Browsing by Author "Bhattacharjee, Harsha"
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Item Adaptive optics scanning laser ophthalmoscopy may support early diagnosis of glaucoma(All India Ophthalmological Society, 2022-08) Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Das, Dipankar; Javeri, Henal; Buragohain, SuklengmungPurpose: To compare image characteristics of retinal nerve fiber layer (RNFL) between glaucoma patients and healthy controls using adaptive optics scanning laser ophthalmoscopy (AOSLO). Methods: This was a cross-sectional pilot study with two groups: a glaucoma group with patients with moderate or severe glaucoma as per the Hodapp–Parrish–Anderson classification system and a control group with healthy individuals. The optic nerve damage in moderate glaucoma was predominantly located in only one hemisphere; the other hemisphere was un- or minimally affected on optical coherence tomography and automated perimetry and is referred to as early glaucoma. The structure of RNFL bundles and gain (%) in RNFL images with mean pixel values between 15 and 35 were analyzed. Imaging was performed one degree away from the optic disc margin at two and four cardinal clock positions in the glaucoma and control groups, respectively. The field of view was 1.3° at 2.3 ? resolution. We studied one eye per participant. Results: There were 11 glaucoma patients and 7 healthy controls. Imaging was successful at 88% of the locations in controls and early glaucoma; the reflectivity differed significantly (0.51 and 0.56, respectively, P < 0.001) but not the structure of RNFL bundles (Cohen’s Kappa 0.11) between them. In patients with moderate and severe glaucoma, imaging was successful only at 46% of the locations; RNFL bundles were not discernible, and RNFL reflectivity did not differ from those with early glaucoma (P < 0.11). Conclusion: The recorded gain (%) of RNFL images obtained using AOSLO could be an objective indicator of early glaucomaItem Bilateral Iris depigmentation, transillumination defects and hypotony in Vogt–Koyanagi–Harada disease(All India Ophthalmological Society, 2022-07) Garg, Mohit; Das, Dipankar; Bhattacharjee, Harsha; Godani, Kanika; Mahapatra, Madhusmita; Raichura, RiddhiItem Bilateral spontaneous anterior dislocation of intraocular lens with the capsular bag in a patient with pseudoexfoliation.(2015-10) Bhattacharjee, Harsha; Saxena, Rushil Kumar; Medhi, JnanankarWe report a rare case of bilateral spontaneous anterior partial in‑the‑bag intraocular lens (IOL) dislocation in a 75‑year‑old man with pseudoexfoliation (PXF). He underwent uneventful phacoemulsification in both eyes with in‑the‑bag IOL implantation 9 years back. In the right eye, single piece poly (methyl methacrylate) (PMMA) IOL (+19 D) and in the left eye, single piece acrylic foldable IOL (+19 D) were implanted. An attempt at pharmacological IOL repositioning was unsuccessful. The dislocated IOLs were explanted and exchanged with scleral suture fixated PMMA IOLs. Vision improved to 20/30 in both eyes following surgery, without any associated ocular morbidity. We believe that zonular weakness secondary to PXF, capsular contraction, and myopia together were the predisposing factors for partial anterior dislocation of IOLs and IOL exchange with scleral suture fixation of IOL is a safe and effective treatment option.Item Bilateral sub-internal limiting membrane hemorrhage in a COVID-19 patient(All India Ophthalmological Society, 2022-08) Ghodake, Aparna; Das, Dipankar; Bhattacharjee, Harsha; Barman, Manab J; Magdalene, Damaris; Ghosh, Rituparna; Mishra, SakshiSub-internal limiting membrane hemorrhages, although uncommon, have been documented to occur in Valsalva retinopathy, blood dyscrasias, Terson syndrome, and ocular trauma. Due to their predilection for the macular region, they often lead to severe vision loss in young patientsItem Causes of childhood blindness in the northeastern states of India.