Parykshit Saikia

The Outcome of Early Surgical Repair With Vitrectomy and Silicone Oil in Open-Globe Injuries With Retinal Detachment

PURPOSE To determine the functional and anatomic outcome of early surgical repair with vitrectomy and silicone oil in open-globe injuries with retinal detachment (RD). DESIGN Retrospective consecutive interventional case series. METHODS All patients with open-globe injuries with RD treated between 1997 and 2007 underwent primary repair including vitrectomy with silicone oil within 8 hours after presentation. For data analysis, patients were divided into 3 groups according to the BETT classification: Group 1, intraocular foreign body; Group 2, penetrating injury; Group 3, globe rupture. Outcome measures were final reading visual acuity (0.4 logMAR or better), final ambulatory visual acuity (1.6 logMAR or better), endophthalmitis, and postoperative proliferative vitreoretinopathy (PVR). RESULTS Eighty-eight patients were included (Group 1, n = 13; Group 2, n = 36; Group 3, n = 39). Mean follow-up was 22 months (standard deviation [SD] = 23, range 6-107 months). Eight percent of patients retained reading vision without significant difference between the 3 groups. Fewer patients in Group 3 than in Group 1 or 2 retained ambulatory visual acuity (Group 1, 62%; Group 2, 64%; Group 3, 33%, P = .024). Endophthalmitis occurred in 3.4% of eyes (1 eye in each group). PVR grade B-C, type 1-3 developed in 44% of patients without significant difference between the 3 groups. Re-RD occurred in 38% of eyes. CONCLUSIONS Few patients achieved reading vision while 50% of patients retained ambulatory visual acuity. Final visual outcome is related to the severity of the injury. The frequency of postoperative endophthalmitis is low. Postoperative development of advanced PVR is avoided in most patients.

Franceschetti hereditary recurrent corneal erosion.

PURPOSE To describe new affected individuals of Franceschettis original pedigree of hereditary recurrent erosion and to classify a unique entity called Franceschetti corneal dystrophy. DESIGN Observational case series. METHODS Slit-lamp examination of 10 affected individuals was conducted. Biomicroscopic examinations were supplemented by peripheral corneal biopsy in 1 affected patient with corneal haze. Tissue was processed for light and electron microscopy and immunohistochemistry was performed. DNA analysis was carried out in 12 affected and 3 nonaffected family members. RESULTS All affected individuals suffered from severe ocular pain in the first decade of life, attributable to recurrent corneal erosions. Six adult patients developed bilateral diffuse subepithelial opacifications in the central and paracentral cornea. The remaining 4 affected individuals had clear corneas in the pain-free stage of the disorder. Histologic and immunohistochemical examination of the peripheral cornea in a single patient showed a subepithelial, avascular pannus. There was negative staining with Congo red. DNA analysis excluded mutations in the transforming growth factor beta-induced (TGFBI) gene and in the tumor-associated calcium signal transducer 2 (TACSTD2) gene. CONCLUSION We have extended the pedigree of Franceschetti corneal dystrophy and elaborated its natural history on the basis of clinical examinations. A distinctive feature is the appearance of subepithelial opacities in adult life, accompanied by a decreased frequency of recurrent erosion attacks. Its clinical features appear to distinguish it from most other forms of dominantly inherited recurrent corneal erosion reported in the literature.

Bilateral Posterior Scleritis: An Idiopathic Painless Presentation

Purpose: To describe a presentation of painless posterior scleritis. Methods: This study was an interventional case report. An 18-year-old boy was admitted to the authors’ clinic with symptoms of low degree of vision and no ocular pain. Ophthalmologic examination, ocular ultrasonography, magnetic resonance imaging, fundus fluorescein angiography (FFA), optical coherence tomography (OCT), thoracic radiography, abdominal sonography, and laboratory testing were carried out and the results were evaluated. Results: OCT revealed bilateral exudative retinal detachment. Diffuse bilateral posterior scleral thickening and serous retinal detachment were found in B-scan ultrasonography, suggesting posterior scleritis. Laboratory findings and imaging disclosed no systemic disease. The patient responded to oral prednisolone 60 mg once daily. Conclusions: The case reported here indicates that pain is not always present in posterior scleritis.