RESUMO
In this retrospective, multicenter study of 261 eyes (259 patients), patients who underwent rhegmatogenous retinal detachment repair during the coronavirus disease 2019 (COVID-19) post-lockdown period experienced an additional 22-day delay, leading to significantly more epiretinal membrane and proliferative vitreoretinopathy and lower single-surgery anatomic success rates. During lockdown, perfluoropropane gas was used more commonly, and pneumatic retinopexy was used more commonly in COVID-19-positive patients.
Assuntos
COVID-19 , Descolamento Retiniano , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Acuidade VisualRESUMO
Purpose: This report describes a case of West African crystalline maculopathy. Methods: A case report is presented. Results: A 71-year-old Nigerian man was referred for evaluation of bilateral crystalline retinal deposits seen on routine examination. The patient had no acute visual symptoms and no significant ocular history except for cataract extraction and intraocular lens implantation in both eyes. Dilated fundocscopic examination was notable for bilateral greenish-yellow, foveocentric intraretinal crystalline deposits, which were visible on color fundus photography, multicolor confocal scanning laser ophthalmoscopy, and spectral-domain optical coherance tomography. The crystalline deposits were not associated with abnormal short-wavelength autofluorescence or fluorescein angiography findings. Conclusions: A diagnosis of West African crystalline maculopathy was made after other causes of crystalline maculopathy were excluded.
RESUMO
BACKGROUND/PURPOSE: To describe the use of topical mitomycin-C in sclerostomy revision for recalcitrant idiopathic uveal effusion syndrome. METHODS: A 50-year-old healthy man presented with painless, gradual vision loss in the right eye. He underwent multimodal retinal imaging with wide-field fundus photography, spectral domain optical coherence tomography, and B-scan and A-scan ultrasonography. He was found to have idiopathic (non-nanophthalmic) uveal effusion syndrome with choroidal and serous retinal detachments in the right eye and a peripheral choroidal detachment in the left eye. Central vision became threatened in the right eye. Medical treatment with oral corticosteroids and surgical treatment with choroidal drainage through sclerostomies and sclerostomy revision were administered. RESULTS: Initial treatment with systemic corticosteroids was ineffective. Subsequent choroidal drainage through sclerostomies only partially resolved the effusion. Later sclerostomy revision with application of topical mitomycin-C led to complete resolution with anatomical stability maintained after at least 42 months of follow-up. CONCLUSION: Successful use of topical mitomycin-C in sclerostomy revision has not previously been reported in idiopathic (non-nanophthalmic) uveal effusion syndrome. We propose that topical mitomycin-C may be considered as a potential therapeutic adjunct in the treatment of refractory idiopathic uveal effusion syndrome before further sclerostomy procedures are attempted in additional quadrants of the eye.
Assuntos
Mitomicina , Esclerostomia , Síndrome da Efusão da Úvea , Administração Tópica , Humanos , Masculino , Pessoa de Meia-Idade , Mitomicina/administração & dosagem , Resultado do Tratamento , Síndrome da Efusão da Úvea/tratamento farmacológico , Síndrome da Efusão da Úvea/cirurgiaAssuntos
Neoplasias do Sistema Nervoso Central/complicações , Angiofluoresceinografia/métodos , Papiledema/diagnóstico , Retina/patologia , Veia Retiniana/patologia , Tomografia de Coerência Óptica/métodos , Macroglobulinemia de Waldenstrom/complicações , Adolescente , Neoplasias do Sistema Nervoso Central/diagnóstico , Feminino , Fundo de Olho , Humanos , Papiledema/etiologia , Macroglobulinemia de Waldenstrom/diagnósticoAssuntos
Doenças da Coroide/diagnóstico , Corioide/patologia , Traumatismos Oculares/complicações , Retina/patologia , Descolamento Retiniano/diagnóstico , Líquido Sub-Retiniano , Ferimentos não Penetrantes/complicações , Adolescente , Corioide/lesões , Doenças da Coroide/etiologia , Traumatismos Oculares/diagnóstico , Humanos , Masculino , Remissão Espontânea , Retina/lesões , Descolamento Retiniano/etiologia , Tomografia de Coerência Óptica/métodos , Ferimentos não Penetrantes/diagnósticoAssuntos
Fístula Carótido-Cavernosa/diagnóstico , Edema Macular/diagnóstico , Síndrome Pós-Trombótica/diagnóstico , Doenças Retinianas/diagnóstico , Hemorragia Retiniana/diagnóstico , Idoso , Fístula Carótido-Cavernosa/terapia , Angiografia Cerebral , Diagnóstico Diferencial , Embolização Terapêutica , Feminino , Humanos , Edema Macular/terapia , Síndrome Pós-Trombótica/terapia , Doenças Retinianas/terapia , Hemorragia Retiniana/terapia , Tomografia de Coerência ÓpticaAssuntos
