Posterior Scleritis: About A Case

Posterior scleritis is a rare and often unknown condition that can simulate many conditions including intraocular tumor or orbital pathology. We report the case of a 44-year-old patient with left eye pain and redness followed by a significant decrease in visual acuity. Clinical examination showed papillary hyperemia, chorioretinal folds at the posterior pole, venous tortuosity, and absence of hyalitis or vasculitis in the fundus oculi associated angiography retinal. Orbital-cerebral MRI and B ultrasound allowed the diagnosis of posterior scleritis

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A case of Gayet-Wernicke encephalopathy with misleading symptoms

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-020-00115-5 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Mohamed Hadbi ◽

Dalila Benalakma ◽

Nadia Fellah

Keyword(s):

Visual Acuity ◽

Hyperemesis Gravidarum ◽

Neurological Complication ◽

Vitamin Supplementation ◽

Motor Deficit ◽

Ophthalmological Examination ◽

Cerebral Mri ◽

Sensory Motor ◽

Brain Stroke ◽

Decrease In Visual Acuity

Abstract Background The dramatic evolution of incoercible vomiting in pregnancy is at the origin of a rare and serious neurological complication known as EGW; its symptomatology is polymorphic posing a diagnostic problem. MRI is the test of choice for screening. Early vitamin supplementation is essential to improve the maternal-fetal prognosis. Case presentation A 35-year-old parturient, G5P1, without particular pathological history presented incoercible vomiting at 8 weeks, which led to dehydration, undernutrition, and impairment of general condition. Neurological signs: headaches, confused scored at 14 on the Glasgow scale, amnesia, a cerebellar syndrome, sensory-motor deficit. Ophthalmological examination revealed: edema in the eye fundus, a decrease in visual acuity, nystagmus, and ophthalmoplegia. The biological analysis showed moderate hepatic cytolysis. Given the polymorphic neurological symptomatology presented by our parturient, several differential diagnoses were evoked: intracranial hypertension (headache - vomiting - decrease in visual acuity - papillary edema), brain stroke (sensory-motor deficit, ground “pregnancy”), deficit in vitamin B12 (sensory-motor deficit, confusion, memory impairment), and GWE (nystagmus-confusion-ataxia). Cerebral MRI has allowed us to establish the diagnosis of GWE. Conclusion All pregnant with severe hyperemesis gravidarum should be supplemented with thiamine prior to glucose administration to prevent and improve the prognosis of GWE.

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Cerulean Cataract in a Person with Down s Syndrome

10.26420/austinophthalmol.2021.1027 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Madbouhi K ◽

◽

Cherkaoui O ◽

Keyword(s):

Visual Acuity ◽

Clinical Examination ◽

Down's Syndrome ◽

Anterior Segment ◽

Down’S Syndrome ◽

Congenital Form ◽

The Right ◽

Radial Arrangement ◽

Loss Of Visual Acuity

We report the case of an 18-year-old patient who consults for a loss of visual acuity in the right eye for 1 year. On clinical examination, visual acuity is 20/100. Eye tone is 12 mmhg. Examination of the anterior segment shows the existence of a cataract made up of whitish opacities corresponding to a congenital cerulean cataract (Figure 1). The treatment consisted of a cataract cure by phacoemulsification with good progress. Cerulean cataract is a rare congenital form of bluish tint, made up of whitish opacities in concentric layers with a radial arrangement at their center. Visual acuity is fairly good in childhood but may deteriorate later. In the literature, the incidence of cataracts in Down’s children ranges from 5% to 50%. In previous studies of congenital or infantile cataract, 3-5 % of cases were associated with Down’s syndrome [1].

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Choroidal Neovascularization Associated with Punctate Inner Choroidopathy: Combination of Intravitreal Anti-VEGF and Systemic Immunosuppressive Therapy

Case Reports in Ophthalmology ◽

10.1159/000441694 ◽

2015 ◽

Vol 6 (3) ◽

pp. 385-389 ◽

Cited By ~ 6

Author(s):

Bettina Hohberger ◽

Michael Rudolph ◽

Antonio Bergua

Keyword(s):

