Kumudini Sharma - Academia.edu (original) (raw)

Papers by Kumudini Sharma

Cureus

Malignant hypertension (MHT) is a sudden and severe increase in systemic blood pressure (BP) asso... more Malignant hypertension (MHT) is a sudden and severe increase in systemic blood pressure (BP) associated with advanced bilateral retinopathy. It comes under a broader term, called hypertensive emergency, where an acute rise in BP results in end-organ damage. The condition usually requires hospital admission and intensive care management. Although there are lots of sophisticated machines and laboratory tests present to diagnose various organ damage, the role of ophthalmologists will still be at the top. A record of the acute rise of BP to a defining level and simple ophthalmoscopy with high clinical suspicion can save a patient's life and preserve target organ function by timely referral. So, every ophthalmologist should be aware of this dangerous condition. In this review, we have tried to compile all the current knowledge regarding malignant hypertension that an ophthalmologist may require in day-today practice.

Indian Journal of Ophthalmology

Purpose: The aim of this study was to determine the alteration in ganglion cell complex and its r... more Purpose: The aim of this study was to determine the alteration in ganglion cell complex and its relationship with retinal nerve fiber layer (RNFL) thickness as measured by spectral-domain optical coherence tomography (OCT) in pituitary adenoma cases and also its correlation with visual field (VF). Methods: This is a prospective comparative study wherein detailed neuro-ophthalmic examination including perimetry, RNFL and ganglion cell layer inner plexiform layer (GCL-IPL) thickness were measured preoperatively in the cases of pituitary adenoma with chiasmal compression with visual symptoms and field changes who were planned for neuro-surgical intervention. These parameters were repeated 1 year after the surgery. GCL-IPL, RNFL parameters were compared with controls and were correlated with VF mean deviation (MD). The diagnostic power of GCL-IPL was tested using the receiver operating characteristic (ROC) curve. Healthy age and sex-matched controls without any ocular and systemic abnormality were taken for comparison. Results: Twenty-four patients qualified the inclusion criteria. A significant thinning of GCL-IPL (P = 0.002) and RNFL (P = 0.039) was noticed in the pituitary adenoma group. GCL-IPL (r = 0.780 P < 0.001) and RNFL (r = 0.669, P < 0.001) were significantly correlated with the MD. The ROC curve values of GCL-IPL were 0.859 (95% confidence interval 0.744% to 0.973) and of RNFL were 0.731 (95% confidence interval 0.585–0.877). The diagnostic ability of GCL-IPL was more as compared to the RNFL analysis, although it was statistically insignificant (P = 0.122). Conclusion: GCL-IPL measurements on the OCT are a sensitive tool to detect early anterior visual pathway changes in chiasmal compression for pituitary adenoma patients.

Indian Journal of Case Reports, 2021

Desbuquois dysplasia is characterized by the presence of short stature, short extremities, joint ... more Desbuquois dysplasia is characterized by the presence of short stature, short extremities, joint laxity with frequent dislocation, osteopenia, vertebral abnormalities, distinctive facial characteristics, and other abnormalities including myopia and glaucoma. A variant form of Desbuquois type skeletal dysplasia (DBQD), the Kim variant, has also been described and is characterized by short stature, joint, and minor facial anomalies. Here, we report a case of bilateral open-angle glaucoma and high myopia occurring in a young female who presented with Desbuquois syndrome, a rare type of osteochondrodysplasia. The patient presented to the ophthalmology clinic with persistent eye pain and unstable refractive error. Her preliminary examination revealed raised intraocular pressure, high myopia, and skeletal deformities. A complete systemic examination and genetic workup suggested DBQD, Kim variant. With no detailed ophthalmic reports of such patients existing in the literature, it is important that such patients undergo a complete ophthalmic survey to rule out glaucoma, high myopia, and strabismus.

