ABSTRACT
Peripapillary capillary network using optical coherence tomography angiography (OCT-A) was analysed in two siblings suffering from dominant optic atrophy linked to OPA-1 gene mutation. Peripapillary capillary network has been scarcely described in this type of optic atrophy.
Subject(s)
Optic Atrophy, Autosomal Dominant , Optic Atrophy , Humans , Optic Atrophy, Autosomal Dominant/diagnosis , Optic Atrophy, Autosomal Dominant/genetics , Mutation , Tomography, Optical Coherence/methods , Siblings , Fluorescein Angiography/methods , GTP Phosphohydrolases/geneticsABSTRACT
The authors report the use of topical recombinant human nerve growth factor cenegermin 0.02% in 5 patients diagnosed with neurotrophic keratopathy (NK) in a real-life setting. These 5 patients affected with stage II and III NK mainly of herpetic cause received cenegermin six times daily for 8 weeks. It was initiated upon refractoriness to prior conventional topical treatment. Visual acuity, corneal sensitivity test at four corneal quadrants, fluorescein staining, OC,T and photography were performed weekly during 9 weeks of follow-up from the completion of treatment. At the ninth week of follow-up, corneal sensitivity improvement and healing of corneal ulcers were found in all patients. No adverse events were reported, and no corneal ulcer recurrence was observed over a 4-year follow-up period. Cenegermin should be used in combination with conventional therapy for advanced NK, as it is an effective treatment for healing corneal ulcers, improving the corneal surface homeostasis and avoiding surgery.
ABSTRACT
A 64-year-old Caucasian woman was referred to our hospital after referring vision loss; she had been previously diagnosed with systemic diffuse large B-cell lymphoma. Retinal and optic nerve involvement were found in her right eye, and iris and vitreous involvement were found in her left eye. Vitreoretinal lymphomas (VRL) are rare in medical literature, hence there is a lack of standardised studies regarding therapeutic options in these patients. In our patient, we decided to add intravitreal injections of rituximab and methotrexate to systemic chemotherapy, and to perform pars plana vitrectomy.
Subject(s)
Lymphoma, Large B-Cell, Diffuse , Retinal Neoplasms , Female , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Methotrexate , Middle Aged , Retinal Neoplasms/drug therapy , Retrospective Studies , Rituximab , Vitreous BodyABSTRACT
A case of a young Caucasian male who presented bilateral papilledema is described. He was misdiagnosed with bilateral anterior optic neuritis, developing panuveitis and exudative bilateral retinal detachment after being treated with megadoses of corticosteroids. He was finally diagnosed with ocular syphilis and treated with intravenous aqueous crystalline penicillin for 14 days, with complete resolution of his symptoms.
Subject(s)
Eye Infections, Bacterial/diagnosis , Glucocorticoids/adverse effects , Methylprednisolone/adverse effects , Optic Neuritis/diagnosis , Panuveitis/diagnosis , Retinal Detachment/chemically induced , Syphilis/diagnosis , Adult , Anti-Bacterial Agents/administration & dosage , Eye Infections, Bacterial/drug therapy , Humans , Infusions, Intravenous , Male , Optic Neuritis/drug therapy , Panuveitis/drug therapy , Penicillins/administration & dosage , Retinal Detachment/diagnostic imaging , Syphilis/drug therapy , Syphilis Serodiagnosis , Tomography, Optical Coherence , Visual Acuity/physiologyABSTRACT
A 22-year-old male was referred for headaches, hearing impairment, and right eye scotoma. Branch retinal artery occlusion was revealed during the ophthalmological examination. Susac syndrome was suspected due to the symptoms described and the absence of cardiovascular risk factors. An extensive ophthalmological examination, including multimodal imaging was carried out, which is of special interest as it is considered to be a rare syndrome.
ABSTRACT
Corneal dellen appeared as a complication after perilimbal conjunctival papilloma dissection in a six-year-old patient. Our purpose was to describe the use of plasma rich in growth factors (PRGF) fibrin membrane in covering the corneal defect after conventional medical treatment failure. PRGF fibrin membrane is an interesting therapeutical option to consider not only in adult patients, but also in children.
Subject(s)
Fibrin , Intercellular Signaling Peptides and Proteins , Adult , Child , Conjunctiva , Humans , PlasmaABSTRACT
A Caucasian male with known severe aortic stenosis was referred to our Ophthalmology Department after undergoing cardiac surgery using extracorporeal circulation. Signs of retinal ischaemia were found during fundus examination and neuroimaging showed posterior cerebral artery occlusion.
