ABSTRACT
O objetivo deste trabalho é relatar um caso de trauma ocular por projétil de arma de fogo, que atingiu e se alojou na cavidade orbitária, desenvolvendo coriorretinite esclopetária. Foram abordados o mecanismo fisiopatológico, os principais achados clínicos e de exames complementares, além das opções de tratamento. As características do caso relatado reforçam a importância de uma abordagem multidisciplinar no trauma ocular.
The objective of this study is to report a case of ocular trauma by gunshot bullet, which struck and lodged in the orbit, developing chorioretinitis sclopetaria. We also addressed the pathophysiological mechanism, the main clinical findings and laboratory tests, and treatment options. The characteristic of this case enhances the importance of a multidisciplinary approach in the ocular trauma.
Subject(s)
Humans , Male , Adult , Choroid/injuries , Chorioretinitis/diagnosis , Chorioretinitis/physiopathology , Chorioretinitis/therapy , Eye Injuries, Penetrating , Wounds, GunshotABSTRACT
Purpose: To describe the findings of fundus autofluorescence (FAF) imaging in patients with blunt ocular trauma. Methods: In this non-interventional retrospective study, we reviewed medical records and imaging examination results. The data analyzed included gender, age, laterality, trauma etiology, time between trauma and imaging, visual acuity, changes in the retinal periphery, fundus examination results, and FAF imaging findings. FAF imaging was performed using a Topcon TRC-50DX Retinal Camera (Tokyo, Japan). Results: Eight eyes from 8 patients were studied. The mean age was 27.6 years (range, 19-43 years). Men (n=7) were more frequently affected by blunt ocular trauma than women (n=1). Physical aggression was the most common trauma etiology (n=3), followed by accidents with fireworks (n=2). Other causes were car accidents (n=1), occupational trauma caused by a grinder (n=1), or being hit by a stone (n=1). Visual acuity ranged from 20/80 to light perception. Traumatic pigment epitheliopathy (TPE) was identified in 5 cases, choroidal rupture in 3 cases, subretinal hemorrhage in 3 cases, and Purtscher's retinopathy in 1 case. Hypoautofluorescence was observed in cases of choroidal rupture, recent subretinal hemorrhage, and intraretinal hemorrhage, and in two cases of TPE. Hyperautofluorescence was observed in cases of old subretinal hemorrhage and at the edge of the lesion in two cases of choroidal rupture. Mild hyperautofluorescence was observed in the posterior pole in Purtscher's retinopathy. Three cases of TPE exhibited hypoautofluorescence with diffuse hyperautofluorescent areas. Conclusion: FAF imaging is a non-invasive method for assessing changes in the posterior segment of the eye resulting from blunt ocular trauma. Furthermore, this technique provides valuable information. We described the findings of FAF imaging in cases of TPE, choroidal rupture, subretinal hemorrhage, and Purtscher's retinopathy. .
Objetivo: Descrever os achados do exame de autofluorescência do fundo de olho (AFF) em pacientes vítimas de trauma ocular contuso. Métodos: Estudo retrospectivo, não intervencionista, realizado através da revisão de prontuários e exames de imagem. Os dados analisados foram: sexo, idade, lateralidade, etiologia do trauma, tempo decorrente entre o trauma e a realização do exame, acuidade visual, alterações na periferia da retina, diagnóstico fundoscópico e achados ao exame de AFF (realizada no aparelho Topcon TRC-50DX Retinal Camera). Resultados: Oito olhos de 8 pacientes foram estudados. A idade média foi de 27,6 anos (de 19 a 43 anos), o sexo masculino (n=7) foi mais acometido do que o feminino (n=1), agressão física foi a etiologia mais comum do trauma (n=3), seguido de acidente com fogos de artifício (n=2). Outras causas foram acidente automobilístico (n=1), trauma ocupacional com lixadeira (n=1) e pedrada (n=1). A acuidade visual variou de 20/80 a percepção luminosa. Epiteliopatia pigmentar traumática (EPT ) foi identificada em 5 casos, rotura de coroide em 3, hemorragia subretiniana em 3 e retinopatia de Purtscher em 1 caso. Hipoautofluorescência foi observada nos casos de rotura de coroide, hemorragia subretiniana recente, hemorragia intrarretiniana e em 2 casos de EPT. Hiperautofluorescência foi visualizada nos casos de hemorragia subretiniana em degradação, na borda de 2 casos de roturas de coroide e discretamente no polo posterior na retinopatia de Purtcher. Três casos de EPT apresentaram hipoautofluorescência com pontos hiperautofluorescentes difusos. Conclusão: O exame de AFF permite avaliar as alterações do segmento posterior do olho decorrentes do trauma ocular contuso de forma não invasiva, somando informações valiosas. Foram descritos achados do exame ...
