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Correlative X‐ray microscopy, including synchrotron X‐ray diffraction and fluorescence, is leveraged to understand the local role of europium as a B‐site additive in CsPbBr3 perovskite crystals. Europium addition reduces microstrain in the perovskite, despite the fact that the degree of europium incorporation into the perovskite varies locally, with a maximum loading over twice the nominal stoichiometry. The presence of europium improves photoluminescence yield and bandwidth, while shifting the emission to bluer wavelengths. Finally, europium‐containing crystals have greatly improved X‐ray hardness. The findings show promise for europium as an additive in perovskite optoelectronic devices. [ABSTRACT FROM AUTHOR]

Background: Ankle sprains are a common musculoskeletal injury among the general population and often involve the lateral ligament complex. Although the majority of ankle sprains are treated successfully with nonsurgical conservative measures, an estimated 5% to 20% of ankle injuries ultimately develop chronic lateral ankle instability (CAI). Multiple surgical treatment modalities for the lateral ankle complex exist, such as anatomical and nonanatomical reconstruction. The current gold standard for primary surgical repair is the Broström-Gould procedure. This is the first article to provide PROMIS scores following BG and the largest study with 5-year outcomes for an open BG. Methods: This was a descriptive study of a retrospective cohort of patients undergoing a BG with a minimum follow-up of 5 years. Patient-reported outcome instruments collected postoperatively were PROMIS Pain, Physical Function, Depression, and FAAM. Further preoperative clinic characteristics were analyzed to correlate with the final outcome. The electronic medical record was queried for Current Procedural Terminology ( CPT ) code 27698 (Broström-Gould) from January 2010 to June 2017. Surveys were conducted in the clinic and through phone interviews. Patient charts were reviewed to obtain basic patient demographic information including sex, age, race, and body mass index (BMI). The following preoperative variables were recorded: history of prior CAI procedures, history of major trauma, duration of symptoms, number of diagnosed ankle sprains, other collagen pathologies, generalized ligament laxity, participation in sports/activity level, peroneal subluxation, clinically diagnosed peroneus longus or brevis tendinopathy, deltoid ligament injury, anterior ankle impingement, and posterior ankle impingement. The PROMIS and Foot and Ankle Ability Measure (FAAM) scores were obtained with a combination of clinic and phone interviews. Data were aggregated in Microsoft Excel and entered in R (version 4.2.0) for statistical analysis. Results: Our results show that the minimum 5-year patient-reported PROMIS scores for patients following a Broström-Gould procedure are as follows: PROMIS physical function, 50.5; PROMIS pain interference, 48.2; and PROMIS depression, 38.2. This indicates, at a minimum, that patients 5 years removed from the procedure are within 1 SD of the general population in regard to PROMIS physical function and pain. Our patient-reported FAAM, activities of daily living, and FAAM sports scores were 59.6 and 13.0 respectively. Preoperative magnetic resonance imaging (MRI) findings were recorded. Arthroscopic examination was performed before lateral ligaments reconstruction for patients with intra-articular pathologies confirmed on MRI. Conclusion: The findings from our study offer evidence supporting the effectiveness of the Broström-Gould procedure to be associated with normal physical function, even 5 years after surgery. Furthermore, our research identified specific factors such as tobacco use, diabetes, and sports participation that independently correlated with reported outcome measures. These insights enable physicians to better manage patient expectations and tailor treatment strategies accordingly. Our study establishes a foundation for future prospective research endeavors that aim to leverage the PROMIS system for comprehensive outcome assessments. Level of Evidence: Level III, retrospective cohort study.

Category: Hindfoot Introduction/Purpose: Adult acquired flatfoot deformity (AAFD) is a debilitating condition that is common in the United States. Triple arthrodesis (TA) is a treatment option reserved for advanced disease. Evidence on patient outcomes following this procedure remains limited. This study aims to report patient-reported outcomes following TA via patient reported outcome measurement information systems (PROMIS). Secondary aims are to delineate any demographics or patient characteristics that significantly impact PROMIS scoring. Methods: In this single institution study, we identified all patients who underwent triple arthrodesis between 2014 and 2021 based on CPT coding. Patients who underwent a TA procedure for AAFD with a minimum of 24 months follow-up were eligible for inclusion in this study. Patients under the age of 18, those undergoing revision surgeries, or those with pathologies other than AAFD were excluded from this study. Patient demographics and surgical complications were collected through chart review. The Patient Reported Outcomes Measurement Information System (PROMIS) survey and Foot Function Index (FFI) scores were collected via telephone interview. PROMIS scores were analyzed with a Type III “SS” ANOVA test to stratify independent risk factors and account for confounding variables. Results: 49 patients (43%) submitted responses to the survey. Patient outcomes were collected at an average of 5.50 years postoperatively. There were no significant differences in the rates of complications among any of the variables analyzed. The average PROMIS physical function score was 38.35, the average pain interference score was 61.52, and the average depression score was 49.82. Males and patients with prior foot and ankle procedures had significant increases in PROMIS physical function scores (p 50 years old had significantly higher FFI pain, disability, and total scores (p

