scholarly journals A donor twin discordant with Peters anomaly in a twin–twin transfusion syndrome case: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yao-Lung Chang ◽  
An-Shine Chao ◽  
Ching-Yu Chou ◽  
Shuenn-Dyh Chang ◽  
Ming-Chou Chiang ◽  
...  
Keyword(s):  
Gestational Age ◽  
Congenital Cataract ◽  
Anterior Segment ◽  
Corneal Opacity ◽  
Monozygotic Twin ◽  
Genetic Abnormality ◽  
Case Presentation ◽  
Peters Anomaly ◽  
Magnetic Resonance Imaging Mri

Abstract Background Peters anomaly is a rare form of anterior segment ocular dysgenesis, the antenatal image of Peters anomaly had not been reported. We herein showcased a discordant finding of Peters anomaly in a monozygotic twin complicated with twin-twin transfusion syndrome (TTTS) and exhibited its antenatal sonographic images, Case presentation A 38-year-old gravida 2 para 1 pregnant woman visited our clinic at the gestational age of 18 weeks where TTTS stage III was diagnosed and the following laser therapy was done successfully. Ten days after the surgery, the follow-up ultrasound detected the opacity of both fetal eyeballs in the donor twin and thus congenital cataract was suspected initially. Then magnetic resonance imaging (MRI) examination was arranged at the gestational age of 23 weeks, and no central nervous system or other anomaly was found. At the 29 weeks of gestation, the opacity of both fetal eyeballs of the donor twin did not clear. The pregnancy resulted in cesarean section at the gestational age of 37 weeks indicated by malpresentation where two male live births were born. Examination under anesthesia was arranged for donor twin after delivery and Peters anomaly was diagnosed based on central corneal opacity with iridocorneal and corneolenticular adhesions. Conclusions The prenatal image of Peters anomaly may present as the opacity of the fetal eyeballs similar to congenital cataract. Some cases of the Peters anomaly had been reported with a genetic abnormality, but since our case presented discordant presentation in monozygotic twin pregnancy where both twins are supposed to share the same genetic make-up, therefore other factors that are epigenetic may be held accountable. Nevertheless, a genetic origin of the anomaly in our case cannot be excluded.

Abdominopelvic Pain in Patient with Uterus Didelphys and Unilateral Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome)

2021 ◽  
Author(s):  
Zahra Tavoli ◽  
Ali Montazeri
Keyword(s):  
Renal Agenesis ◽  
Primary Diagnosis ◽  
Case Presentation ◽  
Uterus Didelphys ◽  
Future Fertility ◽  
History Of ◽  
Ohvira Syndrome ◽  
Obstructed Hemivagina ◽  
Magnetic Resonance Imaging Mri

Introduction: Uterus didelphys with obstructed hemivagina associated with ipsilateral renal agenesis (OHVIRA syndrome) is a rare female urogenital malformation and delay in its diagnosis could lead to several complications. Case presentation: A 21-year-old virgin woman was admitted to the emergency department (ED) with severe abdominal pain, without fever and vaginal discharge. She reported a history of cyclic abdominopelvic pain and dysmenorrhea for 5 years. The primary diagnosis (OHVIRA syndrome) was made using ultrasonography, spiral computed tomography (CT) and magnetic resonance imaging (MRI). In addition, laparoscopy was performed to confirm diagnosis and drain hematosalpinx. Then, hysteroscopy was carried out for septum resection and catheter insertion. At one-month follow-up the ultrasonography showed normal left hemicavity of uterus associated with significant decrease in dysmenorrhea. Conclusion: Being aware of OHVIRA syndrome and clinical suspicion of this rare anomaly are essential for making a timely diagnosis, preventing complications, relieving symptoms, and preserving future fertility.

scholarly journals Complete reconstruction of anterior segment surgery for a patient with traumatic cataract and iris defects: a case report

2019 ◽  
Author(s):  
Zhenyu Wang ◽  
Xuemin Li
Keyword(s):  
Ocular Trauma ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Traumatic Cataract ◽  
Case Presentation ◽  
Iris Defect ◽  
Uncorrected Visual Acuity ◽  
Posterior Synechia ◽  
Anterior Segment Surgery

