Journal of Evolution of medical and Dental Sciences, 2013
1. Professor, Department Of Ophthalmology, Regional Institute Of Ophthalmology Medical College, K... more 1. Professor, Department Of Ophthalmology, Regional Institute Of Ophthalmology Medical College, Kolkata 2. PhD Scholar, Department Of Ophthalmology, PGMER. 3. PhD scholar, Department Of Ophthalmology, PGMER. 4. PhD scholar, Department Of Ophthalmology, PGMER. 5. Director of Medical, Regional Institute Of Ophthalmology Medical College, Kolkata 6. Director Of Medical Education, Department of Ophthalmology, Government of Tripura.
Purpose. To assess the distribution of the 24-hour intraocular pressure (IOP) in subjects with pr... more Purpose. To assess the distribution of the 24-hour intraocular pressure (IOP) in subjects with primary openangle glaucoma (POAG) in a population-based study in rural West Bengal. Methods. All untreated POAG patients (n = 132) identified by a door to door survey in the Hugli District of West Bengal were invited to attend a follow-up study in which IOP was tested with a Goldmann Applanation tonometer at 10 AM, 1 PM, 4 PM, 7PM, 10 PM, 1 AM, and 6 AM. Results. 72 subjects with untreated POAG (72/132; 88.6%) attended the study. Of them, 59 (83.0%) had a peak IOP ≤ 21 mm Hg. The peak IOP (mean ± SD) was 16.4 ± 4.2 mm Hg. Peak IOP occurred in early morning in approximately 78.5% of the subjects (6 AM to 10 AM), and the trough occurred during night time in 72.2% of the subjects (10 PM to 1 AM). The 24-hour IOP (mean ± SD) was 14.2 ± 4.4 mm Hg and the mean fluctuation was 4.0 ± 6.8 mm Hg (range, 2–11 mm Hg). In the 32 persons with unilateral glaucoma, no significant differences were found in...
Journal of Clinical & Experimental Ophthalmology, 2019
Unutilized, enormous intracellular glucose in insulin-nondependent tissues, including retina, lea... more Unutilized, enormous intracellular glucose in insulin-nondependent tissues, including retina, leads to several consequences: (i) increased formation of advanced glycation end products, (ii) activation of polyol pathway, (iii) anaerobic glycolysis, (iv) glutamate toxicity, (v) lipid peroxidation and oxidative stress, and all of these, finally, resulting in convergence to up regulation of antigenic VEGF and VEGFR2, the crucial player in the development of DR. The purpose of the present pilot study is to assess the effects of one kind of intervention on the development of DR: supplementation of B-vitamins (B1, B2, B3, B5 and B6), vitamin C and vitamin E on amelioration of biochemical derangements related to development of DR. 400 diagnosed type 2 diabetic patients were identified for the study, of which subjects were randomised 1:1 to receive oral antidiabetic medication along with B-vitamins, vitamin C and vitamin E or only antidiabetic medication to give the study and controlled popu...
Hurler's disease, also known as mucopolysaccharidoses 1H, an autosomal recessive disease due ... more Hurler's disease, also known as mucopolysaccharidoses 1H, an autosomal recessive disease due to enzyme alpha-iduronidase deficiency has generally a spectrum of findings involving the eye, skeletal abnormality, organomegaly, joint stiffness, hernia, mental retardation and cardiovascular abnormalities. The two cases presented here are related to each other as brother of 9 years age and sister of 7 years of age with their parents had consanguineous marriage. On ocular examination in both the cases there was dense bilateral corneal opacities. Glycosaminoglycan's level was found to be 4 mg/mmol cr in the first case and 5 mg/mmol cr in the second case. In the first case no ocular treatment was planned and in the second case penetrating keratoplasty was the choice of management.
