scholarly journals A Case of Presumed Dyskeratosis Congenita Causing Severe Retinal Vascular Occlusion

2021 ◽  
pp. 344-349
Author(s):  
Takahisa Hirokawa ◽  
Shou Oosuka ◽  
Masahiro Tonari ◽  
Hiroshi Mizuno ◽  
Teruyo Kida ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Rare Case ◽  
Bone Marrow Failure ◽  
Vitreous Hemorrhage ◽  
Vascular Occlusion ◽  
Dyskeratosis Congenita ◽  
Vitreous Surgery ◽  
Hard Exudates ◽  
Retinal Vascular Occlusion ◽  
The Right

Dyskeratosis congenita (DKC) is a rare, multisystem, bone marrow failure disease characterized by abnormalities such as in the skin, mucosa, nervous system, and lungs. Here we report a rare case of presumed DKC causing total retinal detachment in the right eye and severe peripheral retinal vascular occlusion in the left eye. A 3-year-old boy was presented with vitreous hemorrhage and total retinal detachment in the right eye and was scheduled to undergo vitreous surgery in the right eye and detailed ophthalmologic examination of the left eye under general anesthesia. Since a systemic examination revealed anemia and marked thrombocytopenia, he underwent a detailed pediatric examination. Although genetic testing revealed no significant pathologic mutations, the presence of shortened telomere length and other clinical findings suggested the possibility of DKC. His right eye had severe proliferative vitreoretinopathy, and retinal reattachment was not achieved with vitreous surgery, thus resulting in phthisis bulbi. The left eye showed a wide retinal avascular area in the temporal retina, retinal neovascularization, and hard exudates on fluorescein fundus angiography and was treated with laser photocoagulation using a binocular indirect ophthalmoscopic photocoagulator. Following laser surgery, the new blood vessels regressed, and the visual acuity was maintained at 1.0. The findings in this rare case indicate that DKC can cause severe retinal vascular occlusion, thus leading to vitreous hemorrhage and retinal detachment. Therefore, early detection with fundus examination and early treatment with photocoagulation are important.

scholarly journals Suspected Gentamicin-Induced Retinal Vascular Occlusion after Vitrectomy

2020 ◽  
Vol 11 (2) ◽  
pp. 473-480 ◽  
Author(s):  
Fumiko Murao ◽  
Takamasa Kinoshita ◽  
Takashi Katome ◽  
Hiroki Sano ◽  
Masanori Niki ◽  
...  
Keyword(s):  
Vascular Occlusion ◽  
Perioperative Period ◽  
Retinal Hemorrhage ◽  
Optic Disk ◽  
Subconjunctival Injection ◽  
Ocular Surgery ◽  
Gas Tamponade ◽  
Retinal Vascular Occlusion ◽  
The Right ◽  
Arteries And Veins

Retinal vascular occlusion after ocular surgery is a rare but serious complication. A history of cardiovascular diseases, retrobulbar anesthesia injection, high intraocular pressure during the perioperative period, and drug toxicity have been reported as possible causative factors. We report here two cases of multiple retinal vascular occlusions after the subconjunctival injection of gentamicin at the end of uncomplicated 25-gauge vitrectomy. Case 1 was a 61-year-old man who developed a macular hole in the right eye. Phacovitrectomy with gas tamponade was performed. On postoperative day (POD) 1, dot hemorrhage was observed on the temporal side of the optic disk. On POD10, macular whitening, retinal hemorrhage, and multiple occlusion of retinal arteries and veins were observed. Case 2 was a 51-year-old woman who was diagnosed with rhegmatogenous retinal detachment in the right eye and underwent phacovitrectomy with gas tamponade. On POD3, macular whitening with cotton wool spots and retinal hemorrhage were observed with macular ischemia owing to occlusion of retinal arteries and veins. In both cases, subconjunctival injection of gentamicin given at the end of surgery was the most suspected cause of retinal vascular occlusion.

scholarly journals Coats’ Retinitis or Retinoblastoma in a 3-Year-Old Girl: A Case Report

Medicina ◽  
2012 ◽  
Vol 48 (4) ◽  
pp. 32
Author(s):  
Alvydas Paunksnis ◽  
Daiva Imbrasienė ◽  
Rasa Liutkevičienė ◽  
Kristina Rilienė ◽  
Evaldas Keleras ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Abnormal Development ◽  
Eye Drops ◽  
Exudative Retinal Detachment ◽  
Hard Exudates ◽  
Appropriate Treatment ◽  
Department Of Ophthalmology ◽  
Coats Disease ◽  
The Right

