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  1. Article ; Online: Evolving Fuchs' uveitis - A diagnostic challenge.

    Kawali, Ankush / Sriram, Radhika / Srinivasan, Sanjay / Mahendradas, Padmamalini / Shetty, Rohit

    Indian journal of ophthalmology

    2024  

    Abstract: Purpose: To study cases of Fuchs' uveitis (FU) diagnosed as uveitis other than FU at initial visits.: Methods: A retrospective, observational chart review. Details of clinical presentation, initial diagnosis, treatment details, and follow-up before ... ...

    Abstract Purpose: To study cases of Fuchs' uveitis (FU) diagnosed as uveitis other than FU at initial visits.
    Methods: A retrospective, observational chart review. Details of clinical presentation, initial diagnosis, treatment details, and follow-up before and after the diagnosis of FU was studied.
    Result: Twenty eyes of 19 patients finally diagnosed with FU. Mean total follow-up was 39 months (range: 3-120 months, median: 30 months) and follow-up after diagnosis of FU was 18 months (range: 0-84 months, median: 11 months). Most of the cases were diagnosed with anterior plus intermediate uveitis at the presentation (n = 8, 42.1%) and received steroid treatment. Keratic precipitates (KPs) typical of FU developed after mean 5.4 months of presentation (range: 1-18 months, median: 2 months). Altered iris pattern was noted after 17 months of presentation (range: 2-70 months, median: 8.5). Vitritis of grades 1-2 was present in all eyes. Overlap of uveitis of other etiology (retinal vasculitis, presumed tubercular intermediate uveitis) was found in three patients. Systemic immune disease (systemic lupus erythematosus, pulmonary sarcoidosis) was present in two patients. No treatment for the ocular inflammation was given after the diagnosis of FU in any patient and no change in the pattern of FU was observed during further follow-up.
    Conclusion: Evolving FU may lead to misdiagnosis and mismanagement. We suggest a conservative approach, withholding steroid treatment, allowing FU to evolve, in otherwise asymptomatic patients with white eye, mild to moderate anterior chamber (AC) and vitreous inflammation, absent posterior synechiae and normal fundus examination or fundus examination suggestive of resolved uveitis.
    Language English
    Publishing date 2024-02-05
    Publishing country India
    Document type Journal Article
    ZDB-ID 187392-1
    ISSN 1998-3689 ; 0301-4738
    ISSN (online) 1998-3689
    ISSN 0301-4738
    DOI 10.4103/IJO.IJO_1151_23
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  2. Article ; Online: Hemophagocytic Lymphohistiocytosis After Dengue Fever and Its Ocular Features.

    Patil, Aditya / Mahendradas, Padmamalini / Shetty, Rohit

    JAMA ophthalmology

    2023  Volume 141, Issue 9, Page(s) e231069

    MeSH term(s) Humans ; Lymphohistiocytosis, Hemophagocytic/diagnosis ; Lymphohistiocytosis, Hemophagocytic/drug therapy ; Lymphohistiocytosis, Hemophagocytic/etiology ; Eye ; Dengue/complications ; Dengue/diagnosis
    Language English
    Publishing date 2023-09-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2701705-9
    ISSN 2168-6173 ; 2168-6165
    ISSN (online) 2168-6173
    ISSN 2168-6165
    DOI 10.1001/jamaophthalmol.2023.1069
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  3. Article ; Online: COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis.

    Sanjay, Srinivasan / Kawali, Ankush / Mahendradas, Padmamalini

    Indian journal of ophthalmology

    2023  Volume 71, Issue 5, Page(s) 2269–2272

    Abstract: A 36-year-old Asian Indian male presented with redness and pain in his right eye of 1 week duration. He was diagnosed to have right acute anterior uveitis and had a history of being admitted at a local hospital for dengue hepatitis a month earlier. He ... ...

