Posterior Segment Manifestations Research Articles

Correlation of posterior segment lesions with anterior segment biometric parameters and FBN1 genotype in patients with Marfan syndrome

Objective: To investigate the characteristics of posterior segment lesions in Marfan syndrome (MFS) patients and their relationship with anterior segment biometric parameters and FBN1 genotype. Methods: A cross-sectional study was conducted. A total of 121 MFS patients, 76 males and 45 females, with an average age of (11.72±11.66) years, who visited the Department of Ophthalmology, Eye & ENT Hospital of Fudan University from January 2013 to March 2023 were included. The presence of posterior scleral staphyloma was observed using B-mode ultrasound, and macular lesions were identified and classified using the atrophy-traction-neovascularization system based on ultra-widefield fundus images, color fundus images, and optical coherence tomography scans. Anterior segment biometric parameters, including axial length of the eye, average corneal curvature, corneal astigmatism, horizontal corneal diameter, anterior chamber depth, and lens thickness, were collected, and the direction and extent of lens dislocation were observed. Molecular genetic analysis of FBN1 gene mutations in patients was performed using next-generation sequencing based on a panel of ocular genetic diseases, and the impact of the genotype and anterior segment biometric parameters on the posterior segment manifestations was analyzed. Results: Sixty patients exhibited posterior segment lesions, including retinal detachment (4 cases, 3.31%), macular lesions (47 cases, 38.84%), and posterior scleral staphyloma (54 cases, 44.63%). There was statistically significant difference in axial length of the eye between patients with and without posterior scleral staphyloma [23.09 (22.24, 24.43) and 27.04 (25.44, 28.88) mm], between patients with and without macular lesions [23.16 (22.24, 24.61) and 27.04 (25.74, 28.78) mm], and between patients with and without atrophic macular lesions [23.16 (22.24, 24.61) and 27.04 (25.74, 28.79) mm] (all P<0.001). There was statistically significant difference in anterior chamber depth between patients with and without macular lesions [3.11 (2.75, 3.30) and 3.34 (3.09, 3.60) mm] (P<0.05). There was also statistically significant difference in corneal astigmatism between patients with and without posterior scleral staphyloma [2.15 (1.20, 2.93) and 1.40 (1.00, 2.20) diopters] (P<0.05). The location and region of the FBN1 gene mutation not only showed statistically significant difference from the positive rates of posterior scleral staphyloma and macular lesions (all P<0.05), but also influenced the occurrence of atrophic macular lesions (both P<0.05). Patients with FBN1 mutations located in the transforming growth factor β regulatory sequence had the highest proportion of posterior scleral staphyloma and macular lesions (both 10/11). Conclusions: Posterior scleral staphyloma and macular lesions have a relatively high incidence in MFS patients and tend to progress to more severe grades. The age, axial length of the eye, anterior chamber depth, corneal astigmatism, and location and region of the FBN1 gene mutation are factors affecting the posterior segment lesions in MFS patients.

Posterior Segment Manifestations of Syphilis and Correlation With Serologic Markers of Infection.

Retrospective analysis correlating serologic titers of ocular syphilis with posterior segment manifestations. This study consisted of 40 patients (80 eyes imaged, 68 affected) with positive rapid plasma reagin (RPR) and Treponema Pallidum immunoglobulin G. We collected demographic and presentation data including HIV status, absolute CD4 count, RPR, cerebrospinal fluid-venereal disease research laboratory (CSF-VDRL) test, and retinal zone. We categorized imaging into syphilitic outer retinopathy (SOR), acute syphilitic posterior placoid chorioretinopathy, retinitis/chorioretinitis (RC), and papillitis. Multivariate analysis correlated HIV status, RPR, and VDRL titers with posterior segment findings and zone. Mean age of 42.8 ± 10.7 years, with 70% male patients. Presenting visual acuity (logMAR) 0.66 ± 0.74 did not correlate with RPR, nor was it associated with papillitis, RC, or acute syphilitic posterior placoid chorioretinopathy. Higher RPR (≥ 1:128) positively associated with SOR (P = 0.031) and zone 1 (odds ratio [OR], 1.62; P = 0.02), but negatively associated with zone 2 (OR 0.35; P = 0.005). HIV positivity increased RC odds (OR, 4.45; P = 0.047). Higher RPR correlated with SOR and zone 1, whereas HIV positivity correlated with RC. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].

