Mithun Thulasidas - Academia.edu (original) (raw)

Papers by Mithun Thulasidas

Journal of pediatric ophthalmology and strabismus, Mar 14, 2024

American Journal of Ophthalmology

Indian Journal of Ophthalmology, Dec 21, 2023

Indian Journal of Ophthalmology, 2022

Dear Editor, We thank Sarkar and Deb[1] for the interest shown and comments on our article.[2] We... more Dear Editor, We thank Sarkar and Deb[1] for the interest shown and comments on our article.[2] We agree that a prospective comparative study might provide more meaningful results, as we had mentioned in the limitations of the study. The present study was a retrospective study conducted to evaluate the outcomes of combined microincision phacoemulsification with transpupillary passive silicone oil (SO) removal using bimanual irrigation/aspiration; this less invasive technique was found to be effective based on our results.

Springer eBooks, 2021

Visual field examination using perimetry is an integral part of the ophthalmic evaluation. Here, ... more Visual field examination using perimetry is an integral part of the ophthalmic evaluation. Here, we focus on some practical aspects of visual field testing, including patients with media opacities. Cornea and lens opacities can cause a defect in the visual field and can make interpreting the measurements and indices more challenging. The depressions caused by media opacities are typically diffuse on the total deviation map and correlate with the opacity location, although opacities that are sufficiently deep may also result in concurrent defects on the pattern deviation map. Through some clinical examples, we provide useful insights to help ophthalmologists prevent misdiagnosis and overtreatment of glaucoma.

IJAR - Indian Journal of Applied Research, 2018

The purpose of this study is to compare the efficacy of one-site and two-site combined phacotrabe... more The purpose of this study is to compare the efficacy of one-site and two-site combined phacotrabeculectomy in eyes with concomitant glaucoma and cataract Methodology: 22 Patients with concomitant glaucoma and cataract (36 eyes) over a period of 1 year were randomly assigned to undergo either a one-site (19eyes) or a two-site (17eyes) combined procedure. Results: Mean postoperative intraocular pressure (IOP) significantly decreased in both groups compared to the preoperative level and was 16mmHg in the one-site group and 15mmHg in the two-site group. Best-corrected visual acuity (BCVA) was not different in both groups, postoperative (induced) astigmatism was less in the two-site group. Conclusion: Both techniques yielded similar results regarding postoperative IOP reduction and final BCVA. However, the two-site group had less induced astigmatism compared to the one-site group.

Indian Journal of Ophthalmology, 2020

Clinical Ophthalmology, Dec 1, 2020

Purpose: To report a case series of four ocular toxoplasmosis patients who received intravitreal ... more Purpose: To report a case series of four ocular toxoplasmosis patients who received intravitreal clindamycin as first-line treatment. Materials and Methods: Retrospective interventional case series. Results: Four (two females and two males) patients were diagnosed with active primary toxoplasmic retinochoroiditis based on their clinical presentation. All patients received intravitreal clindamycin 1mg/0.1mL as first-line therapy (two injections with 1-week interval). Oral corticosteroid 1mg/kg/day was also given in a tapering fashion over 4-6 weeks. A remarkable response was seen in all cases with improved visual acuity, sharpening of the lesion borders, and resolution of inflammation within 4-6 weeks. No recurrence or reactivation was noted until 2 years follow-up. Conclusion: Intravitreal clindamycin, combined with oral corticosteroids, can be considered an effective and safe first-line therapy for active toxoplasmic retinochoroiditis. It provides the patient a more convenience, safer systemic side effect profile, increased availability, and fewer follow-up visits and hematologic investigations.

Indian Journal of Ophthalmology, 2023

Indian Journal of Ophthalmology, 2022

Clinical Ophthalmology, Jun 1, 2021

Retropupillary iris-claw intraocular lenses (ICIOLs) have been increasingly chosen by surgeons no... more Retropupillary iris-claw intraocular lenses (ICIOLs) have been increasingly chosen by surgeons nowadays as a primary or secondary procedure of IOL implantation in eyes with insufficient capsular or zonular support. They have gained popularity due to their simple fast technique, favourable functional outcomes, and safety. The transition in the ICIOL fixation from prepupillary to a more biologically appropriate retropupillary position and change in the optic design from biconvex to convex-concave have provided better visual outcomes and improved safety. A peer-reviewed literature search was conducted in Medline (PubMed), Embase, and Cochrane Library using the keywords "retropupillary iris claw" and "iris claw". The search yielded 310 articles that were screened. Forty-three articles on retropupillary ICIOLs were finally found to be relevant and reviewed in full-text versions. The functional outcomes following retropupillary implantation of ICIOLs have been acceptable in eyes with no ocular co-morbidities otherwise. However, the indications for surgery may affect the outcomes. The major postoperative complications directly associated with ICIOLs include pupil ovalization and redislocation. Nevertheless, the rate of disenclavation depends on the experience and skill of the surgeon. This review is based on a literature review, and it focuses on the preoperative evaluation, surgical technique, postoperative outcomes, and associated complications. Prospective randomized trials with a larger sample size and longer follow-up are needed for comparison with other techniques of IOL fixation and confirmation of long-term safety profile.

