11 results on '"Ratra, Dhanashree"'
Search Results
2. Clinical Outcomes of Retinal Detachment Surgery following Cytomegalovirus Retinitis in Patients on Highly Active Anti-retroviral Therapy for Acquired Immune Deficiency Syndrome.
- Author
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Mathur G, Ratra D, Bhuibhar SS, and Roy R
- Subjects
- Acquired Immunodeficiency Syndrome drug therapy, Antiretroviral Therapy, Highly Active adverse effects, Antiviral Agents administration & dosage, Cytomegalovirus Retinitis drug therapy, Female, Follow-Up Studies, Humans, Intravitreal Injections, Male, Retinal Detachment diagnosis, Retinal Detachment etiology, Retrospective Studies, Treatment Outcome, Visual Acuity, Acquired Immunodeficiency Syndrome complications, Antiviral Agents adverse effects, Cytomegalovirus Retinitis complications, Retinal Detachment surgery, Vitrectomy methods
- Abstract
Aim: The objective of this study is to describe the surgical outcomes of patients of HIV on HAART who underwent surgery for CMV retinitis related retinal detachment., Method and Materials: A retrospective analysis of the medical records of 40 eyes of 35 consecutive HIV positive patients who underwent surgical repair for CMV retinitis associated rhegmatogenous retinal detachment between January 2000 to August 2010 was done. All patients had an adequate follow up of atleast 6 months., Results: Favourable anatomical outcome was achieved in 78 % of eyes with the eyes having a attached retina, clear media and controlled intraocular pressure.Favourable functional outcome (vision >3/60) was achieved in 56%., Conclusion: Though anatomical outcomes have not changed from the pre HAART era but there has been an increase in favorable functional outcomes possibly due to effects of antiretroviral therapy.
- Published
- 2015
- Full Text
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3. Surgical management for treatment-resistant cases of inflammatory exudative retinal detachment: Mission impossible?
- Author
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Ratra, Dhanashree, Pradhana, Divya, and Majumder, Parthopratim Dutta
- Subjects
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RETINAL detachment , *VISION , *VISUAL acuity , *VITRECTOMY , *THERAPEUTICS , *PROLIFERATIVE vitreoretinopathy - Abstract
Purpose: To report the outcome of surgical intervention for inflammatory, exudative retinal detachment (ERD). Methods: A retrospective analysis of eyes with ERD that underwent vitrectomy. Results: Twelve eyes (10 patients) with ERD, non-responsive to medical therapy, underwent vitrectomy. The mean age was 35.7 ± 17.7 years. Five eyes (42%) had Vogt--Koyanagi--Harada disease, three (25%) had presumed tuberculosis (TB), two (17%) pars planitis, and one (8%) had sympathetic ophthalmia. The mean time of vitrectomy was 6.76 ± 4.1 months after onset. Six (50%) eyes had a recurrence, two settled with medical treatment, and four underwent re-surgery. The mean follow-up was 2.7 years. At the last visit, 10 (83.3%) eyes had attached retina; the best-corrected visual acuity (BCVA) had reduced to 1.6 ± 0.7 logarithms of the minimum angle of resolution (logMAR) from 1.3 ± 0.7 at baseline. Conclusion: Vitrectomy in ERD can act as an adjuvant to conventional medical therapy and help maintain structural integrity. Early vitrectomy may help preserve visual function. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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4. Intravitreal cysticercosis presenting as neovascular glaucoma
- Author
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Ratra Dhanashree, Phogat Chekitaan, Singh Maneesh, and Choudhari Nikhil
- Subjects
Bevacizumab ,cysticercosis ,neovascular glaucoma ,vitrectomy ,Ophthalmology ,RE1-994 - Abstract
We report two cases of intraocular cysticercosis which showed a peculiar presentation of neovascular glaucoma which is hitherto unreported. Two young adults presented with symptoms of raised intraocular pressure due to neovascular glaucoma. On dilated fundus examination both were found to have dead intravitreal cysticercosis. The cysts were removed by a three-port vitrectomy and intracameral injection of bevacizumab was given to help in the regression of rubeosis. Trabeculectomy had to be combined in one case. The intraocular pressure returned to normal. No recurrence of rubeosis was seen even after one year.
