Bhaskar Gupta

• FRCOphth, Doctorate in Medicine(Research), MSOphthal, DO, MBBS
• Consultant at University Hospital Southampton NHS Foundation Trust

Purpose This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up, and therapeutic approach of uveitic epiretinal membranes (ERM). Methods A thorough investigation of the literature was conducted using the PubMed database. Additionally, a complementary search was carried out on Google Scholar to ensur...

Background Our aim was to examine the long term anatomical and functional outcomes in patients with refractory diabetic macular oedema (DMO) undergoing treatment switch from ranibizumab to aflibercept. Methods Retrospective review of patients with DMO undergoing treatment switch from ranibizumab to aflibercept at a single centre between 2015 and 2...

Matrix metalloproteinase-9 (MMP9) and total amyloid-beta (Aβ) are prospective biomarkers of ocular ageing and retinopathy. These were quantified by ELISA in the vitreous and blood from controls (n = 55) and in a subset of age-related macular degeneration (AMD) patients (n = 12) for insights and possible additional links between the ocular and syste...

Purpose To evaluate visual and anatomic outcomes following pars plana vitrectomy and intravitreal or subretinal tissue plasminogen activator for submacular hemorrhage in patients with age-related macular degeneration. Methods This was a retrospective study on patients with a minimum follow-up of 12 months undertaken at a tertiary referral center....

Purpose This article describes the clinical features and differential diagnosis of 4 cases of sector autosomal dominant (AD) retinitis pigmentosa (RP) studied with multimodal imaging, using autofluorescence (AF) imaging as a key diagnostic tool. Methods The current study is an observational case series of 4 patients with characteristic visual fiel...

Purpose: To contribute a global description of the spectrum of choroidal involvement in tubercular uveitis (TBU). Methods: Retrospective cohort study of TBU patients with choroidal involvement from 25 centers between January 2004 and December 2014. Medical records of patients with a minimum follow-up of 1 year were reviewed. Results: 245 patie...

Purpose To report a rare complication of choroidal neovascular membrane (CNV) after pars plana vitrectomy for macular pathology. Methods Retrospective case series. All cases underwent routine vitreoretinal surgery with membrane blue assisted epiretinal (ERM) and internal limiting membrane (ILM) peel at University Hospitals Southampton NHS Foundati...

A case series was used to evaluate the efficacy of half-fluence photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSCR). Patients were treated with standard-dose verteporfin and half-fluence PDT. Totally 13 eyes from 11 patients were included. The mean patient age was 52.0y. There was a mean reduction in central retinal thick...

Management of postoperative bacterial endophthalmitis was explored in the Endophthalmitis Vitrectomy Study37(EVS) in 1995, which has underpinned the core protocols in treatment ever since. While surgical techniques have continued to evolve, little has changed in the overall clinical management as no further large randomized controlled trials have t...

Aim: Review of current literature regarding infection rates following intravitreal dexamethasone implant shows very little real-world data to date. Comparisons with infection rates following anti-VEGF or triamcinolone injections may not be clinically useful due to differing procedures and localised drug effects. We report the first direct clinical...

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 (...

Background To evaluate the contribution made to the diagnostic work-up for patients with suspected ocular tuberculosis (TB) by QuantiFERON-TB Gold In-Tube (QFT) tests using latent class analysis model. MethodsA single centre retrospective cohort study. A Bayesian latent class model was constructed on the basis of demographics, phenotypes and test r...

Purpose: To review the literature regarding intraocular gas tamponade after vitrectomy for rhegmatogenous retinal detachment. Methods: The history and evolution of the use of gas is described. The theories explaining gas tamponade are discussed, and efficacy and safety studies in human and animal models are covered. Results: A total of 61 arti...

The aim of the study is to provide normative data on endothelium and morphology

AIM: To report the change in visual acuity and central macular thickness (CMT) following treatment with intravitreal aflibercept injections in patients with neovascular age-related macular degeneration (nAMD) with suboptimum response to ranibizumab. METHODS: This was a retrospective study. The inclusion criteria were patients with nAMD who responde...