SIGNIFICANCE A differential outcome in randomized controlled trials of anti–vascular endothelial ... more SIGNIFICANCE A differential outcome in randomized controlled trials of anti–vascular endothelial growth factor (anti-VEGF) therapy, including ranibizumab, for diabetic macular edema is a major dilemma for planning, optimizing, and managing clinical usage. The variable outcome of the therapeutics necessitates the importance of finding a predictive biomarker for anti-VEGF therapy to improve subject selection. PURPOSE Our study correlates the baseline pro- and anti-VEGF isoforms and its three receptors (VEGFReceptor1, VEGFReceptor2, and VEGFReceptor3) for circulatory candidate protein molecules among diabetic patients with macular edema, with the clinical outcome of ranibizumab therapy. METHODS This study included 86 individuals who were anti-VEGF naive at the time of ascertainment but have completed the standardized therapy regimen of the clinic. Plasma proteins for pro- and anti-VEGF isoforms and its three receptors were determined in replicate by an enzyme-linked immunosorbent assay...
Purpose: Despite the disease having similar glycemic status and duration microangiopathy in some ... more Purpose: Despite the disease having similar glycemic status and duration microangiopathy in some patients develop within few years whereas it doesn't appear as a health complication in some diabetics for a considerable period. This study is undertaken to assess the hyperglycemia-induced biochemical background behind the development of diabetic retinopathy (DR) in type 2 diabetes mellitus (DM). Methods: Following proper diagnosis, 100 patients of type 2 DM of 10–12 years duration having no DR, and 42 patients of type 2 DM of the same duration and glycemic status as the second group, with mild retinopathy were recruited in the study. Lactic acid, glutamate, malondialdehyde (MDA), nitrate, advanced glycation end-products (AGEs), peripheral blood mononuclear cell reactive oxygen species (ROS), vascular endothelial growth factor (VEGF), and its receptor 2 (VEGFR2) in these two groups were produced in an assay following standard methodology. Results: Biochemical markers of anaerobic glycolysis, lipid peroxidation, AGEs, glutamate concentration, oxidative stress, and expression of VEGF and its VEGFR2 with significantly elevated markings were found in them who developed earliest stage of DR rather than them who had not. Conclusion: Hyperglycemia-induced anomalous glucose metabolism, lipid peroxidation, advanced glycation, glutamate toxicity, and oxidative stress create a background where apoptosis of retinal capillary endothelial cells invite increased expression of VEGF and VEGFR2, these being the crucial factors behind the development of diabetic microangiopathy.
Aim: To clinically analyse the various optic nerve head parameters in a rural and urban populatio... more Aim: To clinically analyse the various optic nerve head parameters in a rural and urban population in West Bengal aged over 40 years and with open angles. Materials and Methods: This research work has two arms, the rural arm is an eye care centre in Hooghly District of West Bengal (Village: Kuliapara, P.O. Dhobapara, P.S. Balagarh) and the urban arm is a tertiary eye hospital in Kolkata, West Bengal. People aged 40 years and above or those turning 40 in the calendar year and not on any topical or systemic medications underwent complete ophthalmological examination including clinical evaluation of optic nerve head with slit lamp biomicroscopy. Patients with history of intraocular surgery, ocular trauma, and corneal opacities preventing accurate applanation tonometry and media haze dense enough to preclude adequate fundal view were not enumerated. Results: The sample size analysed is 1641, making it one of the largest study of its kind in India. There is a positive correlation of VCDR...
Aplastic anaemia is pancytopenia with marrow hypocellularity. Hepatitis-associated aplastic anaem... more Aplastic anaemia is pancytopenia with marrow hypocellularity. Hepatitis-associated aplastic anaemia is a varient or aplastic anaemia that follows an acute attack of seronegative hepatitis. Here a case of hepatitis-associated aplastic anaemia presenting with sudden onset of severe simultaneous bilateral vision loss and without any other usual presenting signs is reported. Partial recovery of blood cell count occurred following immunosuppressive therapy. Posterior hyalodotmy helped rapid resolution of premacular subhyaloid haemorrhage. Although bilateral vision loss may rarely be the initial presentation of aplastic anaemia, no such report is known in hepatitis-associated aplastic anaemia. Posthepatitis vision loss needs careful investigation to exclude an underlying haematological disorder.
A 40-year-old woman presented with protrusion and diminution of vision of left eye for 3 months. ... more A 40-year-old woman presented with protrusion and diminution of vision of left eye for 3 months. CT scan of orbit revealed an intra-orbital cystic space occupying lesion. Exenteration of the left orbit was done and histopathological examination of the cystic mass proved it to be a case of hydatid cyst.
