The term ocular surface disorders indicate a close relationship between the conjunctival and corn... more The term ocular surface disorders indicate a close relationship between the conjunctival and corneal epithelium in many corneal and external diseases. The human amniotic membrane has a thick basement membrane and an avascular stromal matrix and its first ophthalmic use was reported by deRoth for conjunctival surface reconstruction. It was subsequently used for different ophthalmic reasons. Amniotic membrane transplantation can be used in a number of conditions eg, as a graft to replace damaged ocular surface stromal matrix or as a patch to prevent unwanted inflammatory insults from gaining access to the damaged ocular surface. Amniotic membrane can be utilised in persistent of recurrent corneal epithelial and stromal defects; in cases of corneal perforation due to ulcer or melting; after conjunctival excision for acquired melanosis, neoplasia, etc; in cases of pemphigoid, Stevens-Johnson syndrome, chemical bums; in cases of symblepharon, in dry eyes or in large leaking filtering blebs.
To compare the role of topically applied serum therapy with preservative-free artificial tear (AT... more To compare the role of topically applied serum therapy with preservative-free artificial tear (AT) drops in patients with moderate to severe dry eye in Hansen's disease along with change in tear protein profile. 144 consecutive patients were randomly divided into three groups. After a baseline examination of clinical parameters, each of the patients received designated modality of topical therapy six times a day for 6 weeks. Post-treatment documentation of clinical parameters was done at 6 weeks, and then at 12 weeks after discontinuation of topical therapy. Analysis of three tear proteins using gel electrophoresis (sodium dodecyl sulfate polyacrylamide gel electrophoresis) was done at baseline, at the first and second post-treatment visits. In the cord blood serum (CBS) group, except for McMonnies score and staining score, all other clinical parameters showed continued improvement in the first and second post-treatment analyses. In the autologous serum (ALS) group, all the clinical parameters except Schirmer's I showed significant improvement in the first post-treatment analysis .This was sustained at a significant level in the second analysis except for tear film break-up time (TBUT) and conjunctival impression cytology grading. In the AT group, all the parameters improved at a non-significant level except for TBUT in the first analysis. In the next analysis, apart from McMonnies score and TBUT, other clinical parameters did not improve. In the ALS and CBS groups, tear lysozyme, lactoferrin levels improved in both post-treatment measurements (statistically insignificant).Total tear protein continued to increase at statistically significant levels in the first and second post-treatment analyses in the CBS group and at a statistically insignificant level in the ALS group. In the AT group, the three tear proteins continued to decrease in both the analyses. In moderate to severe dry eye in Hansen's disease, serum therapy in comparison with AT drops, improves clinical parameters and causes betterment in tear protein profile. CTRI/2013/07/003802.
We report the functional outcome of a patient who had undergone Boston keratoprosthesis type I fo... more We report the functional outcome of a patient who had undergone Boston keratoprosthesis type I for extensive ocular surface damage caused by latex of Euphorbia. The milky sap or latex of the Euphorbia plant is highly toxic and an irritant to the skin and eye. Damage to the eye ranges from mild to severe corneal edema, epithelial defects, anterior uveitis, secondary elevated intraocular pressure and, rarely, limbal stem cell deficiency with corneal neovascularization. A restrospective review was conducted of this patient for more than 1 year. During this period he was given subconjunctival bevacizumab injection to regress the corneal vascularization without much benefit, before finally performing Boston keratoprosthesis type I. The patient was evaluated periodically for both anatomical and visual outcome. At the end of 1-year follow-up the keratoprosthesis is well retained with a best-corrected visual acuity of 20/40 in the affected eye.
Indian Journal of Clinical Biochemistry, Feb 3, 2013
Hyperhomocysteinemia has been shown to be an independent risk factor for cardiovascular disease a... more Hyperhomocysteinemia has been shown to be an independent risk factor for cardiovascular disease as well as retinal vascular occlusion. Because of the epidemiological, dietary, genetic and environmental diversity among the different countries, each country should establish the reference interval of homocysteine of their own population for recommending appropriate medical decision limits. Hence a total of 1,288 apparently healthy subjects including 636 male and 652 female were enrolled in the present study to determine the reference intervals of homocysteine in an Indian population. Results of the study were presented as mean, standard deviation, median and 2.5th and 97.5th percentile with the 0.90 confidence interval of each percentile values of homocysteine along with decade-wise changes.
