213 results on '"Mamta Agarwal"'
Search Results
2. Uveal effusion syndrome following COVID-19 vaccination
- Author
-
Mamta Agarwal, Gazal Patnaik, and Amod Gupta
- Subjects
COVID-19 vaccination ,Uveal effusion syndrome ,Vaccination induced uveitis ,Ophthalmology ,RE1-994 - Abstract
Purpose: To report a rare case of uveal effusion syndrome following COVID-19 vaccination. Observation: A 71-year-old Asian man presented to his ophthalmologist with blurred vision and noticing distorted lines in his left eye two weeks after the first dose of COVID-19 vaccination. Examination revealed choroidal detachment and he was advised systemic corticosteroids. The symptoms were ignored and the second vaccine dose was taken. After five months, he presented to our clinic with persistent visual complaints. He also had a history of COVID-19 infection three months prior to vaccination. Ocular examination revealed a quiet anterior chamber with annular choroidal detachment consistent with the diagnosis of Type 3 uveal effusion syndrome. B-scan ultrasonography revealed increased choroidal thickness with detachment. Optical coherence tomography showed subretinal fluid with retinal pigment epithelium and choroidal folds. Ultrasound biomicroscopy revealed all around supraciliary effusion in the left eye. The patient was treated with oral prednisolone and mycophenolate mofetil which resulted in complete resolution of uveal effusion and improvement in visual acuity. Conclusions and importance: Uveal effusion syndrome is a rare ocular disease, however it may manifest following COVID-19 vaccination. Our case highlights the importance of a complete ophthalmic examination in patients with ocular symptoms after vaccination.
- Published
- 2023
- Full Text
- View/download PDF
3. Cluster Formation in a Filamentary Cloud: The Case of the Stellar Cluster NGC 2316
- Author
-
Saurabh Sharma, Aayushi Verma, Kshitiz Mallick, Lokesh K. Dewangan, Harmeen Kaur, Ram Kesh Yadav, Neelam Panwar, Devendra K. Ojha, Tarak Chand, and Mamta Agarwal
- Subjects
Interstellar filaments ,Star clusters ,Star formation ,Astronomy ,QB1-991 - Abstract
We present a multiwavelength analysis of the star cluster NGC 2316 and its surroundings. We estimated the physical parameters of the NGC 2316 cluster, including its shape (elongated), size ( R _cluster = 0.4 pc), distance (1.3 ± 0.3 kpc), and minimum reddening ( A _V = 1.55 mag). We discovered two massive stars (B2.0V-B1.5V, age ∼12 Myr) embedded ( A _V = 4 mag) within this cluster. The cluster region still forms young stars even though the most massive star was born ∼12 Myr ago. We also found evidence of positive feedback from these massive stars. We identified a cold gas/dust lane extending westward from the cluster. The western end of the dust lane seems to favor low-mass star formation, whereas the cluster end favors bit massive star formation, which seems to have started earlier than the western end. We found an elongated molecular cloud in this region, characterized by numerous filamentary structures. The morphology of the filaments, along with position–velocity maps, velocity dispersion maps, channel maps, etc., indicate a coalescence of filaments and a potential longitudinal flow of matter toward the cluster through the western end of the gas/dust lane. This entire region seems to be a Hub-filamentary system (HFS), in which the NGC 2316 cluster is probably the hub and the dark lane is the main filamentary structure. Being the gravity well of this HFS, star formation started first in the NGC 2316 region and went on to the other filamentary nodes.
- Published
- 2024
- Full Text
- View/download PDF
4. Presentation of sclerouveitis with features of Vogt Koyanagi Harada syndrome and ocular tuberculosis – A Rare Combination
- Author
-
Purva Vijay Deore, Syed Faraaz Hussain, Mamta Agarwal, and Yogya Reddy
- Subjects
sclerouveitis ,tuberculosis ,vogt-koyanagi-harada syndrome ,Ophthalmology ,RE1-994 - Abstract
Inflammation of sclera with involvement of uvea is an uncommon and underdiagnosed disease entity seen in an ophthalmological outpatient setting. A 34-year-old male presented with complaints of headache, redness, pain, photophobia, and blurring of vision in the left eye > right eye with associated tinnitus, decreased hearing, and recurrent severe headaches over 3 months. Detailed ophthalmological examination revealed signs of sclerouveitis. We thoroughly investigated the patient which revealed manifestations of incomplete VKH syndrome, along with strongly positive mantoux test hence, he was started on oral steroids under antituberculous treatment cover after physician consult. On follow-up, the patient was symptomatically better with resolution of inflammatory signs over a period of 3 months. The patient is being followed up by multispecialty approach to discern VKH manifestations of later disease.
- Published
- 2022
- Full Text
- View/download PDF
5. Bilateral Pseudomonas aeruginosa keratitis as presenting feature in an infant of cystic fibrosis
- Author
-
Meena Lakshmipathy, Manokamna Agarwal, Mamta Agarwal, and Natraj Palanaiappan
- Subjects
bilateral keratitis ,cystic fibrosis ,infant ,pediatric penetrating keratoplasty ,pseudomonas keratitis ,Ophthalmology ,RE1-994 - Published
- 2022
- Full Text
- View/download PDF
6. Immunological tests and their interpretation in uveitis
- Author
-
S R Rathinam, Ilknur Tugal-Tutkun, Mamta Agarwal, Vedhanayaki Rajesh, Merih Egriparmak, and Gazal Patnaik
- Subjects
infectious ,investigations ,non-infectious ,novel infections ,uveitis ,Ophthalmology ,RE1-994 - Abstract
Uveitis is a complex disorder including both infectious and non-infectious etiologies. Clinical diagnosis is a challenge because many diseases share common clinical signs. Laboratory support is crucial for confirming the clinical diagnosis. Laboratory diagnosis includes direct tests and indirect tests. For example smear, culture, and molecular diagnostics demonstrate the pathogens, hence they are direct tests. Immunologic tests employ an antigen to detect presence of antibodies to a pathogen, or an antibody to detect the presence of an antigen, of the pathogen in the specimens. The immunological tests used in laboratories are made by producing artificial antibodies that exactly “match” the pathogen in question. When these antibodies come into contact with a sample they bind to the matching pathogen if found in the sample. Hence they are grouped under indirect evidence. There are several investigations in uveitis to reach the confirmed diagnosis including microbiological, immunological, imaging and molecular diagnostic testing. In this section we will discuss immunological investigations of infectious and non-infectious uveitis.
- Published
- 2020
- Full Text
- View/download PDF
7. Diagnostic and Therapeutic Challenges
- Author
-
Drs. Atul Arora, Mohit Dogra, Mr. Aman Sharma, Drs. Simar Rajan Singh, Rupesh Agrawal, Piergiorgio Neri, Vishali Gupta, and Mamta Agarwal
- Subjects
Ophthalmology ,General Medicine - Published
- 2023
8. Tofacitinib in Scleritis: A Case Series
- Author
-
Richa, Pyare, Parthopratim, Dutta Majumder, Mauli, Shah, Viswanathan, Kaushik, Mamta, Agarwal, and Jyotirmay, Biswas
- Subjects
Ophthalmology ,Immunology and Allergy - Abstract
To report the use of tofacitinib in ten patients with scleritis where the traditional immunomodulation was not successful or could not be used.A retrospective chart review.Tofacitinib was successful in the treatment of scleritis in patients either recalcitrant to or intolerant to conventional therapy in 9 out of 10 cases reported here. Two patients had developed reactivation of herpetic infection after 1 month of starting tofacitinib. The duration from diagnosis of scleritis to the institution of tofacitinib therapy varied from 1 month to 60 months. Duration of follow-up varies from 2 months to 11 months.Tofacitinib can be used as an important future option for managing recurrent and recalcitrant cases of scleritis.
- Published
- 2022
9. First reported case of Alcaligenes faecalis isolated from bronchoalveolar lavage in a patient with dengue hemorrhagic fever
- Author
-
Arun Agarwal, Samiksha Sharma, Vivek Bhargava, Vibha Bhargava, Mamta Agarwal, and Mala Airun
- Subjects
Acute respiratory distress syndrome ,Alcaligenes faecalis ,bronchoalveolar lavage ,dengue fever ,dengue hemorrhagic fever ,Diseases of the respiratory system ,RC705-779 - Abstract
Bacterial co-infections have been reported in association with dengue fever (DF) and can exacerbate dengue infections. However, DF with acute respiratory distress syndrome and co-infection with Alcaligenes faecalis (A. faecalis) has not been reported earlier. Most infections caused by A. faecalis are opportunistic. Urinary tract infection, bacterial keratitis, postoperative endophthalmitis, skin and soft tissue infections, bacteremia, meningitis, wound infections, and peritonitis in patients undergoing peritoneal dialysis have been described in association with A. faecalis. A. faecalis, a Gram-negative environmental organism rarely cause significant infections. Treatment can be difficult in some cases due to the high level of resistance to commonly used antibiotics. We report a case of fatal bronchopneumonia caused by extensively drug resistance A. faecalis in a patient of dengue hemorrhagic fever.
- Published
- 2017
- Full Text
- View/download PDF
10. HOME ENVIRONMENT AND INTERNET ADDICTION AMONG ADOLESCENTS
- Author
-
Mamta Agarwal
- Subjects
Immunology - Published
- 2022
11. Mooren’s Ulcer
- Author
-
Emmett T. Cunningham, Mamta Agarwal, Derrick P. Smit, Ilknur Tugal-Tutkun, and Jennifer E. Thorne
- Subjects
Ophthalmology ,Immunology and Allergy - Published
- 2023
12. Wide Field Optical Coherence Tomography and Optical Coherence Tomography Angiography in Uveitis
- Author
-
Dilraj S. Grewal, Mamta Agarwal, and Marion R. Munk
- Subjects
Ophthalmology ,Immunology and Allergy - Abstract
We review the current literature on the use of wide-field optical coherence tomography (OCT) and wide-field optical coherence tomography angiography (OCTA) in different uveitic phenotypes as well as various sequelae of uveitis and discuss the limitations of this evolving technology.Current consensus guidelines on nomenclature in wide-field OCT and OCTA are described. The specific utility of wide-field OCT and OCTA in assessment of the retina and choroid using different en-face and cross-sectional slabs in various inflammatory diseases is reviewed. Furthermore, we discuss widefield OCT and OCTA in assessment of retinal ischemia and its limitations in assessing retinal vascular leakage.Wide-field OCT and OCTA deliver more sensitive measures of inflammation. With continued advancement in both hardware technology and software processing, these modalities will allow for more accurate assessment of uveitis, better understanding of disease mechanisms, and precise monitoring of treatment response.
