ABSTRACT
A 16-year-old girl presented with a unilateral red eye, progressive visual loss and diplopia. A detailed clinical assessment with appropriate investigations led to a diagnosis of Orbital Apex Syndrome (OAS) secondary to Tuberculosis (TB). We report this unusual case of TB OAS, which resulted in a poor visual outcome despite appropriate management.
Subject(s)
Diplopia/etiology , Optic Nerve Diseases/complications , Orbital Diseases/complications , Tuberculosis, Ocular/complications , Tuberculosis, Pulmonary/complications , Vision Disorders/etiology , Adolescent , Antitubercular Agents/therapeutic use , Diplopia/diagnosis , Diplopia/physiopathology , Female , Humans , Magnetic Resonance Imaging , Optic Nerve Diseases/diagnosis , Optic Nerve Diseases/drug therapy , Orbital Diseases/diagnosis , Orbital Diseases/drug therapy , Tuberculosis, Ocular/diagnosis , Tuberculosis, Ocular/drug therapy , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/drug therapy , Vision Disorders/diagnosis , Vision Disorders/physiopathologyABSTRACT
PURPOSE: To report the outcomes of pars plana vitrectomy with epiretinal membrane (ERM) peel, with or without internal limiting membrane peel, in patients with uveitis. METHODS: Retrospective interventional case series of patients undergoing pars plana vitrectomy with ERM peel between January 2005 and March 2012. Sixteen consecutive patients (16 eyes) were identified, with a minimum postoperative follow-up of 6 months. Visual acuity, anatomical outcomes, perioperative control of inflammation, and complications were assessed. RESULTS: The mean age at surgery was 47.3 years (range, 14-68 years), with a mean duration of ERM at surgery of 21.3 months (3-84 months). At 6 months, visual acuity improved in 31.25% of eyes, stabilized in 31.25%, and was worse in 37.5%. The causes of reduced visual acuity postoperatively included severe preexisting macular pathology and unoperated cataract. CONCLUSION: Pars plana vitrectomy with ERM peel in eyes with uveitis may improve or stabilize visual acuity, especially in eyes with macular traction, but in the absence of traction, outcomes are variable and unpredictable. Prevention of ERM formation by aggressive control of inflammation is important.
Subject(s)
Epiretinal Membrane/surgery , Uveitis/surgery , Visual Acuity/physiology , Vitrectomy , Adolescent , Adult , Aged , Azathioprine/therapeutic use , Drug Therapy, Combination , Endotamponade , Epiretinal Membrane/complications , Epiretinal Membrane/physiopathology , Female , Follow-Up Studies , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Male , Middle Aged , Mycophenolic Acid/analogs & derivatives , Mycophenolic Acid/therapeutic use , Prednisolone/therapeutic use , Retrospective Studies , Tomography, Optical Coherence , Uveitis/etiology , Uveitis/physiopathology , Young AdultSubject(s)
Endotamponade , Retinal Hemorrhage/diagnosis , Retinal Hemorrhage/surgery , Tomography, Optical Coherence , Vitrectomy , Adult , Anemia/chemically induced , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Drainage , Fourier Analysis , Humans , Male , Pancytopenia/chemically induced , Retinal Hemorrhage/chemically induced , Testicular Neoplasms/drug therapy , Visual AcuityABSTRACT
PURPOSE: To assess repeatability of visual function measures in patients with early, intermediate or late age-related macular degeneration (AMD) without active neovascular disease in the study eye, but active neovascular AMD in the fellow eye. METHODS: One hundred subjects from an ongoing trial were screened for this study in which their LogMAR acuity, contrast sensitivity and reading performance were assessed using standardised protocols by trained optometrists. The same measures were repeated one month later and repeatability of the visual functions assessed. RESULTS: Data from 83 subjects satisfied inclusion criteria for analysis. Coefficient of repeatability was 14.9 letters for LogMAR visual acuity , 7.2 letters for Pelli Robson contrast sensitivity, 0.72 for LogMAR reading acuity, 110.4 words/ min for reading speed and 0.67 for LogMAR critical print size. Intraclass correlation coefficients allowed comparison between measures and were found to be 0.96 for LogMAR visual acuity, 0.93 for contrast sensitivity, 0.75 for LogMAR reading acuity, 0.79 for reading speed and 0.74 for LogMAR critical print size. Coefficients of variation were 9.4 %, 10.7 %, 48.4 %, 28.4 % and 31.8 % respectively. CONCLUSIONS: We found coefficients of repeatability that concurred with previous studies demonstrating variability of visual functions in patients with AMD. In addition, we found intraclass correlation coefficients to be better with visual acuity and contrast sensitivity than with measures of reading performance.
