6/15 - 6/48, Group 2: < or = 6/60). Macular sensitivity and fixation stability were measured using the LCD microperimeter. Mean retinal sensitivity (at central 12 degrees) and fixation stability (at 2 degrees and 4 degrees) were correlated with best-corrected visual acuity. RESULTS: Mean retinal sensitivity correlated with the visual acuity in both groups [Group 1 eyes: 28 point central 12 degrees (9.0 dB); Group 2: central 12 degrees (4.183 dB)] (P < 0.05). The fixation stability correlated similarly with the visual acuity for the groups [Group 1 eyes: 2 degrees (81.2%) and 4 degrees (94.6%); Group 2 eyes: 2 degrees (44.1%) and 4 degrees (80.7%] (P < 0.05). CONCLUSION: In the present study, the mean retinal sensitivity and fixation stability measured with LCD microperimeter correlated with visual acuity. LCD microperimetry reliably measures fixation stability and retinal sensitivity in eyes with various macular pathologies.

Adult↗
PubMed2003

Newly designed self-retaining contact lens for vitreous surgery.

PURPOSE: Development of a new self-retaining acrylic contact lens for vitreous surgery. DESIGN: A standard -60 diopters plano concave lens with the radius of curvature 6.7 mm (less than the cornea curvature) was modified with addition of four foot plates to facilitate stability and centration. METHODS: A drop of viscoelastic material placed between lens and cornea induces negative suction and helps retain the lens in position. CONCLUSIONS: This specially designed lens eliminates the need for suturing on the sclera or dependence on the assistant to provide placement. It provides a stable well-centered view of the fundus during vitreous surgery.

Acrylic Resins↗
PubMed2003

Small-gauge, sutureless pars plana vitrectomy to manage vitreous loss during phacoemulsification.

This technique manages vitreous prolapse associated with posterior capsule rupture during phacoemulsification by performing small-gauge pars plana vitrectomy with a sutureless, self-sealing incision performed in a closed chamber, maintaining normal intraocular pressure. A high-speed cutter exerts minimal traction on the vitreous. Accessibility to the vitreous through the pars plana is better, ensuring more complete removal of the vitreous and restoration of normal anatomy.

Eye Diseases↗