Pramod Bhende - Academia.edu (original) (raw)

Papers by Pramod Bhende

Research paper thumbnail of Commentary: Entry sites and access in retinopathy of prematurity surgery: How important are they?

Indian Journal of Ophthalmology, 2020

Correct placement of sclerotomies is the primary and probably the most important step in vitrecto... more Correct placement of sclerotomies is the primary and probably the most important step in vitrectomy for a non‐rhegmatogenous retinal detachment (RD) or vitrectomy in the presence of a clear crystalline lens. Inappropriate port placement can not only cause damage to the crystalline lens anteriorly or the retina posteriorly but also can lead to complications related to inconvenient instrument positioning and difficulty in accessing desired tissues. This is especially true while dealing with tiny retinopathy of prematurity (ROP) eyes where there is uncertainty and variation in location of the ora serrata and configuration of RD.

Research paper thumbnail of Commentary: The challenges of managing suprachoroidal hemorrhage

Indian Journal of Ophthalmology, 2021

9. Le Mer Y, Renard Y, Allagui M. Secondary management of suprachoroidal hemorrhages. Graefes Arc... more 9. Le Mer Y, Renard Y, Allagui M. Secondary management of suprachoroidal hemorrhages. Graefes Arch Clin Exp Ophthalmol 1993;231:351–3. 10. Chang S. Low viscosity liquid fluorochemicals in vitreous surgery. Am J Ophthalmol 1987;103:38‐43. 11. Feretis E, Mourtzoukos S, Mangoouritass G, Kabanarou SA, Inoba K, Xirou T. Secondary management and outcome of massive suprachoroidal hemorrhage. Eur J Ophthalmol 2006;16:835‐40. 12. Wirostko WJ, Han DP, Mieler WF, Pulido JS, Connor TB Jr, Kuhn E. Suprachoroidal hemorrhage: Outcome of surgical management according to haemorrhage severity. Ophthalmology 1998;105:2271‐5. 13. Rezende FA, Kickinger MC, Li G, Prado RF, Regis LG. Transconjunctival drainage of serous and hemorrhagic choroidal detachment. Retina 2012;32:242‐9. 14. Rossi T, Boccassini B, Iossa M, Lesnoni G, Tamburrelli C. Choroidal haemorrhage drainage through 23‐gauge vitrectomy cannulas. Retina 2010;30:174–6. 15. Rizzo S, Tartaro R, Faraldi F, Franco F, Finocchio L, Barca F, et al. Two‐stage surgery to manage massive suprachoroidal hemorrhage. Retina 2019;39(Suppl 1):S151‐5. 16. Kwon OW, Kang SJ, Lee JB, Lee SC, Yoon YD, Oh JH. Treatment of suprachoroidal haemorrhage with tissue plasminogen activator. Ophthalmologica 1998;212:120–5. 17. Liu JC, Peyman GA, Oncel M. Treatment of experimental suprachoroidal haemorrhage with intravenous tissue plasminogen activator. Int Ophthalmol 1990;14:267–70. 18. Kunjukunju N, Gonzales CR, Rodden WS. Recombinant tissue plasminogen activator in the treatment of suprachoroidal hemorrhage. Clin Ophthalmol 2011;5:155‐7.

Research paper thumbnail of Faster Visual Recovery in MIVS

Jaypee Brothers Medical Publishers (P) Ltd. eBooks, 2013

Research paper thumbnail of Surgical management of complicated retinal detachment in a case of retinal hemangioblastoma

Indian Journal of Ophthalmology

Research paper thumbnail of Preferred practice patterns in aphakia management in adults in India: A survey

Indian Journal of Ophthalmology

Research paper thumbnail of Retinopathy of prematurity

Indian Journal of Ophthalmology, 2020

Research paper thumbnail of Swiss-cheese macula

Indian Journal of Ophthalmology, 2020

Research paper thumbnail of Ocular Trauma in Armed Conflicts: Manifestations, Management, and Outcomes—Complex Case Scenarios

Research paper thumbnail of Micro Incision Vitrectomy Surgery (MIVS): An Overview

