scholarly journals Isolated Intraocular Rosai-Dorfman Disease

2019 ◽  
Vol 5 (6) ◽  
pp. 418-423 ◽  
Author(s):  
Franz Fogt ◽  
Thomas Rüediger ◽  
Albert J. Augustin ◽  
Dale M. Frank ◽  
Andreas Rosenwald ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Vision Loss ◽  
The Elderly ◽  
Final Diagnosis ◽  
Retrospective Case ◽  
Rare Presentation ◽  
Systemic Involvement ◽  
Rosai Dorfman Disease ◽  
The Right ◽  
Imaging Patient

Background/Aims: To report a case of Rosai-Dorfman disease (RDD) presenting as a solitary, choroidal mass, initially suspicious for uveal melanoma, in a 72-year-old woman. Methods: Retrospective case report of a single patient. Results: A 72-year-old woman presented with sudden vision loss in the right eye. A month prior, visual acuity was 20/40, but she was noted to have a choroidal mass confirmed with B-scan ultrasonography. Patient’s vision deteriorated significantly a month later and a shallow retinal detachment was newly noted. Magnetic resonance imaging was obtained, demonstrating a hyperintense intraocular tumor on TI imaging. Patient underwent enucleation of the right eye for suspicion of a uveal melanoma. Pathology revealed a mixed cellular infiltrate with histiocytes, some exhibiting emperipolesis. Macrophage immunohistochemical stains were positive, while melanocytic markers were negative. A diagnosis of RDD was made. Subsequently, the patient had a negative workup for systemic involvement. A final diagnosis of intraocular RDD without extraocular and systemic involvement was determined. Conclusion: We describe a rare presentation of RDD as a solitary choroidal mass in an elderly patient with overlapping features of uveal melanoma. Definitive diagnosis could only be made on histology. RDD should be considered in the differential diagnosis of a choroidal lesion in the elderly.

scholarly journals Etiology of dizziness among patients referring to an Iranian ear, nose and throat clinic

2018 ◽  
Author(s):  
Masoumeh Saeedi ◽  
Mohammad Ajalloueyan ◽  
Farzaneh Zamiri Abdollahi ◽  
Mohammadreza Choobdari
Keyword(s):  
Endolymphatic Hydrops ◽  
The Elderly ◽  
Final Diagnosis ◽  
Emotional Reactions ◽  
Blood Analysis ◽  
Vestibular Evoked Myogenic Potentials ◽  
Emergency Rooms ◽  
Systemic Involvement ◽  
Chief Complaints ◽  
Comprehensive Evaluations

Background and Aim: Dizziness is one the most common complaints of patients in the emergency rooms. It has various etiologies and can lead to falling and other life-threatening injuries, especially in the elderly. Dizziness aff­ects the quality of life and results in negative emotional reactions. This research studied the etiology of dizziness in a three-year study. Methods: This study was conducted on 650 patients with the complaint of dizziness, whose specialists suspected them of having possible vestibular involvement, referred to a tertiary audiology clinic from 2015 to 2018. Videonys­tagmography, electrocochleography and cervical vestibular evoked myogenic potentials were administered. Other medical tests including neu­rologic examinations, blood analysis, and brain imaging were performed based on patients’ complaints. * Corresponding author: Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Piche-Shemiran, Enghelab Ave., Tehran, 1148965141, Iran. Tel: 009821-77530636, E-mail: [email protected]   Results: This was a descriptive study of dizzi­ness prevalence with different etiologies. Patie­nts’ age range was 18-85 years with mean (SD) age: 42.34 (13.12), including 377 (58%) females and 273 (42%) males. Patients’ chief complaints included vertigo in 64.8%, dizziness in 20.2% and imbalance in 15.1%. Vestibular disorders were identified in 49.2% of the referred patients. The patients’ final diagnosis in order of preva­lence were as follows: systemic involvement (292 cases), benign paroxysmal positional ver­tigo (187 cases), unilateral vestibular weakness (63 cases), endolymphatic hydrops (51 cases), bilateral vestibular weakness (37 cases), central involvement (20 cases), cervical (10 cases) and migraine-associated vertigo (8 cases). Conclusion: About 49.2% of the patients refe­rred to the ENT clinic had actual vestibular involvement. Careful history taking, teamwork, and comprehensive evaluations are necessary to differentiate underlying cause and selecting app­ropriate treatment.