Purpose: To determine certifications of visual impairment (CVIs) due to diabetic retinopathy (DR) in a region that has operated diabetic screening since 1992. Methods: A retrospective review of all CVIs due to DR was conducted, with mid-year population estimates and a diabetes prevalence model used to determine the annual incidence of certificat...

Purpose: To describe the visual morbidity associated with intraocular tuberculosis (TB) and to report ocular complications of intraocular TB. Methods: Retrospective cohort study of patients diagnosed with intraocular TB at a tertiary referral eye care hospital in central London. Data on baseline and final best-corrected visual acuity (BCVA) along w...

Approximately 10% of UK blindness registrations are attributed to glaucoma[1]. The risk of glaucoma increases with age and it is estimated that the prevalence of chronic open angle glaucoma (COAG) is about 10% in white Europeans who are older than 70. There are an estimated 24.4 million people aged over 40 in England and around 489 000 people are c...

Purpose The true prevalence of retinal detachment and other vitreoretinal disorders in different ethnic groups is not well-established. Understanding differences in vitreoretinal disease prevalence is important to appropriately allocate resources to meet demand where ethnic variation in the community exists. The aim of this study is to provide hosp...

Purpose To compare the intraoperative complications between 23-G and 20-G instrumentation in patients undergoing pars plana vitrectomy (PPV). Methods This was a retrospective comparative study of 4,274 PPV procedures by the same surgical team between 1998 and 2016. A total of 2,648 operations were carried out with 20-G surgery and 1,626 operations...

Purpose: Describe the clinical features and outcomes of patients with peripheral retinal vasculitis (RV) and describe clinical characteristics of presumed tubercular RV in a nonendemic setting. Methods: Retrospective cohort study of 110 consecutive patients with peripheral RV at a tertiary referral eye care center in the United Kingdom. Retinal...

Intraocular tuberculosis (TB) remains a diagnostic and management conundrum for both ophthalmologists and pulmonologists. We analyse the efficacy and safety of anti-tubercular therapy (ATT) in patients with intraocular TB and factors associated with favorable outcome. Twenty-eight studies are included in this review, with a total of 1917 patients....

Tuberculosis (TB) remains a major global health burden and has both pulmonary and extra-pulmonary manifestations. One well-recognised and complex extra-pulmonary form is ocular TB, with its diverse extra- and intra-ocular presentations and often without signs of systemic illness. These could be caused directly by Mycobacterium tuberculosis and infl...

Minimally invasive glaucoma surgery is a developing area that has the potential to replace traditional glaucoma surgery, with its known risk profile, but at present there are no randomised controlled data to validate its use. We report on a case where sequential bilateral combined ab interno trabeculotomy and lens extraction surgery was performed o...

Objective: To describe the clinical spectrum and outcome of patients with presumed tubercular uveitis and choroidal involvement. Methods: A retrospective case series nested in a cohort study was enrolled at a tertiary referral eye care center in the UK. Failure was defined as recurrence of lesion within 6 months of completion of antitubercular t...

Purpose: To describe the ocular and systemic features in biopsy proven (definite) and non-biopsy proven (clinical) ocular sarcoidosis and to compare the ocular features with those proposed by the International Workshop for Ocular Sarcoidosis (IWOS). Methods: Retrospective chart review of 83 patients who attended a tertiary referral uveitis clini...

To assess the impact of antitubercular therapy (ATT), oral steroids and steroid sparing immunosuppressive treatment on treatment success in cases with presumed ocular tuberculosis in an area of low endemic prevalence. A retrospective cross-sectional study was performed for 213 patients with presumed ocular tuberculosis from a database from a tertia...

Objective: To analyze the factors affecting the treatment outcome in patients with presumed ocular tuberculosis on anti-tubercular therapy (ATT). Methods: Retrospective chart review of patients with presumed ocular tuberculosis seen at a tertiary referral eye care center in the United Kingdom. Failure was defined as recurrence of inflammation wi...

INTRODUCTION Congenital nasolacrimal duct obstruction is in the main caused by a membranous obstruction at the distal end of the nasolacrimal duct. For unresolved cases, probing is a successful procedure2–4 , although with increasing age the success rate may be reduced.2 Children who do not respond positively to probing/ intubation may require a Da...

