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Srinivasan Sanjay

Srinivasan Sanjay

MBBS, MS(Ophth), DNB(Ophth), MRCS(ED)(Ophth), MMED(Oph) MNAMS

About

215
Publications
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1,495
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Introduction
COVID-19; Dengue; Herpes zoster; Ocular infections; Ocular inflammation

Publications

Publications (215)
Article
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In the dynamic field of ophthalmology, artificial intelligence (AI) is emerging as a transformative tool in managing complex conditions like uveitis. Characterized by diverse inflammatory responses, uveitis presents significant diagnostic and therapeutic challenges. This systematic review explores the role of AI in advancing diagnostic precision, o...
Article
Severe acute respiratory syndrome corona virus 2 (SARS‐ CoV‐2) infection associated respiratory disease – COVID‑19 (2019‑nCoV) is currently a pandemic involving more than 151,767 infected patients in India,[1] and over 5,404,512 cases all overthe world.[2] Reports have shown the likelihood of disease transmission through the ocular secretions of pa...
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Acute retinal necrosis (ARN) is a sight-threatening ophthalmic emergency that requires aggressive treatment to prevent irreversible vision loss. However, primary treatment failure (PTF), where the initial antiviral therapy is ineffective, is a common challenge in ARN management. This comprehensive review examines PTF in ARN, drawing insights from a...
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Background: The coronavirus disease 2019 (COVID-19) pandemic created new challenges for private eye care practices. Safety issues were encountered by both the healthcare workers and patients. This short communication addresses the changes made in our private eye care practice during the pandemic and the valuable lessons learned for the future. Meth...
Article
A woman in her late 30s presented with sudden diminution of vision, redness and pain in the right eye (OD) of 10 days’ duration. Best corrected visual acuity (BCVA) was 20/160 in OD and 20/20 in the left eye (OS). Anterior segment of OD showed keratic precipitates, flare 3+, cells 2+ and a festooned pupil. Vitreous haze and cells were seen in OD. F...
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Purpose To study the choroidal thickness (CT) and central macular thickness (CMT) in post-fever retinitis (PFR) and their correlation with visual acuity and treatment. Methods A retrospective, observational study of patients presenting with PFR from 2013 to 2021 and with spectral domain optical coherence tomography (SD-OCT) (Heidelberg®, Spectrali...
Article
A woman in her 60s presented with diminution of vision and redness in her right eye (OD) 1.5 months duration, 10 months post cataract surgery. The best-corrected visual acuity (BCVA) on the OD was fingers counting at 0.5 m. The anterior section of the OD demonstrated superior pre-Descemet’s intrastromal bleeding, superior dense fibrovascular growth...
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Purpose: To compare various ocular thermography parameters in posterior scleritis (PS), choroiditis (choroidal granuloma [CG], Vogt–Koyanagi–Harada [VKH] syndrome), central serous chorioretinopathy (CSCR), and healthy controls. Methods: This retrospective, observational, comparative study evaluated cases undergoing ocular thermography between April...
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Purpose To study cases of Fuchs’ uveitis (FU) diagnosed as uveitis other than FU at initial visits. Methods A retrospective, observational chart review. Details of clinical presentation, initial diagnosis, treatment details, and follow-up before and after the diagnosis of FU was studied. Result Twenty eyes of 19 patients finally diagnosed with FU...
Article
Objective To describe a case of bilateral retinal vasculitis due to presumed sarcoidosis and rickettsial retinitis complicated with neovascularization with tear biomarker analysis. Methods A retrospective case report. Results A 16-year-old male presented with bilateral retinal vasculitis and retinitis in both eyes with inferotemporal quadrant neo...
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Background: Radiation retinopathy is a major cause of vision loss in patients receiving radiotherapy to the head and orbit. Diabetic retinopathy is included in the differential diagnosis owing to similar clinical features, including microaneurysms, cotton-wool spots, hard exudates, and macular edema. The only significant pathological difference is...
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Background Immunologic and inflammatory adverse effects following vaccination against COVID-19 are being reported. While some reactions may develop denovo others concern its immunogenic effect in patients with pre-existing inflammatory conditions. Methods Retrospective consecutive patients diagnosed with ocular inflammatory manifestations within 8...
