ABSTRACT
PURPOSE: To report a case of unilateral acute idiopathic maculopathy (UAIM) associated with yellow fever. OBSERVATIONS: A 59-year-old man presented with acute blurring of his vision 30 days after symptoms of yellow fever virus infection. Findings resembling unilateral acute idiopathic maculopathy of the left eye were noted on ophthalmoscopy, fluorescein angiography and optical coherence tomography. The right eye exam was normal. He was managed conservatively and recovered complete visual function in 8 weeks. CONCLUSIONS: We describe a case of unilateral acute idiopathic maculopathy disease in a patient infected by yellow fever virus confirmed with reverse transcriptase polymerase chain reaction (RT-PCR).
ABSTRACT
PURPOSE: To describe the ocular findings of 3 cases of suspected congenital Zika viral infection with microcephaly and maculopathy. DESIGN: Retrospective, consecutive case series. PARTICIPANTS: Three male infants born in northern Brazil whose mothers demonstrated a viral syndrome during the first trimester and who subsequently were born with microcephaly. METHODS: Observational report of macular findings. MAIN OUTCOME MEASURES: Continued observation. RESULTS: Three male infants were born with microcephaly to mothers who had a viral syndrome during the first trimester of gestation in an area that subsequently has demonstrated epidemic Zika infection, a flavivirus related to Dengue. Ocular examination was performed. All 6 eyes demonstrated a pigmentary maculopathy ranging from mild to pronounced. In 4 eyes, well-delineated macular chorioretinal atrophy with a hyperpigmented ring developed. Three eyes demonstrated vascular tortuosity and 2 eyes demonstrated a pronounced early termination of the retinal vasculature on photographic evaluation. Two eyes demonstrated a washed out peripheral retina with a hypolucent spot. One eye had scattered subretinal hemorrhages external to the macula. Finally, 1 eye demonstrated peripheral pigmentary changes and clustered atrophic lesions resembling grouped congenital albinotic spots (polar bear tracks). CONCLUSIONS: Zika virus has been linked to microcephaly in children of mothers with a viral syndrome during the first trimester of pregnancy. Ocular findings previously described a pigmentary retinopathy and atrophy that now can be expanded to include torpedo maculopathy, vascular changes, and hemorrhagic retinopathy. Ophthalmologic screening guidelines need to be defined to determine which children would benefit from newborn screening in affected regions.
Subject(s)
Eye Infections, Viral/diagnosis , Microcephaly/diagnosis , Pregnancy Complications, Infectious/diagnosis , Retinal Diseases/diagnosis , Retinal Vessels/pathology , Zika Virus Infection/diagnosis , Brazil , Corneal Dystrophies, Hereditary/diagnosis , Eye Infections, Viral/virology , Female , Gestational Age , Humans , Infant, Newborn , Male , Microcephaly/virology , Pregnancy , Pregnancy Complications, Infectious/virology , Retinal Diseases/virology , Retinal Hemorrhage/diagnosis , Retrospective Studies , Zika Virus Infection/virologyABSTRACT
Purpose: To determine the frequency and clinical features of the extrinsic ocular motility changes in patients with multiple sclerosis living in the state of Sao Paulo (Brazil), consecutive cases series from 1996 to 2011. Methods: Eighty-three consecutive multiple sclerosis subjects were enrolled, aged from 17 to 59 years. All patients had a history taking and a comprehensive ocular exam. Results: Extrinsic ocular motility changes was detected in 17 (20,48%) out of 83 individuals. Diplopia as the first symptom of the disease occurred in 11 (13,25%) individuals. Conclusions: Frequency of diplopia as first symptom of multiple sclerosis is relevant. According to this statement, crucial importance should be given concerning spreading of knowledge and skills to internal medicine and general ophthalmology practicing physicians about early diagnosis of multiple sclerosis, which would reduce a delay in diagnosis of the disease and would help patients in the prognosis of the disease which they endure.
Objetivo:Determinar a frequência e as características clínicas das alterações da motilidade ocular extrínseca em indivíduos portadores de esclerose múltipla, residentes no estado de São Paulo, em série de casos consecutivos de 1996 a 2011.Métodos:Foram selecionados oitenta e três indivíduos com esclerose múltipla, com idade entre 17 e 59 anos. Todos foram submetidos à anamnese e exame ocular completo.Resultados:Alterações da motilidade ocular extrínseca foram encontradas em 17 ( 20,48%) dos 83 indivíduos. A diplopia ocorreu como primeiro sintoma da doença em 11 (13,25%) indivíduos.Conclusão:A frequência de diplopia como primeiro sintoma de esclerose múltipla é relevante. Por esse fato, é fundamental ressaltar a importância da difusão do conhecimento desse achado para a realização de diagnóstico precoce de esclerose múltipla, tanto para o oftalmologista geral, como para o médico generalista, melhorando assim o prognóstico dos pacientes que dela padecem.
