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356
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Introduction
Skills and Expertise
Current institution
Publications
Publications (356)
Purpose
To analyze the efficacy of scleral buckling in the hands of vitreo-retina (VR) fellows under training in eyes with retinal detachment associated with retinal dialysis and analyze the patient and retinal characteristics in these eyes.
Methods
We carried out a retrospective consecutive case review at a tertiary eye care center in North India...
Purpose:
To compare the diagnostic ability of macular ganglion cell inner plexiform layer (mGCIPL) and peripapillary retinal nerve fiber layer (pRNFL) thickness on optical coherence tomography (OCT) and macular and peripapillary perfusion changes using OCT angiography (OCTA) in glaucoma suspect and early primary open angle glaucoma (POAG).
Method...
Purpose
To describe the features of peripheral retinal degenerations using an Ultra-Widefield (UWF) Swept Source Optical Coherence Tomography (SS-OCT).
Method
In this cross-sectional study done at a tertiary eye care centre in Northern India, peripheral retinal degenerations such as lattices, snail track lesion, paving stone, White With-Out Pressu...
Angioid streaks are irregular breaks in the brittle Bruch’s membrane and commonly present as pigmented linear lines radiating from the optic disc. They may be associated with systemic disease in up to 50% of the patients. Systemic diseases such as pseudoxanthoma elasticum, Paget’s disease, and hemoglobinopathies are commonly associated with angioid...
Microvascular complications of diabetic retinopathy (DR) may require surgical intervention in the form of vitrectomy. Since its inception, diabetic vitrectomy has evolved with introduction of better instruments, newer techniques, and smaller port sizes. Common indications for diabetic vitrectomy include nonresolving vitreous hemorrhage, tractional...
Hard Exudate (HE) is a common manifestation of various eye diseases, such as diabetic retinopathy (DR), and a prominent cause of vision loss and blindness. Researchers aim to visualize and quantify these exudates using deep learning (DL) and image processing (IP) models from retinal images. However, the requirement for a large number of labelled im...
A man in his 20s presented with complaints of diminution of vision in both eyes for the past 15 days. He had a history of carcinoma colon for which he underwent hemicolectomy 2 months ago. There was vitritis with white fluffy exudate lesion suggestive of infective foci along the superior arcade, which was noted on fundus examination. A provisional...
Th17/Treg cell balance is essential for immune homeostasis and when disrupted, is associated with the occurrence and development of inflammation in numerous autoimmune diseases. However, its contribution in path-ophysiology of uveitis remains unexplored. In this study, we deciphered the role of Th17/Treg cell balance in autoimmune uveitis subjects....
Choroidal neovascular membrane (CNVM) in Vogt-Koyanagi-Harada disease (VKH) is a known entity, observed primarily during the chronic convalescent and chronic-recurrent phases of the disease. However, the peripapillary location of CNVM is a rare finding.
We describe a case of chronic VKH with bilateral peripapillary CNVM detected using multimodal i...
PURPOSE
The purpose of this study was to identify biomarkers that predict the response of treatment-naive idiopathic choroidal neovascularization (iCNV) to anti-VEGF treatment.
METHODS
Fourteen eyes diagnosed with iCNV underwent a dilated fundus examination, Swept Source Optical Coherence Tomography (SS-OCT) and Optical Coherence Tomography - Angi...
A 33-year-old male presented with unilateral painless vision loss with a history of sub-tenon steroid for the same. The fundus showed an elevated focus of retinochoroiditis with vitritis. On investigating for the cause, polymerase chain reaction test on the anterior chamber tap was found to be positive for Toxoplasma. Such confusing and atypical ca...
Purpose
To study ultra-widefield indocyanine green angiography (ICGA) patterns in central serous chorioretinopathy (CSC).
Methods
A cross-sectional observational study was undertaken on 30 patients aged 20 to 60 years with CSC at the retina clinic of a tertiary care center. Of them, 43 eyes were affected by CSC, whereas 17 eyes were unaffected as...