    Abstract A 36-year-old Asian Indian male presented with redness and pain in his right eye of 1 week duration. He was diagnosed to have right acute anterior uveitis and had a history of being admitted at a local hospital for dengue hepatitis a month earlier. He had been on adalimumab 40 mg three weekly once and oral methotrexate 20 mg/week for human leucocyte antigen (HLA) B27 spondyloarthropathy and recurrent anterior uveitis. Our patient had re-activation of his anterior chamber inflammation on three distinct occasions: first, 3 weeks following recovery from coronavirus disease 2019 (COVID-19), the second after the second dose of COVID-19 vaccination, and the third after recovery from dengue fever-associated hepatitis. We propose molecular mimicry and bystander activation as the postulated mechanisms for the re-activation of his anterior uveitis. In conclusion, patients with auto-immune diseases can have recurrent ocular inflammation following COVID-19 or its vaccination or dengue fever as seen in our patient. The anterior uveitis is usually mild and responds to topical steroids. Additional immuno-suppression may not be needed. Mild ocular inflammation following vaccination should not deter individuals from getting COVID-19 vaccination.
    MeSH term(s) Humans ; Male ; Adult ; COVID-19 Vaccines/adverse effects ; Hepatitis A ; COVID-19 ; Uveitis, Anterior/diagnosis ; Uveitis, Anterior/etiology ; Inflammation ; HLA-B27 Antigen ; Hepatitis ; Vaccination/adverse effects ; Dengue/complications ; Dengue/diagnosis ; Uveitis
    Chemical Substances COVID-19 Vaccines ; HLA-B27 Antigen
    Language English
    Publishing date 2023-05-18
    Publishing country India
    Document type Case Reports ; Journal Article ; Comment
    ZDB-ID 187392-1
    ISSN 1998-3689 ; 0301-4738
    ISSN (online) 1998-3689
    ISSN 0301-4738
    DOI 10.4103/ijo.IJO_2064_22
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Monitoring Weil-Felix test in epidemic retinitis.

    Kawali, Ankush / Sanjay, Srinivasan / Mahendradas, Padmamalini / Shetty, Bhujang

    Indian journal of ophthalmology

    2023  Volume 71, Issue 1, Page(s) 162–165

    Abstract: Purpose: The objective was to study the positivity of the Weil-Felix test (WFT) in epidemic retinitis (ER) during the course of the disease.: Methods: This is a retrospective, observational case series of patients diagnosed with ER and presented to a ...

    Abstract Purpose: The objective was to study the positivity of the Weil-Felix test (WFT) in epidemic retinitis (ER) during the course of the disease.
    Methods: This is a retrospective, observational case series of patients diagnosed with ER and presented to a tertiary eye care hospital in south India. Patients with positive WFT at the presentation, and who underwent a follow-up WFT during or after the resolution of ER were studied from September 2019 to March 2022. Patient's demographics, timings of clinical presentation and resolution, and investigation details with a special focus on WFT positivity and its duration were noted.
    Results: Sixteen patients were studied. Patients presented after 5 weeks of the fever (range: 2-12 weeks, median: 4). After 1-2 months, WFT was still positive in eight patients (50%). Only in one patient titers increased after 1 month, while in others, the titers decreased (n = 11) or remained the same (n = 4). Repeated tests in those patients (n = 6) after 3-4 months turned negative. Resolution of ER was seen at 1.35 months (range: 1-3 months) after the presentation. The mean duration for WFT to turn negative was 2 months from the presentation (range: 1-4 months) or 3.2 months of the fever (range: 1.5-6 months).
    Conclusion: In contrast to the reported physician's observation of increasing titers of WFT after rickettsial fever, ophthalmologists may observe decreasing WFT titers in ER. The clinical resolution of ER may precede the normalization of WFT. Follow-up WFT titers should be studied in larger series in confirmed cases of rickettsial-ER to validate the affordable and readily available WFT in India.
    MeSH term(s) Humans ; Rickettsia ; Retrospective Studies ; Epidemics ; Retinitis/epidemiology ; India/epidemiology ; Fever
    Language English
    Publishing date 2023-01-06
    Publishing country India
    Document type Observational Study ; Journal Article
    ZDB-ID 187392-1
    ISSN 1998-3689 ; 0301-4738
    ISSN (online) 1998-3689
    ISSN 0301-4738
    DOI 10.4103/ijo.IJO_902_22
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  5. Article ; Online: Moth-Eaten Appearance of the Iris in Hansen Disease.

    Mahendradas, Padmamalini / Rajendran, Jananee / Sriram, Radhika

    JAMA ophthalmology

    2023  Volume 141, Issue 11, Page(s) e232470

    MeSH term(s) Humans ; Iris ; Leprosy/diagnosis
    Language English
    Publishing date 2023-11-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2701705-9
    ISSN 2168-6173 ; 2168-6165
    ISSN (online) 2168-6173
    ISSN 2168-6165
    DOI 10.1001/jamaophthalmol.2023.2470
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  6. Article ; Online: Quantitative and comparative analysis of thermography parameters in posterior scleritis, choroiditis, and controls.

    Kawali, Ankush / Khanum, Aayesha / Mishra, Sai Bhakti / Sanjay, Srinivasan / Mahendradas, Padmamalini / Shetty, Rohit

    Indian journal of ophthalmology

    2024  

    Abstract: Purpose: To compare various ocular thermography parameters in posterior scleritis (PS), choroiditis (choroidal granuloma [CG], Vogt-Koyanagi-Harada [VKH] syndrome), central serous chorioretinopathy (CSCR), and healthy controls.: Methods: This ... ...