Purpose. To assess the distribution of the 24-hour intraocular pressure (IOP) in subjects with pr... more Purpose. To assess the distribution of the 24-hour intraocular pressure (IOP) in subjects with primary openangle glaucoma (POAG) in a population-based study in rural West Bengal. Methods. All untreated POAG patients (n = 132) identified by a door to door survey in the Hugli District of West Bengal were invited to attend a follow-up study in which IOP was tested with a Goldmann Applanation tonometer at 10 AM, 1 PM, 4 PM, 7PM, 10 PM, 1 AM, and 6 AM. Results. 72 subjects with untreated POAG (72/132; 88.6%) attended the study. Of them, 59 (83.0%) had a peak IOP ≤ 21 mm Hg. The peak IOP (mean ± SD) was 16.4 ± 4.2 mm Hg. Peak IOP occurred in early morning in approximately 78.5% of the subjects (6 AM to 10 AM), and the trough occurred during night time in 72.2% of the subjects (10 PM to 1 AM). The 24-hour IOP (mean ± SD) was 14.2 ± 4.4 mm Hg and the mean fluctuation was 4.0 ± 6.8 mm Hg (range, 2–11 mm Hg). In the 32 persons with unilateral glaucoma, no significant differences were found in...
Cataract is the major cause of blindness worldwide. The transition of couching of cataract to mos... more Cataract is the major cause of blindness worldwide. The transition of couching of cataract to most modem phaco-emulsification gained popularity with more scientific capsulorhexis. Ongoing research is taking place with laser technologies for removal of cataract. Surgery has an important role in advanced corneal diseases. Corneal transplantation is the most successful form. The refractive errors can be corrected by laser-assisted in-situ keratomileusis, intrastromal corneal rings and phacic intra-ocular lenses. Current research is going on to identify the gene responsible for glaucoma and once this is identified, medical therapy can be developed to control the disease. Thermocautery or photocoagulation and indenting the globe so as to bring the choroid nearer the break by scleral buckling forms the basis of modern surgery of retinal detachment. Vitreoretinal diseases, macular degeneration, diabetic retinopathy are no longer considered problematic. We are optimistic that more clinical ...
Postequatorial (12 mm) recession of all four horizontal recti was done in nine patients with cong... more Postequatorial (12 mm) recession of all four horizontal recti was done in nine patients with congenital nystagmus. Fifteen of 18 eyes showed decreased amplitude of nystagmus while 12 eyes also showed an increase in visual acuity. Functionally, significant limitation of ocular motility was not encountered despite unconventionally large recessions.
The purpose of the study was to differentiate ischemic central retinal vein occlusion (CRVO) from... more The purpose of the study was to differentiate ischemic central retinal vein occlusion (CRVO) from nonischemic CRVO during the early acute phase using plasma homocysteine as a biochemical marker. Methods: Fasting plasma homocysteine, serum vitamin B12, and folate levels were measured in 108 consecutive unilateral elderly adult (age >50 years) ischemic CRVO patients in the absence of local and systemic disease and compared with a total of 144 age and sex matched nonischemic CRVO patients and 120 age and sex matched healthy control subjects. Results: Homocysteine level was significantly increased in the patients with ischemic CRVO in comparison with nonischemic CRVO patients (p = 0.009) and also in comparison with control subjects (p < 0.001). Analysis also showed that hyperhomocysteinemia was associated with increased incidence of ischemic CRVO (odds ratio, 18) than that for nonischemic CRVO (odds ratio, 4.5). Serum vitamin B12 and folate levels were significantly lower (p < 0.001) in CRVO patients compared to the control but were not significantly different between nonischemic and ischemic CRVO patients (p > 0.1). Conclusions: Hyperhomocysteinemia can be regarded as useful in differentiating nonischemic and ischemic CRVO during the early acute phase in absence of local and systemic disease in the elderly adult (age >50 years) population.
