scholarly journals Acute Macular Neuroretinopathy Related to Alcoholic Hepatitis

2021 ◽  
pp. 293-298
Author(s):  
Grace Anne Mc Cabe ◽  
William Gordon Campbell ◽  
Thomas Gordon Campbell
Keyword(s):  
Alcoholic Hepatitis ◽  
Plexiform Layer ◽  
Acute Onset ◽  
Acute Macular Neuroretinopathy ◽  
Microvascular Changes ◽  
First Case ◽  
Paracentral Scotoma ◽  
The Right ◽  
Sd Oct ◽  
Subfoveal Fluid

A 33-year-old woman admitted for acute alcoholic hepatitis was referred to the ophthalmology department with an acute onset paracentral scotoma of the left eye. On examination, best-corrected visual acuity was Snellen 6/4 in the right eye and 6/9 in the left eye. Dilated left fundus examination revealed wedge-shaped changes at the macula. Spectral-domain ocular coherence tomography (SD-OCT) initially revealed a small cuff of subfoveal fluid and band-like hyperreflectivity extending outwards from the outer plexiform layer consistent with acute macular neuroretinopathy (AMN). Four days later, repeat SD-OCT was performed and it demonstrated resolution of the subfoveal fluid and disruption of the outer retinal layers. At the 6-week follow-up, the patient had no improvement in her symptoms and OCT angiography demonstrated coarsening and microvascular changes in both the deep vascular plexus and the choriocapillaris. To our knowledge, this is the first case of AMN in association with acute hepatitis. Although the exact pathophysiology of AMN remains obscure, this case highlights the benefits of multimodal retinal imaging and aims to bring attention to the possible association of AMN with alcoholic hepatitis.

scholarly journals Paediatric case of peripapillary choroidal neovascularisation associated with optic disc drusen treated with aflibercept

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-228134 ◽  
Author(s):  
Weh Loong Gan ◽  
Vernon W Long
Keyword(s):  
Visual Acuity ◽  
Optic Disc ◽  
Rare Complication ◽  
Fundus Autofluorescence ◽  
Choroidal Neovascularisation ◽  
First Case ◽  
Optic Disc Drusen ◽  
Intravitreal Aflibercept ◽  
The Right ◽  
Subfoveal Fluid

Peripapillary choroidal neovascularisation (PPCNV) associated with optic disc drusen is a rare complication that can result in severe vision impairment in children. We report the first case of paediatric PPCNV secondary to optic disc drusen successfully treated with intravitreal aflibercept. A 6-year-old girl presented with a one week history of reduced vision in her right eye with best-corrected visual acuity of 20/500. Fundus examination revealed bilateral elevated discs with a peripapillary pigmentary lesion in the right eye. Optical coherence tomography of the right eye showed marked subfoveal fluid. Both B-scan ultrasonography and fundus autofluorescence demonstrated findings consistent with optic disc drusen. Diagnosis of PPCNV was further confirmed on fluorescein fundus angiography. The child received three intravitreal aflibercept injections with complete resolution of the subfoveal fluid. Her visual acuity improved to 20/25 with no recurrence at a 16-month follow-up. No adverse side effects were reported.

scholarly journals Thicknesses of Macular Inner Retinal Layers in Children with Anisometropic Amblyopia

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Zheren Xia ◽  
Hao Chen ◽  
Suilian Zheng
Keyword(s):  
Structural Changes ◽  
Plexiform Layer ◽  
Inner Plexiform Layer ◽  
Macular Area ◽  
Anisometropic Amblyopia ◽  
Retinal Layers ◽  
Significant Difference ◽  
The Right ◽  
Fellow Eyes ◽  
Sd Oct

Objective. To investigate the thicknesses of macular inner retinal layers in children with anisometropic amblyopia using spectral domain optical coherence tomography (SD-OCT). Methods. Thirty-seven children with anisometropic amblyopia and fifty-seven children with normal vision were recruited in the study. Both eyes of children with anisometropic amblyopia and the right eyes of normal controls underwent scanning with the Spectralis OCT. The segmentation of retinal layers was performed automatically to measure individual inner retinal layers in the five sectors of the macular. An independent sample t -test was applied to compare the mean layer thicknesses of anisometropic eyes and fellow eyes with those of control eyes. Results. There was no significant difference in the total macular thickness between amblyopic and control eyes. However, in the peripheral macular area, three of the four quadrants of both the ganglion cell layer (GCL) and the inner plexiform layer (IPL) thicknesses were significantly reduced in amblyopic eyes compared to control eyes. Moreover, two of the four quadrants of the GCL thickness and three of the four quadrants of the IPL thickness in the peripheral macular area were significantly reduced in fellow eyes than in control eyes. Conclusion. The SD-OCT data revealed differences in the thicknesses of some macular inner retinal layers in both eyes of children with anisometropic amblyopia compared with those with emmetropia, indicating that structural changes might exist in the retina of children with amblyopia.