(2008-11-01) Bhattacharjee, Harsha; Das, Kalyan; Borah, Rishi Raj; Guha, Kamalesh; Gogate, Parikshit; Purukayastha, S; Gilbert, ClareBackground: The northeastern region (NER) of India is geographically isolated and ethno-culturally different from the rest of the country. There is lacuna regarding the data on causes of blindness and severe visual impairment in children from this region. Aim: To determine the causes of severe visual impairment and blindness amongst children from schools for the blind in the four states of NER of India. Design and Setting: Survey of children attending special education schools for the blind in the NER. Materials and Methods: Blind and severely visually impaired children (best corrected visual acuity < 20/200 in the better eye, aged up to 16 years) underwent visual acuity estimation, external ocular examination, retinoscopy and fundoscopy. Refraction and low vision workup was done where indicated. World Health Organization's reporting form was used to code anatomical and etiological causes of visual loss. Statistical Analysis: Microsoft Excel Windows software with SPSS. Results: A total of 376 students were examined of whom 258 fulfilled the eligibility criteria. The major anatomical causes of visual loss amongst the 258 were congenital anomalies (anophthalmos, microphthalmos) 93 (36.1%); corneal conditions (scarring, vitamin A deficiency) 94 (36.7%); cataract or aphakia 28 (10.9%), retinal disorders 15 (5.8%) and optic atrophy 14 (5.3%). Nearly half of the children were blind from conditions which were either preventable or treatable (48.5%). Conclusion: Nearly half the childhood blindness in the NER states of India is avoidable and Vitamin A deficiency forms an important component unlike other Indian states. More research and multisectorial effort is needed to tackle congenital anomalies.Item Changing pattern of childhood blindness in eight North-Eastern states and review of the epidemiological data of childhood blindness of India(All India Ophthalmological Society, 2022-01) Bhattacharjee, Harsha; Magdalene, Damaris; Javeri, Henal Jagdip; Buragohain, Suklengmung; Mohapatra, Shyam Sundar Das; Garg, MohitPurpose: To assess the causes of visual impairment and blindness in children in all the schools for the blind in eight northeastern states and to determine its temporal trend, and to analyze the result with reference to various regional epidemiological data on childhood blindness in India. Methods: Children aged ?16 years, with a visual acuity of ?6/18 in the better eye, attending 17 schools for the blind were examined between November 2018 and March 2020. WHO protocol and reporting format was used for the evaluation, diagnosis, and classification of the causes. Results: Out of 465 eligible study participants, 93.76% were blind and only 12.26% of causes were avoidable. Anatomical causes of childhood blindness were whole globe (43.2%), cornea (17.20%), optic nerve (12.04%), retina (9.68%), and lens (9.46%). Etiological causes were unknown (52.69%), hereditary (26.02%), intrauterine (15.05%), and 26.08% had blinding congenital ocular abnormality (s). Regional temporal trend revealed a decrease in corneal and childhood causes and an increase in retina, optic nerve, hereditary, and intrauterine causes. Conclusion: A constellation of causes were differentiable but matched with the overall emerging trend of childhood blindness in India. Higher corneal, unavoidable, and unknown causes suggest a region?specific action plan for controlling childhood blindness as well as rehabilitationItem The changing patterns of uveitis in a tertiary institute of Northeast India.(2015-09) Das, Dipankar; Bhattacharjee, Harsha; Das, Kalyan; Tahiliani, Prerana S; Bhattacharyya, Pankaj; Bharali, Gayatri; Das, Manik; Deka, Apurba; Paul, RajashreeUveitis incorporates innumerable conditions, all of which are characterized by inflammation of the uveal tract. Study of etiological factors in uveitis in the population often give important disease‑specific indications and changing pattern in subsequent studies are important to know further newer occurrences of various disease prevalence. Awareness of regional variation in disease configuration is essential to develop a region specific list of differential diagnoses and also for comparison with different sub‑population of the country and the world. We report the changing pattern of uveitis in a tertiary institute in the Northeast India and found that tubercular uveitis had increased in hospital‑based study.Item Clear lens extraction and intraocular lens implantation in a case of microspherophakia with secondary angle closure glaucoma.(2010-01) Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Medhi, Jnanankar; DasGupta, SushobhanPhacoemulsification with implantation of single-piece acrylic foldable intraocular lens (IOL) in a 19-year-old boy with microspherophakia, high myopia and angle closure glaucoma is described. The associated myopia and angle closure glaucoma was severely compromising the quality of life. Post-surgical visual recovery was 20/20 with sustained normal intraocular pressure. Management of such cases at times calls for innovations in current surgical technique.Item Comparative analysis of use of porous orbital implant with mucus membrane graft and dermis fat graft as a primary procedure in reconstruction of severely contracted socket.