Visual acuity outcomes in cytomegalovirus retinitis: early versus late diagnosis

2018 ◽  
Vol 102 (12) ◽  
pp. 1607-1610 ◽  
Author(s):  
Somsanguan Ausayakhun ◽  
Michael Yen ◽  
Choeng Jirawison ◽  
Sakarin Ausayakhun ◽  
Preeyanuch Khunsongkiet ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Vision Loss ◽  
Cd4 Count ◽  
Hiv Care ◽  
Early Screening ◽  
Hand Motion ◽  
Cmv Retinitis ◽  
Eye Examination ◽  
Study Participants ◽  
Late Group

AimsTo determine if early dilated fundus examination for cytomegalovirus (CMV) retinitis leads to better visual outcomes in areas with limited HIV care, where patients may have long-standing retinitis before they are diagnosed with HIV.MethodsTwenty-four eyes of 17 patients with CMV retinitis who were seen at an urban HIV clinic in Chiang Mai, Thailand, were included in this retrospective cohort study. Participants were divided into two groups based on the amount of time from the first documented CD4 count below 100 cells/mm3 to the first eye examination for CMV retinitis. Average visual acuity in each group was calculated at the time CMV retinitis was first detected, and then at 3, 6 and 12 months after diagnosis.ResultsThe group of patients who received an eye examination within approximately 4 months of the initial low CD4 count measurement had better baseline visual acuity (median 20/30,IQR 20/20 to 20/60) compared with patients who presented later (median 20/80, 20/60 to hand motion); p=0.03). Visual acuity did not change significantly during the 12-month study period in either the early group (p=0.69) or late group (p=0.17).ConclusionIn this study, patients who were examined sooner after a low CD4 count had better vision than patients who were examined later. Routine early screening of patients with CD4 counts under below 100 cells/mm3 may detect earlier disease and prevent vision loss.

scholarly journals Nd:YAG Laser Hyaloidotomy for Treatment of Subhyaloid Hemorrhage in Pregnancy

2020 ◽  
Author(s):  
Mojtaba Abrishami ◽  
Nasser Shoeibi ◽  
Hamid Reza Heidarzadeh ◽  
Ghodsieh Zamani
Keyword(s):  
Visual Acuity ◽  
Nd:Yag Laser ◽  
Pregnant Patient ◽  
Visual Recovery ◽  
Case Presentation ◽  
Hand Motion ◽  
Valsalva Retinopathy ◽  
Eye Examination ◽  
In Pregnancy ◽  
Subhyaloid Hemorrhage

Abstract Purpose: To report a pregnant patient with impaired vision due to macular involvement of valsalva retinopathy associated with subhyaloid hemorrhage, who was effectively treated with Nd:YAG laser hyaloidotomy and led to successful visual recovery.Case presentation: A thirty-year-old pregnant woman at 36-week gestational age was referred due to suddenly decreased visual acuity in her left eye following a severe vomiting. Left eye examination showed a dense large subhyaloid hemorrhage in front of macula extending from superior to inferior arcade with a clear media. With the diagnosis of subhyaloid hemorrhage she underwent Nd:YAG laser hyaloidotomy and visual acuity improved from hand motion to 20/20 after one week.Conclusion: In this report, Nd:YAG laser hyaloidotomy was shown to be effective and safe in treatment of dense subhyaloid hemorrhage in pregnant patients with Valsalva retinopathy.

scholarly journals Case report: restored vision after ocular Closantel intoxication and blindness

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Reza Khalili ◽  
Athar Zareei
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Visual Function ◽  
Vision Loss ◽  
Ocular Toxicity ◽  
Present Case Report ◽  
Hospital Arrival ◽  
Hand Motion ◽  
Complete Restoration

