Closantel Retinal Toxicity: Case Report and Literature Review

A 57-year-old shepherd was referred with a 2-week history of decreased visual acuity in both eyes. Optical coherence tomography (OCT) (Heidelberg Engineering GmbH, Heidelberg, Germany) revealed diffuse outer nuclear layer hyperreflectivity and indistinguishable external limiting membrane and ellipsoid zone. The patient announced to us that he took two 500 mg of closantel tablets (15.15 mg/kg) three days before the initiation of visual problems for sore throat as an antibiotic. Electroretinography displayed severely attenuated responses in both eyes. We decided to admit the patient with the presumed diagnosis of closantel retinal toxicity and treated him with intravenous methylprednisolone 1 g per day and intravenous erythropoietin 10000 IU twice a day, and reevaluation of the patient proved no change in his visual acuity on the third day of admission. Closantel is a veterinary drug with serious side effects in the human retina and central nervous system even in previously reported doses. Public awareness and appropriate drug labeling about its side effects could prevent accidental toxicity. OCT is a noninvasive and rapid diagnostic modality that should be done in suspected toxic retinopathy.

Download Full-text

Ibopamine Treatment in Chronic Hypotony Secondary to Long-Lasting Uveitis. A Case Report

European Journal of Ophthalmology ◽

10.1177/112067210001000411 ◽

2000 ◽

Vol 10 (4) ◽

pp. 332-334 ◽

Cited By ~ 12

Author(s):

P. Pivetti-Pezzi ◽

S. Da Dalt ◽

M. La Cava ◽

M. Pinca ◽

F. De Gregorio ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Case Report ◽

Side Effects ◽

Visual Field ◽

Clinical Efficacy ◽

Eye Drops ◽

Days Of Therapy ◽

History Of

Purpose To assess the clinical efficacy of ibopamine eye drops in severe hypotony secondary to chronic progressive uveitis. Methods Case report. A 47-year-old man with a 37-year history of diffuse uveitis and severe refractory hypotony was treated with topical 2% ibopamine (Trazyl®) six times a day. Intraocular pressure, visual acuity, visual field and side effects were recorded during 15 months of follow-up. Results IOP, visual acuity and visual field increased after four days of therapy and lasted for two months when the drug was suspended because of the onset of filamentous keratopathy. A new course of treatment with 2% ibopamine eye drops in a different solvent (BSS®) resulted in a stable increase in IOP, VA and visual field, with no side effects in a follow-up of 13 months. Conclusions Ibopamine 2% eye drops in BSS® solvent seem effective in the treatment of uveitis-related hypotony.

Download Full-text

IATROSACEA FOLLOWING ABUSE OF TOPICAL STEROIDS AS A FACE-WHITENING CREAM IN MOSUL CITY

International Research Journal of Pharmacy ◽

10.7897/2230-8407.1202119 ◽

2021 ◽

Vol 12 (2) ◽

pp. 5-10

Author(s):

Deena Al-Samman ◽

Mohammed Attar Bashi

Keyword(s):

Side Effects ◽

Public Awareness ◽

Educational Status ◽

Clinical Aspects ◽

Topical Steroids ◽

Inappropriate Use ◽

Facial Erythema ◽

The Face ◽

History Of ◽

And Control

Objectives: To highlight the knowledge, frequency, types, and the clinical aspects of overusing TCs on the face as well as the motivation for such practice, with the aim of rising the public awareness in Mosul City. Methods: This prospective observational study included 180 patients aged 13-53 years, with steroid dermatitis resembling rosacea "Iatrosacea" with history of using TCs on face > 1 month, were evaluated at Al-Qudis Health Center for Family Medicine. Patients contradicted using TCs, or with classical rosacea were excluded. Results: The majority were females (90%). Duration was 2 months to 7 years. The motives were fairness (55%) and melasma (19%). The commonly abused drug was Betamethasone Valerate (35%). The reported side effects were facial erythema (84%), telangiectasia (79%), rebound phenomenon (66%), rosacea (56%), and acne (42%). The exacerbation on stopping TCs (63%) and skin lightening (37%) were the main reasons behind continued use; 59% were unaware about side effects of TCs; 42% obtained the products from cosmetic shop/Beautician and 27% from nurse clinic. In spite of observable side effects, 74% of abusers didn't feel guilty for applying them for protracted periods. Conclusion: Inappropriate use of TCs for cosmetic purposes is still commonly encountered in our environment, with believe TCs will correct any facial imperfection. As fair skin is correlated with beauty and social privilege, both genders of different ages, social, and educational status are indulged in this practice that exposed them to medical and social problems. It is a multiphase issue necessitates collaboration of different sectors to raise public awareness and control their easy availability to overcome this dilemma.

