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Gopalakrishnan N, Nagesha CK, Gadde SGK, Jayadev C. Photic maculopathy after accidental exposure to a mirror-reflected non-therapeutic diode laser. BMJ Case Rep 2023; 16:e257345. [PMID: 38160033 PMCID: PMC10759013 DOI: 10.1136/bcr-2023-257345] [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: 01/03/2024] Open
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Wall JD, Sathirapongsasuti JF, Gupta R, Rasheed A, Venkatesan R, Belsare S, Menon R, Phalke S, Mittal A, Fang J, Tanneeru D, Deshmukh M, Bassi A, Robinson J, Chaudhary R, Murugan S, Ul-Asar Z, Saleem I, Ishtiaq U, Fatima A, Sheikh SS, Hameed S, Ishaq M, Rasheed SZ, Memon FUR, Jalal A, Abbas S, Frossard P, Fuchsberger C, Forer L, Schoenherr S, Bei Q, Bhangale T, Tom J, Gadde SGK, B V P, Naik NK, Wang M, Kwok PY, Khera AV, Lakshmi BR, Butterworth AS, Chowdhury R, Danesh J, di Angelantonio E, Naheed A, Goyal V, Kandadai RM, Kumar H, Borgohain R, Mukherjee A, Wadia PM, Yadav R, Desai S, Kumar N, Biswas A, Pal PK, Muthane UB, Das SK, Ramprasad VL, Kukkle PL, Seshagiri S, Kathiresan S, Ghosh A, Mohan V, Saleheen D, Stawiski EW, Peterson AS. South Asian medical cohorts reveal strong founder effects and high rates of homozygosity. Nat Commun 2023; 14:3377. [PMID: 37291107 PMCID: PMC10250394 DOI: 10.1038/s41467-023-38766-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 05/15/2023] [Indexed: 06/10/2023] Open
Abstract
The benefits of large-scale genetic studies for healthcare of the populations studied are well documented, but these genetic studies have traditionally ignored people from some parts of the world, such as South Asia. Here we describe whole genome sequence (WGS) data from 4806 individuals recruited from the healthcare delivery systems of Pakistan, India and Bangladesh, combined with WGS from 927 individuals from isolated South Asian populations. We characterize population structure in South Asia and describe a genotyping array (SARGAM) and imputation reference panel that are optimized for South Asian genomes. We find evidence for high rates of reproductive isolation, endogamy and consanguinity that vary across the subcontinent and that lead to levels of rare homozygotes that reach 100 times that seen in outbred populations. Founder effects increase the power to associate functional variants with disease processes and make South Asia a uniquely powerful place for population-scale genetic studies.
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Affiliation(s)
- Jeffrey D Wall
- Institute for Human Genetics, University of California, San Francisco, CA, 94143, USA.
- Dept of Ornithology and Mammology, California Academy of Sciences, San Francisco, CA, 94118, USA.