Abstract Background: Ocular trauma has relationship with variable damage towards anterior segment or posterior segment. Among them, cornea, iris and lens are vulnerable to injury. For patients with traumatic cataract and other anterior segment trauma， complete reconstruction of anterior segment surgery can be a good option to restore patients’ anterior segment that helps them regain their vision. Case presentation: We presented a case of traumatic cataract with iris defects after explosive trauma. A surgery was done to fully reconstruct the anterior segment of the patient’s left eye including separating posterior synechia of iris, removing cataract and implantation of IOL. Postoperatively, the patient didn’t complain about photophobia anymore and the uncorrected visual acuity (UCVA) of the patient reached from counting fingers to 20/25 and remained stable on follow-up at 1 week and 1 month. Conclusion: Our case suggested the importance of completely reconstruct anterior segment for patients who have traumatic cataract with traumatic iris defects and its benefits for society. Keywords: Traumatic cataract; Traumatic iris defect; Surgery

scholarly journals Hypertrophic olivary degeneration concomitant with bilateral middle cerebellar peduncles Wallerian degeneration following unilateral pontine infarction

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bing Bao ◽  
Xiangbin Wu ◽  
Zhongbin Xia ◽  
Yaoyao Shen
Keyword(s):  
Wallerian Degeneration ◽  
Corticospinal Tract ◽  
Brain Magnetic Resonance Imaging ◽  
Acute Onset ◽  
Case Presentation ◽  
Hypertrophic Olivary Degeneration ◽  
Pontine Infarction ◽  
Cerebellar Peduncles ◽  
Magnetic Resonance Imaging Mri

Abstract Background Wallerian degeneration (WD) can occur in different projecting systems, such as corticospinal tract, dentate-rubro-olivary pathway, and corticopontocerebellar tract. However, the co-occurrence of hypertrophic olivary degeneration (HOD) and middle cerebellar peduncles (MCPs) degeneration secondary to unilateral pontine infarction in a single patient is extremely rare. Case presentation A 71-year-old man presented with acute onset of dizzness, slurred speech, and right-sided weakness. On the next day, his previous neurologic deficits deteriorated. Brain magnetic resonance imaging (MRI) revealed acute ischemic stroke of the left pons. After treatment with thrombolysis, antiplatelets, and rehabilitation training, his speaking and motor function improved moderately. At the 3-month follow-up, the MRI showed hyperintensity in the left medulla oblongata and bilateral MCPs on T2-weighted and FLAIR images, suggesting HOD as well as MCPs degeneration. Conclusions It is of great importance for us to know the anatomic knowledge of dentate-rubro-olivary and corticopontocerebellar pathways.

scholarly journals Clinical Application of Foldable Capsular Vitreous Bodies in the Treatment of Severe Ocular Trauma and Silicone Oil Dependent Eyes

2021 ◽  
Author(s):  
Hao Jiang ◽  
Chao Xue ◽  
Yanlin Gao ◽  
Ying Chen ◽  
Yan Wang
Keyword(s):  
Visual Acuity ◽  
Clinical Application ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Anterior Segment ◽  
Vitreous Body ◽  
Corneal Opacity ◽  
Ultrasound Biomicroscopy ◽  
Significant Difference

Abstract Background: Recently, a new type of foldable capsular vitreous body (FCVB) has been developed for clinical application to fill the vitreous cavity with vitreous substitutes. It may be an ideal substitute for the vitreous body in eyes with severe retinal detachment. The aim of this study was to assess the application of a foldable capsular vitreous body (FCVB) in the treatment of severe ocular trauma and silicone oil (SO) dependent eyes.Methods: A retrospective analysis was performed on the clinical application of FCVB in the treatment of severe ocular trauma and SO dependent eyes. The results of best-corrected visual acuity and intraocular pressure (IOP) evaluation, B-scan ultrasonography or color Doppler ultrasonography, ultrasound biomicroscopy, and anterior segment photography were recorded during follow-up. A paired t-test was used to compare the difference in IOP before and after FCVB implantation. Results: Seven eyes of seven patients were included in the 6 months follow-up. In all cases, B-scan ultrasonography and ultrasound biomicroscopy showed that FCVB adapted closely to the globe wall and ciliary body, thus supporting the retina. Visual acuity did not improve, except in one case from LP to HM. The mean±SD IOP was 9.29±1.60mmHg prior to FCVB implantation and 10.43±0.98mmHg after implantation, with no significant difference between these measurements (P=0.066). Five of the seven patients developed differing degrees of corneal opacity and keratopathy. Conclusions: FCVB implantation may be a safe and effective method for the treatment of severe ocular trauma and SO dependent eyes. However, corneal opacity and keratopathy are potential serious complications after surgery. Appropriate case selection and proper surgical time require further investigation.

