ABSTRACT
INTRODUCTION AND IMPORTANCE: Macular Holes (MH) are variable thickness openings of the retina that develop in the fovea. This case presents a branch macular artery avulsion during internal limiting membrane (ILM) peeling for idiopathic macular hole management in an adult patient. The proper management of this complication along with the preventive measures is mentioned. CASE PRESENTATION: A 65-year-old woman developed a branch macular artery avulsion during ILM peeling for MH. After cataract extraction by phacoemulsification with intraocular lens implantation and pars plana vitrectomy, during ILM peeling, a multifocal bleeding along a macular artery was noted indicating its avulsion. The intraocular pressure was raised to control hemorrhage, blood remnants were passively aspirated and ILM peeling was kindly completed under adequate visualization. CLINICAL DISCUSSION: Branch macular artery avulsion is a potential complication even for experienced surgeons. Proper management of this complication involves the increase of intraocular pressure for hemostasia. If hemostasia and proper visualization are achieved, the surgery could be completed, and if it is not the case, the ILM peeling could be completed in a second procedure. This complication might be avoided by initiating the ILM peeling away from the macular vessels. CONCLUSION: Branch macular artery avulsion is an intraoperative complication that might be avoided by initiating the ILM peeling away from the macular vessels.
ABSTRACT
Se presenta un caso de una mujer de 56 años de edad con un agujero macular grande, de larga evolución, a quien se le realizó una cirugía de trasplante autógeno de retina neurosensorial. En el seguimiento con retinografías y tomografía de coherencia óptica de dominio espectral, destacó la presencia de edema del injerto con hiperreflectividad de las capas retinianas internas, en las primeras semanas. Después, se observaron puntos hiperreflectivos, predominantemente en las capas internas de la retina, manteniendo la continuidad de las capas externas y la presencia de un material de aspecto lanudo en la superficie del injerto. Al final del seguimiento hubo una integración completa del injerto en la zona receptora del agujero, con la correspondiente mejoría funcional (AU)
A case is presented of a 56-year-old female patient with a long-standing large macular hole who underwent autologous retina transplant surgery. Fundus images and spectral-domain optical coherence tomography images showed the presence of graft oedema with its corresponding hyper-reflectivity of the inner retinal layers in the first weeks of follow-up. Hyper-reflective dots later appeared mainly in the inner retinal layers. The integrity of the outer retinal layers and a woolly-looking material on the surface of the graft were observed. At the end of follow-up, the graft had integrated with the recipient tissue with functional improvement (AU)
Subject(s)
Humans , Female , Middle Aged , Retinal Perforations/surgery , Retina/transplantation , Tomography, Optical Coherence , Follow-Up Studies , Transplantation, Autologous , Acute DiseaseABSTRACT
A case is presented of a 56-year-old female patient with a long-standing large macular hole who underwent autologous retina transplant surgery. Fundus images and spectral-domain optical coherence tomography images showed the presence of graft oedema with its corresponding hyper-reflectivity of the inner retinal layers in the first weeks of follow-up. Hyper-reflective dots later appeared mainly in the inner retinal layers. The integrity of the outer retinal layers and a woolly-looking material on the surface of the graft were observed. At the end of follow-up, the graft had integrated with the recipient tissue with functional improvement.
ABSTRACT
OBJECTIVE: To describe a case of lung adenocarcinoma for which the first clinical manifestation was an iris metastasis. CASE REPORT: A 76-year-old male patient came for consultation referring a «pinkish speck¼ on his right eye. On biomicroscopy examination, a mass was found on the iris of the right eye. Subsequent systemic work-up of the patient revealed a left lung adenocarcinoma. DISCUSSION: Although uncommon, iris metastasis secondary to lung cancer should be part of differential diagnosis in iris tumours.
Subject(s)
Adenocarcinoma/secondary , Iris Neoplasms/secondary , Lung Neoplasms/pathology , Adenocarcinoma/diagnosis , Aged , Fatal Outcome , Humans , Lung Neoplasms/diagnosis , MaleABSTRACT
OBJECTIVE: To evaluate the safety and efficacy of combined phacoemulsification and triamcinolone-assisted vitrectomy with intravitreal injection of bevacizumab in patients with cataract and diffuse diabetic macular edema. METHODS: In this prospective, non randomized, interventional case series we included 13 eyes of 13 patients with posterior subcapsular cataracts and diffuse macular edema who underwent phacoemulsification, 25G triamcinolone-assisted vitrectomy, endophotocoagulation and had a bevacizumab injection at the end of the procedure. The follow-up consisted of basal best corrected visual acuity, fluorescein angiography, and optical coherent tomography performed at 2 weeks, one, three and six months post-operatively. RESULTS: An improvement in the best corrected visual acuity of at least two lines was seen in 10 of the 13 patients. The basal average central macular thickness initially was 358.23 micro (SD 50 micro) while at the end of follow-up was 216.6 micro (SD 23.2 micro). CONCLUSION: This combined surgical and pharmacological treatment resulted in an improvement of central macular thickness and non-progression of diabetic retinopathy in the six month follow-up period. Larger comparative studies are necessary to establish the real impact of this therapeutic approach.