Posterior segment manifestations of Takayasu arteritis: A narrative review.

Ocular symptoms can be the presenting manifestation of Takayasu arteritis (TA) or could be indicative of disease reactivation. A review of published literature related to posterior segment manifestations of TA by using the keywords "Takayasu arteritis," "ophthalmic manifestations," "retina," "retinopathy," "ocular," "optic nerve," and "optic neuropathy" was performed. In total, 62 case reports and 12 case series were included. The majority of the articles were from Asia (n = 47, 64%). Females outnumbered males in the ratio of 7:1. The mean age of patients was 33 years (range: 8-78 years, SD: 13.5 years). In 58% (n = 41 out of 71) cases, ocular symptoms were the presenting manifestation of the underlying disease. Hypotensive retinopathy was found in 70% of eyes, and hypertensive retinopathy was found in 27%. The mean presenting visual acuity (VA) was +1.03 logMAR (range: -0.12 to 3, SD: 1.07), and at the final follow-up was +1.02 logMAR (range: -0.12 to 3, SD 1.17). VA improved in 34% (n = 29/86), remained stable in 45% (39/86), and worsened in 21% (18/86). The mean follow-up was 9 months (range: 0.5-204, SD: 16 months).

Ophthalmic manifestations in hematological malignancies: An observational study from a tertiary care health center in Eastern India.

This study aimed to document the spectrum of ocular manifestations of hematological malignancies presenting to a tertiary health center in Eastern India and their association with blood parameters. This hospital-based cross-sectional study was conducted from August 2021 to July 2022. Patients diagnosed with leukemia, lymphoma, and multiple myeloma were enrolled in the study. A comprehensive ophthalmic evaluation was done in each case. A total of 97 patients with a confirmed diagnosis of hematological malignancies and meeting the inclusion and exclusion criteria were included in the study. Ocular manifestations were noted in 48 (49.48%) patients. Acute lymphocytic leukemia accounted for 35.4% of cases, followed by acute myeloid leukemia (31.25%), lymphoma (4.2%), and minimum manifestation in multiple myeloma (2.1%) patients. Among 48 patients with ocular manifestations, anterior segment involvement was found in 6.2% of cases, with subconjunctival hemorrhage being the most common, and the posterior segment was involved in 100% of patients, with intraretinal hemorrhages being the most common manifestation. A statistically significant association was noted between hemoglobin, total red blood cell count, and total platelet count with posterior segment manifestations ( p < 0.001). On multivariable logistic regression, only total leucocyte count and total platelet count were significant predictors for ocular manifestation. Indirect involvement of the retina is the most common ocular pathology in hematological malignancies, with intraretinal hemorrhages being the most common finding. Ophthalmic examination is highly recommended as a part of the routine evaluation at the time of diagnosis of hematological malignancies and periodically thereafter to diagnose any ocular involvement.

Ocular manifestations in HIV patients attending a tertiary care hospital in Eastern India and correlation of posterior segment lesions with CD4+ counts.

We aimed to study the ocular manifestations in human immunodeficiency virus (HIV)-infected patients and the correlation of posterior segment lesions with CD4+ counts. This hospital-based, cross-sectional study enrolled HIV-positive patients attending the ophthalmology department of a tertiary care hospital in Eastern India. Complete demographic information was obtained for each patient. Comprehensive ophthalmic evaluation was done in each case. A total of 184 HIV-positive patients were enrolled in the study. Ocular manifestations were detected in 62 cases. The prevalence of ocular manifestations in the present study was 33.69%. Mean age of patients included in the study was 34.8 ± 10.77 years. Prevalence of ocular manifestations was highest in the age group of 30-39 years (41.93%). Highest prevalence of ocular manifestations was noted in patients with low level of education and poor socioeconomic status. Sexual transmission was the major route of HIV transmission (in 92% of cases). Posterior segment lesions were seen in 69.35% of cases. HIV retinopathy was the most common posterior segment manifestation noted in 25 eyes. Significant positive correlation was noted between severities of posterior segment findings and CD4+ counts, which we found to increase with decrease in CD4+ counts (P < 0.001). Detailed ophthalmic evaluation including fundus examination is must in all cases of HIV/acquired immunodeficiency syndrome (AIDS) patients as it may help in early diagnosis, treatment, and prevention of sight-threatening complications due to opportunistic infections.

