About OJO | Search | Ahead of print | Current Issue | Archives | Author Instructions | Reviewer Guidelines | Online submissionLogin
Oman Journal of Ophthalmology Oman Journal of Ophthalmology
  Editorial Board | Subscribe | Advertise | Contact
Users Online: 40  Wide layoutNarrow layoutFull screen layout Home Print this page  Email this page Small font size Default font size Increase font size
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
   Table of Contents - Current issue
Coverpage
May-August 2015
Volume 8 | Issue 2
Page Nos. 83-137

Online since Wednesday, June 24, 2015

Accessed 3,353 times.

PDF access policy
Journal allows immediate open access to content in HTML + PDF

EPub access policy
Full text in EPub is free except for the current issue. Access to the latest issue is reserved only for the paid subscribers.
View as eBookView issue as eBook
Author Institution MappingAuthor Institution Mapping
Access StatisticsIssue statistics
RSS FeedRSS
Hide all abstracts  Show selected abstracts  Export selected to  Add to my list
REVIEW ARTICLES  

Recent trends: Medical management of infectious keratitis Highly accessed article p. 83
Sneha Solanki, Manisha Rathi, Sumeet Khanduja, CS Dhull, Sumit Sachdeva, Jitender Phogat
DOI:10.4103/0974-620X.159104  
This review article highlights the newer diagnostic modalities and approaches in the medical management of infectious keratitis. A Medline literature search conducted to March 2014 has been included. Recent studies or publications were selected from international indexed journals using suitable key words. Development of specular microscopy and polymerase chain reaction (PCR) has a promising role as diagnostic modalities in infectious keratitis, especially in refractory cases. Previously fortified antibiotics have been the mainstay of treatment for bacterial keratitis. Recently, the advent of fourth-generation fluoroquinolones monotherapy has shown promising results in the management of bacterial keratitis. Corneal collagen cross-linking is being considered in the refractory cases. Topical natamycin and amphotericin B should be considered as the first choice anti-fungal agents in suspected filamentous or yeast infection respectively. Voriconazole and newer routes of administration such as intrastromal and intracameral injection of conventional anti-fungal agents have demonstrated a positive clinical response. Ganciclovir is a newer anti-viral agent with promising results in herpes simplex keratitis. Thus, introduction of newer diagnostic modalities and collagen cross-linking along with fourth-generation fluoroquinolones and newer azoles have a promising role in the management of infectious keratitis.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Corneal cross-linking treatment of keratoconus p. 86
Mahgol Farjadnia, Mohammad Naderan
DOI:10.4103/0974-620X.159105  
Keratoconus as the most common cause of ectasia is one of the leading cause of corneal transplants worldwide. The current available therapies do not modify the underlying pathogenesis of the disease, and none of the available approaches but corneal transplant hinder the ongoing ectasia. Several studies document Crosslink defect between collagen fibrils in the pathogenesis of keratoconus. Collagen cross link is a relatively new approach that with the application of the riboflavin and ultraviolet A, new covalent bands reform. Subjective and objective results following this method seem to be promising. Endothelial damage besides other deep structural injury, which is the major concern of this technique have not yet been reported, when applying the standard method.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Morphological and functional outcomes following modified early treatment diabetic retinopathy study laser in diabetic macular edema p. 92
Rajiv Raman, Kiruthika Santhanam, Laxmi Gella, Bikramjit P Pal, Tarun Sharma
DOI:10.4103/0974-620X.159252  
Aim: The aim was to report morphological and functional outcomes following modified early treatment diabetic retinopathy study (ETDRS) laser in diabetic macular edema (DME). Materials and Methods: Structural and functional changes using spectral domain optical coherence tomography (OCT) and microperimetry (MP) were studied before and 4 months after laser in 37 eyes with clinically significant macular edema (ME) requiring modified ETDRS laser treatment. Paired t-test was used to compare pre and postlaser outcomes P < 0.05 was considered statistically significant. Results: Central foveal thickness showed a significant reduction after laser P = 0.004. There was a significant reduction in mean retinal thickness (MRT) and retinal volume in all the quadrants of ETDRS except for the temporal and nasal quadrants in outer 6 mm ring. Maximum reduction in MRT was seen in eyes with DME having neurosensory detachment (382.66 μ to 292.61 μ). Retinal sensitivities reduced in all quadrants following laser, however, fixation patterns showed improvements. The change in VA was positively correlated to change in MRT (r = 0.468, P = 0.032). Conclusion: Laser not only causes structural benefits such as reduction of retinal thickness and volume, it also causes improvement of fixation patterns.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Visual function of children with visual and other disabilities in Oman: A case series p. 97
