ABSTRACT
A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal relationship has been confirmed, PDE5 inhibition at chorioretinal level produces vasodilatation, increased choroid hydrostatic pressure, and exudation into the subretinal space. In cases of NRD, a thorough assessment of the drug treatment history is crucial. Patients who use PDE5I drugs should be alerted to their potential ocular side effects.
Subject(s)
Retinal Detachment , Choroid , Humans , Male , Middle Aged , Retinal Detachment/chemically induced , Retinal Detachment/diagnostic imaging , Subretinal Fluid , Tadalafil/adverse effects , Tomography, Optical Coherence/methodsABSTRACT
Se presenta el caso de un varón de 53 años con desprendimiento retiniano neurosensorial (DNS) bilateral asintomático detectado en una revisión rutinaria. No se encontraron patologías sistémicas subyacentes, salvo hipertensión arterial controlada. En la anamnesis dirigida, el paciente reveló ingesta de tadalafilo, un inhibidor de la fosfodiesterasa 5 (IPDE5) utilizado en el tratamiento de la disfunción eréctil. Tras la retirada del fármaco, se observó una reabsorción del fluido subretiniano con persistencia de alteraciones crónicas y campimétricas en la tomografía de coherencia óptica (OCT). Los IPDE5 presentan efectos secundarios oculares entre los que se ha descrito el desprendimiento seroso retiniano. Aunque no se ha podido comprobar la relación causal directa, la inhibición de la fosfodiesterasa 5 (PDE5) a nivel coriorretiniano produce vasodilatación, aumento de la presión hidrostática coroidea y exudación al espacio subretiniano. En casos de DNS, es fundamental una historia farmacoterapéutica completa. Se debería advertir de los posibles efectos secundarios oculares de los IPDE5 a los pacientes usuarios de este tipo de fármacos (AU)
A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal relationship has been confirmed, PDE5 inhibition at chorioretinal level produces vasodilatation, increased choroid hydrostatic pressure, and exudation into the subretinal space. In cases of NRD, a thorough assessment of the drug treatment history is crucial. Patients who use PDE5I drugs should be alerted to their potential ocular side effects (AU)
Subject(s)
Humans , Male , Middle Aged , Retinal Detachment/chemically induced , Retinal Detachment/diagnostic imaging , Tadalafil/adverse effects , Phosphodiesterase 5 Inhibitors/adverse effects , Tomography, Optical CoherenceABSTRACT
Varón de 65 años, sin antecedentes patológicos, que presenta nódulo escleral nasal hiperémico doloroso sugestivo de escleritis anterior nodular, sin otros hallazgos
Subject(s)
Middle Aged , Health Sciences , Ophthalmology , Scleritis/diagnostic imagingABSTRACT
No disponible
Subject(s)
Humans , Male , Aged, 80 and over , Carcinoma, Squamous Cell/drug therapy , Conjunctival Neoplasms/drug therapy , Interferon alpha-2/therapeutic use , Carcinoma, Squamous Cell/pathology , Biopsy , Conjunctival Neoplasms/pathologyABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Empty Sella Syndrome/complications , Empty Sella Syndrome/diagnostic imaging , Intracranial Hypertension/complications , Intracranial Hypertension/diagnostic imaging , Papilledema/diagnostic imaging , Papilledema/etiology , Magnetic Resonance Imaging , Spinal PunctureSubject(s)
Carcinoma, Squamous Cell/drug therapy , Chemotherapy, Adjuvant , Conjunctival Neoplasms/drug therapy , Immunologic Factors/therapeutic use , Interferon alpha-2/therapeutic use , Aged, 80 and over , Biological Dressings , Carcinoma, Squamous Cell/therapy , Combined Modality Therapy , Conjunctival Neoplasms/therapy , Cryotherapy , Humans , Male , Neoplasm Recurrence, Local/prevention & controlABSTRACT
No disponible
Subject(s)
Humans , Female , Child , Persistent Hyperplastic Primary Vitreous/diagnostic imaging , Tomography, Optical CoherenceABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Adenocarcinoma of Lung/pathology , Angiography/methods , Choroid Neoplasms/diagnostic imaging , Choroid Neoplasms/secondary , Tomography, Optical CoherenceABSTRACT
No disponible
Subject(s)
Humans , Retinal Diseases/diagnostic imaging , Retinal Artery , Tomography, Optical CoherenceABSTRACT
No disponible
Subject(s)
Humans , Lens Capsule, Crystalline/pathology , Retinitis Pigmentosa/diagnostic imaging , Tomography, Optical Coherence , Aqueous Humor/chemistry , Cytokines/analysis , Epithelial Cells/pathology , Lasers, Solid-State/therapeutic use , Metaplasia/radiotherapy , Phacoemulsification , Retinitis Pigmentosa/metabolism , Retinitis Pigmentosa/pathologySubject(s)
Lens Capsule, Crystalline/pathology , Retinitis Pigmentosa/diagnostic imaging , Tomography, Optical Coherence , Aqueous Humor/chemistry , Cytokines/analysis , Epithelial Cells/pathology , Humans , Lasers, Solid-State/therapeutic use , Metaplasia/radiotherapy , Phacoemulsification , Retinitis Pigmentosa/metabolism , Retinitis Pigmentosa/pathologyABSTRACT
