103 results on '"Akduman L"'
Search Results
2. Multicenter study of pars plana vitrectomy for optic disc pit maculopathy: MACPIT study
- Author
-
Avci, R, primary, Kapran, Z, additional, Ozdek, Ş, additional, Teke, M Y, additional, Oz, O, additional, Guven, D, additional, Yilmaz, S, additional, Kaderli, B, additional, Durukan, A H, additional, Sobaci, G, additional, Unver, Y B, additional, Akduman, L, additional, Kaynak, S, additional, Dogan, I, additional, and Inan, U U, additional
- Published
- 2017
- Full Text
- View/download PDF
3. The Association of Grades of Photoreceptor Inner Segment-Ellipsoid Band Disruption with Severity of Retinopathy in Type 2 Diabetes Mellitus
- Author
-
Saxena S, Akduman L, Mishra N, Meyer Ch, and Sharma
- Subjects
medicine.medical_specialty ,Visual acuity ,business.industry ,Type 2 Diabetes Mellitus ,Diabetic retinopathy ,medicine.disease ,eye diseases ,Open access publishing ,Ophthalmology ,Medicine ,medicine.symptom ,business ,Photoreceptor inner segment ,Retinopathy - Abstract
A prospective case-control study was undertaken to evaluate the association of inner segment-ellipsoid (ISel) band disruption with severity of diabetic retinopathy on spectral-domain optical coherence tomography. ISel disruption was graded as grade 0: intact ISel; grade 1: focal disruption (subfoveal ISel disruption) and grade 2: global disruption (ISel disruption involving macular cube). Increased severity of diabetic retinopathy was found to be associated with increase in disruption of ISel (r = 0.49, p < 0.001). ‘Global’ disruption of ISel in proliferative diabetic retinopathy (PDR) (n=40) was significantly higher as compared non proliferative diabetic retinopathy (NPDR) (n=40) (Intact/Focal/Global: 5/25/10 (NPDR) vs. 0/11/29 (PDR), χ2=19.70; p
- Published
- 2014
4. Intravitreal bevacizumab therapy in non-arteritic anterior ischemic optic neuropathy
- Author
-
Çetin, E.N. and Akduman, L.
- Subjects
visual field ,genetic structures ,visual acuity ,adult ,ischemic optic neuropathy ,article ,visual impairment ,afferent pupillary defect ,papilledema ,bevacizumab ,eye diseases ,aged ,male ,visual field defect ,treatment outcome ,case report ,sense organs ,Non-arteritic ischemic optic neuropathy ,anterior ischemic optic neuropathy ,human ,Anti-vascular endothelial growth factor - Abstract
Up to date there is no golden standard for the treatment of non-arteritic ischemic optic neuropathy. Here we report two cases which underwent intravitreal bevacizumab injection for non-arteritic ischemic optic neuropathy. In the first case, visual acuity changed from 2/200 to 20/400 at 2 week and 4/200 at one year. In the second case, visual acuity decreased from 20/30 to 20/400 with a worsened visual field defect at 6 week and to 20/200 at 5.5 month. Bevacizumab did not seem to improve visual outcome in non-arteritic ischemic optic neuropathy.
- Published
- 2013
5. Lamellar macular hole after intravitreal ocriplasmin injection
- Author
-
Chod, R. B., primary, Goodrich, C., additional, Saxena, S., additional, and Akduman, L., additional
- Published
- 2015
- Full Text
- View/download PDF
6. Ischaemia-reperfusion injury in central retinal artery occlusion
- Author
-
Saxena, S., primary, Mishra, N., additional, Meyer, C. H., additional, and Akduman, L., additional
- Published
- 2013
- Full Text
- View/download PDF
7. Macular translocation with retinotomy and retinal rotation for exudative age-related macular degeneration
- Author
-
William R. Freeman, Akduman L, J C MacDonald, Marietta P. Karavellas, and Olk Rj
- Subjects
Proliferative vitreoretinopathy ,medicine.medical_specialty ,Visual acuity ,genetic structures ,Rotation ,Fundus Oculi ,medicine.medical_treatment ,Visual Acuity ,Ophthalmologic Surgical Procedures ,Retina ,Macular Degeneration ,Postoperative Complications ,Ophthalmology ,medicine ,Humans ,Silicone Oils ,Macula Lutea ,Fluorescein Angiography ,Macular hole ,Aged ,Retinal pigment epithelium ,Laser Coagulation ,business.industry ,Retinal detachment ,General Medicine ,Exudates and Transudates ,Macular degeneration ,medicine.disease ,eye diseases ,Choroidal Neovascularization ,medicine.anatomical_structure ,Female ,sense organs ,Epiretinal membrane ,medicine.symptom ,business ,Laser coagulation ,Follow-Up Studies - Abstract
To determine the effectiveness of macular translocation with retinotomy and retinal rotation in exudative age-related macular degeneration.After written informed consent was obtained, 20 patients underwent macular translocation. We created a 180-degree retinotomy superior, inferior, and temporal to the macula near the equator. The hinged retinal flap was rotated superiorly or inferiorly to place the center of the fovea over an area of healthy retinal pigment epithelium. The retina was flattened under silicone oil and laser photocoagulation was placed.The fovea was moved 425 to 1,700 microm (965+/-262 microm) superiorly or inferiorly. Follow-up time was 2 to 12 months (median 8 months). Complications included macular pucker (3 eyes), subfoveal hemorrhage (2 eyes), macular hole (1 eye), and progression of cataract in phakic eyes (3 eyes). Thirteen of 20 eyes showed various degrees of proliferative vitreoretinopathy with epiretinal membrane formation over the inferior peripheral retina with the inferior retinal detachment stabilized by the silicone oil. One eye progressed to phthisis bulbi. Initial visual acuity ranged from 20/80 to 20/800 (median 20/150) and final visual acuity ranged from light perception to 20/200 (median 20/1000).The fovea can be moved up to 1,700 microm with retinotomy and retinal rotation; however, there is a high rate of complications. Proliferative vitreoretinopathy is the major complication of this technique and is probably related to the extensive retinotomy and subretinal irrigation inherent in the technique. Other techniques such as scleral shortening may have fewer complications.
- Published
- 1999
8. Acute central retinal vein occlusion following episode of myopericarditis in an adolescent patient
- Author
-
Desai, A., primary, Saxena, S., additional, and Akduman, L., additional
- Published
- 2013
- Full Text
- View/download PDF
9. Three-dimensional spectral domain optical coherence tomography imaging of the retina in choroidal tuberculoma
- Author
-
Saxena, S., primary, Singhal, V., additional, and Akduman, L., additional
- Published
- 2013
- Full Text
- View/download PDF
10. Vitreopapillary and vitreomacular traction in proliferative Eales' disease
- Author
-
Saxena, S., primary, Jain, A., additional, and Akduman, L., additional
- Published
- 2012
- Full Text
- View/download PDF
11. Minimal intensity diode laser (810 nanometer) photocoagulation (MIP) for diffuse diabetic macular edema (DDME).
- Author
-
Olk RJ, Akduman L, Olk, R J, and Akduman, L
- Published
- 2001
12. A CASE OF OCULAR BRUCELLOSIS - IMPORTANCE OF VITREOUS SPECIMEN
- Author
-
Meral Or, Kurtar K, Hasanreisoğlu B, and Akduman L
- Subjects
Pars plana ,medicine.medical_specialty ,Pathology ,Adolescent ,genetic structures ,medicine.drug_class ,medicine.medical_treatment ,Antibiotics ,Vitrectomy ,Brucella ,Brucellosis ,Eye Infections, Bacterial ,Ophthalmology ,medicine ,Humans ,biology ,business.industry ,General Medicine ,medicine.disease ,biology.organism_classification ,Antibodies, Bacterial ,eye diseases ,Vitreous Body ,Agglutination (biology) ,Titer ,medicine.anatomical_structure ,Female ,sense organs ,business ,Uveitis - Abstract
Brucellosis is a rare cause of uveitis, seen more often in developing countries. We report a case of ocular brucellosis, where diagnosis was confirmed with a high Brucella agglutination titer in the vitreous specimen. The case was treated by pars plana vitrectomy and antibiotics. We believe that a vitreous specimen is very important in the diagnosis of ocular brucellosis.