    Abstract Purpose: To compare various ocular thermography parameters in posterior scleritis (PS), choroiditis (choroidal granuloma [CG], Vogt-Koyanagi-Harada [VKH] syndrome), central serous chorioretinopathy (CSCR), and healthy controls.
    Methods: This retrospective, observational, comparative study evaluated cases undergoing ocular thermography between April 2017 and October 2023. The study groups included cases of PS, CG, and VKH, while the control group comprised CSCR cases and healthy individuals. Various thermography parameters were assessed, which were as follows: Ocular surface temperature (OST), central corneal temperature (CCT), average scleral temperature (ST), nasal scleral temperature (nST), temperature difference between both the eyes (Dt), and difference between scleral and corneal temperatures (ST - CCT, nST - CCT).
    Results: It was found that Dt was significantly higher in the PS group compared to the CG (P = 0.005), CSCR (P = 0.0001), and control groups (dilated control: P =0.006, undilated control: P = 0.0001). ST - CCT and nST - CCT were significantly higher in the undilated control and CSCR groups and significantly lower in the PS group. ST - CCT and nST - CCT showed less difference in the affected eyes compared to contralateral healthy eyes of PS and CG cases. OST, CCT, ST, and nST displayed statistically insignificant differences across all groups.
    Conclusion: It is advisable to focus on temperature differences between the affected and healthy eyes, or the difference between the central corneal and scleral temperature of the affected eye, utilizing parameters such as ∆t, ST - CCT, and nST - CCT. These composite parameters offer a more effective approach than individual measurements like OST, CCT, ST, and nST. Thermography can serve as a screening tool to suspect and differentiate PS.
    Language English
    Publishing date 2024-03-08
    Publishing country India
    Document type Journal Article
    ZDB-ID 187392-1
    ISSN 1998-3689 ; 0301-4738
    ISSN (online) 1998-3689
    ISSN 0301-4738
    DOI 10.4103/IJO.IJO_2830_23
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  7. Article ; Online: A COVID-19 perspective of multiple evanescent white dot syndrome (MEWDS).

    Kashyap, Himanshu / Manoharan, Anitha / Mahendradas, Padmamalini / Agarwal, Aniruddha / Majumder, Parthopratim Dutta

    Indian journal of ophthalmology

    2024  Volume 72, Issue 5, Page(s) 620–625

    Abstract: Multiple evanescent white dot syndrome (MEWDS) is a rare form of posterior uveitis characterized by involvement in the posterior pole and mid-periphery. A viral etiology that provokes an immune-mediated response has been hypothesized to be the inciting ... ...

    Abstract Multiple evanescent white dot syndrome (MEWDS) is a rare form of posterior uveitis characterized by involvement in the posterior pole and mid-periphery. A viral etiology that provokes an immune-mediated response has been hypothesized to be the inciting factor of the pathology. Recently, there has been an increase in the literature regarding new-onset uveitis and reactivation of previously diagnosed cases of uveitis following COVID-19 vaccinations. The COVID-19 vaccination has been speculated to trigger an immunomodulatory shift in recipients, resulting in an autoimmune event. MEWDS following COVID-19 vaccination was reported in 31 patients. It was most commonly observed following the first dose, affecting 15 patients, and least commonly after the booster dose, in only one patient. MEWDS-like disease following anti-SARS-CoV-2 vaccinations was reported the most in 16 cases after the Pfizer-BioNTech vaccination (BNT162b2 mRNA). Most of these cases had Primary MEWDS without any previous history of a similar event in the past.
    MeSH term(s) Humans ; COVID-19/complications ; COVID-19/epidemiology ; COVID-19 Vaccines/adverse effects ; Fluorescein Angiography/methods ; Fundus Oculi ; Tomography, Optical Coherence ; Uveitis, Posterior/diagnosis ; Uveitis, Posterior/virology ; White Dot Syndromes/diagnosis
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2024-01-08
    Publishing country India
    Document type Journal Article
    ZDB-ID 187392-1
    ISSN 1998-3689 ; 0301-4738
    ISSN (online) 1998-3689
    ISSN 0301-4738
    DOI 10.4103/IJO.IJO_2029_23
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  8. Article ; Online: Choroidal and central macular thickness before and after treatment in post fever retinitis.

    Sanjay, Srinivasan / Acharya, Isha / Kawali, Ankush / Chitturi, Sai Prashanti / Mahendradas, Padmamalini

    Indian journal of ophthalmology

    2024  Volume 72, Issue 5, Page(s) 728–734

    Abstract: Purpose: To study the choroidal thickness (CT) and central macular thickness (CMT) in post-fever retinitis (PFR) and their correlation with visual acuity and treatment.: Methods: A retrospective, observational study of patients presenting with PFR ... ...

