Manisha Agarwal

RPE Atrophy following Photodynamic Therapy in Type 2A Idiopathic Parafoveal Telangiectasis

We report a case of Type 2A idiopathic parafoveal telangiectasis treated by Photodynamic Therapy (PDT), resulting in retinal pigment epithelial (RPE) atrophy corresponding to the size of the laser spot used. This raises a doubt regarding the safety of photodynamic therapy in CNVM secondary to type 2A parafoveal telangiectasis.

Aspergillus iris granuloma in a young male: a case report with review of literature.

Endogenous aspergillosis is a rare occurrence. Endogenous Aspergillus endophthalmitis is a rare but devastating infection usually associated with disseminated aspergillosis or with intravenous drug abuse. We report a case of an isolated Aspergillus iris granuloma in a young immunocompetent male patient with review of the literature.

Retinoblastoma presenting as orbital cellulitis: report of four cases with a review of the literature.

purpose To analyze the clinical and histopathological features of retinoblastoma presenting as orbital cellulitis. material and methods Retrospective analysis of case records and review of the histopathology of four patients with retinoblastoma presenting as orbital cellulitis. results On histopathological examination, all eyes showed anterior segment involvement with extensive necrosis. One case had a well-differentiated tumor and one showed extraocular extension of the tumor. conclusion Advanced necrotic retinoblastoma with anterior segment involvement may often present as orbital cellulitis.

Clinical and Investigative Profile of Biopsy-Proven Sarcoid Uveitis in India

Purpose: Retrospective analysis of the clinical features, investigative profile, response to treatment, and final visual outcome in histopathologically confirmed cases of sarcoid uveitis. Methods: Retrospective case series analysis was done of 15 eyes of 9 patients seen between July1999 and August 2003 with biopsy-proven sarcoid uveitis. There were 3 were males and 6 females. The mean age at presentation was 44.1 years (range 11–62 years), The mean follow-up was 28.4 months. Results: Six patients had bilateral ocular involvement and 3 had unilateral involvement. Five out of 9 patients had primarily ocular involvement. The most common presentation was intermediate uveitis and granulomatous anterior uveitis in 7 patients. Eight of 9 patients responded well to the medical treatment with systemic and periocular steroids. Conclusions: Ocular lesions can be the primary manifestation of systemic sarcoidosis. Sarcoid uveitis in the Asian Indian population often presents an intermediate uveitis with granulomatous anterior uveitis.

Bilateral choroidal osteoma with choroidal neovascular membrane treated with bevacizumab in a child

Choroidal osteoma is a rare benign tumor. We report a male child diagnosed with bilateral choroidal osteoma, high myopia and secondary choroidal neovascularization (CNV) membrane in one eye. Co-existence of posterior staphyloma made the clinical diagnosis of choroidal osteoma difficult due to the osteoma filling the depression of the posterior staphyloma. Typical findings on fundus fluorescein angiography, optical coherence tomography, B-scan and indocyanine green angiography confirmed the diagnosis. A review of literature was performed. CNV secondary to choroidal osteoma was treated with intravitreal bevacizumab and it responded well. Regular follow-up is essential for recurrence of CNV and decalcification of the osteoma.

The Collaborative Ocular Tuberculosis Study (COTS)-1 Report 3: Polymerase Chain Reaction in the Diagnosis and Management of Tubercular Uveitis: Global Trends

ABSTRACT Purpose: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. Methods: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. Results: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation. Conclusions: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario.

Rapidly blinding posterior tubercular uveitis

BackgroundA 21-year-old female patient had chorioretinitis in the left eye which relapsed while being on anti-tubercular treatment and oral corticosteroids leading to blindness and the loss of the left eye.FindingsMycobacterium tuberculosis causing chorioretinitis showed a poor response, and the lung lesions showed a good response to the same anti-tubercular treatment.ConclusionsMycobacterium tubercle bacilli in the eye may show a poor response to the anti-tubercular drugs due to poor ocular penetration of the drugs secondary to early ocular hypoxia.

Tubercular retinal vasculitis mimicking frosted branch angiitis: a case report

BackgroundTubercular vasculitis is an important manifestation of ocular tuberculosis and this report highlights the mimicking nature of the disease with frosted branch angiitis.ResultsA patient presented with a severe form of retinal vasculitis in both eyes and a branch retinal vein occlusion in the left eye. He had a positive tuberculin skin test (TST) and a raised erythrocyte sedimentation rate (ESR) and serum angiotensin-converting enzyme (ACE) levels. Radiological investigations revealed a sub-pleural nodule and mediastinal lymph nodes, which on histopathological evaluation confirmed a granulomatous etiology.ConclusionRetinal vasculitis secondary to tubercular etiology may mimic a viral vasculitis; however, a clinical suspicion with a timely diagnosis and management helps in preventing loss of vision and the eye.

An Update on Tubercular Uveitis

Tuberculosis (TB) is an important cause of infectious uveitis causing significant morbidity and mortality especially in endemic countries. Mycobacterium tuberculosis (MTb) may infect any tissue or organ in the body, lungs being the most commonly affected. Ocular TB occurs due to hematogenous dissemination of MTb or due to a hypersensitivity reaction to the bacteria. It may lead to a very severe inflammation and destruction of ocular tissues leading to an irreversible loss of vision. Infection of the eye by MTb most commonly involves the uveal tissue causing anterior, intermediate, and posterior or panuveitis. Awareness of the varied clinical manifestations is important to suspect the ocular TB which may often be difficult to confirm by diagnostic tests available. A timely diagnosis and management may help in preventing severe loss of vision and the eye.

Managing multiple caterpillar hair in the eye

Ophthalmia nodosa with vitreoretinal involvement is rare and may cause permanent loss of eye due to persistent inflammation of the eye. A young female patient having multiple caterpillar hair in the eye including cornea, anterior chamber, sclera, and pars plana presented with recurrent vitritis and pars planitis. Ultrasound biomicroscopy played a vital role and helped in localizing the hair embedded in the pars plana region which were managed by pars plana vitrectomy leading to complete recovery.