Ramesh Venkatesh

Narayana Nethralaya Hospital | NARAYANA NETHRALAYA · Department of Ophthalmology

The medical condition referred to as “central retinal artery occlusion” (CRAO) was first documented by Albrecht von Graefe in 1859. Subsequently, CRAO has consistently been identified as a serious medical condition that leads to substantial visual impairment. Furthermore, it is correlated with vascular complications that have the potential to affec...

Background Macular retinoschisis (MRS) and myopic macular neovascularization (mMNV) are both potentially blinding complications of high myopia. In this case report, we highlight the progression of MRS after intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment for mMNV, as well as an extensive review of the literature on this t...

A 23-year-old male experienced a cricket ball injury to his right eye 1 day ago. Right eye visual acuity was counting fingers close to face. He presented with anterior uveitis, commotio retinae, and vitreous hemorrhage. Steroids and cycloplegics were given. Fundus showed resolved vitreous hemorrhage, a healthy optic disc, patchy epiretinal membrane...

Background Purtscher or Purtscher-like retinopathy is diagnosed by retinal hemorrhages and areas of retinal whitening on fundus examination, as well as a reduction in visual acuity due to microvascular occlusion of the precapillary retinal arterioles. We describe novel optical coherence tomography (OCT) findings of internal limiting membrane (ILM)...

Purpose To study the role of artificial intelligence (AI) in developing diabetic macular edema (DME) management recommendations by creating and comparing responses to clinicians in hypothetical AI-generated case scenarios. The study also examined whether its joint recommendations followed national DME management guidelines. Methods The AI hypothet...

Purpose To describe a case of acquired glaucomatous optic disc pit-related maculopathy successfully treated with glaucoma filtering surgery alone. Case description A 67-year-old male was diagnosed with advanced primary open angle glaucoma in both eyes, with a cup: disc ratio of 0.85 in the right eye and 0.95 in the left eye. Visual acuity at prese...

Purpose To compare changes in the fibrous component of pigment epithelium detachment composition indices (PEDCI-F) in neovascular age-related macular degeneration (n-AMD) and polypoidal choroidal vasculopathy (PCV) over 12 months. Methods This was a retrospective chart review of treatment-naïve n-AMD and PCV eyes treated with anti-vascular endothe...

Purpose To describe the findings of Multicolour® imaging (MCI) in the presence of residual emulsified silicone oil (SiO) droplets. Case report A 62-year-old man had previously undergone surgery for a traumatic retinal detachment in the left eye, followed by SiO removal a few years ago. His presenting visual acuity was 6/60 in the left eye and intr...

Purpose To report a rare case of progressive retinoschisis and retinal detachment after uncomplicated macular hole (MH) surgery. Case description A 67-year-old man with recent onset vision complaints in the right eye (visual acuity – 20/30), was diagnosed with a small idiopathic full-thickness MH. He underwent a 3-port 25G pars plana vitrectomy su...

Purpose To study the role of artificial intelligence (AI) to identify key risk factors for diabetic retinopathy (DR) screening and develop recommendations based on clinician and large language model (LLM) based AI platform opinions for newly detected diabetes mellitus (DM) cases. Methods Five clinicians and three AI applications were given 20 AI-g...

The present photographic essay showcases a unique observation of a 'inverse posterior hyperoleon' that occurred subsequent to vitreoretinal surgery in an eye affected by pathological myopia.

A 52-year-old woman with extrafoveal polypoidal choroidal vasculopathy (PCV) in her right eye was treated with a single intravitreal injection of 6 mg/0.05ml Brolucizumab (BZB) and focal thermal laser therapy. The patient complained of redness and blurred vision in her right eye for the previous week at the 4-week follow-up visit. PCV-related clini...

This photographic essay describes a rare case of cilia incarnata externum growing underneath the skin in the right upper eyelid and treated with exteriorization of the eyelash with the help of an epilation forceps.

Clinical relevance: Central retinal artery occlusion (CRAO) is an ophthalmic emergency with a poor prognosis. Several initial CRAO presentation factors can influence the final visual outcome. Fluorescein angiography filling of retinal vessels in CRAO has not been studied in great detail. Background: The aim of this paper is to study the aberrant fi...

Purpose To describe the different types of vitreomacular interface abnormalities (VMIA) seen on optical coherence tomography (OCT) in type 2 macular telangiectasia (MacTel) and explain the possible reasons for its development. Methods In this retrospective cross-sectional study, type 2 MacTel eyes with macular volumetric OCT imaging protocol were...