Acute and Chronic Manifestations of Sympathetic Ophthalmia on Multimodal Imaging

ABSTRACT Purpose To report the clinical and multimodal imaging features of sympathetic ophthalmia in the acute and chronic phases. Methods Retrospective cohort study of consecutive patients with sympathetic ophthalmia seen at a tertiary referral center. Charts, imaging studies, and histopathological specimens were reviewed. The clinical features and multimodal imaging in the sympathizing eye were analyzed by sorting features into those seen in the acute and chronic phase. Results Ten patients were included in the analysis and all of them had previous ocular trauma or complicated retinal detachment. In the acute phase, 70% had anterior uveitis, 70% had vitritis, and 100% had active posterior uveitis; posterior uveitis included multifocal choroiditis (80%), optic disc swelling (40%), multiple serous retinal detachments (20%), MEWDS-like findings (10%), and retinal vasculitis with chorioretinitis (10%). In the chronic phase, posterior manifestations included widespread patches of chorioretinal atrophy in the mid- and far-periphery (80%), peripapillary subretinal fibrosis (50%), and nummular perivascular atrophy (50%). Conclusions Sympathetic ophthalmia shows different posterior segment manifestations in the acute and chronic phase. Active sympathetic ophthalmia should be ruled out in eyes with a MEWDS-like presentation or rapidly progressing chorioretinitis, and history of trauma in the fellow eye. Peripapillary subretinal fibrosis and perivascular nummular atrophy may be useful features to suspect SO once acute inflammation has resolved.

Combined central retinal artery occlusion and anterior ischemic optic neuropathy as presenting signs of systemic lupus erythematosus

Systemic Lupus Erythematosus (SLE) is a chronic auto-immune condition with systemic and ocular involvement. Ophthalmological findings are diverse and can involve all layers of the globe. Posterior segment manifestations can include lupus retinopathy, retinal vascular occlusions and lupus choroidopathy. We report here a rare case of central retinal artery occlusion (CRAO) associated with anterior ischemic optic neuropathy (AION) in a young female patient as presenting signs of SLE. In this case report, we highlight a very uncommon initial presentation of this severe systemic vasculitis. A multidisciplinary approach is required in order to prevent life-threatening vaso-occlusive complications.

Combined central serous chorioretinopathy, hypermetropia, short axial length, chorioretinal folds, enlarged/thickened ocular coats, with varying association of scleral changes (CHAFES)

PurposeTo describe a condition with the following features: chronic central serous chorioretinopathy (CCSC), chorioretinal folds, scleral changes (including any of the following flattened or ‘squared off’ posterior pole, ‘T sign’, or thickened ocular coats), accompanied by a short axial length and hypermetropia in a series of 7 patients.MethodsThe case notes of 7 patients presenting with a combination of CSC, choroidal folds scleral changes and hypermetropia were reviewed as part of a retrospective case series. Corrected visual acuities, serial refraction, colour imaging, fluorescein and indocyanine green angiography findings, together with B-ultrasound scan features were recorded, with axial length measurements as available (< 23.3 mm was defined as short).ResultsThe study included 14 eyes of 7 subjects (2 females and 5 males) with a primary presentation of central vision disturbance. All patients showed signs of previous or current episodes of the following features in at least one eye: CSC (5/7 bilateral); choroidal folds (6/7 bilateral), thickening of ocular coats in the 5 in whom this was measured, at least one scleral abnormality on ultrasound in at least one eye. A short axial length at final appointment was recorded in 13/14 eyes.Conclusions and relevanceThe combination of CCSC with choroidal folds, hypermetropia with apparent shortening of the eyeball associated with one or more scleral abnormalities such as a flattened or ‘squared off ‘appearance of the B ultrasound may be a specific ocular condition. The aetiology of this particular combination of posterior segment manifestations is unknown; the choroid could be the primary focus of disease with secondary involvement of the sclera. Alternatively, the features observed may result from a chronic inflammatory process affecting the sclera with secondary effects on the choroid, retinal pigment epithelium and retina. In our case series, the final vision was not significantly different from vision at presentation.