Indian journal of ophthalmology, 2021

Indian Journal of Ophthalmology, 2021

In this study, Intraocular pressure (IOP) was measured with schiotz tonometer in all the eyes. It... more In this study, Intraocular pressure (IOP) was measured with schiotz tonometer in all the eyes. It would have been ideal to use the Goldmann applanation tonometer for IOP measurement, as IOP was one of the outcome measures of the study. Central corneal thickness (CCT) was measured using pachymetry. However, it is not mentioned which pachymeter was used for the measurement – contact or non‐contact? Which company ICIOL was implanted is also not mentioned.

American Journal of Ophthalmology Case Reports, Mar 1, 2022

Purpose To report a case of unilateral posterior dislocation of the cataractous lens and subluxat... more Purpose To report a case of unilateral posterior dislocation of the cataractous lens and subluxation of the lens in the fellow eye of a patient with Parkinson-plus syndrome. Observations A 67-year-old-man who was a known case of Parkinson-plus syndrome on long-term dopamine agonists and anti-psychotic medications demonstrated apraxia of lid opening associated with moderate-to-severe blepharospasm. He had unilateral posterior dislocation of the cataractous lens and subluxation of the lens in the fellow eye with no prior history of trauma or other known ocular risk factors. Conclusion and importance This case may represent an unusual example of spontaneous lens dislocation secondary to apraxia of lid opening and concurrent blepharospasm, which is associated with Parkinson-plus syndrome.

Indian Journal of Ophthalmology, 2020

Uveal melanoma is a rare malignancy originating from melanocytes within the uveal tract of the ey... more Uveal melanoma is a rare malignancy originating from melanocytes within the uveal tract of the eye. True multifocal uveal melanomas (>2melanomas in 1 eye) occurring in the same eye are very rare. We report a clinically and histologically well-documented case of a patient who presented with 3 uveal melanoma lesions in the same eye over a span of 2.5 years. The eye had to be enucleated finally and diagnosis confirmed histologically. This case report highlights the need for a close follow-up, even after successful treatment of the presenting lesion in uveal melanomas.

Indian Journal of Ophthalmology, 2019

A 56‐year‐old female presented with blurred vision in the right eye. Best corrected visual acuity... more A 56‐year‐old female presented with blurred vision in the right eye. Best corrected visual acuity was 6/18, N12 in the right eye and 6/6, N6 in the left eye. Fundus examination in both eyes showed significant tessellation. Spectral domain OCT revealed a split in the neurosensory retina at the level of Henle’s layer nasal to fovea with schitic changes extending to fovea. En face OCT demonstrated a very characteristic half wheel or coral shaped pattern at the level of outer plexiform layer highlighting the complete extent of the retinoschisis [Fig. 1].

Indian Journal of Ophthalmology, 2021

Indian Journal of Ophthalmology, 2022

Purpose: To compare the postoperative uncorrected distance visual acuity (UDVA) and refractive ou... more Purpose: To compare the postoperative uncorrected distance visual acuity (UDVA) and refractive outcomes of cataract patients with astigmatism following implantation of Eyecryl™ and Tecnis® toric intraocular lenses (IOLs). Methods: We conducted a single-center, retrospective study including patients who had undergone phacoemulsification and implantation with either Eyecryl™ toric (Group 1) or Tecnis® toric (Group 2) IOL. The primary outcome measures included postoperative UDVA and residual astigmatism at 3 months. The secondary outcome measure was IOL misalignment >10° throughout the follow-up period. Results: One hundred and eight eyes of 76 patients (44 males and 32 females) were analyzed. Twenty-nine patients (38 eyes) received Eyecryl™ toric IOL (Group 1), and 47 patients (70 eyes) received Tecnis® toric IOL (Group 2). Groups 1 and 2 showed a mean postoperative logMAR UDVA of 0.09 ± 0.11 and 0.06 ± 0.09, respectively, at 3 months (P = 0.114). In both groups, all the eyes achieved a postoperative UDVA of ≤0.3 logMAR. The postoperative residual astigmatism of group 1 and group 2 was -0.29 ± 0.34 D and -0.16 ± 0.27 D, respectively (P = 0.038). Postoperative astigmatism was within ± 1.00 D in all the eyes. No eyes had an IOL misalignment >10° throughout the follow-up period. Conclusion: Both Eyecryl™ and Tecnis® toric IOLs provided significant improvement in uncorrected visual acuity and astigmatism correction postoperatively. The Tecnis® toric IOL provided statistically significant lower residual astigmatism than Eyecryl™toric IOL. However, the difference in postoperative astigmatism between the two IOLs was clinically insignificant.

