scholarly journals Ampiginous Choroiditis

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Joumany Brahim Salem ◽  
Imane Tarib ◽  
Mahdi Khammaily ◽  
Sidi Dahi ◽  
Yassine Mouzari ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Inflammatory Disease ◽  
Neurosensory Retina ◽  
Pigmented Epithelium ◽  
Yellowish White

Ampiginous choroiditis is a rare inflammatory disease that progressively alters the chorio-capillary, pigmented epithelium (PE) and neurosensory retina. We report the case of a 43-year-old patient with decreased visual acuity at finger count (CF) in both eyes, with multiple yellowish-white lesions of varying size, mostly in the peri-papillary region.

Bilateral fungal infection inducing a serpiginous-like picture

2020 ◽  
pp. 112067212090872
Author(s):  
Alvaro Fernández-Vega González ◽  
Carlos Fernández-Vega González ◽  
Beatriz Fernández-Vega Sanz ◽  
María Teresa Peláez ◽  
Jesús Merayo-Lloves
Keyword(s):  
Visual Acuity ◽  
Fungal Infection ◽  
Inflammatory Diseases ◽  
Histopathological Examination ◽  
Clinical Findings ◽  
Blood Analysis ◽  
Retinal Pigmented Epithelium ◽  
Pigmented Epithelium ◽  
Laboratory Investigations ◽  
The Right

Purpose: To report the clinical findings of a patient who presented with an atypical bilateral fungal retinitis that was established by retinochoroidal biopsy. Methods: Case report. Results: A 56-year-old systemically healthy man presented with progressive visual loss in his left eye for 3 weeks. Visual acuity was 20/40 in the left eye, and 20/20 in the right eye and fundus examination showed macular retinal pigmented epithelium changes in his left eye. Over the following four months, his lesions progressed to serpiginous-like widespread retinal pigmented epithelium atrophy and his visual acuity decreased to 20/100, but no signs of ocular inflammation were found. Treatment with oral corticoids, valganciclovir and trimethoprim/sulfamethoxazole showed no efficacy. Blood analysis and cultures, laboratory investigations, and imaging tests were carried out looking for infectious and inflammatory diseases, but all tests were negative. Two months later, the patient presented with the same kind of lesions in the other eye (right eye), so he was subjected to retinochoroidal biopsy. Histopathological examination of specimen revealed the presence of intraretinal and choroidal fungal hyphae. Oral voriconazole was initiated achieving clinical remission, but no visual improvement was obtained. The source of the infection remains unknown since all tests results were negative. However, his profession as brewmaster might be related to the origin of the infection. Conclusion: Diagnosis of intraocular fungal infection can be challenging. Retinochoroidal biopsy may be useful to establish the diagnosis in those atypical cases with nonrevealing workup and inflammation localized to the retina.

scholarly journals Macular Retinoschisis and Its Semiotic Importance: A Case Report

2015 ◽  
Vol 69 (1) ◽  
pp. 40-44
Author(s):  
Milena Golubovic ◽  
Bekim Tatesi ◽  
Igor Isjanovski ◽  
Karolina Buzarovska
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Disease Transmission ◽  
Correct Diagnosis ◽  
Diagnostic Methods ◽  
Hereditary Diseases ◽  
Macular Retinoschisis ◽  
Pigmented Epithelium ◽  
Vitreoretinal Degeneration ◽  
The Right

