Five-year demographic profile of retinopathy of prematurity at a tertiary care institute in North India

Purpose:The purpose of this study is to study the demographic profile and pattern of retinopathy of prematurity (ROP) at a tertiary care institute in India.Methods:An ambispective study from January 2013 to December 2017. Infants with birth weights (BWs) <1750 g and gestational ages <34 weeks were screened for ROP. Demographic details and ROP severity were recorded.Results:Data of 2595 of the 3697 infants screened were analyzed. The number of infants screened and treated for ROP increased from 190 and 29, respectively (2013), to 818 and 132, respectively (2017). The overall incidence of “any ROP” was 32.3%, and severe ROP was 17.7%. Though 39.5% of all infants were outborns (not born in the study center), severe ROP was present in 69.7% of these compared to 18.8% among inborns. Outborns with ROP had a higher mean BW (1308 g) compared to inborns (1202 g) (P < 0.01). ROP Stage 1 was seen in 12%, Stage 2 in 34%, Stage 3 in 13%, Stage 4 in 6%, Stage 5 in 14%, and aggressive posterior ROP (APROP) in 20%. APROP was seen in 16% of infants in 2013, 10% in 2014, 15% in 2015, 22% in 2016, and 28% in 2017. Infants with Stage 4B/Stage5 (15.6% of all ROP) were presented at a mean age of 7.5 months and all had no/delayed screening.Conclusion:Incidence of any ROP was 32.3% and was more common in outborns than inborns. The proportion of infants with APROP showed a rising trend over the years. Nearly 15.6% of infants were presented with stage4B/5 ROP due to delayed/absent screening.     

Structural sequelae and refractive outcome 1 year after laser treatment for type 1 prethreshold retinopathy of prematurity in Asian Indian eyes

Aim:

The aim was to study the structural sequelae and refractive outcome after laser treatment for Type 1 prethreshold retinopathy of prematurity (ROP) in Asian Indian eyes.

Materials and Methods:

A retrospective chart review of infants with Type 1 prethreshold ROP (defined according to the Early Treatment for Retinopathy of Prematurity study) undergoing laser treatment at a tertiary center between January 2004 and December 2008 was done. The 1-year outcome of infants was analyzed.

Results:

Sixty-nine eyes of 36 infants were included. The mean birth weight was 1121.69 ± 254.81 g and the gestational age was 28.99 ± 2.03 weeks. Sixty-five eyes (94.2%) had zone 2 and 4 (5.8%) had zone 1 disease. Forty-four (63.77%) eyes had stage 2 ROP with plus disease and 25 (36.23%) eyes had prethreshold (fewer than five contiguous or eight cumulative clock hours) stage 3 ROP with plus disease. None of the eyes developed retinal structural sequelae. On cycloplegic retinoscopy, 59.4% eyes had nonsignificant hyperopia [spherical equivalent (SE) ≤ 4 D], 14.5% eyes had no refractive error (SE 0 D), 24.7% eyes had low myopia (SE < 5 D), and 1.4% eyes had high myopia (SE > 5.0 D). Eyes developing myopia were associated with a greater number of clock hours of ROP, greater number of laser spots used, and a longer time to disease regression. Two infants (5.6%) had esotropia and one (2.8%) had exotropia.

Conclusion:

Asian Indian infants treated for Type 1 prethreshold ROP did not develop retinal structural sequelae. Myopia was seen in nearly one-fourth of the eyes.The risk factors for myopia were a greater number of clock hours of ROP, greater number of laser spots, and a longer time to regression of ROP.     

703 IGF-IR Tyrosine Kinase as a Novel Molecular Target to Eradicate Mantle Cell Lymphoma

Upregulation of IGF-IR signaling induces significant oncogenic effects. We found the expression and activation of IGF-IR tyrosine kinase in mantle cell lymphoma (MCL) cell lines and patient tumors. Inhibition of IGF-IR induced MCL cell death. IGF-IR may represent a molecular target that can be utilized for the treatment of MCL.

