Papers by sameeksha agrawal
To report a case of foveolitis associated with dengue fever. Methods: Retrospective, observationa... more To report a case of foveolitis associated with dengue fever. Methods: Retrospective, observational case report. Case description: A 12-year-old male child, presented to the retina department with complaints of sudden blurring of vision in left eye since 1 week following dengue fever. His presenting visual acuity in left eye was 20/60, N8. Fundus showed wellcircumscribed, pale yellow-orange lesion at the foveal center in LE. Retinal imaging findings were consistent with the diagnosis of foveolitis. Results: Foveolitis and macular swelling were found to resolve over time on serial OCT, with visual acuity improving to 20/20,N6 with a resolution of scotoma. Conclusion: Infection with dengue virus might be associated with foveolitis. We suggest that serial OCT be performed to monitor maculopathy.
Case Reports, Apr 1, 2023
A man in his early 50s on regular follow-up for a stable non-proliferative diabetic retinopathy (... more A man in his early 50s on regular follow-up for a stable non-proliferative diabetic retinopathy (NPDR) presented with decreased vision, worsening of retinal pathology and macular oedema in both eyes. His corrected distance visual acuity (CDVA) was 6/9 in the right eye and 6/15 in the left eye and fundus examination showed multiple intraretinal haemorrhages in all quadrants. His systemic workup revealed a severe thrombocytopaenia, which prompted a further detailed systemic evaluation revealing him to be positive for HIV with retinopathy complicating the pre-existing NPDR. Given the significant inflammation and macular oedema, a cocktail of intravitreal bevacizumab, ganciclovir and dexamethasone was administered. The retinopathy and macular oedema resolved and the CDVA improved to 6/6 in both eyes over a 6-month follow-up period. Any sudden worsening of fundus findings in a patient with diabetes necessitates immediate and detailed ocular and systemic evaluation, especially when the immune status is unknown.
Indian Journal of Ophthalmology, May 1, 2023
Beyoğlu eye journal, 2022
Coronavirus disease 2019 (COVID-19) is associated with ocular involvement either during or after ... more Coronavirus disease 2019 (COVID-19) is associated with ocular involvement either during or after the infection. These include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, reactivation of quiescent anterior uveitis, anterior sclero-uveitis, cotton wool spots, retinal hemorrhages, retinal artery/vein occlusion, ophthalmic artery occlusion, panuveitis, papillophlebitis, central serous retinopathy, presumed fungal endophthalmitis, and multifocal chorioretinitis (1-11). We herein report a patient with unilateral presumed bacterial endogenous endophthalmitis 3 weeks after COVID-19. Coronavirus disease 2019 (COVID-19) is associated with ocular involvement either during or after the infection. These include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, reactivation of anterior uveitis, or presenting as anterior sclero-uveitis, cotton wool spots, retinal hemorrhages, retinal artery/vein occlusion, ophthalmic artery occlusion, panuveitis, papillophlebitis, central serous retinopathy, presumed fungal endophthalmitis, and multifocal chorioretinitis. A 47-year-old Asian Indian male was diagnosed with COVID-19 and had no other systemic history of note at the time of admission. Three weeks later, he developed sudden loss of vision in the right eye (OD). Visual acuity in OD was perception of light. OD had features of endophthalmitis. OD underwent pars plana vitrectomy with intravitreal antibiotics. Anterior chamber tap for fungal culture and polymerase chain reaction for panfungal genome was negative. Culture of ocular specimens did not reveal bacterial growth. Vitreous sample showed few Gram-positive cocci in singles and pairs with no evidence of fungal elements. Polymerase chain reaction for eubacterial genome was positive. He was treated with topical and systemic antibiotics and steroids. Final follow-up 6 weeks later, OD had a best-corrected visual acuity which was 20/200 with a quiet anterior chamber, cataract, with a macular traction and reduced sub retinal exudates and fluid. Post-COVID-19 sequelae causing sight-threatening manifestations as illustrated by this case report needs early recognition and prompt treatment to achieve a favorable visual outcome.