Abstract Introduction. The concept of retinoschisis means splitting of the layers of neural retina. It can happen equally at the peripheral part of retina, as well as in the region of macula when we talk about macular retinoschisis. Macular retinoschisis appears as one of the characteristics of a few hereditary diseases. According to the ophthalmoscopes’ picture it can easily be mixed with cystoid macular edema. Even though macular changes, in both cases, during time lead to decrease of visual acuity, distinction of macular changes is of semiotic significance in differential diagnosis of retinal diseases, which is important from a broader medical aspect. The aim of this paper is, by presenting a case with a rare hereditary disorder, to show the importance and complementarities of diagnostic methods, especially OCT and its meaning in establishing the correct diagnosis. Case report. The paper presents a patient with macular retinoschisis, as a part of Goldmann-Favre vitreoretinal degeneration. It is a hereditary disorder, which in addition to schisms changes in the macula is characterized by changes in the pigmented epithelium at the medial part of retina. OCT finding in our patient showed cystic hyporeflexive change in the fovea, with palisade oriented smaller hyporeflexive changes, between plexiform layers and in the inner granular layer of the macula. On fluorescein angiography the leakage of the fluorescein in the macular region was absent, but the changes on the level of pigmented epithelium in the area of medial retina were evident. However, perimetry did not show defect in the visual field. Conclusion. Newer diagnostic methods, such as optical coherence tomography, proved their importance in the decision making process and in making the right diagnosis in macular lesions. Beside the fact that the correct diagnosis of the disorder frequently has no importance in the sense of therapeutic possibility of the disease, its value can be seen in proper information of possibility of disease transmission as well as in prediction of affected person’s life perspective, associated with the decrease of visual acuity.

Traumatic macular hole: Clinical aspects and controversies

2020 ◽  
Vol 3 ◽  
pp. 3
Author(s):  
David Pelayes ◽  
Francesc March de Ribot ◽  
Ferenc Kuhn ◽  
Sundaram Natarajan ◽  
Wolfang Schrader
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Spontaneous Closure ◽  
Clinical Aspects ◽  
Full Thickness ◽  
Hole Formation ◽  
Eye Injuries ◽  
Neurosensory Retina ◽  
Macular Hole Formation ◽  
Loss Of Visual Acuity

The traumatic macular hole is a rare pathology posterior to eye injuries, resulting in loss of visual acuity. It generally affects young men. The pathogenesis of macular hole formation after blunt trauma is today controversial. They frequently appear immediately after the injury, nevertheless in some cases can occur weeks later. The vision usually ranges between 20/80 and 20/400. The exploration typically shows a full-thickness defect of the neurosensory retina at the fovea, elliptical, and with irregular edges. The management can include observation under certain conditions because there is a chance of spontaneous closure. Surgery with vitrectomy obtains the closure of the hole in between 92% and 96% of cases.

scholarly journals Correlation Between Refraction Level and Retinal Breaks in Myopic Eye

2008 ◽  
Vol 8 (4) ◽  
pp. 346-349 ◽  
Author(s):  
Emina Alimanović-Halilović
Keyword(s):  
Retinal Detachment ◽  
Age Differences ◽  
Laser Photocoagulation ◽  
Retinal Breaks ◽  
Neurosensory Retina ◽  
Pigmented Epithelium ◽  
Severe Impairment ◽  
Axis Length ◽  
Ophthalmological Assessment

In this study we analyzed 180 myopic eyes in order to determine the refraction that is “critical” for the occurrence of retinal breaks as a main cause of retinal detachment. Detachment of retina involves separation of the neurosensory retina from the pigmented epithelium with the severe impairment of vision. After the focused ophthalmological assessment, determination of objective refraction, indirect binocular ophthalmoscopy, we compared the diagnosed retinal breaks according to the shape with the refraction. All the examined eyes were divided into six groups according to the axis length. Mean age of our patients was between 48,43 and 51,60 years with SD ranging from 13,88 to 18,45. The age differences among the groups were not statistically significant. This study included 102 (56,7%) male and 78 (43,3%) female patients and no statistically significant differences between genders was found regarding the occurrence of retinal breaks compared to refraction. The most dominant ruptures were the round ones (28,2%), followed by oval (25%), the category of multiple small holes (19,2%), horseshoe shaped (15,3%), and finally holes with operculum. In cases with myopic refraction ranging between 3,50 and 7,49 dsph, the frequency of retinal breaks statistically significantly differs from all other analyzed refractions. Also, there is positive correlation between the above mentioned myopic refraction and the frequency of retinal breaks.In order to prevent retinal detachment in a myopic eye, we suggest further thorough examinations of the eye fundus in patients with the above mentioned myopia. Diagnosing retinal breaks involves the application of adequate therapy: laser photocoagulation, cryotherapy, sclera buckling and pneumatic retinopexy.