Management of ocular trauma is both challenging and controversial. Using current available evidence in literature and author experience this review aims to highlight critical issues in management of ocular and orbital trauma. This review provides a working framework from initial presentation, investigations, management principles, complications and...

To provide estimates of visual impairment in people with diabetes attending screening in a multi-ethnic population in England (United Kingdom). The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK) Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the...

To compare the prevalence of diabetic retinopathy (DR) in people of various ethnic groups with diabetes in the United Kingdom (UK). The Diabetic Retinopathy In Various Ethnic groups in UK (DRIVE UK) Study is a cross-sectional study on the ethnic variations of the prevalence of DR and visual impairment in two multi-racial cohorts in the UK. People o...

The study reports 10-year anatomical and visual outcome in patients who underwent pars plana vitrectomy (PPV) for complications due to proliferative diabetic retinopathy (PDR). Retrospective analysis of patients undergoing 20 G PPV from January 1999 to May 2010 for tractional retinal detachment (TRD) and non-clearing vitreous hemorrhage (NCVH) seco...

End-stage diabetic eye disease is an important cause of severe visual impairment in the working-age group. With the increasing availability of refined surgical techniques as well as the early diagnosis of disease because of screening, one would predict that the prevalence of this condition is decreasing and the visual outcome is improving. To study...

This study investigates the efficacy of an intravitreal gas injection in inducing a posterior vitreous detachment (PVD) in patients with clinically significant diabetic macular edema refractory to laser therapy. A local ethics committee-approved technique of an intravitreal injection of pure perfluoropropane gas (C(3)F(8)) was performed for all par...

Purpose: The purpose of this study was to present a case of posterior rupture in a previously detached retina after blunt trauma. Method: This is a case report. Result: A child with idiopathic bilateral retinal dialyzes sustained accidental blunt trauma to the left eye while awaiting surgery. This caused a posterior rupture of the retina in an alre...

Ranibizumab (Lucentis), a humanised antibody fragment that inhibits vascular endothelial growth factor (VEGF)-A, is widely used for the treatment of neovascular age-related macular degeneration (NV-AMD). The objective of this study was to compare the outcomes of two different treatment protocols: loading dose (LD) and pro re nata (PRN (as needed))...

Retinal pigment epithelial detachment (PED) is a recognised associated finding in central serous chorioretinopathy (CSC). We report our experience in treating patients using photodynamic therapy (PDT) in a variant of chronic CSC that presents with only an isolated PED. We present long-term follow-up data and novel observations on the pattern of ret...

Bietti crystalline dystrophy is a rare autosomal recessive condition characterised by the presence of crystals in the retina and is followed by retinal and choroidal degeneration. We present a novel finding of juxtafoveal choroidal neovascularisation in Bietti crystalline dystrophy and demonstrate a spectral domain optical coherence tomography imag...

Ranibizumab (Lucentis, Novartis, Basel, Switzerland) is currently indicated for use in neovascular age-related macular degeneration (NVAMD). This study assessed the real-life outcomes based on baseline visual acuity when treated with intravitreal ranibizumab on a three + pro re nata (PRN) dosing schedule for NVAMD. This retrospective chart-review w...

Neovascular age related macular degeneration (AMD) is relatively uncommon in the black population. We report the 12-month outcome of ranibizumab therapy in five black patients with choroidal neovascular membrane (CNV) secondary to AMD. Retrospective analysis of a prospective audit database maintained for all patients on ranibizumab therapy in a ret...

Roopa Vemala, Bhaskar Gupta, Sobha SivaprasadLaser and Retinal Research Unit, King’s College Hospital, London SE5 9RS, UKIntroduction: Neovascular age related macular degeneration (AMD) is relatively uncommon in the black population. We report the 12-month outcome of ranibizumab therapy in five black patients with choroidal neovascular membrane (CN...

The pathophysiology of sickle cell disease is not limited to abnormal red blood cells. The clinical manifestations of sickle cell disease include complex pathways and processes such as endothelial activation, inflammation, bioavailability of nitric oxide, oxidative stress, and the adhesiveness of a variety of blood cells. Increasingly, distinct sub...

