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Madurai, India

Radhakrishnan S.,Aravind Eye Hospital | Maneksha V.,Oculoplasty and Oncology | Adulkar N.,Postgraduate Institute of Ophthalmology
Ophthalmic Plastic and Reconstructive Surgery | Year: 2014

A case of crystal-storing histiocytosis (CSH) associated with mucosa-associated lymphoid tissue (MALT) lymphoma of orbit is reported. The patient was a 53-year-old man who presented with an 8-year history of a slowly enlarging tumor in his right orbit. Histopathologic examination revealed that the tumor was composed predominantly of sheets of spindle-shaped cells resembling striated muscle cells and scattered aggregates of atypical lymphoid cells, showing prominent plasmacytoid differentiation. Immunohistochemical analysis demonstrated that the spindle-shaped cells were CD68-positive histiocytes containing abundant crystals in their cytoplasm, consistent with the diagnosis of CSH. The aggregates of atypical lymphoid cells were diagnosed as MALT lymphoma based on their immunophenotype. Although CSH is a well-recognized manifestation in lymphoproliferative disorders, CSH complicated by MALT type of ocular adnexal lymphoma has rarely been reported. Given the rarity of this, every case presenting with such crystal-storing histiocytes warrants a thorough search for a hidden lymphoid dyscrasia. © 2014 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.

Shah P.K.,Aravind Eye Hospital
Archives of disease in childhood. Fetal and neonatal edition | Year: 2012

To describe aggressive posterior retinopathy of prematurity (APROP) in a subset of premature babies, having gestational age (GA) of ≥28 weeks and birth weight (BW) of ≥1000 g. Retrospective observational case series. Case records of 99 babies, who were diagnosed to have APROP between July 2002 and October 2010 were reviewed. Fundus fluorescein angiography (FFA) was carried out in 19 babies. The mean GA was 31.7 weeks (range 28-35 weeks) and mean BW was 1572 g (range 1000-2310 g). All these babies received supplemental unblended oxygen 3 days or longer after birth. Of the 52 babies who had an eye exam in the neonatal intensive care unit prior to discharge, 35 babies had loss of vascularised retina from zone II to zone I and four babies from zone III to zone I, when examined as an outpatient. FFA revealed large geographic areas of vaso-obliteration (more than 30 disc areas) posterior to the shunt vessels within vascularised retina. Features of severe capillary bed loss in the vascularised retina were seen in our cases. Oxygen could be a precipitating factor in causing this retinopathy of prematurity in large babies.

Sengupta S.,Post Graduate Institute of Ophthalmology | Thiruvengadakrishnan K.,Post Graduate Institute of Ophthalmology | Ravindran R.D.,Post Graduate Institute of Ophthalmology | Vaitilingam M.C.,Aravind Eye Hospital
Ophthalmic Epidemiology | Year: 2012

Purpose: To report changing trends in referral patterns of microbial keratitis evidenced by laboratory results of culture-positive cases from a tertiary eye-care hospital in south India. Methods: All patients presenting with microbial (nonviral) keratitis to the cornea services of Aravind Eye Hospital from 2003 to 2009 were identified from a computerized database. Microbiologic characteristics were recorded and annual distributions of causative organisms over the 7-year study period were compared. Results: Out of a total of 3059 cases of presumed microbial keratitis, 1756 had positive cultures (57.4%). Among the culture-positive cases, fungal pathogens were isolated from 1224 cases (70%), 488 (27.7%) showed bacterial growth, 18 (1.03%) grew acanthamoeba species and 26 (1.5%) demonstrated mixed bacterial and fungal growth. The percentage of fungal isolates in culture-positive cases increased gradually over the study period from 59% in 2004 to 78% in 2009. This increase in frequency of fungal keratitis was statistically significant (P = 0.023). A proportionally decreasing trend was seen in the number of bacterial isolates ranging from 31% in 20032005 to 22% in 2009 (P = 0.04). Conclusions: An incremental increase was seen in the number of fungal keratitis cases referred to our institute during the study period. Bacterial keratitis showed a decline. This disconcerting trend may lead to an increase in the incidence of corneal blindness in the developing world and thus warrants further research. © 2012 Informa Healthcare USA, Inc.

Manohar B.B.,Uvea Clinic | Rathinam S.R.,Aravind Eye Hospital
Indian Journal of Ophthalmology | Year: 2010

Intermediate uveitis (IU) is described as inflammation in the anterior vitreous, ciliary body and the peripheral retina. In the Standardization of Uveitis Nomenclature (SUN) working group's international workshop for reporting clinical data the consensus reached was that the term IU should be used for that subset of uveitis where the vitreous is the major site of the inflammation and if there is an associated infection (for example, Lyme disease) or systemic disease (for example, sarcoidosis). The diagnostic term pars planitis should be used only for that subset of IU where there is snow bank or snowball formation occurring in the absence of an associated infection or systemic disease (that is, "idiopathic"). This article discusses the clinical features, etiology, pathogenesis, investigations and treatment of IU.

Haripriya A.,Aravind Eye Hospital | Chang D.F.,Altos Eye Physicians | Namburar S.,University of Baltimore | Smita A.,Aravind Eye Hospital | Ravindran R.D.,Aravind Eye Hospital
Ophthalmology | Year: 2016

Purpose To compare the rate of postoperative endophthalmitis before and after initiation of intracameral (IC) moxifloxacin for endophthalmitis prophylaxis in patients undergoing cataract surgery. Design Retrospective, clinical registry. Participants All charity and private patients (116 714 eyes) who underwent cataract surgery between February 15, 2014, and April 15, 2015, at the Madurai Aravind Eye Hospital were included. Group 1 consisted of 37 777 eyes of charity patients who did not receive IC moxifloxacin, group 2 consisted of 38 160 eyes of charity patients who received IC moxifloxacin prophylaxis, and group 3 consisted of 40 777 eyes of private patients who did not receive IC moxifloxacin. Methods The electronic health record data for each of the 3 groups were analyzed, and the postoperative endophthalmitis rates were statistically compared. The cost of endophthalmitis treatment (groups 1 and 2) and the cost of IC moxifloxacin prophylaxis (group 2) were calculated. Main Outcome Measures Postoperative endophthalmitis rate before and after initiation of IC moxifloxacin endophthalmitis treatment cost. Results Manual, sutureless, small incision cataract surgery (M-SICS) accounted for approximately all of the 75 937 cataract surgeries in the charity population (97%), but only a minority of the 40 777 private surgeries (21% M-SICS; 79% phacoemulsification). Thirty eyes in group 1 (0.08%) and 6 eyes in group 2 (0.02%) were diagnosed with postoperative endophthalmitis (P < 0.0001). The group 3 endophthalmitis rate was 0.07% (29 eyes), which was also higher than the second group's rate (P < 0.0001). There were no adverse events attributed to IC moxifloxacin in group 2. The total cost of treating the 30 patients with endophthalmitis in group 1 was virtually identical to the total combined cost in group 2 of routine IC moxifloxacin prophylaxis and treatment of the 6 endophthalmitis cases. Conclusions Routine IC moxifloxacin prophylaxis achieved a highly significant, 4-fold reduction in postoperative endophthalmitis in patients undergoing M-SICS. Compared with previous studies, having such a high volume of patients undergoing surgery during a relatively short 14-month time period strengthens the conclusion. This study provides further evidence that moxifloxacin is an effective IC prophylactic antibiotic and suggests that IC antibiotics should be considered for M-SICS and phacoemulsification. © 2016 American Academy of Ophthalmology.

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