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Fogla R, Biswas J, Kumar SK, Madhavan HN, Kumarasamy N, Solomon S. Squamous cell carcinoma of the conjunctiva as initial presenting sign in a patient with acquired immunodeficiency syndrome (AIDS) due to human immunodeficiency virus type-2. Eye (Lond) 2000; 14 ( Pt 2):246-7. [PMID: 10845028 DOI: 10.1038/eye.2000.65] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Biswas J, Mani B, Bhende M. Spontaneous resolution of bilateral macular haemorrhage in a patient with kala-azar. Eye (Lond) 2000; 14 ( Pt 2):244-6. [PMID: 10845027 DOI: 10.1038/eye.2000.64] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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De BK, Sen S, Biswas PK, Biswas J, Maity AK. Clinical and haemodynamic aspects of hepatopulmonary syndrome in Indian patients with cirrhosis. J Gastroenterol Hepatol 2000; 15:412-6. [PMID: 10824886 DOI: 10.1046/j.1440-1746.2000.02156.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND Hepatopulmonary syndrome consists of the triad of hepatic dysfunction and/or portal hypertension, intrapulmonary vascular dilatation and hypoxaemia, in the absence of detectable primary cardiopulmonary diseases. In the present study, we examined the frequency of hepatopulmonary syndrome among Indian patients with cirrhosis, and studied clinical predictors and pulmonary haemodynamic alterations. METHODS Forty-five patients with cirrhosis and no cardiopulmonary diseases were investigated by air-contrast echocardiography. Where patients were positive, arterial blood gas analysis was carried out. Positive contrast echocardiography with PO2 < 70 mmHg confirmed the diagnosis of hepatopulmonary syndrome. Three cases with the syndrome and 24 without were assessed for haemodynamic status by hepatic and pulmonary catheterization. RESULTS Four of 45 cases of cirrhosis (8.9%) had positive contrast echocardiographies, including three (6.7%) with hepatopulmonary syndrome and one 'subclinical' case (positive contrast echocardiography without hypoxaemia). Under haemodynamic study, the mean pulmonary arterial and pulmonary capillary wedge pressures appeared to be lower among those patients with hepatopulmonary syndrome. CONCLUSIONS In this small study, the frequency of hepatopulmonary syndrome was relatively low (6.7%). Cyanosis was the only reliable clinical indicator, and there was no clear relationship with the severity of cirrhosis by Child's grading.
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Rao SK, Biswas J, Rajagopal R, Sitalakshmi G, Padmanabhan P. Ligneous conjunctivitis: a clinicopathologic study of 3 cases. Int Ophthalmol 2000; 22:201-6. [PMID: 10674863 DOI: 10.1023/a:1006256114463] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The clinical, histopathologic features, and treatment outcomes in 3 patients with ligneous conjunctivitis are described. Bilateral, idiopathic membranes occurred in the palpebral conjunctiva in 2 patients. In 1 patient, unilateral conjunctival changes occurred in the bulbar conjunctiva, at the site of pterygium excision. Treatment included topical hyaluronidase, chymotrypsin, heparin, and cyclosporine and surgical excision with limited or no success. In one patient, conjunctival autografting from the normal fellow eye resulted in pseudomembrane formation at the donor site in the previously unaffected eye. Histopathological evaluation of excised membranes revealed the presence of amorphous eosinophilic hyaline material and chronic inflammatory cells. Immunohistochemical study revealed a predominance of T-lymphocytes. This case series confirms the recalcitrant clinical course of ligneous conjunctivitis. Conventional treatment modalities described in literature were not useful in the management of this condition. Surgical manipulation of the unaffected fellow eye in patients with unilateral disease can result in pathologic conjunctival changes, and is best avoided.
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Battu RR, Biswas J, Jayakumar N, Madhavan HN, Kumarsamy N, Solomon S. Papilloedema with peripapillary retinal haemorrhages in an acquired immunodeficiency syndrome (AIDS) patient with cryptococcal meningitis. Indian J Ophthalmol 2000; 48:47-9. [PMID: 11271934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
A case of cryptococcal meningitis in an AIDS patient who presented with optic disc edema, bilateral retinal and peripapillary haemorrhages is reported.