A late adolescent with tuberous sclerosis (TS) presented with reduced vision in one eye to our tertiary care university hospital 4 years ago. Fundus examination revealed multiple retinal astrocytic hamartomas (RAHs) in both eyes. His younger sibling, who also had TS, was found to have RAH on retinal screening. The swept-source optical coherence tom...
Background
This study aimed to compare the clinical outcomes of a heparin surface-modified (HSM) hydrophobic acrylic foldable intraocular lens (IOL) (CT LUCIA 601PY) and non-heparin-modified hydrophobic acrylic foldable IOL (AcrySof IQ SN60WF) in diabetic patients undergoing phacoemulsification.
Methodology
This randomized, single-surgeon, double-m...
Purpose
To compare Supine versus Prone positioning in fresh rhegmatogenous retinal detachments (RRDs) treated with vitrectomy and gas tamponade.
Methods
This was a prospective randomized controlled trial of 72 eyes with fresh RRD who underwent 25-gauge vitrectomy. 37 eyes were allotted supine position and 35 were allotted prone position. Cases wer...
Purpose
To assess whether medical undergraduates can be trained to effectively screen diabetic retinopathy (DR) by statistical comparison with a retina specialist at a tertiary eye care center in India.
Methods
Three final-year undergraduate medical students, having completed ophthalmology department rotation, received training from a retina speci...
AIM: To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to treatment. • METHODS: An observational study comprised of 201 uveitic patients presenting for the first time to our centre from January 2019 to June 2020. Detailed information regarding systemic investigations undertaken by specialists at...
AIM: To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to treatment. METHODS: An observational study comprised of 201 uveitic patients presenting for the first time to our centre from January 2019 to June 2020. Detailed information regarding systemic investigations undertaken by specialists at t...
Purpose
The efficacy of additional barrage laser posterior to ridge in advanced stage 3 or stage 4 retinopathy of prematurity (ROP) is established, but its role in early stages is not defined. The objective was to study the efficacy of additional posterior barrage laser in type I zone 2 disease.
Methods
In a randomized trial, patients with type I...
Prcis:
In primary angle closure glaucoma (PACG), micropulse cyclophotocoagulation resulted in a significant reduction in intraocular pressure (IOP), and the number of antiglaucoma medications without any sight-threatening complications. However, the IOP lowering efficacy decreased over time.
Purpose:
The purpose of this study was to evaluate the...
Purpose:
To analyze the topographic distribution of neovascularization (NV) and capillary nonperfusion (CNP) using ultra-wide field fluorescein angiography (UWFFA) in patients with proliferative diabetic retinopathy (PDR).
Methods:
This was a prospective, single-center, observational study in which all patients who presented between March 2019 a...
Significance:
This is the first human study that confirmed penetration of 0.01% topical atropine in aqueous and vitreous humor in live human eyes. This supports the possible mode of action of atropine via posterior ocular structures. This knowledge will help improve the outcomes in myopia management.
Purpose:
The purpose of this study was to eva...
A Buckle Suture Gone Wrong Scleral buckling surgery was performed on the left eye of a 35-year-old woman with pathologic myopia and subtotal rhegmatogenous retinal detachment. Intraoperatively, inadvertent perforation of the thin ocular coats was suspected after noticing unintentional external drainage of subretinal fluid. The needle was withdrawn...
Purpose:
To report a case a patient of anterior uveitis, iris neovascularization, high IOP and vasculitis in a patient with subconjunctival and intra ocular caterpillar hair.
Method:
Case report.
Results:
A 30-year-old man complaining of episodes of blurring of vision and colored haloes in his LE was referred for high IOP that was uncontrolled...
Purpose:
To assess the characteristics of completed PRP, using UWF in PDR.
Methods:
Quantitative assessment of UWF images of 133 patients with PDR with completed PRP was made using Image J software. The parameters assessed included distance of laser spots from the optic disc, foveal centre, superior and inferior arcade, extent of maximum width o...
Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED) is a multisystemic rare genetic disorder characterised by abnormalities of the immune system. We report the ocular features of APECED in two siblings of an Indian family, out of four who are still living. The ocular features of this disorder primarily included madarosis, refrac...
Purpose:
To derive a formula for accurate axial length (AL) assessment using routine ultrasound in silicone oil-filled eyes, where optical biometry is unavailable or not possible.
Methods:
This was a prospective, consecutive, nonrandomized study of 50 eyes of 50 patients conducted in a tertiary care hospital in North India. AL measurements were...
Purpose:
To study the long-term microvasculature changes at the macula and the optic disk in eyes with nonarteritic anterior ischemic optic neuropathy (NAION).
Methods:
Patients with acute NAION of less than 6 weeks duration were included. Optical coherence tomography angiography (OCTA) of the macula and the optic disk was performed at baseline,...
Objective: To describe a novel reverberation artifact named corneal reverberation artifact in ocular ultrasound.
Design: Prospective observational study.
Subjects: 30 eyes with decompensated corneas were grouped into two groups- group A (with positive corneal reverberation on USG) and group B (without reverberation artifact).
Methods: 30 eyes with...
A man in his 20s presented with diminished vision in the left eye. He had a history of Pott’s spine and had been diagnosed elsewhere as having left eye tubercular granuloma in the retina. He was started on anti-tubercular therapy and high-dose oral steroids. He presented to us 1 month later. Presently fundus examination revealed a yellow to whitish...
Retinopathy of Prematurity (ROP) is the most common cause of visual impairment among premature babies throughout the world. The consequence of ROP impairment can be minimized by performing suitable screening and treatment. However, due to deficiency of health care resources, many of these premature infants remain unidentified after birth. As a resu...
Purpose:
To compare disease regression in cases of Fluorescein Angiography (FA) guided laser vs. conventional laser treatment in infants with Aggressive retinopathy of prematurity (AROP).
Methods:
60 eyes of 30 infants of AROP were randomized into two groups. In both the group's FA was done once. Montage of the fundus, FA images was created and...
Background
The definitive diagnosing of ocular tuberculosis (TB) is difficult; therefore, there is a need of better understanding of investigating TB DNA in presumed ocular TB patients.
Objectives
The aim of this study is to correlate tubercular DNA PCR of aqueous/vitreous and blood in cases of presumed ocular TB.
Design
A prospective study.
Met...
Purpose:
To study the effect of subthreshold micropulse yellow laser treatment on central serous chorioretinopathy (CSC) and to compare two laser protocols. As per our knowledge, there are no studies comparing the two protocols of subthreshold laser.
Methods:
Twenty-three patients with non-resolving CSC of at least three months duration were tre...
Background and Aims
Optical Coherence Tomography Angiography (OCTA) images retinal vasculature without the need of contrast injection. In the present study we aim to determine whether OCTA findings can predict functional outcomes (mRS, modified Rankin Score) in patients with ECAD -stroke.
Material and Methods
This Exploratory study enrolled was per...
The standard of care for posterior segment disorders such as wet age-related macular degeneration, diabetic macular oedema and retinal vascular occlusions is pharmacotherapy by intravitreal drug delivery. Since the therapeutic effect of these drugs lasts only around 4 to 8 weeks, repeated intravitreal injections are required. Pain is experienced by...
Purpose:
To assess the macular vessel density (VD) on optical coherence tomography angiography (OCT-A) using proprietary software (automated) and image processing software (manual) in diabetic patients.
Methods:
In a retrospective study, OCT-A images (Triton, TOPCON Inc.) of type 2 diabetics presenting to a tertiary eye care center in North Indi...
Systemic immunosuppressants and biologicals have been a valuable tool in the treatment of inflammatory diseases and malignancies. The safety profile of these drugs has been debatable, especially in localized systems, such as the eye. This has led to the search for fairly local approaches, such as intravitreal, subconjunctival, and topical route of...
Background
To analyse the varied clinical profile and treatment outcomes of posterior zone 1 retinopathy of prematurity (ROP).
