Publications by authors named "Chhablani J"

Wide field retinal imaging has emerged as a transformative technology over the last few decades, revolutionizing our ability to visualize the intricate landscape of the retina. By capturing expansive retinal areas, these techniques offer a panoramic view going beyond traditional imaging methods. In this review, we explore the significance of retinal imaging-based biomarkers to help diagnose ocular and systemic conditions.

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: Inherited retinal diseases (IRDs) are a genetically complex group of disorders, usually resulting in progressive vision loss due to retinal degeneration. Traditional imaging methods help in structural assessments, but limitations exist in early functional cellular-level detection that are crucial for guiding new therapies. : This review includes a systematic search of PubMed and Google Scholar for studies on advanced imaging techniques for IRDs.

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Background: To compare the characteristics of type 1 macular neovascularization (MNV) and the surrounding choriocapillaris (CC) perfusion in patients with neovascular age-related macular degeneration (nAMD) versus those with pachychoroid neovasculopathy (PNV) using swept-source optical coherence tomography angiography (SS-OCTA).

Methods: This retrospective study included 64 treatment-naïve eyes (37 nAMD, 27 PNV) with type 1 MNV. SS-OCTA images were analysed to measure MNV area and perimeter, and CC flow deficits (FD) in five concentric rings surrounding the lesion.

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Eye diseases such as age-related macular degeneration (AMD) are major causes of irreversible vision loss. Early and accurate detection of these diseases is essential for effective management. Optical coherence tomography (OCT) imaging provides clinicians with in vivo, cross-sectional views of the retina, enabling the identification of key pathological features.

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Background: Accurate localization of premacular hemorrhages (PMHs) is crucial as treatment strategies vary significantly based on whether the hemorrhage resides within the vitreous gel, subhyaloid space, or beneath the internal limiting membrane (ILM). This report outlines the clinical features, diagnostic findings, and treatment outcomes in a patient diagnosed with a PMH secondary to suspected Valsalva retinopathy.

Methods: This is a retrospective interventional case report.

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To assess the choroidal vessels in healthy eyes using a novel three-dimensional (3D) deep learning approach. In this cross-sectional retrospective study, swept-source OCT 6 × 6 mm scans on Plex Elite 9000 device were obtained. Automated segmentation of the choroidal layer was achieved using a deep-learning ResUNet model along with a volumetric smoothing approach.

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Purpose: To evaluate various supervised machine learning (ML) statistical models to predict anatomical outcomes after macular hole (MH) surgery using preoperative optical coherence tomography (OCT) features.

Methods: This retrospective study analyzed OCT data from idiopathic MH eyes at baseline and at 1-month post-surgery. The dataset was split 80:20 between training and testing.

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Diabetic vitrectomy is a highly intricate surgical procedure performed during the advanced stages of diabetic retinopathy (DR). It is used to treat conditions such as tractional or combined retinal detachment, vitreous hemorrhage, and subhyaloid hemorrhage, which are all severe manifestations of proliferative DR. The results of the surgery are uncertain and variable.

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Article Synopsis
  • Central Serous Chorioretinopathy (CSC) is characterized by retinal detachments due to fluid leakage, often linked to stress, psychiatric issues, or corticosteroid use, prompting a study to investigate BALAD as a potential biomarker for CSC severity.
  • The research involved a global case-control study of patients with CSC, assessing clinical characteristics, risk factors, and OCT findings in those with and without Bacillary Layer Detachment (BALAD) to better understand its implications in diagnosis and treatment.
  • Results showed 37 patients with CSC and BALAD, revealing distinct clinical features on examination and OCT, compared to a control group without BALAD, suggesting significant differences in the manifestation of CSC.
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Objectives: Various imaging features on optical coherence tomography (OCT) are crucial for identifying and defining disease progression. Establishing a consensus on these imaging features is essential, particularly for training deep learning models for disease classification. This study aims to analyze the inter-rater reliability in labeling the quality and common imaging signatures of retinal OCT scans.

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Pentosan polysulfate sodium (PPS) maculopathy is a recently described condition of macular toxicity. We report the prevalence (15 %), the clinical characteristics, and the multimodal imaging (MMI) features of PPS maculopathy based on a final prospective analysis of a cohort of 154 subjects and highlight the association with inflammatory bowel disease (IBD). In addition, we summarize the most recent and relevant literature on PPS maculopathy.

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Purpose: To compare short- and long-term anatomical, functional, and refractive outcomes between combined phacovitrectomy (PVS) and consecutive vitrectomy (CVS) for idiopathic macular holes (MHs). Also, to evaluate the role of preoperative optical coherence tomography (OCT) image quality in guiding surgical selection.

Methods: This retrospective study analyzed 183 phakic MH eyes operated between 2012 and 23, with patients divided into PVS and CVS groups.