(2014-02) Bhattacharjee, Kasturi; Bhattacharjee, Harsha; Kr Das, Jayanta; Dey, DebleenaPurpose: The purpose of our study is to present a surgical technique of primary porous orbital ball implantation with overlying mucus membrane graft (MMG) for reconstruction of severely contracted socket and to evaluate prosthesis retention and motility in comparison to dermis fat graft (DFG). Study Design: Prospective comparative study. Materials and Methods: A total of 24 patients of severe socket contracture (Grade 2‑4 Krishna’s classification) were subdivided into two groups, 12 patients in each group. In Group I, DFG have been used for reconstruction. In Group II, porous polyethylene implant with MMG has been used as a primary procedure for socket reconstruction. In Group I DFG was carried out in usual procedure. In case of Group II, vascularized scar tissues were separated 360° and were fashioned into four strips. A scleral capped porous polyethylene implant was placed in the intraconal space and four strips of scar tissue were secured to the scleral cap and extended part overlapped the implant to make a twofold barrier between the implant and MMG. Patients were followed‑up as per prefixed proforma. Prosthesis motility and retention between the two groups were measured. Results: In Group I, four patients had recurrence of contracture with fall out of prosthesis. In Group II stable reconstruction was achieved in all the patients. In terms of prosthesis motility, maximum in Group I was 39.2% and Group II, was 59.3%. The difference in prosthesis retention (P = 0.001) and motility (P = 0.004) between the two groups was significant. Conclusion: Primary socket reconstruction with porous orbital implant and MMG for severe socket contracture is an effective method in terms of prosthesis motility and prosthesis retention.Item Comparison on testability of visual acuity, stereo acuity and colour vision tests between children with learning disabilities and children without learning disabilities in government primary schools.(2014-02) Bhattacharjee, Kasturi; Bhattacharjee, Harsha; Kuri, Ganesh; Kr Das, Jayanta; Dey, DebleenaContext: Children with learning disabilities might have difficulties to communicate effectively and give reliable responses as required in various visual function testing procedures. Aims: The purpose of this study was to compare the testability of visual acuity using the modified Early Treatment Diabetic Retinopathy Study (ETDRS) and Cambridge Crowding Cards, stereo acuity using Lang Stereo test II and Butterfly stereo tests and colour perception using Colour Vision Test Made Easy (CVTME) and Ishihara’s Test for Colour Deficiency (Ishihara Test) between children in mainstream classes and children with learning disabilities in special education classes in government primary schools. Materials and Methods: A total of 100 primary school children (50 children from mainstream classes and 50 children from special education classes) matched in age were recruited in this cross‑sectional comparative study. The testability was determined by the percentage of children who were able to give reliable respond as required by the respective tests. ‘Unable to test’ was defined as inappropriate response or uncooperative despite best efforts of the screener. Results: The testability of the modified ETDRS, Butterfly stereo test and Ishihara test for respective visual function tests were found lower among children in special education classes (P < 0.001) but not in Cambridge Crowding Cards, Lang Stereo test II and CVTME. Conclusion: Non verbal or “matching” approaches were found to be more superior in testing visual functions in children with learning disabilities. Modifications of vision testing procedures are essential for children with learning disabilities.Item Delayed accumulation of lens material behind the foldable intraocular lens.