ABSTRACT
El uso indebido de los punteros láser, especialmente el recreativo en los niños, puede causar lesiones retinianas que amenazan la visión. El daño retiniano que producen no está bien caracterizado, debido a que la mayoría de las publicaciones son casos aislados o series pequeñas. El tratamiento y el pronóstico visual es variable según la morfología del daño macular que presenten. En algunos casos, no existe tratamiento, y pueden evolucionar a la curación espontánea; sin embargo, otros precisan cirugía. En una serie de 13 casos, uno requirió cirugía, mientras que el resto necesitó solo observación. De estos 13 casos, 3 pacientes se curaron en forma espontánea, con agudeza visual de 10/10.Se describen dos pacientes de 16 y 12 años con disminución de agudeza visual tras el uso indebido de punteros láser. En el fondo de ojo, presentaron alteraciones maculares. La agudeza visual de ambos se recuperó completamente sin tratamiento.
The improper use of laser pointers, especially for recreational use in children, may cause sight-threatening retinal injuries. The retinal damage it is not well characterized because most publications are isolated cases or small series.The treatment and visual prognosis are variable according to the morphology of the macular damage. In some cases, there is no treatment, and spontaneous healing can be developed; however, others require surgery. In a series of 13 cases, 1 required surgery and the rest observation; 3 patients obtained a spontaneous healing with visual acuity of 10/10.We describe two patients aged 16 and 12 years with decreased visual acuity. Macular alterations appear in the fundus of the eye. The visual acuity of both recovered completely without treatment
Subject(s)
Humans , Male , Child , Adolescent , Retinal Diseases , Lasers/adverse effects , Macula Lutea/radiation effects , Macula Lutea/injuriesABSTRACT
PURPOSE: To report on the anatomical and functional changes to the macula in nine patients suffering from commotio retinae not accompanied by any other types of traumatic retinopathy. METHODS: Nine injured eyes with commotio retinae were evaluated soon after ocular trauma with ophthalmic examination, including Spectral-domain optical coherence tomography (SD-OCT). In 12 eyes of 6 patients, Humphrey visual field (HVF) and multifocal electroretinogram (mfERG) were performed. Re-examinations were periodically performed for a mean of 26 days. Data from 9 injured eyes were collected and compared to data collected from the 9 non-affected eyes of the same patients. RESULTS: SD-OCT revealed no significant differences in the foveal thickness and total macular volume between traumatized and intact eyes in all 9 patients. Only 3 out of the 9 injured eyes showed abnormal findings in SD-OCT images such as discontinuity of the inner/outer segment (IS/OS) junction or abnormal hyper-reflectivity from the IS/OS and retinal pigment epithelium (RPE) lines in the macula. HVF and mfERG results did not show any functional deterioration in the injured eyes compared with intact eyes. During follow-up, the commotio retinae resolved in all 9 eyes. The changes to the outer retinal region detected in 3 patients by SD-OCT were also resolved. CONCLUSIONS: Acute retinal changes in commotio retinae, not associated with other retinal pathologies, were resolved without histological and functional sequelae. In a few cases of commotio retinae, SD-OCT revealed transient abnormalities mainly observed at the IS/OS and RPE complexes.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Electroretinography , Eye Injuries/classification , Follow-Up Studies , Macula Lutea/injuries , Prognosis , Retinal Diseases/etiology , Retinal Pigment Epithelium/injuries , Retrospective Studies , Tomography, Optical Coherence , Trauma Severity Indices , Visual Acuity , Visual FieldsABSTRACT
Here, we report the case of a patient who sustained Nd: YAG laser macular injury with subsequent 6 year follow-up evaluation. A 23-year-old female was accidentally exposed to a Q-switched Nd: YAG laser without protective goggles. Upon initial evaluation, the best-corrected visual acuity of her affected eye was 20/100 OD. Fundoscopic examination revealed a macular laser burn and vitreous hemorrhage. Corticosteroids, in the form of 60 mg prednisolone, were administered orally with a 10 mg per week taper. Nineteen days following exposure, fundoscopic examination revealed a distinct epiretinal membrane which resolved within six months. The best-corrected visual acuity of the affected eye remained 20/100 OD. This clinical course is similar to those of previously reported cases including vitreous hemorrhage and subsequent epiretinal membrane formation. However, visual acuity did not recover despite spontaneous regression of the epiretinal membrane and at 6 year follow-up, there was neither choroidal neovascularization nor macular hole formation.
