Showing papers by "Rahul N. Khurana published in 2006"

Optical coherence tomography to assess intrastromal corneal ring segment depth in keratoconic eyes

Abstract: Purpose To investigate intrastromal corneal ring segment depth with a high-speed corneal optical coherence tomography (OCT) system. Setting Doheny Eye Institute, University of Southern California, Los Angeles, California, USA. Methods A prospective observational case series comprised 4 eyes of 4 patients receiving Intacs intrastromal corneal ring segments (Addition Technology, Inc.) for keratoconus. Optical coherence tomography (OCT) was performed between 7 days and 43 days after implantation. Results The slitlamp impression of intrastromal corneal ring segment implantation depth did not correlate well with OCT measurements ( r 2 = 0.68). The fractional implantation depth was correlated with several surgical variables using a stepwise multivariate regression model, and 2 statistically significant correlations were found. The position of the distal portions of the ring segments was shallower than that of the portion closer to the insertion site ( P = .003). Segments placed in the inferior cornea ( P = .008) experienced more distal shallowing. Shallower depth was associated with greater fractional anterior stromal compression ( P = .04). Conclusions Shallower placement of intrastromal corneal ring segments may result in more complications, such as epithelial–stromal breakdown and extrusion, because of the greater anterior stromal tensile strain. The distal and inferior portions of intrastromal corneal ring segments tended to be placed at a shallower depth. Optical coherence tomography provided precise measurement of ring segment depth and may help identify implants that pose a greater risk for depth-related complications.

Central retinal vein occlusion in Wegener's granulomatosis without retinal vasculitis.

Abstract: The classic type of Wegener’s granulomatosis is characterised by necrotising granulomatous lesions of the upper and lower respiratory tracts, generalised focal necrotising vasculitis and glomerulonephritis, whereas the limited type has no renal involvement.1 Ocular manifestations occur in 30–50% of the patients,1 with retinal involvement less frequent and varying from 1 to 13% in the literature.2,3 We report a case of Wegener’s granulomatosis presenting with a central retinal vein occlusion (RVO) without clinical evidence of intraocular inflammation or retinal vasculitis. A 22-year-old white man presented with a 1-week history of intermittent obscuration of vision in his right eye. His medical history was remarkable for classic Wegener’s granulomatosis that had been in remission for the past year. His best-corrected visual acuities were 20/25 in the right eye and 20/20 in …

Salt-and-Pepper Retinopathy of Rubella

Abstract: 39-year-old woman presented at a clinic for a second opinion regarding a diagnosis of age-related macular degeneration, which had been noted on routine ophthalmologic examination. She reported having no visual problems. Her medical history was notable for congenital hearing loss associated with her mother’s having contracted rubella during her pregnancy. The visual acuity was 20/20 in both eyes. Findings on slit-lamp examination and intraocular pressure were normal. Funduscopic examination revealed granular, pigmentary mottling in the macula and periphery, with punctuate hypopigmentation (arrowheads) and hyperpigmentation (arrows) consistent with the “salt-and-pepper” retinopathy of rubella. The findings on cardiac examination were normal. The classic triad of congenital rubella includes ocular abnormalities, heart disease, and deafness, but myriad other signs have been reported. Congenital rubella produces a classic salt-and-pepper pigmentation of the fundus, as seen in this patient. The nonprogressive retinopathy is generally benign and does not interfere with vision unless choroidal neovascularization develops in the macula. At follow-up four months later, the patient continued to be asymptomatic and no changes were noted