- Published
- 2022
13. Professor Doctor Manfred Zierhut - Devoted Clinician, Researcher, and Educator (1953 to 2022)
- Author
-
Emmett T. Cunningham and Mamta Agarwal
- Subjects
Ophthalmology ,Immunology and Allergy - Published
- 2022
14. Ocular Complications Following COVID-19 Vaccination - Coincidence, Correlation, or Causation?
- Author
-
Emmett T. Cunningham, Ramana S. Moorthy, Mamta Agarwal, Derrick P. Smit, and Manfred Zierhut
- Subjects
Ophthalmology ,COVID-19 Vaccines ,Vaccination ,Immunology and Allergy ,COVID-19 ,Humans ,Eye - Published
- 2022
15. Bilateral hazy vitreous in a patient with convulsions
- Author
-
Mihir Trivedi, Muna Bhende, Pradeep Susvar, S Krishnakumar, and Mamta Agarwal
- Subjects
Ophthalmology ,RE1-994 - Published
- 2020
- Full Text
- View/download PDF
16. Bilateral
- Author
-
Meena, Lakshmipathy, Manokamna, Agarwal, Mamta, Agarwal, and Natraj, Palanaiappan
- Subjects
Keratitis ,Cystic Fibrosis ,Pseudomonas aeruginosa ,Humans ,Infant ,Pseudomonas Infections - Published
- 2022
17. Consensus Recommendations for the Diagnosis of Vitreoretinal Lymphoma
- Author
-
Denise Carbonell, Rupesh Agrawal, H. Nida Sen, Daniel Vitor Vasconcelos-Santos, Mamta Agarwal, Elisabetta Miserocchi, Sarah E. Coupland, Jacob Pe'er, Luca Cimino, Manabu Mochizuki, James T. Rosenbaum, Tracy T. Batchelor, Manfred Zierhut, Alejandra de-la-Torre, Massimo Accorinti, Bianka Sobolewska, Sarakshi Mahajan, Justine R. Smith, Soon-Phaik Chee, Tanja Bülow, Zohar Habot-Wilner, Helmut Sitter, Michael Simion, Vishali Gupta, Shahar Frenkel, Thomas Ness, Jennifer E. Thorne, Jose S. Pulido, Michal Kramer, Nicholas P Jones, Ninette H. ten Dam-van Loon, and Jyotirmay Biswas
- Subjects
Delphi Technique ,Lymphoma ,genetic structures ,diagnosis ,DNA Mutational Analysis ,Myeloid differentiation primary response ,chemistry.chemical_compound ,0302 clinical medicine ,consensus recommendations ,Vitreoretinal lymphoma ,Biomarkers, Tumor ,Humans ,Interleukin-10 ,Interleukin-6 ,Intraocular Lymphoma ,Lymphoma, Large B-Cell, Diffuse ,Mutation, Missense ,Myeloid Differentiation Factor 88 ,Retinal Neoplasms ,Retrospective Studies ,Surveys and Questionnaires ,Vitreous Body ,Immunology and Allergy ,Tumor ,Diffuse ,medicine.anatomical_structure ,medicine.medical_specialty ,03 medical and health sciences ,Retinal pigment epithelium atrophy ,Ophthalmology ,Large B-Cell ,medicine ,Macular edema ,030203 arthritis & rheumatology ,Retina ,business.industry ,Diagnostic vitrectomy ,Retinal ,medicine.disease ,eye diseases ,Fundus autofluorescence ,chemistry ,Mutation ,030221 ophthalmology & optometry ,Missense ,business ,Biomarkers - Abstract
Purpose To provide recommendations for diagnosis of vitreoretinal lymphoma (VRL). Methods Literature was reviewed for reports supporting the diagnosis of VRL. A questionnaire (Delphi 1 round) was distributed to 28 participants. In the second round (Delphi 2), items of the questionnaire not reaching consensus (75% agreement) were discussed to finalize the recommendations. Results Presenting symptoms include floaters and painless loss of vision, vitreous cells organized into sheets or clumps. Retinal lesions are usually multifocal creamy/white in the outer retina. Other findings include retinal lesions with "leopard-skin" appearance and retinal pigment epithelium atrophy. Severe vitreous infiltration without macular edema is the most likely presentation. Diagnostic vitrectomy should be performed. Systemic corticosteroid should be discontinued at least 2 weeks before surgery. An interleukin (IL)-10:IL-6 ratio > 1, positive mutation for the myeloid differentiation primary response 88 gene and monoclonality are indicators of VRL. Multi-modal imaging (optical coherence tomography, fundus autofluorescence) are recommended. Conclusions A consensus meeting allowed the establishment of recommendations important for the diagnosis of VRL.
- Published
- 2021
18. Clinical Profile of Scleritis Presenting for the First Time in the Elderly
- Author
-
Kowsigan Magesan, Janani Surya, Sudharshan Sridharan, Vineeta Nair, Mamta Agarwal, Amala Elizabeth Agarwal, Jyotirmay Biswas, and Parthopratim Dutta Majumder
- Subjects
Ophthalmology ,Immunology and Allergy - Abstract
To analyze clinical characteristics of scleritis in elderly patients and also compare the data with relatively younger patients with scleritis (60 years).Retrospective analysis of medical records of patients with scleritis who visited a tertiary eye care centre between 2008 and 2018.Scleritis in ≥60 years accounted for 3% of the total scleritis cases. The mean age of the patients was 67 ± 6 years, and a female (66%) predominance was noted. Of the 44 elderly patients with scleritis, 48% were 66-70 years of age and 20% were above 70 years of age. Diffuse scleritis was the most common subtypes followed by necrotizing scleritis (35%). Overall, 32% of elderly patients with scleritis had underlying disease and the most common systemic association was granulomatous with polyangiitis. When compared with a subset of patients (60 years of age), the elderly group showed higher rate of recurrences and complications.Scleritis in elderly patients is relatively rare but can have a higher recurrence rate with a increased complications.
- Published
- 2022
19. COVID-19 Vaccination and Uveitis: Epidemiology, Clinical Features and Visual Prognosis
- Author
-
Nawfel Ferrand, Massimo Accorinti, Mamta Agarwal, Christoph Spartalis, Priscilla Manni, Nicole Stuebiger, and Manfred Zierhut
- Subjects
Adult ,Male ,COVID-19 Vaccines ,Vaccination ,COVID-19 ,Antibodies, Viral ,Prognosis ,Uveitis ,Ophthalmology ,Immunology and Allergy ,Humans ,Female ,Follow-Up Studies ,Retrospective Studies - Abstract
To study the epidemiological and clinical features of uveitis post-COVID-19 vaccination.Retrospective chart review of patients presenting with uveitis after COVID-19 vaccination in tertiary uveitis services.In total, 25 patients, 76% females, mean age 43.2 years, were included. Uveitis occurred after Pfizer, Moderna, Astra-Zeneca and Covaxin vaccination. Anterior uveitis was the most frequent type of uveitis (56%). History of uveitis was found in 19 cases (76%), among whom 90.9% of the tested patients developed anti-Sars-CoV-2 spike antibodies after vaccination. In a mean follow-up of 5 months, one-line decrease in visual acuity was found in 12% of patients. During post-vaccine uveitis, 15.8% of cases needed an increase in their systemic therapy. According to Naranjo score, new-onset uveitis had a higher probability of being associated with vaccination (p.01).COVID-19 vaccination can cause uveitis but has no significant impact on the visual prognosis after resolution.
- Published
- 2022
20. Epidemiology of Viral Induced Anterior Uveitis
- Author
-
Mamta Agarwal, Manfred Zierhut, Aleksandra Radosavljević, and Soon-Phaik Chee
- Subjects
medicine.medical_specialty ,viruses ,Eye Infections, Viral ,medicine.disease_cause ,Rubella ,Dengue fever ,Dengue ,Uveitis ,03 medical and health sciences ,0302 clinical medicine ,Infectious anterior uveitis ,Epidemiology ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Chikungunya ,Zika Virus Infection ,business.industry ,Zika Virus ,Hemorrhagic Fever, Ebola ,medicine.disease ,Uveitis, Anterior ,3. Good health ,Ophthalmology ,Immunology ,030221 ophthalmology & optometry ,Chikungunya Fever ,Racial differences ,Anterior uveitis ,business - Abstract
Viral agents are the most common cause of infectious anterior uveitis worldwide. The purpose of this review is to analyze the frequency, gender and racial differences of viral anterior uveitis (VAU) in various populations.Systematized literature review of epidemiological reports of VAU cited in PubMed, EMBASE and the Cochrane Library database published until June 30th, 2020.A total of 12 clinical studies on epidemiology of definite VAU and 36 clinical studies of presumed VAU were identified. Members of Herpesviridae family represent the most common causes of VAU. Other less frequently reported causes, such as rubella and endemic viruses (HTLV-1, Chikungunya, Dengue, Ebola, Zika virus) were also analyzed.HSV, VZV are prevalent worldwide. CMV is more frequent in Asia, and rubella in the West. However, due to globalization and air travel, HTLV-1, Chikungunya, Dengue and Ebola may become important causes of VAU across the world.
- Published
- 2021
21. Ocular Co-infection with Mycobacterium Tuberculosis and Toxoplasma Gondii in an Immunocompetent Patient – A Case Report
- Author
-
Mamta Agarwal, Vikas Khetan, Gazal Patnaik, and Alejandra de-la-Torre
- Subjects
030203 arthritis & rheumatology ,biology ,business.industry ,Toxoplasma gondii ,biology.organism_classification ,Virology ,humanities ,Mycobacterium tuberculosis ,03 medical and health sciences ,Ophthalmology ,0302 clinical medicine ,parasitic diseases ,030221 ophthalmology & optometry ,Immunology and Allergy ,Medicine ,business ,Co infection - Abstract
Purpose: To report a case of ocular co-infection with Mycobacterium tuberculosis and Toxoplasma gondii in an immunocompetent woman. Method: Retrospective observational case report. Result: A 61-yea...
