Pakistan Journal of Ophthalmology

Anatomical and Visual Outcomes of Macular Hole Surgeries

Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To determine the anatomical and visual outcomes of macular hole surgeries in patients with full thickness macular holes in a tertiary care center of Pakistan.

Study Design: Interventional case series.

Place and Duration of Study: LRBT tertiary teaching eye hospital Korangi, Karachi, from January 2023 to July 2023.
Methods: Twenty-four eyes of 24 patients were included by convenient sampling. Patients with Gass stage 2,3 and 4 were included in the study after an informed consent.The study omitted holes with stage 1, macular cysts, and secondary macular holes. Visual acuity of the patients was recorded in decimal notations based on Snellen's chart. OCT was done in all patients. after peri-bulbar anesthesia, 25G pars plana vitrectomy was performed with C3F8 gas as internal tamponade. All individuals were followed up on day 1, week 1, 6, 12 and 24. OCT images were taken to see hole closure. The paired sample t-test was used to compare the difference of pre and post operative VA. P-values less than 0.05 were considered statistically significant.
Results: Out of 24 eyes, 62.5% were males and 37.5% were females.The mean age of the patients was 65.3±9.1 years. Visual acuity significantly improved after surgery with p- value of <0.05.
Conclusion: Macular hole surgery using 25G pars plana vitrectomy with C3F8 gas tamponade yielded favorable anatomical and visual outcomes in patients with full-thickness macular holes.

Balance Training Exercises and Mobility in Children with Visual Impairments: A Randomized Controlled Trial

Mubashra Tariq, Fareeha Kausar, Maria Khalid, Wajida Perveen, Sana Umar — Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To evaluate the effects of Balance Training Exercises on mobility in open and closed environments in children with Visual Impairments.

Study Design: A Randomized controlled trial.

Place and Duration: Rising Sun Special School from December 2022 to May 2023.

Methods: A total of 24 children with visual impairments were randomly assigned to experimental and control groups. Pretest assessments using the Timed Up and Go (TUG) test and the Gross Motor Function Measure (GMFM-88) were conducted after an initial instructional session. The experimental group received both static and dynamic balance training exercises, while the control group received static balance exercises and walking training twice a week for eight weeks. Post test assessments were conducted after 16 training sessions.

Results: Significant improvements were observed in GMFM-88 scores for both the experimental and control groups in open and closed environments (p = 0.002 and 0.003, respectively). Similarly, TUG scores showed significant improvement (p = 0.000 and 0.001, respectively).The Mann-Whitney test showed no statistically significant difference between groups for GMFM-88 in open and closed environments (p = 0.154). Similarly, no significant difference was found for TUG scores (p = 0.154).

Conclusion: Balance training led to significant improvements in mobility within both groups in open and closed environments. However, between-group analysis showed no statistically significant differences. Despite this, clinical improvements in mobility were observed.

Effect of Internal Limiting Membrane peeling on Success of Pars Plana Vitrectomy in Epi-Macular Membrane

Ali Abbas Hassan Fazaa, Hasan AbdulAmirAl-Maamar, Mudhher Ghani Abdulla — Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To determine the effect of internal limiting membrane (ILM) peeling on the success of pars plana vitrectomy (PPV).

Study Design: Quasi experimental study.

Place and Duration of Study: Al-Firdous Private Eye Hospital from 2021 and 2022.

Method: This study included patients with an epiretinal macular membrane (EMM) and visual symptoms who were scheduled for PPV. Patients with diabetes mellitus, cellophane maculopathy, or those without symptoms were excluded. A total of 40 patients were enrolled and divided into two groups (20 in each) using convenient sampling. Group A underwent PPV with EMM and ILM peeling. Group B underwent PPV with EMM but without ILM peeling. The primary outcome was the recurrence of EMM within two years. Qualitative data were analyzed using the Chi-square test in Microsoft Excel, with a significance level set at p < 0.05.