Indian Journal of Ophthalmology, 2020

Purpose: To analyse topographic and tomographic changes in fellow eyes of unilateral keratoconus ... more Purpose: To analyse topographic and tomographic changes in fellow eyes of unilateral keratoconus patients by comparing them with normal eyes. Methods: This five-year retrospective observational comparative case study included 15 advanced keratoconus eyes of unilateral keratoconus (KCN group), 15 normal fellow eyes of unilateral keratoconus (Fellow eye group) and 34 eyes of normal refractive surgery candidates (Normal group). Topographic and tomographic data, data from enhanced elevation maps, and keratoconus indices were measured in all study eyes using Pentacam. Receiver operating characteristic (ROC) curves were used to evaluate the area under the curve (AUC), sensitivity and specificity of each parameter and identify cut-off points in discriminating between the fellow and normal eyes. Results: Corneal thickness at the apex (CTA, P = 0.001) and at the thinnest point (CTT, P < 0.001), corneal volume (CV, P = 0.007), Belin/Ambrosio Enhanced Ectasia Display (BAD) - thinnest point (Dt, P = 0.002) and thinnest point displacement (Da, P = 0.002) were significantly lower in the fellow group compared to eyes of normal subjects. On ROC curve analysis, the most efficient distinguishing indices between the fellow group and normal controls were BAD - overall D value (AUC = 0.859), Dt (AUC =0.827), Da (AUC = 0.789) followed by pachymetric progression index maximum (AUC = 0.741). Conclusion: BAD-D value and pachymetric progression index could be useful in detecting the earliest form of subclinical keratoconus. However, every single parameter alone is not enough to detect early changes; a combination of different data is required to distinguish subclinical keratoconus.

Journal of pediatric ophthalmology and strabismus, Mar 14, 2024

American Journal of Ophthalmology

Indian Journal of Ophthalmology, Dec 21, 2023

Indian Journal of Ophthalmology, 2022

Dear Editor, We thank Sarkar and Deb[1] for the interest shown and comments on our article.[2] We... more Dear Editor, We thank Sarkar and Deb[1] for the interest shown and comments on our article.[2] We agree that a prospective comparative study might provide more meaningful results, as we had mentioned in the limitations of the study. The present study was a retrospective study conducted to evaluate the outcomes of combined microincision phacoemulsification with transpupillary passive silicone oil (SO) removal using bimanual irrigation/aspiration; this less invasive technique was found to be effective based on our results.

Springer eBooks, 2021

Visual field examination using perimetry is an integral part of the ophthalmic evaluation. Here, ... more Visual field examination using perimetry is an integral part of the ophthalmic evaluation. Here, we focus on some practical aspects of visual field testing, including patients with media opacities. Cornea and lens opacities can cause a defect in the visual field and can make interpreting the measurements and indices more challenging. The depressions caused by media opacities are typically diffuse on the total deviation map and correlate with the opacity location, although opacities that are sufficiently deep may also result in concurrent defects on the pattern deviation map. Through some clinical examples, we provide useful insights to help ophthalmologists prevent misdiagnosis and overtreatment of glaucoma.

IJAR - Indian Journal of Applied Research, 2018

The purpose of this study is to compare the efficacy of one-site and two-site combined phacotrabe... more The purpose of this study is to compare the efficacy of one-site and two-site combined phacotrabeculectomy in eyes with concomitant glaucoma and cataract Methodology: 22 Patients with concomitant glaucoma and cataract (36 eyes) over a period of 1 year were randomly assigned to undergo either a one-site (19eyes) or a two-site (17eyes) combined procedure. Results: Mean postoperative intraocular pressure (IOP) significantly decreased in both groups compared to the preoperative level and was 16mmHg in the one-site group and 15mmHg in the two-site group. Best-corrected visual acuity (BCVA) was not different in both groups, postoperative (induced) astigmatism was less in the two-site group. Conclusion: Both techniques yielded similar results regarding postoperative IOP reduction and final BCVA. However, the two-site group had less induced astigmatism compared to the one-site group.

