Case of Bilateral Retinal Neovascularization Associated with Chronic Idiopathic Myelofibrosis

We report a case of bilateral peripheral retinal neovascularization and chronic idiopathic myelofibrosis in a 69-year-old man. Ophthalmic examination revealed peripheral retinal nonperfusion with retinal neovascularization in both eyes and vitreous hemorrhage in the right eye. Fluorescein angiography of both eyes showed a marked midperipheral and peripheral avascular retina temporally with arteriovenous anastomosis and sea-fan neovascularizations. Blood tests showed pancytopenia and teardrop-shaped red blood cells, and bone marrow examination showed hypocellular marrow with severe fibrosis. The neovascularization was regressed following pars plana vitrectomy in the right eye and scatter laser photocoagulation in the left. The results suggest that peripheral retinal vessel occlusion and neovascularization may be associated with idiopathic myelofibrosis.

Progressive Outer Retinal Necrosis Combined with Vitreous Hemorrhage in a Patient with Acquired Immunodeficiency Syndrome

PURPOSE: To describe an unusual case of rapidly progressive outer retinal necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from what was probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes simplex type 1,2, as proven by the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). METHODS: This study is a case report detailing clinical follow-up and an aqueous humor test by PCR-RFLP. RESULTS: The deep, white retinal lesions coalesced and progressively expanded in a circumferential manner, with sparing of the perivascular retina. However, retinal and vitreous hemorrhages, unusual findings for PORN, could be noted around the optic nerve. Varicellar-zoster virus (VZV), cytomegalovirus (CMV), and herpes simplex types 1,2 (HSV-1,2) were detected in the aqueous humor by PCR. CONCLUSIONS: PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, concurrent or combined etiologic agents can include HSV-1, HSV-2, and CMV in AIDS patients. Therefore, combined antiviral therapy with acyclovir and ganciclovir could be more reasonable as an initial therapy.

Unilateral loss of vision following snakebite.

A 14- year-old boy presented at the outpatients' department with the complaint of visual loss in the right eye of 1 1/2 months duration. He had the history of snakebite for which he was admitted to hospital. The diminution of vision started next day after snakebite. On examination, he had no perception of light in his right eye. USG B scan showed vitreous haemorrhage in his right eye. He was given IV methylpredinisolone. At follow-up after one month he still had no perception of light in his right eye with the haemorrhage in the vitreous subsided.

Hemorragia vítrea: avaliação de 81 pacientes submetidos à vitrectomia na Fundação Altino Ventura, Recife-PE / Vitreous hemorrhage: evaluation of 81 patients submitted to vitrectomy at Fundação altino Ventura, Recife-PE

Objetivos: Avaliar casos de hemorragia vítrea (HV) submetidos à vitrectomia, dando ênfase a fotores predisponentes, diagnóstico etiológico, resultados funcionais visuais e complicações pós-operatórias.Métodos: Analisaram-se retrospectivamente 482 prontuários de pacientes submetidos à vitrectomia via pars plana (VPP), no período de janeiro de 1998 a dezembro de 2000, na Fundação Altino Ventura, Recife-PE. Selecionaram-se 81 pacientes (84 olhos) com hemorragia vítrea, excluiendo se as causas traumáticas e associadas a descolamento de retina, onde foram analisados os fatores predisponentes, diagnóstico etiológico, a acuidade visual pré e pós-operatória e complicações no pós-operatório.Resultados: Trinta pacientes (37, 0 por cento) eram do sexo masculino e 51 (63,0 por cento) do sexo feminino. Observaram-se 59 pacientes com hipertensão arterial sistêmica (72,8 por cento) e 48 (59,2 por cento) pacientes diabéticos. Houve maior frequancia de retinopatia diabética proliferativa (RDP) como causa de HV (40 olhos, 47,6 por cento), seguida de oclusão vascular com 30 casos (35,7 por cento). Melhora visual foi mais observada em pacientes com síndrome de Terson, oclusões de ramo venoso retiniano e retinopatia hipertensiva. Notaram-se oito reoperações (9,5 por cento) por recidiva de hemorragia e cinco pacientes (6,0 por cento) evoluíram com descolamento de retina. Conclusões: Em nossos pacientes, as complicações da retinopatia diabética foram a maior indicação para VPP. Doenças sistêmicas, como hipertensão arteriale diabetes, foram os principais fatores predisponentes associados à HV. A VPP mostrou-se um procedimento cirúrgico eficaz no tratamento da hemorragia vítrea, tendo baixos riscos de complicações e permitindo reabilitação visual em casos específicos.