Abstract Background Closantel is the best-known anti-parasitic medicine for veterinarians, which is contraindicated in humans. After reviewing the literature on ocular toxicity following mistaken usage of Closantel in humans, this report was found as the first complete restoration of visual function after Closantel intoxication. This report could be useful in anticipating the possibility of a further improvement based on a dose-response relationship. An important point of this report is the apparent reversibility of the vision and Electrophysiological parameters after Closantel intoxication and blindness. To conclude, the present case report demonstrates the importance of immediate referral and management in Closantel intoxication to avoid the long-term adverse effects of drug on visual function. Case presentation A 47-year-old man mistakenly took about 20 cc of Closantel 5% (15.87 mg/kg). Four hours after mistaken usage of Closantel, he was transferred to the district hospital due to dizziness and nausea. His stomach was washed out immediately after hospital arrival. He was being hospitalized in that hospital for 3 days. Then, he was referred to our clinic due to progressive vision loss. Methylprednisolone acetate 250 mg was injected once on 5th day after taking Closantel. His vision was reducing gradually so low that he could only detect hand motion (HM) on the 14th day after taking Closantel. ERG test was requested. It showed an exclusive reduction in b-wave amplitude under photopic and scotopic conditions. Later, his vision surprisingly improved gradually and his visual acuity was fully restored on the 28th day after the incident. After 3 years, we checked him again. His visual acuity was 20/20 in both eyes and the patient did not have any problem and his ERG report was completely normal. Conclusions In low dose of Closantel and immediate referral, ocular toxicity could be resolved.

Efficacy of Vision Therapy Software (CureSee) in Amblyopia

2021 ◽  
Author(s):  
Suneel Kr Dixit
Keyword(s):  
Visual Acuity ◽  
Vision Loss ◽  
Spatial Vision ◽  
Binocular Summation ◽  
Ocular Surgery ◽  
Before And After ◽  
Eye Examination ◽  
Training Objective ◽  
Vision Therapy ◽  
Stereo Acuity

A developmental disorder of spatial vision, Amblyopia is defined clinically as a decrease in visual acuity (VA) in one, or more often in both eyes, in the absence of a clear disorder or ocular disease Amblyopia is the most common cause of monocular vision loss in children [1]. Affected individuals exhibit stereo acuity impairment and abnormal binocular summation [2]. Binocular therapies designed to improve amblyopia by binocular stimulation are highly differentiated into perceptual learning and differential training. Objective • To determine the efficacy of Vision Therapy software (CureSee) in Amblyopia. • To compare Stereopsis findings before and after VT • To compare Visual Acuity before and after VT • To compare Vergence amplitude before and after VT. Methodology: 68 Amblyopic Subjects who are visiting Ahooja Eye & Dental Institute, Gurugram for eye examination and Amblyopia management were taken. Patients diagnosed with Amblyopia were included as well as Patients with Ocular surgery done within 2 months and Patients with any Ocular pathology were excluded. Verbal Consent was taken and selected patients were enrolled into CureSee Vision Therapy Software management for Amblyopia. Data is collected prior and post the use of CureSee Vision Therapy Software by patients and the collected data were decoded and tabulated using the Ms. Excel 2010 computer program and IBM Statistical Package for Social Sciences (SPSS) statistics version 23.0 was used for the analysis of data. Result and Conclusion: Visual Acuity improved significantly by 0.14 LogMar to the Median Values of Right Eye and by 0.60 LogMar to the Median Values of Left Eye. Stereopsis improved from 800 ± 520 sec of arc to 60 ± 60 sec of arc with P≤0.001. PFV and NFV also improved significantly after the use of Vision Therapy Software. Results conclude that Vision Therapy software is effective in improving Stereopsis, Visual Acuity and Vergence values in Amblyopic patients.