Keratic precipitates morphology in vitreoretinal lymphoma evaluated with in-vivo confocal microscopy

A 51-year-old female patient presented to our department with a one-year history of bilateral blurred vision with floaters. Ocular examination showed bilateral vitritis with a moderate haze which was more accentuated and prominent at the periphery in the right eye (OD) (figure 1 A, asterisks). Spectral-domain optical coherence tomography (SD-OCT) showed numerous pigment epithelial detachment (figure B, white arrows), with a lumpy-bumpy choroid. The diagnosis of vitreoretinal lymphoma (VRL) was suspected and confirmed histologically by the presence of atypical lymphocytes in the vitreous samples and an elevated Interleukin (IL)-10 to IL-6 ratio. In addition to those posterior segment manifestations, slit-lamp examination of the OD showed central stellate granulomatous keratic precipitates (KPs) (figure C). On in-vivo confocal microscopy (IVCM), those infiltrating KPs appeared as a hyperreflective deposit at the level of the corneal endothelium with a dendritic shape, and were interconnected by multiple thin and fibrillar pseudopodia in a comet-like appearance (figure D, yellow arrows), which is a highly suggestive pattern of KPs of VRL associated anterior uveitis when the latter is unusually granulomatous.

Posterior segment involvement in systemic lupus erythematosus – A series from South India

To report the spectrum of posterior segment manifestations and visual outcomes in a large series of patients with systemic lupus erythematosus (SLE).Retrospective study at a tertiary referral eye center in south India between 2016 and 2022.Charts of 109 patients diagnosed to have SLE were retrieved from our medical database. Only nine cases of SLE (8.25%) had posterior segment involvement. The male: female ratio was 1:8. The mean age was 28 years. Unilaterality was the most common presentation in eight cases (88.89%). Lupus nephritis was the most common systemic presentation in five cases (55.56%). Antiphospholipid antibodies (APLA) positivity was seen in two cases (22.22%). Ocular manifestations included microangiopathy (cotton wool spots) in one case, occlusive retinal vasculitis with cotton wool spots in four cases (five eyes), optic disc edema with combined venous and arterial occlusion (one case), central retinal vein occlusion with cotton wool spots and hemorrhages (one case), macular edema (four cases), posterior scleritis with optic disc edema and exudative retinal detachment in the posterior pole (one case), and tubercular choroidal granuloma (one case). Treatment included systemic steroids, hydroxychloroquine sulfate (HCQS), and immunosuppression in all cases, blood thinners in two cases, and laser photocoagulation in four cases. HCQS-related retinal toxicity was not seen in any of the 109 cases. Ocular manifestation was the initial presentation of SLE in one case. Visual outcome was poor in three cases.Presence of posterior segment findings in cases with SLE may suggest a severe systemic disease. Early detection and aggressive treatment result in better visual outcomes. Ophthalmologists could play a vital role in guiding systemic therapy.

Posterior Segment Ocular Findings in HLA-B27 Positive Patients with Uveitis: A Retrospective Analysis.

To describe the prevalence and characteristics of posterior segment manifestations in patients with HLA-B27-associated uveitis using wide field imaging. Medical records of patients diagnosed with HLA-B27-associated uveitis from a tertiary uveitis clinic were reviewed. Posterior segment involvements including but not limited to peripheral vasculitis, optic disc inflammation, and macula edema documented based on medical records and various imaging modalities including wide field fluorescein angiography and optical coherence tomography, were noted. Demographic characteristics, accompanied with systemic diseases as well as duration and chronicity of uveitis, were also evaluated. Patients with significant systemic and ocular comorbidities were excluded. Statistical analyses including chi-squared tests and paired t-tests were employed. Of the 44 patients with HLA-B27 associated uveitis, 22 patients (50%) were noted to demonstrate posterior segment involvement. Disc leakage and peripheral vasculitis were the most common findings of posterior involvement. Those with anterior chamber inflammation were found to have a significantly increased risk of posterior involvement. Those with posterior involvement were also noted to have a statistically significant decreased visual acuity. No significant association was found between documented duration of disease and posterior segment involvement. The prevalence of posterior segment involvement in HLA-B27 associated uveitis is higher compared to previous reports when evaluated with wide angle imaging modalities. Careful examination of the posterior segment is required in patients with HLA-B27 associated uveitis.

