ABSTRACT
Two patients presented to the University of Illinois at Chicago Eye and Ear Infirmary within 1 year with penetrating eye injuries caused by similar collapsible cloth and wire laundry hampers. Penetrating eye injuries in children are relatively rare but can result in poor visual outcomes and multiple vision-threatening complications. Both injuries at the University of Illinois resulted in an eye laceration as well as retinal complications similar to those reported with a high velocity injury. This now represents a significant pattern of eye injury and suggests that there exists a nontrivial risk for all children in households with this type of collapsible laundry hamper. Parents should receive a warning of the risks of these hampers.
Subject(s)
Consumer Product Safety , Eye Injuries, Penetrating/etiology , Household Products/adverse effects , Laundering/instrumentation , Cataract/diagnosis , Cataract/etiology , Cataract Extraction , Child , Combined Modality Therapy , Contact Lenses, Hydrophilic , Corneal Injuries , Eye Injuries, Penetrating/diagnosis , Eye Injuries, Penetrating/surgery , Female , Hospitals, University , Humans , Infant , Lens, Crystalline/injuries , Male , Patient Transfer , Reoperation , Retina/injuries , Retina/surgery , Risk Factors , Treatment Outcome , Visual Acuity , Vitrectomy , Vitreous Hemorrhage/diagnosis , Vitreous Hemorrhage/etiology , Vitreous Hemorrhage/surgeryABSTRACT
PURPOSE: Detecting retinal vigabatrin toxicity in patients with partial symptomatic or cryptogenic epilepsy can be challenging because of preexisting visual field defects secondary to a structural abnormality in the brain or lack of collaboration. The aim of this study was to measure the retinal nerve fiber layer thickness (RNFLT) with optic coherence tomography (OCT), as well as contrast sensitivity, color vision, and perimetry, in patients with partial symptomatic or cryptogenic epilepsy on vigabatrin, and to determine the efficacy of these tests as markers of vigabatrin-related retinal damage in these subgroups of epileptic patients. METHODS: The study involved 38 patients with either partial symptomatic or cryptogenic epilepsy and 16 healthy individuals comprising the control group. At the time of the study, 14 of the patients were using vigabatrin, 10 were receiving sodium valproate monotherapy, and 14 were on carbamazepine monotherapy. All the participants underwent RNFLT imaging with OCT, contrast sensitivity, color discrimination assessment, and perimetry. RESULTS: The average 360 degrees RNFLT of the vigabatrin group was significantly lower when compared to the other groups. The average RNFLT of all quadrants except the temporal one in the vigabatrin group was also significantly reduced. There was no difference in the mean deviation, contrast sensitivity, and color discrimination between the study groups, but they were all significantly lower than the control group. CONCLUSIONS: RNFLT measurement with OCT can efficiently identify vigabatrin toxicity in patients with partial symptomatic and cryptogenic epilepsy. Perimetry, contrast sensitivity, and color discrimination assessment might be inconclusive in these particular subgroups of epileptic patients.
Subject(s)
Anticonvulsants/adverse effects , Epilepsies, Partial/drug therapy , Retina/drug effects , Retinal Diseases/chemically induced , Vigabatrin/adverse effects , Adult , Anticonvulsants/therapeutic use , Cross-Sectional Studies , Epilepsy/drug therapy , Female , Humans , Incidence , Male , Prospective Studies , Retina/pathology , Retinal Diseases/diagnosis , Retinal Diseases/epidemiology , Risk Factors , Tomography, Optical Coherence , Turkey/epidemiology , Vigabatrin/therapeutic useABSTRACT
PURPOSE: To describe optical coherence tomography (OCT) findings of ocular lesions in pseudoxanthoma elasticum (PXE). METHODS: Sixteen eyes of 8 patients with PXE and 20 eyes of 10 age-matched healthy volunteers were included in the study. All patients in the study and control group underwent a complete ophthalmologic examination and OCT. Fluorescein angiography was performed on the patients with PXE. RESULTS: In the areas of peau de orange mottling, OCT demonstrated increased reflectivity on the level of retinal pigment epithelium (RPE), Bruch membrane, and choriocapillaris complex. OCT scans of crystalline body showed a hyperreflective shell and an isoreflective or hyporeflective core. OCT scans of the angioid streaks demonstrated thinning in RPE-Bruch membrane-choriocapillaris complex. CONCLUSIONS: Disturbances on the level of RPE, choroid, and Bruch membrane may be responsible for the ocular lesions in PXE. OCT may give clues to the pathophysiology of the retinal lesions. Spectral domain OCT could provide more details and information. Further studies using this new technology should be performed.