To compare the role of topically applied serum therapy with preservative-free artificial tear (AT... more To compare the role of topically applied serum therapy with preservative-free artificial tear (AT) drops in patients with moderate to severe dry eye in Hansen's disease along with change in tear protein profile. 144 consecutive patients were randomly divided into three groups. After a baseline examination of clinical parameters, each of the patients received designated modality of topical therapy six times a day for 6 weeks. Post-treatment documentation of clinical parameters was done at 6 weeks, and then at 12 weeks after discontinuation of topical therapy. Analysis of three tear proteins using gel electrophoresis (sodium dodecyl sulfate polyacrylamide gel electrophoresis) was done at baseline, at the first and second post-treatment visits. In the cord blood serum (CBS) group, except for McMonnies score and staining score, all other clinical parameters showed continued improvement in the first and second post-treatment analyses. In the autologous serum (ALS) group, all the clin...
To study the correlation between central corneal thickness (CCT) measured by ultrasound pachymetr... more To study the correlation between central corneal thickness (CCT) measured by ultrasound pachymetry and Frequency Doubling Technology Perimetry (FDT) in patients aged more than or equal to 40 years with high IOP and normal discs. Materials and Methods: This research work has two arms, the rural arm is an eye care centre in Hooghly District of West Bengal (Village: Kuliapara, P.O. Dhobapara, P.S. Balagarh)and the urban arm is a tertiary eye hospital in Kolkata, West Bengal. People aged 40 years and above or those turning 40 in the calendar year with high IOP and normal discs and not on any topical or systemic medications underwent complete ophthalmological examination including CCT assessment by ultrasound pachymetry (Ocuscan RxP) and FDT (Humphrey, Carl Zeiss). Patients with history of intraocular surgery, ocular trauma, corneal opacities preventing accurate applanation tonometry and media haze dense enough to preclude adequate fundal view were not enumerated. Results: One hundred and eighty subjects fulfilled the laid down study inclusion criteria. Average CCT for the right eye(RE) is 530.74 µ and that for the left eye(LE) is 531.32µ(p=0.61, not statistically significant). IOP in the RE varied from 18 to 32 mm Hg with an average value of 23 mm Hg and that in the LE varied from 14 to 32 mm Hg with an average value of 22 mm Hg. Abnormal FDT in either eye was present in eighteen subjects of whom nine subjects had bilateral abnormal FDT and eight subjects had only RE affection and one subject had only LE affection. Conclusion: Our study concludes that the included subjects with abnormal FDT had thinner CCTs as compared to those with a normal FDT. Extending this relation further, we conclude that among subjects with a higher IOP and normal discs or patients grouped as ocular hypertensives, thicker corneas lower the risk for development of early glaucomatous functional damage as picked up by FDT, as compared to patients with thinner corneas.
Hyperhomocysteinemia has been shown to be an independent risk factor for cardiovascular disease a... more Hyperhomocysteinemia has been shown to be an independent risk factor for cardiovascular disease as well as retinal vascular occlusion. Because of the epidemiological, dietary, genetic and environmental diversity among the different countries, each country should establish the reference interval of homocysteine of their own population for recommending appropriate medical decision limits. Hence a total of 1,288 apparently healthy subjects including 636 male and 652 female were enrolled in the present study to determine the reference intervals of homocysteine in an Indian population. Results of the study were presented as mean, standard deviation, median and 2.5th and 97.5th percentile with the 0.90 confidence interval of each percentile values of homocysteine along with decade-wise changes.
