Sankara Nethralaya is a not-for-profit missionary institution for ophthalmic care (i.e., an eye hospital) headquartered in Chennai, India. In the name "Sankara Nethralaya", "Sankara" is a reference to Adi Shankaracharya and "Nethralaya" means "The Temple of the Eye". Sankara Nethralaya receives patients from India and abroad. Sankara Nethralaya has over 1000 employees and serves around 1500 patients per day, performing over 100 surgeries per day. The annual revenue as per the taxes is close to US$100 million.Sankara Nethralaya was rated among the top four ophthalmic institutions worldwide in 2020 by Newsweek. Nani A. Palkivala, former Indian ambassador to United States, described Sankara Nethralaya as the "Best managed charitable organization in India".
To compare automated and manual quantification of retinal haemorrhages in eyes with diabetic retinopathy (DR) and to analyse the risk of progression to proliferative DR (PDR). Retinal haemorrhages on ultra-widefield (UWF) pseudocolor images in eyes with non-proliferative diabetic retinopathy (NPDR) were manually segmented. DR severity was assessed within the seven ETDRS fields at baseline and 1-year follow-up. Lesions were also automatically segmented using EyeRead UWF software (Eyenuk) and the frequency and area of retinal haemorrhages and the average distance of haemorrhages from the optic nerve centre were computed. Manual and automated results were compared and correlated with progression to PDR at one year. Sixty-three eyes with NPDR at baseline were included, of which 29 progressed to PDR over one year. The automated measurements of total haemorrhage frequency, area and the distance from the optic nerve were significantly lower compared to manual grading, but the parameters were significantly correlated (r = 0.5–0.96; all P < 0.001). The distance of the haemorrhages from the optic nerve was found to be a significant risk factor for progression to proliferative DR from both approaches. Automated detection of retinal haemorrhages may serve as a surrogate to the manual grading in predicting the progression to PDR. Although the automated approach detects a lower number of lesions compared to manual grading, the results are correlated and the automatically determined parameters are still predictive of progression.
To describe the clinical and multimodal imaging characteristics of congenital grouped albinotic spots (CGAS) and to explore their functional implications using full-field electroretinography (ERG). Two patients with incidentally detected CGAS underwent comprehensive ophthalmic examination, including best-corrected visual acuity, refraction, dilated fundus evaluation, swept-source optical coherence tomography (SSOCT), fundus autofluorescence (FAF) imaging, and full-field ERG. Longitudinal follow-up was available for one case over 7 years. Clinical and imaging findings were qualitatively compared with previously reported CGAS features and with differential diagnoses of flecked retina disorders. Both patients demonstrated numerous, bilaterally symmetrical, flat hypopigmented lesions that were small and round at the posterior pole, sparing the fovea and larger, linear, and radially oriented in the periphery. FAF showed striking hyperautofluorescence corresponding to the hypopigmented patches. SSOCT in both cases showed preserved foveal contour, normal retinal architecture, and intact RPE–photoreceptor complex. Visual acuity was 20/20 in both patients at last examination, after refractive correction. ERG responses were largely within normal reference limits, although each case exhibited minimally reduced photopic responses. CGAS represents a benign, nonprogressive RPE abnormality with characteristic peripheral hypopigmented spots that are paradoxically hyperautofluorescent on FAF and associated with preserved retinal structure and good visual function. FAF and OCT are valuable, non-invasive tools for confirming the diagnosis, delineating lesion extent, and distinguishing CGAS from inherited flecked-retina dystrophies. Additional case series and genetic studies are warranted to clarify underlying mechanisms and potential associations.
