Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 101
Filter
2.
Arch. Soc. Esp. Oftalmol ; 96(2): 89-92, feb. 2021. ilus
Article in Spanish | IBECS | ID: ibc-200793

ABSTRACT

CASO CLÍNICO: Varón caucásico de 46 años con antecedente de hiperemia conjuntival crónica que acude a nuestra clínica 5 años después de realizar el procedimiento quirúrgico de blanqueamiento ocular cosmético. En la exploración observamos granuloma piógeno en el ojo derecho, además de uveítis anterior no granulomatosa aguda y escleritis necrosante en ambos ojos. RESULTADO: Se realizó una evaluación clínica con exclusión de enfermedades sistémicas completas. El granuloma piógeno se trató con resección quirúrgica y la uveítis anterior y escleritis necrosante se trataron con éxito con corticoesteroides sistémicos y metotrexato. CONCLUSIÓN: El blanqueamiento ocular cosmético quirúrgico podría tener como complicación el granuloma piógeno además de la escleritis necrosante y la uveítis anterior no granulomatosa y presentarse 5 años después del procedimiento. La resección quirúrgica es un tratamiento exitoso para esta presentación de granuloma piógeno


CLINICAL CASE: A 46-year-old caucasian male with a history of chronic conjunctival hyperemia, presented at our clinic 5 years after he underwent the surgical procedure of cosmetic eye whitening. On examination we observed pyogenic granuloma in the right eye; besides acute nongranulomatous anterior uveitis and necrotizing scleritis in both eyes. RESULT: Complete clinical evaluation and full work-up exclusion of systemic diseases was done. The pyogenic granuloma was treated with surgical resection, as well as anterior uveitis and necrotizing scleritis were successfully treated with systemic corticoesteroids and methotrexate. CONCLUSION: The surgical cosmetic eye whitening could have as complication the pyogenic granuloma in addition to necrotizing scleritis and nongranulomatous anterior uveitis; and be present 5 years after the procedure. The surgical resection is a successful treatment for this presentation of pyogenic granuloma


Subject(s)
Humans , Male , Middle Aged , Hyperemia/surgery , Conjunctival Diseases/surgery , Conjunctival Diseases/etiology , Granuloma, Pyogenic/etiology , Cosmetic Techniques/adverse effects , Scleritis/etiology , Uveitis, Anterior/etiology , Granuloma, Pyogenic/surgery
4.
Arch Soc Esp Oftalmol (Engl Ed) ; 96(2): 89-92, 2021 Feb.
Article in English, Spanish | MEDLINE | ID: mdl-33158667

ABSTRACT

CLINICAL CASE: A 46-year-old caucasian male with a history of chronic conjunctival hyperemia, presented at our clinic 5 years after he underwent the surgical procedure of cosmetic eye whitening. On examination we observed pyogenic granuloma in the right eye; besides acute nongranulomatous anterior uveitis and necrotizing scleritis in both eyes. RESULT: Complete clinical evaluation and full work-up exclusion of systemic diseases was done. The pyogenic granuloma was treated with surgical resection, as well as anterior uveitis and necrotizing scleritis were successfully treated with systemic corticoesteroids and methotrexate. CONCLUSION: The surgical cosmetic eye whitening could have as complication the pyogenic granuloma in addition to necrotizing scleritis and nongranulomatous anterior uveitis; and be present 5 years after the procedure. The surgical resection is a successful treatment for this presentation of pyogenic granuloma.