Indian Journal of Ophthalmology, 2020

Clinical Ophthalmology, Dec 1, 2020

Purpose: To report a case series of four ocular toxoplasmosis patients who received intravitreal ... more Purpose: To report a case series of four ocular toxoplasmosis patients who received intravitreal clindamycin as first-line treatment. Materials and Methods: Retrospective interventional case series. Results: Four (two females and two males) patients were diagnosed with active primary toxoplasmic retinochoroiditis based on their clinical presentation. All patients received intravitreal clindamycin 1mg/0.1mL as first-line therapy (two injections with 1-week interval). Oral corticosteroid 1mg/kg/day was also given in a tapering fashion over 4-6 weeks. A remarkable response was seen in all cases with improved visual acuity, sharpening of the lesion borders, and resolution of inflammation within 4-6 weeks. No recurrence or reactivation was noted until 2 years follow-up. Conclusion: Intravitreal clindamycin, combined with oral corticosteroids, can be considered an effective and safe first-line therapy for active toxoplasmic retinochoroiditis. It provides the patient a more convenience, safer systemic side effect profile, increased availability, and fewer follow-up visits and hematologic investigations.

Indian Journal of Ophthalmology, 2023

Indian Journal of Ophthalmology, 2022

Clinical Ophthalmology, Jun 1, 2021

Retropupillary iris-claw intraocular lenses (ICIOLs) have been increasingly chosen by surgeons no... more Retropupillary iris-claw intraocular lenses (ICIOLs) have been increasingly chosen by surgeons nowadays as a primary or secondary procedure of IOL implantation in eyes with insufficient capsular or zonular support. They have gained popularity due to their simple fast technique, favourable functional outcomes, and safety. The transition in the ICIOL fixation from prepupillary to a more biologically appropriate retropupillary position and change in the optic design from biconvex to convex-concave have provided better visual outcomes and improved safety. A peer-reviewed literature search was conducted in Medline (PubMed), Embase, and Cochrane Library using the keywords "retropupillary iris claw" and "iris claw". The search yielded 310 articles that were screened. Forty-three articles on retropupillary ICIOLs were finally found to be relevant and reviewed in full-text versions. The functional outcomes following retropupillary implantation of ICIOLs have been acceptable in eyes with no ocular co-morbidities otherwise. However, the indications for surgery may affect the outcomes. The major postoperative complications directly associated with ICIOLs include pupil ovalization and redislocation. Nevertheless, the rate of disenclavation depends on the experience and skill of the surgeon. This review is based on a literature review, and it focuses on the preoperative evaluation, surgical technique, postoperative outcomes, and associated complications. Prospective randomized trials with a larger sample size and longer follow-up are needed for comparison with other techniques of IOL fixation and confirmation of long-term safety profile.

Indian journal of ophthalmology, 2021

Indian Journal of Ophthalmology, 2021

In this study, Intraocular pressure (IOP) was measured with schiotz tonometer in all the eyes. It... more In this study, Intraocular pressure (IOP) was measured with schiotz tonometer in all the eyes. It would have been ideal to use the Goldmann applanation tonometer for IOP measurement, as IOP was one of the outcome measures of the study. Central corneal thickness (CCT) was measured using pachymetry. However, it is not mentioned which pachymeter was used for the measurement – contact or non‐contact? Which company ICIOL was implanted is also not mentioned.

American Journal of Ophthalmology Case Reports, Mar 1, 2022

Purpose To report a case of unilateral posterior dislocation of the cataractous lens and subluxat... more Purpose To report a case of unilateral posterior dislocation of the cataractous lens and subluxation of the lens in the fellow eye of a patient with Parkinson-plus syndrome. Observations A 67-year-old-man who was a known case of Parkinson-plus syndrome on long-term dopamine agonists and anti-psychotic medications demonstrated apraxia of lid opening associated with moderate-to-severe blepharospasm. He had unilateral posterior dislocation of the cataractous lens and subluxation of the lens in the fellow eye with no prior history of trauma or other known ocular risk factors. Conclusion and importance This case may represent an unusual example of spontaneous lens dislocation secondary to apraxia of lid opening and concurrent blepharospasm, which is associated with Parkinson-plus syndrome.