Vision loss in a pregnant woman with nephrotic syndrome

2021 ◽  
pp. 112067212110547
Author(s):  
Zoi Tsani ◽  
Antonios Ntafos ◽  
Victoria Toumanidou ◽  
Anna Dastiridou ◽  
Ioanna Ploumi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Nephrotic Syndrome ◽  
Pregnant Woman ◽  
Vision Loss ◽  
Pigment Epithelium ◽  
Hand Motion ◽  
Corrected Visual Acuity ◽  
Visual Acuity Loss ◽  
The Right

Purpose To report acute visual acuity loss in a pregnant woman with nephrotic syndrome. Case Report A 34-year-old pregnant woman was referred to our service for acute, bilateral visual impairment, associated with bilateral below knee edema (BKE). Best-corrected visual acuity (BCVA) was hand motion in the right eye and 20/200 in the left eye. Dilated fundus exam disclosed multiple pigment epithelium detachments involving the macula in both eyes. After consultation with a nephrologist a diagnosis of nephrotic syndrome was made. Unfortunately, a week later she lost the fetus. At follow-up evaluation, 20 days after the miscarriage, BCVA improved to 20/25 in both eyes with near normal restoration of the retinal anatomy. Conclusion In nephrotic syndrome, sequestration of interstitial fluids, which leads to classic generalized edema, could be the origin of interstitial accumulation of fluids in the retinal and subretinal layers. Increased awareness by the gynaecologists and prompt treatment may prevent fetus miscarriage.

scholarly journals The impact of HIV-associated immunosuppression on the Plasmodium falciparum chloroquine resistance transporter gene (PfCRT) of HIV patients in Akure, Nigeria

2020 ◽  
Vol 44 (1) ◽  
Author(s):  
Iyabo Adepeju Simon-Oke ◽  
Adeola Olanireti Ade-Alao ◽  
Foluso Ologundudu
Keyword(s):  
Plasmodium Falciparum ◽  
Malaria Prevalence ◽  
Cd4 Count ◽  
Chloroquine Resistance ◽  
Hiv Care ◽  
Transporter Gene ◽  
Hiv Patients ◽  
Chloroquine Resistance Transporter ◽  
Hiv Test ◽  
Low Prevalence

Abstract Background The study evaluated the prevalence of malaria and Plasmodium falciparum chloroquine resistance transporter gene (PfCRT) in HIV patients attending Specialist Hospital, Akure. This study was carried out between April and June 2019. Three hundred and seventeen (317) patients attending the antiretroviral clinic (ART) were involved, out of which 89 (28.08%) were males and 228 (71.92%) were females. HIV test was done using the Unigold® HIV test kit, malaria test was done using thick and thin blood smear, CD4 test was done using the Partec® CD4 counter and PCR was used to detect the presence of plasmodium falciparum mutant gene. The data obtained from this analysis was subjected to Pearson’s Chi-square test. Results The overall result showed low prevalence of malaria (23.03%) in the sampled patients. Highest malaria prevalence (31.0%) was recorded in HIV patients with CD4 count between 200–500 cells/μl of blood, with the males recording 24.7% malaria prevalence. The age group 20–29 years recorded the highest prevalence of 27.3%. A higher prevalence 91.1% of PfCRT gene in HIV-positive and (40.0%) in HIV-negative patients was recorded with 100% prevalence in patients with CD4 count ≤ 200. This shows that the low prevalence of malaria recorded in this study could be credited to good health-seeking attitude of HIV patients and the upscale of HIV care and treatment centres. Conclusion The high prevalence of PfCRT gene shows that treatment of malaria with chloroquine is still being practised despite the availability of artemisinin-based combination therapy (ACTs) as the recommended regimen for malaria treatment.

Retinal Vasculitis Associated With Dermatomyositis Treated With Intravenous Steroids

2021 ◽  
pp. 247412642110189
Author(s):  
Austen N. Knapp ◽  
Jawad I. Arshad ◽  
Daniel F. Martin ◽  
Rula Hajj-Ali ◽  
Kimberly Baynes ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vasculitis ◽  
Subretinal Fluid ◽  
Retrospective Case ◽  
Hand Motion ◽  
Frosted Branch Angiitis ◽  
Intravenous Steroids