| | - J Fah Sathirapongsasuti
- MedGenome Inc., Foster City, CA, 94404, USA
- GenomeAsia 100K Foundation, Foster City, CA, 94404, USA
| | - Ravi Gupta
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | - Asif Rasheed
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Radha Venkatesan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu, 600086, India
| | - Saurabh Belsare
- Institute for Human Genetics, University of California, San Francisco, CA, 94143, USA
| | - Ramesh Menon
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | - Sameer Phalke
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | | | - John Fang
- Thermo Fisher Scientific, Santa Clara, CA, 95051, USA
| | - Deepak Tanneeru
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | | | - Akshi Bassi
- MedGenome Labs Pvt. Ltd., Bengaluru, Karnataka, 560099, India
| | - Jacqueline Robinson
- Institute for Human Genetics, University of California, San Francisco, CA, 94143, USA
| | | | | | - Zameer Ul-Asar
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Imran Saleem
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Unzila Ishtiaq
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Areej Fatima
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | | | | | | | | | | | - Anjum Jalal
- Faisalabad Institute of Cardiology, Faisalabad, Pakistan
| | - Shahid Abbas
- Faisalabad Institute of Cardiology, Faisalabad, Pakistan
| | - Philippe Frossard
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
| | - Christian Fuchsberger
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, 48109, USA
- Institute for Biomedicine, Eurac Research, Bolzano, Italy
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lukas Forer
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sebastian Schoenherr
- Institute of Genetic Epidemiology, Department of Genetics and Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Qixin Bei
- Department of Molecular Biology, Genentech, South San Francisco, CA, 94080, USA
| | - Tushar Bhangale
- Department of Human Genetics, Genentech, South San Francisco, CA, 94080, USA
| | - Jennifer Tom
- Product Development Data Sciences, Genentech, South San Francisco, CA, 94080, USA
| | | | - Priya B V
- Narayana Nethralaya Foundation, Bengaluru, Karnataka, 560010, India
| | | | - Minxian Wang
- Program in Medical and Population Genetics & Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - Pui-Yan Kwok
- Institute for Human Genetics, University of California, San Francisco, CA, 94143, USA
- Cardiovascular Research Institute and Department of Dermatology, University of California San Francisco, San Francisco, CA, 94143, USA
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Amit V Khera
- Harvard Medical School, Boston, MA, 02115, USA
- Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, MA, 02115, Boston, USA
- Verve Therapeutics, Cambridge, MA, 02139, USA
| | - B R Lakshmi
- MDCRC, Royal Care Super Speciality Hospital 1/520, Neelambur, Coimbatore, Tamil Nadu, 641062, India
| | - Adam S Butterworth
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Rajiv Chowdhury
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - John Danesh
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK
| | - Emanuele di Angelantonio
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Aliya Naheed
- Initiative for Non Communicable Diseases, Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Vinay Goyal
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
- Medanta Hospital, New Delhi, India
- Medanta, The Medicity, Gurgaon, India
| | | | | | - Rupam Borgohain
- Nizams Institute of Medical Sciences (NIMS), Hyderabad, India
| | - Adreesh Mukherjee
- Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, India
| | | | - Ravi Yadav
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Soaham Desai
- Shree Krishna Hospital and Pramukhaswami Medical College, Bhaikaka University, Karamsad, Gujarat, India
| | - Niraj Kumar
- All India Institute of Medical Sciences, Rishikesh, India
| | - Atanu Biswas
- Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, India
| | - Pramod Kumar Pal
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Uday B Muthane
- Parkinson and Ageing Research Foundation, Bengaluru, India
| | - Shymal K Das
- Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, India
| | | | - Prashanth L Kukkle
- All India Institute of Medical Sciences, Rishikesh, India
- Manipal Hospital, Miller Road, Bengaluru, India
- Parkinson's Disease and Movement Disorders Clinic, Bengaluru, India
| | - Somasekar Seshagiri
- GenomeAsia 100K Foundation, Foster City, CA, 94404, USA
- Department of Molecular Biology, Genentech, South San Francisco, CA, 94080, USA
| | - Sekar Kathiresan
- Program in Medical and Population Genetics & Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
- Verve Therapeutics, Cambridge, MA, 02139, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Arkasubhra Ghosh
- Narayana Nethralaya Foundation, Bengaluru, Karnataka, 560010, India
| | - V Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu, 600086, India
| | - Danish Saleheen
- Center for Non-Communicable Disease, Karachi, Karachi City, Sindh, 75300, Pakistan
- Seymour, Paul and Gloria Milstein Division of Cardiology at Columbia University, New York, NY, 10032, USA
| | - Eric W Stawiski
- MedGenome Inc., Foster City, CA, 94404, USA
- GenomeAsia 100K Foundation, Foster City, CA, 94404, USA
- Department of Molecular Biology, Genentech, South San Francisco, CA, 94080, USA
- Caribou Biosciences, Berkeley, CA, 94710, USA
| | - Andrew S Peterson
- MedGenome Inc., Foster City, CA, 94404, USA.
- GenomeAsia 100K Foundation, Foster City, CA, 94404, USA.
- Department of Molecular Biology, Genentech, South San Francisco, CA, 94080, USA.