Download Full-text

Probiotics in gastroenterology – from a different angle

Orvosi Hetilap ◽

10.1556/oh.2013.29547 ◽

2013 ◽

Vol 154 (8) ◽

pp. 294-304 ◽

Cited By ~ 2

Author(s):

György Miklós Buzás

Keyword(s):

Side Effects ◽

Beneficial Effect ◽

Analytical Data ◽

Well Being ◽

Gastrointestinal Diseases ◽

Convincing Evidence ◽

Probiotic Treatment ◽

History Of ◽

Irritable Bowel

After a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. The indications of probiotic administration have been defined and extended in recent years. The author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. Probiotics are useful in preventing and treating diarrhoea caused by antibiotics and Clostridium difficile caused diarrhoea. In the treatment of Helicobacter pylori infection, preparations containing certain Lactobacillus,Bifidobacterium strains or Saccaromyces boulardii could enhance by 5–10% the rate of successful eradication and reduce the incidence and severity of the side effects. Some symptoms of irritable bowel syndrome and thus the quality of life can be improved by probiotics. Their beneficial effect in ulcerative colitis was proven, while in Crohn’s disease has not yet been defined. The use of probiotics is not included in guidelines, with the exception of the Maastricht IV/Florence consensus. For each disease it is advisable to use probiotics containing strains only with proven beneficial effect. The efficiency of preparations containing mixed strains has not yet been properly investigated. The author reviews the rare but potentially serious side effects of probiotics. In Hungary, there are many probiotic preparations available which can be purchased in pharmacies without prescription: their use is more empirical than evidence-based. The European Food Safety Authority has recently rejected claims for probiotics to be classed as medicines given the lack of convincing evidence on the effects of probiotics on human health and well-being. Clearly, further research is needed to collect evidence which could be incorporated into the international guidelines. Orv. Hetil., 2013, 154, 294–304.

Download Full-text

Adenoid cystic carcinoma of the labium oris with rare metastasis to the pleural cavity

BMJ Case Reports ◽

10.1136/bcr-2020-237622 ◽

2021 ◽

Vol 14 (1) ◽

pp. e237622

Author(s):

Osama Mosalem ◽

Anas Alsara ◽

Fawzi Abu Rous ◽

Borys Hrinczenko

Keyword(s):

Side Effects ◽

Adenoid Cystic Carcinoma ◽

Pleural Cavity ◽

Epigastric Pain ◽

Asian Woman ◽

Upper Lip ◽

Adenoid Cystic ◽

History Of ◽

The Right

A 57-year-old Southeast Asian woman with a remote history of adenoid cystic carcinoma (ACC) of the right labium superius oris (upper lip) presented to the hospital with vague epigastric pain. On workup, she was found to have multiple pleural nodules. Histopathology confirmed the diagnosis of metastatic ACC. After 8 months of active surveillance, evidence of disease progression was found and the patient was started on pembrolizumab. Follow-up after starting pembrolizumab showed stable disease with no significant side effects.

Download Full-text

Lung adenocarcinoma concomitant with xeroderma pigmentosum: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02754-0 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Masataka Matsumoto ◽

Kazumi Kaneshiro ◽

Kiyonobu Takatsuki

Keyword(s):

Epidermal Growth Factor Receptor ◽

Growth Factor ◽

Side Effects ◽

Epidermal Growth Factor ◽

Lung Adenocarcinoma ◽

Xeroderma Pigmentosum ◽

Growth Factor Receptor ◽

Consanguineous Marriage ◽

History Of ◽

Epidermal Growth

Abstract Background Xeroderma pigmentosum is a rare, autosomal-recessive photosensitive dermatosis. Patients with xeroderma pigmentosum have an impaired ability to repair deoxyribonucleic acid damage caused by ultraviolet rays, resulting in skin cancer. Patients with xeroderma pigmentosum are more susceptible to some cancers. We herein report a case of xeroderma pigmentosum accompanied by lung cancer. Case presentation The patient was a Japanese woman in her 70s with a family history of consanguineous marriage. Her medical history included squamous cell carcinoma and basal cell carcinoma, in addition to xeroderma pigmentosum. She presented with dry skin with small, pigmented spots, which were particularly focused around the areas exposed to sunlight. Chest computed tomography was conducted to assess for any evidence of metastatic skin carcinoma, and revealed a tumor in the left upper subpleural lobe of the lung. Consequently, she was referred to our department. Finally, we diagnosed lung adenocarcinoma (pT2aN0M1b: stage IVA). She had an epidermal growth factor receptor (EGFR) mutation (p.L858R). Treatment with an epidermal growth factor receptor tyrosine kinase inhibitor (gefitinib) was initiated, and the tumor gradually regressed. No side effects were observed. However, she later died from aspiration pneumonia. Conclusions Although xeroderma pigmentosum is rare, a history of consanguineous marriage should be verified. Because of the severe side effects of cisplatin and radiotherapy in xeroderma pigmentosum patients, the risks and benefits of treatment should be considered thoroughly.