(2007-11-24) Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Bhattacharjee, PankajFoldable acrylic intraocular lenses (IOLs) are known to reduce posterior capsule opacification by preventing migration of lens epithelial cells with its square edge design and its property of tackiness. Studies have reported a mean adhesiveness to posterior capsule more than three times higher for certain acrylic foldable IOLs than polymethyl methacrylate IOLs. The authors would like to report two cases where the force of tackiness was compensated, thereby presenting with delayed accumulation of lens material in the capsular bags behind the IOL with temporary loss of vision.Item Descemet's membrane detachment caused by inadvertent vancomycin injection.(2008-05-18) Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Medhi, Jnanankar; Altaf, AbuDescemet's membrane detachment is a condition with a wide range of etiologies. The most common cause is a localized detachment occurring after cataract surgery. We report a case of vancomycin injection-induced Descemet's membrane detachment as a complication following a routine cataract surgery and its management.Item IgG4‑related intraocular inflammation masquerading as ciliary body melanoma in a young girl.(2016-08) Das, Dipankar; Deka, Panna; Verma, Geeta; Kuri, Ganesh Chandra; Bhattacharjee, Harsha; Bharali, Gayatri; Pandey, Divya; Koul, Akanksha; Das, Bidisha; Deka, ApurbaImmunoglobulin G4 (IgG4‑related diseases) affects various tissues and organs of the human body. Orbital, adnexal, and scleral inflammations were already reported in the medical literature. To the best of our knowledge, we report the first case of intraocular IgG4‑associated inflammatory mass in the ciliary body mimicking as a melanoma in a 23‑year‑old female from Northeast India. Characteristic histopathology, immunohistochemistry in the tissue, protein chemistry, and raised serum IgG4 were supportive for the diagnosis. As this newly diagnosed disease has multi‑organ affection and little is known about its pathogenesis particularly in eye and adnexa, the present case will open many challenges in clinico‑pathological diagnosis and research in the future.Item Indirect optic nerve injury in two-wheeler riders in northeast India.(2008-11-01) Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Jain, Lokesh; Sarma, Gitumoni; Sarma, Angshuman Sen; Medhi, Jnanankar; Das, Dipankar; Buragohain, Sanjoy KrPurpose: To investigate the association of posterior indirect traumatic optic neuropathy and superior temporal orbital rim injury in two-wheeler riders and documentation of the clinical profile of such cases. Design: Retrospective observational study. Materials and Methods: Records of all patients reporting with cranio-orbital injury and vision loss following road traffic accidents between October 1994 and April 2006 were reviewed and from them cases with vision loss solely from indirect optic nerve injury were taken up for study. The prognostic significance of different presenting features, role of intravenous methyl prednisolone (IVMP) and relative risk of superior orbital rim injury to posterior indirect traumatic optic neuropathy (at 95% confidence interval) was calculated. Results: Out of 129 consecutive cases of cranio-orbital injury, 35 had posterior indirect traumatic optic neuropathy with minor ipsilateral superior temporal orbital rim trauma and none used any protective headwear. Presenting clinical features like relative afferent pupillary defect ( P = 0.365), optic disc status ( P = 0.518) and visual evoked potential (VEP) ( P = 0.366) were disproportionate to visual loss. Only VEP had prognostic significance. The IVMP did not provide any added therapeutic benefit. The remaining 94 cases sustained direct blinding ocular trauma and 28 of them had associated intracranial pathology. The relative risk of superior temporal orbital rim injury to posterior indirect optic nerve trauma was 2.25. Conclusion: Superior temporal orbital rim injury, even when minor, carries a potential risk for development of blindness from indirect posterior indirect traumatic optic neuropathy in two-wheeler drivers. Presenting signs do not correlate with visual status. Only VEP has prognostic significance and the condition is untreatable.Item An interesting case of angiogenesis in cavernous hemangioma.(2016-10) Das, Dipankar; Bhattacharjee, Kasturi; Deka, Panna; Bhattacharjee, Harsha; Misra, Diva Kant; Koul, Akanksha; Kapoor, Deepika; Deka, ApurbaCavernous hemangioma is the most common orbital tumor in adult. There is lot of literatures for clinicopathological features of this tumor. These tumors had been studied for the model of angiogenesis in many of the experimental setups. We present a case of 34‑year‑old male with this tumor in the left eye with computerized tomography evidence. Postsurgical laboratory findings gave interesting evidence of tumor angiogenesis with tumor endothelial cells and sprouting of the small vessels endothelial cells. Podosome rosette could be conceptualized from the characteristic patterns seen in the tumor.Item Lady in red: A case of Kearns–Sayre syndrome supported by histopathology(All India Ophthalmological Society, 2022-07) Godani, Kanika; Das, Dipankar; Bhattacharjee, Kasturi; Bhattacharjee, Harsha; Raichura, RiddhiItem Liquefied after cataract and its surgical treatment.