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ABSTRACT: AIM: To report serious adverse events and long-term outcomes of initial experience with intraocular bevacizumab in retinopathy of prematurity (ROP). METHODS: Consecutive vascularly active ROP cases treated with bevacizumab, in addition to laser and surgery, were analysed retrospectively from a prospective computerised ROP database. Primary efficacy outcome was regression of new vessels. Secondary outcomes included the anatomic and visual status. Serious systemic and ocular adverse events were documented. RESULTS: 24 ROP eyes in 13 babies, received single intraocular bevacizumab for severe stage 3 plus after failed laser (seven eyes), stage 4A plus (eight eyes), and stage 4B/5 plus (nine eyes). Drug was injected intravitreally in 23 eyes and intracamerally in one eye. New vessels regressed in all eyes. Vision salvage in 14 of 24 eyes and no serious neurodevelopmental abnormalities were noted up to 60 months (mean 30.7 months) follow-up. Complications included macular hole and retinal breaks causing rhegmatogenous retinal detachment (one eye); bilateral, progressive vascular attenuation, perivascular exudation and optic atrophy in one baby, and progression of detachment bilaterally to stage 5 in one baby with missed follow-up. One baby who received intracameral injection developed hepatic dysfunction. One eye of this baby also showed a large choroidal rupture. CONCLUSIONS: Though intraocular bevacizumab, along with laser and surgery salvaged vision in many otherwise progressive cases of ROP, vigilance and reporting of serious adverse events is essential for future rationalised use of the drug. We report one systemic and four ocular adverse events that require consideration in future use of the drug.
Archives of Disease in Childhood - Fetal and Neonatal Edition 12/2012; · 3.05 Impact Factor
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ABSTRACT: Blunt ocular trauma in the elderly can result in anterior dislocation of the crystalline lens into the subconjunctival space (phacocele). Although rare, this presentation can be missed, especially if the patient presents several days after the injury and if the lid is not everted on examination. While a careful clinical examination is adequate in the diagnosis, imaging techniques can be put to use for the accurate location of the associated sclera rupture. We report three cases of post-traumatic phacocele wherein ultrasound biomicroscopy (UBM) was compared to the anterior segment optical coherence tomography (AS-OCT) and B-scan ultrasonography (B-scan), in order to establish the best imaging tool for this condition. We concluded, based on image quality, that UBM could be the imaging modality of choice to aid in the diagnosis of phacocele.
Indian Journal of Ophthalmology 01/2012; 60(1):63-5. · 1.02 Impact Factor
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ABSTRACT: Acute retinal necrosis, caused by the herpes family of viruses, is a rapidly progressing ocular inflammatory disorder commonly reported in adults but rarely in children. The accepted diagnostic criteria include presence of 1 or more foci of retinal necrosis, rapid progression, circumferential spread, occlusive vasculopathy, and inflammation in the vitreous and anterior chamber. We report bilateral acute retinal necrosis with encephalitis due to herpes simplex virus (HSV-2) in newborn twins.
Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus 12/2010; 14(6):541-3. · 1.07 Impact Factor
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Retina (Philadelphia, Pa.) 02/2010; 30(2):381-2; author reply 382. · 2.93 Impact Factor