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2014
To study change in tear protein profile with duration of diabetes and severity of diabetic retino... more To study change in tear protein profile with duration of diabetes and severity of diabetic retinopathy (DR) in type 2 diabetes patients. Tear protein profile was ascertained by SDS PAGE method in 30 patients with DR (group A) and 37 patients without DR (group B). Six distinct bands of proteins were identified; these proteins are as follows: 91kDa (P1), 66kDa (P2), 60kDa (P3), 30kDa (P4), 18.4kDa (P5) and 14.4kDa (P6). Prevalence of P3 was significant (p=0.036) in group A, especially in cases with diabetes ≤8 years compared with diabetes &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;8 years (p=0.0107). In group B, P2 was significantly prevalent (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0013) in cases with diabetes ≤8 years compared to diabetes &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;8 years. Considering the changes in terms of duration of diabetes in general, patients with diabetes of ≤8 years, P3 was significantly prevalent in group A compared to group B (p=0.004); and when the duration of diabetes is &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;8 years, P2 was found significantly more in group A compared to group B (p=0.01). No significant difference in P3 (p=0.025), P4 (p=0.2877), P5 (p=0.4801), P6 (p=0.0985) was observed in mild to moderate NPDR group compared to severe NPDR to PDR group. P1 and P2 were present only in severe NPDR and PDR. Variable protein expression was observed with duration of diabetes and severity of diabetic retinopathy.
Investigative Ophthalmology & Visual Science, 2015
The purpose of this study was to determine whether aqueous-deficient dry eyes (ADDE) is a protein... more The purpose of this study was to determine whether aqueous-deficient dry eyes (ADDE) is a protein conformational disease. Up to now the therapeutic regimen has been based on empirical results, but these observations may unfold new theranostic approaches for ADDE management. METHODS. Fifty ADDE patients and 46 healthy volunteers were recruited. Schirmer's test, tear breakup time, tear meniscus height, and fluorescein staining tests were conducted on the subjects. Tear protein for ADDE and control patients was collected and extracted using Schirmer's strip. Protein aggregation was studied by appraisal of average protein size, using dynamic light scattering (DLS), fast performance liquid chromatography (FPLC), and synchronous fluorescence spectroscopy (SFS). RESULTS. Dynamic light scattering data showed a comparatively higher abundance of aggregated proteins in ADDE patients than that in controls. For controls, the size distribution of tear proteins was <50 nm in diameter, whereas the size distribution for ADDE individuals was up to 300 nm in diameter. Fast performance liquid chromatography experiments in native tear proteins exhibited minimal difference in the FPLC profiles for ADDE patients and controls. Denatured tear protein FPLC profiles for patients indicated the presence of protein aggregates which were absent in controls. Our hypothesis was further verified by SFS; lower tryptophan fluorescence in ADDE patients is an indication of oxidative stress, which leads to protein aggregation. CONCLUSIONS. Aqueous-deficient dry eyes is likely to be a protein conformational disease. Unlike other conformational diseases where single proteins are involved, this may be a reflection of structural loss for a significant fraction of the tear proteome.
Journal of Ocular Biology, Diseases, and Informatics, 2012
Limbal cell transplantation is an efficacious procedure for rehabilitation of visual acuity in pa... more Limbal cell transplantation is an efficacious procedure for rehabilitation of visual acuity in patients with severe ocular surface disorders. Cultivation of limbal epithelial stem cell with fetal bovine serum for transplantation has been a promising treatment for reconstructing the ocular surface in severe limbal stem cell deficiency caused by Steven Johnson syndrome, chemical or thermal injury. This technique of "cell therapy" has been accepted worldwide but the cost of cultivating the cells for transplantation is high. The objective of this study was to investigate the effect of cord blood serum in place of fetal bovine serum on the growth of human limbal epithelial cell culture. Our group has experimented with human cord blood serum which was obtained free of cost from willing donors. The use of human cord blood serum in place of fetal bovine serum for ex vivo culture of limbal stem cell has helped us in reducing the cost of culture. Fresh human limbal tissues from donor cadavers were cultured on intact and denuded amniotic membrane. Cells were proliferated in vitro with cell culture media containing human cord blood serum. Reverse transcription-polymerase chain reaction and immunofluorescence cytochemistry of cultured human limbal epithelial stem cell was done for characterization of the cells.
