Purpose: The gold standard for evaluating Retinopathy of prematurity (ROP), a potentially blinding disease in preterm babies, is by indirect ophthalmoscopy which is quite subjective. Digital imaging with RetCam, an advanced wide field imaging system is more precise but it is not easily available or affordable. Smartphones are being explored as an alternate cost effective and accessible imaging tool. This is possible because of the good illumination and the built-in high resolution cameras available in modern smartphones. The aim of this study is to illustrate the utility of MII RetCam assisted smartphone based fundus imaging (MSFI) in the documentation and monitoring of ROP. Methods: Single-centre, retrospective observational study of all the preterm babies subjected to MSFI as part of ROP screening from September 2017 to November 2018. iPhone 4S and + 20 Diopter lens attached to the MII RetCam device was used for fundus imaging at baseline and during follow up. The statistical analysis used for the same is the SPSS statistical software. Results: Good quality images of central and peripheral retina could be captured in 33 out of 42 babies (78.57%) with ROP. Serial imaging done in 24 babies with ROP helped in precise monitoring of the disease and planning management. Incidentally detected non-ROP findings were also documented. Unique design of the device enabled imaging by a single examiner. Image database created was useful for academic and counselling purposes. Smaller field images which can cause difficulty in distinguishing the zones is a limitation. Conclusion: MSFI is a potential alternate imaging tool enabling objective documentation and monitoring of ROP in low resource settings.

PURPOSE:The purpose of the study was to evaluate the long-term efficacy and safety of intravitreal bevacizumab (IVB) in the treatment of choroidal neovascularization (CNV) secondary to angioid streaks (AS).MATERIALS AND METHODS:Noncomparative, interventional retrospective case series involving ten patients (15 eyes) with a minimum follow-up of 25 months following IVB for AS-associated CNV. Demographic and clinical details at baseline and during follow-up were collected from patient records. Detailed clinical examination was followed by fundus fluorescein angiography and optical coherence tomography to confirm CNV. Both primary and recurrent CNVs were treated with monthly injections of IVB till the lesion stabilized. Primary outcome measures were the percentage of patients with stable or improved visual acuity (VA) and with stable or decreased central retinal thickness (CRT) at the last visit. Secondary outcome measure was the incidence of ocular and systemic complications.RESULTS:Recurrence was observed in 11 eyes (73.33%) over a mean follow-up of 57.33 months (range: 25–100). A mean number of injections administered was 5.60. VA improved or stabilized in 73.33% and deteriorated in 26.67% of eyes at the final visit. Mean CRT improved from 324.40 μm at baseline to 265.53 μm at final visit, which was statistically significant. Complications observed were ocular hypertension in one patient and thromboembolic event in another patient.CONCLUSIONS:IVB appears to be a safe and effective option to treat CNV and to preserve vision over a prolonged period. It cannot eliminate the risk of recurrent CNV indicating the need for more effective treatments to arrest this visually debilitating condition.

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Purpose:To report a rare case of periorbital emphysema concurrent with cervicofacial and mediastinal emphysema in an elderly woman who underwent upper gastrointestinal endoscopy for chronic liver disease.Case Report:An elderly woman with decompensated chronic liver disease presented with features of periorbital, facial, and mediastinal emphysema, characterized with crepitant swelling over the right periorbital area, face, neck, and mediastinum after undergoing upper gastrointestinal endoscopy. There was no history of trauma or Valsalva maneuver. Ocular findings were stable with no evidence of orbital compartmental syndrome. Urgent computed tomography scans of the orbit and chest were performed, and emergency systemic treatment with nasogastric decompression and antibiotics was initiated. However, she suddenly collapsed and succumbed despite all resuscitative efforts.Conclusion:Our case demonstrates that periorbital emphysema can occur following procedures such as upper gastrointestinal endoscopy, in the eyes without history of local trauma. This complication should be suspected especially if there is associated cervicofacial and mediastinal emphysema. Subcutaneous emphysema is usually self-resolving; however, extension of air into deeper planes can cause dangerous complications such as blindness due to orbital emphysema or mortality due to mediastinal emphysema. Hence, prompt diagnosis and urgent intervention are crucial to avoid vision and life threatening complications.