Introduction: Fungal infections of the orbit have been recognized as one of the most critical inf... more Introduction: Fungal infections of the orbit have been recognized as one of the most critical infective lesions in the field of ophthalmology due to its morbidity, its association with blindness and even mortality. Delayed presentation and nonspecific symptoms present peculiar challenges in diagnosis and management to the ophthalmologist. This descriptive retrospective study was done to characterize fungal infections of orbit in terms of demographic variables and associated risk factors as well as to describe the clinical spectrum and outcomes of the disease. Materials and Methods: The study is a retrospective, clinicopathological analysis of invasive fungal orbital disease presenting at a tertiary care multi-speciality centre. Data collected included demographic details as well as any medical or surgical morbidities, ongoing treatment, clinical examination findings which included detailed ophthalmologic examination, findings of routine investigations as well as HIV serology, orbita...

Journal of Clinical Ophthalmology and Research, 2020

Wolfram syndrome (WFS) is a rare neurodegenerative disorder characterized by young-onset diabetes... more Wolfram syndrome (WFS) is a rare neurodegenerative disorder characterized by young-onset diabetes mellitus, central diabetes insipidus, optic nerve atrophy, and hearing loss. The ophthalmic association of this order has been limited to optic nerve atrophy. We report here a case of WFS and its disease course with childhood glaucoma as a rare ophthalmic manifestation which has been reported just once earlier. The patient had young-onset diabetes mellitus (insulin dependent), diabetes insipidus, and optic-disc pallor suggestive of partial optic atrophy. However, hearing assessment was normal at the time of presentation and in due course of disease. Glaucoma is one of the rare possible ocular manifestations of WFS which should be highly considered while evaluating patient with this disorder.

TNOA Journal of Ophthalmic Science and Research, 2020

A 12-year-old girl with the diagnosis of chronic liver disease was referred for ophthalmological ... more A 12-year-old girl with the diagnosis of chronic liver disease was referred for ophthalmological evaluation to rule out Keyser– Fleischer (KF) ring in the cornea. Her slit-lamp examination revealed bilateral characteristic greenish–brown granular deposition at level of Descemet’s membrane suggestive of KF ring [Figure 1a] and also found the yellowish-brown opacities with a petal-like appearance in the anterior subcapsular cortex of the lens, suggestive of sunflower cataract [Figure 1b]. KF ring has been described as a pathognomonic sign of Wilson’s disease (WD).[1] Therefore, its examination plays a crucial part in diagnosing WD. Though rare, sunflower cataract also aids in the diagnosis of WD.[2]

Angiology: Open Access, 2018

Purpose: To evaluate the presentation, clinical course and outcome of carotid-cavernous fistula (... more Purpose: To evaluate the presentation, clinical course and outcome of carotid-cavernous fistula (CCF) cases with endovascular treatment in our institution during the last 10 years. Methods: It is a prospective, protocol-based study of 45 consecutive cases who had presented in our Neuroophthalmology department from 2005 to 2015. Detailed history and complete neuro-ophthalmic examination along with relevant investigations and treatment was done. The patients were followed up immediately after the procedure and at three monthly intervals for one year and then yearly. Results: In our study the age range is from 3 to 63 years. Of the total 45 cases 42 had direct CCF while 3 cases were of dural CCF. Orbital and neuro-ophthalmological symptoms and signs were most common clinical presentation at diagnosis. All the cases but one responded well to transfemoral balloon/coil embolization in our institute Conclusion: CCF mostly have classical presentation but few cases can cause a diagnostic dilemma and so the ophthalmologist have to be observant about the disease. Early diagnosis results into least morbidity. Timely intervention with endovascular coiling results in successful closure of the fistula.

Journal of Pediatric Ophthalmology & Strabismus, 2003

... Titre du document / Document title. Post-traumatic pseudomeningocele of the orbit in a young ... more ... Titre du document / Document title. Post-traumatic pseudomeningocele of the orbit in a young child. Auteur(s) / Author(s). KUMAR Raj (1) ; VERMA Atul (2) ; SHARMA Kumudini (2) ; RATHIBharti (3) ; MALIK Vikas (4) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ...