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Madhavan HN, Therese KL, Gunisha P, Jayanthi U, Biswas J. Polymerase chain reaction for detection of Mycobacterium tuberculosis in epiretinal membrane in Eales' disease. Invest Ophthalmol Vis Sci 2000; 41:822-5. [PMID: 10711699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
PURPOSE Tuberculous etiology has been suggested in Eales' disease. Because epiretinal membrane (ERM) is formed on the inner surface of the retina in Eales' disease, it could be the most appropriate intraocular specimen for investigation. Therefore, a nested polymerase chain reaction (nPCR), which detects MPB64 gene of Mycobacterium tuberculosis on the archival specimens of ERM of well-documented Eales' and non-Eales' patients, was applied and the results compared. METHODS nPCR technique was standardized, and the sensitivity and specificity of the primers were determined. nPCR technique was applied to tissue sections obtained from formalin-fixed and paraffin-embedded tissues of ERM from 23 patients with Eales' disease and 27 noninfective and non-Eales' disease patients as controls. RESULTS nPCR technique was specific for M. tuberculosis genome and sensitive enough to detect 0.25 fg (corresponding to the presence of a single bacillus). Eleven (47.8%) ERM of 23 Eales' disease and 3 (11.1%) of 27 controls were positive for M. tuberculosis genome. The difference between the two groups was statistically significant (P = 0.001), indicating association of this bacterium with Eales' disease. CONCLUSIONS The demonstration of the presence of M. tuberculosis DNA by nPCR technique in significant number of ERM of Eales' disease compared with the controls further emphasizes the probable role of this bacterium in the pathogenesis of this enigmatic clinical condition.
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Choudhry S, Rao SK, Biswas J, Madhavan HN. Necrotizing nocardial scleritis with intraocular extension: a case report. Cornea 2000; 19:246-8. [PMID: 10746462 DOI: 10.1097/00003226-200003000-00023] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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83
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Biswas J, Mani B, Shanmugam MP, Patwardhan D, Kumar KS, Badrinath SS. Retinoblastoma in adults. Report of three cases and review of the literature. Surv Ophthalmol 2000; 44:409-14. [PMID: 10734240 DOI: 10.1016/s0039-6257(99)00132-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Retinoblastoma usually presents in children younger than 5 years. To our knowledge, 20 cases of retinoblastoma in adults (older than 20 years) have been reported in the literature. Of 173 patients with histopathologically proven retinoblastoma seen in our institute, three were adults. All the patients had endophytic tumors with vitreous seeds. Ultrasonography did not reveal calcification in two cases. Immunohistochemistry with neuron-specific enolase was used to confirm the diagnosis in two cases. All three patients ultimately required enucleation. None of the patients had been referred with a diagnosis of retinoblastoma. The diagnosis of retinoblastoma should be considered in cases of whitish mass lesion in the fundus of an adult.
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Fogla R, Biswas J, Parikh S, Madhavan HN. Micrococcal endophthalmitis following extracapsular cataract extraction with foldable silicone intraocular lens implantation. Indian J Ophthalmol 2000; 48:50-2. [PMID: 11271937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
A case of postoperative endophthalmitis caused by micrococci, after phacoemulsification and foldable silicone intraocular lens (IOL) implantation is reported.
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Fogla R, Rao SK, Biswas J. Avoiding conjunctival necrosis after periocular depot corticosteroid injection. J Cataract Refract Surg 2000; 26:163-4. [PMID: 10683780 DOI: 10.1016/s0886-3350(99)00449-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Biswas J, Kumar SK, Gopal L, Bhende MP. Leiomyoma of the ciliary body extending to the anterior chamber: clinicopathologic and ultrasound biomicroscopic correlation. Surv Ophthalmol 2000; 44:336-42. [PMID: 10667440 DOI: 10.1016/s0039-6257(99)00114-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Leiomyoma of the ciliary body is a rare tumor that often causes a diagnostic dilemma. Sclerouvectomy has been found to be beneficial in the management of iris and ciliary body leiomyoma. We treated a case of leiomyoma of the ciliary body presenting as a fleshy mass in the anterior chamber, removed by partial lamellar sclerouvectomy. Ultrasound biomicroscopic and histopathologic features, including light microscopic, immunohistochemistry, and transmission electron microscopic features, were studied and the literature was reviewed.
