Macular Degeneration: Chalam KV

Chalam KV, Malkani S, Shah VA. · Department of Ophthalmology, University of Florida College of Medicine, Jacksonville 32209, USA. · Ophthalmic Surg Lasers Imaging. · Pubmed #12757090 No free full text.

Abstract: BACKGROUND AND OBJECTIVE: Corticosteroids remain the mainstay for control of ocular inflammation after vitreous surgery. A controlled, randomized, prospective study was performed to evaluate the effectiveness of a single intravitreal injection of dexamethasone phosphate on postoperative inflammation after simple vitreous surgery in patients with proliferative diabetic retinopathy and macular pucker. PATIENTS AND METHODS: Aqueous cell flare intensity was measured preoperatively and on days 1, 10, and 90 in 56 consecutive patients who underwent vitreous surgery for proliferative diabetic retinopathy and macular pucker. Subjects were consecutively randomized to two groups: 400 microg of intravitreal dexamethasone (treatment group) or no dexamethasone (control group) RESULTS: Before surgery, cell and flare intensity was similar in both groups. Flare intensity was significandy lower at 10, 30, and 90 days in the proliferative diabetic retinopathy treatment group (P < .05). CONCLUSION: Intravitreal dexamethasone significantly alleviates postoperative inflammation after vitreous surgery and is a useful adjunct.

Browning DJ, Apte RS, Bressler SB, Chalam KV, Danis RP, Davis MD, Kollman C, Qin H, Sadda S, Scott IU, Anonymous00031. · Charlotte Eye Ear Nose and Throat Assoc, PA, Charlotte, North Carolina, USA. · Retina. · Pubmed #19174719 No free full text.

Abstract: PURPOSE: To determine whether the extensiveness of diabetic macular edema using a 10-step scale based on optical coherence tomography explains pretreatment variation in visual acuity and predicts change in macular thickness or visual acuity after laser photocoagulation. METHODS: Three hundred twenty-three eyes from a randomized clinical trial of two methods of laser photocoagulation for diabetic macular edema were studied. Baseline number of thickened optical coherence tomography subfields was used to characterize diabetic macular edema on a 10-step scale from 0 to 9. Associations were explored between baseline number of thickened subfields and baseline fundus photographic variables, visual acuity, central subfield mean thickness (CSMT), and total macular volume. Associations were also examined between baseline number of thickened subfields and changes in visual acuity, CSMT, and total macular volume at 3.5 and 12 months after laser photocoagulation. RESULTS: For baseline visual acuity, the number of thickened subfields explained no more variation than did CSMT, age and fluorescein leakage. A greater number of thickened subfields was associated with a greater baseline CSMT, total macular volume, area of retinal thickening, and degree of thickening at the center of the macula (r = 0.64, 0.77, 0.61-0.63, and 0.45, respectively) and with a lower baseline visual acuity (r = 0.38). Baseline number of thickened subfields showed no association with change in visual acuity (r < or = 0.01-0.08) and weak associations with change in CSMT and total macular volume (r from 0.11 to 0.35). CONCLUSION: This optical coherence tomography based assessment of the extensiveness of diabetic macular edema did not explain additional variation in baseline visual acuity above that explained by other known important variables nor predict changes in macular thickness or visual acuity after laser photocoagulation.

Chalam KV, Keshavamurthy R, Brar VS. · University of Florida College of Medicine, Department of Ophthalmology, Jacksonville, FL 32204, USA. · Eur J Ophthalmol. · Pubmed #18850569 No free full text.

Abstract: PURPOSE: Cystoid macular edema is one of the important causes of visual loss in branch retinal vein occlusion. Proximity of the cyst to the external limiting membrane and disruption of the layer on time domain optical coherence tomography is associated with poor final visual outcomes. The authors describe pre- and post-intravitreal bevacizumab spectral domain optical coherence tomography features in a case of cystoid macular edema associated with branch retinal vein occlusion that was resolved after treatment with intravitreal bevacizumab. METHODS: A 50-year-old woman was diagnosed with cystoid macular edema due to branch retinal vein occlusion and underwent intravitreal injection with bevacizumab after the primary treatment with laser photocoagulation failed. RESULTS: The patient's visual acuity recovered from 20/40 to 20/20. Spectral domain optical coherence tomography documented complete resolution of a large foveal cyst (150 micronm by 280 micronm) and recovery of the discontinuity of the external limiting membrane 1 week after treatment. CONCLUSIONS: Spectral domain optical coherence tomography is a useful tool in identifying the ultrastructural changes associated with cystoid macular edema associated with branch retinal vein occlusion and identifying the possible factors involved in prognosticating visual outcome after effective treatment.

Shah VA, Gupta SK, Shah KV, Vinjamaram S, Chalam KV. · Department of Ophthalmology, University of Florida/College of Medicine, Jacksonville, Florida 32209, USA. · Ophthalmic Epidemiol. · Pubmed #14977496 No free full text.

Abstract: PURPOSE: To evaluate the utility scores in patients with varying degrees of visual morbidity due to diabetic retinopathy or ARMD. METHODS: Patients with vision < or =20/40 in one eye due to diabetic retinopathy or ARMD were enrolled. Utility scores were measured by the time trade-off (TTO) method after stratifying the patient population with visual impairment in the better eye (group 1, 20/20 to 20/40; group 2, 20/50 to 20/100; group 3, 20/200 to no light perception). RESULTS: Sub-group analysis revealed that subjects in group 1 were willing to give up a median of 1 year as compared to 3 years by the subjects in group 3 for perfect bilateral visual acuity (P<0.05). The median utility score was 0.94 for group 1, 0.96 for group 2 and 0.80 for group 3. While the utility scores for groups 1 and 2 were comparable (P>0.05), there was a significant difference in the utility scores between groups 1 and 3 and between groups 2 and 3 (P<0.05). There was no significant effect on the utility scores of age, educational level or prior ocular surgery. CONCLUSION: Substantial visual loss secondary to diabetic retinopathy or ARMD is associated with a significant decrease in utility scores. However, TTO scores were not sensitive enough to demonstrate a difference between subjects with mild (group 1) and moderate (group 2) visual loss in the better eye secondary to diabetic retinopathy or ARMD.

Shah VA, Chalam KV. · No affiliation provided · Eye. · Pubmed #16273084 No free full text.

This publication has no abstract.

Chalam KV, Shah GY, Shah VA. · No affiliation provided · Am J Ophthalmol. · Pubmed #15953467 No free full text.

This publication has no abstract.