Bilateral decompression retinopathy after deep sclerectomy with mitomycin C in a child with tubulointerstitial nephritis and uveitis syndrome

2019 ◽  
Vol 30 (3) ◽  
pp. NP1-NP6 ◽  
Author(s):  
Francisco J Muñoz-Negrete ◽  
Laura Díez-Álvarez ◽  
Carlota Fuente Garcia ◽  
Gema Rebolleda
Keyword(s):  
Visual Acuity ◽  
Ocular Hypertension ◽  
Mitomycin C ◽  
Tubulointerstitial Nephritis ◽  
Deep Sclerectomy ◽  
Retinal Hemorrhages ◽  
First Case ◽  
The Right ◽  
Chronic Use ◽  
Decompression Retinopathy

Introduction: To report the first case of bilateral ocular decompression retinopathy after uneventful non-perforating deep sclerectomy with mitomycin C in a child with tubulointerstitial nephritis and uveitis syndrome. Case description: An 8-year-old girl affected by tubulointerstitial nephritis and uveitis syndrome developed ocular hypertension (45 mmHg in the right eye and 42 mmHg in the left eye) associated with recurrent episodes of uveitis and chronic use of steroids despite maximum hypotensive medical treatment. Bilateral non-perforating deep sclerectomy with mitomycin C (0.2 mg/mL, 1 min) was performed under general anesthesia without complications. The first postoperative day, the visual acuity was reduced to 0.6 in the right eye and 0.05 in the left eye and the intraocular pressure was 3 mmHg in both eyes. Fundoscopy revealed bilateral optic nerve swelling and diffuse retinal hemorrhages, some of them with scattered-white centers. About 2 months after surgery, the visual acuity was normal and the fundus examination showed complete resolution. Conclusion: The ocular decompression retinopathy is an uncommon complication after non-perforating deep sclerectomy. This is the first case of bilateral ocular decompression retinopathy reported after non-perforating deep sclerectomy in a child with ocular hypertension secondary to recurrent uveitis and chronic use of steroids associated with tubulointerstitial nephritis and uveitis syndrome.

scholarly journals Recurrent Self-Induced Nontraumatic Orbital Emphysema Causing Orbital Compartment Syndrome with Optic Nerve Dysfunction

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. Cutting ◽  
C. Davies-Husband ◽  
C. Poitelea
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Compartment Syndrome ◽  
Valsalva Manoeuvre ◽  
First Case ◽  
Orbital Emphysema ◽  
History Of ◽  
Nerve Dysfunction ◽  
The Right ◽  
Needle Decompression

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction. The patient underwent emergency needle decompression. A 51-year-old man presented to the Emergency Department with right-sided unilateral proptosis, reduced visual acuity, and binocular diplopia. This occurred after performing a Valsalva manoeuvre with no history of head trauma. He also mentioned that over the past year he had experienced multiple episodes of transient proptosis occurring after Valsalva manoeuvres. Visual acuity in the right eye was reduced to 6/21. A relative afferent pupillary defect was present and intraocular pressure (IOP) was 12 mmHg. The CT scan showed significant orbital emphysema in the medial aspect of the right orbit. Needle decompression was performed resulting in immediate resolution of his symptoms. This case demonstrates that, in cases of orbital emphysema, a lack of a history of trauma and a normal IOP cannot always be used to rule out serious pathology.

scholarly journals Ocular Decompression Retinopathy with Macular Edema after Deep Sclerectomy with Intrascleral Implantation

2020 ◽  
Vol 11 (1) ◽  
pp. 151-155
Author(s):  
Pablo Diaz Aljaro ◽  
Jordi Loscos Arenas ◽  
Laura Broc Iturralde ◽  
Marc Carbonell Puig ◽  
Pau Romera Romero
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Medical Therapy ◽  
Open Angle Glaucoma ◽  
Retinal Hemorrhage ◽  
Eye Drops ◽  
Medical Procedure ◽  
Deep Sclerectomy ◽  
Pars Plana ◽  
Decompression Retinopathy

We report a case of ocular decompression retinopathy (ODR) with macular edema, diagnosed by optical coherence tomography, after a deep sclerectomy (DS) with an intrascleral implant, resolved with medical therapy 6 months later. The medical literature reports that in 14% of patients suffering from ODR, a pars plana vitrectomy was required, and 15% of patients had a poor final visual acuity. An otherwise healthy 75-year-old man with high myopia and a primary open-angle glaucoma, with previous intraocular pressure (IOP) of 24 mm Hg, underwent a DS with intrascleral implant without complications. The patient suffered postoperatively from ODR with macular edema that required medical therapy with nonsteroidal anti-inflammatory eye drops (Nepafenac® 0.3%) for a period of 6 months. ODR is an infrequent complication that may occur after any surgical or medical procedure that causes a sudden IOP decrease. The presence of macular edema is only reported in 5% of cases and can occur in patients who report a decreased visual acuity, commonly associated with a retinal hemorrhage. We have described a case of ODR with macular edema after DS with intrascleral implant. Although ODR is considered to cause a low level of morbidity, in some patients this may not be the case.