The term ocular surface disorders indicate a close relationship between the conjunctival and corn... more The term ocular surface disorders indicate a close relationship between the conjunctival and corneal epithelium in many corneal and external diseases. The human amniotic membrane has a thick basement membrane and an avascular stromal matrix and its first ophthalmic use was reported by deRoth for conjunctival surface reconstruction. It was subsequently used for different ophthalmic reasons. Amniotic membrane transplantation can be used in a number of conditions eg, as a graft to replace damaged ocular surface stromal matrix or as a patch to prevent unwanted inflammatory insults from gaining access to the damaged ocular surface. Amniotic membrane can be utilised in persistent of recurrent corneal epithelial and stromal defects; in cases of corneal perforation due to ulcer or melting; after conjunctival excision for acquired melanosis, neoplasia, etc; in cases of pemphigoid, Stevens-Johnson syndrome, chemical bums; in cases of symblepharon, in dry eyes or in large leaking filtering blebs.
To compare the role of topically applied serum therapy with preservative-free artificial tear (AT... more To compare the role of topically applied serum therapy with preservative-free artificial tear (AT) drops in patients with moderate to severe dry eye in Hansen&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease along with change in tear protein profile. 144 consecutive patients were randomly divided into three groups. After a baseline examination of clinical parameters, each of the patients received designated modality of topical therapy six times a day for 6 weeks. Post-treatment documentation of clinical parameters was done at 6 weeks, and then at 12 weeks after discontinuation of topical therapy. Analysis of three tear proteins using gel electrophoresis (sodium dodecyl sulfate polyacrylamide gel electrophoresis) was done at baseline, at the first and second post-treatment visits. In the cord blood serum (CBS) group, except for McMonnies score and staining score, all other clinical parameters showed continued improvement in the first and second post-treatment analyses. In the autologous serum (ALS) group, all the clinical parameters except Schirmer&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s I showed significant improvement in the first post-treatment analysis .This was sustained at a significant level in the second analysis except for tear film break-up time (TBUT) and conjunctival impression cytology grading. In the AT group, all the parameters improved at a non-significant level except for TBUT in the first analysis. In the next analysis, apart from McMonnies score and TBUT, other clinical parameters did not improve. In the ALS and CBS groups, tear lysozyme, lactoferrin levels improved in both post-treatment measurements (statistically insignificant).Total tear protein continued to increase at statistically significant levels in the first and second post-treatment analyses in the CBS group and at a statistically insignificant level in the ALS group. In the AT group, the three tear proteins continued to decrease in both the analyses. In moderate to severe dry eye in Hansen&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease, serum therapy in comparison with AT drops, improves clinical parameters and causes betterment in tear protein profile. CTRI/2013/07/003802.
We report the functional outcome of a patient who had undergone Boston keratoprosthesis type I fo... more We report the functional outcome of a patient who had undergone Boston keratoprosthesis type I for extensive ocular surface damage caused by latex of Euphorbia. The milky sap or latex of the Euphorbia plant is highly toxic and an irritant to the skin and eye. Damage to the eye ranges from mild to severe corneal edema, epithelial defects, anterior uveitis, secondary elevated intraocular pressure and, rarely, limbal stem cell deficiency with corneal neovascularization. A restrospective review was conducted of this patient for more than 1 year. During this period he was given subconjunctival bevacizumab injection to regress the corneal vascularization without much benefit, before finally performing Boston keratoprosthesis type I. The patient was evaluated periodically for both anatomical and visual outcome. At the end of 1-year follow-up the keratoprosthesis is well retained with a best-corrected visual acuity of 20/40 in the affected eye.
Indian Journal of Clinical Biochemistry, Feb 3, 2013
Hyperhomocysteinemia has been shown to be an independent risk factor for cardiovascular disease a... more Hyperhomocysteinemia has been shown to be an independent risk factor for cardiovascular disease as well as retinal vascular occlusion. Because of the epidemiological, dietary, genetic and environmental diversity among the different countries, each country should establish the reference interval of homocysteine of their own population for recommending appropriate medical decision limits. Hence a total of 1,288 apparently healthy subjects including 636 male and 652 female were enrolled in the present study to determine the reference intervals of homocysteine in an Indian population. Results of the study were presented as mean, standard deviation, median and 2.5th and 97.5th percentile with the 0.90 confidence interval of each percentile values of homocysteine along with decade-wise changes.
