Acute Glaucoma Filtering Surgery Failure following Herpes Zoster Ophthalmicus Infection

Herein, we report a case of acute failure of a previously successful trabeculectomy, following an infection with herpes zoster ophthalmicus (HZO). HZO remains a common infection, especially among elderly and immunocompromised patients. There is a strong link between HZO infection, the incidence of secondary glaucoma, and the need for glaucoma filtering surgery. Though, to our knowledge, there are no cases reporting on the effect that a concomitant infection may have on a previously successful trabeculectomy. In our case, a 76-year-old immunocompetent male with primary open-angle glaucoma in both eyes and a history of a successful right eye trabeculectomy 1 year earlier presented with acute primary HZO involving the ophthalmic branch of the right trigeminal nerve. Appropriate topical and systemic treatment was immediately initiated. Three days later, the trabeculectomy bleb showed hyperemia and flattening and concomitant rise of intraocular pressure was noted. A week later, the cutaneous signs were improving yet the trabeculectomy had failed and high intraocular pressure was established, requiring both topical and systemic antiglaucoma medications. Our study suggests that a previously successful trabeculectomy may manifest signs of compromise and subsequent failure following a HZO infection.

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Herpes zoster ophthalmicus following onabotulinumtoxinA administration for chronic migraine: A case report and literature review

Cephalalgia ◽

10.1177/0333102414544974 ◽

2014 ◽

Vol 35 (5) ◽

pp. 443-448 ◽

Cited By ~ 8

Author(s):

Paul M Gadient ◽

Jonathan H Smith ◽

Stephen J Ryan

Keyword(s):

Herpes Zoster ◽

Literature Review ◽

Chronic Migraine ◽

Young Patients ◽

Viral Reactivation ◽

Herpes Zoster Ophthalmicus ◽

Local Trauma ◽

Physician Awareness ◽

History Of ◽

The Right

Background There is a growing body of literature documenting local herpes zoster outbreak following procedures. The mechanism underlying these outbreaks remains elusive. We present a case of zoster following onabotulinumtoxinA (BTX) for migraine and a literature review. Methods Chart and literature review. Case A 72-year-old woman with chronic migraine received BTX injections for 3 years without incident. She had a history of thoracic zoster with subsequent post-herpetic neuralgia. In August 2013, 48 hours after receiving BTX injections, she developed a painful rash in the right V1 distribution consistent with herpes zoster ophthalmicus. One week later the rash had resolved without treatment. Literature review We identified 65 (including 2 from Juel-Jenson) cases of zoster reactivation following minor procedures. These cases tend to be in young patients without specific risk factors. Outbreaks characteristically occur at the level of exposure to local trauma. Discussion Our review suggests that local trauma, regardless of the nature of stimuli, may be sufficient for zoster reactivation. We hypothesize that the stressors in these reported cases exert a local epigenetic influence on viral transcription, allowing for viral reactivation. Conclusion Zoster is a potential complication of BTX administration for chronic migraine in adults. Physician awareness can reduce the significant morbidity associated with this disease.

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Significant hyperopic shift in a patient with extreme myopia following severe hypotonia caused by glaucoma filtering surgery

European Journal of Ophthalmology ◽

10.1177/1120672118794564 ◽

2018 ◽

Vol 29 (1) ◽

pp. NP6-NP9 ◽

Cited By ~ 2

Author(s):

João C Costa ◽

Jorge Alió

Keyword(s):

