Vision loss in a pregnant woman with nephrotic syndrome

2021 ◽  
pp. 112067212110547
Author(s):  
Zoi Tsani ◽  
Antonios Ntafos ◽  
Victoria Toumanidou ◽  
Anna Dastiridou ◽  
Ioanna Ploumi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Nephrotic Syndrome ◽  
Pregnant Woman ◽  
Vision Loss ◽  
Pigment Epithelium ◽  
Hand Motion ◽  
Corrected Visual Acuity ◽  
Visual Acuity Loss ◽  
The Right

Purpose To report acute visual acuity loss in a pregnant woman with nephrotic syndrome. Case Report A 34-year-old pregnant woman was referred to our service for acute, bilateral visual impairment, associated with bilateral below knee edema (BKE). Best-corrected visual acuity (BCVA) was hand motion in the right eye and 20/200 in the left eye. Dilated fundus exam disclosed multiple pigment epithelium detachments involving the macula in both eyes. After consultation with a nephrologist a diagnosis of nephrotic syndrome was made. Unfortunately, a week later she lost the fetus. At follow-up evaluation, 20 days after the miscarriage, BCVA improved to 20/25 in both eyes with near normal restoration of the retinal anatomy. Conclusion In nephrotic syndrome, sequestration of interstitial fluids, which leads to classic generalized edema, could be the origin of interstitial accumulation of fluids in the retinal and subretinal layers. Increased awareness by the gynaecologists and prompt treatment may prevent fetus miscarriage.

Macular Telangiectasia Type 2 With Spontaneous Resolution of Intraretinal/Sub-Internal Limiting Membrane Hemorrhage in the Absence of Neovascularization

2017 ◽  
Vol 1 (6) ◽  
pp. 415-419 ◽  
Author(s):  
Varun Chandra ◽  
Rohan Merani ◽  
Alex P. Hunyor ◽  
I-Van Ho ◽  
Mark Gillies
Keyword(s):  
Visual Acuity ◽  
Multimodal Imaging ◽  
Internal Limiting Membrane ◽  
Macular Telangiectasia ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Macular Telangiectasia Type 2 ◽  
The Right

Purpose: To describe a case of macular telangiectasia type 2 (MacTel) presenting with decreased vision due to intraretinal/sub-internal limiting membrane (ILM) hemorrhage in the absence of neovascularization. Method: Clinical examination and multimodal imaging were performed. Results: A 65-year-old female presented with blurred left vision, recording 20/160 in that eye. There was intraretinal hemorrhage at the left macula centrally, with sub-ILM hemorrhage superiorly and inferiorly. Optical coherence tomography (OCT) showed no evidence of subretinal neovascularization. Imaging of the right macula was consistent with MacTel. The blood spontaneously cleared and the left visual acuity gradually improved to 20/25 by 4 months. Fluorescein angiography confirmed MacTel, and once the hemorrhage resolved, both inner and outer retinal cavitation was identified on OCT of the left macula. The left best-corrected visual acuity remained at 20/25 at 2-year follow-up. Conclusion: Spontaneous resorption of hemorrhage was accompanied by visual improvement.

scholarly journals Avaliação dos Resultados do Tratamento Antiangiogénico na Neovascularização Coroideia Associada à Miopia Patológica

2014 ◽  
Vol 27 (1) ◽  
pp. 49 ◽  
Author(s):  
Beatriz Carvalho ◽  
Paulo Freitas-Costa ◽  
João Pinheiro-Costa ◽  
Manuel Falcão ◽  
Ângela Carneiro ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Vision Loss ◽  
Long Term Results ◽  
Myopic Choroidal Neovascularization ◽  
Corrected Visual Acuity ◽  
Foveal Center ◽  
Best Corrected Visual Acuity

