ABSTRACT
Purpose@#To report a case of successful treatment of bilateral infectious keratitis combined with endophthalmitis caused by Pseudomonas aeruginosa in an immunocompromised patient.Case summary: A 66-year-old male with colon cancer and lung metastasis was referred to our clinic with ocular pain and reduced visual acuity in both eyes for 3 days. Visual acuity was “light perception” in both eyes at the first visit. On slit lamp examination, he presented with corneal central necrosis with mucopurulent discharge and anterior chamber hypopyon in both eyes. The left eye especially had vitreous haziness using a B-scan. Pseudomonas aeruginosa was detected in the corneal scrape culture and percutaneous transhepatic biliary drainage culture. After administration of topical eye drops, intravitreal injection, and systemic antibiotics, visual acuity improved from “light perception” to 20/63 in the right eye and to 20/125 in the left eye. @*Conclusions@#Although bilateral corneal ulcers combined with endophthalmitis induced by Pseudomonas aeruginosa are rare it can occur in immunocompromised patients. In the case of corneal ulcers combined with endophthalmitis, thorough ocular examinations and active treatments with intravitreal injections and systemic administration of antibiotics can help to recover vision.
ABSTRACT
Purpose@#To report a case of Behçet’s disease presenting as a macular hole with exudative retinal detachment and an examination of its mechanism.Case summary: A 19-year-old woman presented with decreased visual acuity in her right eye for a month. The visual acuity of the right eye was finger count. Inflammation was evident in the anterior chamber cells and vitreous. Optical coherence tomography revealed a macular hole with retinal detachment. Retinal vasculitis was observed in fluorescein angiography imagery. Vasculitis was well controlled with administration of 1 mg per kg oral prednisolone. Vitrectomy and internal limiting membrane (ILM) peeling were performed with ILM flap creation. The macular hole was closed after the surgery. Behçet’s disease was diagnosed based on a manifestation of genital and oral ulcers during tapering of prednisolone. Subcutaneous adalimumab has been used to control uveitis due to repeated relapse. @*Conclusions@#This is a case of Behçet’s disease initially presenting as macular hole retinal detachment. Uveitis such as that occurring with Behçet’s disease should be considered if the macular hole retinal detachment is noticed in a young patient without posterior staphyloma.
ABSTRACT
Purpose@#To report a case of Behçet’s disease presenting as a macular hole with exudative retinal detachment and an examination of its mechanism.Case summary: A 19-year-old woman presented with decreased visual acuity in her right eye for a month. The visual acuity of the right eye was finger count. Inflammation was evident in the anterior chamber cells and vitreous. Optical coherence tomography revealed a macular hole with retinal detachment. Retinal vasculitis was observed in fluorescein angiography imagery. Vasculitis was well controlled with administration of 1 mg per kg oral prednisolone. Vitrectomy and internal limiting membrane (ILM) peeling were performed with ILM flap creation. The macular hole was closed after the surgery. Behçet’s disease was diagnosed based on a manifestation of genital and oral ulcers during tapering of prednisolone. Subcutaneous adalimumab has been used to control uveitis due to repeated relapse. @*Conclusions@#This is a case of Behçet’s disease initially presenting as macular hole retinal detachment. Uveitis such as that occurring with Behçet’s disease should be considered if the macular hole retinal detachment is noticed in a young patient without posterior staphyloma.
ABSTRACT
PURPOSE: To evaluate visual acuity changes over 3 years following surgical reattachment of macular hole retinal detachment (MHRD) developed in high myopia.METHODS: A retrospective analysis was performed using the medical records of patients with highly myopic eyes who underwent pars plana vitrectomy with internal limiting membrane peeling or the internal limiting membrane flap technique for MHRD. Changes in best-corrected visual acuity (BCVA) were measured at baseline, 6 months, 1 year, 2 years, and 3 years.RESULTS: Of the 22 eyes analyzed, macular hole was closed in 13 and unclosed in nine. BCVA significantly improved from 1.61 ± 0.39 logarithm of the minimum angle of resolution (logMAR) at baseline to 1.17 ± 0.43 logMAR at 6 months and 1.33 ± 0.48 logMAR at 2 years after MHRD surgery. At 3 years, BCVA significantly decreased compared with that at 6 months, and visual improvement from baseline was not significant. BCVA and proportion of vision loss ≥0.3 logMAR were not different between the closed and unclosed macular hole groups.CONCLUSIONS: Visual improvement after surgical reattachment of MHRD in high myopia was not maintained, and favorable macular hole closure effects were not observed at 3-year follow-up.