5.
Eye (Lond) ; 32(4): 734-742, 2018 04.
Article in English | MEDLINE | ID: mdl-29303152

ABSTRACT

PurposeTo identify predictive biomarkers of treatment outcomes by multimodal retinal imaging in patients affected by central serous chorioretinopathy (CSC).Patients and methodsIn this interventional non-randomized clinical study, 27 treatment-naive CSC patients were prospectively enrolled and treated with oral eplerenone for 5-13 weeks. Primary outcomes included presence of pathological findings on indocyaine green angiography (ICGA), structural optical coherence tomography (OCT) and OCT-angiography (OCT-A) at baseline associated with different response to the treatment.ResultsA total of 29 eyes of 27 patients (2 females, 25 males) met the inclusion criteria and were included in the study (mean age was 45±7 years). Mean CSC duration at baseline was 13.5±4.4 weeks. After a mean of 10.5 weeks of treatment, mean central macular thickness significantly reduced (P<0.001), and mean best-corrected visual acuity improved (P<0.001). Seventeen eyes (61%) demonstrated total reabsorption of subretinal fluid on structural OCT, five eyes (18%) presented a partial response to eplerenone therapy and six eyes (21%) showed no response. The complete response to the treatment was associated with absence of CNV at OCT-A and the presence of hotspot at ICGA (P<0.001 and P=0.002, respectively). None of eight eyes with CNV in OCT-A imaging had a complete response to eplerenone and none of three eyes without hotspot at ICGA showed a complete response to the treatment.ConclusionsMultimodal retinal imaging allowed us to propose predictive biomarkers (ie, absence of CNV on OCT-A and presence of hotspot on ICGA) for treatment outcomes.


Subject(s)
Central Serous Chorioretinopathy/diagnostic imaging , Central Serous Chorioretinopathy/drug therapy , Eplerenone/therapeutic use , Fluorescein Angiography/methods , Mineralocorticoid Receptor Antagonists/therapeutic use , Tomography, Optical Coherence/methods , Adult , Aged , Female , Humans , Indocyanine Green/administration & dosage , Male , Middle Aged , Multimodal Imaging , Prospective Studies
6.
Eye (Lond) ; 32(1): 55-66, 2018 01.
Article in English | MEDLINE | ID: mdl-29265111

ABSTRACT

PurposeTo correlate function and structural optical coherence tomography (OCT) to optical coherence tomography angiography (OCT-A) measures in patients affected by central serous chorioretinopathy (CSC) and to describe their changes after treatments (ie oral eplerenone, half-fluence photodynamic therapy (PDT)).Patients and methodsTwenty eyes of 16 consecutive patients with treatment-naïve CSC undergoing either eplerenone or PDT were enrolled in this prospective, observational study. All patients underwent structural OCT and OCT-A at baseline and after therapy at months 1 and 3.ResultsEleven eyes of nine patients and nine eyes of seven patients underwent eplerenone or PDT treatment, respectively. Central macular thickness (CMT) and subretinal fluid (SRF) correlated to fovea avascular zone (FAZ) area (r=0.74 and r=0.71, P=0.01) and vessel density (r=0.77 and r=0.68, P=0.01) at deep capillary plexus (DCP). CMT (P=0.0011), SRF (P=0.0005), SFCT (P=0.0016), FAZ area at DCP (P=0.0334) improved at 3-month visit. A significant reduction of deep FAZ area was appreciated in eplerenone (P=0.0204) but not in PDT (P=0.5) group. SFCT reduction was significantly higher in PDT than eplerenone group (P=0.0347).ConclusionStructural and vascular parameters are correlated in CSC and they improve after different treatments. Both half-fluence PDT and oral eplerenone do not permanently damage choriocapillaris or other choroidal layers as evaluated by OCT-A.


Subject(s)
Central Serous Chorioretinopathy/drug therapy , Fluorescein Angiography/methods , Multimodal Imaging , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Spironolactone/analogs & derivatives , Tomography, Optical Coherence/methods , Administration, Oral , Adult , Central Serous Chorioretinopathy/diagnosis , Choroid/pathology , Eplerenone , Female , Follow-Up Studies , Fundus Oculi , Humans , Male , Middle Aged , Mineralocorticoid Receptor Antagonists/administration & dosage , Prospective Studies , Retina/pathology , Spironolactone/administration & dosage , Visual Acuity
7.
Eye (Lond) ; 31(12): 1740-1743, 2017 Dec.
Article in English | MEDLINE | ID: mdl-28731055