Purpose To describe a typical case of acute central retinal artery occlusion (CRAO) with an ink-blot pattern of hyperfluorescent leak on fundus fluorescein angiography (FFA). Case description A 21-year-old woman came to the clinic with one day of painless right eye vision loss. Her right eye had finger counting at ½ meter. Her right eye had a rela...

Purpose: To study right-angled vessels (RAV) in disease progression and macular neovascularization in type 2 macular telangiectasia (MacTel) eyes. Methods: This retrospective image analysis study examined type 2 MacTel patients' multicolour® and OCT imaging records from January 2015 to March 2023. Age, gender, laterality, visual acuity, systemic...

Background Intraocular inflammation is common after anterior or posterior segment surgery. They typically manifest either as non-infectious inflammation of the anterior or posterior segment, known as toxic anterior or posterior segment syndrome (TPSS), or as sterile or infective endophthalmitis. In this report, we describe a rare case of TPSS follo...

A 38-year-old pregnant woman presented to the retina clinic with complaints of sudden vision loss in her right eye for one week. The clinical examination of the right eye revealed a macula-off rhegmatogenous retinal detachment with multiple retinal breaks in different meridians, posterior retinal breaks, inferior peripheral retinal degeneration, an...

Purpose The purpose of this study is to describe and compare the demographic, ocular, and imaging characteristics of a cohort of patients with congenital and acquired optic disc pit maculopathy (ODPM). Methods This retrospective case series included patients diagnosed with ODPM between June 2017 and April 2023. These patients’ baseline demographic...

Background Demarcation line in a rhegmatogenous retinal detachment (RD) is a classic finding noted in chronic cases. In this case report, we describe a case of evolution of post-operative demarcation line after pneumatic retinopexy (PnR) in a subtotal rhegmatogenous RD. Case description A 31-year-old male diagnosed with acute, subtotal, macula-off...

Background: Large language models (LLMs) such as ChatGPT have emerged as a potentially powerful application in medicine. One of these strengths is the ability for ChatGPT to analyze text and to perform certain tasks. International Classification of Diseases (ICD) codes are universally utilized in medicine and have served as a uniform platform for i...

Purpose To report eplerenone use by retina specialists worldwide for central serous chorioretinopathy (CSCR). Methods A self-reporting questionnaire was distributed to retina specialists worldwide to gather clinicians’ perspectives on CSCR cases treated, eplerenone dosage and duration, reasons to use it, and side effects. Results The survey inclu...

Purpose To report contributory factors and clinical outcomes of central posterior hyaloid fibrosis (CPHF) associated with neovascular age-related macular degeneration (nAMD). Methods In this retrospective, single-center study, patients with CPHF and nAMD were included. Demographic and imaging characteristics, as well as the anatomical and functiona...

Purpose: To describe a rare clinical finding of epiretinal membrane (ERM) and abnormal optic disc vascularisation in type 2A macular telangiectasia (MacTel). Case description: A 52-year-old asymptomatic healthy male was examined in the retina clinic. In both eyes, corrected visual acuity was 20/20, N6. Anterior segment examination and intraocula...

Purpose: Control of blindness due to retinopathy of prematurity (ROP) requires timely screening and treatment within 48-72 h. Anticipating that the coronavirus disease 2019 (COVID-19) pandemic would disrupt ROP services, we devised strategies ''on-the''-go"" to ameliorate this possiblity. We describe the successful outcomes of this approach in pre...

Purpose Macular telangiectasia (MacTel) type 2 is observed in patients in their 5th–8th decades of life. The clinical and imaging findings in younger patients is unknown in larger cohorts. The study purpose is to report prevalence, baseline clinical and spectral domain optical coherence tomography (SDOCT) findings in young MacTel patients below 40...

Objective To evaluate the short-term effectiveness and safety outcomes following brolucizumab treatment in patients with neovascular age-related macular degeneration (nAMD) as a part of real-world clinical practice in India. Methods This was a retrospective, observational, multicentre study including patients (≥50 years old) diagnosed with nAMD. A...

Purpose The aim of this study is to describe and compare the baseline demographic, ocular, and imaging characteristics of a cohort of patients with optic disc pit (ODP) or optic disc coloboma (ODC) maculopathy. Methods This retrospective study included patients diagnosed with ODP or ODC on clinical examination between June 2017 and December 2022....

Purpose To describe the development and outcome of mid-phase pinpoint hyperfluorescent spots (MPHS) on fundus fluorescein angiography (FFA) in acute (< 7-day symptom onset) central retinal artery occlusion (CRAO) patients. Methods This retrospective study included acute CRAO patients who underwent multimodal imaging utilizing optical coherence tom...