A 7 year-old boy with unilateral septic cavernous sinus thrombosis following a pyoderma in the ey... more A 7 year-old boy with unilateral septic cavernous sinus thrombosis following a pyoderma in the eyebrow is described. Problems in diagnosis and the role of magnetic resonance imaging (MRI) in the management are highlighted. Patient recovered with mild residual sequelae. The unique feature of this case was absence of chemosis and non-toxic presentation of the patient.
A 10-year-old female child attended outpatients department of Regional Institute of ophthalmology... more A 10-year-old female child attended outpatients department of Regional Institute of ophthalmology, Kolkata with the complaints of gradual dimness of vision of both eyes, recurrent pain, redness and photophobia. On examination, she was found to have bilateral anterior uveitis, poliosis and vitiligo. Laboratory tests were performed to rule out other causes of granulomatous uveitis. She was treated with topical and systemic steroids and topical cycloplegic. Then pars plana vitrectomy with lensectomy was carried out. The vision still remained poor.
A case of epidermal naevus syndrome in a 25-year-old male presenting with maldevelopment of the l... more A case of epidermal naevus syndrome in a 25-year-old male presenting with maldevelopment of the lid margin in the left eye, pigmentation of the left half of the body and alopecia is presented here along with a brief discussion of literature.
Glaucoma is the second largest blinding disorder, after cataract, affecting about 67 million peop... more Glaucoma is the second largest blinding disorder, after cataract, affecting about 67 million people worldwide. In India about 1.5 million people are blind due to glaucoma. Primary open angle glaucoma is the major sub-type of glaucoma affecting all ages and is genetically complex. Myocilin and optineurin are two different genes that have been implicated for primary open angle glaucoma. This review is focused on the studies being conducted in India on primary open angle glaucoma to identify the molecular defects and new directions undertaken using bioinformatic approaches towards a better understanding of the disease.
Diabetes is a worldwide medical problem and is a significant cause of morbidity and mortality. It... more Diabetes is a worldwide medical problem and is a significant cause of morbidity and mortality. It has considerable impact on both the patient and the society because it typically affects individuals in their most productive years. It is also one of the leading causes of blindness and visual impairment. A person with diabetes has 25 times the risk of blindness compared to a non-diabetic. This article reviews the variety of ways in which the eye and its adnexa can be involved in diabetes mellitus.
Ophthalmomyiasis is a rare condition. Here two such patients, one of 70-year-old male farmer with... more Ophthalmomyiasis is a rare condition. Here two such patients, one of 70-year-old male farmer with history of neglected trauma presented with painful swelling with sinus of right orbit and the second one of 65-year-old female destitute who presented with fungating mass near the medial canthus of left eye with pain and bleeding are reported. All the maggots were removed after applying ether.
A total number of 631 cases of orbital and para-orbital tumours causing proptosis was analysed in... more A total number of 631 cases of orbital and para-orbital tumours causing proptosis was analysed in a retrospective way in relation to age, anatomic location, histological and clinical profile. CT-scan was considered as the primary modality of investigation as it correctly delineates the extent of the tumour, integrity of bony structures and intracranial spread. Different modalities of surgery like lateral orbitotomy, medial orbitotomy, lateral rhinotomy and endoscopic excision, etc, had been performed depending upon the anatomical locations. Surgical approaches, histological types of various tumours are analysed in detail.
Stem Cell Antigen-1 or Sca-1 is a cell surface receptor protein commonly used to detect adult mur... more Stem Cell Antigen-1 or Sca-1 is a cell surface receptor protein commonly used to detect adult murine haematopoietic stem cell population. Outside the haematopoietic system Sca-1 is similarly expressed in stem and progenitor cells in a wide variety of tissues and organs such as skeletal muscle, mammary gland, prostate, heart, liver and dermis. Thus Sca-1 has become a candidate marker in the search of tissue specific stem cells. The maintenance of a healthy corneal epithelium is achieved by a unique population of stem cell located in the limbal epithelial region. This limbal epithelium mainly contains limbal epithelial stem cells and its immediate progenitor early transient amplifying cells (e-TAC) which have self renewal capacity. As stem cells in other organs have been identified by their expression of Sca-1, in our study we wanted to determine whether this antigen could be present in the limbal epithelial region which contains stem cell population by using immunofluorescence throug...