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Article Synopsis
  • Hydroxychloroquine (HCQ) can cause retinal toxicity, prominently manifesting as bull's eye maculopathy, but can be confused with other conditions.
  • Identifying HCQ-related retinal toxicity is complicated due to similarities with other drug-related toxicities, genetic retinal disorders, and systemic diseases.
  • The review highlights essential clinical and diagnostic differences to aid ophthalmologists and primary care providers in accurately diagnosing HCQ retinopathy.
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Article Synopsis
  • Retinal conditions such as age-related macular degeneration (AMD) and diabetic retinopathy can significantly impair vision, leading to challenges in daily activities.
  • Central serous chorioretinopathy (CSCR) and retinal vein occlusion are also serious conditions that can result in sudden vision loss or blurriness.
  • Overall, these retinal issues not only impact eyesight but also diminish a person's overall quality of life and independence.
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Purpose: To compare the choroidal vasculature in eyes with early- and intermediate-stage age-related macular degeneration (dAMD) and healthy using a novel three-dimensional algorithm.

Methods: Patients with dAMD and healthy controls underwent clinical examinations and swept-source optical coherence tomography scans (PlexElite-9000 device) centered on the fovea. Scans with quality scores >6 were included.

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Article Synopsis
  • - The study investigates how the longest treatment-free interval (TFI) between anti-VEGF injections affects visual acuity and the recurrence of macular edema in patients with branch retinal vein occlusion (BRVO) over five years.
  • - It included 60 patients with an average age of nearly 72, finding that 72% experienced recurrence of macular edema, with significant predictors being TFI and initial visual acuity.
  • - The results suggest that longer TFIs lead to worse visual outcomes and higher rates of macular edema recurrence, indicating the need for more frequent injections in cases of severe BRVO.
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Polypoidal choroidal vasculopathy (PCV) is an aneurismal type of macular neovascularization that show similarities with age-related macular degeneration and diseases that are part of the pachychoroid disease spectrum. Exudative changes in PCV can be treated with intravitreal anti-vascular endothelial growth factor monotherapy; however, a combination therapy with photodynamic therapy may be required. In this systematic review and meta-analysis, we evaluated the efficacy of faricimab for PCV.

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Purpose: To study the outcomes of patients presenting with submacular hemorrhage (SMH) and bacillary layer detachment (BALAD) following intervention.

Methods: This retrospective study examined fundus photographs and optical coherence tomography (OCT) scans to identify treatment-naive SMH and BALAD cases. Two groups were formed: SMH cases with and without BALAD.

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Article Synopsis
  • A case study reports a rare instance of acute bacterial endophthalmitis following scleral buckling surgery using a non-contact wide-angle viewing system (WAVS) and chandelier endoillumination in a 63-year-old man.
  • The patient experienced a significant decrease in vision and ocular pain a week after surgery, with examinations revealing severe vitreous haze and infection, confirmed through a vitreous biopsy.
  • Successful treatment involved a vitreous biopsy and intravitreal antibiotics, leading to recovery of vision over six weeks, highlighting the need for clinicians to be aware of infection risks associated with this surgical method.
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  • The study investigated choroidal vascular responses in chronic central serous chorioretinopathy (CSCR) patients using optical coherence tomography (OCT) during temporary blood pressure increases from physical stress.
  • It compared CSCR patients with age-matched healthy individuals, measuring parameters like mean ocular perfusion pressure (MOPP) and choroidal thickness at rest and during hand-grip exercises.
  • Results showed CSCR patients had higher MOPP and choroidal thickness compared to controls, but unlike healthy subjects, they did not exhibit a vasoconstrictive response to stress, indicating possible impairment in their choroidal blood flow regulation.
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Caffeine, commonly found in coffee and tea, affects various aspects of eye health as it blocks adenosine receptors, impacting tear production, intraocular pressure, macular perfusion, and choroidal thickness. However, its connection with eye conditions like glaucoma and cataracts remains uncertain due to conflicting research findings. Some studies suggest potential benefits for cataracts, while others warn against frequent caffeine intake in glaucoma and surgical scenarios due to possible increases in intraocular pressure.

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The age-related macular degeneration (AMD) field is witnessing promising advancements in therapeutic options. Breakthrough drugs such as pegcetacoplan and avacincaptad have been FDA-approved for dry AMD, marking a significant development as there were no treatment options until August 2023. While several antivascular endothelial growth factor (VEGF) inhibitors have been approved for wet AMD, challenges persist with the need for frequent dosing.

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Article Synopsis
  • The study tracked the growth of geographic atrophy (GA) from age-related macular degeneration over five years in 41 eyes of 29 patients, average age 81.76.
  • Significant GA area increased from 8.44 mm² to 13.32 mm², showing an average annual growth rate of 1.14 mm².
  • Smaller and fovea-sparing GA areas had larger proportional increases, while the presence of outer retinal tubulations indicated slower progression; trends suggested faster growth in females and smokers.
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Purpose: To analyze the efficacy and safety of microsecond pulsing laser therapy (MLT) in the management of central serous chorioretinopathy (CSCR) complicated by choroidal neovascularization (CNV).

Methods: Patients with CSCR complicated by CNV defined as the presence of characteristic OCT angiography features were randomly assigned to either study or control group. All patients of the study group underwent MLT targeting CNV area using navigated laser system followed by at least 6-month follow-up.

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