Visual improvement in amblyopic eye following treatment-induced vision loss in dominant eye with uveal melanoma

2019 ◽  
Vol 104 (2) ◽  
pp. 202-207
Author(s):  
Aldo Vagge ◽  
Carol L Shields ◽  
Jerry A Shields ◽  
Renelle Pointdujour-Lim ◽  
Bruce Schnall
Keyword(s):  
Visual Acuity ◽  
Uveal Melanoma ◽  
Visual Loss ◽  
Vision Loss ◽  
Case Series ◽  
Retrospective Case ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Dominant Eye ◽  
The Mean

ObjectiveTo determine the frequency and amount of visual improvement in amblyopic eyes of adults following visual loss in the dominant eye resulting from treatment of uveal melanoma.Methods and analysisRetrospective case series of adult patients with amblyopia and dominant eye visual loss resulting from treatment of uveal melanoma. Review of best-corrected visual acuity (BCVA) in each eye (amblyopia eye vs melanoma eye) at date first seen and over time following treatment of uveal melanoma. BCVA in each eye was graded as improved (>2 logarithm of minimal angle of resolution (logMAR) lines) or unimproved (<2 logMAR lines).ResultsTwenty-one patients that met the inclusion criteria. Mean age at presentation was 56 years (range 39–73 years). Following treatment of the uveal melanoma and decline of BCVA in the dominant, the BCVA in the amblyopic eye improved in 11/21 (52%; 95% CI 30% to 74 %) patients. The degree of visual loss in the melanoma eye was to the level of the amblyopic eye or worse in 14 patients. In this group, BCVA improved in the amblyopic eye in 9/14 (64%; 95% CI 35% to 87 %) patients. Of these nine with improved eyes, the mean starting visual acuity was logMAR 0.6 (20/80) with mean improvement of logMAR 0.4 (4 lines±0.13 (range 0.2–0.6). Eight of nine eyes achieved a BCVA of 20/25 (n=3) or 20/20 (n=5).ConclusionVisual acuity in the amblyopic eye of adults can improve following visual loss in the contralateral dominant eye associated with treatment for uveal melanoma.

Nachhaltigkeit in Wald und Gesellschaft trotz «Überalterung» und «Unterjüngung» (Essay)

2013 ◽  
Vol 164 (8) ◽  
pp. 236-239
Author(s):  
Werner Schärer
Keyword(s):  
Civil Society ◽  
Technical Progress ◽  
The Elderly ◽  
Human Populations ◽  
Civil Society Organisations ◽  
Care For The Elderly ◽  
Economic Reasoning ◽  
The Right ◽  
Implementation Programme ◽  
Effective Distribution

Sustainability in forest and society despite “overmaturity” and “lack of regeneration” (essay) This essay compares efforts to move towards sustainability in the forests with those in the care for the elderly in Switzerland, and tries to draw conclusions which may promote sustainability. It is wrong, for forests and human populations, to talk of “overmaturity”, as this assumes the primacy of economic reasoning. To guarantee sustainability, the balance between all aspects is crucial. To attain true sustainability, we need binding guidelines and the “right” scale of implementation programme. Civil society organisations have been working for decades – often longer than the state itself – to improve sustainability. In many different areas, good cooperation and effective distribution of tasks between these institutions can be observed. This is important, among other things, because the ever greater speed of technical progress may overwhelm the adaptive capacity of both forests and people, which would influence sustainability in a negative way.

scholarly journals Acute Zonal Occult Outer Retinopathy: Vision Loss in an Active Duty Soldier

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Courtney M. Crawford ◽  
Bruce A. Rivers ◽  
Mark Nelson
Keyword(s):  
Visual Field ◽  
Visual Field Defect ◽  
Vision Loss ◽  
Fundus Autofluorescence ◽  
Final Diagnosis ◽  
Active Duty ◽  
Visual Field Defects ◽  
Fundus Photographs ◽  
Optical Coherence Tomograph ◽  
Field Defect