- Published
- 2010
5. Comparison of three techniques of harvesting full-thickness retinal tissue for large or persistent macular holes.
- Author
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Dhami, Abhinav, Biswas, Rupak, Dogra, Mohit, Singh, Ramandeep, Mittal, Sangeet, Ratra, Dhanashree, and Biswas, Rupak Kanti
- Abstract
Purpose: To evaluate the success rate of autologous retinal graft (ARG) for the closure of full-thickness macular holes (MHs) and compare the outcomes of three different techniques of harvesting the graft.Methods: Clinic files of all patients who had undergone ARG for MH using intraocular scissors, membrane loop, or retinal punch to harvest retinal tissue were retrospectively reviewed. All patients were evaluated for MH closure, retinal reattachment, and visual improvement.Results: Twenty-two eyes of 22 patients were included. ARG was done for 16 eyes (72.7%) with failed, large persistent MH, and six eyes (27.3%) also underwent simultaneous repair of retinal detachment. The basal diameter of MH was 1103.67 ± 310.09 (range 650-1529) μm. Intraocular scissors were used in 10 eyes (45.5%), a membrane loop in five eyes (22.7%), and a retinal punch in seven eyes (31.8%). Silicone oil tamponade was used in seven (31.8%) eyes and gas in 15 (68.1%) eyes. The follow-up ranged from 6 to 18 months. The hole closure rate was 72.7% (16/22). Visual improvement was noted in 18 eyes (81.8%). Retinal reattachment was seen in all eyes. Good graft integration with the surrounding area was seen in 17 eyes (77.3%). Graft retraction was seen in four eyes (18.18%) and graft loss in one eye (4.55%). No significant differences were noted among the three groups.Conclusion: ARG is successful in closing large, failed MH with and without retinal detachment. A membrane loop and retinal punch are equally useful in harvesting the graft, but scissors are preferable in case the retina is detached. With all three techniques, integration of the graft with the surrounding tissue can be achieved. [ABSTRACT FROM AUTHOR]- Published
- 2022
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6. Altered mucins and aquaporins indicate dry eye outcome in patients undergoing Vitreo-retinal surgery
- Author
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Ramalingam Mani, Ratra Vineet, Narayanasamy Angayarkanni, Natarajan Viswanathan, Padmanabhan Prema, P. S. Shobha, Ratra Dhanashree, and Saravanan Thilagavathi
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0301 basic medicine ,Male ,Physiology ,medicine.medical_treatment ,Gene Expression ,Vitrectomy ,Mucin 5AC ,Biochemistry ,0302 clinical medicine ,Endocrinology ,Immune Physiology ,Medicine and Health Sciences ,Medicine ,Innate Immune System ,Multidisciplinary ,Ophthalmic Procedures ,Cataract Surgery ,Middle Aged ,Aquaporin 4 ,medicine.anatomical_structure ,Cytokines ,Dry Eye Syndromes ,Female ,Anatomy ,Conjunctiva ,Research Article ,medicine.medical_specialty ,Endocrine Disorders ,Science ,Immunology ,Surgical and Invasive Medical Procedures ,Vitreoretinal Surgery ,Aquaporins ,Scleral buckle ,03 medical and health sciences ,Ocular System ,Ophthalmology ,Diabetes mellitus ,Genetics ,Diabetes Mellitus ,Humans ,Goblet cell ,Mucin-4 ,business.industry ,Mucin ,Mucins ,Biology and Life Sciences ,Proteins ,Membrane Proteins ,Cataract surgery ,Molecular Development ,medicine.disease ,Aquaporin 5 ,030104 developmental biology ,Interleukin 1 receptor antagonist ,Immune System ,Metabolic Disorders ,CA-125 Antigen ,Tears ,030221 ophthalmology & optometry ,Eyes ,sense organs ,business ,Head ,Developmental Biology - Abstract
Vitreo-retinal (VR) surgeries induce conjunctival changes. However, there are no study reports regarding prevalence and severity of dry eye after these surgeries. This study evaluated dry eye outcome after VR surgery. Patients undergoing VR surgery classified as scleral buckle and microincision vitrectomy surgery (n = 44, mean age: 56.09±10.2 years) were recruited. Dry eye evaluation was done before and 8 weeks after surgery (2 weeks after omitting topical eye drops). Conjunctival imprint cytology for goblet cell count and tear Mucin 5AC (MUC5AC) protein estimation was done. Gene expressions of MUC5AC, MUC4, MUC16, Aquaporin 4 (AQP4) and AQP5 were analyzed in the conjunctival imprint cells by qPCR. None of the patients exhibited clinical signs of dry eye after VR surgery. But the conjunctival goblet cell density (GCD) was significantly lowered post-VR surgery (63% cases, **p = 0.012) with no alterations in the tear MUC5AC protein. Post-VR surgery, the conjunctival cell gene expression of MUC4, MUC16 and AQP4 were significantly increased (*p = 0.025, *p = 0.05 and *p = 0.02 respectively) and AQP5 was significantly lowered (*p = 0.037), with no change in MUC5AC expression. Tear cytokines were significantly increased post-VR surgery (anti-inflammatory: IL1RA, IL4, IL5, IL9, FGF; PDGFbb and pro-inflammatory: IL2, IL6, IL15, GMCSF and IFNg). Though clinical signs of dry eye were not observed after VR surgery, ocular surface changes in the form of reduced GCD, altered MUC5AC, MUC4, MUC16, AQP4, AQP5 and cytokines are suggestive of dry eye outcome at the molecular level especially inpatients aged above 51 years, especially female gender and those who are diabetic.
