scholarly journals Rare Association of Perivascular Granulomatous Lesions in a Patient with Acute Retinal Necrosis

2015 ◽  
Vol 6 (3) ◽  
pp. 373-379
Author(s):  
Takahiro Sogawa ◽  
Noriyasu Hashida ◽  
Miki Sawa ◽  
Kohji Nishida
Keyword(s):  
Retinal Hemorrhage ◽  
Japanese Woman ◽  
Acute Retinal Necrosis ◽  
Systemic Corticosteroids ◽  
Keratic Precipitates ◽  
Granulomatous Lesions ◽  
Old Japanese ◽  
Perivascular Area ◽  
Active Inflammation ◽  
Sd Oct

Purpose: The aim of this study was to examine sequential changes in perivascular granulomatous lesions with acute retinal necrosis (ARN). Methods: A healthy 46-year-old Japanese woman, who developed floaters and pain in her left eye, underwent optical coherence tomography (OCT), fluorescein angiography, and routine ophthalmological examinations. Treatment-associated changes in perivascular granulomatous lesions were monitored using spectral-domain (SD)-OCT. Results: The patient had no previous ophthalmic history, and her general condition was good. A slit-lamp examination revealed keratic precipitates and aqueous cells (2+) in the left eye. A fundus examination showed yellow-white patches of necrotizing retinal lesions in the temporal upper area, retinal arteritis, retinal hemorrhage, and vitreous opacities. The patient was diagnosed with ARN according to diagnostic criteria. SD-OCT images confirmed high-intensity and uniform granulomatous deposits in the perivascular area and fovea. Systemic corticosteroids and antiviral therapy were initiated, resulting in the gradual resolution of granulomatous lesions. The patient continues to be followed untreated without evidence of recurrence, retinal detachment, or active inflammation. Conclusions: This is the first report of perivascular granulomatous lesions in a patient with ARN. Our results showed that the formation of granulomas may be induced in the retina of ARN patients without fulminant inflammation.

scholarly journals A Case of Focal Choroidal Excavation Development Associated with Multiple Evanescent White Dot Syndrome

2018 ◽  
Vol 9 (2) ◽  
pp. 388-394 ◽  
Author(s):  
Hisashi Matsubara ◽  
Eriko Uchiyama ◽  
Katsuya Suzuki ◽  
Yoshito Matsuda ◽  
Mineo Kondo
Keyword(s):  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Japanese Woman ◽  
Posterior Pole ◽  
Spectral Domain Oct ◽  
White Dot Syndrome ◽  
Focal Choroidal Excavation ◽  
Different Types ◽  
Old Japanese ◽  
Sd Oct

Focal choroidal excavation (FCE) is described as an excavated lesion of the choroid that can be detected by optical coherence tomography (OCT). While the exact pathogenesis of FCE remains unclear, it has been proposed in some cases that there is an association with the inflammation in the outer retina. We present a case of FCE development that was detected by spectral domain OCT (SD-OCT) and found to be associated with multiple evanescent white dot syndrome (MEWDS). A 40-year-old Japanese woman was diagnosed with MEWDS based on multiple white dots observed from the posterior pole to the midperiphery, along with yellow granularity in the fovea. SD-OCT revealed separation between the retinal pigment epithelium (RPE) and Bruch’s membrane (BM) and discontinuations of the ellipsoid zone, RPE, and BM. At 4 weeks after onset, several of the white dots disappeared, the yellow granularity in the fovea became small, and we detected nonconforming choroidal excavation under the central fovea. The choroidal excavation gradually deepened and changed to a conforming pattern. These findings suggest that the degree of the impairment caused by inflammation and the plasticity of the BM and RPE complex may be associated with different types of acquired FCE.

scholarly journals Retinal Angiomatous Proliferation in an Eye with Cuticular Drusen