scholarly journals Idiopathic Omental Infarction Mimic Acute Appendicitis: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Hamad Almakinzy ◽  
Bandar Idress ◽  
Hamad Almakinzy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Inflammatory Markers ◽  
Iliac Fossa ◽  
Young Patients ◽  
Acute Onset ◽  
First Case ◽  
Laparoscopy Surgery ◽  
The Right

Idiopathic Omental Infarct (IOI) is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Since first case was described by Elitelin 1899, more than 300 cases have been published [1]. It can mimic serious surgical pathology. It occurs in <1% of appendicitis cases [2]. It’s challenge to diagnose, as features may mimic acute appendicitis and therefore in young patients, may only be discovered intra-operative. Here, we present a case of omental infarct in 26-year-old gentleman with no significant medical or surgical background who present with acute onset of right iliac fossa (RIF) pain. Examination revealed tenderness over the right iliac fossa and was having localized rebound. His inflammatory markers were high. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day.

Abstract 1122‐000051: Isolated Diplacusis Due to Ipsilateral Temporal Lobe Infarction: A Case Report

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Ali Kerro ◽  
Reza Bavarsad Shahripour
Keyword(s):  
Case Report ◽  
Temporal Lobe ◽  
Case Reports ◽  
Sensorineural Deafness ◽  
Screen Test ◽  
Acute Onset ◽  
First Case ◽  
Ischemic Infarct ◽  
Pubmed Search ◽  
The Right

Introduction : Double hearing or Diplacusis is a synchronous double perception of a sound and can have Binauralis or Monauralis pattern, with inner ear disorders being the main culprit [1] . Other forms of Auditory illusions have been reported as a co‐manifestation of stroke syndromes, but none as an isolated presentation [1][2] . This is a case of a 77‐year‐old male with acute onset isolated Diplacusis in a patient due to a right temporal lobe ischemic infarct. To our knowledge, this is the first case report of an isolated diplacusis due to cortical infarct. Methods : A case presentation with Pubmed search of review articles and case reports. Results : The patient had a past medical history of sensorineural deafness in his left ear. He described any sound heard as the same quality but occurring with an echo heard a fraction of a second later in his right ear. There was no decreased hearing quality or tinnitus reported in his right ear. His drug screen test was negative. His examination was only remarkable for a sensorineural hearing loss pattern on his left ear. His (NIHSS) was zero, and no other cranial nerve abnormalities were detected. His MRI was significant for a punctate restricted diffusion on the right temporal lobe, resembling an ischemic infarct (Figure). Conclusions : Isolated diplacusis can present as acute ischemic stroke in the temporal lobe. Further studies are needed to understand its pathophysiology.

scholarly journals Acute macular neuroretinopathy in a patient with acute myeloid leukemia and deceased by COVID-19: a case report

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ghodsieh Zamani ◽  
Sajjad Ataei Azimi; ◽  
Ali Aminizadeh ◽  
Elham Shams Abadi ◽  
Mostafa Kamandi ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Outer Nuclear Layer ◽  
Plexiform Layer ◽  
Underlying Disease ◽  
Outer Retina ◽  
Acute Macular Neuroretinopathy ◽  
En Face Oct ◽  
The Right ◽  
Acute Myeloid