Intraocular Pressure ◽

Macular Edema ◽

Intraocular Lens ◽

Axial Length ◽

Length Change ◽

Filtering Surgery ◽

Lens Extraction ◽

History Of ◽

Severe Hypotonia ◽

The Right

Introduction: To report the case of a high hyperopic refractive shift associated with significant shortening of the ocular axial length following glaucoma filtering surgery. Methods: Case report. Patient’s records were consulted retrospectively. Results: A 57-year-old woman, highly myopic, with a history of bilateral intraocular refractive surgery in 1998 (phakic lens ZB5M) and bilensectomy in 2011 (phakic intraocular lens extraction plus cataract surgery with pseudophakic intraocular lens implantation), presented with consistently high intraocular pressure. Despite the treatment with different topical antiglaucomatous medications and good compliance, her intraocular pressure values remained consistently above 20 mmHg. In 2016, the patient was submitted for glaucoma filtering surgery and the mini shunt Ex-Press was implanted in both the eyes (3 months between surgeries). On the first postoperative day, the eyes were hypotonic (intraocular pressure of 5 mmHg) and bilateral macular edema was observed. Three days later, the intraocular pressure in both the eyes reached values higher than 6 mmHg (between 6 and 14 mmHg). Five months after the surgery the macular edema resolved and a significant shortening of the axial length and an important hyperopic refractive shift was observed. When comparing the preoperative and postoperative (18 months) measurements, the variation of the axial length was 2.49 mm in the right eye and 2.19 mm in the left eye; the patient refraction (spherical equivalent) shifted 2.50 diopters in the right eye and 1.75 diopters in the left eye. Conclusion: To the best of our knowledge, we report herein the first documented case of an axial length change of this magnitude after glaucoma filtering surgery.

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Therapeutic Effects of Hab Shabyar on Open-Angle Glaucoma: A Double-Blinded, Randomized, Placebo-Controlled Trial

10.31661/gmj.v0i0.1218 ◽

2019 ◽

Vol 8 ◽

pp. 1218

Author(s):

Ebrahim Khalil BaniHabib ◽

Ali Mostafai ◽

Seyyed Mohammad Bagher Fazljou ◽

Ghadir Mohammdi

Keyword(s):

Placebo Group ◽

Intraocular Pressure ◽

Open Angle Glaucoma ◽

Controlled Trial ◽

Intervention Group ◽

Therapeutic Effects ◽

Open Angle ◽

The Mean ◽

The Right ◽

Double Blinded

Background: Open-angle glaucoma (OAG) is one of the leading causes of blindness worldwide. This study evaluates the therapeutic effects of hab shabyar in patients with open-angle glaucoma. Materials and Methods: In this clinical randomized controlled trial, 50 patients with OAG were randomized into two groups. The intervention group was received a drop of timolol plus 500 mg of hab shabyar every 12 hours. The placebo group was received a drop of timolol every 12 hours plus 500 mg of wheat germ as a placebo. The intraocular pressure in patients with OAG was measured in each group and compared at before the intervention (t1), one month (t2), and two months (t3) after the intervention. Results: The mean decrease in intraocular pressure for the right eye at three times in the intervention group was statistically significant, but the mean decrease in the placebo group was not significant. Similar results were obtained for the left eye at t1 when compared to t3. The patients in the intervention group expressed more satisfaction than the patients in the placebo group (P≤0.001). Conclusion: Our study demonstrated that consumption of timolol plus hab shabyar instead of consuming of timolol alone was probably more effective for reducing intraocular pressure in patients with OAG.[GMJ.2019;In press:e1218]

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Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma

European Journal of Ophthalmology ◽

10.1177/11206721211010402 ◽

2021 ◽

pp. 112067212110104

Author(s):

Mehmet Talay Koylu ◽

Fatih Mehmet Mutlu ◽

Alper Can Yilmaz

Keyword(s):

Intraocular Pressure ◽

Female Patient ◽

Congenital Glaucoma ◽

Safe Procedure ◽

Primary Congenital Glaucoma ◽

History Of ◽

Kahook Dual Blade ◽

The Right ◽

Ab Interno

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.