Journal of Evolution of medical and Dental Sciences, 2013
1. Professor, Department Of Ophthalmology, Regional Institute Of Ophthalmology Medical College, K... more 1. Professor, Department Of Ophthalmology, Regional Institute Of Ophthalmology Medical College, Kolkata 2. PhD Scholar, Department Of Ophthalmology, PGMER. 3. PhD scholar, Department Of Ophthalmology, PGMER. 4. PhD scholar, Department Of Ophthalmology, PGMER. 5. Director of Medical, Regional Institute Of Ophthalmology Medical College, Kolkata 6. Director Of Medical Education, Department of Ophthalmology, Government of Tripura.
Purpose. To assess the distribution of the 24-hour intraocular pressure (IOP) in subjects with pr... more Purpose. To assess the distribution of the 24-hour intraocular pressure (IOP) in subjects with primary openangle glaucoma (POAG) in a population-based study in rural West Bengal. Methods. All untreated POAG patients (n = 132) identified by a door to door survey in the Hugli District of West Bengal were invited to attend a follow-up study in which IOP was tested with a Goldmann Applanation tonometer at 10 AM, 1 PM, 4 PM, 7PM, 10 PM, 1 AM, and 6 AM. Results. 72 subjects with untreated POAG (72/132; 88.6%) attended the study. Of them, 59 (83.0%) had a peak IOP ≤ 21 mm Hg. The peak IOP (mean ± SD) was 16.4 ± 4.2 mm Hg. Peak IOP occurred in early morning in approximately 78.5% of the subjects (6 AM to 10 AM), and the trough occurred during night time in 72.2% of the subjects (10 PM to 1 AM). The 24-hour IOP (mean ± SD) was 14.2 ± 4.4 mm Hg and the mean fluctuation was 4.0 ± 6.8 mm Hg (range, 2–11 mm Hg). In the 32 persons with unilateral glaucoma, no significant differences were found in...
Journal of Clinical & Experimental Ophthalmology, 2019
Unutilized, enormous intracellular glucose in insulin-nondependent tissues, including retina, lea... more Unutilized, enormous intracellular glucose in insulin-nondependent tissues, including retina, leads to several consequences: (i) increased formation of advanced glycation end products, (ii) activation of polyol pathway, (iii) anaerobic glycolysis, (iv) glutamate toxicity, (v) lipid peroxidation and oxidative stress, and all of these, finally, resulting in convergence to up regulation of antigenic VEGF and VEGFR2, the crucial player in the development of DR. The purpose of the present pilot study is to assess the effects of one kind of intervention on the development of DR: supplementation of B-vitamins (B1, B2, B3, B5 and B6), vitamin C and vitamin E on amelioration of biochemical derangements related to development of DR. 400 diagnosed type 2 diabetic patients were identified for the study, of which subjects were randomised 1:1 to receive oral antidiabetic medication along with B-vitamins, vitamin C and vitamin E or only antidiabetic medication to give the study and controlled popu...
Hurler's disease, also known as mucopolysaccharidoses 1H, an autosomal recessive disease due ... more Hurler's disease, also known as mucopolysaccharidoses 1H, an autosomal recessive disease due to enzyme alpha-iduronidase deficiency has generally a spectrum of findings involving the eye, skeletal abnormality, organomegaly, joint stiffness, hernia, mental retardation and cardiovascular abnormalities. The two cases presented here are related to each other as brother of 9 years age and sister of 7 years of age with their parents had consanguineous marriage. On ocular examination in both the cases there was dense bilateral corneal opacities. Glycosaminoglycan's level was found to be 4 mg/mmol cr in the first case and 5 mg/mmol cr in the second case. In the first case no ocular treatment was planned and in the second case penetrating keratoplasty was the choice of management.
SIGNIFICANCE A differential outcome in randomized controlled trials of anti–vascular endothelial ... more SIGNIFICANCE A differential outcome in randomized controlled trials of anti–vascular endothelial growth factor (anti-VEGF) therapy, including ranibizumab, for diabetic macular edema is a major dilemma for planning, optimizing, and managing clinical usage. The variable outcome of the therapeutics necessitates the importance of finding a predictive biomarker for anti-VEGF therapy to improve subject selection. PURPOSE Our study correlates the baseline pro- and anti-VEGF isoforms and its three receptors (VEGFReceptor1, VEGFReceptor2, and VEGFReceptor3) for circulatory candidate protein molecules among diabetic patients with macular edema, with the clinical outcome of ranibizumab therapy. METHODS This study included 86 individuals who were anti-VEGF naive at the time of ascertainment but have completed the standardized therapy regimen of the clinic. Plasma proteins for pro- and anti-VEGF isoforms and its three receptors were determined in replicate by an enzyme-linked immunosorbent assay...