Abstract Purpose Acute macular neuroretinopathy (AMN) is a visual-deteriorating rare clinical entity with an uncertain etiology. We aimed to report a case of AMN and underlying disease of acute myeloid leukemia (AML). Case presentation A thirty-five-year-old female patient with bone marrow biopsy confirmed AML, and bicytopenia, under chemotherapy, complained of sudden paracentral visual field defect in her right eye was referred. Visual acuity was 20/20 in both eyes. Posterior segment evaluation revealed multiple Roth’s spots. Optical coherence tomography (OCT) demonstrated hyper-reflectivity band, in the outer nuclear layer and outer plexiform layer, nasal to the fovea of the right eye, and hyperreflective patch in outer retina segmentation en-face OCT, suggestive of the diagnosis of AMN. Nine days after AMN diagnosis, dyspnea, malaise, and cough was initiated. Ground glass opacities in lung CT scan, beside reverse transcription polymerase chain reaction of severe acute respiratory syndrome coronavirus-2, was conclusive of coronavirus disease 2019 (COVID-19). The patient deceased after 6 days. Conclusion We report a rare case of AMN following AML. Our findings support the role of ischemia in the outer retina, of which AML may contributed to the pathophysiological process. The patient has deceased less than 2 weeks from AMN initiation.

scholarly journals Bilateral Acute Macular Neuroretinopathy in a Young Patient: Imaging and Visual Field during Two-Year-Follow-Up

Diagnostics ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 259 ◽  
Author(s):  
Alessandro Porta ◽  
Sarah Tripodi ◽  
Mario Damiano Toro ◽  
Robert Rejdak ◽  
Konrad Rejdak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Field ◽  
Indocyanine Green Angiography ◽  
Plexiform Layer ◽  
Young Female ◽  
Fundus Examination ◽  
Outer Retina ◽  
Acute Macular Neuroretinopathy ◽  
The Right

Acute macular neuroretinopathy (AMN) is a rare disorder. We report a case of bilateral AMN in a young female patient, without any risk factors. She referred a positive scotoma in both eyes after flu-like symptoms. Fundus examination revealed parafoveal dark-reddish oval lesions in both eyes. Therefore, we performed visual field, optical coherence tomography (OCT), fluorescein angiography (FA) and indocyanine green angiography (ICG) at baseline and several times during the two years of follow-up. The infrared (IR) imaging showed one rounded hyporeflective lesion in the left eye and two similar lesions in the right eye. The OCT demonstrated the characteristic alterations in the outer retina. The visual field also demonstrated scotomas corresponding with these lesions. The OCT and IR features disappeared at the end of the follow-up except for the left eye, which continued to have hyperreflective spots in the outer plexiform layer. The patient complained about a residual scotoma only in the left eye after two years. Our case shows a difference in disease progression in the two eyes of the same patient, suggesting that several mechanisms can be implicated in the pathology of AMN.

Ibrutinib-related uveitis: A report of two severe cases

2021 ◽  
pp. 112067212110012
Author(s):  
Marcela Bohn ◽  
Luciano Bravo-Ljubetic ◽  
Richard W J Lee ◽  
Harry Petrushkin
Keyword(s):  
Anterior Uveitis ◽  
Subretinal Fluid ◽  
Acute Onset ◽  
Steroid Treatment ◽  
Oral Steroid ◽  
Temporal Association ◽  
Drug Induced ◽  
Cardiac Side Effects ◽  
First Case ◽  
The Right

Introduction: Ibrutinib is a small-molecule drug approved for the treatment of haematological disorders and is known to be associated with visual disturbances, but uveitis has not yet been reported as an adverse effect of this medication. We present two cases of ibrutinib-associated severe uveitis in patients with chronic lymphocytic leukaemia. Case description: Our first case is a 65-year-old woman who presented with acute onset of bilateral fibrinous anterior uveitis 1 day after starting ibrutinib. Her vision was hand movements in the right eye and 20/120 in the left with hyperaemic discs and subretinal fluid. Ibrutinib was stopped and she experienced a significant improvement under local and oral steroid treatment. The second case is a 64-year-old male with subacute onset of bilateral hypertensive anterior uveitis with pupillary seclusion and right eye hyphaema. He was on ibrutinib for the past 9 months. His vision at presentation was 20/80 and 20/60 for the right and left eye, respectively. He responded poorly to local steroid treatment until ibrutinib was stopped due to cardiac side-effects, after which his uveitis resolved and treatment was stopped. Conclusion: The temporal association between changes in ibrutinib treatment and our patients’ ocular inflammation suggests a causative link. Ibrutinib increases Th1-based immune responses which is proposed as a mechanism for drug-induced uveitis. Its antiplatelet effect may explain the fibrinous nature of the inflammation and hyphaema.

scholarly journals Bordetella Holmesii: An Unusual Cause of Endogenous Endophthalmitis in a Patient With Sickle Cell Disease