Indian Journal of Ophthalmology, 2020

Uveal melanoma is a rare malignancy originating from melanocytes within the uveal tract of the ey... more Uveal melanoma is a rare malignancy originating from melanocytes within the uveal tract of the eye. True multifocal uveal melanomas (>2melanomas in 1 eye) occurring in the same eye are very rare. We report a clinically and histologically well-documented case of a patient who presented with 3 uveal melanoma lesions in the same eye over a span of 2.5 years. The eye had to be enucleated finally and diagnosis confirmed histologically. This case report highlights the need for a close follow-up, even after successful treatment of the presenting lesion in uveal melanomas.

Indian Journal of Ophthalmology, 2019

A 56‐year‐old female presented with blurred vision in the right eye. Best corrected visual acuity... more A 56‐year‐old female presented with blurred vision in the right eye. Best corrected visual acuity was 6/18, N12 in the right eye and 6/6, N6 in the left eye. Fundus examination in both eyes showed significant tessellation. Spectral domain OCT revealed a split in the neurosensory retina at the level of Henle’s layer nasal to fovea with schitic changes extending to fovea. En face OCT demonstrated a very characteristic half wheel or coral shaped pattern at the level of outer plexiform layer highlighting the complete extent of the retinoschisis [Fig. 1].

Indian Journal of Ophthalmology, 2021

Indian Journal of Ophthalmology, 2022

Purpose: To compare the postoperative uncorrected distance visual acuity (UDVA) and refractive ou... more Purpose: To compare the postoperative uncorrected distance visual acuity (UDVA) and refractive outcomes of cataract patients with astigmatism following implantation of Eyecryl™ and Tecnis® toric intraocular lenses (IOLs). Methods: We conducted a single-center, retrospective study including patients who had undergone phacoemulsification and implantation with either Eyecryl™ toric (Group 1) or Tecnis® toric (Group 2) IOL. The primary outcome measures included postoperative UDVA and residual astigmatism at 3 months. The secondary outcome measure was IOL misalignment >10° throughout the follow-up period. Results: One hundred and eight eyes of 76 patients (44 males and 32 females) were analyzed. Twenty-nine patients (38 eyes) received Eyecryl™ toric IOL (Group 1), and 47 patients (70 eyes) received Tecnis® toric IOL (Group 2). Groups 1 and 2 showed a mean postoperative logMAR UDVA of 0.09 ± 0.11 and 0.06 ± 0.09, respectively, at 3 months (P = 0.114). In both groups, all the eyes achieved a postoperative UDVA of ≤0.3 logMAR. The postoperative residual astigmatism of group 1 and group 2 was -0.29 ± 0.34 D and -0.16 ± 0.27 D, respectively (P = 0.038). Postoperative astigmatism was within ± 1.00 D in all the eyes. No eyes had an IOL misalignment >10° throughout the follow-up period. Conclusion: Both Eyecryl™ and Tecnis® toric IOLs provided significant improvement in uncorrected visual acuity and astigmatism correction postoperatively. The Tecnis® toric IOL provided statistically significant lower residual astigmatism than Eyecryl™toric IOL. However, the difference in postoperative astigmatism between the two IOLs was clinically insignificant.

Indian Journal of Ophthalmology, 2020

Purpose: To analyse topographic and tomographic changes in fellow eyes of unilateral keratoconus ... more Purpose: To analyse topographic and tomographic changes in fellow eyes of unilateral keratoconus patients by comparing them with normal eyes. Methods: This five-year retrospective observational comparative case study included 15 advanced keratoconus eyes of unilateral keratoconus (KCN group), 15 normal fellow eyes of unilateral keratoconus (Fellow eye group) and 34 eyes of normal refractive surgery candidates (Normal group). Topographic and tomographic data, data from enhanced elevation maps, and keratoconus indices were measured in all study eyes using Pentacam. Receiver operating characteristic (ROC) curves were used to evaluate the area under the curve (AUC), sensitivity and specificity of each parameter and identify cut-off points in discriminating between the fellow and normal eyes. Results: Corneal thickness at the apex (CTA, P = 0.001) and at the thinnest point (CTT, P < 0.001), corneal volume (CV, P = 0.007), Belin/Ambrosio Enhanced Ectasia Display (BAD) - thinnest point (Dt, P = 0.002) and thinnest point displacement (Da, P = 0.002) were significantly lower in the fellow group compared to eyes of normal subjects. On ROC curve analysis, the most efficient distinguishing indices between the fellow group and normal controls were BAD - overall D value (AUC = 0.859), Dt (AUC =0.827), Da (AUC = 0.789) followed by pachymetric progression index maximum (AUC = 0.741). Conclusion: BAD-D value and pachymetric progression index could be useful in detecting the earliest form of subclinical keratoconus. However, every single parameter alone is not enough to detect early changes; a combination of different data is required to distinguish subclinical keratoconus.