Clinical and Experimental Optometry, Jul 27, 2021
Retinal vessel dilatation or tortuosity occur as a result of worsening or impending retinal or sy... more Retinal vessel dilatation or tortuosity occur as a result of worsening or impending retinal or systemic vascular diseases like hypertension, diabetes, cardiovascular disease, hyper viscosity states, arteriosclerosis, collagen vascular disease and sickle cell disease. Congenital retinal vessel tortuosity, when bilateral, is usually discovered during routine fundus examination because it has no associated symptoms. It also has an excellent visual prognosis. Herein, we describe a case of bilateral congenital retinal vessel tortuosity diagnosed incidentally in a 21-year-old girl.
Journal of Clinical Medicine, Oct 11, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Indian Journal of Ophthalmology, 2022
BMJ Case Reports
A man in his early 50s on regular follow-up for a stable non-proliferative diabetic retinopathy (... more A man in his early 50s on regular follow-up for a stable non-proliferative diabetic retinopathy (NPDR) presented with decreased vision, worsening of retinal pathology and macular oedema in both eyes. His corrected distance visual acuity (CDVA) was 6/9 in the right eye and 6/15 in the left eye and fundus examination showed multiple intraretinal haemorrhages in all quadrants. His systemic workup revealed a severe thrombocytopaenia, which prompted a further detailed systemic evaluation revealing him to be positive for HIV with retinopathy complicating the pre-existing NPDR. Given the significant inflammation and macular oedema, a cocktail of intravitreal bevacizumab, ganciclovir and dexamethasone was administered. The retinopathy and macular oedema resolved and the CDVA improved to 6/6 in both eyes over a 6-month follow-up period. Any sudden worsening of fundus findings in a patient with diabetes necessitates immediate and detailed ocular and systemic evaluation, especially when the im...
UP Journal of Ophthalmology
Purpose: To report a case of foveolitis associated with dengue fever. Methods: Retrospective, obs... more Purpose: To report a case of foveolitis associated with dengue fever. Methods: Retrospective, observational case report. Case description: A 12-year-old male child, presented to the retina department with complaints of sudden blurring of vision in left eye since 1 week following dengue fever. His presenting visual acuity in left eye was 20/60, N8. Fundus showed wellcircumscribed, pale yellow-orange lesion at the foveal center in LE. Retinal imaging findings were consistent with the diagnosis of foveolitis. Results: Foveolitis and macular swelling were found to resolve over time on serial OCT, with visual acuity improving to 20/20,N6 with a resolution of scotoma. Conclusion: Infection with dengue virus might be associated with foveolitis. We suggest that serial OCT be performed to monitor maculopathy.
International Journal of Retina and Vitreous
Background To report spectral domain optical coherence tomography (SDOCT) imaging findings in typ... more Background To report spectral domain optical coherence tomography (SDOCT) imaging findings in type 2 macular telangiectasia (MacTel) and correlate them with clinical stages and visual acuity. Methods This retrospective, cross-sectional study included type 2 MacTel cases who underwent SDOCT imaging with Spectralis machine. Macular SDOCT images were analysed. Imaging features were tested for correlation with different clinicals stages and visual acuity. Results 212 eyes of 108 type 2 MacTel patients were included. Hyperreflective middle retinal layer (87%) was the most frequently detected abnormality. This was followed by inner retinal cavities (49%), outward bending of inner retinal layers (35%), retinal pigment clumps (35%) and foveal contour irregularity (31%). Hyperreflective middle retinal layers (p < 0.001), inner (p = 0.032) and outer retinal (p = 0.002) cavities and internal limiting membrane drape (p = 0.031) were associated with poor vision in non-proliferative group and ...
