ABSTRACT
ABSTRACT During the routine ophthalmologic examination of a 38-day old female infant, indirect ophthalmoscopy revealed a dense hemorrhage on the fovea and a couple of superficial hemorrhages in the nasal retina of the left eye. No hemorrhage was observed in the right eye. A hand-held spectral domain optical coherence tomography (SD-OCT) was used at the time of diagnosis. The hemorrhage at the nasal retina resolved in the first week of follow-up, and the foveal hemorrhage resolved 12 weeks after birth. Spectral domain optical coherence tomography was repeated once the foveal hemorrhage had resorbed, and it showed that the foveal contour had reformed without any sequelae. This case suggests that birth-related foveal hemorrhages do not cause any disturbance in the foveal architecture.
RESUMO Durante o exame oftalmológico de rotina de uma criança do sexo feminino de 38 dias, a oftalmoscopia indireta revelou uma hemorragia densa na fóvea e algumas hemorragias superficiais na retina nasal do olho esquerdo. Nenhuma hemorragia foi observada no olho direito. Foi utilizada uma tomografia de coerência óptica de domínio espectral no momento do diagnóstico. A hemorragia na retina nasal foi resolvida na primeira semana de acompanhamento e a hemorragia foveal foi resolvida em 12 semanas após o nascimento. A tomografia de coerência óptica de domínio espectral foi repetida uma vez que a hemorragia foveal foi reabsorvida, e mostrou que o contorno foveal havia se reformado sem sequelas. Este caso sugere que as hemorragias foveais relacionadas ao nascimento não causam qualquer distúrbio na arquitetura foveal.
Subject(s)
Humans , Female , Infant , Retinal Hemorrhage/diagnostic imaging , Tomography, Optical Coherence/methods , Fovea Centralis/diagnostic imaging , Ophthalmoscopy , Remission, Spontaneous , Time Factors , Retinal Hemorrhage/pathology , Fovea Centralis/pathologyABSTRACT
We describe the case of a 23-month-old female infant with a diagnosis of hemolytic uremic syndrome (HUS) and hemorrhagic retinopathy. The patient had a past history of abdominal pain, bloody diarrhea, and acute renal failure. On ophthalmologic examination, indirect ophthalmoscopy revealed extensive areas of flame-shaped hemorrhage, cotton wool spots, macular edema and optic nerve head neovascularization in both eyes. Fluorescein angiography showed severe bilateral retinal ischemia and neovascularization leakage in disk. The patient, who had the visual acuity of 20/1000 in the right eye (OD) and 20/540 in the left eye (OS) at the first examination, was treated with panretinal photocoagulation (PRP) and presented at the end of the 6th month of follow-up improvement to 20/540 in OD and 20/270 in OS. There was also a regression of disc neovascularization, hemorrhages and macular edema. Despite intense retinal ischemia, there were no complications related to angiogenesis such as vitreous hemorrhage and/or neovascular glaucoma. We describe, in this report, the association between hemorrhagic retinopathy with features of Purtscher-like disease and HUS.
Descrevemos o caso de um lactente do sexo feminino de 23 meses com diagnóstico de síndrome hemolítico-urêmica (SHU) e retinopatia hemorrágica. A paciente apresentou história clínica prévia de dor abdominal, diarréia sanguinolenta e insuficiência renal aguda. Ao exame oftalmológico, a oftalmoscopia indireta evidenciou, em ambos os olhos, extensas áreas de hemorragia em chama de vela, exsudatos algodonosos, edema macular e neovasos na cabeça do nervo óptico. A angiofluoresceinografia mostrou intensa isquemia retiniana bilateral e vazamento na neovascularização de disco. A paciente, a qual apresentava acuidade visual de 20/1000 no olho direito (OD) e 20/540 no olho esquerdo (OE) no primeiro exame, foi tratada com panfotocoagulação retiniana e apresentou no final do 6º mês de acompanhamento a acuidade visual de 20/540 no OD e 20/270 no OE. Observou-se ainda a regressão dos neovasos, das hemorragias retininanas e do edema. Apesar da intensa isquemia retiniana não houve complicações relacionadas à angiogênese como hemorragia vítrea e/ou glaucoma neovascular. Descreve-se, neste relato, a associação entre retinopatia hemorrágicas com características de Purtscher-like e síndrome hemolítico-urêmica.