Introduction In today’s world of nano-technology where bigger no longer means better, everything ... more Introduction In today’s world of nano-technology where bigger no longer means better, everything from smartphones to surgical incisions are getting smaller and more refined. The advantages of smaller surgical incision have resulted in faster postoperative recovery. Vitreoretinal surgery is no exception. We have come a long way since the time of open sky vitrectomy and Machemer’s first 17-gauge closed pars plana vitrectomy (PPV) in 1971. In 1974, O’Malley and Heintz introduced a smaller 20-gauge (G) vitrector (0.9 mm diameter) for use with the three-port sclerotomy system that became the gold standard for modern PPV and has been the standard of care for almost three decades. However, in current times, just attaching the retina is not enough. Variables like patient comfort (both intra and post-operative), surgical time and precision, post-operative recovery time, surgically induced refractive error, cosmesis, etc. are becoming increasingly important. To take these factors into account...

Research paper thumbnail of Burden of undiagnosed and sub‐optimally controlled diabetes in selected regions of India: Results from the <scp>SMART</scp> India population‐level diabetes screening study

Diabetic Medicine, Jun 21, 2023

AimsTo estimate the prevalence of undiagnosed diabetes and suboptimally controlled diabetes and t... more AimsTo estimate the prevalence of undiagnosed diabetes and suboptimally controlled diabetes and the associated risk factors by community screening in India.MethodsIn this multi‐centre, cross‐sectional study, house‐to‐house screening was conducted in people aged ≥40 years in urban and rural areas across 10 states and one union territory in India between November 2018 and March 2020. Participants underwent anthropometry, clinical and biochemical assessments. Capillary random blood glucose and point‐of‐care glycated haemoglobin (HbA1c) were used to diagnose diabetes. The prevalence of undiagnosed diabetes and suboptimal control (HbA1c ≥53 mmol/mol [≥7%]) among those with known diabetes was assessed.ResultsAmong the 42,146 participants screened (22,150 urban, 19,996 rural), 5689 had known diabetes. The age‐standardised prevalence of known diabetes was 13.1% (95% CI 12.8–13.4); 17.2% in urban areas and 9.4% in rural areas. The age‐standardised prevalence of undiagnosed diabetes was 6.0% (95% CI 5.7–6.2); similar in both urban and rural areas with the highest proportions seen in the East (8.0%) and South (7.8%) regions. When we consider all people with diabetes in the population, 22.8% of individuals in urban areas and 36.7% in rural areas had undiagnosed diabetes. Almost 75% of the individuals with known diabetes had suboptimal glycaemic control.ConclusionsHigh prevalence of undiagnosed diabetes and suboptimally controlled diabetes emphasises the urgent need to identify and optimally treat people with diabetes to reduce the burden of diabetes.

Research paper thumbnail of Next-generation sequencing-based genetic testing and phenotype correlation in retinitis pigmentosa patients from India

Indian Journal of Ophthalmology, Jun 1, 2023

Objective: Familial partial lipodystrophy (FPL) of the Dunnigan type (FPLD) is an autosomal domin... more Objective: Familial partial lipodystrophy (FPL) of the Dunnigan type (FPLD) is an autosomal dominant condition characterized by fat loss in the limbs and trunk, fat accumulation in the head and neck, and early onset diabetes mellitus. Here we describe the establishment and utilization of next-generation sequencing (NGS)-based genetic testing for FPLD. Methods: We describe NGS-based mutational analysis of the lamin A/C (LMNA) gene, followed by confirmation through Sanger sequencing. Results: We report a patient and her mother with accumulation of fat in the neck and face and loss of fat in the limbs and trunk typical of FPLD2, with young onset diabetes mellitus without ketoacidosis. Both subjects had elevated homeostasis model assessment estimated insulin resistance (HOMA-IR) values and serum triglyceride levels, indicating insulin resistance. Dual energy X-ray absorptiometry confirmed typical fat redistribution. NGS-based mutational analysis of the LMNA gene in these patients revealed a hot spot missense mutation (c.1444C>T, p.Arg482Trp) that was further confirmed by Sanger sequencing. Conclusion: A high index of clinical suspicion is essential to make an accurate clinical diagnosis in subjects with diabetes at an early age. FPLD should be considered in the differential diagnosis of monogenic diabetes with lipodystrophy. Ion torrent NGS offers flexibility and a multiplexing option that provides a robust and inexpensive platform for screening single-gene disorders. (AACE Clinical Case Rep. 2015;1:e28-e31) Abbreviations: FPL = familial partial lipodystrophy; FPLD = familial partial lipodystrophy of the Dunnigan type; NGS = next-generation sequencing