<strong>Introduction:</strong> Choroidal neovascularization secondary to pathological myopia is one of the leading causes of irreversible central vision loss in younger patients. The purposes of our study is to evaluate the long-term results of antiangiogenic treatment, with ranibizumab and/or bevacizumab, in myopic choroidal neovascularization and define the predictive factors for visual and anatomic outcomes.<br /><strong>Material and Methods:</strong> In this study were included 84 eyes from 81 patients with myopic choroidal neovascularization. Eighty-four (100%) eyes accomplish 12 months of follow-up, 67 (79.8%) 24 months, 54 (64.3%) 36 months, 29 (34.5%) 48 months, and 15 (16.7%) 60 months. We retrieved data related to best corrected visual acuity measured with ETDRS chart, foveal center thickness on optical coherence tomography and fluorescein angiographic findings, before and after treatment.<br />Results: The best corrected visual acuity and foveal center thickness improvements were statistically significant for all follow-up times (p &lt; 0.05). Mean baseline best corrected visual acuity was 43.7 ± 20.1 letters and mean baseline foveal center thickness was 304.8 ± 127.9μm. Mean best corrected visual acuity was 55.6 ± 18.5, 52.1 ± 22.3, 52.1 ± 22.6, 50.3 ± 23.8 and 47.8 ± 24.5 for 12, 24, 36, 48 and 60 months of treatment, respectively. Mean foveal center thickness was 209.7 ± 86.2, 190.6 ± 76.1, 174.7 ± 60.6, 189.8 ± 96.7 and 159.4 ± 73.3 for the same follow-up times. Baseline best corrected visual acuity was the only predictive factor for better visual outcome (p &lt; 0.001).<br /><strong>Discussion/Conclusion:</strong> Intravitreal anti-VEGF injections in patients with myopic choroidal neovascularization yielded a significant and sustained functional and anatomic improvement. Randomized long-term clinical trials are needed to determine the sustained efficacy of these drugs.

Fingolimod-associated central serous chorioretinopathy in a young girl

2021 ◽  
Vol 14 (8) ◽  
pp. e243207
Author(s):  
Gajanan Chavhan Pratima ◽  
Doris Benita ◽  
Sandip Sarkar ◽  
Amit Kumar Deb
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Complete Resolution ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Corrected Visual Acuity ◽  
Sphingosine 1 Phosphate ◽  
Eye Examination ◽  
The Right

Fingolimod is a sphingosine-1-phosphate analogue used for the treatment of multiple sclerosis. We, hereby, report a rare case of fingolimod-associated central serous chorioretinopathy (CSCR) in a 21-year-old woman who presented with blurring of vision in the right eye 3 weeks after initiation of oral fingolimod. On examination, best-corrected visual acuity was 20/20 in both the eyes. Fundus examination revealed shallow, serous macular neurosensory detachment in the right eye, and it was confirmed with spectral domain optical coherence tomography. Left eye fundus was normal. Fluorescein angiography showed focal retinal pigment epithelium leak inferior to the fovea. A diagnosis of fingolimod-associated CSCR was made. Oral fingolimod was discontinued. Subsequent follow-up visits showed partial resolution of CSCR at 2 weeks and at 1 month and complete resolution of the subretinal fluid at 2 months. CSCR is, therefore, a rare adverse effect of oral fingolimod treatment. Baseline eye examination and subsequent follow-up at regular intervals are recommended for patients on fingolimod.

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.

Multimodal imaging in iodate-induced toxic retinopathy

2020 ◽  
pp. 112067212092686
Author(s):  
Sebile Çomçalı ◽  
Pınar Topcu Yılmaz ◽  
Cemal Çavdarlı ◽  
Mehmet Numan Alp
Keyword(s):  
Visual Acuity ◽  
Retinal Pigment Epithelium ◽  
Iodine Deficiency ◽  
Vision Loss ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Vitamin Supplementation ◽  
Potassium Iodate ◽  
Intentional Ingestion ◽  
The Right

Introduction Iodine deficiency is a leading cause of preventable physical and mental retardation. Potassium iodate is used for iodine supplementation to prevent iodine deficiency. We herein report a case of toxic retinopathy following intentional ingestion of potassium iodine. Case Presentation A 41-year-old male presented with a 5-day history of blurred vision in both eyes. His visual acuity (VA) was hand motion and his pupillary reactions were sluggish bilaterally. The fundus examination revealed bilaterally diffuse retinal pigment epithelium atrophy and secondary pigmentary changes at the posterior pole, but his peripheral fundus was relatively spared. Choroidal thinning, punctate hyperreflective dots along the retinal pigment epithelium layer, and outer retinal atrophy were the optical coherence tomography findings, which were consistent with widespread areas of retinal pigment epithelium window defects observed on fundus fluorescein angiography. The visual evoked potential test showed no response in the right eye and revealed a delay in the latency and a decrease in the amplitude of the P100 wave in the left eye. Wave b responses of the photoreceptors could not be observed in the patient’s electroretinogram. After a vitamin supplementation protocol consistent with the literature, at the 4-month follow-up visit his visual acuity had improved to 0.3 in the right eye and counting fingers in the left eye. Conclusion Potassium iodate toxicity is a cause of serious retinal and choroidal damage and results in severe vision loss. Hydration, hemodialysis, and antioxidants can be helpful to minimize the complications.

