Browsing by Author "Rishi, Ekta"
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Item Author Reply.(2014-12) Rishi, Pukhraj; Reddy, Sumanth; Rishi, EktaItem Author response: Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery.(2015-04) Rishi, Pukhraj; Reddy, Sumanth; Rishi, EktaItem Author's reply.(2013-11) Rishi, Ekta; Gopal, Lingam; Rishi, Pukhraj; Sengupta, Sabyasachi; Sharma, TarunItem Author's response Comments on Repeat gas insufflation for successful closure of idiopathic macular hole following failed primary surgery.(2015-01) Rishi, Pukhraj; Reddy, Sumanth; Rishi, EktaItem Breakthrough vitreous hemorrhage after ICGA guided PDT for PCV.(2009-03-25) Rishi, Pukhraj; Kadekar, Aradhana; Rishi, EktaItem Clinical and histopathological features of posttraumatic iris cyst.(2008-11-01) Rishi, Pukhraj; Rishi, Ekta; Biswas, Jyotirmay; Nandi, KrishnenduIris cyst excision involves complex surgical maneuvers and may have a variable visual outcome depending upon preexisting and postoperative complications. Hereby, we report a case series of 10 eyes from which posttraumatic iris cysts were excised and proven histopathologically. Histopathology records were reviewed. Data regarding patient profile, clinical profile, surgical details, treatment outcomes and follow-up were reviewed. Outcome measures were defined as recurrences, visual acuity and number of other surgeries required. Non-parametric Wilcoxon test was used to compare changes in the visual acuity and Fisher test was used to find out the significance of several risk factors. Mean age was 24.7 years (3-58 years). Mean follow-up was 2.36 years. Mean preoperative logMAR visual acuity was 0.56 in comparison to final logMAR visual acuity of 1.62. Factors related to adverse functional outcome were related to post-surgical complications.Item Coats' disease: An Indian perspective.(2010-03) Rishi, Pukhraj; Rishi, Ekta; Uparkar, Mahesh; Sharma, Tarun; Gopal, Lingam; Bhende, Pramod; Bhende, Muna; Sen, Pratik Ranjan; Sen, ParveenAim: To describe the clinical features, treatment and outcome patterns in 307 eyes with Coats' disease. Materials and Methods: Retrospective chart review of patients diagnosed with Coats' disease between January 1996 and January 2006 from a single referral center in southern India. Results: Two hundred and eighty patients (307 eyes) with mean age of 15.67 years (range: Four months-80 years) were included. Decreased vision (77%), unilateral affection (90%) and male preponderance (83.4%) were chief presenting features. Anterior segment involvement was seen in 67 (21.8%) eyes. Retinal telangiectasia were seen in 302 (99%) eyes, exudation in 274 (89%) eyes and retinal detachment in 158 (51.5%) eyes. Four-quadrant disease was seen in 207 (67.2 %) eyes. Visual acuity was < 20/200 in 249 (80.9%) eyes. One hundred and nine of 176 treated eyes (61.93%) had favorable anatomical outcome; 207 of 280 eyes (74%) had an optimal structural outcome. Seventeen (5.3%) eyes were enucleated. Complications following treatment included phthisis bulbi (7%), neovascular glaucoma (5%), epiretinal membrane (4.4%) and rubeosis iridis (4.4%). Conclusion: Indian patients with Coats' disease have a high male predominance, the majority of whom present with severe visual impairment and extensive four-quadrant exudation. Unusual presentations such as pain, vitreous hemorrhage and a high incidence of anterior segment involvement are distinctive to Indian eyes.Item Coats’ disease of adult‑onset in 48 eyes.(2016-07) Rishi, Ekta; Rishi, Pukhraj; Appukuttan, Bindu; Uparkar, Mahesh; Sharma, Tarun; Gopal, LingamBackground: Coats’ disease diagnosed in adulthood is an idiopathic, retinal exudative vascular disease without an inciting factor and has retinal features different from the childhood disease. Aim: To describe clinical features, treatment, and outcomes of eyes with Coats’ disease first diagnosed in patients 35 years or older. Materials and Methods: Retrospective chart review of patients first diagnosed with Coats’ disease at the age of 35 years or more at a tertiary eye care center between January 1995 and 2012. Eyes with retinal exudation or Coats’‑like response from secondary causes were excluded. Results: Forty‑five of 646 patients (7%) diagnosed with Coats’ disease had adult‑onset disease. Mean age at presentation was 47 years. Systemic hypertension was the most common (22%) systemic association and decreased vision the predominant presenting feature (83%). Localized (<6 clock h) presentation (74%) was unique to adults as against diffuse involvement (69%) in children (P < 0.001). Eyes were treated with laser photocoagulation 29 (60%), cryotherapy (4%), or both (2%) with surgical intervention in three (6%) eyes. Following treatment eight (35%) eyes improved, 11 (48%) eyes were stable while four (12%) eyes worsened due to complications. Conclusion: Adult‑onset Coats’ disease has less extensive involvement, more benign natural course, and a more favorable treatment outcome as against the childhood‑onset disease. The bilateral presentation emphasizes the need for regular follow‑up to detect possible future involvement of the fellow eye.Item Combination photodynamic therapy and bevacizumab for choroidal neovascularization associated with toxoplasmosis.