Research paper thumbnail of Ultrasound biomicroscopy of sclerotomy sites after pars plana vitrectomy for diabetic vitreous hemorrhage11The authors have no proprietary interest in any of the materials used in this study

Ophthalmology, Sep 1, 2000

ObjectiveThis study was aimed at assessing changes at the sclerotomy site using the ultrasound bi... more ObjectiveThis study was aimed at assessing changes at the sclerotomy site using the ultrasound biomicroscope (UBM) in eyes that underwent primary pars plana vitrectomy for complications of proliferative diabetic retinopathy.

Research paper thumbnail of Vitreoretinal Surgical Equipment and Instruments Why and How Are They Different in Children?

Research paper thumbnail of Anatomical and surgical considerations and outcomes in infantile Terson syndrome

Indian Journal of Ophthalmology, 2023

Research paper thumbnail of Posterior Segment Manifestations of Cysticercosis

Springer eBooks, Oct 26, 2019

Research paper thumbnail of Ultrasound biomicroscopy of sclerotomy sites: Author’s reply

Ophthalmology, Jul 1, 2001

Ophthalmology, Volume 108, Issue 7, Pages 1176, July 2001, Authors:Muna Bhende, MD; Satish G Agra... more Ophthalmology, Volume 108, Issue 7, Pages 1176, July 2001, Authors:Muna Bhende, MD; Satish G Agraharam, MD; Lingam Gopal, MD; Kallakuri Sumasri, BS; Balusamy Sukumar; Joshua George, MD; Tarun Sharma, MD; Mahesh P Shanmugam, MD; Pramod S Bhende, MD ...

Research paper thumbnail of Removal of Silicone Oil and Epimacular Proliferation From Eyes Following Vitrectomy

Ophthalmic Surgery, Lasers and Imaging Retina

Epimacular proliferation (EMP) represents a localized form of reproliferation at the macula. The ... more Epimacular proliferation (EMP) represents a localized form of reproliferation at the macula. The significance of EMP in eyes that have undergone vitrectomy is still not clear. This study investigated the redetachment rate following silicone oil removal when combined with removal of EMP. Twenty-two consecutive eyes underwent removal of silicone oil and EMP These eyes had attached retinas following silicone oil injection used as an adjunct to complex vitreoretinal surgery. The retina remained attached in 19 (86.4%) of the eyes, with functional improvement it vision in 81.8% of the eyes. Visual acuity of 6/60 (20/200) or better was obtained in 12 (54.5%*) of the eyes. The mean follow-up time was 6.3 months. These results suggest that removal of EMP and silicone oil does not increase the risk of redetachment.

Research paper thumbnail of Using deep learning to detect diabetic retinopathy on handheld non-mydriatic retinal images acquired by field workers in community settings

Scientific Reports

Diabetic retinopathy (DR) at risk of vision loss (referable DR) needs to be identified by retinal... more Diabetic retinopathy (DR) at risk of vision loss (referable DR) needs to be identified by retinal screening and referred to an ophthalmologist. Existing automated algorithms have mostly been developed from images acquired with high cost mydriatic retinal cameras and cannot be applied in the settings used in most low- and middle-income countries. In this prospective multicentre study, we developed a deep learning system (DLS) that detects referable DR from retinal images acquired using handheld non-mydriatic fundus camera by non-technical field workers in 20 sites across India. Macula-centred and optic-disc-centred images from 16,247 eyes (9778 participants) were used to train and cross-validate the DLS and risk factor based logistic regression models. The DLS achieved an AUROC of 0.99 (1000 times bootstrapped 95% CI 0.98–0.99) using two-field retinal images, with 93.86 (91.34–96.08) sensitivity and 96.00 (94.68–98.09) specificity at the Youden’s index operational point. With single ...

Research paper thumbnail of Prevalence of diabetic retinopathy in India stratified by known and undiagnosed diabetes, urban–rural locations, and socioeconomic indices: results from the SMART India population-based cross-sectional screening study

Research paper thumbnail of Preferred practice guidelines for retinopathy of prematurity screening during the COVID-19 pandemic

World Journal of Clinical Pediatrics

Research paper thumbnail of Commentary: Entry sites and access in retinopathy of prematurity surgery: How important are they?