- Published
- 1993
13. Accuracy of Ocular Axial Length Measurement with MRI
- Author
-
Akduman, E.I., primary, Nacke, R.E., additional, Leiva, P.M., additional, and Akduman, L., additional
- Published
- 2008
- Full Text
- View/download PDF
14. Successful Surgical Repair and Good Visual Outcome of a Recurrent Macular Hole of Seven Years Duration
- Author
-
Oz, O., primary and Akduman, L., additional
- Published
- 2003
- Full Text
- View/download PDF
15. Prevalence of uveitis in an outpatient juvenile arthritis clinic: outset of uveitis more than a decade after onset of arthritis
- Author
-
Akduman, L, primary, Kaplan, HJ, additional, and Tychesen, L, additional
- Published
- 1997
- Full Text
- View/download PDF
16. Progressive changes in the fluorescein and indocyanine green angiogram in acute idiopathic maculopathy.
- Author
-
Akduman, Levent, Feiner, Michael, Pollack, John S., Kaplan, Henry J., Akduman, L S, Feiner, M S, Pollack, J S, and Kaplan, H J
- Subjects
FLUORESCEIN ,INDOCYANINE green ,EYE blood vessel radiography ,NEOVASCULARIZATION - Abstract
Aims/background: To report progressive changes in the fluorescein and indocyanine green angiograms of a patient with acute idiopathic maculopathy (AIM).Methods: Over a two-year period, the patient underwent repeated ophthalmoscopic examinations and fluorescein (FA) and indocyanine green (ICG) angiography.Results: The patient presented with subretinal neovascularization in his right eye. He developed recurrences after laser photocoagulation and surgical removal of the neovascular complex. One year later, he experienced a sudden loss of vision in his left eye with a maculopathy consistent with AIM. The maculopathy resolved after two weeks with poor vision. During the acute stage, FA showed lobular hyperfluorescence in the early phase and pooling in the late phase of the angiogram. In the resolved stage of the disease, FA showed irregular window defects and blockage. ICG revealed late hyperfluorescence of the macula in the acute stage. In the resolved stage of the disease, early hypofluorescence was noted in the ICG, which persisted throughout the late phase.Conclusion: This patient had poor vision in his right eye as a result of subretinal retinal neovascularization and poor vision in his left eye from a severe form of AIM. FA and ICG differed markedly during the acute and resolved stages of AIM. All cases of idiopathic subretinal neovascularization should be carefully evaluated to exclude AIM as the primary disease. [ABSTRACT FROM AUTHOR]- Published
- 1999
- Full Text
- View/download PDF
17. Therapeutic Benefits of Infrared (810-nm) Diode Laser Macular Grid Photocoagulation in Prophylactic Treatment of Nonexudative Age-related Macular Degeneration: Two-year Results of a Randomized Pilot Study
- Author
-
Olk, R. J., Friberg, T. R., Stickney, K. L., Akduman, L., Wong, K. L., Chen, M. C., Levy, M. H., Garcia, C. A., and Morse, L. S.
- Published
- 1999
- Full Text
- View/download PDF
18. Major blinding complication of acquired immune deficiency syndrome (AIDS)
- Author
-
Akduman, L., Jose Arribas, Del Priore, L. V., Kaplan, H. J., and Powderly, W. G.
19. Major blinding complication of acquired immune deficiency syndrome (AIDS)
- Author
-
Akduman L, Jose Arribas, Lv, Del Priore, Hj, Kaplan, and Wg, Powderly
- Subjects
Adult ,Male ,AIDS-Related Opportunistic Infections ,Cytomegalovirus Retinitis ,Visual Acuity ,Humans ,Female ,Lymphocyte Count ,CD8-Positive T-Lymphocytes ,Blindness ,Lymphocyte Depletion ,CD4 Lymphocyte Count ,Follow-Up Studies
20. A randomized pilot study comparing subthreshold vs threshold diode laser photocoagulation (PC) in the reduction of drusen associated with age-related macular degeneration
- Author
-
Oik, R. J., Friberg, T. R., Stickney, K. L., Akduman, L., Wong, K. L., Chen, M., Morse, L., Garcia, C. A., and David Musch
21. Retinal photoreceptor ellipsoid zone is a structural biomarker for visual outcome after successful macular hole surgery: A novel grading system-based study.
- Author
-
Singh S, Saxena S, Meyer CH, Chandra A, and Akduman L
- Abstract
Purpose: To develop a novel external limiting membrane (ELM) and ellipsoid zone (EZ) restoration-based grading system after successful macular hole surgery (MHS) and to evaluate EZ as a structural biomarker for the final visual outcome., Methods: In a tertiary care center-based retrospective study, 34 consecutive cases of successful MHS for full-thickness macular holes (FTMHs) were included. Spectral domain optical coherence tomography (SD-OCT) cross-sectional analysis was performed on preoperative and postoperative data of weeks 1, 4, 12, and 24, respectively. Sequential measurements of FTMH size, ELM and EZ defect were performed using the caliper function of SD-OCT. MHS was uniquely graded as grade 0: persistence of ELM and EZ defect; grade 1: partial or complete restoration of ELM with shortening of EZ defect; and grade 2: complete restoration of ELM and EZ. Data were statistically analyzed on Statistical Package for the Social Sciences software-version 24., Results: MHS was graded as grade 0 (n = 8), grade 1 (n = 15), and grade 2 (n = 11). Best corrected visual activity (BCVA) was found to be 1.13 ± 0.19 in grade 0, 0.59 ± 0.09 in grade 1, and 0.26 ± 0.06 in grade 2. One-way analysis of variance showed improvement in final BCVA among the three grades (P < 0.001) Postoperative visual acuity and residual EZ defect had a statistically significant linear correlation (r = 0.899, P < 0.001). EZ was found to be an excellent structural biomarker for final BCVA (area under the curve = 0.99)., Conclusion: Successful MHS is associated with better visual outcomes in eyes with restored EZ. ELM restoration preceded EZ regeneration. MHS novel grading system is physician friendly, incorporates pathoanatomic aspects, and correlates well with visual outcomes., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)
- Published
- 2024
- Full Text
- View/download PDF
22. Off-label use of intravitreal bevacizumab: A global conundrum.
- Author
-
Singh S, Saxena S, Akduman L, and Meyer CH
- Subjects
- Humans, Global Health, Angiogenesis Inhibitors administration & dosage, Angiogenesis Inhibitors therapeutic use, Antibodies, Monoclonal, Humanized therapeutic use, Bevacizumab administration & dosage, Bevacizumab therapeutic use, Intravitreal Injections, Off-Label Use, Vascular Endothelial Growth Factor A antagonists & inhibitors
- Abstract
Bevacizumab is a monoclonal, humanized, full-length antibody targeting vascular endothelial growth factor(VEGF-A), known for its anti-angiogenic properties. The off-label use of bevacizumab has stirred legal, financial, industrial, and ethical complexities. With its potential to treat diverse ocular conditions, this commentary delves into the multifaceted dimensions of bevacizumab's off-label utilization, encompassing clinical trials, regulatory frameworks, safety considerations, comparative effectiveness, and economic implications., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)