- Broadwing Bio, South San Francisco, CA, 94080, USA.
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Jayadev C, Gupta I, Gopi Krishna Gadde S. Atypical Refractory Macular Edema: Are We Missing Something? J Ophthalmic Vis Res 2022; 17:437-442. [PMID: 36160091 PMCID: PMC9493426 DOI: 10.18502/jovr.v17i3.11584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 01/01/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To report a case of bilateral refractory macular edema in a diabetic macular edema in a diabetic with an underlying systemic illness. Case Report A 65-year-old male presented with the symptom of blurred vision in both eyes for three months. He was a known diabetic patient and was also hypertensive for the last 10 years. The corrected distance visual acuity was 20/120 in the right eye and 20/80 in the left eye. Fundus examination revealed multiple deep and superficial retinal hemorrhages, cystoid macular edema, and serous macular detachment in both eyes. With a diagnosis of diabetic macular edema in both eyes, the patient was treated with multiple intravitreal injections of anti-vascular endothelial growth factor and steroids. Since he did not show a favorable response, the patient was further investigated and diagnosed with multiple myeloma. After undergoing treatment for the same, the patient was seen a year later and noted to have significant resolution of the macular edema and subretinal fluid in both eyes. Conclusion In patients who suffer with atypical macular edema that is resistant to conventional treatment, it is imperative to look for underlying systemic illnesses such as immunoproliferative disorders and hematologic malignancies.
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Affiliation(s)
- Chaitra Jayadev
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bangalore, India
| | - Ishank Gupta
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bangalore, India
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Poornachandra B, Snehith R, Reddy N, Jayadev C, Gadde SGK. Multimodal imaging in central areolar choroidal dystrophy. Oman J Ophthalmol 2022; 15:247-249. [PMID: 35937725 PMCID: PMC9351974 DOI: 10.4103/ojo.ojo_83_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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/01/2021] [Accepted: 06/08/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- B. Poornachandra
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
| | - Ram Snehith
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
| | - Nikitha Reddy
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
| | - Chaitra Jayadev
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India,Address for correspondence: Dr. Chaitra Jayadev, Department of Vitreoretina, Narayana Nethralaya Eye Institute, 121/C, Chord Road, 1 “R” Block, Rajajinagar, Bengaluru - 560 010, Karnataka, India. E-mail:
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Gadde SGK, Sridharan A, Reddy NG, Jayadev C. Neovascular glaucoma following Nd:YAG laser capsulotomy: a rare complication in a postvitrectomised patient with diabetes. BMJ Case Rep 2022; 15:e249264. [PMID: 35396242 PMCID: PMC8996006 DOI: 10.1136/bcr-2022-249264] [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] [Accepted: 04/02/2022] [Indexed: 11/03/2022] Open
Abstract
To describe a case of acute-onset neovascular glaucoma (NVG) after a neodymium:yttrium-aluminium-garnet (Nd:YAG) capsulotomy in a diabetic vitrectomized eye of a patient with severe systemic and ocular comorbidities. A man in his 50s underwent a Nd:YAG capsulotomy for visually significant posterior capsular opacification with a previous history of vitrectomy with silicone oil in situ for diabetic retinopathy. He had systemic and ocular comorbidities implicating an advanced ischaemic status, both systemically and locally. Five days post Nd:YAG capsulotomy, extensive neovascularisation of the iris and angles was noted. Despite maximum antiglaucoma medication, an evisceration ensued due to intractable NVG. This case report highlights the importance of irreversible complications after a seemingly simple capsulotomy in eyes with advanced ocular conditions and systemic comorbidities necessitating extreme caution.
