Rakhi P Dcruz

Bio: Rakhi P Dcruz is an academic researcher. The author has contributed to research in topics: Aniridia & Megalocornea. The author has an hindex of 1, co-authored 2 publications receiving 6 citations.

Paracentral acute middle maculopathy following SARS-CoV-2 infection: the D-dimer hypothesis.

Abstract: We herein report a case of bilateral acute-onset scotoma following SARS-CoV-2 infection in a 19-year-old girl attributed to the presence of paracentral acute middle maculopathy (PAMM). She was tested positive for SARS-CoV-2 infection 2 weeks prior by reverse transcription PCR testing and

Atypical presentations of non-familial anterior megalophthalmos: a rare disease.

Abstract: Anterior megalophthalmos usually presents early in life with megalocornea, deep anterior chamber, raised intraocular pressure, glaucomatous optic nerve damage and iridodonesis/stromal thinning with positive family history. We report atypical features and presentations in two patients (four eyes) with non-familial megalophthalmos. While the first patient, a male, presented at 51 years of age with megalocornea, cataract, phacodonesis, normal pupillary dilatation/normal iris and advanced glaucoma, the second patient presented with iridodonesis with stromal thinning, aphakia and advanced glaucoma. The family history was negative in both patients. The vitreous index was unusually high, >70% in all four eyes, owing to aphakia in the second patient and possible late presentation/variant phenotype in the first patient. Thus, atypical features such as greater vitreous length, absent iris involvement and late-onset adult presentation are common in non-familial anterior megalophthalmos. Clinical surprises due to varied phenotypes should be kept in mind in such cases.

Retinal and choroidal manifestations of COVID-19.

Abstract: Purpose of review The novel coronavirus disease in 2019 (COVID-19) has a wide range of systemic manifestations. Ocular manifestations are now well recognized, with conjunctivitis being the most common. Posterior segment involvement is uncommon and has mainly been described in case reports. This review provides an overview of the posterior segment involvement of COVID-19. Recent findings Severe acute respiratory syndrome coronavirus 2 affects the retina and the choroid through either direct entry or triggering an indirect inflammatory response. Majority of the retinal findings is a result of microvascular derangement leading to cotton wool spots, intraretinal hemorrhages, paracentral acute middle maculopathy, acute macular neuroretinopathy, or retinal vein occlusions. Rarely, inflammation involving the retina or the choroid, or reactivation of previously quiescent uveitis, can be seen. Summary It is important to recognize the possible correlation between ophthalmic conditions and COVID-19 as it can aid in diagnosis, management, and mitigation of the disease.

Acute macular neuroretinopathy as a manifestation of coronavirus disease 2019: A case report.

Abstract: The current findings is important in raising clinicians' awareness of the possibility of coincident acute macular neuroretinopathy (AMN) and COVID-19 as a potential cause of retinal vascular damage and ischemia.

Sub-internal limiting membrane haemorrhage as a manifestation of transiently deranged coagulation profile following SARS-CoV-2 infection

Abstract: © BMJ Publishing Group Limited 2021. No commercial reuse. See rights and permissions. Published by BMJ. DESCRIPTION We herein report a case of unilateral acuteonset transient selfresolving central visual loss following SARSCoV2 infection in a 41yearold man attributed to the presence of subinternal limiting membrane (ILM) haemorrhage. He tested positive for SARSCoV2 infection, confirmed with RTPCR, was advised home isolation, and treated with antipyretics, multivitamin medications only. He developed a drop in vision in the right eye 4 weeks after testing positive for COVID19. His presenting visual acuity was 20/60 for distance, N10 for near in right eye while left eye had normal vision (20/20, N6). Dilated fundus evaluation exhibited the presence of yellowishwhite altered subILM bleed at the fovea in the right eye. The left eye had the presence of cotton wool spots along the inferotemporal arcade along with segmental arteriolar attenuation (figure 1A,B). Optical coherence tomography (OCT) showed the presence of focal hyperreflectivity in the inner retinal layers underneath ILM with back shadowing (figure 1C) features consistent with subILM haemorrhage while left eye showed normal OCT scan with foveal contour well maintained (figure 1D). His fundus fluorescein angiography showed normal arm to retina and AV transit time with mild blocked fluorescence in the right eye. While the left eye showed patchy early choroidal hypo fluorescence with late iso fluorescence indicating either choroidal hypoperfusion or ischaemia. We investigated and found that he had a normal haemogram, normal C reactive protein levels (0.6 mg/mL), normal Ddimer levels (<50 ng/ mL), erythrocyte sedimentation rate of 20 mm/hour. However, he had a prolonged (>120 s) activated partial thromboplastin time (aPTT), prolonged prothrombin time (PT) of 29.0 s. He had gradual resolution of subILM haemorrhage with improvement in visual acuity. His visual acuity at 3 months followup was 20/25 in the right eye with complete resolution of subILM haemorrhage (figure 2). His aPTT (33.5 s) and PT (11.6 s) achieved normality at this visit. Spontaneous sub‐ILM haemorrhages in absence of vascular disorders have mainly been associated with Valsalva retinopathy and Terson’s syndrome. Sub‐ILM haemorrhages have been described in a variety of clinical settings and often lead to severe visual impairment because of their predilection for the macular region. The predilection to the macula is explained by the absence of firm attachments of the ILM to the retina at the posterior pole. A deranged coagulation profile is often seen in patients with COVID19 along with/without elevation of Ddimer levels. Ddimer, commonly elevated in patients with COVID19, is a fibrindegradation product that is increased in thrombotic events, indicating fibrinolysis. Raised Ddimer values, lead to activation of coagulation cascade secondary to systemic inflammatory response syndrome, correlate to the disease severity and high mortality in such patients. On the contrary, in our patient Ddimer levels were normal postCOVID while PT and aPTT were raised. With time, the recovery and Figure 1 Fundus photography at presentation. (A) Right eye showing foveal yellowish subILM haemorrhage. (B) Left eye cotton wool spot with segmental arteriolar attenuation. (C) OCT right eye confirmed subILM location with focal hyperreflectivity and back shadowing. (D) Left eye OCT was normal. ILM, internal limiting membrane; OCT, optical coherence tomography.

Characterizing covid-19–related retinal vascular occlusions

Abstract: To describe clinical and ophthalmologic features and outcomes of patients with coronavirus disease-19 with retinal vascular occlusions.Retrospective multicenter case series and PubMed review of cases reported from March 2020 to September 2021. Outcome measures are as follows: type of occlusion, treatments, best-corrected visual acuity, and central macular thickness on optical coherence tomography.Thirty-nine patients were identified. Fifteen patients with a median age of 39 (30-67) years were included in the multicenter study. Vascular occlusions included central retinal vein occlusion (12 eyes), branch retinal vein occlusion (4 eyes), and central retinal artery occlusion (2 eyes). Three cases were bilateral. Baseline best-corrected visual acuity was 20/45 (no light perception-20/20). Baseline central macular thickness was 348.64 (±83) μm. Nine eyes received anti-vascular endothelial growth factor agents, dexamethasone intravitreal implant, or both. Final best-corrected visual acuity was 20/25 (no light perception-20/20), and central macular thickness was 273.7 ± 68 μm (follow-up of 19.6 ± 6 weeks). Among the 24 cases from the literature review, retinal vein occlusion was the predominant lesion. Clinical characteristics and outcomes were similar to those found in our series.Coronavirus disease-19-associated retinal vascular occlusions tend to occur in individuals younger than 60 years. Retinal vein occlusion is the most frequent occlusive event, and outcomes are favorable in most cases.