(2011-01) Rishi, Pukhraj; Venkataraman, Anusha; Rishi, EktaA 14-year-old girl presenting with visual loss in both eyes was diagnosed to have healed toxoplasma retinochoroiditis in the right eye with active choroidal neovascularization (CNV) secondary to toxoplasmosis in the left. She underwent combination photodynamic therapy (PDT) and intravitreal bevacizumab as primary treatment. PDT was performed as per the ‘Treatment of Age-related Macular Degeneration by Photodynamic therapy’ study protocol and was followed by intravitreal bevacizumab after 2 days. CNV regressed at 8 weeks of follow-up and remained stable at 8 months of follow-up. The initial visual acuity improved from 20/120 to 20/30. Combination therapy with PDT and intravitreal bevacizumab appears to be effective in the treatment of CNV secondary to toxoplasma retinochoroiditis.Item Combined photodynamic therapy and intravitreal bevacizumab as primary treatment for subretinal neovascularization associated with type 2 idiopathic macular telangiectasia.(2009-05-23) Rishi, Pukhraj; Rishi, Ekta; Shroff, DaraiusItem Epiretinal membrane removal in patients with Stargardt disease.(2015-01) Bhende, Muna; Appukuttan, Bindu; Rishi, EktaEpiretinal membranes (ERMs) in Stargardt disease have been known to undergo spontaneous separation in children. Results of surgical intervention in adult patients with Stargardt disease have rarely been reported. A retrospective review of results of surgical intervention for ERM causing visual impairment in two adult patients of Stargardt disease was carried out. Both patients developed ERM in one eye during their follow‑up period with the resultant drop in their preexisting visual acuity. Postsurgery, restoration of foveal contour with some improvement in visual acuity was observed in both patients. No adverse effect of surgery was noted.Item Fractured Ozurdex™ implant in the vitreous cavity.(2012-07) Rishi, Pukhraj; Mathur, Gaurav; Rishi, EktaItem Giant nevus of Ota.(2015-06) Rishi, Pukhraj; Rishi, Ekta; Bhojwani, DeepakNevus of Ota is a hamartoma of dermal melanocytes presenting as blue hyperpigmented patches on the face usually within the distribution of ophthalmic and maxillary branches of the trigeminal nerve.[1] A case of giant nevus of Ota involving all three branches of the trigeminal nerve is presented.Item Hemi-central retinal artery occlusion in young adults.(2010-09) Rishi, Pukhraj; Rishi, Ekta; Sharma, Tarun; Mahajan, SheshadriAmongst the clinical presentations of retinal artery occlusion, hemi-central retinal artery occlusion (Hemi-CRAO) is rarely described. This case series of four adults aged between 22 and 36 years attempts to describe the clinical profile, etiology and management of Hemi-CRAO. Case 1 had an artificial mitral valve implant. Polycythemia and malignant hypertension were noted in Case 2. The third patient had Leiden mutation while the fourth patient had Eisenmenger’s syndrome. Clinical examination and fundus fluorescein angiography revealed a bifurcated central retinal artery at emergence from the optic nerve head, in all cases. Color Doppler examination of the central retinal artery confirmed branching of the artery behind the lamina cribrosa. It is hypothesized that bifurcation of central retinal artery behind the lamina cribrosa may predispose these hemi-trunks to develop an acute occlusion if associated with underlying risk factors. The prognosis depends upon arterial recanalisation and etiology of the thromboembolic event.Item Intravitreal bevacizumab for choroidal neovascular membrane associated with Best's vitelliform dystrophy.