Poonam Kishore

Protective effect of an aphrodisiac herb Tribulus terrestris Linn on cadmium-induced testicular damage

Aim: The aim of the present study was to investigate whether Tribulus terrestris Linn (TT) could protect the cadmium (Cd)-induced testicular tissue peroxidation in rats and to explore the underlying mechanism of the same. Materials and Methods: In vitro and in vivo studies were conducted to know the protective effect of ethanolic extract of TT (eTT) in Cd toxicity. In in vitro studies, total antioxidant and ferrous metal ion chelating activity of TT was studied. In vivo studies were conducted in rats. A total of 40 Wistar strain adult male rats were divided into four groups. Group 1 served as control, while group 2 to 4 received CdCl2 (3 mg/kg b. wt. s/c once a week). In addition to Cd, group 3 and 4 rats also received eTT (5 mg/kg b.wt. daily as oral gavage) and α-tocopherol (75 mg/kg daily by oral gavage), respectively. At the end of 6th week, all the rats were sacrificed and the separated testes were weighted and processed for estimation of tissue peroxidation markers, antioxidant markers, functional markers, and Cd concentration. The testes were also subjected to histopathological screening. Results: In in vitro studies, the percentage of metal ion chelating activity of 50 μg/ml of eTT and α-tocopherol were 2.76 and 9.39, respectively, and the antioxidant capacity of eTT was equivalent to 0.063 μg of α-tocopherol/μg of eTT. In in vivo studies, administration of Cd significantly reduced the absolute and relative testicular weight, antioxidant markers such as superoxide dismutase and glutathione, and functional markers such as LDH and ALP, along with significant increase in peroxidation markers such as malondialdehyde and protein carbonyls in testicular tissue. Testes of Cd only-treated group showed histological insults like necrotic changes in seminiferous tubules and interstitium, shrunken tubules with desquamated basal lamina, vacuolization and destruction of sertoli cells, and degenerating Leydig cells. This group also had higher Cd levels in testicular tissue. Co-treatment with eTT and α-tocopherol significantly reduced the Cd burden in the testes along with reversal of the Cd-induced changes. Conclusions: eTT exhibited protective effect against Cd-induced testicular damage. The protective effect appears to be mediated through inhibition of testicular tissue peroxidation by antioxidant and metal chelator activity and also, may be indirectly by stimulating the testosterone production from Leydig cells.

Topical bevacizumab for corneal neovascularization after penetrating keratoplasty

Purpose To evaluate the efficacy of topical bevacizumab for corneal neovascularization in graft rejection. Methods A 55-year-old man presented with corneal neovascularization and graft rejection 6 months following penetrating keratoplasty (triple procedure) in the left eye. His best-corrected visual acuity (BCVA) was counting fingers at 1 meter. He was administered topical bevacizumab (4 mg/4 mL) in a dose of one drop twice a day for 15 days. No adjunct therapy was given during bevacizumab administration. Results After 1 month, his BCVA improved to 20/120. Corneal vascularization and stromal haze regressed. After 6 months, his BCVA improved to 20/60 with further regression in corneal vascularization and stromal haze. At 9-month follow-up, he maintained BCVA of 20/60. Conclusions Short-term topical bevacizumab therapy may potentially offer a safer and more effective alternative in treating graft rejection after penetrating keratoplasty. (Eur J Ophthalmol 2009; 19: 870–2)

Mesenchymal Chondrosarcoma of the Orbit: A Report of Two Cases and Review of the Literature

Mesenchymal chondrosarcoma, an uncommon lesion in bone and extraskeletal tissue, is extremely rare in the orbit. Two cases of orbital mesenchymal chondrosarcoma in young adults presenting with proptosis and diminution of vision are reported. The diagnosis was established by histopathological examination in both cases, which showed undifferentiated mesenchymal cells with islands of cartilage. Both patients underwent exenteration followed by chemotherapy and radiation therapy and are alive with healthy orbits after two years of follow-up.

Association of contrast sensitivity with LogMAR visual acuity and glycosylated hemoglobin in non-insulin dependent diabetes mellitus

A tertiary care center-based prospective case–control study was undertaken to evaluate the association of contrast sensitivity with LogMAR visual acuity and glycosylated hemoglobin (HbA1c) in 205 cases of non-insulin dependent diabetes mellitus and 115 controls. LogMAR visual acuity and contrast sensitivity were scored using ETDRS and Pelli-Robson charts, respectively. Bivariate correlation between contrast sensitivity and LogMAR visual acuity showed significant inverse correlation in cases without retinopathy (r = −0.466) and with non-proliferative retinopathy (r = −0.307). In a multivariate model, on applying linear regression analysis, LogMAR visual acuity (p < 0.001) and HbA1c (p = 0.002) had significant association with contrast sensitivity. Significant difference in contrast sensitivity was not observed between cases without diabetic retinopathy and with non-proliferative diabetic retinopathy, implying no association with retinal microvascular changes. Contrast sensitivity dysfunction observed in diabetes mellitus results from changes in retinal function secondary to alteration in carbohydrate metabolism depicted in glycosylated hemoglobin.