- Published
- 2024
- Full Text
- View/download PDF
23. A TITANIUM MACULAR BUCKLE IMPLANT DESIGNED FOR AN EASY PLACEMENT IN MYOPIC MACULAR HOLES.
- Author
-
Akduman L
- Subjects
- Male, Humans, Middle Aged, Titanium, Tomography, Optical Coherence, Retina, Vitrectomy methods, Retrospective Studies, Retinal Perforations diagnosis, Retinal Perforations surgery, Retinal Perforations etiology, Myopia complications, Myopia surgery
- Abstract
Purpose: A new easy-to-place titanium macular buckle implant and the surgical technique for placing it in myopic macular holes are presented. A 60-year-old patient with pathologic myopia presented with macular holes in both eyes. The hole in the right eye was recurrent and long-standing since the initial diagnosis, which was over 5 years ago. He refused surgery for the better seeing left eye. The vision of the right eye was 20/200. The patient only wanted macular hole repair in the right eye if a macular buckle could be incorporated in the surgery., Methods: Because there was no commercially available macular buckle in the United States, a custom-made titanium buckle was designed and manufactured for this patient. In addition to the standard pars plana vitrectomy, internal limiting membrane peel, and gas tamponade, the titanium macular buckle was placed externally to provide indentation over the macula., Results: The titanium macular buckle provided approximately 1 mm of indentation, shortening the axial length from 28.88 mm to 27.94 mm. The macular hole was closed postoperatively. Postoperative best-corrected visual acuity was 20/200 at 1 month with no complications from the titanium macular buckle implant or the surgical technique. There was no improvement in the final visual acuity, which was attributed to foveal atrophy because of the long-standing nature of the macular hole., Conclusion: This titanium macular buckle implant designed for an easy placement could be an invaluable addition for surgical success in myopic macular pathologies, including myopic macular holes.
- Published
- 2024
- Full Text
- View/download PDF
24. Management of Myopic Maculopathy: A Review.
- Author
-
Anderson WJ and Akduman L
- Subjects
- Humans, Visual Acuity, Tomography, Optical Coherence, Vision Disorders, Blindness, Myopia, Degenerative complications, Myopia, Degenerative diagnosis, Retinal Diseases, Macular Degeneration
- Abstract
Myopia, including pathologic myopia, has seen a significant increase in prevalence in recent years. It is a significant cause of irreversible vision loss worldwide and prediction models demonstrate the substantial future impact on the population. With increased awareness and research, it is possible to prevent blindness on a large scale in the younger, productive age group affected by myopic maculopathy (MM). The vision-threatening manifestations of pathologic myopia include myopic choroidal neovascularization, macular atrophy, maculoschisis, macular hole, and retinal detachment. Myopic traction maculopathy (MTM) is a progressive manifestation of pathologic myopia and its treatment includes pars plana vitrectomy, macular buckle, or a combination. In this article we aim to review the diagnosis, clinical characteristics, and treatment of MM with an emphasis on recent developments in the surgical management of MTM. We discuss commercially available macular buckles, along with potential advantages to the use of macular buckle in MM. We review the new MTM staging system and its role in determining surgical management of these complex cases., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2023 by the Turkish Ophthalmological Association / Turkish Journal of Ophthalmology published by Galenos Publishing House.)
- Published
- 2023
- Full Text
- View/download PDF
25. Surgery for macular hole with retinal detachment: An enigma.
- Author
-
Arya S, Akduman L, and Saxena S
- Subjects
- Humans, Visual Acuity, Vitrectomy, Retrospective Studies, Tomography, Optical Coherence, Retinal Detachment diagnosis, Retinal Detachment surgery, Retinal Perforations diagnosis, Retinal Perforations surgery
- Abstract
Competing Interests: None
- Published
- 2023
- Full Text
- View/download PDF
26. Anti-Vegf therapy leads to an improvement in grade of retinal pigment epithelium alterations on single layer retinal pigment epithelium map in diabetic macular edema.
- Author
-
Saxena S, Singh M, Chaubey A, Mohan A, De S, Kaur A, Gilhotra JS, Meyer CH, and Akduman L
- Subjects
- Animals, Cattle, Retinal Pigment Epithelium, Vascular Endothelial Growth Factor A, Angiogenesis Inhibitors therapeutic use, Prospective Studies, Tomography, Optical Coherence methods, Macular Edema diagnosis, Macular Edema drug therapy, Macular Edema etiology, Diabetic Retinopathy complications, Diabetic Retinopathy diagnosis, Diabetic Retinopathy drug therapy, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy
- Abstract
Purpose: In bovine retinal pigment epithelium (RPE) cells, increased secretion of vascular endothelial growth factor (VEGF) has a positive linear association with proliferation of RPE. Spectral domain optical coherence tomography (SD-OCT) based improvement in grades of topographic retinal pigment epithelium alterations (RPE-A), were evaluated after intravitreal anti-VEGF therapy, in diabetic macular edema (DME), for the first time., Methods: A tertiary care center-based, prospective study. Forty-four consecutive patients, 40-65 years of age with type 2 diabetes mellitus (DM) with DME, were administered three doses of anti-VEGF therapy at monthly intervals. Pre- and post-intervention SD-OCT was done and central sub field thickness (CST), cube average thickness (CAT) and topographic grades of RPE-A were assessed using single layer RPE map (SL-RPE) as; Grade 0: No alterations, Grade 1: Alteration in two quadrants, Grade 2: Alteration in more than two quadrants., Results: CST decreased from 354.2 ± 16.0 µm pre-intervention to 233.2 ± 7.9 µm post-intervention. CAT reduced from 340.6 ± 6.5 µm pre-intervention to 274.1 ± 5.1 µm post-intervention. Significant improvement in grades of RPE-A pre- v/s post-intervention were observed. (Grade 0: 0 v/s 39; Grade 1: 17 v/s 3; Grade 2: 27 v/s 2) (p < 0.001)., Conclusion: Anti-VEGF therapy is associated with an improvement in grades of RPE-A in DME.The study was registered with the Clinical Trial Registry of India (CTRI/2019/03/018135).
- Published
- 2023
- Full Text
- View/download PDF
27. External limiting membrane and ellipsoid zone structural integrity in diabetic macular edema.
- Author
-
Saxena S, Meyer CH, and Akduman L
- Subjects
- Humans, Retina, Retrospective Studies, Tomography, Optical Coherence, Visual Acuity, Diabetes Mellitus, Diabetic Retinopathy drug therapy, Macular Edema diagnosis, Macular Edema drug therapy, Macular Edema etiology
- Abstract
The external limiting membrane (ELM) and ellipsoid zone (EZ) can be observed exquisitely by SD-OCT. In diabetic macular edema (DME), dysfunction of mitochondria, represented by the EZ in the foveal photoreceptors results in reduced visual acuity (VA). An increase in VEGF was found to correlate with increased severity of DR, increased central subfield thickness (CST), and sequential disruption of ELM and EZ. The mechanism of ELM and EZ restoration after anti-VEGF therapy in DME has been discovered. The ELM restores first followed by EZ restoration. Thus, authors have discovered and established ELM as a novel retinal structural barrier.