scholarly journals Management of Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE): Insights from Multimodal Imaging with OCTA

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Mariana A. Oliveira ◽  
Jorge Simão ◽  
Amélia Martins ◽  
Cláudia Farinha
Keyword(s):  
Visual Acuity ◽  
Multimodal Imaging ◽  
Indocyanine Green Angiography ◽  
Optical Coherence Tomography Angiography ◽  
Posterior Pole ◽  
Blurred Vision ◽  
Corrected Visual Acuity ◽  
The Right ◽  
Yellowish White ◽  
Best Corrected Visual Acuity

A 28-year-old man presented to the emergency room with blurred vision in the right eye for two days. He reported a preceding flu-like illness one week earlier. His best-corrected visual acuity (BCVA) was 20/40 in the right eye and 20/25 in the left eye. There was no anterior chamber inflammation or vitritis in either eye. He presented multiple yellowish-white placoid lesions in the posterior pole, some involving the foveal area, bilaterally. General examination and systemic investigation were unremarkable. Multimodal evaluation with fluorescein angiography, indocyanine green angiography, and spectral domain and optical coherence tomography angiography (OCTA) were consistent with the diagnosis of acute posterior multifocal placoid pigment epitheliopathy. Due to centromacular involvement with decreased BCVA, treatment with oral methylprednisolone was started after infectious causes were ruled out. After two weeks, the patient presented functional and anatomical improvement. OCTA showed partial reperfusion of the choriocapillaris in the affected areas, in both eyes.

scholarly journals Fundus Autofluorescence in Multiple Evanescent White Dot Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Fernando Marcondes Penha ◽  
Eduardo Vitor Navajas ◽  
Fábio Bom Aggio ◽  
Eduardo B. Rodrigues ◽  
Michel Eid Farah
Keyword(s):  
Visual Acuity ◽  
Indocyanine Green ◽  
Vision Loss ◽  
Fundus Autofluorescence ◽  
Posterior Pole ◽  
Autofluorescence Imaging ◽  
Fluorescein Angiogram ◽  
White Dot Syndrome ◽  
Neurosensory Retina

A patient complained of photopsia and vision loss in the left eye for two days, with visual acuity of 20/32. Right eye was normal. Funduscopy revealed foveal granularity and gray-white lesions in the posterior pole, mainly temporal to the fovea. The lesions (dots and spots), along with a few other areas surrounding them, showed hyperautofluorescence on autofluorescence imaging. Fluorescein angiogram (FA) depicted some early hyperfluorescent dots with late staining. Indocyanine green angiogram (ICGA) showed hypofluorescent lesions in a greater number compared with funduscopy, autofluorescence, and FA. Thirty days later, BCVA was 20/20 in both eyes and the complimentary exams were almost normal, despite an ICGA that showed few small hypofluorescent lesions. This case supports the hypothesis that the choroidal involvement occurs primarily in MEWDS, with secondary involvement of the RPE and the neurosensory retina.

scholarly journals Case series of clinical features in siblings with X-linked juvenile retinoschisis

2021 ◽  
Vol 3 (3) ◽  
pp. 159-168
Author(s):  
Kah Joon Eng ◽  
Malisa Ami ◽  
Safinaz Mohd Khialdin
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Effective Treatment ◽  
Clinical Features ◽  
Case Series ◽  
Clinical Findings ◽  
Posterior Segment ◽  
The Other ◽  
Juvenile Retinoschisis ◽  
Neurosensory Retina

X-linked juvenile retinochisis (XLRS) is a rare inherited bilateral vitreoretinal dystrophy which usually affects males early in life. We describe the clinical findings, outcome, and challenges in treatment of three siblings diagnosed with XLRS. Three siblings with ages ranging from 5 to 9 years old presented with reduced visual acuity (VA) and posterior segment showing varying degrees of vitreous veil and spoke-wheel maculopathy. Optical coherence tomography (OCT) of the macula was performed, revealing retinoschisis in all eyes. All three siblings were diagnosed with XLRS and were started on topical brinzolamide twice daily. OCT was repeated at 6 months and 18 months. At 18 months, three eyes showed stable VA and three eyes showed improved in VA. One out of the three eyes with stable VA showed improved retinoschisis while the other two eyes showed worsening retinoschisis. On the other hand, one out of the three eyes with improved VA had improved retinoschisis and the other two had worsening retinoschisis. We demonstrated that the VA of patients with retinoschisis is not directly proportional to the degree of splitting of the neurosensory retina. Retinoschisis treatment is challenging, as there is no one proven effective treatment up to date.