Background: An experimental study was designed to evaluate the effect of chlorhexidine gluconate chips on clinical status of peri-implant mucosa and plaque formation on healing abutments following single-stage implant surgeries. Materials and Methods: Twenty-eight single-stage implant sites were grouped into 14 test and control sites. The study commences from the time of suture removal following surgery, designated as day 0. Chlorhexidine chip insertion into peri-implant sulcus in test sites was done on day 0, 10, and 20. Peri-implant crevicular fluid was collected on day 0, 10, 20, and 30 for biochemical estimation of aspartate aminotransferase (AST). The modified sulcus bleeding index (mBI) score was obtained in both test and control sites on day 10, 20, and 30. On day 30, all the healing abutments were unscrewed and sent for stereomicroscopic analysis to assess the plaque formation on its surface. Results: Statistically significant difference was not observed in AST levels and mBI in both test and control groups in various time intervals. In the stereomicroscopic assessment of healing abutment, mild grade of plaque accumulation was seen in three samples in test group, one sample in control group, and severe grade was seen in six samples in test group and nine samples in the control group. Conclusion: Inflammatory condition of peri-implant mucosa and plaque retentive properties on healing abutment surface were found to have reduced with the usage of chlorhexidine gluconate chips. However, the study failed to establish a statistically significant correlation of these observations.

Background: A split-mouth longitudinal study was conducted to compare and evaluate the effect of ozonated water and photodynamic therapy (PDT) in nonsurgical management of chronic periodontitis, along with mechanical debridement procedure. Materials and Methods: Twenty-two patients diagnosed with chronic generalized periodontitis were subjected to the study. Following the assessment of gingival index, periodontal pocket depth, and clinical attachment loss, all patients underwent full-mouth scaling and root planing. Upper right and left quadrants of each patient were considered as sample sites in the study. Among these split-mouth sites, upper right quadrant of each patient was subjected to ozonated water irrigation with a 22-gauge needle and left upper quadrant was treated with PDT, which involved sulcus irrigation with indocyanine green dye (0.05 mg/ml) followed by low-level diode laser light application at 0.5 W and 810 nm (AMD Picasso) through a fiber-optic tip of 10 mm length, default angle of 60°, and fiber core diameter of 400 μm in noncontact continuous wave mode. Patients were recalled at the 2nd and 4th months regularly, and the therapy was repeated at the same sites in the same manner. Clinical parameters recorded before the study were assessed again at the end of the 2nd- and 6th-month period. Results: A statistically significant reduction (P < 0.05) was observed in gingival index scores within both the study groups at all intervals of the study. In Ozone therapy (OT) group, a statistically significant difference was noted for total periodontal pocket depth values between baseline and 2nd month (P = 0.000), baseline and 6th month (P = 0.000), and between 2nd month and 6th month (P = 0.029). In the PDT group, on contrary, a statistically significant difference was noticed in total periodontal pocket probing depth values between baseline and 2nd month (P = 0.000) and baseline to 6th month (P = 0.000), but a similar significant difference was not noticed between 2nd-month and 6th-month periods (P = 0.269). In group OT, a statistically significant difference was noted for total clinical attachment loss between baseline and 2nd month (P = 0.000), baseline and 6 months (P = 0.000), and 2nd month and 6th month (P = 0.019). In group PDT, a statistically significant difference in terms of its improvement was noted at intervals between baseline and 2 months (P = 0.000) and from baseline to 6 months (P = 0.000) but not between 2nd month and 6th month (P = 0.129). Conclusion: Results of the study showed that sub-gingival OT and PDT equally improved the clinical outcomes of treatment drastically following mechanical debridement at the end of first 2 months. Thereafter, it was shown to improve steadily throughout the study period, with slightly better results with OT compared with PDT.

Introduction: Porphyromonas gingivalis is one among the major etiological agent in periodontal diseases and has been proved to cause gingival inflammation under orthodontic appliances. Aim: To assess the effect of amine fluoride and probiotic mouthwashes on levels of P. gingivalis during orthodontic treatment, using real time-polymerase chain reaction (RT-PCR). Materials and Methods: A randomised controlled trial was performed including 45 patients. There were three groups: Group A (control group), Group B (patients using Amflor mouthwash) and Group C (patients using probiotic mouthwash). During the treatment, all the 3 groups were advised to brush twice a day using Colgate tooth paste and Group B patients were advised to swish 15 ml fluoridated mouthwash (Amflor) and Group C advised to swish probiotic for 60 s before swallowing, once in the morning and once before sleep. After gently removing supragingival plaque, subgingival plaque samples were collected by inserting a sterile dental curette into the bottom of the gingival crevice around 31, 32, 41, and 42 at two different intervals: T1 at start and T2 after 6 months of fixed orthodontic treatment. Sub-gingival plaque samples collected were transferred to laboratory within 48 h for RT-PCR analysis in Tris-buffer solution, to maintain the integrity of bacterial DNA. Results: The levels of P. gingivalis were significantly decreased with probiotic mouth wash. Conclusions: Probiotic mouth wash can be used as an adjunctive measure along with regular brushing to improve periodontal status during fixed orthodontic treatment.