A CROSS SECTIONAL STUDY OF ASSESSMENT OF OCULAR MANIFESTATION IN HEAD INJURY IN A TERTIARY CARE CENTRE OF NORTH-EAST INDIA

Introduction:The involvement of ocular damage as a result of a head injury in the development of partial or total blindness remains a major public health concern. Aim and objectives: To study the proportion and involvement of ocular manifestations in head injury patients. Materials and methods:AHospital based observational cross sectional study was conducted in a tertiary care centre of North East India for a period of one year. A total of 170 cases of Head injury with associated ocular manifestations were included in the study. Detailed history and ophthalmic examination were done. Results: Out of 170 patients,88.82% were males and most vulnerable age group for head injury was 21-30 years (42.94%). Road trafc accident was the commonest mode of injury (71.76%). Most of the cases had multiple ocular manifestations. Soft tissue injury was seen among 162 patients in which lid edema was the most frequent manifestations in 40% cases. Most common posterior segment manifestation was macular edema(4.70%). Floor of the orbit was the most common wall involved in orbital fracture (12%). Conclusion: In our study, external ocular injury constitutes the major portion of ocular manifestations. It has become necessary to investigate head injury cases in order to determine the cause, pattern, and identication of clinical features, and thus to assist in the restoration of sight through timely interventions.

Wide-Field Fluorescein Angiography in Patients With Idiopathic Acute Anterior Uveitis

ABSTRACT Purpose To elucidate whether wide-field fluorescein angiography (WFFA) can yield additional information in patients with newly diagnosed idiopathic acute anterior uveitis (AAU). Methods The WFFA was performed in patients with idiopathic AAU, and the findings were analyzed according to the scoring system by Angiography Scoring for Uveitis Nomenclature. Results Forty-four eyes of 30 patients (22 eyes of 13 patients in the pediatric group and 22 eyes of 17 patients in the adult group) were studied. The mean age was 12.41 ± 3.92 (range, 5–18) years in the pediatric group and 42.36 ± 32.07 (range, 24–68) years in the adult group. Thirteen eyes (59%) of pediatric patients and 12 eyes (54%) of adult patients showed some evidence of posterior segment activity on the WFFA (p = .764). Systemic treatment was administered in 53.8% of the pediatric and 5.9% of adult patients, depending on the disease severity. Conclusion Pediatric patients with idiopathic AAU may have subtle posterior segment manifestations more than adult patients, and posterior segment findings may affect the treatment preferences of physicians.

A cross-sectional study to describe the spectrum of ocular manifestations and risk factors of mucormycosis presenting to a tertiary hospital of East India.

To report the clinico-demographic profile of rhino-orbito-cerebral mucormycosis (ROCM) in patients during the "second wave" of the COVID-19 pandemic in eastern India, and their ophthalmic manifestations at presentation to our tertiary institute. Cross-sectional study amongst patients presenting to our center based on their hospital records. Demographic information, history related to COVID-19, records of detailed ocular examination, and microbiological, radiological, and histopathological investigation were entered into an online worksheet and analyzed using SPSS 26.0. A total of 219 patients with ROCM were treated from May to September 2021, and 110 of these had ocular manifestations at presentation (50.2%). The age of patients ranged from 22 to 83 years and the mean ± standard deviation (SD) age was 49.9 ± 12.9 years. Ninety (81.8%) patients had been diagnosed with diabetes mellitus, 31 (34%) had hypertension, and 10 had other comorbidities. The duration between the onset of COVID-19 and mucormycosis symptoms was 0 to 60 days with a mean ± SD interval of 20.9 ± 12.6 days. Fifty-six (50.9%) patients had a history of steroid use. Unrelenting ocular or facial pain was the most common presenting symptom, ptosis was the most common anterior segment manifestation, and ophthalmic artery occlusion was the most common posterior segment manifestation. Our data from eastern India reinforces the relationship between COVID-19, diabetes, corticosteroid use, and ROCM. Knowledge of various presenting anterior and posterior segment manifestations of the disease as described in the present study will guide clinicians to recognize the disease early and make every effort to prevent complications.