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To demonstrate viral proteins/inflammatory cytokines in a patient with unilateral keratouveitis. Retrospective case report. A 70-year-old Asian-Indian male presented with acute onset of blurring of vision in the left eye (OS) of 2 days duration. He had was coronavirus disease 2019 (COVID-19)-positive 3 months earlier. He had undergone cataract surg...
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he current study explores the occurrence of ophthalmic manifestations following coronavirus disease-19 (COVID-19) vaccination. The study discusses the case of a 72-year-old Indian male, who received oral methotrexate for ocular inflammation (recurrent post-operative uveitis with pseudoexfoliative glaucoma) and two doses of COVISHIELD™ vaccine and a...
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Purpose: To study the impact of the novel coronavirus disease‑2019 (COVID‑19) pandemic on incidence, seasonal variation, clinical presentation, and disease outcome of epidemic retinitis (ER) and to compare clinical outcomes with positive and negative COVID‑19 serology. Methods: This is a retrospective, observational study conducted at a tertiary ey...
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Purpose To study the clinical presentation and treatment outcome of epidemic retinitis (ER) during pregnancy. Methods This is a retrospective, observational chart review of pregnant patients diagnosed with ER from January 2014 to February 2023. Demographic details, month of pregnancy at the onset of ocular symptoms, history of present illness, cli...
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Monitoring of Weil-Felix test in epidemic retinitis: An update Dear Editor, A four-fold increase in two sera of Weil-Felix test (WFT) within 1-2 weeks between the acute and convalescent phase of systemic disease is considered diagnostic of rickettsial infections. [1] We recently reported on decreasing titers of WFT in cases of epidemic retinitis (E...
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Background: The coronavirus disease (COVID-19) vaccines exert ocular adverse effects, including episcleritis, scleritis, anterior and recurrent uveitis, acute macular neuroretinopathy, paracentral acute middle maculopathy, ophthalmic vein thrombosis, Graves' disease, arteritic anterior ischemic optic neuropathy, non-arteritic anterior ischemic opti...
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A 36-year-old Asian Indian male presented with redness and pain in his right eye of 1 week duration. He was diagnosed to have right acute anterior uveitis and had a history of being admitted at a local hospital for dengue hepatitis a month earlier. He had been on adalimumab 40 mg three weekly once and oral methotrexate 20 mg/week for human leucocyt...
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The aim of this study is to report the clinical features, imaging findings including confocal imaging, corneal nerve fiber analysis, and management outcomes in a series of three cases of varicella zoster virus (VZV) reactivation following one dose of coronavirus disease 2019 (COVID-19) vaccination. This was a retrospective and observational study....
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Purpose: To evaluate choroidal lesions with spectral domain optical coherence tomography (SD-OCT) scan in varicella zoster virus (VZV) uveitis. Methods: VZV-uveitis cases which underwent OCT scan for choroidal lesions were studied. SD-OCT scan passing through these lesions was studied in detail. Subfoveal choroidal thickness (SFCT) during active...
Article
A man in his early 20s presented with acute loss of vision in his only eye, the left eye (OS), and was on oral steroids. He had lost vision in his right eye during his childhood and the cause was unknown. There was no history of trauma. Best-corrected visual acuity (BCVA) in OS was 20/100 and in the right eye was hand movements. OS showed non-granu...
Article
A man in his early 50s on regular follow-up for a stable non-proliferative diabetic retinopathy (NPDR) presented with decreased vision, worsening of retinal pathology and macular oedema in both eyes. His corrected distance visual acuity (CDVA) was 6/9 in the right eye and 6/15 in the left eye and fundus examination showed multiple intraretinal haem...
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Background: Coronavirus disease (COVID-19) vaccines can cause adverse ocular effects, including vascular insults, acute macular neuroretinopathy, paracentral acute middle maculopathy (PAMM), ophthalmic vein thrombosis, Graves’ disease, arteritic anterior ischemic optic neuropathy (A-AION), and nonarteritic AION. Here, we report a case of unilateral...
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A young adult Asian Indian male presented to us with a 1-month history of trauma to the right eye (RE) with a tennis ball. He had intraocular pressure (IOP) of 32 mmHg while on three topical antiglaucoma drugs and oral acetazolamide, with uncontrolled inflammation in the anterior chamber (AC) and arteriolar occlusions in the periphery. His best cor...
