ABSTRACT
PURPOSE: To investigate the beneficial effect of bevacizumab injection one week prior to panretinal photocoagulation (PRP) on the occurrence of vitreous hemorrhage (VH) following PRP in high-risk proliferative diabetic retinopathy (PDR). METHODS: This was a case-control pilot study conducted on two groups: an anti-VEGF treatment group, treated with bevacizumab injection one week prior to the first PRP session, and a control group of treatment-naive PDR patients who underwent PRP treatment and were not given an intravitreal bevacizumab injection, consecutively recruited. In both groups, a complete ophthalmological examination was conducted prior to PRP and at 4, 9, and 16 weeks following treatment. The primary endpoint studied was the occurrence of VH. RESULTS: The control group included 69 patients (mean age 63±12.3 years) with high-risk PDR who received PRP treatment only, and the anti-VEGF treatment group included 67 patients (mean age 63.13±10.3 years). None of the demographic variables or comorbidities showed any significant difference between the two groups. The number of PRP sessions was not significantly correlated to the occurrence of VH in either of the groups (P=0.167). Vitreous hemorrhage within 16 weeks following laser treatment occurred in 10 patients (14.5%) in the control group and in only 3 patients (4.5%) in the anti-VEGF group (P=0.047). CONCLUSION: Our case-control pilot study demonstrates that a bevacizumab injection preceding the initial PRP session might be beneficial in reducing the occurrence of VH in the first 16 weeks following PRP.
Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Humans , Middle Aged , Aged , Bevacizumab/adverse effects , Diabetic Retinopathy/drug therapy , Diabetic Retinopathy/epidemiology , Vitreous Hemorrhage/epidemiology , Vitreous Hemorrhage/etiology , Vitreous Hemorrhage/therapy , Angiogenesis Inhibitors , Pilot Projects , Antibodies, Monoclonal, Humanized/adverse effects , Laser Coagulation/adverse effects , Intravitreal Injections , Diabetes Mellitus/drug therapyABSTRACT
Subacute sclerosing panencephalitis (SSPE) is a progressive encephalitis caused by persistent measles infection. The disease is almost always fatal and mainly affects children and young adults. Ophthalmological signs are frequently observed and can be the presenting manifestations. We report the case of a 22-year-old young man who presented with bilateral posterior retinal necrosis confirmed by fluorescein angiography and normal laboratory tests. The appearance of peripheral retinal tears and stereotyped myoclonic movements were signs of the evolving condition. Diagnosis of SSPE was confirmed by brain MRI, EEG, and cerebrospinal fluid examination. The patient's neurological condition deteriorated rapidly and he died 2 months following the onset of ophthalmological manifestations.
Subject(s)
Retinitis/etiology , Subacute Sclerosing Panencephalitis/diagnosis , Adult , Age Factors , Fluorescein Angiography , Humans , Male , Retinal Necrosis Syndrome, Acute/diagnosis , Retinal Necrosis Syndrome, Acute/etiology , Retinal Perforations/diagnosis , Retinal Perforations/etiology , Retinitis/diagnosis , Subacute Sclerosing Panencephalitis/complications , Subacute Sclerosing Panencephalitis/mortality , Time FactorsABSTRACT
A patient with acquired immune deficiency and antecedents of pancreatitis presented with headaches, fever, dyspnea and bilateral decrease of vision. A diagnosis of disseminated cryptococcosis was made by lumbar puncture, alveolar washing and elevated cryptococcal antigen in blood, urine and stool. Bilateral chorioretinitis with ischaemic maculopathy was responsible of the low vision and attributed to cryptococcal infection after vitreous puncture and isolation of yeast from the vitreous. Systemic treatment with Amphotericin led to resolution of the chorioretinitis. A retinitis due to cytomegalovirus was associated short time before the patient died. Post-mortem anatomopathologic analysis revealed cryptococcus in high number in the choriocapillaris.
Subject(s)
AIDS-Related Opportunistic Infections/microbiology , Chorioretinitis/microbiology , Cryptococcosis/microbiology , Cryptococcus neoformans/isolation & purification , Adult , Chorioretinitis/complications , Chorioretinitis/diagnosis , Fluorescein Angiography , Humans , Male , Visual FieldsABSTRACT
The Crow-Fukase syndrome or POEMS syndrome (Polyneuropathy, Organomegaly, Edema, Monoclonal protein, Skin changes) is an uncommon plasma cell dyscrasia leading to a multisystemic disorder. An optic disc swelling is often related to this syndrome. We report the case of a 51-year-old man with a papilledema. We presume that vasculitis or plasma cell infiltration is the cause of the papilledema.
Subject(s)
POEMS Syndrome/diagnosis , Papilledema/diagnosis , Adrenal Cortex Hormones/therapeutic use , Humans , Immunoglobulin A/isolation & purification , Immunoglobulin lambda-Chains/isolation & purification , Interferon alpha-2 , Interferon-alpha/therapeutic use , Male , Middle Aged , Optic Disk Drusen , POEMS Syndrome/drug therapy , POEMS Syndrome/immunology , Papilledema/etiology , Recombinant ProteinsABSTRACT
High myopia may produce a masquerade syndrome, exhibiting clinical findings similar to those found in endocrine ophthalmopathy. Several hypotheses have been proposed as an explanation: sixth nerve paresis, structural changes in oculomotor muscles, contact between elongated globes and the bones of the orbital apices. These hypotheses are discussed after the presentation of a case with electroneuro-oculographic and tomodensitometric findings.