Purpose. To assess the distribution of the 24-hour intraocular pressure (IOP) in subjects with pr... more Purpose. To assess the distribution of the 24-hour intraocular pressure (IOP) in subjects with primary openangle glaucoma (POAG) in a population-based study in rural West Bengal. Methods. All untreated POAG patients (n = 132) identified by a door to door survey in the Hugli District of West Bengal were invited to attend a follow-up study in which IOP was tested with a Goldmann Applanation tonometer at 10 AM, 1 PM, 4 PM, 7PM, 10 PM, 1 AM, and 6 AM. Results. 72 subjects with untreated POAG (72/132; 88.6%) attended the study. Of them, 59 (83.0%) had a peak IOP ≤ 21 mm Hg. The peak IOP (mean ± SD) was 16.4 ± 4.2 mm Hg. Peak IOP occurred in early morning in approximately 78.5% of the subjects (6 AM to 10 AM), and the trough occurred during night time in 72.2% of the subjects (10 PM to 1 AM). The 24-hour IOP (mean ± SD) was 14.2 ± 4.4 mm Hg and the mean fluctuation was 4.0 ± 6.8 mm Hg (range, 2–11 mm Hg). In the 32 persons with unilateral glaucoma, no significant differences were found in...
Cataract is the major cause of blindness worldwide. The transition of couching of cataract to mos... more Cataract is the major cause of blindness worldwide. The transition of couching of cataract to most modem phaco-emulsification gained popularity with more scientific capsulorhexis. Ongoing research is taking place with laser technologies for removal of cataract. Surgery has an important role in advanced corneal diseases. Corneal transplantation is the most successful form. The refractive errors can be corrected by laser-assisted in-situ keratomileusis, intrastromal corneal rings and phacic intra-ocular lenses. Current research is going on to identify the gene responsible for glaucoma and once this is identified, medical therapy can be developed to control the disease. Thermocautery or photocoagulation and indenting the globe so as to bring the choroid nearer the break by scleral buckling forms the basis of modern surgery of retinal detachment. Vitreoretinal diseases, macular degeneration, diabetic retinopathy are no longer considered problematic. We are optimistic that more clinical ...
Postequatorial (12 mm) recession of all four horizontal recti was done in nine patients with cong... more Postequatorial (12 mm) recession of all four horizontal recti was done in nine patients with congenital nystagmus. Fifteen of 18 eyes showed decreased amplitude of nystagmus while 12 eyes also showed an increase in visual acuity. Functionally, significant limitation of ocular motility was not encountered despite unconventionally large recessions.
The purpose of the study was to differentiate ischemic central retinal vein occlusion (CRVO) from... more The purpose of the study was to differentiate ischemic central retinal vein occlusion (CRVO) from nonischemic CRVO during the early acute phase using plasma homocysteine as a biochemical marker. Methods: Fasting plasma homocysteine, serum vitamin B12, and folate levels were measured in 108 consecutive unilateral elderly adult (age >50 years) ischemic CRVO patients in the absence of local and systemic disease and compared with a total of 144 age and sex matched nonischemic CRVO patients and 120 age and sex matched healthy control subjects. Results: Homocysteine level was significantly increased in the patients with ischemic CRVO in comparison with nonischemic CRVO patients (p = 0.009) and also in comparison with control subjects (p < 0.001). Analysis also showed that hyperhomocysteinemia was associated with increased incidence of ischemic CRVO (odds ratio, 18) than that for nonischemic CRVO (odds ratio, 4.5). Serum vitamin B12 and folate levels were significantly lower (p < 0.001) in CRVO patients compared to the control but were not significantly different between nonischemic and ischemic CRVO patients (p > 0.1). Conclusions: Hyperhomocysteinemia can be regarded as useful in differentiating nonischemic and ischemic CRVO during the early acute phase in absence of local and systemic disease in the elderly adult (age >50 years) population.