Full Abstract

Type I insulin-like growth factor receptor (IGF-IR) is a homodimeric transmembrane receptor tyrosine kinase. Upregulation of IGF-IR signaling induces significant oncogenic effects. Compared with epithelial cancers, the role of IGF-IR signaling in hematological malignancies is less investigated. Mantle cell lymphoma (MCL) is a non-Hodgkin's lymphoma of B-cell immunophenotype. It has a poor prognosis and tendency to develop resistance to current therapeutics. The expression and potential

     

Improvement with ongoing Enzyme Replacement Therapy in advanced late-onset Pompe disease: a case study

Benefits of enzyme replacement therapy with Myozyme^® (alglucosidase alfa), anecdotally reported in late-onset Pompe disease, range from motor and pulmonary improvement in less severely affected patients, to stabilization with minimal improvement in those with advanced disease. We report a case of a 63-year-old patient with significant morbidity who made notable motor and pulmonary function gains after two years on therapy. Thus, improvements in those with advanced disease may be possible after long-term treatment.     

Clinical profile and outcome of ocular manifestation in Marfans syndrome in India

Purpose:Marfan syndrome (MFS) is a genetic disorder associated with considerable morbidity and mortality. Presently, well-documented information on this condition is not available in India.Methods:In this retrospective cohort study, we recruited patients with clinically diagnosed MFS who presented to the outpatient department using revised Ghent nosology. We retrieved complete ophthalmic information, including vision, anterior and posterior segments, exported from electronic medical records, and relevant investigations, surgical details, and follow-up data were obtained in a specific, pretested format.Results:Our cohort consisted of 86 eyes of 43 patients and had a male preponderance. The prevalence was 20.5 per 100,000 individuals. The mean age of the patients was 23.9 years. All eyes were treated either optically with refraction or surgically using lensectomy and vitrectomy with suture supported scleral fixated intraocular lens (IOL), which significantly affected the visual outcome (P = 0.000).Conclusion:Although considered a rare disease, MFS is commonly found in the ophthalmological setting. Refraction and surgery (lensectomy with scleral fixated IOL) may improve the vision significantly.     

Screening for obstructive sleep apnea in a diabetic retinopathy clinic in a tertiary care center

Purpose:To screen for obstructive sleep apnea (OSA) in patients presenting to diabetic retinopathy (DR) clinic and to correlate its presence with the severity of DR.Methods:A prospective, cross-sectional study of diabetes mellitus patients in retina clinic of a tertiary care referral center, North India (January 2019–March 2020). All were subjected to STOP-Bang Questionnaire and Epworth Sleepiness Scale (ESS) score. Patients at high OSA risk (STOP-Bang score ≥5 and ESS score ≥10) were referred to Department of Otorhinolaryngology (sleep clinic) for polysomnography. Based on Apnea Hypopnea Index (AHI), OSA was graded as mild (AHI = 5–14/h), moderate (AHI = 15–30/h), and severe (AHI >30/h). Statistical analysis was done using three models of outcome measures: (1) “No DR” versus “any DR,” (2) “Less severe DR” versus “More severe DR,” and (3) “No diabetic macular edema (DME)” versus “DME.”Results:Of 362 patients screened, 18 (4.97%) had OSA (11 mild, 5 moderate, and 2 severe). Though OSA did not show a significant association with various outcome measures, patients with moderate–severe OSA had higher odds in developing “any DR” (OR = 7.408; 95% CI = 0.533–102.898), “more severe DR” (OR = 1.961; 95% CI = 0.153–25.215), and “DME” (OR = 2.263; 95% CI = 0.357–14.355), on multiple logistic regression.Conclusion:Ours is the first screening study of OSA in DR patients in India, the diabetes capital of the world. We detected OSA in 4.97% of patients in a DR clinic, with an increased risk of “any DR,” “more severe DR,” and “DME” in the presence of moderate–severe OSA.