A 69-year-old lady presented with complaints of decreased vision in left eye since one month. Best Corrected Visual Acuity (BCVA) was 6/18 in that eye. Fundus examination revealed non-central geographic atrophy and soft drusens at macula in both eyes. Temporal periphery of left eye revealed subretinal exudates with altered sub-RPE hemorrhage mimicking peripheral exudative hemorrhagic chorioretinopathy (PEHCR). Fundus Fluorescein Angiogram showed window defects at macula and blocked fluorescence at temporal periphery in left eye. However, Indocyanine green angiography (ICGA) revealed active peripheral choroidal polyps. The patient was successfully treated with intravitreal bevacizumab and ICGA-guided laser photocoagulation. 27 months after laser treatment, BCVA improved to 6/9. Rationale of consecutive anti-vascular endothelial growth factor (VEGF) treatment followed by more definitive laser photocoagulation is that anti-VEGF aids in resolution of subretinal fluid, thus making the polyp more amenable to focal laser photocoagulation which stabilizes the choroidal vasculature and prevents further leakage. [ABSTRACT FROM AUTHOR]

Amongst the clinical presentations of retinal artery occlusion, hemi-central retinal artery occlusion (Hemi-CRAO) is rarely described. This case series of four adults aged between 22 and 36 years attempts to describe the clinical profile, etiology and management of Hemi-CRAO. Case 1 had an artificial mitral valve implant. Polycythemia and malignant hypertension were noted in Case 2. The third patient had Leiden mutation while the fourth patient had Eisenmenger's syndrome. Clinical examination and fundus fluorescein angiography revealed a bifurcated central retinal artery at emergence from the optic nerve head, in all cases. Color Doppler examination of the central retinal artery confirmed branching of the artery behind the lamina cribrosa. It is hypothesized that bifurcation of central retinal artery behind the lamina cribrosa may predispose these hemi-trunks to develop an acute occlusion if associated with underlying risk factors. The prognosis depends upon arterial recanalisation and etiology of the thromboembolic event. [ABSTRACT FROM AUTHOR]

Background: Maxillary labial frenum is a dynamic structure with a diverse morphology. Although an abnormal labial frenum is associated with syndromic and nonsyndromic conditions, it is often been neglected during the routine intraoral examination. The significance of various types of frenum (normal to abnormal), based on the attachment site and morphology in different skeletal patterns, has not been studied yet. Materials and Methods: A cross-sectional study was conducted in a clinical setting on 150 participants (50 each in Class I, Class II, and Class III skeletal pattern) within the age group of 13–30 years. Frenum was examined by direct visual method and intraoral photographs were taken for all the participants. Results: Chi-square and Fisher's exact tests were used. No gender-wise differences were found among the various frenum typologies. Mucosal type was the most prevalent in Class I and II and gingival type in Class III. Simple frenum was the common type in all the three groups. However, abnormal frenum categories based on its location and morphology were more in class III and found to be statistically significant. Papillary and papillary penetrating types are significantly associated with skeletal class III pattern and midline diastema (P < 0.05). Conclusion: The prevalence of papillary and papillary penetrating types of frenum are significantly more in Class III skeletal pattern. A labial frenum that is attached close to the gingival margin could be an etiological factor in midline diastema, mucogingival problems, and affect the growth of the alveolar process. Hence, an early diagnosis of abnormal frenum prevents the emergence of periodontal as well as orthodontic problems.

Background: A split-mouth longitudinal study was designed here to evaluate the effect of ozonated water delivered subgingivally through a jet device (Kent Ozone dental TY 820 jet) in controlling gingival inflammation of patients undergoing fixed orthodontic therapy. Materials and Methods: Twenty-eight patients undergoing fixed orthodontic treatment following thorough oral prophylaxis were recalled after 2 weeks, and baseline gingival inflammation was estimated. This study was conducted as split-mouth technique with the upper left quadrant (Control side) was irrigated by jetting saline into sulcus by air–water syringe with gauge 22 needle tip and upper right quadrant (Test side) irrigated with ozonated water by a jet device using similar delivery tip. The patients were recalled at the end of 1st, 2nd, 3rd, and 4th month and the irrigations as well as gingival inflammation estimation were repeated. A biochemical assessment of gingival inflammation (estimation of aspartate aminotransferase [AST] in gingival crevicular fluid [GCF]) and clinical assessment (gingival index scoring) was done at each visit. Results: At the test side, the AST level in the GCF was found to be maintained almost the same value as baseline till the end of 4th month, indicating not much of change in inflammatory status. Statistically significant difference in GCF-AST and gingival index score between test and control sites were found at the end of 3rd and 4th month with a significance of P < 0.05. Conclusion: The patient undergoing fixed orthodontic treatment showed a consistent improvement in gingival inflammation on frequent irrigation with ozone jet irrigation as compared with saline irrigation delivered with same jetting force.

