Coats Disease in 9 Patients: A Hispanic Case Series

2021 ◽  
Author(s):  
Maximiliano Barrera-Sánchez ◽  
Rosa E. Martinez-Muñoz ◽  
Raul E. Ruiz-Lozano ◽  
Catharina Busch ◽  
Juan Homar Paez-Garza ◽  
...  
Keyword(s):  
Case Series ◽  
Retrospective Chart Review ◽  
Visual Outcome ◽  
Exudative Retinal Detachment ◽  
Visual Prognosis ◽  
Hand Motion ◽  
Hispanic Patients ◽  
Unilateral Disease ◽  
Coats Disease ◽  
Anatomical Success

Abstract Background/Aim To describe demographic and clinical characteristics, treatment, and visual prognosis of Coats disease in Hispanic patients. Methods A retrospective chart review was performed on nine patients (ten eyes) diagnosed with Coats disease in our two clinical centrers from 2004 – 2017. Results Mean age at diagnosis was 5.5 years (range 1 – 12 years) and mean follow-up time was 48 months (range 9 – 108 months). Eight patients (89%) were male and had unilateral disease and one (11%) female patient had bilateral disease. In 40% of the cases, patients were asymptomatic. Visual acuity at first presentation was worse than hand motion in 60% of the eyes. Half of the eyes (5/10 eyes, 50%) had exudative retinal detachment (≥ stage IIIA). Vascular ablation with cryotherapy combined with retinal photocoagulation was the most frequent therapeutic approach (40%). Despite anatomical success at 6 months in 100% of the treated eyes, visual outcome at 1 year of treatment was poor (worse than 20/200) in 70% of the cases. Conclusions In our case series, patients were mostly asymptomatic on presentation, with severe stages of Coats disease. Even with anatomical success after surgical treatment in all treated cases, long-term visual prognosis remained very limited.

Selective Photocoagulation in Coats' Disease: Ten-year Follow-up

2002 ◽  
Vol 12 (6) ◽  
pp. 501-505 ◽  
Author(s):  
P. Nucci ◽  
F. Bandello ◽  
M. Serafino ◽  
M.E. Wilson
Keyword(s):  
Visual Outcome ◽  
Severe Form ◽  
Posterior Pole ◽  
Dye Laser ◽  
Exudative Retinal Detachment ◽  
Continuous Control ◽  
Poor Visual Outcome ◽  
Unilateral Disease ◽  
Coats Disease

Purpose The diagnostic hallmark of Coats' disease is development of “light bulb” telangiectasis in the retinal periphery, leading to posterior pole intraretinal and subretinal exudation. Even after complete obliteration of all abnormal vessels and resorption of all exudates, follow-up examinations are mandatory for several years. Methods We retrospectively analyzed the charts, pictures and/or fluorescein angiographies of a series of 32 consecutive patients, in which the diagnosis of Coats' disease was made. All patients underwent selective photocoagulation of the telangiectasis using a yellow-dye laser. Efficacy of treatment was monitored with drawings and/or fluorescein angiographies. Results All our patients had unilateral disease, with macular involvement and exudative retinal detachment. Visual acuity improved in one patient, decreased from light perception to blindness in another, and was unchanged in the remainder. Conclusions This is the first report of anatomical benefits from treatment with a yellow-dye laser (i.e., selective photocoagulation without cryotherapy or drainage) despite the presence of a severe form of Coats' disease. Our young Coats' patients responded quickly to treatment. With successful obliteration of the abnormal vasculature, exudates began to absorb in about 4 to 8 weeks although, in some cases, 10 to 12 months were needed to obtain resolution of the exudative detachment. Poor visual outcome of 20/100 or worse was common. In Coats' patients, the key issue is continuous control and long-term follow-up.

scholarly journals Visual outcome of endogenous endophthalmitis in Thailand

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Preeyachan Lourthai ◽  
Pitipol Choopong ◽  
Dhanach Dhirachaikulpanich ◽  
Kunravitch Soraprajum ◽  
Warinyupa Pinitpuwadol ◽  
...  
Keyword(s):  
Retrospective Chart Review ◽  
Visual Outcome ◽  
Post Treatment ◽  
Endogenous Endophthalmitis ◽  
Infectious Episode ◽  
Hand Motion ◽  
Phthisis Bulbi ◽  
Causative Agents ◽  
Corneal Decompensation ◽  
The Mean