Article
Introduction: Coronavirus disease (COVID-19) vaccines have been reported to have ocular side effects including scleritis and episcleritis. Purpose: To report scleritis and episcleritis within a month following administration of COVID-19 vaccine. Methods: Retrospective case series. Results: 15 eyes of 12 consecutive patients with scleritis an...
Article
Background: Anterior staphyloma is defined as a localized defect in the anterior eye wall with protrusion of the uveal tissue due to alterations in scleral thickness and structure. The causes could be congenital, trauma, or following infection. Surgical options include staphylectomy with graft (corneal/corneoscleral), biosynthetic graft, enucleati...
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Background: Corneal melt with iris prolapse is a rare complication of autoimmune diseases, especially rheumatoid arthritis. Purpose: To highlight a challenging case of a peripheral ulcerative keratitis (PUK) with corneal melt and iris prolapse in a patient's only eye. Synopsis: A 56-year-old Asian Indian male presented with blurring of vision...
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Purpose: The objective was to study the positivity of the Weil-Felix test (WFT) in epidemic retinitis (ER) during the course of the disease. Methods: This is a retrospective, observational case series of patients diagnosed with ER and presented to a tertiary eye care hospital in south India. Patients with positive WFT at the presentation, and wh...
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A 35-year-old Asian Indian female previously diagnosed with bilateral anterior uveitis and on oral methotrexate developed bilateral anterior uveitis following first/second dose of coronavirus disease 2019 (COVID-19) vaccination. She had skipped her weekly dose of oral methotrexate following first dose of vaccination. Following the second dose, she...
Article
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Purpose: To evaluate efficacy of topical interferon alfa-2b (IFN) in the treatment of uveitic macular edema (UME). Methods: This is a prospective, interventional case study of patients with UME. Injection IFN was reconstituted into eye drops and a four times/day (QID) application was prescribed. Central macular thickness (CMT) on optical coheren...
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Background: Snow ball associated ocular injuries are rare. We present the 1st case of a snow ball injury reported in India with symptoms occurring after 10 days. Purpose: To highlight the fact that symptoms can occur many days after the injury. The injuries can cause structural damage to ocular structures and can be permanent. Synopsis: A 25-y...
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Introduction Varicella zoster virus (VZV) uveitis presenting as acute retinal necrosis with vasculitis is well known, but VZV-vasculitis without retinitis is rarely reported. Identification of such presentation can be challenging especially when other signs of ocular VZV are absent. This is particularly important before considering immunomodulatory...
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A South Asian woman in her 60s, presented with complaints of blurring of vision in her right eye for 10 days. She was a known case of adeno-carcinoma of the lungs with brain metastasis. Her recent positron emission tomography scan showed hepatic metastasis and regressing lobulated mass in the lungs but no ocular involvement. She had received radiot...
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Background: Dengue fever is associated with various sight-threatening ocular manifestations, some of which can occur several months after fever. These include subconjunctival hemorrhage, vitreous hemorrhage, retinal hemorrhage, cotton wool spots, central and branch retinal artery occlusion, central scotoma, papilledema, optic neuropathy, retinal va...
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Coronavirus disease 2019 (COVID-19) is associated with ocular involvement either during or after the infection. These include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, reactivation of anterior uveitis, or presenting as anterior sclero-uveitis, cotton wool spots, retinal hemorrhages, retinal artery/vein occlusion, ophthalmic artery...
Article
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Coronavirus disease 2019 (COVID-19) is associated with ocular involvement either during or after the infection. These include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, reactivation of anterior uveitis, or presenting as anterior sclero-uveitis, cotton wool spots, retinal hemorrhages, retinal artery/vein occlusion, ophthalmic artery...
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Characteristics and course of known seasonal diseases of pre-coronavirus disease (COVID-19) pandemic era may or may not change during the pandemic. Labelling COVID-19 as a novel etiology for those seasonal diseases or considering it as coinfection is debatable. Appropriate investigations are required to rule out previously known etiologies before c...