Objective@#To review available resources and provide evidence-based recommendations that may optimize otorhinolaryngologic out-patient health care delivery in the “post”-COVID-19 era while ensuring the safety of our patients, healthcare workers and staff.@*Data Sources@#Relevant peer-reviewed journal articles; task force, organizational and institutional, government and non-government organization recommendations; published guidelines from medical, health-related, and scientific organizations.@*Methods@#A comprehensive review of the literature on the COVID-19 pandemic as it pertained to “post”-COVID 19 out-patient otorhinolaryngologic practice was obtained from peer-reviewed articles, guidelines, recommendations, and statements that were identified through a structured search of the data sources for relevant literature utilizing MEDLINE (through PubMed and PubMed Central PMC), Google (and Google Scholar), HERDIN Plus, the World Health Organization (WHO) Global Health Library, and grey literature including social media (blogs, Twitter, LinkedIn, Facebook). In-patient management (including ORL surgical procedures such as tracheostomy) were excluded. Retrieved material was critically appraised and organized according to five discussion themes: physical office set-up, patient processing, personal protection, procedures, and prevention and health-promotion.@*Conclusion@#These recommendations are consistent with the best available evidence to date, and are globally acceptable while being locally applicable. They address the concerns of otorhinolaryngologists and related specialists about resuming office practice during the “post”-COVID-19 period when strict quarantines are gradually lifted and a transition to the “new” normal is made despite the unavailability of a specific vaccine for SARS-CoV-2. While they target practice settings in the Philippines, they should be useful to ENT (ear, nose & throat) surgeons in other countries in ensuring a balance between service and safety as we continue to serve our patients during these challenging times.
ABSTRACT
CASO CLÍNICO: Varón de 36 años consulta tras exposición bilateral a puntero láser el día anterior. En funduscopia se evidenciaron alteraciones pigmentarias maculares dispersas y en tomografía de coherencia óptica, desestructuración de las capas retinianas. La agudeza visual fue de contaje de dedos en ambos ojos. Nueve meses después se evidenció en la angiografía mediante tomografía de coherencia óptica una alteración del flujo vascular coriocapilar en la zona lesionada por el láser. Discusión: El láser afecta principalmente al epitelio pigmentario retiniano. Sin embargo, con este caso ponemos de manifiesto la posible afectación más allá del epitelio pigmentario retiniano, apareciendo alteración vascular coriocapilar tras la exposición a puntero láser
CASE REPORT: A 36-year-old man went to the emergency department the day after exposure to a laser pointer. Funduscopy revealed dispersed macular pigment alterations, and optical coherence tomography showed a disruption of the retinal layers. The visual acuity was counting fingers in both eyes. Nine months later, optical coherence tomography angiography showed a rarefaction in the choriocapillaris vascular flow in the area of the laser injuries. DISCUSSION: The retinal layer mainly damaged by the laser injury was the retinal pigment epithelium. However, it is suggested that the laser injury could involve tissues beyond the retinal pigment epithelium, since a rarefaction of the choriocapillaris was found after exposure to the laser
Subject(s)
Humans , Male , Adult , Lasers/adverse effects , Macular Degeneration/diagnosis , Tomography, Optical Coherence , Angiography/methods , Retina/radiation effects , Retina/injuries , Vision Disorders/epidemiology , Visual Acuity , Fundus OculiABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Retinal Artery , Aneurysm/diagnosis , Hypertension/complications , Antihypertensive Agents/therapeutic use , Vitreoretinal Surgery/methods , Patient Care Team , Aneurysm/therapy , Treatment OutcomeABSTRACT
CASO CLÍNICO: Presentamos un caso de osteoma de coroides unilateral con excavación coroidea y membrana neovascular asociada estudiado mediante angiografía-TCO. En TCO y angiografía-TCO se objetivó excavación coroidea y una membrana neovascular coroidea activa. Se administraron tres dosis de aflibercept estabilizando la neovascularización coroidea. DISCUSIÓN: La angiografía-TCO permitió el análisis morfológico de la red vascular superficial del osteoma así como el control evolutivo de la membrana neovascular
CLINICAL CASE: A case is presented of a unilateral choroidal osteoma with choroidal excavation and associated neovascular membrane that was studied using OCT-angiography. The OCT and OCT-angiography revealed an area of choroidal excavation and an active neovascular membrane. Three doses of aflibercept were administered to the patient, which stabilised the neovascularisation. DISCUSSION: OCT-angiography was used to analyse the morphology of the superficial vascular network of the osteoma, as well as to monitor the evolution of the neovascular membrane
