Caracterização clínica e histopatológica de bulbos oculares de cães e gatos (2005-2015) / Clinical and histopathologic characterization of ocular bulbs in dogs and cats (2005-2015)

Objetivou-se realizar a caracterização clínica e histopatológica de bulbos oculares de cães e gatos, removidos cirurgicamente por indicação clínica, no período entre 2005-2015. Foram realizados 101 procedimentos de remoção do bulbo ocular, 93 enucleações (92%) e 8 exenterações (8%). Os procedimentos foram realizados em 80 cães, (79% dos casos) e em 21 gatos (21% dos casos). Os cães submetidos à intervenção cirúrgica apresentavam perfurações oculares (n=31, 39%), glaucoma (n=19, 24%), protrusão ocular (n=13, 16%), diagnósticos sugestivos de neoplasia (n=10, 12,5%) e outros (n=3, 2,97%). Dentre os gatos os diagnósticos clínicos compreenderam perfuração ocular (n=9, 49%), glaucoma (n=3, 14,2%), microftalmia (n=3, 14,2%), sugestivo de neoplasia (n=2, 9,5%), protrusão ocular (n=2, 9,5%) e outros (n=2, 9,5%). Vinte e sete amostras de bulbos oculares foram submetidas para avaliação histopatológica, sendo 23 provenientes de cães e quatro de gatos. Dentre as amostras de origem canina, sete exibiram achados histopatológicos compatíveis com glaucoma, sete perfurações oculares, seis neoplasias intraoculares, duas panoftalmites e um quadro de Phthisis bulbi. Nos bulbos oculares de gatos foram diagnosticadas duas neoplasias intraoculares, uma microftalmia e uma perfuração ocular. Constatou-se que o glaucoma secundário, as neoplasias e as perfurações oculares estão entre as principais causas de enucleação em cães, e associadas a alterações primárias como a ceratoconjuntivite seca e as uveítes. Estas afecções, diferentemente das neoplasias, podem ter êxito terapêutico mediante diagnóstico e tratamento precoces, prevenindo a cegueira e a remoção do bulbo ocular.(AU)

This study aimed to carry out the clinical and histopathologic characterization of ocular bulbs from dogs and cats, surgical removed as clinical indication between 2005-2015. Hundred-one procedures were performed, 93 enucleations (92%) and 8 exenterantions (8%). The procedures were performed on 80 dogs (79% of cases) and 21 cats (21% of cases). The dogs underwent to surgery had ocular perfuration (n=31, 39%), glaucoma (n=19, 24%), ocular protrusion (n=13, 16%), diagnosis suggestive of neoplasia (n=10, 12, 5%) and other (n=3, 2.97%). Among the clinical diagnosis cats comprise ocular perforation (n=9, 49%), glaucoma (n=3, 14.2%), microphthalmia (n=3, 14.2%), suggestive of neoplasia (n=2, 9.5%), ocular protrusion (n=2, 9.5%) and other (n=2, 9.5%). Twenty-seven samples of ocular bulbs were sent for histopathologic evaluation in Veterinary Pathology Laboratory, being 23 from dogs and four cats. Among the samples of dogs, seven exhibited histopathologic findings compatible with glaucoma, seven ocular perforations, six had intraocular neoplasias, two panoftalmites and condition of Phthisis bulbi. The ocular bulbs of cats received the diagnosis of two intraocular neoplasias, one microphthalmia and ocular perforation. It was found that the secondary glaucoma and ocular perforations are among the leading causes of enucleation in dogs, and associated with primary disorders such as keratoconjunctivitis sicca and uveitis. These disorders, unlike neoplasia, may have therapeutic success through early diagnosis and treatment, preventing blindness and removal of the eyeball.(AU)

A Case of Ocular Perforation by an Acupuncture Needle Directly Through the Bulbar Conjunctiva

PURPOSE: To report a case of ocular perforation by an acupuncture needle directly through the bulbar conjunctiva. CASE SUMMARY: A 62-year-old male visited our clinic with acute ocular pain and decreased vision in his left eye. He had received intraocular acupuncture therapy one day earlier. A slit-lamp examination revealed conjunctival hyperemia and vitreous prolapse at the superonasal quadrant of the bulbar conjunctiva. Grade one of anterior chamber cells was found in the left eye. Dilated fundoscopy revealed three retinal hemorrhages at the superonasal quadrant of the retina; vitreous hemorrhage and opacity were also observed. Thus, vitrectomy and injections of intravitreal antibiotics were performed. Intraoperatively, we identified the entry site, located in the superonasal retinal quadrant, immediately behind the ora serratia. At the three-month postoperative follow-up, the patient's visual acuity was 0.9 in the left eye and the retina remained flat with no postoperative complications. CONCLUSIONS: We observed a case of ocular perforation and endophthalmitis following ocular acupuncture treatment. This case illustrates the dangers of intraocular acupuncture therapy.

