ABSTRACT
In this case series, 3 unique cases of severe immune-mediated pathologies (primary ocular lymphoma, toxoplasmosis chorioretinitis, and syphilitic retinitis) after dropless cataract surgery with intraocular steroid injection are reported. Patient immune status and subsequent local immunosuppression after dropless cataract surgery played roles in the worsening of these pathologies. This report demonstrates the need for vigilance when administering immunosuppressive agents locally during cataract surgery.
Subject(s)
Cataract Extraction , Cataract , Intraocular Lymphoma , Lens, Crystalline , Retinitis , Humans , Intraocular Lymphoma/diagnosisABSTRACT
PURPOSE: To describe the findings seen on optical coherence tomography angiography (OCTA) in patients with punctate inner choroidopathy (PIC) and multifocal choroiditis and panuveitis (MCP) complicated by choroidal neovascular membranes. METHODS: This was an Institutional Review Board-approved prospective, descriptive case series. 12 patients with PIC and MCP complicated by choroidal neovascularisation (CNV) were included. Each patient underwent slit-lamp examination by a uveitis specialist followed by conventional spectral domain OCT imaging of the macula. OCTA images of the macula were then obtained. RESULTS: 12 patients were enrolled in the study, out of which 9 patients were followed longitudinally. CNV was identified in 11 of the 12 patients. In all patients where fluorescein angiography (FA) was inconclusive for presence of CNV, OCTA identified CNV. Various lesions on OCT suggestive of activity correlated with changes in the vascular structure of OCTA to confirm suspicion of clinical activity. CONCLUSION: In patients with PIC and MCP complicated by CNV, OCTA successfully identified underlying CNV. Given the difficulty of differentiating inflammatory lesions from early CNV on OCT and FA, OCTA may provide a valuable method of monitoring patients with posterior uveitis highly correlated with development of CNV.
Subject(s)
Choroidal Neovascularization/pathology , Choroiditis/pathology , Panuveitis/pathology , Tomography, Optical Coherence/methods , Adult , Angiogenesis Inhibitors/therapeutic use , Bevacizumab/therapeutic use , Choroidal Neovascularization/diagnostic imaging , Choroidal Neovascularization/drug therapy , Choroiditis/diagnostic imaging , Choroiditis/drug therapy , Female , Fluorescein Angiography , Humans , Male , Middle Aged , Multifocal Choroiditis , Panuveitis/diagnostic imaging , Panuveitis/drug therapy , Prospective Studies , Retrospective Studies , Steroids/therapeutic use , Visual Acuity , Young AdultABSTRACT
Neovascularization may be associated with cat-scratch neuroretinitis in the absence of retinal vascular occlusion. Bartonella organisms establish an intimate relationship with the vascular endothelium, causing angioproliferative lesions, which might represent a dedicated pathogenic strategy for expanding the bacterial host cell habitat. In the eye, pathological angiogenesis caused by Bartonella has been described as peripapillary or macular choroidal neovascularization, but the presence of neovascularization within foci of chorioretinitis has never before been reported. The authors present a case of Bartonella chorioretinitis in which optical coherence tomography angiography, by detecting erythrocyte motion, was able to identify neovessels inside the infectious focus. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:585-588.].
Subject(s)
Bartonella Infections/diagnosis , Chorioretinitis/diagnosis , Eye Infections, Bacterial/diagnosis , Fluorescein Angiography/methods , Tomography, Optical Coherence/methods , Adolescent , Diagnosis, Differential , Fundus Oculi , Humans , MaleABSTRACT
The purpose of the study was to describe the findings seen on anterior segment spectral domain optical coherence tomography (SD-OCT) in patients with anterior scleritis and determine the feasibility of using SD-OCT to image and grade the degree of scleral inflammation and monitor response to treatment. All patients underwent slit lamp examination by a uveitis specialist, and the degree of scleral inflammation was recorded. Spectral domain OCT imaging was then performed of the conjunctiva and scleral tissue using a standardized acquisition protocol. The scans were graded and compared to clinical findings. Twenty-eight patients with anterior scleritis and ten patients without ocular disease were included in the study. Seventeen of the scleritis patients were followed longitudinally. Common findings on SD-OCT in patients with active scleritis included changes in hyporeflectivity within the sclera, nodules, and visible vessels within the sclera. There was significant variation in findings on SD-OCT within each clinical grade of active scleritis. These changes on SD-OCT improved with treatment and clinical improvement. SD-OCT imaging provided various objective measures that could be used in the future to grade inflammatory activity in patients with anterior scleritis. Longitudinal imaging of patients with active scleritis demonstrated that SD-OCT may have great utility in monitoring response to treatment.
