Ravi Keshavamurthy

Evaluation of Modified Portable Digital Camera for Screening of Diabetic Retinopathy

Aims: To describe a portable wide-field noncontact digital camera for posterior segment photography. Methods: The digital camera has a compound lens consisting of two optical elements (a 90-dpt and a 20-dpt lens) attached to a 7.2-megapixel camera. White-light-emitting diodes are used to illuminate the fundus and reduce source reflection. The camera settings are set to candlelight mode, the optic zoom standardized to ×2.4 and the focus is manually set to 3.0 m. Results: The new technique provides quality wide-angle digital images of the retina (60°) in patients with dilated pupils, at a fraction of the cost of established digital fundus photography. Conclusions: The modified digital camera is a useful alternative technique to acquire fundus images and provides a tool for screening posterior segment conditions, including diabetic retinopathy in a variety of clinical settings.

Spectral domain OCT documented resolution of recalcitrant macular edema after intravitreal bevacizumab in branch retinal vein occlusion.

Purpose Cystoid macular edema is one of the important causes of visual loss in branch retinal vein occlusion. Proximity of the cyst to the external limiting membrane and disruption of the layer on time domain optical coherence tomography is associated with poor final visual outcomes. The authors describe pre- and post-intravitreal bevacizumab spectral domain optical coherence tomography features in a case of cystoid macular edema associated with branch retinal vein occlusion that was resolved after treatment with intravitreal bevacizumab. Methods A 50-year-old woman was diagnosed with cystoid macular edema due to branch retinal vein occlusion and underwent intravitreal injection with bevacizumab after the primary treatment with laser photocoagulation failed. Results The patients visual acuity recovered from 20/40 to 20/20. Spectral domain optical coherence tomography documented complete resolution of a large foveal cyst (150 μm by 280 μm) and recovery of the discontinuity of the external limiting membrane 1 week after treatment. Conclusions Spectral domain optical coherence tomography is a useful tool in identifying the ultrastructural changes associated with cystoid macular edema associated with branch retinal vein occlusion and identifying the possible factors involved in prognosticating visual outcome after effective treatment.

Aplastic anemia induced disc edema and visual loss in pregnancy: a case report

IntroductionA case of aplastic anemia diagnosed during pregnancy, which developed bilateral disc edema and acute pre-retinal hemorrhage leading to vision loss.Case PresentationA 20 year old primagravid female developed acute vision loss in her right eye, during hospitalization for treatment of aplastic anemia diagnosed during her pregnancy. Her best-corrected visual acuity (BCVA) was hand motions and fundus evaluation revealed a large pre-macular hemorrhage in the right eye (OD) and bilateral disc edema. Neuro-imaging studies did not reveal any signs of intracranial mass lesion or edema.ConclusionThere was resolution of the disc edema with improvement in the pre-macular hemorrhage resulting in 20/50 vision in the right eye, following supportive transfusions. Ophthalmic manifestations developing in a pregnant patient with aplastic anemia can be successfully managed with supportive care including red blood cell and platelet transfusions.