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Affiliation(s)
| | - Akhila Sridharan
- Vitreoretina Services, Narayana Nethralaya Eye Institute, Bangalore, India
| | | | - Chaitra Jayadev
- Vitreoretina Services, Narayana Nethralaya Eye Institute, Bangalore, India
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Sharief S, Jayadev C, Gadde SGK. Commotio retinae halo. BMJ Case Rep 2022; 15:e249270. [PMID: 35301188 PMCID: PMC8932277 DOI: 10.1136/bcr-2022-249270] [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] [Accepted: 03/06/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Shama Sharief
- Department of Vitreo-Retina, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
| | - Chaitra Jayadev
- Department of Vitreo-Retina, Narayana Nethralaya Eye Hospital, Bengaluru, Karnataka, India
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Abstract
Purpose To compare multicolor imaging (MCI) with Optos color fundus photography (OCFP) for the evaluation of morphology and extent of preretinal membranes in diabetic tractional retinal detachments (TRD). Methods In this retrospective study, 30 eyes with diabetic TRDs were imaged using the MCI feature of the Heidelberg Spectralis Spectral-domain optical coherence tomography (SD-OCT) and color photo using the Optos Daytona ultra-widefield fundus camera. Two investigators independently graded and determined the agreeability between the two modalities with respect to the extent of the TRD and preretinal membranes on the SD-OCT B-scan images. Results The MCI provided better visualization of the attachments and traction points of the posterior hyaloid face and preretinal membranes and is comparable to the SD-OCT B-scan images. The inter-rater agreeability rates for OCFP had a Kappa (κ) value of 0.37, while the MCI had a κ value of 0.46. When comparing between images of different wavelengths, grading using infrared reflectance (IR) had a poor agreement (-0.04 ± 0.04) while green reflectance (GR) (0.46 ± 0.32) and blue reflectance (BR) (0.53 ± 0.19) had a moderate agreement. The composite MCI and GR images also had comparatively higher intraclass coefficient when compared to the OCFP (0.25 [-0.09-0.55]) and IR (-0.03 [-0.39-0.34]) images. Conclusion MCI is more sensitive for determining the extent of TRDs and for the detection of secondary membranes when compared to OCFP, thus, aiding in better surgical planning.
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Affiliation(s)
| | - Akhila Sridharan
- Vitreoretina Services, Narayana Nethralaya, Bangalore, Karnataka, India
| | | | - B Poornachandra
- Vitreoretina Services, Narayana Nethralaya, Bangalore, Karnataka, India
| | | | - Chaitra Jayadev
- Vitreoretina Services, Narayana Nethralaya, Bangalore, Karnataka, India
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Sanjay S, Gadde SGK, Kumar Yadav N, Kawali A, Gupta A, Shetty R, Mahendradas P. "Bilateral Sequential Acute Macular Neuroretinopathy in an Asian Indian Female with β Thalassemia Trait following (Corona Virus Disease) COVID-19 Vaccination and Probable Recent COVID Infection- Multimodal Imaging Study.". Ocul Immunol Inflamm 2022; 30:1222-1227. [PMID: 35050826 DOI: 10.1080/09273948.2022.2026978] [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: 10/19/2022]
Abstract
INTRODUCTION Corona virus disease (COVID-19) has been associated with a variety of ophthalmic manifestations including acute macular neuroretinopathy and paracentral middle maculopathy. Posterior segment manifestations after post COVID-19 vaccinations have been reported. CASE REPORT A 25- year-old Asian Indian female developed sequential bilateral AMN following a single dose of COVISHIELD™ vaccine. On investigations she was found to have a β thalassemia trait. Presentation started unilaterally and progressed to the other eye after a month. On clinical examination, the fundus was apparently normal in both eyes. Significant changes suggestive of AMN were seen on multimodal imaging of the posterior segment of the respective eye at the time of involvement which resolved spontaneously in due course. CONCLUSION We report a temporal association of COVID-19 vaccination and AMN.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | | | | | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Aditi Gupta
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Neuro-ophthalmology, Narayana Nethralaya, Bangalore, India
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Jayadev C, Suvarna D, Thomas S, Vinekar A, Gadde SGK, Poornachandra B. Solved mystery of the stellate lesion! Eur J Ophthalmol 2022; 32:NP271-NP273. [DOI: 10.1177/1120672120962021] [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: 11/17/2022]
Affiliation(s)
- Chaitra Jayadev
- Narayana Nethralaya Eye Institute, Bangalore, Karnataka, India
| | | | - Sherina Thomas
- Narayana Nethralaya Eye Institute, Bangalore, Karnataka, India
| | - Anand Vinekar
- Narayana Nethralaya Eye Institute, Bangalore, Karnataka, India
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Reddy NG, Venkatesh R, Jayadev C, Gadde SGK, Agrawal S, Mishra P, Yadav NK, Chhablani J. Diabetic Retinopathy and Diabetic Macular Edema in People With Early-Onset Diabetes. Clin Diabetes 2022; 40:222-232. [PMID: 35669299 PMCID: PMC9160541 DOI: 10.2337/cd21-0110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examined the clinical profile, treatment profile, and vision outcomes of people ≤40 years of age with diabetes and diabetic macular edema (DME). Within this age-group, the prevalence of center-involving DME was 16%, with 74% of eyes showing cystoid edema, 37% showing spongiform edema, and 41% having neurosensory detachment. Longer diabetes duration (P = 0.001) and greater severity of diabetic retinopathy (P <0.001) were associated with DME prevalence. Thus, regular and more frequent follow-up, as well as early and aggressive treatment of diabetic eye disease, are required in people diagnosed early with diabetes.