Purpose To study the optical coherence tomography (OCT) changes in eyes with acute central retinal artery occlusion (CRAO) of different severity and at different disease stages. Methods The study included acute CRAO cases of < 7 days duration, imaged on OCT at various time points. Based on the OCT findings at presentation, cases were classified in...

Purpose: To describe a rare presentation of torpedo maculopathy (TM). Case description: A 25-year-old male was examined in the retina clinic for a macular scar in the left eye. His visual acuity was 20/20, N6 in both eyes and no past history of ocular trauma or any medical or ocular history. The anterior segment was quiet and intraocular pressur...

In this case report, we describe a rare imaging finding of foveal duplication identified on spectral domain optical coherence tomography (OCT) through undilated pupils in a 49-year-old asymptomatic anxious lady with type 2 diabetes mellitus who visited the retina clinic for diabetic retinopathy screening. A simple patient counseling for cooperation...

Purpose: To evaluate the influence of tamponade on the visual and anatomic outcomes of pars plana vitrectomy for myopic traction maculopathy (MTM). Design: Multicenter, retrospective clinical cohort study. Methods: Consecutive eyes that underwent vitrectomy for advanced MTM with tamponade of either air, SF6, or C3F8, or without tamponade with...

Objectives: To study the prevalence of fundus lesions in anaemics and define the hematological risk factors for retinopathy using the receiver operating characteristic curve analysis. Methods: For this retrospective study, patients ≥18 years and diagnosed with anemia with dilated fundus examination by a retina specialist from May 2019-April 2020...

Purpose: To evaluate the incidence, pathogenesis, risk factors, and treatment outcomes of postoperative macular hole (MH) after pars plana vitrectomy (PPV) for myopic traction maculopathy (MTM). Design: Multicenter, interventional, retrospective case series. Subjects: Consecutive eyes that underwent PPV for MTM with a minimum six-month follow-...

Purpose: To study the inter‑eye asymmetry in cases diagnosed with type 2 macular telangiectasia (MacTel). Methods: Herein, type 2 MacTel cases were staged as per Gass and Blodi classification with multiple imaging techniques. Based on disease stage symmetry, two groups identified. Group 1: Symmetrical stage and Group 2: Asymmetrical stage MacTel d...

Introduction: This study aimed to analyse the clinical retinal examination findings and undilated Optomap ultrawide field retinal imaging for the detection of proliferative diabetic retinopathy (DR) as compared to the fluorescein angiography (FA). Materials and methods: In this retrospective cross-sectional study, five hundred and twenty-three p...

Dry eye disease (DED) can lead to ocular discomfort as well as visual disturbances. Older adults are more likely to develop DED. They are also more likely to develop retinal diseases such as diabetic retinopathy and age-related macular degeneration, which may require vitreoretinal surgeries, lasers, and intravitreal injections. Posterior segment su...

Purpose: To compare real-life data on delayed intravitreal treatment of diabetic macular edema (DME) patients to early treatment. Methods: In this single-centre, retrospective, interventional, comparative study, DME patients were divided into two groups based on when they received treatment: Group 1 - received treatment within 24 weeks and Group...

Abstract: This study evaluated predictors for choroidal neovascularization (CNV) associated with central serous chorioretinopathy (CSCR) based on multimodal imaging. A retrospective multicenter chart review was conducted on 134 eyes of 132 consecutive patients with CSCR. Eyes were classified as per the multimodal imaging-based classification of CSC...

Purpose: To report a case demonstrating the relevance of ocular examination and retinal imaging timing in type 2 macular telangiectasia (MacTel). Case description: A 55-year-old-female complained of blurring of vision in the left eye for the last 6 months. Corrected visual acuity was 20/20, N6 and 20/30, N8 in the right and left eye respectively...

Background: The purpose of this study was to look at the long-term effects of retinal phototoxicity after macular hole repair surgery using xenon endolight illumination and Brilliant blue G (BBG) dye. Case presentation: An elderly man in his late seventies underwent para plana vitrectomy with BBG dye to repair an idiopathic full-thickness macular h...

Purpose To report a series of cases of post-operative new secondary retinal breaks following vitrectomy for proliferative diabetic retinopathy (PDR). Methods This retrospective case series included data of patients diagnosed with post-operative retinal breaks following uneventful vitrectomy surgery for PDR from January 2018 to December 2021. Resu...

