Hem Tewari | All India Institute of Medical Sciences, New Delhi (original) (raw)

Papers by Hem Tewari

Research paper thumbnail of Subretinal fluid in the diagnosis of posterior scleritis

Australian and New Zealand journal of ophthalmology, 1990

The etiology of subretinal mass lesions is very difficult to establish. A 28-year-old man present... more The etiology of subretinal mass lesions is very difficult to establish. A 28-year-old man presented to us with an area of choroiditis, which progressed, despite corticosteroid and antibiotic therapy, to an exudative retinal detachment, secondary glaucoma and a painful blind eye. To develop a means of identifying the cause of such lesions, we did a subretinal fluid tap prior to enucleation. Cytopathology showed only inflammatory cells and the final histopathological diagnosis was that of a granulomatous scleritis.

Research paper thumbnail of Argon laser vaporization for management of projecting suture ends after cataract surgery

Research paper thumbnail of Diabetic retinopathy for general practitioners

Journal of the Indian Medical Association, 2004

The most significant complication of diabetes mellitus involves the eye and which develops 85% of... more The most significant complication of diabetes mellitus involves the eye and which develops 85% of all diabetics eventually to retinopathy. Diabetic retinopathy is the commonest cause of blindness between 4th and 7th decades. It is essentially a microangiopathy with two distinct stages during its evolution, the preclinical and clinical stages. Diabetic maculopathy is the commonest cause of visual loss in diabetics. Progression of the diseases can be retarded by early diagnosis and using appropriate measures. Well known risk factors are diabetes age, metabolic control of hypertension, associated renal disease and pregnancy. The management plan of the secondary level is early diagnosis and laser photocoagulation or surgical intervention. Vitreoretinal surgery is certainly of benefit in patients with advanced diabetic eye disease. The PROMPT factors can be applied to decrease diabetes mellitus related blindness.

Research paper thumbnail of Macular thickness evaluation using the optical coherence tomography in normal Indian eyes

Indian journal of ophthalmology, 2004

To determine the normative values for macular thickness and volume by Optical Coherence Tomograph... more To determine the normative values for macular thickness and volume by Optical Coherence Tomography (OCT 3) in healthy Indian subjects. The macula of 170 consecutive, randomly selected normal subjects was imaged on OCT 3 in this cross-sectional study. OCT parameters of macular thickness were analysed with baseline variables including age, gender, axial length and refractive error. The average foveal thickness in the population under study was 149.16 +/- 21.15 micro. Macular thickness and volume parameters of OCT correlated significantly (Pearson's Correlation coefficient) with age (r=0.23, P<0.01), but not with gender, axial length and refraction. The macular thickness and volume parameters have a significant correlation with age. This normative database of macular thickness by OCT in Indian eyes may be a useful guideline for management and further research in diseases of the macula and glaucoma.

Research paper thumbnail of Comparison of scleral buckling with combined scleral buckling and pars plana vitrectomy in the management of rhegmatogenous retinal detachment with unseen retinal breaks

Clinical & experimental ophthalmology, 2003

The purpose of the present paper was to compare the techniques of conventional scleral buckling a... more The purpose of the present paper was to compare the techniques of conventional scleral buckling and combined pars plana vitrectomy and scleral buckling procedures in rhegmatogenous retinal detachments with unseen retinal breaks. Forty-four consecutive eyes with uncomplicated, primary rhegmatogenous retinal detachments with a clear media and unseen retinal breaks were randomized to two groups. The scleral buckling group underwent 360 degrees scleral buckling, cryopexy and external subretinal fluid drainage. In the combined surgery group, 360 degrees scleral buckling, pars plana vitrectomy, air-fluid exchange, endolaser and injection of 14% perfluoropropane gas was done. At 3 months follow up the primary reattachment rate was 80% (16/20 cases) in the combined surgery group, and 70% (14/20 cases) in the scleral buckling group (P = 0.716). The visual acuity improved significantly from a preoperative median of hand movement (HM; range: HM to 6/60; similar in both the groups), to a median...