Results: The mean age in Group A was 43 ± 3.2 years, while in Group B, it was 45 ± 3.7 years (p > 0.5). Males comprised most participants (67.7%, n=27), with 16 males in Group B. Recurrence of EMM requiring a second PPV was observed in 6 patients (30%) from Group B, whereas no recurrence occurred in Group A (p = 0.007).

Conclusion: ILM peeling significantly reduces the recurrence rate of EMM following PPV, demonstrating its superiority in surgical success.

The Impact of the COVID-19 Pandemic on Surgical Practices in Ophthalmology at the National Referral Hospital in Yogyakarta

Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To assess the impact of the COVID-19 pandemic on ophthalmic surgical practices at the National Referral Hospital in Yogyakarta by comparing surgical data from the pre-pandemic period with data collected during the pandemic.

Study Design: Retrospective comparative study.

Methods: Patient data were divided into two groups: pre-COVID and during-COVID. Demographic and surgical data were collected. Continuous variables (e.g., patient age, number of surgeries) were presented as mean ± standard deviation (SD), while categorical variables (e.g., type of surgery, gender distribution) were presented as frequencies and percentages. A paired t-test was used to compare continuous variables, and the Chi-square test was applied to compare proportions (e.g., elective vs. emergency surgeries). Statistical analysis was conducted using SPSS 25.0, with p < 0.05 considered statistically significant.

Results: Among 4,578 patients, there was a +11.73% increase in total surgeries from pre-COVID to the COVID era (p > 0.05). Based on surgery type, elective surgeries increased by +15.56% (p > 0.05), while emergency surgeries significantly decreased by -60.51% (p < 0.05).Cataract & Refractive Surgery, Glaucoma, Vitreo-Retinal Surgery, Infection & Immunology Surgery increased by +4.83% (p > 0.05), +103.5% (p < 0.05), +5.63%
(p > 0.05), +7.28% (p < 0.05) and +26.8% (p > 0.05) respectively. While reconstructive, oculoplastic &oncology Surgery decreased by -5.36% (p > 0.05).

Conclusion: The COVID-19 pandemic led to a significant decrease in emergency surgeries while increasing elective procedures, particularly in glaucoma and pediatric ophthalmology.

To Determine the Effectiveness of Ranibizumab in Patients with Branch and Central Retinal Vein Occlusion: A Hospital Based Study

Ronak Afza Memon, Fariha Sherwali, Shehnilla Shujaat, Waqas Ali, Asra Talpur — Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To determine the effectiveness of ranibizumab in patients with branch and central retinal vein occlusion in a tertiary care hospital.

Study Design: Interventional case series.

Place and Duration of Study: Sindh Institute of Ophthalmology and Visual Sciences, Hyderabad.from July 2023 to March 2024.

Methods: Patients of either gender and aged at least 20 years, diagnosed with macular edema (ME) secondary to CRVO or BRVO and best corrected visual acuity (BCVA) of less than 6/9 were included in the study. Patients with known retinal diseases, infection or previous treatment with laser photocoagulation, or a history of anti-VEGFinjections or corticosteroids in the last 6 months were excluded. Three intravitreal ranibizumab injections were givenat monthly intervals. The effectiveness of ranibizumab injection was investigated by measuring the difference in meancentral macular thickness and BCVA at 0, 3,6and 9months. Data was analyzed using SPSS version 25.

Results: Total 188 patients were included with mean age of 57.53±10.74 years. Majority were males (63.8%) and 59% had disease in the right eye. Injections were administered to 158 patients (84%)for three months, while 30 (16%) patients required injections forsix months. The mean central macular thickness was 541.54±146.99 before injection, and 270.99±82.10, 240.02±22.50, 234.73±18.06 at 3, 6,and 9months,respectively. The mean BCVA (LogMAR) was1.21±0.57 before injection, 0.30±0.27 at 3 months, 0.21±0.16 at 6 monthsand 0.17±0.14at 9 months.

Conclusion: Ranibizumab is effective in decreasing central macular thickness and improving BCVA in patients with macular edema following retinal vein occlusion.