Urmi Gogri, Salah Al Harby, Rajiv Khandekar
DOI:10.4103/0974-620X.159253  
Background : We assessed visual functioning of the children with special needs in Oman between 2009 and 2012. We present the methods of assessing different visual functions, outcomes and interventions carried out to improve their functioning. Materials and Methods : In this case series type of study, optometrists assessed visual functions of children of "day care centers" in Oman. Experts further assessed them and provided low vision care. Ocular movements, refractive corrections, near, distance, contrast color, motion, field of vision and cognitive, visual function test results were noted. Feedback to caregivers was given to improving visual functioning of these children. Results: We grouped 321 participants, (196 (61.1%) boys, age range of 3-18 years) into 61; Down syndrome (DS), 72 with intellectual disabilities, 67; hearing impaired and 121 with other conditions. Refractive error and lag of accommodation was 26 (42.6%) and 14 (22.6%) among children with DS. Contrast sensitivity was impaired in 8 (12.7%) among hearing impaired children. Defective distant and near vision was in 162 (70%) and 104 (42%) of our cohort. Children with intellectual disability were most difficult to assess. Children in group of other disabilities'' had a higher proportion of impaired visual functioning. They were given low vision aids (telescopes (22), filters (7) and magnifiers (3)) in large numbers compared to those in other groups. Conclusions : The outcomes of assessment of visual functioning of children with other disabilities show great variation and difficult to group. The care therefore should be individual. All visual functions cannot be assessed at one time.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Ocular response analyzer parameters in healthy, keratoconus suspect and manifest keratoconus eyes p. 102
Mehrdad Mohammadpour, Ifa Etesami, Zahra Yavari, Mohammad Naderan, Fatemeh Abdollahinia, Mahmoud Jabbarvand
DOI:10.4103/0974-620X.159255  
Background: To evaluate and compare corneal biomechanical indices and their specificity among keratoconus (KC), keratoconus suspect (KCS), and normal eyes (NL) before and after controlling potential confounders. Materials and Methods: A total of 160 eyes in three groups were included prospectively: NL, KC, and KCS groups based on clinical examination and topography. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured by the ocular response analyzer. CH and CRF were compared between the three groups by analysis of variances test. Results: The three groups consisted of 80 NL, 48 KC, and 32 KCS eyes. The mean CH measured was 10.4 ± 1.25, 7.83 ± 1.28 and 10.17 ± 1.80 mm Hg in NL, KC and KCS eyes, respectively. The mean CRF was 10.23 ± 1.75, 6.5 ± 1.63 and 9.98 ± 2.00 mm Hg in NL, KC and KCS eyes, respectively. Mean CH and CRF were significantly different between the NL and KC (P < 0.05); however after controlling for central corneal thickness and sex; there was no significant difference between NL and KCS (P > 0.05). Conclusion: CH and CRF can be helpful in differentiating KC from NL eyes; however, they are not valuable for detecting KCS that is the main concern for refractive surgery. Future studies focusing on more accurate tests for identifying KCS, using a consistent grading scale for defining KC and KCS are still warranted.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A novel strategy for management of uncorrected refractive errors in urban slums p. 107
Prema K Chande, Hiral Korani, BR Shamanna
DOI:10.4103/0974-620X.159258  
Background: Blindness and Vision impairment remains a major public health issue not only in rural but also in urban areas. Concept of using peripheral health centers to render primary health care services to the community was a WHO proposed model. However, establishing them in urban slums is a challenge as most of the slums are illegal establishments. So, aim was to establish vision centers for providing primary eye care services in the urban slums of Mumbai, West India. Methods: Vision centers were established in various slum pockets of Mumbai from the year 2008 till 2009. Refraction and screening for ocular morbidity were carried out for those who attended this center and management for uncorrected refractive errors was done. Results: Data from 6 such vision centers located in various slum pockets of Mumbai city from April 9 to March 2011 were collected and analyzed. Of the 19,550 adults, 2270 (11.61%) had moderate vision impairment with presenting visual acuity of <0.5 LogMAR in both eyes. Severe Visual impairment was seen in (723) 3.70%. Blindness was seen in (357) 1.82%. Of the 2993, which were moderately and severely visually impaired, 1893 subjects that is, 63.24% of them improved to 0.2 LogMAR or better with spectacle correction Conclusions: About 63.24% of visual impairment was due to uncorrected refractive errors, these included both moderately and severely vision impaired. Totally, 357 (1.82%) were also identified as blind. This model of vision centers has a role in the identification and management of sight-threatening problems.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

