ABSTRACT
We examined three patients with optic disc edema and peripapillary hemorrhages. Each was found by standard echography to have calcified nodules within the retrobulbar portion of the optic nerves. These nodules were located approximately 2 mm posterior to the lamina cribrosa. Each patient had unilateral congestion of the optic nerve head with dilated, tortuous retinal veins that appeared much like a partial central retinal vein occlusion; one patient subsequently developed optic atrophy. The central location of the calcifications within the anterior aspect of the optic nerves suggests that each nodule may have been situated within the central retinal vein or artery. Calcifications within the retrolaminar space may be associated with some etiologies of unilateral congestion of the optic nerve head.
Subject(s)
Calcinosis/complications , Optic Nerve Diseases/complications , Papilledema/etiology , Retinal Hemorrhage/etiology , Adult , Aged , Calcinosis/diagnostic imaging , Female , Fluorescein Angiography , Fundus Oculi , Humans , Male , Optic Atrophy/etiology , Optic Nerve Diseases/diagnostic imaging , Retinal Diseases/etiology , Retinal Vessels , Ultrasonography , Vision TestsABSTRACT
We retrospectively analyzed 46 consecutive cases of penetrating keratoplasty performed as part of the treatment of corneal perforations; the minimum follow-up time after keratoplasty was 7 months. Predisposing conditions leading to perforation were an infectious keratitis in 26 eyes (57%), trauma in 14 eyes (30%), and corneal melt associated with ocular surface disorder in 6 eyes (13%). The success of penetrating keratoplasty in the treatment of corneal perforation depended on the timing of surgery and the cause of the perforation. If the perforation was traumatic in origin, delaying surgery for at least 3 months significantly improved the chances for graft success. Eighty percent of the penetrating keratoplasties delayed 3 months following primary repair of corneal laceration remained clear, and 50% of these patients had a visual acuity of 20/60 or better. If penetrating keratoplasties were performed for an infectious corneal perforation, grafts had a better chance to remain clear if surgery could be delayed. All grafts performed for corneal perforation associated with melting and ocular surface abnormalities failed.
Subject(s)
Corneal Diseases/therapy , Corneal Injuries , Corneal Transplantation , Wounds, Penetrating/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Infant , Male , Middle Aged , Postoperative Complications , Time FactorsABSTRACT
We retrospectively studied 50 consecutive cases of exogenous endophthalmitis treated between 1972 and 1985. Twenty-two of these cases occurred after penetrating ocular trauma and the remaining 28 followed ocular surgery. Thirty-two (64%) of the cases were culture-positive. A wide variety of organisms were identified in the post-traumatic cases, while the isolated agent in the majority of postoperative cases was Staphylococcus epidermidis. Twenty-nine of the 50 patients received treatment with vitrectomy and intraocular antibiotics; of these, 14 (48%) achieved final visual acuities better than or equal to 20/400. Of the 21 patients who were treated with parenteral, topical, and subconjunctival antibiotics alone eight (38%) reached this same final visual acuity. Culture-negative cases, postoperative cases, and cases treated with vitrectomy and intraocular antibiotics were associated with improved visual outcomes.
Subject(s)
Endophthalmitis/etiology , Eye Injuries/complications , Postoperative Complications , Visual Acuity , Wounds, Penetrating/complications , Adolescent , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Endophthalmitis/physiopathology , Endophthalmitis/therapy , Female , Humans , Infant , Male , Middle Aged , Prognosis , Retrospective Studies , VitrectomyABSTRACT
Experimental anaerobic bacterial endophthalmitis was produced in pseudophakic and aphakic rabbits by using anterior chamber inoculation of 2.5 x 10(6) Propionibacterium acnes organisms. Clinical inflammation was more intense and prolonged in operated eyes with an intraocular lens in place. The presence of an intraocular lens favors the development of chronic low-grade P. acnes-related inflammation.
Subject(s)
Bacteria, Anaerobic , Endophthalmitis/microbiology , Eye Infections, Bacterial/etiology , Gram-Positive Bacterial Infections/etiology , Lenses, Intraocular , Propionibacterium acnes/isolation & purification , Animals , Aphakia, Postcataract/complications , Chronic Disease , Endophthalmitis/pathology , Eye Infections, Bacterial/pathology , Gram-Positive Bacterial Infections/pathology , Lenses, Intraocular/adverse effects , Male , RabbitsABSTRACT
Cataract extraction in patients with chronic uveitis may be hazardous, although recent studies have indicated an improvement in prognosis using lensectomy-vitrectomy techniques in selected cases of uveitic cataracts. The results of lensectomy-vitrectomy in 12 eyes with uveitic cataract are reported. All patients had improvement in vision. No significant "flare-up" of the underlying uveitis occurred. The importance of extensive preoperative evaluation is emphasized. The major cause of decreased acuity postoperatively was persistent cystoid macular edema, a complication of chronic inflammation.
Subject(s)
Cataract Extraction/methods , Uveitis/therapy , Vitrectomy , Adolescent , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Cataract/complications , Child , Chronic Disease , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Macular Edema/epidemiology , Male , Middle Aged , Postoperative Complications/epidemiology , Premedication , Uveitis/complications , Uveitis/drug therapy , Visual AcuityABSTRACT
Cataract extraction in patients with chronic uveitis may be hazardous. Recent studies have indicated an improvement in prognosis using lensectomy-vitrectomy techniques in selected cases of uveitic cataracts. The results of lensectomy-vitrectomy in 12 cases of uveitic cataract are reported. All patients had improvement in vision. No significant "flare-up" of the underlying uveitis was found and no patients deteriorated. The importance of extensive preoperative evaluation is emphasized. The major cause of decreased acuity after operation was persistent cystoid macular edema, a complication of chronic inflammation.
Subject(s)
Cataract Extraction , Uveitis/surgery , Vitreous Body/surgery , Adolescent , Adult , Aged , Child , Chronic Disease , Female , Humans , Male , Middle Aged , Postoperative Complications , Visual AcuityABSTRACT
Se analiza el aspecto controversial que representa la coexistencia de un desprendimiento regmatogeno de retina y un melanoma maligno, desde los puntos de vista diagnosticos y terapeuticos. Se hace un razonamiento de la decision tomada en este caso
