Evaluation of Derived Cell-Free DNA-Based Multi-Targeted Real-Time PCR from Vitreous Fluid (VF) Samples to Diagnose Ocular Tuberculosis.

Background: Ocular tuberculosis (OTB) is an important cause of vision loss in India. Rapid and accurate diagnosis of OTB is paramount to decreasing morbidity and saving the eyes from blindness. DNA present in cell-free form is expected to give a higher detection yield.

A decade-long review: insights into diagnosis and disease evolution of uveitis from a single-center study.

Purpose: To analyse the evolution of uveitis diagnosis over a 10-year period, emphasizing the change in etiological diagnosis, and the factors associated with recurrences.

Design: Retrospective chart review.

Methods: A total of 15,000 patients with uveitis presented at our tertiary care institute in North India between 1992 and 2023.

Transitioning from Teaching to Mentoring in Medical Sciences.

The transition from traditional teaching to mentoring in medical education is urgently required to create future-ready physicians, researchers, and medical teachers in India. A roadmap was drawn by the pioneers of modern medicine more than 100 years ago, who mentored and prepared the next generation of subspecialists and teachers. We need mentors rather than conventional teachers to inspire students to dream, learn, and grow.

Uveal effusion syndrome following COVID-19 vaccination.

Purpose: To report a rare case of uveal effusion syndrome following COVID-19 vaccination.

Observation: A 71-year-old Asian man presented to his ophthalmologist with blurred vision and noticing distorted lines in his left eye two weeks after the first dose of COVID-19 vaccination. Examination revealed choroidal detachment and he was advised systemic corticosteroids.

TLR9 signalling activation via direct ligation and its functional consequences in CD4 + T cells.

CpG Oligodeoxynucleotides (ODNs) are established TLR9 ligands; however, their functional responses in CD4+ T cells are believed to be independent of TLR9 and MyD88. We studied ligand-receptor interactions of ODN 2216 and TLR9 in human CD4+ T cells and assessed their consequences in terms of TLR9 signalling and cell phenotype. We demonstrated that the uptake of ODN 2216, a synthetic TLR9 agonist, is controlled by TLR9 signalling molecules and results in an increase in the expression of TLR9 signalling molecules, regulated via a feedback mechanism.

Evaluating Truenat Assay for the Diagnosis of Ocular Tuberculosis and Detection of Drug Resistance.

Background: Truenat MTB Plus assay was evaluated for diagnosing ocular tuberculosis (OTB) and detecting multi-drug resistant (MDR) and extremely-drug resistant (XDR) OTB.

Methods: A total of 75 vitreous fluid specimens [five confirmed OTB, 40 clinically suspected OTB and 30 controls] were subjected to Truenat MTB Plus, multiplex PCR, and Xpert Ultra. Chips of Truenat were used for detecting rifampicin, isoniazid, fluoroquinolone and bedaquiline resistance.

Comparative Evaluation of GeneXpert MTB/RIF Ultra and GeneXpert MTB/RIF for Detecting Tuberculosis and Identifying Rifampicin Resistance in Pars Plana Vitrectomy Samples of Patients with Ocular Tuberculosis.

Background: Xpert MTB/RIF Ultra (Ultra) was evaluated for the first time on Ocular tuberculosis (OTB) samples and compared with Xpert.

Methods: Seventy five vitreous fluid samples (3 confirmed OTB, 47 clinically suspected OTB, and 25 controls) were subjected to Ultra, Xpert and Multiplex-PCR and compared against culture, composite reference standard (CRS), and gene sequencing.

Results: The sensitivity of Ultra was 50% in diagnosing OTB (100% against culture and 46.

Detection of viable Mycobacterium tuberculosis in ocular fluids using mRNA-based multiplex polymerase chain reaction.

Purpose: Intra ocular tuberculosis (IOTB) can affect nearly any part of the eye and delayed diagnosis can result in permanent loss of vision. mRNA, with the ability to detect viable bacilli just like culture, could serve as an important tool to differentiate whether ocular manifestations of IOTB are due to active infection or hypersensitivity response to dead mycobacteria.