Ocular Risk Factors Affecting Intraoperative Complications In Mature Cataract Surgery

Doğukan Cömerter, Yasemin Un, Okşan Alpoğan, Melike Sarıdoğan — Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To identify the demographic and ocular risk factors associated with complications in phacoemulsification and planned extracapsular cataract extraction (PECCE) for mature cataracts.

Study Design: Retrospective chart analysis.

Place and Duration of Study: Haydarpaşa Numune Training and Research Hospitalfrom January 2018 and December 2021.

Methods: A total of 236 eyes of 236 patients who underwent surgery for mature cataracts between 2018 and 2021 were included in the study. Demographic characteristics, presence of pseudoexfoliation, cataract type, pupil dilation, anterior chamber depth, presence of phacodonesis, preoperative best-corrected visual acuity, intraocular pressure, intraoperative and postoperative surgical complications, and postoperative first month visual acuity were analyzed.

Results: A total of 194 eyes (82%) underwent phacoemulsification, while 42 eyes (18%) underwent PECCE. The mean age and mean preoperative BCVA LogMAR values were significantly higher in the PECCE group (p=0.001 and p=0.027, respectively). Among ocular risk factors, only pupillary mid-dilation was significantly higher in the PECCE group (p=0.04). Intraoperative complications were more frequent in brown cataracts within the PHACO group compared to eyes without brown cataracts (p=0.004). Additionally, intraoperative complications, postoperative complications, and the need for postoperative revision were significantly higher in the PECCE group (p<0.05 for all).

Conclusion: The preoperative rate of mid-dilated pupils was higher, and preoperative visual acuity was lower in eyes with mature cataracts undergoing PECCE surgery. The presence of brown cataracts was associated with an increased risk of complications in PHACO surgery.

Visual Outcome and Complications in Retro-Pupillary Iris Claw Intra-Ocular Lens in Patients with Insufficient Capsular/Zonular Support

Imran Ahmad, Nazli Gul, Bilal Khan, Jawad hamayun, Fahad khan — Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To determine the safety and effectiveness of iris claw lenses in cases of deficient capsular support.

Study Design: Interventional case series.

Place and Duration of Study: Khyber Teaching Hospital, from June 2023 to April 2024.

Methods: Aphakic patients with posterior capsule rupture and insufficient support for sulcus fixation intraocular lens (IOL) implantation were included in the study. Exclusion criteria included patients with atrophic iris or deficient iris for holding iris claw IOL, dilated pupils due to poor function of the constrictor pupillae muscle, pre-operative corneal scars, diabetic retinopathy, or posterior segment pathologies. Retro-pupillary placement of iris claw IOL was performed in all cases. Postoperatively, corneal sutures were removed 40 days after surgery, and visual acuity was assessed one week after suture removal. For quantitative variables, mean and standard deviation were calculated, while frequencies were used for qualitative variables. Pre- and post-operative best-corrected visual acuity (BCVA) were compared. A p-value of less than 0.05 was considered statistically significant.

Results: A total of 35 iris claw procedures were performed. The mean age of participants was 60.31±6.90 years, with 54.28% male and 45.72% female patients. No complications were documented in 74.28% of patients. Documented complications included: irregular iris (12.24%), High intraocular pressure (2.85%), IOL subluxation (2.85%), Cystoid macular edema (2.85%) and Hyphema (2.85%).

Conclusion: The study demonstrates that retro-pupillary placement of the iris claw IOL is a safe and effective procedure for patients with deficient capsular support, with a majority experiencing no postoperative complications.

Effectiveness of Temporary Keratoprosthesis in Vitreo-Retinal Surgeries

Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To determine the effectiveness of temporary keratoprosthesis in facilitating successful combined penetrating Keratoplasty and vitreoretinal surgery.

Study Design: Retrospective interventional case series.

Place and Duration of Surgery: Department of Ophthalmology, Peshawar Medical College, from January 2020 and December 2023.