To compare the role of topically applied serum therapy with preservative-free artificial tear (AT... more To compare the role of topically applied serum therapy with preservative-free artificial tear (AT) drops in patients with moderate to severe dry eye in Hansen's disease along with change in tear protein profile. 144 consecutive patients were randomly divided into three groups. After a baseline examination of clinical parameters, each of the patients received designated modality of topical therapy six times a day for 6 weeks. Post-treatment documentation of clinical parameters was done at 6 weeks, and then at 12 weeks after discontinuation of topical therapy. Analysis of three tear proteins using gel electrophoresis (sodium dodecyl sulfate polyacrylamide gel electrophoresis) was done at baseline, at the first and second post-treatment visits. In the cord blood serum (CBS) group, except for McMonnies score and staining score, all other clinical parameters showed continued improvement in the first and second post-treatment analyses. In the autologous serum (ALS) group, all the clin...
To study the correlation between central corneal thickness (CCT) measured by ultrasound pachymetr... more To study the correlation between central corneal thickness (CCT) measured by ultrasound pachymetry and Frequency Doubling Technology Perimetry (FDT) in patients aged more than or equal to 40 years with high IOP and normal discs. Materials and Methods: This research work has two arms, the rural arm is an eye care centre in Hooghly District of West Bengal (Village: Kuliapara, P.O. Dhobapara, P.S. Balagarh)and the urban arm is a tertiary eye hospital in Kolkata, West Bengal. People aged 40 years and above or those turning 40 in the calendar year with high IOP and normal discs and not on any topical or systemic medications underwent complete ophthalmological examination including CCT assessment by ultrasound pachymetry (Ocuscan RxP) and FDT (Humphrey, Carl Zeiss). Patients with history of intraocular surgery, ocular trauma, corneal opacities preventing accurate applanation tonometry and media haze dense enough to preclude adequate fundal view were not enumerated. Results: One hundred and eighty subjects fulfilled the laid down study inclusion criteria. Average CCT for the right eye(RE) is 530.74 µ and that for the left eye(LE) is 531.32µ(p=0.61, not statistically significant). IOP in the RE varied from 18 to 32 mm Hg with an average value of 23 mm Hg and that in the LE varied from 14 to 32 mm Hg with an average value of 22 mm Hg. Abnormal FDT in either eye was present in eighteen subjects of whom nine subjects had bilateral abnormal FDT and eight subjects had only RE affection and one subject had only LE affection. Conclusion: Our study concludes that the included subjects with abnormal FDT had thinner CCTs as compared to those with a normal FDT. Extending this relation further, we conclude that among subjects with a higher IOP and normal discs or patients grouped as ocular hypertensives, thicker corneas lower the risk for development of early glaucomatous functional damage as picked up by FDT, as compared to patients with thinner corneas.
Hyperhomocysteinemia has been shown to be an independent risk factor for cardiovascular disease a... more Hyperhomocysteinemia has been shown to be an independent risk factor for cardiovascular disease as well as retinal vascular occlusion. Because of the epidemiological, dietary, genetic and environmental diversity among the different countries, each country should establish the reference interval of homocysteine of their own population for recommending appropriate medical decision limits. Hence a total of 1,288 apparently healthy subjects including 636 male and 652 female were enrolled in the present study to determine the reference intervals of homocysteine in an Indian population. Results of the study were presented as mean, standard deviation, median and 2.5th and 97.5th percentile with the 0.90 confidence interval of each percentile values of homocysteine along with decade-wise changes.