- Published
- 2021
22. Collaborative Ocular Tuberculosis Study Consensus Guidelines on the Management of Tubercular Uveitis—Report 1
- Author
-
Rupesh Agrawal, Ilaria Testi, Sarakshi Mahajan, Yew Sen Yuen, Aniruddha Agarwal, Onn Min Kon, Talin Barisani-Asenbauer, John H. Kempen, Amod Gupta, Douglas A. Jabs, Justine R. Smith, Quan Dong Nguyen, Carlos Pavesio, Vishali Gupta, Mamta Agarwal, Manisha Agarwal, Ashutosh Aggarwal, Kanika Aggarwal, Mukesh Agrawal, Hassan Al-Dhibi, Sofia Androudi, Fatma Asyari, Manohar Babu Balasundaram, Kalpana Babu Murthy, Edoardo Baglivo, Alay Banker, Reema Bansal, Soumyava Basu, Digamber Behera, Jyotirmay Biswas, Bahram Bodaghi, Ester Carreño, Laure Caspers, Soon Phaik Chee, Romi Chhabra, Luca Cimino, Luz Elena Concha del Rio, Emmett T. Cunningham, Andrè Luiz Land Curi, Dipankar Das, Janet Davis, Marc DeSmet, Ekaterina Denisova, Alastair K. Denniston, Marie-Hélène Errera, Alejandro Fonollosa, Amala George, Debra A. Goldstein, Yan Guex Crosier, Dinesh Visva Gunasekeran, Avinash Gurbaxani, Alessandro Invernizzi, Hazlita M. Isa, Shah Md. Islam, Nicholas Jones, Deeksha Katoch, Moncef Khairallah, Amit Khosla, Michal Kramer, Amitabh Kumar, Atul Kumar, Rina La Distia Nora, Richard Lee, Careen Lowder, Saurabh Luthra, Padmamalini Mahendradas, Dorine Makhoul, Shahana Mazumdar, Peter McCluskey, Salil Mehta, Elisabetta Miserocchi, Manabu Mochizuki, Oli S. Mohamed, Cristina Muccioli, Marion R. Munk, Somasheila Murthy, Shishir Narain, Heloisa Nascimento, Piergiorgio Neri, Myhanh Nguyen, Annabelle A. Okada, Pinar Ozdal, Alan Palestine, Francesco Pichi, Dhananjay Raje, S.R. Rathinam, Andres Rousselot, Ariel Schlaen, Shobha Sehgal, H. Nida Sen, Aman Sharma, Kusum Sharma, Samir S. Shoughy, Nirbhai Singh, Ramandeep Singh, Masoud Soheilian, Sudharshan Sridharan, Jennifer E. Thorne, Christoph Tappeiner, Stephen Teoh, Maria Sofia Tognon, Ilknur Tugal-Tutkun, Mudit Tyagi, Harvey Uy, Daniel Vitor Vasconcelos Santos, Natasa Vidovic Valentincic, Mark Westcott, Ryoji Yanai, Bety Yanez Alvarez, Rahman Zahedur, and Manfred Zierhut
- Subjects
0303 health sciences ,medicine.medical_specialty ,Tuberculosis ,business.industry ,MEDLINE ,Modified delphi ,Ocular tuberculosis ,medicine.disease ,eye diseases ,03 medical and health sciences ,Ophthalmology ,Choroiditis ,0302 clinical medicine ,030221 ophthalmology & optometry ,medicine ,Tuberculoma ,Intensive care medicine ,business ,Uveitis ,Ocular inflammation ,030304 developmental biology - Abstract
Topic An international, expert-led consensus initiative organized by the Collaborative Ocular Tuberculosis Study (COTS), along with the International Ocular Inflammation Society and the International Uveitis Study Group, systematically developed evidence- and experience-based recommendations for the treatment of tubercular choroiditis. Clinical relevance The diagnosis and management of tubercular uveitis (TBU) pose a significant challenge. Current guidelines and literature are insufficient to guide physicians regarding the initiation of antitubercular therapy (ATT) in patients with TBU. Methods An international expert steering subcommittee of the COTS group identified clinical questions and conducted a systematic review of the published literature on the use of ATT for tubercular choroiditis. Using an interactive online questionnaire, guided by background knowledge from published literature, 81 global experts (including ophthalmologists, pulmonologists, and infectious disease physicians) generated preliminary consensus statements for initiating ATT in tubercular choroiditis, using Oxford levels of medical evidence. In total, 162 statements were identified regarding when to initiate ATT in patients with tubercular serpiginous-like choroiditis, tuberculoma, and tubercular focal or multifocal choroiditis. The COTS group members met in November 2018 to refine these statements by a 2-step modified Delphi process. Results Seventy consensus statements addressed the initiation of ATT in the 3 subtypes of tubercular choroiditis, and in addition, 10 consensus statements were developed regarding the use of adjunctive therapy in tubercular choroiditis. Experts agreed on initiating ATT in tubercular choroiditis in the presence of positive results for any 1 of the positive immunologic tests along with radiologic features suggestive of tuberculosis. For tubercular serpiginous-like choroiditis and tuberculoma, positive results from even 1 positive immunologic test were considered sufficient to recommend ATT, even if there were no radiologic features suggestive of tuberculosis. Discussion Consensus guidelines were developed to guide the initiation of ATT in patients with tubercular choroiditis, based on the published literature, expert opinion, and practical experience, to bridge the gap between clinical need and available medical evidence.
- Published
- 2021
23. Collaborative Ocular Tuberculosis Study Consensus Guidelines on the Management of Tubercular Uveitis—Report 2
- Author
-
Rupesh Agrawal, Ilaria Testi, Baharam Bodaghi, Talin Barisani-Asenbauer, Peter McCluskey, Aniruddha Agarwal, John H. Kempen, Amod Gupta, Justine R. Smith, Marc D. de Smet, Yew Sen Yuen, Sarakshi Mahajan, Onn Min Kon, Quan Dong Nguyen, Carlos Pavesio, Vishali Gupta, Mamta Agarwal, Manisha Agarwal, Ashutosh Aggarwal, Kanika Aggarwal, Mukesh Agrawal, Hassan Al-Dhibi, Sofia Androudi, Fatma Asyari, Manohar Babu Balasundaram, Kalpana Babu Murthy, Edoardo Baglivo, Alay Banker, Reema Bansal, Soumyava Basu, Digamber Behera, Jyotirmay Biswas, Ester Carreño, Laure Caspers, Soon Phaik Chee, Romi Chhabra, Luca Cimino, Luz Elena Concha del Rio, Emmett T. Cunningham, Andrè Luiz Land Curi, Dipankar Das, Janet Davis, Marc DeSmet, Ekaterina Denisova, Alastair K. Denniston, Marie-Hélène Errera, Alejandro Fonollosa, Amala George, Debra A. Goldstein, Yan Guex Crosier, Dinesh Visva Gunasekeran, Avinash Gurbaxani, Alessandro Invernizzi, Hazlita M. Isa, Shah M.d. Islam, Nicholas Jones, Deeksha Katoch, Moncef Khairallah, Amit Khosla, Michal Kramer, Amitabh Kumar, Atul Kumar, Rina La Distia Nora, Richard Lee, Careen Lowder, Saurabh Luthra, Padmamalini Mahendradas, Dorine Makhoul, Shahana Mazumdar, Salil Mehta, Elisabetta Miserocchi, Manabu Mochizuki, Oli S. Mohamed, Cristina Muccioli, Marion R. Munk, Somasheila Murthy, Shishir Narain, Heloisa Nascimento, Piergiorgio Neri, Myhanh Nguyen, Annabelle A. Okada, Pinar Ozdal, Alan Palestine, Francesco Pichi, Dhananjay Raje, S.R. Rathinam, Andres Rousselot, Ariel Schlaen, Shobha Sehgal, H. Nida Sen, Aman Sharma, Kusum Sharma, Samir S. Shoughy, Nirbhai Singh, Ramandeep Singh, Masoud Soheilian, Sudharshan Sridharan, Jennifer E. Thorne, Christoph Tappeiner, Stephen Teoh, Maria Sofia Tognon, Ilknur Tugal-Tutkun, Mudit Tyagi, Harvey Uy, Daniel Vitor Vasconcelos Santos, Natasa Vidovic Valentincic, Mark Westcott, Ryoji Yanai, Bety Yanez Alvarez, Rahman Zahedur, Manfred Zierhut, and Zheng Xian
- Subjects
First episode ,0303 health sciences ,medicine.medical_specialty ,Tuberculosis ,business.industry ,Retinal vasculitis ,education ,MEDLINE ,Retrospective cohort study ,Eye infection ,medicine.disease ,03 medical and health sciences ,Ophthalmology ,0302 clinical medicine ,Internal medicine ,030221 ophthalmology & optometry ,medicine ,Intermediate uveitis ,business ,Uveitis ,030304 developmental biology - Abstract
Topic The Collaborative Ocular Tuberculosis Study (COTS), supported by the International Ocular Inflammation Society, International Uveitis Study Group, and Foster Ocular Immunological Society, set up an international, expert-led consensus project to develop evidence- and experience-based guidelines for the management of tubercular uveitis (TBU). Clinical Relevance The absence of international agreement on the use of antitubercular therapy (ATT) in patients with TBU contributes to a significant heterogeneity in the approach to the management of this condition. Methods Consensus statements for the initiation of ATT in TBU were generated using a 2-step modified Delphi technique. In Delphi step 1, a smart web-based survey based on background evidence from published literature was prepared to collect the opinion of 81 international experts on the use of ATT in different clinical scenarios. The survey included 324 questions related to tubercular anterior uveitis (TAU), tubercular intermediate uveitis (TIU), tubercular panuveitis (TPU), and tubercular retinal vasculitis (TRV) administered by the experts, after which the COTS group met in November 2019 for a systematic and critical discussion of the statements in accordance with the second round of the modified Delphi process. Results Forty-four consensus statements on the initiation of ATT in TAU, TIU, TPU, and TRV were obtained, based on ocular phenotypes suggestive of TBU and corroborative evidence of tuberculosis, provided by several combinations of immunologic and radiologic test results. Experts agreed on initiating ATT in recurrent TAU, TIU, TPU, and active TRV depending on the TB endemicity. In the presence of positive results for any 1 of the immunologic tests along with radiologic features suggestive of past evidence of tuberculosis infection. In patients with a first episode of TAU, consensus to initiate ATT was reached only if both immunologic and radiologic test results were positive. Discussion The COTS consensus guidelines were generated based on the evidence from published literature, specialists’ opinions, and logic construction to address the initiation of ATT in TBU. The guidelines also should inform public policy by adding specific types of TBU to the list of conditions that should be treated as tuberculosis.
- Published
- 2021
24. Tuberculous Scleritis and Multidrug Resistance
- Author
-
Manfred Zierhut, Mamta Agarwal, Gayathri Ar, Gazal Patnaik, Appakkudal R. Anand, Geetha Iyer, Jyotirmay Biswas, and Shweta Agarwal
- Subjects
Adult ,medicine.medical_specialty ,Tuberculosis ,Antitubercular Agents ,Tuberculosis, Ocular ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Anterior scleritis ,Humans ,Immunology and Allergy ,Sclerokeratitis ,Retrospective Studies ,Keratitis ,030203 arthritis & rheumatology ,business.industry ,medicine.disease ,Dermatology ,Drug Resistance, Multiple ,Multiple drug resistance ,Ophthalmology ,030221 ophthalmology & optometry ,Female ,business ,Scleritis - Abstract
To present a case of necrotizing sclerokeratitis in a patient with multidrug-resistant tuberculosis and study the challenges in diagnosis and management of anterior tuberculous scleritis.Retrospective observational case report and review of anterior tuberculous scleritis.A 28-year-old woman, previously diagnosed as presumed tubercular panuveitis, presented with necrotizing sclerokeratitis and progressed to develop panophthalmitis. Laboratory investigations revealed multidrug-resistantDiagnosis of tuberculous scleritis is a challenge. Therapeutic failure must alert the clinician for drug resistance which is diagnosed early, can prevent the devastating outcomes.
