Aparna Rao

Causes of Immediate and Early IOP Spikes After Circumferential Gonioscopy-Assisted Transluminal Trabeculotomy Using ASOCT

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Purpose: To report the early postoperative causes of intraocular pressure (IOP) spikes after complete circumferential gonioscopy-assisted transluminal trabeculotomy (GATT) using anterior segment optical coherence tomography (ASOCT). Methods: This was retrospective interventional case series of patients who underwent circumferential GATT by a single surgeon (APR) from 2021 to 2022 at a tertiary eye care in East India and who developed IOP spikes at 1 day-2 weeks (immediate) or early (> 2 weeks– 2 months) after GATT. The intraocular pressure (IOP), glaucoma medications, and angle evaluation by ASOCT at 1 week, and 1 month were compared between the two groups. Results: Thirty-two eyes of 32 consecutive patients, aged 40± 20.1 years (20 exfoliation glaucoma, 9 juvenile open-angle, and 3 developmental glaucoma), that developed IOP spikes between immediate (n=20) or early (n=12) IOP spikes after GATT, were included. Immediate postoperative spikes were seen in 20 eyes due to retained ...

Automated iris volume analysis and trabecular meshwork length using anterior segment optical coherence tomography – Application in pseudoexfoliation and pseudoexfoliation glaucoma

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Purpose: The aim of this study was to evaluate differences in the iris and angle parameters in psuedoexfoliation syndrome (PXF) and pseudoexfoliation glaucoma (PXG) using anterior segment optical coherence tomography (ASOCT). Methods: Patients with PXF or PXG were compared using ASOCT with primary open-angle glaucoma POAG eyes as controls in this noninterventional comparative study conducted at a tertiary eye care center in East India. All angle parameters, TM length, and iris thickness were analyzed from the enhanced depth imaging (EDI) single scans obtained. Quadrant scans were used for the calculation of iris volume using a custom-built in-house software. In particular, the software performs multiple operations including edge detection, connected components, and thresholding to localize and segment the iris. Differences in the iris volume/thickness and TM length in PXF and PXG with POAG were analyzed. Results: A total of 225 eyes were included, which included 75 PXG and 98 PXF ca...

Comparing focal and global responses on multifocal electroretinogram with retinal nerve fibre layer thickness by spectral domain optical coherence tomography in glaucoma

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Purpose To evaluate first and second order responses on multifocal electroretinogram (mfERG) and with retinal nerve fibre layer thickness (RNFL) on Cirrus spectral domain optical coherence tomography (SD-OCT) in glaucoma. Methods Patients (old and new) diagnosed with primary open angle glaucoma, primary angle closure glaucoma or normal tension glaucoma attending glaucoma services from November 2012 to January 2013 were screened. Ninety-seven eyes fulfilling inclusion criteria were evaluated by Humphrey visual field, Cirrus SD-OCT imaging and mfERG (Veris Science 5.1.10X; EDI, Redwood City, California, USA) for this observational cross-sectional study. The global and averaged quadrant-wise peak-to-trough amplitudes and peak implicit times of the first trough (N1), the first peak (P1) and the second trough (N2) of the mfERG were compared with average RNFL-full circle (FC) or quadrant RNFL thickness in early (mean deviation (MD) >−6 dB), moderate (MD −6 to −12 dB) ...

Comparison of relation between visual function index and retinal nerve fiber layer structure by optical coherence tomography among primary open angle glaucoma and primary angle closure glaucoma eyes

Purpose: To compare the visual field index (VFI) in primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) eyes, and to study the correlation with disc variables on optical coherence tomography (OCT) in all stages of severity. Materials and Methods: Thirty POAG and PACG underwent Humphrey visual field 24-2 along with detailed examination. They also underwent stratus OCT imaging of the optic nerve and retinal nerve fiber layer (RNFL). The correlation of VFI with RNFL thickness was compared in POAG and PACG. Results: The VFI significantly differed between POAG and PACG, with POAG eyes apparently having a better VFI at all severities of glaucoma. There were statistically significant differences in the superior max (Smax) and inferior max (Imax) in early and moderate POAG and PACG eyes. In early and moderate glaucoma, multivariate regression showed that maximum correlation of the VFI was seen with the mean deviation (b = 1.7, P < 0.001), average and superior RNF...

Retinal Nerve Fiber Layer Thickness in Children <18 Years by Spectral-domain Optical Coherence Tomography

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Objectives: To establish a normative database for retinal nerve fiber layer (RNFL) thickness in children<18 years by spectral-domain optical coherence tomography (SD-OCT). Methods: Children <18 years, who were consecutively enrolled from July-August 2011 in this cross-sectional hospital study, underwent Cirrus SD-OCT. Recorded demographics and clinical characteristics included age, sex, axial length, spherical equivalent, intraocular pressure (by Perkins tonometry) and cup disc ratio. The RNFL thickness full circle (RNFL-FC), superior, (RNFL-S), inferior (RNFL-I), temporal (RNFL-T), and nasal (RNFL-N) and the influence of clinical and demographic factors on the RNFL thickness were assessed using linear regression analysis. Results: 148 eyes of 74 children were analyzed (females: males = 37: 37) with a mean age of 10 ± 3.4years (range 4-17 years) and a mean spherical equivalent of -0.6 ± 1.2 dioptres. The mean RNFL-FC was ...

Atypical features of nanophthalmic macula- a spectral domain OCT study

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Background To report atypical features on Spectral domain optical coherence tomography (SD-OCT) in a case of non-familial pure adult nanophthalmos. Case: A 39 year old male hyperope was found to have biometric and fundus findings typical of nanophthalmos. The additional atypical features included serous pigment epithelial detachment in right eye and a cuff of subretinal fluid with underlying yellow deposits along superotemporal arcade in the left eye. Fundus flourescein angiogram showed hyperfluorescence due to window defect, dye pooling due to serous PED in right eye and leak superior to disc in right eye and along superotemporal arcade in left eye. Cirrus-SD OCT horizontal line scan passing through the fovea showed extensive inner limiting membrane corrugations causing distorted foveal contour in both eyes. A large juxtafoveal serous PED and a small extrafoval PED were seen with folds in the retinal pigment epithelium (RPE)-choriocapillary layer in the right eye. Conclusion Struct...

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