Efficiency evaluation of intravitreal injections of Aflibercept in patients with various vascular and neovascular retinal diseases

2021 ◽  
pp. 235-239
Author(s):  
O.Y. Kuznetsova ◽  
◽  
D.V. Peregudov ◽  
D.V. Levina ◽  
A.Y. Novikova. ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Macular Edema ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Visual Functions ◽  
Age Related ◽  
Pigmented Epithelium ◽  
Wet Amd ◽  
Myopic Cnv

Purpose. To evaluate the efficiency of Aflibercept in patients with various vas-cular and neovascular diseases of the retina. Material and methods. 43 patients (55 eyes) with various ophthalmic patholo-gies were treated: wet form of age-related macular degeneration of the retina (AMD), myopic CNV, diabetic macular edema (DME) and macular edema due to occlusion of the retinal veins. Among them, 17 (39.5%) men and 26 (60.5%) women aged 38 to 84 years (62±1.9 years). All patients underwent a compre-hensive ophthalmological examination. A total of 158 intravitreal injections (IVI) of Aflibercept were performed. The observation period was 6 months. The efficiency of treatment was assessed according to the data of visual acuity, OCT, as well as subjective feelings and changes in the area of central scotoma. Results. Visual acuity among all patients after three loading injections increased by an average of 2.8 lines. Subjective improvement in visual functions was noted in 38 (89%) patients. The greatest increase in visual functions was observed in the exudative form of wet AMD, which manifests itself mainly in the form of detachment and / or edema of the neuroepithelium. The smallest in-crease in visual acuity was observed in patients with exudative-hemorrhagic form of wet AMD with detachment of the pigmented epithelium and neuroepi-thelium, as well as in myopic CNV. Over the next three months after the course of loading injections, visual acuity increased by an average of 5-7%. The thick-ness of the retina in the fovea decreased by an average of 156.8 ± 52 µm (from 45 to 290 µm), while the greatest decrease in the thickness was observed in pa-tients with DMO and exudative form of wet AMD, manifested as detachment of neuro- and pigmented epithelium, and the least expressed was in myopic CNV. Conclusion. The use of IVV Aflibercept is effective in various vascular and ne-ovascular diseases of the retina. The highest functional result is observed in pa-tients with an exudative form of wet AMD, manifested by detachment and / or edema of the neuroepithelium. Key words: аflibercept, intravitreal injection, vascular endothelial growth fac-tor, age-related macular degeneration, macular edema.

Diagnostik und Therapie der Adnexitis (Pelvic Inflammatory Disease)

2020 ◽  
Vol 77 (4) ◽  
pp. 164-170
Author(s):  
Franziska Siegenthaler ◽  
Elke Krause ◽  
Michael D. Mueller
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Diagnostik Und Therapie ◽  
Operative Exploration

Zusammenfassung. Die Adnexitis, im anglo-amerikanischen Sprachgebrauch hat sich der Sammelbegriff Pelvic Inflammatory Disease (PID) durchgesetzt, stellt ein häufiges medizinisches Problem dar. Die Diagnose einer PID kann schwierig sein, da die klinischen Manifestationen unspezifisch sind und sie andere Becken- und Bauchprozesse imitieren können. Infektionen im Bereich der Adnexen können schwerwiegend sein und Langzeitkomplikationen (chronische Unterbauchschmerzen, Infertilität) verursachen, weshalb eine rasche Diagnosestellung und der frühzeitige Beginn einer adäquaten Antibiotika Therapie von grosser Wichtigkeit sind. Unkomplizierte PID haben meistens einen günstigen Verlauf, bei komplizierten Formen mit Tuboovarialabzess ist meist eine operative Exploration notwendig.

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