Subject(s)
Female , Humans , Young Adult , Accidents , Fluorescein Angiography , Follow-Up Studies , Fundus Oculi , Glucocorticoids/therapeutic use , Lasers, Solid-State/adverse effects , Macula Lutea/injuries , Prednisolone/therapeutic use , Radiation Injuries/complications , Treatment Outcome , Visual Acuity/radiation effects , Vitreous Hemorrhage/etiologyABSTRACT
Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months.
O buraco macular traumático é doença cuja patogênese não é totalmente esclarecida e a melhor conduta terapêutica ainda é controversa. Relatamos 2 casos de buraco macular traumático para os quais adotamos condutas diferentes. No primeiro caso, um menino de 9 anos apresentou buraco macular traumático secundário a trauma ocular contuso com uma pedra, com visão inicial de 20/300. Foi submetido a tratamento cirúrgico e obteve visão final igual a 20/70 com buraco fechado após 1 ano de seguimento. No segundo caso, mulher de 20 anos sofreu traumatismo penetrante por projétil de arma de fogo na fronte, do lado esquerdo. O trauma causou avulsão do nervo óptico no olho esquerdo com perda de percepção luminososa neste olho. No olho direito apresentou buraco macular traumático e sinais sugestivos de coriorretinite esclopetária, com acuidade visual igual a 20/60. O caso foi inicialmente observado e a visão melhorou para 20/30 com diminuição do diâmetro do buraco. A visão e o diâmetro do buraco mantiveram-se estáveis por 8 meses.
Subject(s)
Child , Female , Humans , Male , Young Adult , Eye Injuries, Penetrating/complications , Macula Lutea/injuries , Retinal Perforations/etiology , Wounds, Gunshot/complications , Wounds, Nonpenetrating/complications , Macula Lutea/pathology , Retinal Perforations/pathology , Tomography, Optical Coherence , Visual Acuity/physiology , Young AdultABSTRACT
A case of bilateral accidental globe penetration during administration of retrobulbar steroid for bilateral optic neuritis is discussed. One eye with bisected macula was managed successfully by vitrectomy, internal gas tamponade, and postoperative laser to the edges of the retinal tear. The fellow eye was blind due to central retinal artery occlusion.
Subject(s)
Adult , Dexamethasone/administration & dosage , Eye Injuries, Penetrating/etiology , Glucocorticoids/administration & dosage , Humans , Injections , Macula Lutea/injuries , Male , Needles/adverse effects , Needlestick Injuries/etiology , Optic Neuritis/drug therapy , Orbit , Retinal Perforations/etiology , VitrectomyABSTRACT
Este trabalho vem acrescentar mais uma entidade etiológica ao capítulo das Uveites - a Coroidite Esquistossomótica - fato inédito na literatura mundial. Apresentamos 6 casos clínicos, os quais säo descritos através de estudo laboratorial, anamnéstico, biomicroscópico, fundoscópico e angioretinográfico. O aspecto morfológico em 5 dos casoselhante e bilateral, caracterizado por nódulos branco-amarelados, de tamanhos variados, distribuidos pela coroide, e 1 caso foi unilateral, com nódulos e papilite. Além desses casos, descrevemos 1 caso no qual tivemos a felicidade de constatar, pela histologia de 100 cortes, a presença de S. mansoni na coroide. Também fazemos uma discussäo sobre os diagnósticos diferenciais e as possíveis vías pelas quais o parasita alcança a coroide, e outras formas de uveite