RESUMO
In the spring of 2017, a full-term infant with microcephaly was delivered in South Florida. During first trimester, the mother presented with fever, nausea, and vomiting. She reported no foreign travel for herself or her partner. The infant's neurologic, ophthalmologic, neuroradiologic, and audiologic findings were highly suggestive of congenital Zika syndrome (CZS), confirmed by IgM antibodies and plaque reduction neutralization test. New observations, including peripheral temporal retinal avascularity and peripapillary retinal nerve fiber layer thinning, are presented from this first known case of non-travel-associated CZS in the United States. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e93-e98.].
Assuntos
Distrofias Hereditárias da Córnea/diagnóstico , Infecções Oculares Virais/diagnóstico , Microcefalia/diagnóstico , Doenças do Nervo Óptico/diagnóstico , Complicações Infecciosas na Gravidez , Infecção por Zika virus/diagnóstico , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , RNA Viral/genética , Reação em Cadeia da Polimerase em Tempo Real , Ultrassonografia Pré-Natal , Estados Unidos , Adulto Jovem , Zika virus/genética , Infecção por Zika virus/congênitoRESUMO
BACKGROUND AND OBJECTIVE: To report the visual and anatomical outcomes and microbiologic spectrum of culture-positive endophthalmitis in open globe injuries (OGIs) with or without intraocular foreign bodies (IOFBs). PATIENTS AND METHODS: A retrospective, interventional case series of OGIs (n = 718) treated between 2004 and 2015. Patients underwent a management protocol for OGI, including systemic broad-spectrum antibiotics, on presentation. RESULTS: Culture-positive cases of endophthalmitis after open globe repair occurred in 2.1% of eyes (n = 15 of 718 eyes); two eyes had evidence of endophthalmitis on presentation. The most common organism was Staphylococcus species (five of 17 eyes). An IOFB was present in 6.8% of eyes (n = 49 of 718 eyes). All of these eyes received prophylactic intravitreal antimicrobials. In eyes with IOFB, the rate of culture-positive endophthalmitis after initial globe repair was 8.1% (n = 4 of 49 eyes) versus 1.6% (n = 11 of 669 eyes) in eyes without IOFB (P < .01). CONCLUSION: Culture-positive endophthalmitis was identified after OGIs more often in eyes with a concurrent IOFB. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:632-637.].
Assuntos
Bactérias/isolamento & purificação , Endoftalmite/microbiologia , Corpos Estranhos no Olho/complicações , Infecções Oculares Bacterianas/microbiologia , Ferimentos Oculares Penetrantes/complicações , Órbita/lesões , Infecção dos Ferimentos/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/patogenicidade , Endoftalmite/diagnóstico , Endoftalmite/etiologia , Corpos Estranhos no Olho/diagnóstico , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/etiologia , Ferimentos Oculares Penetrantes/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Virulência , Acuidade Visual , Infecção dos Ferimentos/etiologia , Infecção dos Ferimentos/microbiologia , Adulto JovemRESUMO
PURPOSE: To evaluate the incidence rates of cystoid macular edema (CME) and epiretinal membrane (ERM) formation after uncomplicated primary 23-G and 25-G retinal detachment (RD) repair and to identify risk factors associated with postoperative CME and ERM formation. METHODS: This was a consecutive interventional case series of 587 eyes that underwent one RD repair with 23-G or 25-G pars plana vitrectomy (PPV) with scleral buckling. Epiretinal membrane and CME were confirmed by optical coherence tomography (OCT) and fluorescein angiography (FA). RESULTS: A total of 587 eyes with a mean follow-up of 404 days had incidence rates of 35.1% for ERM and 15.2% for CME. The incidence of ERM after combined PPV and scleral buckling (48.4%) (n = 61) was greater (p<0.0001) compared to that after PPV alone (31.2%) (n = 144). CONCLUSIONS: Epiretinal membrane and CME develop frequently after small-gauge RD repair. Pars plana vitrectomy combined with scleral buckling is associated with a higher incidence of ERM. Patients might benefit from increased use of OCT and FA to help rule out CME/ERM.
Assuntos
Membrana Epirretiniana/etiologia , Edema Macular/etiologia , Complicações Pós-Operatórias , Descolamento Retiniano/cirurgia , Vitrectomia/métodos , Idoso , Membrana Epirretiniana/cirurgia , Feminino , Angiofluoresceinografia , Humanos , Edema Macular/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Recurvamento da Esclera , Tomografia de Coerência Óptica , Acuidade Visual/fisiologiaRESUMO
BACKGROUND AND OBJECTIVE: To identify rates and potential risk factors for epiretinal membrane (ERM) and for membrane peel (MP) after 23- or 25-gauge repair and to compare outcomes for eyes with ERM that underwent MP versus observation. PATIENTS AND METHODS: Review of 587 eyes with ERM after retinal detachment repair. Patients who developed ERM either underwent pars plana vitrectomy (PPV) and MP or were observed. RESULTS: Preoperatively, the PPV and MP group had a mean best corrected visual acuity (BCVA) of 20/100, compared to 20/40 for the observation group (P < .001). The PPV and MP group had a higher mean central subfield mean thickness (CSMT) (414 µm vs 281 µm). In the PPV and MP group, mean BCVA was 20/100 preoperatively and 20/50 postoperatively (P < .01). Mean CSMT was 397.5 µm preoperatively and 282.6 µm postoperatively (P < .01). CONCLUSION: ERM is common after 23- or 25-gauge PPV. PPV and MP can improve BCVA and decrease CSMT.
