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Purpose@#To report a case of juvenile dermatomyositis that presented with erythematous swelling on the upper eyelid as the first clinical sign.Case summary: An 11-year-old female patient presented with erythematous swelling of both upper eye lids that persisted for 3 weeks prior to examination. She also had an erythematous rash over both cheeks but no pain or hyperemia in either eye. During anti-inflammatory eye drop treatment under suspicion of blepharitis, a reddish-purple heliotrope rash appeared around the eyelid margin. She also developed fever, arthralgia, multiple oral ulcers, an erythematous scaly rash behind the ear, and erythematous firm papules on the metacarpal (MCP) joint and around the elbow. On evaluation, aspartate aminotransferase was elevated to 184 IU/L, alanine aminotransferase to 352 IU/L, and alkaline phosphatase to 266 IU/L. We performed a skin biopsy. Based on histopathological examination, the eyelid lesion was diagnosed as dermatomyositis and the MCP joint lesion as Gottron’s papule. From the above findings, we diagnosed the patient with juvenile dermatomyositis based on the European League Against Rheumatism/American College of Rheumatology classification. The patient was treated with prednisolone. Three months after diagnosis, she died from rapidly progressive interstitial pneumonia, a complication of juvenile dermatomyositis. @*Conclusions@#Heliotrope rash should be considered in the differential diagnosis of patients presenting with eyelid swelling, for early diagnosis and better prognosis of juvenile dermatomyositis.
RESUMO
Purpose@#To report a case of juvenile dermatomyositis that presented with erythematous swelling on the upper eyelid as the first clinical sign.Case summary: An 11-year-old female patient presented with erythematous swelling of both upper eye lids that persisted for 3 weeks prior to examination. She also had an erythematous rash over both cheeks but no pain or hyperemia in either eye. During anti-inflammatory eye drop treatment under suspicion of blepharitis, a reddish-purple heliotrope rash appeared around the eyelid margin. She also developed fever, arthralgia, multiple oral ulcers, an erythematous scaly rash behind the ear, and erythematous firm papules on the metacarpal (MCP) joint and around the elbow. On evaluation, aspartate aminotransferase was elevated to 184 IU/L, alanine aminotransferase to 352 IU/L, and alkaline phosphatase to 266 IU/L. We performed a skin biopsy. Based on histopathological examination, the eyelid lesion was diagnosed as dermatomyositis and the MCP joint lesion as Gottron’s papule. From the above findings, we diagnosed the patient with juvenile dermatomyositis based on the European League Against Rheumatism/American College of Rheumatology classification. The patient was treated with prednisolone. Three months after diagnosis, she died from rapidly progressive interstitial pneumonia, a complication of juvenile dermatomyositis. @*Conclusions@#Heliotrope rash should be considered in the differential diagnosis of patients presenting with eyelid swelling, for early diagnosis and better prognosis of juvenile dermatomyositis.
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PURPOSE: To evaluate the effectiveness of cyclosporine 0.05% for dry eye after cataract surgery. METHODS: Thirty-two newly diagnosed patients with dry eye syndrome 1 week after cataract surgery received a twice-daily treatment of cyclosporine 0.05% for one eye and normal saline 0.9% for the other. Disease severity was measured at 2 weeks, 1 month, 2 months, and 3 months by Schirmer test I (ST-I), tear film break-up time (tBUT), corneal temperature and dry eye symptom questionnaire (Ocular Surface Disease Index). RESULTS: Both groups increased in ST-I and tBUT over time. ST-I in the cyclosporine 0.05% group showed a significant increase at 3 months and tBUT in the cyclosporine 0.05% group showed an increase at 2 and 3 months. The dry eye symptom score was significantly reduced in the cyclosporine 0.05% group. CONCLUSIONS: Cyclosporine 0.05% can also be an effective treatment for dry eye after cataract surgery.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Extração de Catarata , Ciclosporina/administração & dosagem , Síndromes do Olho Seco/tratamento farmacológico , Imunossupressores/administração & dosagem , Soluções Oftálmicas/administração & dosagem , Complicações Pós-Operatórias/tratamento farmacológico , Resultado do TratamentoRESUMO
PURPOSE: To evaluate the stability of implantable collamer lens (ICL, Staar Surgical AG, Niau, Switzerland) by comparing changes of tilt, decentration and anteroir chamber depth after ICL implantation during 1 year. METHODS: The results of 8 high myopic patients (16 eyes) that had received ICL implantation were retrospectively studied. Tilt and decentration of ICL were measured using an anterior eye segment analysis system (Scheimpflug camera, EAS-1000, Nidek, Japan). Anterior chamber depth was measured in both eyes preoperatively and postoperatively by Scheimpflug camera. The follow-up period was 1 year. RESULTS: Tilt was 1.90 +/- 1.23degrees, 1.75 +/- 0.80degrees, 1.64 +/- 0.86degrees, 2.08 +/- 1.33degrees (p = 0.36) and decentration were 0.04 +/- 0.01 mm, 0.03 +/- 0.01 mm, 0.03 +/- 0.02 mm, 0.04 +/- 0.02 mm (p = 0.59) at 1 week, 1 month, 6 months and 1 year respectively. Tilt and decentration showed no significant change after ICL implantation. The average anterior chamber depth was 2.85 +/- 0.26 mm preoperatively, and 2.17 +/- 0.39 mm, 2.06 +/- 0.31 mm, 2.06 +/- 0.34 mm, 2.04 +/- 0.35 mm at 1 week, 1 month, 6 months and 1 year respectively. Anterior chamber depth became narrow after ICL implantation (p = 0.02), but showed no significant narrowing postoperatively (p = 0.08). CONCLUSIONS: The IOL position remained stable, with no significant changes for an extended period of tilt, decentration, or anterior chamber depth after ICL implantation.