2020 ◽  
pp. 247412642094663
Author(s):  
Roma B. Pegany ◽  
Roshan T. George ◽  
Alice Yang Zhang
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Acute Onset ◽  
Endogenous Endophthalmitis ◽  
Causative Organism ◽  
Cell Disease ◽  
First Case ◽  
The Right

Purpose: This case report describes a rare organism causing endogenous endophthalmitis in a patient with sickle cell disease. Methods: A case report was conducted. Results: A 41-year-old man with sickle cell disease presented with acute onset of blurry vision of the right eye. His visual acuity was counting fingers in the right eye and 20/20 in the left eye. He had ophthalmic findings of hypopyon and vitritis in the right eye, consistent with endophthalmitis. He was treated with intravitreal and systemic antibiotics. Vitreous cultures grew Bordetella holmesii. His visual acuity at follow-up visits improved to 20/40 in the setting of improved vitritis. Conclusions: This is the first case describing B holmesii, a rare causative organism of endogenous endophthalmitis, in a patient with sickle cell disease. More studies are needed to improve the early detection and treatment of this unusual organism.

scholarly journals Pyogenic Sacroiliitis in Children: Two Case Reports

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
L. Ghedira Besbes ◽  
S. Haddad ◽  
A. Abid ◽  
Ch. Ben Meriem ◽  
M. N. Gueddiche
Keyword(s):  
Antimicrobial Therapy ◽  
Case Reports ◽  
Acute Onset ◽  
Blood Cultures ◽  
Mri Findings ◽  
Pyogenic Sacroiliitis ◽  
First Case ◽  
Magnetic Resonance Imaging Mri ◽  
Bone Scans ◽  
The Right

Pyogenic sacroiliitis is rare and accounts for approximately 1-2% of osteoarticular infections in children. Considerable delay between presentation and diagnosis is recognized. Two cases of pyogenic sacroiliitis are described. The first case is a 28-month-old girl presented with acute onset of fever, pain in the left hip, and limpness. Computed tomography (CT), bone scans, and magnetic resonance imaging (MRI) of the pelvis showed characteristic findings of infectious sacroiliitis, and blood cultures were negatives. The second case is a 13-year-old girl presented with acute onset of fever, pain in the right hip, and buttock, with inability to walk. The diagnosis of pyogenic sacroiliitis was confirmed by bone scans, and CT of the pelvis and blood cultures have identifiedProteus mirabilis. The two children recovered fully after 6 weeks of antimicrobial therapy. Pyogenic sacroiliitis is an uncommon disease in children. The key to successful management is early diagnosis in which CT, bone scans, and MRI findings play a crucial role. If the diagnosis is established promptly, most patients can be managed successfully with antimicrobial therapy.

scholarly journals Noonan Syndrome with Multiple Lentigines and PTPN11 Mutation: A Case with Intracerebral Hemorrhage

2021 ◽  
pp. 1-7
Author(s):  
Eduardo Orrego-González ◽  
Carlos Martin-Restrepo ◽  
Alberto Velez-Van-Meerbeke
Keyword(s):  
Intracerebral Hemorrhage ◽  
Noonan Syndrome ◽  
Tyrosine Phosphatase ◽  
Acute Onset ◽  
Physical Exam ◽  
Autosomal Dominant Disorder ◽  
Acute Hemorrhage ◽  
First Case ◽  
The Right ◽  
Multiple Lentigines

Noonan syndrome with multiple lentigines (NSML), previously known as LEOPARD syndrome, is a rare autosomal dominant disorder with an unknown prevalence. Characteristics of this disease include cutaneous, neurologic, and cardiologic abnormalities. In this case report, we present a 12-year-old girl who was admitted to the emergency department for acute-onset left weakness, unsteady gait, nausea, and vomiting. Her physical exam notably showed left side upper motor neuron signs and dysmetria. CT scan revealed an acute hemorrhage of the right thalamus. Physical exam exhibited several craniofacial dysmorphisms and lentigines. The genetic test revealed a heterozygous missense mutation in the protein tyrosine phosphatase non-receptor type 11 (<i>PTPN11</i>) gene and a variant of unknown significance of the <i>MYH11</i> gene. To the best of our knowledge, this is the first case of a patient with NSML presenting an intracerebral hemorrhage.

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