Sequential bilateral Behçet’s neuroretinitis associated with prepapillary vitreous exudate: case report

Abstract Objective To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and methods A single case report documented with multimodal imaging. Results A 37-year-old man developed neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but 1 year later a similar neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. Swept source (SS) OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCT angiography (OCTA) demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects. Conclusion Sequential bilateral neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.

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Sequential bilateral Behçet’s neuroretinitis associated with prepapillary vitreous exudate: case report

10.21203/rs.3.rs-44040/v3 ◽

2021 ◽

Author(s):

Imen Ksiaa ◽

Safa Ben Aoun ◽

Sourour Zina ◽

Dhouha Nefzi ◽

Sana Khochtali ◽

...

Keyword(s):

Case Report ◽

Single Case ◽

Signal Loss ◽

Fiber Layer ◽

Single Case Report ◽

Shadowing Effect ◽

Eye Involvement ◽

One Year ◽

The Right ◽

Inflammatory Changes

Abstract Objective: To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and Methods: A single case report documented with multimodal imaging.Results: A 37-year-old man developed neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but one year later a similar neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. SS OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCTA demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects.Conclusion: Sequential bilateral neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.

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Sequential bilateral Behçet’s neuroretinitis associated with prepapillary vitreous exudate: case report

10.21203/rs.3.rs-44040/v2 ◽

2020 ◽

Author(s):

Imen Ksiaa ◽

Safa Ben Aoun ◽

Sourour Zina ◽

Dhouha Nefzi ◽

Sana Khochtali ◽

...

Keyword(s):

Visual Acuity ◽

Case Report ◽

Multimodal Imaging ◽

Single Case ◽

Signal Loss ◽

Fiber Layer ◽

Swept Source ◽

Single Case Report ◽

Shadowing Effect ◽

Inflammatory Changes

Abstract Objective: To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral prepapillary inflammatory vitreous exudate (PIVE) documented with multimodal imaging, including swept source optical coherence tomography (SS OCT) and OCT angiography. Material and Methods: A single case report.Results: A 37-year-old man developed sequential bilateral PIVE, initially misdiagnosed as toxoplasmic neuroretinitis, before extraocular features of BD became evident and the patient treated accordingly. SS OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCTA demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects.Conclusion: Sequential bilateral PIVE may occur in the absence of other clinical features of BD. SS OCT and OCTA can provide useful information for the diagnosis and management of PIVE and underlying optic nerve inflammation.

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Multimodal imaging in Behçet disease uveitis manifesting with sequential bilateral prepapillary inflammatory vitreous exudate

10.21203/rs.3.rs-44040/v1 ◽

2020 ◽

Author(s):

Imen Ksiaa ◽

Safa Ben Aoun ◽

Sourour Zina ◽

Dhouha Nefzi ◽

Sana Khochtali ◽

...

Keyword(s):

Multimodal Imaging ◽

Single Case ◽

Behçet Disease ◽

Behcet Disease ◽

Signal Loss ◽

Fiber Layer ◽

Swept Source ◽

Single Case Report ◽

Shadowing Effect ◽

Inflammatory Changes

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Two-Year Outcome of Aflibercept for the Treatment of Choroidal Neovascularization in Punctate Inner Choroidopathy

Case Reports in Ophthalmology ◽

10.1159/000496143 ◽

2019 ◽

Vol 10 (1) ◽

pp. 24-31 ◽

Cited By ~ 4

Author(s):

Luis Arrevola ◽

María Almudena Acero ◽

María Jesús Peral

Keyword(s):