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Castelino AM, Rao SK, Biswas J, Gopal L, Madhavan HN, Kumar SK. Conjunctival rhinosporidiosis associated with scleral melting and staphyloma formation: diagnosis and management. Cornea 2000; 19:30-3. [PMID: 10632005 DOI: 10.1097/00003226-200001000-00007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Although conjunctival rhinosporidiosis is endemic in India, associated scleral melting and staphyloma formation are quite rare. We report clinical features and management in three patients with this unusual presentation. METHODS Retrospective review of case records of three patients with conjunctival rhinosporidiosis. RESULTS Infection occurred in young, healthy adults and was localized to the forniceal conjunctiva in all patients. The affected conjunctiva had numerous grey-white spherules, but a polyp-like lesion was not present in any patient. Diagnosis was based on clinical features and examination of scrapings from the involved conjunctiva. Treatment was surgical, with excision of infected conjunctival tissues and staphyloma repair with homologous sclera or autogenous periosteum. Failure to recognize the conjunctival pathology in one patient resulted in recurrence of the staphyloma. CONCLUSION Conjunctival rhinosporidiosis can be associated with scleral staphyloma in young, healthy, adults. Differentiating this entity from idiopathic scleral ectasia requires knowledge of the clinical features of conjunctival rhinosporidiosis and a high index of clinical suspicion.
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Biswas J, Madhavan HN, George AE, Kumarasamy N, Solomon S. Ocular lesions associated with HIV infection in India: a series of 100 consecutive patients evaluated at a referral center. Am J Ophthalmol 2000; 129:9-15. [PMID: 10653406 DOI: 10.1016/s0002-9394(99)00415-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To document the ocular disorders seen in patients known to be infected with human immunodeficiency (HIV) virus at a referral eye clinic in India. METHODS The first 100 individuals known to be HIV-positive at a referral eye clinic between 1993 and 1998 were enrolled in a prospective study. They underwent complete ocular and systemic evaluation. RESULTS Most of the patients (76%) were in the 20-to 40-year age group. Heterosexual exposure to commercial sex workers was the most common risk factor (70%) for HIV infection. Cytomegalovirus (CMV) retinitis (17%) and HIV retinopathy (15%) were the most common HIV-associated ophthalmic lesions. Pulmonary tuberculosis (67%) and oropharyngeal candidiasis (66%) were the most commonly associated systemic infections. Ocular involvement was most common in children who contracted the disease through perinatal transmission (66.7%) and in homosexual patients (60%). Ocular involvement was comparatively less common in patients who contracted the disease through blood transfusions (33%) or exposure to commercial sex workers (24.3%). CONCLUSIONS This study shows that the spectrum of ocular lesions associated with HIV infection in India is different from that seen elsewhere in the world. The prevalence of CMV retinitis and HIV retinopathy is lower in India, and there have been no cases of ocular Kaposi sarcoma. Adnexal infections, albeit rare, were seen in our series. The nonavailability and cost of therapy influenced the visual prognosis in these patients.
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De BK, Sen S, Biswas PK, Sanyal R, Majumdar D, Biswas J. Hepatopulmonary syndrome in inferior vena cava obstruction responding to cavoplasty. Gastroenterology 2000; 118:192-6. [PMID: 10611168 DOI: 10.1016/s0016-5085(00)70428-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Reports show that hepatopulmonary syndrome mostly occurs in the setting of advanced hepatic dysfunction, with the associated vasoactive substance imbalance believed to be responsible for its pathogenesis. However, hepatopulmonary syndrome has also been reported in cases of mild hepatic dysfunction or noncirrhotic portal hypertension, indicating that portal hypertension also plays a part in the pathogenesis. Liver transplantation remains the only therapeutic option of proven benefit. We describe 2 cases of hepatopulmonary syndrome in the setting of inferior vena cava (suprahepatic) obstruction, but with minimal hepatic dysfunction. After balloon cavoplasty, 1 patient showed, in addition to improvement of the features of hepatic outflow obstruction, significant reduction of dyspnea, cyanosis, and hypoxemia with arterial blood gas normalization within 2 weeks and intrapulmonary shunt reversal within 8 weeks. This implies that hemodynamic alterations (such as portal hypertension) independently contribute to the pathogenesis of hepatopulmonary syndrome in at least some of the cases. Therapies aimed at correcting these abnormal hemodynamics may be important in the treatment of this condition, especially when the hepatic functional status by itself does not warrant a liver transplant.