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Eye Injuries/diagnosis , Optical Imaging/methods , Wounds, Nonpenetrating/diagnosis , Choroid/injuries , Eye Injuries/etiology , Eye Injuries/physiopathology , Fluorescein Angiography/methods , Reproducibility of Results , Retrospective Studies , Retina/injuries , Visual Acuity/physiology , Wounds, Nonpenetrating/etiology , Wounds, Nonpenetrating/physiopathologyABSTRACT
Eighty-two-year-old patient with a pacemaker using warfarin due to arrhythmia and having an intraocular lens in the right eye, developed spontaneous hemorrhagic choroidal detachment one day after the use of combined preparation of 0.5% timolol maleate and 0.004% travoprost, due to primary open-angle glaucoma. Hemorrhagic detachment was detected by anterior and posterior segment examination, as well as B-scan ultrasonography. After the detachment, excessive increased intraocular pressure was controlled with oral carbonic anhydrase inhibitor, cycloplegic and steroid therapy. After four months, visual acuity was 20/20 and the intraocular pressure was under control with 0.5% timolol maleate and 1% brinzolamide. Controlled reduction of the intraocular pressure should be considered, particularly in older patients under anticoagulant therapy and that had undergone prior ocular surgery.
Paciente de oitenta e dois anos de idade com marca-passo e utilizando varfarina devido à arritmia cardíaca e com uma lente intraocular no olho direito, desenvolveu descolamento de hemorrágico espontâneo de coroide um dia após o uso de colírio combinado de maleato de timolol a 0,5% e travoprosta a 0,004%, devido ao glaucoma de ângulo aberto primário. O descolamento hemorrágico foi detectado por análise do segmento anterior e posterior, bem como ultrassonografia modo B. Após o descolamento, o aumento excessivo da pressão intraocular foi controlado por inibidor da anidrase carbônica via oral, terapia cicloplégica e esteroides. Após quatro meses, a acuidade visual era 20/20 e a pressão intraocular estava sob controle com o maleato de timolol a 0,5% e brinzolamida a 1%. A redução controlada da pressão intraocular deve ser considerada, especialmente em pacientes idosos sob terapia anticoagulante e que tinham sido submetidos à cirurgia ocular prévia.
Subject(s)
Aged, 80 and over , Humans , Male , Antihypertensive Agents/adverse effects , Choroid Hemorrhage/chemically induced , Choroid/injuries , Cloprostenol/analogs & derivatives , Timolol/adverse effects , Choroid Hemorrhage , Cloprostenol/adverse effects , Glaucoma/drug therapy , Intraocular Pressure/drug effects , Ophthalmic SolutionsABSTRACT
We describe complimentary imaging technologies in traumatic chorioretinal injury. Color and fundus autofluorescence [FAF] images were obtained with a non-mydriatic retinal camera. Optical coherence tomography [OCT] helped obtain detailed images of retinal structure. Microperimetry was used to evaluate the visual function. A 40-year-old man sustained blunt ocular trauma with a stone. Color fundus image showed a large chorioretinal scar in the macula. Software filters allowed detailed illustration of extensive macular fibrosis. A 58-year-old man presented with blunt force trauma with a tennis ball. Color fundus imaging showed a crescentric area of macular choroidal rupture with fibrosis. FAF imaging delineated an area of hypofluorescence greater on fundus imaging. OCT showed chorioretinal atrophy in the macula. Microperimetry delineated an absolute scotoma with no response to maximal stimuli. Fundus imaging with digital filters and FAF illustrated the full extent of chorioretinal injury, while OCT and microperimetry corroborated the structure and function correlations.