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Affiliation(s)
| | - Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
- Corresponding author: Ramesh Venkatesh,
| | - Chaitra Jayadev
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | | | - Sameeksha Agrawal
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Pranjal Mishra
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, Bangalore, India
| | - Jay Chhablani
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Sanjay S, Gadde SGK, Agrawal S, Mahendradas P, Govindaswamy N, Kawali A, Jayadev C, Sangai S, Roy AS, Shetty R. Optical coherence tomography angiography (OCTA) of retinal vasculature in patients with post fever retinitis: a qualitative and quantitative analysis. Sci Rep 2021; 11:17647. [PMID: 34480039 PMCID: PMC8417288 DOI: 10.1038/s41598-021-96715-8] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 08/10/2021] [Indexed: 11/08/2022] Open
Abstract
Post fever retinitis is a heterogenous entity that is seen 2-4 weeks after a systemic febrile illness in an immunocompetent individual. It may occur following bacterial, viruses, or protozoal infection. Optical coherence angiography (OCTA) is a newer non-invasive modality that is an alternative to fundus fluorescein angiography to image the retinal microvasculature. We hereby describe the vascular changes during the acute phase of post fever retinitis on OCTA. Imaging on OCTA was done for all patients with post fever retinitis at presentation with 3 × 3 mm and 8 × 8 mm scans centred on the macula and corresponding enface optical coherence tomography (OCT) scans obtained. A qualitative and quantitative analysis was done for all images. 46 eyes of 33 patients were included in the study. Salient features noted were changes in the superficial (SCP) and deep capillary plexus (DCP) with capillary rarefaction and irregularity of larger vessels in the SCP. The DCP had more capillary rarefaction when compared to the SCP. The foveal avascular zone (FAZ) was altered with an irregular perifoveal network. Our series of post fever retinitis describes the salient vascular features on OCTA. Although the presumed aetiology was different in all our patients, they developed similar changes on OCTA. While OCTA is not useful if there is gross macular oedema, the altered FAZ can be indicative of macular ischemia.
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India.
