[Case report on choroidal effusion after oral acetazolamide administration: an unusual manifestation of a well-known idiosyncratic effect?] / Acetazolamid orális alkalmazása mellett jelentkezo chorioidealeválás két esete: ismert idioszinkráziás hatás szokatlan megjelenési formája?

Sulpha drugs are widely employed in medicine for various diseases and disorders. During the last several decades, numerous papers had been published on supra ciliary and posterior choroidal effusion likely presenting as an idiosyncratic effect of these drugs especially of acetazolamide. In each publication, the effusion was associated with either an acute angle-closure glaucoma or transitory myopia or both of these as leading symptoms. In the current publication, authors report on two cases where the acetazolamide-induced choroidal effusion was an accidental finding without either a myopic shift in refraction or an acute elevation in intraocular pressure. To our best knowledge, ours is the first report in the literature describing this unusual, "silent" form of a sulpha drug-induced choroidal effusion. Since the choroidal involvement may vary in size and location, and is not necessarily associated with acute glaucoma and myopia, one can assume that a considerable amount of acetazolamide-related ocular side-effects will not be discovered. The above case report aims to draw the attention of other specialities to the need for ophthalmic examination for their patients taking sulpha drugs with acute visual deterioration. Orv Hetil. 2017; 158(50): 1998-2002.

Description of five dirofilariasis cases in South Hungary and review epidemiology of this disease for the country.

BACKGROUND: Dirofilariasis is an emerging zoonosis (supported by climate change) in Central Europe. Human infections are usually caused by Dirofilaria repens and Dirofilaria immitis with mediation of mosquito vectors. Aims of this publication were to report our dirofilariasis cases, and to summarize Hungarian epidemiological data by reviewing literature. METHODS AND RESULTS: We present five (four ophthalomological, one subcutaneous) cases observed within a 2-year period in Southern Hungary. Ages of infected patients were between 31 and 74 years. First case during pregnancy is also reported. There was no travel history in the anamnesis of patients which could explain acquisition of the infection. Moving, intact worms eliminated by surgical interventions were identified on the basis of morphological features as D. repens. Since the first report of human case, 115 further episodes (in addition to ours) were diagnosed in Hungary. Mean age of the patients was 47 years. Reviewing national reports, the ratio of subcutaneous infections was higher than that of the ocular ones (66 and 45, respectively). Evaluation of the territorial distribution of human episodes revealed that most infections occurred in patients living in the Danube-Tisza interfluvial region and eastern part of the country. However, sporadic cases were also found in western counties during 2014. CONCLUSION: Most of the Hungarian dirofilariasis cases were autochthonous infections. Occurrence in the western counties may suggest the spreading of this emerging zoonosis to these areas. Comprehensive monitoring and data analysis are desirable, therefore reporting the epidemiologic data in the case of human infections should be made mandatory.

Role of ultrasound biomicroscopy in diagnosis and treatment of Terrien disease.

PURPOSE: Terrien disease is a rare form of peripheral corneal degeneration characterized by vascularization, opacification, lipid deposition, and corneal thinning. In this study, a high-frequency ultrasound biomicroscope (UBM) was used to detect the morphologic changes before and after surgery and to determine the stages of this disease. METHODS: Two patients with Terrien disease were examined by UBM, corneal topography, and a keratometer before and after surgery (full-thickness keratectomy). RESULTS: The absence of the Bowman layer and thinning of the Descemet layer in the ectatic part of the peripheral cornea were detected by using the UBM before surgery. Earlier, these signs could be detected only with optical and electron microscopy from histologic samples; now we can detect the signs of Terrien disease with noninvasive devices such as the UBM. CONCLUSIONS: The UBM is an effective device for following the progression of Terrien disease and determining the timing of these patients' surgeries.

[Ultrasound biomicroscopy examination of tumors of the iris and ciliary body]. / Az iris és a corpus ciliare térfoglaló folyamatainak ultrahangbiomikroszkópos vizsgálata.

The ultrasound biomicroscope (UBM) has a major role in detecting and following different types of intra-ocular masses in the anterior part of the eye. This equipment may provide the possibility to detect the inner structure of the masses, to differentiate between cysts and solid tumours, and to follow their progression and spreading into the surrounding tissue. In the last six years 30 patients with iris and ciliary body tumour were found in our laboratory. The examination were performed by Zeiss Humphrey Ultrasound Biomicroscope, Model 840, 50 MHz probe. We followed closely 22 patients. Surgical removal and histological examination were performed in 3 cases. Melanocytoma, retinoblastoma and ring melanoma were revealed. Although the symptoms of the anterior uveal tumours are uncommon, and these tumours show very slow progression, early detection and regular follow-up is needed. In the case of tumour progression the UBM has an important role in planning and timing of surgery or radiotherapy, which can have a favourable effect on the outcome of the disease.