• Lin Mogensen posted an update 6 months, 1 week ago

    Purpose To report a rare case series of 14 patients of the Marcus-Gunn jaw-winking phenomenon (MGJWP) without ptosis. Methods This was a retrospective noninterventional case series. The medical records of all patients diagnosed with MGJWP over the past 10 years were retrieved. Patients with documented evidence of absence of ptosis were segregated and analyzed for visual acuity, the severity of Marcus-Gunn, the presence of squint and amblyopia, and the presence of other aberrant regenerations. Results A total of 207 patients were diagnosed with MGJWP, out of which 14 (6.76%) patients had isolated MGJWP without blepharoptosis. The mean age of presentation was 9.5 years and males and females were equally affected. The left eye was involved more commonly (57.2%) than the right eye. Twelve patients were congenital and two were presumed to be of traumatic origin. The most common refractive error in this cohort was astigmatism (10, 71.42%), followed by hyperopia (5, 35.71%). One patient had anisometropic amblyopia. Marcus-Gunn was found to be mild (≤2 mm of lid excursion) in all cases. None of the patients had strabismus or any other aberrant innervations. None of the patients underwent surgery and did not develop ptosis or worsening or improvement of Marcus-Gunn after a mean follow-up period of 2.3 years. Conclusion Isolated MGJWP in the absence of ptosis is a very rare entity and this is the largest series to date to report such an occurrence. All patients had a mild form of MGJWP with no intervention required in any of the cases.Purpose To study the correlation between thyroid eye disease (TED) with type-2 diabetes mellitus. Methods A cross-sectional cohort study was conducted from Jan 2018 to Dec 2018, in patients presenting with thyroid eye disease to orbit and oculoplasty clinic of a tertiary eye care hospital. A total of 105 patients were included in the study. Zidesamtinib All patients underwent detailed ophthalmic evaluation and thyroid eye disease workup. Patients were categorized into mild, moderate, and severe/sight-threatening TED based on EUGOGO classification. Systemic history of diabetes was noted. RBS was done in all patients. Results Mild disease was noted 61 patients of which 11 were diabetics, moderate in 26 patients (8 diabetics), and severe disease in 18 patients (14 diabetics). All patients were treated accordingly. Among the TED patients, the percentage of diabetic patients was noted to be in increasing order toward the severity spectrum of TED. The prevalence of severe TED was found to be much higher in diabetic patients accounting upto 77.77% of 18 patients. A statistically significant correlation was noted (P = 0.014) between severe TED and type-2 diabetes mellitus. In addition, early onset of thyroid eye disease was noted in type-2 diabetes patients. Even though female preponderance was noted, severe TED was more in men (66.6%). Conclusion An autoimmune etiology for the association of thyroid and type-1diabetes has been well established. This study shows that type-2 diabetic patients can have more severity in the clinical presentation of TED. Therefore, the presence of type-2 DM in patients with TED can be a predictive factor for onset, progression, and severity of disease. Hence, a high concern of interest among treating ophthalmologists and endocrinologists regarding this entity would help in early prediction and decreased morbidity among such patients.Purpose To compare the five-year incidence of acute post-operative endophthalmitis following cataract surgery, between centers with and without laminar air flow and high-efficiency particulate air (HEPA) filters in operating rooms. Methods Retrospective analysis of medical records of patients operated in a single network of a tertiary and four secondary hospitals across north India. Cases of endophthalmitis were identified from the records between January 2013 and June 2018. Protocols and consumables were standardized across all hospitals. The only infrastructural difference being the presence of laminar air flow and high energy particulate air filters in operating rooms of the tertiary center. The type of surgery, along with the demographic and socio-economic details, were captured and analyzed, using z-test for proportions and logistic regression. Results Out of 88,297 cataract surgeries conducted, 36 cases of endophthalmitis were reported. The incidence of endophthalmitis across the network was estimated to be 0.041%, (95% CI 0.027 to 0.054). There was no statistically significant difference between the incidence of POE at the tertiary (0.042%) and secondary centers (0.039%). Certain risk factors for high endophthalmitis incidence were identified, namely patients undergoing small incision cataract surgery and belonging to lower socio-economic status. However, for both factors the difference was not statistically significant. Conclusion The five-year incidence of acute post-operative endophthalmitis in our network was found comparable to the best reported in literature. Incidence at secondary centers, without laminar air flow and high energy particulate air filters was found comparable to that in the tertiary center having these facilities.Purpose This purpose of this study was to find the association between severity of visual impairment and retinal nerve fiber layer (RNFL) thickness loss in different demyelinating diseases using optical coherence tomography (OCT) and, simultaneously, assess the fellow eye for subclinical RNFL thickness loss. Methods This cross-sectional, observational study included 60 eyes of 30 patients above the age of 20 years with diagnosed cases of multiple sclerosis (MS), neuromyelitis optica (NMO), and clinically isolated syndrome (CIS) who had history of (h/o) optic neuritis (ON) attack were included. Participants included in the study group underwent best-corrected visual acuity (BCVA) measurement, color perception, swinging flashlight test, slit-lamp examination, and dilated fundus examination (DFE). RNFL thickness was measured using spectral domain OCT (SD-OCT) (Optovue RTVue-V6.11 A Fourier). Intergroup analysis of RNFL thickness was done using a Chi-square test (P less then 0.05 was considered significant). Spearman’s rank correlation coefficient (Spearman’sρ) was used for association (ρ less then 0.

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