| | | | - Sameeksha Agrawal
- Department of Retina, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Padmamalini Mahendradas
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Nivedhitha Govindaswamy
- Imaging Bio Mechanics and Mathematical Solutions Lab, Narayana Nethralaya Foundation, #258/A Hosur Road, Bommasandra, Bangalore, Karnataka, 560099, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Chaitra Jayadev
- Department of Retina, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Sajjan Sangai
- Department of Retina, Narayana Nethralaya, 121/C, Chord Road, Bangalore, Karnataka, 560010, India
| | - Abhijit Sinha Roy
- Imaging Bio Mechanics and Mathematical Solutions Lab, Narayana Nethralaya Foundation, #258/A Hosur Road, Bommasandra, Bangalore, Karnataka, 560099, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, 121/C. Chord Road, Bangalore, Karnataka, 560010, India
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Venkatesh R, Sangai S, Reddy NG, Sridharan A, Pereira A, Aseem A, Gadde SGK, Yadav NK, Chhablani J. Intracystic hyperreflective material in centre-involving diabetic macular oedema. Graefes Arch Clin Exp Ophthalmol 2021; 259:2533-2544. [PMID: 33710472 DOI: 10.1007/s00417-021-05083-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 09/04/2020] [Accepted: 01/15/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To report evolution and predictive value of intracystic hyperreflective material (ICHRM) on optical coherence tomography (OCT) in centre-involving diabetic macular oedema (CI-DME). METHODS Demographic and OCT features of patients with treatment-naïve CI-DME were analysed retrospectively. OCT parameters noted were macular oedema type, ICHRM presence, presence of hyperreflective spots, disorganised inner retinal layers and outer retinal layers integrity. Eyes were grouped into group 1 CI-DME without ICHRM and group 2 CI-DME with ICHRM. Univariate and multivariate linear regression analyses were done to study the correlation between various OCT features and final vision. RESULTS In this study, 62 eyes of 50 patients were included in group 1 and 61 eyes of 51 patients in group 2. Mean presenting logMAR vision in groups 1 and 2 was 0.374 ± 0.346 and 0.523 ± 0.369 respectively. Poor final visual acuity was noted in CI-DME with ICHRM group (p = 0.015). On linear regression analysis, 3 OCT features, namely, ICHRM presence (p = 0.034), inner segment-outer segment layer disruption (p = 0.001) and ellipsoid zone defects (p = 0.003), were associated with poor final vision. More intravitreal anti-VEGF (2.98 vs 0.629) and steroid (1.51 vs 0.242) injections were required for macular oedema resolution in ICHRM group. CONCLUSION This study is the first to assess the ICHRM on OCT as predictor for treatment outcome in DME eyes. We described its evolution during the DME management and its plausible influence on intravitreal therapy. We believe that this finding has the potential to become a novel biomarker for predicting the visual outcome in DME.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India.
| | - Sajjan Sangai
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Nikitha Gurram Reddy
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Akhila Sridharan
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Arpitha Pereira
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Aditya Aseem
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Santosh Gopi Krishna Gadde
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India
| | - Jay Chhablani
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburgh, PA, 15213, USA
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Affiliation(s)
- Srinivasan Sanjay
- Department of Uvea and Ocular Iimmunology, Narayana Nethralaya, Bangalore, Karnataka, India
| | | | - Ankush Kawali
- Department of Uvea and Ocular Iimmunology, Narayana Nethralaya, Bangalore, Karnataka, India
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Ghosh S, Liu H, Yazdankhah M, Stepicheva N, Shang P, Vaidya T, Hose S, Gupta U, Calderon MJ, Hu MW, Nair AP, Weiss J, Fitting CS, Bhutto IA, Gadde SGK, Naik NK, Jaydev C, Lutty GA, Handa JT, Jayagopal A, Qian J, Sahel JA, Rajasundaram D, Sergeev Y, Zigler JS, Sethu S, Watkins S, Ghosh A, Sinha D. βA1-crystallin regulates glucose metabolism and mitochondrial function in mouse retinal astrocytes by modulating PTP1B activity. Commun Biol 2021; 4:248. [PMID: 33627831 PMCID: PMC7904954 DOI: 10.1038/s42003-021-01763-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 01/28/2021] [Indexed: 02/08/2023] Open
Abstract
βA3/A1-crystallin, a lens protein that is also expressed in astrocytes, is produced as βA3 and βA1-crystallin isoforms by leaky ribosomal scanning. In a previous human proteome high-throughput array, we found that βA3/A1-crystallin interacts with protein tyrosine phosphatase 1B (PTP1B), a key regulator of glucose metabolism. This prompted us to explore possible roles of βA3/A1-crystallin in metabolism of retinal astrocytes. We found that βA1-crystallin acts as an uncompetitive inhibitor of PTP1B, but βA3-crystallin does not. Loss of βA1-crystallin in astrocytes triggers metabolic abnormalities and inflammation. In CRISPR/cas9 gene-edited βA1-knockdown (KD) mice, but not in βA3-knockout (KO) mice, the streptozotocin (STZ)-induced diabetic retinopathy (DR)-like phenotype is exacerbated. Here, we have identified βA1-crystallin as a regulator of PTP1B; loss of this regulation may be a new mechanism by which astrocytes contribute to DR. Interestingly, proliferative diabetic retinopathy (PDR) patients showed reduced βA1-crystallin and higher levels of PTP1B in the vitreous humor.
