Publications by authors named "Rupesh Agrawal"
Introduction: The left atrium (LA) dilates and its function decreases as a chronic secondary change in hypertrophic cardiomyopathy (HCM). LA strain is a more sensitive measure of LV filling pressure than LA volume and can be used to predict the functional capacity in HCM.
Objective: To analyze LA strain in patients with HCM and its correlation with exercise tolerance.
Early versus delayed timing of vitrectomy after open-globe injury.
Cochrane Database Syst Rev
November 2024
Article Synopsis
- This protocol outlines a Cochrane Review focused on the timing of vitrectomy following open-globe injuries.
- The main goal is to compare the effects of performing the surgery early versus later on patients' visual outcomes.
- The review aims to provide evidence that could guide clinical decisions regarding the optimal timing for vitrectomy in such cases.
Introduction: With technological advancements and the growing prevalence of smartphones, ophthalmology has opportunely harnessed medical technology for visual function assessment as a home monitoring tool for patients. Ophthalmology applications that offer these have likewise become more readily available in recent years, which may be used for early detection and monitoring of eye conditions. To date, no review has been done to evaluate and compare the utility of these apps.
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- 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.
Article Synopsis
- Cytomegalovirus retinitis (CMVR) is a major cause of blindness in advanced AIDS patients, with varied treatment approaches due to the lack of established guidelines.
- A review of 59 studies revealed an 18% improvement in visual acuity and a 90% rate of inflammation resolution, with ganciclovir being the most commonly used antiviral treatment.
- Notably, patients on antiretroviral therapy (ART) had a significantly lower recurrence rate of inflammation compared to those not on ART, and the most common side effect reported was neutropenia related to ganciclovir.
Article Synopsis
- - The study aims to compare the retinal and choroidal structures and microvascular health between individuals with mild to moderate traumatic brain injury (TBI) and healthy controls using optical coherence tomography (OCT) and OCT angiography (OCTA).
- - Results show significant reductions in certain OCTA parameters, including the foveal avascular zone circularity and macular vessel density in TBI patients, particularly those also experiencing posttraumatic stress disorder.
- - The choroidal vascularity index demonstrated potential for indicating the severity of TBI, suggesting that further research could utilize OCT and OCTA as non-invasive tools to monitor retinal and choroidal changes in TBI patients.
Article Synopsis
- Patients with severe mitral stenosis and left atrial appendage inactivity have elevated levels of procoagulants and fibrinogen, indicating a hypercoagulable state, similar to those with atrial fibrillation.* -
- The study involved 35 patients with severe mitral stenosis compared to 35 healthy controls, analyzing their echocardiography results and blood samples for procoagulant levels.* -
- Results showed significantly higher levels of various procoagulants in patients, suggesting the need for further consideration of oral anticoagulant usage in this group.*
Article Synopsis
- - The survey, developed by the International Uveitis Study Group, aimed to assess how uveitis and retina specialists use current terminology and multimodal imaging (MMI) for diagnosing white dot syndromes (WDS).
- - Out of 432 initial respondents, 263 completed the survey, revealing that most participants specialize in uveitis and utilize MMI, with nearly 90% using it for WDS diagnosis but showing varied usage of the term WDS.
- - The findings suggest a strong consensus among specialists for redefining WDS based on anatomical location rather than the current clinical term, emphasizing MMI's role in enhancing diagnostic precision.
Article Synopsis
- The study aimed to assess visual outcomes and prognostic factors in patients with bird beak eye injuries in South India.
- A detailed examination of patient demographics and injury characteristics was conducted, followed by assessments of visual acuity during follow-up.
- Significant visual improvements were observed post-treatment, but timely intervention was crucial, as delays or multiple surgeries negatively affected recovery, highlighting the need for public awareness to prevent such injuries.
Article Synopsis
- Frontotemporal dementia (FTD) is a neurodegenerative disorder affecting brain areas linked to cognition and personality, and this study aimed to explore retinal and choroidal changes in FTD patients compared to cognitively normal individuals using specialized imaging techniques.
- The study involved analyzing various retinal imaging parameters in 19 FTD patients and 48 control participants, using methods like optical coherence tomography (OCT) and OCT angiography (OCTA) to assess differences in retinal tissue and blood flow.
- Results indicated significant reductions in macular perfusion density and vessel density in FTD patients, suggesting that retinal changes could serve as potential biomarkers for early detection of FTD, warranting further research using noninvasive imaging techniques.
