scholarly journals A Case of Intraocular Erosion and Intrusion by an Arruga Suture

2016 ◽  
Vol 7 (1) ◽  
pp. 174-178 ◽  
Author(s):  
Takakuni Kitagaki ◽  
Seita Morishita ◽  
Ryohsuke Kohmoto ◽  
Masanori Fukumoto ◽  
Hiroyuki Suzuki ◽  
...  

Purpose: To report a case of intraocular erosion and intrusion by an Arruga suture. Case Report: This study involved a 62-year-old male who had undergone scleral buckling surgery 40 or more years ago at another hospital for rhegmatogenous retinal detachment, as well as trabeculectomy 20 years ago for primary open-angle glaucoma, in his left eye at the same hospital. However, he recently became aware of blurred vision in that eye. Upon examination, iritis was observed in the anterior portion of his left eye, as well as a great number of pigment cell keratoprecipitates on the posterior surface of the cornea. In the ocular fundus, extensive atrophy of the retinal pigment epithelium and partial hyperpigmentation was observed, accompanied by subretinal strands, yet the retina remained attached. Around the entire peripheral area of the retina we observed a ring-shaped protrusion, but we also saw a shiny, filamentous material in the vitreous cavity that penetrated the sclera and choroid, completely extending from the 4- to 8-o'clock position of the scleral buckle protrusion. To treat the iritis in the patient's left eye, we began to administrate low-concentration steroid eye drops, after which the inflammation disappeared. Conclusion: In this study, we experienced a case of intraocular erosion and intrusion by an Arruga suture, and opted to treat the patient with steroid eye drops and conservative follow-up observations unless retinal redetachment and/or vitreous hemorrhage occurs.

2021 ◽  
Author(s):  
Chenxu Wang ◽  
Jia Xu ◽  
Thomas D. Kocher ◽  
Minghui Li ◽  
Deshou Wang

Premelanosome protein (pmel) is a key gene for melanogenesis in vertebrates. Mutations in this gene are responsible for white plumage in chicken, but its role in pigmentation of fish remains to be demonstrated. In this study we found that most fishes have two pmel genes arising from the teleost-specific whole genome duplication. Both pmela and pmelb were expressed at high levels in the eyes and skin of Nile tilapia. We mutated both genes in tilapia using CRISPR/Cas9 gene editing. Homozygous mutation of pmela resulted in yellowish body color with weak vertical bars and a hypo-pigmented retinal pigment epithelium (RPE) due to significantly reduced number and size of melanophores. In contrast, we observed an increased number and size of xanthophores in mutants compared to wild-type fish. Homozygous mutation of pmelb resulted in a similar, but milder phenotype than pmela -/- mutants, without effects on RPE pigmentation. Double mutation of pmela and pmelb resulted in loss of additional melanophores compared to the pmela -/- mutants, and also an increase in the number and size of xanthophores, producing a strong golden body color without bars in the trunk. The RPE pigmentation of pmela -/ - ;pmelb -/- was similar to pmela -/- mutants, with much less pigmentation than pmelb -/- mutants and wild-type fish. Taken together, our results indicate that, while both pmel genes are important for the formation of body color in tilapia, pmela plays a more important role than pmelb. To our knowledge, this is the first report on mutation of pmelb or both pmela;pmelb in fish. Studies on these mutants suggest new strategies for breeding golden tilapia, and also provide a new model for studies of pmel function in vertebrates.


e-CliniC ◽  
2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Ade J. Nursalim ◽  
Vera Sumual

