Diffuse subretinal fibrosis syndrome: A rare entity

2018 ◽  
Vol 28 (6) ◽  
pp. NP1-NP6 ◽  
Author(s):  
Natacha D Stolowy ◽  
Benjamin P Donnadieu ◽  
Alban CM Comet ◽  
Sébastien Nadeau ◽  
Marie A-S Beylerian ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Subretinal Fluid ◽  
Retinal Hemorrhage ◽  
Functional Improvement ◽  
First Line ◽  
Viable Option ◽  
Systemic Corticosteroids ◽  
Subretinal Fibrosis ◽  
The Right ◽  
Fibrotic Lesion

Background/ purpose: Diffuse subretinal fibrosis and uveitis syndrome is an inflammatory disease rarely reported. The purpose of this article is to describe a rare case of diffuse subretinal fibrosis syndrome in an 8-year-old child. Methods and results: The patient initially presented with a loss of vision in his right eye, with a visual acuity of 20/200. The visual acuity of the left eye was normal. Clinical examination showed bilateral anterior and posterior inflammation while the fundus revealed on the right eye an inter maculopapillar fibrosed lesion with a discrete retinal hemorrhage and a similar but smaller lesion on the left eye. The optical coherence tomography showed hyper-reflective material compatible with pre-retinal and subretinal pigment epithelial fibrosis and associated subretinal fluid. The angiography facilitated the diagnosis of neovascularization that was associated with the fibrotic lesion. The rest of the clinical pediatric examination remained negative and a diagnosis of diffuse subretinal fibrosis syndrome complicated with neovascularization was made. Treatment with systemic corticosteroids at the dose of 1 mg/kg/day for 1 month with a progressive decrease of 5 mg per month allowed for both anatomical and functional improvement. The visual acuity of the right eye improved from 20/200 to 20/63 at 1 month, 20/32 at 2 months, and 20/20 at 4 months. Conclusion: To our knowledge, this is the first reported case of bilateral diffuse subretinal fibrosis complicated by neovascularization. General corticosteroid therapy proved to be effective in this case and appears to be a viable option in first-line treatment.

scholarly journals Posterior Uveal Effusion after Cataract Surgery

2021 ◽  
pp. 62-67
Author(s):  
Annegret Abaza ◽  
Özlem Dikmetas ◽  
Irmingard Neuhann ◽  
Faik Gelisken
Keyword(s):  
Cataract Surgery ◽  
Corticosteroid Therapy ◽  
Anterior Segment ◽  
Subretinal Fluid ◽  
Posterior Pole ◽  
Functional Improvement ◽  
Long Term Observation ◽  
The Right ◽  
Uveal Effusion

We report a case of posterior uveal effusion (UE) with a long-term follow-up that has occurred following cataract surgery. A 64-year-old woman presented with diminished vision of the right eye (RE) 3 weeks after an uneventful phacoemulsification and intraocular lens implantation. Complete ophthalmic examination including fluorescein angiography (FA), indocyanine green angiography (ICGA), echography and optical coherence tomography (OCT) were performed. Best corrected visual acuity (BCVA) of the RE was 20/50. Anterior segment and intraocular pressure were unremarkable. OCT revealed prominent folds of the choroid and retina, subretinal fluid and darkening of the choroid with reduced visibility of the choroidal vessels and the scleral border. The left eye (LE) was unremarkable. BCVA of the LE was: 20/20. After topical anti-inflammatory and systemic corticosteroid therapy for 5 months, no morphological change of the macula was seen. The patient was observed without any treatment. Forty-three months after the cataract surgery and 38 months after cessation of the corticosteroid therapy, OCT revealed a normal macular morphology and the BCVA improved to 20/25. Even though rare, UE at the posterior pole may occur after modern cataract surgery. OCT examination is a reliable tool in monitoring the macular morphology. Since morphological and functional improvement can be seen in long-term, observation may be considered for some cases of posterior UE with resistance to the therapy.

scholarly journals Focal Choroidal Excavation in a Case of Choroidal Osteoma Associated with Choroidal Neovascularization