Purpose: This work aims to present treatment and long-term follow-up of a 31-year-old woman with dermatomyositis who presented with hemorrhagic retinal vasculitis and macular edema. Methods: A retrospective case report is presented. Results: A 31-year-old woman with dermatomyositis treated with systemic immunosuppression was evaluated for acute, reduced vision. Best-corrected visual acuity was hand motion in the right eye and 20/200 in the left eye. Fundus examination revealed diffuse intraretinal hemorrhages, cotton-wool spots, and vascular sheathing with a frosted branch angiitis–like appearance. Optical coherence tomography revealed significant macular edema and subretinal fluid that quickly resolved after admission and treatment with intravenous steroids. Multimodal imaging at 7-year follow-up disclosed long-term sequelae including peripheral nonperfusion and retinal neovascularization. Conclusions: When vasculitis associated with dermatomyositis is treated aggressively with intravenous steroids at initial presentation, good visual acuity outcomes can be achieved, but long-term consequences of retinal nonperfusion and neovascularization persist.

scholarly journals 1010. Effective Management of HIV in Rural Georgia Using Telemedicine

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S533-S533
Author(s):  
Folake J Lawal ◽  
Arni S R Srinivasa Rao ◽  
Jose A Vazquez
Keyword(s):  
Rural Areas ◽  
Viral Suppression ◽  
Retrospective Chart Review ◽  
Cd4 Count ◽  
Hiv Care ◽  
Resistance Mutations ◽  
Remote Communities ◽  
Hiv Viral Load ◽  
Viral Control ◽  
Significant Difference

Abstract Background The increasing incidence of HIV and lack of care in rural areas contributes to the ongoing epidemic. The dearth of specialized health services within remote communities and access of this population to available services poses a challenge to HIV care. Telemedicine (TM) is a potential tool to improve HIV care in these remote communities, but little is known about its effectiveness when compared to traditional (face-to-face) (F2F) care. The objective of this study is to examine the effectiveness of HIV care delivered through TM, and compare to F2F care. Methods This is a retrospective chart review of all HIV positive patients who attended either the F2F clinic (Augusta, GA) or the TM clinic (Dublin, GA) between May 2017 to April 2018. Data extracted included demographics, CD4 count, HIV PCR, co-morbidities, dates of clinic attendance, HIV resistance mutations and ART changes. Viral suppression and gain in CD4 counts were compared. T-test was conducted to test differences in characteristics and outcomes between the two groups. Results 385 cases were included in the study (52.5% black, 82% females, F2F=200, TM=185). Mean CD4 count in the TM group was statistically higher (643.9 cells/mm3) than the F2F group (596.3 cells/mm3) (p< 0.001). There was no statistically significant difference in mean HIV viral load (F2F= 416.8 cp/ml, TM=713.4 cp/ml, p=0.3) and rates of year-round viral control (F2F= 73% vs TM = 77% p= 0.54). 38 patients achieved viral suppression during the study period (F2F= 24, TM =14) with a mean change of -3.34 x 104 vs -1.24 x 104, respectively. The difference in mean change was not statistically significant by Snedacor’s W Statistics. This indicates there was no significant difference between the two populations in terms of mean viral suppression among patients who were otherwise not suppressed before the study period. Conclusion To achieve an HIV cure, HIV care is required to extend to rural areas of the country and the world. Through delivery of care using TM, trained specialists can target communities with little or no health care. Moreover, use of TM achieves target outcome measures comparable to F2F clinics. Increase in the use of TM will improve the access to specialty HIV care and help achieve control of HIV in rural communities. Disclosures All Authors: No reported disclosures

scholarly journals Suicidal ideation, psychopathology and associated factors among HIV-infected adults in Indonesia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Youdiil Ophinni ◽  
Adrian ◽  
Kristiana Siste ◽  
Martina Wiwie ◽  
Gina Anindyajati ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Single Point ◽  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Cd4 Count ◽  
Depression Symptoms ◽  
Early Screening ◽  
Cross Sectional ◽  
Aids Epidemic ◽  
Hiv Aids