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Parikh S, Shanmugam MP, Biswas J. Bisected macula following retrobulbar steroid injection. Indian J Ophthalmol 1999; 47:247-8. [PMID: 10892482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
A case of bilateral accidental globe penetration during administration of retrobulbar steroid for bilateral optic neuritis is discussed. One eye with bisected macula was managed successfully by vitrectomy, internal gas tamponade, and postoperative laser to the edges of the retinal tear. The fellow eye was blind due to central retinal artery occlusion.
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George AE, Biswas J, Agarwal R, Kumarasamy N, Solomon S. Subretinal cysticercosis in a patient with AIDS: treatment with xenon arc photocoagulation. Retina 1999; 19:467-8. [PMID: 10546951 DOI: 10.1097/00006982-199919050-00024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sen S, Biswas PK, Biswas J, Das TK, De BK. Primary pulmonary hypertension in cirrhosis of liver. Indian J Gastroenterol 1999; 18:158-60. [PMID: 10531718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Primary pulmonary hypertension (PPH) is a grave association of portal hypertension, and is potentially fatal in liver transplant candidates. AIM To investigate the prevalence of PPH among cirrhotics with portal hypertension. METHODS 43 cirrhotics with portal hypertension (Child B 22, C 14), after screening for cardiopulmonary diseases, were evaluated by hemodynamic study. RESULTS PPH was detected in 2 cases (4.7%), both in Child B, hepatitis B and C viruses being the etiologies. Neither had portal axis thrombosis. Two other cases also had pulmonary hypertension, but with high pulmonary capillary wedge pressure (PCWP). The 41 cases without and 2 cases with PPH had, respectively, mean pulmonary artery pressure (MPAP) 16.3 (5.9) mmHg, 26 mmHg and 33 mmHg; PCWP 11.5 (6.7) mmHg, 12 mmHg and 11 mmHg; transpulmonary pressure gradient 4.8 (2.6) mmHg (n = 27), 14 mmHg and 22 mmHg; and pulmonary vascular resistance 80.2 (55.8) dyne.sec.cm-5 (n = 27), 155.6 dyne.sec.cm-5 and 366.7 dyne.sec.cm-5. No correlation of MPAP was found with either Child-Pugh scoring (r2 = 0.0347) or with hepatic venous pressure gradient (r2 = 0.0021). CONCLUSION PPH has a prevalence of 4.7% among cirrhotics with portal hypertension; it bears no relation with severity of liver disease.
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Biswas J, Raizada S, Gopal L, Kumarasamy N, Solomon S. Bilateral frosted branch angiitis and cytomegalovirus retinitis in acquired immunodeficiency syndrome. Indian J Ophthalmol 1999; 47:195-7. [PMID: 10858779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
This report describes a case of frosted branch angiitis associated with AIDS.
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Basu S, Khanra M, Dash B, Majumdar J, Biswas J, Chaudhuri P. The role of neoadjuvant and adjuvant chemotherapy regimens consisting of different combinations of drugs in the treatment of advanced oral cancer. Cancer Immunol Immunother 1999; 16:199-203. [PMID: 10523800 DOI: 10.1007/bf02906132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We performed a retrospective analysis on the effect of neoadjuvant chemotherapy with three cycles of methotrexate (100 mg/m2 on day 1), cisplatin (90 mg/m2 on day 1) and bleomycin (20mg/m2 on day 1-5) with 21 d gap between each cycle in 44 patients with advanced squamous cell carcinoma of the cheek, lip and tongue followed by surgery and adjuvant chemotherapy consisting of cisplatin (90 mg/m2 on day 1), Mitomycin C (6 mg/m2 on day 1) and 5-fluorouracil (1000 mg/m2 120 h continuous infusion from day 1) repeated every 3 weeks for three cycles. Following induction chemotherapy, complete response was observed in 11 out of 44 patients (25%), and a partial response in a further 28 patients (64%). The overall median survival of all patients was 29 months and those in stage III and stage IV were 30 and 15 months respectively (P< 0.001). The median duration of the time to relapse in patients who responded to adjuvant chemotherapy was 28 months. The main toxic effect was vomiting followed by hematological toxicity. No treatment-related deaths occurred. The regimen showed a significant response, encouraging median survival and a good tolerability profile.