Subject(s)
Humans , Male , Adult , Middle Aged , Wounds, Nonpenetrating , Fundus Oculi , Optical Imaging , Tomography, Optical Coherence , Choroid/injuries , Retina/injuriesABSTRACT
The authors present a patient with posttraumatic choroidal neovascular membrane (CNVM) treated with PDT resulting in regression of the CNVM.
Subject(s)
Choroid/injuries , Choroidal Neovascularization/drug therapy , Eye Injuries/complications , Fluorescein Angiography , Humans , Male , Middle Aged , Photochemotherapy , Photosensitizing Agents/therapeutic use , Porphyrins/therapeutic use , Racquet Sports/injuries , Rupture , Visual Acuity , Wounds, Nonpenetrating/complicationsABSTRACT
Air-bags have received widespread support as an effective means of enhancing automotive safety, and they are becoming more common as standard automobile equipment on many cars. Although air-bag induced ocular injuries are rare, they present a serious concern because of the possibility of permanent damage or visual impairment. To date, most reports have investigated ocular injury from high velocity motor vehicle accidents and reports of ocular injury from low speed motor vehicle accidents have been rare. We describe a patient who sustained severe ocular injury, including periorbital fracture, hyphema, vitreous hemorrhage, and choroidal rupture of the macular area, due to an inflated air-bag in a low speed motor vehicle accident.
Subject(s)
Adult , Female , Humans , Accidents, Traffic , Air Bags/adverse effects , Choroid/injuries , Eye Injuries/etiology , Hyphema/etiology , Orbital Fractures/etiology , Rupture , Tomography, X-Ray Computed , Vitreous Hemorrhage/etiologySubject(s)
Retinal Detachment , Choroid/injuries , Choroid , Diagnosis, Differential , Diagnostic ImagingABSTRACT
Los traumatismos contusos del globo ocasionan frecuentemente ruptura coroides, que se asocian a diversas complicaciones tardías del polo posterior. Se presenta un caso de ruptura y neovascularización tardía de la coroides
Subject(s)
Humans , Male , Adult , Rupture/etiology , Eye Injuries/physiopathology , Choroid/injuries , Retinal Neovascularization/diagnosis , Retinal Neovascularization/etiologyABSTRACT
O objetivo deste trabalho foi estudar, através da microscopia óptica e eletrônica, lesöes cório-retinianas em olhos de coelhos, obtenidas com fotocoagulaçäo com laser de argônio via pars plana com diversas intensidades e vários intervalos de tempo. Um grupo controle de 16 animais foi submetido à facectomia e vitrectomia via pars plana. Outro grupo de 8 animais recebeu, adicionalmente, fotocoagulaçäo com laser de argônio via pars plana em olhos preenchidos com fluido ou com ar. Os estudos clínicos e histopatológicos foram realizados no primeiro, sétimo, trigésimo e nonagésimo dias de evoluçäo pós-operatória. As lesöes apresentaram proliferaçäo de células gliais e células do epitélio pigmentado. Estas mostraram um contato caracterizado pela adesäo sobre a membrana de Brüch e interdigitaçöes de vilosidades com a s células de Müller. A fotocoagulaçäo com raio laser de argônio via pars plana mostrou-se como um método fácil, rápido, seguro e reprodutível ao se utilizar uma abordagem cirúrgica interna para a produçäo de cicatrizes adesivas cório-retinianas