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2,490 results on '"Selva, Dinesh"'

11. Predictive Modeling of New-Onset Postoperative Diplopia Following Orbital Decompression for Thyroid Eye Disease

Author

Nair, Archana A, Ediriwickrema, Lilangi S, Dolman, Peter J, Law, Geoffrey, Harrison, Andrew R, Mokhtarzadeh, Ali, Stewart, Krista, Men, Clara, Lucarelli, Mark J, van Landingham, Suzanne, Wingelaar, Maxwell, Verma, Rohan, Chen, Allison, Selva, Dinesh, Garrity, James, Eckel, Laurence, Kazim, Michael, Godfrey, Kyle, Baxter, Sally L, Korn, Bobby S, and Kikkawa, Don O

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Ophthalmology and Optometry, Clinical Research, Eye Disease and Disorders of Vision, Patient Safety, Prevention, Brain Disorders, Humans, Graves Ophthalmopathy, Retrospective Studies, Decompression, Surgical, Diplopia, Orbit, Treatment Outcome, Opthalmology and Optometry, Ophthalmology & Optometry, Ophthalmology and optometry
Abstract

PurposeTo identify risk factors for the development of new-onset, postoperative diplopia following orbital decompression surgery based on patient demographics, clinical exam characteristics, radiographic parameters, and surgical techniques.MethodsWe conducted a multi-center retrospective chart review of patients who underwent orbital decompression for thyroid eye disease (TED). Patient demographics, including age, gender, smoking history, preoperative exophthalmometry, clinical activity score (CAS), use of peribulbar and/or systemic steroids, and type of orbital decompression were reviewed. Postoperative diplopia was determined at a minimum of 3 months postoperatively and before any further surgeries. Cross-sectional area ratios of each extraocular muscle to orbit and total fat to orbit were calculated from coronal imaging in a standard fashion. All measurements were carried out using PACS imaging software. Multivariable logistic regression modeling was performed using Stata 14.2 (StataCorp, College Station, TX).ResultsA total of 331 patients without preoperative diplopia were identified. At 3 months postoperatively, 249 patients had no diplopia whereas 82 patients developed diplopia. The average postoperative follow-up was 22 months (range 3-156) months. Significant preoperative clinical risk factors for postoperative diplopia included older age at surgery, proptosis, use of peribulbar or systemic steroids, elevated clinical activity score, and presence of preoperative compressive optic neuropathy. Imaging findings of enlarged cross-sectional areas of each rectus muscle to the overall orbital area also conferred a significant risk of postoperative diplopia. Regarding surgical factors, postoperative diplopia was more common among those undergoing medial wall decompression, bilateral orbital surgery, and balanced decompression, whereas endoscopic medial wall decompression was found to be relatively protective.ConclusionsThis study identifies risk factors associated with the development of diplopia following orbital decompression using multivariable data. This study demonstrates that several characteristics including age, clinical activity score, the cross-sectional muscle to orbit ratios, in addition to the type of orbital decompression surgery, are predictive factors for the development of new-onset postoperative diplopia.

Published
2022

39. Orbital Multiple Myeloma

Author

Aujla, Jaskirat, Juniat, Valerie, Patel, Sandy, Selva, Dinesh, Ben Simon, Guy, editor, Greenberg, Gahl, editor, and Landau Prat, Daphna, editor

Published
2022
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40. Orbital Lymphoma

Author

Aujla, Jaskirat, Juniat, Valerie, Patel, Sandy, Selva, Dinesh, Ben Simon, Guy, editor, Greenberg, Gahl, editor, and Landau Prat, Daphna, editor

Published
2022
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47. Topical dorzolamide for macular holes: A randomised, double‐blind, placebo‐controlled trial.

Author

Lee, Yong Min, Bahrami, Bobak, Baranage, Duleepa, Sivagurunathan, Premala Devi, Wong, Wilson, Bausili, Montserrat Maria, Agrawal, Surbhi, Gilhotra, Jagjit Singh, Durkin, Shane, Sia, David, Selva, Dinesh, Lake, Stewart, Casson, Robert J., and Chan, Weng Onn

Subjects
END of treatment, VISUAL acuity, IDIOPATHIC diseases, CLINICAL trials, CONTROL groups
Abstract

Background: To assess topical dorzolamide as medical therapy for idiopathic full‐thickness macular holes (FTMHs). Methods: Randomised, double‐blinded, placebo‐controlled, single‐centre clinical trial involving 32 patients with idiopathic small FTMHs (<400 μm). Participants in both arms used topical dorzolamide 2% or saline thrice daily for 8 weeks with monthly OCT. Those with persisting FTMH underwent vitrectomy with ILM peel and gas tamponade. The primary outcome was the rate of FTMH closure at the end of treatment. Results: Between 6 March 2020 and 16 June 2023, 32 eligible patients were enrolled: 16 participants in each arm. All participants in both groups were included in the final analysis. At the final visit, 3 of 16 (18.8%) patients in both the topical dorzolamide and placebo group demonstrated closure. There was no statistically significant difference in the proportion of FTMH closure between the control and treatment group (p = 1.00), nor statistically significant difference in the mean change in best corrected visual acuity (BCVA; p = 0.909). There was no difference in the change in FTMH diameter between groups (p = 0.225). No serious adverse events were reported in either group. Conclusion: Topical dorzolamide was safe but not superior to placebo in the functional and anatomical outcomes of FTMH. [ABSTRACT FROM AUTHOR]

Published
2024
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49. Varicella zoster virus meningoencephalitis presenting as orbital myositis – a case report.

Author

Gowda, Akash, Tong, Jessica Y., and Selva, Dinesh

Subjects
VARICELLA-zoster virus, EXANTHEMA, MENINGOENCEPHALITIS, LUMBAR puncture, STEROID drugs
Abstract

The authors present a case of meningoencephalitis caused by Varicella zoster virus (VZV) infection, which initially manifested as orbital myositis followed by rapid progression to orbital apex syndrome, meningoencephalitis and death. There was no development of a cutaneous rash. An orbital biopsy demonstrated VZV infection, which was confirmed on a lumbar puncture. In this case, VZV meningoencephalitis was not responsive to steroid or antiviral therapy. This case highlights an atypical presentation of VZV with orbital myositis preceding intracranial involvement. [ABSTRACT FROM AUTHOR]

Published
2024
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