Indian Journal of Ophthalmology, 2020

Correct placement of sclerotomies is the primary and probably the most important step in vitrecto... more Correct placement of sclerotomies is the primary and probably the most important step in vitrectomy for a non‐rhegmatogenous retinal detachment (RD) or vitrectomy in the presence of a clear crystalline lens. Inappropriate port placement can not only cause damage to the crystalline lens anteriorly or the retina posteriorly but also can lead to complications related to inconvenient instrument positioning and difficulty in accessing desired tissues. This is especially true while dealing with tiny retinopathy of prematurity (ROP) eyes where there is uncertainty and variation in location of the ora serrata and configuration of RD.

Research paper thumbnail of Commentary: The challenges of managing suprachoroidal hemorrhage

Indian Journal of Ophthalmology, 2021

9. Le Mer Y, Renard Y, Allagui M. Secondary management of suprachoroidal hemorrhages. Graefes Arc... more 9. Le Mer Y, Renard Y, Allagui M. Secondary management of suprachoroidal hemorrhages. Graefes Arch Clin Exp Ophthalmol 1993;231:351–3. 10. Chang S. Low viscosity liquid fluorochemicals in vitreous surgery. Am J Ophthalmol 1987;103:38‐43. 11. Feretis E, Mourtzoukos S, Mangoouritass G, Kabanarou SA, Inoba K, Xirou T. Secondary management and outcome of massive suprachoroidal hemorrhage. Eur J Ophthalmol 2006;16:835‐40. 12. Wirostko WJ, Han DP, Mieler WF, Pulido JS, Connor TB Jr, Kuhn E. Suprachoroidal hemorrhage: Outcome of surgical management according to haemorrhage severity. Ophthalmology 1998;105:2271‐5. 13. Rezende FA, Kickinger MC, Li G, Prado RF, Regis LG. Transconjunctival drainage of serous and hemorrhagic choroidal detachment. Retina 2012;32:242‐9. 14. Rossi T, Boccassini B, Iossa M, Lesnoni G, Tamburrelli C. Choroidal haemorrhage drainage through 23‐gauge vitrectomy cannulas. Retina 2010;30:174–6. 15. Rizzo S, Tartaro R, Faraldi F, Franco F, Finocchio L, Barca F, et al. Two‐stage surgery to manage massive suprachoroidal hemorrhage. Retina 2019;39(Suppl 1):S151‐5. 16. Kwon OW, Kang SJ, Lee JB, Lee SC, Yoon YD, Oh JH. Treatment of suprachoroidal haemorrhage with tissue plasminogen activator. Ophthalmologica 1998;212:120–5. 17. Liu JC, Peyman GA, Oncel M. Treatment of experimental suprachoroidal haemorrhage with intravenous tissue plasminogen activator. Int Ophthalmol 1990;14:267–70. 18. Kunjukunju N, Gonzales CR, Rodden WS. Recombinant tissue plasminogen activator in the treatment of suprachoroidal hemorrhage. Clin Ophthalmol 2011;5:155‐7.

Research paper thumbnail of Faster Visual Recovery in MIVS

Jaypee Brothers Medical Publishers (P) Ltd. eBooks, 2013

Research paper thumbnail of Surgical management of complicated retinal detachment in a case of retinal hemangioblastoma

Indian Journal of Ophthalmology

Research paper thumbnail of Preferred practice patterns in aphakia management in adults in India: A survey

Indian Journal of Ophthalmology

Research paper thumbnail of Retinopathy of prematurity

Indian Journal of Ophthalmology, 2020

Research paper thumbnail of Swiss-cheese macula

Indian Journal of Ophthalmology, 2020

Research paper thumbnail of Ocular Trauma in Armed Conflicts: Manifestations, Management, and Outcomes—Complex Case Scenarios

Research paper thumbnail of Micro Incision Vitrectomy Surgery (MIVS): An Overview