Methods: A retrospective study was conducted which included 15 patients who underwent combined penetrating Keratoplasty and temporary keratoprosthesis-assisted vitreoretinal surgery. Data for pre and postoperative visual acuity, IOP, retinal attachment and graft status were obtained from hospital records. Surgical success was determined by the presence of a clear corneal graft, stable retinal attachment, normal intraocular pressure, and maintained or improved visual acuity. Data was analyzed using SPPS version 24. An independent test was employed to compare continuous variables between patients with successful and unsuccessful surgical outcomes.

Results: A total of 15 cases with mean age of 39.27 ± 15.88 years were included in this study. Visual acuity improved in 33.3% of cases, worsened in 13.3%, and remained stable in 53.3%. Postoperative corneal opacity occurred in 73.3% of patients, while 26.7% retained a clear graft. Functional vision was achieved in approximately 40% of the cases while only 13.3% were considered surgical success.

Conclusion: Complete surgical success was attained in only a minority of cases, and functional vision was achieved in less than half of the patients. Graft failure was the predominant postoperative complication, while corneal laceration with posterior segment pathology was the most frequent surgical indication.

Comparison of Central Corneal Thickness between Normal Individuals and Primary Open-Angle Glaucoma Patients Using Topical Anti-Glaucoma Therapy

Husna Haroon, Nargis Nizam Ashraf, Arwa Ismail — Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To investigate and compare the difference in central corneal thickness among normal individuals and patients with POAG taking long term (>6months) different topical anti-glaucoma medications.

Study Design: Cross-sectional comparative study.

Place and Duration of Study: Civil Hospital Eye OPD from May 2024 to December 2024.

Methods: The study included 170 individuals (85 primary open angle glaucoma patients and 85 normal individuals) after informed consent.The right eye of each patient was selected for central corneal thickness (CCT) measurement using Nidek AL Scan between 10:00am and 02:00pm to avoid diurnal variation in CCT. Frequencies and descriptive statistics were used to calculate mean and standard deviation to assess the general characteristics of study population. Independent T-tests were used to assess differences in mean CCT between distinct groups to find which variables were significantly related to CCT.

Results: The results were analyzed using SPSSv23. Mean age of participants was 54.87±7.55 (range 20-80) years.Individuals with POAG had a lower mean CCT compared to those without glaucoma (p-value <0.001).Use of prostaglandins (p<0.001), beta-blockers, carbonic anhydrase inhibitors and carbonic anhydrase with beta blocker combination was significantly related with decreased CCT compared to control.

Conclusion: Patients with long-standing POAG tend to have thinner CCT compared to healthy individuals. Among glaucoma treatments, prostaglandin analogues are associated with the lowest mean CCT values, highlighting their potential effect on corneal thickness.

Eye Care Practices and Perceptions among Saudi Individuals: Gaps in Awareness and Service Utilization

Sun, 30 Mar 2025 00:00:00 +0000

Purpose: In Saudi Arabia, the demand for eye care is growing with population growth and high prevalence of diabetes, a major risk to eye disorders. The aim of the present study was to evaluate the perspectives and practices of Saudi individuals regarding visual examinations and the role of optometrists, identifying potential gaps in eye care utilization.

Study Design: A descriptive cross-sectional study.

Place and Duration of Study: Qassim University, Saudi Arabia in August 2024.

Methods: The survey covered demographics, visual correction use, eye exam frequency and preferences, intraocular pressure (IOP) awareness, diabetes status, fundus exam history, and attitudes toward fundus devices in optometric centres. Data were analysed using descriptive and inferential statistics.

Results: A total of 423 participants completed the study, with a mean age of 27.64±17.89 years; 51.3% were female. Over half (52.7%) used glasses or contacts, and 51.5% preferred optometric centres for eye examinations. While 51.1% underwent eye examinations every 1-2 years, 38.1% had them less frequently or never. Awareness of IOP measurement was reported by 51.5%, and among diabetics (22%), only 40.9% had fundus exams. Most (78.5%) believed that the availability of fundus devices in optometric centres improved adherence to regular eye examinations.

