ABSTRACT
CASE REPORT: We report a case of a 63-year-old patient with epilepsy treated with vigabatrin, who was seen because of diminished visual acuity. Examination showed a toxic retinopathy with optic nerve pallor and severely constricted visual fields. One year after cessation of the vigabatrin, no change in the perimetric constriction had occurred. DISCUSSION: Ophthalmologists and neurologists need to be aware of the possibility of retinal toxicity due to the use of vigabatrin. It is still unclear as to which ophthalmologic assessment is of the most diagnostic value; however visual field examination covering the peripheral 60 degrees and optical coherence tomography could be most useful for the screening of patients using this agent.
Subject(s)
Anticonvulsants/adverse effects , Retinal Diseases/chemically induced , Vigabatrin/adverse effects , Electroretinography , Follow-Up Studies , Humans , Male , Middle Aged , Time Factors , Tomography, Optical Coherence , Visual Acuity , Visual Field Tests , Visual FieldsABSTRACT
Caso clínico: Paciente epiléptico de 63 años en tratamiento con vigabatrina que refería déficit de agudeza visual. Presentaba una retinopatía tóxica con palidez papilar e importante retracción del campo visual. Tras un año de suspensión del tratamiento persistía la retracción campimétrica. Discusión: Neurólogos y oftalmólogos debemos concienciarnos del potencial efecto retinotóxico de la vigabatrina. No hay consenso en cuanto a la estrategia de screening a utilizar. Una evaluación campimétrica hasta los 60º y una tomografía óptica de coherencia (OCT) parecen ser test diagnósticos sensibles en el screening de pacientes que toman vigabatrina
Case report: We report a case of a 63-year-old patient with epilepsy treated with vigabatrin, who was seen because of diminished visual acuity. Examination showed a toxic retinopathy with optic nerve pallor and severely constricted visual fields. One year after cessation of the vigabatrin, no change in the perimetric constriction had occurred. Discussion: Ophthalmologists and neurologists need to be aware of the possibility of retinal toxicity due to the use of vigabatrin. It is still unclear as to which ophthalmogic assessment is of the most diagnostic value; however visual field examination covering the peripheral 60º and optical coherence tomography could be most useful for the screening of patients using this agent
Subject(s)
Male , Middle Aged , Humans , Diabetic Retinopathy/complications , Diabetic Retinopathy/diagnosis , Diabetes Mellitus/complications , Carbamazepine/adverse effects , Carbamazepine/therapeutic use , Vigabatrin/adverse effects , Tomography, Optical Coherence/methods , Tomography, Optical Coherence , Visual Field Tests/trends , Visual Field Tests , Vigabatrin/therapeutic use , Tomography, Optical Coherence/instrumentation , Tomography, Optical Coherence/trendsABSTRACT
CASE REPORT: A fifty-five year old man complained of diminished visual acuity in his right eye and reported a deep venous thrombosis in his right leg five years ago. Examination showed a central retinal vein occlusion in the right eye. Mutations in the factor V gene and prothrombin gene were found in a thrombophilia study. The patient was anticoagulated and no laser photocoagulation was required. DISCUSSION: Various coagulation disorders induced by genetic mutations are often associated with an increased risk for retinal vein occlusion although there are no statistically significant associations reported in the literature.
Subject(s)
Factor V Deficiency/complications , Factor V/genetics , Mutation , Prothrombin/genetics , Retinal Vein Occlusion/etiology , Anticoagulants/therapeutic use , Factor V Deficiency/drug therapy , Factor V Deficiency/genetics , Fluorescein Angiography , Fundus Oculi , Heterozygote , Humans , Male , Middle Aged , Retinal Vein Occlusion/diagnosis , Retinal Vein Occlusion/drug therapyABSTRACT
CASE REPORT: We report the case of a diabetic twenty-five-year-old male with an asymptomatic bull's eye maculopathy in the left eye who was diagnosed by chance in a routine examination. The electrophysiological test showed a right eye photopic electroretinogram at the lower limit of normality. DISCUSSION: In the presence of a bull's eye maculopathy we must rule out several pathologies like degenerative diseases, drug toxicity, previous trauma and infectious -- inflammatory diseases. Electrophysiology as well as family and personal history can help us to differentiate between several diseases though in our case the cause was unknown.
Subject(s)
Retinal Diseases/diagnosis , Adult , Electroretinography , Fluorescein Angiography , Fundus Oculi , Humans , Macula Lutea/pathology , Male , Visual AcuityABSTRACT
CASE REPORT: A thirty year-old-woman that had received radiotherapy three years before for a frontal glyoma consulted because of diminished visual acuity in her left eye. Examination showed a proliferative radiation retinopathy in the left eye and non-proliferative radiation retinopathy in the right eye that was confirmed by fluorescein angiography. The patient was treated with panretinal photocoagulation, and her visual acuity remained stable. DISCUSSION: Patients receiving cranial or neck radiotherapy should be followed for long periods of time because radiation retinopathy may appear many years after the treatment. Follow-up may permit early diagnosis of ischemic radiation retinopathy that can benefit from laser photocoagulation.
Subject(s)
Eye Injuries/etiology , Radiation Injuries/etiology , Retinal Hemorrhage/etiology , Retinal Neovascularization/etiology , Adult , Brain Neoplasms/radiotherapy , Female , Fluorescein Angiography , Glioma/radiotherapy , Humans , Radiation Injuries/diagnosis , Retinal Hemorrhage/diagnosis , Retinal Neovascularization/diagnosis , Visual AcuityABSTRACT
Caso Clínico: Mujer de treinta años, tratada con radioterapia por un glioma frontal tres años atrás, que refería déficit de agudeza visual en el ojo izquierdo (OI). Presentaba una retinopatía isquémica proliferante en OI y no proliferante en el derecho, lo cual fue confirmado mediante angiografía fluoresceínica. La paciente fue panfotocoagulada, quedando estabilizada la agudeza visual. Discusión: La retinopatía por radiación puede aparecer muchos años después de aplicada ésta, por lo que los pacientes que reciben radioterapia de cabeza y cuello deben ser controlados para detectarla precozmente ya que se pueden beneficiar del tratamiento con láser (AU)