Visual Acuity ◽

Choroidal Neovascularization ◽

Combined Therapy ◽

Retinal Pigment ◽

Posterior Pole ◽

Prednisolone Acetate ◽

Eye Drops ◽

Punctate Inner Choroidopathy ◽

Anti Vegf ◽

Systemic Medication

Purpose: Choroidal neovascularization (CNV) associated with punctate inner choroidopathy (PIC) is a rare clinical entity, yet still a challenge for medical treatment. A case of a young myopic woman developing CNV secondary to unilateral PIC is presented. Clinical morphology, diagnostic procedure and follow-up are reported. Case Report: A 29-year-old woman presented with multiple yellowish dots at the posterior pole. No other signs of inflammation could be seen. Angiography with fluorescein yielded hyperfluorescent signals in the affected areas with a diffuse leak, and SD-OCT showed a slightly elevated retinal pigment epithelial layer, consistent with the diagnosis of PIC. Additionally a classic CNV was observed. Results: Anti-inflammatory therapy with local prednisolone acetate eye drops in combination with intravitreal injection of anti-vascular endothelial growth factor (VEGF, bevacizumab) yielded an increased best-corrected visual acuity. As CNV reappeared, systemic medication with prednisone and azathioprine in combination with two further intravitreal injections of anti-VEGF stabilized CNV and increased visual acuity again. Conclusion: Combined therapy of immunosuppression with intravitreal anti-VEGF injections can be considered as therapeutic strategy in the management of recurrent CNV associated with PIC.

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Visual Acuity, Contrast Sensitivity and Color Vision Three Years After Iodine-125 Brachytherapy for Choroidal and Ciliary Body Melanoma

The Open Ophthalmology Journal ◽

10.2174/1874364101509010131 ◽

2015 ◽

Vol 9 (1) ◽

pp. 131-135 ◽

Cited By ~ 2

Author(s):

Irena Tsui ◽

Robert M Beardsley ◽

Tara A McCannel ◽

Scott C Oliver ◽

Melissa W Chun ◽

...

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Color Vision ◽

Ciliary Body ◽

Case Series ◽

Vision Measurement ◽

Corrected Visual Acuity ◽

Iodine 125 ◽

Decrease In Visual Acuity ◽

Ciliary Body Melanoma

Purpose : To report visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after iodine-125 brachytherapy for choroidal and ciliary body melanoma (CCM). Design : Prospective interventional case series. Participants : Thirty-seven patients (37 eyes) with CCM. Methods : Patients had best-corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, Pelli-Robson contrast sensitivity and Hardy-Rand-Rittler color vision measurement; comprehensive ophthalmology examination; optical coherence tomography; and ultrasonography at baseline prior to, 1 year after, 2 years after and 3 years after I-125 brachytherapy. Main Outcome Measures : Visual acuity, contrast sensitivity and color vision prior to, 1 year after, 2 years after and 3 years after brachytherapy. Results : Nineteen (19) men and 18 women with mean age of 58 years (SD 13, range 30-78) prior to, 1 year after, 2 years after and 3 years after brachytherapy had mean best-corrected visual acuity of 77 letters (20/32), 65 letters (20/50), 56 letters (20/80) and 47 letters (20/125); contrast sensitivity of 30, 26, 22 and 19 letters; color vision of 26, 20, 17 and 14 test figures, respectively. Decrease in visual acuity, contrast sensitivity and color vision was statistically significant from baseline at 1 year, 2 years, and 3 years after brachytherapy. Decreased acuity at 3 years was associated with mid-choroid and macula melanoma location, ≥ 4.1 mm melanoma height, radiation maculopathy and radiation optic neuropathy. Conclusion : 1, 2 and 3 years after brachytherapy, eyes with CCM had significantly decreased visual acuity, contrast sensitivity and color vision.

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Vision impairment as the first symptom of encephalomyelitis in a paediatric patient

OphthaTherapy Therapies in Ophthalmology ◽

10.24292/01.ot.250521 ◽

2021 ◽

Vol 8 (2) ◽

pp. 93-98

Author(s):

Aleksandra Świerczyńska ◽

Małgorzata Woś

Keyword(s):

Visual Acuity ◽

Paediatric Patient ◽

Optic Disc ◽

Acute Disseminated Encephalomyelitis ◽

Vision Impairment ◽

Optic Disc Oedema ◽

Disc Oedema ◽

Decrease In Visual Acuity

An 8-year-old boy was admitted to the Ophthalmology Department due to a vision impairment with an accompanying decrease in visual acuity and bilateral optic disc oedema. As a result of interdisciplinary diagnostics, acute disseminated encephalomyelitis, probably related to preceding infection, was diagnosed.

