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Textbook of

Vitreoretinal Diseases

and Surgery

Textbook of

Vitreoretinal Diseases

and Surgery

Chief Editors

S Natarajan DO FMRF

Chief Managing Director

Aditya Jyot Eye Hospital Pvt Ltd

Mumbai, India

Nazimul Hussain MD DNB

Consultant Ophthalmologist

Vitreoretinal Specialist

Al Zahra Hospital

Sharjah, United Arab Emirates

Co-Editor

Supriya Dabir MD DNB

Vitreoretinal Consultant

Aditya Jyot Eye Hospital Pvt Ltd

Mumbai, India

Foreword

SS Badrinath and Tarun Sharma

®

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Textbook of Vitreoretinal Diseases and Surgery

© 2009, Jaypee Brothers Medical Publishers

All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.

This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters to be settled under Delhi jurisdiction only.

First Edition: 2009

ISBN 978-81-8448-619-3

Typeset at JPBMP typesetting unit

Printed at Ajanta Offset

Contributors

Stefan Mennel MD

Department of Ophthalmology

Philipps-University Marburg

Robert-Koch-Sector 4, 35037

Marburg, Germany

Jörg C Schmidt MD

Department of Ophthalmology

Philipps-University Marburg

Robert-Koch-Sector 4, 35037

Marburg, Germany

Kuan-Jen Chen MD

Department of Ophthalmology

Chang Gung Memorial Hospital

Chang Gung University

Taiwan

Nan-Kai Wang MD

Lecturer and

Attending Staff

Department of Ophthalmology

Chang Gung Memorial Hospital

Chang Gung University

Taiwan

Wei-Chi Wu MD PhD

Associate Professor and

Attending Staff

Department of Ophthalmology

Chang Gung Memorial Hospital

Chang Gung University

Taiwan

Yih-Shiou Hwang MD

Lecturer and Attending Staff

Department of Ophthalmology

Chang Gung Memorial Hospital

Chang Gung University

Taiwan

Ling Yeung MD

Lecturer and Attending Staff

Department of Ophthalmology

Chang Gung Memorial Hospital

Chang Gung University

Taiwan

Chi-Chun Lai MD

Associate Professor and

Director of Retina

Department of Ophthalmology

Chang Gung Memorial Hospital

Chang Gung University

Taiwan

Hemanth Murthy MD

Retina Institute of Karnataka

Bengaluru, Karnataka, India

KS Sriprakash MS

Superintendent and Chief of

Vitreoretinal Surgery

Minto Eye Hospital

Bengaluru Medical College and

Research Centre

Bengaluru 560 002

Karnataka, India

Rajesh B Babu MS

Consultant, Uveitis and Ocular

Immunology

Narayana Nethralaya

Bengaluru, Karnataka, India

Rajvardhan Azad MD FRCS FAMS

Chief, Vitreoretinal Services Dr RP Centre for Ophthalmic Sciences AIIMS, New Delhi, India

Avinash Pathengay FRCS

Consultant

Retina Vitreous Services

LV Prasad Eye Institute GMR Varalakshmi Campus Visakhapatnam

Andhra Pradesh, India

Mayur Morekar MD

Consultant

Uvea and Immunology

LV Prasad Eye Institute Kallam Anji Reddy Campus Banjara Hills, Hyderabad Andhra Pradesh, India