Research paper thumbnail of Sympathetic-Parasympathetic Activity and Reactivity in Central Serous Chorioretinopathy: A Case-Control Study

PURPOSE. This case- control study was conducted to evaluate autonomic function activity and react... more PURPOSE. This case- control study was conducted to evaluate autonomic function activity and reactivity in patients with central serous chorioretinopathy (CSCR), because stress and type A personality, known risk factors, are also related to autonomic nervous system activity. METHODS. Patients with CSCR were selected from the outpa- tient department and medical retina services in one center. Control subjects were chosen

Research paper thumbnail of BILATERAL NECROTIZING HERPETIC RETINOPATHY THREE YEARS AFTER HERPES SIMPLEX ENCEPHALITIS FOLLOWING PULSE CORTICOSTEROID TREATMENT

Retina-the Journal of Retinal and Vitreous Diseases, 1999

Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home &amp;amp;amp;amp;amp;gt; 1999 - ...

Research paper thumbnail of PHOTOTOXIC RETINOPATHY

Ophthalmology Clinics of North America, 2001

Although the occurrence of iatrogenic light-induced retinal toxicity is beyond doubt, several iss... more Although the occurrence of iatrogenic light-induced retinal toxicity is beyond doubt, several issues remain to be studied further. These include conflicting reports regarding the wavelength of light that is most hazardous; what mechanism contributes more significantly in the pathogenesis of light-induced retinal toxicity-photochemical or photothermal; why does it occur in only some patients; and what is the protective role of UV absorbing chromophores in intraocular implants. Nevertheless, it is important for all ophthalmic surgeons to be aware of this complication and take measures that could decrease the risk of its occurrence.

Research paper thumbnail of Continuous production of lactic acid from molasses by free and immobilized Sporolactobacillus cellulosolvens

World Journal of Microbiology & Biotechnology, 1995

Both free and immobilized cells of Sporolactobacillus cellulosolvens, in continuous culture on mo... more Both free and immobilized cells of Sporolactobacillus cellulosolvens, in continuous culture on molasses (50 g sugar 1(-1)) at 40°C, had maximum lactic acid productivities of 0.03 and 0.06 mol l(-1) h, at dilution rates of 0.27 and 0.25 h(-1), respectively.

Research paper thumbnail of COMBINED OPTIC NEUROPATHY AND CENTRAL RETINAL ARTERY OCCLUSION IN MILIARY TUBERCULOSIS

Retina, 2001

Miliary tuberculosis is the simultaneous involvement of multiple organs by the acid-fast bacillus... more Miliary tuberculosis is the simultaneous involvement of multiple organs by the acid-fast bacillus Mycobacterium tuberculosis. Ocular involvement may also be a feature in disseminated tuberculosis. Although the first case of a tuberculoma of the optic nerve was ...

Research paper thumbnail of Results of Anterior Chamber Clearance via the Pars plana in Pseudophakic Endophthalmitis

Ophthalmologica, 2003

Patients with endophthalmitis have extensive fibrinous exudates in the anterior chamber. Clearanc... more Patients with endophthalmitis have extensive fibrinous exudates in the anterior chamber. Clearance of these exudates in pseudophakic patients during vitrectomy is difficult. We evaluated the results of the pars plana approach for clearing these exudates. Eighteen patients with pseudophakic endophthalmitis underwent clearance of anterior chamber exudates through the pars plana approach after initial creation of a peripheral iridectomy with a vitrectome. The exudates were adequately cleared in all 18 patients with good posterior segment visualization during vitrectomy. Minor punctate iris bleeds (4 patients), intraoperative dislocation of the intraocular lens (IOL) (1 patient) and postoperative dislocation of the IOL following blunt trauma, 9 months after vitrectomy (1 patient) were the complications noted. This technique is simple, safe and helps clearing anterior chamber exudates. It also permits excellent visualization during vitrectomy for pseudophakic endophthalmitis.

Research paper thumbnail of Topical Atropine and Timolol Therapy in Failed Retinal Detachment Surgery

Ophthalmologica, 1994

We conducted a double-blind randomized prospective study to evaluate the efficacy of topical timo... more We conducted a double-blind randomized prospective study to evaluate the efficacy of topical timolol alone and topical timolol and atropine combined in cases of operated failed retinal detachment surgery cases in which no apparent open break explained the surgical failure. In both groups with and without proliferative vitreoretinopathy no statistically significant difference in retinal reattachment was found.

