ABSTRACT
Abstract Pre-eclampsia (PE) is an obstetric disease with a multifactorial cause that affects ∼ 5% of pregnant women. Vision can be affected with varying severity, and retinal detachment is a very rare complication. It tends to be bilateral, diagnosed postpartum, and more prevalent in women who are primiparous and/or undergo caesarean delivery. The condition typically resolves completely and rarely causes total visual loss in the affected women. Fluorescence angiographic findings support the hypothesis that retinal detachment in PE is secondary to choroidal ischemia from intense arteriolar vasospasm. The present article is related to a case of a 37-year-old pregnant woman who had PE associated with a progressive blurred vision, diagnosed by ophthalmology as serous macular detachment of the retina.
Resumo A pré-eclâmpsia (PE) é uma doença obstétrica com uma causa multifactorial que afeta ∼ 5% das grávidas. A visão pode ser afetada com uma gravidade variável, sendo o descolamento de retina uma complicação muito rara. Geralmente é bilateral e seroso, e a sua patogênese encontra-se relacionada com a isquemia coroidal, secundária a um intenso vaso espasmo arteriolar. A maioria dos doentes tem recuperação completa da visão com tratamento conservador. No presente artigo, é relatado um caso de uma grávida de 37 anos que desenvolveu PE com critérios de gravidade associada a um quadro de visão turva progressiva, diagnosticada pela oftalmologia como descolamento macular seroso da retina.
Subject(s)
Humans , Female , Pregnancy , Adult , Pre-Eclampsia , Prenatal Diagnosis , Retinal Detachment/diagnosis , Pregnancy Trimester, Third , Retinal Detachment/complications , Retinal Detachment/diagnostic imaging , Cesarean SectionABSTRACT
AIM: To study the association of serum levels of anti-myeloperoxidase (MPO) antibody with retinal photoreceptor ellipsoid zone (EZ) disruption in diabetic retinopathy. METHODS: Consecutive patients with type 2 DM [diabetes mellitus with no retinopathy (NODR; n=20); non-proliferative diabetic retinopathy (NPDR; n=18); proliferative diabetic retinopathy (PDR; n=16)] and healthy controls (n=20) between the ages of 40 and 65years were included. Disruption of EZ was graded by spectral domain optical coherence tomography as no disruption of EZ and disrupted EZ. The serum levels of anti-MPO antibody was analyzed using standard protocol. Association between the variables was evaluated using multiple regression analysis. RESULTS: A significant difference was found between the serum levels of anti-MPO antibody in various study groups (p<0.001). A positive association was found between EZ disruption and levels of anti-MPO antibody [adjusted odd's ratio (AOR)=1.079, CI 1.010-1.124, p=0.04]. A significant positive correlation was found between logMAR visual acuity and grade of disruption (AOR=1.008, CI 1.006-5.688, p=0.04). CONCLUSIONS: An increased serum anti-MPO antibody levels is associated with retinal photoreceptor EZ disruption and decreased visual acuity in diabetic retinopathy.
Subject(s)
Diabetic Retinopathy/diagnostic imaging , Isoantibodies/analysis , Models, Immunological , Peroxidase/antagonists & inhibitors , Photoreceptor Cells, Vertebrate/pathology , Retina/diagnostic imaging , Retinal Degeneration/complications , Cross-Sectional Studies , Diabetes Mellitus, Type 2/complications , Diabetic Retinopathy/blood , Diabetic Retinopathy/immunology , Female , Humans , Imaging, Three-Dimensional , India , Male , Middle Aged , Photoreceptor Cells, Vertebrate/immunology , Regression Analysis , Reproducibility of Results , Retina/immunology , Retinal Degeneration/blood , Retinal Degeneration/diagnostic imaging , Retinal Degeneration/immunology , Tertiary Care Centers , Tomography, Optical Coherence , Visual AcuitySubject(s)
Eye Diseases/etiology , Rosacea/diagnosis , Eye Diseases/diagnosis , Female , Humans , Middle Aged , Rosacea/complications , Visual AcuityABSTRACT
PURPOSE: To report three various cases of retinal hemorrhages caused by Plasmodium vivax malaria. CASE SUMMARY: Two 55-year-old male patients and a 52-year-old male patient with cyclic high fever were admitted to the department of internal medicine. Three of the patients were diagnosed with malaria caused by P. vivax based on a peripheral blood smear. The patients were treated with hydroxychloroquine and premaquine but complained of decreased visual acuity. The patients were examined with funduscopy, fluorescein angiography, and optical coherence tomography. The first case showed 2 areas of retinal hemorrhages on the macular in the right eye and 1 area of retinal hemorrhage in the left eye. The second case showed many cotton-wool spots along with a number of small retinal hemorrhages and tortuous blood vessels in both eyes. The third case showed 1 area of retinal hemorrhage in the right eye and many cotton-wool spots in both eyes. CONCLUSIONS: P. vivax malaria rarely causes retinal hemorrhage. Manifestations of retinal hemorrhage and degree of visual acuity loss may vary among patients. P. vivax malaria should be considered when patients with unexplained high fever present with retinal hemorrhage, even without a history of overseas travel.
Subject(s)
Humans , Male , Middle Aged , Blood Vessels , Eye , Fever , Fluorescein Angiography , Hydroxychloroquine , Internal Medicine , Malaria , Malaria, Vivax , Plasmodium , Plasmodium vivax , Retinal Hemorrhage , Retinaldehyde , Tomography, Optical Coherence , Visual AcuityABSTRACT
