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Sinha S, Nishant P, Sinha RK, Morya AK, Prasad R. Nutrition interventions and clinical outcomes of pregnant women with gestational diabetes mellitus: More than meets the eye. World J Diabetes 2024; 15:126-128. [PMID: 38313850 PMCID: PMC10835497 DOI: 10.4239/wjd.v15.i1.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
In the retrospective study by Luo et al regarding clinical outcomes in gestational diabetes mellitus (GDM), the results are statistically significant in favour of the benefits of individualized nutrition interventions enumerated therein. The study has provided important evidence to improve maternal and child health in the Asian population. The methods, however, appear to have considerable limi-tations, wherein the time point of diagnosis of GDM, severity of GDM, selection bias, compliance to therapy, important maternal covariates, observable microvascular abnormalities and the confounding effect of added insulin have not been considered. We have provided suggestions to improve the external validity of the study, including the use of Equator Network reporting guidelines and inclusion of overweight and obese patients in future studies.
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Affiliation(s)
- Sony Sinha
- Department of Ophthalmology-Vitreo-Retina, Neuro-Ophthalmology and Oculoplasty, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, ESIC Medical College, Patna, Patna 801103, Bihar, India
| | - Ranjeet Kumar Sinha
- Department of Community Medicine, Patna Medical College, Patna 800004, Bihar, India
| | - Arvind Kumar Morya
- Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
| | - Ripunjay Prasad
- Department of Ophthalmology, RP Eye Institute, Delhi 110001, Delhi, India
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Nishant P, Singh P, Raj A, Sinha S. Avoiding complications in cataract surgery by recognition of Spider Web sign. Indian J Ophthalmol 2024; 72:143-144. [PMID: 38131594 PMCID: PMC10841803 DOI: 10.4103/ijo.ijo_1926_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Prabhakar Singh
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Amit Raj
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Sony Sinha
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
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Sinha S, Nishant P, Morya AK. Integrated approach for cataract surgical training and objective assessment of resident surgeons. Indian J Ophthalmol 2024; 72:135-136. [PMID: 38131587 PMCID: PMC10841809 DOI: 10.4103/ijo.ijo_1664_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Sony Sinha
- Additional Professor and Unit Chief for Vitreo-Retina, Neuro-Ophthalmology and Oculoplasty, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Arvind Kumar Morya
- Cataract, Glaucoma, Refractive, Squint, Paediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Hyderabad, Telangana, India
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Kumar R, Nishant P, Nanda J, Raj A. Management of blinding premacular subhyaloid haemorrhage by Nd:YAG laser posterior hyaloidotomy. BMJ Case Rep 2023; 16:e255836. [PMID: 37996140 PMCID: PMC10668195 DOI: 10.1136/bcr-2023-255836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Affiliation(s)
- Roshan Kumar
- Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Prateek Nishant
- Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Jayadev Nanda
- Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Amit Raj
- Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
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Sinha S, Nishant P, Morya AK. Innovative approaches to overcome intra-operative challenges using illumination. Indian J Ophthalmol 2023; 71:3576-3577. [PMID: 37870032 PMCID: PMC10752314 DOI: 10.4103/ijo.ijo_1677_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Affiliation(s)
- Sony Sinha
- Vitreo-Retina and Oculoplasty, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Arvind Kumar Morya
- Cataract, Glaucoma, Refractive, Squint, Paediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
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Morya AK, Ramesh PV, Sinha S, Nishant P, Nain N, Ramavath RN, Gone C, Prasad R. Axenfeld-Reiger syndrome: A search for the missing links. World J Clin Cases 2023; 11:7034-7042. [PMID: 37946776 PMCID: PMC10631407 DOI: 10.12998/wjcc.v11.i29.7034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Axenfeld-Rieger syndrome (ARS) is a rare cause of congenital glaucoma and may result in loss of vision. ARS is mostly autosomal dominant in nature characterized by developmental abnormalities in the angle of anterior chamber and iris of the eye, also associated with structural abnormalities in the body. AIM To study and observe the demographics and clinical findings in a very rare ocular disease known as ARS. METHODS Case records of symptomatic patients attending Ophthalmology outpatient department and diagnosed to have ocular hypertension or glaucoma in 3 years from March 2017 to March 2020 were evaluated to search for cases diagnosed with ARS. Records of all patients diagnosed with ARS were then analysed for demographic and clinical characterization as well as management and success of therapy. RESULTS Eight out of ten patients with positive clinical signs were symptomatic and had glaucoma. One of these patients had limbal stem cell deficiency and another had vernal keratoconjunctivitis. CONCLUSION Clinical characterization of ARS is important for making a definitive diagnosis and determining prognosis.