Research paper thumbnail of Spontaneous Resolution of Macular Exudation with Good Visual Recovery in Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis (IRVAN): A Case Report

Neuro-Ophthalmology, 2005

... Pradeep Venkatesh 1 † , Ravi Keshavamurthy 1 , Vivek M. Bhaskar 1 , Sat Pal Garg 1 and Hem K.... more ... Pradeep Venkatesh 1 † , Ravi Keshavamurthy 1 , Vivek M. Bhaskar 1 , Sat Pal Garg 1 and Hem K. Tewari 1 1 Retina Service, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. ...

Research paper thumbnail of Retinal vasculopathy in autosomal dominant neurofibromatosis type 1

Neuro-Ophthalmology, 2001

ABSTRACT

Research paper thumbnail of Syphilitic neuroretinitis, a report of three cases and review of literature

Neuro-Ophthalmology, 2001

ABSTRACT

Research paper thumbnail of Posterior vitreous wick syndrome: a potential cause of endophthalmitis following vitreo-retinal surgery

Medical Hypotheses, 2002

Endophthalmitis following pars-plana procedures such as a vitrectomy vitreo-retinal procedures ha... more Endophthalmitis following pars-plana procedures such as a vitrectomy vitreo-retinal procedures has been infrequently reported in literature. The cited incidence is about 0.1% to 0.2%. In the 8 cases of endophthalmitis that have been reported in literature, the prognosis has been indicated as very poor due to a delay in diagnosis (1±3). Also, no possible source of an inoculum of the pathogenic organism reaching the vitreous cavity has been considered in these reports. We have encountered a few cases of endophthalmitis following vitreo-retinal surgeries at our tertiary eye care centre. Here again not being able to identify the possible source of infectious spread, we now report for the first time in literature, a new entity, the`posterior vitreous wick syndrome'. This potential source of infectious spread, to the best of our knowledge, has not been considered earlier. We describe the patho-mechanism of thè posterior vitreous wick syndrome' and also suggest methods of reducing its occurrence during vitreo-retinal procedures. This could also be the patho-mechanism of endophthalmitis following inadvertent loss of scleral integrity during extraocular surgeries like retinal detachment surgery and strabismus surgery (4,5). & 2002 Published by

Research paper thumbnail of A Prospective Controlled Trial to Evaluate the Adjunctive Role of Posterior Subtenon Triamcinolone in the Treatment of Diffuse Diabetic Macular Edema

Journal of Ocular Pharmacology and Therapeutics, 2004

The aim of the present prospective controlled trial was to evaluate the adjuvant role of posterio... more The aim of the present prospective controlled trial was to evaluate the adjuvant role of posterior subtenon triamcinolone in the treatment of diffuse diabetic macular edema (DDME). Thirty one (31) eyes with DDME were divided into an interventional group subjected to grid laser photocoagulation and 0.5 mL of 40 mg/mL posterior subtenon triamcinolone, and a noninterventional group subjected to grid laser photocoagulation only. Best-corrected visual acuity, contrast sensitivity, and intraocular pressures were assessed at presentation, and at 6, 12, and 24 weeks after intervention. The interventional group showed a statistically significant (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) change in both mean best corrected visual acuity, from 20/160 to 20/100 (two-line increase on Early Treatment Diabetic Retinopathy Study (ETDRS)) (p = 0.024), and mean contrast sensitivity, from 0.9 to 1.09 (p = 0.01), at the end of 24 weeks. A significant rise in intraocular pressure was not described in any of the patients in either group. Posterior subtenon triamcinolone injection is a useful and safe adjunct to the conventional management of diabetic macular edema.