Journal of Clinical Medicine
We report on a case series that revealed flat, choroidal lesions on optical coherence tomography ... more We report on a case series that revealed flat, choroidal lesions on optical coherence tomography (OCT) and on enface MultiColor® (MCI) imaging of the fundus but were not noticeable on clinical examination or conventional color fundus images. This observational study included 12 eyes from 11 patients who had distinct, orange-colored lesions on MCI. Retinal imaging was conducted using conventional color fundus photography and OCT. On the color fundus images and the blue and green reflectance channels of MCI, each of the lesions was difficult to distinguish. On the infrared channel, the lesion was identified as bright white in color and bright orange on the multicolor image. The lesion was identified on OCT as a flat, homogeneous hyperreflective lesion involving the choroid, with an intact overlying retinal pigment epithelium and retinal layers. A comparison of the clinical and imaging features with other known entities led to the conclusion that the lesion was a distinct clinical enti...
Indian Journal of Ophthalmology
Beyoglu Eye Journal
Coronavirus disease 2019 (COVID-19) is associated with ocular involvement either during or after ... more Coronavirus disease 2019 (COVID-19) is associated with ocular involvement either during or after the infection. These include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, reactivation of quiescent anterior uveitis, anterior sclero-uveitis, cotton wool spots, retinal hemorrhages, retinal artery/vein occlusion, ophthalmic artery occlusion, panuveitis, papillophlebitis, central serous retinopathy, presumed fungal endophthalmitis, and multifocal chorioretinitis (1-11). We herein report a patient with unilateral presumed bacterial endogenous endophthalmitis 3 weeks after COVID-19. Coronavirus disease 2019 (COVID-19) is associated with ocular involvement either during or after the infection. These include conjunctivitis, conjunctival hyperemia, chemosis, epiphora, reactivation of anterior uveitis, or presenting as anterior sclero-uveitis, cotton wool spots, retinal hemorrhages, retinal artery/vein occlusion, ophthalmic artery occlusion, panuveitis, papillophlebitis, central serous retinopathy, presumed fungal endophthalmitis, and multifocal chorioretinitis. A 47-year-old Asian Indian male was diagnosed with COVID-19 and had no other systemic history of note at the time of admission. Three weeks later, he developed sudden loss of vision in the right eye (OD). Visual acuity in OD was perception of light. OD had features of endophthalmitis. OD underwent pars plana vitrectomy with intravitreal antibiotics. Anterior chamber tap for fungal culture and polymerase chain reaction for panfungal genome was negative. Culture of ocular specimens did not reveal bacterial growth. Vitreous sample showed few Gram-positive cocci in singles and pairs with no evidence of fungal elements. Polymerase chain reaction for eubacterial genome was positive. He was treated with topical and systemic antibiotics and steroids. Final follow-up 6 weeks later, OD had a best-corrected visual acuity which was 20/200 with a quiet anterior chamber, cataract, with a macular traction and reduced sub retinal exudates and fluid. Post-COVID-19 sequelae causing sight-threatening manifestations as illustrated by this case report needs early recognition and prompt treatment to achieve a favorable visual outcome.
Eye
To assess the relationship of retinal pigment clump (RPC) size and its location with visual acuit... more To assess the relationship of retinal pigment clump (RPC) size and its location with visual acuity and retinal neovascularisation in eyes with type 2 macular telangiectasia (MacTel). In this cross-sectional study, eyes diagnosed with type 2 MacTel showing RPC were included. Area occupied by pigment was measured on the multicolour image using the area tool on the Spectralis, Heidelberg machine. Pigment location within retinal layers was noted with OCT. Analysis was performed to identify factors associated with poor vision and proliferative disease. Sixty-two eyes of 42 patients diagnosed with type 2 MacTel and RPC were included. The mean age was 64.31 ± 10.19 years. There were 13 (31%) males and 29 (69%) females in the study. 74% of patients were diabetics and the mean logMAR visual acuity of the participants was 0.619 ± 0.359. Univariate and multivariate binary logistic regression analysis identified female gender (p = 0.026), increasing RPC size (p = 0.008) and its presence above the outer plexiform layer (p = 0.006) to be associated with poor vision and proliferative disease in type 2 MacTel. Our data identified female gender, larger pigment size and its location above the OPL to be associated with poor vision and proliferative disease. This data may be useful for further improving the current system for staging disease severity in type 2 MacTel.