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Affiliation(s)
- Arvind Kumar Morya
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India
| | - Prasanna Venkatesh Ramesh
- Glaucoma Medical Officer, Mahathma Eye Hospital Private Limited, Thennur, Trichy 620017, Tamil Nadu, India
| | - Sony Sinha
- Department of Ophthalmology-Vitreo-Retina and Oculoplasty, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Patna 801507, Bihar, India
| | - Nazia Nain
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India
| | - Ravi Naik Ramavath
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India
| | - Chetana Gone
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India
| | - Ripunjay Prasad
- Department of Ophthalmology, RP Eye Institute, Delhi 110001, Delhi, India
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Raj A, Kumar A, Sinha U, Nishant P. Double capsular tension rings in cataracts with large subluxations. BMJ Case Rep 2023; 16:e253291. [PMID: 37751986 PMCID: PMC10533707 DOI: 10.1136/bcr-2022-253291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Management of subluxated cataracts is challenging, especially in cases with more than 5 clock hours of subluxation. Capsular bag stabilising devices are of utmost importance in these cases. We report two cases of post-traumatic lens subluxation of more than 6 clock hours, in which the bag was stabilised intraoperatively using two capsular tension rings (CTRs) placed diametrically opposite to each other, in place of the conventional Cionni ring. Slow phacoemulsification was done followed by intraocular lens (IOL) implantation. Postoperatively, the IOLs were found to be well centred. Also, the use of two CTRs maintains the shape of the capsular bag and prevents lens epithelial cell migration and capsular cocontraction.
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Affiliation(s)
- Amit Raj
- Ophthalmology, All India Institute of Medical Sciences - Patna, Patna, Bihar, India
| | - Amit Kumar
- Ophthalmology, All India Institute of Medical Sciences - Patna, Patna, Bihar, India
| | - Upasna Sinha
- Radio Diagnosis and Imaging, All India Institute of Medical Sciences - Patna, Patna, Bihar, India
| | - Prateek Nishant
- Ophthalmology, All India Institute of Medical Sciences - Patna, Patna, Bihar, India
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Sinha S, Nishant P, Sinha RK. Dr. Dukhan Ram: The pioneer of ophthalmic education in Bihar. Indian J Ophthalmol 2023; 71:3266. [PMID: 37602625 PMCID: PMC10565936 DOI: 10.4103/ijo.ijo_959_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Affiliation(s)
- Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Ranjeet K. Sinha
- Department of Community Medicine, Patna Medical College, Patna, Bihar, India
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Nishant P, Aftab N, Raj A, Jha VC, Sinha U. Adult-onset Dandy-Walker syndrome with atypical ocular manifestations. Can J Ophthalmol 2023; 58:e175-e177. [PMID: 36716793 DOI: 10.1016/j.jcjo.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/25/2022] [Accepted: 01/10/2023] [Indexed: 01/30/2023]
Affiliation(s)
| | - Naila Aftab
- All India Institute of Medical Sciences Patna, Bihar, India
| | - Amit Raj
- All India Institute of Medical Sciences Patna, Bihar, India.