Massive ocular hemorrhage resulting in blindness in a patient with the sickle cell trait who developed leptospirosis. Case report

This case report describes the findings of a 18 year-old black male from Bahia, a Northeastern state in Brazil, with the sickle cell trait, who developed bilateral hyphema and vitreous hemorrhage with blindness in the course of leptospirosis. The patient started to complain of blurred vision four days after the start of fever and muscular pain and approximately twelve hours after the introduction of penicillin. The severity of the leptospirosis in conjunction with sickle cell trait was considered to be the most likely explanation for this ocular complication

Mielinizaçäo de fibras nervosas associada a telangiectasias retinianas e hemorragia vítrea / Myelinated retinal nerve fibers associated with teleangiectasic retinal vascular and vitreous hemorrhage

Os autores relatam um caso de mielinizaçäo de fibras nervosas associada a alteraçöes vasculares retinianas tipo telangiectasias, que levaram à hemorragia vítrea. Além das alteraçöes vasculares, verifica-se a tríade miopia axial, ambliopia refracional e fibras mielinizadas

Terson's syndrome: report of case with favorable outcome

Terson's syndrome is characterized by presence of a subarachnoid hemorrhage accompanied by retinal and vireous hemorrhage leading to a not very favorable prognosis. We describe a case with a good outcome, probably because of a early diagnosis and medical intervention. We emphasize the routine optician's check up as very important in the evaluation of a prognosis in the cases of a suspect intracranial hemorrhage.

Eales' disease with myelopathy.

The first Thai case of Eales' disease with myelopathy is reported. This entity must be differentiated from other causes of myelopathy such as those due to infectious-inflammatory causes. The ophthalmologic findings are the most important diagnostic clues. Since many infectious diseases such as tuberculosis and dental sepsis may be potentially related to Eales' disease, and these infections are rather common in Thailand, the diagnosis of Eales' disease with neurological complications especially myelopathy should be looked for.

Blue field entoptoscopy in diabetic retinopathy.

Blue field entoptoscopy was performed in 50 consecutive patients with diabetic retinopathy. Several statistically significant correlations were obtained. The number of "flying corpuscles" was reduced in eyes harboring a vitreous hemorrhage, and in severe and proliferative diabetic retinopathy. On the other hand, patients with a history of focal or panretinal photocoagulation had better corpuscle counts than patients who had never received any treatment. It appears therefore, that argon laser photocoagulation is beneficial in preserving the blue field entoptic phenomenon.

Melanoma de coroides en hemorragía vítrea bilateral: estudio clínico patológico / Choroidal melanoma in bilateral vitreous hemorrhage: a clinical pathological study

Se presenta el caso de un paciente portador de una hemorragia vítrea bilateral en el cual se evidenció una masa tumoral ecográficamente en uno de los ojos. Después de un extenso estudio y discusión se procedió a efectuar una punción biopsia del tumor que confirmó el diagnóstico de Melanoma Maligno de Coroides. Se discute la utilidad e indicaciones de esta técnica en casos diagnósticos difíciles

Hemorragia vítrea: enfoque clínico / Vitreous hemorrhage: clinical approach

Se analizan diversas etiologías de hemorragia vítrea, con énfasis en las más frecuentes. Se señalan sus complicaciones y la conducta general frente a ellas, así como las pautas a seguir frente a las causas más frecuentes de ésta complicación en especial cuando ha sido causada por las llamadas retinopatías proliferativas