Abstrak: Central serous chorioretinopathy (CSC) adalah terkumpulnya cairan serosa di bawah lapisan epitel pigmen retina yang mengakibatkan terlepasnya retina neurosensorik (detachment). Keadaan ini dapat disebabkan oleh berbagai faktor risiko, termasuk stres psikologik. Jenis kelamin laki-laki merupakan salah satu faktor risiko CSC. Terapi kondisi psikologik merupakan pena-nganan utama CSC yang diinduksi oleh stres kerja. Kami melaporkan seorang laki-laki berusia 27 tahun yang datang ke Poliklinik Mata RSUP Prof. Dr. R. D. Kandou Hospital dengan keluhan kekaburan mata kanan yang mendadak sejak seminggu lalu tanpa didahului oleh nyeri pada mata. Pasien juga mengalami kesulitan dalam membaca teks dan mengenali wajah bila hanya menggunakan mata kanannya. Pasien telah pergi ke optik tetapi tidak mendapatkan ukuran kacamata yang sesuai. Pasien bekerja sebagai tenaga administrasi dan akhir-akhir ini mendapatkan beban kerja berlebihan. Pasien mengakui bahwa ia mengalami kesulitan dalam mengatur aktivitasnya, dan merasakan kelelahan sepanjang hari serta kehilangan minat kerja. Hasil pemeriksaan mata mendapatkan visus 6/15 untuk mata kanan dan visus 6/6 untuk mata kiri, dan metamorphopsia sedangkan hasil pemeriksaan oftalmoskopi memperlihatkan adanya edema dengan lingkaran kekuningan dan berbatas tidak jelas pada mata kanan. Pemeriksaan lanjut dengan OCT menunjukkan adanya cairan subretinal pada mata kanan disertai terlepasnya lapisan epitel pigmen. Saat kontrol setelah 36 hari, visus mata kanan telah membaik 6/6F2 dan peme-riksaan OCT menunjukkan penurunan tebal makula dari 289 μm pada kunjugan pertama men-jadi 190 μm, serta tidak tampak adanya cairan subretinal. Simpulan kasus ini ialah central serous chorioretinopathy yang diinduksi oleh stres kerja, dengan penanganan utama ialah terapi psikologik untuk memperbaiki kualitas hidup.Kata kunci: central serous chorioretinopathy (CSC), stres kerja Abstract: Central serous chorioretinopathy (CSC) is a condition where serous fluid builds up in the retinal pigment epithelium layer which causes neurosensory retinal detachment. This condition is affected by many risk factors, including psychological stress. Male gender is one of the risk factors for CSC. Treatment to the patient's psychological condition can be the main therapy in handling CSC induced by work stress. We reported a 27-year-old male came to the eye clinic at Prof. dr. R. D. Kandou Hospital complaining of sudden blurred vision in his right eye a week ago without initial pain in the eye. The patient also experienced difficulty in reading text and recognizing people’s face using the right eye. The patient went to an optic store but he did not find suitable glasses. The patient works as an administrative employee and is currently getting a heavy workload at his workplace. The patient admitted that he had issues in managing his life in a day. Patients felt tired throughout the day and had no interest in making any activities. The results of the eye examination showed vision 6/15 in the right eye and 6/6 in the left eye, metamorphopsia, edema with a yellowish circle with an unclear border on the right eye using ophthalmoscopy examination, and a subretinal fluid image in the patient's right eye with epithelial detachment pigment acquired through the examination with OCT. After 36 days from the first visit, the right eye vision was improved to 6/6 F2 and OCT examination resulted in a decrease in macula thickness from 289 μm at the first visit to 190 μm, and there was no subretinal fluid. In conclusion, this was a CSC case induced by work stress, and the main treatment was psychological therapy in order to improve the quality of life (QoL).Keywords: central serous chorioretinopathy (CSC), work stress


Development ◽  
1999 ◽  
Vol 126 (17) ◽  
pp. 3757-3767 ◽  
Author(s):  
J.A. Lister ◽  
C.P. Robertson ◽  
T. Lepage ◽  
S.L. Johnson ◽  
D.W. Raible

We report the isolation and identification of a new mutation affecting pigment cell fate in the zebrafish neural crest. Homozygous nacre (nac(w2)) mutants lack melanophores throughout development but have increased numbers of iridophores. The non-crest-derived retinal pigment epithelium is normal, suggesting that the mutation does not affect pigment synthesis per se. Expression of early melanoblast markers is absent in nacre mutants and transplant experiments suggested a cell-autonomous function in melanophores. We show that nac(w2) is a mutation in a zebrafish gene encoding a basic helix-loop-helix/leucine zipper transcription factor related to microphthalmia (Mitf), a gene known to be required for development of eye and crest pigment cells in the mouse. Transient expression of the wild-type nacre gene restored melanophore development in nacre(−/−) embryos. Furthermore, misexpression of nacre induced the formation of ectopic melanized cells and caused defects in eye development in wild-type and mutant embryos. These results demonstrate that melanophore development in fish and mammals shares a dependence on the nacre/Mitf transcription factor, but that proper development of the retinal pigment epithelium in the fish is not nacre-dependent, suggesting an evolutionary divergence in the function of this gene.


2020 ◽  
pp. 112067212094657
Author(s):  
Dario Pasquale Mucciolo ◽  
Vittoria Murro ◽  
Dario Giorgio ◽  
Andrea Sodi ◽  
Ilaria Passerini ◽  
...  