| | - Vikas C Jha
- All India Institute of Medical Sciences Patna, Bihar, India
| | - Upasna Sinha
- All India Institute of Medical Sciences Patna, Bihar, India
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Sinha S, Nishant P, Morya AK, Bejjenki P. Commentary: The untapped potential of protective eyewear for primary prevention of ocular trauma. Indian J Ophthalmol 2023; 71:2215-2216. [PMID: 37202951 PMCID: PMC10391492 DOI: 10.4103/ijo.ijo_3376_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Arvind K Morya
- Cataract, Glaucoma, Refractive, Squint, Pediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Priyanka Bejjenki
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
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Kumari A, Ranjan A, Nishant P, Sinha S, Sinha RK. Cross-sectional study to describe the severity, bio-chemical associations, and final outcomes of COVID-19-associated rhino-orbital-cerebral mucormycosis in a tertiary hospital of East India. Indian J Ophthalmol 2023; 71:2193-2198. [PMID: 37202947 PMCID: PMC10391476 DOI: 10.4103/ijo.ijo_2507_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose The second wave of coronavirus disease 2019 (COVID-19) pandemic triggered a mucormycosis epidemic in India. Diabetes mellitus and dysregulated immune response were contributors, and rhino-orbital-cerebral mucormycosis (ROCM) was the most common presentation. It is however not known whether bio-chemical parameters at presentation correlate with stage of ROCM or final outcome in terms of vision or mortality. Methods This retrospective, hospital-based study included all in-patients of mucormycosis with ophthalmic manifestations at presentation admitted during June 1, 2021 to August 31, 2021. It aimed to evaluate the association between severity of infection, serum levels of HbA1c, ferritin, interleukin-6 (IL-6), C-reactive protein (CRP), and D-dimer levels at presentation and outcome. Results There were altogether 47 eligible cases having a mean age of 48.8 ± 10.9 years with a male:female ratio of 2.6:1; forty-two (89.4%) had pre-existing diabetes, and five (10.6%) had steroid-induced hyperglycemia. The mean HbA1c among diabetics was 9.7 ± 2.1. HbA1c and serum CRP showed an increase over subsequent stages, which was not statistically significant (P = 0.31). IL-6 values for all stages were similar (P = 0.97). Only serum ferritin levels showed a statistically significant increase over stages (P = 0.04). IL-6 was significantly lower (P = 0.03) in patients who survived, whereas CRP levels were significantly lower in patients who had final visual acuity (VA) better than only perception of light (P = 0.03). Conclusion Uncontrolled diabetes mellitus is a significant association of ROCM. Serum ferritin levels at presentation best correlate with extent of the disease. CRP levels are best to prognosticate cases that will have sufficient VA to carry on activities of daily living, whereas IL-6 levels are best associated with survival.
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Affiliation(s)
- Abhilasha Kumari
- Department of Ophthalmology, Patna Medical College, Patna, India
| | - Alok Ranjan
- Department of Ophthalmology, Patna Medical College, Patna, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, India
| | - Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, India
| | - Ranjeet K Sinha
- Department of Community Medicine, Patna Medical College, Patna, India
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Nishant P, Sinha S, Morya AK, Bejjenki P. Commentary: Advances in anterior segment optical coherence tomography technology: A new perspective on ocular anatomy. Indian J Ophthalmol 2023; 71:768-769. [PMID: 36872674 DOI: 10.4103/ijo.ijo_2266_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Affiliation(s)
- Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
| | - Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Arvind K Morya
- Cataract, Glaucoma, Refractive, Squint, Pediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Priyanka Bejjenki
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
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Sinha S, Nishant P, Kaur K, Gurnani B, Morya AK. Commentary: Post-pandemic lessons learnt regarding triage, mitigation, and management of emergency ocular conditions. Indian J Ophthalmol 2023; 71:871-872. [PMID: 36872697 DOI: 10.4103/ijo.ijo_2_23_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Affiliation(s)
- Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Kirandeep Kaur
- Cataract, Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janakikund, Chitrakoot, Madhya Pradesh, India
| | - Bharat Gurnani
- Cataract, Cornea, Trauma, External Disease, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janakikund, Chitrakoot, Madhya Pradesh, India
| | - Arvind Kumar Morya
- Cataract, Glaucoma, Refractive, Squint Paediatric Ophthalmology and Medical Retina Services, Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
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14
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Nishant P, Sinha S, Sinha RK. Role of residents' experience in cadaver dissection during the mucormycosis epidemic. Indian J Ophthalmol 2023; 71:1047. [PMID: 36872745 DOI: 10.4103/ijo.ijo_2506_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Affiliation(s)
- Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Ranjeet Kumar Sinha
- Department of Community Medicine, Patna Medical College, Patna, Bihar, India
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Raj A, Nishant P, Sadhukhan K, Saha BC, Sinha U, Kokkayil P, Gupta A, Kumar A, Tiwari P. A cross-sectional study to describe the spectrum of ocular manifestations and risk factors of mucormycosis presenting to a tertiary hospital of East India. Indian J Ophthalmol 2023; 71:249-256. [PMID: 36588245 PMCID: PMC10155590 DOI: 10.4103/ijo.ijo_1699_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose To report the clinico-demographic profile of rhino-orbito-cerebral mucormycosis (ROCM) in patients during the "second wave" of the COVID-19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute. Methods Cross-sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID-19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0. Results A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID-19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty-six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation. Conclusion Our data from eastern India reinforces the relationship between COVID-19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications.
