ABSTRACT
A 38 years male, admitted in the department of Internal Medicine with a history of snake bite in his left lower leg during agriculture work. He was treated with anti snake venom after admission. He had history of dimness of vision in both eyes. On examination, swelling and subcutaneous hemorrhage was noted in his left leg. His best corrected visual acuity (BCVA) was 6/60 in the both eyes. Fundus examination with 90 D lens and Indirect Ophthalmoscopy of both eyes showed retinal hemorrhage with cotton wool spots. Blood tests revealed increased titers of D-dimer and fibrin degradation products. The patient was followed up regularly at 2 weeks interval and BCVA and Fundus examination was carried out. At the end of 10 weeks, retinal hemorrhages had significantly cleared in both eyes with improvement of vision in both eyes (BCVA of right eye at last follow-up 6/6 and left eye 6/9).
ABSTRACT
PURPOSE: To present a case of a single isolated cotton-wool spot in a healthy patient. CASE SUMMARY: A 43-year-old woman with no systemic disease complained of sudden inferior field defect of the right eye. On fundoscopic examination of the right eye, a single soft white spot was observed in the superotemporal vascular arcade. An elevated hyper-reflective area in the inner retina corresponding to a white spot was observed on optical coherence tomography. Automated perimetry revealed an arcuate field defect which was wider than the cotton-wool spot. A complete workup for systemic diseases was within normal range except a positive rheumatoid factor. At the 2-week follow-up, the patient's subjective symptom improved and the white spot decreased. After 6 months, the cotton-wool spot disappeared and slit-like retinal nerve fiber layer (RNFL) defects corresponding to the location of the cotton-wool spot was noticed. One year later, disc and RNFL defect were unchanged but the previous field defect disappeared. CONCLUSIONS: Isolated cotton-wool spots can occur without serious systemic diseases in healthy patients. A single isolated cotton-wool spot in the present case disappeared spontaneously leaving permanent structural damage on the retina over time.
Subject(s)
Adult , Female , Humans , Dental Caries , Eye , Follow-Up Studies , Nerve Fibers , Reference Values , Retina , Retinaldehyde , Rheumatoid Factor , Tomography, Optical Coherence , Visual Field TestsABSTRACT
PURPOSE: To present a case of a single isolated cotton-wool spot in a healthy patient. CASE SUMMARY: A 43-year-old woman with no systemic disease complained of sudden inferior field defect of the right eye. On fundoscopic examination of the right eye, a single soft white spot was observed in the superotemporal vascular arcade. An elevated hyper-reflective area in the inner retina corresponding to a white spot was observed on optical coherence tomography. Automated perimetry revealed an arcuate field defect which was wider than the cotton-wool spot. A complete workup for systemic diseases was within normal range except a positive rheumatoid factor. At the 2-week follow-up, the patient's subjective symptom improved and the white spot decreased. After 6 months, the cotton-wool spot disappeared and slit-like retinal nerve fiber layer (RNFL) defects corresponding to the location of the cotton-wool spot was noticed. One year later, disc and RNFL defect were unchanged but the previous field defect disappeared. CONCLUSIONS: Isolated cotton-wool spots can occur without serious systemic diseases in healthy patients. A single isolated cotton-wool spot in the present case disappeared spontaneously leaving permanent structural damage on the retina over time.
Subject(s)
Adult , Female , Humans , Dental Caries , Eye , Follow-Up Studies , Nerve Fibers , Reference Values , Retina , Retinaldehyde , Rheumatoid Factor , Tomography, Optical Coherence , Visual Field TestsABSTRACT
PURPOSE: We report a case of Purtscher-like retinopathy following the removal of a dislocated IOL and scleral fixation of a new IOL. METHODS: A 60-year-old man presented with sudden visual loss of the right eye. An ophthalmologic examination revealed IOL dislocation. He underwent removal of the dislocated IOL and scleral fixation of the new IOL. Visual acuity was 0.02 in the right eye on the second postoperative day. A fundus examination and fluorescein angiography were performed. RESULTS: A peripapillary multiple cotton wool spot, pale macula and cherry red spot were noted in the right eye. Fluorescein angiography showed arteriolar obstruction around the macula and leakage of the mild arteriolar fluorescein dye. At one month follow-up, macular edema, hemorrhage and peripapillary cotton wool spots were increased. CONCLUSIONS: This case of Purtscher-like retinopathy following scleral fixation of the IOL did not have any obvious etiologic cause.
Subject(s)
Humans , Middle Aged , Joint Dislocations , Fluorescein , Fluorescein Angiography , Follow-Up Studies , Hemorrhage , Macular Edema , Prunus , Visual Acuity , WoolABSTRACT
PURPOSE: We report one case of Purtscher's retinopathy related to chest compression by safety belts during motor vehicle accident. METHODS: A 31 old year man was referred to our ophthalmologic department because of diminished vision in the left eye at 6 days after motor vehicle accident. Best uncorrected visual acuity (UCVA) was right eye 1.0 and left eye 0.5. RESULTS: Best corrected visual acuity (BCVA) was both 1.0. In the left fundus there was multiple cotton wool spots, retinal hemorrhages and macular edema. At 15 days after accident, multiple cotton wool spots and retinal hemorrhages still be seen. Fluorescein angiography showed capillary nonperfusions and blocked fluorescence by retinal hemorrhages in the arteriovenous phase, leakage of dye in the region of capillary nonperfusion in the late venous phase. At 58 days after accident, multiple cotton wool spots remarkably decreased, however vision remained as 0.2. At 78 days after accident, left eye vision improved to 0.5. CONCLUSIONS: This case suggested to consider a safety belt injury as the cause of Purtscher's retinopathy.