Download Full-text

Descemet membrane suturing to manage recurrent graft detachment in a patient with Descemet membrane endothelial keratoplasty on failed penetrating keratoplasty

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211027705 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110277

Author(s):

Zahra Ashena ◽

Thomas Hickman-Casey ◽

Mayank A. Nanavaty

Keyword(s):

Visual Acuity ◽

Penetrating Keratoplasty ◽

Anterior Segment ◽

Endothelial Keratoplasty ◽

Descemet Membrane Endothelial Keratoplasty ◽

Descemet Membrane ◽

Ocular Coherence Tomography ◽

Corrected Visual Acuity ◽

Intracameral Injection ◽

History Of

A 65-year-old patient with history of keratoconus, mild cataract and penetrating keratoplasty over 30 years ago developed corneal oedema subsequent of graft failure with best corrected visual acuity (BCVA) of counting fingers. He underwent a successful cataract surgery combined with a 7.25 mm Descemet’s Membrane Endothelial Keratoplasty (DMEK) with Sodium Hexafluoride (SF6) gas. His cornea remained oedematous inferiorly at 4 weeks, despite two subsequent re-bubbling due to persistent DMEK detachment inferiorly. This was managed by three radial full thickness 10-0 nylon sutures placed in the inferior cornea along with intracameral injection of air. Following this, his anterior segment ocular coherence tomography (OCT) confirmed complete attachment of the graft, and the sutures were removed 4 weeks later. Unaided visual acuity was 20/63 and BCVA was 20/32 after 8 months. DMEK suturing can be helpful in persistent DMEK detachments, which is refractory to repeated re-bubbling due to uneven posterior surface of previous PK.

Download Full-text

Choroidal metastases: case report and review

Journal of Radiotherapy in Practice ◽

10.1017/s1460396920001090 ◽

2020 ◽

pp. 1-7

Author(s):

Victor Duque ◽

Carolina de la Pinta ◽

Ciriaco Corral ◽

Carmen Vallejo ◽

Margarita Martin ◽

...

Keyword(s):

Visual Acuity ◽

Side Effects ◽

External Beam Radiotherapy ◽

Choroidal Metastasis ◽

Good Visual Acuity ◽

Good Local Control ◽

Radiological Response ◽

The Right ◽

The Brain

Abstract Introduction: Choroidal metastases are the most frequent intraocular secondary tumours, with a prevalence of 2–7% according to the literature. Our aim was to review a clinical case of choroidal metastasis. We present a case of a 63-year-old male patient diagnosed in 2018 with lung adenocarcinoma cT4N0M1. The patient had three metastases in the brain, which were successfully treated with radiosurgery (RS). The patient was treated with chemotherapy with pemetrexed–cisplatin schedule. Five months after diagnosis, the patient presented with decreased vision in the right eye. After ophthalmologic evaluation, he was diagnosed with a right choroidal metastasis, which was treated with external beam radiotherapy with 20 Gy in five fractions, resulting in improved visual acuity and a complete clinical and radiological response. The patient took part in a clinical trial that continued with systemic chemotherapy. Twenty-two months after radiotherapy to the eye, the patient has good visual acuity without any side effects. Conclusions: Choroidal metastasis treated with radiotherapy achieves good local control, with limited side effects, allowing an improvement in visual acuity and consequently, an improvement in the patient´s quality of life.

Download Full-text

Natural History of Idiopathic Epiretinal Membrane in Eyes with Good Vision Assessed by Spectral-Domain Optical Coherence Tomography

Ophthalmologica ◽

10.1159/000437058 ◽

2015 ◽

Vol 234 (2) ◽

pp. 91-100 ◽

Cited By ~ 12

Author(s):

Ik Soo Byon ◽

Gang Yun Pak ◽

Han Jo Kwon ◽

Kyong Ho Kim ◽

Sung Who Park ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Natural History ◽