ABSTRACT

PurposeTo describe multimodal imaging features of choroidal osteoma (CO) complicated by choroidal neovascularization (CNV) and focal choroidal excavation (FCE).MethodsPatients presenting with CO and CNV between January and October 2016 were considered for this study. Diagnosis of CO was confirmed by ultrasound examination. All patients underwent multimodal imaging including optical coherence tomography (OCT), swept-source OCT angiography (DRI OCT Triton, Topcon, Inc., Tokyo, Japan) and fluorescein angiography (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany).ResultsTwo patients (one with bilateral CO) were included in the study. OCT showed a FCE in two eyes of two patients (one in correspondence of the CNV and the other adjacent to the CNV). OCT-A demonstrated presence of microvascular flow within neovascular network of the CNVs. Decalcification of the tumor was noted in correspondence of one eye with FCE.ConclusionsFCE may be found in eyes with choroidal osteoma and CNV. OCT-A was a valuable tool for detection of CNV complicating choroidal osteoma. Decalcification of choroidal osteoma may represent a common pathogenic pathway for development of FCE and CNV in choroidal osteoma.


Subject(s)
Choroid Neoplasms/diagnosis , Choroid/pathology , Choroidal Neovascularization/etiology , Osteoma/diagnosis , Adult , Choroid Neoplasms/complications , Choroidal Neovascularization/diagnosis , Female , Fluorescein Angiography , Follow-Up Studies , Fundus Oculi , Humans , Male , Osteoma/complications , Retrospective Studies , Tomography, Optical Coherence
8.
Eye (Lond) ; 31(11): 1600-1605, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28622313

ABSTRACT

PurposeTo describe optical coherence tomography (OCT) features in the Bruch's membrane (BM) of eyes with angioid streaks (AS) and evaluate their evolution over the follow-up.Patients and methodsPatients with AS presenting between March 2016 and September 2016 at two tertiary referral centers were consecutively recruited in this study. Eligibility criteria included prior spectral domain (SD)-OCT images, taken at least 3 months before at the same referral center, with automated eye tracking and image alignment modules. Alterations of BM were described and compared to previous scans over the follow-up. Multimodal imaging was used to identify alteration of retinal pigment epithelium (RPE) and choroid.ResultsThirty-two eyes of 16 consecutive patients with AS were included. BM undulations, mostly observed around the optic nerve head, were found in 19 (59.4%) of 32 eyes. BM breaks were found in 31 (96.9%) out of 32 eyes. Evolution of BM undulations into BM breaks was observed in 5 eyes (15.6%). Choroidal neovascularization (CNV) was observed in 12 eyes (37.5%) during follow-up, typically in areas of BM interruption.ConclusionsBM undulations, probably caused by high stretching forces exerted on the BM around the optic nerve head, seem to precede some BM breaks. BM interruptions may be a preferred way for the growth of CNV, which was identified in one-third of our cases.


Subject(s)
Angioid Streaks/diagnosis , Bruch Membrane/pathology , Choroid/pathology , Tomography, Optical Coherence/methods , Visual Acuity , Aged , Female , Fluorescein Angiography/methods , Follow-Up Studies , Fundus Oculi , Humans , Male , Optic Disk/pathology , Reproducibility of Results , Retinal Pigment Epithelium/pathology , Retrospective Studies
10.
Eye (Lond) ; 30(6): 888-93, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27034199

