scholarly journals Valsalva-Like Retinopathy Spontaneously Occurred after Ocular Massage

2015 ◽  
Vol 6 (1) ◽  
pp. 88-92
Author(s):  
Keiko Uchida ◽  
Masayuki Takeyama ◽  
Masahiro Zako
Keyword(s):  
Vitreous Hemorrhage ◽  
Internal Limiting Membrane ◽  
Posterior Pole ◽  
Yttrium Aluminium Garnet ◽  
Case Presentation ◽  
Vascular Abnormalities ◽  
Corrected Visual Acuity ◽  
Japanese Female ◽  
Old Japanese ◽  
Yttrium Aluminium Garnet Laser

Purpose: The aim of this study is to describe a case of Valsalva-like retinopathy that occurred after ocular massage. Case Presentation: A healthy 44-year-old Japanese female had massaged her eye with strong pressure several times. Subsequently, she noticed a loss in the left central vision. A left-eye fundus examination showed a dense preretinal hemorrhage located under the internal limiting membrane at the posterior pole and a mild vitreous hemorrhage. We performed a neodymium-doped yttrium-aluminium-garnet laser membranotomy to perforate the internal limiting membrane. Her best-corrected visual acuity improved from 0.01 to 1.0. No retinal vascular abnormalities in the macular area were found. Conclusion: Ocular massage can cause Valsalva-like retinopathy.

scholarly journals Valsalva retinopathy induced by handstand: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Toshiya Miyaki ◽  
Teruyo Kida ◽  
Shou Oosuka ◽  
Masanori Fukumoto ◽  
Takaki Sato ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Head ◽  
Venous Pressure ◽  
Vitreous Hemorrhage ◽  
Internal Limiting Membrane ◽  
Posterior Pole ◽  
Intraabdominal Pressure ◽  
Physical Education Class ◽  
Case Presentation ◽  
Valsalva Retinopathy

Abstract Background Valsalva retinopathy is known to occur as a sudden preretinal or sub-internal limiting membrane hemorrhage induced by a rapid rise in venous pressure following increased intrathoracic or intraabdominal pressure. Here we report a case of Valsalva retinopathy that was probably induced by straining that occurred due to following a handstand. Case presentation A 15-year-old boy became aware of decreased visual acuity in his left eye immediately after doing a handstand for approximately 10 s during physical education class, and subsequently visited a local clinic on the same day. Upon examination, a vitreous hemorrhage (VH) in the posterior pole of the fundus was found in his left eye, and he was subsequently referred to our department 7 days later. Upon examination, the VH around the optic nerve head of the left eye appeared to be resolved, and an oval-shaped sub-internal limiting membrane (sub-ILM) hemorrhage was found in the superonasal side of the optic nerve head. No abnormalities were observed in the macular area. Four months later, the sub-ILM hemorrhage was found to have spontaneously resolved. Subsequent fluorescein angiography examinations revealed no abnormal findings at the lesion site. Conclusions In this patient, we hypothesize that the Valsalva retinopathy was induced by straining that occurred due to a handstand, and that the resultant sub-ILM hemorrhage progressed to VH.

scholarly journals Unusual eye injury related to abusive head trauma

Rechtsmedizin ◽  
2021 ◽  
Author(s):  
Cordula Eddahabi ◽  
Yassin Djalali-Talab ◽  
Sibylle Banaschak ◽  
Katharina Feld
Keyword(s):  
Optic Disc ◽  
Head Trauma ◽  
Vitreous Hemorrhage ◽  
Abusive Head Trauma ◽  
Internal Limiting Membrane ◽  
Posterior Pole ◽  
Ophthalmological Examination ◽  
Eye Injuries ◽  
Two Phase ◽  
The Right

AbstractOphthalmological examination is an essential component in clinically diagnosing abusive head trauma (AHT). Typical of AHT injuries is retinal bleeding, with other parts of the eye sometimes also being affected. Visual impairment and blindness are long-term complications in this context. We present a case with unusual eye injuries after a diagnostically confirmed AHT.The ophthalmological findings on admission day showed a massive subhyaloid hemorrhage at the posterior pole and extensive flame-shaped intraretinal hemorrhages accented on the right side., A centrally localized vitreous hemorrhage appeared on both sides 3 weeks later, obscuring the optic disc and macula most probably due to a breakthrough of a sub-internal limiting membrane (ILM) hemorrhage into the vitreous cavity. Follow-up 4 weeks later revealed a dense and organized vitreous hemorrhage occupying the optic disc and macula so that a pars plana vitrectomy was performed on both eyes.The bilateral bleeding in different retinal layers, the vitreous hemorrhage and the proliferative vitreoretinal reaction (PVR) indicated massive damage caused by a significant acceleration-deceleration trauma. A two-phase vitreous hemorrhage in a child with AHT does not yet appear to have been described in the literature.