Visual Acuity ◽

Case Report ◽

Choroidal Neovascularization ◽

Single Case ◽

Case Reports ◽

Oral Prednisone ◽

Case Series ◽

Punctate Inner Choroidopathy ◽

Single Case Report ◽

The Right

Punctate inner choroidopathy (PIC) is a rare inflammatory chorioretinopathy that predominantly affects young myopic women. Visual prognosis is generally good, but occurrence of choroidal neovascularization (CNV) is common and may be vision threatening. Case reports and short case series support the effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) agents (ranibizumab and bevacizumab) for CNV associated with PIC given their anti-angiogenic and anti-inflammatory effects. Evidence concerning aflibercept, a more recent intravitreal anti-VEGF, is limited to a single case report. In this case report, we illustrate the case of a 43-year-old myopic woman presenting with visual acuity loss and distortion in the right eye over the last 5 days in whom CNV associated with PIC was diagnosed. Treatment with 1 injection per month of intravitreal aflibercept for 2 months and full-dose oral prednisone for 1 week, being tapered afterwards, improved visual acuity and resolved CNV, with benefits lasting up to 24 months.

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“At-Home” Photobiomodulation: A New Approach for Bell’s Palsy Treatment

Case Reports in Neurological Medicine ◽

10.1155/2021/5043458 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Carlo Fornaini ◽

Zhao Meng ◽

Elisabetta Merigo ◽

Jean-Paul Rocca

Keyword(s):

Case Report ◽

Single Case ◽

Bell’S Palsy ◽

Pharmacological Therapy ◽

Bell's Palsy ◽

Single Case Report ◽

First Case ◽

Total Fluence ◽

The Right ◽

At Home

Objective. This report is the first one to describe the possibility to use “self‐administered” photobiomodulation (PBM) for Bell’s palsy (BP) treatment. Background. BP is a peripheral disorder of the facial nerve causing sudden paralysis of unilateral facial muscles, and PBM has been successfully suggested for its treatment without any side effect. This is the first case report where a laser device was successfully used at home by the patient herself to treat BP opening new perspectives on the therapy of this disease. Methods. This report describes the “at-home PBM” treatment performed on a 15-year-old girl who presented BP consisting of acute pain on the right side of her face, difficulty in biting and dripping saliva from the right side of her lips. The treatment was performed twice a day by cutaneous applications, each of 15 minutes (total fluence 48 J/cm2) in an area corresponding to the parotid gland by a device emitting at 808 nm at 250 mW output power. Results. Two weeks after PBM treatment, performed at home twice a day by the patient herself without any kind of pharmacological therapy, the complete disappearing of the disease was noticed with no side effects. Conclusion. With the limitations due to a single case report and with the need of further clinical trials to confirm it, “at-home PBM” seems to represent a good and safe approach to the treatment of BP.

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Katupila (Securinega leucopyrus) A Boon for Bedsore- A Case Report

Journal of Natural Remedies ◽

10.18311/jnr/2020/24855 ◽

2021 ◽

Vol 20 (4) ◽

pp. 198

Author(s):

Snehal Sonani ◽

Vivekanand Kullolli ◽

Krishna Thorat

Keyword(s):

Case Report ◽

Single Case ◽

Decubitus Ulcer ◽

External Pressure ◽

Decubitus Ulcers ◽

External Application ◽

Single Case Report ◽

Bony Prominence ◽

The Right ◽

Patent Medicine

Pressure ulcer is a sequel of tissue necrosis and ulceration due to prolonged pressure. External pressure of more than 30 mmHg on the skin leads to ischemia (reduced blood flow) causing ischeohypoxia, necrosis and ulceration. It is more common between bony prominence and an external surface. It may be due to impaired blood supply, defective nutrition and neurological deficit. Ayurveda describes this type of non-healing ulcer in terms of Dusta vrana, in that context Acharya Sushruta had also mentioned it as “Dirghakalanubandhi” which suggests that these kind of ulcers take longer time to heal due to underlying reasons. This article is about the single case report of a 51-year-old male patient with a stage 3 decubitus ulcer over the right heel since 2 months. As decubitus ulcers especially of stage 3 is difficult to cure, ayurvedic management with internal medication and external therapy was performed in this reported case. For Internal medication, Tablet septilin (A Patent medicine of Himalaya pharmacy, India) and Punarnavadi kashay (A Patent medicine of Vaidhyaratnam pharmacy, India) was used for enhancement of better wound healing. For external application Paste Katupila and honey was applied for 30 days. According to the assessment, wound showed good response within 10 days and was completely healed in 30 days.

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