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.

Pars plana vitrectomy for dislocated crystalline/artificial intraocular lens: Factors predicting the visual outcome

Aims: This study aims to study the factors predicting the visual outcome of pars plana vitrectomy (PPV) done for dislocated crystalline or artificial intraocular lens (IOL). Settings and Design: This was a retrospective observational study. Subjects and Methods: The records of patients who underwent PPV with lens retrieval and IOL exchange or repositioning for traumatic or iatrogenic dislocation of crystalline or artificial IOL were reviewed. Pre- and post-operative visual acuity and complications were recorded. Six-month patient follow-up data were reviewed. Statistical Analysis Used: Chi-square test. Results: Final best-corrected visual acuity (BCVA) 6/60 or better was found in the majority of patients who underwent PPV within 1 year of dislocation, but for patients who were delayed for over a year, the final BCVA was <6/60 (P = 0.001). Significant correlations were found between delayed PPV and postoperative retinal detachment (RD) (P = 0.001); between PPV for dislocated nuclear fragment(s) due to complicated cataract surgery and preoperative uveitis (P = 0.007) as well as postoperative cystoid macular edema (CME) (P = 0.001); between preoperative corneal edema and postoperative corneal decompensation (P = 0.03). Finally, the final BCVA <6/60 had significant correlations with preoperative corneal edema (P = 0.001) and uveitis (P = 0.039) and with postoperative corneal decompensation (P = 0.013), CME (P = 0.001), and RD (P = 0.001). Conclusions: In cases of dislocated lens, factors such as delayed intervention, dislocated nuclear fragment(s), preoperative uveitis, and corneal edema were related to increased postoperative sight-threatening complications resulting in poorer visual outcome.

Ocular trauma in Indian pediatric population

Background: Trauma to the eye and ensuing visual disability is an important cause of preventable mono-ocular blindness in the pediatric age group in India. Policy decisions are helpful in preventing this kind of trauma and improving the required trauma management services warrant an accurate estimate of various aspects of ocular trauma and its outcome in Indian population. Aims: To understand the patterns of ocular trauma in Indian pediatric population and its short-term visual outcome. Settings and Design: A tertiary center based, retrospective, observational study. Materials and Methods: Data collection from January 2010 to June 2013 including demographic profile, place of injury, distance from tertiary center, type of health care facility first sought, time delay in first treatment, medico-legal status, pattern of ocular injury on Birmingham Eye Trauma Terminology System (classification), trauma elsewhere in the body, treatment given by us, and best corrected visual acuity (BCVA) at the time of presentation and 3 months. Statistical Analysis: Multinomial logistic regression analysis to identify factors independently affecting BCVA posttreatment which included age, time of the first contact, and time delay in treatment, pretreatment BCVA. Results and Conclusions: Mean age of injury was 7.6 ± 3.3 years with 151 (79.1%) males and 40 (20.9%) females. Seventy-eight percent of patients were from rural areas and 43% first sought treatment at some other government health facility. Majority of children 83/191 (43.5%) sustained injuries at agricultural fields. Best visual acuity was observed in cases of closed globe injuries which was better than 6/18 in 81.8% (18/22) cases.

Macular spectral domain optical coherence tomography data in Indian subjects with cataract

Introduction: The objective of this study is to provide baseline optical coherence tomography (OCT) macular parameters data in Indian subjects with cataract and to compare these parameters with the published normative data on Indian population to understand the effect of cataract on macular thickness using cirrus spectral domain OCT. Material and Methods: This was a prospective, observational, cross-sectional analysis of 108 eyes of 108 cataract cases of north Indian origin. Results: It was observed that age of the patients and the best corrected visual acuity (BCVA) are not found to be the independent factor predicting the change in the mean values of different OCT parameters of macular thickness studied (linear regression analysis β = −2.197 to 0.34, P = 0.902–0.073). Comparison of mean values of different OCT parameters of macular thickness of studied patients with the normative population data from Indian population showed statistical difference in the values with noncataractous population having higher values for most of the studied parameters (t-test; t = 93.6–9.2, P = 0.007–0.043). Conclusion: Though the mean macular thickness of a cataract patient is lesser than that of population, age of the cataract patient does not independently predict the variation in baseline macular thickness. The BCVA achieved after an uneventful cataract surgery is found to be independent of baseline macular thickness of the patient. Moreover the presence of cataract or its grade is not associated with baseline macular thickness of the patient.