ABSTRACT

PurposeTo report the clinical course and the optical coherence tomography angiography (OCTA) findings of patients presenting with paracentral acute middle maculopathy (PAMM) and central retinal vein occlusion (CRVO).MethodsRetrospective case series. Clincal records and multimodal imaging findings of patients presenting with PAMM and CRVO were reviewed.ResultsThree eyes of three patients (2 males; mean age: 66 years) were included in the study. Mean follow-up was 9 months and images using OCTA (AngioVue OCT angiography system, Optovue, Inc., Fremont, CA, USA) were available at the last follow-up visit. During follow-up, best corrected visual acuity (BCVA) of case 1 was unchanged at 85 ETDRS letters and OCTA revealed a mild attenuation of the perifoveal deep capillary plexus (DCP); in case 2, BCVA changed from 83 to 77 ETDRS letters and OCTA revealed patchy areas of attenuation and pruning of the DCP; in case 3, BCVA decreased from 26 to 8 ETDRS letters and OCTA revealed extensive areas of DCP dropout.ConclusionThe natural course of visual acuity in patients with PAMM secondary to CRVO may vary. In these patients, the extent of DCP dropout on OCTA may reflect the extent of visual acuity impairment.


Subject(s)
Ischemia/diagnostic imaging , Retinal Vein Occlusion/complications , Retinal Vessels/diagnostic imaging , Scotoma/diagnostic imaging , Tomography, Optical Coherence , Aged , Angiography , Female , Humans , Ischemia/etiology , Male , Middle Aged , Multimodal Imaging , Retinal Vessels/pathology , Retrospective Studies , Scotoma/etiology , Visual Acuity/physiology
11.
Dev Ophthalmol ; 56: 107-12, 2016.
Article in English | MEDLINE | ID: mdl-27023453

ABSTRACT

PURPOSE: To describe the optical coherence tomography angiography (OCTA) features of diabetic retinopathy. METHODS: Literature review and case series. RESULTS: Four cases are presented. CONCLUSION: OCTA is an effective method for evaluating retinal changes in diabetic retinopathy and represents a novel complement or alternative to fluorescein angiography. Although OCTA should currently be considered an investigational technique, in the near future, it may play key roles in the diagnosis and management of diabetic retinopathy.


Subject(s)
Angiography/methods , Diabetic Retinopathy/diagnostic imaging , Tomography, Optical Coherence/methods , Fluorescein Angiography , Humans , Retinal Vessels/diagnostic imaging
12.
Eye (Lond) ; 30(5): 754-7, 2016 05.
Article in English | MEDLINE | ID: mdl-26915743

ABSTRACT

PurposeTo report the clinical course of patients presenting with stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) concomitant with exudative maculopathies.MethodsRetrospective case series. Multimodal imaging findings, including spectral-domain optical coherence tomography (SD-OCT) were reviewed. Genetic testing for the RS1 gene was performed in one patient.ResultsWe identified two female patients who fit the definition of SNIFR and presented with concomitant neovascular age-related macular degeneration (n-AMD). In both the patients, SD-OCT showed exudative macular features and splitting (bilateral in patient 1, unilateral in patient 2) of the outer plexiform layer (OPL) in the macula with no other evidence of hereditary or an acquired predisposing condition. Genetic testing excluded mutation of RS1 gene in patient 1. The fundi of both the patients showed characteristic signs of active choroidal neovascularization (CNV) and following anti-VEGF treatment, visual acuity improved and CNV-related exudative changes resolved. However, the split along the OPL remained unaltered.ConclusionsSNIFR may be associated with n-AMD. It is important to recognise the presence of retinoschisis when there is other exudative pathology as the former may be misinterpreted as intraretinal fluid, prompting unnecessary treatment.


Subject(s)
Retinoschisis/complications , Wet Macular Degeneration/complications , Aged, 80 and over , Angiogenesis Inhibitors/therapeutic use , Coloring Agents/administration & dosage , Exudates and Transudates , Female , Fluorescein Angiography , Humans , Indocyanine Green/administration & dosage , Multimodal Imaging , Retinoschisis/diagnostic imaging , Retrospective Studies , Tomography, Optical Coherence , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity/physiology , Wet Macular Degeneration/diagnostic imaging , Wet Macular Degeneration/drug therapy
13.
J Fr Ophtalmol ; 39(1): 64-8, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26679385