- Published
- 2022
- Full Text
- View/download PDF
28. Serum cortisol is a biomolecular biomarker for severity of diabetic retinopathy.
- Author
-
Mohan A, Saxena S, Kaur A, Ali W, and Akduman L
- Subjects
- Adult, Aged, Area Under Curve, Cross-Sectional Studies, Diabetes Mellitus, Type 2 blood, Diabetic Retinopathy diagnosis, Disease Progression, Female, Humans, Male, Middle Aged, Prolactin blood, ROC Curve, Severity of Illness Index, Biomarkers blood, Diabetic Retinopathy blood, Hydrocortisone blood
- Abstract
Purpose: Cortisol and prolactin are multifunctional hormones essential for various metabolic processes in the human body. This study evaluated for the first time the association between serum cortisol and prolactin levels and severity of diabetic retinopathy (DR) and their role as biomolecular biomarkers for disease progression., Methods: A tertiary care center-based cross-sectional study was conducted. Forty-six consecutive cases of type 2 diabetes mellitus (DM) were included. Retinopathy was graded according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification: diabetes with no retinopathy (NoDR, n = 15), nonproliferative DR (NPDR, n = 16), and proliferative DR (PDR, n = 15). Healthy controls (n = 15) were also included. All study participants underwent complete ophthalmological evaluations. Serum levels of cortisol and prolactin were analyzed using the chemiluminescence microparticle assay method. Statistical analysis was performed using ANOVA, univariate and multivariate ordinal logistic regression, and receiver operating characteristics (ROC) area under the curve (AUC)., Results: The mean serum cortisol levels (µg/dl) were 10.25±1.380 for the NoDR group, 12.00±2.540 for the NPDR group, 13.19±2.170 for the PDR group, and 8.22±2.97 for the control group. The mean serum prolactin levels (ng/ml) were13.13±1.97 for the NoDR group, 11.04±2.59 for the NPDR group, 7.84±1.17 for the PDR group, and 7.38±3.34 for the control group. ANOVA showed a statistically significant increase in serum cortisol levels (F = 12.87, p<0.001) and a decrease in serum prolactin levels (F = 19.31, p<0.001) with severity of DR. However, the multivariate ordinal logistic regression analysis showed serum cortisol is a statistically significant independent predictor for severity of DR (odds ratio (OR) = 0.49, 95% confidence interval (CI) = 0.36-0.68, p<0.001). The AUC analysis of the serum cortisol levels to discriminate between severity of DR showed statistically significant diagnostic accuracy (NoDR group: AUC = 0.787, p<0.001; NPDR group: AUC = 0.852, p<0.001; PDR group: AUC = 0.887, p<0.001). Serum cortisol levels of >9.5 µg/dl and >10.2 µg/dl were found to be statistically significantly associated with occurrence of NPDR and PDR, respectively., Conclusions: Statistically significantly elevated serum cortisol levels are observed before development of signs of DR. Serum cortisol levels are statistically significantly associated with severity of DR and serve as a sensitive and specific biomolecular biomarker for disease progression., (Copyright © 2021 Molecular Vision.)
- Published
- 2021
29. Sequential restoration of external limiting membrane and ellipsoid zone after intravitreal anti-VEGF therapy in diabetic macular oedema.
- Author
-
De S, Saxena S, Kaur A, Mahdi AA, Misra A, Singh M, Meyer CH, and Akduman L
- Subjects
- Bevacizumab, Humans, Retina, Retrospective Studies, Tomography, Optical Coherence, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Diabetic Retinopathy drug therapy, Macular Edema drug therapy
- Abstract
Background/objectives: To study the mechanism of restoration of retinal photoreceptor ellipsoid zone (EZ), after intravitreal bevacizumab (IVB) therapy, in diabetic macular oedema (DMO)., Subjects/methods: Forty-four consecutive patients aged 40-65 years having type 2 diabetes mellitus (DM) with DMO were prospectively recruited for IVB therapy. It comprised of three doses (1.25 mg in 0.05 ml) of IVB at monthly intervals. Patients with other ocular and systemic diseases affecting retinal vessels and earlier ophthalmological interventions were excluded. Visual acuity (logMAR VA) was recorded. Spectral domain optical coherence tomography (SD-OCT) was performed pre and post intervention. Central sub-foveal thickness (CST) and grades of disorganization of retinal inner layers (DRIL), external limiting membrane (ELM) and EZ were assessed. Data were statistically analysed on SPSS software. Clinical trials registry: CTRI/2019/03/018135., Results: Mean logMAR VA decreased after IVB therapy from 1.78 ± 0.07 pre-intervention to 0.42 ± 0.05 post intervention (p < 0.001). Similarly, CST reduced from 354.23 ± 15.0 µm pre-intervention to 233.18 ± 7.88 µm post intervention (p < 0.001). Among qualitative variables, DRIL decreased from 93.2% pre-intervention to 13.6% post intervention. Likewise, global ELM disruption reduced from 81.8 to 9.1% and global EZ disruption reduced from 79.5 to 11.4%. ELM restoration preceded EZ restoration., Conclusion: Anti-VEGF therapy restores the barrier effect of ELM. It causes ELM to restore first followed by EZ restoration in DMO.
- Published
- 2021
- Full Text
- View/download PDF
30. External limiting membrane: retinal structural barrier in diabetic macular edema.
- Author
-
Saxena S, Akduman L, and Meyer CH
- Abstract
Advances in spectral-domain optical coherence tomography (SD-OCT) technology have enhanced the understanding of external limiting membrane (ELM) and ellipsoid zone (EZ) in diabetic macular edema. An increase in VEGF has been demonstrated to be associated with sequential ELM and EZ disruption on SD-OCT. An intact ELM is a prerequisite for an intact EZ in DME. Anti-VEGF therapy leads to restoration of barrier effect of ELM. The ELM restores first followed by EZ restoration.
- Published
- 2021
- Full Text
- View/download PDF
31. Resistive index of central retinal artery is a bioimaging biomarker for severity of diabetic retinopathy.
- Author
-
Khatri M, Saxena S, Kumar M, Chabbra AK, Bhasker SK, Akduman EI, Pham H, and Akduman L
- Abstract
Background: The present study was undertaken to assess the resistive index (RI) of central retinal artery (CRA) as a bioimaging biomarker for the severity of diabetic retinopathy (DR), for the first time., Methods: Eighty-one consecutive patients of type 2 diabetes mellitus between the ages of 40 and 70 years were included in a tertiary care center-based cross sectional study. Severity of retinopathy was assessed according to Early Treatment Diabetic Retinopathy Study (ETDRS) classification: diabetes mellitus with no retinopathy (No DR) (n = 26); non-proliferative diabetic retinopathy (NPDR) (n = 29); and proliferative diabetic retinopathy (PDR) (n = 26). Twenty-six healthy controls of similar age were also included. Resistive index of CRA was studied using color Doppler and gray scale sonography. Central subfield thickness (CST), cube average thickness (CAT), retinal photoreceptor ellipsoid zone (EZ) disruption, and retinal nerve fiber layer (RNFL) thickness were evaluated using spectral domain optical coherence tomography. Sensitivity and specificity were assessed by receiver operating characteristic (ROC) curve., Results: Mean RI of CRA for the study groups revealed significant increase with severity of diabetic retinopathy (F = 10.24, P < 0.001). The ROC curve analysis showed diagnostic accuracy of RI of CRA (area under curve = 0.841-0.999; sensitivity = 76-100%, specificity = 95.45-100%, P < 0.001) in discriminating controls and patients. Univariate regression analysis revealed significant association between the study groups and RI of CRA (P < 0.001). RI of CRA correlated positively with CST (r = 0.37), CAT (r = 0.45), EZ disruption (r = 0.43) and negatively with RNFL thickness (r = - 0.35) (P < 0.001)., Conclusions: Resistive index of CRA is a reliable bioimaging biomarker for the severity of DR., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2019.)