Introduction In today’s world of nano-technology where bigger no longer means better, everything ... more Introduction In today’s world of nano-technology where bigger no longer means better, everything from smartphones to surgical incisions are getting smaller and more refined. The advantages of smaller surgical incision have resulted in faster postoperative recovery. Vitreoretinal surgery is no exception. We have come a long way since the time of open sky vitrectomy and Machemer’s first 17-gauge closed pars plana vitrectomy (PPV) in 1971. In 1974, O’Malley and Heintz introduced a smaller 20-gauge (G) vitrector (0.9 mm diameter) for use with the three-port sclerotomy system that became the gold standard for modern PPV and has been the standard of care for almost three decades. However, in current times, just attaching the retina is not enough. Variables like patient comfort (both intra and post-operative), surgical time and precision, post-operative recovery time, surgically induced refractive error, cosmesis, etc. are becoming increasingly important. To take these factors into account...

Research paper thumbnail of Burden of undiagnosed and sub‐optimally controlled diabetes in selected regions of India: Results from the <scp>SMART</scp> India population‐level diabetes screening study

Diabetic Medicine, Jun 21, 2023

AimsTo estimate the prevalence of undiagnosed diabetes and suboptimally controlled diabetes and t... more AimsTo estimate the prevalence of undiagnosed diabetes and suboptimally controlled diabetes and the associated risk factors by community screening in India.MethodsIn this multi‐centre, cross‐sectional study, house‐to‐house screening was conducted in people aged ≥40 years in urban and rural areas across 10 states and one union territory in India between November 2018 and March 2020. Participants underwent anthropometry, clinical and biochemical assessments. Capillary random blood glucose and point‐of‐care glycated haemoglobin (HbA1c) were used to diagnose diabetes. The prevalence of undiagnosed diabetes and suboptimal control (HbA1c ≥53 mmol/mol [≥7%]) among those with known diabetes was assessed.ResultsAmong the 42,146 participants screened (22,150 urban, 19,996 rural), 5689 had known diabetes. The age‐standardised prevalence of known diabetes was 13.1% (95% CI 12.8–13.4); 17.2% in urban areas and 9.4% in rural areas. The age‐standardised prevalence of undiagnosed diabetes was 6.0% (95% CI 5.7–6.2); similar in both urban and rural areas with the highest proportions seen in the East (8.0%) and South (7.8%) regions. When we consider all people with diabetes in the population, 22.8% of individuals in urban areas and 36.7% in rural areas had undiagnosed diabetes. Almost 75% of the individuals with known diabetes had suboptimal glycaemic control.ConclusionsHigh prevalence of undiagnosed diabetes and suboptimally controlled diabetes emphasises the urgent need to identify and optimally treat people with diabetes to reduce the burden of diabetes.

Research paper thumbnail of Next-generation sequencing-based genetic testing and phenotype correlation in retinitis pigmentosa patients from India

Indian Journal of Ophthalmology, Jun 1, 2023

Objective: Familial partial lipodystrophy (FPL) of the Dunnigan type (FPLD) is an autosomal domin... more Objective: Familial partial lipodystrophy (FPL) of the Dunnigan type (FPLD) is an autosomal dominant condition characterized by fat loss in the limbs and trunk, fat accumulation in the head and neck, and early onset diabetes mellitus. Here we describe the establishment and utilization of next-generation sequencing (NGS)-based genetic testing for FPLD. Methods: We describe NGS-based mutational analysis of the lamin A/C (LMNA) gene, followed by confirmation through Sanger sequencing. Results: We report a patient and her mother with accumulation of fat in the neck and face and loss of fat in the limbs and trunk typical of FPLD2, with young onset diabetes mellitus without ketoacidosis. Both subjects had elevated homeostasis model assessment estimated insulin resistance (HOMA-IR) values and serum triglyceride levels, indicating insulin resistance. Dual energy X-ray absorptiometry confirmed typical fat redistribution. NGS-based mutational analysis of the LMNA gene in these patients revealed a hot spot missense mutation (c.1444C>T, p.Arg482Trp) that was further confirmed by Sanger sequencing. Conclusion: A high index of clinical suspicion is essential to make an accurate clinical diagnosis in subjects with diabetes at an early age. FPLD should be considered in the differential diagnosis of monogenic diabetes with lipodystrophy. Ion torrent NGS offers flexibility and a multiplexing option that provides a robust and inexpensive platform for screening single-gene disorders. (AACE Clinical Case Rep. 2015;1:e28-e31) Abbreviations: FPL = familial partial lipodystrophy; FPLD = familial partial lipodystrophy of the Dunnigan type; NGS = next-generation sequencing