Syphilitic Outer Retinopathy: A Case Report and Review of the Literature

2021 ◽  
pp. 247412642110183
Author(s):  
Claudia Amaral ◽  
Leilani Joy ◽  
Hiram Jimenez ◽  
Yousef J. Cruz-Inñigo ◽  
Jan P. Ulloa-Padilla ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Vision Loss ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Oral Prednisone ◽  
Posterior Uveitis ◽  
Central Scotoma ◽  
Demarcation Line

Purpose: This work presents a case of syphilitic outer retinopathy with findings similar to those of acute zonal occult outer retinopathy (AZOOR). We also discuss the clinical characteristics, treatment, and prognosis of this entity. Methods: A case report and systematic literature review are presented. Results: A 56-year-old woman presented with acute vision loss, localized photopsia, a central scotoma, and retinal findings that were all consistent with AZOOR. A further workup led to a diagnosis of syphilis. Oral prednisone and intravenous penicillin resulted in the resolution of the posterior uveitis and the restoration of visual acuity. However, the central scotoma remained at the 3-year follow-up visit. Conclusions: Syphilitic outer retinopathy is a distinct entity characterized by the disruption of the ellipsoid zone visible on optical coherence tomography and a corresponding increase in fundus hyperautofluorescence in the affected areas. Although some patients may present with a demarcation line, as is seen with AZOOR, the fundus is oftentimes unremarkable or may show only subtle retinal pigment epithelium changes. Uveitis resolution and visual acuity restoration may be expected following treatment; however, visual field disturbances may persist.

scholarly journals DMEK IN KERATOCONUS WITH ACUTE HYDROPS: A CASE REPORT

2018 ◽  
Vol 17 (3) ◽  
pp. 81
Author(s):  
Lucio V L Maranhão ◽  
Paulo E C Dantas ◽  
Natalia R L Ramalho ◽  
Wanessa P Pinto
Keyword(s):  
Visual Acuity ◽  
Corneal Edema ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Hand Motion ◽  
Severe Visual Loss ◽  
Corrected Visual Acuity ◽  
Corneal Hydrops ◽  
The Right ◽  
Initial Results ◽  
Best Corrected Visual Acuity

We describe the initial results of a Descemet Membrane Endothelial Keratoplasty (DMEK) procedure for acute corneal hydrops in a 45-years female with keratoconus that presented with severe visual loss in the left eye (OS). The patients’ best-corrected visual acuity at presentation in the right eye was 20/80 and hand motion in OS. Slit-lamp examination revealed an extensive Descemet’s membrane tear and stromal corneal edema in OS. Two months after the DMEK procedure, the patient presented with a best corrected visual acuity of 20/200 in the affected eye, corneal edema improvement, and an attached Descemet graft.  

scholarly journals Explantation and Rotation of Intracorneal Ring Segments with the Support of Femtosecond Laser: An Asymmetrical Version

2013 ◽  
Vol 2 (1) ◽  
pp. 40-42
Author(s):  
E Levinger ◽  
S Levinger ◽  
A Hirsh
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Lower Segment ◽  
Medical Optics ◽  
Corrected Visual Acuity ◽  
Body Sensation ◽  
Uncorrected Visual Acuity ◽  
The Right ◽  
Visual Results