Subject(s)
Cardiac Surgical Procedures/adverse effects , Fluorescein Angiography/methods , Fovea Centralis/pathology , Postoperative Complications , Retinal Diseases/diagnosis , Fundus Oculi , Heart Valve Diseases/surgery , Humans , Male , Middle Aged , Retinal Diseases/etiologyABSTRACT
We present a case of a 27-year-old contact lens male user who was diagnosed with Acanthamoeba keratitis. Given the inefficiency of medical treatment and high risk of corneal perforation, we decided to use Vivostat PRF®, with satisfactory results. To our knowledge, this is the first described case in medical literature in which Vivostat PRF® is used as part of Acanthamoeba keratitis treatment.
Subject(s)
Acanthamoeba Keratitis/therapy , Contact Lenses/adverse effects , Eye Infections, Parasitic/therapy , Visual Acuity , Adult , Equipment Design , Humans , MaleABSTRACT
PURPOSE: To estimate the influence of clinical and demographical information in the understanding of cataract surgery informed consent, identifying less understandable areas. To assess informed consent document concept. METHODS: Multiple-choice questionnaire was designed to collect information and to evaluate the understanding of cataract surgery and informed consent. An ordinary regression model was adjusted to express the effect of clinical and demographic variables to the questionnaire score. RESULTS: The study comprised 180 patients. Sex (female, p=0.404), non-ophthalmologist source of information (p=0.397), previous surgical history (p=0.571), not having a companion (p=0.396) nor the days since the signing of informed consent form (p=0.535) had no influence in the understanding of cataract surgery informed consent. Age (r=-0.083, p<0.001) and educational level (secondary studies r=1.845, p<0.001; tertiary studies r=4.289, p<0.001) showed statistical significance with greater strength of association educational level (OR secondary studies = 6.33, OR tertiary studies = 72.86) than age had (OR = 0.92). CONCLUSION: Patient's knowledge about cataract informed consent is influenced by age and educational level. The purpose and the risks, consequences of not performing surgery and postoperative indications are the least understood topics. Informed consent is seen as a forced legal obligation.
OBJETIVOS: estimar la influencia de la información clínica y demográfica en la comprensión del consentimiento informado de la cirugía de cataratas, identificando áreas menos comprensibles. Evaluar el concepto de "documento de consentimiento informad". MÉTODOS: el cuestionario de opción múltiple se diseñó para reunir información y evaluar la comprensión de la cirugía de cataratas y el consentimiento informado. Se ajustó un modelo de regresión ordinario para expresar el efecto de las variables clínicas y demográficas en la puntuación del cuestionario. RESULTADOS: El estudio abarcó 180 pacientes. Sexo (femenino, p = 0.404); fuente de información no oftalmológica (p = 0.397); historial quirúrgico previo (p = 0.571); no tener acompañante (p = 0.396), y los días desde la firma del formulario de consentimiento informado (p = 0,535), que no tuvo influencia en la comprensión del consentimiento informado en la cirugía de cataratas. La edad (r = -0.083, p <0.001) y el nivel educativo (estudios secundarios r = 1.845, p <0.001; estudios terciarios r = 4.289, p <0.001) mostraron significación estadística con una mayor fuerza del nivel educativo de asociación (OR estudios secundarios = 6.33, OR estudios terciarios = 72.86) que la edad (OR = 0.92). CONCLUSIÓN: El conocimiento del paciente sobre el consentimiento informado en cirugía de cataratas está influenciado por la edad y el nivel educativo. Los temas menos entendidos son el propósito y los riesgos, las consecuencias de no realizar la cirugía y las indicaciones postoperatorias. El consentimiento informado se considera una obligación legal forzada.
OBJETIVO: Estimar a influência de informações clínicas e demográficas na compreensão do consentimento informado para cirurgia de catarata, identificando áreas menos compreensíveis. Avaliar o conceito do documento de consentimento informado. MÉTODOS: Um questionário de múltipla escolha foi desenvolvido para coletar informações e avaliar a compreensão sobre cirurgia de catarata e de consentimento informado. Um modelo de regressão ordinária foi ajustado para expressar o efeito das variáveis clínicas e demográficas no escore do questionário. RESULTADOS: O estudo envolveu 180 pacientes. Sexo (feminino, p=0,404), fonte de informações não oftalmológica (p=0,397), história cirúrgica prévia (p=0,571), não ter um/a companheiro/a (p=0,396) nem os dias desde a assinatura do formulário de consentimento informado (p=0,535) tiveram influência na compreensão do consentimento informado para cirurgia de catarata. Idade (r=-0,083, p<0,001) e nível educacional (estudos secundários r=1,845, p<0,001; estudos terciários r=4,289, p<0,001) mostraram significância estatística, com maior força de associação para o nível educacional (OR estudos secundários = 6,33, OR estudos terciários = 72,86) que para a idade (OR = 0,92). CONCLUSÃO: O conhecimento do paciente sobre o consentimento informado para cirurgia de catarata é influenciado pela idade e nível educacional. O objetivo e os riscos, consequências, de não fazer a cirurgia e as indicações pós-operatórias são os tópicos menos compreensíveis. O consentimento informado é visto como uma obrigação legal compulsória.