Purpose: While there are a few studies that show the prevalence of blindness and ocular morbidity in children, studies on socioeconomic factors in childhood cataracts are scarce. We aimed to study the socioeconomic status, education and occupation of the parents, consanguinity, and gender inequality among children presenting with cataracts. Metho...

Objective: To describe the ocular blood vessel arrangement in choroidal coloboma eyes. Methods: In this retrospective, observational cross-sectional study, fundus images from 69 coloboma eyes of 45 patients were classified as per Ida Mann's classification. The arrangement and distribution of retinal, choroidal, and episcleral vessels, as well as...

Purpose To report evolution and outcomes of hyperreflective crystalline deposit (HCD) on optical coherence tomography (OCT) in diabetic maculopathy (DM). Methods Patients with DM showing HCD on OCT for the first time between June 2017 and May 2021 were included in the study. Demographic, ophthalmic and OCT features were documented and analysed. Fa...

Purpose: To determine the post-operative enface optical coherence tomography (OCT) pattern of closure in idiopathic macular holes (MH). Design: Retrospective, multicentric, observational study PARTICIPANTS: Patients more than 18 years with a diagnosis of idiopathic MH, with well documented enface OCT images. Methods: Baseline characteristics a...

Background To report spectral domain optical coherence tomography (SDOCT) imaging findings in type 2 macular telangiectasia (MacTel) and correlate them with clinical stages and visual acuity. Methods This retrospective, cross-sectional study included type 2 MacTel cases who underwent SDOCT imaging with Spectralis machine. Macular SDOCT images were...

Objective: To study aberrant filling of the retinal vessels on fluorescein angiography (FA) images in patients with branch (BRAO) or hemi-central retinal artery occlusions (hemi-CRAO) and correlate with associated changes on optical coherence tomography (OCT). Methods: Cases of acute BRAO or hemi-CRAO having FA and OCT images at presentation bet...

Purpose To report a case series of tamoxifen retinopathy (TR) with and without type 2 macular telangiectasia (MacTel) and compare their clinical and imaging findings. Methods Retrospective comparative study. Female patients with tamoxifen use or with clinical diagnosis of type 2 MacTel were divided into 4 groups: Group A—tamoxifen use without reti...

This is a Reply Letter to Torpedo Retinopathy or Chorioretinopathy? and does not have an abstract. Please download the PDF or view the article HTML.

We report on a case series that revealed flat, choroidal lesions on optical coherence tomography (OCT) and on enface MultiColor® (MCI) imaging of the fundus but were not noticeable on clinical examination or conventional color fundus images. This observational study included 12 eyes from 11 patients who had distinct, orange-colored lesions on MCI....

Some degenerations involving the peripheral retina can result in a rhegmatogenous retinal detachment. Currently, there are no clear guidelines for retinal screening and/or management of these peripheral retinal degenerations in patients with or without recent onset posterior vitreous detachment or in those prior to refractive surgery or intraocular...

Purpose To correlate the structural-vascular-functional changes in type 2 non-proliferative macular telangiectasia (MacTel) using optical coherence tomography (OCT) angiography (OCTA). Methods In this retrospective study, OCTA and enface OCT image analysis of eyes with confirmed diagnosis of non-proliferative type 2 MacTel was performed. The ‘MacT...

Purpose To describe the clinical and imaging features in a series of patients diagnosed with macular coloboma (MC) and intrachoroidal cavitation (ICC). Methods Patients diagnosed with MC based on clinical examination between June 2017 and July 2021 were retrieved from the electronic medical record system and were included in the study. Colour fund...

Purpose To study the regression patterns of subretinal fluid (SRF) in central serous chorioretinopathy (CSCR) on sequential en face optical coherence tomography (OCT) and its relationship to leak locations. Methods Retrospective study on patients with acute CSCR. Inclusion criteria were (i) availability of data, sequential OCT and OCT angiography...

Purpose: To report a rare case of macular outer retinal and retinal pigment epithelium (RPE) damage following brilliant blue G (BBG)-assisted epiretinal membrane (ERM) removal surgery. Methods: Retrospective, observational case report. Results: An 85-year-old lady presented with decreased vision in the left eye and a best-corrected visual acui...

Clinical relevance: Posterior microphthalmos (PM) is a rare developmental disorder characterised by high hyperopia, short axial length, presence of retinal papillomacular fold and relatively normal anterior segment findings. Background: The purpose of the study was to compare the retinal arcade distance from fovea between PM cases and to correla...