(2010-03) Rishi, Ekta; Rishi, Pukhraj; Mahajan, SheshadriBest's vitelliform macular dystrophy is a hereditary form of progressive macular dystrophy that can be complicated by choroidal neovascularization. Authors report successful treatment of choroidal neovascularization with intravitreal bevacizumab in one such eye in an ‘adult’ Indian male with visual improvement. A 23-year-old male presented with diminution of vision in the right eye for the past sixteen months. Visual acuity was 20/400 in the that eye. After three consecutive intravitreal injections of bevacizumab (1.25 mg/0.05 ml), vision improved to 20/120. Seven months following the last injection of bevacizumab, fundus appeared stable and visual acuity was maintained. No drug-related ocular or systemic side effects were encountered. To the best of our knowledge (PubMed search), this is the first report of its kind in an adult Indian patient. Intravitreal bevacizumab appears to be a promising and cost-effective modality of treatment in such eyes with potential for improvement in vision. However, a long-term follow-up is warranted.Item Intravitreal bevacizumab for treatment of choroidal neovascularization associated with osteogenesis imperfecta.(2012-05) Rishi, Pukhraj; Rishi, Ekta; Venkatraman, AnushaA 12-year-old girl, diagnosed of osteogenesis imperfecta, presented with sudden visual loss in the left eye. Investigations revealed an active choroidal neovascular membrane. She underwent treatment with intravitreal Bevacizumab (1.25 mg/0.05 ml). Follow-up at 1 month revealed the development of lacquer crack running through the macula, underlying the fovea. The patient received two re-treatments at 1-month intervals, following which the choroidal neovascularization (CNV) regressed completely. However, further progression of lacquer cracks was noted. At the last follow-up, 6 months following the last injection, the fundus remained stable and vision was maintained at 20/200. Considering the natural history of the disease and the increased risk of rupture of the Bruch's membrane in such eyes, the possible complication of a lacquer crack developing must be borne in mind, before initiating treatment.Item Lightning injury of posterior segment of the eye.(2016-02) Rishi, Ekta; Indu, V P; Rishi, PukhrajItem Management of intralenticular caterpillar setae.(2008-09-20) Rishi, Pukhraj; Agarwal, Mamta; Mahajan, Sheshadri; Rishi, EktaItem Management of peripheral polypoidal choroidal vasculopathy with intravitreal bevacizumab and indocyanine green angiography-guided laser photocoagulation.(2012-01) Rishi, Pukhraj; Das, Atheeswar; Sarate, Pallavi; Rishi, EktaA 69-year-old lady presented with complaints of decreased vision in left eye since one month. Best Corrected Visual Acuity (BCVA) was 6/18 in that eye. Fundus examination revealed non-central geographic atrophy and soft drusens at macula in both eyes. Temporal periphery of left eye revealed subretinal exudates with altered sub-RPE hemorrhage mimicking peripheral exudative hemorrhagic chorioretinopathy (PEHCR). Fundus Fluorescein Angiogram showed window defects at macula and blocked fluorescence at temporal periphery in left eye. However, Indocyanine green angiography (ICGA) revealed active peripheral choroidal polyps. The patient was successfully treated with intravitreal bevacizumab and ICGA-guided laser photocoagulation. 27 months after laser treatment, BCVA improved to 6/9. Rationale of consecutive anti-vascular endothelial growth factor (VEGF) treatment followed by more definitive laser photocoagulation is that anti-VEGF aids in resolution of subretinal fluid, thus making the polyp more amenable to focal laser photocoagulation which stabilizes the choroidal vasculature and prevents further leakage.Item Photodynamic monotherapy or combination treatment with intravitreal triamcinolone acetonide, bevacizumab or ranibizumab for choroidal neovascularization associated with pathological myopia.(2011-05) Rishi, Pukhraj; Rishi, Ekta; Venkataraman, Anusha; Gopal, Lingam; Sharma, Tarun; Bhende, Muna; Ratra, Dhanashree; Sen, Pratik Ranjan; Sen, ParveenThis retrospective, interventional case series analyses treatment outcomes in eyes with choroidal neovascularization (CNV) secondary to pathological myopia, managed with photodynamic therapy, (PDT), (Group 1, N = 11), PDT and intravitreal triamcinolone acetonide (4 mg/0.1ml) (Group 2, N = 3), PDT and intravitreal anti-vascular endothelial growth factor (anti-VEGF) bevacizumab 1.25 mg/0.05 ml, ranibizumab 0.5 mg/0.05 ml and reduced-fluence PDT and intravitreal ranibizumab 0.5 mg/0.05 ml (Group 3, N=12). All the patients underwent PDT. Intravitreal injections were repeated as required. SPSS 14 software was used to evaluate the data. Wilcoxon signed ranks test was used to evaluate pre- and post-treatment vision. The Kruskal-Wallis test was used for comparison between the groups. All the groups were statistically comparable. All the eyes showed complete regression of CNV, with a minimum follow-up of six months. All groups had visual improvement; significantly in Group 3 (P = 0.003). Combination PDT with anti-VEGF agents appeared to be efficacious in eyes with myopic CNV. However, a larger study with a longer follow-up is required to validate these results.