scholarly journals Palladium-103 plaque therapy for multifocal iris melanoma: Radiation of the entire anterior segment of the eye

2020 ◽  
pp. 112067212091423
Author(s):  
Paul T Finger ◽  
Ankit Singh Tomar ◽  
Kimberly J Chin
Keyword(s):  
Visual Acuity ◽  
Local Control ◽  
Anterior Segment ◽  
Case Series ◽  
Corneal Opacity ◽  
Iris Melanoma ◽  
Good Visual Acuity ◽  
Eye Plaque ◽  
Plaque Brachytherapy

Purpose: To investigate the safety and tolerability of total anterior segment palladium-103 (103Pd) eye plaque brachytherapy for multifocal iris melanoma. Methods: Interventional case series of 11 patients with multifocal iris melanomas. Anterior segment ultrasound revealed tumor size, location, and intraocular margins. Epicorneal amniotic membrane grafts protected the cornea and decreased pain during total anterior segment 103-Pd ophthalmic plaque brachytherapy. Results: Eleven diffuse iris melanomas were American Joint Committee on Cancer 8th edition–classified as T1 (n = 5, 45.5%) and T2 (n = 6, 54.5%). Plaque radiation was completed to a minimum mean tumor dose of 85 Gy (mean dose rate, 58.1 cGy/h). Ultrasonographic tumor thickness regression was 41% (follow up mean 58.7, median 50, range: 8–139 months). Despite 100% local control and 100% eye retention, one patient (9.1%) developed metastatic disease. Four eyes required cataract surgery. There was no corneal stem-cell deficiency, corneal opacity, radiation maculopathy, or optic neuropathy. While visual acuity prior to treatment was 20/40 or better in 10 (91%), 9 were 20/40 or better (81.9%) at last follow-up. Four (36%) had glaucoma prior to treatment and three eyes developed glaucoma after treatment for a total of 63%. Conclusion: Total anterior segment (103Pd) plaque brachytherapy resulted in local control, good visual acuity, eye and life preservation in the treatment of multifocal iris melanoma.

Should Unilateral Congenital Corneal Opacities in Peters’ Anomaly be Grafted?

2011 ◽  
Vol 21 (6) ◽  
pp. 695-699 ◽  
Author(s):  
Chrysanthi Basdekidou ◽  
Pascal Dureau ◽  
Catherine Edelson ◽  
Patrice De Laage De Meux ◽  
Georges Caputo
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Axial Length ◽  
Corneal Opacity ◽  
Late Complications ◽  
Posterior Segment ◽  
Time Of Surgery ◽  
Peters Anomaly ◽  
Corneal Opacities

Purpose. To evaluate the surgical outcomes and visual results after penetrating keratoplasty for congenital unilateral corneal opacities in Peters anomaly. Methods. This was a retrospective study of 14 children who underwent keratoplasty for a unilateral Peters anomaly between 1999 and 2009. All patients received a topical treatment of cyclosporine and corticosteroids. Suture ablation was performed between the first and second postoperative month and all patients had spectacle correction and amblyopia treatment. Age at time of surgery, posterior segment status evaluated by ultrasonography, axial length, preoperative intraocular pressure, fellow eye status, mean follow-up time, early and late complications, final graft outcome, refraction, and visual acuity upon the last visit were noted. Results. Mean age at the time of surgery was 9 months. Posterior segment was normal in all cases. Mean axial length was 18 mm and mean intraocular pressure was 11 mmHg. Mean follow-up was 30 months. Four children had graft rejection episodes, 2 of which responded to medication. Four underwent cataract surgery, one developed pupil deformation requiring a pupilloplasty and 2 cases were complicated by surgical glaucoma. A total of 11 eyes (78.6%) had clear grafts at the end of the follow-up. Mean spherical equivalent was −1.5 D. Visual acuity was measurable in 3 cases and was 20/50 in one case, 20/63 in the second, and 20/2000 in the third. Concerning preverbal children, central, steady, and maintained fixation was found in 8 cases. Conclusions. Operating on a unilateral congenital corneal opacity is a challenging decision and should be taken after explaining the need for long-term follow-up to the parents. Useful vision can be achieved and maintained after strict amblyopia therapy. A multidisciplinary ophthalmologic follow-up is necessary.