scholarly journals Vitrectomy With Peeling the Internal Limiting Membrane for the Treatment of Macular Hole Following Ruptured Retinal Arterial Macroaneurysm: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhigao Liu ◽  
Shuya Wang ◽  
Yu Wang ◽  
Aihua Ma ◽  
Bojun Zhao
Keyword(s):  
Macular Hole ◽  
Posterior Vitreous Detachment ◽  
Internal Limiting Membrane ◽  
Case Presentation ◽  
Surgical Closure ◽  
Retinal Arterial Macroaneurysm ◽  
Corrected Visual Acuity ◽  
Pars Plana ◽  
Sudden Decrease ◽  
The Right

Background: This study aimed to report a case of vitrectomy with peeling the internal limiting membrane for the treatment of macular hole (MH) following ruptured retinal arterial macroaneurysm (RAMA).Case Presentation: A 65-year-old woman noticed a sudden decrease in vision in the left eye. She had no other ocular problems apart from a mild cataract in both eyes before. Her best-corrected visual acuity (BCVA) was 20/33 in the right eye, and 6/100 in the left eye. Fluorescein angiography (FFA) showed a retinal arterial macroaneurysm with telangiectatic retinal vascular changes in the inferior temporal macular region. Optical coherence tomography (OCT) examination demonstrated the presence of subretinal hemorrhage extending into the foveal area and incomplete posterior vitreous detachment. Because of the presence of submacular hemorrhage, some medicine was administrated and the patient was followed up. Then, 5 months later, the hemorrhage was absorbed. OCT examination exhibited a full-thickness MH with a macular epiretinal membrane. The size of the MH was 722 μm in diameter. She was then given a standard three-port pars plana vitrectomy (PPV), along with peeling of the internal limiting membrane (ILM) and filling the vitreous cavity with air. Anatomic closure of the MH was achieved after 4 weeks of the surgery by the examination of OCT. The BCVA was improved to 15/100.Conclusions: This case expanded our knowledge of the association of MH secondary to ruptured RAMA. We reported a case with successful surgical closure of the MH and improvement of BCVA.

scholarly journals Masked diabetes insipidus in pituitary metastasis from breast cancer after thalamic biopsy: a case report

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Hiroaki Hashimoto ◽  
Tomoyuki Maruo ◽  
Masami Nakamura ◽  
Yukitaka Ushio ◽  
Masayuki Hirata ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diabetes Insipidus ◽  
Plasma Sodium ◽  
Case Presentation ◽  
Delayed Treatment ◽  
Pituitary Dysfunction ◽  
Asymptomatic Patients ◽  
Japanese Female ◽  
Old Japanese ◽  
Pituitary Metastasis

Abstract Background Symptomatic pituitary metastasis is rare; furthermore, it can result in diabetes insipidus and panhypopituitarism. Since diabetes insipidus is masked by concurrent panhypopituitarism, it can impede the diagnosis of pituitary dysfunction. Case presentation A 68-year-old Japanese female suffering from pituitary and thalamic metastases caused by untreated breast cancer, underwent a biopsy targeting the thalamus, not the pituitary. She lacked prebiopsy pituitary dysfunction symptoms; however, these symptoms unexpectedly occurred after biopsy. Diabetes insipidus was masked by corticosteroid insufficiency, and she showed normal urinary output and plasma sodium levels. Upon commencement of glucocorticoid replacement therapy, the symptoms of diabetes insipidus appeared. Conclusions In this case, thalamic biopsy, as opposed to pituitary biopsy, was performed to preserve pituitary function. However, pituitary dysfunction could not be avoided. Caution is necessary for asymptomatic patients with pituitary metastases as invasive interventions, such as surgery, may induce pituitary dysfunction. Moreover, with respect to masked diabetes insipidus, there is a need to carefully consider pituitary dysfunction to avoid misdiagnosis and delayed treatment.