ABSTRACT Purpose To report a 25-year-old man who presented with advance keratoconus in the right eye with uncorrected visual acuity (UCVA) of 0.2 and best spectacle-corrected visual acuity (BSCVA) of 0.33 with +0.50 −9.25 × 45°. Materials and methods Clinical examination and corneal topography revealed grade III keratoconus in the right eye. Intracorneal ring segments (INTACS SK; Addition Technology, Des Plaines, IL) were implanted without surgical complications at 400 µm, with the 450 µm segments implanted superiorly and inferiorly using the femtosecond laser (Intralase®, Advanced Medical Optics, Inc, Abbott Park, IL). Results For 3 months postoperatively, BSCVA remained at 0.5 with plano −4.50 × 25°. The patient was complaining of foreign body sensation in the upper part of the eye and glare asking the surgeon to remove the two segments. The superior segment was removed and the lower segment was rotated 30° counter clockwise. Three months later, UCVA was 0.67 and remained stable for 24 months of follow-up. Conclusion This report shows that implanting the thicker segment inferiorly provides better visual results. How to cite this article Levinger E, Levinger S, Hirsh A. Explantation and Rotation of Intracorneal Ring Segments with the Support of Femtosecond Laser: An Asymmetrical Version. Int J Kerat Ect Cor Dis 2013;2(1):40-42.

scholarly journals Corneal crosslinking in a case with Axenfeld–Rieger syndrome and unilateral pellucid marginal degeneration

2019 ◽  
Vol 11 ◽  
pp. 251584141882228 ◽  
Author(s):  
Mustafa Koc ◽  
Pinar Kosekahya ◽  
Merve Inanc ◽  
Kemal Tekin
Keyword(s):  
Visual Acuity ◽  
Male Patient ◽  
Vision Loss ◽  
Slit Lamp ◽  
Slit Lamp Examination ◽  
Corneal Crosslinking ◽  
Rieger Syndrome ◽  
Corrected Distance Visual Acuity ◽  
The Right

A 31-year-old male patient presented with the complaint of progressive vision loss in his left eye. Slit-lamp examination showed posterior embryotoxon, iris hypoplasia, and iridocorneal adhesion in both eyes, corectopia in the right, and peripheral inferior thinning and ectasia in the left eye. Corneal topography showed slightly asymmetric bowtie pattern in the right eye and crab-claw pattern in the left eye. Topographic examination was compared with his previous topography. The comparison showed 1.6-D steepening of maximum keratometry ( Kmax) and 22-µm decrease of thinnest corneal pachymetry. Corneal crosslinking treatment was performed on the left eye. At the postoperative 28-month follow-up visit, Kmax decreased from 54.1 to 53.0 D and corrected distance visual acuity improved to 20/20 with scleral lens. This is the first reported a case with Axenfeld–Rieger syndrome and pellucid marginal degeneration association. We suggest that corneal crosslinking can be useful for management of pellucid marginal degeneration and longer follow-up might be needed in order to corroborate the effectiveness of the corneal crosslinking procedure.

scholarly journals Perifoveal exudative vascular anomalous complex in a highly myopic eye

2020 ◽  
Vol 12 ◽  
pp. 251584142094793
Author(s):  
Riccardo Sacconi ◽  
Enrico Borrelli ◽  
Francesco Bandello ◽  
Giuseppe Querques
Keyword(s):  
Visual Acuity ◽  
Fundus Examination ◽  
Corrected Visual Acuity ◽  
Capillary Plexus ◽  
The Right ◽  
Superficial Capillary Plexus ◽  
Best Corrected Visual Acuity ◽  
Past Conditions ◽  
Chorioretinal Degeneration

‘Perifoveal Exudative Vascular Anomalous Complex’ (PEVAC) is a perifoveal, unilateral, isolated, perifoveal aneurysm, in otherwise healthy patients. Here, we report a case of PEVAC in a highly myopic eye of a 86-year-old woman affected by a visual decline in the right eye (best-corrected visual acuity of 20/100). She had no other relevant past conditions and/or ocular impairment. Fundus examination in the right eye showed myopic chorioretinal degeneration with a concomitant PEVAC. Structural optical coherence tomography (OCT) showed a round lesion with a hyperreflective wall associated with intraretinal cystic spaces. OCT-angiography nicely disclosed an isolated large aneurysmal retinal dilation featuring the PEVAC with detectable flow in superficial capillary plexus, deep capillary plexus, and avascular slab. This case highlights the importance of discerning between different vascular disorders of the macula, in order to be able to offer the right treatment and/or follow-up to the patient.

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