AbstractTo evaluate a 10-year visual outcome of endogenous endophthalmitis (EE) patients. A 10-year retrospective chart review of EE patients. Thirty-eight patients (40 eyes) were diagnosed with EE at the mean age of 42. Among the identifiable pathogens (71.1% culture positive), the causative agents were predominantly gram-negative bacteria (48.1%). The most common specie was Klebsiella pneumoniae (25.9%). About a quarter of the patients required surgical eye removal, and the remaining 45.7% had visual acuity (VA) worse than hand motion at one month after the infectious episode. The most common complication was ocular hypertension (52.5%). Poor initial VA was significantly associated with a worse visual outcome in the early post-treatment period (p 0.12, adjusted OR 10.20, 95% CI 1.65–62.96). Five patients continued to visit the clinic for at least ten years. One patient had gained his vision from hand motion to 6/7.5. Two patients had visual deterioration, one from corneal decompensation, and the other from chronic retinal re-detachment. Two patients developed phthisis bulbi, with either some VA perception of light or no light perception. Poor initial VA is the only prognostic factor of a poor early post-treatment visual outcome of EE.

Retinoschisis in Coats Disease: Clinical Picture, Therapeutic Considerations, and Management Outcomes

2020 ◽  
pp. 247412642095430
Author(s):  
Nathan L. Scott ◽  
Linda A. Cernichiaro-Espinosa ◽  
Jonathan F. Russell ◽  
Timothy G. Murray ◽  
Sander R. Dubovy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Pigment ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
Retinal Pigment Epithelial Cells ◽  
Clinical Feature ◽  
Exudative Retinal Detachment ◽  
Corrected Visual Acuity ◽  
Coats Disease ◽  
Best Corrected Visual Acuity

Purpose: Retinoschisis in inflammatory and exudative retinopathy is a known but rare entity. We describe the presentation and clinical and surgical outcomes of a series of patients with retinoschisis in the setting of Coats disease. Methods: This retrospective case series of patients with Coats disease recorded visual acuity and the number and type of treatments (eg, angiography-guided photocoagulation, intravitreal bevacizumab, sub-Tenon triamcinolone, or vitreoretinal surgery). Results: Eighteen of 133 patients with Coats disease were diagnosed with retinoschisis by color imaging. All (100%) of the areas of schisis or macrocyst were associated with dense subretinal exudation, whereas only 7 (38.8%) were associated with exudative retinal detachment. Initial best-corrected visual acuity in the schisis cohort was 1.14 ± 1.19 (Snellen equivalent, 20/276) vs 1.42 ± 1.40 (Snellen, 20/526) in those without ( P = .56). Final best-corrected visual acuity was 1.76 ± 1.37 (Snellen, 20/1150) and 1.45 ± 1.44 (Snellen, 20/563), respectively ( P = .43). The mean number of treatments in individuals with schisis was 4.8 ± 2.9 for angiography-guided photocoagulation, 4.5 ± 2.9 for intravitreal bevacizumab, and 1.7±1.2 for sub-Tenon triamcinolone. Intraocular surgery was required in 39% (7 of 18) of patients with schisis vs 22% (25 of 115) for patients without schisis ( P = .14). One eye required enucleation, and histopathology of the schisis pocket was obtained. Conclusions: The pathophysiology of retinoschisis in Coats disease is not completely understood. We propose that telangiectatic leakage, hypoxia, and toxicity to the retinal pigment epithelial cells play a role in cavity development, and therefore may represent a clinical feature of advanced or uncontrolled disease.

scholarly journals Management of Posterior Segment Intraocular Foreign Body with Vitrectomy; Visual and Anatomical Outcome

2018 ◽  
Vol 5 (2) ◽  
pp. 45-48
Author(s):  
Ritesh Kumar Shah ◽  
Raghunandan Byanju ◽  
Sangeeta Pradhan
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Intraocular Foreign Body ◽  
Medical Sciences ◽  
Hand Motion ◽  
Magnetic Metal ◽  
Anatomical Success ◽  
Anatomical Outcome

