ABSTRACT
PURPOSE: To describe a patient who fulfilled the criteria for both clinically definite multiple evanescent white dot syndrome (MEWDS) and multiple sclerosis. METHODS: We performed a complete ophthalmologic and neurological examination in a 30-year-old woman who was referred to our department for blurred vision in her left eye (LE) with photopsia. RESULTS: Following a complete ophthalmologic examination, the patient was diagnosed with MEWDS and coincident multiple sclerosis. She underwent therapy with intravenous methylprednisolone (1000 mg/day) for three days, followed by oral prednisone (1 mg/kg per day) for 15 days. Most of the symptoms and signs apparently regressed within one month, despite a still abnormal OCT macular scan, probably due to atrophic post-inflammatory changes in the outer and photoreceptor layers (rods and cones). CONCLUSION: This report, showing the clinical features of MEWDS associated with multiple sclerosis, strongly suggests common neuropathological and inflammatory mechanisms between MS and white dot syndromes.
Subject(s)
Chorioretinitis/diagnosis , Multiple Sclerosis/diagnosis , Optic Neuritis/diagnosis , Administration, Oral , Adult , Anti-Inflammatory Agents/administration & dosage , Brain/pathology , Chorioretinitis/drug therapy , Diplopia/etiology , Drug Therapy, Combination , Electroretinography/drug effects , Evoked Potentials, Visual/drug effects , Evoked Potentials, Visual/physiology , Female , Fluorescein Angiography , Humans , Magnetic Resonance Imaging , Methylprednisolone/administration & dosage , Multiple Sclerosis/drug therapy , Optic Neuritis/drug therapy , Papilledema/diagnosis , Papilledema/drug therapy , Prednisone/administration & dosage , Tomography, Optical Coherence , Visual Field TestsABSTRACT
Purpose. To report the outcomes after primary intravitreal pegaptanib sodium in patients with diabetic macular edema (DME). Methods. We conduced a retrospective analysis of eyes with DME treated with primary intravitreal pegaptanib sodium (Macugen) (intravitreal pegaptanib group). The results were compared with the ones of eyes treated with intravitreal pegaptanib sodium associated with macular laser photocoagulation (combined treatment group), and the ones of eyes treated with primary macular laser photocoagulation (macular laser photocoagulation group). Results. For the intravitreal pegaptanib group (13 eyes), we found significant changes in mean best-corrected visual acuity (BCVA) and reductions in mean central macular thickness (CMT) at the last follow-up visit (P = .0014 and P = .0001). For the macular laser photocoagulation group (15 eyes), we found no statistically significant changes in mean BCVA and CMT at the last follow-up visit (P > .05). For the combined treatment group (12 eyes), we found no significant changes in mean BCVA at the last follow-up visit (P > .05) despite significant reductions in mean CMT (P = .0188). Conclusion. Intravitreal pegaptanib treatment alone may be superior to macular laser photocoagulation alone and to combined intravitreal pegaptanib treatment associated with macular laser photocoagulation in patients with DME.
ABSTRACT
In the last 50 years cocaine usage has had a growing incidence worldwide. Chronic nasal abuse of this drug can cause extensive oromaxillofacial destructive process as oronasal perforation. To author's knowledge the only type of oronasal fistula in cocaine abusers that has been reported to date has been perforation of the hard palate; a case of oronasal fistulas involving another region of oral cavity, the anterior gingival sulcus, has been reported only once. In this article authors present the first case of oronasal fistula involving hard palate and the right supero-lateral vestible induced by prolonged cocaine snort described in literature, review about the better surgical management for this lesion and the relationship between chronic cocaine abuse and elevated serum levels of c-ANCA.