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Purpose: To evaluate the efficacy of intensive topical interferon alfa-2b (IFN) therapy in uveitic macular edema (UME). Methods: This is a prospective, interventional case study of eyes with UME. Commercially available injection IFN for subcutaneous use was reconstituted to form eye drops and a dose of 6 times/day for 2 weeks, 5 times/day for ne...
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Corona virus disease-19 (COVID-19) vaccines have been approved for emergency use. Ocular adverse effects following the vaccines have been reported. Purpose To report an unique case of recurrent central serous chorioretinopathy following both doses of COVID-19 vaccine. Observations A 40-year-old male presented with blurring of vision in the left e...
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There is no universal or standard definition of a rare disease. A condition that occurs infrequently is generally considered a rare disease, and has been described in terms of prevalence–either in absolute terms or in terms of prevalence per 10,000 population. A country or region defines a rare disease most appropriate in the context of its own pop...
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Aim: The aim of the study is to analyze visual fields defects (VFDs) in epidemic retinitis (ER). Methods: Patients with ER and Humphrey’s visual field (HFA) 30–2 performed after resolution were studied. VFD severity grading was performed. Patients treated with oral doxycycline (Group-A) versus doxycycline-steroids (group-B) were compared. Results...
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Coronavirus disease (COVID)‑19 is associated with ophthalmic manifestations during and after recovery from the disease and may be sight‑threatening. A 54‑year‑old Asian Indian female patient presented to us with redness, pain, and blurred vision in her right eye (RE) of 2‑day duration. In RE, the best‑corrected visual acuity was 20/25, and she was...
Article
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A woman in her 50s presented with diminution of vision in her left eye (OS) 4 days after COVISHIELDTM vaccination. She had been diagnosed with non-arteritic anterior ischaemic optic neuropathy (NA-AION) of right eye (OD) 8 months earlier. The present episode revealed a best-corrected visual acuity (BCVA) of 20/50 in OD and 20/20 in OS with grade 1...
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Background/purpose: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in the pediatric population and anterior uveitis is its commonest extra-articular manifestation. Typically the uveitis presents as chronic anterior uveitis and there is limited literature of the posterior segment manifestations of the disease. Similar to o...
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Purpose: The coronavirus disease (COVID-19) pandemic continues to play havoc in our lives. During the first " lockdown" in 2020, we were keen on assessing the anxiety levels of patients who sought ophthalmic care despite the lockdown. Public health actions, such as social distancing, were necessary to reduce the spread of COVID-19. As a result, mo...
Article
Purpose: To describe a case of herpes simplex virus 1 (HSV 1) infection following coronavirus disease 2019 (COVID-19) vaccination in an Asian Indian female. Methods: Retrospective case report. Result: A 40-year-old female presented with decreased vision, pain, and photophobia of 2 weeks duration. She reported receiving the second dose of COVIS...
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Purpose Dengue fever (DF) epidemics in Singapore in 2005–2006 and 2007 were caused predominantly by dengue virus serotypes 1 (DENV-1) and 2 (DENV-2) respectively. We investigated the prevalence of ophthalmic manifestations during these consecutive epidemics. Methods Seropositive DF patients admitted to the hospital during two separate dengue epide...
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During the Coronavirus Disease 2019 (COVID-19) pandemic, we have witnessed increase in number of reports of a known uveitic entity being associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Causal relation is yet to be proven for many reports. Perhaps, occurrence of a previously known region-specific endemic disease or clos...
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Purpose: To study the use of teleophthalmology as a tool to manage patients with uveitis and to describe the experience of teleconsultation for uveitis at a tertiary eye care hospital in India during the two waves of the COVID-19 pandemic. Methods: A prospective observational case series of uveitis patients seeking teleconsultations during the f...
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Purpose: To identify factors other than macular edema and retinitis location responsible for poor visual outcomes in epidemic retinitis (ER). Methods: A. retrospective, observational, comparative study. Eyes with corrected distant visual acuity (CDVA) 20/200 or worse at resolution formed Group A. Eyes with central macular thickness (CMT) 600 μm...
Article
Abstract Introduction: Corona virus disease (COVID-19) has been associated with ophthalmic manifestations which can occur during or following the infection. Purpose: To explore the systemic status in ophthalmic patients who had a recent history of COVID-19 or those with positive COVID-19 antibody status. Methods: Retrospective case series. Resul...