AIM: To evaluate the anatomical and visual outcome following removal of intraocular foreign body (IOFB) through pars planavitrectomy.MATERIAL & METHODS: A retrospective analysis of 11 cases of retained posterior segment foreign body that underwent pars planavitrectomy for removal of foreign body during the period of January 2013 to August 2017 was conducted. Demographics of patients, mechanism and details of injury, Snellen best corrected visual acuity, examination results at presentation and after surgery, any diagnostic imaging and surgical procedure were recorded and analysed.RESULTS: Out of eleven eyes of eleven patients (mean age= 25.4}8.6, range 22 50 years; all male) preoperative retinal detachment and endophthalmitis was seen in 27.3% and 36.4% of cases respectively. Eighty-two percent of cases presented within 17 days of sustaining injury. Foreign body size ranged from 2mm to 8 mm and all were magnetic metal. After vitrectomy and removal of foreign body, the number of eyes with vision of hand motion or worse decreased from 72.7% to 27.3%. Similarly 45.5% of eyes gained best corrected postoperative visual acuity of better than 6/60. Anatomical success could be achieved in 81.8% of eyes.CONCLUSION: Anatomical outcome following vitrectomy in eyes with retained posterior segment IOFB in terms of retinal attachment is sufficient; however, visual outcome can be affected by other collateral ocular injuries and their sequelae.Journal of Universal College of Medical Sciences, Vol. 5, No. 2, 2017, Page: 45-48 

scholarly journals Long-Term Outcomes of Behçet’s Syndrome-Related Uveitis: A Monocentric Italian Experience

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jurgen Sota ◽  
Luca Cantarini ◽  
Antonio Vitale ◽  
Arianna Sgheri ◽  
Stefano Gentileschi ◽  
...  
Keyword(s):  
Retinal Vasculitis ◽  
Human Leukocyte ◽  
Retrospective Chart Review ◽  
Treatment Decision ◽  
Visual Outcome ◽  
Posterior Uveitis ◽  
Epiretinal Membranes ◽  
Visual Prognosis

Objectives. To examine demographic and clinical characteristics and long-term visual outcome in a cohort of Italian patients affected by Behçet’s uveitis (BU). Materials and Methods. Retrospective chart review of 47 patients with BU attending our unit between January 2018 and December 2019. Ophthalmologic manifestations, best-corrected visual acuity (BCVA), fluoroangiography and optical coherence tomography findings, and ocular complications were recorded. Predictive factors of a poor visual outcome and long-term complications were also investigated. Results. Forty-seven patients (23 males and 24 females) for a total of 84 eyes were enrolled. Uveitis was bilateral in 37 (78.7%) patients with panuveitis being the most frequent anatomical pattern (40 out of 84 eyes), whereas 27 eyes presented a posterior uveitis. Isolated anterior uveitis was detected in 16 eyes. A significant improvement of median BCVA between baseline and last follow-up values was detected (p=0.042). A higher risk of poor visual prognosis was observed in patients with uveitis duration greater than 15 years (p=0.019). A significant resolution of retinal vasculitis was detected between baseline and last follow-up evaluation (p<0.0001) whereas the mean±SD macular thickness did not decrease significantly between baseline (376.00±97.45 μm) and last follow-up evaluation (338.08±55.81 μm). Forty-two eyes developed 57 complications during the disease course. Cataract was the most frequent (n=12), followed by epiretinal membranes (n=11) and cystoid macular edema (n=6). The following variables were identified as predictors of long-term complications: human leukocyte antigen- (HLA-) B51 (p=0.006), panuveitis (p=0.037), and a uveitis duration of more than 15 years (p=0.049). Conclusions. In Italian patients, BU typically arises in the third decade and predominantly manifests as a bilateral posterior uveitis or panuveitis. Its duration is associated with a poor visual prognosis. Uveitis duration, the presence of HLA-B51, and panuveitis are predictors of long-term structural complications, thus representing main drivers in the treatment decision-making.