Conclusion: Significant gaps exist in eye care practices and awareness among Saudi individuals, particularly in regular eye examination adherence and diabetic eye care. Enhancing public awareness and improving access to diagnostic services in optometric centres will improve eye health outcomes in the population.

Associations between With-The-Rule and Against-The-Rule Astigmatism and Higher-Order Aberrations in Compound Myopic Astigmatism

Sahar Mohaghegh, Haleh Kangari, Shahram Bamdad, Saeed Rahmani — Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To examine the relationship between astigmatism axis and higher-order aberrations (HOAs) in patients with compound myopic astigmatism.

Study Design: Cross-sectional descriptive study.

Place and Duration of Study: Cornea Clinic in the Shiraz University of Medical Science, Shiraz, Iran, from 2018-2020.

Methods: A total of 1370right eyes, aged 18-40 years, were included in the study. Subjective cycloplegic refraction and distance aberrometry, measured with a Shack-Hartmann device, were analyzed. Zernike components of horizontal coma(Z₃¹), vertical coma(Z₃^-1), oblique trefoil(Z₃³), vertical trefoil(Z₃^-3), spherical aberration, and total root-mean-square wave-front errors for 6 mm pupils were analyzed. With the rule and against the rule astigmatism groups were defined based on vector analysis for the astigmatism axis (J0 and J45). Positive and negative values of J0 indicate with-the-rule and against-the-rule astigmatism, respectively. Spearman’s correlations were calculated between HOAs and J0.(To simplify evaluation, we did not consider J45 in analysis which indicates oblique astigmatism).

Results: The mean age was 29.01±5.19. The mean spherical equivalent (SEQ) was -3.64 ± 1.59D, range [-0.75 to -10.00 D] and the mean cylindrical power was -1.01 ± 0.95D, range [0 to -5.00D]. J0 correlates positively with vertical coma(Z₃^-1) (r = 0.1 p <0.001) and negatively with oblique trefoil(Z₃³), (r = -0.1, p < 0.001).

Conclusion: We found weak systematic correlations between third-order aberrations and the astigmatism axis. Increasing against-the-rule is associated with a positive shift in oblique trefoil(Z₃³) and a negative shift in vertical coma(Z₃^-1).

Refractive Error and Anisometropia in Down Syndrome: A Cross-Sectional Study in A Tertiary Hospital

Ni Made Ayu Surasmiati, Krisnhaliani Wetarini, Saphira Evani — Sun, 30 Mar 2025 00:00:00 +0000

Purpose: To determine the frequency of refractive errors and the magnitude of anisometropia in children with Down syndrome (DS) across different age groups.

Study Design: Cross-sectional study.

Place and Duration of Study: Ophthalmology Clinic at Ngoerah General Hospital from January 2024 to September 2024.

Methods: A total of 53 DS children were included in the study. Refractive errors were recorded from the latest control visit, with measurements taken from fully dilated pupils. The highest recorded hypermetropic value, as well as the lowest myopic and cylindrical values from both eyes, were used for analysis. Continuous variables were reported as mean ± standard deviation (SD), and categorical variables were reported as frequencies and percentages. Refractive errors were compared between preschool (<6 years) and school-age (≥6 years) groups using the Mann-Whitney test, with p-values <0.05 considered statistically significant.

Results: Out of 53 DS children, 85% had refractive errors. The most common refractive error was myopia (37.7%), followed by hypermetropia (28.3%) and astigmatism (18.9%). Among the 35 children in the school-age group (≥6 years), 45.7% had myopia and 22.8% had hypermetropia, whereas among the 18 children under 5 years of age, 38.9% had hypermetropia. A significant difference in the spherical equivalent between the two age groups was observed (p < 0.05). Anisometropia was present in 19% of participants, with 15% exhibiting a low degree of anisometropia.

Conclusion: The high prevalence of refractive errors in DS children and the tendency toward myopia in primary school-aged children support an age-dependent myopic shift.