Multimodal imaging and adaptive optics in internal limiting membrane dystrophy

2020 ◽  
Vol 13 (8) ◽  
pp. e234960
Author(s):  
Avadhesh Oli ◽  
Divya Balakrishnan
Keyword(s):  
Adaptive Optics ◽  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Internal Limiting Membrane ◽  
Posterior Pole ◽  
Retinal Surface ◽  
Corrected Visual Acuity ◽  
Normal Colour ◽  
Fundus Photo

An 18-year-old boy presented with a mild blurring of vision in both his eyes for the last 2 years. His best-corrected visual acuity was 20/60 in both the eyes with normal colour vision. Fundus evaluation showed exaggerated shiny reflex from the internal limiting membrane (ILM) with the wrinkled inner retinal surface at posterior pole. No vessel attenuation or retinal pigment epithelium changes were evident. Optical coherence tomography showed thickened ILM, which was appreciated in fundus photo also. The electrodiagnostic tests were normal, and the photoreceptors appeared normal in adaptive optics in the central macula at 2°–4° eccentricity. Among the very few reported cases of Muller cells sheen dystrophy, our patient was the probably the youngest and was picked up by a thoughtful ophthalmologist in detailed clinical examination. Adaptive optics in the case of ILM dystrophy is also not reported earlier.

scholarly journals Immediate post partum macular subretinal bleeding in a highly myopic patient: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karen Bitton ◽  
J.-L. Bacquet ◽  
F. Amoroso ◽  
S. Mrejen ◽  
M. Paques ◽  
...  
Keyword(s):  
Valsalva Maneuver ◽  
Post Partum ◽  
Pathologic Myopia ◽  
Pathological Myopia ◽  
Case Presentation ◽  
Sudden Loss ◽  
Corrected Visual Acuity ◽  
First Case ◽  
History Of ◽  
Macular Hemorrhage

Abstract Background Pathologic myopia is a major cause of visual impairment and blindness. Case presentation We report a case of an immediate post partum macular subretinal bleeding observed in a highly myopic patient. A 30-years-old woman presented two days after childbirth for sudden loss of vision in her right eye. Multimodal imaging showed macular hemorrhage masking a subtle yellowish linear lesion corresponding to lacker crack. Due to the lack of evidence for choroidal neovascularization, a simple clinical and imaging monitoring was recommended. Six weeks later, we noted an improvement in her best-corrected visual acuity and a decreased in size of the macular hemorrhage. Conclusions This is the first case reporting a macular subretinal bleeding on macular lacquer cracks in a highly myopic patient in immediate post partum. Valsalva maneuver associated with vaginal delivery could explain the occurrence of the hemorrhage associated with lacquer crack. However, natural history of pathological myopia could not be excluded.

scholarly journals A Case Report of Tongue Lymphoepithelial Carcinoma with a Histological Diagnostic Dilemma

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1039
Author(s):  
Daisuke Takeda ◽  
Manabu Shigeoka ◽  
Tenyu Sugano ◽  
Nanae Yatagai ◽  
Takumi Hasegawa ◽  
...  
Keyword(s):  
Histological Finding ◽  
Atypical Epithelium ◽  
Diagnostic Dilemma ◽  
Barr Virus ◽  
Japanese Female ◽  
Old Japanese ◽  
Neoplastic Change ◽  
Diagnostic Difficulties ◽  
Epstein Barr ◽  
Characteristic Features

Most head and neck lymphoepithelial carcinomas (LECs) arise in the nasopharynx and harbor Epstein–Barr virus (EBV). LEC is also a rare subtype of the oral squamous cell carcinoma (SCC). Morphologically, LEC is defined as resembling non-keratinizing nasopharyngeal carcinoma, undifferentiated subtype. The histological features and pathogenesis of oral LEC are not established. We describe a case of tongue LEC with histopathological diagnostic difficulties. A 72-year-old Japanese female presented with a whitish change on her left-side tongue. The diagnosis was atypical epithelium; neoplastic change could not be ruled out by a biopsy. Although the lesion was monitored at our hospital per her request, invasive carcinoma was detected 11 months later. Microscopically, conventional SCC was observed with the characteristic features as LEC confined to the deep part of the lesion. We briefly discuss this unusual histological finding and make a novel proposal for distinguishing oral LEC from LECs in other regions based on these histological findings.

scholarly journals Septic shock due to Yersinia pseudotuberculosis infection in an adult immunocompetent patient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takehiro Hashimoto ◽  
Ryuichi Takenaka ◽  
Haruka Fukuda ◽  
Kazuhiko Hashinaga ◽  
Shin-ichi Nureki ◽  
...  
Keyword(s):  
Septic Shock ◽  
Therapeutic Strategy ◽  
Yersinia Pseudotuberculosis ◽  
Immunocompromised Host ◽  
Immunocompetent Patient ◽  
Case Presentation ◽  
Gram Negative ◽  
Old Japanese ◽  
The Right ◽  
Immunocompetent Patients