scholarly journals A Clinical Case of Two-Stage Visual-Functional Rehabilitation of a Patient with Postinfectious Central Corneal Opacity in Combination with Mixed Astigmatism Using Laser Keratorefractive Surgery

2021 ◽  
Vol 18 (4) ◽  
pp. 981-987
Author(s):  
N. V. Maychuk ◽  
I. A. Mushkova ◽  
M. R. Obraztsova
Keyword(s):  
Clinical Case ◽  
Treatment Algorithm ◽  
Visual Fields ◽  
Anterior Segment ◽  
Functional Results ◽  
Corneal Opacity ◽  
Film Rupture ◽  
Two Stage ◽  
Functional Rehabilitation

Introduction: to evaluate the clinical and functional results of two-stage treatment in a patient with post-infectious Central corneal opacity combined with mixed astigmatism.Patient and methods. Patient N., 19 years old with postinfectious (postherpetic) Central corneal opacity, mixed astigmatism was examined and operated using two-stage corneal laser treatment. To determine the possibility of surgical treatment of the patient, a complex of General ophthalmology was performed (checking visual acuity near and far in natural conditions and in conditions of drug-induced mydriasis, IOP measurement, autorefractometry, examination of visual fields, A- and Bscanning, ophthalmoscopy with examination of the Central and peripheral areas of the fundus), as well as special (keratopography and Scheimpflug camera examination, optical coherence tomography (OCT) of the anterior segment of the eye with analysis of the epithelial map, quantitative assessment (Schirmer test-1) and qualitative (tear film rupture time) lachrymal products, assessment of the epithelium state when stained with vital dyes and infrared meibography) research methods. To determine the activity of herpetic infection, PCR diagnostics were performed. The follow-up period was 2 years.Results and discussion. To achieve high visual-functional rehabilitation while preserving the native lens, a two-stage treatment algorithm was developed using technologies of laser corneal refractive surgery. At the first stage, in order to regularize the ocular surface and eliminate Central corneal opacity, an inverted topographically oriented PRK was performed; at the second stage, residual refractive errors were corrected using topographically oriented FemtoLASIK technology.Conclusion. According to the results of a literature search and analysis of Internet resources, there were no previously recorded and published works using a similar two-stage method. Therefore, the described clinical case justifies the relevance and novelty of the goal and has an evidence-based Foundation for the use of a two-stage laser keratorefractive treatment system in the ophthalmological practice of visual and functional rehabilitation of patients with Central corneal opacity in combination with mixed astigmatism or hypermetropic refraction. The two-year postoperative follow-up period showed stable and high visual-functional results with no recurrence of the inflammatory process.

scholarly journals Overlapping syndrome mimicking infectious meningoencephalitis in a patient with MOG and GFAP IgG