Subject(s)
Female , Humans , Infant , Hemolytic-Uremic Syndrome/complications , Retinal Hemorrhage/etiology , Retinal Hemorrhage/pathology , Fluorescein Angiography , Laser Coagulation/methods , Neovascularization, Pathologic/surgery , Retinal Hemorrhage/surgery , Treatment Outcome , Visual Acuity/physiologyABSTRACT
Previous studies have shown ocular haemorrhages in choline-deficient rats. The aim of this paper is to study further the relationship between ocular and renal lesions and biochemical alterations in rats fed a choline-deficient diet. Fifty one weanling male Wistar rats, were divided into two groups. Thirty one ofthem were fed a choline-deficient diet and the rest was fed a choline- supplemented diet ad libitum. Animalsfrom both groups were killed between the fifth and the eighth day. Urea, creatinine and homocysteine concentrations in blood were determined. Eyes were used for light microscopy study; high resolution lightmicroscopy and the study of the retina as rétine a plat. Kidneys were studied by light microscopy. Cholinesupplementedrats did not show ocular or renal lesion. Choline-deficient rats that showed renal lesions, tubular or cortical necrosis, did not always have ocular changes. There were no ocular changes in the only cholinedeficient rat without renal lesion. The ocular changes consisted mainly in haemorrhage in both cameras andciliary and vitreous bodies. Correlations between ocular and renal lesion (r=0.72, p<0.0001, CI 95%: 0.48-0.86); ocular lesion and creatinine (r=0.86, p<0.0001, CI 95%: 0.72-0.93) and ocular lesion and urea (r=0.70, p<0.0001, CI 95%: 0.44-0.85) were positive. Choline-deficiency induces ocular haemorrhagic lesions after the development of renal necrosis. The ocular pathology could be due to the immaturity of the ocular vasculature at this age. The hyaloid, choroid and retinal system are involved
Estudios previos han demostradohemorragia ocular en ratas deficientes en colina. El objetivo de este trabajo es profundizar en la relación entre las alteraciones oculares, renales y bioquímicas en ratas deficientes en colina. Cincuenta y una ratas Wistar macho recién destetadas fueron divididas en dos grupos: treinta y una fueron alimentadas con una dieta colino deficiente y el resto con colina suplementada ad-libitum. Los animales de ambos grupos fueron sacrificados entre el quinto y el octavo día. Se midió la concentración de urea, creatinina y homocisteína en sangre. Los ojos fueron estudiados por microscopía de luz, microscopía óptica de alta resolución y para el estudio de la retina como retina plana. Los riñones fueron estudiados por microscopía de luz. Las ratas suplementadas con colina no mostraron lesiones oculares o renales. Las colino deficientes que mostraron lesiones renales, necrosis tubular o cortical, no siempre tuvieron cambios oculares. No se encontraron cambios oculares en la única rata deficiente en colina sin lesión renal. Los cambios oculares consistieron principalmente en hemorragia enambas cámaras, cuerpo ciliar y vítreo. La correlación entre la lesión ocular y renal (r=0.72, p<0.0001, CI 95%:0.48-0.86), lesión ocular y creatinina (r=0.86, p<0.0001, CI 95%: 0.72-0.93) y lesión ocular y urea (r=0.70,p<0.0001, CI 95%: 0.44-0.85) fue positiva. La deficiencia de colina induce lesiones oculares luego del desarrollode la necrosis renal. La patología ocular podría ser debida a la inmadurez de los vasos oculares. El sistemahialoide, coroideo y retinal están involucrados
Subject(s)
Animals , Male , Rats , Choline Deficiency/pathology , Diet , Eye Injuries/pathology , Eye/ultrastructure , Kidney Cortex Necrosis/pathology , Kidney Tubular Necrosis, Acute/pathology , Analysis of Variance , Choline Deficiency/complications , Creatinine/blood , Disease Models, Animal , Eye Injuries/complications , Eye/blood supply , Homocysteine/blood , Kidney Cortex Necrosis/etiology , Kidney Tubular Necrosis, Acute/etiology , Rats, Wistar , Retinal Hemorrhage/etiology , Retinal Hemorrhage/pathology , Severity of Illness Index , Urea/bloodABSTRACT
Se estudió el fondo de ojo de recién nacidos y se comunican los hallazgos: 12% de hemorragias y un caso de coriorretinitis por toxoplasmosis confirmada. Se discuten las causas probables de las hemorragias y se revisa la literatura pertinente.
Subject(s)
Humans , Male , Female , Infant, Newborn , History, 20th Century , Eye Hemorrhage/pathology , Eye Infections/complications , Fundus Oculi , Retinal Hemorrhage/pathology , Toxoplasmosis/pathologyABSTRACT
Os autores relatam um caso de hemorragia expulsiva ocorrida durante uma ceratoplastia penetrante, complicaçäo rara e desastrosa da cirurgia intraocular, e fazem uma revisäo bibliográfica do assunto, com discussäo da patogênese e das medidas preventivas e curativas na ocorrência desta complicaçäo