- Published
- 2020
7. A Delphi method based consensus statement for surgical management of proliferative diabetic retinopathy in India.
- Author
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Sengupta, Sabyasachi, Sindal, Manavi D., Shanmugam, P. Mahesh, Bhende, Pramod, Ratra, Dhanashree, Nagpal, Manish, Narayanan, Raja, Rajendran, Anand, Saravanan, Veerappan, Kelkar, Aditya, Maiti, Aniruddha, Chakraborty, Debdulal, Dogra, Mohit, and Behera, Sourabh
- Subjects
DIABETIC retinopathy ,DELPHI method ,LASER photocoagulation ,VITRECTOMY ,IRIS (Eye) ,RETINAL detachment - Abstract
Purpose: To derive consensus statements for surgical management of proliferative diabetic retinopathy (PDR) for vitreoretinal (VR) surgeons. Methods: Thirteen prolific VR surgeons representing all regions of India were invited to participate in a 42-point questionnaire based on the Delphi methodology describing various surgical scenarios commonly encountered in PDR. Consensus was derived using predefined robust analytics. Scenarios that returned a moderate consensus in round 1 were taken to round 2 as per the Delphi methodology. After considering all inputs, the final consensus criteria were developed. Results: A strong consensus was derived about waiting for 4 weeks before considering vitrectomy. In treatment-naïve eyes with fresh vitreous hemorrhage (VH), the wait time was slightly shorter for extramacular tractional retinal detachment (2-4 weeks) and longer (4-6 weeks) for eyes treated previously with laser or anti-VEGF agents. The expert panel recommended using preoperative anti-VEGF only in eyes with large membranes requiring extensive dissection. For post vitrectomy VH, while a conservative approach was recommended for the first episode of VH, experts recommended immediate vitreous lavage for recurrent episodes of VH. In eyes with iris neovascularization, the panel recommended immediate anti-VEGF injection followed by early vitreous lavage in nonresponsive eyes. A strong consensus was derived for stopping antiplatelet agents before surgery, while there was only a moderate consensus for performing vitrectomy for recalcitrant macular edema unresponsive to anti-VEGF injections in the absence of traction. Conclusion: This study provides valuable consensus on managing the different scenarios encountered during surgical management of PDR and should help guide the VR surgeons in clinical decision-making. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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8. Surgical management of a case of double optic disc pits with maculopathy.
- Author
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Nadig, Ramya and Ratra, Dhanashree
- Subjects
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OPTIC disc , *MACULAR degeneration , *SURGERY , *VITRECTOMY , *FIBRIN tissue adhesive , *PARS plana - Abstract
Background: Double optic disc pit maculopathy is a rare entity. It can be difficult to manage because of excessive leakage and chronic maculopathy. Purpose: To describe surgical management in a case of double optic disc pits with maculopathy. Synopsis: A 42-year-old male presented with double optic disc pits with macular detachment in the left eye. The best-corrected visual acuity (BCVA) was 20/60, N12. Preoperative OCT showed the presence of two disc pits. The macular region had large retinoschisis and subretinal fluid (SRF) with a central foveal thickness of 879 microns and loss of the ellipsoid zone. A shallow communication from the temporal aspect of the disc to the submacular area was also noted. Among the options of observation, laser photocoagulation, and surgery, the patient opted for surgical management. Surgical technique: A standard-3 port 23-gauge pars plana vitrectomy was done. After staining the ILM with brilliant blue, ILM peeling was done with the help of forceps and Finesse loop. ILM flaps were inverted over to cover the optic disc pits and sealed with a drop of fibrin glue. Next, 20% SF6 gas was used for tamponade. Pre- and post-surgery parameters such as visual acuity and OCT were evaluated. Postoperative evaluation: After 6 weeks, left eye BCVA was 20/40 with OCT showing reduced SRF and reduced intraretinal schisis with a foveal thickness of 546 microns. At 3 months of follow-up, the vision in the left eye had improved to 20/30 with further reduction in the retinoschisis and foveal thickness of 482 microns. Highlights: In this interesting case, we demonstrate a unique way of sealing the defect surgically by vitrectomy and inverted ILM flap with fibrin glue over the disc pits. Despite sealing the maculopathy is slow to resolve. Video Link: https://youtu.be/s9nY5UPe1s4 [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