- Published
- 2021
25. Current practice in the management of ocular toxoplasmosis
- Author
-
Yogeswaran, Kengadhevi, Furtado, João M, Bodaghi, Bahram, Matthews, Janet M, Accorinti, Massimo, Aniruddha, Agarwal, Mamta, Agarwal, Seong Joon Ahn, Nurettin, Akyol, Carlos, Alvarez, Radgonde, Amer, Sofia, Androudi, Cheryl, Arcinue, Lourdes, Arellanes-Garcia, J Fernando Arevalo, Cesar, Arrieta-Bechara, Joseba, Artaraz, Ashraf, Ata, Viera Kalinina Ayuso, Kalpana, Babu, Reema, Bansal, Matthias, Becker, Lyll Karen Bigornia-Arriola, Jyotirmay, Biswas, Ana, Blanco-Esteban, Bahram, Bodaghi, Marcelo, Bursztyn, Maria Jose Capella, Ester, Carreño, Wei-Chun, Chan, Yo-Chen, Chang, Yu-Jang, Chao, Rashel, Cheja-Kalb, Luca, Cimino, Kåre, Clemmensen, Lidia, Cocho, Luz Elena Concha-Del-Rio, Diana, Conrad, Dipankar, Das, Janet, Davis, Joke De Boer, Ekaterina, Denisova, Larissa, Derzko-Dzulynsky, Luca De Simone, Christoph, Deuter, Jesús, Díaz-Cascajosa, Oleksandra, Dorokhova, Gonzalo, Duarte, Nazanin, Ebrahimiadib, Sivan, Elyashiv, Parisa, Emami-Naeini, Marie Helene Errera, Alex, Fonollosa, Eric, Fortin, Samantha, Fraser-Bell, Marion, Funk, Manuel, Garza-Leon, Justus, Garweg, Zsuzsanna, Géhl, Raz, Gepstein, Terese, Gerges, Alex, Gimenez, Hiroshi, Goto, Chloe, Gottlieb, Konstantin, Gugleta, Vishali, Gupta, Avinash, Gurbaxani, Zohar, Habot-Wilner, Anthony, Hall, Noriyasu, Hashida, Christopher, Henry, Maryam, Hosseini, Chen, Hsi-Fu, Boonsiri, Hunchangsith, De-Kuang, Hwang, Yih Shiou Hwang, Alessandro, Invernizzi, Salam Saeb Iriqat, Hamisah, Ishak, Bulbul, Islam, Chiharu, Iwahashi, Margarita, Jódar-Márquez, Bouleau, Julien, Toshikatsu, Kaburaki, Sibel, Kadayifçilar, Koju, Kamoi, Kashyap, Kansupada, Tzu-En, Kao, Alexander, Kaplan, Hiroshi, Keino, John, H Kempen, Moncef, Khairallah, Min, Kim, Seong-Woo, Kim, Alexandra, Kozyreff, Robert, Kuijpers, Sentaro, Kusuhara, Timothy Y, Y Lai, Jenny, Laithwaite, Blerta, Lang, Maria Igo Larrocea, Caspers, Laure, Christopher Seungkyu Lee, Ji Hwan Lee, Lyndell, Lim, Victor, Llorenç, Ann-Marie, Lobo-Chan, Preeyachan, Lourthai, Padmamalini, Mahendradas, Dorine, Makhoul, Irene Redondo Marcos, Cynthia Espinosa Martinez, Lucía, Martínez-Costa, Peter, Mccluskey, Ilhem, Mili-Boussen, Elisabetta, Miserocchi, Manabu, Mochizuki, Shelina Oli Mohamed, Philip, I Murray, Kei, Nakai, Satoko, Nakano, Nakhoul, Nakhoul, Kenichi, Namba, Heloisa, Nascimento, Piergiorgio, Neri, Nor Fariza Ngah, John, Nguyen, Quan Dong Nguyen, Rachael, Niederer, Aya, Oguma, Shigeaki, Ohno, Kouichi, Ohta, Annabelle, A Okada, Narciss, Okhravi, Pinar, Özdal, Yılmaz, Özyazgan, Alan, Palestine, Paroli, Maria Pia, Jorge Aa Partida, Carlos, Pavesio, Eduard, Pedemonte-Sarrias, Francesco, Pichi, Lefebvre, Pierre, Uwe, Pleyer, Joanna, Przeździecka-Dołyk, Aleksandra, Radosavljevic, Zahedur, Rahman, Stephanie Voorduin Ramos, Narsing, Rao, Ola, Rauer, Lia Judice Relvas, Josephine, Richards, Alejandro, Rodriguez-Garcia, Maite, Sainz-de-la-Maza, Beatriz, Sánchez, Hla, Sandar, Shaul, Sar, Luiz Pb Schmidt, Yuen Yew Sen, Juan Ls Sevila, Shwu-Jiuan, Sheu, Shiri, Shulman, Monica Cunha Signorelli, Sukhum, Silpa-Archa, Justine, Smith, Wendy, Smith, Ovi, Sofia, Thanapong, Somkijrungroj, Sreekanth, Sreekantam, Sridharan, Sudharshan, Hiroshi, Takase, Masaru, Takeuchi, Christoph, Tappeiner, Mei-Ling, Tay-Kearney, Barbara, Teuchner, Jennifer, E Thorne, Sara, Touhami, Victoria, Toumanidou, Peter, Trittibach, Ilknur, Tugal-Tutkun, Mayjane, Tumulak, Anna Nur Utami, Julie, Vadboncoeur, Luc Van Os, Daniel Vitor Vasconcelos-Santos, Erika, Vazquez, François, Willermain, May Za Win, Lihteh, Wu, Nilüfer, Yalçındağ, Ryoji, Yanai, Peizeng, Yang, Nobuyo, Yawata, Oleksandra, Zborovska, Manfred, Zierhut, Mar Esteban-Ortega Smith, and Justine, R
- Subjects
Cellular and Molecular Neuroscience ,Ophthalmology ,retina ,inflammation ,infection ,Sensory Systems - Abstract
BackgroundOcular toxoplasmosis is common across all regions of the world. Understanding of the epidemiology and approach to diagnosis and treatment have evolved recently. In November 2020, an international group of uveitis-specialised ophthalmologists formed the International Ocular Toxoplasmosis Study Group to define current practice.Methods192 Study Group members from 48 countries completed a 36-item survey on clinical features, use of investigations, indications for treatment, systemic and intravitreal treatment with antiparasitic drugs and corticosteroids, and approach to follow-up and preventive therapy.ResultsFor 77.1% of members, unilateral retinochoroiditis adjacent to a pigmented scar accounted for over 60% of presentations, but diverse atypical presentations were also reported. Common complications included persistent vitreous opacities, epiretinal membrane, cataract, and ocular hypertension or glaucoma. Most members used clinical examination with (56.8%) or without (35.9%) serology to diagnose typical disease but relied on intraocular fluid testing—usually PCR—in atypical cases (68.8%). 66.1% of members treated all non-pregnant patients, while 33.9% treated selected patients. Oral trimethoprim–sulfamethoxazole was first-line therapy for 66.7% of members, and 60.9% had experience using intravitreal clindamycin. Corticosteroid drugs were administered systemically by 97.4%; 24.7% also injected corticosteroid intravitreally, almost always in combination with an antimicrobial drug (72.3%). The majority of members followed up all (60.4%) or selected (35.9%) patients after resolution of acute disease, and prophylaxis against recurrence with trimethoprim–sulfamethoxazole was prescribed to selected patients by 69.8%.ConclusionOur report presents a current management approach for ocular toxoplasmosis, as practised by a large international group of uveitis-specialised ophthalmologists.
- Published
- 2022
26. Surgically induced necrotizing scleritis (SINS): Is it a standalone condition or a variant of necrotizing scleritis?
- Author
-
Kowsigan Magesan, Parthopratim Dutta Majumder, Mamta Agarwal, Amala E George, Vinita Nair, Sudha K Ganesh, and Jyotirmay Biswas
- Subjects
corticosteroid ,immunosuppression ,necrotizing scleritis ,surgically induced necrotizing scleritis ,Ophthalmology ,RE1-994 - Abstract
Purpose: To report the clinical pattern of surgically induced necrotizing scleritis (SINS) in a tertiary eye care center in Southern India. Methods: Retrospective analysis of all SINS cases visiting the uveitis clinic of a tertiary eye institute between January 2009 and April 2019. Results: In total, 15 patients with a median age of 65 (IQR: 52–70) years were included in the study. Male (53%) predominance was noted, and SINS was unilateral (100%) in all cases. Most (87%) of the patients developed SINS after a single surgical procedure, with a median onset period of 251 (IQR: 127–1095) days. None of these patients had any evidence of systemic association. Ocular hypertension (n = 3, 20%), and cataract (n = 5, 33%) were the most common complications. When compared with a cohort of patients with idiopathic necrotizing scleritis, the index study did not find any statistically significant difference between SINS and idiopathic scleritis. Conclusion: SINS is idiopathic necrotizing scleritis rather than an independent entity of scleritis.
- Published
- 2025
- Full Text
- View/download PDF
27. Successful Treatment of Pulmonary Embolus Secondary to Diabetic Ketoacidosis with Tissue Plasminogen Activator
- Author
-
Hiren Bhanderi, Vishal Singh Charan, Mamta Agarwal, and Arun Agarwal
- Subjects
medicine.medical_specialty ,Diabetic ketoacidosis ,business.industry ,General Medicine ,Heparin ,medicine.disease ,Tissue plasminogen activator ,Pulmonary embolism ,PULMONARY EMBOLUS ,Internal medicine ,Tissue plasminogen activator alteplase ,medicine ,Cardiology ,business ,medicine.drug - Abstract
A 75-year-old woman with a history of Type 2 Diabetes mellitus attended triage with complaints of nausea, occasional vomit, pain in epigastrium and some vague heaviness in breathing of 4-5 days duration. On her physical examination she had mild tachypnea, peripheral capillary oxygen saturation (SpO2) 92% on room air, and high blood glucose and ketones respectively. She was evaluated and diagnosed to have bilateral submassive pulmonary Thromboemboli. She was managed with fibrinolytic treatment, Heparin, and supportive treatment along with management of Diabetic Ketoacidosis (DKA). Etiological examinations did not reveal any underlying cause. The contribution of diabetes and its acute complication, DKA, to the development of pulmonary thromboembolism is controversial and is discussed. This case with the presentation of sub-massive pulmonary embolism in a patient of DKA with no underlying cause identified is being reported owing to its rareness.
