ABSTRACT
We report 2 consecutive siblings who presented with unilateral and bilateral macular scars, respectively (initially presumed in the older sibling to be from congenital toxoplasmosis), who also developed chronic kidney disease. Both underwent genetic testing and were positive for a mutation in CLDN19, confirming the diagnosis of familial hypomagnesemia with hypercalciuria and nephrocalcinosis with severe ocular involvement. One of our patients had the unique finding of mild foveal hypoplasia, which is not typically associated with CLDN19 mutations.
Subject(s)
Cicatrix/congenital , Claudins , Eye Diseases, Hereditary/diagnosis , Macula Lutea/pathology , Renal Tubular Transport, Inborn Errors/diagnosis , Claudins/genetics , Eye Diseases, Hereditary/genetics , Humans , Mutation , Renal Tubular Transport, Inborn Errors/genetics , SiblingsABSTRACT
PURPOSE: To report the first known case of spontaneous choroidals in association with a patient on dabigatran etexilate. METHODS: Observational case report. RESULTS: An 82-year-old man on 150 mg dabigatran etexilate by mouth twice a day for atrial fibrillation developed spontaneous choroidal hemorrhage in his left eye. No other causes were found after careful history and examination. CONCLUSION: Dabigatran is a popular new alternative to warfarin that has no blood monitoring or reversal agent. Physicians should be aware of this new medication and its possible hemorrhagic complications.
Subject(s)
Benzimidazoles/adverse effects , Choroid Hemorrhage/chemically induced , Factor Xa Inhibitors/adverse effects , Pyridines/adverse effects , Aged, 80 and over , Dabigatran , Humans , MaleABSTRACT
BACKGROUND AND OBJECTIVE: To identify the relationship between preoperative parameters and postoperative overcorrection or undercorrection in eyes with myopic astigmatism treated with wavefront-guided laser in situ keratomileusis (LASIK), and to develop an advanced surgical nomogram. PATIENTS AND METHODS: A retrospective chart review of 468 eyes that underwent wavefront-guided LASIK for myopia with astigmatism with the Alcon LADARVision 4000 (Alcon Laboratories, Fort Worth, TX), of which 235 had flaps created by microkeratome (OneUse; Moria Surgical, Doylestown, PA) and 233 by femtosecond laser (Intralase; AMO, Santa Ana, CA). Manifest sphere, cylinder, and spherical equivalent were recorded preoperatively and 3 months postoperatively. Various parameters from patient records were analyzed to identify which had greatest influence on outcomes. RESULTS: Manifest spherical equivalent was the most important predictor of surgical overcorrection, with the second being spherical aberration. In both groups, there was a statistically significant (P < .0001) correlation of spherical aberration with the amount of overcorrection. Using these two parameters, compensatory nomograms were derived. CONCLUSION: Surgical overcorrection in wavefront-guided LASIK for myopic astigmatism correlates positively with the amount of spherical equivalent treated and preoperative spherical aberration. Nomograms incorporating spherical aberration may improve accuracy of outcomes.