Purpose: Despite the disease having similar glycemic status and duration microangiopathy in some ... more Purpose: Despite the disease having similar glycemic status and duration microangiopathy in some patients develop within few years whereas it doesn't appear as a health complication in some diabetics for a considerable period. This study is undertaken to assess the hyperglycemia-induced biochemical background behind the development of diabetic retinopathy (DR) in type 2 diabetes mellitus (DM). Methods: Following proper diagnosis, 100 patients of type 2 DM of 10–12 years duration having no DR, and 42 patients of type 2 DM of the same duration and glycemic status as the second group, with mild retinopathy were recruited in the study. Lactic acid, glutamate, malondialdehyde (MDA), nitrate, advanced glycation end-products (AGEs), peripheral blood mononuclear cell reactive oxygen species (ROS), vascular endothelial growth factor (VEGF), and its receptor 2 (VEGFR2) in these two groups were produced in an assay following standard methodology. Results: Biochemical markers of anaerobic glycolysis, lipid peroxidation, AGEs, glutamate concentration, oxidative stress, and expression of VEGF and its VEGFR2 with significantly elevated markings were found in them who developed earliest stage of DR rather than them who had not. Conclusion: Hyperglycemia-induced anomalous glucose metabolism, lipid peroxidation, advanced glycation, glutamate toxicity, and oxidative stress create a background where apoptosis of retinal capillary endothelial cells invite increased expression of VEGF and VEGFR2, these being the crucial factors behind the development of diabetic microangiopathy.
Aim: To clinically analyse the various optic nerve head parameters in a rural and urban populatio... more Aim: To clinically analyse the various optic nerve head parameters in a rural and urban population in West Bengal aged over 40 years and with open angles. Materials and Methods: This research work has two arms, the rural arm is an eye care centre in Hooghly District of West Bengal (Village: Kuliapara, P.O. Dhobapara, P.S. Balagarh) and the urban arm is a tertiary eye hospital in Kolkata, West Bengal. People aged 40 years and above or those turning 40 in the calendar year and not on any topical or systemic medications underwent complete ophthalmological examination including clinical evaluation of optic nerve head with slit lamp biomicroscopy. Patients with history of intraocular surgery, ocular trauma, and corneal opacities preventing accurate applanation tonometry and media haze dense enough to preclude adequate fundal view were not enumerated. Results: The sample size analysed is 1641, making it one of the largest study of its kind in India. There is a positive correlation of VCDR...
Aplastic anaemia is pancytopenia with marrow hypocellularity. Hepatitis-associated aplastic anaem... more Aplastic anaemia is pancytopenia with marrow hypocellularity. Hepatitis-associated aplastic anaemia is a varient or aplastic anaemia that follows an acute attack of seronegative hepatitis. Here a case of hepatitis-associated aplastic anaemia presenting with sudden onset of severe simultaneous bilateral vision loss and without any other usual presenting signs is reported. Partial recovery of blood cell count occurred following immunosuppressive therapy. Posterior hyalodotmy helped rapid resolution of premacular subhyaloid haemorrhage. Although bilateral vision loss may rarely be the initial presentation of aplastic anaemia, no such report is known in hepatitis-associated aplastic anaemia. Posthepatitis vision loss needs careful investigation to exclude an underlying haematological disorder.
A 40-year-old woman presented with protrusion and diminution of vision of left eye for 3 months. ... more A 40-year-old woman presented with protrusion and diminution of vision of left eye for 3 months. CT scan of orbit revealed an intra-orbital cystic space occupying lesion. Exenteration of the left orbit was done and histopathological examination of the cystic mass proved it to be a case of hydatid cyst.