The intravitreal injection of an expansile gas bubble can relieve vitreofoveal traction and be used as an outpatient-based procedure for impending macular hole. We present a case in which this procedure was successfully employed and demonstrated with spectral domain optical coherence tomography (OCT) imaging.

BACKGROUND AND OBJECTIVE A program involving three operations—the first to reattach most of the retina under silicone oil, the second to reattach the remaining retina by planned delayed relaxing retinectomy (PDRR), and the third to remove silicone oil—was tested. PATIENTS AND METHODS Review of electronic records of patients receiving PDRR for prol...

To describe the use of intravitreal bevacizumab in idiopathic retinal vasculitis prior to vitrectomy and delamination. A young healthy male presented with idiopathic retinal vasculitis. His condition was refractory to panretinal photocoagulation and systemic steroids. The progression of his condition necessitated vitrectomy and delamination. Intrav...

Central serous chorioretinopathy (CSC) is usually characterized by a localized detachment of the neurosensory retina that is self-limiting. However, some cases may persist or recur leading to degenerative changes of the retinal pigment epithelium and the neurosensory retina resulting in severe visual loss and requiring intervention. This retrospect...

Retinal angiomatous proliferation (RAP) accounts for 12-15% of all patients with neovascular age-related macular degeneration (NV-AMD). However, this subtype is often excluded from clinical trials aimed at assessing the efficacy of various treatment options for NV-AMD. Thus, there are no established protocols for the management of RAP. This review...

To classify the clinical characteristics that might identify patients who may not require next-day follow-up following routine vitreoretinal intervention. Prospective case series. The only statistically significant factors for raised intraocular pressure (IOP) were gas tamponade and preoperative raised IOP. 44.7% (17/38) of patients with preoperati...

Purpose To assess the visual outcome following intravitreal ranibizumab in eyes with wet age related macular degeneration(AMD) in patients with three different baseline vision viz; <35, 35‐54 and >54 ETDRS letters. Methods This study assessed the ETDRS visual acuity at diferent time points in a total of 98 patients.Optical coherent tomography and f...

Choroidal neovascularisation (CNV) is characterised by new blood vessel growth under the retina that usually results in significant visual impairment when the fovea is involved. Though CNV is more commonly associated with age-related macular degeneration (AMD), it can occur secondary to a variety of other diseases. Recent successes with anti-angiog...

IntroductionIn this pilot study the effects of vitrectomy on PO2 in the vitreous cavity in CRVO were investigated. Study designProspective, controlled, interventional study. MethodSix patients with ischaemic CRVO in one eye (undergoing vitrectomy for radial optic neurotomy, RON) and six with either macula hole or membrane were included. An oxygen...

Data on the outcome of surgery facilitate informed preoperative patient counselling. Most studies on the outcome of surgery for idiopathic full thickness macular hole surgery have concentrated on rates of anatomical closure. The aim of this study was to identify factors predicting visual success (better than 20/40; 6/12 Snellen) following macular h...

Patients with central retinal vein occlusion (CRVO) may experience reduced vision in the morning. This may be due to increased cystoid macular oedema (CMO), which can be measured on optical coherence tomography (OCT). A prospective study was performed on ten patients. Retinal thickness measurements were made with the Topcon 3D OCT-1000: at 9 A.M.,...

To investigate the effectiveness of a new technique for the identification of occult retinal breaks in vitrectomy retinal detachment repair. Dye Extrusion Technique involves injection of sub retinal dye and extrusion through the unidentified breaks using perfluorocarbon liquid. Retrospective case note analysis. Main outcome measures: rate of break...

Proliferative vitreoretinopathy (PVR) is a severe complication of retinal detachment, which can be treated surgically by relaxing retinectomy. In this study, we describe patients with severe inferior retinal folding after this surgical intervention (SIRF). A retrospective review of the electronic patient records of 254 patients who received relaxin...

A case of spontaneous, painless partial III (pupil-sparing) and IV fascicular nerve paresis as the first presentation of anaplastic astrocytoma is reported. The other ocular, neurological and systemic examination was within normal limits. The literature and possible anatomical location of this atypical presentation is reviewed.