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Affiliation(s)
- Sayan Ghosh
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Haitao Liu
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Meysam Yazdankhah
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nadezda Stepicheva
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peng Shang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tanuja Vaidya
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, India
| | - Stacey Hose
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Urvi Gupta
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Michael Joseph Calderon
- Department of Cell Biology and Center for Biologic Imaging, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ming-Wen Hu
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Joseph Weiss
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christopher S Fitting
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Imran A Bhutto
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Naveen Kumar Naik
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, India
| | - Chaitra Jaydev
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, India
| | - Gerard A Lutty
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James T Handa
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Jiang Qian
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Dhivyaa Rajasundaram
- Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Yuri Sergeev
- National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Samuel Zigler
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Swaminathan Sethu
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, India
| | - Simon Watkins
- Department of Cell Biology and Center for Biologic Imaging, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Arkasubhra Ghosh
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, India
| | - Debasish Sinha
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Department of Cell Biology and Center for Biologic Imaging, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Poornachandra B, Sharma K, Sudhakar NP, Gadde SGK, Jayadev C. Branch retinal artery occlusion - Finding the culprit! Indian J Ophthalmol 2020; 68:196-198. [PMID: 31856513 PMCID: PMC6951130 DOI: 10.4103/ijo.ijo_1222_19] [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: 11/17/2022] Open
Affiliation(s)
- B Poornachandra
- Vitreoretina Services, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
| | - Karen Sharma
- Vitreoretina Services, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
| | - Neha Peraka Sudhakar
- Vitreoretina Services, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
| | | | - Chaitra Jayadev
- Vitreoretina Services, Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
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Gadde SGK, Snehith R, Jayadev C, Poornachandra B, Naik NK, Yadav NK. Macular tractional retinal detachment: A rare complication of blunt trauma. Indian J Ophthalmol 2020; 68:2602-2604. [PMID: 33120708 PMCID: PMC7774172 DOI: 10.4103/ijo.ijo_1424_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: 12/02/2022] Open
Abstract
Traumatic rhegmatogenous retinal detachment after blunt ocular trauma is a known entity. A tractional macular detachment occurring posttrauma without a retinal break is a unique presentation. A 25-year-old gentleman after blunt ocular trauma with a ball presented a week later with a vision of 20/800, large subretinal bleed and resolving vitreous hemorrhage in the right eye. Three weeks later, an extensive glial proliferation at the posterior pole and macular tractional retinal detachment was noted with the worsening of visual acuity. A vitrectomy, membrane peeling, and silicone oil tamponade with a subsequent silicone oil removal at 6 months stabilized the macula, and vision improved to 20/120. A tractional macular detachment post blunt trauma is rare albeit an interesting occurrence, which can be effectively managed with vitrectomy and allied procedures.