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Comparative Study of the Usefulness of the Binocular Spot Vision Screener Autorefractor in the Detection of Childhood Visual Disorders

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/s-0044-101012 ◽

2018 ◽

Vol 235 (04) ◽

pp. 416-419 ◽

Cited By ~ 2

Author(s):

Nathalie Voide ◽

Nicole Hoeckele ◽

Pierre-François Kaeser

Keyword(s):

Visual Acuity ◽

Clinical Examination ◽

Screening Tool ◽

Ocular Motility ◽

Primary Position ◽

Visual Potential ◽

Visual Acuity Loss ◽

Eye Examination ◽

Visual Screening ◽

Vision Screener

Abstract Background The Spot Vision Screener (SVS) is designed to detect significant ametropia, anisometropia, and strabismus in non-dilated eyes. This study evaluates the efficacy of the SVS in paediatric visual screening. Patients and Methods All children screened during the paediatric visual screening day in Lausanne in 2016 were evaluated with the SVS, conventional monocular autorefractors, and clinical orthoptic examination. Recommendations for a further eye examination of the SVS were compared with those issued from traditional clinical screenings (monocular refraction and orthoptic examination). Results One hundred and sixty-eight consecutive children were included. The median age was 3.9 years. The SVS median spherical equivalent (SE) was + 0.25 D OU and it detected seven cases of (4.2%) anisometropia (SE difference ≥ 1 D). The conventional monocular autorefractor median SE was − 0.13 D OU and 20 cases of anisometropia (11.9%) were detected. Refraction could not be measured in 1.2% of patients with SVS versus 17.2% with monocular refractors. The SVS screened two manifest strabismus cases against five manifest and > 100 latent strabismus with orthoptic examination. As expected, the SVS was unable to assess reactions to monocular occlusion, visual acuity, and stereovision as well as to detect ocular motility disorders without strabismus in the primary position, and missed two cases of abnormal Brückner reflexes. Overall, the SVS identified 66 suspect patients (39.3%) against 102 (60.7%) after complete clinical examination. Conclusions The SVS can be a useful objective screening tool for non-ophthalmologists. However, because it fails to detect ocular motility troubles, organic visual acuity loss, or to assess the visual potential, it should only be used in association with a clinical examination, even in routine screening procedures.

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Retinal haemangioblastoma associated with peripheral non-perfusion: widefield fluorescein angiography analysis of 41 cases

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-314021 ◽

2019 ◽

Vol 104 (2) ◽

pp. 167-172 ◽

Cited By ~ 2

Author(s):

Lauren A Dalvin ◽

Michael D Yu ◽

David Arturo Ancona-Lezama ◽

Jose S Pulido ◽

Timothy W Olsen ◽

...

Keyword(s):

Visual Acuity ◽

Fluorescein Angiography ◽

Basal Diameter ◽

Younger Patients ◽

Von Hippel Lindau ◽

Patient Demographics ◽

Time Period ◽

Vhl Disease ◽

Decrease In Visual Acuity

AimsTo investigate the association of peripheral retinal non-perfusion with retinal haemangioblastoma.MethodsMedical and widefield fluorescein angiography records of patients diagnosed with retinal haemangioblastoma from 1990 to 2018 were reviewed for patient demographics, tumour features, fluorescein angiography features and characteristics of peripheral retinal non-perfusion.ResultsThere were 41 eyes of 40 patients with retinal haemangioblastoma imaged by widefield fluorescein angiography during this time period. Of 41 eyes, 14 (34%) had haemangioblastoma-associated peripheral retinal non-perfusion on fluorescein angiography. A comparison of eyes with versus without non-perfusion revealed younger mean age at presentation (28 vs 43 years old, p=0.05), increased prevalence of von Hippel-Lindau (VHL) disease (62% vs 22%, p=0.01), greater mean largest tumour basal diameter (3.7 vs 2.5 mm, p=0.04), greater tumour distance from optic nerve (8.4 vs 1.9 mm, p<0.01) and increased prevalence of vascular leakage from the tumour (86% vs 52%, p=0.03). After mean follow-up of 97 versus 71 months (p=0.52), eyes with non-perfusion were significantly more likely to develop neovascularisation (40% vs 0%, p<0.01) and experience a three-line or greater decrease in visual acuity (60% vs 11%, p<0.01).ConclusionPeripheral retinal non-perfusion can be associated with retinal haemangioblastoma, and could be more common with larger, more peripheral tumours in younger patients with VHL disease. Eyes with haemangioblastoma-associated peripheral non-perfusion could be more likely to develop neovascularisation and lose visual acuity.