Research paper thumbnail of Sympathetic-Parasympathetic Activity and Reactivity in Central Serous Chorioretinopathy: A Case-Control Study

Investigative Ophthalmology & Visual Science, 2006

This case-control study was conducted to evaluate autonomic function activity and reactivity in p... more This case-control study was conducted to evaluate autonomic function activity and reactivity in patients with central serous chorioretinopathy (CSCR), because stress and type A personality, known risk factors, are also related to autonomic nervous system activity. Patients with CSCR were selected from the outpatient department and medical retina services in one center. Control subjects were chosen from the healthy subjects of similar age group. The autonomic activity (both sympathetic and parasympathetic) in 45 patients with CSCR was evaluated and compared with that in 28 healthy control subjects, by using HRV (heart rate variability) analysis according to the guidelines laid down by the Task Force of European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996). Autonomic reactivity (both sympathetic and parasympathetic) was also evaluated in 32 patients with CSCR and compared with that in 28 healthy control subjects, by using standard autonomic function tests: HRV, as a measure of the resting sympathetic and parasympathetic activity (tone), and changes in blood pressure response and heart rate changes during various stressor stimuli in the tests as a measure of sympathetic and parasympathetic reactivity. Patients with CSCR showed significantly decreased parasympathetic activity (P = 0.002), significantly increased sympathetic activity (P = 0.005), and significantly increased sympathetic-parasympathetic balance (P = 0.004) as measured from different measures of beat-to-beat heart rate variability. The patients also showed significantly decreased parasympathetic reactivity (P = 0.03). Sympathetic reactivity showed a trend toward lessening. Autonomic function, both activity and reactivity components of sympathetic and parasympathetic system, is impaired in patients with CSCR. Because autonomic supply modulates the choroidal blood flow, there may be a correlation between measures of autonomic function and the presence of CSCR.

Research paper thumbnail of A pilot trial for comparison of photodynamic therapy and transpupillary thermotherapy for the management of classic subfoveal choroidal neovascularization secondary to age-related macular degeneration

Indian Journal of Ophthalmology, 2007

The aim of the study was to compare the visual outcomes of photodynamic therapy (PDT) with vertep... more The aim of the study was to compare the visual outcomes of photodynamic therapy (PDT) with verteporfin and transpupillary thermotherapy (TTT) for classic subfoveal choroidal neovascularization (CNVM) secondary to age-related macular degeneration (ARMD). Patients with subfoveal classic CNVM caused by ARMD attending vitreo-retinal services at a tertiary care setup were included in this nonrandomized, open label, prospective, clinical, comparative pilot trial. Standardized refraction, visual acuity testing, evaluation of fundus and serial color photography and fundus fluorescein angiography were carried out to evaluate the effects of treatment in 32 eyes each undergoing either PDT or TTT. Follow-up was carried out at four weeks, 12 weeks and six months. Retreatment if indicated was carried out three months post treatment. Stabilization or improvement occurred in 69% of patients undergoing PDT and 50% patients undergoing TTT at six months of follow-up. Among patients with a pretreatment visual acuity greater than or equal to 20/63, only one out of six patients who underwent PDT had a drop of visual acuity &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 2 lines as compared to four patients (100%) who underwent TTT. (P =0.0476, two-tailed Fisher&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact test). For short-term preservation of vision in patients of classic CNVM due to ARMD, PDT seems to be better than TTT if the pre-laser best corrected visual acuity is &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 20/63 but both are equally effective if pre-laser best corrected visual acuity is &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 20/63.

Research paper thumbnail of Prehypertension may be common in patients with central serous chorioretinopathy

Graefe's Archive for Clinical and Experimental Ophthalmology, 2006

To test an observational hypothesis that patients with central serous chorioretinopathy (CSCR) ma... more To test an observational hypothesis that patients with central serous chorioretinopathy (CSCR) may have a tendency towards hypertension compared with normal individuals. In this case-control study we evaluated resting blood pressure in 32 patients with CSCR and compared it with that in 32 healthy controls in a standard laboratory environment. Differences in resting systolic and diastolic blood pressure were measured. Mean systolic blood pressure was 123.56+/-4.8 in the CSCR group and 113.63+/-12.62 in the control group. Mean diastolic blood pressure was 84.75+/-10.2 in the CSCR group and 76.75+/-0.4 in the control group. The difference in mean blood pressure values between the two groups was statistically significant. Patients with CSCR may be predisposed to prehypertension. Hence they should be advised on lifestyle modification and followed up periodically for early detection of progression to stage 1 or 2 hypertension.