Objective To study the regression patterns of subretinal fluid (SRF) in central serous chorioretinopathy (CSCR) on sequential en-face optical coherence tomography (OCT) and its relationship to leak locations. Purpose Patients present at different stages of resolution of subretinal fluid (SRF), and persistence of subfoveal SRF raises concerns about...

Purpose: To describe the choroidal variations in posterior microphthalmos (PM). Methods: In this observational case series, four eyes of two patients diagnosed as PM based on the characteristic clinical features were included. Multimodal retinal imaging with clinical fundus documentation using ultrawide field fundus camera, optical coherence tom...

Purpose: To report the retinal vessel wall changes in a patient with acute branch retinal artery occlusion with fundus fluorescein angiography and adaptive optics imaging. Methods: Retrospective, observational case. Case description: A 49-year-old female with cardiac ailment complained of sudden onset superior field loss for 4 days in her righ...

Purpose To report Multicolour® imaging (MCI) findings in commotio retinae (CR) involving macula and correlate topographically with outer retinal layers on optical coherence tomography (OCT). Methods This retrospective study included participants with CR involving macula without any other type of traumatic maculopathy and imaged with OCT and MCI....

Purpose: To study the retinal and choroidal thickness variations on enhanced depth imaging optical coherence tomography scans in ocular albinism (OA) and compare with age-matched healthy subjects. Methods: This retrospective observational study had 48 eyes of 24 patients diagnosed clinically as OA and age, sex, and axial length-matched control h...

Purpose: To validate Lincoff's rules (LRs) in cases of rhegmatogenous retinal detachment (RRD) in the pediatric age group and to identify factors in cases LR was not followed. Method: This was a retrospective study where 98 pediatric patients with RRD were identified through surgery records. Forty case sheets with complete record of ocular exami...

Purpose To compare clinical and imaging features and treatment outcomes between eyes having peripheral polypoidal choroidal vasculopathy (PCV) and macular PCV. Methods In this retrospective comparative case series, confirmed cases of peripheral and macular PCV cases on indocyanine green angiography (ICGA) were included. The various demographic fea...

Purpose: The coronavirus disease (COVID-19) pandemic continues to play havoc in our lives. During the first " lockdown" in 2020, we were keen on assessing the anxiety levels of patients who sought ophthalmic care despite the lockdown. Public health actions, such as social distancing, were necessary to reduce the spread of COVID-19. As a result, mo...

Objective: To assess the relationship of retinal pigment clump (RPC) size and its location with visual acuity and retinal neovascularisation in eyes with type 2 macular telangiectasia (MacTel). Methods: In this cross-sectional study, eyes diagnosed with type 2 MacTel showing RPC were included. Area occupied by pigment was measured on the multico...

Purpose To report a case of sequential retinal pigment epithelium (RPE) tears following intravitreal Ranibizumab injections for neovascular age-related macular degeneration (AMD). Methods Retrospective, observational case Case description A 75-year-old hypertensive male was diagnosed with active neovascular AMD and pre-existing RPE tear in the le...

Purpose To assess the influence of fellow eye information on diagnosis and classification of central serous chorioretinopathy (CSCR) using multimodal imaging-based classification. Methods This was a retrospective, observational study including patients with CSCR with unilateral or bilateral involvement. Multimodal images of both eyes of each patie...

Objectives: To analyse the longitudinal changes in visual acuity and risk factors for recurrence or development of choroidal neovascularisation (CNV) in eyes with acute or chronic central serous chorioretinopathy (CSCR). Methods: This was a retrospective, multicentric, longitudinal, observational study done in patients with a diagnosis of unilat...

Aim: To report a case of unilateral acute idiopathic maculopathy (UAIM) following SARS-CoV-2 virus infection. Case description: A 44-year-old male patient, infected with SARS-CoV-2 virus previously, presented to the retina department with complaints of sudden blurring of vision in right eye. His presenting visual acuity in right eye was 20/30, N...

Purpose: To study factors leading to bridge arch-shaped subretinal fluid (SRF) on optical coherence tomography (OCT) in wet age-related macular degeneration and evaluate its anatomical and functional outcomes. Methods: In this single-center, retrospective study, patients with bridge arch-shaped SRF and choroidal neovascular membrane (CNVM) were...

Purpose: To report a case of proliferative type 2 macular telangiectasia (MacTel) treated successfully with direct laser photocoagulation to the right-angled vessel. Methods: Descriptive case report. Case description: A 61-year-old male, with no past medical history, diagnosed and treated previously elsewhere for bilateral proliferative type 2...