ABSTRACT

PURPOSE: To report two cases of spontaneous retinal pigment epithelial (RPE) tears occurring in two patients affected with geographic atrophy (GA) due to non-exudative age-related macular degeneration (AMD). CASE REPORT: Two patients (a 79-year-old man and a 71-year-old woman) presented to our department with progressive visual loss. The man had a best-corrected visual acuity (BCVA) of 20/100 in the right eye (RE) and 20/50 in the left eye (LE); the woman had a BCVA of 20/200 in the RE and 20/160 in the LE. Upon complete ophthalmologic examination, revealing a large area of atrophy (>175 µm in diameter) along with pigmentary changes, calcified drusen and no choroidal neovascularization (CNV) in either eye, the patients were diagnosed with GA due to non-exudative AMD. Interestingly, the imaging modalities performed, including fluorescein angiography (FA), indocyanine green angiography (ICGA) and spectral-domain optical coherence tomography (SD-OCT), clearly highlighted the presence of spontaneous RPE tears in the context of non-exudative AMD, while in general, RPE tears are a well-recognized complication of exudative AMD. CONCLUSIONS: To our knowledge, this is the first description of spontaneous RPE tears as a possible complication of GA due to non-exudative AMD.


Subject(s)
Geographic Atrophy/complications , Retinal Perforations/etiology , Retinal Pigment Epithelium/pathology , Aged , Angiography , Calcinosis/etiology , Female , Fluorescein Angiography , Humans , Indocyanine Green , Male , Retinal Drusen/etiology , Retinal Perforations/diagnosis , Rupture, Spontaneous , Tomography, Optical Coherence , Visual Acuity
14.
Graefes Arch Clin Exp Ophthalmol ; 253(10): 1647-51, 2015 Oct.
Article in English | MEDLINE | ID: mdl-25382074

ABSTRACT

PURPOSE: To compare the effects of subthreshold grid laser treatment (SGLT) and intravitreal bevacizumab injection (IVBI) for the treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) recurring after conventional grid laser photocoagulation. METHODS: Thirty-five eyes were considered in this prospective, randomised, interventional study and treated with micropulse diode laser (SGLT subgroup) or IVBI (IVBI subgroup). SGLT was administered once, whereas IVBI (1.25 mg) was given at baseline and then on a pro re nata regimen according to ME presence on optical coherence tomography (OCT), performed at monthly examinations over a 12-month follow-up. Primary outcome measures were the mean BCVA changes over the follow-up and the decrease in mean central foveal thickness (CFT) on optical coherence tomography (OCT). Secondary outcomes included the proportion of eyes that gained at least 15 letters (approximately three lines) at the 12-month examination. RESULTS: Eighteen and 17 patients were assigned to SGLT and IVBI subgroups, respectively. At baseline, the subgroups were similar with regard to mean ME duration, BCVA, and CFT. At month 12, mean CFT significantly improved from 484 µm to 271 µm in the IVBI subgroup, whereas it was unchanged in the SGLT subgroup. Mean BCVA changed from 0.92 ± 0.3 (LogMAR) to 0.99 ± 0.2 in the SGLT subgroup; in the IVBI subgroup, mean BCVA showed a statistically significant improvement from 0.94 ± 0.3 to 0.72 ± 0.2. Ten patients in the IVBI subgroup (58 %) and no patient in the SGLT subgroup gained at least three lines. CONCLUSION: At the 1-year follow-up, IVBI provided a significant functional and anatomical improvement, whereas SGLT failed to demonstrate any beneficial effects. IVBI might be a useful approach in the treatment of recurrent ME secondary to BRVO already treated with conventional grid laser photocoagulation. UMIN registry, number UMIN000005014, URL: http://www.umin.ac.jp/ctr/index.htm.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Bevacizumab/therapeutic use , Laser Coagulation , Macular Edema/therapy , Retinal Vein Occlusion/therapy , Aged , Female , Fluorescein Angiography , Humans , Intravitreal Injections , Macular Edema/drug therapy , Macular Edema/etiology , Macular Edema/surgery , Male , Middle Aged , Prospective Studies , Recurrence , Retinal Vein Occlusion/complications , Retinal Vein Occlusion/drug therapy , Retinal Vein Occlusion/surgery , Tomography, Optical Coherence , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity/physiology
15.
Br J Ophthalmol ; 98(4): 519-22, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24414400

