ABSTRACT
We report two cases of fulminant toxoplasmic retinochoroiditis following intravitreal triamcinolone acetonide (IVTA) administration. Case 1: A 42-year-old female received IVTA for presumed non-infectious panuveitis. Within 2 months, she developed diffuse macular retinochoroiditis with optic disc edema. Upon starting anti-toxoplasmic therapy (ATT), her intraocular inflammation resolved with catastrophic damage to the disc and macula. Case 2: A 30-year-old male received IVTA for presumed reactivation of previously scarred toxoplasmic retinochoroiditis. Despite simultaneous ATT, within 6 weeks, he developed extensive, multifocal macular retinochoroiditis. He continued to require ATT for 18 months and later underwent vitrectomy with silicone oil placement for severe epiretinal proliferation. Aqueous tap polymerase chain reactions were found positive for Toxoplasma gondii in both cases. In conclusion, IVTA administration can lead to fulminant toxoplasmic retinochoroiditis even when used with appropriate ATT. Extreme caution should be exercised while administering depot corticosteroids in eyes with panuveitis of unknown origin.
Subject(s)
Adult , Anti-Inflammatory Agents/adverse effects , Choroiditis/etiology , Choroiditis/parasitology , Female , Humans , Intravitreal Injections , Male , Opportunistic Infections/etiology , Opportunistic Infections/parasitology , Panuveitis/drug therapy , Retinitis/etiology , Retinitis/parasitology , Toxoplasmosis/etiology , Toxoplasmosis/etiology , Triamcinolone Acetonide/adverse effectsABSTRACT
The clinical features of HIV/AIDS-related ocular manifestations in Korean patients were investigated in this study. Data on 200 consecutive Korean patients diagnosed with AIDS who visited the Seoul National University Hospital from January 2003 to June 2008 were reviewed. Fifty-seven patients (28.5%) had ocular manifestations, and they showed significantly lower CD4+ T cell count than patients without ocular manifestations. Among them, 23 (40.3%) patients showed retinal microvasculopathy, and 22 (38.5%) patients showed cytomegalovirus (CMV) retinitis. Other manifestations included retinal vein occlusion (n = 4), herpes zoster ophthalmicus (n = 4), syphilitic uveitis (n = 2), acute retinal necrosis (n = 1), and progressive outer retinal necrosis (n = 1). The mean CD4+ lymphocyte counts of the patients with retinal microvasculopathy and cytomegalovirus retinitis were 108.5 cells/microL and 69.4 cells/microL, respectively. In conclusion, ocular manifestations including CMV retinitis are common complications in Korean patients with AIDS even in the era of highly active anti-retroviral therapy. Compared to previous reports in western countries, prevalence of CMV retinitis is relatively low and CD4+ lymphocytes count at the time of diagnosis is relatively high.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , AIDS-Related Opportunistic Infections/etiology , Anti-HIV Agents/therapeutic use , CD4 Lymphocyte Count , CD4-Positive T-Lymphocytes/cytology , Cytomegalovirus Retinitis/epidemiology , Eye Diseases/etiology , Eye Infections, Viral/etiology , HIV Infections/complications , Necrosis/etiology , Prevalence , Republic of Korea/epidemiology , Retinitis/etiology , Uveitis/etiologyABSTRACT
Behçet disease is an idiopathic, multisystem disorder characterized by recurrent episodes of orogenital ulceration and vasculitis of the veins and arteries of all calibers. Ocular involvement may affect the conjunctiva, sclera, uveal tract, vitreous, blood vessels, and retina. Many theories have pointed toward an autoimmune response behind its pathogenesis, which may be triggered by exposure to an infectious agent. Frosted branch angiitis is characterized by vascular inflammation, sheathing, retinal edema, and retinal hemorrhages. The disease may be idiopathic in a majority of the cases or may be associated with ocular and systemic pathology. Association between Behηet disease, Frosted branch angiitis, and neuroretinitis is not reported in literature. This uncommon combination reflects the varied systemic and ocular manifestations in Behηet disease, especially in patients who are not diagnosed and treated in time. We hereby report a case of bilateral frosted branch angiitis and neuroretinitis in a young male from Middle-east, suffering from Behçet disease.