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Biswas J, Bhende PS, Gopal L, Parikh S, Badrinath SS. Subconjunctival cysts following silicone oil injection: a clinicopathological study of five cases. Indian J Ophthalmol 1999; 47:177-80. [PMID: 10858773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
PURPOSE To study the occurrence, risk factors and management of subconjunctival cysts formed following the use of intraocular silicone oil as a tamponade. METHODS We analyzed 5 cases of single and multioculated subconjunctival oil cysts between 1986 and 1996. RESULTS Cysts were observed 15 days to 4 months following silicone oil injection. Clinically they showed minimal inflammatory signs but histopathology of removed cysts showed emulsified silicone oil globules with chronic inflammatory cellular infiltration. CONCLUSION Though silicone oil is considered to be nontoxic, it can cause chronic inflammation when spilled into the subconjunctival space.
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Sulochana KN, Biswas J, Ramakrishnan S. Eales' disease: increased oxidation and peroxidation products of membrane constituents chiefly lipids and decreased antioxidant enzymes and reduced glutathione in vitreous. Curr Eye Res 1999; 19:254-9. [PMID: 10487964 DOI: 10.1076/ceyr.19.3.254.5312] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To measure the levels of oxidation and peroxidation products of membrane constituents chiefly lipids produced by oxygen and lipid free radicals as thiobarbituric acid reacting substances (TBARS), reduced glutathione (GSH) and the antioxidant enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GP) in vitreous samples from patients with Eales' disease and estimate GSH, SOD, GP in the erythrocytes of patients with Eales' disease with active perivasculitis and healed perivasculitis. METHODS Vitreous samples on vitrectomy from 11 patients with Eales' disease and 11 patients with diabetic vitreous hemorrhage were used for comparison. For study on erythrocytes, 30 patients of Eales' disease at the active vasculitis stage (group-I), 33 of healed vasculitis stage (group-II) and 25 controls (group-III) were used. The male female ratio was kept the same among the patients and the controls. Oxidation and peroxidation products of membrane constituents chiefly lipids were estimated as TBARS, SOD by its activity to inhibit auto-oxidation of epinephrine, GP by estimating the reduction in the level of GSH and GSH by its colour reaction with 5,5'-dithio bis (2-nitro) benzoic acid (DTNB). RESULTS TBARS were increased 6 fold in the vitreous of Eales' patients compared to the samples from those with diabetic vitreous hemorrhage while there was a reduction of 95.9% of SOD and 84.2% of GSH. Activity of SOD, GP and the levels of GSH in the erythrocytes were reduced (%) by 81.6, 65 and 56.5 respectively in group I and 22,46.4 and 29.2% respectively in group II. The values are statistically significant. CONCLUSIONS Increased levels of TBARS and decreased levels of SOD and GSH in the vitreous could explain inflammation, retinal damage and neovascularization in patients with Eales' disease. Decrease of SOD, GP and GSH is found in erythrocytes both in the active perivasculitis stage and the healed perivasculitis stage. Treatment of Eales' disease with antioxidants vitamin E, C as also vitamin A may have a beneficial effect.