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Affiliation(s)
| | - Ram Snehith
- Vitreoretina Department, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Chaitra Jayadev
- Vitreoretina Department, Narayana Nethralaya, Bangalore, Karnataka, India
| | - B Poornachandra
- Vitreoretina Department, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Naveen K Naik
- Vitreoretina Department, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Naresh Kumar Yadav
- Vitreoretina Department, Narayana Nethralaya, Bangalore, Karnataka, India
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Venkatesh R, Gadde SGK, Pereira A, Singh V, Sangai S, Sridharan A, Bavaharan B, Jain N, Yadav NK. Impact of sub-foveal choroidal thickness on clinical features and long-term clinical outcomes in polypoidal choroidal vasculopathy. Int Ophthalmol 2020; 41:87-97. [PMID: 32844237 DOI: 10.1007/s10792-020-01555-6] [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] [Received: 05/17/2020] [Accepted: 08/16/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To study the clinical features and long-term clinical outcomes in polypoidal choroidal vasculopathy (PCV) in eyes with different sub-foveal choroidal thickness (SFCT). METHODS In this retrospective, observational comparative study, treatment-naïve eyes diagnosed with PCV using the 'EVEREST-2' study criteria were included. The eyes were divided into three groups of thin, medium and thick choroids, based on the SFCT data of total study eyes. Demographic, clinical, imaging features and treatment outcomes between the 3 groups were compared. RESULTS Sixty-three eyes in 63 patients were included. Right eye was involved in 39 (61%) cases and left eye in 24 (39%) cases. Mean age was 68.3 ± 6.82 years (range 54-85 years). Mean SFCT was 274 µm (median = 269 µm), and one standard deviation was 79.2 µm. Totally, 11, 43 and 9 eyes were included in the thin, medium and thick choroid groups, respectively. The mean SFCT was 161 ± 24.1 µm, 275 ± 39.6 µm and 412 ± 26.2 µm in the thin, medium and thick choroid groups, respectively. There was no statistically significant difference in the clinical and imaging features and treatment outcomes between eyes with thin, medium and thick SFCT. CONCLUSION Eyes with PCV can have a choroid of varying thicknesses. Clinical, imaging and treatment responses were similar between the three sub-foveal choroidal thickness groups in this study. In future, more studies are required to evaluate the role of the choroidal thickness and its relationship to treatment in PCV.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina-Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Benguluru, 560010, India.
| | - Santosh Gopi Krishna Gadde
- Department of Retina-Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Benguluru, 560010, India
| | - Arpitha Pereira
- Department of Retina-Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Benguluru, 560010, India
| | - Vivek Singh
- Department of Retina-Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Benguluru, 560010, India
| | - Sajjan Sangai
- Department of Retina-Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Benguluru, 560010, India
| | - Akhila Sridharan
- Department of Retina-Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Benguluru, 560010, India
| | - Bharathi Bavaharan
- Department of Retina-Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Benguluru, 560010, India
| | - Nimesh Jain
- Department of Retina-Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Benguluru, 560010, India
| | - Naresh Kumar Yadav
- Department of Retina-Vitreous, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajaji Nagar, Benguluru, 560010, India
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Abstract
BACKGROUND Foveal cysts have been associated with vitreous traction due to a taut posterior hyaloid. These eyes may progress to become a full-thickness macular hole, remain stable, or resolve after a posterior vitreous detachment. A foveal cyst in an eye with a complete posterior vitreous detachment and no other obvious pathology is unusual. CASE PRESENTATION A 21-year-old male presented with blurred vision in the left eye of 1-month duration. On examination his left-eye vision was 20/60, and anterior segment examination was normal. Fundus examination showed internal limiting membrane folds with a suspected lamellar macular hole. A spectral domain optical coherence scan showed a thin dome-like cyst in the sub foveal region involving the outer retinal layer with a detached posterior hyaloid face. A trial of intravitreal dexamethasone implant was given, following which there was improvement in vision and resolution of the foveal cyst. At the third-month follow-up, the patient presented with a stellate pattern of hyporeflectivity in the macular area both on spectral domain optical coherence scan and multicolor imaging with no change in visual acuity. CONCLUSION The presence of a foveal cyst in a young male without any risk factors is peculiar, and the rapid response to intravitreal dexamethasone implant raises questions about the pathogenesis. The stellate pattern of hyporeflectivity on spectral domain optical coherence scan imaging with an intraretinal "filling defect"-like picture on fluorescein angiography suggests a possible ongoing ischemic pathology.
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Affiliation(s)
- Chaitra Jayadev
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bangalore, India
| | - Sherina Thomas
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bangalore, India
| | - Anand Vinekar
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bangalore, India
| | | | - B Poornachandra
- Department of Vitreoretina, Narayana Nethralaya Eye Institute, Bangalore, India
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