Methods
This retrospective case-series included 54 eyes of 27 infants of posterior zone 1 ROP treated at our centre from January 2018 to June 2019. Three clinical patterns were observed at presentation - Posterior zone 1 R...
We read with great interest the review article on ocular syphilis published in your journal. 1 Furtado and Smith should be congratulated for the excellent article which has addressed the re-emergence of syphilis and highlighted the varied presentations of ocular syphilis. The article mentions vitritis associated with retinitis and chorioretinitis....
Purpose:
To determine and validate retinal vascular caliber measurements by using the confocal scanning laser ophthalmoscopy system. Retinal vasculature changes are often regarded as clinical markers for systemic disease.
Methods:
It was a prospective observational study conducted on 600 eyes of 300 normal subjects with no systemic or ocular ill...
Purpose:
Real-life comparison of three intravitreal drug regimens used in cases of endophthalmitis at a tertiary care center in India.
Methods:
In this prospective, comparative study, patients of bacterial endophthalmitis were grouped according to intravitreal antibiotic drug regimens into Group 1 (ceftazidime and vancomycin), Group 2 (piperacil...
Objective
To determine whether Optical Coherence Tomography Angiography (OCTA) findings of retinal and Optic Nerve Head (ONH) can help predict functional outcomes (mRS, modified Rankin Score) in patients with Extracranial Carotid Artery Atherosclerotic Disease (ECAD).
Background
OCTA can image retinal vasculature without the need of contrast injec...
Purpose:
To compare pneumatic vitreolysis and pars plana vitrectomy in the management of focal symptomatic vitreomacular traction (VMT).
Method:
Patients aged 18 years or older, with idiopathic focal symptomatic VMT and best-corrected visual acuity <20/40, without any other retinal pathology were randomized to undergo pneumatic vitreolysis (Grou...
Congenital heart disease can be classified physiologically into 3 categories: volume overload, cyanotic, and obstructive. Cyanotic congenital heart disease (cCHD) includes lesions with right-to-left shunts or mixing abnormalities (e.g., transposition of the great vessels, persistent truncus arteriosus, tetralogy of Fallot).1 Tetralogy of fallot (To...
A 56-year-old woman presented with floaters and diminution of vision in the right eye for 1 week. On examination, visual acuity was 20/400 in the right eye and 20/60 in the left eye. Indirect ophthalmoscopy revealed vitritis in the right eye and subretinal deposits in both eyes. Vitreous biopsy of the right eye revealed large B-cell-type primary in...
It explains in detail (with illustrations) the various aspects of anatomy and physiology of the retina and choroid along with their clinical implications.
The world is facing a myopia pandemic. Pathological myopia can lead to severe vision loss. This chapter includes the latest pathophysiology, classification systems, clinical features (with illustrations) of pathological myopia. Diagnostic and management strategies for myopic CNVM and myopic foveoschisis are described in detail. The focus has been o...
This chapter deals with the latest innovations in the field of vitreoretinal surgery like 3D Heads Up vitrectomy (digitally assisted vitreoretinal surgery), Improvement in retinal instrumentation, role of microscope-integrated OCT and special considerations related to COVID-19 while performing vitreoretinal surgeries.
Retinopathy of prematurity (ROP) is the leading cause of blindness in premature babies worldwide. ROP is
quantified through the structural information of the retinal vessel map, such as vessels width, tortuosity and
extent. Therefore, the accuracy of quantitative studies depends on the quality of the segmented blood vessels’
map. Fundus images used...
Purpose:
Stress and Type A personality are established risk factors for the development of central serous chorioretinopathy (CSC). Meditation is known to have a positive effect on reducing stress levels. This study aimed to assess the effect of short-term meditation training in patients of CSC.
Methods:
A pilot study was conducted where 40 patie...
Purpose:
To determine the utility of optical coherence tomography-angiography (OCT-A) in diabetic retinopathy (DR) and comparison versus fluorescein angiography (FA) in vision-threatening diabetic retinopathy (VTDR).