Objective. To describe a case of acute zonal occult outer retinopathy (AZOOR) in an active duty patient.Methods. In this paper we studied fundus photographs, optical coherence tomograph, Humphrey visual field 30-2, fundus autofluorescence images, fluorescein angiograms, and electroretinography.Results. Exam findings on presentation: a 34-year-old American Indian female presented with bilateral photopsias, early RPE irregularity, and an early temporal visual field defect. Progression RPE damage and visual field defect along with ERG findings support final diagnosis of AZOOR.Conclusion. AZOOR may initially be identified as a broader category of disease called the “AZOOR complex of disorders”. Specific visual field defects, ERG results, and clinical exam findings will help distinguish AZOOR from other similar disorders.

scholarly journals Early recognition of PIMS-TS: a single centre retrospective review

2021 ◽  
Vol 5 (1) ◽  
pp. e001011
Author(s):  
Roshni Mistry ◽  
Nicola Scanlon ◽  
James Hibberd ◽  
Fionnghuala Fuller
Keyword(s):  
Early Recognition ◽  
Febrile Illness ◽  
Final Diagnosis ◽  
University Hospital ◽  
Single Centre ◽  
Retrospective Case ◽  
Reactive Protein ◽  
Review Reports ◽  
Specific Symptoms

IntroductionResearch into paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) has focused on tertiary level management. This review reports on symptoms and investigations at presentation.MethodsSingle centre retrospective case note analysis of patients fulfilling PIMS-TS diagnostic criteria from March to May 2020 in a London district level university hospital.ResultsSix patients presented in the week prior to their final diagnosis with fever and non-specific symptoms. Raised C-reactive protein (CRP), lymphopenia and hyponatraemia were noted. Kawasaki-like symptoms were under-represented in all patients.InterpretationThe results suggest that a proportion of children with early PIMS-TS present with a non-specific febrile illness and abnormal blood results. Further research is needed to determine the most appropriate identification and follow-up of these children.

scholarly journals Proning related bilateral anterior ischaemic optic neuropathy in a patient with COVID-19 related acute respiratory distress syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsty Michelle Clarke ◽  
Vivi Riga ◽  
Amy-lee Shirodkar ◽  
Joel Meyer
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Visual Field ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Vision Loss ◽  
Prone Positioning ◽  
Disc Oedema ◽  
Ischaemic Optic Neuropathy ◽  
The Right

Abstract Background Non-arteritic ischaemic optic neuropathy (NAION) is a rare but harmful complication of prone positioning. Prone mechanical ventilation is a therapeutic strategy which has been used extensively during the COVID-19 pandemic to treat acutely hypoxemic patients with COVID-19 related acute respiratory distress syndrome (ARDS). Though a small number of cases of unilateral NAION have been reported in patients testing positive for the SARS-CoV-2 virus, we describe what is to our knowledge, the first reported case of bilateral NAION occurring in a patient proned extensively for the treatment of COVID-19 related ARDS. We consider the potential aetiological factors leading to NAION after prone mechanical ventilation in patients with COVID-19 and suggest strategies to protect against its development. Case presentation : We report a case of severe, irreversible, visual impairment secondary to bilateral anterior ION in a fifty-five-year-old male who underwent eight episodes of prone mechanical ventilation to treat COVID-19 related ARDS. Once weaned from his sedation he reported bilateral painless vision loss, and bedside ophthalmological assessment identified a reduced visual acuity of 3/30 unaided in the left eye and counting fingers in the right. Dilated indirect ophthalmoscopy revealed inferotemporal optic disc oedema with splinter haemorrhages in the right eye and mild disc oedema, temporal pallor, and nerve fibre layer haemorrhages inferiorly in the left eye. Humphrey visual field 24 − 2 testing confirmed a severely constricted visual field with macular sparing on the right and depressed inferonasal vision with preserved peripheral vision on the left eye. OCT disc imaging shortly after diagnosis revealed bilateral disc swelling and flame haemorrhages in the right eye. Conclusions NAION is a devastating, but preventable complication of prone positioning, which may pose significant risk of vision loss in patients with COVID-19 related ARDS.

