ABSTRACT
CASE REPORT: We present an unusual case of recurrent and bilateral multiple evanescent white dot syndrome (MEWDS), who had three bilateral episodes in a period of nine years. Thirteen years after the first episode, she was diagnosed with subretinal neovascularization (SRNV) which showed a satisfactory response to photodynamic therapy, with a final visual acuity of 20/40. DISCUSSION: MEWDS is considered classically to be an inflammatory disease with a good visual prognosis. Although the development of SRNV is unusual, we recommend long term follow-up of these patients since the early diagnosis and treatment of SRNV are both relevant for the retention of visual acuity.
Subject(s)
Choroidal Neovascularization/diagnosis , Vision Disorders/diagnosis , Adult , Female , Humans , Recurrence , Syndrome , Time FactorsABSTRACT
Caso clínico: Se presenta un caso de presunto síndrome de múltiples manchas blancas evanescentes (MEWDS) recurrente y bilateral (tres episodios bilaterales en nueve años). Trece años después del episodio inicial, presentó una membrana neovascular subretiniana (MNVSR) que respondió favorablemente a terapia fotodinámica, con una agudeza visual final de 20/40. Discusión: El MEWDS se considera una enfermedad inflamatoria con buen pronóstico visual. Sin embargo, existe la posibilidad de desarrollar a largo plazo complicaciones como la MNVSR. Por ello,recomendamos el seguimiento periódico de estos pacientes por la importancia del diagnóstico y tratamiento precoz de las MNVSR en la agudeza visual final
Case report: We present an unusual case of recurrent and bilateral multiple evanescent white dot syndrome (MEWDS), who had three bilateral episodes in a period of nine years. Thirteen years after the first episode, she was diagnosed with subretinal neovascularization (SRNV) which showed a satisfactory response to photodynamic therapy, with a final visual acuity of 20/40. Discussion: MEWDS is considered classically to be an inflammatory disease with a good visual prognosis. Although the development of SRNV isunusual, we recommend long term follow-up of these patients since the early diagnosis and treatmentof SRNV are both relevant for the retention of visual acuity
Subject(s)
Female , Adult , Humans , Choroidal Neovascularization/pathology , Retinal Diseases/pathology , Vision, Low/etiology , Vision Disorders/etiology , Recurrence , Visual AcuityABSTRACT
CASE REPORT: A 78-year-old woman, with an acute exacerbation of chronic obstructive airways disease, was treated with nebulised ipratropium bromide and salbutamol. Twenty hours after beginning this treatment, she developed acute angle-closure glaucoma (AACG) in her left eye which resolved rapidly with appropriate treatment. DISCUSSION: Nebulised ipratropium bromide and salbutamol increases the intraocular pressure and may cause an AACG in susceptible patients (those with a shallow anterior chamber, hypermetropia, or chronic angle-closure glaucoma). Increased vigilance in such patients treated with these bronchodilators may avoid this adverse effect. Ensuring the mask is correctly fitted, using a T-piece or unvented nebuliser and protective eye wear, are some of the many recommendations made to minimize the development of AACG in these patients.
Subject(s)
Albuterol/adverse effects , Bronchodilator Agents/adverse effects , Glaucoma, Angle-Closure/chemically induced , Ipratropium/adverse effects , Aged , Female , Humans , Pulmonary Disease, Chronic Obstructive/drug therapyABSTRACT
Caso clínico: Mujer de 78 años, con un cuadro de reagudización de enfermedad pulmonar obstructiva crónica tratada con bromuro de ipratropio y salbutamol nebulizados. Tras 20 horas desde el inicio del tratamiento, la paciente desarrolló un glaucoma agudo de ángulo cerrado (GACA) en el ojo izquierdo que respondió rápidamente al tratamiento médico adecuado. Discusión: El bromuro de ipratropio y el salbutamol nebulizados, aumentan la presión intraocular y pueden desencadenar un GACA en pacientes predispuestos (cámara anterior estrecha, hipermétropes, glaucoma crónico de ángulo estrecho). Una mayor precaución en los pacientes tratados con estos broncodilatadores, podría evitar este efecto adverso indeseable. Además, la correcta aplicación de la mascarilla facial, el uso de terminales en T y gafas de protección, son algunas medidas a tomar para prevenir un GACA en estos pacientes
Case report: A 78-year-old woman, with an acute exacerbation of chronic obstructive airways disease, was treated with nebulised ipratropium bromide and salbutamol. Twenty hours after beginning this treatment, she developed acute angle-closure glaucoma (AACG) in her left eye which resolved rapidly with appropriate treatment. Discussion: Nebulised ipratropium bromide and salbutamol increases the intraocular pressure and may cause an AACG in susceptible patients (those with a shallow anterior chamber, hypermetropia, or chronic angle-closure glaucoma). Increased vigilance in such patients treated with these bronchodilators may avoid this adverse effect. Ensuring the mask is correctly fitted, using a T-piece or unvented nebuliser and protective eye wear, are some of the many recommendations made to minimize the development of AACG in these patients
Subject(s)
Female , Aged , Humans , Glaucoma/chemically induced , Bronchodilator Agents/adverse effects , Pulmonary Disease, Chronic Obstructive/drug therapy , Albuterol/adverse effects , Intraocular Pressure , Ipratropium/adverse effectsABSTRACT
CASE REPORT: A 53-year-old woman, with a history of a right retinal detachment treated by vitrectomy and silicone oil injection, who subsequently had the oil removed. She presented to us with a hypertensive anterior uveitis, which could not be controlled with medical treatment. On examination, micro-bubbles of emulsified silicone oil were evident in the anterior chamber simulating tyndall. A secondary glaucoma to emulsified silicone oil in the anterior chamber was diagnosed, and surgical treatment was proposed. DISCUSSION: Although secondary glaucoma is a frequent complication after oil silicone injection in vitreo-retinopathy surgery, the presence of emulsified silicone oil in the anterior chamber simulating tyndall is uncommon.
Subject(s)
Anterior Chamber , Glaucoma/chemically induced , Silicone Oils/adverse effects , Female , Humans , Middle AgedABSTRACT
Caso clínico: Mujer de 53 años, con antecedentes de desprendimiento de retina (DR) en el ojo derecho (OD), intervenido mediante vitrectomía e inyección de aceite de silicona (AS) aspirada en un segundo tiempo.Acudió a nuestra consulta diagnosticada de uveítis anterior aguda hipertensiva resistente al tratamiento. A la exploración presentaba microburbujas de aceite de silicona emulsificado en cámara anterior que simulaba un tyndall.Se diagnosticó un glaucoma secundario a aceite de silicona emulsificado en cámara anterior y se propuso tratamiento quirúrgico.Discusión: El glaucoma secundario es una complicación frecuente tras la utilización del AS en la cirugía vitreorretiniana. Esta forma de presentación del aceite de silicona emulsificado en cámara anterior, simulando un tyndall, es infrecuente
Case report: A 53-year-old woman, with a history of a right retinal detachment treated by vitrectomy and silicone oil injection, who subsequently had the oil removed. She presented to us with a hypertensive anterior uveitis, which could not be controlled with medical treatment. On examination, micro-bubbles of emulsified silicone oil were evident in the anterior chamber simulating tyndall. A secondary glaucoma to emulsified silicone oil in the anterior chamber was diagnosed, and surgical treatment was proposed. Discussion: Although secondary glaucoma is a frequent complication after oil silicone injection in vitreo-retinopathy surgery, the presence of emulsified silicone oil in the anterior chamber simulating tyndall is uncommon