2020 ◽  
Author(s):  
Mahdieh Azimizadeh ◽  
Seyedeh Maryam Hosseini ◽  
Esmaeil Babaei
Keyword(s):  
Choroidal Neovascularization ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Retinal Hemorrhage ◽  
Retinal Layers ◽  
Choroidal Osteoma ◽  
Focal Choroidal Excavation ◽  
Neurosensory Retina ◽  
The Right

Purpose: To report a case of choroidal osteoma associated with reactivation of choroidal neovascularization (CNV) and development of focal choroidal excavation (FCE). Case Report: A 34-year-old woman with choroidal osteoma complicated by CNV in the right eye for two years presented with deterioration of visual acuity in her right eye. A small retinal hemorrhage accompanied by subretinal fluid (SRF) was seen in the macular area of the right eye. Optical coherence tomography (OCT) showed that the inner retina was intact, and the outer retinal layers had outward displacement. SRF and a wedge-shaped choroidal depression were also seen. This choroidal excavation was not present on previous OCT images. The integrity of the inner retinal layers was maintained, and an optically clear space was present between the neurosensory retina and the retinal pigment epithelium. Conclusion: Choroidal osteoma can be complicated by CNV and FCE could occur as a consequence. Again, FCE can lead to CNV development. This cascade can deteriorate vision and sometime lead to permanent visual loss.

scholarly journals Unilateral Vogt-Koyanagi-Harada Disease: A Clinical Case Report

2015 ◽  
Vol 6 (3) ◽  
pp. 361-365 ◽  
Author(s):  
Arminda Neves ◽  
Ana Cardoso ◽  
Mariana Almeida ◽  
Joana Campos ◽  
António Campos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Retinal Detachment ◽  
Serous Retinal Detachment ◽  
Subretinal Fluid ◽  
Posterior Pole ◽  
Exudative Retinal Detachment ◽  
The Right ◽  
Clinical Records ◽  
Vkh Disease

Purpose: To report a case of a 20-year-old female with decreased visual acuity (VA) in the left eye (LE). Methods: This is a retrospective and descriptive case report based on data from clinical records, patient observation and analysis of diagnostic tests. Results: A 20-year-old female presented with decreased VA in the LE for 3 days. Best-corrected visual acuity (BCVA) was 20/20 in the right eye (RE) and 20/40 in the LE. Pupillary function, intraocular pressure, results of external segment examinations and slit-lamp biomicroscopy were normal, bilaterally. RE fundoscopy was normal, and in the LE it revealed papillitis and posterior pole exudative retinal detachment. Optical coherence tomography (OCT) confirmed the macular serous retinal detachment and showed thickening of the posterior choroid also revealed by orbital ultrasound and magnetic resonance imaging (MRI). Fluorescein angiography showed angiographic features typical of Vogt-Koyanagi-Harada (VKH) disease: disseminated spotted choroidal hyperfluorescence and choroidal multifocal hypofluorescence, multifocal profuse leakage in the retina with pooling, serous retinal detachment and optic disc hyperfluorescence. Serological testing for the diagnosis of infectious pathologies was negative, and the review of systems was normal. The patient received systemic steroids and cyclosporine. LE BCVA improved up to 20/20 at 18 months after the diagnosis, with complete reabsorption of subretinal fluid and normal retinal and choroidal thickness by OCT. Conclusion: Despite the unilateral involvement, the clinical and angiographic features were typical of VKH disease, and ophthalmologists should be aware to recognize this rare clinical variant of the disease.

scholarly journals Baseline predictors for subretinal fibrosis in neovascular age-related macular degeneration

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Philipp K. Roberts ◽  
Markus Schranz ◽  
Alice Motschi ◽  
Sylvia Desissaire ◽  
Valentin Hacker ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Subretinal Fluid ◽  
Retinal Hemorrhage ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Age Related ◽  
Increased Risk ◽  
Significant Difference ◽  
Subretinal Fibrosis ◽  
Treatment Naïve