Research paper thumbnail of Subretinal fluid in the diagnosis of posterior scleritis

Australian and New Zealand journal of ophthalmology, 1990

The etiology of subretinal mass lesions is very difficult to establish. A 28-year-old man present... more The etiology of subretinal mass lesions is very difficult to establish. A 28-year-old man presented to us with an area of choroiditis, which progressed, despite corticosteroid and antibiotic therapy, to an exudative retinal detachment, secondary glaucoma and a painful blind eye. To develop a means of identifying the cause of such lesions, we did a subretinal fluid tap prior to enucleation. Cytopathology showed only inflammatory cells and the final histopathological diagnosis was that of a granulomatous scleritis.

Research paper thumbnail of Argon laser vaporization for management of projecting suture ends after cataract surgery

Research paper thumbnail of Diabetic retinopathy for general practitioners

Journal of the Indian Medical Association, 2004

The most significant complication of diabetes mellitus involves the eye and which develops 85% of... more The most significant complication of diabetes mellitus involves the eye and which develops 85% of all diabetics eventually to retinopathy. Diabetic retinopathy is the commonest cause of blindness between 4th and 7th decades. It is essentially a microangiopathy with two distinct stages during its evolution, the preclinical and clinical stages. Diabetic maculopathy is the commonest cause of visual loss in diabetics. Progression of the diseases can be retarded by early diagnosis and using appropriate measures. Well known risk factors are diabetes age, metabolic control of hypertension, associated renal disease and pregnancy. The management plan of the secondary level is early diagnosis and laser photocoagulation or surgical intervention. Vitreoretinal surgery is certainly of benefit in patients with advanced diabetic eye disease. The PROMPT factors can be applied to decrease diabetes mellitus related blindness.

Research paper thumbnail of Macular thickness evaluation using the optical coherence tomography in normal Indian eyes

Indian journal of ophthalmology, 2004

To determine the normative values for macular thickness and volume by Optical Coherence Tomograph... more To determine the normative values for macular thickness and volume by Optical Coherence Tomography (OCT 3) in healthy Indian subjects. The macula of 170 consecutive, randomly selected normal subjects was imaged on OCT 3 in this cross-sectional study. OCT parameters of macular thickness were analysed with baseline variables including age, gender, axial length and refractive error. The average foveal thickness in the population under study was 149.16 +/- 21.15 micro. Macular thickness and volume parameters of OCT correlated significantly (Pearson's Correlation coefficient) with age (r=0.23, P<0.01), but not with gender, axial length and refraction. The macular thickness and volume parameters have a significant correlation with age. This normative database of macular thickness by OCT in Indian eyes may be a useful guideline for management and further research in diseases of the macula and glaucoma.

Research paper thumbnail of Comparison of scleral buckling with combined scleral buckling and pars plana vitrectomy in the management of rhegmatogenous retinal detachment with unseen retinal breaks

Clinical & experimental ophthalmology, 2003

The purpose of the present paper was to compare the techniques of conventional scleral buckling a... more The purpose of the present paper was to compare the techniques of conventional scleral buckling and combined pars plana vitrectomy and scleral buckling procedures in rhegmatogenous retinal detachments with unseen retinal breaks. Forty-four consecutive eyes with uncomplicated, primary rhegmatogenous retinal detachments with a clear media and unseen retinal breaks were randomized to two groups. The scleral buckling group underwent 360 degrees scleral buckling, cryopexy and external subretinal fluid drainage. In the combined surgery group, 360 degrees scleral buckling, pars plana vitrectomy, air-fluid exchange, endolaser and injection of 14% perfluoropropane gas was done. At 3 months follow up the primary reattachment rate was 80% (16/20 cases) in the combined surgery group, and 70% (14/20 cases) in the scleral buckling group (P = 0.716). The visual acuity improved significantly from a preoperative median of hand movement (HM; range: HM to 6/60; similar in both the groups), to a median...