- Published
- 2020
28. Twenty-four Month Outcomes in the Collaborative Ocular Tuberculosis Study (COTS)-1: Defining the 'Cure' in Ocular Tuberculosis
- Author
-
Sofia Androudi, Kalpana Babu, Su Ling Ho, Soon-Phaik Chee, Bruttendu Moharana, Mamta Agarwal, Somasheila I. Murthy, Ilaria Testi, Manisha Agarwal, Kusum Sharma, Aman Sharma, Emmett T. Cunningham, Dhananjay Raje, Rupesh Agrawal, Kanika Aggarwal, Julio J. González-López, Richard W J Lee, Vishali Gupta, Padmamalini Mahendradas, Dinesh Visva Gunasekeran, Sarakshi Mahajan, Peter McCluskey, Carlos Pavesio, Manfred Zierhut, Debra A. Goldstein, Hassan Al-Dhibi, Sengal Nadarajah, Bahram Bodaghi, Ester Carreño, Onn Min Kon, Talin Barisani-Asenbauer, Anastasia Tasiopoulou, Aniruddha Agarwal, Carl P. Herbort, Luca Cimino, Reema Bansal, Mark Westcott, Quan Dong Nguyen, Ilknur Tugal-Tutkun, Ramandeep Singh, Ruchi Vala, Soumayava Basu, Simona Degli Esposti, Jyotirmay Biswas, John H. Kempen, Alessandro Invernizzi, Shishir Narain, Moncef Khairallah, Sharanaya Abraham, Nicholas Jones, and Stephen C. Teoh
- Subjects
medicine.medical_specialty ,genetic structures ,business.industry ,Treatment outcome ,Ocular tuberculosis ,medicine.disease ,eye diseases ,antitubercular therapy ,Collaborative Ocular Tuberculosis Study (COTS) group ,cure ,tubercular uveitis ,tuberculous ,uveitis ,Ophthalmology ,Internal medicine ,Immunology and Allergy ,Medicine ,sense organs ,business ,Uveitis - Abstract
To report the clinical findings, anatomical features, and treatment outcomes in subjects with ocular tuberculosis (OTB) at 24 months in the Collaborative Ocular Tuberculosis Study (COTS)-1. Of the ...
- Published
- 2020
29. Immunological tests and their interpretation in uveitis
- Author
-
Vedhanayaki Rajesh, Ilknur Tugal-Tutkun, Mamta Agarwal, Gazal Patnaik, Sivakumar R. Rathinam, and Merih Egriparmak
- Subjects
Immunologic Tests ,Antibodies ,Antigen ,lcsh:Ophthalmology ,Humans ,Medicine ,Letters to the Editor ,Pathogen ,novel infections ,biology ,business.industry ,Molecular diagnostics ,medicine.disease ,non-infectious ,investigations ,Ophthalmology ,infectious ,Molecular Diagnostic Techniques ,lcsh:RE1-994 ,Immunology ,Etiology ,biology.protein ,Immunological tests ,uveitis ,Antibody ,business ,Uveitis - Abstract
Uveitis is a complex disorder including both infectious and non-infectious etiologies. Clinical diagnosis is a challenge because many diseases share common clinical signs. Laboratory support is crucial for confirming the clinical diagnosis. Laboratory diagnosis includes direct tests and indirect tests. For example smear, culture, and molecular diagnostics demonstrate the pathogens, hence they are direct tests. Immunologic tests employ an antigen to detect presence of antibodies to a pathogen, or an antibody to detect the presence of an antigen, of the pathogen in the specimens. The immunological tests used in laboratories are made by producing artificial antibodies that exactly "match" the pathogen in question. When these antibodies come into contact with a sample they bind to the matching pathogen if found in the sample. Hence they are grouped under indirect evidence. There are several investigations in uveitis to reach the confirmed diagnosis including microbiological, immunological, imaging and molecular diagnostic testing. In this section we will discuss immunological investigations of infectious and non-infectious uveitis.
- Published
- 2020
30. Syphilitic uveitis as the presenting feature of HIV
- Author
-
Ekta Rishi, Madanagopalan V Govindarajan, Jyotirmay Biswas, Mamta Agarwal, S Sudharshan, and Pukhraj Rishi
- Subjects
Acquired immune deficiency syndrome, eye, human immunodeficiency virus, syphilis, uveitis ,Ophthalmology ,RE1-994 - Published
- 2016
- Full Text
- View/download PDF
31. Diagnostic Value of Optical Coherence Tomography in the Early Diagnosis of Macular Complications in Chronic Vogt-Koyanagi-Harada Disease
- Author
-
Ekta Rishi, Mamta Agarwal, Aleksandra Radosavljević, Gazal Patnaik, and Francesco Pichi
- Subjects
Vogt–Koyanagi–Harada disease ,Adult ,Male ,medicine.medical_specialty ,genetic structures ,Adolescent ,Visual Acuity ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Optical coherence tomography ,Ophthalmology ,Choroidal neovascular membrane ,medicine ,Immunology and Allergy ,Humans ,Fluorescein Angiography ,Child ,Macular hole ,Macular edema ,030304 developmental biology ,Subclinical infection ,Aged ,Retrospective Studies ,Inflammation ,0303 health sciences ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,eye diseases ,3. Good health ,Early Diagnosis ,030221 ophthalmology & optometry ,Female ,sense organs ,business ,Uveomeningoencephalitic Syndrome ,Value (mathematics) ,Tomography, Optical Coherence - Abstract
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.Retrospective observational study. Clinical features, OCT images, treatment, and visual outcome were analyzed.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%).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.
- Published
- 2020
32. Conjunctival Inclusion Cysts in Chronic Vernal Keratoconjunctivitis: String of Pearls
- Author
-
Mamta Agarwal
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,business.industry ,Cysts ,String (computer science) ,medicine.disease ,Dermatology ,Conjunctival Diseases ,Ophthalmology ,medicine ,Humans ,Inclusion (mineral) ,business ,Vernal keratoconjunctivitis ,Tomography, Optical Coherence ,Conjunctivitis, Allergic - Published
- 2020
33. Presentation of sclerouveitis with features of Vogt Koyanagi Harada syndrome and ocular tuberculosis – A Rare Combination
- Author
-
PurvaVijay Deore, SyedFaraaz Hussain, Mamta Agarwal, and Yogya Reddy
- Published
- 2022
34. An unusual complication after subarachnoid block in a cesarean section patient: Lidocaine allergic contact dermatitis
- Author
-
SARGAM GOEL, MAMTA AGARWAL, ARIJIT SARKAR, and MADHU PAKRASHI
- Abstract
Type I hypersensitivity reactions to lidocaine are infrequent, whilst type IV- delayed hypersensitivity reactions are even rarer, with only a few reported cases in the literature. A proper diagnosis is essential to differentiate between the two, for appropriate management of the same. As local anesthetic agents are routinely used for various invasive procedures, it is imperative to be familiar with the presentation and management of the such allergic reactions. We present a case of morbidly obese obstetric patient who developed allergic contact dermatitis (ACD) after receiving subcutaneous lidocaine before subarachnoid block. Patch test was positive for lidocaine, and the diagnosis was further confirmed by a positive intradermal challenge test.
- Published
- 2022
35. Anesthesia in a rare case of Type IA Oromandibular-Limb Hypogenesis Syndrome: A Case Report
- Author
-
Sargam Goel and Mamta Agarwal
- Subjects
General Medicine - Abstract
Oromandibular limb hypogenesis syndrome (OLHS) is a rare congenital disorder with only a handful of cases reported worldwide. Isolated hypoglossia/microglossia is rarer, with very few cases presenting for surgical procedures requiring anesthesia. This case reports the successful anesthesia management of a 5-year-old boy who presented for colostomy closure and had a previous history of difficult tracheal intubation.
- Published
- 2022
36. Ocular Gnathostomiasis Presenting as Branch Retinal Artery Occlusion
- Author
-
Mamta Agarwal, Vinata Rajendran, Emmett T. Cunningham, and Jyotirmay Biswas
- Subjects
medicine.medical_specialty ,genetic structures ,Anterior Chamber ,Retinal Artery Occlusion ,Gnathostoma spinigerum ,03 medical and health sciences ,0302 clinical medicine ,Branch retinal artery occlusion ,Ophthalmology ,medicine ,Gnathostomiasis ,Immunology and Allergy ,Humans ,030203 arthritis & rheumatology ,biology ,business.industry ,medicine.disease ,biology.organism_classification ,Uveitis, Anterior ,eye diseases ,Vitreous Hemorrhage ,030221 ophthalmology & optometry ,Female ,sense organs ,business - Abstract
To report a case of ocular Gnathostomiasis presenting as branch retinal artery occlusion.Observational case report.A 22-year-old Asian woman presented to her ophthalmologist with redness, tearing, and decreased vision in her left eye. Examination revealed anterior uveitis and branch retinal artery occlusion associated with both intra-retinal and vitreous hemorrhage. The patient was treated with topical corticosteroids and cycloplegics. After 3 weeks, she presented in our emergency, with further decrease in vision and worsening pain in the left eye. Slit lamp examination revealed a brown colored live worm on the posterior corneal surface, anterior uveitis, multiple iris holes, and vitreous cells. Indirect ophthalmoscopy showed focal retinal hemorrhages, subretinal tracts, and vitreous hemorrhage. Surgical removal of the worm from anterior chamber was done immediately.Branched retinal artery occlusion with intraretinal and vitreous hemorrhage, panuveitis, and multiple iris holes may suggest the presence of an intraocular parasite.