A 12-year-old girl, diagnosed of osteogenesis imperfecta, presented with sudden visual loss in the left eye. Investigations revealed an active choroidal neovascular membrane. She underwent treatment with intravitreal Bevacizumab (1.25 mg/0.05 ml). Follow-up at 1 month revealed the development of lacquer crack running through the macula, underlying the fovea. The patient received two re-treatments at 1-month intervals, following which the choroidal neovascularization (CNV) regressed completely. However, further progression of lacquer cracks was noted. At the last follow-up, 6 months following the last injection, the fundus remained stable and vision was maintained at 20/200. Considering the natural history of the disease and the increased risk of rupture of the Bruch's membrane in such eyes, the possible complication of a lacquer crack developing must be borne in mind, before initiating treatment. [ABSTRACT FROM AUTHOR]

Best's vitelliform macular dystrophy is a hereditary form of progressive macular dystrophy that can be complicated by choroidal neovascularization. Authors report successful treatment of choroidal neovascularization with intravitreal bevacizumab in one such eye in an 'adult' Indian male with visual improvement. A 23-year-old male presented with diminution of vision in the right eye for the past sixteen months. Visual acuity was 20/400 in the that eye. After three consecutive intravitreal injections of bevacizumab (1.25 mg/0.05 ml), vision improved to 20/120. Seven months following the last injection of bevacizumab, fundus appeared stable and visual acuity was maintained. No drug-related ocular or systemic side effects were encountered. To the best of our knowledge (PubMed search), this is the first report of its kind in an adult Indian patient. Intravitreal bevacizumab appears to be a promising and cost-effective modality of treatment in such eyes with potential for improvement in vision. However, a long-term follow-up is warranted. [ABSTRACT FROM AUTHOR]

Context: Gingival changes in pregnancy have been attributed to changes in the subgingival biofilm related to hormonal variations. Aims: To evaluate the subgingival plaque microflora in pregnant and nonpregnant women to determine if pregnancy induces any alterations in the subgingival plaque and to associate these changes with changes in periodontal status. Settings and Design: Thirty pregnant and 10 nonpregnant women within the age group of 20-35 years having a probing pocket depth (PPD) of 3-4 mm were included in the study. The pregnant women were equally divided into 3 groups of 10, each belonging to I, II, and III trimester. Materials and Methods: Plaque index, gingival index, PPD, and microbiologic evaluation for specific bacterial counts for Prevotella intermedia, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, and Fusobacterium nucleatum were carried out for all subjects. Statistical Analysis: Mann-Whitney U test. Results: Increase in gingival inflammation was observed in II and III trimester as compared with I trimester and control. Plaque scores did not show any significant difference between pregnant and nonpregnant women. Specific bacterial examination revealed an increase in proportion of P. intermedia in pregnant women of both II and III trimester as compared with I trimester and nonpregnant women. Conclusions: A definite increase in proportions of P. intermedia occurs in subgingival plaque microflora in pregnancy that may be responsible for the exaggerated gingival response.

The large-scale mining and high-throughput genotyping of novel gene-based allelic variants in natural mapping population are essential for association mapping to identify functionally relevant molecular tags governing useful agronomic traits in chickpea. The present study employs an alternative time-saving, non-laborious and economical pool-based EcoTILLING approach coupled with agarose gel detection assay to discover 1133 novel SNP allelic variants from diverse coding and regulatory sequence components of 1133 transcription factor (TF) genes by genotyping in 192 diverse desi and kabuli chickpea accessions constituting a seed weight association panel. Integrating these SNP genotyping data with seed weight field phenotypic information of 192 structured association panel identified eight SNP alleles in the eight TF genes regulating seed weight of chickpea. The associated individual and combination of all SNPs explained 10-15 and 31% phenotypic variation for seed weight, respectively. The EcoTILLING-based large-scale allele mining and genotyping strategy implemented for association mapping is found much effective for a diploid genome crop species like chickpea with narrow genetic base and low genetic polymorphism. This optimized approach thus can be deployed for various genomics-assisted breeding applications with optimal expense of resources in domesticated chickpea. The seed weight-associated natural allelic variants and candidate TF genes delineated have potential to accelerate marker-assisted genetic improvement of chickpea.

Aim: To describe the clinical features, treatment and outcome patterns in 307 eyes with Coats′ disease. Materials and Methods: Retrospective chart review of patients diagnosed with Coats′ disease between January 1996 and January 2006 from a single referral center in southern India. Results: Two hundred and eighty patients (307 eyes) with mean age of 15.67 years (range: Four months-80 years) were included. Decreased vision (77%), unilateral affection (90%) and male preponderance (83.4%) were chief presenting features. Anterior segment involvement was seen in 67 (21.8%) eyes. Retinal telangiectasia were seen in 302 (99%) eyes, exudation in 274 (89%) eyes and retinal detachment in 158 (51.5%) eyes. Four-quadrant disease was seen in 207 (67.2 %) eyes. Visual acuity was < 20/200 in 249 (80.9%) eyes. One hundred and nine of 176 treated eyes (61.93%) had favorable anatomical outcome; 207 of 280 eyes (74%) had an optimal structural outcome. Seventeen (5.3%) eyes were enucleated. Complications following treatment included phthisis bulbi (7%), neovascular glaucoma (5%), epiretinal membrane (4.4%) and rubeosis iridis (4.4%). Conclusion: Indian patients with Coats′ disease have a high male predominance, the majority of whom present with severe visual impairment and extensive four-quadrant exudation. Unusual presentations such as pain, vitreous hemorrhage and a high incidence of anterior segment involvement are distinctive to Indian eyes.