Research paper thumbnail of Sympathetic-Parasympathetic Activity and Reactivity in Central Serous Chorioretinopathy: A Case-Control Study

PURPOSE. This case- control study was conducted to evaluate autonomic function activity and react... more PURPOSE. This case- control study was conducted to evaluate autonomic function activity and reactivity in patients with central serous chorioretinopathy (CSCR), because stress and type A personality, known risk factors, are also related to autonomic nervous system activity. METHODS. Patients with CSCR were selected from the outpa- tient department and medical retina services in one center. Control subjects were chosen

Research paper thumbnail of BILATERAL NECROTIZING HERPETIC RETINOPATHY THREE YEARS AFTER HERPES SIMPLEX ENCEPHALITIS FOLLOWING PULSE CORTICOSTEROID TREATMENT

Retina-the Journal of Retinal and Vitreous Diseases, 1999

Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home &amp;amp;amp;amp;amp;gt; 1999 - ...

Research paper thumbnail of PHOTOTOXIC RETINOPATHY

Ophthalmology Clinics of North America, 2001

Although the occurrence of iatrogenic light-induced retinal toxicity is beyond doubt, several iss... more Although the occurrence of iatrogenic light-induced retinal toxicity is beyond doubt, several issues remain to be studied further. These include conflicting reports regarding the wavelength of light that is most hazardous; what mechanism contributes more significantly in the pathogenesis of light-induced retinal toxicity-photochemical or photothermal; why does it occur in only some patients; and what is the protective role of UV absorbing chromophores in intraocular implants. Nevertheless, it is important for all ophthalmic surgeons to be aware of this complication and take measures that could decrease the risk of its occurrence.

Research paper thumbnail of Continuous production of lactic acid from molasses by free and immobilized Sporolactobacillus cellulosolvens

World Journal of Microbiology & Biotechnology, 1995

Both free and immobilized cells of Sporolactobacillus cellulosolvens, in continuous culture on mo... more Both free and immobilized cells of Sporolactobacillus cellulosolvens, in continuous culture on molasses (50 g sugar 1(-1)) at 40°C, had maximum lactic acid productivities of 0.03 and 0.06 mol l(-1) h, at dilution rates of 0.27 and 0.25 h(-1), respectively.

Research paper thumbnail of COMBINED OPTIC NEUROPATHY AND CENTRAL RETINAL ARTERY OCCLUSION IN MILIARY TUBERCULOSIS

Retina, 2001

Miliary tuberculosis is the simultaneous involvement of multiple organs by the acid-fast bacillus... more Miliary tuberculosis is the simultaneous involvement of multiple organs by the acid-fast bacillus Mycobacterium tuberculosis. Ocular involvement may also be a feature in disseminated tuberculosis. Although the first case of a tuberculoma of the optic nerve was ...

Research paper thumbnail of Results of Anterior Chamber Clearance via the Pars plana in Pseudophakic Endophthalmitis

Ophthalmologica, 2003

Patients with endophthalmitis have extensive fibrinous exudates in the anterior chamber. Clearanc... more Patients with endophthalmitis have extensive fibrinous exudates in the anterior chamber. Clearance of these exudates in pseudophakic patients during vitrectomy is difficult. We evaluated the results of the pars plana approach for clearing these exudates. Eighteen patients with pseudophakic endophthalmitis underwent clearance of anterior chamber exudates through the pars plana approach after initial creation of a peripheral iridectomy with a vitrectome. The exudates were adequately cleared in all 18 patients with good posterior segment visualization during vitrectomy. Minor punctate iris bleeds (4 patients), intraoperative dislocation of the intraocular lens (IOL) (1 patient) and postoperative dislocation of the IOL following blunt trauma, 9 months after vitrectomy (1 patient) were the complications noted. This technique is simple, safe and helps clearing anterior chamber exudates. It also permits excellent visualization during vitrectomy for pseudophakic endophthalmitis.

Research paper thumbnail of Topical Atropine and Timolol Therapy in Failed Retinal Detachment Surgery

Ophthalmologica, 1994

We conducted a double-blind randomized prospective study to evaluate the efficacy of topical timo... more We conducted a double-blind randomized prospective study to evaluate the efficacy of topical timolol alone and topical timolol and atropine combined in cases of operated failed retinal detachment surgery cases in which no apparent open break explained the surgical failure. In both groups with and without proliferative vitreoretinopathy no statistically significant difference in retinal reattachment was found.