Coats’ disease is an idiopathic disorder defined by an abnormal development of retinal vessels with a progressive deposition of intraretinal or subretinal exudates, leading to exudative retinal detachment. The most difficult task is to differentiate Coats’ disease from retinoblastoma. We present a rare case of Coats’ disease diagnosed in a 3-year-old girl. From the age of 6 months, the girl was followed up 2 times a year at the Department of Ophthalmology, Hospital of Lithuanian University of Health Sciences, due to congenital convergent strabismus and refractive errors. At the age of 3.6 years, a routine examination of the fundus of the right eye revealed hard exudates, telangiectasia and tortuosity, gray color lesion below the optic nerve disc, submacular exudation in the inferior nasal part of the retina, and exudative retinal detachment, which extended from the 7-o’clock position to the 4-o’clock position. Before this examination, no abnormalities were found in the fundus of her both eyes. The girl was not treated with laser photocoagulation, cryocoagulation, or intravitreal injections, as the diagnosis of retinoblastoma could not be excluded; therefore, only eye drops were prescribed. In order to exclude the diagnosis of retinoblastoma, ultrasonography, magnetic resonance imaging, and computed tomography were carried out, and an appointment to see an ophthalmic oncologist was scheduled. Due to early and appropriate treatment, the progression of Coats’ disease in patients could be arrested. However, in some cases, when the diagnosis is ambiguous, it is better to follow up the patient and to treat only with eye drops.

scholarly journals Missed Diagnosis of an Intraorbital Foreign Body of Homemade Fireworks Origin: A Case Report

2015 ◽  
Vol 6 (3) ◽  
pp. 448-452 ◽  
Author(s):  
Dan-dan Zhou ◽  
Kai Niu ◽  
Cheng-wei Lu ◽  
Ji-long Hao ◽  
Bing-jie Zhang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Retinal Detachment ◽  
Traumatic Injury ◽  
Vitreous Hemorrhage ◽  
Initial Assessment ◽  
Retinal Tear ◽  
Orbital Wall ◽  
Oral Steroids ◽  
The Right

Purpose: We report a rare case of traumatic injury to the eye caused by homemade fireworks in a Chinese juvenile patient with a metal ring left in the orbit after having been sutured at the Emergency Department. Methods: An 11-year-old boy presented with a traumatic injury to the right eye from homemade fireworks. Following initial assessment involving maxillofacial computed tomography (CT) and suturing at the Emergency Department, he was transferred to our department for further evaluation because of his poor sight 1 day later. On examination, a skin laceration beneath the right eyebrow was noted, but the superior orbit was not fully visible on the maxillofacial CT performed 1 day previously. Therefore, an orbital CT scan was carried out on the second day, which showed a hyperdense ring embedded in the superior border of the orbital wall; the ring was surgically removed. On postoperative day 7, a fundus examination revealed resolving vitreous hemorrhage, blunt traumatic retinal detachment, and a large retinal tear superior to the macula. The patient refused to take surgery for retinal detachment into consideration. Therefore, we opted for oral steroids and careful observation. Results: After 2 months' observation, the large retinal tear had healed and white fibrous scar tissue had developed, and the retinal detachment superior to the macula had reattached itself spontaneously. The patient's vision had further improved to 20/200. During 1 year of follow-up, he remained clinically stable. Conclusion: To avoid missing the diagnosis, a complete history of the mechanism of injury and accurate imaging still prove most useful. Complete removal of the foreign body by the emergency physician is necessary because of the ocular toxicity of an iron-containing foreign body. As evidenced by the current case, oral steroids and observation for a period of several months is a management of choice for traumatic retinal detachment and retinal tear superior to the macula associated with homemade fireworks in children.

Vitrectomy for Retinal Detachment

2009 ◽  
Author(s):  
Daniel A. Brinton ◽  
Charles P. Wilkinson
Keyword(s):  
Retinal Detachment ◽  
Penetrating Trauma ◽  
Subretinal Fluid ◽  
Vitreous Hemorrhage ◽  
Scleral Buckling ◽  
Scleral Buckle ◽  
Vitreous Surgery ◽  
Retinal Breaks ◽  
Vitreoretinal Degeneration ◽  
Treat All

