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Biomedical subjects

L Gopal

Publications and source records attributed to L Gopal.

At least 55 records · Page 3Linked to original sources
PubMed1997

A case-control study of suprachoroidal hemorrhage during pars plana vitrectomy.

BACKGROUND AND OBJECTIVE: To investigate the risk factors associated with suprachoroidal hemorrhage (SCH) during vitrectomy. PATIENTS AND METHODS: Of 6971 pars plana vitrectomies performed between May 1988 and December 1994, SCH occurred intraoperatively in 12 (0.17%) cases. Forty-two age- and sex-matched control subjects were selected by computer-generated random numbers. Preoperative and intraoperative variables were subjected to univariate and conditional logistic regression analysis. RESULTS: Statistically significant risk factors for SCH after univariate analysis included myopia (P = .048), aphakia or pseudophakia (P = .024), rhegmatogenous retinal detachment (P = .044), scleral buckling and/or encirclage at vitrectomy (P = .029), and longer duration of surgery (P = .044). Multivariate analysis revealed independent risks associated with the absence of a lens and longer duration of the surgery. CONCLUSION: A knowledge of the risk factors involved with SCH helps the physician to identify patients who are at a greater risk for this complication.

Adult↗
PubMed1997

Current concepts in the management of adult intraocular tumours.

The management of intraocular tumours has come a long way since the days when enucleation was the only modality of treatment available to the ophthalmologist. Despite the fact that enucleation is still necessary in certain situations, the emphasis is currently on conservative management, thereby saving the eye and some amount of useful vision wherever possible. This review highlights the current trends in the management of adult intraocular tumours with emphasis on newer diagnostic modalities such as computed tomography, magnetic resonance imaging, and fine needle aspiration biopsy. Only those tumours that are most likely to be seen in clinical practice are included.

Adult↗
PubMed1996

Optic disc in fundus coloboma.

PURPOSE: To categorize and describe the type of optic disc involvement and blood vessel patterns seen in patients with fundus coloboma. METHODS: This is a prospective study involving 67 eyes of 40 patients with choroidal coloboma. The evaluation included documentation of fundus details using fundus drawings or photographs, or both. RESULTS: Six types of disc involvement were identified: (1) normal disc outside fundus coloboma (27.8%); (2) disc outside the fundus coloboma and abnormal (10.4%); (3) disc outside the fundus coloboma and independently colobomatous (8.9%); (4) disc within the fundus coloboma and normal (5.0%); (5) disc within the fundus coloboma and colobomatous (44.3%); and (6) disc shape not identified but blood vessels seen emanating from the superior border of the large fundus coloboma (2.9%). Visual acuity was better in types I, II, and III compared with IV, V, and VI. Microphthalmos was more common with the more severe anomalies. High myopia was more common in the less severe anomalies. CONCLUSION: Optic disc involvement in fundus coloboma is widely variable. Of fundus colobomas, 67.2% are associated with either a frankly colobomatous or an altered disc. Of the discs located outside fundus colobomas, 41% are also abnormal. Visual acuity was better in types I, II, and III.

Adolescent↗
PubMed1996

Removal of silicone oil and epimacular proliferation from eyes following vitrectomy.

BACKGROUND AND OBJECTIVES: Epimacular proliferation (EMP) represents a localized form of reproliferation at the macula. The significance of EMP in eyes that have undergone vitrectomy is still not clear. This study investigated the redetachment rate following silicone oil removal when combined with removal of EMP. PATIENTS AND METHODS: Twenty-two consecutive eyes underwent removal of silicone oil and EMP These eyes had attached retinas following silicone oil injection used as an adjunct to complex vitreoretinal surgery. RESULTS: The retina remained attached in 19 (86.4%) of the eyes, with functional improvement it vision in 81.8% of the eyes. Visual acuity of 6/60 (20/200) or better was obtained in 12 (54.5%*) of the eyes. The mean follow-up time was 6.3 months. CONCLUSION: These results suggest that removal of EMP and silicone oil does not increase the risk of redetachment.