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Herpes Zoster pada Anak – Laporan Kasus

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.10.1.2018.19005 ◽

2018 ◽

Vol 10 (1) ◽

Author(s):

Thigita A. Pandaleke ◽

Herry E. J. Pandaleke ◽

Ratna I. Susanti ◽

Julieta D. P. Dotulong

Keyword(s):

Herpes Zoster ◽

Physical Examination ◽

Primary Infection ◽

Giant Cells ◽

Lumbar Region ◽

Sensory Ganglia ◽

Laboratory Findings ◽

Varicella Zoster ◽

History Of ◽

The Right

Abstract: Herpes zoster (HZ) is an acute vesicular eruption caused by latent varicella zoster virus (VVZ) reactivation in sensory ganglia after primary infection. Its incidence increases with age and it is rarely found in children. We reported a case of 10-year-old male with blisters on the right side of his stomach and back 3 days ago. The patient was suffered from fever, common cold, and cough a week before, and had a history of varicella at 5 years old. Dermatologic status showed multiple vesicles on erythematous base at the anterior dan posterior sides of his right lumbar region. The Tzank test showed multinucletaed giant cells. Acyclovir resulted in significant improvement after 7- day therapy. Conclusion: Diagnosis of herpes zoster was based on anamnesis, physical examination, and laboratory findings. Antiviral drugs was aimed to reduce complications and viral shedding.Keywords: Herpes zoster, childAbstrak: Herpes zoster (HZ) merupakan erupsi vesikuler akut yang disebabkan oleh reaktivasi dari virus varisela zoster (VVZ) laten pada ganglia sensoris yang sebelumnya terpajan dengan infeksi primer varisela. Insiden HZ meningkat seiring pertambahan usia dan jarang ditemukan pada anak-anak. Kami melaporkan kasus seorang anak laki-laki, 10 tahun, dengan bintil-bintil berair di perut dan punggung sebelah kanan sejak 3 hari lalu. Riwayat demam, batuk dan pilek 1 minggu sebelum timbul lesi. Riwayat varisela pada usia 5 tahun. Status dermatologis ditemukan vesikel multipel berisi cairan jernih yang tersusun bergerombol di atas kulit yang eritema di regio lumbar dekstra anterior dan posterior. Tes Tzank memperlihatkan sel raksasa berinti banyak. Pasien diterapi dengan asiklovir oral selama 7 hari dan menunjukkan perbaikan yang bermakna. Simpulan: Anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang kasus ini khas untuk herpes zoster. Pemberian obat antiviral bertujuan untuk mengurangi komplikasi dan menurunkan viral shedding.Kata kunci: herpes zoster, anak

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Use of micropulse trans-scleral cyclophotocoagulation for acute rise in intraocular pressure due to anterior segment inflammation

European Journal of Ophthalmology ◽

10.1177/1120672120924341 ◽

2020 ◽

pp. 112067212092434

Author(s):

Shotaro Asano ◽

Victor Koh Teck Chang ◽

Maria Cecilia Domingo Aquino ◽

Paul Chew Tec Kuan

Keyword(s):

Intraocular Pressure ◽

Rescue Therapy ◽

Anterior Segment ◽

Poor Response ◽

Posterior Capsular Opacification ◽

Nd:Yag Laser Capsulotomy ◽

Pressure Spike ◽

History Of ◽

The Right ◽

Rescue Procedure

Purpose The aim of this study was to report the use of micropulse trans-scleral cyclophotocoagulation as an adjunct therapy for two cases of medically uncontrolled intraocular pressure spikes due to anterior segment inflammation. Case description: Case 1 had previous cataract surgery and exhibited an intraocular pressure spike due to phacoantigenic uveitis (right eye intraocular pressure = 52 mmHg). Despite medical treatment, the right eye intraocular pressure remained high (43 mmHg), thus micropulse trans-scleral cyclophotocoagulation was carried out as a rescue therapy. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 3 weeks was 9 and 16 mmHg, respectively. Case 2 had a history of previous blunt ocular trauma and 180° of angle recession. Both eyes were pseudophakia and underwent right eye Nd:YAG laser capsulotomy for posterior capsular opacification. Immediately after the procedure, the right eye intraocular pressure increased to 64 mmHg. Due to poor response to medical therapy, rescue micropulse trans-scleral cyclophotocoagulation was performed. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 2 months was 12 and 21 mmHg, respectively. Conclusion Micropulse trans-scleral cyclophotocoagulation successfully decreased intraocular pressure in both cases of acute rise in intraocular pressure. Micropulse trans-scleral cyclophotocoagulation can potentially be useful as a rescue procedure to safely reduce medically uncontrollable intraocular pressure spike due to anterior segment inflammation.