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 IMPROVEMENT OF LEUKEMIC RETINOPATHY AFTER LEUKAPHERESIS IN CHRONIC MYELOGENOUS LEUKEMIA WITH LEUKOSTASIS

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Ruchyta Ranti ◽  
Sauli Ari Widjaja ◽  
Wimbo Sasono ◽  
Muhammad Firmansjah ◽  
Ima Yustiarini ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Chronic Myelogenous Leukemia ◽  
Visual Disturbance ◽  
Myelogenous Leukemia ◽  
Laboratory Examination ◽  
Retinal Hemorrhages ◽  
Case Presentation ◽  
Retinal Blood Vessels ◽  
Wbc Count ◽  
The Right

ABSTRACT Introduction: to report a case of bilateral leukemic retinopathy due to leukostasis that was successfully managed by leukapheresis. Case Presentation: 31-year-old male with mild visual disturbance was referred to ophthalmology department. He suffered from Chronic Myelogenous Leukemia (CML) with white blood cell (WBC) count 533.900/microL. He was started on hydroxyurea, allopurinol, and once leukapheresis. Ophthalmologic evaluation revealed visual acuity of 4/4 in the right eye and 4/6,3 in the left eye. Funduscopy examination showed the presence of bilateral papilledema, venous engorgement, tortuosity, and retinal hemorrhages. Then this patient continued with second leukapheresis. Result: Visual acuity, laboratory examination, and funduscopic finding was evaluated. His visual acuity was improved, papilledema and retinal blood vessels abnormality had markedly reduced concurring with the patient’s hematological remission. Decreasing WBC count after leukapheresis has improved blood flow that reflected from the retinal findings and visual acuity improvement. Conclusion: Leukapheresis treatment is sufficient to improved clinical condition for leukemic retinopathy caused by CML with leukostasis. Keywords: chronic myelogenous leukemia (CML), hyperleukocytosis, leukostasis, leukemic retinopathy

scholarly journals Nd:YAG Laser Photodisruption for Multilevel Premacular Hemorrhage due to Isolated Retinal Venous Macroaneurysm

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Kenan Sonmez ◽  
Pehmen Y. Ozcan
Keyword(s):  
Visual Acuity ◽  
Fluorescein Angiography ◽  
Laser Treatment ◽  
Nd:Yag Laser ◽  
Blood Cells ◽  
Internal Limiting Membrane ◽  
Hand Motion ◽  
First Case ◽  
The Right

A 55-year-old man presented with sudden deterioration of vision in the right eye. His visual acuity was reduced to hand motion because of a large multilevel premacular hemorrhage. Nd:YAG laser was performed to drain the entrapped hemorrhage under the internal limiting membrane (ILM) and posterior hyaloid face in the macula into the vitreous. Immediately after laser treatment, streaming of red blood cells into the vitreous gel through the perforation site was observed. At the first-month follow-up, BCVA improved to 20/25 and ILM wrinkling was observed at the macula where the preretinal hemorrhage cleared. Fluorescein angiography revealed an isolated retinal venous macroaneurysm located on the macular branch of the superotemporal vein at the bifurcation site. In contrast to retinal arterial macroaneurysms, retinal venous macroaneurysms are quite rare. To the best of our knowledge, this is the first case reported with multilevel premacular hemorrhage caused by an isolated retinal venous macroaneurysm.

scholarly journals Intravitreal Aflibercept in Recalcitrant Radiation Maculopathy due to External Beam Radiotherapy for Nasopharyngeal Cancer: A First Case Report

2017 ◽  
Vol 8 (1) ◽  
pp. 87-90 ◽  
Author(s):  
Eleni Loukianou ◽  
Georgia Loukianou
Keyword(s):  
Visual Acuity ◽  
Retinal Thickness ◽  
External Beam Radiotherapy ◽  
Nasopharyngeal Cancer ◽  
External Beam ◽  
Safety And Efficacy ◽  
Corrected Visual Acuity ◽  
First Case ◽  
Intravitreal Aflibercept ◽  
The Right