Methods:
In this cross-sectional observational study, 60 eyes with no DR (NDR), 60 eyes with non-proliferative diabetic retinopath...
Sympathetic ophthalmia is a rare bilateral diffuse granulomatous panuveitis that usually results from surgical or penetrating trauma to one eye. The symptoms range from impaired near vision to pain, photophobia, and loss of visual acuity. Anterior segment manifestations include bilateral acute uveitis with mutton-fat keratic precipitates and poster...
Purpose:
To assess the retinal features in eyes with postoperative metamorphopsia (POM) following rhegmatogenous retinal detachment (RRD) repair using multimodal imaging (MMI).
Methods:
In this cross-sectional; case-control study, patients after successful RRD repair following 25-gauge vitrectomy, clear vitreous cavity, and corrected distance vi...
Background:
Regular screening for retinopathy and timely intervention reduces blindness from diabetes by 90%. Screening is currently dependent on the interpretation of images captured by trained technicians. Inherent barriers of accessibility and affordability with this approach impede widespread success of retinopathy screening programs. Herein,...
Optical coherence tomography angiography (OCTA) is a non-invasive tool to assess the retino-choroidal vasculature in vivo. It tracks the red blood cell movement and maps the vasculature in quick succession. In routine, diabetic retinopathy, age related macular degeneration, central serous chorioretinopathy, and others are commonly being studied to...
Age-related macular degeneration (ARMD) is one of the prominent causes of central visual loss in the older age group in the urbanized, industrialized world. In recent years, many epidemiological studies and clinical trials have evaluated the role of antioxidants and micronutrients to prevent the progression of ARMD. In this article, we review some...
A family of three siblings affected with gyrate atrophy of the choroid and retina is presented. Ultrawide field fundus imaging was used to monitor the progression of the disease objectively over 5 years.
Purpose:
To compare the anatomical and functional outcomes of drainage through posterior retinotomy (PR) versus perfluorocarbon liquid (PFCL)-assisted drainage in vitreoretinal surgery (VRSx) for rhegmatogenous retinal detachment (RRD) and to study intra-operative and post-operative complications.
Methods:
This was a prospective randomized study...
Background:
Members of genus Rhodotorula are widely distributed in nature and have been traditionally considered non-pathogenic. Last few decades have seen the yeast as an emerging pathogen. We observed increase in numbers of Rhodotorula isolates from ocular infections in last few years, thus this prospective study was planned.
Objectives:
1. To...
An 18-year-old man presented with decreased vision in the right eye (OD) noticed for 1 month. On examination, OD best-corrected visual acuity was 3/60 and the left eye (OS) was 6/6 with intraocular pressure of 12 mm Hg in both the eyes (OU). OD fundus revealed an inferior optic-disc-pit with macular-retinoschisis and an inferior choroidal coloboma....
A 19-year-old man with Alport syndrome presented with diminution of vision in his left eye. Slit-lamp biomicroscopy showed an early anterior lenticonus with an anterior subcapsular cataract in his right eye (Fig. 1A) and a dense anterior polar and anterior subcapsular cataract in his left eye (Fig. 1B). Fundus photography revealed central perimacul...
To determine the demographic profile, clinical features and surgical outcomes of giant retinal tear (GRT) related retinal detachments (RD) in children.
In this retrospective study, medical records of children aged 14 years and below, who underwent surgery for RD at our centre in the last 5 years were reviewed. Among these, we selected medical recor...
Purpose:
To evaluate risk factors and outcomes of preferred practice for infants with aggressive posterior retinopathy of prematurity (APROP) at a tertiary eye center in India.
Methods:
This was an observational study of infants with APROP where patients were divided into three groups after 2 weeks of initial treatment depending on the treatment...
Optical coherence tomography angiography (OCTA) images the layers of retinal and choroidal vasculature in the absence of an injectable dye. Since its introduction, OCTA has been utilized in various posterior segment diseases, including central serous chorioretinopathy (CSCR). We provide a comprehensive review of OCTA's application to CSCR published...
