Hassan Mansoor | University of Health Sciences Lahore (original) (raw)

Papers by Hassan Mansoor

Journal of Clinical Medicine, 2022

Keratoconus is the most common primary corneal ectasia characterized by progressive focal thinnin... more Keratoconus is the most common primary corneal ectasia characterized by progressive focal thinning. Patients experience increased irregular astigmatism, decreased visual acuity and corneal sensitivity. Corneal collagen crosslinking (CXL), a minimally invasive procedure, is effective in halting disease progression. Historically, keratoconus research was confined to ex vivo settings. In vivo confocal microscopy (IVCM) has been used to examine the corneal microstructure clinically. In this review, we discuss keratoconus cellular changes evaluated by IVCM before and after CXL. Cellular changes before CXL include decreased keratocyte and nerve densities, disorganized subbasal nerves with thickening, increased nerve tortuosity and shortened nerve fibre length. Repopulation of keratocytes occurs up to 1 year post procedure. IVCM also correlates corneal nerve status to functional corneal sensitivity. Immediately after CXL, there is reduced nerve density and keratocyte absence due to mechani...

Volume 1(2): 1-3 Introduction A dermoid cyst is a teratoma which is composed of well differentiat... more Volume 1(2): 1-3 Introduction A dermoid cyst is a teratoma which is composed of well differentiated parenchymal tissue and it usually develops from one or sometimes all of the germ cell layers [1]. Common sites of dermoid cysts are testis ovaries but can also be present in extra gonadal locations like cranium, mediastinum and retroperitoneum [2]. Dermoid cysts involving adrenal glands are very uncommon with the reported incidence of about 4% in literature [3,4].

Purpose: Cutaneous Leishmaniasis is endemic in Pakistan. The current study was undertaken in Dist... more Purpose: Cutaneous Leishmaniasis is endemic in Pakistan. The current study was undertaken in District Chakwal to measure the prevalence of ocular lesions in cutaneous leishmaniasis. Patients and Methods: A 60 years male presented to the Oculoplastic Clinic at AlShifa Trust Eye Hospital Rawalpindi, Pakistan, with an isolated chronic non-healing ulcerative lesion of left upper eye lid. Clinically suspected to be squamous cell carcinoma, it underwent total excision followed by Cutler-Beard reconstruction. The histopathology was cutaneous leishmaniasis. A team was dispatched to the health center, Choa Saiden Shah of the area to which the patient belonged (120 km southeast of Islamabad). The area was found to be endemic for leishmaniasis. A total of 925 patients with known cutaneous leishmaniasis were registered for treatment at the health center and examined for ocular involvement. Results: The prevalence of ocular lesions was found to be about 1%. Most of the lesions involved the skin ...

Community Eye Health, 2015

Cutaneous leishmaniasis is endemic in over 80 countries of the world, encompassing almost five co... more Cutaneous leishmaniasis is endemic in over 80 countries of the world, encompassing almost five continents. According to the World Health Organization, leishmaniasis has an estimated incidence of twelve million worldwide.2 Leishmaniasis is a parasitic disease caused by a haemoflagellate Leishmania. It is transmitted to humans by the bite of female sand flies, of which there are 30 species. The epidemiology of cutaneous leishmaniasis is strongly correlated with the temporal and geographical distribution of the vector (the sand fly). The activity of the sand fly is in turn affected by both rainfall and temperature. Extensive land reclamation, the presence of infected rodents and unnaturally moist soil all lead to an increase in the density of the vector.

OBJECTIVE To determine the changes in IgE levels in diagnosis and postoperative monitoring of orb... more OBJECTIVE To determine the changes in IgE levels in diagnosis and postoperative monitoring of orbital fungal granuloma. STUDY DESIGN Descriptive analytical study. PLACE AND DURATION OF STUDY Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan, from July 2012 to June 2013. METHODOLOGY Cases with clinically high index of suspicion for orbital fungal granuloma and 50 healthy volunteers were inducted as control subjects. Patients with recurrent cases of orbital fungal granuloma, previous orbital surgery, and those with very low clinical suspicion of fungal granuloma were excluded. Total serum IgE level (IU/ml), eosinophil counts and skin prick test were performed in all subjects. Independent t-test was used for comparison of healthy volunteers and patients with biopsy proven orbital fungal granuloma. Repeated measures ANOVA was used for comparing the preoperative and postoperative total serum IgE level of patients with biopsy proven fungal granuloma. RESULTS The mean total serum IgE level...