Following the introduction of closed vitrectomy techniques by Robert Machemer in the early 1970s, complicated retinal detachments became one of the important indications for vitreous surgery. Most of these were due to proliferative diabetic retinopathy (PDR) or to proliferative vitreoretinopathy (PVR), frequently following failure of routine scleral buckling procedures. As experience in vitreoretinal surgery expanded, the advantages of these techniques in the management of more routine types of retinal detachment became apparent. The popularity of vitrectomy for primary retinal detachments continues to grow, particularly with regard to pseudophakic cases. Indications for performing a vitrectomy rather than a scleral buckle or a pneumatic retinopexy are summarized in Chapter 10. Virtually all authorities note that a vitrectomy is required (along with a broad scleral buckle) in eyes with severe PVR, and the technique is also clearly indicated for cases due to PDR, detachments associated with major vitreous hemorrhage or scarring from penetrating trauma, and those with giant retinal tears. On the other hand, few would suggest a vitrectomy to repair a very shallow and small retinal detachment due to a single break that could be easily closed with a scleral buckle or pneumatic procedure. Between these two extremes, indications remain a matter of personal choice of the surgeon, and they are influenced by his or her training and experiences with a variety of techniques. Most surveys demonstrate a growing popularity of vitrectomy for an increasing percentage of cases. The goals of vitrectomy for retinal detachment are to… 1. Remove axial opacities such a 1. s vitreous hemorrhage or debris. 2. Eliminate vitreoretinal, epiretinal, or subretinal traction. 3. Identify and treat all retinal breaks. 4. Internally reattach the retina. 5. Facilitate placement of a large intraocular tamponade. 6. Avoid complications associated with scleral buckling surgery…. The usual sequence of events includes removal of vitreous gel and epiretinal membranes, identification of retinal breaks, internal removal of subretinal fluid, laser therapy to all responsible breaks and areas of significant vitreoretinal degeneration, and placement of an internal tamponade with gas or silicone oil. Vitrectomy is frequently combined with placement of a scleral buckle.

scholarly journals Laser treatment of macular retinal folds in late postoperative period after retinal detachment repair

2021 ◽  
Author(s):  
KhP Takhchidi ◽  
EKh Takhchidi ◽  
TA Kasmynina ◽  
EP Tebina
Keyword(s):  
Retinal Detachment ◽  
Postoperative Period ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Symptoms ◽  
Vascular Occlusion ◽  
Early Postoperative Period ◽  
Repeat Surgery ◽  
Retinal Vascular Occlusion ◽  
Retinal Folds ◽  
Late Postoperative Period

Macular retinal folds are a rare yet grave complication of surgical rhegmatogenous retinal detachment repair. Clinical symptoms vary depending on the location and severity of folding. Fold located in the periphery of the ocular fundus can be asymptomatic, but macular retinal folds cause diminished visual acuity and metamorphopsia. Currently, the most effective treatment for retinal folds is repeat surgery. Its serious disadvantage is the risk of complications in the early postoperative period, including hemophthalmia, inflammation, secondary glaucoma, cataracts, RRD recurrence, macular tears, retinal vascular occlusion, etc. The clinical case described below demonstrates the potential of combination laser therapy for the treatment of macular retinal folds based on the use of modern diagnostic and therapeutic methods.

scholarly journals Two Cases of Giant Melanocytoma (Hyperpigmented Magnocellular Nevus)

2020 ◽  
Vol 6 (5) ◽  
pp. 344-352
Author(s):  
David I.T. Sia ◽  
Jorge Agi ◽  
Parampal Grewal ◽  
Laurie Russell ◽  
Ezekiel Weis
Keyword(s):  
Optic Nerve ◽  
Retinal Detachment ◽  
Ciliary Body ◽  
Rhegmatogenous Retinal Detachment ◽  
Vitreous Hemorrhage ◽  
Melanocytic Nevus ◽  
First Case ◽  
Iodine 125 ◽  
The Right ◽  
Plaque Brachytherapy

Melanocytoma or hyperpigmented magnocellular nevus is a variant of melanocytic nevus that is most commonly seen in the optic nerve, but has also been reported to occur in the iris, ciliary body, choroid, sclera, and conjunctiva. We present two cases of giant uveal melanocytoma with histopathology. The first case occurred in a 10-year-old girl who presented with decreased vision in the right eye and a mushroom-shaped pigmented choroidal lesion measuring 15.5 mm in apical height. The lesion was abutting the lens but not causing a cataract. This was diagnosed as a choroidal melanocytoma on open scleral window biopsy. The second case was in a 68-year-old lady, referred for a left nasal pigmented choroidal lesion measuring 8 mm in apical height and having a mushroom configuration. The lesion grew to 8.6 mm in height and was complicated by a vitreous hemorrhage and rhegmatogenous retinal detachment and was treated with iodine-125 plaque brachytherapy. Subsequently, the treated eye became a painful phthisical eye and was enucleated. Histopathology confirmed melanocytoma with extrascleral extension but without malignant transformation. Features of melanocytoma and other very large cases reported in the literature are discussed.

Popliteal nodal metastasis from squamous cell cancer of the foot. Case report and literature review

2019 ◽  
pp. 1-2
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Literature Review ◽  
Squamous Cell ◽  
Rare Case ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Nodal Metastasis ◽  
Regional Disease ◽  
The Right

We report a very rare case of squamous cell cancer of the right foot which had metastasize to the ipsilateral popliteal lymph node after initial diagnosis and treatment for the loco-regional disease.

Sign in / Sign up

Export Citation Format

Share Document