The safety and Efficacy of Phacoemulsification in Diabetic Versus Non-Diabetic Patients: A Systematic Review and Meta-Analysis

Sun, 30 Mar 2025 00:00:00 +0000

This review aims to compare the safety and efficacy of phacoemulsification cataract surgery between diabetic and non-diabetic patients, focusing on the differences in postoperative outcomes. RevMan 5.4 was used for data analysis. Eighteen studies were included consisting of 2233 cases. We found better best corrected visual acuity (BCVA) at first post-operative day in non-diabetic patients and a lower endothelial cell density (ECD) in diabetic patients at 1^stweek and 3^rdmonth. The central corneal thickness (CCT) was significantly thicker in diabetic group at 1^stweek and 1^stmonth postoperatively. The coefficient of variations (CV) was significantly higher and hexagonal cell percentage (HCP) was significantly lower in the diabetic group at 1^stweek. HCP was significantly lower in at 1^st and 3^rdmonth postoperatively in diabetic group. No significant difference of central macular thickness (CMT) was found.Phacoemulsification has a greater impact on corneal endothelial damage and visual acuity in patients with diabetes mellitus (DM).

Oral Rifampicin 300mg in Central Serous Chorioretinopathy(CSCR)

Muhammad Ali Haider, Nida Usman; Uzma Sattar — Sun, 30 Mar 2025 00:00:00 +0000

This study evaluated the effectiveness of half-dose (300 mg) oral rifampicin in improving visual outcomes and reducing central macular thickness (CMT) in patients with idiopathic central serous chorioretinopathy (CSCR). Ten eyes from 10 patients who met the inclusion criteria were recruited by convenient sampling. Baseline visual acuity (VA) on the LogMAR chart and CMT measured via OCT were recorded. Patients received 300 mg rifampicin daily for six weeks, after which changes in VA and CMT were analyzed. Results showed significant improvements, with mean VA improving from 0.6±0.2 to 0.29±0.1 and mean CMT reducing from 556.5±15 µm to 262±60 µm. The mean reduction in CMT was 293±130 µm, and the improvement in VA was 0.32±0.2, both statistically significant (p ≤ 0.05). This study suggests that half-dose rifampicin is effective for CSCR treatment, offering a safer alternative with reduced side effects compared to full-dose therapy.

Beyond the Darkness: Navigating Oguchi Disease with a Singular Case Insight

Hajra Arshad Malik, Shehr Bano Abbas, Saman Gulzar, Najia Uzair — Sun, 30 Mar 2025 00:00:00 +0000

Oguchi disease represents a hereditary condition characterized by stationary night blindness. It has a characteristic clinical sign, the Mizuo-Nakamura phenomenon. We present a case of a 9-year-old girl who was evaluated for complaints of impaired night vision. Best-corrected visual acuity in both eyes was 20/100. Dilated fundus examination demonstrated a metallic sheen across the retina bilaterally. After a dark adaptation for 2 hours, the characteristic golden-yellow metallic sheen resolved, demonstrating the clinical phenomenon known as the Mizuo-Nakamura effect.

Evolution of Cataract Surgery in Pakistan over the Past Four Decades

Abdul Majeed Malik — Sun, 30 Mar 2025 00:00:00 +0000

Cataract is one of the leading causes of reversible blindness worldwide.¹ In Pakistanreversible blindnessdue to cataract remains the leading cause due to increase in aging population, poverty and comparatively lesser surgical facilities.²The prevalence of cataract blindness was higher in women than men (1.80% versus 1.67%, p<0.001). The prevalence of cataract causing <6/60 in eyes was 5.0% (95% CI 4.7%, 5.2%), which projects to an estimated 3 560 000 eyes with a visual acuity of <6/60 caused by cataract in Pakistan (year 2003). This number was projected to increase to 7380 000 by the year 2020.³