Research paper thumbnail of Spontaneous Resolution of Macular Exudation with Good Visual Recovery in Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis (IRVAN): A Case Report

Neuro-Ophthalmology, 2005

... Pradeep Venkatesh 1 † , Ravi Keshavamurthy 1 , Vivek M. Bhaskar 1 , Sat Pal Garg 1 and Hem K.... more ... Pradeep Venkatesh 1 † , Ravi Keshavamurthy 1 , Vivek M. Bhaskar 1 , Sat Pal Garg 1 and Hem K. Tewari 1 1 Retina Service, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. ...

Research paper thumbnail of Retinal vasculopathy in autosomal dominant neurofibromatosis type 1

Neuro-Ophthalmology, 2001

ABSTRACT

Research paper thumbnail of Syphilitic neuroretinitis, a report of three cases and review of literature

Neuro-Ophthalmology, 2001

ABSTRACT

Research paper thumbnail of Posterior vitreous wick syndrome: a potential cause of endophthalmitis following vitreo-retinal surgery

Medical Hypotheses, 2002

Endophthalmitis following pars-plana procedures such as a vitrectomy vitreo-retinal procedures ha... more Endophthalmitis following pars-plana procedures such as a vitrectomy vitreo-retinal procedures has been infrequently reported in literature. The cited incidence is about 0.1% to 0.2%. In the 8 cases of endophthalmitis that have been reported in literature, the prognosis has been indicated as very poor due to a delay in diagnosis (1±3). Also, no possible source of an inoculum of the pathogenic organism reaching the vitreous cavity has been considered in these reports. We have encountered a few cases of endophthalmitis following vitreo-retinal surgeries at our tertiary eye care centre. Here again not being able to identify the possible source of infectious spread, we now report for the first time in literature, a new entity, the`posterior vitreous wick syndrome'. This potential source of infectious spread, to the best of our knowledge, has not been considered earlier. We describe the patho-mechanism of thè posterior vitreous wick syndrome' and also suggest methods of reducing its occurrence during vitreo-retinal procedures. This could also be the patho-mechanism of endophthalmitis following inadvertent loss of scleral integrity during extraocular surgeries like retinal detachment surgery and strabismus surgery (4,5). & 2002 Published by

Research paper thumbnail of A Prospective Controlled Trial to Evaluate the Adjunctive Role of Posterior Subtenon Triamcinolone in the Treatment of Diffuse Diabetic Macular Edema

Journal of Ocular Pharmacology and Therapeutics, 2004

The aim of the present prospective controlled trial was to evaluate the adjuvant role of posterio... more The aim of the present prospective controlled trial was to evaluate the adjuvant role of posterior subtenon triamcinolone in the treatment of diffuse diabetic macular edema (DDME). Thirty one (31) eyes with DDME were divided into an interventional group subjected to grid laser photocoagulation and 0.5 mL of 40 mg/mL posterior subtenon triamcinolone, and a noninterventional group subjected to grid laser photocoagulation only. Best-corrected visual acuity, contrast sensitivity, and intraocular pressures were assessed at presentation, and at 6, 12, and 24 weeks after intervention. The interventional group showed a statistically significant (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) change in both mean best corrected visual acuity, from 20/160 to 20/100 (two-line increase on Early Treatment Diabetic Retinopathy Study (ETDRS)) (p = 0.024), and mean contrast sensitivity, from 0.9 to 1.09 (p = 0.01), at the end of 24 weeks. A significant rise in intraocular pressure was not described in any of the patients in either group. Posterior subtenon triamcinolone injection is a useful and safe adjunct to the conventional management of diabetic macular edema.