Iris cyst excision involves complex surgical maneuvers and may have a variable visual outcome depending upon preexisting and postoperative complications. Hereby, we report a case series of 10 eyes from which posttraumatic iris cysts were excised and proven histopathologically. Histopathology records were reviewed. Data regarding patient profile, clinical profile, surgical details, treatment outcomes and follow-up were reviewed. Outcome measures were defined as recurrences, visual acuity and number of other surgeries required. Non-parametric Wilcoxon test was used to compare changes in the visual acuity and Fisher test was used to find out the significance of several risk factors. Mean age was 24.7 years (3-58 years). Mean follow-up was 2.36 years. Mean preoperative logMAR visual acuity was 0.56 in comparison to final logMAR visual acuity of 1.62. Factors related to adverse functional outcome were related to post-surgical complications.

The availability of safe and pristine water is a global challenge when large numbers of natural and anthropogenic water resources are being depleted with faster rate. The remaining water resources are severely contaminated with various kinds of contaminants including microorganisms. Enterobacter is one of the fecal coliform bacteria of family Enterobacteriaceae. Enterobacter was earlier used as an indicator bacterium along with other fecal Coliforms namely Escherichia coli, Citrobacter and Klebsiella, but it is now known to cause various diseases in human beings. In this study, we have collected 55 samples from potable water and riverine system and proved their presence using their conserved sequences of 16S rRNA and 23S rRNA genes with the help of SYBR green real-time PCR, which showed very high specificity for the detection of Enterobacter. The Enterobacter counts in potable water were found to 1290 ± 32.89 to 1460 ± 39.42 cfu/100ml. The Enterobacter levels in surface water were 1.76 x104 ±492, 1.33 x104 ±334, 1.15 x104 ±308, 2.56 x104 ±802, 2.89 x104 ±962, 8.16 x104 ±3443 cfu/100ml; the levels of Enterobacter contamination associated with hydrophytes were 4.80 x104 ±1804, 3.48 x104 ±856, 8.50 x104 ±2074, 8.09 x104 ±1724, 6.30 x104 ±1738, 3.68 x104 ±949 cfu/10 g and the Enterobacter counts in sediments of the river, were 2.36 x104 ±703, 1.98 x104 ±530, 9.92 x104 ±3839, 6.80 x104 ±2230, 8.76 x104 ±3066 and 2.34 x104 ±732 cfu/10g at the sampling Site #1, Site # 2, Site # 3, Site # 4, Site # 5 and Site # 6 respectively. The assay could be used for the regular monitoring of potable water and other water reservoirs to check waterborne outbreaks.

A 14-year-old girl presenting with visual loss in both eyes was diagnosed to have healed toxoplasma retinochoroiditis in the right eye with active choroidal neovascularization (CNV) secondary to toxoplasmosis in the left. She underwent combination photodynamic therapy (PDT) and intravitreal bevacizumab as primary treatment. PDT was performed as per the ′Treatment of Age-related Macular Degeneration by Photodynamic therapy′ study protocol and was followed by intravitreal bevacizumab after 2 days. CNV regressed at 8 weeks of follow-up and remained stable at 8 months of follow-up. The initial visual acuity improved from 20/120 to 20/30. Combination therapy with PDT and intravitreal bevacizumab appears to be effective in the treatment of CNV secondary to toxoplasma retinochoroiditis.

