Sudha Menon - Academia.edu (original) (raw)
Papers by Sudha Menon
Journal of Glaucoma
Precis: Combined average visual field index (VFI) is a simple, novel tool for binocular visual fi... more Precis: Combined average visual field index (VFI) is a simple, novel tool for binocular visual field which agrees with the existing binocular integrated visual field (IVF) model, as well as patient reported activity limitation in glaucoma. Purpose: The aim was to determine the correlation between novel models of binocular visual field with the existing IVF and glaucoma activity limitation (GAL-9). Materials and Methods: IVFs were calculated from the monocular visual fields of 58 patients with primary glaucoma and the novel binocular visual field models termed binocular summation visual field index (BiSumVFI) and combined average visual field index (CaVFI) were derived from the VFIs of both fields. GAL-9 questionnaire was administered to the patients. The relationship between IVF and the 2 newer models of binocular fields were determined and the correlation of IVF, BiSumVFI, and CaVFI with GAL-9 was estimated. Results: A very strong correlation was seen between IVF and BiSumVFI (r=−0.913, P<0.001, confidence interval: −0.958 to −0.821) and also between IVF and CaVFI (r=−0.896, P<0.001, confidence interval: −0.947 to −0.802). Linear regression analysis showed a significant R 2 of 0.902 (P<0.001) to predict IVF from BiSumVFI and R 2 of 0.847 (P<0.001) to predict IVF from CaVFI. IVF, BiSumVFI, and CaVFI correlated moderately and significantly with GAL-9 with correlation coefficients of 0.481, −0.499, and −0.505, respectively. Conclusion: The binocular summation VFI and combined average VFI models of binocular visual field are good predictors of IVF in glaucoma. They correlate well with the existing IVF model in estimating patients’ perception of activity limitation in glaucoma.
Journal of Stroke Medicine, 2022
Retinal vessels provide an indirect window to the status of cerebral vasculature. Pathological ch... more Retinal vessels provide an indirect window to the status of cerebral vasculature. Pathological changes in cerebral vessels secondary to hypertension and other predisposing conditions precede the onset of hemorrhagic stroke. Retinal vessel assessment may help in early detection of these changes and several studies have shown that retinal vessel caliber assessment can be a valuable tool in the primary prevention of hemorrhagic stroke. Technical considerations have been a limiting factor in the widespread use of this simple user friendly tool. However, recent technological and software advances especially in the realm of artificial intelligence and machine learning have simplified the procedure. This article explores the current status and future prospects of this extremely promising tool.
Ophthalmology Journal, 2021
The orbit encases the ocular globe with its appendages. Tumours of the orbit include a broad spec... more The orbit encases the ocular globe with its appendages. Tumours of the orbit include a broad spectrum of pathologies [1-3]. Its unique anatomical outline and its proximity to the cranial cavity make surgical approaches to the orbit a challenging pursuit [4]. Different surgical corridors have been described to access the orbit, each customised this article is available in open access under Creative Common attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
Journal of Clinical Ophthalmology and Research, 2021
Ocular trauma and retained foreign bodies in the eye form a common occurrence in ophthalmic pract... more Ocular trauma and retained foreign bodies in the eye form a common occurrence in ophthalmic practice. Mild trauma may often be overlooked and patients, quite often, present late with serious complications. The clinical presentations and management of three patients who presented with a FB in the anterior chamber, within the lens, and within the orbit, respectively, are discussed. The diagnostic and management issues are highlighted along with a brief review of relevant literature.
Journal of Neurosciences in Rural Practice, 2020
Background Spheno-orbital meningiomas (SOMs) constitute a rare cause for orbital proptosis and vi... more Background Spheno-orbital meningiomas (SOMs) constitute a rare cause for orbital proptosis and visual impairment. This study aims to share our outcome experience with regard to vision and exophthalmos following the surgical management of 17 patients with SOM. Methods Retrospective analysis of the case records of all surgically treated SOMs in the last 10 years. Exophthalmos index (EI) was calculated based on preoperative magnetic resonance imaging/computed tomography imaging. Vision was assessed using the Snellen’s chart and Goldman’s perimeter. Orbital volume was calculated using three-dimensional volume rendering assisted region-of-interest computation. Preoperative duration of symptoms and extent of surgery were the other predictors analyzed. Results Patients’ age ranged from 17 to 72 years (mean, 50.57 y; median, 50.0 years). Women represented 13 (76.4%) of the entire study group. Proptosis (14/17; 82.4%) and visual impairment (14/17; 82.3%) were the two most common presenting c...