Research paper thumbnail of Sympathetic-Parasympathetic Activity and Reactivity in Central Serous Chorioretinopathy: A Case-Control Study

Investigative Ophthalmology & Visual Science, 2006

This case-control study was conducted to evaluate autonomic function activity and reactivity in p... more This case-control study was conducted to evaluate autonomic function activity and reactivity in patients with central serous chorioretinopathy (CSCR), because stress and type A personality, known risk factors, are also related to autonomic nervous system activity. Patients with CSCR were selected from the outpatient department and medical retina services in one center. Control subjects were chosen from the healthy subjects of similar age group. The autonomic activity (both sympathetic and parasympathetic) in 45 patients with CSCR was evaluated and compared with that in 28 healthy control subjects, by using HRV (heart rate variability) analysis according to the guidelines laid down by the Task Force of European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996). Autonomic reactivity (both sympathetic and parasympathetic) was also evaluated in 32 patients with CSCR and compared with that in 28 healthy control subjects, by using standard autonomic function tests: HRV, as a measure of the resting sympathetic and parasympathetic activity (tone), and changes in blood pressure response and heart rate changes during various stressor stimuli in the tests as a measure of sympathetic and parasympathetic reactivity. Patients with CSCR showed significantly decreased parasympathetic activity (P = 0.002), significantly increased sympathetic activity (P = 0.005), and significantly increased sympathetic-parasympathetic balance (P = 0.004) as measured from different measures of beat-to-beat heart rate variability. The patients also showed significantly decreased parasympathetic reactivity (P = 0.03). Sympathetic reactivity showed a trend toward lessening. Autonomic function, both activity and reactivity components of sympathetic and parasympathetic system, is impaired in patients with CSCR. Because autonomic supply modulates the choroidal blood flow, there may be a correlation between measures of autonomic function and the presence of CSCR.

Research paper thumbnail of A pilot trial for comparison of photodynamic therapy and transpupillary thermotherapy for the management of classic subfoveal choroidal neovascularization secondary to age-related macular degeneration

Indian Journal of Ophthalmology, 2007

The aim of the study was to compare the visual outcomes of photodynamic therapy (PDT) with vertep... more The aim of the study was to compare the visual outcomes of photodynamic therapy (PDT) with verteporfin and transpupillary thermotherapy (TTT) for classic subfoveal choroidal neovascularization (CNVM) secondary to age-related macular degeneration (ARMD). Patients with subfoveal classic CNVM caused by ARMD attending vitreo-retinal services at a tertiary care setup were included in this nonrandomized, open label, prospective, clinical, comparative pilot trial. Standardized refraction, visual acuity testing, evaluation of fundus and serial color photography and fundus fluorescein angiography were carried out to evaluate the effects of treatment in 32 eyes each undergoing either PDT or TTT. Follow-up was carried out at four weeks, 12 weeks and six months. Retreatment if indicated was carried out three months post treatment. Stabilization or improvement occurred in 69% of patients undergoing PDT and 50% patients undergoing TTT at six months of follow-up. Among patients with a pretreatment visual acuity greater than or equal to 20/63, only one out of six patients who underwent PDT had a drop of visual acuity &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 2 lines as compared to four patients (100%) who underwent TTT. (P =0.0476, two-tailed Fisher&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact test). For short-term preservation of vision in patients of classic CNVM due to ARMD, PDT seems to be better than TTT if the pre-laser best corrected visual acuity is &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 20/63 but both are equally effective if pre-laser best corrected visual acuity is &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 20/63.

Research paper thumbnail of Prehypertension may be common in patients with central serous chorioretinopathy

Graefe's Archive for Clinical and Experimental Ophthalmology, 2006

To test an observational hypothesis that patients with central serous chorioretinopathy (CSCR) ma... more To test an observational hypothesis that patients with central serous chorioretinopathy (CSCR) may have a tendency towards hypertension compared with normal individuals. In this case-control study we evaluated resting blood pressure in 32 patients with CSCR and compared it with that in 32 healthy controls in a standard laboratory environment. Differences in resting systolic and diastolic blood pressure were measured. Mean systolic blood pressure was 123.56+/-4.8 in the CSCR group and 113.63+/-12.62 in the control group. Mean diastolic blood pressure was 84.75+/-10.2 in the CSCR group and 76.75+/-0.4 in the control group. The difference in mean blood pressure values between the two groups was statistically significant. Patients with CSCR may be predisposed to prehypertension. Hence they should be advised on lifestyle modification and followed up periodically for early detection of progression to stage 1 or 2 hypertension.