(2014-05) Bhattacharjee, Harsha; Bhattacharjee, Kasturi; Bhattacharjee, Pankaj; Das, Dipankar; Gogoi, Krishna; Arati, DiyaliAims: To describe liquefi ed after cataract (LAC) and its surgical management following an uneventful phacoemulsifi cation with posterior chamber in-the-bag intraocular lens (IOL) implantation and continuous curvilinear capsulorrhexis (CCC). Design: Interventional case series. Materials and Methods: Eleven patients with LAC, following uneventful phacoemulsifi cation with CCC and in-the-bag IOL implantation were enrolled. After the basic slit lamp examination, each case was investigated with Scheimpfl ug photography and ultrasound biomicroscopy (UBM). Each case was treated with capsular lavage. Biochemical composition of the milky fl uid was evaluated and ring of anterior capsular opacity (ACO) was examined under electron microscope. Results: All 11 cases presented with blurring of vision after 6-8 years of cataract surgery with IOL implantation. All cases had IOL microvacuoles, 360° anterior capsule, and anterior IOL surface touch along with ACO, ring of Soemmering, and posterior capsule distension fi lled with opalescent milky fl uid with whitish fl oppy or crystalline deposits. Biochemically, the milky fl uid contained protein (800 mg/dl), albumin (100 mg/dl), sugar (105 mg/dl), and calcium (0.13%) and was bacteriologically sterile. Histologically, the dissected ACO showed fi brous tissue. All cases were successfully treated with capsular lavage with good visual recovery and with no complication. There was no recurrence of LAC during 2 years postoperative follow-up in any of the cases. Conclusions: LAC is a late complication of standard cataract surgery. It may be a spectrum of capsular bag distension syndrome (CBDS) without shallow anterior chamber and secondary glaucoma. Capsular bag lavage is a simple and eff ective treatment for LAC and a safe alternative to neodymium-doped y rium aluminum garnet (Nd-YAG) capsulotomy.Item Morgagnian globules in cataractous lens of sympathetic ophthalmia: Clinicopathological image(All India Ophthalmological Society, 2022-07) Das, Dipankar; Bhattacharjee, Harsha; Rehman, Obaidur; Mahapatra, Madhusmita; Deka, ApurbaItem Neuromyelitis optica spectrum disorder post-COVID-19 infection: A rare case report from Northeast India(All India Ophthalmological Society, 2022-05) Das, Dipankar; Bhattacharjee, Harsha; Rehman, Obaidur; Deori, Nilutparna; Magdalene, Damaris; Bharali, Gayatri; Mishra, Sakshi; Godani, KanikaMultiple sclerosis and neuromyelitis optica spectrum disorder may be seen in the acute setting of coronavirus disease 2019 (COVID-19) infection or even post-recovery. Such patients may present with optic neuropathy along with weakness in the back and lower limbs. Ascending paralysis can present with respiratory distress in acute COVID-19 infection and may even prove to be fatal. We report a unique case of a 16-year-old female with past history of COVID-19 infection having optic neuropathy, and radioimaging showing demyelinating plaques in the central nervous system with spinal cord edema. Serology showed positivity for rheumatoid arthritis, and the patient was managed with steroids and rituximab.Item A new rosette in retinoblastoma.(2014-05) Das, Dipankar; Bhattacharjee, Kasturi; Barthakur, Sumita Sarma; Tahiliani, Prerana Sushil; Deka, Panna; Bhattacharjee, Harsha; Deka, Apurba; Paul, RajashreeRetinoblastoma, the most common primary malignant intraocular tumor of childhood is a great success story in pediatric and ocular oncology. Pathology of retinoblastoma is important to guide the treatment modalities. Diff erentiated retinoblastoma is commonly seen in younger age group. Since a hundred years, we have been observing two typical true rose es in retinoblastoma in the form of Flexner-Wintersteiner (FW) and Homer Wright (HW) rose es and in many occasions pseudorose es have been documented. In the present case report, a third new type of rose e was identifi ed in a diff erentiated retinoblastoma which had an unusual anterior segment involvement.