2015 ◽  
Vol 6 (1) ◽  
pp. 127-131 ◽  
Author(s):  
Atsuko Sato ◽  
Nami Senda ◽  
Emi Fukui ◽  
Kouichi Ohta
Keyword(s):  
Japanese Woman ◽  
Retinal Angiomatous Proliferation ◽  
Scanning Laser Ophthalmoscopy ◽  
Retinal Hemorrhages ◽  
Confocal Scanning Laser Ophthalmoscopy ◽  
Old Japanese ◽  
Confocal Scanning ◽  
Confocal Scanning Laser ◽  
Sd Oct

Purpose: To report the presence of retinal angiomatous proliferation (RAP) in an eye with cuticular drusen detected by fluorescein and indocyanine green angiography by confocal scanning laser ophthalmoscopy and by spectral-domain optical coherence tomography (SD-OCT). Methods: Case report of a 65-year-old Japanese woman with cuticular drusen. Results: At her first ophthalmic examination, her visual acuity was 20/20 in both eyes. An ophthalmoscopy showed many small subretinal pigment epithelial deposits in both eyes. These deposits had a ‘saw-tooth pattern' in the SD-OCT images. During the follow-up examination, retinal hemorrhages were observed, and fluorescein angiography showed a ‘stars-in-the-sky' appearance and intraretinal neovascularization. The patient was diagnosed with cuticular drusen associated with RAP. Conclusion: We suggest that the cuticular drusen were associated with RAP, so periodic follow-up examinations are needed for patients with cuticular drusen for the early detection and treatment of RAP.

scholarly journals Neuroendocrine carcinoma arising in a wound of the postoperative maxillary sinus

2012 ◽  
Vol 2 (1) ◽  
pp. 16
Author(s):  
Takeshi Kusunoki ◽  
Katsuhisa Ikeda
Keyword(s):  
Maxillary Sinus ◽  
Neuroendocrine Carcinoma ◽  
Past History ◽  
Japanese Woman ◽  
Old Japanese ◽  
Weighted Magnetic Resonance Imaging ◽  
Maxillary Cyst ◽  
Left Maxillary Sinus ◽  
Eye Movement Disorders ◽  
Cheek Swelling

We report a case of a neuroendocrine carcinoma arising in a wound of the postoperative maxillary sinus that was difficult to distinguish from a postoperative maxillary cyst. The patient was a 65-year-old Japanese woman who complained of left exophthalmos with cheek swelling and eye movement disorders. In past history, she had, 40 years previously undergone operation on the bilateral maxillary sinus by Caldwell-Luc’s method. In a preoperative computed tomography, a mass occupied the left maxillary sinus showing irregular densities with destruction of the posterior bone walls and invasion into the left orbital. Both TI and T2 weighted magnetic resonance imaging showed low intensities and unevenness in the mass. We performed a biopsy of the maxillary tumor according to Caldwell-Luc’s method. Histological examination diagnosed neuroendocrine carcinoma. Radiation therapy (total 66Gy) resulted in partial response for this tumor. However, sinonasal neuroendocrine carcinoma has been identified as highly aggressive, with a high probability of recurrence and metastasis.

scholarly journals Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuki Yamauchi ◽  
Hiraku Kameda ◽  
Kazuno Omori ◽  
Michio Tani ◽  
Kyu Yong Cho ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Cushing’S Disease ◽  
Cardiopulmonary Arrest ◽  
Severe Infection ◽  
Japanese Woman ◽  
The Body ◽  
Cushing's Disease ◽  
Old Japanese ◽  
Subclinical Cushing’S Disease ◽  
Physical Features

Abstract Background Subclinical Cushing’s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing’s disease. Infection is an important complication associated with mortality in Cushing’s disease, while no reports on infection in SCD are available. To make clinicians aware of the risk of infection in SCD, we report a case of SCD with disseminated herpes zoster (DHZ) with the mortal outcome. Case presentation An 83-year-old Japanese woman was diagnosed with SCD, treated with cabergoline in the outpatient. She was hospitalized for acute pyelonephritis, and her fever gradually resolved with antibiotics. However, herpes zoster appeared on her chest, and the eruptions rapidly spread over the body. She suddenly went into cardiopulmonary arrest and died. Autopsy demonstrated adrenocorticotropic hormone-positive pituitary adenoma, renal abscess, and DHZ. Conclusions As immunosuppression caused by SCD may be one of the triggers of severe infection, the patients with SCD should be assessed not only for the metabolic but also for the immunodeficient status.