Objective To evaluate the utility of teleconsultation in the provision of eye care services durin... more Objective To evaluate the utility of teleconsultation in the provision of eye care services during the COVID-19 lockdown. Disparities in the consultation burden of sub-specialities and socio-demographic differences in teleconsultation utilization were also assessed. Methods Al-Shifa Trust Eye Hospital Rawalpindi began audio and video teleconsultation using broadband telecommunication services during the lockdown. Patients’ and consultations’ data gathered during the first three weeks after the commencement of this programme were compared with data from the four weeks prior to lockdown. The weekly consultation ratio and overall consultation burden of sub-specialities were measured. Chi-Square tests of association determined the relationship between different variables (socioeconomic status and consultation characteristics) and consultation modality (on-site vs online). Results In total, 17507 on-site consultations (4377/week) were conducted compared to 1431 teleconsultations (477/wee...

Pakistan Journal of Ophthalmology

Purpose: To determine the importance of patient satisfaction as a tool for quality improvement. ... more Purpose: To determine the importance of patient satisfaction as a tool for quality improvement. Study Design: Cross sectional survey. Place and Duration of Study: Pediatric Ophthalmology Department of Al-Shifa Trust Eye Hospital, Rawalpindi, from May 2017 to September 2017. Methods: This study included 500 individuals, who were caregivers of children visiting the hospital at the time of data collection. Individuals who visited departments other than pediatric department were excluded. Two groups were made. Group 1 included 300 individuals who were interviewed for to assess the patient satisfaction. On the basis of response, play area was made spacious, additional registration counters were placed and more reception staff members were hired to shorten the waiting and registration time, additional fans were installed in the waiting area and patient information was displayed on TV screens to aid uneducated patients and their attendants. Second group with 200 individuals were interv...

Scientific Reports

The introduction of femtosecond laser-assisted cataract surgery is an alternative approach to con... more The introduction of femtosecond laser-assisted cataract surgery is an alternative approach to conventional cataract surgery. Our study aimed to determine the effectiveness of femtosecond laser-assisted capsulotomy in the presence of different ophthalmic viscoelastic devices (OVDs) in the anterior chamber. Fresh porcine eyes (n = 96) underwent LDV Z8-assisted anterior capsulotomy, either in the presence of an OVD (Viscoat, Provisc, Healon, Healon GV or HPMC) or without, using 90% and 150% energies respectively. Following that, the capsule circularity, tag’s arc-length, tag-length, tag-area and rupture strength (mN) of the residual capsular bag were evaluated. We found that increasing energy from 90 to 150% across the OVD sub-groups improved the studied capsulotomy parameters. Amongst the 90% energy sub-groups, the circularity and tag-parameters were worse with Viscoat and Healon GV, which have higher refractive index and viscosity compared to the aqueous humour. Using 150% energy, He...

Journal of Clinical Medicine

Diabetic keratopathy (DK) is a common, but underdiagnosed, ocular complication of diabetes mellit... more Diabetic keratopathy (DK) is a common, but underdiagnosed, ocular complication of diabetes mellitus (DM) that has a significant economic burden. It is characterised by progressive damage of corneal nerves, due to DM-induced chronic hyperglycaemia and its associated metabolic changes. With advances in corneal nerve imaging and quantitative analytic tools, studies have shown that the severity of diabetic corneal neuropathy correlates with the status of diabetic peripheral neuropathy. The corneal nerve plexus is, therefore, considered as an important surrogate marker of diabetic peripheral neuropathy and helps in the evaluation of interventional efficacy in the management of DM. The clinical manifestations of DK depend on the disease severity and vary from decreased corneal sensitivity to sight-threatening corneal infections and neurotrophic ulcers. The severity of diabetic corneal neuropathy and resultant DK determines its management plan, and a step-wise approach is generally suggest...