IP International Journal of Ocular Oncology and Oculoplasty, 2020
Choroidal melanoma is the most common intraocular tumor in adults, but is rare in Asia. Patients ... more Choroidal melanoma is the most common intraocular tumor in adults, but is rare in Asia. Patients can present with diminished vision, floaters or visual field loss but most often, tumors are detected incidentally on routine examination. We report a case of a 71 year old female who presented to us with decreased vision and pain in the right eye, who was diagnosed with acute angle closure glaucoma and was treated for the same. On further evaluation, she was found to have choroidal melanoma. This highlights the need for complete evaluation of a successfully treated acute angle closure crisis case.
Indian Journal of Clinical and Experimental Ophthalmology, 2019
Introduction: Oculomotor nerve palsy following mild traumatic brain injury is uncommon. The exact... more Introduction: Oculomotor nerve palsy following mild traumatic brain injury is uncommon. The exact pathogenesis, management protocol and outcome of such patients is unclear in the absence of large series. This article attempts to analyze the patterns of injury and recovery in a series of twenty one patients with third cranial nerve palsy following mild traumatic brain injury (TBI). Materials and Methods: All patients admitted with mild head injury and third nerve involvement were included in the study. This retrospective study covered a three-year period from January 2015 to December 2017. Mild head injury was defined as patients with a Glasgow Coma score of 14-15 and having a normal CT scan at admission. The clinical profile of the injury and recovery of the oculomotor nerve were jointly evaluated and followed up in the department of neurosurgery and ophthalmology. Results: Our study group included twenty one patients. Levator palpebrae superioris involvement with ptosis (95.23%) was the most consistently affected third nerve function followed by extraocular muscles (90.47%) and pupillary fibers (80.9%). Ptosis was partial in 11 patients and complete in nine. Of the extra ocular muscles, the most common muscles to be involved were the inferior rectus and the medial rectus which were involved in 19 patients (90.47%). Superior rectus involvement was seen in 13 patients and inferior oblique in nine patients. Imaging including thin section CT scans (all patients) and FIESTA MRI sequence (2 patients) did not reveal any significant abnormality. All our patients were managed conservatively. Steroids and corrective surgery was not tried in any patient. On follow up, after a mean period of 6 months, partial ptosis recovered completely while complete ptosis recovered only in four patients (44.4%). Of the seventeen patients with pupillary involvement, pupillary size and reaction improved in four (23.5%) and remained static in 13 patients. Of the extraocular muscles superior rectus (9/13) and inferior oblique (6/9) appeared to have a better recovery than inferior rectus (09/19) and medial rectus (08/19). Conclusion: Isolated oculomotor nerve palsy following minor head injury is uncommon. The exact pathogenesis is unclear. Advanced MRI sequences may reveal structural lesions along the course of the third cranial nerve in few cases. Pupillary fibers are most susceptible to injury and have the least rate of recovery. Partial ptosis recovers well. Recovery of extraocular muscle paresis is inconsistent. Management is essentially symptomatic and the outcome is unpredictable.
Journal of Neurosciences in Rural Practice, 2017
ABSTRACTPostoperative visual loss is a dreaded complication following transcranial excision of tu... more ABSTRACTPostoperative visual loss is a dreaded complication following transcranial excision of tuberculum sella meningioma. Visual deterioration is commonly noticed immediately after surgery, and delayed deterioration after 72 h is uncommon. We report a case of delayed postoperative deterioration in a 48-year-old female and discuss the possible mechanisms.
Journal of Neurosciences in Rural Practice, 2017
ABSTRACTCavernous carotid aneurysms (CCA) pose considerable dilemmas in management. It is still u... more ABSTRACTCavernous carotid aneurysms (CCA) pose considerable dilemmas in management. It is still unclear as to whether an asymptomatic CCA should be subjected to treatment. Similarly, the ideal management strategy for a symptomatic aneurysm is controversial. We present the case of a 60-year-old female with a giant CCA and discuss the management issues.