ABSTRACT

PURPOSE: To assess the effects of intravitreal bevacizumab (IVB) in the treatment of choroidal neovascularisation (CNV) secondary to serpiginous choroiditis (SC). DESIGN: Non-randomised, interventional case series. PARTICIPANTS: Seven patients (seven eyes) affected by juxtafoveal CNV (six eyes) and subfoveal CNV (one eye) associated with SC were recruited. METHODS: Each patient underwent an ophthalmological examination, including measurement of best-corrected visual acuity (BCVA), fluorescein angiography (FA) and optical coherence tomography (OCT). After a first IVB injection (1.25 mg), patients were evaluated monthly over a 12-month follow-up. Further re-treatments were performed on the basis of detection of any type of fluid on OCT and/or presence of leakage on FA. The primary outcome considered was the median change in BCVA, as well as the proportion of eyes gaining at least 5 and 10 Early Treatment Diabetic Retinopathy Study (ETDRS) letters at the end of the 12-month follow-up. Secondary outcomes included median changes in central macular thickness (CMT) and number of injections over the planned follow-up. RESULTS: Median BCVA changed from 0.3 to 0.4 LogMAR. A functional improvement of at least 5 and 10 ETDRS letters was obtained in two eyes (28%) and one eye (14%), respectively, at the 12-month examination. Four eyes (57%) had stable BCVA, whereas one eye (14%) experienced a two-line decrease. Median CMT at baseline was 261 µm, decreasing to 196 µm at the 12-month examination. The median number of IVB injections was 1 in 12 months. CONCLUSIONS: IVB can achieve anatomical stabilisation of CNV secondary to SC, avoiding a decline in visual acuity, in almost 90% of cases over a 12-month follow-up.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Choroidal Neovascularization/drug therapy , Choroiditis/complications , Bevacizumab , Choroidal Neovascularization/diagnosis , Choroidal Neovascularization/etiology , Choroiditis/diagnosis , Choroiditis/drug therapy , Female , Fluorescein Angiography , Follow-Up Studies , Humans , Immunosuppressive Agents/therapeutic use , Intravitreal Injections , Male , Middle Aged , Prospective Studies , Tomography, Optical Coherence , Treatment Outcome , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity/physiology
16.
Ophthalmic Res ; 51(2): 88-95, 2014.
Article in English | MEDLINE | ID: mdl-24356667

ABSTRACT

Diabetic macular edema (DME) is a highly prevalent cause of vision loss and has a remarkable impact on public health, and on the quality of life of diabetic patients. Even though laser photocoagulation has been the standard of care for decades, a substantial group of patients are unresponsive and fail to improve after laser treatment. Recently, new pharmacological approaches based on the use of intravitreal drugs, such as corticosteroids and anti-vascular endothelial growth factor, have revolutionized the treatment of DME. The use of intravitreal drugs is supported by the improvement in visual acuity reported by several clinical trials and can limit the potentially destructive effects of the laser treatment. Encouraging results also emerged from studies evaluating the use of a combination therapy, or the association of intravitreal drugs and laser treatment. This review aims at providing a brief synopsis of the main investigations regarding the current pharmacological approach to DME.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Diabetic Retinopathy/drug therapy , Glucocorticoids/therapeutic use , Macular Edema/drug therapy , Combined Modality Therapy , Delayed-Action Preparations , Drug Implants , Humans , Intravitreal Injections , Laser Coagulation , Treatment Outcome , Vascular Endothelial Growth Factor A/antagonists & inhibitors
SELECTION OF CITATIONS
SEARCH DETAIL