Ramesh Murthy MD FRCS

Consultant, Pediatric

Ophthalmology and Strabismus

Oculoplasty and Ocular Oncology

LV Prasad Eye Institute

LV Prasad Marg, Hyderabad

Andhra Pradesh, India

Sima Das MS

Consultant, Pediatric

Ophthalmology and Strabismus

Oculoplasty and Ocular Oncology

LV Prasad Eye Institute

LV Prasad Marg, Hyderabad

Andhra Pradesh, India

Santosh G Honavar MD FACS

Director and Head

Oculoplasty and Ocular Oncology

LV Prasad Eye Institute

LV Prasad Marg, Hyderabad

Andhra Pradesh, India

Pramod S Bhende MS

Consultant, Sankara Nethralaya

18 College Road, Chennai

Tamil Nadu, India

Chintamani Madhav Khare MS

Consultant, Sankara Nethralaya

18 College Road, Chennai

Tamil Nadu, India

Yashoda Ghanekar PhD

Cell Biologists

Pune, Maharashtra, India

Nazimul Hussain MS DNB

Consultant Ophthalmologist

Vitreoretinal Specialist

Al Zahra Hospital, PO Box 3499

Sharjah, UAE

S Natarajan DO

Chairman and Managing Director

Aditya Jyot Eye Hospital Pvt Ltd

Mumbai, Maharashtra, India

Textbook of Vitreoretinal Diseases and Surgery

Soumen Mondal MD

Jatinder Singh

Saumil Sheth MD FRCS

Aditya Jyot Eye Hospital Pvt Ltd

Aravind Eye Hospital

Consultant Vitreoretinal Specialist

Mumbai, Maharashtra, India

Madurai, Tamil Nadu, India

Aditya Jyot Eye Hospital

Hemanth Trehan MD

Ramasamy Kim

Mumbai, Maharashtra, India

 

Aravind Eye Hospital

Bharat Ramchandani MD

Consultant Ophthalmologists

Madurai, Tamil Nadu, India

Aravind Eye Hospital

Command Hospital

 

Bengaluru, Karnataka, India

P Namperumalsamy

Madurai, Tamil Nadu, India

 

 

Saritha Katta PhD

Kallam Anji Molecular Genetics

Laboratory, LV Prasad Eye Institute

Hyderabad, Andhra Pradesh, India

Subhabrata Chakrabarti PhD

Scientist, Kallam Anji Molecular

Genetics Laboratory, LV Prasad Eye

Institute, Hyderabad

Andhra Pradesh, India

Inderjeet Kaur PhD

Scientist, Kallam Anji Molecular

Genetics Laboratory, LV Prasad Eye

Institute, Hyderabad

Andhra Pradesh, India

Supriya Dabir MD

Vitreoretinal Consultant

Aditya Jyot Eye Hospital

Mumbai, Maharashtra, India

Anjli Hussain MD

Medical Retina and ROP Specialist

UAE

Anand Rajendran

Aravind Eye Hospital

Madurai, Tamil Nadu, India

Dhananjay Shukla

Aravind Eye Hospital

Madurai, Tamil Nadu, India

Aravind Eye Hospital

Madurai, Tamil Nadu, India

Emmett T Cunningham Jr

Aravind Eye Hospital

Madurai, Tamil Nadu, India

Ashad Sivram DO

Aditya Jyot Eye Hospital

Mumbai, Maharashtra, India

Abhijit Datta MD

Aditya Jyot Eye Hospital

Mumbai, Maharashtra, India

Angshuman Mukherjee DO DNB

Aditya Jyot Eye Hospital

Mumbai, Maharashtra, India

Anirudha Maiti MD

Aditya Jyot Eye Hospital

Mumbai, Maharashtra, India

Anupam Malpani MD

Visiting Consultant

Aditya Jyot Eye Hospital

Mumbai, Maharashtra, India

Dharmesh Kar MD

Aditya Jyot Eye Hospital

Mumbai, Maharashtra, India

Deepak Agarwal

Aravind Eye Hospital

Madurai, Tamil Nadu, India

Anuradha Dhawan

Aravind Eye Hospital

Madurai, Tamil Nadu, India

Tunji Qluleye

Aravind Eye Hospital

Madurai, Tamil Nadu, India

Steffen Hörle

Department of Ophthalmology

Philipps-University Marburg

Robert-Koch-Sector 4, 35037

Marburg, Germany

Priyanka Doctor MS DNB

Aditya Jyot Eye Hospital Pvt Ltd

Mumbai, Maharashtra, India

Ajay Dudani MD

Associate Professor

KJ Somaiya Medical College and

Hospital, Mumbai

Maharashtra, India

Padmini P Badle

KJ Somaiya Medical College and

Hospital, Mumbai

Maharashtra, India

vi

Foreword

Science and technology related to medicine is a fast growing field.