- Published
- 2020
37. Atypical Case of Bilateral Chandler Syndrome With Recurrent Band Keratopathy
- Author
-
Krishnakumar Subramanian, Richa Dhiman, and Mamta Agarwal
- Subjects
Adult ,Male ,medicine.medical_specialty ,genetic structures ,Endothelium ,Corneal Pachymetry ,Visual Acuity ,Recurrence ,Cornea ,Ophthalmology ,medicine ,Humans ,Endothelial dysfunction ,Iridocorneal Endothelial Syndrome ,Band keratopathy ,Edetic Acid ,Calcium Chelating Agents ,Retrospective Studies ,Corneal Dystrophies, Hereditary ,Microscopy, Confocal ,Corneal Decompensation ,business.industry ,Corectopia ,medicine.disease ,Combined Modality Therapy ,eye diseases ,Iridocorneal endothelial syndrome ,medicine.anatomical_structure ,Chandler syndrome ,sense organs ,medicine.symptom ,business ,Descemet Stripping Endothelial Keratoplasty - Abstract
Purpose To report a unique case of bilateral Chandler syndrome with recurrent band keratopathy. Methods This is a retrospective observational case report. Results A 39-year-old Asian man presented with progressive painless diminution of vision in both eyes for 6 years. Examination revealed diffuse corneal edema, hammered silver appearance of endothelium with guttae-like lesions, and corectopia in the right eye and mild corneal edema, central band keratopathy, and guttae-like lesions on the endothelium and peripheral anterior synechiae in the left eye. Routine specular microscopy, confocal microscopy, and pachymetry were performed. A clinical diagnosis of bilateral Chandler syndrome with band keratopathy was made. Superficial epithelial keratectomy with ethylenediaminetetraacetic acid (EDTA) chelation was performed in the left eye first, followed by Descemet-stripping automated endothelial keratoplasty in the right eye. Histopathological examination of the surgically excised Descemet membrane in the right eye showed multilayered endothelium with adhered epithelial cells consistent with Chandler syndrome. At 9-month follow-up, the right eye showed a clear cornea with an attached graft and the left eye revealed recurrence of central band keratopathy for which repeat EDTA chelation was successfully performed. Conclusions Recurrent band keratopathy coincident with endothelial dysfunction in iridocorneal endothelial syndrome can be repeatedly treated with EDTA chelation, whereas endothelial keratoplasty might be delayed until the time point of corneal decompensation.
- Published
- 2020
38. Bilateral hazy vitreous in a patient with convulsions
- Author
-
Mamta Agarwal, S. Krishnakumar, Mihir Trivedi, Muna Bhende, and Pradeep Susvar
- Subjects
Ophthalmology ,medicine.medical_specialty ,lcsh:Ophthalmology ,business.industry ,lcsh:RE1-994 ,Seizures ,medicine ,MEDLINE ,Humans ,business ,One Minute Ophthalmology ,Surgery - Published
- 2020
39. The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Descriptive Review of Tubercular Uveitis in Paediatric Population
- Author
-
Sengal Nadarajah, Talin Barisani-Asenbauer, Ester Carreño, Aniruddha Agarwal, Quan Dong Nguyen, Sharanaya Abraham, Anastasia Tasiopoulou, Luca Cimino, Mamta Agarwal, Kalpana Babu, Jyotirmay Biswas, Alessandro Invernizzi, Dhananjay Raje, Sofia Androudi, Kusum Sharma, Richard W J Lee, Bahram Bodaghi, Shishir Narain, John H. Kempen, Aman Sharma, Emmett T. Cunningham, Reema Bansal, Onn Min Kon, Manisha Agarwal, Hassan Al-Dhibi, Soon-Phaik Chee, Su Ling Ho, Carlos Pavesio, Nicholas Jones, Sarakshi Mahajan, Moncef Khairallah, Stephen C. Teoh, Ilknur Tugal-Tutkun, Simona Degli Esposti, Peter McCluskey, Rupesh Agrawal, Ruchi Vala, Kanika Aggarwal, Julio J. González-López, Debra A. Goldstein, Somasheila I Murthy, Soumayava Basu, Ilaria Testi, Carl P. Herbort, Bruttendu Moharana, Ramandeep Singh, Vishali Gupta, Padmamalini Mahendradas, Dinesh Visva Gunasekeran, Mark Westcott, and Manfred Zierhut
- Subjects
030203 arthritis & rheumatology ,Pediatrics ,medicine.medical_specialty ,business.industry ,Ocular tuberculosis ,children ,Collaborative Ocular Tuberculosis Study (COTS) ,pediatric population ,tubercular uveitis ,Disease ,medicine.disease ,humanities ,03 medical and health sciences ,Ophthalmology ,0302 clinical medicine ,030221 ophthalmology & optometry ,Immunology and Allergy ,Medicine ,business ,Uveitis ,Pediatric population ,Paediatric population - Abstract
To examine disease profile of tubercular uveitis (TBU) in Paediatric population. Among 945 patients of the retrospective multinational study by the Collaborative Ocular Tuberculosis Study (COTS)-1,...
- Published
- 2020
40. Voriconazole Induced Ocular Surface Dysplasia - Report of Two Cases
- Author
-
Mamta Agarwal, Gayatri S, Rama Rajagopal, and Subramanian Krishna Kumar
- Subjects
Male ,medicine.medical_specialty ,Antifungal Agents ,Cornea ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Immunology and Allergy ,Humans ,Fungal keratitis ,Aged ,030203 arthritis & rheumatology ,Voriconazole ,Keratitis ,business.industry ,Middle Aged ,medicine.disease ,Dermatology ,Ophthalmology ,Dysplasia ,030221 ophthalmology & optometry ,Female ,business ,Ocular surface ,Eye Infections, Fungal ,medicine.drug - Abstract
To report ocular surface dysplasia induced by voriconazole treatment in two patients with recalcitrant fungal keratitis.Observational study.Prolonged topical voriconazole treatment in fungal keratitis can induce ocular surface dysplasia. Early diagnosis and treatment of the dysplastic changes can result in complete remission and prevent recurrence.
- Published
- 2020
41. Clinicopathological, Microbiological and Polymerase Chain Reaction Study in a Case of Nocardia Scleritis
- Author
-
Appakkudal R. Anand, M K Janani, Mamta Agarwal, Jyotirmay Biswas, Gazal Patnaik, and Kaushal Sanghvi
- Subjects
Adult ,DNA, Bacterial ,Male ,medicine.medical_specialty ,Sulfamethoxazole ,Visual Acuity ,Administration, Oral ,Nocardia Infections ,Microbial Sensitivity Tests ,Slit Lamp Microscopy ,Polymerase Chain Reaction ,Eye Infections, Bacterial ,Nocardia ,Trimethoprim ,law.invention ,Microbiology ,Mycobacterium tuberculosis ,03 medical and health sciences ,0302 clinical medicine ,law ,Immunology and Allergy ,Medicine ,Humans ,Amikacin ,Polymerase chain reaction ,Retrospective Studies ,030203 arthritis & rheumatology ,Cefuroxime ,biology ,business.industry ,biology.organism_classification ,medicine.disease ,humanities ,Anti-Bacterial Agents ,Ophthalmology ,Drug Combinations ,030221 ophthalmology & optometry ,Histopathology ,business ,Scleritis - Abstract
To describe the clinicopathological, microbiological and polymerase chain reaction (PCR) study in a case of Nocardia scleritis.A retrospective chart review.A 32-year old male presented with pain, r...
- Published
- 2020
42. Medical Therapy of Uveitic Macular Edema: Biologic Agents
- Author
-
Mamta Agarwal, Manfred Zierhut, Aleksandra Radosavljević, Justine R. Smith, and Bahram Bodaghi
- Subjects
medicine.medical_specialty ,Macular Edema ,law.invention ,Uveitis ,03 medical and health sciences ,Biological Factors ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Immunology and Allergy ,Medicine ,Humans ,In patient ,Fluorescein Angiography ,Macular edema ,030203 arthritis & rheumatology ,medicine.diagnostic_test ,business.industry ,Therapeutic effect ,medicine.disease ,Fluorescein angiography ,3. Good health ,Biologic Agents ,Ophthalmology ,030221 ophthalmology & optometry ,business ,Medical therapy ,Tomography, Optical Coherence - Abstract
Introduction: Uveitic macular edema (UME) is a significant cause of visual impairment in all uveitis types. Methods: Reports that were cited in the MEDLINE database, that analyzed the effectiveness of biologics for UME in at least five patients, with a minimum follow-up of 3 months, published prior to April 1, 2019 were included. Reports that did not compare UME findings before and after the therapy, using either OCT or fluorescein angiography, were excluded. Results: Case series that analyzed the efficacy of intravitreal anti-VEGF agents showed modest, short-term benefit. Studies that investigated systemic anti-TNF agents in patients with noninfectious uveitis reported a therapeutic effect on UME. Anti-IL-6 antibodies have shown promising results for most severe cases of noninfectious UME. Interferon represents an option for patients with persistent UME in infectious and noninfectious uveitis. Conclusion: Multicenter, randomized controlled trials are needed to assess the effectiveness of each group of biologic agents in sufficient number of patients.
- Published
- 2020
43. Visual Morbidity in Ocular Tuberculosis - Collaborative Ocular Tuberculosis Study (COTS)-1: Report #6
- Author
-
Julio J. González-López, Kanika Aggarwal Ms, Moncef Khairallah, Sofia Androudi, Su Ling Ho FRCSGlasg, Somasheila I Murthy Dnb, Kusum Sharma, Aman Sharma, Emmett T. Cunningham, Aniruddha Agarwal Ms, Debra A. Goldstein, Bahram Bodaghi, Sarakshi Mahajan Mbbs, Shishir Narain, Soon-Phaik Chee FRCSEd, Stephen Teoh FRCSEd, Sengal Nadarajah, Dinesh Visva Gunasekeran Mbbs, Vishali Gupta Ms, Ester Carreño, Manisha Agarwal Ms, Bruttendu Moharana Ms, Simona Degli Esposti, Onn Min Kon Mrcp, Fcrs Rupesh Agrawal Md, John H. Kempen, Mark Westcott FRCOphth, Alessandro Invernizzi, Padmamalini Mahendradas Dnb, Carl P. Herbort, Talin Barisani-Asenbauer, Soumayava Basu Ms, Dhananjay Raje, Ramandeep Singh Ms, Peter McCluskey, Mamta Agarwal Dnb, Jyotirmay Biswas Ms, Richard W J Lee, Hassan Al-Dhibi, Ilknur Tugal-Tutkun, Ruchi Vala, Kalpana Babu Dnb, Ilaria Testi, Anastasia Tasiopoulou, Luca Cimino, Reema Bansal Ms, Manfred Zierhut, Nicholas Jones FRCSOphth, Carlos Pavesio FRCSOphth, Sharanaya Abraham, and Quan Dong Nguyen
- Subjects
blindness ,Tuberculosis ,uveitis ,visual impairment ,visual morbidity ,Pediatrics ,medicine.medical_specialty ,genetic structures ,Blindness ,business.industry ,Visual impairment ,Ocular tuberculosis ,medicine.disease ,eye diseases ,Natural history ,Ophthalmology ,medicine ,Immunology and Allergy ,In patient ,medicine.symptom ,business ,Uveitis - Abstract
Aim of the study was to examine extent, natural history, and clinical features associated with visual impairment (VI) in patients diagnosed with ocular tuberculosis (OTB) by the Collaborative Ocula...