Role of B-scan in Blunt Ocular Trauma: A Cross-sectional Study

Introduction: Ocular trauma is a significant cause of unilateral vision loss, especially in developing countries. Proper assessment of ocular damage and prompt treatment initiation after the injury have a crucial impact on the final outcome. B-scan Ultrasonography (USG) plays an important role in detecting findings that may not be evident during clinical examination. Aim: To assess the role of B-scan in blunt ocular trauma and to determine if B-scan provides any additional advantages over clinical examination. Materials and Methods: A cross-sectional study was conducted from May 1, 2021 to April 30, 2022, at Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India. Fifty consecutive patients with blunt ocular trauma, presenting with hazy or opaque ocular media or unexplained visual loss during clinical examination, were evaluated in the casualty and ophthalmology Out Patient Department (OPD). The frequency of lesions such as traumatic cataract, vitreous degeneration, and retinal detachment was assessed clinically and using B-scan USG. Anterior and posterior segment manifestations of blunt trauma, including traumatic cataract, vitreous haemorrhage, and retinal detachment, were evaluated clinically and with B-scan imaging. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 22.0, including frequency counts, percentage calculations, and Kappa’s statistical analysis to correlate B-scan USG and clinical findings. Results: Majority of patients (28%) were in the age group of 21-30 years. Workplace-related injuries, particularly agricultural injuries, were the most common cause of blunt ocular trauma (30%). Traumatic cataract (44%), vitreous degeneration (8%), vitreous haemorrhage (6%), and retinal detachment (4%) were the common clinical posterior segment findings. On B-scan USG, the most frequent findings were retinal detachment (30%) and vitreous haemorrhage (28%). Choroidal detachment was noted in 2% of cases. B-scan USG was more helpful in accurately diagnosing vitreous lesions and retinal lesions (52%, 30%) compared to clinical examination (16%, 6%). Conclusion: B-scan USG emerged as a superior diagnostic tool for identifying posterior segment lesions, including vitreous, retinal, and choroidal lesions. Lesions such as retinal detachment and vitreous haemorrhage were more easily identified using USG, especially in the presence of hazy or opaque media. Therefore, B-scan USG should be considered an integral part of all ophthalmic set-ups dealing with trauma to avoid missing significant posterior segment pathologies.

Ocular Manifestations in People Living with HIV/AIDS (PLWHA) at the Kerti Praja Foundation, Denpasar, Bali

Background and purpose: People living with Human Immunodeficiency Virus - acquired immunodeficiency syndrome (PLWHA) could present various ocular manifestations according to the CD4+ lymphocyte count. This study aims to determine the socio-demographic characteristics and ocular manifestations of PLWHA. Methods: This study is an observational study with a cross-sectional design and consecutive sampling, involving a total of 118 samples, conducted in August 2021 at Kerti Praja Foundation Denpasar. Data were collected through history taking and ocular examinations, which included the variables of gender, age, occupation, residence, working status, level of education, duration of ARV treatment, treatment compliance, visual acuity, anterior segment manifestation, posterior segment manifestation, and CD4 T-cell count. Data analysis was performed with a statistical software. Results: A total of 118 samples were involved in this study, with 53 respondents (44.9%) experienced ocular manifestations and 55.1% did not experience ocular manifestations. The most frequent ocular manifestation identified was dry eye (68.5% found in right eye and 54.9% found in left eye), while only 2 patients have posterior-segment manifestation. Conclusion: The most common ocular manifestation in HIV-infected people on anti-retroviral therapy was dry eye. Screening for dry eye is recommended in PLWHA.

STUDY OF OPHTHALMIC MANIFESTATIONS IN PATIENTS WITH HAEMATOLOGICAL DYSCRASIAS

BackgroundAndObjectives:Haematologicaldyscrasiasreferstodisorders of the cellular elements of the blood, indicating a pathologicalcondition.Tostudythetypesofophthalmicmanifestationsinhaematological dyscrasias. Methods: This was a Descriptive cross-sectional study of 200cases admitted and diagnosed with various haematological dyscrasias inMedicine, Paediatrics wardsof the hospital betweenDecember 2020 toNovember2022.Allpatientsunderwentastandardisedandcomprehensiveophthalmic evaluation. Results:Outof200cases,152caseswereofnonmalignantdiseases,and 48 cases were of malignant diseases.Male cases were predominantly higherthan female cases. Conjunctival pallor was the most common anteriorsegment manifestation observed, and Retinal haemorrhage was the mostcommon posterior segmentmanifestation observedduring the studyperiod. Conclusion: It is essential to examine all patients with haematologicaldisordersforocularmanifestationsasithelpsindiagnosisandprognosis. Early recognition of the ocular manifestations is of greatimportance as an early treatment institution may prevent or alleviatebothocularandsystemic complications.