Addressing Burnout in Ophthalmology—A Call for Systemic Change

Ambreen Gull — Sun, 30 Mar 2025 00:00:00 +0000

Burnout or ‘Syndrome of Professional Wear and Tear’’ is an increasingly recognized issue in the field of ophthalmology, affecting both those in training and established practitioners.A study reported that 6.9% of participants experiencing burnout were from ophthalmology, with most being residents (81.4%) working 60–80 hours per week.¹ Burnout rates were higher in females, with 46.3% reporting early burnout and 36.6% advanced burnout, compared to 32.8% and 25% in males, respectively. While general surgeons and gynecologists were more prone to advanced burnout, eye surgeons and residents showed a notable vulnerability to burnout.^1,2Ophthalmologists experience notable levels of emotional exhaustion, depersonalization and a diminished sense of personal accomplishment, representing key types of burnouts in the field.The relentless demands of a highly specialized and technical field of surgery, coupled with administrative burdens and the pressure to maintain a work-life balance, contribute to early career exits and declining mental well-being among professionals.³ To ensure the longevity and fulfillment of ophthalmologists, a multifaceted approach that addresses burnout at both individual and systemic levels is critical.

Anomalous Retinal Neovascularisation in chronic Central Serous Chorio Retinopathy

Sivaranjani, Sumita Calaivanane, Manavi D Sindal — Sun, 30 Mar 2025 00:00:00 +0000

There are varied presentations of chronic Central Serous Chorio Retinopathy(CSCR) which include diffuse retinal pigment epitheliopathy, Exudative retinal detachment, choroidal neovascularization, and polypoidal choroidal vasculopathy. Retinal neovascularization is an exceptionally rare complication associated with it. In this report, we aim to discuss an unusual case of abnormal retinal neovascularization in a patient suffering from chronic CSCR.in both eyes. The CSCR with anomalous NVE was confirmed by Fundus Fluorescein Angiography (FFA) and Optical Coherence Tomography (OCT). The patient underwent Pan Retinal Photocoagulation (PRP) in both eyes. After 2 months, the new vessels started regressing, with a reduction in the sub retinal fluid (SRF)of both eyes. Tailored approaches and parallel treatment of NVE are required to avoid ischemia-related complications and optimal outcomes.

Artificial Intelligence-Driven Vision Therapy for Cerebral Visual Impairment in Remote Settings: A Three-Year Follow-Up Case Report

Renu Thakur, Jyoti Gangta — Sun, 30 Mar 2025 00:00:00 +0000

Cerebral visual impairment (CVI) is a neuro developmental disorder that affects the brain's visual processing centres. It is typically associated with perinatal hypoxia, traumatic brain injury, infections, and genetic disorders. Artificial Intelligence in vision therapy can revolutionize optometric treatment. We describe a case of AI-powered vision treatment of a patient diagnosed with CVI in a remote region. AI powered remote vision therapy was provided to a 4-year-old male with CVI in the Indian state of Himachal Pradesh. The 14-week therapy was monitored and altered using AI findings. The patient was followed up with continued home therapy. The findings were monitored on a quarterly basis.After 14 weeks of distant vision therapy, visual acuity, contrast sensitivity, and oculomotor function improved significantly, and a consistent improvement was noticed. Artificial Intelligence powered vision treatment technologies have the potential to enhance optometry care equity.

Ocular Kaposi Sarcoma as the Initial Manifestation of Human Immunodeficiency Virus (HIV) Infection: A Case Report

Mutmainah Mahyuddin, Neni Anggraini, Agung Nugroho, Eka Susanto — Sun, 30 Mar 2025 00:00:00 +0000

Kaposi sarcoma associated with Human Herpesvirus-8 (HHV8) infection, is a low-grade malignant vascular spindle-cell tumour, commonly linked to acquired immunodeficiency syndrome (AIDS). This case report highlights a rare presentation of ocular KS leading to diagnosis of Human Immunodeficiency Virus (HIV) infection. A 25-year-old otherwise healthy Indonesian male presented with slow-growing erythematous masses on the superior eyelid and conjunctiva, two months after colliding with a door. Excisional biopsy confirmed KS, and subsequent HIVtest was positive. A multidisciplinary approach was initiated to evaluate and treat the underlying AIDS and KS. Recognizing ocular KS as an initial sign of HIV through thorough examination is crucial for accurate diagnosis, prompt treatment, and improved prognosis.