Publications by authors named "Atul Arora"

Diabetic retinopathy (DR) is a serious microvascular complication of diabetes mellitus and may result in irreversible visual loss. Laser treatment has been the gold standard treatment for diabetic macular edema and proliferative diabetic retinopathy for many years. Of late, intravitreal therapy has emerged as a cornerstone in the management of DR.

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Article Synopsis
  • The retinal microvasculature can be visualized non-invasively, making it a promising method for detecting microvascular changes linked to systemic diseases like diabetes, hypertension, and cerebrovascular issues.
  • Research shows that structural changes in the retinal blood vessels correlate with cardiovascular risks and can predict complications and mortality from systemic hypertension.
  • There is a push for better diagnostic tools using retinal imaging, emphasizing the importance of understanding 3D vascular structures and advocating for larger, long-term studies to clarify how these retinal changes relate to various systemic health conditions.
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  • Retinal vasculitis has various causes, including infections, autoimmune disorders, and sometimes the cause is unknown, making diagnosis challenging for doctors.
  • Due to its complexity, patients often undergo extensive and sometimes unnecessary tests to identify the exact cause, which can delay effective treatment and vision preservation.
  • The article proposes an algorithmic approach that integrates clinical assessments, imaging, lab tests, and tailored investigations to ensure timely and accurate diagnosis for targeted therapy.
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Purpose: To assess the utility of pre-defined imaging biomarkers on optical coherence tomography (OCT) and OCT angiography (OCTA) in patients with diabetic macular edema (DME) following anti-vascular endothelial growth factor (anti-VEGF) therapy in determining visual and anatomical outcomes.

Methods: In this prospective, non-randomized, and interventional study, 17 patients with treatment-naive DME were included. OCT biomarkers [size/reflectivity of cysts, disorganization of retinal inner layers, integrity of ellipsoid zone or external limiting membrane, subfoveal serous retinal detachment, hyper-reflective foci (HRF)] and OCTA [vascular density (VD), foveal avascular zone (FAZ), and total micro-aneurysms in superficial capillary plexus and deep capillary plexus (DCP)] were analyzed at baseline and after three monthly intravitreal anti-VEGF injections.

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The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 was one of the most devastating public health issues in recent decades. The ophthalmology community is as concerned about the COVID-19 pandemic as the global public health community is, as COVID-19 was recognized to affect multiple organs in the human body, including the eyes, early in the course of the outbreak. Ophthalmic manifestations of COVID-19 are highly variable and could range from mild ocular surface abnormalities to potentially sight and life-threatening orbital and neuro-ophthalmic diseases.

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Till today, ocular tuberculosis (OTB) presents clinicians with significant challenges in diagnosis and management. There is no one-size-fits-all approach to a heterogeneous disease like OTB, and clinicians often have to consider a multitude of factors when initiating treatment, such as tuberculosis endemicity, the probability of a true OTB diagnosis in the setting of nonspecific ocular features, the effective duration of treatment, and the likelihood of vision-threatening complications in the patient. It is no wonder that treatment protocols are widely varied globally.

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Article Synopsis
  • Vitreous hemorrhage happens when there’s bleeding in the eye, and it can be caused by different problems like diabetes, eye injuries, or other diseases.
  • To find out if someone has vitreous hemorrhage, doctors ask questions, do exams, and might use special machines like ultrasounds.
  • Treatment can include watching the situation, using lasers, surgeries, or other injections, and the success of treatment depends on what caused the bleeding.
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Purpose: Clinical registries are increasingly important in research and clinical advancement. This review explores and compares current uveitis registries and recommends future directions on how uveitis registries can complement one another for synergistic effect and benefit.

Methods: From a systematic search, 861 citations were screened for longitudinal, non-interventional, and multicenter uveitis-specific registries.

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Endogenous endophthalmitis (EE) is an uncommon but potentially devastating ocular infection involving the inner layers of the eye. The global incidence of EE is on the rise. Common ocular signs and symptoms associated with EE include conjunctival injection, ocular pain, and reduced visual acuity.

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Immunoglobulin A nephropathy (IgAN) is a rare but important systemic disease with or without ocular manifestations. We describe 4 cases of IgAN presenting with scleritis and review the various ocular manifestations in patients with IgAN. We found 55 cases with ocular manifestations in patients with prior or newly-diagnosed IgAN described in 38 publications.

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Introduction: Ocular toxoplasmosis is the leading cause of posterior uveitis worldwide, affecting individuals acrossdifferent age groups. The key to reducing vision loss includes prompt diagnosis and treatment. However, despite the prevalence of ocular toxoplasmosis, there has been little consensus regarding its pathophysiology,clinical features, diagnosis, and especially management.

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Purpose: To describe clinical and imaging findings in a young boy presenting with bilateral rapidly progressive necrotizing macular retinitis.

Methods: A 12-year-old Asian Indian boy developed bilateral progressive macular retinitis. He had generalized tonic-clonic seizures for the past 3 months and gave a history of poor scholastic performance with dementia of recent onset.

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Purpose: To analyze the structural features of subretinal hyper-reflective material (SHRM) in posterior uveitis using swept-source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (SS-OCTA).

Methods: In this observational study, subjects with quiescent posterior uveitis and the presence of SHRM on SS-OCT were subjected to SS-OCTA to identify the presence of an intrinsic choroidal neovascular (CNV) network. OCT features were compared for SHRM harboring CNV (vascular SHRM) with those without CNV network (avascular SHRM) to identify clinical signs pointing toward the presence of CNVM inside SHRM.

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Purpose: To study the utility of MultiColor confocal scanning laser ophthalmoscope imaging (MCI) in identifying the morphology of uveitic lesions compared with conventional color fundus photography (CFP) in patients with posterior uveitis.

Methods: In this prospective observational study, subjects with posterior uveitis underwent MCI and CFP. The images obtained by the two modalities were analyzed by two independent reviewers for vitreoretinal surface abnormalities, retinal fluid and hemorrhages, and depth/location of lesions.

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Corynespora cassiicola is an environmental phytopathogen implicated in various human infections and has been isolated from one case of keratitis. We report here the first case of endophthalmitis caused by Corynespora cassiicola in a 54-year-old diabetic patient, who developed diminished vision, redness, and watering in the right eye, six weeks after intravitreal triamcinolone acetonide for non-proliferative diabetic retinopathy and macular oedema. Direct microscopy of the vitreous tap revealed septate hyphae, and culture grew white mycelium that turned olive-grey to black within two days and was confirmed as C.

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Purpose: The COVID-19 pandemic has brought medical and surgical training to a standstill across the medical sub-specialties. Closure of outpatient services and postponement of elective surgical procedures have dried up opportunities for training vitreoretinal trainees across the country. This "loss" has adversely impacted trainees' morale and mental health, leading to feelings of uncertainty and anxiety.

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Purpose: To report recurrence of tubercular choroiditis following anti-SARS-CoV-2 vaccination in two patients with quiescent disease activity for more than a year.

Methods: Retrospective observational case reports.

Results: Two patients (one female and one male) under follow-up for posterior uveitis having stable course with absence of ocular inflammation for more than a year presented with recurrence of choroiditis lesions 2-6 weeks following anti-SARS-CoV-2 vaccination.

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