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Abstract Introduction: Corona virus disease (COVID-19) has been associated with a variety of ophthalmic manifestations including acute macular neuroretinopathy and paracentral middle maculopathy. Posterior segment manifestations after post COVID-19 vaccinations have been reported. Case report: A 25- year-old Asian Indian female developed sequentia...
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Purpose The purpose was to highlight the potential dangers of the air gun loaded with carbide commonly used by the farmers, causing injury to the eye. Scare airguns are used to prevent the birds from destroying the crops in their fields. Method This was an observational study. Results A 44-year-old Indian male presented to us with redness, diminu...
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ABSTRACT Background: To report the posterior segment (uvea and retinal) manifestations and imaging characteristics of eyes of patients with and after coronavirus disease 2019 (COVID-19). Methods:We searched the PubMed/MEDLINE database to identify relevant articles using the following search terms: COVID-19, SARS-CoV-2, retina, uvea, optic nerve, r...
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Purpose To describe composite multicolour (MC) imaging features along with the monocoloured fundus reflectance images in active and resolving stages of post-fever retinitis (PFR). Methods Retrospective image analysis of cases of PFR who underwent dilated retinal clinical examination followed by optical coherence tomography and MC imaging. Results...
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A 35-year-old Asian Indian female developed recurrent attacks of bilateral anterior uveitis with vitritis following a febrile episode. Extensive systemic investigations for a febrile episode did not yield any clue. Systemic clinical examination was also within normal limits. In this patient, we found an association of high coronavirus disease 2019...
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Coronavirus disease 2019 (COVID-19) pandemic can cause ocular manifestations which include conjunctivitis to retinal manifestations. A 41-year-old Asian Indian male presented with unilateral blurring, glare, and pain in the left eye (LE), 22 days after COVID-19 infection. He had been administered intravenous steroids followed by oral steroids. Eye...
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The data from the study adds a new perspective for diabetes control in the perioperative period to prevent the risk of endophthalmitis
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Purpose To present the clinical features of a rare case of varicella zoster infection following one dose of Coronavirus Disease 2019 (COVID-19) vaccination in an elderly Asian Indian male. Methods Retrospective observational case report. Results A 71-year-old gentleman presented to us with complaints of reduced vision associated with redness and...
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Post fever retinitis is a heterogenous entity that is seen 2–4 weeks after a systemic febrile illness in an immunocompetent individual. It may occur following bacterial, viruses, or protozoal infection. Optical coherence angiography (OCTA) is a newer non-invasive modality that is an alternative to fundus fluorescein angiography to image the retinal...
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Coronavirus disease (COVID-19) can be associated with ophthalmic manifestations like conjunctivitis, retinal hemorrhages, retinal vascular occlusions, papillophlebitis and Adie’s syndrome. We herein report for a case of an unilateral acute anterior uveitis which was quiescent for 13 years and was reactivated post COVID-19 infection in a 43 year old...
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Abstract Purpose: The aim of this study was to evaluate the efficacy of topical interferon (IFN) therapy in pseudophakic cystoid macular edema (P-CME). Methods: This is a prospective, interventional case series of patients with P-CME. Patients presenting with P-CME were given the option of topical IFN therapy against conventional treatment with or...
Article
Background and objective: To study spectral-domain optical coherence tomography (SD-OCT) characteristics in multifocal advanced dendritic serpiginous-like choroiditis (D-SLC) and placoid serpiginous-like choroiditis (P-SLC). Patients and methods: Retrospective, comparative study. SD-OCT features were studied in both the groups. Area of involveme...
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Dengue fever (DF) is endemic in India and Singapore, and also causes frequent epidemics. Dengue virus belongs to the Flavivirus genus of the family Flaviviridae and its members include the 4 antigenically related serotypes of dengue virus (DENV 1–4). It is transmitted to humans through the bite of infected female Aedes aegypti mosquitoes, and is ch...
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Introduction: As the world fights the pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), several reports of retinal manifestations of the disease are emerging. Post fever retinitis is a well reported ocular inflammatory reaction to multiple invasive agents, be it virus, bacteria or other microbial agent. Purpose: W...