Subject(s)
Adult , Antirheumatic Agents/administration & dosage , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , Behcet Syndrome/drug therapy , Colchicine/administration & dosage , Drug Administration Schedule , Fundus Oculi , Humans , Injections, Intravenous , Magnetic Resonance Imaging , Male , Prednisone/administration & dosage , Prednisone/analogs & derivatives , Retinal Hemorrhage/diagnosis , Retinal Hemorrhage/etiology , Retinitis/diagnosis , Retinitis/etiology , Silymarin/administration & dosage , Vasculitis/diagnosis , Vasculitis/etiology , Vasculitis/pathologyABSTRACT
Diffuse unilateral subacute neuroretinitis [DUSN] can be a diagnostic dilemma photocoagulation of the subretinal worm is an effective treatment for eradication. Early laser photocoagulation has been advocated. We report a case of a middle aged man who presented with decreased vision and a sub retinal macular worm that required two laser sessions for complete eradication of the worm
Subject(s)
Humans , Male , Middle Aged , Retinitis/therapy , Helminths , Laser Coagulation , Retinitis/etiologyABSTRACT
En el presente trabajo se estudiaron 49 pacientes a los cuales se les diagnósticó lesiones de coriorretinitis de etiología toxoplasmósica. En el grupo de pacientes estudiados se encontró un predominio del sexo femenino con 67,34 por ciento de los casos. La localización de las lesiones en la retina fue de 73,46 por ciento en el área macular; 12,36 por ciento en regiones adyacentes al disco óptico y 2,16 por ciento en otros sitios de la retina. Clínicamente las lesiones fueron inactivas en 63,26 por ciento y activas en 36,73 por ciento. Mientras que el compromiso de la agudeza visual por las lesiones de retinocoroiditis fue de importancia, es decir una agudeza entre 20/400 por ciento o peor en un 36,73 por ciento
Subject(s)
Humans , Male , Female , Retina/injuries , Retinitis/etiology , Toxoplasmosis, Ocular/diagnosis , Chorioretinitis/diagnosis , OphthalmologyABSTRACT
A retinocoroidite toxoplásmica inicia-se nas camadas internas da retina, associando-se, sistematicamente, a vitreite mais ou menos importante. Apresentamos um caso incomum de toxoplasmose ocular envolvendo exclusivamente a retina externa, cujo diagnóstico etiológico foi confirmado pelas lesöes clássicas desta doença observadas no olho contralateral
Subject(s)
Humans , Female , Adult , Retinitis/etiology , Toxoplasmosis, Ocular/diagnosis , Uveitis/etiologyABSTRACT
Durante un año fueron estudiados 61 pacientes consecutivos VIH positivos, con el fin de establecer la prevalencia de las manifestaciones oftalmológicas. 29 pacientes estaban en el estadio de SIDA (IV de la clasificación CDC) y 32 eran portadores asintomaticos. En la primera evaluación, se encontro compromiso oftalmológico en 15 de 29 pacientes con SIDA (51.72 por ciento); siendo los hallazgos:microangiopatia retinal no infecciosa 27.6 por ciento, infecciones oportunisticas 20.68 por ciento; Sarcoma de Kaposi 3.44 por ciento y Atrofia optica en 3.44 por ciento. De las infecciones oportunisticas encontradas en la primera visita, la mas importante fue la retinitis por citomegalovirus (CMV) en 10.34 por ciento. En portadores asintomaticos, uno presento microangiopatia retinal no infecciosa con presencia de manchas algodonosas retinales (3.1 por ciento). En el seguimiento de los pacientes con SIDA cuyo examen inicial era normal, 2 desarrollaron microangiopatia y 3 retinitis por CMV; mientras que de los pacientes que al inicio tenian microangiopatia retinal, 5 desarrollaron retinitis por CMV en la evolución. Tambien se observo un nuevo caso de Sarcoma de Kaposi conjuntival y uno de paralisis del VI par craneal y papilitis. Al termino de este estudio habiamos acumulado 9 casos de retinitis por CMV (31 por ciento) y compromiso oftalmológico en 19 de 29 pacientes con SIDA (65.51 por ciento). De los 32 portadores asintomaticos, uno desarrollo retinitis por CMV, debutando como SIDA con una manifestación ocular. Se concluye que elcompromiso oftalmológico en el SIDA es importante, por lo que es necesario un adecuado seguimiento oftalmológico en esta población
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , HIV Infections/complications , Eye Manifestations , Acquired Immunodeficiency Syndrome/complications , Retinitis/etiology , Retinitis/pathology , Sarcoma, Kaposi/diagnosis , Sarcoma, Kaposi/pathology , Toxoplasmosis, Ocular/diagnosis , Toxoplasmosis, Ocular/pathology , Cranial Nerve Diseases , Cytomegalovirus/pathogenicity , Optic Atrophy/complications , Optic Atrophy/diagnosis , Optic Atrophy/etiology , Optic Atrophy/pathologyABSTRACT
Os autores apresentam um caso de neurorretinite bilateral pós-picada pro crotalus terrificus e discutem as açöes e os efeitos do veneno sobre o olho humano
Subject(s)
Humans , Aged , Eye Manifestations , Retinitis/etiology , Snake Bites/complications , Snake Venoms/immunologyABSTRACT
Relato de 2 casos de pacientes com AIDS e quadro ocular atípico. Os pacientes, respectivamente com retinite por Herpes zoster e toxoplasmose, desenvolveram uveíte com primeira manifestaçäo clínica da AIDS, apresentando lesöes atípicas no pólo posterior e pobre resultado visual
Subject(s)
Humans , Male , Adult , Herpes Zoster Ophthalmicus/diagnosis , Opportunistic Infections/diagnosis , Retinitis/etiology , Acquired Immunodeficiency Syndrome/physiopathology , Toxoplasmosis, Ocular/diagnosis , Uveitis/etiologyABSTRACT
Os autores fazem uma revisäo bibliográfica na literatura dos últimos 10 anos, sobre retinite a Citomegalovírus e Necrose Retiniana Aguda, apresentando 2 casos clínicos e discutindo sobre a eficácia dos tratamentos empregados na atualidade
Subject(s)
Humans , Adult , Female , Male , Cytomegalovirus/drug effects , Retinitis/etiology , Retinal Necrosis Syndrome, Acute/etiology , Acyclovir/therapeutic use , BrazilABSTRACT
A propósito de un caso de daño macular originado en un cortocircuito de corriente eléctrica de 220 volts., comprobado angiográficamente, se revisan los mecanismos de daño retinal que reconocen a la luz como causa etiológica. Se comenta lo inusual del daño fotoquímico como causa de compromiso retinal y se analizan sus implicancias laborales
Subject(s)
Adult , Humans , Male , Light/adverse effects , Retina/injuries , Retinitis/etiologyABSTRACT
La autora hace un breve resumen de las manifestaciones oculares del síndrome de inmunodeficiencia adquirida (SIDA) informadas por algunos autores, sus efectos sobre la visión de los pacientes afectados, los tratamientos ensayados y sus resultados. Concluye que aunque éstos no son completamente satisfactorios, constituyen un paso de avance para estudios posteriores