Purpose: To report a case of choroideremia characterized by peripheral retinoschisis with vascular abnormalities and vitreous hemorrhage. Observations: A 58-year-old man affected by advanced-stage choroideremia was diagnosed with peripheral retinoschisis in both eyes. Vitreous hemorrhage was present in the right eye with a peculiar clot-like lesion at the periphery. At the 1-year follow-up, the vitreous hemorrhage had reabsorbed and the vascular clot-like lesion in the periphery had almost completely disappeared. Conclusion and importance: We have reported fundoscopic and OCT features of peripheral-acquired retinoschisis with vascular abnormalities in a patient with choroideremia. OCT examination is extremely useful in clinical evaluation of the peripheral retinal alterations in these cases, where the absence of the retinal pigment epithelium and the choriocapillaris pose many diagnostic difficulties.


2020 ◽  
pp. 112067212096202
Author(s):  
Aowang Qiu ◽  
Yan Yu ◽  
Junlong Huang ◽  
Qinghuai Liu ◽  
Yannis M Paulus ◽  
...  

Retinitis punctata albescens (RPA) is generally diagnosed by the presence of numerous clusters of white punctate lesions in the retina that progress over time and are related to several gene variants. The multifocal variant of congenital hypertrophy of the retinal pigment epithelium (CHRPE) is characterized by multiple, grouped, sharply circumscribed, pigmented spots. The PRPH2 gene encodes a photoreceptor-specific glycoprotein, which is essential for the morphogenesis of rod and cone photoreceptor outer segments. A 39-year-old Chinese female with nyctalopia, complained about blurred vision, presented a unique co-existing feature of RPA and CHRPE. Dilated fundus exam demonstrated numerous porcelain white discrete dots in both eyes and multiple, small, flat clusters of round brown to black pigmented lesions in the left eye. The full field electroretinography (ERG) showed decreased responses after standard dark adaptation and normal b-wave amplitudes after a long (4-h) dark-adapted period. A heterozygous PRPH2 splicing variant was detected in the proband. In addition, the same variant was found in her mother, her son, and her daughter. We describe a PRPH2 variant in a rare case of RPA associated with multifocal CHRPE of the same individual.


2020 ◽  
Author(s):  
Seyedeh Maryam Hosseini ◽  
Nasser Shoeibi ◽  
Mahdieh Azimi Zadeh ◽  
Mahdi Ghasemi ◽  
Mojtaba Abrishami

Abstract Background: Scleral buckling (SB) is usually considered an extraocular operation, and it is presumed to have low risk of sympathetic ophthalmia (SO). We aimed to report a rare case of presumed SO in a young female patient following SB. Case Presentation: A nineteen year-old female patient was referred for visual loss in her left eye because of macula off inferior longstanding rhegmatogenous retinal detachment (RD). Best corrected visual acuity (BCVA) was 20/400 in the left eye. SB with 360 degrees encircling band and inferior segmental tire, with one spot cryoretinopexy at the break site and subretinal fluid drainage was performed. One week after operation, BCVA was improved to 20/80 and retina was totally attached. Six weeks later, patient came with severe visual loss in both eyes as counting finger 1 meter. Bilateral multifocal serous RD and vitreous cells was found. The patient was diagnosed as sympathetic Ophthalmia, and treated with intravenous corticosteroid pulse therapy and mycophenolate mofetil. The inflammation was controlled and serous RD resolved after five days intravenous treatment and was not relapsed after six months. BCVA became 20/20 in right eye and 20/50 in the left eye after six months. Systemic workup was negative for any extraocular disease or systemic involvement. Conclusion: As SB usually considered as a procedure without manipulating intraocular tissues, it is considered to have low risk for SO. In this report, we presented SO occurance after successful SB. Inciting the choroid and retinal pigment epithelium with cryoretinopexy or perforating for drainage may induce SO.


2008 ◽  
Vol 18 (2) ◽  
pp. 304-308 ◽  
Author(s):  
S.C.B. Teoh ◽  
E.J. Mayer ◽  
R.J. Haynes ◽  
R.H.B. Grey ◽  
A.D. Dick ◽  
...  

Purpose To report the management and outcome of retinal reattachment surgery in retinochoroidal coloboma. Methods Four patients with retinochoroidal colobomata presented to the Bristol Eye Hospital (a UK tertiary referral center for vitreoretinal surgery) with retinal detachment. INTERVENTION. All were type II colobomatous detachments (three patients with type IIB, one patient with type IID). All eyes underwent vitrectomy with endolaser and/or cryotherapy and three eyes underwent scleral buckling. Two eyes had internal tamponade with gas (SF6, C3F8) while the other two had silicone oil. Endolaser was applied over healthy retinal pigment epithelium. Results At last follow-up, all (100%) remained attached, with no recurrences. Three patients achieved visual acuity of 6/120 or better and were able to perform satisfactory near work with appropriate magnifiers. The last patient began with hand movement vision and retained similar vision but subjectively felt more navigational. Conclusions Good anatomic and functional outcomes can be achieved in this patient group with combined vitrectomy with or without scleral buckling surgery. Endolaser retinopexy is effective over healthy RPE at the margin of the coloboma combined with either gas or oil internal tamponade.