Adolescent↗
PubMed1996

Fluid vitreous substitutes in vitreo retinal surgery.

Advances in the surgical instrumentation and vitreoretinal techniques have allowed intraoperative reapproximation of retina to a more normal position. The use of intravitreally injected liquid materials (viscoelastic liquids, liquid perfluorocarbons and silicone oil), as adjunctive agents to vitreo-retinal surgery play an important role in facilitating retinal reattachment. These materials are used as intraoperative instruments to re-establish intraocular volume, assist in separating membranes adherent to the retina, manipulate retinal detachments and mechanically flatten detached retina. Over the longer term, silicone oil maintains intraocular tamponade. One should be cognizant of the potential uses, benefits and risks of each of these vitreous substitutes.

Animals↗
PubMed1995

Pattern of retinal breaks and retinal detachments in eyes with choroidal coloboma.

PURPOSE: To describe the type of breaks that occur in the diaphanous tissue within the coloboma of the choroid and the types of retinal detachment that are associated with these breaks. METHODS: This is a retrospective study of 36 eyes of 36 patients with retinal detachments that extended into the choroidal coloboma. Preoperative findings were documented using detailed fundus drawings and color photographs. Intraoperative identification of retinal breaks was possible using high magnification of the operating microscope. RESULTS: Based on the identifiable breaks inside the coloboma and the extent of retinal detachment, these patients were divided into five subgroups. Three distinct types of breaks were identified within the coloboma: (1) breaks at the edge of the detachment inside the coloboma; (2) oval atrophic breaks; and (3) breaks in anatomic macula that was involved in the coloboma. Multiple breaks were common. CONCLUSIONS: Retinal detachments that extend into the colobomatous area always are associated with breaks in the diaphanous tissue. Intraoperative identification of these breaks is relatively easy. Commonly, the breaks are seen at the edge of the retinal detachment inside the coloboma or as oval breaks within the detached diaphanous tissue. Macula, if involved in the coloboma, occasionally can harbor a retinal break.

Adolescent↗
PubMed1995

Vitrectomy for accidental intraocular steroid injection.

BACKGROUND: Accidental perforation of the globe and intraocular injection of steroid is a potential complication of periocular injections. Final outcomes in eyes in which this complication has occurred have been reported to be unsatisfactory in the past. However, the advent of vitrectomy has altered their prognosis significantly. METHODS: A retrospective analysis was done of five cases of accidental intraocular steroid injection, treated by vitrectomy. Additional procedures involved treatment of retinal breaks (where required) with endolaser or transscleral cryopexy. Scleral buckling was done in one case. RESULTS: Barring one case in which retinal detachment developed, there were no postoperative complications. At last follow up all patients had satisfactory recovery of visual acuity; had attached retina; and quiet anterior chamber and vitreous cavities. CONCLUSION: Vitrectomy is associated with satisfactory results in cases of accidental intraocular steroid injection. Delay up to a few days does not seem to materially influence the outcome.

Adolescent↗
PubMed1995

Investigations in the virological etiology in acute retinal inflammation.

Virological investigations for herpes simplex virus (HSV), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were performed in nine patients of acute retinal inflammation. Serum samples of all the patients were assayed for IgG and IgM antibodies to HSV, CMV and EBV. Vitreous fluid (VF) from 5 patients was tested by immunofluorescence and culture for detection of HSV and CMV. In four patients, VF was also assayed for IgG and IgM antibodies to HSV and CMV. HSV was shown to be the etiological agent in 3 patients with acute retinal necrosis (ARN) syndrome and in one patient with multifocal retinitis. CMV was the causative agent in one patient of ARN and 1 patient with clinically diagnosed CMV retinitis. Evidences of infection with these three viral agents could not be obtained in one patient with clinical diagnosis of CMV retinitis who tested positive for antibody to human immunodeficiency virus 1. All other patients were HIV negative. Identification of the causative viral agent of acute retinal inflammations may help an ophthalmologist to institute specific therapy particularly for HSV and CMV infections.

