LASER INTERVENTION IN MACULAR OEDEMA DUE TO BRANCH RETINAL VEIN OCCLUSION

20 out of 25 patients of Branch Retinal Vein Occlusion (BRVO), with macular oedema of more than six months duration and less than one year, with visual acuity (VA) less than 6/18 corrected and without retinal neovascularisation (NVE) or capillary non-perfusion (CNP) were subjected to argon-green laser photocoagulation applied in a macular grid fashion. At the end of two years 14/20 (70%) laser treated eyes in comparison to 2/5 (40%) of the non-laser group had corrected visual acuity of 6/12.KEY WORDS: Branch Retinal Vein Occlusion (BRVO), Laser, Macular grid, Macular oedema     

Prevalence of Helicobacter pylori, cytomegalovirus,and Chlamydia pneumoniae immunoglobulin seropositivity in coronary artery disease patients and normal individuals in North Indian population

Background

In present day atherosclerosis is perceived as a chronic inflammatory vascular condition and infectious diseases are believed to contribute to its pathophysiology. In this context, the microorganisms which are believed to play a role in the pathophysiology include Chlamydia pneumoniae, cytomegalovirus (CMV), and Helicobacter pylori.

Method

A case control study (retrospective) was conducted over a two-year period. The study population was divided into two groups with 200 individuals in each group. The first group comprised cases of coronary artery disease (CAD) and the second comprised healthy controls selected from the general population after matching for age and sex. Enzyme-linked immunosorbent assay (ELISA) was done for immunoglobulin (IgG) antibodies to H. pylori, C. pneumonia, and CMV. They were also evaluated for conventional risk factors including hypertension, diabetes, obesity, and dyslipidaemia. Epi Info™ version 6 six software was used for analysis of data. Odds ratio, χ² for trend and multiple logistic regression analysis were used to find out statistically significant results.

Results

Seropositivity for H. pylori was present in 119 patients of CAD (59.5%) but it was present in only 76 controls (38%) (P = 0.001). There was a statistically significant association between seropositivity for H. pylori and CAD. There was no statistically significant association between C. pneumoniae and CMV seropositivity with CAD. Multiple logistic regression analysis was done with CAD as the outcome (dependent variable). The predictor covariates (independent) variables were seropositivity to H. pylori, C. pneumoniae, and CMV, hypertension, obesity, diabetes, and dyslipidaemia. It was found that seropositivity to H. pylori, hypertension, obesity, and dyslipidaemia were significant risk factors for CAD.

Conclusion

Our study shows an association between IgG antibody response to H. pylori and CAD. Multiple logistic regression analysis showed that this association was retained even on comparison with the other risk factors.     

High-frequency electric welding: a novel method for improved immediate chorioretinal adhesion in vitreoretinal surgery

Purpose

To evaluate high-frequency electric welding (HFEW) as a novel technique for retinopexy with improved immediate chorioretinal adhesion

Methods

In a prospective, randomized, experimental study, we examined 104 eyes of 52 rabbits randomly assigned to either standard 810 nm endolaser retinopexy, alternating current 14–16 V or 18–20 V HFEW retinopexy. A full-thickness fragment of eye wall tissue containing the retinopexy was isolated 1 h, 3 days, 1 week, or 1 month respectively after the intervention, and fixed to an analytical electronic scale. A nylon suture passed through the retina was elevated by a biomechanical force elongation tester. The reduction in weight at the time of retinopexy rupture was registered as a measure for retinopexy adhesion strength.

Results

One hour post-exposure, adhesive strengths were significantly higher in both HFEW groups than in controls (212?±?26.6 mg and 122?±?16 mg vs 104?±?10 mg; p?=?0.0001 and p?=?0.024 respectively) while laser retinopexy did not significantly change adhesive strength (114?±?14.0 mg, p?=?0.149). Subsequent adhesive strengths were significantly increased for all retinopexy techniques: 3 days post-op 14–16 V HFEW 224?±?30.0 mg (p?=?0.001), 18–20 V HFEW 128?±?15.6 (p?=?0.001), laser 131?±?12.7 mg (p?=?0.0007); at 1 week 14–16 HFEW 235?±?24.7 mg, 18–20 V HFEW 213?±?22.4 mg, laser 188?±?18.7 mg (all p?≤?0.001); 1 month post-op 14–16 V HFEW 275?±?32.0 mg, 18–20 V HFEW 283?±?31.0 mg, laser 276?±?21.7 mg, rspectively (all p?≤? 0.0001).

Conclusion

HFEW represents a novel technique for retinopexy during vitreoretinal surgery. It allows firm chorioretinal adhesion immediately after exposure. In non-vitrectomized eyes, using 14–16 V is particularly effective.     

Method of opening the anterior chamber of the eye

A method for opening the anterior chamber from under the conjunctival corneal flap was developed. Experimental study of the healing characteristics of the back' profile corneal incision and of the method suggested by the authors, that was used in 12 isolated cadaver eyes, has demonstrated the advantages of the new technique. Clinical trials have confirmed better healing characteristics of the new incision as against the corneal incision. This helped reduce the number of the healing sutures from 7-8 to 4-5. The functional results of treatment (vision acuity, postoperative astigmatism) were also better after anterior chamber opening from under the conjunctival corneal flap.     

The lack of public health research output from India

Background  

Systematic assessment of recent health research output from India, and its relation with the estimated disease burden, is not available. This information would help understand the areas in health research that need improvement in India to enhance the health of India's population.