Abstract Background Suicidal behavior is a prevalent psychiatric emergency in HIV-infected adults. Detection of suicidal ideation is important in planning early psychiatric intervention and optimizing HIV/AIDS management. Characterization of suicidal ideation among HIV-infected adults is crucial; however, practically there is no data in Indonesia, the country with the second largest burden of HIV/AIDS epidemic in Asia. This study aims to identify suicidal ideation and analyze the associated psychopathology and determining factors among HIV-infected adults in Indonesia. Methods An observational cross-sectional study was conducted among HIV-infected adults aged 18–65 years old receiving antiretroviral therapy (ART). Measurement using Symptom Checklist-90 (SCL-90) was performed to assess the existing psychopathology. Firth’s penalized logistic regression analysis was performed to identify factors associated with suicidal ideation. Results A total of 86 subjects were recruited. Most subjects were male (65.1%), median age was 35 years, and median latest CD4 count was 463 cells/μl. Lifetime suicidal ideation was identified in 20 subjects (23.3%). Mean SCL-90 T-score for depressive and anxiety symptoms were both significantly higher among subjects with suicidal ideation (M = 60.75, SD = 12.0, p = 0.000 and M = 57.9, SD = 2.8, p = 0.001, respectively) compared to those without. Bivariate analyses showed that lifetime suicidal ideation was associated with depressive and anxiety symptoms, non-marital status, CD4 count < 500 cells/μl, and efavirenz use. Multivariate analysis identified that a single-point increase in SCL-90 depression symptoms score (AOR 1.16, 95% CI 4.5–123.6, p = 0.000) and efavirenz use (AOR 5.00, 95% CI 1.02–24.6, p = 0.048) were significant independent factors related to suicidal ideation. Conclusion Suicidal ideation is commonly found among Indonesian HIV-infected adults on ART. Depressive symptoms and efavirenz use are independent factors related to the presence of suicidal ideation. Thus, early screening of psychopathology as well as substitution of efavirenz with other ART regiment are recommended to prevent suicide and improve HIV/AIDS management outcome.

scholarly journals Valsalva Retinopathy Associated with Sexual Activity

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Khalid Al Rubaie ◽  
J. Fernando Arevalo
Keyword(s):  
Visual Acuity ◽  
Sexual Activity ◽  
Vision Loss ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Sudden Loss ◽  
Initial Visual Acuity ◽  
Pars Plana ◽  
23 Gauge ◽  
The Right

A 54-year-old healthy male presented complaining of sudden loss of vision in the right eye. Initial visual acuity was counting fingers. The patient’s acute vision loss developed after sexual activity. Color fundus photos and fluorescein angiography were performed showing a large subinternal limiting membrane hemorrhage in the macular area. A 23-gauge sutureless pars plana vitrectomy with brilliant blue assisted internal limiting membrane peeling was performed with best-corrected visual acuity recovery to 20/50 at 6 months of followup.

scholarly journals Role of Paediatricians in Paediatric Ophthalmology

2013 ◽  
Vol 33 (1) ◽  
pp. 80-82
Author(s):  
Ujjowala Devi Shrestha
Keyword(s):  
Vitamin A Deficiency ◽  
Early Screening ◽  
Early Referral ◽  
Eye Health ◽  
Total Lack ◽  
Eye Examination ◽  
The Common ◽  
One Year ◽  
Paediatric Ophthalmology

Children are primarily examined by paediatricians. In Nepal, child health is in low priority due to illiteracy, there is total lack of awareness about children’s eye health. The common avoidable causes of childhood blindness are refractive errors, amblyopia, retinopathy of prematurity (ROP), vitamin A deficiency (VAD), xerophthalmia, ophthalmia neonatorum (ON), congenital cataract, and retinoblastoma. Paediatricians could be the key persons for early referral of these children to a paediatric ophthalmologist. Paediatricians can send the patients for eye examination after birth within 6 weeks, at 6 months, at one year and before going to school. In conclusion, early screening and referral by the paediatricians to the paediatric ophthalmologist prevents children from being sightless. DOI: http://dx.doi.org/10.3126/jnps.v33i1.7605 J Nepal Paediatr Soc. 2013;33(1):80-82

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