RETINAL Cases & Brief Reports, 2022
Purpose: To report a case of proliferative Type 2 macular telangiectasia treated successfully wit... more Purpose: To report a case of proliferative Type 2 macular telangiectasia treated successfully with direct laser photocoagulation to the right-angled vessel. Methods: Descriptive case report. Case Description: A 61-year-old man, with no past medical history, was diagnosed and treated previously elsewhere for bilateral proliferative Type 2 macular telangiectasia. He complained of recent onset decrease in vision in his right eye for last 2 months. Right eye visual acuity was counting fingers at 3 m and left eye was 6/18. Fundus examination showed proliferative Type 2 macular telangiectasia in both eyes with active neovascular complex in the right eye. Direct thermal laser photocoagulation to the tips of the right-angled vessels with single-spot PASCAL Synthesis (Topcon Medical Laser System) at 532 nm wavelength was done. After laser, reduction in the hyporeflective space height was noted on optical coherence tomography. No additional intravitreal anti–vascular endothelial growth factor...
Clinical and Experimental Optometry
Retinal vessel dilatation or tortuosity occur as a result of worsening or impending retinal or sy... more Retinal vessel dilatation or tortuosity occur as a result of worsening or impending retinal or systemic vascular diseases like hypertension, diabetes, cardiovascular disease, hyper viscosity states, arteriosclerosis, collagen vascular disease and sickle cell disease. Congenital retinal vessel tortuosity, when bilateral, is usually discovered during routine fundus examination because it has no associated symptoms. It also has an excellent visual prognosis. Herein, we describe a case of bilateral congenital retinal vessel tortuosity diagnosed incidentally in a 21-year-old girl.
European journal of ophthalmology, 2021
PURPOSE To report the bacillary layer detachment on optical coherence tomography in exudative age... more PURPOSE To report the bacillary layer detachment on optical coherence tomography in exudative age-related macular degeneration. METHODS Retrospective, observational cases. CASE DESCRIPTIONS Two cases of exudative age-related macular degeneration, one diagnosed as polypoidal choroidal vasculopathy following exudative age-related macular degeneration and other as wet age-related macular degeneration with choroidal neovascular membrane showed separation of myoid and ellipsoid zones of photoreceptor layer on optical coherence tomography. This is termed as BALAD. Other associated features noted were the presence of subretinal hyperreflective material, submacular hemorrhage and subretinal fluid. Both cases were treated with monthly intravitreal injections of Inj. Ranibizumab (0.5 mg/0.05 ml). Following 3 intravitreal injections at monthly intervals, reattachment of the bacillary layer detachment were noted in case 1 while the bacillary layer detachment persisted in case 2. CONCLUSION Mult...
Clinical Diabetes, 2022
This study examined the clinical profile, treatment profile, and vision outcomes of people ≤40 ye... more This study examined the clinical profile, treatment profile, and vision outcomes of people ≤40 years of age with diabetes and diabetic macular edema (DME). Within this age-group, the prevalence of center-involving DME was 16%, with 74% of eyes showing cystoid edema, 37% showing spongiform edema, and 41% having neurosensory detachment. Longer diabetes duration (P = 0.001) and greater severity of diabetic retinopathy (P <0.001) were associated with DME prevalence. Thus, regular and more frequent follow-up, as well as early and aggressive treatment of diabetic eye disease, are required in people diagnosed early with diabetes.
Uploads
Papers by sameeksha agrawal