scholarly journals Neovascular Glaucoma as a Presenting Sign of Catastrophic Antiphospholipid Syndrome with a “Catastrophic” Heart Valve Finding

2021 ◽  
pp. 664-669
Author(s):  
Anya Grinberg ◽  
Mohamad Midlij ◽  
Beatrice Tiosano ◽  
Roni Shreter ◽  
Anat Kesler
Keyword(s):  
Magnetic Resonance Imaging ◽  
Visual Acuity ◽  
Heart Valve ◽  
Antiphospholipid Syndrome ◽  
Neovascular Glaucoma ◽  
Retinal Ischemia ◽  
Resonance Imaging ◽  
Transesophageal Echocardiogram ◽  
Catastrophic Antiphospholipid Syndrome ◽  
Valve Lesions

We aimed to describe a case of neovascular glaucoma (NVG) as a first presenting sign of catastrophic antiphospholipid syndrome (CAPS) with heart valve aseptic vegetations known as Libman-Sacks endocarditis. A 39-year-old man was referred for left eye decreased visual acuity and pain, upon examination left eye high intraocular pressure; rubeosis iridis of both eyes (BE); and prominent retinal ischemia. Clinical and fluorescein angiography findings established the diagnosis of left eye NVG with vaso-occlusive disease in BE. Magnetic resonance imaging of the head showed widespread ischemic lesions and hemorrhagic foci. The transesophageal echocardiogram showed 2 big mitral valve lesions consistent with the diagnosis of Libman-Sacks endocarditis. Laboratory and clinical diagnosis of CAPS and suspected SLE was confirmed, and treatment with anticoagulants and IV steroids was initiated. This case demonstrates that severe vaso-occlusive retinopathy with severe brain ischemia should raise the suspicion of systemic autoimmune pro-coagulative diseases with heart valve aseptic vegetations.

scholarly journals Scleroderma-panniculitis: view of the rheumatologist

2021 ◽  
Vol 15 (2) ◽  
pp. 77-82
Author(s):  
A. S. Potapova ◽  
O. N. Egorova ◽  
O. G. Alekseeva ◽  
A. V. Volkov ◽  
D. M. Kudinsky
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Histological Examination ◽  
Antiphospholipid Syndrome ◽  
Clinical Case ◽  
Soft Tissues ◽  
Resonance Imaging ◽  
Diagnosis And Therapy

Difficulties in diagnosis and therapy of scleroderma-panniculitis (S-PN), one of the variants of the septal PN, are discussed. Feasibility of ultrasonography, magnetic resonance imaging of soft tissues and histological examination of the lesions in order to set the diagnosis of PN in time is considered. The clinical case of S-PN combined with antiphospholipid syndrome is presented.

Optic nerve size assessed by magnetic resonance imaging and visual acuity in optic nerve hypoplasia

2021 ◽  
Vol 25 (4) ◽  
pp. e45
Author(s):  
Samantha D. Sagaser ◽  
John C. Benson ◽  
Laurence J. Eckel ◽  
Sasha A. Mansukhani ◽  
Launia White ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Optic Nerve Hypoplasia ◽  
Resonance Imaging

Recurrent Germinoma in the Optic Nerve: Report of Two Cases

Neurosurgery ◽  
2001 ◽  
Vol 48 (1) ◽  
pp. 214-218 ◽  
Author(s):  
Takeshi Nakajima ◽  
Toshihiro Kumabe ◽  
Hidefumi Jokura ◽  
Takashi Yoshimoto
Keyword(s):  
Magnetic Resonance Imaging ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Complete Response ◽  
Drug Regimen ◽  
Resonance Imaging ◽  
Optic Nerves ◽  
Whole Brain Radiation ◽  
Visual Acuity Loss

Abstract OBJECTIVE AND IMPORTANCE Intracranial germinomas often disseminate via the ventricular and subarachnoid pathways, but seeding to the perioptic arachnoid space is extremely unusual. We report two cases of recurrent germinoma seeding in the optic nerve. CLINICAL PRESENTATION Two men with pure germinoma were initially treated with three cycles of a three-drug regimen of bleomycin, etoposide, and cisplatin, and a complete response was achieved. Patient 1 experienced ventricle wall dissemination 10 months after undergoing the initial treatment and was successfully treated with three cycles of carboplatin and etoposide and then by 24-Gy whole-ventricle radiation. Twelve months later, he complained of progressive visual acuity loss, and magnetic resonance imaging demonstrated bilateral enhancement of the optic nerves. Patient 2 also experienced ventricle wall dissemination 3 months after undergoing the initial chemotherapy, but he exhibited a complete response after undergoing 24-Gy whole-ventricle radiation. Two years later, he complained of progressive visual acuity loss. Magnetic resonance imaging demonstrated bilateral enhancement of the optic nerves and cerebellar hemispheres. INTERVENTION None of the locations of recurrence were included in the irradiation field, whereas there was no recurrence within the radiation field. Complete responses were obtained with three cycles of a three-drug regimen of ifosfamide, cisplatin, and etoposide and then by 24-Gy whole-brain radiation that included the bilateral optic nerves. The visual acuity of each patient improved slightly. CONCLUSION Delayed seeding in the optic nerve may result from germinoma cells that remain dormant, so they cannot be destroyed by chemotherapy regimens alone.

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