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Ultrasound Cyclo Plasty for Treatment of Surgery-Naïve Open-Angle Glaucoma Patients: A Prospective, Multicenter, 2-Year Follow-Up Trial

Journal of Clinical Medicine ◽

10.3390/jcm10214982 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4982

Author(s):

Michele Figus ◽

Chiara Posarelli ◽

Marco Nardi ◽

Ingeborg Stalmans ◽

Evelien Vandewalle ◽

...

Keyword(s):

Focused Ultrasound ◽

Vision Loss ◽

Open Angle Glaucoma ◽

Mean Value ◽

Piezoelectric Transducers ◽

High Intensity Focused Ultrasound ◽

Filtering Surgery ◽

Open Angle ◽

History Of

Background: The purpose of this prospective study was to evaluate the efficacy and safety of the Ultrasound Cyclo Plasty (UCP) procedure using high-intensity focused ultrasound in surgery-naïve open-angle glaucoma patients. Methods: prospective, non-randomized, single-arm, multicenter clinical trial. Sixty-six eyes with primary open-angle glaucoma, intraocular pressure (IOP) ≥21 mmHg and with no history of filtering surgery were enrolled. Patients were treated by UCP with a therapy probe comprising six piezoelectric transducers, consecutively activated for 8 s each. Complete ophthalmic examination was performed before the procedure, 1 day after the procedure, and 1, 3, 6, 12, 18 and 24 months after the procedure. Primary outcomes were complete success (defined as IOP lowering from baseline ≥20% without additional glaucoma medications) and vision-threatening complications. Secondary outcomes were the presence of complications and the reduction of the number of medications used. Results: IOP was significantly reduced after one procedure (p < 0.05), from a mean pre-operative value of 24.3 ± 2.9 mmHg (n = 2.3 hypotensive medications) to a mean value of 15.9 ± 3.6 mmHg (n = 2.2 hypotensive medications) at 2 years (mean IOP lowering of 33%). Surgical success was achieved in 74% of eyes. Notwithstanding side effects such as transient anterior chamber inflammation, refractive error changes, transient hypotony and macular edema, no major intra or post-operative complications such as phthisis, induced cataract, neovascularization or significant vision loss were observed. Conclusions: Ultrasound Cyclo Plasty is a valuable, effective and well-tolerated procedure to lower IOP in patients with open-angle glaucoma without previous filtering surgery.

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Ocular blastomycosis in a dog

Brazilian Journal of Veterinary Pathology ◽

10.24070/bjvp.1983-0246.v14i2p133-136 ◽

2021 ◽

Vol 14 (2) ◽

pp. 133-136

Author(s):

Bianca de Cecco ◽

◽

Mariano Carossino ◽

Pilar Camacho-Luna ◽

Christopher Alling ◽

...

Keyword(s):

Intraocular Pressure ◽

Poor Prognosis ◽

Emergency Service ◽

Clinical History ◽

Secondary Glaucoma ◽

Response To Treatment ◽

State University ◽

Louisiana State University ◽

History Of ◽

The Right

Clinical History: A 2-year-old, female Poodle dog presented to the Emergency Service at the Veterinary Teaching Hospital (VTH), Louisiana State University School of Veterinary Medicine with a history of lethargy and anorexia. At clinical examination the dog was anemic and febrile. The dog was bilaterally blind. The right eye was buphthalmic and the intraocular pressure was elevated (42 mm Hg). During an ophthalmological consult, bilateral severe panuveitis and optic neuritis with secondary glaucoma in the right eye was diagnosed and treatment was instituted. Despite treatment, the intraocular pressure kept increasing (up to 72 mm Hg overnight), and the clinicians decided to enucleate the right eye due to poor prognosis. After one month, and no response to treatment, the left eye was also enucleated. Gross Findings: Right and left eyes: The vitreous chamber was filled with a yellow, gelatinous exudate while the anterior chamber was filled with a translucent, gelatinous fluid. The retina appeared detached and embedded within the exudate present in the vitreous chamber.