Latest advances related to various diseases such as cell biology, molecular engineering, physical sciences, application of mathematics and information technology are being added up to the knowledge pool almost every year. So is true for vitreoretinal diseases, and the literature has started touching the related aspects such as genetics, stem cell research and nanotechnology.

While the thickness of the neurosensory retina is just around 200 microns, the body of knowledge on vitreoretinal diseases is gigantic. This book that summarizes the deliberations of the Textbook of Vitreoretinal Diseases and Surgery takes us to a further level of understanding the current concepts in the diagnosis and management of diseases affecting retina.

Starting with the first chapter on genetics of age-related macular degeneration with such intricately woven information on the latest developments and trends in twin analysis, gene mapping and screening, role of oxidative stress and inflammation, this book takes us through a journey via the various vitreoretinal diseases, which have been a topic of debate and discussion in the recent past. Delicately touching the medical and surgical aspects of adult and paediatric retinal diseases, lasers, and diagnostic modalities, the information contained in the text is vast and enormous, with the material organised as an integrated text.

Written by the experts in the field, each of the twenty-three chapters begins with an introductory note, progressing gradually into the detailed but concise and up-to-date knowledge with well illustrated figures, legends and references, to impart a visual impact on the reader. As a result, the text presents factual and concise package and expert perspective with the latest in the field.

We wish to congratulate Chief Editors, Dr S Natarajan and Dr Nazimul Hussain and the Co-Editor Dr Supriya Dabir, who undoubtedly have presented the information in the book with a focused approach guided by their immense experience in academics.

The book will be a useful guide to the clinicians, scientists and students. It appears as a complete quantum of basic, medical and surgical information, garnished with molecular genetics and stem cell flavors.

SS Badrinath FRCSEd

Tarun Sharma MD FRCSEd MBA

President

Director

Medical Research Foundation

Shri Bhagwan Mahavir Vitreoretinal Services

Chairman Emeritus

Director, Fund Raising

Sankara Nethralaya

Medical Director, Sankara Nethralaya

Preface

After the great triumph of the 8th International Advanced Vitreoretinal Surgery Conference held in picturesque Kuala Lumpur early in 2008 with world renowned faculty, it became imperative for me to share the thoughts, speeches and ideas which made the conference a resounding success.

As the Chairman of the Scientific Committee for this conference, I feel extremely privileged to bring you this book which marks the first such successful compilation of the collection of scientific sessions with bridging plenary lectures focusing on the updates in vitreoretinal diseases.

This anthology addresses the latest treatment modalities in both medical as well as surgical retina. It also highlights the painstaking research in genetics, stem cell therapy, lasers etc. Apart from this, focus has been on the utility of various advanced diagnostic modalities in day-to-day practice.

This book is meant to cater to not only to nascent retinal surgeons but also practicing surgeons as an update to their knowledge. Since the conference limits the audience to a few, this book is meant to rejuvenate the information on the updates in the field of vitreoretinal surgery to all those unable to attend the meet.

I would like to thank all the guests and invited speakers from across the world from the bottom of my heart. Their time and contributions are greatly cherished and undoubtedly provide the icing on the academic cake. A book of this stature would be incomplete without its scientific programme and I am duty bound to felicitate all those who have provided scientific contributions. I would also like to thank and appreciate Dr Nazimul Hussain and Dr Supriya Dabir who have worked tirelessly with me and contributed immensely in completing the book.

Ultimately, they have justified the efforts of the Organising and Scientific Committees.

“A man’s learning is imperishable and a precious wealth All other possessions are less golden”

—Thirukkural-Verse 400

Thank you for granting me the privilege of serving as the Chairman of the Committee.

S Natarajan