Subject(s)
Humans , Male , Female , Aged , Cataract Extraction/psychology , Health Knowledge, Attitudes, Practice , Cataract Extraction/ethics , Cross-Sectional Studies , Surveys and Questionnaires , Regression Analysis , Age Factors , Paternalism , Personal Autonomy , Educational Status , Informed Consent/psychology , Informed Consent/ethics , JurisprudenceABSTRACT
SIGNIFICANCE: Use of anterior segment optical coherence tomography (OCT) is reported, exploring its advantages over other examination techniques. PURPOSE: The purpose of this study was to report a case in which anterior segment OCT was used to evaluate the presence of intraocular bodies after corneal perforation. CASE REPORT: A 33-year-old man was referred to our ophthalmology department after traumatic ocular injury. Swept-source anterior segment was carried out showing corneal perforation and anterior lens capsule rupture. CONCLUSIONS: Evaluating the integrity of posterior capsule and iris after traumatic ocular injury with corneal perforation using anterior segment OCT is a valuable tool to rule out the presence of intraocular foreign bodies without contact and without using radiating imaging techniques.
Subject(s)
Anterior Eye Segment/diagnostic imaging , Corneal Perforation/diagnostic imaging , Eye Foreign Bodies/diagnostic imaging , Adult , Humans , Male , Tomography, Optical Coherence/methodsABSTRACT
Cyclosporine 0.1% was used in a patient with Lyell syndrome, which had undergone a KeraKlear® keratoprosthesis implant due to the severe ocular involvement to avoid overuse of corticoid agents. To the best of our knowledge, this is the first reported case of cyclosporine 0.1% eye drops to use in Lyell syndrome previously treated with keratoprosthesis implant.
ABSTRACT
A 73-year-old woman with a history of muscular weakness and dyspnoea of unknown etiology was referred to our Ophthalmology Department for dacryocystitis. Lacrimal sac biopsy revealed IgG4 plasma cell infiltration and systemic diagnosis was done based on this, allowing an appropriate treatment to be established. To our knowledge, this is the first reported case of IgG4-related dacryocystitis associated to aortitis.
Subject(s)
Aortitis/immunology , Dacryocystitis/immunology , Immunoglobulin G/blood , Lacrimal Apparatus/pathology , Aged , Female , HumansABSTRACT
We present two cases of women who suffered from neurotrophic keratopathy (one of them had undergone penetrating keratoplasty) which had led to corneal thinning. Tachosil® was used as an adjuvant treatment after topical medication by itself failed in both cases. To our knowledge, there are no reported cases of the use of Tachosil® in corneal grafts.
Subject(s)
Corneal Perforation/prevention & control , Corneal Ulcer/therapy , Cranial Nerve Diseases/therapy , Fibrinogen/therapeutic use , Ophthalmic Nerve/pathology , Surgical Sponges , Thrombin/therapeutic use , Aged , Aged, 80 and over , Corneal Ulcer/pathology , Cranial Nerve Diseases/pathology , Drug Combinations , Female , Humans , Keratoplasty, PenetratingABSTRACT
La queratitis micótica es una importante causa de discapacidad visual en los países desarrollados. En los últimos años ha aumentado su incidencia en países de regiones tropicales, relacionado con el aumento de las conductas de riesgo como el uso indiscriminado de antifúngicos y corticoides oftálmicos en la práctica médica. La confirmación del diagnóstico es necesaria, no sólo en caso de queratitis micótica, sino también en otras enfermedades oculares infecciosas para así iniciar la terapia oportuna y exacta, y evitar el uso innecesario de antimicrobianos. El pronóstico visual de los pacientes dependerá del diagnóstico temprano y el tratamiento médico oportuno.
Fungal keratitis is a major cause of visual disability in developed countries. In recent years its incidence has increased in tropical countries, related with risk behaviors such as indiscriminate use of antifungal and corticosteroid ophthalmic in clinical practice. Diagnostic confirmation is needed, not only in cases of fungal keratitis, but also for other infectious eye diseases, to initiate timely and accurate therapy, and avoid the unnecessary use of antimicrobials. The visual prognosis of patients depends on rapid diagnosis and prompt medical treatment.
