ABSTRACT
Antiphospholipid antibody syndrome (APS) has been reported to cause elevated intracranial pressure, but usually this is due to cerebral venous sinus thrombosis (CVST). We present a 36-year old man with APS with elevated intracranial pressure with neuro-ophthalmic, renal and hematological involvement without identifiable CVST.
Subject(s)
Antiphospholipid Syndrome/complications , Intracranial Hypertension/etiology , Sinus Thrombosis, Intracranial/physiopathology , Adult , Humans , Kidney/pathology , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Male , Papilledema/etiology , Visual Field TestsABSTRACT
Laser photocoagulation has been the mainstay of diabetic retinopathy treatment since its development in mid-20(th) century. With the advent of antivascular endothelial growth factor therapy, the role of laser therapy appeared to be diminished, however many advances in laser technology have been developed since. This review will describe recent advances in laser treatment of diabetic retinopathy including pattern scan laser, short-pulse duration and a reduced fluence laser, and navigated laser system for proliferative diabetic retinopathy and macular edema.
Subject(s)
Diabetic Retinopathy/surgery , Laser Coagulation/methods , Diabetic Retinopathy/physiopathology , Humans , Macular Edema/physiopathology , Macular Edema/surgery , Visual Acuity/physiologyABSTRACT
BACKGROUND: To report palinopsia as a possible side effect of topiramate. METHODS: Case series and review of the literature. RESULTS: Nine patients in our series, and 4 previously reported patients, who developed palinopsia while on topiramate, are reviewed. All patients were women, and comorbidities included migraine, idiopathic intracranial hypertension, and bulimia nervosa. Palinopsia resolved in 8 patients after stopping or decreasing the dose of topiramate. The lowest dose of topiramate causing palinopsia was 25 mg twice a day. More than half of our patients reported exacerbation of visual disturbance in early morning or late evening. CONCLUSIONS: Topiramate-induced palinopsia may be underdiagnosed because physicians do not inquire about such visual symptoms.
Subject(s)
Anticonvulsants/adverse effects , Fructose/analogs & derivatives , Sensation Disorders/chemically induced , Visual Perception/drug effects , Adult , Female , Fructose/adverse effects , Humans , Illusions/drug effects , Male , Middle Aged , TopiramateABSTRACT
PURPOSE: To report an unusual case of Demodex folliculitis presenting as periocular vesiculopustular rash. DESIGN: Case report. RESULTS: A 68 year-old woman presented with a unilateral periocular rash that was initially treated by her primary ophthalmologist with topical steroids and antivirals. Slit-lamp examination revealed severe bilateral blepharitis, right greater than left, with waxy sleeves around the eyelashes. The diagnosis of Demodex infestation was considered. Treatment with daily lid scrub with polyhexamethylene biguanide (PHMB), 1,2-hexanediol and 1,2-octanediol (OCuSOFT PLUS) and erythromycin ointment twice a day resulted in complete resolution of the symptoms after 4 weeks. CONCLUSIONS: Ophthalmologists should be aware of Demodex and consider it in the differential diagnosis of periocular skin lesions.
Subject(s)
Blepharitis/diagnosis , Folliculitis/diagnosis , Mite Infestations/diagnosis , Mites , Skin Diseases, Vesiculobullous/diagnosis , Aged , Animals , Anti-Bacterial Agents/therapeutic use , Biguanides/therapeutic use , Blepharitis/drug therapy , Blepharitis/parasitology , Disinfectants/therapeutic use , Drug Therapy, Combination , Erythromycin/therapeutic use , Female , Folliculitis/drug therapy , Folliculitis/parasitology , Glycols/therapeutic use , Hexanes/therapeutic use , Humans , Mite Infestations/drug therapy , Mite Infestations/parasitology , Octanols/therapeutic use , Ointments , Skin Diseases, Vesiculobullous/drug therapy , Skin Diseases, Vesiculobullous/parasitologyABSTRACT
The peptide hormone ghrelin requires Ser-3 acylation for receptor binding, orexigenic and anti-inflammatory effects. Functions of desacylghrelin are less well understood. In vitro kinase assays reveal that the evolutionarily conserved Ser-18 in the basic C-terminus is an excellent substrate for protein kinase C. Circular dichroism reveals that desacylghrelin is approximately 12% helical in aqueous solution and approximately 50% helical in trifluoroethanol. Ser-18-phosphorylation, Ser-18-Ala substitution, or Ser-3-acylation reduces the helical character in trifluoroethanol to approximately 24%. Both ghrelin and desacylghrelin bind to phosphatidylcholine:phosphatidylserine sucrose-loaded vesicles in a phosphatidylserine-dependent manner. Phosphoghrelin and phosphodesacylghrelin show greatly diminished phosphatidylserine-dependent binding. These results are consistent with binding of ghrelin and desacylghrelin to acidic lipids via the basic face of an amphipathic helix with Ser-18 phosphorylation disrupting both helical character and membrane binding.