AbstractTo find baseline predictors for subretinal fibrosis (SF) in neovascular age-related macular degeneration (nAMD). Forty-five eyes of 45 participants with treatment-naïve nAMD were consecutively enrolled and treated according to a standardized treat-and-extend protocol. Spectral-domain optical coherence tomography (OCT), color fundus photography and fluorescein angiography as well as novel imaging modalities polarization-sensitive OCT and OCT angiography (OCTA) were performed to detect SF after 1 year and find baseline predictors for SF development. Baseline OCTA scans were evaluated for quantitative features such as lesion area, vessel area, vessel junctions, vessel length, vessel endpoints and mean lacunarity. Additionally, the type of macular neovascularization, the presence of subretinal fluid, intraretinal fluid (IRF), subretinal hyperreflective material (SHRM), retinal hemorrhage as well as best-corrected visual acuity (BCVA) were evaluated. After 12 months 8 eyes (18%) developed SF. Eyes with SF had worse baseline BCVA (p = .001) and a higher prevalence of IRF (p = .014) and SHRM at baseline (p = .017). There was no significant difference in any of the evaluated quantitative OCTA parameters (p > .05) between eyes with and without SF. There were no quantitative baseline microvascular predictors for SF in our study. Low baseline BCVA, the presence of IRF and SHRM, however, are easily identifiable baseline parameters indicating increased risk.

Vincristine and Corticosteroids as First-Line Treatment of Kasabach-Merritt Syndrome in Kaposiform Hemangioendothelioma

2009 ◽  
Vol 13 (3) ◽  
pp. 155-159 ◽  
Author(s):  
Aaron M. Drucker ◽  
Elena Pope ◽  
Sanjay Mahant ◽  
Miriam Weinstein
Keyword(s):  
American Literature ◽  
Line Treatment ◽  
First Line ◽  
Kaposiform Hemangioendothelioma ◽  
The North ◽  
First Line Therapy ◽  
Line Therapy ◽  
Systemic Corticosteroids ◽  
The Right ◽  
First Line Treatment

Background: Historically, patients with the consumptive coagulopathy Kasabach-Merritt syndrome (KMS) have been treated with systemic corticosteroids as first-line therapy, but many patients do not respond. Recently, there have been increasing reports of the use of the chemotherapeutic drug vincristine in these patients. Objective: To report a case of a newborn with a kaposiform hemangioendothelioma (KHE) of the right leg associated with KMS treated successfully with vincristine and oral corticosteroids. Methods: The patient's chart and the literature on the subject were reviewed using Medline and PubMed. Results: Treatment with vincristine and corticosteroids lead to sustained shrinking of the tumor and correction of the thrombocytopenia and coagulopathy through 1 year of age. We believe this is the first report in the North American literature of corticosteroids and vincristine being used concomitantly as first-line therapy for KHE with KMS. Conclusion: Vincristine and corticosteroids should be considered first-line treatment for KMS.

Bullous central serous chorioretinopathy and retinal pigment epithelium sequelae postblunt trauma

2020 ◽  
Vol 13 (9) ◽  
pp. e235882
Author(s):  
Nithin Teja Gunna ◽  
Deepika C Parameswarappa ◽  
Padmaja Kumari Rani
Keyword(s):  
Visual Acuity ◽  
Retinal Pigment Epithelium ◽  
Central Serous Chorioretinopathy ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Specific Treatment ◽  
Subretinal Fluid ◽  
Fundus Fluorescein Angiography ◽  
Near Vision ◽  
The Right