Intravitreal Dexamethasone in the Management of Acute Endophthalmitis: A Comparative Retrospective Study

2016 ◽  
Vol 27 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Elad Moisseiev ◽  
Sam Abbassi ◽  
Susanna S. Park
Keyword(s):  
Intravitreal Injection ◽  
Retrospective Chart Review ◽  
Visual Outcome ◽  
Complication Rates ◽  
Light Perception ◽  
Motion Vision ◽  
Hand Motion ◽  
Bacterial Endophthalmitis ◽  
Intravitreal Dexamethasone

Purpose To compare the clinical outcome of eyes with acute bacterial endophthalmitis treated with intravitreal injection of antibiotics with or without intravitreal dexamethasone. Methods This was a retrospective chart review of 63 eyes diagnosed with acute bacterial endophthalmitis and treated with vitreous tap and intravitreal injection of antibiotics, 19 eyes (30.2%) with and 44 eyes (69.8%) without concurrent intravitreal dexamethasone. Results Visual acuity had significantly improved by 1 week and was maintained long-term (p<0.001). There were no differences in visual outcome or rates of ocular complications between the groups. None of the eyes treated with dexamethasone required repeated intravitreal antibiotic injection while 6 (13.6 %) of the other eyes required repeated intravitreal antibiotic injection (p = 0.09). A subset analysis of 21 eyes that presented with light perception/no light perception vision where vitrectomy was not possible demonstrated that intravitreal antibiotic injection improved vision and achieved similar visual gain as in eyes that presented with hand motion vision or better, with no higher complication rates. Conclusions No adverse effect of intravitreal dexamethasone in the acute management of infectious endophthalmitis was noted. A trend toward less need for repeat intravitreal antibiotic therapy was noted in eyes with acute bacterial endophthalmitis treated with concurrent intravitreal dexamethasone at presentation.

Medium-term tamponade with vitrectomy and perfluorodecalin for the management of complex retinal detachments

2020 ◽  
pp. 112067212094510
Author(s):  
Luke K Chehade ◽  
Brad Guo ◽  
Weng Chan ◽  
Jaqjit Gilhotra
Keyword(s):  
Retinal Detachment ◽  
Medical Records ◽  
Case Series ◽  
Visual Outcome ◽  
Medium Term ◽  
Retrospective Case ◽  
Retinal Tears ◽  
Safe Technique ◽  
Anatomical Success

Purpose: To describe the clinical presentation, anatomical and visual outcome of a series of patients in our department with complex retinal detachments, managed with vitrectomy and perfluorodecalin (PFD) for medium-term tamponade. Study design: Retrospective case series. Methods: Retrospective analysis of the medical records of all patients in the last 6 years presenting with complex retinal detachment managed with vitrectomy where PFD was used as a medium-term tamponade. Results: A total of 85 eyes in 85 patients were included in the study, with a mean follow-up period of 16.0 ± 2.67 months (range 3–59). About 26 detachments presented with associated PVR-C, and 10 had giant retinal tears. The location of the retinal detachment was inferior in 40% of cases, and total in 18.9% of cases. Anatomical success, defined as retinal reattachment at 12 months, was achieved in 98.8% of cases, and there was a mean improvement in BCVA of logMAR 0.64 ± 0.20, which was statistically significant ( p < 0.001, paired t-test 6.23). Of the 41 phakic eyes included in the study, 20 underwent cataract surgery within the follow-up period. Conclusion: In this case series, we have demonstrated a 98.8% anatomical success and significant improvement in BCVA, with no reports of retinal toxicity. Medium-term tamponade PFD appears to be an efficacious and safe technique for management of a variety of complex retinal detachments, including those secondary to GRT, the presence of PVR-C, inferior location, tractional, traumatic, and re-detachments.

ASSESSMENT OF ANATOMICAL & FUNCTIONAL SUCCESS IN EXTERNAL DACRYOCYSTORHINOSTOMY BY AIR BUBBLE TEST

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Vikas Tantuway
Keyword(s):  
Case Series ◽  
Invasive Procedure ◽  
Nasolacrimal Duct ◽  
Good Tool ◽  
Predictive Values ◽  
Reliability Indices ◽  
Air Bubble ◽  
Bubble Test ◽  
External Dacryocystorhinostomy ◽  
Anatomical Success

Aim: To assess reliability indices of Air Bubble Test (ABT) for anatomical and functional success in external Dacryocystorhinostomy (DCR). Methods: Prospective case series of nasolacrimal duct obstruction underwent DCR. Functional success defined as Munk score 0 & 1 & anatomical success as free irrigation at followup.ABT performed by putting antibiotic drops into eye& asking patient to exhale while keeping nose & mouth closed. Formation of bubbles at punctum considered as positive test. Specificity, sensitivity, positive & negative predictive values calculated. Results: There were 103 DCR in 97 patients(23 male,74 female)with mean age 45.56 yr. Anatomical and functional success was 99.02% & 98.05%, respectively.ABT showed sensitivity 96.07%, specificity 100% for anatomical success after DCR. Sensitivity and specificity were 97.02% & 100% for functional success. Conclusion: As non-invasive procedure ABT is a good tool to assess success of DCR, though lacrimal syringing remains the gold standard. Keywords: Anatomical, Dacryocystorhinostomy & Air Bubble Test.