Methods: A total of 19 patients with suspected IOTB and 20 controls (10 patients with active inflammation but no evidence of IOTB and 10 patients with no intraocular inflammation) were included.

Effect of sustained-release long-acting intravitreal dexamethasone implant in patients of non-proliferative diabetic retinopathy undergoing phacoemulsification: A randomized controlled trial.

Purpose: Cataract and diabetes, both being a major health care problem, an intervention evaluated for the combination of the two attains paramount importance. The purpose of the study was to determine the role of intraoperative intravitreal dexamethasone implant in patients with diabetic retinopathy with/without macula edema undergoing phacoemulsification.

Methods: The study was a two-arm, single-center, randomized, assessor-blinded trial of 151 patients with type-2 diabetes mellitus and cataract.

Precise, simplified diagnostic criteria and optimised management of initial-onset Vogt-Koyanagi-Harada disease: an updated review.

Vogt-Koyanagi-Harada (VKH) disease is a primary autoimmune stromal choroiditis. This review aimed to provide a novel perspective of the disease. We took into account recent developments in the understanding of the disease and crucial progress in investigational modalities of the choroid, which has led to new, simpler diagnostic criteria.

Proteomic profile of vitreous in patients with tubercular uveitis.

Objective: To elucidate disease-specific host protein profile in vitreous fluid of patients with intraocular inflammation due to tubercular uveitis (TBU).

Methods: Vitreous samples from 13 patients with TBU (group A), 7 with non-TBU (group B) and 9 with no uveitis (group C) were analysed by shotgun proteomics using Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). Differentially expressed proteins (DEPs) were subjected to pathway analysis using WEB-based Gene SeT Analysis Toolkit software.

Protein Biomarkers in Uveitis.

The diseases affecting the retina or uvea (iris, ciliary body, or choroid) generate changes in the biochemical or protein composition of ocular fluids/tissues due to disruption of blood-retinal barrier. Ocular infections and inflammations are sight-threatening diseases associated with various infectious and non-infectious etiologies. Several etiological entities cause uveitis, a complex intraocular inflammatory disease.

Bacillary Layer Detachment in Hyper-acute Stage of Acute Posterior Multifocal Placoid Pigment Epitheliopathy: A Case Series.

Background: The term bacillary layer detachment (BLD) represents a possible separation between the myoid and ellipsoid component of the inner segment, following insult or injury to the outer retina. It has been described previously in cases of toxoplasma retinochoroiditis, central serous chorioretinopathy, Vogt Koyanagi Harada disease and trauma.

Purpose: To describe the presence of BLD in Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE).

Outcome of pars plana vitrectomy in patients with retinal detachments secondary to retinal vasculitis.

Purpose: Retinal detachments (RD) secondary to retinal vasculitis are highly complex. We report the clinical profile and outcome of vitrectomy in RDs secondary to retinal vasculitis in terms of intraoperative findings, final anatomical, and functional outcome.

Methods: In a retrospective review of 68 patients (6 with bilateral RD; 74 eyes) undergoing pars plana vitrectomy (PPV) between 2000 and 2015 for vasculitic RD, tractional RD was present in 50 (67.

Collaborative Ocular Tuberculosis Study Consensus Guidelines on the Management of Tubercular Uveitis-Report 2: Guidelines for Initiating Antitubercular Therapy in Anterior Uveitis, Intermediate Uveitis, Panuveitis, and Retinal Vasculitis.

Topic: The Collaborative Ocular Tuberculosis Study (COTS), supported by the International Ocular Inflammation Society, International Uveitis Study Group, and Foster Ocular Immunological Society, set up an international, expert-led consensus project to develop evidence- and experience-based guidelines for the management of tubercular uveitis (TBU).

Clinical Relevance: The absence of international agreement on the use of antitubercular therapy (ATT) in patients with TBU contributes to a significant heterogeneity in the approach to the management of this condition.

Methods: Consensus statements for the initiation of ATT in TBU were generated using a 2-step modified Delphi technique.