Acute Disease↗
PubMed1995

Retinal detachment secondary to ocular perforation during retrobulbar anaesthesia.

The clinical characteristics and the retinal breaks associated with rhegmatogenous retinal detachments secondary to accidental globe perforation during local infiltration anaesthesia in five highly myopic eyes are presented. Retinal detachment was total with variable proliferative vitreoretinopathy. The pattern of retinal breaks was rather typical and predictable. Management involved vitreous surgery with internal tamponade by silicone oil in four eyes and perfluoropropane gas in one eye. At the last follow-up, all eyes had attached retina. One eye did not recover useful vision due to possible concurrent optic nerve damage.

Anesthesia, Local↗
PubMed1995

Endophthalmitis caused by anaerobic bacteria.

A retrospective analysis of 22 patients who underwent pars plana vitrectomy for endophthalmitis and had culture-proven anaerobic bacteria, was done. Elimination of infection with attached retina and recovery of ambulatory vision > or = 2/60 were considered as anatomic success and functional success, respectively. Mean follow-up period was 12.7 months (range, 2 to 48 months). Anatomic success was attained in 14 (63.6%) eyes and functional success in 12 (54.6%) eyes. A poor preoperative visual acuity was found to be associated with poor functional outcome (p < 0.046). In endophthalmitis, a routine anaerobic culture of intraocular specimen is recommended.

Adolescent↗
PubMed1995

Intraocular tuberculosis. Clinicopathologic study of five cases.

BACKGROUND: Intraocular tuberculosis is a rare disease. Only approximately 18 cases of microbiologically or histopathologically proven cases of intraocular tuberculosis have been reported. METHODS: Between 1984 and 1994, five cases of intraocular tuberculosis were confirmed microbiologically and histopathologically from intraocular specimens in the authors' uveitis clinic. Systemic antitubercular treatment was instituted, along with the treatment for the ocular inflammation. RESULTS: Clinical presentation included subretinal abscess (two cases), granulomatous anterior uveitis with scleral perforation, an exudative mass in the anterior chamber, and choroidal mass with panuveitis (one case each). Aqueous aspirate in three patients and eviscerated material in the other two showed presence of acid fast bacilli. One globe that required enucleation revealed granulomatous inflammation with caseation necrosis. Two patients showed a significant response to antitubercular therapy, whereas the other three patients eventually required evisceration or enucleation. CONCLUSIONS: Intraocular tuberculosis can have protean manifestations and variable response to systemic antitubercular therapy.

Abscess↗
PubMed1995

Retinopathy of prematurity: a study.

A total of 50 infants of less than 2000 gm birth weight were screened for retinopathy of prematurity (ROP) by binocular indirect ophthalmoscopy. The incidence of ROP was found in 19 patients (38%). Of these, 8 patients (16 eyes) had threshold disease. Significantly, occurrence of threshold ROP was seen in both 1600 gm birth weight in one infant and in the absence of oxygen administration in 2 infants. Ten of the 16 eyes underwent therapeutic intervention while 6 eyes did not receive treatment for lack of consent from the parents. The treatment consisted of indirect laser photocoagulation (8 eyes) and transconjunctival cryopexy (2 eyes). Good regression of the disease (favourable outcome) was noted in all the treated eyes.

Birth Weight↗
PubMed1995

Clinical features and virologic studies in viral retinitis.

Viral retinitis is an important infectious disease of the retina which can occur in both healthy and immunocompromized or immunodeficient individuals. The clinical picture and the role of laboratory studies in diagnosis of viral retinitis are still not well-defined. We correlated the clinical picture and virologic study in the serum and vitreous specimens by Enzyme-linked Immunosorbent Assay (ELISA), rapid immunofluorescence technique and culture in five clinically suspected patients of viral retinitis. None of the patients had any evidence of systemic viral infections. In four patients, the virus was detected by immunofluorescence, ELISA or culture from the vitreous sample. Paired serum samples showed elevation of antiviral IgG titre in two cases and high antiviral IgM titre in all cases. Our study evaluated the role of virological investigations of vitreous aspirate and rising antibody titre in the paired serum samples in the diagnosis of active viral retinitis.

