Khushboo Srivastav

Nitric oxide and oxidative stress is associated with severity of diabetic retinopathy and retinal structural alterations

The aim of the study was to determine plasma nitric oxide (NO) and lipid peroxide (LPO) levels in diabetic retinopathy and its association with severity of disease.

Photoreceptor inner segment ellipsoid band integrity on spectral domain optical coherence tomography

Spectral domain optical coherence tomography cross-sectional imaging of the macula has conventionally been resolved into four bands. However, some doubts were raised regarding authentication of the existence of these bands. Recently, a number of studies have suggested that the second band appeared to originate from the inner segment ellipsoids of the foveal cone photoreceptors, and therefore the previously called inner segment-outer segment junction is now referred to as inner segment ellipsoidband. Photoreceptor dysfunction may be a significant predictor of visual acuity in a spectrum of surgical and medical retinal diseases. This review aims to provide an overview and summarizes the role of the photoreceptor inner segment ellipsoid band in the management and prognostication of various vitreoretinal diseases.

Increased serum urea and creatinine levels correlate with decreased retinal nerve fibre layer thickness in diabetic retinopathy.

Abstract Correlation of increased levels of serum urea and creatinine with retinal nerve fibre layer (RNFL) thinning on spectral domain optical coherence tomography (SD-OCT) was studied in diabetic retinopathy (DR). Sixty consecutive cases and 20 healthy controls were included. Cases were divided into three groups: without DR, non-proliferative DR with macular oedema and proliferative DR with oedema. Serum urea and creatinine were measured using a standard protocol. Average (RNFL) was measured using SD-OCT. Increased severity of DR was associated with decrease in levels of serum urea and serum creatinine levels. RNFL thinning correlated positively with increase in serum urea and creatinine levels.

Spectral Domain Optical Coherence Tomography Based Alterations in Macular Thickness and Inner Segment Ellipsoidare Associated with Severity of Diabetic Retinopathy

Objective: To study the association of spectral domain optical coherence tomography (SD-OCT) based alterations in macular thickness and inner segment-ellipsoid band (ISel) with severity of retinopathy in cases of type 2 diabetes mellitus. Method: Two hundred thirty eight consecutive cases and seventy nine healthy controls were included. Eyes of cases were divided into three groups according to ETDRS classification: diabetes without retinopathy (No DR) (n=79), non-proliferative diabetic retinopathy (NPDR) with macular edema (n=79), and proliferative diabetic retinopathy (PDR) with macular edema (n=80). Visual acuity was assessed using logMAR scale. Fasting and post prandial blood glucose and glycosylated hemoglobin were estimated as per standard protocol. All the study subjects were evaluated using SD-OCT using the macular cube 512×128 feature. Central subfield thickness (µm), cube average thickness (µm) and ISel disruption in foveal region were noted. The integrity of ISel was evaluated by two experienced observers masked to the status of diabetic retinopathy. Chi–square test, analysis of variance, unpaired t test and pearson correlation analysis were used to assess association between the study variables. Results: Statistically significant decrease in visual acuity was found between the study groups (p<0.0001 ). Significant negative correlation of visual acuity was found with HbA1c, central sub field thickness and ISel disruption (p<0.001).Significant increase in central subfield thickness and cube average thickness were found between the study groups (p<0.001). ISel disruption increased with increase in severity of diabetic retinopathy [(NPDR, n=55) versus (PDR, n=68)] (p<0.001).Statistically significant difference in the mean central subfield thickness in the cases with intact and disrupted ISel was observed in NPDR and PDR groups respectively. Conclusion: Diabetic macular edema as assessed by central subfield thickness, cube average thickness and ISel disruption, on SD-OCT, is associated with increased severity of diabetic retinopathy. For the first time, it has been demonstrated that with progression of retinopathy from non-proliferative to proliferative stage, increase in central subfield thickness is associated with ISel disruption.

Metabolic Syndrome is Associated with Increased Severity of Diabetic Retinopathy

Purpose: To study the association of metabolic syndrome with severity of diabetic retinopathy. Materials and method: Seventy-one consecutive cases of type 2 diabetes mellitus of more than 10 years duration aged 38 to 82 years were included. Metabolic syndrome was identified as per American Heart Association- National Cholesterol Education Programme Adult Treatment Panel III (AHA-NCEP ATP III) criteria. All the cases were assessed for log MAR visual acuity, intraocular pressure (IOP) and seven field fundus photography. The photographs were scored for 16 diabetic lesions. A single severity level (identical to the ETDRS Interim Scale) was calculated for each eye by using the Vanderbilt Classification System. Data was analysed using paired t-test. Results: Of the 71 cases, 47 cases fulfilled at least 3 of the ATP III criteria for metabolic syndrome. Among the cases of metabolic syndrome, 18 cases fulfilled 3 criteria, 28 cases fulfilled 4 criteria and 1 case fulfilled all the 5 criteria. The analyses of the mean Vanderbilt score for severity of retinopathy showed significantly higher score (more severe retinopathy) in cases of metabolic syndrome (p<0.001). Higher IOP was observed in cases of metabolic syndrome (p<0.001). LogMAR visual acuity deteriorated (p<0.01), severity of retinopathy and intraocular pressure increased (p<0.001, p<0.001, respectively) with an increase in the number of components of metabolic syndrome. Triglyceride levels showed positive correlation with severity of retinopathy (p<0.001) and IOP (p<0.001). High density lipoprotein (HDL) levels also showed positive correlation with vision (p<0.001), severity of retinopathy (p<0.001) and IOP (p<0.001). Conclusion: Metabolic syndrome is significantly associated with increased severity of diabetic retinopathy, decreased visual acuity and increased IOP.

Retinal Photoreceptor Ellipsoid Zone Integrity in Diabetic Macular Edema

Spectral domain optical coherence tomography (SD-OCT) and further advances in OCT technology have enabled higher resolution retinal imaging. With the delineation of the four hyperreflective bands in the outer retina, retinal microstructural changes have been documented in diabetic retinopathy. The integrity of photoreceptor external limiting membrane and inner segment ellipsoid zone, in particular, has been correlated with disease severity and visual acuity. Various OCT-based grading systems with regard to disruption of photoreceptor external limiting membrane and inner segment ellipsoid zone have been proposed. The pretreatment status of photoreceptor layer is also useful in predicting the post-treatment recovery of inner segment ellipsoid zone and visual acuity.

EFFECT OF TRACTORIZATION ON REDUCTION IN NATURAL POPULATION OF PROSOPIS CINERARIA (L.) IN AGRO ECOSYSTEM OF THAR DESERT.

Shiwani Bhatnagar, Sangeeta Singh, Ameen Ullah Khan, Bundesh Kumar, Parveen Goran, S. I. Ahmed, K. K. Srivastav and T.S Rathore. Forest Protection Division, Arid Forest Research Institute, New Pali Raod, Jodhpur. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History