- Published
- 2019
- Full Text
- View/download PDF
32. Serum vascular endothelial growth factor is a biomolecular biomarker of severity of diabetic retinopathy.
- Author
-
Ahuja S, Saxena S, Akduman L, Meyer CH, Kruzliak P, and Khanna VK
- Abstract
Background: Elevated serum vascular endothelial growth factor (VEGF) levels are associated with diabetic retinopathy (DR). Serum VEGF levels correlate with vitreous levels. Neuroretinal changes occur even before the appearance of vascular signs in DR. Role of VEGF as a biomarker for DR has not been assessed. Serum VEGF as a biomarker for severity of DR, was evaluated for the first time., Methods: Consecutive cases of type 2 diabetes mellitus [without DR, (no DR, n = 38); non-proliferative DR, (NPDR, n = 38); proliferative DR, (PDR, n = 40)] and healthy controls (n = 40) were included. Serum VEGF was measured using enzyme linked immunosorbent assay. Accuracy of VEGF as a biomarker for severity of retinopathy was measured using the area under the receiver operator characteristic (ROC) curve., Results: Serum VEGF levels in controls, No DR, NPDR and PDR groups showed significant incremental trend from 138.96 ± 63.37 pg/ml (controls) to 457.18 ± 165.69 pg/ml (PDR) (F = 48.47; p < 0.001). Serum VEGF levels were observed to be significantly elevated even before DR had set in clinically. ROC for serum VEGF levels was significant in discriminating between the cases and the controls and had good accuracy in discerning between subjects with and without retinopathy. The area under curve (AUC ± SE) for discrimination was significant: (a) cases and controls (n = 156): AUC = 0.858 ± 0.029, p < 0.001; (b) DR (NPDR + PDR) and No DR (n = 116): AUC = 0.791 ± 0.044, p < 0.001; and (c) NPDR and PDR (n = 78): AUC = 0.761 ± 0.056, p < 0.001, with over 90% projected sensitivity and specificity at various cut off values., Conclusion: Serum VEGF level is a simple, effective laboratory investigative test in predicting the onset of DR in eyes showing no evidence of DR and serves as a reliable biomolecular biomarker for severity of DR., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2019.)
- Published
- 2019
- Full Text
- View/download PDF
33. Risk of Endophthalmitis in Boston Type 1 Keratoprosthesis Combined with Vitrectomy and Silicone Oil Insertion.
- Author
-
Abou Shousha M, Eleiwa T, Gibbons A, Smith C, Edelstein S, Kontadakis G, Schmitz Z, Abernathy J, Chod R, Bodnar Z, McDaniel K, Bentivegna R, and Akduman L
- Abstract
Purpose: To identify the incidence of endophthalmitis and visual outcomes in eyes with Boston type 1 keratoprosthesis combined with pars plana vitrectomy and silicone oil insertion (KPro + PPV + SOI) as compared to eyes receiving Boston type 1 keratoprosthesis (KPro) alone., Patients and Methods: Retrospective chart review of 29 eyes of 27 patients with KPro having at least 12-month follow-up. Thirteen of these eyes had hypotony and/or retinal detachment in addition to corneal pathology and thus received KPro + PPV + SOI. Polymyxin-trimethoprim with a quinolone was used as chronic topical antibiotic prophylaxis in both groups after the first postoperative month. Outcome measures recorded at the 1-, 3-, 6-, 12-, and 24-month follow-up visits included best-corrected visual acuity (BCVA) and rates of postoperative complications., Results: All the patients had completed 24-month follow-up except one case in the KPro group who lost to follow-up after 12-month visit. In the KPro + PPV + SOI group, no eyes had developed endophthalmitis by the 24-month follow-up visit versus 5 eyes of 5 patients in the uncombined KPro group ( P =0.048). The 2-year cumulative endophthalmitis incidence was 31.2% in the KPro group versus zero in the KPro + PPV + SOI group ( P =0.030). Four of these 5 eyes had vitreous taps with positive cultures; 2 were positive with Staphylococcus aureus , 1 with coagulase-negative staphylococci, and 1 with Streptococcus pneumoniae . Other complications included KPro extrusion (1 in each group), retinal detachment (2 in the KPro and 1 in the KPro + PPV + SOI group), newly developed glaucoma (2 in each group), and retroprosthetic membrane (9 in the KPro and 5 in the KPro + PPV + SOI group). The KPro group had better average preoperative BCVA compared to those of the KPro + PPV + SOI group (-2.29 ± 0.72 LogMAR, versus -2.95 ± 0.30 LogMAR; P =0.004). No statistically significant difference in BCVA was noted in subsequent follow-up visits., Conclusion: The addition of PPV and SOI to the KPro implantation in the eyes with corneal pathology, as well as hypotony and/or retinal detachment, is a safe and effective procedure for visual rehabilitation. Pars plana vitrectomy and silicone oil insertion may have a protective effect against the development of postoperative endophthalmitis in eyes receiving KPro., Competing Interests: The authors declare that there are no conflicts of interest.
- Published
- 2019
- Full Text
- View/download PDF
34. Central subfield thickness and cube average thickness as bioimaging biomarkers for ellipsoid zone disruption in diabetic retinopathy.
- Author
-
Ahuja S, Saxena S, Meyer CH, Gilhotra JS, and Akduman L
- Abstract
Background: To evaluate the association of central subfield thickness (CST) and cube average thickness (CAT) with ellipsoid zone (EZ) disruption on spectral domain optical coherence tomography (SD-OCT) in patients of diabetic retinopathy (DR)., Methods: Cross sectional study including consecutive patients of type 2 diabetes mellitus [without DR (No DR, n = 97); non-proliferative DR (NPDR, n = 91); proliferative DR (PDR, n = 83)] and healthy controls (n = 82) was undertaken. CST and CAT values were measured using SD-OCT. Data was analyzed using Chi square test, ANOVA and multivariate analysis. Discriminant values of CST and CAT for EZ disruption were evaluated using receiver operator characteristic curve. Area under curve (AUC) was computed., Results: Mean CAT and CST values in the study subjects showed an incremental trend. Multivariate ordinal logistic regression analysis showed increase in CST (OR = 1.022, p < 0.001) and CAT (OR = 1.029, p < 0.001) as significant independent predictors of EZ disruption. Area under curve showed excellent predictive results of CST (AUC = 0. 943 ± 0.021, 95% CI, 0.902-0.984, p < 0.05) and CAT (AUC = 0.959 ± 0.012, 95% CI 0.936-0.982, p < 0.05), as bioimaging biomarkers, for EZ disruption., Conclusion: Increase in CST and CAT is associated with increased odds of EZ disruption and these macular parameters serve as bioimaging biomarkers for EZ disruption in DR.
- Published
- 2018
- Full Text
- View/download PDF
35. INCREASED SERUM LEVELS OF UREA AND CREATININE ARE SURROGATE MARKERS FOR DISRUPTION OF RETINAL PHOTORECEPTOR EXTERNAL LIMITING MEMBRANE AND INNER SEGMENT ELLIPSOID ZONE IN TYPE 2 DIABETES MELLITUS.