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The Skin and the Eye - Herpes Zoster Ophthalmicus in a Healthy 18-month-old Toddler

Folia Medica ◽

10.1515/folmed-2017-0064 ◽

2018 ◽

Vol 60 (1) ◽

pp. 170-174 ◽

Cited By ~ 1

Author(s):

Radka T. Komitova ◽

Oliana B. Boykinova ◽

Nina S. Stoyanova

Keyword(s):

Herpes Zoster ◽

Varicella Zoster Virus ◽

Late Pregnancy ◽

Varicella Zoster Virus Infection ◽

First Year ◽

Healthy Children ◽

Herpes Zoster Ophthalmicus ◽

Varicella Zoster ◽

First Year Of Life ◽

Ophthalmic Branch

Abstract Herpes zoster, caused by reactivation of varicella-zoster virus, is uncommon in infancy. Even more uncommon is herpes zoster ophthalmicus, defined as herpes zoster of the ophthalmic branch of the fifth cranial nerve. Among healthy children, primary varicella-zoster virus infection during gestation as a result of maternal varicella or the first year of life is the major risk factor for development of herpes zoster in a relatively young age. Here we present an unusual case of herpes zoster ophthalmicus with dissemination in an immunocompetent toddler with favorable outcome. The child’s mother contracted chickenpox in late pregnancy and her son was very likely infected with varicella-zoster virus in utero. During a two-year follow-up the child vision was normal and there was no evidence of post herpetic neuralgia.

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Chorioretinal Folds in the Trabeculectomized Eye with Normal Intraocular Pressure after Phacoemulsification

Medicina ◽

10.3390/medicina57090896 ◽

2021 ◽

Vol 57 (9) ◽

pp. 896

Author(s):

Yi-Fen Lai ◽

Ching-Long Chen ◽

Ke-Hao Huang ◽

Yi-Hao Chen

Keyword(s):

Intraocular Pressure ◽

Case Report ◽

Visual Loss ◽

Early Recognition ◽

Open Angle Glaucoma ◽

Eye Drops ◽

Fundus Examination ◽

Blurred Vision ◽

Foveal Thickness ◽

The Right

Background and Objectives: This case report discusses possible causes of chorioretinal fold (CRF) formation. Materials and Methods: A case report. Results: A 48-year-old man presented with a history of high myopia and primary open-angle glaucoma in both eyes. He underwent a trabeculectomy followed by phacoemulsification in both eyes. Two months later, he complained of blurred vision in the right eye. The intraocular pressure (IOP) was 17 mmHg in the left eye and 9 mmHg in the right eye. Refraction showed a hyperopic shift in both eyes. Slit-lamp examination showed a deep anterior chamber without cells and a well-functional bleb without leakage. Fundus examination revealed CRFs in the macula of the right eye. No papilledema, choroidal lesions, or other retinal lesions were found. Wrinkling of CRFs at the macula, an increase in central foveal thickness, and a fluid cleft were demonstrated by spectral-domain optical coherence tomography. After using steroid eye drops, the IOP in the right eye and refraction in both eyes recovered to the baseline level. Visual acuity improved in both eyes. Conclusions: CRFs in trabeculectomized eyes with normal IOP after phacoemulsification have not been reported. This case demonstrated that the trabeculectomized eye remains at risk of CRF formation, even if the IOP is normal without hypotony. The importance of a detailed fundus examination in patients with unexplained blurred vision may be necessary after having undergone these procedures. The early recognition of the cause of visual loss may facilitate immediate treatment and may avoid irreversible changes with permanent visual loss.

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