Indian journal of ophthalmology, May 1, 2018

This case series aimed to review the significance of revisiting papilledema after successful cere... more This case series aimed to review the significance of revisiting papilledema after successful cerebral venous sinus thrombosis (CVST) management with sinus angioplasty. Four patients presented with blurring and transient obscuration of vision with papilledema, headache, tinnitus, and vomiting. On magnetic resonance venography and digital subtraction angiography, chronic transverse sinus thrombosis was diagnosed for which patients underwent endovascular intervention (stenting). After the resolution of CVST, patients developed the recurrence of symptoms which on digital subtraction angiography revealed dural arteriovenous malformation (DAVM). DAVM and papilledema resolved with endovascular embolization. This case series highlights a need of constant monitoring of CVST cases after the endovascular intervention.

Journal of Pediatric Neurology, 2015

A 7-year-old boy presented with complaint of progressive and painless protusion of right eye for ... more A 7-year-old boy presented with complaint of progressive and painless protusion of right eye for 6 months. On examination, he had no light perception in right eye. There was marked proptosis with superomedial deviation of right eye (Fig. 1). Ocular movements were ...

Indian Journal of Applied Research, Feb 1, 2015

In this paper, an attempt has been made to analyze the land use pattern in viratnagar Tehsil and ... more In this paper, an attempt has been made to analyze the land use pattern in viratnagar Tehsil and its sus- tainability. The study is based on secondary data collected from secondary sources. Therefore, viratnagar Tehsil has greater potential to increase agricultural area in order to make the economy and agriculture more sustain- able. Indian Economy is primarily based on agriculture and its major challenges are-growth, sustainability, efficiency and equity. Reviewing land use pattern it is observed that large forest areas have been converted to cropland creating unprecedented ecological imbalance. In face of increasing demand for food grains intensive agriculture based on ir- rigation-fertilizer-high yielding seed technology is the common practice and create serous environmental problems. Sustainable agriculture with its emphasis on preservation of ecology, optimization of economic and social benefits and conservation of energy is seen to provide stable and lasting solution.

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2016

Primary orbital varix is a rare lesion but difficult to treat. Our main aim was to demonstrate th... more Primary orbital varix is a rare lesion but difficult to treat. Our main aim was to demonstrate the varices and their central venous communication and to explore the feasibility of embolization of these lesions. In four patients with clinical suspicion of varix, in whom MRI showed retro-global vascular channels, microcatheter digital subtraction angiography (DSA) of the varices was performed using femoral venous access. Embolization was carried out in two patients. In all four patients orbital varices could be accessed with a microcatheter through inferior petrosal sinus and ophthalmic vein (superior or inferior) route. Microcatheter angiography showed opacification of varices and demonstrated their central venous communication. Two patients were treated with coil embolization. Complete resolution of symptoms was seen in one patient and partial relief in the other. The study presents microcatheterization of orbital varices via the inferior petrosal sinus-cavernous sinus-ophthalmic ve...

Journal of ophthalmic & vision research, 2011

To report an unusual presentation of tuberculosis. A six-year old boy presented with left upper l... more To report an unusual presentation of tuberculosis. A six-year old boy presented with left upper lid swelling of 15 days' duration and an asymptomatic midline neck mass from 2 months ago. Imaging studies, and microbiologic tests which demonstrated acid-fast bacilli in the fine needle aspirate of the thyroid mass, both confirmed a diagnosis of cold tuberculous thyroid abscess with presumed hematogenous spread to the orbit. The patient demonstrated marked improvement of both lesions with antitubercular drugs. This case illustrates a very rare association of orbital and thyroid tuberculosis.

The Journal of craniofacial surgery, 2015

Pseudotumor cerebri (idiopathic intracranial hypertension) is a syndrome characterized by intracr... more Pseudotumor cerebri (idiopathic intracranial hypertension) is a syndrome characterized by intracranial pressure elevation and associated signs and symptoms in the absence of a space-occupying intracranial lesion. The most common symptoms are visual loss and headache. Sometimes, surgical therapy is needed in patients who have no apparent response to medical therapy and exhibit a progressive course. Optic nerve decompression is an effective and recommended treatment approach for patients with pseudotumor cerebri in whom visual loss predominates. With the growing experience with endoscopic skull base approaches, this method has begun to be used as an alternative and effective treatment modality. In this study, we aimed to present the outcome of endoscopic endonasal optic nerve decompression and to review the literature on this treatment modality in 2 patients diagnosed with pseudotumor cerebri that was unresponsive to medical therapy and associated with progressive visual loss.

