Dr.RAJESH RAMANJULU - Academia.edu (original) (raw)
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Papers by Dr.RAJESH RAMANJULU
JAMA Ophthalmology, Jan 17, 2024
Indian journal of ophthalmology. Case reports, Apr 1, 2024
European Journal of Ophthalmology, Jun 8, 2023
Indian Journal of Ophthalmology, May 1, 2023
Delhi Journal of Ophthalmology, Jun 1, 2015
Indian journal of ophthalmology, 2023
Indian Journal of Ophthalmology - Case Reports
Indian Journal of Ophthalmology
Purpose: Coats' disease is associated with poor outcomes, and there are limited studies on lo... more Purpose: Coats' disease is associated with poor outcomes, and there are limited studies on long-term outcomes of Coats' disease. The purpose of our study is to identify various predictive factors to help in prognosticating the treatment outcomes in advanced Coats' disease in children. Methods: This is a retrospective case series from a single tertiary eye care center of children (<18 years) diagnosed with coat's disease. Sixty-seven patients with Coat's disease were identified from the medical records from 2009 to 2020. Patients' demographic data, clinical presentation, stage, extent of involvement, detailed treatment history, clinical sequelae post-treatment (including complications and anatomical and functional outcomes) were noted. Binary logistic regression was performed to correlate the predictive factors for anatomical and functional improvement. Results: Of the 67 patients, 51 eyes of 51 patients were included in the study. The male to female proportion was 2.2. Mean age at presentation was 4.98 ± 3.55 years (range: 2 months–15 years). Mean duration of follow-up was 31.53 ± 26.38 months. Overall, our globe salvage rate was 92.2%. We found that vitreoretinal fibrosis (P < 0.001), subretinal gliosis (P < 0.001), vitreous hemorrhage (P = 0.02), tractional or combined retinal detachment (P < 0.001), foveal scar (P < 0.006), and cataract (P < 0.001) to be important factors to affect the outcome. Conclusion: Advanced stage of presentation (stage 3B and above), diffuse involvement, cataract, vitreoretinal fibrosis (preretinal and subretinal), vitreous hemorrhage, tractional or combined retinal detachment, and anterior hyaloid proliferation are poor prognostic factors for globe salvage in advanced disease. Subretinal gliotic nodule or scar and lack of visual rehabilitation suggest poor functional outcomes.
Nigerian Journal of Ophthalmology
Indian Journal of Ophthalmology - Case Reports
Indian Journal of Ophthalmology - Case Reports
Indian Journal of Ophthalmology
Indian Journal of Ophthalmology
Indian Journal of Ophthalmology
Indian Journal of Ophthalmology
Ophthalmic Surgery, Lasers and Imaging Retina
Indian Journal of Ophthalmology
Acta Ophthalmologica
Unremoved vitreoschisis-induced vitreous cortex remnants (VCR) are associated with macular pathol... more Unremoved vitreoschisis-induced vitreous cortex remnants (VCR) are associated with macular pathology. When present on the retinal periphery, they may play a role in proliferative vitreoretinopathy and retinal detachment after vitrectomy. Existing instruments for their removal involve substantial risk of iatrogenic retinal damage. Purpose of this study was to evaluate the use of a new technique, Vitreous Wiping, for removal of VCR during vitrectomy. Methods: Proof-of-concept case series of six eyes (six patients) treated with vitrectomy for various pathologies (macula-on and macula-off retinal detachment, macular hole, macular pucker and vitreous floaters). Vitreous cortex remnants on the surface of the retina were visualized with triamcinolone and removed by Vitreous Wiping with a rectangular piece of polyvinyl alcohol (PVA) held with intra-ocular forceps. Visual acuity and clinical course were assessed during a follow-up of 6 months. All eyes underwent postoperative macular optical coherence tomography. Eyes without preoperative macular pathology, underwent retinal sensitivity testing and eyes without paracentral pathology underwent visual field analysis. Results: Vitreous cortex remnants could be removed completely in all eyes. There were no intra-or postoperative complications. We observed that PVA is soft like a sponge and vitreous sticks to it, making Vitreous Wiping easier and safer, compared to alternative instruments. Visual acuity improved in all eyes. Microperimetry and visual field analysis revealed no abnormalities related to Vitreous Wiping. Conclusion: Vitreoschisis-induced VCR can be removed effectively and safely from the retinal surface by Vitreous Wiping. Larger studies are needed to confirm this promising finding and its potential impact.