Ocular symptoms can be the presenting manifestation of Takayasu arteritis (TA) or could be indicative of disease reactivation. A review of published literature related to posterior segment manifestations of TA by using the keywords "Takayasu arteritis," "ophthalmic manifestations," "retina," "retinopathy," "ocular," "optic nerve," and "optic neuropathy" was performed. In total, 62 case reports and 12 case series were included. The majority of the articles were from Asia (n = 47, 64%). Females outnumbered males in the ratio of 7:1. The mean age of patients was 33 years (range: 8-78 years, SD: 13.5 years). In 58% (n = 41 out of 71) cases, ocular symptoms were the presenting manifestation of the underlying disease. Hypotensive retinopathy was found in 70% of eyes, and hypertensive retinopathy was found in 27%. The mean presenting visual acuity (VA) was +1.03 logMAR (range: -0.12 to 3, SD: 1.07), and at the final follow-up was +1.02 logMAR (range: -0.12 to 3, SD 1.17). VA improved in 34% (n = 29/86), remained stable in 45% (39/86), and worsened in 21% (18/86). The mean follow-up was 9 months (range: 0.5-204, SD: 16 months)., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Purpose: The purpose of this study was to evaluate the outcomes of phacoemulsification with intravitreal triamcinolone acetonide (IVTA) injection in patients with cataract and diabetic macular edema (DME) across the grades of diabetic retinopathy (DR)., Materials and Methods: It was a retrospective observational study. The study included 70 patients (75 eyes) with cataract and clinically significant macular edema in diabetics with nonproliferative (61 eyes) or proliferative (14 eyes) DR who underwent phacoemulsification with IVTA. Visual outcome and progression of DME over 3 months were studied in terms of the best-corrected visual acuity (BCVA) and central macular thickness (CMT), respectively., Results: The case records of 70 patients (75 eyes) were studied. The mean baseline BCVA ( n = 75) in the logMAR scale ± SD was 0.92 ± 0.53. 3 weeks after the surgery, the mean BCVA improved to 0.39 ± 0.26 and the mean CMT ( n = 40) was 382.57 ± 192.30 compared with the mean preoperative CMT of 480.57 ± 163.25 in the same set ( P = 0.01). The mean CMT decreased at 3 weeks in 22 (55% of the eyes). An improvement of ≥2 lines was seen at 3 weeks in 52 (69.33%) eyes and in 49 (65.33%) eyes at 3 months. The mean CMT at 3 months was 445.51 ± 222.99 ( n = 70) compared to the preoperative mean CMT of 470.72 ± 176.15 in the same set ( P = 0.29). The mean CMT decreased at 3 months in 34 (48.5%) eyes., Conclusions: Phacoemulsification with IVTA injection improved the mean visual acuity at 3 weeks and 3 months in two-thirds of cases and decreased the mean CMT at 3 weeks in nearly half the numbers., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Oman Ophthalmic Society.)

Global health security threats and the public health impact resulting from emerging infectious diseases including the ongoing COVID-19 pandemic and recent Ebola virus disease outbreaks continuously emphasize the need for a comprehensive approach to preparedness, management of disease outbreaks, and health sequelae associated with emergent pathogens. A spectrum of associated ophthalmic manifestations, along with the potential persistence of emerging viral pathogens in ocular tissues, highlight the importance of an ophthalmic approach to contributing to efforts in the response to public health emergencies from disease outbreaks. This article summarizes the ophthalmic and systemic findings, epidemiology, and therapeutics for emerging viral pathogens identified by the World Health Organization as high-priority pathogens with epidemic potential.

Glucocorticosteroids commonly used to treat certain ocular inflammatory conditions cause an unwarranted elevation in intraocular pressure (IOP) leading to steroid-induced ocular hypertension (OHT). This study aims to identify novel genetic variants in the Indian population associated with steroid responsiveness, specifically to that of intravitreal Triamcinolone acetonide (TA) injections, which leads to OHT in 27% of the TA-treated Indian subjects. Genetic determinants and pathways regulating TA-OHT progression were investigated by applying whole-genome sequencing (WGS) on DNA extracted from 53 blood samples that included TA responders and non-responders. Sequencing analysis yielded 45 intronic and 49 exonic variants to be associated with TA-OHT, which are known to play a vital role in eye, heart, brain, and bone deformities. Of these, the most significant genetic variant associated with TA-OHT was further considered for molecular dynamics (MD) simulation studies. Variants in the CRPPA, PLOD1, ARHGAP1, TIMELESS and TNFSF4 genes were found to be directly implicating TA-OHT. Furthermore, these genes were enriched in pathways associated with cardiomyopathy, focal adhesion, extracellular matrix, and actin cytoskeleton reorganization. MD simulation studies revealed that the top significant variant (rs141625803) in the CRPPA gene possesses a high pathogenic and structurally destabilizing effect. Thus, novel genetic variants that could be significantly associated with the TA-OHT progression were identified in this study. Validation of these targets in a larger cohort of patients along with their functional analysis would inform on the disease, thereby adding to the existing knowledge on the pathophysiology of TA-OHT., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To describe the role of optical coherence tomography (OCT) in detecting subclinical choroidal inflammation and early diagnosis of macular complications in chronic Vogt-Koyanagi-Harada (VKH) disease with sunset glow fundus., Methods: Retrospective observational study. Clinical features, OCT images, treatment, and visual outcome were analyzed., Results: Fourteen patients (9 females and 5 males) were included in the study. Mean age was 39 years (range 7-67 years). Mean duration of disease was 5.25 years (range 1-15 years). Anterior uveitis was seen in 14 eyes (52%). Fundus examination showed sunset glow fundus in all patients with no obvious macular pathology. OCT showed macular edema in 16 eyes (59%), choroidal neovascular membrane in 8 eyes (30%), and macular hole in 3 eyes (11%)., Conclusion: OCT should be regularly used to detect subclinical inflammation and early macular complications in chronic VKH disease where sunset glow fundus may delay the clinical diagnosis thus causing permanent damage.