Clinical & Experimental Ophthalmology

cyclophosphamide-induced ischaemic retinopathy. We are not sure whether bilateral severe retinal ... more cyclophosphamide-induced ischaemic retinopathy. We are not sure whether bilateral severe retinal ischaemia in our case was induced by either paclitaxel or cyclophosphamide alone or by the synergistic effect of these two drugs. However, this case highlights the fact that ischaemic retinopathy is possible with chemotherapeutic drugs other than platinum analogue. In the absence of fluorescein angiography, we cannot ascertain the exact aetiological diagnosis of this retinal ischaemia; however, the clinical pictures including arteriolar sclerosis, mild venous dilatation, optic disc oedema and gross macular oedema were suggestive of combined occlusion of the central retinal artery and central retinal vein. Retinal vascular dysregulation induced by intravenous paclitaxel administration may account for this manifestation. Although complete loss of vision with no perception of light is usually not seen in these vascular or ischaemic complications, the presenting visual acuity in central retinal arterial occlusion can range from near normal to counting fingers or worse. Accordingly, the clinical picture may also show a wide range from milder ischaemic changes to severe, as seen in our case. In a study examining the natural history of central retinal artery occlusion, Hayreh and Zimmerman found that about 7% of patients (19/260 eyes) presented with no light perception. Another contributing factor for the complete loss of vision could be associated optic nerve ischaemia induced by paclitaxel as reported in previous studies.

International Journal of Molecular Sciences

The corneal functions (transparency, refractivity and mechanical strength) deteriorate in many co... more The corneal functions (transparency, refractivity and mechanical strength) deteriorate in many corneal diseases but can be restored after corneal transplantation (penetrating and lamellar keratoplasties). However, the global shortage of transplantable donor corneas remains significant and patients are subject to life-long risk of immune response and graft rejection. Various studies have shown the differentiation of multipotent mesenchymal stem cells (MSCs) into various corneal cell types. With the unique properties of immunomodulation, anti-angiogenesis and anti-inflammation, they offer the advantages in corneal reconstruction. These effects are widely mediated by MSC differentiation and paracrine signaling via exosomes. Besides the cell-free nature of exosomes in circumventing the problems of cell-fate control and tumorigenesis, the vesicle content can be genetically modified for optimal therapeutic affinity. The pharmacology and toxicology, xeno-free processing with sustained deli...

Journal of the College of Physicians and Surgeons Pakistan

Objective: To describe different types of primary extraocular muscle (EOM) tumours based on the r... more Objective: To describe different types of primary extraocular muscle (EOM) tumours based on the results of imaging studies, peroperative clinical picture and their histopathological diagnosis. Study Design: Case series.

Journal of pediatric ophthalmology and strabismus, Mar 1, 2018

To present the clinical, radiological, histopathological, immunohistochemical features and the fo... more To present the clinical, radiological, histopathological, immunohistochemical features and the follow-up of orbital primitive neuroectodermal tumors (PNETs) in pediatric patients along with a review of the literature. A retrospective analysis of all diagnosed cases of orbital PNET was done. Patients' ophthalmic findings, imaging, immunohistochemistry, metastatic work-up, treatment, globe salvation, and survival were documented and a mini literature review of orbital PNET was performed. Four diagnosed cases of orbital PNET presented with proptosis and visual impairment were treated during the study period. The radiological imaging showed primary orbital involvement. There were three males and one female with a mean age of 63.75 months (range: 3 to 244 months). Histopathology of all studied patients showed round malignant cells with hyperchromatic nuclei, increased nuclear cytoplasmic ratio, and positive test results for CD99 and FLI-1. The studied patients underwent orbital surge...

$Research paper thumbnail of Anisometropia and Refractive Status in Children with Bilateral Congenital Nasolacrimal Duct Obstruction$

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, Mar 1, 2018

To evaluate the state of refraction in children with bilateral congenital nasolacrimal duct obstr... more To evaluate the state of refraction in children with bilateral congenital nasolacrimal duct obstruction (CNLDO). Descriptive study. Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan, from April 2014 to April 2016. Children with bilateral CNLDO were studied. Patients' refractive status were evaluated by performing cycloplegic refraction, followed by appropriate management plan. The refractive errors of both eyes were noted and compared for any significant anisometropia. One hundred and seventeen (n=117) children with median age (IQR) of 32 (12) months having bilateral CNLDO were enrolled. Children with bilateral CNLDO had insignificant interocular difference in terms of spherical equivalent (SE) and cylindrical refractive errors (p>0.05). The rate of the anisometropia (>1 D difference between the two eyes) was 5.98% (n=7) in children with bilateral CNLDO. Performing cycloplegic refraction routinely in patients with bilateral CNLDO is not as urgent as compared to ones with u...