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Biswas J, Therese L, Madhavan HN. Use of polymerase chain reaction in detection of Mycobacterium tuberculosis complex DNA from vitreous sample of Eales' disease. Br J Ophthalmol 1999; 83:994. [PMID: 10413707 PMCID: PMC1723160 DOI: 10.1136/bjo.83.8.994] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Fogla R, Biswas J, Ganesh SK, Ravishankar K. Evaluation of cataract surgery in intermediate uveitis. OPHTHALMIC SURGERY AND LASERS 1999; 30:191-8. [PMID: 10100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND AND OBJECTIVE The authors analyzed the results of cataract surgery performed on patients with intermediate uveitis from January 1990 through January 1997. MATERIALS AND METHODS Fifty-two eyes of 44 patients with intermediate uveitis underwent cataract surgery during this period. These patients were evaluated with respect to duration of intermediate uveitis, treatment regimen, intraoperative complications and final visual results. RESULTS Visual acuity improved following surgery in 94.2% eyes and 71.2% eyes achieved a final visual acuity better than or equal to 20/60. Intraocular lens implantation accompanied the surgery in 24 eyes. Regional and systemic steroids were required for control of inflammation. The factors that limited visual recovery were severe cystoid macular edema, epiretinal membrane formation, and secondary retinal detachment. Recurrence of uveitis was noted in 6 cases. CONCLUSION Absolute control of inflammation, atraumatic surgery, and regular postoperative follow-up can improve the results of cataract extraction. Intraocular lens implantation in selected cases is well tolerated with good visual results.
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Das A, McGuire PG, Eriqat C, Ober RR, DeJuan E, Williams GA, McLamore A, Biswas J, Johnson DW. Human diabetic neovascular membranes contain high levels of urokinase and metalloproteinase enzymes. Invest Ophthalmol Vis Sci 1999; 40:809-13. [PMID: 10067990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
PURPOSE Retinal neovascularization is one of the leading causes of blindness. A crucial event in this process is the remodeling and penetration of the capillary basement membrane by migrating endothelial cells. This process requires proteolysis of basement membrane components by a variety of proteinases. The objective of the present study was to determine the expression of proteinases in human retinal tissues showing active neovascularization. METHODS Epiretinal neovascular membranes surgically removed from patients with proliferative diabetic retinopathy were analyzed by zymography, and the types and amounts of proteinases present in the tissues were determined. Retinas from nondiabetic donor eyes served as control specimens. RESULTS Both the high- (54 kDa) and low- (33 kDa) molecular-weight forms of urokinase were present at significantly higher levels in neovascular membranes than in normal retinas. The pro forms of the matrix metalloproteinases (MMP) MMP-2 and MMP-9 were significantly elevated in the neovascular membranes in comparison with levels in normal retinas. In addition, the active forms of these enzymes were present in the membranes, whereas there was no detectable level of the active forms in normal retinas. CONCLUSIONS Human diabetic neovascular membranes contain high levels of urokinase and MMP. The increased activity of proteinases in the final common pathway of retinal neovascularization indicates that inhibition of these enzymes may be a useful therapeutic target as an alternative approach in the management of proliferative retinopathies.
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Badrinath SS, Gopal L, Sharma T, Parikh S, Shanmugam MP, Bhende P, Biswas J. Vitreoschisis in Eales' disease: pathogenic role and significance in surgery. Retina 1999; 19:51-4. [PMID: 10048373 DOI: 10.1097/00006982-199901000-00008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the surgical anatomy of vitreoretinal adhesions as observed intraoperatively in patients undergoing vitreous surgery for complications of Eales' disease. METHODS Eighteen consecutive male patients (18 eyes) undergoing vitrectomy for Eales' disease were studied prospectively. Intraoperative diagnosis was vitreous hemorrhage (VH) in nine cases, traction retinal detachment (TRD) in four, VH and TRD in three, and combined traction-rhegmatogenous retinal detachment in two. Epiretinal membranes (ERMs) obtained during surgery were studied using light microscopy and immunohistochemistry. RESULTS An incomplete posterior vitreous detachment was observed in all eyes. Multifocal vitreoretinal adhesions were evident in 83.3% of eyes. The proliferation was fibrovascular in 10 eyes and fibrous in eight. A radial traction fold extending from optic disk to periphery was observed in three eyes. A double-layered membrane, probably the result of vitreoschisis, caused tangential traction. ERMs consisted principally of type II collagen and the cellular element was predominantly composed of lymphocytes, glial cells, and macrophage-like cells (probably hyalocytes). CONCLUSIONS Fibrous and fibrovascular proliferations have multiple areas of adhesions to the posterior vitreous cortex. The presence of type II collagen in the ERM indicates a possible vitreous collagen component to the double-layered membranes (vitreoschisis). Recognition of the double-layered membranes aids in relief of traction during surgery by delamination.
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