Purpose: Analysis of outcomes of macular hole (MH) surgery using 12% C 3 F 8 , 16% C 2 F 6 , or 18% SF 6 as randomized gas tamponading agent., Methods: This is a prospective, randomized, interventional study of 159 eyes with idiopathic MH undergoing 23/25G pars-plana vitrectomy with internal limiting membrane peeling and gas tamponade. Eyes were stratified into two groups: Group I (MH < 800 µ) and group II (MH > 800 µ) according to MH apical diameter. Eyes in group I were randomized to receive either 18% SF 6 , 16% C 2 F 6, or 12% C 3 F 8 . Eyes in group II were randomized to either 16% C 2 F 6 or 12% C 3 F 8 . Clinical details, MH parameters on optical coherence tomography, surgical details and complications were analyzed. Outcome measures were type of hole closure (I/II), best corrected visual acuity, intraocular pressure, and cataract progression., Results: In Group I (n = 139), type 1 closure was achieved in 107 (77%) eyes. Type 1 closure rates in group I per gas tamponade were as follows: SF 6 (70%), C 2 F 6 (80%), C 3 F 8 (78%) (p = 0.503, chi-square test for independence). There was no statistical difference in MH closure rates between SF 6 and C 2 F 6 (p = 0.134), SF 6 and C 3 F 8 (p = 0.186), and C 2 F 6 and C 3 F 8 (p = 0.373). In Group II (n = 20), type 1 closure was achieved in 12 (60%) eyes. Type 1 closure rates in group II per gas tamponade were as follows: C 2 F 6 (75%), C 3 F 8 (50%) (p = 0.132, Two proportion Z test). Mean follow-up after surgery was 2.66 ± 2.74 months., Conclusion: Given the similar outcomes of using 18% SF 6 , 16% C 2 F 6, or 12% C 3 F 8 in idiopathic macular hole surgery, the advantage of using a shorter acting tamponade translates into earlier recovery and rehabilitation., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: To evaluate choroidal vascularity index (CVI) among normal subjects using image binarization of swept source optical coherence tomography (SS-OCT)., Materials and Methods: Four hundred and sixty eyes of 230 normal participants were included. Total circumscribed choroidal area, luminal area, stromal area (SA), and CVI were derived from SS-OCT scans using open-source software (ImageJ) with the modified Niblack method. Both CVI and subfoveal choroidal thickness (SFCT) were correlated with age, refractive error, intraocular pressure, and mean ocular perfusion pressure (MOPP) using mixed linear model analysis. Pearson's correlation coefficient was used to determine the relationship between age and each dependent factor. Analyses were performed using the SPSS software version 20.0 (IBM Corp., Armonk USA) and statistical significance was tested at 5%., Results: The mean age was 42.1 (±17.6) years. Mean SFCT was 307 ± 79 μm. Mean CVI was 66.80 (±3.8)%. There was statistically significant positive correlation between CVI and increasing age ( r = 0.259, P < 0.0001) and statistically significant negative correlation between SFCT and age ( r = -0.361, P < 0.0001). There was positive linear correlation between refractive error and CVI ( r = 0.220, P < 0.0001) and negative correlation between SFCT and refractive error. There was no significant effect of MOPP on both CVI ( P = 0.07) and SFCT ( P = 0.7)., Conclusion: CVI and SFCT are significantly correlated with age and refractive error in normal Indian eyes., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Oman Ophthalmic Society.)

Aim : To analyze the incidence, microbiological profile, risk factors, and outcomes in eyes with osteo-odonto keratoprosthesis (OOKP) developing endophthalmitis. Methods & material : Retrospective review of medical records of patients presenting between 2003 and 2013 with OOKP and endophthalmitis was undertaken after obtaining IRB approval. Patient demographics, clinical features, microbiological evaluation, treatment details, and outcomes were analyzed. Results : Of 92 eyes with OOKP, 8 (9%) had endophthalmitis. Indications for OOKP included Steven-Johnson syndrome (SJS; n = 6; 75%) and chemical injuries (n = 2; 25%). The mean duration from OOKP surgery to endophthalmitis was 49.4 ± 32.3 months. Seven of eight eyes had associated laminar resorption. Endophthalmitis resolved with conservative management in three eyes. Lamina removal was required in three eyes; one eye underwent evisceration. At presentation, mean BCVA was 2.76 ± 0.24 logMAR that improved to 2.48 ± 1.0 logMAR after intervention. Mean follow-up was 12.6 ± 13.2 months. Conclusion : Endophthalmitis portends a grave prognosis for eyes with OOKP. The most important risk factors are SJS (75%) and lamina resorption (88%).