- Author
-
Saxena S, Ruia S, Prasad S, Jain A, Mishra N, Natu SM, Meyer CH, Gilhotra JS, Kruzliak P, and Akduman L
- Subjects
- Adult, Aged, Analysis of Variance, Biomarkers blood, Case-Control Studies, Diabetic Retinopathy physiopathology, Female, Humans, Male, Middle Aged, Photoreceptor Cells, Vertebrate pathology, Retinal Diseases, Severity of Illness Index, Creatinine blood, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 pathology, Diabetic Retinopathy blood, Diabetic Retinopathy pathology, Epiretinal Membrane pathology, Retinal Photoreceptor Cell Inner Segment pathology, Urea blood
- Abstract
Purpose: To evaluate the role of serum urea and creatinine as surrogate markers for disruption of retinal photoreceptor external limiting membrane (ELM) and inner segment ellipsoid zone (EZ) in Type 2 diabetic retinopathy (DR) using spectral-domain optical coherence tomography, for the first time., Methods: One hundred and seventeen consecutive cases of Type 2 diabetes mellitus (diabetes without retinopathy [No DR; n = 39], nonproliferative diabetic retinopathy [NPDR; n = 39], proliferative diabetic retinopathy [PDR; n = 39]) and 40 healthy control subjects were included. Serum levels of urea and creatinine were assessed using standard protocol. Spectral-domain optical coherence tomography was used to grade the disruption of ELM and EZ as follows: Grade 0, no disruption of ELM and EZ; Grade 1, ELM disrupted, EZ intact; Grade 2, ELM and EZ disrupted. Data were analyzed statistically., Results: Increase in serum levels of urea (F = 22.93) and creatinine (F = 15.82) and increased grades of disruption of ELM and EZ (γ = 116.3) were observed with increased severity of DR (P < 0.001). Increase in serum levels of urea (F = 10.45) and creatinine (F = 6.89) was observed with increased grades of disruption of ELM and EZ (P = 0.001)., Conclusion: Serum levels of urea and creatinine are surrogate markers for disruption of retinal photoreceptor ELM and EZ on spectral-domain optical coherence tomography in DR.
- Published
- 2017
- Full Text
- View/download PDF
36. Increased serum level of homocysteine correlates with retinal nerve fiber layer thinning in diabetic retinopathy.
- Author
-
Srivastav K, Saxena S, Mahdi AA, Shukla RK, Meyer CH, Akduman L, and Khanna VK
- Subjects
- Adult, Aged, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Female, Folic Acid blood, Humans, Male, Middle Aged, Prospective Studies, Tomography, Optical Coherence, Vitamin B 12 blood, Diabetic Retinopathy blood, Diabetic Retinopathy diagnosis, Homocysteine blood, Nerve Fibers pathology, Retinal Ganglion Cells pathology
- Abstract
Purpose: To study the correlation between serum levels of vitamin B
12 , folic acid, and homocysteine and the severity of diabetic retinopathy and the correlation with retinal nerve fiber layer (RNFL) thinning on spectral domain optical coherence tomography (SD-OCT)., Methods: In a tertiary care center-based prospective cross-sectional study, 60 consecutive cases and 20 healthy controls in the age group of 40-65 years were included. The eyes of the cases were divided into three groups according to Early Treatment Diabetic Retinopathy Study (ETDRS) classification: diabetes mellitus without retinopathy (n = 20), non-proliferative diabetic retinopathy with macular edema (n = 20), and proliferative diabetic retinopathy with macular edema (n = 20). The serum levels of vitamin B12 and folic acid were measured using a standard protocol. The serum homocysteine assay was performed using an enzyme-linked immunosorbent assay (ELISA) kit. Average RNFL thickness was measured using SD-OCT. Statistical analysis was used to assess the correlations between the study variables., Results: Increased severity of diabetic retinopathy was found to correlate with an increase in the serum levels of homocysteine (F = 53.79; p<0.001). The mean serum levels of vitamin B12 and folic acid were found to be within the normal reference range. A positive correlation was found between retinal nerve fiber layer thinning and serum levels of homocysteine (p<0.001)., Conclusions: This study, for the first time, demonstrated a correlation between increased homocysteine with a decrease in RNFL thickness and increased severity of diabetic retinopathy.- Published
- 2016
37. In vivo early retinal structural alterations following laser photocoagulation using three-dimensional spectral domain optical coherence tomography.
- Author
-
Saxena S, Mishra N, Ruia S, and Akduman L
- Subjects
- Follow-Up Studies, Humans, Male, Middle Aged, Retina surgery, Retinal Pigment Epithelium diagnostic imaging, Treatment Outcome, Imaging, Three-Dimensional methods, Laser Coagulation, Lasers, Solid-State therapeutic use, Retina diagnostic imaging, Retinal Vein Occlusion surgery, Tomography, Optical Coherence methods
- Abstract
To study the retinal structural alterations and surface topography of retinal pigment epithelium (RPE) immediately following laser photocoagulation up to day 7. Cross-sectional retinal imaging and RPE segmentation maps on spectral domain optical coherence tomography were obtained immediately at hour 1, day 1, day 4 and day 7 following 532 nm neodymium:YAG laser photocoagulation in a 56-year-old male patient for branch retinal vein occlusion. Immediately postlaser, loss of reflectivity of all the retinal layers was observed. At hour 1, hyper-reflectivity of outer retinal layers was observed with increase in hyporeflective spaces by day 1. Immediately postlaser, pitting of the RPE was observed on surface topography which regressed at day 1. On day 4, smooth RPE surface topography was observed with the occurrence of small elevated areas on day 7. The present report provides an insight into the in vivo changes in the retinal structure and RPE surface topography after laser photocoagulation., (2016 BMJ Publishing Group Ltd.)
- Published
- 2016
- Full Text
- View/download PDF
38. Correlation of biomarkers thiobarbituric acid reactive substance, nitric oxide and central subfield and cube average thickness in diabetic retinopathy: a cross-sectional study.
- Author
-
Ruia S, Saxena S, Prasad S, Sharma SR, Akduman L, and Khanna VK
- Abstract
Background: To evaluate the role of thiobarbituric acid reactive substance (TBARS) and nitric oxide (NO) as biochemical biomarkers and central subfield (CST) and cube average thickness (CAT) as biomarkers for medical imaging in diabetic retinopathy., Methods: Forty consecutive cases of diabetic retinopathy and 20 healthy controls were included. Cases were divided into two groups: non proliferative diabetic retinopathy (n = 20) and proliferative diabetic retinopathy (n = 20) according to ETDRS classification. LogMAR visual acuity was documented. Plasma levels of TBARS, NO and glycated hemoglobin (HbA1c) were measured using standard protocol. CST and CAT were analyzed on spectral domain optical coherence tomography. Data was analyzed statistically., Results: Increased severity of diabetic retinopathy was associated with an increase in plasma levels of TBARS (F = 10.92; p < 0.001), NO (F = 21.8; p < 0.001) and HbA1c (F = 5.87; p = 0.001). Increase in CST (F = 61.51; p < 0.001) and CAT (F = 60.84; p < 0.001) was also found to be associated with increased severity of diabetic retinopathy. Pearson's correlation analysis revealed a positive correlation of TBARS with CST (r = 0.29; p = 0.038) and CAT (r = 0.31; p = 0.04). A positive correlation of NO with CST (r = 0.27; p = 0.03) and CAT (r = 0.7; p = 0.001) was also observed. On univariate analysis with logMAR visual acuity as dependent variable, a significant increase in visual acuity was observed with increase in independent variables TBARS (B = 0.22; p = 0.004), NO (B = 0.006; p < 0.001), CST (B = 0.005; p < 0.001) and CAT (B = 0.005; p < 0.001). On multivariate linear regression analysis with logMAR visual acuity as dependent variable and adjusting for other factors like duration of diabetes and HbA1c, it was observed that increase in independent variables TBARS (B = 0.07), NO (B = 0.001) and CST (B = 0.004) independently predict increase in logMAR visual acuity (p < 0.001)., Conclusion: Thiobarbituric acid reactive substance and nitric oxide serve as potential biochemical markers whereas central subfield and cube average thickness serve as potential biomarkers for medical imaging for severity of diabetic retinopathy. In a clinical retinal setting, CAT and CST will help in early recognition of increase in severity of diabetic retinopathy.