9. The deceptive coloboma.
- Author
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Ratra, Dhanashree, Mohan, Sashwanthi, Nadig, Ramya, and Kashyap, Himanshu
- Subjects
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BLUNT trauma , *SURFACE tension , *MACULAR degeneration , *SURGERY , *VITRECTOMY , *TISSUE adhesions - Abstract
Background: Scleral fistulas are known to develop following blunt trauma in patients with retinochoroidal coloboma. These cases can be managed by surgical options such as silicone buckles, or with glue and scleral patch graft. Some cases have been shown to close spontaneously. We report the first-ever case managed by vitrectomy, endophotocoagulation, and gas tamponade. Purpose: We present a rare and interesting case of an atypical choroidal coloboma with traumatic scleral fistula due to blunt trauma manifesting with hypotony-related disc edema, maculopathy, and chorioretinal folds, which was managed surgically with vitrectomy, endophotocoagulation, and gas tamponade with a good anatomical and visual outcome. Synopsis: The video contains the case description and surgical management of a traumatic scleral fistula in a patient with atypical superotemporal choroidal coloboma. The patient developed hypotonic maculopathy and disc edema after 3 months following a blunt trauma sustained in a road traffic accident. A scleral fistula was suspected at the temporal edge of the coloboma but could not be accurately localized. In addition, due to the edge effect of the coloboma, the external repair was difficult. Hence, vitrectomy with internal tamponade was attempted. Highlights: The video highlights a different surgical approach to managing a traumatic scleral fistula at the edge of a retinochoroidal coloboma. There was a risk of leakage of intravitreal fluid into the orbit through the fistula; however, the gas bubble gave a better tamponade due to higher surface tension. It sealed the fistula presumably by creating a trap-door-like effect. The endophotocoagulation helped create adhesion between the tissues at the edge of the coloboma effectively sealing it. This was followed by a rapid recovery of the hypotony-related problems with good vision. Traumatic scleral fistula, at a difficult place such as the edge of a coloboma, can be successfully closed from an internal approach with vitrectomy, endolaser, and gas tamponade. Video link: https:// youtu.be/6rxgtFyy6cw [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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10. Surgery for macular holes associated with unusual concomitant pathologies.
- Author
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Ratra, Dhanashree and Raval, Vishal
- Subjects
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RETINITIS pigmentosa , *PIGMENTATION disorders , *RETINAL degeneration , *VISION disorders , *EYE diseases - Abstract
Macular hole (MH) is uncommonly seen in association with retinitis pigmentosa (RP), optic disc pit or choroidal coloboma. The visual disability in eyes with RP, optic disc pit or choroidal coloboma can range from mild to severe. However, the macula may not be involved in the primary pathology and hence, the central vision may be preserved in these eyes. If a MH develops in such eyes the central vision is lost, making the patient severely vision disabled. A perceived poor prognosis in such patients may lead to no intervention. However, an attempt should be made to repair and restore the macula in these situations in order to conserve the vision and limit disability. These eyes can however pose unique surgical challenges. We report our experiences of operating on cases of MH associated with unusual concomitant pathologies such as RP, choroidal coloboma, and optic pit. The outcomes and the surgical challenges differed greatly from the conventional idiopathic MH surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
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11. Commentary: Fibrin glue in rhegmatogenous retinal detachment repair-Are we there yet?
- Author
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Anshuman, Kumar and Ratra, Dhanashree
- Subjects
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RETINAL detachment , *FIBRIN tissue adhesive , *RETINAL surgery , *VITRECTOMY , *ADHESIVES in surgery , *OPHTHALMIC surgery , *PROLIFERATIVE vitreoretinopathy , *RETINA , *RETINAL diseases - Published
- 2019
- Full Text
- View/download PDF
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