Purpose: To compare the incidence, risk factors, treatment, and outcomes associated with intravitreal triamcinolone-acetonide (TA) and dexamethasone-implant (Dex)-induced ocular hypertension (OHT)., Methods: This retrospective study reviewed 1,549 TA and Dex administrations in 1,075 eyes of 897 patients. Intraocular pressure (IOP) values were monitored for a period of 6 months following intravitreal injection(s) and patients were categorized as steroid-responders (SR): IOP≥21 mm Hg, and steroid non-responders (NR): IOP≤20 mm Hg. Glaucoma patients, glaucoma suspects, uveitis, trauma, and less than 1 month of IOP follow-up cases were excluded from the study. The incidence of IOP rise, time and magnitude of IOP rise, and its management procedures were studied. Ocular and systemic associations with OHT incidence were investigated. Statistical analysis was performed using SPSS.23 and p < 0.05 was considered significant., Result: Twenty-eight percent of TA and 17% of Dex administered eyes developed OHT. Male subjects and elderly people (greater than 40 years of age) are at higher risk for OHT following steroid treatment. A high percentage of IOP rise was observed on day 1 (41%) for TA-SR, and after 1 month (50%) for Dex-SR. IOP rise was found to be more severe (>30 mm Hg) for TA-SR compared to Dex-SR (p = 0.006). 6% TA-SR required trabeculectomy with medically uncontrollable IOP. Myopia is a risk factor for secondary OHT, whereas diabetes mellitus and hypercholesterolemia are protective of it., Conclusion: Twenty-eight percent of TA and 17% of Dex administrations developed OHT. Early and severe IOP rises were more common in TA than among Dex administrations. Myopia is a risk for Dex-OHT., (© 2022 S. Karger AG, Basel.)

Purpose: To describe the clinical features, management, and outcomes of choroidal neovascularization (CNV) in children less than 18 years of age., Methods: This was a retrospective, case control study of 111 eyes of 96 patients. CNV was clinically diagnosed in all patients. Eyes were classified as those that were observed (Controls; Group 1) or those that had treatment (Cases; Group 2). CNV was categorized as regressed, persistent, or recurrent in order to evaluate the anatomical outcomes., Results: Of 96 patients, 68(71%) were male. Mean presenting age was 11.4 ± 3.4 years (median = 11 years, range = 1-17 years). CNV was bilateral in 15(16%) patients. Of 111 eyes, 38 eyes had treatment (Cases) and 73 eyes did not (Natural history group or Controls). Subfoveal CNV was seen in majority of cases (59%). Most common etiology was post-inflammatory (38%), followed by trauma (16%). Eyes were classified as those that were observed (controls; Group 1) or those that had treatment (cases; Group 2). In group 1, spontaneous regression of CNV was seen in 26(36%) eyes and there was no recurrence in this group. In group 2 following treatment, 25(66%) of 38 eyes achieved complete regression at mean 4.9 months and was persistent in 5 eyes. CNV recurrence was seen in 10 eyes with the mean time to first recurrence being 9 months. At presentation, mean best-corrected visual acuity (BCVA) of eyes with subfoveal CNV was logMAR 0.99 that improved to logMAR 0.63 with treatment. Mean follow-up was 17 months., Conclusion: CNV results in significant visual decline in children; most commonly of post-inflammatory etiology. Treatment achieves high regression rates, albeit with limited visual improvement., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Introduction: Hypotrichosis with juvenile macular dystrophy (HJMD) is an autosomal recessive disease with progressive macular degeneration leading to blindness in the first three decades of life along with hypotrichosis., Case: We herein report a case of a five year old boy with hypotrichosis with juvenile macular dystrophy diagnosed with multi-modal imaging which was later confirmed by genetic testing by whole genome sequencing., Observations: Fundus examination of both eyes revealed symmetrical hypopigmentation in peripapillary retinal pigment epithelium (RPE) involving posterior pole and surrounded by a mottled hyperpigmented border. Fundus autofluorescence showed central hypo autofluorescence with surrounding hyper autofluorescence corresponding to RPE atrophy and a faint hypo autofluorescence at the junction of normal retina. SD-OCT showed segmental outer retinal and choriocapillaris atrophy temporal to fovea with interdigitation zone and ellipsoid zone loss and RPE irregularities with hyperreflective subretinal deposits at the fovea. Electroretinogram showed normal waves but a slight reduction of b wave amplitude in both eyes. He had sparse scalp-hair., Conclusion: Children with reduced vision not falling into a typical macular degeneration should be examined systemically and may just have sparse scalp hair and still have a genetic disease. A regular follow-up should be emphasized in view of progressive nature of the disease., (© NEPjOPH.)

Aim: To analyze choroidal parameters in eyes with diabetic macular edema (DME) treated with intravitreal Ozurdex., Patients and Methods: Twenty eyes of 14 patients were included in this prospective study. Optical coherence tomography images were obtained before and 8-10 weeks after intravitreal Ozurdex injection; binarized and subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) were calculated., Results: Mean SFCT (treatment naïve; 242.22 ± 32.87 reduced to 218.10 ± 22.10, P = 0.158 and previously treated; 330.4 ± 56.72 reduced to 328.93 ± 50.55, P = 0.833) and mean CVI (treatment naïve; 0.64 ± 0.03 changed to 0.65 ± 0.04, P = 0.583 and previously treated; 0.65 ± 0.05 reduced to 0.64 ± 0.03, P = 0.208) showed no significant change., Conclusion: Intravitreal Ozurdex showed no significant effects on SFCT and CVI in eyes with DME over short term. Larger studies with longer follow-up may allow a better understanding., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Oman Ophthalmic Society.)