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Affiliation(s)
- Amit Raj
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
| | - Kaushik Sadhukhan
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
| | - Bhawesh C Saha
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
| | - Upasna Sinha
- Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
| | - Prathyusha Kokkayil
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
| | - Abhishek Gupta
- Department of Ophthalmology, All India Institute of Medical Sciences, Kalyani, Kalyani, West Bengal, India
| | - Amit Kumar
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
| | - Pragati Tiwari
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
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Rungta N, Ranjan A, Nishant P, Sinha S. Nevus of Ota with ipsilateral optic disc pigmentation and pigmentary glaucoma. Indian J Ophthalmol 2022; 70:2656-2657. [PMID: 35791191 PMCID: PMC9426108 DOI: 10.4103/ijo.ijo_2893_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Nisha Rungta
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Alok Ranjan
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
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Nishant P, Ramawat A, Shrinkhal N, Gupta N, Mittal SK. Correlation of meiboscale symptom score and sign score for primary meibomian gland dysfunction in Indian eyes - A cross-sectional study. Indian J Ophthalmol 2022; 70:1958-1962. [PMID: 35647962 PMCID: PMC9359244 DOI: 10.4103/ijo.ijo_10_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Purpose: To evaluate the correlation of Meiboscale with symptom score (Ocular Surface Disease Index [OSDI]) and meibomian gland dysfunction (MGD) sign score. Methods: We performed a cross-sectional hospital-based study of 53 patients of primary MGD who filled the OSDI questionnaire form and underwent complete ocular examination. The MGD sign score was calculated in both eyes using the sum of six grading systems proposed by Arita et al. in 2016. The participants underwent imaging of the upper and lower eyelids of both eyes (212 eyelids) by specular microscope. The area of meibomian gland loss (MGL) was visually assessed and scored using the Meiboscale photographic card. Correlation between these three values – OSDI score, sign score, and MGL score based on Meiboscale - was calculated using Spearman’s correlation analysis and Jonckheere–Terpstra (J–T) test. Correlation coefficient rs > 0.5 was considered clinically significant. Results: Associations between MGL score and OSDI score, as well as between OSDI and sign score were statistically significant, but not clinically significant (rs = 0.3684, P < 0.001 and rs = 0.41179, P < 0.001, respectively). The association between MGL score and MGD sign score was statistically as well as clinically significant (rs = 0.8392, P < 0.001). J–T test revealed large effect size (P < 0.001, r-effect = 0.93). Conclusion: The Meiboscale card had not been tested for utility in the Indian outpatient setting yet. Meiboscale can be used for reliable assessment and grading of MGD, and has clinical utility similar to the sum of six MGD sign scores. Additionally, assessment of symptoms using OSDI or a similar questionnaire is also recommended.
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Affiliation(s)
- Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Achala Ramawat
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - N Shrinkhal
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Neeti Gupta
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev K Mittal
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Sood G, Samanta R, Kumawat D, Nishant P. Simultaneous bilateral inflammatory choroidal neovascularization in a case of healed serpiginous-like choroiditis. GMS Ophthalmol Cases 2022; 12:Doc12. [PMID: 35912124 PMCID: PMC9284432 DOI: 10.3205/oc000199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective Inflammatory choroidal neovascularization (i-CNV) is an infrequent but sight-threatening complication of posterior uveitis. Although it can occur in a wide range of infectious and non-infectious uveitides, presence of simultaneous bilateral i-CNV is rare. In this report, we present a unique case of bilateral simultaneous i-CNV in a young patient of healed tubercular serpiginous-like choroiditis. Method A 20-year-old male presented with recent worsening of vision in the right eye for one month. Fundus examination revealed bilateral multifocal healed choroiditis lesions with right eye tiny subfoveal hemorrhage raising the suspicion of an underlying choroidal neovascularization. Fundus fluorescein angiography and optical coherence tomography confirmed presence of choroidal neovascular membrane in both eyes. Result Resolution of activity was noted in both eyes after bilateral sequential intravitreal bevacizumab injections. Conclusion Inflammatory choroidal neovascularization may be seen in patients with healed tubercular serpiginous-like choroiditis, after a long period of quiescence. Simultaneous bilateral presentation is rare but possible, requiring mandatory multimodal imaging of both eyes under high index of suspicion. Early institution of anti-vascular endothelial growth factor may salvage optimum vision in such a scenario.