Microbial keratitis following accelerated corneal collagen cross-linking p. 111
Shreesha Kumar Kodavoor, Nikit J Sarwate, D Ramamurhy
DOI:10.4103/0974-620X.159259  
A deep stromal infiltrate with hypopyon appeared in central cornea of right eye of a 15-year-old boy postoperatively after 2 days, who underwent uneventful accelerated corneal collagen crosslinking (C3R) with riboflavin and ultraviolet-A (UVA) for the treatment of keratoconus. Staphylococcus aureus keratitis was confirmed by the microbiological studies, which guided intense treatment with topical and systemic antibiotics. Before C3R, the best corrected visual acuity (BCVA) in the ocular dexter was 20/30 with the refraction of − 1.00 DS/−5.00 DC × 30° with drop to 20/400 following the infection. After intensive treatment BCVA recovered to 20/40 with the refraction of −4.0 DC × 60° at 6 months postprocedure. Slit lamp examination at this stage revealed a faint nebulo-macular grade scar in the central cornea involving visual axis. Collagen crosslinking with riboflavin-UVA is a minimally invasive method, but traditionally requires epithelial removal, which could be a predisposing factor to bacterial keratitis.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Metastatic Serratia endophthalmitis associated with extravasation injury in a preterm neonate p. 114
Manavi D Sindal, Chinmay P Nakhwa
DOI:10.4103/0974-620X.159261  
The authors report a case of a preterm neonate who presented with lid edema, corneal edema, and an inflammatory membrane with whitish exudates in the pupillary area, suggestive of endophthalmitis. There was also a cutaneous ulcer with an eschar on the right wrist at the site of extravasation associated with previous intravenous catheter. Cultures from the ulcer and vitreous samples both grew Serratia marcescens with identical antibiotic sensitivity and resistance patterns. The ocular infection was rapidly progressive and did not respond to administered medical and surgical therapy leading to subsequent phthisis bulbi. Serratia can cause endophthalmitis refractory to antibiotics and despite aggressive and timely treatment can have an unfavorable outcome. This report aims at highlighting the possibility of metastatic infection from an extravasation injury with a potentially fatal outcome.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Brown's syndrome with ocular albinism: Case report of a rare presentation and literature review p. 117
Soumya Nambiar, Srikanth Ramasubramanian, Meenakshi Swaminathan
DOI:10.4103/0974-620X.159264  
We report a rare case of Brown's syndrome associated with ocular albinism in a 10-year-old boy. This report highlights the importance of further analysis of cases of Brown's syndrome and throws some light on the etiology and association of this rare condition.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Surgical management of glaucoma secondary to idiopathic elevated episcleral venous pressure p. 120
Zia Sultan Pradhan, Ashish Kuruvilla, Pushpa Jacob
DOI:10.4103/0974-620X.159266  
Idiopathic elevated episcleral venous pressure is characterized by dilated episcleral veins and open angle glaucoma. Trabeculectomies in these eyes are often complicated by uveal effusions (intraoperative or postoperative) at nonhypotonous pressures. We highlight the ability to avoid the need for sclerostomies by preventing intraoperative shallowing of the anterior chamber and the use of tight scleral sutures which should be adjusted postsurgery to gradually reach the target intraocular pressure in a step-wise manner.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Spontaneous ophthalmic artery occlusion in children due to Hyperhomocysteinemia p. 122
Virender Sachdeva, Ravi Garg, Avinash Pathengay, Ramesh Kekunnaya
DOI:10.4103/0974-620X.159270  