A 68-year-old man presented with diminution of distance and near vision in the right eye for a duration of 1 month postblunt trauma with a stick. On examination, his visual acuity in the right eye was 20/320 and near vision was <N36. Right eye fundus showed bullous neurosensory retinal detachment at posterior pole and retinal pigment epithelium (RPE) atrophic area temporal to fovea. Optical coherence tomography showed subretinal fluid with pigment epithelial detachment and an area of RPE and photoreceptor loss temporal to fovea. Fundus fluorescein angiography and indocyanine green angiography showed focal leaks and transmitted hyperfluorescence corresponding to the area of RPE loss. Left eye examination was unremarkable except for senile cataract of nuclear opalescence grade 3. A diagnosis of right eye bullous central serous chorioretinopathy (CSCR) and RPE sequelae postblunt trauma was made. Our patient was managed conservatively with no specific treatment for CSCR. One month later, there was improvement in vision with decrease in neurosensory detachment. The area of RPE loss remained the same with photoreceptor loss. Since this area of RPE and photoreceptor loss were temporal to fovea, our patient’s visual acuity was not affected significantly.

scholarly journals Effect of oral eplerenone in anatomical and functional improvement in patients with chronic central serous chorioretinopathy

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Omer Farooq ◽  
Asad Habib ◽  
Masood Alam Shah ◽  
Najia Ahmed
Keyword(s):  
Visual Acuity ◽  
Central Serous Chorioretinopathy ◽  
Subretinal Fluid ◽  
Sampling Technique ◽  
Functional Improvement ◽  
P Value ◽  
Chronic Central Serous Chorioretinopathy ◽  
Creative Commons ◽  
Collection Data ◽  
Quasi Experimental

Objective: To determine the efficacy of oral eplerenone in anatomical and functional improvement in patients with chronic central serous chorioretinopathy (CSCR). Methods: This quasi experimental study was performed at PNS Shifa Hospital Karachi from September 2018 to February 2019. Study included 23 patients. Patients were included using consecutive sampling technique and informed consent was taken from all patients before staring treatment. 50 mg of oral eplerenone per day was given for three months. Subretinal fluid (SRF) height and visual acuity (VA) were noted at baseline, one month and three month follow-up. Structured Study performa was used for data collection. Data was analysed and assessed with SPSS version 23. P value of <0.05 was considered statistically significant. Results: Mean age of patients was 40.7±7 years and mean duration of disease before treatment was 3.7±0.76 months. Mean baseline BCVA and SRF height was 0.39±0.02 logMAR and 123±12.5 µm respectively. Sixty-five percent patients responded at one month and 80% at three months with reduction in SRF height. Improvement in visual acuity was also statistically significant at 3 months (p<0.05). Conclusion: Use of eplerenone in chronic CSCR resulted in significant improvement in vision and decrease in mean SRF height. doi: https://doi.org/10.12669/pjms.35.6.896 How to cite this:Farooq O, Habib A, Shah MA, Ahmed N. Effect of oral eplerenone in anatomical and functional improvement in patients with chronic central serous chorioretinopathy. Pak J Med Sci. 2019;35(6):1544-1547. doi: https://doi.org/10.12669/pjms.35.6.896 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Clinical Profile and Visual Outcome of Ocular Bartonellosis in Malaysia

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Chai Lee Tan ◽  
Lai Chan Fhun ◽  
Evelyn Li Min Tai ◽  
Nor Hasnida Abdul Gani ◽  
Julieana Muhammed ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Presentation ◽  
Visual Outcome ◽  
Limited Data ◽  
Viable Option ◽  
Systemic Corticosteroids ◽  
History Of ◽  
Unilateral Involvement ◽  
The Mean ◽  
Better Than

Background.Ocular bartonellosis can present in various ways, with variable visual outcome. There is limited data on ocular bartonellosis in Malaysia.Objective.We aim to describe the clinical presentation and visual outcome of ocular bartonellosis in Malaysia.Materials and Methods.This was a retrospective review of patients treated for ocular bartonellosis in two ophthalmology centers in Malaysia between January 2013 and December 2015. The diagnosis was based on clinical features, supported by a positiveBartonellaspp. serology.Results.Of the 19 patients in our series, females were predominant (63.2%). The mean age was 29.3 years. The majority (63.2%) had unilateral involvement. Five patients (26.3%) had a history of contact with cats. Neuroretinitis was the most common presentation (62.5%). Azithromycin was the antibiotic of choice (42.1%). Concurrent systemic corticosteroids were used in approximately 60% of cases. The presenting visual acuity was worse than 6/18 in approximately 60% of eyes; on final review, 76.9% of eyes had a visual acuity better than 6/18.Conclusion.Ocular bartonellosis tends to present with neuroretinitis. Azithromycin is a viable option for treatment. Systemic corticosteroids may be considered in those with poor visual acuity on presentation.