- Published
- 2016
- Full Text
- View/download PDF
39. Lamellar macular hole after intravitreal ocriplasmin injection.
- Author
-
Chod RB, Goodrich C, Saxena S, and Akduman L
- Subjects
- Aged, Female, Humans, Intravitreal Injections, Retinal Perforations drug therapy, Tissue Adhesions drug therapy, Fibrinolysin administration & dosage, Fibrinolysin adverse effects, Macula Lutea drug effects, Peptide Fragments administration & dosage, Peptide Fragments adverse effects, Retinal Perforations chemically induced, Vitreous Body pathology
- Abstract
Intravitreal ocriplasmin was recently approved by the Food and Drug Administration to achieve medical vitreolysis in the setting of vitreomacular adhesion (VMA). We report a case of a 76-year-old woman who developed a lamellar macular hole following treatment with intravitreal ocriplasmin injection for VMA. A pathophysiological mechanism to explain this previously unreported complication of ocriplasmin injection is proposed., (2015 BMJ Publishing Group Ltd.)
- Published
- 2015
- Full Text
- View/download PDF
40. Three-dimensional spectral domain optical coherence tomography in vitreomacular traction.
- Author
-
Saxena S, Manisha, Meyer CH, and Akduman L
- Subjects
- Aged, Humans, Male, Middle Aged, Tissue Adhesions, Tomography, Optical Coherence, Visual Acuity, Retina pathology, Retinal Diseases pathology, Vitreous Body pathology, Vitreous Detachment
- Abstract
Spectral domain optical coherence tomography (SD-OCT) is a non-invasive tool providing unprecedented imaging and analysis of vitreomacular interface. Two cases of vitreomacular traction were analysed by advanced three-dimensional (3D) SD-OCT imaging. En-face OCT permitted localisation of the exact point of attachment of vitreous to retina. A comprehensive view of the surface topography and anatomical configuration of vitreomacular affection was revealed by 3D imaging with segmentation technique. Macular change analysis programme revealed progression to full-thickness macular hole in the second case. Non-invasive high-resolution SD-OCT imaging has transformed the understanding and management of vitreomacular traction. Its role is further reinforced by the introduction of ocriplasmin for management of vitreomacular adhesions., (2014 BMJ Publishing Group Ltd.)
- Published
- 2014
- Full Text
- View/download PDF
41. Occult wooden posterior segment intraocular foreign body.
- Author
-
Desai A, Parihar R, Mathews J, and Akduman L
- Subjects
- Aged, Eye Foreign Bodies diagnostic imaging, Eye Injuries, Penetrating diagnostic imaging, Female, Glass, Humans, Male, Metals, Plastics, Posterior Eye Segment diagnostic imaging, Tomography, X-Ray Computed, Ultrasonography, Vitrectomy, Eye Foreign Bodies diagnosis, Eye Injuries, Penetrating diagnosis, Posterior Eye Segment injuries, Wood
- Abstract
Background and Objective: To evaluate B-scan and computed tomographic appearance of a wooden intraocular foreign body within the posterior segment., Materials and Methods: The authors report a case of a patient with an occult retained foreign body. To identify why the object was elusive, an in vitro study was conducted using computed tomography (CT) and B-scan on five human cadaveric eyes with known foreign bodies implanted into the vitreous cavity., Results: Posterior segment metal and glass produced comet tail artifacts on B-scan, whereas stone, wood, and plastic produced shadowing artifacts. There was difficulty in identifying wood within the posterior chamber via CT. However, stone and plastic were easily detectable but difficult to identify without Hounsfield units., Conclusion: CT provides quick imaging of suspected posterior segment foreign bodies; however, B-scan ultrasonography may prove more useful than CT in detecting wooden foreign bodies., (Copyright 2014, SLACK Incorporated.)
- Published
- 2014
- Full Text
- View/download PDF
42. Ischaemia-reperfusion injury in central retinal artery occlusion.
- Author
-
Saxena S, Mishra N, Meyer CH, and Akduman L
- Subjects
- Fluorescein Angiography, Fundus Oculi, Humans, Male, Middle Aged, Retinal Artery pathology, Retinal Artery Occlusion diagnosis, Retinal Artery Occlusion pathology, Reperfusion Injury etiology, Retinal Artery Occlusion complications
- Abstract
A 53-year-old man presented with sudden painless diminution of vision in his right eye for 3 days. His fundus examination showed diffuse whitening of the retina with a cherry red spot at the fovea with cilioretinal artery sparing. On fluorescein angiography delayed arteriovenous transit was observed. Three-dimensional spectral domain optical coherence tomography was used to assess retinal nerve fibre layer thickness and average macular central subfield thickness on days 3, 7, 30 and 90. Marked retinal oedema due to ischaemia was observed on day 3 of occurrence of central retinal artery occlusion. On day 7, significant decrease in retinal nerve fibre thickness and macular thickness was noted suggestive of acute reperfusion injury. Retinal nerve fibre layer thickness and macular thickness returned to near normal on day 30 due to restoration of blood supply with wash out of stress mediators. Retinal atrophy was observed on day 90.
- Published
- 2013
- Full Text
- View/download PDF
43. Ocular vasculitis.
- Author
-
Espinoza GM, Desai A, and Akduman L
- Subjects
- Behcet Syndrome diagnosis, Biological Products therapeutic use, Diagnosis, Differential, Eye Diseases drug therapy, Eye Diseases etiology, Eye Infections diagnosis, Humans, Neoplasms complications, Neoplasms diagnosis, Systemic Vasculitis diagnosis, Vasculitis drug therapy, Vasculitis etiology, Eye Diseases diagnosis, Vasculitis diagnosis
- Abstract
Vasculitis is the inflammation of blood vessels that leads to loss of perfusion and ischemia with necrosis. When this occurs in the orbit, the consequences are typically very conspicuous and can be devastating with decreased quality of life and loss of vision. Systemic vasculitides are often related to ophthalmic disorders, which can serve as the first diagnostic manifestation of potentially life-threatening disease. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (e.g., granulomatosis with polyangiitis), Behcet's disease, rheumatoid arthritis, sarcoidosis, and systemic lupus erythematosus are a few of the diseases commonly associated with ocular vasculitis. Collaboration between ophthalmologists and rheumatologists is important in the successful diagnosis and treatment of patients with vasculitis.
- Published
- 2013
- Full Text
- View/download PDF
44. ND-yag laser arteriotomy for central retinal artery occlusion.
- Author
-
Akduman L, Currie M, Scanlon C, Grant A, and Cetin EN
- Abstract
Purpose: To report a case of central retinal artery occlusion treated with Nd-YAG arteriotomy with successful outcome., Methods: Interventional case report of a 61-year-old man with central retinal artery occlusion who underwent an arteriotomy with embolectomy/embolysis with Nd-YAG laser., Results: Best-corrected visual acuity improved to 9/200 immediately and 20/200 one day after the procedure. Two months later, the patient underwent pars plana vitrectomy for dispersed, nonclearing vitreous hemorrhage. Three months later, the patient had cataract surgery. Visual field significantly improved centrally at 5 months after Nd-YAG laser procedure. The final visual acuity was 20/40 at 15 months after the procedure., Conclusion: Nd-YAG laser may be beneficial in selected cases of retinal artery occlusion by enhancing the restoration of blood flow in the retinal vessels.