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suqiong Ji ◽  
Chenchen Liu ◽  
Zhuajin Bi ◽  
Huajie Gao ◽  
Jian Sun ◽  
...  
Keyword(s):  
White Matter ◽  
Oral Prednisolone ◽  
Pulse Therapy ◽  
Tuberculosis Treatment ◽  
Case Presentation ◽  
Steroid Pulse ◽  
Csf Analysis ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract Background Central nervous system overlapping autoimmune syndromes are uncommon, especially with the coexistence of MOG-IgG and GFAP-IgG. Case presentation A 23-year-old woman presented with transient convulsions, a loss of consciousness, persistent fever, headache, and vomiting. Cerebrospinal fluid (CSF) analysis revealed elevated cellularity, and magnetic resonance imaging (MRI) showed diffuse leptomeningeal enhancement. She had fever and headache with antiviral and antibiotic treatment for 2 weeks, and she had empirical anti-tuberculosis treatment and oral prednisolone therapy. She was followed for 3 months after presentation with improved symptoms and normal CSF analysis. A 3-month follow-up MRI showed asymmetric lesions in the cerebellum, corona radiata, and white matter with enhancement. The anti-tuberculosis treatment was continued, and steroid therapy was discontinued. After she stopped taking prednisolone, an interrupted headache gradually appeared. MRI at 4 months after presentation revealed a partial reduction in lesions but enlarged areas in the left cerebellum and right parietal white matter and a new lesion in the region of the right ependyma with linear enhancement. Her CSF was positive for anti-myelin oligodendrocyte glycoprotein (MOG) and anti-glial fibrillary acidic protein (GFAP) antibodies using a transfected cell-based assay. She was diagnosed with overlapping syndrome of MOG‑IgG‑associated disease and GFAP astrocytopathy. She received steroid pulse therapy (methylprednisolone, 1 g for 5 days), followed by a gradual tapering of oral prednisolone and the addition of an immunosuppressant (tacrolimus, 3 mg per day). Six months after the initial presentation, she had no symptoms. An MRI showed that the lesions had diminished, and no enhancement was found. Conclusions We report a case that was positive for double antibodies, which was initially misdiagnosed as infectious meningoencephalitis. This case broadens the clinical and phenotypic presentation of the overlapping syndrome spectrum.

scholarly journals Renal Cell Carcinoma Initially Presenting as an Arteriovenous Malformation: A Case Presentation and a Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Samuel Volin ◽  
Peter Steinberg ◽  
Derek Mittleider
Keyword(s):  
Renal Cell Carcinoma ◽  
Arteriovenous Malformation ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Arterial Embolization ◽  
Case Presentation ◽  
Renal Arteriovenous Malformation ◽  
Magnetic Resonance Imaging Mri ◽  
Monitor Treatment Response

We describe a case of a patient who presented with hematuria and was diagnosed with a renal arteriovenous malformation (AVM). Transcatheter arterial embolization subsequently was performed on this lesion multiple times. Follow-up imaging demonstrated that the AVM was masking an underlying, rapidly growing renal cell carcinoma (RCC). We describe the pathological and radiographic characteristics of AVMs and RCC. We describe the strengths and weaknesses of computed tomography (CT) and magnetic resonance imaging (MRI) to detect and characterize RCC and AVM. We recommend initial and follow-up MR imaging in patients with an AVM to establish a baseline, monitor treatment response, and survey lesions for underlying and obscured malignancy.

scholarly journals A case of an injured calcaneus secundarius in a professional soccer player

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kepka Sabrina ◽  
Morel Marc ◽  
Garnier Franck ◽  
Pietra François ◽  
Marjanovic Nicolas ◽  
...  
Keyword(s):  
Soccer Player ◽  
Case Presentation ◽  
Anterior Process ◽  
Professional Soccer ◽  
Accessory Ossicle ◽  
Inflammatory Drugs ◽  
Magnetic Resonance Imaging Mri ◽  
Professional Soccer Player

Abstract Background The calcaneus secundarius (CS) is an accessory ossicle of the anterior facet of the calcaneus and is usually asymptomatic. This accessory bone can be frequently mistaken for a fracture of the anterior process of the calcaneus. Few reports of symptomatic CS have been published, and physicians need to be familiar with imaging strategies when encountering chronic ankle pain or in case of suspicion of fracture of the anterior process of the calcaneus. Case presentation We describe the case of symptomatic CS in a professional soccer player injured during a match. First, computed tomography showed a large CS. Second, magnetic resonance imaging (MRI) demonstrated synchondrosis between the CS and the calcaneus, as well as edema (high MR T2 signal) within it, corresponding to posttraumatic edema. The patient was successfully treated with nonsteroidal anti-inflammatory drugs and physiotherapy; no surgical management was necessary. At the 4-week follow-up, he was pain-free and returned to activity. Conclusion This case illustrates the role of imaging for the diagnosis of CS in cases of acute pain of the foot. CT, as well as MRI, helped to confirm the diagnosis of CS traumatized synchondrosis, which can be mistaken for a fracture.

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