A 7 year-old boy with unilateral septic cavernous sinus thrombosis following a pyoderma in the ey... more A 7 year-old boy with unilateral septic cavernous sinus thrombosis following a pyoderma in the eyebrow is described. Problems in diagnosis and the role of magnetic resonance imaging (MRI) in the management are highlighted. Patient recovered with mild residual sequelae. The unique feature of this case was absence of chemosis and non-toxic presentation of the patient.
A 10-year-old female child attended outpatients department of Regional Institute of ophthalmology... more A 10-year-old female child attended outpatients department of Regional Institute of ophthalmology, Kolkata with the complaints of gradual dimness of vision of both eyes, recurrent pain, redness and photophobia. On examination, she was found to have bilateral anterior uveitis, poliosis and vitiligo. Laboratory tests were performed to rule out other causes of granulomatous uveitis. She was treated with topical and systemic steroids and topical cycloplegic. Then pars plana vitrectomy with lensectomy was carried out. The vision still remained poor.
A case of epidermal naevus syndrome in a 25-year-old male presenting with maldevelopment of the l... more A case of epidermal naevus syndrome in a 25-year-old male presenting with maldevelopment of the lid margin in the left eye, pigmentation of the left half of the body and alopecia is presented here along with a brief discussion of literature.
Glaucoma is the second largest blinding disorder, after cataract, affecting about 67 million peop... more Glaucoma is the second largest blinding disorder, after cataract, affecting about 67 million people worldwide. In India about 1.5 million people are blind due to glaucoma. Primary open angle glaucoma is the major sub-type of glaucoma affecting all ages and is genetically complex. Myocilin and optineurin are two different genes that have been implicated for primary open angle glaucoma. This review is focused on the studies being conducted in India on primary open angle glaucoma to identify the molecular defects and new directions undertaken using bioinformatic approaches towards a better understanding of the disease.
Diabetes is a worldwide medical problem and is a significant cause of morbidity and mortality. It... more Diabetes is a worldwide medical problem and is a significant cause of morbidity and mortality. It has considerable impact on both the patient and the society because it typically affects individuals in their most productive years. It is also one of the leading causes of blindness and visual impairment. A person with diabetes has 25 times the risk of blindness compared to a non-diabetic. This article reviews the variety of ways in which the eye and its adnexa can be involved in diabetes mellitus.
Ophthalmomyiasis is a rare condition. Here two such patients, one of 70-year-old male farmer with... more Ophthalmomyiasis is a rare condition. Here two such patients, one of 70-year-old male farmer with history of neglected trauma presented with painful swelling with sinus of right orbit and the second one of 65-year-old female destitute who presented with fungating mass near the medial canthus of left eye with pain and bleeding are reported. All the maggots were removed after applying ether.
A total number of 631 cases of orbital and para-orbital tumours causing proptosis was analysed in... more A total number of 631 cases of orbital and para-orbital tumours causing proptosis was analysed in a retrospective way in relation to age, anatomic location, histological and clinical profile. CT-scan was considered as the primary modality of investigation as it correctly delineates the extent of the tumour, integrity of bony structures and intracranial spread. Different modalities of surgery like lateral orbitotomy, medial orbitotomy, lateral rhinotomy and endoscopic excision, etc, had been performed depending upon the anatomical locations. Surgical approaches, histological types of various tumours are analysed in detail.
Stem Cell Antigen-1 or Sca-1 is a cell surface receptor protein commonly used to detect adult mur... more Stem Cell Antigen-1 or Sca-1 is a cell surface receptor protein commonly used to detect adult murine haematopoietic stem cell population. Outside the haematopoietic system Sca-1 is similarly expressed in stem and progenitor cells in a wide variety of tissues and organs such as skeletal muscle, mammary gland, prostate, heart, liver and dermis. Thus Sca-1 has become a candidate marker in the search of tissue specific stem cells. The maintenance of a healthy corneal epithelium is achieved by a unique population of stem cell located in the limbal epithelial region. This limbal epithelium mainly contains limbal epithelial stem cells and its immediate progenitor early transient amplifying cells (e-TAC) which have self renewal capacity. As stem cells in other organs have been identified by their expression of Sca-1, in our study we wanted to determine whether this antigen could be present in the limbal epithelial region which contains stem cell population by using immunofluorescence throug...
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Papers by Gautam Bhaduri