Purpose: To present the safety and efficacy of intravitreal aflibercept (Eylea) in a patient with radiation maculopathy secondary to external beam radiotherapy for nasopharyngeal cancer unresponsive to other therapeutic options. Methods: A 73-year-old female presented with decreased visual acuity in both eyes 18 months after completing 47 external beam cycles of radiation for nasopharyngeal cancer. On presentation, her best corrected visual acuity was 6/60 in the right eye and counting fingers from 1 meter in the left eye. She received 5 bevacizumab injections in the right eye and 7 bevacizumab injections in the left eye over the last year without any improvement. A treatment with intravitreal injections of aflibercept was recommended in both eyes. Results: The patient received 3 intravitreal aflibercept injections (2 mg/0.05 mL) in each eye every 4 weeks. The visual acuity improved from 6/60 to 6/12 in the right eye and from counting fingers to 6/36 in the left eye. Biomicroscopy showed less exudates, hemorrhages, and microaneurysms. Optical coherence tomography revealed reduced central retinal thickness in both eyes after 1–3 intravitreal aflibercept injections. Conclusion: Intravitreal aflibercept should be regarded a safe and effective treatment in patients with recalcitrant macular edema due to radiation maculopathy.

scholarly journals Surgical tretment of postcontusion orbital hem atom a in its late phase

2003 ◽  
Vol 131 (9-10) ◽  
pp. 396-399 ◽  
Author(s):  
Milos Jovanovic
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Surgical Intervention ◽  
Late Phase ◽  
Fat Tissue ◽  
Retinal Hemorrhages ◽  
Contusion Injury ◽  
The Right ◽  
Orbital Hematoma ◽  
Retinal Folds

OBJECTIVE The object of the study was to present successfully performed decompression of the orbit in orbital hematoma. MATERIAL AND METHODS Male 51 years of age sustained the contusion injury of the right eye during his fall on the bath tap. It caused the development of a large orbital hematoma with protrusion, restricted movement of the eyeball, pain, diplopia folding of the retina due to hemtoma compression to bulbus oculi and retinal hemorrhages, higher intraocular pressure and impaired visual acuity to 2/60. He was treated by medicaments for a month, but the results were not favorable. After one month from the injury, anterior-inferior transcutaneous orbitotomy was performed. During the surgical intervention hematoma and a part of orbital fat tissue were removed. RESULTS The globe of the eye was retracted and the exophthalmos disappeared immediately after the surgery, while the mobility of the eyeball, disappearance of retinal folds with gradual receding of hemorrhage, normal intraocular pressure abatement of pain and diplopia as well as the restoration of visual acuity to normal ensued in a few subsequent days. CONCLUSION This study illustrated that decompression of the orbit in orbital hematoma might be successful even in the late phase, e.g., one month following the injury. It is assumed that surgical intervention would be performed by experienced orbital surgeon.

scholarly journals Immediate Manifestation of Ocular Decompression Retinopathy following Anterior Chamber Paracentesis

2019 ◽  
Vol 10 (2) ◽  
pp. 287-291 ◽  
Author(s):  
Jamie Prince ◽  
David Fleischman
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Light Perception ◽  
Laser Trabeculoplasty ◽  
Anterior Chamber Paracentesis ◽  
The Right ◽  
Decompression Retinopathy

Ocular decompression retinopathy (ODR) is a complication of rapid lowering of intraocular pressure (IOP) resulting in hemorrhages in multiple retinal layers. We report a case of ODR that developed within minutes following anterior chamber paracentesis in an adult female with primary open-angle glaucoma. A 61-year-old Black woman with primary open-angle glaucoma presented with marked elevation of IOP (46 mm Hg in the right eye and 30 mm Hg in the left) despite maximal medical therapy and bilateral selective laser trabeculoplasty. Vision in the right eye decreased from counting fingers at 3 feet 1 week earlier to no light perception at the time of presentation. Anterior chamber paracentesis was performed on the right eye to reduce IOP and stabilize the eye until further surgical intervention could be performed. IOP in the right eye decreased to 6 mm Hg postoperatively. Within minutes of the procedure, several intraretinal blot hemorrhages appeared in the periphery of the right eye. During this time, visual acuity remained at no light perception. The findings were consistent with decompression retinopathy. By 12 weeks postoperatively, the ODR had resolved with visual acuity of light perception and normal fundoscopy except for profound cupping. Our case demonstrates how rapidly ocular decompression can form following IOP reduction.

Ocular Decompression Retinopathy after Deep Sclerectomy with Mitomycin C in an Eye with Exfoliation Glaucoma

2011 ◽  
Vol 21 (3) ◽  
pp. 324-327 ◽  
Author(s):  
Vassilios P. Kozobolis ◽  
Eleni Kalogianni ◽  
Andreas Katsanos ◽  
Doukas Dardabounis ◽  
Stavrenia Koukoula ◽  
...  
Keyword(s):  
Mitomycin C ◽  
Deep Sclerectomy ◽  
Exfoliation Glaucoma ◽  
Decompression Retinopathy

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.

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