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2014
To study change in tear protein profile with duration of diabetes and severity of diabetic retino... more To study change in tear protein profile with duration of diabetes and severity of diabetic retinopathy (DR) in type 2 diabetes patients. Tear protein profile was ascertained by SDS PAGE method in 30 patients with DR (group A) and 37 patients without DR (group B). Six distinct bands of proteins were identified; these proteins are as follows: 91kDa (P1), 66kDa (P2), 60kDa (P3), 30kDa (P4), 18.4kDa (P5) and 14.4kDa (P6). Prevalence of P3 was significant (p=0.036) in group A, especially in cases with diabetes ≤8 years compared with diabetes &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;8 years (p=0.0107). In group B, P2 was significantly prevalent (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0013) in cases with diabetes ≤8 years compared to diabetes &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;8 years. Considering the changes in terms of duration of diabetes in general, patients with diabetes of ≤8 years, P3 was significantly prevalent in group A compared to group B (p=0.004); and when the duration of diabetes is &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;8 years, P2 was found significantly more in group A compared to group B (p=0.01). No significant difference in P3 (p=0.025), P4 (p=0.2877), P5 (p=0.4801), P6 (p=0.0985) was observed in mild to moderate NPDR group compared to severe NPDR to PDR group. P1 and P2 were present only in severe NPDR and PDR. Variable protein expression was observed with duration of diabetes and severity of diabetic retinopathy.
Investigative Ophthalmology & Visual Science, 2015
The purpose of this study was to determine whether aqueous-deficient dry eyes (ADDE) is a protein... more The purpose of this study was to determine whether aqueous-deficient dry eyes (ADDE) is a protein conformational disease. Up to now the therapeutic regimen has been based on empirical results, but these observations may unfold new theranostic approaches for ADDE management. METHODS. Fifty ADDE patients and 46 healthy volunteers were recruited. Schirmer's test, tear breakup time, tear meniscus height, and fluorescein staining tests were conducted on the subjects. Tear protein for ADDE and control patients was collected and extracted using Schirmer's strip. Protein aggregation was studied by appraisal of average protein size, using dynamic light scattering (DLS), fast performance liquid chromatography (FPLC), and synchronous fluorescence spectroscopy (SFS). RESULTS. Dynamic light scattering data showed a comparatively higher abundance of aggregated proteins in ADDE patients than that in controls. For controls, the size distribution of tear proteins was <50 nm in diameter, whereas the size distribution for ADDE individuals was up to 300 nm in diameter. Fast performance liquid chromatography experiments in native tear proteins exhibited minimal difference in the FPLC profiles for ADDE patients and controls. Denatured tear protein FPLC profiles for patients indicated the presence of protein aggregates which were absent in controls. Our hypothesis was further verified by SFS; lower tryptophan fluorescence in ADDE patients is an indication of oxidative stress, which leads to protein aggregation. CONCLUSIONS. Aqueous-deficient dry eyes is likely to be a protein conformational disease. Unlike other conformational diseases where single proteins are involved, this may be a reflection of structural loss for a significant fraction of the tear proteome.
Journal of Ocular Biology, Diseases, and Informatics, 2012
Limbal cell transplantation is an efficacious procedure for rehabilitation of visual acuity in pa... more Limbal cell transplantation is an efficacious procedure for rehabilitation of visual acuity in patients with severe ocular surface disorders. Cultivation of limbal epithelial stem cell with fetal bovine serum for transplantation has been a promising treatment for reconstructing the ocular surface in severe limbal stem cell deficiency caused by Steven Johnson syndrome, chemical or thermal injury. This technique of "cell therapy" has been accepted worldwide but the cost of cultivating the cells for transplantation is high. The objective of this study was to investigate the effect of cord blood serum in place of fetal bovine serum on the growth of human limbal epithelial cell culture. Our group has experimented with human cord blood serum which was obtained free of cost from willing donors. The use of human cord blood serum in place of fetal bovine serum for ex vivo culture of limbal stem cell has helped us in reducing the cost of culture. Fresh human limbal tissues from donor cadavers were cultured on intact and denuded amniotic membrane. Cells were proliferated in vitro with cell culture media containing human cord blood serum. Reverse transcription-polymerase chain reaction and immunofluorescence cytochemistry of cultured human limbal epithelial stem cell was done for characterization of the cells.
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