Ocular Perforation and Visual Field Defect Caused by an Acupuncture Needle: a Case Report

PURPOSE: To report a case of globe perforation and linear retinal tear after periocular acupuncture therapy which resulted in persistent temporal field defect with normal retinal function evidenced by multifocal electroretinogram (MERG). CASE SUMMARY: A 42-year-old female presented with decreased visual acuity and pain in her right eye after a periocular acupuncture therapy for blepharospasm. At initial presentation, the best corrected visual acuity (BCVA) was 0.08 in the injured eye and the intraocular pressure was 15 mmHg. Ultrasonography showed minimal vitreous hemorrhage and fundus examination revealed a linear retinal tear in the posterior pole sparing the macula. Consequently, barrier laser photocoagulation was performed around the lesion. The patient suffered from metamorphopsia and persistent decreased visual acuity even after 3 months. On fundus examination, epiretinal membrane with macular pucker was observed on the macula. Spectral domain optical coherence tomography (SD-OCT) revealed retinal nerve fiber layer defect with a full-thickness posterior wall tear. Multifocal electroretinogram showed normal retinal function; however, Humphrey visual field test demonstrated field defect corresponding to the injury. A 25-gauge pars plana vitrectomy was performed with membranectomy and ILM peeling. One month postoperatively, improvement in BCVA and metamorphopsia was achieved; however, the scotomata remained unchanged. CONCLUSIONS: Ocular perforation or retinal tear caused by an acupuncture needle is a rare condition that has not been reported previously in Korea. Furthermore, no case of traumatic visual field defect with preserved retinal function has been reported elsewhere. Hence, the authors present a case of isolated visual field defect without retinal dysfunction following full-thickness retinal tear caused by an acupuncture needle.

Chronic macular edema associated with extrafoveal vitreoretinal traction / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To describe an association between extrafoveal vitreoretinal traction and chronic macular edema, either diffuse (DiME) or cystoid (CME), by the use of optical coherence tomography (OCT).·METHODS: Charts and OCT findings of two patients with persistent DiME or persistent DiME accompanied by CME, both associated with extrafoveal vitreous traction membranes were analyzed. Excluded were eyes that either had another vitreoretinopathy that could affect the analysis, had undergone pars plana vitrectomy or that had been treated by intravitreal medications. An agematched normal control group for OCT (n=12) allowed for the quantification of the normal macular thicknesses.·RESULTS: One patient (one eye) following perforating ocular injury and one patient (one eye) of idiopathic origin, both with chronic macular edema refractive to conventional treatment, were found to be associated with extrafoveal vitreoretinal traction in each eye.Retinal edema that was underlying the traction site in each eye was in continuum with the central macular edema, thus manifesting as diffuse macular edema. The automatic central 6-radial lines program in the OCT enabled the detection of the traction site in one eye, while in the other eye the diagnosis was achieved only with the additional use of the Line group program.·CONCLUSION:Chronic diffuse macular edema might be related to extrafoveal vitreoretinal traction. Careful search with the diverse OCT programs should be made in order to detect extrafoveal traction sites. Further studies and a larger cohort are required to compare the efficacy of early vitrectomy or pharmacologic vitreolysis versus the current therapeutic approaches in these situations.

Inadvertent Ocular Perforation during Lid Anesthesia for Hordeolum Removal

PURPOSE: Ocular perforation during lid anesthesia is rarely reported. We describe here a case of inadvertent corneal perforation and traumatic cataract that occurred during lid anesthesia in a procedure for hordeolum removal. METHODS: A 33-year-old woman presented with a sudden visual loss of her left eye. She had undergone hordeolum removal the day before at a local clinic. On ophthalmologic examination, the cornea was perforated and the lens cortex was extruded into the anterior chamber. After cataract removal and IOL implantation, antibiotics were injected into the vitreous. RESULTS: Her final visual acuity of the left eye was 20/20. Postoperative specular microscopic examination revealed a normal-range endothelial cell count, coefficient of variation, and hexagonality despite the intracameral lidocaine injection. CONCLUSIONS: Anesthetic injection of an infected lid should be done with great caution. Although there are possibilities of corneal endothelial toxicity and endophthalmitis in case of intracameral lidocaine injection through the infected lid, yet proper management may save the patient's vision without complications.

Ocular Perforation During Reattachment Surgery for Recurrent Retinal Detachment

Ocular perforation during retinal reattachment surgery is very uncommon intraoperative complication.If globe rupture occurs, intraocular fluid leakage, ocular hypotony, and vitreous hemorrhage follow. Authors made an intraoperative ocular perforation inadvertently by scleral depressor on our patient who had a recurrent retinal detachment on his right eye. However, immediate scleral suture of the ruptured wound and balanced salt solution injection by pars plana route, and effective scleral exoplant maintained his retina anatomically flat. So, we present the case with a brief literatures review.