- Published
- 2020
44. The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Review of 165 Patients with Tubercular Anterior Uveitis
- Author
-
Ilknur Tugal-Tutkun, Ruchi Vala, Onn Min Kon Mrcp, Peter McCluskey, Kusum Sharma, Aman Sharma, Emmett T. Cunningham, Rupesh Agrawal Md Fcrs, Aniruddha Agarwal Ms, Manisha Agarwal Ms, Dhananjay Raje, Ramandeep Singh Ms, Sharanya Abraham, Bruttendu Moharana Ms, Kanika Aggarwal Ms, Anastasia Tasiopoulou, Moncef Khairallah, Luca Cimino, Somasheila I Murthy Dnb, Debra A. Goldstein, Vishali Gupta Ms, Sofia Androudi, Bahram Bodaghi, Shishir Narain, Mamta Agarwal Dnb, Ester Carreño, Mark Westcott FRCSOphth, Su Ling Ho FRCSGlasg, Reema Bansal Ms, Jyotirmay Biswas Ms, Sarakshi Mahajan Mbbs, Hassan Al-Dhibi, Alessandro Invernizzi, Talin Barisani-Asenbauer, Richard W J Lee, Soon-Phaik Chee FRCSEd, Stephen Teoh FRCSEd, Sengal Nadarajah, Dinesh Visva Gunasekeran, Nicholas Jones FRCSOphth, John H. Kempen, Carlos Pavesio FRCSOphth, Simona Degli Esposti, Manfred Zierhut, Padmamalini Mahendradas Dnb, Ilaria Testi, Soumayava Basu Ms, Quan Dong Nguyen, Julio J. González-López, Carl P. Herbort, Kalpana Babu Dnb, and Bjorn Betzler Mbbs
- Subjects
030203 arthritis & rheumatology ,medicine.medical_specialty ,business.industry ,Treatment regimen ,Ocular tuberculosis ,Retrospective cohort study ,medicine.disease ,humanities ,body regions ,03 medical and health sciences ,Ophthalmology ,0302 clinical medicine ,Anti-tubercular therapy ,collaborative ocular tuberculosis study (COTS) ,ocular tuberculosis ,tubercular anterior uveitis ,uveitis ,Internal medicine ,030221 ophthalmology & optometry ,medicine ,Immunology and Allergy ,Anterior uveitis ,business ,Uveitis - Abstract
The Collaborative Ocular Tuberculosis Study (COTS) Group sought to address the diagnostic uncertainty through retrospective cohort analysis of treatment regimens and therapeutic outcomes for patien...
- Published
- 2020
45. The Collaborative Ocular Tuberculosis Study (COTS) Consensus (CON) Group Meeting Proceedings
- Author
-
Mudit Tyagi, Marie Hélène Errera, Luz Elena Concha del Rio, Manisha Agarwal, Nirbhai Singh, Talin Barisani-Asenbauer, Alessandro Invernizzi, Romi Chhabra, Aman Sharma, D Makhoul, Soumyava Basu, Hazlita Mohd Isa, Sudharshan Sridharan, Yew Sen Yuen, Alay S. Banker, Jennifer E. Thorne, Carlos Pavesio, Samir S. Shoughy, Soon-Phaik Chee, Debra A. Goldstein, Manfred Zierhut, Dipankar Das, Richard W J Lee, Mamta Agarwal, Somasheila I Murthy, Shahana Mazumdar, Edoardo Baglivo, Saurabh Luthra, Kusum Sharma, Shobha Sehgal, Atul Kumar, Mukesh Agrawal, Ilknur Tugal-Tutkun, Amit Khosla, Marion R. Munk, Ester Carreño, Aniruddha Agarwal, Myhanh Nguyen, Manabu Mochizuki, Francesco Pichi, Salil Mehta, Maria Sofia Tognon, Marc DeSmet, Oli S. Mohamed, Emmett T. Cunningham, Nataša Vidovič Valentinčič, Amod Gupta, Sivakumar R. Rathinam, Sarakshi Mahajan, A.E. George, Hassan Al-Dhibi, Onn Min Kon, Careen Y. Lowder, Cristina Muccioli, Heloisa Nascimento, Laure Caspers, Bety Yanez Alvarez, Shishir Narain, Andres Rousselot, H. Nida Sen, Masoud Soheilian, Mark Westcott, Fatma Asyari, Douglas A. Jabs, Peter Mc Cluskey, Alastair K Denniston, Digamber Behera, Justine R. Smith, Vishali Gupta, Nicholas Jones, Alejandro Fonollosa, Padmamalini Mahendradas, Deeksha Katoch, Stephen C. Teoh, Christoph Tappeiner, Yan Guex Crosier, Ekaterina Denisova, Michal Kramer, Elisabetta Miserocchi, Reema Bansal, Piergiorgio Neri, Jyotirmay Biswas, Manohar Babu Balasundaram, Ilaria Testi, Luca Cimino, Quan Dong Nguyen, Sofia Androudi, John H. Kempen, Bahram Bodaghi, Dhananjay Raje, Shah Md. Islam, Pinar Cakar Ozdal, Ramandeep Singh, Daniel Vítor Vasconcelos Santos, Rahman Zahedur, Annabelle A. Okada, Ariel Schlaen, André Luiz Land Curi, Rupesh Agrawal, Kalpana Babu Murthy, Harvey S. Uy, Amitabh Kumar, Kanika Aggarwal, Rina La Distia Nora, Dinesh Visva Gunasekeran, Ryoji Yanai, Moncef Khairallah, Avinash Gurbaxani, and Alan G. Palestine
- Subjects
030203 arthritis & rheumatology ,medicine.medical_specialty ,business.industry ,Retinal vasculitis ,Ocular tuberculosis ,Computer-assisted web interviewing ,medicine.disease ,03 medical and health sciences ,Ophthalmology ,0302 clinical medicine ,Antitubercular therapy ,choroiditis ,Collaborative Ocular Tuberculosis Study Consensus (COTS CON) ,consensus guidelines ,ocular tuberculosis ,Family medicine ,030221 ophthalmology & optometry ,Immunology and Allergy ,Medicine ,Intermediate uveitis ,In patient ,Anterior uveitis ,business ,computer ,Uveitis ,Delphi ,computer.programming_language - Abstract
An international, expert led consensus initiative was set up by the Collaborative Ocular Tuberculosis Study (COTS) group to develop systematic, evidence, and experience-based recommendations for the treatment of ocular TB using a modified Delphi technique process. In the first round of Delphi, the group identified clinical scenarios pertinent to ocular TB based on five clinical phenotypes (anterior uveitis, intermediate uveitis, choroiditis, retinal vasculitis, and panuveitis). Using an interactive online questionnaires, guided by background knowledge from published literature, 486 consensus statements for initiating ATT were generated and deliberated amongst 81 global uveitis experts. The median score of five was considered reaching consensus for initiating ATT. The median score of four was tabled for deliberation through Delphi round 2 in a face-to-face meeting. This report describes the methodology adopted and followed through the consensus process, which help elucidate the guidelines for initiating ATT in patients with choroidal TB.
- Published
- 2020
- Full Text
- View/download PDF
46. The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Review of 447 Patients with Tubercular Intermediate Uveitis and Panuveitis
- Author
-
Soon Phaik Chee, Manisha Agarwal, Sofia Androudi, Kalpana Babu, Carlos Pavesio, Bjorn Kaijun Betzler, Bahram Bodaghi, Quan Dong Nguyen, Ester Carreño, Aniruddha Agarwal, Mamta Agarwal, Rupesh Agrawal, Kusum Sharma, Kanika Aggarwal, Aman Sharma, Emmett T. Cunningham, Moncef Khairallah, Shishir Narain, Debra A. Goldstein, Sarakshi Mahajan, Bruttendu Moharana, Somasheila I Murthy, Sharanaya Abraham, Talin Barisani-Asenbauer, Simona Degli Esposti, Soumayava Basu, Dhananjay Raje, Vishali Gupta, Padmamalini Mahendradas, Dinesh Visva Gunasekeran, Sengal Nadarajah, Su Ling Ho, Nicholas Jones, Ilknur Tugal-Tutkun, Manfred Zierhut, Stephen C. Teoh, Richard W J Lee, Anastasia Tasiopoulou, Reema Bansal, Luca Cimino, Hassan Al-Dhibi, Peter McCluskey, Ruchi Vala, Ilaria Testi, Onn Min Kon, Jyotirmay Biswas, John H. Kempen, Julio J. González-López, Alessandro Invernizzi, Ramandeep Singh, and Mark Westcott
- Subjects
medicine.medical_specialty ,tubercular panuveitis ,business.industry ,Panuveitis ,Ocular tuberculosis ,ocular tuberculosis ,tubercular intermediate uveitis ,medicine.disease ,Diagnostic tools ,Dermatology ,Ophthalmology ,Anti-tubercular therapy ,collaborative ocular tuberculosis study (COTS) ,tubercular uveitis ,uveitis ,Immunology and Allergy ,Medicine ,Intermediate uveitis ,business ,Uveitis - Abstract
Purpose: Tubercular intermediate uveitis (TIU) and panuveitis (TBP) are difficult to manage because of limitations in diagnostic tools and lack of evidence-based treatment guidelines. The Collabora...
- Published
- 2020
47. Clinical profile, risk factors and outcome of medical, surgical and adjunct interventions in patients with Pythiuminsidiosum keratitis
- Author
-
Bhaskar Srinivasan, Geetha Iyer, Lily Therese K, S. Krishnakumar, Mamta Agarwal, Shweta Agarwal, Rama Rajagopal, N.C. Narayanan, Meena Lakshmipathy, N Radhika, and Saket Benurwar
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Cryotherapy ,Azithromycin ,Pythium insidiosum ,Keratitis ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,Evisceration (ophthalmology) ,biology ,business.industry ,Retrospective cohort study ,Eye infection ,medicine.disease ,biology.organism_classification ,Sensory Systems ,Surgery ,Ophthalmology ,chemistry ,Linezolid ,030221 ophthalmology & optometry ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
PurposeTo report clinical profile and compare management options for Pythium keratitis.MethodRetrospective interventional study of 46 patients diagnosed as Pythium keratitis by PCR DNA sequencing from January 2014 to July 2017. Interventions were categorised into medical management (MM) (topical azithromycin and linezolid with oral azithromycin at presentation), surgery (S) (therapeutic penetrating keratoplasty, TPK), surgical adjunct (SA) (cryotherapy±alcohol with TPK) and medical adjunct (MA) (MM after TPK).ResultsPrimary treatment included MM (1 eye), SA (3 eyes) and S (42 eyes). Recurrence occurred in 27/43 eyes (MM+S group). Second surgery (S) was required in 11 eyes (TPK-2), with additional procedures (SA) in 10 eyes and evisceration in five eyes. 8/43 eyes received MA after TPK-1. One eye required TPK-3. Recurrence occured in all eyes that received MA (100%) and in 28 of 54 TPKs (51.8%) (TPK 1+2+3) in 42 eyes. Recurrence was noted in 1/14 (7.1%) that underwent SA.ConclusionThe currently available and recommended treatment for Pythium keratitis is surgical by means of a TPK and in worse cases evisceration. In our study, MM/MA measures showed no benefit with recurrence or worsening of infection requiring resurgery. Almost 50% of TPKs had a recurrence requiring resurgery. However, adjunctive procedures during TPK appear to have additional benefit with low risk of recurrence and could be included as routine care.