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Affiliation(s)
- Gitanjli Sood
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Ramanuj Samanta
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India,*To whom correspondence should be addressed: Ramanuj Samanta, Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Virbhadra Road Shivaji Nagar, Rishikesh, 249203 Uttarakhand, India, Phone: +91 8872292345, E-mail:
| | - Devesh Kumawat
- Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
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Abstract
Increasing prevalence of diabetes mellitus warrants recognition of factors related to asymmetric diabetic retinopathy (DR). This thematic synthesis based on an iterative literature review conducted in Medline and Google Scholar pertaining to diabetes with coexistent asymmetry of retinopathy included 45 original articles, 21 case reports and series, and 18 review articles from 1965 to 2020. Asymmetric DR is defined as proliferative DR (PDR) in one eye and nonproliferative, preproliferative, background, or no DR in the other eye lasting for at least 2 years. It is observed in 5%–10% of patients with PDR. Associated factors can be divided into (i) vascular: carotid obstructive disease, ocular ischemic syndrome, and retinal vascular diseases; (ii) Inflammatory: uveitis, endophthalmitis, and Fuchs’ heterochromic cyclitis; (iii) degenerative: posterior vitreous detachment, high myopia and anisometropia, uveal coloboma, retinal detachment, retinitis pigmentosa, and chorioretinal atrophy and scarring; (iv) cataract surgery and vitrectomy; and (v) miscellaneous: elevated intraocular pressure, glaucoma, amblyopia, retinal detachment, and optic atrophy. The gamut of diagnostic modalities for asymmetric DR includes thorough ocular examination, slit-lamp biomicroscopy, fundus photography, fundus fluorescein angiography, optical coherence tomography, and newer modalities such as ultra-widefield fluorescein angiography and optical coherence tomography angiography, along with a complete systemic evaluation and carotid Doppler studies. The differential diagnosis includes other causes of retinal neovascularization that may present in an asymmetric manner, such as sickle cell retinopathy, retinal vein occlusions, and featureless retina. This review discusses in detail the aforementioned considerations and draws a comprehensive picture of asymmetric DR in order to sensitize ophthalmologists to this important condition.
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Affiliation(s)
- Rajvardhan Azad
- Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
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Gumber A, Nishant P, Sinha S, Goel R, Malik KPS. Changes in corneal curvature and visual acuity in North Indian adults after pterygium excision with modified sutureless, glueless limbal-conjunctival autograft. Indian J Ophthalmol 2021; 69:2401-2405. [PMID: 34427231 PMCID: PMC8544074 DOI: 10.4103/ijo.ijo_2747_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose: To identify the exact time point during after following pterygium excision with a modified technique of sutureless, glueless limbal-conjunctival autograft, when stabilization of the change in corneal curvature is achieved; correlate size of pterygium with uncorrected visual acuity and astigmatism at baseline, and assess changes in these parameters postoperatively over time. Methods: This prospective study longitudinally assessed 30 eyes of 30 north Indian adults with primary pterygium encroaching upon ≥1 mm of the cornea pre- and postoperatively at 1 week and then monthly for 4 months, recording uncorrected (UCVA) and best-corrected logMAR visual acuity, astigmatism and keratometry. Results were analyzed using ANOVA, Mauchly’s test of sphericity with Greenhouse–Geisser correction, and post-hoc test using Bonferroni correction. Pearson’s correlation coefficient r > 0.5 was considered clinically significant, and P < 0.05 statistically significant. Results: Pterygium size was well correlated with pre-operative astigmatism (r = 0.867, P < 0.001) and pre-operative UCVA (r = 0.856, P < 0.001). There was mean improvement of 0.43 logMAR units of visual acuity (P < 0.00001), a mean increase of 0.79D of keratometric value for the flatter meridian (P < 0.00001) and a mean reduction of 2.00D of astigmatism (P < 0.00001). At 2-month follow-up, the keratometric value for the flatter meridian approached the final keratometric reading at 4 months such that the difference was not significant (t = 1.185, P = 0.245). There were no significant complications or recurrence during the follow-up period. Conclusion: Pterygium excision with modified autograft reduced corneal astigmatism and improved visual acuity comparable to classical technique. Alteration in corneal curvature stabilizes 2 months after surgery, when spectacle correction can be given to patients.