scholarly journals Conservatively Treated Femoral Intertrochanteric Fracture With Early Asymptomatic Novel Coronavirus Disease 2019 (COVID-19): A Case Report

2020 ◽  
Vol 11 ◽  
pp. 215145932096938
Author(s):  
Yuki Suzuki ◽  
Toshihiko Kasashima ◽  
Kazutoshi Hontani ◽  
Yasuhiro Yamamoto ◽  
Kanako Ito ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
Screening Method ◽  
Oxygen Demand ◽  
Japanese Woman ◽  
Trauma Patients ◽  
Lung Field ◽  
Old Japanese ◽  
Femoral Intertrochanteric Fracture ◽  
Novel Coronavirus ◽  
The Right

Introduction: The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19. Case presentation: An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital. Conclusion: This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.

Rapid Deterioration of Latent HBV Hepatitis during Cushing Disease and Posttraumatic Stress Disorder after Earthquake

2017 ◽  
Vol 78 (04) ◽  
pp. 407-411 ◽  
Author(s):  
Ryosuke Tashiro ◽  
Teiji Tominaga ◽  
Yoshikazu Ogawa
Keyword(s):  
Hepatic Dysfunction ◽  
Residual Tumor ◽  
Optic Chiasm ◽  
Japanese Woman ◽  
Hbv Reactivation ◽  
Cushing Disease ◽  
Old Japanese ◽  
Threatening Condition ◽  
The Right ◽  
Subtotal Removal

AbstractReactivation of the hepatitis B virus (HBV) is a risk in the 350 million HBV carriers worldwide. HBV reactivation may cause hepatocellular carcinoma, cirrhosis, and fulminant hepatitis, and HBV reactivation accompanied with malignant tumor and/or chemotherapy is a critical problem for patients with chronic HBV infection. Multiple risk factors causing an immunosuppressive state can also induce HBV reactivation.We present a case of HBV reactivation during an immunosuppressive state caused by Cushing disease and physical and psychological stress after a disaster. A 47-year-old Japanese woman was an inactive HBV carrier until the Great East Japan Earthquake occurred and follow-up was discontinued. One year after the earthquake she had intractable hypertension, and her visual acuity gradually worsened. Head magnetic resonance imaging showed a sellar tumor compressing the optic chiasm, and hepatic dysfunction with HBV reactivation was identified. Endocrinologic examination established the diagnosis as Cushing disease. After normalization of hepatic dysfunction with antiviral therapy, transsphenoidal tumor removal was performed that resulted in subtotal removal except the right cavernous portion. Steroid hormone supplementation was discontinued after 3 days of administration, and gamma knife therapy was performed for the residual tumor. Eighteen months after the operation, adrenocorticotropic hormone and cortisol values returned to normal. The patient has been free from tumor regrowth and HBV reactivation throughout the postoperative course.Accomplishment of normalization with intrinsic steroid value with minimization of steroid supplementation should be established. Precise operative procedures and careful treatment planning are essential to avoid HBV reactivation in patients with this threatening condition.

scholarly journals Aphakic Pupillary Block by an Intact Anterior Vitreous Membrane after Total Lens Extraction by Phacoemulsification

2021 ◽  
pp. 882-888
Author(s):  
Michihiro Kono ◽  
Akiko Ishida ◽  
Sho Ichioka ◽  
Masato Matsuo ◽  
Hiroshi Shimizu ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Cataract Extraction ◽  
Japanese Woman ◽  
Acute Angle ◽  
Angle Closure ◽  
Pupillary Block ◽  
Lens Extraction ◽  
Old Japanese ◽  
Acute Angle Closure ◽  
Vitreous Prolapse