- Published
- 2018
48. Standardization of Nomenclature for Ocular Tuberculosis - Results of Collaborative Ocular Tuberculosis Study (COTS) Workshop
- Author
-
Marion R. Munk, Yan Guex-Crosier, Ilknur Tugal-Tutkun, Massimo Accorinti, J. Fernando Arevalo, Moncef Khairallah, Joyce Hisae Yamamoto, Avinash Gurbaxani, Zohar Habot-Wilner, Talin Barisani-Asenbauer, Justine R. Smith, Douglas A. Jabs, Mamta Agarwal, Stephen C. Teoh, Marie-Hélène Errera, Alastair K Denniston, Alex Fonollosa, Fatma Asyari, Digambar Behra, Ekaterina Denisova, Aera Kee, Debra A. Goldstein, Richard W J Lee, H. Nida Sen, Sudha K Ganesh, Peizeng Yang, Ariel Schlaen, Careen Y. Lowder, Rubens Belfort, Alan G. Palestine, Kalpana Babu, Sarakshi Mahajan, Aman Sharma, Radgonde Amer, Manisha Agarwal, Francesco Pichi, Peter McCluskey, Samir S. Shoughy, Soumyava Basu, Piergiorgio Neri, Manfred Zierhut, Dipankar Das, Annabelle A. Okada, Jyotirmay Biswas, Amitabh Kumar, Yilmaz Ozyazgan, John H. Kempen, Luca Cimino, Amod Gupta, Edoardo Baglivo, Rupesh Agrawal, Carlos Pavesio, Atul Kumar, Myhanh Nguyen, Salil Mehta, Saurabh Luthra, Kanika Aggarwal, Yonca A. Akova, Quan Dong Nguyen, Daniel Vitor Vasconcelos-Santos, Lucia Kuffova, Rina La Distia Nora, Harvey S. Uy, Maria Sofia Tognon, Jennifer E. Thorne, Romi Chhabra, Heloisa Nascimento, Cristina Muccioli, Justus G. Garweg, Mark Westcott, Christoph Tappeiner, D Makhoul, Onn Minn Kon, Ilaria Testi, Bulbul Islam Shah, Janet L. Davis, Arnd Heiligenhaus, Bahram Bodaghi, Ester Carreño, Vishali Gupta, Padmamalini Mahendradas, Aniruddha Agarwal, Alay S. Banker, Soon-Phaik Chee, Marc D. de Smet, Elisabetta Miserocchi, André Luiz Land Curi, Pinar Cakar Ozdal, Masoud Soheilian, Shelina Oli Mohamed, and Alessandro Invernizzi
- Subjects
medicine.medical_specialty ,Tuberculosis ,Blinding ,Standardization ,Ocular tuberculosis ,Disease ,03 medical and health sciences ,0302 clinical medicine ,remission ,tuberculous ,medicine ,Immunology and Allergy ,In patient ,Intensive care medicine ,tubercular uveitis ,Nomenclature ,030203 arthritis & rheumatology ,business.industry ,medicine.disease ,Antitubercular therapy ,Ophthalmology ,030221 ophthalmology & optometry ,uveitis ,business ,Uveitis - Abstract
Purpose: To standardize a nomenclature system for defining clinical phenotypes, and outcome measures for reporting clinical and research data in patients with ocular tuberculosis (OTB).Methods: Uveitis experts initially administered and further deliberated the survey in an open meeting to determine and propose the preferred nomenclature for terms related to the OTB, terms describing the clinical phenotypes and treatment and reporting outcomes.Results: The group of experts reached a consensus on terming uveitis attributable to tuberculosis (TB) as tubercular uveitis. The working group introduced a SUN-compatible nomenclature that also defines disease "remission" and "cure", both of which are relevant for reporting treatment outcomes.Conclusion: A consensus nomenclature system has been adopted by a large group of international uveitis experts for OTB. The working group recommends the use of standardized nomenclature to prevent ambiguity in communication and to achieve the goal of spreading awareness of this blinding uveitis entity.
- Published
- 2019
49. Tubercular Uveitis: Nuggets from Collaborative Ocular Tuberculosis Study (COTS)-1
- Author
-
Mark Westcott, Rupesh Agrawal, Kalpana Babu, Ilknur Tugal-Tutkun, Richard W J Lee, Kanika Aggarwal, Simona Degli Esposti, Robert Grant, Peter McCluskey, Ruchi Vala, Vishali Gupta, Andres Rousselot, Bruttendu Moharana, Padmamalini Mahendradas, Aman Sharma, Emmett T. Cunningham, Ester Carreño, Sharanya Abraham, Aniruddha Agarwal, Manfred Zierhut, Dinesh Visva Gunasekeran, Sofia Androudi, Moncef Khairallah, Debra A. Goldstein, Manisha Agarwal, Somasheila I Murthy, Talin Barisani-Asenbauer, Carl P. Herbort, Mamta Agarwal, Dhananjay Raje, Kusum Sharma, Julio J. González-López, Soon-Phaik Chee, Onn Min Kon, Anastasia Tasiopoulou, Luca Cimino, Ramandeep Singh, Carlos Pavesio, Quan Dong Nguyen, Reema Bansal, Nicholas Jones, Sengal Nadarajah, Bahram Bodaghi, Shishir Narain, Stephen C. Teoh, Sarakshi Mahajan, Su Ling Ho, Jyotirmay Biswas, John H. Kempen, Alessandro Invernizzi, Hassan Al-Dhibi, Soumayava Basu, and Ilaria Testi
- Subjects
030203 arthritis & rheumatology ,Tuberculosis ,Data collection ,Anti-tubercular therapy ,choroiditis ,Collaborative Ocular Tuberculosis Study (COTS) ,global experts ,tubercular uveitis ,tuberculosis ,Disease expression ,business.industry ,media_common.quotation_subject ,Treatment outcome ,Ocular tuberculosis ,Data entry ,medicine.disease ,03 medical and health sciences ,Ophthalmology ,Presentation ,0302 clinical medicine ,030221 ophthalmology & optometry ,medicine ,Immunology and Allergy ,Medical emergency ,business ,Uveitis ,media_common - Abstract
Background: Tuberculosis (TB) is a major infection that can affect the eye as first and sole presentation without features of systemic disease. Controversy exists regarding diagnosis and management of tubercular uveitis (TBU), further compounded by regional variations in disease expression. Purpose: Collaborative Ocular Tuberculosis Study (COTS)-1 aims to address knowledge deficits through collaboration amongst uveitis specialists across the globe by sharing the data of patients with TBU presented at participating centers from January 2004 to December 2014. Methods: Data collection was facilitated by a novel method of real-time encrypted web-based data entry allowing regular updates as new data and recommendations become available. Results: Information on clinical features, investigation findings, management, and treatment outcomes were reviewed to get an idea about real world scenario. Conclusion: The current review aims to focus on methodology and briefing of published reports from COTS group in COTS-1 study to highlight key messages from this large data.
- Published
- 2019
50. The Collaborative Ocular Tuberculosis Study (COTS)-1 Report 3: Polymerase Chain Reaction in the Diagnosis and Management of Tubercular Uveitis: Global Trends
- Author
-
Dhananjay Raje, Simona Degli Esposti, Somasheila L. Murthy, Anastasia Tasiopoulou, Luca Cimino, Vishali Gupta, Aman Sharma, Emmett T. Cunningham, Ho Su Ling, Mamta Agarwal, Bhaskar Gupta, Ester Carreño, Hassan Al-Dhibi, Kusum Sharma, Aniruddha Agarwal, Soon-Phaik Chee, Kalpana Babu, Ilknur Tugal-Tutkun, Onn Min Kon, Sarakshi Mahajan, Alessandro Invernizzi, Quan Dong Nguyen, Ruchi Vala, Richard W J Lee, Dinesh Visva Gunasekaran, Julio J. González-López, Soumayava Basu, Debra A. Goldstein, Manfred Zierhut, Peter McCluskey, Manisha Agarwal, Mark Westcott, Bruttendu Moharana, Ramandeep Singh, Sengal Nadarajah, Padmamalini Mahendradas, Carl P. Herbort, Jyotirmay Biswas, Carlos Pavesio, Talin Barisani-Asenbauer, Bahram Bodaghi, Shishir Narain, Sharanya Abraham, Nicholas Jones, Reema Bansal, Stephen C. Teoh, Rupesh Agrawal, Kanika Aggarwal, Sofia Androudi, and Moncef Khairallah
- Subjects
Male ,Treatment outcome ,Antitubercular Agents ,Ocular tuberculosis ,Ophthalmology & Optometry ,Polymerase Chain Reaction ,Eye Infections, Bacterial ,law.invention ,0302 clinical medicine ,law ,Immunology and Allergy ,Child ,Pcr analysis ,Polymerase chain reaction ,biology ,Middle Aged ,PCR ,tuberculosis ,1107 Immunology ,CHOROIDITIS ,Female ,Life Sciences & Biomedicine ,Uveitis ,Adult ,DNA, Bacterial ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,Tuberculosis, Ocular ,Aqueous Humor ,Anti-tubercular therapy ,Young Adult ,03 medical and health sciences ,Internal medicine ,INTRAOCULAR TUBERCULOSIS ,medicine ,Humans ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Science & Technology ,business.industry ,Mycobacterium tuberculosis ,biology.organism_classification ,medicine.disease ,choroidal tuberculoma ,choroiditis ,polymerase chain reaction ,Ophthalmology ,Intraocular fluid ,030221 ophthalmology & optometry ,business ,Follow-Up Studies ,Mycobacterium - Abstract
PURPOSE: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. METHODS: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. RESULTS: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation. CONCLUSIONS: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario.
- Published
- 2017
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.