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Affiliation(s)
- Akriti Gumber
- Department of Ophthalmology, N.S.C.B. Subharti Medical College and Chhatrapati Shivaji Subharti Hospital, Meerut, Uttar Pradesh, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, India
| | - Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Ruchi Goel
- Professor, Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
| | - K P S Malik
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Sinha S, Sinha RK, Nishant P. Profile of donors and corneal tissue obtained through hospital cornea retrieval programme in a recently established eye bank of a tertiary care teaching hospital of Eastern India. J Family Med Prim Care 2021; 10:2195-2201. [PMID: 34322412 PMCID: PMC8284231 DOI: 10.4103/jfmpc.jfmpc_2279_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/02/2020] [Accepted: 03/17/2021] [Indexed: 11/05/2022] Open
Abstract
Context: There is a global need for quality eye banking practices and sensitization of primary care physicians toward corneal donation. Aims: To evaluate performance of a recently established eye bank (EB) and quality of corneas obtained, and identify areas of improvement during procurement and utilization of donor corneas. Settings and Design: This retrospective observational study is based on records of corneas collected through hospital cornea retrieval programme (HRCP) in the EB of a tertiary care institution during the first 2 years of its establishment. Methods and Material: Data on demographic characteristics of donors, death-preservation interval, specular microscopy parameters of corneas, indications for utilization, and reasons for non-utilization of corneas were collected. Statistical Analysis Used: Means, standard deviation, range, frequencies, and proportions were analyzed. Spearman's correlation coefficient and Kruskal–Wallis test were applied taking P < 0.05 as significant. Results: The EB retrieved 54 corneas from 27 donors with mean age 42.3 ± 24.2 years. All tissues were preserved in Cornisol®. Majority (50%) of transplantable tissues had an endothelial cell density (ECD) between 2,000 and 2,500 cells/mm2. ECD decreased significantly with increasing age (Spearman's ρ -0.747, P < 0.001; Kruskal–Wallis P < 0.001). Overall utilization rate of tissues was 87.04% (47/54), and utilizable corneas (50/54, 92.6%) were mainly used for optical purposes (34/50, 68%). Conclusions: Successful HCRP of the recently established EB has shown considerable promise in terms of quality and utilisation of corneas. There is need for active involvement of primary care physicians in contributing to increasing voluntary eye donation through awareness, advocacy, and social mobilization.
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Affiliation(s)
- Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Ranjeet K Sinha
- Department of Community Medicine, Patna Medical College, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
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Sinha S, Nishant P, Azad R. Residents' proficiency in diagnostics with all ophthalmic equipment - Need of the hour. Indian J Ophthalmol 2021; 69:1966-1967. [PMID: 34146074 PMCID: PMC8374780 DOI: 10.4103/ijo.ijo_980_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Rajvardhan Azad
- Vitreoretinal Services, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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Nishant P, Sinha S, Sinha RK, Choudhary S. Clinico-demographic profile of young people presenting with refractive errors to a medical college hospital of Bihar, India. Ophthalmol J 2020. [DOI: 10.5603/oj.2020.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
We hereby report a case of metastatic Ewing's sarcoma presenting with rapid-onset total ophthalmoplegia, optic atrophy, and right temporal hemianopia. Comprehensive ophthalmic and neurological evaluation with targeted radioimaging revealed a tumor mass centered over the sella, compressing optic chiasma, extending to involve the left cavernous sinus and the left orbital apex. Whole-body imaging revealed the evidence of multifocal lung and mediastinal metastasis with focal lytic defect in the left femoral head. Histopathological evaluation of transnasal punch biopsy from the nasopharyngeal extension of the tumor revealed small round-cell tumor with strong CD99 positivity, supporting the diagnosis of Ewing's sarcoma. Rapid, aggressive extensions of the metastatic tumor into vital structures despite the initiation of chemoradiation of the extensive intracranial tumor led to unexpected demise of the patient. Our case is an unusual case of Ewing's sarcoma metastasis manifesting as a sellar mass and mimicking a pituitary adenoma radiologically, with a rapid progression within 2 weeks to cause massive extension of tumor into suprasellar, infrasellar, and left parasellar area, indicative of highly malignant nature of the tumor.
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Affiliation(s)
- Vinita Gupta
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Kirti Aggarwal
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rajnish Kumar Arora
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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