Abstract Background Yersinia pseudotuberculosis infection can occur in an immunocompromised host. Although rare, bacteremia due to Y. pseudotuberculosis may also occur in immunocompetent hosts. The prognosis and therapeutic strategy, especially for immunocompetent patients with Y. pseudotuberculosis bacteremia, however, remains unknown. Case presentation A 38-year-old Japanese man with a mood disorder presented to our hospital with fever and diarrhea. Chest computed tomography revealed consolidation in the right upper lobe with air bronchograms. He was diagnosed with pneumonia, and treatment with intravenous ceftriaxone and azithromycin was initiated. The ceftriaxone was replaced with doripenem and the azithromycin was discontinued following the detection of Gram-negative rod bacteria in 2 sets of blood culture tests. The isolated Gram-negative rod bacteria were confirmed to be Y. pseudotuberculosis. Thereafter, he developed septic shock. Doripenem was switched to cefmetazole, which was continued for 14 days. He recovered without relapse. Conclusions We herein report a case of septic shock due to Y. pseudotuberculosis infection in an adult immunocompetent patient. The appropriate microorganism tests and antibiotic therapy are necessary to treat patients with Y. pseudotuberculosis bacteremia.

scholarly journals The Temporomandibular Joint in a Rheumatoid Arthritis Patient after Orthodontic Treatment

2009 ◽  
Vol 79 (4) ◽  
pp. 804-811 ◽  
Author(s):  
Kenichi Sasaguri ◽  
Rika Ishizaki-Takeuchi ◽  
Sakurako Kuramae ◽  
Eliana Midori Tanaka ◽  
Takashi Sakurai ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Mouth Opening ◽  
Pharmacological Therapy ◽  
Open Bite ◽  
Anterior Open Bite ◽  
Orthodontic Therapy ◽  
Japanese Female ◽  
Severe Erosion ◽  
Old Japanese ◽  
History Of

Abstract A 32-year-old Japanese female patient consulted the authors' dental clinic with a 4.5-year history of rheumatoid arthritis (RA). She complained of pain during mouth opening and difficulty in eating due to masticatory dysfunction caused by an anterior open bite. Imaging showed severe erosion and flattening of both condyles. RA stabilized after pharmacological therapy and became inactive during the orthodontic therapy aimed at reconstructing an optimal occlusion capable of promoting functional repositioning of the mandible. At present, 4 years and 2 months postretention, the reconstructed occlusion remains stable, and both condyles continue to be remodeled. The distance from reference position to intercuspal position has gradually decreased throughout the 4-year posttreatment and postretention periods. Orthodontic therapy that comprehensively reconstructs occlusion and enhances the functioning of the mandible can induce remodeling of eroded condyles, even those with a history of rheumatoid arthritis.

scholarly journals Euphorbia grandicornis Sap Keratouveitis: A Case Report

2016 ◽  
Vol 7 (1) ◽  
pp. 125-129
Author(s):  
María Gómez-Valcárcel ◽  
Graciana Fuentes-Páez
Keyword(s):  
Complete Resolution ◽  
Sesquiterpene Lactones ◽  
Sodium Hyaluronate ◽  
Conjunctival Hyperemia ◽  
Blurred Vision ◽  
Case Presentation ◽  
Corrected Visual Acuity ◽  
Dexamethasone Phosphate ◽  
Best Corrected Visual Acuity ◽  
Extraction Spectrophotometry

Purpose: To describe a case of keratouveitis caused by Euphorbia grandicornis sap, that resolved with topic steroids. Methods: We report a case presentation of a patient with keratouveitis. Results: A 70-year-old woman suffered from accidental ocular contact with E. grandicornis sap in her left eye. Two hours after the contact, she attended the clinic due to conjunctival hyperemia and pain. Best-corrected visual acuity (BCVA) was 20/25. The toxic conjunctivitis was treated with topical lubricant and steroid. After 24 h, she presented blurred vision. BCVA was 20/80. Toxic keratouveitis was diagnosed. Topical treatment with 1% cyclopentolate t.i.d., 5% sodium chloride, 1.14% dexamethasone phosphate each hour, and 4% sodium hyaluronate each hour was continued. Complete resolution was obtained 1 week later. Euphorbia sap content analysis was performed using dissolvent extraction spectrophotometry. Its contents included flavonoids, alkaloids, phenols and sesquiterpene lactones. Conclusion: Corneal exposure to E. grandicornis sap is a cause of nonvisually threatening keratouveitis when adequately treated with corticosteroids.

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