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Valsalva retinopathy associated with intranasal cocaine abuse: A case report

European Journal of Ophthalmology ◽

10.1177/1120672118799627 ◽

2018 ◽

Vol 29 (3) ◽

pp. NP5-NP8 ◽

Cited By ~ 1

Author(s):

Evdoxia-Maria A Karasavvidou ◽

Georgios P Athanasopoulos ◽

Anastasios G Konstas ◽

Eleni A Tsirampidou ◽

Paris G Tranos

Keyword(s):

Visual Acuity ◽

Case Report ◽

Cocaine Abuse ◽

Posterior Pole ◽

Normal Limits ◽

Valsalva Retinopathy ◽

Intranasal Cocaine ◽

Treatment Measures ◽

History Of ◽

Field Defect

Introduction: The purpose of this report is to describe a case of Valsalva retinopathy in an intranasal cocaine user. Case report: A 49-year-old male presented with a history of sudden loss of vision and inferior visual field defect in his left eye. Clinical evaluation of the affected eye showed best corrected visual acuity of 20/25 and fundus examination revealed a preretinal hemorrhage superior to the disk with multiple intraretinal hemorrhages in and around the posterior pole. On further questioning, the patient revealed intranasal cocaine use the day before the onset of his visual symptoms. Blood tests were requested to exclude blood dyscrasias or predisposition to vascular occlusive disorders and no further treatment measures were taken. The patient was reviewed a month later when his hemorrhages had completely resolved and his visual acuity had improved to 20/20. His blood results were within normal limits. Conclusion: Although never been reported before, Valsalva retinopathy can be associated with intranasal cocaine abuse and should be considered in the differential diagnosis of visual reduction in such population.

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Polypoidal Choroidal Vasculopathy

International Journal of Retina ◽

10.35479/ijretina.2018.vol001.iss002.46 ◽

2018 ◽

Vol 1 (2) ◽

Author(s):

Mirza Metita ◽

Yorihisa Kitagawa ◽

Hiroyuki Shimada ◽

Hiroyuki Nakashizuka

Keyword(s):

Visual Acuity ◽

Intravitreal Injection ◽

Combined Treatment ◽

Serous Retinal Detachment ◽

Posterior Pole ◽

First Year ◽

Blurred Vision ◽

Retrobulbar Anesthesia ◽

Intravitreal Aflibercept ◽

Pneumatic Displacement

Introduction: to report a case of PCV that has been successfully treated with intravitreal injection of t-PA, ranibizumab, and pneumatic displacement. Method: A 65 years old man presented with blurred vision of his right eye. No systemic abnormalities were found. Initial visual acuity RE was 6/18. Funduscopy examination showed submacular hemorrhage in posterior pole. OCTA, FA and ICG confirmed the diagnosis of PCV. We performed anterior chamber paracentesis and intravitreal injection of 0,05 ml t-PA, 0,05 ml ranibizumab, and 0,3 ml 100% C3F8 at a time in retrobulbar anesthesia. The patient was instructed to maintain face down positioning for 2 days. Results: We evaluated the visual acuity, central retinal thickness (CRT), and central pigment epithelial detachment (PED) thickness for 2 years. The visual acuity was increasing gradually from 6/18 to 6/6 in the first year. The hemorrhage was displaced completely, the CRT and central PED thickness were decreased. In the second year the patient had recurrence of PCV with serous retinal detachment and treated with intravitreal aflibercept. Conclusion: Combined treatment of intravitreal t-PA, ranibizumab, and C3F8 can be used as a beneficial therapy for PCV.

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Modern notions about the tactics of treatment of patients with non-full thickness macular holes: to observe or to operate?

Ophthalmology journal ◽

10.17816/ov2019137-44 ◽

2019 ◽

Vol 12 (1) ◽

pp. 37-44

Author(s):

Konstantin S. Zhogolev ◽

Yaroslav V. Bayborodov

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Functional State ◽

Visual Function ◽

Full Thickness ◽

Dynamic Observation ◽

Macular Holes ◽

Tangential Traction ◽

Decrease In Visual Acuity

In this review, the opinions of different authors on the problem of non-full thickness macular holes are discussed in detail. Currently, there are three different approaches to the management of this condition. Dynamic observation allows assessing the degree of their progression, to determine some or other anatomical indicators which influence the functional state of the retina and visual function. Pharmacological vitreolysis in some cases allows eliminating vertical and tangential traction in a least invasive mannor. To resolve this problem in a radical way is possible by surgical treatment posterior vitrectomy, but this is also related to certain surgical risks, and does not always lead to an increase in visual acuity. As a rule, it is recommended to patients with a significant decrease in visual acuity. Currently, indications for surgical treatment of patients with high visual function are ambiguous.

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