Author(s):  
Daniel A. Brinton ◽  
Charles P. Wilkinson

Inflammatory detachments are usually treated medically. Some serous detachments, such as choroidal hemangioma, respond to photocoagulation or photodynamic therapy (PDT). Selected traction detachments, such as diabetic or post-traumatic detachments, may be cured with intraocular microsurgery (vitrectomy). Radiation therapy is often used for detachments secondary to metastatic tumors. This chapter is confined to the surgical management of rhegmatogenous detachments with scleral buckling. Alternative methods of repair are discussed in Chapters 8 and 9, and the three techniques are compared in Chapter 10. Controversy exists regarding the details of the surgical technique, but surgeons generally agree on the three basic steps in closing retinal breaks and reattaching the retina:… 1. Conducting thorough preoperative and intraoperative 1. examinations with the goal of locating all retinal breaks and assessing any vitreous traction on the retina. 2. Creating a controlled injury to the retinal pigment epithelium and retina to produce a chorioretinal adhesion surrounding all retinal breaks so that intravitreal fluid can no longer reach the subretinal space. 3. Employing an appropriate technique, such as scleral buckling and/or intravitreal gas, to approximate the retinal breaks to the underlying treated retinal pigment epithelium…. If the surgeon follows these basics and applies modern surgical techniques, retinal reattachment may be expected following a single operation in more than 85% of uncomplicated primary detachments, and in more than 95% following additional procedures. The traditional scleral buckle has served very well since the 1950’s. However, more recent developments have produced a more comprehensive menu for retinal reattachment surgery from which the surgeon may select the appropriate procedure for each case. By the turn of the millennium, surveys had demonstrated that scleral buckling alone was no longer the most popular means of repairing uncomplicated primary retinal detachments. Still, it is a valuable technique that is indicated in many situations. Temporary scleral buckling can be performed with scleral infolding, gelatin, or orbital balloon. The term scleral buckling without a qualifying adjective is generally recognized as referring to a “permanent” scleral buckle with the implantation of a foreign material usually made of silicone.


2015 ◽  
Vol 6 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Carlos Eduardo Veloso ◽  
Ursula Schmidt-Erfurth ◽  
Márcio B. Nehemy

Purpose: To report the first case of choroidal neovascularization (CNV) secondary to dengue fever. Case Report: A 54-year-old female was referred to our department with blurred vision and metamorphopsia in her left eye. Two weeks earlier, she had presented all of the classic symptoms of dengue fever including a positive serology. Her best-corrected visual acuity (BCVA) was 20/150 in the left eye. She underwent a fundus examination, fluorescein angiography (FA) and spectral domain optical coherence tomography. Results: All findings were consistent with CNV secondary to dengue fever. FA revealed a classic CNV associated with focal retinal pigment epithelium (RPE) destruction and detachment. Three consecutive monthly injections of intravitreal ranibizumab resulted in functional and anatomical improvement for as long as 6 months with a BCVA of 20/25. However, CNV recurred 2 years later, again with an improvement after ranibizumab therapy, but with persistence of a fibrovascular RPE detachment, highlighting the pathomechanism of a classic CNV formation. Conclusions: Maculopathy in dengue fever may be followed by CNV as a result of the immunologic alteration of the RPE. Physicians should be aware of this manifestation to be able to initiate adequate treatment with excellent functional and anatomical results.


2021 ◽  
Vol 11 (1) ◽  
pp. 1-3
Author(s):  
Sercan Cate ◽  
Caglar Bektas ◽  
Burak Turgut

A 45-year-old female patient presented with complaints of blurred vision and metamorphopsia with a duration of two months. Visual acuities were 0.1 in the right eye and 1.0 in the left eye. Fundus examination revealed bilateral, subretinal, round and yellow-white flecks with scattered localization in the fovea, macula and peripheral retina. Flecks were mostly concentrated in the macula and midperipheral fundus however were rare in the peripheral fundus. In fluorescein angiography, flecks were stained as well-demarcated hyperfluorescent lesions. In optical coherence tomography, there were hump-shaped lesions which have medium degree internal reflectivity at the level of retinal pigment epithelium along with hyporeflective dome-shaped pigment epithelial detachments. No genetic predisposition was found. As a consequence of these findings, the patient was diagnosed with an atypically distributed fleck case with multiple retinal pigment epithelial detachments


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