scholarly journals Role of Extradural Clinoidectomy and Optic Unroofing in Resection of an Anterior Clinoidal Meningioma with Encasement of the Internal Carotid Artery and Its Branches

2021 ◽  
Author(s):  
Sima Sayyahmelli ◽  
Zhaoliang Sun ◽  
Emel Avci ◽  
Mustafa K. Başkaya
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Skull Base ◽  
Vision Loss ◽  
Internal Carotid ◽  
Extent Of Resection ◽  
World Health ◽  
Who Grade ◽  
The Right ◽  
Supraclinoid Internal Carotid Artery

AbstractAnterior clinoidal meningiomas (ACMs) remain a major neurosurgical challenge. The skull base techniques, including extradural clinoidectomy and optic unroofing performed at the early stage of surgery, provide advantages for improving the extent of resection, and thereby enhancing overall outcome, and particularly visual function. Additionally, when the anterior clinoidal meningiomas encase neurovascular structures, particularly the supraclinoid internal carotid artery and its branches, this further increases morbidity and decreases the extent of resection. Although it might be possible to remove the tumor from the artery wall despite complete encasement or narrowing, the decision of whether the tumor can be safely separated from the arterial wall ultimately must be made intraoperatively.The patient is a 75-year-old woman with right-sided progressive vision loss. In the neurological examination, she only had light perception in the right eye without any visual acuity or peripheral loss in the left eye. MRI showed a homogeneously enhancing right-sided anterior clinoidal mass with encasing and narrowing of the supraclinoid internal carotid artery (ICA). Computed tomography (CT) angiography showed a mild narrowing of the right supraclinoid ICA with associated a 360-degree encasement. The decision was made to proceed using a pterional approach with extradural anterior clinoidectomy and optic unroofing. The surgery and postoperative course were uneventful. MRI confirmed gross total resection (Figs. 1 and 2). The histopathology was a meningothelial meningioma, World Health Organization (WHO) grade I. The patient continues to do well without any recurrence and has shown improved vision at 15-month follow-up.This video demonstrates important steps of the microsurgical skull base techniques for resection of these challenging tumors.The link to the video can be found at https://youtu.be/vt3o1c2o8Z0

scholarly journals Emphysematous pyelonephritis with air bubble in the inferior vena cava

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Tiffany A. Perkins ◽  
Alberic Rogman ◽  
Murali K. Ankem
Keyword(s):  
Septic Shock ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Rare Presentation ◽  
Emphysematous Pyelonephritis ◽  
Case Presentation ◽  
Air Bubble ◽  
First Case ◽  
The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

scholarly journals Central Nervous System Vasculitis as a Rare Presentation of Mycoplasma pneumoniae: A Case Report

2020 ◽  
Vol 12 (3) ◽  
pp. 402-409
Author(s):  
Ashraf Omer Elamin Ahmed ◽  
Mona Mohammad Ibraheem Babikir ◽  
Amir Elssoni Mahjoup Khojali ◽  
Suresh Nalaka Menik Arachchige ◽  
Abdirahman Mohamud Abdirahman ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Central Nervous System Involvement ◽  
Lower Respiratory Tract Infections ◽  
Central Nervous System Vasculitis ◽  
Rare Presentation ◽  
Systemic Involvement ◽  
Tract Infections

<i>Mycobacteria pneumoniae</i> (MP) commonly causes upper and lower respiratory tract infections. The clinical manifestation is classified as pulmonary and extrapulmonary. These manifestations vary according to the involved system. MP may affect one system or more at a time. Commonly prodromal respiratory symptoms precede systemic involvement. Central nervous system involvement in uncommon. This report is presenting a rare case of central nervous system vasculitis secondary to MP, highlighting the diagnosis and management with a succinct literature review.

scholarly journals Recurrent Intraocular Lens Dislocation in a Patient with Familial Ectopia Lentis

2021 ◽  
Vol 18 (9) ◽  
pp. 4545
Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka
Keyword(s):  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Silicone Oil ◽  
Single Case ◽  
Recurrent Dislocation ◽  
Ectopia Lentis ◽  
Pars Plana ◽  
The Right

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.

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