Ophthalmic artery occlusion usually presents as a sudden onset profound decrease in vision in the middle-aged and elderly patients following periocular procedures (retrobulbar injection/glabellar fat injection), embolism from the heart or after prolonged systemic surgery. In this report, we describe three children with spontaneous ophthalmic artery occlusion who presented with unilateral loss of vision and diagnosed elsewhere as optic atrophy whose detailed history and examination were suggestive of ophthalmic artery occlusion. Detailed systemic and laboratory evaluation revealed hyperhomocysteinemia as the only potential risk factor. To the best of our knowledge, this is the first report of the association of hyperhomocysteinemia and spontaneous ophthalmic artery occlusion.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Melanoma associated retinopathy: A new dimension using adaptive optics p. 125
Supriya Dabir, Shwetha Mangalesh, Indu Govindraj, Ashwin Mallipatna, Rajani Battu, Rohit Shetty
DOI:10.4103/0974-620X.159273  
We report a 56-year-old male patient, complaining of metamorphopsia in his left eye nevertheless visual acuity, slit lamp, and fundus examinations were within normal limits. Microperimetry (MAIA, Centervue, Italy) revealed central field loss and spectral domain optical coherence tomography (Spectralis, Heidelberg, Germany) showed disrupted cone outer segment tip layer. The patient had a diagnosis of cutaneous melanoma in his foot for which an excision biopsy with lymph node dissection was performed 5 months earlier. Our clinical diagnosis was melanoma-associated retinopathy. Electrophysiology confirmed the diagnosis. Adaptive optics retinal imaging (Imagine eyes, Orsay) was performed to assess the cone mosaic integrity across the central retina. This is the first report on the investigation of autoimmune retinopathy using adaptive optics ophthalmoscopy. This case highlights the viability of innovative diagnostic modalities that aid early detection and subsequent management of vision threatening retinal.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Neonatal orbital abscess p. 128
Pratik Y Gogri, Somen L Misra, Neeta S Misra, Hitesh V Gidwani, Akshay J Bhandari
DOI:10.4103/0974-620X.159274  
Orbital abscess generally occurs in older children but it can rarely affect infants and neonates too. We report a case of community acquired methicillin resistant staphylococcus aureus (CA-MRSA) neonatal orbital abscess in a 12-day-old term female neonate with no significant past medical history or risk factor for developing the infection. The case highlights the importance of consideration of CA-MRSA as a causative agent of neonatal orbital cellulitis even in a neonate without any obvious predisposing condition. Prompt initiation of appropriate medical therapy against MRSA and surgical drainage of the abscess prevents life threatening complications of orbital cellulitis which more often tend to be fatal in neonates.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CLINICAL QUIZ Top

Fissure, fluid, and functional loss p. 132
Radha Shenoy, Magda Al Yahyahi, Rashid Mohammed Al Saedi
DOI:10.4103/0974-620X.159275  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
LETTERS TO THE EDITOR Top

Is transcanalicular laser dacryocystorhinostomy using low energy 810 nm diode laser better than 980 nm diode laser? p. 134
Ruchi Goel, Smriti Nagpal, Sonam Garg, Krishan Pal Singh Malik
DOI:10.4103/0974-620X.159276  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

A case of decompressive retinopathy p. 135
Aarti S Agrawal, Suresh J Ramchandani, Abhijit A Naik, Saurabh Shrivastava
DOI:10.4103/0974-620X.159277  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta

Cataract surgery as a risk factor for non-arteritic anterior ischemic optic neuropathy and the intra-operative use of intravitreal corticosteroid p. 136
Jagdeep Singh Gandhi
DOI:10.4103/0974-620X.159278  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
  Feedback 

Submit articles
Most popular articles
Joiu us as a reviewer
Email alerts
Recommend this journal