Calcinose/complicações , Doenças da Coroide/complicações , Neovascularização de Coroide/etiologia , Doenças da Esclera/complicações , Idoso , Inibidores da Angiogênese/uso terapêutico , Calcinose/diagnóstico , Cálcio/sangue , Doenças da Coroide/diagnóstico , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/tratamento farmacológico , Corantes/administração & dosagem , Membrana Epirretiniana/diagnóstico por imagem , Feminino , Angiofluoresceinografia , Glucocorticoides/uso terapêutico , Humanos , Verde de Indocianina/administração & dosagem , Edema Macular/diagnóstico por imagem , Hormônio Paratireóideo/sangue , Drusas Retinianas/diagnóstico por imagem , Doenças da Esclera/diagnóstico , Tomografia de Coerência Óptica , Triancinolona Acetonida/uso terapêutico , Ultrassonografia , Transtornos da Visão , Campos Visuais , Vitamina D/sangueAssuntos
Migração do Implante de Lente Intraocular/etiologia , Corpo Ciliar/cirurgia , Glaucoma de Ângulo Aberto/etiologia , Implante de Lente Intraocular/efeitos adversos , Complicações Pós-Operatórias , Migração do Implante de Lente Intraocular/cirurgia , Extração de Catarata , Remoção de Dispositivo , Implantes para Drenagem de Glaucoma , Glaucoma de Ângulo Aberto/cirurgia , Gonioscopia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Implantação de Prótese , Reoperação , Tonometria Ocular , Acuidade Visual/fisiologiaRESUMO
PURPOSE: To investigate glaucomatous damage in Boston keratoprosthesis type I (KPro) patients through structural analysis of the optic nerve head and digital planimetric quantification of Goldmann visual fields, a novel method of monitoring perimetric changes in KPro patients. METHODS: Records of patients undergoing KPro implantation from 2007 to 2015 at a single institution were reviewed. Parameters related to glaucoma status and KPro outcomes were analyzed. RESULTS: Twenty-two eyes from 21 patients met inclusion criteria, with mean follow-up of 49.4 months (range 15-90). Mean results for the following parameters before KPro implantation and at last follow-up were (pre-KPro; at last follow-up): best-corrected visual acuity (2.07; 0.70 logMAR), number of glaucoma medications (1.14; 1.05), intraocular pressure (IOP) (18.4; 18.4 mm Hg), vertical cup-to-disc ratio (C/D) (0.48; 0.50), and horizontal C/D (0.52; 0.52). IOP-lowering procedures were performed pre-KPro (5/22), concurrently with KPro (10/22), post-KPro (6/22), or never (6/22). An increase in C/D ≥0.1 and loss of V4e isopter area >30% occurred in 22.7% and 12.5%, respectively. Development of post-KPro glaucoma, progression of preexisting or post-KPro glaucoma, and no glaucoma development as evidenced by an objective assessment of structural and functional parameters were seen in 2/22 (9.1%), 7/22 (31.8%), and 6/22 (27.3%) eyes, respectively. CONCLUSIONS: Clinicians should strive to vigilantly monitor for glaucoma despite the inherent difficulties in tonometry, optic nerve visualization and imaging, and visual field testing in KPro patients. Meticulous glaucoma surveillance with structural and functional testing combined with earlier IOP-lowering surgical intervention may result in decreased rates of glaucomatous vision loss in KPro patients.
Assuntos
Doenças da Córnea/cirurgia , Glaucoma/patologia , Doenças do Nervo Óptico/patologia , Próteses e Implantes/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Glaucoma/diagnóstico por imagem , Glaucoma/etiologia , Glaucoma/fisiopatologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Disco Óptico/patologia , Doenças do Nervo Óptico/etiologia , Doenças do Nervo Óptico/fisiopatologia , Implantação de Prótese/efeitos adversos , Campos Visuais/fisiologia , Adulto JovemRESUMO
BACKGROUND: Wolf-Hirschhorn syndrome is a rare genetic syndrome caused by a heterozygous deletion on chromosome 4p16.3 and is characterized by a "Greek warrior helmet" facies, hypotonia, developmental delay, seizures, structural central nervous system defects, intrauterine growth restriction, sketelal anomalies, cardiac defects, abnormal tooth development, and hearing loss. A variety of ocular manifestations may occur in up to 40% of patients. MATERIALS/METHODS: We report the genetic testing results, systemic findings, and complete ophthalmologic examination findings in a patient with Wolf-Hirschhorn syndrome, including external photography, RetCam3 (Clarity Medical Systems, Pleasonton, CA) goniography, and fundus photography. In addition, we review the literature on ocular manifestations of Wolf-Hirschhorn syndrome. RESULTS: Microarray analysis revealed an unbalanced translocation between 4p16.3-15.3 and Xp22.33-p22.2. Systemic findings included "Greek warrior helmet" facies, hypotonia, cleft palate, neonatal tooth eruption, talipes equinovarus, bilateral clinodactyly, clitoromegaly, partial agenesis of the corpus callosum, bilateral renal hypoplasia, and two atrial septal defects. Ocular findings included normal intraocular pressures and corneal diameters, large-angle exotropia, downward slanting of the palpebral fissures, absent eyelid creases, upper and lower eyelid retraction with shortage of the anterior eyelid lamellae, euryblepharon, lagophthalmos with poor Bell's reflex and exposure keratopathy, hypertelorism, Axenfeld's anomaly, megalopapillae, and cavitary optic disc anomaly. CONCLUSIONS: We describe the ocular phenotype of a patient with Wolf-Hirschhorn syndrome, including the rare descriptions and photographs of Axenfeld's anomaly, megalopapilla, and cavitary optic disc anomaly in this condition.