- Published
- 2013
- Full Text
- View/download PDF
45. Acute central retinal vein occlusion following episode of myopericarditis in an adolescent patient.
- Author
-
Desai A, Saxena S, and Akduman L
- Subjects
- Acute Disease, Adolescent, Humans, Male, Myocarditis complications, Pericarditis complications, Retinal Vein Occlusion etiology
- Abstract
A 15-year-old African-American boy presented with unilateral decrease in vision following an episode of myopericarditis. His ocular examination was significant for diffuse retinal oedema and intraretinal haemorrhages. He was diagnosed with a central retinal vein occlusion and was referred to rheumatology for further evaluation following negative hypercoaguable studies. He was later found to have systemic lupus erythematous. Approximately 8 months after presentation, the patient's vision improved and remained stable at 20/40.
- Published
- 2013
- Full Text
- View/download PDF
46. Three-dimensional spectral domain optical coherence tomography imaging of the retina in choroidal tuberculoma.
- Author
-
Saxena S, Singhal V, and Akduman L
- Subjects
- Adolescent, Choroid Diseases pathology, Female, Humans, Tuberculoma pathology, Tuberculosis, Ocular pathology, Choroid pathology, Choroid Diseases diagnosis, Retina pathology, Tomography, Optical Coherence, Tuberculoma diagnosis, Tuberculosis, Ocular diagnosis
- Abstract
Introduction: To study retinal imaging in choroidal tuberculoma by three-dimensional spectral domain optical coherence tomography (SD-OCT) for the first time., Methods: QuantiFERON-TB GOLD test, colour Doppler imaging, fluorescein angiography and SD-OCT were performed in an 18-year-old immunocompetent female patient., Results: Three-dimensional imaging over the choroidal lesion revealed marked retinal elevation. Subfoveal neurosensory detachment along with serous retinal detachment resulted from effusion of fluid from the underlying choroidal lesion. Granularity of the outer photoreceptor layer and proliferating retinal pigment epithelium cells indicated chronicity of the underlying choroidal lesion abutting the retina. Antitubercular therapy, after 2 weeks, resulted in a resolution of the subfoveal neurosensory detachment, reduction in the serous retinal detachment and a decrease in retinal elevation., Conclusions: Three-dimensional SD-OCT allows a spatial visualisation and documentation of retinal elevation. It also allows a detailed visualisation of the secondary retinal pigment epithelial and intraretinal changes and is helpful in monitoring the response to medication.
- Published
- 2013
- Full Text
- View/download PDF
47. Spontaneous dissociation and dislocation of Retisert pellet.
- Author
-
Akduman L, Cetin EN, Levy J, Becker MD, Mackensen F, and Lim LL
- Subjects
- Adult, Diagnosis, Differential, Drug Implants adverse effects, Female, Foreign-Body Migration diagnosis, Foreign-Body Migration surgery, Glucocorticoids administration & dosage, Humans, Male, Middle Aged, Vitrectomy, Vitreous Body, Fluocinolone Acetonide administration & dosage, Foreign-Body Migration etiology, Uveitis, Posterior drug therapy
- Abstract
Purpose: To report 4 cases of spontaneous Retisert pellet dislocation., Design: Retrospective case series., Methods: Description of cases., Results: In all 4 cases, the time of Retisert implantation was 3-6 years prior to presentation. One case was complicated by retinal commotio and a retinal tear; another was complicated by corneal endothelial failure, due to dislocation of the pellet into the anterior chamber., Conclusion: Spontaneous pellet separation may occur with Retisert as a late complication. It is unclear whether these dislocations are from a manufacturing fault or are related to extended intraocular exposure.
- Published
- 2013
- Full Text
- View/download PDF
48. Vitreopapillary and vitreomacular traction in proliferative Eales' disease.
- Author
-
Saxena S, Jain A, and Akduman L
- Subjects
- Adult, Humans, Imaging, Three-Dimensional, Macula Lutea pathology, Male, Ophthalmoscopy methods, Optic Disk pathology, Tomography, Optical Coherence methods, Traction, Epiretinal Membrane etiology, Macular Edema etiology, Neovascularization, Pathologic complications, Retina pathology, Retinal Vasculitis complications, Retinoschisis etiology, Vitreous Body pathology
- Abstract
Vitreoretinal interface alterations leading to vitreopapillary and vitreomacular traction in a 29-year case of proliferative Eales' disease is described for the first time. On fundus examination, an ellipsoid area of vitreomacular traction was noted temporal to the optic disc. A triangular-shaped infolding of the retina was observed superior to the fovea. Epiretinal membrane was seen temporal to the disc involving the macula. Imaging by spectral domain optical coherence tomography in the papillomacular bundle region revealed retinoschisis at the level of the outer nuclear layer and confirmed the presence of retinal infolding and epiretinal membrane in the macular area. Three-dimensional imaging documented vitreoretinal interface alterations exquisitely.
- Published
- 2012
- Full Text
- View/download PDF
49. Three-dimensional spectral domain optical coherence tomography of retina in choroidal metastasis due to breast and lung carcinoma.
- Author
-
Saxena S, Jain A, and Akduman L
- Published
- 2012
- Full Text
- View/download PDF
50. Resistant Fusarium keratitis progressing to endophthalmitis.
- Author
-
Edelstein SL, Akduman L, Durham BH, Fothergill AW, and Hsu HY
- Subjects
- Coumarins isolation & purification, Disease Progression, Drug Resistance, Multiple, Fungal, Eye Enucleation, Eye Infections, Fungal microbiology, Eye Infections, Fungal surgery, Fusariosis drug therapy, Humans, Middle Aged, Treatment Outcome, Antifungal Agents therapeutic use, Endophthalmitis microbiology, Eye Infections, Fungal drug therapy, Fusariosis complications, Keratitis microbiology
- Abstract
Objective: To report a case of multidrug-resistant Fusarium sp keratitis that progressed to endophthalmitis and that eventually required enucleation., Methods: Case report and literature review. Isolate identification and susceptibility testing were performed by the Fungus Testing Laboratory at San Antonio, TX., Results: A 52-year-old soft contact lens wearer had a corneal abrasion and developed a corneal infiltrate. Examination of corneal scrapings revealed filamentous hyphae with septation and conidia. Despite aggressive antifungal therapy with topical natamycin, amphotericin B, and systemic fluconazole, the keratitis progressed, and a penetrating keratoplasty was performed. Histopathologic analysis of the corneal button showed disruption of Descemet's membrane with periodic acid-Schiff-positive fungal hyphae on both sides. Recurrent infection of the graft and progression to endophthalmitis was treated with repeated intravitreal amphotericin B injections, repeat penetrating keratoplasties, and pars plana vitrectomies. Even after systemic use of itraconazole, voriconazole, and posaconazole and topical use of voriconazole, the infection progressed and an enucleation was required. Isolate identification and susceptibility testing found a multidrug-resistant Fusarium solani species complex, partially sensitive to natamycin only., Conclusions: Multidrug-resistant Fusarium sp is rare and may have devastating consequences in patients with advanced keratitis progressing to endophthalmitis. Such an extensive multidrug resistance is surprising in that resistance to antifungal treatment is supposedly rare. Empirical antifungal therapy is usually instituted using one or more antifungal agents, without checking antifungal sensitivities. In light of the growing concern for increased emergence of resistant strains, we propose a lower threshold to check for sensitivities in the face of unresponsive fungal infections.
- Published
- 2012
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.