Saudi Journal of Ophthalmology, 2012

A twenty-six year old male with decreased vision in right eye was diagnosed with non-rhegmatogeno... more A twenty-six year old male with decreased vision in right eye was diagnosed with non-rhegmatogenous retinal detachment. Further evaluation revealed a yet undiagnosed left testicular mass found to be choriocarcinoma on histopathology. Chemotherapy resulted in complete remission; however, there was no improvement in vision. There is a substantial risk of visual loss in the presence of ocular metastatic lesions. Early detection and treatment is highly effective in terms of tumor control and a more favorable survival and visual outcome. The onus of the ocular diagnosis lies on the ophthalmologist. The presence of a testicular origin tumor must be considered in a young male with intraocular metastasis.

American Journal of Ophthalmology, 1992

Indian Journal of Rheumatology, 2011

S17 patients showed the following order of joint involvement: hip > MIP/PIP > elbow > wrist > kne... more S17 patients showed the following order of joint involvement: hip > MIP/PIP > elbow > wrist > knees = feet > spine and shoulder. Exception to this were 2/16 (12.5%) cases presenting with camptodactyly at birth. We also observed that the rate of progression and spine involvement in the case of familial cases was slower than the cases presenting as first time. The initial event in progression is the restriction of movement, swelling and finally contractures. While widening of the metacarpophalangeal, proximal and middle phalangeal joints, platyspondyly, joint narrowing, epiphyseal widening and irregularity, mild metaphyseal changes characterize the disease, joint destruction, subcortical cysts and extensive osteopenia are absent. The systemic and biochemical inflammatory markers are conspicuous by their absence. The response to anti-inflammatory drugs and immune modulators is very disappointing. Conclusion: PPAC is a single gene disorder presenting as debilitating heritable skeletal dysplasia phenotypically resembling JIA. Two entities can be accurately distinguished on the radiological and molecular analysis. The timely diagnosis of this entity will spare the patient of the unnecessary trials of the toxic drugs and investigations. It will also help in appropriate genetic counselling, prognostication and prediction of the recurrence among family members.

Annals of Ophthalmology, 2006

Pulsatile proptosis is caused by vascular lesion of orbit or by herniation of brain through bony ... more Pulsatile proptosis is caused by vascular lesion of orbit or by herniation of brain through bony defect in orbit. Pulsatile proptosis secondary to a metastatic tumor of orbit is very uncommon. We report a 69-year-old male who presented with pulsatile proptosis owing to metastasis of an asymptomatic renal cell carcinoma.

Orbit, 2003

purpose To report two cases of a cystic isolated extraocular muscle abscess in a young boy. metho... more purpose To report two cases of a cystic isolated extraocular muscle abscess in a young boy. method Case report. results Two cases of young boys with a cystic isolated extraocular muscle abscess are described. Each presented as an inflammatory lesion in the orbit that had been stable for approximately three weeks. Neurodiagnostic imaging of the two cases revealed a cystic lesion in close proximity to an extraocular muscle. An ultrasound-guided aspiration of each lesion revealed material that, when cultured, grew Staphylococcus aureus. Both patients recovered with appropriate antibiotic therapy. No other systemic illness could be identified in either case. conclusion These cases illustrate that an isolated abscess involving an extraocular muscle may present like an inflammatory cyst even without any evidence of systemic illness. When evaluating and managing such lesions, the authors recommend the use of ultrasound-guided aspiration to avoid complications arising from delay in diagnosis and inappropriate treatment.

Journal of the Neurological Sciences, 1997

We report a teenage girl with acute endosulfan poisoning who developed psychosis, generalized ton... more We report a teenage girl with acute endosulfan poisoning who developed psychosis, generalized tonic-clonic seizures, myoclonic jerks, cortical blindness and limb rigidity. Serial magnetic resonance imaging (MRI) showed bilateral reversible lesions localized to caudate nucleus, putamen and occipital cortex; internal capsule and thalamus were spared. This selective involvement may have a bearing on mechanisms underlying endosulfan toxicity.