Visual Function ◽

Epiretinal Membrane ◽

Membrane Separation ◽

Early Stage ◽

Optical Coherence ◽

Idiopathic Epiretinal Membrane ◽

History Of

Purpose: To investigate the natural history of idiopathic epiretinal membrane (ERM) in eyes with good visual function using optical coherence tomography (OCT). Methods: Sixty-two eyes of 58 patients with idiopathic ERM, visual acuity of 20/40 or better, and no significant metamorphopsia were included. The best corrected visual acuity (BCVA), central macular thickness (CMT), membrane configuration, and ellipsoid zone signal data over 24 months were retrospectively analyzed. Based on OCT findings, ERM configurations were categorized as global attachment (GA), partial attachment (PA), pseudohole, and vitreomacular traction (VMT). Results: The mean BCVA and CMT did not change significantly between baseline and 24 months. GA, PA, pseudohole, and VMT types were observed in 33, 19, 9, and 1 eye at baseline, and in 20, 22, 10, and 1 eye at 24 months, respectively. A membrane configuration change was noted in 24 eyes (38.7%) during follow-up, and the distribution shifted from GA to the other types (p < 0.001). Six eyes had visual loss due to membrane progression, and 4 eyes had spontaneous membrane separation. Of the 10 eyes with progression or separation, 6 were of the PA type. Conclusions: Although the BCVA remains stable over 2 years in most idiopathic ERM eyes with good visual function at baseline, the membrane configuration may change, affecting visual acuity. The GA type would be an early stage, and the PA type is prone to changes in visual acuity.

Download Full-text

Dermal Discoloration Secondary to Triamcinolone Acetonide Injection Observed in Patients with Autoimmune Disorders

Journal of the American Podiatric Medical Association ◽

10.7547/20-210 ◽

2021 ◽

Vol 111 (4) ◽

Author(s):

James A. Wright ◽

Jessica A. Wenz ◽

Gabrielle Jackson Madrigal

Keyword(s):

Psoriatic Arthritis ◽

Side Effects ◽

Autoimmune Disease ◽

Triamcinolone Acetonide ◽

Current Literature ◽

Side Effect ◽

Inflammatory Conditions ◽

Rare Side Effect ◽

History Of ◽

Synthetic Glucocorticoid

Triamcinolone acetonide is a synthetic glucocorticoid used to treat numerous acute and chronic inflammatory conditions. The various side effects of this drug from parenteral administration are well documented in the literature. In this study, three patients present with a rare side effect of violaceous dermal pigmentation. To the best of the authors' knowledge, this finding is rarely presented in the current literature. The purpose of this study is to provide awareness of a less-documented, delayed side effect from triamcinolone acetonide administration. Although all patients presenting in this study had a known history of autoimmune disease (eg, lupus, psoriatic arthritis) further research is needed to suggest a possible association between dermal violaceous change and the use of triamcinolone.

Download Full-text

Elucidating the Potential Side Effects of Current Anti- Seizure Drugs for Epilepsy

Current Neuropharmacology ◽

10.2174/1570159x19666210826125341 ◽

2021 ◽

Vol 19 ◽

Author(s):

Enes Akyüz ◽

Mohd. Farooq Shaikh ◽

Betül Köklü ◽

Cansu Ozenen ◽

Alina Arulsamy

Keyword(s):

Quality Of Life ◽

Side Effects ◽

Adverse Effects ◽

Side Effect ◽

First Line ◽

Epileptic Patients ◽

Life Threatening ◽

Visual Problems ◽

Gaba Transmission

: Over the decades, various interventions have been developed and utilized to treat epilepsy. However, majority of epileptic patients are often first prescribed with anti-epileptic drugs (AED), now known as anti-seizure drugs (ASD), as a first line of defense to suppress their seizures and regain their quality of life. ASDs exert their anti-convulsant effects through various mechanisms of action including regulation of ion channels, blocking of glutamate-mediated stimulating neurotransmitter interaction, and enhancing the inhibitory GABA transmission. About one third of epileptic patients are often resistant to anti-convulsant drugs, while others develop numerous side effects which may lead to treatment discontinuation and further deterioration of quality of life. Common side effects of ASDs include headache, nausea and dizziness. However, more adverse effects such as auditory and visual problems, skin problems, liver dysfunction, pancreatitis and kidney disorders may also be witnessed. Some ASDs may even result in life-threatening conditions as well as serious abnormalities, especially in patients with comorbidities and in pregnant women. Nevertheless, some clinicians had observed a reduction in the development of side effects post individualized ASD treatment. This suggest that a careful and well-informed ASD recommendation to patients may be crucial for an effective and side-effect free control of their seizures. Therefore, this review aimed to elucidate the anticonvulsant effects of ASDs as well as their side effect profile, by discussing their mechanism of action and reported adverse effects based on clinical and preclinical studies, thereby providing clinicians with a greater understanding of the safety of current ASDs.

Download Full-text