ABSTRACT
We report a case of focal subretinal abscess in a 27-year-old diabetic man presenting with Staphylococcus sepsis. The follow-up study was based on visual acuity (VA), fundus photography, fluorescein angiography, ultrasound and optical coherence tomography, and an intravenous specific antibiotic was administered with an unusual good outcome.
Subject(s)
Abscess/diagnosis , Eye Infections, Bacterial/diagnosis , Retina , Retinal Diseases/diagnosis , Adult , Diagnosis, Differential , Fluorescein Angiography , Follow-Up Studies , Fundus Oculi , Humans , Male , Microscopy, Acoustic , Tomography, Optical Coherence , Visual AcuityABSTRACT
PURPOSE: To assess the efficacy and safety of the "Crozafon-De Laage punch" during combined phacoemulsification-trabeculectomy interventions. METHODS: We conducted a retrospective Study of 75 eyes of 75 patients with cataract and open-angle glaucoma inadequately controlled by maximum medical and/or physical treatment. They underwent phacotrabeculectomy using the Crozafon-De Laage punch. We noted pre- and postoperative best visual acuity (VA) and intraocular pressure (IOP) as well as intra- and postoperative complications. RESULTS: After a mean follow-up of 24 months (range, 9-36), the functional results were satisfactory, with an average VA gain during the 1(st) postsurgical month of 5.8/10(e)+/-1.58 (compared to the preoperative VA). This gain in VA was steady with VA greater than 5/10(e) in 96% of our patients at 1 and 24 postoperative months. The mean IOP reduction was meaningful and steady: reduction of 8.2mm at the 9(th) postoperative month maintained to the 24(th) month. Ninety-five percent of our patients did not need medical treatment until the last follow-up; for the remaining 5%, IOP was controlled using a single agent. No intraoperative complications related to the use of the Crozafon-De Laage punch were noted. The postoperative complications were marked by the occurrence of a minimal and transient inflammatory reaction in 5.3% of cases; it was associated with a pseudoexfoliative syndrome in all cases. CONCLUSION: Phacotrabeculectomy using the Crozafon-De Laage punch provides better control of glaucoma, faster functional rehabilitation, and fewer complications associated with filtration surgery.
Subject(s)
Cataract/complications , Glaucoma, Open-Angle/complications , Glaucoma, Open-Angle/surgery , Phacoemulsification/methods , Trabeculectomy/methods , Aged , Female , Humans , Male , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
INTRODUCTION: Macular edema is responsible for a significant degree of visual loss in diabetic patients. The prognosis factors in diabetic macular edema are varied and better documented by optical coherence tomography (OCT). We describe the patterns of diabetic macular edema demonstrated by OCT and correlate them with visual acuity. PATIENTS AND METHOD: A prospective study of 297 eyes with diabetic macular edema was conducted. An OTI/OCT exam was done for all eyes. The Fisher test was used to search for a correlation between visual acuity and each feature of diabetic macular edema (macular thickness, cystoid macular edema, central cyst, tractional component, and serous retinal detachment). RESULTS: Visual acuity varied from 1.3 log MAR to 0 log MAR. The mean visual acuity was 0.51 log MAR. The presence of central cyst on OCT scan was significantly associated with worse vision (p<0.0001). Increased retinal thickness in all patterns was significantly correlated with worse visual acuity (p<0.0001). The OCT patterns containing a tractional component and serous retinal detachment were also associated with visual loss (p<10(-6)). CONCLUSION: OCT is a very useful objective tool to describe, classify, and manage diabetic macular edema. It provides a better analysis of different prognosis factors and therefore can assist in determining a more suitable treatment for diabetic macular edema.