Journal of Glaucoma
Precis: Combined average visual field index (VFI) is a simple, novel tool for binocular visual fi... more Precis: Combined average visual field index (VFI) is a simple, novel tool for binocular visual field which agrees with the existing binocular integrated visual field (IVF) model, as well as patient reported activity limitation in glaucoma. Purpose: The aim was to determine the correlation between novel models of binocular visual field with the existing IVF and glaucoma activity limitation (GAL-9). Materials and Methods: IVFs were calculated from the monocular visual fields of 58 patients with primary glaucoma and the novel binocular visual field models termed binocular summation visual field index (BiSumVFI) and combined average visual field index (CaVFI) were derived from the VFIs of both fields. GAL-9 questionnaire was administered to the patients. The relationship between IVF and the 2 newer models of binocular fields were determined and the correlation of IVF, BiSumVFI, and CaVFI with GAL-9 was estimated. Results: A very strong correlation was seen between IVF and BiSumVFI (r=−0.913, P<0.001, confidence interval: −0.958 to −0.821) and also between IVF and CaVFI (r=−0.896, P<0.001, confidence interval: −0.947 to −0.802). Linear regression analysis showed a significant R 2 of 0.902 (P<0.001) to predict IVF from BiSumVFI and R 2 of 0.847 (P<0.001) to predict IVF from CaVFI. IVF, BiSumVFI, and CaVFI correlated moderately and significantly with GAL-9 with correlation coefficients of 0.481, −0.499, and −0.505, respectively. Conclusion: The binocular summation VFI and combined average VFI models of binocular visual field are good predictors of IVF in glaucoma. They correlate well with the existing IVF model in estimating patients’ perception of activity limitation in glaucoma.
Journal of Stroke Medicine, 2022
Retinal vessels provide an indirect window to the status of cerebral vasculature. Pathological ch... more Retinal vessels provide an indirect window to the status of cerebral vasculature. Pathological changes in cerebral vessels secondary to hypertension and other predisposing conditions precede the onset of hemorrhagic stroke. Retinal vessel assessment may help in early detection of these changes and several studies have shown that retinal vessel caliber assessment can be a valuable tool in the primary prevention of hemorrhagic stroke. Technical considerations have been a limiting factor in the widespread use of this simple user friendly tool. However, recent technological and software advances especially in the realm of artificial intelligence and machine learning have simplified the procedure. This article explores the current status and future prospects of this extremely promising tool.
Ophthalmology Journal, 2021
The orbit encases the ocular globe with its appendages. Tumours of the orbit include a broad spec... more The orbit encases the ocular globe with its appendages. Tumours of the orbit include a broad spectrum of pathologies [1-3]. Its unique anatomical outline and its proximity to the cranial cavity make surgical approaches to the orbit a challenging pursuit [4]. Different surgical corridors have been described to access the orbit, each customised this article is available in open access under Creative Common attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
Journal of Clinical Ophthalmology and Research, 2021
Ocular trauma and retained foreign bodies in the eye form a common occurrence in ophthalmic pract... more Ocular trauma and retained foreign bodies in the eye form a common occurrence in ophthalmic practice. Mild trauma may often be overlooked and patients, quite often, present late with serious complications. The clinical presentations and management of three patients who presented with a FB in the anterior chamber, within the lens, and within the orbit, respectively, are discussed. The diagnostic and management issues are highlighted along with a brief review of relevant literature.
Journal of Neurosciences in Rural Practice, 2020
Background Spheno-orbital meningiomas (SOMs) constitute a rare cause for orbital proptosis and vi... more Background Spheno-orbital meningiomas (SOMs) constitute a rare cause for orbital proptosis and visual impairment. This study aims to share our outcome experience with regard to vision and exophthalmos following the surgical management of 17 patients with SOM. Methods Retrospective analysis of the case records of all surgically treated SOMs in the last 10 years. Exophthalmos index (EI) was calculated based on preoperative magnetic resonance imaging/computed tomography imaging. Vision was assessed using the Snellen’s chart and Goldman’s perimeter. Orbital volume was calculated using three-dimensional volume rendering assisted region-of-interest computation. Preoperative duration of symptoms and extent of surgery were the other predictors analyzed. Results Patients’ age ranged from 17 to 72 years (mean, 50.57 y; median, 50.0 years). Women represented 13 (76.4%) of the entire study group. Proptosis (14/17; 82.4%) and visual impairment (14/17; 82.3%) were the two most common presenting c...