scholarly journals EFFECT OF SADYOVAMANA IN THE TREATMENT OF CENTRAL SEROUS CHORIORETINOPATHY: A CASE STUDY

AYUSHDHARA ◽  
2020 ◽  
pp. 2681-2684
Author(s):  
Sreekumar Karunakaran* ◽  
Jayalakshmi.S
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Laser Photocoagulation ◽  
Subretinal Fluid ◽  
Total Absorption ◽  
Serous Fluid ◽  
First Line ◽  
Treatment Procedure ◽  
Excessive Accumulation

CSR is a challenging disease to understand and treat, since its pathogenesis remains elusive and multifactorial. CSR is an idiopathic disorder characterised by a localised serous detachment of sensory retina at the macula secondary to leakage from the choriocapillaries through one or more hyperpermeable RPE sites. In Ayurvedic literature, all the conditions which cause impairment of vision are included under Timiraroga. The present case CSCR, can be included under Sannipathikatimira. The treatment procedure Vamana is contraindicated in Timira but CSR is a disease in which excessive accumulation of serous fluid. So, it can be considered as Ekamgajasopha. The first line of treatment of Sopha is Apatarpana. Vamana is one of the Apatarpana procedures. So, Vamana can be incorporated in CSR. Management of CSR usually involves the use of laser photocoagulation, photodynamic therapy with verteporfin and anti VEGF agents in case of choroidal neovascularization related to CSR. As per Ayurvedic classics this condition can be included under Timiraroga. This article describes a case report of 47 years old male patient presented with CSR. In present study, Sadyovamana is found very effective to improve his visual acuity. OCT studies showed almost total absorption of subretinal fluid after treatment.

scholarly journals Peripapillary Choroidal Neovascular Membrane Secondary to Sarcoidosis-Related Panuveitis: Treatment with Aflibercept and Ranibizumab with a 50-month Follow-Up

2021 ◽  
pp. 186-192
Author(s):  
Artemis Matsou ◽  
Maria Dermenoudi ◽  
Despina Tzetzi ◽  
Tryfon Rotsos ◽  
Olga Makri ◽  
...  
Keyword(s):  
Sudden Onset ◽  
Functional Improvement ◽  
Choroidal Neovascular Membrane ◽  
Anti Vegf ◽  
Systemic Corticosteroids ◽  
Rapid Enlargement ◽  
Diagnostic Work ◽  
The Right ◽  
Endothelial Growth Factor

A case of peripapillary choroidal neovascular membrane (PCNM) secondary to sarcoidosis-related panuveitis successfully treated with anti-vascular endothelial growth factor (anti-VEGF) agents and systemic immunomodulatory therapy is reported. Diagnosis and follow-up were based on fundoscopic, optical coherence tomography as well as fluorescein angiography findings. A 45-year-old female patient presented with sudden onset bilateral blurring of vision. Fundoscopy revealed bilateral granulomatous panuveitis with solitary peripheral granuloma in the right eye and PCNM in the left eye. Diagnostic work-up including conjunctival biopsy confirmed the diagnosis of sarcoidosis. Topical and systemic corticosteroids controlled the inflammation. Within 4 weeks, PCNM showed rapid enlargement (best-corrected visual acuity [BCVA]: 6/60) with foveal involvement. Monthly intravitreal aflibercept injections and systemic methotrexate were administered. After 5 aflibercept injections, anatomical and functional improvement was noted (BCVA: 6/6). Due to aflibercept unavailability, further treatment included ranibizumab injections. During a 50-month follow-up period, every anti-VEGF injection was followed by total NV regression and 6/6 BCVA. Both aflibercept and ranibizumab appear to be effective in the treatment of PCNM secondary to sarcoidosis.

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