Vocal Fold Injection Augmentation for Post-Airway Reconstruction Dysphonia: A Case Series

2021 ◽  
pp. 000348942110125
Author(s):  
Mathieu Bergeron ◽  
John Paul Giliberto ◽  
Meredith E. Tabangin ◽  
Alessandro de Alarcon
Keyword(s):  
Vocal Fold ◽  
Care Center ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Pediatric Care ◽  
Voice Perception ◽  
Perceptual Evaluation ◽  
Airway Reconstruction ◽  
Vocal Fold Injection ◽  
History Of

Objectives: Post airway reconstruction dysphonia (PARD) is common and has a significant effect on the quality of life of patients. Vocal fold injection augmentation (VFIA) is one treatment that can be used to improve glottic insufficiency in some patients. The goal of this study was to characterize the use and outcomes of VFIA for PARD. Methods: Retrospective chart review from January 2007 to July 2018 at a tertiary pediatric care center. Consecutive patients with PARD who underwent VFIA, who had a preoperative voice evaluation and a follow-up evaluation within 3 months after VFIA (fat, carboxymethylcellulose gel, hyaluronic acid). Results: Thirty-four patients (20 female) underwent VFIA. The mean age at the time of the injection was 13.6 years (SD 6.1). Twenty patients (58.8%) had a history of prematurity and a mean of 1.8 open airway surgeries. After injection, 29/34 patients (85.3%) noted a subjective voice improvement. The baseline Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) overall severity score decreased by a mean of 5.7 (SD = 19.6) points, P = .12. Total pediatric Voice Handicap Index (pVHI) improved by 6.0 (SD = 19.5) points, from 57.4 (SD = 20.0) to 51.4 (SD = 17.2), P = .09. Functional pVHI subscore demonstrated a significant improvement, with a decrease of 3.4 (SD = 7.3) points, P = .02. All procedures were performed as an overnight observation and no complication occurred. Conclusion: Patients with PARD represent a complex subset of patients. VFIA is a straightforward intervention that may improve voice perception. Many patients reported subjective improvement despite minimal objective measurement. Further work is warranted to elucidate the role of injection in management of PARD

scholarly journals A national study of choanal atresia in tertiary care centers in Canada – part I: clinical presentation

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Josee Paradis ◽  
Agnieszka Dzioba ◽  
Hamdy El-Hakim ◽  
Paul Hong ◽  
Frederick K. Kozak ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Choanal Atresia ◽  
Case Series ◽  
Retrospective Chart Review ◽  
National Study ◽  
Feeding Difficulties ◽  
Presenting Symptoms ◽  
Tertiary Care Centers

Abstract Background To evaluate the clinical presentation of choanal atresia (CA) in tertiary centers across Canada. Methods Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with CA at a participating center. Results The health charts of 215 patients (59.6% female) with CA were reviewed and included in this study. The mean age of patients at time of CA presentation was 0.4 months (range 0.1 to 7.2 months) for bilateral CA and 37.8 months (range 0.1 to 164.1 months) for unilateral cases. The most common presenting symptoms for bilateral CA in decreasing order were respiratory distress (96.4%), feeding difficulties (68.2%), and rhinorrhea (65.5%), and for unilateral cases in decreasing order were rhinorrhea (92.0%), feeding difficulties (24.7%), and respiratory distress (18.0%). For the majority of patients (73.2%), the obstruction comprised mixed bony and membranous tissue, with only 10.5% presenting with a purely membranous obstruction. Familial history of CA was confirmed in only 3.3% of cases. One half of patients with CA presented with one or more associated anomalies and 30.6% had a syndrome. Conclusions The present investigation is the first national multi-institutional study evaluating the clinical presentation of CA over three decades. The present cohort of CA patients presented with a breadth of co-morbidities with highly variable presentations, with bilateral cases being more severely affected than unilateral cases. Further investigation into hereditary linkages to CA development is warranted. Graphical abstract

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