Orbit

This study describes different types of orbital osteoma based on clinical per-operative morpholog... more This study describes different types of orbital osteoma based on clinical per-operative morphology and radiological findings to facilitate communication between ophthalmologists and surgical management for a better patient outcome. The study was conducted in the Orbit and Oculoplastics Department of Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan, from July 1, 2001 to June 30, 2014. A retrospective analysis of 520 diagnosed orbital tumours who presented to us was carried out and the prevalence of orbital osteoma was determined. The sampling technique was non-randomized sampling. Based on the clinical morphology observed during surgical intervention as well as the radiological findings of the orbital osteoma, a simple yet useful description of orbital osteoma was introduced. The retrospective analysis of 520 diagnosed orbital tumours revealed a prevalence of 2.3% (n = 12) of orbital osteoma. Based on our observation of the 12 (n = 12) cases of orbital osteoma, we have classified orbital osteoma into a combination of seven types: &amp;quot;sessile&amp;quot; or broad-based osteoma; &amp;quot;pedunculated&amp;quot; or mushroom osteoma with a thin cylindrical stalk of origin; &amp;quot;dumb-bell&amp;quot;-shaped osteoma with the simultaneous presence in orbital and adjoining sinus/nasal cavity; &amp;quot;wrapped&amp;quot; osteoma, covered by a thin cartilaginous layer; &amp;quot;naked&amp;quot; osteoma, without any such covering; &amp;quot;homogenous&amp;quot; or uniformly dense osteoma; and &amp;quot;heterogeneous&amp;quot;, soft-dense osteoma with varying areas of density. This study attempts to introduce a simple description of different types of orbital osteoma based on clinical per-operative morphology and radiological findings for the first time to facilitate the surgical removal of orbital osteoma.

Asia-Pacific Journal of Ophthalmology, 2017

To determine the role of a single cycle of topical azithromycin in preventing long-term trachoma ... more To determine the role of a single cycle of topical azithromycin in preventing long-term trachoma complications in children from an area with endemic trachoma. A longitudinal cohort study. Two hundred thirty-eight (n = 238) children with active trachoma were enrolled in the current study. They were aged 1 to 10 years, with trachomatous inflammation based on the simplified World Health Organization grading system. These children were identified out of a survey of 8600 children from 7 villages in Punjab, Pakistan, where trachoma was endemic. The studied patients with active trachoma were treated with a single regimen of azithromycin 1.5% eye drops, given twice daily for 3 days, and were followed up for 3 years. The long-term effects of this therapy were documented for the first time in an endemic area. Two hundred fourteen children (90%) were present at 1-year follow-up with 10% dropout, and 178 (75%) were present at 3-year follow-up with 25% dropout. Of these, 23% and 11% had active trachoma at 1 and 3 years, respectively. Active trachoma was minimized from 100% at baseline to 11% at the end of 3 years. The reinfection rate was 4%. None of the patients developed trachoma-related ocular complications during the study period. A single cycle of topical azithromycin can be used as an effective and safe option for treating active trachoma in children in endemic areas. This study also documented that a single cycle of topical azithromycin prevents trachoma-related ocular complications in an endemic area.

Indian journal of ophthalmology, 2016

A 5-year-old boy presented with a large 5 cm × 5 cm cyst covering the left eye completely since b... more A 5-year-old boy presented with a large 5 cm × 5 cm cyst covering the left eye completely since birth. The cyst was excised in toto and was sent for histopathological examination. During the surgery, the inferior oblique (IO) muscle was seen originating from medial orbital wall, 10-12 mm behind the medial orbital margin, just posterior to the lacrimal bone and moving laterally, downward, and posteriorly from its origin making a more acute angle - around 20° to its site of origin. The insertion of the IO to sclera was at its normal site. The abnormal origin of IO was confirmed later by magnetic resonance imaging. The ocular movements of the left eye were tested 2 weeks after the surgery and were found to be normal in all directions. However, the child was hypertrophic and amblyopic. The histopathological findings showed the orbital cyst to contain dermal elements, respiratory, and intestinal epithelium.

Community eye health / International Centre for Eye Health, 2015