RESUMO
Ocriplasmin is a recombinant protease approved as a nonsurgical treatment for vitreomacular traction (VMT) and small macular holes with vitreomacular adhesion (VMA). Successful ocriplasmin treatment in clinical studies has been defined as nonsurgical resolution of VMA as demonstrated on optical coherence tomography (OCT) by day 28 after intravitreal injection. This report presents three eyes with improvement in visual acuity and clinical symptoms despite only partial release of VMT over 28 days after ocriplasmin injection.
Assuntos
Oftalmopatias/tratamento farmacológico , Fibrinolisina/uso terapêutico , Fibrinolíticos/uso terapêutico , Fragmentos de Peptídeos/uso terapêutico , Doenças Retinianas/tratamento farmacológico , Corpo Vítreo/efeitos dos fármacos , Idoso , Idoso de 80 Anos ou mais , Oftalmopatias/metabolismo , Oftalmopatias/fisiopatologia , Feminino , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/metabolismo , Doenças Retinianas/fisiopatologia , Aderências Teciduais/tratamento farmacológico , Aderências Teciduais/metabolismo , Aderências Teciduais/fisiopatologia , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Corpo Vítreo/metabolismoRESUMO
Progressive outer retinal necrosis is an aggressive form of necrotizing herpetic retinitis that presents in immunocompromised patients. It is usually secondary to varicella zoster virus or, rarely, herpes simplex virus type 1. The authors report a case of progressive outer retinal necrosis associated with herpes simplex virus type 2 in a patient with a history of congenital herpes. [Ophthalmic Surg Lasers Imaging Retina. 2014;45:xxx-xxx.].
RESUMO
BACKGROUND AND OBJECTIVE: To evaluate clinical features, course, and outcome of patients with acute exudative paraneoplastic polymorphous vitelliform maculopathy (AEPPVM). PATIENTS AND METHODS: Retrospective case series of 5 patients. RESULTS: There were 3 males and 2 females, with a median age of 74 years. The primary neoplasms were cutaneous melanoma (n = 2), choroidal melanoma (n = 1), lung adenocarcinoma (n = 1), and lung plus breast adenocarcinoma (n = 1). The mean interval between the diagnosis of the primary neoplasm and the diagnosis of AEPPVM was 42 months. The presenting symptom was blurred vision in all cases. Ophthalmoscopy disclosed multifocal localized shallow serous detachments of the post-equatorial neurosensory retina with yellow-white subretinal debris confirmed by optical coherence tomography (OCT). There was a mean of 21 individual sites of detachment per eye, each measuring a mean of approximately 0.8 millimeter in diameter. Fundus autofluorescence depicted hyperautofluorescence corresponding to the detachments. After mean follow-up of 5 months, three patients had died of metastases. Of the two survivors, one showed resolution of lesions and the other was unchanged. CONCLUSION: AEPPVM is a paraneoplastic retinopathy found in patients with metastatic melanoma or carcinoma. The most salient feature is reduced visual acuity from multifocal shallow retinal detachments less than 1-mm diameter, best depicted on OCT.