OCULAR MANIFESTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS – A CLINICAL STUDY

Aim: To determine the various ocular manifestations of SLE for early diagnosis, prompt initiation of therapy and better prognosis of SLE cases. A total of 50 diagnosed patients of SLE attending RIO a Materials And Methods: nd department of Dermatology, GMCH were selected for the study. Detailed history and a thorough ocular examination was performed. Laboratory investigations including R/E blood, ESR, RBS, R/E urine, 24 hours urinary protein, RFT and ANA were done. Results And Observations: Incidence of ocular manifestations of SLE was 70%. The mean age of presentation was 32.2 years. The female: male was 11.5:1. The median duration of illness was 1.75 years. The commonest systemic involvement was hematological(90%), followed by cutaneous(64%), musculoskeletal(60%), renal(42%), serosal(4%), neurological(2%). 72% had SLEDAI score ≤10 and 28% had &gt;10. Anterior segment involvement(58%) is more than posterior segment(12%). Common anterior segment manifestations were Keratoconjunctivitis sicca, PSC, eyelid lesions, ulcerative blepheritis, subconjunctival haemorrhage, periorbital oedema, PUK, episcleritis. Posterior segment manifestations were lupus retinopathy, hypertensive retinopathy, CSCR, CRVO, optic atrophy and pigmentary maculopathy. 56% were on steroid therapy, 36% were on steroid+HCQS and 8% were on steroid+cyclophosphamide. SLE is a multisyst Conclusion: em disease with varied manifestations and diagnosis depends upon careful evaluation of all the systems including the eye. The ophthalmologist may play an important role in the care of the SLE patients, since ocular inammatory lesions may precede potentially serious extraocular disease and may guide towards the diagnosis.

A Review Study on Ocular Posterior Segments &amp; Neuro-Ophthalmic Manifestations Associated with Human Immunodeficiency Virus (HIV) Infection and its Management Options

To describe the various types of ocular posterior segment and neuro-ophthalmic manifestation associated with Human Immuno-deficiency virus (HIV) infection. And also describe the management or preventive measures associated with it. In all cases of ocular disease due to HIV, there is only one reason i.e. immune system. A Descriptive study was done to review the articles available on PubMed, Google Scholar, Medline, Publon, Orcid, Healthstar, Science Open, Cochrane Library, Paperity and others related to the ocular complications associated with HIV infections. Peer-reviewed articles/ studies were referred to ascertain the available screening tests, preventive measures, hygiene, neuro-ophthalmic manifestation and management options for HIV patients. Some authors suggest that ocular posterior segment &amp; neuro-ophthalmic manifestation due to HIV infection is not recovered, but few authors suggest that it can be recovered with the help of highly active antiretroviral therapy (HAART) in combination with some preventive measures and hygiene. The Eye-care professional’s responsibility is to spread awareness about the complications related to the eye and their management or preventive measures. Ocular complications are very diverse and relatively frequent in the case of HIV infection. Commonly it is associated with a concurrent diagnosis of depression, anxiety, panic, attack and psychiatric disorders, etc. There are various management or preventive measures like regular eye examinations, follow-up of the HIV patients, following the preventive measures strategies, taking therapy properly, preventing to spread of the infection, etc.

Ocular Manifestations in Hematological Disorders

BackgroundOphthalmic manifestations are a common feature in hematological malignancies and may be divided into two groups: those attributable to the disease's infiltration of the eye, and the ocular consequences due to blood abnormalities. This study aims to determine the prevalence of ocular manifestations and their association with the different hematological disease subgroups.Materials and methodsWe conducted a retrospective and observational study enrolling 137 consecutive patients on active treatment or follow-up for hematological malignancies from January 2016 to January 2020 at the Cheikh Khalifa International University Hospital. All patients underwent a standardized and comprehensive ophthalmic evaluation.ResultsOcular involvement was primarily disclosed in acute myeloid leukemia (AML), non-Hodgkin's lymphoma (NHL), and multiple myeloma (MM). We herein report the different ocular changes divided into anterior segment manifestations, posterior segment manifestations, dry eye disease, and ocular adnexa findings. Patients with leukemia had a significantly higher rate of lesions in the ocular posterior segment (p < 0.001). Despite the high prevalence of anterior segment and ocular adnexa findings in lymphoma patients, no significant association emerged between these lesions and the aforementioned condition. In addition, dry eye disease was found in all instances without any association with the disease itself.ConclusionsAwareness of ocular pathology in hematological malignancies is important as it may precede systemic diagnosis or be a sign of recurrence. We should also be concerned about the side effects of treatments, predominantly, dry eye disease. Therefore, periodic ophthalmic assessment throughout the disease's course, as well as interdisciplinary coordination of care, is crucial to promote early diagnosis and treatment, hence improving long-term outcomes.