Research paper thumbnail of Ultrasound biomicroscopy of sclerotomy sites after pars plana vitrectomy for diabetic vitreous hemorrhage11The authors have no proprietary interest in any of the materials used in this study

Ophthalmology, Sep 1, 2000

ObjectiveThis study was aimed at assessing changes at the sclerotomy site using the ultrasound bi... more ObjectiveThis study was aimed at assessing changes at the sclerotomy site using the ultrasound biomicroscope (UBM) in eyes that underwent primary pars plana vitrectomy for complications of proliferative diabetic retinopathy.

Research paper thumbnail of Vitreoretinal Surgical Equipment and Instruments Why and How Are They Different in Children?

Research paper thumbnail of Anatomical and surgical considerations and outcomes in infantile Terson syndrome

Indian Journal of Ophthalmology, 2023

Research paper thumbnail of Posterior Segment Manifestations of Cysticercosis

Springer eBooks, Oct 26, 2019

Research paper thumbnail of Ultrasound biomicroscopy of sclerotomy sites: Author’s reply

Ophthalmology, Jul 1, 2001

Ophthalmology, Volume 108, Issue 7, Pages 1176, July 2001, Authors:Muna Bhende, MD; Satish G Agra... more Ophthalmology, Volume 108, Issue 7, Pages 1176, July 2001, Authors:Muna Bhende, MD; Satish G Agraharam, MD; Lingam Gopal, MD; Kallakuri Sumasri, BS; Balusamy Sukumar; Joshua George, MD; Tarun Sharma, MD; Mahesh P Shanmugam, MD; Pramod S Bhende, MD ...

Research paper thumbnail of Removal of Silicone Oil and Epimacular Proliferation From Eyes Following Vitrectomy

Ophthalmic Surgery, Lasers and Imaging Retina

Epimacular proliferation (EMP) represents a localized form of reproliferation at the macula. The ... more Epimacular proliferation (EMP) represents a localized form of reproliferation at the macula. The significance of EMP in eyes that have undergone vitrectomy is still not clear. This study investigated the redetachment rate following silicone oil removal when combined with removal of EMP. Twenty-two consecutive eyes underwent removal of silicone oil and EMP These eyes had attached retinas following silicone oil injection used as an adjunct to complex vitreoretinal surgery. The retina remained attached in 19 (86.4%) of the eyes, with functional improvement it vision in 81.8% of the eyes. Visual acuity of 6/60 (20/200) or better was obtained in 12 (54.5%*) of the eyes. The mean follow-up time was 6.3 months. These results suggest that removal of EMP and silicone oil does not increase the risk of redetachment.

Research paper thumbnail of Using deep learning to detect diabetic retinopathy on handheld non-mydriatic retinal images acquired by field workers in community settings

Scientific Reports

Diabetic retinopathy (DR) at risk of vision loss (referable DR) needs to be identified by retinal... more Diabetic retinopathy (DR) at risk of vision loss (referable DR) needs to be identified by retinal screening and referred to an ophthalmologist. Existing automated algorithms have mostly been developed from images acquired with high cost mydriatic retinal cameras and cannot be applied in the settings used in most low- and middle-income countries. In this prospective multicentre study, we developed a deep learning system (DLS) that detects referable DR from retinal images acquired using handheld non-mydriatic fundus camera by non-technical field workers in 20 sites across India. Macula-centred and optic-disc-centred images from 16,247 eyes (9778 participants) were used to train and cross-validate the DLS and risk factor based logistic regression models. The DLS achieved an AUROC of 0.99 (1000 times bootstrapped 95% CI 0.98–0.99) using two-field retinal images, with 93.86 (91.34–96.08) sensitivity and 96.00 (94.68–98.09) specificity at the Youden’s index operational point. With single ...

Research paper thumbnail of Prevalence of diabetic retinopathy in India stratified by known and undiagnosed diabetes, urban–rural locations, and socioeconomic indices: results from the SMART India population-based cross-sectional screening study

Research paper thumbnail of Preferred practice guidelines for retinopathy of prematurity screening during the COVID-19 pandemic

World Journal of Clinical Pediatrics