    Abstract Purpose: To study the choroidal thickness (CT) and central macular thickness (CMT) in post-fever retinitis (PFR) and their correlation with visual acuity and treatment.
    Methods: A retrospective, observational study of patients presenting with PFR from 2013 to 2021 and with spectral domain optical coherence tomography (SD-OCT) (Heidelberg®, SpectralisTM, Heidelberg, Germany) images were included. The CT and CMT were measured at presentation and at the final visit. The CT was measured subfoveally and at points 2000 µm superior, inferior, medial, and lateral from the fovea using the caliper tool.
    Results: Seventy-nine eyes of 65 patients were included for this study. The mean age was 39.03 (±16.00) years with female preponderance of 53.84% (n = 35). Mean follow-up duration was 30 days. Mean CT at presentation and at follow-up was 254.12 µm and 241.51 µm, respectively. CT was decreased in majority of the eyes 67.1% (n = 53) from their baseline value. Mean CMTs at presentation and final visit were 454.8 µm and 223.7 µm, respectively. Best corrected visual acuity had a positive correlation with CMT (r = 0.340; P = 0.002) and negligible correlation with CT. A significant decrease in the mean CT was noted in patients who received doxycycline either alone or in combination with a steroid as compared to those who did not receive any treatment (P < 0.001). The significance of which is unknown presently.
    Conclusion: CMT has a greater role in determining the final visual outcome than CT. CT can be reduced post-treatment with no effect on vision.
    MeSH term(s) Humans ; Female ; Retrospective Studies ; Male ; Tomography, Optical Coherence/methods ; Adult ; Choroid/pathology ; Choroid/diagnostic imaging ; Visual Acuity/physiology ; Macula Lutea/pathology ; Macula Lutea/diagnostic imaging ; Retinitis/diagnosis ; Retinitis/drug therapy ; Retinitis/physiopathology ; Follow-Up Studies ; Middle Aged ; Eye Infections, Bacterial/diagnosis ; Eye Infections, Bacterial/drug therapy ; Young Adult ; Anti-Bacterial Agents/therapeutic use ; Adolescent
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2024-04-22
    Publishing country India
    Document type Journal Article ; Observational Study
    ZDB-ID 187392-1
    ISSN 1998-3689 ; 0301-4738
    ISSN (online) 1998-3689
    ISSN 0301-4738
    DOI 10.4103/IJO.IJO_1557_23
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Systemic and Ophthalmic Manifestations of Chikungunya Fever.

    Mahendradas, Padmamalini / Patil, Aditya / Kawali, Ankush / Rathinam, Sivakumar R

    Ocular immunology and inflammation

    2023  , Page(s) 1–8

    Abstract: Purpose: Chikungunya is a re-emerging viral infection across the globe. The purpose of this article is to review the systemic and ophthalmic manifestations associated with chikungunya fever.: Method: A review of literature was conducted using online ... ...

    Abstract Purpose: Chikungunya is a re-emerging viral infection across the globe. The purpose of this article is to review the systemic and ophthalmic manifestations associated with chikungunya fever.
    Method: A review of literature was conducted using online databases.
    Results: In this report, we have reviewed the presently available literature on uveitis caused by chikungunya and highlighted the current knowledge of its clinical manifestations, imaging features, laboratory diagnostics, and the available therapeutic modalities from the systemic and ophthalmic standpoint.
    Conclusions: Ocular involvement in chikungunya infection may occur at the time of systemic manifestations or it may occur as a delayed presentation many weeks after the fever. Treatment relies on a supportive therapy for systemic illness. Treatment of ocular manifestation depends on the type of manifestations and usually includes a combination of topical and oral steroids.
    Language English
    Publishing date 2023-09-29
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1193873-0
    ISSN 1744-5078 ; 0927-3948
    ISSN (online) 1744-5078
    ISSN 0927-3948
    DOI 10.1080/09273948.2023.2260464
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  10. Article ; Online: Monitoring of Weil-Felix test in epidemic retinitis: An update.

    Kawali, Ankush / Patil, Aditya / Mahendradas, Padmamalini / Sanjay, Srinivasan / Shetty, Bhujang

    Indian journal of ophthalmology

    2023  Volume 71, Issue 6, Page(s) 2615–2616

    MeSH term(s) Humans ; Epidemics ; Retinitis ; Typhus, Epidemic Louse-Borne
    Language English
    Publishing date 2023-06-15
    Publishing country India
    Document type Letter
    ZDB-ID 187392-1
    ISSN 1998-3689 ; 0301-4738
    ISSN (online) 1998-3689
    ISSN 0301-4738
    DOI 10.4103/IJO.IJO_500_23
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