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1.
Emerg Infect Dis ; 23(7): 1102-1109, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28628441

RESUMO

We conducted a case-control study in Freetown, Sierra Leone, to investigate ocular signs in Ebola virus disease (EVD) survivors. A total of 82 EVD survivors with ocular symptoms and 105 controls from asymptomatic civilian and military personnel and symptomatic eye clinic attendees underwent ophthalmic examination, including widefield retinal imaging. Snellen visual acuity was <6/7.5 in 75.6% (97.5% CI 63%-85.7%) of EVD survivors and 75.5% (97.5% CI 59.1%-87.9%) of controls. Unilateral white cataracts were present in 7.4% (97.5% CI 2.4%-16.7%) of EVD survivors and no controls. Aqueous humor from 2 EVD survivors with cataract but no anterior chamber inflammation were PCR-negative for Zaire Ebola virus, permitting cataract surgery. A novel retinal lesion following the anatomic distribution of the optic nerve axons occurred in 14.6% (97.5% CI 7.1%-25.6%) of EVD survivors and no controls, suggesting neuronal transmission as a route of ocular entry.


Assuntos
Ebolavirus , Doença pelo Vírus Ebola/complicações , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Sobreviventes , Adulto , Estudos de Casos e Controles , Feminino , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/história , Doença pelo Vírus Ebola/virologia , História do Século XXI , Humanos , Masculino , Oftalmoscópios , Vigilância da População , Prevalência , Doenças Retinianas/epidemiologia , Índice de Gravidade de Doença , Serra Leoa/epidemiologia , Acuidade Visual , Adulto Jovem
3.
Doc Ophthalmol ; 125(2): 169-78, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22729668

RESUMO

The aim of this study is to correlate multifocal electroretinogram (mfERG) and visual evoked potential (VEP) changes with visual acuity and clinical features in patients with posterior segment inflammation secondary to syphilis. A retrospective interventional case series of 4 patients with visual loss secondary to syphilitic uveitis is reported. The mfERG (P1) showed diminished amplitudes and prolonged latency in 7 affected eyes. Visual acuity rapidly improved 2 weeks after initiation of therapy. OCT demonstrated anatomical recovery at 1 month. In three patients, visual acuity was restored to 6/6 at 6-9 months but mfERG responses remained significantly reduced and delayed for 12-15 months before recovery to normal levels. One patient developed a retinal detachment, but achieved 6/9 vision at 30 months. VEP changes, interpreted in combination with mfERG responses, showed evidence of optic nerve involvement in 6 eyes. Ocular findings, including posterior placoid chorioretinitis, are important diagnostic features of secondary and tertiary syphilis. Visual acuity and clinical recovery occur early with appropriate diagnosis and treatment, and precede full electrophysiological recovery of the outer retina-RPE complex. Ophthalmologists have the opportunity to play a key role in undetected or missed diagnoses of syphilis, and with appropriate treatment the visual prognosis is excellent.


Assuntos
Coriorretinite/fisiopatologia , Eletrorretinografia , Potenciais Evocados Visuais , Infecções Oculares Bacterianas/fisiopatologia , Sífilis/fisiopatologia , Adulto , Idoso , Coriorretinite/microbiologia , Infecções Oculares Bacterianas/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Sífilis/microbiologia , Acuidade Visual
5.
BMJ Case Rep ; 20102010 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-22767570

RESUMO

A 55-year-old man presented with bilateral reduced visual acuity, limitation of extraocular movements, areflexia and ataxia. He was diagnosed with Miller Fisher Syndrome, precipitating bilateral simultaneous acute angle closure glaucoma due to autonomic dysfunction. He was subsequently treated for both conditions and made an excellent recovery.


Assuntos
Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Fechado/cirurgia , Iridectomia/métodos , Síndrome de Miller Fisher/diagnóstico , Seguimentos , Glaucoma de Ângulo Fechado/complicações , Humanos , Terapia a Laser/métodos , Masculino , Pessoa de Meia-Idade , Síndrome de Miller Fisher/complicações , Medição de Risco , Fatores de Tempo , Resultado do Tratamento
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