Adolescent↗
PubMed1995

Postsurgical endophthalmitis: diagnosis and management.

Infectious endophthalmitis following intraocular surgery is a complication that could cause severe visual loss or loss of the eye. The categorisation of the event that led to intraocular infection will help the clinician to predict the infectious agent and begin appropriate therapy. Most of the cases of postsurgical endophthalmitis are seen following cataract surgery. It is important for all ophthalmologists, irrespective of specialisation and areas of interest, to be familiar with the management of endophthalmitis. This review briefly describes the facets of clinical and laboratory diagnosis, pathology, and management. While the different viewpoints in the management of endophthalmitis are mentioned in appropriate places, more attention is paid to present a rational approach to the management of endophthalmitis.

Anti-Bacterial Agents↗
PubMed1994

Intraocular Gnathostoma spinigerum. Clinicopathologic study of two cases with review of literature.

BACKGROUND: Live intraocular nematode is a rare occurrence that is mostly reported in Southeast Asian countries. Common nematodes that are seen live in the eye are microfilaria, Gnathostoma, and Angiostrongylus. Approximately 12 cases of intraocular gnathostomiasis have been reported in the literature. METHOD: Two cases of intraocular gnathostoma, removed by vitrectomy in the first case and by paracentesis in the second case, are reported. Morphologic study of the parasites in wet preparation was performed under dissecting microscope and fixed in Karnovosky's fixative. Light microscopic and scanning electron microscopic studies were also performed. RESULTS: The first patient had anterior uveitis, multiple iris holes, and dense vitreous haze with fibrous proliferation over the optic disc. On resolution of the vitreous haze, a live worm was seen in the vitreous cavity. The second patient had anterior uveitis with secondary glaucoma, multiple iris holes, mild vitritis, and focal subretinal haemorrhage with subretinal tracts. Four days later a live worm was seen in the anterior chamber and removed. Microscopic study of the parasites from both patients revealed typical head bulb with four circumferential rows of hooklets, and fine cuticular spines were seen on the surface of the body. CONCLUSIONS: Iris holes, uveitis, and subretinal haemorrhage with subretinal tract can be characteristic features of intraocular gnathostomiasis. Identification of this parasite can be made by typical features, which can be identified on light and scanning electron microscopic study.

Adult↗
PubMed1994

New tumours in non-enucleated eyes of bilateral retinoblastoma patients.

Forty non-enucleated eyes with bilateral retinoblastoma which were treated by external beam radiation therapy (EBRT), transconjunctival cryopexy, and photocoagulation were retrospectively analysed for the age of onset and location of new intraocular tumours. Of these 40 eyes, 9 (22.5%) eyes developed 17 new tumour foci over a mean follow-up of 3 years. The risk of new tumour formation was age-related being 47% in children with age at onset of retinoblastoma less than 1 year compared to 4.4% in older children (P < 0.001). Four eyes (44%) had 2 episodes of tumour formation. All tumour foci developed within 11 months of initial treatment at an average episode interval of 4.0 months. In 89% of cases, new lesions ceased to occur by 18 months of age. Our study clearly shows that EBRT did not prevent development of new lesions. The tumour islands which developed in the peripheral retina in 88% of cases were successfully treated with transconjunctival cryopexy. In 8 cases (89%), the eye could be salvaged. All young bilateral retinoblastoma patients should undergo frequent periodic detailed examination of the retinal periphery with 360 degrees scleral depression to pick up new tumour lesion early and to treat them effectively with simple globe saving methods.

Child, Preschool↗