An 85-year-old Japanese woman with acute primary angle closure in her right eye underwent cataract extraction. Because of the weakness of the Zinn’s zonules, all of the lens tissue including the lens capsule was removed by phacoemulsification. Because of the absence of vitreous prolapse into the anterior chamber, vitrectomy was not performed. Nine days postoperatively, acute angle closure due to pupillary block by an anterior vitreous membrane developed. To resolve the pupillary block, anterior vitrectomy was performed on the same day. Postoperatively, her symptoms resolved, the anterior chamber deepened, and the intraocular pressure normalized. Although rare, acute angle closure due to pupillary block by an anterior vitreous membrane can occur after total lens extraction with phacoemulsification. If no vitreous prolapse occurs with total lens extraction, an intentional hyaloidotomy using an anterior vitreous cutter or iridectomy should be considered to avoid secondary angle closure.

scholarly journals Pericardial effusion in the course of fabry disease cardiomyopathy: A case report

2021 ◽  
Author(s):  
Toshihiro Tsuruda ◽  
Yoshimasa Higashi ◽  
Toshihiro Gi ◽  
Shoichiro Nakao
Keyword(s):  
Pericardial Effusion ◽  
Fabry Disease ◽  
Interleukin 6 ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Japanese Woman ◽  
Pericardial Fluid ◽  
Interleukin 18 ◽  
Previous Diagnosis ◽  
Old Japanese

Abstract Background Fabry disease is an X chromosome-linked inherited disorder of glycosphingolipid metabolism due to deficient or absent lysosomal α-galactosidase A activity. Case summary A 51-year-old Japanese woman with a previous diagnosis of Fabry disease presented with pericardial effusion. The exudative pericardial fluid contained globotriaosylsphingosine. Left ventricular hypertrophy progressed despite regular administration of agalsidase alfa every 2 weeks over a 7-year period, with increases in plasma levels of globotriaosylsphingosine and interleukin-18. In addition, the interleukin-6 level in the pericardial fluid was markedly higher than that in plasma. Discussion This case suggests that elevated interleukin-6 and interleukin-18 levels in pericardial fluid and plasma indicate the severity of Fabry disease cardiomyopathy.

Uveitis associated with latent tuberculosis: A comparative study of the impact of antitubercular therapy combined or not with systemic corticosteroids

2020 ◽  
pp. 112067212096206
Author(s):  
Sacha Nahon-Esteve ◽  
Arnaud Martel ◽  
Celia Maschi ◽  
Mohamed Alketbi ◽  
Stephanie Baillif ◽  
...  
Keyword(s):  
Remission Rate ◽  
Latent Tuberculosis ◽  
Antitubercular Therapy ◽  
Corrected Visual Acuity ◽  
Systemic Corticosteroids ◽  
Significant Difference ◽  
Treatment Data ◽  
Active Inflammation ◽  
The Impact ◽  
Active Disease

Purpose: To study the outcome of latent tubercular uveitis (LTBU) treated with antitubercular therapy (ATT) combined or not with adjuvant systemic corticosteroids. Methods: Twenty patients (27 eyes) with LTBU were included in a monocentric retrospective study and evaluated for the absence of active disease after treatment. Data on the clinical outcomes (active inflammation), vision (best-corrected visual acuity, BCVA) and treatment were collected retrospectively. Results: Fourteen patients received ATT alone and six patients received ATT combined with systemic corticosteroids. The two groups were not comparable in terms of proportion of tubercular panuveitis cases and initial BCVA (59.3 ± 8.2 letters vs 44.2 ± 15.2 letters). There was no significant difference in remission rate and in BCVA between both groups 3 months after ATT discontinuation. Conclusion: Patients with LTBU treated with ATT alone had visual and inflammatory outcomes at least comparable to those of patients treated with ATT combined with systemic corticosteroids.

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