Indian Journal of Ophthalmology
JAMA Ophthalmology, Jan 17, 2024
Indian journal of ophthalmology. Case reports, Apr 1, 2024
European Journal of Ophthalmology, Jun 8, 2023
Indian Journal of Ophthalmology, May 1, 2023
Delhi Journal of Ophthalmology, Jun 1, 2015
Indian journal of ophthalmology, 2023
Indian Journal of Ophthalmology - Case Reports
Indian Journal of Ophthalmology
Purpose: Coats' disease is associated with poor outcomes, and there are limited studies on lo... more Purpose: Coats' disease is associated with poor outcomes, and there are limited studies on long-term outcomes of Coats' disease. The purpose of our study is to identify various predictive factors to help in prognosticating the treatment outcomes in advanced Coats' disease in children. Methods: This is a retrospective case series from a single tertiary eye care center of children (<18 years) diagnosed with coat's disease. Sixty-seven patients with Coat's disease were identified from the medical records from 2009 to 2020. Patients' demographic data, clinical presentation, stage, extent of involvement, detailed treatment history, clinical sequelae post-treatment (including complications and anatomical and functional outcomes) were noted. Binary logistic regression was performed to correlate the predictive factors for anatomical and functional improvement. Results: Of the 67 patients, 51 eyes of 51 patients were included in the study. The male to female proportion was 2.2. Mean age at presentation was 4.98 ± 3.55 years (range: 2 months–15 years). Mean duration of follow-up was 31.53 ± 26.38 months. Overall, our globe salvage rate was 92.2%. We found that vitreoretinal fibrosis (P < 0.001), subretinal gliosis (P < 0.001), vitreous hemorrhage (P = 0.02), tractional or combined retinal detachment (P < 0.001), foveal scar (P < 0.006), and cataract (P < 0.001) to be important factors to affect the outcome. Conclusion: Advanced stage of presentation (stage 3B and above), diffuse involvement, cataract, vitreoretinal fibrosis (preretinal and subretinal), vitreous hemorrhage, tractional or combined retinal detachment, and anterior hyaloid proliferation are poor prognostic factors for globe salvage in advanced disease. Subretinal gliotic nodule or scar and lack of visual rehabilitation suggest poor functional outcomes.
Nigerian Journal of Ophthalmology
Indian Journal of Ophthalmology - Case Reports
Indian Journal of Ophthalmology - Case Reports
Indian Journal of Ophthalmology
Indian Journal of Ophthalmology
Indian Journal of Ophthalmology
Indian Journal of Ophthalmology
Ophthalmic Surgery, Lasers and Imaging Retina
Indian Journal of Ophthalmology
Acta Ophthalmologica
Unremoved vitreoschisis-induced vitreous cortex remnants (VCR) are associated with macular pathol... more Unremoved vitreoschisis-induced vitreous cortex remnants (VCR) are associated with macular pathology. When present on the retinal periphery, they may play a role in proliferative vitreoretinopathy and retinal detachment after vitrectomy. Existing instruments for their removal involve substantial risk of iatrogenic retinal damage. Purpose of this study was to evaluate the use of a new technique, Vitreous Wiping, for removal of VCR during vitrectomy. Methods: Proof-of-concept case series of six eyes (six patients) treated with vitrectomy for various pathologies (macula-on and macula-off retinal detachment, macular hole, macular pucker and vitreous floaters). Vitreous cortex remnants on the surface of the retina were visualized with triamcinolone and removed by Vitreous Wiping with a rectangular piece of polyvinyl alcohol (PVA) held with intra-ocular forceps. Visual acuity and clinical course were assessed during a follow-up of 6 months. All eyes underwent postoperative macular optical coherence tomography. Eyes without preoperative macular pathology, underwent retinal sensitivity testing and eyes without paracentral pathology underwent visual field analysis. Results: Vitreous cortex remnants could be removed completely in all eyes. There were no intra-or postoperative complications. We observed that PVA is soft like a sponge and vitreous sticks to it, making Vitreous Wiping easier and safer, compared to alternative instruments. Visual acuity improved in all eyes. Microperimetry and visual field analysis revealed no abnormalities related to Vitreous Wiping. Conclusion: Vitreoschisis-induced VCR can be removed effectively and safely from the retinal surface by Vitreous Wiping. Larger studies are needed to confirm this promising finding and its potential impact.
Indian Journal of Ophthalmology