IP International Journal of Ocular Oncology and Oculoplasty, 2020
Choroidal melanoma is the most common intraocular tumor in adults, but is rare in Asia. Patients ... more Choroidal melanoma is the most common intraocular tumor in adults, but is rare in Asia. Patients can present with diminished vision, floaters or visual field loss but most often, tumors are detected incidentally on routine examination. We report a case of a 71 year old female who presented to us with decreased vision and pain in the right eye, who was diagnosed with acute angle closure glaucoma and was treated for the same. On further evaluation, she was found to have choroidal melanoma. This highlights the need for complete evaluation of a successfully treated acute angle closure crisis case.
Indian Journal of Clinical and Experimental Ophthalmology, 2019
Introduction: Oculomotor nerve palsy following mild traumatic brain injury is uncommon. The exact... more Introduction: Oculomotor nerve palsy following mild traumatic brain injury is uncommon. The exact pathogenesis, management protocol and outcome of such patients is unclear in the absence of large series. This article attempts to analyze the patterns of injury and recovery in a series of twenty one patients with third cranial nerve palsy following mild traumatic brain injury (TBI). Materials and Methods: All patients admitted with mild head injury and third nerve involvement were included in the study. This retrospective study covered a three-year period from January 2015 to December 2017. Mild head injury was defined as patients with a Glasgow Coma score of 14-15 and having a normal CT scan at admission. The clinical profile of the injury and recovery of the oculomotor nerve were jointly evaluated and followed up in the department of neurosurgery and ophthalmology. Results: Our study group included twenty one patients. Levator palpebrae superioris involvement with ptosis (95.23%) was the most consistently affected third nerve function followed by extraocular muscles (90.47%) and pupillary fibers (80.9%). Ptosis was partial in 11 patients and complete in nine. Of the extra ocular muscles, the most common muscles to be involved were the inferior rectus and the medial rectus which were involved in 19 patients (90.47%). Superior rectus involvement was seen in 13 patients and inferior oblique in nine patients. Imaging including thin section CT scans (all patients) and FIESTA MRI sequence (2 patients) did not reveal any significant abnormality. All our patients were managed conservatively. Steroids and corrective surgery was not tried in any patient. On follow up, after a mean period of 6 months, partial ptosis recovered completely while complete ptosis recovered only in four patients (44.4%). Of the seventeen patients with pupillary involvement, pupillary size and reaction improved in four (23.5%) and remained static in 13 patients. Of the extraocular muscles superior rectus (9/13) and inferior oblique (6/9) appeared to have a better recovery than inferior rectus (09/19) and medial rectus (08/19). Conclusion: Isolated oculomotor nerve palsy following minor head injury is uncommon. The exact pathogenesis is unclear. Advanced MRI sequences may reveal structural lesions along the course of the third cranial nerve in few cases. Pupillary fibers are most susceptible to injury and have the least rate of recovery. Partial ptosis recovers well. Recovery of extraocular muscle paresis is inconsistent. Management is essentially symptomatic and the outcome is unpredictable.
Journal of Neurosciences in Rural Practice, 2017
ABSTRACTPostoperative visual loss is a dreaded complication following transcranial excision of tu... more ABSTRACTPostoperative visual loss is a dreaded complication following transcranial excision of tuberculum sella meningioma. Visual deterioration is commonly noticed immediately after surgery, and delayed deterioration after 72 h is uncommon. We report a case of delayed postoperative deterioration in a 48-year-old female and discuss the possible mechanisms.
Journal of Neurosciences in Rural Practice, 2017
ABSTRACTCavernous carotid aneurysms (CCA) pose considerable dilemmas in management. It is still u... more ABSTRACTCavernous carotid aneurysms (CCA) pose considerable dilemmas in management. It is still unclear as to whether an asymptomatic CCA should be subjected to treatment. Similarly, the ideal management strategy for a symptomatic aneurysm is controversial. We present the case of a 60-year-old female with a giant CCA and discuss the management issues.