Article Synopsis
- Choroidal vascularity index (CVI) is used to evaluate the choroid in various diseases, but this study focuses on its relation to natural aging by examining 309 healthy individuals aged 20 to over 70.
- The study found that CVI is highest in the central area of the retina compared to the periphery, yet it does not significantly change with age, despite certain choroidal area parameters declining as one gets older.
- This research established a normative database of CVI and other choroidal metrics, aiding in differentiating between normal aging and pathological changes in future studies.
Article Synopsis
- This study is the first of its kind to statistically assess how well the Collaborative Ocular Tuberculosis Study (COTS) calculator predicts the need for antitubercular therapy (ATT) in patients with suspected tubercular uveitis (TBU) in an international setting.
- The main goal was to determine if a score of 4 or higher on the COTS calculator effectively guides the initiation of ATT.
- Results showed that among 492 participants, 45.7% received a high probability for ATT initiation, and the COTS-5 score showed the highest specificity at 88.7%, suggesting its effectiveness compared to clinician judgment.
Artificial Intelligence (AI) is transforming systematic reviews (SRs) in health research by automating processes such as study screening, data extraction, and quality assessment. This perspective highlights recent advancements in AI tools that enhance efficiency and accuracy in SRs. It discusses the benefits, challenges, and future directions of AI integration, emphasising the need for human oversight to ensure the reliability of AI outputs in evidence synthesis and decision-making in healthcare.
View Article and Find Full Text PDFBackground: Visual acuity (VA) represents a fundamental measure of visual function. The significant prevalence of underdiagnosed ocular disorders underscores the importance of effective VA assessment. This study evaluates the efficacy of a web-based VA assessment tool ("PocDoc") versus conventional VA testing.
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- - IL-6 inhibitors are emerging as effective treatments for non-infectious uveitis (NIU) that doesn't respond well to standard therapies, addressing key issues like inflammation and vision loss.
- - Review studies highlight that these biologic agents have succeeded in reducing inflammation in 34% to 88% of patients and decreasing dependency on corticosteroids by about 55%.
- - Although results are promising, showing improvements in visual acuity and macular edema, more research is necessary to confirm the long-term safety and effectiveness of IL-6 inhibitors in uveitis management.
Article Synopsis
- Intermediate uveitis involves inflammation of the vitreous and pars planitis, which can stem from various causes including infections, systemic diseases, or may be idiopathic (unknown origin).
- The specific term "pars planitis" refers to the idiopathic form characterized by distinctive findings like snowballs and snowbanks in the eye.
- Diagnosis relies on recognizing symptoms (like floaters) and conducting a thorough eye examination, while advanced techniques like PCR testing help identify underlying infectious or neoplastic causes.
Article Synopsis
- - The study investigated sympathetic ophthalmia (SO) by examining its incidence, timing, causes, and associated visual outcomes following intraocular procedures, using data from multiple cohorts between 2017 and 2021.
- - A total of 159 patients were identified with SO, with the median time from the inciting event to SO being 151 days; notably, only two patients developed SO after open globe trauma, while none occurred after vitrectomy.
- - Visual outcomes were poor, especially for the inciting eye, highlighting the importance of early diagnosis and treatment to improve vision in the sympathizing eye.
Article Synopsis
- Sarcoidosis and tuberculosis (TB) are similar granulomatous diseases that can cause uveitis, prompting a study of inflammation-related proteins in serum from patients in the Netherlands (sarcoidosis) and Indonesia (TB).
- Researchers found 192 proteins unique to sarcoidosis and 102 unique to active pulmonary TB when compared to healthy controls, but noted overlapping immune pathways in both diseases.
- A specific B-lymphocyte activation signature linked to sarcoidosis was identified, distinguishing it from TB, indicating that B-cell signaling differences are a crucial immunological factor between the two conditions.
Article Synopsis
- 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.
Article Synopsis
- Retinal detachment from eye trauma (TrRD) is a major cause of blindness and visual impairment globally, with diagnosis dependent on trauma history.
- The conditions leading to TrRD include various incidents such as workplace injuries, sports accidents, and road traffic collisions.
- There is a lack of detailed discussion in existing literature on the underlying causes, treatment, and results of TrRD, prompting a thorough review of these aspects in the current study.
Article Synopsis
- * Timely surgical intervention is crucial to reduce the risk of serious complications like endophthalmitis, which can affect visual outcomes.
- * A review of 15 studies showed that repairs done within 24 hours significantly lowered the odds of endophthalmitis, but visual outcomes were similar regardless of repair timing.